The Relationship Between Leadership Characteristics and Services Provided Among IHS Urban Indian Health Programs.

The Urban Indian Health Program was created by the Indian Health Service to establish a culturally appropriate health care delivery model for Native Americans who relocate to urban areas. The 31 community-based Indian Health Programs under the Office of Urban Indian Health Program vary in culture, socioeconomic, and patient mix. Strategic decision-making by these community-based Indian Health Programs depends upon various factors, including leaders' characteristics, organizational characteristics, and service area market factors.

Leveraging machine learning to enhance appointment adherence at a novel post-discharge care transition clinic.

Objective: This study applies predictive analytics to identify patients at risk of missing appointments at a novel post-discharge clinic (PDC) in a large academic health system. Recognizing the critical role of appointment adherence in the success of new clinical ventures, this research aims to inform future targeted interventions to increase appointment adherence.

Materials And Methods: We analyzed electronic health records (EHRs) capturing a wide array of demographic, socio-economic, and clinical variables from 2168 patients with scheduled appointments at the PDC from September 2022 to August 2023.

Electronic consultation to improve care outcomes in patients with suspected and confirmed heparin-induced thrombocytopenia.

Background: Heparin-induced thrombocytopenia (HIT) is a complication of heparin exposure associated with high risk for morbidity and mortality. Diagnosis and management are complex due to limitations of laboratory testing and the need for nonheparin anticoagulation.

Objectives: To increase the delivery of evidence-based care of patients with suspected and confirmed HIT via electronic consultation (e-consult).

The role of patient and family advisory boards in promoting greater attention to patient social needs by U.S. acute care hospitals.

Background: There is growing attention to individual-level patient social needs such as unstable housing and food insecurity. Such considerations, however, have historically been the purview of public health and have not been a priority of more traditional health care delivery organizations, such as acute care hospitals.

Purpose: The purpose of this study was to examine whether the presence of patient and family advisory boards (PFABs) among acute care community hospitals was associated with screening for and programs to address patient social needs.

Service mix and financial performance in rural hospitals: A contingency theory perspective.

Background: Rural hospitals are increasingly at risk of closure. Closure reduces the availability of hospital care in rural areas, resulting in a disparity in health between rural and urban citizens, and it has broader economic impacts on rural communities as rural hospitals are often large employers and are vital to recruiting new businesses to a community. To combat the risk of closure, rural hospitals have sought partnerships to bolster financial performance, which often results in a closure of services valuable to the community, such as obstetrics and certain diagnostic services, which are viewed as unprofitable.

Federally Qualified Health Centers' Screening for Social Risk Factors and Health Outcomes.

Federally Qualified Health Centers (FQHCs) are ideally positioned to identify and address health-related social needs, but little is understood about the relationship between social risk factor (SRF) screening and health outcomes. We studied 1352 FQHCs from the 2019 Uniform Data System. Ordinary least squares regression was used to estimate the relationship between SRF screening and the percentage of patients with adequately controlled diabetes and hypertension.

Improving Communication with Family Members during a Global Pandemic: Effect on Patient Experience.

Objectives: Communication with patients and their families/caregivers to facilitate informed decision making is an integral part of patient/family-centered care. Due to the high coronavirus disease 2019 (COVID-19) infection rates and limited personal protective equipment, healthcare systems were forced to restrict patient visitors, limit patient-provider interactions, and implement other changes in treatment protocols that disturbed traditional communications and risked eroding patient/family-centered care and adversely affected patient satisfaction. This article focuses on changes in patient experience in two dedicated COVID-19 units of an academic medical center located in the US South as a result of the enhanced communication process implemented specifically during the COVID-19 pandemic.

Using Community Health Advisors to Increase Lung Cancer Screening Awareness in the Black Belt: a Pilot Study.

Disease stage at the time of diagnosis is the most important determinant of prognosis for lung cancer. Despite demonstrated effectiveness of lung cancer screening (LCS) in reducing lung cancer mortality, early detection continues to elude populations with the highest risk for lung cancer death. Consistent with the national rate, current screening rate in Alabama is dismal at 4.

