scholarly journals Lesbian, Gay, Bisexual, Transgender, and Queer Patients: Collegiate Athletic Trainers' Perceptions

2019 ◽  
Vol 54 (3) ◽  
pp. 334-344 ◽  
Author(s):  
Emma A Nye ◽  
Ashley Crossway ◽  
Sean M. Rogers ◽  
Kenneth E. Games ◽  
Lindsey E. Eberman
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Sexual Orientation ◽  
Athletic Training ◽  
Access To Health Care ◽  
Student Athletes ◽  
Student Athlete ◽  
Cross Sectional ◽  
Training And Education

Context Research suggests that patients who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) are at risk for certain conditions and denied equal access to health care in physician offices compared with their heterosexual counterparts. However, little evidence exists regarding the treatment of LGBTQ student-athlete patients in the athletic training clinic and the role the athletic trainer (AT) plays in these health care experiences. Objective To explore the perceptions of ATs treating LGBTQ student-athlete patients. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants A total of 1077 collegiate and university ATs completed the survey (5685 e-mails distributed, 1214 surveys started, access rate = 21.4%, completion rate = 88.7%). Main Outcome Measure(s) Demographic information and level of agreement in 3 areas (approach, quality of care, and comfort) were obtained on a 5-point Likert scale. We asked ATs their likeliness of providing guidance to student-athletes about navigating their sexuality generally and as it related to athletic participation, if they thought they provided equal health care to a student-athlete who identified as LGBTQ, how comfortable they were treating LGBTQ student-athlete patients, and how comfortable they thought student-athlete patients would be seeking care from them or from providers in their clinic. Results Overall, we found differences among groups for sexual orientation, gender, religion, and the existence of interpersonal contact with LGBTQ friends or family for approach, quality of care, and comfort. We also identified 2 main themes indicating ATs' desire for more training and education, specifically in caring for transgender student-athletes and providing patient-centered care with professionalism, regardless of gender identity or sexual orientation. Conclusions Although differences existed among demographic groups, ATs had a generally positive view of treating LGBTQ student-athlete patients and wanted more training and education on the specific needs of this population.

scholarly journals Lesbian, Gay, Bisexual, Transgender, and Queer Athletic Trainers: Collegiate Student-Athletes' Perceptions

2019 ◽  
Vol 54 (3) ◽  
pp. 324-333
Author(s):  
Ashley Crossway ◽  
Sean M. Rogers ◽  
Emma A. Nye ◽  
Kenneth E. Games ◽  
Lindsey E. Eberman
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Student Athletes ◽  
National Collegiate Athletic Association ◽  
Athletic Trainers ◽  
Cross Sectional ◽  
Seek Health Care ◽  
Cross Sectional Design ◽  
Strongly Agree

Context Lesbian, gay, bisexual, transgender, and queer (LGBTQ) athletic trainers (ATs) face uncertain acceptance in the workplace. Objective To examine the perceptions of National Collegiate Athletic Association (NCAA) student-athletes toward ATs who identified as LGBTQ. Design Cross-sectional design. Setting Web-based survey. Patients or Other Participants A total of 623 (males = 212, females = 403, other = 8; age = 19.7 ± 1.4 years) NCAA student-athletes completed the survey. Main Outcome Measure(s) Participants completed a 19-item survey to assess their perceptions about the appropriateness of, quality of care from, and comfort with ATs who identified as LGBTQ. We asked 10 demographic questions and 2 questions regarding the student-athlete's exposure to individuals who identified as LGBTQ. Five matrix questions had 5 stems each to represent LGBTQ individuals on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree) and 2 open-ended questions elicited qualitative data. We analyzed characteristics of central tendency to evaluate the level of appropriateness, quality of care, and level of comfort perceived by student-athletes of ATs who identified as LGBTQ. We used Mann-Whitney U and Kruskal-Wallis tests for post hoc analyses where appropriate. We used grounded theory to identify themes in the answers to the open-ended questions. Results Participants indicated they would seek health care and would feel comfortable approaching an AT who identified as LGBTQ. Participants agreed it was appropriate for an LGBTQ AT to work with both male and female sports and did not agree that health care provided by heterosexual and LGBTQ ATs differed. The open-ended responses revealed 4 themes: professionalism, upbringing, situational concerns, and concerns about specific populations that affected their perceptions. Conclusions In general, the NCAA student-athletes had positive perceptions of ATs who identified as LGBTQ.

