Primary, Secondary, and Tertiary Prevention Capabilities of Selected HMOs: Findings of an Employer Survey

1997 ◽  
Vol 12 (2) ◽  
pp. 102-109 ◽  
Author(s):  
Larry S. Chapman ◽  
Lou Nelson ◽  
Beverly Sloan ◽  
Robert Plankenhorn

Purpose. To survey Health Maintenance Organizations (HMOs) of a major employer regarding the extent of their health promotion and disease prevention capabilities. Design. A one-time cross-sectional survey. Setting. The setting involved in this study was managed care organizations. Subjects. The subjects were 22 HMOs located in the western part of the United States. Measures. The study involved completion of a survey grid on a fairly comprehensive range of primary, secondary, and tertiary prevention activities. Results. Twenty-two HMOs were surveyed and 20 responded, providing a response rate of 90.9%. Analysis of distribution of responses and simple means were used. If a “perfect score” included addressing all 52 prevention targets across all 13 intervention modalities (minus inappropriate combinations) and that represented a score of 100%, the highest scoring HMO indicated that it provided or addressed 36.8% of all possible modalities and prevention target combinations. The composite average score for all three areas of prevention for all responding HMOs was slightly less than 13%. Additionally, five of the HMO respondents provided approximately 59% of all the prevention activity reported in the survey. Nonrepresentativeness of the HMOs in the sample represents the most significant study limitation. Conclusions. Results suggest that prevention capabilities among the HMOs surveyed are unevenly distributed and somewhat concentrated.

2017 ◽  
Vol 158 (2) ◽  
pp. 273-279 ◽  
Author(s):  
Karthik Balakrishnan ◽  
Ellis M. Arjmand ◽  
Brian Nussenbaum ◽  
Carl Snyderman

Objective The objective is to describe variations in the otolaryngology morbidity and mortality (M&M) conference and to compare with other specialties. Design Cross-sectional survey. Setting The setting included otolaryngology departments across the United States and nonotolaryngology medical and surgical departments at 4 academic medical centers. Subjects and Methods Participants were members of a national otolaryngology quality/safety network and nonotolaryngology quality leaders at 4 large academic hospitals. Surveys were administered January 2017. Respondents described M&M conference practices, goals, and educational role. Results Twenty-eight of 39 individuals representing 28 institutions completed the otolaryngology survey (72% response rate). Of 197 individuals, 60 (30% response rate) representing 11 surgical and 20 nonsurgical specialties completed the comparison survey. Twenty-seven of 28 otolaryngologists (46 of 60 nonotolaryngologists) worked in academic settings. All otolaryngology programs conducted an M&M conference: 54% discussed all adverse events and errors; 32% used standard case selection processes; 70% used structured discussion, usually root cause analysis (64%); and 32% classified harm level. In comparison with other specialties, otolaryngology programs were more likely to discuss all adverse events and errors ( P = .01). Most conferences led to quality projects and intrainstitutional communication: 22% communicated to patients and families; 73% of respondents thought that M&M conferences should be standardized or use “best practices.” In both surveys, improving patient care was rated the conference’s most important function, followed by trainee education and culture change. Patient care and practice-based learning were rated the most relevant Accreditation Council for Graduate Medical Education Core Competencies in both surveys. Conclusions Academic otolaryngology M&M practices generally align with other specialties, but specifics vary widely, making collaborative quality improvement challenging. Educational and administrative priorities cross specialties. Most respondents thought that standardization and best practices are worthwhile. Nonacademic practice data are needed.


2018 ◽  
Vol 11 (01) ◽  
pp. 035-044 ◽  
Author(s):  
Raman Mehrzad ◽  
Adnan Prsic ◽  
Marten Basta ◽  
Reena Bhatt

AbstractAlthough microsurgery plays a more expansive role in hand surgery, microsurgery training systems may not have followed the same evolution, as have other operative techniques. A cross-sectional survey study with 13 multiple choice questions was administered to the members of the American Society for Surgery of the Hand; 503 out of 3,395 responded to the survey (14.8% response rate), and 58% did not have a microsurgical laboratory in their institution, whereas 42% did. Of the institutions that had a microsurgical laboratory, 32.4% also had a microsurgical rat laboratory. Of all respondents, 78% agreed or strongly agreed that their training program should have microsurgery training outside of the operating room, and 53% agreed or strongly agreed that their curriculum needed improvement; 65.6% agreed or strongly agreed that training should be standardized across the nation. Our results indicate that the training needs standardization and that institutional training curriculum needs to be improved. This is a Level III study.


2021 ◽  
Vol 11 (8) ◽  
pp. 106
Author(s):  
Sheikh Saifur Rahman Jony ◽  
Ubydul Haque ◽  
Nathaniel J. Webb ◽  
Emily Spence ◽  
Md. Siddikur Rahman ◽  
...  

