Research

Access to Paid Sick Leave is a Public Health Issue

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5765
                    [post_author] => 8
                    [post_date] => 2018-10-29 07:00:09
                    [post_date_gmt] => 2018-10-29 11:00:09
                    [post_content] => You wake up in the middle of the night and hear your daughter crying. You place your hand on her forehead and notice she has a fever.  For over a quarter of American workers, this is a situation that could compromise their family’s livelihood. Indeed, most workers occasionally need to take off time from work to recuperate from an illness or to seek preventive or acute medical care for themselves or a loved one. As a result, 28% of workers risk losing a day’s wage and are at risk of being fired.

Most people are probably not aware that vigorous legislative activity is happening around the country regarding a little-understood public health issue: paid sick leave. Indeed, in the last decade, 9 states and 32 localities have passed laws mandating paid sick leave benefits for certain groups of employees. At the same time, 15 states have passed preemptive legislation that prevents such mandates. Our team of researchers from Cleveland State University and Florida Atlantic University, led by myself, Dr. LeaAnne DeRigne, and Dr. Linda Quinn has been working to develop an evidence base that can be used to inform these political decisions. We used two highly regarded, nationally representative datasets to analyze trends, while controlling for other variables that might explain the relationships we found. We reported our findings in a series of peer reviewed published papers over the last four years.

Time and again we found paid sick leave is significantly related to health-related variables. Indeed, workers who lack paid sick leave are less likely to receive eight preventive care services including monitoring of blood pressure, cholesterol, and blood sugar; certain cancer screenings; and the flu shot. This is particularly important since workers who lack paid sick leave are also more likely to attend work while sick, which increases the spread of disease.
A cascading effect occurs where workers who lack paid sick leave are more likely to delay or forgo needed care for themselves and their family members.  
A cascading effect occurs where workers who lack paid sick leave are more likely to delay or forgo needed care for themselves and their family members. As a result, medical conditions may become more complicated and expensive to treat. Not surprisingly, workers who lack paid sick leave are more likely to have higher health care costs compared to workers who have paid sick leave benefits. Correspondingly, workers who lack paid sick leave are more likely to worry about finances and have symptoms of psychological distress. They are also more likely to be poor and need welfare benefits. The American Public Health Association endorses paid sick leave, but currently the United States lags behind other nations when it comes to mandating paid sick leave benefits. Some initial research regarding the ideal number of paid sick days suggests six to ten or more paid sick days are needed before changes in worker’s preventive health care seeking are observed.  More research is needed.
Offering paid sick leave benefits is good for business, reducing "presenteeism" costs, errors in production, workplace injuries, and the spread of contagious illness in the workplace.  
Offering paid sick leave benefits is good for business, reducing "presenteeism" costs (i.e. reduced productivity due to attending work while sick), errors in production, workplace injuries, and the spread of contagious illness in the workplace. Public health advocates have constructed a possible policy option for paid sick leave distinct from Family Medical Leave Act, which provides up to 12 weeks of unpaid, job-protected leave for some workers with long-term chronic health conditions. At the federal level, The Healthy Families Act has been proposed to provide workers employed by businesses with at least 15 employees an opportunity to earn up to seven paid sick days annually. Workers employed by businesses with fewer than 15 workers could earn up to 7 unpaid sick days. Overall, the evidence base regarding paid sick leave has rapidly increased over the last five years.  Our hope is that existing and future policy will be evaluated in light of the evidence. Feature image: Lucaa15/iStock [post_title] => Access to Paid Sick Leave is a Public Health Issue [post_excerpt] => The American Public Health Association endorses paid sick leave, but currently the United States lags behind other nations when it comes to mandating paid sick leave benefits. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => access-to-paid-sick-leave-is-a-public-health-issue [to_ping] => [pinged] => [post_modified] => 2018-11-02 06:40:03 [post_modified_gmt] => 2018-11-02 10:40:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5765 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

The American Public Health Association endorses paid sick leave, but currently the United States lags behind other nations when it comes to mandating paid sick leave benefits.

...more
Research

Breaking Down Barriers: Video Mental Health Treatment

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5725
                    [post_author] => 8
                    [post_date] => 2018-10-26 05:25:02
                    [post_date_gmt] => 2018-10-26 09:25:02
                    [post_content] => Half of US adults experience mental illness during their lifetime and 1 in 5 each year. Less than half receive treatment. Barriers to mental health care include a shortage of providers, particularly in rural areas, and logistical challenges like difficulty taking time off work or school, arranging childcare, and other family responsibilities. For some individuals, symptoms of anxiety or depression make it difficult to leave their homes for treatment. Inability to pay for services and stigma also stand in the way of seeking and receiving mental health care.

