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Sample records for program home health

  1. Building a peer mentor home health aide program: implications for home health aide retention.

    PubMed

    Kreiser, Athena Lu; Adamski, Tom; Gallagher, Bridget

    2010-09-01

    The Home Health Aide (HHA) industry is challenged with low wages, little possibility of career advancement, and high turnover rates. Jewish Home Lifecare, Home Assistance Personnel Inc. (HAPI) is a home care aide agency that has developed a Peer Mentor HHA program. Peer Mentor HHAs mentor newly hired/trained HHAs within our agency. This career path leads to higher paying work that allows for growth of our workforce for the identified growing care need and positively impacts HHA retention. PMID:20811183

  2. 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…

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

    PubMed

    Abraham, Chon; Rosenthal, David A

    2008-01-01

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

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

    PubMed

    2015-11-01

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

  5. Publication of the OIG compliance program guidance for home health agencies--OIG. Notice.

    PubMed

    1998-08-01

    This Federal Register notice sets forth the recently issued Compliance Program Guidance for Home Health Agencies developed by the Office of Inspector General (OIG) in cooperation with, and with input from, several provider groups and industry representatives. Many home health care providers have expressed interest in better protecting their operations from fraud and abuse through the adoption of a voluntary compliance program. The OIG has previously developed and published compliance program guidances focused on the clinical laboratory and hospital industries (62 FR 9435, March 3, 1997 and 63 FR 8987, February 23, 1998, respectively). We believe that the development of this compliance program guidance for the home health industry will continue as a positive step towards promoting a higher level of ethical and lawful conduct throughout the entire health care community.

  6. 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, ...

  7. TARCOG Home Start Program.

    ERIC Educational Resources Information Center

    Top of Alabama Regional Council of Governments, Huntsville. Human Resources Program.

    This report describes the Top of Alabama Regional Council of Governments (TARCOG) Home Start Program. Five aspects of the program are presented. (1) The nutrition component is aimed at helping parents make the best use of food resources through good planning, buying, and cooking. (2) The health program involves provision of medical and dental…

  8. 77 FR 60128 - Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-02

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

  9. 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…

  10. Home health care

    MedlinePlus

    ... Skilled nursing - home care; Physical therapy - at home; Occupational therapy - at home; Discharge - home health care ... medicines that you may be taking. Physical and occupational therapists can make sure your home is set ...

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

    PubMed

    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

  12. 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

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

    PubMed

    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.

  14. 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 ...

  15. 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

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

    PubMed

    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

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

    ERIC Educational Resources Information Center

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

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

  18. 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

  19. Interpretive Flexibility in Mobile Health: Lessons From a Government-Sponsored Home Care Program

    PubMed Central

    Mathiassen, Lars

    2013-01-01

    Background Mobile technologies have emerged as important tools that health care personnel can use to gain easy access to client data anywhere. This is particularly useful for nurses and care workers in home health care as they provide services to clients in many different settings. Although a growing body of evidence supports the use of mobile technologies, the diverse implications of mobile health have yet to be fully documented. Objective Our objective was to examine a large-scale government-sponsored mobile health implementation program in the Danish home care sector and to understand how the technology was used differently across home care agencies. Methods We chose to perform a longitudinal case study with embedded units of analysis. We included multiple data sources, such as written materials, a survey to managers across all 98 Danish municipalities, and semistructured interviews with managers, care workers, and nurses in three selected home care agencies. We used process models of change to help analyze the overall implementation process from a longitudinal perspective and to identify antecedent conditions, key events, and practical outcomes. Results Strong collaboration between major stakeholders in the Danish home care sector (government bodies, vendors, consultants, interest organizations, and managers) helped initiate and energize the change process, and government funding supported quick and widespread technology adoption. However, although supported by the same government-sponsored program, mobile technology proved to have considerable interpretive flexibility with variation in perceived nature of technology, technology strategy, and technology use between agencies. What was first seen as a very promising innovation across the Danish home care sector subsequently became the topic of debate as technology use arrangements ran counter to existing norms and values in individual agencies. Conclusions Government-sponsored programs can have both positive and

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

    PubMed Central

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

    1997-01-01

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

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

    PubMed

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

    1997-10-01

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

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

    PubMed

    2013-12-01

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

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

    PubMed

    2013-12-01

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

  4. Home Health in Chinatown.

    ERIC Educational Resources Information Center

    Health Services Administration (DHEW/PHS), Rockville, MD. Bureau of Community Health Services.

    The document reports on the successful efforts of the San Francisco Home Health Service, which brings much needed homemaker/home health aide services to hundreds of elderly people in the San Francisco Chinatown area. Providing historical and cultural background information about the area, its residents, and its particular health problems, the…

  5. Healthy Start Programa Madrina: A Promotora Home Visiting Outreach and Education Program to Improve Perinatal Health among Latina Pregnant Women

    ERIC Educational Resources Information Center

    Bill, Debra E.; Hock-Long, Linda; Mesure, Maryann; Bryer, Pamela; Zambrano, Neydary

    2009-01-01

    The purpose of this article is to describe the development, implementation, and evaluation of Healthy Start Programa Madrina (HSPM), a home visiting promotora outreach and education program for Latina pregnant women and to present the 10-year findings of the program (1996-2005). Perinatal health disparities continue to persist among low-income…

  6. Clinical application of the Omaha system with the Nightingale Tracker: a community health nursing student home visit program.

    PubMed

    Sloan, Helen L; Delahoussaye, Carolyn P

    2003-01-01

    The application of computer use in the clinical and educational arena needs to be emphasized for both the improved management of patient data and nursing knowledge. Faculty commitment to automation of home visit documentation records was essential to sustain the trial of implementing the Nightingale Trackers in the clinical area. The Nightingale Tracker is a software program that automates the Omaha system, a community-friendly nursing language that encourages a focus on health promotion. A team approach involving students, faculty, and technical support enabled the automation of the patient record of a home visiting program in a community health nursing course.

  7. Creating Healthful Home Food Environments: Results of a Study with Participants in the Expanded Food and Nutrition Education Program

    ERIC Educational Resources Information Center

    Cullen, Karen Weber; Smalling, Agueda Lara; Thompson, Debbe; Watson, Kathleen B.; Reed, Debra; Konzelmann, Karen

    2009-01-01

    Objective: To evaluate a modified curriculum for the 6-session Texas Expanded Food and Nutrition Education Program (EFNEP) promoting healthful home food environments and parenting skills related to obesity prevention. Design: Two-group randomized control trial; intervention versus usual EFNEP curriculum. Setting: Texas EFNEP classes. Participants:…

  8. 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.

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

    PubMed

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

    2015-11-01

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

  10. Ostomy Home Skills Program

    MedlinePlus

    ... Directory Annual Meeting Mentorship Program Outside Activities Member Communities Military Health System Strategic Partnership Military Health System Strategic Partnership American College of Surgeons Overview Military Health System Strategic Partnership ...

  11. Health care and social service professionals’ perceptions of a home-visit program for young, first-time mothers

    PubMed Central

    Li, S.-A.; Jack, S. M.; Gonzalez, A.; Duku, E.; MacMillan, H. L.

    2015-01-01

    Abstract Introduction: Little is known about health care and social service professionals’ perspective on the acceptability of long-term home-visit programs serving low-income, first-time mothers. This study describes the experiences and perspectives of these community care providers involved with program referrals or service delivery to mothers who participated in the Nurse–Family Partnership (NFP), a targeted nurse home-visit program. Methods: The study included two phases. Phase I was a secondary qualitative data analysis used to analyze a purposeful sample of 24 individual interviews of community care providers. This was part of a larger case study examining adaptations required to increase acceptability of the NFP in Hamilton, Ontario, Canada. In Phase II (n = 4), themes identified from Phase I were further explored through individual, semi-structured interviews with community health care and social service providers, giving qualitative description. Results: Overall, the NFP was viewed as addressing an important service gap for first-time mothers. Providers suggested that frequent communication between the NFP and community agencies serving these mothers could help improve the referral process, avoid service duplication, and streamline the flow of service access. The findings can help determine key components required to enhance the success of integrating a home-visit program into an existing network of community services. Conclusion: The function of home-visit programs should not be viewed in isolation. Rather, their potential can be maximized when they collaborate and share information with other agencies to provide better services for first-time mothers. PMID:26605565

  12. Philani Plus (+): A Mentor Mother Community Health Worker Home Visiting Program to Improve Maternal and Infants’ Outcomes

    PubMed Central

    le Roux, Ingrid M.; Tomlinson, Mark; Mbewu, Nokwanele; Comulada, W. Scott; le Roux, Karl; Stewart, Jacqueline; O’Connor, Mary J.; Hartley, Mary; Desmond, Kate; Greco, Erin; Worthman, Carol M.; Idemundia, Faith; Swendeman, Dallas

    2013-01-01

    Pregnant mothers in South African townships face multiple health risks for themselves and their babies. Existing clinic-based services face barriers to access, utilization, and human resource capacities. Home visiting by community health workers (CHW) can mitigate such barriers. The Philani Plus (+) Intervention Program builds upon the original Philani CHW home-visiting intervention program for maternal and child nutrition by integrating content and activities to address HIV, alcohol, and mental health. Pregnant Mothers at Risk (MAR) for HIV, alcohol, and/or nutrition problems in 24 neighborhoods in townships in Cape Town, South Africa (n=1,239) were randomly assigned by neighborhood to an intervention (Philani Plus (+), N=12 neighborhoods; n=645 MAR) or a standard-care control condition of neighborhood clinic-based services (N=12 neighborhoods; n=594 MAR). Positive peer deviant “Mentor Mother” CHWs are recruited from the township neighborhoods and trained to deliver four antenatal and four postnatal home visits that address HIV, alcohol, nutrition, depression, health care regimens for the family, caretaking and bonding, and securing government-provided child grants. The MAR and their babies are being monitored during pregnancy, 1 week post-birth, and 6 and 18 months later. Among the 1,239 MAR recruited: 26% were HIV-positive; 27% used alcohol during pregnancy; 17% previously had low-birthweight babies; 23% had at least one chronic condition (10% hypertension, 5% asthma, 2% diabetes); 93% had recent sexual partners with 10% known to be HIV+; and 17% had clinically significant prenatal depression and 42% had borderline depression. This paper presents the intervention protocol and baseline sample characteristics for the “Philani Plus (+)” CHW home-visiting intervention trial. PMID:21850488

  13. Rolling Back Medicare Home Health

    PubMed Central

    Komisar, Harriet L.

    2002-01-01

    The Balanced Budget Act (BBA) of 1997 included major changes to Medicare's home health benefit designed to control spending and promote efficient delivery of services. Using national data from Medicare home health claims, this study finds the initial effect of the BBA was to steeply reduce use of the home health benefit and intensify its focus on post-acute skilled nursing and therapy services. The striking responsiveness of home health agencies (HHAs) to altered financial incentives suggests that we may again see large shifts in patterns of care under the new incentives of Medicare's prospective payment system (PPS) for home health. PMID:12690694

  14. Prenatal-Postnatal Intervention: A Description and Discussion of Preliminary Findings of a Home Visit Program Supplying Cognitive, Nutritional and Health Information to Disadvantaged Homes.

    ERIC Educational Resources Information Center

    Wright, Charlene; And Others

    This paper describes the development of a program which uses paraprofessional home visitors, known as Child Development Trainers, as disseminators of information necessary for the growth and development of the fetus and young infant. These Trainers serve a low income population. Weekly home visits were designed to aid the expectant mother to…

  15. 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....

  16. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  17. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 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....

  18. 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....

  19. 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....

  20. 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)

  1. 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.…

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

    PubMed

    Lee, Teresa; Schiller, Jennifer

    2015-02-01

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

  3. Overview of the federal home visiting program.

    PubMed

    Adirim, Terry; Supplee, Lauren

    2013-11-01

    On March 23, 2010, the President signed into law the Affordable Care Act (Public Law 111-148), which included an amendment of Title V of the Social Security Act authorizing the creation of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program. Authorized and funded at $1.5 billion for 5 years, the MIECHV represents a large investment in health and development outcomes for at-risk children through evidence-based home visiting programs. The MIECHV presents unprecedented opportunities to integrate early childhood services systems, not only on the federal level but also within states and local communities. The MIECHV is funded in escalating amounts over 5-year period authorized, as follows: $100 million in fiscal year (FY) 2010, $250 million in FY 2011, $350 million in FY 2012, $400 million in FY 2013, and $400 million in FY 2014. Most of the funding is being provided to states and territories to provide home visiting services in their at-risk communities. In addition, the legislation included a 3% set-aside for tribes, tribal organizations, and urban Indian organizations and a 3% set-aside for research and evaluation. This investment has spurred the creation of more comprehensive and coordinated early childhood service systems across the United States. This article provides an overview of the MIECHV program, including descriptions of the various requirements under the Affordable Care Act. These include partnering with states to provide evidence-based home visiting services to at-risk families, working with tribal communities to implement culturally competent home visiting programs, and developing a mechanism to systematically review the evidence of effectiveness for home visiting program models and to conduct a national evaluation of the MIECHV program. PMID:24187124

  4. 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…

  5. 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…

  6. Home audit program: management manual

    SciTech Connect

    Not Available

    1980-09-01

    Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)

  7. Health Promotion Seminar. An Instructor Resource Guide. Appendix to a Final Report on the Paraprofessional Rurally Oriented Family Home Health Training Program.

    ERIC Educational Resources Information Center

    Myer, Donna Foster

    This instructor's resource guide, one in a series of products from a project to develop an associate degree program for paraprofessional rural family health promoters, deals with conducting a health promotion seminar. Covered in the first section of the guide are the role of a health care promotion seminar in rural health promotional training,…

  8. Establishing a successful home dialysis program.

    PubMed

    Diaz-Buxo, Jose A; Crawford-Bonadio, Terri L; St Pierre, Donna; Ingram, Katherine M

    2006-01-01

    The renewed interest in home dialysis therapies makes it pertinent to address the essentials of establishing and running a successful home dialysis program. The success of a home program depends on a clear understanding of the structure of the home program team, the physical plant, educational tool requirements, reimbursement sources and a business plan. A good command of the technical and economic aspects is important, but the primary drivers for the creation and growth of a home dialysis program are the confidence and commitment of the nephrological team. PMID:16361836

  9. Maternal Engagement in Home Visiting: The MOM Program

    ERIC Educational Resources Information Center

    Radcliffe, Jerilynn; Schwarz, Donald F.

    2013-01-01

    The MOM Program is an innovative home visiting program whose aim is to empower low-income urban mothers to obtain health and early intervention services for their children. The authors discuss a recent evaluation of the MOM program which sought to examine maternal involvement in the program. The results raise important questions and call for…

  10. 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

    ... the May 5, 2010 Federal Register (75 FR 24437), we issued the ``Medicare and Medicaid Programs... standards for health care industries, (65 FR 69432, November 17, 2000). Individuals and States are not... working in collaboration with the physician in accordance with State law, or a certified nurse-midwife...

  11. 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 [ ...

  12. Solar home show: Homes designed for the solar homebuilders program

    NASA Astrophysics Data System (ADS)

    1982-07-01

    Ten passive solar homes are presented that resulted from a program to demonstrate that passive solar homes can be attractive, affordable, functional, and therefore, marketable. For each home is given: the designer and builder, floor plans, perspective of the outside, passive solar and conservation features, and a comparison of the estimated heating bill for the house and a conventional house the same size. A brief discussion is included on the basics of passive solar design, ventilation and cooling, and solar access.

  13. 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

  14. Transforming home health nursing with telehealth technology.

    PubMed

    Farrar, Francisca Cisneros

    2015-06-01

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

  15. Guidelines for Dietitians and Public Health Nutritionists in Home Health Services.

    ERIC Educational Resources Information Center

    Community Health Service (DHEW/PHS), Bethesda, MD.

    Prepared by the Public Health Service to clarify the role of health professionals and subprofessionals in the home care field, this guide is directed to dietitians and public health nutritionists who are involved in planning, directing, carrying out, and evaluating the nutrition aspects of medical care programs for patients at home. Program…

  16. Patient Experience in Health Center Medical Homes.

    PubMed

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

    2015-12-01

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

  17. Parent Experience of Implementing Effective Home Programs

    ERIC Educational Resources Information Center

    Novak, Iona

    2011-01-01

    The aim of this preliminary study was to describe parent views about implementing effective home programs to inform practice recommendations. Semi-structured interviews were conducted with 10 parents of children with cerebral palsy (2 fathers and 8 mothers) who had participated in a home program by using a partnership-based approach. Transcripts…

  18. Assessing Quality in Home Visiting Programs

    ERIC Educational Resources Information Center

    Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

    2013-01-01

    Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

  19. 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

  20. Development and testing of the Dementia Symptom Management at Home (DSM-H) program: An interprofessional home health care intervention to improve the quality of life for persons with dementia and their caregivers.

    PubMed

    Brody, Abraham A; Guan, Carrie; Cortes, Tara; Galvin, James E

    2016-01-01

    Home health care agencies are increasingly taking care of sicker, older patients with greater comorbidities. However, they are unequipped to appropriately manage these older adults, particular persons living with dementia (PLWD). We therefore developed the Dementia Symptom Management at Home (DSM-H) Program, a bundled interprofessional intervention, to improve the care confidence of providers, and quality of care delivered to PLWD and their caregivers. We implemented the DSM-H with 83 registered nurses, physical therapists, and occupational therapists. Overall, there was significant improvement in pain knowledge (5.9%) and confidence (26.5%), depression knowledge (14.8%) and confidence (36.1%), and neuropsychiatric symptom general knowledge (16.8%), intervention knowledge (20.9%), attitudes (3.4%) and confidence (27.1%) at a statistical significance of (P < .0001). We also found significant differences between disciplines. Overall, this disseminable program proved to be implementable and improve clinician's knowledge and confidence in caring for PLWD, with the potential to improve quality of care and quality of life, and decrease costs. PMID:26922312

  1. Infections in Nursing Homes: Epidemiology and Prevention Programs.

    PubMed

    Montoya, Ana; Cassone, Marco; Mody, Lona

    2016-08-01

    This review summarizes current literature pertaining to infection prevention in nursing home population including post-acute care patients and long-term care residents. Approximately 2 million infections occur each year and more than one-third of older adults harbor multidrug-resistant organisms in this setting. Surveillance, hand hygiene, isolation precautions, resident and employee health programs, education, and antibiotic stewardship are essential elements of infection prevention and control programs in nursing homes. This article discusses emerging evidence suggesting the usefulness of interactive multimodal bundles in reducing infections and antimicrobial resistance, thereby enhancing safety and quality of care for older adults in nursing homes.

  2. Comparison of Home Retrofit Programs in Wisconsin

    SciTech Connect

    Cunningham, K.; Hannigan, E.

    2013-03-01

    To explore ways to reduce customer barriers and increase home retrofit completions, several different existing home retrofit models have been implemented in the state of Wisconsin. This study compared these programs' performance in terms of savings per home and program cost per home to assess the relative cost-effectiveness of each program design. However, given the many variations in these different programs, it is difficult to establish a fair comparison based on only a small number of metrics. Therefore, the overall purpose of the study is to document these programs' performance in a case study approach to look at general patterns of these metrics and other variables within the context of each program. This information can be used by energy efficiency program administrators and implementers to inform home retrofit program design. Six different program designs offered in Wisconsin for single-family energy efficiency improvements were included in the study. For each program, the research team provided information about the programs' approach and goals, characteristics, achievements and performance. The program models were then compared with performance results -- program cost and energy savings -- to help understand the overall strengths and weaknesses or challenges of each model.

  3. Comparison of Home Retrofit Programs in Wisconsin

    SciTech Connect

    Cunningham, Kerrie; Hannigan, Eileen

    2013-03-01

    To explore ways to reduce customer barriers and increase home retrofit completions, several different existing home retrofit models have been implemented in the state of Wisconsin. This study compared these programs' performance in terms of savings per home and program cost per home to assess the relative cost-effectiveness of each program design. However, given the many variations in these different programs, it is difficult to establish a fair comparison based on only a small number of metrics. Therefore, the overall purpose of the study is to document these programs' performance in a case study approach to look at general patterns of these metrics and other variables within the context of each program. This information can be used by energy efficiency program administrators and implementers to inform home retrofit program design. Six different program designs offered in Wisconsin for single-family energy efficiency improvements were included in the study. For each program, the research team provided information about the programs' approach and goals, characteristics, achievements and performance. The program models were then compared with performance results-program cost and energy savings-to help understand the overall strengths and weaknesses or challenges of each model.

  4. 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…

  5. The Learning, Physical and Emotional Environment of the Home in the Context of Poverty: The Infant Health and Development Program.

    ERIC Educational Resources Information Center

    Brooks-Gun, Jeanne; And Others

    1995-01-01

    Examined the impact of individual environmental and biological risks on the home environment of three-year olds in a sample of low birth weight, premature infants. Suggests that compared to nonpoor families, poor families experienced more multiple risk factors. Poverty clearly had a negative effect on the provision of learning experiences,…

  6. 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

    ... Fiscal intermediaries. FR Federal Register. FY Fiscal year. GEM General equivalency mapping. HAVEN Home..., we published a final rule in the July 3, 2000 Federal Register (65 FR 41128) to implement the HH PPS... and full description of the HH PPS as required by the BBA, see the July 2000 HH PPS final rule (65...

  7. EXAMINING LONG-TERM EFFECTS OF AN INFANT MENTAL HEALTH HOME-BASED EARLY HEAD START PROGRAM ON FAMILY STRENGTHS AND RESILIENCE.

    PubMed

    Mckelvey, Lorraine; Schiffman, Rachel F; Brophy-Herb, Holly E; Bocknek, Erika London; Fitzgerald, Hiram E; Reischl, Thomas M; Hawver, Shelley; Cunningham Deluca, Mary

    2015-01-01

    Infant Mental Health based interventions aim to promote the healthy development of infants and toddlers through promoting healthy family functioning to foster supportive relationships between the young child and his or her important caregivers. This study examined impacts of an Infant Mental Health home-based Early Head Start (IMH-HB EHS) program on family functioning. The sample includes 152 low-income families in the Midwestern United States, expectant or parenting a child younger than 1 year of age, who were randomly assigned to receive IMH-HB EHS services (n = 75) or to a comparison condition (n = 77). Mothers who received IMH-HB EHS services reported healthier psychological and family functioning, outcomes that are consistent with the IMH focus, when their children were between the ages of 3 and 7 years of age. Specifically, mothers in the IMH-HB EHS group reported healthier family functioning and relationships, better coping skills needed to advocate for their families, and less stress in the parenting role versus those in the comparison condition. The study also examined support seeking coping, some of which changed differently over time based on program group assignment. Overall, findings suggest that the gains families achieve from participating in IMH-HB EHS services are maintained after services cease. PMID:26118949

  8. EXAMINING LONG-TERM EFFECTS OF AN INFANT MENTAL HEALTH HOME-BASED EARLY HEAD START PROGRAM ON FAMILY STRENGTHS AND RESILIENCE.

    PubMed

    Mckelvey, Lorraine; Schiffman, Rachel F; Brophy-Herb, Holly E; Bocknek, Erika London; Fitzgerald, Hiram E; Reischl, Thomas M; Hawver, Shelley; Cunningham Deluca, Mary

    2015-01-01

    Infant Mental Health based interventions aim to promote the healthy development of infants and toddlers through promoting healthy family functioning to foster supportive relationships between the young child and his or her important caregivers. This study examined impacts of an Infant Mental Health home-based Early Head Start (IMH-HB EHS) program on family functioning. The sample includes 152 low-income families in the Midwestern United States, expectant or parenting a child younger than 1 year of age, who were randomly assigned to receive IMH-HB EHS services (n = 75) or to a comparison condition (n = 77). Mothers who received IMH-HB EHS services reported healthier psychological and family functioning, outcomes that are consistent with the IMH focus, when their children were between the ages of 3 and 7 years of age. Specifically, mothers in the IMH-HB EHS group reported healthier family functioning and relationships, better coping skills needed to advocate for their families, and less stress in the parenting role versus those in the comparison condition. The study also examined support seeking coping, some of which changed differently over time based on program group assignment. Overall, findings suggest that the gains families achieve from participating in IMH-HB EHS services are maintained after services cease.

  9. Evaluation of home respiratory therapy delivered to patients in the Ministry of Health's Home Medical Program (HMP) and administered through the Madinah HMP Center, Kingdom of Saudi Arabia, 2013.

    PubMed

    Alhelali, Rana A; McNabb, Scott J N; Memish, Ziad A

    2016-03-01

    This was an evaluation of home respiratory therapy (HRT) services administered through the Madinah Home Medical Program (MHMP) Center of the Ministry of Health (MoH), Kingdom of Saudi Arabia (KSA). Using a retrospective design and descriptive analyses, we analyzed 83 patient records for the clinical care received, outcomes, and patient satisfaction. We also assessed a subset from an economic perspective. Demographically, 72% were >60 years of age, 80% were female, and 90% were Saudi. Asthma accounted for 34% of the diagnosed respiratory diseases, followed by chronic obstructive pulmonary disease (11%). Most patients (71%) required two or three respiratory modalities: 94% used oxygen therapy and 14% were on mechanical ventilation. A full 90% of HMP patients expressed a high level of satisfaction with the HMP overall care, and 43% saw an improvement in their condition. The MHMP lowered healthcare costs for HRT-receiving patients by decreasing the frequency of emergency room (ER) and outpatient visits by 50.8% from 59 to 30 visits. HRT administered through the MHMP Center improved clinical outcomes and increased patient satisfaction while reducing hospital utilization and associated costs. A prospective study is recommended to assess HMP services in comparison with hospitalization. PMID:26304013

  10. Evaluation of home respiratory therapy delivered to patients in the Ministry of Health's Home Medical Program (HMP) and administered through the Madinah HMP Center, Kingdom of Saudi Arabia, 2013.

    PubMed

    Alhelali, Rana A; McNabb, Scott J N; Memish, Ziad A

    2016-03-01

    This was an evaluation of home respiratory therapy (HRT) services administered through the Madinah Home Medical Program (MHMP) Center of the Ministry of Health (MoH), Kingdom of Saudi Arabia (KSA). Using a retrospective design and descriptive analyses, we analyzed 83 patient records for the clinical care received, outcomes, and patient satisfaction. We also assessed a subset from an economic perspective. Demographically, 72% were >60 years of age, 80% were female, and 90% were Saudi. Asthma accounted for 34% of the diagnosed respiratory diseases, followed by chronic obstructive pulmonary disease (11%). Most patients (71%) required two or three respiratory modalities: 94% used oxygen therapy and 14% were on mechanical ventilation. A full 90% of HMP patients expressed a high level of satisfaction with the HMP overall care, and 43% saw an improvement in their condition. The MHMP lowered healthcare costs for HRT-receiving patients by decreasing the frequency of emergency room (ER) and outpatient visits by 50.8% from 59 to 30 visits. HRT administered through the MHMP Center improved clinical outcomes and increased patient satisfaction while reducing hospital utilization and associated costs. A prospective study is recommended to assess HMP services in comparison with hospitalization.

  11. 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.

  12. The Mother-Child Home Program.

    ERIC Educational Resources Information Center

    Levenstein, Phyllis

    This paper provides a description and evaluation of the Mother-Child Program (developed by the Verbal Interaction Project) for prevention of educational disadvantage. The program consists of 46 semi-weekly home visits by "Toy Demonstrators" in each of two seven month program years, following the local school calendar. Toy Demonstrators are former…

  13. Ethical Considerations in Home-Based Programs.

    ERIC Educational Resources Information Center

    Levenstein, Phyllis

    This paper provides a checklist of 10 potential ethical problems associated with intervention in families through home-based programs. Problems which directly involve program participants are (1) pressure on parents to join the program, (2) violation of confidentiality, (3) intrusiveness, (4) need to respect the family's style of living, (5)…

  14. 75 FR 43172 - Maternal, Infant, and Early Childhood Home Visiting Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-23

    ... Maternal, Infant, and Early Childhood Home Visiting Program AGENCY: Health Resources and Services... entities to apply for funding under the Affordable Care Act Maternal, Infant, and Early Childhood Home... Care Act (ACA) Maternal, Infant, and Early Childhood Home Visiting program is designed to...

  15. Minding the Baby: Enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home visiting program

    PubMed Central

    Sadler, Lois S.; Slade, Arietta; Close, Nancy; Webb, Denise L.; Simpson, Tanika; Fennie, Kristopher; Mayes, Linda C.

    2013-01-01

    In this paper we focus on the first wave of outcomes in a pilot phase randomized control trial of a home-based intervention for infants and their families, Minding the Baby® (MTB), an interdisciplinary, mentalization-based intervention in which home visiting services are provided by a team that includes a nurse practitioner and a clinical social worker. Families are recruited during mother's pregnancy and continue through the child's second birthday. Analyses revealed that intervention families were more likely to be on track with immunization schedules at 12 months, had lower rates of rapid subsequent childbearing, and were less likely to be referred to child protective services. In addition, mother-infant interactions were less likely to be disrupted at 4 months when mothers were teenagers, and all intervention infants were more likely to be securely attached, and less likely to be disorganized in relation to attachment at one year. Finally, mothers’ capacity to reflect on their own and their child's experience improved over the course of the intervention in the most high-risk mothers. PMID:24049219

  16. 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.

