Medicine and Health Sciences Commons^™

Drawing On The Strengths Of Community Health Workers To Address Sexually Transmitted Infections: Roles, Medicaid Reimbursement, And Partnerships, Naomi Seiler, Katie Horton, Paige Organick-Lee, Claire Heyison, Alexis Osei, Greg Dwyer, Aaron Karacuschansky, Mekhi Washington, Amanda Spott

Health Policy and Management Informal Communications

Rates of bacterial sexually transmitted infections (STIs) in the United States are high and, largely, still soaring. Though chlamydia cases have decreased slightly since 2017, gonorrhea and syphilis have increased by 25% and 68%, respectively, and congenital syphilis has increased by 184%. Bacterial STI can lead to pain, infertility, and even, in the case of syphilis and congenital syphilis, death. With appropriate detection and treatment, all of these STIs are curable. And yet a range of barriers between communities and the healthcare system perpetuate the STI epidemic.

Community health workers (CHWs) could play a key role in helping bridge the …

Sexually Transmitted Infections And Social Determinants Of Health: Emerging Opportunities In The Medicaid Program, Naomi Seiler, Katie Horton, Paige Organick-Lee, Mekhi Washington, Taylor Turner, Lily Ryan

Health Policy and Management Informal Communications

No abstract provided.

Congenital Syphilis In The Medicaid Program: Assessing Challenges And Opportunities Through The Experiences Of Seven Southern States, Naomi Seiler, Claire Heyison, Paige Organick-Lee, Aaron Karacuschansky, Gregory Dwyer, Alexis Osei, Helen Stoll, Katie Horton

Health Policy and Management Informal Communications

Congenital syphilis (CS) is an infection acquired in utero that can lead to devastating outcomes, including stillbirth, infant death, or long-term health complications. Over the past decade, rising national rates of syphilis, including among women, have led to major increases in congenital syphilis cases and deaths.

CS is tragic and costly, but it is also preventable. With appropriate testing and treatment during prenatal care, syphilis in a pregnant woman can be identified and treated, and transmission to the fetus averted.

The Medicaid program is the payer for nearly half of all births in the U.S., making the program a crucial …

Characterization And Assessment Of Barriers And Facilitators To The Decision-Making Process For Blood And Blood Donor Safety In The United States: A Collective Case Study, Lauren A. Crowder

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Over 16 million blood components are transfused to patients in need every year in the United States (Jones et al., 2021). Because of the reliance on human blood donors, the donation and transfusion of blood will always be associated with some level of risk for both donors and recipients; the tolerability of these risks may vary from stakeholder to stakeholder. While the U.S. Food and Drug Administration (FDA) concedes that attaining a blood supply with zero risk for transmission of infectious diseases may be unattainable (U.S. Food and Drug Administration, 2019), they continue to strive for the lowest …

The Earth Biogenome Project 2020: Starting The Clock., Harris A Lewin, Stephen Richards, Erez Lieberman Aiden, Miguel L Allende, John M Archibald, Miklós Bálint, Katharine B Barker, Bridget Baumgartner, Katherine Belov, Giorgio Bertorelle, Mark L Blaxter, Jing Cai, Nicolette D Caperello, Keith Carlson, Juan Carlos Castilla-Rubio, Shu-Miaw Chaw, Lei Chen, Anna K Childers, Jonathan A Coddington, Dalia A Conde, Montserrat Corominas, Keith A. Crandall, Andrew J Crawford, Federica Dipalma, Richard Durbin, Thankgod E Ebenezer, Scott V Edwards, Olivier Fedrigo, Paul Flicek, Giulio Formenti, Richard A Gibbs, M Thomas P Gilbert, Melissa M. Goldstein, Jennifer Marshall Graves, Henry T Greely, Igor V Grigoriev, Kevin J Hackett, Neil Hall, David Haussler, Kristofer M Helgen, Carolyn J Hogg, Sachiko Isobe, Kjetill Sigurd Jakobsen, Axel Janke, Erich D Jarvis, Warren E Johnson, Steven J M Jones, Elinor K Karlsson, Paul J Kersey, Jin-Hyoung Kim, W John Kress, Shigehiro Kuraku, Mara K N Lawniczak, James H Leebens-Mack, Xueyan Li, Kerstin Lindblad-Toh, Xin Liu, Jose V Lopez, Tomas Marques-Bonet, Sophie Mazard, Jonna A K Mazet, Camila J Mazzoni, Eugene W Myers, Rachel J O'Neill, Sadye Paez, Hyun Park, Gene E Robinson, Cristina Roquet, Oliver A Ryder, Jamal S M Sabir, H Bradley Shaffer, Timothy M Shank, Jacob S Sherkow, Pamela S Soltis, Boping Tang, Leho Tedersoo, Marcela Uliano-Silva, Kun Wang, Xiaofeng Wei, Regina Wetzer, Julia L Wilson, Xun Xu, Huanming Yang, Anne D Yoder, Guojie Zhang

