Health Management Program Research Articles

"We need to work towards it, whatever it takes."-participation factors in the acceptability and feasibility of lung cancer screening in Australia: the perspectives of key stakeholders.

Low dose computed tomography (LDCT) screening, targeted at those at high-risk, has been shown to significantly reduce lung cancer mortality and detect cancers at an early stage. Practical, attitudinal and demographic factors can inhibit screening participation in high-risk populations. This study aimed to explore stakeholders' views about barriers and enablers (determinants) to participation in lung cancer screening (LCS) in Australia. Twenty-four focus groups (range 2-5 participants) were conducted in 2021 using the Zoom platform. Participants were 84 health professionals, researchers, policy makers and program managers of current screening programs. Focus groups consisted of a structured presentation with facilitated discussion lasting about 1 hour. The content was analysed thematically and mapped to the Consolidated Framework for Implementation Research (CFIR). Screening determinants were identified across each stage of the proposed screening and assessment pathway. Challenges included participant factors such as encouraging participation for individuals at high-risk, whilst ensuring that access and equity issues were carefully considered in program design. The development of awareness campaigns that engaged LCS participants and health professionals, as well as streamlined referral processes for initial entry and follow-up, were strongly advocated for. Considering practical factors included the use of mobile vans in convenient locations. Participants reported that LCS in Australia was acceptable and feasible. Participants identified a complex set of determinants across the proposed screening and assessment pathway. Strategies that enable the best chance for program success must be identified prior to implementation of a national LCS program.

Machine-learning model predicting quality of life using multifaceted lifestyles in middle-aged South Korean adults: a cross-sectional study

BackgroundIn the context of population aging, advances in healthcare technology, and growing interest in healthy aging and higher quality of life (QOL), have gained central focus in public health, particularly among middle-aged adults.MethodsThis study presented an optimal prediction model for QOL among middle-aged South Korean adults (N = 4,048; aged 30–55 years) using a machine-learning technique. Community-based South Korean population data were sampled through multistage stratified cluster sampling. Twenty-one variables related to individual factors and various lifestyle patterns were surveyed. QOL was assessed using the Short Form Health Survey (SF-12) and categorized into total QOL, physical component score (PCS), and mental component score (MCS). Seven machine-learning algorithms were used to predict QOL: decision tree, Gaussian Naïve Bayes, k-nearest neighbor, logistic regression, extreme gradient boosting, random forest, and support vector machine. Data imbalance was resolved with the synthetic minority oversampling technique (SMOTE). Random forest was used to compare feature importance and visualize the importance of each variable.ResultsFor predicting QOL deterioration, the random forest method showed the highest performance. The random forest algorithm using SMOTE showed the highest area under the receiver operating characteristic (AUC) for total QOL (0.822), PCS (0.770), and MCS (0.786). Applying the data, SMOTE enhanced model performance by up to 0.111 AUC. Although feature importance differed across the three QOL indices, stress and sleep quality were identified as the most potent predictors of QOL. Random forest generated the most accurate prediction of QOL among middle-aged adults; the model showed that stress and sleep quality management were essential for improving QOL.ConclusionThe results highlighted the need to develop a health management program for middle-aged adults that enables multidisciplinary management of QOL.

Dental decay in children and the link to weight status: A cross-sectional analysis of national school health data

Recent national reports have indicated an increasing trend of dental decay among school-aged children. National school-based data are required to guide decision-making to ensure effective public health efforts to manage dental decay. This study aimed to assess the prevalence of dental decay among school-age children in Saudi Arabia and explore the possible link between dental decay and weight status. This was a cross-sectional analysis of a national sample including 1,134,317 Saudi children in the 1st, 4th, 7th, and 10th grades who participated in a national school screening program. Data for weight, height, body mass index (BMI), dental decay prevalence, and decayed, missing, and filled teeth (DMFT) index were analysed. An independent t-test, one-way analysis of variance, and chi-square test were used to compare the means, while Pearson’s r correlation and multiple linear regression were used to examine the relationships between the study variables. The prevalence of dental decay was 24.20%, and dental decay was the highest among female students (26.5%), students in primary school (25.9%), students living in the eastern region (35.2%), in the administrative capital (27.6%), and in rural areas (23.4%). Dental decay was the highest among students who were underweight. Female sex and living in rural areas significantly predicted higher DMFT while being overweight/obese significantly predicted lower DMFT. Dental decay is highly prevalent among underweight students, female students, and students living in rural areas and the eastern regions of Saudi Arabia. To reduce the prevalence of dental decay and related health disparities, dental health screening programs should be designed to detect dental decay early among children at high risk due to abnormal BMIs and sociodemographic factors. In addition, dental health screening and management programs should utilize standardized dental decay assessment methods and ethnically representative growth charts.

