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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. Advancing the Practice of Health Coaching: Differentiation From Wellness Coaching.

    PubMed

    Huffman, Melinda H

    2016-09-01

    The increasing demand for health coaches and wellness coaches in worksite health promotion and the marketplace has resulted in a plethora of training programs with wide variations in coaching definitions, content, attributes, and eligibility of those who may train. It is in the interest of public awareness and safety that those in clinical practice take the lead in this discussion and offer a reasonable contrast and comparison focusing on the risks and responsibilities of health coaching in particular. With the endorsement of the American Association of Occupational Health Nurses (AAOHN), the National Society of Health Coaches, whose membership is primarily nurses, discusses the issue and states its position here.

  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.

  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. Health coaching: an update on the national consortium for credentialing of health & wellness coaches.

    PubMed

    Mittelman, Michele

    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.

  7. 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…

  8. Health Coaching: A Developing Field within Health Education

    ERIC Educational Resources Information Center

    Palmer, Stephen

    2004-01-01

    The health promotion and health education literature has references to health counselling. Yet, beyond the field of health, coaching has become a popular method to enhance and facilitate individual and group performance in business, sports, and personal areas of life. This paper focuses on the recent development of health coaching by practitioners…

  9. 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…

  10. 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, ...

  11. 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.

  12. 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 ...

  13. Improving patient's home cooking - A case series of participation in a remote culinary coaching program.

    PubMed

    Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J

    2017-04-04

    This case series describes and examines the outcomes of a remote culinary coaching program, aimed at improving nutrition through home cooking. Participants (n=4) improved attitudes about the perceived ease of home cooking (p<0.01) and self-efficacy to perform various culinary skills (p=0.02); and also in confidence to continue e-learning culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health related culinary interventions.

  14. 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.

  15. Home Health Aides

    MedlinePlus

    ... do the following: Assist clients in their daily personal tasks, such as bathing or dressing Provide basic ... social networks and communities Home health aides, unlike personal care aides , typically work for certified home health ...

  16. 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…

  17. 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…

  18. 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

  19. 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.

  20. 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

  1. 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…

  2. 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.

  3. Coaching mental health peer advocates for rural LGBTQ people.

    PubMed

    Willging, Cathleen E; Israel, Tania; Ley, David; Trott, Elise M; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

    Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities.

  4. 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

  5. Role of Health Coaches in Pediatric Weight Management.

    PubMed

    Rice, Kerrilynn G; Jumamil, Riana B; Jabour, Sarah M; Cheng, Jennifer Kimberly

    2017-02-01

    This study aims to describe patients' and families' perspectives regarding the ideal role and responsibilities of a health coach to facilitate pediatric weight management in the primary care setting. Systematic thematic analysis of semistructured interviews with overweight children and their parents was performed. The majority of participants self-identified as racial/ethnic minorities and were Medicaid eligible. Desired health coaching elements included ( a) customized support and encouragement, including goal setting and maintenance, cultural sensitivity, and consideration of budget and lifestyle; ( b) nutritional guidance, including meal planning, assistance obtaining healthy food, and education and counseling; and ( c) linkage to resources, including social services, physical activity support, and programs for children with special health care needs. We conclude that families' specific needs should be holistically considered in the design of health coaching programs targeting pediatric obesity. Such support may help overcome social and financial barriers to changing health behaviors related to weight management.

  6. Problematizing health coaching for chronic illness self-management.

    PubMed

    Howard, Lisa M; Ceci, Christine

    2013-09-01

    To address the growing costs associated with chronic illness care, many countries, both developed and developing, identify increased patient self-management or self-care as a focus of healthcare reform. Health coaching, an implementation strategy to support the shift to self-management, encourages patients to make lifestyle changes to improve the management of chronic illness. This practice differs from traditional models of health education because of the interactional dynamics between nurse and patient, and an orientation to care that ostensibly centres and empowers patients. The theoretical underpinnings of coaching reflect these differences, however in its application, the practices arranged around health coaching for chronic illness self-management reveal the social regulation and professional management of everyday life. This becomes especially problematic in contexts defined by economic constraint and government withdrawal from activities related to the 'care' of citizens. In this paper, we trace the development of health coaching as part of nursing practice and consider the implications of this practice as an emerging element of chronic illness self-management. Our purpose is to highlight health coaching as an approach intended to support patients with chronic illness and at the same time, problematize the tensions contained in (and by) this practice.

  7. 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

  8. 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…

  9. 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...

  10. 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.

  11. Coaching mental health peer advocates for rural LGBTQ people

    PubMed Central

    Willging, Cathleen E.; Israel, Tania; Ley, David; Trott, Elise M.; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

    2016-01-01

    Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities. PMID:27458498

  12. Unobtrusive monitoring of divided attention in a cognitive health coaching intervention for the elderly.

    PubMed

    McKanna, James A; Pavel, Misha; Jimison, Holly

    2010-11-13

    Assessment of cognitive functionality is an important aspect of care for elders. Unfortunately, few tools exist to measure divided attention, the ability to allocate attention to different aspects of tasks. An accurate determination of divided attention would allow inference of generalized cognitive decline, as well as providing a quantifiable indicator of an important component of driving skill. We propose a new method for determining relative divided attention ability through unobtrusive monitoring of computer use. Specifically, we measure performance on a dual-task cognitive computer exercise as part of a health coaching intervention. This metric indicates whether the user has the ability to pay attention to both tasks at once, or is primarily attending to one task at a time (sacrificing optimal performance). The monitoring of divided attention in a home environment is a key component of both the early detection of cognitive problems and for assessing the efficacy of coaching interventions.

  13. Pharmacist-based health coaching: A new model of pharmacist-patient care.

    PubMed

    Lonie, John M; Austin, Zubin; Nguyen, Rosalie; Gill, Imninder; Tsingos-Lucas, Cherie

    2016-07-15

    This paper describes a provider-patient communication process, which although not new to health care in general, is new to the pharmacy profession. Health coaching is a technique that empowers patients to make lasting health behavior changes that improve overall well-being. It provides patients with health care implementation options that better suit their lifestyle and abilities. Health coaching programs have the potential to foster better health outcomes, especially with patients who are chronically ill or represent an at risk population for medication non-adherence (e.g. elderly, patients on psychotropic medications). Other health professions (e.g. nursing and medicine) have had success with the implementation of health coaching models. For example, nurse coaching is recognized by the American Nurse Association and recent statistics show 3.1 million nurses in the U.S.A are also trained in nurse coaching. The pharmacy profession has yet to tap the patient-related benefits of health coaching. This commentary will discuss (i) The theoretical foundations of health coaching (ii) Distinctions between health coaching, motivational interviewing and traditional medication therapy counseling (iii) Training necessary for health coaching; and (iv) How pharmacists can use health coaching in practice.

  14. 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…

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

    ERIC Educational Resources Information Center

    Grant, Anthony M.

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

  16. 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

  17. 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

  18. Effect of motivational interviewing-based health coaching on employees' physical and mental health status.

    PubMed

    Butterworth, Susan; Linden, Ariel; McClay, Wende; Leo, Michael C

    2006-10-01

    Motivational Interviewing (MI) based health coaching is a relatively new behavioral intervention that has gained popularity in public health because of its ability to address multiple behaviors, health risks, and illness self-management. In this study, 276 employees at a medical center self-selected to participate in either a 3-month health coaching intervention or control group. The treatment group showed significant improvement in both SF-12 physical (p = .035) and mental (p = .0001) health status compared to controls. Because of concerns of selection bias, a matched case-control analysis was also performed, eliciting similar results. These findings suggest that MI-based health coaching is effective in improving both physical and mental health status in an occupational setting.

  19. 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

  20. 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.

  1. 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

  2. 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.

  3. 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.

  4. 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

  5. MyAirCoach: the use of home-monitoring and mHealth systems to predict deterioration in asthma control and the occurrence of asthma exacerbations; study protocol of an observational study

    PubMed Central

    Honkoop, Persijn J; Simpson, Andrew; Bonini, Matteo; Snoeck-Stroband, Jiska B; Meah, Sally; Fan Chung, Kian; Usmani, Omar S; Fowler, Stephen; Sont, Jacob K

    2017-01-01

    Introduction Asthma is a variable lung condition whereby patients experience periods of controlled and uncontrolled asthma symptoms. Patients who experience prolonged periods of uncontrolled asthma have a higher incidence of exacerbations and increased morbidity and mortality rates. The ability to determine and to predict levels of asthma control and the occurrence of exacerbations is crucial in asthma management. Therefore, we aimed to determine to what extent physiological, behavioural and environmental data, obtained by mobile healthcare (mHealth) and home-monitoring sensors, as well as patient characteristics, can be used to predict episodes of uncontrolled asthma and the onset of asthma exacerbations. Methods and analysis In an 1-year observational study, patients will be provided with mHealth and home-monitoring systems to record daily measurements for the first-month (phase I) and weekly measurements during a follow-up period of 11 months (phase II). Our study population consists of 150 patients, aged ≥18 years, with a clinician's diagnosis of asthma, currently on controller medication, with uncontrolled asthma and/or minimally one exacerbation in the past 12 months. They will be enrolled over three participating centres, including Leiden, London and Manchester. Our main outcomes are the association between physiological, behavioural and environmental data and (1) the loss of asthma control and (2) the occurrence of asthma exacerbations. Ethics This study was approved by the Medical Ethics Committee of the Leiden University Medical Center in the Netherlands and by the NHS ethics service in the UK. Trial registration number NCT02774772. PMID:28119390

  6. 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…

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

    PubMed

    Caldwell, Karen L; Gray, Jennifer; Wolever, Ruth Q

    2013-05-01

    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.

  8. 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

  9. 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.

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

    PubMed

    Simmons, Leigh Ann; Wolever, Ruth Q

    2013-07-01

    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.

  11. Managing Home Health Care (For Parents)

    MedlinePlus

    ... Your 1- to 2-Year-Old Managing Home Health Care KidsHealth > For Parents > Managing Home Health Care A ... español La atención médica en el hogar Intensive Health Care at Home Kids can need intensive health care ...

  12. Home health care

    MedlinePlus

    ... this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy , editorial process and privacy policy . A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www. ...

  13. Advancing Health Promotion in Dentistry: Articulating an Integrative Approach to Coaching Oral Health Behavior Change in the Dental Setting

    PubMed Central

    Howard, Anita R.

    2015-01-01

    Oral health is managed based on objective measures such as the presence and severity of dental caries and periodontal disease. In recent years, oral health researchers and practitioners have shown increasing interest in a widened array of physical, psychological, and social factors found to influence patients’ oral health. In this article, we introduce a behavior change coaching approach that can be used to enhance psychosocial diagnosis and client-centered delivery of health-promoting interventions. Briefly, this health coaching approach is based on an interactive assessment (both physical and psychological), a non-judgmental exploration of patients’ knowledge, attitudes, and beliefs, a mapping of patient behaviors that may contribute to disease progression, gauging patient motivation, and tailoring health communication to encourage health-promoting behavior change. Developed in a clinical setting, this coaching model is supported by interdisciplinary theory, research, and practice on health behavior change. We suggest that, with supervision, this coaching process may be learned. PMID:26457237

  14. 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…

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

    PubMed

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

    2010-01-01

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

  17. 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 [ ...

  18. The Future of Home Health Care

    PubMed Central

    Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica

    2016-01-01

    The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670

  19. Case report of hemoglobin a1c and weight reduction in integrative health coaching.

    PubMed

    Moore, Cynthia

    2013-05-01

    Integrative health coaching (IHC) offers significant health improvement in biometric measures without pharmaceuticals. In this case of newly diagnosed impaired glucose tolerance (IGT) with obesity, IHC used the patient's strengths to reverse IGT, prevent frank diabetes, and reduce weight by 40 lbs or 21% of her original weight. This intervention included a client self-assessment and 14 in-person health coaching sessions over 11 months. IHC provides a framework to accomplish short-term goals and identify and overcome barriers while drawing on the strengths and aims of the individual.

  20. 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.

  1. Health coaching interventions with a heart-healthy lenoir project client.

    PubMed

    Tillman, Jim

    2013-05-01

    The Heart-Healthy Lenoir Project is a multi-study project designed to reduce the risk burden of heart disease in Lenoir County, North Carolina. This case report examines one client's experience in this project and the impact of health coaching interventions that were used. The client presented with unhealthy lifestyle behaviors and a systolic blood pressure (BP) of more than 200 mmHg. After 1 year of educational group meetings and personalized health coaching, the client was able to reduce her BP to an acceptable range and has adopted many new lifestyle behaviors. This case report demonstrates one way health coaching is being integrated into educational programs and in collaboration with primary care practices.

  2. 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

  3. Bringing the concepts of peer coaches and local health workers from Africa to Harlem.

    PubMed

    Singh, Prabhjot

    2012-12-01

    Prabhjot Singh, a PhD scientist and medical resident, saw the effectiveness of community health workers while working in Africa. Now he helps run a New York-based organization that trains peer coaches to help struggling Americans manage their health.

  4. 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

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

    PubMed Central

    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 five urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. Results Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. Conclusions Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains. PMID:22428941

  6. 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)…

  7. 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

  8. 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

  9. 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

  10. Financing of Pediatric Home Health Care.

    PubMed

    Simpser, Edwin; Hudak, Mark L

    2017-03-01

    Pediatric home health care is an effective and holistic venue of treatment of children with medical complexity or developmental disabilities who otherwise may experience frequent and/or prolonged hospitalizations or who may enter chronic institutional care. Demand for pediatric home health care is increasing while the provider base is eroding, primarily because of inadequate payment or restrictions on benefits. As a result, home care responsibilities assumed by family caregivers have increased and imposed financial, physical, and psychological burdens on the family. The Patient Protection and Affordable Care Act set forth 10 mandated essential health benefits. Home care should be considered as an integral component of the habilitative and rehabilitative services and devices benefit, even though it is not explicitly recognized as a specific category of service. Pediatric-specific home health care services should be defined clearly as components of pediatric services, the 10th essential benefit, and recognized by all payers. Payments for home health care services should be sufficient to maintain an adequate provider work force with the pediatric-specific expertise and skills to care for children with medical complexity or developmental disability. Furthermore, coordination of care among various providers and the necessary direct patient care from which these care coordination plans are developed should be required and enabled by adequate payment. The American Academy of Pediatrics advocates for high-quality care by calling for development of pediatric-specific home health regulations and the licensure and certification of pediatric home health providers.

  11. Rationale and design of a comparative effectiveness trial of home- and clinic-based self-management support coaching for older adults with asthma.

    PubMed

    Federman, Alex D; Martynenko, Melissa; O'Conor, Rachel; Kannry, Joseph; Karp, Adam; Lurio, Joseph; Hoy-Rosas, Jamillah; Lopez, Ray; Obiapi, Rosemary; Young, Edwin; Wolf, Michael S; Wisnivesky, Juan P

    2015-07-31

    Older adults with asthma face numerous barriers to effective self-management and asthma control, and experience worse outcomes than younger asthmatics. Yet, there have been no controlled trials of interventions specifically designed to improve their care and outcomes. Through a multi-stakeholder collaboration (patients, academia, community-based organizations, a state department of health, and an advocacy organization) we developed a multi-component asthma self-management support intervention to address the myriad psychosocial, functional, health status, and cognitive barriers to effective asthma self-management in adults ages 60 and older. We are recruiting 425 New Yorkers in Manhattan and the Bronx for a pragmatic randomized controlled trial with 3 arms: the intervention delivered in primary care settings or in their home, or usual care. In the intervention, care coaches use a novel screening tool to identify the specific barriers to asthma control and self-management they experience. Once identified, the coach and patient choose from a menu of actions to address it. The intervention emphasizes efficiency, flexibility, shared decision making and goal setting, communication strategies appropriate for individuals with limited cognition and literacy skills, and ongoing reinforcement and support. Additionally, we introduced asthma-specific enhancements to the electronic health records of all participating clinical practices, including an asthma severity assessment, clinical decision support, and a patient-tailored asthma action plan. Patients will be followed for 12months and interviewed at baseline, 3, 6, and 12months and data on emergency department visits and hospitalizations will be obtained through the New York State Statewide Planning and Research Cooperative System.

  12. Personalized health planning with integrative health coaching to reduce obesity risk among women gaining excess weight during pregnancy.

    PubMed

    Yang, Nancy Y; Wroth, Shelley; Parham, Catherine; Strait, Melva; Simmons, Leigh Ann

    2013-07-01

    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.

  13. 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…

  14. 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 home-based…

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

    MedlinePlus

    ... care + Share widget - Select to show What’s home health care? 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 ...

  16. Health promotion activities of sports clubs and coaches, and health and health behaviours in youth participating in sports clubs: the Health Promoting Sports Club study

    PubMed Central

    Kokko, Sami; Selänne, Harri; Alanko, Lauri; Heinonen, Olli J; Korpelainen, Raija; Savonen, Kai; Vasankari, Tommi; Kannas, Lasse; Kujala, Urho M; Aira, Tuula; Villberg, Jari; Parkkari, Jari

    2015-01-01

    Introduction Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. Methods and analysis The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14–16 (n=759) years evaluate the coaches’ health promotion activity. The survey of the adolescents’ health behaviours consist of two data sets—the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. Ethics and dissemination The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  18. Reliability assessment of home health care services.

    PubMed

    Spyrou, Stergiani; Bamidis, Panagiotis; Kilintzis, Vassilis; Lekka, Irini; Maglaveras, Nicos; Pappas, Costas

    2007-01-01

    In this paper, a model of reliability assessment of services in Home Health Care Delivery is presented. Reliability is an important quality dimension for services and is included in non-functional requirements of a system. A stochastic Markov model for reliability assessment is applied to patient communication services, in the field of home health care delivery. The methodology includes the specification of scenarios, the definition of failures in scenarios as well as the application of the analytical model. The results of the methodology reveal the critical states of the Home Health Care System and recommendations for improvement of the services are proposed. The model gives valuable results in predicting service reliability and, independently of the error types, it can be applied to all fields of Regional Health Network (RHN).

  19. 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…

  20. Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs

    PubMed Central

    Thomas, Melanie; Delgadillo-Duenas, Adriana T.; Leong, Karen; Najmabadi, Adriana; Harleman, Elizabeth; Rios, Christina; Quan, Judy; Soria, Catalina; Handley, Margaret A.

    2016-01-01

    Background. Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is an ongoing randomized control trial (RCT) evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18–39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results. Most of the 86 women included to date (88%) have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion. The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420. PMID:27830157

  1. The effects on team emotions and team effectiveness of coaching in interprofessional health and social care teams.

    PubMed

    Dimas, Isabel Dórdio; Renato Lourenço, Paulo; Rebelo, Teresa

    2016-07-01

    The purpose of this study was to examine the effects of coaching behaviours provided by peers and by the leader on the emotions experienced by interprofessional health and social care teams and on members' satisfaction with the team, as well as on team performance. Data were obtained from a survey among 344 employees working in 52 interprofessional health and social care teams from nine Portuguese organizations. The results show that leader coaching and peer coaching have a positive effect on the level of team members' satisfaction with the team and on positive emotions, and a negative effect on negative emotions. Furthermore, coaching provided by peers presents a positive effect on team performance as assessed by the leader of the team. Our findings put forward the importance of engaging in coaching behaviours to promote quality of the team experience, as well as the achievement of team performance objectives. Further studies should explore how coaching behaviours impact the patient, whose well-being is the ultimate objective of a team in the health and social care system, namely in terms of the patient's perception of quality care or patient outcomes.

  2. Peer health coaching for overweight and obese individuals with serious mental illness: intervention development and initial feasibility study.

    PubMed

    Aschbrenner, Kelly A; Naslund, John A; Barre, Laura K; Mueser, Kim T; Kinney, Allison; Bartels, Stephen J

    2015-09-01

    Effective and scalable interventions are needed to reach a greater proportion of individuals with serious mental illness (SMI) who experience alarmingly high rates of obesity. This pilot study evaluated the feasibility of translating an evidenced-based professional health coach model (In SHAPE) to peer health coaching for overweight and obese individuals with SMI. Key stakeholders collaborated to modify In SHAPE to include a transition from professional health coaching to individual and group-based peer health coaching enhanced by mobile health technology. Ten individuals with SMI were recruited from a public mental health agency to participate in a 6-month feasibility pilot study of the new model. There was no overall significant change in mean weight; however, over half (56 %) of participants lost weight by the end of the intervention with mean weight loss 2.7 ± 2.1 kg. Participants reported high satisfaction and perceived benefits from the program. Qualitative interviews with key stakeholders indicated that the intervention was implemented as planned. This formative research showed that peer health coaching for individuals with SMI is feasible. Further research is needed to evaluate its effectiveness.

  3. 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

  4. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  5. Misalignment between Medicare Policies and Depression Care in Home Health Care: Home health provider perspectives

    PubMed Central

    Bao, Yuhua; Eggman, Ashley; Richardson, Joshua; Bruce, Martha

    2013-01-01

    Objective Depression affects one in four older adults receiving home health care. Medicare policies are influential in shaping home health practice. This study aims to identify Medicare policy areas that are aligned or misaligned with depression care quality improvement in home health care. Methods Qualitative study based on semi-structured interviews with nurses and administrators from five home health agencies in five states (n=20). Digitally recorded interviews were transcribed and analyzed using the grounded theory method. A multi-disciplinary team iteratively developed a codebook from interview data to identify themes. Results Several important Medicare policies are largely misaligned with depression care quality improvement in home health care: Medicare eligibility requirements for patients to remain homebound and to demonstrate a need for skilled care restrict nurses’ abilities to follow up with depressed patients for sufficient length of time; the lack of explicit recognition of nursing time and quality of care in the home health Prospective Payment System (PPS) provides misaligned incentives for depression care; incorporation of a two-item depression screening tool in Medicare-mandated comprehensive patient assessment raised clinician awareness of depression; however, inclusion of the tool at Start-of-Care only but not any other follow-up points limits its potential in assisting nurses with depression care management; under-development of clinical decision support for depression care in vendor-developed electronic health records constitutes an important barrier to depression quality improvement in home health care. Conclusions Several influential Medicare policies and regulations for home health practice may be misaligned with evidence-based depression care for home health patients. PMID:24632686

  6. Home Health Compare: Find a Home Health Agency

    MedlinePlus

    ... You” Handbook Help with file formats & plug-ins CMS & HHS Websites HealthCare.gov STOPMedicareFraud.gov InsureKidsNow.gov MyMedicare.gov Medicaid.gov CMS.gov HHS.gov Get Involved with Us Twitter ...

