Publications by authors named "Roxanne Muiruri"

Background: The Adult Changes in Thought (ACT) study is an ongoing population-based prospective cohort study that began in 1994 and aims to identify risk and preventive factors for dementia. ACT randomly selects and enrolls Kaiser Permanente Washington (KPWA) health plan members age ≥ 65 years. Historically, the cohort make up has been 88% non-Hispanic White participants.

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Background: Whether history of adverse pregnancy outcomes (APOs) contributes to cognitive decline in later life is not understood because few cohorts have information on pregnancy history and later-life cognition. We hypothesized that history of any APO would be related to lower global cognition and faster cognitive decline among older adults, compared to no APO history.

Method: The Adult Changes in Thought (ACT) Study is a prospective cohort study embedded in an integrated health care system of adults aged 65 and older without dementia at enrollment.

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Background: A self-administered tablet app, StaySafe, helps people under community supervision to make better decisions regarding health risk behaviors, especially those linked to HIV, viral hepatitis, and other sexually transmitted infections. The multi-session StaySafe design uses an interactive, analytical schema called WORKIT that guides users through a series of steps, questions, and exercises aimed at promoting critical thinking about health risks associated with substance use and unprotected sex. Repetition of the WORKIT schema is designed to enhance procedural memory that can be rapidly accessed when individuals are faced with making decisions about risky behaviors.

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Despite the high prevalence of substance use disorders among juvenile offenders, most do not receive services. System-level process improvement plans to address unmet service needs can be optimized by combining data-driven decisions and facilitated meetings with behavioral health stakeholders. This paper operationalizes and analyzes the level of specified complexity among process improvement plans evident within 36 juvenile probation and drug courts across 7 states.

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This paper describes the development and protocol for feasibility and efficacy testing of a risk reduction intervention designed to improve behavioral health outcomes among drug offenders on probation under community supervision or in residential substance abuse treatment centers. is a self-administered tablet-based intervention for teaching better decision-making skills regarding health risk behaviors, especially those involving HIV risks. We are using pre/post, experimental/control group randomized clinical trial (RCT) in both community and residential probation settings with goals to 1) assess the feasibility and acceptance of by examining participation rates and satisfaction measures, and 2) examine the impact of on decision-making skills, confidence and motivation to avoid sex and drug risks, willingness to discuss health risks and concerns with helpful others, and engagement in health risk behaviors.

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