Public Health Commons^™

Medicaid Managed Care Restrictions On Medications For The Treatment Of Opioid Use Disorder, Maureen T. Stewart, Christina M. Andrews Ph.D., Sage R. Feltus, Dominic Hodgkin, Constance M. Horgan, Cindy Parks Thomas, Thuong Nong

Faculty Publications

Objective: To examine whether Medicaid managed care plan (MCP) utilization management policies for buprenorphine–naloxone and injectable naltrexone are related to key state Medicaid program policy decisions. Data Sources and Study Setting: We abstracted data on state Medicaid regulatory and policy information from publicly available sources and publicly available insurance benefit documentation from all 241 Medicaid MCPs operating in 2021. Study Design: In this cross-sectional study, we used bivariate and multivariate analyses to examine whether Medicaid MCP prior authorization and quantity limits on receipt of buprenorphine and injectable naltrexone were associated with key state Medicaid choices to leverage federal funds to …

Human Mobility And The Infectious Disease Transmission: A Systematic Review, M. Naser Lessani, Zhenlong Li, Fengrui Jing, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Recent decades have witnessed several infectious disease outbreaks, including the coronavirus disease (COVID-19) pandemic, which had catastrophic impacts on societies around the globe. At the same time, the twenty-first century has experienced an unprecedented era of technological development and demographic changes: exploding population growth, increased airline flights, and increased rural-to-urban migration, with an estimated 281 million international migrants worldwide in 2020, despite COVID-19 movement restrictions. In this review, we synthesized 195 research articles that examined the association between human movement and infectious disease outbreaks to understand the extent to which human mobility has increased the risk of infectious disease outbreaks. …

Association Between Sociodemographics And Change In Alcohol Or Tobacco Use Behaviors During The Covid-19 Pandemic, Selam Habtemariam, Chloe M. Hery, Xiaochen Zhang, Mengda Yu, Darren Mays, Toyin Adeyanju, Brittany Bernardo, Electra D. Paskett

Faculty Publications

No abstract provided.

How Individuals’ Opinions Influence Society’S Resistance To Epidemics: An Agent-Based Model Approach, Geonsik Yu, Michael J. Garee, Mario Ventresca, Yuehwern Yih

Faculty Publications

Background: Protecting public health from infectious diseases often relies on the cooperation of citizens, especially when self-care interventions are the only viable tools for disease mitigation. Accordingly, social aspects related to public opinion have been studied in the context of the recent COVID-19 pandemic. However, a comprehensive understanding of the effects of opinion-related factors on disease spread still requires further exploration. Methods: We propose an agent-based simulation framework incorporating opinion dynamics within an epidemic model based on the assumption that mass media channels play a leading role in opinion dynamics. The model simulates how opinions about preventive interventions change over …

Cancer Survivorship And Subjective Cognitive Decline In The Us: Results From A Nationally Representative Sample, Monique J. Brown, Ally Hucek, Jingkai Wei, Loretta Anderson, Muzi Na

Faculty Publications

Cancer may be associated with objective cognitive decline. However, studies examining the link between cancer and subjective cognitive decline (SCD), which occurs earlier during cognitive trajectories, are lacking. In addition, research assessing risk factors for SCD among cancer survivors is scant. Therefore, this study aimed to examine the association between cancer and SCD in the past year, and assess the association between age of diagnosis, cancer treatment, and SCD among cancer survivors. Data were obtained from the 2021 Behavioral Risk Factor Surveillance System (N=15,447). Crude and adjusted logistic regression models, controlling for sociodemographic characteristics, were used to determine the association …

Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Health disparities exist at every step of the HIV care continuum (HCC) among racial/ethnic minority population. Such racial/ethnic disparities may have significantly delayed the progress in HCC in the Southern US states that are strongly represented among geographic focus areas in the 2019 federal initiative titled 'Ending the HIV Epidemic: A Plan for America'. However, limited efforts have been made to quantify the long-term spatiotemporal variations of HCC disparities and their contributing factors over time, particularly in the context of COVID-19 pandemic. This project aims to identify the spatiotemporal patterns of racial disparities of each HCC outcome and then …

Disease Severity Of Covid-19 In Different Phases Of The Pandemic: Do Healthcare Workers Have Better Outcomes?, Xueying Yang Ph.D., Fanghui Shi, Jiajia Zhang Ph.D., Haoyuan Gao, Shujie Chen, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Background:

This study aimed to characterize and compare the demographics, clinical profile, and COVID-19 outcomes between healthcare workers (HCWs) and non-HCWs COVID-19 patients diagnosed in different phases of the pandemic defined by the vaccine rollout policy and different variants that circulated in South Carolina (SC).

