<p> This dissertation provides an analysis and evaluation of factors influencing states to enact inpatient health care transparency laws between 1971 and 2006 inclusive, using event history analysis. The primary research question investigates "What factors influence a state legislature to enact a health care transparency law?" To narrow the scope of study, I focus on factors influencing states to enact health care transparency laws to collect and publicly report inpatient data. </p><p> The Unified Model of State Policy Innovation, developed by F.S. Berry and W.D. Berry (1990, 1999), provides the framework for the study hypotheses and the analysis of inpatient health care transparency law enactments by states. The Unified Model of State Policy Innovation posits a unified explanation for state policy adoptions. The model unifies the internal determinants and regional diffusion approaches of analysis for state policy adoption. </p><p> This study tests eight hypotheses using event history analysis (EHA). EHA is an analytical technique that allows for the testing of a state government innovation theory that incorporates internal determinants and regional influences on state policy adoption. Although there are numerous methods to conduct event history analysis, this study uses the Cox proportional hazards model (also known as Cox regression). Cox regression is a popular method for studying time-to-event data for policy adoption and diffusion studies. This study's quantitative analysis provides support for legislative ideology and unified party control of state government acting as factors influencing inpatient health care transparency law enactments by states. Additionally, the health care crisis and neighbors variables were statistically significant, but in an opposite direction than predicted. </p><p> The findings of this research suggest that state adopters of an inpatient health care transparency law are more likely to enact an inpatient health care transparency law when the state government is increasing in liberalism and when unified political party control of the governor and the governorship of both houses of the state legislature is increasing. </p><p> To generate new insights into the enactment of inpatient health care transparency laws, I conduct a case study of a national health care data professional association using several techniques, including telephone interviews. The qualitative analysis provides support for professional associations and policy champions as diffusion agents for inpatient health care transparency law enactments by states. </p><p> This dissertation supports variables traditionally used in policy adoption research including legislative ideology and unified political party control in state government. However, it will be interesting to see whether internal determinants such as professional associations gain traction over the traditional regional diffusion influences such as states sharing borders as factors influencing state policy adoption. Meanwhile, as evidenced in this study, there continues to be support for a model incorporating both internal and regional influences to explain policy adoption by states. The theory of policy innovation and diffusion to predict the factors influencing the spread of policies and the use of Berry &amp; Berry's (1990, 1999) Unified Model of State Policy Innovation prosper as their applicability to numerous public policy areas, including health care, are continually demonstrated. Similarly, event history analysis and specifically the Cox regression method continue to gain support as their value as analytical methods and appropriateness for use in public policy studies is repeatedly demonstrated. </p><p> The outlook for the future of the health care transparency movement looks promising. The health care transparency movement promotes improved access to information, patient empowerment, improved patient safety and quality of care, improved provider accountability, and lower health care costs. This movement is not a fad, but rather a permanent change being implemented in all health care settings across the United States. Improved health through reliable, accessible data and data-supported decisions is increasingly becoming the norm and less an idealistic scenario to be realized in the distant future. </p>

<p> Autism is a rapidly increasing global health concern. In the United States, many families and individuals with autism find it difficult to access treatment for this condition because it is commonly excluded from health insurance plans. Apprehension about passing autism health insurance legislation includes concerns regarding the impact on small businesses. Many businesses advocates and law makers have expressed concern that passing an autism health insurance mandate will cause small businesses to close or to stop offering health insurance plans to their employees. In an effort to substantiate these concerns, this study provides an analysis of publicly available data on small business closures and small business health insurance plans to determine if a relationship exists between passing an autism health insurance mandate and a change in the number of small business closures or the percentage of small businesses that offer health insurance plans to their employees.</p><p> The methodology for this study includes testing of Pearson&rsquo;s <i> r</i> correlation models, semipartial correlation models and analysis of variance (ANOVA) models. Findings indicate there is insufficient evidence to conclude that a relationship exists between enacting an autism health insurance mandate and an increase in the number of small business closures. In addition, findings indicate there is insufficient evidence to conclude that a relationship exists between enacting an autism health insurance mandate and a decrease in the percentage of small businesses offering health insurance to their employees. </p>

