PubMed Health⌕ Search

Biomedical subjects

L Michele Issel

Publications and source records attributed to L Michele Issel.

7 recordsLinked to original sources
PubMed2004

Using multilevel, multisource needs assessment data for planning community interventions.

African Americans and Latinos share higher rates of cardiovascular disease (CVD) and diabetes compared with Whites. These diseases have common risk factors that are amenable to primary and secondary prevention. The goal of the Chicago REACH 2010-Lawndale Health Promotion Project is to eliminate disparities related to CVD and diabetes experienced by African Americans and Latinos in two contiguous Chicago neighborhoods using a community-based prevention approach. This article shares findings from the Phase 1 participatory planning process and discusses the implications these findings and lessons learned may have for programs aiming to reduce health disparities in multiethnic communities. The triangulation of data sources from the planning phase enriched interpretation and led to more creative and feasible suggestions for programmatic interventions across the four levels of the ecological framework. Multisource data yielded useful information for program planning and a better understanding of the cultural differences and similarities between African Americans and Latinos.

Adult↗
PubMedDate not supplied

Administrative characteristics of comprehensive prenatal case management programs.

The purpose of this study was to examine comprehensive prenatal case management programs in terms of organizational, program, and process characteristics. Data from 66 program surveys of government agencies were used. Organizational capacity was measured as extent of organizational change and extent of interagency agreements. Program data included age and size of the program, reasons for having case management, and funding diversity. Process data were eight types of interventions. The most highly rated reason for having case management was to improve client outcomes. The greatest organizational change was in the area of the organizational structure, followed by financial status and types of services provided. Contracts with other agencies were rare. Agencies with more interagency contacts reported higher levels of change in the case management department and turnover among mid-level managers. Older programs had fewer employees. Approximately 49% of client contacts were not billed to Medicaid. Larger programs had significantly less time allocated to emotional support and coaching. Data on organizational characteristics, program, and process variables provide insights into comprehensive case management. Relationships among these variables underscore the importance of studying client outcomes within the context of program and organizational idiosyncrasies. Future studies of comprehensive prenatal case management should focus on cross-level questions.

Case Management↗
PubMedDate not supplied

Nursing homes as complex adaptive systems: relationship between management practice and resident outcomes.

BACKGROUND: Despite numerous clinical and regulatory efforts, problems of poor quality of care in nursing homes continue, suggesting a need for effective management practices. OBJECTIVE: To test complexity hypotheses about the relationship between management practices (communication openness, decision making, relationship-oriented leadership, and formalization) and resident outcomes (aggressive behavior, restraint use, immobility of complications, and fractures), while controlling for case mix, size, ownership, and director's tenure and experience. METHOD: A cross-sectional correlational field study design was used. Primary data were obtained from directors of nursing and registered nurses employed in 164 Texas nursing homes. Investigators administered self-report surveys onsite. Secondary data were obtained from 1995 Medicaid Cost Reports and the Texas nursing home Minimum Data Set (MDS) and were linked to primary data using a unique identifier. RESULTS: Hypotheses were supported in that each management practice explained one or more of the resident outcomes. Larger size and longer director of nursing tenure and experience also explained better resident outcomes. Predictors explained 11% ñ 21% of the variance. DISCUSSION: Complexity science was used to explain the results. The findings open the door to rethinking nursing home management practice. Practices that increase communication and interaction among people are needed for better resident outcomes.

Adult↗
PubMedDate not supplied

Self-reported competency of public health nurses and faculty in Illinois.

Having a public health workforce with a high level of competency is a prerequisite for having an effective public health system. The purpose of these two studies was to assess the competency level of practicing public health nurses (PHNs; n=168) from 50 local health agencies and public health nursing faculty (n=46) from 31 nursing programs in Illinois. The questionnaire consisted of nine reliable scales using self-reported levels of competence in each PHN competency domain. Overall, PHNs reported only feeling competent in one domain: "linking people to services." Although PHN faculty felt competent across the nine domains, they did not report feeling competent to teach any of the domains. Thus, PHNs and public health nursing faculty need education and training to meet the professionally established level of competence.

Attitude of Health Personnel↗