While there has been increasing education on diversity, equity, and inclusion (DEI) for medical students and residents, neurology faculty are also in need of formal education on race and racism. The aim was to implement and evaluate the feasibility, efficacy and preliminary impact of an interactive Zoom-based anti-racism curriculum that was repeated in a new academic year to foster learning and discussion amongst neurology faculty. A Justice Equity Diversity and Inclusion Curriculum (JEDI) was delivered to Brown University Neurology faculty during 2021-2022 and again in 2023-2024.
View Article and Find Full Text PDFBackground: Data-driven decision-making is an implementation strategy to improve system performance and health outcomes for individuals with substance use and mental health needs interacting with criminal-legal systems. We currently have limited understanding of how agencies define and use data in their decision-making processes. A qualitative study was conducted with agency leaders from jails, probation and parole, and community mental health and substance use service agencies to characterize (1) how respondents defined data and data use, (2) current level of data use for decision-making, (3) data capacity needs, and (4) agency perspectives on best practices and their recommendations.
View Article and Find Full Text PDFObjective: Understanding the consequences that occur when bystanders intervene to address problematic alcohol use in others is of utmost importance because the consequences that bystanders experience can influence their behavior in future situations. Consequences are defined as the effects of attempting to help another person and may be positive and/or negative. Given the dearth of measurement scales for alcohol-related bystander intervention, the present study aimed to develop two valid and reliable measures of consequences following alcohol-related bystander intervention: one assessing positive consequences and one assessing negative consequences.
View Article and Find Full Text PDFBackground: While telemedicine has become an established component of healthcare delivery globally, challenges to scaling emerging initiatives persist across multiple levels. Over the last 5 years, our team has developed a pediatric telemedicine and medication delivery service (TMDS) in Haiti that integrates clinical guidance with rapid access to medications. Building on successful proof-of-concept studies, we are now well positioned to characterize both general challenges to telemedicine scale-up and those unique to the TMDS model.
View Article and Find Full Text PDF: Dissemination of methods for developing psychometric instruments is essential for the production of high-quality research. This article describes a multistep process used to conduct the qualitative phase in the development of a battery of measures related to bystander behavior for hazardous alcohol use among young adults. : Qualitative methods were used to inform the content and wording of developed items to be relevant to young adults' lived experiences.
View Article and Find Full Text PDFBackground: Takotsubo syndrome (TS) is preceded by emotional/physical triggers in two-thirds of cases and no trigger in one-third. Information on triggers is typically obtained in the emergency room, and patients rarely have the opportunity to describe in detail the event(s) leading to TS onset.
Objective: This study aimed to conduct a qualitative exploration of patients' narratives regarding the events preceding their TS episode.
Interagency teams are considered an evidence-based change practice, but there is a paucity of research examining them in criminal justice (CJ) and behavioral health (BH) reform contexts. This study draws on qualitative interviews ( = 52) and survey data ( = 791) from BH and CJ leaders across the United States to examine who is on them, what they do, and effective strategies for building and sustaining them. Findings indicated that CJ-BH interagency teams often incorporate agencies from a range of CJ, BH, social service, and health agencies.
View Article and Find Full Text PDFBackground: A total of 12 modifiable risk factors account for 40% of dementia cases globally, yet population adherence to health behaviors associated with these factors is low. Midlife is a critical window for dementia prevention, as brain pathology often begins to accumulate years or decades before the onset of symptoms. Although multidomain behavioral interventions have been efficacious in reducing the risk of cognitive decline, adherence is low.
View Article and Find Full Text PDFObjective: The objective of this study was to determine the preliminary effectiveness of an intervention to mitigate adverse pregnancy outcomes associated with pre-pregnancy obesity in American Samoa.
Methods: We enrolled n = 80 low-risk pregnant women at <14 weeks' gestation. A complete case analysis was conducted with randomized group assignment (group prenatal care-delivered intervention vs.
Glob Adv Integr Med Health
August 2024
Background: Approximately one-half of all adults with HIV experience chronic pain. Needed are nonpharmacological approaches to improve pain management in this population.
Methods: For this study, we conducted in-depth qualitative interviews (n = 20) with thirteen adults with HIV and 7 HIV care providers regarding their perceptions of Tai Chi for chronic pain management.
Daily oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, though efficacy depends on adherence. Digital pill systems (DPS) can enable direct, real-time adherence measurement. HIV-negative men who have sex with men (MSM) with substance use (excluding alcohol) utilized a DPS over 90 days and completed weekly surveys reporting sexual activity, condom use, and substance use.