  7. Health promotion profile of youth sports clubs in Finland: club officials' and coaches' perceptions.

    PubMed

    Kokko, Sami; Kannas, Lasse; Villberg, Jari

    2009-03-01

    The purpose of this article is to examine the current health promotion orientation of youth sports clubs in Finland in view of the standards created previously for the health promoting sports club (HPSC). Ninety-seven youth sports clubs participated, and 273 sports club officials and 240 coaches answered the questionnaires. To describe clubs health promotion orientations, an HPSC index was created. The HPSC index was formulated on sub-indices by factor analysis. The sub-indices were: policy, ideology, practice and environment indexes. The results indicate that youth sports clubs are fairly health promoting in general. On average, the clubs fulfilled 12 standards for HPSC out of 22. Every fourth club was categorized as higher health promoting (> or = 15 fulfilled standards), and every third as lower health promoting (<11 fulfilled standards). The variation between clubs was wide. The clubs that had been recognized as exemplary and hence certified by the Young Finland Association were more likely to recognize health promotion than non-certified clubs (OR = 2.36, p = 0.016). The sports club officials were twice as likely to evaluate their clubs as higher health promoting than the coaches (OR = 2.04, p = 0.041). Under the sub-indices, ideologies were recognized best, others less. These findings indicate that minority of the youth sports clubs have realized health promotion comprehensively as a part of their activities. There is a lot of need for development, especially in the area of health promotion policies and practices. The instruments used proved valid and reliable and can therefore be recommended for international use.

  8. Identification of Patients With Diabetes Who Benefit Most From a Health Coaching Program in Chronic Disease Management, Sydney, Australia, 2013

    PubMed Central

    Delaney, Grace; Newlyn, Neroli; Pamplona, Elline; Hocking, Samantha L.; Glastras, Sarah J.; Fulcher, Gregory R.

    2017-01-01

    Introduction Chronic disease management programs (CDMPs) that include health coaching can facilitate and coordinate diabetes management. The aim of this study was to assess changes in patients’ general knowledge of diabetes, self-reported health status, diabetes distress, body mass index (BMI), and glycemic control after enrollment in a face-to-face CDMP group health coaching session (with telephone follow-up) compared with participation in telephone-only health coaching, during a 12-month period. Methods Patients with diabetes were enrolled in a health coaching program at Royal North Shore Hospital, Sydney, Australia, in 2013. Questionnaires were administered at baseline and at 3, 6, and 12 months, and the results were compared with baseline. Glycemic control, measured with glycated hemoglobin A1c (HbA1c) and BMI, were measured at baseline and 12 months. Results Overall, 238 patients attended a face-to-face CDMP session with telephone follow-up (n = 178) or participated in telephone-only health coaching (n = 60). We found no change in BMI in either group; however, HbA1c levels in patients with baseline above the current recommended target (>7%) decreased significantly from 8.5% (standard deviation [SD], 1.0%) to 7.9% (SD, 1.0%) (P = .03). Patients with the lowest self-reported health status at baseline improved from 4.4 (SD, 0.5) to 3.7 (SD, 0.9) (P = .001). Diabetes knowledge improved in all patients (24.4 [SD, 2.4] to 25.2 [SD, 2.4]; P < .001), and diabetes distress decreased among those with the highest levels of distress at baseline (3.0 [SD, 0.4] vs 3.8 [SD, 0.6]; P = .003). Conclusion Diabetes health coaching programs can improve glycemic control and reduce diabetes distress in patients with high levels of these at baseline. PMID:28253473

  9. 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.

  10. Effect of telephone health coaching (Birmingham OwnHealth) on hospital use and associated costs: cohort study with matched controls

    PubMed Central

    Tunkel, Sarah; Blunt, Ian; Bardsley, Martin

    2013-01-01

    Objectives To test the effect of a telephone health coaching service (Birmingham OwnHealth) on hospital use and associated costs. Design Analysis of person level administrative data. Difference-in-difference analysis was done relative to matched controls. Setting Community based intervention operating in a large English city with industry. Participants 2698 patients recruited from local general practices before 2009 with heart failure, coronary heart disease, diabetes, or chronic obstructive pulmonary disease; and a history of inpatient or outpatient hospital use. These individuals were matched on a 1:1 basis to control patients from similar areas of England with respect to demographics, diagnoses of health conditions, previous hospital use, and a predictive risk score. Intervention Telephone health coaching involved a personalised care plan and a series of outbound calls usually scheduled monthly. Median length of time enrolled on the service was 25.5 months. Control participants received usual healthcare in their areas, which did not include telephone health coaching. Main outcome measures Number of emergency hospital admissions per head over 12 months after enrolment. Secondary metrics calculated over 12 months were: hospital bed days, elective hospital admissions, outpatient attendances, and secondary care costs. Results In relation to diagnoses of health conditions and other baseline variables, matched controls and intervention patients were similar before the date of enrolment. After this point, emergency admissions increased more quickly among intervention participants than matched controls (difference 0.05 admissions per head, 95% confidence interval 0.00 to 0.09, P=0.046). Outpatient attendances also increased more quickly in the intervention group (difference 0.37 attendances per head, 0.16 to 0.58, P<0.001), as did secondary care costs (difference £175 per head, £22 to £328, P=0.025). Checks showed that we were unlikely to have missed reductions in

  11. 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

  12. 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.

  13. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  14. 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...

  15. 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...

  16. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  17. 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, 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...

  19. 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....

  20. 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...

  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 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....

  3. Financing of pediatric home health care. Committee on Child Health Financing, Section on Home Care, American Academy of Pediatrics.

    PubMed

    2006-08-01

    In certain situations, home health care has been shown to be a cost-effective alternative to inpatient hospital care. National health expenditures reveal that pediatric home health costs totaled $5.3 billion in 2000. Medicaid is the major payer for pediatric home health care (77%), followed by other public sources (22%). Private health insurance and families each paid less than 1% of pediatric home health expenses. The most important factors affecting access to home health care are the inadequate supply of clinicians and ancillary personnel, shortages of home health nurses with pediatric expertise, inadequate payment, and restrictive insurance and managed care policies. Many children must stay in the NICU, PICU, and other pediatric wards and intermediate care areas at a much higher cost because of inadequate pediatric home health care services. The main financing problem pertaining to Medicaid is low payment to home health agencies at rates that are insufficient to provide beneficiaries access to home health services. Although home care services may be a covered benefit under private health plans, most do not cover private-duty nursing (83%), home health aides (45%), or home physical, occupational, or speech therapy (33%) and/or impose visit or monetary limits or caps. To advocate for improvements in financing of pediatric home health care, the American Academy of Pediatrics has developed several recommendations for public policy makers, federal and state Medicaid offices, private insurers, managed care plans, Title V officials, and home health care professionals. These recommendations will improve licensing, payment, coverage, and research related to pediatric home health services.

  4. Comparison of Coaches' Perceptions and Officials Guidance towards Health Promotion in French Sport Clubs: A Mixed Method Study

    ERIC Educational Resources Information Center

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

    2016-01-01

    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…

  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

  6. Home health services in New Hampshire.

    PubMed Central

    Hale, F A; Jacobs, A R

    1976-01-01

    While home health services have traditionally been an underused component of the health care system, current trends suggest the desirability of expanding these services. These trends include an increase in the number of elderly who need the benefits of home care, the recognition that long-term chronic illnesses require appropriate management at home, and concern that patients have access to care at the level most appropriate to their illnesses. In New Hampshire, 41 certified home health agencies offer services. Little systematic research has been conducted on the kinds of services they provide and the patients seen by their staffs. Patient encounter data were collected from a sample of eight agencies for a 4-week period. Staff of the agencies used the patient contact record developed by the National Functional Task Analysis Cooperative Study to collect data. The data reflected differences among the agencies in the size of the populations they serve, organizational characteristics, reasons for patients' visits, expected sources of the revenue that supported them, and the diagnosis of the patients they cared for. The agencies served areas with populations ranging from 1,000 to 40,000. The staffs ranged from 1 to 14 full-time persons. Two were public agencies; the others had voluntary sponsorship. When data on reasons for visits were averaged for the eight agencies, it was shown that 72% of the visits were made for disease control activities such as care for a chronic or acute condition or for treatment or a laboratory test. Disease prevention activities such as a checkup for adults, children, prenatal or postnatal care, or health education accounted for only 24% of the visits. This result may indicate that, in areas short of physician manpower, the community health nurse is taking on increasing responsibility for medical care as well as health and education. Reimbursement for the visits came from Medicare, 25%; Medicaid-welfare, 14%; the patients, 18%; and health

  7. Impact and Acceptability of the Coach and Teacher Training within a School-Based Sport-for-Health Smoking Prevention Intervention: Smokefree Sports

    ERIC Educational Resources Information Center

    Garnham-Lee, Katy; Trigwell, Joanne; McGee, Ciara E.; Knowles, Zoe; Foweather, Lawrence

    2016-01-01

    This study evaluated the impact and acceptability of a three-hour bespoke training workshop for sports coaches and teachers to subsequently deliver a sport-for-health smoking prevention intervention in primary schools. Questionnaires were completed pre- and post-training by both teachers (N = 24) and coaches (N = 8), and post-intervention by…

  8. The challenge of marketing home health care in the nineties.

    PubMed

    Balazs, A L

    1990-01-01

    This paper explores the recent growth and development of home health care services. Rising medical costs and technological and social changes have made home care a competitive alternative to hospitalization and other forms of institutionalization. Providers of home health care need to familiarize themselves with the demographic trends affecting their customer base. A strategic marketing orientation is suggested for future growth and profitability.

  9. 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.

  10. 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.

  11. 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.…

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

    PubMed

    Freitag, E M

    1988-06-01

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

  13. Effectiveness of Telephone-Based Health Coaching for Patients with Chronic Conditions: A Randomised Controlled Trial

    PubMed Central

    Dwinger, Sarah; Kriston, Levente; Herbarth, Lutz; Siegmund-Schultze, Elisabeth; Bermejo, Isaac; Matschinger, Herbert; Heider, Dirk; König, Hans-Helmut

    2016-01-01

    Background Chronic diseases, like diabetes mellitus, heart disease and cancer are leading causes of death and disability. These conditions are at least partially preventable or modifiable, e.g. by enhancing patients’ self-management. We aimed to examine the effectiveness of telephone-based health coaching (TBHC) in chronically ill patients. Methods and Findings This prospective, pragmatic randomized controlled trial compares an intervention group (IG) of participants in TBHC to a control group (CG) without TBHC. Endpoints were assessed two years after enrolment. Three different groups of insurees with 1) multiple conditions (chronic campaign), 2) heart failure (heart failure campaign), or 3) chronic mental illness conditions (mental health campaign) were targeted. The telephone coaching included evidence-based information and was based on the concepts of motivational interviewing, shared decision-making, and collaborative goal setting. Patients received an average of 12.9 calls. Primary outcome was time from enrolment until hospital readmission within a two-year follow-up period. Secondary outcomes comprised the probability of hospital readmission, number of daily defined medication doses (DDD), frequency and duration of inability to work, and mortality within two years. All outcomes were collected from routine data provided by the statutory health insurance. As informed consent was obtained after randomization, propensity score matching (PSM) was used to minimize selection bias introduced by decliners. For the analysis of hospital readmission and mortality, we calculated Kaplan-Meier curves and estimated hazard ratios (HR). Probability of hospital readmission and probability of death were analysed by calculating odds ratios (OR). Quantity of health service use and inability to work were analysed by linear random effects regression models. PSM resulted in patient samples of 5,309 (IG: 2,713; CG: 2,596) in the chronic campaign, of 660 (IG: 338; CG: 322) in the

  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. 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…

  16. 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.

  17. 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.…

  18. 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.

  19. Marketing considerations in home health care.

    PubMed

    Tanner, D J

    1985-12-01

    Methods for conducting a comprehensive analysis of the potential for strategic entry or expansion in the home health-care (HHC) market are discussed. By conducting a comprehensive analysis of the HHC market, hospital pharmacists can evaluate the feasibility of developing and implementing a hospital-based HHC service. A comprehensive market analysis should include an initial assessment of potential product-line offerings, development of strengths-and-weaknesses and opportunities-and-threats profiles, evaluations of competing providers of HHC and regulatory issues, and formulation of a business plan. The potential impact of program structure, operations management, product pricing, advertising and promotion, and marketing controls should also be considered. The hospital pharmacist has a unique opportunity to further the organizational objectives of the hospital by participating in the provision of HHC; a comprehensive market analysis represents a useful method of assessing the benefits and costs associated with providing integrated HHC services.

  20. Misalignment between medicare policies and depression care in home health care: home health provider perspectives.

    PubMed

    Bao, Yuhua; Eggman, Ashley A; Richardson, Joshua E; Bruce, Martha L

    2014-07-01

    Semistructured interviews with nurses working for home health care agencies in five states raise serious questions about the deleterious effects of Medicare policies and procedures on depression care. The agencies have strong incentives to limit nursing time in a given payment episode and to increase volume, making it difficult to provide high-quality depression care for homebound patients. Some nurses felt forced to "abandon" many patients with depression. The authors call for incremental policy changes in several key areas.

  1. 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)

  2. Development of Home Health Aide Curriculum Project. Final Report.

    ERIC Educational Resources Information Center

    Brown, Patricia

    This package contains materials intended for use in a new home health aide curriculum that is designed to be presented as a two-quarter program at Tacoma Community College in Tacoma, Washington. Included in the package are a final report outlining the objectives and outcomes of the project to develop a home health aide curriculum that would meet…

  3. 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.

  4. Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    PubMed

    2016-11-03

    This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

  5. 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.

  6. 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…

  7. Home health visits using a cable television network: user satisfaction.

    PubMed

    Allen, A; Roman, L; Cox, R; Cardwell, B

    1996-01-01

    There are about 1.5 million home patients who receive home health care (nurses visiting patients in their homes) in the US each year. In a significant proportion of these visits, hands-on care is not needed. Rather, the nurse needs to verify compliance with medication regimes, assess mental or emotional status, or check blood sugar levels, blood pressure and the like. Many of these activities might be handled by a nursing visit using interactive video to the patient's home, saving the nurse's time wasted in driving, finding parking, etc. A system for delivering home health care using interactive video has been piloted in the state of Kansas. Using the local cable television infrastructure for audio and video transmission, this system permits a nurse to see patients in their homes for a fraction of the cost of an on-site visit. This new method of delivering home health care is being evaluated with an ongoing study of utilization and user satisfaction. We conducted a prospective survey administered to home health nurses (n = 2) and homebound patients (n = 3) using a cable TV-mediated interactive video system, to assess utilization and user satisfaction with televideo-mediated home health care visits. One hundred and eighty-one patient questionnaires and 193 nurses questionnaires were completed. The average length of a visit was 15 minutes (range 1-91). All mean scores tabulated for the questions indicated strong nurse and patient satisfaction with the system. Participating nurses and clients were satisfied with the televideo encounters. The mean score for all questions was better than neutral. Recognizing that this was a pilot study, hampered by small numbers and subject to the inherent biases of a single institution study, the results support further investigation and implementation of this modality for home health care.

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

    ERIC Educational Resources Information Center

    Barron, Carla; Paradis, Nichole

    2010-01-01

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

  9. Instructional Coaching

    ERIC Educational Resources Information Center

    Knight, Jim

    2006-01-01

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

  10. Caring for Depression in Older Home Health Patients.

    PubMed

    Bruce, Martha L

    2015-11-01

    Depression is common in older home health patients and increases their risk of adverse outcomes. Depression screening is required by Medicare's Outcome and Assessment Information Set. The Depression Care for Patients at Home (CAREPATH) was developed as a feasible strategy for home health nurses to manage depression in their patients. The protocol builds on nurses' existing clinical skills and is designed to fit within routine home visits. Major components include ongoing clinical assessment, care coordination, medication management, education, and goal setting. In a randomized trial, Depression CAREPATH patients had greater improvement in depressive symptoms compared to usual care. The difference between groups was significant at 3 months, growing larger and more clinically meaningful over 1 year. The intervention had no impact on patient length of stay, number of home visits, or duration of visits. Thus, nurses can play a pivotal role in the long-term course and outcomes of patients with depression.

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

    PubMed

    Beckner, Brittany N; Record, Rachael A

    2016-01-01

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

  12. Experience and education of home health administrators and nursing home administrators and the relationship to establishment ownership.

    PubMed

    Decker, Frederic H; Decker, Sandra L

    2012-01-01

    Administrators in long-term care may have an important influence on quality of care. Limited prior research has described the characteristics of nursing home administrators. Despite growing emphasis on home health care as an alternative to nursing homes, almost no research has described the characteristics of administrators of home health agencies. Using the 2004 National Nursing Home Survey and the 2007 National Home and Hospice Care Survey, we describe the career experience of administrators, and examine the relationship between experience and education of administrators both within and across the nursing home and home health sectors. We also explore the characteristics of nursing homes and home health agencies, including establishment ownership (e.g., nonchain not-for-profit), that are associated with being able to attract administrators with the most experience. We find that home health administrators have, on average, less experience than nursing home administrators. Among home health agencies, administrators with the least experience also tend to have less education. In nursing homes, administrators with less experience tend to have more education. Results from multivariate analysis suggest that chain for-profits may be the least able to attract experienced administrators. More research on the effects of different levels of experience and education among administrators is needed.

  13. 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…

  14. Home-based chronic care. An expanded integrative model for home health professionals.

    PubMed

    Suter, Paula; Hennessey, Beth; Harrison, Gregory; Fagan, Martha; Norman, Barbara; Suter, W Newton

    2008-04-01

    The Chronic Care Model (CCM) developed by is an influential and accepted guide for the care of patients with chronic disease. Wagner acknowledges a current healthcare focus on acute care needs that often circumvents chronic care coordination. He identifies the need for a "division of labor" to assist the primary care physician with this neglected function. This article posits that the role of chronic care coordination assistance and disease management fits within the purview of home healthcare and should be central to home health chronic care delivery. An expanded Home-Based Chronic Care Model (HBCCM) is described that builds on Wagner's model and integrates salient theories from fields beyond medicine. The expanded model maximizes the potential for disease self-management success and is intended to provide a foundation for home health's integral role in chronic disease management.

  15. 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.

  16. 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

  17. 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.

  18. 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…

  19. An Interdisciplinary Mental Health Consultation Team in a Nursing Home.

    ERIC Educational Resources Information Center

    Joseph, Carol; And Others

    1995-01-01

    Describes the Mental Health Consultation Team at the Portland Veterans Affairs Medical Center nursing home. The team is an interdisciplinary group of mental health professionals and primary care providers. Cooperation among these professionals has decreased the demands for formal psychiatry and psychology consultations while increasing mental…

  20. 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.

  1. Integrating mental health parity for homebound older adults under the medicare home health care benefit.

    PubMed

    Davitt, Joan K; Gellis, Zvi D

    2011-04-01

    Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.

  2. Integrated Working for Enhanced Health Care in English Nursing Homes

    PubMed Central

    McNall, Anne; Thompson, Juliana; Hodgson, Philip; Shaw, Lynne; Cowie, Daniel

    2016-01-01

    Abstract Background The increasingly complex nature of care home residents’ health status means that this population requires significant multidisciplinary team input from health services. To address this, a multisector and multiprofessional enhanced healthcare programme was implemented in nursing homes across Gateshead Council in Northern England. Study Aims To explore the views and experiences of practitioners, social care officers, and carers involved in the enhanced health care in care home programme, in order to develop understanding of the service delivery model and associated workforce needs for the provision of health care to older residents. Methods A qualitative constructivist methodology was adopted. The study had two stages. Stage 1 explored the experiences of the programme enhanced healthcare workforce through group, dyad, and individual interviews with 45 participants. Stage 2 involved two workshops with 28 participants to develop Stage 1 findings (data were collected during February–March 2016). Thematic and content analysis were applied. Findings The enhanced healthcare programme provides a whole system approach to the delivery of proactive and responsive care for nursing home residents. The service model enables information exchange across organizational and professional boundaries that support effective decision making and problem solving. Clinical Relevance Understanding of the processes and outcomes of a model of integrated health care between public and independent sector care home services for older people. PMID:28094909

  3. Compensation of home health, public health, and hospital nurses. Extrinsic and intrinsic rewards.

    PubMed

    Hughes, K K; Marcantonio, R J

    1991-11-01

    Despite the proliferation of home health agencies and increased numbers of nurses working in these settings, little is known about home health nurses or how they might differ from their public health and hospital counterparts. The authors discuss differences in monetary compensation and skill usage, as well as the relationship between compensation and retention, among hospital, home health, and public health staff nurses. The results show that these nurses receive different intrinsic and extrinsic rewards and that their reasons for remaining with their employers are similar, yet unique. Implications for nurse administrators and educators are discussed, along with recommendations for further research.

  4. 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…

  5. Adding home health care to the discussion on health information technology policy.

    PubMed

    Ruggiano, Nicole; Brown, Ellen L; Hristidis, Vagelis; Page, Timothy F

    2013-01-01

    The potential for health information technology to improve the efficiency and effectiveness of health care has resulted in several U.S. policy initiatives aimed at integrating health information technology into health care systems. However, home health care agencies have been excluded from incentive programs established through policies, raising concerns on the extent to which health information technology may be used to improve the quality of care for older adults with chronic illness and disabilities. This analysis examines the potential issues stemming from this exclusion and explores potential opportunities of integrating home health care into larger initiatives aimed at establishing health information technology systems for meaningful use.

  6. Home-Sweet-Home Health Care [and] Drugs Manufacturing: A Prescription for Jobs.

    ERIC Educational Resources Information Center

    Freeman, Laura; Heffler, Stephen

    1995-01-01

    Lower costs, new technology, and expanded Medicare benefits are some of the reasons for the rapid increase in employment in home health services. Employment in the drugs manufacturing industry has increased despite recessions and structural changes in the economy. (Author/JOW)

  7. 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

    2015-11-05

    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.

  8. 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

  9. Teaching Principles of Geriatrics Through a Home Health Care Rotation.

    ERIC Educational Resources Information Center

    Francisco, George E., Jr.

