IU Indianapolis ScholarWorks :: Browsing by Author "Miech, Edward"

Browsing by Author "Miech, Edward"

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Conditions Associated with Successful Implementation of an Advance Care Planning Intervention in Nursing Homes
(Oxford University Press, 2023-12-21) Hickman, Susan; Miech, Edward; Stump, Timothy; Mack, Laramie; Tu, Wanzhu; Unroe, Kathleen; School of Nursing
Implementing evidence-based interventions in nursing homes is challenging in part because clinical trials requiring a controlled experimental environment are difficult to sustain. In contrast, pragmatic clinical trials develop and evaluate evidence-based interventions in the “real world” with the goal of streamlining implementation after study completion. However, there is minimal information available identifying conditions associated with successful implementation of pragmatic interventions in the nursing home setting. The “Aligning Patient Preferences - a Role Offering Alzheimer’s patients, Caregivers, and Healthcare Providers Education and Support” (APPROACHES) project is a pragmatic trial designed to test and evaluate a staff-led advance care planning (ACP) intervention for residents with ADRD in 131 nursing homes (64 intervention, 67 control) between September 1, 2021 and August 31, 2022. ACP Specialists received training on ACP facilitation and implementation of the ACP program in the facility. Twenty of 65 (31%) sites successfully implemented the APPROACHES intervention and had > 75% of residents with documented ACP conversations. Using configurational analysis, we found two solutions directly linked with successful pragmatic implementation: (1) no executive director turnover during the observation period combined with site participation in monthly intervention support calls with ACP staff at other facilities; and (2) higher rates of hospitalization (3.96 – 7.2 per 1000 resident days) combined with a low number of certified beds. Findings suggest that leadership stability and engagement with peers were essential drivers of successful implementation. Having greater improvement opportunities as well as a more manageable caseload for the ACP Specialist may also help explain successful implementation.
Exploring the Social Determinants of Mental Health by Race and Ethnicity in Army Wives
(Springer, 2024) Dodge, Jessica; Sullivan, Kathrine; Miech, Edward; Clomax, Adriane; Riviere, Lyndon; Castro, Carl; Emergency Medicine, School of Medicine
Objective: To explore the social determinants of mental health (SDoMH) by race/ethnicity in a sample with equal access to healthcare. Using an adaptation of the World Health Organization's SDoMH Framework, this secondary analysis examines the socio-economic factors that make up the SDoMH by race/ethnicity. Method: This paper employed configurational comparative methods (CCMs) to analyze various racial/ethnic subsets from quantitative survey data from (N = 327) active-duty Army wives. Data was collected in 2012 by Walter Reed Army Institute of Research. Results: Initial exploratory analysis revealed the highest-scoring factors for each racial/ethnic subgroup: non-Hispanic Black: employment and a history of adverse childhood events (ACEs); Hispanic: living off post and a recent childbirth; junior enlisted non-Hispanic White: high work-family conflict and ACEs; non-Hispanic other race: high work-family conflict and not having a military history. Final analysis showed four models consistently explained clinically significant depression symptoms and four models consistently explained the absence of clinical depression symptoms, providing a solution for each racial/ethnic minority group (non-Hispanic Black, Hispanic, junior enlisted non-Hispanic White, and non-Hispanic other). Discussion: These findings highlight that Army wives are not a monolithic group, despite their collective exposure to military-specific stressors. These findings also highlight the potential for applying configurational approaches to gain new insights into mental health outcomes for social science and clinical researchers.
