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Sample records for health coaching home

  1. Remote Health Coaching for Interactive Exercise with Older Adults in a Home Environment*

    PubMed Central

    Jimison, Holly B.; Hagler, Stuart; Kurillo, Gregorij; Bajcsy, Ruzena; Pavel, Misha

    2016-01-01

    Optimal health coaching interventions are tailored to individuals’ needs, preferences, motivations, barriers, and readiness to change. Technology approaches are useful in both monitoring a user’s adherence to their behavior change goals and also in providing just-in-time feedback and coaching messages. User models that incorporate dynamically varying behavior change variables with algorithms that trigger tailored messages provide a framework for making health interventions more effective. These principles are applied in the described system for assisting older adults in meeting their physical exercise goals with a tailored interactive video system with just-in-time feedback and encouragement. PMID:26737533

  2. Health coaching for the underserved.

    PubMed

    Jordan, Meg

    2013-05-01

    Twelve individuals (four homeless, two formerly homeless, and six low-income) received 12 weeks of free health coaching, an intervention normally undertaken by clients who pay $40 to $200 out of pocket for coaching services. The health coaching relationships were conducted with protocols developed for managing executive health at a Fortune 100 firm. This experimental model was constructed to explore what happens when coaching conversations for change and possibility are delivered to marginalized and underserved communities that typically undergo vastly different interactions with authorities in law, healthcare, and social services. Phase 1 of the project recruited the homeless individuals from street sites throughout San Francisco, California, and a temporary shelter. Phase 2 of the project worked with low-income and formerly homeless individuals who occupied a subsidized housing complex. Of the coaching recipients, three were black, five were Hispanic, three were of mixed race, and one declined to disclose his ethnicity. Half were Spanish speaking; immigrant status was recent for five of the 12. None had ever talked with a health coach before; only three knew how to utilize low-cost public health clinics. This case report illustrates how the motivational power of coaching conversations was a modestly useful methodology in breaking through the social isolation and loneliness of street-dwelling adults with chronic health problems. It also was a useful methodology for developing capacity for accomplishing short-term goals that were self-identified. Additionally, health coaching presented an opportunity for transitioning poverty-level individuals from passive recipients using public health sector services to more empowered actors with first-stage awareness who initiated preventive health actions. PMID:24416675

  3. Health Coaching for the Underserved

    PubMed Central

    2013-01-01

    Twelve individuals (four homeless, two formerly homeless, and six low-income) received 12 weeks of free health coaching, an intervention normally undertaken by clients who pay $40 to $200 out of pocket for coaching services. The health coaching relationships were conducted with protocols developed for managing executive health at a Fortune 100 firm. This experimental model was constructed to explore what happens when coaching conversations for change and possibility are delivered to marginalized and underserved communities that typically undergo vastly different interactions with authorities in law, healthcare, and social services. Phase 1 of the project recruited the homeless individuals from street sites throughout San Francisco, California, and a temporary shelter. Phase 2 of the project worked with low-income and formerly homeless individuals who occupied a subsidized housing complex. Of the coaching recipients, three were black, five were Hispanic, three were of mixed race, and one declined to disclose his ethnicity. Half were Spanish speaking; immigrant status was recent for five of the 12. None had ever talked with a health coach before; only three knew how to utilize low-cost public health clinics. This case report illustrates how the motivational power of coaching conversations was a modestly useful methodology in breaking through the social isolation and loneliness of street-dwelling adults with chronic health problems. It also was a useful methodology for developing capacity for accomplishing short-term goals that were self-identified. Additionally, health coaching presented an opportunity for transitioning poverty-level individuals from passive recipients using public health sector services to more empowered actors with first-stage awareness who initiated preventive health actions. PMID:24416675

  4. Health Coaching: An Update on the National Consortium for Credentialing of Health & Wellness Coaches

    PubMed Central

    2015-01-01

    In September 2014, Global Advances in Health and Medicine editor Michele Mittelman, RN, MPH, interviewed four of the leaders in health and wellness coaching about trends in coaching and the progress of the National Consortium for Credentialing of Health & Wellness Coaches. Following are the transcripts of those interviews. Additionally, videos of the interviews are available at www.gahmj.com. PMID:25694854

  5. Home Health Care

    MedlinePLUS

    ... Page Resize Text Printer Friendly Online Chat Home Health Care Home health care helps older adults live independently for as long ... need for long-term nursing home care. Home health care may include occupational and physical therapy, speech therapy, ...

  6. Complexity and Health Coaching: Synergies in Nursing

    PubMed Central

    Mitchell, Gail J.; Wong, Winnie; Rush, Danica

    2013-01-01

    Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN health coach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons' lives. Informed by complexity thinking and relational inquiry, the RN health coach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living. PMID:24102025

  7. Home Health Services

    MedlinePLUS

    ... Medicare doesn't pay for: 24-hour-a-day care at home Meals delivered to your home Homemaker ... get home health care if you attend adult day care. Note: Home health services may also include medical ...

  8. Group health coaching: strengths, challenges, and next steps.

    PubMed

    Armstrong, Colin; Wolever, Ruth Q; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L; Masemer, Susan; Lawson, Karen

    2013-05-01

    There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of "Group Health and Wellness Coaching" is proposed, and important next steps for research and for the training of group coaches are presented. PMID:24416678

  9. Respiratory Home Health Care

    MedlinePLUS

    ... Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources Immunizations Pollution Nutrition ... Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at home can contribute to improved ...

  10. Danish Health Professionals' Experiences of Being Coached: A Pilot Study

    ERIC Educational Resources Information Center

    Ammentorp, Jette; Jensen, Hanne Irene; Uhrenfeldt, Lisbeth

    2013-01-01

    Introduction: In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze health professionals' experiences from…

  11. Health Promotion in Coaching: Possibilities for Improving the Profession

    ERIC Educational Resources Information Center

    Vickers, Brad

    2008-01-01

    Coaching is a dynamic field in which many forms of health promotion occur directly and indirectly on a daily basis. It would therefore be of interest to determine the extent to which research-based data has been collected pertaining to health promotion and its influence throughout coaching. Thus, the purpose of this study was to inductively…

  12. Danish Health Professionals' Experiences of Being Coached: A Pilot Study

    ERIC Educational Resources Information Center

    Ammentorp, Jette; Jensen, Hanne Irene; Uhrenfeldt, Lisbeth

    2013-01-01

    Introduction: In recent years, coaching, as a supplement to professional development, has received increased attention, especially in nursing. Still, only little is known about how health professionals experience participating in coaching sessions. The purpose of this pilot study was to describe and analyze health professionals' experiences from

  13. Are Low-Income Peer Health Coaches Able to Master and Utilize Evidence-Based Health Coaching?

    PubMed Central

    Goldman, Matthew L.; Ghorob, Amireh; Hessler, Danielle; Yamamoto, Russell; Thom, David H.; Bodenheimer, Thomas

    2015-01-01

    PURPOSE A randomized controlled trial found that patients with diabetes had lower HbA1c levels after 6 months of peer health coaching than patients who did not receive coaching. This paper explores whether the peer coaches in that trial, all low-income patients with diabetes, mastered and utilized an evidence-based health coaching training curriculum. The curriculum included 5 core features: ask-tell-ask, closing the loop, know your numbers, behavior-change action plans, and medication adherence counseling. METHODS This paper includes the results of exams administered to trainees, exit surveys performed with peer coaches who completed the study and those who dropped out, observations of peer coaches meeting with patients, and analysis of in-depth interviews with peer coaches who completed the study. RESULTS Of the 32 peer coach trainees who completed the training, 71.9% lacked a college degree; 25.0% did not graduate from high school. The 26 trainees who passed the exams attended 92.7% of training sessions compared with 80.6% for the 6 trainees who did not pass. Peer coaches who completed the study wanted to continue peer coaching work and had confidence in their abilities despite their not consistently employing the coaching techniques with their patients. Quotations describe coaches’ perceptions of the training. CONCLUSIONS Of low-income patients with diabetes who completed the evidenced-based health coaching training, 81% passed written and oral exams and became effective peer health coaches, although they did not consistently use the techniques taught. PMID:26304970

  14. Home health care

    MedlinePLUS

    ... and exercises, wound care, and daily living. Home health care nurses can help manage problems with your wound, ... Centers for Medicare and Medicaid Services. Home health care: what it is and what to expect. ... ...

  15. The Study of Health Coaching: The Ithaca Coaching Project, Research Design, and Future Directions

    PubMed Central

    2013-01-01

    Health coaching (HC) is a process holding tremendous potential as a complementary medical intervention to shape healthy behavior change and affect rates of chronic lifestyle diseases. Empirical knowledge of effectiveness for the HC process, however, is lacking. The purposes of this paper are to present the study protocol for the Ithaca Coaching Project while also addressing research design, methodological issues, and directions for HC research. This is one of the first large-scale, randomized control trials of HC for primary prevention examining impact on physical and emotional health status in an employee population. An additional intent for the project is to investigate self-determination theory as a theoretical framework for the coaching process. Participants (n=300) are recruited as part of a campus-wide wellness initiative and randomly assigned to one of three levels of client-centered HC or a control with standard wellness program care. Repeated measures analyses of covariance will be used to examine coaching effectiveness while path analyses will be used to examine relationships between coaching processes, self-determination variables, and health outcomes. There is a great need for well-designed HC studies that define coaching best practices, examine intervention effectiveness, provide cost:benefit analysis, and address scope of practice. This information will allow a clearer definition of HC to emerge and determination of if, and how, HC fits in modern-day healthcare. This is an exciting but critical time for HC research and for the practice of HC. PMID:24416673

  16. Improving awareness, accountability, and access through health coaching

    PubMed Central

    Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

    2015-01-01

    Abstract Objective To assess patients’ experiences with and perceptions of health coaching as part of their ongoing care. Design A qualitative research design using semistructured interviews that were recorded and transcribed verbatim. Setting Ottawa, Ont. Participants Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Methods Patients’ perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. Main findings All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Conclusion Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability, all factors considered to be precursors to behavioural change. PMID:25932483

  17. Evaluation of Telephone Health Coaching of German Health Insurants with Chronic Conditions

    ERIC Educational Resources Information Center

    Härter, Martin; Dwinger, Sarah; Seebauer, Laura; Simon, Daniela; Herbarth, Lutz; Siegmund-Schultze, Elisabeth; Temmert, Daniel; Bermejo, Isaac; Dirmaier, Jörg

    2013-01-01

    Objective: This study aimed to investigate how patients with chronic conditions evaluate telephone health coaching provided by their health insurance company. Methods: A retrospective survey was conducted among coaching participants ("n" = 834). Outcomes included the general evaluation of the coaching, the evaluation of process and…

  18. Evaluation of Telephone Health Coaching of German Health Insurants with Chronic Conditions

    ERIC Educational Resources Information Center

    Hrter, Martin; Dwinger, Sarah; Seebauer, Laura; Simon, Daniela; Herbarth, Lutz; Siegmund-Schultze, Elisabeth; Temmert, Daniel; Bermejo, Isaac; Dirmaier, Jrg

    2013-01-01

    Objective: This study aimed to investigate how patients with chronic conditions evaluate telephone health coaching provided by their health insurance company. Methods: A retrospective survey was conducted among coaching participants ("n" = 834). Outcomes included the general evaluation of the coaching, the evaluation of process and

  19. Peer coaching: building collegial support for using innovative health programs.

    PubMed

    Gingiss, P L

    1993-02-01

    To ensure students achieve intended benefits from effective health programs, it is necessary to maximize program implementation and maintenance. Peer coaching provides a post-inservice staff development approach for health educators to strengthen teacher use of new health programs during implementation trials. While peer coaching positively influences teacher behavior and student outcomes, previous coaching programs have been limited in scope, have not been theoretically derived or adequately evaluated, and have not been systematically applied to health programs. This paper addresses teacher needs during trials, reviews peer coaching program features, and proposes a model to guide future planning, evaluation, and research. In this model, critical components of the coaching program include classroom assessments, coaching team cluster meetings, and administrative support. Strategies based on Social Learning Theory and Diffusion Theory are incorporated into the peer coaching program to influence teacher perceptions of their work roles, capability to implement a program, and commitment to the new instructional program. Interrelations among components are discussed and directions for future research and practice are suggested. PMID:8479163

  20. Health Coaching Education: A Conversation With Pioneers in the Field

    PubMed Central

    Snyder, Suzanne

    2013-01-01

    In February 2013, Global Advances in Health and Medicine (GAHMJ) interviewed eight pioneers in the field of health coaching education: Michael Arloski, PhD, PCC; Linda Bark, PhD, RN, MCC, NC-BC; Georgianna Donadio, PhD; Meg Jordan, PhD, RN; Sam Magill, MBA, MCC; Margaret Moore, MBA; Linda Smith, PA-C, MA; and Cheryl Walker, ML, MCC. This article features biographies of the participants and their perspectives on the evolution and value of health coaching education and the keys to its success. PMID:24416669

  1. Health coaching for glaucoma care: a pilot study using mixed methods

    PubMed Central

    Vin, Anita; Schneider, Suzanne; Muir, Kelly W; Rosdahl, Jullia A

    2015-01-01

    Introduction Adherence to glaucoma medications is essential for successful treatment of the disease but is complex and difficult for many of our patients. Health coaching has been used successfully in the treatment of other chronic diseases. This pilot study explores the use of health coaching for glaucoma care. Methods A mixed methods study design was used to assess the health coaching intervention for glaucoma patients. The health coaching intervention consisted of four to six health coaching sessions with a certified health coach via telephone. Quantitative measures included demographic and health information, adherence to glaucoma medications (using the visual analog adherence scale and medication event monitoring system), and an exit survey rating the experience. Qualitative measures included a precoaching health questionnaire, notes made by the coach during the intervention, and an exit interview with the subjects at the end of the study. Results Four glaucoma patients participated in the study; all derived benefits from the health coaching. Study subjects demonstrated increased glaucoma drop adherence in response to the coaching intervention, in both visual analog scale and medication event monitoring system. Study subjects’ qualitative feedback reflected a perceived improvement in both eye and general health self-care. The subjects stated that they would recommend health coaching to friends or family members. Conclusion Health coaching was helpful to the glaucoma patients in this study; it has the potential to improve glaucoma care and overall health. PMID:26604666

  2. 76 FR 52377 - Consolidated Energy, Inc., Diamond Home Services, Inc., Goran Capital Inc., Kingsley Coach, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION Consolidated Energy, Inc., Diamond Home Services, Inc., Goran Capital Inc., Kingsley Coach, Inc... that there is a lack of current and accurate information concerning the securities of Diamond...

  3. The Essential Components of Coach Training for Mental Health Professionals: A Delphi Study

    ERIC Educational Resources Information Center

    Moriarity, Marlene Therese

    2010-01-01

    Purpose. The purpose of this study was to discover how coach training experts define coaching and what they would identify to be the essential components of a coach training program for mental health professionals. Methods. A panel of nine experts, through an iterative Delphi process of responding to three rounds of questionnaires, provided

  4. The Essential Components of Coach Training for Mental Health Professionals: A Delphi Study

    ERIC Educational Resources Information Center

    Moriarity, Marlene Therese

    2010-01-01

    Purpose. The purpose of this study was to discover how coach training experts define coaching and what they would identify to be the essential components of a coach training program for mental health professionals. Methods. A panel of nine experts, through an iterative Delphi process of responding to three rounds of questionnaires, provided…

  5. Towards a Psychology of Coaching: The Impact of Coaching on Metacognition, Mental Health and Goal Attainment.

    ERIC Educational Resources Information Center

    Grant, Anthony M.

    A theoretical framework for a psychology of coaching was developed. First, the literature on cognitive approaches to coaching, behavioral approaches to coaching, and combinations of the cognitive and behavioral approaches was reviewed. Next, two studies examined the development and validation of a new measure of private self-consciousness called

  6. Virtual Training and Coaching of Health Behavior: Example from Mindfulness Meditation Training

    PubMed Central

    Hudlicka, Eva

    2014-01-01

    Objective Computer-based virtual coaches are increasingly being explored for patient education, counseling, and health behavior training and coaching. The objective of this research was to develop and evaluate a Virtual Mindfulness Coach for training and coaching in mindfulness meditation. Method The coach was implemented as an embodied conversational character, providing mindfulness training and coaching via mixed initiative, text-based, natural language dialogue with the student, and emphasizing affect-adaptive interaction. (The term mixed initiative dialog refers to a human-machine dialogue where either can initiate a conversation or a change in the conversation topic.) Results Findings from a pilot evaluation study indicate that the coach-based training is more effective in helping students establish a regular practice than self-administered training using written and audio materials. The coached group also appeared to be in more advanced stages of change in terms of the transtheoretical model, and have a higher sense of self-efficacy regarding establishment of a regular mindfulness practice. Conclusion These results suggest that virtual coach-based training of mindfulness is both feasible, and potentially more effective, than a self-administered program. Of particular interest is the identification of the specific coach features that contribute to its effectiveness. Practice Implications Virtual coaches could provide easily-accessible and cost-effective customized training for a range of health behaviors. The affect-adaptive aspect of these coaches is particularly relevant for helping patients establish long-term behavior changes. PMID:23809167

  7. Coaches Coaching Coaches

    ERIC Educational Resources Information Center

    Burkins, Jan Miller; Ritchie, Scott

    2007-01-01

    Researchers have argued that "job-embedded" professional learning is the most valuable model for teachers (Joyce & Showers, 2002). But there is little or no corresponding literature regarding job-embedded professional learning for literacy coaches. In this paper, the authors offer an example of one such model, the Coach-to-Coach

  8. Behavioral changes following participation in a home health promotional program in King County, Washington.

    PubMed Central

    Leung, R; Koenig, J Q; Simcox, N; van Belle, G; Fenske, R; Gilbert, S G

    1997-01-01

    This study examined behavioral changes in households after participation in a home environmental assessment. Home assessment visits by a trained coach, which involved a walk-through in the home with the home residents, were conducted in 36 homes. The walk-through included a list of recommended behavioral changes that the residents could make to reduce their exposures to home pollutants in areas such as dust control, moisture problems, indoor air, hazardous household products, and hobbies. Recruited households were surveyed 3 months after the home assessment to evaluate their implementation of the recommendations. Following the home visits, 31 of 36 households reported making at least one behavioral change, and 41% of the recommendations made by the volunteer coaches were implemented. In conclusion, this study found that the majority of the households who participated in the home assessment reported implementing at least one recommendation. This home health promotional method was effective in influencing behavioral changes. PMID:9349831

  9. Health coaching in primary care: a feasibility model for diabetes care

    PubMed Central

    2014-01-01

    Background Health coaching is a new intervention offering a one-on-one focused self-management support program. This study implemented a health coaching pilot in primary care clinics in Eastern Ontario, Canada to evaluate the feasibility and acceptability of integrating health coaching into primary care for patients who were either at risk for or diagnosed with diabetes. Methods We implemented health coaching in three primary care practices. Patients with diabetes were offered six months of support from their health coach, including an initial face-to-face meeting and follow-up by email, telephone, or face-to-face according to patient preference. Feasibility was assessed through provider focus groups and qualitative data analysis methods. Results All three sites were able to implement the program. A number of themes emerged from the focus groups, including the importance of physician buy-in, wide variation in understanding and implementing of the health coach role, the significant impact of different systems of team communication, and the significant effect of organizational structure and patient readiness on Health coaches capacity to perform their role. Conclusions It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention. PMID:24708783

  10. mHealth in the Wild: Using Novel Data to Examine the Reach, Use, and Impact of PTSD Coach

    PubMed Central

    Jaworski, Beth K; Kuhn, Eric; Makin-Byrd, Kerry N; Ramsey, Kelly M; Hoffman, Julia E

    2015-01-01

    Background A majority of Americans (58%) now use smartphones, making it possible for mobile mental health apps to reach large numbers of those who are living with untreated, or under-treated, mental health symptoms. Although early trials suggest positive effects for mobile health (mHealth) interventions, little is known about the potential public health impact of mobile mental health apps. Objective The purpose of this study was to characterize reach, use, and impact of “PTSD Coach”, a free, broadly disseminated mental health app for managing posttraumatic stress disorder (PTSD) symptoms. Methods Using a mixed-methods approach, aggregate mobile analytics data from 153,834 downloads of PTSD Coach were analyzed in conjunction with 156 user reviews. Results Over 60% of users engaged with PTSD Coach on multiple occasions (mean=6.3 sessions). User reviews reflected gratitude for the availability of the app and being able to use the app specifically during moments of need. PTSD Coach users reported relatively high levels of trauma symptoms (mean PTSD Checklist Score=57.2, SD=15.7). For users who chose to use a symptom management tool, distress declined significantly for both first-time users (mean=1.6 points, SD=2.6 on the 10-point distress thermometer) and return-visit users (mean=2.0, SD=2.3). Analysis of app session data identified common points of attrition, with only 80% of first-time users reaching the app’s home screen and 37% accessing one of the app’s primary content areas. Conclusions These findings suggest that PTSD Coach has achieved substantial and sustained reach in the population, is being used as intended, and has been favorably received. PTSD Coach is a unique platform for the delivery of mobile mental health education and treatment, and continuing evaluation and improvement of the app could further strengthen its public health impact. PMID:26543913

  11. Australian rural football club leaders as mental health advocates: an investigation of the impact of the Coach the Coach project

    PubMed Central

    2010-01-01

    Background Mental ill health, especially depression, is recognised as an important health concern, potentially with greater impact in rural communities. This paper reports on a project, Coach the Coach, in which Australian rural football clubs were the setting and football coaches the leaders in providing greater mental health awareness and capacity to support early help seeking behaviour among young males experiencing mental health difficulties, especially depression. Coaches and other football club leaders were provided with Mental Health First Aid (MHFA) training. Method Pre-post measures of the ability of those club leaders undertaking mental health training to recognise depression and schizophrenia and of their knowledge of evidence supported treatment options, and confidence in responding to mental health difficulties were obtained using a questionnaire. This was supplemented by focus group interviews. Pre-post questionnaire data from players in participating football clubs was used to investigate attitudes to depression, treatment options and ability to recognise depression from a clinical scenario. Key project stakeholders were also interviewed. Results Club leaders (n = 36) who were trained in MHFA and club players (n = 275) who were not trained, participated in this evaluation. More than 50% of club leaders who undertook the training showed increased capacity to recognise mental illness and 66% reported increased confidence to respond to mental health difficulties in others. They reported that this training built upon their existing skills, fulfilled their perceived social responsibilities and empowered them. Indirect benefit to club players from this approach seemed limited as minimal changes in attitudes were reported by players. Key stakeholders regarded the project as valuable. Conclusions Rural football clubs appear to be appropriate social structures to promote rural mental health awareness. Club leaders, including many coaches, benefit from MHFA training, reporting increased skills and confidence. Benefit to club players from this approach was less obvious. However, the generally positive findings of this study suggest further research in this area is desirable. PMID:20482809

  12. Improving hypertension self-management with community health coaches.

    PubMed

    Dye, Cheryl J; Williams, Joel E; Evatt, Janet Hoffman

    2015-03-01

    Approximately two thirds of those older than 60 years have a hypertension diagnosis. The aim of our program, Health Coaches for Hypertension Control, is to improve hypertension self-management among rural residents older than 60 years through education and support offered by trained community volunteers called Health Coaches. Participants received baseline and follow-up health risk appraisals with blood work, educational materials, and items such as blood pressure monitors and pedometers. Data were collected at baseline, 8 weeks, and 16 weeks on 146 participants who demonstrated statistically significant increases in hypertension-related knowledge from baseline to 8 weeks that persisted at 16 weeks, as well as significant improvements in stage of readiness to change behaviors and in actual behaviors. Furthermore, clinically significant decreases in all outcome measures were observed, with statistically significant changes in systolic blood pressure (-5.781 mmHg; p = .001), weight (-2.475 lb; p < .001), and glucose (-5.096 mg/dl; p = .004) after adjusting for multiple comparisons. Although 40.4% of participants met the Healthy People 2020 definition of controlled hypertension at baseline, the proportion of participants meeting this definition at 16 weeks postintervention increased to 51.0%. This article describes a university-community-hospital system model that effectively promotes hypertension self-management in a rural Appalachian community. PMID:24837989

  13. Managing Home Health Care (For Parents)

    MedlinePLUS

    ... Cerebral Palsy: Caring for Your Child Managing Home Health Care KidsHealth > For Parents > Managing Home Health Care Print ... espaol La atencin mdica en el hogar Intensive Health Care at Home Kids can need intensive health care ...

  14. Managing the health of the elite athlete: a new integrated performance health management and coaching model.

    PubMed

    Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

    2014-04-01

    Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games. PMID:24620040

  15. Managing the health of the elite athlete: a new integrated performance health management and coaching model

    PubMed Central

    Dijkstra, H Paul; Pollock, N; Chakraverty, R; Alonso, J M

    2014-01-01

    Elite athletes endeavour to train and compete even when ill or injured. Their motivation may be intrinsic or due to coach and team pressures. The sports medicine physician plays an important role to risk-manage the health of the competing athlete in partnership with the coach and other members of the support team. The sports medicine physician needs to strike the right ethical and operational balance between health management and optimising performance. It is necessary to revisit the popular delivery model of sports medicine and science services to elite athletes based on the current reductionist multispecialist system lacking in practice an integrated approach and effective communication. Athlete and coach in isolation or with a member of the multidisciplinary support team, often not qualified or experienced to do so, decide on the utilisation of services and how to apply the recommendations. We propose a new Integrated Performance Health Management and Coaching model based on the UK Athletics experience in preparation for the London Olympic and Paralympic Games. The Medical and Coaching Teams are managed by qualified and experienced individuals operating in synergy towards a common performance goal, accountable to a Performance Director and ultimately to the Board of Directors. We describe the systems, processes and implementation strategies to assist the athlete, coach and support teams to continuously monitor and manage athlete health and performance. These systems facilitate a balanced approach to training and competing decisions, especially while the athlete is ill or injured. They take into account the best medical advice and athlete preference. This Integrated Performance Health Management and Coaching model underpinned the Track and Field Gold Medal performances at the London Olympic and Paralympic Games. PMID:24620040

  16. National Training and Education Standards for Health and Wellness Coaching: The Path to National Certification

    PubMed Central

    Wolever, Ruth Q.; Lawson, Karen; Moore, Margaret

    2015-01-01

    The purpose of this article is twofold: (1) to announce the findings of the job task analysis as well as national training and education standards for health and wellness coaching (HWC) that have been developed by the large-scale, collaborative efforts of the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC) and (2) to invite commentary from the public. The rapid proliferation of individuals and organizations using the terms of health and/or wellness coaches and the propagation of private industry and academic coach training and education programs endeavoring to prepare these coaches has created an urgent and pressing need for national standards for use of the term health and wellness coach, as well as minimal requirements for training, education, and certification. Professionalizing the field with national standards brings a clear and consistent definition of health and wellness coaching and accepted practice standards that are uniform across the field. In addition, clear standards allow for uniform curricular criteria to ensure a minimal benchmark for education, training, and skills and knowledge evaluation of professional health and wellness coaches. PMID:25984418

  17. The Process of Patient Empowerment in Integrative Health Coaching: How Does it Happen?

    PubMed Central

    Caldwell, Karen L.; Gray, Jennifer

    2013-01-01

    Emerging healthcare delivery models suggest that patients benefit from being engaged in their care. Integrative health coaching (IHC) is designed to be a systematic, collaborative, and solution-focused process that facilitates the enhancement of life experience and goal attainment regarding health, but little research is available to describe the mechanisms through which empowerment occurs in the health coaching process. The purpose of this qualitative study is to describe apparent key components of the empowerment process as it actually occurs in IHC. A sample of 69 recorded health coaching sessions was drawn from 12 participants enrolled in a randomized controlled study comparing two different methods of weight-loss maintenance. Two researchers coded the word-for-word transcripts of sessions focusing on the structure of the sessions and communication strategies used by the coaches. Three basic sections of a coaching session were identified, and two main themes emerged from the communication strategies used: Exploring Participant's Experience and Active Interventions. In IHC, health coaches do not direct with prefabricated education based on the patient's presenting problem; rather, they use a concordant style of communication. The major tenets of the health coaching process are patient-centeredness and patient control focused around patient-originated health goals that guide the work within a supportive coaching partnership. As the field of health coaching continues to define itself, an important ongoing question involves how the structure of the provider-patient interaction is informed by the role of the healthcare provider (eg, nurse, therapist, coach) and in turn shapes the empowerment process. PMID:24416672

  18. Evaluating the Treatment Fidelity of Parents Who Conduct In-Home Functional Communication Training with Coaching via Telehealth

    ERIC Educational Resources Information Center

    Suess, Alyssa N.; Romani, Patrick W.; Wacker, David P.; Dyson, Shannon M.; Kuhle, Jennifer L.; Lee, John F.; Lindgren, Scott D.; Kopelman, Todd G.; Pelzel, Kelly E.; Waldron, Debra B.

    2014-01-01

    We conducted a retrospective, descriptive evaluation of the fidelity with which parents of three children with autism spectrum disorders conducted functional communication training (FCT) in their homes. All training was provided to the parents via telehealth by a behavior consultant in a tertiary-level hospital setting. FCT trials coached by the

  19. Evaluating the Treatment Fidelity of Parents Who Conduct In-Home Functional Communication Training with Coaching via Telehealth

    ERIC Educational Resources Information Center

    Suess, Alyssa N.; Romani, Patrick W.; Wacker, David P.; Dyson, Shannon M.; Kuhle, Jennifer L.; Lee, John F.; Lindgren, Scott D.; Kopelman, Todd G.; Pelzel, Kelly E.; Waldron, Debra B.

    2014-01-01

    We conducted a retrospective, descriptive evaluation of the fidelity with which parents of three children with autism spectrum disorders conducted functional communication training (FCT) in their homes. All training was provided to the parents via telehealth by a behavior consultant in a tertiary-level hospital setting. FCT trials coached by the…

  20. The survive and thrive program: encouraging coaching, mentoring, and peer learning among new local health officials.

    PubMed

    Henry, Vonna; Sarpy, Sue Ann; Green, Rachel; Kaplan, Seth; Bonzon, Ramon

    2010-01-01

    There is a need for programs tailored to train the approximately 300 new local health officials (LHOs) who emerge each year with the knowledge and skills needed to build, maintain, and enhance public health capacity and infrastructure. The Survive and Thrive program incorporates a curriculum that is designed to address the challenges faced by a new LHO. The Survive and Thrive program seeks to address these issues by leveraging the expertise of the current generation of local public health leadership by incorporating experienced LHOs as coaches. Coaching, mentoring, and peer assistance by seasoned LHOs is critical to these new learning opportunities. This article highlights aspects of the coaching component of Survive and Thrive program. Actual examples of its relevance to the professional growth and development of new LHOs and the coaches themselves are presented. The article also describes the novel approach of including coaches in evaluating program effectiveness. The Survive and Thrive program's coaching component can serve as a template for other public health leadership programs and related workforce development initiatives as well as a model to help facilitate lifelong learning of LHOs. PMID:20150793

  1. Marketing home health care.

    PubMed

    Kolatch, A

    1991-11-01

    This case study focuses on the physician as an important customer for home care services. The author describes how Visiting Nurse Service of New York developed and implemented a direct sales strategy to increase the number of referrals from physicians. Five of the direct sales consultants were registered nurses. The tactics used to increase the percentage of cases referred directly by physicians are discussed. PMID:1941173

  2. Can life coaching improve health outcomes? A systematic review of intervention studies

    PubMed Central

    2013-01-01

    Background In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need for an overview of the evidence regarding coaching interventions used in patient care, the effect of the interventions, and the quality of the studies published. However, in order to provide a clear definition of the coaching interventions selected for this review, we have found it necessary to distinguish between health coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching. Methods Intervention studies using quantitative or qualitative methods to evaluate the outcome of the life coach interventions were identified through systematic literature searches in PubMed, Embase, Psycinfo, and CINAHL. The quality of the methodology was independently assessed by three of the authors using a criteria list. Results A total of 4359 citations were identified in the electronic search and five studies were included; two of them were randomized controlled trials and met all quality criteria. The two studies investigating objective health outcomes (HbA1c) showed mixed but promising results, especially concerning the patient group that usually does not benefit from intensified interventions. Conclusion Because of the very limited number of solid studies, this review can only present tendencies for patient outcomes and a preliminary description of an effective life coaching intervention. The coaching method used in these studies aims to improve self-efficacy and self-empowerment. This may explain why the studies including disadvantaged patients showed the most convincing results. The findings also indicate that some patients benefit from being met with an alternative approach and a different type of communication than they are used to from health care personnel. In order to get a closer look at what is in the black box, we suggest that the description and categorisation of the coaching methods are described more comprehensively, and that research into this area is supplemented by a more qualitative approach. PMID:24148189

  3. Clinician perspectives on working with health coaches: A mixed methods approach.

    PubMed

    Dubé, Kate; Willard-Grace, Rachel; O'Connell, Brendon; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Hessler, Danielle; Thom, David H

    2015-09-01

    We sought to understand how health coaches affect the work of primary care clinicians and influence their perception of patient care. As a mixed methods hypothesis-generating study, we administered a structured post-visit survey and conducted in-depth individual interviews with primary care clinicians who worked with health coaches at two urban community health centers. Survey responses were compared using t tests. Interviews were transcribed and analyzed using Atlas.ti software and modified grounded theory. Surveys were completed by 15 of 17 clinicians for 61% of eligible patient visits (269/441). Compared to usual care patients, clinicians rated visits with health-coached patients as less demanding (2.44 vs. 3.06, p < .001) and were more likely to feel that they had adequate time with their patient (3.96 vs. 3.57, p < .001). Qualitative findings expanded upon these results and uncovered four key health coach activities thought to improve patient care. Through developing a rapport with patients over time and working with patients between medical visits, health coaches (a) empower patients by offering self-management support, (b) bridge communication gaps between clinicians and patients, (c) assist patients in navigating the health care system, and (d) act as a point of contact for patients. PMID:25751177

  4. Telephone-based health coaching for chronically ill patients: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background The rising prevalence of chronic conditions constitutes a major burden for patients and healthcare systems and is predicted to increase in the upcoming decades. Improving the self-management skills of patients is a strategy to steer against this burden. This could lead to better outcomes and lower healthcare costs. Health coaching is one method for enhancing the self-management of patients and can be delivered by phone. The effects of telephone-based health coaching are promising, but still inconclusive. Economic evaluations and studies examining the transferability of effects to different healthcare systems are still rare. Aim of this study is to evaluate telephone-based health coaching for chronically ill patients in Germany. Methods/Design The study is a prospective randomized controlled trial comparing the effects of telephone-based health coaching with usual care during a 4-year time period. Data are collected at baseline and after 12, 24 and 36 months. Patients are selected based on one of the following chronic conditions: diabetes, coronary artery disease, asthma, hypertension, heart failure, COPD, chronic depression or schizophrenia. The health coaching intervention is carried out by trained nurses employed by a German statutory health insurance. The frequency and the topics of the health coaching are manual-based but tailored to the patients needs and medical condition, following the concepts of motivational interviewing, shared decision-making and evidence-based-medicine. Approximately 12,000 insurants will be enrolled and randomized into intervention and control groups. Primary outcome is the time until hospital readmission within two years after enrolling in the health coaching, assessed by routine data. Secondary outcomes are patient-reported outcomes like changes in quality of life, depression and anxiety and clinical values assessed with questionnaires. Additional secondary outcomes are further economic evaluations like health service use as well as costs and hospital readmission rates. The statistical analyses includes intention-to-treat and as-treated principles. The recruitment will be completed in September 2014. Discussion This study will provide evidence regarding economic and clinical effects of telephone-delivered health coaching. Additionally, this study will show whether health coaching is an adequate option for the German healthcare system to address the growing burden of chronic diseases. Trial registration German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS) DRKS00000584. PMID:24135027

  5. Health Benefits Home

    MedlinePLUS

    ... health care enrollment each year. Learn more Veterans Financial Assessment VA Removes Annual Income Reporting Requirement Eliminates ... Means Test Frequently Asked Questions(FAQ) CONNECT Veterans Crisis Line: 1-800-273-8255 (Press 1) Social ...

  6. Homemaker/Home Health Aide.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    This curriculum guide provides materials for a five-unit home health aide course. Each unit contains 4 to 36 lesson plans. Unit topics and representative lesson plan topics are as follows: (1) introduction (ethical and legal responsibilities, time management, reporting and recording); (2) communication (techniques, meeting the public, therapeutic…

  7. Homemaker/Home Health Aide.

    ERIC Educational Resources Information Center

    La Mothe, Dolores; And Others

    This curriculum guide is intended to assist vocational instructors in preparing students for entry-level employment as homemakers/home health aides and getting them ready for advanced training in the workplace. The package contains a competency/skill and task list, an instructor's guide, and an annotated bibliography. The following competencies

  8. Homemaker/Home Health Aide.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    This curriculum guide provides materials for a five-unit home health aide course. Each unit contains 4 to 36 lesson plans. Unit topics and representative lesson plan topics are as follows: (1) introduction (ethical and legal responsibilities, time management, reporting and recording); (2) communication (techniques, meeting the public, therapeutic

  9. Experience with Health Coach-Mediated Physician Referral in an Employed Insured Population

    PubMed Central

    Rao, Sowmya R.; Rogers, Robert S.; Mailhot, Johanna R.; Galvin, Robert

    2010-01-01

    BACKGROUND Given increasing interest in helping consumers choose high-performing (higher quality, lower cost) physicians, one approach chosen by several large employers is to provide assistance in the form of a telephonic health coach a registered nurse who assists with identifying appropriate and available providers. OBJECTIVE To evaluate the health coachs influence on provider choice and the quality of the user experience in the early introduction of this service. DESIGN Cross-sectional survey of 3490 employees and covered dependents of a large national firm that offered health coach services to all employees and covered dependents. The survey began in September 2007 with proportionate stratified sampling of 1750 employees and covered dependents who used the services between October 2007 and February 2008, and 1740 non-users. PARTICIPANTS Insured adults (ages 2164) employed by a large national firm or covered dependents of employees. MEASUREMENTS Awareness of the service, reason for using service, visits to providers recommended by service, use of health advice provided by service, user satisfaction. MAIN RESULTS The primary reason for using the service was to obtain provider referrals (73%). Fifty-two percent of users sought a specialist referral, 33% a PCP referral and 9% a hospital referral. Eighty-nine percent of users seeking a provider referral were referred in-network; 81% of those referred visited the referred provider. Measures of satisfaction with both the service and the care delivered by recommended providers were over 70%. CONCLUSIONS Customers largely follow the provider recommendation of the health coach. Users express general satisfaction with existing health coach services, but differences in performance between vendors highlight the need for the services to be well implemented. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1428-4) contains supplementary material, which is available to authorized users. PMID:20556533

  10. Coaching vs Psychotherapy in health and Wellness: Overlap, Dissimilarities, and the Potential for Collaboration

    PubMed Central

    Livingstone, John B.

    2013-01-01

    Health coaches and psychotherapists both work with the art and science of facilitating change in their patients and clients. While the evolving field of health coaching and the established disciplines of clinical or counseling psychology share major areas of overlap, there are also significant distinctions between the two fields. This article outlines those similarities and dissimilarities with the intention of fostering a cooperative and mutually enriching stance between the two helping professions for the benefit of the respective professionals and the countless clients and patients they serve. PMID:24416682

  11. A Proactive Innovation for Health Care Transformation: Health and Wellness Nurse Coaching.

    PubMed

    Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Southard, Mary Elaine; Brekke, Mary E; Sandor, M Kay; Natschke, Mary

    2016-03-01

    A cohort of holistic nurses, recognizing opportunities inherent in health care transformation, organized and worked together from 2009 to 2012. The goal was to hold space for holistic nursing by developing a health and wellness coaching role and certification program for holistic nurses. The intent was to ensure that holistic nurses could work to the fullest of their ability within the evolving health care system, and others could discover the merit of holistic nursing as they explored the possibilities of nurse coaching. Challenges emerged that required the cohort plan strategies that would hold the space for nursing while also moving toward the intended goal. As they worked, this cohort demonstrated leadership skills, knowledge, values, and attitudes of holistic nursing that provide an example for others who follow in the wake of health care transformation. The American Holistic Credentialing Corporation's perspective of the events that unfolded and of the related decisions made by the coalition provides a record of the evolution of holistic nursing. PMID:25911026

  12. Coaches' Perceptions of French Sports Clubs: Health-Promotion Activities, Aims and Coach Motivation

    ERIC Educational Resources Information Center

    Van Hoye, Aurélie; Sarrazin, Philippe; Heuzé, Jean-Philippe; Kokko, Sami

    2015-01-01

    Background: Given the benefits of participating in sport, sports clubs have been recognised as health promoting organizations. To examine health-promotion activities in Finnish sports clubs, Kokko et al. developed a set of standards for health-promoting sports clubs (HPSC). Objective: The present study extends this line of research, by (1)…

  13. Coaches' Perceptions of French Sports Clubs: Health-Promotion Activities, Aims and Coach Motivation

    ERIC Educational Resources Information Center

    Van Hoye, Aurlie; Sarrazin, Philippe; Heuz, Jean-Philippe; Kokko, Sami

    2015-01-01

    Background: Given the benefits of participating in sport, sports clubs have been recognised as health promoting organizations. To examine health-promotion activities in Finnish sports clubs, Kokko et al. developed a set of standards for health-promoting sports clubs (HPSC). Objective: The present study extends this line of research, by (1)

  14. Teacher Consultation and Coaching within Mental Health Practice: Classroom and Child Effects in Urban Elementary Schools

    ERIC Educational Resources Information Center

    Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.

    2012-01-01

    Objective: To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method: Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to…

  15. Teacher Consultation and Coaching within Mental Health Practice: Classroom and Child Effects in Urban Elementary Schools

    ERIC Educational Resources Information Center

    Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.

    2012-01-01

    Objective: To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method: Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to

  16. The Role of Physical and Health Educators and Coaches in the Prevention of Eating Disorders.

    ERIC Educational Resources Information Center

    Moriarty, Dick; And Others

    All teachers, coaches, and guidance counselors should be concerned about eating disorders as a health and life threatening illness. While no reliable research studies or statistics exist on the incidence of eating disorders among athletes and aerobic exercisers, estimates suggest that 10-20% of the female high school population and a much higher

  17. A Systematic Review of the Literature on Health and Wellness Coaching: Defining a Key Behavioral intervention in Healthcare

    PubMed Central

    Simmons, Leigh Ann; Sforzo, Gary A.; Dill, Diana; Kaye, Miranda; Bechard, Elizabeth M.; Southard, Mary Elaine; Kennedy, Mary; Vosloo, Justine; Yang, Nancy

    2013-01-01

    Primary Objective: Review the operational definitions of health and wellness coaching as published in the peer-reviewed medical literature. Background: As global rates of preventable chronic diseases have reached epidemic proportions, there has been an increased focus on strategies to improve health behaviors and associated outcomes. One such strategy, health and wellness coaching, has been inconsistently defined and shown mixed results. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)guided systematic review of the medical literature on health and wellness coaching allowed for compilation of data on specific features of the coaching interventions and background and training of coaches. Results: Eight hundred abstracts were initially identified through PubMed, with 284 full-text articles ultimately included. The majority (76%) were empirical articles. The literature operationalized health and wellness coaching as a process that is fully or partially patient-centered (86% of articles), included patient-determined goals (71%), incorporated self-discovery and active learning processes (63%) (vs more passive receipt of advice), encouraged accountability for behaviors (86%), and provided some type of education to patients along with using coaching processes (91%). Additionally, 78% of articles indicated that the coaching occurs in the context of a consistent, ongoing relationship with a human coach who is trained in specific behavior change, communication, and motivational skills. Conclusions: Despite disparities in how health and wellness coaching have been operationalized previously, this systematic review observes an emerging consensus in what is referred to as health and wellness coaching; namely, a patient-centered process that is based upon behavior change theory and is delivered by health professionals with diverse backgrounds. The actual coaching process entails goal-setting determined by the patient, encourages self-discovery in addition to content education, and incorporates mechanisms for developing accountability in health behaviors. With a clear definition for health and wellness coaching, robust research can more accurately assess the effectiveness of the approach in bringing about changes in health behaviors, health outcomes and associated costs that are targeted to reduce the global burden of chronic disease. PMID:24416684

  18. FastStats: Home Health Care

    MedlinePLUS

    ... Submit What's this? Submit Button NCHS Home Home Health Care Recommend on Facebook Tweet Share Compartir Data are ... Data Alzheimer’s disease Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over [ ...

  19. Home Health Care: Services and Cost

    ERIC Educational Resources Information Center

    Widmer, Geraldine; And Others

    1978-01-01

    Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

  20. Personalized Health Planning With Integrative Health Coaching to Reduce Obesity Risk Among Women Gaining Excess Weight During Pregnancy

    PubMed Central

    Yang, Nancy Y.; Wroth, Shelley; Parham, Catherine; Strait, Melva

    2013-01-01

    Health coaching is an emerging behavioral intervention to improve outcomes in chronic disease management and prevention; however, no studies have investigated its utility in postpartum women who have gained excess weight during pregnancy. A 32-year-old primigravida woman who was overweight at conception and gained 23 lbs more than Institute of Medicine recommendations for her pre-pregnancy body mass index participated in a 6-month personalized health planning with integrative health coaching (PHPIHC) intervention. The intervention included a baseline health risk assessment review with a healthcare provider and eight biweekly, 30-minute telephonic health coaching sessions. The participant demonstrated improvement in physical activity, energy expenditure, knowledge, and confidence to engage in healthpromoting behaviors. Although the participant did not reach the target weight by completion of the health coaching sessions, follow up 8 months later indicated she achieved the target goal (within 5% of prepregnancy weight). This case report suggests that PHP-IHC can support postpartum women in returning to pre-pregnancy weight after gaining excess gestational weight. Future research and clinical trials are needed to determine the best timing, length, and medium (online, in-person, telephonic) of PHP-IHC for postpartum women. PMID:24278848

  1. Teaching Home Environmental Health to Resident Physicians

    PubMed Central

    Zickafoose, Joseph S.; Greenberg, Stuart; Dearborn, Dorr G.

    2011-01-01

    Healthy Homes programs seek to integrate the evaluation and management of a multitude of health and safety risks in households. The education of physicians in the identification, evaluation, and management of these home health and safety issues continues to be deficient. Healthy Homes programs represent a unique opportunity to educate physicians in the home environment and stimulate ongoing, specific patient-physician discussions and more general learning about home environmental health. The Case Healthy Homes and Patients Program addresses these deficiencies in physician training while providing direct services to high-risk households. Pediatric and family practice resident physicians participate in healthy home inspections and interventions for their primary care patients and follow up on identified risks during health maintenance and acute illness visits. PMID:21563707

  2. Coping Skills Training in a Telephone Health Coaching Program for Youth at Risk for Type 2 Diabetes

    PubMed Central

    Jefferson, Vanessa; Jaser, Sarah S.; Lindemann, Evie; Galasso, Pamela; Beale, Alison; Holl, Marita G.; Grey, Margaret

    2010-01-01

    Introduction The purpose of this paper is to describe components of a health coaching intervention based on coping skills training delivered via telephone. This intervention was provided to urban adolescents at risk for type 2 diabetes mellitus (T2DM), reinforcing a school-based curriculum designed to promote a healthy lifestyle and prevent T2DM. Method Health coaching via telephone was provided to at-risk, urban youth enrolled in a study of an intervention to reduce risk for T2DM. Vignettes are used to describe the use of several coping skills in this high risk youth population. Results A variety of vignettes illustrate how telephone health coaching reinforced lifestyle changes in students by incorporating coping skills training. Discussion Given the benefits and the challenges of the telephone health coaching intervention, several suggestions for others who plan to use a similar method are described. PMID:21514490

  3. Home Health Agency Work Environments and Hospitalizations

    PubMed Central

    Flynn, Linda; Lake, Eileen T.; Aiken, Linda H.

