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Articles 1 - 30 of 92
Full-Text Articles in Health Services Administration
Single State Agency Licensure Requirements For Substance Use Disorder Treatment Programs In The United States: Results Of A National Survey, Brooks Yelton Ma, Lmsw, Melissa A. Westlake, Amanda J. Abraham, Colleen M. Grogan, Olivia Hinds, Christina M. Andrews
Single State Agency Licensure Requirements For Substance Use Disorder Treatment Programs In The United States: Results Of A National Survey, Brooks Yelton Ma, Lmsw, Melissa A. Westlake, Amanda J. Abraham, Colleen M. Grogan, Olivia Hinds, Christina M. Andrews
Faculty Publications
Background
Substance use disorder (SUD) remains a critical public health crisis in the United States, with high prevalence and overdose mortality rates. Despite the availability of effective treatments, including medications that significantly reduce overdose risk, fewer than 20% of Americans with active SUD receive treatment annually. Single State Agencies (SSAs), which oversee federal funding and regulate SUD treatment programs, hold significant authority to impose licensure and reporting requirements intended to promote treatment quality.
Methods
This study presents findings from a national survey of SSAs across 50 states and the District of Columbia (94% response rate) conducted between 2020 and 2021, …
Factors Associated With Lapses In Care Among People Living With Hiv In South Carolina, Xueying Yang Ph.D., Fanghui Shi, Shujie Chen, Gavi Samuel, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.
Factors Associated With Lapses In Care Among People Living With Hiv In South Carolina, Xueying Yang Ph.D., Fanghui Shi, Shujie Chen, Gavi Samuel, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.
Faculty Publications
Utilizing statewide electronic health records (EHR) data, this study aims to assess the factors determining the occurrence of lapses in HIV care among people with HIV (PWH) in South Carolina (SC). All adult (≥ 18 years old) PWH who were diagnosed with HIV between 2006 and 2018 with at least two HIV care encounters and at least 1-year follow-up record were included in the analysis. The outcome, a lapse in care, was defined as a repeated measure of HIV care encounter that occurs over a year following the previous visit. Generalized Estimation Equation models were employed. The study cohort had …
The Blurred Boundaries Of Care: A Qualitative Analysis Of Nurse-Doula Role Conflict, Curisa Mae Tucker Phd, Rn, Maria Mcclam, Kelly Russin Dnp, Rnc-Ob, Chse, Nansi Boghossian, Rachel Gulczinski, Lauren Workman
The Blurred Boundaries Of Care: A Qualitative Analysis Of Nurse-Doula Role Conflict, Curisa Mae Tucker Phd, Rn, Maria Mcclam, Kelly Russin Dnp, Rnc-Ob, Chse, Nansi Boghossian, Rachel Gulczinski, Lauren Workman
Faculty Publications
Introduction:
Conflict between nurses and doulas can contribute to miscommunication, delays in treatment, and decreased patient satisfaction, especially among marginalized populations. Nurses and doulas both play essential roles in supporting birthing individuals, yet their interactions are often strained by unclear role boundaries, differing philosophies of care, and institutional policies that fail to integrate doulas into clinical teams. The purpose of this study is to examine the underlying sources of tension between nurses and doulas and identify facilitators that support more effective collaboration within maternity care teams.Methods:
We conducted semi-structured interviews with 20 participants (9 nurses and 11 doulas) recruited …What Factors Influence Health Professions Trainees’ Preferences For Employment In Rural Appalachia? A Qualitative Study To Inform The Design Of A Discrete Choice Experiment, Chris Gillette, Jan Ostermann Ph.D., Aylin A. Aguillar, Sarah O'Neal, Chris Everett, Dawn Caviness, Esita Patel, Laiton Steele, Dawn Goel, Quazi Minhaz Tabassum
