Reporting of black box warnings for prescription drugs by newspapers and the associate press.4.20.09
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1) The document analyzes 478 newspaper and Associated Press reports about black box warnings issued by the FDA for prescription drugs between 2003-2007. 2) It finds that the reports consistently discussed the drug risks that prompted the warnings but often failed to quantify the risks or provide details about the supporting evidence and studies. 3) The reports rarely advised patients to adhere to treatment or consult their healthcare providers when making decisions.
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![Reporting of black box warnings for prescription drugs by newspapers and the Associated Press David N Flynn 1 , BS; Cabral Bigman 2 , MA; Pierre L Yong 3,4,5,6 , MD, MPH 1 University of Pennsylvania School of Medicine, Philadelphia, PA; 2 Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA; 3 Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania School of Medicine, Philadelphia, PA; 4 Philadelphia Veterans Affairs Medical Center, Philadelphia, PA; 5 Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; 6 Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA The purpose of this study was to characterize information presented in articles about BBWs by major U.S. newspapers and the AP ,[object Object],[object Object],[object Object],Background Objective ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Methods Results ,[object Object],[object Object],[object Object],Conclusions Table 1 . Description of AP and Newspaper Reports of Black Box Warnings Report Contents No. (%) Total 478 Drug name Brand 444 (93) Generic 110 (23) Treatment Indications 477 (99) Benefits 133 (28) Risks Risk prompting BBW 474 (99) Quantitative risk information 256 (46) Evidence of risk 394 (82) Study methodology 138 (29) Patient advice Encourage adherence 17 (4) Encourage consult with healthcare provider 34 (7)](https://image.slidesharecdn.com/reportingofblackboxwarningsforprescriptiondrugsbynewspapersandtheassociatepress-4-20-09-100819091457-phpapp01/85/Reporting-of-black-box-warnings-for-prescription-drugs-by-newspapers-and-the-associate-press-4-20-09-1-320.jpg)
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This document discusses the use of group-based incentives, known as gainsharing programs, between hospitals and cardiologists. It presents a theoretical framework for why such incentives could help align the incentives of physicians with the cost considerations of hospitals. The document outlines an empirical study that will test the effects of gainsharing programs on stent costs, quantities, and prices using data from hospitals that have implemented these programs. It will examine whether gainsharing leads to standardization, lower device prices through volume discounts, and a market response from medical device manufacturers.LDI Research Seminar 9_7_12 Eff ects of Federal Policy to Insure Young Adults...
LDI Research Seminar 9_7_12 Eff ects of Federal Policy to Insure Young Adults...Leonard Davis Institute of Health Economics
The document summarizes a study that analyzes the effects of the 2010 Affordable Care Act's dependent coverage mandate on young adults' health insurance coverage and labor market behavior using data from the 2008 panel of the Survey of Income and Program Participation. The study finds that the policy led to a 3.3 percentage point reduction in uninsurance among young adults ages 19-25, a 6.2 percentage point increase in dependent coverage through a parent's employer-sponsored insurance, and evidence of increased labor market flexibility for young adults.CMHPSR/LDI Research Seminar_New Models for Childrens Mental Health Services D...
CMHPSR/LDI Research Seminar_New Models for Childrens Mental Health Services D...Leonard Davis Institute of Health Economics
The document outlines Marc Atkins' presentation goals which include reviewing concerns with the current U.S. children's mental health care system, justifying a focus on schooling using ecological principles and a public health framework, presenting an experimental intervention model and preliminary results, and discussing future directions. It then lists the collaborators involved in the research from various universities.LDI Research Seminar with Art Kellermann, MD, MPH 11_28_12
LDI Research Seminar with Art Kellermann, MD, MPH 11_28_12Leonard Davis Institute of Health Economics
This document summarizes key findings from RAND research on health care spending in the United States. It finds that between 1999-2009, health care costs grew substantially for a median-income American family, consuming money that could have otherwise been used to pay down debt, save for retirement, or pay for education. While Americans received more medical services, the quality of care was still suboptimal, with recommended care received only about 55% of the time. The document also examines different approaches to reducing health care costs, finding that high-deductible health plans with deductibles over $1,000 were effective in reducing spending.Comparison of HIV Testing with other Markers of Chronic Disease Screening 4_...