Technology solutions such as web-based treatments, mobile apps, and telehealth address some of the barriers. Recent advances in telehealth include the expansion of mental health services directly to patients’ homes, allowing mental health providers to reach patients who are unable to attend in-person appointments. While there seems to be great potential in connecting patients to care using video and other technologies, questions remain about how virtual delivery compares to in-person care.

We reviewed the current literature on video-to-home mental health care to examine how this type of virtual delivery compares to in-person mental health treatment in terms of clinical effectiveness, patient and provider satisfaction, and cost. We analyzed ten studies reporting on the clinical effectiveness, cost, feasibility, and satisfaction of video telehealth.
Adult patients of all ages reported high rates of satisfaction with video delivery of mental health care, with 77-99% reporting they would like to receive their care this way again.  
Nine studies reported on the clinical effectiveness of video for delivering psychotherapy and one reported on video delivery of psychiatric medication management services. The treatments targeted a variety of mental health concerns including depression, post-traumatic stress disorder, obsessive compulsive disorder, and substance use. Eight studies were randomized controlled trials comparing video-to-home delivery with in-person treatment. These studies reported comparable treatment effectiveness for the two types of delivery, suggesting that mental health treatment delivered to patients’ homes by video is as effective as in-person meetings. Adult patients of all ages reported high rates of satisfaction with video delivery of mental health care, with 77-99% reporting they would like to receive their care this way again. Patients identified several benefits of video mental health treatment including convenience, the ability to see and connect with their provider virtually, and privacy. The few studies reporting on provider satisfaction highlighted differences between providers experienced with video-to-home delivery and those without. Providers with no experience reported concerns about whether video would be a good fit for their patients, whereas providers experienced with video-to-home delivery viewed it as an effective method of providing needed mental health treatment to patients with limited access to care.
Three studies examining cost effectiveness of video-to-home healthcare delivery found that outcomes were influenced by the type of technology being used.  
Three studies examining cost effectiveness of video-to-home healthcare delivery found that outcomes were influenced by the type of technology being used. Video-to-home delivery was less costly than in-person care when patients used their personal computers, tablets, or smartphones to connect to their providers rather than devices supplied by their mental health provider. Overall, these results suggest that video telehealth is an effective and efficient way to deliver mental health care. For patients facing barriers to in-person care, video telehealth may be the only feasible option to access needed mental health care. Mental health providers should embrace video telehealth as an effective mode of delivery and integrate this service into their current practices. First steps may include becoming familiar with best practices in video telehealth, consulting with colleagues, and reviewing federal and state telehealth guidelines. Feature image by Oliur on Unsplash [post_title] => Breaking Down Barriers: Video Mental Health Treatment [post_excerpt] => There seems to be great potential in connecting patients to care using video and other technologies, but questions remain about how virtual delivery compares to in-person care. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => breaking-down-barriers-video-mental-health-treatment [to_ping] => [pinged] => [post_modified] => 2018-10-26 05:26:04 [post_modified_gmt] => 2018-10-26 09:26:04 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5725 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

There seems to be great potential in connecting patients to care using video and other technologies, but questions remain about how virtual delivery compares to in-person care.

...more
Research

Hearing Loss is Memory Loss

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5727
                    [post_author] => 8
                    [post_date] => 2018-10-25 07:00:35
                    [post_date_gmt] => 2018-10-25 11:00:35
                    [post_content] => According to the 2016 World Alzheimer Report, 47 million people have dementia. By 2050, that number is expected to exceed 130 million. Since at least 1989, researchers have documented that hearing loss is associated with dementia. One-third of adults age 65-74 and almost half over age 75 experience hearing loss.

Two hypotheses explain the relationship between hearing loss and cognitive decline. The common cause hypothesis assumes that degeneration of the central nervous system accounts for both hearing loss and cognitive decline. The cascade hypothesis suggests that hearing loss leads to less stimulation of the brain, which then leads to cognitive decline.

A recent study published by Asri Maharani and colleagues in the Journal of the American Geriatrics Society followed patients for 18 years to measure associations between hearing aid use and episodic memory, defined as “the ability to recall and mentally re-experience specific episodes from one’s personal past.” The researchers measured the rate of cognitive decline both before and after hearing aid use began in over 2,000 people.

