Health Policy Commons^™

Nourishing Births: A Program Evaluation Proposal For Community-Based Nutrition Education, Food Access, And Garden Engagement Among Black Birthing People, Naa Deedei-Vera Hammond

Master's Projects and Capstones

Black birthing people in the United States continue to experience unequal maternal health outcomes, shaped in part by racism and barriers to nutritious food, culturally relevant health education, and supportive community spaces. While prenatal nutrition education and food assistance programs can provide important resources, information alone cannot address the challenges many people face when trying to access healthy and affordable food during pregnancy. The Nourishing Births Initiative is a proposed community-based maternal health program designed to respond to these needs by bringing together prenatal nutrition education, help connecting to food resources, community gardening, and peer support for Black birthing people …

Interdisciplinary, Delphi-Driven Consensus Guidelines On The Use Of Intravenous Ketamine Infusions For Depressive Disorders From The American Society Of Ketamine Physicians, Psychotherapists, And Practitioners (Askp3), David S Mathai, Madeleine Cluck, Amna M Aslam, Erin Amato, Arsalan Azam, Michael Banov, Kathleen A Barrett, Carl J Bonnett, David Feifel, Nicolas Grundmann, H Samuel Ko, Rupert Mcshane, Sandhya Prashad, Tatiana Santini, Lowan H Stewart, Patrick Sullivan, Stefany D Wolfsohn, Jill O Robinson, Amy L Mcguire, L Alison Mcinnes

Center for Medical Ethics and Health Policy Staff Publications

Background: Off-label use of intravenous ketamine (IVK) for depression is a widespread practice with limited regulation in the United States. There is an urgent need for current, evidence-informed treatment guidelines to facilitate patient safety, clinical decision-making, and care quality in real-world contexts.

Methods: The American Society of Ketamine Physicians, Psychotherapists and Practitioners (ASKP3) convened an interdisciplinary working committee tasked with creating guidelines for use of IVK for depression in outpatient settings. Guideline development followed a two-stage process: 1) a hybrid systematic and targeted evidence review and preliminary drafting by the committee, and 2) consensus refinement through a modified Delphi method …

Cost Analysis Of Integrated Genderaffirming And Sexual Health Services For Transgender Women In Thailand: Evidence From The Tangerine Clinic, Braprut Sawatwipachai, Kunncadah Anuwong, Nittaya Phanuphak, Rena Janamnuaysook, Kritima Samitpol, Sujin Nitadpakorn

The Thai Journal of Pharmaceutical Sciences

Background: Transgender women experience a disproportionate burden of human immunodeficiency virus (HIV) globally and in Thailand. Integrating gender-affirming care into sexual health services may improve uptake of HIV and sexually transmitted infections (STIs) testing, treatment, and prevention. Cost data are essential to inform program planning and policy decisions regarding inclusion of such services within Thailand’s Universal Health Coverage (UHC) system.
Objectives: To estimate the full and unit costs of trans-led, integrated gender-affirming and sexual health services along the HIV care cascade.
Methods: Costs of Tangerine Clinic services in 2021 were assessed from the provider perspective, using standard and activity-based costing …

Towards Human-Centered Digital Health Interventions, Kristin M Kostick-Quenet, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

This article discusses the potential of digital health interventions (DHIs) in mental health care, emphasizing the importance of designing them to foster genuine humanistic care. It highlights current challenges in measuring engagement and outcomes, advocating for integrating human-centered endpoints such as dignity, autonomy, and therapeutic alliance into evaluation frameworks. The authors call for mechanistic research to identify effective engagement strategies and context-specific implementation approaches. Ultimately, successful DHIs should demonstrate both clinical efficacy and the preservation of humane, person-centered care, ensuring ethical and meaningful mental health support through technology.

