Health Policy Commons^™

Western Maine Addiction And Recovery Initiative's Substance Misuse Prevention And Wellness Day: Year 2 Feedback Survey For Ohchs, Tyler Egeland Ba, Evelyn Ali Bs, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

As part of the evaluation of the Western Maine Addiction Recovery Initiative’s (WMARI) HRSA Rural Communities Opioid Response Program grant, staff from the Substance Use Research & Evaluation Unit, USM developed a survey to gather feedback from individuals who participated in the 2nd annual OHCHS Substance Use Prevention and Wellness Day. For more information, please contact Lindsey Smith at [email protected]

The Role Of Between-Session Homework In Cognitive-Behavioral Therapy For Comorbid Obsessive-Compulsive Disorder And Autism: A Case Vignette, Molly J Church, Katie H Mangen, Jordan T Stiede, Samuel D Spencer, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Objective: Cognitive-behavioral therapy (CBT), which includes a decided emphasis on exposure and response/ritual prevention (ERP) and between-session practice of treatment principles, has consistently demonstrated efficacy for the treatment of obsessive-compulsive disorder (OCD) and is a gold standard, recommended first-line treatment. CBT with ERP has been successfully adapted to fit the needs of autistic individuals with OCD. The present article provides a brief overview of CBT for OCD and outlines special considerations and adaptations needed when working with patients with OCD and comorbid autism, with an emphasis on the importance of between-session homework.

Method: A case vignette is presented.

Results: This …

Western Maine Addiction And Recovery Initiative's Substance Misuse Prevention And Wellness Day: Year 2 Planning Survey Summary For Ohchs, Evelyn Ali Bs, Tyler Egeland Ba, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The RCORP local evaluation team at the Catherine Cutler Institute deployed a survey to Oxford Hills Comprehensive High School (OHCHS). The purpose of the survey was to understand needs unique to OHCHS to plan for types of activities and information presented at the school’s Substance Use Prevention and Wellness Day. For more information, please contact Lindsey Smith at [email protected]

Parental Descriptions Of Childhood Avoidance Symptoms After Trauma, Zoe Blair-Andrews, Alison Salloum, Stephanie Evans, Vicky Phares, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Recognizing and diagnosing the avoidance symptom cluster of posttraumatic stress disorder (PTSD) in young children has been challenging. This study examines caregivers' descriptions of young children's avoidance reactions. By describing parents' examples of childhood avoidance, clinicians, researchers, and educators may be able to provide more specific psychoeducation which may improve identification of avoidance behaviors in young children. Caregivers (N=73) of young children (age 3-7 years) participated in a semi-structured diagnostic clinical interview prior to enrolling in a clinical trial for childhood trauma. The assessment regarding the caregiver's description of the child's avoidance was audio recorded and transcribed for a thematic …

The Million Veteran Program 1990-1991 Gulf War Era Survey: An Evaluation Of Veteran Response, Characteristics, And Representativeness Of The Gulf War Era Veteran Population, Kelly M Harrington, Rachel Quaden, Lea Steele, Drew A Helmer, Elizabeth R Hauser, Sarah T Ahmed, Mihaela Aslan, Krishnan Radhakrishnan, Jacqueline Honerlaw, Xuan-Mai T Nguyen, Sumitra Muralidhar, John Concato, Kelly Cho, J Michael Gaziano, Stacey B Whitbourne, On Behalf Of The Va Million Veteran Program

Center for Medical Ethics and Health Policy Staff Publications

To address gaps in understanding the pathophysiology of Gulf War Illness (GWI), the VA Million Veteran Program (MVP) developed and implemented a survey to MVP enrollees who served in the U.S. military during the 1990–1991 Persian Gulf War (GW). Eligible Veterans were invited via mail to complete a survey assessing health conditions as well as GW-specific deployment characteristics and exposures. We evaluated the representativeness of this GW-era cohort relative to the broader population by comparing demographic, military, and health characteristics between respondents and non-respondents, as well as with all GW-era Veterans who have used Veterans Health Administration (VHA) services and …

Maine Provider Attitudes Towards Contingency Management For Substance Use Disorders, Evelyn Ali, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