What Factors Influence Health Professions Trainees’ Preferences For Employment In Rural Appalachia? A Qualitative Study To Inform The Design Of A Discrete Choice Experiment, Chris Gillette, Jan Ostermann Ph.D., Aylin A. Aguillar, Sarah O'Neal, Chris Everett, Dawn Caviness, Esita Patel, Laiton Steele, Dawn Goel, Quazi Minhaz Tabassum
Faculty Publications
Optimizing the geographic allocation of health care providers has the potential to improve health care access and health outcomes for rural populations. To inform the design of a discrete choice experiment (DCE) survey to elicit health professions trainees' preferences for rural practice, this formative research aimed to: (1) elicit factors that influence job selection among health profession trainees, including medical residents physician assistant (PA) and nurse practitioner (NP) students, (2) identify how these trainees evaluate trade-offs for rural job placement and (3) inform attribute selection for inclusion into a future DCE to identify health professions trainees’ preferences for rural practice. …
Translating Community Voices To Build Meaningful Engagement: A Community Health Worker Led Study, Lauren Workman, Julie Smithwick Msw, Chw, Kimberly C. Rawlinson, Mark M. Macauda, Lashandra Morgan, Whitney Davis
Translating Community Voices To Build Meaningful Engagement: A Community Health Worker Led Study, Lauren Workman, Julie Smithwick Msw, Chw, Kimberly C. Rawlinson, Mark M. Macauda, Lashandra Morgan, Whitney Davis
Faculty Publications
Background: Understanding community perspectives on barriers and facilitators of meaningful engagement, equitable decision making, and sustainable community improvement is critical for advancing health equity. Community Health Workers can make significant contributions to research teams, as they are bridges into communities and bring unique perspectives. This study describes community voices on barriers to authentic engagement and insights on strategies to build trust, as well as the way in which these data were translated into a tangible assessment tool and a community-facilitated learning academy.
Methods: A team of Community Health Workers led a series of 24 ‘open mic’ discussions in four South …
Challenges, Stressors, And Resilience Resources Experienced By Older Black Women In Rural South Carolina Throughout The Covid-19 Pandemic, Arielle N'Diaye, Camryn Garrett, Sarah Wilcox Phd, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D.
Challenges, Stressors, And Resilience Resources Experienced By Older Black Women In Rural South Carolina Throughout The Covid-19 Pandemic, Arielle N'Diaye, Camryn Garrett, Sarah Wilcox Phd, Bankole Olatosi Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D.
Faculty Publications
Background
Resilience has been established as a protective factor against mental health challenges (e.g., anxiety, depression). From an intersectional perspective, the stressors experienced by Black women living in rural communities are likely to have been exacerbated during the COVID-19 pandemic. This study aims to identify the challenges and stressors experienced and the resilience resources available to and relied upon by rural, Black women, during the pandemic.
Methods
Individual, in-depth, structured interviews (n = 24) were conducted among Black women living in rural South Carolina, recruited by local community health workers, from January to April of 2024. All interviews were recorded, …
Group Antenatal Care Model As An Innovative And Sustainable Maternal And Child Health Service Delivery In A Northern Nigerian State, Pius I. Christopher-Izere, Abiola Ajibola, Abimbola Phillips, Dorcas Magbadelo, Ibidun Jolaoso, Obioma Azurunwa, Francis Ogirima, Collins Imarhiagbe, Anthony Onwuegbusi, David Udanwojo, Emmanuel Udeh, Victor Obagunlu, Adebola Adekogbe, Sunday Joseph, Hamza Abubakar, Neyu Iiyasu, Adetosoye Adebanjo, Barlarbe Gaya, Olayiwola Jaiyeola, Damilola Olaniyan, Bankole Olatosi Ph.D., Deborah Lynn Billings Ph.D., Et. Al.
