Publications by authors named "Ofer Amram"

Background: Addressing key behavioral risk factors for chronic diseases, such as diet, requires innovative methods to objectively measure dietary patterns and their upstream determinants, notably the food environment. Although GIS techniques have pushed the boundaries by mapping food outlet availability, they often simplify food access dynamics to the vicinity of home addresses, possibly misclassifying neighborhood effects. Leveraging Google Location History Timeline (GLH) data offers a novel approach to assess long-term patterns of food outlet utilization at an individual level, providing insights into the relationship between food environment interactions, diet quality, and health outcomes.

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We investigated associations between neighborhood walkability and physical activity using twins (5477 monozygotic and same-sex dizygotic pairs) as "quasi-experimental" controls of genetic and shared environment (familial) factors that would otherwise confound exposure-outcome associations. Walkability comprised intersection density, population density, and destination accessibility. Outcomes included self-reported weekly minutes of neighborhood walking and moderate-to-vigorous physical activity (MVPA) and days per week using transit services (eg, bus, commuter rail).

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Background: Outdoor physical activity (PA) is an important component of overall health; however, it is difficult to measure. Passively collected smartphone location data like Google Location History (GLH) present an opportunity to address this issue.

Objectives: To evaluate the use of GLH data for measuring outdoor PA.

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Objective: Proximity to mental health services is a predictor of timely access to services. The present study sought to investigate whether travel time was associated with engagement in coordinated specialty care (CSC) for early psychosis, with specific attention to whether the interaction of travel time by race and ethnicity had differential impact.

Data Source/study Setting: Data collected between 2019 and 2022 as part of the New Journeys evaluation, the CSC model in Washington State.

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Importance: The impact of cumulative exposure to neighborhood factors on psychosis, depression, and anxiety symptom severity prior to specialized services for psychosis is unknown.

Objective: To identify latent neighborhood profiles based on unique combinations of social, economic, and environmental factors, and validate profiles by examining differences in symptom severity among individuals with first episode psychosis (FEP).

Design, Setting, And Participants: This cohort study used neighborhood demographic data and health outcome data for US individuals with FEP receiving services between January 2017 and August 2022.

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Background: This study evaluates relationships among race, access to endoscopy services, and colorectal cancer (CRC) mortality in Washington state (WA).

Methods: We overlayed the locations of ambulatory endoscopy services with place of residence at time of death, using Department of Health data (2011-2018). We compared CRC mortality data within and outside a 10 ​km buffer from services.

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Article Synopsis
  • The study aims to analyze the distances women travel for breast cancer screenings and treatments in Washington State, focusing on differences between rural and urban areas.
  • The research utilized data from a major healthcare system and applied statistical models to explore how travel distances relate to patients' sociodemographic factors.
  • Findings reveal that travel distances are generally longer for non-core metropolitan areas and that certain racial/ethnic groups, like AI/AN and Hispanic women, face greater travel burdens compared to others; further investigation is suggested to address these inequities.
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Background: The burden of drug overdose mortality varies by race and ethnicity, with American Indian/Alaska Native (AI/AN), Black, and White people experiencing the largest burden. We analyzed census block group data to evaluate differences in travel distance to opioid treatment programs (OTP) and buprenorphine providers by race and ethnicity.

Methods: The Substance Abuse and Mental Health Services Administration provided the addresses of OTPs and buprenorphine providers.

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An exemption to existing U.S. regulation of methadone maintenance therapy after the onset of the COVID-19 pandemic permitted increased take-home doses beginning March 2020.

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Introduction: In response to the COVID-19 pandemic, countries across the world made adaptations to policies regulating the provision of methadone maintenance therapy (MMT) to facilitate social distancing for health care providers and people in treatment. Many countries issued guidance about increasing take-home methadone doses after the onset of the pandemic.

Methods: In this review, we compare the regulation of MMT prior to the pandemic in the United States, Canada, and Australia, analyze changes to treatment policy in the context of COVID-19, and review emerging data on treatment outcomes.

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A 19-year-old woman originally from the Republic of the Marshall Islands presented with diffuse pneumonia and acute hypoxemic respiratory failure. She dies one month into her hospitalization but the diagnosis of pulmonary tuberculosis (TB) was not made until one day before her demise. A contact investigation screened a total of 155 persons with 36 (23%) found to have latent TB infection and seven (4.

