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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. A socialization intervention in remote health coaching for older adults in the home.

    PubMed

    Jimison, Holly B; Klein, Krystal A; Marcoe, Jennifer L

    2013-01-01

    Previous studies have shown that social ties enhance both physical and mental health, and that social isolation has been linked to increased cognitive decline. As part of our cognitive training platform, we created a socialization intervention to address these issues. The intervention is designed to improve social contact time of older adults with remote family members and friends using a variety of technologies, including Web cameras, Skype software, email and phone. We used usability testing, surveys, interviews and system usage monitoring to develop design guidance for socialization protocols that were appropriate for older adults living independently in their homes. Our early results with this intervention show increased number of social contacts, total communication time (we measure email, phone, and Skype usage) and significant participant satisfaction with the intervention. PMID:24111362

  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 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

  5. 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

  6. Coaching via Electronic Performance Feedback to Support Home Visitors' Use of Caregiver Coaching Strategies

    ERIC Educational Resources Information Center

    Krick Oborn, Kellie M.; Johnson, LeAnne D.

    2015-01-01

    Recommended practices for Part C early childhood special education home visitors encourage use of caregiver coaching strategies to enhance learning opportunities within the natural routines of infants and toddlers. The purpose of this study was to evaluate the effects of a multicomponent professional development intervention on home visitors' use…

  7. The Coach Is in: Improving Nutritional Care in Nursing Homes

    ERIC Educational Resources Information Center

    Rahman, Anna N.; Simmons, Sandra F.; Applebaum, Robert; Lindabury, Kate; Schnelle, John F.

    2012-01-01

    Purpose: This article describes and evaluates a long distance coaching course aimed at improving nutritional care in nursing homes (NHs). The course was structured to provide more support than traditional training programs offer. Methods: In a series of 6 monthly teleconferences led by an expert in NH nutritional care, participating NH staff…

  8. 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, ...

  9. Coaches. A missing link in the health care system.

    PubMed

    Brown, B R; Butterfield, S A

    1992-02-01

    The number of children and adolescents who participate in interscholastic athletics demands attention to the quality of the coaching they receive and to the opportunities that the athlete-coach relationship provides for modification of high-risk behaviors, social skills training, and character formation. Although the need for coaches has increased due to the advent of girls' athletic programs, which was mandated by Title IX legislation, only a minority of states require certification for coaches who work in school systems. Four coaching curricula are summarized and contrasted: the American Coaching Effectiveness Program, the curriculum of the National Youth Sports Coaches Association, the Athletic Health Care System, and the Coach Effectiveness Training Program. Recommendations for coach certification by states, physician advocacy for coaching standards, and improved sports medicine services are discussed. PMID:1733152

  10. 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

  11. Promotion of mental health through coaching competitive sports.

    PubMed Central

    Bell, C. C.

    1997-01-01

    Competitive sports can have a negative or positive impact on an athlete's mental health, and an athlete's coach plays a large role in determining this. The coach's goal should be to help athletes realize that developing human potential is equally as important as winning. This article highlights guidelines to assist coaches in instructing and mentoring athletes. PMID:9264218

  12. Health Coaching the Worker With Celiac Disease.

    PubMed

    Smith, Letha

    2016-06-01

    L.Y., a 52-year-old project manager, had a series of minor epistaxis episodes while at work. After seeing his primary care physician, he was diagnosed with anemia which was attributed to the epistaxis. After being evaluated by an ear, nose, and throat (ENT) specialist for treatment of the epistaxis, anemia continued. Eventually, he was diagnosed with celiac disease. Implications for health coaching are explored. PMID:26681604

  13. 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 ...

  14. Home Health Aides

    MedlinePlus

    ... aides, but most aides have at least a high school diploma. Home health aides working in certified home ... aides, but most aides have at least a high school diploma. Home health aides who work for certified ...

  15. 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

  16. Group Health Coaching: Strengths, Challenges, and Next Steps

    PubMed Central

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

    2013-01-01

    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

  17. 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

  18. 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…

  19. 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…

  20. 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

  1. 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. ... ...

  2. The study of health coaching: the ithaca coaching project, research design, and future directions.

    PubMed

    Sforzo, Gary A

    2013-05-01

    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

  3. 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

  4. 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

  5. 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

  6. 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…

  7. 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

  8. Effective Tobacco Cessation via Health Coaching: An Institutional Case Report

    PubMed Central

    Kaye, Miranda; Ayers, Gale D.; Talbert, Betina; Hill, Marilyn

    2014-01-01

    Background: Tobacco abuse is a well-recognized scourge on health and healthcare costs. Attempts to facilitate tobacco cessation are rarely better than marginally effective. Primary Objective: To describe an observational trial of an existing and highly successful tobacco cessation program featuring health coaching as the primary intervention. Core components of program design and data are presented and may serve as a model for other public health settings. Methods: Health coaching and three complementary program components (auriculotherapy, alpha-electrical stimulation, and relaxation techniques) are presented. Quit rates at 6 months for 161 patients over 3 years are provided featuring 30-day point prevalence smoke free and intent-to-treat values. Comparisons for telephonic vs in-clinic health coaching, free choice vs mandated participation, and program costs are provided. Results: Point prevalence quit rate was 88.7% while the more conservative intent-to-treat quit rate was 51.6%. Telephonic and in-clinic health coaching were not significantly different at any time point. Smoke-free rates at 6 and 12 months were 76.9% and 63.2%, respectively. Conclusions: Two cost-effective smoking cessation models featuring health coaching are presented. Point prevalence (30-day) above 80% and an enduring effect was seen. Personal and societal burdens (health and financial) of tobacco use might be greatly impacted if such programs were successfully implemented on a larger scale. PMID:25568823

  9. 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

  10. Efficacy of Adjunct In-Home Coaching to Improve Outcomes in Parent-Child Interaction Therapy

    ERIC Educational Resources Information Center

    Timmer, Susan G.; Zebell, Nancy M.; Culver, Michelle A.; Urquiza, Anthony J.

    2010-01-01

    Objectives: The purpose of this study is to test whether increasing the exposure to coaching by adding an in-home component to clinic-delivered Parent-Child Interaction Therapy (PCIT) will increase the speed of parenting skill acquisition and show greater improvements in children's behaviors and parental stress. Methods: Seventy-three parent-child…

  11. 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...

  12. 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

  13. Transforming Farm Health and Safety: The Case for Business Coaching.

    PubMed

    Blackman, Anna; Franklin, Richard C; Rossetto, Allison; Gray, David E

    2015-01-01

    In the U.S. and Australia, agriculture is consistently ranked as one of the most hazardous industries. The cost of injuries and deaths on Australian farms is significant, estimated to be between AU$0.5 billion and AU$1.2 billion per year. Death and injury in agriculture also place a significant financial and social burden on the family and friends of the injured, the community, and the health system. This article proposes that if farmers were to employ coaching in their businesses, they would benefit from advances in safety practices, resulting in associated improvements in overall farm productivity and a reduction in injury costs to the wider community. A coaching model is presented to demonstrate what an effective coaching process would need to include. An agenda for future research areas is also provided. PMID:26211352

  14. The impacts of using community health volunteers to coach medication safety behaviors among rural elders with chronic illnesses.

    PubMed

    Wang, Chi-Jane; Fetzer, Susan J; Yang, Yi-Ching; Wang, Jing-Jy

    2013-01-01

    It is a challenge for rural health professionals to promote medication safety among older adults taking multiple medications. A volunteer coaching program to promote medication safety among rural elders with chronic illnesses was designed and evaluated. A community-based interventional study randomly assigned 62 rural elders with at least two chronic illnesses to routine care plus volunteer coaching or routine care alone. The volunteer coaching group received a medication safety program, including a coach and reminders by well-trained volunteers, as well as three home visits and five telephone calls over a two-month period. All the subjects received routine medication safety instructions for their chronic illnesses. The program was evaluated using pre- and post-tests of knowledge, attitude and behaviors with regard to medication safety. Results show the volunteer coaching group improved their knowledge of medication safety, but there was no change in attitude after the two-month study period. Moreover, the group demonstrated three improved medication safety behaviors compared to the routine care group. The volunteer coaching program and instructions with pictorial aids can provide a reference for community health professionals who wish to improve the medication safety of chronically ill elders. PMID:23414637

  15. 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…

  16. Using motivational interviewing: through evidence-based health coaching.

    PubMed

    Huffman, Melinda

    2014-10-01

    To enhance compliance and achieve better outcomes, providers must actively engage their patients and caregivers in different ways than in the past. One strategy that has gained national attention is motivational interviewing through evidence-based health coaching. A closer look at this exciting new clinical skill reveals what it is, how it works, why it is so successful, and why our traditional patient approach has fallen short. PMID:25268529

  17. 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

  18. Introducing the health coach at a primary care practice: a pilot study (part 2).

    PubMed

    Lanese, Bethany Sneed; Dey, Asoke; Srivastava, Prashant; Figler, Robert

    2011-01-01

    It is well known that the cost of healthcare in the United States is a poor value proposition. One of the primary goals of the healthcare reform act is to reduce cost while improving healthcare quality. The authors believe that adding a health coach helps to achieve this goal. In part I, the authors discuss the role of a health coach in the healthcare field. They present the findings from a pilot study at a primary care practice managing diabetes of patients using a health coach. The findings from the study suggest that adding a health coach helps in cost savings as well as improved health for the patients. PMID:21678142

  19. Introducing the health coach at a primary care practice: impact on quality and cost (Part 1).

    PubMed

    Lanese, Bethany Sneed; Dey, Asoke; Srivastava, Prashant; Figler, Robert

    2011-01-01

    The cost of healthcare in U.S. is a poor value proposition. One of the primary goals of the healthcare reform act is to reduce cost while improving healthcare quality. We believe that adding a health coach will help in achieving this goal. The health coach is a medical professional who supports both the physician and the patient by meeting previously established goals. This research presents and analyzes the key roles of a health coach in a primary care practice. PMID:21360385

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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…

  7. 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

  8. National training and education standards for health and wellness coaching: the path to national certification.

    PubMed

    Jordan, Meg; Wolever, Ruth Q; Lawson, Karen; Moore, Margaret

    2015-05-01

    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

  9. Training meals on wheels volunteers as health literacy coaches for older adults.

    PubMed

    Rubin, Donald L; Freimuth, Vicki S; Johnson, Sharon D; Kaley, Terry; Parmer, John

    2014-05-01

    Homebound older adults constitute a "hardly reached" population with respect to health communication. Older adults also typically suffer from health literacy challenges, which put them at increased risk of adverse health outcomes. Suboptimal interactions with providers are one such challenge. Interventions to improve interactive health literacy focus on training consumers/patients in question preparation and asking. Meals on Wheels volunteers are uniquely suited to coach their clients in such interaction strategies. Seventy-three Meals on Wheels volunteers participated in workshops to train as health literacy coaches. The 3- to 4-hour workshops included units on communicating with older adults, on the nature of health literacy, and on the process of interactive health literacy coaching. Participants viewed and discussed videos that modeled the targeted communication behaviors for older adult patients interacting with physicians. They role-played the coaching process. After 9 months, coaches participated in a "booster" session that included videos of ideal coaching practices. Evaluation questionnaires revealed that participants had favorable reactions to the workshops with respect to utility and interest. They especially appreciated learning communication skills and seeing realistic videos. A measure of knowledge about the workshop material revealed a significant increment at posttest. Fidelity of coaching practices with respect to workshop curriculum was confirmed. This training in interactive health literacy for community-based lay volunteers constitutes one way to implement the National Action Plan to Improve Health Literacy for one "hardly reached" population. An online tool kit containing all workshop materials is available. PMID:23877229

  10. 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

  11. 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…

  12. Building competency in the novice allied health professional through peer coaching.

    PubMed

    Ladyshewsky, Richard K

    2010-01-01

    The development of competence is an ongoing journey, and one that is particularly punctuated in the early part of a health professional's career. These novice practitioners need to recognize that the challenges inherent in building competency might be resolved more readily by engaging with peers. This paper outlines what it means to be a novice practitioner, and how peer coaching can be used to support professional development in the allied health sciences. An overview of the reasoning process and how peer coaching and experiential learning can be used to build competence is described. A structured and formal approach to peer coaching is outlined in this paper. Novices who embrace this professional development strategy will find the model of coaching practice and underlying strategies described in this paper beneficial to their experience. The importance of formalizing the process and the underlying communication skills needed for coaching are described in detail with accompanying examples to illustrate the model in practice. PMID:20539925

  13. ECI-4: Culturally-Competent Heart Health Coaching Improves Lipids in South Asians

    PubMed Central

    Jose, Powell; Azar, Kristin; Kang, Jennifer; Baek, Marshall; Palaniappan, Latha; Mathur, Ashish; Molina, Cesar

    2013-01-01

    Background/Aims Health coaching programs, delivered by trained non-medical and medical personnel, and focused on diet and lifestyle counseling, have proven beneficial in primary and secondary prevention of cardiovascular disease. These coaching programs, however, have not been tested or validated in South Asians, who have unique dietary and lifestyle habits, and increased risk of coronary artery disease. Methods We examined lipid values in participants who were enrolled in the Heart Health Coaching Program at the South Asian Heart Center at El Camino Hospital. Trained volunteer coaches contacted participants throughout the year by phone and email to deliver culturally-competent health education on diet, physical activity, and stress reduction. Participants were categorized, based on their level of participation, into three groups: those who did not enroll (non-coached, N=33), those who received some coaching (partially coached, N = 145), and those who completed one full year of the program (fully coached, N = 558). Fasting lipid measurements were obtained with mean differences being calculated from their baseline and last available follow-up lab test. Paired t-test was used for comparison of baseline and follow-up labs within each group. Multivariate age-adjusted analyses incorporated MANOVA to detect for differences between groups. Results There were no significant differences in mean age(43, 42 and 43), mean BMI(25.8, 26.5 and 26.2), or baseline lipid values across the three groups (fully-coached, partially coached, and non-coached respectively). There were significant improvements in total cholesterol(TC) (−5.5±28.4mg/dl), LDL(−4.1±24.3), HDL (1.9±6.4), triglycerides(−16.1±67.3), and TC/HDL ratio(−0.31±0.83) in the fully coached group (P <0.001 for all). The partially coached group demonstrated reductions in total cholesterol(−5.2±27.8, p=0.03), LDL(−8.1±28.0mg/dl, P <0.001), and TC/HDL ratio (−0.42±1.01, P <0.001) with a trend towards increased HDL (4.9±31.3, P = 0.06). Non-coached participants did not have any statistically significant differences for any lipid measurement. Coached participants were more likely to improve lipid values than partially coached and non-coached participants (P <0.001). Conclusions Our results suggest the benefit of a volunteer culturally-competent coaching program for South Asians in improving their lipid profile. Benefit was obtained even for partially coached participants. Non-medically trained health coaches may be an effective method to deliver culturally appropriate cardiovascular health messages for South Asians at risk for developing coronary artery disease.

  14. Integrating big data and actionable health coaching to optimize wellness.

    PubMed

    Hood, Leroy; Lovejoy, Jennifer C; Price, Nathan D

    2015-01-01

    The Hundred Person Wellness Project (HPWP) is a 10-month pilot study of 100 'well' individuals where integrated data from whole-genome sequencing, gut microbiome, clinical laboratory tests and quantified self measures from each individual are used to provide actionable results for health coaching with the goal of optimizing wellness and minimizing disease. In a commentary in BMC Medicine, Diamandis argues that HPWP and similar projects will likely result in 'unnecessary and potential harmful over-testing'. We argue that this new approach will ultimately lead to lower costs, better healthcare, innovation and economic growth. The central points of the HPWP are: 1) it is focused on optimizing wellness through longitudinal data collection, integration and mining of individual data clouds, enabling development of predictive models of wellness and disease that will reveal actionable possibilities; and 2) by extending this study to 100,000 well people, we will establish multiparameter, quantifiable wellness metrics and identify markers for wellness to early disease transitions for most common diseases, which will ultimately allow earlier disease intervention, eventually transitioning the individual early on from a disease back to a wellness trajectory. PMID:25575752

  15. 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…

  16. 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

  17. 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…

  18. 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

  19. Behavioral health coaching for rural veterans with diabetes and depression: a patient randomized effectiveness implementation trial

    PubMed Central

    2014-01-01

    Background Depression and diabetes cause significant burden for patients and the healthcare system and, when co-occurring, result in poorer self-care behaviors and worse glycemic control than for either condition alone. However, the clinical management of these comorbid conditions is complicated by a host of patient, provider, and system-level barriers that are especially problematic for patients in rural locations. Patient-centered medical homes provide an opportunity to integrate mental and physical health care to address the multifaceted needs of complex comorbid conditions. Presently, there is a need to not only develop robust clinical interventions for complex medically ill patients but also to find feasible ways to embed these interventions into the frontlines of existing primary care practices. Methods/design This randomized controlled trial uses a hybrid effectiveness-implementation design to evaluate the Healthy Outcomes through Patient Empowerment (HOPE) intervention, which seeks to simultaneously address diabetes and depression for rural veterans in Southeast Texas. A total of 242 Veterans with uncontrolled diabetes and comorbid symptoms of depression will be recruited and randomized to either the HOPE intervention or to a usual-care arm. Participants will be evaluated on a host of diabetes and depression-related measures at baseline and 6- and 12-month follow-up. The trial has two primary goals: 1) to examine the effectiveness of the intervention on both physical (diabetes) and emotional health (depression) outcomes and 2) to simultaneously pilot test a multifaceted implementation strategy designed to increase fidelity and utilization of the intervention by coaches interfacing within the primary care setting. Discussion This ongoing blended effectiveness-implementation design holds the potential to advance the science and practice of caring for complex medically ill patients within the constraints of a busy patient-centered medical home. Trial registration Behavioral Activation Therapy for Rural Veterans with Diabetes and Depression: NCT01572389. PMID:24774351

  20. 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

  1. 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 [ ...

  2. 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

  3. An integrated approach to worker self-management and health outcomes: chronic conditions, evidence-based practice, and health coaching.