    1983-01-01

    A one week rotation in home health care for the aged, included in a required clinical clerkship, provided students with exposure to medical, social, and economic influences on the elderly and provided the patient with nondispensing pharmaceutical services. Improved communication skills and knowledge of geriatric drugs and diseases resulted. (MSE)

  10. Home Economics/Health Grades 6-12. Program Evaluation.

    ERIC Educational Resources Information Center

    Des Moines Public Schools, IA. Teaching and Learning Div.

    Home economics programs are offered to students in grades 6-12 in the Des Moines INdependent Community School District (Iowa). Programs at the middle school level are exploratory, leading to occupational training in family and consumer science, child care, food service, and textile and fashion arts at the high school level. Health education…

  11. 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.

  12. Mental Health Problems among Child Welfare Clients Living at Home

    ERIC Educational Resources Information Center

    Iversen, Anette Christine; Jakobsen, Reidar; Havik, Toril; Hysing, Mari; Stormark, Kjell Morten

    2007-01-01

    The great majority of children receiving intervention from child welfare and protection services (CWS) in Norway live at home. The purpose of this study was to assess mental health problems among these children. Data stem from a population-based study, the Bergen child study, conducted in 2006. Of a sample consisting of 4,162 children in the fifth…

  13. Meaning creation and employee engagement in home health caregivers.

    PubMed

    Nielsen, Mette Strange; Jørgensen, Frances

    2016-03-01

    The purpose of this study is to contribute to an understanding on how home health caregivers experience engagement in their work, and specifically, how aspects of home healthcare work create meaning associated with employee engagement. Although much research on engagement has been conducted, little has addressed how individual differences such as worker orientation influence engagement, or how engagement is experienced within a caregiving context. The study is based on a qualitative study in two home homecare organisations in Denmark using a think-aloud data technique, interviews and observations. The analysis suggests caregivers experience meaning in three relatively distinct ways, depending on their work orientation. Specifically, the nature of engagement varies across caregivers oriented towards being 'nurturers', 'professionals', or 'workers', and the sources of engagement differ for each of these types of caregivers. The article contributes by (i) advancing our theoretical understanding of employee engagement by emphasising meaning creation and (ii) identifying factors that influence meaning creation and engagement of home health caregivers, which should consequently affect the quality of services provided home healthcare patients.

  14. Children’s Environmental Health: Homes of Influence

    PubMed Central

    Afzal, Brenda; Witherspoon, Nsedu Obot; Trousdale, Kristie

    2016-01-01

    Summary: Over the past two decades, diverse stakeholder groups, representing various disciplines and perspectives (e.g., federal, state and local policy makers; nonprofit organizations; health professionals; and industry), have devoted considerable resources, expertise, and influence toward efforts that wittingly and unwittingly affect children’s environmental health. In this article, we refer to these groups as “homes of influence,” and we summarize the wide reach and potential impacts of these homes on childhood asthma, as one example that illustrates how these varied groups impact childhood health outcomes. We posit that diverse homes of influence can be most successful in effecting positive change when they understand and acknowledge their respective influences and work together to develop informed, preventive initiatives under the framework of recommendations called, “A Blueprint for Protecting Children’s Environmental Health: An Urgent Call to Action.” This published resource was developed by a panel of thought leaders and experts in the field of children’s environmental health to guide cross-sector collaboration efforts to proactively protect the environmental health of all children. PMID:27905273

  15. 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

  16. 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,…

  17. 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,…

  18. Sex Discrimination in Coaching.

    ERIC Educational Resources Information Center

    Dessem, Lawrence

    1980-01-01

    Even in situations in which the underpayment of girls' coaches is due to the sex of the students coached rather than to the sex of the coaches, the coaches and the girls coached are victims of unlawful discrimination. Available from Harvard Women's Law Journal, Harvard Law School, Cambridge, MA 02138. (Author/IRT)

  19. Community Level Association between Home Health and Nursing Home Performance on Quality and Hospital 30-day Readmissions for Medicare Patients.

    PubMed

    Wang, Yun; Pandolfi, Michelle M; Fine, Jonathan; Metersky, Mark L; Wang, Changqin; Ho, Shih-Yieh; Galusha, Deron; Nuti, Sudhakar V; Murugiah, Karthik; Spenard, Ann; Elwell, Timothy; Krumholz, Harlan M

    2016-11-01

    We evaluated whether community-level home health agencies and nursing home performance is associated with community-level hospital 30-day all-cause risk-standardized readmission rates for Medicare patients used data from the Centers for Medicare & Medicaid Service from 2010 to 2012. Our final sample included 2,855 communities that covered 4,140 hospitals with 6,751,713 patients, 13,060 nursing homes with 1,250,648 residents, and 7,613 home health agencies providing services to 35,660 zipcodes. Based on a mixed effect model, we found that increasing nursing home performance by one star for all of its 4 measures and home health performance by 10 points for all of its 6 measures is associated with decreases of 0.25% (95% CI 0.17-0.34) and 0.60% (95% CI 0.33-0.83), respectively, in community-level risk-standardized readmission rates.

  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…

  1. 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 Hb

  2. 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.

  3. 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…

  4. 75 FR 76293 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ...; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification... Federal Register entitled ``Medicare Program; Home Health Prospective Payment System Rate Update for... Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes...

  5. 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

  6. The role of the pharmacist in home health care.

    PubMed

    McAllister, J C

    1985-04-01

    Home infusion services, a new facet of home health care (HHC) delivery, have created many new opportunities for hospital pharmacists to participate more actively in patient care. These opportunities can create new roles for the pharmacist as an educator, clinician, and administrator. Early efforts must be made to educate hospital administrators, physicians, and other allied health personnel regarding the advantages and disadvantages of providing HHC--from the perspective of both patients and institutions. The pharmacist can also collect data to assist in determining the extent to which the institution should participate in HHC delivery, and should coordinate the hospital's efforts to initiate home infusion services. Pharmacists should play an active role in screening, selecting, and training patients for HHC before discharge. The input of pharmacists in drug product selection and assistance in product compounding can ensure optimal patient outcomes and minimize costs. Clinical monitoring activities conducted by the pharmacist can include telephone interviews with patients at home and assessment of clinical progress during scheduled return visits to the clinic.

  7. 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…

  8. Monitoring wound healing in the home health arena.

    PubMed

    Eager, C A

    1997-09-01

    To determine the type and quality of documentation in home health care agencies in the United States, a 15-question survey was sent to 500 agencies. The returned surveys revealed the following: (1) narrative notes were the most consistently used documentation tool; (2) 74% of agencies take photographs of the wound as part of their documentation; (3) 87% of agencies stage pressure ulcers according to the National Pressure Ulcer Advisory Panel (NPUAP) staging system; (4) 7% use reverse staging to document improvement in wounds; (5) 32% use standard protocols to treat different types of wounds; (6) 96% to 98% monitored healing by measuring length times width, as well as drainage and wound bed changes. The results indicate that most home health care agencies use the NPUAP staging system but do not track healing in a consistent way. They do not follow a consistent documentation standard, nor do their wound assessments bring together all the monitored factors indicative of healing progress.

  9. Pay Equity for Coaches.

    ERIC Educational Resources Information Center

    Blum, Debra E.

    1994-01-01

    Some colleges are giving substantial raises to women's athletic team coaches, sometimes reducing mens' team coaches' salaries to provide equity. Court litigation, activism by several national coaches' organizations, and debate over federal laws keep the issue in high profile. (MSE)

  10. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    PubMed Central

    Park, Grace; Miller, Diane; Tien, George; Sheppard, Irene; Bernard, Michael

    2014-01-01

    Background A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased). Conclusion Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients. PMID:24648834

  11. '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.

  12. 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…

  13. Building better oral health: a dental home for all Texans.

    PubMed

    2008-01-01

    Poor oral health affects more than just the mouth. It can seriously compromise a person's general health, quality of life and life expectancy. Oral diseases can and do lead to systemic problems--damaging other parts of the body and resulting in the need for expensive emergency department visits, hospital stays and medications. The consequences of poor oral health, however, go far beyond damaging medical effects. Oral disease can also wreak economic havoc--keeping children out of school and adults home from work--not to mention lower productivity of workers in pain. Untreated oral diseases can also drive up health care costs in general. The good news is that with proper oral health care, both at home and in professional settings, many of the negative consequences associated with poor oral health can be prevented. The State of Texas has a unique and unprecedented opportunity to significantly increase access to oral health care for all Texans. Complying with the Frew agreement is a key priority. However, there are additional ways that Texas policymakers can improve the oral health of the state. In an effort to begin a constructive dialogue about improving the oral health of all Texans, the Texas Dental Association (TDA) with grant funding from the American Dental Association (ADA) commissioned an independent third-party report on the issue of access to oral health care in Texas modeled after the 2000 groundbreaking surgeon general's report, Oral Health in America. The TDA assembled a team of five nationally recognized dentists from both academia and private practice to oversee the project. The dentists (hereafter called the editorial review board or ERB) were asked to identify the state's most pressing issues, needs and challenges associated with improving the oral health of all Texans, with a special focus on the state's most vulnerable. The ERB looked carefully at the economic, medical and social consequences of untreated oral disease in Texas. It reviewed the

  14. Flooded homes, broken bonds, the meaning of home, psychological processes and their impact on psychological health in a disaster.

    PubMed

    Carroll, Bob; Morbey, Hazel; Balogh, Ruth; Araoz, Gonzalo

    2009-06-01

    In 2005, Carlisle suffered severe flooding and 1600 houses were affected. A qualitative research project to study the social and health impacts was undertaken. People whose homes had been flooded and workers who had supported them were interviewed. The findings showed that there was severe disruption to people's lives and severe damage to their homes, and many suffered from psychological health issues. Phenomenological and transactional perspectives are utilised to analyse the psychological processes (identity, attachment, alienation and dialectics) underlying the meaning of home and their impact on psychological health. Proposals for policy and practice are made.

  15. 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. PMID:27239318

  16. 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.

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

    PubMed

    Cady, Rhonda; Kelly, Anne; Finkelstein, Stanley

    2008-01-01

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

  18. 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.

  19. Strategies to recruit difficult-to-reach home health care nurses for research.

    PubMed

    Samia, Linda W; Ellenbecker, Carol Hall

    2011-08-01

    Strategies to access a stratified random sample of New England home health care agencies and nurses are described. The combined strategies resulted in a sample of 123 home health care agencies and 2,459 home healthcare nurses from the six New England states. The results will inform researchers aiming to achieve data representativeness and clinicians critiquing the rigor of evidence.

  20. Americans Needing Home Care, United States. Data from the National Health Survey.

    ERIC Educational Resources Information Center

    Feller, Barbara A.

    1986-01-01

    This report presents information from the Home Care Supplement to the National Health Interview Survey (NHIS) on the types of help needed by adults with chronic health problems who live outside of institutions. Home care items discussed include: (1) assistance in basic physical activities; (2) assistance in home management activities; (3) adults…

  1. Home Health Care Utilization: A Review of the Research for Social Work

    ERIC Educational Resources Information Center

    Kadushin, Goldie

    2004-01-01

    The author reviewed the literature to identify the variables associated with home health care utilization using the Andersen-Newman model as a framework for analysis. Sixty-four studies published between 1985 and 2000 were identified through PUBMED, Sociofile, and PsycINFO databases. Home health care was defined as in-home skilled nursing,…

  2. 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

  3. 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…

  4. 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…

  5. 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…

  6. 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.

  7. 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

  8. 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.

  9. 42 CFR 441.16 - Home health agency requirements for surety bonds; Prohibition on FFP.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home health agency requirements for surety bonds... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES General Provisions § 441.16 Home health agency requirements...

  10. 42 CFR 441.16 - Home health agency requirements for surety bonds; Prohibition on FFP.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home health agency requirements for surety bonds... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES General Provisions § 441.16 Home health agency requirements...

  11. 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…

  12. Use of the Home Safety Self-Assessment Tool (HSSAT) within Community Health Education to Improve Home Safety.

    PubMed

    Horowitz, Beverly P; Almonte, Tiffany; Vasil, Andrea

    2016-10-01

    This exploratory research examined the benefits of a health education program utilizing the Home Safety Self-Assessment Tool (HSSAT) to increase perceived knowledge of home safety, recognition of unsafe activities, ability to safely perform activities, and develop home safety plans of 47 older adults. Focus groups in two senior centers explored social workers' perspectives on use of the HSSAT in community practice. Results for the health education program found significant differences between reported knowledge of home safety (p = .02), ability to recognize unsafe activities (p = .01), safely perform activities (p = .04), and develop a safety plan (p = .002). Social workers identified home safety as a major concern and the HSSAT a promising assessment tool. Research has implications for reducing environmental fall risks.

  13. 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…

  14. 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)…

  15. 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. PMID:27170900

  16. Play@home in practice: health visitors' views of perceived facilitators and barriers to programme implementation.

    PubMed

    Miller, Irene; Barton, Gil

    2013-07-01

    Health visitors in Scotland gift 'play@home', a book-based early intervention programme, to parents as part of the universal health visiting service. The provision of health improvement information to parents is recognised as a core function of health visiting and yet evidence shows that not every family receives the play@home resources. This paper discusses the perceived facilitators and barriers to implementing this programme through exploring the views of ten health visitors and four health visiting managers in two health board areas in Scotland. The findings conclude that increasingly vulnerable families, supported by fewer qualified health visitors, present challenges to the health visiting service. The play@home programme is valued by health visitors as a flexible tool with which to engage with families. Collaborative working with other services enhances provision and play@home does become embedded in practice over time. Strategic policy links to raise the profile of play@home are improving.

  17. Home health, long-term care, and other compliance activities.

    PubMed

    Anderson, T D; Sadoff, J W

    1999-04-01

    The Federal government continues to crack down on fraud and abuse in the healthcare industry with such initiatives and tools as Operation Restore Trust and intermediate tax sanctions. Home health and long-term care organizations are the latest entities under study by the Office of Inspector General, and the result of these studies likely will be more antifraud and abuse measures being taken against these entities. All healthcare organizations should pay particular attention to their tax risk exposure. Healthcare organizations that put effective compliance programs in place should be able to reduce the overall risk of challenges to their financial practices.

  18. Changing culture in the home health setting: strategies for success.

    PubMed

    Boan, David

    2006-01-01

    Organizational culture is generally defined as the internal attributes of the staff, such as their values, beliefs, and attitudes. Although technically accurate as a definition, personal attributes defy direct intervention, leading some to question whether it is possible to change culture. It is proposed that it is possible to change the personal internal attributes that define organizational culture by changing the characteristic structures and behaviors of the organization that shape those attributes. This model, called the Quality Capability Model, creates an approach to culture change that accommodates the unique features of home health.

  19. The Effect of Tailored Web-Based Feedback and Optional Telephone Coaching on Health Improvements: A Randomized Intervention Among Employees in the Transport Service Industry

    PubMed Central

    Grotta, Alessandra; Pasquali, Elena; Bakkman, Linda; Bellocco, Rino; Trolle Lagerros, Ylva

    2016-01-01

    Background Lifestyle-related health problems are an important health concern in the transport service industry. Web- and telephone-based interventions could be suitable for this target group requiring tailored approaches. Objective To evaluate the effect of tailored Web-based health feedback and optional telephone coaching to improve lifestyle factors (body mass index—BMI, dietary intake, physical activity, stress, sleep, tobacco and alcohol consumption, disease history, self-perceived health, and motivation to change health habits), in comparison to no health feedback or telephone coaching. Methods Overall, 3,876 employees in the Swedish transport services were emailed a Web-based questionnaire. They were randomized into: control group (group A, 498 of 1238 answered, 40.23%), or intervention Web (group B, 482 of 1305 answered, 36.93%), or intervention Web + telephone (group C, 493 of 1333 answered, 36.98%). All groups received an identical questionnaire, only the interventions differed. Group B received tailored Web-based health feedback, and group C received tailored Web-based health feedback + optional telephone coaching if the participants’ reported health habits did not meet the national guidelines, or if they expressed motivation to change health habits. The Web-based feedback was fully automated. Telephone coaching was performed by trained health counselors. Nine months later, all participants received a follow-up questionnaire and intervention Web + telephone. Descriptive statistics, the chi-square test, analysis of variance, and generalized estimating equation (GEE) models were used. Results Overall, 981 of 1473 (66.60%) employees participated at baseline (men: 66.7%, mean age: 44 years, mean BMI: 26.4 kg/m2) and follow-up. No significant differences were found in reported health habits between the 3 groups over time. However, significant changes were found in motivation to change. The intervention groups reported higher motivation to improve dietary

  20. 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

  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.

  2. Can the care transitions measure predict rehospitalization risk or home health nursing use of home healthcare patients?

    PubMed

    Ryvicker, Miriam; McDonald, Margaret V; Trachtenberg, Melissa; Peng, Timothy R; Sridharan, Sridevi; Feldman, Penny H

    2013-01-01

    The Care Transitions Measure (CTM) was designed to assess the quality of patient transitions from the hospital. Many hospitals are using the measure to inform their efforts to improve transitional care. We sought to determine if the measure would have utility for home healthcare providers by predicting newly admitted patients at heightened risk for emergency department use, rehospitalization, or increased home health nursing visits. The CTM was administered to 495 home healthcare patients shortly after hospital discharge and home healthcare admission. Follow-up interviews were completed 30 and 60 days post hospital discharge. Interview data were supplemented with agency assessment and service use data. We did not find evidence that the CTM could predict home healthcare patients having an elevated risk for emergent care, rehospitalization, or higher home health nursing use. Because Medicare/Medicaid-certified home healthcare providers already use a comprehensive, mandated start of care assessment, the CTM may not provide them additional crucial information. Process and outcome measurement is increasingly becoming part of usual care. Selection of measures appropriate for each service setting requires thorough site-specific evaluation. In light of our findings, we cannot recommend the CTM as an additional measure in the home healthcare setting.

  3. 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

  4. 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.].

  5. Coaches' assessment of their coaching efficacy compared to athletes' perceptions.

    PubMed

    Short, Sandra E; Short, Martin W

    2004-10-01

    This study compared coaches' assessments of their own coaching efficacy with their athletes' perceptions of the coaches' efficacy. Coaching efficacy was measured with the Coaching Efficacy Scale. Participants were 9 football coaches and 76 football players from the same team. Analysis indicated coaches were confident in their coaching abilities (range 6.5 to 9.0 on a 9-point scale). For 7 of the 9 coaches the coaches' ratings of themselves were higher than the athletes' ratings. For the other 2 coaches, athletes' ratings of coaches' efficacy were higher than the coaches' ratings of themselves. All coaches' ratings fell within the 95% confidence interval based on the athletes' ratings of the coaches' efficacy. Results are discussed in terms of the interplay between athletes and coaches efficacy beliefs and its influence on behavior.

  6. 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…

  7. Hospital-based home health: weighing finances and philosophy of care.

    PubMed

    Yarkony, Lisa

    2010-02-01

    As we begin a new decade, hospital-based home health agencies have been waning over the last one, and for a number of reasons. An examination of hospital-based home health since its beginnings in this country yields some answers, but also reveals the importance of many of these home health programs in the communities they serve. There are often more components to consider when weighing the value of these programs than financial statements alone can illuminate.

  8. 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

  9. 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!

  10. 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.

  11. Mapping Coaches' Views of Participation in CrossFit to the Integrated Theory of Health Behavior Change and Sense of Community.

    PubMed

    Heinrich, Katie M; Carlisle, Taran; Kehler, Ainslie; Cosgrove, Sarah J

    Group-based training through CrossFit has recently exploded in popularity. Anecdotally, participants often make lifestyle changes and experience improved fitness. Participation factors were mapped to the Integrated Theory of Health Behavior Change and "sense of community" constructs. Key informant interviews were conducted with 6 CrossFit gym owners/coaches. Data were thematically coded with NVivo 10. Results revealed key factors that both facilitated and restricted participation in CrossFit. Findings provide implications for future theory application and highlight how to improve initiation and adherence by capitalizing on community building and taking steps to reduce intimidation and cost, facilitate realistic goals, and ensure social support.

  12. Handbook of Home Health Standards - Fifth edition Marrelli Tina M Handbook of Home Health Standards - Fifth edition 688pp Elsevier 9780323052245 032305224X [Formula: see text].

    PubMed

    2009-06-03

    Home care is different from other forms of health care. Clinicians are guests in patients' homes and may be the only healthcare providers patients see on a particular day or week, so they should feel comfortable working independently, but recognise they are part of a larger healthcare team.

  13. Ventilation, indoor air quality, and health in homes undergoing weatherization.

    PubMed

    Francisco, P W; Jacobs, D E; Targos, L; Dixon, S L; Breysse, J; Rose, W; Cali, S

    2017-03-01

    Ventilation standards, health, and indoor air quality have not been adequately examined for residential weatherization. This randomized trial showed how ASHRAE 62-1989 (n=39 houses) and ASHRAE 62.2-2010 (n=42 houses) influenced ventilation rates, moisture balance, indoor air quality, and self-reported physical and mental health outcomes. Average total airflow was nearly twice as high for ASHRAE 62.2-2010 (79 vs. 39 cfm). Volatile organic compounds, formaldehyde and carbon dioxide were all significantly reduced for the newer standard and first-floor radon was marginally lower, but for the older standard, only formaldehyde significantly decreased. Humidity in the ASHRAE 62.2-2010 group was only about half that of the ASHRAE 62-1989 group using the moisture balance metric. Radon was higher in the basement but lower on the first floor for ASHRAE 62.2-2010. Children in each group had fewer headaches, eczema, and skin allergies after weatherization and adults had improvements in psychological distress. Indoor air quality and health improve when weatherization is accompanied by an ASHRAE residential ventilation standard, and the 2010 ASHRAE standard has greater improvements in certain outcomes compared to the 1989 standard. Weatherization, home repair, and energy conservation projects should use the newer ASHRAE standard to improve indoor air quality and health.

  14. 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

  15. Home health care quality conferences: promoting change through dialogue.

    PubMed

    Rudin, Danylle

    2006-01-01

    The following brief is based on the results of two conferences on home care quality hosted by the Center for Home Care Policy and Research of the Visiting Nurse Service of New York. For more information about the conference outcomes and proceedings please see: Feldman, P.H.,Peterson, L.E., Reische, L., Bruno, L., & Clark, A. (2004). Charting the course for home healthcare quality: Action steps for achieving sustainable improvement. Conference proceedings. Home Healthcare Nurse, 22(12): 841-850; and Feldman, P.H., Clark, A., & Bruno, L. (2006). Advancing the agenda for home healthcare quality: Conference proceedings and findings. Home Healthcare Nurse, 24(5): 282-290.

