In the United States, there is an issue with low-income uninsured patients using emergency services for nonurgent conditions instead of using primary care services. Primary care services are more beneficial than emergency services for such patients, in that they can receive continual or follow-up care through primary care and thus achieve better health outcomes over the long term. Though information is available concerning factors in (or the rationale for) low-income uninsured patients choosing the emergency department (ED) instead of primary services for nonurgent conditions, research focusing on low-income uninsured patients' perspectives, beliefs, and level of knowledge about this matter is missing from the literature. The purpose of this qualitative phenomenological study was to gain an understanding of the perspectives, beliefs, and level of knowledge of low-income uninsured patients about primary care services and to explore whether patient education can improve access to primary care. The health belief model was used to explore 6 concepts: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Criterion sampling was used to recruit 10 participants, an interview tool was used to collect data, and the data was analyzed deductively. Results revealed that members of the low-income uninsured population believed primary care to be better than the ED because it offers cost-effectiveness, preventative care, efficiency, and familiarity. Results indicated that lack of money or insurance prevented participants from using primary services. This study may bring awareness that leads to the improvement of patient education and navigation, the reduction of ED usage, and an increase in primary care utilization.

There is a noted discrepancy between police psychological services offered and services utilized. It is important to understand reasons for underutilization when creating services for officers. The purpose of this study was providing empirical evidence from the officers-perspectives to answer this question. The conceptual foundation was officers may refuse participation due to police culture. The conceptual framework was represented in research questions focused on officers- perspectives regarding psychological services provided by psychologists without law enforcement (LE) experience. The participants were employed law enforcement officers (LEOs) from regions across the United States. Officer participation from all 50 states was targeted to assist in ensuring demographic variability. Phenomenological methods were employed. Samples were gathered by contacting 2 police departments (PDs) per state, in arbitrarily chosen cities and rural areas. One questionnaire with pre-addressed, stamped envelopes was sent to each department indicating the research post office box. Data were analyzed by applying qualitative research data software, open coding, in-margin notetaking procedures, and individual recognition of themes. Ten to 25 participants were required and 10 were achieved. Two categories, 6 subcategories, 2 themes, and 3 subthemes emerged from the data analyses. Data analyses aligned with previous findings in 2 aspects and did not support others. Positive social change will be affected through identifying reasons for low service utilization. Agencies may begin restructuring program policies, developing more effective training, and other psychological protocols for LEOs and providers.

The operating room (OR) is accountable for most hospital admissions and is one of the most cost and work intensive areas in the hospital. From recent trends, we discover an unexpected parallel increase in expenditure and waiting time. Therefore, improving OR planning has become obligatory, particularly regarding utilization, and service level. Significant challenges in OR planning are the high variations in demand, processing times of surgical specialties, the trade-off between the objectives, and control of OR performance in long-term. Our model provides OR configurations at a strategical level of OR planning to minimize the tradeoff between the utilization and service level accounting for variation in both demand and processing times of surgical specialties. An adaptive control scheme is proposed to aid OR managers to maintain the OR performance within the prescribed controllable limits. Our model is validated using a simulation of demand and processing time data of surgical services at University of Kentucky Health Care.

A specialized system of care for co-occurring clients can be an asset to this population, if the services offered deliver adequate results that contribute to the overall wellbeing of this community. Therefore, providers, including social workers and other professionals to determine the effectiveness of these programs, should routinely assess established programs that are design to meet the most basic needs of co-occurring populations. This will permit an increase the knowledge and understanding of outcomes and perhaps develop alternative resources to connect gaps in the delivery of services. This research evaluated the effectiveness of services that co-occurring clients received from Cedar House Life Change Center. It attempted to understand the correlation between graduation success and other variables, such as length in treatment, mental health and substance use diagnosis, types and frequency of services, and the effects of diverse populations on the treatment outcomes.

The purpose of this research study was to explore Mexican women’s perceptions about utilizing mental health services and to explore the barriers encountered during the process. Previous research suggested Mexican women’s diverse experiences when seeking and utilizing mental health services. The study used a qualitative approach with open-ended and closed-ended questions. The sample size of this study was fifteen individuals who self-identified as Mexican women who reside in Southern California recruited using a snowball approach. Major themes identified included Mexican family values and beliefs, cultural barriers, structural barriers, Mexican women’s strengths, and community suggestions for social work practice. This study highlighted their perspective on mental health, cultural and structural barriers, their personal experiences of utilizing mental health services, techniques on managing difficult situations, support systems, identified mental health symptoms, coping methods, cultural values and suggestions to improve mental health services in the general Latino community.

This thesis was designed to test the relationship between parents' health attitudes and beliefs and utilization of preventive health services of their children. Four measures of health attitudes and beliefs (HAB) were examined in this study, they were: 1) Interest in and concern with health; 2) Skepticism about physicians; 3) Tendency to consult physicians; and 4) Efficacy. Preventive care utilization included well-child care and immunization.

Adverse childhood experiences (ACEs) are linked to increased mental health problems in children, but their association with mental health services utilization is not well known. This secondary analysis used 2016 National Survey of Children’s Health data from two samples: children aged 6-17-years-old with a mental or behavioral condition in need of treatment or counseling (N = 5,723); and a subsample of children who experienced at least one ACE (n = 3,812). Multiple logistic regression and latent class analysis (LCA) were performed to examine the association between ACEs and mental health services utilization. Multiple logistic regressions also examined the associations of parent/caretaker vulnerability, school-system, and medical-system factors on mental health services utilization for children with ACEs using the Gelberg-Andersen Behavioral Model for Vulnerable Populations and a Systems of Care approach as the framework for model building. Children with increased ACE scores did not have higher odds of utilizing mental health services compared to children at lower levels of or no ACEs. For children who experienced adversity, increased parent/caretaker vulnerability was associated with lower odds and the current receipt of special education services with increased odds of mental health services utilization in adjusted models. Strengths of this study included the large dataset and generalizability to the U.S. population. There were limitations to the measurement of ACEs and other key variables. The current study identified children who experienced adversity as an underserviced population for mental health services.

