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The coronavirus disease (COVID-19) pandemic disrupted healthcare and clinical research, including a suite of 11 pragmatic clinical trials (PCTs), across clinics within the Department of Veterans Affairs (VA) and the Department of Defense... more
The coronavirus disease (COVID-19) pandemic disrupted healthcare and clinical research, including a suite of 11 pragmatic clinical trials (PCTs), across clinics within the Department of Veterans Affairs (VA) and the Department of Defense (DOD). These PCTs were designed to evaluate an array of nonpharmacological treatments and models of care for treatment of patients with pain and co-occurring conditions. The aims of the study are to (a) describe modifications to PCTs and interventions to address the evolving pandemic and (b) describe the application of implementation science methods for evaluation of those PCT modifications. The project used a two-phase, sequential, mixed-methods design. In Phase I, we captured PCT disruptions and modifications via a Research Electronic Data Capture questionnaire, using Periodic Reflections methods as a guide. In Phase II, we utilized the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) taxonomy to develop a focus group intervi...
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Introduction: With the coronavirus disease 2019 (COVID-19) (most recent) Omicron variant surge across the U.S, more research is needed to better understand how vaccination and booster uptake can be increased. COVID-19 vaccinations have... more
Introduction: With the coronavirus disease 2019 (COVID-19) (most recent) Omicron variant surge across the U.S, more research is needed to better understand how vaccination and booster uptake can be increased. COVID-19 vaccinations have proven to help decrease the likelihood of becoming seriously ill, hospitalized, or dying. Studies examining patient characteristics of individuals who received COVID-19 vaccinations are limited. This study examines the patient characteristics of Veterans who were vaccinated during the first 8 months (December 2020–July 2021) of the vaccination rollout at the U.S. Department of Veterans Affairs (VA). Methods: Using VA administrative and clinical data, bivariate and multivariate analyses were conducted to determine sociodemographic and health factors associated with the likelihood of receiving COVID-19 vaccination at the VA. Results: The analytic sample included 5,914,741 VA-users (49.7% vaccinated). Among the VA medical facilities nationwide, COVID-19 vaccination rates (≥1 dose) varied from 33.9% to 73.7%. Veterans who were non-Hispanic American Indian/Alaskan-Natives, younger, living in rural areas, male and unmarried, with VA health insurance only, with fewer chronic conditions, who did not receive the seasonal influenza vaccine, and not living in community living centers or nursing homes were less likely to get vaccinated. Conclusions: Understanding which groups of Veterans are less likely to be vaccinated allows the VA to develop targeted interventions to improve uptake in these groups. These results can also guide non-VA organizations to create evidence-based educational outreach programs that reduce vaccine hesitancy among Veterans that do not use VA.
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Background: In the Veterans Health Administration (VA), Primary Care-Mental Health Integration (PC-MHI) clinics offer mental health services embedded in primary care, a strategy shown to reduce overall specialty mental health clinic... more
Background: In the Veterans Health Administration (VA), Primary Care-Mental Health Integration (PC-MHI) clinics offer mental health services embedded in primary care, a strategy shown to reduce overall specialty mental health clinic burden while facilitating prompt referrals when indicated. Among newly initiated patients, same-day access to PC-MHI from primary care increases subsequent specialty mental health engagement. However, the impact of virtual care on the association between same-day access to PC-MHI and subsequent mental health engagement remains unclear. Objective: To examine the effects of same-day access to PC-MHI and virtual care use on specialty mental health engagement. Methods: We used administrative data from 3066 veterans who initiated mental health care at a large, California VA PC-MHI clinic during 3/1/2018 to 2/28/2022 and had no previous mental health visits for at least 2 years prior to the index appointment. We conducted Poisson regression analyses to examine the effects of same-day access to PC-MHI, virtual access to PC-MHI and their combined effect on subsequent specialty mental health engagement. Results: Same-day access to PC-MHI from primary care was positively associated with specialty mental health engagement (IRR = 1.19; 95% CI 1.14-1.24). Virtual access to PC-MHI was negatively associated with specialty mental health engagement (IRR = 0.83; 95% CI 0.79-0.87). The positive effect of same-day access on specialty mental health engagement was smaller among patients who initiated PC-MHI in a virtual visit (IRR = 1.07) compared to in-person visits (IRR = 1.29; 95% CI 1.22-1.36). Conclusions: Although same-day access to PC-MHI increased overall specialty mental health engagement, the magnitude of this effect varied between in-person and virtual modalities. More research is needed to understand mechanisms of the association between virtual care use, same-day access to PC-MHI, and specialty mental health engagement.