This report summarizes healthcare provider attitudes toward Contingency Management (CM), including barriers and facilitators to its implementation. A 17-question electronic survey, including the Contingency Management Beliefs Questionnaire (CMBQ), was distributed to providers across Maine. Of 131 eligible respondents, 80% reported treating SUD, yet only 27% had experience with CM. While training and organizational support were cited as barriers, overall attitudes toward CM were favorable. Providers expressed strong willingness to implement CM, citing its potential to engage clients and support treatment adherence. The report concludes that positive perceptions of CM outweigh concerns and suggests that training and organizational support could enhance …

Treatment And Recovery Beliefs Of Rural Vermont Family Members Of People With Opioid Use Disorder, Kate Peasley-Miklus Phd, Julia Shaw Mph, Katie Rosingana Ba, Mary Lindsey Smith Phd, S. Sigmon, Sarah H Heil Phd, J. Jewiss, Andrea C Villanti, Valerie S Harder

Substance Use Research & Evaluation

Purpose: Few studies have addressed beliefs about treatment for opioid use disorder (OUD) among family members of people with OUD, particularly in rural communities. This study examined the beliefs of rural family members of people with OUD regarding treatment, including medication for OUD (MOUD), and recovery. Methods: Semi-structured qualitative interviews were conducted with rural Vermont family members of people with OUD. Twenty family members completed interviews, and data were analyzed using thematic analysis. Results: Four primary themes related to beliefs about OUD treatment emerged: (1) MOUD is another form of addiction or dependency and should be used short-term; (2) essential …

Healthy Acadia Downeast Community Opioid Response Program: Year 3 Summary, Tyler Egeland Ba, Gordon Mcintire Ba, Evelyn Ali, Mary Lindsey Smith Phd, Katie Rosingana Ba

Substance Use Research & Evaluation

The Downeast Substance Treatment Network is a group of diverse organizations working to improve integration and access to treatments and services for people with substance use disorder. The consortium’s Rural Communities Opioid Response Program grant project aims to: (1) expand the reach of their treatment network, (2) increase awareness and practice of harm reduction, and (3) facilitate transitions of care to improve partner efficacy. This project included a mixed-methods evaluation led by Catherine E. Cutler Institute’s Substance Use Research and Evaluation Team (SURE). This final year 3 summary presentation includes feedback from program partners, key informants, and program clients, in …

Qualitative Brief: Perspectives On Opioid Use Disorder Treatment Access And Engagement From Rural Family Members And People In Treatment, Katie Rosingana Ba, Evelyn Ali Mph, Tyler Egelund Ba, Mary Lindsey Smith Phd, Kate Peasley-Miklus Phd, J. Shaw

Substance Use Research & Evaluation

"This qualitative data brief provides findings from the Vermont baseline needs assessment, conducted in collaboration with research staff at the University of Southern Maine's Catherine Cutler Institute, with the goal to identify current and future opioid use disorder (OUD) treatment needs and barriers in rural Vermont. This data brief aims to identify current and future addiction treatment needs and barriers in Vermont with direct input from practitioners, community partners, and people impacted personally by opioid use. Preceptions included in this data brief are informed by semi-structured qualitative interviews conducted with family members of people with lived experience (PWLE). For more …

Time To Ask Program At Redington-Fairview General Hospital: Summary Of Participant Feedback, Mary Lindsey Smith Phd, Tyler Egeland Ba, Evelyn Ali Bs

Substance Use Research & Evaluation

The goals of the Time to Ask (TTA) education and quality improvement program are to increase the capacity of the interprofessional care team to effectively, efficiently and compassionately discuss alcohol use with their patients through screening, brief intervention, and referral (SBIRT) as well as to expand regular screening and monitoring of unhealthy alcohol use at the practices. This infographic is a summary of a participant feedback following the TTA program at Redington-Fairview General Hospital. For more information, please contact Lindsey Smith at [email protected]

Healthy Acadia Downeast Community Opioid Response Program: Year 2 Summary, Mary Lindsey Smith Phd, Evelyn Ali Bs, Katie Rosingana Ba

Substance Use Research & Evaluation

The Downeast Substance Treatment Network is a group of diverse organizations working to improve integration and access to treatments and services for people with substance use disorder. The consortium’s Rural Communities Opioid Response Program grant project aims to: (1) expand the reach of their treatment network, (2) increase awareness and practice of harm reduction, and (3) facilitate transitions of care to improve partner efficacy. This project included a mixed-methods evaluation led by Catherine E. Cutler Institute’s Substance Use Research and Evaluation Team (SURE). This year 2 summary presentation includes feedback from program partners, key informants, and program clients, in addition …

