Biostatistics Commons^™

Maternal Care Utilization And Provision During The Covid-19 Pandemic: Voices From Minoritized Pregnant And Postpartum Women And Maternal Care Providers In Deep South, Ran Zhang, Tiffany Byrd, Shan Qiao Ph.D., Myriam E. Torres Phd, Msph, Xiaoming Li Ph.D., Jihong Liu Sc.D.

Faculty Publications

Background

The COVID-19 pandemic has significantly affected maternal care services especially for minoritized individuals, creating challenges for both service users (i.e., African American and Hispanic pregnant/postpartum women) and maternal care providers (MCPs). Guided by a socioecological framework, this study aims to investigate the experiences of African American and Hispanic pregnant and postpartum women, as well as MCPs, in accessing and providing maternal care services during the COVID-19 pandemic in the Deep South.

Methods

We conducted semi-structured interviews with 19 African American women, 20 Hispanic women, and 9 MCPs between January and August 2022. Participants were recruited from Obstetrics and Gynecology …

Identifying Multilevel Predictors Of Behavioral Outcomes Like Park Use: A Comparison Of Conditional And Marginal Modeling Approaches, Marilyn E. Wende, S. Morgan Hughey, Alexander C. Mclain, Shirelle Hallum, J. Aaron Hipp, Jasper Schipperijn, Ellen W. Stowe, Andrew T. Kaczynski Ph.D.

Faculty Publications

This study compared marginal and conditional modeling approaches for identifying individual, park and neighborhood park use predictors. Data were derived from the ParkIndex study, which occurred in 128 block groups in Brooklyn (New York), Seattle (Washington), Raleigh (North Carolina), and Greenville (South Carolina). Survey respondents (n = 320) indicated parks within one half-mile of their block group used within the past month. Parks (n = 263) were audited using the Community Park Audit Tool. Measures were collected at the individual (park visitation, physical activity, sociodemographic characteristics), park (distance, quality, size), and block group (park count, population density, age structure, racial …

Latent Classification Of Multi-Model Non-Homogeneous Continuous-Time Markov Chains, Joonha Chang

Dissertations and Theses (Open Access)

The continuous-time Markov chain (CTMC) model and latent clustering models are commonly used to study longitudinal measures of categorical outcomes. Because of its simple but powerful Markovian property, CTMC models have been widely used in medical and public health researches. Due to limitations in the standard CTMC model, there have been some studies on non-homogeneous continuous-time Markov chain (NH-CTMC) that utilized time-dependent rates, but the progresses have been limited. NH-CTMC can be more powerful than CTMC by its default nature of time-dependent rate that can be fitted to a wider range of applications in medical studies. In this study, we …

Identifying A Group Of Factors Predicting Cognitive Impairment Among Older Adults, Longgang Zhao, Yuan Wang, Eric Mishio Bawa, Zichun Meng, Jingkai Wei, Sarah Newman-Norlund, Tushar Trivedi, Hatice Hasturk, Roger Newman-Norlund, Julius Fridriksson Ph.D., Anwar T. Nerchant

Faculty Publications

Background

Cognitive impairment has multiple risk factors spanning several domains, but few studies have evaluated risk factor clusters. We aimed to identify naturally occurring clusters of risk factors of poor cognition among middle-aged and older adults and evaluate associations between measures of cognition and these risk factor clusters.

Methods

We used data from the National Health and Nutrition Examination Survey (NHANES) III (training dataset, n = 4074) and the NHANES 2011–2014 (validation dataset, n = 2510). Risk factors were selected based on the literature. We used both traditional logistic models and support vector machine methods to construct a composite score …

Associations Between Sleep Duration, Sleep Disturbance And Cardiovascular Disease Biomarkers Among Adults In The United States, Prince Nii Ossah Addo, Paddington T. Mundagowa, Longgang Zhao, Mufaro Kanyangarara, Monique J. Brown Ph.D., Mph, Jihong Liu Sc.D.

Faculty Publications

Background

Sleep problems are associated with abnormal cardiovascular biomarkers and an increased risk of cardiovascular diseases (CVDs). However, studies investigating associations between sleep problems and CVD biomarkers have reported conflicting findings. This study examined the associations between sleep problems and CVD biomarkers in the United States.

Methods

Data were from the National Health and Nutrition Examination Survey (NHANES) (2007–2018) and analyses were restricted to adults ≥ 20 years (n = 23,749). CVD biomarkers [C-reactive Protein (CRP), low-density lipoproteins, high-density lipoproteins (HDL), triglycerides, insulin, glycosylated hemoglobin (HbA1c), and fasting blood glucose] were categorized as abnormal or normal using standardized cut-off …

Obesity: The Effects On Health And Healthcare, Nadia Abdulbaki

Posters - 2024

▪ In 2022, 1 in 8 people in the world were living with obesity.

