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1.
Ashley M. Kranz Sarah Dalton Cheryl Damberg Justin W. Timbie 《Joint Commission journal on quality and patient safety / Joint Commission Resources》2018,44(12):731-740
Background
Health centers provide care to vulnerable and high-need populations. Recent investments have promoted use of health information technology (HIT) capabilities for improving care coordination and quality of care in health centers. This study examined factors associated with use of these HIT capabilities and the association between these capabilities and quality of care in a census of health centers in the United States.Methods
Cross-sectional secondary data from the 2015 Health Resources and Services Administration's Uniform Data System was used to examine 6 measures of HIT capability related to care coordination and clinical decision support and 16 measures of quality (12 process measures, 3 outcome measures, 1 composite measure) for health centers in the United States. Adjusted logistic regressions were used to examine health center characteristics associated with use of HIT capabilities, and adjusted linear regressions were used to examine associations between HIT capabilities and quality of care.Results
Many health centers reported using HIT for care coordination activities, including coordinating enabling services (67.3%) or engaging patients (81.0%). Health center size and medical home recognition were associated with significantly greater odds of using HIT for enabling services and engaging patients. These HIT capabilities were associated with higher overall quality and higher rates of six process measures (adult screening and maternal and child health) and hemoglobin A1c control.Conclusion
Use of HIT for such activities as arranging enabling services and engaging patients are underleveraged tools for care coordination. There may be opportunities to further improve quality of care for vulnerable patients by promoting health centers’ use of these HIT capabilities. 相似文献2.
Background
Today, there is a clear understanding of what Brexit means in legal terms and how it involves the health-related issues but, there is no clear view as to how these issues can vary for different Brexit scenarios or how Brexit negotiations impact the citizens healthcare concerns.Objective
In this study, we investigate the facts and issues surrounding Brexit options and their possible influences on healthcare issues from the public perspectives.Methods
We designed two scenarios for controlled online experiments. We used Analysis of Variance to compare participants’ perceptions about the two Brexit scenarios (hard and soft). Data were collected from four countries (England, Scotland, Wales and Northern Ireland). Totally, 459 respondents participated in the two experiments.Results
The findings show that there are significance differences in respondents’ perceptions of medical products and technologies, information management, service delivery, and healthcare leadership between two Brexit scenarios. Our results show that perception of health risks is significantly lower for soft Brexit scenario comparing to the hard Brexit. Soft Brexit perceived to be significantly more effective in improving medical technology accessibility, information management, service delivery, and healthcare leadership.Conclusions
This work is among the first attempts to describe the way the British public feel about the possible Brexit options’ implications for healthcare. The significant difference between Brexit scenarios on medical products, information management, service delivery, and healthcare leadership indicates that the future EU–UK relations depend on how effectively the entire health community and policy systems in the UK address these challenges. The results of this study recommend guidelines for reshaping existing agreements or reaching new arrangements in the Brexit negotiations. 相似文献3.
Limin Buchanan Heather Yeatman Bridget Kelly Kishan Kariippanon 《Journal of nutrition education and behavior》2018,50(9):888-895
Objective
To examine whether digital marketing strategies are more strongly associated with energy drink use than other marketing and whether Theory of Planned Behavior (TPB) constructs mediated the effects of digital marketing on energy drink use.Design
A cross-sectional online survey using the TPB was administered in 2016.Setting
Illawarra region of New South Wales, Australia.Participants
A total of 359 young adults aged 18–24 years completed the survey. Participants were mainly students.Main Outcome Measures
Relative impacts of digital and other marketing on energy drink use and the mediating effects of TPB constructs: attitudes, subjective norm, and perceived behavioral control.Analysis
Stepwise regression analysis was employed to compare the effects on energy drink use from digital and other marketing. Mediation analysis was used to examine the mediating effects of the TPB constructs.Results
Digital marketing was more strongly associated than other marketing with young adults’ energy drink use. Attitudes, subjective norms, and perceived behavioral control mediated the effects of digital marketing on energy drink use.Conclusions and Implications
The marketing of unhealthy food and beverages such as energy drink products on the Internet requires greater scrutiny. Future interventions may focus on strategies to attenuate young adults’ attitudes toward energy drinks, denormalize energy drink use, and strengthening self-efficacy to reject energy drinks among this age group. 相似文献4.
