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PubMed1978

A second look at the dichotomy between consumers and providers in an HSA.

A study of the voting behavior of both consumers and providers involved in an HSA review committee is undertaken to determine the amount of voting cohesion (solidarity) demonstrated by these two basic interest groups as well as the directions in review decisions desired by both of these groups. The case study, involving the third largest HSA in the country, attempts to discern whether the theory of interest group liberalism can be used to describe correctly consumer and provider behavior relative to review decisions. The conclusions reached are that (1) consumers and providers do have differences in their intra-group voting cohesion, but that more importantly (2) they vote for the same end results in terms of approving or denying project reviews. The paper suggests that rational decision tools can play more of an effective role in achieving cost containment.

Capital Expenditures↗
PubMed2006

A typology of organizational and contractual arrangements for purchasing and delivery of behavioral health care.

The evolution of behavioral health care financing and delivery has led to a wide variety of arrangements connecting consumers to behavioral health services. In this paper, we present a typology based on three distinguishing features of behavioral health arrangements along which there is a high degree of variability and this variability has been shown to affect the cost and quality of behavioral health care: (1) the extent to which sponsor oversight over care is outsourced by way of contracts rather than performed directly; (2) whether financing for behavioral health is partitioned from health care financing overall; and (3) the amount of financial risk shared by the sponsor with third parties.

Behavioral Medicine↗
PubMed1983

Educational self-help approaches in childhood asthma.

Self-help is defined as "a process whereby a layperson functions on his/her own behalf in health promotion and prevention and in disease detection and treatment. . . ." Evidence that benefits are derived for patients who subscribe to the self-care philosophy comes from research in the areas of (1) self-efficacy, (2) information sharing, (3) patient satisfaction, and (4) patient involvement. This article presents five criteria of educational self-help. These criteria are: (1) encouragement of client responsibility, (2) full disclosure of information pertaining to the illness, (3) training of the patient in decision-making skills, (4) use of peer educators, and (5) training of professionals to encourage self-help attitudes and behaviors of their patients. The asthma projects presented at the June 1981 meeting in Los Angeles, entitled Self-management Educational Programs for Childhood Asthma, are reviewed in terms of the above five criteria. Each program manifested varying numbers of criteria with different levels of expertise. Findings suggest that those programs that most completely incorporated these principles tended to be more effective in favorably influencing behavioral, physiologic, and financial outcomes.

Asthma↗
PubMed1989

Social desirability and questioning children in dental research.

The influence of social desirability on the results of a social dental investigation was examined in a survey of 320 15-yr-old children. Children with a lower level of schooling seemed to be more inclined to give social desirable answers. It appeared that the stronger the social desirability, the more satisfaction children tended to show with their dentist, the less they said they were afraid of him, but, surprisingly, the less responsible they felt for their dental health. Other measures were not influenced by social desirability: dental hygiene, perception of the quality of one's own teeth, knowledge about dental health, sources of information, and evaluation of the dentist's behavior. Also independent of social desirability were the measures of the amount of fluid sugar consumed, the child's obesity, and the actual dental health (DMFS, degree of treatment, P.H.P.). Several aspects of the meaning of social desirability in dental research are discussed.

Adolescent↗
PubMed1999

Metabolic and behavioral consequences of a snack consumed in a satiety state.

BACKGROUND: In view of the influence of dietary habits on obesity, human eating patterns merit study. OBJECTIVE: We investigated the behavioral and biological consequences of consumption of a 1-MJ snack by subjects in a satiety state. DESIGN: Eleven lean young men were deprived of time cues and subjected to continuous blood withdrawal over each of 4 sessions scheduled 2 wk apart. The first session was a basal session designed to determine the following in each subject: 1) the amount eaten in an ad libitum lunch; 2) the temporal patterns of plasma concentrations of glucose, insulin, fatty acids, and triacylglycerols between lunch and the spontaneous dinner request; and 3) the latency of the dinner request. In the 3 other sessions, each subject ingested the same lunch as in the basal session and a nutritionally well-balanced snack either 5 min before his individual peak of hyperglycemia observed in the first session, 40 min after this peak, or 120 min before the time he had requested his dinner in the first session. RESULTS: There was no significant difference in latency of the dinner request or the energy intake at dinner between sessions. Insulin secretion increased but glucose profiles did not change significantly regardless of the time of snack intake. CONCLUSION: A snack consumed in a satiety state fails to prolong the intermeal interval and would thus tend to favor storage.

Adult↗
PubMed1984

The Louisiana Mental Health Client-Outcome Evaluation Project: an initial progress report.

The Louisiana Mental Health Client-Outcome Evaluation Project is assessing the effectiveness of the Schainblatt - Hatry system of client-oriented outcome monitoring as applied to Louisiana CMHC outpatient settings. This system involves incorporating a self-administered mental health questionnaire into the routine center intake procedures and use of a combination mail-out and telephone follow-up data collection method. Follow-up procedures can be operated by a small evaluation staff through the State central office. This initial progress report provides an overview of the instruments and procedures being utilized and discusses results of the project obtained thus far.

