Understanding the role of psychological attitudes in health behaviors and health care utilization... more Understanding the role of psychological attitudes in health behaviors and health care utilization has important implications for improving health and reducing health care costs. This is particularly important among the elderly, who require more and costlier health services. This dissertation explores the relationship between optimism (positive future expectation) and cynical hostility (mistrust of others) on smoking cessation, physical activity, and preventive service use in post-menopausal women. Chapter one assesses the relationship between optimism and cynical hostility on smoking cessation. Women with higher cynical hostility were less likely to quit smoking over time. Smoking cessation programs may consider incorporating attitudes measures to better target smokers who are less likely to quit on their own. Chapter two focuses on understanding the role of optimism and cynical hostility in use of screening mammograms and lipid screenings and in particular how these attitudes media...
Supplemental material, sj-pdf-1-irp-10.1177_26334895211043791 for Patient and provider perception... more Supplemental material, sj-pdf-1-irp-10.1177_26334895211043791 for Patient and provider perception of appropriateness, acceptability, and feasibility of behavioral health home (BHH) core components based on program implementation in an urban, safety-net health system by Ana M Progovac, Miriam C Tepper, H. Stephen Leff, Dharma E Cortés, Alexander (Cohen) Colts, Andrea Ault-Brutus, Sherry S-Y Hou, Frederick Lu, Sara Banbury, Dennis Sunder and Benjamin L Cook in Implementation Research and Practice
Background This manuscript evaluates patient and provider perspectives on the core components of ... more Background This manuscript evaluates patient and provider perspectives on the core components of a Behavioral Health Home (BHH) implemented in an urban, safety-net health system. The BHH integrated primary care and wellness services (e.g., on-site Nurse Practitioner and Care Manager, wellness groups and tools, population health management) into an existing outpatient clinic for people with serious mental illness (SMI). Methods As the qualitative component of a Hybrid Type I effectiveness-implementation study, semi-structured interviews were conducted with providers and patients 6 months after program implementation, and responses were analyzed using thematic analysis. Valence coding (i.e., positive vs. negative acceptability) was also used to rate interviewees’ transcriptions with respect to their feedback of the appropriateness, acceptability, and feasibility/sustainability of 9 well-described and desirable Integrated Behavioral Health Core components (seven from prior literature a...
Supplemental material, Final_Appendix_1_2018-01-22 for A Review of Mental Health and Mental Healt... more Supplemental material, Final_Appendix_1_2018-01-22 for A Review of Mental Health and Mental Health Care Disparities Research: 2011-2014 by Benjamin Lê Cook, Sherry Shu-Yeu Hou, Su Yeon Lee-Tauler, Ana Maria Progovac, Frank Samson and Maria Jose Sanchez in Medical Care Research and Review
Cardiac patients are more likely to suffer from depression, and depression itself predicts increa... more Cardiac patients are more likely to suffer from depression, and depression itself predicts increased morbidity among patients with cardiovascular disease. As research uncovers more and more information about the link between depression and cardiovascular disease (CVD), an increasing number of candidate genes which play some role in the association are also being uncovered. Here we chose to study the Serotonin Transporter Length Polymorphism (5-HTTLPR) in the Serotonin Transporter gene (SLC6A4) and Tryptophan Hydroxylase-2 (TPH2). Both genes are in the Serotonin (5-HT) pathway. Subjects for the study are drawn from the Cardiac Rehabilitation Center here at U of M Preventive Cardiology Services under the direction of Dr. Melvyn Rubenfire, and genotyping of the 5-HTTLPR is combined with extensive clinical information collected at the hospital in an attempt to create a model that accurately characterizes the role of 5-HTTLPR and TPH2 in depression cardiovascular disease. This thesis would have been impossible without these people. I thank them warmly. Dr. Margit Burmeister-Sponsor. You welcomed me into the lab, and have provided guidance and support for this project as well as my future endeavors. Dr. Sandra Villafuerte-Mentor. Without your interest and expertise in this topic I would not have gotten the opportunity to work on it. Without your patience and understanding I certainly would not have succeeded in finishing it. Thank you very very much! Ela Śliwerska-Lab manager. Thank you for all your help with both Taqman assays, and, more importantly, for the help, guidance, and sense of humor throughout my time in the lab. Kathrin Stoßberg-Medical student. Thank you for the hours and hours you spent perfecting the 5-HTTLPR genotyping. It made my job a whole lot easier! Dr. Richard Hume-Advisor and First Reader of my thesis. For your time and endless patience, even while on sabbatical. Dr. John Kuwada-Co-sponsor. For your support and mentorship through the independent research program. Sanguettha Mahadevan-Statistician. A great help! The Burmeister Lab-Thank you for the help, the friendships, the memories, and the laughter. And the wonderful food! Dušan and Ljiljana Progovac-My parents. Thank you both for your love and support throughout college, and for always pushing me to do my best.
As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with... more As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino ( n = 4), non-Hispanic/Latino Black ( n = 8), or non-Hispanic/Latino White ( n = 9). Twelve reported health care discrimination due to race/ethnicity, language, perceived social class, and/or mental health diagnosis. Health care discrimination exacerbated barriers to initiating and continuing depression treatment among patients from diverse backgrounds or with stigmatized mental health conditions. Treatment preferences emerged as fluid and shaped by shared decisions made within a trustworthy patient–provider relationship. Howev...
