Medicine and Health Sciences Commons^™

Measuring The Impact Of The Affordable Care Act Medicaid Expansion On Access To Primary Care Using An Interrupted Time Series Approach, Elizabeth A. Brown, Brandi M. White, Walter J. Jones, Mulugeta Gebregziabher, Kit N. Simpson

Health and Clinical Sciences Faculty Publications

BACKGROUND: The Patient Protection and Affordable Care Act of 2010, commonly referred to as the Affordable Care Act (ACA), was created to increase access to primary care, improve quality of care, and decrease healthcare costs. A key provision in the law that mandated expansion of state Medicaid programme changed when states were given the option to voluntarily expand Medicaid. Our study sought to measure the impact of ACA Medicaid expansion on preventable hospitalization (PH) rates, a measure of access to primary care.

METHODS: We performed an interrupted time series analysis of quarterly hospitalization rates across eight states from 2012 to …

Racial And Ethnic Disparities In Stroke Outcomes: A Scoping Review Of Post-Stroke Disability Assessment Tools, Suzanne Perea Burns, Brandi M. White, Gayenell Magwood, Charles Ellis, Ayaba Logan, Joy N. Jones Buie, Robert J. Adams

Health and Clinical Sciences Faculty Publications

Purpose: To identify how post-stroke disability outcomes are assessed in studies that examine racial/ethnic disparities and to map the identified assessment content to the International Classification of Functioning, Disability, and Health (ICF) across the time course of stroke recovery.

Methods: We conducted a scoping review of the literature. Articles published between January 2001 and July 2017 were identified through Scopus, PubMed, CINAHL, and PsycINFO according to predefined inclusion and exclusion criteria.

Results: We identified 1791 articles through database and hand-searching strategies. Of the articles, 194 met inclusion criteria for full-text review, and 41 met inclusion criteria for study inclusion. The …

Reducing Symptom Distress In Patients With Advanced Cancer Using An E-Alert System For Caregivers: Pooled Analysis Of Two Randomized Clinical Trials, David H. Gustafson, Lori L. Dubenske, Amy K. Atwood, Ming-Yuan Chih, Roberta A. Johnson, Fiona Mctavish, Andrew Quanbeck, Roger L. Brown, James F. Cleary, Dhavan Shah

Health and Clinical Sciences Faculty Publications

Background: Symptom distress in patients toward the end of life can change rapidly. Family caregivers have the potential to help patients manage those symptoms, as well as their own stress, if they are equipped with the proper resources. Electronic health (eHealth) systems may be able to provide those resources. Very sick patients may not be able to use such systems themselves to report their symptoms but family caregivers could.

Objective: The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient’s symptoms, as …

A Pilot Test Of A Mobile App For Drug Court Participants, Kimberly Johnson, Stephanie Richards, Ming-Yuan Chih, Tae Joon Moon, Hilary Curtis, David H. Gustafson

Health and Clinical Sciences Faculty Publications

The U.S. criminal justice system refers more people to substance abuse treatment than any other system. Low treatment completion rates and high relapse rates among addicted offenders highlight the need for better substance use disorder treatment and recovery tools. Mobile health applications (apps) may fill that need by providing continuous support. In this pilot test, 30 participants in a Massachusetts drug court program used A-CHESS, a mobile app for recovery support and relapse prevention, over a four-month period. Over the course of the study period, participants opened A-CHESS on average of 62% of the days that they had the app. …

Exploring The Use Patterns Of A Mobile Health Application For Alcohol Addiction Before The Initial Lapse After Detoxification, Ming-Yuan Chih

Health and Clinical Sciences Faculty Publications

How patients used Addiction-Comprehensive Health Enhancement Support System (A-CHESS), a mobile health intervention, while quitting drinking is worthy exploring. This study is to explore A-CHESS use patterns prior to the initial lapse reported after discharge from inpatient detoxification programs. 142 patients with alcohol addiction from two treatment agencies in the U.S. were included. A comprehensive set of A-CHESS use measures were developed based on a three-level system use framework and three A-CHESS service categories. In latent profile analyses, three A-CHESS system use patterns-inactive, passive, and active users-were found. Compared to the passive users (with the highest chance of the initial …

Mobile Delivery Of Treatment For Alcohol Use Disorders: A Review Of The Literature, Andrew Quanbeck, Ming-Yuan Chih, Andrew Isham, David H. Gustafson

Health and Clinical Sciences Faculty Publications

Several systems for treating alcohol-use disorders (AUDs) exist that operate on mobile phones. These systems are categorized into four groups: text-messaging monitoring and reminder systems, text-messaging intervention systems, comprehensive recovery management systems, and game-based systems. Text-messaging monitoring and reminder systems deliver reminders and prompt reporting of alcohol consumption, enabling continuous monitoring of alcohol use. Text-messaging intervention systems additionally deliver text messages designed to promote abstinence and recovery. Comprehensive recovery management systems use the capabilities of smart-phones to provide a variety of tools and services that can be tailored to individuals, including in-the-moment assessments and access to peer discussion groups. Game-based …