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Introduction: Telehealth has the potential to improve access and timeliness of care, enabling primary care teams to deliver hybrid (virtual/in-person) services that will likely extend beyond the COVID-19 pandemic. To optimize its use and... more
Introduction: Telehealth has the potential to improve access and timeliness of care, enabling primary care teams to deliver hybrid (virtual/in-person) services that will likely extend beyond the COVID-19 pandemic. To optimize its use and sustainability, it is imperative to understand how primary care teams perceive the suitability of telehealth services, including appropriate choice of mode (telephone or video). However, there is limited research on providers’ decision-making processes surrounding telehealth use in primary care, including whether to use telephone or video, which this VA-focused study addresses. We examined how primary care (PC) team members determine whether to use telehealth and the mode of delivery, in the care of patients. Methods: Qualitative case study that included 15 semi-structured interviews with employees who provided or supported telehealth care at primary care clinics at the Veterans Health Administration. We used a team-based rapid analysis approach to identify experiences using telehealth soon after COVID-19’s emergence, consisting of the creation of structured summaries of each transcribed interview. The lead author then identified and compiled themes and sub-themes related to the suitability of telehealth in primary care, as well as associated quotes from transcripts. Resulting themes and quotes were reviewed and validated by 2 members of the project team. Results: Primary care team members considered several factors when assessing both the suitability of telehealth for appointments, and mode of use. They were largely guided by patient-related factors including patient preferences, specific health issues, and access to technology. Additional considerations centered on team members’ personal preferences and factors that supported the wellbeing of the team, such as the flexibility to work from home (work-life balance) and protection from infection. Generally, participants viewed the option of both telephone and video telehealth modalities as useful tools in the care of patients although a few respondents emphasized its inferiority to in-person care. Conclusions: Determining the suitability of telehealth services, including appropriate choice of mode is complex. Its suitability is tied to a variety of factors related to multilevel resources, preferences, and timing. When appropriate, telehealth should be considered a useful tool in the care of patients and for employee well-being.
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Objective: An infectious disease outbreak can place a significant burden on healthcare systems, however, our understanding of the broader healthcare workforce’s preparedness during a pandemic is limited. This study examines factors that... more
Objective: An infectious disease outbreak can place a significant burden on healthcare systems, however, our understanding of the broader healthcare workforce’s preparedness during a pandemic is limited. This study examines factors that influence perceived workforce preparedness at the U.S. Department of Veterans Affairs (VA) during a pandemic. Methods: The VA Preparedness Survey was a random, anonymous, web-based survey fielded nationwide October to December 2018. Multivariate statistical analyses examined the effects of study relevant factors (sociodemographic, work-related, general health, and household-related characteristics of VA employees) on perceptions of workforce preparedness, including institutional readiness and understanding of individual roles during a pandemic. Results: Four thousand and twenty-six VA employees responded. Overall, 55% were confident in their VA medical facility’s ability to respond; 49% understood their role; and 68% reported their role to be importa...
