Relationship Between Cardiorespiratory Fitness, Weight Status, and Academic Performance: Longitudinal Evidence From 1 School District.

Objectives: We examined the longitudinal relationship between cardiovascular fitness (CRF) and academic performance (AP) among students in a diverse public school district. Furthermore, we determined whether the relationship between CRF and AP varied by student sociodemographic characteristics.

Methods: This study used data from 2005-2006 to 2008-2009.

Does behavioral health integration improve primary care providers' perceptions of health-care system functioning and their own knowledge?

Objective: To examine the impact of behavioral health integration (BHI) on primary care providers' (PCPs') (1) perceptions of behavioral health (BH)-primary care (PC) system functioning and (2) perceptions of their own knowledge regarding how to manage, triage, and access help in caring for patients with mental health conditions and substance use disorders.

Methods: We implemented BHI based on evidence-based models consisting of seven elements: (1)Screening for mental health and substance use disorders, (2)Training of PC teams, (3)Integration of BH providers into PC teams, (4)Roll-out of unlicensed mental health care managers and establishment of a BH registry, (5)Psychiatry consult service, (6)Site-based BHI meetings, and (7)Site self assessments. The intervention was rolled out in early integration sites during two years and late integration sites during the subsequent two years.

Effectiveness of IMPACT:Ability to Improve Safety and Self-Advocacy Skills in Students With Disabilities-Follow-Up Study.

Background: Research shows that individuals with disabilities are more likely to experience abuse than their peers without disabilities. Yet, few evidenced-based abuse prevention interventions exist. This study examines whether positive outcomes identified previously in an evaluation of IMPACT:Ability were maintained 1 year later.

The Impact of the Massachusetts Behavioral Health Child Screening Policy on Service Utilization.

Objective: In 2008, Massachusetts Medicaid implemented a pediatric behavioral health (BH) screening mandate. This study conducted a population-level, longitudinal policy analysis to determine the impact of the policy on ambulatory, emergency, and inpatient BH care in comparison with use of these services in California, where no similar policy exists.

Methods: With Medicaid Analytic Extract (MAX) data, an interrupted time-series analysis with control series design was performed to assess changes in service utilization in the 18 months (January 2008-June 2009) after a BH screening policy was implemented in Massachusetts and to compare service utilization with California's.

Effect of Pediatric Behavioral Health Screening and Colocated Services on Ambulatory and Inpatient Utilization.

Objective: The study sought to determine the impact of a pediatric behavioral health screening and colocation model on utilization of behavioral health care.

Methods: In 2003, Cambridge Health Alliance, a Massachusetts public health system, introduced behavioral health screening and colocation of social workers sequentially within its pediatric practices. An interrupted time-series study was conducted to determine the impact on behavioral health care utilization in the 30 months after model implementation compared with the 18 months prior.

Unauthorized Immigrants Prolong the Life of Medicare's Trust Fund.

Background And Objective: Unauthorized immigrants seldom have access to public health insurance programs such as Medicare Part A, which pays hospitals and other health facilities and is funded through the Medicare Trust Fund.

Design And Main Measures: We tabulated annual and total Trust Fund contributions and withdrawals by unauthorized immigrants (i.e.

A planned care approach and patient registry to improve adherence to clinical guidelines for the diagnosis and management of attention-deficit/hyperactivity disorder.

Background: Attention-deficit/hyperactivity disorder (ADHD) affects almost 2.4 million US children. Because American Academy of Pediatrics guidelines for ADHD recommend use of standardized diagnostic instruments, regular follow-up and the chronic care model, this pilot project sought to implement and assess an electronic registry of patients with ADHD combined with care coordination by a planned care team.

Effectiveness of the IMPACT:Ability program to improve safety and self-advocacy skills in high school students with disabilities.

Background: Individuals with disabilities experience higher rates of abuse than the nondisabled. Few evidence-based prevention interventions have been published despite a need for such work. This study evaluated

Impact: Ability, a safety and self-advocacy training for individuals with cognitive and/or physical disabilities.

Behavioral health services following implementation of screening in Massachusetts Medicaid children.

Objectives: To determine the relationship of child behavioral health (BH) screening results to receipt of BH services in Massachusetts Medicaid (MassHealth) children.

Methods: After a court decision, Massachusetts primary care providers were mandated to conduct BH screening at well-child visits and use a Current Procedural Terminology code along with a modifier indicating whether a BH need was identified. Using MassHealth claims data, a cohort of continuously enrolled (July 2007-June 2010) children was constructed.

Parents' obesity-related behavior and confidence to support behavioral change in their obese child: data from the STAR study.

Objective: Successful childhood obesity interventions frequently focus on behavioral modification and involve parents or family members. Parental confidence in supporting behavior change may be an element of successful family-based prevention efforts. We aimed to determine whether parents' own obesity-related behaviors were related to their confidence in supporting their child's achievement of obesity-related behavioral goals.

Referral and follow-up after mental health screening in commercially insured adolescents.

Purpose: Although mental health screening is recommended for adolescents, little is known about the predictors of referral to mental health services or engagement in treatment. We examined predictors of mental health referral from primary care and service use for commercially insured youth who had been screened using the Pediatric Symptom Checklist or Youth-Pediatric Symptom Checklist.