Jessica L. Thomson Melissa H. Goodman Alicia S. Landry Annie Donoghue Audrey Chandler Rachel Bilderback 《Journal of nutrition education and behavior》2018,50(9):868-875
Objective
Determination of feasibility of online nutrition education in the federal workplace.Design
Pretest–posttest pilot study with data collection occurring from September to December, 2016.Setting
Two US Department of Agriculture workplaces.Participants
Convenience sample of 26 federal government employees. Posttest response rate was 85% (22 of 26 employees).Intervention
A 12-week online nutrition education program designed and taught by registered dietitian nutritionists.Variables Measured
Program component satisfaction, use, and understanding ratings and clinical measures including body composition, blood pressure, and skin carotenoid level (biomarker for fruit and vegetable intake).Analysis
Paired t tests to determine whether significant changes occurred after the intervention.Results
Mean number of class videos viewed and program components used were 7 and 5 (out of 12 for both). Mean program component ratings ranged from 4.0 to 4.7 (n?=?12, maximum score of 5) for the surveyitems motivated/helped me to eat healthier. Statistically significant decreases were observed in body mass index, percent body fat, and visceral fat level.Conclusions and Implications
Online nutrition education in the federal workplace is feasible for some employees as evidenced by the program components’ high satisfaction and understanding ratings and high retention rate. Limited evidence was apparent for the intervention's positive impact on health outcomes. 相似文献5.
Erin R. Hager Hee-Jung Song Hannah G. Lane Hallene H. Guo Lea H. Jaspers Megan A. Lopes 《Journal of nutrition education and behavior》2018,50(8):765-775
Objective
To develop and pilot-test Wellness Champions for Change (WCC) to enhance local wellness policy (LWP) implementation by forming wellness teams.Design
Randomized, controlled school-level pilot study.Setting
Five Maryland school districts.Participants
A total of 63 elementary, middle, or high schools.Intervention(s)
Developed from stakeholder interviews, focus groups, and existing programs. Schools were randomized within district to (1) WCC training (6-hour, single-day teacher training), (2) WCC training plus technical assistance (TA), or (3) delayed training (control).Main Outcome Measure(s)
Online teacher/administrator survey pre-post (spring, 1 year apart) that examined the direct effect of the intervention on active wellness team formation (postintervention, 8-item sum score) and LWP implementation (29 items, not implemented to fully implemented)/indirect effect of intervention on LWP implementation via active wellness team formation.Analysis
Adjusted linear or logistic regression and mediation modeling.Results
Postintervention, WCC plus TA and WCC had more active wellness teams (vs control, β?=?1.49, P?=?.02 and β?=?1.42, P?=?.03, respectively). No direct effect of intervention on LWP implementation was found. Formation of active wellness teams mediated the association between both WCC plus TA and WCC and LWP implementation (WCC plus TA confidence interval [CI], 1.22–16.25; WCC CI, 10.98–15.61 [CI was significant without 0]).Conclusions and Implications
The WCC intervention approaches indirectly affected LWP implementation through the formation of active wellness teams. These results support building and school-level wellness teams. 相似文献6.
Objective
This study seeks to examine how the extent of socioeconomic deprivation, racial and ethnic isolation, and health disadvantage differ among Medicare beneficiaries in Mississippi. Methods: Geographical information system (GIS) mappings are used in conjunction with cluster analysis to examine patterns of disparities in disease distribution, healthcare utilization and socioeconomic well-being among different counties in Mississippi.Results
Results reveal that counties in these two clusters are markedly different in terms of socio-economic well-being but are somewhat similar in terms of disease distributions and healthcare utilization.Conclusion
Addressing the geographic disparities in disease distribution and healthcare utilization that exist among the counties should be a public health priority. Specifically, health policies and programs should be renewed to target people living in counties that are either predominantly rural or predominantly Black or have higher percentages of population living below the poverty level. 相似文献7.
8.
Holly A. Harris Elena Jansen Kimberley M. Mallan Lynne Daniels Karen Thorpe 《Journal of nutrition education and behavior》2018,50(8):757-764
Objective
To examine the role of parent concern in explaining nonresponsive feeding practices in response to child fussy eating in socioeconomically disadvantaged families.Design
Mediation analysis of cross-sectional survey data.Setting
Socioeconomically disadvantaged urban community in Queensland, Australia.Participants
Cohabiting mother–father pairs (n?=?208) with children aged 2–5 years.Main Outcome Measure(s)
Two validated measures of nonresponsive feeding: persuasive feeding and reward for eating.Analysis
Mediation analysis tested concern as a mediator of the relationship between child food fussiness (independent variable) and parent nonresponsive feeding practices (dependent variables), adjusted for significant covariates and modeled separately for mothers and fathers.Results
Maternal concern fully mediated the relationship between child food fussiness and persuasive feeding (indirect effect: B [SE]?=?0.10 [0.05]; 95% confidence interval [CI], 0.01–0.20). Concern also fully mediated the relationship between child food fussiness and reward for eating for mothers (indirect effect: B [SE]?=?0.17 [0.07]; CI, 0.04–0.31) and fathers (indirect effect: B [SE]?=?0.14 [0.05]; CI, 0.04–0.24)Conclusions and Implications
Concern for fussy eating behaviors may explain mothers’ and fathers’ nonresponsive feeding practices. In addition to providing education and behavioral support, health professionals working with socioeconomically disadvantaged families can incorporate strategies that aim to alleviate parents’ concerns about fussy eating. 相似文献9.
