How would a certification in harm reduction impact service delivery and the harm reduction workforce? A qualitative study.

Introduction: Harm reduction utilizes evidence-based strategies to reduce the negative health and social impacts of substance use. As harm reduction services expand across the U.S.

Admission and Discharge Practices Among Assisted Living Communities: The Role of State Regulations and Organizational Characteristics.

Background And Objectives: A better understanding of factors associated with assisted living admission and discharge practices can help identify communities that are more likely to allow residents to age in place. This study examined how state regulations and assisted living organizational characteristics related to community admission and discharge practices for bathing, getting out of bed, and feeding.

Research Design And Methods: Using data from a representative sample of 250 assisted living communities in seven states and a database of assisted living state regulations, we employed multilevel logistic regression models to examine regulatory and organizational correlates of assisted living community admission and discharge practices for 3 activities of daily living (bathing, getting out of bed, and feeding).

Varying Estimates of Social Workers in the United States: Which Data Source to Use?

Behavioral health needs continue rise in the United States and constitute a key driver of health care utilization, costs, and outcomes. Social workers provide a wide range of services across health, behavioral health, and community settings, and while this heterogeneity in practice benefits care delivery, it complicates health workforce analyses. This analysis compares five commonly used national data sources and details similarities and differences in their estimates of the number, type, and practice characteristics of social workers.

Appropriateness of Hysterectomy as Treatment for Benign Gynecological Conditions.

To assess the appropriateness of hysterectomies performed at a large tertiary health system using the 1997 RAND appropriateness classification system and an updated algorithm. We abstracted structured and unstructured data from electronic medical records on patient demographics, primary indication(s) for hysterectomy, diagnosis codes associated with the hysterectomy, previous treatments, and laboratory results. Patients aged 18-44 years.

A pre-visit video/question prompt list intervention to increase youth question-asking about attention deficit hyperactivity disorder during pediatric visits.

Objective: To conduct a pragmatic randomized controlled trial to test the effectiveness of an ADHD question prompt list with video intervention to increase youth question-asking and provider education about ADHD during visits.

Methods: English-speaking youth ages 11-17 with ADHD and their caregivers were enrolled from two pediatric clinics. Youth were randomized to intervention or usual care groups.

Assessing the Training for Certified Peer Support Specialists Who Provide Mental Health and Substance Use Services.

The behavioral health system's peer support workforce must be adequately trained to perform peer support services, but evidence of the adequacy of their training needs to be improved. With survey data from 667 certified peer support specialists (CPSS) from North Carolina, Kentucky, Virginia, and Tennessee, this study used (a) binomial probability test to assess perceptions about the adequacy of the workforce's training, (b) latent profile analysis to identify patterns and predictors of perceptions about the SAMHSA core competencies covered in their training, and (c) thematic analysis to identify additional training needs. Most respondents identified as White (72%), female (73%), and had some college education (83%).

The evolution of health system planning and implementation of maternal telehealth services during the COVID-19 Pandemic.

Background: Differential access to healthcare is associated with disparities in maternal outcomes. Telehealth is one approach for improving access to maternal services. However, little is known regarding how health systems leverage telehealth to close the access gap.

Examining facilitative services for entry into substance use disorder treatment: A cluster analysis of treatment facilities.

Objectives: We examined services to facilitate access to entering substance use disorder (SUD) treatment among a national sample of SUD treatment facilities.

Methods: We analyzed data from the National Survey of Substance Abuse Treatment Services (N-SSATS) 2020. Facilities were included in the sample based on criteria such as SUD treatment provision and being in the U.

Neighborhood context and children's health care utilization and health outcomes: a comprehensive descriptive analysis of national survey data.

While child health and health care disparities arising from unequal distribution of resources are well documented, a nationally representative inventory of health and well-being for children across the spectrum of opportunity is lacking. Using the nationally representative sample of children from pooled 2013-2017 Medical Expenditure Panel Survey data linked to the census-tract-level Child Opportunity Index 2.0, a composite measure of neighborhood health, education, and socioeconomic conditions, we describe US children's socioeconomic characteristics, health care utilization and expenditures across the spectrum of child neighborhood opportunity levels.

Financial Hardship Among Traditional Medicare and Medicare Advantage Enrollees With and Without Food Insecurity.

Background: Compared to traditional Medicare (TM), Medicare Advantage (MA) plans impose out-of-pocket cost limits and offer extra benefits, potentially providing financial relief for MA enrollees, especially for those with food insecurity.

Objective: To examine whether the prevalence of food insecurity differs between TM and MA enrollees at baseline and then examine whether MA enrollment in a baseline year is associated with less financial hardships in the following year, relative to TM enrollment, especially for those experiencing food insecurity.