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People experiencing homelessness during the 2017–2018 California wildfires faced significant risks of disruption. Homeless service organizations (HSOs) are an essential safety net for this population. To learn about how HSOs performed... more
People experiencing homelessness during the 2017–2018 California wildfires faced significant risks of disruption. Homeless service organizations (HSOs) are an essential safety net for this population. To learn about how HSOs performed during the wildfires, this study interviewed U.S. Department of Veterans Affairs (VA) staff overseeing HSOs providing transitional housing under the VA's Grant and Per Diem (GPD) program to Veterans experiencing homelessness. We employed a comparative case study approach exploring GPD organizations' disaster response actions, including evacuating Veterans from wildfire‐affected areas or taking in disaster‐displaced Veterans. This article presents three themes in the GPD organizations' disaster response: (1) Organizations benefitted from close collaboration and communication with the VA during the disaster, creating a safety net to ensure Veterans' well‐being and enact rapid re‐housing to prevent homelessness; (2) Organization staff perf...
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Training healthcare workers in disaster preparedness has been shown to increase their willingness and ability to report to work during emergencies. This article assesses the perceived need for additional disaster preparedness training... more
Training healthcare workers in disaster preparedness has been shown to increase their willingness and ability to report to work during emergencies. This article assesses the perceived need for additional disaster preparedness training among clinicians and nonclinicians at the US Department of Veterans Affairs for three types of disasters (natural, pandemic, manmade) and examines the determinants, including sociodemographic, household, and workforce characteristics, that influence the desire for such training. Identifying which factors influence participation in preparedness trainings will guide national training efforts and improve hospital operations and health services delivery before, during, and after disasters. Abstract Objectives Training healthcare workers in disaster preparedness has been shown to increase their willingness and ability to report to work during disasters. Little is known, however, about the relation between sociodemographic, household, and workforce character...
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BackgroundA growing empirical base suggests that there is a positive relationship between teacher social interaction and student achievement. However, much of this research is based on standardized summative assessments, which, while... more
BackgroundA growing empirical base suggests that there is a positive relationship between teacher social interaction and student achievement. However, much of this research is based on standardized summative assessments, which, while important, may have limited applicability to timely instructional decision making. As such, in this work, we examine the relationship between teacher social interaction and interim benchmark formative assessments, which have been argued to play a more useful role in instructional decision making.PurposeIn this study we used a human and social capital framework to explore the relationship between teacher social interaction and student achievement on an interim benchmark formative assessment. We hypothesized that teacher social capital would be positively related with student achievement as measured by an interim assessment, even after controlling for student and teacher demographics as well as proxies for teacher human capital.PopulationA sample of 63 te...
Research Interests: Psychology, Gender Studies, Mentoring, Student Achievement Motivation, Formative Assessment, and 15 moreSocial Capital, Education Policy, Social Network Analysis (SNA), Human Capital, Educational reform, Teacher Leadership, Student learning outcomes, Intersectionality, Work Life Balance, Faculty Diversity, Professional Women, Women and Minority In STEM Fields, Pipeline Issues, Career Progression In Science and Engineering, and Interim
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Fibromyalgia syndrome (FMS) is a prevalent musculoskeletal disorder associated with pain, mood state alteration, and disability. A structured and effective treatment plan for palliative care has not been established. The genesis of FMS is... more
Fibromyalgia syndrome (FMS) is a prevalent musculoskeletal disorder associated with pain, mood state alteration, and disability. A structured and effective treatment plan for palliative care has not been established. The genesis of FMS is not clear. FMS occurs primarily in adult women. Using a quasi-experimental clinical design and following the criteria of the American College of Rheumatology (ACR), for FMS, 21 participants completed the study. The mean age was 53.6 years. The data were collected at baseline and at 1 and 2 months. Acupuncture treatments included 17 points for FMS symptoms, and 8 outcome measures were collected. The Fibromyalgia Impact Questionnaire (FIQ) showed significant differences at 1 and 2 months. For the SF-12, 3 subscales showed significant differences between baseline and 2 months. Four of 6 items were significantly changed. The mean number of general health symptoms was significantly decreased by 2 months. For the Catastrophe Index, significant difference...
