1
|
Lorino A, Talero Cabrejo P, Coppola S. Occupational Experiences of Medication Management Among Adults Living With Multiple Chronic Conditions. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:414-426. [PMID: 37162213 DOI: 10.1177/15394492231172931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Adults with multiple chronic conditions (MCCs) often face difficulties with medication management, affecting their experiences of well-being and illness. The objective of this study was to identify and describe the occupational experiences of medication management and their impact on well-being and illness in adults living with MCCs. We used document analysis methods to analyze 134 illness narrative blog posts authored by 52 adults aged 18 and older with MCCs. Content and thematic analysis of their textual content was based on the Pan Occupational Paradigm. Medication management is enacted through the dimensions of doing, belonging, becoming, being, and knowing, in an interconnected, nonlinear manner, with a more notable impact on illness than well-being due to the complexities associated with medication management for MCCs. Occupational therapy practices for medication management should consider all occupational dimensions and their impact on health rather than focusing primarily on the performance of medication tasks and routines.
Collapse
Affiliation(s)
- Amy Lorino
- Binghamton University, Binghamton, NY, USA
| | | | - Susan Coppola
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
2
|
Jahrami H. Unlocking the potential: Exploring the opportunities for occupational therapists in cyberpsychology. Hong Kong J Occup Ther 2024; 37:3-9. [PMID: 38912100 PMCID: PMC11192431 DOI: 10.1177/15691861231222074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 12/07/2023] [Indexed: 06/25/2024] Open
Abstract
It has long been established that occupational therapists (OTs) play an important role in assisting clients suffering from a variety of physical and mental health conditions. Cyberpsychology is a relatively new field in medicine that pertains to how technology influences people's mental health and behavior. It covers the effects of social media, online gaming, virtual-augmented reality, artificial intelligence, and other forms of technology on individuals. Among the known psychological phenomena arising from individuals' interactions with digital technologies are cyberbullying and technology addiction. This commentary explores how OTs in the cyberpsychology field can develop personalized interventions to enhance digital well-being and promote healthy technology use.
Collapse
Affiliation(s)
- Haitham Jahrami
- Government Hospitals, Bahrain
- Arabian Gulf University, Bahrain
| |
Collapse
|
3
|
Wei D, Loganathan T, Wong LP. Employees of the banking sector in Guizhou Province in China: prevalence of migraine, symptoms, disability and occupational risk factors. J Headache Pain 2023; 24:52. [PMID: 37170218 PMCID: PMC10173247 DOI: 10.1186/s10194-023-01591-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Although studies have identified a high prevalence of migraine among employees in the banking sector, the symptoms of migraine, related disability and occupational risk factors are not well understood. AIMS To determine migraine prevalence, symptoms and disability among bank employees in Guizhou province in China and to examine occupational risk factors associated with migraine positivity and symptoms. METHODS In a cross-sectional survey, two-stage probability sampling was used to select bank employees in Guizhou province, China. From May to October 2022, uniformly trained interviewers conducted face-to-face interviews using the HARDSHIP questionnaire. Logistic regression was used to examine factors associated with migraine positivity and symptoms. RESULTS Of 1,985 contactable eligible subjects, 1,929 (male 45.4%, female 54.6%) completed the survey. The one-year prevalence of migraine was 27.2% (95% CI 25.2-29.2%). Of migraine-positive individuals, 11.2% had a monthly frequency ≥ 15 days, 11.8% had an attack duration > 72 h, and 14.9% had severe pain intensity. The median of days lost from work, housework and social activities due to migraine during a three-month period was 4, 3 and 2 days, respectively, with more than half (52.8%) patients reporting Grade III or IV disability. In multivariable analyses, positions in data analysis (OR = 1.8 [95% CI 1.2-2.8], p < 0.01) and information technology (OR = 3.8 [95% CI 1.7-8.3], p < 0.01) were occupational risk factors for migraine positivity. It was also found that professional positions were predictive of migraine attacks ≥ 15 days per month, administrative positions were predictive of duration > 72 h and severe pain intensity of migraine attacks, and working in remote branches was predictive of duration > 72 h. CONCLUSIONS Migraine is prevalent among employees in the banking sector in Guizhou province in China, with a large proportion of sufferers carrying a high burden of symptoms and disability. The practical implication of this study is that the risk factors identified here could be translated to the focus of workplace monitoring and interventions to manage and prevent migraine.
