6 research outputs found
Strides for Change: Incentivizing Hispanic Youth to Promote Exercise, Fitness and Wellbeing
The United Way of Western Connecticut\u27s 2014 annual report on Danbury\u27s Young Children found that Danbury\u27s children are facing many physical fitness challenges compared to the state of CT. A study looking at 4th graders in a physical fitness test finds that Danbury students consistently have a harder time passing the fitness test. Of the population studied, 42.5% were ethnically Hispanic.https://scholarworks.uvm.edu/fmclerk/1045/thumbnail.jp
Happy Feet: Podiatric Needs of the Burlington Homeless Population
Introduction. Many homeless individuals spend a large portion of their days standing or walking, placing particular importance on lower extremity health in this population. However, few studies have been performed to investigate the podiatric needs of this group.https://scholarworks.uvm.edu/comphp_gallery/1195/thumbnail.jp
Sustainment of the TeleSleep program for rural veterans
BackgroundIn fiscal year 2021, the Veterans Health Administration (VHA) provided care for sleep disorders to 599,966 Veterans, including 189,932 rural Veterans. To further improve rural access, the VA Office of Rural Health developed the TeleSleep Enterprise-Wide Initiative (EWI). TeleSleep's telemedicine strategies include tests for sleep apnea at the Veteran's home rather than in a sleep lab; Clinical Video Telehealth applications; and other forms of virtual care. In 2017 and 2020, VHA provided 3-year start-up funding to launch new TeleSleep programs at rural-serving VA medical facilities.MethodsIn early 2022, we surveyed leaders of 24 sites that received TeleSleep funding to identify successes, failures, facilitators, and barriers relevant to sustaining TeleSleep implementations upon expiration of startup funding. We tabulated frequencies on the multiple choice questions in the survey, and, using the survey's critical incident framework, summarized the responses to open-ended questions. TeleSleep program leaders discussed the responses and synthesized recommendations for improvement.Results18 sites reported sustainment, while six were “on track.” Sustainment involved medical centers or regional entities incorporating TeleSleep into their budgets. Facilitators included: demonstrating value; aligning with local priorities; and collaborating with spoke sites serving rural Veterans. Barriers included: misalignment with local priorities; and hiring delays. COVID was a facilitator, as it stimulated adoption of telehealth practices; and also a barrier, as it consumed attention and resources. Recommendations included: longer startup funding; dedicated funding for human resources to accelerate hiring; funders communicating with local facility leaders regarding how TeleSleep aligns with organizational priorities; hiring into job classifications aligned with market pay; and obtaining, from finance departments, projections and outcomes for the return on investment in TeleSleep
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Cost and Outcomes Analysis of Polypoidal Choroidal Vasculopathy (Aneurysmal Type 1 Neovascularization) Treatment Strategies
Purpose: This work compares the relative cost utility of ranibizumab and aflibercept with and without verteporfin photodynamic therapy (vPDT) for the treatment of polypoidal choroidal vasculopathy. Methods: A retrospective cost and outcomes analysis of the PLANET (Efficacy and Safety of Intravitreal Aflibercept for Polypoidal Choroidal Vasculopathy) and EVEREST II (Efficacy and Safety of Ranibizumab With or Without Verteporfin Photodynamic Therapy for Polypoidal Choroidal Vasculopathy) studies was performed. Clinical utilization and outcomes were based on data from these clinical trials, and costs were obtained from Medicare fee schedules. Cost utility was derived from published visual outcomes and expressed as quality-adjusted life-years (QALYs). Cost per QALY and cost per line of vision gained for each treatment strategy (in US dollars) were assessed as the main outcome measure. Results: The 1-year facility (nonfacility) costs per QALY were 260,088.19), 182,831.77), 188,425.33), and 189,703.05) for ranibizumab as-needed monotherapy, ranibizumab as-needed with combination therapy, aflibercept monotherapy, and aflibercept with delayed vPDT combination therapy, respectively. Conclusions: Ranibizumab as-needed monotherapy was the least clinically effective and least cost efficient over 1 year. Ranibizumab as-needed with combination therapy, aflibercept monotherapy, and aflibercept with deferred vPDT combination therapy all had similar overall cost utility at 1 year. If bevacizumab were to be substituted for ranibizumab, the cost per QALY could be reduced by approximately a factor of 5, showing the benefit of bevacizumab for increasing the cost utility of polypoidal choroidal vasculopathy treatment
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Sustainment of the TeleSleep program for rural veterans.
BACKGROUND: In fiscal year 2021, the Veterans Health Administration (VHA) provided care for sleep disorders to 599,966 Veterans, including 189,932 rural Veterans. To further improve rural access, the VA Office of Rural Health developed the TeleSleep Enterprise-Wide Initiative (EWI). TeleSleeps telemedicine strategies include tests for sleep apnea at the Veterans home rather than in a sleep lab; Clinical Video Telehealth applications; and other forms of virtual care. In 2017 and 2020, VHA provided 3-year start-up funding to launch new TeleSleep programs at rural-serving VA medical facilities. METHODS: In early 2022, we surveyed leaders of 24 sites that received TeleSleep funding to identify successes, failures, facilitators, and barriers relevant to sustaining TeleSleep implementations upon expiration of startup funding. We tabulated frequencies on the multiple choice questions in the survey, and, using the surveys critical incident framework, summarized the responses to open-ended questions. TeleSleep program leaders discussed the responses and synthesized recommendations for improvement. RESULTS: 18 sites reported sustainment, while six were on track. Sustainment involved medical centers or regional entities incorporating TeleSleep into their budgets. Facilitators included: demonstrating value; aligning with local priorities; and collaborating with spoke sites serving rural Veterans. Barriers included: misalignment with local priorities; and hiring delays. COVID was a facilitator, as it stimulated adoption of telehealth practices; and also a barrier, as it consumed attention and resources. Recommendations included: longer startup funding; dedicated funding for human resources to accelerate hiring; funders communicating with local facility leaders regarding how TeleSleep aligns with organizational priorities; hiring into job classifications aligned with market pay; and obtaining, from finance departments, projections and outcomes for the return on investment in TeleSleep