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1.
J Addict Nurs ; 32(3): 197-204, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34473449

RESUMEN

ABSTRACT: This article provides examples of the application of technology transfer to improve the delivery of addiction prevention, treatment, and recovery. The article describes a case example of two regional Technology Transfer Centers (TTCs) focused on addiction and mental health. It illustrates the importance of cross-regional and network-wide activities as well as meaningful collaborations with other regional networks, professional associations, and state and federal entities. This article describes a model of identifying and delivering meaningful training and technical assistance (T/TA), which also advances interprofessional collaborations and shared ownership. The described model includes collaboration in assessing behavioral health T/TA needs and preference for delivery of T/TA. The case study presents the process of engaging providers and connecting them with content experts on emerging topics in the field of addiction. This work included T/TA around integrated care, co-occurring disorders, cultural humility and inclusion, and use of data to advance system care. The case also outlines the application and use of evidence-based translation models, including Project ECHO (Extension for Community Healthcare Outcomes) and Communities of Practice.


Asunto(s)
Fuerza Laboral en Salud , Psiquiatría , Humanos , Salud Mental , Transferencia de Tecnología , Recursos Humanos
2.
J Am Dent Assoc ; 152(9): 717-718, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34454646
3.
J Am Dent Assoc ; 152(4): 293-301, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33775287

RESUMEN

BACKGROUND: American Indian (AI), Alaska Native (AN), and Native Hawaiian (NH) populations report higher rates of diabetes, poorer oral health, and fewer dental visits than their peers. The authors aimed to identify relationships between oral health and dental visits and diabetes diagnosis among AI, AN, and NH elders. METHODS: Data were obtained from a national survey of AI, AN, and NH elders 55 years and older (April 2014-2017) and included 16,136 respondents. Frequencies and χ2 tests were used to assess the relationship between oral health and dental visits, and diabetes. RESULTS: Nearly one-half of the elders reported receiving a diagnosis of diabetes (49.2%). A significantly (P < .01) greater proportion of elders with diabetes reported a dental visit in the past year (57.8%) than those without. Differences (P < .01) were found between reported diabetes and need for extraction, denture work, and relief of dental pain. The authors found lower dental visit rates among elders with diabetes who were low income, older, unemployed, not enrolled in the tribe, lived on the reservation, and had only public insurance. CONCLUSIONS: There is a need to increase oral health literacy and dental visits among elders with diabetes and, more urgently, a need to focus on providing care for subpopulations reporting lower visit rates. PRACTICAL IMPLICATIONS: Dental providers must serve as a referral resource for at-risk elders and must work with and educate about the importance of oral health those who assist tribal elders with diabetes management, including primary care physicians, certified diabetes educators, nutritionists and dietitians, and public health care professionals.


Asunto(s)
Nativos Alasqueños , Diabetes Mellitus , Indios Norteamericanos , Anciano , Nativos Estadounidenses , Diabetes Mellitus/epidemiología , Humanos , Grupo de Ascendencia Oceánica , Salud Bucal
4.
Health Educ Behav ; 48(1): 63-73, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33218261

RESUMEN

Empirical evidence describes the negative outcomes people with mental health disorders experience due to societal stigma. The aim of this study was to examine the role of gender and rural-urban living in perceptions about mental illness. Participants completed the Day's Mental Illness Stigma Scale, a nationally validated instrument for measuring stigma. Directors of Chambers of Commerce in North Dakota distributed the electronic survey to their members. Additionally, distribution occurred through use of social media and other snowball sampling approaches. Analysis of data gathered from 749 participants occurred through examination of the difference in perceptions based on geography and gender. The zip codes of residence were sorted to distinguish between rural and urban participants. Application of weighting measures ensured closer alignment with the general population characteristics. Findings indicate that for the majority of the seven stigma measures the Day's Mental Illness Stigma Scale examines, the coefficient of rural-gender interactions was positive and highly significant with higher levels of stigma in rural areas. Females exhibited lower stigma perceptions than males. However, women living in rural areas held higher degrees of stigma compared to urban residing females. Implications of the study include the need to advance mental health literacy campaigns for males and people residing in rural communities. Additional empirical studies that examine the role of geography and gender in understanding stigma toward people with mental health disorders will result in improved treatment outcomes due to increased and focused educational efforts.


Asunto(s)
Trastornos Mentales , Población Rural , Femenino , Geografía , Humanos , Masculino , Estigma Social , Población Urbana
5.
J Aging Health ; 31(10): 1917-1940, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-30238843

RESUMEN

Objective: This study describes trends in self-reported dental care utilization and services needed among American Indian/Alaska Native/Native Hawaiian (AI/AN/NH) elders 2008 to 2017, including demographic and socioeconomic variability. Method: Researchers utilized data from the Survey of Elders administered by the National Resource Center on Native American Aging, representing all regions of the United States and 262 tribes. Data were analyzed comparing means over time and between/within groups. Results: Between April 2008 and March 2017, there was a statistically significant (p < .001) increase in the proportion of older adults who visited a dentist and an increase in need for treatment. A smaller proportion of older adults reported need for treatment among those who were privately insured, high income, had no tobacco use, were employed, and had visited a dental professional in the last year. Discussion: These findings highlight current dental needs among tribal elders while also identifying elders at greater risk of poor oral health.