Environmental Perspective For System Dynamics Modeling Of Stunting Mitigation To Achieve The Sustainable Development Goals In West Sumatra, Indonesia, Elsa Yuniarti, Nabila Azzahra, Yulhendri Yulhendri, Heldi Heldi, Mery Delvina, Saskia Putri Azeli

Kesmas

This study developed a system dynamics model to simulate stunting reduction in West Sumatra Province, Indonesia, by integrating infant and toddler health, maternal health, and environmental determinants. Secondary data from 2020–2024 on low birth weight, immunization, malnutrition, exclusive breastfeeding, maternal chronic energy deficiency, iron and folic acid supplement distribution, sanitation, and safe drinking water access were compiled from West Sumatra Provincial Health Office and Statistics Indonesia, and validated through consultation with five stakeholder institutions. Causal Loop Diagrams mapped feedback relationships among determinants and were translated into Stock Flow Diagrams using Powersim Studio 10. The model was validated through structural verification, …

Cost Analysis Of Rheumatoid Arthritis In Insured Patients And Its Determinant Factors: Data From A National Referral Hospital In Indonesia, Rudy Hidayat, Fara Fauzia, Mochammad Alfansyah Dhifanra, Aries Maulana

Kesmas

Rheumatoid arthritis (RA) leads to progressive functional impairment and considerable economic burden. This study estimated the annual (12-month) cost per patient among patients with RA and its determinant factors. A descriptive cross-sectional economic study of RA patients who had been treated for at least one year at the outpatient clinic of a national referral hospital in Jakarta, Indonesia, and met the 2010 ACR–EULAR criteria. Data collected from January 2023 to December 2024 were obtained from medical and billing records for demographic characteristics, direct medical costs, and DAS28-based disease activity, whereas non-medical and indirect costs were collected through structured patient interviews. …

From Structure To Experiences: How Facility Capacity And Staffing Shape The Adoption And Impact Of Lgbt-Affirming Policies In Long-Term Care, Andrew Alberth

Graduate Doctoral Dissertations

Long-term care (LTC) settings – including nursing homes (NHs) and assisted living facilities (ALFs) – provide necessary care for individuals with extreme health and functioning limitations. Sexual and gender minority (LGBT) older adults report challenges receiving effective, person-centered care LTC. Some LGBT older adults may hide their sexual orientation and gender identity when entering LTC settings or delay seeking needed LTC fearing discrimination from staff and other residents. Furthermore, staff in LTC settings indicate little awareness of LGBT-residents and possess inadequate LGBT-cultural competency necessary for providing person-centered care. Therefore, LGBT-residents LTC experiences remain underexplored in the broader research. Adopting LGBT-affirming …

The Effect Of State Policy On Individuals With Mental Illness In Nursing Homes: A Multilevel Analysis, Adrita Barooah

Graduate Doctoral Dissertations

ABSTRACT

THE EFFECT OF STATE POLICY ON INDIVIDUALS WITH MENTAL ILLNESS IN NURSING HOMES: A MULTILEVEL ANALYSIS

August 2026

Adrita Barooah, B.Sc., University of Delhi, India

M.S., University of Massachusetts Boston

Ph.D., University of Massachusetts Boston

Directed by Professor Pamela Nadash

The proportion of individuals living with a mental illness in U.S. nursing homes has grown substantially over the past few decades (Fashaw et al., 2020), raising serious concerns about care quality, resource adequacy, and costs to both nursing homes and government payers. The lack of adequate resources and knowledge has resulted in sub-par mental health care (O'Connor et al., …

Identifying And Addressing Problematic Studies In Allergy And Asthma Research: A Commentary, Alexandro W L Chu, Gordon H Guyatt, Jason W Busse, Romina Brignardello-Petersen, Xiajing Chu, Daniel G Rayner, Paul Oykhman, Vanessa Wong, Yetiani Roldan, Diane R Baker, Leonard B Bacharier, Lisa A Beck, Moshe Ben-Shoshan, Bradley Chipps, Flavia Hoyte, Elliot Israel, David M Lang, Sameer K Mathur, Sharmilee M Nyenhuis, Paul M O'Byrne, Eric T Oliver, John Oppenheimer, Tamara T Perry, Katherine Rivera-Spoljaric, Sarbjit S Saini, Javed Sheikh, Kaharu Sumino, Susan Waserman, Elissa M Abrams, Aikaterini Anagnostou, Jonathan A Bernstein, Anne K Ellis, David B K Golden, Caroline C Horner, Dennis K Ledford, Jay Lieberman, Giselle Mosnaim, Matthew A Rank, Marcus Shaker, Julie Wang, David A Khan, Derek K Chu

