Health Policy Commons^™

Experiences Seeking Meaningful Employment For Individuals With Substance Use Disorder In York County Maine, Tyler Egeland Ba, Mark Richards Bs Bs, Evelyn Ali Bs, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

Two focus groups and one interview conducted in November 2021 collected information from a total of six respondents regarding theiremployment experiences in York County as individuals receiving treatment for substance use disorder. The guided discussion coveredtopics related to resources and services for finding employment opportunities, experiences obtaining meaningful employment, andpotential barriers and facilitators to maintaining employment. The interview and focus groups were facilitated and analyzed byexperienced researchers from the Catherine Cutler Institute at the University of Southern Maine. For more information, please contact Lindsey Smith at [email protected]

Nh Delivery System Reform Incentive Payment Program (Dsrip): Key Findings From The Summative Evaluation Report, Mary Lindsey Smith Phd, Deborah Thayer Mba, Katie Rosingana Ba, Rachel M. Gallo Mph, Catherine Mcguire Bs, Evelyn Ali Mph, Katharine Knight Mph, Chinonye Anumaka, Tyler Egeland Ba, Mark Richards Bs, Karen Pearson Mlis

Substance Use Research & Evaluation

Delivery System Reform Incentive Payment (DSRIP) programs are part of the broader Center for Medicare & Medicaid Services (CMS) Section 1115 Waiver programs and provide states with significant funding to support system transformation efforts. CMS approved New Hampshire’s five-year Building Capacity for Transformation Section 1115(a) Medicaid Demonstration Waiver in 2015. The overall goal of the DSRIP Demonstration is to improve the care for New Hampshire’s Medicaid Beneficiaries with behavioral health disorders by addressing workforce and infrastructure shortages, improving care transitions, and integrating physical and behavioral health. This condensed report highlights key findings from the NH DSRIP summative evaluation report. For …

Summative Evaluation Report By The Independent Evaluator For The New Hampshire Delivery System Reform Incentive Payment (Dsrip) Program, Mary Lindsey Smith Phd, Deborah Thayer Mba, Katie Rosingano Ba, Rachel M. Gallo Mph, Catherine Mcguire Bs, Evelyn Ali Mph, Katharine Knight Mph, Chinonye Anumaka Od, Mph, Tyler Egelund Ba, Mark Richards Bs, Karen Pearson Mlis, Ma

Substance Use Research & Evaluation

Delivery System Reform Incentive Payment (DSRIP) programs are part of the broader Center for Medicare & Medicaid Services (CMS) Section 1115 Waiver programs and provide states with significant funding to support system transformation efforts. CMS approved New Hampshire’s five-year Building Capacity for Transformation Section 1115(a) Medicaid Demonstration Waiver in 2015. The overall goal of the DSRIP Demonstration is to improve the care for New Hampshire’s Medicaid Beneficiaries with behavioral health disorders by addressing workforce and infrastructure shortages, improving care transitions, and integrating physical and behavioral health. This report is the final summative evaluation report on New Hampshire's DSRIP program. For …

Factors Associated With The Nutritional Status Of Infants And Young Children From Rural Honduras, Ana M. Palacios, Mario Keko, Aishat Adewoye, Haresh Rochani, Asli Aslan, Dziyana Nazaruk, Ana Gisela Ramos, Weston L. Oliver, Laura Manship

Health Policy & Community Health: Faculty Publications

Objectives

Malnutrition is a major public health problem in children. Undernutrition and excessive weight at young ages are associated with life-long consequences. The main objective of this study was to characterize the sociodemographic and food insecurity factors associated with the nutritional status of rural children ages 6 to 24 months living in 27 rural communities in Intibucá, Honduras.

Methods

This secondary analysis of baseline data included a total of 402 children ages 6 to 24 months who were recruited to participate in a cluster-non-randomized trial of a community-based nutrition intervention. Data were collected in January 2021 through a survey that …

Spending On Public Benefit Programs And Exposure To Adverse Childhood Experiences, Megan Collins

Research Days

Watch recording of live presentation.

Background: Adverse childhood experiences (ACEs) have been shown to be associated with poor health outcomes, and children living in poverty are more likely to experience ACEs. Our objective was to estimate the association between spending on benefit programs and cumulative exposure to ACEs among children.

