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Greater probability of choosing a plan, rather than being assigned. Sample members who learned about plans from their doctors were more likely to report the information was very useful, but these sample members were less likely to choose their plans. People with mental retardation were more likely to rely on friends and family for information, but these sources were not associated with choosing plans and providers. Less than half of SSI enrollees rated providers' information about tests and procedures very good or excellent, and a fifth rated it poor or fair. Adults with communications impairments were the least satisfied with information about tests and procedures. Conclusions: Although SSI enrollees faced barriers to informed participation, most were able to overcome the barriers. Others, especially people with cognitive and communication impairments, were less able to receive information or make informed decisions. Implications for Policy, Delivery or Practice: Information dissemination should be tailored to the diverse needs of people with disabilities. While most people with disabilities appear to be able to overcome barriers to receiving and using information to make health care decisions about plans and providers, greater efforts may be needed to assist people with communications and cognitive impairments. Information resources targeted to the family and friends of people with mental retardation may improve their ability to make informed decisions. Additional assistance is needed to facilitate information sharing between providers and people with communication impairments. Primary Funding Source: DHHS Assistant Secretary for Planning and Evaluation Predictors of Early Prenatal Care Use, Preterm Birth and Low Birthweight Among Rural and Urban Women Marianne Hillemeier, Ph.D., M.P.H., Carol Weisman, Ph.D., Gary Chase, Ph.D., Megan Darnell, M.S. Presented by: Marianne Hillemeier, Ph.D., M.P.H., Assistant Professor, Health Policy & Administration, Pennsylvania State University, 116 Henderson Building, University Park, PA 16802; Tel: 814.863.0873; Fax: 814.863.2905; E-mail: mmh18 psu Research Objective: To examine predictors of prenatal care use, preterm birth, and low birthweight at the individual and community levels and to examine the impact of urban-rural maternal residence using measures that capture the differences among types of rural communities. Study Design: Birth certificate records were analyzed for the 28-county central Pennsylvania region, which contains urban areas as well as a sizable rural population. Birth record data were merged with county-level indicators of socioeconomic status and health care resources from the Area Resource File and U.S. Census data. Multiple logistic regression analyses were conducted to model the determinants of 1 ; receipt of early first trimester ; prenatal care; 2 ; preterm birth 37 weeks gestation and 3 ; low birthweight 2500 grams ; . Independent variables included measures of maternal sociodemographics age, education, race ethnicity ; , maternal health smoking, chronic high blood pressure, diabetes ; , and county-level socioeconomic and health care resources percent high school graduates, percent nonwhite, percent of. Discount pill guide: tuesday, april 05, 2005. Practice Report: The practice report is the physician's report of how well clinic is doing regarding improved access and office efficiency. It will also be the standard reporting format for monthly progress updates in the Collaborative. This concise two-page report includes an aim statement, measures to be used, a sampling plan, a listing of the changes made and the results displayed graphically on annotated run charts. Pre-work Packet: A book containing a complete description of the Collaborative, along with expectations and activities to complete prior to the first meeting of the Collaborative. Pre-work Period: The time prior to the first learning session when teams prepare for their work in the Collaborative, including selecting team members, attending cluster conference calls, scheduling initial meetings, consulting with senior leaders, preparing their aim statement, and initiating data collection by defining a population of focus, selecting measures, and beginning to populate a registry. Process Change: A specific change in a process in the organization. More focused and detailed than a change concept, a process change describes what specific changes should occur. Registry: A list or database set of records that contain individual patient information. The registry should provide the following: clinically useful and timely information, reminders and feedback for providers and patients, identify relevant patient subgroups and support proactive care, and facilitate individual patient care planning. "Registry size" refers to the count of patients represented in the list. Registry Summary Report RSR ; : Displays summary statistics of individual patients and subgroups of patients. This report serves as a key tool for managing and improving the health status of a defined population of patients Run Chart: A graphic representation of data over time, also known as a "time series graph" or "line graph." This type of data display is particularly effective for process improvement activities. Sampling Plan: A specific description of the data to be collected, the interval of data collection, and the subjects from whom the data will be collected. This is included on all Senior Leader reports. It emphasizes the importance of gathering samples of data to obtain "just enough" information. Senior Leader: The executive in the organization who supports the team and controls all the resources employed in the processes to be changed. The Senior Leader works to connect the team's aim to the organization's mission, provides resources for the team, and promotes the spread of work of the team to other sites, providers, and conditions. Senior Leader Report: The standard reporting format for reporting monthly progress during the Collaborative. This concise two-page report includes an aim statement, measures to be used, a data collection plan, a listing of the changes made, and the results displayed graphically on annotated run charts. Report to be prepared by pilot team and sent to the Cluster Director and the Senior Leader. Spread: Increasing the number of patients exposed to the benefits of the Care Model Approach to chronic disease care through intentional and methodical expansion from one provider to additional providers, one site to additional sites, and or one disease to additional diseases. The theory and application comes from literature on the concept of Diffusion of Innovation. Storyboard: The board that displays information about a team and its progress and that is displayed at learning sessions to help create an environment conducive to sharing and learning from the experiences of others. Sustain: Holding the gains and maintaining the improvements an organization has accomplished in their care of patients with a chronic illness and "cementing" positive changes into their system of care and into the fabric of the organization. System Leader: The core team member who has direct authority to allocate the time and resources to achieve the team's aim, has direct authority over the particular systems affected by the change, and will champion the spread of successful changes throughout the department or service area. The system leader attends all three learning sessions as well as the National Forum. Team: The group of individuals, usually from multiple disciplines, that drive and participate in the improvement process. A core team of three to four individuals attend the learning sessions, but a larger team of six to eight people participate in the improvement process in the organization. Technical Expert: The team member in the organization, usually a physician, within the center who has a strong understanding of the process to be improved and changes to be made. A technical expert may also provide expertise in process improvement, data collection and analysis, and team function. 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