Browsing by Subject "barriers"
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Item A Health Assessment of Refugee Children From Former Yugoslovia in Tarrant County(2001-12-01) Podgore, John K.; Marshall, Murial; Rene, Antonio; Sandhu, RaghbirThis study was conducted to provide an assessment of the health status and health care utilization of children from former Yugoslavia living in Tarrant County. Additionally an assessment of barriers and problems encountered by these families in obtaining health care for their children was presented. One hundred thirteen households of refugee families arriving in Tarrant County from 1998 through 2000 participated by answering a 79 item health information questionnaire. The results revealed that most of the refugee families had no regular health care provider to assure continuity of medical care. Lack of access to dental care and inappropriate utilization of hospital emergency facilities were also identified as problems. Insufficient understanding of health insurance issues and inability to access health information were additional problems. Addressing these problems by local and state health care agencies may help to improve health care delivery for these and future refugee children.Item Barriers to Health Care Access Among Vietnamese Refugees in Tarrant County, Texas.(2004-05-01) Le, Tuan D.; Chiehwen Ed Hsu; Sue Lurie; Raghbir SandhuLe, Tuan D., Barriers to Health Care Access among Vietnamese Refugees in Tarrant County, Texas. Master of Public Health (Health Management & Policy), May 2004, 88 pp., 17 tables, 11 illustrations, bibliography, 56 titles. The refugee community is the most vulnerable community due to existing medical conditions without proper treatment and many barriers in accessing the health care system, including different language, cultural conflict, legal restrictions, and socioeconomic status. The purpose of this study is to determine the nature of these barriers that keep the Vietnamese refugees from accessing the health care system in Tarrant County. The study found that 45.8% have no health insurance, 17.4% received Medicaid, 53.7% have no primary care physician, and 57.14% of Vietnamese elderly refugees, who have been living in the U.S. between seven and ten years, and have lost SSI and Medicaid. These findings are significant at p [less than] .001. Vietnamese refugees perceived factors that kept them from accessing the health care system as major barriers, including language (14%), legal issues (17%), misunderstanding of the medical system (15%), lack of insurance (14%), and different culture (11%). These results may assist social service providers, health care providers, and policy activists to enhance their services and advocate for legal issues, in order to remove these barriers and help refugees to access health care better.Item Differences in Motivational Factors that Influence Participation in Research Studies(2013-05-01) Lee, Michelle R.; Kimberly FuldaBackground: Whether it is a clinical trial to test the efficacy of a new drug, treatments for cancer or studies to find out risk factors for diseases, clinical research is an important resource for the medical profession. However, the major issue associated with clinical research is low recruitment and retention rates of participants. Low study enrollment can introduce bias and limit the study outcome. Therefore, it is important for researchers to understand what motivates and prevents people from participating in research studies. There is literature addressing reasons why adults consent to participate in research. Some studies break down the differences in research participation between gender, race/ethnicity and education level individually. However, there is not information on how the factors that motivate people to participate in research studies differ by gender, race/ethnicity and education. Nor is there information on how occupation relates to these motivational factors. Additionally, there is not sufficient information on why parents enroll their children in research studies and if the factors that motivate people to participate in research differ from what motivates them to enroll their children in research studies. The purpose of this study was to determine what motivational factors influence a person’s decision to participate in research studies and enroll their children in research studies. A secondary aim of this study was to determine if these motivational factors differ by a person’s gender, race/ethnicity, occupation and education level. Methods: This cross-sectional study recruited 101 participants (18 years and older). They were asked to complete a questionnaire that contained questions related to the adult participant and their child. For each variable, simple and multiple logistic regression were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between education, occupation, gender, and race/ethnicity with willingness to participate in clinical research and allow their children to participate in future