Center for Medical Ethics and Health Policy Staff Publications

Randomized controlled trials underpin evidence-based medicine, but a growing proportion of trials contain implausible, inaccurate, or fabricated data. When such studies are incorporated into systematic reviews, they distort effect estimates, inflate evidence certainty, and can mislead the guideline recommendations that the reviews aim to inform. Within 8 recent American Academy of Allergy, Asthma & Immunology and American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters (JTFPP) systematic reviews, 17% of trials published between 2021 and 2024 were problematic, and in a network meta-analysis of antihistamines for chronic urticaria, 39% of recent trials were excluded because of …

Roots And Systems: A Portfolio Of Clinical Growth, Trauma-Informed Care, And Culturally Centered Practice, Sarah Rice

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.

Bridging Fiscal Sustainability And Health Equity: A Policy Analysis Of California’S Healthcare Coverage Safeguards, Guadalupe Castaneda Martinez

Master's Projects and Capstones

Without structural policy intervention, approximately 4.6 million Californians remain at risk of being uninsured by 2030, worsening racial and ethnic health disparities and hospital uncompensated care burdens. This policy analysis advocates for a hybrid universal coverage model combining sliding-scale subsidies (California Senate Bill 78) with full-scope Medi-Cal expansion for all income-eligible residents regardless of legal status (California Assembly Bill 133). The framework relies on existing funding mechanisms, including the Managed Care Organization tax and the Health Care Affordability Reserve Fund. Comparative analysis indicates that market-only subsidies leave severe equity gaps, whereas immediate single-payer transitions pose substantial fiscal and administrative risks. …

Medical Tourism Patient Guidance: A Content Analysis Of Risk Reduction Guidelines Available To Global Health Seekers., Alicia Mason, Angela Ashmore

Faculty Submissions

This study examines medical tourism (MT) patient guidance messages intended to reduce procedural risks—those directly related to biomedical treatments—and process risks, which involve logistical, administrative, and interpersonal challenges of seeking healthcare abroad. The analysis focuses on print and digital publications authored by individuals independent of the MT industry, including policy researchers, travel health experts, lifestyle reporters, and consumer-focused medical travel writers. Using a two-phase digital and database search strategy, 27 publications from 2009 to 2024 were identified and analyzed using exploratory content analysis methods. Findings reveal important differences in the scope and depth of guidance aimed at reducing risks for …

Mission Of Mercy: Restoring Smiles With Dignity, Anne Berquist

The Journal of the Michigan Dental Association

This feature chronicles Michigan’s 2026 Mission of Mercy clinic, where more than 1,200 volunteers provided 5,656 procedures to 771 patients. The article describes patient experiences, volunteer contributions, and the extensive planning required to transform a sports arena into a temporary dental clinic. Beyond oral healthcare delivery, the program restored confidence, relieved pain, and highlighted the dental profession’s commitment to serving underserved populations.

Sari-Sari Stores As Community Pharmacies? A Qualitative Exploration Of Sari-Sari Stores Selling Medicines In The Philippines, Melissa Louise M. Prieto, Gamaliel P. Galigao, Ana Rica S. Navarra-Cruz, Louise Gabriel R. Jimenez, Gideon Lasco

Medical Anthropology

Background and Objective. Despite laws prohibiting the sale of pharmaceuticals outside licensed pharmacies, sari-sari stores continue to informally sell medicines, bridging access challenges especially in remote areas. The study explores the roles and perceptions of sari-sari stores as informal medicine providers. Methods. The study draws on ethnographic insights from key informant interviews with fourteen (14) sari-sari store owners or tinderas, probing into medicines sold in sari-sari stores and their perceived effectiveness. Data were analyzed using thematic analysis. Results. Sari-sari stores serve as informal yet critical points of access to common medicines for everyday illnesses, especially in remote areas where …