    PubMed

    Miller, Colleen

    2011-11-01

    Employee health, prevention, and maintenance programs are growing exponentially each year as costs continue to rise across the health care continuum. Employers and payers alike continue to be challenged by chronic health risks, effective prevention strategies, optimal health and wellness strategies, and programs that are effective for America's work force. In light of these challenges, new and exciting health management approaches are evolving. Changes in occupational health nursing practice can ultimately affect the way occupational health nurses plan, structure, and conduct education sessions. New trends, such as health coaching, embrace the incorporation of health research through evidence-based practice and standards of care to provide the science clinicians need to support interventions. Through knowledge of chronic conditions, evidence-based practice, and health coaching, occupational health nurses possess the skills and strategies that form the foundation necessary to affect and safely guide employee self-discovery and self-management and produce optimal health outcomes. PMID:22045011

  4. 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)…

  5. Health "Smart" home: information technology for patients at home.

    PubMed

    Rialle, Vincent; Duchene, Florence; Noury, Norbert; Bajolle, Lionel; Demongeot, Jacques

    2002-01-01

    This article reviews the emerging concept of health "Smart" homes (HSH) and its potential through the use of telemedical information systems and communication technologies. HSH systems provide health care services for people with special needs who wish to remain independent and living in their own home. The large diversity of needs in a home-based patient population requires complex technology. Meeting these needs technically requires the use of a distributed approach and the combination of many hardware and software techniques. We also describe the wide scope of new information, communication, and data-acquisition technologies used in home health care. We offer an introduction to the HSH concept in terms of technical, economic, and human requirements. Examples of HSH projects are presented, including a short description of our own smart home and telehealthcare information system project. PMID:12626109

  6. 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…

  7. 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…

  8. 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

  9. 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

  10. Integrative Health Coaching and Motivational interviewing: Synergistic Approaches to Behavior Change in Healthcare

    PubMed Central

    Wolever, Ruth Q.

    2013-01-01

    As rates of preventable chronic diseases and associated costs continue to rise, there has been increasing focus on strategies to support behavior change in healthcare. Health coaching and motivational interviewing are synergistic but distinct approaches that can be effectively employed to achieve this end. However, there is some confusion in the literature about the relationship between these two approaches. The purpose of this review is to describe a specific style of health coaching—integrative health coaching—and motivational interviewing, including their origins, the processes and strategies employed, and the ways in which they are similar and different. We also provide a case example of how integrative health coaching and motivational interviewing might be employed to demonstrate how these approaches are synergistic but distinct from each other in practice. This information may be useful for both researchers and clinicians interested in investigating or using behavior change interventions to improve health and cost outcomes in chronic disease. PMID:24416683

  11. Home Health Compare: Find a Home Health Agency

    MedlinePlus

    ... page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with " ... widget - Select to show Back to top Footer Home A federal government website managed by the Centers ...

  12. 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

  13. 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

  14. 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

  15. Transforming home health nursing with telehealth technology.

    PubMed

    Farrar, Francisca Cisneros

    2015-06-01

    Telehealth technology is an evidence-based delivery model tool that can be integrated into the plan of care for mental health patients. Telehealth technology empowers access to health care, can help decrease or prevent hospital readmissions, assist home health nurses provide shared decision making, and focuses on collaborative care. Telehealth and the recovery model have transformed the role of the home health nurse. Nurses need to be proactive and respond to rapidly emerging technologies that are transforming their role in home care. PMID:25999070

  16. Integrating executive coaching and simulation to promote interprofessional education of health care students.

    PubMed

    Ekmekci, Ozgur; Plack, Margaret; Pintz, Christine; Bocchino, Joseph; LeLacheur, Susan; Halvaksz, Jennifer

    2013-01-01

    This study used executive coaching and simulation to enhance interprofessional teamwork by promoting collaboration and leadership capacity in health professional students attending undergraduate programs. A mixed methods approach to program evaluation was used. A statistically significant (p<0.05) increase was noted pre- and post-program on the Team Assessment Inventory. Qualitative analysis of reflective essays and focus group interviews revealed that students participated as a career-building opportunity and because they wanted to gain a better appreciation for the roles and contributions of other health care providers. The themes that emerged related to aspects of the process students found helpful, lessons learned about professional roles, and the meaning of leadership in the context of interprofessional teams. Students also provided recommendations for future studies. Findings suggest that integrating executive coaching and simulation in interprofessional education may have the potential to create meaningful experiences for health professional students. While more empirical research is needed to investigate this potential, in terms of how executive coaching and simulation may increase professional collaborative care and improve the quality of health care delivery, the initial insights seem promising. PMID:23471281

  17. Improving home health care for the Navajo.

    PubMed

    Boyle, J S; Szymanski, M T; Szymanski, M E

    1992-01-01

    Home health care clients on the Navajo reservation present complex nursing problems that require interventions that are culturally sensitive. A collaborative project was developed that used the skills of researchers, clinicians, and members of the Navajo culture to develop culturally appropriate nursing care. Traditional life themes, values, and beliefs of the Navajo related to health and illness are described with examples of how the project facilitated home health care for Navajo clients. PMID:1293518

  18. Home remedies: health care at the doorstep.

    PubMed

    1986-01-01

    The roots of modern medicine are in traditional medicine. The availability of modern medicine is limited; medicines cost more than some people can afford to pay; pharmacies, hospitals and clinics are often located far away from communities; many drugs are difficult to find or unavailable in some parts of the world. Home remedies are, in many cases, a practical alternative to modern drugs. Dr. John, a physician trained at Christian Medical College Hospital in India, now directs the World Neighbors-assisted health program in an Indian community. She and her staff of 18 village health workers diagnose and treat 80% of their neighbors health problems with home remedies and simple medications. She cites several reasons for supporting home remedies: there is little danger of misuse or overuse of drugs; since the same home remedies are used in different countries, this is a good indication that they are effective; many of the plants used in home remedies are used to produce modern medicines; and community-wide attention to health results when people participate in solving their own health problems. Home remedies should be used only in the early stages of illness and not in its chronic form. To learn more about treating health problems with home remedies, a filmstrip on medicinal plants is recommended. PMID:12314442

  19. 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…

  20. Home Health Management Aide. Final Report.

    ERIC Educational Resources Information Center

    Mincemoyer, Betty Jane

    The report describes a demonstration project to provide a course of study at the senior high level in home health management for the academically handicapped. The course consisted of practice in nursing skills, home management and laboratory work in food preparation techniques, the family, and child care. Activities included field trips,…

  1. Preliminary Data from the Caring for Older Adults and Caregivers at Home (COACH) Program: A Care Coordination Program for Home-Based Dementia Care and Caregiver Support in a Veterans Affairs Medical Center.

    PubMed

    D'Souza, Maria F; Davagnino, Judith; Hastings, S Nicole; Sloane, Richard; Kamholz, Barbara; Twersky, Jack

    2015-06-01

    Caring for Older Adults and Caregivers at Home (COACH) is an innovative care coordination program of the Durham Veteran's Affairs Medical Center in Durham, North Carolina, that provides home-based dementia care and caregiver support for individuals with dementia and their family caregivers, including attention to behavioral symptoms, functional impairment, and home safety, on a consultation basis. The objectives of this study were to describe the COACH program in its first 2 years of operation, assess alignment of program components with quality measures, report characteristics of program participants, and compare rates of placement outside the home with those of a nontreatment comparison group using a retrospective cohort design. Participants were community-dwelling individuals with dementia aged 65 and older who received primary care in the medical center's outpatient clinics and their family caregivers, who were enrolled as dyads (n = 133), and a control group of dyads who were referred to the program and met clinical eligibility criteria but did not enroll (n = 29). Measures included alignment with Dementia Management Quality Measures and time to placement outside the home during 12 months of follow-up after referral to COACH. Results of the evaluation demonstrated that COACH aligns with nine of 10 clinical process measures identified using quality measures and that COACH delivers several other valuable services to enhance care. Mean time to placement outside the home was 29.6 ± 14.3 weeks for both groups (P = .99). The present study demonstrates the successful implementation of a home-based care coordination intervention for persons with dementia and their family caregivers that is strongly aligned with quality measures. PMID:26032224

  2. Network solutions for home health care applications.

    PubMed

    Herzog, Almut; Lind, Leili

    2003-01-01

    The growing number of the elderly in industrialised countries is increasing the pressure on respective health care systems. This is one reason for recent trends in the development and expansion of home health care organisations. With Internet access available to everyone and the advent of wireless technologies, advanced telehomecare is a possibility for a large proportion of the population. In the near future, one of the authors plans to implement a home health care infrastructure for patients with congestive heart failure and patients with chronic obstructive pulmonary disease. The system is meant to support regular and ad-hoc measurements of medical parameters in patient homes and transmission of measurement data to the home health care provider. In this paper we look at network technologies that connect sensors and input devices in the patient home to a home health care provider. We consider wireless and Internet technologies from functional and security-related perspectives and arrive at a recommendation for our system. Security and usability aspects of the proposed network infrastructures are explored with special focus on their impact on the patient home. PMID:12697950

  3. 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 ...

  4. 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

  5. The Four Pillars of Health Coaching: Preserving the Heart of a Movement

    PubMed Central

    2013-01-01

    In this special themed issue of Global Advances in Health and Medicine and in articles published on the journal's website (www.gahmj.com), you will read all about this new and maturing approach to health behavior change and the social and cultural conditions in modern medicine that have called this practice into being. You will learn about its inception and history,1 the philosophic constructs of its application,2,3 and its proposed mechanism of action.4 There are multiple case reports5–7 and clinical studies8–10 expanding our scientific understanding of coaching in health and wellness and descriptions about how to educate professionals to provide this new service.11,12 A review of existing literature in the field demonstrates the rapidly growing reported demonstration of its impact.13 I believe coaching is poised to have a major transformative impact on health and healthcare internationally; it also is at risk of being usurped and thereby deformed by the power of the existing paradigm of Western disease care and reductionistic scientific thought. That is the issue I wish to raise: How do we ensure the integrity of this new approach so that it can serve as a bridge from a broken system to a new horizon of holistic health and well-being? PMID:24416668

  6. 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

  7. 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…

  8. 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)

  9. 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

  10. A Profile of Home Health Users in 1992

    PubMed Central

    Mauser, Elizabeth; Miller, Nancy A.

    1994-01-01

    Recently, the use of home health services by Medicare beneficiaries has been growing. From 1987 to 1992, the percentage of all enrollees receiving home health rose from 4.8 to 7.2 percent, while the average number of visits among users increased from 23 to 54. This article uses the 1992 Medicare Current Beneficiary Survey (MCBS) to profile home health users. In addition to providing descriptive information about who uses Medicare home health, Tobit models are estimated to determine the factors that predict home health utilization and reimbursement. Various policy options for redesigning the home health benefit are also discussed. PMID:10140153

  11. 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…

  12. 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

  13. 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)

  14. [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

  15. Improving care transitions from hospital to home: standardized orders for home health nursing with remote telemonitoring.

    PubMed

    Heeke, Sheila; Wood, Felecia; Schuck, Jennifer

    2014-01-01

    A task force at a multihospital health care system partnered with home health agencies to improve gaps during the discharge transition process. A standardized order template for home health nursing and remote telemonitoring was developed to decrease discrepancies in communication between hospital health care providers and home health nurses caring for patients with heart failure. Pilot results showed significantly improved communication with no readmissions, using the order template. PMID:23938358

  16. 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....

  17. 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....

  18. 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...

  19. 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...

  20. 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....

  1. 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...

  2. 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...

  3. 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....

  4. 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...

  5. Home health services in New Hampshire.

    PubMed

    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

  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. 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

  8. 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

  9. 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

  10. Sharps injuries and bloodborne pathogen exposures in home health care.

    PubMed

    Chalupka, Stephanie M; Markkanen, Pia; Galligan, Catherine; Quinn, Margaret

    2008-01-01

    Home health care is one of the fastest growing industries in the United States. Approximately 20,000 provider agencies deliver home health care services to 7.6 million individuals with acute illness, long-term health conditions, permanent disability, or terminal illness. The home health care setting poses many challenges that likely increase the risk of sharps injuries. Home health nurses face unique challenges in preventing and reporting sharps injuries in the home. This article examines the nature of and risk factors for sharps injuries in the home health care setting, the scope of the problem, the legislative and regulatory framework relevant to sharps injuries, and the role of occupational health nurses in promoting a culture of safety to prevent sharps injuries and bloodborne pathogen exposures. PMID:18293597

  11. A preliminary survey of health education in Indiana home schools.

    PubMed

    Havice, Adam M; Clark, Jeffrey K

    2003-10-01

    The total US school enrollment of 52.7 million students in 1998 excluded an estimated 1.2 million students educated in their homes. In 1989, some 1,148 home school families enrolled with the Indiana Department of Education. Just over a decade later, some 18,260 home school families had registered, and this number continues to increase. Despite knowledge about the growing numbers of families choosing to home school, limited empirical data exists of how health education is presented in home schools or the needs of home school educators who teach health education. This preliminary study examined health education content areas taught by home school educators in Indiana. An instrument was developed, piloted, and administered to a random sample of 600 home school educators. Results indicated most home school educators taught a variety of health education topics. Three topics--first aid, physical activity and fitness, and nutrition and diet--were taught most frequently in the health curriculum of home schools. Violence prevention, suicide prevention, and consumer health were covered less frequently in the health curriculum. Health was typically taught in a nonstructured, teachable moment format. Implications for coordinated school health programs and suggestions for further research are discussed. PMID:14593945

  12. 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.

  13. 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

  14. 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 1998–2010. 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 company’s real estate holdings. Conclusions Private investment acquired facilities are an important feature of today’s 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

  15. 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…

  16. 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…

  17. 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…

  18. 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.…

  19. 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.

  20. Comparison of coaches' perceptions and officials guidance towards health promotion in French sport clubs: a mixed method study.

    PubMed

    Van Hoye, A; Heuzé, J-P; Larsen, T; Sarrazin, P

    2016-06-01

    Despite the call to improve health promotion (HP) in sport clubs in the existing literature, little is known about sport clubs' organizational capacity. Grounded within the setting-based framework, this study compares HP activities and guidance among 10 football clubs. At least three grassroots coaches from each club (n = 68) completed the Health Promoting Sports Clubs scale to assess their perceptions of HP; an official (n = 10) was interviewed about club's activities and official's guidance provided to coaches. A concurrent embedded design with quantitative results guiding the qualitative analysis was used. Despite no significant differences regarding coaches' perceptions of HP between the 10 sport clubs, except for the policy dimension, officials' interviews revealed some contradictions. Sport participation was recognized as automatically promoting HP, meaning that sport practice entails many benefits, without questioning the nature of the activities. HP was considered as a secondary aim in regard to sport performance, leading to the lack of written policies, partnerships and sporadic HP activities. Future interventions should consider: (i) the creation of required policy and long-term vision; (ii) the link between HP and sport performance; (iii) the rootedness of sport clubs within their community and (iv) guidelines towards HP from sport federations. PMID:27060789

  1. Home health care with telemonitoring improves health status for older adults with heart failure.

    PubMed

    Madigan, Elizabeth; Schmotzer, Brian J; Struk, Cynthia J; DiCarlo, Christina M; Kikano, George; Piña, Ileana L; Boxer, Rebecca S

    2013-01-01

    Home telemonitoring can augment home health care services during a patient's transition from hospital to home. Home health care agencies commonly use telemonitors for patients with heart failure although studies have shown mixed results in the use of telemonitors to reduce rehospitalizations. This randomized trial investigated if older patients with heart failure admitted to home health care following a hospitalization would have a reduction in rehospitalizations and improved health status if they received telemonitoring. Patients were followed up to 180 days post-discharge from home health care services. Results showed no difference in the time to rehospitalization or emergency visit between those who received telemonitoring versus usual care. Older heart failure patients who received telemonitoring had better health status by home health care discharge than those who received usual care. Therefore, for older adults with heart failure, telemonitoring may be an important adjunct to home health care services to improve health status. PMID:23438509

  2. Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

    PubMed Central

    Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

    2012-01-01

    Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools – accountability measures and payment designs – to improve access to and quality of care for patients with behavioral health needs. PMID:23188486

  3. Collaboration and synergy in the field of health and wellness coaching: naïve or necessary?

    PubMed

    Wolever, Ruth Q

    2013-07-01

    The rise of health and wellness coaching holds significant promise for facilitating sustainable behavior change to help legions of individuals prevent and manage chronic disease. We all know the threats associated with the staggering epidemic of chronic disease and associated unhealthy lifestyles. But did we get here through a failure of personal responsibility? A failure of family units to support appropriate health behaviors? A failure of educational systems to teach healthy behaviors? A failure of medicine to cultivate health behaviors in patients? A failure of municipalities from an urban planning perspective? A failure of the social sciences to apply the latest in adult learning theory, psychology, and behavioral economics to health behaviors? A failure of government to incentivize or reinforce health behaviors? A failure of industry to prioritize health over capital? A failure of society to integrate all of the above? Or is this just the perfect time to synergize all that we know from numerous disciplines to conquer the challenge of unhealthy behavior that creates chronic disease? From my perspective as a health psychologist, understanding the origins of the problems will help us draft the solution. But from my perspective as a coach, how we got here is much less important than how we get out of here. PMID:24416680

  4. 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 Politécnica de Madrid for R&D activities. PMID:19964893

  5. 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

  6. 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

  7. 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)

  8. 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)

  9. 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

  10. Will drivers for home energy efficiency harm occupant health?

    PubMed

    Bone, Angie; Murray, Virginia; Myers, Isabella; Dengel, Andy; Crump, Derrick

    2010-09-01

    The U.K. government has committed to an 80% reduction in carbon emissions by 2050, with housing accounting for 27% of total current emissions. There are several drivers both to reduce emissions from homes and to reduce fuel poverty, promoting a range of building and behavioural measures in homes. The health benefits of warmer homes in winter have been described, but there has been less consideration of the potential negative impacts of some of these measures. We examine the changes in U.K. homes, and the possible consequences for health. The main concerns for health surround the potential for poor indoor air quality if ventilation is insufficient and the possible risks of overheating in heatwave conditions. This paper notes a limited evidence base and the need for further research on the health effects of energy-efficient homes, particularly with regard to ventilation. PMID:21086820

  11. The impact of a value-based insurance design plus health coaching on medication adherence and medical spending.

    PubMed

    Musich, Shirley; Wang, Sara; Hawkins, Kevin

    2015-06-01

    The objective of this study was to evaluate medication adherence, medical services utilization, and combined medical and pharmacy expenditures associated with diabetes and hypertension value-based insurance design (VBID) plus health/disease coaching programs implemented by a large employer. A pre/post participant versus nonparticipant study design was used to measure medication possession ratios (MPRs), inpatient admissions, emergency room utilization, and combined medical and pharmacy expenditures for employees/spouses with diabetes (n = 1090; average 23 months follow-up) and hypertension (n = 3254; average 13 months follow-up) participating in a VBID plus health/disease coaching relative to eligible nonparticipants. Outcome measures were propensity score weighted and regression adjusted to estimate the independent impact of the programs. MPRs for diabetes and hypertension were significantly increased 3 to 4 percentage points for VBID participants, while MPRs for respective nonparticipants decreased by about 10 percentage points. Employer-paid pharmacy expenditures increased significantly for both participants with diabetes and hypertension while out-of-pocket patient co-payments decreased significantly. Medical expenditures for diabetes VBID participants decreased but not significantly. Hypertension participants experienced medical expenditure increases. Medical services utilization of inpatient admissions and emergency room visits underwent minimal change. Thus employer-sponsored diabetes and hypertension VBID plus health/disease coaching programs can be expected to lower patient co-payments and significantly increase medication adherence. Meanwhile, medical spending outcomes indicated that increased diabetes and hypertension pharmacy expenditures were partially offset by medical savings (for diabetes) but not sufficiently to be cost neutral. PMID:25247449

  12. 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

  13. 42 CFR 484.36 - Condition of participation: Home health aide services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Home health aide... HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Furnishing of Services § 484.36 Condition of participation: Home health aide services. Home health aides are selected...