Collapse
Affiliation(s)
- Du Wei
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, China
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Tharani Loganathan
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
- Department of Social and Preventive Medicine, Centre for Epidemiology and Evidence-Based Practice, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Li Ping Wong
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
- Department of Social and Preventive Medicine, Centre for Epidemiology and Evidence-Based Practice, Universiti Malaya, Kuala Lumpur, Malaysia.
| |
Collapse
|
4
|
Klinedinst TC, Ciro CA, Kendzor DE. A pilot, randomized, feasibility study to improve health self-management behaviors in older adults with multiple chronic conditions and functional limitations: Protocol for the Behavioral Activation and Occupational Therapy Trial (BA+OT). JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231163037. [PMID: 36911183 PMCID: PMC9998403 DOI: 10.1177/26335565231163037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/14/2023] [Indexed: 03/14/2023]
Abstract
Background Approximately 45% of older adults in the U.S. have 2 or more chronic health conditions (e.g., arthritis, hypertension, diabetes) in addition to functional limitations that prevent performance of health self-management activities. Self-management continues to be the gold standard for managing MCC, but functional limitations create difficulty with these activities (e.g., physical activity, symptom monitoring). Restricted self-management accelerates the downward spiral of disability and accumulating chronic conditions which, in turn, increases rates of institutionalization and death by 5-fold. Currently, there are no tested interventions designed to improve independence in health self-management activities in older adults with MCC and functional limitations. Research suggests that older adults are more likely to change behavior with interventions that assist with planning health-promoting daily activities, especially when contending with complex medical regimens and functional limitations. Our team asserts that combining occupational therapy (OT) and behavioral activation (BA) shows promise to improve health self-management in populations with chronic conditions and/or functional limitations. This innovative combination uses the goal setting, scheduling/monitoring activities, and problem-solving components of the BA approach as well as the environmental modification, activity adaptation, and focus on daily routines from OT practice. Objectives We will test the effect of this combined approach in a Stage I, randomized controlled pilot feasibility study compared to enhanced usual care. We will recruit 40 older adults with MCC and functional limitation and randomize 20 to the PI- delivered BA-OT protocol. This research will inform modification and larger-scale testing of this novel intervention.
Collapse
Affiliation(s)
- Tara C Klinedinst
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center- Schusterman Campus, Tulsa, OK, USA.,Department of Internal Medicine, OU-TU School of Community Medicine, Tulsa, OK, USA
| | - Carrie A Ciro
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Heath Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
5
|
Gately ME, Quach ED, Shirk SD, Trudeau SA. Understanding Variation in Adoption of Video Telehealth and Implications for Health Care Systems. MEDICAL RESEARCH ARCHIVES 2022; 10:10.18103/mra.v10i5.2751. [PMID: 36405543 PMCID: PMC9670247 DOI: 10.18103/mra.v10i5.2751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Telehealth has rapidly expanded since COVID-19. Veterans Health Administration (VHA), the largest integrated health care system in the United States, was well-positioned to incorporate telehealth across specialties due to existing policies and infrastructure. OBJECTIVES The objective of this study is to investigate predictors of occupational therapy (OT) practitioners' adoption of video telehealth. METHODS This study presents data from a convenience sample of VHA occupational therapy (OT) practitioners administered pre-pandemic, in fall 2019. Survey development was guided by the Promoting Action on Research Implementation in Health Services framework, and gathered clinician attitudes, experiences, and perspectives about video telehealth to deliver OT services. Items included telehealth usage, perceived effectiveness of specific OT interventions, and perceptions about evidence. Our outcome variable denoted practitioners' level of adoption of video telehealth: telehealth users (adopters), non-users who want to use telehealth (potential adopters and reference group), and non-users who do not want to use telehealth (non-adopters). In multiple multinomial logistic regressions, we tested whether level of adoption was associated with years of VHA work experience and perceived strength of evidence. RESULTS Of approximately 1455 eligible practitioners, 305 VHA occupational therapy practitioners participated in the survey (21% response rate). One hundred and twenty-five (41%) reported using video telehealth, whereas 180 (59%) reported not using video telehealth. Among non-users, 107 (59%) indicated willingness to adopt telehealth whereas 73 (41%) were not willing. More VHA work experience predicted higher odds of being an adopter than a potential adopter; perceptions of stronger evidence regarding video telehealth predicted higher odds of being a potential adopter than a non-adopter. CONCLUSION Clinician beliefs and years of experience exerted an influence on clinicians' use or willingness to use video telehealth. Efforts to enhance adoption of video telehealth should address clinicians' beliefs regarding the innovative nature of and organizational resources necessary to foster utilization.
Collapse
Affiliation(s)
- Megan E Gately
- Geriatric Research Education and Clinical Center, VA Bedford Healthcare System Bedford, MA
| | - Emma D Quach
- Geriatric Research Education and Clinical Center, VA Bedford Healthcare System Bedford, MA
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA
- Department of Gerontology, University of Massachusetts Boston
| | - Steven D Shirk
- VA Bedford Healthcare System, Bedford, MA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Scott A Trudeau
- Geriatric Research Education and Clinical Center, VA Bedford Healthcare System Bedford, MA
- American Occupational Therapy Association, Bethesda, MD
| |
Collapse
|
6
|
Wallis A, Meredith P, Stanley M. Changing occupational roles for the young adult with cancer: A longitudinal case study. Aust Occup Ther J 2022; 69:243-254. [PMID: 35040159 DOI: 10.1111/1440-1630.12786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Young adulthood is a period of rapid occupational role development. While the impact of a cancer diagnosis at this time is likely to be substantial, little research has addressed this topic. The aims of this study were to gain insights into the impact of cancer on occupational roles throughout the cancer disease trajectory, from diagnosis to the palliative stage, for one young person. METHODS A longitudinal case study design was used. Five semi-structured interviews, layered with photo elicitation, were conducted over 3 years. Qualitative data were analysed thematically. RESULTS Three themes emerged: the adjusted plan, establishing rules, and damage control and self-preservation. Challenges impacting participation in, and meaning of, and the occupational roles themselves shifted over time. CONCLUSION Findings provide knowledge of occupational adaptation, and the reconstruction of occupational role identity and participation, of the young adult living with cancer along the disease trajectory.