Episodic memory and cognitive decline were measured using a word recall test. Participants were read a list of ten words and then asked to repeat them immediately and again after a short delay. The researchers note that they focused on episodic memory because it is age-sensitive and strongly correlated with dementia. Study participants also self-reported hearing aid use.
Episodic memory scores decreased as participants aged. However, the researchers found that memory loss slowed after participants started using hearing aids.  
Episodic memory scores decreased as participants aged. However, the researchers found that memory loss slowed after participants started using hearing aids. These findings support the cascade hypothesis that memory loss is caused by lack of stimulation. When asked about the implications of these results in an email interview, Dr. Maharani, the lead author, said, “Our finding underlines just how important it is to overcome the barriers which deny people from accessing hearing and visual aids. Treating age-related hearing impairment has a significant consequence on cognitive status; the earlier hearing impairment is identified and treated, the better the probable outcome.” Many persons do not seek treatment for hearing loss because of the costs, as state-of-the art prescription hearing aids can cost thousands of dollars. Others do not seek treatment because of a lack of awareness of hearing impairment, which often occurs gradually. Still others resist hearing aid usage due pride or vanity. The researchers highlight that steps need to be taken to ensure that those who are low-income have access to evaluation of hearing loss and to treatment. Some forms of insurance cover the cost of hearing aids, including Medicaid in many states. The FDA is currently drafting legislation on a new category of over-the-counter hearing aids, which is expected to put pressure on current manufacturers to lower prices. The market for hearing aids is expected to expand as the population ages. Families and physician need to be attentive to hearing loss beginning in middle age. You can’t remember what you can’t hear. Feature image: BackyardProduction/iStock [post_title] => Hearing Loss is Memory Loss [post_excerpt] => Asri Maharani and colleagues followed patients for 18 years to measure associations between hearing aid use and episodic memory. Memory loss slowed after participants started using hearing aids. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => hearing-loss-is-memory-loss [to_ping] => [pinged] => [post_modified] => 2018-10-22 07:26:19 [post_modified_gmt] => 2018-10-22 11:26:19 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5727 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Asri Maharani and colleagues followed patients for 18 years to measure associations between hearing aid use and episodic memory. Memory loss slowed after participants started using hearing aids.

...more
Research

Tantrums in the Snack Aisle

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5736
                    [post_author] => 8
                    [post_date] => 2018-10-24 05:30:57
                    [post_date_gmt] => 2018-10-24 09:30:57
                    [post_content] => When young children do not get their way, things can get hairy for their parents. In grocery stores, parents denying their children a favorite snack can end in tantrums. And the last thing a stressed parent may want is a screaming, crying child in a public space, drawing unwanted attention. The American Psychological Association explains that these outbursts occur because children are still learning how to process their emotions and frustrations and recognize a sense of power.

In supermarkets, children’s interests are heavily influenced by their parents, their friends, and media advertisements; kids between ages 2 and 7 years old are particularly impressionable. Young kids skillfully use their pester power to convince parents to give in to their demands, which typically involve highly-marketed, prepared foods.

Food is incredibly powerful, not only in terms of nutrition, but also because it can be used as an agent to control behavior. Most research addressing this method to manage youth behavior has focused on the home setting. Kathryn Lively and colleagues set out to understand how mothers respond to the requests children make in the grocery store, and how such responses relate to their feeding habits.

The researchers collected information from mothers with children between 2 and 7 years old through an online survey. In addition to sharing their feeding practices, participants responded to questions about how often their children requested food purchases. The questionnaire asked about mothers’ willingness to purchase the foods their kids requested, and mothers were presented with images of food types. The researchers categorized these food types into two groups: nutrient-dense and nutrient-poor.
Mothers who tended to use food as a reward were generally more willing to buy nutrient-poor items requested by their kids, compared to those who did not reward children with food.  
Mothers were questioned about three types of food-related practices, which were assessed with elements from the Comprehensive Feeding Practices Questionnaire: using food as rewards, for emotion regulation, and to model eating habits. Rewarding children included offering something sweet or a favorite food item in exchange for good behavior. Emotion regulation captured giving children food or drinks when fussy, bored, or upset. And modeling described those times when mothers actively and enthusiastically ate nutrient-dense food in front of their children. Mothers who tended to use food as a reward were generally more willing to buy nutrient-poor items requested by their kids, compared to those who did not reward children with food. Similarly, the likelihood of giving into nutrient-poor food requests was greater among mothers who used food to manage their children’s emotions, compared to mothers who did not. Willingness to purchase nutrient-dense foods was found to be higher among mothers who responded that they modeled healthy eating habits. Understanding the dynamic between mothers and children in the snack aisle of a grocery store may provide insight into health promotion efforts about nutrition. The researchers suggest that mothers engaging in conversations with their children about eating habits can influence food purchasing trends. They also acknowledge, however, that their study captures the experiences of more affluent mothers, and propose exploring how income may factor into the relationship between grocery store behavior and child nutrition. Feature image: Filipovic018/iStock [post_title] => Tantrums in the Snack Aisle [post_excerpt] => Understanding the dynamic between mothers and children in the snack aisle of a grocery store may provide insight into health promotion efforts about nutrition. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => tantrums-in-the-snack-aisle [to_ping] => [pinged] => [post_modified] => 2018-10-24 05:47:51 [post_modified_gmt] => 2018-10-24 09:47:51 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5736 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Understanding the dynamic between mothers and children in the snack aisle of a grocery store may provide insight into health promotion efforts about nutrition.

