Social and Behavioral Sciences Commons^™

Does Assisted Living Provide Assistance And Promote Living?, Sheryl Zimmerman, Robyn Stone, Paula Carder, Kali Thomas

Institute on Aging Publications

Assisted living has promised assistance and quality of living to older adults for more than eighty years. It is the largest residential provider of long-term care in the United States, serving more than 918,000 older adults as of 2018. As assisted living has evolved, the needs of residents have become more challenging; staffing shortages have worsened; regulations have become complex; the need for consumer support, education, and advocacy has grown; and financing and accessibility have become insufficient. Together, these factors have limited the extent to which today's assisted living adequately provides assistance and promotes living, with negative consequences for aging …

Ambulatory Intensive Care For Medically Complex Patients At A Health Care Clinic For Individuals Experiencing Homelessness The Summit Randomized Clinical Trial, Brian Chan, Christina Nicolaidis, Meg Devoe, Priya Srikanth, P. Todd Korthuis, Samuel T. Edwards, Devan Kansagara, Rachel Solotaroff, Somnath Saha

School of Social Work Faculty Publications and Presentations

Importance Intensive primary care interventions have been promoted to reduce hospitalization rates and improve health outcomes for medically complex patients, but evidence of their efficacy is limited.

Objective To assess the efficacy of a multidisciplinary ambulatory intensive care unit (A-ICU) intervention on health care utilization and patient-reported outcomes.

Design, Setting, and Participants The Streamlined Unified Meaningfully Managed Interdisciplinary Team (SUMMIT) randomized clinical trial used a wait-list control design and was conducted at a health care clinic for patients experiencing homelessness in Portland, Oregon. The first patient was enrolled in August 2016, and the last patient was enrolled in November 2019. …

Centering Communities Of Color In The Modernization Of A Public Health Survey System: Lessons From Oregon, Daniel F. López-Cevallos, Kusuma Madamala, Mira Mohsini, Andres Lopez, Roberta Hunte, Ryan Petteway, Tim Holbert

School of Social Work Faculty Publications and Presentations

Context: Public health survey systems are tools for informing public health programming and policy at the national, state, and local levels. Among the challenges states face with these kinds of surveys include concerns about the representativeness of communities of color and lack of community engagement in survey design, analysis, and interpretation of results or dissemination, which raises questions about their integrity and relevance.

Approach: Using a data equity framework (rooted in antiracism and intersectionality), the purpose of this project was to describe a formative participatory assessment approach to address challenges in Oregon Behavioral Risk Factor Surveillance System (BRFSS) and Student …

All Chronic Rhinosinusitis Endotype Clusters Demonstrate Improvement In Patient Reported And Clinical Outcome Measures After Endoscopic Sinus Surgery, Nikita Chapurin, Rodney J. Schlosser, Jorge Gutierrez, Jess C. Mace, Todd Bodner, Timothy L. Smith, Jose L. Mattos, Vijay R. Ramakrishnan, Jeremiah Alt, Zachary M. Soler

Psychology Faculty Publications and Presentations

Background

It is unclear if chronic rhinosinusitis (CRS) endotypes show differential response to endoscopic sinus surgery (ESS). We explored mucus inflammatory cytokine expression in a cohort with CRS and associations with both patient-reported and clinically measured postoperative outcome measures.

Methods

Patients with CRS were prospectively recruited between 2016-2021 into a multi-center observational study. Mucus was collected from the olfactory cleft preoperatively and evaluated for 26 biomarkers using cluster analysis. Patient reported outcome measures included the Sino-Nasal Outcome Test (SNOT-22) and Questionnaire of Olfactory Dysfunction (QOD). Additional clinical measures of disease severity included Threshold, Discrimination, and Identification (TDI) scores using Sniffin’ …

Describing Physical Activity Patterns Of Truck Drivers Using Actigraphy, Bradley Wipfli, Sean P.M. Rice, Ryan Olson, Kasey Ha, Caitlyn F. Trullinger-Dwyer, Todd Bodner

Psychology Faculty Publications and Presentations

Background: Truck driving is a highly sedentary occupation that places workers at risk for chronic health conditions, such as obesity and high blood pressure. The primary purpose of this study was to objectively describe truck drivers’ typical physical activity (PA) patterns. Methods: We used w7e10-day baseline PA actigraphy data samples from drivers in the Safety & Health Involvement For Truckers (SHIFT) study (n ¼ 394). Driver PA patterns (e.g., average number of 10 minute Freedson bouts per week, time in bouts, and common days/times for PA) were summarized with descriptive analyses. We also compared objective accelerometer data to self-reports. Results: …

