NAU publications by CHER
Faculty & staff publications
NAU faculty and staff have the opportunity to publish their findings and knowledge as authors. CHER has many researchers that have been cited multiple times in major publications for their great work. The Center for Health Equity Research has accumulated all faculty publications into one, easy to navigate database.
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2020 |
Camplain, Ricky; Sotres-Alvarez, Daniela; Alvarez, Carolina; Wilson, Rebbecca; Perreira, Krista M; Castañeda, Sheila F; Merchant, Gina; Gellman, Marc D; Chambers, Earle C; Gallo, Linda C; Evenson, Kelly R The association of acculturation with accelerometer-assessed and self-reported physical activity and sedentary behavior: The Hispanic Community Health Study/Study of Latinos Journal Article Forthcoming ScienceDirect, 17 , Forthcoming. @article{Camplain2020b, title = {The association of acculturation with accelerometer-assessed and self-reported physical activity and sedentary behavior: The Hispanic Community Health Study/Study of Latinos}, author = {Ricky Camplain and Daniela Sotres-Alvarez and Carolina Alvarez and Rebbecca Wilson and Krista M. Perreira and Sheila F. Castañeda and Gina Merchant and Marc D. Gellman and Earle C. Chambers and Linda C. Gallo and Kelly R. Evenson }, url = {https://doi.org/10.1016/j.pmedr.2020.101050}, doi = {10.1016/j.ypmed.2017.07.024}, year = {2020}, date = {2020-03-01}, journal = {ScienceDirect}, volume = {17}, abstract = {The adoption of US culture among immigrants has been associated with higher leisure-time physical activity and sedentary behavior. However, most research to date assesses this association using single measures of acculturation and physical activity. Our objective was to describe the cross-sectional association between acculturation and both physical activity and sedentary behavior among US Hispanic/Latino adults. Participants included Hispanic/Latinos 18–74 years living in four US locations enrolled in the Hispanic Community Health Study/Study of Latinos from 2008 to 2011. Acculturation was measured using acculturation scales (language and social), years in the US, language preference, and age at immigration. Physical activity and sedentary behavior were measured using the Global Physical Activity Questionnaire (N = 15,355) and Actical accelerometer (N = 11,954). Poisson, logistic, and linear regression were used, accounting for complex design and sampling weights. English-language preference was positively associated with self-reported leisure-time and transportation physical activity and accelerometer-assessed moderate-to-vigorous physical activity (MVPA). Social acculturation was positively associated with self-reported leisure-time and transportation physical activity and MVPA. Years in the US and age at immigration were positively associated with accelerometer-assessed MVPA. Language acculturation, years in the US, and age at immigration were associated with occupational physical activity among those who reported employment. Most acculturation measures were associated with self-reported sitting but not with accelerometer-assessed sedentary behavior. Different measures of acculturation, capturing various domains acculturation, were associated with physical activity and sedentary behavior. However, the direction of the association was dependent on the measures of acculturation physical activity/sedentary behavior, highlighting the complexity of these relationships.}, keywords = {}, pubstate = {forthcoming}, tppubtype = {article} } The adoption of US culture among immigrants has been associated with higher leisure-time physical activity and sedentary behavior. However, most research to date assesses this association using single measures of acculturation and physical activity. Our objective was to describe the cross-sectional association between acculturation and both physical activity and sedentary behavior among US Hispanic/Latino adults. Participants included Hispanic/Latinos 18–74 years living in four US locations enrolled in the Hispanic Community Health Study/Study of Latinos from 2008 to 2011. Acculturation was measured using acculturation scales (language and social), years in the US, language preference, and age at immigration. Physical activity and sedentary behavior were measured using the Global Physical Activity Questionnaire (N = 15,355) and Actical accelerometer (N = 11,954). Poisson, logistic, and linear regression were used, accounting for complex design and sampling weights. English-language preference was positively associated with self-reported leisure-time and transportation physical activity and accelerometer-assessed moderate-to-vigorous physical activity (MVPA). Social acculturation was positively associated with self-reported leisure-time and transportation physical activity and MVPA. Years in the US and age at immigration were positively associated with accelerometer-assessed MVPA. Language acculturation, years in the US, and age at immigration were associated with occupational physical activity among those who reported employment. Most acculturation measures were associated with self-reported sitting but not with accelerometer-assessed sedentary behavior. Different measures of acculturation, capturing various domains acculturation, were associated with physical activity and sedentary behavior. However, the direction of the association was dependent on the measures of acculturation physical activity/sedentary behavior, highlighting the complexity of these relationships. |
Fisher, Kim W; Williamson, Heather; Guerra, Nichole Technology and Social Inclusion: Technology Training and Usage by Youth With IDD in the National Longitudinal Transition Study of 2012 Journal Article Inclusion, 8 (1), pp. 43–57, 2020. @article{Fisher2020, title = {Technology and Social Inclusion: Technology Training and Usage by Youth With IDD in the National Longitudinal Transition Study of 2012}, author = {Kim W. Fisher and Heather Williamson and Nichole Guerra}, url = {https://doi.org/10.1352/2326-6988-8.1.43}, doi = {10.1352/2326-6988-8.1.43}, year = {2020}, date = {2020-03-01}, journal = {Inclusion}, volume = {8}, number = {1}, pages = {43–57}, abstract = {Technology use is a key form of social inclusion and a means to engage in community participation. People with intellectual and developmental disabilities (IDD) experience a digital divide with less technology access as compared to their peers. We used data from the National Longitudinal Transition Study of 2012 to study technology use and access to instruction among adolescents with IDD compared to adolescents with other disabilities and adolescents without disabilities. Results indicate adolescents with IDD use technology less, receive less technology training, and engage in fewer social inclusion opportunities than their peers. Implications for future research, policy, and practice are provided, including promoting digital citizenship training during transition planning and the use of social capital theory. }, keywords = {}, pubstate = {published}, tppubtype = {article} } Technology use is a key form of social inclusion and a means to engage in community participation. People with intellectual and developmental disabilities (IDD) experience a digital divide with less technology access as compared to their peers. We used data from the National Longitudinal Transition Study of 2012 to study technology use and access to instruction among adolescents with IDD compared to adolescents with other disabilities and adolescents without disabilities. Results indicate adolescents with IDD use technology less, receive less technology training, and engage in fewer social inclusion opportunities than their peers. Implications for future research, policy, and practice are provided, including promoting digital citizenship training during transition planning and the use of social capital theory. |
Armstrong-Heimsoth, Amy; Hahn-Floyd, Molly; Williamson, Heather J; Kurka, Jonathan M; Yoo, Wonsuk; Jesús, Sue Rodríguez De A Former Foster System Youth: Perspectives on Transitional Supports and Programs Journal Article The Journal of Behavioral Health Services and Research, 2020. @article{Armstrong-Heimsoth2020, title = {Former Foster System Youth: Perspectives on Transitional Supports and Programs}, author = {Amy Armstrong-Heimsoth and Molly Hahn-Floyd and Heather J. Williamson and Jonathan M. Kurka and Wonsuk Yoo and Sue A. Rodríguez De Jesús}, url = {https://doi.org/10.1007/s11414-020-09693-6}, doi = {10.1007/s11414-020-09603-6}, year = {2020}, date = {2020-02-24}, journal = {The Journal of Behavioral Health Services and Research}, abstract = {Youth aging out of the foster care system have well-documented challenges when transitioning to adulthood. Multiple transition services provide support in the transition process; however, limited research is available regarding youth’s perceptions of programming. In this pilot study, sixteen youth between ages 18 and 20 participated in semi-structured interviews, support mapping, an resiliency measurements to gather the experiences of the transition from foster care. Comparisons between those who chose initial transition supports and those who did not receive or delayed receiving transition supports were initially explored. Common themes emerged in participants’ needs and perceived resiliency regardless of transition support services. All youth reported relationship, trust, and concern for well-being as highly important characteristics in transition team members. A need for earlier transition programming, decision-making opportunities, and life skills courses were important themes in transition programming needs. Implications for policy, research, and practice are presented based upon findings.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Youth aging out of the foster care system have well-documented challenges when transitioning to adulthood. Multiple transition services provide support in the transition process; however, limited research is available regarding youth’s perceptions of programming. In this pilot study, sixteen youth between ages 18 and 20 participated in semi-structured interviews, support mapping, an resiliency measurements to gather the experiences of the transition from foster care. Comparisons between those who chose initial transition supports and those who did not receive or delayed receiving transition supports were initially explored. Common themes emerged in participants’ needs and perceived resiliency regardless of transition support services. All youth reported relationship, trust, and concern for well-being as highly important characteristics in transition team members. A need for earlier transition programming, decision-making opportunities, and life skills courses were important themes in transition programming needs. Implications for policy, research, and practice are presented based upon findings. |
Pro, George; Zaller, Nick PLOS One, 15 (2), 2020. @article{Pro2020c, title = {Interaction Effects in the Association Between Methadone Maintenance Therapy and Experiences of Racial Discrimination in U.S. Healthcare Settings}, author = {George Pro and Nick Zaller}, url = {https://doi.org/10.1371/journal.pone.0228755}, doi = {10.1371/journal.pone.0228755}, year = {2020}, date = {2020-02-06}, journal = {PLOS One}, volume = {15}, number = {2}, abstract = { Background Disparities in methadone maintenance therapy (MMT) outcomes have received limited attention, but there are important negative outcomes associated with MMT that warrant investigation. Racial discrimination is common in healthcare settings and affects opioid use disorder (OUD) treatment and comorbidities. However, race/ethnicity alone may not fully explain experiences of discrimination. MMT remains highly stigmatized and may compound the effect of race/ethnicity on discrimination in healthcare settings. We sought to quantify differential associations between MMT and experiences of racial discrimination between racial/ethnic groups in a U.S. national sample. Methods We used the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012–2013) to identify a subset of individuals with a lifetime OUD who had ever used MMT (survey n = 766; weighted population n = 5,276,507). We used multivariable logistic regression to model past-year experience of racial discrimination in a healthcare setting. We included an interaction term between race/ethnicity and MMT status to identify the odds of discrimination (MMT vs. no MMT [referent]) within racial/ethnic groups. We used survey procedures with weights to account for the parent study’s complex survey design. Findings Twenty-two percent of our sample experienced racial discrimination in a healthcare setting in the past year. Discrimination was more common among those who had ever used MMT (x2 = 10.00, p = 0.001) and racial/ethnic minorities (x2 = 23.15, p<0.001). The interaction effect was much stronger than the main effects of race/ethnicity and MMT status. MMT status (versus no MMT) was positively associated with discrimination among Blacks (aOR = 3.93, 95% CI = 3.87–3.98, p<0.001), Whites (aOR = 2.25, 95% CI = 2.23–2.27, p<0.001), and Latino/Latinas (aOR = 1.59, 95% CI = 1.55–1.62, p<0.001). Among American Indian/Alaska Natives (AI/AN), those who had used MMT had over thirty times the odds of racial discrimination, compared to their non-MMT counterparts (aOR = 32.78, 95% CI = 31.16–34.48, p<0.001). Conclusion Race/ethnicity alone did not sufficiently account for racial discrimination in healthcare settings among those with a lifetime OUD. MMT status was strongly associated with racial discrimination among AI/AN. Our strong interaction effect is indicative of an additional barrier to health services utilization among AI/AN, which has important implications for OUD treatment outcomes and comorbidities. Health promotion programs aimed at increased adoption of MMT are promising, but should be considered in the context of racial/ethnic disparities, drug use and MMT stigma, and implicit biases in clinical settings. }, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Disparities in methadone maintenance therapy (MMT) outcomes have received limited attention, but there are important negative outcomes associated with MMT that warrant investigation. Racial discrimination is common in healthcare settings and affects opioid use disorder (OUD) treatment and comorbidities. However, race/ethnicity alone may not fully explain experiences of discrimination. MMT remains highly stigmatized and may compound the effect of race/ethnicity on discrimination in healthcare settings. We sought to quantify differential associations between MMT and experiences of racial discrimination between racial/ethnic groups in a U.S. national sample. Methods We used the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012–2013) to identify a subset of individuals with a lifetime OUD who had ever used MMT (survey n = 766; weighted population n = 5,276,507). We used multivariable logistic regression to model past-year experience of racial discrimination in a healthcare setting. We included an interaction term between race/ethnicity and MMT status to identify the odds of discrimination (MMT vs. no MMT [referent]) within racial/ethnic groups. We used survey procedures with weights to account for the parent study’s complex survey design. Findings Twenty-two percent of our sample experienced racial discrimination in a healthcare setting in the past year. Discrimination was more common among those who had ever used MMT (x2 = 10.00, p = 0.001) and racial/ethnic minorities (x2 = 23.15, p<0.001). The interaction effect was much stronger than the main effects of race/ethnicity and MMT status. MMT status (versus no MMT) was positively associated with discrimination among Blacks (aOR = 3.93, 95% CI = 3.87–3.98, p<0.001), Whites (aOR = 2.25, 95% CI = 2.23–2.27, p<0.001), and Latino/Latinas (aOR = 1.59, 95% CI = 1.55–1.62, p<0.001). Among American Indian/Alaska Natives (AI/AN), those who had used MMT had over thirty times the odds of racial discrimination, compared to their non-MMT counterparts (aOR = 32.78, 95% CI = 31.16–34.48, p<0.001). Conclusion Race/ethnicity alone did not sufficiently account for racial discrimination in healthcare settings among those with a lifetime OUD. MMT status was strongly associated with racial discrimination among AI/AN. Our strong interaction effect is indicative of an additional barrier to health services utilization among AI/AN, which has important implications for OUD treatment outcomes and comorbidities. Health promotion programs aimed at increased adoption of MMT are promising, but should be considered in the context of racial/ethnic disparities, drug use and MMT stigma, and implicit biases in clinical settings. |