Design: We conducted a retrospective longitudinal cohort study.

Quantifying the Time to Administer Outpatient Parenteral Antimicrobial Therapy: A Missed Opportunity to Compensate for the Value of Infectious Diseases.

Outpatient parenteral antimicrobial therapy (OPAT) relies on substantial uncompensated provider time. In this study of a large academic OPAT program, the median amount of unbilled OPAT management time was 27 minutes per week, per OPAT course. These data should inform benchmarks in pursuing novel payment approaches for OPAT.

Drivers of hospital nurse practitioner turnover: A national sample survey analysis.

Background: Hospital nurse practitioner (NP) turnover is costly and complex.

Purpose: Provide a pre-COVID-19 pandemic baseline of hospital NP turnover.

Methods: A secondary analysis of NSSRN18 data on 6,558 (67,863 weighted) NPs employed in hospitals on 12/31/2017.

Racial and Ethnic Disparities in All-Cause and Cause-Specific Mortality Among US Youth.

Importance: Mortality rates in US youth have increased in recent years. An understanding of the role of racial and ethnic disparities in these increases is lacking.

Objective: To compare all-cause and cause-specific mortality trends and rates among youth with Hispanic ethnicity and non-Hispanic American Indian or Alaska Native, Asian or Pacific Islander, Black, and White race.

Prescription and Dispensation of QT-Prolonging Medications in Individuals Receiving Hemodialysis.

Importance: Individuals with dialysis-dependent kidney failure have numerous risk factors for medication-related adverse events, including receipt of care by multiple clinicians and initiation of some QT-prolonging medications with known risk of torsades de pointes (TdP), which is associated with higher risk of sudden cardiac death. Little is known about the prescription and dispensation patterns of QT-prolonging medications among people receiving dialysis, hindering efforts to reduce drug-related harm from these and other medications in this high-risk population.

Objective: To examine prescription and dispensation patterns of QT-prolonging medications with known TdP risk and selected interacting medications prescribed to individuals receiving hemodialysis.

Culinary Medicine Experiences for Medical Students and Residents in the U.S. and Canada: A Scoping Review.

Phenomenon: Despite the importance of diet in the prevention and management of many common chronic diseases, nutrition training in medicine is largely inadequate in medical school and residency. The emerging field of culinary medicine offers an experiential nutrition learning approach with the potential to address the need for improved nutrition training of physicians. Exploring this innovative nutrition training strategy, this scoping review describes the nature of culinary medicine experiences for medical students and resident physicians, their impact on the medical trainees, and barriers and facilitators to their implementation.

Disparities in Maternal Health Visits Between Rural and Urban Communities in the United States, 2016-2018.

Objective: The objective was to estimate the rural-urban differences in the receipt of prepregnancy, prenatal, and postpartum services.

Methods: The authors conducted a cross-sectional data analysis using data from the Pregnancy Risk Assessment and Monitoring System from 2016 to 2018 to analyze rural-urban differences in the receipt of medical visits and care content delivery during the prepregnancy year, as well as the prenatal and postpartum periods among birthing people in the US, using survey-weighted multivariable logistic regression models.

Results: Rural-dwelling birthing people were significantly less likely to attend a medical visit in the prepregnancy year or postpartum period, even when controlled for sociodemographic and clinical characteristics.

Clarifying the causal contrast: An empirical example applying the prevalent new user study design.

Purpose: The prevalent new user design extends the active comparator new user design to include patients switching to a treatment of interest from a comparator. We examined the impact of adding "switchers" to incident new users on the estimated hazard ratio (HR) of hospitalized heart failure.

Methods: Using MarketScan claims data (2000-2014), we estimated HRs of hospitalized heart failure between patients initiating GLP-1 receptor agonists (GLP-1 RA) and sulfonylureas (SU).

Human Trafficking in Correctional Institutions: A Survey of Correctional and Anti-Trafficking Leaders.

Growing awareness of the overlap between justice involvement and human trafficking victimization has led to calls for correctional institutions to prevent, identify, and respond to trafficking. However, it is unclear how correctional facilities (i.e.

Substance use problems and disorders among adults 50 years and older receiving mental health treatment for a primary neurocognitive disorder.

Objectives: This study sought to (1) identify the percentage of high-risk substance use or substance use disorder (SUD) and (2) examine the factors associated with high-risk substance use or SUD in adults aged 50 years and older receiving mental health treatment with a primary delirium or dementia diagnosis.

Method: This study used 7 years (2013-2019) of national administrative data on community mental health center patients aged 50 years and older with a primary delirium or dementia diagnosis receiving treatment in the United States (U.S.