Positive And Negative Experiences With Supportive Services And Programming: Gaps And Recommendations From Youth Experiencing Homelessness, Judy Y. Tan, G. Allen Ratliff, Ilsa Lund, Sherilyn Adams, Colette Auerswald, Marguerita Lightfoot

OHSU-PSU School of Public Health Faculty Publications and Presentations

Services for youth experiencing homelessness (YEH) are designed with limited input from the youth themselves. This study explored the experiences and recommendations for services aimed at mitigating the negative effects of homelessness among youth. A total of 45 interviews were conducted with YEH (ages 15 to 24, M = 21.5 years) who experienced at least one night of homelessness. Transcripts were coded by using a modified constructivist grounded theory approach. YEH reported myriad challenges to navigating disjointed programming and misguided policies. Recommendations from YEH for policy and programmatic change include peacekeeping and diffusion training for program staff, trauma-informed approaches, and …

Paperwork, Paradox, And Prn: Psychotropic Medication Deficiencies In Assisted Living, Sarah Dys, Paula Carder

Institute on Aging Publications

Individual state approaches to assisted living/residential care (AL/RC) licensing and oversight in the United States result in different practice standards and requirements, including psychotropic medication use. We examined 170 psychotropic medication deficiency citations issued to 152 Oregon AL/RC settings from 2015 to 2019. Applied thematic analysis resulted in the following themes: (1) documentation issues are primarily responsible for noncompliance, (2) unclear parameters place direct care workers in a role paradox, and (3) there is a persistent disconnect about when to seek qualified expertise before requesting psychotropic medications. AL/RC-specific mechanisms for medication prescription and administration are necessary to improve the structure …

The People’S Social Epi Project: Pdx With Ryan Petteway, Ryan J. Petteway

PDXPLORES Podcast

In this episode of PDXPLORES, Ryan J. Petteway, Associate Professor at the Oregon Health & Science University-Portland State University School of Public Health, discusses the research behind The People's Social Epi Project: PDX. Providing a counternarrative to the settler-colonial and racial capitalist practices of traditional epidemiological research on health inequities, Petteway's PSEP: PDX initiative is a portfolio of three projects centering around youth-led participatory research, music, and poetry. PSEP: PDX seeks to "center the margins'' to advance health and epistemic justice.

Click on the "Download" button to access the audio transcript.

Conspiracy Theories And Ebola: Lessons Learned Important For Future Pandemics, Shawn C. Smallman

International & Global Studies Faculty Publications and Presentations

The public health campaign against Ebola in the Democratic Republic of the Congo faced serious challenges, some due to conspiracy theories and denial. These beliefs were so powerful that they even caused repeated attacks upon health care providers and medical centers. These conspiracy theories were nothing new, as they are a common feature of all frightening epidemics, such as HIV and COVID-19. These narratives also circulated during the 2015 West African Ebola outbreak. Addressing conspiracy theories during an epidemic requires a coordinated campaign involving not only local leaders but also the cooperation of social media organizations

The Resident View In Community- Based Care Residential Settings, Diana L. White, Ozcan Tunalilar, Serena Hasworth, Jaclyn Winfree

Institute on Aging Publications

The Resident VIEW is a measure of person-centered care (PCC) from residents’ perspectives and was previously studied in nursing homes. The current study presents descriptive data for the Resident VIEW in community-based care settings including assisted living, residential care (AL/RC), and adult foster homes (AFH). Using a two-stage sampling design, we recruited 31 AL/RC and 119 AFH in Oregon and completed face-to-face structured interviews with 227 and 195 residents, respectively. Residents provided ratings for both the importance of and their experience with 66 items that tapped into PCC practices in eight domains. Results are provided for each item, many of …

Parent Attitudes Towards Childhood Vaccines After The Onset Of Sars-Cov-2 In The United States, Douglas J. Opel, Anna Furniss, Chuan Zhou, John D. Rice, Heather Spielvogle, Christine Spina, Cathryn Perreira, Jessica Giang, Jeffrey D. Robinson, Multiple Additional Authors

Communication Faculty Publications and Presentations

Objective: To understand the influence of a novel infectious disease epidemic on parent general attitudes about childhood vaccines.

