Factors Associated with Physical Activity Increases and Decreases Among a Sample of Appalachian Residents During the COVID-19 Pandemic: A Cross-Sectional Study.

Introduction: Physical activity (PA) can prevent and reduce the deleterious physical and mental health effects of COVID-19 and associated lockdowns. Research conducted early in the pandemic demonstrates that a greater proportion of adults in the U.S.

Lessons learned from employing Medicaid-funded peer recovery support specialists in residential substance use treatment settings: An exploratory analysis.

Introduction: This article explores the experiences of peer recovery support specialists (PRSS) and their colleagues working in residential adult services (RAS) facilities in a rural state to better understand how the role has been implemented in this setting. In West Virginia, PRSS and RAS services have been covered by Medicaid since 2018 for the treatment of substance use disorder (SUD). Thus, the aim of this study is to uncover what has and has not worked well in the early years of service implementation from the perspectives of both PRSS and their colleagues working in the SUD field.

Drive Times to Methadone Treatment among Medicaid Patients.

Objective: To describe round-trip drive times and travel distance to methadone clinics among Medicaid enrollees in West Virginia, testing for differences between those in rural versus urban areas.

Findings: In this cross-sectional analysis of West Virginia Medicaid enrollees' claims from 2018-2019, methadone recipients on average traveled almost an hour round-trip to receive their daily treatment. The travel burden was substantially higher among those in more rural areas.

Using adverse childhood experiences to explore the usefulness of community health needs assessments to monitor complex determinants of health at the local level.

Background: Hospital led community health needs assessments (CHNAs) are intended to help medical care organizations assess determinants of health within the communities they serve. This study demonstrates the utility of data from non-profit hospital CHNAs to monitor complex health issues such as adverse childhood events (ACEs) at the local-level.

Methods: CHNA data were collected from August to November 2019 and analyzed July 2021.

Systematic Observation of Physical Distancing Behaviors of Trail Users During the COVID-19 Pandemic.

During the early months of the COVID-19 pandemic, opportunities for indoor and sometimes outdoor recreation were restricted across the world. Despite restrictions, many greenways and rail-trails saw increased use. Messaging from the federal and state public health authorities stressed the importance of social distancing and other preventive measures in reducing spread of the coronavirus.

Field Test of a Passive Infrared Camera for Measuring Trail-Based Physical Activity.

Trails are ubiquitous and far-reaching, but research on the impact trails have on physical activity is limited by the lack of resource-efficient, accurate, and practical systematic observation tools. Commonly used infrared trail sensors count trail use and may broadly differentiate activity (i.e.

School Climate as a Universal Intervention to Prevent Substance Use Initiation in Early Adolescence: A Longitudinal Study.

Initiation of substance use often starts during adolescence, with tobacco and alcohol use frequently preceding the use of marijuana and other illicit drugs. Studies suggest that a positive school climate may prevent substance use while promoting healthy student behaviors. The purpose of this study was to determine the longitudinal associations between school climate and substance use initiation in a group of middle school students.

The Importance of Individual-Site and System-Wide Community Health Needs Assessments.

In order to fulfill the Patient Protection and Affordable Care Act's Community Health Needs Assessment requirements, hospital systems sometimes vary in detail between individual hospital sites or locations and performing an assessment for the entire system. This article examines needs assessments and their accompanying implementation plans across a large university hospital system and finds support for conducting assessments at the local site-level but evidence that system-wide approaches may also have significant benefits, especially at the implementation phase. It suggests a hybrid approach to the needs assessment process where systems and their individual hospitals work together to maximize health benefits to the communities served.

Adoption and Reach of a statewide policy, systems, and environment intervention to increase access to fresh fruits and vegetables in West Virginia.

Food deserts-areas with limited access to affordable, healthy foods-are disproportionately in low-income areas of the USA and have been linked with poorer nutrition behaviors and health outcomes. From a social ecological perspective, increasing access to affordable fresh fruits and vegetables in communities should encourage consumption and health improvements. Change the Future West Virginia, a statewide intervention, was undertaken to make policy, system, and environment (PSE) changes to enhance access to fresh fruits and vegetables in schools, farmers markets, and retail food outlets.

Evaluability assessment of "growing healthy communities," a mini-grant program to improve access to healthy foods and places for physical activity.

Background: Mini-grants have been used to stimulate multisector collaboration in support of public health initiatives by funding non-traditional partners, such as economic development organizations. Such mini-grants have the potential to increase access to healthy foods and places for physical activity through built environment change, especially in small and rural towns in the United States. Although a promising practice, few mini-grant evaluations have been done.

Assessment and Response to Intimate Partner Violence in Home Visitation: A Qualitative Needs Assessment With Home Visitors in a Statewide Program.

There is growing recognition that home visitation programs serving at-risk families may be an appropriate mechanism for detecting and reducing intimate partner violence (IPV). More research is needed about how home visitors assess and respond to IPV, especially in rural and underserved areas with unique social and geographic challenges. This study describes the qualitative, needs assessment phase of a larger mixed-methods evaluation of IPV assessment, referral processes, and safety planning with clients within a statewide home visitation program.

Healthcare resource availability and cardiovascular health in the USA.

Objectives: Cardiovascular disease (CVD) remains the leading cause of death in the USA. Reducing the population-level burden of CVD disease will require a better understanding and support of cardiovascular health (CVH) in individuals and entire communities. The objectives for this study were to examine associations between community-level healthcare resources (HCrRes) and CVH in individuals and entire communities.

