Dissertations / Theses on the topic 'Preventive health services Victoria'
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1
Carrigan, Amanda Jane. "Determining the Cost-Effectiveness of Preventive Health Services." Thesis, The University of Arizona, 2010. http://hdl.handle.net/10150/146241.
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The purpose of the thesis was to explore the issues surrounding the cost and implementation of prevention. Specifically, methods for determining cost-effectiveness and measuring the health benefits conferred from prevention were explored and services that have been determined to be cost-effective were discussed. Through interviews with health care professionals, administrators, and public health professors, perceptions of the benefits and costs of prevention were explored. Barriers to the implementation of prevention were discussed. The thesis concludes with suggestions on steps that health care providers and policy-makers can take to improve the health of the U.S. population through prevention.
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Berry, Elizabeth. "PREVENTIVE DENTAL SERVICES FOR INFANTS AND SUBSEQUENT UTILIZATION OF DENTAL SERVICES." VCU Scholars Compass, 2009. http://scholarscompass.vcu.edu/etd/1708.
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The purpose of this study was to examine the use of dental services for young children following a preventive oral health intervention in a pediatric medical clinic. Over a 3 year period (2005-2008), children 0-36 months of age, enrolled in Medicaid, were provided preventive oral health services in a medical setting. Descriptive statistics and multivariate logistic regression were used to determine the effect receiving the preventive oral health services in a medical setting with the outcomes of dental utilization. 15% were determined to have dental caries at the intervention and 42% found to have a dental visit post-intervention. Children determined to have decay at the intervention were significantly more likely to have one or more restorative or adjunctive service post-intervention. After receiving preventive oral health care in a medical clinic, the resulting utilization of dental services was higher than what is commonly reported for dental utilization in infant populations of low-income children.
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Guo, Jong-long. "Comparisons of clinical preventive services utilization among elderly, middle-aged and young adults in five Texas sites /." Digital version accessible at:, 2000. http://wwwlib.umi.com/cr/utexas/main.
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Lapierre, Sophie. "The logistics of preventive health services using fixed and mobile facilities." Diss., Georgia Institute of Technology, 1995. http://hdl.handle.net/1853/24353.
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Marine, Marjorie Butler. "Marketing health care services for a preventive health care agency : a categorical study." Virtual Press, 1987. http://liblink.bsu.edu/uhtbin/catkey/530368.
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The purpose of the study was to determine the needs of one marketing segment of clients seen in a contraceptive clinic in the Midwest. The marketing segment targeted for study was women with positive Pap smears. A comparison group of women with negative Pap smears was sampled from the same clinic during the time frame July 1, 1982, to July 1, 1984.Nine research questions were investigated. Responses have been reported relative to the following questions:1. Does the incidence of positive Pap smears depend on the presence of cervical infection a woman may have?2. Does the incidence of positive Pap smears depend on whether or not a woman smokes?3. Does the incidence of positive Pap smears depend on the type of contraceptive (pill or barrier) used by a woman?4. Does the incidence of positive Pap smears depend number of abortions experienced by a woman?5. Does the incidence of positive Pap smears depend on the number of pregnancies experienced by a woman?6. Does the incidence of positive Pap smears depend on whether the woman is white or black?7. Does the incidence of positive Pap age of the woman?8. Does the incidence of positive Pap smears depend on the smears depend on whether the woman is married or not?9. Does the incidence of positive Pap smears depend on the educational status of the woman?Five conclusions were drawn from findings of the study and were confined to the population for the study, clients of the selected clinic:1. Women with positive Pap smears are more likely to have infections than women with negative Pap smears.2. Women who have had abortions are more likely to have positive Pap smears.3. The incidence of positive Pap smears is associated with pregnancies; that is women with one or more pregnancies are more likely to have positive Pap smears.4. A higher proportion of black women have positive Pap smears than white women.5. Women with less education have more positive Pap smears than women with higher levels of education.Department of Educational Administration and Supervision
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Balogh-Reynolds, Joanna. "Self-Rated Health Status' Influence on Utilization of Clinical Preventive Services." Thesis, Carlow University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10605473.
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Early identification through preventive care screenings has proven to lessen the cost and impact of illness, while reducing premature mortality. Current literature has identified disparities related to access and utilization of preventive care services. The current assumption is that females have a higher likelihood to comply with recommended preventive care screenings than men. A variance identified in gender studies indicated women have a higher usage of preventive care screenings, and a higher use of overall medical services. The objective of this study is to understand if there is a predictive value of self-reported health status that can impact the utilization of preventive care services in women accessing a mammogram voucher program.
A convenience sample of 40 participants from the Mammogram Voucher Program administered by Adagio Health was surveyed. Using the RAND 36-Item Health Survey, participants’ self-rated health status was assessed. Demographic data and survey responses were compared with utilization of the mammogram voucher to ascertain if a correlation occurs. The survey results did not indicate, in this sample, that a relationship exists. However, demographic data indicated there is a relative impact on voucher utilization compared to self-perception. Specifically, the education level of the respondents yielded a statistically significant result. Participants with a reported education level of at least 12 years were found to be more likely to utilize a voucher while those with greater than 12 years of education did not. The lack of demonstrated statistical correlations for the self-rated health status questions do not necessarily prove a lack of relationship with utilization of preventative health care, rather suggests that demographics may influence preventive health care utilization more strongly. A larger sample size comparing additional factors will need to be studied.
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Li, Jun. "The use of child health computing systems in primary preventive care : an evaluation." Thesis, University College London (University of London), 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274686.
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Condon, Louise Jane. "Understanding preventive community health services for pre-school children : origins, policy and current practice." Thesis, University of Bristol, 2009. http://hdl.handle.net/1983/cf5dd7c3-8fef-492d-b8a4-192e4c6b98e2.
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Community health services for pre-school children have been the major universal health provision for well-children for over a hundred years. Traditionally these services have been largely delivered by health visitors, who are now community nurses with a specialist post-graduate qualification. Preventive health services for children in the UK have been increasingly criticised as insufficiently evidence-based. Criticism has led to reform of national policy and subsequent major changes to existing services, particularly in targeting services to those with the highest health and social needs. The effect of these policy changes upon the service provided for pre-school children by health visitors is not known. This thesis explores the origins and development of children's preventive health services and examines the effect of post-1989 policy changes in practice, in particular the move to a predominately targeted child health promotion programme. The empirical study used a mixed methods approach to investigate changes to local policy and practice. A national survey was made of health visitors' child health promotion practice (n=1043) which was followed by an in-depth interview study (n=25) of health visitors' views on service changes. Study findings illuminate the effect of post-1989 reforms on child health services, showing a diversity of practice across the country, and resistance to key aspects of policy and practice among health visitors. Despite a revised national child health promotion programme being published in April 2008, which addresses some of the areas of concern highlighted by this study, flaws remain which have implications for the successful implementation of this programme. These flaws reflect wider contentious issues in NHS policy-making, related to the distribution of power and resources between different professional groups within the NHS and service users. Failing to explore these issues in policy and practice reduces the ability of preventive health services to maintain and improve pre-school children's health.