    2014-01-01

    Background: An important goal of home health care is to assist patients to remain in community living arrangements. Yet home care often fails to prevent hospitalizations and to facilitate discharges to community living, thus putting patients at risk of additional health challenges and increasing care costs. Objectives: To determine the relationship between home health agency work environments and agency-level rates of acute hospitalization and discharges to community living. Methods and Design: Analysis of linked Center for Medicare and Medicaid Services Home Health Compare data and nurse survey data from 118 home health agencies. Robust regression models were used to estimate the effect of work environment ratings on between-agency variation in rates of acute hospitalization and community discharge. Results: Home health agencies with good work environments had lower rates of acute hospitalizations and higher rates of patient discharges to community living arrangements compared with home health agencies with poor work environments. Conclusion: Improved work environments in home health agencies hold promise for optimizing patient outcomes and reducing use of expensive hospital and institutional care. PMID:25215647

  4. Coaching without a Coach

    ERIC Educational Resources Information Center

    Steinbacher-Reed, Christina; Powers, Elizabeth A.

    2012-01-01

    Ironically, at a time when coaching seems to have come into its own as a way to improve teacher practice, school districts across the United States are experiencing funding cuts and eliminating coaching positions. The threats that budget woes pose to established school coaching programs led the authors to ask themselves what practices schools and

  5. Home Health Compare: Find a Home Health Agency

    MedlinePLUS

    ... gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you ... application is not fully accessible to users whose browsers do not support or have Cascading Style Sheets ( ...

  6. Sustained Effects of a Nurse Coaching Intervention via Telehealth to Improve Health Behavior Change in Diabetes

    PubMed Central

    Young, Heather; Ward, Deborah; Dharmar, Madan; Tang-Feldman, Yajarayma; Berglund, Lars

    2014-01-01

    Abstract Background: Diabetes educators and self-management programs are scarce in rural communities, where diabetes is the third highest-ranking health concern. The goal of this study was to evaluate the benefits of nurse telehealth coaching for persons with diabetes living in rural communities through a person-centered approach using motivational interviewing (MI) techniques. Materials and Methods: A randomized experimental study design was used to assign participants to receive either nurse telehealth coaching for five sessions (intervention group) or usual care (control group). Outcomes were measured in both groups using the Diabetes Empowerment Scale (DES), SF-12, and satisfaction surveys. Mean scores for each outcome were compared at baseline and at the 9-month follow-up for both groups using a Student's t test. We also evaluated the change from baseline by estimating the difference in differences (pre- and postintervention) using regression methods. Results: Among the 101 participants included in the analysis, 51 received nurse telehealth coaching, and 50 received usual care. We found significantly higher self-efficacy scores in the intervention group compared with the control group based on the DES at 9 months (4.03 versus 3.64, respectively; p<0.05) and the difference in difference estimation (0.42; p<0.05). Conclusions: The nurse MI/telehealth coaching model used in this study shows promise as an effective intervention for diabetes self-management in rural communities. The sustained effect on outcomes observed in the intervention group suggests that this model could be a feasible intervention for long-term behavioral change among persons living with chronic disease in rural communities. PMID:25061688

  7. Impact of Peer Health Coaching on Glycemic Control in Low-Income Patients With Diabetes: A Randomized Controlled Trial

    PubMed Central

    Thom, David H.; Ghorob, Amireh; Hessler, Danielle; De Vore, Diana; Chen, Ellen; Bodenheimer, Thomas A.

    2013-01-01

    PURPOSE Peer health coaches offer a potential model for extending the capacity of primary care practices to provide self-management support for patients with diabetes. We conducted a randomized controlled trial to test whether clinic-based peer health coaching, compared with usual care, improves glycemic control for low-income patients who have poorly controlled diabetes. METHOD We undertook a randomized controlled trial enrolling patients from 6 public health clinics in San Francisco. Twenty-three patients with a glycated hemoglobin (HbA1C) level of less than 8.5%, who completed a 36-hour health coach training class, acted as peer coaches. Patients from the same clinics with HbA1C levels of 8.0% or more were recruited and randomized to receive health coaching (n = 148) or usual care (n = 151). The primary outcome was the difference in change in HbA1C levels at 6 months. Secondary outcomes were proportion of patients with a decrease in HbA1C level of 1.0% or more and proportion of patients with an HbA1C level of less than 7.5% at 6 months. Data were analyzed using a linear mixed model with and without adjustment for differences in baseline variables. RESULTS At 6 months, HbA1C levels had decreased by 1.07% in the coached group and 0.3% in the usual care group, a difference of 0.77% in favor of coaching (P = .01, adjusted). HbA1C levels decreased 1.0% or more in 49.6% of coached patients vs 31.5% of usual care patients (P = .001, adjusted), and levels at 6 months were less than 7.5% for 22.0% of coached vs 14.9% of usual care patients (P = .04, adjusted). CONCLUSIONS Peer health coaching significantly improved diabetes control in this group of low-income primary care patients. PMID:23508600

  8. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Requirements for home health services. 424.22... Requirements 424.22 Requirements for home health services. Medicare Part A or Part B pays for home health... payment of home health services under Medicare Part A or Medicare Part B, a physician must certify...

  9. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Requirements for home health services. 424.22... 424.22 Requirements for home health services. Medicare Part A or Part B pays for home health services... payment of home health services under Medicare Part A or Medicare Part B, a physician must certify...

  10. The Happy Life Club study protocol: A cluster randomised controlled trial of a type 2 diabetes health coach intervention

    PubMed Central

    2011-01-01

    Background The Happy Life Club is an intervention that utilises health coaches trained in behavioural change and motivational interviewing techniques to assist with the management of type 2 diabetes mellitus (T2DM) in primary care settings in China. Health coaches will support participants to improve modifiable risk factors and adhere to effective self-management treatments associated with T2DM. Methods/Design A cluster randomised controlled trial involving 22 Community Health Centres (CHCs) in Fengtai District of Beijing, China. CHCs will be randomised into a control or intervention group, facilitating recruitment of at least 1320 individual participants with T2DM into the study. Participants in the intervention group will receive a combination of both telephone and face-to-face health coaching over 18 months, in addition to usual care received by the control group. Health coaching will be performed by CHC doctors and nurses certified in coach-assisted chronic disease management. Outcomes will be assessed at baseline and again at 6, 12 and 18 months by means of a clinical health check and self-administered questionnaire. The primary outcome measure is HbA1c level. Secondary outcomes include metabolic, physiological and psychological variables. Discussion This cluster RCT has been developed to suit the Chinese health care system and will contribute to the evidence base for the management of patients with T2DM. With a strong focus on self-management and health coach support, the study has the potential to be adapted to other chronic diseases, as well as other regions of China. Trial Registration Current Controlled Trials ISRCTN01010526 PMID:21303564

  11. Home Health Care: What It Is and What to Expect

    MedlinePLUS

    ... care + Share widget - Select to show What’s home health care & what should I expect? What's home health care? Home health care is a wide range of ... listed. What should I expect from my home health care? Doctor’s orders are needed to start care. Once ...

  12. Coaching the Coaches.

    ERIC Educational Resources Information Center

    Mangan, Katherine S.

    1995-01-01

    Increasingly, college athletic coaches are attending programs to help them relate to athletes more effectively on and off the field and deal with issues such as ethics, academic responsibility, careers. Coaches are learning new ways to communicate with students, identify need for help, and participate in the institution's educational mission. (MSE)

  13. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home health...

  14. Health Information Technology and Nursing Homes

    ERIC Educational Resources Information Center

    Liu, Darren

    2009-01-01

    Nursing homes are considered lagging behind in adopting health information technology (HIT). Many studies have highlighted the use of HIT as a means of improving health care quality. However, these studies overwhelmingly do not provide empirical information proving that HIT can actually achieve these improvements. The main research goal of this

  15. Mindfulness: An effective coaching tool for improving physical and mental health

    PubMed Central

    Robins, Jo Lynne W.; Kiken, Laura; Holt, Melissa; McCain, Nancy L.

    2014-01-01

    Purpose: This article provides an overview of the mechanisms of action, evidence base, and practice of mindfulness, with an emphasis on how to easily incorporate this valuable skill into practice. Data sources: PubMed, CINAHL, PsychInfo Databases. Conclusions: Conscious attention to the present moment in a receptive way is known as mindfulness. A growing body of research indicates that mindfulness can be taught and cultivated to improve physical and mental health. Implications for practice: Accordingly, as part of the coaching competency, mindfulness can be practiced and taught by advanced practice nurses to support lifestyle and behavioral changes, decrease perceived stress, enhance quality of life, and, ultimately, improve health and health outcomes. PMID:24259186

  16. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Requirements § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home...

  17. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Requirements § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home...

  18. Health Coaching Integration Into Primary Care for the Treatment of Obesity

    PubMed Central

    Crocker, Ben; Dill, Diana; Judge, David

    2013-01-01

    Obesity (and its related comorbidities) is one of the fastest-growing health concerns facing the United States and shows no sign of abating.1 The Centers for Disease Control and Prevention calculated that nearly 36% of American adults were obese in 2010 and estimates that this number will reach 44% by 2018. The current standard of care for the management of patients with obesity in primary care is often a general recommendation by the physician to lose weight through improved nutrition and increased physical activity. Educational materials may be provided along with a referral to a dietician, nutritionist, or weight management program. Health coaching as an obesity intervention has yet to be fully integrated into primary care practice but has proven to be effective in corporate wellness and behavioral weight loss programs.25 PMID:24278845

  19. How Coaches Manage Stress.

    ERIC Educational Resources Information Center

    Ruder, M. Karen

    1991-01-01

    Presents stress management strategies for coaches, focusing on what stress is, how it affects the body, and what to do to minimize the effects of stress on health. The article explains on- and off-the-job stress factors so coaches can recognize potential stress situations and handle them as they occur. (SM)

  20. Handbook for Home Health Aide Training. Revised Edition.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Education, Oklahoma City.

    The home health aide is a member of a team which provides home health care services, usually a part of the overall health services furnished by the local county health department. She does those things which are required to maintain normal physical and emotional comfort and to help the patient toward independent living in his own home, working…

  1. Executive Coaching.

    ERIC Educational Resources Information Center

    Pardini, Priscilla

    2003-01-01

    Describes executive coaching services for public school administrators, especially superintendents. The purpose of coaching is to help an administrator professionally and personally. Coaches differs from consultants in that coaches do not offer solutions to problems, nor do they give advice and offer solutions as do mentors. Includes descriptions

  2. Patient Satisfaction and Perceived Success with a Telephonic Health Coaching Program: The Natural Experiments for Translation in Diabetes (NEXT-D) Study, Northern California, 2011

    PubMed Central

    Goler, Nancy C.; Sanna, Rashel S.; Boccio, Mindy; Bellamy, David J.; Brown, Susan D.; Neugebauer, Romain S.; Ferrara, Assiamira; Wiley, Deanne M.; Schmittdiel, Julie A.

    2013-01-01

    Introduction Health coaching can improve lifestyle behaviors known to prevent or manage chronic conditions such as diabetes. However, little is known about the patient experience with telephonic coaching programs in real-world care settings. We examined patient satisfaction, patients perceived success in achieving program goals, and the patient-level correlates of these outcomes in a voluntary telephonic coaching program at a large integrated health care delivery system in northern California. Methods Kaiser Permanente Northern California patients who participated in a telephonic coaching program in 2011 were sent a cross-sectional survey about their satisfaction with health coaching and perceived success with program goals. We examined associations with patient characteristics. Results The survey response rate was 34%; analyses were based on the 32% who completed the survey. Of those who had completed 2 or more sessions (n = 232 [52%]), most reported being satisfied (70%) or neutral (20%) with the program, and 71% would recommend health coaching. Healthy weight, healthful eating, and physical activity were the most common topics discussed (88%). Adjusting for demographic characteristics, 73% of those who had 2 or more sessions reported that health coaching helped achieve their weight-related goal. Outcomes were positively correlated with patient activation but not consistently correlated with patient demographic characteristics. Conclusion Levels of satisfaction and perceived success with telephonic health coaching provided by a health plan were high and positively correlated with the number of sessions completed and patient activation. Voluntary telephonic health coaching programs should promote retention and assess patients activation levels. PMID:24176083

  3. The Future of Home Health project: developing the framework for health care at home.

    PubMed

    Lee, Teresa; Schiller, Jennifer

    2015-02-01

    In addition to providing high-quality care to vulnerable patient populations, home healthcare offers the least costly option for patients and the healthcare system, particularly in postacute care. As the baby boom generation ages, policymakers are expressing concerns about rising costs, variation in home healthcare service use, and program integrity. The Alliance for Home Health Quality and Innovation seeks to develop a research-based strategic framework for the future of home healthcare for older Americans and those with disabilities. This article describes the initiative and invites readers to provide comments and suggestions. PMID:25654456

  4. [Supply and demand in home health care].

    PubMed

    Braga, Patrícia Pinto; Sena, Roseni Rosângela de; Seixas, Clarissa Terenzi; Castro, Edna Aparecida Barbosa de; Andrade, Angélica Mônica; Silva, Yara Cardoso

    2016-03-01

    The changes in the demographic and epidemiologic profiles of the Brazilian population and the need to rethink the health care model have led many countries like Brazil to consider Home Care (HC) as a care strategy. However, there is a gap between the supply of HC services, the demand for care and the health needs manifested by the population. Thus, this article analyzes scientific output regarding the status of the relation between supply, demand and the needs related to home health care. This work is based on an integrative review of the literature in the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin America and the Caribbean Literature on Health and Science (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) and Web of Science. Despite the fact that few articles refer to the issue in question, there is evidence indicating that health demands and needs are seldom taken into account either in a quantitative or qualitative approach when developing the organization of HC services. The analysis would indicate that there is a national and international deficit in the supply of HC services considering the demand for health care and needs currently prevailing. PMID:26960102

  5. The Early Childhood Coaching Handbook

    ERIC Educational Resources Information Center

    Rush, Dathan D.; Shelden, M'Lisa L.

    2011-01-01

    Evidence-based and highly effective, "coaching" helps early childhood practitioners support other professionals and families as they enhance existing knowledge, develop new skills, and promote healthy development of young children. This hands-on guide shows professionals how to conduct skillful coaching in any setting--home, school, or community.…

  6. The Early Childhood Coaching Handbook

    ERIC Educational Resources Information Center

    Rush, Dathan D.; Shelden, M'Lisa L.

    2011-01-01

    Evidence-based and highly effective, "coaching" helps early childhood practitioners support other professionals and families as they enhance existing knowledge, develop new skills, and promote healthy development of young children. This hands-on guide shows professionals how to conduct skillful coaching in any setting--home, school, or community.

  7. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  8. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  9. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  10. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  11. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  12. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  13. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  14. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  15. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  16. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  17. Home health services in New Hampshire.

    PubMed Central

    Hale, F A; Jacobs, A R

    1976-01-01

    While home health services have traditionally been an underused component of the health care system, current trends suggest the desirability of expanding these services. These trends include an increase in the number of elderly who need the benefits of home care, the recognition that long-term chronic illnesses require appropriate management at home, and concern that patients have access to care at the level most appropriate to their illnesses. In New Hampshire, 41 certified home health agencies offer services. Little systematic research has been conducted on the kinds of services they provide and the patients seen by their staffs. Patient encounter data were collected from a sample of eight agencies for a 4-week period. Staff of the agencies used the patient contact record developed by the National Functional Task Analysis Cooperative Study to collect data. The data reflected differences among the agencies in the size of the populations they serve, organizational characteristics, reasons for patients' visits, expected sources of the revenue that supported them, and the diagnosis of the patients they cared for. The agencies served areas with populations ranging from 1,000 to 40,000. The staffs ranged from 1 to 14 full-time persons. Two were public agencies; the others had voluntary sponsorship. When data on reasons for visits were averaged for the eight agencies, it was shown that 72% of the visits were made for disease control activities such as care for a chronic or acute condition or for treatment or a laboratory test. Disease prevention activities such as a checkup for adults, children, prenatal or postnatal care, or health education accounted for only 24% of the visits. This result may indicate that, in areas short of physician manpower, the community health nurse is taking on increasing responsibility for medical care as well as health and education. Reimbursement for the visits came from Medicare, 25%; Medicaid-welfare, 14%; the patients, 18%; and health insurance, 3%. For 35% of the visits there was no charge; they were underwritten by community resources. PMID:825922

  18. Managerial Coaching

    ERIC Educational Resources Information Center

    Bommelje, Rick

    2015-01-01

    This chapter explores how coaching equips managers and supervisors to be successful in the 21st-century workplace. Coaching has benefited these professionals by providing them with viable tools to enhance the leadership and managerial tools they already possess.

  19. Patient Experience in Health Center Medical Homes.

    PubMed

    Cook, Nicole; Hollar, Lucas; Isaac, Emmanuel; Paul, Ludmilla; Amofah, Anthony; Shi, Leiyu

    2015-12-01

    The Human Resource and Services Administration, Bureau of Primary Health Care Health Center program was developed to provide comprehensive, community-based quality primary care services, with an emphasis on meeting the needs of medically underserved populations. Health Centers have been leaders in adopting innovative approaches to improve quality care delivery, including the patient centered medical home (PCMH) model. Engaging patients through patient experience assessment is an important component of PCMH evaluation and a vital activity that can help drive patient-centered quality improvement initiatives. A total of 488 patients from five Health Center PCMHs in south Florida were surveyed in order to improve understanding of patient experience in Health Center PCMHs and to identify quality improvement opportunities. Overall patients reported very positive experience with patient-centeredness including being treated with courtesy and respect (85% responded "always") and communication with their provider in a way that was easy to understand (87.7% responded "always"). Opportunities for improvement included patient goal setting, referrals for patients with health conditions to workshops or educational programs, contact with the Health Center via phone and appointment availability. After adjusting for patient characteristics, results suggest that some patient experience components may be modified by educational attainment, years of care and race/ethnicity of patients. Findings are useful for informing quality improvement initiatives that, in conjunction with other patient engagement strategies, support Health Centers' ongoing transformation as PCMHs. PMID:26026275

  20. Physicians' attitudes and behaviors toward home health care services.

    PubMed

    Javalgi, R; Joseph, W B

    1991-12-01

    The authors investigate physicians' attitudes, information-seeking behaviors, and behavioral intentions toward home health care programs. Survey results show that physicians favor the concept, but knowledge and awareness levels about available programs vary with the physicians' specialties. Evidence also is reported on specific problems encountered, sources of information used to make home care referrals, and physicians' perceptions of the impact of home care programs on their practice. Finally, policy implications are drawn for marketers of home health care programs. PMID:10115897

  1. The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures.

    PubMed

    Rahman, Momotazur; Galarraga, Omar; Zinn, Jacqueline S; Grabowski, David C; Mor, Vincent

    2016-02-01

    Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes. PMID:26223431

  2. Interaction Coaching with Mothers of Children with Congenital Deaf-Blindness at Home: Applying the Diagnostic Intervention Model

    ERIC Educational Resources Information Center

    Janssen, Marleen J.; Riksen-Walraven, J. Marianne; van Dijk, Jan P. M.; Ruijssenaars, Wied A. J. J. M.

    2010-01-01

    This article describes the application of the Diagnostic Intervention Model and its effects in two case studies of 3-year-old boys, Rolf and Ruud, using individual interaction coaching with their mothers. Positive effects were found for all the target categories in both cases, although an interaction that used materials appeared to be more

  3. Interaction Coaching with Mothers of Children with Congenital Deaf-Blindness at Home: Applying the Diagnostic Intervention Model

    ERIC Educational Resources Information Center

    Janssen, Marleen J.; Riksen-Walraven, J. Marianne; van Dijk, Jan P. M.; Ruijssenaars, Wied A. J. J. M.

    2010-01-01

    This article describes the application of the Diagnostic Intervention Model and its effects in two case studies of 3-year-old boys, Rolf and Ruud, using individual interaction coaching with their mothers. Positive effects were found for all the target categories in both cases, although an interaction that used materials appeared to be more…

  4. The Health Care Home Model: Primary Health Care Meeting Public Health Goals

    PubMed Central

    Greene, Danielle

    2012-01-01

    In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home. PMID:22515874

  5. Marketing in home health care. A practical approach.

    PubMed

    Freitag, E M

    1988-06-01

    Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level. PMID:3285333

  6. Homemaker/Home Health Aide Services in the United States.

    ERIC Educational Resources Information Center

    Trager, Brahna

    Defining the role of the homemaker/home health aide, the volume presents a comprehensive treatment of the principles and procedures for recruiting, training, and directing the activities of these essential health workers. In addition to providing an analysis of the contribution that the homemaker/home health aide can make to patient care, the book

  7. Building Medical Homes for Children with Special Health Care Needs.

    ERIC Educational Resources Information Center

    Nickel, Robert E.; Cooley, W. Carl; McAllister, Jeanne W.; Samson-Fang, Lisa

    2003-01-01

    Discussion of medical homes for children with special health care needs suggests such homes can provide quality health care services to children in partnership with families and community professionals. Early intervention and early childhood special education providers are encouraged to collaborate with primary health care professionals, thereby

  8. Integrative Health Coach Training: A Model for Shifting the Paradigm Toward Patient-centricity and Meeting New National Prevention Goals

    PubMed Central

    Smith, Linda L.; Lake, Noelle H.; Simmons, Leigh Ann; Perlman, Adam; Wroth, Shelley

    2013-01-01

    Objective: To describe the evolution, training, and results of an emerging allied health profession skilled in eliciting sustainable health-related behavior change and charged with improving patient engagement. Methods: Through techniques sourced from humanistic and positive psychology, solution-focused and mindfulness-based therapies, and leadership coaching, Integrative Health Coaching (IHC) provides a mechanism to empower patients through various stages of learning and change. IHC also provides a method for the creation and implementation of forward-focused personalized health plans. Results: Clinical studies employing Duke University Integrative Medicine's model of IHC have demonstrated improvements in measures of diabetes and diabetes risk, weight management, and risk for cardiovascular disease and stroke. By supporting and enabling individuals in making major lifestyle changes for the improvement of their health, IHC carries the potential to reduce rates and morbidity of chronic disease and impact myriad aspects of healthcare. Conclusion: As a model of educational and clinical innovation aimed at patient empowerment and lifestyle modification, IHC is aligned well with the tenets and goals of recently sanctioned federal healthcare reform, specifically the creation of the first National Prevention and Health Promotion Strategy. Practice Implications: IHC may allow greater patient-centricity while targeting the lifestyle-related chronic disease that lies at the heart of the current healthcare crisis. PMID:24416674

  9. Private Investment Purchase and Nursing Home Financial Health

    PubMed Central

    Cadigan, Rebecca Orfaly; Stevenson, David G; Caudry, Daryl J; Grabowski, David C

    2015-01-01

    Objective To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Data Sources Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 19982010. Study Design Regression specification incorporating facility and time fixed effects. Principal Findings We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the companys real estate holdings. Conclusions Private investment acquired facilities are an important feature of todays nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. PMID:25104476

  10. Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

    ERIC Educational Resources Information Center

    Davitt, Joan K.

    2014-01-01

    Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.

  11. Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

    ERIC Educational Resources Information Center

    Davitt, Joan K.

    2014-01-01

    Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…

  12. Home health aide services: barriers perceived by dementia family caregivers.

    PubMed

    Liken, M A; King, S K

    1995-01-01

    This study explored barriers to using home health aide services as perceived by family caregivers of relatives with dementia. The authors analyzed data collected from interviews of 32 family caregivers of relatives with dementia. The major findings included the recurrent theme of cost/expectation, which emerged as a major barrier to using home health aide services. Caregivers in many cases indicated that the price paid for services outweighed benefits; however they continued to use home health aide services. Implications for home healthcare nurses are discussed. PMID:8698595

  13. Home e-health system integration in the Smart Home through a common media server.

    PubMed

    Pau, I; Seoane, F; Lindecrantz, K; Valero, M A; Carracedo, J

    2009-01-01

    Home e-health systems and services are revealed as one of the most important challenges to promote Quality of Life related to Health in the Information Society. Leading companies have worked on e-health systems although the majority of them are addressed to hospital or primary care settings. The solution detailed in this paper offers a personal health system to be integrated with Smart Home services platform to support home based e-care. Thus, the home e-health system and architecture detailed in this research work is ready to supply a seamless personal care solution both from the biomedical data analysis, service provision, security guarantee and information management s point of view. The solution is ready to be integrated within the Accessible Digital Home, a living lab managed by Universidad Politcnica de Madrid for R&D activities. PMID:19964893

  14. Healing at Home: 100 Years of Public Health Nursing.

    ERIC Educational Resources Information Center

    Fahy, Ellen T.; And Others

    1994-01-01

    Includes "Now More than Ever" (Fahy); "Healing at Home" (photo essay); "Amelia Greenwald: Pioneer in International Public Health Nursing" (Mayer); "Alaska's Watched Pot" (Nord); and "Gertrude Weld Peabody: Unsung Patron of Public Health Nursing Education" (Doona). (JOW)

  15. Outcomes of a Mobile Health Coaching Platform: 12-Week Results of a Single-Arm Longitudinal Study

    PubMed Central

    Walsh, James K

    2016-01-01

    Background The number of mobile health coaching applications is expanding at a rapid rate. An application that uses a guiding intelligence to deliver an individualized structured program has the potential to provide a significant benefit. However, there are few studies of this approach that examine multiple clinical outcomes in a longitudinal manner. Objective The objective of the study was to conduct a 12-week evaluation of participants using the YouPlus Health mobile coaching platform, specifically examining the effects on body weight, waist measurement, blood pressure, lipid profile, glycohemoglobin (A1C), and maximum volume of oxygen consumption (VO2 max). Methods A quasi-experimental research design was used. This included a single-arm pre and post intervention assessment of outcomes. Participants underwent a 12-week intervention in which they received the entirety of the mobile health coaching program via an application on their mobile phones and were evaluated in the same physician’s office setting every two weeks. Data regarding app usage was continuously collected and maintained in a database. Results 10 subjects were enrolled in and completed the pilot study. The mean weight loss was 13.5 lbs. which represented 7.3% of baseline (P=.005). Mean waist circumference was reduced by 7.2 cm or 6.6% of baseline (P=.005). Both systolic (SBP) and diastolic (DBP) blood pressure measures were significantly lower after 12 weeks of intervention. Mean SBP fell 18.6 mmHg (P=.005) and mean DBP declined 6.4 mmHg (P=.005). VO2 max increased by an average of 3.13 ml/kg/min from baseline to study end (P=.005). From baseline to end-of-study HDL levels increased significantly by 4.0 mg/dL (P=.04) Total cholesterol, LDL, triglycerides, and glycohemoglobin (A1C) trended in the desired direction but did not meet statistical significance. All of the participants in the study completed the necessary in-app tutorials and also completed the in-app questions and received feedback. Every individual completed the appropriate amount of program levels necessary to give the specifics of the program, and the mean weekly app open rate ranged from 5.1 to 18.4. Conclusions Users of the YouPlus Health mobile coaching platform experienced significant reductions in body weight, waist circumference, and both systolic and diastolic blood pressures, while attaining significant increases in HDL and VO2 Max. PMID:26747611

  16. Are ADNs Prepared to Be Home Health Nurses?

    ERIC Educational Resources Information Center

    Neighbors, Marianne; Monahan, Frances D.

    1997-01-01

    Responses from 132 of 350 home health nurses identified techniques and skills associate degree nurses (ADNs) should acquire to work for home health agencies. Accredited ADN programs reported that only 24 of the techniques are taught in all programs and 55 of the skills are taught in 90% of the programs. (SK)

  17. Navigating the thin-ideal in an athletic world: influence of coach communication on female athletes' body image and health choices.

    PubMed

    Beckner, Brittany N; Record, Rachael A

    2016-03-01

    This study sought to investigate how interpersonal communication between coaches and female athletes influences the female athletes' perceptions of body image and health choices. Much of the current literature has focused on the fact that female athletes are at risk for disordered eating and a distorted body image due to susceptibility to the feminine "thin-ideal" while maintaining the fitness levels necessary to compete in their sport. However, very little research has examined how interpersonal interaction plays a role in female athletes' body image perceptions and health behaviors. Utilizing the Communication Theory of Identity (CTI) as a lens to examine communication between female athletes and their coaches, the researchers analyzed transcripts from in-depth interviews with 28 female athletes and identified themes within the personal, relational, enacted, and communal layers of identity. Coach communication with their female athletes was found to be influential to the athletes' body images and health choices. PMID:26361233

  18. Payment reform will shift home health agency valuation parameters.

    PubMed

    Hahn, A D

    1998-12-01

    Changes authorized by the Balanced Budget Act of 1997 have removed many of the payment benefits that motivated past home health agency acquisition activity and temporarily have slowed the rapid pace of acquisitions of home health agencies. The act required that Medicare's cost-based payment system be replaced with a prospective payment system (PPS) and established an interim payment system to provide a framework for home health agencies to make the transition to the PPS. As a consequence, realistic valuations of home health agencies will be determined primarily by cash flows, with consideration given to operational factors, such as quality of patient care, service territory, and information systems capabilities. The limitations imposed by the change in payment mechanism will cause acquisition interest to shift away from home health agencies with higher utilization and revenue expansion to agencies able to control costs and achieve operating leverage. PMID:10338795

  19. Pragmatic Replication Trial of Health Promotion Coaching for Obesity in Serious Mental Illness and Maintenance of Outcomes

    PubMed Central

    Bartels, Stephen J.; Pratt, Sarah I.; Aschbrenner, Kelly A.; Barre, Laura K.; Naslund, John A.; Wolfe, Rosemarie; Xie, Haiyi; McHugo, Gregory J.; Jimenez, Daniel E.; Jue, Ken; Feldman, James; Bird, Bruce L.

    2015-01-01

    Objective Few studies targeting obesity in serious mental illness report clinically significant risk reduction, and none have been replicated within community settings or have demonstrated sustained outcomes after intervention withdrawal. This pragmatic clinical trial aims to replicate positive health outcomes demonstrated in a prior randomized effectiveness study of the In SHAPE program across urban community mental health organizations serving an ethnically diverse population. Methods Persons with serious mental illness and BMI>25 receiving services in three community mental health organizations were randomized to the 12-month In SHAPE program (health promotion coach and membership to a public fitness club) or to fitness club membership alone. Primary outcomes were weight and cardiorespiratory fitness (measured with the 6-Minute Walk Test) collected at baseline, 3-, 6-, 9-, 12-, and 18-months. Results Participants (N=210) were ethnically diverse (46% non-White) with mean baseline BMI=36.88.2. At 12-months In SHAPE (n=104) compared to a fitness club membership alone (n=106) contributed to greater reduction in weight and improved fitness. Primary outcomes were maintained at 18-months follow-up. Approximately half of In SHAPE participants (51% at 12-month program completion and 46% at 18-month follow-up) achieved clinically significant cardiovascular risk reduction (?5% weight loss or >50 meter increase on the 6-Minute Walk Test). Conclusions Sustained weight loss and improved fitness can be achieved by community mental health organizations providing health promotion coaching and access to fitness facilities. Health promotion should be integrated into mental health services for persons with serious mental illness at risk for cardiovascular disease and early mortality. PMID:25827032

  20. Instructional Coaching

    ERIC Educational Resources Information Center

    Knight, Jim

    2006-01-01

    The number of school districts using instructional coaches is growing at a staggering rate. Coaching is becoming popular, in part, because many educational leaders recognize the old form of professional development, built around traditional in-service sessions for teachers, simply does not affect student achievement. By offering support, feedback,

  1. Hospitalization Among Medicare-Reimbursed Skilled Home Health Recipients

    PubMed Central

    OConnor, Melissa

    2015-01-01

    This article presents a summary and critique of the published empirical evidence between the years 2002 and 2011 regarding rehospitalization among Medicare-reimbursed, skilled home health recipients. The knowledge gained will be applied to a discussion regarding ACH among geriatric home health recipients and areas for future research. The referenced literature in MEDLINE, PubMed and Cochrane databases was searched using combinations of the following search terms: home care and home health and Medicare combined with acute care hospitalization, rehospitalization, hospitalization, and adverse events and limited to studies conducted in the United States. Twenty-five research studies published in the last eight years investigated hospitalization among patients receiving Medicare-reimbursed, skilled home health. Empirical findings indicate telehomecare can reduce hospitalizations and emergency room use. The identification of risk factors for hospitalization relate to an elders sociodemographic, clinical and functional status that can be identified upon admission and interventions taken in order to reduce hospitalizations. Disease management, frontloading nurse visits, the structure of home health services and OBQI are also among the interventions identified to reduce hospitalizations. However, the body of evidence is limited by a paucity of research and the over reliance on small sample sizes. Few published studies have explored methods that effectively reduce hospitalization among Medicare-reimbursed skilled home health recipients. Further research is needed to clarify the most effective ways to structure home health services to maximize benefits and reduce hospitalization among this chronically ill geriatric population.

  2. What Is Best for Esther? Building Improvement Coaching Capacity With and for Users in Health and Social Care—A Case Study

    PubMed Central

    Levander, Märta Sund; Thor, Johan

    2016-01-01

    While coaching and customer involvement can enhance the improvement of health and social care, many organizations struggle to develop their improvement capability; it is unclear how best to accomplish this. We examined one attempt at training improvement coaches. The program, set in the Esther Network for integrated care in rural Jönköping County, Sweden, included eight 1-day sessions spanning 7 months in 2011. A senior citizen joined the faculty in all training sessions. Aiming to discern which elements in the program were essential for assuming the role of improvement coach, we used a case-study design with a qualitative approach. Our focus group interviews included 17 informants: 11 coaches, 3 faculty members, and 3 senior citizens. We performed manifest content analysis of the interview data. Creating will, ideas, execution, and sustainability emerged as crucial elements. These elements were promoted by customer focus—embodied by the senior citizen trainer—shared values and a solution-focused approach, by the supportive coach network and by participants' expanded systems understanding. These elements emerged as more important than specific improvement tools and are worth considering also elsewhere when seeking to develop improvement capability in health and social care organizations. PMID:26783868

  3. What Is Best for Esther? Building Improvement Coaching Capacity With and for Users in Health and Social Care-A Case Study.

    PubMed

    Vackerberg, Nicoline; Levander, Märta Sund; Thor, Johan

    2016-01-01

    While coaching and customer involvement can enhance the improvement of health and social care, many organizations struggle to develop their improvement capability; it is unclear how best to accomplish this. We examined one attempt at training improvement coaches. The program, set in the Esther Network for integrated care in rural Jönköping County, Sweden, included eight 1-day sessions spanning 7 months in 2011. A senior citizen joined the faculty in all training sessions. Aiming to discern which elements in the program were essential for assuming the role of improvement coach, we used a case-study design with a qualitative approach. Our focus group interviews included 17 informants: 11 coaches, 3 faculty members, and 3 senior citizens. We performed manifest content analysis of the interview data. Creating will, ideas, execution, and sustainability emerged as crucial elements. These elements were promoted by customer focus-embodied by the senior citizen trainer-shared values and a solution-focused approach, by the supportive coach network and by participants' expanded systems understanding. These elements emerged as more important than specific improvement tools and are worth considering also elsewhere when seeking to develop improvement capability in health and social care organizations. PMID:26783868

  4. The Effect of Entry Regulation in the Health Care Sector: the Case of Home Health

    PubMed Central

    Polsky, Daniel; David, Guy; Yang, Jianing; Kinosian, Bruce; Werner, Rachel

    2013-01-01

    The consequences of government regulation in the post-acute care sector are not well understood. We examine the effect of entry regulation on quality of care in home health care by analyzing the universe of hospital discharges during 2006 for publicly insured beneficiaries (about 4.5 million) and subsequent home health admissions to determine whether there is a significant difference in home health utilization, hospital readmission rates, and health care expenditures in states with and without Certificate of Need laws (CON) regulating entry. We identify these effects by looking across regulated and nonregulated states within Hospital Referral Regions, which characterize well-defined health care markets and frequently cross state boundaries. We find that CON states use home health less frequently, but system-wide rehospitalization rates, overall Medicare expenditures, and home health practice patterns are similar. Removing CON for home health would have negligible system-wide effects on health care costs and quality. PMID:24497648

  5. Recovery Coaches and Substance Exposed Births: An Experiment in Child Welfare

    ERIC Educational Resources Information Center

    Ryan, Joseph P.; Choi, Sam; Hong, Jun Sung; Hernandez, Pedro; Larrison, Christopher R.

    2008-01-01

    Objectives: Substance exposed infants present a major challenge to child welfare and public health systems. Prenatal substance exposure and continued substance abuse in the home are associated with a wide range of adverse social, emotional, and developmental outcomes. The objective of the current study is to evaluate the use of recovery coaches in

  6. Recovery Coaches and Substance Exposed Births: An Experiment in Child Welfare

    ERIC Educational Resources Information Center

    Ryan, Joseph P.; Choi, Sam; Hong, Jun Sung; Hernandez, Pedro; Larrison, Christopher R.

    2008-01-01

    Objectives: Substance exposed infants present a major challenge to child welfare and public health systems. Prenatal substance exposure and continued substance abuse in the home are associated with a wide range of adverse social, emotional, and developmental outcomes. The objective of the current study is to evaluate the use of recovery coaches in…

  7. Trajectories of At-Homeness and Health in Usual Care and Small House Nursing Homes

    ERIC Educational Resources Information Center

    Molony, Sheila L.; Evans, Lois K.; Jeon, Sangchoon; Rabig, Judith; Straka, Leslie A.

    2011-01-01

    Background: Long-term care providers across the United States are building innovative environments called "Green House" or small-house nursing homes that weave humanistic person-centered philosophies into clinical care, organizational policies, and built environments. Purpose: To compare and contrast trajectories of at-homeness and health over

  8. Trajectories of At-Homeness and Health in Usual Care and Small House Nursing Homes

    ERIC Educational Resources Information Center

    Molony, Sheila L.; Evans, Lois K.; Jeon, Sangchoon; Rabig, Judith; Straka, Leslie A.

    2011-01-01

    Background: Long-term care providers across the United States are building innovative environments called "Green House" or small-house nursing homes that weave humanistic person-centered philosophies into clinical care, organizational policies, and built environments. Purpose: To compare and contrast trajectories of at-homeness and health over…

  9. The home health workforce: a distinction between worker categories.

    PubMed

    Stone, Robyn; Sutton, Janet P; Bryant, Natasha; Adams, Annelise; Squillace, Marie

    2013-01-01

    The demand for home health aides is expected to rise, despite concerns about the sustainability of this workforce. Home health workers receive low wages and little training and have high turnover. It is difficult to recruit and retain workers to improve clinical outcomes. This study presents national estimates to examine how home health workers and the subgroup of workers differ in terms of sociodemographic characteristics, compensation, benefits, satisfaction, and retention. Hospice aides fare better than other categories of workers and are less likely to leave their job. Policymakers should consider strategies to increase the quality and stability of this workforce. PMID:24372475

  10. Reading Coaching Discourse: Exploring Coaching Processes

    ERIC Educational Resources Information Center

    Heineke, Sally Frances

    2009-01-01

    This study investigates the discourse of elementary school reading coaches and teachers during coaching interactions in four Alabama schools. Coach/teacher dyads recorded naturally occurring coaching dialogue over periods of 3 to 6 weeks. Each participant shared her views on coaching and commented on the recorded discourse during post-interviews

  11. Exercise and Bone Health for Women: The Skeletal Risk of Overtraining

    MedlinePLUS

    ... your browser. Home Bone Basics Lifestyle Exercise and Bone Health for Women: The Skeletal Risk of Overtraining ... With, or Coach May Be at Risk for Bone Loss, Fracture, and Other Health Problems? Here are ...

  12. Health@Home - An e-Service Model for Disease Prevention and Healthcare in the Home

    NASA Astrophysics Data System (ADS)

    Gupta, Milon; Chotard, Laure; Ingrsson, lafur; Bastos, Joo; Borges, Isabel

    The ageing of the population, the growth of chronic diseases, and the explosion of healthcare costs jeopardise the sustainability of healthcare systems in many European countries. This opens opportunities for innovative prevention and healthcare services supported by information and communication technologies (ICT). The natural focus for providing such services is the home. However, the e-health services provided in the home so far are limited in scope and fragmented. This paper suggests a comprehensive service model for home-based e-health services in Europe, which aims to overcome the current service fragmentation. The Health@Home model integrates disease prevention and healthcare for different groups of citizens at different stages on the health scale. The technical challenge of this model is the national and Europe-wide integration of heterogeneous systems and services in a way that makes them reliable and easy to use for all citizens, particularly those with low technical abilities and severe impairments.

  13. Health Coaching by Medical Assistants to Improve Control of Diabetes, Hypertension, and Hyperlipidemia in Low-Income Patients: A Randomized Controlled Trial

    PubMed Central

    Willard-Grace, Rachel; Chen, Ellen H.; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Thom, David H.

    2015-01-01

    PURPOSE Health coaching by medical assistants could be a financially viable model for providing self-management support in primary care if its effectiveness were demonstrated. We investigated whether in-clinic health coaching by medical assistants improves control of cardiovascular and metabolic risk factors when compared with usual care. METHODS We conducted a 12-month randomized controlled trial of 441 patients at 2 safety net primary care clinics in San Francisco, California. The primary outcome was a composite measure of being at or below goal at 12 months for at least 1 of 3 uncontrolled conditions at baseline as defined by hemoglobin A1c, systolic blood pressure, and low-density lipoprotein (LDL) cholesterol. Secondary outcomes were meeting all 3 goals and meeting individual goals. Data were analyzed using ?2 tests and linear regression models. RESULTS Participants in the coaching arm were more likely to achieve both the primary composite measure of 1 of the clinical goals (46.4% vs 34.3%, P = .02) and the secondary composite measure of reaching all clinical goals (34.0% vs 24.7%, P = .05). Almost twice as many coached patients achieved the hemoglobin A1c goal (48.6% vs 27.6%, P = .01). At the larger study site, coached patients were more likely to achieve the LDL cholesterol goal (41.8% vs 25.4%, P = .04). The proportion of patients meeting the systolic blood pressure goal did not differ significantly. CONCLUSIONS Medical assistants serving as in-clinic health coaches improved control of hemoglobin A1c and LDL levels, but not blood pressure, compared with usual care. Our results highlight the need to understand the relationship between patients clinical conditions, interventions, and the contextual features of implementation. PMID:25755034

  14. Behavioral coaching.

    PubMed

    Seniuk, Holly A; Witts, Benjamin N; Williams, W Larry; Ghezzi, Patrick M

    2013-01-01

    The term behavioral coaching has been used inconsistently in and outside the field of behavior analysis. In the sports literature, the term has been used to describe various intervention strategies, and in the organizational behavior management literature it has been used to describe an approach to training management personnel and staff. This inconsistency is problematic in terms of the replication of behavioral coaching across studies and aligning with Baer, Wolf, and Risley's (1968) technological dimension of applied behavior analysis. The current paper will outline and critique the discrepancies in the use of the term and suggest how Martin and Hrycaiko's (1983) characteristics of behavioral coaching in sports may be used to bring us closer to establishing a consistent definition of the term. In addition, we will suggest how these characteristics can also be applicable to the use of the term behavioral coaching in other domains of behavior analysis. PMID:25729141

  15. Behavioral Coaching

    PubMed Central

    Seniuk, Holly A.; Witts, Benjamin N.; Williams, W. Larry.; Ghezzi, Patrick M.

    2013-01-01

    The term behavioral coaching has been used inconsistently in and outside the field of behavior analysis. In the sports literature, the term has been used to describe various intervention strategies, and in the organizational behavior management literature it has been used to describe an approach to training management personnel and staff. This inconsistency is problematic in terms of the replication of behavioral coaching across studies and aligning with Baer, Wolf, and Risley's (1968) technological dimension of applied behavior analysis. The current paper will outline and critique the discrepancies in the use of the term and suggest how Martin and Hrycaiko's (1983) characteristics of behavioral coaching in sports may be used to bring us closer to establishing a consistent definition of the term. In addition, we will suggest how these characteristics can also be applicable to the use of the term behavioral coaching in other domains of behavior analysis. PMID:25729141

  16. Infant Mental Health Home Visitation: Setting and Maintaining Professional Boundaries

    ERIC Educational Resources Information Center

    Barron, Carla; Paradis, Nichole

    2010-01-01

    Relationship-based infant mental health home visiting services for infants, toddlers, and their families intensify the connection between the personal and professional. To promote the therapeutic relationship and maximize the effectiveness of the intervention, home visitors must exercise good judgment, in the field and in the moment, to set and

  17. 42 CFR 484.245 - Accelerated payments for home health agencies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies 484.245 Accelerated payments for home health agencies. (a) General...

  18. 42 CFR 484.245 - Accelerated payments for home health agencies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies 484.245 Accelerated payments for home health agencies. (a) General...

  19. 42 CFR 484.245 - Accelerated payments for home health agencies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Accelerated payments for home health agencies. 484... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment System for Home Health Agencies 484.245 Accelerated payments for home health agencies. (a) General...

  20. Home health care agencies struggle with new federal rules.

    PubMed

    Lumsdon, K

    1991-11-20

    The rules governing home health care are confusing, contradictory and expensive, say providers, and they're getting more so. But that doesn't mean the rules should be made lax, they argue. Some even look forward to quality enhancement as a by-product of new "outcome-oriented" Medicare surveys. Inevitably, home health care administrators agree, increased federal scrutiny has likely been spurred by the massive growth in the field in the past 15 years. PMID:1937447

  1. Evaluation of Home Health Care Devices: Remote Usability Assessment

    PubMed Central

    2015-01-01

    Background An increasing amount of health care is now performed in a home setting, away from the hospital. While there is growing anecdotal evidence about the difficulty patients and caregivers have using increasingly complex health care devices in the home, there has been little systematic scientific study to quantify the global nature of home health care device usability in the field. Research has tended to focus on a handful of devices, making it difficult to gain a broad view of the usability of home-care devices in general. Objective The objective of this paper is to describe a remote usability assessment method using the System Usability Scale (SUS), and to report on the usability of a broad range of health care devices using this metric. Methods A total of 271 participants selected and rated up to 10 home health care devices of their choice using the SUS, which scores usability from 0 (unusable) to 100 (highly usable). Participants rated a total of 455 devices in their own home without an experimenter present. Results Usability scores ranged from 98 (oxygen masks) to 59 (home hormone test kits). An analysis conducted on devices that had at least 10 ratings showed that the effect of device on SUS scores was significant (P<.001), and that the usability of these devices was on the low end when compared with other commonly used items in the home, such as microwave ovens and telephones. Conclusions A large database of usability scores for home health care devices collected using this remote methodology would be beneficial for physicians, patients, and their caregivers.

