Showing papers by "Joan R. Bloom published in 1993"
TL;DR: Interventions designed to increase utilization of social networks may be an effective way to increase use of cancer screening, which may ultimately lead to reduced mortality from cancer.
Abstract: Background Age-adjusted cancer mortality is 27% higher for Black Americans than for the general U.S. population, which may result from inappropriate use of cancer detection tests. Social support has been shown to affect adjustment to breast cancer and survival, but it has not been studied as a predictor of use of preventive health care services in the older population. Our hypothesis is that larger social networks are associated with greater utilization of cancer-screening tests in the older population. Purpose The objective of this study was to examine the relationship between social support and use of cancer-screening tests among older Black Americans. Methods Data for this study were obtained from a 1986 baseline survey evaluation of a community intervention program to increase cancer awareness and a 1991 end-point survey of use of cancer detection tests. Our study sample consisted of 617 Black Americans aged 55 years or older who lived in San Francisco (Calif.), the control community, and in Oakland (Calif.), the target community for intervention. The survey included measures of 1) social network characteristics, as determined by a modified version of Berkman and Syme's Social Network Index; 2) demographic characteristics; and 3) use of six cancer-screening tests--mammography, occult blood stool examination, cervical smear, clinical breast examination, digital rectal examination, and sigmoidoscopy. Results Multiple logistic regression analysis of the Social Network Index results indicated statistically significant positive associations of social support with the use of mammography and occult blood stool examination but not with the other cancer-screening tests. There were statistically significant associations between having HMO (Health Maintenance Organization) insurance and increased use of mammography and occult blood stool examination, compared with having Medi-Cal or other insurance. The interval between the surveys had a statistically significant positive association with use of mammography. These significant associations were not explained by differences in the other variables, which included health status, age, gender, education, type of health insurance, interval between the surveys, and a regular source of care. Conclusions Social support seems to be associated with increased use of mammography and occult blood stool examinations among older Black Americans. Implications Interventions designed to increase utilization of social networks may be an effective way to increase use of cancer screening, which may ultimately lead to reduced mortality from cancer.
113 citations
01 Apr 1993
TL;DR: Use of part-time RNs and experienced staff reduced personnel and benefit costs while the use of temporary agencies for RNs increased non-personnel operating costs and an RN rich skill mix was not related to either measure of hospital costs.
Abstract: The objective of this study was to assess the effect of four different nurse staffing strategies on hospital costs: Part-time RNs; RN temporary agencies; RN rich skill mix; and organizationally experienced RNs. Two regression equations were specified to consider the effect of these strategies on personnel and benefit costs and on non-personnel operating costs. A number of additional variables were also included in the equations to control for the effect of other organization and environmental causes of hospital costs. Consistent with the hypotheses, use of part-time RNs and experienced staff reduced personnel and benefit costs while the use of temporary agencies for RNs increased non-personnel operating costs. An RN rich skill mix was not related to either measure of hospital costs. The implications of our findings for hospital administration are discussed.
1 citations
Posted Content•
TL;DR: In this article, the authors examined the relationship between turnover and demographic heterogeneity among nursing staff in 383 community hospitals and found that three of the four dimensions of demographic heterogeneity in hospital nursing staff were positively and monotonically related to voluntary turnover among full-time registered nurses.
Abstract: This paper advances the study of organizational demography and its relationship to organizational turnover by examining two of Blau's concepts of social structure: non-linear and multiform heterogeneity. In a sample of 383 community hospitals, nursing turnover was examined in relation to four dimensions of demographic heterogeneity among nursing staff in those hospitals. The form of the relationships between turnover and heterogeneity was specified to test whether heterogeneity relates to higher turnover in a linear fashion or, alternatively, whether heterogeneity affects turnover in an inverted U-shaped pattern. Results of multivariate analyses suggested strong support for the former proposition. Three of the four dimensions of demographic heterogeneity in hospital nursing staffs were positively and monotonically related to voluntary turnover among full-time registered nurses (RNs). No support was found for a curvilinear relationship, nor did mean levels of the demography measures, reflecting the locus of concentration, account for the observed relationship between demographic heterogeneity and turnover.
1 citations