Anxiety can influence an individual's decision-making process; however, researchers have yet to establish whether anxiety has an impact on the healthcare utilization practices of mothers of children with a mental health diagnosis. The purpose of this study was to assess whether trait anxiety, coping styles, and self-efficacy in mothers of children with a mental health diagnosis affected their healthcare utilization decisions. The transactional model of stress and coping was used to analyze the impact of children with mental health disorders on their caretakers. For this study, a quantitative, cross-sectional research design was employed. The 4 survey tools, administered through SurveyMonkey.com as well as in paper form, included the Brief COPE, State-Trait Anxiety Inventory for Adults (STAID-AD), Health Self-Efficacy Measure, and Healthcare Utilization Questionnaire. Study participants (N = 152) were mothers primarily ages 30-49 years (90.8%), Caucasian (57.9%), and high school graduates (63.2%) who were residents of Lawrence County, Pennsylvania. Mothers reported their children were primarily ages 3-6 years (34.2%), Caucasian (49.3%), had a mental health diagnosis, were living in the home, and were currently in mental health treatment. The outcomes of a binary logistic regression found that trait anxiety did not have a significant impact on healthcare utilization. A Sobel test of mediation indicated that coping styles and self-efficacy were not mediating variables between trait anxiety and healthcare utilization. The implications for positive social change as a result of this research may lead to the training of healthcare providers on the specific characteristics of mothers of children with a mental health diagnosis and the development of social policies concerning healthcare utilization.

Thesis (M.A.) (Social Work) --University of Limpopo, 2007. / An evaluation of Employee Assistance Programme is pivotal in any department or enterprise. An EAP must be evaluated to justify its existence to external authorities, to ascertain the extent to which the programme is fulfilling its objectives and to find ways to improve its performance. The purpose of this study was to evaluate the EAP within the Department of Public Works in Vhembe District specifically focusing on the employees’ awareness of the programme, its utilization, as well as programme adequacy. A quantitative approach was used in this study. Eighty six (86) employees from various levels in the Department were selected to participate in the study using a systemic random sampling in which every tenth person from the sampling frame was selected. Summary of the main findings The following is a summary of major findings from the study: 􀂃 The majority of the employees were aware of EAP within the Department of Public Works through meetings. 􀂃 The Employee Assistance Programme within the Department of Public Works was viewed as accessible by the majority of employees. 􀂃 The utilization rate of EAP within the Department of Public Works in Vhembe District was low, since only 29% of employees indicated that they had utilized the services before. 􀂃 The employees who had utilized the EAP were mainly referred by their supervisors while some referred themselves. Only ten percent (10%) of supervisors/managers indicated that they had referred employees to the EAP. The referral rate of employees to the EAP by supervisors/managers was low. 􀂃 EAP was viewed as confidential by the majority of employees within the Department and the level of employees’ trust to the EAP staff was high. v 􀂃 The majority of employees were not aware of the EAP policy and they had never participated in policy formulation. 􀂃 Most employees within the Department indicated that the EAP was addressing their personal problems, and the programme was viewed as useful (programme adequacy). 􀂃 The majority of employees were satisfied with the EAP within the Department of Public Works in Vhembe. 􀂃 Most employees identified a need for EAP staff to inform all employees within the Department about its services and to visit the Cost Centres frequently. / Not available

Thesis (MPH.) -- University of Limpopo, 2012 / Tuberculosis (TB) is the cause of 1, 8 million deaths annually, 99% of the deaths occurs in the developing countries and among the poorest people of these countries. Studies between high and low income countries demonstrate that rates of TB are significantly higher in poorer populations. World Health Organization introduced DOTS as global strategy for providing TB services which was expected to be delivered primarily by government run public health services (Malmborg, Mann, Thomson, & Squire, 2006). AIM Investigate factors that influence compliance and non-compliance to treatment among patients on tuberculosis drug treatment. STUDY SITE This study was conducted in Shiluvane local area in Greater Tzaneen Municipality under Mopani District in Limpopo Province, South Africa. One district hospital, one health centre and five clinics were selected for this study: Dr CN Phatudi hospital, Shiluvane Health Centre, Moime, Lenyenye, Mogoboya, Maake and Lephepane Clinics. (v) STUDY DESIGN This is a quantitative and qualitative study as mixed methods were used to get a comprehensive research report. SAMPLING The sample size used 150 of a given population using Morgan and Krejcie table (1994). The case register was used to select respondents. The respondents were selected according to particular interval; each second name on the list was selected. Questionnaire and structured interview was selected for data collection. Questionnaires were distributed among clients who are able to read and write for them to complete, the researcher and the assistant helped to fill questionnaires for those who cannot read or write. The study was conducted at identified hospital, health center and clinics. RESULTS Education Level, the findings of this study displays that only 3,7% of participants hold tertiary qualifications, and 50% secondary education and 37,3% of primary education. Occupation, 76.4% of participants are unemployed. Income, 52,6% of participants earn between R1000-R2999 and 17,5% does not have income. (vi) CONCLUSION In conclusion based on the results and objectives of this study compliance with drug treatment among patients with tuberculosis in Shiluvane local Area, Mopani District, Limpopo province is 90.9%.