  14. 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…

  15. 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

  16. 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

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

    PubMed

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

    2014-02-01

    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

  18. Leadership and quality of working life in home health care.

    PubMed

    Smith, H L; Hood, J N; Piland, N F

    1994-01-01

    Home health care has undergone startling changes in the past decade and, in the process, become a strategically important ingredient of health care delivery. However, the question remains whether home health care organizations can deliver the benefits anticipated for integrated care delivery systems. The answer to this question depends to a great extent on whether home health care organizations build vibrant, visionary leadership capable of transforming organizations and motivating staff to deliver high quality and low cost services. This paper examines a case study of transformational leadership as it relates to the quality of working life for nurses, homemakers, and staff. The findings indicate that leader behaviour is strongly associated with homemakers', and to a lesser extent staff members', job satisfaction, job involvement, and propensity to remain with the organization. These job attitudes have been shown to be related to higher job performance. The implications for leadership in home health agencies are discussed. PMID:10134028

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

    NASA Astrophysics Data System (ADS)

    Gupta, Milon; Chotard, Laure; Ingþórsson, Ólafur; Bastos, João; 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.

  20. 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…

  1. 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...

  2. 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...

  3. 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...

  4. 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

  5. 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

  6. 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.

  7. 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

  8. 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…

  9. 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 χ2 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

  10. 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

  11. 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

  12. 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…

  13. 42 CFR 484.245 - Accelerated payments for home health agencies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 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 System for Home Health Agencies § 484.245...

  14. 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

  15. Job satisfaction of rural public and home health nurses.

    PubMed

    Juhl, N; Dunkin, J W; Stratton, T; Geller, J; Ludtke, R

    1993-03-01

    Based on Vroom's expectancy theory, this study was conducted to identify differences in job satisfaction between nurses working in public health settings, and staff nurses and administrators working in both settings. Questionnaires containing an adaptation of a job satisfaction scale were mailed to all 258 registered nurses practicing in public health and home health settings (response rate 57%) in a rural midwestern state. Respondents were asked to rate their satisfaction with various dimensions of their jobs, as well as how important each aspect was to them. Although both groups of nurses reported low satisfaction with salary, public health nurses were significantly less satisfied with their salaries than were home health nurses (F = 32.96, P < or = 0.001); home health nurses, however, were significantly less satisfied with benefits/rewards (F = 11.85, P < or = 0.001), task requirements (F = 8.37, P < or = 0.05), and professional status (F = 5.30, P < or = 0.05). Although administrators did not differ significantly from staff nurses on job satisfaction, they did perceive organizational climate (F = 4.50, P < or = 0.05) to be an important feature of satisfaction. These differences may be partially explained by divergent salaries, roles, and responsibilities between public health and home health nurses. PMID:8516258

  16. 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…

  17. Promoting spiritual health in home healthcare.

    PubMed

    Taylor, Elizabeth Johnston

    2008-06-01

    This article explores how clinicians can promote patient and family caregiver spiritual health. After a review of pertinent theory and research, clinical implications are identified, including appropriate goals for clinicians with regard to spiritual health promotion. PMID:18562823

  18. 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

  19. Evidence-Based Health Promotion in Nursing Homes: A Pilot Intervention to Improve Oral Health

    ERIC Educational Resources Information Center

    Cadet, Tamara J.; Berrett-Abebe, Julie; Burke, Shanna L.; Bakk, Louanne; Kalenderian, Elsbeth; Maramaldi, Peter

    2016-01-01

    Nursing home residents over the age of 65 years are at high risk for poor oral health and related complications such as pneumonia and adverse diabetes outcomes. A preliminary study found that Massachusetts' nursing homes generally lack the training and resources needed to provide adequate oral health care to residents. In this study, an…

  20. Mental health service use by the elderly in nursing homes.

    PubMed Central

    Burns, B J; Wagner, H R; Taube, J E; Magaziner, J; Permutt, T; Landerman, L R

    1993-01-01

    OBJECTIVES. Because current Omnibus Budget Reconciliation Act regulations influence the disposition of US nursing home residents who have mental illness, National Nursing Home Survey (1985) data are analyzed for predictors of mental health service use. METHODS. Elderly residents' rates of mental health service use are presented. Logistic regression yielded odds ratios for treatment by both mental health specialists and general practitioners for client and service system variables. RESULTS. Among the two thirds of elderly residents with a mental disorder (including dementia), only 4.5% receive any mental health treatment in a 1-month period. The ratio of specialist to general practitioner care is approximately 1:1. Patients seen by a specialist are likely to be younger (aged 65 to 74); live in the Northeast; and have a diagnosis of schizophrenia (13:1), dementia (3:1), or other mental disorders (5:1). Prior residence in a psychiatric hospital predicts care by both health professional types. Rural location, nonproprietary ownership of the nursing home, and aggressive behavior point to general physician care. CONCLUSIONS. Our findings indicate significant neglect of the mental health needs of older nursing home residents and underscore the importance of monitoring the regulations for screening and treatment of mental disorders under the Omnibus Budget Reconciliation Act. PMID:8438968

  1. 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

  2. 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.

  3. 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

  4. Association of Discharge Home with Home Health Care and 30-day Readmission after Pancreatectomy

    PubMed Central

    Sanford, Dominic E; Olsen, Margaret A; Bommarito, Kerry M; Shah, Manish; Fields, Ryan C; Hawkins, William G; Jaques, David P; Linehan, David C

    2014-01-01

    Background We sought to determine if discharge home with home health care (HHC) is an independent predictor of increased readmission following pancreatectomy. Study Design We examined 30-day readmissions in patients undergoing pancreatectomy using the Healthcare Cost and Utilization Project State Inpatient Database for California from 2009 to 2011. Readmissions were categorized as severe or non-severe using the Modified Accordion Severity Grading System. Multivariable logistic regression models were used to examine the association of discharge home with HHC and 30-day readmission using discharge home without HHC as the reference group. Propensity score matching was used as an additional analysis to compare the rate of 30-day readmission between patients discharged home with HHC to patients discharged home without HHC. Results 3,573 patients underwent pancreatectomy and 752 (21.0%) were readmitted within 30 days of discharge. In a multivariable logistic regression model, discharge home with HHC was an independent predictor of increased 30-day readmission (OR=1.37; 95%CI=1.11-1.69, p=0.004). Using propensity score matching, patients who received HHC had a significantly increased rate of 30-day readmission compared to patients discharged home without HHC (24.3% vs 19.8%, p<0.001). Patients discharged home with HHC had a significantly increased rate of non-severe readmission compared to those discharged home without HHC by univariate comparison (19.2% vs 13.9%, p<0.001), but not severe readmission (6.4% vs 4.7%, p= 0.08). In multivariable logistic regression models, excluding patients discharged to facilities, discharge home with HHC was an independent predictor of increased non-severe readmissions (OR=1.41; 95%CI=1.11-1.79, p=0.005), but not severe readmissions (OR=1.31; 95%CI=0.88-1.93, p=0.18). Conclusions Discharge home with HHC following pancreatectomy is an independent predictor of increased 30-day readmission; specifically, these services are associated with increased non-severe readmissions, but not severe readmissions. PMID:25440026

  5. 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

  6. 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

  7. 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…

  8. 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)

  9. Competition and quality in home health care markets.

    PubMed

    Jung, Kyoungrae; Polsky, Daniel

    2014-03-01

    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

  10. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... initial certification must document that the face-to-face patient encounter, which is related to the... therapy services as defined in § 409.42(a) and (c) of this chapter, respectively. (A) The face-to-face... directly admitted to home health. (B) The documentation of the face-to-face patient encounter must be...

  11. 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

  12. 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,

  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. 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

  16. Public health. Parity begins at home.

    PubMed

    Hawker, J

    1999-01-01

    The NHS can make a considerable contribution to reducing social exclusion and inequalities. GPs' surgeries should play a greater role in giving information on social security benefits. Primary care should be targeted at those most in need. The NHS has many employees on low incomes and should provide them with an effective occupational health service. PMID:10339198

  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. 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.

  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. 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

  1. Integrative health coaching: a behavior skills approach that improves HbA1c and pharmacy claims-derived medication adherence

    PubMed Central

    Wolever, Ruth Q; Dreusicke, Mark H

    2016-01-01

    Objective Medication adherence requires underlying behavior skills and a supporting mindset that may not be addressed with education or reminders. Founded in the study of internal motivation and health psychology, integrative health coaching (IHC) helps patients gain insight into their behaviors and make long-term, sustainable lifestyle changes. The purpose of the study is to determine whether IHC improves oral medication adherence, glycated hemoglobin (HbA1c), and psychosocial measures, and to assess whether adherence changes are sustained after the intervention. Methods Using a prospective observational design, participants (n=56) received 14 coaching calls by telephone over 6 months. Medication possession ratio (MPR) was calculated for time intervals before, during, and after the intervention. HbA1c and patient-reported psychosocial outcomes were obtained to test interactions with MPR. Results Medication adherence (MPR) increased from 0.74±0.197 to 0.85±0.155 during coaching, and was sustained at 0.82±0.175 during a 6-month period after the study. Better adherence correlated with a greater decrease in HbA1c. HbA1c decreased from 8.0±1.92% to 7.7±1.70% over the 6-month intervention. All psychosocial measures showed significant improvement. In addition to discussing medication adherence strategies with their coach, patients discussed nutrition and exercise (86.9% of calls), stress management (39.8%), and social support and relationships (15.4%). Conclusions IHC targets internal motivation and supports behavior change by facilitating patients’ insight into their own behaviors, and it uses this insight to foster self-efficacy. This approach may yield sustainable results for medication adherence and warrants further exploration for health-related behavior change.

  2. Orientation to Health Aide Careers Mini-Course & Home Health Aide Course.

    ERIC Educational Resources Information Center

    Novak, Kathy; And Others

    Designed for use in a self-paced, open-entry/open-exit vocational training program for home health aides, this program guide is one of six for teachers of adult women offenders from a correctional institution. Module topic outlines are presented on eight topics: your career as a health aide; maintaining health; recognizing illness; positioning and…

  3. 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…

  4. 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

  5. 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

  6. 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…

  7. 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

  8. Virtual Visits in Home Health Care for Older Adults

    PubMed Central

    Husebø, 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

  9. Practical guide on home health in heart failure patients

    PubMed Central

    Jaarsma, Tiny; Larsen, Torben; Strömberg, Anna

    2013-01-01

    Introduction Chronic heart failure is a common condition affecting up to 15 million people in the extended Europe. Heart failure is burdensome and costly for patients in terms of decreased quality of life and poor prognosis, and it is also costly for society. Better integrated care is warranted in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. Method We developed a guide on Home Health in Heart Failure patients from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. Results In integrated home care for heart failure patients, it is advised to consider the following components: integrated multidisciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimised treatment. Discussion We summarised the state of the art of home-based care for heart failure patients in Europe, described the typical content of such care to provide a guide for health care providers. PMID:24250283

  10. 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

  11. 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

  12. COACH trial: A randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: Rationale and design

    PubMed Central

    Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

    2011-01-01

    Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. PMID:21241828

  13. Hurricane emergency planning by home health providers serving the poor.

    PubMed

    Kirkpatrick, Dahlia V; Bryan, Marguerite

    2007-05-01

    Five agencies providing home health care to indigent populations in New Orleans, Louisiana were evaluated in terms of emergency planning and implementation. This was to help improve response to community disasters for indigent populations. Preparation for Hurricane Katrina was examined looking at interaction with local and state departments of health. It was found that the state dept of health provided leadership in making the emergency plans, but not in implementation. Local departments of health appeared to have very little responsibility in emergency planning. Although every agency had a plan, when it came to implementation there was lack of coordination and breakdown in communication at all government levels. Recommendations for future policy include: 1) early evacuation of special needs patients; 2) improved training of staff to include practice drills; 3) improve communication systems; and, 4) increased funding of state and local departments of health to provide training. PMID:17483559

  14. 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.

  15. 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

    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

  16. 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

  17. 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…

  18. 'Redefining health care': medical homes or archipelagos to navigate?

    PubMed

    Enthoven, Alain C; Crosson, Francis J; Shortell, Stephen M

    2007-01-01

    This paper provides an analysis of the structure of the health care delivery system, emphasizing physician group practices. The authors argue for comprehensive integrated delivery systems (IDSs). The jumping-off point for their analysis is the recently published Redefining Health Care: Creating Value-Based Competition on Results, by Michael Porter and Elizabeth Teisberg. The authors focus on the book's core idea that competitors should be freestanding integrated practice units (or "islands in archipelagos") versus IDSs (or "medical homes"). In any case, the authors contend that this issue should be resolved by competition to attract and serve informed, cost-conscious, responsible consumers on a level playing field. PMID:17848447

  19. 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…

  20. Transpersonal Coaching.

    PubMed

    Schaub, Bonney Gulino; White, Mary Beth

    2015-08-01

    These are just a few of many stories shared by patients who have benefited from transpersonal coaching. This practice blends well with holistic nursing and can be easily applied to a variety of situations and healthcare settings. When a holistic nurse works from the assumption that the transpersonal aspect of human nature is an objective fact, it is possible to help patients gain access to their transpersonal nature and thereby experience new feelings and insights. The insights usually come in the form of images and energies and provide the personality with a greater sense of wholeness and courage. PMID:26521625

  1. Coaching for ADHD

    ERIC Educational Resources Information Center

    Murphy, Kevin; Ratey, Nancy; Maynard, Sandy; Sussman, Susan; Wright, Sarah D.

    2010-01-01

    Despite limited scientific study on ADHD coaching as an intervention for adults with ADHD, the field of ADHD coaching has grown significantly and gained popularity in recent years. ADHD coaching is becoming a bona fide profession where one must advance through a rigorous training process, in order to be certified as a professional ADHD coach.…

  2. 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…

  3. Wireless health data exchange for home healthcare monitoring systems.

    PubMed

    Lee, Malrey; Gatton, Thomas M

    2010-01-01

    Ubiquitous home healthcare systems have been playing an increasingly significant role in the treatment and management of chronic diseases, such as diabetes and hypertension, but progress has been hampered by the lack of standardization in the exchange of medical health care information. In an effort to establish standardization, this paper proposes a home healthcare monitoring system data exchange scheme between the HL7 standard and the IEEE1451 standard. IEEE1451 is a standard for special sensor networks, such as industrial control and smart homes, and defines a suite of interfaces that communicate among heterogeneous networks. HL7 is the standard for medical information exchange among medical organizations and medical personnel. While it provides a flexible data exchange in health care domains, it does not provide for data exchange with sensors. Thus, it is necessary to develop a data exchange schema to convert data between the HL7 and the IEEE1451 standard. This paper proposes a schema that can exchange data between HL7 devices and the monitoring device, and conforms to the IEEE 1451 standard. The experimental results and conclusions of this approach are presented and show the feasibility of the proposed exchange schema. PMID:22319296

  4. 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…

  5. 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…

  6. 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

  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. The Experience of Critical Self-Reflection by Life Coaches: A Phenomenological Study

    ERIC Educational Resources Information Center

    Shaw, Deanna Lynn

    2012-01-01

    The purpose of this study was to describe the experience of critical self-reflection by life coaches. Life coaching is expanding within many disciplines including education, health care, business, social work, and wellness. Life coaching involves a coach working with an individual or groups aimed at effecting change for professional and personal…

  9. Automated Health Alerts Using In-Home Sensor Data for Embedded Health Assessment

    PubMed Central

    Guevara, Rainer Dane; Rantz, Marilyn

    2015-01-01

    We present an example of unobtrusive, continuous monitoring in the home for the purpose of assessing early health changes. Sensors embedded in the environment capture behavior and activity patterns. Changes in patterns are detected as potential signs of changing health. We first present results of a preliminary study investigating 22 features extracted from in-home sensor data. A 1-D alert algorithm was then implemented to generate health alerts to clinicians in a senior housing facility. Clinicians analyze each alert and provide a rating on the clinical relevance. These ratings are then used as ground truth for training and testing classifiers. Here, we present the methodology for four classification approaches that fuse multisensor data. Results are shown using embedded sensor data and health alert ratings collected on 21 seniors over nine months. The best results show similar performance for two techniques, where one approach uses only domain knowledge and the second uses supervised learning for training. Finally, we propose a health change detection model based on these results and clinical expertise. The system of in-home sensors and algorithms for automated health alerts provides a method for detecting health problems very early so that early treatment is possible. This method of passive in-home sensing alleviates compliance issues.

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

    MedlinePlus

    ... first conducted in 1992 and was repeated in 1993, 1994, 1996, 1998, 2000, and 2007. Agencies that ... elderly home health care users: Data from the 1993 National Home and Hospice Care Survey. Advance data ...

  11. 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)…

  12. 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....

  13. 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....

  14. 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....

  15. 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....

