Browsing by Subject "health"
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Item HEALTH PROFESSIONALS’ ATTITUDES TOWARDS THE HOMELESS(2014-03) Burdex, Ashley; Nejtek, Vicki; Talari, Deepika; Koehl, StevenPurpose (a): About 50% of Tarrant County homeless (n=2,123) have co-occurring medical disorders, receive inconsistent medical care, are at high risk for repeated crisis care hospitalization, and are often discharged prior to full stabilization.1,2 Whether or not medical crisis recidivism is influenced by clinical attitudes towards treating the homeless is uncertain. Here, we examined medical student, resident, and physician attitudes about the homeless condition and treating homeless patients. We hypothesize that medical students MS 1-4, residents, and physicians significantly differ in their attitudes in treating homeless patients. Methods (b): A prospective, cross-sectional between-group comparison of the attitudes towards treating homeless patients among medical school students, residents, and physicians (n=238) was conducted. Data were analyzed using analysis of variance (ANOVA) and Chi-square procedures. Statistical significance was determined using a 95% confidence interval and a probability alpha of 0.05. Results (c): The MS 1-2, residents, and physicians showed more empathy and had a higher interest in treating homeless patients than MS 3-4 (p=0.004). In contrast to other groups, MS 3-4 regard homeless people as lazy (p=0.001) and rude (p=0.028). Compared to medical students, physicians and residents believe that health dollars should be directed toward serving the poor and homeless (p=0.001). In comparison to physicians, MS 3-4 do not perceive homelessness as a health issue (p=0.002), and all medical students judged that government should not waste money on homelessness (p=0.001). Further, compared to other groups (especially physicians), MS 3-4 reported that alcoholism is a personal weakness (p=0.003) rather than a medical illness and think that clinicians should only address physical and not social problems (p=0.014). Conclusions (d): Overall, MS 3-4 are significantly more cynical and judgmental about the homeless condition and treating homeless patients than any other group. The lack of biological insight about the medical needs of the poor and homeless expressed by MS 3-4 is truly concerning. These data indicate a critical need for specialized education that will better inform medical students about socioeconomic conditions that significantly influence medical disease onset, etiology and prognostic outcomes in this vulnerable, complex, and difficult-to-treat patient population.Item MEDICAL SCHOOL EMPLOYEE HEALTH COMPARED TO STATE AND NATIONAL AVERAGES(2014-03) Lovell, Andrew J.; Nejtek, Vicki A.; Talari, Deepika; Ake, Steven; Filipetto, FrankPurpose (a): The 2012 Center for Disease Control (CDC) survey found 65.1% of Texans and 63.9% of U.S. citizens’ body mass index (BMI) is >25 indicating that most Americans are overweight or obese.1 Health data for medical school employees in comparison to state and national averages is scarce. Here, we examined the health status and behaviors of medical school employees to determine the influence of the health promotion environment. We hypothesized that medical school employees are healthier than the state and national averages. Methods (b): A prospective study was conducted to examine medical school employee health status and behaviors. Vital signs, weight, fat percentage, random serum glucose, exercise, and sleep were primary outcomes measured. Subjects completing the study received $1 compensation. Frequencies and chi-square analyses were performed using SPSS (version 19). A 95% confidence interval and an alpha of 0.05 were used to determine significance. Results (c): Sixty-nine employees volunteered to participate. We found that BMI (25.8 + 5.5) was slightly higher than the recommended range (18.5-24.9). Almost 45% of participants were slightly overweight edging towards obesity (BMI >25). Mean systolic/diastolic blood pressure was 125/79 mmHg (normal=120/80). Mean body fat % for men (17.2) was within the recommended range (15-20%), but was slightly higher for women (31.8 vs. 24-30%). However, these values are substantially lower than the national average (28.1 = men, 39.8 = women). Significant race/ethnicity differences in BMI were evident. Conclusions (d): Based on the recommended values and the state and national averages, these data suggest that medical school employees seem to have healthier physiology than the general population. Although prevalence of overweight and obesity in our sample is better than the state and national averages, these values are still higher than the recommended range. Working in a medical school environment may offer some protective factors, but more work is needed to reduce body weight. These preliminary data interpretations are limited due to a small sample size.Item Menopause Clinical Education Aid(2008-01-01)Item Rural Vs. Urban Residents and Obesity in Texas(2005-05-01) Ohagi, Emeka J.; Borders, Ty; Hilsenrath, Peter; Cardarelli, KathrynOhagi, Emeka J., Rural vs. Urban Residents and Obesity in Texas. Master of Public Health (Health Informatics), May 2005, 52 pp., 3 tables, bibliography, 90 titles. Obesity in the United States has been described as an epidemic and Texas has been identified as one of the most obese states in the country. The purpose of this study is to examine obesity among Texas adults in order to determine if there are differences in obesity levels based on residence, and to explore