Factors influencing commencement and adherence to a home-based balance exercise program for reducing risk of falls: perceptions of people with Alzheimer's disease and their caregivers.

PubMed

Suttanon, Plaiwan; Hill, Keith D; Said, Catherine M; Byrne, Karin N; Dodd, Karen J

2012-07-01

Balance exercise is an important component of falls-prevention interventions, with growing evidence that it can be beneficial for people with Alzheimer's disease (AD). However, to implement a balance exercise program successfully for people with AD it is important to consider factors that can affect commencement and adherence to the program. This qualitative study explored these factors. Ten participants with AD, who had completed a six-month home-based balance exercise program, and their caregivers (n = 9) participated. A phenomenological theoretical framework with semi-structured interviews was used for data collection and analysis. Factors influencing the decision to commence the program were: possible benefits of the program, recommendations from health professionals, value of research, positive attitude towards exercise, and minimizing caregivers' burden. Factors influencing adherence to the program were grouped under 11 themes: six themes facilitated completion (program characteristics, physiotherapist, exercise recording sheet, caregivers' support, sense of commitment, and perceived benefit) and five themes were barriers (pre-existing conditions, dislike of structured exercise, absence from home, caregiver's health or commitment, and bad weather). A home-based exercise program with regular support from a physiotherapist and caregiver are key elements facilitating continuing program adherence in people with AD.

BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

PubMed

Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

2017-03-01

Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs. © 2017 Michigan Association for Infant Mental Health.

Impact of Pharmacists in a Community-Based Home Care Service: A Pilot Program.

PubMed

Walus, Ashley N; Woloschuk, Donna M M

2017-01-01

Historically, pharmacists have not been included on home care teams, despite the fact that home care patients frequently experience medication errors. Literature describing Canadian models of pharmacy practice in home care settings is limited. The optimal service delivery model and distribution of clinical activities for home care pharmacists remain unclear. The primary objective was to describe the impact of a pharmacist based at a community home care office and providing home visits, group education, and telephone consultations. The secondary objective was to determine the utility of acute care clinical pharmacy key performance indicators (cpKPIs) in guiding home care pharmacy services, in the absence of validated cpKPIs for ambulatory care. The Winnipeg Regional Health Authority hired a pharmacist to develop and implement the pilot program from May 2015 to July 2016. A referral form, consisting of consultation criteria used in primary care practices, was developed. The pharmacist also reviewed all patient intakes and all patients waiting in acute care facilities for initiation of home care services, with the goal of addressing issues before admission to the Home Care Program. A password-protected database was built for data collection and analysis, and the data are presented in aggregate. A total of 197 referrals, involving 184 patients, were received during the pilot program; of these, 62 were excluded from analysis. The majority of referrals (95 [70.4%]) were for targeted medication reviews, and 271 drug therapy problems were identified. Acceptance rates for the pharmacist's recommendations were 90.2% (74 of 82 recommendations) among home care staff and 47.0% (55 of 117 recommendations) among prescribers and patients. On average, 1.5 cpKPIs were identified for each referral. The pilot program demonstrated a need for enhanced access to clinical pharmacy services for home care patients, although the best model of service provision remains unclear. More research is warranted to determine the optimal pharmacy service for home care patients and the most appropriate cpKPIs to measure its effects.

Sustaining new parents in home visitation services: key participant and program factors.

PubMed

Daro, Deborah; McCurdy, Karen; Falconnier, Lydia; Stojanovic, Daniela

2003-10-01

As prevention efforts have adopted more intensive service models, concerns over initial enrollment and retention rates have become more salient. This study examines the participant, provider and program factors that contribute to a longer length of stay and greater number of home visits for new parents enrolling in one national home visitation program. Retrospective data were collected on a random sample of 816 participants served by one of 17 Healthy Families America (HFA) program sites around the country. Using case record reviews, research staff documented each participant's characteristics and service experiences. To capture relevant staff and program information, research staff collected basic descriptive information from published documents and interviews with program managers. All home visitors who had contact with sample families also completed a self-assessment instrument regarding personal and professional characteristics. Hierarchical linear modeling allowed us to examine the unique role of participant, provider and program characteristics while recognizing the lack of independence among these three sets of variables. The combined provider and program levels in the HLM model accounted for one-third of the variance in service duration and one-quarter of the variance in the number of home visits. Older participants, those unemployed, and those who enrolled in the program early in their pregnancy were more likely to remain in services longer and to complete a greater number of home visits. Compared to White participants, African Americans and Hispanics were significantly more likely to remain in services longer and, in the case of African Americans, to receive a greater number of home visits. Participants who were enrolled in school were more likely to remain in services longer. Age was the only consistent provider characteristic associated with positive results in both models, with younger home visitors performing better. Prior experience showed a significant relationship only in the service dosage model and African American workers demonstrated greater success than White home visitors did in retaining families in service. At the program level, programs with lower caseloads and greater success in matching their participants and providers on parenting status and race/ethnicity were significantly more likely to demonstrate stronger enrollment patterns.

Transition of Premature Infants From Hospital to Home Life

PubMed Central

Lopez, Greta L.; Anderson, Kathryn Hoehn; Feutchinger, Johanna

2013-01-01

Purpose To conduct an integrative literature review to studies that focus on the transition of premature infants from neonatal intensive care unit (NICU) to home. Method A literature search was performed in Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and MEDLINE to identify studies consisting on the transition of premature infants from hospital to home life. Results The search yielded seven articles that emphasized the need for home visits, child and family assessment methods, methods of keeping contact with health care providers, educational and support groups, and described the nurse’s role in the transition program. The strategy to ease the transition differed in each article. Conclusion Home visits by a nurse were a key component by providing education, support, and nursing care. A program therefore should consist of providing parents of premature infants with home visits implemented by a nurse or staying in contact with a nurse (e.g., via video-conference). PMID:22763247

Introduction of Renal Key Performance Indicators Associated with Increased Uptake of Peritoneal Dialysis in a Publicly Funded Health Service.

PubMed

Toussaint, Nigel D; McMahon, Lawrence P; Dowling, Gregory; Holt, Stephen G; Smith, Gillian; Safe, Maria; Knight, Richard; Fair, Kathleen; Linehan, Leanne; Walker, Rowan G; Power, David A

2017-01-01

♦ BACKGROUND: Increased demand for treatment of end-stage kidney disease has largely been accommodated by a costly increase in satellite hemodialysis (SHD) in most jurisdictions. In the Australian State of Victoria, a marked regional variation in the uptake of home-based dialysis suggests that use of home therapies could be increased as an alternative to SHD. An earlier strategy based solely on increased remuneration had failed to increase uptake of home therapies. Therefore, the public dialysis funder adopted the incidence and prevalence of home-based dialysis therapies as a key performance indicator (KPI) for its health services to encourage greater uptake of home therapies. ♦ METHODS: A KPI data collection and bench-marking program was established in 2012 by the Victorian Department of Health and Human Services, with data provided monthly by all renal units in Victoria using a purpose-designed website portal. A KPI Working Group was responsible for analyzing data each quarter and ensuring indicators remained accurate and relevant and each KPI had clear definitions and targets. We present a prospective, observational study of all dialysis patients in Victoria over a 4-year period following the introduction of the renal KPI program, with descriptive analyses to evaluate the proportion of patients using home therapies as well as home dialysis modality survival. ♦ RESULTS: Following the introduction of the KPI program, the net growth of dialysis patient numbers in Victoria remained stable over 4 years, at 75 - 80 per year (approximately 4%). However, unlike the previous decade, about 40% of this growth was through an increase in home dialysis, which was almost exclusively peritoneal dialysis (PD). The increase was identified particularly in the young (20 - 49) and the elderly (> 80). Disappointingly, however, 67% of these incident patients ceased PD within 2 years of commencement, 46% of whom transferred to SHD. ♦ CONCLUSIONS: Introduction of a KPI program was associated with an increased uptake of PD but not home HD. This change in clinical practice restricted growth of SHD and reduced pressure on satellite services. The effect was offset by a modest PD technique survival. Many patients in whom PD was unsuccessful were subsequently transferred to SHD rather than home HD. Copyright © 2017 International Society for Peritoneal Dialysis.

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

This case study describes a unique vocational program at Lancaster County Career Technology Center in Mount Joy, PA, where high school students are gaining hands-on construction experience in building high performance homes with help from Building America team, Home Innovation Research Labs. This collaboration resulted in the Green Home 3, the third in a series of high performance homes for Apprentice Green. As one of LCCTC’s key educational strategies for gaining practical experience, students are involved in building real houses that incorporate state-of-the-art energy efficiency and green technologies. With two homes already completed, the Green Home 3 achieved a 44%more » whole-house energy savings over the Building America New Construction B10 Benchmark, DOE Zero Energy Ready Home (formerly Challenge Home) certification, and National Green Building Standard Gold-level certification.« less

Strategies to Reduce Hospitalizations of Children With Medical Complexity Through Complex Care: Expert Perspectives.

PubMed

Coller, Ryan J; Nelson, Bergen B; Klitzner, Thomas S; Saenz, Adrianna A; Shekelle, Paul G; Lerner, Carlos F; Chung, Paul J

Interventions to reduce disproportionate hospital use among children with medical complexity (CMC) are needed. We conducted a rigorous, structured process to develop intervention strategies aiming to reduce hospitalizations within a complex care program population. A complex care medical home program used 1) semistructured interviews of caregivers of CMC experiencing acute, unscheduled hospitalizations and 2) literature review on preventing hospitalizations among CMC to develop key drivers for lowering hospital utilization and link them with intervention strategies. Using an adapted version of the RAND/UCLA Appropriateness Method, an expert panel rated each model for effectiveness at impacting each key driver and ultimately reducing hospitalizations. The complex care program applied these findings to select a final set of feasible intervention strategies for implementation. Intervention strategies focused on expanding access to familiar providers, enhancing general or technical caregiver knowledge and skill, creating specific and proactive crisis or contingency plans, and improving transitions between hospital and home. Activities aimed to facilitate family-centered, flexible implementation and consideration of all of the child's environments, including school and while traveling. Tailored activities and special attention to the highest utilizing subset of CMC were also critical for these interventions. A set of intervention strategies to reduce hospitalizations among CMC, informed by key drivers, can be created through a structured, reproducible process. Both this process and the results may be relevant to clinical programs and researchers aiming to reduce hospital utilization through the medical home for CMC. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Breathe Easy at Home: A Qualitative Evaluation of a Pediatric Asthma Intervention.

PubMed

Rosofsky, Anna; Reid, Margaret; Sandel, Megan; Zielenbach, Molly; Murphy, Johnna; Scammell, Madeleine K

2016-01-01

The Breathe Easy at Home Program enables clinicians to refer asthmatic patients to Boston Inspectional Services Department (ISD) if they suspect housing conditions trigger symptoms. The authors conducted one-on-one interviews with clinicians ( n = 10) who referred patients, and focus groups with inspectors from the ISD ( n = 9) and a variety of stakeholders ( n = 13), to gain insight into program function and implementation. Clinician interviews revealed inconsistencies in enrollment approaches, dissatisfaction with the web-based system, and patient follow-up difficulties. Inspectors identified barriers to working effectively with residents and landlords, and the stakeholder focus group highlighted successes of an unusual institutional collaboration. Interviews and focus groups identified strong and personal rapport between clinicians, inspectors, and patients as key to program retention, and that participating families required additional support throughout the process. Despite recommendations for improvement in program implementation, clinicians, inspectors, and stakeholders felt that the program overall improved both the home environment and asthma outcomes.

Implementation of a Complex Intervention to Support Leadership Development in Nursing Homes: A Multimethod Participatory Study.

PubMed

Dewar, Belinda; Barrie, Karen; Sharp, Cathy; Meyer, Julienne

2017-04-01

Leadership is key to quality improvement in nursing homes. This article reports on the initial analysis of the transformational My Home Life Leadership Support program for nursing home managers being implemented in Scotland. It analyses learning from a multimethod participatory descriptive study. Contribution analysis theory informed the evaluation. Evidence-Based Practice, Relationship-Centered Care, Appreciative Inquiry, and Caring Conversations informed the intervention to develop transformational leadership. Data generation methods included baseline and postintervention questionnaires to describe culture change within the study population, together with more in-depth qualitative data generated from group discussions throughout the leadership support program. Qualitative data analysis was an iterative collaborative process with participants to generate themes about the impact of the program on themselves and their practice. Data showed positive changes in managers' perceptions of their self-awareness, leadership communication and relationship skills, and development of positive cultures. This model offers lessons for those interested in ways to approach the emotional, educational, and cultural dynamics of change in other human service contexts.

Effect of Home Exercise Program in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis.

PubMed

Anwer, Shahnawaz; Alghadir, Ahmad; Brismée, Jean-Michel

2016-01-01

The Osteoarthritis Research Society International recommended that nonpharmacological methods include patient education programs, weight reduction, coping strategies, and exercise programs for the management of knee osteoarthritis (OA). However, neither a systematic review nor a meta-analysis has been published regarding the effectiveness of home exercise programs for the management of knee OA. The purpose of this systematic review was to examine the evidence regarding the effect of home exercise programs with and without supervised clinic-based exercises in the management of knee OA. We searched PubMed, CINAHL, Embase, Scopus, and PEDro for research articles published prior to September 2014 using key words such as pain, exercise, home exercise program, rehabilitation, supervised exercise program, and physiotherapy in combination with Medical Subject Headings "Osteoarthritis knee." We selected randomized and case-controlled trials published in English language. To verify the quality of the selected studies, we applied the PEDro Scale. Two evaluators individually selected the studies based on titles, excluding those articles that were not related to the objectives of this review. One evaluator extracted data from the included studies. A second evaluator independently verified extracted data for accuracy. A total of 31 studies were found in the search. Of these, 19 studies met the inclusion criteria and were further analyzed. Seventeen of these 19 studies reached high methodological quality on the PEDro scale. Although the methods and home exercise program interventions varied widely in these studies, most found significant improvements in pain and function in individuals with knee OA. The analysis indicated that both home exercise programs with and without supervised clinic-based exercises were beneficial in the management of knee OA. The large evidence of high-quality trials supports the effectiveness of home exercise programs with and without supervised clinic-based exercises in the rehabilitation of knee OA. In addition, small but growing evidence supports the effectiveness of other types of exercise such as tai chi, balance, and proprioceptive training for individuals with knee OA.

NJDOT research peer exchange, October 2001 : information package.

DOT National Transportation Integrated Search

2001-10-01

Summary of the Peer Exchange Take Home Ideas: : Be proactive in regularly meeting with key stakeholder managers to identify their : strategic needs in moving their program responsibilities forward. : Incorporate discussion of strategic ...

Medicaid nursing home pay for performance: where do we stand?

PubMed

Arling, Greg; Job, Carol; Cooke, Valerie

2009-10-01

Nursing home pay-for-performance (P4P) programs are intended to maximize the value obtained from public and private expenditures by measuring and rewarding better nursing home performance. We surveyed the 6 states with operational P4P systems in 2007. We describe key features of six Medicaid nursing home P4P systems and make recommendations for further development of nursing home P4P. We surveyed the six states with operational P4P systems in 2007. The range of performance measures employed by the states is quite broad: staffing level and satisfaction, findings from the regulatory system, clinical quality indicators, resident quality of life or satisfaction with care, family satisfaction, access to care for special populations, and efficiency. The main data sources for the measures are the Minimum Data Set (MDS), nursing home inspections, special surveys of nursing home residents, consumers or employees, and facility cost reports or other administrative systems. The most common financial incentive for better performance is a percentage bonus or an add-on to a facility's per diem rate. The bonus is generally proportional to a facility performance score, which consists of simple or weighted sums of scores on individual measures. States undertaking nursing home P4P programs should involve key stakeholders at all stages of P4P system design and implementation. Performance measures should be comprehensive, valid and reliable, risk adjusted where appropriate, and communicated clearly to providers and consumers. The P4P system should encourage provider investment in better care yet recognize state fiscal restraints. Consumer report cards, quality improvement initiatives, and the regulatory process should complement and reinforce P4P. Finally, the P4P system should be transparent and continuously evaluated.

The keys to healthy family child care homes intervention: study design and rationale.

PubMed

Østbye, Truls; Mann, Courtney M; Vaughn, Amber E; Namenek Brouwer, Rebecca J; Benjamin Neelon, Sara E; Hales, Derek; Bangdiwala, Shrikant I; Ward, Dianne S

2015-01-01

Obesity is a major public health problem for which early preventive interventions are needed. Large numbers of young children are enrolled in some form of child care program, making these facilities influential environments in children's development. Family child care homes (FCCH) are a specific type of child care in which children are cared for within the provider's own residence. FCCHs serve approximately 1.5 million children in the U.S.; however, research to date has overlooked FCCH providers and their potential to positively influence children's health-related behaviors. Keys to Healthy Family Child Care Homes (Keys) is a cluster-randomized controlled trial testing the efficacy of an intervention designed to help providers become healthy role models, provide quality food- and physical activity-supportive FCCH environments, and implement effective business practices. The intervention is delivered through workshops, home visits, tailored coaching calls, and educational toolkits. Primary outcomes are child physical activity measured via accelerometry data and dietary intake data collected using direct observation at the FCCH. Secondary outcomes include child body mass index, provider weight-related behaviors, and observed obesogenic environmental characteristics. Keys is an innovative approach to promoting healthy eating and physical activity in young children. The intervention operates in a novel setting, targets children during a key developmental period, and addresses both provider and child behaviors to synergistically promote health. Copyright © 2014. Published by Elsevier Inc.

The Keys to Healthy Family Child Care Homes intervention: Study design and rationale

PubMed Central

Østbye, Truls; Mann, Courtney M.; Vaughn, Amber E.; Namenek Brouwer, Rebecca J.; Benjamin Neelon, Sara E.; Hales, Derek; Bangdiwala, Shrikant I.; Ward, Dianne S.

2014-01-01

Background Obesity is a major public health problem for which early preventive interventions are needed. Large numbers of young children are enrolled in some form of child care program, making these facilities influential environments in children’s development. Family child care homes (FCCH) are a specific type of child care in which children are cared for within the provider’s own residence. FCCHs serve approximately 1.5 million children in the U.S.; however, research to date has overlooked FCCH providers and their potential to positively influence children’s health-related behaviors. Methods Keys to Healthy Family Child Care Homes (Keys) is a cluster-randomized controlled trial testing the efficacy of an intervention designed to help providers become healthy role models, provide quality food- and physical activity-supportive FCCH environments, and implement effective business practices. The intervention is delivered through workshops, home visits, tailored coaching calls, and educational toolkits. Primary outcomes are child physical activity measured via accelerometry data and dietary intake data collected using direct observation at the FCCH. Secondary outcomes include child body mass index, provider weight-related behaviors, and observed obesogenic environmental characteristics. Conclusion Keys is an innovative approach to promoting healthy eating and physical activity in young children. The intervention operates in a novel setting, targets children during a key developmental period, and addresses both provider and child behaviors to synergistically promote health. PMID:25460337

A Qualitative Exploration of Co-location as an Intervention to Strengthen Home Visiting Implementation in Addressing Maternal Child Health.

PubMed

Kellom, Katherine S; Matone, Meredith; Adejare, Aderinola; Barg, Frances K; Rubin, David M; Cronholm, Peter F

2018-06-01

Objectives The aim of this paper is to explore the process and impact of co-locating evidence-based maternal and child service models to inform future implementation efforts. Methods As part of a state-wide evaluation of maternal and child home visiting programs, we conducted semi-structured interviews with administrators and home visitors from home visiting agencies across Pennsylvania. We collected 33 interviews from 4 co-located agencies. We used the Consolidated Framework for Implementation Research (CFIR) to describe the key elements mitigating implementation of multiple home visiting models. Results A primary advantage of co-location described by participants was the ability to increase the agency's base of eligible clients through the implementation of a model with different program eligibility (e.g. income, child age) than the existing agency offering. Model differences related to curriculum (e.g. content or intensity/meeting frequency) enabled programs to more selectively match clients to models. To recruit eligible clients, new models were able to build upon the existing service networks of the initial program. Co-location provided organizational opportunities for shared trainings, enabling administrative efficiencies and collaborative staff learning. Programs implemented strategies to build synergies with complementary model features, for instance using the additional program option to serve waitlisted clients and to transition services after one model is completed. Conclusions for Practice Considerable benefits are experienced when home visiting models co-locate. This research builds on literature encouraging collaboration among community agencies and provides insight on a specific facilitative approach. This implementation strategy informs policy across the social services spectrum and competitive funding contexts.

Development of the Intervention Materials for the HomeStyles Obesity Prevention Program for Parents of Preschoolers

PubMed Central

Martin-Biggers, Jennifer; Spaccarotella, Kim; Delaney, Colleen; Koenings, Mallory; Alleman, Gayle; Hongu, Nobuko; Worobey, John; Byrd-Bredbenner, Carol

2015-01-01

Home environment is key to the development of obesity-preventing behaviors during childhood, yet few resources help preschool parents address factors at home associated with obesity risk. This paper describes creation of materials for an in-home intervention (HomeStyles) with this population. An advisory group of stakeholders and target audience members determined salient factors affecting childhood obesity to address in-home and developed program materials. The Social Cognitive Theory, Faith’s Core Behavior Change Strategies to Treat Childhood Obesity, Adult Learning Theory and motivational interviewing techniques guided development of 12 guides targeting strategies parents can use to shape the home environment. Interviews were conducted to determine effectiveness of the guides. Cognitive testing of guide design (n = 251) and content (n = 261) occurred in English and Spanish in New Jersey and Arizona with parents and home visitation staff who would present the guides. Interviews investigated perceptions of content usefulness and parent comprehension. Findings were also examined in light of theoretical underpinnings. Both home visitation staff and parents felt the guides were very readable and useful. Parents appreciated use of motivational interviewing techniques and Adult Learning Theory. Current research is testing these guides through an in-home, randomized control trial. PMID:26266419

DOE Office of Scientific and Technical Information (OSTI.GOV)

Puttagunta, Srikanth

National programs such as Home Performance with ENERGY STAR® and numerous other utility air sealing programs have brought awareness to homeowners of the benefits of energy efficiency retrofits. Yet, these programs tend to focus on the low-hanging fruit: air-sealing the thermal envelope and ductwork where accessible, switch to efficient lighting, and low-flow fixtures. At the other end of the spectrum, deep-energy retrofit programs are also being encouraged by various utilities across the country. While deep energy retrofits typically seek 50% energy savings, they are often quite costly and most applicable to gut-rehab projects. A significant potential for lowering energy usagemore » in existing homes lies between the low hanging fruit and deep energy retrofit approaches - retrofits that save approximately 30% in energy over the existing conditions. A key is to be non-intrusive with the efficiency measures so the retrofit projects can be accomplished in occupied homes. This cold climate retrofit project involved the design and optimization of a home in Connecticut that sought to improve energy savings by at least 30% (excluding solar PV) over the existing home's performance. This report documents the successful implementation of a cost-effective solution package that achieved performance greater than 30% over the pre-retrofit - what worked, what did not, and what improvements could be made.« less

Train the trainer in dementia care. A program to foster communication skills in nursing home staff caring for dementia patients.

PubMed

Franzmann, J; Haberstroh, J; Pantel, J

2016-04-01

Improvement of communication skills in nursing home staff is key to provide better care for dementia patients and decrease occupational mental stress. An innovative train-the-trainer program to improve and maintain professional caregivers' social competencies in nursing home dementia care is described. Over a period of 6 months, a group of 6 senior staff members were qualified as program trainers (multiplicators) for the TANDEM training program, which qualified them to design, deliver, and evaluate training sessions that foster specific social competencies in dementia care. In a subsequent intervention study with 116 geriatric caregivers in 14 nursing homes, training was provided either by multiplicators (intervention group) or directly by project coworkers (control group). Participants in both groups improved their dementia-specific communication skills. In a follow-up survey, the intervention group also reported lasting reductions in mental stressors at work (p < 0.05) and occupational mental stress (p < 0.01) compared with the control group. The qualification of staff members in German nursing homes to be multiplicators for the TANDEM train-the-trainer program for dementia-specific communication skills has a beneficial influence on social competencies, mental stressors at work, and occupational mental stress of staff who care for dementia patients and may contribute to a sustainable implementation of dementia-specific social competencies.

Impact of Pharmacists in a Community-Based Home Care Service: A Pilot Program

PubMed Central

Walus, Ashley N; Woloschuk, Donna M M

2017-01-01

Background Historically, pharmacists have not been included on home care teams, despite the fact that home care patients frequently experience medication errors. Literature describing Canadian models of pharmacy practice in home care settings is limited. The optimal service delivery model and distribution of clinical activities for home care pharmacists remain unclear. Objectives The primary objective was to describe the impact of a pharmacist based at a community home care office and providing home visits, group education, and telephone consultations. The secondary objective was to determine the utility of acute care clinical pharmacy key performance indicators (cpKPIs) in guiding home care pharmacy services, in the absence of validated cpKPIs for ambulatory care. Methods The Winnipeg Regional Health Authority hired a pharmacist to develop and implement the pilot program from May 2015 to July 2016. A referral form, consisting of consultation criteria used in primary care practices, was developed. The pharmacist also reviewed all patient intakes and all patients waiting in acute care facilities for initiation of home care services, with the goal of addressing issues before admission to the Home Care Program. A password-protected database was built for data collection and analysis, and the data are presented in aggregate. Results A total of 197 referrals, involving 184 patients, were received during the pilot program; of these, 62 were excluded from analysis. The majority of referrals (95 [70.4%]) were for targeted medication reviews, and 271 drug therapy problems were identified. Acceptance rates for the pharmacist’s recommendations were 90.2% (74 of 82 recommendations) among home care staff and 47.0% (55 of 117 recommendations) among prescribers and patients. On average, 1.5 cpKPIs were identified for each referral. Conclusions The pilot program demonstrated a need for enhanced access to clinical pharmacy services for home care patients, although the best model of service provision remains unclear. More research is warranted to determine the optimal pharmacy service for home care patients and the most appropriate cpKPIs to measure its effects. PMID:29299003

A learning-based agent for home neurorehabilitation.

PubMed

Lydakis, Andreas; Meng, Yuanliang; Munroe, Christopher; Wu, Yi-Ning; Begum, Momotaz

2017-07-01

This paper presents the iterative development of an artificially intelligent system to promote home-based neurorehabilitation. Although proper, structured practice of rehabilitation exercises at home is the key to successful recovery of motor functions, there is no home-program out there which can monitor a patient's exercise-related activities and provide corrective feedback in real time. To this end, we designed a Learning from Demonstration (LfD) based home-rehabilitation framework that combines advanced robot learning algorithms with commercially available wearable technologies. The proposed system uses exercise-related motion information and electromyography signals (EMG) of a patient to train a Markov Decision Process (MDP). The trained MDP model can enable an agent to serve as a coach for a patient. On a system level, this is the first initiative, to the best of our knowledge, to employ LfD in an health-care application to enable lay users to program an intelligent system. From a rehabilitation research perspective, this is a completely novel initiative to employ machine learning to provide interactive corrective feedback to a patient in home settings.

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

PubMed

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

2015-01-01

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. 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. 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. 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.

The Effect of Positive Reinforcement on Students in Juvenile Institutions.

ERIC Educational Resources Information Center

Phelps, Vincent

This thesis details a program of teacher-reinforced behaviors for juveniles convicted of a felony and incarcerated at the West Virginia Industrial Home for Youth (WVIHY). The goal was to determine an effective way to control behaviors of incarcerated youth in an educational setting by use of a positive reinforcement program: "Keys to Innervision."…

About STIP | OSTI, US Dept of Energy Office of Scientific and Technical

Science.gov Websites

Information Skip to main content Scientific and Technical Information Program The home of the U.S. Department of Energy's Scientific and Technical Information Program (STIP) Here you will find through scientific and technical information (STI), a key outcome of DOE R&D and other activities

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. Copyright © 2016 Mosby, Inc. All rights reserved.

Re-entry and reintegration: returning home after combat.

PubMed

Doyle, Michael E; Peterson, Kris A

2005-01-01

Soldier life exists on a continuum of readiness for deployment. Re-entry and reintegration-the return home and reunion with family and community-key the success of the deployment cycle. In current and projected future operations, the Army and society will both bear the burden of this re-entry and re-integration. Programs and procedures in place work towards improving communication, mitigating distress and resolving crises during reentry and reintegration. Key elements include: inclusion of families and communities early into the planning for reentry and reintegration; normalization (non-medicalization of distress); easy access to behavioral health professionals; and education of families on resources and benefits. Through broad collaboration, maximal benefit to the Soldier, family members and society be realized.

A Study of the Association Between Multidisciplinary Home Care and Home Death Among Thai Palliative Care Patients.

PubMed

Nagaviroj, Kittiphon; Anothaisintawee, Thunyarat

2017-06-01

Many terminally ill patients would prefer to stay and die in their own homes, but unfortunately, some may not be able to do so. Although there are many factors associated with successful home deaths, receiving palliative home visits from the multidisciplinary care teams is one of the key factors that enable patients to die at home. Our study was aimed to find whether there was any association between our palliative home care program and home death. A retrospective study was conducted in the Department of Family Medicine at Ramathibodi Hospital between January 2012 and May 2014. All of the patients who were referred to multidisciplinary palliative care teams were included. The data set comprised of patient's profile, disease status, functional status, patient's symptoms, preferred place of death, frequency of home visits, types of team interventions, and patient's actual place of death. Multiple logistic regression was applied in order to determine the association between the variables and the probability of dying at home. A total of 142 patients were included into the study. At the end of the study, 50 (35.2%) patients died at home and 92 (64.8%) patients died in the hospital. The multivariate logistic regression analysis demonstrated a strong association between multidisciplinary home care and home death (odds ratio 6.57, 95% confidence interval [CI] 2.48-17.38). Palliative home care was a significant factor enabling patients who want to die at home. We encourage health policy makers to promote the development of community-based palliative care programs in Thailand.

"In the Driver's Seat": Parent Perceptions of Choice in a Participant-Directed Medicaid Waiver Program for Young Children with Autism

ERIC Educational Resources Information Center

Timberlake, Maria T.; Leutz, Walter N.; Warfield, Marji Erickson; Chiri, Giuseppina

2014-01-01

This study investigated families' experience of choice within a participant-directed Medicaid waiver program for young children with autism. Fourteen parents or grandparents participated in in-depth interviews about their experience of choosing personnel, directing in-home services, and managing the $25,000 annual allocation. Key findings…

Enhancing Resident Safety by Preventing Healthcare-Associated Infection: A National Initiative to Reduce Catheter-Associated Urinary Tract Infections in Nursing Homes

PubMed Central

Mody, Lona; Meddings, Jennifer; Edson, Barbara S.; McNamara, Sara E.; Trautner, Barbara W.; Stone, Nimalie D.; Krein, Sarah L.; Saint, Sanjay

2015-01-01

Preventing healthcare-associated infection (HAI) is a key contributor to enhancing resident safety in nursing homes. In 2013, the U.S. Department of Health and Human Services approved a plan to enhance resident safety by reducing HAIs in nursing homes, with particular emphasis on reducing indwelling catheter use and catheter-associated urinary tract infection (CAUTI). Lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent CAUTI in over 950 acute care hospitals called “On the CUSP: STOP CAUTI” will now be implemented in nearly 500 nursing homes in all 50 states through a project funded by the Agency for Healthcare Research and Quality (AHRQ). This “AHRQ Safety Program in Long-Term Care: HAIs/CAUTI” will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship as well as promoting patient safety culture, team building, and leadership engagement. We anticipate that an approach integrating technical and socio-adaptive principles will serve as a model for future initiatives to reduce other infections, multidrug resistant organisms, and noninfectious adverse events among nursing home residents. PMID:25814630

HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity.

PubMed

Flattum, Colleen; Draxten, Michelle; Horning, Melissa; Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Garwick, Ann; Kubik, Martha Y; Story, Mary

2015-04-29

Involvement in meal preparation and eating meals with one's family are associated with better dietary quality and healthy body weight for youth. Given the poor dietary quality of many youth, potential benefits of family meals for better nutritional intake and great variation in family meals, development and evaluation of interventions aimed at improving and increasing family meals are needed. This paper presents the design of key intervention components and process evaluation of a community-based program (Healthy Home Offerings via the Mealtime Environment (HOME) Plus) to prevent obesity. The HOME Plus intervention was part of a two-arm (intervention versus attention-only control) randomized-controlled trial. Ten monthly, two-hour sessions and five motivational/goal-setting telephone calls to promote healthy eating and increasing family meals were delivered in community-based settings in the Minneapolis/St. Paul, MN metropolitan area. The present study included 81 families (8-12 year old children and their parents) in the intervention condition. Process surveys were administered at the end of each intervention session and at a home visit after the intervention period. Chi-squares and t-tests were used for process survey analysis. The HOME Plus program was successfully implemented and families were highly satisfied. Parents and children reported that the most enjoyable component was cooking with their families, learning how to eat more healthfully, and trying new recipes/foods and cooking tips. Average session attendance across the ten months was high for families (68%) and more than half completed their home activities. Findings support the value of a community-based, family-focused intervention program to promote family meals, limit screen time, and prevent obesity. NCT01538615.

End-of-life care for advanced dementia patients in residential care home-a Hong Kong perspective.

PubMed

Luk, James K H; Chan, Felix H W

2017-08-28

Dementia will become more common as the population ages. Advanced dementia should be considered as a terminal illnesses and end-of-life (EOL) care is very much needed for this disease group. Currently, the EOL services provided to this vulnerable group in Hong Kong, especially those living in residential care homes, is limited. The usual practice of residential care homes is to send older residents with advanced dementia to acute hospitals when they are sick, irrespective of their wish, premorbid status, diagnoses and prognosis. This may not accord with what the patients perceive to be a "good death". There are many barriers for older people to die in place, both at home and at the residential care home. In the community, to enhance EOL care to residential care home for the elderly (RCHE) residents, pilot EOL program had been carried out by some Community Geriatric Assessment Teams. Since 2015, the Hospital Authority funded program "Enhance Community Geriatric Assessment Team Support to End-of-life Patients in Residential Care Homes for the Elderly" has been started. In the program, advance care planning (ACP), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) (non-hospitalized) order will be established and the program will be expected to cover all clusters in Hong Kong by 2018/2019. In hospital setting, EOL clinical plan and EOL ward in geriatric step-down hospitals may be able to improve the quality of death of older patients. In Sep 2015, the Hospital Authority Guidelines on Life-Sustaining Treatment in the Terminally Ill was updated. Amongst other key EOL issues, careful (comfort) hand feeding was mentioned in the guideline. Other new developments include the possible establishment of enduring power of attorney for health care decision and enhancement of careful hand feeding amongst advanced dementia patients in RCHEs.

Satellite television broadcasting - Direct to the home

NASA Astrophysics Data System (ADS)

D'Abreu, A.

1988-10-01

The introduction in Europe of TV from satellites direct to the home is discussed with emphasis place on those issues which will influence its success. It is believed that the key factors in the successful development of DBS ventures in Europe are: (1) whether reception equipment will be cheaply and widely available in a format that will appeal to the consumer, and (2) whether there will be sufficiently attractive programming. It is concluded that vertically integrated media groups will dominate European broadcasting in the 1990s.

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

??National programs such as Home Performance with ENERGY STAR(R) and numerous other utility air sealing programs have brought awareness to homeowners of the benefits of energy efficiency retrofits. Yet, these programs tend to focus on the low-hanging fruit: air-sealing the thermal envelope and ductwork where accessible, switch to efficient lighting, and low-flow fixtures. At the other end of the spectrum, deep-energy retrofit programs are also being encouraged by various utilities across the country. While deep energy retrofits typically seek 50% energy savings, they are often quite costly and most applicable to gut-rehab projects. A significant potential for lowering energy usagemore » in existing homes lies between the low hanging fruit and deep energy retrofit approaches - retrofits that save approximately 30% in energy over the existing conditions. A key is to be non-intrusive with the efficiency measures so the retrofit projects can be accomplished in occupied homes. This cold climate retrofit project involved the design and optimization of a home in Connecticut that sought to improve energy savings by at least 30% (excluding solar PV) over the existing home's performance. This report documents the successful implementation of a cost-effective solution package that achieved performance greater than 30% over the pre-retrofit - what worked, what did not, and what improvements could be made. Confirmation of successfully achieving 30% source energy savings over the pre-existing conditions was confirmed through energy modeling and comparison of the utility bills pre- and post- retrofit.« less

Weatherization Innovation Pilot Program: Program Overview and Philadelphia Project Highlight (Fact Sheet)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2012-01-01

Case Study with WIPP program overview, information regarding eligibility, and successes from Pennsylvania's Commission on Economic Opportunity (CEO) that demonstrate innovative approaches that maximize the benefit of the program. The Department of Energy (DOE) Office of Energy Efficiency and Renewable Energy (EERE) recently launched the Weatherization Innovation Pilot Program (WIPP) to accelerate innovations in whole-house weatherization and advance DOE's goal of increasing the energy efficiency and health and safety of homes of low-income families. Since 2010, WIPP has helped weatherization service providers as well as new and nontraditional partners leverage non-federal financial resources to supplement federal grants, saving taxpayer money.more » WIPP complements the Weatherization Assistance program (WAP), which operates nation-wide, in U.S. territories and in three Native American tribes. 16 grantees are implementing weatherization innovation projects using experimental approaches to find new and better ways to weatherize homes. They are using approaches such as: (1) Financial tools - by understanding a diverse range of financing mechanisms, grantees can maximize the impact of the federal grant dollars while providing high-quality work and benefits to eligible low-income clients; (2) Green and healthy homes - in addition to helping families reduce their energy costs, grantees can protect their health and safety. Two WIPP projects (Connecticut and Maryland) will augment standard weatherization services with a comprehensive green and healthy homes approach; (3) New technologies and techniques - following the model of continuous improvement in weatherization, WIPP grantees will continue to use new and better technologies and techniques to improve the quality of work; (4) Residential energy behavior change - Two grantees are rigorously testing home energy monitors (HEMs) that display energy used in kilowatt-hours, allowing residents to monitor and reduce their energy use, and another is examining best-practices for mobile home energy efficiency; (5) Workforce development and volunteers - with a goal of creating a self-sustaining weatherization model that does not require future federal investment, three grantees are adapting business models successful in other sectors of the home performance business to perform weatherization work. Youthbuild is training youth to perform home energy upgrades to eligible clients and Habitat for Humanity is developing a model for how to incorporate volunteer labor in home weatherization. These innovative approaches will improve key weatherization outcomes, such as: Increasing the total number of homes that are weatherized; Reducing the weatherization cost per home; Increasing the energy savings in each weatherized home; Increasing the number of weatherization jobs created and retained; and Reducing greenhouse gas emissions.« less

Sustained health home visiting can improve families' social support and community connectedness.

PubMed

Stubbs, Joanne M; Achat, Helen M

2016-01-01

Home visiting (HV) is a strategy used internationally to address the multiple needs of infants and families at risk of suboptimal health and developmental outcomes. Describe nursing interventions and program achievements of a pilot HV program for families living in a highly disadvantaged outer suburb of Sydney, New South Wales, Australia. A family partnership model was adopted. Follow-up is reported for 65 of the 75 clients remaining in the program for at least 6 months. Nurses most commonly provided clients with emotional support, information about health and well-being and information on infant development. Clients experienced noteworthy improvements consistent with key objectives - greater access to support services, and increased self-efficacy and social networks. Consistent with the growing body of international literature on the achievements of HV, HV programs can empower vulnerable families to better cope with daily life demands and their family.

Patient preferences for the delivery of disease management in chronic heart failure: a qualitative study.

PubMed

Whitty, Jennifer A; Carrington, Melinda J; Stewart, Simon; Holliday, Julie; Marwick, Thomas H; Scuffham, Paul A

2012-01-01

Chronic heart failure (CHF) management programs (CHF-MPs) are applied in different ways including via face-to-face settings. However, we know little about consumer preferences when applying CHF-MPs via a patient's home or specialist hospital clinic. The aim of this pilot study was to explore CHF-MP characteristics that are considered desirable by patients with CHF. Semistructured interviews with a purposive sample of 12 CHF patients. Participants had a mean age of 61 (SD, 17) years, 3 were female, and the majority was of white background. Most were assessed as either functional New York Heart Association class III (n = 3) or IV (n = 6). Home- and clinic-based CHF-MPs were preferred by 5 and 7 participants, respectively. Key themes around patient preferences related to practical aspects of program delivery and social and peer support, as well as health-related benefits that translate to traditional outcomes in program evaluations. Participants identified transport, cost, and ill health as barriers to attending a clinic-based program. However, they also highlighted benefits (eg, the ability to share experiences with other patients) that may be difficult to provide with a home-based service unless specifically organized. These preliminary data suggest that patients value aspects of a program beyond those directly related to health outcomes. They also recognize a need for flexibility in program delivery, with potential preferences for home- or clinic-based programs depending largely on individual patient circumstances. More definitive studies are required to explore how best to cater for individual preferences while optimizing health outcomes.

