Medicine and Health Sciences Commons^™

Social Cognitive Outcomes Are Associated With Improvements In Mobility Performance Following Lifestyle Intervention In Prostate Cancer Patients Undergoing Androgen Deprivation Therapy, Zachary L. Chaplow, Alexander R. Lucas, Elizabeth Grainger, Christina Simpson, Ciaran M. Fairman, Victoria R. Descenza, Jessica Bowman, Steven K. Clinton, Brian C. Focht

Health Behavior and Policy Publications

Objective
To compare the effects of an exercise and dietary intervention with those of standard-of-care management upon change in lift and carry performance and mobility-related self-efficacy beliefs and explore associations in prostate cancer patients undergoing androgen deprivation therapy.

Methods
32 prostate cancer patients (M age = 66.2 years; SD = 7.8) undergoing androgen deprivation therapy were randomly assigned to a 3-month exercise and dietary lifestyle intervention (n = 16) or standard-of-care management (n = 16). Outcome assessments were obtained at baseline, 2- and 3-month follow-up.

Results
The lifestyle intervention resulted in significantly greater improvements in lift and …

A Scoping Review Of The Roles, Training, And Impact Of Community Health Workers In Oral Health Supplemental Tables, Dina T. Garcia, Jaime Lawson, Erica R. Brody, Susan C. Mckernan, Sarah E. Raskin, Nixon Arauz, Maghboeba Mosavel, Tegwyn Brickhouse

Health Behavior and Policy Publications

Objective: To synthesize English or Spanish-language literature on community health workers’ (CHWs’) roles, training, and impact in oral health. Basic research design: A scoping review conducted in accordance with the Arksey and O’Malley (2005) methodological framework. Method: Electronic literature searches were conducted in Medline (Ovid), Embase (Ovid), DOSS, CINAHL, Web of Science, and Global Health CAB from inception of the databases to April 2020. Three reviewers independently conducted the title and abstract and full-text reviews. This was followed by data charting by three reviewers and data summarizing by two reviewers. Results: Out of the 36 articles that met the inclusion …

Multi-Morbidities Are Not A Driving Factor For An Increase Of Copd-Related 30-Day Readmission Risk, Shuo-Yu Lin, Hong Xue, Yangyang Deng, Askar Chukmaitov

Health Behavior and Policy Publications

Background and Objective: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. COPD is expensive to treat, whereas the quality of care is difficult to evaluate due to the high prevalence of multi-morbidity among COPD patients. In the US, the Hospital Readmissions Reduction Program (HRRP) was initiated by the Centers for Medicare and Medicaid Services to penalize hospitals for excessive 30-day readmission rates for six diseases, including COPD. This study examines the difference in 30-day readmission risk between COPD patients with and without comorbidities.
Methods: In this retrospective cohort study, we used Cox …

Trajectories In Muscular Strength And Physical Function Among Men With And Without Prostate Cancer In The Health Aging And Body Composition Study, Alexander R. Lucas, Rhonda L. Bitting, Jason Fanning, Scott Isom, W. Jack Rejeski, Heidi D. Klepin, Stephen B. Kritchevsky

Health Behavior and Policy Publications

Objectives

To examine and compare changes in strength and physical function from pre- to post-diagnosis among men with prostate cancer (PC, [cases]) and matched non-cancer controls identified from the Health, Aging and Body Composition (Health ABC) study.

Materials and methods

We conducted a longitudinal analysis of 2 strength and 3 physical function-based measures among both cases and controls, identified from a large cohort of community living older adults enrolled in the Health ABC study. We plotted trajectories for each measure and compared cases vs. controls from the point of diagnosis onwards using mixed-effects regression models. For cases only, we examined …

Implementing Parallel Spreadsheet Models For Health Policy Decisions: The Impact Of Unintentional Errors On Model Projections, Stephanie L. Bailey, Rose S. Bono, Denis Nash, April D. Kimmel

Health Behavior and Policy Publications

Background

Spreadsheet software is increasingly used to implement systems science models informing health policy decisions, both in academia and in practice where technical capacity may be limited. However, spreadsheet models are prone to unintentional errors that may not always be identified using standard error-checking techniques. Our objective was to illustrate, through a methodologic case study analysis, the impact of unintentional errors on model projections by implementing parallel model versions.

