A randomized controlled trial of Native CHOICES: Impact on alcohol-exposed pregnancy risk reduction among American Indian and Alaska Native women.

Background: Prevention of alcohol-exposed pregnancy (AEP) involves reducing risky alcohol consumption among women at-risk for pregnancy, using effective contraception among women drinking at risky levels to prevent pregnancy, or both. This study presents the outcomes of a randomized controlled trial assessing the efficacy of Native CHOICES, a culturally tailored adaptation of the CHOICES intervention, among American Indian/Alaska Native (AI/AN) women.

Methods: AI/AN women aged 18-44 who were at-risk for an AEP were randomly assigned in a 1:1 ratio to either the Native CHOICES intervention or a waitlist control group.

Measuring the Direct Medical Costs of Hospital-Onset Infections Using an Analogy Costing Framework.

Background: The majority of recent estimates on the direct medical cost attributable to hospital-onset infections (HOIs) has focused on device- or procedure-associated HOIs. The attributable costs of HOIs that are not associated with device use or procedures have not been extensively studied.

Objective: We developed simulation models of attributable cost for 16 HOIs and estimated the total direct medical cost, including nondevice-related HOIs in the USA for 2011 and 2015.

The cost-efficacy of a healthy food box for managing hypertension within a native American population: a group randomized controlled trial.

Background: Dietary interventions are used for the treatment of hypertension. We evaluated the cost-efficacy of delivering boxes of healthy, culturally tailored foods and checks that can only be spent on produce in a Native American population.

Methods: We conducted a group randomized controlled trial from 2018 to 2020 with N = 2 treatment counties and N = 2 control counties and a total of N = 160 Native American adults with baseline stage 1 or stage 2 hypertension.

The use of patient navigation to transition detoxification patients to substance use treatment in the Alaska Interior.

Objectives: Detoxification clinics manage acute intoxication and withdrawal from alcohol and other drugs. At discharge, patients are referred to treatment, yet many are readmitted to detoxification, creating a "revolving door" of discharges and admissions. This pattern disproportionately affects some groups such as Alaska Native and American Indian (AN/AI) people.

Leaving the labor market: Exit routes, personality traits and well-being.

In this paper we examine the buffering effects of personality traits when people leave their work in later life. Using large-scale panel data for the UK, we show that depending on the exit route and satisfaction related to overall life and the domains of income and leisure, different personality traits act as moderators. Besides augmenting leisure satisfaction for those who hit mandatory retirement, conscientiousness augments life satisfaction for those becoming unemployed.

Choice of home blood pressure monitoring device: the role of device characteristics among Alaska Native and American Indian peoples.

Background: Home blood pressure monitoring (HBPM) is an effective tool in treatment and long-term management of hypertension. HBPM incorporates more data points to help patients and providers with diagnosis and management. The characteristics of HBPM devices matter to patients, but the relative importance of the characteristics in choosing a device remains unclear.

GEOGRAPHICAL ACCESS TO RECREATIONAL MARIJUANA.

We investigate whether adult marijuana use in Washington responds to increased local access as measured by drive time to the nearest legal marijuana retailer as well as measures of retail density. Using survey data from the Behavioral Risk Factor Surveillance System, we find that as retailers open closer to where they live, more individuals use marijuana and more frequently. These effects are concentrated among young adults (ages 18-26), women, and rural residents.

Home Blood Pressure Monitoring Devices: Device Performance in an Alaska Native and American Indian Population.

Home blood pressure monitoring (HBPM) is an important component of blood pressure (BP) management. We assessed performance of two HBPM devices among Alaska Native and American Indian people (ANAIs). We measured BP using Omron BP786 arm cuff, Omron BP654 wrist cuff, and Baum aneroid sphygmomanometer in 100 ANAIs.

A culturally tailored intervention to reduce risk of alcohol-exposed pregnancies in American Indian communities: Rationale, design, and methods.

Introduction: Prenatal exposure to alcohol can cause lifelong physical and cognitive challenges in the form of fetal alcohol syndrome and other fetal alcohol spectrum disorders (FASDs). The prevention of prenatal alcohol exposure is thus a public health priority - and one that should account for the particular needs of subpopulations, including in American Indian/Alaska Native (AI/AN) communities. Prior to conception, alcohol-exposed pregnancy prevention is accomplished by encouraging the reduction or elimination of risky alcohol use and/or promoting effective contraceptive use among risky drinkers who could become pregnant.

Emergency department utilization among individuals with idiopathic intracranial hypertension.

Purpose: Idiopathic intracranial hypertension (IIH) can be a debilitating disorder that is difficult to identify and treat. Failure to adequately manage IIH symptoms may force patients to present at emergency departments (EDs) seeking symptom relief. The purpose of this paper is to empirically characterize ED use by previously diagnosed IIH patients.

The "Real" Number of Washington State Adolescents Using Marijuana, and Why: A Misclassification Analysis.

Background: Although causality is difficult to establish, the regular use of marijuana has been associated with many adverse physiological and sociological consequences. There is considerable concern regarding marijuana use among adolescents, as the likelihood of adverse consequences increases significantly for this age group. The most comprehensive data for identifying risk factors for adolescent marijuana use is typically self-report, which may be over- or under-reported for a variety of reasons, including stigmatization, peer-pressure, or fear of being discovered.

Recreational marijuana legalization and college student use: Early evidence.

