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Changes in telehealth usage among Medicaid beneficiaries with mental illnesses in a rural state: An analysis of Kentucky Medicaid dataset over 5 years (2018-2022)

Introduction: Accessing mental health care remains challenging for Medicaid beneficiaries with mental illnesses (MI) in rural settings. The COVID-19 pandemic prompted telehealth service expansion through temporary policy changes and shifts in health care delivery. Despite the increased availability of telehealth as a modality to address disparities in health care access, telehealth adoption and associated use are inadequately explored among Medicaid beneficiaries with MI in Kentucky.

Objective: To examine trends and factors associated with telehealth use by residence status among Kentucky Medicaid beneficiaries with MI.

Design: A retrospective analysis of Kentucky Medicaid claims data obtained from 174,354 beneficiaries aged 18 years or older and diagnosed with MI. Chi-square tests and logistic regression analyses were performed to examine telehealth use over time and factors associated with its use.

Results: Telehealth use increased significantly from 0.3% in 2018 to 1.0% in 2022. Telehealth use was higher among urban residents (from 0.5% in 2018 to 1.4% in 2022) versus rural residents (from 0.2% in 2018 to 0.6% in 2022). Factors associated with increased telehealth use were being female, younger age, White non-Hispanic, having serious MI (SMI) or concurrent SMI and substance use disorders, and having a fee-for-service payor type. Rural residents were less likely than urban residents to use telehealth despite a similar trend of year-to-year increase.

Conclusion: Although telehealth use remains low, its utilization has increased among Medicaid beneficiaries with MI in Kentucky. Demographic characteristics, MI status, and payor type were associated with telehealth use, with notable disparities between urban and rural populations. These results highlight the need to further examine barriers that deter or promote telehealth use in rural states.

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Psychometric Properties of the Mental Health Help-Seeking Scale Among Nursing Students

AIM 

This study evaluated the psychometric properties of the Mental Health Help-Seeking Scale (MHHSS) for measuring nursing students’ intentions to seek mental health services.

METHODS 

An online survey with 148 nursing students was conducted. Factor analysis via principal components analysis was used to examine the scale’s factor structure. Convergent validity was assessed by comparing MHHSS scores with the Adverse Childhood Experiences (ACEs) and Kessler Psychological Distress scales. Internal consistency was measured with Cronbach’s alpha.

RESULTS 

Cronbach’s alpha was .924. Factor analysis identified a four-factor structure accounting for 83.2 percent of item variance. Convergent validity analysis showed significant positive correlations between MHHSS total and subscales (attitudes, subjective norms, perceived behavioral control, intentions) and both the ACEs and psychological distress scales.

CONCLUSION 

The MHHSS shows strong construct validity and reliability among nursing students; minor item refinement was recommended for improved attitude measurement.

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Publication Authors

Almogheer, Zainab S.; Okoli, Chizimuzo; Schuman, Donna L.; Rayens, Mary Kay; Moser, Debra

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Determining the Feasibility of Implementing a Work-Learning Program for Nursing Staff Working in a State Psychiatric Hospital

The psychiatric nursing field faces challenges in recruiting, training, and retaining educated nurses. A Work-Learning Program (WLP) within an academic-practice partnership may address these issues.

Document Category
Dimensions of Wellbeing

Assessing the psychometric properties of a Comic Book rating Scale to evaluate health information

Although graphical modalities have emerged as a potential medium to communicate health information, few studies have examined measurement instruments used to evaluate such modalities. This study examined the use of a Comic Book Rating Scale (CoBoRs) adapted from an existing Mobile Application Rating Scale (MARS) for assessing the quality of a comic book that delivers health information.

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Dimensions of Wellbeing

Examining Factors Associated with the Intentions Toward and Use of Tele-Mental Health Services Among Medicaid Providers and Beneficiaries

Treatment adherence among individuals with mental illness remains a pressing public health issue. Tele-mental health care (TMH) can improve care access and continuity. This study applied the theory of planned behavior (TPB) to examine how intrinsic motivations influence intentions and use of TMH among Medicaid beneficiaries and providers.

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Dimensions of Wellbeing
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The association of self-care practices with test anxiety in nursing students

BACKGROUND: Test anxiety can be a significant challenge for nursing students, potentially impacting academic performance and mental well-being. Timely intervention is crucial to address the underlying factors contributing to test anxiety and prevent adverse outcomes.

Document Category
Dimensions of Wellbeing
Publication Authors

Hua Kang

Chizimuzo Okoli

Shuyao Wang

Xiaoli Wang

Aijuan Cheng

Dongmei Wu

Qingyuan Wang

Dan Wang

Zijiang Yang

Lizi Hu

Adverse childhood experiences and test anxiety in Chinese nursing students: The mediating effect of psychological distress

Background

Test anxiety is a common issue among students, potentially leading to adverse academic consequences. Students with psychological distress are more susceptible to test anxiety. Adverse childhood experiences (ACEs) have been linked to psychological distress. However, there is a lack of studies on the associations between ACEs, psychological distress, and test anxiety in college students.
Document Category
Dimensions of Wellbeing
Publication Authors

Hua Kang MSN, RN a, Chizimuzo Okoli PhD, MPH, MSN, FAAN b, Shuyao Wang BSN, RN a, Xiaoli Wang MSN, RN c, Aijuan Cheng MSN, RN d, Dongmei Wu PhD, RN e, Qingyuan Wang BSN, RN a, Dan Wang BSN, RN a, Zijiang Yang BSN, RN a, Lizi Hu MSN, RN a

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Factors Associated With Telehealth Usability Among Medicaid Beneficiaries With Mental Illness: A Cross-Sectional Analysis of Consumers and Providers

Background:

Telehealth offers a flexible and effective alternative to in-person behavioral health services, with users generally reporting high satisfaction. However, several barriers can limit equitable access among Medicaid beneficiaries.
Document Category
Dimensions of Wellbeing
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The Value of an Educational Intervention on Knowledge, Attitudes, and Practices Related to Seclusion and Restraint Use in a Psychiatric/Mental Health Setting

Objectives

The use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. This pilot evaluation project assessed the impact of a web-based educational intervention on the knowledge, practices, and attitudes of front-line nurses concerning seclusion and restraints and on the actual use of restraints and seclusion in an inpatient psychiatric hospital setting.
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Social and environmental factors during the smoking cessation process: The experiences of adults with serious mental illnesses

People living with schizophrenia and other serious mental illnesses (SMI) face a disproportionate burden of tobacco-related prevalence and, consequently, tobacco-induced morbidity, in comparison to those without SMI.

Document Category
Dimensions of Wellbeing
Publication Authors

Heather Leutwyler, Jeremiah Mock, Erin Hubbard, Theodore Bussell, Negin Zahedikia, Nikta Vaghar, Dennys Balestra, Sophia Wuest, Meg Wallhagen, Chizimuzo Okoli

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