The Effect of an Empowerment-Based Health Management Program within a Medical Consortium Framework on Secondary Prevention of Stroke

The Effect of an Empowerment-Based Health Management Program within a Medical Consortium Framework on Secondary Prevention of Stroke

Determinants of Oral Health-Related Quality of Life in Older People with Diabetes Mellitus: A Secondary Analysis of the 8th Korean Longitudinal Study of Aging (KLoSA) Dataset

Purpose : This study aimed to comprehensively evaluate the factors that influence the oral health-related quality of life (OHRQoL) of older adults with diabetes mellitus (DM) using the 8th Korean Longitudinal Study of Aging (KLoSA) dataset. Methods : This secondary analysis utilized the 8th KLoSA dataset from 2020, with a study sample of 1,144 older adults with DM. Dependent variable: OHRQoL; independent variables categorized into socio-demographic, oral health-related, and health-related characteristics. Complex Samples General Linear Model and Bonferroni correction in IBM SPSS/Win 26.0 were employed for assessing factors influencing OHRQoL. Results : The average OHRQoL was 33.96±0.28 points out of 60. Factors influencing OHRQoL included subjective health status (good: t＝3.00, p＝.003; moderate: t＝4.38, p＜.001), wearing dentures (yes) (t＝ -2.89, p＝.004), having heart disease (t＝-2.50, p＝.013), having arthritis (t＝-2.19, p＝.028), and experiencing depression (t＝-4.28, p＜.001). These factors explained approximately 20% of OHRQoL in older adults with DM. Conclusion : To enhance OHRQoL in older adults with DM, it is crucial to consider psychological factors such as depression in the development of continuous oral health management programs. Additional factors to consider include effective denture management and chronic disease conditions.

Sustainable prevention infrastructure in the healthcare system: Developments in The Netherlands

Introduction: There is increasing attention to (disease) prevention within healthcare. However, in OECD countries only around 1% of health expenditure is spent on prevention. In the Netherlands different parties are responsible for organizing prevention. As a consequence, embedding preventive activities into the Dutch healthcare system lags behind. Especially for people with health risks, such as overweight children or frail older people. In order to move towards sustainable organized prevention, it is necessary that organizations start working together. In recent years several policy interventions have been introduced to stimulate cross-sector collaboration and the transition towards sustainable prevention infrastructure in the healthcare system. The aim of this study is to learn more form this transition.
 Who is it for? Researchers, policymakers, collaborative prevention networks.
 Methods: This longitudinal qualitative study was conducted among collaborative networks working together on integrating prevention, care and welfare to build a prevention infrastructure. Interviews were held with representatives of municipalities, health insurers, municipality health services and program managers. Two to five interviews per network were conducted during a five year study period. In total 88 semi-structured interviews were held. Networks were followed over time to gain insight into experiences with cross-sectoral collaboration. And to explore the changes in perceived barriers and facilitators associated with collaborating on implementing a prevention infrastructure.
 Key findings: Barriers for implementing a prevention infrastructure are unknown (cost-)effectiveness and differences in organization culture between municipalities and health insurers. Growing awareness of the urgency of prevention and acknowledgement of mutual responsibilities can be seen as a facilitator. As well as national policy interventions concerning a regional prevention infrastructure and a intervention-oriented approach. Preconditions for cross-sector collaboration became more specific over time, commitment and trust provide the basis, followed by low-threshold contact and having a shared goal. Clearness about legal responsibilities is important for stakeholders in order to work together to organize prevention. The discussion on appropriate funding played a major role over the years.
 Conclusions/Learning: This study shows that collaboration regarding prevention is becoming more and more common. The relationship between key stakeholders, like municipalities and health insurers, is generally more strengthened than five years ago. They have better understanding of each other’s interests and expectations. In addition, they started to consider prevention more as their mutual responsibility in recent years. It was found to be important for the government to regularly collect from stakeholders what they need, in order to continuously improve national public health policy. 
 Next steps: Policies regarding prevention infrastructure continues to evolve, in order to further stimulate collaboration between stakeholder. Developments in this area will continue to be monitored in the coming years.
 Keywords: Prevention, health policy, healthcare system, cross-sector collaboration, longitudinal qualitative research, collaborative networks.

