248 results match your criteria: "Pardee Rand Graduate School[Affiliation]"

Introduction: Black children in the United States have lower rates of dental visits and higher rates of poor oral health. However, few studies have examined the role of structural racism as a contributor to racial gaps in children's oral health. This study assessed associations between state-level structural racism and oral health outcomes of children and the related Black-White disparities.

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Background And Objectives: COVID-19 negatively influenced resident wellbeing in nursing homes (NHs). We examine perceptions and experiences of U.S.

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This systematic review investigates disparities in COVID-19 outcomes (infections, hospitalizations, and deaths) between urban and rural populations in the United States. Of the 3,091 articles screened, 55 were selected. Most studies ( = 43) conducted national analyses, using 2020 data, with some extending into 2021.

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As a wide group of medicines, the effectiveness and safety of 'medical cannabis' products is likely to vary in relation to product-specific dimensions such as potency, dosage, route of administration, and cannabinoid composition. Systematic reviews can perform a crucial role in analysing and synthesising the outcomes of medical cannabis interventions found in empirical research. We analysed 23 contemporary systematic reviews on the effectiveness and safety of medical cannabis to discern the extent to which this body of work aimed to capture, and ultimately captured, the differing outcomes of medical cannabis products by product-specific dimensions of treatment.

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Collaborative governance has become a prominent, if not dominant, framework for thinking about multi-scalar and cross-jurisdictional environmental management. The literature broadly and consistently suggests that collaborative capacity and inter-organizational networks provide the institutional framework for addressing social-ecological system challenges. Surprisingly little scholarship addresses processes of social influence (or contagion) in social-ecological systems writ large, or more specifically as it relates to collaborative capacity.

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They Will Come, You Must Build It: A Modified Delphi Process Applied to Preparing Acute Care Facilities Infrastructure for High-Consequence Infectious Diseases.

Health Secur

October 2024

Justin Chan, MD, MPH, is Director, Infection Prevention and Control, NYC Health + Hospitals/Bellevue, and an Associate Professor, Department of Medicine, NYU Grossman School of Medicine; both in New York, NY. Eileen F. Searle, PhD, RN, CCRN, is Director of Funded Projects, and Logan Denson, MPA, is Biothreats Project Manager; both at the Center for Disaster Medicine, Massachusetts General Hospital, Boston, MA. Dmitry Khodyakov, PhD, MA, is a Senior Behavioral/Social Scientist, RAND; Director, ExpertLens; Co-Director, Center for Qualitative and Mixed Methods; and Professor of Policy Analysis, Pardee RAND Graduate School; all in Santa Monica, CA. Andrea Echeverri is Associate Director, Infection Control, NYC Health + Hospitals/Bellevue, New York, NY. Edward M. Browne, MS, CHPA, CHFM, FASHE, LFACHE, is a Consultant; Yvonne Chiarelli is an Associate Editor; and Douglas S. Erickson is CEO Emeritus; all at the Facility Guidelines Institute, St. Louis, MO. Linda L. Dickey, BSN, MPH, is Past President 2022, Association for Professionals in Infection Control and Epidemiology, Washington, DC. Jonathan Flannery, MHSA, FACHE, FASHE, CHFM, is Senior Associate Director, ASHE Regulatory Affairs, American Society for Health Care Engineering of the American Hospital Association, Chicago, IL. Lewis J. Kaplan, MD, FACS, FCCP, FCCM, is a Professor of Surgery, Division of Trauma, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Sarah Markovitz, AIA, is Principal, NBBJ, Boston, MA. Saskia V. Popescu, PhD, MPH, MA, is an Assistant Professor, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD. Erica S. Shenoy, MD, PhD, is Chief of Infection Control, Mass General Brigham; a Physician, Division of Infectious Diseases, Massachusetts General Hospital; and an Associate Professor, Harvard Medical School, Boston, MA.

Patients with suspected or confirmed high-consequence infectious diseases (HCIDs) may present for care at any acute care facility. However, there are limited data to inform recommendations for the design, maintenance, and operation of isolation spaces for patients with suspected or confirmed HCIDs. To address this gap, we developed consensus statements by convening a group of 29 subject matter experts to participate in a modified Delphi process facilitated by a validated tool (the RAND-developed ExpertLens system).