Methods:

Extracted from the statewide electronic health record data, we analyzed the clinical outcome of 34,502 HCWs and 1,071,020 non-HCWs adults diagnosed with SARS-CoV-2 between March 2, 2020 to April 14, 2022. Logistic regression models were used to explore the association between different pandemic phases and COVID-19 severity-related outcomes.

Results:

Substantial reductions in mortality were …

Racial Disparities In Adequacy Of Prenatal Care During The Covid-19 Pandemic In South Carolina, 2018–2021, Emmanuel Fabrice Julceus Md, Mph, Bankole Olatosi Ph.D., Peiyin Hung Ph.D., Jiajia Zhang Ph.D., Xiaoming Li Ph.D., Jihong Liu Sc.D.

Faculty Publications

Background: During the COVID-19 pandemic, hospitals’ decision of not admitting pregnant women’s partner or support person, and pregnant women’s fear of contracting COVID-19 in hospitals may disrupt prenatal care. We aimed to examine whether prenatal care utilization in South Carolina varied before and during the COVID-19 pandemic, and whether the variation was different by race.

Methods: We utilized 2018–2021 statewide birth certificate data using a pre-post design, including all women who delivered a live birth in South Carolina. The Kotelchuck Index - incorporating the timing of prenatal care initiation and the frequency of gestational age-adjusted visits - was employed to …

Dual Barriers: Examining Digital Access And Travel Burdens To Hospital Maternity Care Access In The United States, 2020, Peiyin Hung Ph.D., Marion Granger, Nansi Boghossian, Jiani Yu, Sayward Harrison, Jihong Liu Sc.D., Berry A. Campbell, Bo Cai Ph.D., Chen Liang, Xiaoming Li Ph.D.

Faculty Publications

Policy Points The White House Blueprint for Addressing the Maternal Health Crisis report released in June 2022 highlighted the need to enhance equitable access to maternity care. Nationwide hospital maternity unit closures have worsened the maternal health crisis in underserved communities, leaving many birthing people with few options and with long travel times to reach essential care. Ensuring equitable access to maternity care requires addressing travel burdens to care and inadequate digital access. Our findings reveal socioeconomically disadvantaged communities in the United States face dual barriers to maternity care access, as communities located farthest away from care facilities had the …

Development Of A Methodology For The Quantification Of Reaerosolization Of A Biological Contaminate Surrogate Particle From A Military Uniform Fabric, George Cooksey, Jeremy M. Slagley, Casey W. Cooper, Douglas Lewis, Alisha Helm

Faculty Publications

In a mass casualty medical evacuation after a bioaerosol (BA) dispersal event, a decontamination (DC) method is needed that can both decontaminate and prevent biological particle (BP) re-aerosolization (RA) of contaminated clothes. However, neither the efficacy of current DC methods nor the risk of BP RA is greatly explored in the existing literature. The goals of this study were to develop a repeatable method to quantify the RA of a biological contaminant off military uniform fabric swatches and to test the efficacy of one DC protocol (high-volume, low-pressure water) using 1 µm polystyrene latex (PSL) spheres as a surrogate. A …

Establishment Of A Birth-To-Education Cohort Of 1 Million Palestinian Refugees Using Electronic Medical Records And Electronic Education Records, Zeina Jamaluddine, Akihiro Seita, Ghada Ballout, Hussam Al-Fudoli, Gloria Paolucci, Shatha Albaik, Rami Ibrahim, Miho Sato, Hala Ghattas Ph.D., Oona M.R. Campbell

Faculty Publications

Introduction

By linking datasets, electronic records can be used to build large birth-cohorts, enabling researchers to cost-effectively answer questions relevant to populations over the life-course. Currently, around 5.8 million Palestinian refugees live in five settings: Jordan, Lebanon, Syria, West Bank, and Gaza Strip. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides them with free primary health and elementary-school services. It maintains electronic records to do so.