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Ischemic heart disease (IHD) is a leading cause of morbidity and mortality in both developing and developed countries. An underlying cause of IHD involves retention and deposit of serum lipids in coronary arteries, decreasing blood flow.... more
Ischemic heart disease (IHD) is a leading cause of morbidity and mortality in both developing and developed countries. An underlying cause of IHD involves retention and deposit of serum lipids in coronary arteries, decreasing blood flow. Drugs (conventional and herbal) are used to lower levels of serum cholesterol to help prevent IHD. The Ayurvedic medicine pharmacopoeia identified herbs that might contribute to a decrease in cholesterol and therefore reduce the risk of IHD. Literature searches were conducted at 3 points: 2003, 2004, and 2007. Databases searched included PubMed, the National Library of Medicine, the National Center for Complementary and Alternative Medicine, Ovid, and EBSCO Information Services, and other search strategies also were used. Each article was assessed for quality by 3 people, and discrepancies were resolved by arbitration using a fourth person, who also read and scored each article. Additional assessments of safety using a scale and determination of rep...
Research Interests: Research Design, Evidence Based Medicine, Ayurvedic Medicine, Complementary and Alternative Medicine, Traditional Medicine, and 13 moreTreatment Outcome, Health, Medicinal Plants, Medicine, Quality Control, Phytotherapy, Humans, Female, Pubmed, Male, Randomized Controlled Trial, Randomized Controlled Trials as Topic, and Hyperlipidemias
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Research Interests: Health insurance, Medicine, Los Angeles, Humans, Alcoholism, and 15 moreFemale, Male, Regression Analysis, Follow-up studies, Clinical Sciences, Peer group, Adult, Odds ratio, Guidance and Counseling Intervention Programs, Brief Intervention, Emergency Department, Confidence Interval, Socioeconomic Factors, Interviews as topic, and mass Screening
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Using qualitative data, this study examines hardiness and social support among twenty-two African American and Hispanic subjects, at least 18 years of age, who received treatment for a jaw fracture and participated in an hour-long focus... more
Using qualitative data, this study examines hardiness and social support among twenty-two African American and Hispanic subjects, at least 18 years of age, who received treatment for a jaw fracture and participated in an hour-long focus group to discuss the treatment they received at King/Drew Medical Center, an inner-city hospital in Los Angeles, California. Treatment was either a non-surgical wiring of the teeth closed for six to eight weeks or surgical placement of a metal bone plate in the lower jaw with a short period of jaw fixation following surgery. A mandibular fracture is one of the most common orofacial traumas for minority individuals, and the majority of these fractures among patients at urban trauma centers are a result of interpersonal violence. Thus the link between psychosocial stress and oral health is evident, yet exposure to daily stress does not automatically place one at risk for distress. Some people under daily stress have hardiness, conceptualized as an internal personal resource consisting of control, commitment, and challenge. This study examines hardiness and social support relevant to an underserved, minority population. Hardiness and social support were identified and noted in order of frequency according to participant characteristics of treatment type, gender, and ethnicity. Main themes related to hardiness and social support are highlighted with verbatim quotes providing additional context to the theme presented.
