Public Health Commons^™

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among …

Education Mitigates The Relationship Of Stress And Mental Disorders Among Rural Indian Women, Nisha Fahey, Apurv Soni, Jeroan J. Allison, Jagdish Vankar, Anusha Prabhakaran, Tiffany A. Moore Simas, Nancy Byatt, Ajay Phatak, Eileen O'Keefe, Somashekhar Nimbalkar

Apurv Soni

BACKGROUND: Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics.

OBJECTIVES: To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics.

METHODS: Cross-sectional survey of 700 women from rural Gujarat, India. …

Organizations As Evil Structures, Cary Federman, Dave Holmes

Cary Federman

Nursing practice in forensic psychiatry opens new horizons in nursing. This complex, professional, nursing practice involves the coupling of two contradictory socioprofessional mandates: to punish and to provide care. The purpose of this chapter is to present nursing practice in a disciplinary setting as a problem of governance. A Foucauldian perspective allows us to understand the way forensic psychiatric nursing is involved in the governance of mentally ill criminals through a vast array of power techniques (sovereign, disciplinary, and pastoral), which posit nurses as “subjects of power.” These nurses are also “objects of power” in that nursing practice is constrained …

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Massachusetts Medicaid Members That Smoked In 2008: Characteristics Associated With Smoking Status In 2014, Alexis D. Henry, John Gettens, Judith A. Savageau, Doris Cullen, Anna Landau

Judith A. Savageau

The smoking rate among non-elderly Medicaid enrollees is more than double the rate for those privately insured; smoking-related conditions account for 15% of Medicaid expenditures. Under state health reform, Massachusetts Medicaid (MassHealth) made tobacco cessation treatment available beginning in 2006. We used surveys conducted in 2008 and 2014 to examine changes in smoking abstinence rates among MassHealth members identified as smokers and to identify factors associated with being a former smoker. Members previously identified as smokers were surveyed by mail or phone; 2008 and 2014 samples included 3,116 and 2,971 members, respectively. Surveys collected demographic and health information, asked members …

Prevalence And Correlates Of Indoor Tanning And Sunless Tanning Product Use Among Female Teens In The United States, Megan Quinn, Arsham Alamian, Joel J. Hillhouse, Colleen Scott, Rob Turrisi, Katie Baker

Arsham Alamian

Background

Indoor tanning (IT) before the age of 35 increases melanoma risk by 75%. Nevertheless, IT and sunless tanning product (STP) use have gained popularity among youth. However, there are limited data on the prevalence and sociodemographic correlates of both IT and STP use in a representative sample of American teens.

Methods

Teenage females (N = 778) aged 12–18 years were recruited as part of an on-going longitudinal study conducted between May 2011 and May 2013. Descriptive statistics explored IT and STP usage in teen females at baseline. Logistic regression was used to determine sociodemographic correlates of IT and STP …

Self-Injurious Behaviors In Prisons: A Nationwide Survey Of Correctional Mental Health Directors, Kenneth L. Appelbaum, Judith A. Savageau, Robert L. Trestman, Jeffrey L. Metzner

Judith A. Savageau

Self-injurious behavior (SIB) by inmates has serious health, safety, operational, security and fiscal consequences. Serious incidents require a freeze in normal facility operations. Injuries that need outside medical attention create additional security risks, including potential escape attempts. The interruption of normal operations, diversion of staff, cost of outside care, and drain on medical and mental health resources all have significant fiscal consequences. This session will present the results and implications of a survey of the Mental Health Directors in all 51 state and federal prison systems on the extent of SIB by inmates, including incidence and prevalence, adverse consequences, and …

Evaluation Of The Massachusetts Peer Specialist Training And Certification Program (Phase Two), Linda M. Cabral, Kathy Muhr, Laura A. Sefton, Judith A. Savageau

Judith A. Savageau

Most public mental health systems are shifting to a recovery-oriented system of care; however, offering recovery-oriented and peer support services to various cultural and linguistic groups is challenging. This study sought to better understand how persons with mental health conditions from two cultural groups – Latinos and Deaf and Hard of Hearing (D/HH) - access recovery-based services. Interviews with national key informants were conducted prior to data collection to better formulate instruments. Cultural brokers, identified as leaders in their communities who also have mental health conditions, were hired to aid in recruitment and data collection. Interviews and focus groups were …

Trait Hope And Preparation For Future Care Needs Among Older Adult Primary Care Patients, Jodi L. Southerland, Deborah L. Slawson, Robert Pack, Silvia Sörensen, Jeffrey M. Lyness, Jameson K. Hirsch