  16. 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

  17. 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

  18. Health coaching to promote healthier lifestyle among older people at moderate risk for cardiovascular diseases, diabetes and depression: a study protocol for a randomized controlled trial in Sweden

    PubMed Central

    2013-01-01

    Background The challenge of an aging population in the society makes it important to find strategies to promote health for all. The aim of this study is to evaluate if repeated health coaching in terms of motivational interviewing, and an offer of wide range of activities, will contribute to positive lifestyle modifications and health among persons aged 60–75 years, with moderately elevated risk for cardiovascular disease (CVD), diabetes, or mild depression. Methods/Design Men and women between 60 and 75 are recruited in four regions in Sweden if they fulfill one or more of the four inclusion criteria. •Current reading of blood pressure (140-159/90-99) without medication. •Current reading of blood sugar (Hba1c 42–52 mmol/mol) without medication. •A current waist-circumference of ≥94 cm for men and ≥80 for women. •A minor/mild depression (12–20 points) according to Montgomery-Åsberg Depression Rating Scale without medication. Individuals with a worse result than inclusion criteria are treated according to regular guidelines at the PHCs and therefore not included. Exclusion criteria for the study are dementia, mental illness or other condition deemed unsuitable for participation. All participants fill out a questionnaire at baseline, and at the 6-, 12- and 18-month follow-ups containing questions on demographic characteristics, social life, HRQoL, lifestyle habits, general health/medication, self-rated mental health, and sense of coherence. At the 12-month follow-up, the health coach will give each participant a second questionnaire to capture attitudes and perceptions related to health coaching and venues/activities offered. Qualitative data will be collected twice to obtain a deeper understanding of perceptions and attitudes related to health and lifestyle/lifestyle modifications. A health economic assessment will be performed. Individual costs for health care utilisation will be collected and QALY-scores will be estimated. Discussion Several drawbacks can be identified when conducting research in real life. However, many of the identified problems can diminish the positive results of the intervention and if the intervention shows positive effects they might be underestimated. Trial registration Current Controlled Trials ISRCTN01396033. PMID:23497163

  19. 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!

  20. 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, today’s 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.

  1. 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

  2. Workplace Participatory Occupational Health/Health Promotion Program: Facilitators and Barriers Observed in Three Nursing Homes.

    PubMed

    Zhang, Yuan; Flum, Marian; Kotejoshyer, Rajashree; Fleishman, Jane; Henning, Robert; Punnett, Laura

    2016-06-01

    Nursing home employees experience high physical and psychosocial workloads, resulting in poor health outcomes. An occupational health/health promotion program, designed to facilitate employee participation, was initiated in three nursing homes. The aim of the current study was to evaluate facilitators and barriers of the program after 3-year implementation. Focus groups with employees and in-depth interviews with top and middle managers were conducted. The Social Ecological Model was used to organize the evaluation. Facilitators and barriers were reported from both managers' and employees' perspectives, and were categorized as intrapersonal, interpersonal, institutional, and corporate level. Management support, financial resources, and release time for participation were identified as the three most important factors. Supports from multiple levels including both human and environment, and managers and employees, are important for a successful participatory occupational health/health promotion program. [Journal of Gerontological Nursing, 42(6), 34-42.]. PMID:26977705

  3. 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

  4. Health coaching and pedometers to enhance physical activity and prevent falls in community-dwelling people aged 60 years and over: study protocol for the Coaching for Healthy AGEing (CHAnGE) cluster randomised controlled trial

    PubMed Central

    Tiedemann, Anne; Rissel, Chris; Howard, Kirsten; Tong, Allison; Merom, Dafna; Smith, Stuart; Wickham, James; Bauman, Adrian; Lord, Stephen R; Vogler, Constance; Lindley, Richard I; Simpson, Judy M; Allman-Farinelli, Margaret; Sherrington, Catherine

    2016-01-01

    Introduction Prevention of falls and promotion of physical activity are essential for maximising well-being in older age. However, there is evidence that promoting physical activity among older people without providing fall prevention advice may increase fall rates. This trial aims to establish the impact of a physical activity and fall prevention programme compared with a healthy eating programme on physical activity and falls among people aged 60+ years. Methods and analysis This cluster randomised controlled trial will involve 60 groups of community-dwelling people aged 60+ years. Participating groups will be randomised to: (1) a physical activity and fall prevention intervention (30 groups), involving written information, fall risk assessment and prevention advice, a pedometer-based physical activity tracker and telephone-based health coaching; or (2) a healthy eating intervention (30 groups) involving written information and telephone-based dietary coaching. Primary outcomes will be objectively measured physical activity at 12 months post-randomisation and self-reported falls throughout the 12-month trial period. Secondary outcomes include: the proportion of fallers, the proportion of people meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and health and community service use. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will be preplanned, conducted while masked to group allocation, will take into account cluster randomisation, and will use an intention-to-treat approach. Ethics and dissemination Protocol has been approved by the Human Research Ethics Committee at The University of Sydney, Australia (number 2015/517). Results will be disseminated via peer-reviewed journal articles, international conference presentations and participants' newsletters. Trial registration number ACTRN12615001190594. PMID:27165652

  5. Promoting Health and Home Safety for Children of Parents with Intellectual Disability: A Randomized Controlled Trial.

    ERIC Educational Resources Information Center

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

    2003-01-01

    This study evaluated a home-based intervention for parents with intellectual disability to promote child health and home safety in the preschool years. The intervention improved parents' ability to recognize home dangers and to handle emergencies, increased their knowledge about illness and medicines, and increased the number of safety precautions…

  6. Bringing Central Line–Associated 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 line–associated 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 children’s 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 agency’s 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

  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 Coaching of Teaching.

    ERIC Educational Resources Information Center

    Joyce, Bruce; Showers, Beverly

    1982-01-01

    Teachers, like athletes, are more likely to adopt new ways of doing their jobs if they are coached, and they are also likely to get worse before they get better. This article describes the coaching of teachers and includes an interview with a football coach to illustrate parallels with athletics. (PGD)

  9. Identifying the key performance improvement domains for home health agencies

    PubMed Central

    Koru, Güneş; Alhuwail, Dari; Rosati, Robert J.

    2015-01-01

    Objective: The objective of this study was to support home health agencies (HHAs) in the United States (US) in their individualized quality assessment and performance improvement (QAPI) initiatives by identifying their key performance improvement domains (KPIDs). Methods: Qualitative research was conducted by following the Framework method. Rich contextual data were obtained through focus group meetings participated by domain experts. The analysis results were further refined in an online forum and validated at a final meeting. Results: Four focus groups involving a total of 20 participants resulted in useful discussions during which various perspectives were expressed by the expert participants. A well-defined set of 17 KPIDs emerged under four categories, namely, economical value, sociocultural sensitivity, interpersonal relationships, and clinical capabilities. Conclusions: The feedback we received from the focus groups indicates that performance improvement in HHAs is a lot more complicated than simply assessing whether certain clinical tasks are performed. The KPIDs identified in this study can help HHAs in their focused and individualized QAPI initiatives. Therefore, the results should be immediately relevant, interesting, and useful to the home care industry and policy makers in the US. PMID:27092266

  10. 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 world’s 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 1998–2011 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

  11. Preparing Nursing Homes for the Future of Health Information Exchange

    PubMed Central

    Rantz, M.; Galambos, C.; Vogelsmeier, A.; Flesner, M.; Popejoy, L.; Mueller, J.; Shumate, S.; Elvin, M.

    2015-01-01

    Summary Objective Our purpose was to describe how we prepared 16 nursing homes (NHs) for health information exchange (HIE) implementation. Background NH HIE connecting internal and external stakeholders are in their infancy. U.S. initiatives are demonstrating HIE use to increase access and securely exchange personal health information to improve patient outcomes. Method To achieve our objectives we conducted readiness assessments, performed 32 hours of clinical observation and developed 6 use cases, and conducted semi-structured interviews with 230 participants during 68 site visits to validate use cases and explore HIE. Results All 16 NHs had technology available to support resident care. Resident care technologies were integrated much more with internal than external stakeholders. A wide range of technologies were accessible only during administrative office hours. Six non-emergent use cases most commonly communicated by NH staff were: 1) scheduling appointments, 2) Laboratory specimen drawing, 3) pharmacy orders and reconciliation, 4) social work discharge planning, 5) admissions and pre-admissions, and 6) pharmacy-medication reconciliation. Emerging themes from semi-structured interviews about use cases included: availability of information technology in clinical settings, accessibility of HIE at the point of care, and policies/procedures for sending/receiving secure personal health information. Conclusion We learned that every facility needed additional technological and human resources to build an HIE network. Also, use cases help clinical staff apply theoretical problems of HIE implementation and helps them think through the implications of using HIE to communicate about clinical care. PMID:26171073

  12. 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

  13. 76 FR 9502 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-18

    ...: Randy Throndset, (410) 786-0131. SUPPLEMENTARY INFORMATION: I. Background In FR Doc. 2010-27778 (75 FR...; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home Health Agencies and Hospices; Correction AGENCY: Centers for Medicare & Medicaid...

  14. 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…

  15. Behavioral Characteristics of "Favorite" Coaches: Implications for Coach Education

    ERIC Educational Resources Information Center

    Stewart, Craig; Owens, Lynn

    2011-01-01

    The purpose of this paper was to use athletes' and former athletes' memories of their favorite coach to improve coach education curriculum. Player preferences of coaching behavior can affect both their attitudes toward their sport experiences and team performance. By identifying positive coaching behaviors as recalled by athletes, coach educators…

  16. 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…

  17. 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

  18. The role of the Medicare fiscal intermediary and the Regional Home Health Intermediary, Part 1.

    PubMed

    Randall, D A

    1992-06-01

    The Medicare fiscal intermediaries (FIs) are private insurance companies that serve as the federal government's agents in the administration of the Medicare program, including the payment of claims. There are two primary functions for the FI--reimbursement review and medical coverage review. Hospital-based home health agencies relate to the hospital's FI for reimbursement purposes. All home health agencies are assigned to a special FI, the Regional Home Health Intermediary (RHHI), for medical review issues. The same or a different FI may audit the hospital's cost report. Freestanding home health agencies deal with separate reimbursement and medical review divisions within a single RHHI's office. The author reviews the role of the Medicare FI and the RHHI and their relationship to home health agencies. Part 2 will appear in the July/August issue. PMID:1597760

  19. The role of the Medicare fiscal intermediary and the regional home health intermediary, Part 2.

    PubMed

    Randall, D A

    1992-01-01

    The Medicare fiscal intermediaries (FIs) are private insurance companies that serve as the federal government's agents in the administration of the Medicare program, including the payment of claims. There are two primary functions of the FI--reimbursement review and medical coverage review. Hospital-based home health agencies relate to the hospital's FI for reimbursement purposes. All home health agencies are assigned to a special FI, the Regional Home Health Intermediary (RHHI), for medical review issues. This may be the same FI or a different one than that audits the hospital's cost report. Freestanding home health agencies deal with separate reimbursement and medical review divisions within a single RHHI's office. The author reviews the role of the Medicare FI and the RHHI and their relationship to home health agencies. Part 1 was featured in the June issue. PMID:1506908

  20. Protecting home health care workers: a challenge to pandemic influenza preparedness planning.

    PubMed

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

    2009-10-01

    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

  1. 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

  2. Supporting SIDS Families: The Public Health Nurse SIDS Home Visit.

    PubMed

    Stastny, Penny F; Keens, Thomas G; Alkon, Abbey

    2016-05-01

    Sudden infant death syndrome (SIDS) death has a devastating effect on parents. There is no known cause, so parents experience guilt about what they might have done or not done to contribute to the death. Although some SIDS parents may receive support from family and friends, the public health nurse (PHN) has an important professional role in providing grief support, SIDS education, and offering SIDS resources and referrals. Based on years of clinical practice, we recommend the following: Perform the home visit as soon as possible. Show care and compassion. Personalize the baby by using his or her name and asking to see photographs. Reassure the parents that grief is a process which takes time. Educate about what SIDS is and what it is not. Increasingly, SIDS deaths occur in the presence of risk factors. Explain that risk factors are not causes of death. As an authority in health care, reassuring families that they did not cause their baby's death has a tremendous impact on relieving guilt. Putting newly bereaved SIDS parents in contact with other SIDS parents is one of the most helpful actions a PHN can take to help families. PMID:26822270

  3. The impact of home-prepared diets and home oral hygiene on oral health in cats and dogs.

    PubMed

    Buckley, Catherine; Colyer, Alison; Skrzywanek, Michal; Jodkowska, Katarzyna; Kurski, Grzegorz; Gawor, Jerzy; Ceregrzyn, Michal

    2011-10-01

    Many factors influence the oral health status of cats and dogs. The present study aimed to elucidate the influence of feeding home-prepared (HP) food v. commercial pet food on oral health parameters in these animals and to investigate the effect of home oral hygiene on oral health. The study surveyed 17,184 dogs and 6371 cats visiting over 700 Polish veterinary surgeries in 2006-7 during a Pet Smile activity organised by the Polish Small Animal Veterinary Association. All animals underwent conscious examinations to assess dental deposits, size of mandibular lymph nodes and gingival health. An oral health index (OHI) ranging from 0 to 8 was calculated for each animal by combining examination scores, where 0 indicates good oral health and 8 indicates poorest oral health. Information was collected on age, diet and home oral hygiene regimens. There was a significant effect of diet on the OHI (P < 0.001) whereby feeding the HP diet increased the probability of an oral health problem in both cats and dogs. There was a significant beneficial effect of feeding only commercial pet food compared with the HP diet when at least part of the diet was composed of dry pet food. Daily tooth brushing or the offering of daily dental treats were both effective in significantly reducing the OHI in both cats and dogs compared with those receiving sporadic or no home oral hygiene. Feeding only a dry diet was beneficial for oral health in cats and dogs. Tooth brushing and the offering of dental treats were very effective in maintaining oral health, provided they were practised daily. PMID:22005407

  4. Developmental coaching: bridge to organizational success.

    PubMed

    Locke, Ann

    2008-01-01

    Leaders of successful organizations understand the value of workforce engagement and learning. They also know that classroom training alone is not enough to ensure the transfer of learning to practice. This reality has spawned an interest in developmental coaching: an educational tool that bridges the gap between knowledge and performance and gets bottom-line results. This article discusses the background and relevance of developmental coaching and provides examples of its potential in health care. PMID:18834032

  5. 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…

  6. 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

  7. Increasing home health service referrals, boon or bane?

    PubMed

    Gay, E G; Kronenfeld, J J; Baker, S L

    1994-01-01

    Discharges to home health services (HHS) increased dramatically for the elderly after Medicare's prospective payment system (PPS) was enacted in October 1983. A longitudinal study of fourth quarter South Carolina discharge abstracts from 68 of 71 short term acute care hospitals in the state were analyzed to appraise hospital responses to implementation of this significant change in Medicare's reimbursement system. PPS caused shifts in hospital practices as financial incentives radically changed from a cost-based system that encourages expenditures to a PPS that evokes conservation of resources within a hospital stay. In so doing, the "output" (i.e., discharge) changed. One of those changes observed was an increase in referrals to HHS. Apparently, capping the amount reimbursed for a particular diagnosis left the more resource-intensive patient vulnerable and in want of care on discharge. Demand for HHS rose significantly (+47% in 1983; +234% by 1985). Though a HHS referral may be appropriate during the recuperative phase of an illness, questions arise as to hospital motivation. The HHS referral represented the most resource-intensive, but arguably unprofitable segment. Had hospitals sought earlier discharges to "protect their bottom line" as reimbursement essentially was capped? Was a referral to HHS appropriate to meet the existing patient-care needs that remained? Did HHS offer a more cost-effective substitution for care formerly provided the patient in the hospital? What provider and consumer characteristics are at risk and why? Both consumer and provider concerns need to be addressed. Answers to these questions are most critical to future health care reform. Allocation decisions of scarce resources need to be grounded in realistic expectations drawn from appraisals of what does and does not work in the health care market. PMID:10134030

  8. Monitoring changes in home health care: a comparison of two national surveys.

    PubMed

    Mullner, R M; Jewell, M A; Mease, M A

    1999-02-01

    Home health care is the fastest growing component of medical care in the United States. To understand better the nature and scope of changes taking place in home health, two current national surveys are described and compared. The two federally sponsored surveys are the National Home and Hospice Care Survey (NHHCS) conducted by the National Center for Health Statistics and the Medical Expenditure Panel Survey (MEPS) of the Agency for Health Care Policy and Research. Computer data files from both surveys are publicly available. PMID:10321376

  9. Federal Enactment of Healthy Homes Legislation in the United States to Improve Public Health

    PubMed Central

    Ferguson, Alesia Coralie; Yates, Christopher

    2016-01-01

    Not all homes across America are “healthy” homes. This contributes to the poor health of Americans and exacerbates existing health conditions costing millions each year in health-care cost. Newer research is being conducted into strategies to alleviate biological, chemical, and physical hazards in the home, and various programs exist to assist the homeowner in making improvements in the quality of their home. Not every homeowner or renter nationwide or within community localities has access to these strategies or programs that could potentially improve their home environment and therefore the health of their family. The objective of this article is to propose elements of a policy to address this inconsistency and variation. This proposal centers around the federal enactment of a national policy demanding that each state implements a healthy homes program tailored to fit their specific state housing and health needs. Members of Congress from States that have successfully implemented healthy home programs should champion this policy. Organizations that recognize the impact of housing on health should support the development of a national healthy homes strategy. This article will discuss the need, outcomes, stakeholders, and minimum requirements of such a policy. PMID:27047913

  10. Federal Enactment of Healthy Homes Legislation in the United States to Improve Public Health.

    PubMed

    Ferguson, Alesia Coralie; Yates, Christopher

    2016-01-01

    Not all homes across America are "healthy" homes. This contributes to the poor health of Americans and exacerbates existing health conditions costing millions each year in health-care cost. Newer research is being conducted into strategies to alleviate biological, chemical, and physical hazards in the home, and various programs exist to assist the homeowner in making improvements in the quality of their home. Not every homeowner or renter nationwide or within community localities has access to these strategies or programs that could potentially improve their home environment and therefore the health of their family. The objective of this article is to propose elements of a policy to address this inconsistency and variation. This proposal centers around the federal enactment of a national policy demanding that each state implements a healthy homes program tailored to fit their specific state housing and health needs. Members of Congress from States that have successfully implemented healthy home programs should champion this policy. Organizations that recognize the impact of housing on health should support the development of a national healthy homes strategy. This article will discuss the need, outcomes, stakeholders, and minimum requirements of such a policy. PMID:27047913

  11. 42 CFR 410.170 - Payment for home health services, for medical and other health services furnished by a provider...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payment for home health services, for medical and other health services furnished by a provider or an approved ESRD facility, and for comprehensive outpatient rehabilitation facility (CORF) services: Conditions. 410.170 Section 410.170 Public Health CENTERS FOR MEDICARE & MEDICAID...

  12. 42 CFR 410.170 - Payment for home health services, for medical and other health services furnished by a provider...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for home health services, for medical and other health services furnished by a provider or an approved ESRD facility, and for comprehensive outpatient rehabilitation facility (CORF) services: Conditions. 410.170 Section 410.170 Public Health CENTERS FOR MEDICARE & MEDICAID...

  13. 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

  14. 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…

  15. 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 DISEASE SERVICES; OPTIONAL...