...more
Research

Teen Sexting

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5728
                    [post_author] => 8
                    [post_date] => 2018-10-23 07:00:21
                    [post_date_gmt] => 2018-10-23 11:00:21
                    [post_content] => Almost every teenager in the United States has access to a smart phone. Close to half report being online almost all the time. This year, more than two-thirds of 13-17 year olds reported that online communication with their friends was preferable to in-person communication. As intimate relationships expand through technologic platforms, teenagers are finding new mediums for exploring their sexuality.  So should older laws, created specifically to address child pornography, be used to prosecute modern-day teenagers who engage in sexting?

As teenagers develop online romantic relationships, the inclination to share explicit pictures electronically (i.e., “sexting”) has become common. A 2012 study in Texas found that, across seven public high schools, 28% of students had sent naked pictures of themselves. Thirty-one percent had requested a sext from someone, and 57% reported having been asked to send a sext. US teens who pay their own cell phone bill are more likely to engage in sexting.

Although sexting is legal between consenting adults, minors who exchange explicit images or videos are at risk of legal prosecution for possessing child pornography. Child pornography laws are designed to protect minors from becoming victims of sexual exploitation. But youth who share nude selfies are not victims of sexual exploitation. A 2018 article by Brian Holoyda and colleagues reviewed the repercussions teens face when prosecuted for sexting, and how some states are reviewing sexting policies.
Although sexting is legal between consenting adults, minors who exchange explicit images or videos are at risk of legal prosecution for possessing child pornography.  
Prosecuted minors can face prison sentences and may have to register as sex offenders. Minors who become registered as sex offenders can experience lifetime psychological and traumatic stress resulting from the substantial employment, housing, and educational barriers that they face. Child pornography laws were created to prevent children from exploitation and abuse. The laws are fundamental for cases in which exchanged material is shared without consent, goes viral, or is used for sexual exploitation. But is it fair to apply same laws against teens who are caught harmlessly exploring their sexuality? Holoyda and his team ask prosecutors to reconsider how children are prosecuted when caught.
Twenty states have sought to reduce the harshness of their sentencing by introducing laws that include terminology specific to “teen sexting.”  
Some states have passed legislation to provide alternative forms of justice for minors prosecuted for sexting. Twenty states have sought to reduce the harshness of their sentencing by introducing laws that include terminology specific to “teen sexting.” Florida’s sexual cyber-harassment law penalizes based on the severity of the crime, ranging from community service for non-criminal violations to a felony charge, prison sentence, and hefty fine for violations found to be criminal. Distributing an image to a single person in Arizona is considered a petty offense punishable by fine, and a misdemeanor if distributed to more than one person. Several states, such as California and Colorado, have laws to address revenge porn, images of others shared without consent. Massachusetts, Maine, and New Hampshire have no sexting laws in place. Few sexting cases among minors result in felony charges. In most cases, police officers are cognizant of the repercussions associated with prosecuting teens under child pornography laws, and usually drop benign cases. A 2011 study found that arrests of minors for child pornography were uncommon unless adults or “aggravating elements” were involved (such as non-consensual or malicious use). The study found that very few sexual sexting instances were reported to law enforcement and the majority of youth were not arrested for their actions. Only 47 out of 214 teenagers arrested for having shared images consensually, not one was prosecuted under sex offender laws. Feature image: The Accent, sexting, used under CC BY-SA 2.0 [post_title] => Teen Sexting [post_excerpt] => Teenagers are using technology to explore their sexuality. However, older laws created specifically to address child pornography can be used to prosecute teen sexting. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => teen-sexting [to_ping] => [pinged] => [post_modified] => 2018-10-23 06:34:26 [post_modified_gmt] => 2018-10-23 10:34:26 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5728 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Teenagers are using technology to explore their sexuality. However, older laws created specifically to address child pornography can be used to prosecute teen sexting.

...more
Research

Opioid Overdose Deaths among the Formerly Incarcerated

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5737
                    [post_author] => 8
                    [post_date] => 2018-10-22 07:00:15
                    [post_date_gmt] => 2018-10-22 11:00:15
                    [post_content] => Targeting high-risk populations for prevention and treatment is a proven strategy to control epidemics; however, the United States has underutilized this strategy in responding to the opioid epidemic. One population at high risk of opioid overdose death are people with history of incarceration.

