Purpose Hemophilia Treatment Centers (HTCs) provide integrated and comprehensive services to individuals affected with rare bleeding disorders, such as hemophilia and Von Willebrand disease. Through the 340 Drug Pricing Program, HTCs may use pharmacy income to support clinical staff and patient services. The objective of this study was to describe the impact of the 340B program funding on services and support provided by HTCs to persons affected by rare bleeding disorders. Description Federally designated comprehensive HTCs with established 340B programs were invited to participate in a mailed survey in 2014. Participants were requested to report on 340B program-funded staff and services in the calendar year 2013. Assessment The 31 of 37 HTCs responding served over 10,000 individuals, or one-third of the national HTC patient population. The majority of responding HTCs reported that 340B program income supported over 90% of staff such as nurses, social workers, and physical therapists. Conclusion The results from this survey of 31 centers with established programs demonstrates the HTCs’ reliance on 340B program support for vital comprehensive services, that are otherwise non-reimbursable, and highlights the importance of the 340B program in sustaining the high quality of care and in increasing access for a geographically dispersed, medically vulnerable population.
The purpose of this study was to examine the psychometric properties of a culturally sensitive sexual functioning instrument, the Sexual Dimensions Instrument for Hispanic Women (SDIHW). Using a vignette, the respondent indicated her level of agreement with 26 items that were developed by Hispanic and Anglo nurses/researchers and validated by a panel of clinical and instrument experts. It was translated into Spanish and back-translated; the reading level was at the sixth to seventh grade. The convenience sample consisted of 179 Hispanic women being treated for gynecologic cancer as outpatients. The typical respondent was 35-50 years of age, married, minimally acculturated, religious, and surviving for 1-3 years; she had three or more children, had less than a high-school education, and had little sexual activity in the past month. A three-factor scale with 22 items was determined to have conceptual clarity and moderate reliability (0.63-0.77). Factors included role (eight items), personal sexual satisfaction (eight items), and relationship (six items). The instrument was completed in Spanish by 60% of the respondents. Total and subscale scores were generally not influenced by demographic characteristics. The psychometric properties of the SDIHW indicate future research value. Moderate internal consistency, reliability, content, and construct validity were demonstrated. Achieving a better understanding of the Hispanic woman's perception of herself as a sexual being will aid the clinician in the development of culturally sensitive interventions.
Children growing up in poverty are at risk for various health problems. For low-income, Mexican-American children, these risks include obesity, diabetes, and accidental injuries, 3 conditions that can largely be prevented by healthy life-styles. Despite the potential for prevention through education leading to health-promoting behaviors, very little is known about the development of health knowledge in this population. The present study examined low-income, Mexican-American children's understanding of the relation between health behavior and health status in 3 areas: nutrition, hygiene, and safety. 79 children (41 boys, 38 girls) ages 4 to 8 years participated. Children's knowledge was assessed in a structured play situation conducted in a laboratory setting. Results revealed that children knew the least about the relation between food consumption and their health, and knew the most about beneficial and harmful practices in the areas of safety and hygiene. Age and gender differences were also significant, with girls and older children more likely to provide elaborate and complex rationales for their responses. Implications of the findings for understanding the role of cognitive development and experience in the development of health knowledge are considered.
Children growing up in poverty are at risk for various health problems. For low‐income, Mexican‐American children, these risks include obesity, diabetes, and accidental injuries, 3 conditions that can largely be prevented by healthy life‐styles. Despite the potential for prevention through education leading to health‐promoting behaviors, very little is known about the development of health knowledge in this population. The present study examined low‐income, Mexican‐American children's understanding of the relation between health behavior and health status in 3 areas: nutrition, hygiene, and safety. 79 children (41 boys, 38 girls) ages 4 to 8 years participated. Children's knowledge was assessed in a structured play situation conducted in a laboratory setting. Results revealed that children knew the least about the relation between food consumption and their health, and knew the most about beneficial and harmful practices in the areas of safety and hygiene. Age and gender differences were also significant, with girls and older children more likely to provide elaborate and complex rationales for their responses. Implications of the findings for understanding the role of cognitive development and experience in the development of health knowledge are considered.
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