Comparison of HIV Testing with other Markers of Chronic Disease Screening 4_...Leonard Davis Institute of Health Economics
This document analyzes survey data from 2002-2010 on HIV testing rates and chronic disease screening in Southeastern Pennsylvania. It finds that HIV testing rates are lower than screening for other chronic diseases. Populations receiving care at community health clinics, emergency rooms, or with no primary care are more likely to get HIV testing than those at private clinics. While community health clinics perform similar to private clinics on chronic disease screening, those using emergency rooms or with no primary care are less likely to receive routine chronic disease screening. Primary care physicians adhere to guidelines for screening of conditions like blood pressure and cancer but may neglect appropriately screening for HIV.Healthcare System Supports for Internists Caring for Young Adult Patients wit...
Healthcare System Supports for Internists Caring for Young Adult Patients wit...Leonard Davis Institute of Health Economics
This study examined the healthcare system supports for internists caring for young adult patients with chronic illnesses that began in pediatric care. Semi-structured interviews were conducted with 21 internists across 4 states. The interviews identified 5 major themes of healthcare system burdens experienced by internists, including difficulty identifying patients' medical teams, inadequate time for complex patients, significant administrative burden, lack of social/case management support, and financial constraints. The interviews also identified 3 potential strategies to improve supports, such as formalizing transfer processes, maximizing electronic records/communication, and leveraging patient-centered medical homes and bundled payments.High Value Cost Conscious Care: Is it Rationing or Rational Care? 1_11_13
High Value Cost Conscious Care: Is it Rationing or Rational Care? 1_11_13Leonard Davis Institute of Health Economics
1. The document discusses high value cost conscious care and whether it constitutes rationing or rational care.
2. It notes that health care costs in the US continue to rise significantly each year, with diagnostic imaging being a major driver of increasing costs.
3. Data from 6 large health systems showed large variations in diagnostic imaging rates between different regions without clear clinical benefits, indicating opportunities for more rational use of imaging to improve quality and reduce costs.Is the quality of case management in a medical home associated with patient s...
Is the quality of case management in a medical home associated with patient s...Leonard Davis Institute of Health Economics
This study examines the association between patient perceptions of case manager performance and satisfaction with care, as well as the relationship between perceptions of case managers and primary care providers (PCPs) and subsequent healthcare utilization. The study analyzed survey and claims data from over 2,000 patients receiving primary care from a medical home model with embedded case managers. The results found that higher ratings of both case manager and PCP performance were independently associated with greater patient satisfaction. The study concludes by noting that perceptions of case management may impact health outcomes and behaviors, warranting further analysis of utilization patterns.Elderly Adults with Dementia and Young Adults with Developmental Disabilities...
Elderly Adults with Dementia and Young Adults with Developmental Disabilities...Leonard Davis Institute of Health Economics
Most internists found more similarities than differences in caring for young adults with intellectual and developmental disabilities (I/DD) and elderly adults with dementia. Both populations require longer office visits and more staffing resources due to complex health histories. Obtaining records and coordinating care can be difficult for both. Reliance on advocates, community services for transportation and supervision, and vulnerability to insurance changes are also similarities. While specific diseases differ, models for geriatric care could potentially address supervision and caretaking needs for adults with I/DD. Strengthening safety net services would help low-income families and elderly patients with dementia or I/DD.Comparison of HIV Testing with other Markers of Chronic Disease Screening
Comparison of HIV Testing with other Markers of Chronic Disease Screening Leonard Davis Institute of Health Economics
This study analyzed survey data from 50,698 individuals in Southeastern Pennsylvania between 2002-2010 to compare HIV testing rates to other routine health screenings. It found that HIV testing rates were lower than for other conditions. Those receiving care at community health clinics, emergency rooms, or with no primary care had higher odds of receiving an HIV test compared to private clinics. While community health clinics performed similarly to private clinics on other screenings, emergency rooms and no primary care had lower rates. The study suggests primary care physicians may neglect appropriate HIV screening of patients despite adhering to other screening guidelines.LDI Health Policy Seminar with Jeffrey Brenner_ Bending the Cost Curve and Im...