Pro, George; Utter, Jeff; Cram, Jessica; Baldwin, Julie A Journal of Psychoactive Drugs, 2020. @article{Pro2020, title = {Racial/Ethnic and Gender Differences in Associations of Medication-Assisted Therapy and Reduced Opioid Use between Outpatient Treatment Admission and Discharge}, author = {George Pro and Jeff Utter and Jessica Cram and Julie A Baldwin}, doi = {10.1080/02791072.2020.1717685}, year = {2020}, date = {2020-01-31}, journal = {Journal of Psychoactive Drugs}, abstract = {Medication-assisted therapy (MAT) for opioid use disorders is an effective treatment strategy. Racial/ethnic and gender disparities in MAT utilization have been documented, but less is known about disparities in MAT outcomes. We used the Treatment Episodes Dataset–Discharges (TEDS-D; 2015– 2017) to identify outpatient treatment episodes with heroin or illicit opioids indicated at admission (n = 232,547). We used multivariate logistic regression to model the association between MAT and a reduction in opioid use between treatment admission and discharge. We explored moderation by race/ethnicity and gender by including an interaction term. We identified a strong moderating effect of race/ethnicity and gender. American Indian/Alaska Native (AI/AN) women demonstrated the strongest association between MAT (versus no MAT) and a reduction in opioid use (aOR = 6.05, 95% CI = 4.81– 7.61), while White men demonstrated the weakest association (aOR = 2.78, CI = 2.70– 2.87). Our findings could inform changes in clinical MAT settings that are based on harm reduction and the incremental transition from illicit opioids to medication-assistance among a diverse opioid use disorder population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Medication-assisted therapy (MAT) for opioid use disorders is an effective treatment strategy. Racial/ethnic and gender disparities in MAT utilization have been documented, but less is known about disparities in MAT outcomes. We used the Treatment Episodes Dataset–Discharges (TEDS-D; 2015– 2017) to identify outpatient treatment episodes with heroin or illicit opioids indicated at admission (n = 232,547). We used multivariate logistic regression to model the association between MAT and a reduction in opioid use between treatment admission and discharge. We explored moderation by race/ethnicity and gender by including an interaction term. We identified a strong moderating effect of race/ethnicity and gender. American Indian/Alaska Native (AI/AN) women demonstrated the strongest association between MAT (versus no MAT) and a reduction in opioid use (aOR = 6.05, 95% CI = 4.81– 7.61), while White men demonstrated the weakest association (aOR = 2.78, CI = 2.70– 2.87). Our findings could inform changes in clinical MAT settings that are based on harm reduction and the incremental transition from illicit opioids to medication-assistance among a diverse opioid use disorder population. |
Camplain, Ricky; Camplain, Carolyn; II, Robert Trotter T; Pro, George; Sabo, Samantha; Eaves, Emery; Peoples, Marie; Baldwin, Julie A Racial/Ethnic Differences in Drug- and Alcohol-Related Arrest Outcomes in a Southwest County From 2009 to 2018 Journal Article American Journal of Public Health, 110 (51), pp. 585-592, 2020. @article{Camplain2020c, title = {Racial/Ethnic Differences in Drug- and Alcohol-Related Arrest Outcomes in a Southwest County From 2009 to 2018}, author = {Ricky Camplain and Carolyn Camplain and Robert T. Trotter II and George Pro and Samantha Sabo and Emery Eaves and Marie Peoples and Julie A. Baldwin}, url = {https://doi.org/10.2105/AJPH.2019.305409}, doi = {10.2105/AJPH.2019.305409}, year = {2020}, date = {2020-01-22}, journal = {American Journal of Public Health}, volume = {110}, number = {51}, pages = {585-592}, abstract = {More than 60% of criminal justice–involved individuals are racial/ethnic minorities, even though these groups make up just 30% of the US population. Black, Latino, and American Indian/Alaska Native (AI/AN) persons are more likely to be incarcerated compared with White persons, 1–3 and police interactions among racial/ethnic minorities are more likely to result in arrest, even after accounting for arrest decision-making by police. Although it is clear that racial/ethnic minorities are overrepresented in the criminal justice system, it is less clear how outcomes at different points of interactions with the criminal justice system, including entry into the system, prosecution and pretrial services, adjudication, sentencing and sanctions, and corrections,14 differ by race/ethnicity, specifically for drug- and alcohol-related offenses. Thus, we aimed to estimate the association between race/ethnicity and arrest outcomes among individuals arrested for drug- or alcohol-related reasons in a rural Southwest US county (the county) from 2009 to 2018.}, keywords = {}, pubstate = {published}, tppubtype = {article} } More than 60% of criminal justice–involved individuals are racial/ethnic minorities, even though these groups make up just 30% of the US population. Black, Latino, and American Indian/Alaska Native (AI/AN) persons are more likely to be incarcerated compared with White persons, 1–3 and police interactions among racial/ethnic minorities are more likely to result in arrest, even after accounting for arrest decision-making by police. Although it is clear that racial/ethnic minorities are overrepresented in the criminal justice system, it is less clear how outcomes at different points of interactions with the criminal justice system, including entry into the system, prosecution and pretrial services, adjudication, sentencing and sanctions, and corrections,14 differ by race/ethnicity, specifically for drug- and alcohol-related offenses. Thus, we aimed to estimate the association between race/ethnicity and arrest outcomes among individuals arrested for drug- or alcohol-related reasons in a rural Southwest US county (the county) from 2009 to 2018. |
Pro, George; Camplain, Ricky; de Heer, Brooke; Chief, Carmenlita; Teufel-Shone, Nicolette I Journal of Racial and Ethnic Health Disparities, 2020. @article{Pro2020bb, title = {A National Epidemiologic Profile of Physical Intimate Partner Violence, Adverse Childhood Experiences, and Supportive Childhood Relationships: Group Differences in Predicted Trends and Associations}, author = {George Pro and Ricky Camplain and Brooke de Heer and Carmenlita Chief and Nicolette I. Teufel-Shone}, url = {https://doi.org/10.1007/s40615-019-00696-4}, doi = {10.1007/s40615-019-00696-4}, year = {2020}, date = {2020-01-07}, journal = {Journal of Racial and Ethnic Health Disparities}, abstract = {Adverse childhood experiences (ACEs) are common in the USA and associated with multiple health sequelae. Physical intimate partner violence (IPV) is a type of revictimization that some adults with ACEs may be more prone to. Positive and supportive childhood environments may buffer the effects of ACEs, but little is known about the differential associations between physical IPV and ACEs and supportive childhood environments. We sought to illustrate racial/ethnic and gender differences in the adjusted predicted probability of physical IPV across multiple ACE and supportive childhood scores.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Adverse childhood experiences (ACEs) are common in the USA and associated with multiple health sequelae. Physical intimate partner violence (IPV) is a type of revictimization that some adults with ACEs may be more prone to. Positive and supportive childhood environments may buffer the effects of ACEs, but little is known about the differential associations between physical IPV and ACEs and supportive childhood environments. We sought to illustrate racial/ethnic and gender differences in the adjusted predicted probability of physical IPV across multiple ACE and supportive childhood scores. |
Camplain, Ricky ; Pinn, Travis ; Williamson, Heather J; Pro, George ; Becenti, Lyle ; Bret, James ; Luna, Crystal ; Baldwin, Julie A Adaptation of the System for Observing Play and Recreation in Communities (SOPARC) for the Measurement of Physical Activity in Jail Settings Journal Article International Journal of Environmental Research and Public Health, 17 (349), pp. 1-11, 2020. @article{Camplain2020, title = {Adaptation of the System for Observing Play and Recreation in Communities (SOPARC) for the Measurement of Physical Activity in Jail Settings}, author = {Camplain, Ricky and Pinn, Travis and Williamson, Heather J and Pro, George and Becenti, Lyle and Bret, James and Luna, Crystal and Baldwin, Julie A. }, doi = {https://doi.org/10.3390/ijerph17010349}, year = {2020}, date = {2020-01-03}, journal = {International Journal of Environmental Research and Public Health}, volume = {17}, number = {349}, pages = {1-11}, abstract = {Over 9 million people are incarcerated in jail each year, but physical activity has not been assessed among incarcerated populations. Measuring physical activity in the jail setting is complicated as current physical activity measurement tools are not designed for use inside jail facilities. Therefore, we adapted an evidence-based physical activity measurement tool, the System for Observing Play and Recreation in Communities (SOPARC), to assess physical activity within a jail facility. SOPARC was designed to obtain observational information on physical activity of individuals. The study team created a protocol for SOPARC for use in jail facilities. Unlike the original SOPARC, access to recreation time in jail required prior scheduling. Target areas were unnecessary as recreation spaces were enclosed. The adapted SOPARC protocol for jails included start and end times, the number of individuals that attended, and recreation time users’ physical activity levels, footwear, outerwear, uniform color, and use of mobility assistive devices. The use of SOPARC in the jail setting requires adaptation to adequately capture physical activity data among incarcerated individuals. Accurately measuring physical activity among incarcerated individuals and the environment in which they are active may allow for future development and testing of physical activity interventions in jail facilities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Over 9 million people are incarcerated in jail each year, but physical activity has not been assessed among incarcerated populations. Measuring physical activity in the jail setting is complicated as current physical activity measurement tools are not designed for use inside jail facilities. Therefore, we adapted an evidence-based physical activity measurement tool, the System for Observing Play and Recreation in Communities (SOPARC), to assess physical activity within a jail facility. SOPARC was designed to obtain observational information on physical activity of individuals. The study team created a protocol for SOPARC for use in jail facilities. Unlike the original SOPARC, access to recreation time in jail required prior scheduling. Target areas were unnecessary as recreation spaces were enclosed. The adapted SOPARC protocol for jails included start and end times, the number of individuals that attended, and recreation time users’ physical activity levels, footwear, outerwear, uniform color, and use of mobility assistive devices. The use of SOPARC in the jail setting requires adaptation to adequately capture physical activity data among incarcerated individuals. Accurately measuring physical activity among incarcerated individuals and the environment in which they are active may allow for future development and testing of physical activity interventions in jail facilities. |
2019 |
Samantha Sabo Matthew Butler, Kelly McCue Patrick Wightman Vern Pilling Martín Celaya Sara Rumann Evaluation protocol to assess maternal and child health outcomes using administrative data: a community health worker home visiting programme Journal Article BMJ Open, 9 (12), pp. 1–9, 2019. @article{Sabo2019, title = {Evaluation protocol to assess maternal and child health outcomes using administrative data: a community health worker home visiting programme}, author = {Samantha Sabo, Matthew Butler, Kelly McCue, Patrick Wightman, Vern Pilling, Martín Celaya, Sara Rumann}, url = {http://dx.doi.org/10.1136/bmjopen-2019-031780}, doi = {10.1136/bmjopen-2019-031780}, year = {2019}, date = {2019-12-10}, journal = {BMJ Open}, volume = {9}, number = {12}, pages = {1–9}, abstract = {Emerging evidence suggests community health workers (CHWs) delivering preventive maternal and child health (MCH) interventions through home visiting improve several important health outcomes, including initiation of prenatal care, healthy birth weight and uptake of childhood immunizations.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Emerging evidence suggests community health workers (CHWs) delivering preventive maternal and child health (MCH) interventions through home visiting improve several important health outcomes, including initiation of prenatal care, healthy birth weight and uptake of childhood immunizations. |
Behzad Karami Matin Mohammad Kamali, Heather Williamson Fardin Moradi Shahin Solatni J The Predictors of Access to Health Services for People with Disabilities: A Cross Sectional Study in Iranian Context Journal Article Medical Journal of the Islamic Republic of Iran , 33 (125), 2019. @article{Matin2019, title = {The Predictors of Access to Health Services for People with Disabilities: A Cross Sectional Study in Iranian Context}, author = {Behzad Karami Matin, Mohammad Kamali, Heather J. Williamson, Fardin Moradi, Shahin Solatni}, url = {http://mjiri.iums.ac.ir/article-1-5458-en.html}, doi = {10.34171/mjiri.33.125}, year = {2019}, date = {2019-11-23}, journal = {Medical Journal of the Islamic Republic of Iran }, volume = {33}, number = {125}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Rock, Tommy; Camplain, Ricky; Teufel-Shone, Nicolette I; Ingram, Jani C Traditional Sheep Consumption by Navajo People in Cameron, Arizona Journal Article International Journal of Environmental Research and Public Health, 16 (21), pp. 1-13, 2019. @article{Rock2019, title = {Traditional Sheep Consumption by Navajo People in Cameron, Arizona}, author = {Tommy Rock and Ricky Camplain and Nicolette I. Teufel-Shone and Jani C. Ingram}, doi = {10.3390/ijerph16214195 }, year = {2019}, date = {2019-10-30}, journal = { International Journal of Environmental Research and Public Health}, volume = {16}, number = {21}, pages = {1-13}, abstract = {Over 500 abandoned uranium mines are located on the Navajo Reservation. Different pathways of environmental uranium exposure have been studied with respect to the Navajo people including water, soil, and plants; however, uranium exposure from traditional Navajo food, specifically mutton (sheep), has not been reported. This study focuses on mutton consumption in the small community of Cameron, Arizona, located in the southwestern region of the Navajo Nation and initiated after community members expressed concern with the uranium exposure of their sheep. Preliminary investigation into the presence of uranium in sheep raised near Cameron showed elevated uranium levels in the kidneys the sheep tested. The goal of this study is to investigate mutton consumption among the Navajo living in Cameron. Mutton is a traditional food of the Navajo, but consumption practices are not well documented. An important aspect of determining the extent of exposure through food consumption is to assess the frequency of consumption. The results of this study indicate the Cameron participants consume mutton most commonly at family gatherings or celebrations. The survey suggests that less mutton is consumed now compared to the past, and there is concern that contaminated mutton may change traditional ceremonies}, keywords = {}, pubstate = {published}, tppubtype = {article} } Over 500 abandoned uranium mines are located on the Navajo Reservation. Different pathways of environmental uranium exposure have been studied with respect to the Navajo people including water, soil, and plants; however, uranium exposure from traditional Navajo food, specifically mutton (sheep), has not been reported. This study focuses on mutton consumption in the small community of Cameron, Arizona, located in the southwestern region of the Navajo Nation and initiated after community members expressed concern with the uranium exposure of their sheep. Preliminary investigation into the presence of uranium in sheep raised near Cameron showed elevated uranium levels in the kidneys the sheep tested. The goal of this study is to investigate mutton consumption among the Navajo living in Cameron. Mutton is a traditional food of the Navajo, but consumption practices are not well documented. An important aspect of determining the extent of exposure through food consumption is to assess the frequency of consumption. The results of this study indicate the Cameron participants consume mutton most commonly at family gatherings or celebrations. The survey suggests that less mutton is consumed now compared to the past, and there is concern that contaminated mutton may change traditional ceremonies |