Group Antenatal Care Model As An Innovative And Sustainable Maternal And Child Health Service Delivery In A Northern Nigerian State, Pius I. Christopher-Izere, Abiola Ajibola, Abimbola Phillips, Dorcas Magbadelo, Ibidun Jolaoso, Obioma Azurunwa, Francis Ogirima, Collins Imarhiagbe, Anthony Onwuegbusi, David Udanwojo, Emmanuel Udeh, Victor Obagunlu, Adebola Adekogbe, Sunday Joseph, Hamza Abubakar, Neyu Iiyasu, Adetosoye Adebanjo, Barlarbe Gaya, Olayiwola Jaiyeola, Damilola Olaniyan, Bankole Olatosi Ph.D., Deborah Lynn Billings Ph.D., Et. Al.
Faculty Publications
The maternal and child health situation in developing countries remains critical and deeply concerning, These regions account for 99% of global maternal and under-five deaths. In Nigeria, uptake of critical life-saving maternal, neonatal and child health (MNCH) services, delivered through antenatal care (ANC), are sub-optimal, leading to poor outcomes. Group antenatal care (G-ANC) is an evolving antenatal care delivery model in low and medium-income countries. G-ANC models can improve quality and uptake of maternal health services.G-ANC model was implemented across 255 primary health facilities (PHFs) to ensure pregnant women receive components of a well-defined package of MNCH services at regular …
Preferences Of Health Professions Learners: A Scoping Review Of The Use And Role Of Dces In Health Professions Education, Sarah O'Neal, Natalie Smith, Jan Ostermann Ph.D., Binbin Zheng, Laiton Steele, Chris Gillette
Preferences Of Health Professions Learners: A Scoping Review Of The Use And Role Of Dces In Health Professions Education, Sarah O'Neal, Natalie Smith, Jan Ostermann Ph.D., Binbin Zheng, Laiton Steele, Chris Gillette
Faculty Publications
While discrete choice experiments (DCE), have increasingly been used in the medical literature, little is known about the use of these methods for eliciting preferences from and about students and trainees in health professions. The objectives of this scoping review are to (1) describe the extent to which DCEs have been used in health professions’ education, (2) identify which health professionals have been studied, and (3) identify thematic areas of research in which these methods have been used thematic areas. Between June and September 2024, we conducted a scoping review of the PubMed/Medline, EconLit, Web of Science, and Global Index …
Sociodemographic And Hiv-Related Characteristics Associated With Mental Health Diagnoses Among People Living With Hiv, Monique J. Brown Ph.D., Mph, Jiayang Xiao, Xueying Yang Ph.D., Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.
Sociodemographic And Hiv-Related Characteristics Associated With Mental Health Diagnoses Among People Living With Hiv, Monique J. Brown Ph.D., Mph, Jiayang Xiao, Xueying Yang Ph.D., Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.
Faculty Publications
Mental health diagnoses have been linked to poor HIV treatment outcomes and poorer quality of life among people living with HIV (PLWH). Therefore, this study aimed to investigate the association between sociodemographic and HIV-related characteristics, and common and serious mental health disorders among PLWH in South Carolina (SC). Data were obtained from the integrated system of statewide electronic health record (EHR) data in SC (2006–2019; N = 8,124). Multivariable logistic regression models were used to determine the associations between sociodemographic and HIV-related characteristics, and common mental health disorders and serious mental health disorders. Among the study population, 4% were 60 …
State Prior Authorization Prohibitions And Buprenorphine Retention Among Privately Insured Patients, Ju-Chen Hu, Shashi N. Kapadia, Hao Zhang, Ali Jalali, Kristen Underhill, Christina Andrews Ph.D., Yuhua Bao
State Prior Authorization Prohibitions And Buprenorphine Retention Among Privately Insured Patients, Ju-Chen Hu, Shashi N. Kapadia, Hao Zhang, Ali Jalali, Kristen Underhill, Christina Andrews Ph.D., Yuhua Bao
Faculty Publications
Importance Buprenorphine is the most commonly prescribed medication for opioid use disorder, but rates of retention in treatment remain low. Prior authorization (PA) has been identified as a barrier to the administration of buprenorphine, and patients may need multiple PAs to continue treatment; thus, many states have passed laws to prohibit the use of PA for buprenorphine in private insurance.