Methods: This cross-sectional study examined state and federal spending, at the state-level, on 5 categories of public benefit programs: cash, housing, and in-kind assistance; housing infrastructure; childcare assistance; refundable Earned Income Tax Credit; and Medical Assistance Programs (e.g., Medicaid). The primary exposure was median annual spending per person living below …

Greater Portland Health Medication Assisted Treatment: Prescription Drug And Opioid Addiction Expansion Project: Biannual Summary, Mary Lindsey Smith Phd, Katharine Knight, Mark Richards Bs, Tyler Egeland Ba, Evelyn Ali Bs

Substance Use Research & Evaluation

Greater Portland Health (GPH) in collaboration with Preble Street Resource Center was awarded a Medication Assisted Treatment: Prescription Drug & Opioid Addiction (MOUD-PDOA) grant from SAMHSA. The GPH MOUD-PDOA project included a mixed-methods evaluation led by Catherine E. Cutler Institute’s Substance Use Research and Evaluation Team (SURE). The aims of the evaluation are to build knowledge, document lessons learned, and provide feedback to inform the implementation and refinement of the GPH MOUD-PDOA Program. This summary presentation is a biannual summary of the GPH MOUD-PDOA Project. For more information, please contact Lindsey Smith at [email protected]

Characterization Of Folic Acid, 5-Methyltetrahydrofolate And Synthetic Folinic Acid In The High-Affinity Folate Transporters: Impact On Pregnancy And Development, Ana M. Palacios, Rachel A. Feiner, Robert M. Cabrera

Health Policy & Community Health: Faculty Publications

Objectives:

Folates are B vitamins that are essential for several molecular, cellular, and biological processes, including nucleotide synthesis, methylation, and methionine cycling. The physiological impacts of these processes on health also extend to cell proliferation, folate deficiency anemia, and reduction of the risk of birth defects during pregnancy. The primary objective of this study was to characterize the binding affinities of different folate forms, folic acid (FA), 5-methyltetrahydrofolate (5MTHF), and folinic acid, to the folate receptors α and β, and to the bovine milk folate binding protein. These three dietary forms of folate are found in enriched grains (FA), various …

Promoting Health Equity Among Racial And Ethnic Minorities During And After The Covid-19 Pandemic, Alexandra Viramontes, Deserry Salgado

Electronic Theses, Projects, and Dissertations

Racial and ethnic minorities experience disproportionate health outcomes during a pandemic, yet preparedness plans have failed to address the social determinants of health that produce the most severe impact. By examining social workers’ perspectives on the health disparities faced by racial and ethnic minorities during the COVID-19 pandemic, this study provides insight into the ways in which services can be improved in a future health crisis. In this exploratory study, a qualitative approach was utilized where social workers were asked to participate in interviews consisting of open-ended questions. The qualitative data was obtained in the form of interview transcripts, which …

Helping Our Heroes: An Evaluation Of Mental Health And Organizational Policies Surrounding Suicide Prevention And Postvention Strategies For Nebraska First Responders, Maria S. Mickles

Capstone Experience: Master of Public Health

Suicide is ranked as one of the leading causes of death in the United States. Over 40,000 individuals die by suicide each year (Stanley, Hom, & Joiner, 2016; Vigil et al, 2021), and, in 2020, it was ranked in the top 9 causes of death for all ages (10-64), and second for those 10-14 and 25-34 years of age (Centers for Disease Control and Prevention, 2022). These statistics disproportionately reflect first responders (i.e., firefighters, dispatchers, law enforcement, EMS, paramedics, etc.), as they die by suicide more than the general public (National EMS Management Association, 2016). Within their line of work …

Youth Mental Health In The Mountain West, Kristian Thymianos, Olivia K. Cheche, Kelliann Beavers, Katie M. Gilbertson, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet explores youth mental health metrics of Mountain West states from the Hopeful Futures Campaign’s 2022 report, America’s School Mental Health Report Card. This study provides state snapshots on school mental health policies and workforce availability for all 50 states and the District of Columbia. The Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah are considered here.

Covid-19 Vaccine Uptake Among College Students, Erin Hoening, Elizabeth Morse, David Phillippi, Krystal Huesmann

DNP Projects

Background: Public health strategies to improve COVID-19 vaccine uptake among college students living in residential communities varied, some universities opted to mandate COVID-19 vaccines while other universities opted to promote and influence the choice for vaccination.

Purpose: This descriptive, cross-sectional study examined the voluntary uptake of COVID-19 vaccines among residential students on a college campus in the southeastern U.S. that elected an evidence-driven health promotion strategy that included strong health promotion messaging coupled with coordinated efforts to make the vaccine accessible and appealing to students on campus.