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The study goal was to explore contextual patient- and surgeon-related characteristics that influence the perception of injury severity and treatment strategy for mandible fractures. After reviewing plain radiographs of 22 patients with... more
The study goal was to explore contextual patient- and surgeon-related characteristics that influence the perception of injury severity and treatment strategy for mandible fractures. After reviewing plain radiographs of 22 patients with mandible fractures, 18 oral and maxillofacial surgeons were queried on summary severity ratings and treatment decisions for each injury. Subsequently, they were asked to indicate how various hypothetical fracture and patient-specific factors would alter their perception of injury severity and original treatment recommendations. The effect of the level of clinician trauma expertise on perception of injury severity and treatment choice was also assessed. Each of the fracture-specific characteristics-number of constituent fractures, fracture complexity, degree of displacement, and summary injury severity-influenced the choice of treatment modality. Surgeon-specific characteristics were related to both perception of injury severity and treatment choice. Although clinicians with greater trauma loads tended to provide higher summary severity ratings for the same range of injuries (P <.001), they appeared to recommend maxillomandibular fixation for a much broader spectrum of injury severity (R = -0.42). Surgeons' perception of injury severity appeared to escalate with increasing damage to the soft tissue envelope; the influence of patient-related risk factors was less distinct. More than half of the surgeons suggesting maxillomandibular fixation for a particular case changed their treatment recommendation to rigid internal fixation on learning that the patient was noncompliant. Clinical decision making for mandible fractures is not a precise and fully reliable activity. Contextual factors (fracture, patient, and surgeon related) appear to influence the clinical decision and may be responsible for the existing variations in practice patterns.
Research Interests: Dentistry, Decision Making, Fracture, Medicine, Clinical Decision Making, and 15 moreHumans, Dislocations, Risk factors, Spectrum, Analysis of Variance, Mandibular Fractures, Soft Tissue Injuries, Jaw Fixation Techniques, Chi Square Distribution, Risk Factors, Soft Tissue, Clinical Competence, Cohort Studies, Facial Injuries, and Injury Severity Score
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Research Interests: Emergency Medicine, Health Care, Dialysis, Medicine, Natural Disasters, and 15 moreHumans, Clinical research, Health Services, New York City, Female, Male, Aged, Middle Aged, Longitudinal Studies, Adult, Kidney Disease, Emergency Department, Cohort Studies, Health Services Accessibility, and Disaster planning
Research Interests: Dentistry, Health Equity, Cultural Diversity, Employment, Anxiety, and 15 moreHumans, Female, Income, Ethnic Groups, Health Status, African Americans, General Health, Adult, Ethnic Group, Age Factors, Educational Status, European Continental Ancestry Group, ANXIETY, Cultural Deprivation, and attitude to health
ABSTRACTBackgroundThe largest gas leak in United States history occurred October 2015 through February 2016 near Porter Ranch (PR), California, and prompted the temporary relocation of nearby residents because of health concerns related... more
ABSTRACTBackgroundThe largest gas leak in United States history occurred October 2015 through February 2016 near Porter Ranch (PR), California, and prompted the temporary relocation of nearby residents because of health concerns related to natural gas exposure.MethodsA retrospective cohort study was conducted using US Department of Veterans Affairs (VA) administrative and clinical data. On the basis of zip codes, we created two groups: PR (1920 patients) and San Fernando Valley (SFV) (15 260 patients) and examined the proportion of outpatient visits to VA providers with respiratory-related diagnoses between October 2014 and September 2017.ResultsWe observed an increase in the proportion of visits in the PR group during the leak (7.0% vs 6.1%, P<0.005) and immediately after the leak (7.7% vs 5.3%, P<0.0001). For both groups, we observed a decrease in respiratory diagnoses one year after the leak (7.0% to 5.9%, P<0.05 PR; 6.1% to 5.7%, P<0.01 SFV).ConclusionExposure to natural gas likely led to the observed increase in respiratory-related diagnoses during and after the PR gas leak. Early relocation following natural gas leaks may mitigate respiratory exacerbations. (Disaster Med Public Health Preparedness. 2019;13:419-423)
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Research Interests: Dentistry, Decision Making, Focus Groups, Public Health Dentistry, Medicine, and 15 moreHumans, Minority Groups, Public, Female, Male, Patient Satisfaction, African Americans, Decision making process, Mandibular Fractures, Jaw Fixation Techniques, Minority Group, Internal Fixation, Bone Plates, attitude to health, and Molar