  17. Marketing home health care to health maintenance organizations.

    PubMed

    Shalowitz, J

    1987-01-01

    Home health care is a rapidly growing industry whose continued success depends upon expansion into new markets. One target market a successful company will need to reach is health maintenance organizations. The following article summarizes basic marketing strategies a home care company needs to follow in order to access such contracts.

  18. Home Visiting Programs: What the Primary Care Clinician Should Know.

    PubMed

    Finello, Karen Moran; Terteryan, Araksi; Riewerts, Robert J

    2016-04-01

    Responsibilities for primary care clinicians are rapidly expanding ascomplexities in families' lives create increased disparities in health and developmental outcomes for young children. Despite the demands on primary care clinicians to promote health in the context of complex family and community factors, most primary care clinicians are operating in an environment of limited training and a shortage of resources for supporting families. Partnerships with evidence-based home visiting programs for very young children and their families can provide a resource that will help to reduce the impact of adverse early childhood experiences and facilitate health equity. Home visiting programs in the United States are typically voluntary and designed to be preventative in nature, although families are usually offered services based on significant risk criteria since the costs associated with universal approaches have been considered prohibitive. Programs may be funded within the health (physical orbehavioral/mental health), child welfare, early education, or early intervention systems or by private foundation dollars focused primarily on oneof the above systems (e.g., health), with a wide range of outcomes targeted by the programs and funders. Services may be primarily focused on the child, the parent, or parent-child interactions. Services include the development of targeted and individualized intervention strategies, better coaching of parents, and improved modeling of interactions that may assist struggling families. This paper provides a broad overview ofthe history of home visiting, theoretical bases of home visiting programs, key components of evidence-based models, outcomes typically targeted, research on effectiveness, cost information, challenges and benefits of home visiting, and funding/sustainability concerns. Significance for primary care clinicians isdescribed specifically and information relevant for clinicians is emphasized throughout the paper. PMID:26872870

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

    MedlinePlus

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

  20. Engaging and Retaining Abused Women in Perinatal Home Visitation Programs

    PubMed Central

    Alhusen, Jeanne L.; Bullock, Linda; Bhandari, Shreya; Ghazarian, Sharon; Udo, Ifeyinwa E.; Campbell, Jacquelyn

    2013-01-01

    OBJECTIVES: Intimate partner violence (IPV) during pregnancy affects 0.9% to 17% of women and affects maternal health significantly. The impact of IPV extends to the health of children, including an increased risk of complications during pregnancy and the neonatal period, mental health problems, and cognitive delays. Despite substantial sequelae, there is limited research substantiating best practices for engaging and retaining high-risk families in perinatal home visiting (HV) programs, which have been shown to improve infant development and reduce maltreatment. METHODS: The Domestic Violence Enhanced Home Visitation Program (DOVE) is a multistate longitudinal study testing the effectiveness of a structured IPV intervention integrated into health department perinatal HV programs. The DOVE intervention, based on an empowerment model, combined 2 evidence-based interventions: a 10-minute brochure-based IPV intervention and nurse home visitation. RESULTS: Across all sites, 689 referrals were received from participating health departments. A total of 339 abused pregnant women were eligible for randomization; 42 women refused, and 239 women were randomly assigned (124 DOVE; 115 usual care), resulting in a 71% recruitment rate. Retention rates from baseline included 93% at delivery, 80% at 3 months, 76% at 6 months, and 72% at 12 months. CONCLUSIONS: Challenges for HV programs include identifying and retaining abused pregnant women in their programs. DOVE strategies for engaging and retaining abused pregnant women should be integrated into HV programs’ federal government mandates for the appropriate identification and intervention of women and children exposed to IPV. PMID:24187115

  1. The U.S. Army Telemedicine and m-Health Program: making a difference at home and abroad.

    PubMed

    Poropatich, Ronald; Lai, Eva; McVeigh, Francis; Bashshur, Rashid

    2013-05-01

    This article highlights the deployment of telemedicine by the U.S. Army through the various echelons of care and in overseas locations, including range and scope of health services provided by telemedicine in a challenging environment. This is followed by a discussion of technological developments advances in mobile communications likely to change the practice of telemedicine in the military from limited fixed-point access to a highly mobile individual with handheld communication devices.

  2. 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…

  3. 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...

  4. A Guide for Planning Competency-Based Institutional and Home Management Services Education in Home Economics Education Programs.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Education, Columbia. Office of Vocational Education.

    This guide is designed to help teachers, especially in South Carolina, develop an effective competency-based vocational education program in occupational home economics, with emphasis on home health aides or homemaker services for the elderly. The course covers the following topics: the aging process (biological aging, psychology of aging,…

  5. Cost-effectiveness implications based on a comparison of nursing home and home health case mix.

    PubMed

    Kramer, A M; Shaughnessy, P W; Pettigrew, M L

    1985-10-01

    Case-mix differences between 653 home health care patients and 650 nursing home patients, and between 455 Medicare home health patients and 447 Medicare nursing home patients were assessed using random samples selected from 20 home health agencies and 46 nursing homes in 12 states in 1982 and 1983. Home health patients were younger, had shorter lengths of stay, and were less functionally disabled than nursing home patients. Traditional long-term care problems requiring personal care were more common among nursing home patients, whereas problems requiring skilled nursing services were more prevalent among home health patients. Considering Medicare patients only, nursing home patients were much more likely to be dependent in activities of daily living (ADLs) than home health patients. Medicare nursing home and home health patients were relatively similar in terms of long-term care problems, and differences in medical problems were less pronounced than between all nursing home and all home health patients. From the standpoint of cost-effectiveness, it would appear that home health care might provide a substitute for acute care hospital use at the end of a hospital stay, and appears to be a more viable option in the care of patients who are not severely disabled and do not have profound functional problems. The Medicare skilled nursing facility, however, is likely to continue to have a crucial role in posthospital care as the treatment modality of choice for individuals who require both highly skilled care and functional assistance.

  6. 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...

  7. 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

  8. The premature infant home intervention program.

    PubMed

    Jones, S; Struk, C; Hack, M; Friedman, H

    1990-12-01

    The Premature Infant Home Intervention Program, a collaborative effort of the Visiting Nurse Association of Cleveland and Rainbow Babies and Children's Hospital of Cleveland, is designed to provide family support and medical surveillance for high-risk premature infants, to ensure post-discharge wellbeing, and improve survival outcome during the first years of life.

  9. Computerized documentation in home health.

    PubMed

    Noone, C; Cavanaugh, J; McKillip, C

    1995-01-01

    Computerized documentation in community health nursing is only now receiving the attention it deserves. The authors explain one agency's experience with adapting a computerized clinical documentation system to visiting nurses' needs and the nurses' responses to the process.

  10. Enhancing fire department home visiting programs: results of a community intervention trial.

    PubMed

    Gielen, Andrea C; Shields, Wendy; Frattaroli, Shannon; McDonald, Eileen; Jones, Vanya; Bishai, David; O'Brocki, Raymond; Perry, Elise C; Bates-Hopkins, Barbara; Tracey, Pat; Parsons, Stephanie

    2013-01-01

    This study evaluates the impact of an enhanced fire department home visiting program on community participation and installation of smoke alarms, and describes the rate of fire and burn hazards observed in homes. Communities were randomly assigned to receive either a standard or enhanced home visiting program. Before implementing the program, 603 household surveys were completed to determine comparability between the communities. During a 1-year intervention period, 171 home visits took place with 8080 homes. At baseline, 60% of homes did not have working smoke alarms on every level, 44% had unsafe water temperatures, and 72% did not have carbon monoxide alarms. Residents in the enhanced community relative to those in the standard community were significantly more likely to let the fire fighters into their homes (75 vs 62%). Among entered homes, those in the enhanced community were significantly more likely to agree to have smoke alarms installed (95 vs 92%), to be left with a working smoke alarm on every level of the home (84 vs 78%), and to have more smoke alarms installed per home visited (1.89 vs 1.74). The high baseline rates of home hazards suggest that fire department home visiting programs should take an "all hazards" approach. Community health workers and community partnerships can be effective in promoting fire departments' fire and life safety goals. Public health academic centers should partner with the fire service to help generate evidence on program effectiveness that can inform decision making about resource allocation for prevention. PMID:23237821

  11. A Home Visiting Asthma Education Program: Challenges to Program Implementation

    ERIC Educational Resources Information Center

    Brown, Josephine V.; Demi, Alice S.; Celano, Marianne P.; Bakeman, Roger; Kobrynski, Lisa; Wilson, Sandra R.

    2005-01-01

    This study describes the implementation of a nurse home visiting asthma education program for low-income African American families of young children with asthma. Of 55 families, 71% completed the program consisting of eight lessons. The achievement of learning objectives was predicted by caregiver factors, such as education, presence of father or…

  12. INTERFACING INFANT MENTAL HEALTH KNOWLEDGE SYSTEMS: REFLECTIONS ON THE NARRATIVES OF LAY HOME VISITORS' EXPERIENCES OF LEARNING AND APPLYING RELATIONAL CONCEPTS OF DEVELOPMENT IN A SOUTH AFRICAN INTERVENTION PROGRAM.

    PubMed

    Baradon, Tessa; Bain, Katherine

    2016-07-01

    The question of interfacing research and clinically generated knowledge in the field of infant mental health (IMH) with local cultural knowledge and belief systems has provoked extended discussion in recent years. This article explores convergences and divergences between current research-based, relational IMH mental health models and "community" knowledge held by a group of South African lay home visitors from a socioeconomically deprived township. These women were trained in a psychoanalytic and attachment-informed infant mental health program that promotes a relational model of infant development. They provide an intervention that supports high risk mother-infant relationships in the same locality. A two-tiered approach was taken to the analysis of the home visitor interviews and focused on the home visitors' constructed narratives of infant development posttraining as well as the personal impact of the training and work on the home visitors themselves. The study found that psychoanalytic and attachment-informed thinking about development makes sense to those operating within the local South African cultural context, but that the accommodation of this knowledge is a complex and challenging process.

  13. INTERFACING INFANT MENTAL HEALTH KNOWLEDGE SYSTEMS: REFLECTIONS ON THE NARRATIVES OF LAY HOME VISITORS' EXPERIENCES OF LEARNING AND APPLYING RELATIONAL CONCEPTS OF DEVELOPMENT IN A SOUTH AFRICAN INTERVENTION PROGRAM.

    PubMed

    Baradon, Tessa; Bain, Katherine

    2016-07-01

    The question of interfacing research and clinically generated knowledge in the field of infant mental health (IMH) with local cultural knowledge and belief systems has provoked extended discussion in recent years. This article explores convergences and divergences between current research-based, relational IMH mental health models and "community" knowledge held by a group of South African lay home visitors from a socioeconomically deprived township. These women were trained in a psychoanalytic and attachment-informed infant mental health program that promotes a relational model of infant development. They provide an intervention that supports high risk mother-infant relationships in the same locality. A two-tiered approach was taken to the analysis of the home visitor interviews and focused on the home visitors' constructed narratives of infant development posttraining as well as the personal impact of the training and work on the home visitors themselves. The study found that psychoanalytic and attachment-informed thinking about development makes sense to those operating within the local South African cultural context, but that the accommodation of this knowledge is a complex and challenging process. PMID:27186854

  14. Introductory Epidemiology. An Instructor Resource Guide. Appendix to a Final Report on the Paraprofessional Rurally Oriented Family Home Health Training Program.

    ERIC Educational Resources Information Center

    Best, Stephen H.; Myer, Donna Foster

    This instructor's resource guide, one in a series of products from a project to develop an associate degree program for paraprofessional rural family health promoters, deals with teaching a course in introductory epidemiology. Covered in the first section of the guide are the role of epidemiology in rural health promotional training, general…

  15. Chemistry for the Life Sciences. An Instructor Resource Guide. Appendix to a Final Report on the Paraprofessional Rurally Oriented Family Home Health Training Program.

    ERIC Educational Resources Information Center

    Odom, H. Clyde; Myer, Donna Foster

    This instructor's resource guide, one in a series of products from a project to develop an associate degree program for paraprofessional rural family health promoters, deals with teaching chemistry for the life sciences. Covered in the first section of the volume are the role of chemistry in rural health promotional training, general objectives…

  16. Evaluating Fidelity in Home-Visiting Programs a Qualitative Analysis of 1058 Home Visit Case Notes from 105 Families

    PubMed Central

    Saïas, Thomas; Lerner, Emilie; Greacen, Tim; Simon-Vernier, Elodie; Emer, Alessandra; Pintaux, Eléonore; Guédeney, Antoine; Dugravier, Romain; Tereno, Susana; Falissard, Bruno; Tubach, Florence; Revah-Levy, Anne

    2012-01-01

    Objective Implementation fidelity is a key issue in home-visiting programs as it determines a program’s effectiveness in accomplishing its original goals. This paper seeks to evaluate fidelity in a 27-month program addressing maternal and child health which took place in France between 2006 and 2011. Method To evaluate implementation fidelity, home visit case notes were analyzed using thematic qualitative and computer-assisted linguistic analyses. Results During the prenatal period, home visitors focused on the social components of the program. Visitors discussed the physical changes in pregnancy, and psychological and social environment issues. Discussing immigration, unstable employment and financial related issues, family relationships and dynamics and maternity services, while not expected, were found in case notes. Conversely, health during pregnancy, early child development and postpartum mood changes were not identified as topics within the prenatal case notes. During the postnatal period, most components of the intervention were addressed: home visitors observed the mother’s adaptation to the baby; routine themes such as psychological needs and medical-social networks were evaluated; information on the importance of social support and on adapting the home environment was given; home visitors counseled on parental authority, and addressed mothers’ self-esteem issues; finally, they helped to find child care, when necessary. Some themes were not addressed or partially addressed: health education, child development, home environment, mother’s education plans and personal routine, partner support and play with the child. Other themes were not expected, but found in the case notes: social issues, mother-family relationship, relation with services, couple issues, quality of maternal behavior and child’s language development. Conclusions In this program, home visitors experienced difficulties addressing some of the objectives because they gave precedence

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

    PubMed

    Heeke, Sheila; Wood, Felecia; Schuck, Jennifer

    2014-01-01

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

  18. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  19. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 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...

  20. 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...

  1. 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...

  2. 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...

  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. 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

  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. 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

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for home health agency services. 413.125 Section 413.125 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL...

  8. 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; Prohibition on FFP. 441.16 Section 441.16 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS...

  9. Constraining Medicare Home Health Reimbursement: What Are the Outcomes?

    PubMed Central

    McCall, Nelda; Korb, Jodi; Petersons, Andrew; Moore, Stanley

    2002-01-01

    The implementation of the Balanced Budget Act (BBA) of 1997 resulted in substantial decreases in the amount of Medicare home health use. Use among home health users decreased by two-fifths from fiscal year (FY) 1997, just before the passage of the BBA to FY 1999, the first full year after the implementation of the home health interim payment system. This article examines whether these dramatic reductions in use resulted in increased incidence of potential adverse outcomes, i.e., increases in hospitalizations, skilled nursing home facility admissions, emergency room (ER) use, or death among home health users. PMID:12690695

  10. 77 FR 75441 - Healthy Home and Lead Hazard Control Grant Programs Data Collection; Progress Reporting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-20

    ... URBAN DEVELOPMENT Healthy Home and Lead Hazard Control Grant Programs Data Collection; Progress... progress of Healthy Homes Demonstration Program, Healthy Homes Technical Studies Program, Lead Base paint Hazard Control program, Lead Hazard Reduction Demonstration Program, Lead Outreach Program,...

  11. Home Visiting Family Support Programs: Benefits of the Maternal, Infant, and Early Childhood Home Visiting Program. Fact Sheet

    ERIC Educational Resources Information Center

    Home Visiting Campaign, 2015

    2015-01-01

    The federally funded, locally administered Maternal, Infant, and Early Childhood Home Visiting Program sponsors family support programs that are often called "home visiting" because they take place in the homes of at-risk families. These families often lack support, experience, and knowledge of basic parenting skills. Because children…

  12. Home Delivery Medicament Program: access, inactivity and cardiovascular risk 1

    PubMed Central

    Araújo, Roque da Silva; Arcuri, Edna Apparecida Moura; Lopes, Victor Cauê

    2016-01-01

    ABSTRACT Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. Conclusions: due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (s)he stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample), diabetic (44%) and dyslipidemic patients (31%). PMID:27737378

  13. Practical guide on home health in heart failure patients

    PubMed Central

    Jaarsma, Tiny; Larsen, Torben; Strömberg, Anna

    2013-01-01

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

  14. Medicare, Medicaid, and Children's Health Insurance Programs: announcement of the extended temporary moratoria on enrollment of ambulance suppliers and home health agencies in designated geographic locations. Extension of temporary moratoria.

    PubMed

    2014-08-01

    This document announces the extension of temporary moratoria on the enrollment of new ambulance suppliers and home health agencies (HHAs) in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse.

  15. MENTAL HEALTH PROGRAM.

    ERIC Educational Resources Information Center

    CHAMBERLAIN, IDA

    WEST VIRGINIA IS A RURAL STATE HAVING A LARGE POVERTY STRICKEN POPULATION. SINCE THIS GROUP HAD NO ACCESS TO MENTAL HEALTH SERVICES, THE STATE DEPARTMENT OF MENTAL HEALTH SPONSORED A VISTA PROGRAM IN MENTAL HEALTH AND MENTAL RETARDATION, AND ENCOURAGED THE VOLUNTEERS TO USE THEIR OWN CREATIVITY AND INGENUITY IN PROVIDING SUCH SERVICES AS--(1)…

  16. Health Promotion Program.

    ERIC Educational Resources Information Center

    McClary, Cheryl

    The Health Promotion Program began with establishment of a one-credit course in health promotion and wellness and the training of family practice residents at the Mountain Area Health Education Center to serve as lab leaders in the course. The course later became part of the university's general education requirements. In addition, a health…

  17. Impact of a Kentucky Maternal, Infant, and Early Childhood Home-Visitation Program on Parental Risk Factors

    ERIC Educational Resources Information Center

    Ferguson, Jonnisa M.; Vanderpool, Robin C.

    2013-01-01

    As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families' participation in a home-visitation program offered by a central Kentucky…

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

    PubMed

    Freitag, E M

    1988-06-01

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

  19. 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

  20. Cathy Zoi on the new Home Energy Score pilot program

    ScienceCinema

    Zoi, Cathy

    2016-07-12

    Acting Under Secretary Cathy Zoi talks about the new Home Energy Score pilot program that was announced today by Vice President Biden and U.S. Department of Energy Secretary Steven Chu. The Home Energy Score will offer homeowners straightforward, reliable information about their homes' energy efficiency. A report provides consumers with a home energy score between 1 and 10, and shows them how their home compares to others in their region. The report also includes customized, cost-effective recommendations that will help to reduce their energy costs and improve the comfort of their homes.

  1. Cathy Zoi on the new Home Energy Score pilot program

    SciTech Connect

    Zoi, Cathy

    2011-01-01

    Acting Under Secretary Cathy Zoi talks about the new Home Energy Score pilot program that was announced today by Vice President Biden and U.S. Department of Energy Secretary Steven Chu. The Home Energy Score will offer homeowners straightforward, reliable information about their homes' energy efficiency. A report provides consumers with a home energy score between 1 and 10, and shows them how their home compares to others in their region. The report also includes customized, cost-effective recommendations that will help to reduce their energy costs and improve the comfort of their homes.

  2. Using TQM to improve management of home health aides.

    PubMed

    Dansky, K H; Brannon, D

    1996-12-01

    Home health aides are at the front line of the home health industry, raising quality of care issues and human resource (HR) management challenges. Total quality management (TQM) provides a framework to help meet those challenges. The authors investigated the relationship between TQM and HR effectiveness in home health agencies. Results suggest that TQM practices are related to HR effectiveness. Suggestions are offered to make human resource management consistent with a TQM culture.

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

    PubMed

    2008-01-01

    current systems of oral health care delivery and payment throughout the state. The team also studied the oral health status of Texans in general and analyzed the oral health disparities that exist in the state. Finally, the ERB made specific and practical policy recommendations to expand access to oral health care in Texas, including: 1) Identifying a "dental home" for every Texan. 2) Strengthening the Texas Department of State Health Services (DSHS) Oral Health Program (OHP). 3) Creating new programs to encourage general dentists and specialists to practice in underserved areas and to treat underserved populations. 4) Developing a comprehensive oral health public awareness and education campaign. 5) Expanding access to oral health services for older Texans. As the face of Texas continues to change, the state must put in place a new, more aggressive strategy to improve access to oral health care. This challenge must be approached as a shared responsibility--among dentists, allied health professionals, primary care providers, policymakers, community-based organizations, parents and schools. The job is too big--and too important--for any one group to try to tackle alone. The time to act is now. PMID:19363885

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

    PubMed

    2008-01-01

    current systems of oral health care delivery and payment throughout the state. The team also studied the oral health status of Texans in general and analyzed the oral health disparities that exist in the state. Finally, the ERB made specific and practical policy recommendations to expand access to oral health care in Texas, including: 1) Identifying a "dental home" for every Texan. 2) Strengthening the Texas Department of State Health Services (DSHS) Oral Health Program (OHP). 3) Creating new programs to encourage general dentists and specialists to practice in underserved areas and to treat underserved populations. 4) Developing a comprehensive oral health public awareness and education campaign. 5) Expanding access to oral health services for older Texans. As the face of Texas continues to change, the state must put in place a new, more aggressive strategy to improve access to oral health care. This challenge must be approached as a shared responsibility--among dentists, allied health professionals, primary care providers, policymakers, community-based organizations, parents and schools. The job is too big--and too important--for any one group to try to tackle alone. The time to act is now.

  5. Home Health Care With Telemonitoring Improves Health Status for Older Adults with Heart Failure

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2012-01-01

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

  7. The Medical Home: Every Child Deserves One! Program Services Paper.

    ERIC Educational Resources Information Center

    Vitaglione, Tom

    Noting that health benefits for children should be one of the principal goals of comprehensive early childhood initiatives, this Smart Start brochure provides information on "medical homes" and their importance to the overall health of children; the brochure also describes community strategies to help promote a medical home for all children. The…

  8. A Boarding Home Program for Handicapped Children. A Manual.

    ERIC Educational Resources Information Center

    Melcher, John W.

    The manual discusses the Wisconsin boarding home program for handicapped children who live too far from special programs to commute daily. During the school week, the child lives with boarding home parents, who are paid by the Division for Handicapped Children's Services through the local school board. Explained are the child's needs (physical and…

  9. Community Service Program in Foster Home Management and Creative Arts.

    ERIC Educational Resources Information Center

    Rhode Island Univ., Kingston.

    A training program for prospective foster home operators and volunteer workers with creative arts was held in the fall of 1968 and again in the spring of 1969 under the joint sponsorship of the Program in Gerontology of the University of Rhode Island, the Cooperative Extension Service, and the Rhode Island Medical Center. The foster homes under…

  10. 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

  11. Enhancing Fire Department Home Visiting Programs: Results of a Community Intervention Trial

    PubMed Central

    Gielen, Andrea C.; Shields, Wendy; Frattaroli, Shannon; McDonald, Eileen; Jones, Vanya; Bishai, David; O’Brocki, Raymond; Perry, Elise C.; Bates-Hopkins, Barbara; Tracey, Pat; Parsons, Stephanie

    2012-01-01

    Background This study evaluates the impact of an enhanced fire department home visiting program on community participation and installation of smoke alarms and describes the rate of fire and burn hazards observed in homes. Methods Communities were randomly assigned to receive either a standard or enhanced home visiting program. Prior to implementing the program, 603 household surveys were completed to determine comparability between the communities. During a one year intervention period, 171 home visit events took place with 8,080 homes. Results At baseline, 60% of homes did not have working smoke alarms on every level; 44% had unsafe water temperatures; and 72% did not have CO alarms. Residents in the enhanced community relative to those in the standard community were significantly more likely to let the fire fighters into their homes (75% vs 62%). Among entered homes, those in the enhanced community were significantly more likely to agree to have smoke alarms installed (95% vs 92%), to be left with a working smoke alarm on every level of the home (84% vs 78%) and to have more smoke alarms installed per home visited (1.89 vs 1.74). Conclusions The high baseline rates of home hazards suggest that fire department home visiting programs should take an “all hazards” approach. CHWs and other community partnerships can be effective in promoting fire departments’ fire and life safety goals. Public health academic centers should partner with the fire service to help generate evidence on program effectiveness that can inform decision making about resource allocation for prevention. PMID:23237821

  12. Is home health care a substitute for hospital care?

    PubMed

    Lichtenberg, Frank R

    2012-01-01

    A previous study used aggregate (region-level) data to investigate whether home health care serves as a substitute for inpatient hospital care and concluded that "there is no evidence that services provided at home replace hospital services." However, that study was based on a cross-section of regions observed at a single point of time and did not control for unobserved regional heterogeneity. In this article, state-level employment data are used to reexamine whether home health care serves as a substitute for inpatient hospital care. This analysis is based on longitudinal (panel) data--observations on states in two time periods--which enable the reduction or elimination of biases that arise from use of cross-sectional data. This study finds that states that had higher home health care employment growth during the period 1998-2008 tended to have lower hospital employment growth, controlling for changes in population. Moreover, states that had higher home health care payroll growth tended to have lower hospital payroll growth. The estimates indicate that the reduction in hospital payroll associated with a $1,000 increase in home health payroll is not less than $1,542, and may be as high as $2,315. This study does not find a significant relationship between growth in utilization of home health care and growth in utilization of nursing and residential care facilities. An important reason why home health care may serve as a substitute for hospital care is that the availability of home health care may allow patients to be discharged from the hospital earlier. Hospital discharge data from the Healthcare Cost and Utilization Project are used to test the hypothesis that use of home health care reduces the length of hospital stays. Major Diagnostic Categories with larger increases in the fraction of patients discharged to home health care tended to have larger declines in mean length of stay (LOS). Between 1998 and 2008, mean LOS declined by 4.1%, from 4.78 to 4.59 days

  13. Is home health care a substitute for hospital care?

    PubMed

    Lichtenberg, Frank R

    2012-01-01

    A previous study used aggregate (region-level) data to investigate whether home health care serves as a substitute for inpatient hospital care and concluded that "there is no evidence that services provided at home replace hospital services." However, that study was based on a cross-section of regions observed at a single point of time and did not control for unobserved regional heterogeneity. In this article, state-level employment data are used to reexamine whether home health care serves as a substitute for inpatient hospital care. This analysis is based on longitudinal (panel) data--observations on states in two time periods--which enable the reduction or elimination of biases that arise from use of cross-sectional data. This study finds that states that had higher home health care employment growth during the period 1998-2008 tended to have lower hospital employment growth, controlling for changes in population. Moreover, states that had higher home health care payroll growth tended to have lower hospital payroll growth. The estimates indicate that the reduction in hospital payroll associated with a $1,000 increase in home health payroll is not less than $1,542, and may be as high as $2,315. This study does not find a significant relationship between growth in utilization of home health care and growth in utilization of nursing and residential care facilities. An important reason why home health care may serve as a substitute for hospital care is that the availability of home health care may allow patients to be discharged from the hospital earlier. Hospital discharge data from the Healthcare Cost and Utilization Project are used to test the hypothesis that use of home health care reduces the length of hospital stays. Major Diagnostic Categories with larger increases in the fraction of patients discharged to home health care tended to have larger declines in mean length of stay (LOS). Between 1998 and 2008, mean LOS declined by 4.1%, from 4.78 to 4.59 days

  14. Diversion, transition programs target nursing homes' status quo.

    PubMed

    Reinhard, Susan C

    2010-01-01

    As millions of Americans age and exercise their preference for long-term care in the least restrictive environment, policymakers search for ways to increase community-based services. A new federal program--Money Follows the Person--is off to a slow but promising start. The program's "downstream" approach moves residents out of nursing homes and into community care settings. For example, states with mature nursing home transition programs have managed to relocate 25-35 percent of their nursing home residents to assisted living. Other programs successfully using "upstream" strategies to keep people out of nursing homes have not been widely copied. The challenge for policymakers is to maintain funding and flexibility so that nursing homes are no longer the default option for older adults and people with disabilities.

  15. 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.

  16. 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…

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

    ERIC Educational Resources Information Center

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

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

  18. 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…

  19. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Moratoria-Designated Geographic Locations. Implementation of the waiver demonstration.

    PubMed

    2016-08-01

    This notice announces the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in 6 states. The demonstration is being implemented in accordance with section 402 of the Social Security Amendments of 1967 and gives CMS the authority to grant waivers to the statewide enrollment moratoria on a case-by-case basis in response to access to care issues, and to subject providers and suppliers enrolling via such waivers to heightened screening, oversight, and investigations. PMID:27487580

  20. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Moratoria-Designated Geographic Locations. Implementation of the waiver demonstration.