Methods: We conducted a natural experiment utilizing cross-sectional survey data from parents of infants in Washington and Colorado participating in a larger trial that began on September 27, 2019. At enrollment, parents completed the short version of the Parental Attitudes about Childhood Vaccines (PACV-SF), a validated survey scored from 0-4, with higher scores representing more negative attitudes. The exposure variable was onset of the SARS-CoV-2 pandemic in the US, with the before-period defined as September 27, 2019 –– February 28, …

Tools For Addressing Intimate Partner Violence And Suicide Risk: Lessons Learned From Oha’S Covid-19 Emergency Response For Suicide Prevention Grant, Karen Cellarius, Aliza Tuttle, Lea Sevey

Regional Research Institute for Human Services

In August 2020, the Oregon Coalition Against Domestic and Sexual Violence (OCADSV), the Oregon Health Authority (OHA), and Portland State University’s Regional Research Institute for Human Services (PSU RRI) began an 18-month collaboration to strengthen support for domestic violence and mental health agencies during COVID-19. As part of this grant, six domestic violence advocacy organizations around Oregon were able to place co-located advocates with their mental health partner agencies for services and cross-training. The content of this booklet is another product of this collaboration.

2022 Zero Suicide Implementation In Oregon: Cross‐Site Follow‐Up Change Report, Karen Cellarius, Aliza Tuttle

Regional Research Institute for Human Services

This implementation self‐assessment and the accompanying web survey were adapted for the Oregon Health Authority (OHA) by Portland State University in collaboration with the OHA Youth Suicide Prevention staff. The assessment was adapted from three existing Zero Suicide resources available at http://zerosuicide.org/.

The Organizational Self‐Study is a questionnaire about the extent to which each component of the Zero Suicide approach is in place at a single organization. Zero Suicide recommends completing this self‐study at the start of an organization’s Zero Suicide initiative, then every 12 months after that as a measure of fidelity to the model. The self‐study questions …

Reconstructability Analysis: Discrete Multivariate Modeling, Martin Zwick

Systems Science Faculty Publications and Presentations

An introduction to Reconstructability Analysis for the Discrete Multivariate Modeling course and for other purposes.

A Comparison Of The Risk Of Fracture In Rheumatoid Arthritis Patients With And Without Receiving Chinese Herbal Medicine, Hou-Hsun Liao, Hanoch Livneh, Yu-Jung Chung, Ching-Hsing Lin, Ning-Sheng Lai, Hung-Rong Yen, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Objective: Patients with rheumatoid arthritis (RA) often suffer from bone complications due to persistent joint inflammation, especially incident fracture. Nowadays, Chinese herbal medicines (CHMs) have provided safe and effective therapy for treating skeletal conditions, but it is unclear whether CHMs can prevent fracture onset among RA individuals. This study aimed to determine the association between the use of CHMs and the risk of fracture among them.

Methods: This retrospective, population-based study retrieved administrative health data from the Taiwan National Health Insurance (NHI) database to identify patients with newly diagnosed RA between 2000 and 2009. Of the 6178 incident …

“It’S Like 1998 Again”: Why Parents Still Refuse And Delay Vaccines, Jiana L. Ugale, Heather Spielvogle, Christine Spina, Cathryn Perreira, Ben Katz, Barbara Pahud, Phd Amanda F. Dempsey Md, Jeffrey D. Robinson Phd, Kathleen Garrett Ma, Mph Sean T. O’Leary Md, Mph Douglas J. Opel Md

Communication Faculty Publications and Presentations

We conducted a qualitative study from 2018 to 2019 to update the reasons why US parents’ refuse or delay vaccines. Four focus groups and 4 semi-structured interviews involving 33 primary care pediatric providers were conducted in Washington and Colorado. A thematic analysis was conducted to identify themes related to reasons for parental refusal or delay. Five predominant themes were identified: (1) vaccine safety, (2) relative influence of information sources, decision-makers, and timing, (3) low perceived risk of contracting vaccine-preventable disease, (4) lack of trust, and (5) religious objection. Vaccine safety was the theme mentioned most frequently by providers (N = …

Graphical Models In Reconstructability Analysis And Bayesian Networks, Marcus Harris, Martin Zwick

Systems Science Faculty Publications and Presentations

Reconstructability Analysis (RA) and Bayesian Networks (BN) are both probabilistic graphical modeling methodologies used in machine learning and artificial intelligence. There are RA models that are statistically equivalent to BN models and there are also models unique to RA and models unique to BN. The primary goal of this paper is to unify these two methodologies via a lattice of structures that offers an expanded set of models to represent complex systems more accurately or more simply. The conceptualization of this lattice also offers a framework for additional innovations beyond what is presented here. Specifically, this paper integrates RA and …

Travelling For Abortion Services In Mexico 2016–2019: Community-Level Contexts Of Mexico City Public Abortion Clients, Laura E. Jacobson Mph, Biani Saavedra-Avendano, Evelyn Fuentes-Rivera, Raffaela Schiavon, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To describe the community context of women who travel to access Mexico City’s public sector abortion programme and identify factors associated with travelling from highly marginalised settings.