Collapse
Affiliation(s)
- Amy Wallis
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,School of Health, Medical and Applied Sciences, Central Queensland University, Central Rockhampton, Queensland, Australia
| | - Pamela Meredith
- School of Health, Medical and Applied Sciences, Queensland University, Central Rockhampton, Queensland, Australia
| | - Mandy Stanley
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| |
Collapse
|
7
|
Fox V, Bailliard AL. Liminal Space of First-Episode Psychosis: Health Management and Its Effect on Social Participation. Am J Occup Ther 2021; 75:14665. [PMID: 34780626 DOI: 10.5014/ajot.2021.046953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Managing health requires extensive time and effort, especially in the early stages of a new illness. Although important, health management occupations contribute to treatment burden, disrupt engagement in other occupations, and galvanize the incorporation of the illness into identity. This is especially true for young adults after first-episode psychosis (FEP). OBJECTIVE To explore the impact of health management occupations on the social participation of young adults after FEP. DESIGN Qualitative study. SETTING Community with participants from primarily urban environments. PARTICIPANTS Five adults between 18 and 30 yr old who experienced FEP within the previous 5 yr. Data collection occurred through semistructured interviews, participant observations, and discourse elicitation. Outcomes and Measures: Two participant observations per month for 6 mo with 4 study participants; six observations total for a 5th participant. RESULTS Health management dominated participants' occupations immediately after FEP and hindered their social participation as they experienced a liminal space (i.e., transition space) in their life trajectory. Some participants were "stuck" in this space and deferred life goals to focus on illness management, whereas others used the liminal space as a space for growth and transformation. CONCLUSIONS AND RELEVANCE Health management occupations are essential; however, overemphasizing health management can hinder social participation and quality of life. Occupational therapy practitioners can assist clients with moving through liminal spaces after diagnosis by supporting participation beyond mental health treatment environments, helping clients to imagine alternative life trajectories, and finding strategies to reduce overall treatment burden. What This Article Adds: The concept of liminality holds promise for understanding and supporting health management and social participation after FEP.
Collapse
Affiliation(s)
- Valerie Fox
- Valerie Fox, PhD, OTR/L, CPRP, is Occupational Therapist, Durham Veterans Affairs Medical Center, Durham, NC;
| | - Antoine L Bailliard
- Antoine L. Bailliard, PhD, OTR/L, is Associate Professor, Occupational Therapy Doctorate Division, Duke University School of Medicine, Durham, NC, and Consultant and Trainer, Center for Excellence in Community Mental Health, University of North Carolina at Chapel Hill
| |
Collapse
|
8
|
Wong SR, Ngooi BX, Kwa FY, Koh XT, Chua RJJ, Dancza KM. Exploring the meaning of value-based occupational therapy services from the perspectives of managers, therapists and clients. Br J Occup Ther 2021. [DOI: 10.1177/03080226211030095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction There is a worldwide trend towards value-based health care, which strives to control healthcare costs while maximising value for clients. The main concept of value has been defined as health outcomes achieved per US dollar spent. This research explored how clients of occupational therapy services, managers and occupational therapists perceived value in occupational therapy services. Method A qualitative design was used to explore the perspectives of clients ( n = 11), occupational therapists ( n = 7) and occupational therapy managers ( n = 7). Appreciative inquiry guided the two phases of semi-structured interviews ( n = 5) and focus groups ( n = 6). Inductive and deductive coding were used to establish themes. Findings Three themes encompassed the participants’ perceived value of occupational therapy services: (1) outcomes which are meaningful to daily life, (2) a constructive client–therapist relationship and (3) affordable, coordinated and understandable therapy. Conclusion Participants attributed value to occupational therapy services when they encountered personalised goal setting, focused on meaningful outcomes, managed personal costs and experienced positive therapeutic relationships. Enhancing services could focus on (1) developing skills in collaborative goal setting, (2) determining suitable outcome measures which are meaningful at personal- and service-level reporting, (3) encouraging self-management strategies, and (4) emphasising therapeutic relationships and supporting therapeutic communication skill development.