According to the Department of Justice, in 2015 more than 6.7 million individuals in the United States were incarcerated or under correctional supervision. Many more individuals are released each year. North Carolina alone releases twenty to thirty thousand individuals each year. These formerly incarcerated persons are disproportionately Black, Hispanic, underserved, and socioeconomically disadvantaged. Many suffer from mental health conditions including substance use disorders, making them vulnerable to fatal overdose.

In a recent study, we used prison release data from the North Carolina Department of Public Safety from 2000 to 2015 and linked them to NC death records from 2000 to 2016. Our team found that the opioid overdose death rate was 39 times greater among formerly incarcerated NC residents over the first two weeks after release than in general population.
Our team found that the opioid overdose death rate was 39 times greater among formerly incarcerated NC residents over the first two weeks after release than in general population.  
The heroin-specific overdose death rate was 73 times greater among formerly incarcerated persons at two weeks after release than the general NC population. Formerly incarcerated persons who died of opioid overdoses in the first two weeks tended to be White men over age 50 with a history of two or more incarcerations, a drug-related conviction, and a history of mental health and substance use disorders. Medication-assisted treatment with buprenorphine and methadone is a highly effective way to treat substance use disorder and reduce overdose deaths. However, most treatment in prisons is abstinence-based. Medication-assisted treatment is seldom used, despite recommendations from the Office of National Drug Control Policy, a presidential Commission on Combating Drug Addiction and the Opioid Crisis, and the World Health Organization. Dignity, self-esteem, love, social connections, and sense of belonging are essential for human life, which is the very reason we live in a society, form communities, follow customs, and celebrate one another. Those who break rules, go out of step with social norms, or do things that harm the social harmony are punished. The punishments, however, are intended to be corrective, so that a person can get a second chance to restore their dignity and self-esteem. Hence, prisons are often referred to as correctional facilities.
In 2016, the Rhode Island Department of Corrections started a program to continue buprenorphine or methadone treatment for newly incarcerated persons who were receiving treatment at the time of their arrest.  
Once the correction has taken place, we, as a society, must help former prisoners to assimilate back into society and regain their lost dignity and self-esteem. As a nation, we seem to be failing at that. But Rhode Island recently seems to have turned an important corner. In 2016, the Rhode Island Department of Corrections started a program to continue buprenorphine or methadone treatment for newly incarcerated persons who were receiving treatment at the time of their arrest. After release from prison, these individuals are connected to community organizations who offer medication-assisted treatment. This strategy resulted in a decrease in overdose deaths among individuals leaving prison. Additionally, more importantly, the entire state experienced a decrease in opioid overdose deaths. Reducing stigma and discrimination against formerly incarcerated persons, along with evidenced-based prevention and treatment for opioid-use disorders and overdoses will have a positive impact that goes beyond these individuals, to their families, communities and the entire nation. Feature image by Ye Jinghan on Unsplash [post_title] => Opioid Overdose Deaths among the Formerly Incarcerated [post_excerpt] => The United States has underutilized prevention and treatment strategies in its response to opioid overdose death in people with a history of incarceration. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => opioid-overdose-deaths-among-formerly-incarcerated-persons [to_ping] => [pinged] => [post_modified] => 2018-10-23 16:06:16 [post_modified_gmt] => 2018-10-23 20:06:16 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5737 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

The United States has underutilized prevention and treatment strategies in its response to opioid overdose death in people with a history of incarceration.

...more
Research

Prison Employee PTSD

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5715
                    [post_author] => 8
                    [post_date] => 2018-10-18 05:30:08
                    [post_date_gmt] => 2018-10-18 09:30:08
                    [post_content] => The prison setting is a uniquely challenging work environment, with employees facing constant exposure to threat, violence, and trauma. Previous research has shown that prison employees are at high risk for serious psychological distress leading to the development of mental illness such as depression and anxiety. Another serious concern for prison employees is post-traumatic stress disorder (PTSD). “Trauma” within the PTSD context generates from an event or series of events from which the person feels like they cannot escape. This trauma can result from direct experience of grievous injury or sexual violence. Or it could come from witnessing such events or death. Prison employees, particularly correction officers, are at high risk for both routinely witnessing trauma and potentially experiencing it themselves.