  16. 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

  17. 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…

  18. Financial impact of home health care on the hospital.

    PubMed

    Hughes, T F

    1985-11-01

    A method for analyzing the financial impact of new home health-care (HHC) programs on the hospital is presented. Clinical service objectives and long-term goals for new programs must match patient needs with institutional opportunities and constraints. Planning and evaluating new HHC programs require an accurate analysis of the financial impact of the proposed program on the hospital. A method for financial program analysis is presented through three different hypothetical scenarios based on realistic situations of hospitals considering HHC alternatives. Marginal analysis is presented as a microeconomic tool, and the calculation of marginal cost from a linear total cost function is described. Pro forma spread sheets of revenue and expense are used to assess three different HHC program alternatives--an independent HHC agency, a hospital-based agency, and a joint venture between a vendor and a hospital. Net present-value calculations are explained and applied to one case. It is important to use realistic assumptions in estimating the financial performance of HHC programs. PMID:3934963

  19. 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

  20. 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

  1. Occupational health of home care aides: results of the safe home care survey

    PubMed Central

    Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J; Sama, Susan R; Kriebel, David; Gore, Rebecca J; Brouillette, Natalie M; Okyere, Daniel; Sun, Chuan; Punnett, Laura; Laramie, Angela K; Davis, Letitia

    2016-01-01

    Objectives In countries with ageing populations, home care (HC) aides are among the fastest growing jobs. There are few quantitative studies of HC occupational safety and health (OSH) conditions. The objectives of this study were to: (1) assess quantitatively the OSH hazards and benefits for a wide range of HC working conditions, and (2) compare OSH experiences of HC aides who are employed via different medical and social services systems in Massachusetts, USA. Methods HC aides were recruited for a survey via agencies that employ aides and schedule their visits with clients, and through a labour union of aides employed directly by clients or their families. The questionnaire included detailed questions about the most recent HC visits, as well as about individual aides’ OSH experiences. Results The study population included 1249 HC aides (634 agency-employed, 615 client-employed) contributing information on 3484 HC visits. Hazards occurring most frequently related to musculoskeletal strain, exposure to potentially infectious agents and cleaning chemicals for infection prevention and experience of violence. Client-hired and agency-hired aides had similar OSH experiences with a few exceptions, including use of sharps and experience of verbal violence. Conclusions The OSH experience of HC aides is similar to that of aides in institutional healthcare settings. Despite OSH challenges, HC aides enjoy caring for others and the benefits of HC work should be enhanced. Quantification of HC hazards and benefits is useful to prioritise resources for the development of preventive interventions and to provide an evidence base for policy-setting. PMID:26209318

  2. Health Visiting in the Infant's Home in Denmark.

    ERIC Educational Resources Information Center

    Wagner, Mary; Wagner, Marsden G.

    A program of infant home visiting was established in Denmark as a result of concern about the rate of infant mortality. The objectives, problems, and promise of the infant Home Visiting Program are summarized and evaluated in terms of their implications for the United States. Although the results of the program have been overwhelmingly favorable…

  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. 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

  5. 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

  6. A Home-Based Infant Mental Health Intervention: The Centrality of Relationships in Reflective Supervision

    ERIC Educational Resources Information Center

    Weatherston, Deborah

    2007-01-01

    This article explores the essential relationship needs and capacities of infants, parents, practitioners, and supervisors in a story about reflective practice. The author shares her experience supervising a home visitor who is a trainee in an infant mental health intervention program. The home visitor's relationship with her supervisor was a…

  7. 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

  8. Outcomes for Children with Problematic Behavior in School and at Home Served By Public Mental Health

    ERIC Educational Resources Information Center

    Hodges, K.; Xue, Y.; Wotring, J.

    2004-01-01

    The authors report outcomes for 4,777 youth served by the public mental health system in Michigan who had problems in school, at home, in interpersonal relationships, or in modulating their mood. Cluster analysis identified five subgroups: Pervasive Problems with Mood Disturbance (i.e., severe or moderate impairment in school, at home, in behavior…

  9. 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…

  10. 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 Health Services Under Hospital Insurance §...

  11. 42 CFR 409.50 - Coinsurance for durable medical equipment (DME) furnished as a home health service.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 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 Health Services Under Hospital Insurance §...

  12. Leadership development: an external-internal coaching partnership.

    PubMed

    McNally, Kimberly; Lukens, Rosemary

    2006-03-01

    Professional coaching is a leadership development strategy that has the potential to improve individual and organizational performance, retain leadership talent, support succession planning, and help healthcare leaders meet professional and personal goals. The authors describe the development and benefits of a partnership between an external and an internal coach who joined forces to provide individual and group coaching to 64 clinical leaders in a health system. Program evaluation demonstrated an excellent return on investment. Recommendations for implementing professional coaching programs in other healthcare organizations are provided. PMID:16601519

  13. 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

  14. A neighborhood-based approach to population health in the pediatric medical home.

    PubMed

    Brown, Courtney M; Perkins, Jana; Blust, Annette; Kahn, Robert S

    2015-02-01

    Health care reform is increasingly focused on population health outcomes. Local strategies low-income neighborhoods could connect every newborn to a medical home and create a platform to link them with other health-promoting community resources. (1) To improve connections to the medical home for infants from one low-income neighborhood (2) To increase the number of families enrolled in a local home visiting program, and (3) To improve communication between medical staff and home visitors. The study was conducted in a neighborhood with 550 births per year and median household income of $27,000. Quality improvement methods were used to test: (1) newborn registry in the medical home, (2) proactive outreach by nursing staff, (3) standardized protocol for enrolling families in home visiting, and (4) coordination of care between medical home and home visitors. Outcomes were timeliness of well child care and enrollment in home visiting. Time series analyses compared patients from the intervention neighborhood with a demographically similar neighborhood. Mean age at newborn visit decreased from 14.4 to 10.1 days of age. Attendance at 2- and 4-month well child visits increased from 68 to 79% and 35 to 59 %, respectively. Rates did not improve for infants from the comparison neighborhood. Confirmed enrollment in home visiting increased. After spread to 2 more clinics, 43 % of infants in the neighborhood were reached. Neighborhood-based newborn registries, proactive nursing outreach, and collaboration with a home visiting agency aligned multiple clinics in a low-income neighborhood to improve access to health-promoting services. PMID:24923727

  15. The Perceived Need for Home Health Care of the Elderly as Stated by Both the Elderly and Health Professionals.

    ERIC Educational Resources Information Center

    Wilson, Cindy C.; Wallace, Bill C.

    The differences between what health professionals and the elderly perceive concerning the need for home health care were studied. Elderly persons were interviewed to ascertain their perceived needs while health professionals responded to a questionnaire. Preliminary analysis of the resulting data revealed that the most frequently perceived…

  16. 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

  17. 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 ...

  18. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... items is determined on a case-by-case basis, based on the nature of the item prescribed; (4) Physical therapy, occupational therapy, or speech pathology and audiology services, provided by a home...

  19. The nurse manager: change agent, change coach?

    PubMed

    Stefancyk, Amanda; Hancock, Beverly; Meadows, Mary T

    2013-01-01

    Change in today's health care landscape is a daily, if not hourly, reality. The nurse manager must have strong leadership skills to navigate through change with a focus on the patient and the provision of safe and reliable care. The historical term for those leading change is "change agent." In this article, the authors introduce the idea of a change coach, building on the nurse manager foundational skill of coaching and weaving this concept into the manager's role in change. A change coach uses the coaching behaviors including guidance, facilitation, and inspiration to inspire others toward change, altering human capabilities, and supporting and influencing others toward change. An exemplar of the nurse manager's role as a change coach in practice is provided using American Organization of Nurse Executives' Care Innovation and Transformation initiative. It is the agile manager that is able to successfully move between the roles of change agent and change coach to continuously transform the environment and how care is delivered. PMID:23222749

  20. 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

  1. 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…

  2. 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…

  3. 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…

  4. Coaching for Balance.

    ERIC Educational Resources Information Center

    Larson, Bonnie

    2001-01-01

    Discusses coaching for balance the integration of the whole self: physical (body), intellectual (mind), spiritual (soul), and emotional (heart). Offers four ways to identify problems and tell whether someone is out of balance and four coaching techniques for creating balance. (Contains 11 references.) (JOW)

  5. 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

  6. Professional Preparation in Physical Education and Coaching.

    ERIC Educational Resources Information Center

    American Association for Health, Physical Education, and Recreation, Washington, DC.

    This booklet is the product of a conference of the American Association of Health, Physical Education, and Recreation, the purpose of which was to revise professional preparation quidelines in dance, physical education, recreation education, and health and safety education. This report includes sections on physical education and coaching and on…

  7. 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

  8. 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

  9. 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…

  10. 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

  11. 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

  12. Private nursing homes: contribution to long stay care of the elderly in the Brighton Health District.

    PubMed Central

    Bennett, J

    1986-01-01

    Two surveys of private nursing homes, designated geriatric wards, and a sample of social service part III homes were carried out in the Brighton Health District using questionnaires supplemented (in the second survey) by some interviews. The dependency of old people in the private nursing homes was more like that of long stay hospital patients rather than that of residents in social services homes. In the private nursing homes, however, a smaller proportion of patients were in the medium to heavy nursing category (178 (31%) compared with 158 (63%) in the hospital long stay wards) and a larger proportion in the heavy nursing category (170 (30%) compared with 44 (17%) in the long stay wards). Of the patients in private nursing homes, 401 (82%) were local residents, 488 (86%) were long stay, and 459 (88%) were women; their mean age was 88 years. Two thirds of the patients were over 80. There were no significant differences between the private nursing homes and the wards in nursing workloads or staffing, except for a slightly higher provision of state registered nurses in the private sector. In the private nursing homes 348 (63%) of the patients had fees paid by private funds, 26 (5%) were in contract beds paid for by the National Health Service, and 176 (32%) were subsidized by the Department of Health and Social Security. Private nursing homes make a substantial contribution to the care of the elderly in the Brighton Health District, and the health authority should develop a more active partnership with this sector. PMID:3094690

  13. PERCEIVED RACIAL DISCRIMINATION AMONG HOME HEALTH AIDES: EVIDENCE FROM A NATIONAL SURVEY.

    PubMed

    Lee, Doohee; Muslin, Ivan; McInerney, Marjorie

    2016-01-01

    Home health aides are one of our essential human resources in the U.S. long-term care industry but understanding whether home health aides experience racial discrimination in the workplace and, if so, which personal/organizational factors are associated at the national level has been unnoticed. Using a nationally representative sample (n=3377), we attempt to investigate the association between racial discrimination and personal and organizational factors. The study found the 13.5% prevalence rate of racial discrimination. The study findings from multiple regression analysis reveal that black home care aides are more likely than white aides to experience racial discrimination in the workplace, suggesting that racial disparity may be an additional barrier to our home health care industry. National chain affiliation and low income were also found to be associated with perceived racial discrimination. PMID:27079055

  14. 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

  15. Huddle-coaching: a dynamic intervention for trainees and staff to support team-based care.

    PubMed

    Shunk, Rebecca; Dulay, Maya; Chou, Calvin L; Janson, Susan; O'Brien, Bridget C

    2014-02-01

    Many outpatient clinics where health professionals train will transition to a team-based medical home model over the next several years. Therefore, training programs need innovative approaches to prepare and incorporate trainees into team-based delivery systems. To address this need, educators at the San Francisco Veterans Affairs (VA) Medical Center included trainees in preclinic team "huddles," or briefing meetings to facilitate care coordination, and developed an interprofessional huddle-coaching program for nurse practitioner students and internal medicine residents who function as primary providers for patient panels in VA outpatient primary care clinics. The program aimed to support trainees' partnerships with staff and full participation in the VA's Patient Aligned Care Teams. The huddle-coaching program focuses on structuring the huddle process via scheduling, checklists, and designated huddle coaches; building relationships among team members through team-building activities; and teaching core skills to support collaborative practice. A multifaceted evaluation of the program showed positive results. Participants rated training sessions and team-building activities favorably. In interviews, trainees valued their team members and identified improvements in efficiency and quality of patient care as a result of the team-based approach. Huddle checklists and scores on the Team Development Measure indicated progress in team processes and relationships as the year progressed. These findings suggest that the huddle-coaching program was a worthwhile investment in trainee development that also supported the clinic's larger mission to deliver team-based, patient-aligned care. As more training sites shift to team-based care, the huddle-coaching program offers a strategy for successfully incorporating trainees. PMID:24362383

  16. The health risks of incense use in the home: an underestimated source of indoor air pollution?

    PubMed

    Roberts, Debbie; Pontin, David

    2016-03-01

    The health impact of indoor air pollution is a growing area of interest for public health professionals. People typically spend up to 90 per cent of their time indoors, particularly women, young children and elders. Although the adverse health effects of second-hand tobacco smoke are well recognised, the impact of burning incense in the home has received little attention in Western literature. Incense burning in the home is common in a number of cultures (particularly Asian, North African or Arabic). Many health visitors (HVs) work with communities who use incense regularly for religious/cultural reasons and it is a neglected area of study and research.The literature suggests that home incense use can have significant adverse health effects, particularly on cardiopulmonary morbidity and mortality. Further research is needed to identify which individuals are most susceptible, which types of incense are most harmful, and whether any actions can be taken to minimise exposure. PMID:27111977

  17. Medicare and Medicaid Home Health and Medicaid Waiver Services for Dually Eligible Older Adults: Risk Factors for Use and Correlates of Expenditures

    ERIC Educational Resources Information Center

    Fortinsky, Richard H.; Fenster, Juliane R.; Judge, James O.

    2004-01-01

    Purpose: The purpose of this work was to, among frail dually eligible older adults, determine risk factors for the likelihood of using Medicare home health and Medicaid home health services and to, among service users, determine correlates of Medicare home health, Medicaid home health, and Medicaid waiver service expenditures. Design and Methods:…

  18. 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

  19. 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,…

  20. 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

  1. Effectiveness of home visits by public health nurses in maternal and child health: an empirical review.

    PubMed Central

    Combs-Orme, T; Reis, J; Ward, L D

    1985-01-01

    The effectiveness of public health nursing in promoting maternal and child health through home visits is summarized from empirical studies published between 1960 and 1984. Eight reports identified through a comprehensive reference search were first classified according to the components of nursing service studied (assessment, teaching, counseling or support, referral, and clinical services). The results of each study were then analyzed for study population characteristics, the research design and statistical methods employed, the reliability of the measures used, significant treatment effects, sample size, and statistical power. The research is evenly divided among studies employing an experimental design, a quasi-experimental design, and samples of low-income and middle-income mothers. The reliability of the measures was, with one exception, not reported. All but one study had final sample sizes for treatment and control or comparison groups of fewer than 100 subjects. Four of the studies thus had sample sizes sufficiently large to detect a medium treatment effect; power calculations showed that none could measure a small treatment impact. Within the methodological limitations of these studies, our review found that under certain circumstances public health nurses can effectively impart health knowledge to high-risk mothers and can effect positive change in maternal attitudes and parenting practices that in turn can be associated with positive changes in infant health and development. Cumulative knowledge from this body of research suggests that a priority for future evaluations of public health nursing is development of theoretical frameworks that maximize the fit between the needs of the population served and the services provided and between the outcomes measured and the nursing services being assessed. PMID:3931163

  2. Medicare and Medicaid programs; CY 2015 Home Health Prospective Payment System rate update; Home Health Quality Reporting Requirements; and survey and enforcement requirements for home health agencies. Final rule.

    PubMed

    2014-11-01

    This final rule updates 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, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model. PMID:25376056

  3. Home health agencies: targets of anti-fraud and abuse investigations.

    PubMed

    Richardson, C

    1995-08-01

    Increased health care fraud and abuse investigations could result in home health agencies, and other targets, becoming politically acceptable casualties of war in the battle to balance the federal budget. To protect themselves, home health agencies would be well advised to conduct internal fraud and abuse audits on an annual basis and to develop corporate compliance plans (see Newsletter, Vol. 9, No. 7, July 1994, at 16, and next month's issue, which will discuss corporate compliance programs as well as the OIG's new voluntary disclosure program). In addition, purchasers of home health agencies should be especially vigilant of fraud and abuse problems during the due diligence phase of the acquisition and, if problems are discovered, should consider whether voluntary disclosure to the OIG and settlement of any resulting claims is an appropriate condition of closing. PMID:10144422

  4. 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.

  5. 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…

  6. 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…

  7. Aids for Health and Home Extension Volunteers. Appropriate Technologies for Development. Reprint R-3.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC. Information Collection and Exchange Div.

    This book contains various aids for Peace Corps home extension volunteers. Section I, "Culture Resource Material," contains four articles by Paul Benjamin: (1) "Values in American Culture"; (2) "The Cultural Context of Health Education"; (3) "Problems of Introducing Public Health Programs in 'Underdeveloped Areas'"; and (4) "The Role of Beliefs…

  8. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Services of residents in skilled nursing facilities... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health...' services furnished in the following settings that meet the specified requirements: (1) Skilled...

  9. 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...

  10. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Services of residents in skilled nursing facilities... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health...' services furnished in the following settings that meet the specified requirements: (1) Skilled...

  11. 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

  12. 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

  13. Enabling Occupational Performance of Children through Coaching Parents: Three Case Reports

    ERIC Educational Resources Information Center

    Graham, Fiona; Rodger, Sylvia; Ziviani, Jenny

    2010-01-01

    This study explores the use of occupational performance coaching (OPC) with three parent-child dyads using descriptive case study methodology. OPC is a parent-directed intervention in which parents are coached to improve their own or their children's performance in home and community contexts. In this study, parent and child performance was…

  14. 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

  15. 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

  16. Coaching for Human Performance.

    ERIC Educational Resources Information Center

    Nowack, Kenneth M.; Wimer, Scott

    1997-01-01

    Offers a four-step approach that highlights the key issues at each stage of the coaching process: (1) contract with the client; (2) observe and assess needs; (3) constructively challenge; and (4) handle resistance. (JOW)

  17. Health@Home: The Work of Health Information Management in the Household (HIMH): Implications for Consumer Health Informatics (CHI) Innovations

    PubMed Central

    Moen, Anne; Brennan, Patricia Flatley

    2005-01-01

    Objective: Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment. Design: We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community. Measurements: During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH. Results: The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled “just-in-time,” “just-because,” “just-in-case,” and “just-at-hand,” reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it. Conclusion: Laypeople develop and employ robust, complex strategies for managing health information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information. PMID:16049230

  18. Starting a hospital-based home health agency: Part III--Marketing.

    PubMed

    Montgomery, P

    1993-10-01

    Successfully marketing home healthcare involves not only community awareness, but the system's support as well--nurses, physicians, administration, social services. Working together with common goals and commitments is essential to the program's success. Addressing questions and concerns ensures a successful business start-up and ongoing implementation. A service benefit profile, target markets, and a feasibility analysis are provided in this final section of a three-part series on establishing a home health agency. PMID:8414297

  19. 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.