Collapse
Affiliation(s)
- Su Ren Wong
- National University Hospital, Singapore
- Health and Social Sciences, Singapore Institute of Technology, Singapore
| | | | - Fang Yin Kwa
- Health and Social Sciences, Singapore Institute of Technology, Singapore
- Ng Teng Fong General Hospital, Singapore
| | - Xiang Ting Koh
- Health and Social Sciences, Singapore Institute of Technology, Singapore
- Changi General Hospital, Singapore
| | - Rachel J J Chua
- Health and Social Sciences, Singapore Institute of Technology, Singapore
- Ng Teng Fong General Hospital, Singapore
| | - Karina M Dancza
- Health and Social Sciences, Singapore Institute of Technology, Singapore
| |
Collapse
|
9
|
Armstead AB, Wilkerson JM, Gemeinhardt G, Nyitray A, Collins DM. Antiretroviral Therapy Adherence, Functional Independence, and Falls among People with HIV. Occup Ther Health Care 2021; 35:318-335. [PMID: 34137654 DOI: 10.1080/07380577.2021.1938337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chronic disease management coupled with education may improve outcomes for those with chronic disease. As Human Immunodeficiency Virus (HIV) is now a chronic disease, addressing the needs of as people living with HIV (PLWH) is essential as they experience an accelerated aging process due to the mechanisms of the disease and medications taken. Although studies exist on the management of chronic HIV, few discuss the implications of medication adherence and activities of daily living related to falls among PLWH. To inform occupational therapy services for PLWH, this case-control study used extracted data from the electronic medical records of PLWH who had received occupational therapy (OT) at a large academic hospital. Two-hundred-and-four subjects were included in the final dataset; sixty-eight were cases that reported a fall within the last 12 months, while 136 were controls which were PLWH who had not sustained a fall. The association between falls and antiretroviral therapy adherence indicated males who were ART non-adherent and had balance deficits were more likely to fall. The association between ADL dysfunction and falls among PLWH showed those more likely to fall had moderate ADL dysfunction and balance deficits. The findings suggest further examination of the person factors of PLWH who are categorized clinically as non-adherent with antiretroviral therapy and have ADL dysfunction may improve health outcomes and reduce falls when paired with occupation-based interventions.
Collapse
Affiliation(s)
- Amber B Armstead
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA.,Department of Occupational Therapy, School of Health Professions, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - J Michael Wilkerson
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Gretchen Gemeinhardt
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Alan Nyitray
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Diane M Collins
- Department of Occupational Therapy, School of Health Professions, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| |
Collapse
|
10
|
Schepens Niemiec SL, Vigen CLP, Martínez J, Blanchard J, Carlson M. Long-Term Follow-Up of a Lifestyle Intervention for Late-Midlife, Rural-Dwelling Latinos in Primary Care. Am J Occup Ther 2021; 75:7502205020p1-7502205020p11. [PMID: 33657344 PMCID: PMC7929605 DOI: 10.5014/ajot.2021.042861] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Importance: Rural-dwelling Latinos are an underresourced population in need of accessible and effective wellness programs. Objective: To evaluate patients’ long-term health-related outcomes after lifestyle intervention. Design: An uncontrolled pilot trial assessing change in health from pretreatment to long-term follow-up (12 mo after intervention completion, no contact) and from posttreatment to long-term follow-up. Setting: Rural, community-based primary care. Participants: Latino and Hispanic safety-net primary care patients, ages 50 to 64 yr. Intervention: A culturally tailored, 4-mo lifestyle intervention co-led by occupational therapy practitioners and Latino community health workers that features telehealth and in-home sessions covering topics such as healthy eating and navigating health care. Outcomes and Measures: Self-reported and physiological outcomes: symptom–well-being (primary), stress, sleep disturbance, social satisfaction, physical activity, patient activation, blood pressure, and weight. Exit interviews addressed health experiences and intervention impact on participants’ lives. Results: Participants (N = 27) demonstrated clinically significant pretreatment to long-term follow-up benefits in all symptom–well-being dimensions (Cohen’s d ≥ 0.8, p ≤ .004), with additional gains from posttreatment to long-term follow-up (d ≥ 0.4, p ≤ .05). Significant improvements from pre- to posttreatment in systolic blood pressure, stress, and social role and activity satisfaction were maintained at long-term follow-up. No changes were observed in weight, physical activity, or diastolic blood pressure. Participants described the intervention’s sustained positive effect on their wellness. Conclusions and Relevance: A lifestyle intervention led by occupational therapy practitioners and community health workers in a primary care context has potential to achieve long-term health benefits in rural-dwelling, late-midlife Latinos. What This Article Adds: This study reveals that rural, late-midlife Latinos showed long-lasting improvements in psychological and physical health after finishing a program that helped them make healthy lifestyle choices. This finding supports the unique contribution of occupational therapy in primary care settings.