  2. Integrating new graduate nurses in home health care.

    PubMed

    Meadows, Carl A

    2009-10-01

    In 2005, the home health nursing sector of a large Canadian health authority was on its way toward changing a hiring prerequisite of acute care (medical or surgical) experience for entry to practice into home care nursing. At that time, home healthcare services in Canada and the United States were generally requiring acute care experience as prerequisites for working in home health. However, much of the research beginning as early as early 2000 challenged this perspective and universities and colleges offering baccalaureate degrees in nursing began including home health content in their curricula. The findings from research add to the ongoing critique of this acute care requirement and support the concept that acute care and home care are different practice areas with distinct competencies. This article discusses the contextual background that influenced the undertaking of our research, the relevant research literature, our research findings, model for integration, and evaluation of our pilot and lessons learned. The successes seen as a result of New Graduate integration are now being utilized by other home care nursing offices as a result of this work. PMID:19820662

  3. Telemonitoring and Mobile Phone-Based Health Coaching Among Finnish Diabetic and Heart Disease Patients: Randomized Controlled Trial

    PubMed Central

    Karhula, Tuula; Rääpysjärvi, Katja; Pakanen, Mira; Itkonen, Pentti; Tepponen, Merja; Junno, Ulla-Maija; Jokinen, Tapio; van Gils, Mark; Lähteenmäki, Jaakko; Kohtamäki, Kari; Saranummi, Niilo

    2015-01-01

    Background There is a strong will and need to find alternative models of health care delivery driven by the ever-increasing burden of chronic diseases. Objective The purpose of this 1-year trial was to study whether a structured mobile phone-based health coaching program, which was supported by a remote monitoring system, could be used to improve the health-related quality of life (HRQL) and/or the clinical measures of type 2 diabetes and heart disease patients. Methods A randomized controlled trial was conducted among type 2 diabetes patients and heart disease patients of the South Karelia Social and Health Care District. Patients were recruited by sending invitations to randomly selected patients using the electronic health records system. Health coaches called patients every 4 to 6 weeks and patients were encouraged to self-monitor their weight, blood pressure, blood glucose (diabetics), and steps (heart disease patients) once per week. The primary outcome was HRQL measured by the Short Form (36) Health Survey (SF-36) and glycosylated hemoglobin (HbA1c) among diabetic patients. The clinical measures assessed were blood pressure, weight, waist circumference, and lipid levels. Results A total of 267 heart patients and 250 diabetes patients started in the trial, of which 246 and 225 patients concluded the end-point assessments, respectively. Withdrawal from the study was associated with the patients’ unfamiliarity with mobile phones—of the 41 dropouts, 85% (11/13) of the heart disease patients and 88% (14/16) of the diabetes patients were familiar with mobile phones, whereas the corresponding percentages were 97.1% (231/238) and 98.6% (208/211), respectively, among the rest of the patients (P=.02 and P=.004). Withdrawal was also associated with heart disease patients’ comorbidities—40% (8/20) of the dropouts had at least one comorbidity, whereas the corresponding percentage was 18.9% (47/249) among the rest of the patients (P=.02). The intervention showed no statistically significant benefits over the current practice with regard to health-related quality of life—heart disease patients: beta=0.730 (P=.36) for the physical component score and beta=-0.608 (P=.62) for the mental component score; diabetes patients: beta=0.875 (P=.85) for the physical component score and beta=-0.770 (P=.52) for the mental component score. There was a significant difference in waist circumference in the type 2 diabetes group (beta=-1.711, P=.01). There were no differences in any other outcome variables. Conclusions A health coaching program supported with telemonitoring did not improve heart disease patients' or diabetes patients' quality of life or their clinical condition. There were indications that the intervention had a differential effect on heart patients and diabetes patients. Diabetes patients may be more prone to benefit from this kind of intervention. This should not be neglected when developing new ways for self-management of chronic diseases. Trial Registration ClinicalTrials.gov NCT01310491; http://clinicaltrials.gov/ct2/show/NCT01310491 (Archived by WebCite at http://www.webcitation.org/6Z8l5FwAM). PMID:26084979

  4. Predictors of Home-Based Child Care Providers' Participation in Professional Development Workshops and Coaching

    ERIC Educational Resources Information Center

    Rusby, Julie C.; Jones, Laura B.; Crowley, Ryann; Smolkowski, Keith; Arthun, Chris

    2013-01-01

    Background: Little is known about factors that influence home-based child care providers' participation in professional development. Factors that predict participation in activities that are designed to promote the utilization and maintenance of skills taught are of particular interest. Objective: Our aim was to examine factors in the

  5. The effectiveness of medical assistant health coaching for low-income patients with uncontrolled diabetes, hypertension, and hyperlipidemia: protocol for a randomized controlled trial and baseline characteristics of the study population

    PubMed Central

    2013-01-01

    Background Many patients with chronic disease do not reach goals for management of their conditions. Self-management support provided by medical assistant health coaches within the clinical setting may help to improve clinical outcomes, but most studies to date lack statistical power or methodological rigor. Barriers to large scale implementation of the medical assistant coach model include lack of clinician buy-in and the absence of a business model that will make medical assistant health coaching sustainable. This study will add to the evidence base by determining the effectiveness of health coaching by medical assistants on clinical outcomes and patient self-management, by assessing the impact of health coaching on the clinician experience, and by examining the costs and potential savings of health coaching. Methods/Design This randomized controlled trial will evaluate the effectiveness of clinic-based medical assistant health coaches to improve clinical outcomes and self-management skills among low-income patients with uncontrolled type 2 diabetes, hypertension, or hyperlipidemia. A total of 441 patients from two San Francisco primary care clinics have been enrolled and randomized to receive a health coach (n?=?224) or usual care (n?=?217). Patients participating in the health coaching group will receive coaching for 12months from medical assistants trained as health coaches. The primary outcome is a change in hemoglobin A1c, systolic blood pressure, or LDL cholesterol among patients with uncontrolled diabetes, hypertension and hyperlipidemia, respectively. Self-management behaviors, perceptions of the health care team and clinician, BMI, and chronic disease self-efficacy will be measured at baseline and after 12months. Clinician experience is being assessed through surveys and qualitative interviews. Cost and utilization data will be analyzed through cost-predictive models. Discussion Medical assistants are an untapped resource to provide self-management support for patients with uncontrolled chronic disease. Having successfully completed recruitment, this study is uniquely poised to assess the effectiveness of the medical assistant health coaching model, to describe barriers and facilitators to implementation, and to develop a business case for sustainability. Trial registration ClinicalTrials.gov identifier NCT-01220336 PMID:23433349

  6. Automated Assessment of Cognitive Health Using Smart Home Technologies

    PubMed Central

    Dawadi, Prafulla N.; Cook, Diane J.; Schmitter-Edgecombe, Maureen; Parsey, Carolyn

    2014-01-01

    BACKGROUND The goal of this work is to develop intelligent systems to monitor the well being of individuals in their home environments. OBJECTIVE This paper introduces a machine learning-based method to automatically predict activity quality in smart homes and automatically assess cognitive health based on activity quality. METHODS This paper describes an automated framework to extract set of features from smart home sensors data that reflects the activity performance or ability of an individual to complete an activity which can be input to machine learning algorithms. Output from learning algorithms including principal component analysis, support vector machine, and logistic regression algorithms are used to quantify activity quality for a complex set of smart home activities and predict cognitive health of participants. RESULTS Smart home activity data was gathered from volunteer participants (n=263) who performed a complex set of activities in our smart home testbed. We compare our automated activity quality prediction and cognitive health prediction with direct observation scores and health assessment obtained from neuropsychologists. With all samples included, we obtained statistically significant correlation (r=0.54) between direct observation scores and predicted activity quality. Similarly, using a support vector machine classifier, we obtained reasonable classification accuracy (area under the ROC curve = 0.80, g-mean = 0.73) in classifying participants into two different cognitive classes, dementia and cognitive healthy. CONCLUSIONS The results suggest that it is possible to automatically quantify the task quality of smart home activities and perform limited assessment of the cognitive health of individual if smart home activities are properly chosen and learning algorithms are appropriately trained. PMID:23949177

  7. Marketing home health care medical services: the physician's view.

    PubMed

    Ryan, E J; Phelps, R A

    1993-01-01

    The authors surveyed physicians serving the Jackson, Mississippi home health care market. They identified problems and studied physician perceptions regarding services provided by home health care agencies, private duty nursing agencies, and durable medical equipment suppliers. Respondents perceived home health care as providing: (1) increased patient satisfaction, (2) greater patient convenience, (3) earlier discharge, and (4) lowered patient costs. They least liked: (1) lack of control and involvement in the patient caring process, (2) paperwork, (3) quality control potential, and the possibility that patient costs could increase. Two sets of implications for health care marketers are presented that involve both national and regional levels. Overall results indicate that a growing and profitable market segment exists and is being served in an effective and socially responsible manner. PMID:10127916

  8. Correlates of Home Health Care Services Use among the Elderly.

    ERIC Educational Resources Information Center

    Starrett, Richard A.; And Others

    The use of health and social services is influenced by economic, community, geographic, organizational, societal, and environmental factors. A study was conducted to examine predisposing, enabling, and need-for-care factors related to the use of home health care services by a stratified random sample of 400 older adults. Predisposing factors

  9. Physical Restraint Initiation in Nursing Homes and Subsequent Resident Health

    ERIC Educational Resources Information Center

    Engberg, John; Castle, Nicholas G.; McCaffrey, Daniel

    2008-01-01

    Purpose: It is widely believed that physical restraint use causes mental and physical health decline in nursing home residents. Yet few studies exist showing an association between restraint initiation and health decline. In this research, we examined whether physical restraint initiation is associated with subsequent lower physical or mental

  10. Softball Coaching.

    ERIC Educational Resources Information Center

    Lopiano, Donna; And Others

    1981-01-01

    A collection of articles provides current instructional information to softball players and coaches. Topics discussed in the series include practice, basic skills, defense, pitching, catching, offense, and warm-up exercises to be used in conjunction with other conditioning drills. (JN)

  11. Curbstone Coaching.

    ERIC Educational Resources Information Center

    Cover, William H.

    1980-01-01

    Bridging the gap between the classroom and on-the-job application has been a growing concern to the sales training profession and of sales managers. "Curbstone Coaching," an on-the-job program in which sales managers train their sales representatives in selling skills is a possible solution. (JOW)

  12. Coaches' Handbook.

    ERIC Educational Resources Information Center

    Fields, Max

    The policies and procedures stated in this handbook are to be used as a guide in the performance of duties and responsibilities by the Director of Athletics and athletic coaches at Imperial Valley College (California). This handbook supplements the Faculty Handbook, the district policy manual, the California Junior College Association Athletic…

  13. What Good Coaches Do

    ERIC Educational Resources Information Center

    Knight, Jim

    2011-01-01

    Instructional coaching guru Jim Knight suggests that how we think about coaching can enhance or interfere with our success as a coach. He suggests that coaches take a partnership approach to collaboration and adopt seven principles that define how coaches interact with collaborating teachers: equality, choice, voice, reflection, dialogue, praxis,

  14. The Heart of Coaching

    ERIC Educational Resources Information Center

    Docheff, Dennis M.; Gerdes, Dan

    2015-01-01

    This article challenges coaches to address the more personal, human elements of coaching--the HEART of coaching. While there is much research on numerous aspects of coaching, this article provides ideas that make a lasting impact on the hearts of athletes. Using HEART as an acronym, five elements of effective coaching are presented: Humility,…

  15. The Heart of Coaching

    ERIC Educational Resources Information Center

    Docheff, Dennis M.; Gerdes, Dan

    2015-01-01

    This article challenges coaches to address the more personal, human elements of coaching--the HEART of coaching. While there is much research on numerous aspects of coaching, this article provides ideas that make a lasting impact on the hearts of athletes. Using HEART as an acronym, five elements of effective coaching are presented: Humility,

  16. Management of type 2 diabetes in China: the Happy Life Club, a pragmatic cluster randomised controlled trial using health coaches

    PubMed Central

    Browning, Colette; Chapman, Anna; Yang, Hui; Liu, Shuo; Zhang, Tuohong; Enticott, Joanne C; Thomas, Shane A

    2016-01-01

    Objective To assess the effectiveness of a coach-led motivational interviewing (MI) intervention in improving glycaemic control, as well as clinical, psychosocial and self-care outcomes of individuals with type 2 diabetes mellitus (T2DM) compared with usual care. Design Pragmatic cluster randomised controlled trial (RCT). Setting Community Health Stations (CHSs) in Fengtai district, Beijing, China. Participants Of the 41 randomised CHSs (21 intervention and 20 control), 21 intervention CHSs (372 participants) and 18 control CHSs (296 participants) started participation. Intervention Intervention participants received telephone and face-to-face MI health coaching in addition to usual care from their CHS. Control participants received usual care only. Medical fees were waived for both groups. Outcome measures Outcomes were assessed at baseline, 6 and 12 months. Primary outcome measure was glycated haemoglobin (HbA1c). Secondary outcomes included a suite of anthropometric, blood pressure (BP), fasting blood, psychosocial and self-care measures. Results At 12 months, no differential treatment effect was found for HbA1c (adjusted difference 0.02, 95% CI −0.40 to 0.44, p=0.929), with both treatment and control groups showing significant improvements. However, two secondary outcomes: psychological distress (adjusted difference −2.38, 95% CI −4.64 to −0.12, p=0.039) and systolic BP (adjusted difference −3.57, 95% CI −6.08 to −1.05, p=0.005) were robust outcomes consistent with significant differential treatment effects, as supported in sensitivity analyses. Interestingly, in addition to HbA1c, both groups displayed significant improvements in triglycerides, LDL cholesterol and HDL cholesterol. Conclusions In line with the current Chinese primary healthcare reform, this study is the first large-scale cluster RCT to be implemented within real-world CHSs in China, specifically addressing T2DM. Although a differential treatment effect was not observed for HbA1c, numerous outcomes (including HbA1c) improved in both groups, supporting the establishment of regular, free clinical health checks for people with T2DM in China. Trial registration number ISRCTN01010526; Pre-results. PMID:26944692

  17. Athletic coaches as violence prevention advocates.

    PubMed

    Jaime, Maria Catrina D; McCauley, Heather L; Tancredi, Daniel J; Nettiksimmons, Jasmine; Decker, Michele R; Silverman, Jay G; O'Connor, Brian; Stetkevich, Nicholas; Miller, Elizabeth

    2015-04-01

    Adolescent relationship abuse (ARA) is a significant public health problem. Coaching Boys Into Men (CBIM) is an evidence-based ARA prevention program that trains coaches to deliver violence prevention messages to male athletes. Assessing acceptability and impact of CBIM on coaches may inform prevention efforts that involve these important adults in health promotion among youth. As part of a two-armed cluster-randomized controlled trial of CBIM in 16 high schools in Northern California, coaches completed baseline and postseason surveys (n = 176) to assess their attitudes and confidence delivering the program. Coaches in the intervention arm also participated in interviews (n = 36) that explored program acceptability, feasibility, and impact. Relative to controls, intervention coaches showed increases in confidence intervening when witnessing abusive behaviors among their athletes, greater bystander intervention, and greater frequency of violence-related discussions with athletes and other coaches. Coaches reported the program was easy to implement and valuable for their athletes. Findings illustrate the value of exploring attitudinal and behavioral changes among ARA prevention implementers, and suggest that coaches can gain confidence and enact behaviors to discourage ARA among male athletes. Coaches found the program to be feasible and valuable, which suggests potential for long-term uptake and sustainability. PMID:25015237

  18. Coping with reduced cost limits for home health agencies.

    PubMed

    Cooper, J R; Fogel, L A

    1994-10-01

    The Omnibus Budget Reconciliation Act of 1993, together with cost-limit reductions and wage-index changes published in the Federal Register, have resulted in a substantial reduction in Medicare cost limits, particularly as they apply to hospital-based home health agencies. This article examines specific changes in home health agency cost limits, reviews strategies to identify the bottom-line impact of the Medicare cost-limit reductions, and discusses methods that may be applied to minimize the negative impact of the reduced cost limits. PMID:10146080

  19. Does "Word Coach" Coach Words?

    ERIC Educational Resources Information Center

    Cobb, Tom; Horst, Marlise

    2011-01-01

    This study reports on the design and testing of an integrated suite of vocabulary training games for Nintendo[TM] collectively designated "My Word Coach" (Ubisoft, 2008). The games' design is based on a wide range of learning research, from classic studies on recycling patterns to frequency studies of modern corpora. Its general usage and learning

  20. Parent involvement with children's health promotion: the Minnesota Home Team.

    PubMed Central

    Perry, C L; Luepker, R V; Murray, D M; Kurth, C; Mullis, R; Crockett, S; Jacobs, D R

    1988-01-01

    This study compares the efficacy of a school-based program to an equivalent home-based program with 2,250 third grade students in 31 urban schools in Minnesota in order to detect changes in dietary fat and sodium consumption. The school-based program, Hearty Heart and Friends, involved 15 sessions over five weeks in the third grade classrooms. The home-based program, the Home Team, involved a five-week correspondence course with the third graders, where parental involvement was necessary in order to complete the activities. Outcome measures included anthropometric, psychosocial and behavioral assessments at school, and dietary recall, food shelf inventories, and urinary sodium data collected in the students' homes. Participation rates for all aspects of the study were notably high. Eighty-six per cent of the parents participated in the Home Team and 71 per cent (nearly 1,000 families) completed the five-week course. Students in the school-based program had gained more knowledge at posttest than students in the home-based program or controls. Students in the home-based program, however, reported more behavior change, had reduced the total fat, saturated fat, and monounsaturated fat in their diets, and had more of the encouraged foods on their food shelves. The data converge to suggest the feasibility and importance of parental involvement for health behavior changes with children of this age. PMID:3407811

  1. Is particle board in the home detrimental to health

    SciTech Connect

    Daugbjerg, P. )

    1989-04-01

    A questionnaire concerning health and living conditions was sent to the parents of 1387 children aged 0-15 years to answer the question if children living in homes built with large amounts of particle board had more headaches and respiratory and skin symptoms than other children. There were 1376 possible respondents, and of those 1036 (75.3)% returned the questionnaire. Of the questionnaires returned, 972 (70.6%) were analyzable. The children lived in homes with much particle board (group A); little particle board, or homes as group A but treated in a special way (group B); and homes with no particle board (group C). For the 0- to 5-year-old children, living in homes with much particle board was a risk factor for developing wheezy bronchitis, eye and nose irritation, and coughing. For the 6- to 15-year-old children, living in a home with much particle board was not a risk factor. Risk factors for headache, irritation of the throat, and need for daily antiasthmatic medication were analyzed for all the children collectively. Living in a home with much particle board was a risk factor for all three conditions.

  2. Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    PubMed

    2015-11-01

    This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes. PMID:26552111

  3. Performance model for telehealth use in home health agencies.

    PubMed

    Frey, Jocelyn; Harmonosky, Catherine M; Dansky, Kathryn H

    2005-10-01

    Increasingly, home health agencies (HHAs) are considering the value of implementing telehealth technology. However, questions arise concerning how to manage and use this technology to benefit patients, nurses, and the agency. Performance models will be beneficial to managers and decision makers in the home health field by providing quantitative information for present and future planning of staff and technology usage in the HHA. This paper presents a model that predicts the average daily census of the HHA as a function of statistically identified parameters. Average daily census was chosen as the outcome variable because it is a proxy measure of an agency's capacity. The model suggests that including a telehealth system in the HHA increases average daily census by 40%-90% depending on the number of nurse full-time equivalent(s) (FTEs) and amount of travel hours per month. The use of a home telecare system enhances HHA performance. PMID:16250817

  4. COMPETITION AND QUALITY IN HOME HEALTH CARE MARKETS†

    PubMed Central

    JUNG, KYOUNGRAE; POLSKY, DANIEL

    2013-01-01

    SUMMARY Market-based solutions are often proposed to improve health care quality; yet evidence on the role of competition in quality in non-hospital settings is sparse. We examine the relationship between competition and quality in home health care. This market is different from other markets in that service delivery takes place in patients’ homes, which implies low costs of market entry and exit for agencies. We use 6 years of panel data for Medicare beneficiaries during the early 2000s. We identify the competition effect from within-market variation in competition over time. We analyze three quality measures: functional improvements, the number of home health visits, and discharges without hospitalization. We find that the relationship between competition and home health quality is nonlinear and its pattern differs by quality measure. Competition has positive effects on functional improvements and the number of visits in most ranges, but in the most competitive markets, functional outcomes and the number of visits slightly drop. Competition has a negative effect on discharges without hospitalization that is strongest in the most competitive markets. This finding is different from prior research on hospital markets and suggests that market-specific environments should be considered in developing polices to promote competition. PMID:23670849

  5. Can Low-Cost Support Programmes with Coaching Accelerate Doctoral Completion in Health Science Faculty Academics?

    ERIC Educational Resources Information Center

    Geber, Hilary; Bentley, Alison

    2012-01-01

    Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences…

  6. Can Low-Cost Support Programmes with Coaching Accelerate Doctoral Completion in Health Science Faculty Academics?

    ERIC Educational Resources Information Center

    Geber, Hilary; Bentley, Alison

    2012-01-01

    Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences

  7. 42 CFR 413.125 - Payment for home health agency services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Payment for home health agency services. 413.125... Categories of Costs 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see 409.46 and 409.49(b) of this chapter....

  8. 42 CFR 413.125 - Payment for home health agency services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Payment for home health agency services. 413.125... Categories of Costs 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see 409.46 and 409.49(b) of this chapter....

  9. 42 CFR 413.125 - Payment for home health agency services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for home health agency services. 413.125... Categories of Costs 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see 409.46 and 409.49(b) of this chapter....

  10. 42 CFR 413.125 - Payment for home health agency services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for home health agency services. 413.125... Categories of Costs 413.125 Payment for home health agency services. (a) For additional rules on the allowability of certain costs incurred by home health agencies, see 409.46 and 409.49(b) of this chapter....

  11. Health and Safety Guide for Home Performance Contractors

    SciTech Connect

    Stratton, Chris; Walker, Iain S.

    2012-02-15

    This report is intended to provide home performance contractor trainers with a resource to keep both their workers and home residents safe and healthy. This document is an attempt to describe what we currently believe is safe, what we believe is unsafe, and what we’re unsure about. It is intended to identify health and safety issues and provide historical context and current understanding of both risks and mitigation strategies. In addition, it provides links to more in-depth resources for each issue. When we tighten the thermal envelope of a house to improve comfort and reduce energy use, we have to be sure that we are not compromising the indoor air quality of the home. This means identifying and mitigating or eliminating pollution sources before and after you make changes to the home. These sources can include materials and finishes in the home, exhaust gasses from combustion appliances, soil gasses such as radon, and moisture from a bathroom, kitchen, or unvented clothes dryer. Our first responsibility is to do no harm — this applies both to our clients and to our employees. Currently, there are many new products that are widely used but whose health effects are not well understood. Our in ability to have perfect information means the directive to do no harm can be difficult to obey. Each home is a little bit different, and in the face of a situation you’ve never encountered, it’s important to have a solid grasp of the fundamental concepts of building science when the hard and fast rules don’t apply . The home performance industry is gaining momentum, and has the potential to expand greatly as energy costs continue to rise. It is imperative that we remain vigilant about protecting the health and safety of our workers and our customers. It only takes a few news stories about a family that got sick after their home was tightened by a home performance contractor to scare off potential customers and taint the reputation of the entire industry. Good reputations take time to build, but can be quickly damaged.

  12. Uptake and Effects of the e-Vita Personal Health Record with Self-Management Support and Coaching, for Type 2 Diabetes Patients Treated in Primary Care

    PubMed Central

    van Vugt, M.; de Wit, M.; Sieverink, F.; Roelofsen, Y.; Hendriks, S. H.; Bilo, H. J. G.; Snoek, F. J.

    2016-01-01

    We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of a personal health record. Patients were followed up for 6 months. Uptake and usage were monitored using log data. Outcomes were self-reported diabetes self-care, diabetes-related distress, and emotional wellbeing. Patients' health status was collected from their medical chart. 132 patients agreed to participate in the study of which less than half (46.1%) did not return to the personal health record after 1st login. Only 5 patients used the self-management support program within the personal health record, 3 of whom asked a coach for feedback. Low use of the personal health record was registered. No statistical significant differences on any of the outcome measures were found between baseline and 6 month follow-up. This study showed minimal impact of implementing a personal health record including self-management support in primary diabetes care. Successful adoption of web-based platforms, as ongoing patient centered care, is hard to achieve without additional strategies aimed at enhancing patient motivation and engaging professionals. PMID:26955640

  13. Leadership Coaching: Coaching Competencies and Best Practices

    ERIC Educational Resources Information Center

    Wise, Donald; Hammack, Marc

    2011-01-01

    Leadership coaching is now seen as a valuable tool to assist school leaders. Through a survey of school principals, this study identified specific coaching competencies used by leadership coaches that were perceived by principals to influence key best practices for schools. These best practices have in turn been correlated to increased student

  14. Coaching Behavior of Girls Youth Softball Coaches.

    ERIC Educational Resources Information Center

    Rupnow, Allan; Stotlar, David

    A study examined coaches' behavior and classified the types and rates of coaches' behavior by time of athletic season (early or late), win/loss record, and throughout the time frame within a single contest. Subjects included all the volunteer coaches in a 13 team, softball program for 10-12 year old girls. The season consisted of a double

  15. Lived Experience and Community Sport Coaching: A Phenomenological Investigation

    ERIC Educational Resources Information Center

    Cronin, Colum; Armour, Kathleen M.

    2015-01-01

    Coaching in the participation domain is the act of coaching participants that are less intensely engaged in sport than performance orientated athletes. This form of coaching is a popular activity occurring in community settings such as schools or sport clubs, and it is often undertaken with a broad range of social and health outcomes in mind. The

  16. Lived Experience and Community Sport Coaching: A Phenomenological Investigation

    ERIC Educational Resources Information Center

    Cronin, Colum; Armour, Kathleen M.

    2015-01-01

    Coaching in the participation domain is the act of coaching participants that are less intensely engaged in sport than performance orientated athletes. This form of coaching is a popular activity occurring in community settings such as schools or sport clubs, and it is often undertaken with a broad range of social and health outcomes in mind. The…

  17. [Study on health awareness of home helper for dependent elderly].

    PubMed

    Isobe, T; Shimoyama, K; Uematsu, H; Teraoka, K

    2000-03-01

    The purpose of this study was to investigate the level of oral health awareness and oral health care activities of home helper for dependent elderly. A questionnaire was mailed to persons who took the profession course of care worker training and education (second and third grade) for home helper and short term course (special subject) at care worker support center foundation (33 branches). Responses were obtained from 220 persons qualified as home helpers. Of 220 home helpers, 104 (47.3%) had worked as a home helper for fewer than six years. One hundred forty two (64.5%) were trained and educated for a home helper as a second grade. The results were as follows: 1. One hundred eleven (50.5%) had used a dental floss and an interdental brush. 2. Two hundred eighteen (99.1%) thought it was necessary to perform oral cleaning of dependent elderly. 3. Two hundred fifteen (97.7%) hoped to perform the oral cleaning of dependent elderly. 4. Two hundred nine (95.0%) considered oral cleaning distasteful. 5. Two hundred three (92.3%) recognized food debris between natural teeth and the denture of dependent elderly who could perform oral cleaning themselves. 6. Two hundred three (92.3%) recognized food debris between natural teeth and the denture of dependent elderly who could not perform oral cleaning themselves. 7. One hundred twenty (54.5%) had been trained in oral cleaning for dependent elderly. 8. Two hundred twelve (96.4%) hoped to receive training in oral cleaning for dependent elderly. PMID:10774157

  18. Preventive home visits and health experiences among very old people

    PubMed Central

    2013-01-01

    Background As more people reach older age, there is a growing interest in improving old persons health, activity, independence and social participation, thereby adding quality to the extended years. Preventive home visits (PHV) programs for old people have received much attention in recent decades. A large body of research shows mixed effects, and argues that a home visit is a complex social process influenced by numerous factors. To evaluate the impact of PHV, as well as making decisions on whether, how, and to whom the service should be provided, requires a deeper understanding of PHV than we have now. Consequently, the aim of the study was to describe the variations in older peoples (80+) experiences of a single preventive home visit and its consequences for health. Methods Seventeen participants between 80 and 92 years of age who had all received a structured PHV were interviewed in their own homes. The interviews were analyzed using the phenomenographic method, looking at the variations in the participants experiences. Results The interviews revealed four categories: The PHV made me visible and proved my human value; The PHV brought a feeling of security; The PHV gave an incentive to action; and The PHV was not for me. Conclusions The experiences of a PHV were twofold. On one hand, the positive experiences indicate that one structured PHV was able to empower the participants and strengthen their self-esteem, making them feel in control over their situation and more aware of the importance of keeping several steps ahead. Together this could motivate them to take measures and engage in health-promoting activities. On the other hand, the PHV was experienced as being of no value by a few. These findings may partly explain the positive results from PHV interventions and emphasize that one challenge for health care professionals is to motivate older people who are healthy and independent to engage in health-promoting and disease-preventive activities. PMID:23617420

  19. Considering Student Coaching

    ERIC Educational Resources Information Center

    Keen, James P.

    2014-01-01

    What does student coaching involve and what considerations make sense in deciding to engage an outside contractor to provide personal coaching? The author explores coaching in light of his own professional experience and uses this reflection as a platform from which to consider the pros and cons of student coaching when deciding whether to choose

  20. Correlates of Suicide among Home Health Care Utilizers Who Died by Suicide and Community Controls

    ERIC Educational Resources Information Center

    Rowe, Jennifer L.; Bruce, Martha L.; Conwell, Yeates

    2006-01-01

    Home health care patients often have several late-life risk factors for suicide and constitute a high risk group for suicidal behaviors. In this study, we examined the characteristics of 14 older adult home health care utilizers who died by suicide and four community controls who used similar services. Both groups of home health care utilizers had

  1. "Curriculum Development for Home and Health Nursing," January 1995-1996. Final Report on Project.

    ERIC Educational Resources Information Center

    Nagel, Mary

    In 1995, Southwestern College, in California, participated in a project to develop a home health course for registered nurses and students interested in working in home health settings. The course was intended to provide nurses and students with the knowledge and clinical skills required for home health care, improve collaboration among community

  2. Virtual Visits in Home Health Care for Older Adults

    PubMed Central

    Huseb, Anne Marie Lunde

    2014-01-01

    Background. This review identifies the content of virtual visits in community nursing services to older adults and explores the manner in which service users and the nurses use virtual visits. Design. An integrative literature review. Method. Data collection comprised a literature search in three databases: Cinahl, Medline, and PubMed. In addition, a manual search of reference lists and expert consultation were performed. A total of 12 articles met the inclusion criteria. The articles were reviewed in terms of study characteristics, service content and utilization, and patient and health care provider experience. Results. Our review shows that in most studies the service is delivered on a daily basis and in combination with in-person visits. The findings suggest that older home-dwelling patients can benefit from virtual visits in terms of enhanced social inclusion and medication compliance. Service users and their nurses found virtual visits satisfactory and suitable for care delivery in home care to the elderly. Evidence for cost-saving benefits of virtual visits was not found. Conclusions. The findings can inform the planning of virtual visits in home health care as a complementary service to in-person visits, in order to meet the increasingly complex needs of older adults living at home. PMID:25506616

  3. A Statewide Assessment of Electronic Health Record Adoption and Health Information Exchange among Nursing Homes

    PubMed Central

    Abramson, Erika L; McGinnis, Sandra; Moore, Jean; Kaushal, Rainu

    2014-01-01

    Objective To determine rates of electronic health record (EHR) adoption and health information exchange (HIE) among New York State (NYS) nursing homes. Data Sources/Study Setting Primary data collected from a novel survey administered between November 2011 and March 2012 to all NYS nursing homes. Study Design We used a cross-sectional study design to assess level of EHR implementation, automation of key functionalities, participation in HIE, and barriers to adoption. Data Collection/Extraction Methods We used descriptive statistics to characterize rates of EHR adoption and participation in HIE and logistic regression to identify nursing home characteristics associated with EHR adoption and HIE. Principal Findings We received responses from 375 of 632 nursing homes (59.3 percent). Of respondents, almost one in five (n = 66, 18.0 percent) reported having a fully implemented and operational EHR and a majority (n = 192, 54.4 percent) reported electronically exchanging information. Nursing homes with 100–159 beds were significantly less likely than other facilities to have implemented or be in the process of implementing an EHR (p = .011). Conclusions Our findings present an important systematic look at EHR adoption and HIE by NYS nursing homes. Although the nursing home sector has been reported to lag in health information technology adoption, our results are encouraging. However, they suggest much room for growth and highlight the need for targeted initiatives to achieve more widespread adoption in this important health care sector. PMID:24359612

  4. Contemplating Home Health PPS: Current Patterns of Medicare Service Use

    PubMed Central

    Goldberg, Henry B.; Schmitz, Robert J.

    1994-01-01

    Implementing a per-episode prospective payment system (PPS) for home health services is one option for Medicare policy makers facing rapid increases in service use and expenditures. Analysis of data on recent episodes of Medicare home health care identified systematic differences in service patterns across provider types; these indicate potential differences in the capacity of agencies of different types to adjust to PPS. The second phase of a national demonstration, which is about to be implemented, will provide information on the extent to which the agency practices that generate much of the observed variation (such as the number of visits provided per episode) are susceptible to management decisions; and whether managers can and do respond to the incentives of per-episode prospective payment. PMID:10140150

  5. Smartphone-Enabled Health Coach Intervention for People With Diabetes From a Modest Socioeconomic Strata Community: Single-Arm Longitudinal Feasibility Study

    PubMed Central

    2014-01-01

    Background Lower socioeconomic strata (SES) populations have higher chronic disease risks. Smartphone-based interventions can support adoption of health behaviors that may, in turn, reduce the risks of type 2 diabetes-related complications, overcoming the obstacles that some patients may have with regular clinical contact (eg, shiftwork, travel difficulties, miscommunication). Objective The intent of the study was to develop and test a smartphone-assisted intervention that improves behavioral management of type 2 diabetes in an ethnically diverse, lower SES population within an urban community health setting. Methods This single-arm pilot study assessed a smartphone application developed with investigator assistance and delivered by health coaches. Participants were recruited from the Black Creek Community Health Centre in Toronto and had minimal prior experience with smartphones. Results A total of 21 subjects consented and 19 participants completed the 6-month trial; 12 had baseline glycosylated hemoglobin (HbA1c) levels >7.0% and these subjects demonstrated a mean reduction of 0.43% (SD 0.63) (P<.05) with minimal changes in medication. Conclusions This project supported the feasibility of smartphone-based health coaching for individuals from lower SES with minimal prior smartphone experience. PMID:24907918

  6. A Home Health Care System for Family Doctor

    NASA Astrophysics Data System (ADS)

    Hamabe, Ryuji; Taketa, Norihiro

    We propose a constitution technique of small-scale Home Health Care system for family doctor that has been developed by applying various API of JAVA. One function is vital data transmission which allows a family doctor to check the data of elderly persons with ease via Internet. Vital data is encrypted and transmitted for the purpose of security. The other function is telecommunication with voice and face image for care consulting.

  7. Health Coaching Reduces HbA1c in Type 2 Diabetic Patients From a Lower-Socioeconomic Status Community: A Randomized Controlled Trial

    PubMed Central

    Wayne, Noah; Perez, Daniel F; Kaplan, David M

    2015-01-01

    Background Adoptions of health behaviors are crucial for maintaining good health after type 2 diabetes mellitus (T2DM) diagnoses. However, adherence to glucoregulating behaviors like regular exercise and balanced diet can be challenging, especially for people living in lower-socioeconomic status (SES) communities. Providing cost-effective interventions that improve self-management is important for improving quality of life and the sustainability of health care systems. Objective To evaluate a health coach intervention with and without the use of mobile phones to support health behavior change in patients with type 2 diabetes. Methods In this noninferiority, pragmatic randomized controlled trial (RCT), patients from two primary care health centers in Toronto, Canada, with type 2 diabetes and a glycated hemoglobin/hemoglobin A1c (HbA1c) level of ≥7.3% (56.3 mmol/mol) were randomized to receive 6 months of health coaching with or without mobile phone monitoring support. We hypothesized that both approaches would result in significant HbA1c reductions, although health coaching with mobile phone monitoring would result in significantly larger effects. Participants were evaluated at baseline, 3 months, and 6 months. The primary outcome was the change in HbA1c from baseline to 6 months (difference between and within groups). Other outcomes included weight, waist circumference, body mass index (BMI), satisfaction with life, depression and anxiety (Hospital Anxiety and Depression Scale [HADS]), positive and negative affect (Positive and Negative Affect Schedule [PANAS]), and quality of life (Short Form Health Survey-12 [SF-12]). Results A total of 138 patients were randomized and 7 were excluded for a substudy; of the remaining 131, 67 were allocated to the intervention group and 64 to the control group. Primary outcome data were available for 97 participants (74.0%). While both groups reduced their HbA1c levels, there were no significant between-group differences in change of HbA1c at 6 months using intention-to-treat (last observation carried forward [LOCF]) (P=.48) or per-protocol (P=.83) principles. However, the intervention group did achieve an accelerated HbA1c reduction, leading to a significant between-group difference at 3 months (P=.03). This difference was reduced at the 6-month follow-up as the control group continued to improve, achieving a reduction of 0.81% (8.9 mmol/mol) (P=.001) compared with a reduction of 0.84% (9.2 mmol/mol)(P=.001) in the intervention group. Intervention group participants also had significant decreases in weight (P=.006) and waist circumference (P=.01) while controls did not. Both groups reported improvements in mood, satisfaction with life, and quality of life. Conclusions Health coaching with and without access to mobile technology appeared to improve glucoregulation and mental health in a lower-SES, T2DM population. The accelerated improvement in the mobile phone group suggests the connectivity provided may more quickly improve adoption and adherence to health behaviors within a clinical diabetes management program. Overall, health coaching in primary care appears to lead to significant benefits for patients from lower-SES communities with poorly controlled type 2 diabetes. Trial Registration ClinicalTrials.gov NCT02036892; http://clinicaltrials.gov/ct2/show/NCT02036892 (Archived by WebCite at http://www.webcitation.org/6b3cJYJOD) PMID:26441467

  8. Coaching for behavior change in physiatry.

    PubMed

    Frates, Elizabeth Pegg; Moore, Margaret A; Lopez, Celeste Nicole; McMahon, Graham T

    2011-12-01

    Behavior modification is vital to the prevention or amelioration of lifestyle-related disease. Health and wellness coaching is emerging as a powerful intervention to help patients initiate and maintain sustainable change that can be critical to physiatry practice. The coach approach delivers a patient-centered collaborative partnership to create an engaging and realistic individualized plan. The coaching process builds the psychologic skills needed to support lasting change, including mindfulness, self-awareness, self-motivation, resilience, optimism, and self-efficacy. Preliminary studies indicate that health and wellness coaching is a useful and potentially important adjunct to usual care for managing hyperlipidemia, diabetes, cancer pain, cancer survival, asthma, weight loss, and increasing physical activity. Physiatrists can benefit from the insights of coaching to promote effective collaboration, negotiation, and motivation to encourage patients to take responsibility for their recovery and their future wellness by adopting healthy lifestyles. PMID:22019966

  9. 42 CFR 484.36 - Condition of participation: Home health aide services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Condition of participation: Home health aide services. 484.36 Section 484.36 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Furnishing of Services § 484.36 Condition of participation:...

  10. 42 CFR 484.245 - Accelerated payments for home health agencies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Accelerated payments for home health agencies. 484.245 Section 484.245 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Prospective Payment...

  11. Task Analysis for Health Occupations. Cluster: Nursing. Occupation: Home Health Aide. Education for Employment Task Lists.

    ERIC Educational Resources Information Center

    Lake County Area Vocational Center, Grayslake, IL.

    This document contains a task analysis for health occupations (home health aid) in the nursing cluster. For each task listed, occupation, duty area, performance standard, steps, knowledge, attitudes, safety, equipment/supplies, source of analysis, and Illinois state goals for learning are listed. For the duty area of "providing therapeutic…

  12. Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

    ERIC Educational Resources Information Center

    Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.

    2008-01-01

    Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched…

  13. Home Health Care and Patterns of Subsequent VA and Medicare Health Care Utilization for Veterans

    ERIC Educational Resources Information Center

    Van Houtven, Courtney Harold; Jeffreys, Amy S.; Coffman, Cynthia J.

    2008-01-01

    Purpose: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HOC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum of services differed for a sample of VA HHC users and their propensity-score-matched

  14. Task Analysis for Health Occupations. Cluster: Nursing. Occupation: Home Health Aide. Education for Employment Task Lists.

    ERIC Educational Resources Information Center

    Lake County Area Vocational Center, Grayslake, IL.

    This document contains a task analysis for health occupations (home health aid) in the nursing cluster. For each task listed, occupation, duty area, performance standard, steps, knowledge, attitudes, safety, equipment/supplies, source of analysis, and Illinois state goals for learning are listed. For the duty area of "providing therapeutic

  15. Exploring the activity profile of health care assistants and nurses in home nursing.

    PubMed

    De Vliegher, Kristel; Aertgeerts, Bert; Declercq, Anja; Moons, Philip

    2015-12-01

    Are home nurses (also known as community nurses) ready for their changing role in primary care? A quantitative study was performed in home nursing in Flanders, Belgium, to explore the activity profile of home nurses and health care assistants, using the 24-hour recall instrument for home nursing. Seven dates were determined, covering each day of the week and the weekend, on which data collection would take place. All the home nurses and health care assistants from the participating organisations across Flanders were invited to participate in the study. All data were measured at nominal level. A total of 2478 home nurses and 277 health care assistants registered 336 128 (47 977 patients) and 36 905 (4558 patients) activities, respectively. Home nurses and health care assistants mainly perform 'self-care facilitation' activities in combination with 'psychosocial care' activities. Health care assistants also support home nurses in the 'selfcare facilitation' of patients who do not have a specific nursing indication. PMID:26636895

  16. Perspectives on Agile Coaching

    NASA Astrophysics Data System (ADS)

    Fraser, Steven; Lundh, Erik; Davies, Rachel; Eckstein, Jutta; Larsen, Diana; Vilkki, Kati

    There are many perspectives to agile coaching including: growing coaching expertise, selecting the appropriate coach for your context; and eva luating value. A coach is often an itinerant who may observe, mentor, negotiate, influence, lead, and/or architect everything from team organization to system architecture. With roots in diverse fields ranging from technology to sociology coaches have differing motivations and experience bases. This panel will bring together coaches to debate and discuss various perspectives on agile coaching. Some of the questions to be addressed will include: What are the skills required for effective coaching? What should be the expectations for teams or individu als being coached? Should coaches be: a corporate resource (internal team of consultants working with multiple internal teams); an integral part of a specific team; or external contractors? How should coaches exercise influence and au thority? How should management assess the value of a coaching engagement? Do you have what it takes to be a coach? - This panel will bring together sea soned agile coaches to offer their experience and advice on how to be the best you can be!

  17. MyCoach: In Situ User Evaluation of a Virtual and Physical Coach for Running

    NASA Astrophysics Data System (ADS)

    Biemans, Margit; Haaker, Timber; Szwajcer, Ellen

    Running is an enjoyable exercise for many people today. Trainers help people to reach running goals. However, todays busy and nomadic people are not always able to attend running classes. A combination of a virtual and physical coach should be useful. A virtual coach (MyCoach) was designed to provide this support. MyCoach consists of a mobile phone (real time) and a web application, with a focus on improving health and well-being. A randomised controlled trial was performed to evaluate MyCoach. The results indicate that the runners value the tangible aspects on monitoring and capturing their exercise and analysing progress. The system could be improved by incorporating running schedules provided by the physical trainer and by improving its usability. Extensions of the system should focus on the real-time aspects of information sharing and physical coaching at a distance.

  18. Home telehealth for children with special health-care needs.

    PubMed

    Cady, Rhonda; Kelly, Anne; Finkelstein, Stanley

    2008-01-01

    The U Special Kids (USK) programme at the University of Minnesota provides intensive care coordination and case management services to children with complex special health-care needs. We conducted a one-year pilot study to evaluate the feasibility of videoconferencing between the USK office and family homes. To ensure easy installation, families were provided with prepackaged equipment and software. However, the families had different Internet providers, different modems and/or routers and different firewall software, which required case-by-case resolution during home visits by the project coordinator. Five families participated in 3-5 videoconferencing sessions with a USK nurse. All connections with urban families had clear audio and video, whereas connections with rural families had clear audio, but unclear video. All of the scheduled virtual visits were rated by nurses as providing information that was similar to a telephone call. However, the unscheduled virtual visits were rated by the nurses as providing more information than a telephone call, suggesting that home-based videoconferencing may be useful in the management of children with complex special health-care needs. PMID:18534949

  19. Providing Coaching and Cotinine Results to Preteens to Reduce Their Secondhand Smoke Exposure

    PubMed Central

    Wahlgren, Dennis R.; Liles, Sandy; Jones, Jennifer A.; Hughes, Suzanne C.; Matt, Georg E.; Ji, Ming; Lessov-Schlaggar, Christina N.; Swan, Gary E.; Chatfield, Dale; Ding, Ding

    2011-01-01

    Background: Secondhand smoke exposure (SHSe) poses health risks to children living with smokers. Most interventions to protect children from SHSe have coached adult smokers. This trial determined whether coaching and cotinine feedback provided to preteens can reduce their SHSe. Methods: Two hundred one predominantly low-income families with a resident smoker and a child aged 8 to 13 years who was exposed to two or more cigarettes per day or had a urine cotinine concentration ? 2.0 ng/mL were randomized to control or SHSe reduction coaching groups. During eight in-home sessions over 5 months, coaches presented to the child graphic charts of cotinine assay results as performance feedback and provided differential praise and incentives for cotinine reductions. Generalized estimating equations were used to determine the differential change in SHSe over time by group. Results: For the baseline to posttest period, the coaching group had a greater decrease in both urine cotinine concentration (P = .039) and reported child SHSe in the number of cigarettes exposed per day (child report, P = .003; parent report, P = .078). For posttest to month 12 follow-up, no group or group by time differences were obtained, and both groups returned toward baseline. Conclusions: Coaching preteens can reduce their SHSe, although reductions may not be sustained without ongoing counseling, feedback, and incentives. Unlike interventions that coach adults to reduce child SHSe, programs that increase child avoidance of SHSe have the potential to reduce SHSe in all settings in which the child is exposed, without requiring a change in adult smoking behavior. PMID:21474574

  20. Workforce Implications of Injury among Home Health Workers: Evidence from the National Home Health Aide Survey

    ERIC Educational Resources Information Center

    McCaughey, Deirdre; McGhan, Gwen; Kim, Jungyoon; Brannon, Diane; Leroy, Hannes; Jablonski, Rita

    2012-01-01

    Purpose of study: The direct care workforce continues to rank as one of the most frequently injured employee groups in North America. Occupational health and safety studies have shown that workplace injuries translate into negative outcomes for workers and their employers. The National Institute for Occupational Safety and Health (NIOSH)…

  1. Workforce Implications of Injury among Home Health Workers: Evidence from the National Home Health Aide Survey

    ERIC Educational Resources Information Center

    McCaughey, Deirdre; McGhan, Gwen; Kim, Jungyoon; Brannon, Diane; Leroy, Hannes; Jablonski, Rita

    2012-01-01

    Purpose of study: The direct care workforce continues to rank as one of the most frequently injured employee groups in North America. Occupational health and safety studies have shown that workplace injuries translate into negative outcomes for workers and their employers. The National Institute for Occupational Safety and Health (NIOSH)

  2. Environmental Health and Safety Hazards Experienced by Home Health Care Providers

    PubMed Central

    Polivka, Barbara J.; Wills, Celia E.; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

    2015-01-01

    The number of personnel providing in-home health care services is increasing substantially. The unique configuration of environmental hazards in individual client homes has a significant impact on the safety and health of home health care providers (HHPs). This mixed-methods study used data from a standardized questionnaire, focus groups, and individual interviews to explore environmental health and safety hazards encountered by HHPs in client homes. The participant sample (N = 68) included nurses, aides, therapists, and owners/managers from a variety of geographic locations. The most often-reported hazards were trip/slip/lift hazards, biohazards, and hazards from poor air quality, allergens, pests and rodents, and fire and burns. Frequency of identified key hazards varied by room, that is, kitchen (e.g., throw rugs, water on floor), bathroom (e.g., tight spaces for client handling), bedroom (e.g., bed too low), living room (e.g., animal waste), and hallway (e.g., clutter). Findings indicate the need for broader training to enable HHPs to identify and address hazards they encounter in client homes. PMID:26268486

  3. Use and cost of home health agency services under Medicare

    PubMed Central

    Ruther, Martin; Helbing, Charles

    1988-01-01

    Presented are 1986 data and trend data (1974-86) on the use and cost of home health agency services rendered to aged and disabled Medicare beneficiaries. Since 1974, reimbursements for these services have grown more rapidly than overall Medicare expenditures. From 1974 to 1986, Medicare expenditures for these services increased from $141 million to $1.8 billion, an average annual rate of 24 percent. HHA reimbursements, however, continue to represent only a small proportion (3.6 percent in 1986) of all Medicare expenditures. PMID:10312817

  4. Literacy Coaching for Change

    ERIC Educational Resources Information Center

    Blachowicz, Camille L. Z.; Obrochta, Connie; Fogelberg, Ellen

    2005-01-01

    An urban school district was able to improve its students' reading achievement substantially by implementing a variety of literary coaching models. The six literary coaching process strategies used by schools are discussed.