The safety net medical home initiative: transforming care for vulnerable populations.

PubMed

Sugarman, Jonathan R; Phillips, Kathryn E; Wagner, Edward H; Coleman, Katie; Abrams, Melinda K

2014-11-01

Despite findings that medical homes may reduce or eliminate health care disparities among underserved and minority populations, most previous medical home pilot and demonstration projects have focused on health care delivery systems serving commercially insured patients and Medicare beneficiaries. To develop a replicable approach to support medical home transformation among diverse practices serving vulnerable and underserved populations. Facilitated by a national program team, convening organizations in 5 states provided coaching and learning community support to safety net practices over a 4-year period. To guide transformation, we developed a framework of change concepts aligned with supporting tools including implementation guides, activity checklists, and measurement instruments. Sixty-five health centers, homeless clinics, private practices, residency training centers, and other safety net practices in Colorado, Idaho, Massachusetts, Oregon, and Pennsylvania. We evaluated implementation of the change concepts using the Patient-Centered Medical Home-Assessment, and conducted a survey of participating practices to assess perceptions of the impact of the technical assistance. All practices implemented key features of the medical home model, and nearly half (47.6%) implemented the 33 identified key changes to a substantial degree as evidenced by level A Patient-Centered Medical Home-Assessment scores. Two thirds of practices that achieved substantial implementation did so only after participating in the initiative for >2 years. By the end of the initiative, 83.1% of sites achieved external recognition as medical homes. Despite resource constraints and high-need populations, safety net clinics made considerable progress toward medical home implementation when provided robust, multimodal support over a 4-year period.

USDA updates nutrient values for fast food pizza

USDA-ARS?s Scientific Manuscript database

Consumption of quick service pizza has increased as Americans are spending more on food away from home. Pizza is consistently a primary Key Food in the USDA National Food and Nutrient Analysis Program (NFNAP) because it is a contributor of more than 14 nutrients of public health significance to the...

MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES.

PubMed

Whitesell, Nancy Rumbaugh; Bolan, Marc; Chomos, Julianna C; Heath, Debra; Miles, Jon; Salvador, Melina; Whitmore, Corrie; Barlow, Allison

2018-05-04

In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts. © 2018 Michigan Association for Infant Mental Health.

The history of quality measurement in home health care.

PubMed

Rosati, Robert J

2009-02-01

Quality improvement is as central to home health care as to any other field of health care. With the mandated addition in 2000 of Outcome Assessment and Information Set (OASIS) and outcome-based quality improvement (OBQI), Medicare home health agencies entered a new era of documenting, tracking, and systematically improving quality. OBQI is augmented by the Medicare Quality Improvement Organization (QIO) program, which is now entering the ninth in a series of work assignments, with the tenth scope in the planning stages. Evidence has shown that applied quality improvement methods can drive better outcomes using important metrics, such as acute care hospitalization. This article reviews key findings from the past 2 decades of home care quality improvement research and public policy advances, describes specific examples of local and regional programmatic approaches to quality improvement, and forecasts near-future trends in this vital arena of home health care.

Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities

PubMed Central

Foulon, Stéphanie; Greacen, Tim; Pasquet, Blandine; Dugravier, Romain; Saïas, Thomas; Guedeney, Nicole; Guedeney, Antoine; Tubach, Florence

2015-01-01

Objective Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France. Materials and Methods CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440). The first assessment was at inclusion into the trial at the 27th week of pregnancy and the final assessment when the child reached the age of two. Attrition rates were calculated at 3 and 24 months postpartum. Stepwise logistic regression was used to identify predictors of early (between inclusion and 3 months postpartum) and later (between 3 and 24 months postpartum) attrition among social, psychological and parenting factors. Results Attrition rates were 17% and 63% at 3 and 24 months respectively. At 24 months, there was significantly more attrition in the control arm (70.6%) compared to the intervention arm (55.2%). Five independent predictors of early attrition were identified: having already had an abortion; having greater attachment insecurity as measured with the Vulnerable Attachment Style Questionnaire (VASQ); having lower global severity of psychiatric symptoms as assessed with the Symptom Check-List (SCL-90) at inclusion, being neither currently employed nor studying; and declaring no tobacco consumption during pregnancy. Being randomized into the control arm, having undergone early parental loss before age 11 and having lower global severity of psychiatric symptoms (SCL-90) at 3 months postpartum were the only variables associated with later attrition. Conclusion This study provides key information for identifying mothers who may require specific support to avoid study attrition in trials evaluating a home-visiting program. PMID:26554839

Key ingredients for implementing intensive outpatient programs within patient-centered medical homes: A literature review and qualitative analysis.

PubMed

Breland, Jessica Y; Asch, Steven M; Slightam, Cindie; Wong, Ava; Zulman, Donna M

2016-03-01

Intensive outpatient programs aim to transform care while conserving resources for high-need, high-cost patients, but little is known about factors that influence their implementation within patient-centered medical homes (PCMHs). In this mixed-methods study, we reviewed the literature to identify factors affecting intensive outpatient program implementation, then used semi-structured interviews to determine how these factors influenced the implementation of an intensive outpatient program within the Veterans Affairs' (VA) PCMH. Interviewees included facility leadership and clinical staff who were involved in a pilot Intensive Management Patient Aligned Care Team (ImPACT) intervention for high-need, high-cost VA PCMH patents. We classified implementation factors in the literature review and qualitative analysis using the Consolidated Framework for Implementation Research (CFIR). The literature review (n=9 studies) and analyses of interviews (n=15) revealed key implementation factors in three CFIR domains. First, the Inner Setting (i.e., the organizational and PCMH environment), mostly enabled implementation through a culture of innovation, good networks and communication, and positive tension for change. Second, Characteristics of Individuals, including creativity, flexibility, and interpersonal skills, allowed program staff to augment existing PCMH services. Finally, certain Intervention Characteristics (e.g., adaptability) enabled implementation, while others (e.g., complexity) generated implementation barriers. Resources and structural features common to PCMHs can facilitate implementation of intensive outpatient programs, but program success is also dependent on staff creativity and flexibility, and intervention adaptations to meet patient and organizational needs. Established PCMHs likely provide resources and environments that permit accelerated implementation of intensive outpatient programs. V. Published by Elsevier Inc.

RN jurisdiction over nursing care systems in nursing homes: application of latent class analysis

PubMed Central

Corazzini, Kirsten N.; Anderson, Ruth A.; Mueller, Christine; Thorpe, Joshua M.; McConnell, Eleanor S.

2015-01-01

Background In the context of declining registered nurse (RN) staffing levels in nursing homes, professional nursing jurisdiction over nursing care systems may erode. Objectives The purpose of this study is to develop a typology of professional nursing jurisdiction in nursing homes in relation to characteristics of RN staffing, drawing upon Abbott's (1988) tasks and jurisdictions framework. Method The study was a cross-sectional, observational study using the 2004 National Nursing Home Survey (N=1,120 nursing homes). Latent class analysis tested whether RN staffing indicators differentiated facilities in a typology of RN jurisdiction, and compared classes on key organizational environment characteristics. Multiple logistic regression analysis related the emergent classes to presence or absence of specialty care programs in 8 clinical areas. Results Three classes of capacity for jurisdiction were identified, including ‘low capacity’ (41% of homes) with low probabilities of having any indicators of RN jurisdiction, ‘mixed capacity’ (26% of homes) with moderate to high probabilities of having higher RN education and staffing levels, and ‘high capacity’ (32% of homes) with moderate to high probabilities of having almost all indicators of RN jurisdiction. ‘High capacity’ homes were more likely to have specialty care programs relative to ‘low capacity’ homes; such homes were less likely to be chain-owned, and more likely to be larger, provide higher technical levels of patient care, have unionized nursing assistants, have a lower ratio of LPNs to RNs, and a higher education level of the administrator. Discussion Findings provide preliminary support for the theoretical framework as a starting point to move beyond extensive reliance on staffing levels and mix as indicators of quality. Further, findings indicate the importance of RN specialty certification. PMID:22166907

Interpretive flexibility in mobile health: lessons from a government-sponsored home care program.

PubMed

Nielsen, Jeppe Agger; Mathiassen, Lars

2013-10-30

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. 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. 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. 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. Government-sponsored programs can have both positive and negative results, and managers need to be aware of this and the interpretive flexibility of mobile technology. Mobile technology implementation is a complex process that is best studied by combining organization-level analysis with features of the wider sociopolitical and interorganizational environment.

Kentucky Preschool Evaluation Project, 1998-1999. Final Report.

ERIC Educational Resources Information Center

Hemmeter, Mary Louise; Townley, Kim; Wilson, Stephen; Epstein, Ann; Hines, Huyi

This evaluation of the Kentucky Preschool Program (KPP) focused on two broad areas: (1) readiness for kindergarten; and (2) promotion of language and literacy in the classroom and at home. Key findings include the following: (1) most children who were ineligible because of family income status successfully transitioned to kindergarten; (2) several…

Storytelling Narratives: Social Bonding as Key for Youth at Risk

ERIC Educational Resources Information Center

Nelson, Annabelle; McClintock, Charles; Perez-Ferguson, Anita; Shawver, Mary Nash; Thompson, Greg

2008-01-01

This research used a structured storytelling narrative methodology to capture the lived experience of youth participants to identify effective factors that helped them in three programs in Santa Barbara and Ventura Counties, California. Thirty-nine youth aged 8-17 participated in two storytelling protocols at their home sites; one was a written…

Impact Evaluation of FACTS & Feelings: A Home-Based Video Sex Education Curriculum.

ERIC Educational Resources Information Center

Miller, Brent C.; And Others

1993-01-01

Families (n=548) with seventh- or eighth-grade adolescents were randomly assigned to receive videotape sex education curriculum including videos with mailed newsletters, videos without newsletters, or neither (control group). Found no significant effect of the program on key outcome variables of teenagers' sexual intentions or behaviors.…

Development of a Continuum of Services for Children and Adults with Autism and Other Severe Behavior Disorders.

ERIC Educational Resources Information Center

Luce, Stephen C.; And Others

1992-01-01

Key elements of a continuum of services for individuals with autism and other severe behavior disorders are described, focusing on development of a strong central organization; funding; staff recruitment, training, supervision, and evaluation; program evaluation; outreach parent training; home-based early intervention; vocational training;…

Treatment Retention Among Patients Participating in Coordinated Specialty Care for First-Episode Psychosis: a Mixed-Methods Analysis.

PubMed

Hamilton, Jane E; Srivastava, Devika; Womack, Danica; Brown, Ashlie; Schulz, Brian; Macakanja, April; Walker, April; Wu, Mon-Ju; Williamson, Mark; Cho, Raymond Y

2018-06-05

Young adults experiencing first-episode psychosis have historically been difficult to retain in mental health treatment. Communities across the United States are implementing Coordinated Specialty Care to improve outcomes for individuals experiencing first-episode psychosis. This mixed-methods research study examined the relationship between program services and treatment retention, operationalized as the likelihood of remaining in the program for 9 months or more. In the adjusted analysis, male gender and participation in home-based cognitive behavioral therapy were associated with an increased likelihood of remaining in treatment. The key informant interview findings suggest the shared decision-making process and the breadth, flexibility, and focus on functional recovery of the home-based cognitive behavioral therapy intervention may have positively influenced treatment retention. These findings suggest the use of shared decision-making and improved access to home-based cognitive behavioral therapy for first-episode psychosis patients may improve outcomes for this vulnerable population.

Youth and administrator perspectives on transition in Kentucky's state agency schools.

PubMed

Marshall, Amy; Powell, Norman; Pierce, Doris; Nolan, Ronnie; Fehringer, Elaine

2012-01-01

Students, a large percentage with disabilities, are at high risk for poor post-secondary outcomes in state agency education programs. This mixed-methods study describes the understandings of student transitions in state agency education programs from the perspectives of youth and administrators. Results indicated that: transition is more narrowly defined within alternative education programs; key strengths of transition practice are present in nontraditional schools; and the coordination barriers within this fluid inter-agency transition system are most apparent in students' frequent inter-setting transitions between nontraditional and home schools.

Translating Behavior Change Principles Into a Blended Exercise Intervention for Older Adults: Design Study.

PubMed

Mehra, Sumit; Visser, Bart; Dadema, Tessa; van den Helder, Jantine; Engelbert, Raoul Hh; Weijs, Peter Jm; Kröse, Ben Ja

2018-05-02

Physical activity can prevent or delay age-related impairments and prolong the ability of older adults to live independently. Community-based programs typically offer classes where older adults can exercise only once a week under the guidance of an instructor. The health benefits of such programs vary. Exercise frequency and the duration of the program play a key role in realizing effectiveness. An auxiliary home-based exercise program can provide older adults the opportunity to exercise more regularly over a prolonged period of time in the convenience of their own homes. Furthermore, mobile electronic devices can be used to motivate and remotely guide older adults to exercise in a safe manner. Such a blended intervention, where technology is combined with personal guidance, needs to incorporate behavior change principles to ensure effectiveness. The aim of this study was to identify theory-based components of a blended intervention that supports older adults to exercise at home. The Medical Research Council framework was used to develop the blended intervention. Insights from focus group, expert panels, and literature were combined into leading design considerations. A client-server system had been developed that combined a tablet app with a database in the cloud and a Web-based dashboard that can be used by a personal coach to remotely monitor and guide older adults. The app contains several components that facilitate behavior change-an interactive module for goal setting, the ability to draw up a personal training schedule from a library containing over 50 exercise videos, progress monitoring, and possibilities to receive remote feedback and guidance of a personal coach. An evidence-based blended intervention was designed to promote physical activity among older adults. The underlying design choices were underpinned by behavior change techniques that are rooted in self-regulation. Key components of the tablet-supported intervention were a tailored program that accommodates individual needs, demonstrations of functional exercises, monitoring, and remote feedback. The blended approach combines the convenience of a home-based exercise program for older adults with the strengths of mobile health and personal guidance. ©Sumit Mehra, Bart Visser, Tessa Dadema, Jantine van den Helder, Raoul HH Engelbert, Peter JM Weijs, Ben JA Kröse. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 02.05.2018.

Human factors in mental healthcare: A work system analysis of a community-based program for older adults with depression and dementia.

PubMed

Heiden, Siobhan M; Holden, Richard J; Alder, Catherine A; Bodke, Kunal; Boustani, Malaz

2017-10-01

Mental healthcare is a critical but largely unexplored application domain for human factors/ergonomics. This paper reports on a work system evaluation of a home-based dementia and depression care program for older adults, the Aging Brain Care program. The Workflow Elements Model was used to guide data collection and analysis of 59 h of observation, supplemented by key informant input. We identified four actors, 37 artifacts across seven types, ten action categories, and ten outcomes including improved health and safety. Five themes emerged regarding barriers and facilitators to care delivery in the program: the centrality of relationship building; the use of adaptive workarounds; performance of duplicate work; travel and scheduling challenges; and communication-related factors. Findings offer new insight into how mental healthcare services are delivered in a community-based program and key work-related factors shaping program outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Satisfaction and Experience With a Supervised Home-Based Real-Time Videoconferencing Telerehabilitation Exercise Program in People with Chronic Obstructive Pulmonary Disease (COPD)

PubMed Central

TSAI, LING LING Y.; MCNAMARA, RENAE J.; DENNIS, SARAH M.; MODDEL, CHLOE; ALISON, JENNIFER A.; MCKENZIE, DAVID K.; MCKEOUGH, ZOE J.

2016-01-01

Telerehabilitation, consisting of supervised home-based exercise training via real-time videoconferencing, is an alternative method to deliver pulmonary rehabilitation with potential to improve access. The aims were to determine the level of satisfaction and experience of an eight-week supervised home-based telerehabilitation exercise program using real-time videoconferencing in people with COPD. Quantitative measures were the Client Satisfaction Questionnaire-8 (CSQ-8) and a purpose-designed satisfaction survey. A qualitative component was conducted using semi-structured interviews. Nineteen participants (mean (SD) age 73 (8) years, forced expiratory volume in 1 second (FEV1) 60 (23) % predicted) showed a high level of satisfaction in the CSQ-8 score and 100% of participants reported a high level of satisfaction with the quality of exercise sessions delivered using real-time videoconferencing in participant satisfaction survey. Eleven participants undertook semi-structured interviews. Key themes in four areas relating to the telerehabilitation service emerged: positive virtual interaction through technology; health benefits; and satisfaction with the convenience and use of equipment. Participants were highly satisfied with the telerehabilitation exercise program delivered via videoconferencing. PMID:28775799

Designing of smart home automation system based on Raspberry Pi

NASA Astrophysics Data System (ADS)

Saini, Ravi Prakash; Singh, Bhanu Pratap; Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn

2016-03-01

Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning "on" and "off" of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

Designing of smart home automation system based on Raspberry Pi

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saini, Ravi Prakash; Singh, Bhanu Pratap; Sharma, Mahesh Kumar

Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pinsmore » of Raspberry Pi by pressing the corresponding key for turning “on” and “off” of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.« less

Nursing Home Stakeholder Views of Resident Involvement in Medical Care Decisions

PubMed Central

Garcia, Theresa J.; Harrison, Tracie C.; Goodwin, James S.

2017-01-01

Demand by nursing home residents for involvement in their medical care, or, patient-centered care, is expected to increase as baby boomers begin seeking long-term care for their chronic illnesses. To explore the needs in meeting this proposed demand, we used a qualitative descriptive method with content analysis to obtain the joint perspective of key stakeholders on the current state of person-centered medical care in the nursing home. We interviewed 31 nursing home stakeholders: 5 residents, 7 family members, 8 advanced practice registered nurses, 5 physicians, and 6 administrators. Our findings revealed constraints placed by the long-term care system limited medical involvement opportunities and created conflicting goals for patient-centered medical care. Resident participation in medical care was perceived as low, but important. The creation of supportive educational programs for all stakeholders to facilitate a common goal for nursing home admission and to provide assistance through the long-term care system was encouraged. PMID:25721717

45 CFR 1306.33 - Home-based program option.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 4 2013-10-01 2013-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33 Home-based program option. (a) Grantees implementing a home-based program option must: (1) Provide one home...

45 CFR 1306.33 - Home-based program option.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33 Home-based program option. (a) Grantees implementing a home-based program option must: (1) Provide one home...

45 CFR 1306.33 - Home-based program option.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33 Home-based program option. (a) Grantees implementing a home-based program option must: (1) Provide one home...

DISCOVERING FRUGAL INNOVATIONS THROUGH DELIVERING EARLY CHILDHOOD HOME-VISITING INTERVENTIONS IN LOW-RESOURCE TRIBAL COMMUNITIES.

PubMed

Barlow, Allison; McDaniel, Judy A; Marfani, Farha; Lowe, Anne; Keplinger, Cassie; Beltangady, Moushumi; Goklish, Novalene

2018-05-01

Early childhood home-visiting has been shown to yield the greatest impact for the lowest income, highest disparity families. Yet, poor communities generally experience fractured systems of care, a paucity of providers, and limited resources to deliver intensive home-visiting models to families who stand to benefit most. This article explores lessons emerging from the recent Tribal Maternal and Infant Early Childhood Home Visiting (MIECHV) legislation supporting delivery of home-visiting interventions in low-income, hard-to-reach American Indian and Alaska Native communities. We draw experience from four diverse tribal communities that participated in the Tribal MIECHV Program and overcame socioeconomic, geographic, and structural challenges that called for both early childhood home-visiting services and increased the difficulty of delivery. Key innovations are described, including unique community engagement, recruitment and retention strategies, expanded case management roles of home visitors to overcome fragmented care systems, contextual demands for employing paraprofessional home visitors, and practical advances toward streamlined evaluation approaches. We draw on the concept of "frugal innovation" to explain how the experience of Tribal MIECHV participation has led to more efficient, effective, and culturally informed early childhood home-visiting service delivery, with lessons for future dissemination to underserved communities in the United States and abroad. © 2018 Michigan Association for Infant Mental Health.

Parental and Home Environmental Facilitators of Sugar-Sweetened Beverage Consumption among Overweight and Obese Latino Youth

PubMed Central

Bogart, Laura M.; Cowgill, Burt O.; Sharma, Andrea J.; Uyeda, Kimberly; Sticklor, Laurel A.; Alijewicz, Katie E.; Schuster, Mark A.

2013-01-01

Objective To explore parental and home environmental facilitators of sugar-sweetened beverage (SSB) and water consumption among obese/overweight Latino youth. Methods Semi-structured interviews were conducted with 55 overweight/obese Latino youth aged 10-18 and 55 parents, recruited from school-based clinics and a school in one West-coast district. All youth consumed SSBs regularly and lived in a home where SSBs were available. We used qualitative methods to examine key themes around beliefs about SSBs and water, facilitators of SSB and water consumption, and barriers to reducing SSB consumption. Results A few parents and youth believed that sports drinks are healthy. Although nearly all felt that water is healthy, most parents and about half of youth thought that tap water is unsafe. About half of parent-child dyads had discordant beliefs regarding their perceptions of tap water. About half of parents believed that home-made culturally relevant drinks (e.g., aguas frescas), which typically contain sugar, fruit, and water, were healthy due to their “natural” ingredients. Participants cited home availability as a key factor in SSB consumption. About half of parents set no rules about SSB consumption at home. Among those with rules, most parent-child pairs differed on their beliefs about the content of the rules, and youth reported few consequences for breaking rules. Conclusions Obesity programs for Latino youth should address misconceptions around water, and discuss culturally relevant drinks and sports drinks as potential sources of weight gain. Healthcare providers can help parents set appropriate rules by educating about the risks of keeping SSBs at home. PMID:23680295

Setting up home-based palliative care in countries with limited resources: a model from Sarawak, Malaysia.

PubMed

Devi, B C R; Tang, T S; Corbex, M

2008-12-01

The provision of palliative care (PC) and opioids is difficult to ensure in remote areas in low- and middle-income countries. We describe here the set up of a home-care program in Sarawak (the Malaysian part of the Borneo Island), where half the population lives in villages that are difficult to access. The establishment of this program, initiated in 1994 by the Department of Radiotherapy of Sarawak General Hospital, consisted of training, empowering nurses, simplifying referral, facilitating access to medication, and increasing awareness among public and health professionals about PC. The program has been sustainable and cost efficient, serving 936 patients in 2006. The total morphine usage in the program increased from <200 g in 1993 to >1400 g in 2006. The results show that pain medication can be provided even in remote areas with effective organization and empowerment of nurses, who were the most important determinants for the set up of this program. Education of family was also a key aspect. The authors believe that the experience gained in Sarawak may help other regions with low or middle resources in the set up of their PC program especially for their remote rural population.

The perceptions of cognitively impaired patients and their caregivers of a home telecare system

PubMed Central

Mehrabian, Shima; Extra, Jocelyne; Wu, Ya-Huei; Pino, Maribel; Traykov, Latchezar; Rigaud, Anne-Sophie

2015-01-01

Assistive and telecare technologies have been developed to support older adults with cognitive impairments, as well as their caregivers, from their homes. The way potential users perceive telecare and smart home systems plays a key role in their acceptance of this new technology. We evaluate the acceptance of home telecare technologies among patients suffering from cognitive impairment and their caregivers. Prototypes of telecare devices were developed to demonstrate their features and capabilities and to train patients, families, and health care professionals in their use. We conducted semistructured interviews to elicit the perceptions of 30 patients with mild cognitive impairment, 32 patients with Alzheimer’s disease, and 30 caregivers, regarding the risks and advantages of home telecare and smart houses. Survey results reflected participants’ largely positive reactions to these technologies. Regarding home telecare, the cognitive stimulation program earned the highest proportion of positive responses, followed by the devices’ care of emergencies. The participants generally agreed that home telecare and smart houses could significantly improve their quality of life. However, some technical and ethical concerns, such as the way of provision, installation, and monitoring of the systems, were reported to be in need of addressing before implementation of this system. PMID:25552909

The perceptions of cognitively impaired patients and their caregivers of a home telecare system.

PubMed

Mehrabian, Shima; Extra, Jocelyne; Wu, Ya-Huei; Pino, Maribel; Traykov, Latchezar; Rigaud, Anne-Sophie

2015-01-01

Assistive and telecare technologies have been developed to support older adults with cognitive impairments, as well as their caregivers, from their homes. The way potential users perceive telecare and smart home systems plays a key role in their acceptance of this new technology. We evaluate the acceptance of home telecare technologies among patients suffering from cognitive impairment and their caregivers. Prototypes of telecare devices were developed to demonstrate their features and capabilities and to train patients, families, and health care professionals in their use. We conducted semistructured interviews to elicit the perceptions of 30 patients with mild cognitive impairment, 32 patients with Alzheimer's disease, and 30 caregivers, regarding the risks and advantages of home telecare and smart houses. Survey results reflected participants' largely positive reactions to these technologies. Regarding home telecare, the cognitive stimulation program earned the highest proportion of positive responses, followed by the devices' care of emergencies. The participants generally agreed that home telecare and smart houses could significantly improve their quality of life. However, some technical and ethical concerns, such as the way of provision, installation, and monitoring of the systems, were reported to be in need of addressing before implementation of this system.

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

PubMed Central

Mathiassen, Lars

2013-01-01

Background Mobile technologies have emerged as important tools that health care personnel can use to gain easy access to client data anywhere. This is particularly useful for nurses and care workers in home health care as they provide services to clients in many different settings. Although a growing body of evidence supports the use of mobile technologies, the diverse implications of mobile health have yet to be fully documented. Objective Our objective was to examine a large-scale government-sponsored mobile health implementation program in the Danish home care sector and to understand how the technology was used differently across home care agencies. Methods We chose to perform a longitudinal case study with embedded units of analysis. We included multiple data sources, such as written materials, a survey to managers across all 98 Danish municipalities, and semistructured interviews with managers, care workers, and nurses in three selected home care agencies. We used process models of change to help analyze the overall implementation process from a longitudinal perspective and to identify antecedent conditions, key events, and practical outcomes. Results Strong collaboration between major stakeholders in the Danish home care sector (government bodies, vendors, consultants, interest organizations, and managers) helped initiate and energize the change process, and government funding supported quick and widespread technology adoption. However, although supported by the same government-sponsored program, mobile technology proved to have considerable interpretive flexibility with variation in perceived nature of technology, technology strategy, and technology use between agencies. What was first seen as a very promising innovation across the Danish home care sector subsequently became the topic of debate as technology use arrangements ran counter to existing norms and values in individual agencies. Conclusions Government-sponsored programs can have both positive and negative results, and managers need to be aware of this and the interpretive flexibility of mobile technology. Mobile technology implementation is a complex process that is best studied by combining organization-level analysis with features of the wider sociopolitical and interorganizational environment. PMID:24172852

Boxing Clever: Using Shoeboxes to Support Home-School Knowledge Exchange

ERIC Educational Resources Information Center

Greenhough, Pamela; Scanlan, Mary; Feiler, Anthony; Johnson, David; Yee, Wan Ching; Andrews, Jane; Price, Alison; Smithson, Maggie; Hughes, Martin

2005-01-01

A key tenet of the Home-School Knowledge Exchange Project is that children's learning will be enhanced if the knowledge and experience that are to be found both at home and in school can be brought together. In this paper we explore ways of connecting home and school to support literacy learning at Key Stage 1, focusing on the home-to-school…

Interagency partnership to deliver Veteran-Directed Home and Community-Based Services: Interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.

PubMed

Thomas, Kali S; Allen, Susan M

2016-01-01

Veteran-Directed Home and Community-Based Services (VD-HCBS) is a consumer-directed program that began in 2009 and is jointly administered in a partnership between the Veterans Health Administration and the Administration for Community Living. The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Qualitative interviews with 26 ADNA VD-HCBS personnel across the country were transcribed, coded, and analyzed. Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership, including frequent communication, training in VAMC billing procedures, having a designated VAMC staff person for the program, and active involvement of the VAMC from the onset of VD-HCBS program development. Findings have implications for other interagency partnerships formed to deliver services to vulnerable Veterans.

[Results of a physical therapy program in nursing home residents: A randomized clinical trial].

PubMed

Casilda-López, Jesús; Torres-Sánchez, Irene; Garzón-Moreno, Victor Manuel; Cabrera-Martos, Irene; Valenza, Marie Carmen

2015-01-01

The maintenance of the physical functionality is a key factor in the care of the elderly. Inactive people have a higher risk of death due to diseases associated with inactivity. In addition, the maintenance of optimal levels of physical and mental activity has been suggested as a protective factor against the development and progression of chronic illnesses and disability. The objective of this study is to assess the effectiveness of an 8-week exercise program with elastic bands, on exercise capacity, walking and balance in nursing home residents. A nursing home sample was divided into two groups, intervention group (n=26) and control group (n=25). The intervention group was included in an 8-week physical activity program using elastic bands, twice a week, while the control group was took part in a walking programme. Outcome measurements were descriptive variables (anthropometric characteristics, quality of life, fatigue, fear of movement) and fundamental variables (exercise capacity, walking and balance). A significant improvement in balance and walking speed was observed after the programme. Additionally, exercise capacity improved significantly (P≤.001), and the patients showed an improvement in perceived dyspnea after the physical activity programme in the intervention group. The exercise program was safe and effective in improving dyspnea, exercise capacity, walking, and balance in elderly. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

Environment and quality of life: a reaction from the perspective of social science and environmental design.

PubMed

Grant, L A

1989-11-01

While it is a truism that nursing homes should reflect a homelike setting, relatively few nursing homes have been successful in avoiding a hospital-like image. In this reaction to the paper by Dr. Kayser-Jones, I have reviewed major theoretical models of how environment influences adaptation in the aged and presented some ways in which the nursing home environment can be modified. The delivery of long-term care services to the aged can be improved by addressing their physical, social, and psychological needs through better architectural and interior design, as well as efforts on the part of nursing professionals to ensure adequate patient care. Nurses can play a key role in the design process by assisting architects in programming buildings that meet the basic requirements for good patient care.

Prevalence-Based Targets Underestimate Home Dialysis Program Activity and Requirements for Growth.

PubMed

Bevilacqua, Micheli U; Er, Lee; Copland, Michael A; Singh, R Suneet; Jamal, Abeed; Dunne, Órla Marie; Brumby, Catherine; Levin, Adeera

2018-01-01

Many renal programs have targets to increase home dialysis prevalence. Data from a large Canadian home dialysis program were analyzed to determine if home dialysis prevalence accurately reflects program activity and whether prevalence-based assessments adequately reflect the work required for program growth. Data from home dialysis programs in British Columbia, Canada, were analyzed from 2005 to 2015. Prevalence data were compared to dialysis activity data including intakes and exits to describe program turnover. Using current attrition rates, recruitment rates needed to increase home dialysis prevalence proportions were identified. We analyzed 7,746 patient-years of peritoneal dialysis (PD) and 1,362 patient-years of home hemodialysis (HHD). The proportion of patients on home dialysis increased by 3.34% over the ten years examined, while the number of prevalent home dialysis patients increased 2.65% per year and the number of patients receiving home dialysis at any time in the year increased 4.04% per year. For every 1 patient net home dialysis growth, 13.6 new patients were recruited. Patient turnover included higher rates of transplantation in home dialysis than facility-based HD. Overall, the proportion dialyzing at home increased from 29.3 to 32.6%. There is high patient turnover in home dialysis such that program prevalence is an incomplete marker of total program activity. This turnover includes high rates of transplantation, which is a desirable interaction that affects home dialysis prevalence. The shortcomings of this commonly used metric are important for renal programs to consider, and better understanding of the activities that support home dialysis and the complex trajectories that home dialysis patients follow is needed. Copyright © 2018 International Society for Peritoneal Dialysis.

A Grounded Theory of Mothering in the Early Years for Women Recovering From Substance Use.

PubMed

Marcellus, Lenora

2017-08-01

Women in recovery from addiction experience significant sociostructural barriers to reestablishing self, family, and home after having a baby. The aim of this grounded theory study was to describe pathways that women and their families followed and how transitions were experienced in the early years after receiving services through an integrated community-based maternity program. Eighteen women completed questionnaires and participated in a series of semistructured interviews over 2 years. The overall process women experienced was that of holding it together, which women did by restoring their sense of self during recovery, becoming a strong center for their family, and creating a sense of home no matter what the circumstances. Key elements supporting women in their transition to recovery and parenthood included longer term health, social, and recovery programs and services that addressed determinants of health (in particular, gender, housing, and income), and receiving support provided from strengths-based perspectives.

77 FR 6673 - Removal of the Indian HOME Investment Partnerships Program Regulation

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... Removal of the Indian HOME Investment Partnerships Program Regulation AGENCY: Office of the Assistant... outdated regulations for the Indian HOME Investment Partnerships (Indian HOME) program. Under the Indian... Investment Partnerships Program The HOME Investment Partnerships Act (Title II of the Cranston- Gonzales...

An Evidence-Based Construction of the Models of Decline of Functioning. Part 1: Two Major Models of Decline of Functioning

ERIC Educational Resources Information Center

Okawa, Yayoi; Nakamura, Shigemi; Kudo, Minako; Ueda, Satoshi

2009-01-01

The purpose of this study is to confirm the working hypothesis on two major models of functioning decline and two corresponding models of rehabilitation program in an older population through detailed interviews with the persons who have functioning declines and on-the-spot observations of key activities on home visits. A total of 542…

CE dual-homing protection in layer 1 VPN

NASA Astrophysics Data System (ADS)

Du, Shu; Peng, Yunfeng; Long, Keping

2008-11-01

Layer 1 VPN (L1VPN) extends the notion of VPN to the optical domain to provide virtually dedicated circuit like leased lines, so that the security is more enhanced. Despite their secure gains from channel isolation, VPNs still suffer fragilities resulting from link-failures or node-failures. Extensive activities on survivability designs for wavelength-routed optical networks are proposed, including various protection and restoration schemes, but concerns on network edge are rare. Dual-homing is an effective skill to achieve survivability gains for L1VPNs. There are two dual-homing mode: Active/Standby mode and Load-Sharing mode In this paper, we investigate the problem of PE assignment, which is the key of dual-homing design and is NP-hard. We formulate it as an integer programming problem, and propose heuristic solutions. Simulation results show that the proposed solutions work in a correct and effective way and the Load-Sharing mode has higher bandwidth efficiency than Active/Standby mode.

Open Source Virtual Worlds and Low Cost Sensors for Physical Rehab of Patients with Chronic Diseases

NASA Astrophysics Data System (ADS)

Romero, Salvador J.; Fernandez-Luque, Luis; Sevillano, José L.; Vognild, Lars

For patients with chronic diseases, exercise is a key part of rehab to deal better with their illness. Some of them do rehabilitation at home with telemedicine systems. However, keeping to their exercising program is challenging and many abandon the rehabilitation. We postulate that information technologies for socializing and serious games can encourage patients to keep doing physical exercise and rehab. In this paper we present Virtual Valley, a low cost telemedicine system for home exercising, based on open source virtual worlds and utilizing popular low cost motion controllers (e.g. Wii Remote) and medical sensors. Virtual Valley allows patient to socialize, learn, and play group based serious games while exercising.

Setting up home-based palliative care in countries with limited resources: a model from Sarawak, Malaysia

PubMed Central

Devi, B. C. R.; Corbex, M.

2008-01-01

Background: The provision of palliative care (PC) and opioids is difficult to ensure in remote areas in low- and middle-income countries. We describe here the set up of a home-care program in Sarawak (the Malaysian part of the Borneo Island), where half the population lives in villages that are difficult to access. Methods: The establishment of this program, initiated in 1994 by the Department of Radiotherapy of Sarawak General Hospital, consisted of training, empowering nurses, simplifying referral, facilitating access to medication, and increasing awareness among public and health professionals about PC. Results: The program has been sustainable and cost efficient, serving 936 patients in 2006. The total morphine usage in the program increased from <200 g in 1993 to >1400 g in 2006. The results show that pain medication can be provided even in remote areas with effective organization and empowerment of nurses, who were the most important determinants for the set up of this program. Education of family was also a key aspect. Conclusion: The authors believe that the experience gained in Sarawak may help other regions with low or middle resources in the set up of their PC program especially for their remote rural population. PMID:18641007

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…

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…

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

Effective Home Visiting Training: Key Principles and Findings to Guide Training Developers and Evaluators.

PubMed

Schultz, David; Jones, Shelby S; Pinder, Wendy M; Wiprovnick, Alicia E; Groth, Elisabeth C; Shanty, Lisa M; Duggan, Anne

2018-06-23

Purpose Home visiting programs have produced inconsistent outcomes. One challenge for the field is the design and implementation of effective training to support home visiting staff. In part due to a lack of formal training, most home visitors need to develop the majority of their skills on the job. Home visitors typically receive training in their agency's specific model (e.g., HFA, NFP) and, if applicable, curriculum. Increasingly, states and other home visiting systems are developing and/or coordinating more extensive training and support systems beyond model-specific and curricula trainings. To help guide these training efforts and future evaluations of them, this paper reviews research on effective training, particularly principles of training transfer and adult learning. Description Our review summarizes several meta-analyses, reviews, and more recent publications on training transfer and adult learning principles. Assessment Effective training involves not only the introduction and modeling of concepts and skills but also the practice of, evaluation of, and reflection upon these skills. Further, ongoing encouragement of, reward for, and reflection upon use of these skills, particularly by a home visitor's supervisor, are critical for the home visitor's continued use of these skills with families. Conclusion Application of principles of adult learning and training transfer to home visiting training will likely lead to greater transfer of skills from the training environment to work with families. The involvement of both home visitors and their supervisors in training is likely important for this transfer to occur.

Voices from School and Home: Arkansas Parents and Students Talk about Preparing for the World of Work and the Potential for Youth Apprenticeship. A Report on Focus Group Discussions.

ERIC Educational Resources Information Center

Jobs for the Future, Inc., West Somerville, MA.

This report summarizes several group discussions with parents of high school students, high school students, and nursing students regarding the world of work and the advantages and disadvantages of a youth apprenticeship program. Section I is an executive summary that describes the methodology, summarizes key attitudes toward youth apprenticeships…

IEP (Individualized Educational Program) Co-operation between Optimal Support of Students with Special Needs

NASA Astrophysics Data System (ADS)

Ogoshi, Yasuhiro; Nakai, Akio; Ogoshi, Sakiko; Mitsuhashi, Yoshinori; Araki, Chikahiro

A key aspect of the optimal support of students with special needs is co-ordination and co-operation between school, home and specialized agencies. Communication between these entities is of prime importance and can be facilitated through the use of a support system implementing ICF guidelines as outlined. This communication system can be considered to be a preventative rather than allopathic support.

DOE Zero Energy Ready Home Case Study: Palo Duro Homes — Palo Duro Homes, Albuquerque, NM

DOE Office of Scientific and Technical Information (OSTI.GOV)

none,

2014-09-01

This builder was honored for Most DOE Zero Energy Ready Homes Built in the 2014 Housing Innovation Awards. By July 2014, Palo Duro had completed 152 homes since the program began in 2013 (under the original program title DOE Challenge Home), all of them certified to the stringent efficiency requirements of DOE’s Zero Energy Ready Home program.

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…

The German Long-Term Care Insurance Program: Evolution and Recent Developments.

PubMed

Nadash, Pamela; Doty, Pamela; von Schwanenflügel, Matthias

2018-05-08

Since 1995, Germany has operated one of the longest-running public programs providing universal support for the cost of long term services and supports (LTSS). Its self-funding, social insurance approach provides basic supports to nearly all Germans. We discuss its design and development, including recent reforms expanding the program and ensuring its ongoing sustainability. The study reviews legislative and programmatic changes, using program data, as well as legislative documents and program reports. The program is widely accepted among citizens and has achieved many of its original goals: ensuring access to LTSS and reducing reliance on the locally-funded safety-net social assistance program, which can be used to cover nursing home costs. It also strengthened the LTSS provider infrastructure and expanded access to home care. Recent reforms have addressed some of the program's key issues: the benefit's decreasing value, the eligibility and benefit structure that largely excluded cognitive impairment, and the program's longer-term financial sustainability-particularly its ability to sustain newly expanded benefits, which provide stronger protections to caregivers, index-link benefits, and more systematically incorporate cognitive impairment via a new assessment system. It has addressed financing issues by increasing premiums, introducing subsidies for the purchase of private insurance, and creating a "demographic reserve fund." The reforms constitute a significant strengthening of the program, remarkable in an era of retrenchment. Overall, the program provides evidence for the financial viability of a social insurance model, although longer-term challenges may yet arise.