Understanding the role of psychological attitudes in health behaviors and health care utilization... more Understanding the role of psychological attitudes in health behaviors and health care utilization has important implications for improving health and reducing health care costs. This is particularly important among the elderly, who require more and costlier health services. This dissertation explores the relationship between optimism (positive future expectation) and cynical hostility (mistrust of others) on smoking cessation, physical activity, and preventive service use in post-menopausal women. Chapter one assesses the relationship between optimism and cynical hostility on smoking cessation. Women with higher cynical hostility were less likely to quit smoking over time. Smoking cessation programs may consider incorporating attitudes measures to better target smokers who are less likely to quit on their own. Chapter two focuses on understanding the role of optimism and cynical hostility in use of screening mammograms and lipid screenings and in particular how these attitudes media...
Supplemental material, sj-pdf-1-irp-10.1177_26334895211043791 for Patient and provider perception... more Supplemental material, sj-pdf-1-irp-10.1177_26334895211043791 for Patient and provider perception of appropriateness, acceptability, and feasibility of behavioral health home (BHH) core components based on program implementation in an urban, safety-net health system by Ana M Progovac, Miriam C Tepper, H. Stephen Leff, Dharma E Cortés, Alexander (Cohen) Colts, Andrea Ault-Brutus, Sherry S-Y Hou, Frederick Lu, Sara Banbury, Dennis Sunder and Benjamin L Cook in Implementation Research and Practice
Background This manuscript evaluates patient and provider perspectives on the core components of ... more Background This manuscript evaluates patient and provider perspectives on the core components of a Behavioral Health Home (BHH) implemented in an urban, safety-net health system. The BHH integrated primary care and wellness services (e.g., on-site Nurse Practitioner and Care Manager, wellness groups and tools, population health management) into an existing outpatient clinic for people with serious mental illness (SMI). Methods As the qualitative component of a Hybrid Type I effectiveness-implementation study, semi-structured interviews were conducted with providers and patients 6 months after program implementation, and responses were analyzed using thematic analysis. Valence coding (i.e., positive vs. negative acceptability) was also used to rate interviewees’ transcriptions with respect to their feedback of the appropriateness, acceptability, and feasibility/sustainability of 9 well-described and desirable Integrated Behavioral Health Core components (seven from prior literature a...
Supplemental material, Final_Appendix_1_2018-01-22 for A Review of Mental Health and Mental Healt... more Supplemental material, Final_Appendix_1_2018-01-22 for A Review of Mental Health and Mental Health Care Disparities Research: 2011-2014 by Benjamin Lê Cook, Sherry Shu-Yeu Hou, Su Yeon Lee-Tauler, Ana Maria Progovac, Frank Samson and Maria Jose Sanchez in Medical Care Research and Review
Cardiac patients are more likely to suffer from depression, and depression itself predicts increa... more Cardiac patients are more likely to suffer from depression, and depression itself predicts increased morbidity among patients with cardiovascular disease. As research uncovers more and more information about the link between depression and cardiovascular disease (CVD), an increasing number of candidate genes which play some role in the association are also being uncovered. Here we chose to study the Serotonin Transporter Length Polymorphism (5-HTTLPR) in the Serotonin Transporter gene (SLC6A4) and Tryptophan Hydroxylase-2 (TPH2). Both genes are in the Serotonin (5-HT) pathway. Subjects for the study are drawn from the Cardiac Rehabilitation Center here at U of M Preventive Cardiology Services under the direction of Dr. Melvyn Rubenfire, and genotyping of the 5-HTTLPR is combined with extensive clinical information collected at the hospital in an attempt to create a model that accurately characterizes the role of 5-HTTLPR and TPH2 in depression cardiovascular disease. This thesis would have been impossible without these people. I thank them warmly. Dr. Margit Burmeister-Sponsor. You welcomed me into the lab, and have provided guidance and support for this project as well as my future endeavors. Dr. Sandra Villafuerte-Mentor. Without your interest and expertise in this topic I would not have gotten the opportunity to work on it. Without your patience and understanding I certainly would not have succeeded in finishing it. Thank you very very much! Ela Śliwerska-Lab manager. Thank you for all your help with both Taqman assays, and, more importantly, for the help, guidance, and sense of humor throughout my time in the lab. Kathrin Stoßberg-Medical student. Thank you for the hours and hours you spent perfecting the 5-HTTLPR genotyping. It made my job a whole lot easier! Dr. Richard Hume-Advisor and First Reader of my thesis. For your time and endless patience, even while on sabbatical. Dr. John Kuwada-Co-sponsor. For your support and mentorship through the independent research program. Sanguettha Mahadevan-Statistician. A great help! The Burmeister Lab-Thank you for the help, the friendships, the memories, and the laughter. And the wonderful food! Dušan and Ljiljana Progovac-My parents. Thank you both for your love and support throughout college, and for always pushing me to do my best.
As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with... more As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino ( n = 4), non-Hispanic/Latino Black ( n = 8), or non-Hispanic/Latino White ( n = 9). Twelve reported health care discrimination due to race/ethnicity, language, perceived social class, and/or mental health diagnosis. Health care discrimination exacerbated barriers to initiating and continuing depression treatment among patients from diverse backgrounds or with stigmatized mental health conditions. Treatment preferences emerged as fluid and shaped by shared decisions made within a trustworthy patient–provider relationship. Howev...
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