Proceedings of the 8th Annual Conference on the Science of Dissemination and Implementation
(BioMed Central, 2016-08-01) Chambers, David; Simpson, Lisa; Hill-Briggs, Felicia; Neta, Gila; Vinson, Cynthia; Beidas, Rinad; Marcus, Steven; Aarons, Gregory; Hoagwood, Kimberly; Schoenwald, Sonja; Evans, Arthur; Hurford, Matthew; Rubin, Ronnie; Hadley, Trevor; Barg, Frances; Walsh, Lucia; Adams, Danielle; Mandell, David; Martin, Lindsey; Mignogna, Joseph; Mott, Juliette; Hundt, Natalie; Kauth, Michael; Kunik, Mark; Naik, Aanand; Cully, Jeffrey; McGuire, Alan; White, Dominique; Bartholomew, Tom; McGrew, John H.; Luther, Lauren; Rollins, Angie; Salyers, Michelle P.; Cooper, Brittany; Funaiole, Angie; Richards, Julie; Lee, Amy; Lapham, Gwen; Caldeiro, Ryan; Lozano, Paula; Gildred, Tory; Achtmeyer, Carol; Ludman, Evette; Addis, Megan; Marx, Larry; Bradley, Katharine; VanDeinse, Tonya; Wilson, Amy Blank; Stacey, Burgin; Powell, Byron; Bunger, Alicia; Cuddeback, Gary; Barnett, Miya; Stadnick, Nicole; Brookman-Frazee, Lauren; Lau, Anna; Dorsey, Shannon; Pullmann, Michael; Mitchell, Shannon; Schwartz, Robert; Kirk, Arethusa; Dusek, Kristi; Oros, Marla; Hosler, Colleen; Gryczynski, Jan; Barbosa, Carolina; Dunlap, Laura; Lounsbury, David; O'Grady, Kevin; Brown, Barry; Damschroder, Laura; Waltz, Thomas; Powell, Byron; Ritchie, Mona; Waltz, Thomas; Atkins, David; Imel, Zac E.; Xiao, Bo; Can, Doğan; Georiou, Panayiotis; Narayanan, Shrikanth; Berkel, Cady; Gallo, Carlos; Sandler, Irwin; Brown, C. Hendricks; Wolcik, Sharlene; Mauricio, Anne Marie; Gallo, Carlos; Mehrota, Sanjay; Chandurkar, Dharmendra; Bora, Siddhartha; Das, Arup; Tripathi, Anand; Saggurti, Nirajan; Raj, Anita; Hughes, Eric; Jacobs, Brian; Kirkendall, Eric; Loeb, Danielle; Trinkley, Katy; Yang, Michael; Sprowell, Andrew; Nease, Donald; Lyon, Aaron; Lewis, Cara; Boyd, Meredith; Melvin, Abigail; Nicodimos, Semret; Liu, Freda; Jungbluth, Nathanial; Lyon, Aaron; Landis-Lewis, Zach; Sales, Anne; Baloh, Jure; Ward, Marcia; Zhu, Xi; Bennett, Ian; Unutzer, Jurgen; Mao, Johnny; Proctor, Enola; Vredevoogd, Mindy; Chan, Ya-Fen; Williams, Nathaniel; Green, Phillip; Bernstein, Steven; Rosner, June-Marie; DeWitt, Michelle; Tetrault, Jeanette; Dziura, James; Hsiao, Allen; Sussman, Scott; O'Connor, Patrick; Toll, Benjamin; Jones, Michael; Gassaway, Julie; Tobin, Jonathan; Zatzick, Douglas; Bradbury, Angela R.; Patrick-Miller, Linda; Egleston, Brian; Olopade, Olufunmilayo I.; Hall, Michael J.; Daly, Mary B.; Fleisher, Linda; Grana, Generosa; Ganschow, Pamela; Fetzer, Dominique; Brandt, Amanda; Farengo-Clark, Dana; Forman, Andrea; Gaber, Rikki S.; Gulden, Cassandra; Horte, Janice; Long, Jessica; Chambers, Rachelle Lorenz; Lucas, Terra; Madaan, Shreshtha; Mattie, Kristin; McKenna, Danielle; Montgomery, Susan; Nielsen, Sarah; Powers, Jacquelyn; Rainey, Kim; Rybak, Christina; Savage, Michelle; Seelaus, Christina; Stoll, Jessica; Stopfer, Jill; Yao, Shirley; Domchek, Susan; Hahn, Erin; Munoz-Plaza, Corrine; Wang, Jianjin; Delgadillo, Jazmine Garcia; Mittman, Brian; Gould, Michael; Liang, Shuting (Lily); Kegler, Michelle C.; Cotter, Megan; Philips, Emily; Hermstad, April; Morton, Rentonia; Beasley, Derrick; Martinez, Jeremy; Riehman, Kara; Gustafson, David; Marsch, Lisa; Mares, Louise; Quanbeck, Andrew; McTavish, Fiona; McDowell, Helene; Brown, Randall; Thomas, Chantelle; Glass, Joseph; Isham, Joseph; Shah, Dhavan; Liebschutz, Jane; Lasser, Karen; Watkins, Katherine; Ober, Allison; Hunter, Sarah; Lamp, Karen; Ewing, Brett; Iwelunmor, Juliet; Gyamfi, Joyce; Blackstone, Sarah; Quakyi, Nana Kofi; Plange-Rhule, Jacob; Ogedegbe, Gbenga; Kumar, Pritika; Devanter, Nancy Van; Nguyen, Nam; Nguyen, Linh; Nguyen, Trang; Phuong, Nguyet; Shelley, Donna; Rudge, Sian; Langlois, Etienne; Tricco, Andrea; Ball, Sherry; Lambert-Kerzner, Anne; Sulc, Christine; Simmons, Carol; Shell-Boyd, Jeneen; Oestreich, Taryn; O'Connor, Ashley; Neely, Emily; McCreight, Marina; Labebue, Amy; DiFiore, Doreen; Brostow, Diana; Ho, P. Michael; Aron, David; Harvey, Jillian; McHugh, Megan; Scanon, Dennis; Lee, Rebecca; Soltero, Erica; Parker, Nathan; McNeill, Lorna; Ledoux, Tracey; McIsaac, Jessie-Lee; MacLeod, Kate; Ata, Nicole; Jarvis, Sherry; Kirk, Sara; Purtle, Jonathan; Dodson, Elizabeth; Brownson, Ross; Mittman, Brian; Curran, Geoffrey; Pyne, Jeffrey; Aarons, Gregory; Ehrhart, Mark; Torres, Elisa; Miech, Edward; Stevens, Kathleen; Hamilton, Alison; Cohen, Deborah; Padgett, Deborah; Morshed, Alexandra; Patel, Rupa; Prusaczyk, Beth; Aron, David