    PubMed

    2016-08-01

    This notice announces the Provider Enrollment Moratoria Access Waiver Demonstration of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in 6 states. The demonstration is being implemented in accordance with section 402 of the Social Security Amendments of 1967 and gives CMS the authority to grant waivers to the statewide enrollment moratoria on a case-by-case basis in response to access to care issues, and to subject providers and suppliers enrolling via such waivers to heightened screening, oversight, and investigations.

  1. Home Visitation Programs: Critical Issues and Future Directions

    ERIC Educational Resources Information Center

    Azzi-Lessing, Lenette

    2011-01-01

    As support for intervening early in the lives of vulnerable children has risen in the United States in recent years, so has interest in home-visitation programs. Home visitation is increasingly recognized for its potential to foster early child development and competent parenting, as well as to reduce risk for child abuse and neglect and other…

  2. Paraprofessionals in Home Economics Programs for Low-Income Families.

    ERIC Educational Resources Information Center

    Leidenfrost, Nancy B.; And Others

    This booklet was developed as a guide for home economists who are responsible for teaching paraprofessionals (individuals who usually have no college degree and are trained and supervised by county home economists) how to teach low-income families. The content is in seven short sections: (1) Planning the Program discusses available resources,…

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

    PubMed

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

    2014-02-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Gupta, Milon; Chotard, Laure; Ingþórsson, Ólafur; Bastos, João; Borges, Isabel

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

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

    PubMed

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

    1994-01-01

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

  7. Home Performance with ENERGY STAR: Utility Bill Analysis on Homes Participating in Austin Energy's Program

    SciTech Connect

    Belzer, D.; Mosey, G.; Plympton, P.; Dagher, L.

    2007-07-01

    Home Performance with ENERGY STAR (HPwES) is a jointly managed program of the U.S. Department of Energy (DOE) and the U.S. Environmental Protection Agency (EPA). This program focuses on improving energy efficiency in existing homes via a whole-house approach to assessing and improving a home's energy performance, and helping to protect the environment. As one of HPwES's local sponsors, Austin Energy's HPwES program offers a complete home energy analysis and a list of recommendations for efficiency improvements, along with cost estimates. To determine the benefits of this program, the National Renewable Energy Laboratory (NREL) collaborated with the Pacific Northwest National Laboratory (PNNL) to conduct a statistical analysis using energy consumption data of HPwES homes provided by Austin Energy. This report provides preliminary estimates of average savings per home from the HPwES Loan Program for the period 1998 through 2006. The results from this preliminary analysis suggest that the HPwES program sponsored by Austin Energy had a very significant impact on reducing average cooling electricity for participating households. Overall, average savings were in the range of 25%-35%, and appear to be robust under various criteria for the number of households included in the analysis.

  8. Promoting infant health through home visiting by a nurse-managed community worker team.

    PubMed

    Barnes-Boyd, C; Fordham Norr, K; Nacion, K W

    2001-01-01

    This article describes the Resources, Education and Care in the Home program (REACH-Futures), an infant mortality reduction initiative in the inner city of Chicago built on the World Health Organization (WHO) primary health care model and over a decade of experience administering programs to reduce infant mortality through home visits. The program uses a nurse-managed team, which includes community residents selected, trained, and integrated as health advocates. Service participants were predominately African American families. All participants were low-income and resided in inner-city neighborhoods with high unemployment, high teen birth rates, violent crime, and deteriorated neighborhoods. Outcomes for the first 666 participants are compared to a previous home-visiting program that used only nurses. Participant retention rates were equivalent overall and significantly higher in the first months of the REACH-Futures program. There were two infant deaths during the course of the study, a lower death rate than the previous program or the city. Infant health problems and developmental levels were equivalent to the prior program and significantly more infants were fully immunized at 12 months. The authors conclude that the use of community workers as a part of the home-visiting team is as effective as the nurse-only team in meeting the needs of families at high risk of poor infant outcomes. This approach is of national interest because of its potential to achieve the desired outcomes in a cost-effective manner.

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

    PubMed

    Richardson, C

    1995-08-01

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

  10. 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…

  11. Impact of a Home Leisure Educational Program for Older Adults Who Have Had a Stroke (Home Leisure Educational Program).

    ERIC Educational Resources Information Center

    Nour, Kareen; Desrosiers, Johanne; Gauthier, Pierre; Carbonneau, Helene

    2002-01-01

    Examined the effectiveness of leisure education for older adults having difficulty adjusting psychologically after a stroke. Participants received either an experimental home leisure education program (intervention group) or a friendly home visit (control group) after discharge from rehabilitation. The intervention group performed significantly…

  12. Overview of Home Health Aides: United States, 2007

    MedlinePlus

    ... 56.1%) valued their work very much. Aides’ perceptions of the three groups’ value of their work ... Aide Survey, 2007. Figure 3. Home health aides’ perception of how others value their work: United States, ...

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  14. 42 CFR 484.245 - Accelerated payments for home health agencies.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    PubMed Central

    2015-01-01

    Background An increasing amount of health care is now performed in a home setting, away from the hospital. While there is growing anecdotal evidence about the difficulty patients and caregivers have using increasingly complex health care devices in the home, there has been little systematic scientific study to quantify the global nature of home health care device usability in the field. Research has tended to focus on a handful of devices, making it difficult to gain a broad view of the usability of home-care devices in general. Objective The objective of this paper is to describe a remote usability assessment method using the System Usability Scale (SUS), and to report on the usability of a broad range of health care devices using this metric. Methods A total of 271 participants selected and rated up to 10 home health care devices of their choice using the SUS, which scores usability from 0 (unusable) to 100 (highly usable). Participants rated a total of 455 devices in their own home without an experimenter present. Results Usability scores ranged from 98 (oxygen masks) to 59 (home hormone test kits). An analysis conducted on devices that had at least 10 ratings showed that the effect of device on SUS scores was significant (P<.001), and that the usability of these devices was on the low end when compared with other commonly used items in the home, such as microwave ovens and telephones. Conclusions A large database of usability scores for home health care devices collected using this remote methodology would be beneficial for physicians, patients, and their caregivers. PMID:27025664

  16. The Health Educator Aide Program for Ghetto Areas.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Cincinnati, OH.

    The Health Educator Program provides for indigenous personnel as communication links with residents of urban slums; they visit the homes and teach basic principles of cleanliness and health. Frequently their work involves relationships between landlord and tenant or cooperation with other city departments. A pioneer program in Chicago was so…

  17. Accessibility of Special Education Program Home Pages.

    ERIC Educational Resources Information Center

    Flowers, Claudia P.; Bray, Marty; Algozzine, Robert F.

    1999-01-01

    Eighty-nine special education Web sites were evaluated for accessibility errors. Most (73 percent) special education home pages had accessibility problems, and the majority of these errors severely limited access for individuals with disabilities. The majority of the errors can be easily corrected. Recommendations and methods for improving…

  18. Home Start: How a Home-Based Preschool Program Raised Black Achievements.

    ERIC Educational Resources Information Center

    Scott, Ralph

    This presentation discusses longitudinal results of a home-based program for low SES black and white children whose parents received weekly visits designed to chart children's individualized enrichment when they were from 2 to 5 years of age. The program drew upon school and community resource personnel when appropriate, to provide parents with…

  19. Issues and opportunities in the regulation of home health care.

    PubMed

    Spiegel, A D; Hyman, H H; Gary, L R

    1980-10-01

    Recent federal legislation established a Certificate of Need (CON) process by which health care providers must receive state approval before building or renovating a facility, or adding a new service. Certainly, strict regulation of cost and quality of home health care is needed, but it is asserted that CON is an ineffective way of organizing the delivery of services and limiting costs, and furthermore, that CON is biased in favor of institutionally-based providers and maintenance of the status quo. The authors feel that vested interests have a history of trying to use earlier state CON regulations to control their turf, limit competition, and consequently stifle innovation. Home health care should be incorporated into national health planning goals and integrated into state and regional health plans. Such planning must precede CON regulations and should not be confused with it. Alternatives to CON can achieve quality service and moderate costs and include licensing of personnel, standards for provider accreditation, and utilization review. Planning for these alternatives should begin now to avoid fragmented expansion of home health care. Evidence suggests a comprehensive use of home health care as a cost-effective alternative for many levels of care given in hospitals and nursing homes.

  20. Training Home Economics Program Assistants to Work with Low Income Families.

    ERIC Educational Resources Information Center

    Rouls, Janalyce; And Others

    These materials are designed to present ideas for developing a program for training nonprofessional workers to help low income families to raise their aspirations, develop pride in homemaking, improve homemaking skills, have a more satisfying home and family life, improve the health of family members, gain knowledge to help children develop, and…

  1. The SKI*HI Model: Programming for Hearing Impaired Infants through Home Intervention, Home Visit Curriculum. Fourth Edition.

    ERIC Educational Resources Information Center

    Clark, Thomas C.; Watkins, Susan

    The manual describes the SKI*HI Model, a comprehensive approach to identification and home intervention treatment of hearing impaired children and their families. The model features home programing in four basic areas: the home hearing aid program (nine lessons which facilitate the proper fit and acceptance of amplification by the child), home…

  2. Home-Based Programs: Nightmare or Dream of the Future.

    ERIC Educational Resources Information Center

    Levenstein, Phyllis

    This essay discusses methodological and ethical problems in the implementation and evaluation of home-based intervention programs for young children and their families. Part I notes the difficulties in (1) selecting an appropriate research design to evaluate a program (e.g., preventing sample bias), (2) specifying precisely the intervention method…

  3. Dimensions of Parental Engagement in Home Visiting Programs: Exploratory Study

    ERIC Educational Resources Information Center

    Wagner, M.; Spiker, D.; Inman Linn, M.; Gerlach-Downie, S.; Hernandez, F.

    2003-01-01

    A randomized trial of the multisite evaluation of the Parents as Teachers home visiting program indicated significant attrition from program services and wide variation in participation and involvement of the families. This exploratory study of parental engagement reflects a growing emphasis in the field on research related to implementation…

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

    PubMed

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

    2003-01-01

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

  5. Medicare Interim Payment System's Impact on Medicare Home Health Utilization

    PubMed Central

    Liu, Korbin; Long, Sharon K.; Dowling, Krista

    2003-01-01

    The Medicare home health interim payment system (IPS) implemented in fiscal year 1998 provided very strong incentives for home health agencies (HHAs) to reduce the number of visits provided to each Medicare user and to avoid those beneficiaries whose Medicare plan of care was likely to exceed the average beneficiary cost limit. We analyzed multiple years of data from the Medicare Current Beneficiary Survey (MCBS) to examine how the IPS affected subgroups of the Medicare population by health and socioeconomic characteristics. We found that the IPS strongly reduced overall utilization, but that few subgroups were disproportionately affected. PMID:14997695

  6. A closer look at opportunities in home health markets.

    PubMed

    Altman, K E

    1987-01-01

    The home health market is one of the health industry's fastest growing segments. Cost containment initiatives, competition, and governmental controls have been the dominant forces shaping this rapidly changing market, and observers predict that this will be the case for years to come. Its popularity as a growth industry has produced a rush of new entrants, many experiencing vastly different outcomes. Several otherwise formidable newcomers have already succumbed and others are in jeopardy of stumbling. Long established home health agencies must adapt their mission and strategies or suffer the same fate as the newcomers. However, with proper market research and careful planning, there are excellent opportunities for growth and profit in the home health market.

  7. Stepping Stones To Using "Caring for Our Children": National Health and Safety Performance Standards for Out-of-Home Child Care Programs. Protecting Children from Harm.

    ERIC Educational Resources Information Center

    Colorado Univ. Health Sciences Center, Denver.

    Developed in support of state licensing and regulatory agencies as well as state child care, health, and resource and referral agencies, and a variety of other public and private organizations, parents, and advocacy groups, this guide identifies those standards most needed for the prevention of injury, morbidity, and mortality in child care…

  8. 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…

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

    PubMed

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

    1993-03-01

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

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

    ERIC Educational Resources Information Center

    Starrett, Richard A.; And Others

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

  11. Feasibility and compliance studies of a home measurement monitoring program for cystic fibrosis.

    PubMed

    Finkelstein, S M; Budd, J R; Warwick, W J; Kujawa, S J; Wielinski, C L; Ewing, L B

    1986-01-01

    A home measurement monitoring system has been developed for assessing progress and planning changes in care for patients with cystic fibrosis. Daily diary recording of specified measurements, quantitative symptom data, and free text are to be used for early detection of deteriorating trends before serious complications develop. Daily measurements made at home are lung capacity, body weight, breathing rate, and pulse. The program has been in place for the past two years, and has maintained a 75-80% consistent diary response rate among the 111 patients initially committed to the program. Measurements are easy to perform, equipment design is simple and rugged, and data handling routines designed for the program using the INSIGHT clinical data base system perform satisfactorily. Checking for data entry errors and validity checks of home measurements are a regular part of the data handling activity. Patient acceptance and long-term compliance in this program agrees very favorably with reports of other diary programs in chronic disease. Diary compliance was significantly greater among younger patients and those who lived long distances from the hospital. This study has demonstrated that home monitoring is a feasible program for patients with cystic fibrosis. It presents the possibility of detecting adverse health trends earlier than is now practical, so that patients can be treated before serious complications develop, thereby preventing the large fluctuations in health status that often accompany CF.

  12. 42 CFR 484.36 - Condition of participation: Home health aide services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Furnishing of... health aide”. (a) Standard: Home health aide training—(1) Content and duration of training. The aide... health aide services offered by an HHA must be provided by a qualified home health aide. (d)...

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Furnishing of... health aide”. (a) Standard: Home health aide training—(1) Content and duration of training. The aide... health aide services offered by an HHA must be provided by a qualified home health aide. (d)...

  14. 42 CFR 484.36 - Condition of participation: Home health aide services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Furnishing of... health aide”. (a) Standard: Home health aide training—(1) Content and duration of training. The aide... health aide services offered by an HHA must be provided by a qualified home health aide. (d)...

  15. 42 CFR 484.36 - Condition of participation: Home health aide services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Furnishing of... health aide”. (a) Standard: Home health aide training—(1) Content and duration of training. The aide... health aide services offered by an HHA must be provided by a qualified home health aide. (d)...

  16. 42 CFR 484.36 - Condition of participation: Home health aide services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION HOME HEALTH SERVICES Furnishing of... health aide”. (a) Standard: Home health aide training—(1) Content and duration of training. The aide... health aide services offered by an HHA must be provided by a qualified home health aide. (d)...

  17. A home health care approach to exercise for persons with Alzheimer's disease.

    PubMed

    Logsdon, Rebecca G; McCurry, Susan M; Teri, Linda

    2005-01-01

    Regular exercise is a mainstay of preventive health care for individuals of all ages. Research with older adults has shown that exercise reduces risk of chronic illness, maintains mobility and function, enhances mood, and may even improve cognitive function. For individuals with dementia, exercise programs are particularly likely to improve health, mood, and quality of life; the challenge at this time is to make exercise accessible and enjoyable, demonstrate its benefits, and convince family caregivers of its worth for individuals with dementia. Home health providers are uniquely positioned to assist caregivers in developing and implementing a home exercise program for their care recipient with dementia. Results of a controlled critical trial conducted at the University of Washington have demonstrated the feasibility and efficacy of a home health exercise and problem solving intervention (Reducing Disability in Alzheimer's Disease, or RDAD) for decreasing physical, psychological, and behavioral disabilities associated with dementia. This article describes the RDAD program, discusses the role of home health providers in its delivery, and provides an example of its implementation.

  18. Effectiveness of home visiting programs on child outcomes: a systematic review

    PubMed Central

    2013-01-01

    Background The effectiveness of paraprofessional home-visitations on improving the circumstances of disadvantaged families is unclear. The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families. Methods A comprehensive search of electronic databases (e.g., CINAHL PLUS, Cochrane, EMBASE, MEDLINE) from 1990 through May 2012 was supplemented by reference lists to search for relevant studies. Through the use of reliable tools, studies were assessed in duplicate. English language studies of paraprofessional home-visiting programs assessing specific outcomes for children (0-6 years) from disadvantaged families were eligible for inclusion in the review. Data extraction included the characteristics of the participants, intervention, outcomes and quality of the studies. Results Studies that scored 13 or greater out of a total of 15 on the validity tool (n = 21) are the focus of this review. All studies are randomized controlled trials and most were conducted in the United States. Significant improvements to the development and health of young children as a result of a home-visiting program are noted for particular groups. These include: (a) prevention of child abuse in some cases, particularly when the intervention is initiated prenatally; (b) developmental benefits in relation to cognition and problem behaviours, and less consistently with language skills; and (c) reduced incidence of low birth weights and health problems in older children, and increased incidence of appropriate weight gain in early childhood. However, overall home-visiting programs are limited in improving the lives of socially high-risk children who live in disadvantaged families. Conclusions Home visitation by paraprofessionals is an intervention that holds promise for socially high-risk families with young children. Initiating the intervention prenatally and

  19. Regional, Rural Home ABE Program Spells Impact.

    ERIC Educational Resources Information Center

    Vachon, Claude

    Maine's State Division of Adult Education began setting up a regionalized Adult Basic Education (ABE) program in rural Franklin county in 1974 to serve the area's functional illiterates. Located in the building housing the Franklin County Community Action Program (CAP), linkages were developed with a large number of agencies; initially the 10 CAP…

  20. Preliminary Data on a Care Coordination Program for Home Care Recipients.

    PubMed

    Dean, Katie M; Hatfield, Laura A; Jena, Anupam B; Cristman, David; Flair, Michael; Kator, Kylie; Nudd, Geoffrey; Grabowski, David C

    2016-09-01

    Home care recipients are often hospitalized for potentially avoidable reasons. A pilot program (Intervention in Home Care to Improve Health Outcomes (In-Home)) was designed to help home care providers identify acute clinical changes in condition and then manage the condition in the home and thereby avoid a costly hospitalization. Caregivers answer simple questions about the care recipient's condition during a telephone-based "clock-out" at the end of each shift. Responses are electronically captured in the agency management software that caregivers use to "clock-in," manage care, and "clock-out" on every shift. These are transmitted to the agency's care manager, who follows up on the change in condition and escalates appropriately. A description of the In-Home model is presented, and pilot data from 22 home care offices are reported. In the pilot, caregivers reported a change in condition after 2% of all shifts, representing an average of 1.9 changes per care recipient in a 6-month period. Changes in behavior and skin condition were the most frequently recorded domains. Interviews with participating caregivers and care managers suggested positive attitudes regarding the intervention; challenges included resistance to change on the part of home care staff and difficulties in applying a uniform intervention to individuals with varying needs in home care offices with varying capacities. In an ongoing randomized trial, the success of the overall program will be measured primarily according to the potential reduction in avoidable hospitalizations of home care recipients and the effect this potential reduction has on spending and healthcare outcomes. PMID:27506164

  1. KERNELHR: A program for estimating animal home ranges

    USGS Publications Warehouse

    Seaman, D.E.; Griffith, B.; Powell, R.A.

    1998-01-01

    Kernel methods are state of the art for estimating animal home-range area and utilization distribution (UD). The KERNELHR program was developed to provide researchers and managers a tool to implement this extremely flexible set of methods with many variants. KERNELHR runs interactively or from the command line on any personal computer (PC) running DOS. KERNELHR provides output of fixed and adaptive kernel home-range estimates, as well as density values in a format suitable for in-depth statistical and spatial analyses. An additional package of programs creates contour files for plotting in geographic information systems (GIS) and estimates core areas of ranges.

  2. Flight crew health stabilization program

    NASA Technical Reports Server (NTRS)

    Wooley, B. C.; Mccollum, G. W.

    1975-01-01

    The flight crew health stabilization program was developed to minimize or eliminate the possibility of adverse alterations in the health of flight crews during immediate preflight, flight, and postflight periods. The elements of the program, which include clinical medicine, immunology, exposure prevention, and epidemiological surveillance, are discussed briefly. No crewmember illness was reported for the missions for which the program was in effect.

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

    PubMed Central

    Price, Sarah Kye; Cohen-Filipic, Katherine

    2013-01-01

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

  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. Review of evaluations of utility home-energy-audit programs

    NASA Astrophysics Data System (ADS)

    Berry, L.; Soderstrom, J.; Hirst, E.; Newman, B.; Weaver, R.

    1981-03-01

    Evaluation efforts of utilities with active home energy audit programs are reviewed to suggest methodologies, issues, and data that can contribute to the development of a comprehensive Residential Conservation Service evaluation plan. On the basis mainly of written reports received from the utilities, findings about customer response to programs are summarized. The topics discussed include: correlates of program penetration rates; use of financing; attitudes toward programs; actions taken; characteristics of participants; and energy savings due to programs. Particular attention is given to three studies (Tennessee Valley Authority, Seattle City Light, and Pacific Gas and Electric) that analyze fuel consumption records as part of the evaluation.

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

    PubMed Central

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

    1993-01-01

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

  7. Elementary Rehabilitation Nursing Care; a Manual for Nurses and Ancillary Workers in Nursing Homes, Hospitals, Convalescent Facilities, and Public Health Agencies. Public Health Service Publication No. 1436.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Public Health, Denver. Public Health Nursing Section.

    This guide for teacher and student use presents a comprehensive program of physical rehabilitation for aged and physically disabled patients. Developed by the Public Health Nursing Section, the manual was tested by state health department personnel and persons doing inservice teaching in their respective nursing homes. The program is designed to…

  8. Is particle board in the home detrimental to health

    SciTech Connect

    Daugbjerg, P. )

    1989-04-01

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

  9. 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)

  10. The Ramathibodi Community Health Program

    ERIC Educational Resources Information Center

    Buri, Prem; And Others

    1974-01-01

    The Ramathibodi Faculty of Medicine in Bangkok, Thailand, has developed a teaching and research program in community health aimed at brining the institution into close association with the health needs of the country. (Editor)

  11. Accounting Programs' Home Pages: What's Happening.

    ERIC Educational Resources Information Center

    Peek, Lucia E.; Roxas, Maria L.

    2002-01-01

    Content analysis of 62 accounting programs' websites indicated the following: 53% include mission statements; 62.9% list accreditation; many faculty biographies and personal pages used inconsistent formats; provision of information on financial aid, student organizations, career services, and certified public accountant requirements varied. Many…

  12. School and Home Program, Flint, Michigan.

    ERIC Educational Resources Information Center

    1969

    An experimental program in Flint, Michigan, was designed to raise the academic level of underachieving children by involving their parents in the daily reading exercises and study habits of their children. Children were given materials including booklets made from old basal readers and file boxes for word cards. Parents were given instruction in…

  13. Curriculum analysis of home health content in associate degree and baccalaureate degree nursing education.

    PubMed

    Zink, M R

    1989-03-01

    A statewide study was done with five associate degree (ADN) and five baccalaureate degree (BSN) nursing programs in Georgia to examine the similarities and differences in curriculum based on a nationally used model. From this overall study, select content related to community/home health care was evaluated in the sample programs. Professional standards for community and home health care nursing practice, as well as other published literature on the topic, provided a basis to determine competence to practice. Data were collected through a taped telephone interview to all program chairpersons (N = 10) and mailed questionnaires to faculty involved with all required courses (N = 110). Content analyses of responses allowed for evaluation of frequency of these learning activities between ADN and BSN programs and among BSN programs in the areas of family, teaching, interdisciplinary collaboration, physical assessment, and leadership. Overall, the results indicated lack of conclusive data to support a distinct difference in these educational components between the ADN and BSN sample or among BSN programs. The study was intended to service as a basis for home health care curriculum development in the future.

  14. The Rural Alabama Pregnancy and Infant Health (RAPIH) Program.

    ERIC Educational Resources Information Center

    Leeper, J. D.; And Others

    The impact of the Rural Alabama Pregnancy and Infant Health (RAPIH) Program was evaluated in relation to prenatal care, birth outcome measures, and several child health and home environment outcomes. Begun in 1983, RAPIH targets poor rural blacks in three of west-central Alabama's poorest counties, where economic conditions and infant mortality…

  15. Program of Studies: Home Economics: Grades 7-12.

    ERIC Educational Resources Information Center

    Fairfax County Schools, VA.

    Part 1 of the home economics curriculum guide for grades 7-12 provides a brief program description and concise diagrams depicting the overview chart, course charts for grades 7-8 and grades 9-12, and models for semester courses. Part 2 presents detailed unit plans, which include unit descriptions, credit values, minimum class times, prerequisites,…

  16. 75 FR 32459 - National Energy Rating Program for Homes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... Efficiency and Renewable Energy National Energy Rating Program for Homes AGENCY: Energy Efficiency and Renewable Energy, Department of Energy. ACTION: Request for Information (RFI). SUMMARY: The Department of... Energy Efficiency and Renewable Energy (EE-1), 1000 Independence Avenue, SW., Washington, DC 20585...

  17. The Impact of Home Health Length of Stay and Number of Skilled Nursing Visits on Hospitalization among Medicare-Reimbursed Skilled Home Health Beneficiaries

    PubMed Central

    O'Connor, Melissa; Hanlon, Alexandra; Naylor, Mary D.; Bowles, Kathryn H.

    2015-01-01

    The implementation of the Home Health Prospective Payment System in 2000 led to a dramatic reduction in home health length of stay and number of skilled nursing visits among Medicare beneficiaries. While policy leaders have focused on the rising costs of home health care, its potential underutilization and the relationship between service use and patient outcomes including hospitalization rates have not been rigorously examined. A secondary analysis of five Medicare-owned assessment and claims data sets for the year 2009 was conducted among two independently randomly selected samples of Medicare-reimbursed home health recipients (each n=31,485) to examine the relationship between home health length of stay or number of skilled nursing visits and hospitalization rates within 90 days of discharge from home health. Patients who had a home health length of stay of at least 22 days or received at least 4 skilled nursing visits had significantly lower odds of hospitalization than patients with shorter home health stays and fewer skilled nursing visits. Additional study is needed to clarify the best way to structure home health services and determine readiness for discharge to reduce hospitalization among this chronically ill population. In the mean time, the findings of this study suggest that home health providers should consider the benefits of at least four SNV and/or a home health LOS of 22 days or longer. PMID:25990046

  18. 76 FR 79193 - Medicare Program; Independence at Home Demonstration Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... beneficiaries are defined as Medicare fee-for-service (FFS) patients, who have at least 2 chronic illnesses... practitioners and must have experience providing home-based primary care to patients with multiple chronic illnesses. These practices will also be organized, at least in part, for the purpose of providing...

  19. [Evaluation of a home care program for children with cancer].

    PubMed

    Fernández Navarro, J M; Pozuelo Muñoz, B; Ortí Martínez, P; López Ferrer, L; Cañete Nieto, A; Verdeguer Miralles, V; Castel Sánchez, V

    2000-01-01

    The home care team dependent from the pediatric oncology unit in our institution started working in April, 1997. We evaluate in this paper the medical activities accomplished in seventeen month experience. The team is constituted by a pediatric oncologist, two pediatric nurses and a clinical assistant with experience in the specialty. The geographic area we cover is la Communidad Valenciana. We directly attend children living in Valencia city and its metropolitan area. For the rest of patients, we coordinate the interventions of the local primary care teams and local hospitals. 127 patients have been admitted in the home care unit in 433 occasions. The immediate reasons for the admission were: early discharge from the hospital (61%), followed by the administration of antibiotics (18%) and chemotherapy (12%) at home. We attended 17 children in the terminal phase of their diseases. Five of them required opioid treatment for pain control. Six out of eight patients living in the area of direct intervention of the home care team died at home. The most common cause of discharge (73%) was the achievement of the goals planned when the patient was included in the program. Only in two cases (0.5%) we did not found enough cooperation from the parents and the treatment was completed in the hospital. This program has been well accepted by our patients and their parents and permits to shorten the stay in the hospital.

  20. Health@Home Moves All About the House!

    PubMed

    Casper, Gail R; Brennan, Patricia F; Arnott Smith, Catherine; Werner, Nicole E; He, Yuqi

    2016-01-01

    It is now well recognized that patients play an important and active role in self-care and disease management, and many of these activities happen in their homes. Information technologies to support such care might be better used if they were designed taking into account the physical context of the home and the health information management needs of the residents. We conducted home-based interviews of 20 adults including an extensive analysis of their personal health information management (PHIM) tasks. Here we present these task descriptions, locations of their performance, and distribution across space and time. Implications for the informatics community include accommodating the distributed nature of tasks in the design of consumer technologies. PMID:27332185

  1. Improving oral medication management in home health agencies.

    PubMed

    Shearer, Janelle

    2009-03-01

    This study focused on home health agency characteristics and evidence-based practices that could have an impact on the ability to improve the home health outcome-based quality improvement measure: improvement in the management of oral medications. The findings of this Quality Improvement Organization-approved study suggest that there are organizational characteristics and evidence-based practices associated with better rates for this outcome measure. Organizational characteristics include belonging to a healthcare system that is hospital based, not-for-profit part of a network focused on quality, and intentionally working on the oral medications outcome. Evidence-based practices include use of reminder strategies, phone follow-up interventions, repeat patient education about medications at subsequent home care visits, and use of medication simplification strategies for patients receiving multiple medications.