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

24 CFR 280.20 - Home quality.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Home quality. 280.20 Section 280.20... GRANT PROGRAMS NEHEMIAH HOUSING OPPORTUNITY GRANTS PROGRAM § 280.20 Home quality. (a) Generally. Except for manufactured homes, homes constructed or substantially rehabilitated under a program must comply...

Genes and Hearing Loss

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources ... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources ...

Phase I - Smart Grid Data Access Pilot Program: Utilizing STEM Education as a Catalyst for Residential Consumer Decision Making and Change

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lishness, Alan; Peake, Leigh

2014-11-19

Under Phase I of the Smart Grid Data Access Pilot Program, the Gulf of Maine Research Institute (GMRI) partnered with Central Maine Power (CMP), and the Maine Mathematics and Science Alliance (MMSA) and engaged key vendors Tilson Government Services, LLC (Tilson), and Image Works to demonstrate the efficacy of PowerHouse, an interactive online learning environment linking middle school students with their home electricity consumption data provided through CMP’s Advanced Metering Infrastructure (AMI). The goal of the program is to harness the power of youth to alter home energy consumption behaviors using AMI data. Successful programs aimed at smoking cessation, recycling,more » and seat belt use have demonstrated the power of young people to influence household behaviors. In an era of increasing concern about energy costs, availability, and human impacts on global climate, GMRI sought to demonstrate the effectiveness of a student-focused approach to understanding and managing household energy use. We also sought to contribute to a solid foundation of science-literate students who can analyze evidence to find solutions to increasingly complex energy challenges.« less

76 FR 78343 - HOME Investment Partnerships Program: Improving Performance and Accountability; and Updating...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

... their programs and in managing their growing portfolios of older HOME projects. These challenges include... program. Examples of such uses are hospice buildings, nursing homes, foster homes, halfway houses, and...

The Future of Home Health Care: A Strategic Framework for Optimizing Value.

PubMed

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

2016-11-01

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.

Community Health Workers as Drivers of a Successful Community-Based Disease Management Initiative

PubMed Central

Peretz, Patricia J.; Matiz, Luz Adriana; Findley, Sally; Lizardo, Maria; Evans, David; McCord, Mary

2012-01-01

In 2005, local leaders in New York City developed the Washington Heights/Inwood Network for Asthma Program to address the burden of asthma in their community. Bilingual community health workers based in community organizations and the local hospital provided culturally appropriate education and support to families who needed help managing asthma. Families participating in the yearlong care coordination program received comprehensive asthma education, home environmental assessments, trigger reduction strategies, and clinical and social referrals. Since 2006, 472 families have enrolled in the yearlong program. After 12 months, hospitalizations and emergency department visits decreased by more than 50%, and caregiver confidence in controlling the child's asthma increased to nearly 100%. Key to the program's success was the commitment and involvement of community partners from program inception to date. PMID:22515859

Community health workers as drivers of a successful community-based disease management initiative.

PubMed

Peretz, Patricia J; Matiz, Luz Adriana; Findley, Sally; Lizardo, Maria; Evans, David; McCord, Mary

2012-08-01

In 2005, local leaders in New York City developed the Washington Heights/Inwood Network for Asthma Program to address the burden of asthma in their community. Bilingual community health workers based in community organizations and the local hospital provided culturally appropriate education and support to families who needed help managing asthma. Families participating in the yearlong care coordination program received comprehensive asthma education, home environmental assessments, trigger reduction strategies, and clinical and social referrals. Since 2006, 472 families have enrolled in the yearlong program. After 12 months, hospitalizations and emergency department visits decreased by more than 50%, and caregiver confidence in controlling the child's asthma increased to nearly 100%. Key to the program's success was the commitment and involvement of community partners from program inception to date.

Aboriginal parent support: A partnership approach.

PubMed

Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2018-02-01

This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal. © 2017 John Wiley & Sons Ltd.

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

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5603-N-93] Healthy Home and Lead Hazard... collection is designed to provide HUD timely information on progress of Healthy Homes Demonstration Program, Healthy Homes Technical Studies Program, Lead Base paint Hazard Control program, Lead Hazard Reduction...

Solar residential heating and cooling system development test program

NASA Technical Reports Server (NTRS)

Humphries, W. R.; Melton, D. E.

1974-01-01

A solar heating and cooling system is described, which was installed in a simulated home at Marshall Space Flight Center. Performance data are provided for the checkout and initial operational phase for key subsystems and for the total system. Valuable information was obtained with regard to operation of a solar cooling system during the first summer of operation. Areas where improvements and modifications are required to optimize such a system are discussed.

So, Your Children Are College Bound ... but Are They SAT Ready? Parents Play a Key Role in Preparing Students to Standardized Tests, Experts Agree

ERIC Educational Resources Information Center

Keels, Crystal L.

2004-01-01

Parents are an essential component in their children's SAT success, says Starlett Craig, director of outreach and enrichment programs at Clemson University in South Carolina. Clemson is home to a successful two-week SAT summer camp, where students are immersed in workshops that prepare them for the exam. But whether a child goes to a SAT camp or…

Home Start Followup Study: A Study of Long-Term Impact of Home Start on Program Participants. Final Report.

ERIC Educational Resources Information Center

Bache, William; And Others

This Home Start followup study was designed to determine the long-term impact of Home Start on program participants in sixteen states within the USA. Home Start was a three-year demonstration program which provided Head Start-type comprehensive services to young children (3- to 5-year-olds) and their families in their homes. In Chapter 1…

Who Drops out of Early Head Start Home Visiting Programs?

ERIC Educational Resources Information Center

Roggman, Lori A.; Cook, Gina A.; Peterson, Carla A.; Raikes, Helen H.

2008-01-01

Research Findings: Early Head Start home-based programs provide services through weekly home visits to families with children up to age 3, but families vary in how long they remain enrolled. In this study of 564 families in home-based Early Head Start programs, "dropping out" was predicted by specific variations in home visits and certain family…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

... [CMS-1450-CN] RIN 0938-AR52 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... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...

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,…

Easing the transition between hospital and home: translating knowledge into action.

PubMed

Baumbusch, Jennifer; Semeniuk, Pat; McDonald, Heather; Khan, Koushambhi Basu; Reimer Kirkham, Sheryl; Tan, Elsie; Anderson, Joan M

2007-10-01

Knowledge translation is an interactive, dynamic approach to the uptake of evidence-based knowledge. In this article, the authors present a collaborative model for knowledge translation that grew out of a program of research focusing on the experiences of patients from ethnoculturally diverse groups as they were discharged home from hospital. Research findings highlight issues around gaps in the continuity of services and language and communication. The authors discuss a number of knowledge translation initiatives that were developed to address these gaps. Key to the success of this process has been a collaborative relationship between researchers and practitioners that is grounded in the shared goal of knowledge translation to support ethically sound decision-making in the delivery of health-care services.

Smart Houses

NASA Technical Reports Server (NTRS)

1987-01-01

GWS takes plans for a new home and subjects them to intensive computerized analysis that does 10,000 calculations relative to expected heat loss and heat gain, then provides specifications designed specifically for each structure as to heating, cooling, ventilation and insulation. As construction progresses, GWS inspects the work of the electrical, plumbing and insulation contractors and installs its own Smart House Radiant Barrier. On completion of the home, GWS technicians use a machine that creates a vacuum in the house and enables computer calculation of the air exchanged, a measure of energy efficiency. Key factor is the radiant barrier, borrowed from the Apollo program. This is an adaptation of a highly effective aluminized heat shield as a radiation barrier holding in or keeping out heat, cold air and water vapor.

Communication and effectiveness in a US nursing home quality-improvement collaborative.

PubMed

Arling, Priscilla A; Abrahamson, Kathleen; Miech, Edward J; Inui, Thomas S; Arling, Greg

2014-09-01

In this study, we explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a quality-improvement collaborative of nursing home clinicians. Survey and interview data were collected from nursing home clinicians participating in a quality-improvement collaborative. Quality-improvement outcomes were evaluated using US Federal and State minimum dataset measures. Models were specified evaluating the relationships between resident outcomes, staff perceptions of communication patterns, and staff perceptions of collaborative effectiveness. Interview data provided deeper understanding of the quantitative findings. Reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings, and where respondents perceived that the collaborative kept them informed and provided new ideas. Clinicians observed that participation in a quality-improvement collaborative positively influenced the ability to share innovative ideas and expand the quality-improvement program within their nursing home. For practitioners, a high level of communication, both inside and outside of meetings, was key to making measurable gains in resident health outcomes. © 2013 Wiley Publishing Asia Pty Ltd.

Pilot Study of a Novel Partnership for Installing Smoke Alarms.

PubMed

Omaki, Elise C; Frattaroli, Shannon; Shields, Wendy C; McDonald, Eileen M; Rizzutti, Nicholas; Appy, Meri-K; Voiles, Denise; Jamison, Shelly; Gielen, Andrea C

2018-02-07

Objectives To demonstrate the feasibility of partnering fire department personnel and home visiting nurses to increase the number of low-income homes protected by smoke alarms. Methods During a regularly scheduled home visit, nurses at the Nurse-Family Partnership of Maricopa County (NFP) informed their clients about an opportunity to have smoke alarms installed in their homes for free. For interested families, nurses sent a referral to the Phoenix Fire Department (PFD), scheduled an appointment, and accompanied the PFD volunteers during the installation. During the appointment, PFD personnel installed alarms and provided safety education. Clients completed a follow-up survey 1-3 months after the installation visit. In-depth interviews were completed with key informants from NFP and PFD to solicit feedback on the program. Results Fifty-two smoke alarm installation visits were completed. Before the fire department arrived, 55% of homes had no working smoke alarm. Almost all (94%) homes received at least one new smoke alarm, and every home had at least one working smoke alarm at the end of the fire department visit. At follow-up, all homes maintained at least one working smoke alarm. Members from both organizations were enthusiastic about, and supportive of the project. NFP nurses appreciated the skill and knowledge of the firefighters; PFD representatives noted that the nurses' relationships with clients made it easier for them to gain access to families who are often described as "hard-to-reach". Conclusions Partnering home visiting nurses and fire departments can be successful to increase the number of vulnerable homes with smoke alarms.

The OBRA-87 nursing home regulations and implementation of the Resident Assessment Instrument: effects on process quality.

PubMed

Hawes, C; Mor, V; Phillips, C D; Fries, B E; Morris, J N; Steele-Friedlob, E; Greene, A M; Nennstiel, M

1997-08-01

To characterize changes in key aspects of process quality received by nursing home residents before and after the implementation of the national nursing home Resident Assessment Instrument (RAI) and other aspects of the Omnibus Budget Reconciliation Act (OBRA) nursing home reforms. A quasi-experimental study using a complex, multistage probability-based sample design, with data collected before (1990) and after (1993) implementation of the RAI and other OBRA provisions. Two independent cohorts (n > 2000) of residents in a random sample of 254 nursing facilities located in metropolitan statistical areas in 10 states. OBRA-87 enhanced the regulation of nursing homes and included new requirements on quality of care, resident assessment, care planning, and the use of neuroleptic drugs and physical restraints. One of the key provisions, used to help implement the OBRA requirements in daily nursing home practice, was the mandatory use of a standardized, comprehensive system, known as the RAI, to assist in assessment and care planning. OBRA provisions went into effect in federal law on October 1, 1990, although delays issuing the regulations led to actual implementation of the RAI during the Spring of 1991. MEASUREMENTS AND ANALYSES: Research nurses spent an average of 4 days per facility in each data collection round, assessing a sample of residents, collecting data through interviews with and observations of residents, interviews with multiple shifts of direct staff caregivers for the sampled residents, and review of medical records, including physician's orders, treatment and care plans, nursing progress notes, and medication records. The RNs collected data on the characteristics of the sampled residents, on the care they received, and on facility practices. The effect of being a member of the 1990 pre-OBRA or the 1993 post-OBRA cohort was assessed on the accuracy of information in the residents' medical records, the comprehensiveness of care plans, and on other key aspects of process quality while controlling for any changes in resident case-mix. The data were analyzed using contingency tables and logistic regression and a special statistical software (SUDAAN) to assure proper variance estimation. Overall, the process of care in nursing homes improved in several important areas. The accuracy of information in residents' medical records increased substantially, as did the comprehensiveness of care plans. In addition, several problematic care practices declined during this period, including use of physical restraints (37.4 to 28.1% (P < .001)) and indwelling urinary catheters (9.8 to 7% (P < .001)). There were also increases in good care practices, such as the presence of advanced directives, participation in activities, and use of toileting programs for residents with bowel incontinence. These results were sustained after controlling for differences in the resident characteristics between 1990 and 1993. Other practices, such as use of antipsychotic drugs, behavior management programs, preventive skin care, and provision of therapies were unaffected, or the differences were not statistically significant, after adjusting for changes in resident case-mix. The OBRA reforms and introduction of the RAI constituted an unprecedented implementation of comprehensive geriatric assessment in Medicare- and Medicaid-certified nursing homes. The evaluation of the effects of these interventions demonstrates significant improvements in the quality of care provided to residents. At the same time, these findings suggest that more needs to be done to improve process quality. The results suggest the RAI is one tool that facility staff, therapists, pharmacy consultants, and physicians can use to support their continuing efforts to provide high quality of care and life to the nation's 1.7 million nursing home residents.

Approaches to 30 Percent Energy Savings at the Community Scale in the Hot-Humid Climate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas-Rees, S.; Beal, D.; Martin, E.

2013-03-01

BA-PIRC has worked with several community-scale builders within the hot humid climate zone to improve performance of production, or community scale, housing. Tommy Williams Homes (Gainesville, FL), Lifestyle Homes (Melbourne, FL), and Habitat for Humanity (various locations, FL) have all been continuous partners of the Building America program and are the subjects of this report to document achievement of the Building America goal of 30% whole house energy savings packages adopted at the community scale. Key aspects of this research include determining how to evolve existing energy efficiency packages to produce replicable target savings, identifying what builders' technical assistance needsmore » are for implementation and working with them to create sustainable quality assurance mechanisms, and documenting the commercial viability through neutral cost analysis and market acceptance. This report documents certain barriers builders overcame and the approaches they implemented in order to accomplish Building America (BA) Program goals that have not already been documented in previous reports.« less

Improving Quality of Life and Depression After Stroke Through Telerehabilitation

PubMed Central

Linder, Susan M.; Rosenfeldt, Anson B.; Bay, R. Curtis; Sahu, Komal; Wolf, Steven L.

2015-01-01

OBJECTIVE. The aim of this study was to determine the effects of home-based robot-assisted rehabilitation coupled with a home exercise program compared with a home exercise program alone on depression and quality of life in people after stroke. METHOD. A multisite randomized controlled clinical trial was completed with 99 people <6 mo after stroke who had limited access to formal therapy. Participants were randomized into one of two groups, (1) a home exercise program or (2) a robot-assisted therapy + home exercise program, and participated in an 8-wk home intervention. RESULTS. We observed statistically significant changes in all but one domain on the Stroke Impact Scale and the Center for Epidemiologic Studies Depression Scale for both groups. CONCLUSION. A robot-assisted intervention coupled with a home exercise program and a home exercise program alone administered using a telerehabilitation model may be valuable approaches to improving quality of life and depression in people after stroke. PMID:26122686

Improving Quality of Life and Depression After Stroke Through Telerehabilitation.

PubMed

Linder, Susan M; Rosenfeldt, Anson B; Bay, R Curtis; Sahu, Komal; Wolf, Steven L; Alberts, Jay L

2015-01-01

The aim of this study was to determine the effects of home-based robot-assisted rehabilitation coupled with a home exercise program compared with a home exercise program alone on depression and quality of life in people after stroke. A multisite randomized controlled clinical trial was completed with 99 people<6 mo after stroke who had limited access to formal therapy. Participants were randomized into one of two groups, (1) a home exercise program or (2) a robot-assisted therapy+home exercise program, and participated in an 8-wk home intervention. We observed statistically significant changes in all but one domain on the Stroke Impact Scale and the Center for Epidemiologic Studies Depression Scale for both groups. A robot-assisted intervention coupled with a home exercise program and a home exercise program alone administered using a telerehabilitation model may be valuable approaches to improving quality of life and depression in people after stroke. Copyright © 2015 by the American Occupational Therapy Association, Inc.

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…

Effective recruitment and retention strategies in community health programs.

PubMed

McCann, Jennifer; Ridgers, Nicola D; Carver, Alison; Thornton, Lukar E; Teychenne, Megan

2013-08-01

The aim of this project was to identify effective recruitment and retention strategies used by health-promotion organisations that focus on increasing physical activity and improving nutrition within the local community. Semistructured telephone or face-to-face interviews with 25 key informants from stakeholder organisations were conducted. Key informants discussed strategies used by their organisation to effectively recruit and retain participants into community-based healthy eating and/or physical activity programs. Transcribed data were analysed with NVivo software. Effective recruitment strategies included word of mouth, links with organisations, dissemination of printed materials, media, referrals, cross-promotion of programs and face-to-face methods. Effective retention strategies included encouraging a sense of community ownership, social opportunities, recruiting a suitable leader and offering flexibility and support. Fees and support for recruiting and retaining participants was also identified. This study provides novel insights to a greatly under researched topic in the field of health promotion. There are two key take-home messages from the present study that are applicable to health practitioners as well as developers and deliverers of community health-promotion programs: (1) it is imperative that all community health organisations report on the effectiveness of their recruitment and retention, both successes and failures; and (2) there is a clear need to tailor the recruitment and retention approach to the target population and the setting the program is occurring in. SO WHAT? These findings provide important insights for the development of future community-based healthy eating and physical activity programs.

75 FR 32459 - National Energy Rating Program for Homes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

... Homes AGENCY: Energy Efficiency and Renewable Energy, Department of Energy. ACTION: Request for... parties to assist DOE in developing a voluntary National Energy Rating Program for Homes. The purpose of this program is to encourage consumers to invest in energy improvements in existing homes by providing...

A powerful graphical pulse sequence programming tool for magnetic resonance imaging.

PubMed

Jie, Shen; Ying, Liu; Jianqi, Li; Gengying, Li

2005-12-01

A powerful graphical pulse sequence programming tool has been designed for creating magnetic resonance imaging (MRI) applications. It allows rapid development of pulse sequences in graphical mode (allowing for the visualization of sequences), and consists of three modules which include a graphical sequence editor, a parameter management module and a sequence compiler. Its key features are ease to use, flexibility and hardware independence. When graphic elements are combined with a certain text expressions, the graphical pulse sequence programming is as flexible as text-based programming tool. In addition, a hardware-independent design is implemented by using the strategy of two step compilations. To demonstrate the flexibility and the capability of this graphical sequence programming tool, a multi-slice fast spin echo experiment is performed on our home-made 0.3 T permanent magnet MRI system.

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 home...

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

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 5 2013-04-01 2013-04-01 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 home...

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

... and Services Administration Advisory Committee on the Maternal, Infant and Early Childhood Home... Maternal, Infant and Early Childhood Home Visiting Program Evaluation (MIECHVE). Authority: Section 10(a)(2... meeting: Name: Advisory Committee on the Maternal, Infant, and Early Childhood Home Visiting Program...

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 home...

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.

Comparison of Home Retrofit Programs in Wisconsin

DOE Office of Scientific and Technical Information (OSTI.GOV)

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 patternsmore » 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.« less

Comparison of Home Retrofit Programs in Wisconsin

DOE Office of Scientific and Technical Information (OSTI.GOV)

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 patternsmore » 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.« less

Predicting nursing home placement among home- and community-based services program participants.

PubMed

Greiner, Melissa A; Qualls, Laura G; Iwata, Isao; White, Heidi K; Molony, Sheila L; Sullivan, M Terry; Burke, Bonnie; Schulman, Kevin A; Setoguchi, Soko

2014-12-01

Several states offer publicly funded-care management programs to prevent long-term care placement of high-risk Medicaid beneficiaries. Understanding participant risk factors and services that may prevent long-term care placement can facilitate efficient allocation of program resources. To develop a practical prediction model to identify participants in a home- and community-based services program who are at highest risk for long-term nursing home placement, and to examine participant-level and program-level predictors of nursing home placement. In a retrospective observational study, we used deidentified data for participants in the Connecticut Home Care Program for Elders who completed an annual assessment survey between 2005 and 2010. We analyzed data on patient characteristics, use of program services, and short-term facility admissions in the previous year. We used logistic regression models with random effects to predict nursing home placement. The main outcome measures were long-term nursing home placement within 180 days or 1 year of assessment. Among 10,975 study participants, 1249 (11.4%) had nursing home placement within 1 year of annual assessment. Risk factors included Alzheimer's disease (odds ratio [OR], 1.30; 95% CI, 1.18-1.43), money management dependency (OR, 1.33; 95% CI, 1.18-1.51), living alone (OR, 1.53; 95% CI, 1.31-1.80), and number of prior short-term skilled nursing facility stays (OR, 1.46; 95% CI, 1.31-1.62). Use of a personal care assistance service was associated with 46% lower odds of nursing home placement. The model C statistic was 0.76 in the validation cohort. A model using information from a home- and community-based service program had strong discrimination to predict risk of long-term nursing home placement and can be used to identify high-risk participants for targeted interventions.

Status Survey of Secondary School Home Economics Programs in the State of Wisconsin, 1972; Abstract of Status Survey.

ERIC Educational Resources Information Center

Monts, Elizabeth A.; And Others

A survey of the middle and senior high school home economics teachers and principals in Wisconsin was conducted to identify the present status of the home economics program which would serve as a basis for future program development and staff education. To obtain an accurate description of the home economics program, questionnaires were developed…

A home visiting asthma education program: challenges to program implementation.

PubMed

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

2005-02-01

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 surrogate father in the household, and safety of the neighborhood, but not by child factors, such as age or severity of asthma as implied by the prescribed asthma medication regimen. Incompatibility between the scheduling needs of the families and the nurse home visitors was a major obstacle in delivering the program on time, despite the flexibility of the nurse home visitors. The authors suggest that future home-based asthma education programs contain a more limited number of home visits but add telephone follow-ups and address the broader needs of low-income families that most likely function as barriers to program success.

Five Key Leadership Actions Needed to Redesign Family Medicine Residencies.

PubMed

Kozakowski, Stanley M; Eiff, M Patrice; Green, Larry A; Pugno, Perry A; Waller, Elaine; Jones, Samuel M; Fetter, Gerald; Carney, Patricia A

2015-06-01

New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership. We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change. The Preparing the Personal Physician for Practice (P4) project (2007-2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign. Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience. Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... Administration (FHA): PowerSaver Home Energy Retrofit Loan Pilot Program: Extension of Pilot Program AGENCY...: On March 31, 2011, HUD published a notice that announced HUD's FHA Home Energy Retrofit Loan Pilot Program (Retrofit Pilot Program) known as FHA PowerSaver, which is a pilot program conducted for loans...

Changes in smoke alarm coverage following two fire department home visiting programs: what predicts success?

PubMed

Gielen, Andrea C; Perry, Elise C; Shields, Wendy C; McDonald, Eileen; Frattaroli, Shannon; Jones, Vanya

2014-12-01

Door-to-door canvassing and installation of smoke alarms have been found to be effective at increasing the number of homes protected. This analysis reports on how smoke alarm coverage changes six months after a home visiting program in a large urban sample, and how this change varies by characteristics of the residents and characteristics of the services delivered during the home visit. Fire department Standard and Enhanced home visiting programs were compared. During the home visit, fire fighters installed lithium battery smoke alarms. Residents in the Enhanced program received tailored education about fire safety. Six months after the home visit, participating residences were visited to complete a follow-up survey and to have the installed alarms checked. 81% of the 672 homes that had a working smoke alarm on every level of the home at the end of the home visit remained safe at follow-up, and 87% of the residents found the home visit was very useful, and these rates did not differ between the Enhanced and Standard programs. The degree to which firefighters delivered their services varied, although households in which the resident's engagement with the fire department team was rated as excellent were 3.96 times as likely to be safe at follow-up compared to those with poor or fair resident engagement (p=0.03). There is a need to better understand how to maximize the time spent with residents during smoke alarm home visiting programs. This study helps with the development of methods needed for implementing and evaluating such programs in real-world settings.

A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers.

PubMed

Moor, C C; Wapenaar, M; Miedema, J R; Geelhoed, J J M; Chandoesing, P P; Wijsenbeek, M S

2018-05-29

In idiopathic pulmonary fibrosis (IPF), home monitoring experiences are limited, not yet real-time available nor implemented in daily care. We evaluated feasibility and potential barriers of a new home monitoring program with real-time wireless home spirometry in IPF. Ten patients with IPF were asked to test this home monitoring program, including daily home spirometry, for four weeks. Measurements of home and hospital spirometry showed good agreement. All patients considered real-time wireless spirometry useful and highly feasible. Both patients and researchers suggested relatively easy solutions for the identified potential barriers regarding real-time home monitoring in IPF.

Care of newborn in the community and at home.

PubMed

Neogi, S B; Sharma, J; Chauhan, M; Khanna, R; Chokshi, M; Srivastava, R; Prabhakar, P K; Khera, A; Kumar, R; Zodpey, S; Paul, V K

2016-12-01

India has contributed immensely toward generating evidence on two key domains of newborn care: Home Based Newborn Care (HBNC) and community mobilization. In a model developed in Gadchiroli (Maharashtra) in the 1990s, a package of Interventions delivered by community health workers during home visits led to a marked decline in neonatal deaths. On the basis of this experience, the national HBNC program centered around Accredited Social Health Activists (ASHAs) was introduced in 2011, and is now the main community-level program in newborn health. Earlier in 2004, the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program was rolled out with inclusion of home visits by Anganwadi Worker as an integral component. IMNCI has been implemented in 505 districts in 27 states and 4 union territories. A mix of Anganwadi Workers, ASHAs, auxiliary nursing midwives (ANMs) was trained. The rapid roll out of IMNCI program resulted in improving quality of newborn care at the ground field. However, since 2012 the Ministry of Health and Family Welfare decided to limit the IMNCI program to ANMs only and leaving the Anganwadi component to the stewardship of the Integrated Child Development Services. ASHAs, the frontline workers for HBNC, receive four rounds of training using two modules. There are a total of over 900 000 ASHAs per link workers in the country, out of which, only 14% have completed the fourth round of training. The pace of uptake of the HBNC program has been slow. Of the annual rural birth cohort of over 17 million, about 4 million newborns have been visited by ASHA during the financial year 2013-2014 and out of this 120 000 neonates have been identified as sick and referred to health facilities for higher level of neonatal care. Supportive supervision remains a challenge, the role of ANMs in supervision needs more clarity and there are issues surrounding quality of training and the supply of HBNC kits. The program has low visibility in many states. Now is the time to tap the missed opportunity of miniscule coverage of HBNC; that at least half of the country's birth cohort should be covered by this program by 2016, coupled with rapid scale up of the community-based treatment of neonates with pneumonia or sepsis, where referral is not possible.

Care of newborn in the community and at home

PubMed Central

Neogi, S B; Sharma, J; Chauhan, M; Khanna, R; Chokshi, M; Srivastava, R; Prabhakar, P K; Khera, A; Kumar, R; Zodpey, S; Paul, V K

2016-01-01

India has contributed immensely toward generating evidence on two key domains of newborn care: Home Based Newborn Care (HBNC) and community mobilization. In a model developed in Gadchiroli (Maharashtra) in the 1990s, a package of Interventions delivered by community health workers during home visits led to a marked decline in neonatal deaths. On the basis of this experience, the national HBNC program centered around Accredited Social Health Activists (ASHAs) was introduced in 2011, and is now the main community-level program in newborn health. Earlier in 2004, the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program was rolled out with inclusion of home visits by Anganwadi Worker as an integral component. IMNCI has been implemented in 505 districts in 27 states and 4 union territories. A mix of Anganwadi Workers, ASHAs, auxiliary nursing midwives (ANMs) was trained. The rapid roll out of IMNCI program resulted in improving quality of newborn care at the ground field. However, since 2012 the Ministry of Health and Family Welfare decided to limit the IMNCI program to ANMs only and leaving the Anganwadi component to the stewardship of the Integrated Child Development Services. ASHAs, the frontline workers for HBNC, receive four rounds of training using two modules. There are a total of over 900 000 ASHAs per link workers in the country, out of which, only 14% have completed the fourth round of training. The pace of uptake of the HBNC program has been slow. Of the annual rural birth cohort of over 17 million, about 4 million newborns have been visited by ASHA during the financial year 2013–2014 and out of this 120 000 neonates have been identified as sick and referred to health facilities for higher level of neonatal care. Supportive supervision remains a challenge, the role of ANMs in supervision needs more clarity and there are issues surrounding quality of training and the supply of HBNC kits. The program has low visibility in many states. Now is the time to tap the missed opportunity of miniscule coverage of HBNC; that at least half of the country's birth cohort should be covered by this program by 2016, coupled with rapid scale up of the community-based treatment of neonates with pneumonia or sepsis, where referral is not possible. PMID:27924109

How to Overcome Barriers and Establish a Successful Home HD Program

PubMed Central

Chan, Christopher; Blagg, Christopher; Lockridge, Robert; Golper, Thomas; Finkelstein, Fred; Shaffer, Rachel; Mehrotra, Rajnish

2012-01-01

Summary Home hemodialysis (HD) is an underused dialysis modality in the United States, even though it provides an efficient and probably cost-effective way to provide more frequent or longer dialysis. With the advent of newer home HD systems that are easier for patients to learn, use, and maintain, patient and provider interest in home HD is increasing. Although barriers for providers are similar to those for peritoneal dialysis, home HD requires more extensive patient training, nursing education, and infrastructure support in order to maintain a successful program. In addition, because many physicians and patients do not have experience with home HD, reluctance to start home HD programs is widespread. This in-depth review describes barriers to home HD, focusing on patients, individual physicians and practices, and dialysis facilities, and offers suggestions for how to overcome these barriers and establish a successful home HD program. PMID:23037981

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

PubMed

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

2016-06-01

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

Development of an inter-professional educational program for home care professionals: Evaluation of short-term effects in suburban areas.

PubMed

Tsuchiya, Rumiko; Yoshie, Satoru; Kawagoe, Shohei; Hirahara, Satoshi; Onishi, Hirotaka; Murayama, Hiroshi; Nishinaga, Masanori; Iijima, Katsuya; Tsuji, Tetsuo

2017-01-01

Objective　To examine the short-term effects of an inter-professional educational program developed for physicians and other home care specialists to promote home care in the community.Methods　From March 2012 to January 2013, an inter-professional educational program (IEP) was held four times in three suburban areas (Kashiwa city and Matsudo city in the Chiba prefecture, and Omori district in the Ota ward). This program aimed to motivate physicians to increase the number of home visits and to encourage home care professionals to work together in the same community areas by promoting inter-professional work (IPW). The participants were physicians, home-visit nurses, and other home care professionals recommended by community-level professional associations. The participants attended a 1.5-day multi-professional IEP. Pre- and post-program questionnaires were used to collect information on home care knowledge and practical skills (26 indexes, 1-4 scale), attitudes toward home care practice (4 indexes, 1-6 scale), and IPW (13 indexes, 1-4 scale). Data from all of the participants without labels about the type of professionals were excluded, and both pre-test and post-test responses were used in the analysis. A Wilcoxon signed-rank test and a paired t-test were conducted to compare pre- and post-program questionnaire responses stratified for physicians and other professionals, and the effect size was calculated.Results　The total number of participants for the four programs was 256, and data from 162 (63.3%) were analyzed. The physicians numbered 19 (11.7%), while other professionals numbered 143 (88.3%). Attending this program helped participants obtain home care knowledge of IPW and a practical view of home care. Furthermore, indexes about IPW consisted of two factors: cooperation and interaction; non-physician home care professionals increased their interactions with physicians, other professionals increased their cooperation with other professionals, and physicians increased their cooperation with other physicians.Conclusion　Short-term effects to motivate physicians to increase home visits were limited. However, physicians obtained a practical view of home care by attending the IEP. Also, the participation of physicians and other home care professionals in this program triggered the beginning of IPW in suburban areas. This program is feasible when adapted for regional differences.

"Home is at work and work is at home": telework and individuals who use augmentative and alternative communication.

PubMed

McNaughton, David; Rackensperger, Tracy; Dorn, Dana; Wilson, Natasha

2014-01-01

Telework, the use of distance communication technologies to participate in the workforce, has been suggested as a promising employment strategy for individuals with disabilities. The goal of this study was to obtain a better understanding of the benefits and negative impacts of telework, as well as the supports and challenges to telework activities, for persons who use augmentative and alternative communication (AAC). This study used a series of focus group discussions, conducted on the internet, to examine the employment experiences of nine individuals with disabilities who used AAC and who held jobs that involved the use of telework. Four major themes emerged from the discussion: (a) benefits of telework, (b) negative impacts of telework, (c) strategies for addressing negative impacts of telework, and (d) recommendations for improving employment outcomes for individuals who use AAC. In summary, while participants identified the elimination of travel time and flexible work schedules as key strengths of telework, concerns were expressed regarding feelings of isolation and the difficulty in separating home and work environments. The participants also emphasized the important role of educational programs in supporting the acquisition of literacy and self-advocacy skills, and the need for post-secondary programs to support the school-to-workplace transition.

Approaches to 30% Energy Savings at the Community Scale in the Hot-Humid Climate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas-Rees, S.; Beal, D.; Martin, E.

2013-03-01

BA-PIRC has worked with several community-scale builders within the hot humid climate zone to improve performance of production, or community scale, housing. Tommy Williams Homes (Gainesville, FL), Lifestyle Homes (Melbourne, FL), and Habitat for Humanity (various locations, FL) have all been continuous partners of the BA Program and are the subjects of this report to document achievement of the Building America goal of 30% whole house energy savings packages adopted at the community scale. The scope of this report is to demonstrate achievement of these goals though the documentation of production-scale homes built cost-effectively at the community scale, and modeledmore » to reduce whole-house energy use by 30% in the Hot Humid climate region. Key aspects of this research include determining how to evolve existing energy efficiency packages to produce replicable target savings, identifying what builders' technical assistance needs are for implementation and working with them to create sustainable quality assurance mechanisms, and documenting the commercial viability through neutral cost analysis and market acceptance. This report documents certain barriers builders overcame and the approaches they implemented in order to accomplish Building America (BA) Program goals that have not already been documented in previous reports.« less

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

... Administration for Children and Families Advisory Committee on the Maternal, Infant and Early Childhood Home...: Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation. Date and... and Early Childhood Home Visiting Program Evaluation will meet for its first session on Wednesday...

75 FR 81138 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

... [CMS-1510-CN2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home Health Agencies and Hospices AGENCY... ``Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in...

Goals and Characteristics of Long-Term Care Programs: An Analytic Model.

ERIC Educational Resources Information Center

Braun, Kathryn L.; Rose, Charles L.

1989-01-01

Used medico-social analytic model to compare five long-term care programs: Skilled Nursing Facility-Intermediate Care Facility (SNF-ICF) homes, ICF homes, foster homes, day hospitals, and home care. Identified similarities and differences among programs. Preliminary findings suggest that model is useful in the evaluation and design of long-term…

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…

76 FR 624 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-05

... Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request... Form 10-0476).'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E. DeBakey Home... satisfaction with the quality of services/care provided by home care program staff. An agency may not conduct...

75 FR 62635 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-12

... Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request... determine patients' satisfaction with services provided by or through the Michael E. DeBakey Home Care...: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number...

CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

PubMed

Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

2018-05-01

The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

Assessing the Deployment of Home Visiting: Learning from a State-Wide Survey of Home Visiting Programs.

PubMed

Fischer, Robert L; Anthony, Elizabeth R; Lalich, Nina; Nevar, Ann; Bakaki, Paul; Koroukian, Siran

2016-03-01

Large-scale planning for health and human services programming is required to inform effective public policy as well as deliver services to meet community needs. The present study demonstrates the value of collecting data directly from deliverers of home visiting programs across a state. This study was conducted in response to the Patient Protection and Affordable Care Act, which requires states to conduct a needs assessment of home visiting programs for pregnant women and young children to receive federal funding. In this paper, we provide a descriptive analysis of a needs assessment of home visiting programs in Ohio. All programs in the state that met the federal definition of home visiting were included in this study. Program staff completed a web-based survey with open- and close-ended questions covering program management, content, goals, and characteristics of the families served. Consistent with the research literature, program representatives reported great diversity with regard to program management, reach, eligibility, goals, content, and services delivered, yet consistently conveyed great need for home visiting services across the state. Results demonstrate quantitative and qualitative assessments of need have direct implications for public policy. Given the lack of consistency highlighted in Ohio, other states are encouraged to conduct a similar needs assessment to facilitate cross-program and cross-state comparisons. Data could be used to outline a capacity-building and technical assistance agenda to ensure states can effectively meet the need for home visiting in their state.

Success Begins at Home.

ERIC Educational Resources Information Center

Lombard, Avima D.

Israel's Home Instruction Program for Preschool Youngsters, a nationally administered home-based program of early childhood education, is discussed in this book. In addition to presenting information regarding the social conditions that necessitated development of the program, this book describes the theory and planning behind the program, its…

Nurse Family Partnership: Comparing Costs per Family in Randomized Trials Versus Scale-Up.

PubMed

Miller, Ted R; Hendrie, Delia

2015-12-01

The literature that addresses cost differences between randomized trials and full-scale replications is quite sparse. This paper examines how costs differed among three randomized trials and six statewide scale-ups of nurse family partnership (NFP) intensive home visitation to low income first-time mothers. A literature review provided data on pertinent trials. At our request, six well-established programs reported their total expenditures. We adjusted the costs to national prices based on mean hourly wages for registered nurses and then inflated them to 2010 dollars. A centralized data system provided utilization. Replications had fewer home visits per family than trials (25 vs. 31, p = .05), lower costs per client ($8860 vs. $12,398, p = .01), and lower costs per visit ($354 vs. $400, p = .30). Sample size limited the significance of these differences. In this type of labor intensive program, costs probably were lower in scale-up than in randomized trials. Key cost drivers were attrition and the stable caseload size possible in an ongoing program. Our estimates reveal a wide variation in cost per visit across six state programs, which suggests that those planning replications should not expect a simple rule to guide cost estimations for scale-ups. Nevertheless, NFP replications probably achieved some economies of scale.

Creating a meaningful infection control program: one home healthcare agency's lessons.

PubMed

Poff, Renee McCoy; Browning, Sarah Via

2014-03-01

Creating a meaningful infection control program in the home care setting proved to be challenging for agency leaders of one hospital-based home healthcare agency. Challenges arose when agency leaders provided infection control (IC) data to the hospital's IC Committee. The IC Section Chief asked for national benchmark comparisons to align home healthcare reporting to that of the hospital level. At that point, it was evident that the home healthcare IC program lacked definition and structure. The purpose of this article is to share how one agency built a meaningful IC program.

Home visiting programs for HIV-affected families: a comparison of service quality between volunteer-driven and paraprofessional models.

PubMed

Kidman, Rachel; Nice, Johanna; Taylor, Tory; Thurman, Tonya R

2014-10-02

Home visiting is a popular component of programs for HIV-affected children in sub-Saharan Africa, but its implementation varies widely. While some home visitors are lay volunteers, other programs invest in more highly trained paraprofessional staff. This paper describes a study investigating whether additional investment in paraprofessional staffing translated into higher quality service delivery in one program context. Beneficiary children and caregivers at sites in KwaZulu-Natal, South Africa were interviewed after 2 years of program enrollment and asked to report about their experiences with home visiting. Analysis focused on intervention exposure, including visit intensity, duration and the kinds of emotional, informational and tangible support provided. Few beneficiaries reported receiving home visits in program models primarily driven by lay volunteers; when visits did occur, they were shorter and more infrequent. Paraprofessional-driven programs not only provided significantly more home visits, but also provided greater interaction with the child, communication on a larger variety of topics, and more tangible support to caregivers. These results suggest that programs that invest in compensation and extensive training for home visitors are better able to serve and retain beneficiaries, and they support a move toward establishing a professional workforce of home visitors to support vulnerable children and families in South Africa.

Measuring outcomes of community aged care programs: challenges, opportunities and the Australian Community Outcomes Measurement ACCOM tool.

PubMed

Cardona, Beatriz

2018-05-29

Measuring health and wellbeing outcomes of community aged care programs is a complex task given the diverse settings in which care takes place and the intersection of numerous factors affecting an individual's quality of life outcomes. Knowledge of a strong causal relationship between services provided and the final outcome enables confidence in assuming the care provided was largely responsible for the outcome achieved (Courtney et al., Aust J Adv Nurs 26:49-57, 2009). The Department of Health has recently reported on the findings of The National Aged Care Quality Indicator Program - Home Care Pilot (KPMG, National Aged Care Quality Indicator Program - Home Care Pilot, 2017). The Program sought to test various tools to measure quality of life outcomes of their community aged care programs. Some of the key issues raised in the study reiterate the findings from The Australian Community Care Outcome Measurement (ACCOM) pilot study (Cardona et al., Australas J Ageing 36: 69-71, 2017), including the value of the ASCOT SCT4 tool (Adult Social care Outcomes Toolkit, http://www.pssru.ac.uk/ascot/downloads/questionnaires/sct4.pdf ) to measure social care related quality of life (SCRQoL) in community aged care programs in the Australian context, the collection of additional data to map the relationship of various variables such as functional ability, demographic characteristics and quality of life scores and the governance and administration of measurement tools for the purpose of quality reporting and consumer choice.