Health Policy and Management Faculty Publications

No abstract provided.

Non-Elderly Adults On Disability In The Cf Population, Lea Nolan, Semret Seyoum, Julanne Wilson, Marsha Regenstein

Health Policy and Management Issue Briefs

No abstract provided.

Medicare Support For Dental And Podiatry Graduate Medical Education Programs., Candice Chen, Yoonkyung Chung, Geoffrey Broadbent, Elizabeth Mertz

Health Policy and Management Faculty Publications

Importance: Oral health care faces ongoing workforce challenges that affect patient access and outcomes. While the Medicare program provides an estimated $14.6 billion annually in graduate medical education (GME) payments to teaching hospitals, including explicit support for dental and podiatry programs, little is known about the level or distribution of this public investment in the oral health and podiatry workforce.

Objective: To examine Medicare GME payments to teaching hospitals for dental and podiatry residents from 1998 to 2018, as well as the distribution of federal support among states, territories, and the District of Columbia.

Design, Setting, and Participants: This cross-sectional …

Risk Indicators Of Food Insecurity In The Cf Population, Semret Seyoum, Marsha Regenstein, Lea Nolan

Health Policy and Management Issue Briefs

No abstract provided.

Assessing Social Influencers Of Health And Education, The Center For Health And Health Care In Schools (Chhcs)

Health Policy and Management Issue Briefs

No abstract provided.

Va Medical-Legal Partnerships: Implementation Guidance And Suggested Measures, Jennifer Trott, Kimberly Lattimore, Joel Teitelbaum, Marsha Regenstein

Health Policy and Management Faculty Publications

No abstract provided.

Missouri’S Public Health Response To Covid-19: Key Findings And Recommendations For State Action And Investment, Alexis Acosta, Marie-Anais Benoit, Ciara Conway, Dora Hughes, Jeffrey Levi, Anne Markus, Marsha Regenstein, Semret Seyoum, Jennifer Trott, Hope Van Bronkhorst

Health Policy and Management Issue Briefs

This report from the study, Strengthening Missouri’s Capacity to Respond to Public Health Crises, summarizes key findings that are relevant to strengthening the state’s and local public health agencies’ (LPHAs) capacity to respond to future public health crises. With funding from Missouri Foundation for Health, a George Washington University study team conducted 138 stakeholder interviews within public health and other sectors involved in the COVID-19 response, revealing several key opportunities for the Missouri Department of Health and Senior Services (DHSS). Missouri, like many other states, faced great challenges in responding to the COVID-19 pandemic. Missouri now has a singular opportunity …

Advancing And Promoting Community Health: Opportunities For Accountable Communities For Health And Community Health Centers, Helen Mittmann, Jeffrey Levi, Janet Heinrich, Feygele Jacobs, Rebecca Morris, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Executive Summary:

Accountable Communities for Health (ACHs) are multi -sector, community-based partnerships that aim to address community health and social needs, and Community Health Centers (CHCs) provide important community-based healthcare services for underserved and medically vulnerable populations. Given the critical role that both ACHs and CHCs play in addressing health-related social needs and social determinants of health, a survey of ACHs on CHC engagement was conducted to better understand opportunities and challenges for CHC participation in ACHs. This survey, along with follow-up conversations with ACH and CHC representatives, confirmed that ACHs and CHCs are natural partners in the effort to …

Cost, Coverage, And The Underuse Of Medications Among People With Cf, Semret Seyoum, Marsha Regenstein, Lea Nolan

Health Policy and Management Issue Briefs

No abstract provided.