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Zhang, Jianzhen (Jenny). "Socioeconomic position and utilisation of preventive health services among adults in the general population." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16532/1/Jianzhen_Zhang_Thesis.pdf.
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Background: International research has shown that socioeconomically disadvantaged groups experience significantly higher mortality and morbidity rates than other groups. Both cardiovascular disease (CVD) and diabetes are major contributors to Australia's burden of disease, and individuals from lower socioeconomic groups are more likely to be affected by both, and to have worse prognoses and outcomes. There is substantial research evidence that a range of preventive activities can reduce the morbidity and mortality associated with these conditions. Research in countries with good access to primary health care services has demonstrated that socioeconomically disadvantaged groups tend to have higher levels of medical consultations, but make less use of preventive care and screening services. This fact contributes to their poorer health outcomes, as diagnosis will typically occur later than for more advantaged individuals, thus leading to a poorer prognosis. However, to date, there has been little research on the differential utilisation of preventive health services for CVD and diabetes by different socioeconomic groups in Australia. To understand socioeconomic influences on the use of preventive health services, a comprehensive review of the literature of determinants of health service utilisation was conducted and a number of explanations for this relationship considered. It was proposed that the following factors are likely to be important in this relationship: differences in the perception of the availability of, and accessibility to health care, attitudes and beliefs toward preventive health care, having a regular source of care, perception of interpersonal care from general practitioners, and social support. A number of theoretical models were also reviewed; in particular, the Andersen Behavioural Model of Health Service Research Utilisation.
Aims: This doctoral research program has described the relationship between socioeconomic position (SEP) and utilisation of preventive health services in relation to CVD and diabetes. It aims to improve the understanding of the determinants of uptake and utilisation of preventive health services in general practice by different socioeconomic groups in Australia.
Methods: The study was conducted in Brisbane Australia, in 2004, using a cross-sectional design and a self-administered mailed survey for data collection. A sample of adults aged 25-64 years was selected randomly from the Brisbane Electoral Roll. A conceptual model incorporating a range of relevant socio-demographic, risk-factor and behavioural variables in the relationship between SEP and GP-based use of preventive health services was used to develop a self-administered questionnaire. The questionnaire was pilot-tested and then reviewed by a panel of international experts. A new self-administered questionnaire, the Health Service Utilisation Questionnaire (HSUQ), was developed. It included 79 items: 12 socio-demographic items; 10 items assessing health status, disease conditions and smoking status; 20 items assessing use of health services; and 37 items assessing the factors that might affect use of health services utilisation. The HSUQ was then mailed to 800 randomly selected survey participants. The survey response rate was 65.6 per cent. After exclusion of those patients with cardiovascular diseases and diabetes, the final sample size was 381, consisting of 155 males and 226 females. Socioeconomic indicators were individual education level and family income. Blood pressure, blood cholesterol and blood glucose check-ups by general practitioners (GPs) were used as the major outcome variables. Nine scales and two dichotomous variables that measure those potential factors were derived following Principal Component Analysis and reliability testing. The data were analysed separately by gender, and adjusted for age and each of the socioeconomic indicators. Statistical description, bivariate analysis and multivariable modelling in SPSS were applied for the data analysis.
Results: The survey results were suggestive of socioeconomically disadvantaged people being less likely than more advantaged people to utilise preventive health services for CVD and diabetes. For males, the low socioeconomic groups recorded the least use of preventive health services among the three education and income groups, including blood cholesterol and blood glucose check-ups, while the high socioeconomic group recorded the greatest use of preventive health services. There was no apparent relationship between education level and blood pressure check-up, while individuals from low-income families were less likely to go for a blood pressure check-up. For females, most of the results suggested that the low socioeconomic groups were less likely than the high socioeconomic groups to have blood cholesterol and blood glucose check-ups. However, this was not the case for blood pressure check-ups. The results showed that the low and middle socioeconomic groups were more likely than the high socioeconomic groups to have BP check-ups. However, the low socioeconomic groups were still less likely than the middle socioeconomic groups to have a blood pressure check-up. Overall, there was a similar pattern between education and income and the use of GP-based preventive health services among both males and females.
The findings from the examination of the mediating factors between SEP and the GP-based use of preventive health services suggested that socioeconomically disadvantaged adults (both low level of education and low income) are more concerned about transport and travel time to health care, and accessibility to health care in terms of finding a GP who bulk bills, the cost of seeing a GP and having a choice of GP. They are also less likely to have a regular place of care and social support. These potential factors are likely to result in a lesser use of preventive health services than their high-SEP counterparts. In addition, the findings also suggested that respondents with a low level of education have less-positive attitudes towards health care, and that those from low-income families do not have a regular care provider and are less likely to visit their GP for a preventive check-up in relation to CVD and diabetes in Australia.
Conclusions: Strategies for reducing socioeconomic health inequalities are partly associated with changing social and economic policies, empowering individuals, strengthening social and family networks, and improving the equity of the health care system. Strategies have been recommended for implementation in general practice that are directed at targeting the needs of disadvantaged groups; for example, providing longer consultation time and actively offering information on preventive care. Implementation of health promotion programs is needed in disadvantaged areas to keep the community informed about the availability of health services and to make health services more accessible. The health care system needs to be geographically accessible through improvements to the transport system. In addition, improving access to a regular source of primary health care is likely to be an important step in encouraging low-SEP individuals to use preventive health services.
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Zhang, Jianzhen (Jenny). "Socioeconomic position and utilisation of preventive health services among adults in the general population." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16532/.