LDI Health Policy Seminar with Jeffrey Brenner_ Bending the Cost Curve and Im...Leonard Davis Institute of Health Economics
This document discusses efforts to improve healthcare in Camden, New Jersey, one of the poorest cities in the U.S. It describes the formation of the Camden Coalition of Healthcare Providers to coordinate care for high-cost, high-need patients through a citywide database and care management programs. The Coalition aims to reduce emergency room and hospital utilization by 20-30% through strategies like nurse-led clinics, same-day appointments, and assigning patients to medical homes for coordinated care. The document highlights lessons from Camden including focusing on high-cost patients, adapting to local needs, and standardizing processes gradually over time.1_13_12 LDI/CHIPS Health Policy Seminar-- Building High Value in Health Syste...
1_13_12 LDI/CHIPS Health Policy Seminar-- Building High Value in Health Syste...Leonard Davis Institute of Health Economics
The document discusses the role of the National Quality Forum in developing a national strategy for improving health systems performance measurement. It describes how the NQF works with partners like the National Priorities Partnership to establish priorities focused on increasing value, develop standardized measures, and align public and private accountability programs. The goal is to create a coordinated performance measurement system that drives improvement in health outcomes, quality, and affordability.Viewers also liked (17)
LDI Charles Leighton Memorial Lecture with Mark Chassin, MD 5_4_12
LDI Charles Leighton Memorial Lecture with Mark Chassin, MD 5_4_12
LDI Health Policy Seminar 4_6_12: Care Management at Geisinger: Approach, Res...
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LDI Health Policy Seminar 2_3_12 "Unleashing the Power of Data, IT, and Innov...
LDI Health Policy Seminar 2_3_12 "Unleashing the Power of Data, IT, and Innov...
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LDI Research Seminar_ Standardization under Group Incentives 4_27_12
LDI Research Seminar 9_7_12 Eff ects of Federal Policy to Insure Young Adults...
LDI Research Seminar 9_7_12 Eff ects of Federal Policy to Insure Young Adults...
CMHPSR/LDI Research Seminar_New Models for Childrens Mental Health Services D...
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High Value Cost Conscious Care: Is it Rationing or Rational Care? 1_11_13
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Is the quality of case management in a medical home associated with patient s...
Is the quality of case management in a medical home associated with patient s...
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Comparison of HIV Testing with other Markers of Chronic Disease Screening
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LDI Health Policy Seminar with Jeffrey Brenner_ Bending the Cost Curve and Im...
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Similar to Reporting of black box warnings for prescription drugs by newspapers and the associate press.4.20.09
CDC Opioid Prescribing Guidelines
This document provides guidelines from the CDC for prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care. It summarizes that while opioids can provide short-term pain relief, there is little evidence for their long-term effectiveness and they present serious risks including overdose and opioid use disorder. It then outlines recommendations for clinicians on when to initiate or continue opioids, opioid selection and dosing, assessing risks, and addressing harms to improve safety and reduce risks of long-term opioid therapy.
Is health journalism evidence-based?
- Reuters Health chooses stories based on impact, likelihood of changing practice, strength of evidence, and novelty. They aim to cover stories closely following the HealthNewsReview.org criteria.
- Studies show most health news coverage does not adequately report on benefits, harms, costs or alternatives. Sources with conflicts of interest are often not disclosed.
- Accurate health information is important as many people, especially minorities and those without regular providers, rely on media for health information. Inadequate coverage can negatively impact health behaviors and outcomes.
- Potential interventions include addressing staffing pressures, increasing reporter knowledge, and improving press releases from academic institutions. Targeting coverage at minority audiences may help increase access to care.
Can You Trust What You Read In (Scientific and News)papers?
Presentation at the University of Alabama, Birmingham, June 14, 2013. Contains some slides from previous talks.
Shoot The Messenger? Challenges in Medical Journalism
1) Medical journalism is often lacking in providing complete and balanced information about medical studies, procedures, and products. Many news stories fail to adequately discuss benefits, risks, costs, and alternatives.
2) There are several challenges facing medical journalists, including lack of time and resources to thoroughly research topics, pressure to produce more content, and reliance on sources like press releases that may promote certain findings.
3) Both journalists and academic medical centers could improve by taking more time to ensure coverage is balanced, explaining studies accurately and completely, and addressing potential conflicts of interest among sources. Developing relationships with expert sources can also help improve medical news reporting.
