A5041356352- Health disparities and outcomes
- Diabetes Management and Education
- Schizophrenia research and treatment
- Primary Care and Health Outcomes
- Hepatitis C virus research
- Food Security and Health in Diverse Populations
- Health Policy Implementation Science
- Liver Disease Diagnosis and Treatment
- Health Systems, Economic Evaluations, Quality of Life
- Child Abuse and Trauma
- Chronic Disease Management Strategies
- Patient Satisfaction in Healthcare
- Geriatric Care and Nursing Homes
- Global Health Workforce Issues
- Healthcare Policy and Management
- COVID-19 Clinical Research Studies
- Psychometric Methodologies and Testing
- Cardiac Health and Mental Health
- Epilepsy research and treatment
- Global Cancer Incidence and Screening
- Climate Change and Health Impacts
- Homelessness and Social Issues
- Diabetes Management and Research
- Patient-Provider Communication in Healthcare
- Liver Disease and Transplantation
MetroHealth Medical Center
2016-2025
Case Western Reserve University
2016-2025
MetroHealth
2016-2025
University School
2021-2024
The Ohio State University Wexner Medical Center
2023
Ohio University
2023
Summa Barberton Hospital
2023
University Hospitals of Cleveland
2023
The Centers
2023
Northeast Ohio Medical University
2023
Abstract Background: Patient portals have shown potential for increasing health care quality and efficiency. Internet access other factors influencing patient portal use could worsen disparities. Methods: Observational study of adults with 1 or more visits to the outpatient clinics an urban public system from 2012 2015. We used mixed effects logistic regression evaluate association between broadband internet (1) initiation (whether a logged in at least time) (2) messaging, controlling...
<h3>Importance</h3> Immune dysregulation can increase the risk of infection, malignant neoplasms, and cardiovascular disease, but improved methods are needed to identify quantify immunologic hazard in general population. <h3>Objective</h3> To determine whether lymphopenia is associated with reduced survival outpatients. <h3>Design, Setting, Participants</h3> This retrospective cohort study National Health Nutrition Examination Survey (NHANES) included participants enrolled from January 1,...
Inequality in health outcomes relation to Americans' socioeconomic position is rising.First, evaluate the spatial relationship between neighborhood disadvantage and major atherosclerotic cardiovascular disease (ASCVD)-related events; second, relative extent which physiologic risk account for neighborhood-level variation ASCVD event rates.Observational cohort analysis of geocoded longitudinal electronic records.A single academic center surrounding neighborhoods northeastern Ohio.109 793...
The objective of this study was to characterize population-level trajectories in the probability food insecurity US during first year COVID-19 pandemic and examine sociodemographic correlates associated with identified trajectories.We analyzed data from Understanding America Study survey, a nationally representative panel (N = 7,944) that assessed every 2 weeks April 1, 2020, through March 16, 2021. We used latent class growth analysis determine patterns (or classes) pandemic-related 1-year...
Individuals with serious mental illness (SMI) (major depressive disorder, bipolar schizophrenia), and diabetes (DM), face significant challenges in managing their physical health. The objective of this study was to assess perceived barriers self-management among patients both SMI DM order inform healthcare delivery practices.
Type 2 diabetes (T2D) is one of the nation's leading drivers disability and health care utilization, with elevated prevalence among individuals lower education, income, racial/ethnic minorities. Health information technology (HIT) holds vast potential for helping patients, providers, payers to address T2D skyrocketing rates chronic illness associated costs. Patient portals electronic records (EHRs) serve as a gateway consumer use HIT. We found that disparities in portal portend growing...
Primary care providers do not routinely follow guidelines for the of patients with chronic kidney disease (CKD). Multidisciplinary efforts may improve disease. Pharmacist based interventions have effectively improved management hypertension. We performed a pragmatic, randomized, controlled trial to evaluate effect pharmacist quality improvement program on 1) outcomes CKD and 2) adherence in primary setting. Patients moderate severe receiving services at one thirteen community-based Veterans...
Summary Background Eosinophilic oesophagitis (EoE) is primarily diagnosed by clinicians. There are less than a handful of epidemiological studies in EoE that have included elderly patients (>65 years). Aim To determine the prevalence subjects among and compare their clinical presentation, associated conditions treatment modalities with adult paediatric patients. Methods A large nationwide database (Explorys) between January 2011 2014 was used. The term ‘Eosinophilic Oesophagitis’ used...
Traumatic brain injury (TBI) is a multifaceted condition associated with occupational, social, physical, cognitive, academic, and economic burdens. Mild TBI including traumatic intracranial hemorrhage (tICH), commonly discharged from the emergency department (ED). Despite complexity of factors contributing to outcomes, patient education comprehensive follow-up plans are frequently lacking. We examined health trajectories, recidivism, patterns patients ED tICH identify opportunities improve...
This is an exploratory study of the decision process leading to retirement migration. It uses a unique national sample ( n = 255) retirees who were aging in place city upper Midwest, and 593) retired migrants Southeastern community Florida. Both sets respondents asked extensive set questions (1) about their potential move (or experience having moved), how destinations are chosen; (2) attachments people places lives; (3) images advantages disadvantages living current other locations. These...
A 60-week randomized controlled trial assessed the effects of targeted training in illness management (TTIM) versus treatment as usual among 200 individuals with serious mental and diabetes mellitus.The study used Clinical Global Impression (CGI), Montgomery-Asberg Depression Rating Scale (MADRS), Brief Psychiatric (BPRS) to assess psychiatric symptoms; Assessment Functioning (GAF) Sheehan Disability (SDS) functioning; 36-Item Short-Form Health Survey (SF-36) general health, serum...
Electronic health records (EHRs) offer the potential to study large numbers of patients but are designed for clinical practice, not research. Despite increasing availability EHR data, their use in research comes with its own set challenges. In this article, we describe some important considerations and solutions commonly encountered problems when working large-scale, EHR-derived data services community-relevant Specifically, using requires researcher define relevant patient subpopulation,...
Using a multi-institutional EMR registry, we extracted housing status and evaluated the presence of several important comorbidities in order to describe demographics comorbidity burden persons experiencing homelessness northeast Ohio compare this non-homeless individuals varying socioeconomic position. Of 1,974,766 patients identified 15,920 (0.8%) as homeless, 351,279 (17.8%) top quintile area deprivation index (ADI), 1,607,567 (81.4%) lower four quintiles deprivation. The was highest...
Abstract Background Evidence on the effects of neighborhood socioeconomic disadvantage dementia risk in racially and ethically diverse populations is limited. Our objective was to evaluate relative extent which accounts for racial/ethnic variation incidence rates. Secondarily, we evaluated spatial relationship between risk. Methods In this retrospective study using electronic health records (EHR) at two regional systems Northeast Ohio, participants included 253,421 patients aged >60 years...
Diabetes and obesity among patients with serious mental illness are common. Use of second-generation antipsychotics compounds risk, widely prevalent unhealthy behaviors further contribute to negative outcomes. This column describes Targeted Training in Illness Management, a group-based psychosocial treatment that blends psychoeducation, problem identification, goal setting, behavioral modeling reinforcement. The intervention has been adapted the primary care setting is targeted at...
Abstract In this study we investigated whether witnessing violence and victimization were associated with children's internalizing externalizing behavior problems examined the mediating role of posttraumatic stress (PTS) symptoms in these relationships. Secondary data analysis was conducted using 3 waves from National Survey Child Adolescent Well‐Being. Path analyses to test direct indirect effects exposure on problems, 2,064 children (ages 8–15 years) reported Protective Services for...