Considerations for Behavioral Health Integration Program Implementation in Pediatric Primary Care Settings: A Qualitative Study.

Background: More than 16% of children in the U.S. have a behavioral health (BH) disorder but less than half receive recommended care.

Health Insurance Type and Outpatient Specialist Care Among Children With Asthma.

Importance: Although children with asthma are often successfully treated by primary care clinicians, outpatient specialist care is recommended for those with poorly controlled disease. Little is known about differences in specialist use for asthma among children with Medicaid vs private insurance.

Objective: To examine differences among children with asthma regarding receipt of asthma specialist care by insurance type.

Differences in Health Care Utilization for Asthma by Children with Medicaid versus Private Insurance.

Asthma is the most common chronic disease in children, disproportionately affects families with lower incomes, and is a leading reason for acute care visits and hospitalizations. This retrospective cohort study used the Massachusetts All Payer Claims Database (2014-2018) to examine differences in acute care utilization and quality of care for asthma between Medicaid- and privately insured children in Massachusetts. Outcomes included acute care use (emergency department [ED] or hospitalization), ED visits with asthma, routine asthma visits, and filled prescriptions for asthma medications.

Readiness to Implement a Doula-Hospital Partnership Program.

Objective: To assess obstetric clinicians' and leaders' baseline knowledge, attitudes, and experience with doulas and their readiness to implement a novel doula-hospital partnership program.

Design: Survey of obstetric clinicians and leaders before implementation of the doula program.

Setting/local Problem: Academic medical center in Western Massachusetts that was preparing to pilot a doula-hospital partnership program with Black doulas for Black women to address racial disparities in maternal morbidity and mortality.

Barriers and Facilitators to Optimal Fluoride Varnish Application.

Objective: National guidelines recommend that all children under age six receive fluoride varnish (FV) in medical settings. However, application rates remain low. This study aimed to update understanding of barriers and facilitators to guideline concordant FV application.

Communication of COVID-19 Misinformation on Social Media by Physicians in the US.

Importance: Approximately one-third of the more than 1 100 000 confirmed COVID-19-related deaths as of January 18, 2023, were considered preventable if public health recommendations had been followed. Physicians' propagation of misinformation about COVID-19 on social media and other internet-based platforms has raised professional, public health, and ethical concerns.

Objective: To characterize (1) the types of COVID-19 misinformation propagated by US physicians after vaccines became available, (2) the online platforms used, and (3) the characteristics of the physicians spreading misinformation.

Online survey of consumer awareness and perceptions of a Massachusetts law for 12-month supply of contraception.

Objectives: This study aimed to characterize awareness of a 2017 Massachusetts (MA) law that ensures access to a 12-month supply of short-acting contraceptive methods (e.g., pill, patch, and vaginal ring) among short-acting contraceptive users in MA and to identify perceived benefits and concerns of a 12-month supply.

Knowledge, attitudes, and practices regarding COVID-19 among university students and employees in Massachusetts, USA: A qualitative study.

Objective: To explore the knowledge, attitudes, and practices regarding COVID-19 in university affiliates to inform future COVID-19 policies and practices.

Participants: Undergraduate students, graduate students and university employees at a large public university.

Methods: Semi-structured focus groups and interviews were conducted between December 2020 and January 2021.

Association Between Insurance Type and Fluoride Varnish Application During Well-Child Visits in Massachusetts.

Objective: To compare rates of fluoride varnish (FV) applications during well-child visits for children covered by Medicaid and private medical insurance in Massachusetts.

Methods: This cross-sectional study analyzed well-child visits for children aged 1 to 5 years paid by Medicaid and private insurance during 2016.Çô18 in Massachusetts.

Facilitators and Barriers to Care Coordination Between Medicaid Accountable Care Organizations and Community Partners: Early Lessons From Massachusetts.

Care coordination is central to health care delivery system reform efforts to control costs, improve quality, and enhance patient outcomes, especially for individuals with complex medical and social needs. The potential impact of addressing health-related social needs further illustrates the importance of coordinating health care services with community-based organizations that provide social services and support. This study offers early findings from a unique approach to care coordination delivered by 17 Medicaid Accountable Care Organizations and 27 partnering community-based organizations for individuals with behavioral health conditions and/or those needing long-term services and supports.

Influenza Vaccinations Among Privately and Publicly Insured Children With Asthma.

Objective: Annual influenza vaccination rates for children remain well below the Healthy People 2030 target of 70%. We aimed to compare influenza vaccination rates for children with asthma by insurance type and to identify associated factors.

Methods: This cross-sectional study examined influenza vaccination rates for children with asthma by insurance type, age, year, and disease status using the Massachusetts All Payer Claims Database (2014-2018).

A qualitative study of clinicians' perspectives on a law that allows for a 12-month supply of short-acting contraceptives in Massachusetts: Barriers and facilitators to implementation.