  5. Home Foreclosure, Health, and Mental Health: A Systematic Review of Individual, Aggregate, and Contextual Associations

    PubMed Central

    Tsai, Alexander C.

    2015-01-01

    Background The U.S. foreclosure crisis intensified markedly during the Great Recession of 2007-09, and currently an estimated five percent of U.S. residential properties are more than 90 days past due or in the process of foreclosure. Yet there has been no systematic assessment of the effects of foreclosure on health and mental health. Methods and Findings I applied systematic search terms to PubMed and PsycINFO to identify quantitative or qualitative studies about the relationship between home foreclosure and health or mental health. After screening the titles and abstracts of 930 publications and reviewing the full text of 76 articles, dissertations, and other reports, I identified 42 publications representing 35 unique studies about foreclosure, health, and mental health. The majority of studies (32 [91%]) concluded that foreclosure had adverse effects on health or mental health, while three studies yielded null or mixed findings. Only two studies examined the extent to which foreclosure may have disproportionate impacts on ethnic or racial minority populations. Conclusions Home foreclosure adversely affects health and mental health through channels operating at multiple levels: at the individual level, the stress of personally experiencing foreclosure was associated with worsened mental health and adverse health behaviors, which were in turn linked to poorer health status; at the community level, increasing degradation of the neighborhood environment had indirect, cross-level adverse effects on health and mental health. Early intervention may be able to prevent acute economic shocks from eventually developing into the chronic stress of foreclosure, with all of the attendant benefits this implies for health and mental health status. Programs designed to encourage early return of foreclosed properties back into productive use may have similar health and mental health benefits. PMID:25849962

  6. Montessori-based training makes a difference for home health workers & their clients.

    PubMed

    Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J

    2003-01-01

    Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training. PMID:12557465

  7. Characteristics of Managerial Coaching

    ERIC Educational Resources Information Center

    Gilley, Ann; Gilley, Jerry W.; Kouider, Elies

    2010-01-01

    Coaching has become ubiquitous in organizations. Despite its growth in popularity, the concept remains largely untested through empirical inquiry. This study examined the skills and behaviors associated with managerial coaching. Results indicate a link between specific managerial skills, behaviors, and coaching. (Contains 4 tables.)

  8. The Anatomy of Coaching: Coaching through Storytelling

    ERIC Educational Resources Information Center

    Blackstone, Phyllis A.

    2007-01-01

    In this article, the author posits that storytelling can be used as a method for developing positive interpersonal relationships between coaches and classroom teachers. The author argues that developing interpersonal relationships is a necessary but challenging aspect of successful coaching, and that storytelling offers a mechanism for greater

  9. Work environment characteristics of high-quality home health agencies.

    PubMed

    Tullai-McGuinness, Susan; Riggs, Jennifer S; Farag, Amany A

    2011-10-01

    This concurrent mixed-method study examines the nurse work environment of high-quality Medicare-certified home health agencies. High-quality (n=6) and low-quality (n=6) home health agencies were recruited using agency-level publicly reported patient outcomes. Direct care registered nurses (RNs) from each agency participated in a focus group and completed the Practice Environment Scale of the Nurse Work Index (PES-NWI). No significant differences were found in the PES-NWI results between nurses working in high- and low-quality agencies, though nurses in high-quality agencies scored higher on all subscales. Nurses working in all the high-quality agencies identified themes of adequate staffing, supportive managers, and team work. These themes were not consistently identified in low-quality agencies. Themes of supportive managers and team work are reflective of effective leadership at the manager level. Agencies struggling to improve quality of care might consider developing their managers' leadership skills. PMID:20935216

  10. Understanding challenges in the front lines of home health care: a human-systems approach.

    PubMed

    Beer, Jenay M; McBride, Sara E; Mitzner, Tracy L; Rogers, Wendy A

    2014-11-01

    A human-systems perspective is a fruitful approach to understanding home health care because it emphasizes major individual components of the system - persons, equipment/technology, tasks, and environments - as well as the interaction between these components. The goal of this research was to apply a human-system perspective to consider the capabilities and limitations of the persons, in relation to the demands of the tasks and equipment/technology in home health care. Identification of challenges and mismatches between the person(s) capabilities and the demands of providing care provide guidance for human factors interventions. A qualitative study was conducted with 8 home health Certified Nursing Assistants and 8 home health Registered Nurses interviewed about challenges they encounter in their jobs. A systematic categorization of the challenges the care providers reported was conducted and human factors recommendations were proposed in response, to improve home health. The challenges inform a human-systems model of home health care. PMID:24958610

  11. Coaching to promote professional development in nursing practice.

    PubMed

    Narayanasamy, Aru; Penney, Vivian

    This article presents coaching, which facilitates the highest form of learning, as a potential strategy for promoting professional development in nursing. In doing so, it sets out what coaching is and highlights its benefits in terms of team building, adaptation to changes, career planning and professional development. Having established the rudiments of coaching and identifying its qualities, the article then sets out strategies of coaching using three models: the 3-D Technique Model, The Practice Spiral Model and The Grow Model. Three case histories are presented to explain how these models could be used to implement coaching and personal learning plans (PLP). Directions are provided where training for coaching is available. It is concluded that coaching can be a powerful tool in enhancing nurses' and other health professionals' ability to contribute to the success of healthcare organisations. PMID:24933546

  12. Patient satisfaction and quality in home health care of elderly islanders.

    PubMed

    Nadarevi?-Stefanec, Vesna; Malatestini?, Dulija; Mataija-Redzovi?, Andrea; Nadarevi?, Tin

    2011-09-01

    Patient satisfaction has been a widely investigated subject in health care research. Quality of care from the patient perspective, especially in home health care, however has been investigated only very recently. Home health care is a system of care provided by skilled practitioners to patients in their homes under the direction of a physician. Multidisciplinary nature of home health care services present challenges to quality measurement that differ from those found in a more traditional hospital settings. The aim of the study was to investigate the satisfaction of elderly patients living on islands with home health care. Participants receiving skilled nursing care in their homes, for any diagnosis, who met selection criteria, were surveyed about their perception of the quality of health care. The research was conducted during the year 2010 among the residents of Kvarnerian islands (Krk, Cres and Mali Losinj) under the authority of Croatian Institute for Health Insurance that approved the protocols employed in the investigation. Most older patients (96.2%) reported high levels of satisfaction with health services delivery. Common leading diagnosis among home health care patient include diseases of circulatory system (28.9% of patients), nutritional and metabolic disease (14.5%), malignant diseases (13.2%), musculoskeletal and connective tissue disease (11.8%), diseases of the nervous system (9.2%), followed by injury and poisoning (7.9%). Provision of home health care was well received by elderly patients. Home health care providers seek to provide high quality, safe care in ways that honour patient autonomy and accommodate the individual characteristics of each patients home and family. The demographics of an aging society will sustain the trend towards home-based care. Therefore, research on effective practices, conducted in home health care settings, is necessary to support excellent and evidence-based care. PMID:22220438

  13. Coaches and Coaching in Reading First Schools: A Reality Check

    ERIC Educational Resources Information Center

    Bean, Rita M.; Draper, Jason A.; Hall, Virginia; Vandermolen, Jill; Zigmond, Naomi

    2010-01-01

    The current article investigates the work of 20 Reading First coaches to determine how coaches distribute their time and the rationale they give for their work. Teachers' responses to coaches and the relationships between what coaches do and student achievement are also analyzed. There was great variability among coaches in how they allocated

  14. Coaches and Coaching in Reading First Schools: A Reality Check

    ERIC Educational Resources Information Center

    Bean, Rita M.; Draper, Jason A.; Hall, Virginia; Vandermolen, Jill; Zigmond, Naomi

    2010-01-01

    The current article investigates the work of 20 Reading First coaches to determine how coaches distribute their time and the rationale they give for their work. Teachers' responses to coaches and the relationships between what coaches do and student achievement are also analyzed. There was great variability among coaches in how they allocated…

  15. The Health Home: A Service Delivery Model for Autism and Intellectual Disability.

    PubMed

    Fueyo, Michael; Caldwell, Tim; Mattern, Sarah B; Zahid, Jahanara; Foley, Thomas

    2015-11-01

    Autism spectrum disorder (ASD) and intellectual disability (ID) are lifelong conditions with profound impact on the functioning of affected individuals and their families. Optimizing developmental outcomes requires a lifelong perspective on treatment. The patient-centered health care home (health home) model is currently used to improve health outcomes and care integration in a variety of chronic general medical and psychiatric conditions. The authors propose the health home model as a new conceptual framework from which to build systems of care for persons with ASD or ID and their families. The authors describe essential elements of a health home for these populations, which would be located in a behavioral health setting. They also describe an existing model of such a health home, the Center for Autism and Developmental Disabilities in Pennsylvania. PMID:26129999

  16. Bringing Central LineAssociated Bloodstream Infection Prevention Home: CLABSI Definitions and Prevention Policies in Home Health Care Agencies

    PubMed Central

    Rinke, Michael L.; Bundy, David G.; Milstone, Aaron M.; Deuber, Kristin; Chen, Allen R.; Colantuoni, Elizabeth; Miller, Marlene R.

    2015-01-01

    Background A study was conducted to investigate home health care agency central lineassociated bloodstream infection (CLABSI) definitions and prevention policies and compare them to the Joint Commission National Patient Safety Goal (NPSG.07.04.01), the Centers for Disease Control and Prevention (CDC) CLABSI prevention recommendations, and a best-practice central line care bundle for inpatients. Methods A telephone-based survey was conducted in 2011 of a convenience sample of home health care agencies associated with childrens hematology/oncology centers. Results Of the 97 eligible home health care agencies, 57 (59%) completed the survey. No agency reported using all five aspects of the National Healthcare and Safety Network/Association for Professionals in Infection Control and Epidemiology CLABSI definition and adjudication process, and of the 50 agencies that reported tracking CLABSI rates, 20 (40%) reported using none. Only 10 agencies (18%) had policies consistent with all elements of the inpatient-focused NPSG.07.04.01, 10 agencies (18%) were consistent with all elements of the home care targeted CDC CLABSI prevention recommendations, and no agencies were consistent with all elements of the central line care bundle. Only 14 agencies (25%) knew their overall CLABSI rate: mean 0.40 CLABSIs per 1,000 central line days (95% confidence interval [CI], 0.18 to 0.61). Six agencies (11%) knew their agencys pediatric CLABSI rate: mean 0.54 CLABSIs per 1,000 central line days (95% CI, 0.06 to 1.01). Conclusions The policies of a national sample of home health care agencies varied significantly from national inpatient and home health care agency targeted standards for CLABSI definitions and prevention. Future research should assess strategies for standardizing home health care practices consistent with evidence-based recommendations. PMID:23991509

  17. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review

    PubMed Central

    Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J.; Demiris, George

    2013-01-01

    Introduction There is a critical need for public health interventions to support the independence of older adults as the worlds population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. Methods We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. Results One thousand, six hundred and thirty nine candidate articles were identified. Thirty-one studies from the years 19982011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). Conclusion The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of these used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults, social support and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. PMID:23639263

  18. The Coach and the Evaluator

    ERIC Educational Resources Information Center

    Tschannen-Moran, Bob; Tschannen-Moran, Megan

    2011-01-01

    Evaluation and coaching should not be linked, these authors argue. Although it's tempting for evaluators to identify deficiencies and then specify coaching as a remediation strategy, doing so turns coaching into a consequence of a poor evaluation and termination into a consequence of failed coaching. Another mistake is to use coaching as a data

  19. Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over

    MedlinePLUS

    ... April 18, 2012 Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over ... and Roberto Valverde, M.P.H., Division of Health Care Statistics Abstract Objective —This report presents national estimates ...

  20. A case-control study of home foreclosure, health conditions, and health care utilization.

    PubMed

    Pollack, Craig Evan; Kurd, Shanu K; Livshits, Alice; Weiner, Mark; Lynch, Julia

    2011-06-01

    Though rates of foreclosure are at a historic high, relatively little is known about the link between foreclosure and health. We performed a case-control study to examine health conditions and health care utilization in the time period prior to foreclosure. Homeowners who received a home foreclosure notice from 2005 to 2008 were matched (by name and address) to a university hospital system in Philadelphia and compared with controls who received care from the hospital system and who lived in the same zip code as cases. Outcome measures included prevalent health conditions and visit history in the 2years prior to foreclosure. We found that people undergoing foreclosure were similar to controls with regard to age, gender, and insurance status but significantly more likely to be African American. Rates of hypertension and renal disease were significantly higher among cases after adjustment for sociodemographic characteristics. In the 2years prior to foreclosure, cases were more likely to visit the emergency department, have an outpatient visit, and have a no-show appointment. Cases were less likely to have a primary care physicians (PCP) visit in the 6months immediately prior to the receipt of a foreclosure notice. The results suggest changes in health care utilization in the time period prior to foreclosure. Policies designed to decrease the incidence of home foreclosure and support people during the process should consider its association with poor health and changes in health care utilization. PMID:21491152

  1. Home health and informal care utilization and costs over time in Alzheimer's disease

    PubMed Central

    Zhu, Carolyn W.; Scarmeas, Nikolaos; Torgan, Rebecca; Albert, Marilyn; Brandt, Jason; Blacker, Deborah; Sano, Mary; Stern, Yaakov

    2009-01-01

    Objectives To (1) compare home health and informal (unpaid) services utilization among patients with Alzheimer's disease (AD), (2) examine longitudinal changes in services use, and (3) estimate possible interdependence of home health and informal care utilization. Methods The sample is drawn from the Predictors Study, a large, multi-center cohort of patients with probable AD, prospectively followed annually for up to 7 years in three university-based AD centers. Bivariate probit models estimated the effects of patient characteristics on home health and informal care utilization. Results A large majority of the patients (80.6%) received informal care with a smaller proportion (18.6%) receiving home health services. Home health services utilization increased from 9.9% at baseline to 34.5% in year 4. Among users, number of days that services were provided in three-month recall increased from 21.9 to 56 days over time. Home health services utilization was significantly associated with function, depressive symptoms, being female, and not living with a spouse. Informal care utilization was significantly associated with cognition, function, comorbidities, and living with a spouse or child. Conclusions Home health and informal care utilization relate differently to patient characteristics. Utilization of home health care or informal care was not influenced by utilization of the other. PMID:18510196

  2. Training of Home Health Aides and Nurse Aides: Findings from National Data

    ERIC Educational Resources Information Center

    Sengupta, Manisha; Ejaz, Farida K.; Harris-Kojetin, Lauren D.

    2012-01-01

    Training and satisfaction with training were examined using data from nationally representative samples of 2,897 certified nursing assistants (CNAs) from the National Nursing Assistant Survey and 3,377 home health aides (HHAs) from the National Home Health Aide Survey conducted in 2004 and 2007, respectively. This article focuses on the

  3. Anthroposophic health care--different and home-like.

    PubMed

    Arman, Maria; Ranheim, Albertine; Rehnsfeldt, Arne; Wode, Kathrin

    2008-09-01

    Anthroposophic health care is rooted in the work of Steiner and Wegman in Switzerland during the 1920s. The Swedish hospital in this study offers integrated conventional and anthroposophic health care therapies which are conceptualized as an extended and integrative variant of health care and not as CAM. In anthroposophic care, health is viewed as a matter of body, soul and spirit in balance. Therapeutic resources include nursing care, therapeutic conduct (art and body therapies) and medicines based on natural remedies. This study aims to deepen the understanding of what constitutes good care from a patient's perspective to alleviate patients' suffering and to identify clinical markers for good care. As anthroposophic care is associated with theory and holistic ideas, this study aims at exploring whether or not anthroposophic care has a beneficial effect. A qualitative method was used, and the analysis was conducted with a phenomenological hermeneutic approach. Sixteen former patients, of whom nine were diagnosed with various kinds of cancer and seven with burnout syndrome, were interviewed regarding their experience of anthroposophic care. Patients especially noted the benefits of the holistic caring environment; the empathetic approach and true caring offered, as well as the peaceful atmosphere and rest. A turning point or shift in perspectives, implying a home coming in relation to inner aspects was discussed as an outcome. Although patients in general were overwhelmingly impressed and positive they were also ambivalent. One interpretation is that there is a gap between the anthroposophic and conventional paradigm that affects patients negatively. As mutual scepticism still prevents any real integration between integrative and conventional care, the onus appears to be on the patient to take the risk and act as bridge-builder. From a caring science perspective, the study shows that appropriation of specific values and theory makes it possible to create a true caring culture. PMID:18840219

  4. Protecting Home Health Care Workers: A Challenge to Pandemic Influenza Preparedness Planning

    PubMed Central

    McPhaul, Kathleen; Phillips, Sally; Gershon, Robyn; Lipscomb, Jane

    2009-01-01

    The home health care sector is a critical element in a pandemic influenza emergency response. Roughly 85% of the 1.5 million workers delivering in-home care to 7.6 million clients are low-wage paraprofessionals, mostly women, and disproportionately members of racial and ethnic minorities. Home health care workers' ability and willingness to respond during a pandemic depends on appropriate communication, training, and adequate protections, including influenza vaccination and respiratory protection. Preparedness planning should also include support for child care and transportation and help home health care workers protect their income and access to health care. We summarize findings from a national stakeholder meeting, which highlighted the need to integrate home health care employers, workers, community advocates, and labor unions into the planning process. PMID:19461108

  5. Changing communications within hospital and home health care.

    PubMed

    Torrado-Carvajal, Angel; Rodriguez-Sanchez, Maria Cristina; Rodriguez-Moreno, Alberto; Borromeo, Susana; Garro-Gomez, Cesar; Hernandez-Tamames, Juan Antonio; Luaces, Maria

    2012-01-01

    Over the last decade, new hospitals are integrating Information and Communication Technologies (ICTs) in their facilities. Although e-health is a relatively recent term for healthcare practice supported by electronic processes, ubiquitous healthcare monitoring, also known as m-health, is already an emerging research area. Patient monitoring in diverse environments, such as nursing homes or assisted living, are gaining importance. Traditional methods present some problems, as they don't allow enough patient mobility. In this situation, real time transmission of multiple medical data, wearable computing, wireless access in ubiquitous systems and wearable devices for pervasive healthcare can meet the needs of these environments. However, the software and infrastructure deployed in hospitals is not easy to migrate to wireless systems. In some cases, the migration to new technologies can be costly. This paper focuses on the design of a modular, scalable and economical framework to improve the monitoring and checking of patients in different contexts. The challenge is to produce a system to transmit the patient's biomedical data directly to a hospital for monitoring or diagnosis using new communication modules. The modular designed adopted is intended to provide a future-proofed system, whose functionality may be upgraded by modifying the hardware or software. The modules have been validated in different contexts to prove their versatility. PMID:23367314

  6. Coaching the Multiplicity of Mind: A Strengths-based Model

    PubMed Central

    2013-01-01

    Professional health and wellness coaches are passionate about helping people learn, change, and grow. We are lifelong students of what enables humans to perform at our best. The phrase coaching the whole person is common coaching parlance; full engagement in self-care often requires that clients shift a spectrum of beliefs, motives, and perspectives in order to make changes that are sustainable. Just as important is the need for coaches to fully engage in their own self-care in order to best serve their clients. PMID:24416685

  7. Home Care and Health Reform: Changes in Home Care Utilization in One Canadian Province, 1990-2000

    ERIC Educational Resources Information Center

    Penning, Margaret J.; Brackley, Moyra E.; Allan, Diane E.

    2006-01-01

    Purpose: This study examines population-based trends in home care service utilization, alone and in conjunction with hospitalizations, during a period of health reform in Canada. It focuses on the extent to which observed trends suggest enhanced community-based care relative to three competing hypotheses: cost-cutting, medicalization, and

  8. Home Care and Health Reform: Changes in Home Care Utilization in One Canadian Province, 1990-2000

    ERIC Educational Resources Information Center

    Penning, Margaret J.; Brackley, Moyra E.; Allan, Diane E.

    2006-01-01

    Purpose: This study examines population-based trends in home care service utilization, alone and in conjunction with hospitalizations, during a period of health reform in Canada. It focuses on the extent to which observed trends suggest enhanced community-based care relative to three competing hypotheses: cost-cutting, medicalization, and…

  9. Social Networks and Health: Impact on Returning Home after Entry into Residential Care Homes.

    ERIC Educational Resources Information Center

    Bear, Mary

    1990-01-01

    Extended study of social network analysis and labeling theories into residential care homes (RCHs). Findings suggest that, when members of intense social networks decide to move elderly persons into RCHs, placement is needed and that, although likelihood of returning home from RCHs is affected by sociocultural characteristics, functional and

  10. Health Profile of Aging Family Caregivers Supporting Adults with Intellectual and Developmental Disabilities at Home

    ERIC Educational Resources Information Center

    Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar

    2009-01-01

    The health status of 206 female caregivers supporting adults with intellectual and developmental disabilities at home was investigated using objective (i.e., presence of chronic health conditions and activity limitations) and subjective (i.e., self-perceived health status) health measures compared with those of women in the general population in 2…

  11. Health Profile of Aging Family Caregivers Supporting Adults with Intellectual and Developmental Disabilities at Home

    ERIC Educational Resources Information Center

    Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar

    2009-01-01

    The health status of 206 female caregivers supporting adults with intellectual and developmental disabilities at home was investigated using objective (i.e., presence of chronic health conditions and activity limitations) and subjective (i.e., self-perceived health status) health measures compared with those of women in the general population in 2

  12. 42 CFR 413.125 - Payment for home health agency services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payment for home health agency services. 413.125 Section 413.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL...

  13. Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients.

    PubMed

    Rosati, Robert J; Russell, David; Peng, Timothy; Brickner, Carlin; Kurowski, Daniel; Christopher, Mary Ann; Sheehan, Kathleen M

    2014-06-01

    The Affordable Care Act directed Medicare to update its home health prospective payment system to reflect more recent data on costs and use of services-an exercise known as rebasing. As a result, the Centers for Medicare and Medicaid Services will reduce home health payments 3.5percent per year in the period 2014-17. To determine the impact that these reductions could have on beneficiaries using home health care, we examined the Medicare reimbursement margins and the use of services in a national sample of 96,621 episodes of care provided by twenty-six not-for-profit home health agencies in 2011. We found that patients with clinically complex conditions and social vulnerability factors, such as living alone, had substantially higher service delivery costs than other home health patients. Thus, the socially vulnerable patients with complex conditions represent less profit-lower-to-negative Medicare margins-for home health agencies. This financial disincentive could reduce such patients' access to care as Medicare payments decline. Policy makers should consider the unique characteristics of these patients and ensure their continued access to Medicare's home health services when planning rebasing and future adjustments to the prospective payment system. PMID:24889943

  14. 78 FR 41013 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... INFORMATION CONTACT: Elmer Barksdale, (410) 786-1943. SUPPLEMENTARY INFORMATION: I. Background In FR Doc. 2013... Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements, and Cost Allocation of Home Health Survey Expenses Correction AGENCY: Centers...

  15. Medicaid Program; Face-to-Face Requirements for Home Health Services; Policy Changes and Clarifications Related to Home Health. Final rule.

    PubMed

    2016-02-01

    This final rule revises the Medicaid home health service definition consistent with section 6407 of the Patient Protection and Affordable Care Act of 2010 (the Affordable Care Act) and section 504 of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to add requirements that, for home health services, physicians document, and, for certain medical equipment, physicians or certain authorized non-physician practitioners (NPP) document the occurrence of a face-to-face encounter (including through the use of telehealth) with the Medicaid eligible beneficiary within reasonable timeframes. This rule also aligns the timeframes for the face-to-face encounter with similar regulatory requirements for Medicare home health services. In addition, this rule amends the definitions of medical supplies, equipment, and appliances. We expect minimal impact with the implementation of section 6407 of the Affordable Care Act and section 504 of MACRA. We recognize that states may have budgetary implications as a result of the amended definitions of medical supplies, equipment and appliances. Specifically, this rule may expand coverage of medical supplies, equipment and appliances under the home health benefit. There will be items that had previously only been offered under certain sections of the Act that will now be covered under the home health benefit. PMID:26859898

  16. Lesson Study: Beyond Coaching

    ERIC Educational Resources Information Center

    Lewis, Catherine; Perry, Rebecca; Foster, David; Hurd, Jacqueline; Fisher, Linda

    2011-01-01

    The authors assert that lesson study--a collaborative, teacher-led approach to learning from practice--offers a deeper, broader, more sustainable method of improving teacher practice than one-on-one coaching does. In lesson study, teachers and coaches of all levels of experience can work together, each bringing his or her own professional…

  17. A Coaching Psychology Perspective

    ERIC Educational Resources Information Center

    Palmer, Stephen

    2008-01-01

    In "Psychology in its place" (2008), John Radford considers "what is or should be the "place" of Psychology in education, more particularly Higher Education". In this article, the author looks at the possible inclusion of coaching psychology within undergraduate psychology programmes. Coaching psychology as an applied area of psychology…

  18. Lesson Study: Beyond Coaching

    ERIC Educational Resources Information Center

    Lewis, Catherine; Perry, Rebecca; Foster, David; Hurd, Jacqueline; Fisher, Linda

    2011-01-01

    The authors assert that lesson study--a collaborative, teacher-led approach to learning from practice--offers a deeper, broader, more sustainable method of improving teacher practice than one-on-one coaching does. In lesson study, teachers and coaches of all levels of experience can work together, each bringing his or her own professional

  19. Soccer Coaching Methods.

    ERIC Educational Resources Information Center

    Thomson, Bill

    The basic principles and techniques of soccer are explained and illustrated with photographs and diagrams to aid teachers who are introducing soccer into the physical education curriculum. In addition, it is designed to guide youth soccer coaches who wish to improve their presentations. The book discusses: (1) coaching methods; (2) passing and

  20. The Student Success Coach

    ERIC Educational Resources Information Center

    Neuhauser, Claudia; Weber, Kendra

    2011-01-01

    An innovative position, a Student Success Coach, was created in response to a newly developed undergraduate-degree program on the recently established University of Minnesota Rochester campus. Student Success Coaches serve as the link between the academic and student affairs sides of the campus. They interact closely with students and faculty to…

  1. The medical home and integrated behavioral health: advancing the policy agenda.

    PubMed

    Ader, Jeremy; Stille, Christopher J; Keller, David; Miller, Benjamin F; Barr, Michael S; Perrin, James M

    2015-05-01

    There has been a considerable expansion of the patient-centered medical home model of primary care delivery, in an effort to reduce health care costs and to improve patient experience and population health. To attain these goals, it is essential to integrate behavioral health services into the patient-centered medical home, because behavioral health problems often first present in the primary care setting, and they significantly affect physical health. At the 2013 Patient-Centered Medical Home Research Conference, an expert workgroup convened to determine policy recommendations to promote the integration of primary care and behavioral health. In this article we present these recommendations: Build demonstration projects to test existing approaches of integration, develop interdisciplinary training programs to support members of the integrated care team, implement population-based strategies to improve behavioral health, eliminate behavioral health carve-outs and test innovative payment models, and develop population-based measures to evaluate integration. PMID:25869375

  2. Quality of Mental Health Care for Nursing Home Residents: A Literature Review

    PubMed Central

    Grabowski, David C.; Aschbrenner, Kelly A.; Rome, Vincent F.; Bartels, Stephen J.

    2010-01-01

    Because of the high proportion of nursing home residents with a mental illness other than dementia, the quality of mental health care in nursing homes is a major clinical and policy issue. The authors apply Donabedian's framework for assessing quality of care based on the triad of structure, process, and outcome-based measures in reviewing the literature on the quality of mental health care in nursing homes. Quality measures used within the literature include mental health consultations and hospitalizations, inappropriate use of medications, and mental health survey deficiencies. Factors related to the resident's welfare (nurse staffing), provider norms (locality), and financial factors (payer mix) were associated with the quality of mental health care. Although future research is necessary, the extant literature suggests that persons with mental illness are frequently admitted to nursing homes and their care is often of poor quality and related to a series of resident and facility factors. PMID:20223943

  3. Effects of Medicare Payment Reform: Evidence from the Home Health Interim and Prospective Payment Systems

    PubMed Central

    Huckfeldt, Peter J; Sood, Neeraj; Escarce, José J; Grabowski, David C; Newhouse, Joseph P

    2014-01-01

    Medicare continues to implement payment reforms that shift reimbursement from fee-for-service towards episode-based payment, affecting average and marginal payment. We contrast the effects of two reforms for home health agencies. The Home Health Interim Payment System in 1997 lowered both types of payment; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The Home Health Prospective Payment System in 2000 raised average but lowered marginal payment with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality. PMID:24395018

  4. Engaging home health care providers in a fall prevention best practice initiative.

    PubMed

    Shaw, Jay; Sidhu, Katharina; Kearney, Colleen; Keeber, Mary; McKay, Sandra

    2013-01-01

    This article reports key findings regarding the engagement of home health care providers in the implementation of a fall prevention best practice initiative. Participants were 29 home health care providers from physiotherapy, occupational therapy, and nursing. Each participant completed a self-efficacy for evidence-based practice survey, and a smaller subgroup of volunteers participated in focus groups for each discipline individually. Findings suggest home health care providers value the implementation of best practice in everyday care, but may need to be highly involved in the development of best practice initiatives and implementation strategies to foster engagement with the initiative in everyday practice. PMID:23438506

  5. Development of a quality ranking model for home health care providers.

    PubMed

    Gressel, Justin W

    2013-01-01

    This research aims to increase transparency and simplify consumer decision-making regarding the selection of a home health care provider. Currently, quality information on home health care providers is fragmented and difficult to interpret. In this study, a quality-ranking model is developed by selecting multidimensional quality indicators across multiple sources and respective weights using expert judgment. Given the weights and providers' performance on each quality indicator, a composite score is calculated that summarizes a home health care provider's overall quality level. This quality information empowers consumers to narrow their search and select the best-performing, most efficient providers. PMID:23924223

  6. Building successful student-athlete coach relationships: examining coaching practices and commitment to the coach.

    PubMed

    Rezania, Davar; Gurney, Robert

    2014-01-01

    In this study we utilized the concept of commitment to explain the impact of coaching practices on student-athlete's behaviour. We examined the impact of commitment to the coach on the coaching outcome of in-role behaviour, and the influence of coaching practices, of information sharing, training, and encouraging teamwork, on the formation of relationships. We adopted measures from the organizational behaviour literature and surveyed student-athletes at two universities in Canada. The sample included data from 165 student-athletes from two universities. Results from structural equation modeling indicate support for the effect of coaching practices on commitment to the coach. Results also support the effect of commitment to the coach on the student-athletes' role behaviour and performance. By showing that coaching practices impact commitment to the coach, and that commitment to the coach impacts student-athlete role behaviour and performance, the findings have important implications for a better understanding of the determinants of coaches' and athletes' performance. The managerial significance of this research rests in the insight provided into how coaching practices influence athlete's behaviour through commitment to the coach. This study contributes to the literature on coach-athlete relationship within universities and colleges by applying the concept of commitment to the coach. This helps diversity research approaches to understanding coach-athlete relationships and extends prior research on commitment by looking at the context of the relationship between the student-athlete and their coach. PMID:25105087

  7. Merging home and health via contemporary care delivery: program management insights on a home telehealth project.

    PubMed

    Abraham, Chon; Rosenthal, David A

    2008-01-01

    This article discusses a home telehealth program that uses innovative informatics and telemedicine technologies to meet the needs of a Veterans Affairs Medical Center. We provide background information for the program inclusive of descriptions for the decision support system, patient selection process, and selected home telehealth technologies. Lessons learned based on interview data collected from the project team highlight issues regarding implementation and management of the program. Our goal is to provide useful information to other healthcare systems considering home telehealth as a contemporary option for care delivery. PMID:18769182

  8. Home health care and burn care: an educational and economical program.

    PubMed

    Dattolo, J; Trout, S; Connolly, M L

    1996-01-01

    Changes in health care reimbursement have challenged providers of health care to work smarter instead of harder, with more efficient and effective use of resources. Patients with burn injuries remain hospitalized for dressing changes that could be completed in the home environment by health care professionals. An early discharge for a select group of patients from a resource-intensive hospital stay to a quality, cost-effective home care program was achieved. An educational program was developed to provide home care nurses the necessary knowledge and skill to care for the patient with burn injuries at home. This program combines didactic classroom lectures with a clinical orientation for home care registered nurses. The outcome for patients is a well-integrated continuity of care with a decreased length of hospital stay. PMID:8675510

  9. The Fundamentals of Literacy Coaching

    ERIC Educational Resources Information Center

    Sandvold, Amy; Baxter, Maelou

    2008-01-01

    This book contains strategies for effective literacy coaching of teachers in districts and schools. Whether it's your job to start a literacy coaching initiative or to be an effective literacy coach to your colleagues, this guide has all the steps and strategies you need: (1) Roles and responsibilities of literacy coaches; (2) Keys to building

  10. Family Support in Nursing Homes Serving Residents with a Mental Health History

    ERIC Educational Resources Information Center

    Frahm, Kathryn; Gammonley, Denise; Zhang, Ning Jackie; Paek, Seung Chun

    2010-01-01

    Using 2003 nursing home data from the Minimum Data Set (MDS) database, this study investigated the role of family support among nursing homes serving residents with a mental health history. Exploratory factor analysis was used to create and test a conceptual model of family support using indicators located within the MDS database. Families were

  11. Why Mental Health Centers Should Not Do Home-Based Family Centered Services.

    ERIC Educational Resources Information Center

    Leverington, John J.; Bryce, Marvin

    Home Based Family Centered (HBFC) services give primary responsibility for evaluation, service planning, and counseling to the direct service in-home family therapist. In the mental health center (MHC), the psychiatrist may see a child once in the office and make a diagnosis and recommendation for the child, and sometimes for the parents. Also in

  12. Project CHERISH (Children in Home Environments: Regulation To Improve Safety and Health). Final Report.

    ERIC Educational Resources Information Center

    Grubb, Paul Dallas

    In 1990, Project CHERISH (Children in Home Environments: Regulation to Increase Safety and Health) enabled the Texas Department of Human Services to implement and evaluate several innovative strategies to strengthen regulation of family day care homes. This report contains descriptions of those strategies, an evaluation of their efficacy, and

  13. Home and Health in the Third Age — Methodological Background and Descriptive Findings

    PubMed Central

    Kylén, Maya; Ekström, Henrik; Haak, Maria; Elmståhl, Sölve; Iwarsson, Susanne

    2014-01-01

    Background: The understanding of the complex relationship between the home environment, well-being and daily functioning in the third age is currently weak. The aim of this paper is to present the methodological background of the Home and Health in the Third Age Study, and describe a sample of men and women in relation to their home and health situation. Methods and Design: The study sample included 371 people aged 67–70, living in ordinary housing in the south of Sweden. Structured interviews and observations were conducted to collect data about objective and perceived aspects of home and health. Results: The majority of the participants were in good health and had few functional limitations. Women had more functional limitations and reported more symptoms than men. Environmental barriers were found in every home investigated; the most were found in the kitchen and hygiene area. Environmental barriers were more common in multi-family than in one-family dwellings. Discussion: This study will increase our knowledge on home and health dynamics among people in the third age. The results have potential to contribute to societal planning related to housing provision, home care and social services for senior citizens. PMID:25019267

  14. A Comprehensive, Multidisciplinary Approach to Providing Health Care for Children in Out-of-Home Care.

    ERIC Educational Resources Information Center

    Blatt, Steven D.; And Others

    1997-01-01

    Describes ENHANCE (Excellence in Health Care for Abused and Neglected Children) of Onondaga County, New York, a comprehensive, multidisciplinary clinic for children in out-of-home care involving pediatrics, child psychology, nursing, child development, and child welfare components. Also presents profiles of the health, mental health, and

  15. With Home Testing, Consumers Take Charge of Their Health

    MedlinePLUS

    ... noticed an increase in the number of medical tests you can use in the privacy of your own home. Advances in testing technology—and changing attitudes towards patients’ responsibility for their ...

  16. Medicare and Medicaid programs; Home Health Prospective Payment System rate update for CY 2014, home health quality reporting requirements, and cost allocation of home health survey expenses. Final rule.

    PubMed

    2013-12-01

    This final rule will update the Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, the low-utilization payment adjustment (LUPA) add-on, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective January 1, 2014. As required by the Affordable Care Act, this rule establishes rebasing adjustments, with a 4-year phase-in, to the national, standardized 60-day episode payment rates; the national per-visit rates; and the NRS conversion factor. In addition, this final rule will remove 170 diagnosis codes from assignment to diagnosis groups within the HH PPS Grouper, effective January 1, 2014. Finally, this rule will establish home health quality reporting requirements for CY 2014 payment and subsequent years and will clarify that a state Medicaid program must provide that, in certifying HHAs, the state's designated survey agency carry out certain other responsibilities that already apply to surveys of nursing facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID), including sharing in the cost of HHA surveys. For that portion of costs attributable to Medicare and Medicaid, we will assign 50 percent to Medicare and 50 percent to Medicaid, the standard method that CMS and states use in the allocation of expenses related to surveys of nursing homes. PMID:24294635

  17. Understanding Challenges in the Front Lines of Home Health Care: A Human-Systems Approach

    PubMed Central

    Beer, Jenay M.; McBride, Sara E.; Mitzner, Tracy L.; Rogers, Wendy A.

    2014-01-01

    A human-systems perspective is a fruitful approach to understanding home health care because it emphasizes major individual components of the system – persons, equipment/technology, tasks, and environments –as well as the interaction between these components. The goal of this research was to apply a human-system perspective to consider the capabilities and limitations of the persons, in relation to the demands of the tasks and equipment/technology in home health care. Identification of challenges and mismatches between the person(s) capabilities and the demands of providing care provide guidance for human factors interventions. A qualitative study was conducted with 8 home health Certified Nursing Assistants and 8 home health Registered Nurses interviewed about challenges they encounter in their jobs. A systematic categorization of the challenges the care providers reported was conducted and human factors recommendations were proposed in response, to improve home health. The challenges inform a human-systems model of home health care. PMID:24958610

  18. Health issues of older people with intellectual disability in group homes

    PubMed Central

    BOWERS, BARBARA; WEBBER, RUTH; BIGBY, CHRISTINE

    2014-01-01

    Background This paper explores how group home staff in Victoria, Australia, responded to residents with an intellectual disability (ID) as they developed age-related health conditions. Method The analysis was based on a longitudinal study that followed 17 ageing group home residents over a 3-year period. Eighty-three interviews were conducted with 30 group home staff in 17 group homes. Dimensional analysis, a variant of grounded theory, guided data collection and analysis. Results Findings revealed that the organisations all had systems in place to address health issues. However, the results also suggest an inability of staff to differentiate between significant health conditions and normal age-related changes, thus contributing to delays in care for serious medical conditions. Conclusions Lack of knowledge about normal ageing and an absence of organisational policies influence timeliness of diagnosis and treatment for people with ID. Group home staff could be more effective advocates for older residents, leading to improvements in health outcomes, if they had basic knowledge about normal ageing and symptoms of common age-related illnesses and if group home agencies provided clearer guidance to their staff. The study has implications for staff education and organisational policy development for group homes. PMID:25750581

  19. Effect of a Consumer-Directed Voucher and a Disease-Management-Health-Promotion Nurse Intervention on Home Care Use

    ERIC Educational Resources Information Center

    Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Mukamel, Dana; Eggert, Gerald M.

    2005-01-01

    Purpose: We describe the impact of two interventions, a consumer-directed voucher for in-home supportive services and a chronic disease self-management-health-promotion nurse intervention, on the probability of use of two types of home care-skilled home health care and personal assistance services-received by functionally impaired Medicare

  20. Effect of a Consumer-Directed Voucher and a Disease-Management-Health-Promotion Nurse Intervention on Home Care Use

    ERIC Educational Resources Information Center

    Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Mukamel, Dana; Eggert, Gerald M.

    2005-01-01

    Purpose: We describe the impact of two interventions, a consumer-directed voucher for in-home supportive services and a chronic disease self-management-health-promotion nurse intervention, on the probability of use of two types of home care-skilled home health care and personal assistance services-received by functionally impaired Medicare…

  1. Behavior Modification in Coaching.

    ERIC Educational Resources Information Center

    Lynch, Annette Rutt; Stillman, Stephen M.

    1979-01-01

    An example of behavior modification used in athletic coaching is presented. The case study involves a member of a women's basketball team and details the use of behavior modification for both weight reduction and skill improvement. (JMF)

  2. Variations in levels of care between nursing home patients in a public health care system

    PubMed Central

    2014-01-01

    Background Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. Methods The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. Results There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. Conclusion In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients’ own needs, but also on the needs of all the other residents. PMID:24597468

  3. 42 CFR 409.50 - Coinsurance for durable medical equipment (DME) furnished as a home health service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Coinsurance for durable medical equipment (DME) furnished as a home health service. 409.50 Section 409.50 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home...

  4. Automated Cognitive Health Assessment Using Smart Home Monitoring of Complex Tasks

    PubMed Central

    Dawadi, Prafulla N.; Cook, Diane J.; Schmitter-Edgecombe, Maureen

    2014-01-01

    One of the many services that intelligent systems can provide is the automated assessment of resident well-being. We hypothesize that the functional health of individuals, or ability of individuals to perform activities independently without assistance, can be estimated by tracking their activities using smart home technologies. In this paper, we introduce a machine learning-based method for assessing activity quality in smart homes. To validate our approach we quantify activity quality for 179 volunteer participants who performed a complex, interweaved set of activities in our smart home apartment. We observed a statistically significant correlation (r=0.79) between automated assessment of task quality and direct observation scores. Using machine learning techniques to predict the cognitive health of the participants based on task quality is accomplished with an AUC value of 0.64. We believe that this capability is an important step in understanding everyday functional health of individuals in their home environments. PMID:25530925

  5. Promoting health and home safety for children of parents with intellectual disability: a randomized controlled trial.

    PubMed

    Llewellyn, Gwynnyth; McConnell, David; Honey, Anne; Mayes, Rachel; Russo, Domenica

    2003-01-01

    The objective of this study was to evaluate the efficacy of a home-based intervention targeted to parents with intellectual disability to promote child health and home safety in the preschool years. A total of 63 parents were recruited for the study with 45 parents (40 mothers and 5 fathers) from 40 families completing the project. The research design permitted comparison between the intervention and three alternative conditions with all parents receiving the intervention in an alternating sequence over the life of the project. The intervention consisted of 10 weekly lessons carried out in the parent's home focusing on child health and home safety. The program was adapted to suit the Australian context from the UCLA Parent--Child Health and Wellness Project (Tymchuk, Groen, & Dolyniuk, 2000). Outcome measures assessed parental health and safety behaviours. Standard measures included parental health, intelligence and literacy. The intervention improved parents' ability to recognize home dangers, to identify precautions to deal with these dangers and resulted in a significant increase in the number of safety precautions parents implemented in their homes with all gains being maintained at 3 months post-intervention. Parents' health behaviours including improved understanding of health and symptoms of illness, knowledge of and skills needed to manage life-threatening emergencies, knowledge about visiting the doctor, knowing when to call, what information to provide and what questions to ask, and how to use medicines safely significantly increased. Again, all gains were maintained 3 months post-intervention. The intervention was effective regardless of parental health, literacy skills, and IQ. This form of home-based intervention promotes a healthy and safe environment which is a prerequisite to continuing parental custody. PMID:14622893

  6. Coaching for workers with chronic illness: evaluating an intervention.

    PubMed

    McGonagle, Alyssa K; Beatty, Joy E; Joffe, Rosalind

    2014-07-01

    Working with chronic illness may present challenges for individuals-for instance, managing symptoms at work, attaining accommodations, and career planning while considering health limitations. These challenges may be stressful and lead to strains. We tested a 12-week, 6-session, phone-based coaching intervention designed to help workers manage these challenges and reduce strains. Using theories of stress and resources, we proposed that coaching would help boost workers' internal resources and would lead to improved work ability perceptions, exhaustion and disengagement burnout, job self-efficacy, core self-evaluations, resilience, mental resources, and job satisfaction, and that these beneficial effects would be stable 12 weeks after coaching ended. Fifty-nine full-time workers with chronic illnesses were randomly assigned to either a coaching group or a waitlisted control group. Participants completed online surveys at enrollment, at the start of coaching, after coaching ended, and 12 weeks postcoaching. Compared with the control group, the coaching group showed significantly improved work ability perceptions, exhaustion burnout, core self-evaluations, and resilience-yet no significant improvements were found for job self-efficacy, disengagement burnout, or job satisfaction. Indirect effects of coaching on work ability, exhaustion and disengagement burnout, and job satisfaction were observed through job self-efficacy, core self-evaluations, resilience, and mental resources. Results indicated that the positive effects of coaching were stable 12 weeks after coaching ended. Results suggest that this coaching intervention was helpful in improving the personal well-being of individuals navigating challenges associated with working and managing chronic illness. PMID:24796227

  7. New Careers: The Community/Home Health Aide Trainee's Manual.

    ERIC Educational Resources Information Center

    Hicks, Florence

    Intended for trainee use, the manual is in notebook format with a curriculum corresponding to the trainers' manual (VT 007 909), a related document. Part I, Basic Health Curriculum, deals with (1) the roles of health service aides, (2) Biological Potential and Equilibrium, (3) Professionals in the Health Field, (4) Public Health Administration,…

  8. The Value of the Medical Home for Children Without Special Health Care Needs

    PubMed Central

    Bauchner, Howard; Sege, Robert D.; Cabral, Howard J.; Garg, Arvin

    2012-01-01

    Objective: Although the medical home is promoted by the American Academy of Pediatrics and the Affordable Care Act, its impact on children without special health care needs is unknown. We examined whether the medical home is associated with beneficial health care utilization and health-promoting behaviors in this population. Methods: This study was a secondary data analysis of the 2003 National Survey of Childrens Health. Data were available for 70?007 children without special health care needs. We operationalized the medical home according to the National Survey of Childrens Health design. Logistic regression for complex sample surveys was used to model each outcome with the medical home, controlling for sociodemographic characteristics. Results: Overall, 58.1% of children without special health care needs had a medical home. The medical home was significantly associated with increased preventive care visits (adjusted odds ratio [aOR]: 1.32 [95% confidence interval (CI): 1.221.43]), decreased outpatient sick visits (aOR: 0.71 [95% CI: 0.660.76), and decreased emergency department sick visits (aOR: 0.70 [95% CI: 0.650.76]). It was associated with increased odds of excellent/very good child health according to parental assessment (aOR: 1.29 [95% CI: 1.151.45) and health-promoting behaviors such as being read to daily (aOR: 1.46 [95% CI: 1.131.89]), reported helmet use (aOR: 1.18 [95% CI: 1.031.34]), and decreased screen time (aOR: 1.12 [95% CI: 1.021.22]). Conclusions: For children without special health care needs, the medical home is associated with improved health care utilization patterns, better parental assessment of child health, and increased adherence with health-promoting behaviors. These findings support the recommendations of the American Academy of Pediatrics and the Affordable Care Act to extend the medical home to all children. PMID:22184647

  9. [Challenges Associated with Involvement of Small-Scale Pharmacies in Home Health Care].

