Racial Residential Segregation and Mental Health During Pregnancy.

Importance: Research suggests the social, physical, and socioeconomic contexts of residing in segregated neighborhoods may negatively affect mental health.

Objective: To assess the association between racial residential segregation and prenatal mental health among Asian, Black, Hispanic, and White individuals.

Design, Setting, And Participants: This population-based cross-sectional study was conducted in Kaiser Permanente Northern California (KPNC), an integrated health care delivery system.

Association of Local Cannabis Policy and Retail Availability With Cannabis Use and Problematic Cannabis Use Among Adolescents in Northern California.

To examine whether local cannabis policies and retail availability are associated with cannabis use and problematic cannabis use (PCU) among adolescents in Northern California. The sample comprised adolescents aged 13 to 17 years screened for past-year cannabis use during well-child visits in 2021. Exposures included local bans on cannabis storefront retailers, policy protectiveness, and retail proximity and density.

Hospital Readmissions Among Patients Experiencing Homelessness: An Electronic Health Record Data Study.

Background: Population-level tracking of hospital use patterns with integrated care organizations in patients experiencing homelessness has been difficult. A California law implemented in 2019 (Senate Bill 1152) aimed to ensure safety for this population after discharge from the hospital by requiring additional documentation for patients experiencing homelessness, which provides an opportunity to evaluate hospital use by this population.

Methods: In a large integrated health system in California, patients experiencing homelessness were identified through documentation change requirements associated with this law and compared with a matched group from the general population.

Identifying Predictors of Homelessness Among Adults in a Large Integrated Health System in Northern California.

Introduction Homelessness contributes to worsening health and increased health care costs. There is little published research that leverages rich electronic health record (EHR) data to predict future homelessness risk and inform interventions to address it. The authors' objective was to develop a model for predicting future homelessness using individual EHR and geographic data covariates.

Using Peer Support to Prevent Diabetes: Results of a Pragmatic RCT.

Introduction: High-contact structured diabetes prevention programs are effective in lowering weight and HbA1cs, yet their intensity level can create barriers to participation. Peer support programs improve clinical outcomes among adults with Type 2 diabetes, but their effectiveness in diabetes prevention is unknown. This study examined whether a low-intensity peer support program improved outcomes more than enhanced usual care in a diverse population with prediabetes.

A Randomized Encouragement Trial to Increase Mail Order Pharmacy Use and Medication Adherence in Patients with Diabetes.

Background: Mail order pharmacy (MOP) use has been linked to improved medication adherence and health outcomes among patients with diabetes. However, no large-scale intervention studies have assessed the effect of encouraging MOP use on medication adherence.

Objective: To assess an intervention to encourage MOP services to increase its use and medication adherence.

Using Neighborhood-Level Census Data to Predict Diabetes Progression in Patients with Laboratory-Defined Prediabetes.

Context: Research on predictors of clinical outcomes usually focuses on the impact of individual patient factors, despite known relationships between neighborhood environment and health.

Objective: To determine whether US census information on where a patient resides is associated with diabetes development among patients with prediabetes.

Design: Retrospective cohort study of all 157,752 patients aged 18 years or older from Kaiser Permanente Northern California with laboratory-defined prediabetes (fasting plasma glucose, 100 mg/dL-125 mg/dL, and/or glycated hemoglobin, 5.

Randomized trial of telephone outreach to improve medication adherence and metabolic control in adults with diabetes.

Objective: Medication nonadherence is a major obstacle to better control of glucose, blood pressure (BP), and LDL cholesterol in adults with diabetes. Inexpensive effective strategies to increase medication adherence are needed.

Research Design And Methods: In a pragmatic randomized trial, we randomly assigned 2,378 adults with diabetes mellitus who had recently been prescribed a new class of medication for treating elevated levels of glycated hemoglobin (A1C) ≥8% (64 mmol/mol), BP ≥140/90 mmHg, or LDL cholesterol ≥100 mg/dL, to receive 1) one scripted telephone call from a diabetes educator or clinical pharmacist to identify and address nonadherence to the new medication or 2) usual care.

Safety and effectiveness of mail order pharmacy use in diabetes.

Background: Although research suggests that mail order pharmacy use is associated with greater medication adherence and cardiovascular disease risk factor control, no research has examined the potential impact of mail order pharmacy use on patient safety and utilization.

Objectives: To compare safety and utilization outcomes in patients using mail order versus local pharmacies.

Study Design: Cross-sectional, observational study of 17,217 Kaiser Permanente Northern California adult diabetes patients prescribed new cardiometabolic medications in 2006.

Mail-order pharmacy use and adherence to diabetes-related medications.

Objective: To investigate whether patients who use mail-order pharmacies were more likely to have good medication adherence than patients who use local pharmacies.

Study Design: Cross-sectional investigation.

Methods: We conducted cross-sectional analyses of patients from the Kaiser Permanente Northern California (KPNC) diabetes registry who received a new antiglycemic, antihypertensive, or lipid-lowering index medication between January 1, 2006, and May 31, 2006.

Hospital demand for licensed practical nurses.

Despite evidence that hospital use of licensed practical nurses (LPNs) declined in the 1990s, the current registered nurse (RN) shortage has prompted interest in LPNs as substitutes for RNs. Hospitals, being the dominant employer of RNs, have an economic incentive to use less expensive LPNs as substitutes. Beside wages, there are several forces underlying hospital demand for LPNs.