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Background: International research has shown that socioeconomically disadvantaged groups experience significantly higher mortality and morbidity rates than other groups. Both cardiovascular disease (CVD) and diabetes are major contributors to Australia's burden of disease, and individuals from lower socioeconomic groups are more likely to be affected by both, and to have worse prognoses and outcomes. There is substantial research evidence that a range of preventive activities can reduce the morbidity and mortality associated with these conditions. Research in countries with good access to primary health care services has demonstrated that socioeconomically disadvantaged groups tend to have higher levels of medical consultations, but make less use of preventive care and screening services. This fact contributes to their poorer health outcomes, as diagnosis will typically occur later than for more advantaged individuals, thus leading to a poorer prognosis. However, to date, there has been little research on the differential utilisation of preventive health services for CVD and diabetes by different socioeconomic groups in Australia. To understand socioeconomic influences on the use of preventive health services, a comprehensive review of the literature of determinants of health service utilisation was conducted and a number of explanations for this relationship considered. It was proposed that the following factors are likely to be important in this relationship: differences in the perception of the availability of, and accessibility to health care, attitudes and beliefs toward preventive health care, having a regular source of care, perception of interpersonal care from general practitioners, and social support. A number of theoretical models were also reviewed; in particular, the Andersen Behavioural Model of Health Service Research Utilisation. Aims: This doctoral research program has described the relationship between socioeconomic position (SEP) and utilisation of preventive health services in relation to CVD and diabetes. It aims to improve the understanding of the determinants of uptake and utilisation of preventive health services in general practice by different socioeconomic groups in Australia. Methods: The study was conducted in Brisbane Australia, in 2004, using a cross-sectional design and a self-administered mailed survey for data collection. A sample of adults aged 25-64 years was selected randomly from the Brisbane Electoral Roll. A conceptual model incorporating a range of relevant socio-demographic, risk-factor and behavioural variables in the relationship between SEP and GP-based use of preventive health services was used to develop a self-administered questionnaire. The questionnaire was pilot-tested and then reviewed by a panel of international experts. A new self-administered questionnaire, the Health Service Utilisation Questionnaire (HSUQ), was developed. It included 79 items: 12 socio-demographic items; 10 items assessing health status, disease conditions and smoking status; 20 items assessing use of health services; and 37 items assessing the factors that might affect use of health services utilisation. The HSUQ was then mailed to 800 randomly selected survey participants. The survey response rate was 65.6 per cent. After exclusion of those patients with cardiovascular diseases and diabetes, the final sample size was 381, consisting of 155 males and 226 females. Socioeconomic indicators were individual education level and family income. Blood pressure, blood cholesterol and blood glucose check-ups by general practitioners (GPs) were used as the major outcome variables. Nine scales and two dichotomous variables that measure those potential factors were derived following Principal Component Analysis and reliability testing. The data were analysed separately by gender, and adjusted for age and each of the socioeconomic indicators. Statistical description, bivariate analysis and multivariable modelling in SPSS were applied for the data analysis. Results: The survey results were suggestive of socioeconomically disadvantaged people being less likely than more advantaged people to utilise preventive health services for CVD and diabetes. For males, the low socioeconomic groups recorded the least use of preventive health services among the three education and income groups, including blood cholesterol and blood glucose check-ups, while the high socioeconomic group recorded the greatest use of preventive health services. There was no apparent relationship between education level and blood pressure check-up, while individuals from low-income families were less likely to go for a blood pressure check-up. For females, most of the results suggested that the low socioeconomic groups were less likely than the high socioeconomic groups to have blood cholesterol and blood glucose check-ups. However, this was not the case for blood pressure check-ups. The results showed that the low and middle socioeconomic groups were more likely than the high socioeconomic groups to have BP check-ups. However, the low socioeconomic groups were still less likely than the middle socioeconomic groups to have a blood pressure check-up. Overall, there was a similar pattern between education and income and the use of GP-based preventive health services among both males and females. The findings from the examination of the mediating factors between SEP and the GP-based use of preventive health services suggested that socioeconomically disadvantaged adults (both low level of education and low income) are more concerned about transport and travel time to health care, and accessibility to health care in terms of finding a GP who bulk bills, the cost of seeing a GP and having a choice of GP. They are also less likely to have a regular place of care and social support. These potential factors are likely to result in a lesser use of preventive health services than their high-SEP counterparts. In addition, the findings also suggested that respondents with a low level of education have less-positive attitudes towards health care, and that those from low-income families do not have a regular care provider and are less likely to visit their GP for a preventive check-up in relation to CVD and diabetes in Australia. Conclusions: Strategies for reducing socioeconomic health inequalities are partly associated with changing social and economic policies, empowering individuals, strengthening social and family networks, and improving the equity of the health care system. Strategies have been recommended for implementation in general practice that are directed at targeting the needs of disadvantaged groups; for example, providing longer consultation time and actively offering information on preventive care. Implementation of health promotion programs is needed in disadvantaged areas to keep the community informed about the availability of health services and to make health services more accessible. The health care system needs to be geographically accessible through improvements to the transport system. In addition, improving access to a regular source of primary health care is likely to be an important step in encouraging low-SEP individuals to use preventive health services.
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Ruston, Annmarie. "Implementation of preventive health policies in the field of sexual health : an examination of the influence of health professionals in the implementation of the Health of the NationStrategy-HIV/AIDS and Sexual Health Key Area." Thesis, University of Kent, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310165.
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Chon, Vichea Veena Sirisook. "HIV preventive behaviors among high school male students in Phnom Penh city, Cambodia : an application of health belief model /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd375/4737940.pdf.
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Shelton, Melissa E. "Identifying Communication Barriers and Trust Issues of Black Women Seeking Preventive Health Services in Houston, Texas." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3411.
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Black women mortality rates are perceived to be impacted by communication barriers, trust issues, and the lack of quality preventive health services. The purpose of this phenomenological study was to explore communication barriers and trust issues perceived by Black women when seeking preventive health services. HMB was used to identify public attitudes around receiving preventive health services and to construct each question based on perceived susceptibility and perceived severity of communication barriers and trust issues. An ecological model of the communication process was used as a framework to identify fundamental relationships between the Black female patients and health care providers. Data were collected using open-ended interview questions from Black women in public health and health care professions in southeast Texas (N=10). Results were coded and evaluated by thematic analysis. NVivo 10 software was used to store and manage data. Study findings showed 4 participants voiced their beliefs that their healthcare provider was somewhat apathetic when it came to addressing their health care needs, and 3 of the participants who visited a doctor's office within the last 12 months reportedly expressed having poor communication and trust issues with their health care provider. Emerged themes included lack of attentiveness from health care providers and lack of a comfortable atmosphere or bedside manner when receiving preventive health care services from their healthcare provider. This research has implications for social change if the health inequalities of Black women are identified and addressed, then Black women may have a reduction in health disparities when receiving preventive health services and an increase healthier outcomes.
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Stephenson, Winsome Beverly. "The Experiences of Obese African American Women and Their Utilization of Preventive Healthcare Services." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/nursing_diss/17.
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Obesity is associated with higher death rates from breast and gynecological cancers. African American women(AAW) are more likely to be diagnosed with these cancers at later stages and have lower survival rates than Caucasian women. African American women are also disproportionately affected by obesity. Studies suggest that the healthcare experiences of obese women (primarily stigmatization), may contribute to their decisions to utilize healthcare services. However, these studies have largely comprised Caucasian women; there remains a paucity of studies addressing this issue in AAW. The purpose of this study was to explore the healthcare experiences of obese AAW and their utilization of preventive healthcare services.
Interpretive phenomenology, based on the work of Maxx van Manen, was used to describe and interpret the healthcare experiences of 15 obese AAW living in communities in Georgia. The women ranged in age from 23 to 62, with body mass index ranging from 35-55. The majority of the sample (83%) had adequate health insurance. This was a well educated sample with 87% having college degrees or some college education. Individual, audio-taped interviews were used to collect data.