  16. Process mapping as a tool for home health network analysis.

    PubMed

    Pluto, Delores M; Hirshorn, Barbara A

    2003-01-01

    Process mapping is a qualitative tool that allows service providers, policy makers, researchers, and other concerned stakeholders to get a "bird's eye view" of a home health care organizational network or a very focused, in-depth view of a component of such a network. It can be used to share knowledge about community resources directed at the older population, identify gaps in resource availability and access, and promote on-going collaborative interactions that encourage systemic policy reassessment and programmatic refinement. This article is a methodological description of process mapping, which explores its utility as a practice and research tool, illustrates its use in describing service-providing networks, and discusses some of the issues that are key to successfully using this methodology.

  17. [Organization of the health system from the perspective of home care professionals].

    PubMed

    Andrade, Angélica Mônica; Brito, Maria José Menezes; Silva, Kênia Lara; Montenegro, Lívia Cozer; Caçador, Beatriz Santana; Freitas, Letícia Fernanda de Cota

    2013-06-01

    The aim of this qualitative case study is to analyze how the health system is organized from the perspective of homecare professionals. Data was collected by means of semi-structured interviews with seven professionals that provide home healthcare services. Content analysis revealed the following empirical categories: Perception of home care professionals in relation to their work and the health system; Difficulties in articulating the Home Care Program with other services of the health system; and, Opportunities to articulate the various health services with the Home Care Program. Results indicate that the work conducted in the Home Care Program significantly interfaces with other health service programs, and is considered important to implement principles of the National Health Service.

  18. 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

  19. 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

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

    MedlinePlus

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

  1. Facilitating Mental Health Intervention in Home Visiting: Learning From Content, Context, Clients, and Community

    ERIC Educational Resources Information Center

    Price, Sarah Kye; Gray, Lisa A.; El-Khoury, Dalia

    2014-01-01

    Home visiting programs recognize the importance of promoting women's mental health during and around the time of pregnancy. However, the process of planning and integrating mental health promotion and intervention into the home visiting setting can seem daunting. Using examples and lessons learned from research and practice, the authors provide a…

  2. 77 FR 67067 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2013...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-08

    ... 42 CFR Parts 409, 424, 484, et al. Medicare Program; Home Health Prospective Payment System Rate...; Home Health Prospective Payment System Rate Update for Calendar Year 2013, Hospice Quality Reporting... Prospective Payment System (HH PPS) rates, including the national standardized 60-day episode rates,...

  3. 42 CFR 484.36 - Condition of participation: Home health aide services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... individual under the direct supervision of a registered nurse or licensed practical nurse. (2) Conduct of... at the discretion of the CMS or the State); (D) Has been assessed a civil monetary penalty of not.... The training of home health aides and the supervision of home health aides during the...

  4. 76 FR 40987 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-12

    ...This proposed rule would update the Home Health Prospective Payment System (HH PPS) rates, including: The national standardized 60- day episode rates, the national per-visit rates, the low utilization payment amount (LUPA), and outlier payments under the Medicare prospective payment system for home health agencies effective January 1,...

  5. Pilot Study of a Home-based Asthma Health Education Program.

    ERIC Educational Resources Information Center

    Dolinar, Rose-Marie; Kumar, Vijay; Rowe, Brian H.; Coutu-Wakulczyk, Ginette

    2000-01-01

    Examines the influence of a home-based asthma health education program on parental coping and quality of life. Families (N=40) with children under 11 received either health education sessions or a booklet representing the traditional approach to care. Results suggest the use of a one-time, home-based intervention to assist families caring for…

  6. Design for the Evaluation of the San Francisco Home Health Services. Emergency Family Care Services Program.

    ERIC Educational Resources Information Center

    Remy, Linda L.

    This is a design for the evaluation of emergency family care programs of the San Francisco, California Home Health Services administration. The design objectives are qiven as the promotion of the health and welfare of the family unit and the reduction of the number of out-of-home placements of children and subsequent crises. The objectives of the…

  7. 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

    ... 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 has specifically contracted, this rulemaking will only affect home health and hospice care providers who do...

  8. Promoting Health of People with Intellectual Disabilities: Views of Professionals Working in Group Homes

    ERIC Educational Resources Information Center

    Wahlström, Lina; Bergström, Helena; Marttila, Anneli

    2014-01-01

    Deinstitutionalisation has influenced the life situation for people with intellectual disabilities, whilst the experiences of health promotion in group homes now are limited. This study aimed to explore aspects important to consider when promoting health amongst persons with intellectual disabilities in group homes, from the perspective of…

  9. Rochester's Healthy Home: A community-based innovation to promote environmental health action.

    PubMed

    Korfmacher, Katrina Smith; Kuholski, Kate

    2008-09-16

    Environmental hazards in the home can contribute significantly to disease. These hazards disproportionately affect low income, urban, and minority children. Childhood lead poisoning and asthma are prime examples of health concerns to which poor housing conditions may contribute significantly. A community-academic partnership in Rochester, New York created a model Healthy Home, an interactive museum in a typical city home, to help residents, property owners, contractors, and community groups reduce environmental hazards. The Healthy Home project educates visitors about home environmental health hazards, demonstrates low-cost methods for reducing home hazards, and helps visitors develop individualized strategies for action. In its first year of operation, over 700 people visited the Healthy Home. Evaluation surveys indicate that the Healthy Home experience motivated visitors to take action to reduce environmental hazards in their homes. Follow-up phone interviews indicate that most visitors took some action to reduce home environmental hazards. The Healthy Home has established a diverse Advisory Council to share its messages more broadly, invite input into future directions, and recruit visitors. This paper presents experiences from the Healthy Home's first year, highlighting the partnership principles that guided its development and lessons learned from the process.

  10. 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.)

  11. Nursing Homes

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Nursing Homes Basic Facts & Information Nursing homes have changed ... physical health and/or mental disabilities. Is a Nursing Home Right for You? Almost half of all ...

  12. The Anatomy of Coaching: Coaching through Storytelling

    ERIC Educational Resources Information Center

    Blackstone, Phyllis A.

    2007-01-01

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

  13. 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.

  14. 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.

  15. 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.

  16. Home care for children with multiple complex chronic conditions at the end of life: The choice of hospice versus home health

    PubMed Central

    Lindley, Lisa C.; Mixer, Sandra J.; Mack, Jennifer W.

    2016-01-01

    Families desire to bring their children home at end of life, and this creates a variety of unique care needs at home. This study analyzed the child and family factors associated with hospice versus home health care use in the last year of life among children with multiple complex chronic conditions. Using the Andersen Behavioral Healthcare Utilization Model, predisposing, enabling, and need factors of the child and family were shown to be significant predictors of hospice and home health care use. Hospice and home health care have advantages, and families may wish to use the service that best fits their needs. PMID:27383451

  17. Home care for children with multiple complex chronic conditions at the end of life: The choice of hospice versus home health.

    PubMed

    Lindley, Lisa C; Mixer, Sandra J; Mack, Jennifer W

    2016-01-01

    Families desire to bring their children home at end of life, and this creates a variety of unique care needs at home. This study analyzed the child and family factors associated with hospice versus home health care use in the last year of life among children with multiple complex chronic conditions. Using the Andersen Behavioral Healthcare Utilization Model, the predisposing, enabling, and need factors of the child and family were shown to be significant predictors of hospice and home health care use. Hospice and home health care have advantages, and families may wish to use the service that best fits their needs.

  18. 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.

  19. A Critical Examination of the Use of Trained Health Coaches to Decrease the Metabolic Syndrome for Participants of a Community-Based Diabetes Prevention and Management Program.

    PubMed

    Lucke-Wold, Brandon; Shawley, Samantha; Ingels, John Spencer; Stewart, Jonathan; Misra, Ranjita

    2016-01-01

    The epidemic of obesity and diabetes in the United States poses major challenge to the prevention and management of chronic diseases. Furthermore, when this is viewed in other components of the metabolic syndrome (i.e., the burden of high cholesterol and hypertension), the prevalence of the metabolic syndrome continues to rise in the USA continued challenge is how to deal with this epidemic from a medical and public health standpoint. Community Based Participatory Research (CBPR) is a unique approach and offers a novel perspective for answering this challenge. A critical set of goals for CBPR is to address health disparities and social inequalities while getting community members engaged in all aspects of the research process. Utilizing the West Virginia Diabetes Prevention and Management Program and trained Health Coaches as a model, we discuss topics of consideration related to CBPR, involving trained health coaches, optimizing early adoption of healthy lifestyle behaviors, and enhancing participation. Through careful project planning and design, questions regarding disparities increasing susceptibility and preventive efforts within the community can be addressed successfully. These topics are part of a broader integration of theories such as participatory research, community engagement, and outcomes measurement. The understanding of the pathophysiology and epidemiology of the metabolic syndrome can help frame an appropriate strategy for establishing long-term community-wide changes that promote health. In order to continue to improve investigations for preventing the metabolic syndrome, it will be necessary to have aggressive efforts at the individual and population level for developing culturally sensitive programs that start early and are sustainable in practical environments such as the workplace. In this comprehensive review, we will discuss practical considerations related to project design, implementation, and how to measure effectiveness in regards to

  20. A Critical Examination of the Use of Trained Health Coaches to Decrease the Metabolic Syndrome for Participants of a Community-Based Diabetes Prevention and Management Program

    PubMed Central

    Lucke-Wold, Brandon; Shawley, Samantha; Ingels, John Spencer; Stewart, Jonathan; Misra, Ranjita

    2016-01-01

    The epidemic of obesity and diabetes in the United States poses major challenge to the prevention and management of chronic diseases. Furthermore, when this is viewed in other components of the metabolic syndrome (i.e., the burden of high cholesterol and hypertension), the prevalence of the metabolic syndrome continues to rise in the USA continued challenge is how to deal with this epidemic from a medical and public health standpoint. Community Based Participatory Research (CBPR) is a unique approach and offers a novel perspective for answering this challenge. A critical set of goals for CBPR is to address health disparities and social inequalities while getting community members engaged in all aspects of the research process. Utilizing the West Virginia Diabetes Prevention and Management Program and trained Health Coaches as a model, we discuss topics of consideration related to CBPR, involving trained health coaches, optimizing early adoption of healthy lifestyle behaviors, and enhancing participation. Through careful project planning and design, questions regarding disparities increasing susceptibility and preventive efforts within the community can be addressed successfully. These topics are part of a broader integration of theories such as participatory research, community engagement, and outcomes measurement. The understanding of the pathophysiology and epidemiology of the metabolic syndrome can help frame an appropriate strategy for establishing long-term community-wide changes that promote health. In order to continue to improve investigations for preventing the metabolic syndrome, it will be necessary to have aggressive efforts at the individual and population level for developing culturally sensitive programs that start early and are sustainable in practical environments such as the workplace. In this comprehensive review, we will discuss practical considerations related to project design, implementation, and how to measure effectiveness in regards to

  1. 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.

  2. Medicare-certified home health services: national and regional supply in the 1980s.

    PubMed Central

    Scalzi, C C; Zinn, J S; Guilfoyle, M J; Perdue, S T

    1994-01-01

    The number of Medicare-certified home health agencies nearly doubled from 1980 to 1990. Using Health Care Financing Administration data, this study documented national and regional patterns of entry and exist by Medicare home health providers from 1980 to 1990. Nationally, agency origination rates accelerated during the early 1980s and then dropped abruptly in the second half of the decade. The proprietary sector, accounting for approximately 42% of agencies in existence during the period of the study, exhibited the greatest volatility. Regional differences are also evident. Both expansion and contraction in Medicare home health services appear to be a response to the incentives of legislation implemented during this period. PMID:7943487

  3. 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…

  4. Rochester’s Healthy Home: A community-based innovation to promote environmental health action

    PubMed Central

    Kuholski, Kate

    2010-01-01

    Environmental hazards in the home can contribute significantly to disease. These hazards disproportionately affect low income, urban, and minority children. Childhood lead poisoning and asthma are prime examples of health concerns to which poor housing conditions may contribute significantly. A community-academic partnership in Rochester, New York created a model Healthy Home, an interactive museum in a typical city home, to help residents, property owners, contractors, and community groups reduce environmental hazards. The Healthy Home project educates visitors about home environmental health hazards, demonstrates low-cost methods for reducing home hazards, and helps visitors develop individualized strategies for action. In its first year of operation, over 700 people visited the Healthy Home. Evaluation surveys indicate that the Healthy Home experience motivated visitors to take action to reduce environmental hazards in their homes. Follow-up phone interviews indicate that most visitors took some action to reduce home environmental hazards. The Healthy Home has established a diverse Advisory Council to share its messages more broadly, invite input into future directions, and recruit visitors. This paper presents experiences from the Healthy Home’s first year, highlighting the partnership principles that guided its development and lessons learned from the process. PMID:20634943

  5. 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

  6. A warning detector for urinary incontinence for home health care.

    PubMed

    Tamura, T; Nakajima, K; Matsushita, T; Fujimoto, T; Shimooki, S; Nakano, T

    1995-01-01

    A telemetry system for monitoring urinary incontinence has been developed using two principles, temperature and impedance changes of a diaper. The system is composed of a pair of sensors, a transmitter, and a receiver. Temperature changes are monitored using thermistors, one in the center of the diaper and the other attached to the abdomen, and the temperature differences between them after urinary incontinence is detected. For the impedance method, two electroconductive cloths as electrodes placed in the diaper are used as sensors. Urine acts as a conductor to produce a current between the sensors. Clinical evaluation showed that both methods operate well; 13 of 17 incontinence episodes were detected using the temperature method and 32 of 35 with the impedance method. The misdetections were caused by faulty sensor arrangement for temperature measurement and by detection of exudates by the conductive sensors. These monitors may be used for the care of elderly people who use diapers for home health care, to save care time and help maintain hygiene.

  7. [The role of home palliative care by health insurance pharmacy].

    PubMed

    Kato, Taneko

    2011-12-01

    Our Pharmacy has been practicing pharmaceutical management guidance for 69 homecare patients in the last 13 years. After we started a home parenteral nutrition service, an opportunity to work with the end-stage cancer patient was increased. To contribute to the patient and community health team, we have practiced pharmaceutical management guidance for homecare patient based on the medical and pharmacology point of view with other area of occupational people. We distributed a pain diary and medical usage of drug guidance to the end-stage cancer outpatients. We also made a drug instructional manual and provided a proper prescription to the patient. Because of our efforts, we believe that we had good consistent results from the end-stage cancer outpatients. On the other hand, we have a lot of problems that have to be resolved. They are associated with medical treatment fee, drug dispensing fee, pharmacy management pressure felt from a low dispensing fee, poor quality stocked narcotic drugs and a low recognition of the pharmacist from the patients and regional community medical team. We believe that we can contribute more to the patients, if we can overcome these problems.

  8. 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 3.5 percent 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.

  9. 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

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

    ERIC Educational Resources Information Center

    Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar

    2009-01-01

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

  11. 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…

  12. 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…

  13. Building Health Promotion into the Job of Home Care Aides: Transformation of the Workplace Health Environment.

    PubMed

    Muramatsu, Naoko; Yin, Lijuan; Lin, Ting-Ti

    2017-04-05

    Home care aides (HCAs), predominantly women, constitute one of the fastest growing occupations in the United States. HCAs work in clients' homes that lack typical workplace resources and benefits. This mixed-methods study examined how HCAs' work environment was transformed by a pilot workplace health promotion program that targeted clients as well as workers. The intervention started with training HCAs to deliver a gentle physical activity program to their older clients in a Medicaid-funded home care program. Older HCAs aged 50+ reported increased time doing the types of physical activity that they delivered to their clients (stretching or strengthening exercise) (p = 0.027). Almost all (98%) HCAs were satisfied with the program. These quantitative results were corroborated by qualitative data from open-ended survey questions and focus groups. HCAs described how they exercised with clients and how the psychosocial work environment changed with the program. Building physical activity into HCAs' job is feasible and can effectively promote HCAs' health, especially among older HCAs.

  14. Frontloading and intensity of skilled home health visits: a state of the science.

    PubMed

    O'Connor, Melissa; Bowles, Kathryn H; Feldman, Penny H; St Pierre, Mary; Jarrín, Olga; Shah, Shivani; Murtaugh, Christopher M

    2014-01-01

    Frontloading of skilled nursing visits is one way home health providers have attempted to reduce hospital readmissions among skilled home health patients. Upon review of the frontloading evidence, visit intensity emerged as being closely related. This state of the science presents a critique and synthesis of the published empirical evidence related to frontloading and visit intensity. OVID/Medline, PubMed, and Scopus were searched. Seven studies were eligible for inclusion. Further research is required to define frontloading and visit intensity, identify patients most likely to benefit, and to provide a better understanding of how home health agencies can best implement these strategies.

  15. Filipino Health Care Aides and the Nursing Home Labour Market in Winnipeg.

    PubMed

    Novek, Sheila

    2013-12-01

    Canada’s nursing homes have become increasingly dependent on immigrant health care aides. More than any other ethnic group, Filipino women are over-represented among health care aides in the Canadian health care system. This qualitative study explored the employment experiences of Filipino health care aides in nursing homes from their own perspectives as well as those of policy stakeholders. Fourteen in-depth interviews were conducted with Filipino health care aides and long-term-care policy stakeholders in Winnipeg, Manitoba. The results indicated that migrant social networks act as pathways linking immigrant women with employment opportunities in nursing homes. The composition of the labour force is also shaped by management strategies and labour market accommodations that respond to, and reinforce, these social networks. These findings have implications for workforce planning and the quality of care provision in nursing homes.

  16. 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

  17. [Examination of physical and psychological health conditions and the influence factors of home helpers].

    PubMed

    Ashitomi, Ikuya

    2005-12-01

    The primary aim of this study was to examine the physical and psychological health conditions and the influence factors of home helpers. The secondary aim was to suggest a stress management system for home helpers. Self-report questionnaires were distributed to 1147 home helpers who were with home health care agencies in Kitakyushu-city. Responses from 979 home helpers were received, yielding a response rate of 85.5%. A total of 967 home helpers (excluding 12 male home helpers) were used for analysis. The Japanese version of the General Health Questionnaire 28 (GHQ-28) was used to measure the physical and psychological health conditions of the home helpers. In addition, as an influence factor, stress coping was measured by the Lazarus-type Stress Coping Inventory (SCI). Home helpers also filled out the Ego Aptitude Scale (EAS) as a personality measure. Furthermore, the subjects were asked questions about individual background factors, including age, marital status, working hours, years working as a home helper, type of home helper, job satisfaction, job continuation and awareness of stress. The data were analyzed using the Statistical Package for the Social Sciences (SPSS 11.5 J). The groups of full-time or part-time home helpers showed GHQ-28 total scores of 6.86 +/- 5.48 and 5.21 +/- 4.97 (Mean +/- SD): part-time home helpers had significantly higher scores than full-time home helpers. The GHQ-28 measure indicated that about 20% of home helpers had physical and psychological symptoms, and about 4% had mid-level depressive symptoms. About half of the subjects were aware of stress. There were significant negative correlations between GHQ-28 total scores and age. Also, there was a statistically significant relation between GHQ-28 and job satisfaction, awareness of stress, type of stress coping and individual personality. Furthermore, there was a statistically significant relation between GHQ-28 and the confrontive coping type, positive reappraisal of SCI, and

  18. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program

    PubMed Central

    Mankikar, Deepa; Campbell, Carla; Greenberg, Rachael

    2016-01-01

    This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children’s asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013–2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p < 0.05) of children’s asthma-related doctor visits and hospital admissions at program completion. In addition, there were significantly reduced reports of the presence of home-based hazards, including basement or roof leaks (p = 0.011), plumbing leaks (p = 0.019), and use of an oven to heat the home (p < 0.001). Participants’ pre- and post- test scores showed significant improvement (p < 0.05) in knowledge and awareness of home hazards. Comprehensive home interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term. PMID:27618087

  19. Home Health Telecare and the Elderly in Spain: Technologies Involved and Methodological Issues

    DTIC Science & Technology

    2007-11-02

    Abstract – In this paper we try to develop a pilot experience in home care teleservices to the elderly through the investigation of solutions based...on the application of information technologies and communications. To that end, an individualized attendance to each elderly person will be...Home health telecare, information technologies, elderly people, virtual center. I. INTRODUCTION Nowadays the developed countries are facing

  20. Sexual Health Education at School and at Home: Attitudes and Experiences of New Brunswick Parents.

    ERIC Educational Resources Information Center

    Weaver, Angela D.; Byers, E. Sandra; Sears, Heather A.; Cohen, Jacqueline N.; Randall, Hilary E. S.

    2002-01-01

    Examined New Brunswick parents' attitudes toward sexual health education (SHE) at school and home. Surveys of parents with K-8 children indicated that most parents believed: SHE should be provided in the school and shared between home and school; SHE should begin in elementary or middle school; and a broad range of topics should be included. Most…

  1. 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

    ...-day period was $2,537.40 in FY 2010. The average Medicare reimbursement level for skilled home care....74 less per day from VA for a 60-day episode of care. On average, each of the 8400 providers cares... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care by Non-VA...

  2. 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…

  3. 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…

  4. The impact of population-based disease management services for selected chronic conditions: the Costs to Australian Private Insurance - Coaching Health (CAPICHe) study protocol

    PubMed Central

    2012-01-01

    Background Recent evidence from a large scale trial conducted in the United States indicates that enhancing shared decision-making and improving knowledge, self-management, and provider communication skills to at-risk patients can reduce health costs and utilisation of healthcare resources. Although this trial has provided a significant advancement in the evidence base for disease management programs it is still left for such results to be replicated and/or generalised for populations in other countries and other healthcare environments. This trial responds to the limited analyses on the effectiveness of providing chronic disease management services through telephone health coaching in Australia. The size of this trial and it's assessment of cost utility with respect to potentially preventable hospitalisations adds significantly to the body of knowledge to support policy and investment decisions in Australia as well as to the international debate regarding the effect of disease management programs on financial outcomes. Methods Intention to treat study applying a prospective randomised design comparing usual care with extensive outreach to encourage use of telephone health coaching for those people identified from a risk scoring algorithm as having a higher likelihood of future health costs. The trial population has been limited to people with one or more of the following selected chronic conditions: namely, low back pain, diabetes, coronary artery disease, heart failure, and chronic obstructive pulmonary disease. This trial will enrol at least 64,835 sourced from the approximately 3 million Bupa Australia private health insured members located across Australia. The primary outcome will be the total (non-maternity) cost per member as reported to the private health insurer (i.e. charged to the insurer) 12 months following entry into the trial for each person. Study recruitment will be completed in early 2012 and the results will be available in late 2013. Discussion

  5. Blending Key Ingredients to Assure Quality in Home Health Care.

    ERIC Educational Resources Information Center

    Griffith, Deloris G.