C.; Gupta, Divya; Ball, Sherry; Hand, Rosa; Abram, Jenica; Wolfram, Taylor; Hastings, Molly; Moreland-Russell, Sarah; Tabek, Rachel; Ramsey, Alex; Baumann, Ana; Kryzer, Emily; Montgomery, Katherine; Lewis, Ericka; Padek, Margaret; Brownson, Ross; Mamaril, Cezar Brian; Mays, Glen; Branham, Keith; Timsina, Lava; Mays, Glen; Hogg, Rachel; Fagan, Abigail; Shapiro, Valerie; Brown, Eric; Haggerty, Kevin; Hawkins, David; Oesterle, Sabrina; Hawkins, David; Catalano, Richard; McKay, Virginia; Dolcini, M. Margaret; Hoffer, Lee; Moin, Tannaz; Li, Jinnan; Duru, O. Kenrik; Ettner, Susan; Turk, Norman; Chan, Charles; Keckhafer, Abigail; Luchs, Robert; Ho, Sam; Mangione, Carol; Selby, Peter; Zawertailo, Laurie; Minian, Nadia; Balliunas, Dolly; Dragonetti, Rosa; Hussain, Sarwar; Lecce, Julia; Chinman, Matthew; Acosta, Joie; Ebener, Patricia; Malone, Patrick S.; Slaughter, Mary; Freedman, Darcy; Flocke, Susan; Lee, Eunlye; Matlack, Kristen; Trapl, Erika; Ohri-Vachaspati, Punam; Taggart, Morgan; Borawski, Elaine; Parrish, Amanda; Harris, Jeffrey; Kohn, Marlana; Hammerback, Kristen; McMilan, Becca; Hannon, Peggy; Swindle, Taren; Curran, Geoffrey; Whiteside-Mansell, Leanne; Ward, Wendy; Holt, Cheryl; Santos, Sheri Lou; Tagai, Erin; Scheirer, Mary Ann; Carter, Roxanne; Bowie, Janice; Haider, Muhiuddin; Slade, Jimmie; Wang, Min Qi; Masica, Andrew; Ogola, Gerald; Berryman, Candice; Richter, Kathleen; Shelton, Rachel; Jandorf, Lina; Erwin, Deborah; Truong, Khoa; Javier, Joyce R.; Coffey, Dean; Schrager, Sheree; Palinkas, Lawrence; Miranda, Jeanne; Johnson, Veda; Hutcherson, Valerie; Ellis, Ruth; Kharmats, Anna; Marshall-King, Sandra; LaPradd, Monica; Fonseca-Becker, Fannie; Kepka, Deanna; Bodson, Julia; Warner, Echo; Fowler, Brynn; Shenkman, Elizabeth; Hogan, William; Odedina, Folakami; Leon, Jessica De; Hooper, Monica; Carrasquillo, Olveen; Reams, Renee; Hurt, Myra; Smit, Steven; Szapocznik, Jose; Nelson, David; Mandal, Prabir; Teufel, James; Department of Psychology, School of Science
Protocol for evaluating external facilitation as a strategy to nationally implement a novel stigma reduction training tool for healthcare providers
(BMC, 2022-08-12) Wasmuth, Sally; Belkiewitz, Johnna; Bravata, Dawn; Horsford, Caitlin; Harris, Alex; Smith, Carlton; Austin, Charles; Miech, Edward; Occupational Therapy, School of Health and Human Sciences
Background: Identity Development Evolution and Sharing (IDEAS) is a theatre-based intervention for reducing healthcare provider stigma. IDEAS films are created by collecting narratives from people who have experienced discrimination and healthcare inequity, partnering with professional playwrights to create theatrical scripts that maintain the words of the narratives while arranging them into compelling storylines involving several interviews, and hiring professional actors to perform and record scenes. IDEAS implementation requires a moderator to establish a respectful learning environment, play the filmed performance, set ground rules for discussion, and moderate a discussion between healthcare providers who viewed the film and invited panelists who are members of the minoritized population being discussed. IDEAS' impact on provider stigma is measured via pre/post Acceptance and Action Questionnaire - Stigma (AAQ-S) data collected from participating providers. The objectives of this manuscript are to provide narrative review of how provider stigma may lead to healthcare inequity and health disparities, describe the conceptual frameworks underpinning the IDEAS intervention, and outline methods for IDEAS implementation and implementation evaluation. Methods: This manuscript describes a hybrid type 