View Article and Find Full Text PDFBackground: Research has established the disproportionate impact of COVID-19 on Black, Indigenous, and People of color (BIPOC) communities, and the barriers to vaccine trust and access among these populations. Focusing on perceptions of safety, access, and trustworthiness, studies often attach barriers to community-members, and discuss vaccines as if developed from an objective perspective, or "view from nowhere" (Haraway).
Objective: We sought to follow Haraway's concept of "situated knowledges," whereby no one truth exists, and information is understood within its context, to understand the exertions of expertise surrounding vaccines.
Background: Pulmonary function tests (PFTs) have historically used race-specific prediction equations. The recent American Thoracic Society guidelines recommend the use of a race-neutral approach in prediction equations. There are limited studies centering the opinions of practicing pulmonologists on the use of race in spirometry.
View Article and Find Full Text PDFObjective: Excessive alcohol use is very prevalent among young adults, and consequences of drinking are often observed by witnesses. Understanding the circumstances under which witnesses of risky alcohol use help others and whether they perceive these circumstances as an opportunity to engage in bystander intervention are important, but valid measures of these constructs are needed. The current study is a psychometric evaluation of the Exposure to Hazardous Drinking in Others (EHDO) scale and a single-item indicator of Perceived Alcohol-Related Bystander Opportunity (PARBO).
View Article and Find Full Text PDFThis pilot study explored female caregiver's perception of their child's behaviors during sexual abuse evaluations. We compared reports by caregivers with histories of their own child sexual abuse (PCSA) to caregivers with no prior history of child sexual abuse (NPCSA) regarding their 1) child's sexualized behaviors and (2) perceptions of whether their child had been sexually abused. Forty-four caregivers met inclusion criteria.
View Article and Find Full Text PDFLancet Glob Health
November 2023
Background: Despite the importance of accurate and rapid assessment of hydration status in patients with acute diarrhoea, no validated tools exist to help clinicians assess dehydration severity in older children and adults. The aim of this study is to validate a clinical decision support tool (CDST) and a simplified score for dehydration severity in older children and adults with acute diarrhoea (both developed during the NIRUDAK study) and compare their accuracy and reliability with current WHO guidelines.
Methods: A random sample of patients aged 5 years or older presenting with diarrhoea to the icddr,b Dhaka Hospital in Bangladesh between Jan 30 and Dec 13, 2022 were included in this prospective cohort study.
Introduction: Acute diarrhea remains a leading cause of morbidity and mortality with over 6.3 billion cases and 1.3 million deaths annually.
View Article and Find Full Text PDFIntroduction: Medications for addiction treatment (MAT) are the evidence-based standard of care for treatment of opioid use disorder (OUD), but stigma continues to surround their use. We conducted an exploratory study to characterize perceptions of different types of MAT among people who use drugs.
Methods: We conducted this qualitative study in adults with a history of non-medical opioid use who presented to an emergency department for complications of OUD.
Introduction: Multicomponent interventions can reduce cardiometabolic disease (CMD) risk factors in childhood; however, little synthesis of the literature has taken place in the Pacific region. Pacific Islanders experience a disproportionately high prevalence of CMD risk factors, yet interventions have been slow to reach many communities. We present this protocol for a scoping review to identify and summarize existing multicomponent interventions to address CMD risk in Pacific Islander children.
View Article and Find Full Text PDFObjective: Framework Matrix Analysis (FMA) and Applied Thematic Analysis (ATA) are qualitative methods that have not been as widely used/cited compared to content analysis or grounded theory. This paper compares methods of FMA with ATA for mobile health (mHealth) research. The same qualitative data were analyzed separately, using each methodology.
View Article and Find Full Text PDFEvid Based Pract Child Adolesc Ment Health
November 2021
The prevalence of adolescent depression is increasing, particularly among girls. Existing evidence-based treatments have limitations and/or may not be acceptable to all adolescents and parents. There is evidence that hatha yoga may be useful as an adjunctive treatment for depression in adults.
View Article and Find Full Text PDFBackground: The COVID-19 pandemic provided a unique opportunity to examine social media and technology use during a time in which technology served as adolescents' primary form of socialization. The literature is mixed regarding how increased screen time during this period affected adolescent mental health and well-being. The mechanisms by which screen time use affected adolescent psychosocial outcomes are also unknown.
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