Michelle De Guire

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Clarified the relationships between self-care behaviors and illness-specific outcomes in approximately 270 youths with IDDM. Youths were assessed at three points in time using a semistructured interview measure and multiple indices of dietary intake and physical activity with two different methodologies (i.e., recalls, logs). Glycemic control was most(More)
OBJECTIVE To examine whether family relations and family-life stress predict adherence behaviors and metabolic control in youths by testing a theoretically- and empirically-based model. RESEARCH DESIGN AND METHODS HbA1c levels of 157 youths 12-20 years of age with insulin-dependent diabetes mellitus (IDDM) were evaluated, along with treatment adherence(More)
Evaluated social learning and family systems theoretical models to determine (a) whether illness-specific family relations (based on social learning theory) and general family behaviors (based on family systems theory) relate uniquely to the youths' illness-specific and psychosocial adaptation, and (b) whether these types of family relations covary or(More)
BACKGROUND The purpose of the study was to compare immunization-relevant knowledge, certainty about knowledge, self-efficacy, vested interest, and reported practices of providers and clinical staff in the same clinics. METHODS A valid and reliable instrument measuring the aforementioned issues was developed and administered to a sample of 50 providers and(More)
BACKGROUND The content and context of the process of vaccinating older adults against influenza in outpatient settings has not been adequately described. Failure to appreciate the causal antecedents or precursors to the act of provider recommendation may explain why so many efficacious interventions identified by the U.S. Task Force on Community Preventive(More)
BACKGROUND The goal of this pilot study was to correlate missed opportunities to immunize young children with providers' psychosocial characteristics and self-reported immunization practices. METHODS In a population of children aged 0 to 36 months, missed opportunities to immunize were established for a sample of 28 providers, who also responded to a(More)
Demands to optimize productivity and quality require a patient scheduling system that can balance patient demand and clinic resources. The consequences of unscheduled and late patient arrivals on operational efficiencies have been documented. Less understood is the impact of unscheduled and late arrivals on the quality of service each receives. This article(More)
The objective of this study was to determine the incremental labor costs or opportunity costs associated with the provision of immunizations in ambulatory care settings. A time and motion analysis of primary care health visits by pediatric patients was performed in 10 community clinics and 5 private primary care practices. These clinics and practices were(More)
BACKGROUND As health care organizations face increasing pressure to institute quality assurance activities, the already-underfunded community clinics that treat the poor and underserved are challenged to perform these activities within tight constraints of human and financial resources. With pediatric immunizations as a marker, a workflow observation tool(More)