Electronic Health Physical Activity Behavior Change Intervention to Self-Manage Cardiovascular Disease: Qualitative Exploration of Patient and Health Professional Requirements.

PubMed

Walsh, Deirdre Mj; Moran, Kieran; Cornelissen, Véronique; Buys, Roselien; Cornelis, Nils; Woods, Catherine

2018-05-08

Cardiovascular diseases are a leading cause of premature death worldwide. International guidelines recommend routine delivery of all phases of cardiac rehabilitation. Uptake of traditional cardiac rehabilitation remains suboptimal, as attendance at formal hospital-based cardiac rehabilitation programs is low, with community-based cardiac rehabilitation rates and individual long-term exercise maintenance even lower. Home-based cardiac rehabilitation programs have been shown to be equally effective in clinical and health-related quality of life outcomes and yet are not readily available. Given the potential that home-based cardiac rehabilitation programs have, it is important to explore how to appropriately design any such intervention in conjunction with key stakeholders. The aim of this study was to engage with individuals with cardiovascular disease and other professionals within the health ecosystem to (1) understand the personal, social, and physical factors that inhibit or promote their capacity to engage with physical activity and (2) explore their technology competencies, needs, and wants in relation to an eHealth intervention. Fifty-four semistructured interviews were conducted across two countries. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. Barriers to the implementation of PATHway were also explored specifically in relation to physical capability and safety as well as technology readiness and further mapped onto the COM-B model for future intervention design. Key recommendations included collection of patient data and use of measurements, harnessing hospital based social connections, and advice to utilize a patient-centered approach with personalization and tailoring to facilitate optimal engagement. In summary, a multifaceted, personalizable intervention with an inclusively designed interface was deemed desirable for use among cardiovascular disease patients both by end users and key stakeholders. In-depth understanding of core needs of the population can aid intervention development and acceptability. ©Deirdre MJ Walsh, Kieran Moran, Véronique Cornelissen, Roselien Buys, Nils Cornelis, Catherine Woods. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 08.05.2018.

Understanding dual enrollees' use of Medicare home health services: the effects of differences in Medicaid home care programs.

PubMed

Kenney, G; Rajan, S

2000-01-01

Both the Medicare and Medicaid programs have experienced considerable growth in spending on home care in recent years. As policymakers adopt measures (such as those legislated in the Balanced Budget Act of 1997) to curb the rate of spending growth on home care services, it is important to understand interactions between the Medicare and Medicaid home care programs in serving the dually enrolled population. This study examines the potential effects of the Medicaid home care program on Medicare home health utilization using multivariate models. The study relied on data from the Health Care Financing Administration's Medicare Current Beneficiary Survey (MCBS), a longitudinal survey of Medicare enrollees. The primary MCBS file used was from Round 1 of the survey, which was fielded between September and December 1991. The unit of analysis was individuals. The authors used descriptive and multivariate methods to explore the relationship between Medicare coverage and state home care program characteristics. Included were variables that have been found to be significant determinants of Medicare home health utilization in other studies as well as variables to indicate the availability and generosity of Medicaid home care services in each state represented in the survey. The findings were consistent with those of previous studies, in that dual enrollees were disproportionate users of Medicare home health services, accounting for only 16% of enrollees but receiving 40% of all visits. In addition, lower levels of Medicare home health use were observed in states with relatively higher Medicaid spending on home health and personal care services, but this relationship appeared to be heavily dominated by the inclusion of enrollees living in New York State. When individuals from New York were excluded from the analysis, we found a negative but statistically significant relationship between Medicaid outlays on home health and personal care services and Medicare home health utilization. Because the Medicare and Medicaid programs are interconnected through the sizable dual enrollee population, changes in one program are likely to have ramifications for the other. This study presents another step in exploring how the two programs interact and emphasizes the fact that costs can be shifted between the two programs as policy changes are made to control the rate of home care spending growth.

24 CFR 92.501 - HOME Investment Partnership Agreement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false HOME Investment Partnership... Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.501 HOME Investment Partnership Agreement. Allocated and reallocated funds will be made available pursuant to a HOME...

24 CFR 92.501 - HOME Investment Partnership Agreement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false HOME Investment Partnership... Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.501 HOME Investment Partnership Agreement. Allocated and reallocated funds will be made available pursuant to a HOME...

24 CFR 92.501 - HOME Investment Partnership Agreement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false HOME Investment Partnership... Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.501 HOME Investment Partnership Agreement. Allocated and reallocated funds will be made available pursuant to a HOME...

24 CFR 92.501 - HOME Investment Partnership Agreement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false HOME Investment Partnership... Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.501 HOME Investment Partnership Agreement. Allocated and reallocated funds will be made available pursuant to a HOME...

24 CFR 92.501 - HOME Investment Partnership Agreement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false HOME Investment Partnership... Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.501 HOME Investment Partnership Agreement. Allocated and reallocated funds will be made available pursuant to a HOME...

Income and Child Development

PubMed Central

Berger, Lawrence M.; Paxson, Christina; Waldfogel, Jane

2010-01-01

We examine how income is associated with the home environments and the cognitive and behavioral development of pre-school children, using data from a birth cohort study of children born at the end of the 20th century. Lower-income 3-year-old children are more likely than wealthier children to live in homes with inadequate physical environments and to have mothers who are more likely to be stressed, depressed, harsh and unresponsive. Additionally, low income children have lower PPVT scores, more mother-reported aggressive, withdrawn, and anxious behavior problems, and also more interviewer-reported problems with behavior, than more affluent children. A key policy question is whether increases in the incomes of poor families would result in improvements in children’s outcomes, at least in part through improvements in the home environment. This question is difficult to answer using observational data. However, we argue that, even under the most generous interpretation of the associations we estimate, large income transfer programs would have relatively small effects on children’s cognitive and behavioral outcomes. PMID:20368763

Patients' discharge experiences: returning home after open-heart surgery.

PubMed

Lapum, Jennifer; Angus, Jan E; Peter, Elizabeth; Watt-Watson, Judy

2011-01-01

This study explored patients' narratives of technology in heart surgery and recovery. A narrative inquiry was conducted with a sample of 16 individuals. Interviews were completed 2 to 4 days after transfer from cardiovascular intensive care, and 4 to 6 weeks after discharge. Participants completed journals between these 2 time periods. Discharge and the return home were highlighted as key transitions. These transitions were driven by a technological script that included teachings and texts provided upon discharge. Complicating participants' narratives were their own personal dramas and self-characterizations of vulnerability, as they struggled to incorporate this script into the particularities of their daily lives. Comprehensive conceptualizations of technology that involve the associated logics and pathways of recovery provide deep insights into patients' stories of recovery from heart surgery. It is salient that discharge programs consider the ways that technology enters into patients' narratives, and also consider dialogical approaches to communication, education, and supportive interventions that are offered at multiple intervals and continue in the home. Copyright © 2011 Elsevier Inc. All rights reserved.

Providing More Home-Delivered Meals Is One Way To Keep Older Adults With Low Care Needs Out Of Nursing Homes

PubMed Central

Thomas, Kali S.; Mor, Vincent

2014-01-01

Programs that help older adults live independently in the community can also deliver net savings to states on the costs of long-term supports and services. We estimate that if all states had increased by 1 percent the number of adults age sixty-five or older who received home-delivered meals in 2009 under Title III of the Older Americans Act, total annual savings to states’ Medicaid programs could have exceeded $109 million. The projected savings primarily reflect decreased Medicaid spending for an estimated 1,722 older adults with low-care needs who would no longer require nursing home care— instead, they could remain at home, sustained by home-delivered meals. Twenty-six states could have realized net savings in 2009 from the expansion of their home-delivered meals programs, while twenty-two states would have incurred net costs. Programs such as home-delivered meals have the potential to provide substantial savings to some states’ Medicaid programs. PMID:24101071

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

National Home Start Evaluation. Interim Report V: Case Studies.

ERIC Educational Resources Information Center

Jerome, Chris H.; And Others

One of a series of documents on the evaluation of the National Home Start (NHS) program this third year interim report of case studies describes program efforts and successes with 16 Home Start families throughout the nation. A federally funded demonstration program, NHS is aimed at providing home-based services (such as health, education,…

Associations of Cooking With Dietary Intake and Obesity Among Supplemental Nutrition Assistance Program Participants.

PubMed

Taillie, Lindsey Smith; Poti, Jennifer M

2017-02-01

Participation in the Supplemental Nutrition Assistance Program (SNAP) may help ease economic and time constraints of cooking, helping low-income households prepare healthier meals. Therefore, frequent cooking may be more strongly associated with improved dietary outcomes among SNAP recipients than among income-eligible non-recipients. Alternately, increased frequency of home-cooked meals among SNAP participants may be beneficial simply by replacing fast food intake. This study quantified the association between home cooking and fast food with diet intake and weight status among SNAP recipients. In 2016, data from low-income adults aged 19-65 years from the National Health and Nutrition Survey 2007-2010 (N=2,578) were used to examine associations of daily home-cooked dinner and weekly fast food intake with diet intake, including calories from solid fat and added sugar and key food groups (sugar-sweetened beverages, fruit, and vegetables), and prevalence of overweight/obesity. Differences in these associations for SNAP recipients versus income-eligible non-recipients were analyzed, as well as whether associations were attenuated when controlling for fast food intake. Daily home-cooked dinners were associated with small improvements in dietary intake for SNAP recipients but not for non-recipients, including lower sugar-sweetened beverage intake (-54 kcal/day), and reduced prevalence of overweight/obesity (-6%) (p<0.05). However, these associations were attenuated after controlling for fast food intake. Consuming at least one fast food meal/week was associated with 9.3% and 11.6% higher overweight/obesity prevalence among SNAP recipients and non-recipients, respectively (p<0.05). Strategies to improve dietary intake among SNAP recipients should consider both increasing home cooking and reducing fast food intake. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

An Early Look at Families and Local Programs in the Mother and Infant Home Visiting Program Evaluation-Strong Start: Third Annual Report. OPRE Report 2016-37

ERIC Educational Resources Information Center

Lee, Helen; Crowne, Sarah; Faucetta, Kristen; Hughes, Rebecca

2016-01-01

The Mother and Infant Home Visiting Program Evaluation-Strong Start (MIHOPE-Strong Start) is the largest random assignment study to date to examine the effectiveness of home visiting services on improving birth outcomes and infant and maternal health care use for expectant mothers. The study includes local home visiting programs that use one of…

Home Visitations for Delivering an Early Childhood Obesity Intervention in Denver: Parent and Patient Navigator Perspectives.

PubMed

Knierim, Shanna Doucette; Moore, Susan L; Raghunath, Silvia Gutiérrez; Yun, Lourdes; Boles, Richard E; Davidson, Arthur J

2018-06-23

Objective This qualitative study explored parent and patient navigator perspectives of home visitation as part of a childhood obesity program in a low-income, largely Latino population. Methods Three patient navigators and 25 parents who participated in a home-based, childhood obesity program participated in focus groups or interviews. Emergent themes were identified through content analysis of qualitative data. Results Three overall themes were identified. Patient navigators and parents perceived: (1) enabling characteristics of home-based program delivery which facilitated family participation and/or behavior change (i.e., convenience, increased accountability, inclusion of household members, delivery in a familiar, intimate setting, and individualized pace and content); (2) logistic and cultural challenges to home-based delivery which reduced family participation and program reach (i.e., difficulties scheduling visits, discomfort with visitors in the home, and confusion about the patient navigator's role); and (3) remediable home-based delivery challenges which could be ameliorated by additional study staff (e.g., supervision of children, safety concerns) or through organized group sessions. Both patient navigators and participating parents discussed an interest in group classes with separate, supervised child-targeted programming and opportunities to engage with other families for social support. Conclusions for Practice A home visitation program delivering a pediatric obesity prevention curriculum in Denver was convenient and held families accountable, but posed scheduling difficulties and raised safety concerns. Conducting home visits in pairs, adding obesity prevention curriculum to existing home visiting programs, or pairing the convenience of home visits with group classes may be future strategies to explore.

77 FR 47855 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... development outcomes for at- risk children through evidence-based home visiting programs. Under this program...: Proposed Project: Maternal, Infant and Early Childhood Home Visiting Program FY 2012 Non-Competing... Maternal, Infant, and Early Childhood Home Visiting Program, ( http://frwebgate.access.gpo.gov/cgi-bin...

Home-Start between Childhood and Maturity: A Programme Evaluation.

ERIC Educational Resources Information Center

Terpstra, Linda; van Dijke, Anke

A crucial question for evaluating nationally or internationally implemented programs is whether local adaptations detract from program quality and effectiveness. An evaluation examined the program successes and challenges encountered in the first 5 years of Home-Start in the Netherlands, a home-based family support program for families with young…

Behavior medicine specialist.

PubMed

Tuso, Phillip

2014-01-01

Total Health is a vision for the future and a strategy to prevent preventable disease, save lives, and make health care more affordable. Total Health means health of mind (behavior health) and health of body (physical health). To achieve Total Health we need healthy people in healthy communities. A behavior medicine specialist is a psychologist who works in the medical home with the primary care physician instead of in the Mental Health Department with a psychiatrist. The key to achieving Total Health will be to transform our current health care system from a focus on treating disease to a focus on preventing disease. This transformation will require complex behavior change interventions and services not usually provided in the medical home. The behavior medicine specialist will bring the knowledge and experience used to treat mental illness into the medical home to help the primary care physician improve the care of all patients in the medical home. The behavior medicine specialist will help improve outcomes in synergy with the primary care physician by universal screening of high-risk diseases, stepped care protocols, and efficient use of all resources available to care for patients in the medical home (health education classes, wellness coaches, and online social networking lifestyle management programs). These interventions should increase patient satisfaction, increase access to specialty care (psychiatry), and help us achieve Total Health.

Supervised Versus Home Exercise Training Programs on Functional Balance in Older Subjects.

PubMed

Youssef, Enas Fawzy; Shanb, Alsayed Abd Elhameed

2016-11-01

Aging is associated with a progressive decline in physical capabilities and a disturbance of both postural control and daily living activities. The aim of this study was to evaluate the effects of supervised versus home exercise programs on muscle strength, balance and functional activities in older participants. Forty older participants were equally assigned to a supervised exercise program (group-I) or a home exercise program (group-II). Each participant performed the exercise program for 35-45 minutes, two times per week for four months. Balance indices and isometric muscle strength were measured with the Biodex Balance System and Hand-Held Dynamometer. Functional activities were evaluated by the Berg Balance Scale (BBS) and the timed get-up-and-go test (TUG). The mean values of the Biodex balance indices and the BBS improved significantly after both the supervised and home exercise programs ( P < 0.05). However, the mean values of the TUG and muscle strength at the ankle, knee and hip improved significantly only after the supervised program. A comparison between the supervised and home exercise programs revealed there were only significant differences in the BBS, TUG and muscle strength. Both the supervised and home exercise training programs significantly increased balance performance. The supervised program was superior to the home program in restoring functional activities and isometric muscle strength in older participants.

Case Study of Home-School Visits

ERIC Educational Resources Information Center

Aguerrebere, Yolanda

2009-01-01

This case study evaluated one site of a California teacher home visit program. Home visits have been an important means of connecting families and schooling. In 1999, California inaugurated a statewide home visit program to promote effective partnership between home and school for low-achieving schools. At this site, families in 3 kindergarten…

24 CFR 92.500 - The HOME Investment Trust Fund.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false The HOME Investment Trust Fund. 92... Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.500 The HOME Investment Trust Fund. (a) General. A HOME Investment Trust Fund consists of the accounts described in this...

24 CFR 92.500 - The HOME Investment Trust Fund.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false The HOME Investment Trust Fund. 92... Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.500 The HOME Investment Trust Fund. (a) General. A HOME Investment Trust Fund consists of the accounts described in this...

24 CFR 92.500 - The HOME Investment Trust Fund.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false The HOME Investment Trust Fund. 92... Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.500 The HOME Investment Trust Fund. (a) General. A HOME Investment Trust Fund consists of the accounts described in this...

24 CFR 92.500 - The HOME Investment Trust Fund.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false The HOME Investment Trust Fund. 92... Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.500 The HOME Investment Trust Fund. (a) General. A HOME Investment Trust Fund consists of the accounts described in this...

24 CFR 92.213 - HOME Funds and Public Housing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false HOME Funds and Public Housing. 92... Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Requirements Eligible and Prohibited Activities § 92.213 HOME Funds and Public Housing. (a) General rule. HOME funds may not be used for public...

Reasons for Preference of Home Delivery with Traditional Birth Attendants (TBAs) in Rural Bangladesh: A Qualitative Exploration.

PubMed

Sarker, Bidhan Krishna; Rahman, Musfikur; Rahman, Tawhidur; Hossain, Jahangir; Reichenbach, Laura; Mitra, Dipak Kumar

2016-01-01

Although Bangladesh has made significant progress in reducing maternal and child mortality in the last decade, childbirth assisted by skilled attendants has not increased as much as expected. An objective of the Bangladesh National Strategy for Maternal Health 2014-2024 is to reduce maternal mortality to 50/100,000 live births. It also aims to increase deliveries with skilled birth attendants to more than 80% which remains a great challenge, especially in rural areas. This study explores the underlying factors for the major reliance on home delivery with Traditional Birth Attendants (TBA) in rural areas of Bangladesh. This was a qualitative cross-sectional study. Data were collected between December 2012 and February 2013 in Sunamganj district of Sylhet division and data collection methods included key informant interviews (KII) with stakeholders; formal and informal health service providers and health managers; and in-depth interviews (IDI) with community women to capture a range of information. Key questions were asked of all the study participants to explore the question of why women and their families prefer home delivery by TBA and to identify the factors associated with this practice in the local community. The study shows that home delivery by TBAs remain the first preference for pregnant women. Poverty is the most frequently cited reason for preferring home delivery with a TBA. Other major reasons include; traditional views, religious fallacy, poor road conditions, limited access of women to decision making in the family, lack of transportation to reach the nearest health facility. Apart from these, community people also prefer home delivery due to lack of knowledge and awareness about service delivery points, fear of increased chance of having a caesarean delivery at hospital, and lack of female doctors in the health care facilities. The study findings provide us a better understanding of the reasons for preference for home delivery with TBA among this population. These identified factors can inform policy makers and program implementers to adopt socially and culturally appropriate interventions that can improve deliveries with skilled attendants and thus contribute to the reduction of maternal and neonatal mortality and morbidity in rural Bangladesh.

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.

Training Family Medicine Residents to Perform Home Visits: A CERA Survey.

PubMed

Sairenji, Tomoko; Wilson, Stephen A; D'Amico, Frank; Peterson, Lars E

2017-02-01

Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training. To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors. This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers. There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits. There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.

Evaluation of a community based childhood injury prevention program.

PubMed Central

Bablouzian, L.; Freedman, E. S.; Wolski, K. E.; Fried, L. E.

1997-01-01

OBJECTIVES: This pilot study evaluates the effectiveness of a community based childhood injury prevention program on the reduction of home hazards. METHODS: High risk pregnant women, who were enrolled in a home visiting program that augments existing health and human services, received initial home safety assessments. Clients received education about injury prevention practices, in addition to receiving selected home safety supplies. Fourteen questions from the initial assessment tool were repeated upon discharge from the program. Matched analyses were conducted to evaluate differences from initial assessment to discharge. RESULTS: A significantly larger proportion of homes were assessed as safe at discharge, compared with the initial assessment, for the following hazards: children riding unbuckled in all auto travel, Massachusetts Poison Center sticker on the telephone, outlet plugs in all unused electrical outlets, safety latches on cabinets and drawers, and syrup of ipecac in the home. CONCLUSIONS: A community based childhood injury prevention program providing education and safety supplies to clients significantly reduced four home hazards for which safety supplies were provided. Education and promotion of the proper use of child restraint systems in automobiles significantly reduced a fifth hazard, children riding unbuckled in auto travel. This program appears to reduce the prevalence of home hazards and, therefore, to increase home safety. PMID:9113841

Application on Internet of Things Technology Using in Library Management

NASA Astrophysics Data System (ADS)

Liu, Xueqing; Sheng, Wenwen

Following the computer, Internet and mobile communication network, the Internet of Things (IOT) will bring a new development of information industry, and moreover is a global technology revolution that is bound to have a profound impact on the economic development and social life. This paper analyzes the key technology and working principle of IOT, its development at home and abroad, its application in the library management, and proposes its development direction in the field of library management and promotion programs.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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

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 Nationalmore » 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.« less

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.

HOME-BASED BLOOD PRESSURE INTERVENTIONS FOR AFRICAN AMERICANS

PubMed Central

Feldman, Penny H.; McDonald, Margaret V.; Mongoven, Jennifer M.; Peng, Timothy R.; Gerber, Linda M.; Pezzin, Liliana E.

2009-01-01

Background Efforts to increase blood pressure (BP) control rates in African Americans, a traditionally underserved, high risk population must address both provider practice and patient adherence issues. The Home-Based BP Intervention for African Americans study is a three-arm randomized controlled trial designed to test two strategies to improve HTN management and outcomes in a decentralized service setting serving a vulnerable and complex home care population. The primary study outcomes are systolic BP, diastolic BP, and BP control; secondary outcomes are nurse adherence to HTN management recommendations, and patient adherence to medication, healthy diet and other self-management strategies. Methods and Results Nurses (N=312) in a nonprofit Medicare-certified home health agency are randomized along with their eligible hypertensive patients (N=845). The two interventions being tested are: (i) a “basic” intervention delivering key evidence-based reminders to home care nurses and patients while the patient is receiving traditional post-acute home health care; and (ii) an “augmented” intervention that includes that same as the basic intervention, plus transition to an ongoing HTN Home Support Program that extends support for 12 months. Outcomes are measured at 3 and 12 months post baseline interview. The interventions will be assessed relative to usual care and to each other. Conclusions Systems change to improve BP management and outcomes in home health will not easily occur without new intervention models and rigorous evaluation of their impact. Results from this trial will provide important information on potential strategies to improve BP control in a low income, chronically ill patient population. PMID:20031844

U.S. Department of Energy Zero Energy Ready Home Implementation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rothgeb, Stacey K; Schirber, T.; Mosiman, G.

The intention of this project is to assist home builders in the upper Midwest in achieving DOE Zero Energy Ready Home program certification, and to document the process and outcomes involved in meeting this rigorous standard. NorthernSTAR, in conjunction with our program partner Building Knowledge, Inc., provided technical support to the builders during the design and construction process. At the time of this publication, four qualifying homes have been completed and an additional three are currently under construction to be completed later this year. Three additional homes were excluded from certification due to the HVAC contractor not completing their requiredmore » credentialing until after completion of the homes, though the energy performance would have otherwise qualified the homes for program certification. Both Amaris Homes and Cobblestone Homes note that participation in the ZERH program provides them with competitive advantage in the market place at reasonable construction costs that also result in extremely satisfied clients who are willing to recommend the builders to friends and family.« less

National Home Start Evaluation Interim Report VII. Twenty-Month Program Analysis and Findings.

ERIC Educational Resources Information Center

Love, John M.; And Others

This interim evaluation report focuses on process (formative) and outcome (summative) data collected in spring 1975 on the National Home Start Program. Home Start, a federally-funded 3-year (1972-1975) home-based demonstration program for low-income families with 3- to 5-year-old children was designed to enhance a mother's skills in dealing with…

Home Parental Assistance for Underachieving Readers in Third Grade Using Read-at-Home Program Kits.

ERIC Educational Resources Information Center

Izzo, Theresa Eleanor

Sixty-four third-grade pupils who were underachieving in reading participated in a study to determine the effect of parental home instruction in reading. A four-cell experimental design was used with two treatment factors: programmed home reading instruction given by mothers trained to administer the program versus no instruction, and mother's…

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…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilson, Charles

University Park, Maryland (“UP”) is a small town of 2,540 residents, 919 homes, 2 churches, 1 school, 1 town hall, and 1 breakthrough community energy efficiency initiative: the Small Town Energy Program (“STEP”). STEP was developed with a mission to “create a model community energy transformation program that serves as a roadmap for other small towns across the U.S.” STEP first launched in January 2011 in UP and expanded in July 2012 to the neighboring communities of Hyattsville, Riverdale Park, and College Heights Estates, MD. STEP, which concluded in July 2013, was generously supported by a grant from the U.S.more » Department of Energy (DOE). The STEP model was designed for replication in other resource-constrained small towns similar to University Park - a sector largely neglected to date in federal and state energy efficiency programs. STEP provided a full suite of activities for replication, including: energy audits and retrofits for residential buildings, financial incentives, a community-based social marketing backbone and local community delivery partners. STEP also included the highly innovative use of an “Energy Coach” who worked one-on-one with clients throughout the program. Please see www.smalltownenergy.org for more information. In less than three years, STEP achieved the following results in University Park: • 30% of community households participated voluntarily in STEP; • 25% of homes received a Home Performance with ENERGY STAR assessment; • 16% of households made energy efficiency improvements to their home; • 64% of households proceeded with an upgrade after their assessment; • 9 Full Time Equivalent jobs were created or retained, and 39 contractors worked on STEP over the course of the project. Estimated Energy Savings - Program Totals kWh Electricity 204,407 Therms Natural Gas 24,800 Gallons of Oil 2,581 Total Estimated MMBTU Saved (Source Energy) 5,474 Total Estimated Annual Energy Cost Savings $61,343 STEP clients who had a home energy upgrade invested on average $4,500, resulting in a 13% reduction in annual energy use and utility bill savings of $325. Rebates and incentives covered 40%-50% of retrofit cost, resulting in an average simple payback of about 7 years. STEP has created a handbook in which are assembled all the key elements that went into the design and delivery of STEP. The target audiences for the handbook include interested citizens, elected officials and municipal staff who want to establish and run their own efficiency program within a small community or neighborhood, using elements, materials and lessons from STEP.« less

Intra-family role expectations and reluctance to change identified as key barriers to expanding vegetable consumption patterns during interactive family-based program for Appalachian low-income food preparers.

PubMed

Brown, J Lynne; Wenrich, Tionni R

2012-08-01

Few Americans eat sufficient vegetables, especially the protective deep orange and dark green vegetables. To address this, a community-based wellness program to broaden vegetables served at evening meals targeting Appalachian food preparers and their families was tested in a randomized, controlled intervention. Food preparers (n=50) were predominately married (88%), white (98%), and female (94%), with several children living at home. Experimental food preparers (n=25) attended the program sessions and controls (n=25) were mailed relevant handouts and recipes. At program sessions, participants received nutrition information, hands-on cooking instruction, and prepared recipes to take home for family evaluation. As qualitative assessment, 10 couples from each treatment group (n=20 couples) were randomly selected for baseline and immediate post-intervention interviews to explore impact on the food preparer's family. These in-depth interviews with the food preparer and their adult partner were tape-recorded and transcribed verbatim. Two researchers conducted thematic analysis using constant comparison. Family flexibility about food choices was assessed using roles, rules, and power concepts from Family Systems Theory. Interviews at baseline revealed dinner vegetable variety was very limited because food preparers served only what everyone liked (a role expectation) and deferred to male partner and children's narrow vegetable preferences (power). Control couples reported no change in vegetable dinner variety post-intervention. Most experimental couples reported in-home tasting and evaluation was worthwhile and somewhat broadened vegetables served at dinners. But the role expectation of serving only what everyone liked and the practice of honoring powerful family members' vegetable preferences remained major barriers to change. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

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

2016-09-09

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.

Factors Influencing Implementation of a Physical Activity Intervention in Residential Children's Homes.

PubMed

Lau, Erica Y; Saunders, Ruth P; Pate, Russell R

2016-11-01

The Environmental Intervention in Children's Homes (ENRICH) study was the first published physical activity intervention undertaken in residential children's homes (RCHs). The study revealed differences in implementation across the homes, which may be a key factor that affects program effectiveness. The purpose of this study was to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation of the ENRICH intervention. This study analyzed the ENRICH process evaluation data collected from 24 RCHs. Bayesian Path analysis was used to examine the direct and indirect effects of organizational capacity, provider characteristics, and quality of prevention support system on level of implementation. Level of implementation across RCHs was variable, ranging from 38 to 97 % (M = 68.3, SD = 14.45). Results revealed that organizational capacity and provider characteristics had significant direct associations with level of implementation. Neither direct nor indirect associations between quality of prevention support system and level of implementation reached statistical significance. Conducting formative assessments on organizational capacity and provider characteristics and incorporating such information in implementation planning may increase the likelihood of achieving higher levels of implementation in future studies.

24 CFR 92.1 - Overview.

Code of Federal Regulations, 2010 CFR

2010-04-01

... INVESTMENT PARTNERSHIPS PROGRAM General § 92.1 Overview. This part implements the HOME Investment Partnerships Act (the HOME Investment Partnerships Program). In general, under the HOME Investment Partnerships... jurisdictions may use HOME funds to carry out multi-year housing strategies through acquisition, rehabilitation...

Nutrition component in a comprehensive child development program. I. The home visitor's role in the prenatal intervention phase.

PubMed

Snowman, M K; Dibble, M V

1979-02-01

Nutritional services were integrated in a comprehensive child development program for sixty-eight disadvantaged urban families in an attempt to promote maximum cognitive and psychosocial functioning in their children. Child development trainers made weekly home visits beginning in pregnancy, which combined data gathering, direct nutritional counseling, and early sensory excercises for infants. This paper describes the prenatal home visit program, the training of the home visitors, how the 24-hr. food recall method was adapted for their use, the nature of the home visits, and the complex role of the home visitor. The group whose families participated in the prenatal home visits and were also followed for six months after the infants' birth scored higher on six-month Cattell Scales than did a control group who entered the program at six months of age. There were no stillbirths or neonatal deaths. The incidence of low-birth-weight infants was lower than the national averages. Participation in the program was high.

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.

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

PubMed Central

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

2015-01-01

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

Responsibility Development Transfers across Contexts: Reciprocal Pathways between Home and Afterschool Programs

ERIC Educational Resources Information Center

Raffaelli, Marcela; Simpkins, Sandra D.; Tran, Steve P.; Larson, Reed W.

2018-01-01

We investigated adolescent responsibility across 2 developmental contexts, home and an afterschool program. Longitudinal data were collected from 355 ethnically diverse 11-20-year-old adolescents (M = 15.49; 55.9% female) in 14 project-based programs. Youth rated their responsibility in the program and at home at 4 time points; parents and leaders…

Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

PubMed Central

Kissam, Stephanie; Gifford, David; Parks, Peggy; Patry, Gail; Palmer, Laura; Wilkes, Linda; Fitzgerald, Matthew; Petrulis, Alice Stollenwerk; Barnette, Leslie

2003-01-01

Background In November 2002, the Centers for Medicare & Medicaid Services (CMS) launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs) that led quality improvement efforts in nursing homes from the six pilot states. Results QIOs in the six pilot states found several key outcomes of the Nursing Home Quality Initiative that help to maximize the potential of public reporting to leverage effective improvement in nursing home quality of care. First, public reporting focuses the attention of all stakeholders in the nursing home industry on achieving good quality outcomes on a defined set of measures, and creates an incentive for partnership formation. Second, publicly reported quality measures motivate nursing home providers to improve in certain key clinical areas, and in particular to seek out new ways of changing processes of care, such as engaging physicians and the medical director more directly. Third, the lessons learned by QIOs in the pilot of this Initiative indicate that certain approaches to providing quality improvement assistance are key to guiding nursing home providers' desire and enthusiasm to improve towards a using a systematic approach to quality improvement. Conclusion The Nursing Home Quality Initiative has already demonstrated the potential of public reporting to foster collaboration and coordination among nursing home stakeholders and to heighten interest of nursing homes in quality improvement techniques. The lessons learned from this pilot project have implications for any organizations or individuals planning quality improvement projects in the nursing home setting. PMID:12753699

Green Commuting in the Health Care Sector: Obstacles and Best Practices.

PubMed

Kaplan, Susan; Ai, Ning; Orris, Peter; Sriraj, P S

2016-02-01

Fossil fuel transportation by health care providers contributes to the prevalence of diseases they treat. We conducted an exploratory study to understand obstacles to, and best practices for, greener commuting among health care providers. We surveyed staff of three hospital clinics as to how they commute and why, and interviewed key staff of five hospital leaders in green commuting about their programs. Factors that might change respondents' commuting choices from driving alone included financial incentives, convenience, and solutions to crime and safety concerns. Successful green commuting programs offer benefits including free or reduced transit passes, shuttle buses to transit stations, and free emergency rides home. Exemplary programs throughout the country demonstrate that modifying those factors within reach can impact the amount of fossil fuel energy used for health care provider transportation.

42 CFR 431.701 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION State Programs for Licensing Nursing Home... a State program for licensing administrators of nursing homes, in a State that does not have a... agency or board as meeting all of the requirements for a licensed nursing home administrator specified in...

42 CFR 431.701 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION State Programs for Licensing Nursing Home... a State program for licensing administrators of nursing homes, in a State that does not have a... agency or board as meeting all of the requirements for a licensed nursing home administrator specified in...

Preventing child maltreatment: Examination of an established statewide home-visiting program.

PubMed

Chaiyachati, Barbara H; Gaither, Julie R; Hughes, Marcia; Foley-Schain, Karen; Leventhal, John M

2018-05-01

Although home visiting has been used in many populations in prevention efforts, the impact of scaled-up home-visiting programs on abuse and neglect remains unclear. The objective of this study was to assess the impact of voluntary participation in an established statewide home-visiting program for socially high-risk families on child maltreatment as identified by Child Protective Services (CPS). Propensity score matching was used to compare socially high-risk families with a child born between January 1, 2008 and December 31, 2011 who participated in Connecticut's home-visiting program for first-time mothers and a comparison cohort of families who were eligible for the home-visiting program but did not participate. The main outcomes were child maltreatment investigations, substantiations, and out-of-home placements by CPS between January 1, 2008 and December 31, 2013. In the unmatched sample, families who participated in home-visiting had significantly higher median risk scores (P < .001). After matching families on measured confounders, the percentages of families with CPS investigations (21.1% vs. 20.9%, P = .86) were similar between the two groups. However, there was a 22% decreased likelihood of CPS substantiations (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.64-0.95) for families receiving home visiting. First substantiations also occurred later in the child's life among home-visited families. There was a trend toward decreased out-of-home placement (HR 0.73, 95% CI 0.53-1.02, P = .06). These results from a scaled-up statewide program highlight the potential of home visiting as an important approach to preventing child abuse and neglect. Copyright © 2018 Elsevier Ltd. All rights reserved.

Lessons Learned from Home Visiting with Home-Based Child Care Providers

ERIC Educational Resources Information Center

McCabe, Lisa A.; Peterson, Shira M.; Baker, Amy C.; Dumka, Marsha; Brach, Mary Jo; Webb, Diana

2011-01-01

Caring for Quality and Partners in Family Child Care are home visiting programs designed to improve the quality of home-based child care. This article describes the experiences of two different home visitors to demonstrate how programs such as these can help providers improve the overall quality of care, increase children's development, and lead…

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

PubMed Central

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

1988-01-01

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

Human-pet interaction and loneliness: a test of concepts from Roy's adaptation model.

PubMed

Calvert, M M

1989-01-01

This research used two key concepts from Roy's adaptation model of nursing to examine the relationship between human-pet interaction and loneliness in nursing home residents. These concepts included (a) environmental stimuli as factors influencing adaptation and (b) interdependence as a mode of response to the environment. The hypothesis of this study asserted that the residents of a nursing home who had greater levels of interaction with a pet program would experience less loneliness than those who had lower levels of interaction with a pet. The study used an ex post facto nonexperimental design with 65 subjects. The simplified version of the revised UCLA loneliness scale was used to measure loneliness. Reported level of human-pet interaction was measured according to a four-point scale (1 = no interaction, 4 = quite a lot of interaction). The hypothesis was supported at the p less than 0.03 level of significance. Implications for practice through organizing pet programs in situations where loneliness exists are discussed. Recommendations for future research include replicating the study using a larger sample and developing a comprehensive human-pet interaction tool.

Market diffusion and the effect of demonstrations: A study of Denver metro passive solar home program

NASA Astrophysics Data System (ADS)

Lilien, G. L.

1981-10-01

The reactions to and effects of the Denver metro passive solar home demonstration program, conducted in the spring of 1981 are reported. The program provides impetus to builders for incorporating passive solar designs in spec built homes and demonstrates those designs to prospective buyers to increase buyer receptivity. A pre-post exposure analysis of the effect of the program is reported and four separate groups of prospective new home buyers are studied. The first group heard publicity about and voluntarily visited a demonstration home. The second group saw the home, but was recruited to come to the side. The third group, also in Denver, did not see the site, but answered the same set of questions after receiving a description of and pictures of passive solar homes. The fourth group was a control group, similar to the third, but located in Kansas City.

TDM Status Report: Guaranteed Ride Home

DOT National Transportation Integrated Search

1992-08-01

Guaranteed Ride Home (GRH) is TSM program providing car and vanpool patrons a ride to home or to other destination in an emergency. The intent of the program is to overcome one of the barriers to ridesharing--need of a vehicle to get home, to school,...

Home Economics Cooperative Education.

ERIC Educational Resources Information Center

Texas Tech. Univ., Lubbock. School of Home Economics.

Prepared by home economics instructional materials center staff, this handbook is for use by home economics cooperative education teacher-coordinators in planning vocational home economics gainful employment programs and courses on the high school level. Contents include: (1) general information on the program, (2) approved occupations for the…

Home | SREL Herpetology Program

Science.gov Websites

Savannah River Ecology Laboratory Herpetology Program Herp Home Research Publications Herps of SC /GA P.A.R.C. Outreach SREL Home powered by Google Search Herpetology at SREL The University of SREL herpetology research programs have always included faculty of the University of Georgia, post

Relationship work in an early childhood home visiting program.

PubMed

Heaman, Maureen; Chalmers, Karen; Woodgate, Roberta; Brown, Judy

2007-08-01

A significant component of the work of public health nurses and paraprofessional home visitors who provide home visits to families with young children involves establishing relationships to effectively deliver the visiting program. The purpose of this qualitative and descriptive study was to describe the relationships among participants in a home visiting program in one regional health authority in the Canadian province of Manitoba. Interviews were carried out with 24 public health nurses, 14 home visitors, and 20 parents. The findings related to establishing, maintaining, and terminating relationships as well as factors influencing relationship work are described. Public health nurses and home visitors put significant effort into the work of establishing relationships with each other and their clients and require adequate training, sufficient human resources, and support from the program's administration to sustain these relationships.

Home-based bimanual training based on motor learning principles in children with unilateral cerebral palsy and their parents (the COAD-study): rationale and protocols.

PubMed

Schnackers, Marlous; Beckers, Laura; Janssen-Potten, Yvonne; Aarts, Pauline; Rameckers, Eugène; van der Burg, Jan; de Groot, Imelda; Smeets, Rob; Geurts, Sander; Steenbergen, Bert

2018-04-18

Home-based training is considered an important intervention in rehabilitation of children with unilateral cerebral palsy. Despite consensus on the value of home-based upper limb training, no evidence-based best practice exists. Promoting compliance of children to adhere to an intensive program while keeping parental stress levels low is an important challenge when designing home-based training programs. Incorporating implicit motor learning principles emerges to be a promising method to resolve this challenge. Here we describe two protocols for home-based bimanual training programs, one based on implicit motor learning principles and one based on explicit motor learning principles, for children with unilateral spastic cerebral palsy aged 2 through 7 years. Children receive goal-oriented, task-specific bimanual training in their home environment from their parents for 3.5 h/week for 12 weeks according to an individualized program. Parents will be intensively coached by a multidisciplinary team, consisting of a pediatric therapist and remedial educationalist. Both programs consist of a preparation phase (goal setting, introductory meetings with coaching professionals, design of individualized program, instruction of parents, home visit) and home-based training phase (training, video-recordings, registrations, and telecoaching and home visits by the coaching team). The programs contrast with respect to the teaching strategy, i.e. how the parents support their child during training. In both programs parents provide their child with instructions and feedback that focus on the activity (i.e. task-oriented) or the result of the activity (i.e. result-oriented). However, in the explicit program parents are in addition instructed to give exact instructions and feedback on the motor performance of the bimanual activities, whereas in the implicit program the use of both hands and the appropriate motor performance of the activity are elicited via manipulation of the organization of the activities. With the protocols described here, we aim to take a next step in the development of much needed evidence-based home-based training programs for children with unilateral cerebral palsy.