Research Interests: Health Psychology, Psychiatry, Mental Health, Injury Prevention, Ethnic minorities, and 15 moreAdolescent, Medicine, Los Angeles, Humans, African American, Business and Management, Female, Male, Occupational Safety and Health, Mental Disorders, Ethnic Minorities, Poison Control, Health Psychology and Behavioral Medicine, Alcohol Use, and Interviews as topic
Research Interests: Psychiatry, Mental Health, Depression, Posttraumatic Stress Disorder (PTSD), Women, and 14 moreMedicine, Humans, United States, Female, Veterans, Young Adult, Mental health services, Aged, Middle Aged, Adult, Depressive Symptoms, Cross Sectional Studies, Department of Veterans Affairs, and Health Services Accessibility
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This paper examines the predictors of quality of life among older women (≥65 years of age) veterans in the United States focusing on the effect of comorbidity on health-related quality of life (HRQOL). Data from the National Survey of... more
This paper examines the predictors of quality of life among older women (≥65 years of age) veterans in the United States focusing on the effect of comorbidity on health-related quality of life (HRQOL). Data from the National Survey of Women Veterans, a cross-sectional nationally representative population-based, stratified random sample of women veterans, were used with an analytic sample size of 1,379 older women veterans. The SF12 physical and mental composite scores (PCS and MCS) were used as outcome measures, and a weighted comorbidity index was used as a covariate. Older women veterans who are married, employed, with higher income, and higher education have better physical health (PCS). For mental health, education is positively correlated, whereas depression and posttraumatic stress disorder are negatively correlated with MCS. After adjusting for socio-demographic, mental health, and chronic health indicators, the results showed that SF12 PCS varied by VA use status for each level of Seattle Index of Comorbidity. The same pattern was not found for MCS. For each level of comorbidity, VA users have worse HRQOL which might suggest that case mix adjustments comparing VA users and non-VA users must take into account more than comorbidity alone.
Research Interests: Gerontology, Mental Health, Depression, Quality of life, Public Health, and 15 moreMedicine, Comorbidity, Humans, United States, Female, Veterans, Health Status, Aged, Questionnaires, Public health systems and services research, Health surveys, Quality Life, Cross Sectional Studies, Socioeconomic Factors, and Psychiatric Status Rating Scales
BACKGROUND At the onset of the COVID-19 pandemic, there was a rapid increase in the use of telehealth services at the US Department of Veterans Affairs (VA), which was accelerated by state and local policies mandating stay-at-home orders... more
BACKGROUND At the onset of the COVID-19 pandemic, there was a rapid increase in the use of telehealth services at the US Department of Veterans Affairs (VA), which was accelerated by state and local policies mandating stay-at-home orders and restricting nonurgent in-person appointments. Even though the VA was an early adopter of telehealth in the late 1990s, the vast majority of VA outpatient care continued to be face-to-face visits through February 2020. OBJECTIVE We compared telehealth service use at a VA Medical Center, Greater Los Angeles across 3 clinics (primary care [PC], cardiology, and home-based primary care [HBPC]) 12 months before and 12 months after the onset of COVID-19 (March 2020). METHODS We used a parallel mixed methods approach including simultaneous quantitative and qualitative approaches. The distribution of monthly outpatient and telehealth visits, as well as telephone and VA Video Connect encounters were examined for each clinic. Semistructured telephone interviews were conducted with 34 staff involved in telehealth services within PC, cardiology, and HBPC during COVID-19. All audiotaped interviews were transcribed and analyzed by identifying key themes. RESULTS Prior to COVID-19, telehealth use was minimal at all 3 clinics, but at the onset of COVID-19, telehealth use increased substantially at all 3 clinics. Telephone was the main modality of patient choice. Compared with PC and cardiology, video-based care had the greatest increase in HBPC. Several important barriers (multiple steps for videoconferencing, creation of new scheduling grids, and limited access to the internet and internet-connected devices) and facilitators (flexibility in using different video-capable platforms, technical support for patients, identification of staff telehealth champions, and development of workflows to help incorporate telehealth into treatment plans) were noted. CONCLUSIONS Technological issues must be addressed at the forefront of telehealth evolution to achieve access for all patient populations with different socioeconomic backgrounds, living situations and locations, and health conditions. The unprecedented expansion of telehealth during COVID-19 provides opportunities to create lasting telehealth solutions to improve access to care beyond the pandemic.
