scholarly journals Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012

2015 ◽  
Vol 12 ◽  
Author(s):  
Desiree R. Backman ◽  
Neal D. Kohatsu ◽  
Brian M. Paciotti ◽  
Jennifer V. Byrne ◽  
Kenneth W. Kizer
Keyword(s):  
Health Promotion ◽  
Managed Care ◽  
Low Income ◽  
Care Plans ◽  
Health Promotion Interventions

scholarly journals Assessing Health Promotion Interventions: Limitations of Traditional Research Methods in Community-Based Studies

2017 ◽  
Vol 19 (4) ◽  
pp. 573-580 ◽  
Author(s):  
Anne Dressel ◽  
Robert Schneider ◽  
Melissa DeNomie ◽  
Jennifer Kusch ◽  
Whitney Welch ◽  
...  
Keyword(s):  
Health Promotion ◽  
Research Methods ◽  
Low Income ◽  
Controlled Trial ◽  
Community Settings ◽  
Community Based ◽  
African American Adults ◽  
Randomized Controlled ◽  
Traditional Research ◽  
Health Promotion Interventions

Most low-income Americans fail to meet physical activity recommendations. Inactivity and poor diet contribute to obesity, a risk factor for multiple chronic diseases. Health promotion activities have the potential to improve health outcomes for low-income populations. Measuring the effectiveness of these activities, however, can be challenging in community settings. A “Biking for Health” study tested the impact of a bicycling intervention on overweight or obese low-income Latino and African American adults to reduce barriers to cycling and increase physical activity and fitness. A randomized controlled trial was conducted in Milwaukee, Wisconsin, in summer 2015. A 12-week bicycling intervention was implemented at two sites with low-income, overweight, or obese Latino and African American adults. We found that randomized controlled trial methodology was suboptimal for use in this small pilot study and that it negatively affected participation. More discussion is needed about the effectiveness of using traditional research methods in community settings to assess the effectiveness of health promotion interventions. Modifications or alternative methods may yield better results. The aim of this article is to discuss the effectiveness and feasibility of using traditional research methods to assess health promotion interventions in community-based settings.

scholarly journals Empowered and disempowered voices of low-income people with disabilities on the initiation of government-funded, managed health care

2016 ◽  
Author(s):  
Kathleen McAuliff ◽  
Judah Viola ◽  
Christopher Keys ◽  
Lindsey T. Back ◽  
Amber E. Williams ◽  
...  
Keyword(s):  
Managed Care ◽  
Focus Groups ◽  
Family Caregivers ◽  
Low Income ◽  
Hospital Admissions ◽  
Evaluation Research ◽  
Care Program ◽  
Fee For Service ◽  
Care Plans ◽  
Managed Care Organizations

The health and healthcare of vulnerable populations is an international concern. In 2011, a Midwestern state within the U.S. mandatorily transitioned 38,000 Medicaid recipients from a fee-for-service system into a managed care program in which managed care companies were contracted to provide recipients’ healthcare for a capitated rate. In addition to cost savings through reductions in preventable and unnecessary hospital admissions, the goals of the managed care program (MCP) included: (1) access to a more functional support system, which can support high and medium risk users in the development of care plans and coordination of care, and (2) choice among competent providers. The population transitioned was a high-need, high-cost, low-income, and low-power group of individuals. The evaluation research team used focus groups as one of many strategies to understand the experience of users during the first two years of this complex change effort. The article explores empowerment in terms of users and their family caregivers’ ability to make meaningful choices and access resources with regard to their healthcare. Specifically, factors empowering and disempowering users were identified within three thematic areas: (1) enrollment experiences, (2) access to care and (3) communication with managed care organizations and providers. While the change was not optional for users, a disempowering feature, there remained opportunities for other empowering and disempowering processes and outcomes through the transition and new managed care program. The results are from 74 participants: 65 users and 9 family caregivers in 11 focus groups and six interviews across two waves of data collection. MCP users felt disempowered by an initial lack of providers, difficulty with transportation to appointments, and challenges obtaining adequate medication. They felt empowered by having a choice of providers, good quality of transportation services and clear communication from providers and managed care organizations. Recommendations for increasing prospects for the empowerment of healthcare users with disabilities within a managed care environment are presented.

Prior Approval in the Pediatric Emergency Room

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 674-680
Author(s):  
Deborah Glotzer ◽  
Alan Sager ◽  
Deborah Socolar ◽  
Michael Weitzman
Keyword(s):  
Primary Care ◽  
Managed Care ◽  
Emergency Room ◽  
Low Income ◽  
Primary Care Physicians ◽  
Community Health Centers ◽  
Care Physician ◽  
Care Plans ◽  
Prior Approval

Managed-care plans for low-income Americans are widely promoted to improve the quality and control the cost of medical care by reducing unnecessary specialty and emergency room (ER) care through the use of primary care physicians as case managers/gatekeepers. The purpose of this study was to evaluate one element of managed care, gatekeeping prior approval, for children who use the pediatric ER of one urban public hospital. Over a 6-month period, 518 children and adolescents insured under managed-care plans that required authorization from the primary care physician to receive treatment presented to the ER. Of the 385 records reviewed for this study, the majority (87%) received their primary care at community health centers or the hospital's own outpatient clinics. Most ER visits (72%) were made when primary care sites were closed. According to nursing triage assessment, 57% presented with urgent or emergent conditions, and 26% had a history of chronic illness. Nine percent required hospitalization. Although an elaborate system for gatekeeping was established, only 13 (3%) patients' requests for ER care were denied. Of these, 3 were seen in the ER without authorization, 6 received the recommended follow-up, and 4 were not seen in follow-up. Twenty-nine participating primary care sicians (74%) and 19 ER staff (63%) responded to a survey of their experience with and attitudes toward prior approval. For a variety of reasons, the majority of primary care physicians and ER staff found the gatekeeping policies for after-hours visits burdensome and inappropriate. The low denial rate observed was due in large part to physicians' reluctance, because of clinical, ethical, and legal concerns, to deny care to a child who had already been brought to the ER. This study identifies many problems with the design and implementation of prior-approval policies. It appears that the prior-approval requirement has not visibly changed how patients use this emergency room. The study suggests that on-site gatekeeping for children living in poverty will not result in the anticipated benefits in improved care or reduced costs unless primary care alternatives to the ER can be provided at less cost and with equal availability.