Months Into The Covid-19 Pandemic, Community Health Centers Report Signs Of Improvement, But Face Financial Uncertainty, Jessica Sharac, James Hernandez, Feygele Jacobs, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Executive Summary:

This policy brief reports on the COVID-19 experience of the nation’s community health centers over a six-month period, utilizing data from the Health Resources and Services Administration’s (HRSA’s) weekly Health Center COVID-19 Survey from April 3rd, 2020 to October 2nd, 2020. The data demonstrate that community health centers were immediately responsive to the public health crisis, initiating diagnostic testing for the COVID-19 virus, and adapting care such as telehealth to address patient needs. However, with visits down overall and limited financial relief, the pandemic has taken an enormous financial toll on health centers. Cumulative patient revenue losses over …

Increasing Access To Sti Services In The Medicaid Program, Naomi Seiler, Katie Horton, Darla Bishop, Madina Adil, Claire Heyison

Health Policy and Management Informal Communications

The United States is undergoing an epidemic of sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis. All three bacterial infections are detectable and treatable, yet they often go diagnosed. Untreated chlamydia and gonorrhea can lead to serious pelvic infections and infertility; untreated syphilis can result in severe complications, including death. Congenital syphilis is increasing as well, with a concurrent rise in stillbirth and newborn deaths.

Increased resources and heightened attention are urgently needed to supplement the work of the public health infrastructure, for which STI funding has remained stagnant for two decades. Fortunately, the Medicaid program is well situated …

Activating Nursing To Address Unmet Needs In The 21st Century, Patricia Pittman

Health Policy and Management Faculty Publications

No abstract provided.

Protecting Science At Federal Agencies: How Congress Can Help, Jacobs Institute Of Women’S Health, The George Washington University, Climate Science Legal Defense Fund, Democracy Forward, Environmental Integrity Project, Environmental Protection Network, Government Accountability Project, Greenpeace, National Federation Of Federal Employees, National Partnership For Women & Families, Power To Decide, Project On Government Oversight, Union Of Concerned Scientists

Jacobs Institute of Women's Health

No abstract provided.

Economic Evaluation Of Patient Navigation Programs In Colorectal Cancer Care, A Systematic Review., Chloé Gervès-Pinquié, Anne Girault, Serena Phillips, Sarah Raskin, Mandi Pratt-Chapman

Pediatrics Faculty Publications

Patient navigation has expanded as a promising approach to improve cancer care coordination and patient adherence. This paper addresses the need to identify the evidence on the economic impact of patient navigation in colorectal cancer, following the Health Economic Evaluation Publication Guidelines. Articles indexed in Medline, Cochrane, CINAHL, and Web of Science between January 2000 and March 2017 were analyzed. We conducted a systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality assessment of the included studies was based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Inclusion criteria …

The Changing Composition And Capacity Of Medicare Providers, 2012-2015, Xinxin Han, Clese Elaine Erikson, Qian Luo

GW Research Days 2016 - 2020

Objective: Over the past decade, U.S. medical school enrollment has increased nearly 30 percent, and the growth in mid-level new graduates was even faster. Many of these new graduates are currently serving the large and growing Medicare population. Yet, little evidence so far has documented the workforce that are serving Medicare population. In the anticipation of physician supply shortages, it is important to understand who are taking care of Medicare population recently, and whether there are changes in the overall capacity and patient risk profiles of Medicare providers.

Methods: Data were from 2012-2015 Medicare Physician and Other Supplier Aggregate Tables …

(Video) Barriers To Implementing Advance Care Planning In The Healthcare Setting, Dona Occhipinti, Matias Attene Ramos

GW Research Days 2016 - 2020

Objectives: Current barriers to implementing Advanced Care Planning (ACP) will be examined as applied to the healthcare system.