Ira Klein, Can Value-based Contracting Work for Pharma Companies?
Ira Klein, Can Value-based Contracting Work for Pharma Companies?The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics
March 02, 2018
Value-based health care is one of the most pressing topics in health care finance and policy today. Value-based payment structures are widely touted as critical to controlling runaway health care costs, but are often difficult for health care entities to incorporate into their existing infrastructures. Because value-based health care initiatives have bipartisan support, it is likely that these programs will continue to play a major role in both the public and private health insurance systems. As such, there is a pressing need to evaluate the implementation of these initiatives thus far and to discuss the direction that American health care financing will take in the coming years.
To explore this important issue, the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School collaborated with Ropes & Gray LLP to host a one-day conference on value-based health care. This event brought together scholars, health law practitioners, and health care entities to evaluate the impact of value-based health care on the American health care system.
For more information, visit our website at: http://petrieflom.law.harvard.edu/events/details/will-value-based-care-save-the-health-care-systemDisease Management For Depression
This document provides an overview of disease management for depression. It defines disease management and explains why depression is a suitable condition for a disease management program. Depression is common, underdiagnosed and undertreated despite available effective therapies. Disease management could help improve diagnosis and treatment of depression through strategies like educating healthcare providers, increasing screening of patients, and ensuring adherence to treatment guidelines. This could help reduce the personal and economic burden of depression.
Health News Coverage: Just How Bad It Is, Why It Matters, and What Doctors Ca...
The document summarizes research on the quality of health news coverage and discusses why improving coverage matters and what doctors can do to help. Key findings include:
- Many news stories do not adequately report on the benefits and risks of medical treatments, tests, and drugs or mention costs.
- For many groups, media and doctors are the top sources of health information, so inaccurate coverage can influence health behaviors.
- Doctors can help by developing relationships with reporters, answering questions, reviewing press releases, and providing context on new studies through their own blogs or comments to reporters.
Rx16 tpp wed_200_group
This document summarizes a presentation on health plan involvement in safe prescribing. It includes:
1) Presentations from medical experts on prescription drug abuse trends from medical examiner data and a tribal health system's safe prescribing program.
2) A discussion of health plan policies to reduce "red flag" medication combinations like opioids plus benzodiazepines through prior authorization, formulary changes, and provider restrictions.
3) Examples of one health plan's implementation of policies like restricting methadone prescriptions to pain specialists and removing carisoprodol from its formulary.
Farmaceuticas suplementos dieteticos
El Estudio que Demostró el Control de la Industria de la Enfermedad sobre la Medicina
Este nuevo estudio, el primero en su tipo, comparó específicamente el nivel de publicidad farmacéutica con la cantidad y tipo de publicaciones acerca de suplementos alimenticios. Los autores revisaron un año de publicaciones de los 11 journals más grandes del mundo como por ejemplo el Journal of the American Medical Association, New England Journal of Medicine, British Medical Journal, Canadian Medical Association, Annals of Internal Medicine, Archives of International Medicine, Archives of Pediatric and Adolescent Medicine, Pediatrics and Pediatric Research y el American Family Physician.
American Journal of Emergency & Critical Care Medicine
Background: The Food and Drug Administration relies on adverse event reports linked with health risks to remove potentially harmful dietary supplements from the market. Many emergency medicine physicians encounter suspected adverse events related to
dietary supplement use but we do not know what proportion of those adverse events are reported to the Food and Drug Administration. The objective of the study was to determine emergency medicine physicians’ practices regarding adverse event reporting and knowledge of dietary supplements.
Methods: A prospective, cross-sectional study was conducted across five medical centers around the U.S: three military and two civilian. A web-based survey was distributed to emergency medicine attending physicians and emergency medicine residents. The questionnaire was created and administered using Lime Survey software. An administrator at each site communicated study details to emergency medicine physicians and residents via email. The survey was kept open for fi ve months. To preserve participant anonymity,
neither email domains, email addresses, Internet Protocol addresses, nor any other personally identifi able or demographic information were collected.
