Medicine and Health Sciences Commons^™

Recommendations From People Who Use Drugs In Philadelphia, Pa About Structuring Point-Of-Care Drug Checking, Megan K. Reed, Elias Borne, Tracy Esteves Camacho, Morgan Kelly, Kristin L. Rising

Department of Emergency Medicine Faculty Papers

Background

Adulterants, such as fentanyl and xylazine, among others, are present in a high percentage of the illicit drug supply, increasing the risk for overdose and other adverse health events among people who use drugs (PWUD). Point-of-care drug checking identifes components of a drug sample and delivers results consumers. To successfully meet the diverse needs of PWUD, more information is needed about the utility of drug checking, motivations for using services contextualized in broader comments on the drug supply, hypothesized actions to be taken after receiving drug checking results, and the ideal structure of a program.

Methods

In December 2021, …

Social And Psychosocial Determinants Of Racial And Ethnic Differences In Cardiovascular Health: The Masala And Mesa Studies, Nilay S. Shah, Xiaoning Huang, Lucia C. Petito, Michael P. Bancks, Alka M. Kanaya, Sameera Talegawkar, Saaniya Farhan, Mercedes R. Carnethon, Donald M. Lloyd-Jones, Norrina B. Allen, Namratha R. Kandula, Sadiya S. Khan

Student Papers, Posters & Projects

BACKGROUND: Social and psychosocial determinants are associated with cardiovascular health (CVH).

OBJECTIVES: To quantify the contributions of social and psychosocial factors to racial/ethnic differences in CVH.

METHODS: In the Multi-Ethnic Study of Atherosclerosis and Mediators of Atherosclerosis in South Asians Living in America cohorts, Kitagawa-Blinder-Oaxaca decomposition quantified the contributions of social and psychosocial factors to differences in mean CVH score (range 0-14) in Black, Chinese, Hispanic, or South Asian compared with White participants.

RESULTS: Among 7,978 adults (mean age 61 [SD 10] years, 52 % female), there were 1,892 Black (mean CVH score for decomposition analysis 7.96 [SD 2.1]), 804 …

A Prioritized Patient-Centered Research Agenda To Reduce Disparities In Telehealth Uptake: Results From A National Consensus Conference, Kristin L. Rising, Mackenzie Kemp, Amy E. Leader, Anna Marie Chang, Andrew J. Monick, Amanda Guth, Tracy Esteves Camacho, Gregory Laynor, Brooke Worster

Department of Emergency Medicine Faculty Papers

Introduction: We hosted a national consensus conference with a diverse group of stakeholders to develop a patient-centered research agenda focused on reducing disparities in telehealth use.

Methods: Attendees were purposively invited to participate in a 2-day virtual conference. The group developed a prioritized research agenda focused on reducing disparities in telehealth uptake, with discussion informed by findings from a scoping review. All work was conducted in partnership with a Steering Committee of national experts in telehealth and patient-centered care (n = 5) and a community-based Telehealth Advisory Board with experience with telehealth use and barriers (n = 8).

Results: Sixty …

Changing The Playbook For Immigrant Health, Cheryl Bettigole, Patricia C. Henwood, Sage Myers, Maura Sammon

Department of Emergency Medicine Faculty Papers

Philadelphia’s response to welcoming Afghan evacuees during the COVID-19 pandemic suggests the need for a new approach to immigrant health care.

Ethiopian Residents’ Attitudes Toward Dermatology Research: A Survey Study, Rishab R. Revankar, Heli A. Patel, Joo Yeon Shin, Alice B. Gottlieb, Loren D. Krueger, Benjamin K. Stoff

Student Papers, Posters & Projects

Dermatology programs in resource-limited settings manage high patient volumes.1 Trainees have extensive clinical responsibilities, which may preclude engaging in research. Programs in such settings may lack the infrastructure to provide adequate support. At the Department of Dermatovenereology at the University of Gondar in Ethiopia, residents anecdotally report a high caseload and lack of resources, including time, to pursue research. Members of Emory and Mount Sinai Dermatology designed and delivered a 30-minute presentation about research design and methods. Residents were surveyed pre- and postintervention about their attitudes toward pursuing dermatology research during residency

Communication Of Patients’ And Family Members’ Ethical Concerns To Their Healthcare Providers, Mariam Noorulhuda, Christine Grady, Paul Wakim, Talia Bernhard, Hae Lin Cho, Marion Danis

Student Papers, Posters & Projects

BACKGROUND: Little is known about communication between patients, families, and healthcare providers regarding ethical concerns that patients and families experience in the course of illness and medical care. To address this gap in the literature, we surveyed patients and family members to learn about their ethical concerns and the extent to which they discussed them with their healthcare providers.