Methods: A literature review was performed looking at the current practices of ACP (e.g. filling out advanced directives (AD), Medical Orders for Life Sustaining Treatment (MOLST)/ Physician Orders for Life Sustaining Treatment (POLST), etc.), physician comfort level with having end-of-life discussion (EOL), successful/unsuccessful interventions to increase ACP/EOL discussions among health care providers (HCP), and the current political environment with respect to physicians’ ability to implement ACP/EOL discussions. Cochrane, Pubmed, and Google Scholar were searched for papers written in English after …

Reliability Testing Of The Star Rating For Schools (Sr4s) Mobile Application: Results From A Pilot Study, Ashley Hunt, Morag Mackay, Amira Roess

GW Research Days 2016 - 2020

Globally, approximately 3500 individuals are killed due to a road traffic injury each day, equating to nearly 1.3 million deaths each year and more than a million children are either killed by, or sustain serious injury, from road traffic incidents. School zones are locations where there may be high concentrations of children at certain hours of the day, thereby increasing their exposure to road and pedestrian injuries. The International Road Assessment Programme (iRAP), an NGO established in 2006, developed the Star Ratings measurement system, which is used globally to provide simple, comparable and objective measurements of the built-in safety of …

Improving Adolescents’ Driving Behaviors Through A Personal Narrative-Based Psychosocial Intervention In Serbia, Hagere Yilma, Rajiv Rimal, Nargis Ryskulova

GW Research Days 2016 - 2020

Objectives: Road traffic crashes continue to be the leading cause of death among adolescents. While males are more vulnerable to crashes than females, driver education interventions are less likely to succeed among males than females. Some studies suggest that stronger optimistic bias and overconfidence bias in males may be the reason for this.

Methods: In a quasi-experiment conducted in Serbia, forty schools were stratified by size and randomly assigned to watch a road traffic safety presentation utilizing personal narratives or to a control arm. Surveys were administered before the intervention (N=1,449) and again six months later (N=1,072). Data was …

The Trans Pacific Partnership Agreement, Intellectual Property And Medicines: Differential Outcomes For Developed And Developing Countries, Deborah Gleeson, Joel Lexchin, Ruth Lopert, Burcu Kilic

Health Policy and Management Faculty Publications

The final text of the Trans Pacific Partnership Agreement (TPP), agreed between the 12 negotiating countries in 2016, included a suite of intellectual property provisions intended to expand and extend pharmaceutical company exclusivities on medicines. It drew wide criticism for including such provisions in an agreement that involved developing countries (Vietnam, Peru, Malaysia, Mexico, Chile and Brunei Darussalam) because of the effect on delaying the introduction of low-cost generics. While developing nations negotiated transition periods for implementing some obligations, all parties would have eventually been expected to meet the same standards had the TPP come into force. While the TPP …

Evaluation Of The Associations Between Unplanned Readmissions And The Lace Index And Other Variables, Cathy Stankiewicz, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: Unplanned readmissions, within 30 days following an inpatient hospital admission, are common and costly. Research has identified factors that predict readmissions, and predictive algorithms, such as the LACE index, have been studied and widely adopted by hospitals despite demonstrated variability in predictive ability.

Objectives: To examine the associations between unplanned readmissions and the LACE index, and other variables that reflect patient- and encounter-level factors not currently incorporated in the LACE index.