Objective To examine the association between PA prohibitions and buprenorphine treatment retention overall and by branded vs generic drug status.
Design, Setting, and Participants This cross-sectional study used a difference-in-differences design and private insurance claims data from 49 states and …
What Drives Advanced Practice Nurses To Stay In Rural America? Insights From The 2022 National Survey Of Registered Nurses, Esita Patel, Chris Gillette, Jan Ostermann Phd, Chris Everett, Dawn Caviness, Sarah Garvick
What Drives Advanced Practice Nurses To Stay In Rural America? Insights From The 2022 National Survey Of Registered Nurses, Esita Patel, Chris Gillette, Jan Ostermann Phd, Chris Everett, Dawn Caviness, Sarah Garvick
Faculty Publications
Purpose: Recruiting and retaining a robust rural health care workforce is critical to advancing health outcomes in rural communities. Although increasing the rural provider workforce has been a policy focus for decades, rural access continues to worsen. Using a strengths-based approach, we identify factors that influence the decisions of advanced practice registered nurses (APRNs) to leave or stay in their jobs.
Methods: Secondary analysis of data from the 2022 National Sample Survey of Registered Nurses. We describe rates of turnover, retention, intention to leave, and reasons for leaving and staying by job rurality. We compare reasons by rurality using Pearson …
Changes In Mental Health Care Utilisation Before And During The Covid-19 Pandemic Among People Living With Hiv In The Usa: A Retrospective Cohort Study Using The All Of Us Dataset, Atena Pasha, Shan Qiao, Jiajia Zhang Ph.D., Ruilie Cai, Buwei He, Xueying Yang, Chen Liang Ph.D., Sharon Weissman, Xiaoming Li Ph.D.
Changes In Mental Health Care Utilisation Before And During The Covid-19 Pandemic Among People Living With Hiv In The Usa: A Retrospective Cohort Study Using The All Of Us Dataset, Atena Pasha, Shan Qiao, Jiajia Zhang Ph.D., Ruilie Cai, Buwei He, Xueying Yang, Chen Liang Ph.D., Sharon Weissman, Xiaoming Li Ph.D.
Faculty Publications
Introduction Despite the profound impact of the COVID-19 pandemic on people living with HIV (PLWH) mental health, large-scale, real-world data on mental healthcare utilisation and associated factors among PLWH remain limited. This study explores mental healthcare utilisation and associated factors among PLWH during the COVID-19 pandemic.
Methods Using a retrospective cohort design, we identified and included 4575 PLWH through computational phenotyping based on relevant Observational Medical Outcomes Partnership Common Data Model concept sets from the All of Us programme between March 2018 and March 2022. Mental healthcare utilisation was measured using the yearly count of mental healthcare visits and compared …
In Pursuit Of A Better Hospital Quality Metric For Medicare, Brad Wright Ph.D.
In Pursuit Of A Better Hospital Quality Metric For Medicare, Brad Wright Ph.D.
Faculty Publications
No abstract provided.
Resilience Mediates The Association Between Discrimination And Psychological Distress Among Rural, Black Women In South Carolina: A Structural Equation Model, Camryn Garrett, Abhisheak Aggrawal, Huiyi Xia, Cheuk Chi Tam, Bankole Olatosi Ph.D., Sarah Wilcox Phd, Xiaoming Li Ph.D., Shan Qiao Ph.D.
Resilience Mediates The Association Between Discrimination And Psychological Distress Among Rural, Black Women In South Carolina: A Structural Equation Model, Camryn Garrett, Abhisheak Aggrawal, Huiyi Xia, Cheuk Chi Tam, Bankole Olatosi Ph.D., Sarah Wilcox Phd, Xiaoming Li Ph.D., Shan Qiao Ph.D.