  2. The benefits of a work-at-home program.

    PubMed

    Brownson, Kenneth

    2004-01-01

    Working from home offers the employee and the organization many benefits. The organization can use telework to recruit and retain valuable employees. The organization can also save money on work space and boost morale and loyalty. Employees enjoy the flexibility and convenience that telework offers. Teleworking is popular in the general business world and can be adapted to some jobs in the health care field. Managers must look throughout their organization to see what jobs can be accomplished either partially or completely at home.

  3. 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.

  4. Survey of Home Visiting Programs for Abused and Neglected Children and Their Families.

    ERIC Educational Resources Information Center

    Wasik, Barbara Hanna; Roberts, Richard N.

    1994-01-01

    This report on a survey of 224 home visitation programs that provide services for abused and neglected children and their families presents data on program characteristics, characteristics of home visits, credentials of home visitors, and program documentation procedures. Programs reported that training in parenting skills and parent coping were…

  5. 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.

  6. 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. PMID:27498167

  7. Medicaid: Recoveries from Nursing Home Residents' Estates Could Offset Program Costs.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC. Div. of Human Resources.

    Through asset recovery programs, states can recover from the estates of nursing home residents or their survivors a portion of the expenses the state incurs in providing nursing home care. Estate recovery programs require Medicaid recipients whose primary assets are their homes to contribute toward the cost of their nursing home care in the same…

  8. Welcome Home and Early Start: An Assessment of Program Quality and Outcomes

    ERIC Educational Resources Information Center

    Daro, Deborah, Howard, Eboni; Tobin, Jennifer; Harden, Allen

    2005-01-01

    Chapin Hall Center for Children at the University of Chicago, in collaboration with Westat Associates, designed and implemented a comprehensive evaluation of the Early Childhood Initiative's (ECI) two home visitation programs: Welcome Home, a universal home visitation program that provides a single home visit to all first-time and teen parents,…

  9. ENROLLMENT IN VOCATIONAL HOME ECONOMICS PROGRAMS IN KENTUCKY. A SUMMARY REPORT OF THE RESEARCH STUDY.

    ERIC Educational Resources Information Center

    SIMPSON, RUBY; AND OTHERS

    FACTORS THAT MAY BE INFLUENCING ENROLLMENTS IN HOME ECONOMICS AT THE HIGH SCHOOL LEVEL WERE INVESTIGATED -- (1) THE QUALITY OF THE HOME ECONOMICS PROGRAM, (2) PRESSURES TO TAKE OTHER SUBJECTS, (3) SCHOOL SCHEDULES, (4) ATTITUDES TOWARD HOME ECONOMICS, (5) PATTERNS OF HOME ECONOMICS OFFERINGS, AND (6) JUNIOR HIGH HOMEMAKING PROGRAMS. QUESTIONNAIRES…

  10. Determinants of state variations in home health utilization and expenditures under Medicare.

    PubMed

    Benjamin, A E

    1986-06-01

    Of the key federal programs that finance in-home services to the elderly, the Medicare program represents the largest and fastest growing. Although Medicare is a federal program, utilization and expenditures for home care vary widely across the states. Building on the work of Feldstein, Scanlon, and others, theory and data are presented that attempt to illuminate reasons why such variations exist. Using program data by state for 1982, nearly three fourths of the variation in home health utilization (R2 = 0.72) is explained by seven state characteristics. About three fifths of the variation in expenditures (R2 = 0.61) is accounted for by six state factors. Of most explanatory importance are home health agency (HHA) supply, need levels, presence of alternative sources of care, sources of referrals, and state resources. The results suggest the need to give more analytic attention to the impact of the market share of proprietary HHAs in explaining expenditure variations and the effects of total supply on utilization and spending.

  11. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Implementation and Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations and Lifting of the Temporary Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations. Extension, implementation, and lifting of temporary moratoria.

    PubMed

    2016-08-01

    This document announces the extension of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare home health agencies (HHAs), subunits, and branch locations in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. It also announces the implementation of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare HHAs, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey on a statewide basis. In addition, it announces the lifting of the moratoria on all Part B emergency ground ambulance suppliers. These moratoria, and the changes described in this document, also apply to the enrollment of HHAs and non-emergency ground ambulance suppliers in Medicaid and the Children's Health Insurance Program. PMID:27487581

  12. Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Implementation and Extension of Temporary Moratoria on Enrollment of Part B Non-Emergency Ground Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations and Lifting of the Temporary Moratoria on Enrollment of Part B Emergency Ground Ambulance Suppliers in All Geographic Locations. Extension, implementation, and lifting of temporary moratoria.

    PubMed

    2016-08-01

    This document announces the extension of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare home health agencies (HHAs), subunits, and branch locations in specific locations within designated metropolitan areas in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey to prevent and combat fraud, waste, and abuse. It also announces the implementation of temporary moratoria on the enrollment of new Medicare Part B non-emergency ground ambulance suppliers and Medicare HHAs, subunits, and branch locations in Florida, Illinois, Michigan, Texas, Pennsylvania, and New Jersey on a statewide basis. In addition, it announces the lifting of the moratoria on all Part B emergency ground ambulance suppliers. These moratoria, and the changes described in this document, also apply to the enrollment of HHAs and non-emergency ground ambulance suppliers in Medicaid and the Children's Health Insurance Program.

  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. 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

  15. 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

  16. Revitalizing school health programs worldwide.

    PubMed

    Benzian, Habib

    2010-10-01

    Each year, the Shils Fund recognizes outstanding activities that help improve oral health. The program is named in memory of Dr. Edward B. Shils, who led the Dental Manufacturers of America and Dental Dealers of America for more than 50 years. A 2010 Shils Award will be given to an innovative school health initiative called Fit For Schools Program (FFSP) in the Philippines. Such recognition in the US indicates the lessons that can be learned from a program initially tailored for another country. Health in a highly industrialized nation can be enhanced by heeding the FFSP principles used to craft an effective health promotion initiative. This evidence-based intervention is not exclusively an oral health initiative; it is an integration with other evidence-based health interventions and models a sustainable public-private partnership to advance positive health outcomes in socially responsible entrepreneurial ways. As the editor of this column in Compendium, I wish to applaud both leaders of FFSP: Dr. Habib Benzian and Dr. Bella Monse. The following article was written by the senior advisor, Dr. Benzian, who modestly refers to the program's receipt of another award from the World Bank, the United Nations Development Program, and the World Health Organization in 2009. To my knowledge, the presentation of that award was the first time a health promotion project led by dentists has ever received such high-level global recognition and was one of three projects so recognized for innovative solutions to global health in that year. PMID:20960987

  17. Revitalizing school health programs worldwide.

    PubMed

    Benzian, Habib

    2010-10-01

    Each year, the Shils Fund recognizes outstanding activities that help improve oral health. The program is named in memory of Dr. Edward B. Shils, who led the Dental Manufacturers of America and Dental Dealers of America for more than 50 years. A 2010 Shils Award will be given to an innovative school health initiative called Fit For Schools Program (FFSP) in the Philippines. Such recognition in the US indicates the lessons that can be learned from a program initially tailored for another country. Health in a highly industrialized nation can be enhanced by heeding the FFSP principles used to craft an effective health promotion initiative. This evidence-based intervention is not exclusively an oral health initiative; it is an integration with other evidence-based health interventions and models a sustainable public-private partnership to advance positive health outcomes in socially responsible entrepreneurial ways. As the editor of this column in Compendium, I wish to applaud both leaders of FFSP: Dr. Habib Benzian and Dr. Bella Monse. The following article was written by the senior advisor, Dr. Benzian, who modestly refers to the program's receipt of another award from the World Bank, the United Nations Development Program, and the World Health Organization in 2009. To my knowledge, the presentation of that award was the first time a health promotion project led by dentists has ever received such high-level global recognition and was one of three projects so recognized for innovative solutions to global health in that year.

  18. New Whole-House Solutions Case Study: Meeting DOE Challenge Home Program Certification - Chicago, IL; Denver, CO; Devens, MA

    SciTech Connect

    2015-01-01

    In this project, three production home builders—K. Hovnanian Homes, David Weekley Homes, and Transformations, Inc.—partnered with Building America team Building Science Corporation to evaluate the certification of five test homes to the new DOE Challenge Home program performance standard (now DOE Zero Energy Ready Home program). The builders identified key benefits and barriers that impacted the certification of the test homes, and the likelihood of whether DOE Challenge Home certification would be pursued in future homes

  19. 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…

  20. Home again: effects of the Mother-Child Home Program on mother and child.

    PubMed

    Madden, J; O'Hara, J; Levenstein, P

    1984-04-01

    4 successive cohorts of low-income families were randomly assigned either to a home-based intervention program that focused on modeling verbal interaction between mother and child around selected toys and books or to comparison treatments. Large program effects were found on maternal interaction styles in videotaped observations. Small IQ and program-specific effects were found for children in contrast to much larger IQ effects found in earlier research. IQ effects did not appear to have been mediated by changes in maternal behavior. A variation in which toys and books were supplied without home visits was as effective as the full program on IQ but not on maternal behavior. 3 years postprogram , there were no detectable effects in achievement or IQ tests or in first grade teachers' ratings of school adjustment and performance, but IQ and achievement scores were near national norms. Reasons for discrepancies with earlier results are discussed. The results highlight the need for continued experimental evaluation of early intervention programs with safeguards to insure that samples are educationally at risk.

  1. Older Americans Act Nutrition Programs: A Community-Based Nutrition Program Helping Older Adults Remain at Home.

    PubMed

    Lloyd, Jean L; Wellman, Nancy S

    2015-01-01

    Nutrition interventions are important as the older population, most of whom live in the community, increases in size and diversity. They are key to leading a healthy, functional life and mitigating chronic health conditions. The Older Americans Act Nutrition Program served 86.3 million congregate and 137.4 million home-delivered meals to 1.6 million and 850,000 older adults, respectively (2012). Congregate and home-delivered participants were older, poorer, sicker, more functionally impaired, and at a greater risk of institutionalization than the general U.S. older population. The Nutrition Program is publically and privately funded. About 44% of congregate and 30% of home-delivered expenditures are from federal sources, which dropped from $25 per older adult in 1990 to $12 in 2013. Despite multiple funding sources, funding is insufficient for the expanding older population. Health, nutrition, and social service professionals need to coordinate their community-based services to truly help older adults remain in their homes.

  2. 75 FR 29877 - Affordable Housing Program Amendments: Federal Home Loan Bank Mortgage Refinancing Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... 2590-AA04 Affordable Housing Program Amendments: Federal Home Loan Bank Mortgage Refinancing Authority... Federal Home Loan Banks (Banks) until July 30, 2010, to use Affordable Housing Program (AHP) homeownership..., 2798. B. The Banks' Affordable Housing Program Section 10(j) of the Federal Home Loan Bank Act...

  3. 76 FR 22713 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation; Notice of..., Infant and Early Childhood Home Visiting (MIECHV) Program Evaluation. Date and Time: Thursday, May 5... and Early Childhood Home Visiting Program Evaluation is authorized by subsection 511(g)(1) of Title...

  4. 76 FR 71979 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation; Notice of... the Maternal, Infant and Early Childhood Home Visiting Program Evaluation (MIECHVE). Dates and Times... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

  5. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.61 General requirements for adult day health care program. Adult day health care must be...

  6. 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

  7. Training in testing: a pragmatic approach to recruitment and retention of homemaker-home health aides.

    PubMed

    Young, A

    1990-04-01

    In response to concerns regarding the negative effect that competency-evaluation testing might have on the attrition and recruitment of homemaker-home health aides, the home health industry of New Jersey offers an inservice education module--training supervisors to prepare homemaker-home health aides for testing.

  8. 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…

  9. Economies of scale and scope in the provision of home health services.

    PubMed

    Kass, D I

    1987-06-01

    This study examines the issue of economies of scale for home health agencies. A quadratic cost function is estimated utilizing a 1982 national data set based on Medicare Cost Reports for 2000 home health agencies. This paper concludes that neither economies of scale nor scope are substantial in the provision of home health services.

  10. Environmental health program activities

    NASA Technical Reports Server (NTRS)

    Bergtholdt, C. P.

    1969-01-01

    Activities reported include studies on toxic air contaminants, excessive noise, poor lighting, food sanitation, water pollution, and exposure to nonionizing radiation as health hazards. Formulations for a radiological health manual provide guidance to personnel in the procurement and safe handling of radiation producing equipment and Apollo mission planning. A literature search and development of a water analysis laboratory are outlined to obtain information regarding microbiological problems involving potable water, waste management, and personal hygiene.

  11. Uptake of a technology-assisted home-care cardiac rehabilitation program.

    PubMed

    Varnfield, Marlien; Karunanithi, Mohanraj K; Särelä, Antti; Garcia, Elsa; Fairfull, Anita; Oldenburg, Brian F; Walters, Darren L

    2011-02-21

    The prevalence of cardiovascular disease, a major cause of disease burden in Australia and other developed countries, is increasing due to a rapidly ageing population and environmental, biomedical and modifiable lifestyle factors. Although cardiac rehabilitation (CR) programs have been shown to be beneficial and effective, rates of referral, uptake and utilisation of traditional hospital or community centre programs are poor. Home-based CR programs have been shown to be as effective as centre-based programs, and recent advances in information and communication technologies (ICT) can be used to enhance the delivery of such programs. The Care Assessment Platform (CAP) is an integrated home-based CR model incorporating ICT (including a mobile phone and the internet) and providing all the core components of traditional CR (education, physical activity, exercise training, behaviour modification strategies and psychological counselling). The mobile phone given to patients has an integrated accelerometer and diary application for recording exercise and health information. A central database, with access to these data, allows mentors to assess patients' progress, assist in setting goals, revise targets and give weekly personal feedback. Mentors find the mobile-phone modalities practical and easy to use, and preliminary results show high usage rates and acceptance of ICT by participants. The provision of ICT-supported home-based CR programs may enable more patients in both metropolitan and remote settings to benefit from CR.

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

    PubMed Central

    Goldberg, Henry B.; Schmitz, Robert J.

    1994-01-01

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

  13. Improving nursing documentation for private-duty home health care.

    PubMed

    Borchers, E L

    1999-06-01

    Private-duty, home health care agencies have struggled in assuring compliance with accurate and complete nursing documentation. In this descriptive study, the author reports on an improvement and innovation project in a private-duty, home health care agency aimed at improving nursing documentation, as measured in chart review audits. Initial strategies were directed toward revising the documentation system, with implementation of a flow record, and conducting group nurse education. These efforts had a minimal effect on improving documentation compliance. A major, multifocus strategy was then implemented. The educational component stressed pre- and posttest. The chart audit tool was revised to track individual nurse behaviors. Nurses were mentored when documentation did not meet standards. Lastly, the nurse job description and corresponding performance appraisal document were revised to clarify nurse responsibility and strengthen nurse accountability; progressive discipline was initiated when warranted. Significant and sustained improvement was subsequently realized.

  14. A Home Health Care System for Family Doctor

    NASA Astrophysics Data System (ADS)

    Hamabe, Ryuji; Taketa, Norihiro

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

  15. The Effect of Pay-for-Performance in Nursing Homes: Evidence from State Medicaid Programs

    PubMed Central

    Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel

    2013-01-01

    Objective Pay-for-performance (P4P) is commonly used to improve health care quality in the United States and is expected to be frequently implemented under the Affordable Care Act. However, evidence supporting its use is mixed with few large-scale, rigorous evaluations of P4P. This study tests the effect of P4P on quality of care in a large-scale setting—the implementation of P4P for nursing homes by state Medicaid agencies. Data Sources/Study Setting 2001–2009 nursing home Minimum Data Set and Online Survey, Certification, and Reporting (OSCAR) datasets. Study Design Between 2001 and 2009, eight state Medicaid agencies adopted P4P programs in nursing homes. We use a difference-in-differences approach to test for changes in nursing home quality under P4P, taking advantage of the variation in timing of implementation across these eight states and using nursing homes in the 42 non-P4P states plus Washington, DC as contemporaneous controls. Principal Findings Quality improvement under P4P was inconsistent. While three clinical quality measures (the percent of residents being physically restrained, in moderate to severe pain, and developed pressure sores) improved with the implementation of P4P in states with P4P compared with states without P4P, other targeted quality measures either did not change or worsened. Of the two structural measures of quality that were tied to payment (total number of deficiencies and nurse staffing) deficiency rates worsened slightly under P4P while staffing levels did not change. Conclusions Medicaid-based P4P in nursing homes did not result in consistent improvements in nursing home quality. Expectations for improvement in nursing home care under P4P should be tempered. PMID:23398330

  16. Diet needs of patients referred to home health.

    PubMed

    Gaffney, J T; Singer, G R

    1985-02-01

    The purpose of this study was to document the dietary needs of patients referred to home health care. The charts of 812 patients taken for care by the Visiting Nurse Association of Chicago (VNA) were reviewed for the physician's diet order, number of restrictions, diagnoses, age, height, weight, and fee source. More than half of the patients had therapeutic diets ordered by their physicians. A quarter of the patients with therapeutic diets had two or more dietary modifications. An audit process was developed as a reliability check of the authors' determination of the appropriateness of the diet. Review of the charts by registered dietitians (R.D.s) showed that three-fourths of the patients appeared to need therapeutic diets. Forty-seven percent might have benefited from a different diet. More than half of the patients for whom the R.D.s recommended a special diet needed two or more modifications. This emphasizes the need for the R.D. to develop a system for monitoring the dietary requirements of all patients referred to home health care. It further underscores the need for collaboration between physician and dietitian. The registered dietitian who works in home health care agencies serving diverse age groups needs to be a generalist prepared to develop a plan for the total nutrition treatment of persons throughout the life cycle.

  17. 78 FR 24756 - Health Center Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health... Health System. SUMMARY: The Health Resources and Services Administration (HRSA) will be...

  18. 75 FR 2549 - Health Center Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health... Health Care Affiliates. SUMMARY: The Health Resources and Services Administration (HRSA) will...

  19. 76 FR 17139 - Health Center Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health... Park Health Council, Inc. SUMMARY: The Health Resources and Services Administration (HRSA)...

  20. 75 FR 53701 - Health Center Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health... Park Health Council, Inc. SUMMARY: The Health Resources and Services Administration (HRSA)...

  1. An Operating Environmental Health Program

    NASA Technical Reports Server (NTRS)

    Lipana, J. G.; Masters, R. L.; Winter, W. R.

    1971-01-01

    Some concepts of an operational program for medical and environmental health are outlined. Medical services of this program are primarily concerned with emergency care, laboratory examinations, advice to private physician with patient permission, medical monitoring activities, and suggestions for treatment or control of the malfunction.

  2. Economic assessment of home-based COPD management programs.

    PubMed

    Liu, Sheena Xin; Lee, Michael C; Atakhorrami, Maryam; Tatousek, Jan; McCormack, Meredith; Yung, Rex; Hart, Nicholas; White, David P

    2013-12-01

    Home-based exacerbation management programs have been proposed as an approach to reducing the clinical and financial burden of COPD. We demonstrate a framework to evaluate such programs in order to guide program design and performance decisions towards optimizing cost and clinical outcomes. This study models the impact of hypothetical exacerbation management programs through probabilistic Markov simulations. Patients were stratified by risk using exacerbation rates from the ECLIPSE study and expert opinion. Three scenarios were modeled, using base, worst and best case parameters to suggest potential telehealth program performance. In these scenarios, acute exacerbations could be detected early, with sensitivity and specificity ranging from 60-90%. Detected acute exacerbations could be diverted to either a sub-acute pathway (12.5-50% probability), thus entirely avoiding hospitalization, or a lower cost pathway through length-of-stay reduction (14-28% reduction). For a cohort of patients without prior hospitalization, the base case telehealth scenario results in a cumulative per-patient lifetime savings of $2.9 K over ≈ 12 years. For a higher risk cohort of patients with a prior admission and 1 to 2 acute exacerbations per year, a cumulative $16K per patient was saved during the remaining ≈ 3 life-years. Acceptable prices for home-based exacerbation detection testing were highly dependent on patient risk and scenario, but ranged from $290-$1263 per month for the highest risk groups. These results suggest the economic viability of exacerbation management programs and highlight the importance of risk stratification in such programs. The presented model can further be adapted to model specific programs as trial data becomes available. PMID:23848542

  3. Mother-Child Home Program. Parent-Child Program Series, Report No. 1.

    ERIC Educational Resources Information Center

    Rosenfeld, Anne H.

    Part of a series on early childhood demonstration programs designed to improve early parent-child relationships, stimulate positive child development, and prevent later behavior difficulties, the pamphlet describes the Mother-Child Home Program, in which low-income mothers are educated to become more effective developmental guides for their 2 to 4…

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

    PubMed Central

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

    2009-01-01

    Family-school collaboration related to 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. PMID:19633724

  5. Wireless Health Data Exchange for Home Healthcare Monitoring Systems

    PubMed Central

    Lee, Malrey; Gatton, Thomas M.

    2010-01-01

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

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

    PubMed

    Cady, Rhonda; Kelly, Anne; Finkelstein, Stanley

    2008-01-01

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

  7. 78 FR 9936 - Federal Housing Administration (FHA): PowerSaver Home Energy Retrofit Loan Pilot Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ..., 2011, HUD published a notice at 76 FR 17936 that announced HUD's FHA Home Energy Retrofit Loan Pilot... URBAN DEVELOPMENT Federal Housing Administration (FHA): PowerSaver Home Energy Retrofit Loan Pilot... Home Energy Retrofit Loan Pilot Program (Retrofit Pilot Program) known as FHA PowerSaver, which is...

  8. 78 FR 53150 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation; Notice of Meeting ACTION: Notice of Meeting: Advisory Committee on the Maternal, Infant and Early Childhood Home... Maternal, Infant, and Early Childhood Home Visiting Program Evaluation. Date and Time: September 12,...

  9. 76 FR 12978 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-09

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation; Notice of..., Infant and Early Childhood Home Visiting Program Evaluation. Date and Time: March 23, 2011, 9 a.m.-3 p.m. EST. Place: Webinar. The Advisory Committee on the Maternal, Infant and Early Childhood Home...

  10. 77 FR 72904 - In the Matter of HealthSport, Inc., Home Director, Inc., Home Theater Products International, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-06

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION In the Matter of HealthSport, Inc., Home Director, Inc., Home Theater Products International, Inc... Commission that there is a lack of current and accurate information concerning the securities of...

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

    ERIC Educational Resources Information Center

    Lake County Area Vocational Center, Grayslake, IL.

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  13. 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…

  14. 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,…

  15. Wyandotte Neighborhood Stabilization Program: Retrofit of Two Homes

    SciTech Connect

    Lukachko, A.; Grin, A.; Bergey, D.

    2013-04-01

    The Wyandotte NSP2 project aims to build 20 new houses and retrofit 20 existing houses in Wyandotte, MI. This report will detail the retrofit of 2 existing houses in the program. Wyandotte is part of a Michigan State Housing Development Authority-led consortium that is funded by HUD under the NSP2 program. The City of Wyandotte has also been awarded DOE EE&CBG funds that are being used to develop a district GSHP system to service the project. This draft report examines the energy efficiency recommendations for retrofit construction at these homes. The report will be of interest to anyone planning an affordable, high performance retrofit of an existing home in a Cold Climate zone. Information from this report will also be useful to retrofit or weatherization program staff as some of the proposed retrofit solutions will apply to a wide range of projects. Preliminary results from the first complete house suggest that the technology package employed (which includes spray foam insulation and insulating sheathing) does meet the specific whole house water, air, and thermal control requirements, as well as, the project's affordability goals. Monitoring of the GSHP system has been recommended and analysis of this information is not yet available.

  16. Wyandotte Neighborhood Stabilization Program: Retrofit of Two Homes

    SciTech Connect

    Lukachko, A.; Grin, A.; Bergey, D.

    2013-04-01

    The Wyandotte NSP2 project aims to build 20 new houses and retrofit 20 existing houses in Wyandotte, MI. Wyandotte is part of a Michigan State Housing Development Authority-led consortium that is funded by HUD under the NSP2 program. The City of Wyandotte has also been awarded DOE EE&CBG funds that are being used to develop a district ground source heat pump (GSHP) system to service the project. This report details the retrofit of two existing houses in the program, and examines the energy efficiency recommendations for the homes. The report will be of interest to anyone planning an affordable, high performance retrofit of an existing home in a cold climate zone. Information from this report will also be useful to retrofit or weatherization program staff as some of the proposed retrofit solutions will apply to a wide range of projects. Preliminary results from the first complete house suggest that the technology package employed (which includes spray foam insulation and insulating sheathing) does meet the specific whole house water, air, and thermal control requirements, as well as, the project’s affordability goals. Monitoring of the GSHP system has been recommended and analysis of this information is not yet available.

  17. Home-Based Care Program Reduces Disability And Promotes Aging In Place.

    PubMed

    Szanton, Sarah L; Leff, Bruce; Wolff, Jennifer L; Roberts, Laken; Gitlin, Laura N

    2016-09-01

    The Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program, funded by the Center for Medicare and Medicaid Innovation, aims to reduce the impact of disability among low-income older adults by addressing individual capacities and the home environment. The program, described in this innovation profile, uses an interprofessional team (an occupational therapist, a registered nurse, and a handyman) to help participants achieve goals they set. For example, it provides assistive devices and makes home repairs and modifications that enable participants to navigate their homes more easily and safely. In the period 2012-15, a demonstration project enrolled 281 adults ages sixty-five and older who were dually eligible for Medicare and Medicaid and who had difficulty performing activities of daily living (ADLs). After completing the five-month program, 75 percent of participants had improved their performance of ADLs. Participants had difficulty with an average of 3.9 out of 8.0 ADLs at baseline, compared to 2.0 after five months. Symptoms of depression and the ability to perform instrumental ADLs such as shopping and managing medications also improved. Health systems are testing CAPABLE on a larger scale. The program has the potential to improve older adults' ability to age in place. PMID:27605633

  18. 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)…

  19. Impact of a home-based social welfare program on care for palliative patients in the Basque Country (SAIATU Program)

    PubMed Central

    2013-01-01

    Background SAIATU is a program of specially trained in-home social assistance and companionship which, since February 2011, has provided support to end-of-life patients, enabling the delivery of better clinical care by healthcare professionals in Osakidetza (Basque Health Service), in Guipúzcoa (Autonomous Community of the Basque Country). In January 2012, a retrospective observational study was carried out, with the aim of describing the characteristics of the service and determining if the new social service and the associated socio-health co-ordination had produced any effect on the use of healthcare resources by end-of-life patients. The results of a comparison of a cohort of cases and controls demonstrated evidence that the program could reduce the use of hospital resources and promote the continuation of living at home, increasing the home-based activity of primary care professionals. The objective of this study is to analyse whether a program of social intervention in palliative care (SAIATU) results in a reduction in the consumption of healthcare resources and cost by end-of-life patients and promotes a shift towards a more community-based model of care. Method/design Comparative prospective cohort study, with randomised selection of patients, which will systematically measure patient characteristics and their consumption of resources in the last 30 days of life, with and without the intervention of a social support team trained to provide in-home end-of-life care. For a sample of approximately 150 patients, data regarding the consumption of public healthcare resources, SAIATU activity, home hospitalisation teams, and palliative care will be recorded. Such data will also include information dealing with the socio-demographic and clinical characteristics of the patients and attending carers, as well as particular characteristics of patient outcomes (Karnofsky Index), and of the outcomes of palliative care received (Palliative Outcome Scale). Ethical

  20. 78 FR 25457 - Health Center Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health... Center, Inc. for provision of services in Gwinnett County, Georgia. SUMMARY: The Health Resources...

  1. Does Participation in Home-delivered Meals Programs Improve Outcomes for Older Adults?: Results of a Systematic Review

    PubMed Central

    Campbell, Anthony D.; Godfryd, Alice; Buys, David R.; Locher, Julie L.

    2015-01-01

    Participation in home-delivered meals programs may contribute to the health and independence of older adults living in the community, especially those who are food insecure or those who are making transitions from acute, subacute, and chronic care settings to the home. The purpose of this study was to conduct a comprehensive and systematic review of ALL studies related to home-delivered meals in order to shed light on the state of the science. A complete review of articles appearing in PubMed using the Keyword “Meal” was conducted; and titles, abstracts, and full-texts were screened for relevance. Included in this review are 80 articles. Most studies are descriptive and do not report on outcomes. Frequently reported outcomes included nutritional status based upon self-reported dietary intake. Additionally, most studies included in this review are cross-sectional, have a small sample size, and/or are limited to a particular setting or participant population. More rigorous research is needed to: 1) gain insight into why so few eligible older adults access home-delivered meals programs, 2) support expansion of home-delivered meals to all eligible older adults, 3) better identify what home-delivered meals models alone and in combination with other services works best and for whom, and 4) better target home-delivered meals programs where and when resources are scarce. PMID:26106985

  2. 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

  3. 42 CFR 413.125 - Payment for home health agency services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  4. 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. PMID:25534575

  5. School Health: Findings from Evaluated Programs.

    ERIC Educational Resources Information Center

    Public Health Service (DHHS), Rockville, MD. Office of Disease Prevention and Health Promotion.