Methods: Analysis of vaccine uptake was derived from campus electronic health records during …

House: Homeless Opioid User Service Engagement Program. Year 1 Report, Mary Lindsey Smith Phd, Katharine Knight Mph, Evelyn Ali Bs, Thomas Chalmers Mclaughlin Msw, Phd, Katie Rosingana Ba, Tyler Egeland Ba, Mark Richards Bs, Karen Pearson Mlis, Ma

Substance Use Research & Evaluation

Homelessness and lack of stable housing is often a barrier to achieving stability for individuals who are experiencing homelessness (IWAEH) with an OUD. In order to meet the complex needs of IWAEH with OUD, the Department of Health and Human Services funded a pilot program in 2021, the Homeless Opioid Users Service Engagement (HOUSE) Program; clinicians at Greater Portland Health provide clients with low-barrier Medication Assisted Treatment (MAT), while staff at Preble Street provide casework support and rapid housing assistance to individuals who have been identified as being at high risk of overdose, are experiencing homelessness, and are diagnosed with …

Children Receiving A Nutrition And High-Quality Early Childhood Education Intervention Are Associated With Greater Math And Fluid Intelligence Scores: The Guatemala City Municipal Nurseries, Ana M. Palacios, Lisa A. Villanueva, Matthew B. Flynn, Erik Parker, Stephanie Dickinson, Helen W. Bland, Greg A. Reinhart

Health Policy & Community Health: Faculty Publications

Background: About 47% of children < 5 years of age are stunted in Guatemala. In this study, the investigators aimed to compare growth and cognitive outcomes between children in second grade that attended five Guatemala City Municipal Nurseries (GCMN) vs. same sex, grade, and age-matched children. Methods: A cross-sectional design nested in a retrospective cohort was implemented between 2015 and 2019. Children that attended the GCMN and matched controls completed a math test and validated receptive language and fluid intelligence tests. The primary caregivers completed a sociodemographic survey. General and generalized linear mixed effect models were used to compare children that attended the GCMN vs. controls. The models were adjusted by maternal education, sex, asset score, and other relevant covariates. Results: Children that attended the GCMN exhibited greater math and fluid intelligence scores relative to the controls in the adjusted models (ß = 6.48; 95% CI (2.35–10.61)) and (ß = 1.20; 95% CI (0.12–2.29)), respectively. Lower odds of stunting were significant for children who went to any early childcare institution (AOR = 0.28; 95% CI (0.09–0.89)). Conclusions: The importance of integrating nutrition and high-quality early childhood education interventions in cognitive and growth outcomes is highlighted in this study. The GCMN model may be a scalable model in similar low-resource settings.

Association Between Serum Lycopene And Lung Cancer Mortality: An 18-Year Follow-Up Study Of A National Cohort, Evans Afriyie-Gyawu, Padmini Shankar, Gulzar H. Shah, Alicia A. Brown, Shannon Cearley, Akwasi Ampofo-Yeboah, Nathaniel Abrams, Jian Zhang

Health Policy & Community Health: Faculty Publications

Background: Lycopene is a carotenoid found in some fruits and vegetables that is responsible for the red pigment in tomatoes and tomato products. While many studies have shown a link between lycopene and protection against the initiation and/or progression of lung cancer, data on its effect on lung cancer survivability is limited.

Objective: The primary objective of this study was to see if there was a link between lycopene levels in the blood and lung cancer mortality. A secondary goal was to see if dietary factors influence lycopene levels in the blood.

Materials and Methods: A retrospective …

Covid-19 And Social Determinants Of Health: Medicaid Managed Care Organizations’ Experiences With Addressing Member Social Needs, Samuel T. Opoku, Bettye Apenteng, Linda Kimsey, Angela H. Peden, Charles F. Owens

Health Policy & Community Health: Faculty Publications

Background

The significant adverse social and economic impact of the COVID-19 pandemic has cast broader light on the importance of addressing social determinants of health (SDOH). Medicaid Managed Care Organizations (MMCOs) have increasingly taken on a leadership role in integrating medical and social services for Medicaid members. However, the experiences of MMCOs in addressing member social needs during the pandemic has not yet been examined.

Aim

The purpose of this study was to describe MMCOs’ experiences with addressing the social needs of Medicaid members during the COVID-19 pandemic.

