Publications by authors named "Van A Cain"

The main purpose of this study was to examine whether the Supplemental Nutrition Program for Women, Infants and Children (WIC) helped mothers of overweight/obese preschool children to cut down on dietary fat and sugar intake for their families. Data from the Children Eating Well for Health (CHEW) Nutrition Survey, a probability sample of 150 (50 each White, Black and Hispanic) families with preschoolers participating in the WIC program in Nashville/Davidson County, Tennessee, were analyzed using logistic regression modeling. Mothers who reported that the WIC program helped them reduce fat intake were 2.

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Objectives: We sought to determine whether there are signs of improvement in the rates of heart failure (HF) hospitalizations given the recent reports of improvement in national trends.

Methods: HF admissions data from the Tennessee Hospital Discharge Data System were analyzed.

Results: Hospitalization for primary diagnosis of HF (HFPD) in adults (aged 20 years old or older) decreased from 4.

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This study identified challenges faced by a healthcare safety net system. Surveys of safety net outpatient clinic and hospital emergency department (ED) facilities and key informant interviews ascertained barriers to providing necessary client services and strategies to overcome them. About 60% of key informants responded that Medicaid cuts greatly increased the numbers of uninsured clients.

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The objective of this study was to determine if an association existed between the mid-2005 TennCare (Medicaid) disenrollment and increases in uninsured ambulatory care sensitive condition (ACSC) non-admitted ER visits and inpatient hospitalizations in Davidson County, Tennessee (= the city of Nashville). Logistic regression modeling, using an interactive term for insurance category x year, indicated that the effect of no insurance on ACSC ER visits increased by 18% from 2003 to 2007 (p<.001), but no significant effect was found for uninsured ACSC inpatient hospitalizations.

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Background: Because heart failure (HF) is the final common pathway for most heart diseases, we examined its 10-year prevalence trend by race, sex, and age in Tennessee.

Methods And Results: HF hospitalization data from the Tennessee Hospital Discharge Data System were analyzed by race, sex, and age. Rates were directly age-adjusted using the Year 2000 standard population.

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We investigated the impact of socioeconomic conditions, patterns of morbidity, and physician service utilization on race differences in rates of mortality, and mortality associated with specific diagnoses. Longitudinal data from the Center for Medicare and Medicaid Services (CMS) Physician Billing File data and the Medicare Enrollment Database (EDB) were analyzed to assess physician-diagnosed morbidity, health service use, and mortality, among the population of Medicare beneficiaries in Tennessee (N=665,887). Proportional hazards models were used to examine the effects of race, socioeconomic status, morbidity, and physician service utilization on mortality.

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The objective of this study was to evaluate the effectiveness of a church-based breast cancer screening education program on mammography attainment by African American women 40 years old and older in rural Alabama. The sample consisted of 192 women who volunteered to participate in the study through 13 African American churches in a rural, economically-depressed Alabama county. The design was quasi-experimental and had some features of community-based participatory research.

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This study reports on rural-urban differences in the effectiveness of a church-based educational program aimed at increasing breast cancer screening among African American women ages 40 and over. The data were drawn from an intervention study in urban Nashville, and a pilot extension of the study in five rural counties of West Tennessee. The partial program was equally effective in rural Tennessee (17.

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We describe and evaluate a group therapy program targeting depression among elderly residents (N=303) of subsidized high-rise apartments in Nashville, TN. This eclectic program was comprised of 12 sessions (a total of 24 hours) that included modules on exercise and preventive health behaviors, cognitive and re-motivation therapy, reminiscence and grief therapy, and social skills development. Our multivariate regression analyses of pre-post measures using the Geriatric Depression Scale (GDS) showed that the effects of the group therapy varied by race, age, and level of initial depression among the participants.

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Purpose: This study tested for an association between diabetes and depressive symptoms and assessed the effect of co-occurring diabetes and depressive symptoms on healthcare utilization outcomes among African-American patients.

Procedure: The sample consisted of 303 adult African-American patients age 40 and over from a primary care clinic serving the low-income population in Nashville, TN. Measures were based on self-reports during a structured interview.

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Objective: This study examined differences in the prevalence of dementia among Medicare beneficiaries by race and gender as well as racial differences in the effects of dementia on the use and costs of health care services.

Methods: Data from a 5 percent random sample of Medicare beneficiaries in the state of Tennessee who filed claims between 1991 and 1993 (N=33,680) were analyzed. Dementia was assessed on the basis of ICD-9 codes in the billing records of the Health Care Financing Administration (HCFA), along with information on gender, race, comorbid psychiatric conditions, use of health services, and the actual amounts paid by HCFA.

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