▪ 2.8 million people die each year due to being overweight and obese.

▪ Obesity is a medical disease that raises the likelihood of developing various conditions and diseases that increase the chances of mortality for affected individuals.

▪ Obesity can be caused by several influences, whether behavioral, socioeconomic, environmental, hormonal, or genetic; however, the primary cause of obesity is mostly attributed to lifestyle. Specifically, it is the consumption of a high amount of calories in conjunction with a low amount of calories expended. This is …

Comparison Of Raw Accelerometry Data From Actigraph, Apple Watch, Garmin, And Fitbit Using A Mechanical Shaker Table, James W. White Iii, Olivia L. Finnegan, Nick Tindall, Srihari Nelakuditi, David E. Brown Iii, Russell R. Pate Ph.D., Gregory J. Welk, Massimiliano De Zambotti, Rahul Ghosal, Yuan Wang, Sarah Burkart, Elizabeth L. Adams, Mvs Chandrashekhar, Bridget Armstrong, Michael W. Beets, Robert Weaver Med, Phd

Faculty Publications

The purpose of this study was to evaluate the reliability and validity of the raw accelerometry output from research-grade and consumer wearable devices compared to accelerations produced by a mechanical shaker table. Raw accelerometry data from a total of 40 devices (i.e., n = 10 ActiGraph wGT3X-BT, n = 10 Apple Watch Series 7, n = 10 Garmin Vivoactive 4S, and n = 10 Fitbit Sense) were compared to reference accelerations produced by an orbital shaker table at speeds ranging from 0.6 Hz (4.4 milligravity-mg) to 3.2 Hz (124.7mg). Two-way random effects absolute intraclass correlation coefficients (ICC) tested inter-device reliability. …

Treatment And Mortality Following Cancer Diagnosis Among People With Non-Affective Psychotic Disorders In Ontario, Canada: A Retrospective Cohort Study, Jared C. Wootten, Lucie Richard, Melody Lam, Phillip S. Blanchette, Marco Solmi, Kelly K. Anderson

Epidemiology and Biostatistics Publications

Background and Hypothesis People with psychotic disorders have a higher risk of mortality following cancer diagnosis, compared to people without psychosis. The extent to which this disparity is influenced by differences in cancer-related treatment is currently unknown. We hypothesized that, following a cancer diagnosis, people with psychotic disorders were less likely to receive treatment and were at higher risk of death than those without psychosis. Study Design We constructed a retrospective cohort of cases of non-affective psychotic disorder (NAPD) and a general population comparison group, using Ontario Health (OH) administrative data. We identified cases of all cancers diagnosed between 1995 …

Identifying Environmental And Genetic Risk Factors Of Diseases In Case-Control Studies, Siting Li

Dartmouth College Ph.D Dissertations

In response to the increasing efforts in disease prevention and treatment, this thesis applies statistical methods to investigate environmental and genetic risk factors associated with two diseases: bladder cancer and amyotrophic lateral sclerosis (ALS). For bladder cancer, we investigated the association between toenail metal mixture and bladder cancer risk, along with gene expression levels associated with bladder cancer risk. For ALS, our investigation involves identifying genetic variants and gene expression levels associated with ALS risk and exploring gene-smoking interactions linked to ALS risk.

In chapter two, we developed an adaptive-mixture-categorization (AMC)-based g-computation method combining g-computation with optimized exposure categorization. We …

Road Traffic Noise Annoyance And Cardiovascular Disease Risk In Population: A Case Series Study In Kota Bharu, Malaysia, Faridah Naim, Nurin H M Nasir

Kesmas

Noise pollution can cause annoyance, significantly threatening the population’s health and well-being. This study aimed to find an association between road traffic noise exposure and cardiovascular disease (CVD) risk among residents in Kota Bharu, Malaysia. This descriptive study used a case series approach and surveyed 34 residents in selected residential areas near main roads. An adapted questionnaire was distributed to residents using a purposive sampling method. Questions related to sociodemographic information, self-reporting about CVD, and road traffic noise assessment were asked to investigate the underlying risk factors for CVD. The average score of CVD assessment was classified as moderate risk. …

Impact Of Non-Medical Cannabis Legalization With Market Restrictions On Health Service Use And Incident Cases Of Psychotic Disorder In Ontario, Canada, Kelly K. Anderson, Rebecca Rodrigues, Britney Le, Maliha Mamun, Suzanne Archie, Jordan Edwards, Tara Elton-Marshall, Jason Gilliland, Daniel Thomas Myran, Lena Palaniyappan, Christopher M Perlman, Jamie A Seabrook, Robin M Murray, Salimah Z Shariff

Epidemiology and Biostatistics Publications

BACKGROUND: Cannabis is a risk factor in the onset and persistence of psychotic disorders. There is concern that non-medical cannabis legalization in Canada may have population-level impacts on psychotic disorders. We sought to examine changes in health service use and incident cases of psychotic disorder following cannabis legalization, during a period of tight restrictions on retail stores and product types.

