Improving Population Health
Many discussions surrounding population health initiatives take place at a very high level, resulting in few tangible action items for stakeholders to address. This was not the case at LDI’s 50th Anniversary Symposium, where the breakout session titled “Strategies to Advance Population Health” proposed new approaches to old challenges. The session focused on ways to integrate clinical and non-clinical services, examined policies promoting health, and encouraged unique partnerships and opportunities for strategic innovation.
Community Health Worker Support For Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial
Community health worker interventions hold promise for improving outcomes of low-income patients with multiple chronic diseases.
Dismantling Health Disparities in Philadelphia and Beyond
Carmen Guerra Receives American Cancer Society Award
Active Choice and Financial Incentives to Increase Rates of Screening Colonoscopy – a Randomized Controlled Trial
Shivan J. Mehta, Jordyn Feingold, Matthew Vandertuyn, Tess Niewood, Catherine Cox, Chyke A. Doubeni, Kevin G. Volpp, David A. Asch
In Gastroenterology, Shivan Mehta and colleagues, including Chyke Doubeni, Kevin Volpp, and David Asch, examine various behavioral economics approaches to increase uptake for colorectal cancer screening. The authors assigned 2,245 individuals, all employees of a large academic health system, to one of three interventions: an e-mail containing a phone number for scheduling (control), an e-mail with the active choice to opt in or opt out (active choice), or the active choice e-mail plus a $100 incentive (financial incentive). Participants were followed to determine whether they got...
Calorie Underestimation When Buying High-Calorie Beverages in Fast-Food Contexts
Rebecca L. Franckle, Jason P. Block, Christina A. Roberto
In American Journal of Public Health, Rebecca Franckle and colleagues, including Christina Roberto, assess calorie estimation, particularly in high-calorie beverages, among adolescents and adults visiting fast-food restaurants. Previous research has shown that people eating at fast-food restaurants underestimate the caloric content of their purchases, but little is known about whether purchasing beverages affects calorie estimates. Because beverages are generally not the central focus of a meal and can be consumed quickly and with little effort, it is possible that people fail to...
Vaccine Exemption Laws: Learning What Works
How can state lawmakers decrease non-medical vaccination exemptions without infringing on parental choice? That’s the question that LDI Senior Fellow Alison Buttenheim seeks to answer in her new Governing magazine article.
Unicompartmental Knee Arthroplasty Vs. Total Knee Arthroplasty for Medial Compartment Arthritis in Patients Older Than 75 Years: Comparable Reoperation, Revision, and Complication Rates
Homayoun Siman, Atul F. Kamath, Nazly Carrillo, William S. Harmsen, Mark W. Pagnano, Rafael J. Sierra
In The Journal of Arthroplasty, Homayoun Siman and colleagues, including Atul Kamath, assess the effectiveness of unicompartmental knee arthroplasty (UKA) vs. total knee arthroplasty (TKA) in similar patients. Prior studies have shown that UKA procedures have advantages over TKA, including preservation of bone stock, shorter and easier recovery, lower overall cost, lower morbidity, better functional outcome, and subjective feeling of a more natural knee. The authors conducted a retrospective review of patients 75 years and older who underwent UKA or TKA over a 10-year period in...
Treatment seeking as a mechanism of change in a randomized controlled trial of a mobile health intervention to support recovery from alcohol use disorders
Joseph E. Glass, James R. McKay, David H. Gustafson, Rachel Kornfield, Paul J. Rathouz, Fiona M. McTavish, Amy K. Atwood, Andrew Isham, Andrew Quanbeck, Dhavan Shah
In Journal of Substance Abuse Treatment, Joseph Glass and colleagues, including James McKay, assessed the efficacy of an Addiction-Comprehensive Health Enhancement Support System (A-CHESS) in increasing the use of services for addiction. This model is an electronic health framework that has been applied to a diverse set of health problems, including pediatric asthma and breast and lung cancer, and was previously adopted to alcohol addiction in a randomized-controlled trial. The authors conducted secondary data analyses of this trial, including 349 adults with alcohol use disorders...
Understanding patient-centred readmission factors: a multi-site, mixed-methods study
Ryan Greysen, James D. Harrison, Sunil Kripalani, Eduard Vasilevskis, Edmondo Robinson, Joshua Metlay, Jeffery L. Schnipper, David Meltzer, Neil Sehgal, Gregory W Ruhnke, Mark V. Williams, Andrew D. Auerbach
In BMJ Quality & Safety, Ryan Greysen and colleagues characterize patient- and caregiver-reported factors that contribute to hospital readmissions in general medicine patients. While patient concerns at or before discharge inform many transitional care interventions, few studies examine patients’ perceptions of self-care and other factors related to readmission. The authors surveyed more than 1,000 patient readmitted to 12 hospitals, with multiple choice and open-ended questions that assessed post-discharge difficulty in seven domains of self-care. These domains included...