Methods: A retrospective analysis was conducted utilizing data from electronic health records of inpatients discharged from a large quaternary hospital located in the southeastern United States between January …

Relative Roles Of Race Versus Socioeconomic Position In Studies Of Health Inequalities: A Matter Of Interpretation, Amani Nuru-Jeter, Elizabeth Michaels, Marilyn D. Thomas, Alexis Reeves, Roland Thorpe, Thomas A. Laveist

Health Policy and Management Faculty Publications

An abundance of research has documented health inequalities by race and socioeconomic position (SEP) in the United States. However, conceptual and methodological challenges complicate the interpretation of study findings, thereby limiting progress in understanding health inequalities and in achieving health equity. Fundamental to these challenges is a lack of clarity about what race is and the implications of that ambiguity for scientific inquiry. Additionally, there is wide variability in how SEP is conceptualized and measured, resulting in a lack of comparability across studies and significant misclassification of risk. The objectives of this review are to synthesize the literature regarding common …

Clinician-Investigator Training And The Need To Pilot New Approaches To Recruiting And Retaining This Workforce., Alison K Hall, Sherry L Mills, P Kay Lund

Neurology Faculty Publications

Clinician–investigators, also called physician–scientists, offer critical knowledge and perspectives that benefit research on basic science mechanisms, improved diagnostic and therapeutic approaches, population and outcomes medicine, health policy, and health services, yet few clinically trained health professionals pursue a research career. Sustaining this workforce requires attention to the unique challenges faced by investigators who must achieve clinical and research competence during training and their careers. These challenges include the duration of required clinical training, limited or discontinuous research opportunities, high levels of educational debt, balancing the dual obligations and rewards of clinical care and research, competition for research funding, and the …

Influence Of Pharmaceutical Marketing On Medicare Prescriptions In The District Of Columbia, Susan Wood, Joanna Podrasky, Meghan Mcmonagle, Janani Raveendran, Tyler Bysshe, Alycia Hogenmiller, Adriane Fugh-Berman

Health Policy and Management Faculty Publications

Importance

Gifts from pharmaceutical companies are believed to influence prescribing behavior, but few studies have addressed the association between industry gifts to physicians and drug costs, prescription volume, or preference for generic drugs. Even less research addresses the effect of gifts on the prescribing behavior of nurse practitioners (NPs), physician assistants (PAs), and podiatrists.

Objective

To analyze the association between gifts provided by pharmaceutical companies to individual prescribers in Washington DC and the number of prescriptions, cost of prescriptions, and proportion of branded prescriptions for each prescriber.

Design

Gifts data from the District of Columbia’s (DC) AccessRx program and the …

Barriers And Facilitators To The Integration Of Mental Health Services Into Primary Health Care: A Systematic Review Protocol., Edith K Wakida, Dickens Akena, Elialilia S Okello, Alison Kinengyere, Ronald Kamoga, Arnold Mindra, Celestino Obua, Zohray M Talib

Health Policy and Management Faculty Publications

Background

Mental health is an integral part of health and well-being and yet health systems have not adequately responded to the burden of mental disorders. Integrating mental health services into primary health care (PHC) is the most viable way of closing the treatment gap and ensuring that people get the mental health care they need. PHC was formally adapted by the World Health Organization (WHO), and they have since invested enormous amounts of resources across the globe to ensure that integration of mental health services into PHC works.

Methods

This review will use the SPIDER (Sample, Phenomenon of Interest, Design, …

Does Liberalizing State Nurse Practitioner Scope Of Practice Laws Affect The Primary Care Provider Composition And Productivity In Community Health Centers?, Jeongyoung Park, Xinxin Han, Ellen T. Kurtzman

Health Workforce Research Center Publications

The state scope of practice (SOP) laws determine the range of services nurse practitioners (NPs) can provide and the extent to which they can practice independently. This has been a hot topic amid concerns about primary care provider shortages in light of health reform coverage expansion. Many states consider liberalizing NP SOP laws in an effort to expand primary care capacity. As the demand for primary care increases, NPs are expected to have an active role in meeting primary care needs. The purpose of this study was to examine the effects of expanded nurse practitioner (NP) scope of practice (SOP) …

Supporting And Retaining Village Health Teams: An Assessment Of A Community Health Worker Program In Two Ugandan Districts., Daniel C Mays, Edward J O'Neil, Edison A Mworozi, Benjamin J Lough, Zachary J Tabb, Ashlyn E Whitlock, Edward M Mutimba, Zohray M Talib

Health Policy and Management Faculty Publications

Background

Uganda’s national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, we examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. We report on findings from a standardized survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts to …