Data Challenges in Identifying Patients Due for Colorectal Cancer Screening in Rural Clinics.

Introduction: Colorectal cancer (CRC) incidence and mortality are disproportionately high among rural residents despite the availability of effective screening methods. Outreach activities can improve CRC screening rates but rely on accurate identification of patients due for screening. We report on data challenges in rural clinics and Medicaid health plans in Oregon in identifying patients eligible for CRC screening, in a large project implementing mailed fecal immunochemical tests (FIT) and patient navigation.

Impact of the Early COVID-19 Pandemic on the Number of HIV Preexposure Prophylaxis Uses and the Proportion of Preexposure Prophylaxis Users Receiving Sexually Transmitted Infection Testing Services.

Background: With the potential impact of the COVID-19 pandemic on HIV preexposure prophylaxis (PrEP) care management, we assessed the number of PrEP users and sexually transmitted infection (STI) testing-eligible PrEP users, STI testing rates, and prevalence between prepandemic (January 1, 2018-March 31, 2020) and early-pandemic (April 1, 2020-September 30, 2020) periods.

Methods: In this retrospective cohort study, a PrEP user for a given quarter is defined as either a previous PrEP user or a PrEP initiator who has at least 1-day coverage of tenofovir/emtricitabine in the given quarter. The STI testing-eligible PrEP users for a given quarter were defined as those persons whose runout date (previous dispense date + days of tenofovir/emtricitabine supply) was in the given quarter.

Sexually Transmitted Infection Testing, Prevalence, and Treatment Among Individuals Receiving HIV Preexposure Prophylaxis Within an Integrated Healthcare Delivery System.

Background: Initial and follow-up sexually transmitted infection (STI) and human immunodeficiency virus (HIV) testing are recommended when taking HIV preexposure prophylaxis (PrEP). We assessed STI services before and after PrEP initiation among persons 18 years or older.

Methods: We conducted this retrospective cohort study at a US integrated healthcare delivery system.

A Pragmatic, Randomized Clinical Trial of Gestational Diabetes Screening.

Background: Gestational diabetes mellitus is common and is associated with an increased risk of adverse maternal and perinatal outcomes. Although experts recommend universal screening for gestational diabetes, consensus is lacking about which of two recommended screening approaches should be used.

Methods: We performed a pragmatic, randomized trial comparing one-step screening (i.

Temporal Trends in the Incidence of Anogenital Warts: Impact of Human Papillomavirus Vaccination.

Background: Studies in countries with high human papillomavirus (HPV) vaccination coverage have demonstrated marked reductions in anogenital wart (AGW) incidence. Our goal was to assess the impact of HPV vaccination in a population with suboptimal coverage by comparing AGW incidence trends in the years before and after vaccine introduction.

Methods: We conducted a retrospective analysis of AGW incidence trends using an ecologic study design among 11- through 39-year-olds enrolled at Kaiser Permanente Northwest.

Developing Patient-Refined Messaging for a Mailed Colorectal Cancer Screening Program in a Latino-Based Community Health Center.

Introduction: Colon cancer is the second leading cause of cancer death in the United States, and screening rates are disproportionately low among Latinos. One factor thought to contribute to the low screening rate is the difficulty Latinos encounter in understanding health information, and therefore in taking appropriate health action. Therefore, we used Boot Camp Translation (BCT), a patient engagement approach, to engage Latino stakeholders (ie, patients, clinic staff) in refining the messages and format of colon cancer screening reminders for a clinic-based direct mail fecal immunochemical testing (FIT) program.

Developing Electronic Health Record (EHR) Strategies Related to Health Center Patients' Social Determinants of Health.

Background: "Social determinants of heath" (SDHs) are nonclinical factors that profoundly affect health. Helping community health centers (CHCs) document patients' SDH data in electronic health records (EHRs) could yield substantial health benefits, but little has been reported about CHCs' development of EHR-based tools for SDH data collection and presentation.

Methods: We worked with 27 diverse CHC stakeholders to develop strategies for optimizing SDH data collection and presentation in their EHR, and approaches for integrating SDH data collection and the use of those data (eg, through referrals to community resources) into CHC workflows.

Positive Predictive Value of ICD-9 Code for Herpes Zoster Among Children During the Varicella Vaccine Era.

We examined the positive predictive value of the herpes zoster ICD-9 diagnosis code 053 in the Kaiser Permanente Northwest integrated health plan. Among children 0-17 years old, the positive predictive value was 87.1% (95% confidence interval: 84.

Well-being improvement in a midsize employer: changes in well-being, productivity, health risk, and perceived employer support after implementation of a well-being improvement strategy.

Objective: To evaluate employee well-being change and associated change in productivity, health risk including biometrics, and workplace support over 2 years after implementation of a well-being improvement strategy.