  20. Arbitration agreements in health care nursing home contracts.

    PubMed

    Infante, Marie C; Lovitch, Karen S

    2003-11-01

    Increasingly, long-term care facilities are adopting alternative dispute resolution measures, such as arbitration, in admission contracts. Whereas avoiding the onus of civil lawsuits is understandable, nursing homes must ensure that the arbitration wording in the contract is precise, enforceable, and most importantly, pursuant to state and federal laws, regulations, and guidelines. Otherwise, the contract itself may be the subject of a court action. PMID:14650372

  1. Home health nursing care agenda based on health policy in Korea.

    PubMed

    Ryu, Hosihn; An, Jiyoung; Koabyashi, Mia

    2005-06-01

    Home health nursing care (HHNC) in Korea has taken on an important role under the mandate of the national health care system since 2000. This program was developed to verify the possibility of early discharge of hospitalized patients and cost containment through a research and development project that was conducted with the government from 1994 to 1999. The process of development of HHNC provided an opportunity to realize the advancement and changes in the system into a consumer-focused structure. This is an important turning point for the Korean health care system that suggests certain possibilities for building a foundation for further changes in the service delivery structure. The structure, which had been limited to a supplier-oriented model, is moving to a consumer-oriented structure. Accordingly, the major function and role of nursing policy makers in Korea is to develop an agenda and alternatives for policy-making in a systematic manner and to present implementation strategies clearly. PMID:15877685

  2. Team-level flexibility, work–home 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

  3. Team-level flexibility, work-home spillover, and health behavior.

    PubMed

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

    2013-05-01

    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 U.S. 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

  4. My Home Planet Earth: My Health My World.

    ERIC Educational Resources Information Center

    Tharp, Barbara; Dresden, Judith; Moreno, Nancy

    This curriculum guide for students in grades K-4 is part of the My Health My World series which explores environmental health issues. It includes (1) an activities guide for teachers, which focuses on physical science, life science, and environment and health, presenting activity based lessons that entice students to discover concepts in science,…

  5. 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)...

  6. 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)...

  7. 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

    ... 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, 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)...

  9. 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)...

  10. 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

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

    PubMed

    Bergen, P; Rocker, D; Claußen, 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

  12. 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

  13. Coaching the Job Seeker with Special Needs.

    ERIC Educational Resources Information Center

    Cheek, Freddie

    Career counselors and job search coaches must be prepared to assist disabled clients as this sector of the labor market increases. As the work force ages, there are greater numbers of workers dealing with disabilities and serious health problems. Sadly, individuals with disabilities often approach the job search process with misconceptions,…

  14. 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

  15. Home Health Care (HHC) Managers Perceptions About Challenges and Obstacles that Hinder HHC Services in Jordan

    PubMed Central

    Ajlouni, Musa T.; Dawani, Hania; Diab, Salah M.

    2015-01-01

    Home care aims at supporting people with various degrees of dependency to remain at home rather than use residential, long-term, or institutional-based nursing care. Demographic, epidemiological, social, and cultural trends in Jordan as in other countries are changing the traditional patterns of care with growing emphasis on home care. The purpose of this study is to highlight the most common challenges related to home health care (HHC) services in Jordan as perceived by the managers of HHC agencies. Methods: a descriptive qualitative design that depends on focus group discussions has been used to collect data from a sample of 18 managers who met the selection criteria and who are willing to participate, the study found that, the main challenges of HHC services as perceived by managers were: shortage of female staff, lack of governance and regulation, poor management, unethical practices, lack of referral systems, and low accessibility of the poor and less privileged as HHC services are not included in health insurance schemes, it concludes also that the home health care industry in Jordan is facing many challenges and problems that may have negative effects on the effectiveness, efficiency, equity and quality of services and should be addressed by health policy makers. PMID:25946949

  16. Association of language spoken at home with health and school issues among Asian American adolescents.

    PubMed

    Yu, Stella M; Huang, Zhihuan J; Schwalberg, Renee H; Overpeck, Mary D; Kogan, Michael D

    2002-05-01

    The study examined the association of language spoken at home with the school and health risks and behaviors of Asian American adolescents. Using the United States component of the 1997-1998 World Health Organization Study of Health Behavior in School Children, bivariate and multiple logistic regression analyses were conducted of records for Asian children to explore the relationship between language spoken at home and outcome variables regarding health behaviors, psychosocial and school risk factors, and parental factors. Compared to those who usually speak English at home, adolescents who usually speak another language, or who speak two languages equally, face a greater risk for health risk factors, psychosocial and school risk factors, and parental risk factors. Not speaking English at home was associated with higher health risks, including not wearing seat belts and bicycle helmets; higher psychosocial and school risk factors, including feeling that they do not belong at school, difficulty making new friends, and lacking confidence; and higher parental risks, including reporting that parents were not ready to help them or willing to talk to teachers. Adolescents less acculturated to the United States experience a variety of physical and psychosocial risks. School-based interventions such as early identification and outreach, needs assessment, and counseling and support services should be provided to immigrant students and their families. PMID:12109174

  17. 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.

  18. 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

  19. Racial/ethnic disparities in access to medicare home health care: the disparate impact of policy.

    PubMed

    Davitt, Joan K; Kaye, Lenard W

    2010-10-01

    The Balanced Budget Act of 1997 dramatically decreased reimbursements for traditional Medicare home health patients. A multivariate analysis of Medicare Current Beneficiary Survey data showed that African American and "other" users experienced greater decreases in home care between 1996 and 1998 than did White users. These results suggest (a) race/ethnicity is an independent factor in determining service use post-BBA and (b) health policy has a disparate impact on minority older adults. Capitated payment systems must be pursued cautiously to avoid negative effects on vulnerable populations. The potential for current and future Medicare policy changes to negatively affect vulnerable populations is also discussed. PMID:20865622

  20. Mental health services expenditures among children placed in out-of-home care.

    PubMed

    Clark, Colleen; Yampolskaya, Svetlana; Robst, John

    2011-11-01

    This study examined Florida Medicaid mental health expenditures for children in out-of-home care. Child welfare and Medicaid administrative databases were analyzed using two-part models to identify characteristics associated with expenditures. Mental health expenditures were higher for older children, boys, children who were abused or lost their caregivers, or with a longer length of stay in out-of-home care. In contrast, African American children were less likely to have positive expenditures than White children, but among youth with positive expenditures, African Americans had higher expenditures. In addition, among youth with positive expenditures, substance use and affective disorders were associated with higher expenditures. PMID:21116702

  1. 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

  2. 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…

  3. Middle Grades Literacy Coaching from the Coach's Perspective

    ERIC Educational Resources Information Center

    Smith, Antony T.

    2012-01-01

    This qualitative case study investigated middle grades literacy coaches' perspectives on their efforts to facilitate teacher change and impact classroom practice. Data were collected from three coaches as they worked with a variety of teachers in middle school settings, using field observation and interviews with coaches, teachers, and principals.…

  4. Development of a model home health nurse internship program for new graduates: key lessons learned.

    PubMed

    Shur Coyle, Joanne

    2011-05-01

    A nursing shortage, the aging baby boomer population, an escalating need for home health care, and limited availability of health care dollars are threatening to undermine the quality of health care in the United States. The National Center for Health Workforce Analysis projects a deficit of 275,000 full-time equivalents by 2010 (-12%) and a deficit of 800,000 by 2020 (-29%). This article focuses on one home health agency's strategy to support nurse graduates transitioning from student to professional nurse. Based on Benner's (1984) hallmark theory from novice to expert, the goals of this program are to enhance job satisfaction and social integration, facilitate autonomy, increase critical thinking and psychomotor skills, and develop additional competencies. Eleven key lessons learned are outlined. PMID:20839661

  5. Seeking stability in the Medicare home health benefit. Margins evaporate; agencies in financial jeopardy.

    PubMed

    2003-07-01

    In a watershed moment for the home care industry, National Association for Home Care & Hospice (NAHC) staff has obtained, decoded, deciphered, and tabulated rates of return for all Medicare-participating agencies in the nation. The results show the average rate of return for Medicare agencies in the latest fiscal year--that is, before the October 2002 15 percent cut in home health reimbursements, before audits, and before partial episode payment adjustments--is 5.15 percent. That figure is well below the average 22 percent rate of return the Medicare Payment Advisory Commission alleged that home care agencies were making. Following is the text of NAHC's report, along with a letter from the respected firm of Muse & Associates vouching for the accuracy of NAHC's methodology. PMID:12959032

  6. 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

  7. 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

  8. Expectations of nursing home use in the Health and Retirement Study: the role of gender, health, and family characteristics.

    PubMed

    Holden, K; McBride, T; Perozek, M

    1997-09-01

    Economic models of life cycle behavior suggest that expectations about future events may affect savings, insurance, and retirement planning. This article uses data from the first wave of the Health and Retirement Survey (HRS) to examine how personal characteristics and health conditions influence expectations of nursing home use. Subjective expectations of nursing home use are quite close to known probabilities of lifetime use. There are marked differences in the determinants of expectations for women and men that also conform to actual behavior. There is strong evidence that women and men incorporate what is known about nursing home risk into their own expectations, even many years prior to the time when they are most likely to need long-term care. PMID:9310096

  9. Beliefs About the Health Effects of “Thirdhand” Smoke and Home Smoking Bans

    PubMed Central

    Winickoff, Jonathan P.; Friebely, Joan; Tanski, Susanne E.; Sherrod, Cheryl; Matt, Georg E.; Hovell, Melbourne F.; McMillen, Robert C.

    2013-01-01

    OBJECTIVE There is no safe level of exposure to tobacco smoke. Thirdhand smoke is residual tobacco smoke contamination that remains after the cigarette is extinguished. Children are uniquely susceptible to thirdhand smoke exposure. The objective of this study was to assess health beliefs of adults regarding thirdhand smoke exposure of children and whether smokers and nonsmokers differ in those beliefs. We hypothesized that beliefs about thirdhand smoke would be associated with household smoking bans. METHODS Data were collected by a national random-digit-dial telephone survey from September to November 2005. The sample was weighted by race and gender within Census region on the basis of US Census data. The study questions assessed the level of agreement with statements that breathing air in a room today where people smoked yesterday can harm the health of children. RESULTS Of 2000 eligible respondents contacted, 1510 (87%) completed surveys, 1478 (97.9%) answered all questions pertinent to this analysis, and 273 (18.9%) were smokers. Overall, 95.4% of nonsmokers versus 84.1% of smokers agreed that secondhand smoke harms the health of children, and 65.2% of nonsmokers versus 43.3% of smokers agreed that thirdhand smoke harms children. Strict rules prohibiting smoking in the home were more prevalent among nonsmokers: 88.4% vs 26.7%. In multivariate logistic regression, after controlling for certain variables, belief that thirdhand smoke harms the health of children remained independently associated with rules prohibiting smoking in the home. Belief that secondhand smoke harms the health of children was not independently associated with rules prohibiting smoking in the home and car. CONCLUSIONS This study demonstrates that beliefs about the health effects of thirdhand smoke are independently associated with home smoking bans. Emphasizing that thirdhand smoke harms the health of children may be an important element in encouraging home smoking bans. PMID:19117850

  10. 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

  11. 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…

  12. 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

  13. 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…

  14. 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

  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. 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)

  17. [Moral problems in home health care--a descriptive ethical study].

    PubMed

    Lauxen, Oliver

    2009-12-01

    In Germany there is an increasing importance of home health care and nurses that are employed in the home care sector often have to face ethical issues. The purpose of this ethnographic study was to explore moral problems in the daily practice of these nurses. The method used was qualitative interviews with 20 nurses which have been analysed by content analysis. The results showed that the ethical principle of beneficence was the core concept for the participants. Moral problems arise when nurses cannot act in accordance to this principle or when they cannot determine the good in a situation. In particular, there were four types of moral problems: "beneficence vs. autonomy", "beneficence vs. justice", "beneficence vs. loyalty" and "The good cannot be determined". The way nurses in home health care address moral problems should be improved. Some participants lack ethical competencies. Furthermore, appropriate support services for dealing with moral problems have to be designed. PMID:19943227

  18. Creating a Supportive Environment among Youth Football Players: A Qualitative Study of French and Norwegian Youth Grassroots Football Coaches

    ERIC Educational Resources Information Center

    Larsen, Torill; Van Hoye, Aurelie; Tjomsland, Hege Eikeland; Holsen, Ingrid; Wold, Bente; Heuzé, Jean-Philippe; Samdal, Oddrun; Sarrazin, Philippe

    2015-01-01

    Purpose: The health promoting benefits of sport participation are under-utilized and should be further developed, particularly at the grassroots level. The purpose of this paper is to examine how grassroots coaches in youth football perceive their coaching practices after participating in a community-based coach education program aimed at…

  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. A home-centered ICT architecture for health-enabling technologies.

    PubMed

    Song, Bianying; Marschollek, Michael; Wolf, Klaus-Hendrik; Gietzelt, Matthias; Franken, Thomas; Haux, Reinhold

    2010-01-01

    Population ageing needs health-enabling technologies for delivering pervasive health care. Home care plays an import role in pervasive health care. In this paper, we aim to construct a home-centered health information system architecture which can efficiently manage multi sensors, actuators and decision support systems. Open Services Gateway initiative (OSGI) was used for constructing the service oriented architecture. HL 7 Arden Syntax for medical logic module (MLM) was used to describe the medical knowledge; An Arden compiler was used to interpret the MLMs. The Arden compiler was packed in an OSGI bundle. All of the knowledge bases can share the compiler within the OSGI platform. System within the OSGI-based architecture can change their behaviors during runtime. The proposed prototype architecture was deployed in a case study. PMID:20841648

  1. 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

  2. 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...

  3. 78 FR 40271 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ...This proposed rule would 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, the nonroutine medical supplies (NRS) conversion factor, and outlier payments under the Medicare prospective payment system for home health agencies......

  4. Coaching under pressure: a study of Olympic coaches.

    PubMed

    Olusoga, Peter; Maynard, Ian; Hays, Kate; Butt, Joanne

    2012-01-01

    The Olympic environment has been identified as particularly stressful and unlike any other in terms of the media attention and focus placed on the competition. While the potential negative consequences of stress for coaches and their athletes have been explored, relatively little is known about the factors underpinning successful Olympic coaching performance. We explored elite coaches' perceptions of the factors that enable them to coach in a stressful Olympic environment. Eight coaches from one of Great Britain's most successful Olympic teams (i.e. consistent medal winners in the previous three Olympics) were interviewed. Inductive content analysis indicated that psychological attributes (e.g. emotional control), preparation (e.g. strategic approach), and coping at the event (e.g. team support) were factors that coaches perceived as important for successful Olympic coaching. In addition, coaches offered specific suggestions for training and development. Key themes included coach interaction (e.g. mentoring, formalizing contact) and simulating Olympic pressure. These findings offer suggestions for the education of developing coaches on the pathway to elite sports coaching. PMID:22168369

  5. 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…

  6. 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…

  7. Medicare-Certified Home Health Care: Urban-Rural Differences in Utilization

    ERIC Educational Resources Information Center

    Hartman, Lacey; Jarosek, Stephanie L.; Virnig, Beth A.; Durham, Sara

    2007-01-01

    Context: Availability of Medicare-certified home health care (HHC) to rural elders can prevent more expensive institutional care. To date, utilization of HHC by rural elders has not been studied in detail. Purpose: To examine urban-rural differences in Medicare HHC utilization. Methods: The 2002 100% Medicare HHC claims and denominator files were…

  8. 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

  9. Job Satisfaction of Home Health Satisfaction Workers in the Environment of Cost Containment

    ERIC Educational Resources Information Center

    Egan, Marcia; Kadushin, Goldie

    2004-01-01

    This national survey examined the job satisfaction of 228 home health social workers in the restrictive reimbursement environment of the Medicare interim payment system. Administrators' helpfulness in resolving ethical conflicts between patient access to services and agency financial priorities contributed significantly to greater satisfaction in…

  10. 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…

  11. 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…

  12. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services...

  13. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services...

  14. 42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Services of residents in skilled nursing facilities... SETTINGS Services of Residents § 415.204 Services of residents in skilled nursing facilities and home... nursing facility. Payment to a participating skilled nursing facility may include the cost of services...

  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. 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

  17. 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

  18. 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

  19. 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...

  20. 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,...

  1. 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

  2. Implementing a patient centered medical home in the Veterans health administration: Perspectives of primary care providers.

    PubMed

    Solimeo, Samantha L; Stewart, Kenda R; Stewart, Gregory L; Rosenthal, Gary

    2014-12-01

    Implementation of a patient centered medical home challenges primary care providers to change their scheduling practices to enhance patient access to care as well as to learn how to use performance metrics as part of a self-reflective practice redesign culture. As medical homes become more commonplace, health care administrators and primary care providers alike are eager to identify barriers to implementation. The objective of this study was to identify non-technological barriers to medical home implementation from the perspective of primary care providers. We conducted qualitative interviews with providers implementing the medical home model in Department of Veterans Affairs clinics-the most comprehensive rollout to date. Primary care providers reported favorable attitudes towards the model but discussed the importance of data infrastructure for practice redesign and panel management. Respondents emphasized the need for administrative leadership to support practice redesign by facilitating time for panel management and recognizing providers who utilize non-face-to-face ways of delivering clinical care. Health care systems considering adoption of the medical home model should ensure that they support both technological capacities and vertically aligned expectations for provider performance. PMID:26250631

  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. [Home health care in supplementary care: a device for a productive restructuring].

