Measuring Access to Mental Health Services Among Primary Care Patients.

Background: The lifetime risk of mental health disorders is almost 50% and, in any year, about 25% of the population have a psychiatric disorder. Many of those people are cared for in primary care settings.

Research Objective: Measure access to mental health services, such as getting counselling or prescription mental health medications, using new patient survey questions that can be added to Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys.

Changes in Antidementia Medications upon Admission to the Nursing Home: Who Decides and Why? Results From a National Survey of Nursing Home Administrators.

Objective: Little is known about who is involved and what factors influence changes in antidementia medications for older adults living in nursing homes. The study sought to describe factors associated with initiation and discontinuation of antidementia medications in nursing home residents with dementia.

Design: National survey of nursing homes with ≥30 beds; homes with dementia units were oversampled.

Health Care Service Price Comparison Suggests That Employers Lack Leverage To Negotiate Lower Prices.

Almost two-thirds of the 153 million nonelderly people in the United States who have health insurance through their employer are in self-insured plans. In contrast to fully insured plans, employers using self-insured plans assume responsibility for employees' medical costs and therefore have an incentive to reduce the prices of health care services. We compared prices for common services in self-insured plans with those in fully insured plans.

Rising to the Occasion: A National Nursing Home Study Documenting Attempts to Address Social Isolation During the COVID-19 Pandemic.

Objectives: COVID-19-related policies introduced extraordinary social disruption in nursing homes. In response, nursing facilities implemented strategies to alleviate their residents' loneliness. This study sought to describe interventions nursing homes used, document the perceived effectiveness of efforts, and determine barriers to implementing strategies to mitigate social isolation and loneliness.

Developing a Storytelling Study for African Americans with Hypertension:: A Study Protocol.

Objective: Storytelling is an engaging approach for promoting health and wellness among individuals with health conditions including type 2 diabetes (TTDM), breast cancer, and hypertension. Storytelling interventions are an evidence-based approach that has been effective in promoting behavioral change such as increasing physical activity, medication adherence, and making dietary changes. The use of storytelling to convey health information and promote behavior change is associated with increased engagement in self-management particularly in communities of color.

A Systematic Review of Strategies to Enhance Response Rates and Representativeness of Patient Experience Surveys.

Background: Data from surveys of patient care experiences are a cornerstone of public reporting and pay-for-performance initiatives. Recently, increasing concerns have been raised about survey response rates and how to promote equity by ensuring that responses represent the perspectives of all patients.

Objective: Review evidence on survey administration strategies to improve response rates and representativeness of patient surveys.

Faculty supportive behaviors and nursing student mental health: a pilot study.

Objectives: Relationships between perceived faculty support and prevalence of depression, anxiety, and stress among undergraduate nursing students were explored.

Methods: A mixed method design was used for this descriptive, cross-sectional pilot study. Depression, Anxiety and Stress Scale-21 (DASS-21), Perceived Faculty Support Scale (PFSS), a demographic questionnaire, and open-ended questions were used to collect data.

Vaccination intentions generate racial disparities in the societal persistence of COVID-19.

We combined survey, mobility, and infections data in greater Boston, MA to simulate the effects of racial disparities in the inclination to become vaccinated on continued infection rates and the attainment of herd immunity. The simulation projected marked inequities, with communities of color experiencing infection rates 3 times higher than predominantly White communities and reaching herd immunity 45 days later on average. Persuasion of individuals uncertain about vaccination was crucial to preventing the worst inequities but could only narrow them so far because 1/5th of Black and Latinx individuals said that they would never vaccinate.

Comparing Web and Mail Protocols for Administering Hospital Consumer Assessment of Healthcare Providers and Systems Surveys.

Objective: The objective of this study was to compare results of using web-based and mail (postal) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data collection protocols.

Research Design: Patients who had been hospitalized in a New England Hospital were surveyed about their hospital experience. Patients who provided email addresses were randomized to 1 of 3 data collection protocols: web-alone, web with postal mail follow-up, and postal mail only.

Oral health curriculum evaluation tool (OHCET) for primary care training programs.

Background: Primary care training schools and programs lack a validated tool to assess their oral health curriculum, and researchers lack a tool to compare oral health curricula across programs/schools and different disciplines.

Objective: This study describes the process and results of creating a 15-item oral health curriculum evaluation tool (OHCET).

Methods: Three-phased development of the OHCET from 2018 to 2020 including (a) Delphi group/tool development; (b) tool pilot test; and (c) tool validation/cognitive interviews.

Does Home Remedy Use Contribute to Medication Nonadherence Among Blacks with Hypertension?

Background: Home remedies (HRs) are described as foods, herbs, and other household products used to manage chronic conditions. The objective of this study was to examine home remedy (HR) use among Blacks with hypertension and to determine if home remedy use is correlated with blood pressure and medication adherence.

Methods: Data for this cross-sectional study were obtained from the TRUST study conducted between 2006-2008.

The effect of different sampling and recall periods in the CAHPS Clinician & Group (CG-CAHPS) survey.

Objective: To examine the effect of changing the sampling and reference periods for the CAHPS Clinician & Group Survey from 12 to 6 months.

Data Sources/study Setting: Adult patients with a visit in the last 12 months to New England community health centers.

