Assessment of Trends in Population-Based Health Indicators in the Great Plain States

Purpose/Objective: The objective of this study is to analyze the geographic trends and to highlight the importance of social and geographic based health disparities using population health indicators and Health determinants among the great plains states (Nebraska, North Dakota and South Dakota). Methods/efforts: Online databases (CDC, BRFSS, America’s Health Rankings, SAMHSA, County health rankings etc) were accessed to collect data population-based data for the great plains states. The incident rates of 10 health indicators and health determinants were chosen and studied. After tabulating the data in excel, the analysis was made through plotting graphs in SAS. Line graphs depicting the increase/decrease in the incidence rates were obtained describing the changes in trends with respect to each of the health indicators over the past decade. Results/findings: Among the 10 health indicators/determinants studied, the incidences of death due to alcohol-impaired driving and Chlamydia were significantly higher than the national average. The use of cigarettes among youths between the age range of 12-17 has shown a steep decline over the years. Application to the field/research: Health indicators are important tools used in the assessment of the overall health of the population. It could help in prioritizing the area of focus for improvement. It can depict the impact and disease burden, of the condition in the area. Influence new policy-making. Indicate the need for evaluations of the existing policies and interventions. Population trends give a representation of the success or failure of the health policies and interventions and gives an idea of the progress of the current healthcare programs and allocation of resources. The data also provides a source of comparison between the three states and draws attention towards improving the health outcomeshttps://digitalcommons.unmc.edu/coph_pres/1012/thumbnail.jp

Determinants of Facilitated Health Insurance Enrollment for Patients With HIV Disease, and Impact of Insurance Enrollment on Targeted Health Outcomes.

BACKGROUND: The introduction of the Affordable Care Act (ACA) has provided unprecedented opportunities for uninsured people with HIV infection to access health insurance, and to examine the impact of this change in access. AIDS Drug Assistance Programs (ADAPs) have been directed to pursue uninsured individuals to enroll in the ACA as both a cost-saving strategy and to increase patient access to care. We evaluated the impact of ADAP-facilitated health insurance enrollment on health outcomes, and demographic and clinical factors that influenced whether or not eligible patients enrolled. METHODS: During the inaugural open enrollment period for the ACA, 284 Nebraska ADAP recipients were offered insurance enrollment; 139 enrolled and 145 did not. Comparisons were conducted and multivariate models were developed considering factors associated with enrollment and differences between the insured and uninsured groups. RESULTS: Insurance enrollment was associated with improved health outcomes after controlling for other variables, and included a significant association with undetectable viremia, a key indicator of treatment success (p \u3c .0001). We found that minority populations and unstably housed individuals were at increased risk to not enroll in insurance. CONCLUSION: The National HIV/AIDS Strategy calls for new interventions to improve HIV health outcomes for disproportionately impacted populations. This study provides evidence to prioritize future ADAP-facilitated insurance enrollment strategies to reach minority populations and unstably housed individuals

Barriers and Promoters of Retention of Direct Care Workers in Community Mental Health Agencies

Demand for behavioral health direct-care providers is increasing due to shortage of licensed behavioral health providers. However, high turnover has been reported among them with limited exploratory research. The present study aimed to identify a wide variety of barriers and promoters of retention and strategies to retain direct care workers. An online, self-administered survey designed to measure demographics, job satisfaction, perceived importance of various job aspects, intention to leave, perceived stress and sources of stress was administered among 179 direct care workers from four agencies. Multiple logistic regression exhibited higher odds of intending to leave for those who had higher general perceived stress (OR=1.3, CI=1.1-1.7) and those who experienced stress from supervisor (OR=5.0, CI=1.7-14.4) and organizational culture (OR=4.2, CI=1.1-18.4). Work-related stress is a prevalent issue among direct-care providers and may be associated with turnover. Policy formulation and implementation directed at strategies to reduce stress may be warranted to improve retention.https://digitalcommons.unmc.edu/bhecn_report/1000/thumbnail.jp

Gaps in Survey Data on Cancer in American Indian and Alaska Native Populations: Examination of US Population Surveys, 1960-2010

INTRODUCTION: Population-based data are essential for quantifying the problems and measuring the progress made by comprehensive cancer control programs. However, cancer information specific to the American Indian/Alaska Native (AI/AN) population is not readily available. We identified major population-based surveys conducted in the United States that contain questions related to cancer, documented the AI/AN sample size in these surveys, and identified gaps in the types of cancer-related information these surveys collect. METHODS: We conducted an Internet query of US Department of Health and Human Services agency websites and a Medline search to identify population-based surveys conducted in the United States from 1960 through 2010 that contained information about cancer. We used a data extraction form to collect information about the purpose, sample size, data collection methods, and type of information covered in the surveys. RESULTS: Seventeen survey sources met the inclusion criteria. Information on access to and use of cancer treatment, follow-up care, and barriers to receiving timely and quality care was not consistently collected. Estimates specific to the AI/AN population were often lacking because of inadequate AI/AN sample size. For example, 9 national surveys reviewed reported an AI/AN sample size smaller than 500, and 10 had an AI/AN sample percentage less than 1.5%. CONCLUSION: Continued efforts are needed to increase the overall number of AI/AN participants in these surveys, improve the quality of information on racial/ethnic background, and collect more information on treatment and survivorship

