Medicine and Health Sciences Commons^™

The Impact Of Covid-19 On The Treatment Of Opioid Use Disorder In Carceral Facilities: A Cross-Sectional Study, Elizabeth C. Saunders, Milan F. Satcher, Laura B. Monico, Ryan D. Mcdonald, Sandra A. Springer, David Farabee, Jan Gryczynski, Amesika Nyaku, Elizabeth Needham Waddell, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

While the COVID-19 pandemic disrupted healthcare delivery everywhere, persons with carceral system involvement and opioid use disorder (OUD) were disproportionately impacted and vulnerable to severe COVID-associated illness. Carceral settings and community treatment programs (CTPs) rapidly developed protocols to sustain healthcare delivery while reducing risk of COVID-19 transmission. This survey study assessed changes to OUD treatment, telemedicine use, and re-entry support services among carceral and CTPs participating in the National Institute on Drug Abuse (NIDA)-funded study, Long-Acting Buprenorphine vs. Naltrexone Opioid Treatments in Criminal Justice System-Involved Adults (EXIT-CJS) study. In December 2020, carceral sites (n = 6; median pre-COVID 2020 …

Association Of Maternal Age 35 Years And Over And Prenatal Care Utilization, Preterm Birth, And Low Birth Weight, Mexico 2008–2019, Laura Jacobson, Evelyn Fuentes-Rivera, Raffaela Schiavon, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective:

We compared prenatal care utilization, preterm birth, and low birth weight neonates among women 35 years and older compared to women 20-34 years old in Mexico, 2008-2019.

Methods:

We used birth certificate data and conducted a historical cohort study of all singleton live births in Mexico from 2008-2019. Study outcomes were inadequate prenatal care (timing of initiation of care and number of visits), preterm birth, and low birth weight. We compared outcomes among women 35-39, 40-44, and 45-49 with births to women 20-34. We used logistic regression to account for individual and contextual confounders.

Results:

We included a total …

Issues With Variability In Electronic Health Record Data About Race And Ethnicity: Descriptive Analysis Of The National Covid Cohort Collaborative Data Enclave, Lily A. Cook Ma, David A. Dorr, Nicole G. Weiskopf, Nisha Mathews, Kelly L. Gonzales, Adam Wilcox, Charisse Madlock-Brown, N3c Consortium

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:The adverse impact of COVID-19 on marginalized and under-resourced communities of color has highlighted the need for accurate, comprehensive race and ethnicity data. However, a significant technical challenge related to integrating race and ethnicity data in large, consolidated databases is the lack of consistency in how data about race and ethnicity are collected and structured by health care organizations.

Objective:This study aims to evaluate and describe variations in how health care systems collect and report information about the race and ethnicity of their patients and to assess how well these data are integrated when aggregated into a large clinical database. …

Did Medicaid Expansion Close African American-White Health Care Disparities Nationwide? A Scoping Review, Lonnie R. Snowden, Genevieve Graaf, Latocia Keyes, Katherine Kitchens, Amanda Ryan, Neal Wallace

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives: To investigate the impact of the Affordable Care Act’s (ACA) Medicaid expansion on African Americanwhite disparities in health coverage, access to healthcare, receipt of treatment, and health outcomes. Design: A search of research reports, following the PRISMA-ScR guidelines, identified twenty-six national studies investigating changes in health care disparities between African American and white non-disabled, non-elderly adults before and after ACA Medicaid expansion, comparing states that did and did not expand Medicaid. Analysis examined research design and findings. Results: Whether Medicaid eligibility expansion reduced African American-white health coverage disparities remains an open question: Absolute disparities in coverage appear to have …

Evaluating The Effect Of San Francisco’S Paid Parental Leave Ordinance On Birth Outcomesf, Deborah Karasek, Sarah Raifman, Rita Hamad, William H. Dow, Julia M. Goodman

OHSU-PSU School of Public Health Faculty Publications and Presentations

Since 2017, San Francisco’s Paid Parental Leave Ordinance (PPLO) has allowed parents who work for private-sector employers to take 6 weeks of fully paid postnatal parental leave. Previous studies have linked paid parental leave with health improvements for birthing people and babies, although evidence for birth outcomes is limited. We hypothesized that the PPLO may have improved birth outcomes via reduced stress during pregnancy due to anticipation of increased financial security and postnatal leave. We used linked California birth certificate and hospital discharge records from January 2013 to December 2018 (n = 1,420,781). We used quasi-experimental difference-in-difference (DD) models to …

On Epidemiology As Racial-Capitalist (Re)Colonization And Epistemic Violence, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