Methods: We used data from the Interrupción Legal de Embarazo (ILE) programme (2016–2019) and identified all abortion clients who travelled from outside Mexico City. We merged in contextual information at the municipality level and used descriptive statistics to describe ILE clients’ individual characteristics and municipalities on several measures of vulnerability. We also compared municipalities that ILE clients travelled from with those where no one travelled from. We used logistic regression to identify …

Thematic Content Analysis Of Newspaper Coverage Of The Causes Of The Opioid Crisis, Joseph Daniel Eichenlaub, Essma Nasher

Sociology Faculty Publications and Presentations

This nation pioneered modern life. Now epic numbers of Americans are killing themselves with opioids to escape it”[1]. According to the CDC, In 2017 alone, 47,600 people died from opioid-related overdoses [2]. The current opioid epidemic has developed in three distinct waves. Initially there was a sharp rise in opioid overdoses after doctors began prescribing drugs such as Oxycontin, which they were assured by pharmaceutical companies were less addictive than traditional opiates. The second wave began around 2010, when a rapid …

Shifting Coronavirus Disease 2019 Testing Policy And Research To Include The Full Translation Pipeline, Joseph Catania, Jeffrey Martin, M. Margaret Dolcini, E. Roberto Orellana, Jeffrey Henne

School of Social Work Faculty Publications and Presentations

The current severe acute respiratory syndrome coronavirus 2 testing policy and practice limits testing as a prevention tool. Radical shifts are required to increase the scale of rapid testing strategies and improve dissemination and implementation of venue-based and self-testing approaches. Attention to the full translation pipeline is required to reach high-risk segments of the population.

“Eyes In The Home”: Addressing Social Complexity In Veterans Affairs Home-Based Primary Care, Elizabeth Catherine Hulen, Avery Laliberte, Sarah S. Ono, Somnath Saha, Samuel T. Edwards

Sociology Faculty Publications and Presentations

BACKGROUND: Home-Based Primary Care (HBPC) has demonstrated success in decreasing risk of hospitalization and improving patient satisfaction through patient targeting and integrating long-term services and supports. Less is known about how HBPC teams approach social factors.

OBJECTIVE: Describe HBPC providers’ knowledge of social complexity among HBPC patients and how this knowledge impacts care delivery.

DESIGN, SETTING, AND PARTICIPANTS: Between 2018 and 2019, we conducted in-person semi-structured interviews with 14HBPCproviders representing nursing,medicine, physical therapy, pharmacy, and psychology, at an urban Veterans Affairs (VA) medical center. We also conducted field observations of 6 HBPC team meetings and 2 home visits.

APPROACH: We …

Evaluation Of The Livewell Method: Final Report, Paula Carder, Serena Hasworth, Diana Cater

Institute on Aging Publications

The LiveWell Method uses a practice-based framework to improve the quality of life for people living and working in long-term care settings, including assisted living and memory care. It is designed to improve teamwork, communication, and morale by helping staff organize, track, measure, and improve daily operations. This evaluation is informed by the LiveWell Method’s “bottom-up and top enabled” approach, which engages and empowers direct care staff and administrators to create a more democratic and transparent workplace. In addition, the evaluation included questions to assess LiveWell’s core values, such as creating care innovations, nurturing dignity, creating community, and honoring elders, …

Healthy Birth Initiatives: The Road Toward Reproductive Justice, Roberta Hunte, Susanne Klawetter, Sherly Paul

School of Social Work Faculty Publications and Presentations

This study concerns racialized experiences of reproductive oppression among Black women and the efforts of one organization - Multnomah County’s Healthy Birth Initiatives (HBI) - to combat this oppression and move towards Reproductive Justice. This study explores how Black women experience and respond to racism-related stress and its impacts on their health during and after pregnancy and subsequent parenting. The project was informed by a pilot focus group conducted in 2016 by Drs. Jenna Ramaker and Roberta Hunte in partnership with HBI, which asked HBI clients about the role of toxic stress and racism-related stress in their lives. The current …

Hypergraph Analysis Of Structure Models, Cliff A. Joslyn, Teresa D. Schmidt, Martin Zwick

Systems Science Faculty Publications and Presentations

Theoretical discussion on the analysis of hypergraph networks; application of analysis methods to hypergraph networks derived by applying Reconstructability Analysis to health care data (the PhD dissertation work of Teresa Schmidt).

