Spring 2013 HP 353 ORGANIZATION AND DELIVERY OF HEALTH CARE IN THE UNITED STATES 4 Credits Meeting times: Tuesdays

and Thursdays, 8:00-9:20 am, Room 101

Instructors:

Prof. Jean Peteet, PhD, MPH, PT 617-353-7506 jpeteet@bu.edu Office Sargent Room 523 Hours: Students may sign up for any posted time. Hours are typically posted for Monday, Tuesday, Thursday and Friday

Small Group Discussions: Groups 1-8 SAR 101 Jean Peteet Kenmore Classroom Building (KCB) 565 Commonwealth Ave. Groups 9-14 KCB104 Abby Williams Groups 15-20 KCB102 Michelle Kielty Groups 21-26 KCB201 Gabrielle Purcell Groups 27-32 KCB107 Hannah Nichols Course information: On Blackboard Learn (learn.bu.edu) Course Description: The focus of this interdisciplinary course is on increasing the students understanding of the health care system, the social, environmental, and behavioral factors that affect health care, and on increasing the students ability to advocate for change in the health care system. The student will actively engage in individual work, group discussion and teamwork through written, oral, and web site assignments. HP 151, 252, and 353 provide an opportunity for Sargent students in all majors to develop an understanding of health professions, health across different age groups, and the health care system. This is achieved through written and oral assignments, group discussions, and participation by a wide variety of Sargent professors and outside speakers. These courses accept The World Health Organization (WHO) definition of health that defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 1948). The courses further define and classify health and disability through the use of several theoretical models and frameworks. The socioecological framework of health is emphasized as an overall comprehensive framework. This assumes that health is influenced by the physical and social environments and by the individuals personal attributes. It considers the individuals health behavior in the context of the social, physical, attitudinal, and political dimensions of the environment (Stokols, 1992). A classification system used that assumes this framework is the International Classification of Functioning, Disability and Health (ICF) where functioning and disability is also viewed as a complex interaction between the individuals health status, the environmental contextual factors, and individual personal factors. The ICF applies to all individuals whatever their health condition may be, focuses on function rather than a disease, and is designed to be relevant across cultures, making it useful for the highly diverse population in the US. These definitions and frameworks provide students with a common language for use in discussing health care problems. Writing skills are emphasized in all three courses with the knowledge that writing both reflects and develops a students critical thinking and analysis skills. In the courses HP252 and HP353 students will continue to develop professional writing skills, building on the skills gained in HP151. Students are expected to write using professional terminology (e.g. no jargon or colloquial phrases) and in a respectful manner about people with disabilities (e.g., person-first language). Students will refine skills by targeting their writing to different audiences and by using APA style to correctly referencing their sources of information. By the end of each course,

we expect that students will have refined their ability to synthesize information from multiple sources and communicate that information professional both verbally and in written form. On the completion of the these Sargent core courses, it is expected that students will have a broad understanding of health and disability, will understand their own and other team members roles within the health care system, and will have the ability to work with a diverse population of clients and will be empowered to be an advocate for change at the patient care, health system, and policy levels.
References Stokols, D. (1992). Establishing and maintaining healthy environments: Toward a social ecology of health promotion. American Psychologist,1192,47, 6-22. WHO. (1948). WHO definition of health. Retrieved from http://www.who.int/about/definition/en/.

Course Objectives: The student will be able to: 1. Discuss the role of insurance in health care delivery in the United States. 2. Describe the characteristics of the various health care settings in which care is provided. 3. Describe the diverse roles for health care professionals and support personnel in the current health care systems and the changes in role functions that are needed are part of health care reform. 4. Discuss the roles of the major regulatory bodies that govern health care. 5. Discuss conditions of the physical environment, social and behavioral factors, and the system of delivery that contribute to health. 6. Communicate opinions about health care issues in oral and written form. 7. Work in an interdisciplinary group. 8. Discuss the role of prevention and health promotion in the health care system. 9. Discuss key issues in the delivery of health care services related to access, cost, and quality. 10. Advocate for health care change. Required Reading: 1. Bodenheimer, T. S., & Grumbach, K. (2012). Understanding health policy (6th ed.). New York: Lange Medical Books/McGraw-Hill. 2. Reading assignments as per course syllabus. Recommended References: 1. Hacker, D. (2000). Rules for writers: A brief handbook, with update (4th ed.). Boston: Bedford/St Martin's or 2. American Psychological Association (2009). Publication Manual of the American Psychological Association (6th ed.). Washington, D. C. American Psychological Association. Recommended reading to increase your breadth and depth of knowledge of health care issues: 1. Kaiser Health News Copy and paste the URL into your browser and sign up (no charge) for daily email updates http://www.kaiserhealthnews.org/ 2. Copy and paste https://cdf.nejm.org/campaigns/genericlp.aspx?promo=ONJK0704&cpc=GMAAALLP0709A &query=PPC into your browser. Create an account (free) to have the table of contents of the New England Journal of medicine sent to you via email each week. Select topic areas (e.g. public health and policy) of interest so that you receive an alert each week of relevant articles. 3. Add the Health Affairs Journal URL to your Bookmarks. Check it monthly for articles. http://www.healthaffairs.org/

Assignments Week 1 1/17

Tuesday

Thursday INTRODUCTION Speaker: Jean Peteet Writing: Insurance paper Reading: Ch 1 The Paradox of Excess and Deprivation

