Michael Quinn - Academia.edu (original) (raw)

Papers by Michael Quinn

Journal of racial and ethnic health disparities, Jan 17, 2019

BMC Health Services Research, Jun 4, 2022

Background: Diabetes group visits are shared appointments that include diabetes education in a gr... more Background: Diabetes group visits are shared appointments that include diabetes education in a group setting and individual visits with a medical provider. An 18-month pilot study was designed to evaluate organizational capacity and staff preparedness in implementing and sustaining diabetes group visits. Results: Data were collected and analyzed from pre-post assessments and key informant interviews with community health center (CHC) staff (N = 26) from teams across five Midwestern states. Overall, participants demonstrated high baseline knowledge and awareness about diabetes group visit implementation. Changes in attitudes and practices did occur pertaining to familiarity with billing and increased awareness about potential barriers to diabetes group visit implementation. Key assets to diabetes group visit implementation were access to pre-designed resources and materials, a highly motivated team, and supportive leadership. Key obstacles were socioeconomic challenges experienced by patients, constraints on staff time dedicated to group visit implementation, and staff turnover. Conclusions: Results of the study provide a framework for implementation of diabetes group visit trainings for CHC staff. Future research is needed to assess the training program in a larger sample of CHCs.

Clinical Pediatrics, 2019

Children with medical technology dependency (MTD) require a medical device to compensate for a vi... more Children with medical technology dependency (MTD) require a medical device to compensate for a vital body function and substantial nursing care. As such, they require constant high-level supervision. Respite care provides caregivers with a temporary break, and is associated with reduced stress; however, there are often barriers. The study utilizes mixed methodology with the National Survey of Children with Special Health Care Needs (NS-CSHCN) and semistructured interviews with state-wide care coordinators to understand the gap for respite care services. Fifty-nine percent of parents who needed respite care received none. Parents of older children with MTD were more likely to report respite needs. Care coordinators described that home health shortages created barriers to respite care utilization, and the lack of respite care can lead to hospital readmission. Although respite care is a vital resource to support families of children with MTD, it is infrequently available, which can hav...

Archives of Pediatrics & Adolescent Medicine, 1999

To describe the pediatric interview as it is conducted in different practice settings and with ch... more To describe the pediatric interview as it is conducted in different practice settings and with children ranging in age from infancy to adolescence, and to identify pediatric history-taking strategies that varied across age groups. Participants and Methods: A self-administered survey was designed and mailed to a group of pediatricians in the Chicago metropolitan area to assess commonly used strategies in the pediatric interview across varied patient ages and settings. The pediatricians sampled varied by geographic location as well as by practice setting. Results: Results of the survey indicated that pediatricians use common strategies for establishing rapport, calming the disruptive child, and obtaining information from the child within particular age groups, but vary these strategies as the child matures. Conclusions: The findings substantiate the influence of the developmental stage of the child on interview strategies used by pediatricians. Implications pertaining to development of a standardized teaching curriculum for the pediatric interview are also discussed.

Cancer, Jan 25, 2018

This report details the cost effectiveness of a non-nurse patient navigation (PN) program that wa... more This report details the cost effectiveness of a non-nurse patient navigation (PN) program that was implemented at the University of Chicago Medical Center to increase colonoscopy-based colorectal cancer (CRC) screening. The authors investigated the impact of the PN intervention by collecting process measures. Individuals who received navigation were compared with a historic cohort of non-navigated patients. In addition, a previously validated data-collection instrument was tailored and used to collect all costs related to developing, implementing, and administering the program; and the incremental cost per patient successfully navigated (the cost of the intervention divided by the change in the number who complete screening) was calculated. The screening colonoscopy completion rate was 85.1% among those who were selected to receive PN compared with 74.3% when no navigation was implemented. With navigation, the proportion of no-shows was 8.2% compared with 15.4% of a historic cohort ...