scholarly journals Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar

2020 ◽  
Author(s):  
Bénédicte Razafinjato ◽  
Luc Rakotonirina ◽  
Jafeta Benony Andriantahina ◽  
Laura F. Cordier ◽  
Randrianambinina Andriamihaja ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Community Health ◽  
Access To Health Care ◽  
Care Delivery ◽  
Local Level ◽  
Scale Up ◽  
P Value ◽  
The Impact

AbstractDespite the widespread global adoption of community health (CH) systems, there are evidence gaps in how to best deliver community-based care aligned with global best practice in remote settings where access to health care is limited and community health workers (CHWs) may be the only available providers. PIVOT partnered with the Ministry of Public Health to pilot a new two-pronged approach for care delivery in rural Madagascar: one CHW provided care at a stationary CH site while 2-5 additional CHWs provided care via proactive household visits. The pilot included professionalization of the CHW workforce (i.e. recruitment, training, financial incentive) and twice monthly supervision of CHWs. We evaluated the impact of the CH pilot on utilization and quality of integrated community case management (iCCM) in the first six months of implementation (October 2019-March 2020).We compared utilization and proxy measures of quality of care (defined as adherence to the iCCM protocol for diagnosis, classification of disease severity, treatment) in the intervention commune and five comparison communes, using a quasi-experimental study design and relying on routinely collected programmatic data. Average per capita monthly under-five visits were 0.28 in the intervention commune and 0.22 in the comparison communes. In the intervention commune, 40.0% of visits were completed at the household via proactive care. CHWs completed all steps of the iCCM protocol in 77.8% of observed visits in the intervention commune (vs 49.5% in the comparison communes, p-value=<0.001). A two-pronged approach to CH delivery and professionalization of the CHW workforce increased utilization and demonstrated satisfactory quality of care. National stakeholders and program managers should evaluate program re-design at a local level prior to national or district-wide scale-up.

scholarly journals Trust in health care systems Arab minority, Jewish immigrant and non-immigrant

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Pinchas-Mizrachi ◽  
N Daoud
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care System ◽  
Census Data ◽  
Jewish Immigrant ◽  
Cross Sectional ◽  
Survey Question ◽  
Arab Minority ◽  
Care System

Abstract Background The objective of this study was to examine the level of trust towards Israel’s health care services (HCS) among Palestinian-Arab minority, Jewish immigrant, and non-immigrant Jewish citizens. Previous studies have shown that minorities and immigrants have less trust in health care system (HCSys), which might represent a barrier in access to, and utilization of HCS. Methods We obtained cross-sectional nationwide census data from the 2017 Social Survey of the Israel Central Bureau of Statistics. We studied levels of trust in the HCSys based on a survey question: ’Do you have trust in the healthcare system?” We conducted logistic regression analysis within and between the study groups to compare levels of trust, after adjustment for different relevant covariates in different models. Results Compared to non-immigrant Jews, Arabs had higher trust in the HCS (odds ratio (OR)=3.08, 95% confidence intervals (CI)=3.06,3.10) and compared to non-immigrant Jews, immigrant Jews had more trust (OR = 1.96, 95% CI = 1.94,1.98), even after adjusting for gender, age, education level, religiosity level, perceived discrimination, self-rated health status, HCS use, and having private health insurance. The variables that predicted trust in the HCSys were different in each ethnic group. Conclusions Contrary to our hypothesis and to previous research, Arab and immigrant Jewish respondents in our study had greater trust in the HCS compared to non-immigrant Jews. This might relate to different expectations among our study groupsof the patient-caregiver relations which might affect the access to and utilization of HCS and finally might affect the quality of care. Key messages Exceptionally, in Israel, the Arab minority and Jewish immigrants have more trust in the health care system compared with non-immigrant Jews. More research is needed to understand how trust among minority groups relates to the patterns of utilization of HCS and raises question regarding the quality of care.

scholarly journals The Effect of Ethiopia’s Community-Based Health Insurance Scheme on Revenues and Quality of Care