    PubMed

    Oka, Toyoka; Takeda, Namihiro; Hamana, Tomoko; Hirohara, Masayoshi; Kushida, Kazuki

    2015-11-01

    As our society is progressing towards a composition wherein a significant portion is constituted by the elderly, a comprehensive home health care system is warranted. The provision of pharmacy services is a key factor in ensuring comprehensive home health care. Our pharmacy has been involved in home health care since its inception. This report is an attempt at evaluation of future prospects through identification and analysis of current operational issues. Our pharmacy is adequately equipped to accommodate home cared patients with significant medical dependency. However, being a small-scale business with few employees, coordinating shifts to ensure 24 hours operation in addition to providing home visits when required has been challenging. These place a substantial burden on the staff pharmacists. It is highly challenging for a single small-scale pharmacy to operate as a"self-contained pharmacy"that remains independent and still adequately serves their clients. Creating a collaborative pharmaceutical service team, consisting of several complementary small-scale pharmacies, provisionally called a "regional cooperative pharmacy,"could prove to be a more realistic alternative. In the coming decade, improving the implementation of home health care through regional level cooperation is necessary. This would require the collaboration various professionals, and the involvement of municipalities and professional organizations to ensure adequate regional support services. PMID:26809404

  10. A systematic review of integrated working between care homes and health care services

    PubMed Central

    2011-01-01

    Background In the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working. Methods A systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis. Results Seventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in duration. Conclusions Despite evidence about what inhibits and facilitates integrated working there was limited evidence about what the outcomes of different approaches to integrated care between health service and care homes might be. The majority of studies only achieved integrated working at the patient level of care and the focus on health service defined problems and outcome measures did not incorporate the priorities of residents or acknowledge the skills of care home staff. There is a need for more research to understand how integrated working is achieved and to test the effect of different approaches on cost, staff satisfaction and resident outcomes. PMID:22115126

  11. Health literacy. Part 2. Practical techniques for getting your message home.

    PubMed

    Pontius, Deborah J

    2014-01-01

    Health literacy promotion techniques are important for the school nurse's tool kit. Forty-three percent of the adult population have difficulty understanding basic health information, yet written materials sent home from schools are often at a level well above the average reader. Learning and applying techniques to improve the appearance and comprehension of your written materials will help to get the school nurse's message home. This article is the second and final in a series of articles focusing on health literacy. The first article, focusing on verbal communication, was published in the September 2013 issue of NASN School Nurse. PMID:24624755

  12. Five Years of HHS Home Health Care Evaluations: Using Evaluation to Change National Policy

    ERIC Educational Resources Information Center

    Brandon, Paul R.; Smith, Nick L.; Grob, George F.

    2012-01-01

    In 1997, American Evaluation Association member George Grob, now retired from the U.S. Department of Health and Human Services (HHS) and currently President of the Center for Public Program Evaluation, made a testimony on Medicare home health care fraud and abuse before the U.S. Senate Special Committee on Aging. The occasion was to announce the…

  13. Five Years of HHS Home Health Care Evaluations: Using Evaluation to Change National Policy

    ERIC Educational Resources Information Center

    Brandon, Paul R.; Smith, Nick L.; Grob, George F.

    2012-01-01

    In 1997, American Evaluation Association member George Grob, now retired from the U.S. Department of Health and Human Services (HHS) and currently President of the Center for Public Program Evaluation, made a testimony on Medicare home health care fraud and abuse before the U.S. Senate Special Committee on Aging. The occasion was to announce the

  14. Impacting Home Health Care Services--A Community-Based Approach

    ERIC Educational Resources Information Center

    Andrews, Hans A.; And Others

    1978-01-01

    Describes a community-based alternative to institutionalization of the elderly. Calhoun County, Michigan's home health care services depend on community college resources and a growing model program training health care aides in a 150-clock-hour certificate program. Trained aides are readily absorbed into the community employment market. (TR)

  15. 77 FR 60128 - Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-02

    ... HUMAN SERVICES Health Resources and Services Administration Noncompetitive Supplements to Nursing... Nursing Assistant and Home Health Aide (NAHHA) Program grantees to develop, implement, and evaluate... Sciences Center (TTUHSC) School of Nursing, 302 Pine Street, Abilene, TX 79601, T51HP20702...

  16. Perspectives--Infant Mental Health Home Visiting Strategies: From the Parents' Points of View

    ERIC Educational Resources Information Center

    Weatherston, Deborah

    2010-01-01

    The author interviewed parents who had participated in infant mental health (IMH) home visiting programs in community mental health agencies in Detroit, Michigan, as part of a larger qualitative study exploring parents' and practitioners' perceptions of IMH practice. Parents were asked to describe what they remembered about the practitioner and

  17. School-Based Health Centers and the Patient-Centered Medical Home. Position Statement

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2010

    2010-01-01

    The patient-centered medical home (PCMH) is an innovative care delivery model designed to provide comprehensive primary care services to people of all ages by fostering partnerships between patients, families, health care providers and the community. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies that…

  18. An examination of interventions to reduce respiratory health and injury hazards in homes of low-income families

    SciTech Connect

    Dixon, Sherry L. Fowler, Cecile; Harris, Judy; Moffat, Sally; Martinez, Yolanda; Walton, Heather; Ruiz, Bernice; Jacobs, David E.

    2009-01-15

    We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting.

  19. Home environmental health risks of people with developmental disabilities living in community-based residential settings: implications for community-health nurses.

    PubMed

    Del Bene Davis, Allison

    2009-10-01

    Chronic, long-term exposure to indoor air pollutants is increasingly being recognized as a threat to health. Vulnerable populations, such as those with cognitive disabilities, the elderly, and children, are frequently at increased risk from these hazards. This study assessed home environmental health hazards, home characteristics, and household practices that create risk in a sample of community-based group homes. A survey and a home environmental assessment of each home were used to assess the presence of neurotoxicants, such as lead, mercury, and pesticides, in the home and use of protective measures such as carbon monoxide detectors and radon testing. PMID:19866386

  20. Determinants of the use of specialist mental health services by nursing home residents.

    PubMed Central

    Shea, D G; Streit, A; Smyer, M A

    1994-01-01

    OBJECTIVE. This study examines the effects of resident and facility characteristics on the probability of nursing home residents receiving treatment by mental health professionals. DATA SOURCES/STUDY SETTING. The study uses data from the Institutional Population Component of the 1987 National Medical Expenditure Survey, a secondary data source containing data on 3,350 nursing home residents living in 810 nursing homes as of January 1, 1987. STUDY DESIGN. Andersen's health services use model (1968) is used to estimate a multivariate logistic equation for the effects of independent variables on the probability that a resident has received services from mental health professionals. Important variables include resident race, sex, and age; presence of several behaviors and reported mental illnesses; and facility ownership, facility size, and facility certification. DATA COLLECTION/EXTRACTION METHODS. Data on 188 residents were excluded from the sample because information was missing on several important variables. For some additional variables residents who had missing information were coded as negative responses. This left 3,162 observations for analysis in the logistic regressions. PRINCIPAL FINDINGS. Older residents and residents with more ADL limitations are much less likely than other residents to have received treatment from a mental health professional. Residents with reported depression, schizophrenia, or psychoses, and residents who are agitated or hallucinating are more likely to have received treatment. Residents in government nursing homes, homes run by chains, and homes with low levels of certification are less likely to have received treatment. CONCLUSIONS. Few residents receive treatment from mental health professionals despite need. Older, physically disabled residents need special attention. Care in certain types of facilities requires further study. New regulations mandating treatment for mentally ill residents will demand increased attention from nursing home administrators and mental health professionals. PMID:8005788

  1. A remote data access architecture for home-monitoring health-care applications.

    PubMed

    Lin, Chao-Hung; Young, Shuenn-Tsong; Kuo, Te-Son

    2007-03-01

    With the aging of the population and the increasing patient preference for receiving care in their own homes, remote home care is one of the fastest growing areas of health care in Taiwan and many other countries. Many remote home-monitoring applications have been developed and implemented to enable both formal and informal caregivers to have remote access to patient data so that they can respond instantly to any abnormalities of in-home patients. The aim of this technology is to give both patients and relatives better control of the health care, reduce the burden on informal caregivers and reduce visits to hospitals and thus result in a better quality of life for both the patient and his/her family. To facilitate their widespread adoption, remote home-monitoring systems take advantage of the low-cost features and popularity of the Internet and PCs, but are inherently exposed to several security risks, such as virus and denial-of-service (DoS) attacks. These security threats exist as long as the in-home PC is directly accessible by remote-monitoring users over the Internet. The purpose of the study reported in this paper was to improve the security of such systems, with the proposed architecture aimed at increasing the system availability and confidentiality of patient information. A broker server is introduced between the remote-monitoring devices and the in-home PCs. This topology removes direct access to the in-home PC, and a firewall can be configured to deny all inbound connections while the remote home-monitoring application is operating. This architecture helps to transfer the security risks from the in-home PC to the managed broker server, on which more advanced security measures can be implemented. The pros and cons of this novel architecture design are also discussed and summarized. PMID:16621655

  2. Mental health crisis at home: service user perspectives on what helps and what hinders.

    PubMed

    Hopkins, C; Niemiec, S

    2007-05-01

    This paper presents data which emerged during the process of a participatory research study to identify the perspectives of previous users of a home treatment service. Feedback was sought in order to establish the criteria for the development of a service evaluation questionnaire. Seven themes emerged from the data which were then used as a framework for the evaluation questionnaire. These themes have also been used within this paper to present what our participants told us was important to them when they received a service at home at a time of mental health crisis. Although what is described here is the experience of one group of service users in the North of England, we hope that the views of these participants will create a resonance with providers of other home treatment services and expand the knowledge about which aspects of care at home during mental health crisis are viewed as helpful and those aspects which are not. PMID:17430455

  3. Coaching Considerations: FAQs Useful in the Development of Literacy Coaching

    ERIC Educational Resources Information Center

    Fisher, Douglas

    2012-01-01

    The National Advisory Board for the Literacy Coaching Clearinghouse have identified a number of considerations that it believed needed further discussion as schools, districts, and states embrace literacy coaching. It negotiated and discussed a number of issues surrounding coaching and agreed on 10 key ideas that should be part of the discussions

  4. Designing Smart Health Care Technology into the Home of the Future

    SciTech Connect

    Craft, R.L.; Warren, S.

    1999-04-20

    This editorial paper presents a vision for intelligent health care in the home of the future, focusing on technologies with the highest potential payoff given targeted government funding over the next ten years. A secure, plug-and-play information framework provides the starting point for identifying technologies that must be developed before home-based devices can know their context and assimilate information to support care decisions.

  5. Environmental Health and Safety Hazards Experienced by Home Health Care Providers: A Room-by-Room Analysis.

    PubMed

    Polivka, Barbara J; Wills, Celia E; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

    2015-11-01

    The number of personnel providing in-home health care services is increasing substantially. The unique configuration of environmental hazards in individual client homes has a significant impact on the safety and health of home health care providers (HHPs). This mixed-methods study used data from a standardized questionnaire, focus groups, and individual interviews to explore environmental health and safety hazards encountered by HHPs in client homes. The participant sample (N = 68) included nurses, aides, therapists, and owners/managers from a variety of geographic locations. The most often-reported hazards were trip/slip/lift hazards, biohazards, and hazards from poor air quality, allergens, pests and rodents, and fire and burns. Frequency of identified key hazards varied by room, that is, kitchen (e.g., throw rugs, water on floor), bathroom (e.g., tight spaces for client handling), bedroom (e.g., bed too low), living room (e.g., animal waste), and hallway (e.g., clutter). Findings indicate the need for broader training to enable HHPs to identify and address hazards they encounter in client homes. PMID:26268486

  6. Healthful Eating and Physical Activity in the Home Environment: Results from Multi-Family Focus Groups

    PubMed Central

    Berge, Jerica M.; Arikian, Aimee; Doherty, William J.; Neumark-Sztainer, Dianne

    2012-01-01

    Objective To explore multiple family members perceptions of risk and protective factors for healthy eating and physical activity in the home. Design Ten multi-family focus groups were conducted with 26 families. Setting Community setting. Participants Primarily Black and White families. Family members (n = 103) were between the ages of 861 years. Analysis A grounded hermeneutic approach. Phenomenon of Interest Risk and protective factors for healthy eating and physical activity in the home environment. Results Ten major themes were identified by family members related to health behaviors in the home environment, including: (a) accessibility to healthy foods and activity, (b) time constraints, (c) stage of youth development, (d) individual investment in health behaviors, (e) family investment in health behaviors, (f) family meals and shared activities, (g) parent modeling, (h) making health behaviors fun, (i) making health behaviors part of the family lifestyle, and (j) community investment in family health behaviors. Conclusions and Implications This study identified the importance of the family system and the reciprocal influences within the home environment on health behaviors. In addition, individual and community-level suggestions were identified. Insights from the families provide leads for future research and ideas for the prevention of youth obesity. PMID:22192951

  7. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE... Religious Nonmedical Health Care Institutions-Benefits, Conditions of Participation, and Payment § 403.764 Basis and purpose of religious nonmedical health care institutions providing home service. (a)...

  8. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE... Religious Nonmedical Health Care Institutions-Benefits, Conditions of Participation, and Payment § 403.764 Basis and purpose of religious nonmedical health care institutions providing home service. (a)...

  9. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE... Religious Nonmedical Health Care Institutions-Benefits, Conditions of Participation, and Payment § 403.764 Basis and purpose of religious nonmedical health care institutions providing home service. (a)...

  10. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE... Religious Nonmedical Health Care Institutions-Benefits, Conditions of Participation, and Payment § 403.764 Basis and purpose of religious nonmedical health care institutions providing home service. (a)...

  11. Team-level flexibility, workhome spillover, and health behavior

    PubMed Central

    Moen, Phyllis; Fan, Wen; Kelly, Erin L.

    2013-01-01

    Drawing on two waves of survey data conducted six months apart in 2006, this study examined the impacts of a team-level flexibility initiative (ROWE Results Only Work Environment) on changes in the work-home spillover and health behavior of employees at the Midwest headquarters of a large US corporation. Using cluster analysis, we identified three distinct baseline spillover constellations: employees with high negative spillover, high positive spillover, and low overall spillover. Within-team spillover measures were highly intercorrelated, suggesting that work teams as well as individuals have identifiable patterns of spillover. Multilevel analyses showed ROWE reduced individual- and team-level negative work-home spillover but not positive work-home spillover or spillover from home-to-work. ROWE also promoted employees health behaviors: increasing the odds of quitting smoking, decreasing smoking frequency, and promoting perceptions of adequate time for healthy meals. Trends suggest that ROWE also decreased the odds of excessive drinking and improved sleep adequacy and exercise frequency. Some health behavior effects were mediated via reduced individual-level negative work-home spillover (exercise frequency, adequate time for sleep) and reduced team-level negative work-home spillover (smoking frequency, exercise frequency, and adequate time for sleep). While we found no moderating effects of gender, ROWE especially improved the exercise frequency of singles and reduced the smoking frequency of employees with low overall spillover at baseline. PMID:23517706

  12. Home care assistants’ perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity

    PubMed Central

    Grundberg, Åke; Hansson, Anna; Religa, Dorota; Hillerås, Pernilla

    2016-01-01

    Introduction Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs). Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status. Aim To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity. Methods We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs. Results Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of loneliness, and increasing physical activity. The results indicate that the HCAs seemed dependent on supervision by district nurses and on care managers’ decisions to support the needed care, to schedule assignments related to the detection of mental health problems, and to promote mental health. PMID:26966371

  13. [EurSafety Health-Net: MRSA Eradication in Nursing Homes and Home Care - A Practice Report].

    PubMed

    Bergen, P; Rocker, D; Clauen, K; Kluba, J; Vogelsang, E; Vogelsang, G

    2016-01-01

    In 2009 the project EurSafety Health-Net, funded by Interreg IVa, was initiated in order to create a cross-border quality alliance to enhance patient safety in the field of infectious diseases. Within this framework, several studies and projects addressing key topics of infection control were carried out. We describe the two-year project "MRSA decolonisation in care settings (MSP)", which aimed at evaluating a simple and economic way of decolonisation of non-hospitalised MRSA carriers in 2 districts in Lower Saxony. In the course of the project 181 decolonisations of MRSA carriers were performed by nursing homes and nursing services for outpatients in cooperation with the local public health authorities of the districts Ammerland and Grafschaft Bentheim. Of 181 cases 134 were eligible for statistical analysis. The project provided protocols for 2 different starting situations: 1) Continuing and completing a decolonisation treatment subsequent to a hospital stay by nursing services for outpatients or in a nursing home. 2) Starting a decolonisation treatment in a nursing home or by nursing services for outpatients. The carriers were provided with the required materials either by the hospitals (situation 1) or by the local public health authorities (situation 2) free of charge. The decolonisation treatment and the testing were offered only to carriers free of properties deemed as decolonisation obstacles and was applied without involvement of the general practitioner. Short- and long-term success of the 5 day decolonisation treatment was tested afterwards by two swabs (14 days and 6 months after the end of the treatment). The results of the 6-month control swabs showed that 45% of the carriers were successfully decolonised in the long term. All parties involved regarded the procedure of the MSP project as effective with respect to the target. Thus, even after the project was finished, both districts continued applying the MSP protocol. PMID:25951112

  14. Pre-Exercise Screening and Health Coaching in CHD Secondary Prevention: A Qualitative Study of the Patient Experience

    ERIC Educational Resources Information Center

    Shaw, R.; Gillies, M.; Barber, J.; MacIntyre, K.; Harkins, C.; Findlay, I. N.; McCloy, K.; Gillie, A.; Scoular, A.; MacIntyre, P. D.

    2012-01-01

    Secondary prevention programmes can be effective in reducing morbidity and mortality from coronary heart disease (CHD). In particular, UK guidelines, including those from the Department of Health, emphasize physical activity. However, the effects of secondary prevention programmes with an exercise component are moderate and uptake is highly

  15. Coaching for Tests. ERIC Digest.

    ERIC Educational Resources Information Center

    Wildemuth, Barbara

    The term "coaching" applies to a variety of types of test preparation programs which vary in length, instructional method, and content. Most research on the effectiveness of coaching has examined the Scholastic Aptitude Test (SAT), a measure of academic abilities used to predict college performance. This ERIC Digest reviews studies of coaching for…

  16. Gender and the Coaching Profession.

    ERIC Educational Resources Information Center

    Knoppers, Annelies

    1987-01-01

    This article investigates male domination of coaching using a model which assumes that the structure of the workplace shapes the worker. The effects of three structural determinants on the number of females who enter and leave coaching are explored. Suggestions to improve the workplace for women coaches are made. (Author/MT)

  17. The Principal as Formative Coach

    ERIC Educational Resources Information Center

    Nidus, Gabrielle; Sadder, Maya

    2011-01-01

    Formative coaching, an approach that uses student work as the foundation for mentoring and professional development, can help principals become more effective instructional leaders. In formative coaching, teaches and coaches analyze student work to determine next steps for instruction. This article shows how a principal can use the steps of the

  18. Should Interscholastic Coaches Be Certified?

    ERIC Educational Resources Information Center

    Kelley, E. James; Brightwell, Shelby

    1984-01-01

    Studies indicate that many athletic coaches do not possess adequate knowledge of training and conditioning programs or treatment of athletic injuries. A shortage of qualified teachers able to coach allows for employment of underqualified individuals. Certification of professionals to coach interscholastic sports is suggested. (DF)

  19. Handbook for Youth Sports Coaches.

    ERIC Educational Resources Information Center

    Seefeldt, Vern, Ed.

    This handbook was generated by a survey of the specific needs of the coaching community serving young children as athletic coaches. The survey revealed a need for information that addresses the needs of beginning level volunteer coaches. The first section discusses the benefits of competitive sports for children and youth and the role of the youth

  20. The Power of Virtual Coaching

    ERIC Educational Resources Information Center

    Rock, Marcia L.; Zigmond, Naomi P.; Gregg, Madeleine; Gable, Robert A.

    2011-01-01

    Amid budget cuts in U.S. public schools, the spotlight is on how to make less effective teachers more effective--fast. The authors describe virtual coaching--in which a coach interacts electronically with a teacher as a lesson unfolds--as a promising way to help teachers with weak teaching skills. Virtual coaching uses online and mobile technology

  1. Designing Smart Health Care Technology into the Home of the Future

    SciTech Connect

    Warren, S.; Craft, R.L.; Bosma, J.T.

    1999-04-07

    The US health care industry is experiencing a substantial paradigm shift with regard to home care due to the convergence of several technology areas. Increasingly-capable telehealth systems and the internet are not only moving the point of care closer to the patient, but the patient can now assume a more active role in his or her own care. These technologies, coupled with (1) the migration of the health care industry to electronic patient records and (2) the emergence of a growing number of enabling health care technologies (e.g., novel biosensors, wearable devices, and intelligent software agents), demonstrate unprecedented potential for delivering highly automated, intelligent health care in the home. This editorial paper presents a vision for the implementation of intelligent health care technology in the home of the future, focusing on areas of research that have the highest potential payoff given targeted government funding over the next ten years. Here, intelligent health care technology means smart devices and systems that are aware of their context and can therefore assimilate information to support care decisions. A systems perspective is used to describe a framework under which devices can interact with one another in a plug-and-play manner. Within this infrastructure, traditionally passive sensors and devices will have read/write access to appropriate portions of an individual's electronic medical record. Through intelligent software agents, plug-and-play mechanisms, messaging standards, and user authentication tools, these smart home-based medical devices will be aware of their own capabilities, their relationship to the other devices in the home system, and the identity of the individual(s) from whom they acquire data. Information surety technology will be essential to maintain the confidentiality of patient-identifiable medical information and to protect the integrity of geographically dispersed electronic medical records with which each home-based system will interact.

  2. Do youth hockey coaches allow players with a known concussion to participate in a game?

    PubMed

    Bramley, Harry; Kroft, Christopher; Polk, David; Newberry, Ty; Silvis, Matthew

    2012-03-01

    Ice hockey is a high-risk sport for concussion. It is important that coaches have an understanding of concussion, although previous studies have demonstrated poor knowledge of concussion recognition and management by youth coaches. A cross-sectional survey with 7 case scenarios was completed by 314 youth hockey coaches. Each case scenario described a player with a concussion during a game, and scores reflected how the coach would respond to each scenario. Although most coaches would not allow a player to continue participating in a game after suffering a concussion, there was a small percentage that would. Statistical analysis found an inverse relationship between the coaches' age and consideration of continued participation. This places athletes at significant risk for further injury and is not consistent with current concussion guidelines. USA Hockey should provide additional concussion training for their coaches as well as mandatory health care clearance following a concussion. PMID:21937746

  3. Medicare program; home health prospective payment system rate update for calendar year 2011; changes in certification requirements for home health agencies and hospices. Final rule.

    PubMed

    2010-11-17

    This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the "skilled services" section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care. PMID:21090146

  4. Understanding inequities in home health care outcomes: staff views on agency and system factors.

    PubMed

    Davitt, Joan K; Bourjolly, Joretha; Frasso, Rosemary

    2015-01-01

    Results regarding staff perspectives on contributing factors to racial/ethnic disparities in home health care outcomes are discussed. Focus group interviews were conducted with home health care staff (N = 23) who represented various agencies from three Northeastern states. Participants identified agency and system factors that contribute to disparities, including: (a) administrative staff bias/discretion, (b) communication challenges, (c) patient/staff cultural discordance, (d) cost control, and (e) poor access to community resources. Participants reported that bias can influence staff at all levels and is expressed via poor coverage of predominantly minority service areas, resulting in reduced intensity and continuity of service for minority patients. PMID:25706958

  5. Insights in public health: the Hawai'i Home Visiting Network: evidence-based home visiting services in Hawai'i.

    PubMed

    Yoshimoto, D Kaulana; Robertson, N Tod; Hayes, Donald K

    2014-05-01

    Home visiting services are cost-effective and improve the health of children and families among those at increased risk. From 1985-2008, home visiting services in Hawai'i were provided primarily through state funding of the Hawai'i Healthy Start Program, but the program was severely reduced due to the economy and state budget changes over the past decade. The Maternal and Child Health Branch (MCHB) in the Family Health Services Division responded to these changes by seeking out competitive grant opportunities and collaborations in order to continue to promote home visiting services to those children and families in need. In 2010, the MCHB was awarded a federally funded Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for home visiting services to promote maternal, infant, and early childhood health, safety and development, strong parent-child relationships, and responsible parenting. In 2011, the MCHB was also awarded a competitive MIECHV development grant that funded the re-establishment of the hospital Early Identification program. Families in need of additional support identified through this program are referred for family strengthening services to a network of existing home visiting programs called the Hawai'i Home Visiting Network (HHVN). The HHVN is supported by MIECHV and a small amount of state funds to assist programs with capacity building, training, professional development, quality assurance, and accreditation/certification support. The MIECHV grant requires that programs are evidence-based and address specific outcome measures and benchmarks. The HHVN provides home visiting services to families prenatally through 5 years of age that reside in specific at-risk communities, and is aimed at fostering positive parenting and reducing child maltreatment using a strength-based approach by targeting six protective factors: (1) social connections, (2) nurturing and attachment, (3) knowledge of parenting and child development, (4) parental resilience, (5) social and emotional competence of children, and (6) concrete supports for parents. This article provides an introduction to the HHVN as a diverse network of evidence-based home visiting programs with services currently available on all islands, and highlights aspects of home visiting programs that support the Family-Centered Medical Home (FCMH) model. The HHVN provides important services to families at risk and uses evidence-based practices to yield positive results. Health care professionals can support this network to promote the health of children and families by being aware that these home visiting services exist and encouraging families at-risk to participate. Continued collaboration and expanded partnerships with health providers can help strengthen the home visiting network and improve outcomes for children and families in Hawai'i. PMID:24843840

  6. Assessment of Airborne Exposures and Health in Flooded Homes Undergoing Renovation

    PubMed Central

    Hoppe, Kimberly A.; Metwali, Nervana; Perry, Sarah Spencer; Hart, Tom; Kostle, Pamela A.; Thorne, Peter S.

    2012-01-01

    In June 2008, the Cedar River crested flooding more than 5,000 Cedar Rapids homes. Residents whose homes were flooded were invited to participate in this study. Household assessments and resident interviews were conducted between November 2008 and April 2009. We characterized exposures and symptoms experienced by individuals inhabiting 73 flood-damaged homes. Active air sampling and passive electrostatic dust collectors were used to assess exposures to: culturable mold, culturable bacteria, fungal spores, inhalable particulate matter (iPM), endotoxin, glucans, allergens, lead, asbestos, radon, carbon dioxide, and carbon monoxide. Wall moisture levels and relative humidity were also measured. Exposures and questionnaire-based health assessments were compared at two levels of remediation, in-progress and completed. Homes with remediation in-progress (n=24), as compared to the completed homes (n=49), had significantly higher airborne concentrations of mold, bacteria, iPM, endotoxin and glucan. Residents of in-progress homes had a significantly higher prevalence of doctor diagnosed allergies (adjusted OR=3.08; 95%CI: 1.05–9.02) and all residents had elevated prevalence of self-reported wheeze (adjusted OR=3.77; 95%CI: 2.06–6.92) and prescription medication use for breathing problems (adjusted OR=1.38; 95%CI: 1.01–1.88) after the flood as compared to before. Proper post-flood remediation led to improved air quality and lower exposures among residents living in flooded homes. PMID:22519834

  7. Medication Discrepancies and Associated Risk Factors Identified in Home Health patients.

    PubMed

    Hale, Jennifer; Neal, Erin B; Myers, Amy; Wright, Kelly H S; Triplett, Julia; Brown, Laura Beth; Kripalani, Sunil; Mixon, Amanda S

    2015-10-01

    Medication discrepancies can place patients at increased risk for adverse drug events. We sought to determine the frequency, type, and reason for medication discrepancies in patients receiving home healthcare following hospital discharge. We conducted a retrospective, observational study of adults discharged from an academic medical center who received home healthcare following hospital discharge from one affiliated home healthcare agency. Medication discrepancies were identified by comparing the hospital discharge medication list to what the patient was taking at the first home healthcare visit. Almost all patients (66/70, 94%) had at least one medication discrepancy. The median number of discrepancies per patient was 5. Nearly half of the discrepancies were omissions (46%), in which the patient was not taking a medication on the discharge medication list. Increased age was significantly associated with fewer medication discrepancies overall (IRR = 0.99, p < 0.05). Higher health literacy was associated with more omissions (IRR = 1.85, p < 0.05). PMID:26418109

  8. Effectiveness of home visits by mental health nurses for Japanese women with post-partum depression.

    PubMed

    Tamaki, Atsuko

    2008-12-01

    Post-partum depression affects 10-13% of Japanese women, but many do not receive appropriate treatment or support. This intervention study evaluated the effectiveness of home visits by mental health nurses for Japanese women with post-partum depression. Eighteen post-partum women met the inclusion criteria and were randomly allocated into the intervention (n = 9) or control (n = 9) group at 1-2 months after giving birth. The intervention group received four weekly home visits by a mental health nurse. Control group participants received usual care. Two women in the intervention group did not complete the study. Depressive symptoms and quality of life were measured at 1 and 6 weeks' postintervention. In addition, participants completed an open-ended questionnaire on satisfaction and meaning derived from the home visits. Women in the intervention group had significant amelioration of depressive symptoms over time and reported positive benefits from the home visits, but there were no statistically significant differences between groups. Significant differences (P < 0.05) were observed at times 2 and 3 between groups in terms of increased median scores of physical, environmental, and global subscales, and the total average score of the World Health Organization/quality of life assessment instrument. On the psychological subscale, significant differences (P = 0.042) were observed between groups at time 2. The qualitative analysis of comments about home visitation revealed four categories related to 'setting their mind at ease', 'clarifying thoughts', 'improving coping abilities', and 'removing feelings of withdrawal from others'. These results suggest that home visits by mental health nurses can contribute to positive mental health and social changes for women with post-partum depression. A larger trial is warranted to test this approach to care. PMID:19128289

  9. Multimodal Intervention to Improve Osteoporosis Care in Home Health Settings: Results from a Cluster Randomized Trial

    PubMed Central

    Kilgore, Meredith L.; Outman, Ryan; Locher, Julie L.; Allison, Jeroan J.; Mudano, Amy; Kitchin, Beth; Saag, Kenneth G.; Curtis, Jeffrey R.

    2014-01-01

    Purpose To test an evidence-implementation intervention to improve the quality of care in the home health care setting for patients at high risk for fractures. Methods We conducted a cluster randomized trial of a multimodal intervention targeted at home care for high-risk patients (prior fracture or physician-diagnosed osteoporosis) receiving care in a statewide home health agency in Alabama. Offices throughout the state were randomized to receive the intervention or to usual care. The primary outcome was the proportion of high-risk home health patients treated with osteoporosis medications. A t-test of difference in proportions was conducted between intervention and control arms and constituted the primary analysis. Secondary analyses included logistic regression estimating the effect of individual patients being treated in an intervention arm office on the likelihood of a patient receiving osteoporosis medications. A follow-on analysis examined the effect of an automated alert built into the electronic medical record that prompted the home health care nurses to deploy the intervention for high risk patients using a pre-post design. Results Among the offices in the intervention arm the average proportion of eligible patients receiving osteoporosis medications post-intervention was 19.1%, compared with 15.7% in the usual care arm (difference in proportions 3.4%, 95% CI: ?2.6 ?9.5%). The overall rates of osteoporosis medication use increased from 14.8% prior to activation of the automated alert to 17.6% afterward, a non-significant difference. Conclusions The home health intervention did not result in a significant improvement in use of osteoporosis medications in high risk patients. PMID:23536256

  10. Patterns and Predictors of Home Health and Hospice Use by Older Adults with Cancer

    PubMed Central

    Locher, Julie L.; Kilgore, Meredith L.; Morrisey, Michael A.; Ritchie, Christine S.

    2009-01-01

    OBJECTIVES To describe patterns of home health and hospice use by older cancer patients and a comparison group of older persons without cancer. To identify predictors of home care and hospice utilization. DESIGN Retrospective analysis using the Surveillance, Epidemiology and End Results (SEER)-Medicare Database, a linkage of the SEER Program of the National Cancer Institute (an epidemiological surveillance system of population-based tumor registries) and Medicare Claims. SETTING The SEER data used in this paper cover a service area that includes approximately 14% of the U.S. population, including the states of Connecticut, Hawaii, Iowa, and New Mexico and the metropolitan areas of Detroit, San FranciscoOakland, Atlanta, SeattlePuget Sound, Los Angeles County, and San JoseMonterey. PARTICIPANTS Five analytical samples were drawn. The first consisted of all cases with a diagnosis of cancer in 1997 to 1999 who were eligible for services in calendar year 1999 (n = 120,072). The second and third were subsamples of these and consisted of cases with a new cancer diagnosis in 1999 (n = 46,373) and cases who died in 1999 (n = 41,483). The fourth consisted of a comparison sample without cancer (n = 160,707). The fifth was a subsample of this and consisted of those who died in 1999 (n = 6,639). MEASUREMENTS Utilization rates of home health and hospice services. RESULTS Twenty-nine percent of cancer patients used home health services, and 10.7% used hospice services, compared with 7.8% of noncancer patients who used home health and less than 1% who used hospice. Half (51.4%) of cancer patients who used home health did not have cancer listed as an admitting diagnosis for the use of those services. Home health utilization was lowest for unmarried men. CONCLUSION This is the first study to evaluate community-based home health and hospice utilization by older cancer patients. Future studies must begin to address what constitutes appropriate utilization. PMID:16913986

  11. Scalable ECG Compression for Long-Term Home Health Care.

    PubMed

    Zhang, Tong; Simske, Steven; Blakley, Daniel

    2005-01-01

    Most current Holter devices monitor the ECG for 24 to 72 hours. However, for the accurate diagnosis of many cardiac diseases, especially for the wide variety of asymptomatic cases, continuous ECG monitoring for weeks or even months may be required. In this paper, we focus on the issue of ECG compression during long-term monitoring of the patient. The patient may be at home, at work, or even on a trip. A scalable compression scheme is proposed which ensures optimal signal quality given the limited physical storage on the wearable device. When necessary, the signal quality is progressively and gently degraded in order to adapt to environmental and the patient's conditions. Details of the proposed scheme are described and sample results are presented. PMID:17282196

  12. Effect of Weatherization Combined With Community Health Worker In-Home Education on Asthma Control

    PubMed Central

    Dixon, Sherry; Gregory, Joel; Philby, Miriam; Jacobs, David E.; Krieger, James

    2014-01-01

    Objectives. We assessed the benefits of adding weatherization-plus-health interventions to an in-home, community health worker (CHW) education program on asthma control. Methods. We used a quasi-experimental design to compare study group homes (n?=?34) receiving CHW education and weatherization-plus-health structural interventions with historical comparison group homes (n?=?68) receiving only education. Data were collected in King County, Washington, from October 2009 to September 2010. Results. Over the 1-year study period, the percentage of study group children with not-well-controlled or very poorly controlled asthma decreased more than the comparison group percentage (100% to 28.8% vs 100% to 51.6%; P?=?.04). Study group caregiver quality-of-life improvements exceeded comparison group improvements (P?=?.002) by 0.7 units, a clinically important difference. The decrease in study home asthma triggers (evidence of mold, water damage, pests, smoking) was marginally greater than the comparison group decrease (P?=?.089). Except for mouse allergen, the percentage of study group allergen floor dust samples at or above the detection limit decreased, although most reductions were not statistically significant. Conclusions. Combining weatherization and healthy home interventions (e.g., improved ventilation, moisture and mold reduction, carpet replacement, and plumbing repairs) with CHW asthma education significantly improves childhood asthma control. PMID:24228661

  13. Coaching the Vegetarian Athlete

    ERIC Educational Resources Information Center

    Mandali, Swarna L.

    2011-01-01

    Good nutrition is important for optimal athletic performance. Adolescent athletes often depend on their coaches for nutritional information on weight management, dietary supplements, and dietary practices. Some dietary practices, such as vegetarianism, have the potential to be harmful to the adolescent athlete if not followed with careful…

  14. Coaching preferences of athletes.

    PubMed

    Terry, P C; Howe, B L

    1984-12-01

    The study examined the coaching preferences of 80 male and 80 female athletes, as measured by the Leadership Scale for Sports (Chelladurai and Saleh, 1978, 1980). In addition, it attempted to assess the applicability to sport of the Life-cycle and Path-goal theories of leadership. Comparisons between groups were made on the basis of sex, age, and type of sport. A MANOVA indicated that athletes in independent sports preferred more democratic behaviour (p less than .001) and less autocratic behaviour (p = .028) than athletes in interdependent sports. No differences in coaching preferences were found which could be attributed to the age or sex of the athlete, or the variability of the sports task. These results partially supported the Path-goal theory, but did not support the Life-cycle theory. Athletes of all groups tended to favour coaches who displayed training behaviour and rewarding behaviour "often", democratic behaviour and social support behaviour "occasionally", and autocratic behaviour "seldom". This consistency may be a useful finding for those organizations and institutions interested in preparing coaches. PMID:6525751

  15. Coaching Adolescent Athletes

    ERIC Educational Resources Information Center

    VonMeter, Kerby

    2004-01-01

    Coaching adolescent athletes can be challenging because of their varying degrees of physical, emotional, and social development and/or maturity. How much and how well each athlete develops tactically, psychologically, emotionally, and physically is directly influenced by these factors. This article discusses that the main reasons athletes…

  16. Coaching the "Critters."

    ERIC Educational Resources Information Center

    Colvert, Audra L.

    The purpose of this paper is to create a guide for beginning coaches of the "communication analysis" event in forensics and to attempt to arouse interest in the activity. According to the paper, the American Forensic Association defines communication analysis as an original speech designed to offer an explanation and/or evaluation of a

  17. Tenure and the Coach.

    ERIC Educational Resources Information Center

    Scott, Phebe M.

    The question of whether a coach should be eligible to obtain tenure is receiving considerable attention throughout the educational community. For many years one of the strongest arguments for the inclusion of athletics in the academic world has been that athletics was an integral part of the physical education instructional program. When education…

  18. Coaching the Vegetarian Athlete

    ERIC Educational Resources Information Center

    Mandali, Swarna L.

    2011-01-01

    Good nutrition is important for optimal athletic performance. Adolescent athletes often depend on their coaches for nutritional information on weight management, dietary supplements, and dietary practices. Some dietary practices, such as vegetarianism, have the potential to be harmful to the adolescent athlete if not followed with careful

  19. Health ITEnabled Care Coordination: A National Survey of Patient-Centered Medical Home Clinicians

    PubMed Central

    Morton, Suzanne; Shih, Sarah C.; Winther, Chloe H.; Tinoco, Aldo; Kessler, Rodger S.; Scholle, Sarah Hudson

    2015-01-01

    PURPOSE Health information technology (IT) offers promising tools for improving care coordination. We assessed the feasibility and acceptability of 6 proposed care coordination objectives for stage 3 of the Centers for Medicare and Medicaid Services electronic health record incentive program (Meaningful Use) related to referrals, notification of care from other facilities, patient clinical summaries, and patient dashboards. METHODS We surveyed physician-owned and hospital/health systemaffiliated primary care practices that achieved patient-centered medical home recognition and participated in the Meaningful Use program, and community health clinics with patient-centered medical home recognition (most with certified electronic health record systems). The response rate was 35.1%. We ascertained whether practices had implemented proposed objectives and perceptions of their importance. We analyzed the association of organizational and contextual factors with self-reported use of health IT to support care coordination activities. RESULTS Although 78% of the 350 respondents viewed timely notification of hospital discharges as very important, only 48.7% used health IT systems to accomplish this task. The activity most frequently supported by health IT was providing clinical summaries to patients, in 76.6% of practices; however, merely 47.7% considered this activity very important. Greater use of health IT to support care coordination activities was positively associated with the presence of a nonclinician responsible for care coordination and the practices capacity for systematic change. CONCLUSIONS Even among practices having a strong commitment to the medical home model, the use of health IT to support care coordination objectives is not consistent. Health IT capabilities are not currently aligned with clinicians priorities. Many practices will need financial and technical assistance for health IT to enhance care coordination. PMID:25964403

  20. Professional Nurse Coaching: Advances in National and Global Healthcare transformation

    PubMed Central

    Hess, Darlene

    2013-01-01

    Nurse coaches are responding to the mandate of Florence Nightingale (1820-1910)—the foundational philosopher of modern nursing—to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities that are recognized today as environmental and social determinants of health.1,2 The Institute of Medicine report3 and other health initiatives suggest the need for increased education and leadership from nurses to address the healthcare needs of our nation and world. Nurse coaches are strategically pos-i tioned and equipped to implement health-promoting and evidence-based strategies with clients and support behavioral and lifestyle changes to enhance growth, overall health, and well-being. With possibilities not yet imagined, employment opportunities for nurses who incorporate coaching into professional practice are developing across the entire spectrum of health, well-ness, and healing. PMID:24416681

  1. 76 FR 41032 - Medicaid Program; Face-to-Face Requirements for Home Health Services; Policy Changes and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-12

    ... standards for health care industries, (65 FR 69432, November 17, 2000). Individuals and States are not... services to the categorically needy populations specified in the Act. Home health care for Medicaid... services as part of a written plan of care reviewed every 60 days. B. Summary of New Medicare Home...

  2. Readings in Homemaker Services; Selected Papers Presenting the Background, Uses and Practices of Homemaker-Home Health Aide Programs.

    ERIC Educational Resources Information Center

    National Council for Homemaker-Home Health Aide Services, New York, NY.

    Prepared by the National Council for Homemaker Services for those concerned with homemaker programs, this document contains selected papers which summarize the developments of the homemaker-home health aide service. Sections are: (1) The Philosophy and Goals of Homemaker-Home Health Aide Service, with papers by Elizabeth G. Watkins and Ellen

  3. Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

    ERIC Educational Resources Information Center

    Behkami, Nima A.

    2012-01-01

    It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to

  4. 78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-06

    ... November 21, 2011 (76 FR 71920), VA proposed to amend its regulations concerning the billing methodology... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care to Non-VA Providers... services and hospice care. Because the newly applicable methodology cannot supersede rates for which VA...

  5. The prevalence of infections and patient risk factors in home health care: A systematic review

    PubMed Central

    Shang, Jingjing; Ma, Chenjuan; Poghosyan, Lusine; Dowding, Dawn; Stone, Patricia

    2015-01-01

    Background Home health care (HHC) has been the fastest growing health care sector for the past 3 decades. The uncontrolled home environment, increased use of indwelling devices, and the complexity of illnesses among HHC patients lead to increased risk for infections. Methods A systematic review of studies evaluating infection prevalence and risk factors among adult patients who received HHC services was conducted and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Literature was searched using Medline, PubMed, and the Cumulative Index to Nursing and Allied Health as well as hand searching. Two reviewers independently assessed study quality using validated quality assessment checklists. Results Twenty-five studies met the inclusion criteria and were reviewed. The infection rates and identified risk factors for infections varied dramatically between studies. In general, patients receiving home parental nutrition treatments had higher infection rates than patients receiving home infusion therapy. The identified risk factors were limited by small sample sizes and other methodologic flaws. Conclusions Establishing a surveillance system for HHC infections, identifying patients at high risk for infections, tailoring HHC and patient education based on patient living conditions, and facilitating communication between different health care facilities will enhance infection control in HHC settings. Future studies should use a nationally representative sample and multivariate analysis for the identification of risk factors for infections. PMID:24656786

  6. Articulation Matrix for Home Health Aide, Nursing Assistant, Patient Care Assistant, Practical Nursing.

    ERIC Educational Resources Information Center

    Florida State Univ., Tallahassee. Center for Instructional Development and Services.

    This document demonstrates the relationships among four Florida nursing education programs (home health aide, nursing assistant, patient care assistant, and practical nursing) by listing student performance standards and indicating which ones are required in each program. The 268 student performance standards are arranged in 23 areas of…

  7. Sharps Injuries and Other Blood and Body Fluid Exposures Among Home Health Care Nurses and Aides

    PubMed Central

    Markkanen, Pia K.; Galligan, Catherine J.; Kriebel, David; Chalupka, Stephanie M.; Kim, Hyun; Gore, Rebecca J.; Sama, Susan R.; Laramie, Angela K.; Davis, Letitia

    2009-01-01

    Objectives. We quantified risks of sharp medical device (sharps) injuries and other blood and body fluid exposures among home health care nurses and aides, identified risk factors, assessed the use of sharps with safety features, and evaluated underreporting in workplace-based surveillance. Methods. We conducted a questionnaire survey and workplace-based surveillance, collaborating with 9 home health care agencies and 2 labor unions from 2006 to 2007. Results. Approximately 35% of nurses and 6.4% of aides had experienced at least 1 sharps injury during their home health care career; corresponding figures for other blood and body fluid exposures were 15.1% and 6.7%, respectively. Annual sharps injuries incidence rates were 5.1 per 100 full-time equivalent (FTE) nurses and 1.0 per 100 FTE aides. Medical procedures contributing to sharps injuries were injecting medications, administering fingersticks and heelsticks, and drawing blood. Other contributing factors were sharps disposal, contact with waste, and patient handling. Sharps with safety features frequently were not used. Underreporting of sharps injuries to the workplace-based surveillance system was estimated to be about 50%. Conclusions. Sharps injuries and other blood and body fluid exposures are serious hazards for home health care nurses and aides. Improvements in hazard intervention are needed. PMID:19890177

  8. Population Education in Health and Home Economics: Some Sample Lessons for the Secondary Level.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand). Regional Office for Education in Asia and the Pacific.