No Jobs Like Homes: Careers in Helping Home Buyers and Sellers

ERIC Educational Resources Information Center

Torpey, Elka

2013-01-01

Millions of people buy and sell homes each year. And because these transactions are often complex, many home buyers and sellers turn to workers who can help with the search or the sale--or both. From preparing to put a home on the market to filing the sales documents, many workers are involved in helping a home change hands. Other key industries…

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

The Development and Evaluation of a Parent Training Manual for Home Instruction.

ERIC Educational Resources Information Center

Yaman, Nancy; Hanson, Ralph A.

The development of a simple and effective means of training parents and other non-professionals in the use of a home-based instructional program is the concern of this paper. The home-based program is the SWRL Parent-Assisted Learning Program (PAL). PAL was created as an adjunct to a broader communication skills program, First Year Communication…

Economic Evidence for U.S. Asthma Self-Management Education and Home-Based Interventions

PubMed Central

Hsu, Joy; Wilhelm, Natalie; Lewis, Lillianne; Herman, Elizabeth

2016-01-01

The health and economic burden of asthma in the United States is substantial. Asthma self-management education (AS-ME) and home-based interventions for asthma can improve asthma control and prevent asthma exacerbations, and interest in health care-public health collaboration regarding asthma is increasing. However, outpatient AS-ME and home-based asthma intervention programs are not widely available; economic sustainability is a common concern. Thus, we conducted a narrative review of existing literature regarding economic outcomes of outpatient AS-ME and home-based intervention programs for asthma in the United States. We identified 9 outpatient AS-ME programs and 17 home-based intervention programs with return on investment (ROI) data. Most programs were associated with a positive ROI; a few programs observed positive ROIs only among selected populations (e.g., higher health care utilization). Interpretation of existing data is limited by heterogeneous ROI calculations. Nevertheless, the literature suggests promise for sustainable opportunities to expand access to outpatient AS-ME and home-based asthma intervention programs in the United States. More definitive knowledge about how to maximize program benefit and sustainability could be gained through more controlled studies of specific populations and increased uniformity in economic assessments. PMID:27658535

77 FR 56671 - Notice of Proposed Information Collection: Comment Request Manufactured Home Construction and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... Information Collection: Comment Request Manufactured Home Construction and Safety Standards Program AGENCY... FR 45648, HUD published Manufactured Home Construction and Safety Standards Program. The forms were.... This Notice also lists the following information: Title of Proposal: Manufactured Home Construction and...

24 CFR 92.210 - Troubled HOME-assisted rental housing projects.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Troubled HOME-assisted rental... of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Requirements Eligible and Prohibited Activities § 92.210 Troubled HOME-assisted rental housing projects. (a) The provisions...

Allowing Family to be Family: End-of-Life Care in Veterans Affairs Medical Foster Homes.

PubMed

Manheim, Chelsea E; Haverhals, Leah M; Jones, Jacqueline; Levy, Cari R

2016-01-01

The Medical Foster Home program is a unique long-term care program coordinated by the Veterans Health Administration. The program pairs Veterans with private, 24-hour a day community-based caregivers who often care for Veterans until the end of life. This qualitative study explored the experiences of care coordination for Medical Foster Home Veterans at the end of life with eight Veterans' family members, five Medical Foster Home caregivers, and seven Veterans Health Administration Home-Based Primary Care team members. A case study, qualitative content analysis identified these themes addressing care coordination and impact of the Medical Foster Home model on those involved: (a) Medical Foster Home program supports Veterans' families; (b) Medical Foster Home program supports the caregiver as family; (c) Veterans' needs are met socially and culturally at the end of life; and (d) the changing needs of Veterans, families, and caregivers at Veterans' end of life are addressed. Insights into how to best support Medical Foster Home caregivers caring for Veterans at the end of life were gained including the need for more and better respite options and how caregivers are compensated in the month of the Veteran's death, as well as suggestions to navigate end-of-life care coordination with multiple stakeholders involved.

77 FR 47856 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... and development outcomes for at risk children through evidence-based home visiting programs. Under...: Proposed Project: Maternal, Infant and Early Childhood Home Visiting Program FY 2012 Competitive Grant Non... the Maternal, Infant, and Early Childhood Home Visiting Program, ( http://frwebgate.access.gpo.gov/cgi...

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…

The Home Instruction Program for Preschool Youngsters (HIPPY).

ERIC Educational Resources Information Center

Baker, Amy J. L.; Piotrkowski, Chaya S.; Brooks-Gunn, Jeanne

1999-01-01

Describes the Home Instruction Program for Preschool Youngsters (HIPPY), a two-year home-based early-education intervention program designed to help parents with limited formal education prepare their children for school. Presents findings from a two-site HIPPY study, a one-site case study, and a three-site qualitative study. (SLD)

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…

The effects of ownership and ownership change on nursing home industry costs.

PubMed

Holmes, J S

1996-08-01

This study examines the effects of ownership type and ownership change on nursing home cost structures, differentiating patient care costs from plant costs. Administrative data from the Michigan Department of Social Services, Medical Services Administration (Medicaid), and the Michigan Department of Public Health are used. Cost data are based on audited cost reports for 393 nursing care facilities in Michigan in 1989. Other facility characteristics are based on data from the 1989 annual licensing and certification survey conducted by the Michigan Department of Public Health. A series of ordinary least squares regressions is estimated, in which the dependent variable is either per diem patient costs or per diem plant costs. Ownership types are defined as chain, proprietary non-chain, freestanding non-profit, government-owned, and hospital-based facilities. Pooled estimation techniques, as well as separate regressions by ownership type, are presented to test for interaction effects. Key variables include whether a facility changed ownership in the preceding five years and whether chain facilities are in-state- or out-of-state-owned, in addition to size, payer mix, and case mix. Behavioral differences among nursing home ownership types in respect to patient care costs tended to distinguish government-owned and hospital-based facilities from the freestanding homes rather than the usual distinction between for-profit and not-for-profit classes. Variables traditionally included in nursing home cost studies, such as size, occupancy, payer mix and case mix, were found to have similar effects on per diem patient care costs for freestanding non-profit homes as well as for chain proprietary facilities. With regard to the effects of ownership change on per diem plant and per diem patient costs, however, there are few differences among ownership types. Chain and non-chain for-profit facilities, non-profit homes, and hospital long-term care units that had changed ownership reported significantly higher per diem plant costs than facilities without a change of ownership, but did not spend more on patient-related costs. Michigan Medicaid plant reimbursement system policy changes instituted in 1985 to promote continued ownership of facilities were not entirely successful. Non-profit homes look increasingly like their for-profit counterparts with respect to spending on patient care costs. Increased competition for the more lucrative private-pay patients, coupled with declining state Medicaid reimbursement to nursing homes, may have blurred the historical distinctions between the non-profit and for-profit sectors in the nursing home industry. An exception to increasing homogeneity within the nursing home industry is the tendency of proprietary homes to experience more frequent changes of ownership, which results in higher capital costs passed on to state Medicaid programs. Findings from this study indicate that while facility sales increase per diem plant costs, they do not result in increased spending for direct patient care, suggesting that state Medicaid programs may be indirectly subsidizing facility sales with no accompanying increase in expenditures for patient care. To discourage frequent facility sales, state Medicaid programs may need to consider alternative methods of reimbursing nursing home owners for capital costs.

The role of Aboriginal family workers in delivering a child safety focused home visiting program for Aboriginal families in an urban region of NSW.

PubMed

Clapham, Kathleen; Bennett-Brook, Keziah; Hunter, Kate

2018-05-09

Aboriginal Australian children experience higher rates of injury than other Australian children. However few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of NSW. Delivered by Aboriginal Family Workers the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This paper reports on the qualitative interviews which explored the ways in which clients, IAMS staff, and external service providers experienced the program and assessed its delivery by the Aboriginal Family Workers. A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by Aboriginal Family Workers to vulnerable families. Clients, IAMS staff, and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT?: This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Home-Care Use and Expenditures Among Medicaid Beneficiaries with AIDS

PubMed Central

Sambamoorthi, Usha; Collins, Sara R.; Crystal, Stephen; Walkup, James

1999-01-01

This article compares the use and cost of home-care services among traditional Medicaid recipients with acquired immunodeficiency syndrome (AIDS) and among participants in a statewide Human Immunodeficiency Virus (HIV)/AIDS-specific home and community-based Medicaid waiver program in New Jersey, using Medicaid claims and AIDS surveillance data. Waiver program participation appears to mitigate racial and risk group differences in the probability of home-care use. However, the program's successes are confined to its enrollees of which subgroups of the AIDS population are underrepresented. Our findings suggest the need to expand access to home-care programs to racial minorities and injection drug users (IDUs) with HIV/AIDS. PMID:11482120

Introducing priority setting and resource allocation in home and community care programs.

PubMed

Urquhart, Bonnie; Mitton, Craig; Peacock, Stuart

2008-01-01

To use evidence from research to identify and implement priority setting and resource allocation that incorporates both ethical practices and economic principles. Program budgeting and marginal analysis (PBMA) is based on two key economic principles: opportunity cost (i.e. doing one thing instead of another) and the margin (i.e. resource allocation should result in maximum benefit for available resources). An ethical framework for priority setting and resource allocation known as Accountability for Reasonableness (A4R) focuses on making sure that resource allocations are based on a fair decision-making process. It includes the following four conditions: publicity; relevance; appeals; and enforcement. More recent literature on the topic suggests that a fifth condition, that of empowerment, should be added to the Framework. The 2007-08 operating budget for Home and Community Care, excluding the residential sector, was developed using PBMA and incorporating the A4R conditions. Recommendations developed using PBMA were forwarded to the Executive Committee, approved and implemented for the 2007-08 fiscal year operating budget. In addition there were two projects approved for approximately $200,000. PBMA is an improvement over previous practice. Managers of Home and Community Care are committed to using the process for the 2008-09 fiscal year operating budget and expanding its use to include mental health and addictions services. In addition, managers of public health prevention and promotion services are considering using the process.

Outpatient treatment of venous thromboembolism using low molecular weight heparins. An overview.

PubMed

Matsagas, M I

2004-12-01

The development of low-molecular-weight heparins (LMWHs) was a significant advance in the treatment of venous thromboembolism (VTE). Their better bioavailability and more predictable anticoagulant activity than unfractionated heparin (UFH) allow subcutaneous administration without close laboratory monitoring, and thus make outpatient treatment of deep vein thrombosis (DVT) feasible. The safety and efficacy of outpatient treatment in selected patients were established in randomized clinical trials comparing subcutaneous LMWH administered primarily at home with inpatient intravenous UFH. Furthermore, during the last few years a large number of studies have supported these findings in various clinical settings of every-day practice. It is also important that home treatment has lead to substantial cost reductions along with improvement in patients' satisfaction and quality of life. Thus, outpatient treatment of DVT provides an opportunity, rarely seen in medicine, to improve patient care while reducing the overall VTE health-care cost, and it is likely that will be the preferred regime for the majority of patients in the future. However, the implementation of a home treatment program is not simple, as the risks of insufficient or excessive anticoagulation would be considerable. A structured protocol is necessary to ensure that patient care is optimal, and the keys to a successful outpatient treatment program are patient selection, patient education, patient access to health care team, appropriate follow-up and health care team communication.

Home Visiting in Two Cultures

ERIC Educational Resources Information Center

Lamorey, Suzanne

2017-01-01

The home visiting component of early childhood education programs provides an important portal through which to observe family interactions as well as gain insights about the ethnotheories of the home visitor. Home visits were videotaped in the United States and in Turkey to analyze training and program effectiveness. One striking feature of this…

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

... and Services Administration Advisory Committee on the Maternal, Infant and Early Childhood Home...: Name: Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation..., DC 20005. (202) 289-7600. The Advisory Committee on the Maternal, Infant and Early Childhood Home...

Home Making Around the World.

ERIC Educational Resources Information Center

Extension Service (USDA), Washington, DC.

This book is designed to aid American home economists sent to other countries on technical assistance programs and home economists of other countries responsible for beginning such programs focused on the home and family. The information describes the pioneering experience of trained people in many countries and some ways in which basic principles…

Can typical US home visits affect infant attachment? Preliminary findings from a randomized trial of Healthy Families Durham.

PubMed

Berlin, Lisa J; Martoccio, Tiffany L; Appleyard Carmody, Karen; Goodman, W Benjamin; O'Donnell, Karen; Williams, Janis; Murphy, Robert A; Dodge, Kenneth A

2017-12-01

US government-funded early home visiting services are expanding significantly. The most widely implemented home visiting models target at-risk new mothers and their infants. Such home visiting programs typically aim to support infant-parent relationships; yet, such programs' effects on infant attachment quality per se are as yet untested. Given these programs' aims, and the crucial role of early attachments in human development, it is important to understand attachment processes in home visited families. The current, preliminary study examined 94 high-risk mother-infant dyads participating in a randomized evaluation of the Healthy Families Durham (HFD) home visiting program. We tested (a) infant attachment security and disorganization as predictors of toddler behavior problems and (b) program effects on attachment security and disorganization. We found that (a) infant attachment disorganization (but not security) predicted toddler behavior problems and (b) participation in HFD did not significantly affect infant attachment security or disorganization. Findings are discussed in terms of the potential for attachment-specific interventions to enhance the typical array of home visiting services.

Primary Health Care

PubMed Central

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

2017-01-01

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

Theory! The Missing Link in Understanding the Performance of Neonate/Infant Home-Visiting Programs to Prevent Child Maltreatment: A Systematic Review

PubMed Central

Segal, Leonie; Sara Opie, Rachelle; Dalziel, Kim

2012-01-01

Context Home-visiting programs have been offered for more than sixty years to at-risk families of newborns and infants. But despite decades of experience with program delivery, more than sixty published controlled trials, and more than thirty published literature reviews, there is still uncertainty surrounding the performance of these programs. Our particular interest was the performance of home visiting in reducing child maltreatment. Methods We developed a program logic framework to assist in understanding the neonate/infant home-visiting literature, identified through a systematic literature review. We tested whether success could be explained by the logic model using descriptive synthesis and statistical analysis. Findings Having a stated objective of reducing child maltreatment—a theory or mechanism of change underpinning the home-visiting program consistent with the target population and their needs and program components that can deliver against the nominated theory of change—considerably increased the chance of success. We found that only seven of fifty-three programs demonstrated such consistency, all of which had a statistically significant positive outcome, whereas of the fifteen that had no match, none was successful. Programs with a partial match had an intermediate success rate. The relationship between program success and full, partial or no match was statistically significant. Conclusions Employing a theory-driven approach provides a new way of understanding the disparate performance of neonate/infant home-visiting programs. Employing a similar theory-driven approach could also prove useful in the review of other programs that embody a diverse set of characteristics and may apply to diverse populations and settings. A program logic framework provides a rigorous approach to deriving policy-relevant meaning from effectiveness evidence of complex programs. For neonate/infant home-visiting programs, it means that in developing these programs, attention to consistency of objectives, theory of change, target population, and program components is critical. PMID:22428693

Theory! The missing link in understanding the performance of neonate/infant home-visiting programs to prevent child maltreatment: a systematic review.

PubMed

Segal, Leonie; Sara Opie, Rachelle; Dalziel, Kim

2012-03-01

Home-visiting programs have been offered for more than sixty years to at-risk families of newborns and infants. But despite decades of experience with program delivery, more than sixty published controlled trials, and more than thirty published literature reviews, there is still uncertainty surrounding the performance of these programs. Our particular interest was the performance of home visiting in reducing child maltreatment. We developed a program logic framework to assist in understanding the neonate/infant home-visiting literature, identified through a systematic literature review. We tested whether success could be explained by the logic model using descriptive synthesis and statistical analysis. Having a stated objective of reducing child maltreatment-a theory or mechanism of change underpinning the home-visiting program consistent with the target population and their needs and program components that can deliver against the nominated theory of change-considerably increased the chance of success. We found that only seven of fifty-three programs demonstrated such consistency, all of which had a statistically significant positive outcome, whereas of the fifteen that had no match, none was successful. Programs with a partial match had an intermediate success rate. The relationship between program success and full, partial or no match was statistically significant. Employing a theory-driven approach provides a new way of understanding the disparate performance of neonate/infant home-visiting programs. Employing a similar theory-driven approach could also prove useful in the review of other programs that embody a diverse set of characteristics and may apply to diverse populations and settings. A program logic framework provides a rigorous approach to deriving policy-relevant meaning from effectiveness evidence of complex programs. For neonate/infant home-visiting programs, it means that in developing these programs, attention to consistency of objectives, theory of change, target population, and program components is critical. © 2012 Milbank Memorial Fund.

Building Successful Home Visitor-Mother Relationships and Reaching Program Goals in Two Early Head Start Programs: A Qualitative Look at Contributing Factors

ERIC Educational Resources Information Center

Brookes, Sheila J.; Summers, Jean Ann; Thornburg, Kathy R.; Ispa, Jean M.; Lane, Valeri J.

2006-01-01

This paper presents the results of two qualitative studies, conducted independently in two Early Head Start programs, exploring the reasons given by mothers and home visitors for family success or lack of success in achieving program goals and for engagement in the mother-home visitor relationship. Several patterns pertaining to family issues and…

Scope and Sequence for Vocational Home Economics Education in Oklahoma. Consumer and Homemaking Programs, Occupational Programs, Special Occupational Programs.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater.

Intended for use by high school teachers of vocational home economics in Oklahoma to aid in local planning and developing of a nonrepetitious core curriculum to prepare students for home economics-related occupations and their roles as consumers and homemakers, this curriculum guide covers the entire course program for the high school years. Three…

Formative evaluation on a physical activity health promotion program for the group home setting.

PubMed

Dixon-Ibarra, Alicia; Driver, Simon; VanVolkenburg, Haley; Humphries, Kathleen

2017-02-01

Physical inactivity and high rates of chronic conditions is a public health concern for adults with intellectual disability. Few health promotion programs target the group home setting which is the pre-dominant form of residential accommodation for persons with intellectual disability. A process evaluation of a physical activity health promotion program, Menu-Choice, was conducted with five group home sites for adults with intellectual and developmental disabilities. Menu-Choice assists group home staff in including physical activity goals within resident schedules. The physical activity program was designed based on theoretical frameworks, community-based participatory approaches, and established health promotion guidelines for adults with disabilities. Fourteen program coordinators (age M 39; 77% females), 22 staff (age M 39; 82% females), and 18 residents (age M 59; 72% females; 56% ambulatory) participated. Results from the fidelity survey and program completion highlight potential challenges with implementation. Findings will assist with the refinement of the program for continued implementation trials in the group home community. Published by Elsevier Ltd.

76 FR 17936 - Federal Housing Administration (FHA): Notice of FHA PowerSaver Home Energy Retrofit Loan Pilot...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

... Housing Administration (FHA): Notice of FHA PowerSaver Home Energy Retrofit Loan Pilot Program AGENCY...: Notice. SUMMARY: This notice announces HUD's FHA Home Energy Retrofit Loan Pilot Program (Retrofit Pilot... to conduct an Energy Efficient Mortgage Innovation pilot program targeted to the single family...

A Study of North Carolina Negro Homemakers. Extension Evaluation Study No. 4.

ERIC Educational Resources Information Center

Brown, Minnie Miller; And Others

This statewide study of the home demonstration program in nine representative counties was designed to determine home economics extension program needs, to discover the degree of participation, and to locate people who might profit from the program. Personal interviews were conducted with 498 home demonstration club members and 572 nonmembers.…

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)

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees AGENCY: Health Resources... expansion supplements of $100,000 to 10 Nursing Assistant and Home Health Aide (NAHHA) Program grantees to... University Health Sciences Center (TTUHSC) School of Nursing, 302 Pine Street, Abilene, TX 79601, T51HP20702...

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

... (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request AGENCY... information needed to determine patients' satisfaction with services provided by or through the Michael E...: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number...

Examination of facilitators and barriers to home-based supplemental feeding with ready-to-use food for underweight children in western Uganda

PubMed Central

Jilcott, Stephanie B.; Myhre, Jennifer A.; Adair, Linda S.; Thirumurthy, Harsha; Bentley, Margaret E.; Ammerman, Alice S.

2013-01-01

Poor complementary feeding practices and low quality complementary foods are significant causes of growth faltering and child mortality throughout the developing world. Ready-to-use foods (RUF) are energy dense, lipid-based products that do not require cooking or refrigeration, that have been used to prevent and treat malnutrition among vulnerable children. The effectiveness of these products in improving child nutritional status depends on household use by caregivers. To identify the key facilitators and barriers that influence appropriate in-home RUF consumption by supplemental feeding program beneficiaries, we conducted individual interviews among caregivers (n=80), RUF producers (n=8) and program staff (n=10) involved in the Byokulia Bisemeye mu Bantu (BBB) supplemental feeding program in Bundibugyo, Uganda. By documenting caregiver perceptions and feeding practices related to RUF, we developed a conceptual framework of factors that affect appropriate feeding with RUF. Findings suggest that locally produced RUF is well received by caregivers and children, and is perceived by caregivers and the community to be a healthy supplemental food for malnourished children. However, child feeding practices, including sharing of RUF within households, compromise the nutrient delivery to the intended child. Interventions and educational messages informed by this study can help to improve RUF delivery to targeted beneficiaries. PMID:22136223

Evaluation of the Pilot Program for Home School and ChalleNGe Program Recruits

DTIC Science & Technology

2004-07-01

religious values . Home schoolers have strong aca- demic achievement. 4 The ChalleNGe Program targets 16- to 18-year-old high school drop- outs and...percent of home school association leaders listed an exhibit table at association events, such as conferences, book fairs , and support group meetings...affiliation. Because the average values of attributes of the home school popula- tion may vary among its different segments, it is important that the

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

... Information Collection: Healthy Homes and Lead Hazard Control Programs Data Collection--Progress Reporting AGENCY: Office of Healthy Homes and Lead Hazard Control, HUD. ACTION: Notice. SUMMARY: The revised... of Healthy Homes and Lead Hazard Control, Department of Housing and Urban Development, 451 7th Street...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

24 CFR 291.545 - Financing purchase of the home.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Financing purchase of the home. 291... Neighbor Next Door Sales Program § 291.545 Financing purchase of the home. (a) Purchase using conventional... conventional financing to purchase a home under the GNND Sales Program, the amount of the mortgage may not...

A Systematic Guide for Planning or Improving Your Family Oriented Home-Based Program.

ERIC Educational Resources Information Center

Heffron, Mary Claire; Jonnson, Jerry C.

Guidelines based on Project Head Start performance standards are offered for persons interested in starting and operating a home-based child development program providing individualized family services through home visits. Opening sections of the manual sensitize prospective service providers to problems and positive outcomes of home-based…

Home telecare system using cable television plants--an experimental field trial.

PubMed

Lee, R G; Chen, H S; Lin, C C; Chang, K C; Chen, J H

2000-03-01

To solve the inconvenience of routine transportation of chronically ill and handicapped patients, this paper proposes a platform based on a hybrid fiber coaxial (HFC) network in Taiwan designed to make a home telecare system feasible. The aim of this home telecare system is to combine biomedical data, including three-channel electrocardiogram (ECG) and blood pressure (BP), video, and audio into a National Television Standard Committee (NTSC) channel for communication between the patient and healthcare provider. Digitized biomedical data and output from medical devices can be further modulated to a second audio program (SAP) subchannel which can be used for second-language audio in NTSC television signals. For long-distance transmission, we translate the digital biomedical data into the frequency domain using frequency shift key (FSK) technology and insert this signal into an SAP band. The whole system has been implemented and tested. The results obtained using this system clearly demonstrated that real-time video, audio, and biomedical data transmission are very clear with a carrier-to-noise ratio up to 43 dB.

The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs.

PubMed

Englesbe, Michael J; Grenda, Dane R; Sullivan, June A; Derstine, Brian A; Kenney, Brooke N; Sheetz, Kyle H; Palazzolo, William C; Wang, Nicholas C; Goulson, Rebecca L; Lee, Jay S; Wang, Stewart C

2017-06-01

The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this program was associated with reduced hospital duration of stay and health care costs. We conducted a retrospective, single center, cohort study evaluating patients who participated in the Michigan Surgical Home and Optimization Program and subsequently underwent major elective general and thoracic operative care between June 2014 and December 2015. Propensity score matching was used to match program participants to a control group who underwent operative care prior to program implementation. Primary outcome measures were hospital duration of stay and payer costs. Multivariate regression was used to determine the covariate-adjusted effect of program participation. A total of 641 patients participated in the program; 82% were actively engaged in the program, recording physical activity at least 3 times per week for the majority of the program; 182 patients were propensity matched to patients who underwent operative care prior to program implementation. Multivariate analysis demonstrated that participation in the Michigan Surgical Home and Optimization Program was associated with a 31% reduction in hospital duration of stay (P < .001) and 28% lower total costs (P < .001) after adjusting for covariates. A home-based, preoperative training program decreased hospital duration of stay, lowered costs of care, and was well accepted by patients. Further efforts will focus on broader implementation and linking participation to postoperative complications and rigorous patient-reported outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Fall Prevention for Older Adults Receiving Home Healthcare.

PubMed

Bamgbade, Sarah; Dearmon, Valorie

2016-02-01

Falls pose a significant risk for community-dwelling older adults. Fall-related injuries increase healthcare costs related to hospitalization, diagnostic procedures, and/or surgeries. This article describes a quality improvement project to reduce falls in older adults receiving home healthcare services. The fall prevention program incorporated best practices for fall reduction, including fall risk assessment, medication review/management, home hazard and safety assessment, staff and patient fall prevention education, and an individualized home-based exercise program. The program was implemented and evaluated during a 6-month time frame. Fewer falls occurred post implementation of the falls prevention program with no major injuries.

A university-sponsored home health nursing program in Karachi, Pakistan.

PubMed

Smego, Raymond A; Khan, Mohammad Aslam; Khowaja, Khurshid; Rafique, Rozina; Datoo, Farida

2005-11-01

This article describes a university-sponsored home health nursing program in a large urban center in Pakistan and details the essential elements needed in implementing such a program in a developing country. Compared to in-hospital treatment, home healthcare reduced hospital stay from 12.8 days to 3.9 days, and resulted in a net savings of Pakistani rupees (PRs) 5,374,135 (USD 89,569). A cost-effective home treatment program in a resource-limited country can be successfully implemented by using the hospital pharmacy as the central point for the preparation and distribution of medications and specialty nursing services.

Pay-for-performance in nursing homes.

PubMed

Briesacher, Becky A; Field, Terry S; Baril, Joann; Gurwitz, Jerry H

2009-01-01

Information on the impact of pay-for-performance programs is lacking in the nursing home setting. This literature review (1980-2007) identified 13 prior examples of pay-for-performance programs in the nursing home setting: 7 programs were active as of 2007, while 6 had been terminated. The programs were mostly short-lived, varied considerably in the choice of performance measures and pay incentives, and evaluations of the impact were rare.

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…

The Effect of a Group Discussion Program in a Home for the Aged on the Behavior Patterns of the Participants.

ERIC Educational Resources Information Center

Mason, Wendell Dean

The effect of a group discussion program on the behavior patterns of aged participants was studied in the Indiana Masonic Home. The training program (18 one-hour sessions for six weeks), involved 44 residents (in two group), aged 60-94, in discussions of applying effective learning conditions to adult education programs in homes for the aged. Data…

Comparing Catheter-associated Urinary Tract Infection Prevention Programs Between VA and Non-VA Nursing Homes

PubMed Central

Mody, Lona; Greene, M. Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W.; Wald, Heidi L.; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E.; King, Beth J.; Hogikyan, Robert; Edson, Barbara; Krein, Sarah L.

2018-01-01

OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that U.S. Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the “AHRQ Safety Program for Long-term Care” collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention. RESULTS A total of 353 (71%; 47 VA, 306 non-VA) of 494 nursing homes from 41 states responded. VA nursing homes reported more hours/week devoted to infection prevention-related activities (31 vs. 12 hours, P<.001), and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs. 66%, P<.001), sharing CAUTI data with leadership (94% vs. 70%, P=.014) and nursing personnel (85% vs. 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs. 81%, P=.004) and catheter insertion (83% vs. 94%, P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. PMID:27917728

Transforming Child and Youth Mental Health Care via Innovative Technological Solutions.

PubMed

Pepler, Antonio; Boydell, Katherine M; Teshima, John; Volpe, Tiziana; Braunberger, Peter G; Minden, Debbie

2011-01-01

Live interactive videoconferencing and other technologies offer innovative opportunities for effective delivery of specialized child and adolescent mental health services. In this article, an example of a comprehensive telepsychiatry program is presented to highlight a variety of capacity-building initiatives that are responsive to community needs and cultures; these initiatives are allowing children, youth and caregivers to access otherwise-distant specialist services within their home communities. Committed, enthusiastic champions, adequate funding and infrastructure, creativity and a positive attitude represent key elements in the adaptation of this demonstrated user-friendly modality.

One third of a million days of care at home, 1959 to 1975.

PubMed Central

Hunt, T. E.; Crichton, R. D.

1977-01-01

Although articles on studies of organized home care programs are numerous, reports of long-term effectiveness of these programs are scanty. While government spokesmen appear to advocate more widespread use of alternatives to hospitalization, there has been serious criticism of the efficiency and accomplishments of home care services. A medically oriented home care program in Saskatoon (population, less than 150 000) has grown steadily over a 16-year period and is now serving a daily average of 200 individuals. All patients have required "hospital-like care" at home and most have not ordinarily been sufficiently mobile during their time in the program to attend hospital outpatient services. Many have required "concentrated care" through daily visits of professional health personnel. The program is designed for the physically ill and disabled and is administered by the major teaching hospital in the city, although it provides services to the whole community. Over one third of the patients referred in recent years had been at home. Almost one half of the patients have undergone satisfactory rehabilitation at home. The program has also proven to be an acceptable alternative to long-term institutional care for the permanently seriously disabled, a large number of whom are elderly. The program has been able to operate at considerably less cost to the public than inpatient (hospital or institutional) services would have entailed. PMID:405089

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…

Engaging Parents in Early Head Start Home-Based Programs: How Do Home Visitors Do This?

PubMed

Shanti, Caroline

2017-01-01

Parental engagement is considered elemental to successful outcomes for parents and their children in early childhood home visiting programs. Engagement is that piece of parental involvement that refers to the working relationship between the parent and the home visitor. Multiple papers have called for research to pinpoint the ways in which home visitors work with parents to form these working relationships, and form partnerships to achieve positive outcomes. Analysis revealed that in individualizing their efforts to each family, home visitors follow semi-sequential steps in implementing engagement. This article presents a model of the process home visitors describe that resulted from analysis. Grounded theory techniques were used to analyze 29 interviews with Early Head Start (EHS) home visitors and 11 supervisors across four EHS programs in one region of the United States. The process of engagement as described emerges in three phases: (1) learning the parent's culture and style; (2) deepening the working partnership; and (3) balancing the ongoing work. Analysis further revealed specific strategies and goals that guide the work of home visitors in each of these three phases. This not only adds rich detail to the literature, but also provides a useful guide for programs and policy makers through identifying the areas where training and support will increase home visitor ability to engage parents.

Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non-Veterans Affairs Nursing Homes.

PubMed

Mody, Lona; Greene, M Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W; Wald, Heidi L; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E; King, Beth J; Hogikyan, Robert; Edson, Barbara S; Krein, Sarah L

2017-03-01

OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire. RESULTS A total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; P<.001) and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs 66%; P<.001), sharing CAUTI data with leadership (94% vs 70%; P=.014) and with nursing personnel (85% vs 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. Infect Control Hosp Epidemiol 2017;38:287-293.

What Happens After the Demonstration Phase? The Sustainability of Canada's At Home/Chez Soi Housing First Programs for Homeless Persons with Mental Illness.

PubMed

Nelson, Geoffrey; Caplan, Rachel; MacLeod, Timothy; Macnaughton, Eric; Cherner, Rebecca; Aubry, Tim; Méthot, Christian; Latimer, Eric; Piat, Myra; Plenert, Erin; McCullough, Scott; Zell, Sarah; Patterson, Michelle; Stergiopoulos, Vicky; Goering, Paula

2017-03-01

This research examined the sustainability of Canada's At Home/Chez Soi Housing First (HF) programs for homeless persons with mental illness 2 years after the end of the demonstration phase of a large (more than 2000 participants enrolled), five-site, randomized controlled trial. Qualitative interviews were conducted with 142 participants (key informants, HF staff, and persons with lived experience) to understand sustainability outcomes and factors that influenced those outcomes. Also, a self-report HF fidelity measure was completed for nine HF programs that continued after the demonstration project. A cross-site analysis was performed, using the five sites as case studies. The findings revealed that nine of the 12 HF programs (75%) were sustained, and that seven of the nine programs reported a high level of fidelity (achieving an overall score of 3.5 or higher on a 4-point scale). The sites varied in terms of the level of systems integration and expansion of HF that were achieved. Factors that promoted or impeded sustainability were observed at multiple ecological levels: broad contextual (i.e., dissemination of research evidence, the policy context), community (i.e., partnerships, the presence of HF champions), organizational (i.e., leadership, ongoing training, and technical assistance), and individual (i.e., staff turnover, changes, and capacity). The findings are discussed in terms of the implementation science literature and their implications for how evidence-based programs like HF can be sustained. © Society for Community Research and Action 2017.

Benefits and costs of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease - a multi-centre randomised controlled equivalence trial.

PubMed

Holland, Anne E; Mahal, Ajay; Hill, Catherine J; Lee, Annemarie L; Burge, Angela T; Moore, Rosemary; Nicolson, Caroline; O'Halloran, Paul; Cox, Narelle S; Lahham, Aroub; Ndongo, Rebecca; Bell, Emily; McDonald, Christine F

2013-09-08

Pulmonary rehabilitation is widely advocated for people with chronic obstructive pulmonary disease (COPD) to improve exercise capacity, symptoms and quality of life, however only a minority of individuals with COPD are able to participate. Travel and transport are frequently cited as barriers to uptake of centre-based programs. Other models of pulmonary rehabilitation, including home-based programs, have been proposed in order to improve access to this important treatment. Previous studies of home-based pulmonary rehabilitation in COPD have demonstrated improvement in exercise capacity and quality of life, but not all elements of the program were conducted in the home environment. It is uncertain whether a pulmonary rehabilitation program delivered in its entirety at home is cost effective and equally capable of producing benefits in exercise capacity, symptoms and quality of life as a hospital-based program. The aim of this study is to compare the costs and benefits of home-based and hospital-based pulmonary rehabilitation for people with COPD. This randomised, controlled, equivalence trial conducted at two centres will recruit 166 individuals with spirometrically confirmed COPD. Participants will be randomly allocated to hospital-based or home-based pulmonary rehabilitation. Hospital programs will follow the traditional outpatient model consisting of twice weekly supervised exercise training and education for eight weeks. Home-based programs will involve one home visit followed by seven weekly telephone calls, using a motivational interviewing approach to enhance exercise participation and facilitate self management. The primary outcome is change in 6-minute walk distance immediately following intervention. Measurements of exercise capacity, physical activity, symptoms and quality of life will be taken at baseline, immediately following the intervention and at 12 months, by a blinded assessor. Completion rates will be compared between programs. Direct healthcare costs and indirect (patient-related) costs will be measured to compare the cost-effectiveness of each program. This trial will identify whether home-based pulmonary rehabilitation can deliver equivalent benefits to centre-based pulmonary rehabilitation in a cost effective manner. The results of this study will contribute new knowledge regarding alternative models of pulmonary rehabilitation and will inform pulmonary rehabilitation guidelines for COPD.

Supporting Family Engagement in Home Visiting with the Family Map Inventories.

PubMed

Kyzer, Angela; Whiteside-Mansell, Leanne; McKelvey, Lorraine; Swindle, Taren

2016-01-01

The purpose of this study was to examine the feasibility and usefulness of a universal screening tool, the Family Map Inventory (F MI), to assess family strengths and needs in a home visiting program. The FMI has been used successfully by center-based early childcare programs to tailor services to family need and build on existing strengths. Home visiting coordinators (N = 39) indicated the FMI would provide useful information, and they had the capacity to implement. In total, 70 families who enrolled in a Home Instruction for Parents of Preschool Youngsters (HIPPY) program were screened by the coordinator. The results of the FMI provided meaningful information about the home and parenting environment. Overall, most caregivers provided high levels of school readiness and parental warmth and low levels of family conflict and parenting stress. On the other hand, many families did not provide adequate food quality, exhibited chaotic home environments, and practiced negative discipline. This study demonstrated that the FMI is a feasible and useful option to assess comprehensive family needs in home visiting programs. It also demonstrated that the FMI provided home visiting coordinators a system to measure family strengths and needs. This could provide an assessment of program effectiveness and changes in the family's environment.

Supporting Family Engagement in Home Visiting with the Family Map Inventories

PubMed Central

Kyzer, Angela; Whiteside-Mansell, Leanne; McKelvey, Lorraine; Swindle, Taren

2015-01-01

The purpose of this study was to examine the feasibility and usefulness of a universal screening tool, the Family Map Inventory (F MI), to assess family strengths and needs in a home visiting program. The FMI has been used successfully by center-based early childcare programs to tailor services to family need and build on existing strengths. Home visiting coordinators (N = 39) indicated the FMI would provide useful information, and they had the capacity to implement. In total, 70 families who enrolled in a Home Instruction for Parents of Preschool Youngsters (HIPPY) program were screened by the coordinator. The results of the FMI provided meaningful information about the home and parenting environment. Overall, most caregivers provided high levels of school readiness and parental warmth and low levels of family conflict and parenting stress. On the other hand, many families did not provide adequate food quality, exhibited chaotic home environments, and practiced negative discipline. This study demonstrated that the FMI is a feasible and useful option to assess comprehensive family needs in home visiting programs. It also demonstrated that the FMI provided home visiting coordinators a system to measure family strengths and needs. This could provide an assessment of program effectiveness and changes in the family’s environment. PMID:26681837

Maine PACE Program Final Technical Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fischer, Dana; Adamson, Joy M

The ARRA EECBG BetterBuilding helped augment the existing Home Energy Savings Programs (HESP) and incentives with financing through a subordinate lien PACE and HUD PowerSaver programs. The program was designed to document innovative techniques to dramatically increase the number of homes participating in weatherization programs in participating towns. Maine will support new energy efficiency retrofit pilots throughout the state, designed to motivate a large number of homeowners to invest in comprehensive home energy efficiency upgrades to bring real solutions to market.

Parent Involvement with Children's Health Promotion: A One-Year Follow-up of the Minnesota Home Team.

ERIC Educational Resources Information Center

Perry, Cheryl L.; And Others

1989-01-01

Long-term outcomes of a school-based program (2,250 third-graders in 31 schools) were compared with an equivalent home-based program (1,000 families) involving parents. Students in the home-based program reported more behavior change in the reduction of fat and increase of carbohydrates in their diet. (SK)

Evaluating the Efficacy of Children Participating in Home Instruction for Parents of Preschool Youngsters and Head Start

ERIC Educational Resources Information Center

Brown, Amber L; Lee, Joohi

2017-01-01

The purpose of this study was to evaluate the efficacy of the Home Instruction for Parents of Preschool Youngsters program when implemented within Head Start programs by measuring children's language proficiency scores. Participants were kindergarteners concurrently enrolled in both a Head Start program and the Home Instruction for Parents of…

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…

78 FR 6851 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-31

... (Patient Satisfaction Survey Michael E. DeBakey Home Care Program) Activity: Comment Request AGENCY... Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control Number: 2900-0775. Type... gather feedback from patients regarding their satisfaction with the quality of services/care provided by...

MCHP/VIP: Mother-Child Home Program of the Verbal Interaction Project.

ERIC Educational Resources Information Center

Verbal Interaction Project, Freeport, NY.

This report to the Joint Dissemination Review Panel of the Office of Education and the National Institute of Education provides an overview of the Mother-Child Home Program of the Verbal Interaction Project: a voluntary, home-based early education program for low-income pre- preschoolers (2- and 3-year-old children), their mothers and other adults…

Let's Talk About Breastfeeding: The Importance of Delivering a Message in a Home Visiting Program.

PubMed

McGinnis, Sandra; Lee, Eunju; Kirkland, Kristen; Miranda-Julian, Claudia; Greene, Rose

2018-05-01

To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population. A secondary analysis of program data from a statewide home visitation program. Thirty-six Healthy Families New York sites across New York State. A total of 3521 pregnant mothers at risk of poor child health and developmental outcomes. Home visitors deliver a multifaceted intervention that includes educating high-risk mothers on benefits of breastfeeding, encouraging them to breastfeed and supporting their efforts during prenatal and postnatal periods. Home visitor-reported content and frequency of home visits, participant-reported breastfeeding initiation and duration, and covariates (Kempe Family Stress Index, race and ethnicity, region, nativity, marital status, age, and education). Logistic regression. Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum. Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.

