IU Indianapolis ScholarWorks :: Browsing by Subject "Vulnerable populations"

Browsing by Subject "Vulnerable populations"

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Capsule Commentary on Meredith et al., Impact of Collaborative Care for Underserved Patients with PTSD in Primary Care: A Randomized Controlled Trial
(Springer, 2016-05) Kroenke, Kurt; Department of Medicine, IU School of Medicine
Comment on Impact of Collaborative Care for Underserved Patients with PTSD in Primary Care: a Randomized Controlled Trial. [J Gen Intern Med. 2016]
Design and Rationale of a Randomized Trial of a Care Transition Strategy in Patients With Acute Heart Failure Discharged From the Emergency Department: GUIDED-HF (Get With the Guidelines in Emergency Department Patients With Heart Failure).
(American Heart Association, 2017-02) Fermann, Gregory J.; Levy, Phillip D.; Pang, Peter; Butler, Javed; Ayaz, S. Imran; Char, Douglas; Dunn, Pat; Jenkins, Cathy A.; Kampe, Christy; Khan, Yosef; Kumar, Vijaya A.; Lindenfeld, JoAnn; Liu, Dandan; Miller, Karen; Peacock, W. Frank; Rizk, Samaa; Robichaux, Chad; Rothman, Russell L.; Schrock, Jon; Singer, Adam; Sterling, Sarah A.; Storrow, Alan B.; Walsh, Cheryl; Wilburn, John; Collins, Sean P.; Emergency Medicine, School of Medicine
GUIDED-HF (Get With the Guidelines in Emergency Department Patients With Heart Failure) is a multicenter randomized trial of a patient-centered transitional care intervention in patients with acute heart failure (AHF) who are discharged either directly from the emergency department (ED) or after a brief period of ED-based observation. To optimize care and reduce ED and hospital revisits, there has been significant emphasis on improving transitions at the time of hospital discharge for patients with HF. Such efforts have been almost exclusively directed at hospitalized patients; individuals with AHF who are discharged from the ED or ED-based observation are not included in these transitional care initiatives. Patients with AHF discharged directly from the ED or after a brief period of ED-based observation are randomly assigned to our transition GUIDED-HF strategy or standard ED discharge. Patients in the GUIDED arm receive a tailored discharge plan via the study team, based on their identified barriers to outpatient management and associated guideline-based interventions. This plan includes conducting a home visit soon after ED discharge combined with close outpatient follow-up and subsequent coaching calls to improve postdischarge care and avoid subsequent ED revisits and inpatient admissions. Up to 700 patients at 11 sites will be enrolled over 3 years of the study. GUIDED-HF will test a novel approach to AHF management strategy that includes tailored transitional care for patients discharged from the ED or ED-based observation. If successful, this program may significantly alter the current paradigm of AHF patient care.
Evaluating the Efficacy of Medical-Legal Partnerships that Address Social Determinants of Health
(Johns Hopkins University Press, 2021) Nerlinger, Abby L.; Alberti, Philip M.; Gilbert, Amy L.; Goodman, Tracy L.; Fair, Malika A.; Johnson, Sherese B.; Pettignano, Robert; Pediatrics, School of Medicine
Background: Medical-legal partnerships (MLPs) are health system-community partnerships composed of multi-disciplinary teams designed to improve patient and community health. MLPs provide legal services to address health-harming legal needs that contribute to health inequities. Methods: A grant provided by the Association of American Medical Colleges (AAMC) and the Centers for Disease Control and Prevention established the Accelerating Health Equity, Advancing through Discovery (AHEAD) Initiative to identify, evaluate, and disseminate community-based interventions that improve health equity. Three geographically and demographically diverse institutions were chosen to strengthen the evidence-base surrounding MLP by developing standardized evaluation tools in the areas of community health, health system savings, and learner outcomes. Results: The generalizable process leading to evaluation tool development is described herein, and includes the formation of multi-institutional teams, logic model development, and stakeholder interviews. Conclusions: Although MLP is presented, this process can be used by various types of community health partnerships to develop evaluation tools surrounding social determinants of health (SDOH).
