Publications by authors named "Lori Bilello"

Article Synopsis
  • Two classes of glucose-lowering drugs (GLDs) show benefits in cardiovascular and renal health for patients with type 2 diabetes (T2D), yet minority groups face higher risks but lower access to these medications due to social determinants of health (SDOH).
  • The study aimed to find the link between contextual SDOH and the adoption of newer GLDs among Medicare beneficiaries, as well as exploring how these associations change geographically.
  • Among 795,469 Medicare beneficiaries with T2D, results indicated that GLD usage was inversely related to the percentage of non-Hispanic Black and Hispanic populations, unemployment rates, and positively correlated to median household income, highlighting geographic variations in these associations.
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Article Synopsis
  • The COVID-19 pandemic increased social media usage for support, leading to a study on its impact on adults in Florida's willingness to participate in COVID-19 research.
  • The research analyzed 587 participants and found no significant link between social media use and willingness to join treatment or vaccine studies, though racial and ethnic differences were notable.
  • Specifically, Hispanic/Latino and "Other" racial group participants showed a higher likelihood of participating, and females were more inclined to engage in vaccine research, indicating the need for culturally sensitive recruitment strategies.
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Article Synopsis
  • Racial and ethnic minorities face higher rates of type 2 diabetes (T2D) and related complications due to social factors that influence health outcomes.
  • To address these disparities, researchers developed a machine learning tool called the individualized polysocial risk score (iPsRS) that identifies T2D patients at high risk for hospitalization based on social determinants of health.
  • After adjusting for fairness across different racial and ethnic groups, the iPsRS demonstrated good predictive accuracy, achieving a C statistic of 0.71 for predicting hospitalizations within a year.
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Access to healthy foods, especially for those who are living with diabetes and hypertension, is crucial in managing these chronic diseases. This study evaluates the implementation of a food pharmacy and food prescription program at a safety-net hospital that serves vulnerable populations. Patients who screen as food insecure using the USDA adult food security survey receive a referral from the physician to the food pharmacy program where a dietician reviews their dietary requirements based on their chronic disease and develops a diet plan.

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The purpose of this report is to describe the community engagement research (CEnR) strategies used to implement the (FSRAS), a tri-institutional research project conducted during the height of the COVID-19 pandemic. We describe the CEnR strategies used to enroll adults aged ≥ 25 years old self-identifying as African American (AA), Caribbean (CN), or Hispanic/Latinx (H/L) into FSRAS health research studies. The second goal is to report the number of AA, CN, and H/L adults involved in FSRAS and discuss the implications of CEnR strategies used throughout this research.

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Given its role as a safety net institution, the University of Florida Health (UF Health) Jacksonville has responded to the community's needs through partnerships with the community for decades. Such academic-community partnerships have a broad emphasis on population health and primary care that expands the model of care to include community engagement, which allows such partnerships to promote health and well-being and reduce health inequalities by addressing social determinants of health (SDOH).This report describes the UF Health Jacksonville and University of Florida College of Medicine-Jacksonville's creation of the Urban Health Alliance (UHA) in June 2019 due to continued poor health outcomes and inequities within the community.

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Background: Racial and ethnic minority groups and individuals facing social disadvantages, which often stem from their social determinants of health (SDoH), bear a disproportionate burden of type 2 diabetes (T2D) and its complications. It is crucial to implement effective social risk management strategies at the point of care.

Objective: To develop an electronic health records (EHR)-based machine learning (ML) analytical pipeline to address unmet social needs associated with hospitalization risk in patients with T2D.

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Patients in historically underserved communities are most vulnerable to uncontrolled chronic conditions and report a lack of health knowledge to manage them. This report aims to describe the development of SMART MEDS, a pharmacy-led program implemented to address health literacy disparities among medically and socially vulnerable patients.

