The Influence of Structural Factors and Telemedicine on Missed Appointments Among Medicaid-Insured Patients.

Background: Missed clinic appointments disproportionately affect Medicaid-insured patients and residents of socioeconomically deprived neighborhoods. The role of the recent telemedicine expansion in reducing these disparities is unclear. We analyzed the relationship between census tract (CT) poverty level, residential segregation, missed appointments, and the role of telemedicine.

Examining the affordable connectivity program and telehealth use: a pilot survey of the affordable connectivity program, telehealth, video and audio visits in a racially diverse, lower-income population.

The Affordable Connectivity Program (ACP) aimed to narrow the digital divide by providing discounted internet services for millions of low-income households during the COVID-19 pandemic. This study examined associations between enrollment in the ACP and Telehealth visits in a racially diverse low-income population. Data were obtained via a cross-sectional survey of 213 respondents.

Telemedicine-Related Opioid Use Disorder Services in Underserved Populations: A Qualitative Evaluation of the Waiver Era.

: This pilot study examined access to telemedicine-related opioid use disorder (OUD) treatment in underserved communities in Houston, Texas before July 30, 2023. : Participants, both patients and providers, were recruited in partnership with local substance use treatment clinics. Both groups shared experiences before and after the waiver era.

Pre-pandemic preventable hospitalization is associated with increased telemedicine use in safety-net settings.

Introduction: The COVID-19 pandemic necessitated a major expansion in telemedicine use. The continued use of telemedicine post-pandemic has the potential to enhance healthcare use for people at risk for sub-optimal healthcare access and utilization, such as patients with previous preventable hospitalization. This study analyzed the association between pre-pandemic preventable hospitalizations (PPHs) and telemedicine use during the pandemic.

Innovation in Healthcare Education: Using "Shark Tank" Approaches to Educate Teams of Interprofessional Students in Health Equity.

Inspired by the television show , we developed a summer research program that brought together students from the Colleges of Medicine, Pharmacy, Business, and Communications, to collaborate, find creative solutions, and spark innovations in population health. Under the guidance of faculty, student teams conducted literature reviews and data-thon exercises to examine trends to identify health equity gaps. Students then worked collaboratively to develop and pitch innovative solutions in front of a panel of expert "sharks" for feedback and to gain financial support to advance their ideas.

Patient- and Provider-Level Factors Associated with Patient Portal Usage Among Medicaid Recipients.

Patient portals can improve access to electronic health information and enhance patient engagement. However, disparities in patient portal utilization remain, affecting disadvantaged communities disproportionately. This study examined patient- and provider-level factors associated with portal usage among Medicaid recipients in a large federally qualified health center (FQHC) network in Texas.

Racial and ethnic differences in predictors of participation in an intergenerational social connectedness intervention for older adults.

Background: Social connectedness is a key determinant of health and interventions have been developed to prevent social isolation in older adults. However, these interventions have historically had a low participation rate amongst minority populations. Given the sustained isolation caused by the COVID-19 pandemic, it is even more important to understand what factors are associated with an individual's decision to participate in a social intervention.

Proxy use of patient portals on behalf of children: Federally Qualified Health Centers as a case study.

Objective: This study examined the proxy use of patient portals for children in a large Federally Qualified Health Centers (FQHC) network in Texas.

Methods: We used de-identified individual-level data of patients, 0-18 years, who had 1+ visits between December 2018 and November 2020. Logistic regression was used to examine patient-, clinic-, and geographic-level factors associated with portal usage by an assumed proxy (i.

Ascertainment of Minimal Clinically Important Differences in the Diabetes Distress Scale-17: A Secondary Analysis of a Randomized Clinical Trial.

Importance: The Diabetes Distress Scale-17 (DDS-17) is a common measure of diabetes distress. Despite its popularity, there are no agreed-on minimal clinically important difference (MCID) values for the DDS-17.

Objective: To establish a distribution-based metric for MCID in the DDS-17 and its 4 subscale scores (interpersonal distress, physician distress, regimen distress, and emotional distress).

Evaluating Predictors of Participation in Telephone-Based Social-Connectedness Interventions for Older Adults: A Dual Machine-Learning and Regression Approach.

