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Essay Instructions: I am needing help with an outline for my paper over school-based health clinics involving adolescents. The following is th rubric for the outline:
1 .Introduction
2. Problem definition
3. How it is addressed by the Affordable Care Act
4. Pros and Cons
5. Personal views
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Customer is requesting that (researchpro) completes this order.

Essay Instructions: designing a reaserch srudy: prepare a one-page describtion of your plan to solve the problem of the 2 below mentioned research studies. using the following heading for the problem:

1. statement of the problem
2. research method and sources of information
3. nature of data to be gathered and analysed
4. hypothesis or hypotheses to be proved or disproved


the following in the 2 research studies( each research proposal should be done seperately on one page)

1. as administrator of greater lewisville health services, a family health clinic, you have mailed an informative brouchure to each patient that describes the need to receieve the influenza vaccine. Although a flu season is approaching, very few patients have come in to receive their injections.

2. Karen;s frozen foods, Inc., is considering adding frozen breakfast pizza to its product line in an effort to overcome the flat profit line it has experienced for several years. The marketing staff intendes to target the product to teenagers and working couples whose busy scedule require food that can be heated quickly. Beacuse all production facilities are currently operating at full capacity, introducing the frozen pizza will require adding production capacity.

related learning outcome: identify the characteristics of report, apply steps in the problem solving process and methods for solving a problem, and demonstrate appropriate methods of collecting, organizing and referencing information.

Essay Instructions: This is the situation:
A) I need to write a Thesis proposal. The topic approval form is a group of seven questions as follows:




TOPIC APPROVAL FORM




1. What specific topic or subject area do you propose to explore?

I am currently working with a small group of Mexican-Americans with Schizophrenia and their families. I am interested in identifying barriers related to their continuity of mental-health care.

2. What is your working title?

The working title that I am considering is:
Continuity of Mental-Health Care for Mexican-Americans with
Schizophrenia

3. What is the theoretical foundation for your work

The theoretical foundation of my work is the Qualitative Family Psycho educational approach

4. What is your research question (or questions)?

Please see addendum A

(The questionnaire consists of six main hierarchizied social dimensions
and forty short well wording indicators and subdimensions, using questions of the open type according to a logical sequence).

5. What research methods do you propose to answer your research question?

I am currently working with nine individuals and their nuclear families. If my formal proposal is approved, all participants and their family members would complete the proposed outline interview guide. I have spoken with my supervisor who has given me tentative permission to conduct research with this particular group. I plan to code and analyze all data myself, and I will preserve confidentiality of all questionnaires answered by assigning numbers to each file. I plan to share the results of my research with my supervisor and my group of Mexican-Americans with Schizophrenia and their families.

6. What is the purpose of your research?

To identify barriers that impede the continuity of Mental Health Care in Mexican-Americans with Schizophrenia.

7. What source material have you located thus far to support your research plans?

Andersen RM: Revisiting the behavioral model and access to health care: Does it matter? Journal of Health & Social Behavior 1995; 36:1-10

Briones DF, Heller Pl, Chalfant HP, et al.: Socioeconomic Status, ethnicity, Psychological distress, and readiness to utilize a mental health facility. American Journal of Psychiatry 1990; 147: 1333-1340

Burnam MA, Hough RL, Escobar JI, et al.: Six-month prevalence of specific psychiatric disorders among Mexican-Americans and non-Hispanic whites in Los Angeles. Archives of General Psychiatry 1987; 44:687-694

Cheung FK, Snowden LR, Community mental health and ethnic minority populations. Mental Health Journal 1990; 26: 277-291

Council on Scientific Affairs: Hispanic Health in the United States. Journal of the American Medical Association 1991; 265:248-252

Estrada Al, Trevino FM, Ray LA: Health care utilization barriers among Mexican-Americans: Evidence from HHANES 1982-1984. American Journal of Public Health 1990; 80 (supplement): 27-31

Hall LK: Providing culturally relevant mental health services for Central American immigrants. Hospital and community Psychiatry 1988; 39: 1139-1144

Higginbotham JC, Trevino FM, Ray LA, : Utilization of Curanderos by Mexican-Americans: Prevalence and predictor findings from HHANES 1982-1984. American Journal of Public Health 1990; 80 (supplement): 32-35

Hough RL, Landsverk JA, Karno M, et al.: Utilization of health and mental health services by Los Angeles Mexican ?American and non-Hispanic whites. Archives of General Psychiatry 1987; 44: 702-709

Karno M, Hough Rl, Burman MA , et al.: Lifetime prevalence of specific psychiatric disorders among Mexican-Americans and non-Hispanic whites in Los Angeles. Archives of General Psychiatry 1987; 44: 695-701

Keefe SE: Mexican-Americans? underutilization of mental health clinics: An evaluation of suggested explanations. Hispanic Journal of Behavioral Sciences 1979; 1: 93-115

