Post-incarceration outcomes of a comprehensive statewide correctional MOUD program: a retrospective cohort study.

Background: As opioid overdoses surge, medications for opioid use disorder (MOUD) remain underutilized. MOUD is rarely offered in correctional facilities although individuals involved in the criminal justice system have higher rates of OUD and mortality relative to the general population.

Methods: A retrospective cohort design examined the effect of MOUD while incarcerated on 12 months post-release treatment engagement and retention, overdose mortality, and recidivism.

Long-term effect of field triage on times to endovascular treatment for emergent large vessel occlusion.

Background: Delays to endovascular therapy (EVT) for stroke may be mitigated with direct field triage to EVT centers. We sought to compare times to treatment over a 5.5 year span between two adjacent states, one with field triage and one without, served by a single comprehensive stroke center (CSC).

Beyond HIV outbreaks: protocol, rationale and implementation of a prospective study quantifying the benefit of incorporating viral sequence clustering analysis into routine public health interventions.

Introduction: HIV continues to have great impact on millions of lives. Novel methods are needed to disrupt HIV transmission networks. In the USA, public health departments routinely conduct contact tracing and partner services and interview newly HIV-diagnosed index cases to obtain information on social networks and guide prevention interventions.

Statewide Longitudinal Trends in Transmitted HIV-1 Drug Resistance in Rhode Island, USA.

Background: HIV-1 transmitted drug resistance (TDR) remains a global challenge that can impact care, yet its comprehensive assessment is limited and heterogenous. We longitudinally characterized statewide TDR in Rhode Island.

Methods: Demographic and clinical data from treatment-naïve individuals were linked to protease, reverse transcriptase, and integrase sequences routinely obtained over 2004-2020.

Preventing Overdose Using Information and Data from the Environment (PROVIDENT): protocol for a randomized, population-based, community intervention trial.

Background And Aims: In light of the accelerating drug overdose epidemic in North America, new strategies are needed to identify communities most at risk to prioritize geographically the existing public health resources (e.g. street outreach, naloxone distribution efforts).

Longitudinal typing of molecular HIV clusters in a statewide epidemic.

Background: HIV molecular epidemiology is increasingly integrated into public health prevention. We conducted cluster typing to enhance characterization of a densely sampled statewide epidemic towards informing public health.

Methods: We identified HIV clusters, categorized them into types, and evaluated their dynamics between 2004 and 2019 in Rhode Island.

Rhode Island's Opioid Overdose Hospital Standards and Emergency Department Naloxone Distribution, Behavioral Counseling, and Referral to Treatment.

Study Objective: We sought to determine the influence of the Levels of Care for Rhode Island Emergency Departments and Hospitals for Treating Overdose and Opioid Use Disorder (Levels of Care) on emergency department (ED) provision of take-home naloxone, behavioral counseling, and referral to treatment.

Methods: A retrospective analysis of Rhode Island ED visits for opioid overdose from 2017 to 2018 was performed using data from a statewide opioid overdose surveillance system. Changes in provision of take-home naloxone, behavioral counseling, and referral to treatment before and after Levels of Care implementation were assessed using interrupted time series analysis.

Seroprevalence of SARS-CoV-2 Antibodies in Rhode Island From a Statewide Random Sample.

To characterize statewide seroprevalence and point prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Rhode Island. We conducted a cross-sectional survey of randomly selected households across Rhode Island in May 2020. Antibody-based and polymerase chain reaction (PCR)-based tests for SARS-CoV-2 were offered.

Empirical comparison of analytical approaches for identifying molecular HIV-1 clusters.

Public health interventions guided by clustering of HIV-1 molecular sequences may be impacted by choices of analytical approaches. We identified commonly-used clustering analytical approaches, applied them to 1886 HIV-1 Rhode Island sequences from 2004-2018, and compared concordance in identifying molecular HIV-1 clusters within and between approaches. We used strict (topological support ≥ 0.

Challenges in evaluating the use of viral sequence data to identify HIV transmission networks for public health.

Great efforts are devoted to end the HIV epidemic as it continues to have profound public health consequences in the United States and throughout the world, and new interventions and strategies are continuously needed. The use of HIV sequence data to infer transmission networks holds much promise to direct public heath interventions where they are most needed. As these new methods are being implemented, evaluating their benefits is essential.

Impact of State Regulations on Initial Opioid Prescribing Behavior in Rhode Island.

The opioid epidemic presents an urgent public health problem. Rhode Island has enacted comprehensive rules to address primary prevention of opioid overdose. This study evaluates the efficacy of those regulations in altering prescribing behavior, specifically regarding the initial prescription.

Increased Risk of Opioid Overdose Death Following Cold Weather: A Case-Crossover Study.

Background: The United States is in the midst of an opioid overdose crisis. Little is known about the role of environmental factors in increasing risk of fatal opioid overdose.

Methods: We conducted a case-crossover analysis of 3,275 opioid overdose deaths recorded in Connecticut and Rhode Island in 2014-2017.

Emergency Department and Hospital Care for Opioid Use Disorder: Implementation of Statewide Standards in Rhode Island, 2017-2018.

In March 2017, Rhode Island released treatment standards for care of adult patients with opioid use disorder. These standards prescribe three levels of hospital and emergency department treatment and prevention of opioid use disorder and opioid overdose and mechanisms for referral to treatment and epidemiological surveillance. By June 2018, all Rhode Island licensed acute care facilities had implemented policies meeting the standards' requirements.

A Behavioral Health Survey of Primary Care Integration in Rhode Island.

Background: Integrating behavioral and primary care practices improves quality of care, but limited data exists regarding the extent or attributes of such integration. We conducted a baseline evaluation of the level and characteristics of integrated practices in Rhode Island.

Methods: The Rhode Island Department of Health 2015 Statewide Health Inventory Behavioral Health Survey was sent to behavioral health clinics and outpatient psychiatry and psychology practices.

A Nearly 50% Decrease in New HIV Diagnoses in Rhode Island from 2006-2016: Implications for Policy Development and Prevention.

In the last decade, reductions in HIV incidence have been observed across the United States. However, HIV continues to disproportionately impact gay, bisexual, and other men who have sex with men (MSM). In Rhode Island, rates of HIV diagnoses have decreased by 44% across all groups over the last decade.

Overview of Antimicrobial Stewardship Activities in Rhode Island.

Due to the rise of antibiotic resistance, and the decrease of novel antibiotics coming to market, the Centers for Disease Control and Prevention (CDC) has formally recognized that action must take place to ensure appropriate antibiotic use, and maintain public health. The RI Department of Health (RIDOH) Director responded by initiating the RI Antimicrobial Stewardship and Environmental Cleaning Task Force (RIAMSEC), a multidisciplinary team that set in motion a set of tasks for RIDOH. As a result, a survey of antibiotic stewardship programs (ASP) at the RI acute care hospitals (ACHs) and long-term care (LTC) facilities revealed gaps in addressing HAI prevention and AMS goals for the state.

Postincarceration Fatal Overdoses After Implementing Medications for Addiction Treatment in a Statewide Correctional System.

This analysis examines the association of death from overdose among individuals released from the Rhode Island correctional system after implementation of a comprehensive program of medications for addiction therapy.