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Background And Objectives: The Affordable Care Act required private insurers to cover a set of recommended preventive services without cost-sharing. This included coverage of fluoride varnish (FV) applications without cost-sharing for children aged 1 through 5 during medical visits, an evidence-based treatment that prevents tooth decay. We examined if this coverage mandate was associated with more young children receiving FV.

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Partnerships Between Faith Communities and the Mental Health Sector: A Scoping Review.

Psychiatr Serv

January 2025

RAND, Santa Monica, California (Perez, Wong); Pardee RAND Graduate School, Santa Monica, California (Cardenas, Blagg).

Objective: Faith communities are increasingly providing services to address the mental health needs of their congregations and communities. However, many feel limited in their capacity to address serious illness and experience challenges to collaborating with the mental health sector. To inform the development of faith community-mental health sector partnerships, the authors conducted a scoping review to assess the characteristics and evidence base of partnership approaches to addressing mental health needs.

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Background: Latinos in the United States face multiple barriers to engaging in physical activity (PA). We implemented a faith-based multilevel intervention to promote PA in parks for Latino adults, which was partially adapted to a virtual platform during the COVID-19 pandemic, and evaluated it using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework.

Methods: We conducted in-depth semistructured interviews (83% in Spanish) with 24 intervention participants (75% women) participating in a cluster randomized controlled trial in 2019-2022 that linked 6 churches (3 intervention, 3 control) with parks in East Los Angeles, CA.

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Article Synopsis
  • Pandemics are regular occurrences, and communities must adopt sound principles for better preparedness against future infectious disease threats.
  • The National Science Foundation hosted a conference in 2023 with circumpolar researchers and Indigenous partners to explore lessons from COVID-19.
  • The article suggests future pandemic research areas in Alaska focused on Indigenous knowledge, risk perception, food and housing security, and emphasizes the importance of social sciences in enhancing pandemic preparedness.
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Article Synopsis
  • Millions of people living with HIV rely on lifelong oral antiretroviral therapy (ART) for maintaining their health, with a strong link between medication adherence and HIV outcomes.
  • An observational study involving 313 patients in Uganda revealed that most participants transitioned to the newer dolutegravir (DTG) regimens over four years, which showed a different adherence impact on viral suppression compared to older regimens.
  • While high adherence levels with non-DTG regimens significantly improved viral suppression rates, DTG users maintained over 95% viral suppression across all adherence levels, suggesting DTG may offer a more forgiving treatment option.
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Background: Many persons living with dementias (PLWD) prefer to remain at home as long as possible, and days spent at home (DAH)-defined as the time an individual spends outside of healthcare facilities-has emerged as a person-centred outcome measure in this population. We examined the association between DAH and functional status and health among PLWD.

Methods: Utilizing a nationally representative cohort of individuals age 65 and older in the United States with dementia from the 2010-2018 Health and Retirement Study (HRS), we assessed the relationship between an ordinal categorical DAH variable and number of activities of daily living (ADLs) (range 0-10; 10 being independent), mobility (0-5; 5 being mobile), and self-rated health (SRH) (0-4; 4 being excellent), controlling for patient characteristics.

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Article Synopsis
  • Food insecurity and HIV-related stigma can worsen health outcomes for people living with HIV, and this study aimed to explore how food security interventions impact these issues.
  • The research was conducted in two HIV clinics in the Dominican Republic, involving a pilot trial where participants received training on urban gardening and peer nutritional counseling.
  • Results showed that participants in the intervention group experienced significant reductions in internalized stigma and HIV-related discrimination, as well as some improvement in social support, suggesting that such interventions could be beneficial, although further research is needed.
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Background: Cervical cancer remains a significant but preventable threat to women's health throughout much of the developing world, including Uganda. Cervical cancer screening and timely treatment of pre-cancerous lesions is a cost-effective means of mitigating cervical cancer morbidity and mortality. However, only 5% of women in Uganda have ever been screened.

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Geographic variation in shortfalls of dementia specialists in the United States.