This commentary reflects upon power-knowledge dynamics and matters of epistemic, procedural, and distributive justice that undergird epidemiological knowledge production related to racial health inequities in the U.S. Grounded in Foucault’s power-knowledge concepts—“objects”, “ritual”, and “the privileged”—and guided by Black feminist philosopher Kristie Dotson’s conceptualization of epistemic violence, it critiques the dominant positivist, reductionist, and extractivist paradigm of epidemiology, interrogating the settler-colonial and racial-capitalist nature of the knowledge production/curation enterprise. The commentary challenges epidemiology’s affinity for epistemological, procedural, and methodological norms that effectively silence/erase community knowledge(s) and nuance in favor of reductionist empirical representations/re-presentations produced by researchers who, often, have never …

Gender Differences In Parental Leave Before And After The Introduction Of A Paid Parental Leave Policy: A Sequence Analysis Of Administrative Time-Keeping Records, Julia M. Goodman, Lisset Dumet Poma, David Hurtado, Anna Steeves-Reece, Dawn M. Richardson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Paid leave confers health benefits to new parents and their children, but the absence of a national paid family leave policy in the United States has left workers to navigate a patchwork of paid and unpaid parental leave benefits accessed through their employers. As public and private paid leave policies expand across the US, it is imperative to determine how these benefits impact leave taking behaviors among new parents. We use sequence and cluster analyses of administrative time-keeping records to detail parental leave-taking during the first 180 days after adding a child among employees of a large public-sector organization with …

Perceived Stress, Resilience, And Wellbeing In Seasoned Isha Yoga Practitioners Compared To Matched Controls During The Covid-19 Pandemic, Preeti Upadhyay, Shilpa Narayanan, Tanvi Khera, Lauren Kelly, Pooja A. Mathur, Akshay Shanker, Lena Novack, Ruth Pérez-Robles, Kim A. Hoffman, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Yoga practices, including breathing, meditation, and posture protocols (asanas), have been shown to facilitate physical and mental wellbeing.

Methods: Seasoned yoga practitioners were recruited from the Isha Foundation. Recruitment of the comparison group was achieved using snowball sampling and were not yoga practitioners. Participants in the non-yoga group were randomized to a 3-min Isha practice or a comparator group asked to perform 15-min of daily reading. Participants completed a series of web-based surveys (REDCap) at baseline, 6, and 12 weeks. These surveys include validated scales and objective questions on COVID-19 infection and medical history. The validated questionnaires assess for: …

Engaging Public Health Critical Race Praxis In Local Social Determinants Of Health Research: The Youth Health Equity And Action Research Training Program In Portland, Or—Yheartpdx, Ryan J. Petteway, Lourdes Gonzalez

OHSU-PSU School of Public Health Faculty Publications and Presentations

The social determinants of health (SDH) have long been considered a core mechanism through which racial health inequities are (re)produced and incubated in the U.S. Moreover, scholars have expressly—and appropriately—named structural racism as a precursor to inequities associated with SDH. However, while research on racial health inequities—SDH-related or otherwise—continues to grow, communities of color remain grossly underrepresented as public health researchers and practitioners. Additionally, although SDH are experienced in a very local sense, much research and practice fails to more deeply and thoroughly engage and center local community knowledges. Thus, much work around SDH and racial health inequities presents, ironically, …

Preliminary (Year 1) Report To Oha On Pediatric Sogi: Executive Summary. Report To The Oregon Health Authority, Office Of Equity And Inclusion, Martin Arrigotti, Kieran Chase, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Overview: The enclosed report is the result of collaboration between the authors and the Oregon Health Authority. The report synthesizes the thinking and recommendations of the authors about routine data collection of SOGI data in minors for clinical and demographic purposes. Primary motivations to routinely collect SOGI data include: (1) inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations, (2) to promote health equity between minority and majority SOGI identities, and (3) to direct group-specific services towards those who need them.

Investigation and Findings: These recommendations are informed …

The Duration Of Spontaneous Active And Pushing Phases Of Labour Among 75,243 Us Women When Intervention Is Minimal: A Prospective, Observational Cohort Study, Ellen L. Tilden, Jonathan Snowden, Marit L. Bovbjerg, Jodi Lapidus, Melissa Cheyney, Jack Wiedrick, Aaron B. Caughey

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Friedman's curve, despite acknowledged limitations, has greatly influenced labour management. Interventions to hasten birth are now ubiquitous, challenging the contemporary study of normal labour. Our primary purpose was to characterise normal active labour and pushing durations in a large, contemporary sample experiencing minimal intervention, stratified by parity, age, and body mass index (BMI).