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Objectives: We sought to compare timely access to methadone treatment in the United States (US) and Canada during the COVID-19 pandemic.

Methods: We conducted a cross-sectional study of census tracts and aggregated dissemination areas (used for rural Canada) within 14 US and 3 Canadian jurisdictions in 2020. We excluded census tracts or areas with a population density of less than one person per square km.

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Background: Perceptions of the built environment, such as nature quality, beauty, relaxation, and safety, may be key factors linking the built environment to human health. However, few studies have examined these types of perceptions due to the difficulty in quantifying them objectively in large populations.

Objective: To measure and predict perceptions of the built environment from street-view images using crowd-sourced methods and deep learning models for application in epidemiologic studies.

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Background: Environmental exposures are commonly estimated using spatial methods, with most epidemiological studies relying on home addresses. Passively collected smartphone location data, like Google Location History (GLH) data, may present an opportunity to integrate existing long-term time-activity data.

Objectives: We aimed to evaluate the potential use of GLH data for capturing long-term retrospective time-activity data for environmental health research.

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Background: Routine screening mammography at two-year intervals is widely recommended for the prevention and early detection of breast cancer for women who are 50 years + . Racial and other sociodemographic inequities in routine cancer screening are well-documented, but less is known about how these long-standing inequities were impacted by the disruption in health services during the COVID-19 pandemic. Early in the pandemic, cancer screening and other prevention services were suspended or delayed, and these disruptions may have had to disproportionate impact on some sociodemographic groups.

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Introduction: Studies have shown that cancer screenings dropped dramatically following the onset of the coronavirus diseases 2019 (COVID-19) pandemic. In this study, we examined differences in rates of cervical and colorectal cancer (CRC) screening and diagnosis indicators before and during the first year of the COVID-19 pandemic.

Methodology: We used retrospective data from a large healthcare system in Washington State.

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Purpose: Racial and ethnic minorities in the state of Washington experience higher cancer mortality relative to whites. We sought to characterize differences in travel distance to radiation therapy (RT) facilities in Washington by race and ethnicity with a special focus on non-Hispanic American Indians and Alaska Natives as a contributor to limited access and cancer disparities.

Methods And Materials: Geocoded mortality data from Washington Department of Health (2011-2018) were used to identify decedents with mortality related to all-causes, all cancers, and cancers likely requiring access to RT.

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Background: Background: In response to the COVID-19 pandemic, the US Substance Abuse and Mental Health Services Administration (SAMHSA) allowed for an increase in methadone take-home doses for the treatment of Opioid Use Disorder (OUD) in March 2020.

Objective: To evaluate the effects of the SAMSHA exemption on methadone adherence and OUD-related outcomes.

Methods: A convenience sample of 183 clients (58% female) were recruited from a methadone clinic in the fall of 2019 for a cross-sectional survey.

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Introduction: In response to the COVID-19 pandemic, a federal exemption allowed stable and less stable patients greater take-home doses of methadone. We assessed the adoption of increased take-home medication during COVID-19 and whether increased take-home doses is associated with clients' characteristics.

Methodology: We completed a pre-post study of adults receiving methadone for OUD from an OTP in Spokane, Washington.

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Background: Lockdown measures because of COVID-19 are likely to result in deteriorating physical and mental health. In this study, our aim was to assess the impact of media exposure on increases in substance use during the COVID-19 pandemic.

Methods: A nationally representative online survey of 1264 adults was collected during the pandemic in the United States.

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Studies often rely on home locations to access built environment (BE) influences on physical activity (PA). We use GPS and accelerometer data collected for 288 individuals over a two-week period to examine eight GPS-derived BE characteristics and moderate-to-vigorous PA (MVPA) and light-to-moderate-vigorous PA (LMVPA). NDVI, parks, blue space, pedestrian-orientated intersections, and population density were associated with increased odds of LMVPA and MVPA, while traffic air pollution and noise were associated with decreased odds of LMVPA and MVPA.

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This cohort study investigates the rates of breast cancer screening before and during the COVID-19 pandemic among women in Washington State.

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Objectives: Disparities in access to medication-assisted treatment are a major problem. This study estimated and compared drive time to the nearest opioid treatment program (OTP) and office-based buprenorphine treatment (OBBT) across the urban-rural continuum in the U.S.

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