Methods

We leveraged a real-world need to revise an existing spreadsheet model designed to inform HIV policy. We developed three parallel versions of a previously validated spreadsheet-based model; versions differed by …

Social Determinants Of Smoke Exposure During Pregnancy: Findings From Waves 1 & 2 Of The Population Assessment Of Tobacco And Health (Path) Study, Elizabeth K. Do, Tiffany L. Green, Elizabeth C. Prom-Wormley, Bernard F. Fuemmeler

Health Behavior and Policy Publications

Maternal smoking during pregnancy (MSDP) and secondhand smoke (SHS) exposure are associated with a myriad of negative health effects for both mother and child. However, less is known regarding social determinants for SHS exposure, which may differ from those of maternal smoking during pregnancy (MSDP). To identify social determinants for SHS exposure only, MSDP only, and MSDP and SHS exposure, data were obtained from all pregnant women (18–54 years; N = 726) in waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2014–2015). Multiple logistic regressions were conducted using SAS 9.4. Smoke exposure during pregnancy was …

Triangulating Abuse Liability Assessment For Flavoured Cigar Products Using Physiological, Behavioural Economic And Subjective Assessments: A Within-Subjects Clinical Laboratory Protocol, Catherine S. Wall, Rose S. Bono, Rebecca C. Lester, Cosima Hoetger, Thokozeni Lipato, Mignonne C. Guy, Thomas E. Eissenberg, Warren K. Bickel, Andrew J. Barnes, Caroline O. Cobb

Health Behavior and Policy Publications

Introduction
In the USA, Food and Drug Administration regulations prohibit the sale of flavoured cigarettes, with menthol being the exception. However, the manufacture, advertisement and sale of flavoured cigar products are permitted. Such flavourings influence positive perceptions of tobacco products and are linked to increased use. Flavourings may mask the taste of tobacco and enhance smoke inhalation, influencing toxicant exposure and abuse liability among novice tobacco users. Using clinical laboratory methods, this study investigates how flavour availability affects measures of abuse liability in young adult cigarette smokers. The specific aims are to evaluate the effect of cigar flavours on nicotine …

Mandatory Minimum Sentencing Policies And Cocaine Use In The U.S., 1985–2013, Lauryn Saxe Walker, Briana Mezuk

Health Behavior and Policy Publications

Background: As of May 2017, the United States federal government renewed its prioritization for the enforcement of mandatory minimum sentences for illicit drug offenses. While the effect of such policies on racial disparities in incarceration is well-documented, less is known about the extent to which these laws are associated with decreased drug use. This study aims to identify changes in cocaine use associated with mandatory minimum sentencing policies by examining differential sentences for powder and crack cocaine set by the Anti-Drug Abuse Act (ADAA) (100:1) and the Fair Sentencing Act (FSA), which reduced the disparate sentencing to 18:1.


Methods: Using …

The Relationship Between Body Mass Index, Binge Eating Disorder And Suicidality, Kristal Lyn Brown, Jessica Gokee Larose, Briana Mezuk

Health Behavior and Policy Publications

Background
While restrictive and compensatory eating disorders (e.g. anorexia and bulimia) are associated with elevated risk of suicide, less is known about binge eating disorder (BED). There is suggestive evidence of a U-shaped relationship between body mass index (BMI) and completed suicide, but fewer studies on suicidal ideation or attempts. This study examined the association between BED, BMI, and suicidality, and assessed whether these relationships varied by gender.