    1986-01-01

    Careful staff selection, training, and review are among the methods the author recommends to home care agencies striving to provide top-notch services. Discusses measuring the quality of care employees are providing, accreditation, and the benefits of accreditation. (CT)

  6. Does school health and home economics education influence adults' food knowledge?

    PubMed

    Worsley, A; Wang, W C; Yeatman, H; Byrne, S; Wijayaratne, P

    2016-12-01

    Home economics and health teachers are to be found in many parts of the world. They teach students about food in relation to its nutritional, safety and environmental properties. The effects of such teaching might be expected to be reflected in the food knowledge of adults who have undertaken school education in these areas. This study examined the food knowledge associations of school home economics and health education among Australian adults. Two separate online surveys were conducted nationwide among 2022 (November 2011) and 2146 Australian adults (November-December 2012). True/false and multiple choice questions in both surveys were used to assess nutrition, food safety and environmental knowledge. Knowledge scores were constructed and compared against respondents' experience of school health or home economics education via multiple regression analyses. The results from both studies showed that home economics (and similar) education was associated with higher levels of food knowledge among several age groups. The associations of home economics education with food knowledge differed across several Australian states and recall of home economics themes differed across the age groups. These findings suggest that home economics education may bring about long-lasting learning of food knowledge. Further research is required, however, to confirm the findings and to test the causal influence of home economics education on adults' food knowledge.

  7. 76 FR 68525 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-04

    ...This final rule sets forth updates to the home health prospective payment system (HH PPS) rates, including: the national standardized 60-day episode rates; the national per-visit rates; and the low utilization payment amount (LUPA) under the Medicare PPS for home health agencies effective January 1, 2012. This rule applies a 1.4 percent update factor to the episode rates, which reflects a 1......

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 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... homebound patients who are not entitled to home health benefits may not exceed the amounts payable under...

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 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... homebound patients who are not entitled to home health benefits may not exceed the amounts payable under...

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 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... homebound patients who are not entitled to home health benefits may not exceed the amounts payable under...

  11. 42 CFR 413.125 - Payment for home health agency services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 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... homebound patients who are not entitled to home health benefits may not exceed the amounts payable under...

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 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... homebound patients who are not entitled to home health benefits may not exceed the amounts payable under...

  13. Learning from Alma Ata: the medical home and comprehensive primary health care.

    PubMed

    Gottlieb, Laura M

    2009-01-01

    The patient-centered medical home (PCMH) recently has received much attention in health systems literature. The PCMH holds considerable promise for improving health outcomes and re-establishing a role for family medicine in a fragmented health care system. Despite its philosophical approach to comprehensive health care reform, the PCMH fails to offer concrete recommendations to address the social determinants of health, which include health and social policy. Political engagement to promote health is part of both primary health care and specifically family medicine's history; the absence of practical, adaptable ways to implement this engagement may undermine the PCMH's ultimate goals of improving individual and population health.

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

    PubMed

    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.

  15. 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

  16. The social environment of nursing homes and the health of older residents.

    PubMed

    Zurakowski, T L

    2000-07-01

    This study investigated the effects of two social environment variables, social support and anomia, on the self-reported health of older nursing home residents. Three specific hypotheses were tested as well as the fit of the data to the proposed theory. A nonrandom, convenience sample of 91 nursing home residents was drawn from four nursing homes. Only whites who could speak and understand English and who were judged to be cognitively intact or only mildly cognitively impaired were included. The data were analyzed using path analysis. Only one hypothesis asserting that anomia will have direct negative effects on self-reported health was fully supported.

  17. 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

  18. 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.

  19. Sustainable ubiquitous home health care--architectural considerations and first practical experiences.

    PubMed

    Marschollek, Michael; Wolf, Klaus-H; Bott, Oliver-J; Geisler, Mirko; Plischke, Maik; Ludwig, Wolfram; Hornberger, Andreas; Haux, Reinhold

    2007-01-01

    Despite the abundance of past home care projects and the maturity of the technologies used, there is no widespread dissemination as yet. The absence of accepted standards and thus interoperability and the inadequate integration into transinstitutional health information systems (tHIS) are perceived as key factors. Based on the respective literature and previous experiences in home care projects we propose an architectural model for home care as part of a transinstitutional health information system using the HL7 clinical document architecture (CDA) as well as the HL7 Arden Syntax for Medical Logic Systems. In two short case studies we describe the practical realization of the architecture as well as first experiences. Our work can be regarded as a first step towards an interoperable - and in our view sustainable - home care architecture based on a prominent document standard from the health information system domain.

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

    PubMed

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

    2013-11-01

    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.

  1. 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

  2. Health Hazards in the Home: An Assessment of a Southern Nevada Community.

    PubMed

    Sokolowsky, Amanda; Marquez, Erika; Sheehy, Erin; Barber, Casey; Gerstenberger, Shawn

    2017-02-01

    As a sub-grantee of a Department of Housing and Urban Development (HUD) Lead Hazard Control and Healthy Homes Program, the University of Nevada, Las Vegas' Department of Environmental and Occupational Health performed lead and Healthy Homes investigations and collected data regarding conditions in the home environment in Henderson, Nevada. The purpose of this research is to characterize housing conditions in southern Nevada, compare data to census data, and to highlight the health outcomes associated with adverse housing conditions. Visual home assessments were conducted in 106 homes in southern Nevada, and specific hazards were characterized using the Healthy Homes Rating System. The results were then compared, when possible, to American Housing Survey (AHS) data for the Las Vegas metropolitan area. Lead, domestic hygiene, carbon monoxide, damp and mold, excess cold and heat, and structural collapse were the most frequently identified hazards, found in at least 101 (90%) of participant households. Median household income of program participants was half (50%) that of the surrounding zip code, which was expected, as classification as "low-income" by HUD standards was a requirement for participation. Our data indicated that the AHS data may not be representative of very low income housing in southern Nevada and may underreport actual conditions. In-home inspections performed by trained personnel provide a more accurate picture of conditions than the self-report method used by the AHS. In addition, we recommend the development of a standardized Healthy Homes visual assessment tool to allow for the comparison of housing conditions between communities.

  3. 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)

  4. 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…

  5. Instructional Coaching. Issue Brief

    ERIC Educational Resources Information Center

    Kowal, Julie; Steiner, Lucy

    2007-01-01

    Schools and districts invest a great deal of time and money in professional development for teachers through instructional coaching. With this effort comes the responsibility to design coaching programs that have the greatest potential to improve classroom instruction and, in turn, increase student learning. What research is available to help…

  6. Quality Coaching Counts

    ERIC Educational Resources Information Center

    Gould, Daniel

    2016-01-01

    Scholastic sport is a double-edged sword that can have positive or negative effects. Whether those effects are positive or negative depends on those who wield that sword--chiefly, the school's sports coach. While it is clear that coaches make a difference in ensuring that educational athletics lead to beneficial outcomes for student-athletes, a…

  7. Learning Developmental Coaching

    ERIC Educational Resources Information Center

    Hunt, James M.; Weintraub, Joseph R.

    2004-01-01

    This article describes an educational intervention designed to promote the ability and willingness of MBA students to lead through coaching. MBA leadership students are trained to serve as coaches for undergraduate business students in a developmental assessment center. In this compelling context, their main source of influence is the ability to…

  8. The Coaching Controversy.

    ERIC Educational Resources Information Center

    Rackham, Neil

    1979-01-01

    Knowledge can be taught effectively in the classroom, but skills can best be learned by on-the-job coaching. Coaching is a cost-effective way to reinforce new behaviors and skills until the skill feels more natural and begins to result in better performance. (SK)

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

    MedlinePlus

    ... the instrumentation used to perform the test, and quality control practices. There is no such requirement for consumers who purchase home tests, even the ones prescribed or recommended by their ... are important to your quality of life if you live with chronic illness. ...

  10. Medicare Home Health Services: A Difficult Program to Control

    DTIC Science & Technology

    1981-09-25

    the home to furnish them." Finally, in March 1981 HCFA reversed its position presented to the Blue Cross Association. Section 203 of the HHA manual...to bathe yourself? - Not answered Do you ever have trouble getting to the bathroom on time? 2 No 1 Have a catheter or colostomy 0 Yes - Not answered

  11. 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.

  12. In-home behavioral health case management: an integrated model for high-risk populations.

    PubMed

    Theis, Gerald A; Kozlowski, Deirdre; Behrens, Jenna

    2006-01-01

    The escalating health care costs attributed to high-risk populations have fueled a need for a proactive approach to deal with people affected by complex mental health issues that often coexist with chronic medical conditions. Through an in-home behavioral health case management (CM) program, patients with mental illnesses (some with coexisting medical conditions) receive integrated medical and mental health services through a disease-management approach that has proven effective in treating high-risk patients.

  13. Home care of children and youth with complex health care needs and technology dependencies.

    PubMed

    Elias, Ellen Roy; Murphy, Nancy A

    2012-05-01

    Children and youth with complex medical issues, especially those with technology dependencies, experience frequent and often lengthy hospitalizations. Hospital discharges for these children can be a complicated process that requires a deliberate, multistep approach. In addition to successful discharges to home, it is essential that pediatric providers develop and implement an interdisciplinary and coordinated plan of care that addresses the child's ongoing health care needs. The goal is to ensure that each child remains healthy, thrives, and obtains optimal medical home and developmental supports that promote ongoing care at home and minimize recurrent hospitalizations. This clinical report presents an approach to discharging the child with complex medical needs with technology dependencies from hospital to home and then continually addressing the needs of the child and family in the home environment.

  14. Using home gardens to decipher health and healing in the Andes.

    PubMed

    Finerman, Ruthbeth; Sackett, Ross

    2003-12-01

    Home gardens are a pervasive component of Andean agricultural systems, but have been ignored in anthropological and agronomic research. Recent research in the indigenous community of Saraguro, Ecuador, employed a combination of in-depth interviews, free-listing, videotaped walk-throughs, and mapping to explore the role of home gardens, which are established and controlled by women. Findings reveal that, although gardens offer multiple benefits, they are overwhelmingly devoted to the cultivation of medicinal plants, operating as de facto medicine cabinets that supply women with most of the resources they need to treat family illnesses. Results also suggest that the natural history of home gardens mirrors transformations within the family, and that Saraguro women study the contents of their neighbors' gardens, using this knowledge as a foundation for deciphering the owners' economic and health status. New threats to the sustainability of home gardens threaten the foundation of Saraguro's ethnomedical system and women's authority in the home and community.

  15. The Oral Health Self-Care Behavior and Dental Attitudes among Nursing Home Personnel

    PubMed Central

    Wiener, R. Constance; Meckstroth, Richard

    2014-01-01

    The need for nursing home care will increase for the next several decades. Rural areas will be impacted in particular, as many older adults live in rural areas. Daily oral infection control changes when a person moves from independent living to institutional living. Oral care to dependent individuals is influenced by many factors. The purpose of this study is to determine the association of oral health self-care behavior with dental attitudes in nursing home personnel in a rural state. A survey was provided to attendees at an oral health conference. Questions were asked to determine dental knowledge, oral health self-care behavior, and dental care attitudes. Of 128 long term care health care facilities’ personnel invited, there were 31 attendees, and 21 of the attendees participated (67.7%). Nursing home personnel had a high level of dental knowledge. Oral health self-care behavior was independently influenced by dental knowledge (β=0.17; p=0.0444) and dental attitudes (β=0.55; p=.0081). Further investigation is needed to determine if oral health self-care attitudes and oral self-care behavior of nursing home personnel are factors in the provision of quality daily oral infection control for dependent nursing home residents living in rural areas. PMID:25349776

  16. Coaching Conversations: Enacting Instructional Scaffolding

    ERIC Educational Resources Information Center

    Gibson, Sharan A.

    2011-01-01

    This study analyzed coaching conversations and interviews of four coach/teacher partnerships for specific ways in which kindergarten and first-grade teachers, and coaches, conceptualized instructional scaffolding for guided reading. Interview transcripts were coded for coaches' and teachers' specific hypotheses/ ideas regarding instructional…

  17. 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,…

  18. 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.

  19. 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.

  20. IV treatment at home

    MedlinePlus

    ... venous catheter - home; Port - home; PICC line - home; Infusion therapy - home; Home health care - IV treatment ... is given quickly, all at once. A slow infusion, which means the medicine is given slowly over ...

  1. Moving toward Medicare home health coverage for persons with Alzheimer's disease.

    PubMed

    Cabin, William D

    2008-01-01

    Medicare home health care policy does not incorporate research evidence of effective palliative home care interventions for Alzheimer's disease and dementia patients and caregivers. This article examines the dissonance between the needs and burdens of Alzheimer's disease patients and caregivers, research results on medical and palliative care interventions, and medicalized public policy in the Medicare home health benefit. The article asserts existing research establishes a prima facie case exists for the federal government to fund a Medicare Palliative Home Care for Alzheimer's disease demonstration project. The article cites the success of the Medicare Hospice Demonstration project and Hospice Medicare Benefit in reducing costs and improving client quality of life as precedent and a model for Alzheimer's disease. Other research implications are identified.

  2. 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…

  3. Learning Standards for Health, Physical Education, and Home Economics. Revised Edition.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany.

    This document contains three learning standards for health, physical education, and home economics at three levels: elementary, intermediate, and commencement. The first section consists of these three standards: (1) personal health and fitness, (2) a safe and healthy environment, and (3) resource management. The format for displaying the…

  4. 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…

  5. 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...

  6. 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...

  7. 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…

  8. Creating customer-oriented employees: the case in home health care.

    PubMed

    Hoffman, K D; Ingram, T N

    1991-06-01

    Little empirical research has examined the organizational factors that influence the extent to which health care providers engage in customer-oriented behaviors. The authors examine the influence of role ambiguity, role conflict, and job satisfaction on the customer-oriented behaviors of home health care representatives. Managerial implications based on the study findings are discussed.

  9. Home Care

    MedlinePlus

    ... Based Care Nursing Homes Join our e-newsletter! Aging & Health A to Z Home Care Basic Facts & ... March 2013 Posted: March 2012 © 2017 Health in Aging. All rights reserved. Feedback • Site Map • Privacy Policy • ...

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. Virtual coach technology for supporting self-care.

    PubMed

    Ding, Dan; Liu, Hsin-Yi; Cooper, Rosemarie; Cooper, Rory A; Smailagic, Asim; Siewiorek, Dan

    2010-02-01

    "Virtual Coach" refers to a coaching program or device aiming to guide users through tasks for the purpose of prompting positive behavior or assisting with learning new skills. This article reviews virtual coach interventions with the purpose of guiding rehabilitation professionals to comprehend more effectively the essential components of such interventions, the underlying technologies and their integration, and example applications. A design space of virtual coach interventions including self-monitoring, context awareness, interface modality, and coaching strategies were identified and discussed to address when, how, and what coaching messages to deliver in an automated and intelligent way. Example applications that address various health-related issues also are provided to illustrate how a virtual coach intervention is developed and evaluated. Finally, the article provides some insight into addressing key challenges and opportunities in designing and implementing virtual coach interventions. It is expected that more virtual coach interventions will be developed in the field of rehabilitation to support self-care and prevent secondary conditions in individuals with disabilities.

  15. 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.

  16. Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

    PubMed

    Conrey, Elizabeth J; Seidu, Dazar; Ryan, Norma J; Chapman, Dj Sam

    2013-06-01

    Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.

  17. 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

  18. 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

    ... proposed rule would revise the Medicaid home health service definition as required by section 6407 of the... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND...; Face-to-Face Requirements for Home Health Services; Policy Changes and Clarifications Related to...

  19. 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 8–61 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

  20. 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,…

  1. 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

  2. Hemophilia home treatment. Economic analysis and implications for health policy.

    PubMed

    Ross-Degnan, D; Soumerai, S B; Avorn, J; Bohn, R L; Bright, R; Aledort, L M

    1995-01-01

    This analysis describes the development of technology for home self-infusion of factor VII in the treatment of hemophilia and its clinical, economic, and social consequences, and uses the case study of such home care treatment to illustrate the potentials and pitfalls of formal economic analyses of programs to treat chronically ill children. A comprehensive review of all original data on hemophilia programs, their related costs, and outcomes, conducted from 1966 through 1993, examined the economic outcomes for two hypothetical cohorts, one aged 0-4 years and the other aged 30-34 years. Including the measurement of treatment effects on the productivity of parental caregivers substantially increases the benefit-cost relationship of an intervention directed at chronically ill children. Increased economic productivity and societal return resulting from such a program for young adults exceeds those for a cohort of children, primarily due to assumptions related to discounting. However, estimation of quality-adjusted life years favors the younger age cohort, since children survive for a longer period of time and with each year survived comes a higher quality of life. Unlike simpler instances in which economic benefits can be shown to outweigh resource costs, policy decisions concerning services for chronically ill children raise an additional set of complex analytic issues. Inclusion of the benefits in productivity experienced by family caregivers provides an important added dimension to such analyses. The development of cost-benefit or cost-effectiveness analyses of these programs illustrates the importance of careful measurement of outcomes and explicit statements of underlying assumptions. Such an analysis of home care for children with hemophilia therefore demonstrates both the strengths and the limitations of this approach.

  3. 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

  4. Tips for labor coaches

    MedlinePlus

    ... some tips for getting prepared. Before the big day Arrives Labor coaches should go to childbirth classes ... get through her labor and delivery. When the day Arrives You might be at the hospital for ...

  5. Behavior Modification in Coaching.

    ERIC Educational Resources Information Center

    Lynch, Annette Rutt; Stillman, Stephen M.

    1979-01-01

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

  6. 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

  7. Approaches to better engage parent-child in health home-visiting programmes: A content analysis.

    PubMed

    Lam, Winsome; Dawson, Angela; Fowler, Cathrine

    2016-06-16

    Home visiting is an evidence-based strategy used to enhance child and family health outcomes. Such primary healthcare endeavours demand the full participation of individual and families. We conducted a review to identify approaches to planning, executing and assessing home-visiting health promotion interventions to determine how parents and children can be best engaged. A structured search (2000-2015) was undertaken using a defined search protocol. The quality of the papers was assessed using standard appraisal tools. Sixteen studies were retrieved. A content analysis of the findings sections of the papers was undertaken and guided by the eight phases of the PRECEDE-PROCEED health promotion planning framework. The analysis found that while all the PRECEDE assessment areas were represented no studies included all phases. Parents and children did not appear to be actively involved in undertaking the assessments and evaluation of the home-visiting health promotion programmes. The findings suggest that there is a need to develop a consistent home-visiting approach that includes comprehensive assessments in the planning phases and parent and child involvement at each step of programme development, implementation and evaluation. This approach enables the development of tailored and sustainable health promotion intervention in order to achieve optimal child health outcomes.

  8. 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

  9. Automated Cognitive Health Assessment From Smart Home-Based Behavior Data.

    PubMed

    Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

    2016-07-01

    Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behavior in the home and predicting clinical scores of the residents. To accomplish this goal, we propose a clinical assessment using activity behavior (CAAB) approach to model a smart home resident's daily behavior and predict the corresponding clinical scores. CAAB uses statistical features that describe characteristics of a resident's daily activity performance to train machine learning algorithms that predict the clinical scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years. We obtain a statistically significant correlation ( r=0.72) between CAAB-predicted and clinician-provided cognitive scores and a statistically significant correlation ( r=0.45) between CAAB-predicted and clinician-provided mobility scores. These prediction results suggest that it is feasible to predict clinical scores using smart home sensor data and learning-based data analysis.

  10. 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

  11. Supporting the information domains of fall-risk management in home care via health information technology.

    PubMed

    Alhuwail, Dari; Koru, Güneş; Mills, Mary Etta

    2016-01-01

    In the United States, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from 30 clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians' fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity. Substantial improvement in addressing the FRM information domains is possible by effectively modifying the existing solutions and purposefully adopting new solutions.

  12. The Home Independence Program with non-health professionals as care managers: an evaluation

    PubMed Central

    Lewin, Gill; Concanen, Karyn; Youens, David

    2016-01-01

    The Home Independence Program (HIP), an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model – a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC) service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably with the outcomes achieved in HIP when health professionals take the Care Manager role. These findings will be of interest to managers of home care services and to policy makers interested in reducing the long-term care needs of older community dwelling individuals. PMID:27382264

  13. Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease.

    PubMed

    Harwood, Lori; Clark, Alexander M

    2012-03-01

    Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease This paper examines home-dialysis decision making in people with Chronic Kidney Disease (CKD) from the perspective of critical realism. CKD programmes focus on patient education for self-management to delay the progression of kidney disease and the preparation and support for renal replacement therapy e.g.) dialysis and transplantation. Home-dialysis has clear health, societal and economic benefits yet service usage is low despite efforts to realign resources and educate individuals. Current research on the determinants of modality selection is superficial and insufficient to capture the complexities embedded in the process of dialysis modality selection. Predictors of home-dialysis selection and the effect of chronic kidney disease educational programmes provide a limited explanation of this experience. A re-conceptualization of the problem is required in order to fully understand this process. The epistemology and ontology of critical realism guides our knowledge and methodology particularly suited for examination of these complexities. This approach examines the deeper mechanisms and wider determinants associated with modality decision making, specifically who chooses home dialysis and under what circumstances. Until more is known regarding dialysis modality decision making service usage of home dialysis will remain low as interventions will be based on inadequate epistemology.