Study Design: We randomly assigned patients to receive a survey with either a 12- or 6-month recall period.

A randomized controlled trial of community health workers using patient stories to support hypertension management: Study protocol.

Background: Uncontrolled hypertension is a significant public health problem in the U.S. with about one half of people able to keep blood pressure (BP) under control.

Preparation for Transition to Adult Care Among Medicaid-Insured Adolescents.

Background: Parents of children with chronic illness consistently report suboptimal preparation for transition from pediatric- to adult-focused health care. Little data are available on transition preparation for low-income youth in particular.

Methods: We conducted a mailed survey of youth with chronic illness enrolled in 2 large Medicaid health plans to determine the quality of transition preparation using the Adolescent Assessment of Preparation for Transition (ADAPT).

Medicare Hospice Spending Hit $15.8 Billion In 2015, Varied By Locale, Diagnosis.

Between 2007 and 2015, Medicare hospice spending rose by 52 percent, from $10.4 billion to $15.8 billion.

Development and Validation of the Adolescent Assessment of Preparation for Transition: A Novel Patient Experience Measure.

Purpose: Significant gaps exist in health care transition (HCT) preparation that can impact care and outcomes in young adults with chronic illness. No quality measure exists to directly assess adolescent experiences of HCT preparation. Our objective was to develop an adolescent-reported measure of the quality of HCT preparation received from pediatric health care providers.

Translating comparative effectiveness research into Medicaid payment policy: views from medical and pharmacy directors.

Background: As the USA seeks to expand the conduct and dissemination of comparative effectiveness research (CER), views of key stakeholders will help guide the way.

Methods: We surveyed 60 medical and pharmacy directors from 46 state Medicaid programs.

Results: Over 90% felt that CER would lead to better clinical decision-making and overall value within 5 years and were willing to consider cost-effectiveness in setting medical policy.

The future of nursing: monitoring the progress of recommended change in hospitals, nurse-led clinics, and home health and hospice agencies.

Objective: The objective of this study was to assess the implementation of recommendations of the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health.

Background: In 2010, the IOM made a series of recommendations aimed at transforming the role of nurses in healthcare delivery.

Methods: We conducted a multiyear survey, in 2011 and 2013, with nurse leaders who were members of the American Organization of Nurse Executives, the National Nursing Centers Consortium, or the Visiting Nurses Association of America.

A longitudinal study of electronic cigarette use among a population-based sample of adult smokers: association with smoking cessation and motivation to quit.

Aims: Increasingly popular electronic cigarettes (e-cigarettes) may be the most promising development yet to end cigarette smoking. However, there is sparse evidence that their use promotes cessation. We investigated whether e-cigarette use increases smoking cessation and/or has a deleterious effect on quitting smoking and motivation to quit.

Inaccurate risk perceptions and individualized risk estimates by patients with type 2 diabetes.

Background: We evaluated how diabetic patients understand and respond to the presentation of personalized risk information.

Methods: This was a mixed methods study involving 56 patients with type 2 diabetes and at least 1 additional cardiovascular risk factor. We assessed participants' perceptions of diabetes-related risks; asked them to rank order 6 events (death, heart attack, stroke, blindness, amputation, and kidney failure) by likelihood of occurrence in a specified time frame; presented them with personalized risk estimates; and asked them to re-rank the risks.

Glycemic control in cardiac surgery: implementing an evidence-based insulin infusion protocol.

Background: Acute hyperglycemia following cardiac surgery increases the risk of deep sternal wound infection, significant early morbidity, and mortality. Insulin infusion protocols that target tight glycemic control to treat hyperglycemia have been linked to hypoglycemia and increased mortality. Recently published studies examining glycemic control in critical illness and clinical practice guidelines from professional organizations support moderate glycemic control.

The effect of response scale, administration mode, and format on responses to the CAHPS Clinician and Group survey.

Objective: To examine how different response scales, methods of survey administration, and survey format affect responses to the CAHPS (Consumer Assessment of Healthcare Providers and Systems) Clinician and Group (CG-CAHPS) survey.

Study Design: A total of 6,500 patients from a university health center were randomly assigned to receive the following: standard 12-page mail surveys using 4-category or 6-category response scales (on CG-CAHPS composite items), telephone surveys using 4-category or 6-category response scales, or four-page mail surveys.

Principal Findings: A total of 3,538 patients completed surveys.

Reported racial discrimination, trust in physicians, and medication adherence among inner-city African Americans with hypertension.

Objectives: We sought to determine if reported racial discrimination was associated with medication nonadherence among African Americans with hypertension and if distrust of physicians was a contributing factor.

Methods: Data were obtained from the TRUST project conducted in Birmingham, Alabama, 2006 to 2008. All participants were African Americans diagnosed with hypertension and receiving care at an inner city, safety net setting.

Exploring the association between reported discrimination and hypertension among African Americans: a systematic review.

Background: The experience of racial discrimination among African Americans may contribute to an increased risk of developing hypertension and having poor hypertension control once diagnosed. Although it is a commonly held belief that experiences of discrimination may exert lasting effects on health behavior and physiology, the existing evidence is mixed.

Objective: The objective of this review was to identify evidence linking the experience of discrimination with hypertension among African Americans and to provide an updated synthesis of the literature.