Week 2 Article Assignment 11/22-1/24 Due by Thursday 1/24 11:59 pm

Small Group class- Go directly to Access to Health Care Jean Peteet Reading Ch 3 Access your assigned room to Health Care Bring your health insurance policy to class with you. We will focus on health insurance policies, discussing differences in policy types. Prepare by coming to class with questions you may have about interpreting your policy. Groups 1-8 SAR 101 Kenmore Classroom Building (KCB) 565 Commonwealth Ave. Groups 9-14 KCB104 Groups 15-20 KCB102 Groups 21-26 KCB201 Groups 27-32 KCB107

Week 3 1/29-1/31

PAYING FOR HEALTH CARE Speaker: Mary Palaima

Reading: Ch 2 Paying for Health Care

Small group class- Go directly to your assigned room Chs 2-4 You will need your text in class. Please bring it. Groups 1-8 SAR 101 Kenmore Classroom Building (KCB) 565 Commonwealth Ave. Groups 9-14 KCB104 Groups 15-20 KCB102 Groups 21-26 KCB201 Groups 27-32 KCB107 Reading assignment for discussion is Ch 4- Come prepared to discuss Chs 2,3,4

Week 4 2/5-2/7

ORGANIZATION OF HEALTH HEALTHCARE REIMBURSEMENT CARE Speaker: Jean Peteet Speaker: Mary Palaima Reading: Ch 4 Reimbursing Healthcare Providers Reading: Ch 5&6 How Health Care is Organized
Discussion of Drop box 2 and paper 2

Week 5 2/12-2/14

Test #1 Chs 1,2,3,4,5,6

CONTROLLING COSTS Speaker: Mary Palaima Reading: Ch 8 Painful vs. Painless Cost Control Ch 9 Mechanisms for Controlling Costs QUALITY OF HEALTH CARE Speaker: Dara Chan, MHS, CRC Reading: Ch 10 Quality of Health Care

Week 6 Paper 1 due (Insurance 2/19-2/21 Policy) Bring a hard copy with your policy to class and submit an electronic copy (paper only) to Blackboard Learn. Both submissions are due by 8:00 am Tuesday, 2/19 at the beginning of class Week 7 DUE by 11:59 pm on 2/26-2/28 Thursday 2/28 Assignment 2: Topic, references, and three supporting arguments.

National Health Reform: The Affordable Care Act Jean Peteet Ch 15 pp. 193-197 Affordable Care Act

Small group class- Go directly to your assigned room Chs 8,9,12,13 Reading: Ch 13 Medical Ethics Bring your text to class and the Rationing of Health care Groups 1-8 SAR 101 Kenmore Classroom Building (KCB) 565 Commonwealth Ave. Groups 9-14 KCB104 Groups 15-20 KCB102 Groups 21-26 KCB201 Groups 27-32 KCB107 CLINICAL ETHICS Speaker: Lynn Brady Wagner

Week 8 3/5-3/7

MANAGING CHRONIC DISEASE: Advocacy Speaker: Jean Peteet Jean Peteet PPP- Justin Horvath, Sargent college Senior Media Technician Reading: Ch 12 Long Term Care Groups will meet in class for preparation for PPP project Spring Break

Week 9

Community Health and Current Issues Week 10 Class time for small groups to 3/19-3/21 Meet to develop group PPP You may meet anywhere on campus. Prof. Peteet will be in Room 101 to answer questions.

TEST #2 Ch 8,9,10, 12, 13 & Lecture material

Week 11 assignment 3 3/26-3/28 Due Thursday 3/28 by 11:59 pm

PREVENTION Speaker: Jean Peteet Reading: Ch 11 Prevention

Health Care in the Community Alan Balsam Director Brookline Public Health Department Readings: Posted on Blackboard (Course Documents) 1-George, Graschnewski & Rovniak (2011) Public Health Potential of Farmers Markets on Medical Center Campuses: A Case Study From Penn State Milton S. Hershey Medical Center 2-Public Health Fact Sheet

Week 12 4/2-4/4

Paper 2: Bring a copy to class and Submit Paper 2 to Blackboard Learn Both are DUE by 8:00am on Thursday, 4/4.

National Health Insurance Ch 15 Health Care for Underserved Brian Rosman, Research Director, Populations: Boston Health Care Health Care for All, Boston, for the Homeless Program MA Alyssa Brassil www.hcfama\.org Manager of Special Events, Volunteers & Community Partnerships Come to class understanding some of the health services the St. Francis House provides. http://www.stfrancishouse.org/ Small Group Power Point Presentations Go to your assigned rooms Groups 1-8 SAR 101 Kenmore Classroom Building (KCB) 565 Commonwealth Ave. Groups 9-14 KCB104 Groups 15-20 KCB102 Groups 21-26 KCB201 Groups 27-32 KCB107

Week 13 4/9-4/11

PROVIDING SERVICES IN THE Group PPP due to Blackboard SCHOOL SYSTEM Learn by Monday, 4/8 11:59 Speaker: Prof. Kerole Howland pm Clinical Asst. Professor, Dept. Speech, Language & Hearing Reading: Posted on Blackboard Learn (Course Documents) Section 504 of the Rehabilitation Act: Determining Eligibility and Implications for School Districts

Week 14 4/16

Assignment 4 is Week 15 due Thursday, 4/25 by 11:59 4/23-4/25 pm

International Perspective No Class Documentary: Sick Around the Monday Class Schedule World Reading: Ch 14 Health Care in Four Nations Ms. Kristen McCosh, Legislative BillsCommissioner Jean Peteet Mayor's Commission for Persons with Disabilities , Boston MA

4/30-5/2

Test 3 Friday, May 10 9-10 am All Content after Test 2 Chs 7, 11, 14,15,16,17 & outside speakers

Course Evaluation CONFLICT AND CHANGE IN THE HEALTH CARE SYSTEM Speakers: Jean Peteet, Mary Palaima, Dara Chan Reading: Ch 7 The Health care workforce Ch 16 Conflict and Change in the US Health Care System, Ch 17 Tensions and Challenges