the influence of other demographic, socioeconomic, health and behavioral factors on the distribution of obesity. Results indicate that urban and suburban dwellers are less likely than rural dwellers to be obese (adj. OR=0.64; 0.68, respectively). However, residents of frontier communities have slightly higher odds of obesity (adj. OR=1.09) than rural residents. Age was found to be an important factor in obesity. It is hoped that these and other results will facilitate appropriate channeling of public health response.Item The Impact of Graduation and Work on Health and Behavior(2006-08-01) Minzenmayer, Tracey; Watson, Warren; Townsend, Alicia; Franks, SusanMinzenmayer, Tracey. The Impact of Graduation and Work on Health and Behavior. Doctor of Philosophy (Biomedical Sciences), August, 2006, 131 pp., 1 table, references, 125 titles. The transition of young adults from the educational system to the workplace is affected by individual, cultural, economic, and institutional factors within the specific context of the time of transition. Since World War II, there have been a number of changes in both the order and timing of reaching the traditional markers of adulthood such as financial independence, work, marriage, and children. The lack of guidance in navigating the new path to adulthood has resulted in anecdotal evidence of increased stress in young adults. Little health research has been conducted on new graduates to evaluate the sources and effects of this stress. The current study surveyed psychological distress, health behaviors, and occupational variables in young adults between one and four years after they had received their undergraduate degrees. The majority of the sample believed they could potentially perform their job duties without the benefit of their degree, and over a third regretted their choice of major. A fourth of the sample had jobs that were unrelated to their undergraduate degrees. Underemployment, or not making use of their college education, was strongly associated with depression and worry in the respondents. Having adequate social support had positive relationships with job satisfaction and organizational commitment and was associated with low levels of stress, depression, anxiety, sleep difficulties, and worry. High levels of stress, anxiety, and depression were associated with less sleep. Unfortunately, this study was limited by a small number of respondents, but it is still clear that many graduates are not experiencing all of the benefits of having a college degree. There appears to be a discrepancy between their education and the demands of the workplace. It is recommended that institutions of higher education and employers find ways to address this discrepancy and to better guide graduates through the transition.Item Utilizing PRISM and RE-AIM to implement and evaluate the Rural Telementoring Training Center (RTTC) for health care workforce development in rural communities(Frontiers Media S.A., 2023-11-06) Melhado, Trisha V.; Schneegans, Suyen; Rochat, Andrea; Kawasaki, Keito; Finley, Erin P.; Wheeler, Denna; Allison, Waridibo E.INTRODUCTION: Amid rural health worker shortages and hospital closures, it is imperative to build and maintain the local workforce. Telementoring (TM) or technology-enabled mentoring, is a tool for improving health care quality and access by increasing workforce capacity and support. The national Rural Telementoring Training Center (RTTC) was developed to compile and disseminate TM best practices by delivering free training, tools, and technical assistance to support the implementation, sustainability, and evaluation of new and current TM programs for rural health workers. This paper details how the Practical, Robust Implementation and Sustainability Model (PRISM) was used to understand the context that shaped implementation as well as how Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) was concurrently applied to frame outcomes. METHODS: The RTTC has three implementation strategies: outreach, training and technical assistance (TTA), and a Quality Measure Toolkit. Ongoing periodic reflections with the RTTC team, informed by PRISM, were collected, as were RE-AIM outcomes. Central to this design was the continuous review of incoming data in team meetings to inform programmatic changes by identifying challenges and applying modifications to strategies in real time. RESULTS: Major implementation changes discussed during reflections included providing timely and relevant messaging through various platforms, streamlining and customizing a TTA approach, and offering different options for accessing the Toolkit. The outreach strategy resulted in high Reach across the US, with over 300 organizations contacted. The effectiveness of the RTTC was demonstrated by counts of people engaging with outreach (ex. over 8,300 impressions on LinkedIn), the website (over 6,400 views), and e-bursts (33% open rate). Moreover, there were 32 TTA requests and 70 people accessing the Toolkit. Adoption was demonstrated by 27 people participating in TTA and 14 individuals utilizing the Toolkit. DISCUSSION: The integration of PRISM and RE-AIM frameworks promoted a holistic implementation and evaluation plan. Using PRISM, the RTTC team was able to reflect on the implementation strategies through the lens of contextual factors and make rapid programmatic changes within team meetings. That process resulted in outcomes framed by RE-AIM. The integration of two frameworks in tandem provided an adaptive and comprehensive approach to implementing a large-scale, national program.