    This booklet contains five sample lessons integrating population education into health and home economics instruction. It is one of four in a series. Materials differ from those in an earlier series (1980) in that lessons are presented at the secondary level only; there is no duplication of lessons from the earlier series in content and teaching

  9. Writing Up/Writing Down: Literate Practices in a Mental Health Boarding Home.

    ERIC Educational Resources Information Center

    Alexander, Kathryn

    2000-01-01

    Explores two forms of workplace literacies that served as instruments of management in a community mental health boarding home established for middle-aged women, and summarizes key issues that emerged from analysis of textual ethnography. Examines the record of textual mediation of workers and residents in an extensive, anecdotal workplace text

  10. Healthful Eating and Physical Activity in the Home Environment: Results from Multifamily Focus Groups

    ERIC Educational Resources Information Center

    Berge, Jerica M.; Arikian, Aimee; Doherty, William J.; Neumark-Sztainer, Dianne

    2012-01-01

    Objective: To explore multiple family members' perceptions of risk and protective factors for healthful eating and physical activity in the home. Design: Ten multifamily focus groups were conducted with 26 families. Setting and Participants: Community setting with primarily black and white families. Family members (n = 103) were aged 8 to 61…

  11. Healthful Eating and Physical Activity in the Home Environment: Results from Multifamily Focus Groups

    ERIC Educational Resources Information Center

    Berge, Jerica M.; Arikian, Aimee; Doherty, William J.; Neumark-Sztainer, Dianne

    2012-01-01

    Objective: To explore multiple family members' perceptions of risk and protective factors for healthful eating and physical activity in the home. Design: Ten multifamily focus groups were conducted with 26 families. Setting and Participants: Community setting with primarily black and white families. Family members (n = 103) were aged 8 to 61

  12. Impact of a Statewide Home Visiting Program on Parenting and on Child Health and Development

    ERIC Educational Resources Information Center

    Caldera, Debra; Burrell, Lori; Rodriguez, Kira; Crowne, Sarah Shea; Rohde, Charles; Duggan, Anne

    2007-01-01

    Objectives: To assess the impact of a voluntary, paraprofessional home visiting program on promoting child health and development and maternal parenting knowledge, attitudes, and behaviors. Methods: This collaborative, experimental study of 6 Healthy Families Alaska (HFAK) programs enrolled 325 families from 1/00 to 7/01, randomly assigned them to

  13. Health/Home Economics Classroom Activities for Secondary Schools. Schools in an Aging Society.

    ERIC Educational Resources Information Center

    Connecticut State Dept. of Education, Hartford.

    As the fastest-growing segment of society, older adults can be valuable resources for schools. The intent of this guide is to promote education for, with, and about older adults; to confront stereotypic images; and to present an accurate and balanced view of aging. The manual consists of 21 lesson plans for secondary teachers of health and home

  14. Evaluation of a Home Health Aide Training Program for the Elderly

    ERIC Educational Resources Information Center

    Lyons, Morgan; Steele, G. Alec

    1977-01-01

    A program training senior citizens as home health aides for the elderly is evaluated, using a variety of procedures (questionnaires, interviews, and observation) and involving many related persons. Primary outcome variables center on graduate employment and graduate and patient satisfaction. Quality of instruction, interorganization cooperation,

  15. The Nontoxic Home. Protecting Yourself and Your Family from Everyday Toxics and Health Hazards.

    ERIC Educational Resources Information Center

    Dadd, Debra Lynn

    The document maintains that the world is filled with health hazards and the best a person can do is to assess the danger of individual products, learn the risks, weigh the risks against the benefits, and decide whether or not to personally take these risks or to subject family members to them. This perspective begins in the home. This book

  16. A game-based strategy for the staff development of home health care nurses.

    PubMed

    Popil, Inna; Dillard-Thompson, Darlene

    2015-05-01

    This article describes gaming, an interactive teaching strategy that promotes active learning. An evaluation study conducted with home health care nurses tested the use of a game as a teaching tool. The study evaluated learning outcomes and learners' level of engagement and satisfaction with an educational game as a teaching method. PMID:25955422

  17. 76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... medical charges associated with non-VA outpatient care, provided under 38 CFR 17.52 or 17.120. 75 FR 78901.... See 75 FR 78901. We explained: Home Health Care and Hospice Care he pricing methodology adopted by... amended Sec. 17.56. See 75 FR 7218 (Feb. 18, 2010); 75 FR 78901. We need not repeat them here. Indeed,...

  18. Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

    ERIC Educational Resources Information Center

    Behkami, Nima A.

    2012-01-01

    It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

  19. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Basis and purpose of religious nonmedical health care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health...

  20. The political economy of a public health case management program's transition into medical homes.

    PubMed

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. PMID:26460509

  1. Nutritional Knowledge of UK Coaches

    PubMed Central

    Cockburn, Emma; Fortune, Alistair; Briggs, Marc; Rumbold, Penny

    2014-01-01

    Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05). In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice. PMID:24727434

  2. Nutritional knowledge of UK coaches.

    PubMed

    Cockburn, Emma; Fortune, Alistair; Briggs, Marc; Rumbold, Penny

    2014-04-01

    Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05). In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice. PMID:24727434

  3. Perceptions of health and risk management among home care workers in Sweden

    PubMed Central

    Larsson, A; Karlqvist, L; Westerberg, M; Gard, G

    2013-01-01

    Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. Objectives: This study aims to examine home care workers perceptions of health, risks, working conditions, and risk management within their organization. Method: The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides (n?=?133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations. PMID:24078781

  4. Improving osteoporosis care in high-risk home health patients through a high intensity intervention

    PubMed Central

    Outman, Ryan C.; Curtis, Jeffrey R.; Locher, Julie L.; Allison, Jeroan J.; Saag, Kenneth G.; Kilgore, Meredith L.

    2014-01-01

    Purpose We developed and tested a multi-modal intervention, delivered in the home health care setting, aimed at increasing osteoporosis treatment rates to prevent fractures. Material and Methods The intervention focused on home health nurses. Key components included: nursing education; development of a nursing care plan; patient teaching materials and creation of physician materials. Nursing education consisted of a lecture covering osteoporosis, fracture risks and prevention, and the effectiveness of anti-osteoporosis treatment options. Patients received education materials concerning osteoporosis and anti-osteoporosis medications. A pocket-sized treatment algorithm card and standardized order sets were prepared for physicians. Focus groups of physicians and nurses were conducted to obtain feedback on the materials and methods to facilitate effective nurse-physician communication. Successful application required nurses to identify patients with a fracture history, initiate the care plan, prompt physicians on risk status, and provide patient education. The intervention was piloted in one field office. Results In the year prior to the intervention, home health patients (n=92) with a fracture history were identified in the pilot field office and only 20 (22%) received osteoporosis prescription therapy. In the three months following the intervention, 21 newly enrolled patients were identified and 9 (43%) had received osteoporosis prescription medications. Conclusions Home health care provides a venue where patients and physicians can be informed by nurses about osteoporosis and fracture risks and, consequently, initiate appropriate therapy. This multi-modal intervention is easily transportable to other home health agencies and adaptable to other medical conditions and settings. PMID:22005175

  5. Relationships, Expertise, Incentives, and Governance: Supporting Care Home Residents' Access to Health Care. An Interview Study From England

    PubMed Central

    Goodman, Claire; Davies, Sue L.; Gordon, Adam L.; Meyer, Julienne; Dening, Tom; Gladman, John R.F.; Iliffe, Steve; Zubair, Maria; Bowman, Clive; Victor, Christina; Martin, Finbarr C.

    2015-01-01

    Objectives To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Methods Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Results Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. Conclusion The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. PMID:25687930

  6. mHealth tools for the pediatric patient-centered medical home.

    PubMed

    Slaper, Michael R; Conkol, Kimberly

    2014-02-01

    The concept of the pediatric patient-centered medical home (PCMH) as a theory has been evolving since it was initially conceived more than 40 years ago. When the American Academy of Pediatrics' (AAP) Council on Pediatric Practice first wrote about this model, "medical home" was defined solely as the central location of a pediatric patient's medical records. Approximately two decades later, the AAP published its inaugural policy statement on this topic. Through this policy statement, the medical home was defined as a place where care for pediatric patients would be accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective. Although the lack of access to providers, especially in rural communities, may inhibit the adoption of the PCMH or chronic care models, technology has evolved to the point where many of the gaps in care can be bridged. mHealth, defined by the National Institutes of Health (NIH) as the use of mobile and wireless devices to improve health outcomes, health care services, and health research, can be one specific example of how technology can address these issues. One early study has shown that patients who use mHealth tools are more likely to adhere to self-monitoring requirements and, in turn, have significantly improved outcomes. A rapidly evolving and scalable mHealth technology that has the ability to address these issues are self-management mobile applications, or apps. It has been estimated that there are currently more than 40,000 health care-related apps available. Furthermore, use of these apps is growing, as more than 50% of smartphone users surveyed responded that they have used their device to gather health information, and almost 20% of this population has at least one health care app on their device. PMID:24512160

  7. Community health nursing: can being self-employed work for you in home care?

    PubMed

    Seri, S F

    1997-09-01

    There is a fine distinction between being an independent contractor and being an employee. The advantages of being self-employed as a community health nurse are many. Self-employment suits new parents, graduate students, people in transition, with more than one profession, and who don't want a fixed schedule. However, this type of nursing is not for everyone. A broker such as CHN can help nurses become successfully self-employed. At a time when hospitals are downsizing and home care is becoming more in demand, brokers such as CHN provide a framework in which busy, experienced, community health nurses can work when and where they want. Good clinical and communication skills and a wish to be autonomous are necessities. A willingness to travel to different agencies and a reliable car are also important. A love for variety, flexibility, and independence make self-employment as a home health nurse a clinician's dream. PMID:9335699

  8. The lifespan merger sucess story: combining resources to offer better home health services.

    PubMed

    2005-03-01

    In 1996, "Lifespan" was born when four home care agencies in Battle Creek, Michigan, merged to create a wholly owned subsidiary of the Battle Creek Health System (BCHS), a community health care delivery organization that provides acute care, long-term care, psychological services, outpatient care, home health care, and occupational and business services. By banding together to effect savings through joint contract purchasing and shared services, Lifespan and BCHS have formed a communal relationship that allows the two to offer a seamless continuum of care without establishing wholly discrete organizations. Lifespan has thus been free to independently make mutually beneficial partnerships with an information technology company to enhance patient care services to their clients. PMID:15875424

  9. Effects of home, outside leisure, social, and peer activity on psychological health among Japanese family caregivers

    PubMed Central

    Wakui, Tomoko; Saito, Tami; Agree, Emily M.; Kai, Ichiro

    2014-01-01

    Objective Previous research has indicated that informal caregivers’ personal activities are disrupted by their caregiving role, leading to psychological stress and lower life satisfaction. However, the extent to which engagement in personal activities affects caregivers’ psychological health remains unclear. This study examines the relationship between different types and frequencies of activities and both positive and negative parameters of the psychological health of caregivers. Methods A mail survey was conducted with 727 family caregivers of older persons using adult day care services in the Tokyo metropolitan area. Perceived caregiver burden, care satisfaction, life satisfaction, and depression were used as psychological health outcomes. Engagement in home, outside leisure, social, and peer activities, as well as caregiver and care-recipient characteristics and caregiving situations, were assessed using a multivariate regression analysis. Results Engagement in home activities was related to lower scores on burden and depression and greater care satisfaction after controlling for care needs and caregiver characteristics, and social and peer activities were associated with greater life satisfaction. More frequent engagement was also associated with better psychological health, but a moderate involvement in home activities was most strongly associated with better care satisfaction. The amount of outside leisure activity was not significantly related with any of the outcomes. Conclusion This study shows that activity type and frequency are associated with caregivers’ psychological health, extending previous findings and providing practical implications for the support of family caregivers through programs to improve their participation in specific types of activities. PMID:22360698

  10. Bringing home the health humanities: narrative humility, structural competency, and engaged pedagogy.

    PubMed

    Tsevat, Rebecca K; Sinha, Anoushka A; Gutierrez, Kevin J; DasGupta, Sayantani

    2015-11-01

    As health humanities programs grow and thrive across the country, encouraging medical students to read, write, and become more reflective about their professional roles, educators must bring a sense of self-reflexivity to the discipline itself. In the health humanities, novels, patient histories, and pieces of reflective writing are often treated as architectural spaces or "homes" that one can enter and examine. Yet, narrative-based learning in health care settings does not always allow its participants to feel "at home"; when not taught with a critical attention to power and pedagogy, the health humanities can be unsettling and even dangerous. Educators can mitigate these risks by considering not only what they teach but also how they teach it.In this essay, the authors present three pedagogical pillars that educators can use to invite learners to engage more fully, develop critical awareness of medical narratives, and feel "at home" in the health humanities. These pedagogical pillars are narrative humility (an awareness of one's prejudices, expectations, and frames of listening), structural competency (attention to sources of power and privilege), and engaged pedagogy (the protection of students' security and well-being). Incorporating these concepts into pedagogical practices can create safe and productive classroom spaces for all, including those most vulnerable and at risk of being "unhomed" by conventional hierarchies and oppressive social structures. This model then can be translated through a parallel process from classroom to clinic, such that empowered, engaged, and cared-for learners become empowering, engaging, and caring clinicians. PMID:25945967

  11. Executive Coaching Practices in the Adult Workplace

    ERIC Educational Resources Information Center

    Campone, Francine

    2015-01-01

    This chapter provides an overview of key principles and practices in executive coaching. Coaching is discussed as a reflective learning opportunity and offers the theoretical grounding, strategies, and case studies for each of four key elements of a coaching engagement.

  12. Coaching the toxic leader.

    PubMed

    de Vries, Manfred F R Kets

    2014-04-01

    In his work as an executive coach, psychotherapist Kets de Vries sometimes comes across bosses with mental demons. The four kinds he encounters most frequently are pathological narcissists, who are selfish and entitled, have grandiose fantasies, and pursue power at all costs; manic-depressives, who can leave a trail of emotional blazes behind them; passive-aggressives, who shy away from confrontation but are obstructive and under-handed; and the emotionally disconnected--literal-minded people who cannot describe or even recognize their feelings. Left unchecked, these personalities can warp the interactions, plans, and systems of entire organizations. But with appropriate coaching, toxic bosses can learn to manage their conditions and become effective mentors and leaders. This article describes how to recognize each pathology and, step by step, guide people who suffer from it toward healthier and more-productive interactions. PMID:24830286

  13. Elements of an Art - Agile Coaching

    NASA Astrophysics Data System (ADS)

    Lundh, Erik

    This tutorial gives you a lead on becoming or redefining yourself as an Agile Coach. Introduction to elements and dimensions of state-of-the-art Agile Coaching. How to position the agile coach to be effective in a larger setting. Making the agile transition - from a single team to thousands of people. How to support multiple teams as a coach. How to build a coaches network in your company. Challenges when the agile coach is a consultant and the organization is large.

  14. Unobtrusive In-Home Monitoring of Cognitive and Physical Health: Reactions and Perceptions of Older Adults

    PubMed Central

    Wild, Katherine; Boise, Linda; Lundell, Jay; Foucek, Anna

    2008-01-01

    While the potential benefits of unobtrusive in-home sensing technologies for maintaining health and independence of older adults have been highlighted in recent research, little is known about their views toward such technology. The aims of this project were to identify monitoring needs and expectations of community-residing elderly and their family members. Focus groups were presented with examples of in-home monitoring devices and data output; participants were asked to consider whether the data showed information that was meaningful to them, and how and to whom they would like to have such data disseminated. Content analysis of transcripts revealed four dominant themes: maintaining independence, detecting cognitive decline, sharing of information, and the tradeoff between privacy and usefulness of monitoring. The acceptance by elderly of unobtrusive in-home monitoring was closely tied to perceived utility of data generated by such systems. Privacy concerns appeared to be less of an issue than anticipated in this sample. PMID:19165352

  15. Pesticide assessment: Protecting public health on the home turf

    PubMed Central

    Sears, Meg; Walker, C Robin; van der Jagt, Richard HC; Claman, Paul

    2006-01-01

    Pesticide regulation is examined in the context of Health Canadas Pest Management Regulatory Agencys assessment of the chlorophenoxy herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) for turf. 2,4-D is the most common herbicide used to kill weeds in grass. The medical literature does not uniformly indicate harms from herbicides. However, the balance of epidemiological research suggests that 2,4-D can be persuasively linked to cancers, neurological impairment and reproductive problems. These may arise from 2,4-D itself, from breakdown products or dioxin contamination, or from a combination of chemicals. Regulators rely largely on toxicology, but experiments may not replicate exposures from 2,4-D application to lawns because environmental breakdown products (eg, 2,4-dichlorophenol) may not accumulate and selected herbicides are possibly less contaminated. Dioxins are bioaccumulative chemicals that may cause cancer, harm neurological development, impair reproduction, disrupt the endocrine system and alter immune function. No dioxin analyses were submitted to the Pest Management Regulatory Agency, and the principal contaminants of 2,4-D are not among the 17 congeners covered in pesticide regulation. Independent assessment of all dioxins is needed, in tissues and in the environment. The 2,4-D assessment does not approach standards for ethics, rigour or transparency in medical research. Canada needs a stronger regulator for pesticides. Potentially toxic chemicals should not be registered when more benign solutions exist, risks are not clearly quantifiable or potential risks outweigh benefits. Until landscaping pesticides are curtailed nationally, local bylaws and Quebecs Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides. PMID:19030278

  16. The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges

    PubMed Central

    Phillips, Charles D.

    2015-01-01

    Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM) grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges. PMID:26740744

  17. Food, home and health: the meanings of food amongst Bengali Women in London

    PubMed Central

    2014-01-01

    Background This paper explores the nature of food and plants and their meanings in a British Bengali urban context. It focuses on the nature of plants and food in terms of their role in home making, transnational connections, generational change and concepts of health. Methods An ethnographic approach to the research was taken, specific methods included participant observation, focus group discussions and semi-structured interviews. Thirty women of Bengali origin were mostly composed of “mother” and “daughter” pairs. The mothers were over 45 years old and had migrated from Bangladesh as adults and their grown-up daughters grew up in the UK. Results Food and plants play an important role in the construction of home “here” (London) while continuing to connect people to home “there” (Sylhet). This role, however, changes and is re-defined across generations. Looking at perceptions of “healthy” and “unhealthy” food, particularly in the context of Bengali food, multiple views of what constitutes “healthy” food exist. However, there appeared to be little two-way dialogue about this concept between the research participants and health professionals. This seems to be based on “cultural” and power differences that need to be addressed for a meaningful dialogue to occur. Conclusion In summary, this paper argues that while food is critical to the familial spaces of home (both locally and globally), it is defined by a complex interplay of actors and wider meanings as illustrated by concepts of health and what constitutes Bengali food. Therefore, we call for greater dialogue between health professionals and those they interact with, to allow for an enhanced appreciation of the dynamic nature of food and plants and the diverse perceptions of the role that they play in promoting health. PMID:24886061

  18. Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes

    PubMed Central

    Ichikawa, Kayoko; Fujiwara, Takeo; Nakayama, Takeo

    2015-01-01

    Background Birth outcomes, such as preterm birth, low birth weight (LBW), and small for gestational age (SGA), are crucial indicators of child development and health. Purpose To evaluate whether home visits from public health nurses for high-risk pregnant women prevent adverse birth outcomes. Methods In this quasi-experimental cohort study in Kyoto city, Japan, high-risk pregnant women were defined as teenage girls (range 14–19 years old), women with a twin pregnancy, women who registered their pregnancy late, had a physical or mental illness, were of single marital status, non-Japanese women who were not fluent in Japanese, or elderly primiparas. We collected data from all high-risk pregnant women at pregnancy registration interviews held at a public health centers between 1 July 2011 and 30 June 2012, as well as birth outcomes when delivered from the Maternal and Child Health Handbook (N = 964), which is a record of prenatal check-ups, delivery, child development and vaccinations. Of these women, 622 women were selected based on the home-visit program propensity score-matched sample (pair of N = 311) and included in the analysis. Data were analyzed between January and June 2014. Results In the propensity score-matched sample, women who received the home-visit program had lower odds of preterm birth (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.39 to 0.98) and showed a 0.55-week difference in gestational age (95% CI: 0.18 to 0.92) compared to the matched controlled sample. Although the program did not prevent LBW and SGA, children born to mothers who received the program showed an increase in birth weight by 107.8 g (95% CI: 27.0 to 188.5). Conclusion Home visits by public health nurses for high-risk pregnant women in Japan might be effective in preventing preterm birth, but not SGA. PMID:26348847

  19. What Great Coaches Do Differently: 11 Elements of Effective Coaching

    ERIC Educational Resources Information Center

    Haworth, Rob; Whitaker, Todd

    2010-01-01

    Why do some athletic coaches succeed every season while others suffer loss after loss? This book describes the beliefs, behaviors, and attitudes of great athletic coaches. Where do they focus their attention? How do they spend their time and energy? And how can others gain the same advantages? Here, Rob Haworth and Todd Whitaker describe the

  20. Coaches' Experiences of Formal Coach Education: A Critical Sociological Investigation

    ERIC Educational Resources Information Center

    Piggott, David

    2012-01-01

    According to recent academic reviews, formal coach education courses are rarely considered important or useful events in a broader coach learning process. At present, there is insufficient research to define the nature and extent of this problem which is likely to become more important under the prevailing governing rationalities of modernisation…

  1. Gender differences in high school coaches' knowledge, attitudes, and communication about the female athlete triad.

    PubMed

    Kroshus, Emily; Sherman, Roberta T; Thompson, Ron A; Sossin, Karen; Austin, S Bryn

    2014-01-01

    The objective of this study was to assess high school coaches' knowledge, attitudes, communication, and management decisions with respect to the Female Athlete Triad and to determine whether results are patterned by coach gender. Data were obtained through an online survey of high school coaches (n = 227). Significant differences were found between male and female coaches in certain attitudes and communication behaviors related to eating and menstrual irregularity. School or district level policies may help reduce these differences and may help mitigate the health consequences for athletes related to possible differential prevention and detection of the comorbidities of the Female Athlete Triad. PMID:24456303

  2. Air quality of nursing homes and its effect on the lung health of elderly residents.

    PubMed

    Maio, S; Sarno, G; Baldacci, S; Annesi-Maesano, I; Viegi, G

    2015-12-01

    In industrialized countries the elderly spend most of their time indoors. The elderly may be at a higher risk of suffering from indoor air pollution-related diseases compared to the rest of the population, because of their increased exposure to potential indoor risk factors. This editorial aims to critically analyze the recent literature regarding this important topic. Results of studies performed on the elderly living in nursing homes clearly highlight that they are at risk of respiratory health impairment, even at moderate air pollutant concentrations, particularly if they are over 80years of age and living in poorly ventilated nursing homes. The future epidemiological research on ageing and respiratory diseases should investigate the underlying biological and physiological mechanisms, in addition to the adverse health effects of potential indoor risk factors, in order to help defining effective strategies for healthy ageing. PMID:26535792

  3. Design of Genetics Home Reference: A New NLM Consumer Health Resource

    PubMed Central

    Mitchell, Joyce A.; Fun, Jane; McCray, Alexa T.

    2004-01-01

    The authors have developed the Genetics Home Reference, a consumer resource that addresses the health implications of the Human Genome Project. The research results made possible by the Human Genome Project are being made available increasingly in scientific databases on the Internet, but, because of the often highly technical nature of these databases, they are not readily accessible to the lay public. The authors' goal is to provide a bridge between the clinical questions of the public and the richness of the data emanating from the Human Genome Project. The Genetics Home Reference currently focuses on single gene or polygenic conditions that are also topics on MEDLINEplus, the National Library of Medicine's primary consumer health site. As knowledge of genetics expands, the interrelationships between genes and diseases will continue to unfold, and the site will reflect these developments. PMID:15298997

  4. Daily Life or Diagnosis? Dual Perspectives on Perinatal Depression within Maternal and Child Health Home Visiting

    PubMed Central

    Price, Sarah Kye; Cohen-Filipic, Katherine

    2013-01-01

    This study describes a qualitative inquiry–informing program development in a maternal and child home visiting program. Low-income women's perceptions of the meaning and experiences of depression were ascertained through focus groups and interviews. Simultaneously, the study examines staff member perceptions and roles related to depression. Specific findings from clients and staff reveal culturally situated beliefs about depression and stressful life events; comparing and contrasting these beliefs offers a novel perspective on identification and intervention for maternal depression. This study offers a foundation for a translational research agenda that will be used for program and policy development to enhance mental health services situated within maternal and child health home visiting programs. PMID:23944165

  5. The caring behaviors of the home health nurse and influence on medication adherence.

    PubMed

    Owens, Rhoda A

    2006-09-01

    The purpose of this study was to determine if the caring behaviors of the home health nurse toward the patient influence the patient's medication adherence. The study focused on what effects the verbal and nonverbal caring behaviors of the nurse toward the patient have on the patient's medication adherence. How is the patient's perception of caring by the nurse related to his or her medication adherence? The study was conducted in a Midwestern home health agency over a 4-week period. Findings indicated an improvement in the use of verbal and nonverbal caring behaviors by the nurses with their patients. The patients perceived an increased use of these caring behaviors by the nurses with them. The patients' medication adherence and barriers to adherence improved. Other significant findings indicated that the verbal and nonverbal caring behaviors of the nurses and the patients' perception of the caring behaviors influenced and improved the patients' medication adherence by week 4. PMID:17012957

  6. Experiences of Nursing Personnel Using PDAs in Home Health Care Services in Norwegian Municipalities

    PubMed Central

    Hansen, Linda M.; Fossum, Mariann; Söderhamn, Olle; Fruhling, Ann

    2012-01-01

    Although nursing personnel have used personal digital assistants (PDAs) to support home health care services for the past ten years, little is known about their experiences. This study was conducted to examine experiences of nursing personnel using a specialized home health care computer software application called Gerica. In addition, this research analyzed how well this application aligned with the workflow of the nursing personnel in their daily care of patients. The evaluation methods included user observations and learnability testing. Nursing personnel from two different municipalities were observed while performing real tasks in natural settings. This study shows that the nursing personnel were satisfied with the PDA user interface and the Gerica software; however, they identified areas for improvement. For example, the nursing personnel were concerned about trusting the reliability of the PDA in order to eliminate the need for handwritten documentation. Solutions to meet these shortcomings for nursing managers and vendors are discussed. PMID:24199073

  7. Assessing the Importance of Gender Roles in Couples’ Home-Based Sexual Health Services in Malawi

    PubMed Central

    Gipson, Jessica D; Muntifering, Carie J; Chauwa, Felluna K; Taulo, Frank; Tsui, Amy O; Hindin, Michelle J

    2015-01-01

    To more effectively address individuals’ and couples’ sexual and reproductive health needs, innovative service delivery strategies are being explored. These strategies are logistically and ethically complicated, considering prevailing gender inequalities in many contexts. We conducted an exploratory study to assess the acceptability of couples’ home-based sexual health services in Malawi. We collected qualitative data from six focus group discussions and 10 husband-wife in-depth interviews to gain a more thorough understanding of how gender norms influence acceptability of couples’ sexual health services. Findings reveal that women are expected to defer to their husbands and may avoid conflict through covert contraceptive use and non-disclosure of HIV status. Many men felt that accessing sexual health services is stigmatizing, causing some to avoid services or to rely on informal information sources. Gender norms and attitudes toward existing services differentially impact men and women in this setting, influencing the perceived benefits of couples’ sexual health services PMID:21812199

  8. Hospital Versus Home Death: Results from the Mexican Health and Aging Study

    PubMed Central

    Crdenas-Turanzas, Marylou; Torres-Vigil, Isabel; Tovaln-Ahumada, Horacio; Nates, Joseph L.

    2013-01-01

    Context Characterizing where people die is needed to inform palliative care programs in Mexico. Objectives To determine whether access to health care influences the place of death of older Mexicans and examine the modifying effects of demographic and clinical characteristics. Methods We analyzed 2001 baseline and 2003 follow-up data from the Mexican Health and Aging Study. Cases included adults who completed the baseline interview and died before the follow-up interview and for whom a proxy interview was obtained in 2003. The main outcome variable was the place of death (hospital vs. home). The predictors of the place of death were identified using logistic regression analysis. Results The study group included 473 deceased patients; 52.9% died at home. Factors associated with hospital death were having spent at least one night in a hospital during the last year of life (odds ratio [OR]: 6.73; 95% confidence interval [CI]: 3.29, 13.78) and dying in a city other than the city of usual residence (OR: 4.68, 95% CI: 2.56, 8.57). Factors associated with home death were not having health care coverage (OR: 2.78, 95% CI: 1.34, 5.88), living in a city of less than 100,000 residents (OR: 2.44, 95% CI: 1.43, 4.17), and older age (OR: 1.03, 95% CI: 1.01, 1.05). Conclusion Older Mexicans with access to health care services were more likely to die in the hospital even after controlling for important clinical and demographic characteristics. Findings from the study may be used to plan the provision of accessible end-of-life hospital and home-based services. PMID:21146354

  9. How the Iranian Football Coaches and Players Know About Doping?

    PubMed Central

    Seif Barghi, Tohid; Halabchi, Farzin; Dvorak, Jiri; Hosseinnejad, Heydar

    2015-01-01

    Background: Nowadays, doping is an intricate dilemma. Football is the nationally popular sport in Iran. On the other hand, doping is a serious health hazard sport faces today. Studies dealing with athletes’ knowledge, attitudes and behavior concerning doping in football are scarce. Objectives: Therefore, we aimed to investigate the knowledge and attitudes toward doping among the football coaches and players. Patients and Methods: In a cross sectional study, 375 participants (239 football players and 136 coaches) were studied. A specially made questionnaire was applied. In this study, football teams of different provinces of the country were selected by randomized clustered sampling and questionnaires were distributed among coaches and players. Results: Knowledge of football coaches and players in three categories of doping definitions, recognition of prohibited drugs and side effects of anabolic steroids was poor or moderate in 45.3%, 88.5% and 96.5%, respectively. Conclusions: Football players and coaches have poor knowledge about doping in Iran. Moreover, they believe in some inappropriate myths without any scientific or rational basis.It seems necessary to design a comprehensive educational program for all of the athletes and coaches in Iran. PMID:26448840

  10. Respiratory health among Korean pupils in relation to home, school and outdoor environment.

    PubMed

    Kim, Jeong-Lim; Elfman, Lena; Wieslander, Gunilla; Ferm, Martin; Torén, Kjell; Norbäck, Dan

    2011-02-01

    There are few studies about school-environment in relation to pupils' respiratory health, and Korean school-environment has not been characterized. All pupils in 4th grade in 12 selected schools in three urban cities in Korea received a questionnaire (n = 2,453), 96% participated. Gaseous pollutants and ultrafine particles (UFPs) were measured indoors (n = 34) and outdoors (n = 12) during winter, 2004. Indoor dampness at home was investigated by the questionnaire. To evaluate associations between respiratory health and environment, multiple logistic- and multi-level regression models were applied adjusting for potential confounders. The mean age of pupils was 10 yr and 49% were boys. No school had mechanical ventilation and CO(2)-levels exceeded 1,000 ppm in all except one of the classrooms. The indoor mean concentrations of SO(2), NO(2), O(3) and formaldehyde were 0.6 µg/m(3), 19 µg/m(3), 8 µg/m(3) and 28 µg/m(3), respectively. The average level of UFPs was 18,230 pt/cm(3) in the classrooms and 16,480 pt/cm(3) outdoors. There were positive associations between wheeze and outdoor NO(2), and between current asthma and outdoor UFPs. With dampness at home, pupils had more wheeze. In conclusion, outdoor UFPs and even low levels of NO(2) may adversely contribute to respiratory health in children. High CO(2)-levels in classrooms and indoor dampness/mold at home should be reduced. PMID:21286005

  11. Coaching as an Occupational Subculture

    ERIC Educational Resources Information Center

    Massengale, John D.

    1974-01-01

    Their special role and the unusual demands placed on them isolate coaches from the rest of the academic bureaucracy. Athletes entering the field of coaching are so thoroughly socialized that they bring with them certain personality traits characteristic of athletes, distinct from other members of the faculty. (Editor)

  12. Relational Demography in Coaching Dyads

    ERIC Educational Resources Information Center

    Sagas, Michael; Paetzold, Ramona; Ashley, Frank

    2005-01-01

    The decline in the proportion of female head coaches in the intercollegiate ranks is one of the most significant issues in the realm of women's sports today. To extend the body of research that has studied this topic, we investigated the impact relational demographic effects on the work attitudes of coaches, which differs from previous research

  13. Instructional Coaching and Emotional Intelligence

    ERIC Educational Resources Information Center

    Avant, Rue Celia

    2012-01-01

    School site-based instructional coaching is a form of job-embedded professional development for teachers and an element of school reform. Coaches are hired based upon their pedagogical knowledge, content expertise, prior teaching experience, and "people skills." They are adept at handling a variety of social interactions at school sites,

  14. More Than Mentors: Principal Coaching.

    ERIC Educational Resources Information Center

    Bloom, Gary; Castagna, Claire; Warren, Betsy

    2003-01-01

    A professional development program for leadership, Coaching Leaders to Attain Student Success (CLASS), prepares individuals to coach new and experienced school principals. The program is the product of collaboration between the New Teacher Center at University of California Santa Cruz and the Association of California School Administrators. (MLF)

  15. Coaches, Sexual Harassment and Education

    ERIC Educational Resources Information Center

    Fasting, Kari; Brackenridge, Celia

    2009-01-01

    Sexual harassment in sport has become an active research field within the past decade yet we know relatively little about the characteristics of the harassing coach. How are harassing coaches characterised by their victims, that is, the athletes themselves? Do they demonstrate specific kinds of behaviours? One purpose of this article is to address…

  16. Coaches, Sexual Harassment and Education

    ERIC Educational Resources Information Center

    Fasting, Kari; Brackenridge, Celia

    2009-01-01

    Sexual harassment in sport has become an active research field within the past decade yet we know relatively little about the characteristics of the harassing coach. How are harassing coaches characterised by their victims, that is, the athletes themselves? Do they demonstrate specific kinds of behaviours? One purpose of this article is to address

  17. Relational Demography in Coaching Dyads

    ERIC Educational Resources Information Center

    Sagas, Michael; Paetzold, Ramona; Ashley, Frank

    2005-01-01

    The decline in the proportion of female head coaches in the intercollegiate ranks is one of the most significant issues in the realm of women's sports today. To extend the body of research that has studied this topic, we investigated the impact relational demographic effects on the work attitudes of coaches, which differs from previous research…

  18. Instructional Coaching and Emotional Intelligence

    ERIC Educational Resources Information Center

    Avant, Rue Celia

    2012-01-01

    School site-based instructional coaching is a form of job-embedded professional development for teachers and an element of school reform. Coaches are hired based upon their pedagogical knowledge, content expertise, prior teaching experience, and "people skills." They are adept at handling a variety of social interactions at school sites,…

  19. Paraprofessional Home Visitors' Perspectives on Addressing Poor Mental Health, Substance Abuse, and Domestic Violence: A Qualitative Study

    ERIC Educational Resources Information Center

    Tandon, S. Darius; Mercer, Constance D.; Saylor, Elizabeth L.; Duggan, Anne K.

    2008-01-01

    This research was conducted to understand paraprofessional home visitors' perceptions of their training in addressing poor mental health, substance abuse, and domestic violence, and their actions in working with families in addressing these issues. Five focus groups were conducted with a total of 28 paraprofessional home visitors. Three main

  20. Paraprofessional Home Visitors' Perspectives on Addressing Poor Mental Health, Substance Abuse, and Domestic Violence: A Qualitative Study

    ERIC Educational Resources Information Center

    Tandon, S. Darius; Mercer, Constance D.; Saylor, Elizabeth L.; Duggan, Anne K.

    2008-01-01

    This research was conducted to understand paraprofessional home visitors' perceptions of their training in addressing poor mental health, substance abuse, and domestic violence, and their actions in working with families in addressing these issues. Five focus groups were conducted with a total of 28 paraprofessional home visitors. Three main…

  1. Under-nutrition at baseline and health services utilization and mortality over a one-year period in older adults receiving Medicare home health services

    PubMed Central

    Yang, Yongbin; Brown, Cynthia J.; Burgio, Kathryn L.; Kilgore, Meredith L.; Ritchie, Christine S.; Roth, David L.; West, Delia Smith; Locher, Julie L.

    2010-01-01

    Objective Older adults receiving Medicare home health services who experience under-nutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a one-year period in older adults receiving Medicare home health services. Design This was a longitudinal study using questionnaires and anthropometric measures designed to assess nutritional status (Mini-Nutritional Assessment [MNA]) at baseline and health services utilization and mortality status at six-month and one-year follow-ups. Setting Participants were evaluated in their homes. Participants 198 older adults who were receiving Medicare home health services. Results Based upon MNA, 12.0% of patients were Malnourished, 51.0% were At Risk for Malnourishment, and 36.9% had Normal Nutrition Status. Based upon body mass index (BMI), 8.1% of participants were underweight, 37.9% were normal weight, 25.3% were overweight, and 28.8% were obese. Using multivariate binary logistic regression analyses, participants who were Malnourished or At Risk for Malnourishment were more likely to experience subsequent hospitalization, emergency room visit, home health aide use, and mortality for the entire sample and hospitalization and nursing home stay for overweight and obese participants. Conclusions Experiencing under-nutrition at the time of receipt of Medicare home health services was associated with increased health services utilization and mortality for the entire sample, and with increased health services utilization only for the overweight and obese subsample. Opportunities exist to address risk of under-nutrition in patients receiving home health services, including those who are overweight or obese, to prevent subsequent adverse health outcomes. PMID:21527170

  2. Interpretive Flexibility in Mobile Health: Lessons From a Government-Sponsored Home Care Program

    PubMed Central

    Mathiassen, Lars

    2013-01-01

    Background Mobile technologies have emerged as important tools that health care personnel can use to gain easy access to client data anywhere. This is particularly useful for nurses and care workers in home health care as they provide services to clients in many different settings. Although a growing body of evidence supports the use of mobile technologies, the diverse implications of mobile health have yet to be fully documented. Objective Our objective was to examine a large-scale government-sponsored mobile health implementation program in the Danish home care sector and to understand how the technology was used differently across home care agencies. Methods We chose to perform a longitudinal case study with embedded units of analysis. We included multiple data sources, such as written materials, a survey to managers across all 98 Danish municipalities, and semistructured interviews with managers, care workers, and nurses in three selected home care agencies. We used process models of change to help analyze the overall implementation process from a longitudinal perspective and to identify antecedent conditions, key events, and practical outcomes. Results Strong collaboration between major stakeholders in the Danish home care sector (government bodies, vendors, consultants, interest organizations, and managers) helped initiate and energize the change process, and government funding supported quick and widespread technology adoption. However, although supported by the same government-sponsored program, mobile technology proved to have considerable interpretive flexibility with variation in perceived nature of technology, technology strategy, and technology use between agencies. What was first seen as a very promising innovation across the Danish home care sector subsequently became the topic of debate as technology use arrangements ran counter to existing norms and values in individual agencies. Conclusions Government-sponsored programs can have both positive and negative results, and managers need to be aware of this and the interpretive flexibility of mobile technology. Mobile technology implementation is a complex process that is best studied by combining organization-level analysis with features of the wider sociopolitical and interorganizational environment. PMID:24172852

  3. The Medical Home

    MedlinePLUS

    ... Cerebral Palsy: Caring for Your Child The Medical Home KidsHealth > For Parents > The Medical Home Print A ... for your child. What Does the Term "Medical Home" Mean? A medical home isn't a place ...

  4. Bringing Your Baby Home

    MedlinePLUS

    ... Palsy: Caring for Your Child Bringing Your Baby Home KidsHealth > For Parents > Bringing Your Baby Home Print ... recall your baby's seemingly endless crying episodes. The Home Front Introducing your baby to others at home ...

  5. In Pursuit of Becoming a Senior Coach: The Learning Culture for Australian Football League Coaches

    ERIC Educational Resources Information Center

    Mallett, Clifford J.; Rossi, Tony; Rynne, Steven B.; Tinning, Richard

    2016-01-01

    Background and Purpose: Given the turbulent and highly contested environment in which professional coaches work, a prime concern to coach developers is how coaches learn their craft. Understanding the learning and development of senior coaches (SCs) and assistant coaches (ACs) in the Australian Football League (AFL--the peak organisation for…

  6. In Pursuit of Becoming a Senior Coach: The Learning Culture for Australian Football League Coaches

    ERIC Educational Resources Information Center

    Mallett, Clifford J.; Rossi, Tony; Rynne, Steven B.; Tinning, Richard

    2016-01-01

    Background and Purpose: Given the turbulent and highly contested environment in which professional coaches work, a prime concern to coach developers is how coaches learn their craft. Understanding the learning and development of senior coaches (SCs) and assistant coaches (ACs) in the Australian Football League (AFL--the peak organisation for

  7. Understanding How Ontario High School Teacher-Coaches Learn to Coach

    ERIC Educational Resources Information Center

    Winchester, Geoff; Culver, Diane; Camir, Martin

    2013-01-01

    Background: There are approximately 52,000 teacher-coaches coaching 750,000 high school student-athletes in Canada. Despite this large population, Canadian high school teacher-coaches remain relatively unstudied. High school coaches in Canada are often asked to coach sports with which they are unfamiliar, and because they are not required to

  8. 3 Steps to Great Coaching: A Simple but Powerful Instructional Coaching Cycle Nets Results

    ERIC Educational Resources Information Center

    Knight, Jim; Elford, Marti; Hock, Michael; Dunekack, Devona; Bradley, Barbara; Deshler, Donald D.; Knight, David

    2015-01-01

    In this article the authors describe a three-step instructional coaching cycle that can helps coaches become more effective. The article provides the steps and related components to: (1) Identify; (2) Learn; and (3) Improve. While the instructional coaching cycle is only one effective coaching program, coaches also need professional learning that

  9. Practice patterns among entrants and incumbents in the home health market after the prospective payment system was implemented.

    PubMed

    Kim, Hyunjee; Norton, Edward C

    2015-03-01

    Home health care expenditures were the fastest growing part of Medicare from 2001-2009, despite the implementation of prospective payment. Prior research has shown that home health agencies adopted two specific strategies to take advantage of Medicare policies: provide at least 10 therapy visits to get an enormous marginal payment and recertify patients for additional episodes. We study whether there is heterogeneity in the adoption of those strategic behaviors between home health agency entrants and incumbents and find that entrants were more likely to adopt strategic practice patterns than were incumbents. We also find that for-profit incumbents mimicked one of the practice patterns following entrants in the same market. Our findings suggest that it is important to understand the heterogeneity in providers' behavior and how firms interact with each other in the same market. These findings help explain the rapid rise in expenditures in the home health care market. PMID:25760587

  10. Children's Health and Indoor Air Quality in Primary Schools and Homes in Portugal-Study Design.

    PubMed

    Madureira, Joana; Pacincia, Ins; Ramos, Elisabete; Barros, Henrique; Pereira, Cristiana; Teixeira, Joo Paulo; Fernandes, Eduardo de Oliveira

    2015-01-01

    The main aim of the research project "On the Contribution of Schools to Children's Overall Indoor Air Exposure" is to study associations between adverse health effects, namely, allergy, asthma, and respiratory symptoms, and indoor air pollutants to which children are exposed to in primary schools and homes. Specifically, this investigation reports on the design of the study and methods used for data collection within the research project and discusses factors that need to be considered when designing such a study. Further, preliminary findings concerning descriptors of selected characteristics in schools and homes, the study population, and clinical examination are presented. The research project was designed in two phases. In the first phase, 20 public primary schools were selected and a detailed inspection and indoor air quality (IAQ) measurements including volatile organic compounds (VOC), aldehydes, particulate matter (PM2.5, PM10), carbon dioxide (CO2), carbon monoxide (CO), bacteria, fungi, temperature, and relative humidity were conducted. A questionnaire survey of 1600 children of ages 8-9 years was undertaken and a lung function test, exhaled nitric oxide (eNO), and tear film stability testing were performed. The questionnaire focused on children's health and on the environment in their school and homes. One thousand and ninety-nine questionnaires were returned. In the second phase, a subsample of 68 children was enrolled for further studies, including a walk-through inspection and checklist and an extensive set of IAQ measurements in their homes. The acquired data are relevant to assess children's environmental exposures and health status. PMID:26167757

  11. Parents’ perspectives of the transition to home when a child has complex technological health care needs

    PubMed Central

    Brenner, Maria; Larkin, Philip J.; Hilliard, Carol; Cawley, Des; Howlin, Frances; Connolly, Michael

    2015-01-01

    Introduction There is an increasing number of children with complex care needs, however, there is limited evidence of the experience of families during the process of transitioning to becoming their child's primary care giver. The aim of this study was to explore parents’ perspectives of the transition to home of a child with complex respiratory health care needs. Methods Parents of children with a tracheostomy with or without other methods of respiratory assistance, who had transitioned to home from a large children's hospital in the last 5 years, were invited to participate in the interviews. Voice-centred relational method of qualitative analysis was used to analyse parent responses. Results Four key themes emerged from the interviews including “stepping stones: negotiating the move to home”, “fighting and frustration”, “questioning competence” and “coping into the future”. Discussion There is a need for clear and equitable assessments and shared policies and protocols for the discharge of children with complex care needs. Direction and support are required at the level of health service policy and planning to redress these problems. This study provides evidence that the transition of children with complex care needs from hospital to home is a challenging dynamic in need of further improvement and greater negotiation between the parent and health service provider. There are tangible issues that could be addressed including the introduction of a standardised approach to assessment of the needs of the child and family in preparation for discharge and for clear timelines and criteria for reassessment of needs once at home. PMID:26528098

  12. Family Involvement in School-Based Health Promotion: Bringing Nutrition Information Home

    PubMed Central

    Blom-Hoffman, Jessica; Wilcox, Kaila R.; Dunn, Liam; Leff, Stephen S.; Power, Thomas J.