    This publication presents findings from evaluations of many school health programs from across the United States. Each program includes at least one of the following eight components of a comprehensive school health program: health education, clinical services, counseling and mental health services, school environment, school food programs,…

  6. Home telemental health implementation and outcomes using electronic messaging.

    PubMed

    Godleski, Linda; Cervone, Dana; Vogel, Donna; Rooney, Meghan

    2012-01-01

    In 2007, the VA Connecticut Healthcare System began a home electronic messaging programme for mental health patients. During the first two years, 76 patients with diagnoses of schizophrenia, post traumatic stress disorder, depression and substance-use disorders received a home messaging device, which was connected via an ordinary telephone line. There were daily questions, which were based on disease management protocols, and included alerts, data and educational components. Patient data were sent to a nurse practitioner each day for triage and follow-up. Patients used the device for at least six months. In the six months prior to enrolment, 42 patients were hospitalized for 46 admissions. In the following six months, six patients were hospitalized for nine admissions (P < 0.0001). In the six months prior to enrolment, 47 patients had a total of 80 ER visits. In the following six months, 16 patients had a total of 32 ER visits (P < 0.0001). Questionnaire responses indicated a high level of satisfaction with the home messaging programme.

  7. 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

  8. Health Occupations Extended Campus Program.

    ERIC Educational Resources Information Center

    Likhite, Vivek

    A Health Occupations Program designed as an integrated science course offers students at Evanston Township High School (Illinois) an opportunity to master science skills, content, and laboratory techniques while working and studying within local hospitals (the Evanston Hospital and St. Francis Hospital) as well as within their high school…

  9. Health Insurance Status and the Care of Nursing Home Residents with Advanced Dementia

    PubMed Central

    Goldfeld, Keith S.; Grabowski, David C.; Caudry, Daryl J.; Mitchell, Susan L.

    2013-01-01

    Importance Nursing home residents with advanced dementia commonly experience burdensome and costly hospitalizations that may not extend survival or improve the quality of life. Fragmentation in health care has contributed to poor coordination of care for acutely ill nursing home residents. Objective To compare patterns of care and quality outcomes for nursing home residents with advanced dementia covered by managed care to those covered by traditional fee-for-service Medicare. Design The Choices, Attitudes, and Strategies for Care of Advanced Dementia at the End-of-Life (CASCADE) study was a prospective cohort study that followed 323 nursing home residents over eighteen months to better understand the course of advanced dementia at or near the end of life. CASCADE and Medicare data were linked to determine the health insurance status of study participants. Setting Twenty-two nursing homes in the Boston area. Participants Nursing home residents with advanced dementia and their health care proxies. Exposure The health insurance status of the resident, either managed care or traditional fee-for-service. Main Outcomes The outcomes included survival, symptoms related to comfort, treatment of pain and dyspnea, presence of pressure ulcers, presence of a DNH order, treatment for pneumonia, hospital transfer (hospitalization or emergency room visit) for an acute illness, hospice referral, primary care visits, and family satisfaction with care. Results Residents enrolled in managed care (n=133) were more likely to have do-not-hospitalize orders compared to those in traditional Medicare fee-for service (n=158) (64% vs. 51%, p-value < 0.05), were less likely to be transferred to the hospital for acute illness (4% vs. 16%, p-value < 0.05), had more primary care visits per 90 days (4.8±2.6 vs. 4.2±5.0, p-value < 0.05), and had more nurse practitioner visits (3.0±2.1 vs. 0.8±2.6, p-value < 0.05). Survival, comfort, and other treatment outcomes did not differ across groups

  10. Weatherizing the Homes of Low-Income Home Energy Assistance Program Clients: A Programmatic Assessment

    SciTech Connect

    Tonn, B.

    2002-09-16

    The purpose of this project was to assess the relationships between two federal programs that support low income households, the Weatherization Assistance Program (WAP) and the Low Income Home Energy Assistance Program (LIHEAP). The specific question addressed by this research is: what impact does weatherizing homes of LIHEAP recipients have on the level of need for LIHEAP assistance? The a priori expectation is that the level of need will decrease. If this is the case, then it can be argued that a non-energy benefit of WAP is the reduction in the level of need for LIHEAP assistance for households receiving weatherization assistance. The study area for this project was Boston, Massachusetts, which is representative of large northern urban areas. Additionally, Boston was chosen because one of its social service agencies, Action for Boston Community Development (ABCD), administers both WAP and LIHEAP programs. ABCD has a substantial client base of low-income households and was willing to cooperate in this study. In the State of Massachusetts, an income test is used to determine whether low-income households qualify for standard LIHEAP benefits. Benefits provided to eligible households are determined by a schedule that gauges benefit levels based on household income and number of members in the household. Additionally, households that consume large amounts of primary heating fuel can also qualify an additional high energy subsidy. It was expected that weatherization's biggest influence on the LIHEAP program would be in reducing the number of households qualifying for high energy subsidies. Data were collected for three groups of households that received both weatherization and LIHEAP assistance and for one control group that only received LIHEAP assistance. Table ES-1 indicates the sample sizes, weatherization dates, and winter time periods when changes in energy consumption and receipt of LIHEAP benefits could be expected to be observed. The reason why there is a lag

  11. [Health hazards for immigrants when travelling to their home countries].

    PubMed

    Brunvatne, Reidun; Blystad, Hans; Hoel, Terje

    2002-06-20

    Vacations in the home country are important and positive events in the lives of immigrants, events that allow them to maintain contact with their culture, relatives and friends. However, vacations also carry certain health risks, though these risks can to some degree be prevented. Infectious disease is the greatest risk. Some children and adolescents also run the risk of female genital mutilation, forced marriage, and the risk og being left behind in the home country against their will. Among the notifiable diseases registered with the Norwegian Surveillance System for Communicable Diseases (MSIS), five stand out as having a higher incidence in people of foreign background than in people of Norwegian origin: malaria, hepatitis A, shigella infection, typhoid and paratyphoid fever. This higher incidence is partly the result of less use of pre-travel vaccines and malaria prophylaxis. Immigrants as a group are exposed to varied risks and should be given high priority in relation to vaccines and malaria prophylaxis for travel abroad. High priority should also be given to preventive health measures designed to reduce the risk of female genital mutilation and other violations against children and young people on visit to their country of origin.

  12. 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

  13. Implementation Differences of Two Staffing Models in the German Home Visiting Program "Pro Kind"

    ERIC Educational Resources Information Center

    Brand, Tilman; Jungmann, Tanja

    2012-01-01

    As different competencies or professional backgrounds may affect the quality of program implementation, staffing is a critical issue in home visiting. In this study, N = 430 women received home visits delivered either by a tandem of a midwife and a social worker or by only one home visitor (primarily midwives, continuous model). The groups were…

  14. Weatherization and Indoor Air Quality: Measured Impacts in Single Family Homes Under the Weatherization Assistance Program

    SciTech Connect

    Pigg, Scott; Cautley, Dan; Francisco, Paul; Hawkins, Beth A; Brennan, Terry M

    2014-09-01

    This report summarizes findings from a national field study of indoor air quality parameters in homes treated under the Weatherization Assistance Program (WAP). The study involved testing and monitoring in 514 single-family homes (including mobile homes) located in 35 states and served by 88 local weatherization agencies.

  15. Wildfire ignition resistant home design(WIRHD) program: Full-scale testing and demonstration final report.

    SciTech Connect

    Quarles, Stephen, L.; Sindelar, Melissa

    2011-12-13

    The primary goal of the Wildfire ignition resistant home design(WIRHD) program was to develop a home evaluation tool that could assess the ignition potential of a structure subjected to wildfire exposures. This report describes the tests that were conducted, summarizes the results, and discusses the implications of these results with regard to the vulnerabilities to homes and buildings.

  16. 77 FR 65574 - Notice of Proposed Information Collection: Healthy Homes and Lead Hazard Control Programs Data...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-29

    ... URBAN DEVELOPMENT Notice of Proposed Information Collection: Healthy Homes and Lead Hazard Control Programs Data Collection--Progress Reporting AGENCY: Office of Healthy Homes and Lead Hazard Control, HUD... Miller, Reports Liaison Officer, Office of Healthy Homes and Lead Hazard Control, Department of...

  17. The Impact of a Family Home-Learning Program on Levels of Parental/Caregiver Efficacy

    ERIC Educational Resources Information Center

    Morrison, Tomasine A.

    2009-01-01

    This study sought to determine if participation in a home education learning program would impact the perceived levels of parental self-efficacy of parents/caregivers who participate in the completion of home-learning assignments and increase their levels of home-learning involvement practices. Also, the study examined the relationship between the…

  18. Funding and planning: what you need to know for starting or expanding a home hemodialysis program.

    PubMed

    Howard, Kirsten; McFarlane, Phil A; Marshall, Mark R; Eastwood, Deborah O; Morton, Rachael L

    2015-04-01

    Planning and funding a home hemodialysis (HD) program requires a well-organized effort and close collaboration between clinicians and administrators. This resource provides guidance on the processes that are involved, including a thorough situational analysis of the dialysis landscape, emphasizing the opportunity for a home HD program; careful consideration of the clinical and operational characteristics of a proposed home HD program at your institution; the development of a compelling business case, highlighting the clinical and organizational benefits of a home HD program; and careful construction and evaluation of a request for proposal.

  19. 78 FR 54256 - Health Careers Opportunity Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Careers Opportunity Program AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of Noncompetitive...

  20. Directory of Health Education Programs for Elders.

    ERIC Educational Resources Information Center

    Missouri Univ., Kansas City. Center on Rural Elderly.

    Health education programs for older adults can be an efficient and cost-effective way to meet the challenge of a healthy old age. This directory describes 36 health education programs for the rural elderly in the areas of comprehensive programs, mental health, nutrition, physical health (including exercise), medication, safety, and health…

  1. Migrant Education Health Program 1990. Final Report.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Health, Denver.

    The Colorado Migrant Education Program and the Colorado Migrant Health Program (CMHP) together plan and implement a comprehensive health program for migrant summer school students on a yearly basis. This report provides statistical data about the health status of the migrant students and the health services provided to them during the 1990…

  2. Home Exercise Programs for Adults With Neurological Injuries: A Survey

    PubMed Central

    2016-01-01

    OBJECTIVE. The purpose of this study was to describe current occupational therapy practices in the usage and prescription of and clinical reasoning process supporting home exercise programs (HEPs) for clients with neurological injuries (CWNIs). METHOD. A survey was distributed via mail to 2,000 members of the American Occupational Therapy Association. The survey questions concerned basic demographics, current HEP practices, and attitudes toward using HEPs with CWNIs. RESULTS. In the 360 returned surveys, occupational therapists reported numerous benefits of using HEPs and were able to clearly articulate their clinical reasoning. Commonly reported HEP activities were preparatory in nature, and the most frequently prescribed dosage was 16–30 min daily. Most therapists relied on the same clinical reasoning process but varied in implementation methods. CONCLUSION. This study’s results highlight the gaps between evidence and practice. The active ingredients in HEPs for CWNIs need to be more clearly defined and described. PMID:27089296

  3. Home care for ventilator-assisted children: implications for the children, their families, and health policy.

    PubMed

    Aday, L A; Wegener, D H

    1988-01-01

    This article presents findings from a national study of home care programs for ventilator-assisted children conducted between 1984 and 1987 by the Center for Health Administration Studies at The University of Chicago. These findings point to the issues that need to be addressed in the development of policies surrounding both the delivery and the financing of services for these children and their families: (a) ventilator-assisted children are a widely varying group with diverse needs; (b) most families report that though they are glad to bring their child home, many difficult adjustments are required to do so; (c) full-time nursing care offers support to families but also intrudes on their privacy; (d) both families and children need social and psychological support once the child is home; (e) the needs of the child and the family may change over time; and (f) the financial burden of having a child on a ventilator at home can be a big stress on the family.

  4. Bringing Central Line–Associated Bloodstream Infection Prevention Home: CLABSI Definitions and Prevention Policies in Home Health Care Agencies

    PubMed Central

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

    2015-01-01

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

  5. Health Behaviors and Overweight in Nursing Home Employees: Contribution of Workplace Stressors and Implications for Worksite Health Promotion

    PubMed Central

    Miranda, Helena; Gore, Rebecca J.; Boyer, Jon; Nobrega, Suzanne; Punnett, Laura

    2015-01-01

    Background. Many worksite health promotion programs ignore the potential influence of working conditions on unhealthy behaviors. Methods. A study of nursing home employees (56% nursing aides) utilized a standardized questionnaire. We analyzed the cross-sectional associations between workplace stressors and obesity, cigarette smoking, and physical inactivity. Results. Of 1506 respondents, 20% reported exposure to three or more workplace stressors (physical or organizational), such as lifting heavy loads, low decision latitude, low coworker support, regular night work, and physical assault. For each outcome, the prevalence ratio was between 1.5 and 2 for respondents with four or five job stressors. Individuals under age 40 had stronger associations between workplace stressors and smoking and obesity. Conclusions. Workplace stressors were strongly associated with smoking, obesity, and physical inactivity, even among the lowest-status workers. Current working conditions affected younger workers more than older workers. Although this study is cross-sectional, it has other strengths, including the broad range of work stressors studied. Strenuous physical work and psychosocial strain are common among low-wage workers such as nursing home aides. Workplace health promotion programs may be more effective if they include measures to reduce stressful work environment features, so that working conditions support rather than interfere with employee health. PMID:26380373

  6. The NASA Radiation Health Program

    NASA Technical Reports Server (NTRS)

    Nicogossian, A. E.; Schimmerling, W.

    1991-01-01

    The NASA program for determining the impact of cosmic radiation on health is described in terms of its long-term goal of reducing the uncertainty of radiation-model prediction to +/- 25 percent by 2010. The Space Radiation Health Program (SRHP) is intended to address fundamental issues for establishing a scientific basis for human radiation protection: (1) the prediction of the probability of biological effects from radiation; (2) the reduction of uncertainty in predicted highly charged energetic particles; and (3) the characterization of background flux from Galactic cosmic rays. Another key objective is to develop related technologies for ground- and space-based solar monitoring to predict events involving solar energetic particles. Although substantial uncertainties are involved in the prediction of such events, the SRHP is essential for determining crucial variables related to launching mass and humans into orbit.

  7. 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

  8. Space radiation health program plan

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The Space Radiation Health Program intends to establish the scientific basis for the radiation protection of humans engaged in the exploration of space, with particular emphasis on the establishment of a firm knowledge base to support cancer risk assessment for future planetary exploration. This document sets forth the technical and management components involved in the implementation of the Space Radiation Health Program, which is a major part of the Life Sciences Division (LSD) effort in the Office of Space Science and Applications (OSSA) at the National Aeronautics and Space Administration (NASA). For the purpose of implementing this program, the Life Sciences Division supports scientific research into the fundamental mechanisms of radiation effects on living systems and the interaction of radiation with cells, tissues, and organs, and the development of instruments and processes for measuring radiation and its effects. The Life Sciences Division supports researchers at universities, NASA field centers, non-profit research institutes and national laboratories; establishes interagency agreements for cooperative use and development of facilities; and conducts a space-based research program using available and future spaceflight vehicles.

  9. 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.

  10. 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.

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

    PubMed Central

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

    2015-01-01

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

  12. 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

  13. IV treatment at home

    MedlinePlus

    ... home; PICC line - home; Infusion therapy - home; Home health care - IV treatment ... Often, home health care nurses will come to your home to give you the medicine. Sometimes, a family member, a friend, or ...

  14. Health information use in home care: brainstorming barriers, facilitators, and recommendations.

    PubMed

    Stolee, Paul; Steeves, Brandie; Manderson, Brooke L; Toscan, Justine L; Glenny, Christine; Berg, Katherine

    2010-01-01

    There is growing recognition of the importance of sharing health information in home care; however, limited research exists to identify appropriate strategies, especially with home care providers. We engaged home care stakeholders from three locations in Ontario to determine facilitators, barriers, and recommendations for using health information in home care. The results suggest that health professionals recognize the potential of these systems to enhance communication through several emergent themes; however, there was a lack of agreement on the current facilitators, barriers, and recommendations for future interventions. More research is needed to achieve consensus before strategies for improvement can be initiated.

  15. Non-Technical Medical Care: An In-Home Care Program.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Human Services, Oklahoma City.

    This document describes the Non-Technical Medical Care (NTMC) program, a personal care service offered by the Oklahoma Department of Human Services to eligible persons in their own homes. These NTMC program goals are listed: to provide personal care services to frail elderly and disabled persons, allowing them to remain in their homes; and to…

  16. 76 FR 12977 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-09

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation AGENCY... Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation. SUMMARY: HRSA and ACF announce through this notice the establishment of the Advisory Committee on the Maternal,...

  17. Physical Activity and Beverages in Home- and Center-Based Child Care Programs

    ERIC Educational Resources Information Center

    Tandon, Pooja S.; Garrison, Michelle M.; Christakis, Dimitri A.

    2012-01-01

    Objective: To describe and compare obesity prevention practices related to physical activity and beverages in home- and center-based child care programs. Methods: A telephone survey of licensed home- and center-based child care programs in Florida, Massachusetts, Michigan, and Washington between October and December 2008. Results: Most programs…

  18. Outcomes Assessment Handbook: How To Develop a Practical Outcomes Assessment Program for a Home Study School.

    ERIC Educational Resources Information Center

    Godfrey, Robert J.

    This handbook is designed to provide school decision makers with a global view of how assessment programs for home study schools are developed. Outcomes assessment (OA) is a required element for recognition by the National Home Study Council Accrediting Committee and hence for member schools. This handbook is designed to enable program developers…

  19. Evaluation of a Nurse-Led Fall Prevention Education Program in Turkish Nursing Home Residents

    ERIC Educational Resources Information Center

    Uymaz, Pelin E.; Nahcivan, Nursen O.

    2016-01-01

    Falls are a major cause of morbidity and mortality among the elderly living in nursing homes. There is a need to implement and evaluate fall prevention programs in nursing homes to reduce the number of falls. The purpose of this research was to examine the effect of a nurse-led fall prevention education program in a sample of nursing home…

  20. Home-Based Therapy for Young Children in Low-Income Families: A Student Training Program

    ERIC Educational Resources Information Center

    Mattek, Ryan J.; Jorgenson, Elizabeth T.; Fox, Robert A.

    2010-01-01

    The purpose of this project was to develop an internship training program that offered in-home therapy for young children with significant emotional and behavior problems. The children lived in single-parent, low-income homes in unsafe neighborhoods of a large, urban area. A year-long, training and supervision program was implemented with 10…

  1. 24 CFR 3288.215 - Effect on other manufactured home program requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Effect on other manufactured home... COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MANUFACTURED HOME DISPUTE RESOLUTION PROGRAM State Dispute Resolution Programs in Non-HUD Administered States § 3288.215 Effect on other manufactured...

  2. 24 CFR 3288.215 - Effect on other manufactured home program requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Effect on other manufactured home... COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MANUFACTURED HOME DISPUTE RESOLUTION PROGRAM State Dispute Resolution Programs in Non-HUD Administered States § 3288.215 Effect on other manufactured...

  3. Outcomes in a Nursing Home Transition Case-Management Program Targeting New Admissions

    ERIC Educational Resources Information Center

    Newcomber, Robert; Kang, Taewoon; Graham, Carrie

    2006-01-01

    Purpose: The Providing Assistance to Caregivers in Transition (PACT) program offers nursing home discharge planning and case management for individuals in the transitional period following a return to the community. The PACT program targeted individuals newly admitted to nursing homes and worked with a family caregiver to develop and implement a…

  4. Assessment of surgical wounds in the home health patient: definitions and accuracy with OASIS-C.

    PubMed

    Trexler, Rhonda A

    2011-10-01

    The number of surgical patients receiving home care continues to grow as hospitals discharge patients sooner. Home health clinicians must gain knowledge of the wound healing stages and surgical wound classification to collect accurate data in the Outcome and Assessment Information Set-C (OASIS-C). This article provides the information clinicians need to accurately assess surgical wounds and implement best practices for improving surgical wounds in the home health patient.

  5. Flight Crew Health Stabilization Program

    NASA Technical Reports Server (NTRS)

    Johnston, Smith L.

    2010-01-01

    This document establishes the policy and procedures for the HSP and is authorized through the Director, Johnson Space Center (JSC). This document delineates the medical operations requirements for the HSP. The HSP goals are accomplished through an awareness campaign and procedures such as limiting access to flight crewmembers, medical screening, and controlling flight crewmember activities. NASA's Human Space Flight Program uses strategic risk mitigation to achieve mission success while protecting crew health and safety. Infectious diseases can compromise crew health and mission success, especially in the immediate preflight period. The primary purpose of the Flight Crew Health Stabilization Program (HSP) is to mitigate the risk of occurrence of infectious disease among astronaut flight crews in the immediate preflight period. Infectious diseases are contracted through direct person-to-person contact, and through contact with infectious material in the environment. The HSP establishes several controls to minimize crew exposure to infectious agents. The HSP provides a quarantine environment for the crew that minimizes contact with potentially infectious material. The HSP also limits the number of individuals who come in close contact with the crew. The infection-carrying potential of these primary contacts (PCs) is minimized by educating them in ways to avoid infections and avoiding contact with the crew if they are or may be sick. The transmission of some infectious diseases can be greatly curtailed by vaccinations. PCs are strongly encouraged to maintain updated vaccinations.

  6. 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 ...

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  8. Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context

    PubMed Central

    Shakeel, Saad; Newhouse, Ian; Malik, Ali; Heckman, George

    2015-01-01

    Background Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the ‘feasibility’ of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. Method Six electronic databases were searched by two independent researchers for randomized controlled trials that targeted long-term care residents and included exercise as an independent component of the intervention. Results A total of 39 studies were included in this review. A majority of these interventions were led by physiotherapist(s), carried out three times per week for 30–45 minutes per session. However, a few group-based interventions that were led by long-term care staff, volunteers, or trained non-exercise specialists were identified that also required minimal equipment. Conclusion This systematic review has identified ‘feasible’ physical activity and falls prevention programs that required minimal investment in staff and equipment, and demonstrated positive outcomes. Implementation of such programs represents cost-effective means of providing long-term care residents with meaningful gains in physical, psychological, and social health. PMID:26180563

  9. Early Childhood Health--Mental Health Prevention and Treatment Program.

    ERIC Educational Resources Information Center

    Rubin, Lawrence S.

    The Maimonides Early Childhood Health-Mental Health Prevention and Treatment Program is described. The program provides a broad range of preventive services to children who are five years of age and younger. Services are organized into Post-Natal and Pre-School Programs. The Post-Natal Program offers group education and counseling, individual…

  10. Enhancing knowledge and attitudes in pain management: a pain management education program for nursing home staff.

    PubMed

    Tse, Mimi Mun Yee; Ho, Suki S K

    2014-03-01

    The aim of the study was to examine the effectiveness of a pain management program (PMP) in enhancing the knowledge and attitudes of health care workers in pain management. Many nursing home residents suffer from pain, and treatment of pain is often inadequate. Failure of health care workers to assess pain and their insufficient knowledge of pain management are barriers to adequate treatment. It was a quasiexperimental pretest and posttest study. Four nursing homes were approached, and 88 staff joined the 8-week PMP. Demographics and the knowledge and attitudes regarding pain were collected with the use of the Nurse's Knowledge and Attitudes Survey Regarding Pain-Chinese version (NKASRP-C) before and after the PMP. A deficit in knowledge and attitudes related to pain management was prominent before the PMP, and there was a significant increase in pain knowledge and attitudes from 7.9 ± SD 3.52 to 19.2 ± SD4.4 (p < .05) after the 8-week PMP. A PMP can improve the knowledge and attitudes of nursing staff and enable them to provide adequate and appropriate care to older persons in pain. PMPs for nurses and all health care professionals are important in enhancing care for older adults and to inform policy on the provision of pain management.

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

    PubMed

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

    2011-10-01

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

  12. Utilization of Home Health Services before and after the Balanced Budget Act of 1997: What Were the Initial Effects?

    PubMed Central

    McCall, Nelda; Petersons, Andrew; Moore, Stanley; Korb, Jodi

    2003-01-01

    Objective To estimate the impact of the Balanced Budget Act of 1997 (BBA), which changed the way Medicare reimbursed for home health services, on a range of home health utilization measures, and to examine whether particular subgroups of beneficiaries were differentially impacted in the post-BBA period. Data Sources Secondary data from the Centers for Medicare and Medicaid Services (CMS) Standard Analytic Files for the 1 percent sample of Medicare beneficiaries for fiscal years 1997 and 1999, linked with information from CMS eligibility, provider, and cost report files as well as the Area Resources File. Study Design Logistic regression was used to estimate the effects of being in the post-BBA period on the incidence of home health service use and ordinary least squares (OLS) regression was used to estimate the effects of being in the post-BBA period on the amount and type of use by home health service users. Interaction terms were included for all the independent variables to assess whether the effect was disproportionate among particular beneficiary subgroups. Principal Findings Results show a 22 percent decrease in the percentage using home health services post-BBA and a 39 percent decrease in the number of visits per user. Stronger reductions, though not very large, were found in the incidence of use for beneficiaries aged 85 and older, those in states with high historical Medicare home health use, and those with Medicaid buy-in. More intensive reductions in the number of services were found for those aged 85 and older, in high historical Medicare use states, nonwhites, females, those using for-profit agencies, and those treated for certain diagnoses. Less intensive reductions were associated with hospital-based agencies. Conclusions This research demonstrates that public program expenditures can be sharply curtailed with financial incentives. As reimbursement shifts to a prospective payment system legislated by the BBA, utilization should be closely monitored

  13. Comparing Aging in Place to Home Health Care: Impact of Nurse Care Coordination On Utilization and Costs.

    PubMed

    Popejoy, Lori L; Galambos, Colleen; Stetzer, Frank; Popescu, Mihail; Hicks, Lanis; Khalilia, Mohammed A; Rantz, Marilyn J; Marek, Karen D

    2015-01-01

    The goal of this study was to compare utilization and cost outcomes of patients who received long-term care coordination in an Aging in Place program to patients who received care coordination as a routine service in home health care. This research offered the unique opportunity to compare two groups of patients who received services from a single home health care agency, using the same electronic health record, to identify the impact of long-term and routine care coordination on utilization and costs to Medicare and Medicaid programs. This study supports that long-term care coordination supplied by nurses outside of a primary medical home can positively influence functional, cognitive, and health care utilization for frail older people. The care coordinators in this study practiced nursing by routinely assessing and educating patients and families, assuring adequate service delivery, and communicating with the multidisciplinary health care team. Care coordination managed by registered nurses can influence utilization and cost outcomes, and impact health and functional abilities.

  14. Process Evaluation of a Home-Based Program to Reduce Diet-Related Cancer Risk: The "WIN at Home Series."

    ERIC Educational Resources Information Center

    Finnegan, John R.; And Others

    1992-01-01

    Following media recruitment campaign, WIN at Home, series of diet-related booklets mailed to participants, was evaluated through survey of 226 participants (75 percent). Results showed that 97 percent learned about program through media, women were more likely to learn about it from personal sources, 57 percent shared information with spouses, and…

  15. An evaluation of a "best practices" musculoskeletal injury prevention program in nursing homes

    PubMed Central

    Collins, J; Wolf, L; Bell, J; Evanoff, B

    2004-01-01

    Objective: To conduct an intervention trial of a "best practices" musculoskeletal injury prevention program designed to safely lift physically dependent nursing home residents. Design: A pre-post intervention trial and cost benefit analysis at six nursing homes from January 1995 through December 2000. The intervention was established in January 1998 and injury rates, injury related costs and benefits, and severity are compared for 36 months pre-intervention and 36 months post-intervention. Participants: A dynamic cohort of all nursing staff (n = 1728) in six nursing homes during a six year study period. Intervention: "Best practices" musculoskeletal injury prevention program consisting of mechanical lifts and repositioning aids, a zero lift policy, and employee training on lift usage. Main outcome measures: Injury incidence rates, workers' compensation costs, lost work day injury rates, restricted work day rates, and resident assaults on caregivers, annually from January 1995 through December 2000. Results: There was a significant reduction in resident handling injury incidence, workers' compensation costs, and lost workday injuries after the intervention. Adjusted rate ratios were 0.39 (95% confidence interval (CI) 0.29 to 0.55) for workers' compensation claims, 0.54 (95% CI 0.40 to 0.73) for Occupational Safety and Health Administration (OSHA) 200 logs, and 0.65 (95% CI 0.50 to 0.86) for first reports of employee injury. The initial investment of $158 556 for lifting equipment and worker training was recovered in less than three years based on post-intervention savings of $55 000 annually in workers' compensation costs. The rate of post-intervention assaults on caregivers during resident transfers was down 72%, 50%, and 30% based on workers' compensation, OSHA, and first reports of injury data, respectively. Conclusions: The "best practices" prevention program significantly reduced injuries for full time and part time nurses in all age groups, all lengths of

  16. Effect of a home intervention program on pediatric asthma in an environmental justice community.

    PubMed

    Shani, Zalika; Scott, Richard G; Schofield, Lynne Steuerle; Johnson, John H; Williams, Ellen R; Hampton, Janiene; Ramprasad, Vatsala

    2015-03-01

    Asthma prevalence rates are at an all-time high in the United States with over 25 million persons diagnosed with asthma. African Americans and other minorities have higher asthma prevalence and higher exposure to environmental factors that worsen asthma as compared to Caucasians. This article describes the evaluation of an inner-city home-based asthma education and environmental remediation program that addressed both indoor and outdoor triggers through collaboration between a health system and local environmental justice organization. The program enrolled 132 children older than 2.5 years and centers on a 4- to 6-week intervention with peer counselors using the U.S. Environmental Protection Agency Asthma Home Environment Checklist and the You Can Control Asthma curriculum. Families receive asthma-friendly environmental home kits. Peer counselors reinforce key asthma management messages and facilitate the completion of Asthma Action Plans. The environmental justice community partner organized block cleanups to reduce outdoor triggers. The evaluation used a pretest-posttest design to assess changes in client behavior and asthma symptoms. Data were collected at baseline and during a 6-month postintervention period. Participants saw enhanced conditions on asthma severity and control. The improvement was greatest for children whose asthma was considered "severe" based on the validated Asthma Control Test. Other positive results include the following: greater completion of Asthma Action Plans, significant reduction in the number of emergency room visits (p = .006), and substantial decreases in school absenteeism (p = .008) and use of rescue medications (p = .049). The evaluation suggests that the program was effective in improving asthma self-management in a high-risk population living within an environmental justice community.