Kumar, Amit; Rivera-Hernandez, Maricruz; Karmarkar, Amol M; Chou, Lin-Na; Kuo, Yong-Fang; Baldwin, Julie A; Panagiotou, Orestis A; Burke, Robert; Ottenbacher, Kenneth J Social and Health-Related Factors Associated with Enrollment in Medicare Advantage Plans in Older Adults Journal Article Journal of the American Geriatrics Society, 00 (00), pp. 1-8, 2019. @article{Kumar2019, title = {Social and Health-Related Factors Associated with Enrollment in Medicare Advantage Plans in Older Adults}, author = {Amit Kumar and Maricruz Rivera-Hernandez and Amol M. Karmarkar and Lin-Na Chou and Yong-Fang Kuo and Julie A. Baldwin and Orestis A. Panagiotou and Robert Burke and Kenneth J. Ottenbacher}, url = {https://doi.org/10.1111/jgs.16202}, doi = {10.1111/jgs.16202}, year = {2019}, date = {2019-10-19}, journal = {Journal of the American Geriatrics Society}, volume = {00}, number = {00}, pages = {1-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Eaves, Emery R; Kohlbeck, Bailey S; Camplain, Carolyn Reflexive Challenges in Community Engaged Research in a County Jail Journal Article Practicing Anthropology, 41 (4), pp. 26-30, 2019. @article{Eaves2019b, title = {Reflexive Challenges in Community Engaged Research in a County Jail}, author = {Eaves, Emery R and Kohlbeck, Bailey S and Camplain, Carolyn}, doi = {10.17730/0888-4552.41.4.26}, year = {2019}, date = {2019-10-16}, journal = {Practicing Anthropology}, volume = {41}, number = {4}, pages = {26-30}, abstract = {https://doi.org/10.17730/0888-4552.41.4.26}, keywords = {}, pubstate = {published}, tppubtype = {article} } https://doi.org/10.17730/0888-4552.41.4.26 |
Viacheslav Y. Fofanov Crystal M. Hepp, Jill Hager Cocking ; II, Robert Trotter T Practicing Anthropology, 41 (4), pp. 40-45, 2019. @article{Fofanov2019, title = {Overcoming Institutional, Scientific, and Cross-disciplinary Barriers for Healthcare and Disease Transmission Research in County Jail Settings: Integrating Genomics, Survey Data, and Biological Data Collection Strategies}, author = {Viacheslav Y. Fofanov, Crystal M. Hepp, Jill Hager Cocking, and Robert T. Trotter II }, url = {https://doi.org/10.17730/0888-4552.41.4.40}, doi = {10.17730/0888-4552.41.4.40}, year = {2019}, date = {2019-10-16}, journal = {Practicing Anthropology}, volume = {41}, number = {4}, pages = {40-45}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Fofanov, Viacheslav Y; Trotter, Robert T Organizational and Institutional Compartmentalization as a Barrier to Population Health Journal Article Practicing Anthropology, 41 (4), pp. 35-39, 2019. @article{Fofanov2019b, title = {Organizational and Institutional Compartmentalization as a Barrier to Population Health}, author = {Fofanov, Viacheslav Y. and Trotter, Robert T. }, url = {https://doi.org/10.17730/0888-4552.41.4.35}, doi = {10.17730/0888-4552.41.4.35}, year = {2019}, date = {2019-10-16}, journal = {Practicing Anthropology}, volume = {41}, number = {4}, pages = {35-39}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Camplain, Ricky ; Baldwin, Julie A Commentary: The Search for Health Equity among Individuals Incarcerated in Jail Journal Article Practicing Anthropology, 41 (4), pp. 46-48, 2019. @article{Camplain2019c, title = {Commentary: The Search for Health Equity among Individuals Incarcerated in Jail}, author = {Camplain, Ricky and Baldwin, Julie A. }, url = {https://doi.org/10.17730/0888-4552.41.4.46}, year = {2019}, date = {2019-10-16}, journal = {Practicing Anthropology}, volume = {41}, number = {4}, pages = {46-48}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Schwartz, Margot L; Kosar, Cyrus M; M., Tracy; Kumar, Amit; Rahman, Momotazur Quality of Home Health Agencies Serving Traditional Medicare vs Medicare Advantage Beneficiaries Journal Article Journal of American Medical Association, 2 (9), pp. 1-8, 2019. @article{Schwartz2019, title = {Quality of Home Health Agencies Serving Traditional Medicare vs Medicare Advantage Beneficiaries}, author = {Margot L. Schwartz and Cyrus M. Kosar and Tracy M. and Amit Kumar and Momotazur Rahman}, url = {https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2749236}, doi = {10.1001/jamanetworkopen.2019.10622}, year = {2019}, date = {2019-09-04}, journal = {Journal of American Medical Association}, volume = {2}, number = {9}, pages = {1-8}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Sean D. Rundell and, Linda Resnik ; Heagerty, Patrick J; Kumar, Amit; Jarvik, Jeffrey G Journal of Orthopaedic & Sports Physical Therapy, pp. 1-18, 2019. @article{Rundell2019c, title = {Comparing Performance of Comorbidity Indices in Predicting Functional Status, Health-Related Quality of Life, and Total Health Care Use in Older Adults with Back Pain}, author = {Sean D. Rundell, and, Linda Resnik and Patrick J. Heagerty and Amit Kumar and Jeffrey G. Jarvik}, doi = {10.2519/jospt.2019.8764}, year = {2019}, date = {2019-09-04}, journal = {Journal of Orthopaedic & Sports Physical Therapy}, pages = {1-18}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Williamson, Heather J; Brennan, Alissa C; Tress, Samantha F; Joseph, Darold H; Baldwin, Julie A Exploring Health and Wellness among Native American Adults with Intellectual and/or Developmental Disabilities and Their Family Caregivers Journal Article Journal of Applied Research in Intellectual Disabilities, pp. 1-7, 2019. @article{Williamson2019b, title = {Exploring Health and Wellness among Native American Adults with Intellectual and/or Developmental Disabilities and Their Family Caregivers}, author = {Heather J. Williamson and Alissa C. Brennan and Samantha F. Tress and Darold H. Joseph and Julie A. Baldwin}, url = {https://onlinelibrary.wiley.com/doi/full/10.1111/jar.12664}, doi = {10.1111/jar.12664}, year = {2019}, date = {2019-08-22}, journal = {Journal of Applied Research in Intellectual Disabilities}, pages = {1-7}, abstract = {Background: Adults with intellectual and/or developmental disabilities (IDD) experience health inequities, and those who also identify as a member of an ethnic minority group face additional health inequities. In the United States, a majority of adults with IDD continue to be supported by family caregivers making their health equity also important. The purpose of this study was to explore how Native American adults with IDD and their family caregivers experience health and wellness. Method: This community‐engaged research was guided by a Community Advisory Board (CAB) with study participants completing a photovoice project. Results: Participants identified individual, family and community level influences on health and wellness including the importance of participation in meaningful activities and connection to culture. Conclusions: In order to address health inequities, more research is needed to under‐ stand health and wellness from the unique perspectives of individuals with IDD and those from racial and ethnic minority groups.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background: Adults with intellectual and/or developmental disabilities (IDD) experience health inequities, and those who also identify as a member of an ethnic minority group face additional health inequities. In the United States, a majority of adults with IDD continue to be supported by family caregivers making their health equity also important. The purpose of this study was to explore how Native American adults with IDD and their family caregivers experience health and wellness. Method: This community‐engaged research was guided by a Community Advisory Board (CAB) with study participants completing a photovoice project. Results: Participants identified individual, family and community level influences on health and wellness including the importance of participation in meaningful activities and connection to culture. Conclusions: In order to address health inequities, more research is needed to under‐ stand health and wellness from the unique perspectives of individuals with IDD and those from racial and ethnic minority groups. |
Trotter, Robert T; Camplain, Ricky ; Eaves, Emery R; Fofanov, Viacheslav Y; Dmitrieva, Natalia O; Hepp, Crystal M; Warren, Meghan ; Barrios, Brianna A; Pagel, Nicole ; Mayer, Alyssa ; Baldwin, Julie A Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study Journal Article Journal of Medical Internet Research, 7 (10), 2019. @article{Trotter2019, title = {Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study}, author = {Trotter, Robert T and Camplain, Ricky and Eaves, Emery R and Fofanov, Viacheslav Y and Dmitrieva, Natalia O and Hepp, Crystal M and Warren, Meghan and Barrios, Brianna A and Pagel, Nicole and Mayer, Alyssa and Baldwin, Julie A }, doi = {10.2196/10337}, year = {2019}, date = {2019-08-05}, journal = {Journal of Medical Internet Research}, volume = {7}, number = {10}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Valdez, Elizabeth Salerno; Korchmaros, Josephine; Sabo, Samantha; Garcia, David O; Carvajal, Scott; Stevens, Sally How the U.S.-Mexico border influences adolescent substance use: Youth participatory action research using photovoice Journal Article International Journal of Drug Policy, 2019. @article{Valdez2019b, title = {How the U.S.-Mexico border influences adolescent substance use: Youth participatory action research using photovoice}, author = {Elizabeth Salerno Valdez and Josephine Korchmaros and Samantha Sabo and David O. Garcia and Scott Carvajal and Sally Stevens}, url = {https://www.sciencedirect.com/science/article/pii/S0955395919301896}, doi = {https://doi.org/10.1016/j.drugpo.2019.07.011}, year = {2019}, date = {2019-07-26}, journal = {International Journal of Drug Policy}, abstract = {Introduction The purpose of this study is to use Youth Participatory Action Research (YPAR) methods and Photovoice to identify the perceived environmental factors that influence substance use among adolescents living at the U.S.-Mexico border. Methods One academic and a local youth health coalition engaged in Youth Participatory Action Research (YPAR) using Photovoice and qualitative methods to examine the perceived factors influencing adolescent substance use in their border community. Results Identified novel risk factors for adolescent substance use on the border included the normalization of drug trafficking, normalization of substance use, and cross-border access to substances. Novel protective factors included living in a close-knit binational community and having strong binational family and social support systems. The findings also illustrate a nexus of 'factors' wherein risk and protective elements overlap. Conclusion This study contributes to the broader literature on international border health and how living in a border space influences adolescent substance use. The examination of influential border-bound factors provides a more complete understanding of the experiences of youth living on the U.S.-Mexico border, and informs the field of the importance of considering the border experience for future prevention and risk reduction efforts with border adolescents.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Introduction The purpose of this study is to use Youth Participatory Action Research (YPAR) methods and Photovoice to identify the perceived environmental factors that influence substance use among adolescents living at the U.S.-Mexico border. Methods One academic and a local youth health coalition engaged in Youth Participatory Action Research (YPAR) using Photovoice and qualitative methods to examine the perceived factors influencing adolescent substance use in their border community. Results Identified novel risk factors for adolescent substance use on the border included the normalization of drug trafficking, normalization of substance use, and cross-border access to substances. Novel protective factors included living in a close-knit binational community and having strong binational family and social support systems. The findings also illustrate a nexus of 'factors' wherein risk and protective elements overlap. Conclusion This study contributes to the broader literature on international border health and how living in a border space influences adolescent substance use. The examination of influential border-bound factors provides a more complete understanding of the experiences of youth living on the U.S.-Mexico border, and informs the field of the importance of considering the border experience for future prevention and risk reduction efforts with border adolescents. |
Lemmon, Monica E; Huffstetler, Hanna; Barks, Mary Carol; Kirby, Christine; Katz, Madelaine; Ubel, Peter A; Docherty, Sharron L; Brandon, Debra Neurologic Outcome After Prematurity: Perspectives of Parents and Clinicians. Journal Article American Academy of Pediatrics, 144 (1), 2019. @article{Lemmon2019, title = {Neurologic Outcome After Prematurity: Perspectives of Parents and Clinicians.}, author = {Monica E. Lemmon and Hanna Huffstetler and Mary Carol Barks and Christine Kirby and Madelaine Katz and Peter A. Ubel and Sharron L. Docherty and Debra Brandon}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31248939}, doi = {10.1542/peds.2018-3819}, year = {2019}, date = {2019-07-01}, journal = { American Academy of Pediatrics}, volume = {144}, number = {1}, abstract = {BACKGROUND: Parents and clinicians caring for premature infants face high-stakes and time-sensitive decisions about care. We aimed to characterize how parents and clinicians discuss outcome in the context of decision-making for premature infants. METHODS: In this qualitative descriptive study, we used a case-based, prospective design. Cases of extreme prematurity were targeted. Parents and clinicians completed semistructured interviews about care decisions longitudinally in the first year of life. Interview data were analyzed by using directed content analysis. RESULTS: Sixteen parents and 53 clinicians of 10 infants completed 178 interviews (n = 115 parent; n = 63 clinician). Two primary themes emerged. First, parents and clinicians discussed prognostic information differently from each other. Parents focused on whether their infant would survive, whereas clinicians concentrated on neurologic outcome and the potential for life with disability. Parent discussion of the future was broad and rooted in hope and spirituality. Clinician prognostic language was narrowly focused and probabilistic. Second, we identified barriers and facilitators to a shared understanding of infant outcome. Clinicians perceived that parents were unaware of or unable to process important information about the big picture. Parents valued consistent therapeutic relationships; transitions of care and underused roles of the care team undermined this consistency. Clinical uncertainty forced parents and clinicians to "wait and see" about the future. CONCLUSIONS: Parents and clinicians discuss and weigh information about the future differently from each other as they consider choices for extremely premature infants. Future work should characterize the impact of these differences on prognostic communication and decision-making.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Parents and clinicians caring for premature infants face high-stakes and time-sensitive decisions about care. We aimed to characterize how parents and clinicians discuss outcome in the context of decision-making for premature infants. METHODS: In this qualitative descriptive study, we used a case-based, prospective design. Cases of extreme prematurity were targeted. Parents and clinicians completed semistructured interviews about care decisions longitudinally in the first year of life. Interview data were analyzed by using directed content analysis. RESULTS: Sixteen parents and 53 clinicians of 10 infants completed 178 interviews (n = 115 parent; n = 63 clinician). Two primary themes emerged. First, parents and clinicians discussed prognostic information differently from each other. Parents focused on whether their infant would survive, whereas clinicians concentrated on neurologic outcome and the potential for life with disability. Parent discussion of the future was broad and rooted in hope and spirituality. Clinician prognostic language was narrowly focused and probabilistic. Second, we identified barriers and facilitators to a shared understanding of infant outcome. Clinicians perceived that parents were unaware of or unable to process important information about the big picture. Parents valued consistent therapeutic relationships; transitions of care and underused roles of the care team undermined this consistency. Clinical uncertainty forced parents and clinicians to "wait and see" about the future. CONCLUSIONS: Parents and clinicians discuss and weigh information about the future differently from each other as they consider choices for extremely premature infants. Future work should characterize the impact of these differences on prognostic communication and decision-making. |