2020 ◽  
Vol 17 (22) ◽  
pp. 8558
Author(s):  
Zemzem Shigute ◽  
Anagaw D. Mebratie ◽  
Robert Sparrow ◽  
Getnet Alemu ◽  
Arjun S. Bedi
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Insurance ◽  
Access To Health Care ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Community Based Health Insurance ◽  
The Impact

Ethiopia’s Community-Based Health Insurance (CBHI) scheme was established with the objectives of enhancing access to health care, reducing out-of-pocket expenditure (OOP), mobilizing financial resources and enhancing the quality of health care. Previous analyses have shown that the scheme has enhanced health care access and led to reductions in OOP. This paper examines the impact of the scheme on health facility revenues and quality of care. This paper relies on a difference-in-differences approach applied to both panel and cross-section data. We find that CBHI-affiliated facilities experience a 111% increase in annual outpatient visits and annual revenues increase by 47%. Increased revenues are used to ameliorate drug shortages. These increases have translated into enhanced patient satisfaction. Patient satisfaction increased by 11 percentage points. Despite the increase in patient volume, there is no discernible increase in waiting time to see medical professionals. These results and the relatively high levels of CBHI enrollment suggest that the Ethiopian CBHI has been able to successfully negotiate the main stumbling block—that is, the poor quality of care—which has plagued similar CBHI schemes in Sub-Saharan Africa.

Strategies for Increasing Knowledge Translation of Evidence-Based Practice in Athletic Training

2021 ◽  
pp. 1831-1840
Author(s):  
Brittany V. Allard ◽  
Michelle Lee D'Abundo
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Athletic Training ◽  
Diffusion Of Innovation ◽  
Health Care Professionals ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Aging Populations ◽  
Reducing Costs

The field of health care needs to change in order to address challenges such as rising health care costs, aging populations and the need to treat increasing numbers of people with chronic health conditions. All of this must be accomplished while reducing costs and maintaining quality of care. Health care professionals are being tasked with facilitating this change. Like many other health care professions, athletic training has turned to evidence-based practice to assure that athletic trainers are trained to deliver the highest quality of care in the most efficient way to their patients. The transition to integrating evidence-based practice will be challenging and will require a massive diffusion of innovation throughout the field of athletic training.

Physicians’ Perceptions Toward Use of Telemedicine During COVID-19 Pandemic in Riyadh, Saudi Arabia (Preprint)

2021 ◽  
Author(s):  
sarah idriss ◽  
walaa alasaadi ◽  
abdullah Aldhuhayyan ◽  
Ahmed alenzi ◽  
Reem alharbi ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Well Being ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Face To Face

BACKGROUND The use of communication technologies to deliver health care remotely is known as telemedicine. The coronavirus disease 2019 (COVID-19) pandemic had a variety of consequences for health-care delivery in 2020. As a result, it was necessary to adapt and deliver high-quality care to patients while limiting possible viral exposure for both patients and health-care workers. During the pandemic, physicians employed video visits, phone visits, and electronic written visits (e-consultations), all of which have the ability to provide a comparable quality of care while removing social barriers. OBJECTIVE The study’s aim is to assess physicians’ perspectives and attitudes concerning the usage of telemedicine in Riyadh hospitals during the COVID-19 pandemic. The main domains of the assessment are physicians’ overall experience with telemedicine use before and during COVID-19, future adaptability to using telemedicine, perceptions about patients’ experience, and the influence of telemedicine on burnout. METHODS Methods: An anonymous 28-question cross-sectional survey was developed using SurveyMonkey and distributed to all physicians from all specialty disciplines across Riyadh city hospitals. RESULTS A total of 362 doctors were included in the study. Among them, 28.7% were consultants, 30.4% were specialists, and 40.9% were residents. Male doctors formed the majority (56.1%). When asked about the frequency of using telemedicine, 41.4% answered “frequently,” 26% responded “occasionally,” and 32.6% said “never.” Thirty one percent of doctors agreed and somewhat agreed that the “quality of care during telemedicine is comparable with face-to-face visits.” About 55% doctors believed that telemedicine consultation is a cost-effective way, compared to face-to-face visits. Most of the doctors were skilled (70%) at telemedicine, and they were also able to solve technology issues during telemedicine visits (54%). Overall, the physicians felt that their patients liked telemedicine: 68% said they felt comfortable using telemedicine and 76% said theyfound that it saved time. As per the burnout question, 4.1% of doctors felt burnout every day, 7.5% felt burnout a few times a week, and 27.3% felt burnout a few times per month. CONCLUSIONS Physicians had a generally favorable attitude toward telemedicine, believing that the quality of health-care delivery using it was comparable to that of in-person care. Future research is needed to investigate how physicians’ attitudes toward telemedicine have changed since the pandemic, as well as how this virtual technology might be used to improve their professional and personal well-being.