Data were analyzed using interpretive phenomenological methods, with analysis and collection occurring concurrently. Data were analyzed as a whole then line by line to identify themes across transcripts. Two patterns and five themes were identified. Patterns were: They're not listening and Good or bad, it's my decision. Themes were: Attributing all problems to weight; They say lose weight but give us no tools; Stigmatization; Cancel my appointment please: I won't be back, and Empowerment.
The women recalled a pleothra of negative encounters with providers that they termed "demeaning" and "nastiness for no reason." Many women reacted by delaying or avoiding healthcare, some not returning for preventive health screens for many years. The significant association between obesity and mortality from cervical and breast cancers necessitates timely preventive screens by obese women. The results of this study can help to inform practice, education, and research. Recommendations for all three areas were deleneated in the study.
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Mansman, Robert William II. "Oral Health Services in a Medical Setting." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd/753.
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Purpose: The purpose of this study is to examine the baseline oral health status of infants and the level of their caregiver's oral health knowledge for families who received preventive oral health services in a medical setting. Methods: Using a prospective cohort study, children 0-3 years of age received an oral health screening, risk assessment, caregiver education, and a fluoride varnish treatment in an ambulatory pediatric medical clinic. A 16-item oral health knowledge and socio-demographic questionnaire was delivered to the caregiver of child. This questionnaire included knowledge, behavior and opinion items on risk factors for dental diseases, care of child's teeth, and socio-demographic characteristics of the family. Six-months after the medical visit, dental claims were examined to see if children had made a dental visit. Results: One hundred and ninety-five children received preventive oral health services in this clinic. Of these, 103 caregivers agreed to complete the oral health knowledge and socio-demographic questionnaire. Twenty-percent of children screening had visible signs of tooth decay, according to risk-assessment 72% were categorized as high-risk for tooth decay, and 83% received a fluoride varnish treatment. At 6-months, 9% of children were found to have had a dental visit. According to the caregiver questionnaire the likelihood of having a dental visit was correlated with the caregiver's knowledge of when a child should have their first dental visit and having been told by a medical professional when their child should be going to the dentist. Conclusion: Children are more likely to have a dental visit when caregivers are aware of the age 1 dental visit, or when advised to seek care by a medical professional. With increased education of medical providers, starting in medical residency training, more children can be seen for preventive oral health care resulting in an earlier establishment of a dental home.
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Hu, Weiming. "Effects of parents' health attitudes and beliefs on children's preventive care utilization." PDXScholar, 1992. https://pdxscholar.library.pdx.edu/open_access_etds/4315.
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This thesis was designed to test the relationship between parents' health attitudes and beliefs and utilization of preventive health services of their children. Four measures of health attitudes and beliefs (HAB) were examined in this study, they were: 1) Interest in and concern with health; 2) Skepticism about physicians; 3) Tendency to consult physicians; and 4) Efficacy. Preventive care utilization included well-child care and immunization.
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Chisolm, Deena Brown. "The Role of Perceived Discrimination and Perceived Cultural Competence in Predicting Use of Preventive Health Care Services." The Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=osu1052409673.
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Kirkpatrick, Tara. "Just what the doctor ordered: reformation of the U.S. healthcare system through a dose of preventative and primary care." [Denver, Colo.] : Regis University, 2008. http://165.236.235.140/lib/TKirkpatrick2008.pdf.
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Carney, Patricia Anne. "Using unannounced standardized patients to assess HIV prevention in primary care : a study of clinical performance /." Thesis, Connect to this title online; UW restricted, 1994. http://hdl.handle.net/1773/7258.
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Richter, Sundberg Linda. "Mind the Gap : exploring evidence-based policymaking for improved preventive and mental health services in the Swedish health system." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-118179.
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Background: The challenges in the utilization of scientific findings in the fields of prevention and mental health are well documented. Scholars have found significant gaps between the knowledge available and the knowledge applied in healthcare. Studies have suggested that about half of the patients receive the recommended care for their medical condition. In order to address this gap, health systems at global, national, regional and local levels have made diverse efforts to facilitate the uptake of research for example through evidence-based health policy processes. In Sweden, government agencies and health policy actors such as the National Board of Health and Welfare support and control the health care system through evidence-based policies amongst other steering tools. The overall aim of this thesis is to explore evidence-based policy processes, and to further understand barriers to implementation of policies in the fields of preventive and mental health services. Methods: A multiple case study approach was used, and data were collected from several sources. Qualitative content analysis methodology was used. Case 1 comprises the development and early implementation of national guidelines for methods of preventing disease managed by the National Board of Health and Welfare during 2007–2014. Case 2 covers the effort to improve health care for the older population that was undertaken through an agreement between the Swedish government and the Swedish Association of Local Authorities and Regions during 2009–2014. Case 3 involves an effort to implement an adapted version of a systematic review from the Swedish agency for health technology assessment and assessment of social services on treatment of depression in primary health care. Data was collected between 2007 and 2010. In Paper 1, the policies from Case 1 and 2 were studied using a longitudinal, comparative case study approach. Data were collected through interviews, documents and observations. A conceptual model was developed based on prior frameworks. The model was used to organize and analyse the data. In Paper 2, the guideline development process (Case 1) was studied through interviews and the collection of documents. A prior framework on guideline quality was used in order to organize the data. Paper 3 investigated decision-making processes during guideline development using a longitudinal approach. Qualitative data were collected from questionnaires, documents and observations and analysed using conventional and summative content analysis. In Paper 4, the barriers to implementation were investigated through interviews and the collection of documents. Data were analysed using qualitative content analysis with a conceptual model to structure the analysis. Results: The sources and procedures for policy formulation differed in Case 1 and 2, as did the approaches to promote the implementation of the policies. The policy processes were cyclical, and phases overlapped to a large degree. The policy actors intended to promote implementation, both during and after the policy formulation process. The thesis shows variation in how the key policy actors defined and used research evidence in the policy processes. In addition, other types of knowledge (e.g. politics, context, experience) served as alternative or multiple sources to inform the health policies. The composition of sources that informed the policies changed over time in Cases 1 and B. During the policy formulation and implementation process, efforts to integrate research evidence with clinical experiences and values were associated with tension and recurrent dilemmas. On the local level (i.e. primary health care centres), barriers to implementation were found related to the innovation and among health professionals, patients, in social networks as well as in the organizational, economic and political contexts. Conclusion: The concept of evidence holds a key position in terms of goals and means for knowledge based policymaking in the Swedish health system. Broad definitions of evidence – including research and non-research evidence - were requested and to various extents utilized by the policy actors in the studied cases. An explicit terminology and systematic, transparent methodology to define, identify, and assess also non-research evidence in policy processes would potentially strengthen the clarity and validity of these processes and also enhance policy implementation. Particular determinants to implementation, such as the interventions characteristic, are to a considerable degree established early in the policy process, during agenda setting and policy formulation. This early phase offers unique opportunities to assess and build capacity, initiate and facilitate implementation. Early analysis and considerations of target populations and contexts and other implementation determinants related to the specific policy scope (e.g. disease preventive guidelines) could enhance the forth-coming implementation of the policy.