Relationships, expertise, incentives, and governance: supporting care home residents' access to health care. An interview study from England.

PubMed

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

2015-05-01

To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Home-based intermediate care program vs hospitalization: Cost comparison study.

PubMed

Armstrong, Catherine Deri; Hogg, William E; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S; Saginur, Raphael

2008-01-01

To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. Single-arm study with historical controls. Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P < .001), used more community care services following discharge (coefficient $729, P = .007), and were more likely to be readmitted to hospital within 3 months of discharge (coefficient 17%, P = .012) than patients treated in hospital. Total substituted costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... [CMS-1510-F2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home Health Agencies and Hospices; Correction... set forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: The...

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pigg, Scott; Cautley, Dan; Francisco, Paul

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.

Parents' Perspectives: An Evaluation of Case Management Interventions in Home Visiting Programs for Young Children

ERIC Educational Resources Information Center

Allen, Susan F.

2007-01-01

In home visiting programs for children younger than age three, home visitors work with parents to enhance the child's environment. This study examined how the home visitor-parent relationship, amount of contact, and level of need affected the intensity of case management interventions received. Researchers interviewed 90 mothers to measure the…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, Charles

In the 2nd quarter of 2012, a program was formally initiated at Delta Products to develop smart-grid-enabled Electric Vehicle Supply Equipment (EVSE) product for residential use. The project was funded in part by the U.S. Department of Energy (DOE), under award DE-OE0000590. Delta products was the prime contractor to DOE during the three year duration of the project. In addition to Delta Products, several additional supplier-partners were engaged in this research and development (R&D) program, including Detroit Edison DTE, Mercedes Benz Research and Development North America, and kVA. This report summarizes the program and describes the key research outcomes ofmore » the program. A technical history of the project activities is provided, which describes the key steps taken in the research and the findings made at successive stages in the multi-stage work. The evolution of an EVSE prototype system is described in detail, culminating in prototypes shipped to Department of Energy Laboratories for final qualification. After the program history is reviewed, the key attributes of the resulting EVSE are described in terms of functionality, performance, and cost. The results clearly demonstrate the ability of this EVSE to meet or exceed DOE's targets for this program, including: construction of a working product-intent prototype of a smart-grid-enabled EVSE, with suitable connectivity to grid management and home-energy management systems, revenue-grade metering, and related technical functions; and cost reduction of 50% or more compared to typical market priced EVSEs at the time of DOE's funding opportunity announcement (FOA), which was released in mid 2011. In addition to meeting all the program goals, the program was completed within the original budget and timeline established at the time of the award. The summary program budget and timeline, comparing plan versus actual values, is provided for reference, along with several supporting explanatory notes. Technical information relating to the product design and test results are contained in the appendices to this report.« less

24 CFR 3286.511 - Inspector qualifications.

Code of Federal Regulations, 2010 CFR

2010-04-01

... URBAN DEVELOPMENT MANUFACTURED HOME INSTALLATION PROGRAM Inspection of Installations in HUD-Administered... a manufactured home that is subject to the requirements of the HUD-administered installation program: (1) A manufactured home or residential building inspector employed by the local authority having...

'Physical activity at home (PAAH)', evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design.

PubMed

Freene, Nicole; Waddington, Gordon; Chesworth, Wendy; Davey, Rachel; Goss, John

2011-11-24

It is well recognised that the adoption and longer term adherence to physical activity by adults to reduce the risk of chronic disease is a challenge. Interventions, such as group and home based physical activity programs, have been widely reported upon. However few studies have directly compared these interventions over the longer term to determine their adherence and effectiveness. Participant preference for home based or group interventions is important. Some evidence suggests that home based physical activity programs are preferred by middle aged adults and provide better long term physical activity adherence. Physiotherapists may also be useful in increasing physical activity adherence, with limited research on their impact. 'Physical Activity at Home' is a 2 year pragmatic randomised control trial, with a non-randomised comparison to group exercise. Middle-aged adults not interested in, or unable to attend, a group exercise program will be targeted. Sedentary community dwelling 50-65 year olds with no serious medical conditions or functional impairments will be recruited via two mail outs using the Australian federal electoral roll. The first mail out will invite participants to a 6 month community group exercise program. The second mail out will be sent to those not interested in the group exercise program inviting them to take part in a home based intervention. Eligible home based participants will be randomised into a 6 month physiotherapy-led home based physical activity program or usual care. Outcome measures will be taken at baseline, 6, 12, 18 and 24 months. The primary outcome is physical activity adherence via exercise diaries. Secondary outcomes include the Active Australia Survey, accelerometry, aerobic capacity (step test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Costs will be recorded prospectively and qualitative data will be collected. The planned 18 month follow-up post intervention will provide an indication of the effectiveness of the group and home based interventions in terms of adherence to physical activity, health benefits and cost. If the physiotherapy-led home based physical activity program is successful it could provide an alternative option for physical activity program delivery across a number of settings. Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000890932.

Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program.

PubMed

Deyle, Gail D; Allison, Stephen C; Matekel, Robert L; Ryder, Michael G; Stang, John M; Gohdes, David D; Hutton, Jeremy P; Henderson, Nancy E; Garber, Matthew B

2005-12-01

Manual therapy and exercise have not previously been compared with a home exercise program for patients with osteoarthritis (OA) of the knee. The purpose of this study was to compare outcomes between a home-based physical therapy program and a clinically based physical therapy program. One hundred thirty-four subjects with OA of the knee were randomly assigned to a clinic treatment group (n=66; 61% female, 39% male; mean age [+/-SD]=64+/-10 years) or a home exercise group (n=68, 71% female, 29% male; mean age [+/-SD]=62+/-9 years). Subjects in the clinic treatment group received supervised exercise, individualized manual therapy, and a home exercise program over a 4-week period. Subjects in the home exercise group received the same home exercise program initially, reinforced at a clinic visit 2 weeks later. Measured outcomes were the distance walked in 6 minutes and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Both groups showed clinically and statistically significant improvements in 6-minute walk distances and WOMAC scores at 4 weeks; improvements were still evident in both groups at 8 weeks. By 4 weeks, WOMAC scores had improved by 52% in the clinic treatment group and by 26% in the home exercise group. Average 6-minute walk distances had improved about 10% in both groups. At 1 year, both groups were substantially and about equally improved over baseline measurements. Subjects in the clinic treatment group were less likely to be taking medications for their arthritis and were more satisfied with the overall outcome of their rehabilitative treatment compared with subjects in the home exercise group. Although both groups improved by 1 month, subjects in the clinic treatment group achieved about twice as much improvement in WOMAC scores than subjects who performed similar unsupervised exercises at home. Equivalent maintenance of improvements at 1 year was presumably due to both groups continuing the identical home exercise program. The results indicate that a home exercise program for patients with OA of the knee provides important benefit. Adding a small number of additional clinical visits for the application of manual therapy and supervised exercise adds greater symptomatic relief.

'There is a dependent patient in our home': designing and disseminating a family caregiving program through YouTube.

PubMed

Abu Kamel, Andaleeb

2016-06-01

Family members play a major role in providing care for older people and long-term dependent patients, especially in developing countries where there is a lack of specialized nursing homes and specialized home-visiting programs. Family members are rarely provided with sufficient information or training to provide home care for their dependent relatives. There are inadequate home caregiving educational resources directed to Arabic-speaking caregivers, either in written or in audiovisual presentations. The aims of the present study were (i) to present the process of designing a caregiving educational program entitled 'there is a dependent patient in our home', with an intention to be culturally and linguistically appropriate for a specific Arab-speaking population, and (ii) to present the experience of disseminating the program through YouTube, to be accessible for a wide range of caregivers. The program was a product of a process involving seven phases, starting with a review of the literature and ending with disseminating 17 short 'caregiving' videos on YouTube, the most popular video-sharing website. The program presented necessary skills, instructions, and information that enabled caregivers to provide safe and competent daily caring activities for their functionally dependent relative or older adults at home. The program was registered in the Jordan National Library. After 2 months of broadcasting it on YouTube, the number of views exceeded 6800. Many constructive comments were received from caregivers. Language, simplicity, and attractiveness of the program were judged as the areas of satisfaction by the viewers, whereas lack of a few topics such as verbal communication with patients and dealing with daily caregivers' burden and stressors were the main reasons of dissatisfaction. This program was an endeavor to provide the Arabic library with a home caregiving resource. Adequate advertisement of the program would encourage health providers to search for and use the currently available social media as means of delivering educational services to family caregivers.

Discharge planning, nursing home placement, and the Internet.

PubMed

Collier, Eric J; Harrington, Charlene

2005-01-01

Effective discharge planning and well-coordinated case management related to nursing home (NH) placement are key services in acute-care hospitals. (1) identify the individuals and important factors involved in the discharge planning process; (2) describe the types/sources of information used by discharge planners to recommend specific nursing homes for patients and families; and (3) determine which methods are used to evaluate the quality of US nursing homes (NHs). Descriptive study, with a convenience sample of 41 discharge planners and case managers from California acute-care hospitals. This study found that patients, families, friends, and physicians are all involved in the discharge planning process along with discharge planners and/or case managers. Discharge planners/case managers were generally concerned about NH bed availability, geographic location, and financial considerations. Although the discharge planners and case managers were able to articulate important indicators of quality in NHs, such information was not routinely considered during discharge planning activities. Discharge planners and case managers need to play a more central role in the decision-making process related to the selection of a NH, especially because decisions are time-limited and can benefit from a well-planned discharge planning program that uses a variety of data on quality and costs. The widespread use of Internet-based information sources can be expanded to aid this process.

Effects of a 10-week multimodal exercise program on physical and cognitive function of nursing home residents: a psychomotor intervention pilot study.

PubMed

Pereira, Catarina; Rosado, Hugo; Cruz-Ferreira, Ana; Marmeleira, José

2018-05-01

Nursing home institutionalization tends to exacerbate loss of functioning. Examine the feasibility and the effect of a psychomotor intervention-a multimodal exercise program promoting simultaneous cognitive and motor stimulation-on the executive (planning ability and selective attention) and physical function of nursing home residents. Seventeen participants engaged in a 10-week multimodal exercise program and 17 maintained usual activities. Exercise group improved planning ability (25-32%), selective attention (19-67%), and physical function [aerobic endurance, lower body strength, agility, balance, gait, and mobility (19-41%)], corresponding to an effect size ranging from 0.29 (small) to 1.11 (high), p < 0.05. The multimodal exercise program was feasible and well tolerated. The program improved executive and physical functions of the nursing home residents, reverting the usual loss of both cognitive and motor functioning in older adult institutionalized. Multimodal exercise programs may help to maintain or improve nursing home residents' functioning.

Reablement, Reactivation, Rehabilitation and Restorative Interventions With Older Adults in Receipt of Home Care: A Systematic Review.

PubMed

Sims-Gould, Joanie; Tong, Catherine E; Wallis-Mayer, Lutetia; Ashe, Maureen C

2017-08-01

To systematically review the impact of reablement, reactivation, rehabilitation, and restorative (4R) programs for older adults in receipt of home care services. Systematic review. We searched the following electronic bibliographic databases: MEDLINE, EMBASE, PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health), SPORTDiscus and The Cochrane Library and reference lists. Randomized controlled trials that describe original data on the impact of home-based rehabilitative care and were written in English. Fifteen studies were identified. Study details were recorded using a predefined data abstraction form. Methodological quality was assessed by 2 independent reviewers. If there were discrepancies, a third author resolved these. Given the tailored and personalized approach of the 4R interventions, a range of primary outcomes were assessed, including functional abilities, strength, gait speed, social support, loneliness, and the execution of activities of daily living (ADL) and instrumental ADL (IADL). 4R interventions are intended to reduce the long-term use of home care services. As such, health care resource utilization will be assessed as a secondary outcome. There are 2 distinct clusters of interventions located in this systematic review (defined by hospitalizations): (1) "hospital to home" programs, in which participants are discharged from hospital wards with a 4R home care, and (2) those that focus on clients receiving home care without a hospital stay immediately preceding. Reflecting the highly tailored and personalized nature of 4R interventions, the studies included in this review assessed a wide range of outcomes, including survival, place of residence, health care service usage, functional abilities, strength, walking impairments, balance, falls efficacy and rates of falls, pain, quality of life, loneliness, mental state, and depression. The most commonly reported and statistically significant outcomes were those pertaining to the service usage and functional abilities of participants. From cost savings to improvements in clinical outcomes, 4R interventions show some promise in the home care context. However, there are several key issues across studies, including questions surrounding the generalizability of the results, in particular with respect to the ineligibility criteria for most interventions; the lack of information provided on the interventions; and lack of information on staff training. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Reasons for Preference of Home Delivery with Traditional Birth Attendants (TBAs) in Rural Bangladesh: A Qualitative Exploration

PubMed Central

Sarker, Bidhan Krishna; Rahman, Musfikur; Rahman, Tawhidur; Hossain, Jahangir; Reichenbach, Laura; Mitra, Dipak Kumar

2016-01-01

Background and Objectives Although Bangladesh has made significant progress in reducing maternal and child mortality in the last decade, childbirth assisted by skilled attendants has not increased as much as expected. An objective of the Bangladesh National Strategy for Maternal Health 2014–2024 is to reduce maternal mortality to 50/100,000 live births. It also aims to increase deliveries with skilled birth attendants to more than 80% which remains a great challenge, especially in rural areas. This study explores the underlying factors for the major reliance on home delivery with Traditional Birth Attendants (TBA) in rural areas of Bangladesh. Methods This was a qualitative cross-sectional study. Data were collected between December 2012 and February 2013 in Sunamganj district of Sylhet division and data collection methods included key informant interviews (KII) with stakeholders; formal and informal health service providers and health managers; and in-depth interviews (IDI) with community women to capture a range of information. Key questions were asked of all the study participants to explore the question of why women and their families prefer home delivery by TBA and to identify the factors associated with this practice in the local community. Results The study shows that home delivery by TBAs remain the first preference for pregnant women. Poverty is the most frequently cited reason for preferring home delivery with a TBA. Other major reasons include; traditional views, religious fallacy, poor road conditions, limited access of women to decision making in the family, lack of transportation to reach the nearest health facility. Apart from these, community people also prefer home delivery due to lack of knowledge and awareness about service delivery points, fear of increased chance of having a caesarean delivery at hospital, and lack of female doctors in the health care facilities. Conclusions The study findings provide us a better understanding of the reasons for preference for home delivery with TBA among this population. These identified factors can inform policy makers and program implementers to adopt socially and culturally appropriate interventions that can improve deliveries with skilled attendants and thus contribute to the reduction of maternal and neonatal mortality and morbidity in rural Bangladesh. PMID:26731276

Cathy Zoi on the new Home Energy Score pilot program

ScienceCinema

Zoi, Cathy

2018-05-16

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.

Exploring efficacy of residential energy efficiency programs in Florida

NASA Astrophysics Data System (ADS)

Taylor, Nicholas Wade

Electric utilities, government agencies, and private interests in the U.S. have committed and continue to invest substantial resources in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. Program investments, and the demand for impact evaluations that accompany them, are projected to grow in coming years due to increased pressure from state-level energy regulation, costs and challenges of building additional production capacity, fuel costs and potential carbon or renewable energy regulation. This dissertation provides detailed analyses of ex-post energy savings from energy efficiency programs in three key sectors of residential buildings: new, single-family, detached homes; retrofits to existing single-family, detached homes; and retrofits to existing multifamily housing units. Each of the energy efficiency programs analyzed resulted in statistically significant energy savings at the full program group level, yet savings for individual participants and participant subgroups were highly variable. Even though savings estimates were statistically greater than zero, those energy savings did not always meet expectations. Results also show that high variability in energy savings among participant groups or subgroups can negatively impact overall program performance and can undermine marketing efforts for future participation. Design, implementation, and continued support of conservation programs based solely on deemed or projected savings is inherently counter to the pursuit of meaningful energy conservation and reductions in greenhouse gas emissions. To fully understand and optimize program impacts, consistent and robust measurement and verification protocols must be instituted in the design phase and maintained over time. Furthermore, marketing for program participation must target those who have the greatest opportunity for savings. In most utility territories it is not possible to gain access to the type of large scale datasets that would facilitate robust program analysis. Along with measuring and optimizing energy conservation programs, utilities should provide public access to historical consumption data. Open access to data, program optimization, consistent measurement and verification and transparency in reported savings are essential to reducing energy use and its associated environmental impacts.

Early Steps to School Success (ESSS): Examining Pathways Linking Home Visiting and Language Outcomes

ERIC Educational Resources Information Center

Iruka, Iheoma U.; Brown, Deborah; Jerald, Judith; Blitch, Kimberly

2018-01-01

Background: Improving the home environment and parenting practices to support children's early development and learning is a key focus of many. Home visiting is one potential strategy to improve the home environment and parenting; however, more data about current programmatic efforts is needed, especially for children with multiple risks living in…

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…

YogaHome: teaching and research challenges in a yoga program with homeless adults.

PubMed

Davis-Berman, Jennifer; Farkas, Jean

2012-01-01

YogaHome is a therapeutic yoga program for homeless women. Developing and refining YogaHome provided a unique opportunity to explore the process of teaching yoga to women faced with the physical and emotional stress of living in a homeless shelter. Unique teaching and research challenges are presented and recommendations for future programs are discussed.

Heat or eat: the Low Income Home Energy Assistance Program and nutritional and health risks among children less than 3 years of age.

PubMed

Frank, Deborah A; Neault, Nicole B; Skalicky, Anne; Cook, John T; Wilson, Jacqueline D; Levenson, Suzette; Meyers, Alan F; Heeren, Timothy; Cutts, Diana B; Casey, Patrick H; Black, Maureen M; Berkowitz, Carol

2006-11-01

Public funding for the Low Income Home Energy Assistance Program has never been sufficient to serve more than a small minority of income-eligible households. Low Income Home Energy Assistance Program funding has not increased with recent rapidly rising energy costs, harsh winter conditions, or higher child poverty rates. Although a national performance goal for the Low Income Home Energy Assistance Program is to increase the percentage of recipient households having > or = 1 member < or = 5 years of age, the association of income-eligible households' receipt of the Low Income Home Energy Assistance Program with indicators of well-being in young children has not been evaluated previously. The goal of the current study was to evaluate the association between a family's participation or nonparticipation in the Low Income Home Energy Assistance Program and the anthropometric status and health of their young children. In the ongoing Children's Sentinel Nutrition Assessment Project from June 1998 through December 2004, caregivers with children < 3 years of age in 2 emergency departments and 3 primary care clinics in 5 urban sites participated in cross-sectional surveys regarding household demographics, child's lifetime history of hospitalizations, and, for the past 12 months, household public assistance program participation and household food insecurity, measured by the US Food Security Scale. This scale, in accordance with established procedures, classifies households as food insecure if they report that they cannot afford enough nutritious food for all of the members to lead active, healthy lives. On the day of the interview, children's weight, length, and whether the children were admitted acutely to the hospital from the emergency departments were documented. The study sample consisted only of Low Income Home Energy Assistance Program income-eligible renter households without private insurance who also participated in > or = 1 other means-tested program. In this sample of 7074 caregivers, 16% of families received the Low Income Home Energy Assistance Program, similar to the national rate of 17%. Caregivers who received the Low Income Home Energy Assistance Program were more likely to be single (63% vs 54%), US born (77% vs 68%), and older (mother's mean age: 28.1 vs 26.7 years) but were less likely to be employed (44% vs 47%). Households who received the Low Income Home Energy Assistance Program were more likely to receive Supplemental Nutrition Program for Women, Infants, and Children (85% vs 80%), Supplemental Security Income (13% vs 9%), Temporary Assistance for Needy Families (38% vs 23%), and food stamps (59% vs 37%) and to live in subsidized housing (38% vs 19%) compared with nonrecipients. Children in families participating in the Low Income Home Energy Assistance Program were older than children in nonparticipating families (13.6 vs 12.5 months), were less likely to be uninsured (5% vs 9%), and were more likely to have had a low birth weight < or = 2500 g (17% vs 14%). Families participating in the Low Income Home Energy Assistance Program reported more household food insecurity (24% vs 20%) There were no significant group differences between recipients and nonrecipients in caregiver's education or child's gender. After controlling for these potentially confounding variables, including receipt of other means-tested programs, compared with children in recipient households, those in nonrecipient households had greater adjusted odds of being at aggregate nutritional risk for growth problems, defined as children with weight-for-age below the 5th percentile or weight-for-height below the 10th percentile, with significantly lower mean weight-for-age z scores calculated from age- and gender-specific values from the Centers for Disease Control and Prevention 2000 reference data. However, in adjusted analyses, children aged 2 to 3 years in recipient households were not more likely to be overweight (BMI > 95th percentile) than those in nonrecipient households. Rates of age-adjusted lifetime hospitalization excluding birth and the day of the interview did not differ between Low Income Home Energy Assistance Program recipient groups. Among the 4445 of 7074 children evaluated in the 2 emergency departments, children from eligible households not receiving the Low Income Home Energy Assistance Program had greater adjusted odds than those in recipient households of acute hospital admission on the day of the interview. Even within a low-income renter sample, Low Income Home Energy Assistance Program benefits seem to reach families at the highest social and medical risk with more food insecurity and higher rates of low birth-weight children. Nevertheless, after adjustment for differences in background risk, living in a household receiving the Low Income Home Energy Assistance Program is associated with less anthropometric evidence of undernutrition, no evidence of increased overweight, and lower odds of acute hospitalization from an emergency department visit among young children in low-income renter households compared with children in comparable households not receiving the Low Income Home Energy Assistance Program. The Low Income Home Energy Assistance Program in many states shuts down early each winter when their funding is exhausted. From a clinical perspective, pediatric health providers caring for children from impoverished families should consider encouraging families of these children to apply for the Low Income Home Energy Assistance Program early in the season before funding is depleted. From a public policy perspective, although this cross-sectional study design can only demonstrate associations and not causation, these findings suggest that, particularly as fuel costs and children's poverty rates increase, expanding the Low Income Home Energy Assistance Program funding and meeting the national Low Income Home Energy Assistance Program performance goal of increasing the percentage of recipient households with young children might potentially benefit such children's growth and health.

Characteristics attributed to complementary foods by caregivers in four countries of Latin America and the Caribbean.

PubMed

Dutta, Tanushree; Sywulka, Sara M; Frongillo, Edward A; Lutter, Chessa K

2006-12-01

Attributes that caregivers assign to complementary foods have been primarily described in the context of illness, but attributes assigned to foods in everyday circumstances must be understood to effectively promote good complementary feeding. This study aimed to understand how mothers judge complementary foods to be appropriate by cross-cultural examination of food perceptions in four different Latin American and Caribbean countries. We used semistructured interviews to assess attributes that mothers ascribed to a list of key foods, both home-made and manufactured, and reasons for feeding or not feeding them. We elicited attributes from 79 caregivers with children 6 to 24 months of age from two urban and perirban sites each in Brazil, Jamaica, Mexico, and Panama. Textual analysis based on six home foods common to the four countries and manufactured foods resulted in six attribute categories, five of which could be positive or negative (Nutrient Content, Effects on Child, Child's Response, Availability and Accessibility, and Other Food Attributes); one (Food Quality and Safety) was only negative. Analysis of attributes of home foods (chicken, eggs, beans, carrots, bananas or plantains, and oranges) revealed many beliefs that were common within and across countries, whereas analysis of the attributes of manufactured foods revealed that these foods were less known. The consistency of the attribute categories across countries and across home and manufactured foods suggests their relevance to planning programs to improve complementary feeding in Latin America and the Caribbean and possibly other developing countries. These results can be used programmatically to assess the need for and the focus of food education programs, and to indicate which countries will be more receptive to certain foods as a means of improving complementary feeding.

NREL Improves Building Energy Simulation Programs Through Diagnostic Testing (Fact Sheet)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2012-01-01

This technical highlight describes NREL research to develop Building Energy Simulation Test for Existing Homes (BESTEST-EX) to increase the quality and accuracy of energy analysis tools for the building retrofit market. Researchers at the National Renewable Energy Laboratory (NREL) have developed a new test procedure to increase the quality and accuracy of energy analysis tools for the building retrofit market. The Building Energy Simulation Test for Existing Homes (BESTEST-EX) is a test procedure that enables software developers to evaluate the performance of their audit tools in modeling energy use and savings in existing homes when utility bills are available formore » model calibration. Similar to NREL's previous energy analysis tests, such as HERS BESTEST and other BESTEST suites included in ANSI/ASHRAE Standard 140, BESTEST-EX compares software simulation findings to reference results generated with state-of-the-art simulation tools such as EnergyPlus, SUNREL, and DOE-2.1E. The BESTEST-EX methodology: (1) Tests software predictions of retrofit energy savings in existing homes; (2) Ensures building physics calculations and utility bill calibration procedures perform to a minimum standard; and (3) Quantifies impacts of uncertainties in input audit data and occupant behavior. BESTEST-EX includes building physics and utility bill calibration test cases. The diagram illustrates the utility bill calibration test cases. Participants are given input ranges and synthetic utility bills. Software tools use the utility bills to calibrate key model inputs and predict energy savings for the retrofit cases. Participant energy savings predictions using calibrated models are compared to NREL predictions using state-of-the-art building energy simulation programs.« less

Implementation of home-based medication order entry at a community hospital.

PubMed

Thorne, Alicia; Williamson, Sarah; Jellison, Tara; Jellison, Chris

2009-11-01

The implementation of a home-based order-entry program at a community hospital is described. Parkview Hospital is a 600-bed, community-based facility located in Fort Wayne, Indiana, that provides 24-hour pharmacy services. The main purpose for establishing a home-based order-entry program was to provide extra pharmacist coverage during the event of a spontaneous order surge in an effort to maintain excellent customer service. A virtual private network (VPN) was created to ensure the security and confidentiality of patients' health care information. The names of volunteer pharmacists who met specific criteria and who were capable of performing home-based order entry were collected. These pharmacists were trained and tested in the home-based order-entry process. When home-based order-entry is needed, the lead pharmacist contacts the pharmacists on the list by telephone. If available, the pharmacists (maximum of three) are notified to log into the Internet, access the VPN, and perform order entry with the same vigilance, confidentiality, and care as they would onsite. Home-based order entry is discontinued when off-trigger points are met. Pharmacists entering orders from home are paid by the time spent conducting order entry. Pharmacists reported that the program was easy to contact home-based order-entry volunteers, there were no problems with logging into the VPNs, and turnaround time was close to our target of 25 minutes. A community-based hospital successfully implemented a home-based medication order-entry program. The program alleviated the shortage of pharmacists during spontaneous surges of medication orders.

National Home Start Evaluation Interim Report VI. Twelve-Month Program Issues, Outcomes and Costs.

ERIC Educational Resources Information Center

Goodrich, Nancy; And Others

This report assesses the progress of the six summative Home Start projects as evaluation families completed their first twelve months of enrollment. Home Start, a federally-funded 3-year (1972-1975) home-based demonstration program for low-income families with 3- to 5-year-old children was designed to enhance a mother's skills in dealing with her…

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…

Saving our backs: safe patient handling and mobility for home care.

PubMed

Beauvais, Audrey; Frost, Lenore

2014-01-01

Predicted work-related injuries for nurses and home healthcare workers are on the rise given the many risk factors in the home environment and the escalating demands for home healthcare workers in the United States. Fortunately, safe patient handling and mobility programs can dramatically decrease injuries. Despite strides being made to promote safe patient handling and mobility programs in acute care, more can be done to establish such initiatives in the home care setting.

A Post-Hospital Nursing Home Rehabilitation Program.

ERIC Educational Resources Information Center

Petchers, Marcia K.; And Others

1987-01-01

Describes program of short-term rehabilitation care provided to elderly patients through collaboration between hospital and nursing home. Discusses program planning and implementation experiences, patient satisfaction, and rehabilitation outcomes. Notes that program, although successful, was discontinued due to financial and interorganizational…

Mothers’ experiences in the Nurse-Family Partnership program: a qualitative case study

PubMed Central

2012-01-01

Background Few studies have explored the experiences of low income mothers participating in nurse home visiting programs. Our study explores and describes mothers' experiences participating in the Nurse-Family Partnership (NFP) Program, an intensive home visiting program with demonstrated effectiveness, from the time of program entry before 29 weeks gestation until their infant's first birthday. Methods A qualitative case study approach was implemented. A purposeful sample of 18 low income, young first time mothers participating in a pilot study of the NFP program in Hamilton, Ontario, Canada partook in one to two face to face in-depth interviews exploring their experiences in the program. All interviews were digitally recorded and transcribed verbatim. Conventional content analysis procedures were used to analyze all interviews. Data collection and initial analysis were implemented concurrently. Results The mothers participating in the NFP program were very positive about their experiences in the program. Three overarching themes emerged from the data: 1. Getting into the NFP program; 2. The NFP nurse is an expert, but also like a friend providing support; and 3. Participating in the NFP program is making me a better parent. Conclusions Our findings provide vital information to home visiting nurses and to planners of home visiting programs about mothers' perspectives on what is important to them in their relationships with their nurses, how nurses and women are able to develop positive therapeutic relationships, and how nurses respond to mothers' unique life situations while home visiting within the NFP Program. In addition our findings offer insights into why and under what circumstances low income mothers will engage in nurse home visiting and how they expect to benefit from their participation. PMID:22953748

42 CFR 431.707 - Standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... be met by individuals in order to be licensed as a nursing home administrator. (b) The standards must be designed to insure that nursing home administrators are— (1) Of good character; (2) Otherwise... ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION State Programs for Licensing Nursing Home...

42 CFR 431.707 - Standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION State Programs for Licensing Nursing Home... be met by individuals in order to be licensed as a nursing home administrator. (b) The standards must be designed to insure that nursing home administrators are— (1) Of good character; (2) Otherwise...

The Home Instruction Program for Preschool Youngsters (HIPPY).

PubMed

Baker, A J; Piotrkowski, C S; Brooks-Gunn, J

1999-01-01

The Home Instruction Program for Preschool Youngsters (HIPPY) is a two-year home-based early education intervention program designed to help parents with limited formal education prepare their four- and five-year-old children for school. This article begins with a brief overview of the HIPPY program and then presents the findings from a series of interconnected research studies, including a two-site, two-cohort evaluation in New York and Arkansas, a one-site case study, and a three-site qualitative study. With respect to program effectiveness, results varied across the New York and Arkansas sites and across participating cohorts at each site. For Cohort I, children who had been enrolled in HIPPY scored higher than children in the control/comparison groups on measures of cognitive skills (New York), classroom adaptation (New York and Arkansas), and standardized reading (New York); and more children were promoted to first grade (Arkansas). For Cohort II, comparison group children outperformed HIPPY children on school readiness and standardized achievement at posttest (Arkansas). Analyses to account for the differing results between cohorts were inconclusive. Qualitative analyses revealed considerable variation in parent involvement in HIPPY. Program staff identified four patterns of attrition from HIPPY: (1) early attrition within the first month after enrollment, (2) attrition between the program's first and second years, (3) attrition due to changes in the life circumstances of participating families, and (4) attrition due to turnover among the home visitors. Families were more likely to participate in in-home than out-of-home aspects of the program (for example, group meetings), but different family characteristics were associated with participation in the in- and out-of-home aspects of the program. The authors conclude with recommendations for future practice and research.

Making the transition from lead poisoning prevention to healthy homes: a qualitative study.

PubMed

Maring, Elisabeth F; Singer, Barbara Jones; Shenassa, Edmond D

2010-01-01

The goal of this study was to create a guide for programs considering transition from Lead Poisoning Prevention to Healthy Homes. Healthy Homes programs are comprehensive, focusing on multiple residential housing hazards. This study focused on the Baltimore City Healthy Homes Division, which was selected by the Centers for Disease Control and Prevention to pilot the transition process. For this qualitative study, data were collected through interviews with program staff from the Baltimore City Healthy Homes Division and followed up by focus groups with community members who received its services. Grounded theory procedures were used for data analysis. Interviews and focus groups were conducted in Baltimore City near the Health Department. Seventeen interviews were conducted with Baltimore City Healthy Homes Division staff. Three focus groups were held with 3 to 6 community participants in each group. Findings for the study are arranged around an organizational framework for which transition from Lead Poisoning Prevention to Healthy Homes is the central phenomenon. Three general themes emerged: (1) programmatic changes; (2) policy changes; and (3) partnerships. Quotations from participating staff and community members provide supporting evidence for the results. Findings provide insight into the strengths and challenges of transition for 1 program. The study has implications for change on a national level as programs around the country transition to provide families with comprehensive Healthy Homes services.

78 FR 48689 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... perceptions of the fathers regarding the programs. The findings will be of broad interest to many home..., perceptions, and opinions of the home visiting program and experiences with the program. Respondents...

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

PubMed

Phillips, Charles D

2015-01-01

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

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

PubMed Central

Phillips, Charles D.

2015-01-01

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

Teaching home safety and survival skills to latch-key children: a comparison of two manuals and methods.

PubMed Central

Peterson, L

1984-01-01

I evaluated the influence of two training manuals on latch-key children's acquisition of home safety and survival skills. The widely used, discussion-oriented "Prepared for Today" manual was compared with a behaviorally oriented "Safe at Home" manual. Data were scored by response criteria developed by experts and by parents' and experts' ratings of children's spontaneous answers. With both methods of scoring, three behaviorally trained children demonstrated clear and abrupt increases in skill following training in each of seven trained modules, and these increases largely persisted in real world generalization probes and at 5-month follow-up. Smaller and less stable increases in skill were found in the three discussion-trained children across the seven modules; lower skill levels were also seen in real world generalization probes and at follow-up. Neither group of children demonstrated skill increases in home safety areas that were not explicitly trained. Both training methods produced small decreases in children's self-report of general anxiety and anxiety concerning home safety. Results are discussed in terms of their implications for cost-effective training of latch-key children. PMID:6511698

The Case of an In-Home Recreation Program for an Older Adult in a Naturally Occurring Retirement Community (NORC).

ERIC Educational Resources Information Center

Chow, Yvette

2002-01-01

Describes the implementation of an in-home therapeutic recreation (TR) program with an elderly woman living in a naturally occurring retirement community (NORC) by a fourth-year TR student. The program helped meet her physical, social, and cognitive needs and re-stimulate her interests. Results suggest that in-home TR can be beneficial, and TR…

Does Family Make a Difference? Mid-Term Effects of a School/Home-Based Intervention Program to Enhance Reading Motivation

ERIC Educational Resources Information Center

Villiger, Caroline; Niggli, Alois; Wandeler, Christian; Kutzelmann, Sabine

2012-01-01

This study examined the effects of a school/home-based intervention program designed to enhance the reading motivation and comprehension of Swiss fourth graders (N = 713). In order to identify the specific contribution of the home environment, the program was implemented in one group "without" (N = 244) and in one group "with"…

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…

Links between Home and School among Low-Income Mexican-American and European-American Families. Educational Practice Report: 9.

ERIC Educational Resources Information Center

Azmitia, Margarita; And Others

This report shows that, in low-income Mexican-American and European-American families, children's everyday learning activities at home and aspirations of parents for their children's future are key elements in home-school linkages. Two models of home-school linkages are reviewed: the cultural match/mismatch model and the two-way partnership…

Stakeholders' Voices: Defining Needs of Students with Emotional and Behavioral Disorders Transitioning between School Settings.

PubMed

Buchanan, Rohanna; Nese, Rhonda N T; Clark, Miriam

2016-05-01

Students with emotional and behavioral disorders (EBD) too often do not receive adequate services or care in their school settings, particularly during transitions in educational placements. In addition, school support teams often struggle with creating transition plans that honor the needs of students with input from key stakeholders responsible for supporting student success. This article presents findings from the information-gathering phase of an iterative project that aims to develop a support program for students with EBD transitioning from day-treatment schools to district schools. We conducted 5 semistructured, qualitative focus groups with parents and teachers to explore needs during students' transitions between school settings. Five themes emerged from the focus groups: (a) consistent, behavior-specific feedback and positive reinforcement are vital to sustaining learned prosocial skills; (b) students benefit from regular opportunities to learn and practice social skills; (c) transition programming should emphasize communication between school and home; (d) routines at home and school should be coordinated; and (e) parents need support at school meetings. We will use findings from this study to develop a multifaceted intervention that aims to support students, their caregivers, and their teachers during transitions between the aforementioned types of schools.

Stakeholders’ Voices: Defining Needs of Students with Emotional and Behavioral Disorders Transitioning between School Settings

PubMed Central

Buchanan, Rohanna; Nese, Rhonda N. T.; Clark, Miriam

2017-01-01

Students with emotional and behavioral disorders (EBD) too often do not receive adequate services or care in their school settings, particularly during transitions in educational placements. In addition, school support teams often struggle with creating transition plans that honor the needs of students with input from key stakeholders responsible for supporting student success. This article presents findings from the information-gathering phase of an iterative project that aims to develop a support program for students with EBD transitioning from day-treatment schools to district schools. We conducted 5 semistructured, qualitative focus groups with parents and teachers to explore needs during students’ transitions between school settings. Five themes emerged from the focus groups: (a) consistent, behavior-specific feedback and positive reinforcement are vital to sustaining learned prosocial skills; (b) students benefit from regular opportunities to learn and practice social skills; (c) transition programming should emphasize communication between school and home; (d) routines at home and school should be coordinated; and (e) parents need support at school meetings. We will use findings from this study to develop a multifaceted intervention that aims to support students, their caregivers, and their teachers during transitions between the aforementioned types of schools. PMID:29706679

Alabama SEP Final Technical Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grimes, Elizabeth M.

Executive Summary In the fall of 2010, the Alabama Department of Economic and Community Affairs (ADECA) launched the Multi-State Model for Catalyzing the National Home Energy Retrofit Market Project (Multi-State Project). This residential energy efficiency pilot program was a collaborative effort among the states of Alabama, Massachusetts, Virginia, and Washington, and was funded by competitive State Energy Program (SEP) awards through the U.S. Department of Energy (DOE). The objective of this project was to catalyze the home energy efficiency retrofit market in select areas within the state of Alabama. To achieve this goal, the project addressed a variety of marketplacemore » elements that did not exist, or were underdeveloped, at the outset of the effort. These included establishing minimum standards and credentials for marketplace suppliers, educating and engaging homeowners on the benefits of energy efficiency and addressing real or perceived financial barriers to investments in whole-home energy efficiency, among others. The anticipated effect of the activities would be increased market demand for retrofits, improved audit to retrofit conversion rates and growth in overall community understanding of energy efficiency. The four-state collaborative was created with the intent of accelerating market transformation by allowing each state to learn from their peers, each of whom possessed different starting points, resources, and strategies for achieving the overall objective. The four partner states engaged the National Association of State Energy Officials (NASEO) to oversee a project steering committee and to manage the project evaluation for all four states. The steering committee, comprised of key program partners, met on a regular basis to provide overall project coordination, guidance, and progress assessment. While there were variances in program design among the states, there were several common elements: use of the Energy Performance Score (EPS) platform; an audit and home energy rating tool; emphasis on community based coordination and partnerships; marketing and outreach to increase homeowner participation; training for market actors; access to financing options including rebates, incentives, and loan products; and an in depth process evaluation to support continual program improvement and analysis. In Alabama, Nexus Energy Center operated energy efficiency retrofit programs in Huntsville and Birmingham. In the Huntsville community the AlabamaWISE program was available in five Alabama counties: Cullman, Lawrence, Limestone, Madison, and Morgan. In Birmingham, the program was available to residents in Jefferson and Shelby Counties. In both communities, the program was similar in terms of program design but tailored marketing and partnerships to address the unique local conditions and population of each community. ADECA and the Southeast Energy Efficiency Alliance (SEEA) provided overall project management services and common resources to the local program administrator Nexus Energy Center, including contracted services for contractor training, quality assurance testing, data collection and reporting, and compliance. The fundamental components of the AlabamaWISE program included a vertical contractor-based business model; comprehensive energy assessments; third-party quality assurance; rebates for installation of energy saving measures; accessible, low-interest financing; targeted and inbound marketing; Energy Performance Score (EPS) tool to engage and educate homeowners; training for auditors, contractors, and real estate professionals; and online resources for education and program enrollment. Program participants were eligible to receive rebates or financing toward the assessments and upgrades to their home provided they reached at least 20 percent deemed or modeled energy savings. The design of each program focused on addressing several known barriers including: limited homeowner knowledge on the benefits of energy efficiency, lack of financing options, lack of community support for energy efficiency programs, and lack of trained market actors including contractors and real estate professionals. The programs were able to make progress on addressing all of these barriers and were most successful in offering financing options and training market actors. The most challenging barriers proved to be the act of building a market for energy efficiency where none previously existed, convincing homeowners of the value in investing in energy efficiency (and therefore completing retrofits), engaging electric and natural gas utilities to partner on delivery, and achieving the overall project target of 1,365 completed retrofits. The components that proved to be the most valuable to program success were engaged contractor networks that could promote and endorse the program, partnerships with local business and organizations, and the access to rebates, incentives and financing mechanisms. The programs were successful in building relationships with a variety of community participants including: local contractors, Associations of REALTORS, home builders associations, universities, utilities, local and state governments, and other non-profit organizations. Throughout this program, 933 building audits and 795 building retrofits were completed making homes in Alabama more comfortable, less expensive to operate, more valuable to the marketplace, and safer and healthier for families. Continuing on this momentum, Nexus Energy Center plans to continue operating and expanding operations in Alabama as a Home Performance with ENERGY STAR sponsor and will continue to provide energy services and education to communities in Alabama.« less

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

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.