Methods: A retrospective chart review was conducted of commercially insured patients 14-17 years of age who were newly identified by the Pediatric Symptom Checklist or Youth-Pediatric Symptom Checklist at a well-child visit.

Screening for behavioral health issues in children enrolled in Massachusetts Medicaid.

Objectives: To understand mandated behavioral health (BH) screening in Massachusetts Medicaid including characteristics of screened children, predictors of positive screens, and whether screening identifies children without a previous BH history.

Methods: Massachusetts mandated BH screening in particularly among underidentified groups. 2008.

Evaluation results from an active living intervention in Somerville, Massachusetts.

Background: Community policies and programs can encourage active living and promote physical activity among residents. Somerville MA implemented an Active Living by Design project in 2003-2008 that promoted partnerships and advocacy to encourage physical activity.

Purpose: To evaluate the Active Living by Design project implemented in Somerville.

Structural and organizational characteristics associated with performance of essential public health services in small jurisdictions: findings from a statewide study in Massachusetts.

Background: This study examined jurisdictional, organizational, and structural characteristics associated with capacity to deliver 10 essential public health services (EPHS) in Massachusetts, a state where a majority of local public health departments serve small municipalities.

Design: A survey was administered to local health directors or board of health chairs.

Measures: The main outcome of the study was capacity to perform EPHS, measured by a 25-item screening tool.

Provider's perspectives on the impact of Immigration and Customs Enforcement (ICE) activity on immigrant health.

Introduction: Increasing Immigration and Customs Enforcement (ICE) activities such as raids, detention, and deportation may be affecting the health and well-being of immigrants. This study sought to understand the impact of ICE activities on immigrant health from the perspective of health care providers.

Methods: An online survey of primary care and emergency medicine providers was conducted to determine whether ICE activity was negatively affecting immigrant patients.

Predicting maintenance or achievement of healthy weight in children: the impact of changes in physical fitness.

Physical fitness is often inversely associated with adiposity in children cross-sectionally, but the effect of becoming fit or maintaining fitness over time on changes in weight status has not been well studied in children. We investigated the impact of changes in fitness over 1-4 years of follow-up on the maintenance or achievement of healthy weight among 2,793 schoolchildren who were first measured as 1st to 7th graders. Students were classified as "fit" or "underfit" according to age- and gender-specific norms in five fitness domains: endurance, agility, flexibility, upper body strength, and abdominal strength.

Investigating the myth of the "model minority": a participatory community health assessment of Chinese and Vietnamese adults.

Despite the persistent belief that Asians are the "model minority" there is accumulating evidence of health concerns within Asian subgroups. In this study, we implemented a cross-sectional participatory community health assessment in an urban city in Massachusetts, to understand differences and similarities in demographics, health and healthcare access in Chinese and Vietnamese adults. We gathered qualitative data from community stakeholders to inform the development of a community health assessment tool.

Asian student depression in American high schools: differences in risk factors.

There are inconsistent findings about depression in Asians. This study examined risk factors for depression in Asian and Caucasian adolescents. Stratified bivariate secondary analyses of risk indicators and depressed mood were performed in this cross-sectional study of high school survey data (9th to 12th grades) from 2,542 students (198 Asian).

Mental and behavioral health screening at preventive visits: opportunities for follow-up of patients who are nonadherent with the next preventive visit.

Objectives: To determine the type of subsequent care received by children nonadherent with their next preventive visit and whether behavioral factors predict use of emergency or acute care in this population.

Study Design: Data on 1703 children (4-16 years) screened at a preventive visit with the Pediatric Symptom Checklist (PSC)/Youth-PSC were examined to determine subsequent preventive care adherence (10-18 months later). Then, nonadherent children were monitored to determine whether they returned to their medical home for acute care, delayed preventive care, or visited the emergency department (ED).

Validity of estimated dietary eicosapentaenoic acid and docosahexaenoic acid intakes determined by interviewer-administered food frequency questionnaire among older adults with mild-to-moderate cognitive impairment or dementia.

Epidemiologic research is increasingly being focused on elderly persons, many of whom exhibit mild-to-moderate cognitive impairment. This presents a challenge for collection and interpretation of self-reported dietary data. There are few reports on the impact of cognitive function and dementia on the validity of self-reported dietary intakes.

The homocysteine hypothesis of depression.

High levels of homocysteine are associated with cerebrovascular disease, monoamine neurotransmitters, and depression of mood. A plausible hypothesis for these associations is that high homocysteine levels cause cerebral vascular disease and neurotransmitter deficiency, which cause depression of mood. The homocysteine depression hypothesis, if true, would mandate inclusions of imaging studies for cerebrovascular disease and measures of homocysteine, folate, and B12 and B6 vitamins in the clinical evaluation of older depressed patients.

The Nutrition, Aging, and Memory in Elders (NAME) study: design and methods for a study of micronutrients and cognitive function in a homebound elderly population.

Background: Micronutrient status can affect cognitive function in the elderly; however, there is much to learn about the precise effects. Understanding mediating factors by which micronutrient status affects cognitive function would contribute to elders' quality of life and their ability to remain in the home.

Objectives: The Nutrition, Aging, and Memory in Elders (NAME) Study is designed to advance the current level of knowledge by investigating potential mediating factors by which micronutrient status contributes to cognitive impairment and central nervous system abnormalities in the elderly.