We aimed to establish a birth cohort of Palestinian refugees born between 1st January 2010 and 31st December 2020 living in five settings by linking mother …

Strategies Elementary School Children Use To Influence Mothers' Food Purchasing Decisions, Nazratun N. Monalisa, Edward A. Frongillo Ph.D., Christine E. Blake Ph.D., Rd, Susan E. Steck, Robin B. Dipietro

Faculty Publications

This study aimed to understand the strategies elementary-school-aged children used to influence mothers' food purchasing decisions. Semi-structured qualitative interviews were conducted with 40 children aged 6–11 years and their mothers living in South Carolina. Strategies to influence mothers' food purchases were collected from children and their mothers separately. The interviews were audio-recorded, transcribed verbatim, and open-coded. The constant comparative method was used for data analysis. Coding matrices were used to compare children's and mothers' responses on the children's strategies. Children reported 157 instances of 25 distinct strategies to influence mothers' purchasing decisions. Mothers had concordance with 83 instances of these …

Geographic Differences In The Magnitude Of Black-White Disparities In Having Obesity, Steven A. Cohen, Monique J. Brown, Furong Xu, Caitlin C. Nash, Mary L. Greaney

Faculty Publications

Background

Obesity disparities in the United States are well documented, but the limited body of research suggests that geographic factors may alter the magnitude of these disparities. A growing body of evidence has identified a “rural mortality penalty” where morbidity and mortality rates are higher in rural than urban areas, even after controlling for other factors. Black-White differences in health and mortality are more pronounced in rural areas than in urban areas.

Objective

Therefore, the purpose of this study was to explore how rural-urban status and region moderate Black-White health disparities in obesity.

Methods

Data were abstracted from the 2012 …

Understanding Commitment Of Local Food Banks, Faith-Based Organizations, And Schools To Provide Nongovernment Food Programs, Eliza M. Fishbein, Edward A. Frongillo Ph.D., Sharraf Samin, Audrey L. Richards, Christine E. Blake Ph.D., Rd, Ruth P. Saunders, Cheri J. Shapiro

Faculty Publications

Background: Nongovernment food assistance is typically provided to families by faith-based organizations, schools, and food banks. Community organizations appear to be strongly committed to these programs, but little is known about the basis for this commitment. Objectives: The aim of this study was to examine the values and identities of community organizations to understand the reasons for their commitment to providing nongovernment food assistance. Methods: Thirty-three in-depth interviews were conducted with 36 leaders at faith-based organizations (19 participants), schools (14 participants), and a local food bank (3 participants) in South Carolina. Observations were made, and informational documents (e.g., flyers and …

Examining Cancer Patients' Perceptions Of The Impact Of Covid-19 On Teleoncology: Findings From 15 Nigerian Outpatient Cancer Clinics, Adedayo Joseph, Abdul R. Shour, Nwamaka N. Lasebikan, Mutiu A. Jimoh, Bolanle C. Adegboyega, Emmanuella Nwachukwu, Opeyemi Awofeso, Azeezat Ajose, Abiola Ibraheem, Omolara Aminat Fatiregun, Musa Ali-Gombe, Usman M. Aliyu, Abdallah Elsaid Kotkat, Olusegun Abayomi Biyi-Olutunde, Evaristus Oseiwe Oboh, Ismail H. Zubairu, Mohammad Rifat Haider, Bankole Olatosi Ph.D., David Puthoff, Adedayo A. Onitilo

Faculty Publications

Purpose

To examine cancer patients' perspectives on the impact of COVID-19 on teleoncology in Nigeria.

Methods

Data from a multicenter survey conducted at 15 outpatient clinics to 1,097 patients with cancer from April and July 2020 were analyzed. The study outcome was telemedicine, defined as patients who reported their routine follow-up visits were converted to virtual visits because of COVID-19 (coded yes/no). Covariates included patient age, ethnicity, marital status, income, cancer treatment, service disruption, and cancer diagnosis/type. Stata/SE.v.17 (StataCorp, College Station, TX) was used to perform chi-square and logistic regression analyses. P values ≤ .05 were considered statistically significant.