  17. 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 ...

  18. 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…

  19. California Community College Home Economics Program Plan, 1992. Including: Directory of Professional and Trade Organizations and Directory of Home Economics and Related Program Areas and Instructional Staff.

    ERIC Educational Resources Information Center

    California Community Colleges, Sacramento. Office of the Chancellor.

    Designed to assist local colleges/districts in assessing their existing home economics program, and in developing curricula that respond to the changing needs of students, communities, and the workforce, this plan presents the program guidelines of the California Community Colleges (CCCs). Introductory material describes the history of the program…

  20. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... home visitor with only babysitters or other temporary caregivers in attendance. (1) The purpose of the... visitor with babysitters or other temporary caregivers. (1) The purpose of these socialization activities... Start classroom, community facility, home, or on a field trip. The children are to be supervised by...

  1. Do-It-Yourself Home Savings Techniques Program. Final Report.

    ERIC Educational Resources Information Center

    Halasa, Ofelia; And Others

    This report assesses the Do-It-Yourself Home Savings Techniques project, which was designed to develop and test an instructional unit for making homes energy efficient. The project, implemented at schools in the Cleveland City School District from October 1981 through February 1983, involved 11 science teachers and approximately 1,200 students.…

  2. The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program. A Report to Congress. OPRE Report 2015-11

    ERIC Educational Resources Information Center

    Michalopoulos, Charles; Lee, Helen; Duggan, Anne; Lundquist, Erika; Tso, Ada; Crowne, Sarah Shea; Burrell, Lori; Somers, Jennifer; Filene, Jill H.; Knox, Virginia

    2015-01-01

    "The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program--A Report to Congress" presents the first findings from the Mother and Infant Home Visiting Program Evaluation (MIHOPE), the legislatively mandated national evaluation of the Maternal, Infant, and…

  3. 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

  4. The ALIVE program: developing a web-based professional development program for nursing leaders in the home healthcare sector.

    PubMed

    Lankshear, Sara; Huckstep, Sherri; Lefebre, Nancy; Leiterman, Janis; Simon, Deborah

    2010-05-01

    Home healthcare nurses often work in isolation and rarely have the opportunity to meet or congregate in one location. As a result, nurse leaders must possess unique leadership skills to supervise and manage a dispersed employee base from a distance. The nature of this dispersed workforce creates an additional challenge in the ability to identify future leaders, facilitate leadership capacity, and enhance skill development to prepare them for future leadership positions. The ALIVE (Actively Leading In Virtual Environments) web-based program was developed to meet the needs of leaders working in virtual environments such as the home healthcare sector. The program, developed through a partnership of three home healthcare agencies, used nursing leaders as content experts to guide program development and as participants in the pilot. Evaluation findings include the identification of key competencies for nursing leaders in the home healthcare sector, development of program learning objectives and participant feedback regarding program content and delivery. PMID:20463446

  5. 42 CFR 410.170 - Payment for home health services, for medical and other health services furnished by a provider...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Payment for home health services, for medical and other health services furnished by a provider or an approved ESRD facility, and for comprehensive... services, for medical and other health services furnished by a provider or an approved ESRD facility,...

  6. 42 CFR 410.170 - Payment for home health services, for medical and other health services furnished by a provider...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for home health services, for medical and other health services furnished by a provider or an approved ESRD facility, and for comprehensive... services, for medical and other health services furnished by a provider or an approved ESRD facility,...

  7. 42 CFR 410.170 - Payment for home health services, for medical and other health services furnished by a provider...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Payment for home health services, for medical and other health services furnished by a provider or an approved ESRD facility, and for comprehensive... services, for medical and other health services furnished by a provider or an approved ESRD facility,...

  8. 42 CFR 410.170 - Payment for home health services, for medical and other health services furnished by a provider...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Payment for home health services, for medical and other health services furnished by a provider or an approved ESRD facility, and for comprehensive... services, for medical and other health services furnished by a provider or an approved ESRD facility,...

  9. 42 CFR 410.170 - Payment for home health services, for medical and other health services furnished by a provider...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for home health services, for medical and other health services furnished by a provider or an approved ESRD facility, and for comprehensive... services, for medical and other health services furnished by a provider or an approved ESRD facility,...

  10. Survey of Student Interest in Home Economics Wage-Earning Programs and Employment Opportunities in Home Economics Related Occupations in Dade County, Florida.

    ERIC Educational Resources Information Center

    Hein, Margaret R.

    Occupational areas and coincident student interest in home economics were surveyed in Dade County to provide a basis for future program planning. Surveyed were 11,402 junior and senior high school students enrolled in home and family education courses in May 1972 and 64 employers in home economics related occupations. A series of recommendations…

  11. Rapid EHR development and implementation using web and cloud-based architecture in a large home health and hospice organization.

    PubMed

    Weaver, Charlotte A; Teenier, Pamela

    2014-01-01

    Health care organizations have long been limited to a small number of major vendors in their selection of an electronic health record (EHR) system in the national and international marketplace. These major EHR vendors have in common base systems that are decades old, are built in antiquated programming languages, use outdated server architecture, and are based on inflexible data models [1,2]. The option to upgrade their technology to keep pace with the power of new web-based architecture, programming tools and cloud servers is not easily undertaken due to large client bases, development costs and risk [3]. This paper presents the decade-long efforts of a large national provider of home health and hospice care to select an EHR product, failing that to build their own and failing that initiative to go back into the market in 2012. The decade time delay had allowed new technologies and more nimble vendors to enter the market. Partnering with a new start-up company doing web and cloud based architecture for the home health and hospice market, made it possible to build, test and implement an operational and point of care system in 264 home health locations across 40 states and three time zones in the United States. This option of "starting over" with the new web and cloud technologies may be posing a next generation of new EHR vendors that retells the Blackberry replacement by iPhone story in healthcare.

  12. Rapid EHR development and implementation using web and cloud-based architecture in a large home health and hospice organization.

    PubMed

    Weaver, Charlotte A; Teenier, Pamela

    2014-01-01

    Health care organizations have long been limited to a small number of major vendors in their selection of an electronic health record (EHR) system in the national and international marketplace. These major EHR vendors have in common base systems that are decades old, are built in antiquated programming languages, use outdated server architecture, and are based on inflexible data models [1,2]. The option to upgrade their technology to keep pace with the power of new web-based architecture, programming tools and cloud servers is not easily undertaken due to large client bases, development costs and risk [3]. This paper presents the decade-long efforts of a large national provider of home health and hospice care to select an EHR product, failing that to build their own and failing that initiative to go back into the market in 2012. The decade time delay had allowed new technologies and more nimble vendors to enter the market. Partnering with a new start-up company doing web and cloud based architecture for the home health and hospice market, made it possible to build, test and implement an operational and point of care system in 264 home health locations across 40 states and three time zones in the United States. This option of "starting over" with the new web and cloud technologies may be posing a next generation of new EHR vendors that retells the Blackberry replacement by iPhone story in healthcare. PMID:24943570

  13. Health Is Academic. A Guide to Coordinated School Health Programs.

    ERIC Educational Resources Information Center

    Marx, Eva, Ed.; Wooley, Susan Frelick, Ed.; Northrop, Daphne, Ed.

    This book presents a collection of papers that define comprehensive school health programs and their components and provide action steps for their implementation at the local, state, and national levels: (1) "Linking Health and Learning: An Overview of Coordinated School Health Programs" (Floretta Dukes McKenzie and Julius B. Richmond); (2)…

  14. 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

  15. 23. The long-term care component of the Massachusetts Cooperative Health Statistics Program.

    PubMed

    Caso, E; Freedman, L; Gruenberg, L

    1976-05-01

    The Office of Health Planning and Statistics of the Massachusetts Department of Public Health, with the support of the National Center for Health Statistics, has over the past two years established two data programs in long-term care. The first of these involves experimentation with large-scale collection of patient-specific data from long-term care facilities, with the goal of developing statistically valid algorithms to predict the most appropirate level of care for individual patients. The second program has been the development of a data base for home health care agencies, the elements of which are an agency-specific annual statistical report and a patient-specific discharge abstract program. These two programs mark an effort to document home health care activities so as to provide a base of information for program development and evaluation.

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

    ERIC Educational Resources Information Center

    Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar

    2009-01-01

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

  17. 77 FR 69550 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program... provided by or through the Michael E. DeBakey Home Care Program. DATES: Written comments and... information technology. Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form...

  18. 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.

  19. The NASA Radiation Health Program

    NASA Technical Reports Server (NTRS)

    Schimmerling, Walter

    1991-01-01

    The Space Radiation Health Program (SRHP) is defined in terms of motivation and methodology with specific reference given to the impacts of HZE particles and solar energetic particles. The biological hazards are mentioned that can be associated with the two particle types and ionizing radiation in general. The lack of data on the impact of such radiation and effective shielding countermeasures is identified as the primary motivation for worst-case assumptions. However, the resulting shielding designs can potentially overestimate the thickness by a factor of 10 and add unnecessarily to vehicle take-off mass. A space-based validation system is proposed to complement ground-based investigations of the effects of ionizing radiation in interplanetary space. The Lifesat satellite is proposed as a part of the SRHP effort to determine the requirements for protection and future shielding specifications.

  20. Service and business model for technology enabled and home-based cardiac rehabilitation programs.

    PubMed

    Sarela, Antti; Whittaker, Frank; Korhonen, Ilkka

    2009-01-01

    Cardiac rehabilitation programs are comprehensive life-style programs aimed at preventing recurrence of a cardiac event. However, the current programs have globally significantly low levels of uptake. Home-based model can be a viable alternative to hospital-based programs. We developed and analysed a service and business model for home based cardiac rehabilitation based on personal mentoring using mobile phones and web services. We analysed the different organizational and economical aspects of setting up and running the home based program and propose a potential business model for a sustainable and viable service. The model can be extended to management of other chronic conditions to enable transition from hospital and care centre based treatments to sustainable home-based care.

  1. 3 CFR - State Children's Health Insurance Program

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false State Children's Health Insurance Program Presidential Documents Other Presidential Documents Memorandum of February 4, 2009 State Children's Health Insurance Program Memorandum for the Secretary of Health and Human Services The State Children's...

  2. Misoprostol for Prevention of Postpartum Hemorrhage at Home Birth in Afghanistan: Program Expansion Experience

    PubMed Central

    Ansari, Nasratullah; Zainullah, Partamin; Kim, Young‐Mi; Tappis, Hannah

    2016-01-01

    Introduction Afghanistan has a maternal mortality ratio of 400 per 100,000 live births. Hemorrhage is the leading cause of maternal death. Two‐thirds of births occur at home. A pilot program conducted from 2005 to 2007 demonstrated the effectiveness of using community health workers for advance distribution of misoprostol to pregnant women for self‐administration immediately following birth to prevent postpartum hemorrhage. The Ministry of Public Health requested an expansion of the pilot to study implementation on a larger scale before adopting the intervention as national policy. The purpose of this before‐and‐after study was to determine the effectiveness of advance distribution of misoprostol for self‐administration across 20 districts in Afghanistan and identify any adverse events that occurred during expansion. Methods Cross‐sectional household surveys were conducted pre‐ (n = 408) and postintervention (n = 408) to assess the effect of the program on uterotonic use among women who had recently given birth. Maternal death audits and verbal autopsies were conducted to investigate peripartum maternal deaths that occurred during implementation in the 20 districts. Results Uterotonic use among women in the sample increased from 50.3% preintervention to 74.3% postintervention. Because of a large‐scale investment in Afghanistan in training and deployment of community midwives, it was assumed that all women who gave birth in facilities received a uterotonic. A significant difference in uterotonic use at home births was observed among women who lived farthest from a health facility (> 90 minutes self‐reported travel time) compared to women who lived closer (88.5% vs 38.9%; P < .0001). All women who accepted misoprostol and gave birth at home used the drug. No maternal deaths were identified among those women who used misoprostol. Discussion The results of this study build on the findings of the pilot program and provide evidence on the effectiveness

  3. The Effects of an Education Program on Home Renovation for Fall Prevention of Korean Older People

    ERIC Educational Resources Information Center

    Jang, Miseon; Lee, Yeunsook

    2015-01-01

    This study aims to verify the effects of an education program on home renovation for fall prevention among older people, more specifically fall efficacy and home renovation intentions. A quasiexperimental study with nonequivalent control and comparative groups was conducted to demonstrate the effects of the education. A total of 51 older people…

  4. Toddlers' Expressive Vocabulary Outcomes after One Year of Parent-Child Home Program Services

    ERIC Educational Resources Information Center

    Manz, Patricia H.; Bracaliello, Catherine B.; Pressimone, Vanessa J.; Eisenberg, Rachel A.; Gernhart, Amanda C.; Fu, Qiong; Zuniga, Cesar

    2016-01-01

    This quasi-experimental study examined expressive vocabulary outcomes for Parent-Child Home Program (PCHP) toddlers, after one year of home-visiting services. First, this study applied Rasch modelling to establish the construct validity and reliability of a widely used expressive vocabulary measure, as modified for a sample of ethnic and…

  5. The Parent-Child Home Program in Western Manitoba: A 20-Year Evaluation

    ERIC Educational Resources Information Center

    Gfellner, Barbara M.; McLaren, Lorraine; Metcalfe, Arron

    2008-01-01

    This article is a 20-year evaluation of the Parent-Child Home Program (PCHP) of Child and Family Services in Western Manitoba. Following Levenstein's (1979, 1988) approach, home visitors model parent-child interchanges using books and toys to enhance children's cognitive development through appropriate parenting behaviors. The evaluation provides…

  6. A Message from Home: Findings from a Program for Non-Retarded, Low-Income Preschoolers.

    ERIC Educational Resources Information Center

    Levenstein, Phyllis

    This document describes the Mother-Child Home Program (MCHP) for prevention of educational disadvantage, prepared by the Verbal Interaction Project. The MCHP consisted of 92 semi-weekly, half hour home sessions spread over two years by interviewers called "Toy Demonstrators". The latter were trained in non-didactic techniques to show a mother, by…

  7. Insitute for Home Economics Teacher Educators on Preparing Teachers for Occupational Programs. Final Report.

    ERIC Educational Resources Information Center

    Hill, Alberta D.

    Thirty selected home economics teacher educators from 24 states participated in a 3-week summer institute which was devoted to (1) the identification and clarification of philosophies of vocational education affecting teacher education in home economics, (2) teacher qualifications, (3) program development, and (4) guidelines for evaluating teacher…

  8. The Home Instruction for Parents of Preschool Youngsters Program's Relationship with Mother and School Outcomes

    ERIC Educational Resources Information Center

    Johnson, Ursula Y.; Martinez-Cantu, Veronica; Jacobson, Arminta L.; Weir, Carla-Marie

    2012-01-01

    Research Findings: This study investigated the relationship of the Home Instruction for Parents of Preschool Youngsters (HIPPY) program to mothers' involvement in education at home and school, student school readiness in kindergarten, and student academic outcomes at 3rd grade. HIPPY serves a mostly minority, low-income family population and…

  9. Characteristics Predicting Nursing Home Admission in the Program of All-Inclusive Care for Elderly People

    ERIC Educational Resources Information Center

    Friedman, Susan M.; Steinwachs, Donald M.; Rathouz, Paul J.; Burton, Lynda C.; Mukamel, Dana B.

    2005-01-01

    Long term care in a nursing home prior to enrollment in PACE remain at high risk of readmission, despite the availability of comprehensive services. This study determined overall risk and predictors of long-term nursing home admission within the Program of All-Inclusive Care for the Elderly (PACE). Design and Methods: Data PACE records for 4,646…

  10. Evaluation of Chapter I Take-Home Computer Program. Report No. 7, Vol. 25.

    ERIC Educational Resources Information Center

    Fraser, Lowrie A.

    The Chapter I Take-Home Computer (THC) program was established in nine elementary and eight middle schools in Atlanta (Georgia) in the 1989-90 school year. One hundred and eighty computers were sent home with 422 students, whose parents were willing to work with the students, for 6-week periods. Log sheets were kept by each child regarding the…

  11. Enriched Home Environment Program for Preschool Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Sood, Divya; Szymanski, Monika; Schranz, Caren

    2015-01-01

    This study discusses the impact of the Enriched Home Environment Program (EHEP) on participation in home activities among two children with ASD using case study methodology. EHEP involves occupational therapists to collaborate with families of children with ASD to educate them about the impact of factors that influence child's participation within…

  12. Embedding Home Visitation Programs within a System of Early Childhood Services. Chapin Hall Issue Brief

    ERIC Educational Resources Information Center

    Daro, Deborah

    2009-01-01

    Over the past 20 years, home visitation has emerged as the flagship program through which many states and communities are reaching out to new parents.The presence of bills to advance home visitation in Congress and in state and local legislatures, and the fact that several states and counties are moving forward with comprehensive plans and…

  13. Pilot Evaluation of a Home Visit Parent Training Program in Disadvantaged Families

    ERIC Educational Resources Information Center

    Leung, Cynthia; Tsang, Sandra; Heung, Kitty

    2013-01-01

    Objectives: The study reported the pilot evaluation of the Healthy Start Home Visit Program for disadvantaged Chinese parents with preschool children, delivered by trained parent assistants. Home visiting was used to make services more accessible to disadvantaged families. Method: The participants included 21 parent-child dyads. Outcome measures…

  14. Parental perceptions of the roles of home and school in health education for elementary school children in Finland.

    PubMed

    Sormunen, Marjorita; Tossavainen, Kerttu; Turunen, Hannele

    2013-06-01

    A variety of legislation, initiatives and organizations exist to support, encourage and even oblige schools to collaborate more effectively with parents or guardians. However, there is minimal understanding of the experiences and opinions of parents and school staff about their roles, especially in relation to children's health education. This study examined how parents of 10-11-year-old children perceive the roles of both home and school in educating children about health. A questionnaire, based partly on the Finnish national core curriculum for basic education, was administered to 348 parents; the response rate was 53%. Factor analysis was used to define sum variables, which were then used as dependent variables in an analysis of variance examining the effects of children's gender and health; parents' education, gender, work status and year of birth; and school location (urban/rural). The results suggested that parents considered that either health education was mainly their responsibility, or it was a mutual responsibility with the school. Parents living in rural areas and the youngest group of parents were more likely to consider that health education should be shared with schools than were parents living in cities, or older parents. To expand awareness about the role of home and school in children's health education and to develop further health promotion within the whole school community, it is important to gather parents' views regarding health issues. This study was conducted as part of a broader program in the health promotion network of the Schools for Health in Europe (SHE).

  15. Effects of Medicare payment reform: evidence from the home health interim and prospective payment systems.

    PubMed

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

    2014-03-01

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

  16. 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.

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-21

    ... medical charges associated with non-VA outpatient care, provided under 38 CFR 17.52 or 17.120. 75 FR 78901.... See 75 FR 78901. We explained: Home Health Care and Hospice Care he pricing methodology adopted by...-day period was $2,537.40 in FY 2010. The average Medicare reimbursement level for skilled home...

  19. 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…

  20. [The audience of TV health programs].

    PubMed

    Cianciara, Dorota; Przewłocka, Teresa; Miller, Maria

    2004-01-01

    The viewing figures of 36 unpaid TV health programs was assessed: the number of viewers, their socio-demographic status and interest in specific program. Between June 1998 and June 1999, non commercial TV health programs reached 0.7% to 7.6% TV audience, no more than 2,700.000 viewers per program. Programs broadcasted in evenings and winter time had more viewers. The audience consisted usually of: women, retired persons, rural inhabitants, persons with basic educational background. Pensioners were interested in every program, women in majority. Students, blue-collar workers and men were censorious and appreciated some programs only.

  1. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards §...

  2. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards §...

  3. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards §...

  4. 38 CFR 52.61 - General requirements for adult day health care program.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false General requirements for adult day health care program. 52.61 Section 52.61 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) PER DIEM FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards §...

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

    MedlinePlus

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

  6. [Home care for the chronically ill: a self-care health system].

    PubMed

    Silva, Leticia Robles

    2004-01-01

    This article focuses on home care for chronically ill adults and seniors. According to our thesis, home care should be understood as a self-care system, and its aim is to guarantee the individual's social and bodily survival. Home care consists of three areas, related to illness, the home, and to life history. Caregiving, usually under women's responsibility, is present throughout the history of the illness and the health-seeking process. The article analyzes these issues in light of the ageing process, the epidemiological changes occurring worldwide, and the urgency to incorporate this analysis into the heath care research agenda. PMID:15073644

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

    PubMed Central

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

    2014-01-01

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

  8. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    PubMed

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions.

  9. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    PubMed

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions. PMID:22797030

  10. Why Hospitals and Payers are Recommending Home Care Upon Discharge Instead of SNF or Traditional Home Health Services--Alternative Payment Model Hospital Incentives Aligning with Patient Choice.

    PubMed

    Luke, Josh

    2016-01-01

    Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely non-medical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model. PMID:27180473

  11. Why Hospitals and Payers are Recommending Home Care Upon Discharge Instead of SNF or Traditional Home Health Services--Alternative Payment Model Hospital Incentives Aligning with Patient Choice.

    PubMed

    Luke, Josh

    2016-01-01

    Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely non-medical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model.

  12. Making Connections: Promoting Music Making in the Home through a Preschool Music Program

    ERIC Educational Resources Information Center

    Cooper, Shelly; Cardany, Audrey Berger

    2008-01-01

    The Musical Play program is designed to assist children ages 2 to 5 and their parents. The program creators sought to help families build a repertoire of songs and activities for everyday living and to encourage musical play at home. The program includes developmentally appropriate songs, materials, and activities and incorporates a wide variety…

  13. Evaluation of a Behavior Management Training Program for Nursing Home Caregivers.

    ERIC Educational Resources Information Center

    Marsiske, Michael; And Others

    This study examined the effectiveness of a new skills training program designed to increase nurse aides' knowledge of behavior management. The training program, designed as five 90-minute group learning modules, was implemented in two Western Pennsylvania nursing homes over a 5-month period. Topics covered within the training program included…

  14. Health Careers Recruitment Program Handbook.

    ERIC Educational Resources Information Center

    Pike, Bill, Ed.

    Designed to encourage Native American students in Colorado and New Mexico to pursue health careers, this handbook presents the following information: (1) statistics documenting the need for American Indian health professionals; (2) current career opportunities in the health professions (descriptions of the many health fields and descriptions of…

  15. Student stress and academic performance: home hospital program.

    PubMed

    Yucha, Carolyn B; Kowalski, Susan; Cross, Chad

    2009-11-01

    The purpose of this study was to evaluate whether nursing students assigned to a home hospital experience less stress and improved academic performance. Students were assigned to a home hospital clinical placement (n = 78) or a control clinical placement (n = 79). Stress was measured using the Student Nurse Stress Index (SNSI) and Spielberger's State Anxiety Inventory. Academic performance included score on the RN CAT, a standardized mock NCLEX-RN(®)-type test; nursing grade point average; and first attempt pass-fail on the NCLEX-RN. There were no statistically significant differences between the two groups for age, gender, marital status, ethnicity, or score on the nurse entrance examination. There were significant changes in SNSI over time but not between groups. Academic load and state anxiety showed an interaction of time by group, with the home hospital group showing reductions over time, compared with the control group.

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

    ERIC Educational Resources Information Center

    Blatt, Steven D.; And Others

    1997-01-01

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

  17. Design and methodology of a randomized clinical trial of home-based telemental health treatment for U.S. military personnel and veterans with depression.

    PubMed

    Luxton, David D; Pruitt, Larry D; O'Brien, Karen; Stanfill, Katherine; Jenkins-Guarnieri, Michael A; Johnson, Kristine; Wagner, Amy; Thomas, Elissa; Gahm, Gregory A

    2014-05-01

    Home-based telemental health (TMH) treatments have the potential to address current and future health needs of military service members, veterans, and their families, especially for those who live in rural or underserved areas. The use of home-based TMH treatments to address the behavioral health care needs of U.S. military healthcare beneficiaries is not presently considered standard of care in the Military Health System. The feasibility, safety, and clinical efficacy of home-based TMH treatments must be established before broad dissemination of home-based treatment programs can be implemented. This paper describes the design, methodology, and protocol of a clinical trial that compares in-office to home-based Behavioral Activation for Depression (BATD) treatment delivered via web-based video technology for service members and veterans with depression. This grant funded three-year randomized clinical trial is being conducted at the National Center for Telehealth and Technology at Joint-base Lewis-McChord and at the Portland VA Medical Center. Best practice recommendations regarding the implementation of in-home telehealth in the military setting as well as the cultural and contextual factors of providing in-home care to active duty and veteran military populations are also discussed.

  18. 75 FR 45149 - Announcement of Funding Awards for Healthy Homes and Lead Hazard Control Grant Programs for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-02

    ... Programs (FR-5300-N-06); on September 21, 2009 for the Healthy Homes Demonstration (FR-5300-N-17), Lead Hazard Control Capacity Building (FR-5300-N-31) and Green and Healthy Homes Technical Studies (FR-5300- N-20); and on June 17, 2009 for the Healthy Homes Technical Studies Grant Programs (FR-5300-N-07)....

  19. Parent and Child Perceptions of a Self-Regulated, Home-Based Exercise Program for Children with Cystic Fibrosis

    PubMed Central

    Happ, Mary Beth; Hoffman, Leslie A.; Higgins, Linda W.; DiVirgilio, Dana; Orenstein, David M.

    2014-01-01

    Background Despite recognized benefits, many children with cystic fibrosis (CF) do not consistently participate in physical activities. There is little empirical literature regarding the feelings and attitudes of children with CF toward exercise programs, parental roles in exercise, or factors influencing exercise experiences during research participation. Objectives To describe the exercise experiences of children with CF and their parents during participation in a six-month program of self-regulated, home-based exercise. Methods This qualitative descriptive study nested within a randomized controlled trial of a self-regulated, home-based exercise program used serial semi-structured interviews conducted individually at two and six months with 11 purposively selected children with CF and their parent(s). Results Six boys and five girls, ages 10–16, and parents (nine mothers, four fathers) participated in a total of 44 interviews. Five major thematic categories describing child and parent perceptions and experience of the bicycle exercise program were identified in the transcripts: (a) motivators; (b) barriers; (c) effort/work; (d) exercise routine; (e) sustaining exercise. Research participation, parent-family participation, health benefits, and the child’s personality traits were primary motivators. Competing activities, priorities and responsibilities were the major barriers to implementing the exercise program as prescribed. Motivation waned and the novelty wore off for several (approximately half) parent-child dyads, who planned to decrease or stop the exercise program after the study ended. Discussion We identified motivators and barriers to a self-regulated, home-based exercise program for children with CF that can be addressed in planning future exercise interventions to maximize the health benefits for children with CF and the feasibility and acceptability to the children and their families. PMID:23995464

  20. 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

  1. [Home care workers' oral health awareness and practice for disabled elderly].

