Health Affairs blog - MENTAL HEALTH PARITY: researchers stress importance of out-of-network benefits

There is an interesting insight into US mental health provision/funding and what can be hidden factors posted by Chris Fleming at the Health Affairs Blog.

h2cm: what's in a name? enquiry to Barbara Rylko-Bauer

In October 2006 I exchanged e-mails with Barbara Rylko-Bauer who is Adjunct Associate Professor at Michigan State University; a medical anthropologist interested in health disparities, violence, human rights, and applied anthropology. Back then Barbara had questioned the use of the term 'career' in the title of Hodges' model.

Now with the website - purposes/audiences/content/strategy - review in mind I contacted her again - our correspondence edited for space and context is copied below.

On the website and W2tQ there is a post that references Hughes and the life chances meaning of career. I think Barbara's points about a subtitle, heuristics, synthesis, the knowledge (care) domain labels, e.g. sociology, h2cm as a pathway and other thoughts must certainly influence future developments: see what you think: ...

From: Barbara Rylko-Bauer
Sent: Thursday, 27 December, 2007 11:37:54 PM
Subject: Re: Hodges model (Serres-Hodges paper and PiH)

... I went back and looked at Hodges' model to refresh my memory...and I think that what struck me most was that it serves as both a conceptual tool that encourages a more holistic way of thinking about health and health care, and a heuristic tool that provides links to many different sources, some obviously about health, others less so but still relevant.

So, I'd first ask if there is a way of conveying that across in the title. You might need a subtitle: A tool for holistic approaches to health and health care.

I'd also suggest that your domains could be expanded to reflect better the broad spans of information they cover: so social or social/cultural (rather than sociology) and political-economic rather than just political. Just a thought.

As for the title, in skimming your explanations of "career" I think that a phrase that conveys the broadness of this concept, that it is all-encompassing rather than focusing on "career" in the conventional sense (although clearly the model evolved out of thinking about training of nurses). For example: human-health career and care domains -- one could use "patient" and yet, health and health care goes well beyond concerns of humans who happen to be patients.

Don't know if this helps....but it's nice to reconnect with you.

Thanks and best wishes,
Barbara
======

On Fri, 28 Dec 2007 01:00:30 +0000 (GMT) Peter Jones writes:

Goodness - I had one good idea today and that was to e-mail you! That's really useful, thanks so much.

Would you mind if I share your thoughts in a blog post and if so could you please provide a some details of your background? You've certainly given me something to think about.

All the best Barbara for the new year and many thanks again.

Peter
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From: Barbara Rylko-Bauer
Sent: Tuesday, 1 January, 2008 2:33:45 PM
Subject: Re: Hodges model (Serres-Hodges paper)

Dear Peter:

Happy New Year!

Tx for sending me your chapter.... I was not able to open it but did skim what you attached in the e-mail, and it reinforces my sense that you should try and find a way of presenting the model as a tool for both finding and for synthesizing information on health and health care. I don't think that this is clear just from looking at the title of the model as it now stands or from the way it is imaged. It's really a pathway more than a model...does that make sense?

Go ahead and post my comments. I would prefer that my email address not get posted, just because I'm already swamped and would hate to get emails from people that I could not properly respond to (seems rude).

Good luck with this!

Best wishes,
Barbara

If you also have any thoughts on this please get in touch....

"Perceptions of Nursing and of a Midwestern Associate Degree Nursing Program" study by Shannon Frodge

In August I posted the news and success of Shannon Frodge's Master's study in which Hodges' model was used as a theoretical framework.

I've copied the abstract, Shannon's reference to Hodges' model and her research questions below. There are some 55 pages, 9,700 words in total, if you want to the read the discussion and conclusion well according to Shannon the text is available on ProQuest.

Every so often I'll bring up the matter of nurse, health and social care recruitment on W2TQ: it really is going to be critical. I do not work in HR - recruitment, but being interested in public (mental) health I am very conscious of demographic trends and be(d)sides standards of care matter too...

Thanks Shannon for the copy, your specific focus on this issue and for recognising and using Hodges' model. I know evidence is important in terms of the tools we use, but you've demonstrated that tools can have a legitimate entry point in their adoption and application. You've posed many questions and presented new angles with recommendations too.