Wellness Perception of South Korean Elementary School Students during the COVID-19 Endemic.

Using convenience sampling, 675 South Korean elementary school students (age 11-12 years old) were selected as participants in July 2023. Data for the study were collected via online and offline surveys between July and August 2023. The collected data were subjected to frequency, reliability, and multicollinearity analyses, independent sample t-tests, and importance-performance analysis (IPA). The findings indicated the following: (1) There was no significant difference in health management performance between male and female children. (2) Children who had not experienced COVID-19 infection, had a higher level of "hygiene management" performance. (3) Among children who did not wear masks during physical activity, "mental health management" and "physical activity management" performance were higher, while "hygiene management" performance was lower. (4) The IPA matrix analysis revealed that, compared to the COVID-19 pandemic period, "physical activity management", "dietary habit management", and "sleep management" still required improvement, while "hygiene management" and "disease management" appeared to have decreased due to the relaxation of epidemic control efforts. As per the study's findings, schools, local communities, and families should make efforts to develop and implement preventive and individualized health management programs that consider the individual characteristics of their children.

Implementation of an Integrated Mobile Livestock Service Program at The Livestock and Animal Health Department of Aceh Province

Implementation is the process of carrying out new ideas, programs, or a set of activities with the expectation that others can accept and make changes, conveying several messages, ideas, or concepts through the process carried out by an individual in the sense of human relationships or what is called human relations. Mobile services are one of the implementations that can be applied to livestock information and health management programs. The objective of this research is to determine the implementation of the Integrated Mobile Livestock Service Program at the Livestock and Animal Health Department of Aceh Province. The research approach used in this study is qualitative, which examines the object and reveals existing cases contextually through collected data. Each district surveyed includes 50 people for this mobile cow service program. The observed aspects of this program include: Public complaints about livestock diseases through the application, Interest in using health service information on the application, Public satisfaction with the application. The research results indicate that the complaints found in the community are about scabies and FMD (Foot-and-Mouth Disease). However, these complaints are obtained directly from the community, and only a few come through the application. The average application visitors in Pidie district are 29.87, Bireuen district 29.03, Aceh Utara district 27.47, Aceh Timur district 30.77, and Langsa city 29.33. User satisfaction with the application is assessed through questionnaires given directly to the community. The survey results show that, on average, people still have a limited understanding of the application's usage and are not very satisfied.

간호대학생의 지각된 스트레스, 회복탄력성 및 정신질환에 대한 태도가 정신건강에 미치는 영향

This study was attempted to identify the perceived stress, resilience, attitude toward mental illness, and the degree of mental health of nursing students and their relationship, as well as the factors affecting mental health. The subjects were 200 nursing students from a university located in D City who participated from March 23 to April 10, 2023, and the collected data were analyzed by SPSS/Win 23.0. As a result of the study, the degree of mental health of nursing students was negatively correlated with perceived stress, and resilience and attitude toward mental illness were positively correlated. Perceived stress and resilience were the factors affecting the mental health of nursing students, and resilience was found to have the greatest impact on the mental health of nursing students, and explanatory power was 56.8% (F=88.132, p<.001). Based on the results of this study, it is necessary to develop and apply a mental health management program for nursing students and follow-up studies on various factors affecting the mental health of nursing students.

Facility-Based Audit System With Integrated Community Engagement to Improve Maternal and Perinatal Health Outcomes in Rural Pakistan: Protocol for a Mixed Methods Implementation Study.

