Examining indirect effects of advertising exposure on young adults' cannabis and nicotine vaping.

Objective: To examine longitudinal associations between exposure to two types of advertisements (medical/recreational cannabis and e-cigarette retailers [vape shops]) and young adults' cannabis and nicotine vaping behavior. Positive and negative expectancies for cannabis and vaping nicotine were examined as mediators of these associations.

Method: Secondary analysis of observational data from a longitudinal cohort of young adults recruited from Southern California (Wave 13: = 2,411, 56% female, = 23.

"Palliative Care Is the Only Medical Field That I Feel Like I'm Treated As a Person, Not As a Black Person": A Mixed-Methods Study of Minoritized Patient Experiences with Palliative Care.

Racial and ethnic disparities are well-documented in health care but generally understudied in palliative care. The goal of this mixed-methods study was to examine differences in patient experiences by race/ethnicity in palliative care and to qualitatively explore minoritized patient experiences with care for a serious illness. The data for this study were collected as part of a larger national effort to develop quality measures for outpatient palliative care.

MACRA Palliative Care Quality Measure Development-Testing Summary Report: Measure Name: Receiving Desired Help for Pain.

Palliative care has expanded rapidly in the past 20 years, especially in the ambulatory (office) setting, and there is growing consensus regarding the need to systematically measure and incentivize high-quality care. The Centers for Medicare & Medicaid Services entered a cooperative agreement with the American Academy of Hospice and Palliative Medicine (AAHPM) as part of the Medicare Access and CHIP Reauthorization Act of 2015 to develop two patient-reported measures of ambulatory palliative care experience: Feeling Heard and Understood and Receiving Desired Help for Pain. Under contract to AAHPM, RAND Health Care researchers developed and tested both measures over a three-year project period.

Improving Behavioral Health Care for U.S. Army Personnel: Identifying Predictors of Treatment Outcomes.

This article identifies factors associated with changes in outcomes for soldiers who received Army behavioral health (BH) specialty care and provides recommendations to improve BH care and outcomes. RAND researchers identified three samples of soldiers who received Army BH care with diagnoses of posttraumatic stress disorder (PTSD), depression, or anxiety and whose symptoms were assessed during their care. Multivariate analyses included 141 patient and treatment variables to identify factors associated with symptom improvement.

Association of Primary and Specialty Care Integration on Physician Communication and Cancer Screening in Safety-Net Clinics.

Introduction: Primary care providers who lack reliable referral relationships with specialists may be less likely than those who do have such relationships to conduct cancer screenings. Community health centers (CHCs), which provide primary care to disadvantaged populations, have historically reported difficulty accessing specialty care for their patients. This study aimed to describe strategies CHCs use to integrate care with specialists and examine whether more strongly integrated CHCs have higher rates of screening for colorectal and cervical cancers and report better communication with specialists.

California Community College Faculty and Staff Help Address Student Mental Health Issues.

This study determines the preliminary impact of CalMHSA's prevention and early intervention activities on the knowledge, attitudes, and behaviors of California community college faculty and staff regarding supporting students' mental health needs.

Quantifying Magnitude of Group-Level Differences in Patient Experiences with Health Care.

Objective: Review approaches assessing magnitude of differences in patient experience scores between different providers.

Data Sources: 1990-2016 literature.

Study Design: Systematic literature review.

Using the Early Childhood Environment Rating Scale-Revised in High Stakes Contexts: Does Evidence Warrant the Practice?

Increasingly, states establish different thresholds on the Early Childhood Environment Rating Scale-Revised (ECERS-R), and use these thresholds to inform high-stakes decisions. However, the validity of the ECERS-R for these purposes is not well established. The objective of this study is to identify thresholds on the ECERS-R that are associated with preschool-aged children's social and cognitive development.

Improving Outcomes for Children Exposed to Violence: Safe Start Promising Approaches.

Children's exposure to violence is common and can lead to mental health problems and delinquent behaviors. Because many interventions have focused on specific violence types or symptoms and been difficult to implement in real-world settings, the evidence base is still emerging. The Office of Juvenile Justice and Delinquency Prevention's Safe Start Promising Approaches (SSPA) initiative focused on preventing and reducing the impact of children's exposure to violence through interventions in ten diverse communities.

Examining the associations between daily caregiving discontinuity and children's social-emotional outcomes.

Many child care centers temporarily move children and teachers in and out of their assigned classrooms throughout the day. Such practices create frequent discontinuity in children's experiences in child care, including discontinuity in their peer and teacher relationships. This study examined the prevalence and patterns of teacher and child movement between classrooms, the characteristics of teachers and children who were more likely to move between classrooms on a daily basis, and the associations between children's and teachers' rate of daily movement between classrooms with children's social-emotional outcomes.

Out of the Shadows: The Health and Well-Being of Private Contractors Working in Conflict Environments.

Over the past decade, private contractors have been deployed extensively around the globe. In addition to supporting U.S.

Evaluating the Impact of Prevention and Early Intervention Activities on the Mental Health of California's Population.

