Cardiometabolic deaths in premenopausal black and white women.

Background: Black women in the United States bear a disproportionate burden of cardiometabolic disease (CMD) beginning in adolescence, while CMD mortality is often thought to emerge at menopause. This study estimates and compares CMD mortality risks in Black and White women aged 25-44 years.

Methods: Using National Vital Statistics System data and life table methods, we estimated CMD mortality risk in hypothetical cohorts of non-Hispanic Black and White women aged 25-44, with cohort sizes matched to the 2022 U.

Methadone-involved overdose deaths in urban and rural communities before and after the public health emergency flexibilities for methadone take-home doses.

Background: To mitigate COVID-19 exposure risks in methadone clinics, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a temporary modification of regulations in March 2020 to permit extended take-home methadone doses: up to 28 days of take-home methadone for stable patients and 14 days for those less stable. This study examined the association between the policy change and fatal methadone overdoses across the urban-rural continuum.

Methods: This interrupted time series analysis used the U.

Stimulant-Involved Cardiovascular Disease Mortality and Life Years Lost, 2014 to 2023.

Background: Cocaine and methamphetamine, highly cardiotoxic stimulants, are associated with increased risks of hypertension, coronary artery disease, arrhythmias, cardiomyopathy, and stroke.

Objectives: This study examines trends in stimulant-involved cardiovascular disease (CVD) mortality in the U.S.

Scaling an Evidence-Based Community Health Worker Program With Fidelity: Results and Lessons Learned.

Unlabelled: Policy Points Effectively implemented community health worker (CHW) programs improve patient health outcomes and quality of care, reduce health care costs, and are a key strategy for addressing social and structural drivers of health. As policymakers consider funding mechanisms for CHW programs, it is crucial to tie funding to evidence-based best practices while also allowing for innovation and context-specific adaptations.

Context: Community health worker (CHW) programs represent a key strategy for addressing social and structural drivers of health and have the potential to improve patient health outcomes and enhance quality of care while reducing health care costs.

Effects of a Standardized Community Health Worker Intervention on Health Care Utilization Within an Integrated Delivery System.

Background: Community health worker (CHW) interventions can improve health outcomes and reduce acute care utilization. Few prior studies have examined the association of CHW interventions with health care utilization among patients within an integrated health system.

Objective: To evaluate the effects of Individualized Management for Patient Centered Targets (IMPaCT), a standardized CHW intervention originally developed within a single health system in Philadelphia, PA, on acute care utilization and primary care engagement among low-income patients at two clinics within an integrated health system in Portland, Oregon.

Cardiometabolic deaths in black and white men: Tracing the risks from early- to mid-adulthood.

Objective: This study aimed to estimate and compare cardiometabolic disease (CMD) mortality in U.S. Black and White men during the transition from early adulthood to middle age.

Challenges and Opportunities in Implementing a Multicomponent Dementia Caregiver Program in a Complex Healthcare System.

The Tailored Activity Program (TAP), an intervention for people living with dementia (PLWD) and their caregivers, has been shown to reduce behavioral symptoms for PLWD and caregiver burden. While TAP is proven as an evidence-based practice (EBP), it has yet to be implemented at scale. The Department of Veterans Affairs (VA) has prioritized the Age-Friendly Health System (AFHS) initiative, providing an opportunity to test implementation of TAP in a complex healthcare system.

Organization of primary care and early MOUD discontinuation.

Unlabelled: Primary care clinic structures and operations may influence early MOUD discontinuation. Flexible scheduling can improve early MOUD retention but must be balanced with clinic efficiency. Multidisciplinary teams can improve retention but require additional resources.

The Supporting Emerging Adults With Diabetes (SEAD) Program: An Adult-Based Real-World Clinical Model That Improves Hospitalizations, Diabetes Technology Uptake, and Glycemic Outcomes in Underserved Young Adults With Type 1 Diabetes.

Objective: Underserved young adults (YA) with type 1 diabetes (T1D) experience the worst outcomes across the life span. We developed and integrated the Supporting Emerging Adults with Diabetes (SEAD) program into routine endocrinology care to address unmet social and medical challenges.

Research Design And Methods: This study was designed as a longitudinal cohort study, with prospective data collection over 4 years on YA in SEAD compared with usual endocrine care.

Postdischarge needs identified by an automated text messaging program: A mixed-methods study.

Background: Text messaging has emerged as a popular strategy to engage patients after hospital discharge. Little is known about how patients use these programs and what types of needs are addressed through this approach.

Objective: The goal of this study was to describe the types and timing of postdischarge needs identified during a 30-day automated texting program.

Automated Text Message-Based Program and Use of Acute Health Care Resources After Hospital Discharge: A Randomized Clinical Trial.

Importance: Postdischarge outreach from the primary care practice is an important component of transitional care support. The most common method of contact is via telephone call, but calls are labor intensive and therefore limited in scope.

Objective: To test whether a 30-day automated texting program to support primary care patients after hospital discharge reduces acute care revisits.

Health Equity in the Veterans Health Administration From Veterans' Perspectives by Race and Sex.

Importance: Advancing equitable patient-centered care in the Veterans Health Administration (VHA) requires understanding the differential experiences of unique patient groups.