Methods
Data come from the Collaborative Psychiatric Epidemiologic Surveys (N = 14,497). Binge episodes and BED were assessed using the Composite International Diagnostic Inventory (CIDI). BMI was calculated from self-reported height …

Tobacco Use And Health Insurance Literacy Among Vulnerable Populations: Implications For Health Reform, Robert T. Braun, Yaniv Hanoch, Andrew J. Barnes

Health Behavior and Policy Publications

Background: Under the Affordable Care Act (ACA), millions of Americans have been enrolling in the health insurance marketplaces. Nearly 20% of them are tobacco users. As part of the ACA, tobacco users may face up to 50% higher premiums that are not eligible for tax credits. Tobacco users, along with the uninsured and racial/ethnic minorities targeted by ACA coverage expansions, are among those most likely to suffer from low health literacy – a key ingredient in the ability to understand, compare, choose, and use coverage, referred to as health insurance literacy. Whether tobacco users choose enough coverage in the marketplaces …

African-American Patients With Cancer Talking About Clinical Trials (Tact) With Oncologists During Consultations: Evaluating The Efficacy Of Tailored Health Messages In A Randomised Controlled Trial—The Tact Study Protocol, R F. Brown, R Davis, M Wilson Genderson, S Grant, D Cadet, M Lessard, J Alpert, J Ward, G Ginder

Health Behavior and Policy Publications

Introduction Low rates of accrual of African-American (AA) patients with cancer to therapeutic clinical trials (CTs) represent a serious and modifiable racial disparity in healthcare that impedes the development of promising cancer therapies. Suboptimal physician–patient consultation communication is a barrier to the accrual of patients with cancer of any race, but communication difficulties are compounded with AA patients. Providing tailored health messages (THM) to AA patients and their physician about CTs has the potential to improve communication, lower barriers to accrual and ameliorate health disparities.

Objective (1) Demonstrate the efficacy of THM to increase patient activation as measured by direct …

News Stories Of Intimate Partner Violence: An Experimental Examination Of Participant Sex, Perpetrator Sex, And Violence Severity On Seriousness, Sympathy, And Punishment Preferences, Matthew W. Savage, Jennifer A. Scarduzio, Kate Lockwood Harris, Kellie E. Carlyle, Sarah E. Sheff

Health Behavior and Policy Publications

This study experimentally examines the effects of participant sex, perpetrator sex, and severity of violence on perceptions of intimate partner violence (IPV) seriousness, sympathy toward the victim, and punishment preferences for the perpetrator. Participants (N = 449) were randomly assigned to a condition, exposed to a composite news story, and then completed a survey. Ratings of seriousness of IPV for stories with male perpetrators were significantly higher than ratings of seriousness for stories with female perpetrators. Men had significantly higher sympathy for female victims in any condition than for male victims in the weak or strong severity of violence …

Dna Methylation Of Regulatory Regions Of Imprinted Genes At Birth And Its Relation To Infant Temperament, Bernard F. Fuemmeler, Chien-Ti Lee, Adelheid Soubry, Edwin S. Iversen, Zhiqing Huang, Amy P. Murtha, Joellen M. Schildkraut, Randy L. Jirtle, Susan K. Murphy, Cathrine Hoyo

Health Behavior and Policy Publications

Background: DNA methylation of the differentially methylated regions (DMRs) of imprinted genes is relevant to neurodevelopment.

Methods: DNA methylation status of the DMRs of nine imprinted genes in umbilical cord blood leukocytes was analyzed in relation to infant behaviors and temperament (n = 158).

Results: MEG3 DMR levels were positively associated with internalizing (β = 0.15, P = 0.044) and surgency (β = 0.19, P = 0.018) behaviors, after adjusting for birth weight, gender, gestational age at birth, maternal age at delivery, race/ethnicity, education level, smoking status, parity, and a history of anxiety or depression. Higher methylation levels at the …

Geographic Analysis Of Urologist Density And Prostate Cancer Mortality In The United States, Nengliang Yao, Steven M. Foltz, Anobel Y. Odisho, David C. Wheeler

Health Behavior and Policy Publications

Context

Financial and demographic pressures in US require an understanding of the most efficient distribution of physicians to maximize population-level health benefits. Prior work has assumed a constant negative relationship between physician supply and mortality outcomes throughout the US and has not addressed regional variation.