Technology Solutions Case Study: Zero Energy Ready Home and the Challenge of Hot Water on Demand

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

Production builders in the Stapleton community of Denver, Colorado, now build 2,300-ft2 or larger homes that earn the U.S. Environmental Protection Agency (EPA) ENERGY STAR® through the Certified Homes Program, Version 3. These builders are repositioning to build comparably sized homes to the standards of the U.S. Department of Energy’s (DOE’s) Zero Energy Ready Home (ZERH) program. Most ZERH criteria align closely with ENERGY STAR and are familiar to these builders.

Adverse drug events and medication problems in "Hospital at Home" patients.

PubMed

Mann, Elizabeth; Zepeda, Orlando; Soones, Tacara; Federman, Alex; Leff, Bruce; Siu, Albert; Boockvar, Kenneth

2018-03-26

"Hospital at Home(HaH)" programs provide an alternative to traditional hospitalization. However, the incidence of adverse drug events in these programs is unknown. This study describes adverse drug events and potential adverse drug events in a new HaH program. We examined the charts of the first 50 patients admitted. We found 45 potential adverse drug events and 14 adverse drug events from admission to 30 days after HaH discharge. None of the adverse drug events were severe. Some events, like problems with medication administration, may be unique to the hospital at home setting. Monitoring for adverse drug events is feasible and important for hospital at home programs.

The home stroke rehabilitation and monitoring system trial: a randomized controlled trial.

PubMed

Linder, Susan M; Rosenfeldt, Anson B; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Bay, Curtis R; Wolf, Steven L; Alberts, Jay L

2013-01-01

Because many individuals poststroke lack access to the quality and intensity of rehabilitation to improve upper extremity motor function, a home-based robotic-assisted upper extremity rehabilitation device is being paired with an individualized home exercise program. The primary aim of this project is to determine the effectiveness of robotic-assisted home therapy compared with a home exercise program on upper extremity motor recovery and health-related quality of life for stroke survivors in rural and underserved locations. The secondary aim is to explore whether initial degree of motor function of the upper limb may be a factor in predicting the extent to which patients with stroke may be responsive to a home therapy approach. We hypothesize that the home exercise program intervention, when enhanced with robotic-assisted therapy, will result in significantly better outcomes in motor function and quality of life. A total of 96 participants within six-months of a single, unilateral ischemic, or hemorrhagic stroke will be recruited in this prospective, single-blind, multisite randomized clinical trial. The primary outcome is the change in upper extremity function using the Action Research Arm Test. Secondary outcomes include changes in: upper extremity function (Wolf Motor Function Test), upper extremity impairment (upper extremity portion of the Fugl-Meyer Test), self-reported quality of life (Stroke Impact Scale), and affect (Centers for Epidemiologic Studies Depression Scale). Similar or greater improvements in upper extremity function using the combined robotic home exercise program intervention compared with home exercise program alone will be interpreted as evidence that supports the introduction of in-home technology to augment the recovery of function poststroke. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Going to Bed with Captain Marvel and a Flashlight Is Not a Home Reading Program

ERIC Educational Resources Information Center

Greenfeld, Stuart

1971-01-01

Described is a home reading program for educationally disadvantaged elementary school children who need motivation to read at home. Principles of behavior change and parent role are the major motivation factors used in developing the children's reading ability. (CB)

Coordinated Home Care Training Manual.

ERIC Educational Resources Information Center

Michigan Univ., Ann Arbor. Home Care Training Center.

This manual is intended as a source of information and assistance in the planning, organization, implementation, and evaluation of home care programs. There are ten major sections: (1) Introduction (review of the history of home care and definition of pertinent terms), (2) Program Planning, (3) Organizational Structure, (4) Coordination and…

24 CFR 954.500 - Repayment of investment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Repayment of investment. 954.500... DEVELOPMENT INDIAN HOME PROGRAM Program Administration § 954.500 Repayment of investment. (a) HOME funds will be made available pursuant to a HOME Investment Partnership Agreement. The agreement ensures that...

Children in Transition: The Salvation Army Playschool and Home Visiting Program.

ERIC Educational Resources Information Center

Toelle, Miriam E.; Kerwin, Sheila

1988-01-01

The Salvation Army Emergency Lodge in Chicago, Illinois, provides a playschool and home visitation program for homeless children and families who have recently found homes. The lodge temporarily houses families, and the playschool gives children a protective, supportive environment during their stay. (SKC)

47 CFR 76.802 - Disposition of cable home wiring.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Cable Inside Wiring § 76.802 Disposition of cable home wiring... alternative video programming service provider connects its wiring to the home wiring before the incumbent... alternative video programming service provider shall be responsible for ensuring that the incumbent's wiring...

A preschool program for safety and injury prevention delivered by home visitors

PubMed Central

Johnston, B; Britt, J; D'Ambrosio, L; Mueller, B; Rivara, F

2000-01-01

Objective—To evaluate the feasibility, acceptability, and effectiveness of an injury prevention program delivered by school based home visitors to the families of low income children attending preschool enrichment programs in Washington State. Study sample—The families of children attending preschool Head Start programs in two regions were eligible. A total of 213 families (77.8% of those eligible) from intervention sites, and 149 families (71.9% of those eligible) from concurrent comparison sites, agreed to participate and completed the trial. Intervention—Trained school personnel conducted home safety inspections as part of a planned home visit. Intervention families were offered educational materials as well as smoke detectors, batteries, ipecac, and age appropriate car safety restraints based on results of the home inspection. Evaluation methods—At a repeat home visit three months later, the proportion of families with a positive change in injury prevention knowledge or behavior among those in the intervention group was compared with the proportion in the comparison group. Smoke detector presence and function were observed. Results—Among families without a working smoke detector at baseline, the intervention was associated with an increased probability of having a working detector at follow up (relative risk (RR) 3.3, 95% confidence interval (CI) 1.3 to 8.6). Intervention families were also more likely to report the presence of ipecac in the home (RR 4.7, 95% CI 3.0 to 7.3) at follow up and to have obtained an age appropriate booster seat (RR 4.1, 95% CI 1.9 to 8.8). The program was acceptable to client families and to the home visitors who conducted the intervention. Conclusions—Among the families of low income children enrolled in preschool enrichment programs, home safety inspections and the distribution of safety supplies by school based home visitors appears to improve knowledge and behavior related to poisoning, smoke detector installation, and car safety seat use over three months of follow up. PMID:11144634

Home Start Followup Study: A Study of Long-Term Impact of Home Start on Program Participants. Executive Summary.

ERIC Educational Resources Information Center

Bache, William; Nauta, Marrit J.

This paper provides a summary of a Home Start Followup Study (HSFS) which was initiated in 1976. An attempt was made to examine the durability of gains made as the result of families' (parents and their 3- to 5-year-old children) participation in the program. In addition, the study was designed to determine whether program duration (one versus two…

38 CFR 58.13 - VA Form 10-10SH-State Home Program Application for Veteran Care Medical Certification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-10SH-State Home Program Application for Veteran Care Medical Certification. 58.13 Section 58.13 Pensions, Bonuses... Home Program Application for Veteran Care Medical Certification. ER29AP09.150 ER29AP09.151 ER29AP09.152...

From Discovery to Justification: Outline of an Ideal Research Program in Empirical Psychology

PubMed Central

Witte, Erich H.; Zenker, Frank

2017-01-01

The gold standard for an empirical science is the replicability of its research results. But the estimated average replicability rate of key-effects that top-tier psychology journals report falls between 36 and 39% (objective vs. subjective rate; Open Science Collaboration, 2015). So the standard mode of applying null-hypothesis significance testing (NHST) fails to adequately separate stable from random effects. Therefore, NHST does not fully convince as a statistical inference strategy. We argue that the replicability crisis is “home-made” because more sophisticated strategies can deliver results the successful replication of which is sufficiently probable. Thus, we can overcome the replicability crisis by integrating empirical results into genuine research programs. Instead of continuing to narrowly evaluate only the stability of data against random fluctuations (discovery context), such programs evaluate rival hypotheses against stable data (justification context). PMID:29163256

Ridesharing: Transportation demand management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Valdez, R.; Wang, J.; Flynn, C.P.

1989-01-01

The 13 papers in the report deal with the following areas: Comparison of transportation demand management market research study results and transportation management association development in three suburban activity centers; Ten cities' strategies for transportation demand management; Key considerations for developing local government transportation system management programs; First Hill Action Plan: A unique public/private approach to transportation demand management; Comparison of travel behavior before and after the opening of HOV lanes in a suburban travel corridor; Evaluation of Springfield instant carpooling; George Washington Bridge bus-carpool lane: 1-Year Operational Report; Guaranteed Ride Home: An insurance program for HOV users; Evaluation ofmore » Ridefinders and Central Richmond Association's transportation and parking information service; Vanpools: Pricing and market penetration; Cost-effectiveness of private employer ridesharing programs: An employer's assessment; Temporal analysis of handicapped ridership in specialized transportation service: Lexington/Fayette County experience; Characterization of the 'publico' system of Puerto Rico.« less

Wisconsin Twin Research: early development, childhood psychopathology, autism, and sensory over-responsivity.

PubMed

Schmidt, Nicole L; Van Hulle, Carol A; Brooker, Rebecca J; Meyer, Lauren R; Lemery-Chalfant, Kathryn; Goldsmith, H Hill

2013-02-01

The Wisconsin Twin Research Program comprises multiple longitudinal studies that utilize a panel recruited from statewide birth records for the years 1989 through 2004. Our research foci are the etiology and developmental course of early emotions, temperament, childhood anxiety and impulsivity, autism, sensory over-responsivity, and related topics. A signature feature of this research program is the breadth and depth of assessment during key periods of development. The assessments include extensive home- and laboratory-based behavioral batteries, recorded sibling and caregiver interactions, structured psychiatric interviews with caregivers and adolescents, observer ratings of child behavior, child self-report, cognitive testing, neuroendocrine measures, medical records, dermatoglyphics, genotyping, and neuroimaging. Across the various studies, testing occasions occurred between 3 months and 18 years of age. Data collection for some aspects of the research program has concluded and, for other aspects, longitudinal follow-ups are in progress.

Wisconsin Twin Research: Early Development, Childhood Psychopathology, Autism, and Sensory Over-responsivity

PubMed Central

Schmidt, Nicole L.; Van Hulle, Carol; Brooker, Rebecca J.; Meyer, Lauren R.; Lemery-Chalfant, Kathryn; Goldsmith, H. H.

2012-01-01

The Wisconsin Twin Research Program comprises multiple longitudinal studies that utilize a panel recruited from statewide birth records for the years 1989 through 2004. Our research foci are the etiology and developmental course of early emotions, temperament, childhood anxiety and impulsivity, autism, sensory over-responsivity, and related topics. A signature feature of this research program is the breadth and depth of assessment during key periods of development. The assessments include extensive home and laboratory-based behavioral batteries, recorded sibling and caregiver interactions, structured psychiatric interviews with caregivers and adolescents, observer ratings of child behavior, child self-report, cognitive testing, neuroendocrine measures, medical records, dermatoglyphics, genotyping, and neuroimaging. Across the various studies, testing occasions occurred between 3 months and 18 years of age. Data collection for some aspects of the research program has concluded and, for other aspects, longitudinal follow-ups are in progress. PMID:23200241

Would environmental pollution affect home prices? An empirical study based on China's key cities.

PubMed

Hao, Yu; Zheng, Shaoqing

2017-11-01

With the development of China's economy, the problem of environmental pollution has become increasingly more serious, affecting the sustained and healthy development of Chinese cities and the willingness of residents to invest in fixed assets. In this paper, a panel data set of 70 of China's key cities from 2003 to 2014 is used to study the effect of environmental pollution on home prices in China's key cities. In addition to the static panel data regression model, this paper uses the generalized method of moments (GMM) to control for the potential endogeneity and introduce the dynamics. To ensure the robustness of the research results, this paper uses four typical pollutants: per capita volume of SO 2 emissions, industrial soot (dust) emissions, industrial wastewater discharge, and industrial chemical oxygen demand discharge. The analysis shows that environmental pollution does have a negative impact on home prices, and the magnitude of this effect is dependent on the level of economic development. When GDP per capita increases, the size of the negative impact on home prices tends to reduce. Industrial soot (dust) has the greatest impact, and the impact of industrial wastewater is relatively small. It is also found that some other social and economic factors, including greening, public transport, citizen income, fiscal situation, loans, FDI, and population density, have positive effects on home prices, but the effect of employment on home prices is relatively weak.

Motions and functional performance after supervised physical therapy program versus home-based program after arthroscopic anterior shoulder stabilization: a randomized clinical trial.

PubMed

Ismail, M M; El Shorbagy, K M

2014-01-01

To compare the effects of a standardized supervised physical therapy versus a controlled home-based programs on the rate of shoulder motion and functional recovery after arthroscopic anterior shoulder stabilization. Twenty-seven patients (18-35years) underwent arthroscopic anterior shoulder stabilization. Patients were randomized into two groups. A supervised group (n=14) received a rehabilitation program, 3 sessions/week for 24 weeks and a controlled home treated group (n=13) who followed a home-based program for same period. Range of motion (ROM) of the shoulder was assessed 4 times after each phase of rehabilitation and function was assessed after the 3rd and 4th phase of rehabilitation. Both groups achieved a significant progressive increase in all shoulder motions throughout the study period. Patients in the supervised group achieved 92.6% and 94.2% of the contralateral side in abduction and forward elevation respectively. The controlled home-based group achieved 87.1% and 94.7% of abduction and forward elevation respectively. For external rotation, the percentage ROM achieved was 81.1% for the supervised group and 76.4% for the controlled home-based group. For function assessment, the two groups showed a significant improvement. However, the two groups were not significantly different from each other in all measured variables. A controlled home-based physical therapy program is as effective as a supervised program in increasing shoulder range of motion and function after arthroscopic anterior shoulder stabilization. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Home-based intermediate care program vs hospitalization

PubMed Central

Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

2008-01-01

OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P < .001), used more community care services following discharge (coefficient $729, P = .007), and were more likely to be readmitted to hospital within 3 months of discharge (coefficient 17%, P = .012) than patients treated in hospital. Total substituted costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

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.

Affecting culture change and performance improvement in Medicaid nursing homes: the Promote Understanding, Leadership, and Learning (PULL) Program.

PubMed

Eliopoulos, Charlotte

2013-01-01

A growing number of nursing homes are implementing culture change programming to create a more homelike environment in which residents and direct care staff are empowered with greater participation in care activities. Although nursing homes that have adopted culture change practices have brought about positive transformation in their settings that have improved quality of care and life, as well as increased resident and staff satisfaction, they represent a minority of all nursing homes. Nursing homes that serve primarily a Medicaid population without supplemental sources of funding have been limited in the resources to support such change processes. The purpose of this project was to gain insight into effective strategies to provide culture change and quality improvement programming to low-performing, under-resourced nursing homes that represent the population of nursing homes least likely to have implemented this programming. Factors that interfered with transformation were identified and insights were gained into factors that need to be considered before transformational processes can be initiated. Effective educational strategies and processes that facilitate change in these types of nursing homes were identified. Despite limitations to the study, there was evidence that the experiences and findings can be of value to other low-performing, under-resourced nursing homes. Ongoing clinical work and research are needed to refine the implementation process and increase the ability to help these settings utilize resources and implement high quality cost effective care to nursing home residents. Copyright © 2013 Mosby, Inc. All rights reserved.

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…

A diaper bank and home visiting partnership: Initial exploration of research and policy questions.

PubMed

Sadler, Lois S; Condon, Eileen M; Deng, Shirley Z; Ordway, Monica Roosa; Marchesseault, Crista; Miller, Andrea; Alfano, Janet Stolfi; Weir, Alison M

2018-03-01

The cost of diapering an infant can place a significant financial strain on families living in poverty. Partnerships between diaper banks and home visiting programs for young families may offer an innovative solution to expanding the reach and impact of diaper banks in low-income communities. The purpose of this pilot study was to uncover preliminary information about the functions of diaper distribution through home visiting programs, and to inform future research and policy questions regarding diaper distribution to families in need. In this descriptive qualitative pilot study, semi-structured interviews were conducted with 6 home visitors from Minding the Baby ® (MTB), a home visiting intervention for young parents. MTB clinicians routinely distribute diapers in partnership with The Diaper Bank in Connecticut. We used directed content analysis to code and analyze interview transcripts. These preliminary findings indicate that partnerships between home visiting programs and diaper banks may benefit families by improving diaper access, reducing stigma, and fostering trusting relationships with home visitors. Home visiting program benefits including engagement or re-engagement with families may need to be balanced with potential effects on clinical and therapeutic relationships. Recommendations for next steps in research and related policy questions are discussed. © 2017 Wiley Periodicals, Inc.

A diaper bank and home visiting partnership: Initial exploration of research and policy questions

PubMed Central

Sadler, Lois S.; Condon, Eileen M.; Deng, Shirley Z.; Ordway, Monica Roosa; Marchesseault, Crista; Miller, Andrea; Alfano, Janet Stolfi; Weir, Alison M.

2018-01-01

Objectives The cost of diapering an infant can place a significant financial strain on families living in poverty. Partnerships between diaper banks and home visiting programs for young families may offer an innovative solution to expanding the reach and impact of diaper banks in low-income communities. The purpose of this pilot study was to uncover preliminary information about the functions of diaper distribution through home visiting programs, and to inform future research and policy questions regarding diaper distribution to families in need. Design and Sample In this descriptive qualitative pilot study, semi-structured interviews were conducted with 6 home visitors from Minding the Baby® (MTB), a home visiting intervention for young parents. MTB clinicians routinely distribute diapers in partnership with The Diaper Bank in Connecticut. We used directed content analysis to code and analyze interview transcripts. Results/Conclusion These preliminary findings indicate that partnerships between home visiting programs and diaper banks may benefit families by improving diaper access, reducing stigma, and fostering trusting relationships with home visitors. Home visiting program benefits including engagement or re-engagement with families may need to be balanced with potential effects on clinical and therapeutic relationships. Recommendations for next steps in research and related policy questions are discussed. PMID:29235668

Creating a successful culturally sensitive home care program.

PubMed

Blanter, R; Page, P M

1995-12-01

Providing quality home care services to immigrants requires an integrated, holistic approach that genuinely addresses language and cultural differences. One home care agency in Massachusetts developed a team-oriented, culturally sensitive outreach program that ensures non-English-speaking patients the same level of service that the general population receives.

Pre-Employment Laboratory Education. Home Furnishings/Interior Design Guidebook.

ERIC Educational Resources Information Center

Texas Tech Univ., Lubbock. Home Economics Instructional Materials Center.

This guidebook is designed for use in teaching students enrolled in pre-employment laboratory education (PELE) home furnishing/interior design programs. The first of two major sections includes an overview for teachers on planning, conducting, and evaluating a home furnishings/interior design program. Specific topics discussed in section 1 include…

Actualizing culture change: The Promoting Excellent Alternatives in Kansas Nursing Homes (PEAK 2.0) program.

PubMed

Doll, Gayle A; Cornelison, Laci J; Rath, Heath; Syme, Maggie L

2017-08-01

Nursing homes have been challenged in their attempts to achieve deep, organizational change (i.e., culture change) aimed at providing quality of care and quality of life for nursing home residents through person-centered care. To attain deep change, 2 well-defined components must be in place: a shared understanding of (a) the what, or content goals, and (b) the how, or process of change. However, there are few examples of this at a macro or micro level in long-term care. In an effort to enact true culture change in nursing homes statewide, the Kansas Department for Aging and Disability Services implemented the Promoting Excellent Alternatives in Kansas Nursing Homes program. This program is a Medicaid, pay-for-performance program that formalizes the content and process of achieving culture change through person-centered care principles. This article aims to detail the content (what) and process (how) of a model macro-level program of culture change throughout the State of Kansas. Applications to the micro level (individual homes) are presented, and implications for psychologists' roles in facilitating culture change are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Implementing the Namaste Care Program for residents with advanced dementia: exploring the perceptions of families and staff in UK care homes.

PubMed

Stacpoole, Min; Hockley, Jo; Thompsell, Amanda; Simard, Joyce; Volicer, Ladislav

2017-10-01

Increasing numbers of older people with advanced dementia are cared for in care homes. No cure is available, so research focused on improving quality of life and quality of care for people with dementia is needed to support them to live and die well. The Namaste Care programme is a multi-dimensional care program with sensory, psycho-social and spiritual components intended to enhance quality of life and quality of care for people with advanced dementia. The aim of the study was to establish whether the Namaste Care program can be implemented in UK care homes; and what effect Namaste Care has on the quality of life of residents with advanced dementia, their families and staff. This article explores the qualitative findings of the study, reporting the effect of the programme on the families of people with advanced dementia and care home staff, and presenting their perceptions of change in care. An organisational action research methodology was used. Focus groups and interviews were undertaken pre/post implementation of the Namaste Care program. The researcher kept a reflective diary recording data on the process of change. A comments book was available to staff and relatives in each care home. Data was analysed thematically within each care home and then across all care homes. Six care homes were recruited in south London: one withdrew before the study was underway. Of the five remaining care homes, four achieved a full Namaste Care program. One care home did not achieve the full program during the study, and another discontinued Namaste Care when the study ended. Every home experienced management disruption during the study. Namaste Care challenged normal routinised care for older people with advanced dementia. The characteristics of care uncovered before Namaste was implemented were: chaos and confusion, rushing around, lack of trust, and rewarding care. After the programme was implemented these perceptions were transformed, and themes of calmness, reaching out to each other, seeing the person, and, enhanced well-being, emerged. Namaste Care can enrich the quality of life of older people with advanced dementia in care homes. The program was welcomed by care home staff and families, and was achieved with only modest expenditure and no change in staffing levels. The positive impact on residents quality of life influenced the well-being of family carers. Care staff found the changes in care enjoyable and rewarding. Namaste Care was valued for the benefits seen in residents; the improvement in relationships; and the shift towards a person-centred, relationship-based culture of care brought about by introducing the program. Namaste Care deserves further exploration and investigation including a randomised controlled trial.

Teaching the Fundamentals of Cell Phones and Wireless Communications

NASA Astrophysics Data System (ADS)

Davids, Mark; Forrest, Rick; Pata, Don

2010-04-01

Wireless communications are ubiquitous. Students and teachers use iPhones®, BlackBerrys®, and other smart phones at home and at work. More than 275 million Americans had cell phones in June of 2009 and expanded access to broadband is predicted this year.2 Despite the plethora of users, most students and teachers do not understand "how they work." Over the past several years, three high school teachers have collaborated with engineers at Cingular, Motorola, and the University of Michigan to explore the underlying science and design a three-week, student-centered unit with a constructivist pedagogy consistent with the "Modeling in Physics" philosophy.3 This unique pilot program reinforces traditional physics topics including vibrations and waves, sound, light, electricity and magnetism, and also introduces key concepts in communications and information theory. This article will describe the motivation for our work, outline a few key concepts with the corresponding student activities, and provide a summary of the program that has been developed to engage and inspire the next generation of scientists, engineers, and citizens.

Work-Related Stressors Among Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Home Visitors: A Qualitative Study.

PubMed

Alitz, Paige J; Geary, Shana; Birriel, Pamela C; Sayi, Takudzwa; Ramakrishnan, Rema; Balogun, Omotola; Salloum, Alison; Marshall, Jennifer T

2018-05-31

Background The Florida Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program delivers evidence-based home visiting services to over 1400 families each year. Home visitors are integral in providing resources for families to promote healthy pregnancy, child development, family wellness, and self-sufficiency. Due to the nature of this work, home visitors experience work-related pressures and stressors that can impact staff well-being and retention. Objectives The purpose of this study was to understand primary sources of work-related stress experienced by home visitors, subsequent effects on their engagement with program participants, and to learn of coping mechanisms used to manage stress. Methods In 2015, Florida MIECHV program evaluators conducted ten focus groups with 49 home visitors during which they ranked and discussed their top sources of work-related stress. Qualitative analysis was conducted to identify emergent themes in work-related stressors and coping/supports. Results Across all sites, the burden of paperwork and data entry were the highest ranked work-related stressors perceived as interfering with home visitors' engagement with participants. The second-highest ranked stressors included caseload management, followed by a lack of resources for families, and dangerous environments. Home visitors reported gratification in their helping relationships families, and relied on coworkers or supervisors as primary sources of workplace support along with self-care (e.g. mini-vacations, recreation, and counseling). Conclusions for practice Florida MIECHV home visitors across all ten focus groups shared similar work-related stressors that they felt diminished engagement with program participants and could impact participant and staff retention. In response, Florida MIECHV increased resources to support home visitor compensation and reduce caseloads, and obtained a competitive award from HRSA to implement a mindfulness-based stress reduction training statewide.

Teaching qualitative research to BSW students through exposure to aging.

PubMed

Sidell, Nancy L

2007-01-01

This article describes one rural program's efforts to expose students to gerontology through teaching qualitative research methodology. A collaborative research pilot project was developed with a local nursing home. BSW students worked in two groups to conduct and present qualitative research projects by the course's completion. This article describes the research project and evaluates the project's success from student and instructor viewpoints. Significant differences were found in self-reported student knowledge of key concepts at the project's completion, compared with pre-test knowledge. Student comments revealed value in this teaching approach. Implications for further engaging students in gerontological research are discussed.

Defining the medical home: the Oregon experience.

PubMed

Stenger, Robert J; Smith, Jeanene; McMullan, J Bart; Rodriguez, Glenn S; Dorr, David A; Minniti, Mary; Jaffe, Arthur; Pollack, David; Anderson, Mitchell; Kilo, Charles M; Saultz, John W

2012-01-01

The patient-centered medical home (PCMH) is emerging as a key strategy to improve health outcomes, reduce total costs, and strengthen primary care, but a myriad of operational measures of the PCMH have emerged. In 2009, the state of Oregon convened a public, legislatively mandated committee charged with developing PCMH measures. We report on the process of, outcomes of, and lessons learned by this committee. The Oregon PCMH advisory committee was appointed by the director of the Oregon Department of Human Services and held 7 public meetings between October 2009 and February 2010. The committee engaged a diverse group of Oregon stakeholders, including a variety of practicing primary care physicians. The committee developed a PCMH measurement framework, including 6 core attributes, 15 standards, and 27 individual measures. Key successes of the committee's work were to describe PCMH core attributes and functions in patient-centered language and to achieve consensus among a diverse group of stakeholders. Oregon's PCMH advisory committee engaged local stakeholders in a process that resulted in a shared PCMH measurement framework and addressed stakeholders' concerns. The state of Oregon now has implemented a PCMH program using the framework developed by the PCMH advisory committee. The Oregon experience demonstrates that a brief public process can be successful in producing meaningful consensus on PCMH roles and functions and advancing PCMH policy.

Net Zero Energy Manufactured Homes May Be on their Way

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gilbride, Theresa L.; Dentz, Jordan

This article, published in Home Energy Magazine, describes a research project sponsored by the U.S. Department of Energy's Building America program, to construct and test the first manufactured home in the United States built to the performance criteria of DOE's Zero Energy Ready Home program. A 15-month study was conducted to compare the real-world performance of the DOE Zero Energy Ready home and two other manufactured homes - one built to just above industry standard construction and one built to the ENERGY STAR Certified Home criteria. The homes were built by Clayton Homes' Southern Energy Division and testing was sponsoredmore » by DOE's Building America program and conducted by the Levy Partnership. The DOE ZERH had increased initial construction costs of $6,607 compared to the standard home versus $4,340 for the ENERGY STAR home but reduced energy bills by $50 per month compared to a $33/month savings for the ENERGY STAR home, and monthly savings will continue for the life of the home. Savings were especially noticeable in the summer in this cooling-dominated test location. The DOE ZERH cut cooling costs in half compared to the ENERGY STAR home which performed only slightly better than the standard home in summer, while winter savings between the two advanced homes were more similar. Two technology advances were tested in the DOE ZERH home. Instead of the typical ducted heating and cooling system, the DOE ZERH home was equipped with a ductless heat pump; to condition the bedroom, holes were cut into bedroom walls and small fans were installed to pull air into those rooms, while door undercuts and transfer grilles provide return paths. A novel dense-pack attic insulation was also implemented.« less

Helping Older Adults Sustain Their Physical Therapy Gains: A Theory-Based Intervention to Promote Adherence to Home Exercise Following Rehabilitation.

PubMed

Gallagher, Kristel M

2016-01-01

The benefits of exercise gained by older adults during physical therapy are often not maintained once the program is over. This lack of sustained benefits is thought to be partially the result of poor adherence to the prescribed home exercise program to be continued once therapy is completed. Most of what is known about older adults' adherence to physical therapy and home exercise comes from research seeking to identify and understand predictors of adherence, rather than trying to enhance adherence explicitly. The purpose of this study was to test a theoretically grounded approach to promoting adherence to home exercise programs in older adults. Sixty older adults (M age = 69.3 (6.87) years) in a program of physical therapy received 1 of 2 print messages and magnets promoting adherence to home exercise. The content of the messages was informed by the goal-specific tenets of socioemotional selectivity theory-one message described the emotional and meaningful benefits of home exercise, such as time with loved ones and independence, and one message described facts and information about physiological benefits, such as balance and strength. Adherence to home exercise was measured 2 weeks after participants were discharged from physical therapy by calculating the percentage of the prescribed exercises participants reported completing at home. An analysis of covariance indicated that there was no statistically significant difference in adherence rates between participants receiving either message. However, a 2×2 analysis of covariance did reveal a significant interaction between the type of message participants received and the time at which they received that message. Post hoc analyses separately examined the rates of adherence in participants who received the intervention message with time remaining in their therapy program and participants who received the intervention message on the day of discharge. In the subset of participants who received their intervention message with time remaining in their therapy program, those who received the emotion and meaning message were somewhat more adherent to their home exercise program than those who received the facts and information message (63.6% vs 50.8%; P = .07). Those who received the emotion and meaning message also performed on average more exercises outside of their home exercise program (2.4 vs 1.3; P = .06). Despite lacking a statistically significant difference between message groups, the results of this study suggest that highlighting the emotional and meaningful benefits of home exercise versus providing facts and information about the physiological benefits may encourage older adults to be adherent to their home exercise programs. This may especially be the case if they receive the information while still in therapy. As this was the first study to empirically test an intervention targeting adherence to post-physical therapy home exercise in older adults, future research is needed to better understand what motivates older adults to be adherent.

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

A Cost-Effectiveness Comparision of Two Types of Occupational Home Economics Programs in the State of Kentucky. Final Report.

ERIC Educational Resources Information Center

Gabbard, Lydia Carol Moore

A study compared the cost effectiveness of secondary child care and commercial foods occupational home economics programs in Kentucky. Identified as dependent variables in the study were program effectiveness, cost efficiency, and cost effectiveness ratio. Program expenditures, community size, and program age were considered as independent…

Pulmonary rehabilitation. Sociedad Española de Neumología y Cirugía Torácica (SEPAR).

PubMed

Güell Rous, María Rosa; Díaz Lobato, Salvador; Rodríguez Trigo, Gema; Morante Vélez, Fátima; San Miguel, Marta; Cejudo, Pilar; Ortega Ruiz, Francisco; Muñoz, Alejandro; Galdiz Iturri, Juan Bautista; García, Almudena; Servera, Emilio

2014-08-01

Pulmonary rehabilitation (PR) has been shown to improve dyspnea, exercise capacity and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). PR has also shown benefits in diseases other than COPD but the level of evidence is lower. The fundamental components of PR programs are muscle training, education and chest physiotherapy. Occupational therapy, psychosocial support and nutritional intervention should also be considered. Home programs have been shown to be as effective as hospital therapy. The duration of rehabilitation programs should not be less than 8 weeks or 20 sessions. Early initiation of PR, even during exacerbations, has proven safe and effective. The use of oxygen or noninvasive ventilation during training is controversial and dependent on the patient's situation. At present, the best strategy for maintaining the benefits of PR in the long term is unknown. Longer PR programs or telemedicine could play a key role in extending the results obtained. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Educational and home-environment asthma interventions for children in urban, low-income, minority families.

PubMed

Welker, Kristen; Nabors, Laura; Lang, Myia; Bernstein, Jonathan

2018-02-08

This review examined the impact of environmental change and educational interventions targeting young children from minority groups living in urban environments and who were from low-income families. A scoping methodology was used to find research across six databases, including CINAHL, ERIC, PsycINFO, PubMed, MEDLINE, and EMBASE. 299 studies were identified. Duplicates were removed leaving 159 studies. After reviewing for inclusion and exclusion criteria, 23 manuscripts were identified for this study: 11 featured home-environment change interventions and 12 emphasized education of children. Studies were reviewed to determine key interventions and outcomes for children. Both environmental interventions and educational programs had positive outcomes. Interventions did not always impact health outcomes, such as emergency department visits. Results indicated many of the environmental change and education interventions improved asthma management and some symptoms. A multipronged approach may be a good method for targeting both education and change in the home and school environment to promote the well-being of young children in urban areas. New research with careful documentation of information about study participants, dose of intervention (i.e., number and duration of sessions, booster sessions) and specific intervention components also will provide guidance for future research.

A realist evaluation of value-based care delivery in home care: The influence of actors, autonomy and accountability.

PubMed

Dainty, Katie N; Golden, Brian R; Hannam, Rosemary; Webster, Fiona; Browne, Gina; Mittmann, Nicole; Stern, Anita; Zwarenstein, Merrick

2018-06-01

The increasing demand for home care is occurring in tandem with the need for governments to contain health care costs, maximize appropriate resource utilization and respond to patient preferences for where they receive care. We describe the evaluation of the Integrated Client Care Project (ICCP), a government funded project designed to improve value for outcomes for patients referred to community wound care services in Ontario, Canada. We applied a realist evaluation methodology in order to unpack the influences of contextual and mechanistic choices on the intended outcomes of the ICCP implementation. We collected data through ethnographic methods including 36 months of field observation, 46 key informant interviews and contemporaneous document analysis. The findings presented here highlight how theoretical mechanisms were negatively impacted by strong contextual patterns and weak implementation which led to underwhelming outcomes. Autonomy of the participant organizations, lack of power within the implementation team to drive change, opacity of the goals of the program, and disregard for the impact of complex historical relations within the home care sector compounded to undermine the intended outcome. Copyright © 2018 Elsevier Ltd. All rights reserved.

Around-the-clock nursing care for the elderly in Japan.

PubMed

Murashima, S; Zerwekh, J V; Yamada, M; Tagami, Y

1998-01-01

To describe the first phase of creating a Japanese model of community-based long-term care, called around-the-clock care (ACC), by operationally defining the components of ACC, identifying those eligible for the program, clarifying methods of planning and organization, and exploring outcomes. Exploratory evaluation for the population of frail elderly Japanese citizens living at home. A convenience sample of 44 patients receiving care from four visiting-nurse-service stations during 3 months in 1994 was used. Needs assessments; record reviews of patient encounters; evaluations by patients, families, and visiting nurses; and reviews of administrative data. Nurses perceived that ACC stabilized medical status, reduced the emotional and physical burden of treatment, and improved hygiene. It also reduced family caregiving burdens and the stress of family caregivers' employment responsibilities. The highest rating of ACC by patient and families was for those with the most complex physical needs. Skilled nursing at home permitted early identification and treatment of problems before they became crises or required hospitalization. Early findings suggest 24-hour nurse-home helper teamwork may be an effective system of community-based long-term care and should be considered a key element of future Japanese health policy.

Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial.

PubMed

Burton, Elissa; Lewin, Gill; Clemson, Lindy; Boldy, Duncan

2013-01-01

Restorative home care services are short-term and aimed at maximizing a person's ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults. A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention) or the structured exercise program currently being used in the service (control). Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability. There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program. Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes.

Designing, testing, and implementing a sustainable nurse home visiting program: right@home.

PubMed

Goldfeld, Sharon; Price, Anna; Kemp, Lynn

2018-05-01

Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence-based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

Geriatric Training Needs of Nursing-Home Physicians

ERIC Educational Resources Information Center

Lubart, Emily; Segal, Refael; Rosenfeld, Vera; Madjar, Jack; Kakuriev, Michael; Leibovitz, Arthur

2009-01-01

Medical care in nursing homes is not provided by board-licensed geriatricians; it mainly comes from physicians in need of educational programs in the field of geriatrics. Such programs, based on curriculum guidelines, should be developed. The purpose of this study was to seek input from nursing home physicians on their perceived needs for training…

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…

Pride in Parenting Training Program: A Curriculum for Training Lay Home Visitors.

ERIC Educational Resources Information Center

Jarrett, Marian H.; Katz, Kathy S.; Sharps, Phyllis; Schneider, Susan; Diamond, Linda T.

1998-01-01

Describes the Pride in Parenting Training Curriculum developed by an interdisciplinary team to reduce infant mortality in minority populations. The program has been used to train lay home visitors to deliver a home-visiting curriculum focused on effective use of health-care services and improved infant development. (Author/CR)

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…

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…

Head Start Home-Based Resource Directory.

ERIC Educational Resources Information Center

Trans-Management Systems, Inc.

A revision of the 1989 publication, this directory was compiled in order to help parents and professionals involved with Head Start home-based programming in meeting the needs of young children and families. The directory lists a broad range of guides and resources on topics related to Head Start home-based programs. Each listing provides the…

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…

75 FR 62413 - Notice of Proposed Information Collection: Comment Request; HUD-Owned Real Estate-Dollar Home...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-08

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5380-N-38] Notice of Proposed Information Collection: Comment Request; HUD- Owned Real Estate--Dollar Home Sales Program AGENCY: Office of... information: Title of Proposal: HUD-Owned Real Estate--Dollar Home Sales Program. OMB Control Number, if...

76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-26

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

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,…

New Research Strengthens Home Visiting Field: The Pew Home Visiting Campaign

ERIC Educational Resources Information Center

Doggett, Libby

2013-01-01

Extensive research has shown that home visiting parental education programs improve child and family outcomes, and they save money for states and taxpayers. Now, the next generation of research is deepening understanding of those program elements that are essential to success, ways to improve existing models, and factors to consider in tailoring…

Home Start Evaluation Study. Interim Case Studies IIa.

ERIC Educational Resources Information Center

Fein, Robert

This formative evaluation study of Home Start uses a case study approach. A brief case study focuses on the administrative structure and staff resources and responsibilities of National Home Start. Also included are reports on seven local programs developed after two field visits had been made to each program. In the first visit, objectives chosen…

Rethinking Teaching Nursing Homes: Potential for Improving Long-Term Care

ERIC Educational Resources Information Center

Mezey, Mathy D.; Mitty, Ethel L.; Burger, Sarah Green

2008-01-01

To meet the special needs of and provide quality health care to nursing home residents, the health care workforce must be knowledgeable about the aging process. Health professionals are minimally prepared in their academic programs to care for older adults, and few programs have required rotations in geriatrics. Teaching nursing homes (TNHs) have…

Home Visiting for At-Risk Preschoolers: A Successful Model for Latino Families

ERIC Educational Resources Information Center

Nievar, M. Angela; Jacobson, A.; Dier, S.

2008-01-01

The Home Instruction for Parents of Preschool Youngsters (HIPPY) program promotes school readiness by providing services directly to parents through home visitation. This study describes the outcomes of the HIPPY program for Latino immigrant families in a large Southwestern city. A quasi-experimental design compared 48 families on the program…

78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-26

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2013 Through June 30, 2014...

76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012...

Engaging Families in In-Home Family Intervention

ERIC Educational Resources Information Center

Thompson, Ronald W.; Koley, Sarah

2014-01-01

Boys Town has created a program called In-Home Family Services to deliver help to families in stress. In-home family intervention programs have become widely used to help more families who are at risk and experiencing difficulties with a wide range of problems including domestic violence, child behavior problems, parent-child and family…

The virtual dental home: a critique.