The Role of Stewardship in Addressing Antibacterial Resistance: Stewardship and Infection Control Committee of the Antibacterial Resistance Leadership Group
Deverick J. Anderson, Timothy C. Jenkins, Scott R. Evans, Anthony D. Harris, Robert A. Weinstein, Pranita D. Tamma, Jennifer H. Han, Ritu Banerjee, Robin Patel, Theoklis Zaoutis, Ebbing Lautenbach
In Clinical Infectious Diseases, Deverick Anderson and colleagues, including Jennifer Han and Ebbing Lautenbach, describe the activities of the Antibacterial Resistance Leadership Group (ARLG) in the area of antibacterial stewardship. Antibacterial resistance is increasing globally and has been recognized as a major public health threat. Antibacterial stewardship is the coordinated effort to improve the appropriate use of antibiotics with the aim to decrease selective pressure for multidrug-resistant organisms in order to preserve the utility of antibacterial agents. To date, the...
Coercion or Caring: The Fundamental Paradox for Adherence Interventions for HIV+ People With Mental Illness
Marlene M. Eisenberg, Michael Hennessy, Donna Coviello, Nancy Hanrahan, Michael B. Blank
In AIDS and Behavior, Marlene Eisenberg and colleagues, including Nancy Hanrahan and Michael Blank, examine if a high-intensity HIV-treatment intervention would be perceived as coercive by HIV-positive individuals with serious mental illness. Previous research has shown that potentially coercive mandates during the earliest stages of mental health treatment are associated with later treatment benefits. Furthermore, the prevalence of HIV is significantly higher among populations with mental illness. The authors developed an HIV management regimen that utilized advance practice...
Effect of Electronic Reminders, Financial Incentives, and Social Support on Outcomes After Myocardial Infarction
Kevin G. Volpp, Andrea B. Troxel, Shivan J. Mehta, Laurie Norton, Jingsan Zhu, Raymond Lim, Wenli Wang, Noora Marcus, Christian Terwiesch, Kristen Caldarella, Tova Levin, Mike Relish, Nathan Negin, Aaron Smith-...
In JAMA Internal Medicine, Kevin Volpp and colleagues, including Shivan Mehta, Christian Terwiesch, Kristen Caldarella, and David Asch, investigate whether medication reminders, as well as financial and social support, delay re-hospitalization for a vascular event. The authors randomized participants to either a usual care group (the control), or to an intervention using electronic pill bottles, lottery incentives, and social support for medication adherence. The primary measured outcome of this study was time to first vascular-related re-hospitalization or death, but the authors...
Financial Incentives for Adherence to Hepatitis C Virus Clinical Care and Treatment: A Randomized Trial of Two Strategies
David A. Wohl, Andrew G. Allmon, Donna Evon, Christopher Hurt, Sarah Ailleen Reifeis, Harsha Thirumurthy, Becky Straub, Angela Edwards, Katie R. Mollan
In Open Forum Infectious Diseases, David Wohl and colleagues, including Harsha Thirumurthy, assess the feasibility of two strategies for financially incentivizing adherence to Hepatitis C (HCV) care among patients with substance use disorders. Previous research has shown that, although rates of a sustained response to the virus (SVR) surpass 90%, patients experiencing substance use disorders may struggle to adhere to HCV care. The authors randomly assigned participants to either a fixed or lottery-based monetary incentive for attending clinic appointments, adhering to medications...
Relationships between Parent-Adolescent Communication, Acculturation, and Sexual Knowledge on Latino Adolescent Sexual Behavior: A Systematic Review
Vanessa Pirani Gaioso, Lynda Law Wilson, Antonia Maria Villarruel, Gwendolyn Denice Childs
In International Journal of Studies in Nursing, Vanessa Gaioso and colleagues, including Antonia Villarruel, assess the relationship between specific cultural variables and Latino adolescents' sexual behavior. The authors conducted a systematic review of studies addressing the relationship between selected parenting variables and Latino adolescent sexual behavior. The authors find that cultural attitudes towards sexual behavior are associated with adolescent intentions to have intercourse and to use condoms. However, few studies examined any predictors of parent-adolescent sexual...