Review for test: Jeopardy

COMMON UNDERSTANDINGS 1. Professional behavior: Students will demonstrate professional behaviors which include maintaining attitudes and behaviors that communicate respect, coming to class on time, completing assigned readings, participating in and contributing to class discussions. Up to 5 points of your final grade can be deducted for issues relating to professional behavior. 2. Examination and Assignment Policies: Assignments will be turned in at class time on the day they are due. Papers are considered late if submitted after class begins. Five points will be deducted for each day an assignment is late. Be mindful that drop box assignments must be received on time to receive full credit; allow sufficient time for uploading content. If you are unable to be present for an examination, you must notify Prof. Peteet and make alternative arrangements prior to the start of the examination or the due date of the assignment. Failure to give prior notification and make alternative arrangements will result in a zero for the missed exam or assignment. Make-ups are given at the discretion of Prof. Peteet. 3. All written assignments will be typed, double-spaced, 12-pt. font, Times Roman or Ariel, and 1 margins. Papers will have a separate title and reference page (which do not count toward the page requirement). Students are encouraged to use the Sargent College writing center located in the Machecnie Study Center on the second floor for writing assistance. Papers will be graded on content, grammar, and APA style.

4. Students will adhere to the accepted norms of intellectual honesty in their academic work. Academic integrity is maintained by submitting only your own work for grading and avoiding practices such as submitting duplicate work for separate courses. It is the responsibility of each class member to abide by the University Academic Conduct Code found at http://www.bu.edu/academics/resources/academic-conductcode/ 5. Professor Peteet welcomes the opportunity to discuss grading questions with students. If a student requests a formal re-grading of a paper, he/she knowingly accepts responsibility if a lower grade is assigned during the second review. A re-grade request will be considered up to seven days after the graded paper or assignment is returned. 6. Boston University/Sargent College is committed to providing equal access and opportunity to students with disabilities. Students with a disability who need an accommodation for this class should make appropriate arrangements with Disability Services (617-353-3658 or www.bu.edu/disability). Disability Services is located at 19 Deerfield Street. Students will take responsibility for disclosing their disability, providing documentation and requesting accommodation within the first two weeks of class. GRADING You will be assigned to a small group for the semester for small group discussions and the group project. Pts Assignments & Tests Due Date Drop box assignments are added into your final grade as absolute points. All other assignments are based on 100%.

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Completion and submission of 4 assignments Assignment 1 Article summary and response 2 pts 1/24 11:59 pm

Assignment 2 Paper 2 thesis, arguments, and journal abstracts 3 pts. Assignment 3 Current health care issue 2 pts. Assignment 4 Response to question 3 pts.

2/28 11:59 pm

3/28 11:59 pm

4/25 11:59 pm 2 During the semester at four unannounced times, students who are on time will write a brief response to a question at the beginning of class and we will then discuss the question as a group. Each response is worth .5 pts. Paper 1: Examination of Health Insurance Policy Test 1 50 questions Test 2 50 questions non-cumulative Paper 2: Legislator health care priority recommendation Power Point Presentation Submitted to the drop box (one per group). Presented in class on 4/11.All group members are expected to be present at the presentation. Group grade counts as individual grade. You will have opportunity to confidentially complete a peer evaluation of your group members. Students that fully participate will receive the group grade (see common understandings). Test 3 50 questions non-cumulative

10 15 20 15 10

2/19 9:30 am 2/12 3/21 4/4 9:30 am 4/8 11:59 pm

20 100

5/10 9 am- 10 am

GRADING SCALE (Adapted from Sargent College Undergraduate Education Committee Grading Policy) GRADE A 93% + Excellent CRITERIA Work indicating superior mastery of the material. Content, concepts, or techniques are applied with exceptional skill or great originality in satisfying the requirements of an assignment or course. Work indicating a mastery of material. Thorough knowledge of concepts and/or techniques together with a high degree of skill and/or some elements of originality in satisfying the requirements of an assignment or course. Thorough knowledge of concepts and/or techniques together with a fairly high degree of skill in applying them to satisfy the requirements of an assignment or course Fine level of knowledge of concepts and/or techniques together with considerable skill in using them to satisfy requirements of an assignment or course. Acceptable or adequate level of knowledge of concepts and/or techniques together with considerable skill in using them to satisfy requirements of an assignment or course. Acceptable level of knowledge of concepts and/or techniques with some skill in using them to satisfy requirements of an assignment or course. Acceptable level of knowledge of concepts and/or techniques with minimum skill in using them to satisfy requirements of an assignment or course Minimal knowledge of concepts and/or techniques needed to satisfy the requirements of an assignment or course.

A-

90-92%

B+

87-89%

83-86% Good 80-82%

B-

C+

77-79%

73-76% Satisfactory 70-72% 60-69% Not Meeting Criteria 0 59% & below Fail, no credit

CD

Incomplete assignment and/or considerable error in work done. Incongruities in interpretation reflecting poor grasp of material. ASSIGNMENTS

Assignments/Papers/Power Point Presentation: Go to Assignments in Blackboard Learn. To upload your assignment, click on the green Start New Submission button, scroll down to the Attach File section, click the Browse my computer button, navigate to and select the appropriate file on your computer, then click the green Submit button at the bottom of the page. Be sure you have included you last name_first name_Assignment number.
Assignment 1 Go into Blackboard 8 under assignments. Choose one of the following posted articles. You are encouraged to read them all but are required only to respond to one article. Automated Hovering in Health Care- Watching Over the 5000 Hours How to Think About Future Health Care Spending Who Really Pays For Health Care? The Myth of Shared Responsibility

In one or two paragraphs: 1- Summarize one article, including its main thesis. 2- What are at least two facts or points supporting the thesis? 3- Reflection- a brief personal response to the article.

