Racial and Ethnic and Rural Variations in the Use of Hybrid Prenatal Care in the US.

Importance: Understanding whether there are racial and ethnic and residential disparities in prenatal telehealth uptake is necessary for ensuring equitable access and guiding implementation of future hybrid (ie, both telehealth and in-person) prenatal care.

Objective: To assess temporal changes in individuals using hybrid prenatal care before and during the COVID-19 public health emergency (PHE) by race and ethnicity and residence location in the US.

Design, Setting, And Participants: This retrospective cohort study analyzed electronic health record data of prenatal care visits from the National COVID Cohort Collaborative Data Enclave, comprising data from 75 health systems and freestanding institutes in all 50 US states.

Challenges to School Success Among Children in U.S. Military Families.

Introduction: More than 90% of children in military families attend civilian schools that may lack understanding of the unique experiences and stressors of military life. School success in children of military families has important implications on future academic achievement, health outcomes, and military groups; yet there has not been an examination of challenges of school success among children of military families in the United States using nationally representative data.

Materials And Methods: Data captured in the 2021-2022 National Survey of Children's Health, limited to children aged 6 to 17 years, were used to examine the association between child's caregiver military status and challenges of school success: lack of school engagement measured through caring about school and completing schoolwork, school absenteeism, and grade repetition (n = 60,599).

Examining the Association Between Adverse Childhood Experiences and ADHD in School-Aged Children Following the COVID-19 Pandemic.

Background: Adverse childhood experiences (ACEs) have long been associated with attention-deficit/hyperactive disorder (ADHD) diagnoses in children; but the data used is now over 6 years old (from 2017 to 2018). Understanding the current landscape of their prevalence and association is needed to capture evolving social, environmental, and economic conditions, and ensure interventions remain relevant to addressing current childhood trauma.

Objective: This study provides an updated analysis of the association between ACEs and ADHD using post-acute-COVID-19 pandemic data.

The Health of Children in U.S. Military Families: Evaluation of the 2020-21 National Survey of Children's Health.

Introduction: The health of children and adolescents, particularly children of military families, is instrumental for military departments; yet, there has not been an examination on the overall physical health status, or access to health care, among children of military families compared to children of civilian families.

Materials And Methods: This study used the 2020-2021 National Survey of Children's Health, children aged 0-17 years, to examine the association between military status of the caregiver of the child and the child's health status, financial stability, and health care access via health insurance coverage (n = 90,711 children). Bivariate analyses used Pearson's chi-squared tests and were weighted to be nationally representative.

Geographic variations in driving time to US mental health care, digital access to technology, and household crowdedness.

Rural residents face significant barriers in accessing mental health care, particularly as the demand for such services grows. Telemedicine has been proposed as an answer to rural gaps, but this service requires both access to appropriate technology and private space in the home to be useful. Our study documented longer travel time to mental health facilities in rural areas and greater barriers to digital devices for telemedicine access in those same areas.

Co-occurrence of mental illness and substance use among US pregnant individuals, 2012-2021.

Aim: Substance use disorders are increasingly prevalent among pregnant individuals, with evident risks of adverse perinatal outcomes. This study examines substance use (tobacco, alcohol and marijuana) among pregnant individuals with mental illness.

Methods: A national representative sample of pregnant individuals were derived from 2012 to 2021 National Survey of Drug Use and Health data.

Uterine leiomyomata claim rate estimates and demographic characteristics by county. Florida, 2010-2019.

To describe the demographic characteristics and estimate the uterine leiomyomata claim rates (ULCRs) by women 18 years and older in Florida, we conducted a cross-sectional analysis of the 2010-2019 administrative claims for uterine leiomyomata and associated study variables (age, race, ethnicity, county of residence, anatomic site, length of stay, and additional diagnoses). ULCR ratios were estimated by race and ethnicity, using ULCR for non-Hispanic White women as the reference group. We identified 232,475 claims, most of which were among non-Hispanic White women in their forties.

An urban versus rural comparison of obesity between youth with and without autism spectrum disorder.

To examine obesity prevalence in youth with autism spectrum disorder (ASD) and neurotypical (NT) youth living in rural and urban areas. Data is from the 2019 National Survey of Children's Health, a national dataset that collected information on child health and well-being. Overweight/obesity status was based on parent/caregiver report of child height and weight.

Obesogenic Behaviors of Rural Children on School and Nonschool Days.

Children living in rural areas are at increased risk of overweight and obesity compared with their urban-dwelling counterparts. The purpose of this study was to provide preliminary evidence of rural children's obesogenic behaviors ( activity, sedentary behaviors, sleep, and diet) during school days, nonschool weekdays, and weekend days. A repeated measures 14-day observational study was conducted early March 2020.

Characteristics Associated With Nonreceipt of Surveillance Testing and the Relationship With Survival in Stage II and III Colon Cancer.