The goal of our study was to investigate the prevalence of PTSD among prison employees and explore risk and protective factors. We surveyed 355 Washington state prison employees using a comprehensive questionnaire designed to assess the physical and psychological risks of prison work. Included in the questionnaire were the PTSD checklist from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), the Critical Incident History Questionnaire, and the Work Environment Inventory. We estimated PTSD rates and symptoms, explored risk factors associated with higher PTSD scores, and investigated protective factors associated with lower PTSD scores.
Nineteen percent of respondents met the diagnostic criteria for PTSD—a rate six times higher than the general population, comparable to Iraq and Afghanistan war veterans.  
The majority of the sample was male (65%) and white (81%). Most participants were correction officers (65%) working in male inmate facilities (63%). Nineteen percent of respondents met the diagnostic criteria for PTSD—a rate six times higher than the general population, comparable to Iraq and Afghanistan war veterans. Symptoms that stood out were nightmares related to work events (15%), avoiding reminders of workplace trauma (14%), and disturbing flashbacks (10%). Female employees, Black employees, day-shift employees, and employees with more years of experience reported higher rates of PTSD. Significant risk factors for PTSD included being seriously injured at work and dealing with inmates who had been recently sexually assaulted. Work frustrations including feeling like the prison puts the employees in unnecessary danger and lack of clarity about job roles were also significantly associated with higher PTSD rates. Several factors, however, were found to be protective against PTSD. These included being happy with work assignments, having good relationships with supervisors, and having positive relationships with coworkers. The results of this study have several important implications. First, given the high prevalence of PTSD among prison employees, interventions for promoting resilience to trauma in this population are clearly needed. Second, given that some prison employees are at greater risk (e.g. woman), interventions need to address specific needs of certain prison employee subgroups. Third, more research is needed to understand why certain groups of prison employees are at greater risk, and what types of interventions are the most promising for addressing this critical problem. We urge researchers to focus on this critical problem, and the corrections profession to adopt trainings and interventions that promote resilience to the harmful effects of working behind the walls. Feature image: HakuNellies/iStock, used for illustrative purposes only.  [post_title] => Prison Employee PTSD [post_excerpt] => The prison setting is a uniquely challenging work environment, with employees facing constant exposure to threat, violence, and trauma. Prison employees are at high risk for post-traumatic stress disorder (PTSD). [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => prison-employee-ptsd [to_ping] => [pinged] => [post_modified] => 2018-10-18 06:55:30 [post_modified_gmt] => 2018-10-18 10:55:30 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5715 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

The prison setting is a uniquely challenging work environment, with employees facing constant exposure to threat, violence, and trauma. Prison employees are at high risk for post-traumatic stress disorder (PTSD).

...more
Research

Nurses Leading Collaborative Care

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5714
                    [post_author] => 8
                    [post_date] => 2018-10-17 06:25:35
                    [post_date_gmt] => 2018-10-17 10:25:35
                    [post_content] => When Case Western Reserve University began building something new on their Cleveland campus, the goal was to create a collaborative space for all healthcare students. This new “mini-campus” will be finished in 2019, and will be part of an effort to train medical, dental, and nursing students together.

Similarly, the Robert Wood Johnson Foundation’s Culture of Health initiative emphasizes cross-sector collaborations, taking the effort a step further by involving non-health care organizations like businesses, schools, and the government. These collaborations are meant to not only address general health, but also housing, neighborhood, and income inequities, which can be attributed to 70% of the variation in health outcomes.

Collaboration has been a trendy topic in the health space, but little research actually outlines what kind of conditions benefit from these collaborations. The role of health care providers in catalyzing these improvements and sustaining these efforts has not been studied heavily, either. A group of researchers set out to address this gap. Martsolf and colleagues assessed nurse experiences in health care systems that were modeled around effective collaboration between different sectors. The researchers focused on those who were a part of the American Academy of Nursing’s Edge Runner program. These nurses led or designed care models at their institutions that exhibited positive outcomes both clinically and financially.
These nurses led or designed care models at their institutions that exhibited positive outcomes both clinically and financially.  
Between December 2015 and March 2016, the researchers first used an online survey to gather information from these Edge Runner nurses about their care models, and then followed up with telephone interviews. According to the study results, these care models were often implemented in inpatient settings, or those in which patients stay at the facility for the duration of treatment. Four in five of the models focused on women, and about 61% of the models also heavily considered low-income populations as well as racial and ethnic minorities. Regarding cross-sector work, about 86% of the care models emphasized health care provider collaborations to some extent, and around 76% highlighted non-health care collaborations. The researchers found that specialists, hospital staff, and primary care physicians were the most effective at working together in these care models. As for non-health sectors, the strongest collaborations happened between health care providers and leaders within the community, research organizations, and faith-based groups. On the contrary, emergency room staff and the dialysis department were among the less collaborative, as were environmental organizations, child welfare agencies, and legal firms. Even though the Edge Runner nurses aimed to better understand the community to improve its overall health, there still seemed to be some disconnect.
Considering their study findings, the authors reflect that nurses are important to improving community health because they act as “bridgers” between the health care system and the people they serve.  
The successful collaborations were more likely to feature nurses and other health care providers who could at least speak another language in addition to English. The communities that had a greater sense of neighborliness and trust in their health systems also saw improved conditions through cross-sector collaborations. Additionally, the care models in which collaborating sectors shared a vision and a sense for business did better than others. Considering their study findings, the authors reflect that nurses are important to improving community health because they act as “bridgers” between the health care system and the people they serve. They can help increase a sense of trust, and their role in health care systems is becoming increasingly crucial. Feature image: monkeybusinessimages, iStock [post_title] => Nurses Leading Collaborative Care [post_excerpt] => Martsolf and colleagues assessed the role of nurses in cross-collaborative health care systems, and the ways in which nurses are important to improving community health. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => nurses-leading-collaborative-care [to_ping] => [pinged] => [post_modified] => 2018-10-17 06:29:21 [post_modified_gmt] => 2018-10-17 10:29:21 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5714 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Martsolf and colleagues assessed the role of nurses in cross-collaborative health care systems, and the ways in which nurses are important to improving community health.