COVID-19 has harshly impacted communities globally. This study provides relevant information for creating equitable policy interventions to combat the spread of COVID-19. This study aims to predict the knowledge, attitude, and practice (KAP) of the COVID-19 pandemic at a global level to determine control measures and psychosocial problems. A cross-sectional survey was conducted from July to October 2020 using an online questionnaire. Questionnaires were initially distributed to academicians worldwide. These participants distributed the survey among their social, professional, and personal groups. Responses were collected and analyzed from 67 countries, with a sample size of 3031. Finally, based on the number of respondents, eight countries, including Bangladesh, China, Japan, Malaysia, Mexico, Pakistan, the United States, and Zambia were rigorously analyzed. Specifically, questionnaire responses related to COVID-19 accessibility, behavior, knowledge, opinion, psychological health, and susceptibility were collected and analyzed. As per our analysis, age groups were found to be a primary determinant of behavior, knowledge, opinion, psychological health, and susceptibility scores. Gender was the second most influential determinant for all metrics except information about COVID-19 accessibility, for which education was the second most important determinant. Respondent profession was the third most important metric for all scores. Our findings suggest that greater encouragement from government health authorities and the promotion of health education and policies are essential in the dissemination of COVID-19-awareness and increased control of the spread of COVID-19.


2021 ◽  
Vol 12 ◽  
pp. 215013272110133
Author(s):  
Neel Shimpi ◽  
Ingrid Glurich ◽  
Catherine Maybury ◽  
Min Qi Wang ◽  
Kazumasa Hashimoto ◽  
...  

Objective Health education interventions during pregnancy can influence maternal oral health (OH), maternal OH-behaviors and children’s OH. Interventions that can be delivered at anytime and anywhere, for example mobile-health (mHealth) provides an opportunity to address challenges of health education and support activation of women in underserved and rural communities to modify their health behavior. This pilot study was undertaken as a part of a mHealth initiative to determine knowledge, attitudes, and behaviors related to pregnancy and ECC prevention among women attending obstetrics/gynecology (OB/GYN) practices at a large rurally-based clinic. Methods A cross-sectional survey study was voluntarily engaged by women (n = 191) aged 18 to 59 years attending OB/GYN visits, over a 3-week period from 12/2019 to 1/2020. Survey results were analyzed applying descriptive statistics, X2 and Fisher’s Exact tests. The significance level was set at P < .0001 for all analyses. Results Approximately half of respondents were between 18 and 29 years (53%), had a college degree (55%), and 100% reported cell phone use. Whereas 53% and 31%, respectively, indicated that they were “somewhat” or “very” sure of how to prevent ECC in their children, only 9% recognized evidence of early decay and 30% did not know the purpose of fluoride. Overall, only 27% of participants correctly answered the knowledge-based questions. Further, only 57% reported their provider explained things in a way that was easy to understand. Only 24% reported seeing a dentist during their current pregnancy. Conclusions Study results suggested potential gaps in knowledge and behaviors related to ECC prevention and provided baseline data to inform future interventions to improve ECC prevention practices. Notably, majority of participants used their cell phones for making medical/dental appointments and reported using their phones to look up health-related information. This demographic represents a potentially receptive target for mHealth approaches to improve understanding of oral health maintenance during pregnancy and ECC prevention.


2021 ◽  
Vol 12 ◽  
pp. 215013272110287
Author(s):  
Robert L. Cooper ◽  
Mohammad Tabatabai ◽  
Paul D. Juarez ◽  
Aramandla Ramesh ◽  
Matthew C. Morris ◽  
...  

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.


2021 ◽  
pp. 155982762110181
Author(s):  
Sam Sugimoto ◽  
Drew Recker ◽  
Elizabeth E. Halvorson ◽  
Joseph A. Skelton

Background. Many diseases are linked to lifestyle in the United States, yet physicians receive little training in nutrition. Medical students’ prior knowledge of nutrition and cooking is unknown. Objective. To determine incoming medical students’ prior nutrition knowledge, culinary skills, and nutrition habits. Methods. A dual-methods study of first-year medical students. Cross-sectional survey assessing prior knowledge, self-efficacy, and previous education of cooking and nutrition. Interviews of second-year medical students explored cooking and nutrition in greater depth. Results. A total of 142 first-year medical students participated; 16% had taken a nutrition course, with majority (66%) learning outside classroom settings. Students had a mean score of 87% on the Nutritional Knowledge Questionnaire versus comparison group (64.9%). Mean cooking and food skills score were lower than comparison scores. Overall, students did not meet guidelines for fiber, fruit, vegetables, and whole grains. Interviews with second-year students revealed most learned to cook from their families; all believed it important for physicians to have this knowledge. Conclusions. Medical students were knowledgeable about nutrition, but typically self-taught. They were not as confident or skilled in cooking, and mostly learned from their family. They expressed interest in learning more about nutrition and cooking.


