Publications by authors named "Patricia Harrison"

Several recently published studies and consensus statements have demonstrated that there is only modest (and in many cases, low-quality) evidence that mobile health (mHealth) can improve patient clinical outcomes such as the length of stay or reduction of readmissions. There is also uncertainty as to whether mHealth can improve patient-centered outcomes such as patient engagement or patient satisfaction. One principal challenge behind the "effectiveness" research in this field is a lack of common understanding about what it means to be effective in the digital space (ie, what should constitute a relevant outcome and how best to measure it).

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Background: Despite the growth of and media hype about mobile health (mHealth), there is a paucity of literature supporting the effectiveness of widespread implementation of mHealth technologies.

Objective: This study aimed to assess whether an innovative mHealth technology system with several overlapping purposes can impact (1) clinical outcomes (ie, readmission rates, revisit rates, and length of stay) and (2) patient-centered care outcomes (ie, patient engagement, patient experience, and patient satisfaction).

Methods: We compared all patients (2059 patients) of participating orthopedic surgeons using mHealth technology with all patients of nonparticipating orthopedic surgeons (2554 patients).

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Background: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have published results.

Objective: To use an individual participant data meta-analysis to evaluate the accuracy of two PHQ-9 diagnostic algorithms for detecting major depression and compare accuracy between the algorithms and the standard PHQ-9 cutoff score of ≥10.

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Introduction Unmarried fathers in the U.S. face barriers to establishing a relationship with their newborn children that married fathers do not confront.

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Background: The objective of this study was to develop and validate a short form of the Patient Health Questionnaire-9 (PHQ-9), a self-report questionnaire for assessing depressive symptomatology, using objective criteria.

Methods: Responses on the PHQ-9 were obtained from 7,850 English-speaking participants enrolled in 20 primary diagnostic test accuracy studies. PHQ unidimensionality was verified using confirmatory factor analysis, and an item response theory model was fit.

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Objective: To examine the occurrence of psychosocial risk factors among expectant fathers whose female partners were enrolled in prenatal home visiting services.

Design: Cross-sectional, exploratory, quantitative design.

Sample: Expectant father-mother pairs were recruited from two urban home visiting programs to participate in a randomized controlled trial of a father advocate intervention.

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Background: Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used.

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Voluntary paternity establishment was placed in birthing hospitals by an act of Congress, but little is known about how unmarried parents experience this process. This study presents reactions from 81 racially/ethnically diverse, low-income parents. A qualitative analysis of semi-structured interviews revealed three overall themes and six subthemes: (1) paternity establishment process [subthemes: variety of experiences, strong emotional experience, and poor timing]; (2) meaning of paternity establishment [subthemes: responsible fatherhood, symbol of commitment to child, and importance of the child knowing his father's identity]; and (3) paternity establishment decision-making.

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Article Synopsis
  • The study investigated how depressive symptoms and social support affect late and inadequate prenatal care among low-income women at community health centers.
  • A significant portion of participants showed elevated depressive symptoms and poor social support, with 37% receiving late care and 29% receiving inadequate care.
  • Findings suggest that women with low partner support and elevated depressive symptoms were at the highest risk for late prenatal care, highlighting the need for public health strategies focused on enhancing social support and mental health in prenatal care settings.
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Background: Perinatal mental health problems are common complications of pregnancy that can go undetected and untreated. Research indicated that mental health complications are more prevalent in women from disadvantaged communities, yet women from these communities often experience barriers to accessing treatments and interventions. Untreated depression during pregnancy can lead to poor self-care, increased substance abuse, poor obstetrical outcomes, developmental delay in children, and increased risk of postpartum depression.

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A structured psychosocial risk screening interview, the Prenatal Risk Overview, was administered to 733 women in prenatal care. Either a community health worker (CHW) or a registered nurse (RN) conducted the interview based on day of the week. A comparison of identified risk factors found no significant differences between study samples for six of 13 domains.

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We characterized depressive symptoms in the prenatal and/or postpartum periods and examined associated risk factors among 594 women who received care at community health care centers. Women were screened with comprehensive risk assessments, which included the Patient Health Questionnaire-9 depression screen, during pregnancy and at least 4 weeks after delivery. Fifteen percent had depressive symptoms in the prenatal period only; 6 % in the postpartum period only, and 8 % had depressive symptoms in both periods.