    PubMed

    Atsushi, Ohyama; Yoshinori, Toriyama; Yoshiyuki, Sasaki; Izumi, Koyama; Chie, Shimizu; Norimasa, Kurosaki; Shiro, Mataki

    2003-03-01

    The purpose of this study was to investigate the level of oral health awareness, and to explore the needs for home care workers to provide oral health care for disabled elderly. We conducted a questionnaire survey at two home-help service centers and a social welfare council. Subjects for this investigation were 63 home care workers. The results were as follows: 1. Ninety-six percent of home care workers thought it was necessary to provide oral health care for disabled elderly, but only 11 percent of them put oral care into practice on a daily basis. 2. From the results of a cause and effect diagram, necessities of oral care were summarized as six major causes: 1) Disabled elderly are often unable to brush their teeth, 2) The oral hygiene level may affect physical condition, 3) Disabled elderly should be protected from oral diseases, 4) Disabled elderly should have their mouths kept clean, 5) Eating and swallowing may become increasingly difficult, 6) Disabled elderly should take in adequate nutrition. 3. Sixty-eight percent of home care workers took part in a training course of nursing care including oral care. 4. Home care workers, dentists, dental hygienists, and nurses taught oral health care to home care workers. 5. From the results of a cause and effect diagram, there were three major items that home care workers want to know: 1) denture management, 2) the routine of oral care, 3) infection control. 6. Home care workers recognized that oral care should be provided by family members of disabled elderly or home care workers. PMID:12708030

  2. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during group... hours each. (2) Provide, at a minimum, two group socialization activities per month for each child (a minimum of 16 group socialization activities each year). (3) Make up planned home visits or...

  3. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... necessary to meet the minimums stated above. Medical or social service appointments may not replace home... for the children is to emphasize peer group interaction through age appropriate activities in a Head... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during...

  4. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... necessary to meet the minimums stated above. Medical or social service appointments may not replace home... for the children is to emphasize peer group interaction through age appropriate activities in a Head... specified in 45 CFR 1304.23(b)(2) and provide appropriate snacks and meals to the children during...

  5. Operation of Wastewater Treatment Plants: A Home Study Training Program.

    ERIC Educational Resources Information Center

    California State Univ., Sacramento. Dept. of Civil Engineering.

    This manual was prepared by experienced wastewater treatment plant operators to provide a home study course to develop new qualified workers and expand the abilities of existing workers. The objective of this manual is to provide the knowledge and skills necessary for certification. Participants learn the basic operational aspects of treatment…

  6. Migrant Education Health Program, 1983. Final Report.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Health, Denver.

    During 1983 the Colorado Migrant Health Program, together with the Colorado Migrant Education Program, provided students enrolled in migrant summer schools with a continuum of care which included screening and physical assessment for detection of existing and potential health problems, referral for diagnosis and treatment of identified…

  7. Migrant Education Health Program, 1984. Final Report.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Education, Denver. Compensatory Education Services Unit.

    During 1984 the Colorado Migrant Health Program, together with the Colorado Migrant Education Program, provided students enrolled in migrant summer schools with a continuum of care which included screening and physical assessment for detection of existing and potential health problems, referral for diagnosis and treatment of identified…

  8. Planning and Implementing Health Screening Programs.

    ERIC Educational Resources Information Center

    Webster, Katherine P.

    1980-01-01

    School health screening programs, which include screening, education of children and parents, and follow-up in the form of appropriate treatment, are described. A scoliosis screening program is described as an example of the model presented. Suggestions for planners, participants, and evaluators of any school health screening are summarized. (JMF)

  9. Profiles of Grant Programs: Public Health Service.

    ERIC Educational Resources Information Center

    Department of Health , Education, and Welfare, Washington., DC. Office of the Secretary.

    For potential grant applicants and for the general public, the booklet describes the programs of the six Public Health Service agencies in the American health care system. Each program is described concisely in terms of: its purpose and legal basis; applicants' eligibility for grants and the basis for their award; the special requirements made of…

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  11. Factors associated with a patient-centered medical home among children with behavioral health conditions.

    PubMed

    Knapp, Caprice; Woodworth, Lindsey; Fernandez-Baca, Daniel; Baron-Lee, Jacqueline; Thompson, Lindsay; Hinojosa, Melanie

    2013-11-01

    At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children's parents or guardians completed the 2007 National Survey of Children's Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52 %), White (78 %), non-Hispanic (87 %), and did not have a special health care need (80 %). 6.2 % of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6 %) to Autism Spectrum Disorder (ASD) (1 %). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49 % of children with ADHD and 33 % of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities.

  12. Environmental health program in NASA

    NASA Technical Reports Server (NTRS)

    Marrazzo, R. M.

    1969-01-01

    The NASA policy on environmental health uses medical and environmental concepts to: (1) Determine the health status of employees; (2) prevent illness and promote good health among employees; and (3) identify and control factors that affect the health of personnel and quality of environment. Evaluation and control of physical, chemical, radiological and biological factors surrounding personnel and which represent physiological and psychological stresses and impairment are considered.

  13. Mental Health Program Reports - 5.

    ERIC Educational Resources Information Center

    Segal, Julius, Ed.

    The volume is reported to reflect the broad range of National Institute of Mental Health activities in areas of research, development of mental health manpower, and delivery of mental health services. Twenty papers examine, respectively, relationship of life histories and biochemistry of siblings and twins to schizophrenia, training of Navaho…

  14. Do employee health management programs work?

    PubMed

    Serxner, Seth; Gold, Daniel; Meraz, Angela; Gray, Ann

    2009-01-01

    Current peer review literature clearly documents the economic return and Return-on-Investment (ROI) for employee health management (EHM) programs. These EHM programs are defined as: health promotion, self-care, disease management, and case management programs. The evaluation literature for the sub-set of health promotion and disease management programs is examined in this article for specific evidence of the level of economic return in medical benefit cost reduction or avoidance. The article identifies the methodological challenges associated with determination of economic return for EHM programs and summarizes the findings from 23 articles that included 120 peer review study results. The article identifies the average ROI and percent health plan cost impact to be expected for both types of EHM programs, the expected time period for its occurrence, and caveats related to its measurement.

  15. HOME VISIT QUALITY VARIATIONS IN TWO EARLY HEAD START PROGRAMS IN RELATION TO PARENTING AND CHILD VOCABULARY OUTCOMES.

    PubMed

    Roggman, Lori A; Cook, Gina A; Innocenti, Mark S; Jump Norman, Vonda; Boyce, Lisa K; Christiansen, Katie; Peterson, Carla A

    2016-05-01

    Home-visiting programs aiming to improve early child development have demonstrated positive outcomes, but processes within home visits to individual families are rarely documented. We examined family-level variations in the home-visiting process (N = 71) from extant video recordings of home visits in two Early Head Start programs, using an observational measure of research-based quality indicators of home-visiting practices and family engagement, the Home Visit Rating Scales (HOVRS). HOVRS scores, showing good interrater agreement and internal consistency, were significantly associated with parent- and staff-reported positive characteristics of home visiting as well as with parenting and child language outcomes tested at program exit. When home-visiting processes were higher quality during the program, home visit content was more focused on child development, families were more involved in the overall program, and most important, scores on measures of the parenting environment and children's vocabulary were higher at the end of the program. Results showed that home visit quality was indirectly associated with child language outcomes through parenting outcomes. Observation ratings of home visit quality could be useful for guiding program improvement, supporting professional development, and increasing our understanding of the links between home-visiting processes and outcomes. PMID:27079807

  16. HOME VISIT QUALITY VARIATIONS IN TWO EARLY HEAD START PROGRAMS IN RELATION TO PARENTING AND CHILD VOCABULARY OUTCOMES.

    PubMed

    Roggman, Lori A; Cook, Gina A; Innocenti, Mark S; Jump Norman, Vonda; Boyce, Lisa K; Christiansen, Katie; Peterson, Carla A

    2016-05-01

    Home-visiting programs aiming to improve early child development have demonstrated positive outcomes, but processes within home visits to individual families are rarely documented. We examined family-level variations in the home-visiting process (N = 71) from extant video recordings of home visits in two Early Head Start programs, using an observational measure of research-based quality indicators of home-visiting practices and family engagement, the Home Visit Rating Scales (HOVRS). HOVRS scores, showing good interrater agreement and internal consistency, were significantly associated with parent- and staff-reported positive characteristics of home visiting as well as with parenting and child language outcomes tested at program exit. When home-visiting processes were higher quality during the program, home visit content was more focused on child development, families were more involved in the overall program, and most important, scores on measures of the parenting environment and children's vocabulary were higher at the end of the program. Results showed that home visit quality was indirectly associated with child language outcomes through parenting outcomes. Observation ratings of home visit quality could be useful for guiding program improvement, supporting professional development, and increasing our understanding of the links between home-visiting processes and outcomes.

  17. 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.

  18. 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.

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

    PubMed Central

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

    2014-01-01

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

  20. Advance directives in home health and hospice agencies: United States, 2007.

    PubMed

    Resnick, Helaine E; Hickman, Susan E; Foster, Gregory L

    2011-11-01

    This report provides nationally representative data on policies, storage, and implementation of advance directives (ADs) in home health and hospice (HHH) agencies in the United States using the National Home and Hospice Care Survey. Federally mandated ADs policies were followed in >93% of all agencies. Nearly all agencies stored ADs in a file at the agency, but only half stored them at the patient's residence. Nearly all agencies informed staff about the AD, but only 77% and 72% of home health agencies informed the attending physician and next-of-kin, respectively. Home health and hospice agencies are nearly universally compliant with ADs policies that are required in order to receive Medicare and Medicaid payments, but have much lower rates of adoption of ADs policies beyond federally mandated minimums. PMID:21398271

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

    PubMed

    Lee, Doohee; Muslin, Ivan; McInerney, Marjorie

    2016-01-01

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

  2. Home Health Aide Training: An Appeal for Organizational Support.

    PubMed

    Palesy, Debra

    2016-01-01

    How home healthcare aides (HHAs) adapt their classroom training to their workplaces is central to their own safety and that of their care recipients. A qualitative approach was adopted for this inquiry, where new workers were interviewed in-depth following their classroom training. Findings suggest a perceived lack of supervisor support for classroom training and lack of follow-up in the workplace. Moreover, the need for more peer support was contended, and more comprehensive written materials in clients' homes may also assist workers' learning and enacting safe manual handling techniques in the workplace. The article concludes with recommendations for supporting HHAs' learning, and includes suggestions for future research.

  3. Kennedy Space Center environmental health program.

    PubMed

    Marmaro, G M; Cardinale, M A; Summerfield, B R; Tipton, D A

    1992-08-01

    The Kennedy Space Center's environmental health organization is responsible for programs which assure its employees a healthful workplace under diverse and varied working conditions. These programs encompass the disciplines of industrial hygiene, radiation protection (health physics), and environmental sanitation/pollution control. Activities range from the routine, such as normal office work, to the highly specialized, such as the processing of highly toxic and hazardous materials.

  4. Kennedy Space Center environmental health program

    NASA Technical Reports Server (NTRS)

    Marmaro, G. M.; Cardinale, M. A.; Summerfield, B. R.; Tipton, D. A.

    1992-01-01

    The Kennedy Space Center's environmental health organization is responsible for programs which assure its employees a healthful workplace under diverse and varied working conditions. These programs encompass the disciplines of industrial hygiene, radiation protection (health physics), and environmental sanitation/pollution control. Activities range from the routine, such as normal office work, to the highly specialized, such as the processing of highly toxic and hazardous materials.

  5. An international randomized study of a home-based self-management program for severe COPD: the COMET

    PubMed Central

    Bourbeau, Jean; Casan, Pere; Tognella, Silvia; Haidl, Peter; Texereau, Joëlle B; Kessler, Romain

    2016-01-01

    Introduction Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET) is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions. Design Multicenter parallel randomized controlled, open-label superiority trial. Setting Thirty-three hospitals in four European countries. Participants A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD. Intervention The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease), an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center’s routine practice. Main outcome measures Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs. PMID:27418817

  6. Country prototypes and translation of health programs.

    PubMed

    Sussman, Steve; Unger, Jennifer B; Palinkas, Lawrence A

    2008-06-01

    This article introduces the topic of international translation of health programs. Different perspectives toward the study of national-level variables that are relevant to translation of evidence-based programming developed outside of or in a country are discussed. Concepts including national prototypes, national stereotypes, country clusters, knowledge incompatibility, and absorptive capacity are introduced. The ideas expressed in this article serve to provide direction when considering developing a health behavior program for a country, using previous programmatic knowledge from elsewhere.

  7. MIGRANT HEALTH PROGRAM, NEW JERSEY 1964.

    ERIC Educational Resources Information Center

    DOUGHERTY, WILLIAM; AND OTHERS

    A MAJOR EFFORT WAS MOUNTED TO INCREASE, EXTEND, AND IMPROVE HEALTH SERVICES FOR MIGRANT AGRICULTURAL WORKERS IN NEW JERSEY DURING THE SECOND YEAR OF OPERATION, 1964. THE MIGRANT HEALTH PROGRAM PROVIDED--(1) SERVICE TO 453 CAMPS, (2) OPPORTUNITY FOR 5,000 PERSONS TO COMMUNICATE WITH THE NURSE OR OTHER HEALTH WORKER WHO VISITED THE CAMP, AND (3)…

  8. Migrant Education Health Program, 1989. Final Report.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Health, Denver.

    This report details specific 1989 activities of the Migrant Education Health Program in Colorado. The state health department wrote the report to demonstrate that the health services it provided to migrants that year were within the scope of a contractual agreement with the Colorado Department of Education. The report was also designed to share…

  9. Experience Placements. Mental Health Career Development Programs.

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHEW), Bethesda, MD.

    The purpose of the Mental Health Career Development Program (MHCD) is to recruit and develop talented professionals for major roles in the multidisciplinary Federal mental health effort at the National Institute of Mental Health and other agencies. This booklet is intended to assist MHCD members and their advisors in planning for the transition…

  10. A Health Education Program That Works

    ERIC Educational Resources Information Center

    Albino, Joseph; Davis, Roy

    1975-01-01

    Recounts a successful implementation of the School Health Curriculum Project in an elementary school. Development of the program has been supported by the federal Bureau of Health Education, Center for Disease Control, and the National Clearinghouse for Smoking and Health. (Author/IRT)

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

    PubMed

    Roberts, Debbie; Pontin, David

    2016-03-01

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

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

    PubMed

    Roberts, Debbie; Pontin, David

    2016-03-01

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

  13. Social Support Perspectives on Programs for Parents: Lessons from the Child Survival/Fair Start Home Visiting Programs.

    ERIC Educational Resources Information Center

    Larner, Mary

    This paper discusses home visiting programs for low income parents and infants and describes five such programs known collectively as the Child Survival/Fair Start (CS/FS) projects, funded by the Ford Foundation. It describes a conceptual model which links risk factors and intervention activities to effects on mothers and children and explains how…

  14. Pilot Study of a Parent Training Program for Young Children with Autism: The PLAY Project Home Consultation Program

    ERIC Educational Resources Information Center

    Solomon, Richard; Necheles, Jonathan; Ferch, Courtney; Bruckman, David

    2007-01-01

    The PLAY Project Home Consultation (PPHC) program trains parents of children with autistic spectrum disorders using the DIR/Floortime model of Stanley Greenspan MD. Sixty-eight children completed the 8-12 month program. Parents were encouraged to deliver 15 hours per week of 1:1 interaction. Pre/post ratings of videotapes by blind raters using the…

  15. Effectiveness of the Complete Health Improvement Program

    ERIC Educational Resources Information Center

    Hutchins, Mathew; Melancon, Jim; Sneed, Demarcus; Nunning, Jennifer

    2015-01-01

    Currently, heart disease and diabetes dominate society as the leading cause of death for Americans. In this study, we examined the effectiveness of a lifestyle enhancement program on factors related to the development of heart disease. The Wabash Valley Complete Health Improvement Program (CHIP) is a community-based lifestyle change program with…

  16. Pilot States Program report: Home energy ratings systems and energy-efficient mortgages

    SciTech Connect

    Farhar, B.

    2000-04-04

    This report covers the accomplishments of the home energy ratings systems/energy-efficient mortgages (HERS/EEMs) pilot states from 1993 through 1998, including such indicators as funding, ratings and EEMs achieved, active raters, and training and marketing activities. A brief description of each HERS program's evolution is included, as well as their directors' views of the programs' future prospects. Finally, an analysis is provided of successful HERS program characteristics and factors that appear to contribute to HERS program success.

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  18. 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,…

  19. The cost of starting and maintaining a large home hemodialysis program.

    PubMed

    Komenda, Paul; Copland, Michael; Makwana, Jay; Djurdjev, Ogdjenka; Sood, Manish M; Levin, Adeera

    2010-06-01

    Home extended hours hemodialysis improves some measurable biological and quality-of-life parameters over conventional renal replacement therapies in patients with end-stage renal disease. Published small studies evaluating costs have shown savings in terms of ongoing operating costs with this modality. However, all estimates need to include the total costs, including infrastructure, patient training, and maintenance; patient attrition by death, transplantation, technique failure; and the necessity of in-center dialysis. We describe a comprehensive funding model for a large centrally administered but locally delivered home hemodialysis program in British Columbia, Canada that covered 122 patients, of which 113 were still in the program at study end. The majority of patients performed home nocturnal hemodialysis in this 2-year retrospective study. All training periods, both in-center and in-home dialysis, medications, hospitalizations, and deaths were captured using our provincial renal database and vital statistics. Comparative data from the provincial database and pricing models were used for costing purposes. The total comprehensive costs per patient-incorporating startup, home, and in-center dialysis; medications; home remodeling; and consumables-was $59,179 for years 2004-2005 and $48,648 for 2005-2006. The home dialysis patients required multiple in-center dialysis runs, significantly contributing to the overall costs. Our study describes a valid, comprehensive funding model delineating reliable cost estimates of starting and maintaining a large home-based hemodialysis program. Consideration of hidden costs is important for administrators and planners to take into account when designing budgets for home hemodialysis. PMID:20375983

  20. Building America: The Advanced Whole-Home Efficiency Program (Presentation)

    SciTech Connect

    Engebrecht, C.

    2012-02-01

    This presentation discusses the Building America Program. This presentation discusses the background and goals of the program. A few hot topic technologies are discussed. Outreach activities are discussed as well.

  1. Improved cost, health, and satisfaction with a health home benefit plan for self-insured employers and small physician practices.

    PubMed

    Reeves, Jerry; Kapp, Brian

    2013-01-01

    We compared the impacts on total costs, health, and satisfaction among 615 adults enrolled 2 years in an employer's health home benefit plan to their baseline year in a standard preferred provider organization plan. The new plan combined strong continuity care incentives with nurse coaching support. After 24 months, total medical costs were 23% lower than the baseline year, biometric measures improved for more than 85% of members, and patient satisfaction exceeded 85%. Emergency department visits decreased by 16% and hospital days decreased by 48%. Health home benefit plans engaging small primary care physician practices and members in coordinated continuity care can deliver high value. PMID:23448916

  2. Prevalence of Nursing Assistant Training and Certification Programs within Nursing Homes, 1997-2007

    ERIC Educational Resources Information Center

    Tyler, Denise A.; Jung, Hye-Young; Feng, Zhanlian; Mor, Vincent

    2010-01-01

    Purpose: The purpose of this study was to describe how the prevalence of nurse aide training and competency evaluation programs (NATCEPs) provided in the nursing home (NH) setting changed between 1997 and 2007, to explore the environmental factors that may be influencing the prevalence of these programs, and to examine how the changing prevalence…

  3. Impact of a Statewide Home Visiting Program to Prevent Child Abuse

    ERIC Educational Resources Information Center

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

    2007-01-01

    Objectives: To assess the impact of a voluntary, paraprofessional home visiting program in preventing child maltreatment and reducing the multiple, malleable psychosocial risks for maltreatment for which families had been targeted. Methods: This collaborative, experimental study focused on 6 Healthy Families Alaska (HFAK) programs; 325 families…

  4. The Bridges Program: Promoting Home School Inclusion through a Continuum of Services.

    ERIC Educational Resources Information Center

    Frey, Laura; Lane, Cindy

    The Bridges Program of the Wyandotte Comprehensive Special Education Cooperative in Kansas works to have students with chronic aberrant behavior in alternative school settings function successfully in a self-contained setting in the student's home school. The program works to create an environment which will address the curriculum needs and…

  5. New Homes, New Neighborhoods, New Schools: A Progress Report on the Baltimore Housing Mobility Program

    ERIC Educational Resources Information Center

    Engdahl, Lora

    2009-01-01

    In the Baltimore region, a successful housing mobility program is providing families living in very disadvantaged inner city communities with a new home and a chance for a new life. Minority voucher holders in the federal Housing Choice Voucher Program (formerly titled Section 8) have often been limited to living in "voucher submarkets" where…

  6. Is health care use changing? A comparison between physician, hospital, nursing-home, and home-care use of two elderly cohorts.

    PubMed

    Shapiro, E; Tate, R B

    1989-11-01

    This study used log-linear survival analysis, and log-rank tests to compare 1) the characteristics of two elderly cohorts; 2) their use of physician, hospital, nursing-home and home-care services over 8.5 years; and 3) physician and bed supplies during the two periods. Both cohorts were similar in health status and in their use of hospital, nursing-home, and home-care resources despite a steady decrease in hospital beds during both periods and a shrinking supply of nursing-home beds for the later cohort. Although physician supply increased more rapidly for the first (1971) than for the second (1976) cohort, the later cohort used significantly more ambulatory care than the earlier cohort. Home care appears to substitute for year-to-year variations in nursing-home admissions but not for variations in hospital lengths of stay.

  7. 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. PMID:22547780

  8. Global Health: The Fogarty International Center, National Institutes of Health: Vision and Mission, Programs, and Accomplishments

    PubMed Central

    Breman, Joel G.; Bridbord, Kenneth; Kupfer, Linda E.; Glass, Roger I.

    2011-01-01

    Summary The Fogarty International Center (FIC) of the U.S. National Institutes of Health has supported long-term (>6 months) basic, clinical and applied research training and research for over 3,600 future leaders in science and public health from low- and middle-income countries (LMICs); tens of thousands more persons have received short-term training. FIC started these programs in 1988 with the flagship HIV/AIDS International Training and Research Program (AITRP) in response to the global pandemic. More than 23 extramural training and research programs plus an intramural program are now operating – all in collaboration with other Institutes and Centers at NIH, U.S. government agencies, foundations, and partner institutions in LMICs and the U.S. While infectious diseases still reign mightily in Sub-Saharan African and South East Asian countries, non-communicable diseases are emerging globally, including in LMICs. Newer FIC training programs are addressing chronic, non-communicable diseases and strengthening the quality of medical schools and health care provider training, in addition to expanding expertise in infectious diseases. The model for successful training is based on long-term commitments, institutional strengthening, “twinning” of research centers, focus on local problems, and active mentoring. Trainees from Africa, Asia, and Latin America have made notable scientific contributions to global health, attained leadership positions, and received special recognition nationally and internationally. As the FIC programs are institutional-strengthening partnerships and candidates are carefully selected and mentored, close to 90% of FIC trainees return to their countries of origin. After returning home the FIC-trained leaders have continued to mentor and train thousands of individuals in their home countries. PMID:21896356

  9. 78 FR 14793 - Advancing Interoperability and Health Information Exchange

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-07

    ... of the National Coordinator (ONC) for Health IT (HIT) Certification Program are increasing standards..., laboratories, nursing homes, home health agencies, hospices, rural health clinics, ambulatory surgical centers... Interoperability and Health Information Exchange AGENCY: Office of the National Coordinator for Health...

  10. Report of a National Conference on Home Start and Other Programs for Parents and Children (National Conference on Home-Based Child Development Programs, St. Louis, Missouri, March 18-21, 1975).

    ERIC Educational Resources Information Center

    Office of Child Development (DHEW), Washington, DC.

    This report of the National Conference on Home-Based Child Development Programs is intended to serve as a resource document to people interested in developmental programs for parents and children. The report includes (1) a summary of Home Start evaluation findings; (2) brief descriptions of programs such as Dr. Ira Gordon's Florida Parent…

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

    PubMed

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

    2007-03-01

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

  12. 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…

  13. 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...

  14. 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...

  15. State Regulatory Enforcement and Nursing Home Termination from the Medicare and Medicaid Programs

    PubMed Central

    Li, Yue; Harrington, Charlene; Spector, William D; Mukamel, Dana B

    2010-01-01

    Objectives Nursing homes certified by the Medicare and/or Medicaid program are subject to federally mandated and state-enforced quality and safety standards. We examined the relationship between state quality enforcement and nursing home terminations from the two programs. Study Design Using data from a survey of state licensure and certification agencies and other secondary databases, we performed bivariate and multivariate analyses on the strength of state quality regulation in 2005, and nursing home voluntary terminations (decisions made by the facility) or involuntary terminations (imposed by the state) in 2006–2007. Principal Findings Involuntary terminations were rarely imposed by state regulators, while voluntary terminations were relatively more common (2.16 percent in 2006–2007) and varied considerably across states. After controlling for facility, market, and state covariates, nursing homes in states implementing stronger quality enforcement were more likely to voluntarily terminate from the Medicare and Medicaid programs (odds ratio=1.53, p=.018). Conclusions Although involuntary nursing home terminations occurred rarely in most states, nursing homes in states with stronger quality regulations tend to voluntarily exit the publicly financed market. Because of the consequences of voluntary terminations on patient care and access, state regulators need to consider the effects of increased enforcement on both enhanced quality and the costs of termination. PMID:20819106

  16. Arbitration agreements in health care nursing home contracts.

    PubMed

    Infante, Marie C; Lovitch, Karen S

    2003-11-01

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

  17. 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.

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

    PubMed

    Hopkins, C; Niemiec, S

    2007-05-01

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

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

    PubMed Central

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

    1994-01-01

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

  20. 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.

  1. Starting a hospital-based home health agency: Part II--Key success factors.

    PubMed

    Montgomery, P

    1993-09-01

    In Part II of a three-part series, the financial, technological and legislative issues of a hospital-based home health-agency are discussed. Beginning a home healthcare service requires intensive research to answer key environmental and operational questions--need, competition, financial projections, initial start-up costs and the impact of delayed depreciation. Assessments involving technology, staffing, legislative and regulatory issues can help project service volume, productivity and cost-control.

  2. 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

  3. Dwelling within political violence: Palestinian women's narratives of home, mental health, and resilience.

    PubMed

    Sousa, Cindy A; Kemp, Susan; El-Zuhairi, Mona

    2014-11-01

    Political violence is increasingly played out within everyday civilian environments, particularly family homes. Yet, within the literature on political violence and mental health, the role of threats to home remains under-explored. Using focus group data from 32 Palestinian women, this paper explores the implications of violations to the home within political violence. Threats to the privacy, control, and constancy of the family home - key dimensions of ontological security (Giddens, 1990) emerged as central themes in women's narratives. Surveillance, home invasions, and actual or threatened destruction of women's home environments provoked fear, anxiety, grief, humiliation, and helplessness, particularly as women struggled to protect their children. Women also described how they mobilized the home for economic, familial and cultural survival. Study findings illuminate the impact of threats to intimate environments on the well-being of women and their families living with chronic political violence, and underscore the importance of attention to violations of place and home in research on civilian experiences of and responses to political violence.

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

    ERIC Educational Resources Information Center

    Tharp, Barbara; Dresden, Judith; Moreno, Nancy

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

  5. Engaging military parents in a home-based reintegration program: a consideration of strategies.

    PubMed

    Ross, Abigail M; DeVoe, Ellen R

    2014-02-01

    For more than a decade, the long wars in Afghanistan and Iraq have placed tremendous and cumulative strain on U.S. military personnel and their families. The high operational tempo, length, and number of deployments-and greater in-theater exposure to threat-have resulted in well-documented psychological health concerns among service members and veterans. In addition, there is increasing and compelling evidence describing the significant deleterious impact of the deployment cycle on family members, including children, in military-connected families. However, rates of engagement and service utilization in prevention and intervention services continue to lag far below apparent need among service members and their families, because of both practical and psychological barriers. The authors describe the dynamic and ultimately successful process of engaging military families with young children in a home-based reintegration program designed to support parenting and strengthen parent-child relationships as service member parents move back into family life. In addition to the integration of existing evidence-based engagement strategies, the authors applied a strengths-based approach to working with military families and worked from a community-based participatory foundation to enhance family engagement and program completion. Implications for engagement of military personnel and their loved ones are discussed.

  6. Volunteers' experiences visiting the cognitively impaired in nursing homes: a friendly visiting program.

    PubMed

    Damianakis, Thecla

    2007-01-01

    Two challenges facing nursing-home care today are understanding the concept of quality of life as it relates to cognitively impaired residents and finding effective ways to ensure that it is achieved. Canadian director Allan King's documentary, Memory for Max, Claire, Ida and Company , filmed at Baycrest, captures a method for enhancing the quality of life of six cognitively impaired residents. While the film suggests an intervention model implemented by volunteers, there are challenges unique to institution-based programs (i.e., the recruitment and retention of volunteers). One of the challenges is the fear that volunteers may experience when interacting with the cognitively impaired. We conducted a pilot study of a model for training volunteers to provide friendly visiting and evaluated the impact on the participating residents. Observational accounts of volunteer-resident interactions and seven volunteer interviews were analysed and yielded several themes-(a) relationship building, (b) contribution of the environment, (c) preserving personhood, (d) resident-centred presence and the quality of the moment-and several themes related to the volunteers' role and their perceived impact on the residents. Discussed are the implications for volunteer programs in long-term health care settings.