Fostering Local Health Department and Health System Collaboration Through Case Conferences for At-Risk and Vulnerable Population
(American Public Health Association, 2018-05) Vest, Joshua R.; Caine, Virginia; Harris, Lisa E.; Watson, Dennis P.; Menachemi, Nir; Halverson, Paul; Health Policy and Management, School of Public Health
In case conferences, health care providers work together to identify and address patients' complex social and medical needs. Public health nurses from the local health department joined case conference teams at federally qualified health center primary care sites to foster cross-sector collaboration, integration, and mutual learning. Public health nurse participation resulted in frequent referrals to local health department services, greater awareness of public health capabilities, and potential policy interventions to address social determinants of health.
Implementation of a pharmacogenomics consult service to support the INGENIOUS trial
(Wiley, 2016-07) Eadon, M.T.; Desta, Z.; Levy, K.D.; Decker, B.S.; Pierson, R.C.; Pratt, V.M.; Callaghan, J.T.; Rosenman, M.B.; Carpenter, J.S.; Holmes, A.M.; McDonald, C.A.; Benson, E.A.; Patil, A.S.; Vuppalanchi, R.; Gufford, B.T.; Dave, N.; Robarge, J.D.; Hyder, M.A.; Haas, D.M.; Kreutz, R.P.; Dexter, P.R.; Skaar, Todd C.; Flockhart, D.A.; Medicine, School of Medicine
Hospital systems increasingly utilize pharmacogenomic testing to inform clinical prescribing. Successful implementation efforts have been modeled at many academic centers. In contrast, this report provides insights into the formation of a pharmacogenomics consultation service at a safety-net hospital, which predominantly serves low-income, uninsured, and vulnerable populations. The report describes the INdiana GENomics Implementation: an Opportunity for the UnderServed (INGENIOUS) trial and addresses concerns of adjudication, credentialing, and funding.
An Incremental Adoption Pathway for Developing Precision Medicine Based Healthcare Infrastructure for Underserved Settings
(Medinfo 2017 Conference proceedings, 2017-08) Kasthurirathne, Suranga; Biondich, Paul; Mamlin, Burke; Cullen, Theresa; Grannis, Shaun
Recent focus on Precision medicine (PM) has led to a flurry of research activities across the developed world. understaffed and underfunded health care systems in the US and elsewhere evolve to adapt PM to address pressing But how can healthcare needs? We offer guidance on a wide range of sources of healthcare data / knowledge sources as well as other infrastructure / tools that could inform PM initiatives, and may serve as low hanging fruit easily adapted on the incremental pathway towards a PM based healthcare system. Using these resources and tools, we propose an incremental adoption pathway to inform implementers working in underserved communities around the world on how they should position themselves to gradually embrace the concepts of PM with minimal interruption to existing care delivery.
Integration of Case-Based Dialogue to Enhance Medical Students' Understanding of Using Health Communication to Address Social Determinants of Health
(Dove Press, 2023-03-15) King, Jalysa; Taylor, Jennifer; Medicine, School of Medicine
Background and objectives: With the ever-growing diversity within our communities, it is imperative that we integrate social determinants of health (SDOH) such as racial disparity, economic instability, lack of transportation, intimate partner violence, and limited social supports, and the importance of health literacy into undergraduate medical education. By incorporating evidence-based curriculum on the disproportionality within healthcare faced by racial and ethnic minorities, we have the opportunity to develop more culturally sensitive providers. The purpose of this study was to assess the impact of a case-based debrief experience on medical students' knowledge about how social determinants of health can impact health and healthcare within a family medicine clinical setting and their intent to practice in an underserved community. Methods: We utilized a retrospective paired-sample t-test analysis of program data from 640 third-year medical students who engaged in a family medicine clerkship between July 2020, and April 2022. For inclusion in the study, students must have engaged in a case-based exercise and corresponding small group debrief around the impact of social determinants of health on patient care. Results: We found a statistically significant improvement in students' reported knowledge about SDOH, as well as the confidence and intent to work with and care for individuals of diverse cultural and socioeconomic backgrounds. Conclusion: Medical students must have the knowledge and self-efficacy to understand how social determinants of health can impact health and healthcare within a family medicine clinical setting. As a result of integrating more active learning strategies such as the case-base and debrief experience, students may have a more robust medical education experience.
