Improving student knowledge and perceptions of primary care providers at campus health centers

ABSTRACT

Objective: To examine current knowledge and perceptions toward primary care providers commonly staffed at student health centers (PAs and NPs), and also assess the effectiveness of information-rich provider biographies to improve knowledge and perceptions. Participants: One thousand six hundred forty six students from 2 universities in 2 states participated in this study from February to November, 2016. Methods: An online survey. Students were exposed to an improved biography of an NP discussing how she can perform many of the same duties as primary care physicians. Changes in knowledge and perceptions were assessed pre- and post-biography exposure. Results: More than half of students are unaware NPs and PAs can prescribe medications and diagnose illnesses. Students exposed to the biography increased their knowledge of NPs, and perceptions of their expertise. Conclusions: Results suggest improved provider biographies on student health centers' websites can help reduce the knowledge deficit that exists among students regarding common primary care providers.     

Variations in provider capacity to offer accessible health care for people with disabilities

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

Variations in Provider Capacity to Offer Accessible Health Care for People with Disabilities

Abstract

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

Child Abuse and Children with Disabilities

Children with disabilities experience a significantly increased risk of abuse. This paper explores the cultural context that values body perfection and tolerates violence, so that abuse of children with disabilities, in response to normal frustrations and pressures, becomes a legitimate response. These pressures are analysed as to how they affect parents and siblings. The medical model as it affects hospital organisation and the health care system and rehabilitation is analysed. The objectification of parts of the disabled child is discussed in terms of its effect on lowering the natural modesty boundaries of the child. The child with disabilities as it relates to the family is also a creator of frustration and rage. The structural issues as they apply to the external environment are presented. The paper proposes a new understanding of the child with disabilities within the family, and within the external environment, most particularly the medical system.     

Inequities in health outcomes and access to health care in South Africa: a comparison between persons with and without disabilities

Health is a fundamental human right and if health care is to be universal and equitable it should not be less accessible to some sectors of society than to others. The objective of this study was to compare health outcomes and access to health care between persons living with disabilities and their non-disabled counterparts. The research was based on secondary data analysis of wave 1 of the National Income Dynamic Survey. Results from the study indicated that people with disabilities reported a higher incidence of communicable and non-communicable diseases, lower access to medical insurance and greater use of public health care than their non-disabled counterparts. In conclusion, the findings highlight the inequities in health outcomes and access to health services for people with disabilities and emphasise the need for disability-friendly health care policies that reduce barriers to accessing health care.     

Understanding emerging disabilities

This research seeks to understand social and environmental characteristics that distinguish emerging from traditional disability populations. We qualitatively analysed how emerging disabilities are understood by persons with disabilities, and used these themes with a public use data source to analyse differences between emerging and traditional disabilities. Our findings first illustrate the difficulty in diagnosing and categorizing emerging disabilities. This is true for both persons who have these conditions and medical personnel who are expected to interpret them. Compared with persons with traditional disabilities, persons with emerging disabilities had less education, greater difficulties with activities of daily living, lower income, less private insurance, more frequent medical care and were less likely to work. The picture emerges of that of an underclass within society. There is an ongoing need for a referral and support system with greater recognition and acceptance of all disabilities, especially within independent living centers and among employers.     

从516份司法裁判文书看残疾人权益保障及其完善

通过梳理涉残疾人案件的司法裁判文书,可以发现残疾人通过司法诉讼寻求权益保护的整体概貌.面对残疾人包括健康权、生存权、公民权、政治权等权益诉求,涉及自然人、法人等多元侵权主体以及司法过程中支持性服务供给、经济成本耗费、裁判结果与预期等诸多问题,必须增强残疾人权利意识与维权能力,多角度、多渠道保护重点权利和规制侵权主体,构建立体的权利救济体系.     