    2009-01-01

    Family-school collaboration related to childrens physical development has become increasingly important as childhood obesity rates continue to rise. The present study described the development and implementation of a literacy-based, family component of a school-based health education program and investigated its viability, acceptability, and effectiveness. Interactive childrens books were the mechanism by which students, parents, and teachers received consistent messages at home and school regarding nutrition information. The home-school intervention served to bridge home and school cultures in an urban population. Preliminary process evaluation results indicated that the interactive childrens books were feasible to implement in the school context. Parents, children, and teachers had positive perceptions of the books. Parents who received the books demonstrated increased knowledge of 5 a Day, the primary nutrition message communicated in the program. Although not statistically significant, after the first and second years of intervention, parents in the experimental group reported that their children were eating 0.54 and 0.36 additional servings of fruit and vegetables per day compared with children in the control group. The program did not seem to impact the availability and accessibility of fruits and vegetables at home. PMID:19633724

  13. Getting Home Safe and Sound: Occupational Safety and Health Administration at 38

    PubMed Central

    Silverstein, Michael

    2008-01-01

    The Occupational Safety and Health Act of 1970 (OSHAct) declared that every worker is entitled to safe and healthful working conditions, and that employers are responsible for work being free from all recognized hazards. Thirty-eight years after these assurances, however, it is difficult to find anyone who believes the promise of the OSHAct has been met. The persistence of preventable, life-threatening hazards at work is a failure to keep a national promise. I review the history of the Occupational Safety and Health Administration and propose measures to better ensure that those who go to work every day return home safe and sound. These measures fall into 6 areas: leverage and accountability, safety and health systems, employee rights, equal protection, framing, and infrastructure. PMID:18235060

  14. Ecosystem and population health: the role of Canadian physicians at home and abroad.

    PubMed

    Woollard, R F

    1995-10-15

    Seemingly intractable problems of overpopulation, ecologic degradation, diminishing resources and regional warfare are having a profound effect on global population health. Canadian physicians can assist in ameliorating these problems by helping to modify the overconsumption of natural resources at home and by participating in international health projects focused at the community level, where the health of individuals and that of their environment intersect. The author describes the work of the Canadian Hunger Foundation in Vietnam and Sri Lanka, where a team of professionals worked with local farmers to improve the local water supply, decrease soil erosion and increase food production. The team observed changes in the physical health of communities that resulted in part from interventions that empowered them to address their own problems. PMID:7553520

  15. Public health and English local government: historical perspectives on the impact of returning home

    PubMed Central

    Gorsky, Martin; Lock, Karen; Hogarth, Sue

    2014-01-01

    This article uses history to stimulate reflection on the present opportunities and challenges for public health practice in English local government. Its motivation is the paradox that despite Department of Health policy-makers allusions to a long and proud history and returning public health home there has been no serious discussion of that past local government experience and what we might learn from it. The article begins with a short resum of the achievements of Victorian public health in its municipal location, and then considers the extensive responsibilities that it developed for environmental, preventive and health services by the mid-twentieth century. The main section discusses the early NHS, explaining why historians see the era as one of decline for the speciality of public health, leading to the reform of 1974, which saw the removal from local government and the abolition of the Medical Officer of Health role. Our discussion focuses on challenges faced before 1974 which raise organizational and political issues relevant to local councils today as they embed new public health teams. These include the themes of leadership, funding, integrated service delivery, communication and above all the need for a coherent vision and rationale for public health action in local authorities. PMID:24472776

  16. Public health and English local government: historical perspectives on the impact of 'returning home'.

    PubMed

    Gorsky, Martin; Lock, Karen; Hogarth, Sue

    2014-12-01

    This article uses history to stimulate reflection on the present opportunities and challenges for public health practice in English local government. Its motivation is the paradox that despite Department of Health policy-makers' allusions to 'a long and proud history' and 'returning public health home' there has been no serious discussion of that past local government experience and what we might learn from it. The article begins with a short resum of the achievements of Victorian public health in its municipal location, and then considers the extensive responsibilities that it developed for environmental, preventive and health services by the mid-twentieth century. The main section discusses the early NHS, explaining why historians see the era as one of decline for the speciality of public health, leading to the reform of 1974, which saw the removal from local government and the abolition of the Medical Officer of Health role. Our discussion focuses on challenges faced before 1974 which raise organizational and political issues relevant to local councils today as they embed new public health teams. These include the themes of leadership, funding, integrated service delivery, communication and above all the need for a coherent vision and rationale for public health action in local authorities. PMID:24472776

  17. Instructional Coaching in One Middle School

    ERIC Educational Resources Information Center

    Krohn, Cheryl Ann

    2013-01-01

    This qualitative study examines a model of instructional coaching in a middle school using interviews and observations of both teachers and their coaches. During the 2012-2013 school year, Creekside Middle School implemented a new model of instructional coaching that differed from the traditional model of coaching; it focused on student learning…

  18. National Standards for Athletic Coaches. ERIC Digest.

    ERIC Educational Resources Information Center

    Brylinsky, Jody

    This digest asserts that the question of coach preparation and training has become a priority issue for many schools and communities, though the research is limited. It examines reasons to have coach education; the scope of sport participation; the status of coach education and training in the United States; National standards for coach education;

  19. Coaches' Encouragement of Athletes' Imagery Use

    ERIC Educational Resources Information Center

    Jedlic, Brie; Hall, Nathan; Munroe-Chandler, Krista; Hall, Craig

    2007-01-01

    To investigate whether coaches encourage their athletes to use imagery, two studies were undertaken. In the first, 317 athletes completed the Coaches' Encouragement of Athletes' Imagery Use Questionnaire. In the second, 215 coaches completed a slightly modified version of this questionnaire. It was found that coaches and athletes generally agreed…

  20. Failure to Rehire: Why Coaches Get Fired

    ERIC Educational Resources Information Center

    Stewart, Craig

    2014-01-01

    The purpose of this work was to identify reasons coaches were not rehired in public school coaching positions. The intent was to use this information for content modification of courses in coach education. At the entry level, coaches are too often concerned only with their particular sport and how to develop successful athletes or winning teams.

  1. Leadership for Literacy Coaching: Evolving Research

    ERIC Educational Resources Information Center

    Taylor, Rosemarye T.; Moxley, Dale E.

    2008-01-01

    Leadership for literacy coaching is evolving in both the skills of the literacy coaches and the skills of those they coach. Issues of role clarification, communication with administration, and hesitancy to provide authentic feedback are consistently identified. Trends associated with literacy coaching indicate that they continue on their…

  2. Reflective Coaching Conversations: A Missing Piece

    ERIC Educational Resources Information Center

    Peterson, Debra S.; Taylor, Barbara M.; Burnham, Bobbie; Schock, Rynell

    2009-01-01

    The purpose of this article is to document and describe coaching conversations between literacy coaches and teachers in elementary schools that were seeing gains in students' reading achievement. Participants were drawn from literacy coaches in twenty-four Reading First schools in Minnesota. Detailed notes of the coaching conversations were

  3. Developing Female Coaches: Strategies from Women Themselves

    ERIC Educational Resources Information Center

    Norman, Leanne

    2012-01-01

    The purpose of this study was to explore strategies for the development of aspiring female coaches based on the ideas of existing high-performance female coaches. Drawing on semi-structured interviews with national-level female coaches in the United Kingdom, four recurrent ideas for developing female coaches in a male-dominated profession emerged.

  4. Evaluation: Your Key to Better Coaching.

    ERIC Educational Resources Information Center

    Docheff, Dennis

    1989-01-01

    The Coaches Evaluation Instrument (CEI) is a simple form to help coaches, administrators, and athletes evaluate coaching performance. The instrument may be used to supplement existing evaluation procedures and to help coaches identify areas for improvement. A copy of the CEI and a sample score sheet are included. (IAH)

  5. Developing Female Coaches: Strategies from Women Themselves

    ERIC Educational Resources Information Center

    Norman, Leanne

    2012-01-01

    The purpose of this study was to explore strategies for the development of aspiring female coaches based on the ideas of existing high-performance female coaches. Drawing on semi-structured interviews with national-level female coaches in the United Kingdom, four recurrent ideas for developing female coaches in a male-dominated profession emerged.…

  6. A Gift to Self: Leadership Coaching.

    PubMed

    Bleich, Michael R

    2016-01-01

    In this article, the distinction between mentoring, therapy, and coaching is made, with a focus on the value of leadership coaching. Seven attributes to consider when selecting a coach and a framework describing the value proposition for retaining a coach are presented. J Contin Educ Nurs. 2016;47(1):11-13. PMID:26790491

  7. Coaches' Encouragement of Athletes' Imagery Use

    ERIC Educational Resources Information Center

    Jedlic, Brie; Hall, Nathan; Munroe-Chandler, Krista; Hall, Craig

    2007-01-01

    To investigate whether coaches encourage their athletes to use imagery, two studies were undertaken. In the first, 317 athletes completed the Coaches' Encouragement of Athletes' Imagery Use Questionnaire. In the second, 215 coaches completed a slightly modified version of this questionnaire. It was found that coaches and athletes generally agreed

  8. Longer term impact of the mass media campaign to promote the Get Healthy Information and Coaching Service: increasing the saliency of a new public health program.

    PubMed

    O'Hara, Blythe J; Phongsavan, Philayrath; Gebel, Klaus; Banovic, Debbie; Buffett, Kym M; Bauman, Adrian E

    2014-11-01

    The Get Healthy Information and Coaching Service (GHS) was introduced in New South Wales in February 2009. It used mass reach media advertising and direct mail and/or proactive marketing to recruit participants. This article reports on the long-term impact of the campaign on GHS participation from July 2011 to June 2012. A stand-alone population survey collected awareness, knowledge, and behavioral variables before the first advertising phase, (n = 1,544, August-September 2010), during the advertising period (n = 1,500, February-March 2011; n = 1,500, June-July 2011; n = 1,500, February 2012), and after the advertising period (n = 1,500, June-July 2012). GHS usage data (n = 6,095) were collated during July 2011-June 2012. Unprompted and prompted awareness of GHS mass media significantly increased (0% to 8.0%, p < .001; and 14.1% to 43.9%, p < .001, respectively) as well as knowledge and perceived effectiveness of the GHS. Those from the lowest three quintiles of socioeconomic disadvantage and respondents who were overweight or obese were significantly more likely to report prompted campaign awareness. The majority (84.4%) of new GHS calls occurred when television advertising was present. Participants who cited mass media as their referral source were significantly more likely to enroll in the intensive coaching program. Mass media campaigns remain an effective method of promoting a telephone-based statewide lifestyle program. PMID:24662895

  9. The Effects of the Balanced Budget Act of 1997 on Home Health and Hospice in Older Adult Cancer Patients

    PubMed Central

    Kilgore, Meredith L.; Grabowski, David C.; Morrisey, Michael A.; Ritchie, Christine S.; Yun, Huifeng; Locher, Julie L.

    2009-01-01

    Background Home health and hospice services can constitute important elements in the continuum of care for older adults diagnosed with cancer. The Balanced Budget Act of 1997 (BBA) included provisions affecting those services. Objectives The first aim of this study is to assess the effect of the BBA of 1997 on home health and hospice service utilization in older cancer patients. The second aim is to estimate the effect of the BBA of 1997 on costs associated specifically with home health and hospice services and on total costs of care. The final aim is evaluate the effect of the BBA of 1997 on mortality in these patients. Research Design Longitudinal analysis using the Surveillance, Epidemiology and End Results-Medicare Database, covering a service area that includes 26% of the U.S. population. Participants Community-dwelling Medicare beneficiaries aged 65+. Measures Utilization rates of home health and hospice services; costs associated with those services, and total costs of care; and mortality. Results Home health utilization rates dropped substantially and hospice utilization rates increased following the BBA. Medicare costs for home health services declined as did total Medicare costs, but hospice costs increased. There was no discernable effect on mortality rates. Conclusions The BBA was successful in containing the costs of home health services and resulted in savings in overall costs of care for older cancer patients. Reduction in utilization of home health services did not appear to negatively affect outcomes. The BBA may have contributed to the trend of increasing use of hospice care. PMID:19194333

  10. The Environmental Health/Home Safety Education Project: a successful and practical U.S.-Mexico border initiative.

    PubMed

    Forster-Cox, Susan C; Mangadu, Thenral; Jacquez, Benjamn; Fullerton, Lynne

    2010-05-01

    The Environmental Health/Home Safety Education Project (Proyecto de Salud Ambiental y Seguridad en el Hogar) has been developed in response to a wide array of severe and often preventable environmental health issues occurring in and around homes on the U.S.-Mexico border. Utilizing well-trained community members, called promotoras , homes are visited and assessed for potential environmental hazards, including home fire and food safety issues. Data analyzed from project years 2002 to 2005 shows a significant impact in knowledge levels and initial behavior change among targeted participants as it relates to fire and food safety issues. Since the initiation of the project in 1999, hundreds of participants have improved their quality of life by making their homes safer. The project has proven to be sustainable, replicable, flexible, and attractive to funders. PMID:19843700

  11. Bridging the gap: a virtual health record for integrated home care

    PubMed Central

    Hgglund, Maria; Scandurra, Isabella; Mostrm, Dennis; Koch, Sabine

    2007-01-01

    Introduction The coexistence of different information systems that are unable to communicate is a persistent problem in healthcare and in integrated home care in particular. Theory and methods Physically federated integration is used for design of the underlying technical architecture to implement a mobile virtual health record for integrated home care. A user centered system development approach is followed during design and development of the system. Results A technical platform based on a service-oriented approach where database functionality and services are separated has been developed. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardized way. A physically federated integration enables point-of-care documentation, integrated presentation of information from different feeder systems, and offline access to data on handheld devices. Feeder systems deliver information in XML-files that are mapped against an ideal XML schema, published as an interface for integration with the information broker, and inserted into the mediator database. Conclusions A seamless flow of information between both different care professionals involved in integrated home care and patients and relatives is provided through mobile information access and interaction with different feeder systems using the virtual health record. PMID:17637872

  12. A Water-Damaged Home and Health of Occupants: A Case Study

    PubMed Central

    Thrasher, Jack Dwayne; Gray, Michael R.; Kilburn, Kaye H.; Dennis, Donald P.; Yu, Archie

    2012-01-01

    A family of five and pet dog who rented a water-damaged home and developed multiple health problems. The home was analyzed for species of mold and bacteria. The diagnostics included MRI for chronic sinusitis with ENT and sinus surgery, and neurological testing for neurocognitive deficits. Bulk samples from the home, tissue from the sinuses, urine, nasal secretions, placenta, umbilical cord, and breast milk were tested for the presence of trichothecenes, aflatoxins, and Ochratoxin A. The family had the following diagnosed conditions: chronic sinusitis, neurological deficits, coughing with wheeze, nose bleeds, and fatigue among other symptoms. An infant was born with a total body flare, developed multiple Cafe-au-Lait pigmented skin spots and diagnoses with NF1 at age 2. The mycotoxins were detected in bulk samples, urine and nasal secretions, breast milk, placenta, and umbilical cord. Pseudomonas aueroginosa, Acinetobacter, Penicillium, and Aspergillus fumigatus were cultured from nasal secretions (father and daughter). RT-PCR revealed A. fumigatus DNA in sinus tissues of the daughter. The dog had 72 skin lesions (sebaceous glands and lipomas) from which trichothecenes and ochratoxin A. were detected. The health of the family is discussed in relation to the most recent published literature regarding microbial contamination and toxic by-products present in water-damaged buildings. PMID:22220187

  13. A water-damaged home and health of occupants: a case study.

    PubMed

    Thrasher, Jack Dwayne; Gray, Michael R; Kilburn, Kaye H; Dennis, Donald P; Yu, Archie

    2012-01-01

    A family of five and pet dog who rented a water-damaged home and developed multiple health problems. The home was analyzed for species of mold and bacteria. The diagnostics included MRI for chronic sinusitis with ENT and sinus surgery, and neurological testing for neurocognitive deficits. Bulk samples from the home, tissue from the sinuses, urine, nasal secretions, placenta, umbilical cord, and breast milk were tested for the presence of trichothecenes, aflatoxins, and Ochratoxin A. The family had the following diagnosed conditions: chronic sinusitis, neurological deficits, coughing with wheeze, nose bleeds, and fatigue among other symptoms. An infant was born with a total body flare, developed multiple Cafe-au-Lait pigmented skin spots and diagnoses with NF1 at age 2. The mycotoxins were detected in bulk samples, urine and nasal secretions, breast milk, placenta, and umbilical cord. Pseudomonas aueroginosa, Acinetobacter, Penicillium, and Aspergillus fumigatus were cultured from nasal secretions (father and daughter). RT-PCR revealed A. fumigatus DNA in sinus tissues of the daughter. The dog had 72 skin lesions (sebaceous glands and lipomas) from which trichothecenes and ochratoxin A. were detected. The health of the family is discussed in relation to the most recent published literature regarding microbial contamination and toxic by-products present in water-damaged buildings. PMID:22220187

  14. [Evaluation of the effectiveness of home-based physical activity promotion by community health workers].

    PubMed

    Costa, Evelyn Fabiana; Andrade, Douglas Roque; Garcia, Leandro Martin Totaro; Ribeiro, Evelyn Helena Corgosinho; Santos, Taynã Ishi Dos; Florindo, Alex Antonio

    2015-10-01

    This study analyzed the effectiveness of physical activity promotion by community health workers (CHW) during home visits. This was a non-randomized controlled trial that lasted six months, with one group of CHW that received training to promote physical activity during home visits among users of the Brazilian Unified National Health System (SUS) and a control group. Physical activity and stages of behavior change were evaluated in 176 adults (n = 90 in the intervention group and n = 86 in the control group) assisted by the CHW. Associations, prevalence ratios, and generalized estimate equations were conductec to verify differences between groups. No evidence of differences in physical activity and stages of behavior change were observed between the two groups. CHW from the intervention group conducted more home visits promoting physical activity among elders, those with low schooling, unemployed, and those with chronic diseases. It is important to reassess the work and priorities of CHW to expand physical activity promotion under the SUS. PMID:26735385

  15. Usage of an Internet smoking cessation resource: the Australian QuitCoach

    PubMed Central

    Balmford, James; Borland, Ron; Li, Lin; Ferretter, Ian

    2015-01-01

    Introduction and Aims The QuitCoach (www.quitcoach.org.au) is a tailored, Internet-delivered smoking cessation advice program. This paper compares QuitCoach users both with smokers in general, and with callers to a telephone-based smoking cessation service (the Victorian Quitline). It also explores patterns of QuitCoach usage by time of year and day of the week. Design and Methods Data are from responses to the QuitCoach online assessment collected between 2003–2007 (n=28,247). Comparison data are from the Victorian Quitline service, from the first five waves of the International Tobacco Control Four Country Survey, the 2004–05 National Health Survey, and from anti-smoking TARPS for Australia. Results QuitCoach users were more likely to be female and younger than both smokers in general, and Quitline users. They were intermediate in nicotine dependence. QuitCoach users are less likely to have just quit than Quitline callers. Half of QuitCoach users first use after setting a quit date. Usage is related to anti-smoking advertising and to day of week, being highest earlier in the week. Conclusions The QuitCoach successfully targets the moderately addicted. Use is sensitive to anti-smoking campaigns. There is a need for greater promotion of the QuitCoach as a resource with the capacity to meet the needs of those already quit and those still uncertain as to whether to try. PMID:19320678

  16. Quantitative and qualitative processes of change during staff-coaching sessions: an exploratory study.

    PubMed

    van Oorsouw, Wietske M W J; Embregts, Petri J C M; Bosman, Anna M T

    2013-05-01

    Staff training is one of the interventions that managers can embed in their organizations to help staff improve their professional competences related to challenging behaviour of clients with intellectual disabilities. Individual coaching adds learning opportunities that are feasible but difficult to achieve in an in-service setting. In the present study, we have followed the coaching process of three staff members. Based on differences in the Linell balance of power across sessions, we explored the question: do different coaching processes have similar patterns in the development of dominance and coherence in interactions between coach and staff? Additionally, a qualitative approach was conducted to illustrate and enrich the meaning of quantitative outcomes. Processes were different regarding the balance of power at the start of the coaching, probably due to differences in resistance and insecurity. As a consequence of different starting points and differences in learning styles, each coaching process had its unique development over time. At the end, all dyads were comparable in the sense that all dyads were highly satisfied about the outcomes and process of coaching. This is in line with similar levels of power at the end of the coaching sessions suggesting equal contributions and leadership. The present findings suggest some relevant competencies of coaches within health-care services. Due to the small number of participants, the results have to be interpreted with caution. The present study provides suggestions for future research and clinical practice. PMID:23474998

  17. Guidelines for Environmental Health Management in Children’s Homes in Sub-Sahara Africa

    PubMed Central

    Muruka, Charles; Muruka, Andrew

    2007-01-01

    The field of environmental health focuses on the relationships between human health and well being and the influence of the physical, social and societal environments. Our understanding of the environment–health interface has progressed because of two relatively recent insights: First, the recognition that the unprecedented environmental changes of the last half-century are affecting global population health. Secondly, the recognition that children have greater vulnerability to environmental hazards and are inadequately protected by current regulatory standards. Efforts to redress this situation have shaped the current thrust in environmental health research toward preventing further harm to children’s health. The disproportionate vulnerability of children to environmental hazards can be explained by several reasons. Children are not “little adults.” It is known that children have greater risk of exposure and greater risk of harm compared to adults for many reasons that are unique to each developmental stage. Their behaviour and activity patterns bring them into greater contact with toxins. Children have important biological differences. Immature developing organs and tissues are more vulnerable to harm from toxic exposures. Immature metabolic and physiological systems less effectively protect the child from toxic exposure and effects. In addition, children have additional pathways of exposure that are not applicable to adults, e.g., in utero, via breast milk and via products such as toys, clothing, etc. Children also have a longer “shelf life.” They have much more of their life ahead of them during which time they will be exposed and may develop health problems as a result. Finally, children are more often involuntarily exposed and unable to avoid exposures of their own accord [1]. Due to the AIDS catastrophe in Sub-Saharan Africa, the numbers of children in difficult circumstances have increased. To mitigate the effects of the catastrophe, charitable organizations have sprung up to establish homes for such children, especially those orphaned by AIDS or those infected with HIV. It is important to ensure that environmental health hazards and risks are minimized in these children’s homes. By use of a conceptual synthesis approach, the authors attempt to generate guidelines from literature for environmental health management in children’s homes in sub-Saharan Africa. PMID:18180543

  18. Guidelines for environmental health management in children's homes in sub-Sahara Africa.

    PubMed

    Muruka, Charles; Muruka, Andrew

    2007-12-01

    The field of environmental health focuses on the relationships between human health and well being and the influence of the physical, social and societal environments. Our understanding of the environment-health interface has progressed because of two relatively recent insights: First, the recognition that the unprecedented environmental changes of the last half-century are affecting global population health. Secondly, the recognition that children have greater vulnerability to environmental hazards and are inadequately protected by current regulatory standards. Efforts to redress this situation have shaped the current thrust in environmental health research toward preventing further harm to children's health. The disproportionate vulnerability of children to environmental hazards can be explained by several reasons. Children are not "little adults." It is known that children have greater risk of exposure and greater risk of harm compared to adults for many reasons that are unique to each developmental stage. Their behaviour and activity patterns bring them into greater contact with toxins. Children have important biological differences. Immature developing organs and tissues are more vulnerable to harm from toxic exposures. Immature metabolic and physiological systems less effectively protect the child from toxic exposure and effects. In addition, children have additional pathways of exposure that are not applicable to adults, e.g., in utero, via breast milk and via products such as toys, clothing, etc. Children also have a longer "shelf life." They have much more of their life ahead of them during which time they will be exposed and may develop health problems as a result. Finally, children are more often involuntarily exposed and unable to avoid exposures of their own accord [1]. Due to the AIDS catastrophe in Sub- Saharan Africa, the numbers of children in difficult circumstances have increased. To mitigate the effects of the catastrophe, charitable organizations have sprung up to establish homes for such children, especially those orphaned by AIDS or those infected with HIV. It is important to ensure that environmental health hazards and risks are minimized in these children's homes. By use of a conceptual synthesis approach, the authors attempt to generate guidelines from literature for environmental health management in children's homes in sub-Saharan Africa. PMID:18180543

  19. A Research Agenda on Assessing and Remediating Home Dampness and Mold to Reduce Dampness-Related Health Effects

    SciTech Connect

    Mendell, Mark J.

    2015-05-28

    This report briefly summarizes, based on recent review articles and selected more recent research reports, current scientific knowledge on two topics: assessing unhealthy levels of indoor D/M in homes and remediating home dampness-related problems to protect health. Based on a comparison of current scientific knowledge to that required to support effective, evidence-based, health-protective policies on home D/M, gaps in knowledge are highlighted, prior questions and research questions specified, and necessary research activities and approaches recommended.

  20. A Research Agenda on Assessing and Remediating Home Dampness and Mold to Reduce Dampness-Related Health Effects

    SciTech Connect

    Mendell, Mark J.

    2015-06-01

    This report briefly summarizes, based on recent review articles and selected more recent research reports, current scientific knowledge on two topics: assessing unhealthy levels of indoor D/M in homes and remediating home dampness-related problems to protect health. Based on a comparison of current scientific knowledge to that required to support effective, evidence-based, health-protective policies on home D/M, gaps in knowledge are highlighted, prior questions and research questions specified, and necessary research activities and approaches recommended.

  1. Fragmented implementation of maternal and child health home-based records in Vietnam: need for integration

    PubMed Central

    Aiga, Hirotsugu; Nguyen, Vinh Duc; Nguyen, Cuong Dinh; Nguyen, Tho Thi Thi; Nguyen, Lien Thi Phuong

    2016-01-01

    Background Home-based records (HBRs) are globally implemented as the effective tools that encourage pregnant women and mothers to timely and adequately utilise maternal and child health (MCH) services. While availability and utilisation of nationally representative HBRs have been assessed in several earlier studies, the reality of a number of HBRs subnationally implemented in a less coordinated manner has been neither reported nor analysed. Objectives This study is aimed at estimating the prevalence of HBRs for MCH and the level of fragmentation of and overlapping between different HBRs for MCH in Vietnam. The study further attempts to identify health workers’ and mothers’ perceptions towards HBR operations and utilisations. Design A self-administered questionnaire was sent to the provincial health departments of 28 selected provinces. A copy of each HBR available was collected from them. A total of 20 semi-structured interviews with health workers and mothers were conducted at rural communities in four of 28 selected provinces. Results Whereas HBRs developed exclusively for maternal health and exclusively for child health were available in four provinces (14%) and in 28 provinces (100%), respectively, those for both maternal health and child health were available in nine provinces (32%). The mean number of HBRs in 28 provinces (=5.75) indicates over-availability of HBRs. All 119 minimum required items for recording found in three different HBRs under nationwide scale-up were also included in the Maternal and Child Health Handbook being piloted for nationwide scaling-up. Implementation of multiple HBRs is likely to confuse not only health workers by requiring them to record the same data on several HBRs but also mothers about which HBR they should refer to and rely on at home. Conclusions To enable both health workers and pregnant women to focus on only one type of HBR, province-specific HBRs for maternal and/or child health need to be nationally standardised. Moreover, to ensure a continuum of maternal, newborn, and child health care, the HBRs currently fragmented into different MCH stages (i.e. pregnancy, delivery, child immunisation, child growth, and child development) should be integrated. Standardisation and integration of HBRs will help increase technical efficiency and financial sustainability of HBR operations. PMID:26928218

  2. Methodologic challenges of randomized controlled studies on in-home comprehensive geriatric assessment: the EIGER project. Evaluation of In-Home Geriatric Health Visits in Elderly Residents.

    PubMed

    Stuck, A E; Zwahlen, H G; Neuenschwander, B E; Meyer Schweizer, R A; Bauen, G; Beck, J C

    1995-06-01

    Previous controlled studies have shown that preventive home visits are a promising method for disability prevention in elderly persons; however, due to the lack of data on cost effectiveness and optimal intervention methods, there is still debate on their usefulness. Therefore, additional controlled studies must use new methods to resolve these unanswered issues. We present a novel approach used in the project EIGER (Evaluation of In-Home Geriatric Health Visits in Elderly Residents), an ongoing randomized controlled trial of preventive home visits in community-residing persons aged 75 years and older in Bern, Switzerland. The intervention consists of in-home visits with structured comprehensive geriatric assessment and follow-up by specially trained nurses who collaborate with geriatricians and an interdisciplinary team. Special methods were used to optimize the sample size, to improve the health care cost analysis, to minimize and explore refusal to participate, to apply stratified randomization for subgroup analysis, and to evaluate the intervention process with a tracer method. Selected baseline findings (N = 791, mean age 82 years, 73% female) include uncontrolled systolic hypertension (54%), balance/gait disorder (9%), cognitive impairment (7%), 6 or more medications (21%), depressive symptoms (10%), and impaired basic ADL (15%). Baseline findings demonstrate that this study is likely to contribute to some of the unresolved issues of in-home prevention for older persons. PMID:8547381

  3. Coaching your unit team for results.

    PubMed

    Detmer, Sarah S

    2002-09-01

    Communication and critical thinking skills are core to the coaching processes. Bringing the coaching role to the individual and team level at the bedside is the key to improved results in patient care, nurse retention, clinical performance including error reduction, negotiation, and staff empowerment. Application of coaching concepts where the nurse meets the patient insures the growth and effectiveness of a coaching culture. Clinical review, individual communication, and teamwork examples are explored as effective arenas for coaching at the unit level. PMID:12271765

  4. Progress of Ontarios Family Health Team Model: A Patient-Centered Medical Home

    PubMed Central

    Rosser, Walter W.; Colwill, Jack M.; Kasperski, Jan; Wilson, Lynn

    2011-01-01

    Ontarios Family Health Team (FHT) model, implemented in 2005, may be North Americas largest example of a patient-centered medical home. The model, based on multidisciplinary teams and an innovative incentive-based funding system, has been developed primarily from fee-for-service primary care practices. Nearly 2 million Ontarians are served by 170 FHTs. Preliminary observations suggest high satisfaction among patients, higher income and more gratification for family physicians, and trends for more medical students to select careers in family medicine. Popular demand is resulting in expansion to 200 FHTs. We describe the development, implementation, reimbursement plan, and current status of this multidisciplinary model, relating it to the principles of the patient-centered medical home. We also identify its potential to provide an understanding of many aspects of primary care. PMID:21403144

  5. Health Behaviors and Overweight in Nursing Home Employees: Contribution of Workplace Stressors and Implications for Worksite Health Promotion

    PubMed Central

    Miranda, Helena; Gore, Rebecca J.; Boyer, Jon; Nobrega, Suzanne; Punnett, Laura

    2015-01-01

    Background. Many worksite health promotion programs ignore the potential influence of working conditions on unhealthy behaviors. Methods. A study of nursing home employees (56% nursing aides) utilized a standardized questionnaire. We analyzed the cross-sectional associations between workplace stressors and obesity, cigarette smoking, and physical inactivity. Results. Of 1506 respondents, 20% reported exposure to three or more workplace stressors (physical or organizational), such as lifting heavy loads, low decision latitude, low coworker support, regular night work, and physical assault. For each outcome, the prevalence ratio was between 1.5 and 2 for respondents with four or five job stressors. Individuals under age 40 had stronger associations between workplace stressors and smoking and obesity. Conclusions. Workplace stressors were strongly associated with smoking, obesity, and physical inactivity, even among the lowest-status workers. Current working conditions affected younger workers more than older workers. Although this study is cross-sectional, it has other strengths, including the broad range of work stressors studied. Strenuous physical work and psychosocial strain are common among low-wage workers such as nursing home aides. Workplace health promotion programs may be more effective if they include measures to reduce stressful work environment features, so that working conditions support rather than interfere with employee health. PMID:26380373

  6. Home Oxygen Program review: Regionalization in Vancouver Coastal Health and British Columbia

    PubMed Central

    Sandberg, Dan

    2015-01-01

    Since its inception in the 1980s, the Home Oxygen Program in British Columbia was centrally managed by the Ministry of Health. Initially a small program with few clients across the province, it soon became a large program with many clients and increasing expenditures. A pilot program started in Victoria (British Columbia) in 1996 demonstrated that managing the program locally could offer better client care, better contract management and significant cost savings. In 2002, the pilot’s model and recommendations were implemented in British Columbia’s five health authorities. The present review details the experiences of regionalizing the program in the Vancouver Coastal Health authority. After fine adjustments to the model were developed and new contracts and criteria changes made, better care for clients was provided than the previous centralized model at a reduced cost to the taxpayer. PMID:26078624

  7. The impact of living in a care home on the health and wellbeing of spinal cord injured people.

    PubMed

    Smith, Brett; Caddick, Nick

    2015-04-01

    In the UK, 20% of people with spinal cord injury (SCI) are discharged from rehabilitation into an elderly care home. Despite this, and knowledge that the home is central to health and wellbeing, little research has examined the impact of being in care homes on the health and wellbeing of people with SCI. The purpose of this study was to address this gap. Twenty adults who lived in care homes or had done so recently for over two years were interviewed in-depth. Qualitative data were analyzed using inductive thematic analysis. Analyses revealed that living in a care home environment severely damages quality of life, physical health and psychological wellbeing in the short and long-term. Reasons why quality of life, health, and wellbeing were damaged are identified. These included a lack of freedom, control, and flexibility, inability to participate in community life, inability to sustain relationships, safety problems, restricted participation in work and leisure time physical activity, lack of meaning, self-expression, and a future, loneliness, difficulties with the re-housing process, depression, and suicidal thoughts and actions. It is concluded that for people with SCI, the care home environment violates social dignity, is oppressive, and denies human rights. Implications for housing and health care policies are also offered. PMID:25884273

  8. The Impact of Living in a Care Home on the Health and Wellbeing of Spinal Cord Injured People

    PubMed Central

    Smith, Brett; Caddick, Nick

    2015-01-01

    In the UK, 20% of people with spinal cord injury (SCI) are discharged from rehabilitation into an elderly care home. Despite this, and knowledge that the home is central to health and wellbeing, little research has examined the impact of being in care homes on the health and wellbeing of people with SCI. The purpose of this study was to address this gap. Twenty adults who lived in care homes or had done so recently for over two years were interviewed in-depth. Qualitative data were analyzed using inductive thematic analysis. Analyses revealed that living in a care home environment severely damages quality of life, physical health and psychological wellbeing in the short and long-term. Reasons why quality of life, health, and wellbeing were damaged are identified. These included a lack of freedom, control, and flexibility, inability to participate in community life, inability to sustain relationships, safety problems, restricted participation in work and leisure time physical activity, lack of meaning, self-expression, and a future, loneliness, difficulties with the re-housing process, depression, and suicidal thoughts and actions. It is concluded that for people with SCI, the care home environment violates social dignity, is oppressive, and denies human rights. Implications for housing and health care policies are also offered. PMID:25884273

  9. Community health workers and home-based care programs for HIV clients.

    PubMed Central

    Johnson, Becky A.; Khanna, Sunil K.

    2004-01-01

    In Nyanza Province, Kenya, estimated HIV prevalence is 22%. Given that more than 80% of the population resides in rural areas, the majority of individuals in Nyanza Province do not have access to medical facilities on a regular basis. In response to the growing demands the HIV epidemic has placed on the people and communities in this region, hundreds of lay individuals have been trained as community health workers to provide home-based care to sick or dying HIV/AIDS clients in rural areas. This paper discusses the role and impact of these community health workers in Nyanza Province, Kenya. It outlines the collaborative relationship between community health workers and the Ministry of Health, examining community health workers' use of extant biomedical structures at the district level to provide services that government-run health facilities lack the monetary resources or personnel to provide. Finally, it explores the role played by community health workers in providing HIV/AIDS education to individuals in an attempt to prevent further infections. PMID:15101670

  10. How family carers engage with technical health procedures in the home: a grounded theory study

    PubMed Central

    McDonald, Janet; McKinlay, Eileen; Keeling, Sally; Levack, William

    2015-01-01

    Objectives To explore the experiences of family carers who manage technical health procedures at home and describe their learning process. Design A qualitative study using grounded theory. Participants New Zealand family carers (21 women, 5 men) who managed technical health procedures such as enteral feeding, peritoneal dialysis, tracheostomy care, a central venous line or urinary catheter. In addition, 15 health professionals involved in teaching carers were interviewed. Methods Semistructured interviews were coded soon after completion and preliminary analysis influenced subsequent interviews. Additional data were compared with existing material and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was described. Interviewing continued until no new ideas emerged and concepts were well defined. Results The response of carers to the role of managing technical health procedures in the home is presented in terms of five dispositions: (1) Embracing care, (2) Resisting, (3) Reluctant acceptance, (4) Relinquishing and (5) Being overwhelmed. These dispositions were not static and carers commonly changed between them. Embracing care included cognitive understanding of the purpose and benefits of a procedure; accepting a ‘technical’ solution; practical management; and an emotional response. Accepting embrace is primarily motivated by perceived benefits for the recipient. It may also be driven by a lack of alternatives. Resisting or reluctant acceptance results from a lack of understanding about the procedure or willingness to manage it. Carers need adequate support to avoid becoming overwhelmed, and there are times when it is appropriate to encourage them to relinquish care for the sake of their own needs. Conclusions The concept of embracing care encourages health professionals to extend their attention beyond simply the practical aspects of technical procedures to assessing and addressing carers’ emotional and behavioural responses to health technology during the training process. PMID:26150143

  11. Association Between Patient-Centered Medical Home Rating and Operating Cost at Federally Funded Health Centers

    PubMed Central

    Nocon, Robert S.; Sharma, Ravi; Birnberg, Jonathan M.; Ngo-Metzger, Quyen; Lee, Sang Mee; Chin, Marshall H.

    2013-01-01

    Context Little is known about the cost associated with a health centers rating as a patient-centered medical home (PCMH). Objective To determine whether PCMH rating is associated with operating cost among health centers funded by the US Health Resources and Services Administration. Design, Setting, and Participants Cross-sectional study of PCMH rating and operating cost in 2009. PCMH rating was assessed through surveys of health center administrators conducted by Harris Interactive of all 1009 Health Resources and Services Administrationfunded community health centers. The survey provided scores from 0 (worst) to 100 (best) for total PCMH score and 6 subscales: access/communication, care management, external coordination, patient tracking, test/referral tracking, and quality improvement. Costs were obtained from the Uniform Data System reports submitted to the Health Resources and Services Administration. We used generalized linear models to determine the relationship between PCMH rating and operating cost. Main Outcome Measures Operating cost per physician full-time equivalent, operating cost per patient per month, and medical cost per visit. Results Six hundred sixty-nine health centers (66%) were included in the study sample, with 340 excluded because of nonresponse or incomplete data. Mean total PCMH score was 60 (SD,12; range, 2190). For the average health center, a 10-point higher total PCMH score was associated with a $2.26 (4.6%) higher operating cost per patient per month (95% CI, $0.86$4.12). Among PCMH subscales, a 10-point higher score for patient tracking was associated with higher operating cost per physician full-time equivalent ($27 300; 95% CI,$3047$57 804) and higher operating cost per patient per month ($1.06;95%CI,$0.29$1.98). A 10-point higher score for quality improvement was also associated with higher operating cost per physician full-time equivalent ($32 731; 95% CI, $1571$73 670) and higher operating cost per patient per month ($1.86; 95% CI, $0.54$3.61). A 10-point higher PCMH subscale score for access/communication was associated with lower operating cost per physician full-time equivalent ($39 809; 95% CI, $1893$63 169). Conclusions According to a survey of health center administrators, higher scores on a scale that assessed 6 aspects of the PCMH were associated with higher health center operating costs. Two subscales of the medical home were associated with higher cost and 1 with lower cost. PMID:22729481

  12. Ethical conflicts over access to services: patient effects and worker influence in home health.

    PubMed

    Egan, Marcia; Kadushin, Goldie

    2002-01-01

    A survey of home health social workers (N = 51) explored the effects on patients of ethical conflicts over access to services. The findings suggest that patients were as likely to be discharged or not receive services as they were to receive the services without paying a fee. Social workers rated themselves as moderately influential in the resolution of the conflict. Their influence was significantly correlated with patients more often receiving services and less often being discharged. Social work influence was enhanced by recognition of professional expertise and/or through informal networking within the agency. Implications for practice and education are discussed. PMID:12371789

  13. A randomized study of the impact of home health aides on diabetic control and utilization patterns.

    PubMed

    Hopper, S V; Miller, J P; Birge, C; Swift, J

    1984-06-01

    Home health aides were offered to half of a group of 227 low-income diabetic clinic patients; in the group offered aides, fasting blood sugar (FBS) declined when compared to control group (10.1 mg/dl vs an increase of 5.1 mg/dl), and missed clinic appointments and emergency room use also decreased. The group of 44, who, upon offer of an aide actually accepted one, showed a significant increase in eye clinic appointments as well as the greatest decline in FBS (13.9 mg/dl). PMID:6721016

  14. Coping With Client Death: How Prepared Are Home Health Aides and What Characterized Preparedness?

    PubMed Central

    van Riesenbeck, Isabelle; Boerner, Kathrin; Barooah, Adrita; Burack, Orah R.

    2016-01-01

    This study explored the experiences of 80 home health aides (HHAs) whose client died within the last two months. Data collection involved comprehensive semi-structured in-person interviews to try to better understand characteristics of HHAs and their clients associated with preparedness for death. Among those, personal end-of-life (EOL) care preferences of HHAs and having knowledge of preferences and decisions regarding client’s EOL care showed significant links to preparedness. Findings suggest that HHAs’ preparedness for client death could be enhanced both by addressing their personal views on EOL care and by providing more information about the client’s EOL care plans. PMID:26496432

  15. A mobile-health application to detect wandering patterns of elderly people in home environment.

    PubMed

    Vuong, N K; Goh, S G A; Chan, S; Lau, C T

    2013-01-01

    Wandering is a common and risky behavior in people with dementia (PWD). In this paper, we present a mobile healthcare application to detect wandering patterns in indoor settings. The application harnesses consumer electronics devices including WiFi access points and mobile phones and has been tested successfully in a home environment. Experimental results show that the mobile-health application is able to detect wandering patterns including lapping, pacing and random in real-time. Once wandering is detected, an alert message is sent using SMS (Short Message Service) to attending caregivers or physicians for further examination and timely interventions. PMID:24111292

  16. Mobile Web-Based Monitoring and Coaching: Feasibility in Chronic Migraine

    PubMed Central

    Mak, Sander B; Houtveen, Jan H; Kleiboer, Annet M; van Doornen, Lorenz JP

    2007-01-01

    Background The Internet can facilitate diary monitoring (experience sampling, ecological momentary assessment) and behavioral coaching. Online digital assistance (ODA) is a generic tool for mobile Web-based use, intended as an adjuvant to face-to-face or Internet-based cognitive behavioral treatment. A current ODA application was designed to support home-based training of behavioral attack prevention in chronic migraine, focusing on the identification of attack precursors and the support of preventive health behaviour. Objective The aim was to establish feasibility of the ODA approach in terms of technical problems and participant compliance, and ODA acceptability on the basis of ratings of user-friendliness, potential burden, and perceived support of the training for behavioral attack prevention in migraine. Methods ODA combines mobile electronic diary monitoring with direct human online coaching of health behavior according to the information from the diary. The diary contains three parts covering the following: (1) migraine headache and medication use, (2) attack precursors, and (3) self-relaxation and other preventive behavior; in addition, menstruation (assessed in the evening diary) and disturbed sleep (assessed in the morning diary) is monitored. The pilot study consisted of two runs conducted with a total of five women with chronic migraine without aura. ODA was tested for 8.5 days (range 4-12 days) per participant. The first test run with three participants tested 4-5 diary prompts per day. The second run with another three participants (including one subject who participated in both runs) tested a reduced prompting scheme (2-3 prompts per day) and minor adaptations to the diary. Online coaching was executed twice daily on workdays. Results ODA feasibility was established on the basis of acceptable data loss (1.2% due to the personal digital assistant; 5.6% due to failing Internet transmission) and good participant compliance (86.8% in the second run). Run 1 revealed some annoyance with the number of prompts per day. Overall ODA acceptability was evident by the positive participant responses concerning user-friendliness, absence of burden, and perceived support of migraine attack prevention. The software was adapted to further increase the flexibility of the application. Conclusions ODA is feasible and well accepted. Tolerability is a sensitive issue, and the balance between benefit and burden must be considered with care. ODA offers a generic tool to combine mobile coaching with diary monitoring,independently of time and space. ODA effects on improvement of migraine remain to be established. PMID:18166526

  17. Adverse health effects among adults exposed to home dampness and molds.

    PubMed

    Dales, R E; Burnett, R; Zwanenburg, H

    1991-03-01

    To investigate the association between home dampness and mold and health, questionnaires were administered through the primary school system to parents of school-aged children in six regions of Canada. The present report focuses on the symptoms of the 14,799 adults at least 21 yr of age. The overall response rate was 83%, and missing values for individual variables ranged from 3 to 8%. The presence of home dampness and/or molds (that is, damp spots, visible mold or mildew, water damage, and flooding) was reported by 38% of respondents. The prevalence of lower respiratory symptoms (any cough, phlegm, wheeze, or wheeze with dyspnea) was increased among those reporting dampness or mold compared with those not reporting dampness or mold as follows: 38 versus 27% among current smokers, 21 versus 14% among exsmokers, and 19 versus 11% among nonsmokers (all p values less than 0.001). This association persisted after adjusting for several sociodemographic variables (including age, sex, and region) and several other exposure variables (including active and passive cigarette smoke, natural gas heating, and wood stoves). The odds ratio between symptoms and dampness was 1.62 (95% confidence interval, 1.48 to 1.78) in the final model chosen. This association persisted despite stratification by the presence of allergies or asthma. Exposure to home dampness and mold may be a risk factor for respiratory disease in the Canadian population. PMID:2001058

  18. Why Do Women Deliver at Home? Multilevel Modeling of Ethiopian National Demographic and Health Survey Data

    PubMed Central

    Yebyo, Henock; Alemayehu, Mussie; Kahsay, Alemayehu

    2015-01-01

    Background Despite of the existing intensive efforts to improve maternal health in Ethiopia, the proportion of birth delivered at home remains high and is still the top priority among the national health threats. Objective The study aimed to examine effects of individual women and community-level factors of womens decision on place of delivery in Ethiopia. Methods Data were obtained from the nationally representative 2011 Ethiopian Demographic and Health Survey (EDHS) which used a two-stage cluster sampling design with rural-urban and regions as strata. The EDHS collected data from a big sample size but our study focused on a sample of 7,908 women whose most recent birth was within five years preceding 2011 and 576 communities in which the women were living in. The data were analyzed using a two-level mixed-effects logistic regression to determine fixed-effects of individual- and community-level factors and random-intercept of between-cluster characteristics. Results In the current study, 6980 out of 7908 deliveries (88.3%) took place at home. Lower educational levels (OR=2.74, 95%CI:1.84,4.70; p<0.0001), making no or only a limited number of ANC visits (OR=3.72,95%CI:2.85, 4.83; p<0.0001), non-exposure to media (OR=1.51, 95%CI 1.13, 2.01; p=0.004), higher parity (OR=2.68, 95%CI:1.96,3.68; p<0.0001), and perceived distance problem to reach health facilities (OR=1.29, 95%CI:1.03,1.62; p=0.022) were positively associated with home delivery. About 75% of the total variance in the odds of giving birth at home was accounted for the between-community differences of characteristics (ICC=0.75, p<0.0001). With regard to community-level characteristics, rural communities (OR=4.67, 95%CI:3.06,7.11; p<0.0001), pastoralist communities (OR=4.53, 95%CI:2.81,7.28; p<0.0001), communities with higher poverty levels (OR=1.49 95%CI:1.08,2.22; p=0.048), with lower levels of ANC utilization (OR=2.01, 95%CI:1.42,2.85; p<0.0001) and problem of distance to a health facility (OR=1.29, 95%CI:1.03,1.62; p=0.004) had a positive influence on women to give birth at home. Conclusions Not only individual characteristics of women, but also community-level factors determine womens decision to deliver at home. PMID:25874886

  19. Medical Home Access Among American Indian and Alaska Native Children in 7 States: National Survey of Childrens Health

    PubMed Central

    Kroelinger, Charlan D.; Kogan, Michael D.