The Rural Health Action Network Enhanced Outreach Initiative: Year 2 Interim Evaluation Report, Mary Lindsey Smith Phd, Evelyn Ali Bs, Tyler Egeland Ba, Katie Rosingana Ba

Substance Use Research & Evaluation

Healthy Community Coalition (HCC), in coordination with the Rural Health Action Network (RHAN) of greater Franklin County, is implementing a multi-faceted outreach program to improve health outcomes among the rural poor living with chronic conditions in greater Franklin County, Maine. The goals of the Franklin County Rural Health Action Network Enhanced Outreach Initiative (RHAN-EOI) include: (1) Expand access to quality services; (2) Expand training for community health extenders; (3) Decrease hospital admissions, emergency department use, and costs; and (4) Improve communication and care coordination across project partners. This report highlights the implementation and progress of HCC RHAN in Year 2. …

Boiling Behind Bars: Exploring The Hidden Toll Of Extreme Heat On Mental Health In Texas Prisons, Sandra K. Miller

Social Work Theses - Archive

The State of Texas supports the largest prison system in the US and held 132,859 people in 100 units scattered across the state as of December 2023. Approximately 70% of Texas prison beds are not air conditioned, despite the state’s reputation for dangerously hot, humid summers. The State has officially recorded temperatures inside Texas prison facilities as high as 120 degrees with heat index values of over 150. Although there is a growing body of research on the negative physiological and psychological consequences of extreme heat among the general public, little is known about the physical and emotional toll of …

Identifying Youth Appeals In Alcohol Alternative Social Media Content Through Framing, Melina Oneal

West Chester University Master’s Theses

Proposed regulations for alcohol advertising prevent beverage companies from targeting people under the legal drinking age. However, similar regulations for alcohol alternative beverages are less explored, which could allow alcohol alternative products to create awareness for alcoholic beverages among youth. Alcohol alternatives beverages, including no-alcohol and low-alcohol products, are increasing in popularity and can function as compliments to alcoholic products to decrease the total alcohol volume consumed or as substitutes for alcoholic products. Framing theory can be operationalized through the Content Appealing to Youth Index, an index of content elements found in research literature to be appealing to youth, to …

Study Protocol For Measuring Stigmatization In Persistent Tic Disorders: Development And Validation Of The Tourette Discrimination-Stigmatization Scale, Jaclyn M Martindale, Victor M Ringheanu, Kelly A Pring, Sandra Norona, Kimberly Wiseman, Roy E Strowd, Leah Chapman, Joseph Rigdon, Stephen R Rapp, Eric A Storch, Edward Ip, Jonathan W Mink

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Persistent Tic Disorders such as Tourette Syndrome are common neurodevelopmental disorders that are highly stigmatized. Many individuals with Persistent Tic Disorders experience peer rejection, loneliness, and self-stigma. Experiencing stigmatization during childhood can influence the persistence of moderate-to-severe tics later in life. Additionally, these factors have been associated with increased suicidal ideation, suicide attempts, and psychiatric symptom severity. There is a need for interventions to reduce stigma and stigmatization in Persistent Tic Disorders. Before developing cost-effective interventions to mitigate stigma's profound downstream health impacts, a reliable measure of stigmatization must be created. The overarching goal of this research is to …

Clinical Characteristics Of Probands With Obsessive-Compulsive Disorder From Simplex And Multiplex Families, Monicke O Lima, Leonardo C Saraiva, Vanessa R Ramos, Melaine C Oliveira, Daniel L C Costa, Brazilian Research Consortium On Obsessive-Compulsive Spectrum Disorders, Thomas V Fernandez, James J Crowley, Eric A Storch, Roseli G Shavitt, Euripedes C Miguel, Carolina Cappi

Center for Medical Ethics and Health Policy Staff Publications

Genetic and non-genetic factors contribute to obsessive-compulsive disorder (OCD), with strong evidence of familial clustering. Genomic studies in psychiatry have used the concepts of families that are "simplex" (one affected) versus "multiplex" (multiple affected). Our study compares demographic and clinical data from OCD probands in simplex and multiplex families to uncover potential differences. We analyzed 994 OCD probands (501 multiplex, 493 simplex) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinicians administered the Structured Clinical Interview for DSM-IV (SCID-IV) to diagnose, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess severity, and Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) to assess symptom dimensionality. …