Clinical Outcomes in COVID-19 Patients Treated with Immunotherapy.

Introduction: The full impact of COVID-19 infections on patients with cancer who are actively being treated with chemotherapy or immune checkpoint inhibitors (ICIs) has not been fully defined. Our goal was to track clinical outcomes in this specific patient population. Methods: We performed a retrospective chart review of 121 patients (age > 18 years) at the University of Alabama at Birmingham from January 2020 to December 2021 with an advanced solid malignancy that were eligible to be treated with ICIs or on current therapy within 12 months of their COVID-19 diagnosis.

Serological Confirmed Syphilis Among Transgender Women in Dominican Republic.

Purpose: Transgender women (TW) in the Dominican Republic (DR) are at high risk for syphillis infection. Although treatable, infection rates remain at epidemic proportions.

Methods: In 2016, we conducted a national survey, with serological sampling of TW in the DR (=255).

Inpatient Telehealth and Coronavirus Disease 2019 Outcomes: Experiences in Alabama.

During the early months of the coronavirus disease 2019 (COVID-19) pandemic, hospitals were concerned about preserving personal protective equipment. UAB Hospital Medicine designed a strategy to outfit acute care patient rooms on a COVID-19 unit with telemedicine technology to allow for remote clinician rounding. To describe one hospital's experience with inpatient telehealth and compare outcomes between patients with and without inpatient telehealth visits.

HIV knowledge among cisgender female sex workers of Haitian descent working at the border of Haiti and Dominican Republic.

In this brief report, we aim to assess levels of HIV mis-information among cisgender Haitian female sex workers engaged in sex work at the Haiti and Dominican Republic border. We conducted bivariate analyses on the 2014 Border Study on Sex Workers comparing responses from female sex workers on the Haiti side of the border to those from their peers on the Dominican Republic side (N=212). Prevention of HIV acquisition by correct and consistent condom use with each sex act was correctly endorsed by 90.

Transgender Women in Dominican Republic: HIV, Stigma, Substances, and Sex Work.

Exposure to stigma, violence, sex work, and substance use are associated with increased HIV risk, but relationships between these factors have not been fully elucidated among transgender women whose data are often aggregated with men who have sex with men and other sexual and gender minorities. Considering this gap, we aimed to identify a serologically confirmed HIV estimate for transgender women and examine the relationships between stigma, sex work, substance use, and HIV among a national sample of transgender women in Dominican Republic. We analyzed biomarkers and self-report data from the third wave of Dominican Republic's Encuesta de Vigilancia y Comportamiento con Vinculación Serológica, employing logistic and negative binomial regression to estimate models ( = 307).

Critical Success Factors for Addressing Discharge Inefficiency at a Large Academic Medical Center: A Lean Six Sigma Approach.

Background: Delayed discharges can be a systemic issue. Understanding the systemic factors that contribute to discharge inefficiencies is essential to addressing discharge inefficiencies.

Purpose: This article reports on a Lean Six Sigma approach and the process to identifying inefficiencies and systemic barriers to early discharge in a large US academic medical center.

Using Accountable Care Teams to Improve Timely Discharge: A Pilot Study.

Background And Objective: Hospitals worldwide are faced with the problem of discharging patients on time. Delayed discharge creates domino effects with significant implications for hospitals. The accountable care team (ACT) is a multidisciplinary, unit-based approach to identifying opportunities to improve patient care and address inefficiencies in care delivery and throughput, including assuring timely discharges.

HIV Testing Among Muslim Women in the United States: Results of a National Sample Study.

More than one million Americans are living with human immunodeficiency virus (HIV), and less than half of Americans have ever accepted an HIV test. There are no national HIV testing estimates for Muslim Americans, an underserved and often stigmatized population. Considering the lack of HIV testing estimates for this population, we conducted an exploratory study on HIV testing and potential associates in American Muslim women from across the United States.