    PubMed

    Franco, Túlio Batista; Merhy, Emerson Elias

    2008-01-01

    This study discusses the role the Brazilian Home Health Care Program (Programa de Atenção Domiciliar - PAD) plays in supplementary care using the example of a Group Care provider headquartered in Rio de Janeiro. The purpose of the study was to understand how home health care is produced by verifying the interaction between the medical team, beneficiaries and family members considering that the service in this care model is delivered in the micro-political scenery of the process, in the client's own home. The assessment of this program must consider: infrastructure and logistics, beneficiary eligibility criteria, the care-network formed in support of the PAD and above all the work process. Especially the latter is a strong indicator, in the present case characterized by an eminently multi-professional team operating in networks with integrated therapeutic projects. For the professionals, Home Health Care has the meaning of an innovative and highly valuable approach to care delivery. The article concludes considering the PAD an important device for a fruitful restructuring of supplementary care through different ways of care delivery. PMID:18813653

  8. 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…

  9. 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…

  10. From Teaching to Coaching

    ERIC Educational Resources Information Center

    Zuspan, Tara

    2013-01-01

    In the course of transitioning from classroom teacher to math instructional coach, Tara Zuspan identified critical themes and lessons she had learned. She focused her efforts on building relationships, partnering with the principal, understanding the process of change, and providing teachers with opportunities to collaborate. These intentional…

  11. 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…

  12. 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

  13. 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

  14. Running as fast as they can: organizational changes in home health care.

    PubMed

    Estes, C L; Swan, J H; Bergthold, L A; Spohn, P H

    1992-01-01

    During the 1980s, as the health care industry experienced what observers have dubbed a revolution, the home health industry also experienced its own transformation. Utilizing three organizational theories (neoinstitutional, resource dependency and population ecology), the authors report on a study of a probability sample of 163 home health agencies (HHAs) that were interviewed in 1986 and again in 1987 on the effects of Medicare policy changes including prospective payment (DRGs). This study tests hypotheses concerning the influence of environmental factors (e.g., state policy and characteristics of the local market) and organizational characteristics of the HHA (e.g., tax status and Medicare reliance) in explaining the propensity of HHAs to be (or become) parts of chains and/or multi-facility systems; and to develop particular types of interorganizational relations. The paper discusses the results in the context of public policy changes and the implications for future research and practice. PMID:10126432

  15. Integrity mechanism for eHealth tele-monitoring system in smart home environment.

    PubMed

    Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

    2009-01-01

    During the past few years, a lot of effort has been invested in research and development of eHealth tele-monitoring systems that will provide many benefits for healthcare delivery from the healthcare provider to the patient's home. However, there is a plethora of security requirements in eHealth tele-monitoring systems. Data integrity of the transferred medical data is one of the most important security requirements that should be satisfied in these systems, since medical information is extremely sensitive information, and even sometimes life threatening information. In this paper, we present a data integrity mechanism for eHealth tele-monitoring system that operates in a smart home environment. Agent technology is applied to achieve data integrity with the use of cryptographic smart cards. Furthermore, the overall security infrastructure and its various components are described. PMID:19964802

  16. 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

  17. 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

  18. 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

  19. Predictors of home health care services for cerebral vascular disease patients in Taiwan.

    PubMed

    Li, I-Chuan; Chang, Tsui-Ming

    2004-01-01

    The National Health Insurance in Taiwan has rigid regulations for reimbursing home nursing care with payment only for technical/skill care such as changing nasogastric tubes, urine catheters, and tracheal tubes, wound care, and specimen collection. Patients with chronic illnesses who reside at home, however, require care that is holistic and focuses on wellness rather than illness. Cerebral vascular disease (CVD) patients are the largest group receiving home nursing care. They qualify for reimbursement under NHI. The purposes of this study were to quantify the home health care (HHC) needs of CVD patients and to understand predictors for HHC services for CVD patients in Taiwan. A descriptive correlation design was used to examine the relationship between a CVD patient's health status and the need for HHC services. In total, 195 patients were interviewed by one trained research assistant, with 124 patients being from Taipei (an urban area in Taiwan) and the remaining 71 from I-lan (a rural area in Taiwan). The mean age of subjects was 74.8 years, with 60% of the sample being female. Physiological health status scores (M = 2.56, SD = 0.58, range = 1-5) were worse than the psychosocial health status scores (M = 2.37, SD = 0.91, range = 1-5), which indicates that the need for health education and skilled nursing services was higher than referral services for professional HHC services. Results suggest that there is a need to develop and shape NHI policy to cover more holistic HHC services for CVD patients. PMID:14692988

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

    PubMed

    Dossey, Barbara M; Hess, Darlene

    2013-07-01

    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 report(3) 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

  2. 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

  3. Development of an Applied Framework for Understanding Health Information Technology in Nursing Homes.

    PubMed

    Degenholtz, Howard B; Resnick, Abby; Lin, Michael; Handler, Steven

    2016-05-01

    There is growing evidence that Health Information Technology (HIT) can play a role in improving quality of care and increasing efficiency in the nursing home setting. Most research in this area, however, has examined whether nursing homes have or use any of a list of available technologies. We sought to develop an empirical framework for understanding the intersection between specific uses of HIT and clinical care processes. Using the nominal group technique, we conducted a series of focus groups with different types of personnel who work in nursing homes (administrators, directors of nursing, physicians, mid-level practitioners, consultant pharmacists, and aides). The resulting framework identified key domain areas that can benefit from HIT: transfer of data, regulatory compliance, quality improvement, structured clinical documentation, medication use process, and communication. The framework can be used to guide both descriptive and normative research. PMID:26975206

  4. 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

  5. Implications of Comprehensive Mental Health Services Embedded in an Adolescent Obstetric Medical Home.

    PubMed

    Ashby, Bethany; Ranadive, Nikhil; Alaniz, Veronica; St John-Larkin, Celeste; Scott, Stephen

    2016-06-01

    Purpose Mental health issues in perinatal adolescents are well documented and studies have shown high rates of depressive disorders among this population. Treatment is challenging because pregnant adolescents are poorly adherent with mental health services. We describe a novel integrated mental health care program for pregnant and parenting adolescent mothers and their children. Methods The Colorado Adolescent Maternity Program (CAMP) is a comprehensive, multidisciplinary teen pregnancy and parenting medical home program serving an ethnically diverse and low socioeconomic status population in the Denver metro area. We describe the Healthy Expectations Adolescent Response Team (HEART), an embedded mental health care program focused on improving identification of mental health symptoms and increasing rates mental health treatment in adolescent mothers. Results From January 1, 2011-January 16 2014, 894 pregnant adolescents were enrolled in CAMP and 885 patients were screened for mental health issues. Prior to HEART's inception, 20 % of patients were identified as having mood symptoms in the postpartum period. Successful referrals to community mental health facilities occurred in only 5 % of identified patients. Following the creation of HEART, 41 % of patients were identified as needing mental health services. Nearly half of the identified patients (47 %) engaged in mental health treatment with the psychologist. Demographic factors including age, parity, ethnicity, and parent and partner involvement did not have a significant impact on treatment engagement. Trauma history was associated with lower treatment engagement. Conclusion Our findings suggest that an embedded mental health program in an adolescent obstetric and pediatric medical home is successful in improving identification and engagement in mental health treatment. Key components of the program include universal screening, intensive social work and case management involvement, and ready access to onsite mental health care providers. Limitations of the program are discussed as well directions for future research. PMID:26961142

  6. 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 Canada’s Pest Management Regulatory Agency’s 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 Quebec’s Pesticide Code are prudent measures to protect public health. Physicians have a role in public education regarding pesticides. PMID:19030278

  7. 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

  8. 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

  9. Using e-Coaching to Support an Early Intervention Provider's Implementation of a Functional Assessment-Based Intervention

    ERIC Educational Resources Information Center

    Fettig, Angel; Barton, Erin E.; Carter, Alice S.; Eisenhower, Abbey S.

    2016-01-01

    This study examined the effects of e-coaching on the implementation of a functional assessment-based intervention delivered by an early intervention provider in reducing challenging behaviors during home visits. A multiple baseline design across behavior support plan components was used with a provider-child dyad. The e-coaching intervention…

  10. Smart Home-Based Health Platform for Behavioral Monitoring and Alteration of Diabetes Patients

    PubMed Central

    Helal, Abdelsalam; Cook, Diane J.; Schmalz, Mark

    2009-01-01

    Background Researchers and medical practitioners have long sought the ability to continuously and automatically monitor patients beyond the confines of a doctor's office. We describe a smart home monitoring and analysis platform that facilitates the automatic gathering of rich databases of behavioral information in a manner that is transparent to the patient. Collected information will be automatically or manually analyzed and reported to the caregivers and may be interpreted for behavioral modification in the patient. Method Our health platform consists of five technology layers. The architecture is designed to be flexible, extensible, and transparent, to support plug-and-play operation of new devices and components, and to provide remote monitoring and programming opportunities. Results The smart home-based health platform technologies have been tested in two physical smart environments. Data that are collected in these implemented physical layers are processed and analyzed by our activity recognition and chewing classification algorithms. All of these components have yielded accurate analyses for subjects in the smart environment test beds. Conclusions This work represents an important first step in the field of smart environment-based health monitoring and assistance. The architecture can be used to monitor the activity, diet, and exercise compliance of diabetes patients and evaluate the effects of alternative medicine and behavior regimens. We believe these technologies are essential for providing accessible, low-cost health assistance in an individual's own home and for providing the best possible quality of life for individuals with diabetes. PMID:20046657

  11. 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

  12. 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

  13. The impact of shiftwork on work--home conflict, job attitudes and health.

    PubMed

    Demerouti, Evangelia; Geurts, Sabine A E; Bakker, Arnold B; Euwema, Martin

    2004-07-15

    The present study was designed to test the impact of rotation and timing of shifts on work--home conflict, job attitudes, health and absenteeism among the military police. A total of 3122 employees participated in the study. Discriminant analysis was used to examine the relationships between rotation and timing of shifts on the one hand, and the outcome measures on the other. Whether employees had fixed dayshifts, fixed non-day shifts including weekends, or rotating shifts with or without weekends, could be predicted on the basis of the experienced work--home conflict, job attitudes, health and absenteeism. Each of the two parameters of shiftwork differentially affected the experience of the outcome measures. Rotation was most clearly related to unfavourable job attitudes (namely job satisfaction, cynicism, turnover intentions and professional efficacy), whereas timing was most clearly related to increased work--home conflict. The results suggest that fixed non-day shifts including weekends (i.e., during highly valuable times) should be avoided in order to minimize the conflict between work and home and that rotation rosters should be designed with a high degree of individualization and flexibility. These seem to be the most promising ways to reduce the negative consequences of shiftwork for employees, their families and organizations. PMID:15204274

  14. Innovations in coaching and mentoring: implications for nurse leadership development.

    PubMed

    Fielden, Sandra L; Davidson, Marilyn J; Sutherland, Valerie J

    2009-05-01

    This longitudinal study sought to examine ways in which coaching and mentoring relationships impact on the professional development of nurses in terms of career and leadership behaviours, and evaluating the differences and similarities between those coaching and mentoring relationships. According to the UK government, leadership in nursing is essential to the improvement of service delivery, and the development and training of all nurses is vital in achieving effective change. A coaching and mentoring programme was used to explore the comparative advantages of these two approaches for the leadership development of nurses in acute, primary care and mental health settings. A longitudinal in-depth study was conducted to measure differences and similarities between the mentoring and coaching process as a result of a six-month coaching/mentoring programme. Five nurses from six UK Health Care Trusts were allocated to a coaching group (n = 15) or a mentoring group (n = 15), these were coached or mentored by a member of the senior directorate from their own Trust. Qualitative and quantitative data were collected at three time points (T1 = baseline, T2 = 4 months and T3 = 9 months) using semi-structured interviews and questionnaires. While mentoring was perceived to be 'support' and coaching was described as 'action', descriptions of the actual process and content were quite similar. However, while both groups reported significant development in terms of career development, leadership skills and capabilities, mentees reported the highest level of development with significantly higher scores in eight areas of leadership and management and in three areas of career impact. Implications for nurses and health services are discussed. PMID:19401502

  15. The Health Effects of At-Home Written Emotional Disclosure in Fibromyalgia: A Randomized Trial

    PubMed Central

    Gillis, Mazy E.; Lumley, Mark A.; Mosley-Williams, Angelia; Leisen, James C.C.; Roehrs, Timothy

    2010-01-01

    Background The presence and severity of the chronic pain syndrome, fibromyalgia (FM), is associated with unresolved stress and emotional regulation difficulties. Written emotional disclosure is intended to reduce stress and may improve health of people with FM. Purpose This study tested the effects of at-home, written emotional disclosure about stressful experiences on the health of people with FM and used multiple follow-ups to track the time course of effects of disclosure. Methods Adults with FM (intent-to-treat: n = 83; completers: n = 72) were randomized to write for 4 days at home about either stressful experiences (disclosure group) or neutral time management (control group). Group differences in immediate mood effects and changes in health from baseline to 1-month and 3-month follow-ups were examined. Results Written disclosure led to an immediate increase in negative mood, which did not attenuate across the 4 writing days. Repeated-measures analyses from baseline to each follow-up point were conducted on both intent-to-treat and completer samples, which showed similar outcomes. At 1-month, disclosure led to few health benefits, but control writing led to less negative affect and more perceived support than did disclosure. At 3-month follow-up, these negative affect and social support effects disappeared, and written disclosure led to a greater reduction in global impact, poor sleep, health care utilization, and (marginally) physical disability than did control writing. Interpretation of these apparent benefits needs to be made cautiously, however, because the disclosure group had somewhat poorer health than controls at baseline, and the control group showed some minor worsening over time. Conclusions Written emotional disclosure can be conducted at home, and there is tentative evidence that disclosure benefits the health of people with FM. The benefits, however, may be delayed for several months after writing and may be of limited clinical significance. PMID:16972811

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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

  2. Health smart home: towards an assistant tool for automatic assessment of the dependence of elders.

    PubMed

    Le, Xuan Hoa Binh; Di Mascolo, Maria; Gouin, Alexia; Noury, Norbert

    2007-01-01

    In order to help elders living alone to age in place independently and safely, it can be useful to have an assistant tool that can automatically assess their dependence and issue an alert if there is any loss of autonomy. The dependence can be assessed by the degree of performance, by the elders, of activities of daily living. This article presents an approach enabling the activity recognition for an elder living alone in a Health Smart Home equipped with noninvasive sensors. PMID:18002827

  3. Hospital Versus Home Death: Results from the Mexican Health and Aging Study

    PubMed Central

    Cárdenas-Turanzas, Marylou; Torres-Vigil, Isabel; Tovalín-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

  4. Which Components of Medical Homes Reduce the Time Burden on Families of Children with Special Health Care Needs?

    PubMed Central

    Miller, Jane E; Nugent, Colleen N; Russell, Louise B

    2015-01-01

    Objectives To examine which components of medical homes affect time families spend arranging/coordinating health care for their children with special health care needs (CSHCNs) and providing health care at home. Data Sources 2009–2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-based survey of 40,242 CSHCNs. Study Design NS-CSHCN is a cross-sectional, observational study. We used generalized ordered logistic regression, testing for nonproportional odds in the associations between each of five medical home components and time burden, controlling for insurance, child health, and sociodemographics. Data Collection/Extraction Methods Medical home components were collected using Child and Adolescent Health Measurement Initiative definitions. Principal Findings Family-centered care, care coordination, and obtaining needed referrals were associated with 15–32 percent lower odds of time burdens arranging/coordinating and 16–19 percent lower odds providing health care. All five components together were associated with lower odds of time burdens, with greater reductions for higher burdens providing care. Conclusions Three of the five medical home components were associated with lower family time burdens arranging/coordinating and providing health care for children with chronic conditions. If the 55 percent of CSHCNs lacking medical homes had one, the share of families with time burdens arranging care could be reduced by 13 percent. PMID:25100200

  5. 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

  6. 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…

  7. 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

  8. 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

  9. Public Reporting and Market Area Exit Decisions by Home Health Agencies

    PubMed Central

    Jung, Kyoungrae; Feldman, Roger

    2012-01-01

    Objective To examine whether home health agencies selectively discontinue services to areas with socio-economically disadvantaged people after the introduction of Home Health Compare (HHC), a public reporting program initiated by Medicare in 2003. Study Design /Methods We focused on agencies' initial responses to HHC and examined selective market-area exits by agencies between 2002 and 2004. We measured HHC effects by the percentage of quality indicators reported in public HHC data in 2003. Socio-economic status was measured by per capita income and percent college-educated at the market-area level. Data Source(s) 2002 and 2004 Outcome and Assessment Information Set (OASIS); 2000 US Census file; 2004 Area Resource File; and 2002 Provider of Service File. Principal Findings We found a small and weak effect of public reporting on selective exits: a 10-percent increase in reporting (reporting one more indicator) increased the probability of leaving an area with less-educated people by 0.3 percentage points, compared with leaving an area with high education. Conclusion The small level of market-area exits under public reporting is unlikely to be practically meaningful, suggesting that HHC did not lead to a disruption in access to home health care through selective exits during the initial year of the program. PMID:24800158

  10. 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.

  11. 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

  12. Principles on integrating behavioral health into medical homes must not designate leaders as "physicians only".

    PubMed

    Golden, Angela; Miller, Kenneth

    2014-06-01

    Nurse practitioners have long included high-quality behavioral health in the care they provide to individuals and families nationwide. Just as the principles of the medical home have been an integral part of nurse practitioners' practice, so has the concept of whole person orientation incorporating both physical and mental or behavioral health care. It is therefore encouraging that organized medicine has embraced integrated physical and behavioral health care in patient-centered medical homes, a position that could help improve the wellbeing of patients all throughout the United States. Although the American Association of Nurse Practitioners (AANP) has long supported such integration, we do not support the physician-centric joint principles included in the current issue of Annals of Family Medicine (The Working Party Group on Integrated Behavioral Healthcare et al., 2014), as they create provider and leadership roles that are too narrow and restrictive for the provision of health care in the 21st century. As written, they limit access to high-quality care and restrict patient choice of health care providers. PMID:24955683

  13. 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

  14. 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

  15. Regulating firearm advertisements that promise home protection. A public health intervention.

    PubMed

    Vernick, J S; Teret, S P; Webster, D W

    1997-05-01

    Firearms are a consumer product responsible for 38500 deaths in the United States in 1994. Like other products, firearms are advertised. In the absence of rules governing the design of firearms, regulating the way guns are advertised may be a useful public health intervention. Some gun advertisements include messages suggesting that bringing a handgun into the home is generally protective for the occupants of the home. The best available scientific information contradicts this message. Given this disjunction, regulating those advertisements may be an appropriate response. Under federal law, the Federal Trade Commission (FTC) has authority to prohibit advertisements that are "deceptive" or "unfair." Under the FTC's deception analysis, the focus is on whether consumers are misled by an advertisement. For a finding of unfairness, the FTC looks for advertisements that may cause substantial injury to consumers. Under either analysis, a strong argument can be made that firearm advertisements promising home protection are unlawful. On February 14, 1996, several organizations sent separate petitions to the FTC asking it to consider the issues raised by firearm advertisements that promise home protection. The FTC is still reviewing the information presented. There are no First Amendment or Second Amendment impediments to FTC regulation of deceptive firearm advertising under the US Constitution. PMID:9134946

  16. 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

  17. Providers' Reported and Actual Use of Coaching Strategies in Natural Environments

    ERIC Educational Resources Information Center

    Salisbury, Christine; Cambray-Engstrom, Elizabeth; Woods, Juliann

    2012-01-01

    This case study examined the agreement between reported and actual use of coaching strategies based on home visit data collected on a diverse sample of providers and families. Paired videotape and contact note data of and from providers during home visits were collected over a six month period and analyzed using structured protocols. Results of…

  18. Athletes' Evaluations of Their Head Coach's Coaching Competency

    ERIC Educational Resources Information Center

    Myers, Nicholas D.; Feltz, Deborah L.; Maier, Kimberly S.; Wolfe, Edward W.; Reckase, Mark D.