Results …

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Basic Human Values Drive Food Choice Decision-Making In Different Food Environments Of Kenya And Tanzania, Christine E. Blake Ph.D., Rd, Eva C. Monterrosa, Krystal K. Rampalli, Abdullah Nurus Salam Khan, Ligia I. Reyes, Shiny Deepika Drew, Paula Dominguez-Salas, Salome A. Bukachi, Mariah Ngutu, Edward A. Frongillo Ph.D., Elyse Iruhiriye, Amy Webb Girard

Faculty Publications

Increased access to a variety of foods in low-and-middle-income countries (LMICs) has led to greater autonomy in food choice decision-making. Autonomy allows individuals to make decisions through negotiation of considerations in ways that are consistent with basic values. The aim of this study was to identify and describe how basic human values drive food choice in two diverse populations with transitioning food environments living in the neighboring East African countries of Kenya and Tanzania. Secondary data analysis was carried out on focus group discussions conducted with men and women in Kenya (n = 28) and Tanzania (n = 28) as …

Meta Echo: Using All-Payers Claims Data Analysis As Part Of A Multi-Layered Approach To Plan An Evaluate Echo Programs, Marcy Doyle, Erica Plante

Faculty Publications

No abstract provided.

Reinvigorating Engineered Noise Controls: A Systems Approach, Jeremy Slagley, Adam Dudarewicz, Pawlaczyk-Łuszczyńska Małgorzata, Francis Slagley

Faculty Publications

Excerpt: Hearing loss is a major worldwide health issue affecting an estimated 1.5 billion people. Causes of hearing loss include genetics, chemicals, medications, lifestyle habits such as smoking, and noise. Noise is probably the largest contributing factor for hearing loss. Noise arises from the workplace, ambient environment, and leisure activities. The easiest noise sources to control are workplace and environmental. Workplace noise is unique in that the employer is responsible for the noise and the worker. Also, workers may be exposed to much higher levels of noise than they would accept elsewhere. Employers follow the traditional hierarchy of controls (substitution/engineering, …

Developing An Ethical Framework-Guided Instrument For Assessing Bias In Ehr-Based Big Data Studies: A Research Protocol, Shan Qiao Ph.D., George Khushf, Xiaoming Li, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D.

Faculty Publications

Introduction The emergence of Big Data health research has exponentially advanced the fields of medicine and public health but has also faced many ethical challenges. One of most worrying but still under-researched aspects of the ethical issues is the risk of potential biases in data sets (eg, electronic health records (EHR) data) as well as in the data curation and acquisition cycles. This study aims to develop, refine and pilot test an ethical framework-guided instrument for assessing bias in Big Data research using EHR data sets.

Methods and analysis Ethical analysis and instrument development (ie, the EHR bias assessment guideline) …

Changes In Medicaid Fee-For-Service Benefit Design For Substance Use Disorder Treatment During The Opioid Crisis, 2014 To 2021, Angela Shoulders, Christina Andrews, Melissa A. Westlake, Amanda J. Abraham, Colleen M. Grogan

Faculty Publications

Importance: Medicaid is the largest payer of substance use disorder treatment in the US and plays a key role in responding to the opioid epidemic. However, as recently as 2017, many state Medicaid programs still did not cover the full continuum of clinically recommended care. Objective: To determine whether state Medicaid fee-for-service (FFS) programs have expanded coverage and loosened restrictions on access to substance use disorder treatment in recent years. Design, Setting, and Participants: In 2014, 2017, and 2021, a survey on coverage for substance use disorder treatment was conducted among state Medicaid programs and the District of Columbia with …

The Determinants Of Sustained Adherence To Covid-19 Preventive Measures Among Older Syrian Refugees In Lebanon, Nisreen Salti, Stephen J. Mccall, Berthe Abi Zeid, Noura El Salibi, Marwan Alawieh, Zeinab Ramadan, Hala Ghattas Ph.D, Sawsan Abdulrahim

Faculty Publications

Introduction Lebanon has battled the COVID-19 pandemic in the midst of an economic crisis. The evolution of the pandemic and a fragile health system have meant that public health policy has had to rely heavily on non-pharmaceutical interventions for disease control. However, changes in disease dynamics, an unraveling economy, and pandemic fatigue have meant that disease control policies need to be updated. Methods Using recent and timely data on older (50 years and above) Syrian refugees in Lebanon, this paper uses multivariate linear probability models to explore the determinants of adherence to two non-pharmaceutical COVID-19 prevention measures (wearing a mask …