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 …

The Federal Government Must Revise Public Housing Policies To Protect Vulnerable Populations From Evictions, Caroline Grabowski

Population Health Research Brief Series

Over 100,000 Americans are now dying from drug overdoses annually, signifying that the goal of the 1986 Anti-Drug Abuse Act (ADAA) to end illicit drug use has not been achieved. What’s more, numerous statutes within the ADAA have created or worsened housing instability among people who use drugs and their families. This is because the ADAA allows public housing officials to use their own discretion when determining evictions and lease refusals and has disproportionately harmed individuals in public housing who did not participate in the drug-related activities that led to their eviction. This brief describes how the ADAA negatively affects …

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

Western Maine Addiction And Recovery Initiative's Substance Misuse Prevention And Wellness Day: Year 2 Feedback Survey For Mvhs, Tyler Egeland Ba, Evelyn Ali Bs, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

As part of the evaluation of the Western Maine Addiction Recovery Initiative’s (WMARI) HRSA Rural Communities Opioid Response Program grant, staff from the Catherine Cutler Institute’s Substance Use Research and Evaluation team developed a survey to gather feedback from individuals who participate in substance misuse prevention and wellness events. Two separate PRE/POST surveys were deployed at Mountain Valley High School to assess knowledge gain, beliefs, and satisfaction. For more information, please contact Lindsey Smith at [email protected]

Western Maine Recovery Rally Feedback Survey, Evelyn Ali Bs, Tyler Egeland Ba, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The 7th Annual Western Maine Recovery Rally was hosted on September 17th, 2023 from 11am to 3pm in downtown Norway, Maine; several hundred people attended the event. The local evaluation team developed a survey with the goal of understanding how participants felt about the rally and how future events could be improved. The survey was deployed via QR code on paper materials distributed at the rally, and through social media after the event. For more information, please contact Lindsey Smith at [email protected]

The Impact Of The Covid-19 Pandemic On The Well-Being Of People Incarcerated In United States Prisons, Kimberly Rivera

Department of Sociology: Dissertations, Theses, and Student Research

The COVID-19 pandemic has negatively impacted the population as a whole. However, the incarcerated population (which also experiences a variety of health disparities) has been disproportionately affected by the pandemic. Due to overcrowding, poor ventilation, and lack of resources, the incarcerated population already is at a heightened risk for negative health outcomes, made worse by the recent pandemic. To adapt to the rapidly changing conditions during the pandemic in 2020 and into 2022, new safety measures were implemented, but the unintended consequences associated with the implementation of these procedures have yet to be examined empirically. I conducted a qualitative content …

Depressive Symptoms In Autistic Youth With Anxiety Disorders, Rebecca L Greenberg, Andrew G Guzick, Sophie C Schneider, Saira A Weinzimmer, Minjee Kook, Amanda B Perozo Garcia, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Objective: Anxiety and depression often coexist in youth and share overlapping symptomatology; however, little is known about the comorbidity of anxiety and depression in autistic youth. This study explores (1) the frequency of depressive symptoms among autistic children with clinically significant anxiety, (2) clinical variables that may be associated with elevated depressive symptoms, and (3) whether pretreatment depressive symptoms predict cognitive behavioral therapy (CBT) outcomes for anxiety.

Method: Children aged 7 to 13 years (N = 87) and their parents participated in a randomized controlled trial comparing 2 versions of a parent-led, telehealth-delivered CBT program. Parents and children completed a …

Idiographic Coping Outcomes In Youth With Autism Spectrum Disorder And Co-Occurring Anxiety: Results From The Taasd Study, Lesley A Norris, Jonathan C Rabner, Eric A Storch, Jeffrey J Wood, Connor Kerns, Adam B Lewin, Brent J Small, Philip C Kendall

Center for Medical Ethics and Health Policy Staff Publications

Versions of cognitive behavioral therapy (Coping Cat, CC; Behavioral Interventions for Anxiety in Children with Autism, BIACA) have shown efficacy in treating anxiety among youth with autism spectrum disorder. Measures of efficacy have been primarily nomothetic symptom severity assessments. The current study examined idiographic coping outcomes in the Treatment of Anxiety in Autism Spectrum Disorder study (N = 167). Longitudinal changes in coping with situations individualized to youth fears (Coping Questionnaire) were examined across CC, BIACA and treatment as usual (TAU) in a series of multilevel models. CC and BIACA produced significantly greater improvements than TAU in caregiver-reported coping. Youth …

Suicide Rates Among Adolescents And Young Adults In The Mountain West, Isabelle G. Graham, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet shows data on suicide death rates among adolescents aged 10 to 24 years in the Mountain West:Nevada, New Mexico, Arizona, Colorado, and Utah. This fact sheet includes data from a report published by the Center for Disease Control in the National Vital Statistics Report which examines adolescent suicide in the U.S.

