Background: Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health impacts of youth mental health problems, but is complicated by the limited and fragmented funding available to youth mental health service agencies. Supports are needed that can guide service agencies in accessing sustainable funding for EBTs. We conducted a pilot evaluation of the Fiscal Mapping Process, an Excel-based strategic planning tool that helps service agency leaders identify and coordinate financing strategies for their EBT programs.
View Article and Find Full Text PDFBackground: Evidence-based treatments (EBTs) are critical to effectively address mental health problems among children and adolescents, but costly for mental health service agencies to implement and sustain. Financing strategies help agencies overcome cost-related barriers by obtaining financial resources to support EBT implementation and/or sustainment.
Aims: We sought to (i) understand how youth mental health system decision-makers involved with EBT implementation and sustainment view key features (e.
Community Health Equity Res Policy
April 2024
The COVID-19 pandemic shed light on stark racial and ethnic inequities in access to care and accurate health information in the U.S. When COVID-19 vaccines became available, communities of color faced multiple barriers that contributed to low vaccine rates.
View Article and Find Full Text PDFCommunity Health Equity Res Policy
April 2024
Given COVID-19's disproportionate impact on populations that identify as Black, Indigenous, and People of Color (BIPOC) in the United States, researchers and advocates have recommended that health systems and institutions deepen their engagement with community-based organizations (CBOs) with longstanding relationships with these communities. However, even as CBOs leverage their earned trust to promote COVID-19 vaccination, health systems and institutions must also address underlying causes of health inequities more broadly. In this commentary, we discuss key lessons learned about trust from our participation in the U.
View Article and Find Full Text PDFThe one-year U.S. Equity-First Vaccination Initiative (EVI), launched in April 2021, aimed to reduce racial inequities in coronavirus disease 2019 (COVID-19) vaccination across five demonstration cities (Baltimore, Chicago, Houston, Newark, and Oakland) and over the longer term strengthen the United States' public health system to achieve more-equitable outcomes.
View Article and Find Full Text PDFWe investigated racial and ethnic disparities in COVID-19 vaccine uptake, using data from the Centers for Disease Control and Prevention. As of March 29, 2022, uptake of the first dose was higher among Hispanic and Asian people than among White and Black people. In contrast, uptake rates of the booster were higher among Asian and White people than among Black and Hispanic people.
View Article and Find Full Text PDFThe coronavirus disease 2019 pandemic required significant public health interventions from local governments. Early in the pandemic, RAND researchers developed a decision support tool to provide policymakers with insight into the trade-offs they might face when choosing among nonpharmaceutical intervention levels. Using an updated version of the model, the researchers performed a stress-test of a variety of alternative reopening plans, using California as an example.
View Article and Find Full Text PDFWith new coronavirus disease 2019 (COVID-19) vaccines authorized by the U.S. Food and Drug Administration and likely more to come, the (extraordinarily complex) logistics of deploying them have gotten underway.
View Article and Find Full Text PDFBackground: Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health and economic impacts of youth mental health problems, but is complicated by the limited and fragmented funding available to youth mental health service agencies (hereafter, "service agencies"). Strategic planning tools are needed that can guide these service agencies in their coordination of sustainable funding for EBTs. This protocol describes a mixed-methods research project designed to (1) develop and (2) evaluate our novel fiscal mapping process that guides strategic planning efforts to finance the sustainment of EBTs in youth mental health services.
View Article and Find Full Text PDFBackground: Implementation researchers are increasingly using economic evaluation to explore the benefits produced by implementing evidence-based practices (EBPs) in healthcare settings. However, the findings of typical economic evaluations (e.g.
View Article and Find Full Text PDFObjective: The objective of this study was to explore perceptions of senior leadership in hospitals on the motivations, cost, benefits, barriers, and facilitators of investment in emergency preparedness.
Study Design: This is a qualitative study which used a grounded theory approach to develop a theory of hospital emergency preparedness.
Setting And Study Participants: A purposive sample of hospital leaders (n = 11) in the US state of Nebraska were interviewed.
