Biomedical subjects

Tanya Uden-Holman

Publications and source records attributed to Tanya Uden-Holman.

5 recordsLinked to original sources

PubMed2005

Matching documented training needs with practical capacity: lessons learned from Project Public Health Ready.

The Upper Midwest offers a distinct environment for identifying and addressing threat and preparedness scenarios. The population is often scattered, with residents using urban centers periodically. This has also led to the challenge of providing specific skills and cross-disciplinary awareness and coordination to the public health community. The Upper Midwest Center for Public Health Preparedness was established by a grant from the Centers for Disease Control and Prevention to assist in meeting the challenge of adding capacity to develop the preparedness workforce in the Upper Midwest. Project Public Health Ready (PPHR) provides an example of the role academic preparedness centers can play in partnering with local public health agencies to strengthen the public health workforce. The purpose of this article is to present the Iowa Systems Model for Workforce Development being utilized for workforce training and education, describe how the model has been applied in the example of PPHR, and discuss lessons learned from the PPHR experience.

Bioterrorism↗

PubMed2003

Effectiveness of a nationally implemented smoking cessation guideline on provider and patient practices.

BACKGROUND: The Agency for Health Care Policy and Research (AHCPR) smoking cessation guideline outlines a set of recommendations for physicians to follow in daily practice. However, the effectiveness of this guideline has not been reported. The goal of this project was to evaluate the effect of the AHCPR smoking cessation guideline on provider practices with smokers and on patient smoking rates. METHODS: Patient survey and chart review data from 138 Veterans Administration (VA) acute care medical centers with outpatient facilities were examined. Data were available from both sources in 1996, 1997, and 1998. At the midpoint of this period (1997), the VA recommended the AHCPR smoking cessation clinical practice guideline for implementation throughout the VA healthcare system. RESULTS: From 1996 to 1998, both the chart audit and the patient survey showed a significant increase in the percentage of patients in the VA who were counseled about smoking and a significant decrease in the percentage of patients who smoke. CONCLUSIONS: Because the VA tied the guideline implementation to report cards and other performance-enhancing measures, guideline adherence may have been maximized in this setting. These findings suggest that healthcare systems should take an integrated approach to guideline implementation.

Adult↗

PubMed2002

Physician knowledge, attitudes and practices regarding a widely implemented guideline.

RATIONALE, AIMS AND OBJECTIVES: Although clinical practice guidelines have been promoted widely, there is considerable concern that physicians have not incorporated them into their practice. Models suggest that a 'knowledge-attitude-behaviour' sequence is important in modifying physician practice patterns. To address this, we examined physicians' knowledge of, attitudes towards and compliance with a widely implemented guideline - the Agency for Health Care Policy and Research (AHCPR) smoking cessation guideline. METHODS: A survey was mailed to a random sample of physicians at 128 veterans health administration facilities, which had implemented the guideline 2 years previously. RESULTS: Completed surveys were received from 879 physicians (50.3 response rate). Only 26 of physicians reported receiving a copy or summary of the guideline, 44 reported little or no familiarity with it, 42 did not know if they agreed with it, 40 did not know if they complied with it and 46 did not know if it was effective. However, a high percentage of physicians reported that they always or usually explain the health risks of smoking (86) and that they always or usually suggest that their smoking patients stop (94). CONCLUSIONS: In spite of little familiarity with the guideline, the responding physicians reported practice patterns consistent with adherence to it. Knowledge is only one of a spectrum of barriers that affects physician adherence to guidelines. There are numerous opportunities for health care organizations to overcome the barriers to physician adoption of clinical practice guidelines in their day-to-day practice.

Adult↗

PubMed2002

Organizational and provider characteristics fostering smoking cessation practice guideline adherence: an empirical look.

We examined the relationship between physician adherence with a smoking cessation guideline and organizational structures, policies, leadership support, and physician knowledge and attitudes. A random sample of 844 physicians practicing in 127 VHA hospitals was surveyed. Survey results were aggregated to the hospital level and linked with data on organizational characteristics from the 1998 annual survey of hospitals by the American Hospital Association. Significant predictors of adherence included organizational policies related to nicotine replacement prescriptions, the timing and effectiveness of guideline implementation, physicians' knowledge of VHA clinical guidelines generally, and physicians' beliefs about the receptiveness of patients to smoking cessation.

American Hospital Association↗

PubMedDate not supplied

Developing the academic institution's role in response to bioterrorism: the Iowa Center for Public Health Preparedness.

The terrorist acts during the fall of 2001 triggered renewed concern about the capacity of the nation's public health system to deal with crisis. A critical element of the response ability of the public health system is a prepared workforce. Based on a pre-existing concern about emerging infectious disease, the Centers for Disease Control (CDC), working with the Association of Schools of Public Health, had established a network of university-based Centers for Public Health Preparedness. The events of September 11 accelerated, expanded, and focused this effort. This article discusses this national program, details the activities of the based Center for Public Health Preparedness located at the University of Iowa, and suggests preparedness issues deserving future development.

Bioterrorism↗