Health Aff Sch

July 2024

RAND, Economics, Sociology, and Statistics Department, Boston, MA 02116, USA.

Dementia specialists-neurologists, geriatricians, and geriatric psychiatrists-serve a critical clinical function in diagnosing early-stage Alzheimer's disease and determining eligibility for treatment with disease-modifying therapies. However, the availability of dementia specialists is limited and varies across the United States. Using data from the Area Health Resources Files, we found that the median density of dementia specialists across hospital referral regions in United States is 28.

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Objectives: The aim of this study was to a) explore barriers and facilitators associated with medication-taking habit formation, and b) elicit feedback on the components of an intervention designed to help form strong habits for long-term medication adherence.

Design: The study design was qualitative; we conducted semistructured interviews between September 2021 and February 2022.

Setting: The interviews were conducted online, with 27 participants recruited at the Cedars-Sinai Medical Center in Los Angeles, California.

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Public health policy interventions are associated with many important public health achievements. To provide public health practitioners and decision makers with practical approaches for examining and employing evidence-based public health (EBPH) policy interventions, we describe the characteristics and benefits that distinguish EBPH policy interventions from programmatic interventions. These characteristics include focusing on health at a population level, focusing on upstream drivers of health, and involving less individual action than programmatic interventions.

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Purpose: To describe the well-being supports provided to health care workers (HCWs) during the COVID-19 pandemic in health centers and hospitals.

Design: Cross-sectional qualitative interviews before and after implementation of a peer-based support intervention.

Setting: Purposively sampled hospitals and health centers across the US.

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Importance: Millions of economically disadvantaged children depend on Medicaid for dental care, with states differing in whether they deliver these benefits using fee-for-service or capitated managed care payment models. However, there is limited research examining the association between managed care and the accessibility of dental services.

Objective: To estimate the association between the adoption of managed care for dental services in Florida's Medicaid program and nontraumatic dental emergency department visits and associated charges.

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A growing body of literature uses the concept of core components to better understand small-scale programmatic interventions. Instead of interventions being viewed as unitary "black boxes," interventions are viewed as configurations of core components, which are the parts of interventions that carry their causal potential and therefore need to be reproduced with fidelity to produce the intended effect. To date, the concept of core components has not been as widely applied to public health policy interventions as it has to programmatic interventions.

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Primary care clinics are a frequent focus of policy initiatives to improve the value of health care; yet, it is unclear whether they have the ability or incentive to take on the additional tasks that these initiatives ask of them. This paper reports on a qualitative study assessing barriers that clinic leaders face to reducing cost within a tiered cost-sharing commercial health insurance benefit design that gives both consumers and clinics a strong incentive to reduce cost. We conducted semi-structured interviews of clinical and operational leaders at a diverse set of 12 Minnesota primary care clinics and identified 6 barriers: insufficient information on drivers of cost; clinics controlling a portion of spending; patient preference for higher cost specialists; administrative challenges; limited resources; and misalignment of incentives.

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Objectives: To understand the impact of public discourse and reaction around the COVID-19 pandemic on healthcare worker (HCW) experiences and well-being caring for patients with COVID-19.

Methods: We conducted 60 min in-depth interviews with 11 physicians and 12 nurses who were providing care to patients with COVID-19 in acute care settings at two health systems in the Western USA. Interviews were conducted in Spring-Summer 2022 using a semi-structured interview protocol that guided respondents through different stages of the pandemic.

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An Overlooked Emergency: More Than One in Eight US Adults Have Had Their Lives Disrupted by Drug Overdose Deaths.

Am J Public Health

March 2024

Alison Athey is with The RAND Corporation, Washington, DC. Beau Kilmer is with The RAND Corporation and the Pardee RAND Graduate School, Santa Monica, CA. Julie Cerel is with the College of Social Work, University of Kentucky, Lexington.

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Most health care providers in developing countries know that oral rehydration salts (ORS) are a lifesaving and inexpensive treatment for child diarrhea, yet few prescribe it. This know-do gap has puzzled experts for decades. Using randomized experiments in India, we estimated the extent to which ORS underprescription is driven by perceptions that patients do not want ORS, provider's financial incentives, and ORS stock-outs (out-of-stock events).

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