Faculty Publications
Introduction
The marginalization of intersecting racial, gender, and rural identities compounds the structural vulnerabilities (e.g., discrimination, stigma, health disparities) experienced by Black women in South Carolina’s rural areas. Discriminatory experiences can deteriorate mental health; however, resilience can potentially reduce the ill effects of discrimination by decreasing associated psychological distress. This study examines the mediating role of resilience in the association between discrimination and psychological distress among rural, Black women in South Carolina in the post-pandemic era.
Methods
Black women (n = 300, mean age = 48.6) living in rural South Carolina were recruited from January to February 2024 using …
Medicaid Managed Care Organization Service Coverage And Diagnosis And Treatment Of Opioid Use Disorder: Evidence From Quasi-Random Auto-Assignment In Kentucky, Shelby R. Steuart, Miguel Antonio G Estrada, Christina Andrews Ph.D., Colleen M. Grogan, Olivia M. Hinds, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Melissa A. Westlake, Coady Wing, Amanda J. Abraham
Medicaid Managed Care Organization Service Coverage And Diagnosis And Treatment Of Opioid Use Disorder: Evidence From Quasi-Random Auto-Assignment In Kentucky, Shelby R. Steuart, Miguel Antonio G Estrada, Christina Andrews Ph.D., Colleen M. Grogan, Olivia M. Hinds, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Melissa A. Westlake, Coady Wing, Amanda J. Abraham
Faculty Publications
Introduction
Opioid-related mortality continues to claim tens of thousands of American lives annually. Medicaid plays an outsized role in financing opioid use disorder (OUD) treatment, paying for almost 40% of all Americans who received OUD treatment in 2017. Methods
Using Medicaid T-MSIS Analytic Files data and a novel data set of Medicaid managed care organization (MCO) plan coverage, we examined the relationship between comprehensiveness of benefits for OUD treatment provided by Medicaid MCO plans and the likelihood of OUD diagnosis and medications for OUD (MOUD) receipt among newly enrolled Medicaid beneficiaries in Kentucky. We use two stage least squares to …
Telehealth And In-Person Hiv Care During The Covid-19 Pandemic At A Large Academic Medical Center In North Carolina, Valerie Yelverton, Jan Ostermann Ph.D., Michael E. Yarrington, Andrew K. Weinhold, Nabil Natafgi, Bankole Olatosi, Sharon Weissman, Nathan M. Thielman
Telehealth And In-Person Hiv Care During The Covid-19 Pandemic At A Large Academic Medical Center In North Carolina, Valerie Yelverton, Jan Ostermann Ph.D., Michael E. Yarrington, Andrew K. Weinhold, Nabil Natafgi, Bankole Olatosi, Sharon Weissman, Nathan M. Thielman
Faculty Publications
Background
To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.
Methods
Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time …
Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan
Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan
Faculty Publications
Background
Bangladesh faces one of the highest global burdens of maternal and newborn deaths, primarily caused by hemorrhage and eclampsia/preeclampsia. Despite reducing maternal mortality by 40%, comprehensive medical interventions remain insufficient in health facilities.
Objectives
This study assessed the readiness of sub-district hospitals in Bangladesh to provide Emergency Obstetric and Newborn Care (EmONC) and analyzed the association between facility readiness and delivery rates.
Methods
Using Health Facility Assessment Survey data from 140 hospitals in 2014 and 141 in 2017, facility readiness was measured based on nine signal functions: administering antibiotics, oxytocin, and anticonvulsants; providing blood transfusions; performing cesarean and assisted …
Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan
Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan
Faculty Publications
Background
Bangladesh faces one of the highest global burdens of maternal and newborn deaths, primarily caused by hemorrhage and eclampsia/preeclampsia. Despite reducing maternal mortality by 40%, comprehensive medical interventions remain insufficient in health facilities.
Objectives
This study assessed the readiness of sub-district hospitals in Bangladesh to provide Emergency Obstetric and Newborn Care (EmONC) and analyzed the association between facility readiness and delivery rates.