We investigated characteristics of patients with colon cancer that predicted nonreceipt of posttreatment surveillance testing and the subsequent associations between surveillance status and survival outcomes. This was a retrospective cohort study of the Surveillance, Epidemiology, and End Results database combined with Medicare claims. Patients diagnosed between 2002 and 2009 with disease stages II and III and who were between 66 and 84 years of age were eligible.

Financial hardship among rural cancer survivors: An analysis of the Medical Expenditure Panel Survey.

Some cancer survivors report spending 20% of their annual income on medical care. Undue financial burden that patients face related to the cost of care is referred to as financial hardship, which may be more prevalent among rural cancer survivors. This study examined contrasts in financial hardship among 1419 rural and urban cancer survivors using the 2011 Medical Expenditure Panel Survey supplement - The Effects of Cancer and Its Treatment on Finances.

Disparities in Utilization of Medical Specialists for Colonoscopy.

Colonoscopy is the preferred screening modality for colorectal cancer (CRC) prevention. The quality of the procedure varies although medical specialists such as gastroenterologists and colorectal surgeons tend to have better outcomes. We aimed to determine whether there are demographic and clinical differences between those who received a colonoscopy from a specialist versus those who received a colonoscopy from a nonspecialist.

Rural-urban differences in financial burden among cancer survivors: an analysis of a nationally representative survey.

Purpose: Rural cancer survivors may disproportionately experience financial problems due to their cancer because of greater travel costs, higher uninsured/underinsured rates, and other factors compared to their urban counterparts. Our objective was to examine rural-urban differences in reported financial problems due to cancer using a nationally representative survey.

Methods: We used data from three iterations of the National Cancer Institute's Health Information and National Trends Survey (2012, 2014, and 2017) to identify participants who had a previous or current cancer diagnosis.

Challenges and Opportunities for Lung Cancer Screening in Rural America.

Rural populations have higher rates of smoking and both lung cancer incidence and mortality compared with their urban peers. As such, it is imperative that high-risk, rural populations have access to recommended low-dose CT (LDCT) screening, which can detect lung cancer at an earlier, more treatable stage. Data from the 2015 National Health Interview Survey, a nationally representative survey, were analyzed to assess nonmetropolitan-metropolitan and geographic differences in LDCT utilization among screening-eligible individuals.

Regional variation in lung and bronchus cancer survival in the US using mortality-to-incidence ratios.

Despite major achievements aimed at reducing smoking over the last 50 years in the U.S., lung cancer remains the leading cause of cancer death.

Who Performs Colonoscopy? Workforce Trends Over Space and Time.

Purpose: With the increased availability of colonoscopy to average risk persons due to insurance coverage benefit changes, we sought to identify changes in the colonoscopy workforce. We used outpatient discharge records from South Carolina between 2001 and 2010 to examine shifts over time and in urban versus rural areas in the types of medical providers who perform colonoscopy, and the practice settings in which they occur, and to explore variation in colonoscopy volume across facility and provider types.

Methods: Using an all-payer outpatient discharge records database from South Carolina, we conducted a retrospective analysis of all colonoscopy procedures performed between 2001 and 2010.

The Costs and Valuation of Health Impacts of Measles and Rubella Risk Management Policies.

National and global health policymakers require good information about the costs and benefits of their investments in measles and rubella immunization programs. Building on our review of the existing measles and rubella health economics literature, we develop inputs for use in regional and global models of the expected future benefits and costs of vaccination, treatment, surveillance, and other global coordination activities. Given diversity in the world and limited data, we characterize the costs for countries according to the 2013 World Bank income levels using 2013 U.

Synthesis of Evidence to Characterize National Measles and Rubella Exposure and Immunization Histories.

Population immunity depends on the dynamic levels of immunization coverage that countries achieve over time and any transmission of viruses that occur within the population that induce immunity. In the context of developing a dynamic transmission model for measles and rubella to support analyses of future immunization policy options, we assessed the model inputs required to reproduce past behavior and to provide some confidence about model performance at the national level. We reviewed the data available from the World Health Organization (WHO) and existing measles and rubella literature for evidence of historical reported routine and supplemental immunization activities and reported cases and outbreaks.

Systematic Review of Measles and Rubella Serology Studies.

Serological tests provide information about individual immunity from historical infection or immunization. Cross-sectional serological studies provide data about the age- and sex-specific immunity levels for individuals in the studied population, and these data can provide a point of comparison for the results of transmission models. In the context of developing an integrated model for measles and rubella transmission, we reviewed the existing measles and rubella literature to identify the results of national serological studies that provided cross-sectional estimates of population immunity at the time of data collection.

Systematic Review of Health Economic Analyses of Measles and Rubella Immunization Interventions.

Economic analyses for vaccine-preventable diseases provide important insights about the value of prevention. We reviewed the literature to identify all of the peer-reviewed, published economic analyses of interventions related to measles and rubella immunization options to assess the different types of analyses performed and characterize key insights. We searched PubMed, the Science Citation Index, and references from relevant articles for studies in English and found 67 analyses that reported primary data and quantitative estimates of benefit-cost or cost-effectiveness analyses for measles and/or rubella immunization interventions.