Objective
To investigate (1) how perceived parental control, perceived parental modeling, and parent–teen co–decision making are associated with teenagers’ consumption of fruits and vegetables as well as sugary drinks and less healthful food; and (2) whether self-efficacy mediates this relationship.Design
Cross-sectional survey.Participants
A total of 1,657 adolescents aged 12–17years.Main Outcome Measure(s)
Perceived parental control, perceived parental modeling, parent–teen co–decision making, self-efficacy, and consumption of fruits and vegetables as well as sugary drinks and less healthful food.Analysis
Ordinary least-squares regressions and mediation analyses.Results
After controlling for teenagers’ self-efficacy, perceived parental control was not significantly associated with teenagers’ fruit and vegetable consumption but it was negatively related to teenagers’ consumption of sugary drinks and less nutrient-dense food. Perceived parental modeling had a positive correlation to teenagers’ fruit and vegetable consumption and a negative relationship to their consumption of sugary drinks and less healthful food. Parent–teen co–decision making regarding teenagers’ food consumption emerged as a positive predictor for teenagers’ fruit and vegetable consumption but not for that of sugary drinks and foods with little nutritional value after controlling for self-efficacy.Conclusions and Implications
Findings from this study demonstrated that perceived parental behaviors were related to teenagers’ nutrition intakes. Not exerting too much control and having teenagers participate in the decision-making process could help teenagers eat more healthily. Furthermore, providing a positive role model for teenagers can be an effective strategy to encourage teenagers to eat better. 相似文献10.
11.
Manuel García-Goñi Ayman Fouda Rosemary V Calder Francesco Paolucci 《Health Policy and Technology》2018,7(3):293-301
Objectives
Significant increases in health expenditures have been a global trend and constitute a major concern in Australia and other countries for healthcare providers, payers, policymakers, consumers and population. This trend is largely attributable to emerging healthcare technologies, aging populations, and the impact of non-communicable diseases and chronic conditions on the burden of disease. In this paper, we look at how the Australian health system is responding to this challenge.Methods
We analyze the main drivers of health expenditure with particular focus on chronic care and integrated care and provide an assessment of the most important problems.Results
The key challenge for Australia is how to reorient and rearrange current health funding and service organization through better design with a specific focus on long-term care and chronic care, prevention and early intervention in the search for efficiency in social and economic impacts and costs. We propose that this is most efficiently achieved through a publicly-funded health insurance model focused on chronic health conditions that we name Mandatory Integrated (Public and Private) Health Insurance (MIPPHI). MIPPHI meets the essential foundational components in terms of competitiveness, efficiency, and affordability.Conclusion
We articulate our proposal for a systematic health funding reform in 22 policy actions that, we argue, would improve the sustainability of the Australian health system while preserving its universal character for a more comprehensive basket of chronic and social services. 相似文献12.
13.
Ronel Suthers Michelle Broom Eleanor Beck 《Journal of nutrition education and behavior》2018,50(8):813-823
Objective
To identify characteristics of successful public health interventions aimed at increasing whole grain consumption.Methods
The Preferred Reporting Items for Systematic Reviews and Meta-analyses framework, guided by higher-quality interventions with greatest effect size, was adopted to conduct a systematic literature review.Results
Of 8,500 initial records, only 8 interventions with demonstrated reach (up to national populations) and effectiveness (increasing consumption 8–27 g/d) were eligible for synthesis. Their characteristics included multiple stakeholder involvement, specified target intakes in dietary guidelines, manufacturer codes of practice, product reformulation, evidence-based educational resources, social media, and community events with tasting and preparation opportunities. Empowerment of food service providers was also linked to success.Conclusions and Implications
Successful interventions require multifaceted strategies across multiple aspects of the food system, underpinned by multiple stakeholder partnerships. Uniform capture of interventions using an online, searchable, public domain resource may provide a strategy to enable health professionals globally to plan local interventions across cultural settings, drawing on best practice guidelines developed from interventions with demonstrated reach and effectiveness. 相似文献14.