Service Providers to the Homeless Mentally Ill: Their Thoughts,Perceptions, and Recommendations for the Homeless

A qualitative research study was conducted to obtain an understanding of the people who provide senvices to persons who are homeless and mentally ill. Selvice providers were asked about the kinds of selvices they provide, what they consider beneficial to this population, the kinds of selvices they would like to provide, and what is needed to allevwte the homeless problem. Selvices found in the study included, those that meet basic needs, psychiatric/medical selvices, social setvices, and activities. Service providers indicated the major selvice priority is housing and the necessity of: (a) a safe environment, (b) additional psychiatric/social selvices, (c) day programs, and (d) health care. It is recommended that selvice providers advocate for the necessary improvements in services including, collaborative workshops and training sessions to the public and to each other.     

Delivery of dental care to persons with disabilities and other special populations

Although humankind has long suffered from dental ills, and despite progressive efforts by the field of dentistry to provide dental healthcare in a compassionate and anxiety-free manner, the profession of dentistry has suffered a tarnished reputation. Going to the dentist is considered painful and induces fear among most people; however, this mindset is changing. Dentists of today are beginning to take their rightful place as integral members of the health care team, including disability management initiatives. The public and other health care providers are beginning to recognize the importance of oral health to the overall health of the body. Dental care is a vital component to rehabilitation planning. Unfortunately, some government agencies, insurance companies, and other policy making bodies have failed to grasp the importance of this concept. Also, professionals within the field of dentistry have not fully grasped the important of continued dental care for persons with disabilities, geriatric patients, the deinstitutionalized, and others in need of rehabilitation services. Problems associated with the delivery of dental care to patients with disabilities are discussed.     

Taming predators through photography

In this article we examine an innovative application of visual communication and social science methods, moving the study of indigenous media from the purely academic realm into pediatric health research. Through Video Intervention/Prevention Assessment (VIA), children and adolescents who share a medical condition create visual narratives of their lives with chronic disease to show and tell their illness experiences to health care providers. Clinicians routinely plan medical management with limited knowledge of how patients interact with disease in their “real life” physical, psychological, and social environments. VIA asks young patients to teach clinicians the realities of day‐to‐day life with illness, yielding unique insights that can guide the development of more realistic, more humane, and ultimately more effective medical care. We describe the VIA methodology, a pilot study of asthma, and the illness experiences shown and told by VIA Asthma participants. Not only did VIA generate useful research findings, it also produced visual documents of the child's illness experience that can serve as tools for influencing policy, advocating for patients, and educating health care providers, patients, and their families.     

College students with congenital heart disease: A critical time for transition

As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. Participants: A case of a male with CHD presenting to the college health clinic with a new onset headache. Methods: The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. Results: This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. Conclusions: As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.     

Service providers to the homeless mentally Ill: Their thoughts,perceptions, and recommendations for the homeless

A qualitative research study was conducted to obtain an understanding of the people who provide services to persons who are homeless and mentally ill. Service providers were asked about the kinds of services they provide, what they consider beneficial to this population, the kinds of services they would like to provide, and what is needed to alleviate the homeless problem. Services found in the study included, those that meet basic needs, psychiatric/medical services, social services, and activities. Service providers indicated the major service priority is housing and the necessity of: (a) a safe environment, (b) additional psychiatric/social services, (c) day programs, and (d) health care. It is recommended that service providers advocate for the necessary improvements in services including, collaborative workshops and training sessions to the public and to each other.     

Case managers' and independent living counselors' perspectives on health promotion activities for individuals with physical and developmental disabilities

A fundamental component of maximizing the quality of life for individuals with disabilities is quality health care. We describe the perspectives of case managers and independent living counselors on the role of health promotion as a component of targeted case management services. Respondents held health promotion as an essential element of maximizing the quality of life for individuals with disabilities, although they spent more time on social services as compared to medical services. Their confidence in assisting the individuals they serve with respect to health promotion and disease management activities was demonstrably weaker than their reported knowledge levels for most items. Barriers to accessing those services might create this apparent disconnect between knowledge and confidence.     