scholarly journals AVALIAÇÃO DA ESTRATÉGIA SAÚDE DA FAMÍLIA EM SÃO SEBASTIÃO – DISTRITO FEDERAL

2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Virgílio Luiz Marques De Macedo ◽  
Luciana Fontes Vieira ◽  
Rinaldo De Souza Neves ◽  
Suderlan Sabino Leandro
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Family Health ◽  
Cross Sectional ◽  
Primary Health ◽  
Distrito Federal ◽  
First Contact

Objetivo: Avaliar a qualidade da assistência prestada por profissionais da Estratégia Saúde da Família em São Sebastião, Distrito Federal, na atenção a pacientes portadores de Hipertensão Arterial Sistêmica e Diabetes Mellitus. Metodologia: Trata-se de um estudo descritivo-exploratório transversal de cunho quantitativo com 107 usuários e 27 profissionais de saúde. Resultados: Foram avaliados como satisfatórios pelos usuários apenas os atributos acesso de primeiro contato – utilização e coordenação – sistema de informação. Para os profissionais, os atributos acesso de primeiro contato – acessibilidade e orientação comunitária foram considerados insatisfatórios, indicando que a qualidade da assistência por meio do acesso e informação é aceitável para os usuários e deficiente para os profissionais. Conclusão: Os dados apresentados evidenciam que a Atenção Primária a Saúde não está exercendo sua função de porta de entrada, de coordenadora e ordenadora da Rede de Atenção à Saúde.Descritores: Avaliação em Saúde; Atenção Primária à Saúde; Estratégia de Saúde da Família; Hipertensão; Diabetes Mellitus.EVALUATION OF THE FAMILY HEALTH STRATEGY IN SÃO SEBASTIÃO - FEDERAL DISTRICTObjective: To evaluate the quality of care provided by the health team of Primary Health Care of São Sebastião, Distrito Federal, in the attention to patients with Systemic Arterial Hypertension and Diabetes Mellitus. Method: This is a descriptive-exploratory cross-sectional quantitative study with 107 patients e 27 health profissionals. Results: Only the attributes of first contact access - utilization and coordination - information system were evaluated as satisfactory by the users. For professionals, the attributes of first contact access - accessibility and community orientation were considered unsatisfactory, indicating that the quality of care through access and information is acceptable for users and disabled for professionals. Conclusion: The data presented shows that Primary Health Care is not performing its function as gateway, as coordinator and ordinator of the Health Care Network.Descriptors: Health Evaluation; Primary Health Care; Hypertension; Diabetes Mellitus.EVALUACIÓN DE LA ESTRATEGIA SALUD DE LA FAMILIA EN SÃO SEBASTIÃO - DISTRITO FEDERALObjetivo: Evaluar la calidad de la asistencia prestada por profesionales de la Estrategia Salud de la Familia en São Sebastião, Distrito Federal, en la atención a pacientes portadores de Hipertensión Arterial Sistémica y Diabetes Mellitus. Método: Se trata de un estudio descriptivo-exploratorio transversal de cuño cuantitativo com 107 clientes e 27 profesionales de salud. Resultados: Se evaluaron como satisfactorios por los usuarios sólo los atributos acceso de primer contacto - utilización y coordinación - sistema de información. Para los profesionales, los atributos acceso de primer contacto - accesibilidad y orientación comunitaria se consideraron insatisfactorios, indicando que la calidad de la asistencia a través del acceso e información es aceptable para los usuarios y deficiente para los profesionales. Conclusión: Los datos presentados evidencian que la Atención Primaria a la Salud no está ejerciendo su función de puerta de entrada, de coordinadora y ordenadora de la Red de Atención a la Salud.Descriptores: Evaluación en Salud; Atención Primaria de Salud; Hipertensión; Diabetes Mellitus.

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