Dissertations / Theses on the topic 'Preventative health services'

Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and health education. The health belief model was used to determine how belief and modifying factors influence health decisions. The quantitative study required use of a secondary dataset to determine utilization of preventative care services, insurance affordability, future access to care and understanding of the health care law. The study included testing the statistical significance of these factors among African Americans, White Americans, and Hispanic Americans who participated in the Healthy Americas Survey. Using the program SPSS to process data analyzation and organize output, results reveal that African American participants are concerned about the future ability to access and afford care. With a history of distrust amongst African Americans and the health industry, social implications are for administrators and providers to bridge the gap by offering health education to those in their immediate communities and requesting and implementing feedback from those same individuals.

Thesis (M.P.A.)--Kutztown University, 1996.
Source: Masters Abstracts International, Volume: 45-06, page: 2937. Abstract precedes thesis as [3] preliminary leaves. Typescript. Includes bibliographical references (leaves [3]).

Thesis (Ph.D.) -- University of Western Sydney, 2005.
"A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy, College of Social and Health Sciences, University of Western Sydney, 2005." Includes bibliographical references and appendices.

Men have low use of transformative health services but compared to women, are more likely to die younger and from something preventable. This research is the first to find, while usually assumed to be resilient, privileged groups such as men experience likely customer vulnerability. Three quantitative studies using secondary panel data and an online survey were conducted finding also the effect of masculine norms on men’s health service use is dependent on service context, social generation, and conformity. The research is the first to find masculine norms and value co-destruction behaviours are key indicators of men’s customer experience of vulnerability.

Globally the diabetes epidemic is a major health challenge. Associated with the diagnosis of diabetes is the morbidity and premature mortality stemming from the complications of the disease. It was identified that approximately 50% of clients who attended a diabetes centre in an outer western metropolitan region of Sydney were not completing diabetes education. A strategy employed to overcome this was the introduction of a 2 ½ hour group diabetes education program called the Ongoing Education System (OES), for persons with Type 2 diabetes, that enabled completion of education at this one session. However, debate occurred among health professionals at the Wentworth Diabetes Service (WDS) as to the effectiveness of the OES as compared to the traditional individual education sessions. (one-on-one education). The purpose of this study was to compare the outcomes of two modes of diabetes education for completing education for clients with Type 2 diabetes , namely individual education (Treatment A) and the OES group education (Treatment B). The findings overall revealed no difference in the outcomes of participants who received individual education and those who received the OES at completion of education as well as at 6 and 12 month post education. A secondary finding of this study was the significant influence gender and age exerted on the outcomes of the education programs. One significant implication from the findings for both the person diagnosed with Type 2 diabetes and the health care organisation is that the OES provides a cost effective alternative to individual education that encourages clients to complete diabetes education thereby enabling the person to achieve an optimal quality of life. In addition this study provides research evidence for the benefit of current practice in diabetes education.

Thesis (MEng)-- Stellenbosch University, 2013.
ENGLISH ABSTRACT: South Africa’s health sector has not yet shown enough improvement to reach the Millennium Development Goals related to health. One of the problem areas is the low infant and child vaccination coverage in certain areas of South Africa. The use of mobile phones in health care (mHealth) has the potential to strengthen the primary health care system through improved information management. A mobile health solution for vaccination (MHSV) can be used to improve information management of vaccinations, which in turn can improve vaccination coverage. However, the feasibility of implementing such an MHSV in the South African context is unknown. This study therefore investigates the feasibility of using mobile phones to improve information management for child vaccinations in South Africa. Feasibility is determined by using a feasibility framework together with business model development. The feasibility framework, which is informed by a literature study, surveys and a case study, determines the feasibility of an MHSV in terms of human factors, technical feasibility, information management, policies and ethics, and economics. It is found that an MHSV is feasible in South Africa, although certain areas pose challenges that will have to be considered. Complementing the feasibility framework, business models are developed to suggest possible ways in which an MHSV can be deployed in South Africa. These models build on the results from the feasibility framework and are developed using Osterwalder’s business model canvas. The effect of the National Health Insurance (NHI) on these business models is also examined. In order to validate the feasibility framework and business models, interviews were held with experts in health care and mobile phone solutions. These interviews show that the research is valid and that the feasibility framework and business models can be generalised to the wider field of mHealth solutions.
AFRIKAANSE OPSOMMING: Suid-Afrika se gesondheidsektor het nog nie genoeg verbetering getoon om die gesondheidsverwante Millenium Ontwikkelingsdoelwitte te bereik nie. Een van die probleemareas is die besondere lae inentingsdekking van babas en kinders in sekere gebiede van Suid-Afrika. Die gebruik van selfone vir gesondheidsorg hou die potensiaal in om die primêre gesondheidsorgstelsel te versterk deur inligtingsbestuur te verbeter. ’n Inentingsoplossing wat gebruik maak van selfone, bekend as ‘n “mobile health solution for vaccination” (MHSV), kan inligtingsbestuur van inentings verbeter, wat hoër inentingsdekking tot gevolg kan hê. Die haalbaarheid van die implementering van so ’n MHSV in die konteks van Suid-Afrika is egter onbekend. Hierdie studie ondersoek dus die haalbaarheid daarvan om selfone te gebruik vir beter inligtingsbestuur van kinder-inenting in Suid-Afrika. Haalbaarheid word vasgestel deur ’n haalbaarheidsraamwerk en die ontwikkeling van besigheidsmodelle te gebruik. Die haalbaarheidsraamwerk, wat toegelig word deur ’n literatuurstudie, vraelyste en ’n gevallestudie, bepaal die haalbaarheid van ’n MHSV in terme van menslike faktore, tegniese haalbaarheid, inligtingbestuur, beleid en etiek, en ekonomie. Daar word gevind dat ’n MHSV haalbaar is in Suid-Afrika, alhoewel sekere areas uitdagings inhou. Die haalbaarheidsraamwerk word aangevul deur die ontwikkeling van besigheidsmodelle wat moontlike maniere voorstel waarop ’n MHSV in Suid-Afrika ontplooi kan word. Hierdie modelle word geskoei op die resultate van die haalbaarheidsraamwerk en word ontwikkel met behulp van Osterwalder se besigheidsmodelskema (“business model canvas”). Die effek van die nasionale gesondheidversekering op hierdie modelle word ook ondersoek. Onderhoude met kundiges in die veld van selfoonoplossings vir gesondheidsorg word gebruik om die haalbaarheidsraamwerk en die besigheidsmodelle te valideer. Die onderhoude toon dat die navorsing geldig is en dat die haalbaarheidsraamwerk en besigheidsmodelle veralgemeen kan word na die wyer veld van selfoonoplossings vir gesondheidsorg.