Assignment 2 Advanced Planning and Preparation for paper 2 The paper: You are an intern for a hometown congressman (your choice). He/she wants to become more knowledgeable about health care issues to more effectively discuss and represent the concerns of his constituents. He asks you to write a 3-4 page brief on one of five areas: Health care costs Health disparities Health promotion and disease prevention efforts Womens health or Quality of healthcare The final paper will include I: Context/background of the problem (something already clear and established) II. Identifying the problem III: Three reasons why it is a problem (this would delve into costs, resulting inequities, etc.) IV: One recommended solution with rationale Example.for final paper I. Context: Research has shown the dangers of exposure to second hand smoke and in states allowing workplace smoking, employers experience increased legal risks for employees exposed to second hand smoke. II. Problem: Only 11 states have laws requiring a smoke-free work environment. III. Three reasons why it matters. Work environments where smoking is allowed have higher maintenance costs, have increased employee illness due to exposure to second-hand smoke, and are not meeting the duty of an employer to protect employees from harm in a safe workplace. IV. Solution- Employers and insurance companies should voluntarily adopt smoke free work environment requirements and support state legislation for smoke free environments. This papers focus will be on providing literature-supported information for your congressman. Paper will include a minimum of seven references (minimum of four from peer-reviewed journals). A maximum of three references will be from web sites or texts. All references will be between 2001-12.

For the assignment:

Start with one issue or problem in one of the five broad areas (Health care costs, health disparities, health promotion and disease prevention efforts, womens health or, quality of healthcare and conduct a literature search to see what literature supports the problem and the solutions proposed in the literature. From your search, select 7 references; at least 4 must be peer reviewed journal reference citations published between 2002-2013, and abstracts that are most relevant to the problem and solution you are proposing and three can be online or other sources.

For assignment 2 Preplanning, write in complete sentences and include: I: Identification of the problem (from the possible five detailed above) II: Three reasons why it is a problem (i.e. why it matters)

III. 7 references (see requirements above). Include the abstracts or if the journal provides no abstracts, copy the first few paragraphs. Reference citations should be in APA style. You may copy and paste the abstract into the document. You will be given written comments and feedback on this drop box assignment. Resources Lisa Philpotts, the Mugar Library Sargent Reference Librarian has created a link to make it easier for you to access data bases. Bookmark it and you'll have a quick way to get into all your favorites via BU: PubMed, CINAHL, Web of Science, and more. http://www.bu.edu/library/guide/health/. You can meet with Lisa by contacting her to arrange an appointment if you want help researching a topic. 617) 3586920, philpo@bu.edu

Assignment 3 In two or three paragraphs: 1- Identify a current health care issue that has been discussed within the past 30 days using one source from the New York Times, Boston Globe, Wall Street Journal, CNN, or the BBC. 2- Briefly describe and summarize the issue and how the issue impacts cost, access, or quality of care. 3- Reflection a brief personal response to the issue. Cite your source, using APA style. Assignment 4 You are having a conversation with a friend who knows you are taking this course and asks you why the United States is the only developed nation in the world without universal health insurance. In two or three paragraphs, discuss your answer to this friend. You do not need to cite sources in this assignment.

Paper 1 Health Policy Examination Obtain a copy of your own health insurance policy (also referred to as the Schedule of Benefits) through your family or a copy of your B.U. Aetna Insurance Co. policy, if you carry that insurance. Using your health care policy, write a paper to answer the questions below. Scenario: Sari, a 21 year-old B.U. undergraduate student suffered a head injury over break. Sari is on the crew team. She has a part time job off campus as a waitress. After the injury, she has short- term memory problems, loss of appetite, and is feeling depressed. She has decreased coordination, mild left-sided weakness and mild expressive aphasia (word finding ability). Sari is determined to get back into full participation at school, and with her doctors agreement, begin the semester. She is home after spending one night in the hospital. Her physician clears her to return to school but recommends that she see several different health professionals as an outpatient when she returns to Boston to begin school again. Write in the third person as if you are a professional explaining the policy coverage to someone else. You are role playing as Sari using your own policy. Your paper will address all of the following questions: 1- How much does the subscriber (you or your parents) pay annually? Briefly explain what type of policy this is (e.g. HMO, PPO, IPA, POS model). (Note: The true cost of insurance is often shielded from the consumer. The purpose of this information is to enlighten you as to the cost of insurance). You will need to get this information in most cases directly from your parent/guardian. 2- How much will Sari pay for medications, (including in and out of network costs, co-payments, generic drugs, drug tiers, and mail order)?

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3- Saris physician recommends counseling, at least weekly for the next two months. What does the policy cover (including in and out of network costs)? How much will Sari pay out-of-pocket for counseling? Whom specifically can she see (i.e. a psychologist, psychiatrist, social worker, etc) 4- Sari needs to see a nutritionist, and an occupational therapy, physical therapy, and speech and language health professional and she may need ongoing treatment from each of these practitioners. Which of these services does her policy cover (including in and out of network costs) and how much will she pay for out of pocket for the initial and subsequent visits? 5- Identify and discuss two strengths and two weaknesses of this policy specifically related to this situation (not her initial hospitalization). Paper Requirements: See formatting requirements under Common Understandings. 3-4 pages in length (not including title or reference page). Nothing beyond 4 pages will be read or graded. In the text, reference the page numbers from your policy relevant to each question. Follow APA style for referencing. See Quick reference for APA style Highlight (in color) all pertinent information on the insurance policy Attach your policy to your paper. The paper will not be accepted without the policy. You will receive your policy back with your graded paper. See grading criteria at end of syllabus.