Navigating Undone Science: The Search For Adequate Endometriosis Care, Heather Welty, Melanie Jeske

Center for Medical Ethics and Health Policy Staff Publications

Endometriosis is an estrogen-dependent disease in which tissue similar to the lining of the uterus grows elsewhere in the body leading to a variety of symptoms including heavy and prolonged menstruation, chronic pain, cysts, infertility, and gastrointestinal issues. Despite being one of the most common gynecologic conditions, much remains unknown about potential risk factors for endometriosis, its etiology, and treatment options. First and second-line biomedical treatment options, complementary and alternative medicine, and lifestyle changes are all treatment options that people living with endometriosis (PLE) leverage to manage their symptoms. This article draws on in-depth interviews with 52 people living with …

Oral History With John Barry, Dan Royles

History Faculty Scholarship

Oral history interview with John Barry, who has served as Executive Director of the Southern Tier AIDS Program (STAP) since 2008. He was born in Endicott, New York in 1966, grew up in Vestal, and attended high school at Seton Catholic Central in Binghamton before serving in Germany with the United States Army during the early 1980s. When he returned to Broome County in 1987, some of his friends had been affected by HIV/AIDS and, while earning a degree at SUNY Binghamton, Barry became involved in mutual aid efforts to help people affected by the disease. He went to work …

Vietnamese Grandparents' Caregiving Experiences For Grandchildren Impacted By Hiv/Aids: An Ethnographic Study, Lesley M. Harris, Nguyen D. Thang, Linh Thuy Nguyen

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This ethnographic study explores the caregiving experiences of grandparents in northern Vietnam who are raising grandchildren impacted by HIV/AIDS. Specifically, what is the process of skipped-generation caregiving in families affected by HIV/AIDS in Vietnam? Data were collected between 2009 and 2011 through participant observation and in-depth interviews with 26 grandparent caregivers and eight key informants. Informed by the Caregiving Career framework as a sensitizing concept and using constructivist grounded theory analytic strategies, the study identifies four interconnected caregiving phases shaped by cultural expectations, stigma, and intergenerational disruption. Through fieldwork and analysis, we found that grandparents drew from previous and current …

Screening And Treatment Protocols Used In Nicus Across Minnesota For Perinatal Mood & Anxiety Disorders (Pmads), Rachael Witt

Journal of Justice-Informed Social Work Practice and Research

Parents of infants with prolonged neonatal intensive care unit (NICU) hospitalizations are a population that is overlooked in recommended routine screening for perinatal mood and anxiety disorders (PMADs), yet this population is at greater risk for developing diagnosable mental health disorders. Previous research shows that across the US, PMAD screening and treatment practices vary widely, with many NICUs not providing any routine PMAD screening, psychoeducation, or treatment options to parents. The objective of this study was to explore the current mental health screening and treatment protocols used in NICUs across the state of Minnesota to learn if there are areas …

Fertility And Birth Rates In The Mountain West, 2024, Sydney Mitchell, Maisoon Faris, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet reports 2024 data on the overall birth rate and birth-related health measures in the five Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah using data from the Centers for Disease Control and Prevention (CDC) website. This fact sheet includes information from the National Center for Health Statistics, “Statistics by State” subsection related to birth. This subsection focuses on fertility rates, teen birth rates, infant mortality rates, births to unmarried mothers, cesarean deliveries, pre-term births, and infants with low birth weight.