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Kunz, Laura Marie. "A comparison of the use of preventive health services for diabetics Canada and the United States /." Connect to Electronic Thesis (CONTENTdm), 2010. http://worldcat.org/oclc/647184839/viewonline.
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Campbell, Desiree. "An evaluation of patient engagement with diabetes out-patient services in an ethically diverse urban area in the UK." Thesis, City, University of London, 2018. http://openaccess.city.ac.uk/21477/.
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Diabetes has been described as an epidemic with a significant global burden of illness. This burden is associated with poorer engagement with services and the cost of managing avoidable complications. One outcome measure of engagement in the national health service (NHS) in the United Kingdom (UK) is attendance at appointments. The cost implications (direct and indirect) of non-attendance are significant, with empirical evidence consistently demonstrating higher than average non-attendance rates for out-patient appointments and education sessions by minority ethnic and socio-economically deprived individuals. A gap was identified whereby a comprehensive understanding of non-attendance which moves beyond clinical and technical aspects such as capacity and demand is still required. This thesis provides a fresh approach and granular understanding of patient engagement which can influence clinical care, service delivery and policy. The main research questions in this thesis were: 1. What are the predictors of out-patient attendance? 2. What are the barriers and enablers to attendance? To answer these questions, a retrospective geo-demographic trend analysis, critical narrative literature review of Community Health Worker (CHW) and peer support interventions and a research study were conducted. The case study is based on a dataset which comprised of 35,597 appointments. Its findings highlighted that factors such as age, gender, ethnicity, local geography and deprivation were significant predictors of out-patient attendance. A critical review of CHW and peer support interventions demonstrated that despite the heterogeneity of programme designs, duration of interventions, follow up and healthcare systems in which they were used, they were assessed to be both clinically and cost effective. There was limited evidence on the sustainability of these interventions due to a lack of longitudinal studies. The research element was conducted in two stages and utilised multi methods (focus groups, semi-structured interviews and questionnaires) to evaluate the barriers and facilitators to attendance. Key findings included the need for effective and on-going education, better alignment of health and social care due to the impact of the wider determinants of health but more interestingly, the influence of family on the concept of ownership for one's health by some individuals whose self-determination is limited by language and health literacy. The relationship between patient activation (knowledge, skills and confidence) and attendance was also evaluated. This evaluation demonstrated that the more activated individuals are, they are significantly more likely to attend appointments. However, to maximise care planning and operational effectiveness, activation should not be assessed in isolation. The findings of this thesis highlighted the influence of individual, organisational and structural factors on patients' engagement with out-patient services and the need for a synergistic approach involving service users, clinicians, organisations and policy makers to minimise patient dis-engagement with healthcare services.
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HAMAJIMA, NOBUYUKI, YOKO MITSUDA, SAYO KAWAI, YOSHIKAZU KAMIYA, YASUYUKI GOTO, TAKAAKI KONDO, MIO KURATA, and TAKASHI TAMURA. "PREVENTIVE MEDICAL SERVICES NOT COVERED BY PUBLIC HEALTH INSURANCE AT DAIKO MEDICAL CENTER IN JAPAN, 2004–2011." Nagoya University School of Medicine, 2012. http://hdl.handle.net/2237/16028.
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Talbot, Molly A. "Nutrition and health promotion activities and nutrition." Virtual Press, 1991. http://liblink.bsu.edu/uhtbin/catkey/774735.
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The study was designed to identify current levels of corporate health promotion and nutrition activities and to highlight the need for continued health promotion activities, in particular nutrition education, throughout corporate America.Five hundred surveys were mailed to the Fortune 500 companies throughout the United States. One hundred and twenty-one were completed, yielding a 24% sample for analysis.The wellness/health promotion activities reported to be a part of corporate wellness programs included exercise, nutrition education, CPR training, stress management and intramural sports. It appeared that size of the corporation influenced the nutrition promotion provided at the worksite. There appeared to be no difference between CEO support or lack of support to the wellness/health promotion program and the variety of health promotion activities. It was apparent that having a nutrition consultant resulted in greater and more varied nutrition health promotion activities at the worksite, and that in the future, America's Fortune 500 companies will need to hire a nutrition professional to disseminate nutrition and health promotion information at the worksite.Institute for Wellness
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Dalla, Palu Alice J. "An examination of the process of program evaluation in a community prevention project." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1996. http://www.kutztown.edu/library/services/remote_access.asp.
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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]).
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Awat, Joselito G. Pantyp Ramasoota. "Preventive behavior of malaria among people living along the Thai-Cambodia border, Khilonghad district, Srakaeo province /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd387/4837996.pdf.
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Aoyama, Atsuko, Asmaa Ghareds Mohamed, Michiyo Higuchi, Shokria Adly Labeeb, and Chifa Chiang. "BARRIERS TO THE USE OF BASIC HEALTH SERVICES AMONG WOMEN IN RURAL SOUTHERN EGYPT (UPPER EGYPT)." Nagoya University School of Medicine, 2013. http://hdl.handle.net/2237/18471.
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Larkin, Shaun Maurice. "Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/26735/1/Shaun_Larkin_Thesis.pdf.
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Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services.
Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.
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Larkin, Shaun Maurice. "Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia." Queensland University of Technology, 2008. http://eprints.qut.edu.au/26735/.
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Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services.
Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.
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Rossouw, Willem Wouter. "Efficacy of a HIV intervention in the workplace, as measured by KAP (knowledge, attitudes, and practices) questionnaires a before and after study /." Connect to this title online, 2003. http://upetd.up.ac.za/thesis/available/etd-05092005-102002/.
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Sawyer, Ashlee. "ARE YOU COVERED? EXAMINING HOW KNOWLEDGE OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT INFLUENCES USE OF PREVENTIVE REPRODUCTIVE HEALTH SERVICES." VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4265.
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The Patient Protection and Affordable Care Act (PPACA) expanded access to insurance coverage and health care services for many citizens, and has increased access for women in particular by including preventive reproductive health services as essential health benefits. The current national rates of sexually transmitted infections (STIs), reproductive cancer diagnoses, and unintended pregnancy serve as major areas of concern for women’s health and public health. The present study examined how knowledge of the PPACA influences receipt of preventive reproductive health services among women. Results indicate that higher levels of knowledge of the PPACA are associated with a greater likelihood of receiving cancer and STI screenings, as well as contraceptive counseling, and that increasing contraceptive knowledge, rates of contraceptive counseling, and pap screenings are related to greater use of highly effective contraception. The present study offers support for increased outreach and education efforts, along with additional policy and provider involvement.