Author(s):  
Scott Robert Manning

AbstractThis study examined the strategic planning practices of county-level emergency management agencies (EMAs), with a specific focus on strategic planning adoption and its relationship to local program quality. The study utilized a descriptive, cross-sectional survey design to collect planning- and program-related data from more than 300 county-level EMAs across the United States. The study findings revealed that most of the county EMAs included in the final sample had previously engaged in strategic planning activities, with nearly all of them continuing to use strategic planning as part of their general management practice. The study findings further revealed that strategic planning had a direct and significant impact on the overall quality of local emergency management programs, and that the strategic planning EMAs had significantly higher mean quality scores across all program dimensions when compared to the non-strategic planning EMAs.


Author(s):  
Paulina Majek ◽  
Mateusz Jankowski ◽  
Bartłomiej Nowak ◽  
Maksymilian Macherski ◽  
Maciej Nowak ◽  
...  

Heated tobacco products (HTPs) are devices for generating a nicotine aerosol by heating the tobacco sticks. This study aimed to assess (1) the prevalence of HTP and tobacco cigarette usage among medical students, (2) to characterize smoking habits and (3) to assess students’ awareness and opinions about HTPs. A cross-sectional survey on the frequency and attitudes toward cigarettes, e-cigarettes and HTP use was performed between 2019–2020 at the Medical University of Silesia in Katowice (Poland). The data were obtained from 1344 students aged 21.8 ± 1.9 years (response rate: 66.9%). Current traditional tobacco use was 13.2%, e-cigarettes use 3.5%, and HTP use 2.8% of students. Duration of use was shorter among HTPs users comparing to cigarette smokers (p < 0.001) although the number of tobacco sticks used daily was similar (p = 0.1). Almost 30% of respondents have ever tried HTPs. HTPs were considered safe by 5.3% of respondents (43.2% of HTP users vs. 3.9% of non-HTP users, p < 0.001). HTP users were more likely to report that heating tobacco is not addictive (odds ratio (OR) = 8.9, 95% confidence interval (CI): 1.8–45.8) and disagreed with a public ban on HTP use (OR = 4.9, 95%CI: 2.5–9.8). Among students, HTP use was less popular than cigarette smoking, but awareness of their presence is widespread.


Mycoses ◽  
2007 ◽  
Vol 50 (6) ◽  
pp. 463-469 ◽  
Author(s):  
Rebecca L. Koshnick ◽  
Kia K. Lilly ◽  
Katherine St Clair ◽  
Mary T. Finnegan ◽  
Erin M. Warshaw

2021 ◽  
pp. 088626052199745
Author(s):  
Rob Stephenson ◽  
Tanaka M.D. Chavanduka ◽  
Matthew T. Rosso ◽  
Stephen P. Sullivan ◽  
Renée A. Pitter ◽  
...  

Stay at home orders–intended to reduce the spread of COVID-19 by limiting social contact–have forced people to remain in their homes. The additional stressors created by the need to stay home and socially isolate may act as triggers to intimate partner violence (IPV). In this article, we present data from a recent online cross-sectional survey with gay, bisexual and other men who have sex with men (GBMSM) in the United States to illustrate changes in IPV risks that have occurred during the U.S. COVID-19 epidemic. The Love and Sex in the Time of COVID-19 survey was conducted online from April to May 2020. GBMSM were recruited through paid banner advertisements featured on social networking platforms, recruiting a sample size of 696 GBMSM. Analysis considers changes in victimization and perpetration of IPV during the 3 months prior to the survey (March-May 2020) that represents the first 3 months of lockdown during the COVID-19 epidemic. During the period March-May 2020, 12.6% of participants reported experiencing any IPV with higher rates of emotional IPV (10.3%) than sexual (2.2%) or physical (1.8%) IPV. Of those who reported IPV victimization during lockdown, for almost half this was their first time experience: 5.3% reported the IPV they experienced happened for the first time during the past 3 months (0.8% physical, 2.13% sexual, and 3.3% emotional). Reporting of perpetration of IPV during lockdown was lower: only 6% reported perpetrating any IPV, with perpetration rates of 1.5% for physical, 0.5% for sexual, and 5.3% for emotional IPV. Of those who reported perpetration of IPV during lockdown, very small percentages reported that this was the first time they had perpetrated IPV: 0.9% for any IPV (0.2% physical, 0.2% sexual, and 0.6% emotional). The results illustrate an increased need for IPV resources for GBMSM during these times of increased stress and uncertainty, and the need to find models of resource and service delivery that can work inside of social distancing guidelines while protecting the confidentiality and safety of those who are experiencing IPV.


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