The Growing Needs For Young Adults’ Behavioral Health Services In Oregon And Pathways For Sustainable Service Deliveries, Anis Zaman

Hatfield Graduate Journal of Public Affairs

Recent OHA data indicate a significant surge in behavioral health cases among young adults ages 17-26 across Oregon. Every year in Oregon, the total number of young adults receiving medical treatment includes a significant number of them who have behavioral health challenges. This large group of young adults with mental health conditions is vulnerable to suicidal ideation and substance overdose. Despite sincere efforts by the Oregon Health Authority (OHA), the young adult mental health state of Oregon remains a concern. Therefore, there is a need for a comprehensive action plan for the sustainable delivery of mental health services to young …

Perceived Sensitivity Of Sensor-Based Digital Health Data: Qualitative Interview Study, Christine Deeney, Anika Sonig, Meghan E Hurley, Birkan Tunç, Eric A Storch, John D Herrington, Jennifer Blumenthal-Barby, Kristin Kostick-Quenet

Center for Medical Ethics and Health Policy Staff Publications

Background: Digital health tools are increasingly used in mental health care to passively collect patient data and analyze health status outside of clinical settings. While technologies such as digital phenotyping, affective computing, and computational behavioral analysis offer new insights into symptom manifestation in daily life, they generate large volumes of potentially sensitive data that raise significant data privacy concerns, requiring high levels of patient awareness and consent. Empirical research is lacking on stakeholder understandings toward the sensitivity of these data and expectations for data stewardship, perspectives that are critical for developing robust informed consent and data protection policies for digital …

Elective Genomic Sequencing For Adults In Research, Clinical And Commercial Contexts, Michael D Linderman, Sophia M Adelson, Tala M Berro, Jennifer L Anderson, Scott D Crawford, Tshaka J Cunningham, Edward D Esplin, Altovise T Ewing-Crawford, Daiva E Nielsen, Stacey Pereira, Tara Schmidlen, Heather Andrighetti, Steven B Bleyl, George M Church, Eden V Haverfield, Madhuri Hegde, Lazaridis N Konstantinos, Paul Kruszka, Debra Leonard, Thomas May, Molly Mcginniss, Vaibhav Pandya, Eric E Schadt, Bastian Greshake Tzovaras, Bethany Zettler, Amy L Mcguire, Robert C Green

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Elective genomic sequencing (EGS) returns monogenic disease findings in multiple genes, including potentially novel variants, and may also provide participants with carrier status, pharmacogenomic and other health-related information. The PeopleSeq Study assessed participants' motivations for and concerns about EGS and the associated clinical and psychosocial outcomes across diverse EGS providers.

Methods: We administered a shared questionnaire to participants who chose to undergo EGS via 18 academic, clinical, or commercial EGS platforms.

Results: We enrolled 1575 participants, of whom 1147 (72.8%) completed a questionnaire after receiving their EGS results. A majority (60.3%) of the participants who completed a post-result questionnaire …

Governing Algorithmic Attention: Attention Safeguard Models And The Cognitive Attentional Standard As System Level Interventions In Human Computer Interaction, Behavioral Economics, And Artificial Intelligence, Delante Clark

Graduate Scholarship and Creative Works

Algorithmic recommendation systems and interface designs shape attention by combining visually salient cues with uncertain reward timing and low friction interaction. These conditions can sustain anticipatory checking, extend time on task, and reduce natural disengagement points through patterns such as infinite scrolling and autoplay. This paper synthesizes research across neuroscience, human computer interaction, behavioral economics, and artificial intelligence to argue that attention capture is a predictable outcome of incentive driven design rather than an individual failure of self regulation. It advances the Attention Safeguard Models and the Cognitive Attentional Standard as system level interventions that regulate exposure conditions, pacing, and …

Breaking Bread And Barriers: Interprofessional Strategies To Improve Mental And Nutritional Health In Family Caregivers, Candy Ratliff

The Journal of the Research Association of Minority Professors

Family caregivers provide essential unpaid support to individuals with chronic illness, disability, dementia, and age-related decline; however, caregiving responsibilities often place caregivers at increased risk for psychological, physical, nutritional, and social challenges. This literature review examines the mental health and nutritional implications of family caregiving and explores barriers that contribute to declining caregiver wellness. Findings reveal elevated rates of depression, anxiety, emotional exhaustion, social isolation, food insecurity, sleep disturbances, financial strain, and chronic stress among caregivers. The literature further highlights the interconnected relationship between mental health, nutrition, and overall quality of life. Given the multidimensional nature of caregiver burden, interprofessional …

