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The Correlation between Retained Primitive Reflexes and Scholastic Performance among Early Elementary Students
No full textAims: The purpose of this study was to understand the frequency of reflex retention as well as the correlation between primitive reflex activity and scholastic performance. This quantitative correlational study involved 24 kindergartners and 29 first-graders (31 males and 22 females), aged 5–7 years, who were typically developing. Researchers screened for seven primitive reflexes. The Woodcock–Johnson Test of Cognitive Abilities was administered per regular scholastic testing procedures. Frequency, descriptive, group mean difference, and correlational analyses were performed. Results found that 100% of the participants had at least one active reflex, with the most common retained reflexes being STNR, ATNR R, and ATNR L. Overall, males demonstrated a higher prevalence of the majority of reflexes when compared to females though this was statistically significant for ATNR R only. Analyses found statistically significant and moderately strong correlations between ATNR retention and poorer performance in multiple areas of scholastic performance among males. Mixed and inconsistent results were found among females and by grade. The results support previous research findings and point toward a need to consider primitive reflex retention as a contributing factor when providing therapy services to support academic and scholastic performances. However, ongoing inconsistencies in the available research point to a need for further research to guide therapists in making evidence-based decisions
The Feasibility of Interventions Based on Meaningful and Psychologically Rewarding Occupations in Improving Health and Well-Being
No full textWe investigated the feasibility of interventions based on the guidelines for use of meaningful and psychologically rewarding occupations as a means of improving perceived health and well-being among 21 students, faculty, and staff at a US midwestern University. Using a repeated measures design, we used the RAND SF-36, Warwick-Edinburgh Mental Well-Being Scale, and Meaningful Activity Participation Assessment to gather data on four variables. There was a main effect of interventions on perceived well-being, F (2, 40) = 3.74, p =.03, ɳ 2 =.40, and energy/fatigue, F (2, 40) = 4.57, p =.02, ɳ 2 =.43. The guidelines show promise as a tool for occupational therapists
2022 Research Symposium Program
No full textThe program for the 2022 annual Research Symposium which took place on December 1, 2022
The Effects of ACA Medicaid Expansions on Health After 5 Years
No full textWe examine the Affordable Care Act Medicaid expansion effects on self-rated health status over 5 years. The study uses data from the Behavioral Risk Factor Surveillance System for 2011-2018 and a difference-in-differences design. There is improvement in health status on a 1 to 5 point scale from poor to excellent health among individuals below 100% of the federal poverty line by 0.031, 0.068, 0.031, 0.064, and 0.087 points in 2014, 2015, 2016, 2017, and 2018, respectively. Changes in 2015, 2017, and 2018 are statistically significant (p \u3c.05), and the 2014 change is marginally significant. The difference between 2014 and 2018 effects is statistically significant (p \u3c.05). In most years, we cannot distinguish changes in days not in good physical or mental health from no effect. Overall, there is only minimal evidence for effects intensifying over time, suggesting that health gains thus far have mostly occurred early on due to unmet needs among those previously uninsured
2021 Research Symposium Program
No full textThe program for the 2021 annual Research Symposium which took place on December 2, 2021
Are Low Income Rural Adults Exposed to More Innovative Medicaid Dental Policies? A Comparative Analysis
No full textPurpose: Compared to metro and urban populations, low-income adults in rural regions are disproportionately confronted by barriers to improving oral health outcomes. Financial constraints and rural professional shortages extend periods of forgone dental care, ultimately leading to tooth decay. Left untreated, prolonged tooth decay increases the risk of complete tooth loss by age 65. Despite the critical importance of Medicaid as the source of access, dental programs within Medicaid remain highly variable across the country. This study aims to better understand Medicaid dental policy variation from a rural population perspective, and identify how states adapt their oral Medicaid programs to better serve beneficiaries in rural settings. Methods: Publicly available data from the Centers for Medicare & Medicaid, Kaiser Family Foundation, American Dental Association, and Center for Connected Health Policy were used to construct a state-level Medicaid dental benefit policy dataset. Next, the proportion of low-income rural adults living in states with various Medicaid dental policies were compared with the proportion of non-rural counterparts. Findings: Low-income rural adults were less likely to live in states with innovative Medicaid dental policies. The gaps were widest for comprehensive managed care programs (R=59%, NR = 68%), teledentistry coverage (R = 17%; NR = 34%), and state oral health action plans (R = 27%, NR = 43%). Conclusions: Comparing dental policies across states, rural populations were less likely to be targeted for innovation. This study highlights opportunities for states to improve rural oral health by transforming service delivery and better accommodating rural dental environments
