Off-campus UMass Amherst users: To download campus access dissertations, please use the following link to log into our proxy server with your UMass Amherst user name and password.
Non-UMass Amherst users: Please talk to your librarian about requesting this dissertation through interlibrary loan.
Dissertations that have an embargo placed on them will not be available to anyone until the embargo expires.
ORGANIZATIONAL FACTORS INFLUENCING QUALITY AND EQUITY IN PEDIATRIC PRIMARY CARE: A MIXED METHODS STUDY
Author ORCID Identifier
Campus-Only Access for Five (5) Years
Doctor of Philosophy (PhD)
Year Degree Awarded
Month Degree Awarded
Health Services Research | Medicine and Health
The research conducted for this dissertation broadly explored the relationship between characteristics of healthcare organizations and quality and equity in pediatric healthcare. The first of the three studies identified characteristics of pediatric practices with high scores on measures of quality and patient experience using qualitative methods. The second study assessed whether the candidate characteristics identified in the first study were quantitatively associated with performance on quality measures using a statewide survey and publicly available quality data. This study found several potentially modifiable factors associated with performance, including an organizational culture characterized by good communication and interpersonal relationships amongst providers and staff, having a designated quality champion, and offering co-located ancillary services, such as behavioral health. The third study used ethnographic-style methods to explore implementation of community health workers in a pediatric practice in a new Medicaid accountable care organization. Observations and interviews identified a number of potential barriers to effective planning for integration of the community health workers, which could in turn limit the capacity of the community health worker program to improve quality and address inequities in healthcare for low-income children.
Goff, Sarah L., "ORGANIZATIONAL FACTORS INFLUENCING QUALITY AND EQUITY IN PEDIATRIC PRIMARY CARE: A MIXED METHODS STUDY" (2018). Doctoral Dissertations. 1438.