Although evidence is currently available for population-based genetic screening and testing of individuals and their family members for certain hereditary chronic disease conditions (Tier 1), few states have integrated these genomic applications into chronic disease prevention programs. State and territorial chronic disease directors (CDDs) could provide the leadership needed to deliver these applications in more states. The purpose of this study was to determine whether an association exists between current chronic disease genomics funding or specific state genomic activities and the level of knowledge and interests in genomics by these directors. Rogers's diffusion of innovations (DIT) theory was used to explain the current climate of state chronic disease genomics and the need for an innovation champion to promote these evidence-based applications both in and out of the state health departments. A nonexperimental, cross-sectional, correlational survey of CDDs (N = 58) was performed using the Chronic Disease Director's Survey and results were analyzed using chi-square, independent t test, ANOVA, logistic regression, and Pearson's correlation coefficient. Results showed CDDs knowledge of genomics is unrelated to current state funding; however, CDD knowledge and interest in genomics was associated with inclusion of genetics in cancer control and cardiovascular health action plans, Tier 1 condition education, privacy and nondiscrimination laws, Behavioral Risk Factor Surveillance System (BRFSS) genomics questions, and frequent collaborations with outside entities. These results provide clear ideas to increase CDDs knowledge and interest in chronic disease genomics and potentially impact Tier 1 genomics implementation in more states.

Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban University of Technology, 2013.
Background: Considering the quadruple burden of disease and chronic shortages of health care professionals in South Africa, the stance of the chiropractic profession on public health (PH) matters has not been established. Therefore, this study aimed to determine the attitudes and perceptions of chiropractors practicing in South Africa on PH, health promotion (HP) and disease prevention (DP). The objectives were to determine demographic profile, lifestyle practices and attitudes and perceptions of practicing chiropractors in South Africa regarding PH agencies, HP and DP. Methods: An IRB approved quantitative survey (electronic and postal) was used to collect data from a total sample of practicing chiropractors in South Africa (meeting inclusion criteria). Follow up email and telephone calls were made to encourage response from participants. After a 17 - week period, returned questionnaires were collected and data analysed. Results: A response rate of 45% was obtained. Of the participants, 51.7% were female, 60.3% practiced in upper – middle income communities and 66.4% perceived themselves as neuro - musculoskeletal specialists. Over 90% of practitioners regularly counselled patients on postural habits, injury prevention and ergonomic risk reduction. Where as 35.1% agreed to counselling patients on STI / HIV prevention, tobacco cessation and related risks (41.4%), alcohol abuse (53.4%) and cancer prevention (56.9%). Regarding evidence – based practice (EBP) and PH agencies, 39.1% could not identify the statistical significance of the p value and 46% were unable to provide examples to journals they used to inform best practice. Similarly, 59% of the participants could not identify PH agencies to refer to for information on smoking cessation / risks or PH agencies to refer patients on HIV (57%), notifiable diseases (59%) and terminal illnesses (45%). Conclusion: The results suggest that chiropractors from this study were proficient on topics of DP, but were reletively less proficient in regards to PH, HP and EBP. It was recommended that further research be done regarding EBP within the profession and that greater emphasis be placed on topics of HP and PH in chiropractic training programmes.