Ren-Zong Kuo 《Health Policy and Technology》2018,7(4):365-373
Objectives
This study proposes a research model that combines information system (IS) continuance theory with the DeLone and McLean IS success model to more clearly comprehend the influences of system characteristics on electronic health record system (EMRS) adoption. As Information security management (ISM) awareness enables health workers to be better able to prevent security violations, this study further explores the effects of perceived service quality on the relationship between ISM awareness and system characteristics of EMRS.Methods
Data were gathered from a questionnaire survey of 200 health professionals in Taiwan, and the structural equation modelling technique was utilized to test the research model.Results
The findings of this study enrich our understanding of the effect of ISM awareness and perceived service quality on the improvement of EMRS quality in the post-adoption stage. Specifically, the results indicate that with sufficient technical support and high ISM awareness, it can facilitate to enhance the quality of system characteristics of EMRS, which in turn favourably increases users’ willing to continue using the system to advance their healthcare practices, resulting in successful adoption of EMRS.Conclusions
This study suggests that practitioners who want to successfully implement an EMRS should not merely pay attention to the issue of system design, but also be concerned with and knowledgeable about the formulation of ISM policy and its effective implementation. A successful EMRS adoption therefore should interact well with the ISM policy and sufficient technical support, and both of technical and managerial aspects are necessary fully considered and effectively integrated for the best outcome. 相似文献15.
Nutrition Label Use and Its Association With Dietary Quality Among Latinos: The Roles of Poverty and Acculturation 总被引：1，自引：0，他引：1
Machelle D. Wilson A. Susana Ramírez Joanne E. Arsenault Lisa M. Soederberg Miller 《Journal of nutrition education and behavior》2018,50(9):876-887
Objective
To investigate how acculturation and poverty are independently and jointly associated with the use of the Nutrition Facts panel (nutrition label) and to examine the extent to which nutrition label use moderates the association of poverty and acculturation on dietary quality among Latinos.Design
Cross-sectional analysis of the 2007/2008 and 2009/2010 waves of the National Health and Nutrition Examination Survey.Participants
A total of 3,696 adults (aged >19 years) self-identified as Latino/Hispanic with food label use data from the most recent Consumer Behavior Phone Follow-Up Modules.Main Outcome Measure(s)
Nutrition label use and dietary quality.Analysis
Logistic regression.Results
Acculturation moderated the association of income on the likelihood of using nutrition labels, such that lower-income English-speaking Latinos were half as likely as higher-income English-speakers to use nutrition labels (P?=?.01, odds ratio [OR]?=?0.44, 95% confidence interval [CI], 0.24–0.81); however, Spanish speakers were equally likely to use nutrition labels across income levels (P?=?.99; OR?=?1.00; 95% CI, 0.77–1.31). Nutrition label use moderated the association of acculturation on diet. Among English-speaking Latinos, those who read nutrition labels had less than half the risk for poor diet (P =.001; OR?=?0.43; 95% CI, 0.26–0.69); however, label use was not significantly associated with the diet quality of Spanish speakers (P?=?.07; OR?=?0.82; 95% CI, 0.67–1.02). Nutrition label use decreased the risk for poor dietary quality regardless of poverty status.Conclusions and Implications
Overall, results demonstrated a positive association between the use of the Nutrition Facts panel for Latinos and dietary quality. An important nutrition education strategy among bicultural Latinos at risk for a poor diet as a result of acculturation may include label reading comprehension. This approach may also address the low rates of label use. The study provides evidence of segmented assimilation in which low-income, bicultural Latinos follow an underclass pattern of acculturation demonstrated by a lower likelihood of reading nutrition labels and higher-income, bicultural Latinos follow the more successful selective pattern. 相似文献16.
Przemyslaw M. Waszak Wioleta Kasprzycka-Waszak Alicja Kubanek 《Health Policy and Technology》2018,7(2):115-118
Objectives
Fake news: misinformation and falsehood of health news in social media constitute a potential threat to the public health, but the scope of this issue remains unclear. Our pilot study is an initial attempt to measure a number of the top shared health misinformation stories in the Polish language social media.Methods
Using the BuzzSumo Application, a range of the top shared health web links in the Polish language social media was assessed during the period between 2012 and 2017. We used the following keywords which were related to the most common diseases and causes of death: cancer, neoplasm, heart attack, stroke, hypertension, diabetes, vaccinations, HIV, and AIDS. Each link was checked for the presence of fake news.Results
40% of the most frequently shared links contained text we classified as fake news. These were shared more than 450,000 times. The most fallacious content concerned vaccines, while news about cardiovascular diseases was, in general, well sourced and informative. More than 20% of dangerous links from our material was generated by one source.Conclusions
Analyzing social media top shared news could contribute to identification of leading fake medical information miseducating the society. It might also encourage authorities to take actions such as put warnings on biased domains or scientifically evaluate those generating fake health news. 相似文献17.