Rebecca Ruggear Senior Thesis 2013
The document discusses patient non-adherence to medical treatment plans. It summarizes research showing that healthcare providers and patients have differing views on adherence levels. The main reasons for non-adherence are identified as lack of education, forgetfulness, and cost/complexity of treatment plans. The document reports on surveys of healthcare providers and patients, finding that both groups agree responsibility for adherence is primarily on patients, but that doctors and other providers should better educate patients. Improving communication between providers and patients is seen as key to increasing treatment adherence.
Coverage of Clinical Medicine: A Diagnosis and Treatment Plan
This document provides an overview of challenges in covering clinical medicine and summarizes strategies for improving medical journalism. It discusses issues such as lack of time leading journalists to rely heavily on press releases without sufficient vetting. It also outlines MedPage Today's approach of prioritizing impact, evidence strength, and novelty. Recommendations include curating high-quality sources, specializing in specific topic areas, partnering with other organizations, and getting to know professional groups like the Association of Health Care Journalists. The overall aim is to help journalists overcome barriers and add value through their reporting.
Clinical literature evaluation
This document discusses the importance of evaluating clinical literature and provides guidance on how to systematically approach literature evaluation. It describes how to identify the level and type of reference (tertiary, secondary, primary), and provides tips for evaluating different aspects of clinical studies, such as the objective, subjects, treatment administration, setting, methods, controls, and data analysis. The document also discusses how the FDA communicates important drug safety information to healthcare professionals and the public.
Marketing and promotion_facts_071108_final
Pharmaceutical marketing aims to educate consumers and healthcare professionals about new treatments. While some question the value of marketing, it plays an important role in disseminating medical information. Recent changes include voluntary principles for direct-to-consumer ads and a strengthened industry code of ethics. Studies show marketing helps address underdiagnosis and undertreatment by raising disease awareness and prompting patients to see doctors. However, most physicians say clinical knowledge and patient needs strongly influence prescribing over marketing.
Marketing and promotion_facts_071108_final
Pharmaceutical marketing to healthcare providers provides information on new treatment options, but it is only one of many factors that influence prescribing decisions. Surveys find clinical knowledge, patient factors, and insurance policies have greater impacts. Approximately 67% of US prescriptions are for generic drugs, much higher than other countries. While representatives provide information, prescribing is shaped more by clinical guidelines, peers, formularies, and insurers' prior authorization requirements than representative interactions.
PatientBillofRights
The pharmaceutical industry has made it very difficult to know what the clinical trial evidence actually is regarding psychotropics. Consequently, primary care physicians and other front-line practitioners are at a disadvantage when attempting to adhere to the ethical and scientific mandates of evidence based prescriptive practice. This article calls for a higher standard of prescriptive care derived from a risk/benefit analysis of clinical trial evidence. The authors assert that current prescribing practices are empirically unsound and unduly influenced by pharmaceutical company interests, resulting in unnecessary risks to patients. In the spirit of evidenced based medicine’s inclusion of patient values as well as the movement toward health home, we present a patient bill of rights for psychotropic prescription. We then offer guidelines to raise the bar of care equal to the available science for all prescribers of psychiatric medications.
Web only rx16 pharma wed_200_1_hagemeier_2fleming_3vernachio
Community pharmacists are well positioned to help address the growing problem of opioid and benzodiazepine addiction but face challenges. Early identification of at-risk patients, supportive benefit structures, and intervention training could empower pharmacists. While many recognize their responsibility, behavioral engagement in prevention is often lacking due to practice barriers, lack of patient information, and fear of responses. Standardizing communication expectations and screening tools could help pharmacists better fulfill their role on the treatment team.
MTM
Medication Therapy Management (MTM) involves pharmacists working with patients and their healthcare providers to optimize medication use. MTM services include comprehensive medication reviews, managing chronic conditions, and ensuring treatment adherence. These services help identify medication issues, reduce errors and hospital readmissions, and lower healthcare costs. MTM benefits all patients, especially those with complex medication needs or chronic illnesses.
DINDI.SANDHYA RANI
This document discusses various sources of drug information and a systematic approach for providing unbiased drug information. It describes primary, secondary, and tertiary resources. Primary resources include clinical trials and journal articles. Secondary resources are indexing and abstracting services like MEDLINE. Tertiary resources include textbooks, formularies, and drug compendia that summarize and synthesize information from multiple sources. The document emphasizes that tertiary resources are usually the best starting point for answering drug information questions.