Methods

This is a secondary analysis of the national, validated Midwives Alliance of North America 4·0 (MANA Stats) data registry (n = 75,243), prospectively collected between Jan 1, 2012 and Dec 31, 2018 to describe labour and birth in home and birth center settings where …

A Qualitative Study Of The Acceptability Of Remote Electronic Bednet Use Monitoring In Uganda, Sarah M. Alexander, Alfred Agaba, Jeffrey I. Campbell, Nuriat Nambogo, Mallory Johnson, Kristian R. Olson, Grant Dorsey, David R. Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Distribution of long-lasting insecticide treated nets (LLINs) is the most widely used intervention for the prevention of malaria but recall and social desirability biases may lead to challenges in accurately measuring use of bednets. SmartNet is a remote electronic monitor that provides objective measurements of bednet use over weeks at a time. Assessing local acceptability is important when implementing innovative global health technologies such as SmartNet. This study draws on established models such as the Technology Acceptance Model (TAM) and Theoretical Framework of Acceptability (TFA) to assess acceptability of SmartNet in Ugandan households.

Methods

Semi-structured qualitative interviews were conducted …

Demonstration And Acceptability Of A Safer Conception Intervention For Men With Hiv In South Africa: Pilot Cohort Study, Lynn T. Matthews, Christina Psaros, Mxolisi Mathenjwa, Nzwakie Mosery, Letitia Rambally Greener, Hazar Khidir, Madeline Pratt, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Many men with HIV (MWH) want to have children. HIV viral suppression minimizes sexual HIV transmission risks while allowing for conception and optimization of the health of men, their partners, and their infants.

Objective: This study developed and evaluated the feasibility and acceptability of an intervention to promote serostatus disclosure, antiretroviral therapy (ART) uptake and adherence, and viral suppression among MWH who want to have children in South Africa.

Methods: We developed a safer conception intervention (Sinikithemba Kwabesilisa or We give hope to men) to promote viral suppression via ART uptake and adherence, HIV serostatus disclosure, and other safer …

A Coordinated Approach To Implementing Low-Dose Ct Lung Cancer Screening In A Rural Community Hospital, Jessica Currier, Deb Howes, Cherie Cox, Margaret Bertoldi, Kent Sharman, Bret Cook, Derek Baden, Paige E. Farris, Wesley Stoller, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: The authors describe a rural community hospital’s approach to lung cancer screening using low-dose CT (LDCT) to address the high incidence of lung cancer mortality.

Methods: An implementation project was conducted, documenting planning, education, and restructuring processes to implement a lung cancer screening program using LDCT in a rural community hospital (population 64,917, Rural-Urban Continuum Code 5) located in a region with the highest lung cancer mortality in Oregon. The hospital and community partners organized the implementation project around five recommendations for an efficient and effective lung cancer screening program that accurately identifies high-risk patients, facilitates timely …

Inequities In Paid Parental Leave Across Industry And Occupational Class: Drivers And Simulated Policy Remedies, Julia Goodman, Connor Williams, Holly Elser, William H. Dow

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Paid family leave (PFL) has the potential to reduce persistent health disparities. This study aims to characterize differences in access to paid leave by industry sector and occupational class. Methods: The Bay Area Parental Leave Survey of Mothers included respondents 18 years of age or older who worked in the San Francisco Bay Area and gave birth from 2016 to 2017. Using linear probability models, we examined differences in five separate measures of PFL by industry sector and occupational class. We extended our regression analysis to simulate the full pay equivalent (FPE) weeks of leave that would have been …

Adverse Childhood Experiences, Alcohol Consumption, And The Modifying Role Of Social Participation: Population-Based Study Of Adults In Southwestern Uganda, Scholastic Ashaba, Bernard Kakuhikire, Charles Baguma, Emily N. Satinsky, Jessica M. Perkins, Justin D. Rasmussen, Christine E. Cooper-Vince, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Adverse childhood experiences (ACEs) include multiple forms of child maltreatment, including abuse and neglect, as well as other forms of household dysfunction. Studies from Uganda have revealed a high prevalence of child abuse, as well as one of the highest levels of alcohol consumption in Africa. Few population-based studies from Africa have estimated associations between ACEs and adult alcohol use, or assessed the potential buffering effects of social participation.