Effects Of Size At Birth On Health, Growth And Developmental Outcomes In Children Up To Age 18: An Umbrella Review, Zeina Jamaluddine, Eman Sharara, Vanessa Helou, Nadine El Rashidi, Gloria Safadi, Nehmat El-Helou, Hala Ghattas Ph.D, Miho Sato, Hannah Blencowe, Oona M.R. Campbell

Faculty Publications

Background Size at birth, an indicator of intrauterine growth, has been studied extensively in relation to subsequent health, growth and developmental outcomes. Our umbrella review synthesises evidence from systematic reviews and meta-analyses on the effects of size at birth on subsequent health, growth and development in children and adolescents up to age 18, and identifies gaps.

Methods We searched five databases from inception to mid-July 2021 to identify eligible systematic reviews and meta-analyses. For each meta-analysis, we extracted data on the exposures and outcomes measured and the strength of the association.

Findings We screened 16 641 articles and identified 302 …

Inequalities In Wellbeing In Lebanese Children And Different Refugee Subpopulations: A Multidimensional Child Deprivation Analysis, Zeina Jamaluddine, Gloria Safadi, Alexandra Irani, Nisreen Salti, Jad Chaaban, Sawsan Abdulrahim, Alban Thomas, Hala Ghattas Ph.D.

Faculty Publications

Background and Objectives:

This study constitutes the first attempt to describe the overlapping deprivations faced by Lebanese children (Lebanese) and that of the three sub-populations of refugees living in Lebanon: Palestinian refugees living in Lebanon, Palestinian refugees from Syria and Syrian refugees.

Methods:

Using data from the United Nations International Children's Emergency Fund (UNICEF) Household Survey 2016 (n = 10,555 Lebanese; 7,106 Palestinian refugees living in Lebanon; 2,768 Palestinian refugees from Syria and 5,891 Syrian refugee children aged 2 to 17 years old), we report on single and overlapping deprivations (at least two concurrent deprivations) using indicators related to survival …

Incidence Of Chronic Kidney Disease Following Acute Coronavirus Disease 2019 Based On South Carolina Statewide Data, Roy O. Mathew, Jiajia Zhang Ph.D., Xueying Yang, Shujie Chen, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: Coronavirus disease 2019 (COVID-19) was associated with severe acute illness including multiple organ failure. Acute kidney injury (AKI) was a common finding, often requiring dialysis support.

Objective: Define the incidence of new clinically identified chronic kidney disease (CKD) among patients with COVID-19 and no pre-existing kidney disease.

Design Participants: The South Carolina (SC) Department of Health and Environmental Control (DHEC) COVID-19 mandatory reporting registry of SC residents testing for COVID-19 between March 2020 and October 2021 was included.

Design Main Measures: The primary outcome was a new incidence of a CKD diagnosis (N18.x) in those without a pre-existing diagnosis …

Ten‐Year Cardiovascular Disease Risk Score And Cognitive Function Among Older Adults: The National Health And Nutrition Examination Survey 2011 To 2014, Jingkai Wei, Hanzhang Xu, Angela D. Liese, Anwar T. Nerchant Sc.D, Mph, Dmd, Liang Wang, Chih-Hsiang Yang, Matthew C. Lohman, Monique J. Brown Ph.D., Mph, Tiansheng Wang, Daniela B. Friedman Ph.D.

Faculty Publications

BACKGROUND: The Framingham 10-year cardiovascular disease risk score, which is based on age, sex, smoking, total cholesterol, high-density lipoprotein-cholesterol, blood pressure, and diabetes, has been found to be associated with cognitive health, but these findings have not been validated in a representative sample in the United States. We aimed to examine the associations of Framingham risk score with cognitive function among older adults in a nationally representative sample, as well as by race or ethnicity, education, and family income.