Evaluation of an Intimate Partner Violence Training for Home Visitors Using the Theory of Planned Behavior.

Introduction: Intimate partner violence (IPV) is a public health issue with recent intervention focus by home visiting programs with at-risk families in the United States. Home visitors are typically required to assess IPV but feel unprepared to do so and desire training. Our aim was to evaluate the impact of a daylong IPV training on the intention to enact three key IPV behaviors (screening, making referrals, and safety planning) using the theory of planned behavior.

Polypharmacy and Multimorbidity Among Medicaid Enrollees: A Multistate Analysis.

The purpose of this study is to explore the associations between polypharmacy and multimorbidity using conventional and novel measures of polypharmacy. In this cross-sectional study, data on fee-for-service (FFS) Medicaid enrollees with at least 1 chronic condition and aged 18-64 years (N = 38,329) were derived from the 2010 Medicaid Analytic eXtract (MAX) files of Maryland and West Virginia. Polypharmacy, by the authors' novel definition, was determined as simultaneous use of ≥5 drugs for a consecutive period of 60 days.

Prevalence and Geographic Variations of Polypharmacy Among West Virginia Medicaid Beneficiaries.

Background: West Virginia (WV) residents are at high risk for polypharmacy given its considerable chronic disease burdens.

Objective: To evaluate the prevalence, correlates, outcomes, and geographic variations of polypharmacy among WV Medicaid beneficiaries.

Methods: In this cross-sectional study, we analyzed 2009-2010 WV Medicaid fee-for-service (FFS) claims data for adults aged 18-64 (N=37,570).

The Impact of Community Input in Community Health Needs Assessments.

Objective: To determine the impact of community participation on nonprofit hospital priorities as outlined in a Community Health Needs Assessment.

Design: Using 3 completed Community Health Needs Assessments, we compare key stakeholder survey responses with community survey responses and determine their contribution to the finalized priorities.

Setting: Three communities in West Virginia served by nonprofit hospitals (1 metropolitan statistical area, 1 micropolitan statistical area, and 1 rural community).

Depression Treatment Among Elderly Medicare Beneficiaries With Incident Cases of Cancer and Newly Diagnosed Depression.

Objective: Depression treatment can improve the health outcomes of elderly cancer survivors. There is a paucity of studies on the extent to which depression is treated among elderly cancer survivors. Therefore, this study estimated the rates of depression treatment among elderly cancer survivors and identified the factors affecting depression treatment.

Cancer Type and Risk of Newly Diagnosed Depression Among Elderly Medicare Beneficiaries With Incident Breast, Colorectal, and Prostate Cancers.

Background: Elderly individuals (age >65 years) with cancer are at high risk for newly diagnosed depression after a cancer diagnosis. It is not known whether the risk of newly diagnosed depression varies by cancer type.

Purpose: To examine the variations in the risk of newly diagnosed depression by cancer type among elderly individuals with cancer.

Longitudinal Patterns of Emergency Department Visits: A Multistate Analysis of Medicaid Beneficiaries.

Objective: The objective of this study was to examine the longitudinal patterns of emergency department (ED) visits among adult fee-for-service Medicaid.

Data Sources: Data were obtained from the Medicaid analytic eXtract files, Area Health Resource File, and County Health Rankings.

Study Design: A retrospective longitudinal study design, with four observations for each individual was used.

Factors Associated With Emergency Department Visits: A Multistate Analysis of Adult Fee-for-Service Medicaid Beneficiaries.

Objective: The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia.

Methods: A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files.

Measuring policy and related effects of a health impact assessment related to connectivity.

Health Impact Assessments are an important tool to help policymakers perceive the potential positive and negative contributions of decisions to public health. While they have been increasingly used in the United States, studies have not examined intermediate effects. Using key stakeholder interviews, this manuscript examines policy outcomes and other related effects of the HIA 21months after completing a Health Impact Assessment Report around connectivity policy.

Reviewing risks and benefits of low-dose computed tomography screening for lung cancer.

Lung cancer is the third most common cancer among men and women and is one of the leading causes of cancer-related mortality. Diagnosis at an early stage has been suggested crucial for improving survival in individuals at high-risk of lung cancer. One potential facilitator to early diagnosis is low-dose computed tomography (LDCT).

Changing Awareness of the Health Insurance Marketplace.

The Health Insurance Marketplace was designed to increase the affordability of health insurance. The success of the marketplace depends on people's awareness and use of it. In a statewide mail survey of West Virginians, we found that respondents' awareness of the West Virginia Health Insurance Marketplace increased from 2013 to 2014.

Exploring Health Insurance Status and Emergency Department Utilization.

Emergency department (ED) use, by both insured and uninsured, leads to significant health care costs in the United States. While frequent ED use is often attributed to the uninsured, there is some evidence that insured populations also report utilizing the ED when otherwise preventable or nonurgent. We conducted in-person surveys of patients visiting the ED at a large research hospital and examined the differences in their characteristics based on the health insurance status.

Changes in Cardiovascular Health in the United States, 2003-2011.

Background: Cardiovascular disease is the leading cause of death in the United States, making improving cardiovascular health a key population health goal. As part of efforts to achieve this, the American Heart Association has developed the first comprehensive cardiovascular health index (CVHI). Our objective was to investigate the changes in CVHI in US states from 2003 to 2011.