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This study assessed the prevalence and interrelationships of posttraumatic stress disorder (PTSD), antecedent trauma, and psychosocial risk factors among pregnant women served at three urban Federally Qualified Health Care Centers. This analysis was part of a validation study of the prenatal risk overview, a structured psychosocial risk screening interview. The study sample included 745 prenatal patients at three clinics who also were administered the major depression, PTSD, alcohol, and drug use modules of the Structured Clinical Interview for DSM-IV (SCID).

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Objective: To validate the Prenatal Risk Overview (PRO) drug use questions against a structured diagnostic interview among pregnant women.

Design And Sample: Prenatal care patients were administered the PRO at intake and then asked to consent to a research diagnostic interview. Of 1,367 women asked to participate, 1,274 consented and 745 completed the study.

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The study was designed to validate the Patient Health Questionnaire (PHQ-9) for depression risk identification among pregnant women. Pregnant women were routinely administered the Prenatal Risk Overview, a comprehensive psychosocial screening interview, which included the PHQ-9, at their prenatal intake appointment at three community clinics. Study participants completed the Structured Clinical Interview for DSM-IV (SCID) at a later appointment.

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Evaluation of chronic care management (CCM) programs is necessary to determine the behavioral, clinical, and financial value of the programs. Financial outcomes of members who are exposed to interventions (treatment group) typically are compared to those not exposed (comparison group) in a quasi-experimental study design. However, because member assignment is not randomized, outcomes reported from these designs may be biased or inefficient if study groups are not comparable or balanced prior to analysis.

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Escalating health care expenditures highlight the need to identify modifiable predictors of short-term utilization and cost. Thus, the predictive value of individual well-being scores was explored with respect to 1-year health care expenditures and hospital utilization among 2245 employees and members of a health plan who completed the Well-Being Assessment (WBA). The relationship between well-being scores and hospital admissions, emergency room (ER) visits, and medical and prescription expenditures 12-months post WBA was evaluated using multivariate statistical models controlling for participant characteristics and prior cost and utilization.

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The purpose of the study was to validate the Prenatal Risk Overview (PRO) Alcohol use domain against a structured diagnostic interview. The PRO was developed to screen for 13 psychosocial risk factors associated with poor birth outcomes. After clinic staff administered the PRO to prenatal patients, they asked for consent to administration of selected modules of the structured clinical interview for DSM-IV (SCID) by a research assistant.

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The Prenatal Risk Overview (PRO) screens for 13 psychosocial risk factors associated with poor birth outcomes. This study assessed the extent to which risk factors unreported during an intake interview were identified during a subsequent interview. A total of 708 pregnant women were screened and re-screened at three urban community health care centers between July 2007 and April 2010.

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Abstract Recurrent hospitalizations are responsible for considerable health care spending, although prior studies have shown that a substantial proportion of readmissions are preventable through effective discharge planning and patient follow-up after the initial hospital visit. This retrospective cohort study was undertaken to determine whether telephonic outreach to ensure patient understanding of and adherence to discharge orders following a hospitalization is effective at reducing hospital readmissions within 30 days after discharge. Claims data were analyzed from 30,272 members of a commercial health plan who were discharged from a hospital in 2008 to determine the impact of telephonic intervention on the reduction of 30-day readmissions.

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This study describes a community outreach project designed to increase access to reproductive health services to young African American men living in low-income urban neighborhoods. The project examined the effectiveness of providing community-based outreach and health education on increasing sexually transmitted disease (STD) screening. Outreach workers provided STD education and risk assessment in community settings, including street corners, parks, schools, and community centers.

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Objectives: This study examines alcohol and nonmedical drug use before and during pregnancy and identifies the predictors of use cessation before the first prenatal visit.

Methods: Data analyses were based on the Prenatal Risk Overview (PRO), a structured interview that screens for psychosocial risk factors associated with poor birth outcomes. The study sample includes 1,492 consecutive prenatal care patients from four urban clinics between November 2005 and June 2007.

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