Substance use disorders in the farming population: Scoping review

Purpose The purpose of this scoping review is to summarize the current knowledge base in order to make recommendations for prevention and treatment of substance use disorders among the farming populations. Methods We conducted a scoping review of peer-reviewed articles published between January 1989 and September 2019. The search yielded 3,426 citations and the final review was conducted on 42 articles. The full review was conducted by 4 authors to extract information about the target population, data collection methods, and main results. Findings There were 21 articles on farmers and 21 articles on farmworkers. The majority of the articles were about alcohol. Overall, farmers had higher prevalence of risky alcohol consumption patterns than nonfarmers. The prevalence of risky alcohol consumption was also high among farmworkers compared to the general population. Risk factors for risky alcohol consumption included male gender, lower socioeconomic status, and psychological problems (eg, depression). Recommendations for prevention and intervention of alcohol disorders included policy development and implementation to curb alcohol access by taxation, screening of alcohol-related problems, and alternative means of recreation instead of alcohol consumption. Conclusions This review confirmed that alcohol-related problems are prevalent among farmers and farmworkers. More population-based research is called for to understand the additional risk factors of alcohol disorders and the prevalence of other substance-related disorders. Also, interventions should be tailored to the unique culture of farmers and farmworkers

Matters of Trust: A Comparison of Patient-Provider Trust in Colorectal Cancer Survivors Using the Trust in Oncologist Scale

Objective: Trust is a vital component of the patient-provider relationship. Higher trust is associated with increased adherence to treatment and improved outcomes. The purpose of this study was to compare colorectal cancer (CRC) survivors\u27 reported trust toward their primary care physician (PCP) and oncologist (ONC). Methods: CRC survivors (n=62) were surveyed using the Trust in Oncologist (TiOS) instrument that assessed five domains (honesty, fidelity, caring, competence, and global/overall) using a 5-point Likert scale. Social and demographic variables were analyzed using nonparametric tests. Results: Mean trust was higher toward the ONC compared to the PCP across all TiOS domains (P=0.001-0.023). Trust was lowest in the competence and caring domains for both ONC and PCP. Younger age was associated with lower trust compared to older age (P=.0002, P=0.018). Higher cancer stage was associated with significantly lower trust toward PCP (P=0.074). Conclusion: Results confirm the importance of trust between cancer patients and physicians. Although CRC survivors report high overall trust toward their oncologist, they do not always believe their oncologist is competent to treat their disease. We propose the novel concept of Forced Attachment Theory to explain the phenomenon of an obligated sense of attachment from CRC patients toward their treating physicians

Evaluation of Theoretical Frameworks to Detect Correlates of HPV Vaccination in the Midwest, US, Using Structural Equation Modeling

Knowledge of a valid, well-designed, and targeted theory-based framework helps better characterize reasons for HPV vaccine hesitancy and identify promising approaches to increase vaccination rates for eligible individuals. This study evaluated health theories in explaining factors affecting HPV vaccination and used a theoretical framework to identify direct and indirect predictors and mediators of HPV vaccination. A cross-sectional survey regarding HPV vaccine uptake and related factors was conducted among 1306 teenagers and young adults in the Midwest, US, in March and April 2023. Structural equation modeling confirmed fit of the framework based on the Integrated Health Theory (IHT) to the HPV vaccine data (Comparative Fit Index = 0.93; Tucker-Lewis Index = 0.92; Root Mean Square Error of Approximation = 0.053). While willingness to uptake the HPV vaccine directly predicted increased uptake (p \u3c 0.001), perceived benefits (p \u3c 0.001) and barriers (p \u3c 0.023) about the vaccine indirectly predicted increased and decreased uptake, respectively. In turn, beliefs about susceptibility (p = 0.005) and severity (p \u3c 0.001) of HPV infection and associated cancers and barriers to vaccination in general (p \u3c 0.001) indirectly predicted willingness to uptake the vaccine. In conclusion, IHT can be appropriate in examining predictors of HPV vaccine uptake in teenagers and young adults in the US, particularly in the Midwest

Quality of Life among Cancer Survivors: Comparison of Multiple Cancers Using iCaRe2

Background: The number of cancer survivors continues to increase due to dramatic improvements in cancer treatment, accounting for approximately 5% of the entire population. As cancer survivors continue to live longer, it is important to understand their quality of life (QoL) in order to maximize supportive care efforts. Objectives: In this study, the quality of life (QoL) among patients with different types of cancer was examined. The objectives were to: 1) compare patient-reported outcome measures of QoL using the Short-Form (SF-36) Health Survey scores among patients of different cancer types and 2) identify demographic, oncologic, and clinical factors that are associated with SF-36 QOL scores. Methods: We performed a retrospective review of prospectively collected data from a multi-center cancer registry data collected between January 2007 and February 2020. Multiple linear regression analysis was conducted to identify demographic and clinical factors that are associated with SF-36 Physical Component Score (PCS) and Mental Component Score (MCS). Findings: Both mental and physical aspects of QoL were affected in all cancer patients, regardless of the type, prognosis, and time since diagnosis and treatment. Individual, socioeconomic, disease, and treatment-related variables were associated with QoL among different cancer populations and should be addressed as part of shared treatment decision-making