Characterizing state-level structural cisheterosexism trajectories using sequence and cluster analysis, 1996-2016, 50 U.S. states and Washington, D.C., and associations with health status and healthcare outcomes.

Structural cisheterosexism is a root cause of LGBTQ health inequities. Amidst ongoing legal attacks on LGBTQ populations' rights, research is needed to examine changes in policy contexts over time and associated implications for population health and inequities. To address this gap, we constructed state-level structural cisheterosexism trajectories for each U.

Long-term effects of collaborative dementia care on quality of life and caregiver well-being.

Introduction: Collaborative dementia care models with care navigation, including the Care Ecosystem, improve outcomes for persons living with dementia (PLWDs) and their caregivers. The effects of continuous care over long periods have not been studied.

Methods: In this randomized clinical trial with 456 PLWD-caregiver dyads with high caregiver burden, we evaluated the cumulative 5-year treatment effect on PLWD quality of life, health care utilization, caregiver depression, self-efficacy, and burden.

Using systems thinking to leverage adolescent sexual and reproductive health in rural Latino communities.

Disparities in adolescent sexual and reproductive health (SRH) outcomes in rural areas of the USA persist as a concern in achieving health equity for youth. A growing body of literature recognises that improving adolescents' health necessitates systems thinking to address the culture and environment in which adolescents live. This paper uses systems thinking to identify leverage points to improve adolescent SRH in rural Latino communities in California.

Brain health equity and the influence of social determinants across the life cycle.

Social determinants of health are social, economic and environmental factors known to influence health and development of infants, children and adults. Advancing equity in brain health relies upon interdisciplinary collaboration and recognition of the impact of social determinants on brain health through the lifespan and across generations. Critical periods of fetal, infant and early childhood development encompass intrinsic genetic and extrinsic environmental influences with complex gene-environment interactions.

"It is not the fault of the health care team - it is the way the system works": a mixed-methods quality improvement study of patients with advanced cancer and family members reveals challenges navigating a fragmented healthcare system and the administrative and financial burdens of care.

Background: Healthcare fragmentation and lack of care coordination are longstanding problems in cancer care. This study's goal was to provide in-depth understanding of how the organization and fragmentation of healthcare impacts the experiences of patients with advanced cancer and their families, especially near the end-of-life.

Methods: This mixed-methods quality improvement study took place at a large multi-specialty healthcare organization in Northern California.

Water First School Water Promotion and Access Intervention: A Cost Analysis Study.

Background: Adequate water intake is associated with improved cognitive and physical performance, prevention of dental caries, and overweight and obesity. However, access to free drinking water in schools remains inadequate. Water First, a school-based intervention promoting water consumption, was shown effective in preventing overweight, yet its costs have not been quantified.

Managing Eating Disorders Within Medicaid-Funded Health Care Systems in California.

Objective: This study describes the current management of patients with eating disorders (EDs) served by publicly-funded Medicaid behavioral health systems.

Method: Behavioral health leaders across nine counties in California met on a quarterly basis to share experiences, challenges, and lessons in the management of EDs within publicly-funded service systems. Detailed notes were taken, and a qualitative content analysis was undertaken to identify key themes.

Evaluating the Impact of a Game (Inner Dragon) on User Engagement Within a Leading Smartphone App for Smoking Cessation: Randomized Controlled Trial.

Background: Smartphone apps are a convenient, low-cost approach to delivering smoking cessation support to large numbers of individuals. Yet, the apps are susceptible to low rates of user engagement and retention.

Objective: This study aims to test the effects of a new game module (called Inner Dragon) integrated into Smoke Free (23 Limited), a leading smoking cessation app with established efficacy.

Beyond the bench: LGBTQ+ health equity after India's "no same-sex marriage" verdict.

LGBTQ+ people (e.g., lesbian, gay, bisexual, transgender, and queer or questioning people) experience systemic marginalisation and discrimination globally and throughout India.

Predictors of Outpatient and Inpatient Service Utilization Among Publicly-Insured Youth With Eating Disorders.

Introduction: Although eating disorders (EDs) affect youth from all socioeconomic backgrounds, little is known about the treatment experiences of under-resourced youth with EDs. To address this gap, we examined patterns of outpatient and inpatient service utilization among publicly-insured youth with EDs in California and potential disparities for youth with additional marginalized identities.

Method: Participants were identified from the full sample of California Medicaid/Medi-Cal beneficiaries aged 7-18 with ≥ 1 service episode between January 1, 2014 and December 31, 2016.

Interdisciplinary perspectives on accessing specialty evidence-based treatment for Medicaid-insured adolescents with eating disorders.

Background: Family-based treatment (FBT), the leading intervention for adolescents with anorexia nervosa (AN), is severely understudied in outpatient care settings that serve publicly-insured populations. Many individuals with public insurance are lower-income, racially and ethnically diverse, and experience barriers to accessing evidence-based interventions for eating disorders (EDs).

Methods: Semi-structured interviews were conducted with ten interdisciplinary providers who provide specialty care to youth with EDs in an inpatient and/or outpatient medical setting.

Practice-Based Models of Pediatric Mental Health Care.

Pediatric primary care is widely available in the United States and can help address the growing public health crisis in child and adolescent mental health by providing integrated behavioral health services. This article provides an overview of 3 common models of behavioral health integration in pediatric primary care settings: 1) the Child Psychiatry Access Program model, 2) the Primary Care Behavioral Health model, and 3) the Collaborative Care Model. Pediatric primary care practices may evaluate the different features of each model before adopting an approach for integration and consider tailoring it to their practice environments.

Perceptions of brain health and aging among middle-aged latinos: A qualitative paper.

Objectives: Latinos living in the US are disproportionately impacted by Alzheimer's disease and related dementias (ADRD). To develop culturally-informed interventions, a first step is engaging with key stakeholders. The present study aimed to explore perspectives on brain health and aging among middle-aged Latinos living in Chicago, IL.

Prevalence and Determinants of Prehospital Impression of Stroke in Ischemic Stroke Patients.

Background: Emergency Medical Services (EMS) clinicians are front-line in evaluating patients with stroke in the community. Their ability to correctly identify stroke influences downstream management decisions. We sought to use a large national database of prehospital clinical data to determine risk factors associated with missed EMS stroke identification.