Maternal and newborn mortality in Pakistan remains as a major public health challenge. Pakistan faces significant infrastructure challenges and inadequate access to quality health care, exacerbated by sociocultural factors. Facility-based audit systems coupled with community engagement are key elements in achieving improved health system performance. We describe an implementation approach adapted from the World Health Organization audit cycle in real-world settings, with a plan to scale-up through mixed methods evaluation plan. This study aims to implement a locally acceptable and relevant audit system and evaluate its feasibility within the rural health system of Pakistan for scale-up. The implementation of the audit system comprises six phases: (1) identify facility and community leadership through consultative meetings with government district health offices, (2) establish the audit committee under the supervision of district health officer, (3) initiate audit with ongoing community engagement, (4) train the audit committee members, (5) launch the World Health Organization audit cycle (monthly meetings), and (6) quarterly review and refresher training. Data from all deliveries, live births, maternal deaths, maternal near misses, stillbirths, and neonatal deaths will be identified and recorded from four sources: (1) secondary-level care rural health facilities, (2) lady health workers' registers, (3) community representatives, and (4) project routine survey team. Concurrent quantitative and qualitative data will be drawn from case assessments, process analysis, and recommendations as components of iterative improvement cycles during the project. Outcomes will be the geographic distribution of mortality to measure the reach, proportion of facilities initiated to implement an audit system for measuring the adoption, proportion of audit committees with community representation, and proportion of audit committee members' sharing feedback regularly to measure acceptability and feasibility. In addition, outcomes of effectiveness will be measured based on data recording and reporting trends, identified modifiable factors for mortality and morbidity as underpinned by the Three Delays framework. Qualitative data will be analyzed based on perceived facilitators, barriers, and lessons learned for policy implications. Results will be summarized in frequencies and percentages and triangulated by the project team. Data will be analyzed using Stata (version 16; StataCorp) and NVivo (Lumivero) software. The study will be implemented for 20 months, followed by an additional 4-month period for follow-up. Initial results will be presented to the district health office and the District Health Program Management Team Meeting in the districts. This study will generate evidence about the feasibility and potential scale-up of a facility-based mortality audit system with integrated community engagement in rural Pakistan. Audit committees will complete the feedback loop linking health care providers, community representatives, and district health officials (policy makers). This implementation approach will serve decision makers in improving maternal and perinatal health outcomes. DERR1-10.2196/49578.

Work-related stress and associated factors among health professionals working in Ambo town public health facilities, West Shoa Zone, Ethiopia, 2021: a cross-sectional study

ObjectivesTo assess work-related stress (WRS) and associated factors among health professionals working in Ambo town governmental health facilities, in 2021.DesignInstitution-based analytical cross-sectional study.SettingInstitution-based analytical cross-sectional study was conducted in Ambo...

Newborn Hearing Screening in Québec, Canada.

This study discusses the history and current state of the newborn hearing screening program in Québec and aims to assess general challenges associated with establishing universal newborn hearing screening (UNHS) programs. We reviewed the statistics of the occurrence and long-term effects of congenital hearing loss and the immediate and long-term benefits of UNHS and its limitations. The resources for this study included financial reports related to establishing UNHS in different health care systems; Canadian provincial, territorial, and federal regulations and publications; local and nationwide media; and interviews health care staff and program managers. Because of its benefits and its cost-effectiveness, UNHS programs have been implemented in many health care systems around the world. Despite Canada's success in offering a wide array of health care services to its citizens, certain provinces trail behind others in developing UNHS programs. Although there have been recent improvements in the screening rate of the province of Québec, nearly half of all Québec newborns continue to not be screened for hearing loss. The reasons for the current low screening rate include delays in implementation, information-technology complications, operating costs, and lack of public awareness. For UNHS to be implemented in a timely fashion, those involved in the process should first understand what challenges may arise. Québec's experience with this process may provide useful lessons for other health care systems.

