Greater Kansas City Research Articles

Combined COVID-19 and flu tests could help overwhelmed hospitals

In greater Kansas City, COVID-19 cases are climbing. Raghu Adiga, the chief medical officer at Liberty Hospital, is worried—and a little bit angry. He has neither the staff nor the testing capacity...

A Sociological Peregrination of Cultural Immersion of the South Sudanese “Lost Boys” in the greater Kansas City Area

A Sociological Peregrination of Cultural Immersion of the South Sudanese “Lost Boys” in the greater Kansas City Area

Abstract P481: Key Findings From Multilevel Stakeholder Input On Awareness, Gaps And Needs Related To The Burden Of Hypertension

Background: Hypertension (HTN) continues to pose a considerable challenge to the health system. Suboptimal rates of screening, awareness, treatment and control, reported at national and local levels, reflect an urgent need for a coordinated and collective approach to action. Methods: On May 20, 2017 (World HTN day), we convened a one-day HTN summit in response to an expressed need from stakeholders across the health system (healthcare, public health, community organizations) in the Bi-State Greater Kansas City Area. To help formulate an action plan, we administered a pre-and post-survey to document stakeholder engagement in HTN programs, their awareness of existing key initiates and resources, and perceived needs to address HTN. Results: Overall, 24 individuals from 16 organizations registered for the event and completed a pre-event survey - healthcare system (46%), Public health or Government organizations (17%), Community organizations (29%), Academic entity (8.3). Thirteen (54%) attendees completed the post-event survey - 29% delivered healthcare services, 57% conducted community activities, 21% were patients or caregivers. Only 32% of the attendees reported a current program on blood pressure. Less than 10% of participants reported satisfaction with the availability of regularly scheduled learning opportunities or tools for healthcare professionals or patients to improve HTN. Only 21% of participants reported monitoring of performance on metrics related to high blood pressure programs. All attendees expressed interest in continued meetings, patient engagement resources, and an in-depth exploration of the underlying factors contributing to the burden of uncontrolled HTN. Findings also reflected a significant need to improve the awareness of resources like the Missouri Million Hearts initiative and Target BP™. Conclusion: In spite of temporal advancements in cardiovascular medicine, there exist significant gaps in the awareness and use of resources and tools to support HTN management among stakeholders in the health system. Planned strategies include a dedicated working group to proactively identify and support coordinated, multi-stakeholder efforts to reduce the HTN burden and improve cardiovascular health in our communities.

Lessons from a Broad-based ACA Outreach Effort: Promises and Pitfalls.

The Marketplace Coverage Initiative (MCI) sought to expand awareness and ACA Marketplace enrollment in the greater Kansas City Area. The MCI was evaluated through interviews, surveys, and focus groups. Two main findings are particularly relevant for future Marketplace enrollment efforts. First, the link between contacting someone and actual enrollment is tenuous as follow-up is challenging. Outreach efforts that only track contacts, such as appointments and email addresses, lack information needed to assess enrollment. Linking outreach activities to enrollment outcomes leads us to a dramatically different conclusion about using big data and campaign-style tactics than evaluations of similar techniques such as that pioneered by Enroll America in 11 states. Second, there is a large chasm between the knowledge levels of the uninsured and the decisions they face on the Marketplace. Based on these findings, outreach efforts were redesigned for the 2014 open enrollment period to focus on smaller, community-driven projects.

Capital Matters

This article investigates accrual, role, and impact of social capital of the southern Sudanese formerly known as the Sudanese refugee Lost Boys living in the greater Kansas City area. Since their resettlement in the United States in 2000, Sudan has seen a dramatic transition in its long geo-political conflict since its independence in 1956 ending up in cessation of the south from the north. This cessation has created the newest country in the world (South Sudan). Simultaneously, a group of refugee Boys commonly known as the Lost Boys of Sudan has renounced being called so. Instead, they prefer being called “South Sudanese.” The study uses semi-structured interviews to assess the degree of social capital of each refugee participant relative to types of “capital” valued in mainstream American society. An adjunct inquiry is finding what type of social capital endured by each of these Boys played a key role in helping them cope/integrate into American mainstream society.