  14. Housing and health: does installing heating in their homes improve the health of children with asthma?

    PubMed

    Somerville, M; Mackenzie, I; Owen, P; Miles, D

    2000-11-01

    The objective of this study was to evaluate the use of NHS money to improve health by improving housing conditions. A pilot study assessing health outcomes before and after improving housing conditions was conducted, studying 72 children with previously diagnosed asthma living in 59 damp houses in Cornwall. The intervention was the installation of central heating. This improved the energy efficiency of the housing. The children's health was a symptom-based outcome measure for asthma and time lost from school. Improvements comprised installation of gas central heating in 28/59 (47%) houses, electric storage heaters in 22/59 (37%), solid fuel central heating in 7/59 (12%) and oil-fired central heating in 2/59 (4%) houses. Energy efficiency improved by a mean of 2.1 on the National Home Energy Rating scale (95% CI 1.68-2.47, P<0.001) in the 37/59 (62%) houses for which two readings were available. Initially, 69/72 (92%) children's bedrooms were unheated and 44/72 (61%) were damp; following improvements, the proportions were 10/72 (14%) and 15/72 (21%) respectively. All respiratory symptoms were significantly reduced after intervention; the greatest reduction was seen in nocturnal cough from a median score of 3 (most nights) to 1 (on one or several nights) (P<0.001) in the previous month. School-age children lost significantly less time from school for asthma in the previous 3 months (9.3 days per 100 school days before intervention and 2.1 days afterwards, P<0.01) but not for other reasons (1.4 days per 100 school days before and 3.2 after, P>0.05). In conclusion, this study provides the first evaluation of health outcomes following housing improvements. Lack of a comparison group means that effects of age, season and biased reporting cannot be eliminated. More work is needed to substantiate these results.

  15. Risk management and clinical governance for complex home-based health care.

    PubMed

    Lewis, Mary; Noyes, Jane

    2007-07-01

    Healthcare professionals have an obligation to enable children with complex needs to lead 'ordinary lives' at home but the views of professionals and family members often diverge in relation to the management of risks. Nurses are increasingly taking on the clinical responsibility for children with complex needs within a multidisciplinary, multi-agency team, yet have little training or experience in adapting risk management and clinical governance frameworks to home-based settings. Risk management frameworks for home-based care for children with complex health and social care needs are introduced in this article. Best practice guidance and resources for adapting risk management frameworks are presented to meet this identified gap in knowledge and experience. Children, young people and their parents have increasing expectations relating to the type and quality of home-based support they receive. Developing and applying clinical governance and risk management frameworks are part of improving outcomes for children with complex needs and their families.

  16. Charting the course for home health care quality: action steps for achieving sustainable improvement: conference proceedings.

    PubMed

    Feldman, Penny Hollander; Peterson, Laura E; Reische, Laurie; Bruno, Lori; Clark, Amy

    2004-12-01

    On June 30 and July 1, 2003, the first national meeting Charting the Course for Home Health Care Quality: Action Steps for Achieving Sustainable Improvement convened in New York City. The Center for Home Care Policy & Research of the Visiting Nurse Service of New York (VNSNY) hosted the meeting with support from the Robert Wood Johnson Foundation. Fifty-seven attendees from throughout the United States participated. The participants included senior leaders and managers and nurses working directly in home care today. The meeting's objectives were to: 1. foster dialogue among key constituents influencing patient safety and home care, 2. promote information-sharing across sectors and identify areas where more information is needed, and, 3. develop an agenda and strategy for moving forward. This article reports the meeting's proceedings.

  17. 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.

  18. Recent developments in federal reimbursement for home health-care services and products.

    PubMed

    Curtiss, F R

    1988-08-01

    The current status of reimbursement for home health-care (HHC) products and services is described, and the influence of competition and consolidation on the HHC industry is discussed. Despite inadequate financing and reimbursement pressures, the demand for HHC services continues to grow. The degree of competition in the HHC industry is reflected in bundling of services (gathering payments for services into a single per-capita rate), prospective price negotiations, and competitive bidding. This competition within the home-care industry and pressure on operating margins have spawned a flurry of recent mergers, acquisitions, and corporate restructuring. HHC agencies and suppliers, particularly durable medical equipment suppliers, have been squeezed by inadequate Medicare cost-finding methods, low reimbursement rates, and a high number of denials of Medicare coverage. Three important recent federal measures revised definitions of Medicare coverage, established minimum and maximum payment periods for Medicare reimbursement, reduced payments for services and products covered under Medicare Parts A and B, resurrected prospective-pricing demonstration projects, reduced payments for durable medical equipment and home oxygen supplies, and expanded coverage of services for AIDS patients. State Medicaid program budgets are threatened by recurring administration proposals to cap federal matching payments and by the adoption of a competitive-bid approach to health-care contracting. To survive over the next few years, home health agencies and home-care suppliers will need to monitor operating costs even more closely and pay attention to the patient (payer) mix.

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

    PubMed Central

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

    2014-01-01

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

  20. 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

  1. 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,…

  2. Coaches' Preferences for Continuing Coaching Education in South Africa.

    PubMed

    Kubayi, Alliance; Coopoo, Yoga; Morris-Eyton, Heather

    2016-04-01

    The purpose of this study was to examine coaches' preferences for continuing coaching education. The sample consisted of 122 male and 102 female coaches from the Gauteng Province of South Africa who were purposively recruited to participate in this study. The results of this study showed that the coaches wanted to learn more about motivational techniques, advanced instructional drills, advanced first aid, goal setting, character building and conditioning drills. The results further indicated that sport coaches would be more likely to continue their coaching education if they had a desire to coach at a high level, if topics were relevant and if courses were in line with league requirements and were available online. The practical implications of the findings for the development of coaching education programmes in South Africa were discussed.

  3. Bringing them home: a Gippsland mental health workforce recruitment strategy.

    PubMed

    Sutton, Keith; Maybery, Darryl; Moore, Terry

    2012-02-01

    This paper reports on preliminary findings of a novel program piloted in 2010 to address rural mental health workforce shortages. The program involved exposing allied health and nursing students from rural backgrounds studying in Melbourne to mental health service employment opportunities in Gippsland. A longitudinal study is underway to evaluate the effect and outcomes of the program and includes surveying participants' interest in rural mental health work through an online questionnaire immediately prior to and following the program; and surveying career decisions at 6 months and yearly intervals. Paired sample t-tests were used to analyse participants' level of interest in rural work (pre-event 4.67 (1.50); post-event 5.93 (0.96); P=0.001), career in a rural setting (pre-event 4.67 (1.63); post-event 5.67 (1.23); P=0.006), mental health work (pre-event 4.73 (1.39); post-event 6.07 (0.80); P<0.000) and rural mental health career (pre-event 4.73 (1.33); post-event 5.80 (1.21); P=0.002). These findings indicate a significant increase from pre- to post-event and are supported by strong effect sizes suggesting that the program had a significant effect on participant interest in rural mental health work. Longer-term evaluation will determine whether the program influences participant career decisions and thereby addressing mental health workforce shortages in Gippsland.

  4. [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 conducted 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.

  5. Distributed personal health information management system for dermatology at the homes for senior citizens.

    PubMed

    Lavanya, J; Goh, K W; Leow, Y H; Chio, M T W; Prabaharan, K; Kim, E; Kim, Y; Soh, C B

    2006-01-01

    A distributed personal health information management system (D-PHIMS) has been tested at a nursing home for the senior citizens (NHSC) in Singapore. The personal health information management system (PHIMS) from the University of Washington was customized to Singapore's context for teledermatology. A clinical trial commenced in October 2005 is ongoing and the survey results obtained indicate that the participants are satisfied with the D-PHIMS system. The diagnosis and treatment recommendations made by the dermatologists using the D-PHIMS diagnosis module were effective in most cases based on feedback from the nursing staff at the elderly nursing home. The results suggest that a teledermatology system could become a useful tool for the nursing homes and to control increasing healthcare costs for elderly care.

  6. [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.

  7. Effects of post-hospital Medicare home health and informal care on patient functional status.

    PubMed Central

    Penrod, J D; Kane, R L; Finch, M D; Kane, R A

    1998-01-01

    OBJECTIVE: To examine the effect of post-hospital Medicare home health and informal care on the functional status of 755 Medicare beneficiaries six weeks after hospital discharge for treatment of stroke, chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), hip procedures, and hip fractures. STUDY SETTING/DATA SOURCES: Consecutive patients enrolled in the study between March 1988 and February 1989 prior to discharge from one of 52 hospitals in three cities. Data sources included patient interviews, medical records, and the Medicare Automated Data Retrieval System (MADRS). ANALYSIS: The effect of the two types of care on patients' subsequent functional status was estimated using a selectivity corrected least squares regression of functional status six weeks post-discharge on hours of informal care, Medicare home health expenditures, and patient prior functional and cognitive status. DATA COLLECTION/EXTRACTION METHODS: Patients were interviewed before hospital discharge and six weeks later. The patient's primary caregiver was interviewed by telephone six weeks post-discharge. Patient data included demographic characteristics, illness severity, cognitive status, functional status at discharge and six weeks later, post-discharge expenditures for Medicare home health, and hours of informal care. PRINCIPAL FINDINGS: More informal care after discharge was associated with greater patient functional impairment six weeks later. The amount of Medicare home health that patients used had a nonsignificant effect on subsequent functional status. CONCLUSIONS: Post-acute home care may maintain the patient at home and compensate for functional limitations, rather than promote restoration of function. Future studies are needed to examine the effects of specific types of care, services, and providers as well as factors that mediate their effects on patient functional outcomes. PMID:9685120

  8. Health-related profile and quality of life among nursing home residents: does pain matter?

    PubMed

    Tse, Mimi M Y; Wan, Vanessa T C; Vong, Sinfia K S

    2013-12-01

    The purpose of this exploratory cross-sectional study was to explore the health-related profile and quality of life among older persons living with and without pain in nursing homes. Ten nursing homes were approached, and 535 older persons were invited to join the study from 2009 to 2011. The nursing home residents' demographic information and information regarding their pain situation and the use of oral analgesic drug and nondrug therapy among the older residents with chronic pain were also collected. Residents' physical health (using the Barthel Activities of Daily Living (ADL) and Elderly Mobility Scores); psychologic health, including happiness, life satisfaction, depression, and loneliness (using the Happiness Scale, the Life Satisfaction Scale, the Geriatric Depression Scale, and the UCLA Loneliness Scale); and quality of life were investigated. Among the 535 nursing home residents, 396 (74%) of them suffered from pain, with mean pain scores of 4.09 ± 2.19, indicating medium pain intensity a remaining 139 (26%) reported no pain. The location of pain was mainly in the knees, back and shoulders. Our results demonstrated that, with the exception of the no-pain group (p < .05), nursing home residents' pain affected both their psychologic health, including happiness, life satisfaction, and depression, and their physical quality of life. Nevertheless, only one-half of the older persons with pain used oral analgesic drug or nondrug therapy to relieve their pain. Pain had a significant impact on their mobility and ADL, was positively correlated with happiness and life satisfaction, and was negatively correlated with loneliness and depression. Pain management is a high priority in elderly care; as such, innovative and interdisciplinary strategies are necessary to enhance quality of life particularly for older persons living in nursing homes.

  9. Home-Based Art Therapy for Older Adults with Mental Health Needs: Views of Clients and Caregivers

    ERIC Educational Resources Information Center

    McElroy, Siobhan; Warren, Alison; Jones, Fay

    2006-01-01

    The value of art therapy for older people with mental health problems is well documented although there is a paucity of research for people who are home bound. This study, based in England, involved five clients, all older people with mental health problems, receiving art therapy sessions at home. The clients and caregivers were then interviewed…

  10. 78 FR 72255 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-02

    ...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......

  11. 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......

  12. 78 FR 68364 - Payment for Home Health Services and Hospice Care to Non-VA Providers; Delay of Effective Date

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and Hospice Care to Non-VA Providers... services and hospice care. The preamble of that final rule stated the effective date was November 15, 2013..., applicable to non-VA home health services and hospice care. Section 17.56 provides, among other things,...

  13. Diabetes coaching for individuals with type 2 diabetes: A state-of-the-science review and rationale for a coaching model.

    PubMed

    Sherifali, Diana

    2017-01-13

    Diabetes coaching is emerging as an important role in self-management and care. The conceptualization of coaching, and how to implement and evaluate coaching has not been articulated in the literature. The aim of the study was to review the literature to: (i) identify the components of coaching using a validated framework, including the description of the role of technology; (ii) describe the implementation and evaluation measures for diabetes coaching; and (iii) propose a diabetes coaching model for future implementation. The EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO and Cochrane Central Register of Controlled Trials databases were searched from inception to January 2015. Two evaluators independently screened and extracted data from eligible studies for descriptions of coaching. Eight trials met the selection criteria, with no consistency in the core components of coaching. However, elements noted across all studies included goal setting, diabetes knowledge acquisition, individualized care, and frequent follow-up. Only two studies leveraged technology for coaching communication purposes. Diabetes coaching is an intervention that can support the ongoing and complex needs of patients; however, implementation and evaluation strategies are limited in the literature. A diabetes coaching model is presented, derived from components identified throughout the literature with direction for implementation and evaluation approaches, and optimal integration into the healthcare system.

  14. Investment in home-based maternal, newborn and child health records improves immunization coverage in Indonesia.

    PubMed

    Osaki, K; Hattori, T; Kosen, Soewarta; Singgih, Budihardja

    2009-08-01

    Indonesia Demographic and Health Surveys show that the ownership of home-based immunization records among children aged 12-23 months increased from 30.8% in 1997 and 30.7% in 2002-3 to 37% in 2007. In 2002-3, 70.9% of children who owned records had received all vaccines by the time of the survey, whereas 42.9% of children who did not own records had been fully immunized. An Indonesian ministerial decree of 2004 stated that the Maternal and Child Health Handbook (MCH handbook) was to be the only home-based record of maternal, newborn and child health. The increased immunization coverage seen would be a reflection of MCH handbook implementation, through raising awareness of immunization among community and health personnel and children's parents or guardians and allowing more accurate measurement of immunization coverage.

  15. 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.

  16. The In-Service Education Program of the Home Health Assembly of New Jersey.

    ERIC Educational Resources Information Center

    Young, Patricia Ann; Pelaez, Martha

    1990-01-01

    The ethics education program for home health aides in New Jersey centers around a casebook focusing on four issues: (1) autonomy and decision making; (2) identification and treatment of clients suspected of being victims of abuse and neglect; (3) decisions to terminate life support; and (4) allocation of limited resources. (SK)

  17. An Instrument to Predict Job Performance of Home Health Aides--Testing the Reliability and Validity.

    ERIC Educational Resources Information Center

    Sturges, Jack; Quina, Patricia

    The development of four paper-and-pencil tests, useful in assessing the effectiveness of inservice training provided to either nurses aides or home health aides, was described. These tests were designed for utilization in employment selection and case assignment. Two tests of 37 multiple-choice items and two tests of 10 matching items were…

  18. 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…

  19. The Center for Health Care Law: the legal muscle of home care and hospice.

    PubMed

    Dombi, Bill

    2006-10-01

    The Center for Health Care Law is a unique offering for a trade association. Operating as a law firm within NAHC, the Center has strengthened NAHC's advocacy efforts on all fronts. The law provides a useful structure and a rational system for behavior, provided that the law is understood. The Center brings the necessary understanding of the law to home care and hospice.

  20. 75 FR 70371 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ...This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011.......

  1. 75 FR 43235 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ...This proposed rule would set forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: The national standardized 60-day episode rates, the national per-visit rates, the non-routine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January......

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

    ERIC Educational Resources Information Center

    Alexander, Kathryn

    2000-01-01

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

  3. 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...

  4. 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...

  5. 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...

  6. 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…

  7. 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…

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  9. 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…

  10. Alone in a crowd. A study of social networks in home health and assisted living.

    PubMed

    Tremethick, M J

    2001-05-01

    This study demonstrated the need for intervention in social network development by both clients of home health and residents of assisted living facilities. With the well-known connection between social networks and health, it is vital that nurses working with these populations be aware of the potential for isolation, screen for it, and, if necessary, develop interventions in the care planning process to address the lack of social networks.

  11. Review of a research report on postpartum depression impacted by home health visits.

    PubMed

    Cook, Ashley

    2013-01-01

    The research findings from Tamaki's (2008) study are important to EBNP for both maternity and psychiatric-mental health nurses. Although the findings demonstrated that mental health visits showed improvement in women with postpartum depression, one suggestion would be to implement a study with a larger sample population and in multiple cultures. With support supplied by numerous quantitative and qualitative studies, such as Tamaki's (2008) study, postpartum depression could be treated with a new non-pharmaceutical measure that would be more beneficial and effective to women and their babies. It will also open new doors for EBNP in mental health and revolutionize home health nursing.

  12. 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.

  13. 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

  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. The Principal as Formative Coach

    ERIC Educational Resources Information Center

    Nidus, Gabrielle; Sadder, Maya

    2011-01-01

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

  16. Peer Coaching: Teachers Supporting Teachers.

    ERIC Educational Resources Information Center

    Donegan, Mary M.; Ostrosky, Michaelene M.; Fowler, Susan A.

    2000-01-01

    This article describes peer coaching as a method for teacher improvement and offers guidelines for establishing a peer coaching program for early childhood and early childhood special education teachers and related services professionals. It also identifies common problems and possible solutions of peer coaching programs. Sample forms for use in…

  17. Home Hemodialysis

    MedlinePlus

    ... list clinics that offer home hemodialysis training. Treatment Costs Most health plans pay for home hemodialysis training ... treat. When prepared, this content included the most current information available. For updates or for questions about ...

  18. 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…

  19. [Diet counseling through "Shoku-dietary Coaching"].

    PubMed

    Kageyama, Naoko

    2005-11-01

    "Shoku-dietary Coaching" is a skill under development by Kageyama, who applies "coaching," widely used in the business field, to diet counseling. This counseling aims at improving conventional "nutritional guidance-type diet counseling" and promoting self-motivation so that healthy clients eagerly improve their own health, and clients with obesity or lifestyle-related diseases can learn self-control. In Shoku-dietary Coaching, the basis for the differentiation between healthy and unhealthy conditions is not only the parameters measured by medical devices. In Shoku-dietary Coaching, attention is directed to clients' assessment of their own lifestyle, dietary goals they have, and actions they will take to achieve them. To increase the health level of clients, we are developing techniques to enhance their motivation by showing sympathy with and support for their dietary behavior and health awareness. In addition, we give guidance through both theory and the practice of such things as having three meals a day at regular hours, knowing the kinds and daily amounts of foods appropriate for each client, and clarifying the percentages of seasonings necessary for cooking. The habit of having meals at regular hours alleviates stress, promotes communication with people sitting at the same table, and increases the health level of both the client and the others. These are important elements in the theory of Shoku-dietary Coaching. Putting the above into practice should not be limited to clients, but should include the clinic staff so as to deepen their own understanding and communication. Enhanced communication reinforces team medical care in the clinic. Communication skills which involve respect for others, continuous motivation of individuals, and achievement of purposes that may even require a long time may be useful for all people.

  20. 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

  1. 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.

  2. Illness care at home or in health institutions: the decision process in a low income community.

    PubMed

    Hoga, Luiza Akiko Komura

    2008-01-01

    The aim of this research was to describe the experiences of a group of women about the decision making process related to illness care at home or in health care institutions. The thematic oral history method was applied. The descriptive categories were: a) The poor have their own way of taking care of health and illness; b) The main support to fight the illness is belief in God; c) Medical care is the last resource, when healing resources are not enough and the illness is dangerous. In low income families, the cultural background, associated to the socioeconomic conditions, permeate the decision with regard to taking care of the illness at home or to seek institutionalized medical care. This knowledge is essential for meaningful health care from the perspective of individuals and families.

  3. 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.

  4. 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.

  5. Profit and non-profit home health care agency outcomes: a study of one state's experience.

    PubMed

    Ellenbecker, C H

    1995-01-01

    The home health care industry, traditionally an industry of non-profit organizations, has increasingly become, as has the rest of the health care industry, invaded by for-profit organizations. The impetus for this invasion was the Omnibus Reconciliation Act (OBRA) of 1980 which encouraged previously restricted for-profit organizations to participate in the Medicare and Medicaid home health care program. Following enactment of OBRA, the number of for-profit organizations grew rapidly and the advantages and disadvantages of their presence in the market has been widely debated. The purpose of this study was to describe differences in behaviors and industry outcomes generated by non-profit and for-profit organizations in Massachusetts. Data for the study was from the Massachusetts State Department of Public Health's Annual Reports of Home Health Agencies. Results suggest that while profit and non-profit agencies behave similarly in many areas, there are areas of difference, with significant differences found in the amount of service delivered and the rates charged.

  6. Athletes' assessment of the coach--the coach evaluation questionnaire.

    PubMed

    Rushall, B S; Wiznuk, K

    1985-09-01

    The purpose of this study was to provide an assessment tool to judge coaching performance that was appropriate for completion by athletes. The questionnaire underwent a variety of developmental stages. In its final form, it contained 36 items. The tool was shown to be a valid, reliable, and standardized questionnaire. It demonstrated discriminability and provoked honest, accurate responding in subjects. The test was capable of providing immediate feedback to coaches seeking information about athletes' perceptions of their coaching performance. Responses on the developed scale were weighted to reflect the desirability of the coaching characteristics of a good coach. The questionnaire provides a total score which can be interpreted by the coach as a measure of how much of an "ideal" coach exists in him/her.

  7. 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.

  8. 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…

  9. Coaching: the art of creating exceptional results.

    PubMed

    Schack, M L

    1997-01-01

    Functioning as a Coach is a key role for a manager and, in fact, distinguishes the manager as a leader. Coaching focuses on two distinct areas: 1) coaching to orient employees to new situations, and 2) coaching for performance with employees who are showing marginal performance, who are meeting expectations, or who are showing high performance. This article describes coaching for orientation and for performance, identifies coaching skills, and provides a coaching self-assessment.

  10. 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

  11. Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes.

    PubMed

    Zhang, Yuan; Punnett, Laura; Nannini, Angela

    2016-10-28

    Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p < .01). More work-family conflict was correlated with more job demands, less job control, less social support, and longer work hours. Poor sleep quality, but not short sleep duration, mediated the association between work-family conflict and mental health. Workplace interventions to improve nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.