Barriers and Enablers to Weight Management Programmes for Working Men: A Qualitative Study

Gender-sensitised weight management programmes have been developed to encourage more men to access support. Whilst these programmes have proved successful for some groups of men, they are not a panacea, and the views of men who have never attended any form of structured weight management programme remain unknown. The aim of this research was to explore the views of such men towards body weight, health, and weight management programmes. Participants were recruited purposefully at their place of work. Semi-structured interviews were conducted with 16 adult men with a BMI > 25 who worked in routine manual occupations and had no previous experience of attending a weight management programme. Interviews were analysed using an inductive thematic analysis approach. Interview findings were developed into five themes: “the indestructible breadwinner,” “avoidance of feminine behaviour,” “the body conscious man,” “being one of the lads,” and “doctor knows best.” The findings suggest that these men have high levels of body consciousness, value guidance from GPs, have high levels of agency towards lifestyle choices, and wish to preserve their masculinity. The study identified various factors that help explain low participation in weight management programmes for men and potential ways to improve access. Future interventions should include gender sensitisation of resources and providing men with the opportunity to follow self-directed weight management programmes to increase participation. Individual and population-level interventions to address weight management that includes the perceived and actual needs of men working in routine manual occupations are urgently needed to address health inequalities.

Assessing farmer willingness to participate in a subsidized veterinary herd health management program.

Zoonoses, such as COVID-19, can cause pandemics with many fatalities. Therefore, livestock keepers should attach great importance to livestock disease control. Veterinarians can support farmers in this task through a structured veterinary herd health management (VHHM) program. The dissemination of these programs remained low, and Swiss policy makers planned to launch a subsidy program for VHHM. To inform policy making ex-ante, a survey of 1600 Swiss dairy farmers was conducted to determine whether they are willing to participate and how much they are willing to pay. Contingent evaluation with a discrete choice format elicited willingness to pay (WTP). As a rather high share of farmers who would not participate was expected, a spike model was applied with a single-bounded discrete choice (SBDC) model. Only 47% of the farmers had a positive WTP. Mean WTP in the SBDC was CHF 10.47 per cow and year and in the spike model CHF 57.96. Participation would increase with higher subsidy levels. If the government pays 20% of the costs and farmers pay CHF 96 per cow per year, 23.6% of farms would participate. If the subsidy increases to 80% (CHF 24 for farmers), 40.4% would participate. A logistic regression indicates younger and older farmers, those with lower veterinary costs, and those who consider VHHM relevant only for farms with problems are less likely to participate.

Using Population Health Management Program to Promote Patient Choice for Medical Management Without Dialysis

Using Population Health Management Program to Promote Patient Choice for Medical Management Without Dialysis

Assessment of Epidemiology Courses in Health Management Undergraduate Education in Turkey

Abstract
 
 Objective: In today’s ever-changing health sector, health managers need to focus on promoting the health of populations, therefore they need a specialized understanding of epidemiology, as a necessary requirement for population-based management. Epidemiology is acknowledged as an important component of health management undergraduate education, which provides the knowledge and skills that health managers use in their efforts to promote quality of health. This cross-sectional descriptive study aims to assess the extent to which epidemiology is conducted in health management undergraduate programs in Turkey.
 Material and Method: The current curricula of 75 health management undergraduate programs, listed on the Program Atlas of the Higher Education Council, are reviewed through universities' Information Package for National Qualifications Framework for Higher Education to profile the characteristics of epidemiology courses. Descriptive statistics was expressed as mean±standard deviation for continuous variables, frequency and percentage values were used for categorical variables.
 Findings: A total of 60 (80.0%) programs have epidemiology in their curricula, yet the characteristics of these courses, such as their core/elective status, the semesters they are conducted, the weekly contact hours and ECTS credits, and the topics covered in the syllabus vary across programs.
 Conclusion: The findings of this study reveal that there are variations regarding how epidemiology courses are conducted across health management undergraduate programs in Turkey. Apparently this poses a challenge against all efforts to ensure the uniformity of the minimum core competencies among all health management program graduates; and although the Health Management National Core Education Program has been a great starting point towards standardization, there are further steps to be taken to improve the health management undergraduate curricula in Turkey.