Methods

This cross-sectional, population-based study was conducted in a rural parish in southwestern Uganda between 2016 and 2018. We assessed self-reported ACEs using a modified version of the Adverse Childhood …

Measurement Of Fruit And Vegetable Intake Incorporating A Diversity, Equity, And Inclusion Lens. Comment On Di Noia, J.; Gellermann, W. Use Of The Spectroscopy-Based Veggie Meter® To Objectively Assess Fruit And Vegetable Intake In Low-Income Adults, Carmen Byker Shanks, Betty Izumi, Courtney A. Parks, Amy L. Yaroch

OHSU-PSU School of Public Health Faculty Publications and Presentations

Disparities in fruit and vegetable intake (FVI) and diet-related diseases exist among low-income and racial/ethnic minority populations [1,2,3,4]. Intervention approaches to eliminate FVI disparities frequently utilize dietary assessment to measure impact. Studies measure FVI in varying ways, but do not fully account for diversity, equity, and inclusion (DEI).

Virtual Voices: Examining Social Support Exchanged Through Participant-Generated And Unmoderated Content In A Mobile Intervention To Improve Hiv Antiretroviral Therapy Adherence Among Gbmsm., Christina J. Sun, Thembekile Shato, Ashlynn Steinbaugh, Sharanya Pradeep, K Rivet Amico, Keith Horvath

OHSU-PSU School of Public Health Faculty Publications and Presentations

Antiretroviral therapy (ART) adherence is suboptimal among gay, bisexual, and other men who have sex with men (GBMSM). Online interventions that incorporate social support represent new opportunities to improve adherence. This study focused on how social support was provided and sought within a technology-based ART adherence intervention. We coded and analyzed 1,751 messages. Within the social support messages, half of the time participants sought social support and half of the time they provided social support. Emotional and informational support were the most frequently exchanged forms. The most frequent topic that participants sought support around was interpersonal relationships (29%), followed by …

A Qualitative Exploration To Understand Barriers And Facilitators To Daily Oral Prep Uptake And Sustained Adherence Among Hiv-Negative Women Planning For Or With Pregnancy In Rural Southwestern Uganda, Esther Atukunda, Moran Owembabazi, Madeline Pratt, Christina Psaros, Winnie Muyindike, Pooja Chitneni, Bosco M. Bwana, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Antiretroviral pre-exposure prophylaxis (PrEP) may reduce periconception and pregnancy HIV incidence among women in settings, where gender power imbalances limit HIV testing, engagement in care and HIV viral suppression. We conducted qualitative interviews to understand factors influencing periconception and pregnancy PrEP uptake and use in a cohort of women (Trial registration: NCT03832530) offered safer conception counselling in rural Southwestern Uganda, where PrEP uptake was high. Methods: Between March 2018 and January 2019, in-depth interviews informed by conceptual frameworks for periconception risk reduction and PrEP adherence were conducted with 37 women including those with ≥80% and

Exercise/Physical Activity In Individuals With Type 2 Diabetes: A Consensus Statement From The American College Of Sports Medicine, Jill A. Kanaley, Sheri R. Colberg, Matthew H. Corcoran, Steven K. Malin, Nancy R. Rodriguez, Carlos J. Crespo, John P. Kirwan, Juleen R. Zierath

OHSU-PSU School of Public Health Faculty Publications and Presentations

This consensus statement is an update of the 2010 American College of Sports Medicine position stand on exercise and type 2 diabetes. Since then, a substantial amount of research on select topics in exercise in individuals of various ages with type 2 diabetes has been published while diabetes prevalence has continued to expand worldwide. This consensus statement provides a brief summary of the current evidence and extends and updates the prior recommendations. The document has been expanded to include physical activity, a broader, more comprehensive definition of human movement than planned exercise, and reducing sedentary time. Various types of physical …

Impact Of Medicaid Expansion On Interpregnancy Interval, Can Lui, Jonathan Snowden, Maya Rossin-Slater, Florencia Torche, Julia D. Ditosto, Suzan L. Carmichael

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives

Medicaid expansion under the Affordable Care Act (ACA) improved access to reproductive health care for low-income women and birthing people who were previously ineligible for Medicaid. We aimed to evaluate if the expansion affected the risk of having a short interpregnancy interval (IPI), a preventable risk factor for adverse pregnancy outcomes.

Methods

We evaluated parous singleton births to mothers aged 19 or older from U.S. birth certificate data 2009–2018. We estimated the effect of residing in a state that expanded Medicaid access (expansion status determined at 60 days after the prior live birth) on the risk of having a …

Concerns About Safety Of Minorities In The Collection Of Sogi Data, Kieran Chase, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

This is a position paper concerning the ethics of routine collection of SOGI demographic data, with particular attention paid to erasure and the closet. We hope that the Health Authority will use the perspective presented here to respond to concerns around the safety of individuals who disclose minority sex, minority sexual orientation, or minority gender status. We are epidemiologists with history working on issues of queer demography and social policy. We have both collaborated with OHA’s Office for Equity and Inclusion on the development of the SOGI demographic instrument. We both occupy queer social locations and approach this work through …