Jameson K. Hirsch

We examined associations between trait hope and preparation for future care needs (PFCN) among 66 older adult primary care patients in western New York. Participants completed a questionnaire assessing PFCN (awareness, information gathering, decision-making, concrete planning, and avoidance), and the Adult Trait Hope Scale. In multivariate regressions, lower hope, particularly less agency, was associated with more awareness of needing care, whereas higher hopefulness, particularly pathways thinking, was associated with increased decision-making and concrete planning. Greater hopefulness appears to be linked to goal-directed planning behaviors, although those with lower hope may actually be more aware of the need for planning. Evidence-based …

Basic Psychological Needs, Suicidal Ideation, And Risk For Suicidal Behavior In Young Adults, Peter C. Britton, Kimberly A. Van Orden, Jameson K. Hirsch, Geoffrey C. Williams

Jameson K. Hirsch

Associations between the satisfaction of basic psychological needs of autonomy, competence, and relatedness with current suicidal ideation and risk for suicidal behavior were examined. Two logistic regressions were conducted with a cross-sectional database of 440 university students to examine the association of need satisfaction with suicidal ideation and risk for suicidal behavior, while controlling for demographics and depressive symptoms. Suicidal ideation was reported by 15% of participants and 18% were found to be at risk for suicidal behavior. A one standard deviation increase in need satisfaction reduced the odds of suicidal ideation by 53%, OR (95% CI) = 0.47 (0.33–0.67), …

Optimism And Planning For Future Care Needs Among Older Adults, Silvia Sörensen, Jameson K. Hirsch, Jeffrey M. Lyness

Jameson K. Hirsch

Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism …

Perceived Health In Lung Cancer Patients: The Role Of Positive And Negative Affect, Jameson K. Hirsch, Andrea R. Floyd, Paul R. Duberstein

Jameson K. Hirsch

Purpose: To examine the association of affective experience and health-related quality of life in lung cancer patients, we hypothesized that negative affect would be positively, and positive affect would be negatively, associated with perceived health.

Methods: A sample of 133 English-speaking lung cancer patients (33% female; mean age = 63.68 years old, SD = 9.37) completed a battery of self-report surveys.

Results: Results of our secondary analysis indicate that trait negative affect was significantly associated with poor physical and social functioning, greater role limitations due to emotional problems, greater bodily pain, and poor general health. Positive affect was significantly associated …

The Interrelations Between Spiritual Well-Being, Pain Interference And Depressive Symptoms In Patients With Multiple Sclerosis, Sheri A. Nsamenang, Jameson K. Hirsch, Raluca Topciu, Andrew D. Goodman, Paul R. Duberstein

Jameson K. Hirsch

Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated …

Health Behaviors Among College Students: The Influence Of Future Time Perspective And Basic Psychological Need Satisfaction, Preston L. Visser, Jameson K. Hirsch

Jameson K. Hirsch

Health behavior change may prevent many fatal diseases, and may be influenced by social and motivational constructs. We assessed the interaction effect of future time perspective and basic psychological need fulfillment on positive and negative health behaviors. Future time perspective was associated with more positive, and less negative, health behaviors. Need fulfillment was associated with only positive health behaviors. In moderation analyses, individuals reporting both high need fulfillment and future perspective reported greater positive health behaviors, and were especially unlikely to smoke. Enhancing future-mindedness and supporting need satisfaction in interventions targeting modifiable health behaviors is encouraged.

Functional Impairment, Illness Burden, And Depressive Symptoms In Older Adults: Does Type Of Social Relationship Matter?, Joshua P. Hatfield, Jameson K. Hirsch, Jeffrey M. Lyness

Jameson K. Hirsch

Objective: The nature of interpersonal relationships, whether supportive or critical, may affect the association between health status and mental health outcomes. We examined the potential moderating effects of social support, as a buffer, and family criticism, as an exacerbating factor, on the association between illness burden, functional impairment and depressive symptoms.

Methods: Our sample of 735 older adults, 65 years and older, was recruited from internal and family medicine primary care offices. Trained interviewers administered the Hamilton Rating Scale for Depression, Duke Social Support Inventory, and Family Emotional Involvement and Criticism Scale. Physician-rated assessments of health, including the Karnofsky Performance …

Family Criticism And Depressive Symptoms In Older Adult Primary Care Patients: Optimism And Pessimism As Moderators, Jameson K. Hirsch, Kristin L. Walker, Ross B. Wilkinson, Jeffrey M. Lyness

Jameson K. Hirsch

Objective: Depression is a significant global public health burden, and older adults may be particularly vulnerable to its effects. Among other risk factors, interpersonal conflicts, such as perceived criticism from family members, can increase risk for depressive symptoms in this population. We examined family criticism as a predictor of depressive symptoms and the potential moderating effect of optimism and pessimism.

