A5079361004- Smoking Behavior and Cessation
- Primary Care and Health Outcomes
- Healthcare Policy and Management
- Opioid Use Disorder Treatment
- Substance Abuse Treatment and Outcomes
- Health Promotion and Cardiovascular Prevention
- Obesity, Physical Activity, Diet
- Child and Adolescent Health
- Food Security and Health in Diverse Populations
- Pain Management and Opioid Use
- Chronic Disease Management Strategies
- Health disparities and outcomes
- Behavioral Health and Interventions
- School Health and Nursing Education
- Migration, Health and Trauma
- Global Health Care Issues
- Emergency and Acute Care Studies
- Musculoskeletal pain and rehabilitation
- Nicotinic Acetylcholine Receptors Study
- Health Policy Implementation Science
- COVID-19 and Mental Health
- Asthma and respiratory diseases
- Pediatric health and respiratory diseases
- Health and Wellbeing Research
- Cannabis and Cannabinoid Research
Oregon Health & Science University
2016-2025
Oregon Medical Research Center
2024
University of Portland
2023-2024
UMass Memorial Medical Center
2023
University of Massachusetts Chan Medical School
2023
Children's Medical Center
2023
University of Tsukuba
2020-2023
Ochin
2013-2023
ORCID
2023
Portland State University
2014-2018
<h3>Importance</h3> Patients who use cannabis for medical reasons may benefit from discussions with clinicians about health risks of and evidence-based treatment alternatives. However, little is known the prevalence in primary care how often it documented patient electronic records (EHR). <h3>Objective</h3> To estimate according to confidential survey compare EHR report. <h3>Design, Setting, Participants</h3> This study a cross-sectional performed large system that conducts routine screening...
The Affordable Care Act of 2010 supports marked expansions in Medicaid coverage the United States. As January 1, 2014, a total 25 states and District Columbia expanded their programs. We tested hypothesis that rates uninsured safety net clinic visits would significantly decrease implemented expansion, compared with did not.We undertook longitudinal observational study status for adult community health centers, from 12 months before expansion (January 2013 to December 31, 2013) through 6...
In the United States, health insurance is not universal.Observational studies show an association between uninsured parents and children.This persisted even after expansions in child-only public insurance.Oregon's randomized Medicaid expansion for adults, known as Oregon Experiment, created a rare opportunity to assess causality parent child coverage.OBJECTIVE To estimate effect on child's coverage status when (1) randomly gains access (2) obtains coverage. DESIGN, SETTING, AND...
<h3>PURPOSE</h3> Previous work has shown that asthma-related emergency department (ED) use is greatest among Black and Latine populations, but it unknown whether health care for exacerbations differs across settings (outpatient, ED, inpatient) correlates with of routine outpatient services. We aimed to measure disparities by race, ethnicity, language in pediatric acute asthma using data from US primary community centers. <h3>METHODS</h3> In an observational study electronic records centers...
Using electronic health record data, we examined longitudinal changes in community center (CHC) visit rates from 2013 through 2014 Medicaid expansion versus nonexpansion states. Visits 219 CHCs 5 states and 4 were included. Rates computed using generalized estimating equation Poisson models. increased state for new patient, preventive, limited-service visits (14%, 41%, 23%, respectively, P < .01 all), whereas these remained unchanged One year after ACA expansions, saw an influx of...
<h3>Introduction:</h3> Medication-assisted treatment (MAT) for opioid use disorder (OUD) is underused in primary care. Little known about patient demographics associated with MAT initiation, particularly among models an interdisciplinary approach, including behavioral health integration. We hypothesize few disparities initiation by characteristics after implementing this model OUD. <h3>Methods:</h3> Electronic record data were used to identify adults ≥1 care visit 1 of 2 study clinics a...
This experiment was conducted to determine the impact of cigarette deprivation and availability on reactivity measures cues.Smokers were recruited who 18 years age or older, not attempting quit cut down their smoking, smoked at least 20 cigarettes daily, had been smoking regularly for past year an expired carbon monoxide level 10 parts per million.Smokers assigned randomly abstain from 24 hours (n = 51) continue regular amount 50). Twenty-four later, they exposed trials either a lit glass...
To compare the agreement of electronic health record (EHR) data versus Medicaid claims in documenting adult preventive care. Insurance are commonly used to measure care quality. EHR could serve this purpose, but little information exists about how source compares service documentation. For 13 101 Medicaid-insured patients attending 43 Oregon community centers, we compared documentation 11 services, based on data. Documentation was comparable for most services. Agreement highest influenza...
To examine associations between patient factors and smoking cessation assistance in US safety-net clinics.Using electronic health record data from the OCHIN network, we identified adults with at least 1 primary care visit to a study clinic (n = 143 clinics 12 states) documented "current smoker" status during 2014 2016 136 314; 29.8%). We estimated odds ratios (ORs) of receipt (none [reference], counseling, medication, or both) by covariates.For all categories, were higher among women, those...
IntroductionLittle is known about what clinic-level factors differentiate community health centers that achieve high performance on cancer-preventive care metrics. This study aims to describe the longitudinal trends in delivery of 3 metrics (cervical and colorectal cancer screenings tobacco-cessation intervention) define compare with those low performance.MethodsThis observational used 2012–2019 center data (N=933) from Uniform Data System. High/low was based Healthy People 2020 targets...
Although past research demonstrated that Medicaid expansions were associated with increased emergency department (ED) and primary care (PC) utilization, little is known about how long this utilization persists or whether postcoverage affected by prior insurance status.(1) To assess changes in ED, PC, mental behavioral health care, specialist visit rates among individuals gaining over 24 months postinsurance gain; (2) to evaluate the association of previous utilization.Using claims data, we...
<h3>Importance</h3> Understanding opioid prescribing patterns in community health centers (CHCs) that disproportionately serve low-income patients may help to guide strategies reduce opioid-related harms. <h3>Objective</h3> To assess between January 1, 2009, and December 31, 2018, a network of safety-net clinics serving high-risk patients. <h3>Design, Setting, Participants</h3> Cross-sectional study 3 227 459 prescriptions abstracted from the electronic records 2 129 097 unique primary care...
To estimate how the Affordable Care Act's Medicaid expansions will affect demand for services, we measured ambulatory care utilization among adult patients who gained insurance during Oregon's 2008 expansion. Using electronic health record data from 67 community centers, assessed pre- and postcoverage insurance, compared with continuously insured or uninsured. In comparisons of periods, mean annual encounters persons increased 22% to 35%, but declined in comparison groups. These findings...