research while controlling for whether they have participated in research in the past. Chi-square analyses were performed to determine if motivational factors differed by gender, race/ethnicity, occupation, and education for those who were willing to participate in future studies. Results: In the unadjusted model, education level and occupation were associated with the adult participants’ willingness to participate in future research. In the adjusted model, education level and previous research participation were associated with the adult participants’ willingness to participate. Motivational factors for participation significantly varied by education level (3 factors), occupation (4 factors), gender (1 factor) and race/ethnicity (1 factor). The results for the secondary aim differed slightly. In the adjusted model, previous research participant of the adult was significantly associated with willingness to allow their children to participate in future research studies. Motivational factors for child research participation significantly varied by education level of the adult (2 factors) and occupation of the adult (1 factor) Conclusion: By researchers using these models and finding out what factors motivate these individuals to participate in research and allow their child to participate in research studies, they can make research more appealing and eventually increase participation in research studies among these groups. As a result, researchers will decrease potential biases and increase their ability to analyze data that is collected which can help uncover information about certain conditions and diseases.Item Factors Associated with Difficulty in Using the Community Based Services among Children with Special Health Care Needs(2009-12-01) Talasila, Sreelakshmi; Karan SinghDespite various advances in the health care system, children with special health care needs (CSHCN) face difficulty in accessing required services. The purpose of this study was to identify factors associated with difficulty in using community based services, individual barriers and institutional barriers for CSHCN. Data were obtained from National Survey of CSHCN 2005-06. The Andersen Health Behavioral Model was used to identify predisposing, enabling and need factors. Logistic regression was performed. Education, region, race/ethnicity, number of children, insurance and satisfaction with services were associated with community based services. Results suggest functional limitations and severity of illness are associated with difficulty in using community based services. Further investigation is required to improve health care system.Item Hormone Replacement Therapy: Investigating Language Barriers(2002-04-26) Gamber, Mark A.; Muriel Marshall; Gilbert Ramirez; Janice KneblHormone Replacement Therapy: Investigating Language Barriers. Mark Gamber, BA, BS; Muriel Marhsall, DO, DrPH; Gilbert Ramirez, DrPH, Janice Knebl, DO; Karen Godwin, PhD; Hector Balzacar, PhD; Craig Whiting, DO. Objective: To investigate the relationship between the language spoken (Spanish or English) by the Hispanic patient when talking to their doctor and the patient’s use of HRT. Design: Retrospective chart review. Setting: Northside Family Practice clinic, UNTHSC in Ft. Worth, Texas. 102 postmenopausal Hispanic women. Measurement: HRT use, Spanish or English speaking, natural or surgical menopause. Results: A total of 102 postmenopausal Hispanic females met the inclusion criteria for chart review. The mean age of English speakers is 66.7 years old. The mean age of the Spanish speakers is 64.93 years old. 54% (55) spoke Spanish at their clinic visit and 46% (47) spoke English. Of the 55 Spanish speakers, 36% had at some point used HRT while 64% had never used HRT. Of the 47 English speakers, 49% had at some point used HRT while 51% had never used HRT. There is not a significant difference (p=0.20) when comparing language spoken by the patient at the clinic visit and whether they are prescribed HRT. Conclusion: While a significant difference was not found between the two groups, a greater percentage of English speaker (48%) than Spanish speaking (36%) Hispanic females are prescribed HRT in this study. In fact, when adjusted for age, English speakers were 1.88 times more likely to have used HRT than Spanish speakers. Based on the apparent need to bridge the language barrier between physicians and patients over issues important as menopause and HRT, more research is needed in this area. Key Words: Hormone Replacement Therapy, Hispanic, Women. University of North Texas Health Science Center; Ft. Worth, Texas (MG, MM, GR, JK, KG, HB, CW) Address correspondence and reprint requests to Mark Gamber c/o Dr. Muriel Marshall, University of North Texas Health Science Center; 3500 Camp Bowie Blvd; Fort Worth, Texas 76107. 