Methods: This was an employer case study evaluation of well-being, productivity (presenteeism, absenteeism, and job performance), health risk, and employer support across three employee assessment spanning 2 years. Employee well-being was compared with an independent sample of workers in the community.

Well-being, health, and productivity improvement after an employee well-being intervention in large retail distribution centers.

Objective: To evaluate changes in well-being, biometric, and productivity indicators after a well-being intervention.

Methods: Biometric and self-reported outcomes were assessed among 677 retail distribution center employees before and after a 6-month well-being intervention.

Results: Despite lower well-being at baseline compared to an independent random sample of workers, program participants' well-being, productivity, body mass index, systolic blood pressure, and total cholesterol improved significantly after the intervention, whereas the decline in diastolic blood pressure was not significant.

The STRIDE weight loss and lifestyle intervention for individuals taking antipsychotic medications: a randomized trial.

Objectives: The STRIDE study assessed whether a lifestyle intervention, tailored for individuals with serious mental illnesses, reduced weight and diabetes risk. The authors hypothesized that the STRIDE intervention would be more effective than usual care in reducing weight and improving glucose metabolism.

Method: The study design was a multisite, parallel two-arm randomized controlled trial in community settings and an integrated health plan.

Perceived access to health services and provider information and adverse birth outcomes: findings from LaPRAMS, 2007-2008.

Objectives: Despite targeted public health efforts, racial disparities and poor birth outcomes are still apparent, particularly in the southern United States. Previous research through qualitative and modest quantitative research demonstrates a possible link between disparities in patient-provider conversations during prenatal visits, perceived access to prenatal care, and poor birth outcomes.

Methods: A secondary analysis was conducted using data from the 2007-2008 Louisiana Pregnancy Risk Assessment Monitoring System to examine perceived access to healthcare services and information received and its impact on birth outcomes.

Global epidemiology of obesity, vegetarian dietary patterns, and noncommunicable disease in Asian Indians.

An increase in noncommunicable disease (NCD) in India has been attributed to an epidemiologic transition whereby, due to urbanization, there is an increase in traditional cardiovascular disease risk factors such as obesity. Accumulated biomarker data on the "Asian Indian phenotype" identify central obesity, which occurs at a lower body mass index (BMI), as a particularly potent risk factor in Asian Indians. A revised WHO case definition for obesity in India [BMI (in kg/m(2)) >25] has identified an obesity epidemic that exceeds 30% in some cities and rivals that in Western nations.

Comparing the contributions of well-being and disease status to employee productivity.

Objective: To compare employee overall well-being to chronic disease status, which has a long-established relationship to productivity, as relative contributors to on-the-job productivity.

Methods: Data from two annual surveys of three companies were used in longitudinal analyses of well-being as a predictor of productivity level and productivity change among 2629 employees with diabetes or without any chronic conditions.

Results: Well-being was the most significant predictor of productivity cross-sectionally in a model that included disease status and demographic characteristics.

Effectiveness of pneumococcal conjugate vaccine in infants by maternal influenza vaccination status.

Background: Influenza virus infection can predispose patients to secondary pneumococcal infections. Children are at greatest risk for pneumococcal infection in the first year of life and are not considered fully protected by pneumococcal conjugate vaccine (PCV) until their third dose at 6 months of age. Infants less than 6 months cannot receive influenza vaccination, though maternal influenza vaccination can protect infants.

Newborn size among obese women with weight gain outside the 2009 Institute of Medicine recommendation.

Objective: To estimate risk of delivering macrosomic, large-for-gestational-age and small-for-gestational-age neonates in obese women with gestational weight gain outside the 2009 Institute of Medicine recommendation (11-20 pounds).

Methods: In a retrospective cohort study, we evaluated 2,080 obese women (body mass index 30 or higher) with singleton pregnancies that resulted in term live births within one health maintenance organization between 2000 and 2005; women with diabetes or hypertensive disorders were excluded. Gestational weight gain was categorized as less than 0, 0 to less than 11, 11-20 (referent), greater than 20-30, greater than 30-40, and greater than 40 pounds and as above, below, or within Institute of Medicine recommendations.

Excessive gestational weight gain and postpartum weight retention among obese women.

Objective: To evaluate the incremental effect of weight gain above that recommended for term pregnancy (15 pounds) on postpartum weight retention at 1 year among obese women.

Methods: In a retrospective cohort study, we identified 1,656 singleton gestations resulting in live births among obese women (body mass index at or above 30 kg/m) between January 2000 and December 2005 in Kaiser Permanente Northwest. Pregnancy weight change (last available predelivery weight minus weight at pregnancy onset) was categorized as less than 0, 0-15, greater than 15 to 25, greater than 25 to 35, and greater than 35 pounds.