    2006-01-01

    This study provided initial validity evidence for multidimensional measures of coaching competency derived from the Coaching Competency Scale (CCS). Data were collected from intercollegiate men's (n = 8) and women's (n = 13) soccer and women's ice hockey teams (n = 11). The total number of athletes was 585. Within teams, a multidimensional…

  19. Advocating for Coaching Education with the New "National Coaching Report"

    ERIC Educational Resources Information Center

    Bodey, Kimberly J.; Brylinsky, Jody; Kuhlman, Jolynn

    2008-01-01

    There is much variability in coach preparation across the United States. No one model of coach development seems to fit the needs of all levels of sport competition or the wide variety of consumers. Moreover, there are many entities involved in prescribing requirements such as national governing bodies, state legislatures and boards of education,…

  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. 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…

  2. 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

  3. Getting home safe and sound: occupational safety and health administration at 38.

    PubMed

    Silverstein, Michael

    2008-03-01

    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

  4. 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 resumé 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

  5. 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

  6. The Environmental Health/Home Safety Education Project: a successful and practical U.S.-Mexico border initiative.

    PubMed

    Forster-Cox, Susan C; Mangadu, Thenral; Jacquez, Benjamín; 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

  7. From the Real Front Line: The Unique Contributions of Mental Health Caregivers in Canadian Foster Homes

    PubMed Central

    Piat, Myra; Ricard, Nicole; Sabetti, Judith; Beauvais, Louise

    2016-01-01

    This article reports the findings of a qualitative study on the contribution of foster home caregivers for persons with serious mental illness. Traditionally social workers have played a key role in the supervision of foster homes. Little is known about how the help caregivers provide is similar to, or different from, that provided by mental health professionals. Twenty semi-structured interviews were conducted with caregivers operating foster homes in Montreal, Canada. With no pre-set theoretical framework, data analysis was inductive and ongoing, involving the identification of categories and themes. Overall findings reveal that caregivers consider themselves the real front-line workers. They claim to be available 24/7, to combine egalitarian and affective relationships with their residents, and provide them with personalized care. Caregivers are well positioned to respond immediately to crises. Caregivers also believe that their intimate and thorough familiarity with their residents allows them to assess residents differently than would social workers. These findings have implications for mental health professionals. The combined skills and expertise of non professional caregivers and social workers are essential in promoting the residents’ reintegration into the community. PMID:18326449

  8. 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

  9. [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

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. Supervised classification of Activities of Daily Living in Health Smart Homes using SVM.

    PubMed

    Fleury, Anthony; Noury, Norbert; Vacher, Michel

    2009-01-01

    By 2050, about a third of the French population will be over 65. To face this modification of the population, the current studies of our laboratory focus on the monitoring of elderly people at home. This aims at detect, as early as possible, a loss of autonomy by objectivizing criterions such as the international ADL or the French AGGIR scales implementing automatic classification of the different Activities of Daily Living. A Health Smart Home is used to achieve this goal. This flat includes different sensors. The data from the various sensors were used to classify each temporal frame into one of the activities of daily living that has been previously learnt (seven activities: hygiene, toilets, eating, resting, sleeping, communication and dressing/undressing). This is done using Support Vector Machines. We performed an experimentation with 13 young and healthy subjects to learn the model of activities and then we tested the classification algorithm (cross-validation) on real data. PMID:19965259

  15. 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

  16. 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…

  17. Coaches Guide to Sport Administration.

    ERIC Educational Resources Information Center

    Leith, Larry M.

    This guide for athletic coaches offers a practical approach to the administrative functions of organizing, planning, leading, and controlling. Included are chapters on coaching administration, fund raising, organizing competitions, and designing effective budgets and controls. The guide addresses the following topics: (1) the categories of…

  18. 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…

  19. 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,…

  20. Home medication injection among Latina women in Los Angeles: implications for health education and prevention.

    PubMed

    Flaskerud, J H; Nyamathi, A M

    1996-02-01

    Reuse of needles and syringes after home injection of medications and vitamins may be a risk for transmission of HIV. An exploratory study was done to determine (1) how commonly injectable medications were used in the home; (2) whether needles and syringes were reused; and (3) common practices for cleaning needles and syringes. A survey was conducted of low income Latina women (n = 216) who were attending a Public Health Foundation nutrition programme for women, infants and children (WIC) in Los Angeles. To clarify and expand on the survey findings, focus group interviews were done with an additional 55 women attending WIC. Quantitative data were analysed using descriptive and comparative statistics. Qualitative data were subjected to content analysis. The use of injectable medications purchased in Mexico was fairly common (43.5%); reuse of disposable needles and syringes (48%) and sharing (36%) among injectors were also common. Methods of cleaning needles and syringes were inadequate to CDC recommended guidelines. Injectors and non-injectors differed significantly in ethnicity, religion, and marital status. The only significant predictor of medication injection was educational level. Analysis of qualitative data revealed the reasons that Latina subjects were injecting medication; how they were transporting medicines from Mexico; and how they were cleaning their equipment. The practical implications for health education and prevention programmes should include an awareness that home use and reuse of needles for injection of medications may be common in some social groups and that knowledge of the potential dangers in reuse and sharing of needles may not extend to home medication injection. PMID:8664373

  1. Analysis and proposed model of family caregivers' relationships with home health providers and perceptions of the quality of formal services.

    PubMed

    Funk, Laura; Stajduhar, Kelli

    2013-03-01

    Relationships between families and home health nurses promote effective care and service access for those at end of life, positive caregiver experiences, and satisfaction with care. This study explores family caregivers' accounts of relationships with home care nurses; findings inform a model of relationships and satisfaction with home health services. Ethnographic, qualitative interviews were conducted with 26 bereaved caregivers in one Western Canadian regional health agency. Data analysis was informed by symbolic interactionism. Participants described their relationships with home care nurses and spoke about their assessments of the care provided. Findings highlighted the importance of the length, frequency, and continuity of contact, conversation, socializing, and sharing information. Participants were cognizant of their own and care recipients' roles in building relationship. Nurse behaviors demonstrating affection, acknowledgment, commitment, and understanding were appreciated. A model links relationship preconditions, relational demonstrations, and perceived care quality and may be used to identify points of intervention. PMID:25474216

  2. 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

  3. 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

  4. Health information systems for home telehealth services--a nomenclature for sensor-enhanced transinstitutional information system architectures.

    PubMed

    Ludwig, Wolfram; Wolf, Klaus-Hendrik; Duwenkamp, Christopher; Gusew, Nathalie; Hellrung, Nils; Marschollek, Michael; Von Bargen, Tobias; Wagner, Markus; Haux, Reinhold

    2010-01-01

    Home telehealth services for elderly people promise to contribute to a more efficient health care in the future. Though isolated services at a patient's home might make sense for some applications, the full potential of home telehealth only arises through its integration into existing health information systems (HIS) and care processes. We know about traditional HIS architectures. However, so far no models exist, helping us to understand and describe the upcoming sensor-enhanced transinstitutional information system architectures for home telehealth services. To develop a nomenclature for sensor-enhanced transinstitutional health information system architectures. We conducted two systematic literature reviews, assessing typical services and users of home telehealth and key characteristics of transinstitutional health information system architectures. The information retrieved from both reviews was integrated to build the nomenclature sought after. We present a nomenclature of information and communication technology (ICT) architectures for home telehealth services. The developed dimensions provide an overview on typical users, services, operating organisations, information flow, geographical reach and architectural paradigms of sensor-enhanced transinstitutional health information systems. The developed nomenclature helps us to better understand the upcoming ICT architectures. However, we are still in need of further experiences with their application. PMID:21133774

  5. 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

  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. 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…

  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. Understanding How Ontario High School Teacher-Coaches Learn to Coach

    ERIC Educational Resources Information Center

    Winchester, Geoff; Culver, Diane; Camiré, 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…

  10. Developing a preceptorship/mentorship model for home health care nurses.

    PubMed

    DeCicco, Julie

    2008-01-01

    Preceptorship and mentorship programs are used in the health care sector to educate nurses, enhance their leadership skills, and improve their quality of work life. Recognizing the importance of these initiatives, Saint Elizabeth Health Care sought funding to create an innovative model of preceptorship/mentorship that meets the unique needs of home health care nurses. The methods utilized included focus groups, key informant interviews, and a workflow analysis. Factors that influence preceptorship such as nursing workload, preceptor training and remuneration were examined to develop a new model that offers career enhancement and leadership opportunities for preceptors and mentors, and promotes a welcoming environment for preceptees. Reward and recognition programs were created for preceptors to acknowledge their leadership contribution at the front line. This study demonstrates how evidence and innovation were used to create a preceptorship/mentorship model to develop community nursing leaders of the future. PMID:18444063

  11. Home Oxygen Program review: Regionalization in Vancouver Coastal Health and British Columbia.

    PubMed

    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

  12. 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

  13. 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

  14. 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.…

  15. 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)

  16. 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;…

  17. 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…

  18. 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…

  19. A Coach's Code of Conduct. Position Statement

    ERIC Educational Resources Information Center

    Lyman, Linda; Ewing, Marty; Martino, Nan

    2009-01-01

    Coaches exert a profound impact on our youths; therefore, society sets high expectations for them. As such, whether coaches are compensated or work solely as volunteers, they are responsible for executing coaching as a professional. If we are to continue to enhance the cultural perceptions of coaching, we must strive to develop and master the…

  20. 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.…

  1. 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…

  2. 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

  3. Mentoring Connections between Coaches and Female Athletes.

    ERIC Educational Resources Information Center

    Lough, Nancy L.

    2001-01-01

    Examines the role that mentoring could have in helping female athletes become leaders in their sports through coaching, focusing on: women in coaching; the importance of mentoring potential female coaches; successful mentoring relationships for female coaches; and strategies for mentors. This type of collaboration may help reverse the ongoing…

  4. Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study

    PubMed Central

    2012-01-01

    Background Maternal mortality among poor rural women in the Lao People’s Democratic Republic (Lao PDR) is among the highest in Southeast Asia, in part because only 15% give birth at health facilities. This study explored why women and their families prefer home deliveries to deliveries at health facilities. Methods A qualitative study was conducted from December 2008 to February 2009 in two provinces of Lao PDR. Data was collected through eight focus group discussions (FGD) as well as through in-depth interviews with 12 mothers who delivered at home during the last year, eight husbands and eight grandmothers, involving a total of 71 respondents. Content analysis was used to analyze the FGD and interview transcripts. Results Obstacles to giving birth at health facilities included: (1) Distance to the health facilities and difficulties and costs of getting there; (2) Attitudes, quality of care, and care practices at the health facilities, including a horizontal birth position, episiotomies, lack of privacy, and the presence of male staff; (3) The wish to have family members nearby and the need for women to be close to their other children and the housework; and (4) The wish to follow traditional birth practices such as giving birth in a squatting position and lying on a “hot bed” after delivery. The decision about where to give birth was commonly made by the woman’s husband, mother, mother-in-law or other relatives in consultation with the woman herself. Conclusion This study suggests that the preference in rural Laos for giving birth at home is due to convenience, cost, comfort and tradition. In order to assure safer births and reduce rural Lao PDR’s high maternal mortality rate, health centers could consider accommodating the wishes and traditional practices of many rural Laotians: allowing family in the birthing rooms; allowing traditional practices; and improving attitudes among staff. Traditional birth attendants, women, and their families could be taught and encouraged to recognize the signs of at-risk pregnancies so as to be able to reach health facilities on time. PMID:22925107

  5. 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

  6. 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

  7. 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

  8. 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

  9. Sound and speech detection and classification in a Health Smart Home.

    PubMed

    Fleury, A; Noury, N; Vacher, M; Glasson, H; Seri, J F

    2008-01-01

    Improvements in medicine increase life expectancy in the world and create a new bottleneck at the entrance of specialized and equipped institutions. To allow elderly people to stay at home, researchers work on ways to monitor them in their own environment, with non-invasive sensors. To meet this goal, smart homes, equipped with lots of sensors, deliver information on the activities of the person and can help detect distress situations. In this paper, we present a global speech and sound recognition system that can be set-up in a flat. We placed eight microphones in the Health Smart Home of Grenoble (a real living flat of 47m(2)) and we automatically analyze and sort out the different sounds recorded in the flat and the speech uttered (to detect normal or distress french sentences). We introduce the methods for the sound and speech recognition, the post-processing of the data and finally the experimental results obtained in real conditions in the flat. PMID:19163751

  10. Cancer patient-centered home care: a new model for health care in oncology

    PubMed Central

    Tralongo, Paolo; Ferraù, Francesco; Borsellino, Nicolò; Verderame, Francesco; Caruso, Michele; Giuffrida, Dario; Butera, Alfredo; Gebbia, Vittorio

    2011-01-01

    Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients’ needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients’ needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective. PMID:21941445

  11. Home health care nurse interactions with homebound geriatric patients with depression and disability.

    PubMed

    Liebel, Dianne V; Powers, Bethel Ann; Hauenstein, Emily J

    2015-01-01

    Building therapeutic nurse-patient relationships is pivotal to the provision of optimum nurse care management for geriatric home health care (HHC) patients. However, little is known about which strategies most effectively treat older adult HHC patients with concomitant depression and disability. This qualitative descriptive study was conducted in two parts to explore the issue further. The first part involved interviews regarding HHC nurse perceptions of geriatric depression and disability care management. The second part, which is the focus of the current analysis, describes HHC nurses' use of care management and therapeutic during home visits. Observation of nurse-patient interactions involved 25 nurses home visits to HHC patients 60 and older who had depression and disability. Drawing on clinical knowledge and interpersonal skills, nurses built relationships and fostered trust. However, despite their disabilities to make these connections, multiple missed opportunities occurred for nurses to engage in more productive interactions. Four training components to support improvement of nurse-patient therapeutic relationships are described and recommended. PMID:26042245

  12. 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

  13. 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

  14. Effect of a virtual pain coach on older adults' pain communication: a pilot study.

    PubMed

    McDonald, Deborah Dillon; Gifford, Timothy; Walsh, Stephen

    2011-03-01

    A randomized posttest-only double blind design was used to pilot test the effect of a virtual practitioner pain communication coach on older adults' communication of their osteoarthritis pain. Baseline pain intensity and pain interference with activities were measured using the Brief Pain Inventory Short Form. Thirty older adults watched a video of a practitioner describing important osteoarthritis pain information followed by either a virtual practitioner coach, a video practitioner coach, or no coach. Participants were next asked, via a videotaped health care practitioner, to orally describe their pain as if speaking to their own practitioner. The amount of important distinctive pain information described by the older adults was audiotaped, transcribed, content analyzed, and summed using a priori criteria from the American Pain Society osteoarthritis pain management guidelines. Older adults described M=6.3 (SD=3.17), M=3.0 (SD=2.08), and M=5.2 (SD=2.40) items of important pain information as a result of the virtual coach, video coach, and no coach conditions, respectively; F(2,25)=3.17, p=.06, η²=.01. Older adults who practiced talking with the virtual coach described more than one additional item of important pain information. The clinically significant group difference supports the need to test the intervention in a randomized clinical trial. The virtual coaching and education intervention might enable older adults to communicate their pain management information more effectively to their practitioners. PMID:21349449

  15. COACH Trial: A Randomized Controlled Trial of Nurse Practitioner/Community Health Worker Cardiovascular Disease Risk Reduction in Urban Community Health Centers

    PubMed Central

    Allen, Jerilyn K.; Dennison Himmelfarb, Cheryl R.; Szanton, Sarah L.; Bone, Lee; Hill, Martha N.; Levine, David M.; West, Murray; Barlow, Amy; Lewis-Boyer, LaPricia; Donnelly-Strozzo, Mary; Curtis, Carol; Anderson, Katherine

    2011-01-01

    Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, the implementation of risk-reducing practices remains poor. This paper describes the results of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner/community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patients’ perceptions of the quality of their chronic illness care in patients in urban community health centers. Methods and Results A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL-cholesterol, blood pressure or HbA1c that exceeded goals established by national guidelines were randomized to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacologic management and tailored educational and behavioral counseling for lifestyle modification and problem solving to address barriers to adherence and control. As compared to EUC, patients in the NP/CHW group had significantly greater 12 month improvement in total cholesterol (difference, 19.7mg/dL), LDL cholesterol (difference,15.9 mg/dL), triglycerides (difference, 16.3 mg/dL), systolic blood pressure (difference, 6.2 mm Hg), diastolic blood pressure (difference, 3.1 mm Hg), HbA1c (difference, 0.5%), and perceptions of the quality of their chronic illness care (difference, 1.2 points). Conclusions An intervention delivered by a NP/CHW team using individualized treatment regimens based on treat-to-target algorithms can be an effective approach to improve risk factor status and perceptions of chronic illnes care in high risk patients. PMID:21953407

  16. 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

  17. The power of relationships: exploring how Public Health Nurses support mothers and families during postpartum home visits.

    PubMed

    Aston, Megan; Price, Sheri; Etowa, Josephine; Vukic, Adele; Young, Linda; Hart, Christine; MacLeod, Emily; Randel, Patricia

    2015-02-01

    Postpartum home visiting by Public Health Nurses (PHNs) has been used by many health departments across Canada as a way of supporting new mothers and their families. Although positive health outcomes are linked with support from PHNs, little is known about how this occurs during the home visit. The purpose of this research was to explore how home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs, mothers, and managers in Nova Scotia, Canada. Feminist poststructuralism was used to guide the research and semi-structured face-to-face interviews were conducted with 16 PHNs, 16 mothers, and 4 managers. Participants described how relationships were an essential part of supporting mothers and families. These findings also challenge dominant health discourses and stereotypes that are often associated with mothering and the practice of PHNs with families. PMID:25492494

  18. 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…

  19. 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…

  20. Health Facilities: New York State's Oversight of Nursing Homes and Hospitals. Report to the Honorable Bill Green, House of Representatives.

    ERIC Educational Resources Information Center

    General Accounting Office, New York, NY. Regional Office.

    At the request of Congressman William Green, the General Accounting Office (GAO) evaluated the validity of allegations about deficiencies in the New York State Department of Health's nursing home and hospital inspection processes for certification for participation in the Medicare and Medicaid programs. Health Care Financing Administration and…