Collapse
Affiliation(s)
- Stacey L Schepens Niemiec
- Stacey L. Schepens Niemiec, PhD, OTR/L, is Associate Professor of Research, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
| | - Cheryl L P Vigen
- Cheryl L. P. Vigen, PhD, is Associate Professor of Research, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Jenny Martínez
- Jenny Martínez, OTD, OTR/L, BCG, is Associate Professor, Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA
| | - Jeanine Blanchard
- Jeanine Blanchard, PhD, OTR/L, is Project Manager, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Mike Carlson
- Mike Carlson, PhD, is Professor of Research, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| |
Collapse
|
11
|
Role of Occupational Therapy in Primary Care. Am J Occup Ther 2020; 74:7413410040p1-7413410040p16. [DOI: 10.5014/ajot.2020.74s3001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
The American Occupational Therapy Association (AOTA) affirms that occupational therapy practitioners1 are well prepared to contribute to interprofessional collaborative care teams addressing the primary care needs of individuals across the life course. Because of an increased focus on preventive population health and social determinants of health by health care organizations, synergy between primary care and occupational therapy is growing, with support for client-centered,2 comprehensive whole-person care, health promotion and prevention, disease self-management, and quality of life (Halle et al., 2018). Occupational therapy practitioners’ distinct knowledge of the significant impact that roles, habits, and routines have on health and wellness makes their contribution to primary care valuable (AOTA, 2020b). Occupational therapy’s focus on meaningful engagement in occupations is relevant and vital to participation in individual, family, and community life (AOTA, 2020c). In addition, occupational therapy practitioners’ holistic and population perspectives allow them to be effective both as interprofessional health care team members and as direct care providers to support client, family, and community needs in primary care delivery models (Leland et al., 2017). The purposes of this position paper are to define primary care and to describe occupational therapy’s evolving and advancing role in primary care, including expansion of services into specialty primary care areas such as pediatric primary care and obstetrics and gynecology (AOTA, 2018).
Collapse
|
12
|
Livingstone I, Hefele J, Leland N. Physical and Occupational Therapy Staffing Patterns in Nursing Homes and Their Association with Long-stay Resident Outcomes and Quality of Care. J Aging Soc Policy 2020; 34:723-741. [DOI: 10.1080/08959420.2020.1824544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ian Livingstone
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
- Quality Measurement and Health Policy, RTI International, Waltham, MA, USA
| | - Jennifer Hefele
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
- Health Group, Booze Allen Hamilton, McLean, VA, USA
| | - Natalie Leland
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
13
|
Pyatak EA, Carlson M, Vigen CLP, Blanchard J, Niemiec SS, Sideris J, Baranek GT. Contextualizing the Positive Effects of the Well Elderly 2 Trial: A Response to Schelly and Ohl (2019). Am J Occup Ther 2020; 73:7306205100p1-7306205100p11. [PMID: 31891349 DOI: 10.5014/ajot.2019.038752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE A recent reanalysis of data from the Well Elderly (WE) 2 study purportedly indicated that the intervention did not achieve clinically meaningful or statistically significant effects; this article addresses these criticisms. OBJECTIVE To contextualize the WE 2 study as targeting a nonclinical population and demonstrate that the intervention produced substantively important, statistically significant effects. DESIGN Secondary analysis of WE 2 intervention-based pre-post change scores. SETTING The original trial occurred primarily in senior centers and senior housing facilities in greater Los Angeles. PARTICIPANTS Independent-living older adults (N = 324) who were assessed before and after intervention. INTERVENTION The WE intervention, a version of the Lifestyle Redesign® (LR) approach, was administered by occupational therapists over 6 mo by means of group and individual sessions. OUTCOMES AND MEASURES The 36-item Short Form Health Survey, the Life Satisfaction Index-Z, and the Center for Epidemiologic Studies Depression Scale. RESULTS The WE intervention was associated with statistically significant improvement on 10 of 12 outcome variables that were examined. CONCLUSIONS AND RELEVANCE Because the WE intervention was hypothesized to reduce age-related decline and followed a population-oriented approach, the expectation that average results would be clinically meaningful was inappropriate. The intervention produced positive effects across a wide array of outcome domains. In settings in which clinical meaningfulness is an appropriate index of intervention outcomes, evidence suggests that LR produces effects that are clinically meaningful. As an evidence-based intervention, LR should be considered useful both in population-oriented contexts and in addressing discrete health conditions. WHAT THIS ARTICLE ADDS Valid analyses demonstrate that the positive experimental effects of the WE 2 study are, in fact, genuine and cost-effective, and LR in clinically oriented contexts has produced statistically significant, clinically meaningful results. Clearly and accurately representing the evidence base of occupational therapy in prevention and chronic care is of critical importance to advance the field as a whole.