Methods

In this ecological analysis, geographically weighted regression was used to identify spatially varying relationships between local urologist density and prostate cancer mortality at the county level. Data from 1,492 counties in 30 eastern and southern states from 2006–2010 were analyzed.

Findings

The ordinary least squares (OLS) regression found that, on average, increasing urologist density …

The Real Difficulty In Improving Concordance Of Clinical Practice With Guidelines, Nengliang Yao, Abram Recht

Health Behavior and Policy Publications

The degree to which patient care is concordant with guidelines is widely used to assess the quality of health care. Compliance with guidelines is very high for certain cancers and procedures but not for others. For example, patients with stage I-III colon cancer routinely undergo bowel resection, with very little variation in rates between regions or institutions (1). However, assuming that noncompliance to follow guidelines reflects a failure of the care providers is not so straightforward when there are many possible treatment alternatives that have very different characteristics, especially when there is controversy about whether they are equivalent. …

Diabetes Management Before And After Cancer Diagnosis: Missed Opportunity, Nengliang Yao, Fabian T. Camacho, Askar S. Chukmaitov, Steven T. Fleming, Roger T. Anderson

Health Behavior and Policy Publications

Background

Few studies have examined the management of comorbidities in cancer patients. This study used population-based data to estimate the guideline concordance rates for diabetes management before and after cancer diagnosis and examined if diabetes management services among cancer patients was associated with characteristics of the hospital where the patient was treated.

Methods

We linked 2005-2009 Medicare claims data to information on 2,707 breast and colorectal cancers patients in state cancer registry files. Multivariate logistic regression models examined hospital characteristics associated with receipt of diabetes management care after cancer diagnosis.

Results

The rates of HbAlc testing, LDL-C testing, and retinal …

Job Attributes, Job Satisfaction And The Return To Health After Breast Cancer Diagnosis And Treatment, Andrew J. Barnes, Nicholas Robert, Cathy J. Bradley

Health Behavior and Policy Publications

Background: As detection and treatment of cancer has advanced, the number of working age women with breast cancer has increased. This study provides new information on the intersection of breast cancer treatment and job tasks and how, together, they impact employed and newly diagnosed women.

Methods: The sample comprised 493 employed women within two months of initiating treatment. Job satisfaction and demands were assessed by pre-diagnosis recall along with measures of mental and physical health and assessed again nine months after initiating treatment. Using seemingly unrelated regression, we tested the effect of job tasks and satisfaction on mental and …

Determinants Of Coverage Decisions In Health Insurance Marketplaces: Consumers' Decision-Making Abilities And The Amount Of Information In Their Choice Environment, Andrew J. Barnes, Yaniv Hanoch, Thomas Rice

Health Behavior and Policy Publications

Objective

To investigate the determinants and quality of coverage decisions among uninsured choosing plans in a hypothetical health insurance marketplace.

Study Setting

Two samples of uninsured individuals: one from an Internet-based sample comprised largely of young, healthy, tech-savvy individuals (n = 276), and the other from low-income, rural Virginians (n = 161).

Study Design

We assessed whether health insurance comprehension, numeracy, choice consistency, and the number of plan choices were associated with participants' ability to choose a cost-minimizing plan, given their expected health care needs (defined as choosing a plan costing no more than $500 in excess of the total …

Polypectomy Techniques, Endoscopist Characteristics, And Serious Gastrointestinal Adverse Events, Askar S. Chukmaitov, Cathy J. Bradley, Bassam Dahman, Umaporn Siangphoe, Doumit Bouhaidar, Joan L. Warren

Health Behavior and Policy Publications

Background: A use of polypectomy techniques by endoscopist specialty (primary care, surgery, and gastroenterology) and experience (volume), and associations with serious gastrointestinal adverse events, were examined.