METHODS: We surveyed adult, English-speaking patients and family members receiving inpatient care in five hospitals in the Washington DC-Baltimore metropolitan area from July 2017 to March 2020. Descriptive statistics were used to determine the frequency, comfortableness, and helpfulness of discussions regarding …

What Were The Information Voids? A Qualitative Analysis Of Questions Asked By Dear Pandemic Readers Between August 2020-August 2021, Rachael Piltch-Loeb, Richard James, Sandra S. Albrecht, Alison M. Buttenheim, Jennifer Beam Dowd, Aparna Kumar, Malia Jones, Lindsey J. Leininger, Amanda Simanek, Shoshana Aronowitz

College of Nursing Faculty Papers & Presentations

In the current infodemic, how individuals receive information (channel), who it is coming from (source), and how it is framed can have an important effect on COVID-19 related mitigation behaviors. In light of these challenges presented by the infodemic, Dear Pandemic (DP) was created to directly address persistent questions related to COVID-19 and other health topics in the online environment. This is a qualitative analysis of 3806 questions that were submitted by DP readers to a question box on the Dear Pandemic website between August 30, 2020 and August 29, 2021. Analyses resulted in four themes: the need for clarification …

Physical And Stressful Psychological Impacts Of Prolonged Personal Protective Equipment Use During The Covid-19 Pandemic: A Cross-Sectional Survey Study, Giuseppe Candido, Costanza Tortù, Chiara Seghieri, Riccardo Tartaglia, Chiara Baglioni, Paolo Citti, Ida Marina Raciti, Micaela La Regina, Silvia Simonini, Moira Urbani, Chiara Parretti, Paul Barach

College of Population Health Faculty Papers

BACKGROUND: Healthcare workers (HCWs) caring for COVID-19 infected patients are exposed to stressful and traumatic events with potential for severe and sustained adverse mental and physical health consequences. Our aim was to assess the magnitude of physical and mental health outcomes of HCWs due to the prolonged use of personal protective equipment (PPE) treating COVID-19 patients.

METHODS: This cross-sectional study assessed the symptoms of stress, anxiety, insomnia, and psychological resilience using the Stress and Anxiety to Viral Epidemics (SAVE) scale, Insomnia Severity Index (ISI), and Resilience Scale (RS), respectively, in Italy between 1st February and 31st March 2022. The physical …

Analysis Of Trustworthiness And Readability Of English And Spanish Hypo- And Hyperthyroid-Related Online Patient Education Information, Chitra Parikh, Adam M. Ostrovsky

Student Papers, Posters & Projects

This study aims to determine the readability and trustworthiness of English and Spanish hypo- and hyperthyroid-related online information. Google searches were conducted for four search terms: hypothyroidism, Hashimoto's Disease, hyperthyroidism, and Graves’ Disease. For each search term, the first 10 websites were analyzed with a total of 40 websites analyzed. Readability formulas were used to determine English and Spanish readability. Trustworthiness was determined using HONcode status, JAMA Benchmark Criteria, and NLM Trustworthy Score. Overall readability largely exceeded recommended grade levels. Only 1 website (2.5%) presented information below the eighth-grade reading level based on overall Readability Consensus score, while 31 websites …

Study Protocol: Type Iii Hybrid Effectiveness-Implementation Study Implementing Age-Friendly Evidence-Based Practices In The Va To Improve Outcomes In Older Adults, Kirstin Manges Piazza, Laura Ellen Ashcraft, Liam Rose, Daniel E. Hall, Rebecca T. Brown, Mary Elizabeth (Libby) Bowen, Shahrzad Mavandadi, Alison C. Brecher, Shimrit Keddem, Bruce Kiosian, Judith A. Long, Rachel M. Werner, Robert E. Burke

College of Population Health Faculty Papers

Background

Unmet care needs among older adults accelerate cognitive and functional decline and increase medical harms, leading to poorer quality of life, more frequent hospitalizations, and premature nursing home admission. The Department of Veterans Affairs (VA) is invested in becoming an “Age-Friendly Health System” to better address four tenets associated with reduced harm and improved outcomes among the 4 million Veterans aged 65 and over receiving VA care. These four tenets focus on “4Ms” that are fundamental to the care of older adults, including (1) what Matters (ensuring that care is consistent with each person’s goals and preferences); (2) …

A Systematic Review Identifying Adverse Health Outcomes And Mortality Rates Associated With Telehealth, Fidelia Cascini, Ana Pantovic, Yazan A. Al-Ajlouni, Omar Al Ta'ani, Giovanna Failla, Andriy Melnyk, Paul Barach, Walter Ricciardi

College of Population Health Faculty Papers

Background: The literature supporting telehealth management is growing accelerated by the COVID-pandemic. We hypothesize that there are risks of adverse events associated with telehealth interventions.