...more
Research

Catholic Hospitals and a Woman’s Right to Know

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5655
                    [post_author] => 8
                    [post_date] => 2018-10-15 07:00:37
                    [post_date_gmt] => 2018-10-15 11:00:37
                    [post_content] => Between 2001 and 2016, the number of Catholic-owned or affiliated hospitals grew by over 20%. Catholic facilities often do not provide certain types of reproductive health care, such as sterilization or contraception. Some women have even been denied emergency gynecological procedures in life-threatening situations—for instance following a miscarriage—after being brought to a Catholic hospital.

A study published earlier this year in the American Journal of Obstetrics and Gynecology asked 1,430 women “How important is it for you to know what the hospital’s religion is when making decisions about where to get care?” The women were then asked, after being told that some hospitals restrict care related to reproductive health based on their religious affiliation, “How important is it to you to know what care is restricted before you decide where to get care?” Participants were also asked about their religious affiliation and if it was acceptable for hospitals to restrict the care they provide based on religion.
Over 80% reported that it was somewhat or very important to know what restrictions hospitals have on care. Over half of these responded with “very important.”  
Only one-third of the sample responded that it was somewhat or very important to know a hospital’s religious affiliation when deciding where to get care. Over 80% reported that it was somewhat or very important to know what restrictions hospitals have on care. Over half of these responded with “very important.” Several groups of women reported that it was important to know a hospital’s religious affiliation, including those who reported no religion, atheists and agnostics, and born-again Protestants. The researchers hypothesized that Catholic women and women with stronger religious beliefs would be more supportive of religious restrictions on care. Yet Catholic women were no more likely to respond that it was important to know a hospital’s religious affiliation or care restrictions than non-born-again Protestant women. Women with no religious affiliation and those who identified as atheist or agnostic were more likely to want to know about care restrictions. Over half of the women said that no hospital should be able to restrict care based solely on the hospital’s religious affiliation. Less than one-third said hospitals should be allowed to restrict care under some conditions. Dr. Lori Freedman, the lead author, explained the significance of their findings in an email interview: “Women want more information about how religious policies restrict their care before they decide where to seek it. Findings support policy efforts to compel more transparency from religious healthcare institutions about what they will and will not provide.” Feature image: ArisSu/iStock [post_title] => Catholic Hospitals and a Woman’s Right to Know [post_excerpt] => Catholic hospitals often do not provide certain types of reproductive health care. Freedman and colleagues conducted research on women's knowledge about hospital religious affiliation and its impact on their decisions about where to get care. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => catholic-hospitals-and-a-womans-right-to-know [to_ping] => [pinged] => [post_modified] => 2018-10-15 07:02:32 [post_modified_gmt] => 2018-10-15 11:02:32 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5655 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Catholic hospitals often do not provide certain types of reproductive health care. Freedman and colleagues conducted research on women’s knowledge about hospital religious affiliation and its impact on their decisions about where to get care.

...more
Research

Hacking Public Health

BUPHP_Post Object
(
    [model] => BUPHP_Post_Model Object
        (
            [_post:protected] => WP_Post Object
                (
                    [ID] => 5686
                    [post_author] => 8
                    [post_date] => 2018-10-12 05:30:46
                    [post_date_gmt] => 2018-10-12 09:30:46
                    [post_content] => Everyone loves a hackathon, it seems. Yet, do hackathons really contribute to solving public health problems? Are they a meaningful new tool—or simply the latest fad?

The theory is that hackathons—multi-day, energy-charged events often described as “brainstorming on steroids”—spark exciting new thinking by fostering cognitive diversity, teamwork, and an atmosphere that is competitive yet “safe-to-fail.” A typical hackathon brings people with diverse backgrounds together in a new environment to address a particular problem or challenge. Participants break into teams to design innovative new solutions. They pitch their ideas, rapidly discard or refine them, and often compete for prize money or access to ongoing expert guidance at the end of an action-packed few days. Hackathons can be a fun way to spend a weekend, and they raise the visibility of tricky or overlooked problems. They also hold out the promise of producing the next big breakthrough idea.