Framework for Modeling Urban Restoration Resilience Time in the Aftermath of an Extreme Event

AbstractThe impacts of extreme events continue long after the emergency response has terminated. Effective reconstruction of supply-chain strategic infrastructure (SCSI) elements is essential for postevent recovery and the reconnectivity of a region with the outside. This study uses an interdisciplinary approach to develop a comprehensive framework to model resilience time. The framework is tested by comparing resilience time results for a simulated EF-5 tornado with ground truth data from the tornado that devastated Joplin, Missouri, on May 22, 2011. Data for the simulated tornado were derived for Overland Park, Johnson County, Kansas, in the greater Kansas City, Missouri, area. Given the simulated tornado, a combinatorial graph considering the damages in terms of interconnectivity between different SCSI elements is derived. Reconstruction in the aftermath of the simulated tornado is optimized using the proposed framework to promote a rapid recovery of the SCSI. This research shows promising results when...

Implementation Frameworks and MSW Curricula: Encouraging Pursuit and Use of Model Pertinent Data

Graduate preparation of social workers and the infrastructure of service delivery too often limit the pursuit and use of data to inform practice. We review literature addressing student and practitioner motivation and interests, as well as masters-level social work curriculum content. This establishes a context for presentation of Masters in Social Work (MSW) student evaluations of program implementation at 34 field placement sites throughout the greater Kansas City region. Their evaluations focus through frameworks identified by the National Implementation Research Network to examine patterns of implementation and program data usage. Based on student lessons learned, we suggest MSW curricula revision to foster student and program appreciation and use of data.

Suburban Opposition to District Reorganization: The 1968 Spainhower Commission and Metropolitan Kansas City and St. Louis

The 1968 Spainhower Commission planned extensive changes in the organization of public education in Missouri, proposing larger, comprehensive districts throughout the state. Intended to increase efficiency and reduce inequities, its reform proposals spurred widespread opposition from both rural and suburban communities. In the suburbs hostility was particularly vehement and often was expressed in racial terms, revealing fault lines that came to divide large metropolitan regions in the 1960s. There were differences in the response of suburbanites in Kansas City and St. Louis, however, as resistance was expressed more adamantly in greater Kansas City. In St. Louis, a local tradition of holding meetings to discuss educational problems and inter-district cooperation appears to have helped mediate opposition to the suggestion of change. Eventually districts in greater St. Louis participated in an extensive transfer plan for urban students, while districts in metro Kansas City did not. Despite these differences, suburban residents’ antagonism in both areas toward plans for sending significant numbers of urban students to their schools remains quite high today, suggesting that patterns of conflict revealed in the Spainhower era continue to exist.

Academic Service Partnerships: Organizational Efficiency and Efficacy Between Organizations

Two leading nursing organizations, the Greater Kansas City Area Collegiate Nurse Educators and the Kansas City Area Nurse Executives, represent the Kansas City metropolitan area nursing programs and area employers. These two organizations have been engaged in collaborative workforce planning and strategy development around key nursing issues for over 25 years. This model of collaboration is unique in that the partnership is between organizations representing 17 nursing programs and 28 hospitals. The collaborative partnership has enhanced organizational efficiency and efficacy between the groups, which has directly benefited the organizational members. Most importantly, it has had a transformative impact on both nursing education and professional practice in the Kansas City metropolitan area. This article describes the evolution of the partnership and the collaborative work that has led to the accomplishment of mutual goals.

Keeping It Real

Problem: It is easier than ever to reach out to the public, but as communication channels proliferate, it becomes difficult to compete for people's attention. Also, it seems as though fantasy and spectacle (even in news coverage) have the best chances of capturing an audience. Can planners create what Duncombe (2007) calls “ethical spectacles,” where planning projects get noticed, but still gain substantive public input? Purpose: Currently, reality television shows are the masters of “spectacle” and viewer participation. This article uses the reality TV formula to critique a televised planning event sponsored by the council of governments for the Greater Kansas City region. The model for successful reality TV offers strategies for improving televised planning processes by making these programs more dynamic and interactive. The reality TV formula includes the following: real people, uncontrolled situations, immediacy and intimacy, an emphasis on conflict in which participants balance individual and community needs, an observational style, a “confessional space,” editing to create an entertaining package, and interactive elements (voting, texting by home viewers). Methods: The study uses genre criticism to compare and contrast the Imagine KC televised town meeting with the successful reality TV formula. Results and conclusions: Planners can use reality TV to create “ethical spectacles” and more effectively draw attention to planning issues while creating two-way dialogues with the public. Duncombe's (2007) ethical spectacles are directly democratic, fostering community while allowing for diversity. They also take up real issues but explore alternate futures. These are all familiar to planners who have used more typical public participation techniques (e.g., surveys, charrettes) while adhering to the American Institute of Certified Planners’ code of ethics. Takeaway for practice: While reality TV offers planners strategies for creating compelling televised public participation programming, reality TV is not without its faults. Planners should avoid the exploitative manner in which reality TV producers regard the participants, as well as its manipulative style and aesthetic of humiliation, which emphasizes drama and conflict over documentary realism and ethical considerations. If planners are going to use the medium of television, the reality TV formula provides an attractive option for those seeking to inform and interact with a large, diverse audience. Research support: None.