Methods: A review of PubMed (including MEDLINE), Embase, ISI (Web of Science), VHL/GHL, Scopus, Science Direct, and PsycINFO was conducted for all adverse events associated with telehealth from January 1, 1960 to March 1, 2021. This systematic review and meta-analyses were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Of 5,144 citations 78 published studies met criteria for quality evaluation and underwent full text abstraction including the qualitative …

Increasing Covid-19 Vaccination Coverage For Newcomer Communities: The Importance Of Disaggregation By Language, Abigail Steiner, Kristine Knuti Rodrigues, Nadège Mudenge, Janine Young, Rasulo Rasulo, Colleen Payton, Malini Desilva, Jeremy Michel, Mary Fabio, Katherine Yun

College of Population Health Faculty Papers

The COVID-19 pandemic has disproportionately affected refugee, immigrant, and migrant populations. Vaccines are essential for decreasing transmission and severity of COVID-19 infection. Understanding differences in vaccination coverage based on preferred language is crucial for focusing efforts to decrease COVID-19-related disparities. Four sites in the Minnesota Center of Excellence in Newcomer Health collaboratively evaluated completion of primary COVID-19 vaccination series on or before December 31, 2021, for patients who were 12 years or older on June 30, 2021, by preferred language. The non-English/non-Spanish speaking population included 46,714 patients who spoke 174 languages; COVID-19 vaccination coverage by language ranged from 26.2% to …

Cancer Patient And Provider Responses To Companion Scales Assessing Experiences With Lgbtqi-Affirming Healthcare, Mandi L. Pratt-Chapman, Yan Wang, Gwendolyn P. Quinn, Sylvia Shirima, Sarah Adler, Ruta Brazinskaite, Asa Radix, Barbara Warren, Kristen Eckstrand, Ana Maria Lopez

Department of Medical Oncology Faculty Papers

Background: Sexual and gender minority (SGM) persons are at a higher risk for some cancers and may have poorer health outcomes as a result of ongoing minority stress, social stigma, and cisnormative, heteronormative healthcare environments. This study compared patient and provider experiences of affirming environmental and behavioral cues and also examined provider-reported knowledge, attitudes, behaviors, and clinical preparedness in caring for SGM patients among a convenience sample.

Methods: National convenience samples of oncology providers (n = 107) and patients (n = 88) were recruited separately via snowball sampling. No incentives were provided. After reverse coding of appropriate items for unidirectional …

Telehealth In Medicine: Predictions 2023–2024, Jiang Li, Ingrid Vasiliu-Feltes, Kathleen Mcgrow, Brendan F. Smith, Paul Barach, Sweta Sneha, Francis X. Campion

College of Population Health Faculty Papers

Each year, Telehealth and Medicine Today asks experts in the field to share their insights into the future and predict how telehealth will influence uptake and healthcare in the new year.

Using A Human-Centered, Mixed Methods Approach To Understand The Patient Waiting Experience And Its Impact On Medically Underserved Populations, Elizabeth N. Liao, Lara Z. Chehab, Kathryn Neville, Jennifer Liao, Devika Patel, Amanda Sammann

Department of Emergency Medicine Faculty Papers

Purpose: To use a mixed methods approach to investigate the patient waiting experience for a medically underserved population at an outpatient surgical clinic.

Methods: We used lean methodology to perform 96 time-tracked observations of the patient journey in clinic, documenting the duration of activities from arrival to departure. We also used human-centered design (HCD) to perform and analyze 43 semi-structured interviews to understand patients’ unmet needs.