METHODS: We conducted a cross-sectional interrupted time-series analysis using linked population-based health administrative data from Ontario (Canada) from January 2014 to March 2020. We identified psychosis-related outpatient visits, emergency department visits, hospitalizations, and inpatient length of stay, as well as …

Perioperative Mortality In Low-, Middle-, And High-Income Countries: Protocol For A Multi-Level Meta-Regression Analysis, Kevin Mcintyre, Yun-Hee Choi, Ava John-Baptiste, Daniel J Lizotte, Eunice Y S Chan, Jessica Moodie, Saverio Stranges, Janet Martin

Epidemiology and Biostatistics Publications

BACKGROUND: Surgery is an indispensable component of a functional healthcare system. To date there is limited information regarding how many people die during the perioperative period globally. This study describes a protocol for a systematic review and multilevel meta-regression to evaluate time trends regarding the odds of perioperative mortality among adults undergoing a bellwether surgical procedure while accounting for higher order clustering at the national level.

METHODS: Published studies reporting the number of perioperative deaths from bellwether surgical procedures among adults will be identified from MEDLINE, Embase, Cochrane CENTRAL, LILACS and Global Index Medicus. The primary outcome will be the …

The Performance Of Marginal Modeling Methods For Rare Events With Application To Opioid Overdose Mortality And Morbidity, Shawn Nigam

Theses and Dissertations--Epidemiology and Biostatistics

Opioid misuse is a nationwide epidemic, with Kentucky having one of the highest opioid overdose-related fatality rates across all US states. These rates have increased significantly over the past decade, with particularly large increases during the COVID-19 pandemic. This dissertation aims to study the behavior of these increases and the methods for the marginal modeling of count outcomes related to opioid overdose.

Opioid overdose-related fatality rates in Kentucky increased significantly during the COVID-19 pandemic. In this chapter, we characterize the changes in opioid overdose fatality rates in Kentucky and identify associations between potential factors and fatality rates. County-level opioid overdose …

The Genetic Architecture Of Cervical Change During Pregnancy: From Modeling To Mechanism — Does The Cervix Mediate Maternal Risk For Spontaneous Preterm Birth?, Hope M. Wolf

Theses and Dissertations

This project leverages clinical data and biospecimens from a prospective longitudinal cohort of pregnant women to study the genetic and phenotypic relationships between cervical shortening and the duration of pregnancy. Sonographic cervical length (CL) was measured throughout pregnancy in a cohort of 5,160 Black/African American women in Detroit, Michigan. Maternal DNA samples were sequenced with a next-generation low-pass whole genome platform. The heritability of cervical change during pregnancy and its genetic correlation with gestational age at delivery (GAD) were estimated using Genome-Wide Complex Trait Analysis. These estimates suggest that cervical change is heritable (h²CL = 51%) and highly polygenic trait. …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

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 …

Models Of Shared Care For The Management Of Psychotic Disorder After First Diagnosis In Ontario., Joshua C. Wiener, Rebecca Rodrigues, Jennifer N S Reid, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: To describe the provision of care for young people following first diagnosis of psychotic disorder.

DESIGN: Retrospective cohort study using health administrative data.

SETTING: Ontario.

PARTICIPANTS: People aged 14 to 35 years with a first diagnosis of nonaffective psychotic disorder in Ontario between 2005 and 2015 (N=39,449).

MAIN OUTCOME MEASURES: Models of care, defined by psychosis-related service contacts with primary care physicians and psychiatrists during the 2 years after first diagnosis of psychotic disorder.

RESULTS: During the 2-year follow-up period, 29% of the cohort received only primary care, 30% received only psychiatric care, and 32% received both primary and …

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 …

Addressing The Analytical And Computational Challenges Using Machine Learning In Biomedical Research, Yizhuo Wang

Dissertations and Theses (Open Access)

In the contemporary healthcare field, professionals are confronted with an ever-growing volume of clinical data stored in electronic health records, alongside the genomic data stemming from laboratory experiments. As a response to this deluge of data, the application of machine learning (ML) techniques is gaining popularity since ML techniques have demonstrated an exceptional proficiency in processing big data and deciphering complex nonlinear patterns that are intrinsic to biomedical research.