Panagiotou, Orestis A; Kumar, Amit; Gutman, Roee; Keohane, Laura M; Rivera-Hernandez, Maricruz; Rahman, Momotazur; Gozalo, Pedro L; Mor, Vincent; Trivedi, Amal N Hospital Readmission Rates in Medicare Advantage and Traditional Medicare: A Retrospective Population-Based Analysis Journal Article Annals of Internal Medicine, 171 (2), pp. 99-106, 2019. @article{Panagiotou2019, title = {Hospital Readmission Rates in Medicare Advantage and Traditional Medicare: A Retrospective Population-Based Analysis}, author = {Orestis A. Panagiotou and Amit Kumar and Roee Gutman and Laura M. Keohane and Maricruz Rivera-Hernandez and Momotazur Rahman and Pedro L. Gozalo and Vincent Mor and Amal N. Trivedi}, url = {https://annals.org/aim/article-abstract/2736919/hospital-readmission-rates-medicare-advantage-traditional-medicare-retrospective-population-based}, doi = {10.7326/M18-1795}, year = {2019}, date = {2019-06-25}, journal = {Annals of Internal Medicine}, volume = {171}, number = {2}, pages = {99-106}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Young, Belinda-Rose; Gwede, Clement K; Thomas, Bria; Vázquez-Otero, Coralia; Ewing, Aldenise; Best, Alicia L; Claudia X. Aguado Loi and, Dinorah Martinez-Tyson ; Schneider, Tali; Meade, Cathy D; Baldwin, Julie A; Bryant, Carol Front Public Health, 2019. @article{Young2019, title = {A Systematic Review of U.S.-Based Colorectal Cancer Screening Uptake Intervention Systematic Reviews: Available Evidence and Lessons Learned for Research and Practice.}, author = {Belinda-Rose Young and Clement K. Gwede and Bria Thomas and Coralia Vázquez-Otero and Aldenise Ewing and Alicia L. Best and Claudia X. Aguado Loi and, Dinorah Martinez-Tyson and Tali Schneider and Cathy D. Meade and Julie A. Baldwin and Carol Bryant}, url = {https://www.ncbi.nlm.nih.gov/pubmed/31245345}, doi = {10.3389/fpubh.2019.00145}, year = {2019}, date = {2019-06-11}, journal = {Front Public Health}, abstract = {Background: We examined colorectal cancer screening (CRCS) intervention effectiveness, through the effect sizes associated with: (1) screening modality, (2) intervention level (e.g., client-directed), and (3) intervention component (e.g. client reminders) within published CRCS intervention systematic reviews (SRs). Methods: A search of peer-reviewed CRCS SRs that were written in English was employed utilizing five databases: CINAHL, Cochrane Library, rTIPS, PubMed, and PsycINFO EBSCOHOST. SRs that included CRCS interventions with a randomized controlled trial, quasi-experimental, or single arm design were eligible. Data on effect sizes by screening modality, intervention level, and intervention component were extracted and synthesized. Results: There were 16 eligible CRCS intervention SRs that included 116 studies published between 1986 and 2013. Reviews organized data by CRCS screening modality, or intervention component. Effect size reporting varied by format (i.e., ranges, medians of multiple studies, or effect size per study), and groupings of modalities and components. Overall, the largest effect sizes were for studies that utilized a combination of colonoscopy, fecal occult blood test (FOBT), and sigmoidoscopy as screening options (16-45 percentage point difference). Conclusions: Evidence suggests that CRCS interventions which include a combination of screening modalities may be most effective. This is the first SR to examine effect sizes of published CRCS SRs. However, because some SRs did not report effect sizes and there were tremendous variability reporting formats among those that did, a standard reporting format is warranted. Synthesizing findings can contribute to improved knowledge of evidence-based best-practices, direct translation of findings into policy and practice, and guide further research in CRCS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background: We examined colorectal cancer screening (CRCS) intervention effectiveness, through the effect sizes associated with: (1) screening modality, (2) intervention level (e.g., client-directed), and (3) intervention component (e.g. client reminders) within published CRCS intervention systematic reviews (SRs). Methods: A search of peer-reviewed CRCS SRs that were written in English was employed utilizing five databases: CINAHL, Cochrane Library, rTIPS, PubMed, and PsycINFO EBSCOHOST. SRs that included CRCS interventions with a randomized controlled trial, quasi-experimental, or single arm design were eligible. Data on effect sizes by screening modality, intervention level, and intervention component were extracted and synthesized. Results: There were 16 eligible CRCS intervention SRs that included 116 studies published between 1986 and 2013. Reviews organized data by CRCS screening modality, or intervention component. Effect size reporting varied by format (i.e., ranges, medians of multiple studies, or effect size per study), and groupings of modalities and components. Overall, the largest effect sizes were for studies that utilized a combination of colonoscopy, fecal occult blood test (FOBT), and sigmoidoscopy as screening options (16-45 percentage point difference). Conclusions: Evidence suggests that CRCS interventions which include a combination of screening modalities may be most effective. This is the first SR to examine effect sizes of published CRCS SRs. However, because some SRs did not report effect sizes and there were tremendous variability reporting formats among those that did, a standard reporting format is warranted. Synthesizing findings can contribute to improved knowledge of evidence-based best-practices, direct translation of findings into policy and practice, and guide further research in CRCS. |
Lam, Felix; Pro, George; Agrawal, Shreya; Shastri, Vishal Dev; Wentworth, Leslie; Stanley, Melinda; Beri, Nitin; Tupe, Abhishek; Mishra, Ashutosh; Subramaniam, Hamsa; Schroder, Kate; Prescott, Marta Rose; Trikha, Naresh Journal of Global Health, 9 (1), 2019. @article{Lam2019, title = {Effect of enhanced detailing and mass media on community use of oral rehydration salts and zinc during a scale-up program in Gujarat and Uttar Pradesh.}, author = {Felix Lam and George Pro and Shreya Agrawal and Vishal Dev Shastri and Leslie Wentworth and Melinda Stanley and Nitin Beri and Abhishek Tupe and Ashutosh Mishra and Hamsa Subramaniam and Kate Schroder and Marta Rose Prescott and Naresh Trikha}, url = {https://www.ncbi.nlm.nih.gov/pubmed/30546870}, doi = {10.7189/jogh.09.010501}, year = {2019}, date = {2019-06-09}, journal = {Journal of Global Health}, volume = {9}, number = {1}, abstract = {Background: The Clinton Health Access Initiative implemented a program from 2012-2016 to increase use of oral rehydration salts (ORS) and zinc to treat diarrhea in children under five in three states in India: Gujarat, Madhya Pradesh, and Uttar Pradesh. The program interventions included detailing and development of a rural supply chain to reach private rural health care providers, training of Accredited Social Health Activists (ASHAs), technical support to the state governments, and a mass media campaign targeted at caregivers. In Gujarat and Uttar Pradesh, some of the program activities, such as detailing and ASHA trainings, were targeted to high-burden focal districts, thus providing an opportunity to study their effect compared to statewide activities that covered all districts, such as the mass media campaign. Our study aimed to estimate the effect of activities on ORS and zinc use. Methods: Household surveys were conducted at two points during the program and in both focal and non-focal districts. We used a difference-in-difference quasi-experimental approach to estimate the effect of the enhanced activities in focal districts and mass media campaign on the odds of a child being treated with ORS and zinc. Findings: Focal district interventions were associated with a significant increase in the odds of a diarrhea episode receiving ORS in Gujarat and Uttar Pradesh. Living in focal districts increased the odds of receiving ORS in Gujarat and Uttar Pradesh by factors of 3.42 (95% CI = 1.39-8.33) and 2.29 (95% CI = 1.19-4.39), respectively. Focal district interventions were also associated with 15.02 (95% CI = 2.97-75.19) greater odds of receiving both ORS and zinc in Gujarat. In Uttar Pradesh, where the mass media campaign was focused, exposure to the campaign further modified the odds of receiving ORS and combined ORS and zinc by 1.38 (95% CI = 1.04-1.84) and 1.57 (95% CI = 1.01-2.46), respectively. Conclusion: Comprehensive public and private provider interventions combined with mass media are effective strategies for increasing ORS and zinc use.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background: The Clinton Health Access Initiative implemented a program from 2012-2016 to increase use of oral rehydration salts (ORS) and zinc to treat diarrhea in children under five in three states in India: Gujarat, Madhya Pradesh, and Uttar Pradesh. The program interventions included detailing and development of a rural supply chain to reach private rural health care providers, training of Accredited Social Health Activists (ASHAs), technical support to the state governments, and a mass media campaign targeted at caregivers. In Gujarat and Uttar Pradesh, some of the program activities, such as detailing and ASHA trainings, were targeted to high-burden focal districts, thus providing an opportunity to study their effect compared to statewide activities that covered all districts, such as the mass media campaign. Our study aimed to estimate the effect of activities on ORS and zinc use. Methods: Household surveys were conducted at two points during the program and in both focal and non-focal districts. We used a difference-in-difference quasi-experimental approach to estimate the effect of the enhanced activities in focal districts and mass media campaign on the odds of a child being treated with ORS and zinc. Findings: Focal district interventions were associated with a significant increase in the odds of a diarrhea episode receiving ORS in Gujarat and Uttar Pradesh. Living in focal districts increased the odds of receiving ORS in Gujarat and Uttar Pradesh by factors of 3.42 (95% CI = 1.39-8.33) and 2.29 (95% CI = 1.19-4.39), respectively. Focal district interventions were also associated with 15.02 (95% CI = 2.97-75.19) greater odds of receiving both ORS and zinc in Gujarat. In Uttar Pradesh, where the mass media campaign was focused, exposure to the campaign further modified the odds of receiving ORS and combined ORS and zinc by 1.38 (95% CI = 1.04-1.84) and 1.57 (95% CI = 1.01-2.46), respectively. Conclusion: Comprehensive public and private provider interventions combined with mass media are effective strategies for increasing ORS and zinc use. |
Camplain, Ricky; Baldwin, Julie A; Warren, Meghan; Camplain, Carolyn Physical Activity in People Who Are Incarcerated: A Social Justice Issue Journal Article Journal of Physical Activity and Health, 16 (5), pp. 306-307, 2019. @article{Camplain2019, title = {Physical Activity in People Who Are Incarcerated: A Social Justice Issue}, author = {Ricky Camplain and Julie A Baldwin and Meghan Warren and Carolyn Camplain}, url = {https://journals.humankinetics.com/doi/full/10.1123/jpah.2019-0055}, year = {2019}, date = {2019-05-05}, journal = {Journal of Physical Activity and Health}, volume = {16}, number = {5}, pages = {306-307}, abstract = {Every year, approximately 12 million Americans cycle in and out of jail (ie, short-term facilities that hold individuals awaiting trial and/or sentenced to a term of less than 1 y).1 Although jails allow incarcerated individuals’ recreation time to engage in physical activity,2 it is not clear to what extent these opportunities are utilized. This potential lack of engagement in physical activity is concerning, especially as some of the benefits of physical activity are immediate and may improve the day-to-day life for those who are incarcerated. For example, a single bout of moderate to vigorous physical activity will reduce blood pressure, improve insulin sensitivity, improve sleep and cognition, and reduce symptoms of anxiety symptoms and anger.3 Unfortunately, use of recreation time in the jail setting has not been described previously, thereby precluding an important area for policy intervention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Every year, approximately 12 million Americans cycle in and out of jail (ie, short-term facilities that hold individuals awaiting trial and/or sentenced to a term of less than 1 y).1 Although jails allow incarcerated individuals’ recreation time to engage in physical activity,2 it is not clear to what extent these opportunities are utilized. This potential lack of engagement in physical activity is concerning, especially as some of the benefits of physical activity are immediate and may improve the day-to-day life for those who are incarcerated. For example, a single bout of moderate to vigorous physical activity will reduce blood pressure, improve insulin sensitivity, improve sleep and cognition, and reduce symptoms of anxiety symptoms and anger.3 Unfortunately, use of recreation time in the jail setting has not been described previously, thereby precluding an important area for policy intervention. |
A, Kumar; D, Adhikari; A, Karmarkar; J, Freburger; P, Gozalo; V, Mor; L, Resnik Variation in Hospital-Based Rehabilitation Services Among Patients With Ischemic Stroke in the United States Journal Article Physical Therapy, 99 (5), pp. 494-506, 2019. @article{A2019b, title = {Variation in Hospital-Based Rehabilitation Services Among Patients With Ischemic Stroke in the United States}, author = {Kumar A and Adhikari D and Karmarkar A and Freburger J and Gozalo P and Mor V and Resnik L }, url = {https://www.ncbi.nlm.nih.gov/pubmed/31089705}, doi = {10.1093/ptj/pzz014}, year = {2019}, date = {2019-05-01}, journal = {Physical Therapy}, volume = {99}, number = {5}, pages = {494-506}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Camplain, Ricky; Warren, Meghan; Baldwin, Julie; Camplain, Carolyn; Fofanov, Viacheslav Y; Trotter, Robert T Epidemiology of incarceration Characterizing jail incarceration for public health research Journal Article Epidemiology, 2019. @article{Camplain2019b, title = {Epidemiology of incarceration Characterizing jail incarceration for public health research}, author = {Ricky Camplain and Meghan Warren and Julie Baldwin and Carolyn Camplain and Viacheslav Y Fofanov and Robert T Trotter}, url = {https://journals.lww.com/epidem/Abstract/publishahead/Epidemiology_of_incarceration__Characterizing_jail.98558.aspx}, year = {2019}, date = {2019-04-08}, journal = {Epidemiology}, abstract = {Background: Each year, 9 million individuals cycle in and out of jails. The under-characterization of incarceration as an exposure poses substantial challenges to understanding how varying levels of exposure to jail may affect health. Thus, we characterized levels of jail incarceration including recidivism, number of incarcerations, total and average number of days incarcerated, and time to re-incarceration. Methods: We created a cohort of 75,203 individuals incarcerated at the Coconino County Detention Facility in Flagstaff, Arizona, from 2001-2018 from jail intake and release records. Results: The median number of incarcerations during the study period was 1 (Interquartile range (IQR) 1, 2). Forty percent of individuals had >1 incarceration. The median length of stay for first observed incarcerations was 1 day (IQR 0, 5). The median total days incarcerated was 3 (IQR 1, 23). Average length of stay increased by number of incarcerations. By 18 months, 27% of our sample had been re-incarcerated. Conclusion: Characteristics of jail incarceration have been largely left out of public health research. A better understanding of jail incarcerations can help design analyses to assess health outcomes of individuals incarcerated in jail. Our study is an early step in shaping an understanding of jail incarceration as an exposure for future epidemiologic research.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background: Each year, 9 million individuals cycle in and out of jails. The under-characterization of incarceration as an exposure poses substantial challenges to understanding how varying levels of exposure to jail may affect health. Thus, we characterized levels of jail incarceration including recidivism, number of incarcerations, total and average number of days incarcerated, and time to re-incarceration. Methods: We created a cohort of 75,203 individuals incarcerated at the Coconino County Detention Facility in Flagstaff, Arizona, from 2001-2018 from jail intake and release records. Results: The median number of incarcerations during the study period was 1 (Interquartile range (IQR) 1, 2). Forty percent of individuals had >1 incarceration. The median length of stay for first observed incarcerations was 1 day (IQR 0, 5). The median total days incarcerated was 3 (IQR 1, 23). Average length of stay increased by number of incarcerations. By 18 months, 27% of our sample had been re-incarcerated. Conclusion: Characteristics of jail incarceration have been largely left out of public health research. A better understanding of jail incarcerations can help design analyses to assess health outcomes of individuals incarcerated in jail. Our study is an early step in shaping an understanding of jail incarceration as an exposure for future epidemiologic research. |