Managing physical and mental health conditions: Consumer perspectives on integrated care

Despite the growing trend of integrating primary care and mental health services, little research has documented how consumers with severe mental illnesses (SMI) manage comorbid conditions or view integrated services. We sought to better understand how consumers perceive and manage both mental and physical health conditions and their views of integrated services. We conducted semi-structured interviews with consumers receiving primary care services integrated in a community mental health setting. Consumers described a range of strategies to deal with physical health conditions and generally viewed mental and physical health conditions as impacting one another. Consumers viewed integration of primary care and mental health services favorably, specifically its convenience, friendliness, and knowledge of providers, and collaboration between providers. Although integration was viewed positively, consumers with SMI may need a myriad of strategies and supports to both initiate and sustain lifestyle changes that address common physical health problems.     

Student bodies, past and present

This article examines how the field of college health has evolved over time to address the needs of an increasingly diverse student population. The central argument is that college and university health programs developed in conjunction with shifting standards of medical care and public health practices in the United States. The author reviews the role of college health programs as public health agencies for campus communities, and describes contemporary public health challenges facing college campuses. She shows how the history of college health is intertwined with the history of diversity in higher education. In particular, the author outlines how the growth of health services made higher education accessible to women, racial minorities, veterans, and persons with disabilities.     

Medical care, living conditions, and children's well-being

We examine the effect of medical care and living conditions on children's physical and psychological well-being. We develop a causal model in which living conditions (including the socioeconomic status of the family and the social-psychological aspects of family functioning) may affect well-being both directly, and indirectly through medical care. We find that families in the higher social classes and families that function well tend to go to large prepaid groups where they receive good medical care. High quality technical care of illness, in turn, improves physical health. The quality of psychotherapeutic care, on the other hand, has no effect on psychological well-being. For this aspect of health, the effect of living conditions is largely direct, rather than indirect by way of medical care. Families characterized by high levels of functioning have children who are psychologically healthy. In addition, physical health affects psychological well-being, but not vice versa.     

Translating collaborative models of mental health care for older adults: using Iowa's experience to inform national efforts

The Patient Protection and Affordable Care Act supports the translation of collaborative models of mental health care, but how the act will affect older adults remains unclear. The authors examined a sample of older Medicare beneficiaries and evaluated how individual characteristics, local service supplies, and other contextual features corresponded with the identification of older persons with psychiatric diagnoses and their access to specialty mental health care providers. Older adults presented a variety of psychiatric disorders, and their access and use of specialty mental health care related to age; sex; diagnosis; supply of mental health, health, and long-term care providers; and whether an older person lived in a rural area. Translation of collaborative models should consider a range of psychiatric conditions, adjust for varying local provider supplies, and consider the challenges in establishing collaborative care within rural areas.     

Healthcare Use in the Heartland: How Health Care Selection Varies Between Rural,Retirement‐Age Migrants and Long‐Term Residents

One increasingly important problem affecting rural health care selection is the tendency of older residents to bypass local health care providers. This research investigates how the effects of community characteristics and attachment on health care bypass behavior vary between rural retirement‐age migrants and retirement‐age long‐term residents. Non‐health‐related behaviors, such as purchasing goods and services outside one's community during a health care trip, that is, “outshopping,” could influence bypass if individuals combine trips for their medical care with other consumer needs. Basing our work on the outshopping theory, we argue that bypass behavior is one facet of consumer consumption patterns for both rural retirement‐age migrants and long‐term residents. In addition, dissatisfaction with local health care and services like shopping can “push” rural residents to bypass local health care and travel greater distances for primary health care. We further contend that strong community attachment has an opposite “pull” effect that can help to negate the push of outshopping and reduce the likelihood of bypass. Our results reveal retirement‐age migrants are significantly more likely to bypass local primary health care providers than retirement‐age long‐term residents. Furthermore, our analysis bridges the rural health care and retirement community development literature to suggest that outshopping theory can now be applied to rural primary health care bypass behavior.