Adolescent↗
PubMed1994

Assessing the outcomes of parent-and provider-designed systems of care for children with emotional and behavioral disorders.

There is a paucity of research on the outcomes associated with involving parents of children with emotional and behavioral problems as partners with professionals in designing and implementing a system of care. This study examines the systems, child, and family outcomes associated with providing flexible funds to two counties, one engaged in strengthening its provider-designed system and the other in developing and implementing a parent-designed system. This article describes the qualitative, network, and treatment outcome studies comprising the research.

Adolescent↗
PubMed2006

Simplifying the delivery of a prevention program with web-based enhancements.

The ease with which prevention programs can be delivered may impact whether or not they are implemented as designed. This paper presents a website with enhancements designed to make delivery of the All Stars substance use prevention program easier. Administrative tasks, such as completing paperwork associated with program delivery were automated using web technology. A pilot study of the web site was conducted with program instructors. There was a significant improvement in teachers' perceived ease of program delivery. Modest correlation coefficients were found for the relationship between ease of delivery of specific program activities and adherence to these activities.

Adolescent↗
PubMed2002

Health behaviors of nursing students: a longitudinal study.

To ascertain the degree to which a health science curriculum may influence health-related behaviors among students, nine selected health behaviors of 52 undergraduate nursing students were studied for 3 consecutive years and compared to those of a similar group of education students. In addition, the health behaviors of both student groups were compared to those of the general population. During the study, the nursing students had no significant alterations in the observed health behaviors, and no significant differences were observed between the health behaviors of the two groups of students. Both groups manifested certain health behaviors that were significantly different from the general population. However, nursing students were observed more frequently to be significantly different from the general population. A 3-year nursing curriculum may have facilitated the adoption of some personal health behaviors, but the time demands of academic life may have induced students to reduce time-consuming health behaviors, such as getting enough sleep, eating breakfast, and exercising.

Adult↗
PubMed1985

Modifying test-ordering behavior in the outpatient medical clinic. A controlled trial of two educational interventions.

Education is an effective tool for modifying physician use of the laboratory. We compared two interventions by assigning 56 medical house officers into four groups: control group; feedback group, which received feedback concerning its use of tests; manual group, which received a manual concerning cost-effective laboratory use; and manual plus feedback group, which received both interventions. All intervention groups experienced significant decreases in test use. When we controlled for diagnosis, the manual plus feedback group had the most profound decrease (42%) in laboratory use, followed by the manual group. The feedback and control groups had no change. Attitudes and knowledge did not change. We conclude that one can, via simple techniques, modify house staff use of the outpatient laboratory. The less-expensive intervention was a cost-oriented manual, which may have a "sensitizing" rather than educational effect.

Ambulatory Care↗
PubMed1996

Integrating caregiver report with systematic choice assessment to enhance reinforcer identification.

To determine client preferences, we asked caregivers to rank-order, according to predicted client preference, a standard list of items and a list generated using a structured interview for caregivers, the Reinforcer Assessment for Individuals with Severe Disabilities. Systematic choice assessments were then conducted with both sets of stimuli. A concurrent operants paradigm was used to compare the reinforcing effects of the highest preference stimulus identified from each list. Results indicated that caregiver predictions of client preferences were slightly better for the set of stimuli they generated than for the standard set, and the choice assessment identified more potent reinforcers from the set of stimuli generated by the caregivers than from the standard set.

Adolescent↗
PubMedDate not supplied

Consumers: from perceptions to participation.

As Winston Churchill once said, "Personally, I am always ready to learn, although I don't always like being taught." In behavioral health, consumers can make important contributions to the design and evaluation of programs and services. As demonstrated by this case study, progress can be made in incremental steps, over several years. Another reason for BABH's success was progression from very concrete projects to an ongoing organizational structure that consumers could identify as providing a role in policy and procedure development, program evaluation, strategic planning, and programmatic changes. Performance improvement professionals, through their contributions to the organizational design of committees and communication structures, are in ideal positions to promote the full participation of consumers across all healthcare settings. Just imagine what could be achieved in understanding how to design systems if current issues and recent research results were routinely explored--such as those by Harrington et al. regarding Medicare beneficiary complaints (2001) and Gines et al. (2001) on chronic care and satisfaction with managed care--with a consistent group of consumers. Consider adding consumer participation as a new exciting goal in the next edition of your performance improvement and strategic plans!

Behavioral Medicine↗
PubMed2002

Mechanisms linking employee affective delivery and customer behavioral intentions.

Past empirical evidence has indicated that employee affective delivery can influence customer reactions (e.g., customer satisfaction, service quality evaluation). This study extends previous research by empirically examining mediating processes underlying the relationship between employee affective delivery and customer behavioral intentions. Data were collected from 352 employee-customer pairs in 169 retail shoe stores in Taiwan. Results showed that the influence of employee affective delivery on customers' willingness to return to the store and pass positive comments to friends was indirect through the mediating processes of customer in-store positive moods and perceived friendliness. The study also indicated that employee affective delivery influences customers' time spent in store, which, in turn, influences customer behavioral intentions.

Adult↗