PubMed

Friedman, Jay W; Nash, David A; Mathu-Muju, Kavita R

2017-09-01

The Virtual Dental Home is a concept of the Pacific Center for Special Care of the Arthur A. Dugoni School of Dentistry in San Francisco. It is designed to improve access to dental care for underserved populations, specifically children and institutionalized adults. This article describes the development and implementation of the Virtual Dental Home, subsequently critiquing the concept. The criteria for a dental home are not met by the program. It is the equivalent of a traditional public oral health prevention and screening program, with the additional dimension of allowing dental hygienists and assistants to place interim glass ionomer restorations in dental cavities. The critique questions the need to insert a "cloud" dentist into the process. The routine utilization of radiographs is also challenged. The VDH not only lacks the attributes of a dental home, it has not been shown to be as efficient and effective as traditional programs staffed by dental hygienists and dental therapists. The article concludes by describing how programs utilizing dental therapists could address the deficiencies of the Virtual Dental Home, effectively improving access to oral health care for underserved populations. © 2017 American Association of Public Health Dentistry.

Nurses take center stage in private duty home care.

PubMed

Brackett, Nicole

2013-06-01

The Affordable Care Act gives America's largest group of health care providers--nurses--a unique chance to lead in improving outcomes, increasing patient satisfaction, and lowering costs. Nurses' roles continue to grow in settings from hospitals and long-term care facilities to home health and hospice agencies. Nurses are also key players in private duty home care, where they serve as care coordinators for clients. Working directly with doctors, therapists, in-home caregivers, and families, nurses are critical in delivering quality, seamless in-home care.

The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities.

PubMed

Bartels, Stephen J; Gill, Lydia; Naslund, John A

2015-01-01

The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA.

The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities

PubMed Central

Bartels, Stephen J.; Gill, Lydia; Naslund, John A.

2015-01-01

Abstract The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA. PMID:25811340

Tonsillitis

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Hoarseness

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Sinusitis

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... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Cholesteatoma

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... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

1996-2004 Trends in the Single-Family Housing Market: Spatial Analysis of the Residential Sector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anderson, Dave M.; Elliott, Douglas B.

2006-09-05

This report provides a detailed geographic analysis of two specific topics affecting the residential sector. First, we performed an analysis of new construction market trends using annual building permit data. We report summarized tables and national maps to help illustrate market conditions. Second, we performed a detailed geographic analysis of the housing finance market. We analyzed mortgage application data to provide citable statistics and detailed geographic summarization of the residential housing picture in the US for each year in the 1996-2004 period. The databases were linked to geographic information system tools to provide various map series detailing the results geographically.more » Looking at these results geographically may suggest potential new markets for TD programs addressing the residential sector that have not been considered previously. For example, we show which lenders affect which regions and which income or mortgage product classes. These results also highlight the issue of housing affordability. Energy efficiency R&D programs focused on developing new technology for the residential sector must be conscious of the costs of products resulting from research that will eventually impact the home owner or new home buyer. Results indicate that home values as a proportion of median family income in Building America communities are closely aligned with the national average of home value as a proportion of median income. Other key findings: • The share of home building and home buying activity continues to rise steadily in the Hot-Dry and Hot-Humid climate zones, while the Mixed-Humid and Cold climate zone shares continue to decline. Other zones remain relatively stable in terms of share of housing activity. • The proportion of home buyers having three times the median family income for their geography has been steadily increasing during the study period. • Growth in the Hispanic/Latino population and to a lesser degree in the Asian population has translated into proportional increases in share of home purchasing by both groups. White home buyers continue to decline as a proportion all home buyers. • Low interest rate climate resulted in lenders moving back to conventional financing, as opposed to government-backed financing, for cases that would be harder to financing in higher rate environments. Government loan products are one mechanism for affecting energy efficiency gains in the residential sector. • The rate environment and concurrent deregulation of the finance industry resulted unprecedented merger and acquisition activity among financial institutions during the study period. This study conducted a thorough accounting of this merger activity to inform the market share analysis provided. • The home finance industry quartiles feature 5 lenders making up the first quartile of home purchase loans, 18 lenders making up the second quartile, 111 lenders making up the third quartile, and the remaining nearly 8,000 lenders make up the fourth quartile.« less

Home-Learning Practices in Kenya: Views of Parents and Education Officers

ERIC Educational Resources Information Center

Nyatuka, Benard Omenge

2016-01-01

In order for children to acquire meaningful education, families are advised to participate in learning activities at home. Such activities range from monitoring homework, problem-solving to reading with children during leisure time. But home-learning was claimed to receive little attention from key stakeholders among primary schools in Kenya's…

ResStock - Targeting Energy and Cost Savings for U.S. Homes | NREL

Science.gov Websites

ResStock - Targeting Energy and Cost Savings for U.S. Homes Science and Technology Highlights Highlights in Research & Development ResStock - Targeting Energy and Cost Savings for U.S. Homes Key discovered $49 billion in potential annual utility bill savings through cost-effective energy efficiency

The Key to Me: Seniors' Perceptions of Relationship-Building with In-Home Service Providers

ERIC Educational Resources Information Center

Gantert, Thomas W.; McWilliam, Carol L.; Ward-Griffin, Catherine; Allen, Natalie J.

2008-01-01

Changing demographics and hospital downsizing have placed increasing demands on the home care sector. Many of those receiving in-home care are seniors whose chronic conditions require a collaborative approach. Both providers' paternalistic orientations toward senior clients and seniors' passivity within provider-client interactions have the…

The Family Home Environment, Food Insecurity, and Body Mass Index in Rural Children

ERIC Educational Resources Information Center

Jackson, Jennifer A.; Smit, Ellen; Branscum, Adam; Gunter, Katherine; Harvey, Marie; Manore, Melinda M.; John, Deborah

2017-01-01

Background. Family homes are a key setting for developing lifelong eating and physical activity habits, yet little is known about how family home nutrition and physical activity (FNPA) environments influence food insecurity (FI) and childhood obesity, particularly in rural settings. Aims. This study examined associations among FNPA, FI, and body…

The Cascading Effects of Multiple Dimensions of Implementation on Program Outcomes: a Test of a Theoretical Model.

PubMed

Berkel, Cady; Mauricio, Anne M; Sandler, Irwin N; Wolchik, Sharlene A; Gallo, Carlos G; Brown, C Hendricks

2017-12-14

This study tests a theoretical cascade model in which multiple dimensions of facilitator delivery predict indicators of participant responsiveness, which in turn lead to improvements in targeted program outcomes. An effectiveness trial of the 10-session New Beginnings Program for divorcing families was implemented in partnership with four county-level family courts. This study included 366 families assigned to the intervention condition who attended at least one session. Independent observers provided ratings of program delivery (i.e., fidelity to the curriculum and process quality). Facilitators reported on parent attendance and parents' competence in home practice of program skills. At pretest and posttest, children reported on parenting and parents reported child mental health. We hypothesized effects of quality on attendance, fidelity and attendance on home practice, and home practice on improvements in parenting and child mental health. Structural Equation Modeling with mediation and moderation analyses were used to test these associations. Results indicated quality was significantly associated with attendance, and attendance moderated the effect of fidelity on home practice. Home practice was a significant mediator of the links between fidelity and improvements in parent-child relationship quality and child externalizing and internalizing problems. Findings provide support for fidelity to the curriculum, process quality, attendance, and home practice as valid predictors of program outcomes for mothers and fathers. Future directions for assessing implementation in community settings are discussed.

Supervised rehabilitation versus home exercise in the treatment of acute ankle sprains: a systematic review.

PubMed

Feger, Mark A; Herb, C Collin; Fraser, John J; Glaviano, Neal; Hertel, Jay

2015-04-01

In competitive sports medicine, supervised rehabilitation is the standard of care; in the general population, unsupervised home exercise is more common. We systematically reviewed randomized, controlled trials comparing outcomes for supervised rehabilitation versus home exercise programs. Supervised rehabilitation programs resulted in (1) less pain and subjective instability, (2) greater gains in ankle strength and joint position sense, and (3) inconclusive results regarding prevention of recurrent ankle sprains. We recommend supervised rehabilitation over home exercise programs owing to the improved short-term patient-recorded evidence with a strength-of-recommendation taxonomy level of evidence of 2B. Copyright © 2015 Elsevier Inc. All rights reserved.

A Home Training Program for Young Mentally Ill Children.

ERIC Educational Resources Information Center

Doernberg, Nanette; And Others

To develop a meaningful intervention for waiting list families and their preschool emotionally disturbed children, a home training program for the parent and child was initiated. The focus of the program was on productive cooperation between parents and professionals. During a period of 2 years, 45 families completed the program. The program…

Measuring the efficacy of a wildfire education program in Colorado Springs.

Treesearch

G.H. Donovan; P.A. Champ; D.T. Butry

2007-01-01

We examine an innovative wildfire risk education program in Colorado Springs, which rated the wildfire risk of 35,000 homes in the city's wildland urban interface. Evidence from home sales before and after the program's implementation suggests that the program was successful at changing homebuyers' attitudes toward wildfire risk, particularly preferences...

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…

Home Economics. Education for Technology Employment.

ERIC Educational Resources Information Center

Northern Illinois Univ., De Kalb. Dept. of Technology.

This guide was developed in an Illinois program to help home economics teachers integrate the use of computers and program-related software into existing programs. After students are taught the basic computer skills outlined in the beginning of the guide, 50 learning activities can be used as an integral part of the instructional program. (One or…

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…

Childhelp

MedlinePlus

... Intervention Programs Childhelp National Child Abuse Hotline Childhelp Foster Care & Adoption Services Childhelp Group Homes Childhelp Advocacy ... Intervention Programs Childhelp National Child Abuse Hotline Childhelp Foster Care & Adoption Services Childhelp Group Homes Childhelp Advocacy ...

The Effects of the Home Instruction Program for Preschool Youngsters (HIPPY) on Children's School Performance at the End of the Program and One Year Later.

ERIC Educational Resources Information Center

Baker, Amy J. L.; Piotrkowski, Chaya S.; Brooks-Gunn, Jeanne

1998-01-01

Evaluated whether participation in HIPPY (Home Instruction Program for Preschool Youngsters) has a positive impact on young children's performance in school. Assessed 182 children at baseline, the program's end, and one year later. Interpreted findings as mixed support for the effectiveness of the HIPPY program. (JS)

The Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program: an overview for medical directors and primary care clinicians in long term care.

PubMed

Ouslander, Joseph G; Bonner, Alice; Herndon, Laurie; Shutes, Jill

2014-03-01

Interventions to Reduce Acute Care Transfers (INTERACT) is a publicly available quality improvement program that focuses on improving the identification, evaluation, and management of acute changes in condition of nursing home residents. Effective implementation has been associated with substantial reductions in hospitalization of nursing home residents. Familiarity with and support of program implementation by medical directors and primary care clinicians in the nursing home setting are essential to effectiveness and sustainability of the program over time. In addition to helping nursing homes prevent unnecessary hospitalizations and their related complications and costs, and thereby continuing to be or becoming attractive partners for hospitals, health care systems, managed care plans, and accountable care organizations, effective INTERACT implementation will assist nursing homes in meeting the new requirement for a robust quality assurance performance improvement program, which is being rolled out by the federal government over the next year. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Swallowing Trouble

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Pediatric Sinusitis

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Deviated Septum

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Sinus Surgery

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Mouth Sores

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Valuing Residential Energy Efficiency in Two Alaska Real Estate Markets: A Hedonic Approach

NASA Astrophysics Data System (ADS)

Pride, Dominique J.

Alaska households have high home energy consumption and expenditures. Improving the energy efficiency of the housing stock can reduce home energy consumption, thereby reducing home energy expenditures and CO2 emissions. Improving the energy efficiency of a home may also increase its transaction price if the energy efficiency improvements are capitalized into the value of the home. The relationship between energy efficiency and transaction prices in the Fairbanks and Anchorage, Alaska residential real estate markets is examined. Using a hedonic pricing framework and difference-in-differences analysis, the impact of the Alaska Home Energy Rebate program on the transaction prices of single-family homes in the Fairbanks and Anchorage housing markets from 2008 through 2015 is examined. The results indicate that compared to homes that did not complete the program, homes that completed the program sell for a statistically significant price premium between 15.1% and 15.5% in the Fairbanks market and between 5% and 11% in the Anchorage market. A hedonic pricing framework is used to relate energy efficiency ratings and transaction prices of homes in the Fairbanks and Anchorage residential real estate markets from 2008 through 2015. The results indicate that homes with above-average energy efficiency ratings sell for a statistically significant price premium between 6.9% and 17.5% in the Fairbanks market and between 1.8% and 6.0% in the Anchorage market.

Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: study protocol for a pragmatic randomised controlled trial.

PubMed

Burton, Elissa; Lewin, Gill; Clemson, Lindy; Boldy, Duncan

2013-10-18

Restorative home care services help older people maximise their independence using a multi-dimensional approach. They usually include an exercise program designed to improve the older person's strength, balance and function. The types of programs currently offered require allocation of time during the day to complete specific exercises. This is not how the majority of home care clients prefer to be active and may be one of the reasons that few older people do the exercises regularly and continue the exercises post discharge.This paper describes the study protocol to test whether a Lifestyle Functional Exercise (LiFE) program: 1) is undertaken more often; 2) is more likely to be continued over the longer term; and, 3) will result in greater functional gains compared to a standard exercise program for older people receiving a restorative home care service. A pragmatic randomised controlled trial (RCT) design was employed with two study arms: LiFE program (intervention) and the current exercise program (control). Silver Chain, a health and community care organisation in Perth, Western Australia. One hundred and fifty restorative home care clients, aged 65 years and older. The primary outcome is a composite measure incorporating balance, strength and mobility. Other outcome measures include: physical functioning, falls efficacy, and levels of disability and functioning. If LiFE is more effective than the current exercise program, the evidence will be presented to the service management accompanied by the recommendation that it be adopted as the generic exercise program to be used within the restorative home care service. Australian and New Zealand Clinical Trials Registry ACTRN12611000788976.

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

Seniors managing multiple medications: using mixed methods to view the home care safety lens.

PubMed

Lang, Ariella; Macdonald, Marilyn; Marck, Patricia; Toon, Lynn; Griffin, Melissa; Easty, Tony; Fraser, Kimberly; MacKinnon, Neil; Mitchell, Jonathan; Lang, Eddy; Goodwin, Sharon

2015-12-12

Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs. This study addresses the medication management issues faced by seniors with chronic illnesses, their family, caregivers, and paid providers within Canadian publicly funded home care programs in Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS). Informed by a socio-ecological perspective, this study utilized Interpretive Description (ID) methodology and participatory photographic methods to capture and analyze a range of visual and textual data. Three successive phases of data collection and analysis were conducted in a concurrent, iterative fashion in eight urban and/or rural households in each province. A total of 94 participants (i.e., seniors receiving home care services, their family/caregivers, and paid providers) were interviewed individually. In addition, 69 providers took part in focus groups. Analysis was iterative and concurrent with data collection in that each interview was compared with subsequent interviews for converging as well as diverging patterns. Six patterns were identified that provide a rich portrayal of the complexity of medication management safety in home care: vulnerabilities that impact the safe management and storage of medication, sustaining adequate supports, degrees of shared accountability for care, systems of variable effectiveness, poly-literacy required to navigate the system, and systemic challenges to maintaining medication safety in the home. There is a need for policy makers, health system leaders, care providers, researchers, and educators to work with home care clients and caregivers on three key messages for improvement: adapt care delivery models to the home care landscape; develop a palette of user-centered tools to support medication safety in the home; and strengthen health systems integration.

Process evaluation of two home-based bimanual training programs in children with unilateral cerebral palsy (the COAD-study): protocol for a mixed methods study.

PubMed

Beckers, Laura; van der Burg, Jan; Janssen-Potten, Yvonne; Rameckers, Eugène; Aarts, Pauline; Smeets, Rob

2018-04-24

As part of the COAD-study two home-based bimanual training programs for young children with unilateral Cerebral Palsy (uCP) have been developed, both consisting of a preparation phase and a home-based training phase. Parents are coached to use either an explicit or implicit motor learning approach while teaching bimanual activities to their child. A process evaluation of these complex interventions is crucial in order to draw accurate conclusions and provide recommendations for implementation in clinical practice and further research. The aim of the process evaluation is to systematically assess fidelity of the home-based training programs, to examine the mechanisms that contribute to their effects on child-related and parent-related outcomes, and to explore the influence of contextual factors. A mixed methods embedded design is used that emerges from a pragmatism paradigm. The qualitative strand involves a generic qualitative approach. The process evaluation components fidelity (quality), dose delivered (completeness), dose received (exposure and satisfaction), recruitment and context will be investigated. Data collection includes registration of attendance of therapists and remedial educationalists to a course regarding the home-based training programs; a questionnaire to evaluate this course by the instructor; a report form concerning the preparation phase to be completed by the therapist; registration and video analyses of the home-based training; interviews with parents and questionnaires to be filled out by the therapist and remedial educationalist regarding the process of training; and focus groups with therapists and remedial educationalists as well as registration of drop-out rates and reasons, to evaluate the overall home-based training programs. Inductive thematic analysis will be used to analyse qualitative data. Qualitative and quantitative findings are merged through meta-inference. So far, effects of home-based training programs in paediatric rehabilitation have been studied without an extensive process evaluation. The findings of this process evaluation will have implications for clinical practice and further research regarding development and application of home-based bimanual training programs, executed by parents and aimed at improving activity performance and participation of children with uCP.

Cochlear-Meningitis Vaccination

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Find an ENT

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Smell and Taste

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Voice and Aging

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Tongue-Tie (Ankyloglossia)

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Tonsils and Adenoids

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Pediatric Thyroid Cancer

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Fine Needle Aspiration

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Ear Plastic Surgery

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Ears and Altitude

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About Your Voice

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Find an ENT

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British Thoracic Society quality standards for home oxygen use in adults

PubMed Central

Suntharalingam, Jay; Wilkinson, Tom; Annandale, Joseph; Davey, Claire; Fielding, Rhea; Freeman, Daryl; Gibbons, Michael; Hardinge, Maxine; Hippolyte, Sabrine; Knowles, Vikki; Lee, Cassandra; MacNee, William; Pollington, Jacqueline; Vora, Vandana; Watts, Trefor; Wijesinghe, Meme

2017-01-01

Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for home oxygen provision in the UK, together with measurable markers of good practice. Quality statements are based on the British Thoracic Society (BTS) Guideline for Home Oxygen Use in Adults. Methods Development of BTS Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 10 quality statements have been developed, each describing a key marker of high-quality, cost-effective care for home oxygen use, and each statement is supported by quality measures that aim to improve the structure, process and outcomes of healthcare. Discussion BTS Quality Standards for home oxygen use in adults form a key part of the range of supporting materials that the society produces to assist in the dissemination and implementation of a guideline’s recommendations. PMID:29018527

24 CFR 291.515 - Purchaser qualifications.

Code of Federal Regulations, 2010 CFR

2010-04-01

... in § 291.530) at the time he/she submits a bid to purchase a home through the program and at the time of closing on the purchase of the home; (b) The person must certify to his/her good faith intention... Next Door Sales Program § 291.515 Purchaser qualifications. To qualify to purchase a home through the...

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…

Services in Counseling/Intervention and Life Skills Education (S.C.I.L.S.E.).

ERIC Educational Resources Information Center

Kirk, Mimi

The report describes the Services in Counseling/Intervention and Life Skills Education (SCILSE) Program, a comprehensive program providing services to emotionally disturbed children in their own homes, under the auspices of the Southern Home for Children, a residential treatment center in Philadelphia. The history of the Southern Home for Children…

The Family Expedition Program: Adventure Family Therapy in the Home As Well As in the Outdoors.

ERIC Educational Resources Information Center

Gass, Michael; Dolcino, Carina

The Family Expedition is a federally funded program designed to foster healthy changes in families with troubled adolescents through multifamily adventure therapy experiences. Each Family Expedition cycle is 4 months long, consisting of six multifamily sessions and three home visits. Each 90-minute home visit gives families time to focus on…

Home Start Evaluation Study. Interim Report II: Program Analysis. Revised Draft.

ERIC Educational Resources Information Center

Deloria, Dennis; And Others

This document is the second in a series of evaluative reports directed to evaluation needs of Home Start planners and administrators. It focuses on implementation data about programs gathered during local site visits conducted in the spring and fall of 1972. The two basic evaluative questions asked are: (1) What was Home Start intended by its…

76 FR 15105 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... Nursing Homes; Final Rule #0;#0;Federal Register / Vol. 76 , No. 53 / Friday, March 18, 2011 / Rules and... Services 42 CFR Part 488 [CMS-2435-F] Medicare and Medicaid Programs; Civil Money Penalties for Nursing... collection of civil money penalties by CMS when nursing homes are not in compliance with Federal...

77 FR 3958 - Mortgage Assets Affected by PACE Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... of home improvement projects (e.g., home insulation, solar panels, geothermal energy units, etc... (``ANPR'') concerning mortgage assets affected by Property Assessed Clean Energy (``PACE'') programs and... February 28, 2011, that deal with property assessed clean energy (PACE) programs.'' In response to and...

78 FR 2319 - Relocation of Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... (CFR). The regulations relate to: Community Investment Cash Advance Programs (CICA); Federal Home Loan... (Community Investment Cash Advance Programs) In 1989, Congress amended the Federal Home Loan Bank Act (Bank Act) to authorize the Banks to offer Community Investment Cash Advance (CICA) programs, and to require...

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

Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program

PubMed Central

Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.

2014-01-01

Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659

Tonsillitis

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Hoarseness

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TMJ

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Cholesteatoma

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Sinusitis

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Ear Infection and Vaccines

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Laryngeal (Voice Box) Cancer

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Laryngopharyngeal Reflux and Children

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Keeping Your Voice Healthy

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Snoring and Sleep Apnea

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How the Ear Works

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Tips for Healthy Voices

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Autoimmune Inner Ear Disease

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Secondhand Smoke and Children

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Buying a Hearing Aid

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Diet and Exercise Tips

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Intelligent home risk assessment systems and integration with biometric identification

NASA Astrophysics Data System (ADS)

Roper, William E.

2003-08-01

An overview is given of the Home of the 21st Century Laboratory. The laboratory is operated as a joint program with America-On-Line and George Washington University. The program is described with illustrations and discussion of the systems that are part of the laboratory. The concept of application for face recognition systems in the intelligent home of the future is presented and some initial approaches in using biometrics are shown. Issues of privacy and sharing of information within and outside the home are addressed. Issues include safety and security concerns vs. inappropriate observations of activities in and outside the home. Technology options currently available for application in the home are described and assessed.

Parents Making a Difference: International Research on the Home Instruction for Parents of Preschool Youngsters (HIPPY) Program.

ERIC Educational Resources Information Center

Westheimer, Miriam, Ed.

Begun in Israel in 1960, the HIPPY (Home Instruction for Parents of Preschool Youngsters) program is a family support, parent-focused, early childhood literacy program. This book compiles 17 evaluation studies of the program, from researchers and practitioners in 7 countries. The studies are organized around five themes: exploring theoretical…

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…

42 CFR 431.714 - Waivers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ASSISTANCE PROGRAMS STATE ORGANIZATION AND GENERAL ADMINISTRATION State Programs for Licensing Nursing Home... subpart for any person who has served in the capacity of a nursing home administrator during all of the 3...

Community lay rescuer automated external defibrillation programs: key state legislative components and implementation strategies: a summary of a decade of experience for healthcare providers, policymakers, legislators, employers, and community leaders from the American Heart Association Emergency Cardiovascular Care Committee, Council on Clinical Cardiology, and Office of State Advocacy.

PubMed

Aufderheide, Tom; Hazinski, Mary Fran; Nichol, Graham; Steffens, Suzanne Smith; Buroker, Andrew; McCune, Robin; Stapleton, Edward; Nadkarni, Vinay; Potts, Jerry; Ramirez, Raymond R; Eigel, Brian; Epstein, Andrew; Sayre, Michael; Halperin, Henry; Cummins, Richard O

2006-03-07

Cardiovascular disease is a leading cause of death for adults > or =40 years of age. The American Heart Association (AHA) estimates that sudden cardiac arrest is responsible for about 250,000 out-of-hospital deaths annually in the United States. Since the early 1990s, the AHA has called for innovative approaches to reduce time to cardiopulmonary resuscitation (CPR) and defibrillation and improve survival from sudden cardiac arrest. In the mid-1990s, the AHA launched a public health initiative to promote early CPR and early use of automated external defibrillators (AEDs) by trained lay responders in community (lay rescuer) AED programs. Between 1995 and 2000, all 50 states passed laws and regulations concerning lay rescuer AED programs. In addition, the Cardiac Arrest Survival Act (CASA, Public Law 106-505) was passed and signed into federal law in 2000. The variations in state and federal legislation and regulations have complicated efforts to promote lay rescuer AED programs and in some cases have created impediments to such programs. Since 2000, most states have reexamined lay rescuer AED statutes, and many have passed legislation to remove impediments and encourage the development of lay rescuer AED programs. The purpose of this statement is to help policymakers develop new legislation or revise existing legislation to remove barriers to effective community lay rescuer AED programs. Important areas that should be considered in state legislation and regulations are highlighted, and sample legislation sections are included. Potential sources of controversy and the rationale for proposed legislative components are noted. This statement will not address legislation to support home AED programs. Such recommendations may be made after the conclusion of a large study of home AED use.

A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

ERIC Educational Resources Information Center

Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

2011-01-01

This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

Perforated Eardrum

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Pediatric Sinusitis

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Deviated Septum

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Swallowing Trouble

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Sore Throats

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Sinus Surgery

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Tonsillectomy and Adenoids PostOp

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Cleft Lip and Cleft Palate

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Continuous Positive Airway Pressure (CPAP)

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Effects of Medications on Voice

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Antihistamines, Decongestants, and Cold Remedies

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What is LPR (Laryngopharyngeal Reflux)

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The diamond level health promoting schools (DLHPS) program for reduced child obesity in Thailand: lessons learned from interviews and focus groups.

PubMed

Phaitrakoon, Jaruwan; Powwattana, Arpaporn; Lagampan, Sunee; Klaewkla, Jeeranun

2014-01-01

Overweight and obesity prevalence among children is increasing globally. Health promoting school policy has been initiated in Thailand to tackle this problem. The schools that best conduct obesity management programs are rated as diamond level health promoting schools (DLHPS). However, the methods used by these schools and their efficacies have not been well-documented. This qualitative study aims to analyze the processes and activities used by four DLHPSs in obesity management programs. In-depth interviews were used to obtain information from school directors, teachers, and cooks, whereas focus group discussions were used for students. School-based obesity management programs have resulted from health promoting school policy and the increasing prevalence of overweight students. Teamwork has been a key strategy in program implementation. Policy diffusion and division of labor have been effected by school directors. A monitoring process is put in place to ensure program delivery. The most evident success factor in the present study has been intersectoral cooperation. Challenges have included confusion about the criteria in obtaining the DLHPS status, parental involvement, and students' resistance to consume vegetables and other healthy foods. From the student focus groups discussions, three activities were most valued: class health and nutrition learning; provision of healthy foods and drinks, together with removal of soft drinks and seasoning from the cafeteria; and exercise for health. Intersectoral cooperation is the key success factor for the operationality of DLHPS, especially in making healthy foods available and physical activity the norm, at school and home.

Theory-Based Predictors of Follow-Up Exercise Behavior After A Supervised Exercise Intervention in Older Breast Cancer Survivors

PubMed Central

Loprinzi, Paul D.; Cardinal, Bradley J.; Si, Qi; Bennett, Jill A.; Winters-Stone, Kerri

2014-01-01

Purpose Supervised exercise interventions can elicit numerous positive health outcomes in older breast cancer survivors. However, to maintain these benefits, regular exercise needs to be maintained long after the supervised program. This may be difficult, as in this transitional period (i.e., time period immediately following a supervised exercise program), breast cancer survivors are in the absence of on-site direct supervision from a trained exercise specialist. The purpose of the present study was to identify key determinants of regular exercise participation during a 6-month follow-up period after a 12-month supervised exercise program among women aged 65+ years who had completed adjuvant treatment for breast cancer. Methods At the conclusion of a supervised exercise program, and 6-months later, 69 breast cancer survivors completed surveys examining their exercise behavior and key constructs from the Transtheoretical Model. Results After adjusting for weight status and physical activity at the transition point, breast cancer survivors with higher self-efficacy at the point of transition were more likely to be active 6-months after leaving the supervised exercise program (OR [95% CI]: 1.10 [1.01–1.18]). Similarly, breast cancer survivors with higher behavioral processes of change use at the point of transition were more likely to be active (OR [95% CI]: 1.13 [1.02–1.26]). Conclusion These findings suggest that self-efficacy and the behavioral processes of change, in particular, play an important role in exercise participation during the transition from a supervised to a home-based program among older breast cancer survivors. PMID:22252545

Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon.

PubMed

Gelmon, Sherril; Bouranis, Nicole; Sandberg, Billie; Petchel, Shauna

2018-01-01

Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics. Between 2015 and 2016, semistructured interviews and focus groups were completed with 85 key informants. Clinics reported similar challenges implementing the PCPCH model, including shifting patterns of care use, fidelity to the PCPCH model, and refining care processes. The following ten implementation strategies emerged: expanding access through care teams, preventing unnecessary emergency department visits through patient outreach, improved communication and referral tracking with outside providers, prioritization of selected program metrics, implementing patient-centered practices, developing continuous improvement capacity through committees and "champions," incorporating preventive services and chronic disease management, standardization of workflows, customizing electronic health records, and integration of mental health. Clinic leaders benefited from understanding the local context in which they were operating. Despite differences in size, ownership, geography, and population, all clinic leaders were observed to be proponents of strategies commonly associated with a "learning organization": systems thinking, personal mastery, mental models, shared vision, and team. Clinics can draw on their own characteristics, use state resources, and look to established PCMHs to build the evidence base for implementation in primary care. © Copyright 2018 by the American Board of Family Medicine.

Pilot Implementation of a Field Study Design to Evaluate the Impact of Source Control Measures on Indoor Air Quality in High Performance Homes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Widder, Sarah H.; Chamness, Michele A.; Petersen, Joseph M.

2014-10-01

To improve the indoor air quality in new, high performance homes, a variety of standards and rating programs have been introduced to identify building materials that are designed to have lower emission rates of key contaminants of concern and a number of building materials are being introduced that are certified to these standards. For example, the U.S. Department of Energy (DOE) Zero Energy Ready Home program requires certification under the U.S. Environmental Protection Agency (EPA) Indoor airPLUS (IaP) label, which requires the use of PS1 or PS2 certified plywood and OSB; low-formaldehyde emitting wood products; low- or no-VOC paints andmore » coatings as certified by Green Seal Standard GS-11, GreenGuard, SCS Indoor Advantage Gold Standard, MPI Green Performance Standard, or another third party rating program; and Green Label-certified carpet and carpet cushions. However, little is known regarding the efficacy of the IAP requirements in measurably reducing contaminant exposures in homes. The goal of this project is to develop a robust experimental approach and collect preliminary data to support the evaluation of indoor air quality (IAQ) measures linked to IAP-approved low-emitting materials and finishes in new residential homes. To this end, the research team of Pacific Northwest National Laboratory (PNNL) and Lawrence Berkeley National Laboratory (LBNL) developed a detailed experimental plan to measure IAQ constituents and other parameters, over time, in new homes constructed with materials compliant with IAP’s low-emitting material and ventilation requirements (i.e., section 6.1, 6.2, 6.3, and 7.2) and similar homes constructed to the state building code with conventional materials. The IAQ in IAP and conventional homes of similar age, location, and construction style is quantified as the differences in the speciated VOC and aldehyde concentrations, normalized to dilution rates. The experimental plan consists of methods to evaluate the difference between low-emitting and “conventional” materials as installed in newly constructed residential homes using both (1) highly controlled, short-term active samples to precisely characterize the building-related chemical emissions and building contents and (2) a week-long passive sample designed to capture the impact of occupant behavior and related activities on measured IAQ contaminant levels indoors. The combination of detailed short-term measurements with the home under controlled/consistent conditions during pre- and post-occupancy and the week-long passive sampling data provide the opportunity to begin to separate the different emission sources and help isolate and quantify variability in the monitored homes. Between April and August 2014, the research team performed pre-occupancy and post-occupancy sampling in one conventional home and two homes built with low-emitting materials that were generally consistent with EPA’s Indoor airPLUS guidelines. However, for a number of reasons, the full experimental plan was not implemented. The project was intended to continue for up to three years to asses long-term changes in IAQ but the project was limited to one calendar year. As a result, several of the primary research questions related to seasonal impacts and the long-term trends in IAQ could not be addressed. In addition, there were several unexpected issues related to recruiting, availability of home types, and difficulty coordinating with builders/realtors/homeowners. Several field monitoring issues also came up that provide “lessons learned” that led to improvements to the original monitoring plan. The project produced a good experimental plan that is expected to be be useful for future efforts collecting data to support answering these same or similar research questions.« less

Breastfeeding knowledge, attitudes, and practices among providers in a medical home.

PubMed

Szucs, Kinga A; Miracle, Donna J; Rosenman, Marc B

2009-03-01

Breastfeeding offers numerous health advantages to children, mothers, and society. From obstetrics to pediatrics, breastfeeding dyads come in contact with a wide range of healthcare providers. The American Academy of Pediatrics (AAP) calls for pediatricians to support breastfeeding enthusiastically and for all children to have a medical home. We studied an inner-city healthcare system with a Dyson Community Pediatrics Training Initiative Model Medical Home clinic, to explore how a breastfeeding/baby-friendly medical home might be built upon this framework. We describe breastfeeding knowledge, attitudes, and practices among a full range of providers and healthcare system-level barriers to effective and coordinated breastfeeding services. We conducted eight focus groups using semistructured interviews: (1) pediatricians; (2) obstetricians; (3) pediatric nurses and allied health professionals; (4) obstetric nurses and allied health professionals; (5) 24-hour telephone triage answering service nurses; (6) public health nurses; (7) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) personnel; and (8) lactation consultants and peer counselors. We identified gaps in providers' breastfeeding knowledge, counseling skills, and professional education and training. Providers' cultures and attitudes affect breastfeeding promotion and support. Providers used their own breastfeeding experiences to replace evidence-based knowledge and AAP policy statement recommendations for breastfeeding dyads. There were communication disconnects between provider groups. Providers underestimated their own, and overestimated others', influence on breastfeeding. The system lacked a coordinated breastfeeding mission. This study illuminated key disconnectedness challenges (and, hence, opportunities) for a model medical home in fostering continuous, comprehensive, coordinated, culturally effective, and evidence-based breastfeeding promotion and support.

Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

PubMed

Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

2016-03-01

In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed

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

2016-10-01

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

Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study.

PubMed

Geraedts, Hilde A E; Zijlstra, Wiebren; Zhang, Wei; Bulstra, Sjoerd; Stevens, Martin

2014-06-07

With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older adults and fall risk, and in improving associated physiological parameters. However, adherence to home-based exercise programs is generally low among older adults. Current developments in technology can assist in enlarging adherence to home-based exercise programs. This paper presents the rationale and design of a study evaluating the adherence to and effectiveness of an individually tailored, home-based physical activity program for frail older adults driven by mobility monitoring through a necklace-worn physical activity sensor and remote feedback using a tablet PC. Fifty transitionally frail community-dwelling older adults will join a 6-month home-based physical activity program in which exercises are provided in the form of exercise videos on a tablet PC and daily activity is monitored by means of a necklace-worn motion sensor. Participants exercise 5 times a week. Exercises are built up in levels and are individually tailored in consultation with a coach through weekly telephone contact. The physical activity program driven by mobility monitoring through a necklace-worn sensor and remote feedback using a tablet PC is an innovative method for physical activity stimulation in frail older adults. We hypothesize that, if participants are sufficiently adherent, the program will result in higher daily physical activity and higher strength and balance assessed by physical tests compared to baseline. If adherence to and effectiveness of the program is considered sufficient, the next step would be to evaluate the effectiveness with a randomised controlled trial. The knowledge gained in this study can be used to develop and fine-tune the application of innovative technology in home-based exercise programs. Nederlands Trial Register (NTR); trial number 4265. The study was prospectively registered (registration date 14/11/2013).

Can a Home-based Cardiac Physical Activity Program Improve the Physical Function Quality of Life in Children with Fontan Circulation?

PubMed

Jacobsen, Roni M; Ginde, Salil; Mussatto, Kathleen; Neubauer, Jennifer; Earing, Michael; Danduran, Michael

2016-01-01

Patients after Fontan operation for complex congenital heart disease (CHD) have decreased exercise capacity and report reduced health-related quality of life (HRQOL). Studies suggest hospital-based cardiac physical activity programs can improve HRQOL and exercise capacity in patients with CHD; however, these programs have variable adherence rates. The impact of a home-based cardiac physical activity program in Fontan survivors is unclear. This pilot study evaluated the safety, feasibility, and benefits of an innovative home-based physical activity program on HRQOL in Fontan patients. A total of 14 children, 8-12 years, with Fontan circulation enrolled in a 12-week moderate/high intensity home-based cardiac physical activity program, which included a home exercise routine and 3 formalized in-person exercise sessions at 0, 6, and 12 weeks. Subjects and parents completed validated questionnaires to assess HRQOL. The Shuttle Test Run was used to measure exercise capacity. A Fitbit Flex Activity Monitor was used to assess adherence to the home activity program. Of the 14 patients, 57% were male and 36% had a dominant left ventricle. Overall, 93% completed the program. There were no adverse events. Parents reported significant improvement in their child's overall HRQOL (P < .01), physical function (P < .01), school function (P = .01), and psychosocial function (P < .01). Patients reported no improvement in HRQOL. Exercise capacity, measured by total shuttles and exercise time in the Shuttle Test Run and calculated VO2 max, improved progressively from baseline to the 6 and 12 week follow up sessions. Monthly Fitbit data suggested adherence to the program. This 12-week home-based cardiac physical activity program is safe and feasible in preteen Fontan patients. Parent proxy-reported HRQOL and objective measures of exercise capacity significantly improved. A 6-month follow up session is scheduled to assess sustainability. A larger study is needed to determine the applicability and reproducibility of these findings in other age groups and forms of complex CHD. © 2016 Wiley Periodicals, Inc.

Reducing Energy Use in Existing Homes by 30%: Learning From Home Performance with ENERGY STAR

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liaukus, C.

2014-12-01

The improvement of existing homes in the United States can have a much greater impact on overall residential energy use than the construction of highly efficient new homes. There are over 130 million existing housing units in the U.S., while annually new construction represents less than two percent of the total supply (U.S. Census Bureau, 2013). Therefore, the existing housing stock presents a clear opportunity and responsibility for Building America (BA) to guide the remodeling and retrofit market toward higher performance existing homes. There are active programs designed to improve the energy performance of existing homes. Home Performance with ENERGYmore » STAR (HPwES) is a market-rate program among them. BARA's research in this project verified that the New Jersey HPwES program is achieving savings in existing homes that meet or exceed BA's goal of 30%. Among the 17 HPwES projects with utility data included in this report, 15 have actual energy savings ranging from 24% to 46%. Further, two of the homes achieved that level of energy savings without the costly replacement of heating and cooling equipment, which indicates that less costly envelope packages could be offered to consumers unable to invest in more costly mechanical packages, potentially creating broader market impact.« less

Family risk as a predictor of initial engagement and follow-through in a universal nurse home visiting program to prevent child maltreatment.

PubMed

Alonso-Marsden, Shelley; Dodge, Kenneth A; O'Donnell, Karen J; Murphy, Robert A; Sato, Jeannine M; Christopoulos, Christina

2013-08-01

As nurse home visiting to prevent child maltreatment grows in popularity with both program administrators and legislators, it is important to understand engagement in such programs in order to improve their community-wide effects. This report examines family demographic and infant health risk factors that predict engagement and follow-through in a universal home-based maltreatment prevention program for new mothers in Durham County, North Carolina. Trained staff members attempted to schedule home visits for all new mothers during the birthing hospital stay, and then nurses completed scheduled visits three to five weeks later. Medical record data was used to identify family demographic and infant health risk factors for maltreatment. These variables were used to predict program engagement (scheduling a visit) and follow-through (completing a scheduled visit). Program staff members were successful in scheduling 78% of eligible families for a visit and completing 85% of scheduled visits. Overall, 66% of eligible families completed at least one visit. Structural equation modeling (SEM) analyses indicated that high demographic risk and low infant health risk were predictive of scheduling a visit. Both low demographic and infant health risk were predictive of visit completion. Findings suggest that while higher demographic risk increases families' initial engagement, it might also inhibit their follow-through. Additionally, parents of medically at-risk infants may be particularly difficult to engage in universal home visiting interventions. Implications for recruitment strategies of home visiting programs are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

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