3 design study protocol that uses the Consolidated Framework for Implementation Research (CFIR) to evaluate external facilitation, used as an implementation strategy to expand the reach of IDEAS. CFIR is also used to assess the impact of characteristics of the intervention and implementation climate on implementation success. Implementation success is defined by intervention feasibility and acceptability as well as self-efficacy of internal facilitators. This manuscript details the protocol for collection and evaluation of implementation data alongside that of effectiveness data. The manuscript provides new information about the use of configurational analysis, which uses Boolean algebra to analyze pathways to implementation success considering each variable, within and across diverse clinical sites across the USA. Discussion: The significance of this protocol is that it outlines important information for future hybrid type 3 designs wishing to incorporate configurational analyses and/or studies using behavioral or atypical, complex, innovative interventions. The current lack of evidence supporting occupational justice-focused interventions and the strong evidence of stigma influencing health inequities underscore the necessity for the IDEAS intervention.
Variation in statin prescription among veterans with HIV and known atherosclerotic cardiovascular disease
(Elsevier, 2022) Erqou, Sebhat; Papaila, Alexa; Halladay, Christopher; Ge, Augustus; Liu, Michael A.; Jiang, Lan; Lally, Michelle; Menon, Anupama; Shah, Nishant R.; Miech, Edward; Virani, Salim S.; Zullo, Andrew R.; Shireman, Theresa I.; Longenecker, Christopher T.; Ross, David; Sullivan, Jennifer L.; Wu, Wen-Chih; Rudolph, James L.; Emergency Medicine, School of Medicine
Background: People with HIV have increased atherosclerotic cardiovascular disease (ASCVD) risk, worse outcomes following incident ASCVD, and experience gaps in cardiovascular care, highlighting the need to improve delivery of preventive therapies in this population. Objective: Assess patient-level correlates and inter-facility variations in statin prescription among Veterans with HIV and known ASCVD. Methods: We studied Veterans with HIV and existing ASCVD, ie, coronary artery disease (CAD), ischemic cerebrovascular disease (ICVD), and peripheral arterial disease (PAD), who received care across 130 VA medical centers for the years 2018-2019. We assessed correlates of statin prescription using two-level hierarchical multivariable logistic regression. Median odds ratios (MORs) were used to quantify inter-facility variation in statin prescription. Results: Nine thousand six hundred eight Veterans with HIV and known ASCVD (mean age 64.3 ± 8.9 years, 97% male, 48% Black) were included. Only 68% of the participants were prescribed any-statin. Substantially higher statin prescription was observed for those with diabetes (adjusted odds ratio [OR] = 2.3, 95% confidence interval [CI], 2.0-2.6), history of coronary revascularization (OR = 4.0, CI, 3.2-5.0), and receiving antiretroviral therapy (OR = 3.0, CI, 2.7-3.4). Blacks (OR = 0.7, CI, 0.6-0.9), those with non-coronary ASCVD, ie, ICVD and/or PAD only, (OR 0.53, 95% CI: 0.48-0.57), and those with history of illicit substance use (OR=0.7, CI, 0.6-0.9) were less likely to be prescribed statins. There was significant variation in statin prescription across VA facilities (10th, 90th centile: 55%, 78%), with an estimated 20% higher likelihood of difference in statin prescription practice for two clinically similar individuals treated at two comparable facilities (adjusted MOR = 1.21, CI, 1.18-1.24), and a greater variation observed for Blacks or those with non-coronary ASCVD or history of illicit drug use. Conclusion: In an analysis of large-scale VA data, we found suboptimal statin prescription and significant interfacility variation in statin prescription among Veterans with HIV and known ASCVD, particularly among Blacks and those with a history of non-coronary ASCVD.

Browsing by Author "Miech, Edward"

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