<p> As the rates of breast cancer continue to increase, researchers and medical professionals struggle to give a definitive cause of the disease or find a cure. Unfortunately, it seems that the chance of having a cancer diagnosis within one's lifetime is only increasing. Since breast cancer is somewhat unpredictable, the medical field has taken the pathway of attempting to minimize the risk of mortality through regular screening mammograms. Even with multiple initiatives to increase mammogram utilization, multiple demographic factors such as race, income status, and insurance coverage continue to be underserved. The present study will focus on income status and insurance coverage as barriers to regular screening mammograms. It is hypothesized that those women with low-income status and no insurance coverage are less likely to receive regular screening mammograms than those women with higher income and some type of insurance. After completing a statistical analysis, both hypotheses were supported.</p>

<p> Recently, the Centers for Medicare and Medicaid Services (CMS) ranked all hospitals based on Medicare readmission rates for heart attacks, heart failure, and pneumonia. CMS offered subsidies to hospitals ranked in the 4th quartile to develop community support services to reduce the problem of potentially preventable readmissions (PPRs). CMS cited 4 of the 5 hospitals in Prince George's County in the 4th quartile. The purpose of this quantitative research study was to investigate the relationship between community support services and the reduction of PPRs in Prince George's County. The Evans and Stoddart field model of health and well-being guided this study with support from Bertalannffy's general systems theory. This study sought to relate community support services to PPRs in Prince George's County in contrast to other Maryland counties. To evaluate relationships between community support services and the reduction of PPAs, secondary data were provided by CMS in conjunction with the Robert Wood Johnson Foundation and the University of Wisconsin. The data included 26 behavioral community support factors from 53,229 Medicare paid claims in Maryland residents from July 1, 2008 to June 30, 2011. Lack of diabetes screening is a community support factor within quality of care. Using multiple regressions, there was a statistically significant relationship found between diabetic screenings and pneumonia readmission rate. The implication for social change is that reimbursement of key screening recommendations to CMS, local government, and hospitals in Prince George's County may reduce readmission rates, thereby positively affecting patients, improving community health, and decreasing health care costs in Prince George's County.</p>

<p> This study was designed to explore how the experience of past parental alienation and current estrangement from adult child(ren) affected aging alienated parents particularly in the domains of depression and life satisfaction. This study also explored the link between past parental alienation and late-life estrangement from adult child(ren). The sample of 65 participants responded to an online survey after responding to a recruitment flyer posted on Craig's List. </p><p> The results showed mild to moderate levels of depression and moderate dissatisfaction with life among the study participants. Higher levels of parental alienation were significantly associated with higher levels of depression and greater dissatisfaction with life. Participants also overwhelmingly reported that past parental alienation had contributed to their current estrangement from their adult child(ren). </p><p> Further research is needed on the impact of parental alienation on the well-being of aging parents.</p>

<p> According to U.S. Census figures and the Michigan Department of Community Health (2011), there are approximately 5% - 6% of children in the State of Michigan who are uninsured and it is estimated 70% of these uninsured children may be eligible for State subsidized health insurance. While the percent of uninsured children in Michigan consistently rates well below the national average, it is concerning the rate of uninsured children in Michigan is relatively stable. There are strong financial and social incentives to design outreach efforts to reach all children in the State and make these efforts an "everyday event." </p><p> This research examines the question of whether or not a school-based outreach program is effective in reaching children who are eligible for State subsidized health insurance but are uninsured and will test the following two hypotheses: </p><p> Ho1: Incorporating health status outreach into routine school district operations does not identify a statistically significant number of uninsured children. </p><p> Ho2: There is no statistical difference in the number of applications received from a school-based outreach program during the pilot period. </p><p> The pilot program takes place in six of the eleven school districts that operate in Van Buren County, MI. School districts were provided two health insurance status collection forms. Form A is designed to be distributed with the Free and Reduced Lunch Application. Form B is designed to be distributed as part of the student registration packet and welcome material. The completed Form A and Form B are sent to a State of Michigan registered application assisting agency for SCHIP application assistance and enrollment. </p><p> As a result of the survey, 156 children were identified as not having health insurance. This represents more than 44% of the 358 children who are eligible for State subsidized health insurance, in the participating school districts, but are uninsured. Enrolling these children will help the State of Michigan to meet targeted enrollment gains and earn CHIPRA performance bonus payments. The additional funds from higher CHIPRA bonus payments could be used to provide the resources to fund the following specific recommendations: </p><p> 1. The Michigan Department of Community Health should lead the effort to work with the Michigan Department of Education to modify the Free and Reduced Lunch Application to capture whether or not the applicant has health insurance. </p><p> 2. The Michigan Department of Community Health should lead the effort to incorporate into the direct certified free and reduced lunch eligibility process a systematic check as to whether or not the applicant has State subsidized health insurance. </p><p> 3. The Michigan Department of Community Health should provide resources from the expected performance bonus to work with schools across the State to implement these changes. (Abstract shortened by UMI.)</p>

