Publications by authors named "Helen McIlvain"
Aim: The aim of this study was to describe factors that influence decisions of young African Americans to start smoking.
Background: Young adult African Americans have a high risk for becoming regular smokers, but little is understood about their smoking. This knowledge is needed because understanding young adults' smokers will help develop effective tobacco cessation and prevention strategies.
Studies examining follow-up care among cancer survivors have increased in number, and are mostly focused on who best provides care. It is not known whether having single or multiple physicians as follow-up providers has outcome implications. We prospectively studied the association between number of follow-up providers among survivors of hematologic malignancies and serious medical utilization (defined as emergency room visits or hospitalizations) within a 6-month period.
View Article and Find Full Text PDFContext: In studying physician shortage issues, few studies have utilized individual interviews, allowing rural physicians to voice their own stories.
Purpose: To explore rural physicians' unique characteristics affecting their decisions and satisfactions with practice in a rural area.
Methods: A qualitative interview study with 11 Nebraska family physicians practicing in rural (frontier) areas.
Background: This study aimed to elucidate how clinical preventive services are delivered in family practices and how this information might inform improvement efforts.
Methods: We used a comparative case study design to observe clinical preventive service delivery in 18 purposefully selected Midwestern family medicine offices from 1997 to 1999. Medical records, observation of outpatient encounters, and patient exit cards were used to calculate practice-level rates of delivery of clinical preventive services.
Background: The levels of breast and cervical cancer screening in Nebraska primary care remain suboptimal despite awareness of their importance, and despite implementation of the Every Woman Matters program to assist low-income women. The GAPS model was used to develop a practice-based intervention to identify and reduce barriers to delivery of breast and cervical cancer screening services.
Methods: Seven primary care practices actively participated in this multimethod case study.
Objective: This secondary, qualitative analysis examined physician-patient interaction and patient-centered care in a random sample of encounters of 44 physicians in 18 family practices.
Methods: Fieldworkers were trained in qualitative and quantitative data collection strategies including participatory observation, narrative description, interviewing techniques and note-taking regarding practice observations, patient encounters and community assessment. Fieldworkers spent 4-8 weeks in each practice.
Purpose: This study aims to develop an in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders.
Design And Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis techniques.
Metaphors offer exciting opportunities to identify and explore tacit knowledge and behavior that are embedded in complex organizations and shape health care practices. In this article, the authors explore the theoretical rationale, background, and advantages of using metaphor as an analytic strategy in qualitative health research. They used an analysis of 18 practices in a comparative case study designed to explore office practice strategies for delivering cancer prevention services for illustrations.
View Article and Find Full Text PDFPurpose: Many primary care physicians find caring for elderly patients difficult. The goal of this study was to develop a detailed understanding of why physicians find primary care with elderly patients difficult.
Design And Methods: We conducted in-depth interviews with 20 primary care physicians.
Objectives: This study explored family physicians' attitudes about smoking cessation counseling-its importance, their confidence in their ability to counsel, outcome expectations of counseling, perception of their influence on patient behavior types of counseling skills used, and the extent to which office-based activities are used to support their counseling.
Methods: A cross-sectional design using qualitative and quantitative analyses was used. Data, including information from participant observation of the environment, medical chart reviews, and in-depth interviews, were collected from 89 physicians, drawn randomly from a list of family physicians in Nebraska.