The State of Middle School and High School Labs in the Kansas City Region

This report shares the findings of an audit conducted across thirty school districts in which the state of science labs was assessed. The audit was conducted by SuccessLink, with funding of the project from the Ewing Marion Kauffman Foundation. This study was conducted as part of the Kauffman Foundation’s multi-year agenda to improve student achievement in mathematics, science, and technology subjects in the Greater Kansas City region.Auditors visited 170 school buildings in thirty school districts over a five-month period during the 2006-2007 school year. They recorded observations on safety issues, science lab facilities, and equipment and materials. Auditors also conducted teacher interviews and provided online surveys to teachers and administrators in order to assess aspects of instruction, learning, and district policies. This data was then compared to standards set by the National Science Teachers Association (NSTA). The results indicate that science labs in the Kansas City region do not meet national standards and that much work needs to be done to bring the school science labs up to the national standards.

Youth Leadership, Racism, and Intergroup Dialogue

The National Conference for Community and Justice- Greater Kansas City's Youth Leadership Institute (Anytown) for high school-aged youth-is designed to expose young people to multicultural issues and topics and facilitate purposeful intergroup dialogue on addressing systemic oppression and privilege. An evaluation was conducted over a three-year period to determine whether the Anytown programming had an effect on changing the knowledge and attitudes of participants concerning a variety of racial/ethnic groups. At the beginning of the first day of the 7-day residential institute and again at the end of the last day, the students completed a self-report survey rating a series of statements concerning their knowledge and attitudes. At the end of each day, the students also answered open-ended questions concerning what they had learned during the day. Frequencies, t-tests, ANOVA comparisons, and content analyses were conducted. In every area measured by the pre- and post-Institute surveys, there was a statistically significant positive change, at the 95% or higher confidence level, in respondents' ratings of their knowledge and attitudes.

Observed Distribution Patterns of On-Ramp Merge Lengths on Urban Freeways

Three on-ramp sites with moderate to high volumes of through and merge traffic along I-35 within the greater Kansas City, Kansas and Missouri, metropolitan area were selected for investigation of the distribution patterns of the merge lengths of ramp vehicles. On the basis of the observed merging behaviors, merge vehicles were categorized into three types: free merge (FM), challenged merge (CM), and platoon merge (PM). The field data were analyzed with specifically developed software. The results show that (a) FM vehicles merge onto a freeway at arbitrary locations, (b) CM vehicles require traveling a longer distance before a safe merge, and (c) PM vehicles follow a natural smooth path and force themselves onto the mainline traffic within a certain area of a merge lane. The 85th-percentile merge length of all ramp vehicles was further observed to be related to the CM volume, the PM volume, and the average speed of the freeway right-hand first lane. Finally, the potential applications of these findings were discussed, with an example illustrating how to use the 85th-percentile merge length to determine the minimum merge lane length for an urban freeway on-ramp.

Urban Freeway On-Ramps

In this paper the influences of the ramp flow on the freeway flow are deemed invasive influences because the freeway vehicles' priority is violated and the freeway flow is interrupted. Understanding of the invasive influences of the freeway entry process helps to promote efficient and safe operations of the main-line facility and to identify more straightforward indicators of level of service (LOS) for freeway on-ramp segments. First, on the basis of field observations conducted at three on-ramp sites along I-35 within the greater Kansas City, Kansas and Missouri, metropolitan area, ramp merging behavior of vehicles in platoons was identified as the direct cause of invasive influences on the freeway flow. Then, the significance of the invasive influences was evaluated in accordance with the evasive events performed by freeway drivers. These evasive events, instigated by merging conflicts, include slowdown and lane change actions. Finally, more straightforward LOS indicators were recommended for improving the current (2000) Highway Capacity Manual LOS evaluation procedure for freeway on-ramp segments.