Hospitals are an integral part of community resiliency during and after a disaster or emergency event. In addition to community-level planning through healthcare coalitions, hospitals are required to test and update emergency plans to comply with accreditation standards at their own expense. Justifying costs related to investments in emergency preparedness can be a barrier, as these events are relatively rare.
View Article and Find Full Text PDFDisaster Med Public Health Prep
December 2021
Objective: Emergency departments (EDs) are critical sources of care after natural disasters such as hurricanes. Understanding the impact on ED utilization by subpopulation and proximity to the hurricane's path can inform emergency preparedness planning. This study examines changes in ED utilization for residents of 344 counties after the occurrence of 7 US hurricanes between 2005 and 2016.
View Article and Find Full Text PDFMotor vehicle crashes account for a large number of deaths and injuries. In the United States, in 2015, more than 35,000 people were killed and approximately 2.44 million were injured in motor vehicle crashes.
View Article and Find Full Text PDFTo provide objective analyses about the effects of prevention and treatment programs on child welfare outcomes, RAND researchers built a quantitative model that simulated how children enter and flow through the nation's child welfare system. They then used the model to project how different policy options (preventive services, family preservation treatment efforts, kinship care treatment efforts, and a policy package that combined preventive services and kinship care) would affect a child's pathway through the system, costs, and outcomes in early adulthood. This study is the first attempt to integrate maltreatment risk, detection, pathways through the system, and consequences in a comprehensive quantitative model that can be used to simulate the impact of policy changes.
View Article and Find Full Text PDFThe Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA) current and projected health care capabilities and resources.
View Article and Find Full Text PDFA focused review of recent RAND Health research identified small ideas that could save the U.S. health care system $13 to $22 billion per year, in the aggregate, if successfully implemented.
View Article and Find Full Text PDFDisaster Med Public Health Prep
August 2013
Objective: Although recent emergencies or disasters have underscored the vital role of nongovernmental (NGO) resources, they remain not well understood or leveraged. We intended to develop an assets framework that identifies relevant NGO resources for disaster preparedness and response that can be used to assess their availability at state and local levels.
Methods: We conducted a search of peer-reviewed publications to identify existing asset frameworks, and reviewed policy documents and gray literature to identify roles of NGOs in emergency preparedness, response, and recovery.
Study Objective: Efficient management and allocation of scarce medical resources can improve outcomes for victims of mass casualty events. However, the effectiveness of specific strategies has never been systematically reviewed. We analyze published evidence on strategies to optimize the management and allocation of scarce resources across a wide range of mass casualty event contexts and study designs.
View Article and Find Full Text PDFEvid Rep Technol Assess (Full Rep)
June 2012
Objectives: This systematic review sought to identify the best available evidence regarding strategies for allocating scarce resources during mass casualty events (MCEs). Specifically, the review addresses the following questions: (1) What strategies are available to policymakers to optimize the allocation of scarce resources during MCEs? (2) What strategies are available to providers to optimize the allocation of scarce resources during MCEs? (3) What are the public's key perceptions and concerns regarding the implementation of strategies to allocate scarce resources during MCEs? (4) What methods are available to engage providers in discussions regarding the development and implementation of strategies to allocate scarce resources during MCEs?
Data Sources: We searched Medline, Scopus, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Global Health, Web of Science®, and the Cochrane Database of Systematic Reviews from 1990 through 2011. To identify relevant non-peer-reviewed reports, we searched the New York Academy of Medicine's Grey Literature Report.
Attempts to explain disparities in access to health care faced by racial and ethnic minorities and other underserved populations often focus on individual-level factors such as demographics, personal health beliefs, and health insurance status. This article proposes an examination of these disparities-and an effort to redress them-through the lens of public health. Public health agencies can link people to needed services such as immunizations, testing, and treatment; ensure the availability of health care; ensure the competency of the public health and personal health care workforce; and evaluate the effectiveness, accessibility, and quality of personal and population-based services.
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