Methods

The study was a qualitative study using data from 28 semi-structured …

R.A.C.E. To Recovery Year 1 Evaluation Summary Report, Katie Rosingana Ba, Evelyn Ali Bs, Tyler Egeland Ba, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

Through a collaborative effort led by the Healthy Community Coalition, the multi-sector Rural Addiction Care Expansion (R.A.C.E.) to Recovery initiative consortium is utilizing evidence-based, community-wide response to impact and reduce the effects of the opioid epidemic in the Western Maine Public Health District/ Greater Franklin County. To assess and evaluate the implementation, successes, and challenges of the RACE to Recovery project, the Cutler Institute is collecting and analyzing data for both process and outcomes of the initiative.

In the first year of the initiative, the Cutler evaluation team utilized both primary and secondary data to assess RACE to Recovery program …

The State Of Mental Health In The Mountain West, Olivia K. Cheche, Kristian Thymianos, Katie M. Gilbertson, Kelliann Beavers, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet explores mental health rankings of Mountain West states from Mental Health America’s (MHA) 2022 report, The State of Mental Health in America. This study offers a snapshot of U.S. mental health based on data across all 50 states and the District of Columbia. MHA is the nation’s leading community based mental health nonprofit, founded in 1909, and “dedicated to addressing the needs of those living with mental illness and promoting the overall mental health of all.” This report is a companion to MHA’s interactive data available through its website.

Support For Me Needs Assessment Summary., Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Karen Pearson Mlis, Ma, Mark Richards Bs, Katharine Knight Mph, Tyler Egeland Ba, Olivia Dooley Mpa

Substance Use Research & Evaluation

Maine Department of Health and Human Services contracted with the Catherine Cutler Institute at the University of Southern Maine to conduct a baseline needs assessment. The overall goal was to better understand the current capacity to address substance use in Maine; find barriers to receiving and utilizing SUD treatment and recovery services; and identify any gaps in SUD-related services in the state. The Cutler team conducted interviews, surveys, community listening sessions and focus groups with healthcare key informants (leadership from health systems, residential care, recovery housing, behavioral health agencies), providers (medical, behavioral health, first responders, residential treatment, law enforcement, opioid …

Rural Pregnant Women’S Experiences With Substance Use Disorder: A Qualitative Study, Cami Weber

Dissertations

Rural pregnant women with substance use disorder (SUD) are an understudied vulnerable population that often experiences poor pregnancy outcomes (Higgins et al., 2019; Jumah, 2016; Kramlich et al., 2018; Shaw et al., 2015). Despite the high prevalence and high burden associated with SUD, rural women are less likely than non-pregnant women to seek addiction treatment and complete an outpatient treatment program during pregnancy (Shaw et al., 2015). This study aimed to give voice to rural Missouri women with SUD. The research questions explored the life experiences and motivations for seeking treatment using a qualitative, descriptive research design with grounded theory …

Translatina Immigrant Mental Health Wellness: Suggestive Intervention Strategies The City Of San Francisco Should Consider Adopting, Valeria Vera

Master's Theses

Translatina immigrants in the United States often suffer from intersectional traumas due to their race, gender, sexual orientation, religion, and immigration status — putting them in a vulnerable position socially, psychologically, economically, and medically. Due to their positionality in the intersections of migration, criminalization, cissexism, and mental health, they are often more marginalized and have greater needs than communities with privileged sociocultural identities. As a particularly vulnerable group, they need guaranteed access to gender-affirming healthcare that is inclusive of mental health services. Despite Translatinas’ need for mental health services, there exist many barriers making services inaccessible and insufficient in San …

Time To Ask Program At Greater Portland Health [Infographic], Evelyn Ali Bs, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The goals of the Time to Ask education and quality improvement program of the Lunder Dineen include increasing the capacity of interprofessional care teams in discussing alcohol use with the patients through the screening, brief intervention, and referral (SBIRT) process, and expanding providers' use of screening and monitoring unhealthy alcohol use of their patients.

This evaluation infographic visualizes the impact of Greater Portland Health's use of this program.

For more information about Time to Ask, visit https://lunderdineen.org/program/alcohol-use-time-to-ask/

For more information about the evaluation, please contact M. Lindsey Smith, PhD, [email protected]

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Time For Tobacco-Free Generations In The Western Pacific?, Gianna Gayle H. Amul, Suan Ee Ong, Azrul Mohd Khalib, Joanne Su-Yin Yoong

Ateneo School of Government Publications

No abstract provided.