In 2004, California voters passed the Mental Health Services Act, which was intended to transform California's community mental health system from a crisis-driven system to one that included a focus on prevention and wellness. The vision was that prevention and early intervention (PEI) services comprised the first step in a continuum of services designed to identify early symptoms and prevent mental illness from becoming severe and disabling. Twenty percent of the act's funding was dedicated to PEI services.

Family income and early achievement across the urban-rural continuum.

Rural and suburban children account for the majority of poor children in the United States. Yet, most research examining poverty's associations with child development is focused on urban samples. Using nationally representative data from the Early Childhood Longitudinal Study, Birth Cohort (N ≈ 6,600), this study examines whether the form and magnitude of income's relationship with early achievement differ across the urban-rural continuum.

Using generalized additive modeling to empirically identify thresholds within the ITERS in relation to toddlers' cognitive development.

Research linking high-quality child care programs and children's cognitive development has contributed to the growing popularity of child care quality benchmarking efforts such as quality rating and improvement systems (QRIS). Consequently, there has been an increased interest in and a need for approaches to identifying thresholds, or cutpoints, in the child care quality measures used in these benchmarking efforts that differentiate between different levels of children's cognitive functioning. To date, research has provided little guidance to policymakers as to where these thresholds should be set.

A graphical method for assessing risk factor threshold values using the generalized additive model: the multi-ethnic study of atherosclerosis.

Continuous variable dichotomization is a popular technique used in the estimation of the effect of risk factors on health outcomes in multivariate regression settings. Researchers follow this practice in order to simplify data analysis, which it unquestionably does. However thresholds used to dichotomize those variables are usually ad-hoc, based on expert opinions, or mean, median or quantile splits and can add bias to the effect of the risk factors on specific outcomes and underestimate such effect.

Accounting for Movement between Childcare Classrooms: Does it Change Teacher Effects Interpretations?

Child care studies that have examined links between teachers' qualifications and children's outcomes often ignore teachers' and children's transitions between classrooms at a center throughout the day and only take into account head teacher qualifications. The objective of this investigation was to examine these traditional assumptions and to compare inferences made from these traditional models to methods accounting for transitions between classrooms and multiple teachers in a classroom. The study examined the receptive language, letter-word identification, and passage comprehension skills of 307 children enrolled in 49 community-based childcare centers serving primarily low-income families in Colorado.

The Modified Kalman Filter Macro: User's Guide.

The Modified Kalman Filter approach for pooling information across time and across outcomes is shown to improve accuracy in national estimates of health outcomes, including cancer, diabetes, and hypertension, especially in small racial/ethnic subgroups. The developed SAS macro models true health states in each subgroup assuming a linear time evolution and an autoregressive deviation around such trend. The macro provides multiple options for users.

National Evaluation of Safe Start Promising Approaches.

Safe Start Promising Approaches (SSPA) is the second phase of a community-based initiative focused on developing and fielding interventions to prevent and reduce the impact of children's exposure to violence (CEV). This article shares the results of SSPA, which was intended to implement and evaluate promising and evidence-based programs in community settings. Fifteen program sites across the country were selected to implement a range of interventions for helping children and families cope with the effects of CEV.

Differential item functioning by survey language among older Hispanics enrolled in Medicare managed care: a new method for anchor item selection.

Objective: To propose a permutation-based approach of anchor item detection and evaluate differential item functioning (DIF) related to language of administration (English vs. Spanish) for 9 questions assessing patients' perceptions of their providers from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare 2.0 survey.

Smoothing across time in repeated cross-sectional data.

Repeated cross-sectional samples are common in national surveys of health like the National Health Interview Survey (NHIS). Because population health outcomes generally evolve slowly, pooling data across years can improve the precision of current-year annual estimates of disease prevalence and other health outcomes. Pooling over time is particularly valuable in health disparities research, where outcomes for small groups are often of interest and pooling data across groups would bias disparity estimates.

General Cardiovascular Risk Profile identifies advanced coronary artery calcium and is improved by family history: the multiethnic study of atherosclerosis.

Background: The General Cardiovascular Risk Profile is a multivariable model that predicts global cardiovascular disease risk. Our goal was to assess the ability of the General Cardiovascular Risk Profile to identify individuals with advanced coronary artery calcification (CAC) and determine whether identification is improved with family history.

Methods And Results: Using data from the Multiethnic Study of Atherosclerosis, 3 sex-specific models were developed with ordinal logistic regressions to relate risk factors to CAC scores.

Relation of familial patterns of coronary heart disease, stroke, and diabetes to subclinical atherosclerosis: the multi-ethnic study of atherosclerosis.

Purpose: To investigate the possibility that family history beyond early-onset coronary heart disease might contribute to coronary heart disease susceptibility, we studied associations between additional family history and the coronary artery calcium score.

Methods: Associations between coronary artery calcium score and self-reports of coronary heart disease, stroke, and diabetes in first-degree relatives of 5264 nondiabetic subjects were assessed using logistic and linear regression adjusting for risk factors; adjusted mean coronary artery calcium score estimates were determined by pooling results.

Results: Family history of coronary heart disease alone and in combination with diabetes and/or stroke was significantly associated with a positive coronary artery calcium score compared with no family history with odds ratios ranging from 1.

Provider-related barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs) and hospitals.

We examined provider-reported barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs), and hospitals.