School of Public Health

Permanent URI for this communityhttp://hdl.handle.net/1903/1633

The collections in this community comprise faculty research works, as well as graduate theses and dissertations.

Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.

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Now showing 1 - 4 of 4
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    The Impact of International Accreditation on The Quality of Health Services at King Fahd University Hospital, Saudi Arabia: A Mixed Methods Approach
    (2019) AL Shawan, Deema Saad; Franzini, Luisa; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    The Joint Commission International Accreditation (JCIA) is perceived worldwide as the symbol of exceptional quality of care. Despite the popularity of international accreditation, evidence of its effectiveness on improving health care quality is inconclusive. This dissertation research utilized a Convergent parallel mixed method framework to evaluate the impact of the JCIA process on quality and to identify the factors that influence the effectiveness of this process at King Fahd Hospital of the University in Khobar, Saudi Arabia. An interrupted time series analysis was conducted to assess the changes in a total of 12 quality outcomes pre and post accreditation. Furthermore, a qualitative approach was used to investigate the attitudes and perceptions of 31 health providers towards this process and the factors that influence its success. The quantitative results suggested that the JCIA had a positive impact on 9 out of 12 outcomes. The improved quality outcomes included: the average length of stay, the percentage of hand hygiene compliance, the rate of nosocomial infections, the percentage of radiology reporting outliers, the rate of pressure ulcers, the percentage of the correct identification of patients prior to medication administration, the percentage of critical lab reporting within 30 minutes, and the bed occupancy rate. The outcomes that did not improve were the rate of patients leaving the ER without being seen, the percentage of OR cancelations on the day of the or and the rate of patient falls. The qualitative analysis suggested that the JCIA was perceived positively by all participants. Some of the perceived advantages of international accreditation included the transformation of the organizational culture to a culture that promotes continuous quality improvement, standardization, and the reduced paperwork in some departments. The participants’ responses also indicated that there were many factors that influence the success of the process. Examples of the factors identified in the study include the increased workload and the providers’ resistance to participate in the JCIA process. In conclusion, international accreditation seemed to have a positive impact on quality outcomes and was received positively by providers. Nevertheless, the factors that hindered the JCIA process need to be addressed by the hospital’s leadership to ensure more efficient quality improvement efforts during future accreditation cycles.
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    FAMILY-CENTERED PEDIATRIC CARE: PREDICTORS OF ACCESS AND ASSOCIATIONS WITH CHILD WELL-BEING
    (2019) Fife, Julie Marie; Lewin, Amy B; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Despite widespread recognition that family-centered care (FCC) is a critical component of quality pediatric health care, not all children receive FCC. This study builds on previous work by: (1) examining the extent to which socioeconomic resources are associated with the receipt of FCC after implementation of the Affordable Care Act, (2) exploring whether healthcare workforce shortages interfere with the delivery of FCC, and (3) extending previous research on the role of FCC in child well-being by measuring well-being across multiple domains and including children without special health care needs. Using data from the 2016 National Survey of Children’s Health (n=50,212), this study found a graded relationship between the odds of receiving FCC and multiple indicators of family-level socioeconomic resources, indicating that socioeconomic resources, beyond health insurance, are important factors in accessing quality pediatric health care. Healthcare workforce shortages may also play a role in the availability of FCC. Results from this study found consistent and significant associations between FCC and positive child well-being among healthy and typically developing children, and these associations were found across all domains of development. Findings indicated that FCC is particularly beneficial for young children (0-5 years), and children in households with low to moderate socioeconomic resources, making it a potentially meaningful tool to help reduce health disparities for children from households with more limited socioeconomic resources. Future research, and policies and practices aimed at increasing the delivery of FCC should include and emphasize the experiences of Hispanic families and families with limited socioecnomic resources.
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    THE PHYSICAL CULTURE OF DIVERSITY WORK: A CASE STUDY OF EMBODIED INCLUSION AND EXCLUSION WITHIN THE CONTEMPORARY AMERICAN UNIVERSITY
    (2019) Cork, Stephanie Joan; Jette, Shannon; Kinesiology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Considering recent incidents of white nationalism and racial violence on college campuses, the efficacy of diversity and inclusion work within this context has garnered increased attention. What received less attention, however, the embodied experiences of university employees, specifically “diversity workers,” who are tasked by their institution to combat equity issues. Previous research has shown that experiences of exclusion and discrimination can negatively impact work, educational, and health outcomes.This study explores how these impacts are experienced by the diversity workers themselves, many of whom inhabit intersectionally marginalized identities. In examining the physicality of the diversity worker, this project merges scholarship from the field of public health and the sociology of work to investigate occupational health and wellness through the lens of critical theory. It builds on a long tradition of studying the working body in the field of kinesiology through the lens of occupational health, and in doing so also fills a gap in the area of Physical Cultural Studies given that bodies at work (outside the sporting context) have received little attention in this subfield.The aims of this study are to explore the social, political, and economic context of the diversity worker in contemporary American post-secondary education, and how this impacts health, wellness, and job performance. This study uses a critical qualitative approach drawing from theories of embodiment, radical contextualism, and intersectionality. Data collection entailed a survey (n = 48) and one-on-one semi-structured interviews with diversity workers (n = 8) at an anonymized site referred to here as “public four-year university.” Using thematic analysis and the radical contextual method of articulation, the data was coded and synthesized to construct the three empirical chapters. Through centering the embodied experiences of diversity workers within the context of the contemporary American university, this study contributes to existing scholarship in a variety of disciplines. Study findings point to how we might better support diversity work and workers through a more supportive and healthier workplace environment.
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    The Association of Negative Family Processes in Early Adolescence and Health Status and Body Mass Index in Late Adolescence and Early Adulthood
    (2011) Pollock, Elizabeth Davenport; Shenassa, Edmond; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Extant research suggests that negative family processes during adolescence may be detrimental to health over time. Informed by family systems theory and the biopsychosocial perspective, this study examined the association of negative family processes in early adolescence and health status and body mass index in late adolescence and early adulthood. Data from U.S. males and females in two-parent households from the National Longitudinal Survey of Youth 1997 were examined over a ten year period from early adolescence to early adulthood. Results from logistic regressions and multiple regressions suggest that negative parent-child processes (NPCP) and negative inter-parental processes (NIPP) are associated with elevated risk for poorer health status but are not associated with body mass index. Logistic regressions estimated the association between NPCP and NIPP and youth's risk of very good, good and poor health status, respectively, as compared to excellent health status. Specifically, there is a step function for the association between NPCP and risk for poorer health status in late adolescence and early adulthood, between NIPP and risk for poorer health status in late adolescence and between NIPP and risk for the poorest health status category in early adulthood. Mental health, unhealthy behaviors (tobacco use, marijuana use and alcohol use), and healthy behaviors (i.e. physical activity) partially mediated the association between NPCP and NIPP, respectively, and health status in late adolescence, and mental health and tobacco use (only for NPCP) partially mediated the association with health status in early adulthood. All analyses are independent of race, gender, maternal education, health status in early adolescence, BMI in early adolescence, parental health status, and parental BMI. Moderation by maternal education and implications for public health, future research, programming, and therapy are discussed.