Methods: One hundred five older adult, primary care patients completed self-report measures of family criticism, optimism and pessimism, and symptoms of depression. We hypothesized that optimism and pessimism would moderate the relationship between family criticism and depressive symptoms.

Results: In …

Prevalence And Correlates Of Indoor Tanning And Sunless Tanning Product Use Among Female Teens In The United States, Megan Quinn, Arsham Alamian, Joel J. Hillhouse, Colleen Scott, Rob Turrisi, Katie Baker

Joel Hillhouse

Background

Indoor tanning (IT) before the age of 35 increases melanoma risk by 75%. Nevertheless, IT and sunless tanning product (STP) use have gained popularity among youth. However, there are limited data on the prevalence and sociodemographic correlates of both IT and STP use in a representative sample of American teens.

Methods

Teenage females (N = 778) aged 12–18 years were recruited as part of an on-going longitudinal study conducted between May 2011 and May 2013. Descriptive statistics explored IT and STP usage in teen females at baseline. Logistic regression was used to determine sociodemographic correlates of IT and STP …

New Approaches To Melanoma Prevention, June K. Robinson, Katie Baker, Joel J. Hillhouse

Joel Hillhouse

Skin cancer is a major public health concern, and tanning remains a modifiable risk factor. Multidimensional influences, including psychosocial, individual, environmental, and policy-related factors, create the milieu for individuals to engage in tanning. Parents and physicians can modify the behavior of teens and young adults using strategies based on harm reduction. Environmental and policy-related factors similar to those used to limit smoking by restricting access of minors to cigarettes in the United States in the 20th century need to be created. Federal regulations can restrict direct advertising and the excise tax can be increased to a prohibitive amount. Social networking …

The Behavioral Addiction Indoor Tanning Screener (Baits): An Evaluation Of A Brief Measure Of Behavioral Addictive Symptoms, Jerod L. Stapleton, Joel J. Hillhouse, Rob Turrisi, Katie Baker, Sharon L. Manne, Elliot J. Coups

Joel Hillhouse

No abstract provided.

Theory-Driven Longitudinal Study Exploring Indoor Tanning Initiation In Teens Using A Person-Centered Approach, Joel J. Hillhouse, Rob Turrisi, Michael J. Cleveland, Nichole M. Scaglione, Katie Baker, L. Carter Florence

Joel Hillhouse

Background Younger indoor tanning initiation leads to greater melanoma risk due to more frequent and persistent behavior. Despite this, there are no published studies exploring the predictors of indoor tanning initiation in teen populations. Purpose This longitudinal study uses latent profile analysis to examine indoor tanning initiation in indoor tanning risk subgroups from a national sample of female adolescents. Methods Latent profile analysis used indoor tanning beliefs and perceptions to identify indoor tanning initiation risk subgroups. The teens in each subgroup were reassessed on indoor tanning initiation after a year. Results Three subgroups were identified: a low risk, anti-tanning subgroup …

Engaging Moms On Teen Indoor Tanning Through Social Media: Protocol Of A Randomized Controlled Trial, Sherry L. Pagoto, Katie Baker, Julia Griffith, Jessica L. Oleski, Ashley Palumbo, Barbara Walkosz, Joel J. Hillhouse, Kimberly L. Henry, David Buller

Joel Hillhouse

Background: Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. Objective: This randomized controlled trial will test the efficacy of a …

Accuracy Of Self-Reported Sun Exposure And Sun Protection Behavior, Joel J. Hillhouse, Robert Turrisi, James Jaccard, June K. Robinson

Joel Hillhouse

The objective of this study was to compare the accuracy of self-reported skin cancer risk outcome measures proposed as standards by prevention experts to aggregated estimates of behavior from weekly diaries. Weekly electronic diaries of ultraviolet radiation (UVR) behaviors, initially validated by comparison with daily electronic diaries, were used to assess the accuracy of commonly used end-of-summer self-reported measures among 250 adults. Results revealed low biases, and good correspondence between simple open-ended self-reported estimates of days outside, hours outside, sunbathing days and hours, and days outside when not protected by either sunscreen, long-sleeved shirts, hats, or shade. Rating scale measures …

Trends And Determinants Of Up-To-Date Status With Colorectal Cancer Screening In Tennessee, 2002-2008, Sreenivas P. Veeranki, Shimin Zheng