Contraception, 2014

elevations in coagulation profiles) were not associated with hemorrhage in the IUFD group. Conclu... more elevations in coagulation profiles) were not associated with hemorrhage in the IUFD group. Conclusions: Hemorrhage associated with second-trimester D&E is uncommon. Women with fetal demise of 4 weeks or less and before 21 weeks' gestation have no greater risk than women undergoing D&E for other indications. Inpatient management may be appropriate for cases at or after 21 weeks or with prolonged demise. Preoperative labs were unhelpful in predicting hemorrhage.

Implementation Science Communications, 2021

Background Many evidence-based interventions (EBIs) found to be effective in research studies oft... more Background Many evidence-based interventions (EBIs) found to be effective in research studies often fail to translate into meaningful patient outcomes in practice. The purpose of this study was to identify facilitators and barriers that affect the implementation of three EBIs to improve colorectal cancer (CRC) screening in an urban federally qualified health center (FQHC) and offer actionable recommendations to improve future implementation efforts. Methods We conducted 16 semi-structured interviews guided by the Consolidation Framework for Implementation Research (CFIR) to describe diverse stakeholders’ implementation experience. The interviews were conducted in the participant’s clinic, audio-taped, and professionally transcribed for analysis. Results We used the five CFIR domains and 39 constructs and subconstructs as a coding template to conduct a template analysis. Based on experiences with the implementation of three EBIs, stakeholders described barriers and facilitators relat...

Implementation Science, 2020

Background Screening for colorectal cancer (CRC) not only detects disease early when treatment is... more Background Screening for colorectal cancer (CRC) not only detects disease early when treatment is more effective but also prevents cancer by finding and removing precancerous polyps. Because many of our nation’s most disadvantaged and vulnerable individuals obtain health care at federally qualified health centers, these centers play a significant role in increasing CRC screening among the most vulnerable populations. Furthermore, the full benefits of cancer screenings must include timely and appropriate follow-up of abnormal results. Thus, the purpose of this study is to implement a multilevel intervention to increase rates of CRC screening, follow-up, and referral-to-care in federally qualified health centers, as well as simultaneously to observe and to gather information on the implementation process to improve the adoption, implementation, and sustainment of the intervention. The multilevel intervention will target three different levels of influences: organization, provider, and...

Population Health Management, 2019

The objective was to identify facilitators and challenges of implementing diabetes group visits i... more The objective was to identify facilitators and challenges of implementing diabetes group visits in 5 Midwestern community health center (CHC) settings that care for diverse patient populations. Interview data were collected from July to August 2015. An interview guide was developed to explore health center teams' initial experiences with diabetes group visit implementation. Interviews were conducted with 14 individuals who participated in a training prior to diabetes group visit implementation. Four levels of coding (open, in vivo, categorical, and thematic) were used to identify characteristics of group visit implementation in 5 CHCs. A semi-structured model encouraged interprofessional teamwork across all CHC teams. Self-appointed or chosen team champions were the ''pulse'' or central driving force of implementation. A designated time in the clinic for patients to receive education and psychosocial support enhanced engagement in diabetes selfmanagement. Early buy-in from upper leadership was critical to securing fiscal and human resources as unexpected needs emerged during group visit implementation. Time commitment of clinic staff and providers for ongoing operations, socioeconomic challenges of patients, staff turnover, and billing were reported as challenges in the initial implementation process. This study acknowledges the influence of administrative and sociocultural factors on successful implementation of diabetes group visits. Future research should further explore how these factors influence successful adoption of diabetes group visits in health centers across the United States and the impact of group visit implementation on staff and patient outcomes.