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

    PubMed

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

    2016-01-01

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

  8. Facilitators and barriers to self-management of nursing home residents: perspectives of health-care professionals in Korean nursing homes

    PubMed Central

    Park, Yeon-Hwan; Bang, Hwal Lan; Kim, Ga Hye; Ha, Ji Yeon

    2015-01-01

    Purpose To explore facilitators and barriers to self-management from the viewpoint of staff taking care of nursing home (NH) residents with chronic diseases in South Korea. Patients and methods A qualitative content analysis was done using the focus group interview method. A total of 23 health-care professionals (16 registered nurses and 7 social workers) were interviewed from three urban NHs, each with more than 100 beds. Results Five facilitators were identified: grouping the residents; the resident’s awareness of his/her current health status; the willingness of residents to engage in self-management; residence in the facility; and support from the staff. Additionally, seven barriers were identified: deterioration of the resident’s health; the dependency expectations of the resident; hesitation in asking for help; difference in expectations between the staff and the resident’s family; insufficient staffing and time; lack of standardized guidelines; and conservative tendencies of the staff due to rigid policies. Conclusion The findings of this study can help health-care professionals recognize the factors that influence self-management and provide direction for registered nurses and other health professionals involved in supporting self-management programs for NH residents. PMID:26491277

  9. 77 FR 19305 - Announcement of Funding Awards: Office of Healthy Homes and Lead Hazard Control Grant Programs...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... Lead Based Paint Hazard Control and Lead Hazard Reduction Demonstration Programs (FR-5415-N-11); on October 4, 2010 for the Healthy Homes Production Program (FR-5415-N-18); on October 4, 2010 for Lead Technical Studies and Healthy Homes Technical Studies Programs (FR-5415-N-13); and on October 4, 2010...

  10. 77 FR 19306 - Announcement of Funding Awards: Office of Healthy Homes and Lead Hazard Control Grant Programs...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... Based Paint Hazard Control and Lead Hazard Reduction Demonstration Programs (FR- 5500-N-02); on May 18, 2011 for the Healthy Homes Production Program (FR-5500-N-03); on May 9, 2011 for Lead Technical Studies and Healthy Homes Technical Studies Programs (FR-5500-N-15); and on May 20, 2011 for Asthma in...

  11. Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

    PubMed

    Wood, Siri; Foster, Jennifer; Kols, Adrienne

    2012-08-01

    In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not

  12. Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

    PubMed

    Wood, Siri; Foster, Jennifer; Kols, Adrienne

    2012-08-01

    In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not

  13. Worksite health promotion programs in college settings

    PubMed Central

    Hill-Mey, Patricia E.; Kumpfer, Karol L.; Merrill, Ray M.; Reel, Justine; Hyatt-Neville, Beverly; Richardson, Glenn E.

    2015-01-01

    The purpose of this paper is to describe the multifaceted nature and benefits of worksite health promotion programs (WHPPs), with emphasis on the college setting. An assessment of the peer-reviewed literature was conducted of articles published since 2000. Several search engines were accessed and selected key words were used. Most studies examining WHPPs have focused on return on investment and productivity. Research that targets the softer side-benefits of health promotion programs in the workplace is less available. Although the college setting offers some advantages for implementing health promotion programs. They may also have unique challenges due to their large and diverse employee population. There is little research to show the effectiveness and unique challenges of college-based health promotion programs. PMID:25861657

  14. 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.

  15. Mental and behavioral health conditions among older adults: implications for the home care workforce

    PubMed Central

    Gleason, Hayley P.; Coyle, Caitlin E.

    2016-01-01

    Objectives The shift towards home and community-based care, coupled with the growing prevalence of mental and behavioral health conditions, increases the demand for skilled home care workers. However, little is known about the experiences of home care aides who provide care to clients with mental and behavioral health diagnoses. The purpose of this study was to identify challenges aides face in providing care to this particular group of clients, as well as the strategies and support they utilize to complete their job responsibilities. Methods Data from five focus groups with home care workers (N = 49) throughout Massachusetts were used to examine the experiences of home care workers providing services to adults with mental or behavioral health needs. A constant comparative method was used during analysis of the focus group transcripts. Results Aides described a lack of prior-knowledge of challenging client behaviors, leaving them unprepared to deal with disruptions to care delivery. Aides feel unsafe or unsure providing care to someone with complex needs, made worse by a perceived lack of training and support from the broader care team. Aides develop unique strategies for accomplishing their work. Conclusion This analysis of the aide’s perspective contributes valuable, and often unheard, insight to inform what we know about providing reliable, quality and safe home care to this growing group of vulnerable adults. Implications of this convergence are discussed relative to aides. PMID:25965114

  16. 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

  17. Effects of the Patient-Centered Environment Program on Behavioral and Emotional Problems in Home-Dwelling Patients With Dementia.

    PubMed

    Park, Heeok; Chun, Youngmi; Gang, Min Suk

    2015-12-01

    The current pilot study examined the effects of the Patient-Centered Environment Program (PCEP) on agitation, cognition, stress, pain, sleep, and activities of daily living for home-dwelling patients with dementia. Nine individuals participated in the study. The PCEP included visual, auditory, olfactory, and tactile areas based on participants' preferences. PCEP sessions were held for 30 minutes twice per week and a total of 16 sessions were performed at participants' homes. Findings showed that agitation and pain improved with the PCEP (t = 2.91, p < 0.02; t = 4.51, p < 0.002, respectively). Findings suggested that a better study design, repeated with a reasonable sample size, must be considered for participants' health statuses to meet the PCEP contents.

  18. Texas Field Experiment Results: Performance of the Weatherization Assistance Program in Hot-Climate, Low-Income Homes

    SciTech Connect

    McCold, Lance Neil; Goeltz, Rick; Ternes, Mark P; Berry, Linda G

    2008-04-01

    A field test involving 35 houses was performed in Texas between 2000 and 2003 to study the response of low-income homes in hot climates to weatherization performed as part of the U.S Department of Energy Weatherization Assistance Program and to investigate certain methods to improve weatherization performance. The study found that improved Program designs and the use of advanced energy audits resulted in better weatherization measures being installed (use of blower doors to guide the infiltration work, more frequent installation of attic insulation, and installation of wall insulation) in the study homes, improved space-heating savings performance compared to the Program as implemented in the hot climates in 1989, and more comfortable indoor temperatures. Two key policy dilemmas for Texas and other hot-climate states were highlighted by the study; namely, how to balance expenditures between installing cost-effective weatherization measures and performing health, safety, and repair items, and that health, safety, and repair items can have an adverse impact on energy savings, which further complicates the weatherization decision process. Several occupant and equipment-related behaviors were observed in the field test homes that help explain why audits may over predict energy consumptions and savings and why air-conditioning electricity savings are difficult to measure. Based on this study, it is recommended that states in hot climates be encouraged to select from an expanded list of measures using advanced audits or other techniques, and further studies examining the benefits obtained from air conditioner measures should be performed. In addition, guidelines should be developed for the hot-climate states on how to (a) balance the objectives of saving energy, improving health and safety, and addressing repair issues, and (b) select repair items.

  19. Long-acting injectables and risk for rehospitalization among patients with schizophrenia in the home care program in Taiwan.

    PubMed

    Ju, Po-Chung; Chou, Frank Huang-Chih; Lai, Te-Jen; Chuang, Po-Ya; Lin, Yung-Jung; Yang, Ching-Wen Wendy; Tang, Chao-Hsiun

    2014-02-01

    We aimed at evaluating the relationship between medication and treatment effectiveness in a home care setting among patients with schizophrenia. Patients with schizophrenia hospitalized between 2004 and 2009 with a primary International Classification of Diseases, Ninth Revision, Clinical Modification code of 295 were identified from Psychiatric Inpatient Medical Claims Data released by the National Health Research Institute in Taiwan. Patients who joined the home care program after discharge and were prescribed long-acting injection (LAI) (the LAI group) or oral antipsychotic medications (the oral group) were included as study subjects. The final sample for the study included 810 participants in the LAI group and 945 in the oral group. Logistic regression was performed to examine the independent effect of LAI medication on the risk for rehospitalization within the 12-month observation window after controlling for patient and hospital characteristics and propensity score quintile adjustment. The unadjusted odds ratio for rehospitalization risk was 0.80 (confidence interval, 0.65-0.98) for the LAI group compared to the oral group. The adjusted odds ratio was further reduced to 0.78 (confidence interval, 0.63-0.97). Results remained unchanged when the propensity score quintiles were entered into the regression for further adjustment. In a home care setting, patients treated with long-acting antipsychotic agents are at a significantly lower risk for psychiatric rehospitalization than those treated with oral medication. Consequently, LAI home-based treatment for the prevention of schizophrenia relapse may lead to substantial clinical and economic benefits. PMID:24145217

  20. Long-acting injectables and risk for rehospitalization among patients with schizophrenia in the home care program in Taiwan.

    PubMed

    Ju, Po-Chung; Chou, Frank Huang-Chih; Lai, Te-Jen; Chuang, Po-Ya; Lin, Yung-Jung; Yang, Ching-Wen Wendy; Tang, Chao-Hsiun

    2014-02-01

    We aimed at evaluating the relationship between medication and treatment effectiveness in a home care setting among patients with schizophrenia. Patients with schizophrenia hospitalized between 2004 and 2009 with a primary International Classification of Diseases, Ninth Revision, Clinical Modification code of 295 were identified from Psychiatric Inpatient Medical Claims Data released by the National Health Research Institute in Taiwan. Patients who joined the home care program after discharge and were prescribed long-acting injection (LAI) (the LAI group) or oral antipsychotic medications (the oral group) were included as study subjects. The final sample for the study included 810 participants in the LAI group and 945 in the oral group. Logistic regression was performed to examine the independent effect of LAI medication on the risk for rehospitalization within the 12-month observation window after controlling for patient and hospital characteristics and propensity score quintile adjustment. The unadjusted odds ratio for rehospitalization risk was 0.80 (confidence interval, 0.65-0.98) for the LAI group compared to the oral group. The adjusted odds ratio was further reduced to 0.78 (confidence interval, 0.63-0.97). Results remained unchanged when the propensity score quintiles were entered into the regression for further adjustment. In a home care setting, patients treated with long-acting antipsychotic agents are at a significantly lower risk for psychiatric rehospitalization than those treated with oral medication. Consequently, LAI home-based treatment for the prevention of schizophrenia relapse may lead to substantial clinical and economic benefits.

  1. Health Careers Opportunity Program (HCOP). Section 787 (Public Health Service Act). Program Guide.

    ERIC Educational Resources Information Center

    Department of Health and Human Services, Washington, DC.

    This document summarizes the requirements and guidelines for the Health Careers Opportunity Program (HCOP). This program is authorized by Section 787 of the Public Health Service Act to make grants to and contracts with postsecondary institutions to carry out programs which assist individuals from disadvantaged backgrounds to enter and graduate…

  2. The Journey Home: Psychological Adjustment Symptoms following Wilderness Expedition Programs

    ERIC Educational Resources Information Center

    Dettweiler, Ulrich

    2012-01-01

    Recent empirical research on outdoor education programs describes adjustment symptoms that instructors suffer from after the programs have come to an end. Post-course effects are also documented for students, but those are normally scientifically coded in measured changes in "skills" or "learning effects." In this paper, the author compares the…

  3. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  4. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  5. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  6. 42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    PubMed

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

    2015-11-01

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

  9. Education projects: an opportunity for student fieldwork in global health academic programs.

    PubMed

    Fyfe, Molly V

    2012-01-01

    Universities, especially in higher-income countries, increasingly offer programs in global health. These programs provide different types of fieldwork projects, at home and abroad, including: epidemiological research, community health, and clinical electives. I illustrate how and why education projects offer distinct learning opportunities for global health program fieldwork. As University of California students, we partnered in Tanzania with students from Muhimbili University of Health and Allied Science (MUHAS) to assist MUHAS faculty with a curricular project. We attended classes, clinical rounds, and community outreach sessions together, where we observed teaching, materials used, and the learning environment; and interviewed and gathered data from current students, alumni, and health professionals during a nationwide survey. We learned together about education of health professionals and health systems in our respective institutions. On the basis of this experience, I suggest some factors that contribute to the productivity of educational projects as global health fieldwork.

  10. The Medical Home

    MedlinePlus

    ... 5 Things to Know About Zika & Pregnancy The Medical Home KidsHealth > For Parents > The Medical Home Print ... home" for your child. What Does the Term "Medical Home" Mean? A medical home isn't a ...

  11. Ontario pharmacists practicing in family health teams and the patient-centered medical home.

    PubMed

    Dolovich, Lisa

    2012-04-01

    The patient-centered medical home (PCMH) approach continues to gather momentum in the United States and Canada as a broad approach to reform the delivery of the complete primary care system. The family health team (FHT) model implemented in Ontario, Canada, best mirrors the PCMH approach of the United States. The integration of pharmacists as key members of the health care team providing on-site, in-office coordinated care to FHT patients was included from the start of planning the FHT model and represents a substantial opportunity for pharmacists to realize their professional vision. Several research projects in Canada and elsewhere have contributed to providing evidence to support the integration of pharmacists into primary care practice sites. Two major research programs, the Seniors Medication Assessment Research Trial (SMART) cluster randomized controlled trial and the Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) multipronged demonstration project made substantial contributions to evidence-informed policy decisions supporting the integration of pharmacists into FHTs. These projects can provide useful information to support the integration of pharmacists into the PCMH and to encourage further research to better measure the effect of the pharmacist from the holistic patient-centered perspective.

  12. Preventing unintentional injuries in the home using the Health Impact Pyramid.

    PubMed

    Mack, Karin A; Liller, Karen D; Baldwin, Grant; Sleet, David

    2015-04-01

    Injuries continue to be the leading cause of death for the first four decades of life. These injuries result from a confluence of behavioral, physical, structural, environmental, and social factors. Taken together, these illustrate the importance of taking a broad and multileveled approach to injury prevention. Using examples from fall, fire, scald, and poisoning-related injuries, this article illustrates the utility of an approach that incorporates a social-environmental perspective in identifying and selecting interventions to improve the health and safety of individuals. Injury prevention efforts to prevent home injuries benefit from multilevel modifications of behavior, public policy, laws and enforcement, the environment, consumer products and engineering standards, as demonstrated with Frieden's Health Impact Pyramid. A greater understanding, however, is needed to explain the associations between tiers. While interventions that include modifications of the social environment are being field-tested, much more work needs to be done in measuring social-environmental change and in evaluating these programs to disentangle what works best.

  13. Relationships among employees' working conditions, mental health, and intention to leave in nursing homes.

    PubMed

    Zhang, Yuan; Punnett, Laura; Gore, Rebecca

    2014-02-01

    Employee turnover is a large and expensive problem in the long-term care environment. Stated intention to leave is a reliable indicator of likely turnover, but actual predictors, especially for nursing assistants, have been incompletely investigated. This quantitative study identifies the relationships among employees' working conditions, mental health, and intention to leave. Self-administered questionnaires were collected with 1,589 employees in 18 for-profit nursing homes. A working condition index for the number of beneficial job features was constructed. Poisson regression modeling found that employees who reported four positive features were 77% less likely to state strong intention to leave (PR = 0.23, p < .001). The strength of relationship between working conditions and intention to leave was slightly mediated by employee mental health. Effective workplace intervention programs must address work organization features to reduce employee intention to leave. Healthy workplaces should build better interpersonal relationships, show respect for employee work, and involve employees in decision-making processes.

  14. Relationships among employees' working conditions, mental health, and intention to leave in nursing homes.

    PubMed

    Zhang, Yuan; Punnett, Laura; Gore, Rebecca

    2014-02-01

    Employee turnover is a large and expensive problem in the long-term care environment. Stated intention to leave is a reliable indicator of likely turnover, but actual predictors, especially for nursing assistants, have been incompletely investigated. This quantitative study identifies the relationships among employees' working conditions, mental health, and intention to leave. Self-administered questionnaires were collected with 1,589 employees in 18 for-profit nursing homes. A working condition index for the number of beneficial job features was constructed. Poisson regression modeling found that employees who reported four positive features were 77% less likely to state strong intention to leave (PR = 0.23, p < .001). The strength of relationship between working conditions and intention to leave was slightly mediated by employee mental health. Effective workplace intervention programs must address work organization features to reduce employee intention to leave. Healthy workplaces should build better interpersonal relationships, show respect for employee work, and involve employees in decision-making processes. PMID:24652941

  15. Preventing Unintentional Injuries in the Home Using the Health Impact Pyramid

    PubMed Central

    Mack, Karin A.; Liller, Karen D.; Baldwin, Grant; Sleet, David

    2015-01-01

    Injuries continue to be the leading cause of death for the first four decades of life. These injuries result from a confluence of behavioral, physical, structural, environmental, and social factors. Taken together, these illustrate the importance of taking a broad and multileveled approach to injury prevention. Using examples from fall, fire, scald, and poisoning-related injuries, this article illustrates the utility of an approach that incorporates a social–environmental perspective in identifying and selecting interventions to improve the health and safety of individuals. Injury prevention efforts to prevent home injuries benefit from multilevel modifications of behavior, public policy, laws and enforcement, the environment, consumer products and engineering standards, as demonstrated with Frieden’s Health Impact Pyramid. A greater understanding, however, is needed to explain the associations between tiers. While interventions that include modifications of the social environment are being field-tested, much more work needs to be done in measuring social–environmental change and in evaluating these programs to disentangle what works best. PMID:25829110

  16. 75 FR 73110 - Health Center Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-29

    ... Health Center Program (section 330 of the Public Health Service Act) Increased Demand for Services (IDS..., 2009, to March 26, 2011 (IDS) and June 29, 2009, to June 28, 2011 (CIP). Replacement Awardee: Upper Room AIDS Ministry, Inc. Amount of Replacement Award: $103,317 (IDS) and $262,740 (CIP). Period...

  17. The Environmental Science and Health Effects Program

    SciTech Connect

    Michael Gurevich; Doug Lawson; Joe Mauderly

    2000-04-10

    The goal of the Environmental Science and Health Effect Program is to conduct policy-relevant research that will help us understand atmospheric impacts and potential health effects that may be caused by the use of petroleum-based fuels and alternative transportation fuels from mobile sources.

  18. THE SCHOOL HEALTH AND SAFETY PROGRAM.

    ERIC Educational Resources Information Center

    1963

    INVOLVING INDIVIDUALS AS WELL AS ORGANIZATIONS, THE PROGRAM AIMED AT THE OPTIMUM HEALTH OF ALL CHILDREN, AND IMPROVEMENT OF HEALTH AND SAFETY STANDARDS WITHIN THE COMMUNITY. EACH OF THE CHILDREN WAS URGED TO HAVE A SUCCESSFUL VACCINATION FOR SMALL POX, THE DPT SERIES AND BOOSTER, THE POLIO SERIES, AND CORRECTIONS OF ALL DENTAL DEFECTS AND…

  19. Migrant Health Program, 1969 Annual Report.

    ERIC Educational Resources Information Center

    New Jersey State Dept. of Health, Trenton.

    The New Jersey State Department of Health has placed increasing emphasis on high-quality health care since the first hospital-based Migrant Family Clinic replaced field clinics in 1965. Statistics show that medical services provided by the program reached 38% of all migrant workers in New Jersey at the peak of the 1969 crop season; however,…

  20. The home care allowance program: a change in policy and implications for elder clients.

    PubMed

    Duran-Aydintug, C; Torres, C C; Flaming, K H

    1995-01-01

    This paper reports the findings of a study exploring the effects of cutbacks in Colorado Home Care programs on frail elderly. Results indicate that these cutbacks put the respondents, who live in their own homes but are dependent on relatives, friends, or strangers for assistance in activities of daily living, at risk for long term institutionalization. These households are precursors of a growing healthcare crisis in aging populations where homecare assistance programs must supplement or supplant the resources of a thinning network of kin and friends. PMID:10159096

  1. Community-based home-care program for the management of pre-eclampsia: an alternative.

    PubMed Central

    Helewa, M; Heaman, M; Robinson, M A; Thompson, L

    1993-01-01

    OBJECTIVE: To evaluate the safety, acceptability and cost of a community-based home-care program for the management of mild pre-eclampsia. DESIGN: A descriptive study of outcomes between Apr. 1, 1985, and Dec. 31, 1989. SETTING: St. Boniface General Hospital, Winnipeg. PATIENTS: Urban Winnipeg residents between 27 and 40 weeks' gestation with mild pre-eclampsia who demonstrated acceptance and compliance with home-care management; 321 patients of 1330 were enrolled in the program. INTERVENTIONS: Bed rest at home with daily biochemical and biophysical follow-up protocol and weekly clinic visits; patient education; hospital admission for labour, induction, worsening pre-eclampsia or noncompliance with rest at home. OUTCOME MEASURES: Patterns of referral to the program; clinical, biochemical and biophysical profiles; incidence of severe complications; reduction in total hospital stay and cost analysis. RESULTS: As many women were referred from physicians' offices as were referred from the hospital's antepartum unit, the average gestational age at referral being 36 weeks. Most (205 [64%]) of the women were nulliparous. The average length of stay in the program was 11.5 days. The program's availability resulted in a reduction of 2 days (from 5.7 days to 3.7 days) on average in the length of hospital stay when analysed for all 1330 women with pre-eclampsia. Of the 321 patients in the program 137 (43%) were admitted to hospital for worsening pre-eclampsia; severe pre-eclampsia developed 4 days after admission in 9. No patient suffered eclampsia, disseminated intravascular coagulopathy, abruption or fetal loss related to pre-eclampsia while in the program. The estimated cost saving in the management of pre-eclampsia was over $700,000 over the study period. CONCLUSION: The community-based home-care program is a safe, feasible and less costly alternative to hospital admission in the management of mild pre-eclampsia. PMID:8374846

  2. 45 CFR 1306.33 - Home-based program option.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START... activities designed specifically for the parents. (3) Grantees must follow the nutrition...

  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. 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

  5. Educational Programs in the Health Field.

    ERIC Educational Resources Information Center

    Hospitals, 1971

    1971-01-01

    This document lists by location educational programs in the health field in the United States and Canada. Areas covered include Certified Laboratory Assistant Programs, Cytotechnology, Dental Hygiene, Dentistry, Dietetics, Hospital Administration, Inhalation Therapy, Library Science, Medical Illustration, Medical Records, Medical Technology,…

  6. An Operational Safety and Health Program.

    ERIC Educational Resources Information Center

    Uhorchak, Robert E.

    1983-01-01

    Describes safety/health program activities at Research Triangle Institute (North Carolina). These include: radioisotope/radiation and hazardous chemical/carcinogen use, training, monitoring, disposal; chemical waste management; air monitoring and analysis; medical program; fire safety/training, including emergency planning; Occupational Safety and…

  7. Health Indicators: A Tool for Program Review

    ERIC Educational Resources Information Center

    Abou-Sayf, Frank K.

    2006-01-01

    A visual tool used to evaluate instructional program performance has been designed by the University of Hawaii Community College system. The tool combines features from traffic lights, blood-chemistry test reports, and industry production control charts, and is labeled the Program Health-Indicator Chart. The tool was designed to minimize the labor…

  8. Coordinated School Health Programs. Position Statement. Revised

    ERIC Educational Resources Information Center

    National Association of School Nurses (NJ1), 2008

    2008-01-01

    It is the position of the National Association of School Nurses (NASN) that all children should have the right to coordinated school health programs. NASN supports continued research to document the outcomes of these programs. School nurses should use their professional education and skills to assist their schools and communities in the…

  9. Socioeconomic Disparities in the Use of Home Health Services in a Medicare Managed Care Population

    PubMed Central

    Freedman, Vicki A; Rogowski, Jeannette; Wickstrom, Steven L; Adams, John; Marainen, Jonas; Escarce, José J

    2004-01-01

    Objective To investigate socioeconomic disparities in access to home health visits and durable medical equipment by persons enrolled in two Medicare managed care health plans. Data Sources A telephone survey of 4,613 Medicare managed care enrollees conducted between April and October of 2000 and linked to administrative claims for a subsequent 12-month period. Study Design We estimated a series of logistic regression models to determine which socioeconomic factors were related to home health visits and the use of durable medical equipment (DME) among Medicare managed care enrollees. Principal Findings Controlling for health and demographic differences, Medicare managed care enrollees in the lowest tertile for nonhousing assets had 50 percent greater odds than those in the highest tertile of having one or more home health visits. All else equal, enrollees with less than a high school education had 30 percent lower odds than those who had graduated from high school of using durable medical equipment. Conclusions Medicare managed care enrollees of low socioeconomic status do not appear to have reduced access to home health visits; however, use of durable medical equipment is considerably lower for enrollees with less than a high school education. Physicians and therapists working with Medicare managed care enrollees may want to actively target DME prescriptions to those with educational disadvantages. PMID:15333109

  10. 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

  11. SKI*HI Home-Based Programming for Children with Hearing Impairments: Demographics, Child Identification, and Program Effectiveness, 1979-1991.

    ERIC Educational Resources Information Center

    Strong, Carol J.; And Others

    SKI*HI is a program designed to identify children with hearing impairments as early as possible and to provide them and their families with complete home programming that will facilitate development. The delivery model includes identification/screening services, home visit services, support services, and program management. A parent advisor makes…

  12. Problems associated with community mental health programs.

    PubMed

    Bindman, A J

    1966-12-01

    Community mental health programs vary in relation to their types of administrative and fiscal policy and structure. Discontinuity of services may increase due to proliferation of community-based programs, and community mental health personnel must be trained to deal with many needs and new programs. There will also be conflicts over individual professional interests versus community needs. Problems of staff recruitment will increase and concerted efforts are necessary to increase inservice education in order to re-shape professional roles. Psychologists in particular are interested in new developments in "community psychology" as a means of contributing to these efforts. PMID:24190853

  13. The feasibility of a telephone coaching program on heart failure home management for family caregivers

    PubMed Central

    Piamjariyakul, Ubolrat; Smith, Carol E.; Russell, Christy; Werkowitch, Marilyn; Elyachar, Andrea

    2012-01-01

    Objectives To test the feasibility of delivery and evaluate the helpfulness of a coaching heart failure (HF) home management program for family caregivers. Background The few available studies on providing instruction for family caregivers are limited in content for managing HF home care and guidance for program implementation. Method This pilot study employed a mixed methods design. The measures of caregiver burden, confidence, and preparedness were compared at baseline and 3 months post-intervention. Descriptive statistics were used to summarize program costs and demographic data. Content analysis research methods were used to evaluate program feasibility and helpfulness. Results Caregiver (n=10) burden scores were significantly reduced and raw scores of confidence and preparedness for HF home management improved 3 months after the intervention. Content analyses of nurse and caregiver post-intervention data found caregivers rated the program as helpful and described how they initiated HF management skills based on the program. Conclusion The program was feasible to implement. These results suggest the coaching program should be further tested with a larger sample size to evaluate its efficacy. PMID:23116654

  14. Caregiver Involvement in the Intensive Mental Health Program: Influence on Changes in Child Functioning

    ERIC Educational Resources Information Center

    Richards, Margaret M.; Bowers, Mark J.; Lazicki, Tammy; Krall, Dan; Jacobs, Anne K.

    2008-01-01

    We examined behavioral markers of caregiver involvement and the ways in which family participation was related to treatment outcomes in 47 elementary school children with SED enrolled in a school-based intensive mental health program. Measures of caregiver involvement included therapeutic home visits, attendance at therapeutic meetings, completion…

  15. Identification of Essential Food Skills for Skill-Based Healthful Eating Programs in Secondary Schools

    ERIC Educational Resources Information Center

    Fordyce-Voorham, Sandra

    2011-01-01

    Objective: To identify the food skills deemed essential to include in skill-based healthful eating programs in secondary schools. Methods: Fifty-one food experts including home economics educators, chefs, nutritionists and dietitians, community educators, homemakers, and young people were recruited by invitation, mail, and advertising. Data were…

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

    PubMed

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

    2015-01-01

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

  17. 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.

  18. 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

  19. 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.

  20. Responses of Canada's health care management education programs to health care reform initiatives.

    PubMed

    Angus, D E; Lay, C M

    2000-01-01

    Canada's provincial health care systems have been experiencing significant changes, mostly through horizontal integration achieved by merging hospitals, and, in a few cases, through vertical integration of public health, long term care, home care and hospital services. The government motivation for forcing these changes seems to have been primarily financial. In a few cases, the integration seems to have resulted in a stable and successful outcome, but, in most others, there has been destabilization, and in some, there has been chaos. The question posed in this research was how the five accredited Canadian graduate programs in health care management were responding to these changes. Two of the programs have recently made major changes in structure and/or delivery processes, following careful examination of their perceived environments. One has rationalized by subdividing courses. Another is repatriating courses from the business school in order to achieve more health-related content. Four of the five programs have added a number of courses in the last few years, or plan to do so in the next year or two, either because of accreditation criteria or student or faculty interest. The program directors viewed the educational requirements for clinicians and non-clinicians as being identical. In spite of the major structural changes, and the resulting destabilization of the health care organizations (and even governments), none of the programs emphasized the changes as factors in their plans for program changes. They expressed some concern about the possibility of fads as opposed to significant changes. It may be that these changes are dealt with in the content of individual courses. This aspect was not examined by the survey nor by interviews with the directors. Each of the programs has emphasized its own niche, with no consensus about changes required.