Insurance Paper Grading Criteria

Max Pts. 2 I. Content Clear separate introductory paragraph.

Student Name__________________________________
Comments

Clearly discusses type of policy and cost to subscriber. Clearly and completely discusses cost of medications (including copayments, generic drugs, drug tiers, and mail order) (5pt.) Clearly and completely discusses coverage (3pt) and out of pocket cost (2 pt) of counseling (including in and out of network costs) and the providers (i.e. psychiatrist, social worker, psychologist, etc) that the subscriber can see under the policy. Clearly and completely discusses coverage (including in and out of network costs) and out of pocket cost for nutrition (2pt), occupational therapy (2pt), physical therapy (2pt), and speech and language (2pt).

Clearly and thoughtfully discusses two strengths and two weaknesses (2 pts each) of the policy related to the situation.

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2 2

Clear separate summary paragraph. Policy Page numbers identified next to text (1 pt); Pertinent information is highlighted on policy (1 pt) Follows APA style format: no errors in format, appropriately cites material II. Grammar and spelling, Organization of paper, Clarity of expression, Insightfulness

Ideas are thoughtful and original. Points are well developed and supported with detail and example. Organization is clear; thoughts flow gracefully and logically. Language is sophisticated with a pleasing style and engaging voice. Grammar/mechanics are nearly perfect or perfect.

TOTAL SCORE 50

_____ x 2=

Paper 2 Individual paper You are an intern for a hometown congressman (your choice). He/she wants to become more knowledgeable about health care issues to more effectively discuss and represent the concerns of his constituents. He asks you to write a 3-4 page brief on one of five areas: Health care costs Health disparities Health promotion and disease prevention efforts Womens health or Quality of healthcare The brief should include I: Context/background of the problem (something already clear and established) II. Identifying the problem III: Three reasons why it is a problem (this would delve into costs, resulting inequities, etc.) IV: One recommended solution with rationale Follow details for paper requirements under Common Understandings in the course syllabus. Example. I. Context: Research has shown the dangers of exposure to second hand smoke and in states allowing workplace smoking, employers experience increased legal risks for employees exposed to second hand smoke. Problem: Only 11 states have laws requiring a smoke-free work environment. Three reasons why it matters. Work environments where smoking is allowed have higher maintenance costs, have increased employee illness due to exposure to second-hand

II. III.

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IV.

smoke, and are not meeting the duty of an employer to protect employees from harm in a safe workplace. Solution- Employers and insurance companies should voluntarily adopt smoke free work environment requirements and support state legislation for smoke free environments.

This papers focus should be on providing literature-supported information for your congressman. Paper will include a minimum of seven references (4 from peer-reviewed journals). A maximum of three references will be from web sites or texts. All references will be between 2001-13.

You are encouraged to use the program, http://Turnitin.com that is available for Boston University students and faculty. This program electronically reviews submitted papers and gives feedback on content that is identical or similar to articles or other work available through the internet. You may submit paper #2 to the program at any point prior to the due date. You are advised to allow enough time after submission to revise your paper if necessary. This submission is voluntary and not required but by submitting your paper, you will receive feedback on what percentage of your paper is identical to work written by others. You will receive an originality report that gives you a percent of your work that is identical to previously submitted papers and any content available on the web. It will be your responsibility to determine whether you have correctly cited material that is identical to work done by others. Correct citation means that when you have taken material verbatim (word for word) from another source, you follow APA style and put the material in quotation marks, and provide the author, year, and page number. When you are paraphrasing material, the author and year must be cited. There is no specific percent that is satisfactory. In general though, if the report shows that you have greater than 35 or 40 percent of your paper taken from other sources, even if you have correctly cited those sources, you may want to work further on your paper to synthesize material and put content in your own words. Faculty are not assuming that any of you would intentionally plagiarize but writing thoughts in ones own words can be difficult and one can inadvertently take material without proper citation of the source. You can review the results and make changes before submitting the paper on the due date. You will have access to your paper but not your peers papers. As your instructor, I will have access to all results. I would emphasize that this is offered to you as an educational tool to help you with your writing skills. Submitting your paper to Turnitin will not affect your paper grade. That said, be mindful that if I see a high percentage of any paper that is identical to the work of others, I may independently submit your final paper to Turnitin. Additionally, if you have not submitted your paper to Turnitin, and I have concerns about content, I may independently submit your paper. Those results may affect your paper grade. To submit your paper, go to the website www.turnitin.com and follow instructions to create a user profile. The class ID is 4903467 and the class password is Health (case sensitive). A help icon is available should you have difficulty. This site provides quick instructions to create a profile. http://www.turnitin.com/static/pdf/tii_student_qs.pdf
Paper 2: Grading criteria Name ______________________________ 7 Provides clear separate introductory paragraph. Establishes a context for the problem.(3) The Problem (thesis) is clearly stated and 3 reasons why it matters are introduced. (4) Thesis is supported with three arguments that identifies and clearly

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explains and justifies why the problem matters (i.e. why change is needed). Points are well developed with detail and example (each 6 points). Argument #1 6: Provides good literature (at least two different sources )support for the change and/or the argument is compelling and concise Argument #2 6: Provides good literature support (at least two different sources )for the change and/or the argument is compelling and concise Argument #3 6: Provides good literature support (at least two different sources )for the change and/or the argument is compelling and concise Provides good literature support (at least one source) and discussion for one solution Provides separate concise concluding paragraph. Paper includes a minimum of seven references (4 from peer-reviewed journals. A maximum of three references are from web sites or texts. All references are between 2002-13. American Psychological Association (APA) style (6th edition) is followed for writing and citing references. No errors in format.