My research leverages ML's capabilities to address the computational challenges spanning diverse areas, including adaptive clinical trial designs, survival analysis, and high-dimensional genetic data analysis. Specifically, Chapter 2 focused on the …

Examining Covid-19 Vaccine Hesitancy Among The Nevada African American Population Using The Social-Ecological Model, Katelyn Faulk

UNLV Theses, Dissertations, Professional Papers, and Capstones

In Nevada, COVID-19 vaccines have been widely available to the general population since March 2021; however, even with the wide availability of these vaccines only 40% of the African American population in Nevada has been fully vaccinated against COVID-19 as of May 2023. This is problematic as it has been shown that the African American population is disproportionately affected by COVID-19 with higher rates of cases, hospitalizations, and deaths when compared to other races or ethnicities. Through the literature, it has also been well documented that African Americans may experience hesitancy toward these vaccinations for a multitude of reasons including …

Access To A Regular Primary Care Physician Among Young People With Early Psychosis In Ontario, Canada, Rebecca Rodrigues, Jennifer N S Reid, Joshua C. Wiener, Suzanne Archie, Richard G Booth, Chiachen Cheng, Arlene G Macdougall, Lena Palaniyappan, Bridget L Ryan, Aristotle Voineskos, Paul Kurdyak, Saadia Hameed Jan, Kelly K. Anderson

Epidemiology and Biostatistics Publications

AIM: Access to a primary care physician in early psychosis facilitates help-seeking and engagement with psychiatric treatment. We examined access to a regular primary care physician in people with early psychosis, compared to the general population, and explored factors associated with access.

METHODS: Using linked health administrative data from Ontario (Canada), we identified people aged 14-35 years with a first diagnosis of nonaffective psychotic disorder (n = 39 449; 2005-2015). We matched cases to four randomly selected general population controls based on age, sex, neighbourhood, and index date (n = 157 796). We used modified Poisson regression to estimate prevalence …

Editorial: The Public Health Scholars As The Health Leaders, Al Asyary, Meita Veruswati, Putri Bungsu Machmud, Indri Hapsari Susilowati

Kesmas

1. Achmadi UF. Kesehatan Masyarakat: Teori dan Aplikasi. Jakarta: Rajawali Pers; 2014.

2. Asyary A. Editorial. Kesmas. 2023; 18 (Special Issue 1): 1-3. DOI: 10.21109/kesmas.v18isp1.7201

3. Badan Kebijakan Pembangunan Kesehatan. Pembangunan Kesehatan di Indonesia melalui Kesinambungan Finansial Jaminan Kesehatan serta Meningkatkan Kualitas Layanan dengan Integrasi Data. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023.

Who Sleeps Well In Canada? The Social Determinants Of Sleep Health Among Middle-Aged And Older Adults In The Canadian Longitudinal Study On Aging., Rebecca Rodrigues, Amy Jing, Kelly K. Anderson, Rea Alonzo, Piotr Wilk, Graham J Reid, Jason Gilliland, Guangyong Zou, Kathryn Nicholson, Giuseppe Guaiana, Saverio Stranges

Epidemiology and Biostatistics Publications

OBJECTIVES: Sleep health inequities likely contribute to disparities in health outcomes. Our objective was to identify social determinants of sleep health among middle-aged/older adults in Canada, where prior evidence is limited.

METHODS: We analyzed cross-sectional data from the Canadian Longitudinal Study on Aging, a survey of over 30,000 community-dwelling adults aged 45-85years. Self-reported measures included sleep duration, sleep satisfaction, and sleep efficiency. We explored associations between sleep measures and social determinants of health. We used modified Poisson regression to estimate prevalence ratios for sleep satisfaction and sleep efficiency, and linear regression for sleep duration. Estimates were adjusted for all social, …

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 …

All-Cause And Opioid-Related Mortality Compared Between Traumatic Spinal Cord Injury And The Us General Population, Jaden Whitehead, Beatrice Ugiliweneza

The Cardinal Edge

Individuals with spinal cord injury (SCI) are susceptible to the misuse of opioids due to the introduction of these substances for pain management. There are very few studies examining the relationship between unintentional deaths caused by opioid usage following spinal cord injury. The objective of this study was to evaluate the trend of opioid-related mortality of individuals with spinal cord injury (SCI) over the years and compare these findings to the mortality rates due to opioid misuse in the general population. In this study, we used data provided by the National Spinal Cord Injury Model Systems (NSCIMS) for SCI 1999-2016 …