O?Sullivan MJ, Peterson PD, Cox GB, et al.: Ethnic populations: Community mental Health Services ten years later. American Journal of Community Psychology 1989; 17:17-30

Rogler LH, Malgady RG, Constantino G, et al.: What do culturally sensitive mental health services mean? The case of Hispanics. American Psychologist 1987; 42: 565-570

Rogler LH, Malgady RG, Rodriguez O: Hispanics and Mental Health: A Framework for Research. Malabar, Florida, Robert E. Krieger Publishing Company 1989

Sofaer S: Qualitative methods : What are they and why use them? Health Services Research 1999; 34 (5Pt 2): 1101-1118

Solis, JM, Marks G, Garcia M. et al.: Acculturation, access to care, and use of preventive services by Hispanics: Findings from HHANES 1982-1984. American Journal of Public Health 1990: 80 (supplement): 11-19

Trevino FM, Moyer E, Valdez RB, et al.: Health insurance coverage and utilization of health services by Mexican-Americans, mainland Puerto Ricans, and Cuban-Americans. The Journal of the American Medical Association 1991;265: 233-237

U.S. Bureau of Census: Statistical Abstract of the United States , 111th Edition Washington DC, 1991

Wells KB, Hough RL, Golding JM, Burnam AM, et al.: Which Mexican-Americans underutilize mental health services? American Journal of Psychiatry 1987; 144:918-922


Wells KB, Hough RL, Golding JM, et al.: Acculturation and the probability of use of health services by Mexican-Americans . Health Services Research 1989; 24: 237-257

Woodward AM, Dwinell AD, Arons BS, : Barriers to mental health care for Hispanic Americans: A literature review and discussion. The Journal of Mental Health Administration. 1992;19: 224-236


Zarate R, Kopelowicz A, Gonzales V, Tripodis K: Mental Health services for Latinos with serious mental illness. A literature review and discussion. Community Mental Health Journal, in press











































ADDENDUM A


OUTLINE OF PROPOSED INTERVIEW GUIDE

How are you doing? Como esta Usted?

Is this a good time to talk for you? Es un buen momento para hablar con Usted?

I. Family and Social Network Supports Sistemas de apoyo familiar y
Social

A. Who lives with you in your household? Quien vive con usted en
la casa?

B. Tell me about your family. Cuenteme acerca de su familia

C. What?s a typical day like for you? With your Family? With your

friends? Como pasa Usted el dia? Con su familia? Con sus amigos?

D. Tell me about your friends Cuenteme sobre sus amigos

E. Who are the people you can count on the most in time of need?

Quienes son las personas con las que puede contar cuando las necesita?

F. Do you belong to groups or organizations that you feel you get
support from? Examples? What kind of support?
Pertenece a algun grupo u organizacion que le proporciona apoyo?
Pongame algun ejemplo, que tipo de apoyo?

G. How does the family and friends support you and your family?

Como le apoya la familiay/o amigos a usted y su familia ?





II. Language Idioma ( About relative) (acerca del familiar)

A. What Languages do you speak fluently? Que idiomas habla Ud.
con fluidez?

If Spanish: Do you read and write Spanish? Sabe usted leer y escribir en espanol?

If English: Do you read and write English? Sabe usted leer y
escribir en Ingles?

B. Do you find it easier talking to people in your native language?

Le parece mas facil hablar con la gente en su propio idioma?

C. If bilingual, where did you learn your second language?

Donde aprendio su segundo idioma?

D. What is your language of preference? What is your preference in
Language when talking with your family? Friends? Strangers?

Cual es su idioma de preferencia? Que Idioma prefiere cuando habla con su familia? Amigos? Extranos?

E. Are most of your friends bilingual? Son la mayoria de sus amigos
bilingues?

F. How difficult is for you to comprehend English? Cuan dificil es
para ud. Comprender Ingles?

G. What is your level of education and where did you study?
Cual es su nivel educativo? Y donde estudio? (familiar)













III. Access Problems (Financial, insurance status, transportation and
Child care)

Problemas de accesibilidad (economicos, seguro medico, transporte
Y cuidado de los ninos) ( acerca del paciente y su familia)

A. Who in your household works? Do you work? Quien trabaja
en su casa? Trabaja usted?

B. What do you use for transportation? Que medio de transporte usa? (carro, bus etc)?

C. Do you have access to childcare if needed? Tiene acceso a cuidado
de ninos si lo necesita?

D. Do you have medical insurance? If so, what kind? If not so, how
Do you manage with healthcare payments? Tiene seguro medico?
De que tipo? Como hace para pagar los gastos medicos?




