Social isolation is a well-documented contributor to poor mental and physical health, and interventions promoting social connectedness have been associated with various health benefits. This study examined predictors of participation in a telephone-based social connectedness intervention for socially isolated older adults. Data were obtained from a social-connectedness intervention that paired college students with Houston-area, community-dwelling adults aged 65 years and older and enrolled in Medicare Advantage plans.

Rethinking access to care: A spatial-economic analysis of the potential impact of pharmacy closures in the United States.

Data chronicling the geo-locations of all 61,589 pharmacies in the U.S. (from the Homeland Infrastructure Foundation-Level Data (HIFLD) Open Data interface, updated on April 2018) across 215,836 census block groups were combined with Medically Underserved Areas (MUAs) information, and the Centers for Disease Control and Prevention's Social Vulnerability Index (CDC-SVI).

The Effects of COVID-19 Lockdown on Social Connectedness and Psychological Distress in U.S. Adults with Chronic Diseases.

Lockdown measures enacted in 2020 to control the spread of COVID-19 led to increases in the prevalence of mental health problems. Due to their high-risk status, individuals with chronic diseases may be at increased risk and disproportionately adversely affected by the COVID-19 pandemic. The investigators examined associations between having a high-risk chronic condition, social connectedness, and general distress and COVID-19-specific distress among U.

Comparing In-Person Only, Telemedicine Only, and Hybrid Health Care Visits Among Older Adults in Safety-Net Clinics.

Introduction: Older adults face challenges in seeking health care. This study examined factors associated with in-person only versus telemedicine only versus hybrid health care visits among adults 65+ in safety-net clinics.

Methods: Data were obtained from a large Texas-based Federally Qualified Health Center (FQHC) network.

Trends in Mental Health Utilization Before and During the COVID-19 Pandemic: Federally Qualified Health Centers As a Case Study.

This study examined differential mental health utilization patterns before and during the COVID-19 pandemic. Data were obtained from 12 Federally Qualified Health Center (FQHC)-behavioral health clinics and included 65,561 visits between February 2019 and November 2020 for adults aged 18-64 years. To allow for a year-over-year comparison, the pre-COVID-19 period was flagged as visits between February 2019 and November 2019 and the peri-COVID-19 period as visits between February 2020 and November 2020.

Hospital Length of Stay in Patients with and without Serious and Persistent Mental Illness: Evidence of Racial and Ethnic Differences.

Background: Prior studies have documented racial and ethnic differences in mental healthcare utilization, and extensively in outpatient treatment and prescription medication usage for mental health disorders. However, limited studies have investigated racial and ethnic differences in length of inpatient stay (LOS) in patients with and without Serious and Persistent Mental Illness. Understanding racial and ethnic differences in LOS is necessary given that longer stays in hospital are associated with adverse health outcomes, which in turn contribute to health inequities.

Predictors of COVID-19 perceived susceptibility: insights from population-based self-reported survey during lockdown in the United States.

Background: The COVID-19 pandemic during lockdown has highlighted the importance of identifying individuals most at risk of infection with SARS-CoV-2, underscoring the need to assess factors contributing to susceptibility to disease. With the rapidly evolving nature of the pandemic and its new variants, there is an inadequate understanding on whether there are certain factors such as a specific symptom or collection of symptoms that combined with life-style behaviors may be useful to predict susceptibility. The study aims to explore such factors from pre-vaccination data to guide public health response to potential new waves.

Utilization Gaps During the COVID-19 Pandemic: Racial and Ethnic Disparities in Telemedicine Uptake in Federally Qualified Health Center Clinics.

Background: The Coronavirus Aid, Relief, and Economic Security (CARES) Act led to the rapid implementation of telemedicine across healthcare office settings. This innovation has the potential to improve healthcare use and ensure continuity of care. However, this delivery model could have an unintended consequence of worsening racial/ethnic disparities in healthcare utilization if adoption varies across sub-populations.

Early Impacts of the COVID-19 Pandemic on Telehealth Patterns in Primary Care, Mental Health, and Specialty Care Facilities in Texas.

Objectives: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, many US clinics have shifted some or all of their practice from in-person to virtual visits. In this study, we assessed the use of telehealth among primary care and specialty clinics, by targeting healthcare administrators via multiple channels.

Methods: Using an online survey, we assessed the use of, barriers to, and reimbursement for telehealth.