Methods
Using Health Facility Assessment Survey data from 140 hospitals in 2014 and 141 in 2017, facility readiness was measured based on nine signal functions: administering antibiotics, oxytocin, and anticonvulsants; providing blood transfusions; performing cesarean and assisted …
Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi
Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi
Faculty Publications
The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina’s HIV and STI surveillance systems were linked, and all PWH aged …
Alcohol Use Disorder Medication Coverage And Utilization Management In Medicaid Managed Care Plans, Maureen T. Stewart, Sage R. Feltus, Christina Andrews Ph.D., Andrea Acevedo, Cindy Parks Thomas, Jeffrey Bratberg, Constance M. Horgan, Dominic Hodgkin, Rachel Sayko Adams
Alcohol Use Disorder Medication Coverage And Utilization Management In Medicaid Managed Care Plans, Maureen T. Stewart, Sage R. Feltus, Christina Andrews Ph.D., Andrea Acevedo, Cindy Parks Thomas, Jeffrey Bratberg, Constance M. Horgan, Dominic Hodgkin, Rachel Sayko Adams
Faculty Publications
IMPORTANCE Evidence-based, patient-centered treatment for alcohol use disorder (AUD) can include pharmacotherapy with naltrexone, acamprosate, or disulfiram; however, these medications are rarely used. Medicaid managed care plans (MCPs) manage health services for nearly 80% of Medicaid enrollees and are the largest payer for addiction treatment services. Little is known about Medicaid MCP policies for AUD medications.
OBJECTIVES To describe Medicaid MCPs’ coverage and management of acamprosate, naltrexone, and disulfiram for AUD and examine associations of plan characteristics and state policies with medication coverage.
DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, a content analysis was performed of 2021 insurance benefit …
Alcohol Use Disorder Medication Coverage And Utilization Management In Medicaid Managed Care Plans, Maureen T. Stewart, Sage R. Feltus, Christina M. Andrews Ph.D., Andrea Acevedo, Cindy Parks Thomas, Jeffrey Bratberg, Constance M. Horgan, Dominic Hodgkin, Rachel Sayko Adams
Alcohol Use Disorder Medication Coverage And Utilization Management In Medicaid Managed Care Plans, Maureen T. Stewart, Sage R. Feltus, Christina M. Andrews Ph.D., Andrea Acevedo, Cindy Parks Thomas, Jeffrey Bratberg, Constance M. Horgan, Dominic Hodgkin, Rachel Sayko Adams
Faculty Publications
Importance: Evidence-based, patient-centered treatment for alcohol use disorder (AUD) can include pharmacotherapy with naltrexone, acamprosate, or disulfiram; however, these medications are rarely used. Medicaid managed care plans (MCPs) manage health services for nearly 80% of Medicaid enrollees and are the largest payer for addiction treatment services. Little is known about Medicaid MCP policies for AUD medications. Objectives: To describe Medicaid MCPs' coverage and management of acamprosate, naltrexone, and disulfiram for AUD and examine associations of plan characteristics and state policies with medication coverage. Design, Setting, and Participants: In this cross-sectional study, a content analysis was performed of 2021 insurance benefit …
Rural–Urban Differences In Substance Use During Pregnancy, Emma Kathryn Boswell, Olivia M. Hinds, Cassie Odahowski Phd, Mph, Elizabeth L. Crouch, Peiyin Hung Ph.D, Christina M. Andrews Ph.D.
Rural–Urban Differences In Substance Use During Pregnancy, Emma Kathryn Boswell, Olivia M. Hinds, Cassie Odahowski Phd, Mph, Elizabeth L. Crouch, Peiyin Hung Ph.D, Christina M. Andrews Ph.D.