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Kartakoullis, Nicos Louca. "Fitness levels and exercise behaviour of Cypriots aged 25-34 as preventive measures for one of the risk factors associated with heart disease : implications for health promotion." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301047.
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Hak, Sithan Nonglak Pancharuniti. "Dental health preventive behavior among mothers with preschool children in Nakhon Pathom province, Thailand /." Abstract, 2003. http://mulinet3.li.mahidol.ac.th/thesis/2546/4537452.pdf.
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Dusabe, John. "Development and evaluation of an mHealth intervention to improve the uptake of sexual and reproductive health services in Mwanza Tanzania." Thesis, University of Liverpool, 2014. http://livrepository.liverpool.ac.uk/2014371/.
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This thesis documents the development and evaluation of an mHealth intervention for sexual and reproductive health (SRH) referral from drugstores to health facilities in Mwanza Tanzania. SRH is an important factor for human development. Over the last 2 decades, provision and accessibility to SRH services has benefited from international and national health promotion interventions. In developing countries, use of close to community providers (CTC providers), such as village health workers, has been a key component of health promotion. This has been especially true in Tanzania where up to 70% of formal primary health care facilities lack health staff. CTC providers have been promoted through international initiatives such as the World Health Organization’s (WHO) task-shifting initiative. WHO’s recognition of CTC providers ranges from cadres at the grassroots level such as village health workers and drugstores to formal auxiliary providers based in health facilities, such as medical aides and nurses. In Tanzania, drugstores provide a range of SRH services ranging from simple advice on how to use a condom to complex prescriptions of antibiotics for STI treatment. Evidence has shown that drugstores – though more likely to have health-related training than any other informal CTC providers – lack skills necessary for provision of SRH services. This may contribute to poor SRH outcomes, such as increase in prevalence of sexually transmitted infections (STIs)/human immunodeficiency virus (HIV) and antibiotic resistance. Accessing SRH services at the formal health facility level is key to improving these outcomes. To create SRH service linkages and integration between drugstores and health facilities in Mwanza, Tanzania, an intervention that pioneered an mHealth SRH referral from drugstores to health facilities was designed and implemented for 18 months from September 2012 to February 2014. Referral between these two SRH providers using mHealth tools had not been attempted before. The intervention provided an electronic platform accessible to 52 drugstores and 18 health facilities in two districts of Mwanza region. Through a toll-free number and password, drugstores referred patients with SRH conditions to health facilities using the text-messaging feature on their mobile phones. From the platform’s in-built data collection tool, SRH uptake data demonstrated that 38% of patients referred from drugstores accessed HIV, STIs, family planning and maternal health services at the health facility level. A follow-up randomised household survey found that 72% of the participants would accept such type of referral in future, and among those who had ever visited drugstores for SRH services, 15% had heard about the intervention. At the end of the intervention, drugstores and health facilities confirmed that it was beneficial to their SRH service provision and that they would like to continue implementing it. In conclusion, this text messaging intervention pioneered community referral from drugstores to health facilities for SRH treatment by using mobile phones which appeared to be acceptable and effective in Mwanza Tanzania. With the growing use of mobile phones in Africa and the need to provide SRH services beyond the Millennium Development Goals (MDGs) era, mobile phone-based community referral through CTC providers, such as drugstores, could make an important contribution to achieving Universal Health Coverage targets.
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Lindblom, Johanna, and Maria Lundberg. "HIV prevention work in Moshi, Tanzania : Nurses’ and physicians’ views on Kilimanjaro Aids Control Association." Thesis, Uppsala University, Department of Public Health and Caring Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-112505.
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ABSTRACTAim: Since 2003 Kilimanjaro Aids Control Association (KACA) has collaborated with the Mawenzi Hospital in Moshi, in order to prevent the transmission of HIV/AIDS. The aim of this study was to investigate Mawenzi Hospital’s staff’s views about KACA and its work. Method: Eight semi structured interviews were performed with nurses and physicians. The interviews were recorded, transcribed and analyzed by a qualitative manifest content analysis according to Graneheim and Lundman (2004). Results: All the informants mentioned that KACA is an important stakeholder needed in the collaboration with the government to prevent HIV transmission. They also mentioned that the main problems KACA struggles with is lack of recourses, insufficient HIV tests and lack of information to their clients. KACA was described as an accessible non governmental organization (NGO) working as a bridge from society, channeling HIV positive clients to Mawenzi Hospital. Conclusion: This study confirms that KACA is considered doing a good job and is appreciated by the nurses and physicians at the Mawenzi Hospital. For KACA this may be important information to maintain their prevention work. The problems presented by the informants should be taken under consideration when planning the future work.
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Tang, Sze-kit, and 鄧施潔. "Parents' knowledge concerning their new immigrant child's preventive health care and access to care in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B27050464.
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Brandon, Amy Ford Schuessler Jenny H. "The effects of an advanced practice nurse-led telephone-based intervention upon hospital readmissions, quality of life, and self-care behaviors of heart failure patients." Auburn, Ala, 2008. http://repo.lib.auburn.edu/EtdRoot/2008/SUMMER/Nursing/Thesis/Brandon_Amy_11.pdf.
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Malachi, Judia Yael. "Physician Assistants' Preventive Medicine Practices and Related Habits, Attitudes, and Beliefs." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/890.
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Physician assistants play a pivotal role in expanding access to care, yet research on their preventive medicine practices is limited. Guided by Lewis's conceptual model for predicting counseling practices, this cross-sectional study examined the relationship between physician assistants' preventive medicine practices, personal health habits, prevention and counseling attitudes, and perceived barriers to the delivery of clinical preventive services. A 104-item self-administered survey was used to collect data from 314 physician assistants attending the American Academy of Physician Assistants' 42nd Annual Conference. Data were analyzed using descriptive statistics, Pearson's correlation, and stepwise multiple regression. Results indicated that physician assistants engaged in preventive medicine activities about half the time, believed it was very important to counsel patients on prevention topics, felt they were somewhat effective in changing patient behaviors, and reported that barriers were somewhat important in hindering preventive care delivery. Significant and predictive relationships between physician assistants' health habits, attitudes, perceived barriers, and practices were found. These findings may guide researchers, providers, policymakers, and the public in making informed and comprehensive health care decisions. This study contributes to social change by serving as a baseline for the creation of effective strategies for physician assistant practice and self-assessment. Additionally, data from this study can be used to advocate changes in the education, training, and certification of physician assistants, as well as foster medicine and public health collaborations.