Gilbert, Paul A; Pro, George; Zemore, Sarah E; Mulia, Nina; Brown, Grant Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample. Journal Article Alcoholism: clinical and experimental research, 2019. @article{Gilbert2019, title = {Gender Differences in Use of Alcohol Treatment Services and Reasons for Nonuse in a National Sample.}, author = {Paul A. Gilbert and George Pro and Sarah E. Zemore and Nina Mulia and Grant Brown}, url = {https://www.ncbi.nlm.nih.gov/pubmed/30807660}, doi = { 10.1111/acer.13965}, year = {2019}, date = {2019-04-01}, journal = {Alcoholism: clinical and experimental research}, abstract = {BACKGROUND: The majority of adults with alcohol use disorders do not obtain help, and women are less likely to utilize alcohol services than men. We sought to quantify gender differences in alcohol services utilization, overall and by type, using national longitudinal data and to explore potential gender differences in perceived need for help and reasons for not seeking help. METHODS: We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions from White, African American, and Hispanic adults (n = 2,592) who met DSM-IV criteria for alcohol abuse or dependence at Wave 1 (2000 to 2001). We tested gender differences in Wave 2 (2004 to 2005) services utilization, perceived need for help, and treatment barriers using Rao-Scott chi-square tests and assessed predictors of outcomes in multivariable logistic regression, adjusting for problem severity, co-occurring disorders, and demographics. RESULTS: Women had much lower odds than men of utilizing any alcohol service (adjusted odds ratio [aOR] 0.53; 95% confidence interval [95% CI]: 0.33, 0.86), specialty services (aOR 0.41; 95% CI 0.19, 0.87), and 12-step groups (aOR 0.39; 95% CI 0.21, 0.71). Perceived need for help among those who had not used any services was very low (5%), with no gender difference. Further, men and women reported equivalent numbers of treatment barriers and the same rank order for the most frequently endorsed barriers. However, women were twice as likely as men to think a problem would get better by itself-the most frequent reason for not seeking help (47% vs. 24%, p < 0.001), and men were more likely than women to report unsuccessful past help-seeking and not thinking anyone could help (19% vs. 3%, p < 0.001 and 17% vs. 5%, p = 0.001, respectively). CONCLUSIONS: Consistent with previous studies, women were less likely to utilize alcohol services than men. Future interventions should address low problem recognition, and tailoring to gender-specific barriers may help close the disparity in services utilization.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: The majority of adults with alcohol use disorders do not obtain help, and women are less likely to utilize alcohol services than men. We sought to quantify gender differences in alcohol services utilization, overall and by type, using national longitudinal data and to explore potential gender differences in perceived need for help and reasons for not seeking help. METHODS: We analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions from White, African American, and Hispanic adults (n = 2,592) who met DSM-IV criteria for alcohol abuse or dependence at Wave 1 (2000 to 2001). We tested gender differences in Wave 2 (2004 to 2005) services utilization, perceived need for help, and treatment barriers using Rao-Scott chi-square tests and assessed predictors of outcomes in multivariable logistic regression, adjusting for problem severity, co-occurring disorders, and demographics. RESULTS: Women had much lower odds than men of utilizing any alcohol service (adjusted odds ratio [aOR] 0.53; 95% confidence interval [95% CI]: 0.33, 0.86), specialty services (aOR 0.41; 95% CI 0.19, 0.87), and 12-step groups (aOR 0.39; 95% CI 0.21, 0.71). Perceived need for help among those who had not used any services was very low (5%), with no gender difference. Further, men and women reported equivalent numbers of treatment barriers and the same rank order for the most frequently endorsed barriers. However, women were twice as likely as men to think a problem would get better by itself-the most frequent reason for not seeking help (47% vs. 24%, p < 0.001), and men were more likely than women to report unsuccessful past help-seeking and not thinking anyone could help (19% vs. 3%, p < 0.001 and 17% vs. 5%, p = 0.001, respectively). CONCLUSIONS: Consistent with previous studies, women were less likely to utilize alcohol services than men. Future interventions should address low problem recognition, and tailoring to gender-specific barriers may help close the disparity in services utilization. |
Manda-Taylor, Lucinda; Liomba, Alice; Taylor, Terrie E; Elwell, Kristan Barriers and Facilitators to Obtaining Informed Consent in a Critical Care Pediatric Research Ward in Southern Malawi Journal Article Journal of Empirical Research on Human Research Ethics, 14 (2), pp. 152-168 , 2019. @article{Manda-Taylor2019, title = {Barriers and Facilitators to Obtaining Informed Consent in a Critical Care Pediatric Research Ward in Southern Malawi }, author = {Lucinda Manda-Taylor and Alice Liomba and Terrie E. Taylor and Kristan Elwell}, url = {https://journals.sagepub.com/doi/full/10.1177/1556264619830859}, doi = {https://doi.org/10.1177/1556264619830859}, year = {2019}, date = {2019-03-19}, journal = {Journal of Empirical Research on Human Research Ethics}, volume = {14}, number = {2}, pages = {152-168 }, abstract = {Informed consent is an ethical requirement in clinical research. Obtaining informed consent is challenging in resource-constrained settings. We report results of a formative qualitative study that examined factors that facilitate and hinder informed consent for clinical research among critically ill children in Malawi. We argue that truly informed consent in a pediatric intensive care unit (PICU) is challenged by parental distress, time constraints when balancing care for critically ill patients with research-related tasks, and social hierarchies and community mistrust toward certain research procedures. We interviewed health care providers and parents of children attending a critical care unit to identify potential challenges and solicit strategies for addressing them. Providers and caregivers suggested practical solutions to enhance research participant understanding of clinical trial research, including the use of visual materials, community engagement strategies, and using patients as advocates in promoting understanding of research procedures.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Informed consent is an ethical requirement in clinical research. Obtaining informed consent is challenging in resource-constrained settings. We report results of a formative qualitative study that examined factors that facilitate and hinder informed consent for clinical research among critically ill children in Malawi. We argue that truly informed consent in a pediatric intensive care unit (PICU) is challenged by parental distress, time constraints when balancing care for critically ill patients with research-related tasks, and social hierarchies and community mistrust toward certain research procedures. We interviewed health care providers and parents of children attending a critical care unit to identify potential challenges and solicit strategies for addressing them. Providers and caregivers suggested practical solutions to enhance research participant understanding of clinical trial research, including the use of visual materials, community engagement strategies, and using patients as advocates in promoting understanding of research procedures. |
Williamson, Heather J; Fisher, Kim W; Madhavni, Devanshi; Talarico, Lori Inclusion, 7 (1), pp. 24-40, 2019. @article{Williamson2019, title = {#ADA25 Campaign: Using Social Media to Promote Participation, Social Inclusion, and Civic Engagement of People With Intellectual and Developmental Disabilities}, author = {Heather J Williamson and Kim W Fisher and Devanshi Madhavni and Lori Talarico}, url = {https://www.mdpi.com/1660-4601/16/1/44}, doi = {10.3390/ijerph16010044}, year = {2019}, date = {2019-03-01}, journal = {Inclusion}, volume = {7}, number = {1}, pages = {24-40}, abstract = {Social media is used for civic engagement and building social inclusion. Twitter is one social media tool that facilitates conversations on important societal events. A digital divide between the general population and people with intellectual and developmental disabilities (IDD) remains. Given the divide, we sought to understand the inclusion of the community of people with IDD in the conversations around the 25th anniversary of the Americans with Disabilities Act of 1990 (ADA). We conducted a content analysis of tweets associated with the anniversary and few tweets referenced the community of people with IDD. Our findings suggest that people with IDD are not included in larger civic conversations. Implications include targeted social media training for people with IDD and their support networks.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Social media is used for civic engagement and building social inclusion. Twitter is one social media tool that facilitates conversations on important societal events. A digital divide between the general population and people with intellectual and developmental disabilities (IDD) remains. Given the divide, we sought to understand the inclusion of the community of people with IDD in the conversations around the 25th anniversary of the Americans with Disabilities Act of 1990 (ADA). We conducted a content analysis of tweets associated with the anniversary and few tweets referenced the community of people with IDD. Our findings suggest that people with IDD are not included in larger civic conversations. Implications include targeted social media training for people with IDD and their support networks. |
Dunn, Dorothy J; Schwartz, Anna; Teufel-Shone, Nicolette I; Meyer, Linda A Visions: The Journal of Rogerian Scholar Science, 25 (2), pp. 16, 2019. @article{Dunn2019, title = {Educational Program to Build Resilience for Caregivers, Family Members, and Community Members in the Care of Elder Native Americans who are Experiencing Memory Loss and Cognitive Decline}, author = {Dorothy J Dunn and Anna Schwartz and Nicolette I. Teufel-Shone and Linda A. Meyer }, url = {https://www.societyofrogerianscholars.org/uploads/9/1/7/2/91724284/visions_2019_vol_25_issue_2.pdf}, year = {2019}, date = {2019-03-01}, journal = {Visions: The Journal of Rogerian Scholar Science}, volume = {25}, number = {2}, pages = {16}, abstract = {Partnering with Adopt-A-Native-Elder Program (ANE) afforded the opportunity for tribal and academic partners to explore the role of resilience in contributing positive health outcomes in the Navajo communities who are experience memory loss, cognitive decline, and/or dementia as they age. The purpose of this project was to provide an educational program to build and nurture resilience for caregivers and their Navajo Elder‘s in a manner to maintain their traditional spirit and cultural lifestyle. Using a community-based participatory framework grounded through the lens of compassion energy with ANE and focusing on Navajo Elder’s and their caregivers for this project allowed for a better sense of how caregiving for Native Elders with memory loss and cognitive decline is manifested and experienced.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Partnering with Adopt-A-Native-Elder Program (ANE) afforded the opportunity for tribal and academic partners to explore the role of resilience in contributing positive health outcomes in the Navajo communities who are experience memory loss, cognitive decline, and/or dementia as they age. The purpose of this project was to provide an educational program to build and nurture resilience for caregivers and their Navajo Elder‘s in a manner to maintain their traditional spirit and cultural lifestyle. Using a community-based participatory framework grounded through the lens of compassion energy with ANE and focusing on Navajo Elder’s and their caregivers for this project allowed for a better sense of how caregiving for Native Elders with memory loss and cognitive decline is manifested and experienced. |
Hulen, Elizabeth; Hardy, Lisa J; Teufel-Shone, Nicolette; Sanderson, Priscilla R; Schwartz, Anna L; Begay, Cruz R Community Based Participatory Research (CBPR): A Dynamic Process of Health care, Provider Perceptions and American Indian Patients' Resilience Journal Article Journal of Health Care for the Poor and Underserved, 30 (1), pp. 221-237, 2019. @article{Hulen2019, title = {Community Based Participatory Research (CBPR): A Dynamic Process of Health care, Provider Perceptions and American Indian Patients' Resilience}, author = {Elizabeth Hulen and Lisa J Hardy and Nicolette Teufel-Shone and Priscilla R Sanderson and Anna L Schwartz and Cruz R Begay}, url = {https://muse.jhu.edu/article/717742}, year = {2019}, date = {2019-02-01}, journal = {Journal of Health Care for the Poor and Underserved}, volume = {30}, number = {1}, pages = {221-237}, abstract = {American Indians are disproportionately affected by factors that lead to health disparities, however many Native people demonstrate resilience when faced with health risks. Study objectives were to use a resilience framework to identify wellness strategies among American Indian people and to assess health care provider perceptions of American Indian wellness. Participants included 39 American Indian adults who self-reported resilient change and 22 health care providers who served American Indian patients. Thematic categories across American Indian and health care provider data were identified: 1) relationships inform resilience; 2) prejudice stymies resilience; and 3) place shapes resilience. Results indicated the salience of relationships in demonstrating resilience. Identified challenges and supporters of resilience are discussed.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indians are disproportionately affected by factors that lead to health disparities, however many Native people demonstrate resilience when faced with health risks. Study objectives were to use a resilience framework to identify wellness strategies among American Indian people and to assess health care provider perceptions of American Indian wellness. Participants included 39 American Indian adults who self-reported resilient change and 22 health care providers who served American Indian patients. Thematic categories across American Indian and health care provider data were identified: 1) relationships inform resilience; 2) prejudice stymies resilience; and 3) place shapes resilience. Results indicated the salience of relationships in demonstrating resilience. Identified challenges and supporters of resilience are discussed. |
Cordova-Marks, Felina M; Harris, Robin; Teufel-Shone, Nicolette I; Norton, Beatrice; Mastergeorge, Ann M; Gerald, Lynn Characteristics of American Indian Female Caregivers on a Southwest American Indian Reservation Journal Article Journal of Community Health, 44 (1), pp. 52-60, 2019. @article{Cordova-Marks2019, title = {Characteristics of American Indian Female Caregivers on a Southwest American Indian Reservation}, author = {Felina M Cordova-Marks and Robin Harris and Nicolette I Teufel-Shone and Beatrice Norton and Ann M Mastergeorge and Lynn Gerald}, url = {https://link.springer.com/article/10.1007/s10900-018-0552-7}, year = {2019}, date = {2019-02-01}, journal = {Journal of Community Health}, volume = {44}, number = {1}, pages = {52-60}, abstract = {American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress.}, keywords = {}, pubstate = {published}, tppubtype = {article} } American Indian (AI) caregivers have been excluded from national survey efforts. Drawing from a 2012 survey administered on the Hopi Reservation in northern Arizona, 20% of adults are caregivers. More information is needed to guide program development tailored to Hopi needs. In a University-Community collaboration, a 58 question survey was administered to self-identified caregivers of a family member about amount and type of care provided, difficulties, caregiver health, and desired support services. Characteristics of caregivers and their experiences were described. Forty-four (44) female Hopi caregivers were interviewed from June–October 2017, mean age of 59 years (± 12.6) with mean 5.5 year (± 4.4) history of providing care. Over 84% provided care to either a parent or grandparent. Most caregivers provided transportation (93.2%), housework (93.2%), and medical related care (72.7%). Caregivers stated they had difficulties with not having enough time for family and or friends (88.6%), financial burdens (75.0%), and not having enough time for themselves (61.4%). The most frequently identified difficulty was stress (45.5%). Caregivers would like additional services, with 76.7% asking for training. Over 77% would not consider placing their relative in an assisted living facility. Compared to national data, Hopi female caregivers are older, provide more care hours/week, more caregiving duties, and for a longer number of years. Stress is the most reported difficulty, although lower than national levels. As caregivers are resistant to placing the recipient in assisted living, educational efforts should focus on training caregivers to assist the care recipient and decreasing caregiver stress. |