817-735-2440; 817-735-2137 (fax). mgamber@hotmail.com. Word Count: 1311. Number of Tables: 1. Number of References: 16. Date of Submittal: 4/26/02.Item Identifying and Overcoming Barriers in Clinical Research Management: A Review of Clinical Trials within an Academic Medical Center(2008-12-01) Hatfield, ElishaOver the decades, clinical research has grown and evolved into what one would consider now as the cornerstone of medical advancement. Through the use of clinical trials, new and improved prevention and treatments continue to be discovered. These trials are not only an essential part of the process of drug discovery and development, but are required for drug approval. Conducting these clinical trials takes diligent cooperation between the pharmaceutical industry, government agencies, investigators, and academic medical centers (AMC’s). With the implementation of new regulations as well as continual changes to policies and procedures overseeing clinical research, management of such trials has become a very meticulous and a lengthy process. Additionally, escalating costs of drug development and an increased need for new treatments in the market at faster rates have made the need for more effective and productive means of conducting clinical trials a priority for competitive research sites. With the landscape of clinical research constantly evolving, adaptation of study management and procedures is a continuous hurdle that clinical research sites must overcome. Changes in regulations, limitations of funds and the need for more effective subject recruitment methods are all barriers that most AMC’s are facing today. Finding ways to overcome these obstacles is an essential part of conducting effective and productive clinical trials. In order to keep up with this change and maintain a high quality of research, continual review and audit of current research standards and procedures has become a necessity. Review of standard operating procedures and study documentation can help identify barriers which inhibit the process and initiate appropriate modifications in order to maintain efficient and effective study trials. As such, for this Internship Practicum Project, the intern reviewed the standard procedures and monitored clinical studies with the Gastrointestinal Disease Oriented Team (GI DOT) in an attempt to identify barriers affecting the overall productivity and efficiency of the team. Once these barriers had been outlined, recommendations for changes in standard procedures were made in order to help improve the functionality of the GI DOT and, subsequently, enhance the success of GI protocols within the Simmons Cancer Center Clinical Research Office.Item Implementation of a Pain Management Protocol in Abdominal Surgery Patients Involving an Investigational Fentanyl Patient-Controlled Transdermal System--Issues Involving Patient Enrollment(2005-05-01) Hiraki, Stephanie J.; Harold Sheedlo; Don Peska; John AschenbrennerHiraki, Stephanie J., Implementation of a Pain Management Protocol in Abdominal Surgery Patients Involving an Investigational Fentanyl Patient-Controlled Transdermal System-Issues Involving Patient Enrollment. Master of Science (Clinical Research Management), May 2005, 112 pp., 2 tables, 6 illustrations, bibliography, 42 titles. An open label, randomized, comparative, parallel, phase III multicenter study will be the main focus in the surgery department at the University of North Texas Health Science Center Patient Care Center. The study will evaluate the safety and efficacy of the fentanyl patient-controlled transdermal system (PCTS) versus an intravenous patient controlled anesthesia morphine pump (PCA pump) for abdominal surgery postoperative pain management. Patient enrollment is essential. Slow patient enrollment in clinical trials will lead to a delay in the sponsor’s submission of the investigational product for review and approval from the FDA. The barriers and facilitators to the accrual and retention of patients in this study will be covered.Item Voluntary Hepatitis A Campaigns for Food Handlers and Day Care Workers: Evaluation of Participation and Barriers(2001-05-01) Bosarreyes, Rebecca; Urrutia-Rojas, Ximena; Bayona, Manuel; Lurie, SueBosarreyes, Rebecca L., Voluntary Hepatitis for Food Handlers and Daycare Workers: Evaluation of Participation and Barriers. Master of Public Health (Community Health), May 2001, 84 pp., 20 Tables, references, 32 titles. Food-borne illness is a continuing problem in the United States. Individual’s desire for fast and ready to eat food has contributed to the trend. Ready to eat foods increase risk for spread of viral infections, like hepatitis A. Vaccination of service workers against hepatitis A could decrease this risk. Two recent voluntary vaccination campaigns in North Texas attempted to vaccinate this target group. Both campaigns had low vaccination rates. This study assessed barriers impeding access to the campaigns. Barriers included dissemination of information, knowledge about the disease among the target groups, cost of vaccine, and language spoken by some of the target group. The study findings showed that these barriers combined contribution to the low vaccination rates for the campaign.