Assessing Organizational Factors in Faith-based Organizations Partnering in Health Promotion Interventions

2013 ◽  
Author(s):  
Erin K. Tagai ◽  
Cheryl L. Holt ◽  
Mary Ann Scheirer ◽  
Sherie Lou Z. Santos ◽  
Nancy Atkinson ◽  
...  
Keyword(s):  
Health Promotion ◽  
Organizational Factors ◽  
Faith Based ◽  
Faith Based Organizations ◽  
Health Promotion Interventions

scholarly journals Truckies and the Australian transport industry: Managers’ perspectives about enablers and inhibitors to workplace health promotion

Work ◽  
2021 ◽  
pp. 1-9
Author(s):  
Marguerite C. Sendall ◽  
Alison Brodie ◽  
Laura K. McCosker ◽  
Phil Crane ◽  
Marylou Fleming ◽  
...  
Keyword(s):  
Health Promotion ◽  
Action Research ◽  
Participatory Action Research ◽  
Workplace Health Promotion ◽  
Road Transport ◽  
Successful Implementation ◽  
Workplace Health ◽  
Participatory Action ◽  
Transport Industry ◽  
Health Promotion Interventions

BACKGROUND: There is little published research about managers’ views on implementing and embedding workplace health promotion interventions. OBJECTIVE: To shed light on research-to-practice challenges in implementing workplace health promotion interventions in the Australian road transport industry. METHODS: In this Participatory Action Research project, managers from small-to-midsized companies in the Australian road transport industry were asked their views about enablers and barriers to implementing nutrition and physical activity interventions in their workplace. RESULTS: Managers identified practical assistance with resources, ideas, and staffing as being key enablers to implementation. Barriers included time restraints, worker age and lack of interest, and workplace issues relating to costs and resources. CONCLUSION: Manager perspectives add new insights about successful implementation of workplace health promotion. A Participatory Action Research approach allows managers to develop their own ideas for adapting interventions to suit their workplace. These findings add to a small body of knowledge of managers’ views about implementing workplace health promotion in small-to-midsized road transport companies - a relatively unexplored group. Managers highlight the importance of time constraints and worker availability when designing interventions for the road transport industry. Managers require a good understanding of the workplaces’ socio-cultural context for successful health promotion and health behaviour change.

scholarly journals Evidence for implementation of interventions to promote mental health in the workplace: a systematic scoping review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Charlotte Paterson ◽  
Caleb Leduc ◽  
Margaret Maxwell ◽  
Birgit Aust ◽  
Benedikt L. Amann ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Scoping Review ◽  
Mental Health Problems ◽  
Evaluation Studies ◽  
Grey Literature ◽  
Mental Health Promotion ◽  
Successful Implementation ◽  
Health Promotion Interventions ◽  
Promote Mental Health

Abstract Background Mental health problems are common in the working population and represent a growing concern internationally, with potential impacts on workers, organisations, workplace health and compensation authorities, labour markets and social policies. Workplace interventions that create workplaces supportive of mental health, promote mental health awareness, destigmatise mental illness and support those with mental disorders are likely to improve health and economical outcomes for employees and organisations. Identifying factors associated with successful implementation of these interventions can improve intervention quality and evaluation, and facilitate the uptake and expansion. Therefore, we aim to review research reporting on the implementation of mental health promotion interventions delivered in workplace settings, in order to increase understanding of factors influencing successful delivery. Methods and analysis A scoping review will be conducted incorporating a stepwise methodology to identify relevant literature reviews, primary research and grey literature. This review is registered with Research Registry (reviewregistry897). One reviewer will conduct the search to identify English language studies in the following electronic databases from 2008 through to July 1, 2020: Scopus, PROSPERO, Health Technology Assessments, PubMed, Campbell Collaboration, Joanna Briggs Library, PsycINFO, Web of Science Core Collection, CINAHL and Institute of Occupational Safety and Health (IOSH). Reference searching, Google Scholar, Grey Matters, IOSH and expert contacts will be used to identify grey literature. Two reviewers will screen title and abstracts, aiming for 95% agreement, and then independently screen full texts for inclusion. Two reviewers will assess methodological quality of included studies using the Mixed Methods Appraisal Tool and extract and synthesize data in line with the RE-AIM framework, Nielson and Randall’s model of organisational-level interventions and Moore’s sustainability criteria, if the data allows. We will recruit and consult with international experts in the field to ensure engagement, reach and relevance of the main findings. Discussion This will be the first systematic scoping review to identify and synthesise evidence of barriers and facilitators to implementing mental health promotion interventions in workplace settings. Our results will inform future evaluation studies and randomised controlled trials and highlight gaps in the evidence base. Systematic review registration Research Registry (reviewregistry897)

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