Faculty Publications
Purpose: Drug overdoses are now a leading cause of pregnancy-related deaths in the United States. Despite evidence of rural–urban disparities in substance use, there has not yet been a nationally representative examination of rural–urban differences in perinatal substance use. This study provides a comprehensive examination of rural–urban disparities in perinatal substance use. Methods: This study uses cross-sectional data to examine 3499 pregnant women from the 2015–2019 National Survey on Drug Use and Health (NSDUH). Rural (nonmetro)–urban (metro) differences in past-month tobacco use, alcohol use, binge drinking, illicit drug use, and marijuana use were examined using Rao–Scott chi-square tests and multivariable …
Association Of Racial Residential Segregation And Other Social Determinants Of Health With Hiv Late Presentation, Fanghui Shi, Jiajia Zhang Ph.D., Shujie Chen, Xueying Yang Ph.D., Zhenlong Li, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.
Association Of Racial Residential Segregation And Other Social Determinants Of Health With Hiv Late Presentation, Fanghui Shi, Jiajia Zhang Ph.D., Shujie Chen, Xueying Yang Ph.D., Zhenlong Li, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.
Faculty Publications
Understanding social determinants of HIV late presentation with advanced disease (LPWA) beyond individual-level factors could help decrease LPWA and improve population-level HIV outcomes. This study aimed to examine county-level social determinants of health (SDOH) with HIV late presentation. We aggregated datasets for analysis by linking statewide HIV diagnosis data from the South Carolina (SC) Enhanced HIV/AIDS Reporting System and multiple social contextual datasets (e.g., the American Community Survey). All adult (18 years and older) people with HIV diagnosed from 2014 to 2019 in SC were included. Linear mixed models with forward selection were employed to explore the association of county-level …
Organizational Readiness For Implementation: A Qualitative Assessment To Explain Survey Responses, Maria Mcclam, Lauren Workman, Timothy J. Walker, Emanuelle M. Dias, Derek W. Craig, Joe R. Padila, Andrea E. Lamont, Abraham Wandersman, Maria E. Fernandez
Organizational Readiness For Implementation: A Qualitative Assessment To Explain Survey Responses, Maria Mcclam, Lauren Workman, Timothy J. Walker, Emanuelle M. Dias, Derek W. Craig, Joe R. Padila, Andrea E. Lamont, Abraham Wandersman, Maria E. Fernandez
Faculty Publications
Background
One factor considered essential to successful implementation is organizational readiness. The purpose of this study was to explore ways to improve the measurement of organizational readiness, and in particular to refine a preliminary measure based on the Readiness = Motivation x innovation Specific Capacity x General Capacity (R = MC2) heuristic. We assessed the experiences of staff in Federally Qualified Health Centers (FQHC) implementing evidence-based interventions (EBIs) designed to increase colorectal cancer screening (CRCS) who previously completed the survey and aimed to understand their perspectives on why our data were positively skewed.
Methods
We conducted a series of qualitative …
Longitudinal Viral Load Clustering For People With Hiv Using Functional Principal Component Analysis, Yunqing Ma, Xueying Yang Ph.D., Jiayang Xiao, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.
Longitudinal Viral Load Clustering For People With Hiv Using Functional Principal Component Analysis, Yunqing Ma, Xueying Yang Ph.D., Jiayang Xiao, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.
Faculty Publications
Background: Longitudinal measures of viral load (VL) are critical in monitoring the HIV status. While multiple lab indicators exist for monitoring measures of VL, research on clustering historical/longitudinal VL measures is limited. Analyzing longitudinal VL patterns rather than aggregated measures offers deeper insights into HIV status. This study uses functional data clustering to classify longitudinal VL patterns and characterize each cluster by demographics, comorbidities, social behaviors, and CD4 count.
Methods: Adult PWH diagnosed from 2005 to 2015 in South Carolina with a 5-year minimum follow-up were included. We compared functional principal component analysis (FPCA), K-means, hierarchical clustering, and Gaussian mixture …
Temporal Changes In Racial Disparities Of Hiv Linkage To Care From 2013 To 2020: A Statewide Cohort Analysis, Fanghui Shi, Katherine E. Weaver, Chen Zhang, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Xueying Yang
Temporal Changes In Racial Disparities Of Hiv Linkage To Care From 2013 To 2020: A Statewide Cohort Analysis, Fanghui Shi, Katherine E. Weaver, Chen Zhang, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Xueying Yang
Faculty Publications
Background: Racial disparities have historically existed regarding HIV care outcomes, including linkage to care. This study aims to explore the contribution of contextual features (e.g., socioeconomic and structural environmental factors) to the temporal change of county-level racial disparities in linkage to care.