Objective
The current study aimed to examine the interplay between self-efficacy and perceived availabilities of fruits and vegetables (F&V) and energy-dense, low-nutrient foods and sugary drinks (EDLNF&SD) at home and in the school neighborhoods on adolescents’ eating behaviors.Design
The Family Life, Activity, Sun, Health, and Eating study, a cross-sectional, Internet-based survey was analyzed.Participants
Adolescent–parent dyads (n?=?1,657).Interventions
Self-efficacy for F&V intake and limiting EDLNF&SD consumption, perceived F&V and EDLNF&SD availabilities at home and in the school neighborhood, and F&V intake and EDLNF&SD consumption.Analysis
Multiple regression analyses.Results
Adolescents’ self-efficacy and perceived home and school neighborhood availability of F&V and EDLNF&SD had significant main effects on their F&V intake and EDLNF&SD consumption, respectively (all P < .01). The positive effect of self-efficacy on F&V intake was greater when home F&V availability was high (+1 SD; b?=?.29; P < .001) than when it was low (–1 SD; b?=?.07; P?=?.040). The effect of home F&V availability on F&V intake was significant when F&V were not available in the school neighborhood (b?=?.09; P?=?.006).Conclusions and Implications
Given the central role of home availability, it may be considered a fundamental unit of nutrition intervention for adolescents. Multiple contexts (eg, individual, home, school neighborhood) need to be considered to promote adolescents’ eating behaviors. 相似文献18.
Background
Potential users’ preferences for telemedicine services directed to cardio-vascular diseases are investigated applying a discrete choice experiment (DCE). Given the potential of telemedicine to minimize costs without reducing overall efficiency, assessing preferences for these types of services represents a priority for policy makers. This is especially true for those pathologies that absorb a relatively high quota of total health expenditure. The empirical setting is Sardinia (Italy) because of its insularity and the underdeveloped internal transport network. Telemedicine is likely to mitigate distance between healthcare providers and final users.Methods
A survey conducted between February and May 2013 was administered to a selected Sardinian population older than 18 (potential users) through face-to-face interviews. A discrete choice experiment was implemented and four attributes (i.e. scanning mode, location, waiting list and cost) assess in what measure these influence potential users’ utility by using a random parameter modelling with heterogeneity (RPH).Results
The empirical findings, based on 2000 interviews, highlight that potential users are not very open to the application of telemedicine services in cardiology, mostly preferring the intromoenia (visit at the hospital) and private system. Besides, remarkable individual heterogeneity has been found.Conclusions
Potential users see the implementation of new technologies in healthcare with a certain caution. However, the relatively higher preferences towards services provided at their own municipality suggests that there is ground to explore further the implementation of telemedicine services through the family doctor and local pharmacy. 相似文献19.
Objectives
Although precision medicine is a rapidly-emerging field in healthcare, its growth for the next few decades depends on a number of scientific and economic factors. Policy will play a major role in addressing these factors. In this study, we dynamically simulated the impact of policies related to the two factors—'knowledge sharing and accumulation’ and ‘reimbursement’—foregrounded in the literature as having the most significant influence on the growth of precision medicine.Methods
To analyze the impact of specific policies, we used system dynamics methodology. This allowed us to analyze multiple interaction processes, feedback loops, time delays, and other nonlinear effects.Results
According to our results, strengthening the knowledge sharing and accumulation policy greatly contributes to the growth of precision medicine by significantly increasing its market share through a complex route. Conversely, strengthening the reimbursement policy only slightly increases precision medicine's market share and is therefore unable to change an industry based on blockbuster drugs.Conclusions
We conclude that it is preferable to prioritize and actively implement a knowledge sharing and accumulation policy rather than a reimbursement policy. However, knowledge sharing and accumulation policies must be carefully handled in order to avoid individual privacy issues. To prevent such issues, there must be joint cooperation and efforts not only within one country but also among any related countries. Additionally, although reimbursement funding is often scarce and the policy's effects might be limited, a reimbursement policy is needed throughout the development cycle for drug treatments, devices, and supporting diagnostics. 相似文献20.
Kaipeng Wang Yoosun Chu Adolfo G. Cuevas Robert G. Hasson III Katherine L. Tucker Luis M. Falcón 《Journal of nutrition education and behavior》2018,50(8):829-835