METHODS AND RESULTS: A total of 2254 older adults ≥60years (57% female, 79% non-Hispanic White) in the National Health and Nutrition …

Patterns Of Hiv Disclosure And Its Impact On The Hiv Care Continuum Among Black Men Who Have Sex With Men In South Carolina, Xueying Yang Ph.D., Titilayo A. James, Monique J. Brown Ph.D., Mph, Tony Brown, Sydney Zarsadias, Ran Zhang, Fanghui Shi, Xiaoming Li Ph.D.

Faculty Publications

Addressing the psychosocial concerns of Black men who have sex with men (MSM), such as HIV disclosure, is critical for effective HIV treatment efforts. Black MSM living with HIV experience multiple psychosocial challenges, such as “triple stigma” due to their sexual orientation, racial minority status, and HIV status, which hinder their HIV disclosure and subsequent HIV care-seeking behavior. Our study sought to examine the HIV disclosure patterns and their impact on the HIV care continuum among Black MSM using a qualitative approach. Semi-structured interviews were carried out among 28 Black MSM aged ≥18 years old living in South Carolina. A …

Association Of Selected State Policies And Requirements For Buprenorphine Treatment With Per Capita Months Of Treatment, Bradley D. Stein, Brendan K. Saloner, Olivia K. Golan, Barbara Andraka-Christou, Christina M. Andrews Ph.D., Andrew W. Dick, Corey S. Davis, Flora Sheng, Adam J. Gordon

Faculty Publications

IMPORTANCE Expanding the use of buprenorphine for treating opioid use disorder is a critical component of the US response to the opioid crisis, but few studies have examined how state policies are associated with buprenorphine dispensing. OBJECTIVE To examine the association of 6 selected state policies with the rate of individuals receiving buprenorphine per 1000 county residents. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used 2006 to 2018 US retail pharmacy claims data for individuals dispensed buprenorphine formulations indicated for treating opioid use disorder. EXPOSURES State implementation of policies requiring additional education for buprenorphine prescribers beyond waiver training, continuing medical …

Protocol For Developing A Personalised Prediction Model For Viral Suppression Among Under-Represented Populations In The Context Of The Covid-19 Pandemic, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Bankole Olatosi Ph.D.

Faculty Publications

Introduction Sustained viral suppression, an indicator of long-term treatment success and mortality reduction, is one of four strategic areas of the 'Ending the HIV Epidemic' federal campaign launched in 2019. Under-represented populations, like racial or ethnic minority populations, sexual and gender minority groups, and socioeconomically disadvantaged populations, are disproportionately affected by HIV and experience a more striking virological failure. The COVID-19 pandemic might magnify the risk of incomplete viral suppression among under-represented people living with HIV (PLWH) due to interruptions in healthcare access and other worsened socioeconomic and environmental conditions. However, biomedical research rarely includes under-represented populations, resulting in biased …

Development And Validation Protocol For An Instrument To Measure Household Water Insecurity Across Cultures And Ecologies: The Household Water Insecurity Experiences (Hwise) Scale, Sera L. Young, Shalean M. Collins, Godfred O. Boateng, Torsten B. Neilands, Zeina Jamaluddine, Joshua D. Miller, Alexander A. Brewis, Edward A. Frongillo Jr., Wendy E. Jepson, Hugo Melgar-Quiñonez, Roseanna C. Schuster, Justin B. Stoler, Amber Wuitch, Hwise Research Coordination Network

Faculty Publications

Introduction A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts.

Methods and analysis After domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which water-related problems have been reported (eg, shortages, excess …

Trends In Resources For Neonatal Intensive Care At Delivery Hospitals For Infants Born Younger Than 30 Weeks' Gestation, 2009-2020, Nansi S. Boghossian, Marco Geraci, Ciaran S. Phibbs, Scott A. Lorch, Erika M. Edwards, Jeffrey D. Horbar

Faculty Publications

Importance: In an ideal regionalized system, all infants born very preterm would be delivered at a large tertiary hospital capable of providing all necessary care. Objective: To examine whether the distribution of extremely preterm births changed between 2009 and 2020 based on neonatal intensive care resources at the delivery hospital. Design, Setting, and Participants: This retrospective cohort study was conducted at 822 Vermont Oxford Network (VON) centers in the US between 2009 and 2020. Participants included infants born at 22 to 29 weeks' gestation, delivered at or transferred to centers participating in the VON. Data were analyzed from February to …