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Physician Assistants' Preventive Medicine Practices and Related Habits, Attitudes, and Beliefs Judia Yael Malachi Walden University

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Physician Assistants' Preventive Medicine Practices and Related Habits, Attitudes, and Beliefs Judia Yael Malachi Walden University Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2015 Physician Assistants' Preventive Medicine Practices and Related Habits, Attitudes, and Beliefs Judia Yael Malachi Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Judia Yael Malachi has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Richard Palmer, Committee Chairperson, Public Health Faculty Dr. Jeff Snodgrass, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 Abstract Physician Assistants‘ Preventive Medicine Practices and Related Habits, Attitudes, and Beliefs by Judia Yael Malachi MPH, Walden University, 2007 BS, University of Arizona, 2001 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University May 2015 Abstract Physician assistants play a pivotal role in expanding access to care, yet research on their preventive medicine practices is limited. Guided by Lewis‘s conceptual model for predicting counseling practices, this cross-sectional study examined the relationship between physician assistants‘ preventive medicine practices, personal health habits, prevention and counseling attitudes, and perceived barriers to the delivery of clinical preventive services. A 104-item self-administered survey was used to collect data from 314 physician assistants attending the American Academy of Physician Assistants‘ 42nd Annual Conference. Data were analyzed using descriptive statistics, Pearson‘s correlation, and stepwise multiple regression. Results indicated that physician assistants engaged in preventive medicine activities about half the time, believed it was very important to counsel patients on prevention topics, felt they were somewhat effective in changing patient behaviors, and reported that barriers were somewhat important in hindering preventive care delivery. Significant and predictive relationships between physician assistants‘ health habits, attitudes, perceived barriers, and practices were found. These findings may guide researchers, providers, policymakers, and the public in making informed and comprehensive health care decisions. This study contributes to social change by serving as a baseline for the creation of effective strategies for physician assistant practice and self-assessment. Additionally, data from this study can be used to advocate changes in the education, training, and certification of physician assistants, as well as foster medicine and public health collaborations. Physician Assistants‘ Preventive Medicine Practices and Related Habits, Attitudes, and Beliefs by Judia Yael Malachi MPH, Walden University, 2007 BS, University of Arizona, 2001 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University May 2015 Dedication To my mother, Judia Rebekah Malachi-Jones and late grandmother, Marion Malachi. The two women whose unconditional love, wisdom, praise, encouragement, support, patience, and sacrifice provided me with an environment in which I could learn, grow, and mature. Acknowledgments To God be the Glory! It is by His Grace and Mercy that I have made it this far. I am thankful, blessed, highly favored, and know without a shadow of a doubt, I can do all things through Christ who strengthens me! No task, big or small, is met alone. God, in His infinite wisdom, places people along our path to encourage, guide, and support our endeavors. As I look back on this experience, I am grateful to my family, friends, classmates, professors, and colleagues who have, in their way, contributed to my success. My journey would not have been the same without you; thank you! To my mother, Judia Rebekah Malachi-Jones, thank you for all you have done for me over the years. Your wisdom, support, and prayers are constant reminders of your love for me. You are an exemplary example of an overcomer—no matter life‘s challenges, you have remained positive, prayerful, and have pressed on; I am blessed to be your daughter! To my father, Laval Lev Malachi, thank you for your love, prayers, guidance, and dedicated service to our country. To my father, Nathaniel Jones III, thank you for always wanting the best for me and for ensuring my computers operated in tip- top shape! To my brothers, Mario, Laval, Nate, and Chris; sister, Levette, and sister-in- laws, T‘Pring, Miranda, and Trina, thank you for your love and encouragement. To my nieces, nephews, and Godchildren. Stay focused in school, work hard, accept failure as a part of success, have fun, and do something nice for someone else, just because—I guarantee you will succeed in life! To my aunt, Arlinda Everage and Godmother, Mary Farmer, thank you for encouraging my pursuits. To Tonia Turner and Brenda Wright, thank you for the support over the years. To the best group of friends anyone could ever ask for: Ada Marie Ware-Richardson, Rhonda A. Carroll, Rashandah Zakkiyyah Scipio Butler, Jenessa Johnson, Latoya Ellis, Samantha Glanton, Kayilu Nadia Kosberg, Coressa Britt, Alisha Harris, and Tiesha Davis. Thank you for your friendship, sisterhood, trust, support, encouragement, and all the fun moments—I am inspired by each of you! To Patricia Isennock, MS, BSN, MCHES, you are the best mentor a student could ever have. Over the years, I have learned so much from you—thank you for sharing your knowledge, expertise, and experience. I appreciate your support, encouragement, and vote of confidence. I am glad to call you my friend and colleague. To Dr. Antonio Baines, thank you for the words of wisdom when I first entertained the idea of earning a Ph.D. You were right; the process was challenging at times, but in the end, it was worth it! To James Kielek, PA-C; Johnna Tanner, PA-C, and Chibuike Anokwute, MD, thank you for your medical expertise and guidance. More importantly, thank you for your service to your patients, students, and community. To Mark Yeazel, MD, MPH, thank you for dusting off, what you called, ―ancient analyses‖ to answer my questions regarding the PMAAQ—your time is greatly appreciated. To the Physician Assistant Education Association, thank you for access to the PA Program Directory. To the Agency for Healthcare Research and Quality, thank you for assisting providers and empowering patients through the dissemination of evidence-based research and resources. To the American Academy of Physician Assistants, thank you for allowing me to conduct my study during your 42nd Annual Conference. Moreover, to the 320 physician assistants who were kind enough to participate in this groundbreaking study—thank you, thank you, thank you! Without your contribution, this project would not have been possible. To Laerd Statistics, thank you for simplifying SPSS. To Paul Lai and Dr. Annie Pezalla, thank you for your editorial guidance. To my wonderfully amazing dissertation committee: Chair, Dr. Richard Palmer; Methodologist, Dr. Jeff Snodgrass, and University Research Reviewer, Dr. James Rohrer. I extend to you my sincere gratitude. Thank you for your time, expertise, and direction throughout this process—I am forever grateful! Lastly, to the scholar-practitioners currently enrolled in a doctoral program and those entertaining the idea. The decision to earn a doctorate is one that should not be taken lightly. The journey is not designed to be easy, and it certainly is not for the weak. The dissertation process in itself is arduous and designed to ―test‖ your resolve, ability to think and write critically, defend your position in a scholarly tone, and persevere to the very end, despite life‘s many challenges. Once you understand and accept the process for what it is, you will be able to forge ahead. Nevertheless, there will be times you will question your decision and find yourself on the verge of giving up—don‘t! Always keep in mind the reason why you embarked upon this journey in the first place; it will help you remain focused. Think about the social change contributions you will make and the people who will benefit from your hard work, tears, and sacrifice. As my grandmother would say, ―It‘s not who started, but who finishes to the end!‖ I encourage you to remain steadfast in your pursuit, finish to the end, and be the change agent you were meant to be. The light at the end of the tunnel does exist and is waiting for you. Be blessed! —Dr. Judia Yael Malachi Table of Contents List of Tables .......................................................................................................................v Chapter 1: Introduction to the Study ....................................................................................1 Introduction ....................................................................................................................1
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