Browsing by Subject "Clinical and Medical Social Work"
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Item An Analysis of Texas Hospitals: Assessing the Association between Charity Care, Uncompensated Care, & Community Benefits(2007-05-01) Mitias, Marcus J.; Nuha Lackan; Jeff Talbert; Douglas MainsMitias, Marcus J. An Analysis of Texas Hospitals: Assessing the Association between Charity Care, Uncompensated Care, & Community Benefits. Master of Public Health (Health Management & Policy), May 2007, 47 pp., 5 tables, 11 illustrations, references, 45 titles. The question of whether not-for-profit hospitals are meeting their charitable obligations is once again starting to intensify. Congress is calling for increased scrutiny of not-for-profit hospitals. Similarly, pressure is mounting in Texas where the not-for-profit hospital sector struggles to justify the contributions they make to the community. This cross-sectional study examines the county level association between charity care, uncompensated care expenditures, and community benefits, and hospital structure, and the number of uninsured. Descriptive and multi-linear regression analyses are used to compare hospital charity care and uncompensated care expenditures in Texas. Results indicate the number of uninsured is significantly associated with charity care expenditures and uncompensated care expenditures.Item An Evaluation of an Interdisciplinary House Calls Program For the Frail Homebound Elderly(1999-05-01) Johs, Jennifer L.Johs, Jennifer L. An Evaluation of an Interdisciplinary House Calls Program For the Frail Homebound Elderly. Master of Public Health (Biomedical Sciences), May, 1999, 57 pp., 4 tables, references, 66 titles. The current study compared utilization markers of 87 frail elderly homebound patients prior to and subsequent to enrollment in an interdisciplinary, physician-led house calls program, as well as measured efforts to increase documentation of advance directives. After enrollment in the program the number of hospital admissions (p=0.047) and emergency department visits (p=0.030) were significantly decreased. The number of admissions to skilled nursing facilities (p=0.023) was also reduced, as was length of stay in skilled nursing facilities (p=0.018). The prevalence of advance directives increased from 26% to 74% (p [less than] 0.001) subsequent to enrollment. Patients who died were more likely to die at home (19) than in the hospital (6). All patients who died at home had documented advance directives.Item Evaluating the Sustainability of THE NORTH TEXAS SALUD PARA SU CORAZON PROGRAM: Effects of the Program on Promotores and the Partner Organizations(2008-05-01) Kourosh, Elham Rastegar; Lurie, Sue; Balcazar, Hector; Hollen, MaryKourosh, Elham R., Evaluating the Sustainability of the NORTH TEXAS SALUD PARA SU CORAZON PROGRAM: Effects of the Program on Promotores and the Partner Organizations. Doctor of Public Health, May 2008, 117 pp., 1 table, bibliography, 47 titles. In the light of the rapid growth of the Latino population in Texas, the need for culturally and linguistically appropriate health promotion programs for Latinos is becoming apparent. It is essential that these programs address CVD prevention for this population, since the results of an assessment conducted by the City of Fort Worth in 1998 confirmed that the Latino population in the area is heavily burdened by CVD risk factors such as diabetes and lack of physical activity. It is also important, in light of limited resources for health promotion, that the community health impacts of such programs be sustainable. The purpose of this research was to evaluate the sustainability of the North Texas Salud Para Su Corazon program, by examining two major elements of the program for sustainability: (1) the professional development and work-related experiences of the promotores who participated during the 3 years of operation of the program, and (2) the continuation of the activites that were supported by the network of community partner organizations during the initial period. North Texas Salud Para Su Corazon was a heart health promotion program which trained and mobilized promotores in the Fort Worth area from 2001 to 2004. Guided interviews with a key informant (project director), 14 promotores, and nine partner organization representatives were analyzed using qualitative methods and showed that project activities and effects endured beyond the funding period of the project. Promotores continued to disseminate heart health information after the end of the project, and organizational structures are evolving to support promotora activities, enabling the health effects of the project to continue in the community. Recommendations were made for further support of these activities and included university sponsored studies of the promotores’ work, annual conferences and award ceremonies highlighting their service, and the development of funding for continuous education and job creation programs involving promotores in the health care sector.Item The Effects of Media Exposure on Alcohol Consumption Patters within the African American Population(2005-05-01) Miller, Vanessa G.; Lykens, Kristine; Quinn, James; Cipher, DaishaMiller, Vanessa G., The Effects of Media Exposure on Alcohol Consumption Patterns within the African American Population. Doctor of Public Health (Health Management and Policy), May 2005, 206 pp., 62 tables, 8 illustrations, references, 77 titles. Objectives- The study examined the role of media exposure on alcohol consumption patterns in the African American population. In studying the role of media exposure, the study also examined the role of ethnicity, mood/affect, socio-demographic factors and religion on alcohol consumption patterns in this population. Methods- Secondary analysis of the General Social Survey (GSS), 1972-2002 cumulative data file was used to provide quantitative estimates of the relationship between media exposure, ethnicity, mood/affect, socio-demographic factors, and religiosity as predictors of alcohol consumption. Path analysis was used to determine the direct and indirect effects of these concepts on alcohol consumption patterns. Results- Watching television and reading the newspaper were significant predictors of alcohol use. Watching television had a positive effect on alcohol use; but only in the absence of religiosity. When religiosity was present, as indicated by religious affiliation and attendance at religious services, watching television had a significant negative effect on alcohol use. Reading the newspaper had a negative effect on alcohol use; but this effect was not very significant. Watching TV also had a significant positive effect on alcohol abuse. Reading the newspaper had an effect on alcohol abuse but this effect was not significant. IN the presence of religiosity, neither watching TV nor reading the newspaper had a significant effect on alcohol abuse. The effects of religiosity could also be seen on the relationships between alcohol consumption and socializing patterns, age, sex, ethnicity, and income. The year of the GSS survey had a significant positive effect of television viewing and a significant negative effect on reading the newspaper. Race did not have a significant effect on alcohol use or abuse. Conclusion- This research has significant policy implications, as it indicates that exposure to media, thus exposure to advertising, had an effect on alcohol consumption. Religiosity appeared to act as a protective mechanism against the adverse effects of media exposure, as they relate to alcohol consumption. This research provides support for the implementation of more faith-based initiatives to combat substance abuse (especially alcohol abuse). It also sets the foundation for additional research on the effects of advertising on alcohol consumption, looking at the media revolution of the 21st century.Item The Tarrant County Diabetes Collaboration: A Case Study of a Community Diabetes Coalition(2001-08-01) Sammer, Christine; Lykens, Kristine; Lurie, Sue; Gonzalez, AdelaSammer, Christine, The Tarrant County Diabetes Collaboration: A Case of a Community Diabetes Coalition. Master of Public Health (Health Administration), August, 2001, 66 pp., 2 tables, 1 figure, bibliography, 20 titles. This study considers the characteristics of a diabetes coalition that are necessary for coalition maintenance beyond the formation and building stages. A case study was done of the Tarrant County Diabetes Collaboration (TCDC). Data were collected through recorded interviews and a review of documents. The concepts of collaboration identified were: composition, ownership, value, governance, operational map, fiscal structure, and domain. These concepts are presented in a conceptual model. Conclusions made were that the two main strengths of the TCDC were composition and member’s perception of value. Opportunities for growth included defining member roles, developing strong leadership, operating by an operational map and fiscal plan, and becoming recognized as a force for diabetes in the community.