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II. Grammar and spelling, Organization of paper, Clarity of expression, Insightfulness Excellent Ideas are thoughtful and original. Organization is clear; thoughts flow gracefully and logically. Language is sophisticated with a pleasing style and engaging voice. Grammar/mechanics are nearly perfect or perfect. ___x 2= %

50 Total score:

Power Point Presentation - Group grade counts as individual grade Power Point Presentation Group Project The scenario You are each a staff member in the National Institute of Health organization to which you have been assigned. The organizations director has asked the three of you to develop one PPP for her that advocates for one

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important effort that your organization focuses on that justifies why the organization should receive high priority for funding in the next fiscal year. Your target audience are grant funders. The PPP will be narrated (embedded voice over) and between 5 and 6 minutes. The narrated PowerPoint presentation will be presented to your classmates in your small discussion group and each group of three will answer student questions (3 minutes) after the PPP is presented. Classmates will assume the role of grant funders and at the end of the presentations, each small group will have $1 million dollars in hand to award to the presentation it decides is most worthy of funding. You are asked to: 1. Briefly describe your organizations focus (see group assignments below). 2. Describe and discuss one health disparity that the organization is working on (i.e., a health disparity based on e.g., ethnicity, gender, language, age, disability, sexual orientation) that should be funded. Describe why the disparity is important to address e.g. the severity and incidence and prevalence of the problem, who and how many people it affects. 3. Describe one effort your organization (e.g. funded research study, project, policy initiative) is using to address the health disparity you have identified and the potential impact the effort will have on the problem. In describing the effort, use the table below to a. Identify and discuss two populations that the effort would most help (i.e. well, at risk, acutely ill, chronically ill, and/or end of life). b. Discuss at least one principle for the health care system (i.e. Safe, effective, patient-centered, timely, efficient or equitable) that the effort addresses. Give an example of how the effort you have chosen meets one of these principles. 4. Conclude with a compelling argument for funding. The Power Point Presentations focus should be on advocacy for funding.

Matching Populations with Principles for the Health System Well Patients are alerted immediately when one of their medications is recalled due to safety issues. At Risk Patients have access to information on interactions between their prescribed medications and over-the-counter drugs. Acutely Ill Newly prescribed medications do not have adverse interactions with other drugs in patients regimens. Patients receive all treatments likely to improve their outcome. Patients urgency is head and addressed. Chronically Ill All key patient information is available to patients and their clinicians. End of Life Patients are not subjected to more intensive care or aggressive management than they desire.

Safe

Effective

Patients receive reminders when they need key screening tests.

Patients and clinicians have a shared understanding of preventive health goals. Patients concerns are heard and addressed.

Patients receive all treatments likely to reduce complications of their conditions. Patients are actively engaged in the management of their conditions.

Patients pain is well controlled.

PatientCentered

Patients are offered a variety of options for working with providers.

Patients are in settings of their preference.

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Timely

Patients can access their medical practice to ask questions and make requests by phone or email.

Providers address patients questions within the time frame the patients want.

Patients with acute complaints can be seen for evaluation promptly.

Patients frequent, routine followup care is provided without significant waits. Patients are prescribed the most costeffective medications.

Patients care site can be changed promptly according to needs and preferences.

All patients All patients are Patient preferences are equally equally likely to regarding end-of-life care are likely to receive respected. receive treatments treatments expected to be expected to beneficial. be beneficial. Center for American Progress (2008). The health care delivery system: A blueprint for reform. Accessed from http://www.americanprogress.org/issues/2008/10/pdf/health_delivery_full.pdf. Equitable

Efficient

Prevention is provided in multiple settings beyond the medical system through lower-priced providers.

Providers address education and follow-up, and avoid tests and medications unlikely to benefit them. A diverse provider organization provides a welcoming setting for care.

Care is delivered in the most cost-effective setting.

Patients preferences to avoid hospitalization or intensive care at end of life are known and respected by providers.

Culturally sensitive outreach programs are developed and implemented.

Groups 1, 10, 18, 26 Groups 2, 11, 19, 27 Groups 3, 12, 20, 28 Groups 4, 13, 21, 29 Groups 5, 14, 22, 30 Groups 6, 15, 23, 31

National Human Genome Research Institute (http://www.genome.gov) National Institute on Aging (http://www.nia.nih.gov/alzheimers National Institute on Drug Abuse (http://www.drugabuse.gov) National Institute of Biomedical Imaging and Bioengineering National Institute of Child Health and Human Development National Institute of Environmental Health Sciences National Institute of Mental Health National Institute of Diabetes and Digestive and Kidney Diseases National Institute of Allergy and Infectious Diseases

Groups 7, 16, 24, 32 Group 8, 17 25, 33 Group 9

Narrated PowerPoint Presentation Guidelines: You should link to the technology instructions below for information on how to do a voice overlay with slides.

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IMPORTANT. Because of file sizes, limit your presentation to no more than 13 slides and a voice overlay of no more than 6 minutes. 2 points off the final grade will be deducted for each slide over 13 or for each minute over 6 minutes. Images but not video can be in the presentation. Refer to the technology instructions. http://www.bu.edu/buniverse/view/?v=1qSCQqj2 Narrated Power Point instructions: 1: To record your voice onto your slides follow the tutorial found here:http://www.bu.edu/sargent/infofor-faculty-and-staff/makechnie-study-center/media-support/advanced-powerpoint-techniques/ 2: You must use the latest version of PowerPoint, only versions 2010(PC) or 2011(mac) will work correctly. If you do not have this version of power point you can use a MSC computer, students may only use MSC computers in the MSC. Alternatively you can buy the latest version, for $39 (typically$ 120 if you are not a BU student) by following this link: http://ithc.collegestoreonline.com/ 3: The process will work best if your group members all use the same file and computer to record their audio. It is not recommended that your record audio separately and then paste the slides into one document. 4: Save your document in the .pptx format. Do not use any other software to create the PowerPoint and then try to save your presentation as a pptx. The audio will not function properly if you use any other software, including PowerPoint 2007, 2008,2003, keynote, open office, or Google docs presentation. 5: Play back your presentation to be sure it is working correctly. 6: Name your File _________________.pptx. 6: Follow instructions for uploading your file.