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Research Interests: Dentistry, Family Medicine, Medicine, Logistic Regression, California, and 15 moreHumans, Oral health, North Carolina, Regression Analysis, Michigan, New Jersey, Patient Satisfaction, Income, Ethnic Groups, Health Status, Health Expenditures, Self Assessment, Analysis of Variance, Capitation, and The The
Research Interests: Epidemiology, Biostatistics, Health Care, Public Health, Adolescent, and 15 moreMedicine, Population, Humans, United States, Female, Male, Veterans, Young Adult, Vaccination, Aged, Middle Aged, Adult, Public health systems and services research, National Health Interview Survey, and Influenza vaccines
Research Interests: Cardiology, Primary Care, Family Medicine, Telehealth, Telemedicine, and 11 moreMedicine, Organisation and delivery of health services, Clinical research, Health Services, Videoconferencing, Veterans, Medical Emergency, Pandemic, Department of Veterans Affairs, CoVid, and Coronavirus Disease 2019 (COVID-19)
Research Interests: Demography, Dentistry, Acculturation, Adolescent, Medicine, and 15 moreHumans, Female, Dental Caries, Alcohol Drinking, Male, Dental, Alcohol Consumption, Dental Health Surveys, Adult, Multiple regression analysis, Educational Status, Indexation, health status indicators, DMF index, and Bivariate Analysis
This study analyzes results of 336 patients treated for mandible fractures at King/Drew Medical Center in South Central Los Angeles, California from August 1996 to December 2001. Subjects were enrolled in a prospective study to evaluate... more
This study analyzes results of 336 patients treated for mandible fractures at King/Drew Medical Center in South Central Los Angeles, California from August 1996 to December 2001. Subjects were enrolled in a prospective study to evaluate the association between patient's subjective evaluation and objective clinical evaluations on three surgical outcome measures following orofacial surgery. Subjects were assessed at four time periods--hospital discharge, 10 days post-discharge, 1 month post-discharge and 6 months post-discharge. Three outcome measures were utilized to represent perceived health and oral health-related quality of life--General Oral Health Assessment Index (GOHAI); Mental Health Inventory (MHI-5); and a single-item self-reported health status measure. GOHAI scores at 1 month (mean=31.5, SD=9.5) were not substantially higher than at 10 days (mean=28.6, SD=8.8), but scores did improve substantially by 6 months (mean=42.6, SD=10.6). Mean mental health scores ranged from 17.7 at 10 days to 18.0 at 1 month and 18.6 at 6 months. Mean self-reported health status score were approximately 2.2 at all recalls, describing health as 'good.' A longitudinal growth curve analysis of GOHAI scores over four time periods indicated a significantly higher average intercept for the maxillomandibular fixation (MMF) treatment group (29.67) than in the rigid internal fixation (RIF) treatment group (25.38). Meanwhile, the increase in GOHAI scores over time was significantly greater in the RIF group than in the MMF group, resulting in scores being comparable between groups after 6 months. By implication, patients with MMF self-report fewer problems in the early days after placement of the intra-arch wire compared with patients with RIF.
Research Interests: Dentistry, Mental Health, Quality of life, Treatment Outcome, Adolescent, and 15 moreMedicine, Prospective studies, Humans, Oral health, Female, Male, Patient Satisfaction, Fracture Healing, Health Status, Adult, Public health systems and services research, Mandibular Fractures, Jaw Fixation Techniques, attitude to health, and Patient discharge
Daly, A. J., Der-Martirosian, C., Moolenaar, N., & Liou, Y.-H. (2014). Accessing capital resources: Investigating the effects of teacher human and social capital on student achievement. Teachers College Record, 116(7), 1-42.