Sexually Transmitted Diseases Treatment Guidelines, 2015
Sexually Transmitted Diseases Treatment Guidelines, 2015. U.S. Department of Health and Human Services -- Centers for Disease Control and Prevention
Similar to Reporting of black box warnings for prescription drugs by newspapers and the associate press.4.20.09 (20)
Can You Trust What You Read In (Scientific and News)papers?
Can You Trust What You Read In (Scientific and News)papers?
Shoot The Messenger? Challenges in Medical Journalism
Shoot The Messenger? Challenges in Medical Journalism
Ira Klein, Can Value-based Contracting Work for Pharma Companies?
Ira Klein, Can Value-based Contracting Work for Pharma Companies?
Health News Coverage: Just How Bad It Is, Why It Matters, and What Doctors Ca...
Health News Coverage: Just How Bad It Is, Why It Matters, and What Doctors Ca...
American Journal of Emergency & Critical Care Medicine
American Journal of Emergency & Critical Care Medicine
Coverage of Clinical Medicine: A Diagnosis and Treatment Plan
Coverage of Clinical Medicine: A Diagnosis and Treatment Plan
Web only rx16 pharma wed_200_1_hagemeier_2fleming_3vernachio
Web only rx16 pharma wed_200_1_hagemeier_2fleming_3vernachio
Sexually Transmitted Diseases Treatment Guidelines, 2015
Sexually Transmitted Diseases Treatment Guidelines, 2015
More from Leonard Davis Institute of Health Economics
The Effects of Federal Parity on Substance Use Disorder Treatment_Andrew Epst...
The Effects of Federal Parity on Substance Use Disorder Treatment_Andrew Epst...Leonard Davis Institute of Health Economics
This study analyzed insurance claims data from before and after the implementation of the Federal Mental Health Parity and Addiction Equity Act to examine the effects of parity on substance use disorder treatment. The results showed:
1) There was no change in the use of substance use disorder services or the total annual spending per enrollee on these services (which increased by only $10 per enrollee).
2) There was also no change in out-of-pocket spending for substance use disorder treatment users or several HEDIS quality measures related to identification and initiation of treatment.
3) This suggests that concerns about parity greatly increasing health care costs related to substance use disorder treatment were unfounded.Epstein,andy ispor poster_2013
This study analyzed insurance claims data from before and after the implementation of the Federal Mental Health Parity and Addiction Equity Act to examine the effects of parity on substance use disorder treatment. The results showed:
1) There was no change in the use of substance use disorder services or the total annual spending per enrollee on these services (which increased by only $10 per enrollee).
2) There was also no change in out-of-pocket spending for substance use disorder treatment users or several HEDIS quality measures related to identification and initiation of treatment.
3) This suggests that concerns about parity greatly increasing health care costs related to substance use disorder treatment were unfounded.
Does a Wireless Incentive Structure Improve Retention, Subject Satisfaction a...
Does a Wireless Incentive Structure Improve Retention, Subject Satisfaction a...Leonard Davis Institute of Health Economics
This study compared retention rates, satisfaction, and safety between intimate partner violence (IPV) research participants paid via wireless gift cards versus cash. Participants receiving gift cards completed significantly more of the 12 weekly phone surveys (average 8.3 vs 6 calls). Over 90% of gift card recipients expressed satisfaction, and 60% preferred this method. While safety did not differ, wireless incentives may improve retention in repetitive IPV research that can involve remote data collection.Characterizing Emergency Department Utilization By A Population-based Cohort...
Characterizing Emergency Department Utilization By A Population-based Cohort...Leonard Davis Institute of Health Economics
This study analyzed data from 658 insured pregnant women in a Midwestern county to compare risks and outcomes between those who did and did not utilize the emergency department (ED) during their peripartum period. The study found that 218 women (33%) visited the ED at least once during this time. ED users were more likely to experience psychosocial risks like postpartum depression and smoking, have poorer birth outcomes like prematurity, and have inadequate prenatal care. After adjusting for demographic factors, ED use was associated with a higher likelihood of postpartum depression, smoking during pregnancy, unstable housing, delayed prenatal care initiation, and missing a postpartum visit.Non-Medically Indicated Delivery Prior to 39 Weeks Gestation in United State...