Abstract

The current nursing shortage is complicated by the fact not enough students choose nursing to offset the number of nurses who are nearing retirement. This is distressing to the profession, and is of particular interest to nursing schools. This quantitative, descriptive correlational study examined the perceptions of 99 students in grades sixth through twelfth in a public Midwestern school system regarding nursing as a career choice, 41 current students in the local community college’s nursing program, and recruiting methods that would or did most influence them. The framework for the study is Brian Hodge's Health Career Model. Students were surveyed using a Likert-scale tool with demographics and comments. Descriptive statistics included frequency tables, cross tabulations, chi squared, and confidence intervals. Comments were grouped for qualitative phenomenologic purposes. Findings indicated statistically significant differences in perceptions of students based on sex and grade which could be used to enhance recruitment efforts.

Research Questions

Specific research questions pertaining to this study are:

1. Are middle and high school students in a Midwestern community considering nursing as a career choice?
a. If so, what are the reasons?
b. If not, what are the reasons?
c. What recruitment strategies would most influence these students to decide on nursing as a career choice?
d. What recruitment strategies would most influence these students to seek their education at the Midwestern community college ADN program?

2. Of currently enrolled students in a Midwestern community college ADN program:
a. What recruitment strategies most influenced these students to decide on nursing as a career choice?
b. What recruitment strategies most influenced these students to seek their education at the Midwestern community college ADN program?

Theoretical Framework

The framework for this study is Brian Hodges’ Health Career Model (Hodges, 1997). This model looks at the nurse as an individual whose practice depends on his/her education and past experiences (Hodges, 1997). The model is composed of two intersecting lines that look at the nurse’s attributes both individually and in group settings, and his/her ability to perform job duties both interpersonal and mechanical (Hodges, 1997). Within the four quadrants then, Hodges identifies four major areas of knowledge necessary to practice nursing (Hodges, 1997).

This particular framework lends itself to this study as it looks at traits of individuals who are nurses and helps to explain how their background and knowledge influence the care they give. Hodges writes “the health career is influenced by personal factors of the individual of physical or psychological origin and factors relating to the social world and the policies that govern daily life” (Hodges, pp 1, 1997). Because some of these attributes or interest in these knowledge areas must be present in order for an individual to choose nursing, the model is appropriate to the study.

Perceptions Of Nursing And Of A Midwestern Associate Degree Nursing Program

Last October I posted that Asst. Prof. Shannon Frodge [Maysville Community & Technical College, KY] had contacted me about her Master's study:

Study on Student's Interest in Nursing (Grades 6th-12th)

Shannon found that h2cm provided an appropriate framework and wondered if I could help with an image of Hodges' model. Well Shannon's study is now successfully completed and I've some reading to do. To see h2cm represented in work like this makes the effort so worthwhile, but it's the focus of Prof. Frodge's that really counts as nursing competes for recruits.

Many congrats and thanks Shannon for the reading I've to catch up on and more to follow...

Interactive Domain Model - Best Practice: Guest Reflection!

I'm really grateful to Barbara Kahan in Canada who has helped publicise h2cm as resource of the month last May and by posting a guest reflection on Hodges model for March 2007.

The overlaps between the Interactive Domain Model -

Best practices in health promotion/public health are those sets of processes and activities that are consistent with health promotion/public health values, goals and ethics, theories and beliefs, evidence, and understanding of the environment, and that are most likely to achieve health promotion/public health goals in a given situation.

- and Hodges' model are clear to see.

Before the International Date Line beats me entirely, happy St. David's Day to you Barbara and everyone!

Study on Student's Interest in Nursing (Grades 6th-12th)

The effects of demographic change over the next few decades are a regular topic of debate in the developed nations. The comparison of the workforce with those retired means that the health and social care sector face an increasingly competitive arena to find the staff with the 'right stuff'. Before that point though students need to be interested in health related disciplines. How well do we understand this...?

Asst. Prof. Shannon Frodge [Maysville Community & Technical College, KY] contacted me about using an image of Hodges' Career Model (HCM) in her project:

My study will be to survey 60 children in each grade from grades 6th-12th and students that are currently enrolled in our ADN nursing program. It touches on the four major quadrants of the HCM. I’d like to know what kids think about nursing, and how I can recruit them to our program, and if not our program, a nursing program somewhere else.

No problem Shannon and happy to assist. [Thanks for your OK to post this.] I look forward to hearing more and the possibility that you yourself may share details here as your study progresses. I wonder if anything affects whether students will enroll in traditional nursing programs or online nursing programs. One other thought don't forget the 'fifth' domain - the spiritual - Hodges' four in combination.

Shannon's query is also a useful prompt for me to check and update the quality of some of the images on the site and bundle the existing references.