Shimin Zheng

BACKGROUND: Screening rates for colorectal cancer (CRC) are increasing nationwide including Tennessee (TN); however, their up-to-date status is unknown. The objective of this study is to determine the trends and characteristics of TN adults who are up-to-date status with CRC screening during 2002-2008. METHODS: We examined data from the TN Behavioral Risk Factor Surveillance System for 2002, 2004, 2006 and 2008 to estimate the proportion of respondents aged 50 years and above who were up-to-date status with CRC screening, defined as an annual home fecal occult blood test and/or sigmoidoscopy or colonoscopy in the past 5 years. We identified trends …

Clinical Topic Review 2013 - Behavioral Health Screening Among Masshealth Children And Adolescents, Judith A. Savageau, Georgianna Willis, Kathy Muhr, David M. Keller, Gideon Aweh, Elizabeth O'Connell

Judith A. Savageau

Results from the 2013 evaluation suggest that the Children’s Behavioral Health Initiative had a large impact on formal behavioral health screening and treatment utilization among children and adolescents enrolled in MassHealth.

Clinical Topic Review: Behavioral Health Screening For Children With Well Visits, Judith A. Savageau, Linda M. Cabral, Jack Gettens, Elizabeth O'Connell, Lana Miller, Susan Maguire

Judith A. Savageau

The first Clinical Topic Review was conducted in order to better understand how behavioral health screenings were occurring for children and adolescents during well visits prior to the implementation of a requirement that primary care providers perform behavioral health screening using a standardized behavioral health screening tool during every well child visit.

Barriers And Facilitators To Deaf Trauma Survivors’ Help-Seeking Behavior: Lessons For Behavioral Clinical Trials Research: A Master’S Thesis, Melissa L. Anderson

Melissa L. Anderson

Deaf individuals experience significant obstacles to participating in behavioral health research when careful consideration is not given to accessibility in the design of study methodology. To inform such considerations, we conducted a secondary analysis of a mixed-methods study that explored 16 Deaf trauma survivors’ help-seeking experiences. Our objective was to identify key findings and qualitative themes from consumers' own words that can be applied to the design of behavioral clinical trials methodology. In many ways, the themes that emerged are what we would expect of any research participant, Deaf or hearing – a need for communication access, empathy, respect, strict …

A Pilot Study Of Deaf Trauma Survivors’ Experiences: Early Traumas Unique To Being Deaf In A Hearing World, Melissa L. Anderson, Kelly S. Wolf Craig, Wyatte C. Hall, Douglas M. Ziedonis

Melissa L. Anderson

Conducting semi-structured American Sign Language interviews with 17 Deaf trauma survivors, this pilot study explored Deaf individuals’ trauma experiences and whether these experiences generally align with trauma in the hearing population. Most commonly reported traumas were physical assault, sudden unexpected deaths, and “other” very stressful events. Although some “other” events overlap with traumas in the general population, many are unique to Deaf people (e.g., corporal punishment at oral/aural school if caught using sign language, utter lack of communication with hearing parents). These findings suggest that Deaf individuals may experience developmental traumas distinct to being raised in a hearing world. Such …

Transportation And Retention In Outpatient Drug Abuse Treatment Programs, Peter Friedmann, Stephenie Lemon, Michael Stein

Peter D. Friedmann MD

To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that …

Symptom Patterns Of Posttraumatic Stress Disorder Among Deaf Trauma Survivors, Melissa Anderson, Amanda Sortwell, Kelly Wolf Craig, Douglas Ziedonis

Melissa L. Anderson

Details about Deaf people’s pattern of posttraumatic stress disorder (PTSD) symptoms remain relatively unknown due to inaccessible methods used in most epidemiological research. We conducted semi-structured American Sign Language interviews with 16 trauma-exposed Deaf individuals to explore their PTSD symptom patterns. Half met criteria for current PTSD, a rate higher than the general population. Underlying this disparity may be heightened rates of dissociation and psychogenic amnesia reported by many Deaf trauma survivors. Future research with large samples of Deaf survivors is needed to clarify this hypothesis, and to inform interventions that more accurately target Deaf people’s pattern of trauma symptoms.

Sex Offending And Serious Mental Illness: Directions For Policy And Research, Andrew Harris, William Fisher, Bonita Veysey, Laura Ragusa, Arthur Lurigio

Arthur J. Lurigio

Over the past decade, two rapidly evolving areas of criminal justice practice have garnered increasing attention from policy makers, practitioners, and researchers: the management and treatment of justice involved individuals with serious and persistent mental illness, and the challenges of managing the perceived societal risk presented by sex offenders. Yet, whereas each of these issues has independently attracted significant attention, the nexus between them has remained largely unexamined. Matters of concern include the manner in which individuals with serious mental illness may be disproportionately affected by the expanding range of restrictions placed on those with sexual offense histories, the demands …