A Randomized Controlled Trial of Community Health Workers Using Patient Stories to Support Hypertension Management: Preliminary Results

Background: Uncontrolled hypertension is a significant public health problem in the U.S. with about one half of people able to keep blood pressure under control. Furthermore, the social and economic costs of poor hypertension control are staggering. Community Health Worker (CHW) interventions are a low-cost, culturally tailored approach to improve chronic disease outcomes. Methods: This randomized trial conducted at two Community Health Centers (CHCs) in Massachusetts assessed the effect of CHWs assisting patients with hypertension. CHWs, trained in motivational interviewing, used video narratives from patients who have worked to control their BP through diet, exercise, and better medication adherence. Participants enrolled in the study were randomly assigned to immediate intervention or a delayed intervention (DI) (4 to 6 months later). Each participant received a DVD and met with a CHW 5 times (twice in person and three times telephonically) over six months. Results: One hundred seventy-one patients were randomly assigned to one of two treatment conditions. Participants ranged in age from 25 to 79 years old (mean = 56 years old). Seventy-three percent of participants were Hispanic and reported speaking Spanish at home. The intervention group experienced a significant reduction in BP over the 6 month period of time they were receiving the intervention. At 6 months, the average systolic BP declined from 141 at baseline to 136 (p Discussion: Having culturally appropriate tools, such as narrative videos and CHWs trained in motivational interviewing, can be an important, cost effective aid to educate, support, and encourage people to manage hypertension

Operation of the computer model for direct atomic oxygen exposure of Earth satellites

One of the primary causes of material degradation in low Earth orbit (LEO) is exposure to atomic oxygen. When atomic oxygen molecules collide with an orbiting spacecraft, the relative velocity is 7 to 8 km/sec and the collision energy is 4 to 5 eV per atom. Under these conditions, atomic oxygen may initiate a number of chemical and physical reactions with exposed materials. These reactions contribute to material degradation, surface erosion, and contamination. Interpretation of these effects on materials and the design of space hardware to withstand on-orbit conditions requires quantitative knowledge of the atomic oxygen exposure environment. Atomic oxygen flux is a function of orbit altitude, the orientation of the orbit plan to the Sun, solar and geomagnetic activity, and the angle between exposed surfaces and the spacecraft heading. We have developed a computer model to predict the atomic oxygen exposure of spacecraft in low Earth orbit. The application of this computer model is discussed

Psychometric properties of the Impact Index in patients with chronic conditions

The purpose of this paper was to extend the generalizability of the patient-reported Impact Index by assessing convergent validity in patients with common chronic conditions. We conducted a cross-sectional survey of 1,000 English-speaking patients aged 21 and older who visited their provider in the past 6 months and were included in one or more of a hospital’s chronic condition registries. Patients completed a survey that included the Impact Index (4-item measure of how impacted a patient is by their health condition: range 0-12, higher score indicating greater negative impact on quality of life), overall health, and self-report of diagnosis of 8 chronic conditions. Patients were categorized as having symptomatic conditions (one or more symptomatic conditions) or asymptomatic conditions. We hypothesized that Impact Index scores would be negatively correlated with overall health, positively correlated with the number of chronic conditions (using Pearson correlations) and would be higher for symptomatic than asymptomatic conditions (using an independent t-test). Of the 492 respondents (50% response rate), 381/392 eligible respondents completed all Impact Index items. Impact Index scores ranged from 0 to 12 (M=6, SD=4). As reports of overall health increased (i.e., from poor to excellent), Impact Index scores decreased (r=-0.59, p\u3c.001). As the number of chronic conditions increased, so did Impact Index scores (r=0.33, p\u3c.001). Patients with symptomatic conditions reported higher Impact Index scores (M=6.6, SD=3.5) than those with asymptomatic conditions (M=4.1, SD=3.5, p\u3c.001, d=.70). These findings support the validity of the Impact Index for patients with a range of chronic conditions. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

Testing a Planned Missing Design to Reduce Respondent Burden in Web and SMS Administrations of the CAHPS Clinician and Group Survey (CG-CAHPS)