Collapse
Affiliation(s)
- Elizabeth A Pyatak
- Elizabeth A. Pyatak, PhD, OTR/L, CDE, FAOTA, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles; .,E. A. Pyatak and M. Carlson contributed equally to the conceptualization and writing of this article and should be considered co-first authors
| | - Mike Carlson
- Mike Carlson, PhD, is Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Cheryl L P Vigen
- Cheryl L. P. Vigen, PhD, is Associate Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Jeanine Blanchard
- Jeanine Blanchard, PhD, OTR/L, is Project Manager, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Stacey Schepens Niemiec
- Stacey Schepens Niemiec, PhD, OTR/L, is Assistant Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - John Sideris
- John Sideris, PhD, is Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Grace T Baranek
- Grace T. Baranek, PhD, OTR/L, FAOTA, is Associate Dean, Chair, and Mrs. T. H. Chan Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| |
Collapse
|
14
|
Locas V, Préfontaine C, Veillette N, Vachon B. Integration of occupational therapists into family medicine groups: Physicians’ perspectives. Br J Occup Ther 2019. [DOI: 10.1177/0308022619883481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Occupational therapists remain poorly integrated into family medicine groups in Canada. Physicians are key partners because they can advocate for resources and formulate recommendations to improve the quality of services delivered in their clinics. It is important to explore their perception of the occupational therapist’s role in family medicine groups and the factors influencing their integration. Method A descriptive qualitative study was conducted. Six family physicians participated in an individual interview. Results were analysed using thematic analysis. Results Physicians consider that occupational therapists can meet the needs of diverse primary care clients. Benefits of this integration include improved clients’ functional status, early screening for developmental and age-related problems, and timely access to required care. The main barriers to integration are lack of funding, space and knowledge of the occupational therapist’s role. The strategies identified to facilitate integration are promoting and clarifying the role of occupational therapists in family medicine groups and developing effective integration models. Conclusion According to physicians, the inclusion of occupational therapists in family medicine groups could help primary care teams address many of their clients’ needs and improve the overall quality of primary care services. Targeted strategies are needed to promote the integration of occupational therapists into this practice context.
Collapse
Affiliation(s)
- Valérie Locas
- School of Rehabilitation, Faculty of Medecine, Université de Montréal, Quebec, Canada
| | - Cassandra Préfontaine
- School of Rehabilitation, Faculty of Medecine, Université de Montréal, Quebec, Canada
| | - Nathalie Veillette
- School of Rehabilitation, Faculty of Medecine, Université de Montréal, Quebec, Canada
| | - Brigitte Vachon
- School of Rehabilitation, Faculty of Medecine, Université de Montréal, Quebec, Canada
| |
Collapse
|
15
|
Capsule Commentary on Bowling et al., Prevalence of Activity Limitations and Association with Multimorbidity Among US Adults 50 to 64 Years Old. J Gen Intern Med 2019; 34:2583. [PMID: 31452031 PMCID: PMC6848412 DOI: 10.1007/s11606-019-05297-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
16
|
Jordan K. Occupational Therapy in Primary Care: Positioned and Prepared to Be a Vital Part of the Team. Am J Occup Ther 2019; 73:7305170010p1-7305170010p6. [PMID: 31484019 DOI: 10.5014/ajot.2019.735002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Reilly's (1962) now deeply cherished statement that "man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health" (p. 1) was followed a few years later with a question to current and future occupational therapy practitioners. In 1966, Reilly asked how the profession would respond to the challenges of an expanding knowledge base, accelerating health care costs, and escalating regulatory burden. Visionary Wilma West, a contemporary of Reilly's, expanded on these themes by focusing on ways occupational therapy practitioners could leverage the breadth and depth of their practice to confront these challenges. These issues are now paramount in the primary care arena. An expanding body of literature, including the articles in a special section in this issue of the American Journal of Occupational Therapy, supports occupational therapy's role as a vital part of the solution to contemporary health care challenges. Occupational therapy practitioners are educationally prepared and successfully poised through policy to engage in evidence-based practice in the primary care environment.
Collapse
Affiliation(s)
- Katie Jordan
- Katie Jordan, OTD, OTR/L, is Professor of Clinical Occupational Therapy and Associate Chair of Clinical Occupational Therapy Services, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
| |
Collapse
|
17
|
Pyatak E, King M, Vigen CLP, Salazar E, Diaz J, Schepens Niemiec SL, Blanchard J, Jordan K, Banerjee J, Shukla J. Addressing Diabetes in Primary Care: Hybrid Effectiveness-Implementation Study of Lifestyle Redesign ® Occupational Therapy. Am J Occup Ther 2019; 73:7305185020p1-7305185020p12. [PMID: 31484021 DOI: 10.5014/ajot.2019.037317] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
IMPORTANCE Primary health care is rapidly developing as an occupational therapy practice area. Yet, to date, little evidence supports occupational therapy's feasibility and efficacy in primary care settings. OBJECTIVE To report on the implementation and preliminary clinical outcomes of a Lifestyle Redesign® (LR)-occupational therapy (LR-OT) diabetes management intervention in a primary care clinic. DESIGN Patients were randomized to be offered LR-OT or to a no-contact comparison group (data not reported). We assessed implementation outcomes using mixed methods. SETTING Safety-net primary care clinic. PARTICIPANTS Clinic providers and staff; English- or Spanish-speaking clinic patients ages 18-75 yr with diabetes and a current hemoglobin A1c (HbA1c) ≥ 9.0%. INTERVENTION Eight 1-hr individual sessions of LR-OT focused on diabetes management. OUTCOMES AND MEASURES Clinical and health behavior outcomes were assessed via electronic medical record (EMR) review and self-report surveys of patients receiving LR-OT at initial evaluation and discharge. We assessed implementation outcomes (acceptability, appropriateness, feasibility, fidelity, efficiency, and timeliness) using patient and staff surveys, interviews, focus groups, and observations. RESULTS Seventy-three patients were offered LR-OT: 51 completed one or more sessions, and 38 completed the program. Clinical outcomes among program completers indicate beneficial changes in HbA1c, diabetes self-care, and health status. Implementation challenges included a need for patient and staff education, securing adequate workspace, and establishing a referral process. Factors contributing to implementation success included strong buy-in from clinic leadership, colocation, and shared EMR documentation. CONCLUSIONS AND RELEVANCE LR-OT is a feasible approach to enhancing service delivery and clinical outcomes in primary care. WHAT THIS ARTICLE ADDS This study provides insight into factors that may create challenges or contribute to the success of implementing occupational therapy services within primary health care settings. In addition, this study provides preliminary evidence of occupational therapy's effectiveness in improving clinical outcomes among ethnically diverse, low-income patients with diabetes in a safety-net primary care setting.