An Integrated Evidence-Based Approach To Provide A Practicum-Based Learning Experience To Students, Dziyana Nazaruk, Joseph Telfair, Jamie S. Cromley, Joanne Chopak-Foss, Ana M. Palacios

Health Policy & Community Health: Faculty Publications

Background

Due to the challenges created by the COVID-19 pandemic, the public health field has an exceptional opportunity not only to address current challenges but also to rebuild and expand the workforce. Objectives

The main objective of this presentation is to highlight the 2018-2022 academic year's progress of the practice-based learning experience of the JPH College of Public Health at Georgia Southern University in Georgia, USA. The College serves more than 59, mostly rural counties, and involves diverse practicum preceptors, students, and existing professionals from the USA and other countries. The College provides a unique opportunity for students to develop …

Strengths, Weaknesses, Opportunities And Threats Of A Community-Based Egg Program In Rural Honduras, Lilly Karsa, Dziyana Nazaruk, G. Ramos, L. Manship, Ana M. Palacios

Health Policy & Community Health: Faculty Publications

Background

Young children living in poor rural areas in Honduras are susceptible to suffering from undernutrition. About 1 in every 4 children under age 5 have stunting. Stunting during early childhood has negative consequences on an individual's life that can have short-term and lasting effects. This study's purpose was to explore the perceptions of the mothers of children that participate in a community-based nutrition-agriculture program that offers 1 egg daily to all children ages 6 to 24 months in 13 communities. Methods

Using community-engaged methods, we implemented a SWOT analysis to identify strengths, weaknesses, opportunities, and threats using a semi-structured …

Healthy Acadia Prosper Program: Key Informant Interview Findings, Mary Lindsey Smith Phd, Evelyn Ali Bs, Katharine Knight

Substance Use Research & Evaluation

The PROSPER initiative is a collaborative effort of Healthy Acadia and its regional healthcare and nonprofit partners designed to support pregnant women, mothers, and families with Substance Use Disorder (SUD). The project is funded by a four-year HRSA Outreach grant from 2021 to 2025. Through grant funding, PROSPER provides personal care planning, navigation support, and parenting and life skills training to clients at no cost to them. The partners also work to alleviate regional barriers to care and reduce stigma and discrimination of women seeking treatment to benefit their families.This summary presentation is a brief summary of key findings from …

Centros De Inclusión Social Bajo Gestión Asociada Y La Salud Mental De Las Personas En Situación De Calle, Kien Phan

Independent Study Project (ISP) Collection

Esta investigación se enfoca en analizar las acciones del gobierno de la Ciudad Autónoma de Buenos Aires (CABA) para abordar la salud mental de las personas en situación de calle en 2023. Se examina el estado actual de esta población, identificando factores clave y evaluando las medidas gubernamentales. El marco teórico aborda determinantes sociales y derechos humanos, subrayando la importancia de cambios legislativos para abordar la falta de vivienda. La metodología combina análisis de datos gubernamentales, estudios previos y entrevistas con profesionales de Centros de Inclusión Social. Las organizaciones de la sociedad civil, como Cáritas y la Asociación Civil Isauro …

Poverty And Commercial Surrogacy In India: An Intersectional Analytical Approach, Sheela Suryanarayanan

Dignity: A Journal of Analysis of Exploitation and Violence

The destination and source countries for commercial surrogacy match world patterns of inequality. India, Nepal, Thailand, Mexico, and Cambodia banned commercial surrogacy, moving the market to other less-developed countries in South Africa and South America. India had a commercial surrogacy boom until exploitative factors led to the passage of the Surrogacy (Regulation) Bill in 2019, which banned the practice. This paper examines surrogacy's monetary, health, and emotional effects on 45 surrogate mothers in Gujarat State, India. The study revealed that a majority (63%) of the very poor women remained very poor post-surgery. Surrogate mothers in poor households had to do …