Results: Patients spent an average of 68.5% of their total clinic visit waiting to be seen. While the average visit was 95.8minutes, over a quarter of visits (27%) were over 2hours. Patients waited an …

Increased Incidence Of Suspected Smoke Inhalation During The Coronavirus Disease 2019 Pandemic: A National Database Study, Theodore E Habarth-Morales, Arturo J. Rios Diaz, Emily Isch, Shreyas Chandragiri, Lucy Qi, Rose Ni, Edward J. Caterson

Student Papers, Posters & Projects

The COVID-19 pandemic has forced many Americans to adapt their daily routines. In 2020, there was a significant increase in house fires according to the National Fire Prevention Association (NFPA). The objective of this study was to characterize the changes in suspected smoke inhalations (SSIs) during the first year of the pandemic in the National Emergency Medical Services Information System (NEMSIS). The NEMSIS database was queried for all EMS transports captured between 2017 and 2020. Differences in the incidences of SSIs and fire dispatches in 2020 were estimated using Poisson regression models. There was a 13.4% increase in the incidence …

Emerging Lessons From The Covid-19 Pandemic About The Decisive Competencies Needed For The Public Health Workforce: A Qualitative Study, Osnat Bashkin, Robert Otok, Lore Leighton, Kasia Czabanowska, Paul Barach, Nadav Davidovitch, Keren Dopelt, Mariusz Duplaga, Leah Okenwa Emegwa, Fiona Macleod, Yehuda Neumark, Maya Peled Raz, Theodore Tulchinsky, Zohar Mor

College of Population Health Faculty Papers

The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between …

Credible Practice Of Modeling And Simulation In Healthcare: Ten Rules From A Multidisciplinary Perspective, Ahmet Erdemir, Lealem Mulugeta, Joy P Ku, Andrew Drach, Marc Horner, Tina M Morrison, Grace C Y Peng, Rajanikanth Vadigepalli, William W Lytton, Jerry G Myers

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The complexities of modern biomedicine are rapidly increasing. Thus, modeling and simulation have become increasingly important as a strategy to understand and predict the trajectory of pathophysiology, disease genesis, and disease spread in support of clinical and policy decisions. In such cases, inappropriate or ill-placed trust in the model and simulation outcomes may result in negative outcomes, and hence illustrate the need to formalize the execution and communication of modeling and simulation practices. Although verification and validation have been generally accepted as significant components of a model's credibility, they cannot be assumed to equate to a holistic credible practice, which …

Literature Review On Hospital Costs For Patients Undergoing Colectomy, Brian P.H. Chen, Scm, Hang Cheng, Martha Romney, Rn, Ms, Jd, Mph, Carine Chia-Wen Hsiao

College of Population Health Posters

Objective:

This study aims to identify the range of direct hospital costs associated with a minimally invasive or open colectomy procedure across different countries.

Poster presented at 2016 ISPOR conference in Washington DC.

Literature Review On Hospital Costs For Patients Undergoing Hysterectomy, Brian P.H. Chen, Scm, Pharmd, Hang Cheng, Martha Romney, Rn, Ms, Jd, Mph, Carine Chia-Wen Hsiao

College of Population Health Posters

Objective:

This study aims to identify the range of direct hospital costs associated with a minimally invasive or abdonimal hysterectomy procedure across different countries.

Poster presented at 2016 ISPOR conference in Washington DC.

A Review Of Current Quality Metrics For Evaluating Patient-Centered Medical Homes, Stefan Varga, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

This review sought to explore the quality metrics that are currently utilized to assess PCMHs

Poster presented at 2016 ISPOR conference in Washington DC.

Erosion Of Empathy In Primary Care Trainees, Jacquelyn Mcrae, Pharmd, G. Calusi, Mengdan Liu, V. Scognamiglio, E. Messina, L. Polenzani, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objective:

To evaluate if empathy among physician residents (trainees) differs dependent on training year and to assess trainees' characteristics associated with higher empathy scores.

Poster presented at 2016 ISPOR conference in Washington DC.

Treatment Plan Adherence To Guidelines In Senior Adult Oncology Patients, Amy R. Mackenzie, Md, Andrea M. Barsevick, Phd, Ronald Myers, Phd, Ludmila De Oliveira Koch, Md, Scott W. Keith, Phd, Thomas Wolf, Ma, James Cocroft, Ma, Joshua Schoppe, Mph, Ulysses Williams Iii, Andrew Chapman, Do

Department of Medical Oncology Faculty Papers

Materials & Methods:

• Review of 287 records
• Patients ≥ 65 years old with new diagnosis of cancer
• Seen by 6, dual-boarded hematologists/ oncologists practicing in an urban academic cancer center
• Treatment plans compared to national guidelines to determine plan adherence status
• Patients were recommended:

Adherent plan (AP) or Non-adherent plan (N-AP)

Innovating At Jefferson: Developing The Patient-Centered Medical Home (Pcmh) Cost Tool, Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented at Jefferson School of Population Health Faculty Research Seminar.