    2016-01-01

    To describe the prevalence of medical home among American Indian and Alaska Native children (AIAN) compared to non-Hispanic white (NHW) children and identify areas for improvement in the provision of care within a medical home. Prevalence of medical home, defined as family-centered, comprehensive, coordinated, compassionate, culturally effective care, including a personal doctor or nurse and usual care location, was estimated using 2007 National Survey of Childrens Health data. Analyses included 117 year-olds in states reporting AIAN race as a distinct category (Alaska, Arizona, Montana, New Mexico, North Dakota, Oklahoma, and South Dakota, n = 9,764). Associations between medical home and demographic (childs age, household education and income, and state) and health-related [childs insurance status, special health care need status, and past year Indian Health Service (IHS) utilization] characteristics were assessed among AIAN children. Overall, the prevalence of medical home was 27 % lower among AIAN children (42.6, 95 % CI = 34.450.8) than NHW children (58.3, 95 % CI = 56.260.4). Childs age (adjusted OR [aOR] = 2.7, 95 % CI = 1.35.6) was significantly associated with medical home. IHS utilization was associated with medical home among AIAN children with private insurance (aOR = 0.2, 95 % CI = 0.10.4), but not among uninsured or publicly insured children. Care coordination and family-centered care were noted areas for improvement among AIAN children. Less than half of AIAN children had a medical home. Future studies should further examine the intersection between insurance and IHS to determine if enhanced coordination is needed for this population, which is often served by multiple federally-funded health-related programs. PMID:22466686

  20. Smoking and home oxygen therapy--a preventable public health hazard.

    PubMed

    Edelman, David A; Maleyko-Jacobs, Sharron; White, Michael T; Lucas, Charles E; Ledgerwood, Anna M

    2008-01-01

    Patients who continue to smoke while on home oxygen therapy endanger themselves, family members, neighbors, and firefighters and create an expense to society for their medical care. This phenomenon was studied in our burn center. Fourteen patients were identified prospectively during the last 2 years. All were smoking while on nasal oxygen. The 14 patients (10 males) were 45 to 87 years of age. All suffered facial burns. Only one patient had a significant burn (30% TBSA, 20% 3rd degree), but all suffered from an exacerbation of chronic obstructive pulmonary disease. Two patients gave a history of stage IV lung cancer and four patients had newly found squamous cell cancer seen on bronchoscopy. All six patients with lung cancer and one with severe chronic obstructive pulmonary disease died. Of the seven survivors, only one patient quit smoking. Total charges were $2,861,526 and total costs were $938,311. All patients had Medicare or Medicaid on admission. Hospital loss ($432,561) was incurred in those patients admitted more than 4 days whereas a profit ($33,285) was realized in patients admitted less than 4 days. These deaths and financial loss could be reduced by better testing and more precise guidelines as to which patients can safely receive home oxygen. Patients can have their saliva tested for the nicotine breakdown product of cotinine; the test takes 10 minutes. The American Burn Association, in conjunction with the American College of Chest Physicians, should address this issue and develop guidelines for physicians who order home oxygen therapy and for state departments of public health who should regulate the companies that deliver home oxygen. PMID:18182908

  1. Mental Health Problems in Norwegian School Children Placed Out-of-Home: The Importance of Family Risk Factors

    ERIC Educational Resources Information Center

    Havnen, Karen Skaale; Jakobsen, Reidar; Stormark, Kjell Morten

    2009-01-01

    The main aim of this article is to explore the association between mental health problems in children placed out-of-home and family risk factors reported as reasons for placement. The sample consisted of 109 Norwegian children aged 6-12 years. Mental health problems were assessed by the Revised Rutter scales reported by the parents and the…

  2. The Role of Specialty Mental Health Care in Predicting Child Welfare and Juvenile Justice Out-of-Home Placements

    ERIC Educational Resources Information Center

    Glisson, Charles; Green, Philip

    2006-01-01

    Objective: This longitudinal, prospective study examines the role of specialty mental health care as provided by community-based, usual-care practice settings in predicting out-of-home placements among children served by a child welfare and juvenile justice system. Method: The mental health needs of 1,249 children from 22 counties in Tennessee

  3. Youth Sports: A Pediatrician's Perspective on Coaching and Injury Prevention

    PubMed Central

    Koester, Michael C.

    2000-01-01

    Objective: My objective is to review the factors that influence youth participation in sports, to discuss the role coaches may play in youth sports injuries, and to call on athletic trainers and other health professionals to become involved in youth sports in an effort to limit injury risk. Background: Millions of American youths participate in team sports. Their primary motivation to participate is to have fun. Unfortunately, large numbers of participants have sustained correspondingly large numbers of injuries. Many injuries can be attributed to improper technique and conditioning methods taught by volunteer coaches. Although not the only contributors to injuries, these may be the most amenable to preventive measures, such as formal instruction for coaches in the areas of proper biomechanics and player-coach communication. Description: I provide an overview of the reasons why children participate in sports, discuss participation motivation, and review the literature on coaches' communication methods that have been proved effective in maximizing learning and enjoyment for young athletes. Clinical Advantages: This article provides certified athletic trainers with the background knowledge needed to take an active role in youth sports injury prevention at the community level. PMID:16558664

  4. Effects of water-damaged homes after flooding: health status of the residents and the environmental risk factors.

    PubMed

    Azuma, Kenichi; Ikeda, Koichi; Kagi, Naoki; Yanagi, U; Hasegawa, Kenichi; Osawa, Haruki

    2014-04-01

    We evaluated the health status of residents and the environmental risk factors of housing after flooding. Questionnaires were distributed to 595 selected households (one adult resident per household) in six areas in Japan which were severely flooded between 2004 and 2010. A total of 379 responses were obtained. Indoor dampness and visible mold growth significantly increased in homes with greater flood damage. The incidence of respiratory, dermal, ocular, and nasal symptoms one week after flooding was significantly higher in flooded homes compared with non-flooded homes, the incidence of psychological disorders was significantly high for six months after flooding, and the incidence of post-traumatic stress disorder was significantly high six months after flooding. Significant risk factors for respiratory and nasal symptoms included proximity to industrial and waste incineration plants. Our results suggest that rapid action should be taken after flooding to ensure adequate public health and environmental hygiene in the water-damaged homes. PMID:23802658

  5. [Relations with emergency medical care and primary care doctor, home health care].

    PubMed

    Azuma, Kazunari; Ohta, Shoichi

    2016-02-01

    Medical care for an ultra-aging society has been shifted from hospital-centered to local community-based. This shift has yielded the so-called Integrated Community Care System. In the system, emergency medical care is considered important, as primary care doctors and home health care providers play a crucial role in coordinating with the department of emergency medicine. Since the patients move depending on their physical condition, a hospital and a community should collaborate in providing a circulating service. The revision of the medical payment system in 2014 clearly states the importance of "functional differentiation and strengthen and coordination of medical institutions, improvement of home health care". As part of the revision, the subacute care unit has been integrated into the community care unit, which is expected to have more than one role in community coordination. The medical fee has been set for the purpose of promoting the home medical care visit, and enhancing the capability of family doctors. In the section of end-of-life care for the elderly, there have been many issues such as reduction of the readmission rate and endorsement of a patient's decision-making, and judgment for active emergency medical care for patient admission. The concept of frailty as an indicator of prognosis has been introduced, which might be applied to the future of emergency medicine. As described above, the importance of a primary doctor and a family doctor should be identified more in the future; thereby it becomes essential for doctors to closely work with the hospital. Advancing the cooperation between a hospital and a community for seamless patient-centered care, the emergency medicine as an integrated community care will further develop by adapting to an ultra-aging society. PMID:26915240

  6. Development of a health management support system for patients with diabetes mellitus at home.

    PubMed

    Tani, Shoko; Marukami, Terutaka; Matsuda, Atsuko; Shindo, Akiko; Takemoto, Keiko; Inada, Hiroshi

    2010-06-01

    Recently, a patient with diabetes mellitus (DM) type 2 has been increasing in Japan. The patient should be managed not only by a specialist but also by himself focusing his attention on the improvement of his lifestyle at home. In the present study, we tried to develop a health management support system by which a diabetic patient in early stage can easily enter his daily life information, i.e. the biological information such as the data of blood sugar levels and blood pressure levels etc., the information of exercise and diet and send the information to the medical institution with a personal digital assistant (PDA). Afterwards, the patient can receive health instruction information by the physician in charge for self-care at his home with a PDA. The daily life information sent from the patient is stored in a server installed at the medical institution and analyzed. The physician can obtain the results of analysis by using a PC and send the instruction information necessary for patient management to the patient at home by using e-mail after diagnosing the patient's condition by the system. To evaluate usability of the developed patient information input system with a PDA, an experiment was conducted by corporation of 20 volunteers who were possible self management and whose age's range from 20s to 60s by questionnaire survey. As a result, almost examinees answered that lifestyle information could be easily entered by the sense like a mobile-phone and lots of positive opinions were obtained. PMID:20503606

  7. Marketing environment dynamics and implications for pricing strategies: the case of home health care.

    PubMed

    Ponsford, B J; Barlow, D

    1999-01-01

    This research reviews the factors affecting the pricing or rate schedules of home health care agencies. A large number of factors affect costs and thus rate structures. The major factors include reimbursement structures with accompanying discount structures, administrative burdens, and risks. Channel issues include bargaining power, competition, and size. Staffing issues affect pricing and product through the provider level, productivity, and quality outcomes. Physician and patient issues include quality concerns and choices. These factors are discussed in light of overall marketing strategy and the interaction of pricing with other marketing controllables such as product, place/distribution, and promotion. Economic and accounting principles are also reviewed with consideration to understanding direct and indirect costs in order to enable negotiators to effectively price health care services. PMID:10623194

  8. Value-based financially sustainable behavioral health components in patient-centered medical homes.

    PubMed

    Kathol, Roger G; Degruy, Frank; Rollman, Bruce L

    2014-01-01

    Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integrate behavioral health services into their structure. Yet in today's health care environment, the incorporation of behavioral services into primary care is exceptional rather than usual practice. In this article, we discuss the components considered necessary to provide sustainable, value-added integrated behavioral health care in the PCMH. These components are to: (1) combine medical and behavioral benefits into one payment pool; (2) target complex patients for priority behavioral health care; (3) use proactive onsite behavioral "teams;" (4) match behavioral professional expertise to the need for treatment escalation inherent in stepped care; (5) define, measure, and systematically pursue desired outcomes; (6) apply evidence-based behavioral treatments; and (7) use cross-disciplinary care managers in assisting the most complicated and vulnerable. By adopting these 7 components, PCHMs will augment their ability to achieve improved health in their patients at lower cost in a setting that enhances ease of access to commonly needed services. PMID:24615314

  9. Home care delivery through the mobile telecommunications platform: the Citizen Health System (CHS) perspective.

    PubMed

    Maglaveras, N; Koutkias, V; Chouvarda, I; Goulis, D G; Avramides, A; Adamidis, D; Louridas, G; Balas, E A

    2002-12-18

    Health delivery practices are shifting towards home care. The reasons are the better possibilities for managing chronic care, controlling health delivery costs, increasing quality of life and quality of health services and the distinct possibility of predicting and thus avoiding serious complications. For the above goals to become routine, new telemedicine and information technology (IT) solutions need to be implemented and integrated in the health delivery scene, and these solutions need to be assessed through evidence-based medicine in order to provide solid proof for their usefulness. Thus, the concept of contact or call centers has emerged as a new and viable reality in the field of IT for health and telemedicine. In this paper we describe a generic contact center that was designed in the context of an EU funded IST for health project with acronym Citizen Health System (CHS). Since the generic contact center is composed by a number of modules, we shall concentrate in the modules dealing with the communication between the patient and the contact center using mobile telecommunications solutions, which can act as link between the internet and the classical computer telephony communication means. We further elaborate on the development tools of such solutions, the interface problems we face, and on the means to convey information from and to the patient in an efficient and medically acceptable way. This application proves the usefulness of wireless technology in providing health care services all around the clock and everywhere the citizen is located, it proves the necessity for restructuring the medical knowledge for education delivery to the patient, and it shows the virtue of interactivity by means of using the limited, yet useful browsing capabilities of the wireless application protocol (WAP) technology. PMID:12467795

  10. Teacher-to-Teacher: The Heart of the Coaching Model

    ERIC Educational Resources Information Center

    Shidler, Linda

    2010-01-01

    Coaching occurs when one professional works closely with another professional to increase productivity or to meet a common outcome. For a coach or mentor to be successful, the teacher must believe in the expertise the coach espouses, and the coach must believe in the teacher's abilities. Through "reflective coaching," teachers and coaches

  11. Catching the Bug: How Virtual Coaching Improves Teaching

    ERIC Educational Resources Information Center

    Allen, Megan

    2014-01-01

    In this article the author describes virtual coaching and why it is so effective. The following six points of virtual coaching are explained: (1) Also known as bug-in-ear coaching, virtual coaching is not new; (2) Virtual coaching can save money and time; (3) Bug-in-ear coaching increases the frequency of observations for novice teachers; (4) It…

  12. Catching the Bug: How Virtual Coaching Improves Teaching

    ERIC Educational Resources Information Center

    Allen, Megan

    2014-01-01

    In this article the author describes virtual coaching and why it is so effective. The following six points of virtual coaching are explained: (1) Also known as bug-in-ear coaching, virtual coaching is not new; (2) Virtual coaching can save money and time; (3) Bug-in-ear coaching increases the frequency of observations for novice teachers; (4) It

  13. Elementary Rehabilitation Nursing Care; a Manual for Nurses and Ancillary Workers in Nursing Homes, Hospitals, Convalescent Facilities, and Public Health Agencies. Public Health Service Publication No. 1436.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Public Health, Denver. Public Health Nursing Section.

    This guide for teacher and student use presents a comprehensive program of physical rehabilitation for aged and physically disabled patients. Developed by the Public Health Nursing Section, the manual was tested by state health department personnel and persons doing inservice teaching in their respective nursing homes. The program is designed to…

  14. Health Care Disparities and Language Use at Home among Latino, Asian American, and American Indian Adolescents: Findings from the California Health Interview Survey

    ERIC Educational Resources Information Center

    Hahm, Hyeouk Chris; Lahiff, Maureen; Barreto, Rose M.; Shin, Sunny; Chen, Wan-Yi

    2008-01-01

    Using the 2001 California Health Interview Survey, this study compared health status, medical insurance, and having a usual source of care for 2,230 ethnic minority adolescents based on language use at home: Group 1, English only; Group 2, both English and another language; and Group 3, exclusively another language. Adjusting for demographic…

  15. Informal Math Coaching by Instant Messaging: Two Case Studies of How University Students Coach K-12 Students

    ERIC Educational Resources Information Center

    Hrastinski, Stefan; Edman, Anneli; Andersson, Fredrik; Kawnine, Tanvir; Soames, Carol-Ann

    2014-01-01

    The aim of this study is to describe and explore how instant messaging (IM) can be used to support informal math coaching. We have studied two projects where university students use IM to coach K-12 students in mathematics. The coaches were interviewed with a focus on how informal coaching works by examining coaching challenges, how coaching can…

  16. Informal Math Coaching by Instant Messaging: Two Case Studies of How University Students Coach K-12 Students

    ERIC Educational Resources Information Center

    Hrastinski, Stefan; Edman, Anneli; Andersson, Fredrik; Kawnine, Tanvir; Soames, Carol-Ann

    2014-01-01

    The aim of this study is to describe and explore how instant messaging (IM) can be used to support informal math coaching. We have studied two projects where university students use IM to coach K-12 students in mathematics. The coaches were interviewed with a focus on how informal coaching works by examining coaching challenges, how coaching can

  17. What does an e-mail address add? - Doing health and technology at home.

    PubMed

    Andreassen, Hege K

    2011-02-01

    There is increasing interest in using electronic mail and other electronic health technologies (e-health technologies) in patient follow-ups. This study sheds light on patients' reception of provider-initiated e-health in their everyday environments. In a research project carried out in Norway (2005-2007), an electronic address for a hospital dermatology ward was offered to 50 patient families for improved access to expert advice from the patients' homes. Drawing on semi-structured interviews with 12 families, this paper explores how the electronic address was integrated into everyday health practice. The research illuminates how the electronic address did not only represent changes related to treatment procedures and frequency or nature of expert contact; it was also important to other practices in the everyday lives of the families of patients with chronic illness. Once in place on the patients' computers, the electronic address was ascribed at least four different roles: it was used as the intended riverbed for a flow of information, but also as a safety alarm, as a shield to the medical gaze and as a token of competence in care and parenting. The multiplicity in use and reception of an electronic address in patient settings illustrates the need to include patients' everyday practices in current professional and political discussions of e-mail and other e-health technologies. Thus this paper argues that there is a need for research on electronic patient-provider communication that moves beyond frequency of use and questions on how technology will affect medical encounters. Social science equally needs to investigate how provider-initiated e-health technologies gets involved in patients' moral and social performance of health and illness in everyday life. PMID:21208702

  18. Coaching Conversations in Early Childhood Programs: The Contributions of Coach and Coachee

    ERIC Educational Resources Information Center

    Jayaraman, Gayatri; Marvin, Christine; Knoche, Lisa; Bainter, Sue

    2015-01-01

    Studies to date have linked early childhood (EC) coaching to child, family, and teacher outcomes but have not investigated "what" is happening in a coaching conversation. This exploratory study specifically unpacks nuances associated with the coaching conversation process and associations between the EC coaches' behaviors and coachees'…

  19. Exploring Coaching Actions Based on Developed Values: A Case Study of a Female Hockey Coach

    ERIC Educational Resources Information Center

    Callary, Bettina; Werthner, Penny; Trudel, Pierre

    2013-01-01

    There are few empirical studies that demonstrate how values are developed and how they are linked to coaching actions. There can be a discrepancy between the statement of coaches' values and their actual coaching actions. In order to examine how coaching actions are influenced by values that are developed over a lifetime, the purpose of this

  20. Coaches' and Principals' Conceptualizations of the Roles of Elementary Mathematics Coaches

    ERIC Educational Resources Information Center

    Salkind, Gwenanne M.

    2010-01-01

    Many schools employ coaches to support mathematics instruction and student learning. This research study investigated the roles of coaches from five school districts in Virginia. Participants included 125 elementary mathematics coaches and 59 principals. Results from cross-sectional surveys revealed that most coaches did not have a degree in

  1. The First Step: Assessing the Coaching Philosophies of Pre-Service Coaches

    ERIC Educational Resources Information Center

    Collins, Karen; Barber, Heather; Moore, Kristina; Laws, Amanda

    2011-01-01

    Coaches are influential in creating positive and achievement-oriented sport environments and the development of a sound philosophy is the key to successful coaching (Martens, 2004). Yet, few coaches spend significant time early in their careers developing and modifying their philosophical beliefs (Wilcox & Trudel, 1998). While coaching educators

  2. Implementation of a Coaching Program for School Principals: Evaluating Coaches' Strategies and the Results

    ERIC Educational Resources Information Center

    Huff, Jason; Preston, Courtney; Goldring, Ellen

    2013-01-01

    We present a multi-phase coaching model that was implemented to help principals improve their instructional leadership practices. We then discuss a rubric based on this coaching model that we used to evaluate coaches' implementation of key model phases and to identify principals' responses to the coaching. After presenting the leadership

  3. Coaching Conversations in Early Childhood Programs: The Contributions of Coach and Coachee

    ERIC Educational Resources Information Center

    Jayaraman, Gayatri; Marvin, Christine; Knoche, Lisa; Bainter, Sue

    2015-01-01

    Studies to date have linked early childhood (EC) coaching to child, family, and teacher outcomes but have not investigated "what" is happening in a coaching conversation. This exploratory study specifically unpacks nuances associated with the coaching conversation process and associations between the EC coaches' behaviors and coachees'

  4. [Home visits by community health agents to families with frail elderly individuals].

    PubMed

    Magalhes, Kelly Alves; Giacomin, Karla Cristina; Santos, Wagner Jorge Dos; Firmo, Joslia Oliveira Arajo

    2015-12-01

    The scope of this study was to understand the significance that community health agents attribute to the home visit conducted with families with frail elderly individuals and if the technique has served as a tool for care for this group. Semi-structured interviews were conducted with community health agents in the city of Bambui in the State of Minas Gerais. They were all recorded, transcribed and analyzed. The Signs, Meanings and Actions model was used in the collection and analysis of data. In their ways of thinking and acting, seeing aging as being inexorably associated with disability, the agents "try to help" people who have a sociocultural context similar to theirs to get access to health services. As they do not receive guidelines for working with families with elderly individuals, they intuitively establish "equitable" criteria that ensure they visit more risk groups (the elderly, needy, sick and poor). The visits are in response to immediate demands from these groups, but the focus of attention is based on sickness and the provision of medication and procedures. The need for reorientation of the care model, implementation of the National Health Policy for the Elderly and specific actions of care to families with frail elderly individuals are not perceived. PMID:26691803

  5. Peri-urbanization and in-home environmental health risks: the side effects of planned and unplanned growth.

    PubMed

    Graham, Jay; Gurian, Patrick; Corella-Barud, Vernica; Avitia-Diaz, Raquel

    2004-10-01

    Urbanization is occurring at an explosive rate, and many cities, especially in low-income countries, are struggling to control growth and stop the development of unplanned communities. This research investigates the in-home environmental health risks associated with planned and unplanned growth in peri-urban communities (neighborhoods) of a rapidly growing city in Northern Mexico. Surveys were conducted during home visits to 98 households in a planned community and 202 households in unplanned communities of comparable, though slightly higher, socio-economic status. To assess the differences for the two types of communities, multiple risk factors were measured and compared. Results showed that households in both planned and unplanned communities were vulnerable to poor environmental health conditions, but more risk factors and negative health outcomes were associated with unplanned communities. Some of the obvious benefits of living in a planned community included better-constructed homes and water and sewer connections. Other study results indicated that households in the planned community reported fewer cases of respiratory problems (P = 0.039) and dizziness (P = 0.009). They were also less likely to store insecticides and other chemicals inappropriately in their home (P < 0.001). Providing adequate housing infrastructure appears to provide a number of important benefits to health and behavior beyond the simple provision of additional amenities in the home. PMID:15575560

  6. Integration architecture of a mobile virtual health record for shared home care.

    PubMed

    Hgglund, Maria; Scandurra, Isabella; Mostrm, Dennis; Koch, Sabine

    2005-01-01

    The coexistence of different information systems that are unable to communicate with each other is a persistent problem in health care in general, and in shared care in particular. This is especially critical when it comes to information access needed at the point of care, e.g. in the patient's home. The purpose of this paper is to present the technical architecture of a virtual health record (VHR) that both integrates information from different electronic health records (EHRs) and allows for documenting at the point of care using mobile devices. The VHR supports a seamless information and communication flow between different care providers giving them mobile access to selected patient-oriented information. A service oriented system architecture where database functionality and services are separated has been implemented. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardised way. Major requirements for the VHR have been documentation support at the point of care, integrated presentation of the information from different feeder systems, and the possibility of offline access to the data on handheld devices. Therefore, publishing was chosen for the integration design. A patient centred XML schema is published as an interface for integration with the information broker. The feeder systems deliver their information in XML.-files that are mapped against the ideal schema and inserted into the mediator database. The paper describes both an online web application and an offline solution that was implemented on personal digital assistants (PDAs). The system has been introduced in a Swedish home care district with an established fiber-optical network infrastructure connecting all the locations forming the study site. PMID:16160282

  7. From risky to safer home care: health care assistants striving to overcome a lack of training, supervision, and support

    PubMed Central

    Swedberg, Lena; Chiriac, Eva Hammar; Trnkvist, Lena; Hylander, Ingrid

    2013-01-01

    Patients receiving home care are becoming increasingly dependent upon competent caregivers 24-h availability due to their substantial care needs, often with advanced care and home care technology included. In Sweden, care is often carried out by municipality-employed paraprofessionals such as health care assistants (HC assistants) with limited or no health care training, performing advanced care without formal training or support. The aim of this study was to investigate the work experience of the HC assistants and to explore how they manage when delivering 24-h home care to patients with substantial care needs. Grounded theory methodology involving multiple data sources comprising interviews with HC assistants (n=19) and field observations in patients homes was used to collect data and constant comparative analysis was used for analysis. The initial analysis revealed a number of barriers, competence gap; trapped in the home setting; poor supervision and unconnected to the patient care system, describing the risks associated with the situations of HC assistants working in home care, thus affecting their working conditions as well as the patient care. The core process identified was the HC assistants strivings to combine safe home care with good working conditions by using compensatory processes. The four identified compensatory processes were: day-by-day learning; balancing relations with the patient; self-managing; and navigating the patient care system. By actively employing the compensatory processes, the HC assistants could be said to adopt an inclusive approach, by compensating for their own barriers as well as those of their colleagues and taking overall responsibility for their workplace. In conclusion, the importance of supporting HC assistants in relation to their needs for training, supervision,and support from health care professionals must be addressed when organising 24-h home care to patients with substantial care needs in the future. PMID:23706410

  8. eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop

    PubMed Central

    Barakat, Ansam; Woolrych, Ryan D; Sixsmith, Andrew; Kearns, William D

    2013-01-01

    Background The demand for care is increasing, whereas in the near future the number of people working in professional care will not match with the demand for care. eHealth technology can help to meet the growing demand for care. Despite the apparent positive effects of eHealth technology, there are still barriers to technology adoption related to the absence of a composite set of knowledge and skills among health care professionals regarding the use of eHealth technology. Objective The objective of this paper is to discuss the competencies required by health care professionals working in home care, with eHealth technologies such as remote telecare and ambient assisted living (AAL), mobile health, and fall detection systems. Methods A two-day collaborative workshop was undertaken with academics across multiple disciplines with experience in working on funded research regarding the application and development of technologies to support older people. Results The findings revealed that health care professionals working in home care require a subset of composite skills as well as technology-specific competencies to develop the necessary aptitude in eHealth care. This paper argues that eHealth care technology skills must be instilled in health care professionals to ensure that technologies become integral components of future care delivery, especially to support older adults to age in place. Educating health care professionals with the necessary skill training in eHealth care will improve service delivery and optimise the eHealth care potential to reduce costs by improving efficiency. Moreover, embedding eHealth care competencies within training and education for health care professionals ensures that the benefits of new technologies are realized by casting them in the context of the larger system of care. These care improvements will potentially support the independent living of older persons at home. Conclusions This paper describes the health care professionals’ competencies and requirements needed for the use of eHealth technologies to support elderly adults to age in place. In addition, this paper underscores the need for further discussion of the changing role of health care professionals working in home care within the context of emerging eHealth care technologies. The findings are of value to local and central government, health care professionals, service delivery organizations, and commissioners of care to use this paper as a framework to conduct and develop competencies for health care professionals working with eHealth technologies. PMID:25075233

  9. Under pressure, out of control, or home alone? Reviewing research and policy debates on the occupational health and safety effects of outsourcing and home-based work.

    PubMed

    Quinlan, Michael; Bohle, Philip

    2008-01-01

    The practice of outsourcing or subcontracting of work has grown rapidly in most countries over the past two decades. Outsourcing, de-institutionalization, and a range of other practices have also resulted in a growth of home-based work. Home-based workers, even when not part of a subcontracting process, operate in an isolated situation remote from their employer and other workers. Do such work arrangements expose workers to greater risk of injury, illness, or assault? The authors reviewed international studies of the occupational health and safety (OHS) effects of subcontracting and home-based work undertaken over the past 20 years. Of the 25 studies analyzed, 92 percent found poorer OHS outcomes. The studies were examined for clues about the reasons for these negative outcomes. The authors also identified similarities and differences between subcontracting and home-based work. Despite the evidence of poor OHS outcomes, research into outsourcing has stalled in recent years. With notable exceptions, governments have taken little account of findings on these work arrangements in their laws and policies, in part because neoliberal ideas dominate national and global policy agendas. The authors examine policy challenges and regulatory responses and make suggestions for future research and policy interventions. PMID:18724579

  10. Surveying multiple health professional team members within institutional settings: an example from the nursing home industry.

    PubMed

    Clark, Melissa A; Roman, Anthony; Rogers, Michelle L; Tyler, Denise A; Mor, Vincent

    2014-09-01

    Quality improvement and cost containment initiatives in health care increasingly involve interdisciplinary teams of providers. To understand organizational functioning, information is often needed from multiple members of a leadership team since no one person may have sufficient knowledge of all aspects of the organization. To minimize survey burden, it is ideal to ask unique questions of each member of the leadership team in areas of their expertise. However, this risks substantial missing data if all eligible members of the organization do not respond to the survey. Nursing home administrators (NHA) and directors of nursing (DoN) play important roles in the leadership of long-term care facilities. Surveys were administered to NHAs and DoNs from a random, nationally representative sample of U.S. nursing homes about the impact of state policies, market forces, and organizational factors that impact provider performance and residents' outcomes. Responses were obtained from a total of 2,686 facilities (response rate [RR] = 66.6%) in which at least one individual completed the questionnaire and 1,693 facilities (RR = 42.0%) in which both providers participated. No evidence of nonresponse bias was detected. A high-quality representative sample of two providers in a long-term care facility can be obtained. It is possible to optimize data collection by obtaining unique information about the organization from each provider while minimizing the number of items asked of each individual. However, sufficient resources must be available for follow-up to nonresponders with particular attention paid to lower resourced, lower quality facilities caring for higher acuity residents in highly competitive nursing home markets. PMID:24500999

  11. Hepatitis B outbreak associated with a home health care agency serving multiple assisted living facilities in Texas, 2008-2010.

    PubMed

    Zheteyeva, Yenlik A; Tosh, Pritish; Patel, Priti R; Martinez, Diana; Kilborn, Cindy; Awosika-Olumo, Debo; Khuwaja, Salma; Ibrahim, Syed; Ryder, Anthony; Tohme, Rania A; Khudyakov, Yury; Thai, Hong; Drobeniuc, Jan; Heseltine, Gary; Guh, Alice Y

    2014-01-01

    We investigated a multifacility outbreak of acute hepatitis B virus infection involving 21 residents across 10 assisted living facilities in Texas during the period January 2008 through July 2010. Epidemiologic and laboratory data suggested that these infections belonged to a single outbreak. The only common exposure was receipt of assisted monitoring of blood glucose from the same home health care agency. Improved infection control oversight and training of assisted living facility and home health care agency personnel providing assisted monitoring of blood glucose is needed. PMID:24176604

  12. Improving Our Nation's Health Care System: Inclusion of Chiropractic in Patient-Centered Medical Homes and Accountable Care Organizations

    PubMed Central

    Meeker, William C.; Watkins, R.W.; Kranz, Karl C.; Munsterman, Scott D.; Johnson, Claire

    2014-01-01

    Objective This report summarizes the closing plenary session of the Association of Chiropractic Colleges Educational Conference—Research Agenda Conference 2014. The purpose of this session was to examine patient-centered medical homes and accountable care organizations from various speakers’ viewpoints and to discuss how chiropractic could possibly work within, and successfully contribute to, the changing health care environment. Discussion The speakers addressed the complex topic of patient-centered medical homes and accountable care organizations and provided suggestions for what leadership strategies the chiropractic profession may need to enhance chiropractic participation and contribution to improving our nation’s health. Conclusion There are many factors involved in the complex topic of chiropractic inclusion in health care models. Major themes resulting from this panel included the importance of building relationships with other professionals, demonstrating data and evidence for what is done in chiropractic practice, improving quality of care, improving health of populations, and reducing costs of health care. PMID:25431542

  13. Coaching a High School Science Olympiad Team.

    ERIC Educational Resources Information Center

    Robinson, Scott

    2003-01-01

    Investigates the nature of coaching a high school science olympiad team. The author interviewed nine science teachers about the rewards and challenges of coaching, competition and cooperation, and the relationship between coaching and teaching. Findings include the importance of the social interactions between students and the emphasis on

  14. Dealing with Differences: A Coach's Perspective

    ERIC Educational Resources Information Center

    Docheff, Dennis M.

    2011-01-01

    Coaches have always needed to respond to differences in sport and have always been concerned with finding hard-working kids who mesh well as a team. While coaches still try to build team cohesiveness, today's coaches must respond to complex issues related to diversity and are expected to be politically correct. The purpose of this article is to

  15. Burnout in Coaches of Women's Team Sports.

    ERIC Educational Resources Information Center

    Pastore, Donna L.; Judd, Michael R.

    1992-01-01

    Describes a study to determine the burnout levels of coaches in two-year colleges. The sample consisted of coaches of women's volleyball and basketball (n=147). The female coaches in this study reported higher levels of burnout when compared to their male counterparts. Recommendations for recognizing and reducing burnout are included. (IAH)

  16. Towards a Framework for Leadership Coaching

    ERIC Educational Resources Information Center

    Wise, Donald; Jacobo, Amber

    2010-01-01

    Today's school principals face unprecedented challenges. This article proposes a school-based outline framework in which the principal is the primary agent of change aided by an external coach. In this framework, the principal receives coaching and guides the change process at the school through a variety of coaching practices involving the

  17. Differentiated Coaching: Fostering Reflection with Teachers

    ERIC Educational Resources Information Center

    Stover, Katie; Kissel, Brian; Haag, Karen; Shoniker, Rebecca

    2011-01-01

    Literacy coaches inspire teacher reflection and promote a culture of ongoing professional learning. This article illustrates the role of literacy coaches, describes how coaches differentiate support for a diverse group of teachers, and explains how teacher reflection can be a catalyst for change and professional growth. The authors, current and

  18. Teaching and Coaching: Group and Task Differences.

    ERIC Educational Resources Information Center

    Chelladurai, Packianathan; Kuga, Donna J.

    1996-01-01

    Highlights group and task differences between teaching and coaching which favor coaching, thus making it more amenable to exercise influence by coaches and more motivational than teaching. A model synthesizing antecedents of role preference, influences of organizational and environmental elements, enacted role, role congruence, and resulting job

  19. Coach-Parent Relations in Youth Sport.

    ERIC Educational Resources Information Center

    Hopper, Chris; Jeffries, Stephen

    1990-01-01

    When coaches establish an effective working relationship with parents, the quality of the athlete's, coach's, and parent's experience improves. This article outlines techniques for coaches to gain the confidence and support of parents, to help parents formulate wholesome expectations, and to enlist parents' aid in developing skill and

  20. Identity Tensions in Lesbian Intercollegiate Coaches

    ERIC Educational Resources Information Center

    Krane, Vikki; Barber, Heather

    2005-01-01

    Using social identity perspective, the authors investigated the experiences of 13 lesbian college coaches. Through semistructured interviews, the coaches revealed the daily identity tensions they experienced. There was constant negotiation between their social identities of "coach" and "lesbian." The social context of intercollegiate women's

  1. Towards a Framework for Leadership Coaching

    ERIC Educational Resources Information Center

    Wise, Donald; Jacobo, Amber

    2010-01-01

    Today's school principals face unprecedented challenges. This article proposes a school-based outline framework in which the principal is the primary agent of change aided by an external coach. In this framework, the principal receives coaching and guides the change process at the school through a variety of coaching practices involving the…

  2. Assessing the Cost of Instructional Coaching

    ERIC Educational Resources Information Center

    Knight, David S.

    2012-01-01

    School-based instructional coaching is an increasingly popular approach to professional development used to support in-service learning for teachers. However, little is known about the cost of coaching. The following study aims to fill this gap. First, the study describes a framework for measuring the cost of an instructional coaching program;

  3. Competencies Used to Evaluate High School Coaches.

    ERIC Educational Resources Information Center

    Gratto, John

    1983-01-01

    Studies of how to evaluate high school coaches' effectiveness found that most respondents felt that principals, athletic directors, and coaches should jointly arrive at a method of evaluation. Coaching competencies rated most highly included prevention and care of athletic injuries, supervision, and consistent discipline. Other valued competencies…

  4. Assessing the Cost of Instructional Coaching

    ERIC Educational Resources Information Center

    Knight, David S.

    2012-01-01

    School-based instructional coaching is an increasingly popular approach to professional development used to support in-service learning for teachers. However, little is known about the cost of coaching. The following study aims to fill this gap. First, the study describes a framework for measuring the cost of an instructional coaching program;…

  5. Instructional Coaching: Leadership Styles and Practices

    ERIC Educational Resources Information Center

    Pruett, Maurisa M.

    2013-01-01

    Principals are traditionally the instructional leaders of a school. However, instructional coaching moves the emphasis from principals to instructional coaches by charging instructional coaches with improving the effectiveness of teachers who are critical to ensuring the successful education of a student. This research analyzed the leadership

  6. Coaching: A Tool for Extension Professionals

    ERIC Educational Resources Information Center

    Allen, Kim

    2013-01-01

    Coaching as an approach to improving people's lives is based on a positive relationship and the philosophy that the learner is responsible for their own change. In a coach approach, the educator serves as a coach; a person to help the client succeed by "challenging and supporting a person or a team to develop ways of thinking, ways of

  7. Toward a Theory of Coaching Paradox

    ERIC Educational Resources Information Center

    Barnson, Steven C.

    2014-01-01

    Multiple tensions exist as part of the coaching process. How a coach responds to these tensions is a fundamental determinant of an athlete or team's fate. In today's highly competitive, socially demanding, and ever-changing sports environment, and as the expectations on coaches become more complex, the paradox becomes a critical lens to…

  8. Differentiated Coaching: Fostering Reflection with Teachers

    ERIC Educational Resources Information Center

    Stover, Katie; Kissel, Brian; Haag, Karen; Shoniker, Rebecca

    2011-01-01

    Literacy coaches inspire teacher reflection and promote a culture of ongoing professional learning. This article illustrates the role of literacy coaches, describes how coaches differentiate support for a diverse group of teachers, and explains how teacher reflection can be a catalyst for change and professional growth. The authors, current and…

  9. Instructional Coaching: Leadership Styles and Practices

    ERIC Educational Resources Information Center

    Pruett, Maurisa M.

    2013-01-01

    Principals are traditionally the instructional leaders of a school. However, instructional coaching moves the emphasis from principals to instructional coaches by charging instructional coaches with improving the effectiveness of teachers who are critical to ensuring the successful education of a student. This research analyzed the leadership…

  10. Literacy Coaching: Engaging and Learning with Teachers

    ERIC Educational Resources Information Center

    Dozier, Cheryl L.

    2008-01-01

    Literacy coaching, a unique and generative opportunity to engage with and learn from teachers, is currently viewed as a powerful intervention to increase student literacy achievement. This article focuses on eight principles for responsive literacy coaching. To build trusting relationships, coaches engage with teachers in literacy events, confirm

  11. Coach Education Online: The Montana Model

    ERIC Educational Resources Information Center

    Stewart, Craig

    2006-01-01

    Coach education is important, but expensive--both in cost and time to public and private athletic programs. To provide basic coach education to coaches, new, innovative, inexpensive approaches must be developed. Joint efforts between state high school associations and colleges and universities can meet those needs. The "Montana approach" is one

  12. Coaching Redefined: An Everyday Pedagogical Endeavour

    ERIC Educational Resources Information Center

    Jones, Robyn

    2007-01-01

    Following a brief introduction, in which the chosen format is discussed, this article comprises a dialogue between present-day coaching science (CS) and a critic, educational relationship (ER). ER disparages current conceptualisations of coaching as irrelevant and implores CS to redefine itself as an educational relationship between coach and

  13. Toward a Theory of Coaching Paradox

    ERIC Educational Resources Information Center

    Barnson, Steven C.

    2014-01-01

    Multiple tensions exist as part of the coaching process. How a coach responds to these tensions is a fundamental determinant of an athlete or team's fate. In today's highly competitive, socially demanding, and ever-changing sports environment, and as the expectations on coaches become more complex, the paradox becomes a critical lens to

  14. Effects of out-of-home mental health treatment on probability of criminal charge during the transition to adulthood.

    PubMed

    Pullmann, Michael D

    2011-07-01

    Criminal justice-related outcomes for youth who have been served in out-of-home mental health settings such as residential treatment and inpatient hospitalization are unclear. This study longitudinally modeled the changing probability of being charged with a crime from age 16 to 25, including being served in out-of-home treatment and aging into adulthood, while controlling for person-level covariates such as gender, race, past criminal charges, and mental health diagnoses. Results indicated that out-of-home treatment was related to a decreased probability of being charged with a crime during treatment. However, the preventive effect was small; estimates indicated only one criminal charge avoided for every 4 years of out-of-home treatment. Out-of-home treatment had no relationship to posttreatment probability of charge. Other significant contributors to being charged included gender, a substance use diagnosis, and an offense record prior to age 16. Evidence indicated that out-of-home treatment was used as an alternative to detention and incarceration for both juveniles and adults. PMID:21729021

  15. Smartphone-based analysis of biochemical tests for health monitoring support at home.

    PubMed

    Velikova, Marina; Smeets, Ruben L; van Scheltinga, Josien Terwisscha; Lucas, Peter J F; Spaanderman, Marc

    2014-09-01

    In the context of home-based healthcare monitoring systems, it is desirable that the results obtained from biochemical tests - tests of various body fluids such as blood and urine - are objective and automatically generated to reduce the number of man-made errors. The authors present the StripTest reader - an innovative smartphone-based interpreter of biochemical tests based on paper-based strip colour using image processing techniques. The working principles of the reader include image acquisition of the colour strip pads using the camera phone, analysing the images within the phone and comparing them with reference colours provided by the manufacturer to obtain the test result. The detection of kidney damage was used as a scenario to illustrate the application of, and test, the StripTest reader. An extensive evaluation using laboratory and human urine samples demonstrates the reader's accuracy and precision of detection, indicating the successful development of a cheap, mobile and smart reader for home-monitoring of kidney functioning, which can facilitate the early detection of health problems and a timely treatment intervention. PMID:26609385

  16. Smartphone-based analysis of biochemical tests for health monitoring support at home

    PubMed Central

    Smeets, Ruben L.; van Scheltinga, Josien Terwisscha; Lucas, Peter J.F.; Spaanderman, Marc

    2014-01-01

    In the context of home-based healthcare monitoring systems, it is desirable that the results obtained from biochemical tests tests of various body fluids such as blood and urine are objective and automatically generated to reduce the number of man-made errors. The authors present the StripTest reader an innovative smartphone-based interpreter of biochemical tests based on paper-based strip colour using image processing techniques. The working principles of the reader include image acquisition of the colour strip pads using the camera phone, analysing the images within the phone and comparing them with reference colours provided by the manufacturer to obtain the test result. The detection of kidney damage was used as a scenario to illustrate the application of, and test, the StripTest reader. An extensive evaluation using laboratory and human urine samples demonstrates the reader's accuracy and precision of detection, indicating the successful development of a cheap, mobile and smart reader for home-monitoring of kidney functioning, which can facilitate the early detection of health problems and a timely treatment intervention. PMID:26609385

  17. Wireless home monitoring and health care activity management through the Internet in patients with chronic diseases.

    PubMed

    Tura, Andrea; Quareni, Luca; Longo, David; Condoluci, Claudia; van Rijn, Astrid; Albertini, Giorgio

    2005-12-01

    A project was developed for the creation of an Internet-based network aimed at improved management of home care activities in brain-injured children. At the patient's side, a home care unit was provided, made of a portable medical device, and a tablet PC. Measured clinical data were blood oxygen saturation, heart rate, breath rate and quantity of movement. Thanks to device portability, the patient was free to move while measurements were taken. At prescribed time intervals, measured data were automatically transmitted to the tablet PC via Bluetooth. From the tablet PC, data were transmitted remotely to a Service Centre (via ADSL or GPRS) and made available for consultation by health care professionals through the project Web portal. At the portal, other functionalities were also available, both for patients and families, and for professionals (such as weekly planning agenda, access to relevant information resources, communication tools). Information was delivered for the right participant through a workflow engine. A first trial involving nine patients was performed for two months. At the end, although some improvements were suggested, good acceptance was detected, and 78% of patients and families claimed to be interested in further use of the platform. PMID:16531352

  18. Improving quality of service of home healthcare units with health information technologies.

    PubMed

    Cegarra-Navarro, Juan Gabriel; Wensley, Anthony K P; Snchez-Polo, Maria Teresa

    2011-01-01

    Deployment of health information technologies (HITs) provides home care units with the means to generate improvements in accuracy and timeliness of information required to meet dynamic patient demands and provide high quality patient care. Increasing availability of information can also facilitate organisational learning, which leads to the invocation of processes that result in improved responses and decisions. This study examined crucial links between HITs and quality of service provided through an empirical investigation of 252 patients in a hospital-in-the-home unit (HHU) in a Spanish regional hospital. The study sought to test the relationship between HITs and the quality of service using factor analysis and structural equation modeling (SEM) to investigate how HITs mediate effects of organisational learning on quality of service. Findings support the notion that the relationship between organisational learning and quality of service can be mediated by HITs. This study provides HHU managers with guidelines for understanding the role of organisational learning processes with respect to HITs and quality of service. PMID:21712559

  19. Nitrogen dioxide inside and outside 137 homes and implications for ambient air quality standards and health effects research

    SciTech Connect

    Spengler, J.D.; Duffy, C.P.; Letz, R.; Tibbitts, T.W.; Ferris, B.G. Jr.

    1983-03-01

    Week-long integrated nitrogen dioxide (NO/sub 2/) measurements were made by using diffusion tube samplers inside and outside 137 homes in Portage, WI, over a 1-year period. The annual mean ambient NO/sub 2/ concentrations in this rural community were 10-15 ..mu..g/m/sup 3/. NO/sub 2/ levels inside the kitchens of 112 homes with gas stoves averaged about 50 ..mu..g/m/sup 3/ higher, and bedroom levels were about 30 ..mu..g/m/sup 3/ higher, than outdoor levels. Ten percent of the gas-cooking homes had annual average kitchen NO/sub 2/ levels higher than the National Ambient Air Quality Standard of 100 ..mu..g/m/sup 3/. NO/sub 2/ levels inside kitchens of 25 homes with electric stoves were about two-thirds outdoor levels, while corresponding bedroom levels were one-half outdoor levels. Distinct seasonal patterns (higher indoor levels in winter, lower in summer) consistent with changes in normal air-exchange rates were evident in gas-cooking homes. The large variation of NO/sub 2/ concentrations among homes, likely due to differences in stove use, emission rates, and air-exchange rates, limits the development of prediction models. In addition, this variation would reduce the power of epidemiological studies of respiratory health, which use ambient NO/sub 2/ concentration levels, a simple dichotomous description of stove type and two categories of home cooking fuel to describe exposure.

  20. National Nursing Home Survey

    MedlinePLUS

    ... this page: About CDC.gov . National Nursing Home Survey NCHS Home Surveys and Data Collection Systems National Health Care Surveys Share Compartir National Nursing Home Survey NOTE: This website contains information on the National ...