This project examined the extent to which Nova Scotian adolescents’ counselling needs are being met with respect to physical, sexual, substance use, and psychosocial health by their family physicians. This was accomplished by assessing how well Nova Scotian physicians provide preventative advice consistent with the Guidelines for Adolescent Preventative Services (GAPS). Analyses were performed using pooled data from surveys carried out in 2003 and 2006. Descriptive analyses, Poisson and logistic regression were used to examine associations of sociodemographic characteristics, need, and the presence of school based health centres (SBHCs) with the provision of advice. Advice was not well provided and appeared to be need-driven. Females were significantly more likely to be provided advice and respondent access to a SBHC increased the likelihood of advice being provided. These results have implications for policy and practice, specifically, ways to refine preventative healthcare services for the province’s adolescents to ensure optimal care.

Globally the diabetes epidemic is a major health challenge. Associated with the diagnosis of diabetes is the morbidity and premature mortality stemming from the complications of the disease. It was identified that approximately 50% of clients who attended a diabetes centre in an outer western metropolitan region of Sydney were not completing diabetes education. A strategy employed to overcome this was the introduction of a 2 ½ hour group diabetes education program called the Ongoing Education System (OES), for persons with Type 2 diabetes, that enabled completion of education at this one session. However, debate occurred among health professionals at the Wentworth Diabetes Service (WDS) as to the effectiveness of the OES as compared to the traditional individual education sessions. (one-on-one education). The purpose of this study was to compare the outcomes of two modes of diabetes education for completing education for clients with Type 2 diabetes , namely individual education (Treatment A) and the OES group education (Treatment B). The findings overall revealed no difference in the outcomes of participants who received individual education and those who received the OES at completion of education as well as at 6 and 12 month post education. A secondary finding of this study was the significant influence gender and age exerted on the outcomes of the education programs. One significant implication from the findings for both the person diagnosed with Type 2 diabetes and the health care organisation is that the OES provides a cost effective alternative to individual education that encourages clients to complete diabetes education thereby enabling the person to achieve an optimal quality of life. In addition this study provides research evidence for the benefit of current practice in diabetes education.
Doctor of Philosophy (PhD)

Events around conception such as maternal undernutrition and twinning may have effects on offspring physiology and disease risk in adulthood. Periconceptional undernutrition alters offspring physiology and adult pathology without affecting birth size, while twinning affects birth size and physiology but with inconsistent effects on adult pathology. We investigated the effects of these two periconceptional events and their interaction on maternal cardiovascular adaptation to pregnancy and fetal growth, physiology and endocrinology in late gestation in sheep. Pre and/or postconception undernutrition resulted in increased uterine blood flow in late gestation, but no change in maternal blood volume. Preconception undernutrition alone resulted in a relatively large placenta with a small, slow-growing fetus in late gestation. In contrast, postconception undernutrition alone resulted in a fetus with rapid late-gestation growth that was maintained through a maternal fast. Fetuses of ewes undernourished throughout both periods were similar in growth rate and size to controls. Maternal fasting also demonstrated that plasma levels of C-type natriuretic peptide are acutely and independently regulated by nutrient supply in mother and fetus. Fetuses of ewes undernourished both pre- and postconception had increased glucose disposal following a glucose challenge. Hypothalamic-pituitary-adrenal axis tests in these fetuses showed decreased pituitary adrenocorticotropin hormone response to direct stimulation but increased adrenal response to decreased cortisol negative feedback. Twin fetuses grew more slowly in late gestation than singletons. Twins also had a smaller insulin response to arginine and a greater insulin response to glucose, but periconceptional undernutrition abolished this difference. Twins had suppressed baseline hypothalamic-pituitary-adrenal axis function and decreased adrenal sensitivity compared to singletons, but increased fetal pituitary adrenocorticotropin hormone response to direct stimulation and decreased cortisol negative feedback. These studies suggest that firstly, fetal size is a poor reflection of fetal growth trajectory, physiology and endocrinology. Secondly, pre- and postconception undernutrition affect late-gestation fetal growth in different ways, while undernutrition in both periods alters fetal endocrine status in late gestation. Thirdly, the biology of twin fetal development is fundamentally different from that of singletons, which may explain the inconsistency of the relationship between birth weight and adult disease risk in twins.
Auckland Medical Research Foundation, Health Research Council of New Zealand

The aim of the study was to determine the causes of IODs in the workplace and to identify possible preventative measures to reduce IODs. A literature review was conducted as part of the study, involving assessment of all related articles and books on the subject of IODs in the workplace. A qualitative research methodology was utilised to conduct the study. The main research instruments were four focus group interviews and eight individual interviews. The study concluded that employees experienced IODs in different ways, with most participants describing negative experiences such as physical pain, undue financial hardship, psychological trauma and lack of support from the employer. A minor percentage experienced IODs in a positive sense in that there is heightened safety awareness in the workplace after an IOD has occurred, and the adoption of a more cautious approach by employees when performing their duties. From a practical and organisational/managerial perspective, the adoption of effective training of security officers and adherence to organisational standard operating procedures will assist in reducing IODs in the workplace. Limitations of the study included the small sample size from the research population, perceived language barriers during the interview processes and non-participation and inputs from managers at the organisation. However, it is hoped that the study will form the basis for further research to broaden the field to include parastatal or public-service entities
Human Resource Management
M. Com. (Human Resource Management)