Relationship Between Prereferral Periodontal Care and Periodontal Status at Time of Referral

According to a recent study, the severity of periodontal disease of individuals referred for periodontal care is greater now than in 1980. Variability in the standard of periodontal care in general dental practices may result in less than desirable outcomes and consequences of poorer periodontal health. A sample of 100 newly referred dental patients from three separate periodontal practices in the greater Kansas City, Missouri area participated in this study. Data were collected from three sources: 1) a clinical chart audit, 2) current periodontal disease status as determined by clinical examination, and 3) a patient response questionnaire on past professional care and personal oral care habits. Bivariate analyses were performed using a statistical package. Of the 100 subjects, 74 were diagnosed as periodontal case type IV at the point of referral, of which 29.8% were treatment planned by the periodontist for two or more extractions. Teeth treatment planned for extraction were significant as a function of disease severity (P = 0.0001). Periodontal treatment provided in general dental practices did not vary because of disease severity. The incidence of deep cleanings (scaling and root planing) was reported slightly higher (32.4%) for case type IV than for case type III (26.9%), but this difference was not statistically significant. The average number of cleanings received in the general dental office was less than the standard of care according to the severity of the disease. If one assumes that the data obtained in the Kansas City practices are representative of a larger geographic area, it indicates that dentistry may be failing to address issues of the timely diagnosis of periodontal disease, appropriate treatment, and/or timely referral for treatment.

Access to Polling Places in the 2004 Presidential Election: The Experience of One Metropolitan Midwestern City

According to federal law, polling places must be accessible to persons with disabilities. The rate of compliance with these laws, however, is not known. Our purpose was to determine whether polling places in the Greater Kansas City area were physically accessible to persons with disabilities. Students, faculty, and staff members from four professional programs representing two universities completed surveys at 128 polling places on the day of the 2004 Presidential election. Over the 14 items of interest, compliance ranged from 75% to 99%. The highest rate of deficiencies was found in the lack of a ramp with a handrail to the entrance of the polling place. Only 43% of the polling places were compliant in all of the 14 survey items. Despite laws mandating that polling places be accessible to persons with disabilities, restrictions in access persist. Persons with disabilities may still find polling places inaccessible on Election Day.

Geographic variation, physician characteristics, and diabetes care disparities in a metropolitan area, 2003–2004

Quality improvement begins with quality measurement. Quality improvement continues by examining variation in patient standards of care. Diabetes is a complex chronic disease requiring aggressive care to improve and prolong life. Identifying and determining what factors explain care variation—including physician office location, physician characteristics, practice factors, and the translation of knowledge over time—is an area of important research. Determining physician practice characteristics’ impact on these diabetes measures is an important step in understanding diabetes care in greater Kansas City. Aggregated diabetes HEDIS data from numerous private insurance plans from greater Kansas City, and associated practice factors from these same providers serves as a large and representative source of information to evaluate the impact of these factors on diabetes care. Using both multivariate and logistic methods, we find that the variation in care is largely explained by physician office location, but there is statistical explanatory significance for physician age on A1c testing rates. Also, nephropathy screening rates are positively related to whether a physician is a member of a group or a solo practice. The location of a practice has significant effects for diabetes care because physician office location approximates to some extent patient characteristics. This is not to say that physician practice factors are unimportant, rather that diabetes care is complex, and requires a fruitful interaction between physician and patient. Quantifying the interaction between an informed, activated patient and a prepared, proactive physician is difficult to observe and measure, and evaluating testable hypotheses about this interaction is correspondingly difficult.

Evaluation of the Anytown Leadership Institute Programming on Lesbian, Gay, Bisexual and Transgender Issues

Lesbian, gay, bisexual, and transgender (LGBT) youth in the United States grow up in a social environment that often renders them invisible and targets them for violence and abuse. In addition, both LGBT and heterosexual youth have minimal access to accurate facts and information about sexual orientation and gender identity. In 2002, the National Conference for Community and Justice (NCCJ), Greater Kansas City Region integrated LGBT education into their 7-day residential Anytown Leadership Institute. An evaluation conducted over a three-year period found that there was statistically significant positive change in respondents' self-ratings of knowledge and attitudes before and after the Institute experience.

NAPNAP updates

NAPNAP updates

Building a donor‐focused community foundation

AbstractFor the Greater Kansas City Community Foundation, strategic changes implemented over a ten‐year period have resulted in dramatically increased charitable giving, new types of donors, and growing civic involvement as donors indicate that the foundation's approach adds value to their giving.