Your slides should be developed as you would for a formal presentation, i.e., the slides should clearly list the important topics that you are addressing during your talk; they should be easy to read yet convey the important information for the listener, and be appropriate for your audience. Make your slides visually appealing. See PowerPoint Recommendations below. Read the rubric for more detail about the PowerPoint content. POWER POINT RECOMMENDATIONS First, view Stop death by powerpoint at http://lifehacker.com/323554/stop-death-by-powerpoint. Make your presentation interesting and engaging. Keep slides uncluttered. Make graphics relevant to the topic. All of your information should not be words on the slide. Citing material on slides: APA Style 1. In the slide where you have paraphrased or taken content verbatim, put quotation marks around the content and at the bottom of the slide, type the name of the author and then the year in parentheses. For example, if the author of the paraphrased work is John Smith and it was written in the year 2002, then you would type (Smith, 2002, p. #) after the citation. 2. Create a slide at the end of the presentation titled References. 3. Follow APA style for references Evaluation Guidelines for the Final Project Presentation

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Pts 30 3

Description Content Description of health problem and the target population. Describes one health disparity Describes one effort the organization is using to address the health disparity Identifies and discusses two populations the effort would help (Well, at risk, acutely ill, chronically ill, end of life) Discusses one principle for the health care system (Safe, effective, Patient centered, timely, efficient, or equitable) Final funding argument Presentation Oral presentation: Voice Over and response to student questions

Pts Organizations focus is clearly stated

Comments

Describes one health disparity and justifies its importance Identifies and clearly describes the effort

Clearly discusses two populations

Clearly discusses one principle and an example of how the effort meets that principle

Total Points: ___ x 2= Late presentati on point deduction: 5 points out of 100/day late; 2 points out of 100 for every minute beyond 6 and every slide over 13. Final Grade: QUICK

6 20 10

Compelling argument

10 Excellent Ideas are thoughtful and original. Organization is clear; thoughts flow gracefully and logically. Language is sophisticated with a pleasing style and engaging voice. Public speaking clear and concise 10. Excellent Background of slides is professional, easy to read and fits well with presentation Words on slides clear and convey the message well Pictures and clip art used adds to the presentation No grammatical or spelling errors Appropriate referencing of literature

10

Visual material: Slides

REFERENCE FOR APA STYLE I. General Writing Guidelines Expression of Ideas Present ideas in an orderly fashion. The aim is clear, concise, and logical communication. Avoid jargon. Use familiar terms, rather than fancy ones (i.e., use poverty instead of monetarily felt scarcity). Watch your choice of words. Make sure every word you write means exactly what you intended it to mean.

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Avoid Biased Language Be sensitive to labels. Avoid language that equates persons with their condition. Respect peoples preferences. Refer to people with what they prefer to be called. Use person first language when referring to people with disabilities. o For example, do not say the autistic child. Say child with autism.

Academic Honesty Students are expected to adhere to the Sargent College Academic Conduct code standards for academic honesty. It is expected that work will be independent unless specified as a group project. In writing assignments, students are expected to use their own words. When other sources are used, credit must be given to the source. In the occasional instance where direct quotes are used for emphasis, the quoted text must be set apart with quotation marks and full referencing. Quoting and Paraphrasing Please refer to this website for guidance in avoiding plagiarism. University of Wisconsin Writing Center (n.d.) Retrieved December 19, 2005 from http://www.wisc.edu/writing/Handbook/QPA_plagiarism.html II. Paper Formatting Guidelines One inch margins on top, bottom, left, and right, Flush left margin (uneven on right margin) 12-pt. font (Times Roman or Courier are acceptable typefaces) Double-space throughout the paper, Space once after all punctuation. This includes using one space (not two!) following punctuation marks at the ends of sentences. Indent paragraphs 5-7 spaces Running head Pagination: The page number appears one inch from the right upper edge of the paper on the first line of every page beginning with the title page III. Citation of Sources in APA Format APA style requires two elements for citing outside sources: parenthetical (in-text) references, and a reference list. Together, these elements allow your reader access to the sources you consulted. For the system to function, all authors cited in the text must appear in the reference list, and all authors listed must have been cited in the text. A. In-Text Citations The APA style calls for three kinds of information to be included in in-text citations. The author's last name and the work's date of publication must always appear. The page number is only in a citation to a direct quotation. Placement Place citations within sentences and paragraphs so that it is clear which material has come from which sources. o Example: Smith (1990) found that positioning influences ventilation. In her quasi-experimental study of 20 ICU patients, she used two methods to. . . However, her findings did not support the work of Kline (1987) and Ackers (1989) who used much larger samples to demonstrate that. . . Two or more authors: When a work has a single author or two authors, cite their names and the date of publication whenever you refer to their work in the text. (Exception: Within a given paragraph, do not include the date after the initial citation unless you are citing other publications elsewhere in your paper by the same author(s).) o Join two co-authors in the text with the word "and", but within parentheses use an ampersand (&).

