Dr. Cheryl Kovar

“What sets ECU research apart is the personal touch.”

Research Interest: How public health STD clinics can remain financially solvent as well as being able to provide the required communicable disease screenings for their clients.
Innovation: This research has been the first in the state to assess all 85 local health departments/districts that cover all 100 counties in the state for their attitudes, knowledge, and current practices of billing third party payers (private) for STD services.
Research Context / Setting: The context of the study was done in two main waves: Wave 1 worked with 25 local health departments/districts (LHD) in the eastern part of the state and Wave 2 extended the study to the remaining 60 LHDs in the rest of the state. The setting of the study focused on their STD clinics and knowledge/practice around billing for these services.
Study Design: Surveys, interviews, and focus groups.
Research Population: Staff and leadership working in a public health department/district in the state.
Sampling Strategy: Snowball sampling for the surveys and purposive sampling of the LHDs selected to participate in the interview/focus group components.
Intervention: Toolkit to assist in their process of seeking insurance contracts in order to bill for STD services. The Toolkit also contained other pertinent information to help them in the future.
Study Variables: Attitudes toward billing, knowledge of the ability to bill, current practices in billing for STD services, challenges to providing STD services at the LHD, opportunities to improve these services, collaboration among LHDs, current screening practices for STD services, concerns with billing and coding of these services.
Data Collection Instruments: Qualtrics survey, questionnaires
Analysis Methods: Descriptive statistics were conducted for the survey component. Content analysis was used in the qualitative arm.
Collaborators: Public health professionals such as health directors, health educators, laboratorians, accounting/finance professionals, etc.
Funding: HIV Prevention grant with the CDC and NC DHHS. The project was funded for a little over $800,000 over the 3-year period.

All 85 LHDs over the two Waves (electronic/Qualtrics) were surveyed and used snowball sampling within the LHDs to increase the uptake of survey participants. For the focus groups and interviews, we used audiotaped interviews with both groups that were transcribed verbatim. All transcripts were independently coded, with cross comparison and agreement between researchers. Rigorous thematic and content analyses were performed. Interviews were conducted with health directors, nursing directors or other designed leadership personnel. Focus groups were conducted with clinic staff, front desk staff, lab staff, other front-line staff from the STD clinics.