Objective: To explore clinicians' perspectives regarding the Massachusetts 2017 law, 'An Act Relative to Advancing Contraceptive Coverage and Economic Security in Our State' (ACCESS), including awareness of the law, perceived barriers and facilitators to successful implementation, and recommendations to improve uptake. ACCESS requires all insurers, except self-insured businesses, to cover short-acting reversible contraceptives (SARCs) at no cost to patients and for a 12-month supply to be prescribed/dispensed if desired after the completion of a three-month trial.

Data Sources And Study Setting: We collected primary data from clinicians in Massachusetts from February 1 to July 31, 2021.

Preventive care visits with OB/GYNs and generalist physicians among reproductive-age women with chronic conditions.

Objective: To examine services delivered during preventive care visits among reproductive-age women with and without chronic conditions by physician specialty.

Data Sources: National Ambulatory Medical Care Surveys (2011-2018).

Study Design: We examined provision of specific services during preventive care visits by physician specialty among reproductive-age female patients, overall and among women with five common chronic conditions (diabetes, hypertension, depression, hyperlipidemia, and asthma).

Variation in prices for an evidence-based pediatric preventive service.

Objective: To examine variation in prices paid by private medical insurers for fluoride varnish applications in medical settings, a newly reimbursed service that few children receive.

Data Sources: Private-insurance medical claims from Connecticut, Maine, New Hampshire, and Rhode Island (2016-2018).

Study Design: We examined prices paid for fluoride varnish by private insurers and compared these to prices paid by Medicaid.

A Qualitative Study of Health Workers' Experiences During Early Surges in the COVID-19 Pandemic in the U.S.: Implications for Ongoing Occupational Health Challenges.

Background: Health workers (HWs) have faced significant threats to physical and psychological health during the COVID-19 pandemic. The recent surges associated with the spread of the delta variant in the U.S.

Delivery of fluoride varnish during pediatric medical visits by rurality.

Objectives: To examine variation in the delivery of fluoride varnish during pediatric medical visits by rurality.

Methods: This observational study used private health insurance claims (2016-2018) for children aged 1-5 years from Connecticut, Maine, New Hampshire, and Rhode Island linked to the county-level Rural-Urban Continuum codes. County-level Rural-Urban Continuum codes were categorized into three groups: metropolitan, rural, and remote rural.

Variation in Current Guidelines for Fluoride Varnish Application for Young Children in Medical Settings in the United States.

Background: The United States Preventive Services Task Force recommends that medical providers apply fluoride varnish (FV) to the teeth of all children under 6 years of age, but fewer than 10% of eligible children receive FV as recommended. Prior studies suggest that variation in clinical guidelines is associated with low uptake of other evidence-based health-related interventions, but consistency of national guidelines for the delivery of FV in medical settings is unknown.

Methods: Eligible guidelines for application of FV in medical settings for children under 6 years of age were published in the past 10 years by national pediatric or dental professional organizations or by national public health entities.

Twelve-month supply of short-acting contraception methods: Pharmacists' perspectives on implementation of new state law.

Background: Oral contraceptives and other short-acting reversible contraceptive (SARC) methods such as the patch, vaginal ring, and medroxyprogesterone injections are used by approximately 30% of people using contraception. People may face barriers in obtaining a timely and adequate supply of their SARCs. It is well established that dispensing more than 1-month supply at a time is more convenient for patients, improves continuation, and decreases the risk of unintended pregnancy.

Considerations for Meeting Students' Mental Health Needs at a U.S. University During the COVID-19 Pandemic: A Qualitative Study.

Objective: To better understand the potential ongoing effects of the COVID-19 pandemic on U.S. university students' mental health and to generate hypotheses as to how universities may best meet students' mental health needs.

Evaluation of rapid telehealth implementation for prenatal and postpartum care visits during the COVID-19 pandemic in an academic clinic in Springfield, Massachusetts, United States of America.

Background And Aims: COVID-19 forced healthcare systems to implement telehealth programs, facilitated in Massachusetts by a policy requiring insurers to reimburse for telehealth visits. Prior studies suggest that telehealth is effective for obstetric care, but little is known about its implementation in response to policy changes in underserved communities. We utilized the RE-AIM framework to evaluate telehealth implementation in a large academic urban obstetric practice that serves a medically underserved population.

Community Perspectives on the Creation of a Hospital-Based Doula Program.

Racial and ethnic inequities in perinatal health outcomes are pervasive. Doula support is an evidence-based practice for improving maternal outcomes. However, women in lower-income populations often do not have access to doulas.

Dental Fluoride Varnish Application During Medical Visits Among Children Who Are Privately Insured.

This cross-sectional study examines fluoride varnish application rates during well-child medical visits and identify characteristics associated with fluoride varnish receipt.