Socio-cultural Influence on Lifestyle of Prediabetes Causes T2DM in Ethnic Society in South Sulawesi Province

Cases of diabetes mellitus (DM) in the world are increasing, Indonesia ranks fourth after India, China, and America. The most common DM is type 2 DM (T2DM), which is about 90%. The incidence of T2DM is caused by people’s lifestyles, which are influenced by socio-cultural factors. The highest risk of suffering from T2DM is prediabetes, which is a condition where a person’s blood glucose level is higher than normal but not high enough to be categorized as T2DM. This study aims to determine the socio-cultural influence on the lifestyle of prediabetes causing T2DM in the Bugis, Makassar, and Toraja tribes in South Sulawesi Province. The research design is qualitative with the rapid assessment procedure method. The population were prediabetics from biomedical samples in 7 regencies of South Sulawesi Province at the time of Riskesdas 2013. The samples were residents who are still prediabetes and T2DM in Jeneponto Regency (Makassar Tribe), Pare-Pare City (Bugis Tribe), and Tana Toraja Regency (Toraja Tribe). Information collection was carried out in 2017 through focus group discussions with two groups, non T2DM and T2DM. In-depth interviews with health program managers at the health office, puskesmas officers, health cadres, and community leaders. The study explains that there is a socio-cultural influence of prediabetes, ethnic groups in South Sulawesi Province in shaping the lifestyle that causes T2DM. Socio-cultural influences are the use of vehicles and the habit of doing activities in the Bugis, Makassar, and Toraja tribes. The perception of obesity in the Bugis and Makassar tribes and the habit of consuming alcohol in the Toraja tribe
 Keywords: T2DM, socio-cultural, Bugis, Makassar, and Toraja

Factors Associated With Domestic Violence Against Peri- and Postmenopausal Women.

The goal of the study was to determine factors associated with domestic violence in menopausal women. This was a cross-sectional study that 350 menopausal women participated. Data gathering used a World Health Organization's violence against women instrument. Emotional violence was recognized as one of the most experienced types of domestic violence (48%). According to the multivariate logistic regression model, the status of exposure to sexual violence (before marriage) and the partner's substance abuse was the most robust risk factors for domestic violence, while factors such as employment of women and satisfaction of income were protective against domestic violence. This study has highlighted the factors associated with domestic violence that health program managers need to address.

Docking Analysis of Deltamethrin Pesticide with MHC I and MHC II Molecules to Establish Immunomodulation Effects

Background: Deltamethrin is a class II synthetic pyrethroid pesticide extensively used to control pests and vectors in the agriculture sector and health management programme. Due to excessive applications of this pesticide in the environment, it is harming many organisms other than the target organisms. Higher organisms like human beings are also affected by this pesticide because it instigates the impairment of the central nervous system and also distresses the immune system of vertebrates. Methods: In the current research study, MHC I and MHC II molecules of human origin have been targeted to evaluate the interaction with deltamethrin molecules by the AutoDock tool to establish the immunomodulatory effect. MHC I receptor molecule is presented on every nucleated cell, and MHC II receptors are located specifically on cell surfaces of antigen-presenting cells. These receptors play a role in cell-mediated and humoral immune responses. The binding affinity of deltamethrin with MHC receptors can affect the immune response, specifically the acquired immunity of an individual. Results: Findings of the current research study support that deltamethrin causes the suppression of the immune system by interaction with MHC I and MHC II molecules and may cause the organisms to be more prone towards antigen and disease development. Conclusion: The autoDock tool can be utilized to analyse other pesticides’ effects on the immune system and in the drug development process to minimize the toxic effects due to several types of pesticides.

Exploring Peer Health Coach Roles in the Online Health Management Program for Adults With Spinal Cord Injury

Abstract Date Presented 04/21/2023 Individuals with spinal cord injury (SCI) are at higher risk of developing secondary health issues, many of which can be prevented or managed by health management knowledge and strategies. SCI Peer Health Coaches (PHCs) can play a powerful role in promoting health management because they are trained to support peers as they adjust to life changes and manage health challenges. This poster explores the innovative PHC role and OT practitioner’s role in advocating for the PHC model and supporting PHC training. Primary Author and Speaker: Yaqi Shi Contributing Authors: Sarah Skeels