Collapse
Affiliation(s)
- Elizabeth Pyatak
- Elizabeth Pyatak, PhD, OTR/L, CDE, is Associate Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
| | - Maggie King
- Maggie King, MA, OTR/L, is Doctorate of Occupational Therapy Resident, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Cheryl L P Vigen
- Cheryl L. P. Vigen, PhD, is Associate Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Elia Salazar
- Elia Salazar, MPH, is Project Specialist, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Jesus Diaz
- Jesus Diaz, OTD, OTR/L, is Associate Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Stacey L Schepens Niemiec
- Stacey L. Schepens Niemiec, PhD, OTR/L, is Assistant Professor of Research, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Jeanine Blanchard
- Jeanine Blanchard, PhD, OTR/L, is Project Manager, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Katie Jordan
- Katie Jordan, OTD, OTR/L, is Associate Chair of Occupational Therapy Clinical Services, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
| | - Josh Banerjee
- Josh Banerjee, MD, is Associate Medical Director for Transitions of Care, Los Angeles County+University of Southern California Medical Center, Los Angeles County Department of Health Services, Los Angeles, CA
| | - Jagruti Shukla
- Jagruti Shukla, MD, is Director of Primary Care, Los Angeles County+University of Southern California Medical Center, Los Angeles County Department of Health Services, Los Angeles, CA
| |
Collapse
|
18
|
Berger S, Escher A, Mengle E, Sullivan N. Effectiveness of Health Promotion, Management, and Maintenance Interventions Within the Scope of Occupational Therapy for Community-Dwelling Older Adults: A Systematic Review. Am J Occup Ther 2019; 72:7204190010p1-7204190010p10. [PMID: 29953825 DOI: 10.5014/ajot.2018.030346] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This systematic review examined the effectiveness of health promotion, management, and maintenance interventions within the scope of occupational therapy to improve occupational performance and quality of life (QOL) and decrease health care utilization for community-dwelling older adults. METHOD Thirty-eight articles representing 36 studies were included in the review. Articles were published 2008-2015 and described studies of participants with a mean age of 65 or older who were living in the community. RESULTS Strong evidence supports the use of group, individual, or a combination of group and individual interventions to improve occupational performance. Group interventions were also effective at improving QOL. The evidence was insufficient that any of these interventions decreased health care utilization. CONCLUSION Addressing health promotion, management, and maintenance is within the scope of occupational therapy practice and has been shown to improve occupational performance and QOL for older adults. Implications for practice and future research are discussed.
Collapse
Affiliation(s)
- Sue Berger
- Sue Berger, PhD, is Clinical Associate Professor, Department of Occupational Therapy, Boston University, Boston, MA;
| | - Anne Escher
- Anne Escher, OTD, is Clinical Assistant Professor, Department of Occupational Therapy, Boston University, Boston, MA
| | - Emily Mengle
- Emily Mengle, MS, is Occupational Therapist, Fox Rehabilitation, Shelton, CT. At the time of the systematic review, she was Student, Department of Occupational Therapy, Boston University, Boston, MA
| | - Nicole Sullivan
- Nicole Sullivan, MS, is Occupational Therapist, Hebrew Senior Life, Roslindale, MA. At the time of the systematic review, she was Student, Department of Occupational Therapy, Boston University, Boston, MA
| |
Collapse
|
19
|
The Relationship Between Quality of Care, Physical Therapy, and Occupational Therapy Staffing Levels in Nursing Homes in 4 Years' Follow-up. J Am Med Dir Assoc 2019; 20:462-469. [DOI: 10.1016/j.jamda.2019.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/01/2019] [Accepted: 02/03/2019] [Indexed: 11/15/2022]
|
20
|
Halle AD, Mroz TM, Fogelberg DJ, Leland NE. Occupational Therapy and Primary Care: Updates and Trends. Am J Occup Ther 2018; 72:7203090010p1-7203090010p6. [PMID: 29689169 PMCID: PMC5915228 DOI: 10.5014/ajot.2018.723001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
As our health care system continues to change, so do the opportunities for occupational therapy. This article provides an update to a 2012 Health Policy Perspectives on this topic. We identify new initiatives and opportunities in primary care, explore common challenges to integrating occupational therapy in primary care environments, and highlight international works that can support our efforts. We conclude by discussing next steps for occupational therapy practitioners in order to continue to progress our efforts in primary care.