Objective: To inform a comprehensive strategy for improving VHA health equity through the comparative qualitative analysis of care experiences at the VHA among veterans of Black and White race and male and female sex.

Design, Setting, And Participants: This qualitative study used a technique termed freelisting, an anthropologic technique eliciting responses in list form, at an urban academic VHA medical center from August 2, 2021, to February 9, 2022.

Assessment and prevention of hypoglycaemia in primary care among U.S. Veterans: a mixed methods study.

Background: Hypoglycaemia from diabetes treatment causes morbidity and lower quality of life, and prevention should be routinely addressed in clinical visits.

Methods: This mixed methods study evaluated how primary care providers (PCPs) assess for and prevent hypoglycaemia by analyzing audio-recorded visits from five Veterans Affairs medical centres in the US. Two investigators independently coded visit dialogue to classify discussions of hypoglycaemia history, anticipatory guidance, and adjustments to hypoglycaemia-causing medications according to diabetes guidelines.

Interventions to address global inequity in diabetes: international progress.

Diabetes is a serious chronic disease with high associated burden and disproportionate costs to communities based on socioeconomic, gender, racial, and ethnic status. Addressing the complex challenges of global inequity in diabetes will require intentional efforts to focus on broader social contexts and systems that supersede individual-level interventions. We codify and highlight best practice approaches to achieve equity in diabetes care and outcomes on a global scale.

Racial, Ethnic, and Sex Differences in Methadone-Involved Overdose Deaths Before and After the US Federal Policy Change Expanding Take-home Methadone Doses.

Importance: In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) permitted states to relax restrictions on take-home methadone doses for treatment-adherent patients to minimize COVID-19 exposures.

Objective: To assess whether the methadone take-home policy change was associated with drug overdose deaths among different racial, ethnic, and sex groups.

Design, Setting, And Participants: Interrupted time series analysis from January 1, 2018, to June 30, 2022.

Assessing an electronic self-report method for improving quality of ethnicity and race data in the Veterans Health Administration.

Objective: Evaluate self-reported electronic screening () in a VA Transition Care Management Program (TCM) to improve the accuracy and completeness of administrative ethnicity and race data.

Materials And Methods: We compared missing, declined, and complete (neither missing nor declined) rates between (1) (ethnicity and race entered into electronic tablet directly by patient using eScreening), (2) (Veteran-completed paper form plus interview, data entered by staff), and (3) (multiple processes, data entered by staff). The TCM-eScreening ( = 7113) and TCM-EHR groups ( = 7113) included post-9/11 Veterans.

Adult hospitalizations from immigration detention in Louisiana and Texas, 2015-2018.

Poor health conditions within immigration detention facilities have attracted significant concerns from policymakers and activists alike. There is no systematic data on the causes of hospitalizations from immigration detention facilities or their relative morbidity. The objective of this study, therefore, was to analyze the causes of hospitalizations from immigration detention facilities, as well as the percentage of hospitalizations necessitating ICU or intermediate-ICU (i.

Evaluation of an Automated Text Message-Based Program to Reduce Use of Acute Health Care Resources After Hospital Discharge.

Importance: Posthospital contact with a primary care team is an established pillar of safe transitions. The prevailing model of telephone outreach is usually limited in scope and operationally burdensome.

Objective: To determine whether a 30-day automated texting program to support primary care patients after hospital discharge is associated with reductions in the use of acute care resources.

Digital Health and Community Health Worker Support for Diabetes Management: a Randomized Controlled Trial.

Objective: The aim of this study was to evaluate the effectiveness of a digital health intervention plus community health worker (CHW) support on self-monitoring of blood glucose and glycosylated hemoglobin (HbA1c) among adult Medicaid beneficiaries with diabetes.

Design: Randomized controlled trial.

Setting: Urban outpatient clinic.

Solutions to Address Inequity in Diabetes Technology Use in Type 1 Diabetes: Results from Multidisciplinary Stakeholder Co-creation Workshops.

Racial-ethnic inequity in type 1 diabetes technology use is well documented and contributes to disparities in glycemic and long-term outcomes. However, solutions to address technology inequity remain sparse and lack stakeholder input. We employed user-centered design principles to conduct workshop sessions with multidisciplinary panels of stakeholders, building off of our prior study highlighting patient-identified barriers and proposed solutions.

Design of a randomized controlled trial of digital health and community health worker support for diabetes management among low-income patients.

Background: Insulin-dependent diabetes is a challenging disease to manage and involves complex behaviors, such as self-monitoring of blood glucose. This can be especially challenging in the face of socioeconomic barriers and in the wake of the COVID-19 pandemic. Digital health self-monitoring interventions and community health worker support are promising and complementary best practices for improving diabetes-related health behaviors and outcomes.

Pediatric Hospitalizations from Immigration Detention in Texas, 2015-2018.

Although there are concerns regarding children's health in immigration detention, there are little data regarding hospitalizations in this population. Using 2015-2018 Texas inpatient data, we identified 95 hospitalizations of children in detention and found that most (60%) were driven by infectious causes, and that 37% of these children were admitted to an intensive care unit (ICU) or intermediate ICU.