Journal of General Internal Medicine, 2019

BACKGROUND: The patient-centered medical home (PCMH) is a widely adopted primary care model. Howe... more BACKGROUND: The patient-centered medical home (PCMH) is a widely adopted primary care model. However, it is unclear whether changes in provider and staff perceptions of clinic PCMH capability are associated with changes in provider and staff morale, job satisfaction, and burnout in safety net clinics. OBJECTIVE: To determine how provider and staff PCMH ratings changed under a multi-year PCMH transformation initiative and assess whether changes in provider and staff PCMH ratings were associated with changes in morale, job satisfaction, and burnout. DESIGN: Comparison of baseline (2010) and postintervention (2013-2014) surveys. SETTING: Sixty clinics in five states. PARTICIPANTS: Five hundred thirty-six (78.2%) providers and staff at baseline and 589 (78.3%) post-intervention. INTERVENTION: Collaborative learning sessions and onsite coaching to implement PCMH over 4 years. MEASUREMENTS: Provider and staff PCMH ratings on 0 (worst) to 100 (best) scales; percent of providers and staff reporting good or better morale, job satisfaction, and freedom from burnout. RESULTS: Almost half of safety net clinics improved PCMH capabilities from the perspective of providers (28 out of 59, 47%) and staff (25 out of 59, 42%). Over the same period, clinics saw a decrease in the percentage of providers reporting high job satisfaction (− 12.3% points, p = .009) and freedom from burnout (− 10.4% points, p = .006). Worsened satisfaction was concentrated among clinics that had decreased PCMH rating, with those clinics seeing far fewer providers report high job satisfaction (− 38.1% points, p < 0.001). LIMITATIONS: Control clinics were not used. Individuallevel longitudinal survey administration was not feasible. CONCLUSION: If clinics pursue PCMH transformation and providers do not perceive improvement, they may risk significantly worsened job satisfaction. Clinics should be aware of this potential risk of PCMH transformation and ensure that providers are aware of PCMH improvements.

Social Science Protocols, 2019

Background: American Muslims tend to hold more negative attitudes towards organ donation than oth... more Background: American Muslims tend to hold more negative attitudes towards organ donation than other American populations, and these attitudes are contributed to by gaps in biomedical and religious knowledge. As a result, there is significant need for religiously-tailored health education on organ donation within this community. Thus our study sought to test the effectiveness of a mosque-based, religiously-tailored health education program that addressed biomedical and religious knowledge gaps regarding living organ donation amongst Muslim Americans. Methods: A randomized, controlled, cross-over trial of religiously-tailored educational workshops held at four mosques in Washington D.C. and Chicagoland. Mosques are randomized into early and late intervention arms and participants are recruited at worship services and other mosque events. The primary study outcomes are changes in biomedical and religious knowledge regarding living organ donation. Secondary outcomes include change in pr...

Cancer Research, 2018

Objective: Describe outcomes of a religiously-tailored peer-led group educational intervention ad... more Objective: Describe outcomes of a religiously-tailored peer-led group educational intervention addressing mammography-related barrier beliefs of American Muslims. Methods: We used focus groups and interviews with a diverse group of Muslim women aged 40 and older to identify salient behavioral, normative and control beliefs regarding mammography. We used these data to design the curriculum and messaging for a mosque-based intervention involving peer-led group education. A novel model for religious tailoring was developed to address barrier beliefs by reframing, reprioritizing, and/or reforming belief structures. Peer educators were recruited/trained from mosques to match the ethnic composition of target population. The classes involved facilitated discussions and guest-led didactics covering religion and health, and mammography guidelines. Survey data was collected pre-, post, 6 months, and one-year post-intervention which captured changes in three primary outcome variables (1) perce...