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Sims, Donna. "Impact on Material and Child Health Knowledge as a Result of Participation in a Family Resource\Youth Services Center New and Expectant Parenting Series." TopSCHOLAR®, 1998. http://digitalcommons.wku.edu/theses/320.
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The purpose of this study was to determine whether participation in a Family Resource\Youth Services Center New and Expectant Parenting Series had an impact on maternal and child health knowledge of parents and their future behavior choices. The study had two components. First, a telephone survey was conducted with 40 past program participants asking them nine questions concerning behavior and lifestyle choices in regards to child safety, breast or bottle feeding, immunizations, car seat use, etc. Secondly, thirty participants were given a pretest and posttest questionnaire. As a control group, there were 25 Lamaze class participants, who also completed the pre-test and posttest questionnaires. The questionnaire was a 20 item multiple choice instrument (Learning About Parenting Survey or LAPS) which measured maternal and child health knowledge in such areas as family planning; informed parenting; maternal health; basic baby care; breast-feeding; bottle-feeding; first aid; child's health including immunizations, child safety; nutrition; child development and discipline. Analysis of covariance was performed using the LAPS raw scores from the posttests as the dependent variable, the pretest scores as the covariate and the treatment as the independent variable. The results showed no significant difference in parenting knowledge between the individuals enrolled in the Family Resource\Youth Services Center's New and Expectant Parenting Series and the comparison group who did not take the course.
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Rukundo, Emmanuel Nshakira [Verfasser]. "Effects of community-based health insurance on child health outcomes and utilisation of preventive health services : Evidence from rural south-western Uganda / Emmanuel Nshakira Rukundo." Bonn : Universitäts- und Landesbibliothek Bonn, 2018. http://d-nb.info/1173898611/34.
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Denver, Sara Jane. "Experiences of developing cancer and palliative care services in one community in North West England 1976-2000 : an oral history and documentary reconstruction." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/5526/.
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The purpose of this study was to explore how cancer and palliative care services developed in one place and changed in the course of time. Research on how local cancer and palliative care services have developed is limited. A small number of researchers have provided accounts of hospice developments nationally, but they did not explore individual experiences and the micro context in detail. Other studies have examined accounts of developing local cancer support services, but not hospice developments. This research addresses the question - how were cancer and palliative care services developed in Lancaster 1976 ? 2000? Oral history and documentary sources were used to generate data, which was analysed using thematic analysis/constant comparison. Social constructionism offered a fruitful theoretical basis that increased understandings of oral history accounts. A snowball sample recruited a broad group of participants that had been involved with the local cancer and palliative care services in the relevant period. Thirty five interviews were conducted. The study revealed that services developed in the absence of national planning; participants worked to make them respectable, but there was tension at times. Progress was shaped by a combination of individual and social factors. Services evolved outside the National Health Service, yet alongside oncology and were therefore tripartite in character. Elsewhere developments were often fragmented. Many participants were involved in all the local services; they created networks and collaborated to form comprehensive facilities, which were available from diagnosis to the terminal stage of illness. The approaches complemented each other to reveal that at the macro level services were initially flexible. In time they became more structured, as social, historical, economic, professional and political mechanisms in the broader context impacted to shape them; this created some challenges. The study also uncovered aspects of the meaning of compassion. It revealed that compassionate practices challenged the rationality of conventional approaches and shared relativist perspectives because participants found different ways of providing care. All of these findings contributed to new knowledge about the development of local cancer and palliative care services. The study was limited by the historical period, perhaps by the place and because the reconstruction was one interpretation. It is possible there are others.
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Adams, Karen. "Koori kids and otitis media prevention in Victoria." 2007. http://repository.unimelb.edu.au/10187/2371.
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Otitis media and consequent hearing loss are known to be high in Koori communities. Previous research on otitis media in Koori communities has focused on its identification, treatment and management. Little research has focused on the prevention of otitis media. Victorian Aboriginal communities often have small populations which result in small sample sizes for research projects. Consequently use of traditional quantitative methods to measure of change arising from health interventions can be problematic. The aim of the research was to describe Koori children’s otitis media risk factors using a Koori research method in order to develop, implement and evaluate preventative interventions.
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Mugisha, Emmanuel. "Delivery and utilisation of voluntary HIV counselling and testing services among fishing communities in Uganda." Thesis, 2008. http://hdl.handle.net/10500/2954.
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The study explored, described and explained the current models of voluntary counselling and testing services delivery and analysed the extent to which a given VCT model had influenced uptake of VCT services in the fishing communities along the shores of Lake Victoria, in Wakiso District, with an aim of designing optimal VCT service delivery strategies. The study was therefore exploratory, descriptive and explanatory, and collected both qualitative and quantitative data in a three-phased approach. Phase I involved the Kasenyi fishing community respondents, while phases II and III involved VCT managers and VCT counsellors at the Entebbe and Kisubi Hospitals.
The findings indicated that VCT services are generally available onsite at health facilities, and in the field through mobile VCT outreach or home-based VCT services provided at clients’ homes. Both client-initiated and health provider-initiated VCT services are available and services are integrated with other health services. Despite the availability of VCT, only about half of the respondents in phase I had accessed VCT services although almost all indicated a willingness to undergo HIV testing in the near future. The main challenges to service delivery and utilisation included limited funding and staffing as well as limited awareness in target communities. The strategies drawn are based on the need to increase availability, accessibility, acceptability and utilisation of VCT services.Health Studies
D. Litt. et Phil. (Health Studies)
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Totikidis, Vicky. "Community centred health promotion and prevention in an Australian context." Thesis, 2013. https://vuir.vu.edu.au/24386/.
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Chronic diseases have increased dramatically in Australia and around the world over the
past decade, causing pain, suffering, disability, psychosocial problems, early mortality
and economic and public health crisis. However, many chronic diseases and conditions
could be prevented with better evidence based and community based health promotion
strategies. Guided by a philosophy of idealism, the aim of this thesis was to develop a
community centred health promotion strategy to assist the improvement of health and
the prevention of chronic disease in an Australian context. More specifically, the
research was concerned with exploring the potentiality of statistical or epidemiological
evidence and community collaboration as pathways to chronic disease prevention and
improvement of health at an individual, community and system level. The research
utilised a praxis paradigm and action research design over three stages. Stage One
included in depth quantitative analysis of health and epidemiological data and addressed
the question: What is the current evidence/knowledge about health status, determinants
and inequalities in Victorian communities and the broader Victorian and Australian
context? Stage Two involved qualitative participatory action research methods to
engage a small group of community members from the Brimbank region of Melbourne
(Victoria, Australia) in the community governance of health promotion and disease
prevention. The questions addressed were: What are the benefits of community based
health promotion and prevention? What ideas for health promotion action does the
community have to offer? Stage Three involved a minor evaluation of the strategy as a
whole and addressed the question: In what ways, can health evidence and community
involvement in health promotion contribute to better health outcomes? Stage One
identified various determinants that impact on health status and result in inequalities.