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Article Synopsis
  • * A study analyzed 6,719 T2D patients to identify adherence patterns, revealing four groups: continuously adherent, early discontinuers, late discontinuers, and intermediately adherent users.
  • * Factors like age, gender, race, duration of diabetes, and socioeconomic indicators (like income and education) significantly influenced medication adherence, with higher unemployment and lower income linked to poorer adherence.
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The prevalence of obesity is higher among Black women (56.6%) compared to Hispanic women (50%) and non-Hispanic White women (42%). Notably, interventions to reduce obesity typically result in initial weight loss that is not maintained.

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Objective: To study urban, predominantly Black women's expressed opinions and beliefs related to the use of contraceptives to better inform implementation strategies designed to increase the use of highly effective contraceptives among minoritized and low-income women.

Design: Focus group interviews with women, in conjunction with a community-based organization providing programs for underserved women with a mission of improved women and infant health.

Setting: Focus groups were conducted, and women were recruited from clinical sites in predominantly African American urban neighborhoods in a southeastern US city.

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Background: The US continues to face public health crises related to both chronic pain and opioid overdoses. Thirty percent of Americans suffer from chronic noncancer pain at an estimated yearly cost of over $600 billion. Most patients with chronic pain turn to primary care clinicians who must choose from myriad treatment options based on relative risks and benefits, patient history, available resources, symptoms, and goals.

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Non-Hispanic Black women have the highest rates of overweight/obesity of any group in the United States. To date, few interventions have worked to reduce overweight/obesity in this population. This study investigated the views of Black women with overweight and obesity treated in a primary care setting regarding desired and undesired verbal and non-verbal behaviours by providers in provider-patient clinical encounters focused on losing weight, maintaining weight loss, and/or obesity.

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Implementation research is intended to address challenges posed by the slow adoption of evidence-based science by the medical and health promotion practice community. A case study approach is used to illustrate and discuss the use of Quality improvement and Evaluation as an applied approach to implementation science in contrast of more classic purposes of research. Quality improvement was the implementation model used to facilitate organizational change needed to adopt the use of texting to report sexually transmitted infection test results in over a fifth of Florida's larger county health departments.

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Objectives: To identify important characteristics of quality improvement applications for population health and healthcare settings and to explore the use of quality improvement as a model for implementing and disseminating evidence-based or best practices.

Methods: A meta-synthesis was used to examine published quality improvement case studies. A total of 10 published studies that were conducted in Florida and Georgia were examined and synthesized using meta-synthesis (a qualitative research methodology) for meaningful insights and lessons learned using defined meta-synthesis inclusion criteria.

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Context: Sexually transmitted infections (STIs) continue to be a major health problem and source of health disparities in the United States. With diminishing resources, public health agencies are challenged to limit inefficient STI practices and still maintain effective population health.

Objective: The purpose of this study was to implement a text-messaging strategy to convey STI test results and to assess whether texting positive results was associated with a shorter treatment time frame.

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Background: Approximately 24 million Americans are living with diabetes. Patient activation among individuals with diabetes is critical to successful diabetes management. The Patient Centered Medical Home (PCMH) model holds promise for increasing patient activation in managing their health.

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The objective was to combine cost analysis and participatory research to identify actionable cost-saving opportunities in public health services for sexually transmitted infections (STI). This study used a mixed-methods approach of analyzing Florida public health data, combined with participatory research approaches to data collection including quantitative web-based surveys, qualitative in-depth interviews, and group discussions. Florida surveillance and administrative data on STIs and county health department (CHD) costs of services for 2012 were analyzed in addition to primary data collected from all Florida CHDs during 2014 and 2015.

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The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 aims to expand the use of electronic health records by offering financial incentives to physicians to fully adopt and implement them. We surveyed Florida physicians who deliver care to Medicaid participants to identify their interest in participating in the incentive program. More than 60 percent of all respondents expressed interest in applying for the incentives; of those already using electronic health record systems, 86 percent intend to apply for funding.

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