Assessing Human Immunodeficiency Virus (HIV) Prevention Through Knowledge and Condom Use Among Female Sex Workers at the Border of Haiti and Dominican Republic.

Geographic border studies are relatively scare, but have the potential to inform bilateral health policies that affect the well-being of female sex workers (FSWs) who work at these borders as well as those individuals who solicit their services, both groups being at high risk for human immunodeficiency virus (HIV). We applied bivariate and multivariate techniques to examine FSWs' HIV knowledge and condom use across three partner types, at the Haiti Dominican Republic border, using data from the Study on Sex Workers ( = 241, 2014). Condom use was significantly lower among FSWs on the Haitian side of the border compared to the Dominican side, yet levels of HIV knowledge were similar; specifically, 81% of respondents on the Dominican side reported using condoms every time they had sex with a client, compared to 38% of peers in Haiti ( < 0.

Female Sex Workers' Experiences of Violence and Substance Use on the Haitian, Dominican Republic Border.

Background: Female sex workers (FSW) are socially and economically marginalized, and this vulnerability can be exacerbated when they hold the intersectional identity of also being an immigrant, such as in the case of Haitian FSWs in the Dominican Republic.

Objective: Considering that half of migratory young women and girls relocating across the Latin American and Caribbean region do so without their families, increasing the likelihood of experiencing abuses, our primary objective was to test the hypothesis that Haitian FSWs in the Dominican Republic have higher odds of being physically abused by sexual partners compared to Haitian FSWs in Haiti.

Methods: We conducted bivariate analyses and multivariate analyses on 2014 Hispaniola Sex Workers Study (N = 232).

Human papillomavirus (HPV) and influenza vaccine behavior among Muslim women in the United States.

In this study, we examined vaccination behaviors-single dose human papillomavirus (HPV) vaccination, triple dose HPV vaccination, and influenza vaccination-among Muslim women residing in the United States. Using logistic regression models, we analyzed self-reported survey. We found that respondents had lower rates of HPV vaccination and higher rates of influenza vaccination, relative to the general American population.

Alcohol Use, High Risk Behaviors, and Experiences of Discrimination Among Transgender Women in the Dominican Republic.

This study examines associations between alcohol use, high risk sexual behaviors, and experiences of stigma among transgender women across the Dominican Republic. Data from the 2015 Transgender Health Needs Study were analyzed using bivariate analyses ( = 291). High rates of stigma, verbal abuse, alcohol use, and sex work are found and are associated with each other.

Sex work, social support, and stigma: Experiences of transgender women in the Dominican Republic.

Transgender populations, and especially those in resource-limited settings, are at an elevated risk of experiencing stigma and discrimination. This study sought to examine the relationship between parental, familial, and other social support, experiences of stigma and discrimination, quality of life, and sex work in a national sample of transgender women in the Dominican Republic ( = 291). Descriptive analyses for the outcome variable, sex work, as well as for measures associated with socio-demographics, social support, stigma, quality of life, and experiences of abuse and violence were performed.

HIV Status and Contraceptive Utilization among Women in Cameroon.

Objective: We examined patterns of contraceptive utilization by HIV status among women in Cameroon, hypothesizing that women living with HIV would utilize contraception at higher rates than their HIV-negative peers.

Methods: Deidentified, clinical data from the Cameroon Baptist Convention Health Services (2007-2013) were analyzed (N = 8995). Frequencies compared outcomes between women living with HIV (15.

Behaviors and Risks for Cardiovascular Disease Among Muslim Women in the United States.

This study examines statistical associates of cardiovascular disease risk factors, as defined by the American Heart Association's Life's Simple Seven, among Muslim women who reside in the United States. Data collected nationally through the 2015 Muslim Women's Health project were analyzed (=373). Logistic regression models estimated associations between sample characteristics and diet, exercise, alcohol consumption, blood pressure, cholesterol, and weight.