State-Level Structural Racism and Children's Dental Care Access and Oral Health.

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.

Improving perinatal depression screening uptake: The impact of Medicaid reimbursement policy in Massachusetts.

Objective: To evaluate the impact of the Massachusetts Medicaid program's reimbursement policy change for perinatal depression screening on utilization rates.

Study Setting And Design: This study employed a difference-in-differences design to compare insurance-paid prenatal and postpartum depression screening rates as well as postpartum antidepressant receipt rates between Medicaid and privately insured individuals before and after policy implementation in May 2016.

Data Sources And Analytic Sample: Data are from the 2014-2020 Massachusetts All-Payer Claims Database.

Reducing Hospitalizations and Multidrug-Resistant Organisms via Regional Decolonization in Hospitals and Nursing Homes.

Importance: Infections due to multidrug-resistant organisms (MDROs) are associated with increased morbidity, mortality, length of hospitalization, and health care costs. Regional interventions may be advantageous in mitigating MDROs and associated infections.

Objective: To evaluate whether implementation of a decolonization collaborative is associated with reduced regional MDRO prevalence, incident clinical cultures, infection-related hospitalizations, costs, and deaths.

Preventive Primary Care in the Postpartum Year: The Role of Medicaid Delivery System Reform.

Introduction: Preventive and primary care in the postpartum year is critical for future health and may be increased by primary care focused delivery system reform including implementation of Medicaid Accountable Care Organizations (ACO). This study examined associations of Massachusetts Medicaid ACO implementation with preventive visits in the postpartum year.

Methods: The Massachusetts All-Payer Claims Database was used to identify births to privately-insured or Medicaid ACO-eligible individuals from January 1, 2016 to February 28, 2019.

Association of Postpartum Mental Illness Diagnoses with Severe Maternal Morbidity.

This study aimed to determine whether birthing people who experience severe maternal morbidity (SMM) are more likely to be diagnosed with a postpartum mental illness. Using the Massachusetts All Payer Claims Database, this study used modified Poisson regression analysis to assess the association of SMM with mental illness diagnosis during the postpartum year, accounting for prenatal mental illness diagnoses and other patient characteristics. There were 128,161 deliveries identified, with 55.

Barriers and Facilitators to Optimal Fluoride Varnish Application.

Objective: National guidelines recommend that all children under age six receive fluoride varnish (FV) in medical settings. However, application rates remain low. This study aimed to update understanding of barriers and facilitators to guideline concordant FV application.

National validation of the Centers for Medicare & Medicaid Services strategy for identifying potential surgical-site infections following colon surgery and abdominal hysterectomy.

Objective: National validation of claims-based surveillance for surgical-site infections (SSIs) following colon surgery and abdominal hysterectomy.

Design: Retrospective cohort study.

Setting: US hospitals selected for data validation by Centers for Medicare & Medicaid Services (CMS).

Online survey of consumer awareness and perceptions of a Massachusetts law for 12-month supply of contraception.

Objectives: This study aimed to characterize awareness of a 2017 Massachusetts (MA) law that ensures access to a 12-month supply of short-acting contraceptive methods (e.g., pill, patch, and vaginal ring) among short-acting contraceptive users in MA and to identify perceived benefits and concerns of a 12-month supply.

Adolescents' Views on Preventing Youth Cannabis Marketing Exposure: A Concept Mapping Approach.

Objective: The increasing number of states legalizing recreational cannabis use has raised growing concerns about exposure and access to cannabis for youth. The objective of this study was to develop an adolescent stakeholder-driven concept map toward identifying priority areas for preventing youth cannabis marketing influence.

Method: This study used concept mapping, a validated research method that leverages both qualitative and quantitative approaches to integrate stakeholder input on complex topics.

A qualitative study of clinicians' perspectives on a law that allows for a 12-month supply of short-acting contraceptives in Massachusetts: Barriers and facilitators to implementation.

Objective: To explore clinicians' perspectives regarding the Massachusetts 2017 law, 'An Act Relative to Advancing Contraceptive Coverage and Economic Security in Our State' (ACCESS), including awareness of the law, perceived barriers and facilitators to successful implementation, and recommendations to improve uptake. ACCESS requires all insurers, except self-insured businesses, to cover short-acting reversible contraceptives (SARCs) at no cost to patients and for a 12-month supply to be prescribed/dispensed if desired after the completion of a three-month trial.