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Three to five authors: When citing co-author groups of three to five authors, cite all names and the date in the initial citation, but only the first author followed by et al. and the date in subsequent citations. Six or more authors: For co-author groups of six or more authors, cite in the text only the surname of the first author followed by et al. and the date. If two or more six-author groups shorten to the same surname, cite the surnames of as many subsequent authors as needed to distinguish references.

Punctuation When an author-date citation appears at the end of a sentence, place the period after the parentheses. When an author-date citation appears mid-sentence, punctuation depends on the context. Secondary Sources Indicate in the text when you are citing from a secondary source in one of the following ways: Place both authors in the same citation at the end of the sentence: (Smith, 1976, cited in Carrington, 1989); or cite them separately within the sentence: Smith (1976) formulated a theory about deviant behavior (cited in Carrington, 1989). Quotations A page number always immediately follows a quotation, even when the author and date precede it: Lu (1990) found that "several hypotheses were partially supported" (p. 48). Electronic in text citations (For guidance http://www.apastyle.org/elecref.html) To cite a specific part of a source, indicate the page, chapter, figure, table, or equation at the appropriate point in text. Always give page numbers for quotations. (Cheek & Buss, 1981, p. 332) (Shimamura, 1989, chap. 3) For electronic sources that do not provide page numbers, use the paragraph number, preceded by the paragraph symbol or the abbreviation para. If neither paragraph nor page numbers are available, cite the heading and the number of the paragraph following it to direct the reader to the location of the material. (Myers, 2000, 5) (Beutler, 2000, Conclusion section, para. 1) Personal Interview, Phone Conversation, Letter, or Non-archived E-Mail You should have few citations for personal communication as they are not a retrievable source of information. Because this material is not recoverable (i.e., it is not possible for someone else to see or hear it), it should not be listed in the list of References. It can, however, be cited parenthetically within the text. It is important that what is cited in this way be legitimate and have scholarly integrity. Phone conversation According to Connie May Fowler, the sources for her novel Sugar Cane were largely autobiographical (personal phone conversation, July 22, 2003). OR The sources for the novel Sugar Cane were largely autobiographical (Connie May Fowler, personal phone conversation, July 22, 2003). In text referencing for brochures: When the reference is to a work by a corporate author, use the name of the organization as the author. Example: Sari must pay $2000 out of pocket as an annual deductible before she will be able to use insurance benefits (Aetna, 2004, p. 54).

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B. Reference List The reference list is placed at the end of the paper. Begin references on a new page; label this page References (no quotation marks, underlining, etc.), centered at the top of the page. It should be double-spaced just like the rest of your essay. All lines after the first line of each entry in your reference list should be indented one-half inch from the left margin. This is called hanging indentation. Alphabetize by the last name of the first author of each work. If there is more than one article by the same author, single-author references or multiple-author references with the exact same authors in the exact same order are listed in order by the year of publication, starting with the earliest. When referring to a source that is NOT a journal, such as a book, article, or Web page, capitalize only the first letter of the first word of a title and subtitle, the first word after a colon or a dash in the title, and proper nouns. Do not capitalize the first letter of the second word in a hyphenated compound word. Capitalize all major words in journal titles. Italicize titles of longer works such as books and journals. Article or chapter in edited book Eiser, S., Redpath, A., & Rogers, N. (1987). Outcomes of early parenting: Knowns and unknowns. In A. P. Kern & L. S. Maze (Eds.), Logical thinking in children. (pp. 58-87). New York: Springer. Book Dorn, L. R., & Ryerson, D. (1984). Elements of a healthy childhood (2nd ed.). New York: Macmillan. Book or article with no author or editor named Merriam-Webster's collegiate dictionary (10th ed.).(1993). Springfield, MA: Merriam-Webster. Brochure Research and Training Center on Independent Living. (1993). Guidelines for reporting and writing about people with disabilities (4th ed.) [Brochure]. Lawrence, KS: Author. Government publication National Institute of Mental Health. (1990). Clinical training in serious mental illness (DHHS Publication No. ADM 90-1679). Washington, DC: U.S. Government Printing Office. Internet Document If the author of a document is not identified and there is no date, begin the reference with the title of the document. GVU's 8th WWW user survey. (n.d.). Retrieved from http://www.cc.gatech.edu/gvu/usersurveys/survey199710/ . If there is an author for the website, cite that first, and then put the title after the date, as in a journal citation. Journal article Allegrante, J. P., & Kovar, P. A. (1993). A walking education program for patients with osteoarthritis of the knee: Theory and intervention strategies. [Electronic version]. Health Education Quarterly, 20, 1, 63-82. Author_Last Name, Initials. (Year). Article title in sentence case with only the first word of title capitalized. Journal is italicized, Volume(issue), Page.

Example of a reference list References Boorstin, D. (2008). The creators: A history of the heroes of the imagination. New York: Mosby Press. Jette, A. J., Lachman, M.E., Giorgetti, M. M., Assmann, S. F., Harris, B. A., Levenson, C., Wernick, M., & Krebs, D. (1999). Exercise - It's never too late: The strong for life program. American Journal of Public Health, 89(1), 66-89.

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Lorig, K. R., Stewart, A. L., Brown, B. W., Bandura, A., Gonzalez, V. M., Laurent, D. D., & Holman, H. R. (1999). Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: A randomized trial. Medical Care, 37(3), 5-14. Raczynski, J. M., & DiClemente, R. J. (2001). Handbook of health promotion and disease prevention. New York: Kluwer Academic/Plenum Publishers. Quick Reference to APA Style Handout created by G. Orsmond and adapted from University of WisconsinMadison Writing Center Writers Handbook (http://www.wisc.edu/writing/Handbook/DocAPA.html) and the Purdue Owl Resources site http://owl.english.purdue.edu/owl/resource/560/05/.

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