Non-Medically Indicated Delivery Prior to 39 Weeks Gestation in United State...Leonard Davis Institute of Health Economics
This study conducted a telephone survey of labor and delivery units at U.S. hospitals to determine the prevalence of hospital policies addressing non-medically indicated deliveries prior to 39 weeks gestation. They found that 66.5% of responding hospitals reported having such a policy. Hospitals in states with initiatives to reduce early deliveries were more likely to have a policy, with 67.8% of hospitals in initiative states reporting a policy compared to 62.1% in non-initiative states. The majority (68.8%) of policies were coded as having a "hard stop" against early deliveries. The study concludes that state initiatives can effectively encourage more hospitals to adopt restrictive policies on non-medically indicated early deliverA Qualitative Study of Adverse Childhood Experiences of Low-Income Youth in P...
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This study explored a broader range of adverse childhood experiences reported by low-income adults from Philadelphia compared to those measured in previous research. The researchers conducted focus groups with 119 participants who generated a list of childhood stressors across 10 domains. The most commonly reported experiences were issues within family relationships, community safety threats, personal victimization, and economic hardship. The study concludes that considering a wider range of adversities is important for understanding health impacts on low-income urban populations.The Intersection of Attitudes and Organizational Factors by Provider Type in ...
The Intersection of Attitudes and Organizational Factors by Provider Type in ...Leonard Davis Institute of Health Economics
This document summarizes a mixed-methods study examining the relationship between mental health therapists' attitudes towards evidence-based practices (EBPs), perceptions of organizational factors, and degree status. The study found that doctoral-level therapists with positive attitudes reported more autonomy, while those with less positive attitudes reported requirements to use CBT and lack of time. Non-doctoral therapists reported lack of resources, space, funding, and regular client access as barriers. Managerial support was a facilitator for all therapists. The study provides insight into implementation challenges faced in community clinics from front-line perspectives.Doulas to fill the gap: a proposed model of doula delivery of cognitive-behav...
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This document proposes a model where doulas receive training in cognitive behavioral therapy (CBT) principles from staff at an integrated maternal wellness clinic. The objectives are to incorporate doulas into standard practice while providing training, and to utilize doulas to increase implementation of evidence-based CBT for common mental health issues in the perinatal period like anxiety and depression. Limitations include challenges of implementing a novel intervention and ensuring standardized training, protected staff time, and adherence to practice guidelines.A Glorious Mess: Implementing Evidence-Based Social Skills Interventions in P...
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This study piloted a modified social skills intervention for children with ASD implemented by school personnel in public school settings. The intervention focused on facilitating peer engagement during lunch and recess. Results showed improvements in social network centrality and joint engagement for children who received the immediate treatment compared to those in the waitlist control. However, barriers like unclear staff roles, lack of support, and loss of recess time prevented long-term sustainability. Future work is needed to address school-level barriers to implementation and adapt interventions to fit individual school contexts.LDI Research Seminar- Is Blood Thicker Than Water? Cardiologist Peer Effects ...
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You are to pay special attention to those who, by the accidents of time, place, or circumstances, are brought into closer connection with you.LDI Research Seminar- Targeted Testing & Treatment for Breast Cancer 11_18_11
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Genetic testing for breast cancer like HER2 and gene expression profiling (GEP) can impact healthcare disparities. While HER2 testing is widely used with trastuzumab treatment, there is still some underuse. GEP testing is only modestly used and is associated with less chemotherapy for low risk patients but more for high risk. Studies show black women may be less eligible for GEP and there is inadequate data on effectiveness in diverse groups. Ensuring validation in diverse populations, broad recruitment, and addressing social factors can help reduce disparities in precision medicine.LDI Research Seminar- Hospital Choices, Hospital Prices and Financial Incenti...
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This study investigated the relationship between levels of instrumental activities of daily living (IADL) limitation and history of falls in community-dwelling older adults. The study used a nationally representative sample of 7,401 people aged 70 and older. Participants were classified into five stages based on their ability to perform IADL tasks independently. The results showed that the proportion of people reporting a fall in the past year and multiple falls increased with higher IADL limitation stages, contrary to the study's hypothesis. The highest rates of falling were found in stages II and III, indicating a relationship between IADL limitations and falls risk in older adults.More from Leonard Davis Institute of Health Economics (13)
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