Stage Two revealed six major benefits for community based health promotion and
prevention and generated a number of useful ideas for health promotion action in the
community. Stage Three showed positive evaluations by the participants and identified
numerous indicators of success of the health promotion strategy as a whole.
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Faruq, Quazi Omar. "Management of training to prevent occupational violence: a case study of the Work Health and Safety Management System (WHSMS) in a hospital in Victoria." Thesis, 2018. https://vuir.vu.edu.au/37836/.
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Healthcare is a complex arena of multi-skilled interaction. In recent years, it has grown extensively out of the simple act of treating the sick by a noble healer to taking measures of preventing illness not only of the clients but also of the community. It is no more a deal between two persons: the sick and the healer (like a doctor). Community healthcare is regulated by several agencies including legislative agencies (like government, international health organisations), professional bodies, industrial regulators, consumer advocates and commercial entities (such as insurance companies and pharmaceuticals). Healthcare service providers or professionals are not the sole regulators rather their actions need to balance the legal obligations to the client (such as client satisfaction), to staff (such as workplace safety) and to business (to maintain competitive advantage in the industry).
Current healthcare service provision is challenged by many factors including diversification of the task, diversity of workforce characteristics due to globalisation and increased service demand by knowledgeable customers searching proactive healthcare and not just curative care. To overcome these challenges along with maintaining quality service, organisations need skilled staff. This, however, is threatened by occupational hazards like occupational violence against staff (OVAS) which is well documented globally and across Australia.
The impact of OVAS is not limited only to disruption of service but also to the quality of service and shortage of human resources in some cases. Regulatory agencies like the Department of Health, Comcare, Safe Work Australia and Worksafe Victoria (VAGO, 2013) are providing guidelines on OVAS management.
Most healthcare providers are considering some actions, but not with any universal consensus. According to the hierarchy of control in Work Health and Safety Management System (WHSMS) a hazard could best be controlled by eliminating it, but if not then training of staff is an option. Training will always be needed whether or not other measures of hazard and risk control are implemented. This encourages research to develop effective training in terms of trainers’ perspective (in delivery), learners’ perspective (of appreciating the sessions) and management’ perspective (of the outcome of hazard control).
Literature shows that the workforce training in hospitals to control OVAS lacks consistency and uniformity across Australian hospitals. ‘Management of Violence and Aggression International Training’ (MSVT) is one training programme run by the BN123 Health, Victoria, since 1990.
With that background the main aim of this qualitative case study research project was to “identify the effectiveness of the existing training programme (MSVT) in prevention of occupational violence against staff (OVAS) “. Occupational violence is a part of work health and safety issue. So, the research intended to enquire: ‘Is the existing MSVT in prevention of OVAS achieving its purpose, particularly in the current WHSMS setting of the hospital?’
The literature review assisted in identifying the causes of OVAS, types, prevalence and the factors associated with it. It also helped to analyse the published incidents. Among different training evaluation methods, the Kirkpatrick’s model was found most suitable to evaluate MSVT. Analysis attempted to correlate the outcome of the training against existing objectives. Limited access to information meant that I could not perform in-depth analyses, but the findings of this study are expected to guide future research on the effectiveness of MSVT at BN123 Health with more integration to the WHSMS and other safety programmes
This research used a qualitative case study with Actor-Network Theory (ANT) to fulfil the goal. The limited access to health facilities both due to obstacle in sensitive data collection and accessing busy participants of different sections of the hospital in a limited time frame.
This study explored actors related to OVAS and suggested adoption of an innovative approach to improve workplace safety through the formation of new networks. It did this by looking through the lens of Actor-Network Theory (ANT). The present vision of the government in digitalising the health sector in Australia is a prime opportunity to re-align the network in the WHSMS of the hospital for better impact of training on the OVAS situation.
Limited guidance from top management was an issue. MSVT was under the control of the Psychiatric Department at its inception but was then moved under Human Resources (HR), which seems to have reduced its importance and resource management ability. Hospitals are dominated by clinical priorities rather than HR issues.
Being a part of the general training programme administered by HR has limited the ability of MSVT as it struggled to receive funding to recruit enough full-time trainers to undertake research on OVAS incidents, promote the programme across the whole organisation, publish materials to create awareness to all staff and develop resources to help retain the knowledge of the participants in the post-training period.
Limited flow of information on OVAS was another issue. Even though BN123 Health invests in innovation like RSKSOFT, for reporting it did not purchase all the modules of that programme to improve the flow of information to the trainers of MSVT.
BN123 Health demonstrated a proactive attitude in managing OVAS by procuring and trademarking MSVT but is lacking continuity of efforts in it, maybe due to its commitment to clinical aspects of the service. This could be verified by further research.
The research identified scope for innovation. Firstly, the training programme could be strengthened by incorporating recent updates on organisational objectives and legislative changes and standardisation with industry practices. It could also be strengthened by incorporation of an improved audio-visual component, distance learning facilities for beginners and refreshers, updating resources including books and journals, inter-organisation exchange programmes and inclusion of regular research results in booklets and handouts. Targeted delivery would also assist, with constant vigilance on incidents and inclusion of vulnerable groups in training.
Another worthwhile innovation would be to change the focus from staff only programmes to involve customer or client interest. This could include arranging training for clients and carers as they are a party in the conflict. Management training would be useful to prepare resources for the population of the catchment area, bringing together all healthcare providers (including GPs) who refer clients to the hospital. Updating real-time information collection, storage and analysis by professionals as well as information access to trainers would also be a worthwhile innovation.
With the availability of mobile technology, BN123 Health has scope to improve its ability to get real-time information from the incident spot and to develop better management to control events. This could also provide arrangements for easy data entry by general staff.
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Martins, Carlos Manuel da Silva. "Preventive services in family medicine." Tese, 2014. http://hdl.handle.net/10216/74185.
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Martins, Carlos Manuel da Silva. "Preventive services in family medicine." Doctoral thesis, 2014. https://repositorio-aberto.up.pt/handle/10216/95569.
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Russell, Kathleen P. "Health beliefs and preventive health behaviors of Korean women." 1991. http://catalog.hathitrust.org/api/volumes/oclc/181088679.html.
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Thesis (M.S.)--University of Wisconsin--Madison, 1991Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 54-59).
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Andrews, Ross. "Pneumococcal vaccine for the elderly : impact of a publicly funded program." Phd thesis, 2004. http://hdl.handle.net/1885/148767.
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Thompson, Betsy L. "Insurance, regular source, and regular provider what matters in the case of mammography? : a dissertation submitted in partial fulfillment ... for the degree of Doctor of Public Health (Health Policy) ... /." 2004. http://catalog.hathitrust.org/api/volumes/oclc/69001793.html.
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