  12. Meeting the Needs of Older Adult Refugee Populations With Home Health Services.

    PubMed

    Miner, Sarah M; Liebel, Dianne; Wilde, Mary H; Carroll, Jennifer K; Zicari, Elizabeth; Chalupa, Stephanie

    2015-12-27

    The United States resettles close to 70,000 refugees each year more than any other country in the world. Adult refugees are at risk for negative health outcomes and inefficient health resource use, and meeting the multiple health needs of this vulnerable population is a challenge. The purpose of this study was to assess the impact of a home health care (HHC) pilot project on meeting the needs of older adult refugee patients. A retrospective chart review of 40 refugee adult patients who participated in an HHC pilot was done to analyze their health outcomes using OASIS-C data. Participants' pain level, anxiety level, medication management, and activities of daily living management all significantly improved over the course of their HHC episode. Results of this study indicate that HHC has great potential to improve the health of vulnerable refugee populations and assist the families involved in their care.

  13. 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

  14. 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

  15. 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

  16. The Crucial Coaching Relationship

    ERIC Educational Resources Information Center

    Scales, Peter C.

    2016-01-01

    One of the most powerful ways to boost the payoff from school sports lays in helping coaches build developmental relationships with student-athletes. Developmental relationships are close connections through which young people develop character skills to discover who they are, gain the ability to shape their own lives, and learn how to interact…

  17. 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.

  18. Coaching the Vegetarian Athlete

    ERIC Educational Resources Information Center

    Mandali, Swarna L.

    2011-01-01

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

  19. 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…

  20. Drugs and the Coach.

    ERIC Educational Resources Information Center

    Clarke, Kenneth S., Ed.

    This volume is based on the premise that professional preparation for coaching should include viable experiences in drug education, with particular reference to coping with drug-related problems. The first section provides general information on the purposes and effects of drugs, controls, and concepts of doping. The second section deals with four…

  1. Complex health concerns among child welfare populations and the benefit of pediatric medical homes.

    PubMed

    Rienks, Shauna; Phillips, Jon; McCrae, Julie; Bender, Kim; Brown, Samantha

    2017-03-01

    Children referred to child welfare have higher-than-average rates of physical, mental, and developmental health conditions, yet coordinating medical care to address their complex needs is challenging. This study investigates complex health characteristics of child welfare-involved children to inform evolving patient-centered medical homes that incorporate multidisciplinary care and social health determinants. Study questions include: (1) To what degree do child welfare-involved children present with complex physical, behavioral, and developmental conditions? (2) How does the clustering of complex health concerns vary according to developmental stage? (3) What demographic factors relate to complex health concerns? Data are from 5873 children (birth to 18) who participated in the National Survey of Child and Adolescent Well-being II. Latent class analyses were conducted for children in four developmental groups (infants, preschool-age, elementary school-age, and adolescents), including up to 11 indicators from standardized health measures. For all developmental groups, the best fitting model indicated a complex health concern class and a class with fewer health concerns. Multivariate logistic regressions revealed that membership in the complex health concerns class was associated with: increased age, poverty, poor caregiver health, out-of-home placement, gender, and race/ethnicity; although some developmental differences in predictors were observed. Results suggest that for younger children, preventive approaches and integration of developmental specialists in primary care is needed, while school-age children and adolescents demonstrate greater need for integrated behavioral health. All developmental groups would benefit from multidisciplinary teams that address complex health issues related to environmental risks common among children involved in child welfare.

  2. Antecedents of perceived coach interpersonal behaviors: the coaching environment and coach psychological well- and ill-being.

    PubMed

    Stebbings, Juliette; Taylor, Ian M; Spray, Christopher M; Ntoumanis, Nikos

    2012-08-01

    Embedded in the self-determination theory (Deci & Ryan, 2000) framework, we obtained self-report data from 418 paid and voluntary coaches from a variety of sports and competitive levels with the aim of exploring potential antecedents of coaches' perceived autonomy supportive and controlling behaviors. Controlling for socially desirable responses, structural equation modeling revealed that greater job security and opportunities for professional development, and lower work-life conflict were associated with psychological need satisfaction, which, in turn, was related to an adaptive process of psychological well-being and perceived autonomy support toward athletes. In contrast, higher work-life conflict and fewer opportunities for development were associated with a distinct maladaptive process of thwarted psychological needs, psychological ill-being, and perceived controlling interpersonal behavior. The results highlight how the coaching context may impact upon coaches' psychological health and their interpersonal behavior toward athletes. Moreover, evidence is provided for the independence of adaptive and maladaptive processes within the self-determination theory paradigm.

  3. The ELF@Home project: Elderly sELF-care based on sELF-check of health conditions and sELF-fitness at home.

    PubMed

    Carús, Juan Luis; García, Sonia; García, Rodrigo; Waterworth, John; Erdt, Stefanie

    2014-01-01

    The ELF@Home project is a research and innovation project running from June 1st 2013 to May 31st 2016 and co-funded by the Ambient Assisted Living Joint Programme (AAL JP) and National Authorities in Spain, Sweden and Germany. The ELF@Home project relies on the use of the proven advantages of elderly fitness to develop a self-care solution based on self-check of health conditions and self-fitness at home. The project uses information and communication technologies (ICT) to build an autonomous fitness system targeting healthy or pre-frail elderly people aged over 65 and living independently at home.

  4. Inequality in access to health care in Cambodia: socioeconomically disadvantaged women giving birth at home assisted by unskilled birth attendants.

    PubMed

    Hong, Rathavuth; Them, Rathnita

    2015-03-01

    Cambodia faces major challenges in its effort to provide access to health care for all. Although there is a sharp improvement in health and health care in Cambodia, 6 in 10 women still deliver at home assisted by unskilled birth attendants. This practice is associated with higher maternal and infant deaths. This article analyzes the 2005 Cambodia Demographic and Health Survey data to examine the relationship between socioeconomic inequality and deliveries at home assisted by unskilled birth attendants. It is evident that babies in poorer households are significantly more likely to be delivered at home by an unskilled birth attendant than those in wealthier households. Moreover, delivery at home by an unskilled attendant is associated with mothers who have no education, live in a rural residence, and are farmers, and with higher birth order children. Results from this analysis demonstrate that socioeconomic inequality is still a major factor contributing to ill health in Cambodia.

  5. The Effect of Publicized Quality Information on Home Health Agency Choice.

    PubMed

    Jung, Jeah Kyoungrae; Wu, Bingxiao; Kim, Hyunjee; Polsky, Daniel

    2016-12-01

    We examine consumers' use of publicized quality information in Medicare home health care markets, where consumer cost sharing and travel costs are absent. We report two findings. First, agencies with high quality scores are more likely to be preferred by consumers after the introduction of a public reporting program than before. Second, consumers' use of publicized quality information differs by patient group. Community-based patients have slightly larger responses to public reporting than hospital-discharged patients. Patients with functional limitations at the start of their care, at least among hospital-discharged patients, have a larger response to the reported functional outcome measure than those without functional limitations. In all cases of significant marginal effects, magnitudes are small. We conclude that the current public reporting approach is unlikely to have critical impacts on home health agency choice. Identifying and releasing quality information that is meaningful to consumers may help increase consumers' use of public reports.

  6. 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

  7. The Plastic Surgeon at Work and Play: Surgeon Health, Practice Stress, and Work-Home Balance.

    PubMed

    Bentz, Michael L

    2016-10-01

    Plastic surgeon wellness encompasses physical and mental health, considered in the context of practice stress. In addition, the challenges of work-home balance can lead to substantial negative impact on the surgeon, family, staff, and patients. The data-driven impact of each of these three components with personal vignettes, both individually and collectively, is presented by Michael Bentz, MD as the 2016 presidential address of American Association of Plastic Surgeons.

  8. The Plastic Surgeon at Work and Play: Surgeon Health, Practice Stress, and Work–Home Balance

    PubMed Central

    2016-01-01

    Plastic surgeon wellness encompasses physical and mental health, considered in the context of practice stress. In addition, the challenges of work–home balance can lead to substantial negative impact on the surgeon, family, staff, and patients. The data-driven impact of each of these three components with personal vignettes, both individually and collectively, is presented by Michael Bentz, MD as the 2016 presidential address of American Association of Plastic Surgeons. PMID:27826476

  9. The Relation of Patient Dependence to Home Health Aide Use in Alzheimer’s Disease

    PubMed Central

    Scherer, Rachel K.; Scarmeas, Nikolaos; Brandt, Jason; Blacker, Deborah; Albert, Marilyn S.; Stern, Yaakov

    2009-01-01

    Background Although there has been much research devoted to understanding the predictors of nursing home placement (NHP) in Alzheimer’s disease (AD) patients, there is currently a lack of research concerning the predictors of home health care. The objective of this study was to examine whether the Dependence Scale can predict home health aide (HHA) use. Methods The sample is drawn from the Predictors Study, a large, multicenter cohort of patients with probable AD, prospectively followed annually for up to 7 years in three university-based AD centers in the United States. Markov analyses (n = 75) were used to calculate annual transition probabilities for the “new onset” of HHA use (instances where an HHA was absent at the previous visit, but present at the next visit) as a function of HHA presence at the preceding year’s visit and dependence level at that preceding year’s visit. Results The dependence level at the previous year’s visit was a significant predictor of HHA use at the next year’s visit. Three specific items of the Dependence Scale (needing household chores done for oneself, needing to be watched or kept company when awake, and needing to be escorted when outside) were significant predictors of the presence of an HHA. Conclusion The Dependence Scale is a valuable tool for predicting HHA use in AD patients. Obtaining a better understanding of home health care in AD patients may help delay NHP and have a positive impact on the health and well-being of both the caregiver and the patient. PMID:18840808

  10. Coaching Discourse: Supporting Teachers' Professional Learning

    ERIC Educational Resources Information Center

    Heineke, Sally F.

    2013-01-01

    Although coaching is used in many schools to facilitate teachers' professional learning, few studies look closely at coaching discourse. Exploring how coaching facilitates teachers' professional development, this study used tape-recorded coaching sessions and individual post-interviews to examine the one-on-one coaching interactions of 4…

  11. 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

  12. 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

  13. 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…

  14. Mental health and care homes Tom Dening Mental health and care homes and Alisoun Milne (Eds) Oxford University Press 416pp £34.95 978 0 1995 93637 0199593639 [Formula: see text].

    PubMed

    2012-03-14

    Given the media exposure of poor care, this is a timely publication. It will help those working in the care home sector to administer evidence-based practice and enhance good person-centred health care.

  15. Respiratory Health among Korean Pupils in Relation to Home, School and Outdoor Environment

    PubMed Central

    Elfman, Lena; Wieslander, Gunilla; Ferm, Martin; Torén, Kjell; Norbäck, Dan

    2011-01-01

    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 CO2-levels exceeded 1,000 ppm in all except one of the classrooms. The indoor mean concentrations of SO2, NO2, O3 and formaldehyde were 0.6 µg/m3, 19 µg/m3, 8 µg/m3 and 28 µg/m3, respectively. The average level of UFPs was 18,230 pt/cm3 in the classrooms and 16,480 pt/cm3 outdoors. There were positive associations between wheeze and outdoor NO2, and between current asthma and outdoor UFPs. With dampness at home, pupils had more wheeze. In conclusion, outdoor UFPs and even low levels of NO2 may adversely contribute to respiratory health in children. High CO2-levels in classrooms and indoor dampness/mold at home should be reduced. PMID:21286005

  16. Effect of a Home Telecare Program on Oral Health among Adults with Tetraplegia: A Pilot Study

    PubMed Central

    2012-01-01

    Study design one group pre- and post-test design Objective The primary aim was to examine both the short- and long-term effects of an oral home telecare program on improving gingival health among adults with tetraplegia. Methods Eight adults with tetraplegia participated. The oral home telecare program consisted of individualized oral hygiene training in the use of assistive devices (powered toothbrush and adapted flosser and/or oral irrigator) using PC-based videoconferencing between each participant and an occupational therapist. Training was conducted on an average of five 15 to 30 min sessions across three months. During these training sessions, supervised practice of oral hygiene, and provision of immediate corrective feedback and positive reinforcement in the use of adaptive oral hygiene devices was emphasized. Gingival health assessment using the Löe-Silness gingival index (LSGI) was conducted at baseline, six months and 12 months. Results From baseline to six months, participants showed statistically significant differences (i.e., improvement with less gingival inflammation) in their LSGI scores (z=2.18, P=.03). From baseline to 12 months, participants also showed a statistically significant difference (i.e., improvement, z=2.03; P=.04) in their LSGI scores. Conclusion This study indicates that preventive oral home telecare with repeated oral hygiene training in the use of adaptive devices improved gingival health at six and 12 months among adults with tetraplegia. PMID:23318557

  17. Housing affordability and mental health: does the relationship differ for renters and home purchasers?

    PubMed

    Mason, Kate E; Baker, Emma; Blakely, Tony; Bentley, Rebecca J

    2013-10-01

    There is increasing evidence of a direct association between unaffordable housing and poor mental health, over and above the effects of general financial hardship. Type of housing tenure may be an important factor in determining how individuals experience and respond to housing affordability problems. This study investigated whether a relationship exists between unaffordable housing and mental health that differs for home purchasers and private renters among low-income households. Data from 2001 to 2010 of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey were analysed using fixed-effects linear regression to examine change in the SF-36 Mental Component Summary (MCS) score of individuals aged 25-64 years, associated with changes in housing affordability, testing for an interaction with housing tenure type. After adjusting for age, survey year and household income, among individuals living in households in the lower 40% of the national income distribution, private renters in unaffordable housing experienced somewhat poorer in mental health than when their housing was affordable (difference in MCS = -1.18 or about 20% of one S.D. of the MCS score; 95% CI: -1.95,-0.41; p = 0.003) while home purchasers experienced no difference on average. The statistical evidence for housing tenure modifying the association between unaffordable housing and mental health was moderate (p = 0.058). When alternatives to 40% were considered as income cut-offs for inclusion in the sample, evidence of a difference between renters and home purchasers was stronger amongst households in the lowest 50% of the income distribution (p = 0.020), and between the 30th and 50th percentile (p = 0.045), with renters consistently experiencing a decline in mental health while mean MCS scores of home purchasers did not change. In this study, private renters appeared to be more vulnerable than home purchasers to mental health effects of unaffordable housing. Such a modified

  18. 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…

  19. Nutritional knowledge of UK coaches.

    PubMed

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

    2014-04-10

    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.

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

    PubMed

    Smith, Linda L; Lake, Noelle H; Simmons, Leigh Ann; Perlman, Adam; Wroth, Shelley; Wolever, Ruth Q

    2013-05-01

    目标:介绍一种新兴协联健康职 业在引导患者可持续地改变健康 相关行为、主导改善患者参与程 度上的进展、培训和成效。方法: 综合健康辅导 (IHC) 利 用源自于人本主义心理学和积极 心理学的技术、关注解决疗法和 正念疗法,并进行领导力辅导而 确定了一种机制,赋予患者能力 以完成不同阶段的学习和改 变。IHC 还提供了一种方法,用 以创建和执行具前瞻性的个性化 健康计划。成效: 该等临床研究采用杜克 大学综合医学的 IHC 模式,证 明对糖尿病和糖尿病风险、体重 控制以及心血管疾病和中风风险 的测量方法均已获改进。通过支 持并赋能有关人士为改善其健康 状况而做出重大生活方式改 变,IHC 有可能降低慢性疾病的 患病几率和发病率,并且影响健 康护理的多个方面。结论:作为一个旨在进行患者赋 能和生活方式修正的教育和临床 创新模式,IHC 非常符合最近批 准的联邦健康护理改革的原则和 目标,尤其是在创建首个全国预 防和健康促进战略 (National Prevention and Health Promotion Strategy) 上。实践意义: IHC 在针对与生活 方式相关且处于当前健康护理 危机核心之慢性疾病的同时, 可能允许更加注重患者的中心 性作用。

  1. Exploring Health Information Exchange Implementation Using Qualitative Assessments of Nursing Home Leaders

    PubMed Central

    Alexander, Gregory L.; Popejoy, Lori; Lyons, Vanessa; Shumate, Sue; Mueller, Jessica; Galambos, Colleen; Vogelsmeier, Amy; Rantz, Marilyn; Flesner, Marcia

    2016-01-01

    Objectives Limited research exists on nursing home information technologies, such as health information exchange (HIE) systems. Capturing the experiences of early HIE adopters provides vital information about how these systems are used. In this study, we conduct a secondary analysis of qualitative data captured during interviews with 15 nursing home leaders representing 14 nursing homes in the midwestern United States that are part of the Missouri Quality Improvement Initiative (MOQI) national demonstration project. Methods The interviews were conducted as part of an external evaluation of the HIE vendor contracting with the MOQI initiative with the purpose of understanding the challenges and successes of HIE implementation, with a particular focus on Direct HIE services. Results Emerging themes included (1) incorporating HIE into existing work processes, (2) participation inside and outside the facility, (3) appropriate training and retraining, (4) getting others to use the HIE, (5) getting the HIE operational, and 6) putting policies for technology into place. Discussion Three essential areas should be considered for nursing homes considering HIE adoption: readiness to adopt technology, availability of technology resources, and matching of new clinical workflows. PMID:27843423

  2. Family Involvement in School-Based Health Promotion: Bringing Nutrition Information Home.

    PubMed

    Blom-Hoffman, Jessica; Wilcox, Kaila R; Dunn, Liam; Leff, Stephen S; Power, Thomas J

    2008-12-01

    Family-school collaboration related to children's 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 children's 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 children's 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.

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

    PubMed

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

    1997-05-07

    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.

  4. 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.

  5. Home health care may improve diabetic outcomes among non-English speaking patients in primary care practice: a pilot study.

    PubMed

    Nguyen, Douglas L; DeJesus, Ramona S

    2011-10-01

    There are multiple challenges to proactive diabetic management in minority, non-English speaking populations. In this study, we seek to determine if enrollment in a home health care program would improve diabetic outcomes in this traditionally vulnerable population. Of the 64 non-English speaking diabetics evaluated in our clinic between 1/1/2002 and 12/30/2005, 26 (40.6%) patients who met the criteria for poor glycemic control (defined by HgbA1c > 8% on two separate occasions) were identified, but three were excluded because they did not participate in home health. Comparing diabetic outcomes 24 months post-home health intervention to 24 months prior, patients showed improvement in mean HbA1c, mean LDL, and mean systolic blood pressure. With home health intervention, there appears to be improved diabetic outcomes across all measured parameters.

  6. Children's Health and Indoor Air Quality in Primary Schools and Homes in Portugal-Study Design.

    PubMed

    Madureira, Joana; Paciência, Inês; Ramos, Elisabete; Barros, Henrique; Pereira, Cristiana; Teixeira, João Paulo; Fernandes, Eduardo de Oliveira

    2015-01-01

    The main aim of the research project "On the Contribution of Schools to Children's Overall Indoor Air Exposure" is to study associations between adverse health effects, namely, allergy, asthma, and respiratory symptoms, and indoor air pollutants to which children are exposed to in primary schools and homes. Specifically, this investigation reports on the design of the study and methods used for data collection within the research project and discusses factors that need to be considered when designing such a study. Further, preliminary findings concerning descriptors of selected characteristics in schools and homes, the study population, and clinical examination are presented. The research project was designed in two phases. In the first phase, 20 public primary schools were selected and a detailed inspection and indoor air quality (IAQ) measurements including volatile organic compounds (VOC), aldehydes, particulate matter (PM2.5, PM10), carbon dioxide (CO2), carbon monoxide (CO), bacteria, fungi, temperature, and relative humidity were conducted. A questionnaire survey of 1600 children of ages 8-9 years was undertaken and a lung function test, exhaled nitric oxide (eNO), and tear film stability testing were performed. The questionnaire focused on children's health and on the environment in their school and homes. One thousand and ninety-nine questionnaires were returned. In the second phase, a subsample of 68 children was enrolled for further studies, including a walk-through inspection and checklist and an extensive set of IAQ measurements in their homes. The acquired data are relevant to assess children's environmental exposures and health status.

  7. 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

  8. The impact of paraprofessional home visitors on infants' growth and health at 18 months.

    PubMed

    le Roux, Ingrid M; Rotheram-Borus, Mary Jane; Stein, Judith; Tomlinson, Mark

    2014-01-01

    Paraprofessional home visitors trained to improve multiple outcomes (HIV, alcohol, infant health, and malnutrition) have been shown to benefit mothers and children over 18 months in a cluster randomised controlled trial (RCT). These longitudinal analyses examine the mechanisms which influence child outcomes at 18 months post-birth in Cape Town, South Africa. The results were evaluated using structural equation modelling, specifically examining the mediating effects of prior maternal behaviours and a home visiting intervention post-birth. Twelve matched pairs of neighbourhoods were randomised within pairs to: 1) the control condition, receiving comprehensive healthcare at community primary health care clinics (n=12 neighbourhoods; n=594 pregnant women), or 2) the Philani Intervention Program, which provided home visits by trained, paraprofessional community health workers, here called Mentor Mothers, in addition to clinic care (n=12 neighbourhoods; n=644 pregnant women). Recruitment of all pregnant neighbourhood women was high (98%) with 88% reassessed at six months and 84% at 18 months. Infants' growth and diarrhoea episodes were examined at 18 months in response to the intervention condition, breastfeeding, alcohol use, social support, and low birth weight, controlling for HIV status and previous history of risk. We found that randomisation to the intervention was associated with a significantly lower number of recent diarrhoea episodes and increased rates and duration of breastfeeding. Across both the intervention and control conditions, mothers who used alcohol during pregnancy and had low birth weight infants were significantly less likely to have infants with normal growth patterns, whereas social support was associated with better growth. HIV-infection was significantly associated with poor growth and less breastfeeding. Women with more risk factors had significantly smaller social support networks. The relationships among initial and sustained maternal risk

  9. Working Conditions and Mental Health of Nursing Staff in Nursing Homes.

    PubMed

    Zhang, Yuan; Punnett, Laura; Mawn, Barbara; Gore, Rebecca

    2016-07-01

    Nursing staff in nursing homes suffer from poor mental health, probably associated with stressful working conditions. Working conditions may distribute differently among nursing assistants, licensed practical nurses, and registered nurses due to their different levels in the organizational hierarchy. The objectives of this study were to evaluate the association between working conditions and mental health among different nursing groups, and examine the potential moderating effect of job group on this association. Self-administered questionnaires were collected with 1,129 nursing staff in 15 for-profit non-unionized nursing homes. Working conditions included both physical and psychosocial domains. Multivariate linear regression modeling found that mental health was associated with different working conditions in different nursing groups: physical safety (β = 2.37, p < 0.05) and work-family conflict (β = -2.44, p < 0.01) in NAs; work-family conflict (β = -4.17, p < 0.01) in LPNs; and physical demands (β = 10.54, p < 0.05) in RNs. Job group did not moderate the association between working conditions and mental health. Future workplace interventions to improve mental health should reach to nursing staff at different levels and consider tailored working condition interventions in different nursing groups.