We test a planned missing design to reduce respondent burden in Web and SMS administrations of the CAHPS Clinician and Group Survey (CG-CAHPS), a survey of patient experiences widely used by health care providers. Members of an online nonprobability panel were randomly assigned to one of three invitation and data collection mode protocols: email invitation to a Web survey, SMS invitation to a Web survey, or SMS invitation to an SMS survey. Within these three mode protocols, respondents were randomly assigned to a planned missing design, which shortened the survey by about 40%, or to a control group that received the survey in its entirety. We compare survey duration, breakoff and completion rates, and five key patient experience measures across conditions to assess the effect of the planned missing design across the three modes. We found that a planned missing design worked well with our Web survey, reducing survey duration and breakoff without changing estimates relative to the full-survey control condition. However, mixed findings in the SMS survey suggest that even shortened, 15-item surveys may be too long to substantially reduce respondent burden. We conclude with recommendations for future research

Fishbowl Discussions: Promoting Collaboration between Mathematics and Partner Disciplines

A National Consortium for Synergistic Undergraduate Mathematics via Multi-institutional Interdisciplinary Teaching Partnerships project (SUMMIT-P) is a collaboration of institutions focused on revising first- and second-year mathematics courses with the help of partner disciplines with prerequisite mathematics courses. This paper describes the fishbowl discussion technique used by the consortium members to encourage interdisciplinary conversation. Vignettes describing the results of conversations that occurred at several consortium member institutions are provided by the co-authors

Fishbowl Discussions: Promoting Collaboration between Mathematics and Partner Disciplines

A National Consortium for Synergistic Undergraduate Mathematics via Multi-institutional Interdisciplinary Teaching Partnerships project (SUMMIT-P) is a collaboration of institutions focused on revising first- and second-year mathematics courses with the help of partner disciplines with prerequisite mathematics courses. This paper describes the fishbowl discussion technique used by the consortium members to encourage interdisciplinary conversation. Vignettes describing the results of conversations that occurred at several consortium member institutions are provided by the co-authors

Predictors of patient satisfaction with hospital health care

BACKGROUND: We used a validated inpatient satisfaction questionnaire to evaluate the health care received by patients admitted to several hospitals. This questionnaire was factored into distinct domains, creating a score for each to assist in the analysis. We evaluated possible predictors of patient satisfaction in relation to socio-demographic variables, history of admission, and survey logistics. METHODS: Cross-sectional study of patients discharged from four acute care general hospitals. Random sample of 650 discharged patients from the medical and surgical wards of each hospital during February and March 2002. A total of 1,910 patients responded to the questionnaire (73.5%). Patient satisfaction was measured by a validated questionnaire with six domains: information, human care, comfort, visiting, intimacy, and cleanliness. Each domain was scored from 0 to 100, with higher scores indicating higher levels of patient satisfaction. RESULTS: In the univariate analysis, age was related to all domains except visiting; gender to comfort, visiting, and intimacy; level of education to comfort and cleanliness; marital status to information, human care, intimacy, and cleanliness; length of hospital stay to visiting and cleanliness, and previous admissions to human care, comfort, and cleanliness. The timing of the response to the mailing and who completed the questionnaire were related to all variables except visiting and cleanliness. Multivariate analysis confirmed in most cases the previous findings and added additional correlations for level of education (visiting and intimacy) and marital status (comfort and visiting). CONCLUSION: These results confirm the varying importance of some socio-demographic variables and length of stay, previous admission, the timing of response to the questionnaire, and who completed the questionnaire on some aspects of patient satisfaction after hospitalization. All these variables should be considered when evaluating patient satisfaction

Geriatric oncology health services research: Cancer and Aging Research Group infrastructure core

Founded by the late Dr. Arti Hurria, the Cancer and Aging Research Group (CARG) is a collaborative, interdisciplinary team of investigators dedicated to improving the care of older adults with cancer through research, advocacy, and other scholarly initiatives.1 As part of the CARG National Institute on Aging R21/R33 infrastructure grant to harness the available expertise and prioritize the development of high-impact research, the Health Services Research (HSR) Core was developed to foster and advance HSR in geriatric oncology. The mission of the HSR Core is to support clinical investigators to design and conduct highquality HSR focused on older adults with cancer and their caregivers including patterns of care, comparative effectiveness, and care delivery. At the first R21/R33 conference held at City of Hope in October 2018, Dr. Harvey Jay Cohen (Chair, CARG Oversight Board and HSR Core) led the development of this Core. In this perspective paper, we present a review of HSR in geriatric oncology to build a foundation for the Core rationale; proposed Core function, workflow, policies, and procedures; anticipated interactions with other CARG Cores; and proposed plans for sustainabilit