Davis, Kelly J; Green, Robert C; Kirby, Christine; McGuire, Amy L; Richardson, Ian J; Ubel, Peter A; Vassy, Jason How Primary Care Providers Talk to Patients about Genome Sequencing Results: Risk, Rationale, and Recommendation Journal Article Journal of General Internal Medicine, 33 (6), pp. 877-885, 2019. @article{Davis2019, title = {How Primary Care Providers Talk to Patients about Genome Sequencing Results: Risk, Rationale, and Recommendation}, author = {J. Kelly Davis and Robert C. Green and Christine Kirby and Amy L. McGuire and Ian J. Richardson and Peter A. Ubel and Jason Vassy}, url = {https://www.ncbi.nlm.nih.gov/pubmed/29374360}, doi = {10.1007/s11606-017-4295-4}, year = {2019}, date = {2019-01-26}, journal = {Journal of General Internal Medicine}, volume = {33}, number = {6}, pages = {877-885}, abstract = {BACKGROUND: Genomics will play an increasingly prominent role in clinical medicine. OBJECTIVE: To describe how primary care physicians (PCPs) discuss and make clinical recommendations about genome sequencing results. DESIGN: Qualitative analysis. PARTICIPANTS: PCPs and their generally healthy patients undergoing genome sequencing. APPROACH: Patients received clinical genome reports that included four categories of results: monogenic disease risk variants (if present), carrier status, five pharmacogenetics results, and polygenic risk estimates for eight cardiometabolic traits. Patients' office visits with their PCPs were audio-recorded, and summative content analysis was used to describe how PCPs discussed genomic results. KEY RESULTS: For each genomic result discussed in 48 PCP-patient visits, we identified a "take-home" message (recommendation), categorized as continuing current management, further treatment, further evaluation, behavior change, remembering for future care, or sharing with family members. We analyzed how PCPs came to each recommendation by identifying 1) how they described the risk or importance of the given result and 2) the rationale they gave for translating that risk into a specific recommendation. Quantitative analysis showed that continuing current management was the most commonly coded recommendation across results overall (492/749, 66%) and for each individual result type except monogenic disease risk results. Pharmacogenetics was the most common result type to prompt a recommendation to remember for future care (94/119, 79%); carrier status was the most common type prompting a recommendation to share with family members (45/54, 83%); and polygenic results were the most common type prompting a behavior change recommendation (55/58, 95%). One-fifth of recommendation codes associated with monogenic results were for further evaluation (6/24, 25%). Rationales for these recommendations included patient context, family context, and scientific/clinical limitations of sequencing. CONCLUSIONS: PCPs distinguish substantive differences among categories of genome sequencing results and use clinical judgment to justify continuing current management in generally healthy patients with genomic results.}, keywords = {}, pubstate = {published}, tppubtype = {article} } BACKGROUND: Genomics will play an increasingly prominent role in clinical medicine. OBJECTIVE: To describe how primary care physicians (PCPs) discuss and make clinical recommendations about genome sequencing results. DESIGN: Qualitative analysis. PARTICIPANTS: PCPs and their generally healthy patients undergoing genome sequencing. APPROACH: Patients received clinical genome reports that included four categories of results: monogenic disease risk variants (if present), carrier status, five pharmacogenetics results, and polygenic risk estimates for eight cardiometabolic traits. Patients' office visits with their PCPs were audio-recorded, and summative content analysis was used to describe how PCPs discussed genomic results. KEY RESULTS: For each genomic result discussed in 48 PCP-patient visits, we identified a "take-home" message (recommendation), categorized as continuing current management, further treatment, further evaluation, behavior change, remembering for future care, or sharing with family members. We analyzed how PCPs came to each recommendation by identifying 1) how they described the risk or importance of the given result and 2) the rationale they gave for translating that risk into a specific recommendation. Quantitative analysis showed that continuing current management was the most commonly coded recommendation across results overall (492/749, 66%) and for each individual result type except monogenic disease risk results. Pharmacogenetics was the most common result type to prompt a recommendation to remember for future care (94/119, 79%); carrier status was the most common type prompting a recommendation to share with family members (45/54, 83%); and polygenic results were the most common type prompting a behavior change recommendation (55/58, 95%). One-fifth of recommendation codes associated with monogenic results were for further evaluation (6/24, 25%). Rationales for these recommendations included patient context, family context, and scientific/clinical limitations of sequencing. CONCLUSIONS: PCPs distinguish substantive differences among categories of genome sequencing results and use clinical judgment to justify continuing current management in generally healthy patients with genomic results. |
A, Kumar; L, Resnik; Karmarkar A, Freburger J; D, Adhikari; V, Mor; P, Gozalo Use of Hospital-Based Rehabilitation Services and Hospital Readmission Following Ischemic Stroke in the United States Journal Article Archives of Physical Medicine Rehabilitation, 100 (7), pp. 1218-1225, 2019. @article{A2019, title = {Use of Hospital-Based Rehabilitation Services and Hospital Readmission Following Ischemic Stroke in the United States}, author = {Kumar A and Resnik L and Karmarkar A, Freburger J and Adhikari D and Mor V and Gozalo P}, url = {https://www.ncbi.nlm.nih.gov/pubmed/30684485}, doi = {10.1016/j.apmr.2018.12.028}, year = {2019}, date = {2019-01-24}, journal = {Archives of Physical Medicine Rehabilitation}, volume = {100}, number = {7}, pages = {1218-1225}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Wilson, Jamie; Sabo, Samantha; Chief, Carmenlita; Clark, Hershel; Yazzie, Alfred; Nahee, Jacqueline; Leischow, Scott; Henderson, Patricia Nez DINÉ (NAVAJO) HEALER PERSPECTIVES ON COMMERCIAL TOBACCO USE IN CEREMONIAL SETTINGS: AN ORAL STORY PROJECT TO PROMOTE SMOKE-FREE LIFE Journal Article American Indian and Alaska Native Mental Health Research, 26 (1), pp. 63-78, 2019. @article{Wilson2019, title = {DINÉ (NAVAJO) HEALER PERSPECTIVES ON COMMERCIAL TOBACCO USE IN CEREMONIAL SETTINGS: AN ORAL STORY PROJECT TO PROMOTE SMOKE-FREE LIFE}, author = {Jamie Wilson and Samantha Sabo and Carmenlita Chief and Hershel Clark and Alfred Yazzie and Jacqueline Nahee and Scott Leischow and Patricia Nez Henderson}, url = {http://www.ucdenver.edu/academics/colleges/PublicHealth/research/centers/CAIANH/journal/Documents/Volume-26/26_1_2019_63_wilson.pdf}, year = {2019}, date = {2019-01-01}, journal = {American Indian and Alaska Native Mental Health Research}, volume = {26}, number = {1}, pages = {63-78}, abstract = {Many American Indian (AI) healers are faced with a dilemma of how to maintain the ceremonial uses of traditional tobacco meant to encourage the restoration and balance of mind, body, and spirit, while discouraging commercial tobacco use and protecting against secondhand smoke exposure in ceremonial settings. To explore this dilemma and offer culturally informed solutions, researchers conducted qualitative interviews with Navajo healers who describe the history and role of commercial tobacco within ceremonial contexts. Healers understand the importance of their role on their community’s health and expressed deep concern about the use of commercial tobacco in the ceremonial setting. Healers play an important role in curbing the use of commercial tobacco and limiting the exposure to secondhand smoke in ceremonial settings and beyond. Study implications include the importance of understanding traditional and cultural knowledge and its potential as a pathway to solve contemporary public health issues facing AI communities.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Many American Indian (AI) healers are faced with a dilemma of how to maintain the ceremonial uses of traditional tobacco meant to encourage the restoration and balance of mind, body, and spirit, while discouraging commercial tobacco use and protecting against secondhand smoke exposure in ceremonial settings. To explore this dilemma and offer culturally informed solutions, researchers conducted qualitative interviews with Navajo healers who describe the history and role of commercial tobacco within ceremonial contexts. Healers understand the importance of their role on their community’s health and expressed deep concern about the use of commercial tobacco in the ceremonial setting. Healers play an important role in curbing the use of commercial tobacco and limiting the exposure to secondhand smoke in ceremonial settings and beyond. Study implications include the importance of understanding traditional and cultural knowledge and its potential as a pathway to solve contemporary public health issues facing AI communities. |
Valdez, Elizabeth Salerno; Sabo, Samantha; Butler, Matthew; Camplain, Ricky; Simpson, Rosi; Castro, Yara Perinatal Depression Symptom Prevalence on the U.S.–Mexico Border Journal Article Journal of Rural Mental Health, 43 (1), pp. 38-44, 2019. @article{Valdez2019, title = {Perinatal Depression Symptom Prevalence on the U.S.–Mexico Border}, author = {Elizabeth Salerno Valdez and Samantha Sabo and Matthew Butler and Ricky Camplain and Rosi Simpson and Yara Castro}, editor = {PhD James L. Werth}, url = {https://psycnet.apa.org/record/2019-06780-004?doi=1}, year = {2019}, date = {2019-01-01}, journal = {Journal of Rural Mental Health}, volume = {43}, number = {1}, pages = {38-44}, abstract = {At the U.S.–Mexico border, immigration policies have been documented to exacerbate health inequities among immigrant communities. We examined the prevalence of perinatal depressive symptomatology among Mexican-origin mothers living on the U.S.–Mexico border. Data for 1,629 pre- and postnatal women were drawn from a Community Health Worker Home Visiting Program from 2008 to 2016. Participants were screened for perinatal depressive symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Prevalence and associated 95% confidence intervals for prenatal and postnatal depression scores were estimated among women with prenatal depression scores only, postnatal depression scores only, and among women with both prenatal and postnatal scores by year and by participant characteristics. Participants were predominantly Mexican, Spanish-speaking, unmarried, with less than high school education, and with an annual income of less than $15,000. Prenatal and postnatal EPDS scores indicating low risk for depression (i.e., 0–5) ranged from 59.4% to 64.8% and 62.2% to 71.9%, respectively. Moderate risk prenatal and postnatal EPDS scores (i.e., 6–12) ranged from 28.6% to 32.1% and 22.8% to 25.6%, respectively. High-risk prenatal and postnatal EPDS scores (i.e., ≥13) ranged from 6.6% to 8.5% and 5.3% to 12.3%, respectively. In the context of a proliferation of anti-immigrant policies that jeopardize social determinants of maternal well-being, we observed a sustained upward trend in mean EPDS scores. U.S.–Mexico border women may be at particular risk for discrimination, stress, and victimization because of U.S. immigration and border security policies. This brief report generates a baseline prevalence of perinatal depressive symptomatology among women of Mexican origin and offers public health research explanations for maternal mental well-being at the U.S.–Mexico border. (PsycINFO Database Record (c) 2019 APA, all rights reserved)}, keywords = {}, pubstate = {published}, tppubtype = {article} } At the U.S.–Mexico border, immigration policies have been documented to exacerbate health inequities among immigrant communities. We examined the prevalence of perinatal depressive symptomatology among Mexican-origin mothers living on the U.S.–Mexico border. Data for 1,629 pre- and postnatal women were drawn from a Community Health Worker Home Visiting Program from 2008 to 2016. Participants were screened for perinatal depressive symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Prevalence and associated 95% confidence intervals for prenatal and postnatal depression scores were estimated among women with prenatal depression scores only, postnatal depression scores only, and among women with both prenatal and postnatal scores by year and by participant characteristics. Participants were predominantly Mexican, Spanish-speaking, unmarried, with less than high school education, and with an annual income of less than $15,000. Prenatal and postnatal EPDS scores indicating low risk for depression (i.e., 0–5) ranged from 59.4% to 64.8% and 62.2% to 71.9%, respectively. Moderate risk prenatal and postnatal EPDS scores (i.e., 6–12) ranged from 28.6% to 32.1% and 22.8% to 25.6%, respectively. High-risk prenatal and postnatal EPDS scores (i.e., ≥13) ranged from 6.6% to 8.5% and 5.3% to 12.3%, respectively. In the context of a proliferation of anti-immigrant policies that jeopardize social determinants of maternal well-being, we observed a sustained upward trend in mean EPDS scores. U.S.–Mexico border women may be at particular risk for discrimination, stress, and victimization because of U.S. immigration and border security policies. This brief report generates a baseline prevalence of perinatal depressive symptomatology among women of Mexican origin and offers public health research explanations for maternal mental well-being at the U.S.–Mexico border. (PsycINFO Database Record (c) 2019 APA, all rights reserved) |
Teufel-Shone, Nicolette I; Schwartz, Anna L; Hardy, Lisa J; Heer, Hendrik De D; Williamson, Heather J; Dunn, Dorothy J; Polingyumptewa, Kellen; Chief, Carmenlita Supporting New Community-Based Participatory Research Partnerships Journal Article International Journal of Environmental Research and Public Health, 16 (1), pp. 44, 2019. @article{Teufel-Shone2019, title = {Supporting New Community-Based Participatory Research Partnerships}, author = {Nicolette I Teufel-Shone and Anna L Schwartz and Lisa J Hardy and Hendrik De D Heer and Heather J Williamson and Dorothy J Dunn and Kellen Polingyumptewa and Carmenlita Chief}, url = {https://www.mdpi.com/1660-4601/16/1/44/htm}, year = {2019}, date = {2019-01-01}, journal = {International Journal of Environmental Research and Public Health}, volume = {16}, number = {1}, pages = {44}, abstract = {Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, and co-learning. Trust can be difficult to develop within the short time between a funding opportunity announcement and application submission. Resources to support community- and academic-based investigators’ time to discuss contexts, concerns, integration of expertise and locally acceptable research designs and data collection are limited. The National Institutes of Health (NIH) funded Center for American Indian Resilience and the Southwest Health Equity Research Collaborative have implemented an internal funding mechanism to support community and academic-based investigators’ travel cost and time to discuss complementary areas of interest and skills and to decide if moving forward with a partnership and a collaborative grant proposal would be beneficial to the community. The rationale and administration of this Community-Campus Partnership Support (CCPS) Program are described and four examples of supported efforts are provided. Centers and training programs frequently fund pilot grants to support junior investigators and/or exploratory research. This CCPS mechanism should be considered as precursor to pilot work, to stimulate partnership building without the pressure of an approaching grant application deadline.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Marginalized communities have a documented distrust of research grounded in negative portrayals in the academic literature. Yet, trusted partnerships, the foundation for Community-Based Participatory Research (CBPR), require time to build the capacity for joint decision-making, equitable involvement of academically trained and community investigators, and co-learning. Trust can be difficult to develop within the short time between a funding opportunity announcement and application submission. Resources to support community- and academic-based investigators’ time to discuss contexts, concerns, integration of expertise and locally acceptable research designs and data collection are limited. The National Institutes of Health (NIH) funded Center for American Indian Resilience and the Southwest Health Equity Research Collaborative have implemented an internal funding mechanism to support community and academic-based investigators’ travel cost and time to discuss complementary areas of interest and skills and to decide if moving forward with a partnership and a collaborative grant proposal would be beneficial to the community. The rationale and administration of this Community-Campus Partnership Support (CCPS) Program are described and four examples of supported efforts are provided. Centers and training programs frequently fund pilot grants to support junior investigators and/or exploratory research. This CCPS mechanism should be considered as precursor to pilot work, to stimulate partnership building without the pressure of an approaching grant application deadline. |
2018 |