Objectives:

Describe the cost-collection tool we created for the PCMH Model

Propose improvements to our tool in order to enhance the response rate

Determine our next steps in terms of research and innovation for PCMH at Jefferson

21 slides

The Future Of Population-Based Reimbursement, David Chin, Md, Mba

College of Population Health Forum

David C. Chin, MD, MBA is a Distinguished Scholar at the Johns Hopkins Bloomberg School of Public Health and Johns Hopkins School of Medicine, where he focuses on novel industry/academic research partnerships and preparing health systems and academic medical centers for success under accountable care.

Dr. Chin will describe the Maryland-All payer system as a model of innovative population-based reimbursement. He will discuss early adaptive strategies, including ways in which health care systems will need to change. Dr. Chin will also provide a comparison of the new incentives in the model vs. fee-for-service.

Prior to joining Hopkins Dr. Chin has …

Models For Identifying Patients At Risk Of Hospitalization: Use In Medical Homes In Emilia-Romagna Region, Italy, Vittorio Maio Pharmd, Ms, Msph, Guiseppina Rossi Md, Stefano Del Canale Md, Phd, Massimo Fabi Md, Ettore Brianti Md, Stefano Sforza Ms, Mary Robeson Ms, Scott Keith Phd, Joseph S. Gonnella Md, Daniel Z. Louis Ms

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Modeling To Assess Value: Is It Ready For Prime Time?, Jaime J. Caro, Mdcm, Frcpc, Facp

Jefferson School of Population Health Fellows’ Day

Jaime Caro is Senior Vice President, Research, at a consulting firm, where he leads development and application of novel techniques in health economics, multi-criteria decision analysis, benefit-risk analysis, comparative effectiveness, and epidemiology. He led the Caro Research Institute for more than a decade, until CRI was acquired in 2007. Dr. Caro trained at McGill University, where he practiced internal medicine and continues as adjunct Professor of Medicine, as well as of Epidemiology and Biostatistics. He is also adjunct professor at the Massachusetts College of Pharmacy and Health Sciences and lecturer at Thomas Jefferson University School of Population Health.

Out-Of-Pocket Costs And Prescription Reversals: The Case Of Oral Linezolid, Margaret K. Pasquale, Anthony M. Louder, Michael C. Deminski, Richard B. Chambers, Seema Haider

Jefferson School of Population Health Fellows’ Day

Kim A. Caldwell, RPh

Employed by Humana Inc., Kim is the Director of Pharmacy Professional Affairs for Humana Pharmacy Solutions. In this role, he and his team serve to liaison between HPS business owners, Humana Public Affairs, and key professional and trade partners. They serve as the pharmacy subject matter experts aligned with key business and regulatory issues, including visits with members of federal and state legislatures as well as the interface with state boards of pharmacy and key trade organizations. Previously, he started and directed Competitive Health Analytics, Inc. (CHA) a business unit within Humana Inc. for the first …

Analyzing The Health Care Cost Curve: A Case Study, Robert Lieberthal

College of Population Health Faculty Papers

This case study uses data from a self-insured employer plan to perform an analysis into the properties of the health care cost curve. The analysis shows that one statistical property of the health care cost curve is that costs rise continuously, not on an annual or monthly basis. Graphical analysis indicates that managed care techniques used to restrain costs can also smooth utilization, producing the continuously growing cost curve observed. The analysis further illustrates that there is no one ‘‘cost curve’’—analysis must be segmented by population. Finally, the power of predictive models to fit the cost curve varies by population. …

College Within The College: Population Health, James D. Plumb, Md, Mph, Rickie Brawer, Mph, Phd, Mches, Abbie Santana, Msph, Rob Simmons, Drph, Mph, Mches, Cph, Nancy L. Chernett, Ma, Mph

College of Population Health Lectures, Presentations, Workshops

College within the College (CwiC) – Population Health Skills for Physicians

• Incorporate culturally relevant information into a treatment plan for a patient

• Counsel individuals about healthy lifestyles

• Identify community support and resources to serve patients

• Coordinate health care services as a member of multidisciplinary teams

• Promote primary and secondary prevention

• Advocate for the needs of patients and the community

• Conduct population health research/evaluation

• Promote healthy lifestyles in communities

• Work in partnership with community based agencies and organizations