Explaining Variation In Medical Aid In Dying Policy Across U.S. States, Abigail Hopper

Undergraduate Theses, Capstones, and Recitals

This paper asks why Medical Aid in Dying (MAiD) policy in the United States does not follow a simple partisan pattern between states. Existing scholarship on morality policy emphasizes ideological conflict and partisan alignment, but this framework cannot fully explain why states with similar political compositions have adopted different MAiD policy outcomes, indicating that some key mechanisms shaping the variation have been overlooked. To address this, this paper combines a national dataset of MAiD policies across all fifty states with a comparative case study of Montana, Colorado, and West Virginia, focusing on differences in institutional venues, framing strategies, and coalition …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

When School Culture Excludes: Deficit Discourse, Microaggressions, And The Mental Health Of Marginalized Students – A Conceptual Framework With Implications For School Psychology Practice And Equity Policy, Modupe Mercy Oyewunmi

Publications

Deficit-laden language like ‘behavior problem,’ ‘not college material,’ ‘won’t fit in’, ‘not a cultural fit’, operates as a systemic form of implicit bias and microaggression in school settings. Despite decades of research on school belonging and well-being, school psychology has yet to integrate these exclusionary discursive practices into a coherent health-determinant model that also accounts for the current anti-diversity, equity, and inclusion (DEI) policy environment. This conceptual paper proposes a testable framework linking deficit discourse and school-based microaggressions to student identity suppression, academic impostor phenomenon, and educator moral injury, with downstream effects on school mental health outcomes. We situate these …

2026 Research, Policy, And Practice Summit: “Protecting Access To Rural Community Living For People With Disabilities”, Will Hoard, Lillie Greiman, Rtc: Rural

Independent Living and Community Participation

This summit summary examines the critical personal assistance workforce shortage in rural communities, where demand for care increasingly outpaces supply. Drawing on national data and expert panel insights, the event highlighted how structural barriers including low wages, administrative complexity, and limited data undermine the safety, independence, and dignity of disabled people in rural areas. The summit concluded that protecting rural community living requires coordinated policy investments in workforce wages, working conditions, and data systems, recognizing direct care workers as essential to the health and independence of the people and communities they serve.

Essays On Health And Immigration Policy, Selen Ozdogan

Dissertations, Theses, and Capstone Projects

This dissertation consists of two essays in applied microeconomics, each examining how individuals and institutions respond to policy changes. Both essays leverage natural experiments and recent advances in difference-in-differences estimation to identify causal effects. Both also speak to a common theme in public policy: the gap between intended and actual consequences of government intervention, and the role that policy design plays in shaping those consequences.

The first essay examines the impact of state-level e-cigarette excise taxes on nicotine and tobacco exposure among adults aged 18 and older. A central contribution is its use of individual-level panel biomarker data from urine …

Public Attitudes Toward Cascade Genetic Screening In The United States, Hadley Stevens Smith, Emilie S Zoltick, Madison R Hickingbotham, Emily S Bonkowski, Stacey Pereira, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Katherine E Bonini, Leila Jamal

Center for Medical Ethics and Health Policy Staff Publications

Introduction: After a patient receives genetic test results that indicate an actionable health condition, cascade genetic screening (CGS) is the process of evaluating the patient's relatives for a potentially elevated genetic risk of disease. The United States primarily relies on patients to communicate with their relatives, resulting in suboptimal rates of risk communication, familial genetic testing uptake, and risk-reducing interventions. There is ongoing debate about whether and how best to inform relatives of a potentially increased genetic risk.

Methods: We conducted a nationally representative survey of US adults to assess attitudes toward informing at-risk relatives, acceptability of system-mediated communication, and …