Lam, Felix; Pro, George; Agrawal, Shreya; Shastri, Vishal Dev; Wentworth, Leslie; Stanley, Melinda; Beri, Nitin; Tupe, Abhishek; Mishra, Ashutosh; Subramaniam, Hamsa; Schroder, Kate; Prescott, Marta Rose; Trikha, Naresh Journal of Global Health, 9 (1), 2018. @article{Lam2018, title = {Effect of enhanced detailing and mass media on community use of oral rehydration salts and zinc during a scale-up program in Gujarat and Uttar Pradesh}, author = {Felix Lam and George Pro and Shreya Agrawal and Vishal Dev Shastri and Leslie Wentworth and Melinda Stanley and Nitin Beri and Abhishek Tupe and Ashutosh Mishra and Hamsa Subramaniam and Kate Schroder and Marta Rose Prescott and Naresh Trikha}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287208/}, year = {2018}, date = {2018-12-10}, journal = {Journal of Global Health}, volume = {9}, number = {1}, abstract = {Background The Clinton Health Access Initiative implemented a program from 2012-2016 to increase use of oral rehydration salts (ORS) and zinc to treat diarrhea in children under five in three states in India: Gujarat, Madhya Pradesh, and Uttar Pradesh. The program interventions included detailing and development of a rural supply chain to reach private rural health care providers, training of Accredited Social Health Activists (ASHAs), technical support to the state governments, and a mass media campaign targeted at caregivers. In Gujarat and Uttar Pradesh, some of the program activities, such as detailing and ASHA trainings, were targeted to high-burden focal districts, thus providing an opportunity to study their effect compared to statewide activities that covered all districts, such as the mass media campaign. Our study aimed to estimate the effect of activities on ORS and zinc use. Methods Household surveys were conducted at two points during the program and in both focal and non-focal districts. We used a difference-in-difference quasi-experimental approach to estimate the effect of the enhanced activities in focal districts and mass media campaign on the odds of a child being treated with ORS and zinc. Findings Focal district interventions were associated with a significant increase in the odds of a diarrhea episode receiving ORS in Gujarat and Uttar Pradesh. Living in focal districts increased the odds of receiving ORS in Gujarat and Uttar Pradesh by factors of 3.42 (95% CI = 1.39-8.33) and 2.29 (95% CI = 1.19-4.39), respectively. Focal district interventions were also associated with 15.02 (95% CI = 2.97-75.19) greater odds of receiving both ORS and zinc in Gujarat. In Uttar Pradesh, where the mass media campaign was focused, exposure to the campaign further modified the odds of receiving ORS and combined ORS and zinc by 1.38 (95% CI = 1.04-1.84) and 1.57 (95% CI = 1.01-2.46), respectively. Conclusion Comprehensive public and private provider interventions combined with mass media are effective strategies for increasing ORS and zinc use.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background The Clinton Health Access Initiative implemented a program from 2012-2016 to increase use of oral rehydration salts (ORS) and zinc to treat diarrhea in children under five in three states in India: Gujarat, Madhya Pradesh, and Uttar Pradesh. The program interventions included detailing and development of a rural supply chain to reach private rural health care providers, training of Accredited Social Health Activists (ASHAs), technical support to the state governments, and a mass media campaign targeted at caregivers. In Gujarat and Uttar Pradesh, some of the program activities, such as detailing and ASHA trainings, were targeted to high-burden focal districts, thus providing an opportunity to study their effect compared to statewide activities that covered all districts, such as the mass media campaign. Our study aimed to estimate the effect of activities on ORS and zinc use. Methods Household surveys were conducted at two points during the program and in both focal and non-focal districts. We used a difference-in-difference quasi-experimental approach to estimate the effect of the enhanced activities in focal districts and mass media campaign on the odds of a child being treated with ORS and zinc. Findings Focal district interventions were associated with a significant increase in the odds of a diarrhea episode receiving ORS in Gujarat and Uttar Pradesh. Living in focal districts increased the odds of receiving ORS in Gujarat and Uttar Pradesh by factors of 3.42 (95% CI = 1.39-8.33) and 2.29 (95% CI = 1.19-4.39), respectively. Focal district interventions were also associated with 15.02 (95% CI = 2.97-75.19) greater odds of receiving both ORS and zinc in Gujarat. In Uttar Pradesh, where the mass media campaign was focused, exposure to the campaign further modified the odds of receiving ORS and combined ORS and zinc by 1.38 (95% CI = 1.04-1.84) and 1.57 (95% CI = 1.01-2.46), respectively. Conclusion Comprehensive public and private provider interventions combined with mass media are effective strategies for increasing ORS and zinc use. |
Green, Shana M; Turner, DeAnne; Baldwin, Julie A; Walsh-Buhi, Eric R; Vamos, Cheryl A; Dagne, Getachew; Marhefka, Stephanie L AIDS and Behavior, 2018. @article{Green2018, title = {Towards an Information Motivation and Behavioral Skills Model for New Sex Partners: Results of a Study of Condom Use as an HIV Prevention Method for Emerging Adults Who Met Partners on Dating and Sex-Seeking Platforms or Offline}, author = {Shana M Green and DeAnne Turner and Julie A Baldwin and Eric R Walsh-Buhi and Cheryl A Vamos and Getachew Dagne and Stephanie L Marhefka}, url = {https://link.springer.com/article/10.1007/s10461-018-2349-1#citeas}, year = {2018}, date = {2018-12-01}, journal = {AIDS and Behavior}, abstract = {The information, motivation, behavioral Skills (IMB) model was used to identify factors that affect condom use with new sex partners that were met offline or online. Mixed methods data were collected from adults between the ages of 18 and 29 years who reported a new sex partner. A model was composed of participants’ IMB scale scores to determine the effect of these variables on condom use. A subset of 20 survey participants completed interviews exploring how IMB model elements may have influenced their condom use. Mixed methods results showed condom use skills were influential for condom use during the first sexual encounter between new partners. Qualitative findings suggest the information and motivation may also influence condom use with new sex partners. The IMB model for new partners may be relevant model for the development of interventions that encourage emerging adults to use condoms at first sex with new sex partners.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The information, motivation, behavioral Skills (IMB) model was used to identify factors that affect condom use with new sex partners that were met offline or online. Mixed methods data were collected from adults between the ages of 18 and 29 years who reported a new sex partner. A model was composed of participants’ IMB scale scores to determine the effect of these variables on condom use. A subset of 20 survey participants completed interviews exploring how IMB model elements may have influenced their condom use. Mixed methods results showed condom use skills were influential for condom use during the first sexual encounter between new partners. Qualitative findings suggest the information and motivation may also influence condom use with new sex partners. The IMB model for new partners may be relevant model for the development of interventions that encourage emerging adults to use condoms at first sex with new sex partners. |
Boucher, Nathan; Bull, Janet; Cross, S H; Kirby, Christine; David, Kelly J; Taylor, D H Acceptability of Innovative Palliative Care Model: Healthcare Consumer and Federal Taxpayer Views Journal Article Innovation in Aging, 2 (S1), pp. 1, 2018. @article{Boucher2018d, title = {Acceptability of Innovative Palliative Care Model: Healthcare Consumer and Federal Taxpayer Views}, author = {Nathan Boucher and Janet Bull and S H Cross and Christine Kirby and J Kelly David and D H Taylor}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230062/}, doi = {10.1093/geroni/igy023.767}, year = {2018}, date = {2018-11-11}, journal = {Innovation in Aging}, volume = {2}, number = {S1}, pages = {1}, abstract = {Semi-structured interviews with palliative care users were conducted along with federal taxpayers focus groups to assess palliative care knowledge. Interviewers also queried acceptability of a new model of community-based palliative care. Gaps in interview participants’ knowledge related to knowing services available in palliative care, how palliative care is paid for, and how to initiate palliative care. Similar concerns were shared by focus groups with the addition of their noting improved knowledge of palliative care from the focus group itself. Interview participants’ feedback on the new model of care included not having palliative care explained adequately and palliative care providers seen as consultants rather than providing full-time attention to care. Focus groups indicated the model sounded promising, but likely difficult to enact in our current system. Additional feedback from interviews/focus groups included perceptions that clinicians spent more time and provided more support for patients/families, and the broader application of palliative care.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Semi-structured interviews with palliative care users were conducted along with federal taxpayers focus groups to assess palliative care knowledge. Interviewers also queried acceptability of a new model of community-based palliative care. Gaps in interview participants’ knowledge related to knowing services available in palliative care, how palliative care is paid for, and how to initiate palliative care. Similar concerns were shared by focus groups with the addition of their noting improved knowledge of palliative care from the focus group itself. Interview participants’ feedback on the new model of care included not having palliative care explained adequately and palliative care providers seen as consultants rather than providing full-time attention to care. Focus groups indicated the model sounded promising, but likely difficult to enact in our current system. Additional feedback from interviews/focus groups included perceptions that clinicians spent more time and provided more support for patients/families, and the broader application of palliative care. |
II, Robert Trotter T; Lininger, Monica R; Camplain, Ricky; Fofanov, Viacheslav Y; Camplain, Carolyn; Baldwin, Julie A International Journal of Environmental Research and Public Health, 15 (11), 2018. @article{II2018b, title = {A Survey of Health Disparities, Social Determinants of Health, and Converging Morbidities in a County Jail: A Cultural-Ecological Assessment of Health Conditions in Jail Populations}, author = {Robert Trotter T II and Monica R Lininger and Ricky Camplain and Viacheslav Y Fofanov and Carolyn Camplain and Julie A Baldwin}, url = {https://www.mdpi.com/1660-4601/15/11/2500}, year = {2018}, date = {2018-11-08}, journal = {International Journal of Environmental Research and Public Health}, volume = {15}, number = {11}, abstract = {The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure to infectious diseases, difficult access to treatment for chronic health conditions, interruption in continuity of care for serious behavioral health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. This paper reports on elements of a cross-sectional survey embedded in a parent project, “Health Disparities in Jail Populations.” The overall project includes a comprehensive secondary data analysis of the health status of county jail populations, along with primary data collection that includes a cross-sectional health and health care services survey of incarcerated individuals, coupled with collection of biological samples to investigate infectious disease characteristics of a county jail population. This paper reports on the primary results of the survey data collection that indicate that this is a population with complex and interacting co-morbidities, as well as significant health disparities compared to the general population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure to infectious diseases, difficult access to treatment for chronic health conditions, interruption in continuity of care for serious behavioral health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. This paper reports on elements of a cross-sectional survey embedded in a parent project, “Health Disparities in Jail Populations.” The overall project includes a comprehensive secondary data analysis of the health status of county jail populations, along with primary data collection that includes a cross-sectional health and health care services survey of incarcerated individuals, coupled with collection of biological samples to investigate infectious disease characteristics of a county jail population. This paper reports on the primary results of the survey data collection that indicate that this is a population with complex and interacting co-morbidities, as well as significant health disparities compared to the general population. |
Walters, Karina L; Johnson-Jennings, Michelle; Stroud, Sandra; Rasmus, Stacy; Charles, Billy; John, Simeon; Allen, James; Kaholokula, Joseph Keawe‘aimoku; Look, Mele A; de Silva, Māpuana; Lowe, John; Baldwin, Julie A; Lawrence, Gary; Brooks, Jada; Noonan, Curtis W; Belcourt, Annie; Quintana, Eugenia; Semmens, Erin O; Boulafentis, Johna Prevention Science, pp. 1-11, 2018. @article{Walters2018, title = {Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities}, author = {Karina L Walters and Michelle Johnson-Jennings and Sandra Stroud and Stacy Rasmus and Billy Charles and Simeon John and James Allen and Joseph Keawe‘aimoku Kaholokula and Mele A Look and Māpuana de Silva and John Lowe and Julie A Baldwin and Gary Lawrence and Jada Brooks and Curtis W Noonan and Annie Belcourt and Eugenia Quintana and Erin O Semmens and Johna Boulafentis}, url = {https://link.springer.com/article/10.1007%2Fs11121-018-0952-z}, year = {2018}, date = {2018-11-06}, journal = {Prevention Science}, pages = {1-11}, abstract = {Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts “from the ground up.” Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts “from the ground up.” Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions. |
Walters, Karina L; Johnson-Jennings, Michelle; Stroud, Sandra; Rasmus, Stacy; Charles, Billy; John, Simeon; Allen, James; Kaholokula, Joseph Keawe‘aimoku; Look, Mele A; de Silva, Māpuana; Lowe, John; Baldwin, Julie A; Lawrence, Gary; Brooks, Jada; Noonan, Curtis W; Belcourt, Annie; Quintana, Eugenia; Semmens, Erin O; Boulafentis, Johna Prevention Science, pp. 1-11, 2018. @article{Walters2018b, title = {Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities.}, author = {Karina L. Walters and Michelle Johnson-Jennings and Sandra Stroud and Stacy Rasmus and Billy Charles and Simeon John and James Allen and Joseph Keawe‘aimoku Kaholokula and Mele A. Look and Māpuana de Silva and John Lowe and Julie A. Baldwin and Gary Lawrence and Jada Brooks and Curtis W. Noonan and Annie Belcourt and Eugenia Quintana and Erin O. Semmens and Johna Boulafentis}, url = {https://www.ncbi.nlm.nih.gov/pubmed/30397737}, doi = {10.1007/s11121-018-0952-z}, year = {2018}, date = {2018-11-06}, journal = {Prevention Science}, pages = {1-11}, abstract = {Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts "from the ground up." Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts "from the ground up." Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions. |