The Opioid Epidemic Challenge Summit and Hackathon, hosted in Boston in September 2016, featured the key elements that define hackathons. Initiated by the GE Foundation with the nonprofit, CAMTech, the three-day event convened approximately 265 participants to take on Massachusetts’ opioid crisis. The first day was dedicated to expert presentations that laid out the state’s opioid challenge from prevention to treatment to recovery. From there, hackathon participants—a group that included clinicians, community members, and others—threw out two-minute pitches of problems and proposed solutions.

Seventy ideas were pitched, recalled GE Foundation director, Jennifer Edwards. Of those, teams formed to develop seventeen ideas—including ideas for overcoming stigma, managing medications, and creating community among individuals in recovery—into full-fledged projects.
...numerous ideas had made significant progress by twelve months post-event on measures such as funds raised, pilot projects initiated, patents filed, and new companies formed.  
Early research on public health hackathons has primarily focused on whether they yield actual products. A 2017 article by Olson et al., for example, examined hackathons aimed at seeding new global health tools. The authors found that numerous ideas had made significant progress by twelve months post-event on measures such as funds raised, pilot projects initiated, patents filed, and new companies formed. Importantly, the study also documented broader hackathon impacts on health innovation activities in local communities. For example, over 30% of teams reported that at least one team member went on to work with people they met at the hackathon on other health innovation initiatives. In Boston, two ideas from the 2016 hackathon gained traction. The first, a product called GEMS Boxes—public boxes stocked with naloxone that can be unlocked by 911 dispatch—ran a successful feasibility trial in May 2017. Its founders are now in discussions with potential buyers. The second, a mobile health van called CareZONE, is being piloted in Boston neighborhoods with frequent fatal overdoses. More broadly, the Boston hackathon inspired the Empire State Opioid Innovation Challenge, which CAMTech and partners hosted in New York State last month. And, according to Edwards, the 2016 event also catalyzed private-sector investment in the addressing the opiod crisis in Massachusetts. In March 2017, groups like Partners HealthCare, Blue Cross Blue Shield, and SEIU1199, along with GE Foundation and others, launched RIZE Massachusetts, an innovation fund aimed at ending the state’s opioid epidemic. The high profile organization, which awarded its first “design grants” to community-based providers in June 2018, intends to fuel promising new solutions to opioid addiction. Its grant making, expected to land in the multiple millions, will ensure that local energy remains focused on one of the toughest public health challenges of recent times. GEMS boxes mockup, internal and external locations Feature image: Participants co-creating solutions to curb the local and national opioid epidemic at the 2016 Opioid Epidemic Challenge Summit and Hackathon, hosted by CAMTech in partnership with the GE Foundation in Boston in September 2016. Photo courtesy of CAMTech.  Image in article: Mockup of indoor and outdoor models of GEMS Boxes, $10K grand prize winner of the 2016 Opioid Epidemic Challenge Summit and Hackathon, hosted by CAMTech in partnership with the GE Foundation in Boston in September 2016. A GEMs Box is a solar-powered, remotely-unlockable supply kiosk that communicates with 911, and is stocked with critical first-aid supplies that can be administered with no medical training, such as Naloxone (an opioid antidote), tourniquets/gauze, epi-pens, and AEDs. Photo courtesy of CAMTech.  [post_title] => Hacking Public Health [post_excerpt] => Everyone loves a hackathon, it seems. How much do hackathons really contribute to solving public health problems? Are they a meaningful new tool, or simply the latest fad? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => hacking-public-health [to_ping] => [pinged] => [post_modified] => 2018-10-12 05:51:29 [post_modified_gmt] => 2018-10-12 09:51:29 [post_content_filtered] => [post_parent] => 0 [guid] => https://www.publichealthpost.org/?post_type=bu_research&p=5686 [menu_order] => 0 [post_type] => bu_research [post_mime_type] => [comment_count] => 0 [filter] => raw ) [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [view] => BUPHP_Post_View Object ( [multipage] => [extra_args] => Array ( ) [owner] => BUPHP_Post Object *RECURSION* [_trigger_error:WPLib_Base:private] => 1 ) [extra_args] => Array ( ) [owner] => [_trigger_error:WPLib_Base:private] => 1 )

Everyone loves a hackathon, it seems. How much do hackathons really contribute to solving public health problems? Are they a meaningful new tool, or simply the latest fad?

...more
1 2 3 4 5 20 21 22
SHARES