Exploring the Association of Physician Characteristics to Patient Requests for Genetic Testing

Background: Cancer genomic testing improves health outcomes for individuals at risk, drives cost-efficiency, and facilitates healthcare equity; however, little is known about how physician demographic and practice characteristics influence patient requests for genetic testing. Purpose: To explore whether (and to what extent) physician demographic and practice characteristics are associated with patient requests for cancer genetic testing. Methods: A cross-sectional quantitative design survey was distributed to 1240 primary care physicians registered with the state health department who had active licenses and main practices in Florida. Primary care physicians were defined as those who practice family medicine, internal medicine, obstetrics, and gynecology. The survey tool was developed from a search of the literature and two previously validated surveys. It was administered using a modified Dillmanstrategy. The study sample size was 317 physicians, with an 85% response rate based upon a targeted sample of 372. Statistical calculations were performed using SPSS version 27 and STATA release 17.Results: Logistic regression model found significant associations between patient requests and physicians\u27 race and professional practice size. Physicians identified as White were 1.840 times as likely to have patient requests for genetic testing (p=.036) than physicians whose race was other than White. Physicians whose professional practices were solo or small groups were 2.39 times as likely to have patient requests (p=.001) than physicians affiliated with larger practices. Discussion: Patient requests may be leveraged by physicians, other healthcare providers, and public health professionals; patient requests present a significant opportunity for increasing genetic testing and thus promoting better health outcomes for patients with Lynch syndrome-related colorectal cancer

An exploration of workforce diversity management principles & practices in nursing homes

There is a lack of research related to workforce diversity (WD) specifically in nursing homes. However, there is a need to understand how WD manifests in nursing homes because nursing homes have several distinct characteristics that are unlike other organizations. The study sought to explore WD among nursing homes. The study aims were to 1) examine how nursing home leaders understand and characterize WD; 2) identify specific diversity management practices currently being implemented in nursing homes; 3) examine how internal factors (i.e. profit status, chain affiliation, Medicaid census, culture change adoption, and workforce racial composition) influence WD management practices; and 4) demonstrate how external factors such as geographic location and community racial composition influence WD management practices. Survey methodology was used to survey 1,111 nursing homes across the Deep South (AL, GA, MS, TN). The 39-item survey included items on participant demographics, racial composition of the staff and residents, knowledge of and attitudes toward WD, culture change adoption, and diversity management practices. The final sample included data for 166 individuals. The sample was predominately Caucasian (90.1%) and 58% female with a mean age of 51 years. The results revealed that managers had positive to neutral attitudes toward diversity and tended to narrowly define diversity using terms more commonly associated with Equal Employment Opportunity/Affirmative Action (EEO/AA) programs, such as race, age gender, and national origin. Recruitment, customer service, and communication/interpersonal skills were most frequently reported as activities associated with diversity. Human resources personnel, administrators, and corporate officers were most likely to initiate diversity management programs. One in five leaders reported having diversity policies that addressed the concept of diversity beyond EEO/AA requirements. The influence of internal and external factors on diversity management perceptions and practices was examined with regression analyses. Among the internal factors, chain affiliation and increasing levels of culture change adoption were found to be significant predictors of diversity management principles and practices. The external organizational factors did not significantly predict diversity management. The current study has implications for long-term care management practice and policy development, as well as diversity management interventions. (Published By University of Alabama Libraries