Availability of Supplemental Benefits in Medicare Advantage Plans in Rural and Urban Areas
No full textEnrollment in Medicare Advantage (MA) plans has consistently increased since the program\u27s redesignation by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. MA plans have long included supplemental benefits not available in original Medicare, such as dental and vision coverage. Additional supplemental benefits are becoming available through MA plans, such as those serving beneficiaries with chronic conditions, per Title III of Division E of the Bipartisan Budget Act of 2018. This brief identifies differences in MA plans that include supplemental benefits available to rural (nonmetropolitan) and urban (metropolitan) enrollees. By better understanding the variation in MA plan offerings across the country, policymakers can take appropriate action to improve the value of plans available in rural regions. Key Findings. (1) 3,120 MA plans are being offered in 2020--a 15.0 percent increase from 2019. (2) Noncore counties (neither micropolitan nor metropolitan) average 2.7 fewer organizations providing MA plans than do metropolitan counties. (3) Beneficiaries in noncore and micropolitan counties have significantly fewer MA plans to choose from, with most of the difference attributable to lower availability of health maintenance organization (HMO) and local preferred provider organization (PPO) plans. (4) Among the 12 most common MA supplemental benefits, 11 are available in fewer nonmetropolitan counties compared to metropolitan counties. (5) The difference in supplemental benefits is most prominent for hearing exams, eye exams, preventive dental care, fitness programs, remote access technologies, health education, and over-the-counter items. (6) A smaller proportion of MA plans in nonmetropolitan counties than in metropolitan counties offer a zero-premium option. (7) The average out-of-pocket maximum for all in-network Part A and Part B services for MA plans in noncore counties is $281 lower than in metropolitan counties
Psychometric Properties of the Meaningful and Psychologically Rewarding Occupation Rating Scale: A Pilot Study
No full textWe investigated the internal structure, internal consistency reliability, and convergent validity of the Meaningful and Psychologically Rewarding Occupation Rating Scale (MPRORS). The American Occupational Therapy Association occupational profile interview, MPRORS, and the Meaningful Activity Participation Assessment (MAPA) were administered to 21 study participants. Principal Axis Factor Analysis indicated trends supporting the two-factor structure of the MPRORS. Internal consistency reliability was generally good for the psychologically rewarding scale and acceptable for the meaningfulness scale. Convergent validity of the meaningfulness scale, when compared with the MAPA meaningfulness scores, was not supported. Further validation research with larger heterogeneous samples is indicated
Treating a Public Health Crisis for Rural Moms – A Comparative Analysis of Four Rural States Addressing Maternal Opioid Misuse with Medicaid Innovation Models
No full textObjective As we enter the third decade of the opioid crisis, opioid misuse continues its devastating toll on young women, specifically mothers on Medicaid in rural areas. The evolving Medicaid policy landscape has led to coverage and benefit expansion, yet gaps remain for pregnant women with opioid misuse. Further, the myriad of state specific policy decisions related to maternal eligibility and substance abuse benefits have created a seemingly disjoint policy arena for tackling a specific subgroup’s unmet needs. This policy scan aims to investigate the newly implemented 1115 demonstration model for Maternal Opioid Misuse by comparing the approaches of four rural states.
Methodology All documentation for each demonstration model and waiver were reviewed and analyzed for rural specific content. Policy language referencing rurality or rural concepts were then identified, categorized, and codified for comparison across the four sample states. Finally, policy and programmatic approaches which were inherently rural were identified and compared between the four states. This analysis concludes with a brief synthesis of the results, as well as a discussion on what gaps may remain.
Results Of the two states submitting 1115 Waivers, both (IN, MO) expand eligibility to Medicaid for mothers with opioid-use disorder, but only MO expands Medicaid benefits. Of the three states (CO, IN, ME) implementing the demonstration model, two (CO, IN) leverage health insurance payers as partners while ME partners with local health system providers. Three states (CO, MO, ME) add telehealth and peer support services as authorized Medicaid benefits for mothers with an opioid-use disorder. Only ME used the innovation model to authorize Medicaid to reimburse, provider-to-provider telehealth capacity building models.
Conclusion This study highlights and reaffirms the variation in Medicaid policy at the state level. Expanding Medicaid benefits to reimburse necessary telehealth and peer support services may help address service availability gaps in rural regions. Future research should leverage the continual expansion of these MOM models, especially evaluating differences between rural and non-rural outcomes. The excessive morbidity facing these young mothers warrants prompt evaluation and dissemination to promote diffusion across the country until this public health crisis is fully extinguished