Methods: A retrospective follow-up study with ambulatory surgery and hospital discharge datasets from Florida, 1999-2001, was used. Thirty-day hospitalizations due to colonic perforations and gastrointestinal bleeding were investigated for 323,585 patients.

Results: Primary care endoscopists and surgeons used hot biopsy forceps/ablation, while gastroenterologists provided snare polypectomy or complex colonoscopy. Low-volume endoscopists were more likely to use simpler rather than complex procedures. For hot forceps/ablation and snare polypectomy, low- and medium-volume endoscopists reported higher …

Associations Of Occupational Attributes And Excessive Drinking, Andrew J. Barnes, Frederick J. Zimmerman

Health Behavior and Policy Publications

Numerous work-related drinking mechanisms have been posited and, oftentimes, examined in isolation. We combined data from over 100 occupational attributes into several factors and tested the association of these factors with measures of alcohol use. We used the NLSY79 2006 wave, a U.S. representative sample of 6,426 workers ages 41 to 49 and the 2006 Occupational Information Network database (O*NET), a nationally representative sample of nearly 1,000 occupations. We conducted exploratory factor analysis on 119 occupational attributes and found three independent workplace characteristics – physical demands, job autonomy, and social engagement - explained the majority of the variation. We then …

Physician Trainees’ Decision Making And Information Processing: Choice Size And Medicare Part D, Andrew J. Barnes, Yaniv Hanoch, Melissa Martynenko, Stacey Wood, Thomas Rice, Alex D. Federman

Health Behavior and Policy Publications

Many patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians’ decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious financial consequences. Seventy medical students and internal medicine residents completed a within-subject design using Mouselab, a computer program that allows the information-acquisition process to be examined. We examined highly numerate physician trainees’ decision processes, strategy, and their ability to pick the cheapest drug plan—as price was deemed the most important factor in Medicare beneficiaries’ …

Patient- And Population-Level Health Consequences Of Discontinuing Antiretroviral Therapy In Settings With Inadequate Hiv Treatment Availability, April D. Kimmel, Stephen C. Resch, Xavier Anglaret, Norman Daniels, Sue J. Goldie, Christine Daniel, Angela Y. Wong, Kenneth A. Freedberg, Milton C. Weinstein

Health Behavior and Policy Publications

Background

In resource-limited settings, HIV budgets are flattening or decreasing. A policy of discontinuing antiretroviral therapy (ART) after HIV treatment failure was modeled to highlight trade-offs among competing policy goals of optimizing individual and population health outcomes.

Methods

In settings with two available ART regimens, we assessed two strategies: (1) continue ART after second-line failure (Status Quo) and (2) discontinue ART after second-line failure (Alternative). A computer model simulated outcomes for a single cohort of newly detected, HIV-infected individuals. Projections were fed into a population-level model allowing multiple cohorts to compete for ART with constraints on treatment capacity. In the …

One Fish, Two Fish, Red Fish, Blue Fish: Effects Of Price Frames, Brand Names, And Choice Set Size In Medicare Part D Insurance Plan Decisions, Andrew J. Barnes, Yaniv Hanoch, Stacey Wood, Pi-Ju Liu, Thomas Rice

Health Behavior and Policy Publications

Because many seniors choose Medicare Part D plans offering poorer coverage at greater cost, the authors examined the effect of price frames, brand names, and choice set size on participants' ability to choose the lowest cost plan. A 2×2×2 within-subjects design was used with 126 participants aged 18 to 91 years old. Mouselab, a web-based program, allowed participants to choose drug plans across eight trials that varied using numeric or symbolic prices, real or fictitious drug plan names, and three or nine drug plan options. Results from the multilevel models suggest numeric versus symbolic prices decreased the likelihood of choosing …