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

Social Media Usage And Transitioning Into Online Classes During Covid-19- A Survey Of Undergraduate Students In Georgia, United States, Sylvia Ofori, Janet Choongo, Mario Kekop, Gulzar H. Shah, Haresh Rochani, Joseph Telfair

Health Policy & Community Health: Faculty Publications

Previous studies on the use of social media (SM) during the COVID-19 pandemic have focused on the use in sustaining academic communication. This study aimed to assess the association between SM and the ease of transitioning to online classes during the COVID-19 pandemic using survey data from 872 undergraduate students. The findings showed that Snapchat and Instagram were the most preferred social media sites among participants. Compared to students who use SM for <2 hours a day, use for > 5 hours (AOR= 2.44; 95% CI, 1.13 – 5.25) or 3 to 5 hours a day (AOR = 2.01, 95% CI 1.06-3.81) increased the odds of easily …

Hiv Viral Suppression Among People Living With Hiv On Antiretroviral Therapy In Haut-Katanga And Kinshasa Provinces Of Democratic Republic Of Congo, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Osaremhen Ikhile, Roger Beni, Elodie Engetele, Astrid Mulenga

Health Policy & Community Health: Faculty Publications

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and national guidelines and assess the factors associated with variation in VL levels. Purpose: This study had two objectives—(a) to describe the levels of HIV VL in persons on antiretroviral therapy (ART), and (b) to analyze the significance of variation in VL by patients’ demographic and clinical characteristics, …

Low Acceptance Of Helmet-Use And Injuries From Motorcycle Accidents In Rawalpindi And Abbottabad, Pakistan, Maryam Siddiqa, Gulzar H. Shah, A. Munam

Health Policy & Community Health: Faculty Publications

Background: Motorcycle accidents are a major cause of head injuries and the current study evaluated the beneficial impact and effectiveness of helmet usage among injured Motorcycle users. This study has been performed to observe the Motorcycle collisions within 6 months in Rawalpindi and Abbottabad cities of Pakistan

Objectives: Implications of helmet usage were assessed and the risk factors for severe injury during motorcycle accidents were identified.

Results: The multivariate analysis indicated that riders without a helmet were more likely to experience severe (AOR, 2.216; 95% CI, 2.02 to 10.5) or moderate injury (AOR, 1.215; 95% CI, 0.84 …

Determining The Optimal Healthcare System For America: Comparing The Current American And Universal Healthcare Systems, Tejas Kandharkar

University Honors Program

U.S. citizens ranked healthcare as the most important issue when it comes to voting (Zieff, 2020). The healthcare system’s importance is evident which is why it is important to determine what healthcare system is optimal for America. I used core indicators to compare the current American healthcare system and universal healthcare system and evaluated them for four key parameters. Based on my analysis, I conclusively determined that the universal healthcare system (Score: 8.23/10) is more optimal than the current American healthcare system (Score: 5.10/10). The American system had a somewhat better quality of care but the universal healthcare system was …

Covid-19 Investigated In Terms Of Disparities: An Analysis Of The Past, Present, And Future Of Public Health In Illinois, Hannah Deblock

University Honors Program

As a relatively new topic, previous literature fails to address the relation of social determinants of health to COVID-19. By combining existing knowledge on previous epidemics, information on the role of social determinants of health, and data on COVID-19, conclusions can be made about the path going forward. Historically, nonpharmacologic interventions such as quarantine periods, face coverings, and social distancing have been used in epidemics such as the Spanish Influenza of 1918-19. In terms of social determinants of health, geographical location, educational level, and income level all play a part in the health of an individual. Rather than emphasizing personal …

Support For Me: Substance Use Disorder Prevalence And Treatment Capacity Assessment, Rachel T. Gallo Mph, Katharine Knight Mph, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The aim of this report was to understand the sociodemographic and geographic distribution of substance use disorder (SUD) prevalence in Maine, through a claims-based analysis which assessed current statewide capacity to address SUD by examining current SUD treatment and recovery infrastructure, service utilization patterns, and geographic distribution of services and usage throughout the state to identify any gaps in treatment and recovery capacity.

The authors would like to note that this report was completed during the planning phase of the SUPPORT for ME project, which was funded by the Centers for Medicare & Medicaid Services (CMS) via the SUPPORT Act …