The Phenomenon of Burnout Among Occupational Therapists: A phenomenological mixed methods study
(2023-04) Brooks, Emma; Wilburn, Victoria; Department of Occupational Therapy, School of Health and Human Sciences; Walters, Cherise; Palicki, Angela
Burnout is a phenomenon that has existed well before the occurrence of the COVID-19 pandemic. Yet, since the global pandemic, there has been a greater awareness of the effects of burnout and how it uniquely impacts occupational therapists. Burnout is an experience that is often specific to each individual creating the multifactorial phenomenon. Therefore, the purpose of the doctoral capstone project was to understand the experience of occupational therapists burnout and identify their specific needs through mixed methods phenomenological research at Eskenazi Hospital, a Level I Trauma center in the heart of Indianapolis. Moreover the study sought to utilize research outcomes to assist in programmatic development regarding therapist health and wellness to decrease burnout and increase therapists management of burnout experience and symptoms.
Reducing Physical Activity Disparities Among Vulnerable Minorities: Methods and Preliminary Outcomes
(2022) Alamilla, Rafael A.; Georgiadis, Yanoula M.; Kaushal, Navin; Keith, NiCole R.
INTRODUCTION: Vulnerable minorities experience high rates of chronic disease. Physical Activity (PA) is an effective preventive behavior to mitigate multiple diseases. Vulnerable minorities have low PA participation. Finding ways to engage PA in vulnerable minorities is imperative. PURPOSE: To describe the baseline data from a community-based wait-list pilot PA trial for vulnerable minorities. METHOD: Forty-five participants from a Midwest urban community were randomized to an experimental (EXP) or wait-list control (WLC) group. EXP participants were counseled to engage in regular PA (>4d/wk for >30 mins). EXP participants received a fitness center membership, trainer, and on-site monthly education to help them develop exercise identity and habit formation. The WLC group could engage in PA if desired but did not have the same research resources. Both groups completed monthly surveys assessing exercise identity, social support, and habit formation. Baseline data included one week of moderate-to-vigorous PA (MVPA) and health-related fitness assessments (measured by accelerometry and fitness tests, respectively). CONCLUSIONS: Data show baseline measures did not vary between groups. Moreover, our team experienced difficulties recruiting vulnerable minorities. Participant-stated barriers to participation in our study included: 1) Schedule (work, child’s school, etc.) and conflicting life demands; 2) Fear of getting ill or getting immediate family ill (COVID, flus, etc.); 3) Disruption of routine (e.g., children going on school break); 4) The limited hours of the fitness center; 5) Inflation & rising costs of goods (e.g., gasoline, food, etc.); and 6) Issues interacting with PARCS staff, lack of trust. Next steps include reporting final outcomes and developing refined recruitment methods.
A seven-year analysis of the role and impact of a free community eye clinic
(BMC, 2021-12-02) Rowe, Lucas W.; Scheive, Melanie; Tso, Hanna L.; Wurster, Patrick; Kalafatis, Nicholas E.; Camp, David A.; Thau, Avrey; Yung, Chi Wah Rudy; Ophthalmology, School of Medicine
Background: The Indiana University Student Outreach Clinic (IUSOC) Eye Clinic is a monthly student-run eye clinic that provides free visual screening to the Near East Side community of Indianapolis, IN, USA. Screening includes assessments of visual acuity, intraocular pressure, peripheral visual fields, refraction, and non-mydriatic fundus photography. Methods: This is a retrospective chart review of 875 patients seen at the IUSOC Eye Clinic from October 2013 to February 2020. Data on demographics, insurance coverage, ocular history, physical examination, suspected diagnosis, referral status, and glasses provided were collected and analyzed. Results: 875 patients were seen at the IUSOC Eye Clinic from October 2013 to February 2020. 39.2% of the patients seen at the clinic reported being uninsured. 61.4% of patients were found to have visual acuity of 20/40 or worse, while 51.3% of patients were found to have a near visual acuity of 20/40 or worse. 20.3% of patients were referred to the local county hospital for further evaluation by an ophthalmologist, 14.4% of patients received free glasses prescriptions, and 27.9% of patients received free reading glasses. Common reasons for referral for further ophthalmology evaluation included glaucoma, decreased visual acuity, and diabetic retinopathy. An estimated value of services provided over the seven years of the clinic was 1271 relative value units. Conclusion: The IUSOC Eye Clinic fills an important role in advancing ocular health and preventing irreversible blindness in an underserved Indianapolis community. Additionally, the clinic demonstrates an educational model for involving medical student volunteers.

Browsing by Subject "Vulnerable populations"

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