Data Sources And Study Setting: We collected primary data from clinicians in Massachusetts from February 1 to July 31, 2021.

Preventive care visits with OB/GYNs and generalist physicians among reproductive-age women with chronic conditions.

Objective: To examine services delivered during preventive care visits among reproductive-age women with and without chronic conditions by physician specialty.

Data Sources: National Ambulatory Medical Care Surveys (2011-2018).

Study Design: We examined provision of specific services during preventive care visits by physician specialty among reproductive-age female patients, overall and among women with five common chronic conditions (diabetes, hypertension, depression, hyperlipidemia, and asthma).

Transitions in Health Insurance During the Perinatal Period Among Patients With Continuous Insurance Coverage.

Importance: Although health insurance continuity is important during the perinatal period to improve birth outcomes and reduce maternal morbidity and mortality, insurance disruptions are common. However, little is known about insurance transitions among insurance types for individuals who remained insured during the perinatal period.

Objective: To examine insurance transitions for birthing individuals with continuous insurance, including those with Medicaid and Medicaid managed care coverage, before, during, and after pregnancy.

An expert judgment model to predict early stages of the COVID-19 pandemic in the United States.

From February to May 2020, experts in the modeling of infectious disease provided quantitative predictions and estimates of trends in the emerging COVID-19 pandemic in a series of 13 surveys. Data on existing transmission patterns were sparse when the pandemic began, but experts synthesized information available to them to provide quantitative, judgment-based assessments of the current and future state of the pandemic. We aggregated expert predictions into a single "linear pool" by taking an equally weighted average of their probabilistic statements.

Combined laparoscopic and open colon surgery rankings fail to accurately rank hospitals by surgical-site infection rate.

Objective: To compare strategies for hospital ranking based on colon surgical-site infection (SSI) rate by combining all colon procedures versus stratifying by surgical approach (ie, laparoscopic vs open).

Design: Retrospective cohort study.

Methods: We identified SSIs among Medicare beneficiaries undergoing colon surgery from 2009 through 2013 using previously validated methods.

Variation in Current Guidelines for Fluoride Varnish Application for Young Children in Medical Settings in the United States.

Background: The United States Preventive Services Task Force recommends that medical providers apply fluoride varnish (FV) to the teeth of all children under 6 years of age, but fewer than 10% of eligible children receive FV as recommended. Prior studies suggest that variation in clinical guidelines is associated with low uptake of other evidence-based health-related interventions, but consistency of national guidelines for the delivery of FV in medical settings is unknown.

Methods: Eligible guidelines for application of FV in medical settings for children under 6 years of age were published in the past 10 years by national pediatric or dental professional organizations or by national public health entities.

Postpartum Visit Attendance in the United States: A Systematic Review.

Introduction: Adequate postpartum care, including the comprehensive postpartum visit, is critical for long-term maternal health and the reduction of maternal mortality, particularly for people who may lose insurance coverage postpartum. However, variation in previous estimates of postpartum visit attendance in the United States makes it difficult to assess rates of attendance and associated characteristics.

Methods: We conducted a systematic review of estimates of postpartum visit attendance.

Vasomotor symptoms in midlife women with incident breast cancer: pink SWAN.

Purpose: We compared trajectories of vasomotor symptoms (VMS) and their risk factors in women with breast cancer (BrCa) to those of cancer-free controls.

Methods: Data were from 15 nearly annual follow-up visits (1996-2017) of the multi-racial/ethnic cohort of midlife women enrolled in the Study of Women's Health Across the Nation (SWAN). We compared women with incident BrCa to controls for patterns of VMS, controlling for risk factors identified in bivariate analyses using multivariable longitudinal analyses.

Physician Referrals During Prenatal Care.

Objective: Referrals are an important component of patient care, and have been increasing over time. During pregnancy, people have intensive contact with the healthcare system, but little is known about the involvement of different physicians for pregnant patients during this period. This study examines referral patterns during prenatal care visits.

Sexual Orientation and Obesity: What Do We Know?

Purpose Of Review: This review describes research addressing sexual orientation disparities in obesity and their sequelae, with a focus on new findings from the past year and areas for future work.

Recent Findings: Sexual minority people of color experience important health disparities related to obesity. Sexual minority women may be at greater risk of developing type 2 diabetes than their heterosexual counterparts, potentially because of obesity-related disparities.