Toxic Stress Among Black And African American Oregonians, Roberta Hunte, Margaret J.F. Braun

School of Social Work Faculty Publications and Presentations

Toxic stress is a reaction to ongoing adversity such as abuse, neglect, poverty, racism, discrimination, and exposure to violence; it is powerful enough to change brain chemistry and architecture. Toxic stress and associated changes to the brain can lead to poor health outcomes later in life. Adverse childhood experiences (ACEs), racism*, and discrimination can trigger toxic stress and have long term consequences for the health of many people, particularly those in the Black and African American community.

The current project examined toxic stress and its impact on the health of Black and African American Oregonians. We looked at two indicators …

Impact Of The Covid-19 Outbreak On Long-Term Care In The United States, Courtney H. Van Houtven, Nathan A. Boucher, Walter D. Dawson

Institute on Aging Publications

The United States (US) currently has the most confirmed cases of COVID-19 of any country. Yet, adequate testing for the virus remains a major issue. Approximately 51.6 million Americans are over the age of 65 and 56 percent of adults over 65 are living with two or more chronic conditions (23 percent have 3 or more). Given the higher risk of death and complications associated with advanced age and underlying health conditions, COVID-19 has had an immense impact upon LTC in the United States. Yet, the level and intensity of impact has been sporadic in application. This is due in …

Opioid Agonist Therapy During Hospitalization Within The Veterans Health Administration: A Pragmatic Retrospective Cohort Analysis, Kelsey C. Priest, Travis I. Lovejoy, Honora Englander, Sarah Shull, Dennis Mccarty

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Hospitalization of patients with opioid use disorder (OUD) is increasing, yet little is known about opioid agonist therapy (OAT: methadone and buprenorphine) administration during admission.

Objective

Describe and examine patient- and hospital-level characteristics associated with OAT receipt during hospitalization in the Veterans Health Administration (VHA).

Participants

A total of 12,407 unique patients, ≥ 18 years old, with an OUD-related ICD-10 diagnosis within 12 months prior to or during index hospitalization in fiscal year 2017 from 109 VHA hospitals in the continental U.S.

Main Measure

OAT received during hospitalization.

Key Results

Few admissions received OAT (n = 1914; 15%) …

Association Of Use Of Rehabilitation Services With Development Of Dementia Among Patients With Rheumatoid Arthritis: Analysis Of Domestic Data In Taiwan, Ming-Chi Lu, Hanoch Livneh, Chieh-Tsung Yen, Hua-Lung Huang, Miao-Chiu Lin, Shu-Wen Yen, Ning-Sheng Lai, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Objectives: Rheumatoid arthritis (RA) was found to trigger the higher risk of dementia. Limited information, however, is available on whether the use of rehabilitation services (RS), an integral part of healthcare programs, can lessen dementia risk for RA subjects. The aim of this study was to determine the relationship of RS use to the development of dementia in RA patients.

Methods: We identified 2,927 newly diagnosed patients with RA, 20–70 years of age between 1998 and 2007, from a national health insurance database. 965 patients from this sample received RS, and 1,962 patients were designated as a control group (non-RS …

A Systematic Literature Review Of Video-Based Interventions To Improve Integrated Competitive Employment Skills Among Youth And Adults With Autism Spectrum Disorder, Vidya D. Munandar, Mary E. Morningstar, Sarah R. Carlson

Special Education Faculty Publications and Presentations

BACKGROUND:

People with Autism Spectrum Disorder (ASD) have lower employment rates than their peers without disabilities or other disabilities. Clear evidence exists regarding video-based interventions (VBIs) for improving task performance and social communication skills for students with ASD. However, such interventions have rarely been applied in integrated employment settings.

OBJECTIVE:

This systematic literature review aims to examine the utilization and efficacy of video-based interventions in improving the skills required to secure and maintain a job for youth and adults with ASD.

METHODS:

A systematic literature review was conducted on peer-reviewed articles on VBIs and ASD from electronic databases (n.d. –2019), …

Prevalence And Correlates Of Transactional Sex Among Women Of Low Socioeconomic Status In Portland, Or, Timothy Menza, Lauren Lipira, Amisha Bhattarai, Victoria Cali-De Leon, E. Roberto Orellana

School of Social Work Faculty Publications and Presentations

Background: Women who report transactional sex are at increased risk for HIV and other sexually transmitted infections (STIs). However, in the United States, social, behavioral, and trauma-related vulnerabilities associated with transactional sex are understudied and data on access to biomedical HIV prevention among women who report transactional sex are limited.

Methods: In 2016, we conducted a population-based, cross-sectional survey of women of low socioeconomic status recruited via respondent-driven sampling in Portland, Oregon. We calculated the prevalence and, assessed the correlates of, transactional sex using generalized linear models accounting for sampling design. We also compared health outcomes, HIV screening, and knowledge …