Journal of Community Health, 2019

Introduction-In 2014, the Affordable Care Act (ACA) provided funding for states to expand Medicai... more Introduction-In 2014, the Affordable Care Act (ACA) provided funding for states to expand Medicaid coverage to include citizens who earned up to 138% of the federal poverty line. We sought to ascertain whether physicians practicing in Medicaid expansion states reported an increase in Medicaid or newly insured patients with type 2 diabetes in their panels, compared to physicians practicing in non-expansion states. Methods-We conducted a 55-question cross-sectional survey of 356 physicians providing outpatient care for adults with type 2 diabetes. We used adjusted multivariate logistic regression analyses to compare responses from physicians who practiced in expansion vs. non-expansion states regarding whether they observed an increase since 2014 in 1) the number of Medicaid or newly insured patients with diabetes and 2) the number of additional newly or previously diagnosed patients who were newly receiving care, in their panels, adjusting for physician, practice, and patient-level characteristics, weighted for the U.S. physician population. Results-41% of eligible recipients responded. 64.2% of physicians who practice in an expansion state report an increase in Medicaid or newly insured patients with diabetes compared with 46.1% who practice in non-expansion states (p = 0.05; Table 2). Conclusion-Compared with physicians who practice in non-expansion states, physicians who practice in Medicaid expansion states are more likely to report an increase in the number of Medicaid or newly insured patients with diabetes in their practice since 2014. The increased

Cancer Epidemiology, Biomarkers & Prevention, 2018

Objective: To describe the design of, and participant-level outcomes related to, a religiously ta... more Objective: To describe the design of, and participant-level outcomes related to, a religiously tailored peer-led group education program that addressed mammography-related barrier beliefs of American Muslims. Methods: Using community-engaged research methods including a multidisciplinary community advisory board, we identified and then intervened upon barrier beliefs impeding mammography screening among American Muslim women. Phase 1 of the project involved focus groups and interviews with an ethnically diverse group of women aged 40 and older sampled from Muslim organizations to identify salient behavioral, normative, and control beliefs regarding mammography. Phase 2 entailed interviews with the same target population to elicit ideas about intervention design. CAB members and staff used these data to design the curriculum and messaging for a religiously tailored mosque-based intervention involving peer-led group education classes. Peer educators were recruited and trained from mos...

SAGE Open Medicine, 2018

Objectives: The objectives of this study are to assess patient perspectives on their perceived be... more Objectives: The objectives of this study are to assess patient perspectives on their perceived benefits of hypertension and diabetes medications and determine associations between perceived benefits and demographics, adherence, and disease control. Methods: We interviewed 60 adults with type 2 diabetes and hypertension on oral medications. Participants were asked what benefits they expected from taking their medications. Transcripts were analyzed using a modified template approach. Benefits were categorized into short-term, long-term, or misconceptions (e.g. “medications cure diabetes”). Associations between perceived benefits and demographics, adherence, hemoglobin A1c, and blood pressure were analyzed. Results: In general, participants had relatively high self-reported medication adherence and well-controlled disease. All participants identified benefits of their hypertension medications; however, only 85% identified benefits of their diabetes medications. Half described only shor...

Medical Care, 2011

Background-The patient-centered medical home (PCMH) has become a widely cited solution to the def... more Background-The patient-centered medical home (PCMH) has become a widely cited solution to the deficiencies in primary care delivery in the United States. To achieve the magnitude of change being called for in primary care, quality improvement interventions must focus on wholesystem redesign, and not just isolated parts of medical practices. Methods-Investigators participating in 9 different evaluations of Patient Centered Medical Home implementation shared experiences, methodological strategies, and evaluation challenges for evaluating primary care practice redesign. Results-A year-long iterative process of sharing and reflecting on experiences produced consensus on 7 recommendations for future PCMH evaluations: (1) look critically at models being implemented and identify aspects requiring modification; (2) include embedded qualitative and quantitative data collection to detail the implementation process; (3) capture details concerning how different PCMH components interact with one another over time; (4) understand and describe how and why physician and staff roles do, or do not evolve; (5) identify the effectiveness of individual PCMH components and how they are used; (6) capture how primary care practices interface with other entities such as specialists, hospitals, and referral services; and (7) measure resources required for initiating and sustaining innovations. Conclusions-Broad-based longitudinal, mixed-methods designs that provide for shared learning among practice participants, program implementers, and evaluators are necessary to evaluate the novelty and promise of the PCMH model. All PCMH evaluations should as comprehensive as possible, and at a minimum should include a combination of brief observations and targeted qualitative interviews along with quantitative measures.