Sugar-Sweetened Beverages And Artificially Sweetened Beverages Consumption And The Risk Of Nonalcoholic Fatty Liver (Nafld) And Nonalcoholic Steatohepatitis (Nash), Tung Sung Tseng, Wei Ting Lin, Peng Sheng Ting, Chiung Kuei Huang, Po Hung Chen, Gabrielle V. Gonzalez, Hui Yi Lin

School of Public Health Faculty Publications

Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are fast becoming the most common chronic liver disease and are often preventable with healthy dietary habits and weight management. Sugar-sweetened beverage (SSB) consumption is associated with obesity and NAFLD. However, the impact of different types of SSBs, including artificially sweetened beverages (ASBs), is not clear after controlling for total sugar intake and total caloric intake. The aim of this study was to examine the association between the consumption of different SSBs and the risk of NAFLD and NASH in US adults. The representativeness of 3739 US adults aged ≥20 years …

History And Current Status Of Mediterranean Spotted Fever (Msf) In The Crimean Peninsula And Neighboring Regions Along The Black Sea Coast, Muniver T. Gafarova, Marina E. Eremeeva

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Mediterranean spotted fever (MSF) is a tick-borne rickettsiosis caused by Rickettsia conorii subspecies conorii and transmitted to humans by Rhipicephalus sanguineus ticks. The disease was first discovered in Tunisia in 1910 and was subsequently reported from other Mediterranean countries. The first cases of MSF in the former Soviet Union were detected in 1936 on the Crimean Peninsula. This review summarizes the historic information and main features of MSF in that region and contemporary surveillance and control efforts for this rickettsiosis. Current data pertinent to the epidemiology of the disease, circulation of the ticks and distribution of animal hosts are discussed …

The Public Health Impact Of Paxlovid Covid-19 Treatment In The United States, Yuan Bai, Zhanwei Du, Lin Wang, Eric H. Y. Lau, Isaac Fung, Petter Holme, Ben Cowling, Alison Galvani, Robert Krug, Lauren Ancel Meyers

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

The antiviral drug Paxlovid has been shown to rapidly reduce viral load. Coupled with vaccination, timely administration of safe and effective antivirals could provide a path towards managing COVID-19 without restrictive non-pharmaceutical measures. Here, we estimate the population-level impacts of expanding treatment with Paxlovid in the US using a multi-scale mathematical model of SARS-CoV-2 transmission that incorporates the within-host viral load dynamics of the Omicron variant. We find that, under a low transmission scenario (Re∼1.2) treating 20% of symptomatic cases would be life and cost saving, leading to an estimated 0.26 (95% CrI: 0.03, 0.59) million hospitalizations averted, 30.61 (95% …

Design, Analysis, And Interpretation Of Treatment Response Heterogeneity In Personalized Nutrition And Obesity Treatment Research, Roger S. Zoh, Bridget H. Esteves, Xiaoxin Yu, Amanda J. Fairchild, Ana I. Vazquez, Andrew G. Chapple, Andrew W. Brown, Brandon George, Derek Gordon, Douglas Landsittel, Gary L. Gadbury, Greg Pavela, Gustavo De Los Campos, Luis M. Mestre, David B. Allison

School of Public Health Faculty Publications

It is increasingly assumed that there is no one-size-fits-all approach to dietary recommendations for the management and treatment of chronic diseases such as obesity. This phenomenon that not all individuals respond uniformly to a given treatment has become an area of research interest given the rise of personalized and precision medicine. To conduct, interpret, and disseminate this research rigorously and with scientific accuracy, however, requires an understanding of treatment response heterogeneity. Here, we define treatment response heterogeneity as it relates to clinical trials, provide statistical guidance for measuring treatment response heterogeneity, and highlight study designs that can quantify treatment response …

Differences In Clinical Presentation At First Hospitalization And The Impact On Involuntary Admissions Among First-Generation Migrant Groups With Non-Affective Psychotic Disorders., Kelly K Anderson, Rebecca Rodrigues

Epidemiology and Biostatistics Publications

BACKGROUND: Some migrant and ethnic minority groups have a higher risk of coercive pathways to care; however, it is unclear whether differences in clinical presentation contribute to this risk. We sought to assess: (i) whether there were differences in clinician-rated symptoms and behaviours across first-generation immigrant and refugee groups at the first psychiatric hospitalization after psychosis diagnosis, and (ii) whether these differences accounted for disparities in involuntary admission.

METHODS: Using population-based health administrative data from Ontario, Canada, we constructed a sample (2009-2013) of incident cases of non-affective psychotic disorder followed for two years to identify first psychiatric hospitalization. We compared …