We analyze marijuana use by college undergraduates before and after legalization of recreational marijuana. Using survey data from the National College Health Assessment, we show that students at Washington State University experienced a significant increase in marijuana use after legalization. This increase is larger than would be predicted by national trends.

SYSTEMATICALLY MISCLASSIFIED BINARY DEPENDENT VARIABLES.

When a binary dependent variable is misclassified, that is, recorded in the category other than where it really belongs, probit and logit estimates are biased and inconsistent. In some cases the probability of misclassification may vary systematically with covariates, and thus be endogenous. In this paper we develop an estimation approach that corrects for endogenous misclassification, validate our approach using a simulation study, and apply it to the analysis of a treatment program designed to improve family dynamics.

Opioid misuse among adolescents: new evidence from a misclassification analysis.

Background: Non-medical prescription-opioid (NMPO) use has been declared a national epidemic in the US. Opioid misuse is associated with substantial physiological, psychological, and concomitant economic implications. NMPO use among adolescents warrants special attention given its prevalence and the high risk of addiction.

The Pot Calling the Kettle Black? A Comparison of Measures of Current Tobacco Use.

Researchers often use the discrepancy between self-reported and biochemically assessed active smoking status to argue that self-reported smoking status is not reliable, ignoring the limitations of biochemically assessed measures and treating it as the gold standard in their comparisons. Here, we employ econometric techniques to compare the accuracy of self-reported and biochemically assessed current tobacco use, taking into account measurement errors with both methods. Our approach allows estimating and comparing the sensitivity and specificity of each measure without directly observing true smoking status.

'Behold, a virgin is with HIV!' misreporting sexual behavior among infected adolescents.

In four Southern African countries where the HIV prevalence rate is among the highest in the world, 46.4% of a sample of female adolescents infected with HIV report having never engaged in sex. This would indicate either the dominance of non-sexual modes of HIV transmission or rampant misreporting of sexual behavior in the sample.

Selection effects and prevention program outcomes.

A primary goal of the paper is to provide an example of an evaluation design and analytic method that can be used to strengthen causal inference in nonexperimental prevention research. We used this method in a nonexperimental multisite study to evaluate short-term outcomes of a preventive intervention, and we accounted for effects of two types of selection bias: self-selection into the program and differential dropout. To provide context for our analytic approach, we present an overview of the counterfactual model (also known as Rubin's causal model or the potential outcomes model) and several methods derived from that model, including propensity score matching, the Heckman two-step approach, and full information maximum likelihood based on a bivariate probit model and its trivariate generalization.

Participation in Universal Prevention Programs.

We analyze family decisions to participate in community-based universal substance-abuse prevention programs through the framework of expected utility theory. Family functioning, which has been shown to be a good indicator of child risk for substance abuse, provides a useful reference point for family decision making. Our results show that well-functioning families (with children at low risk for substance use) should have the lowest incentive to participate, but that high-risk families may also opt out of prevention programs.

Measuring bias in self-reported data.

Response bias shows up in many fields of behavioural and healthcare research where self-reported data are used. We demonstrate how to use stochastic frontier estimation (SFE) to identify response bias and its covariates. In our application to a family intervention, we examine the effects of participant demographics on response bias before and after participation; gender and race/ethnicity are related to magnitude of bias and to changes in bias across time, and bias is lower at post-test than at pre-test.

Measuring shared inefficiency between hospital cost centers.

In this article, a combination of data envelopment analysis, spreadsheet modeling and regression techniques is applied to a panel of nonprofit Washington State hospitals in an effort to determine whether (and if so, to what extent) inefficiency in one hospital cost center is shared with inefficiency in other cost centers. The findings suggest that a significant amount of inefficiency is shared across hospital cost centers. The authors further determine that certain cost centers contribute more to the overall performance of a given hospital than others.

Idiopathic intracranial hypertension in the USA: the role of obesity in establishing prevalence and healthcare costs.

This study documents for the first time the extraordinary costs to take care of patients with a chronic, non-fatal, relatively rare disorder who have been incorrectly thought to have an insignificant and self-limiting illness. Idiopathic intracranial hypertension (IIH) occurs worldwide and in all racial groups and is found predominantly in obese women (∼ 90%) of childbearing age. Although the incidence of IIH is increasing as a result of the rapid increase in obesity, the disorder in general receives little recognition, and no recognition of the extensive burden of healthcare costs placed on patients, their families and society.

Detecting selection effects in community implementations of family-based substance abuse prevention programs.

To calculate valid estimates of the costs and benefits of substance abuse prevention programs, selection effects must be identified and corrected. A supplemental comparison sample is typically used for this purpose, but in community-based program implementations, such a sample is often not available. We present an evaluation design and analytic approach that can be used in program evaluations of real-world implementations to identify selection effects, which in turn can help inform recruitment strategies, pinpoint possible selection influences on measured program outcomes, and refine estimates of program costs and benefits.

Determining factors in the treatment choice of patients with hypertension with complications and secondary hypertension.

Purpose: The purpose of this article is to analyze the effects patients' socioeconomic characteristics, along with hospital size and location, had on the initial treatment choice for individuals with hypertension with complications and secondary hypertension.

Design/method/approach: The analysis uses retrospective data and binary logistic regression to analyze treatment choice determinants. Initial diagnostic and/or therapeutic procedures were categorized as invasive or non-invasive, which served as the dependent variable.