A5007126805- Substance Abuse Treatment and Outcomes
- Homelessness and Social Issues
- Alcohol Consumption and Health Effects
- Food Security and Health in Diverse Populations
- Opioid Use Disorder Treatment
- Health Policy Implementation Science
- Adolescent and Pediatric Healthcare
- Child and Adolescent Psychosocial and Emotional Development
- Prenatal Substance Exposure Effects
- Health disparities and outcomes
- Primary Care and Health Outcomes
- Schizophrenia research and treatment
- Smoking Behavior and Cessation
- Housing, Finance, and Neoliberalism
- Maternal Mental Health During Pregnancy and Postpartum
- Mental Health Treatment and Access
- Healthcare Policy and Management
- Emergency and Acute Care Studies
- Child and Adolescent Health
- Urban, Neighborhood, and Segregation Studies
- Pharmaceutical studies and practices
- Childhood Cancer Survivors' Quality of Life
- Suicide and Self-Harm Studies
- Obstructive Sleep Apnea Research
- Infant Development and Preterm Care
Nationwide Children's Hospital
2017-2025
The Ohio State University
2017-2025
Center for Innovation
2017-2022
University of Miami
2022
Jackson Memorial Hospital
2021
Kaiser Permanente Washington Health Research Institute
2013-2019
Health Services Research & Development
2012-2017
VA Puget Sound Health Care System
2012-2016
University of Washington
2012-2016
Seattle University
2013-2015
Aims The US Veterans Health Administration [Veterans Affairs (VA)] used performance measures and electronic clinical reminders to implement brief intervention for unhealthy alcohol use. We evaluated whether documented was associated with subsequent changes in drinking during early implementation. Design Observational, retrospective cohort study using secondary administrative data. Setting Thirty VA facilities. Participants Outpatients who screened positive use [Alcohol Use Disorders...
Aims To evaluate the association between Alcohol Use Disorder Identification Test–Consumption (AUDIT-C) alcohol screening scores, collected as part of routine clinical care, and three outcomes in following year (Aim 1), changes AUDIT-C risk group at 1-year follow-up same subsequent 2). Design Cohort study. Setting Twenty-four US Veterans Affairs (VA) healthcare systems (2004–07), before systematic implementation brief intervention. Participants A total 486 115 out-patients with AUDIT-Cs...
Young adults experiencing homelessness often suffer from adverse mental health outcomes and suicide is a leading cause of death. The objective this study to examine service use psychosocial risk factors for suicide, in relation assessment, inform strategies engaging youth prevention services. A cross-sectional analysis enrolled supportive housing randomized clinical trial. We categorized into three groups (low-, moderate-, high-risk) based on suicidal ideation past-year attempt. patterns...
This article highlights the often underestimated influence of context in improving quality inpatient pediatric care. Context includes environmental, social, cultural, and systemic factors that surround health care service delivery intervention outcomes. Underappreciation for can be responsible lack success patient outcomes lead to differences when initiatives are replicated or spread across settings. We draw from field implementation science (IS) highlight essential concepts measuring...
OBJECTIVE Medications for opioid use disorder (OUD) are under-utilized among adolescents and young adults (“youth”). Offering buprenorphine or naltrexone in primary care settings may reduce barriers to their youth. We conducted a secondary, patient-level analysis of the PROUD cluster-randomized clinical trial, which tested implementation nurse management intervention support prescribing OUD medications. METHODS 12 clinics from 6 health systems were randomized 2018 data was collected 2 years...
Child poverty is linked to poor health outcomes during childhood and throughout the life course, including those targeted by Pediatric Vital Signs project. The Earned Income Tax Credit are powerful antipoverty tools that provide financial resources families lift millions out of each year. Unfortunately, navigating process for filing taxes confusing can be costly, excluding many from these resources. Developing programs offer free tax services requires infrastructure deliver but also...
Objective: Evidence-based brief interventions for primary care patients with at-risk drinking include personalized feedback on alcohol-related risks, yet little is known about associations between alcohol screening scores and outcomes among women. This study evaluated the three-item Alcohol Use Disorders Identification Test–consumption (AUDIT-C) questionnaire self-reported risks consequences veteran Method: Female outpatients from an urban Veterans Affairs facility were mailed annual surveys...
Experts recommend that alcohol use disorders (AUDs) be managed in primary care, but effective approaches are unclear.To test whether 12 months of care management, compared with usual improved drinking outcomes among patients or at high risk for AUDs.This randomized clinical trial was conducted 3 Veterans Affairs (VA) clinics. Between October 11, 2011, and September 30, 2014, the study enrolled 304 outpatients who reported heavy (≥4 drinks per day women ≥5 men).Nurse managers offered outreach...
Criteria for alcohol use disorders (AUD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) were intended to result a similar prevalence AUD as DSM-IV. We evaluated using DSM-5 DSM-IV criteria, compared characteristics patients who met criteria for: neither nor AUD, alone, or both, among Veterans Administration (VA) outpatients Considering Healthier drinking Options In primary CarE (CHOICE) trial.VA care reported frequent heavy enrolled CHOICE trial interviewed...
Homelessness among youth is devastating, with high rates of substance use disorders and mental health comorbidity. Mindfulness-based interventions that include meditation mindfulness skills training reduce stress symptoms anxiety or depression. However, engaging high-risk in challenging. Virtual reality a more flexible platform for delivering may be appealing to youth.The study objectives were evaluate the feasibility virtual collecting outcome measures, including physiologic stress.A sample...
Veterans of Operation Enduring Freedom and Iraqi (OEF/OIF) are at increased risk for alcohol misuse, innovative methods needed to improve their access screening brief interventions (SBI). This study adapted an electronic SBI (e-SBI) website shown be efficacious in college students OEF/OIF veterans reported findings from interviews with about impressions the e-SBI. Outpatient who drank ≥3 days past week were recruited a US Department Affairs (VA) Deployment Health Clinic waiting room....
Objective Valid quality indicators are needed to monitor and encourage identification management of mental health substance use conditions (behavioral conditions). Because behavioral frequently underidentified, often evaluate the proportion patients who screen positive for a condition also have appropriate follow-up care documented. However, these "positive-screen–based" could be biased by differences in denominator due differential screening ("denominator bias") reward fewer with interest....
Rural young adults experience greater unmet need for mental health (MH) and alcohol or drug (AOD) treatment lower insurance coverage than urban residents. It is unknown whether Affordable Care Act (ACA) reforms in 2010 (dependent extended to age 26) 2014 (Medicaid expansion) closed rural/urban gaps treatment. The present study compared changes rates of insurance, MH treatment, AOD rural over a period ACA reforms.Young adult participants (18-25 years) the National Survey on Drug Use Health...
There is growing recognition of the need for effective screening methods and delivering interventions to address health-related social needs (HRSN) in hospital systems, but few studies exist on implementing such a wide-scale undertaking. This article describes implementation preliminary findings phased roll-out an institution-wide HRSN screening.We describe data tracking procedures.During first 13 months roll-out, 62,315 patient encounters from multiple clinics were eligible screening,...