IV. Experience of the Hospital Experiencia del Hospital

A. What?s is like going to the hospital? Como se siente
Al hospital?

B. What do you like about going to the hospital? Que
le gusta de ir al hospital? Why? Porque?

C. What do you dislike about going to the hospital?
Que no le gusta de ir al hospital? Why? Porque?

D. Do you procrastinate when going to the hospital?
Evita ir al hospital? Why? Porque?

E. Do you have obligations that impede going to the
Hospital (such as job, financial problems, etc.)?
Tiene obligaciones que le impiden ir al hospital
Como trabajo, problemas economicos, etc.)?

F. Are there times when going to the hospital is time
Consuming? Example?
Hay veces que ir al hospital le supone por mucho tiempo? Pongame un ejemplo.

G. Is it difficult to travel to the hospital? Why or why
not? Es dificil el transporte hasta el hospital? Por que si o por que no?

H. Do you have difficult in obtaining mental mental healt
Services because of the lack of lack of chilcare? Tiene dificultades en obtener servicios de salud mental por que no tiene nadie que le cuide los ninos?

I. Does language matter to you when going to the
hospital ? Why? How? Le importa en que Idioma le hablan cueando va al hospital? Porque? Como le afecta?

J. How well can you communicate with clinicians at the
hospital? Que bien se comunica con el personal medico del hospital?

K. Is that a strong determinant to using the hospital?
Why? Example? Es esto un factor determinante
para que usted vaya al Hospital? Porque ? Puede darme un ejemplo?
V. Cultural differences. Diferencias culturales

A. What do you expect from mental health treatment for
(relative?s name)? (Do not prompt).
Que espera del tratamiento para la salud mental que
Su familiar recibe?

What are your preferences for mental health
treatment for (relative?s name)
Que tratamientos para la salud mental prefiere
que reciba su familiar?


B. Before taking (relative?s name) to the hospital, what
did you think about mental health treatment?
Antes de traer a su familiar al hospital , que opinaba
usted de los tratamientos de salud mental?

Were you familiar with mental health treatment?
How? Estaba usted familiarizado(a) con los
tratamientos para la salud mental? Como?

C. What mental health services and treatments do you
know of?
Cuales servicios y tratamientos de salud mental conoce
Usted?

D. What is your understanding about (relative?s name)
condition or situation? Que sabe usted de la condicion
o situacion de su familiar?

E. How does the Psychologist/Psychiatrist treats
(relative?s name)? Como el Sicologo/Siquiatra trata a su familiar?

Do you feel comfortable with how the Psychiatrist /Psycologist treats {relative?s name)?Se siente a gusto con el trato que el psiquiatra da a su familiar?
Why? Porque?

F. What other things do you think would help (relative?s
Name)? Que otras cosas cree usted que ayudarian a su familiar?

VI. Future Considerations. Consideraciones futuras.

A. Do you think that (relative?s name) will need
Treatment after the hospital?

Cree usted que su familiar necesitara tratamiento despues de salir del hospital?

B. What will you do if the doctor advises (relative?s
name) to continue treatment after he or she is disrcharged? Why? Que haria usted si el doctor le dijera que su familiar necesita continuar con su tratamiento despues de salir del hospital?

C. Do you think that family and/or friends will encourage
Or discourage continuing treatment after discharge?
Cree usted que su familia y/o amigos le animaran o le desanimaran a continuar su tratamiento despues de salir del hospital?

D. Do you have obligations that impede going to
Treatment at the clinic after discharge from the hospital (such as any of the factors mentioned in the hospital section)? How will these factor impact (relative?s name) ability to receive aftercare?

Tiene obligaciones que le impiden ir a recibir
Tratamiento a la clinica despues de salir del hospital (tales como aquellas mencionadas en la seccion IV (hospital)? Como le afectaran estos factores para poder ir a recibir tratamiento a la clinica?















I submitted to them the answers I believed were the right ones; however this is what this is what the research Topic approval Committee Review answered to me:


Question #1 Describe the general area of Schizophrenia and place it within the context of your target population, Mexican-Americans.

Question # 2 Revise

Question #3 Expand

Question # 4 State the research question(s) that you wish to answer. At present, you have provided a measure in the form of a questionnaire.

Question # 5 Fully describe the research methods and statistical analyses you propose to use in answering your research questions (t-tests, ANOVA, multivariate statistics?).

Questions # 6 expand desensitization


Obviously, I need a custom research service. Will you please do it for me? Also, I suggest to review carefully the outline of the proposed interview guide in order to have a better idea how to answer question #4.

Sincerely,

Edgar
eamc20002000@yahoo.com
edgarito@ny-yankees.net

Essay Instructions: Choose a clinical quality issue in a VA outpatient mental health clinic and diagram this process using one of
the tools described in Chapter 4. Explain the critical evaluation points and how data can be collected. Describe internal and external variables that should be considered when collecting and analyzing data. At what point should the system signal an adverse event?


Since customer satisfaction is a key driver in today’s healthcare organization, discuss ways that providers can educate patients and families about what is “quality care” and how they can play a role.

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