Methods: This is a statewide population-based retrospective cohort study. The patient-level variables in the South Carolina HIV registry system were used to calculate the aggregated county-level linkage to care percentage. Then, we used four indices to measure racial disparities in the county-level percentage of timely linkage to care, i.e., the Black-White ratio, index of disparity (ID), weighted ID, …
Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral
Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral
Faculty Publications
Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV …
Longitudinal Assessments Of Viral Rebound Among People With Hiv In South Carolina: A Population-Based Cohort Study, Jiayang Xiao, Xueying Yang Ph.D., Yunqing Ma, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.
Longitudinal Assessments Of Viral Rebound Among People With Hiv In South Carolina: A Population-Based Cohort Study, Jiayang Xiao, Xueying Yang Ph.D., Yunqing Ma, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.
Faculty Publications
Routinely monitoring viral rebound (VR) is important in the life course of people with HIV (PWH). This study examined risk factors for time to the first VR, the number of VRs and their association with VR history in men who have sex with men (MSM). It includes 8176 adult PWH diagnosed from January 2005 to December 2018, followed until July 2021. We used the Cox model for time to the first VR, the Poisson model for a number of VRs, and logistic regression for VR history in MSM. Younger individuals (50–59 years vs 18–29 years, aHR: 0.43, 95% CI: [0.34, …
Sexual Orientation, Gender Identity And Virologic Failure Among People With Hiv: A Cohort Study In All Of Us Research Program, Fanghui Shi, Ruilie Cai, Buwei He, Xiaoming Li Ph.D., Xueying Yang Ph.D., Sharon Weissman, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.
Sexual Orientation, Gender Identity And Virologic Failure Among People With Hiv: A Cohort Study In All Of Us Research Program, Fanghui Shi, Ruilie Cai, Buwei He, Xiaoming Li Ph.D., Xueying Yang Ph.D., Sharon Weissman, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.
Faculty Publications
Background: Sexual and gender minorities (SGMs) are at higher risk of HIV incidence compared to their heterosexual cisgender counterparts. Despite the high HIV disease burden among SGMs, there was limited data on whether they are at higher risk of virologic failure, which may lead to potential disease progression and increased transmission risk. The All of Us (AoU) Research Program, a national community-engaged program aiming to improve health and facilitate health equity in the United States by partnering with one million participants, provides a promising resource for identifying a diverse and large volunteer TGD cohort. Leveraging various data sources available through …
The Dynamic Risk Factors Of Cardiovascular Disease Among People Living With Hiv: A Real-World Data Study, Ziang Liu, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Haoyuan Gao, Shujie Chen, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.
The Dynamic Risk Factors Of Cardiovascular Disease Among People Living With Hiv: A Real-World Data Study, Ziang Liu, Jiajia Zhang Ph.D., Xueying Yang Ph.D., Haoyuan Gao, Shujie Chen, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.
Faculty Publications
Background: This study aims to investigate the incidence and dynamic risk factors for cardiovascular diseases (CVD) among people living with HIV (PLWH).
Methods: In this population-based statewide cohort study, we utilized integrated electronic health records data to identify adult (age ≥ 18) who were diagnosed with HIV between 2006 and 2019 and were CVD event-free at the HIV diagnosis in South Carolina. The associations of HIV-related factors and traditional risk factors with the CVD incidence were investigated during the overall study period, and by different follow-up periods (i.e., 0-5yrs, 6-10yrs 11-15yrs) using multivariable logistic regression models.
Results: Among 9,082 eligible …