Asunto(s)
Nativos Alasqueños/estadística & datos numéricos , Atención Odontológica/estadística & datos numéricos , Indios Norteamericanos/estadística & datos numéricos , Evaluación de Necesidades , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Anciano , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología
6.
Prev Chronic Dis ; 15: E37, 2018 03 22.
Artículo en Inglés | MEDLINE | ID: mdl-29565785

RESUMEN

INTRODUCTION: Chronic disease studies have omitted analyses of the American Indian/Alaska Native (AI/AN) population, relied on small samples of AI/ANs, or focused on a single disease among AI/ANs. We measured the influence of income, employment status, and education level on the prevalence of chronic disease among 14,632 AI/AN elders from 2011 through 2014. METHODS: We conducted a national survey of AI/AN elders (≥55 y) to identify health and social needs. Using these data, we computed cross-tabulations for each independent variable (annual personal income, employment status, education level), 2 covariates (age, sex), and presence of any chronic disease. We also compared differences in values and used a binary logistic regression model to control for age and sex. RESULTS: Most AI/AN elders (89.7%) had been diagnosed with at least one chronic disease. AI/AN elders were also more than twice as likely to have diabetes and more likely to have arthritis. AI/AN elders with middle-to-low income levels and who were unemployed were more likely to have a chronic disease than were high-income and employed AI/AN elders. CONCLUSION: Addressing disparities in chronic disease prevalence requires focus on more than access to and cost of health care. Economic development and job creation for all age cohorts in tribal communities may decrease the prevalence of long-term chronic diseases and may improve the financial status of the tribe. An opportunity exists to address health disparities through social and economic equity among tribal populations.


Asunto(s)
Nativos Alasqueños/estadística & datos numéricos , Enfermedad Crónica/epidemiología , Disparidades en el Estado de Salud , Indios Norteamericanos/estadística & datos numéricos , Anciano , Enfermedad Crónica/etnología , Estudios Transversales , Estatus Económico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Factores de Riesgo , Distribución por Sexo , Estados Unidos/epidemiología
7.
J Rural Health ; 34(4): 369-376, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29058344

RESUMEN

PURPOSE: In order to redirect at-risk patients to more appropriate, cost-effective behavioral health care, research must identify the prevalence, and common characteristics, of patients presenting to the emergency department (ED) for mental disorders. QUESTION: Are large, small, and/or isolated rural patients presenting to the ED for mental disorders in greater proportion than urban ED patients? METHODS: Analyses included data from the Health Care Cost and Utilization Project State Emergency Department Databases (2013) provided by 7 states, covering all Census regions. Variables included patient demographics, ZIP code, and primary and secondary ED diagnoses. ZIP codes were linked to the Rural-Urban Commuting Areas, aggregating into 4 categories. Prevalence rates were compared within and between groups (P < .05). FINDINGS: Nearly 1 in 20 ED visits carried a primary/secondary diagnosis of mental disorder. Large, small, and isolated rural patients were not more likely than urban patients to present to the ED for mental disorders. Large, small, and isolated rural residents diagnosed with a primary/secondary mental disorder in the ED were more likely than urban to be female, 65 years of age or older, covered by Medicaid or Medicare, and dual eligible. The top 3 diagnoses for mental disorders in the ED were anxiety-state, unspecified; depressive disorder; and suicidal ideation. CONCLUSIONS: EDs treating large, small, or isolated rural patients with mental disorders are more likely to treat populations identified in the literature at greater risk of preventable visits, readmitting, and more costly care. Recommendations are made for policy, community interventions, workforce, and training.


Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Adolescente , Adulto , Anciano , Servicio de Urgencia en Hospital/organización & administración , Femenino , Accesibilidad a los Servicios de Salud/normas , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Servicios de Salud Mental/normas , Servicios de Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , Población Rural/estadística & datos numéricos , Estados Unidos , Población Urbana/estadística & datos numéricos
8.
Popul Health Manag ; 19(3): 216-23, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26451808

RESUMEN

In the spring of 2014, the North Dakota Center for Rural Health (CRH) was tasked with completing an objective assessment of the state oral health environment. This included an assessment of oral health status, review of workforce needs, evaluation of current oral health programs, and policy recommendations to ameliorate identified oral health needs. The report was prepared for the North Dakota Legislative Health Services Interim Committee. This article highlights a research method developed and employed to identify current population health status and policy recommendations through statewide collaboration, transparent process, and objective analyses, regardless of the health specialty of focus. Evidenced-based decision making in health policy requires more than presentation of data. It requires input from the population or community utilizing or struggling to gain access to the given health service. It is now understood that health services researchers must employ a variety of research methods, include end users in the research process, tailor presentation of the findings for the appropriate audience, and include the population of study in the research, allowing them to provide recommended solutions when possible. Although the effort to be described focused specifically on oral health in North Dakota, the methodologies used to answer the research questions could, and are encouraged to, be employed in other states with regard to other specialty health disciplines and population health studies. The study sought to answer 3 questions: (1) What is the population health need?; (2) What is already being done?; and (3) What are the recommendations to improve population health? (Population Health Management 2016;19:216-223).


Asunto(s)
Política de Salud , Necesidades y Demandas de Servicios de Salud , Estado de Salud , Investigación sobre Servicios de Salud , Humanos , Modelos Organizacionales , North Dakota , Formulación de Políticas
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