  10. Assessing overall, technical, and scale efficiency among home health care agencies.

    PubMed

    Valdmanis, Vivian G; Rosko, Michael D; Leleu, Hervé; Mukamel, Dana B

    2016-01-04

    While home health care agencies (HHAs) play a vital role in the production of health, little research has been performed gauging their efficiency. Employing a robust approach to data envelopment analysis (DEA) we assessed overall, technical, and scale efficiency on a nationwide sample of HHAs. After deriving the three efficiency measures, we regressed these scores on a variety of environmental factors. We found that HHAs, on average, could proportionally reduce inputs by 28 % (overall efficiency), 23 % (technical efficiency) and 6 % (scale efficiency). For-profit ownership was positively associated with improvements in overall efficiency and technical efficiency and chain ownership was positively associated with global efficiency. There were also state-by-state variations on all the efficiency measures. As home health becomes an increasingly important player in the health care system, and its share of national health expenditures increases, it has become important to understand the cost structure of the industry and the potential for efficiencies. Therefore, further research is recommended as this sector continues to grow.

  11. 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.

  12. 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.

  13. Primary Health Care: Potential Home for Family-Focused Preventive Interventions.

    PubMed

    Leslie, Laurel K; Mehus, Christopher J; Hawkins, J David; Boat, Thomas; McCabe, Mary Ann; Barkin, Shari; Perrin, Ellen C; Metzler, Carol W; Prado, Guillermo; Tait, V Fan; Brown, Randall; Beardslee, William

    2016-10-01

    Family-focused prevention programs have been shown to effectively reduce a range of negative behavioral health outcomes but have had limited reach. Three key barriers must be overcome to expand the reach of family-focused prevention programs and thereby achieve a significant public health impact. These barriers are (1) current social norms and perceptions of parenting programs; (2) concerns about the expertise and legitimacy of sponsoring organizations to offer parenting advice; and (3) a paucity of stable, sustainable funding mechanisms. Primary healthcare settings are well positioned to overcome these barriers. Recent changes within health care make primary care settings an increasingly favorable home for family-focused prevention and suggest possibilities for sustainable funding of family-focused prevention programs. This paper discusses the existing advantages of primary care settings and lays out a plan to move toward realizing the potential public health impact of family-focused prevention through widespread implementation in primary healthcare settings.

  14. 'Genetics home reference': helping patients understand the role of genetics in health and disease.

    PubMed

    Fomous, Cathy; Mitchell, Joyce A; McCray, Alexa

    2006-01-01

    The surge of information generated by the Human Genome Project has left many health professionals and their patients struggling to understand the role of genetics in health and disease. To aid the lay public and health professionals, the US National Library of Medicine developed an online resource called 'Genetics Home Reference' (GHR), located at http://ghr.nlm.nih.gov/. Launched in April 2003, GHR's goal is to help the public interpret the health implications of the Human Genome Project. It bridges the clinical questions of consumers and the rich technical data emerging from the sequenced human genome. The GHR web site is designed for easy navigation among summaries for genetic conditions and the related gene(s) and chromosome(s). This design strategy enhances the user's appreciation of how genes, chromosomes, and conditions are interrelated.

  15. 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

  16. 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.

  17. 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 Under Hospital Insurance § 409.50 Coinsurance for durable medical equipment (DME) furnished as...

  18. Coaching the alpha male.

    PubMed

    Ludeman, Kate; Erlandson, Eddie

    2004-05-01

    Highly intelligent, confident, and successful, alpha males represent about 70% of all senior executives. Natural leaders, they willingly take on levels of responsibility most rational people would find overwhelming. But many of their quintessential strengths can also make alphas difficult to work with. Their self-confidence can appear domineering. Their high expectations can make them excessively critical. Their unemotional style can keep them from inspiring their teams. That's why alphas need coaching to broaden their interpersonal tool kits while preserving their strengths. Drawing from their experience coaching more than 1,000 senior executives, the authors outline an approach tailored specifically for the alpha. Coaches get the alpha's attention by inundating him with data from 360-degree feedback presented in ways he will find compelling--both hard-boiled metrics and vivid verbatim comments from colleagues about his strengths and weaknesses. A 360-degree assessment is a wake-up call for most alphas, providing undeniable proof that their behavior doesn't work nearly as well as they think it does. That paves the way for a genuine commitment to change. In order to change, the alpha must venture into unfamiliar--and often uncomfortable--psychological territory. He must admit vulnerability, accept accountability not just for his own work for others', connect with his underlying emotions, learn to motivate through a balance of criticism and validation, and become aware of unproductive behavior patterns. The goal of executive coaching is not simply to treat the alpha as an individual problem but to improve the entire team dynamic. Initial success creates an incentive to persevere, and the virtuous cycle reverberates throughout the entire organization.

  19. 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.

  20. 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.

  1. "Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults.

    PubMed

    Young, Rachel; Willis, Erin; Cameron, Glen; Geana, Mugur

    2014-06-01

    While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image.

  2. When professional kindness is misunderstood: boundaries and stalking issues: a case study for the home health clinician.

    PubMed

    Holz, Cheryl L

    2009-01-01

    There is the potential for home health nurses and other home care clinicians to be subjected to intrusive and possibly stalking behavior by current and former clients. Most healthcare clinicians do not receive training on the risk of intrusive interactions or stalking, nor on strategies to manage this objectionable client behavior. This article informs nurses and other home health clinicians about the potential risk of stalking. Included is a true case vignette, the legal definition of stalking, incidence occurrence among clinicians, the basic profile and behaviors of a stalker, the victimology and psychological consequences, and implications for policy and procedures and prevention techniques.

  3. 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.

  4. 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.

  5. 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.

  6. Progress of Ontario's Family Health Team model: a patient-centered medical home.

    PubMed

    Rosser, Walter W; Colwill, Jack M; Kasperski, Jan; Wilson, Lynn

    2011-01-01

    Ontario's Family Health Team (FHT) model, implemented in 2005, may be North America's largest example of a patient-centered medical home. The model, based on multidisciplinary teams and an innovative incentive-based funding system, has been developed primarily from fee-for-service primary care practices. Nearly 2 million Ontarians are served by 170 FHTs. Preliminary observations suggest high satisfaction among patients, higher income and more gratification for family physicians, and trends for more medical students to select careers in family medicine. Popular demand is resulting in expansion to 200 FHTs. We describe the development, implementation, reimbursement plan, and current status of this multidisciplinary model, relating it to the principles of the patient-centered medical home. We also identify its potential to provide an understanding of many aspects of primary care.

  7. 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.

  8. Guidelines for environmental health management in children's homes in sub-Sahara Africa.

    PubMed

    Muruka, Charles; Muruka, Andrew

    2007-12-01

    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.

  9. Guidelines for Environmental Health Management in Children’s Homes in Sub-Sahara Africa

    PubMed Central

    Muruka, Charles; Muruka, Andrew

    2007-01-01

    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

  10. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

    PubMed Central

    Bazzano, Alessandra N.; Taub, Leah; Oberhelman, Richard A.; Var, Chivorn

    2016-01-01

    Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming. PMID:28009812

  11. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia.

    PubMed

    Bazzano, Alessandra N; Taub, Leah; Oberhelman, Richard A; Var, Chivorn

    2016-12-21

    Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  12. 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…

  13. How Coaching Forensics Made Me a Better Writing Coach

    ERIC Educational Resources Information Center

    Williamson, Lynette

    2007-01-01

    The author, a high school teacher and forensics coach, describes ways to teach writing--including on-demand essays--that draw on successful practices she developed in coaching. Students learn the importance of using personal conviction and qualified thesis statements to build arguments, as well as learning "The Debater Four-Step," an effective…

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. 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

  20. Community health workers and home-based care programs for HIV clients.

    PubMed Central

    Johnson, Becky A.; Khanna, Sunil K.

    2004-01-01

    In Nyanza Province, Kenya, estimated HIV prevalence is 22%. Given that more than 80% of the population resides in rural areas, the majority of individuals in Nyanza Province do not have access to medical facilities on a regular basis. In response to the growing demands the HIV epidemic has placed on the people and communities in this region, hundreds of lay individuals have been trained as community health workers to provide home-based care to sick or dying HIV/AIDS clients in rural areas. This paper discusses the role and impact of these community health workers in Nyanza Province, Kenya. It outlines the collaborative relationship between community health workers and the Ministry of Health, examining community health workers' use of extant biomedical structures at the district level to provide services that government-run health facilities lack the monetary resources or personnel to provide. Finally, it explores the role played by community health workers in providing HIV/AIDS education to individuals in an attempt to prevent further infections. PMID:15101670

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

    PubMed

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

    2014-01-01

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

  2. 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.

  3. Effects of Horticultural Therapy on Psychosocial Health in Older Nursing Home Residents: A Preliminary Study.

    PubMed

    Chen, Yuh-Min; Ji, Jeng-Yi

    2015-09-01

    This preliminary study examined the effect of horticultural therapy on psychosocial health in older nursing home residents. A combined quantitative and qualitative design was adopted. Convenience sampling was used to recruit 10 older residents from a nursing home in Taichung, Taiwan. Participants joined a 10-week indoor horticultural program once a week, with each session lasting for about 1.5 hours. A single-group design with multiple measurements was adopted for the quantitative component of this study. Interviews held 1-2 days before the intervention (T0) were used to collect baseline data. The two outcome variables of this study, depression and loneliness, were reassessed during the 5th (T1) and 10th (T2) weeks of the intervention. Generalized estimating equations were used to test the mean differences among T0, T1, and T2 measures. After the 10-week program, qualitative data were collected by asking participants to share their program participation experiences. The results of generalized estimating equation showed significant improvements in depression and loneliness. Four categories emerged from the qualitative data content analysis: social connection, anticipation and hope, sense of achievement, and companionship. Given the beneficial effects of the horticulture therapy, the inclusion of horticultural activities in nursing home activity programs is recommended.

  4. 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.

  5. Enhancing Coach-Media Relations.

    ERIC Educational Resources Information Center

    Staffo, Donald F.

    1989-01-01

    High School and college coaches are offered tips for better coach-media relations. Suggestions are given for making the media's job easier, thus resulting in better coverage. A sample format for a Post-Game Fact Sheet is included. (IAH)

  6. 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,…

  7. Embracing Coaching as Professional Development

    ERIC Educational Resources Information Center

    Driscoll, Mark J.

    2008-01-01

    Because the author and his colleagues at the Center for Leadership and Learning Communities believe that instructional coaching is one of the most exciting developments in education in a long time, they have examined the questions this new strategy has raised for education leaders: Should coaching replace some traditional forms of teacher…

  8. 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…

  9. Experiencing Leadership Like a Coach

    ERIC Educational Resources Information Center

    Matthews, Nancy

    2016-01-01

    This note is a reflection on experiences as an educational leader, as well as provides a perspective on educational leadership, based on professional reading. It offers the metaphor of the coach, initiating a case for using a coaching philosophy as a model for a sustained form of leadership. It invites the reader to consider that with a game plan…

  10. Peer Coaching for Better Teaching.

    ERIC Educational Resources Information Center

    Skinner, Michael E.; Welch, Frances C.

    1996-01-01

    College faculty peer coaching encourages better teaching while addressing the unique nature of college instruction. It is non-evaluative, based on classroom observation or instructional materials review, and targets specific instructional techniques. Programs should have clear purposes and procedures, provide formal coaching training, provide…

  11. 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…

  12. 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

  13. Child Sleep Coaches: Current State and Future Directions.

    PubMed

    Mindell, Jodi A; Owens, Judith A; Babcock, Debra; Crabtree, Valerie McLaughlin; Ingram, David

    2016-11-20

    Given the genuine gaps in the availability of clinical sleep services for children, sleep coaching as a field has emerged and appears to be significantly increasing. Sleep coaches are typically individuals who provide individualized services, often via the Internet or phone, to families of infants and young children (and increasingly to older children, adolescents, and adults as well) with sleep problems. At this time, there is no universally accepted definition of sleep coach, nor are there clear guidelines regarding educational background, training requirements, scope of practice, or credentialing. To start to address the needs of families seeking the services of a sleep coach, educational materials were developed for parents and health care providers regarding issues to consider. Furthermore, there is a need going forward that (1) the designation sleep coach or consultant be clear and well defined, with a clear standard of care and scope of practice; (2) there is a standard core body of knowledge included in all training programs; (3) a certification process is developed for sleep coaches that is reputable and has recognizable and clear standards; and (4) that care for sleep problems in infants and young children are available to diverse populations, irrespective of socioeconomic status.

  14. [Changes of general and oral health status of elderly patients receiving home-visit dental services].

    PubMed

    Nishiyama, Yoshihide

    2005-06-01

    This study investigated the changes of general and oral health status of elderly patients who received home-visit dental services. The subjects were 51 patients (male: 19, female: 32, age: 83.0+/-9.1). The results of initial and re-examination (5.4 months later) by questionnaire survey, oral status and oral microbes were compared. The following results were obtained. 1. More than half of the subjects were bedridden and about 70% were affected by dementia. Three-quarters needed special care for daily activities. 2. The general health condition of the subjects became worse after 5.4 months. Moreover, 11 subjects died within 6 months after re-examination. However, oral health status, such as status of oral hygiene (p < 0.01), inflammation of gingiva (p < 0.01), tongue coating (p < 0.05) and oral malodor (p < 0.01) improved significantly. 3. There was a significant difference in the rate of people with dysphagic problems between the living and dead groups (p < 0.05). 4. The initial general and oral health status of the people with dysphagic problems was significantly worse than that of those without it. After receiving home-visit dental services, general condition became worse. However oral status, such as status of oral hygiene, inflammation of gingiva, oral malodor, and lactobacillus count significantly improved in both groups. These results suggest that dysphagic problems of elderly patients may affect their general health condition and might increase the risk of death. It is recommended to judge dysphagic problems accurately when performing certification of need for long-term care and to provide professional oral care periodically for the dependent elderly needing care.

  15. Improved education and training for nursing assistants: keys to promoting the mental health of nursing home residents.

    PubMed

    Glaister, Judy A; Blair, Charles

    2008-08-01

    The mental health of older adults contributes to their overall well-being. However, numerous studies have reported substantial prevalence of mental health problems, especially depression, in nursing home residents. Due to the poor quality of education and training provided to nursing home front-line caregivers, most of whom are nursing assistants, many residents experiencing depression are not recognized as such and consequently receive no treatment. Emphasizing the aging process and mental health components in education and training programs for nursing assistants could have a positive impact on the detection and treatment of depression in residents.

  16. Oral health care and smoking cessation practices of interprofessional home care providers for their patients with HIV.

    PubMed

    VanDevanter, Nancy; Dorsen, Caroline G; Messeri, Peter; Shelley, Donna; Person, Andresa

    2012-07-01

    The need for oral health services among patients with HIV, especially those in advanced stages of disease and those who smoke, has been well documented. Patients receiving HIV-related home care services provide an opportunity for assessment of oral health and smoking cessation needs; however, the majority of home care providers lack formal training to provide these services, thus interprofessional collaborations may be of value. This study assessed the oral health and smoking cessation practices of a random sample of 81 HIV home care providers. Results showed very favorable attitudes toward providing these services with some differences across disciplines. More than 70% of nurses would like to receive additional training in comprehensive oral health assessment by dental professionals. The study provides evidence for the potential of expanding these services for patients with HIV through interprofessional collaboration, in particular with nurses and dentists.

  17. 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…

  18. 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…

  19. Learning How to Coach: The Different Learning Situations Reported by Youth Ice Hockey Coaches

    ERIC Educational Resources Information Center

    Wright, Trevor; Trudel, Pierre; Culver, Diane

    2007-01-01

    Background: Large-scale coach education programs have been developed in many countries around the world to help prepare coaches for their important role. Coaches have said that they also learn to coach from experience, starting from when they were young athletes until their current coaching positions. Finally, in the last decade, Internet…

  20. 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…

  1. Effects of water-damaged homes after flooding: health status of the residents and the environmental risk factors.

    PubMed

    Azuma, Kenichi; Ikeda, Koichi; Kagi, Naoki; Yanagi, U; Hasegawa, Kenichi; Osawa, Haruki

    2014-04-01

    We evaluated the health status of residents and the environmental risk factors of housing after flooding. Questionnaires were distributed to 595 selected households (one adult resident per household) in six areas in Japan which were severely flooded between 2004 and 2010. A total of 379 responses were obtained. Indoor dampness and visible mold growth significantly increased in homes with greater flood damage. The incidence of respiratory, dermal, ocular, and nasal symptoms one week after flooding was significantly higher in flooded homes compared with non-flooded homes, the incidence of psychological disorders was significantly high for six months after flooding, and the incidence of post-traumatic stress disorder was significantly high six months after flooding. Significant risk factors for respiratory and nasal symptoms included proximity to industrial and waste incineration plants. Our results suggest that rapid action should be taken after flooding to ensure adequate public health and environmental hygiene in the water-damaged homes.

  2. The Role of Specialty Mental Health Care in Predicting Child Welfare and Juvenile Justice Out-of-Home Placements

    ERIC Educational Resources Information Center

    Glisson, Charles; Green, Philip

    2006-01-01

    Objective: This longitudinal, prospective study examines the role of specialty mental health care as provided by community-based, usual-care practice settings in predicting out-of-home placements among children served by a child welfare and juvenile justice system. Method: The mental health needs of 1,249 children from 22 counties in Tennessee…

  3. 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…

  4. 42 CFR 409.50 - Coinsurance for durable medical equipment (DME) furnished as a home health service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Coinsurance for durable medical equipment (DME... Services Under Hospital Insurance § 409.50 Coinsurance for durable medical equipment (DME) furnished as a home health service. The coinsurance liability of the beneficiary or other person for DME furnished...

  5. 42 CFR 409.50 - Coinsurance for durable medical equipment (DME) furnished as a home health service.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Coinsurance for durable medical equipment (DME... Services Under Hospital Insurance § 409.50 Coinsurance for durable medical equipment (DME) furnished as a home health service. The coinsurance liability of the beneficiary or other person for DME furnished...

  6. 42 CFR 409.50 - Coinsurance for durable medical equipment (DME) furnished as a home health service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Coinsurance for durable medical equipment (DME... Services Under Hospital Insurance § 409.50 Coinsurance for durable medical equipment (DME) furnished as a home health service. The coinsurance liability of the beneficiary or other person for DME furnished...

  7. 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... Services Under Hospital Insurance § 409.50 Coinsurance for durable medical equipment (DME) furnished as a home health service. The coinsurance liability of the beneficiary or other person for DME furnished...

  8. 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…

  9. Coaching in Community Settings: A Review.

    ERIC Educational Resources Information Center

    Nettles, Saundra Murray

    Coaching is a means of instruction that combines elements of mentoring and tutoring in natural community environments. Coach and student characteristics, processes of coaching, and outcomes of coaching in varied community settings and across different developmental levels are examined. Programs utilizing adults and peers from the community in…

  10. 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;…

  11. 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.…

  12. 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.

  13. 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…

  14. Supporting Professional Growth through Mentoring and Coaching.

    ERIC Educational Resources Information Center

    Kutilek, Linda M.; Earnest, Garee W.

    2001-01-01

    Compares peer mentoring, peer coaching, and executive coaching. Presents an evaluation of extension professionals with peer coaches, indicating that it increased their skills in program planning and implementation. Suggests that peer coaching is more successful over a shorter time frame and requires follow-up. (SK)

  15. Marketing environment dynamics and implications for pricing strategies: the case of home health care.

    PubMed

    Ponsford, B J; Barlow, D

    1999-01-01

    This research reviews the factors affecting the pricing or rate schedules of home health care agencies. A large number of factors affect costs and thus rate structures. The major factors include reimbursement structures with accompanying discount structures, administrative burdens, and risks. Channel issues include bargaining power, competition, and size. Staffing issues affect pricing and product through the provider level, productivity, and quality outcomes. Physician and patient issues include quality concerns and choices. These factors are discussed in light of overall marketing strategy and the interaction of pricing with other marketing controllables such as product, place/distribution, and promotion. Economic and accounting principles are also reviewed with consideration to understanding direct and indirect costs in order to enable negotiators to effectively price health care services.

  16. Returns to Local-Area Healthcare Spending: Evidence from Health Shocks to Patients Far From Home

    PubMed Central

    Doyle, Joseph J.

    2013-01-01

    Healthcare spending varies widely across markets, and previous empirical studies find little evidence that higher spending translates into better health outcomes. The main innovation in this paper exploits this cross-sectional variation in hospital spending in a new way by considering patients who are exposed to healthcare systems not designed for them: patients far from home when a health emergency strikes. Visitors to Florida who become ill in high-spending areas have significantly lower mortality rates compared to visitors in lower-spending areas. The results are robust within groups of similar visitors and within groups of destinations that appear to be close demand substitutes—areas that likely attract similar visitors. PMID:23853699

  17. Exercise at Home

    MedlinePlus

    ... Training Home Health Insights Exercise Exercise at Home Exercise at Home Ask a Question Find a Doctor ... with the movement and contact your provider. Posture Exercises Better posture means better breathing and movement. Axial ...

  18. Genetics Home Reference

    MedlinePlus

    ... MENU Toggle navigation Home Page Search Share: Email Facebook Twitter Home Health Conditions Genes Chromosomes & mtDNA Resources Help Me Understand Genetics Genetics Home Reference provides consumer-friendly information about the effects of genetic variation ...

  19. 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.

  20. Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.

    PubMed

    Miller, Benjamin F; Ross, Kaile M; Davis, Melinda M; Melek, Stephen P; Kathol, Roger; Gordon, Patrick

    2017-01-01

    The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet. However, challenges to implementing the PCMH framework are compounded for real-world practitioners because payment reform rarely happens concurrently. Nowhere is this more evident than in attempts to integrate behavioral health clinicians into primary care. As behavioral health clinicians find opportunities to work in integrated settings, a comprehensive understanding of payment models is integral to the dialogue. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy. (PsycINFO Database Record