Collapse
Affiliation(s)
- Ashley D Halle
- Ashley D. Halle, OTD, OTR/L, is Assistant Professor and Coordinator of Primary Care Residency & Services, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
| | - Tracy M Mroz
- Tracy M. Mroz, PhD, OTR/L, is Assistant Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Donald J Fogelberg
- Donald J. Fogelberg, PhD, OTR/L, is Associate Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Natalie E Leland
- Natalie E. Leland, PhD, OTR/L, BCG, FAOTA, is Associate Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
21
|
Graham JE, Middleton A, Roberts P, Mallinson T, Prvu-Bettger J. Health Services Research in Rehabilitation and Disability-The Time is Now. Arch Phys Med Rehabil 2018; 99:198-203. [PMID: 28782540 PMCID: PMC5748255 DOI: 10.1016/j.apmr.2017.06.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/23/2017] [Accepted: 06/28/2017] [Indexed: 01/17/2023]
Abstract
Policy drives practice, and health services research (HSR) is at the intersection of policy, practice, and patient outcomes. HSR specific to rehabilitation and disability is particularly needed. As rehabilitation researchers and providers, we are uniquely positioned to provide the evidence that guides reforms targeting rehabilitative care. We have the expertise to define the value of rehabilitation in a policy-relevant context. HSR is a powerful tool for providing this evidence. We need to continue building capacity for conducting rigorous, timely rehabilitation-related HSR. Fostering stakeholder engagement in these research efforts will ensure we maintain a patient-centered focus as we address the "Triple Aim" of better care, better health, and better value. In this Special Communication we discuss the role of rehabilitation researchers in HSR. We also provide information on current resources available in our field for conducting HSR and identify gaps for capacity building and future research. Health care reforms are a reality, and through HSR we can give rehabilitation a strong voice during these transformative times.
Collapse
Affiliation(s)
- James E Graham
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX.
| | - Addie Middleton
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX
| | | | - Trudy Mallinson
- School of Medicine & Health Sciences, George Washington University, Washington, DC
| | - Janet Prvu-Bettger
- Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC
| |
Collapse
|
22
|
Jiang Y, Wang Y, Li Y, Zhang Y, Zhao Y, Wang X, Ma C, Ma S. Inpatient Treatment for the Middle-aged and Elderly in Central China. Front Public Health 2017; 5:7. [PMID: 28210617 PMCID: PMC5288374 DOI: 10.3389/fpubh.2017.00007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 01/17/2017] [Indexed: 11/21/2022] Open
Abstract
Background Compared to outpatient treatment and self-treatment, inpatient treatment corresponds to more severe illness and poses more serious health and financial burden to patients. The goal of this study is to provide an updated and comprehensive description of the prevalence, characteristics, and cost of inpatient treatment for the middle-aged and elderly in Central China, which is highly populated, less-developed, and agriculture-dominating. Methods A survey was conducted in August 2013 in the Henan province. Data on 1,464 subjects were collected. Results Among the surveyed subjects, 582 had at least one episode of inpatient treatment. Subjects with different inpatient treatment status differ in the distributions of age, education, occupation, area, health insurance coverage, physical condition, and presence of chronic disease. The surveyed subjects had up to six inpatient treatments within 12 months. Different episodes have different characteristics. Age and the presence of chronic disease are significantly associated with the number of inpatient treatments. The utilization of grade III hospital for inpatient treatment is associated with gender, marital status, and per capita income. The total and out-of-pocket costs are associated with education, utilization of type III hospital, and insurance utilization. Conclusion This study has provided a comprehensive description of inpatient treatment for Central China, an area with low developmental and economic status. The observations may assist improving health conditions and disease treatment for this less-advantaged area.
Collapse
Affiliation(s)
- Yan Jiang
- Center for Applied Statistics, School of Statistics, Renmin University of China , Beijing , China
| | - Yu Wang
- Center for Applied Statistics, School of Statistics, Renmin University of China , Beijing , China
| | - Yang Li
- Center for Applied Statistics, School of Statistics, Renmin University of China , Beijing , China
| | - Yuming Zhang
- Center for Applied Statistics, School of Statistics, Renmin University of China , Beijing , China
| | - Yinjun Zhao
- School of Public Health, Yale University , New Haven, CT , USA
| | - Xiaojun Wang
- Center for Applied Statistics, School of Statistics, Renmin University of China , Beijing , China
| | - Chi Ma
- Ideological and Political Education Center, Beijing Institute of Petrochemical Technology , Beijing , China
| | - Shuangge Ma
- Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, China; School of Public Health, Yale University, New Haven, CT, USA
| |
Collapse
|