<p> The purpose of this study was to examine the demographic differences in methamphetamine usage among youth and how methamphetamine users engaged in the use of other illegal drugs including, marijuana, cocaine, heroin, ecstasy and also engage in risk taking behaviors. The study utilized secondary data from the National Institute of Health, Youth Behavioral Risk Survey (YRBS) of20011. Sample size consisted of 294 both male and female youth who are methamphetamine users. The findings revealed that drug use amongst youth continues to be on the rise. Findings noted that male meth users had the highest rates of cocaine, ecstasy and heroin use compared to female meth users. The highest rate among female meth users was seen in cocaine use. Findings also revealed that cocaine use was the highest among Hispanic/Latino meth users and ecstasy use was the highest among Non-Hispanic/Latino meth users. In addition findings revealed that a significant association was found in youth's drug use and their involvement in risk taking behaviors. Prior research and findings from this study help society have a more proactive approach when helping youth who suffer from the disease of addiction.</p>

<p> The purpose of the current study was to address the relationship between Body Mass Index (BMI) status and psychological distress within the adolescent population. Data was acquired from the California Health Interview Survey (CHIS) 2011-2012, a state-wide phone survey which addresses health issues among the resident population. The present study used data from 2,1 04 California adolescents, utilizing variables relating to demographics, general health condition, and mental health.</p><p> Results indicated a statistically significant relationship between BMI and psychological distress, with overweight adolescents experiencing more distress and depression than their underweight/healthy weight counterparts. Gender and perceived general health condition were both significantly related to distress, with females and those of poor perceived general health condition experiencing greater psychological distress, regardless of weight status. This study has implications for social work policy and practice, especially in work with youth and families.</p>

<p> The purpose of this project was to write a grant for a mentoring program for HIV youth in foster care ages 12- 20 called "Positive Change." The mentorship program will provide guidance and emotional support to these youth who face the unique challenge of their diagnosis as well as being part of the child welfare system. Potential funding sources were reviewed and evaluated to determine which would best match the proposed project. An extensive literature review was performed to examine the topics of HIV related issues such as stigma, disclosure, health disparities, mental health problems, barriers faced by foster youth, and the efficacy of mentorship programs.</p><p> The program aims to enhance the lives of HIV youth in foster care by connecting them to mentors that can provide emotional support and help them achieve their dreams and hopes. The actual submission and/or funding of this grant was not a requirement for the successful completion of the project. </p>

<p> The purpose of the project was to design a program, identify potential funding source, and complete a grant to fund an educational and supportive program for foster parents who care for autistic foster youth. The services would be offered at SHIELDS a non-profit agency serving the Compton and Watts communities of South Los Angeles. The awareness supportive program will be design to provide educational workshops for foster parents and caregivers who provide care for County of Los Angeles Department of Children and Family Services autistic children. The Weingart Foundation was chosen as the best applicant for submitting this grant proposal based on the population they serve and their interests to provide services to disadvantage communities. Research supports the high need for autistic awareness support services for foster parents and caregivers who care for the youth. The submission of a tangible grant application was not required for the completion of this project. </p>