II, Robert Trotter T; Camplain, Ricky; Eaves, Emery R; Fofanov, Viacheslav Y; Dmitrieva, Natalia O; Hepp, Crystal M; Warren, Meghan; Barrios, Brianna A; Pagel, Nicole; Mayer, Alyssa; Baldwin, Julie A Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study Journal Article JMIR Res Protoc, 7 (10), 2018. @article{II2018b, title = {Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study}, author = {Robert Trotter T II and Ricky Camplain and Emery R Eaves and Viacheslav Y Fofanov and Natalia O Dmitrieva and Crystal M Hepp and Meghan Warren and Brianna A Barrios and Nicole Pagel and Alyssa Mayer and Julie A Baldwin}, editor = {Gunther Eysenbach and Nicola Kuter}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231773/}, year = {2018}, date = {2018-10-24}, journal = {JMIR Res Protoc}, volume = {7}, number = {10}, abstract = {Background Incarcerated populations have increased in the last 20 years and >12 million individuals cycle in and out of jails each year. Previous research has predominately focused on the prison population. However, a substantial gap exists in understanding the health, well-being, and health care utilization patterns in jail populations. Objective This pilot study has 5 main objectives: (1) define recidivists of the jail system, individuals characterized by high incarceration rates; (2) describe and compare the demographic and clinical characteristics of incarcerated individuals; (3) identify jail-associated health disparities; (4) estimate associations between incarceration and health; and (5) describe model patterns in health care and jail utilization. Methods The project has two processes—a secondary data analysis and primary data collection—which includes a cross-sectional health survey and biological sample collection to investigate infectious disease characteristics of the jail population. This protocol contains pilot elements in four areas: (1) instrument validity and reliability; (2) individual item assessment; (3) proof of concept of content and database accessibility; and (4) pilot test of the “honest broker” system. Secondary data analysis includes the analysis of 6 distinct databases, each covered by a formal memorandum of agreement between Northern Arizona University and the designated institution: (1) the Superior Court of Arizona Public Case Finder database; (2) North Country Health Care; (3) Health Choice Integrated Care; (4) Criminal Justice Information Services; (5) Correctional Electronic Medical Records; and (6) iLEADS. We will perform data integration processes using an automated honest broker design. We will administer a cross-sectional health survey, which includes questions about health status, health history, health care utilization, substance use practices, physical activity, adverse childhood events, and behavioral health, among 200 Coconino County Detention Facility inmates. Concurrent with the survey administration, we will collect Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (samples from the nose) and dental microbiome (Streptococcus sobrinus and Streptococcus mutans samples from the mouth) from consenting participants. Results To date, we have permission to link data across acquired databases. We have initiated data transfer, protection, and initial assessment of the 6 secondary databases. Of 199 inmates consented and enrolled, we have permission from 97.0% (193/199) to access and link electronic medical and incarceration records to their survey responses, and 95.0% (189/199) of interviewed inmates have given nasal and buccal swabs for analysis of S. aureus and the dental microbiome. Conclusions This study is designed to increase the understanding of health needs and health care utilization patterns among jail populations, with a special emphasis on frequently incarcerated individuals. Our findings will help identify intervention points throughout the criminal justice and health care systems to improve health and reduce health disparities among jail inmates. International Registered Report Identifier (IRRID) RR1-10.2196/10337}, keywords = {}, pubstate = {published}, tppubtype = {article} } Background Incarcerated populations have increased in the last 20 years and >12 million individuals cycle in and out of jails each year. Previous research has predominately focused on the prison population. However, a substantial gap exists in understanding the health, well-being, and health care utilization patterns in jail populations. Objective This pilot study has 5 main objectives: (1) define recidivists of the jail system, individuals characterized by high incarceration rates; (2) describe and compare the demographic and clinical characteristics of incarcerated individuals; (3) identify jail-associated health disparities; (4) estimate associations between incarceration and health; and (5) describe model patterns in health care and jail utilization. Methods The project has two processes—a secondary data analysis and primary data collection—which includes a cross-sectional health survey and biological sample collection to investigate infectious disease characteristics of the jail population. This protocol contains pilot elements in four areas: (1) instrument validity and reliability; (2) individual item assessment; (3) proof of concept of content and database accessibility; and (4) pilot test of the “honest broker” system. Secondary data analysis includes the analysis of 6 distinct databases, each covered by a formal memorandum of agreement between Northern Arizona University and the designated institution: (1) the Superior Court of Arizona Public Case Finder database; (2) North Country Health Care; (3) Health Choice Integrated Care; (4) Criminal Justice Information Services; (5) Correctional Electronic Medical Records; and (6) iLEADS. We will perform data integration processes using an automated honest broker design. We will administer a cross-sectional health survey, which includes questions about health status, health history, health care utilization, substance use practices, physical activity, adverse childhood events, and behavioral health, among 200 Coconino County Detention Facility inmates. Concurrent with the survey administration, we will collect Methicillin-resistant and Methicillin-sensitive Staphylococcus aureus (samples from the nose) and dental microbiome (Streptococcus sobrinus and Streptococcus mutans samples from the mouth) from consenting participants. Results To date, we have permission to link data across acquired databases. We have initiated data transfer, protection, and initial assessment of the 6 secondary databases. Of 199 inmates consented and enrolled, we have permission from 97.0% (193/199) to access and link electronic medical and incarceration records to their survey responses, and 95.0% (189/199) of interviewed inmates have given nasal and buccal swabs for analysis of S. aureus and the dental microbiome. Conclusions This study is designed to increase the understanding of health needs and health care utilization patterns among jail populations, with a special emphasis on frequently incarcerated individuals. Our findings will help identify intervention points throughout the criminal justice and health care systems to improve health and reduce health disparities among jail inmates. International Registered Report Identifier (IRRID) RR1-10.2196/10337 |
Trotter, Robert ; Camplain, Ricky ; Eaves, Emery ; Fofanov, Viacheslav Y; Dmitrieva, Natalia ; Hepp, Crystal ; Warren, Meghan ; Barrios, Brianna ; Mayer, Alyssa ; Baldwin, Julie Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study Journal Article Journal of Medical Internet Research, 7 (10), 2018. @article{Trotter2018, title = {Health Disparities and Converging Epidemics in Jail Populations: Protocol for a Mixed-Methods Study}, author = {Trotter, Robert and Camplain, Ricky and Eaves, Emery and Fofanov, Viacheslav Y and Dmitrieva, Natalia and Hepp, Crystal and Warren, Meghan and Barrios, Brianna and Mayer, Alyssa and Baldwin, Julie}, doi = {10.2196/10337}, year = {2018}, date = {2018-10-01}, journal = {Journal of Medical Internet Research}, volume = {7}, number = {10}, keywords = {}, pubstate = {published}, tppubtype = {article} } |
Boucher, Nathan A; Bull, Janet H; Cross, Sarah H; Kirby, Christine; Davis, Kelly J; Jr., Donald Taylor H Patient, caregiver and taxpayer knowledge of palliative care and views on a model of community-based palliative care Journal Article Journal of Pain and Symptom Management, 2018. @article{Boucher2018, title = {Patient, caregiver and taxpayer knowledge of palliative care and views on a model of community-based palliative care}, author = {Nathan A Boucher and Janet H Bull and Sarah H Cross and Christine Kirby and Kelly J Davis and Donald Taylor H Jr.}, url = {https://www.sciencedirect.com/science/article/pii/S0885392418304378}, year = {2018}, date = {2018-08-25}, journal = {Journal of Pain and Symptom Management}, abstract = {Context Palliative care (PC) model delivered by two large hospices and PC providers. Objectives To understand study participants' knowledge of PC and acceptability of a new community-based PC model. Methods Semistructured interview with patients and caregivers; focus groups with taxpayers. Descriptive content analysis with an inductive approach. Results Across 10 interviews and four focus groups (n = 4–10 per group), there was varying knowledge of PC. Gaps in interview and focus group participants' knowledge related to knowing the services available in PC, how PC is paid for, how to initiate PC, and how PC affects the patient's relationship with existing providers. Regarding the model, negative feedback from interview participants included not having PC explained adequately and PC providers seen as consultants and not as full-time providers. Focus group participants indicated that the model sounded promising but noted the likely difficulty in enacting it in our current health care system. Positive feedback from interview participants included the perception that clinicians spent more time and provided more support for patients and families and the developing ability of PC services to provide care more broadly than at the very end of life. Focus group participants had similar observations related to perceived attention to care and broader application of PC. Perceptions of time-constrained care delivery and suboptimal provider-patient communication persist for some patients getting PC services. Conclusion Education for patients, caregivers, and community members about the roles and benefits of PC will be needed to successfully expand community-based PC.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Context Palliative care (PC) model delivered by two large hospices and PC providers. Objectives To understand study participants' knowledge of PC and acceptability of a new community-based PC model. Methods Semistructured interview with patients and caregivers; focus groups with taxpayers. Descriptive content analysis with an inductive approach. Results Across 10 interviews and four focus groups (n = 4–10 per group), there was varying knowledge of PC. Gaps in interview and focus group participants' knowledge related to knowing the services available in PC, how PC is paid for, how to initiate PC, and how PC affects the patient's relationship with existing providers. Regarding the model, negative feedback from interview participants included not having PC explained adequately and PC providers seen as consultants and not as full-time providers. Focus group participants indicated that the model sounded promising but noted the likely difficulty in enacting it in our current health care system. Positive feedback from interview participants included the perception that clinicians spent more time and provided more support for patients and families and the developing ability of PC services to provide care more broadly than at the very end of life. Focus group participants had similar observations related to perceived attention to care and broader application of PC. Perceptions of time-constrained care delivery and suboptimal provider-patient communication persist for some patients getting PC services. Conclusion Education for patients, caregivers, and community members about the roles and benefits of PC will be needed to successfully expand community-based PC. |
Williamson, Heather J; Perkins, Elizabeth A; Massey, Oliver T; Baldwin, Julie A; Lulinski, Amie; Armstrong, Mary I; Levins, Bruce L Family Caregivers as Needed Partners: Recognizing Their Role in Medicaid Managed Long‐Term Services and Supports Journal Article Journal of Policy and Practice in Intellectual Disabilities, 15 (3), pp. 214-225, 2018. @article{Williamson2018, title = {Family Caregivers as Needed Partners: Recognizing Their Role in Medicaid Managed Long‐Term Services and Supports}, author = {Heather J Williamson and Elizabeth A Perkins and Oliver T Massey and Julie A Baldwin and Amie Lulinski and Mary I Armstrong and Bruce L Levins}, url = {https://onlinelibrary.wiley.com/doi/full/10.1111/jppi.12258}, year = {2018}, date = {2018-08-24}, journal = {Journal of Policy and Practice in Intellectual Disabilities}, volume = {15}, number = {3}, pages = {214-225}, abstract = {Adults with intellectual and/or developmental disabilities (IDD) in the United States are supported by both formal Medicaid‐funded long‐term services and supports and family caregivers. Lack of alternative housing options and wait lists for long‐term services and supports means the role of the family caregiver is and will continue be critical. Rising long‐term services and supports costs combined with goals to improve care coordination and access to services are driving more states to change the design of their long‐term services and supports systems to a Medicaid‐Managed Long‐Term Services and Supports (MLTSS) approach. Best practices for implementing MLTSS for individuals with IDD include acknowledging the family caregiver role. The current study's aim is to understand how family caregivers and their roles are recognized in MLTSS for adults with IDD in Kansas. Kansas was selected given their unique approach to MLTSS for adults with IDD, referred to as KanCare. In‐depth semi‐structured telephone interviews were completed with 31 stakeholders in Kansas, including statewide/regional representatives (N = 13), service coordination providers (N = 7), and family caregivers (N = 11). Additional family support services were available in KanCare, but families had difficulty accessing them. No formal processes were reported for assessing the needs of family caregivers in KanCare and families found communications with managed care entities challenging. Families reported difficulties with taking on responsibility of managing in‐home supports and there were concerns about being paid to provide care as a guardian. Family caregivers play a critical role in MLTSS, including assisting with care coordination and access to services. However, their role was not formally acknowledged in KanCare. Future research, practice, and policy efforts should focus on promoting family caregiver assessments and identifying best practices for supporting family caregivers in MLTSS.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Adults with intellectual and/or developmental disabilities (IDD) in the United States are supported by both formal Medicaid‐funded long‐term services and supports and family caregivers. Lack of alternative housing options and wait lists for long‐term services and supports means the role of the family caregiver is and will continue be critical. Rising long‐term services and supports costs combined with goals to improve care coordination and access to services are driving more states to change the design of their long‐term services and supports systems to a Medicaid‐Managed Long‐Term Services and Supports (MLTSS) approach. Best practices for implementing MLTSS for individuals with IDD include acknowledging the family caregiver role. The current study's aim is to understand how family caregivers and their roles are recognized in MLTSS for adults with IDD in Kansas. Kansas was selected given their unique approach to MLTSS for adults with IDD, referred to as KanCare. In‐depth semi‐structured telephone interviews were completed with 31 stakeholders in Kansas, including statewide/regional representatives (N = 13), service coordination providers (N = 7), and family caregivers (N = 11). Additional family support services were available in KanCare, but families had difficulty accessing them. No formal processes were reported for assessing the needs of family caregivers in KanCare and families found communications with managed care entities challenging. Families reported difficulties with taking on responsibility of managing in‐home supports and there were concerns about being paid to provide care as a guardian. Family caregivers play a critical role in MLTSS, including assisting with care coordination and access to services. However, their role was not formally acknowledged in KanCare. Future research, practice, and policy efforts should focus on promoting family caregiver assessments and identifying best practices for supporting family caregivers in MLTSS. |
King, Caroline; Atwood, Sidney; Lozada, Mia; Nelson, Adrianne Katrina; Brown, Chris; Sabo, Samantha; Curley, Cameron; Muskett, Olivia; Orav, Endel John; Shin, Sonya PLoS ONE, 13 (8), 2018. @article{King2018b, title = {Identifying risk factors for 30-day readmission events among American Indian patients with diabetes in the Four Corners region of the southwest from 2009 to 2016.}, author = {Caroline King and Sidney Atwood and Mia Lozada and Adrianne Katrina Nelson and Chris Brown and Samantha Sabo and Cameron Curley and Olivia Muskett and Endel John Orav and Sonya Shin}, editor = {Prabath W. B. Nanayakkara}, url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0195476}, doi = {10.1371/journal.pone.0195476}, year = {2018}, date = {2018-08-02}, journal = {PLoS ONE}, volume = {13}, number = {8}, abstract = {OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission.}, keywords = {}, pubstate = {published}, tppubtype = {article} } OBJECTIVE: The objective of this study was to identify risk factors for 30-day readmission events for American Indian patients with diabetes in the southwest. RESEARCH DESIGN AND METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using logistic regression analyses. RESULTS: Of 2,660 patients, 394 (14.8%) patients had at least one readmission within 30 days of discharge. Older age (OR (95% CI) = 1.26, (1.17, 1.36)), longer length of stay (OR (95% CI) = 1.01, (1.0001, 1.0342)), and a history of substance use disorder (OR (95% CI) = 1.80, (1.25, 2.60)) were risk factors for 30-day readmission. An American Indian language preference was protective against readmission. CONCLUSIONS: Readmission events are complex and may reflect broad and interwoven disparities in community systems. Future research should work to support community-defined interventions to address both in hospital and external factors that impact risk factors for readmission. |