Juvena Hitt, MPH

 

I'm thrilled to report that Juvena Hitt was awarded the degree of Master of Public Health from the University of Vermont. Juvena earned the degree while working full-time, herding a thousand cats for the IBH-PC study, and raising her son during a pandemic.  Many congratulations!

Latest pub from van Eegrhn and Clifton on integrated behavioral health in primary care

Congratulations to Connie van Eeghen, Assistant Professor of Medicine, and Jessica Clifton, Faculty Scientist, who were on the team that just published this work:

Defining and measuring core processes and structures in integrated behavioral health in primary care: a cross-model framework

Kari A Stephens, Constance van Eeghen, Brenda Mollis, Margaret Au, Stephanie A Brennhofer, Matthew Martin, Jessica Clifton, Elizabeth Witwer, Audrey Hansen, Jeyn Monkman, Gretchen Buchanan, Rodger Kessler

Translational Behavioral Medicine, Volume 10, Issue 3, June 2020, Pages 527–538

https://doi.org/10.1093/tbm/ibz163

Published: 07 August 2020

Abstract

A movement towards integrated behavioral health (IBH) in primary care continues to grow, among an accumulating evidence base for its effectiveness for improving care. However, healthcare organizations struggle to navigate where to target their limited resources for improving integration. We evaluated a cross-model framework of IBH core processes and structures. We used a mixed-methods approach for evaluation of the framework, which included (a) an evaluation survey of national experts and stakeholders, (b) crosswalks with common IBH measures, and (c) a real-world usability test. Five core IBH principles, mapping to 25 processes, and nine clinic structures were defined. Survey responses from 29 IBH domain and policy experts and stakeholders resulted in uniformly high ratings of importance and variable levels of feasibility for measurement, particularly with respect to electronic health record (EHR) systems. A real-world usability test resulted in good uptake and use of the framework across a state-wide effort. An IBH Cross-Model Framework of core principles, processes, and structures generated good acceptability and showed good real-world utility in a state-wide effort to improve IBH across disparate levels of integration in diverse primary care settings. Findings identify feasible areas of measurement, particularly with EHR systems. Next steps include testing the relationship between the individual framework components and patient outcomes to help guide clinics towards prioritizing efforts focused on improving integration.

Book Club suggestion: "Calling Bullshit: The Art of Scepticism in a Data-Driven World," Bergstrom & West

 I came across this book review in the Economist (alright, I haven't actually read the book) and it sounds like a good set of perspectives and tools for every day life, whether as a scientist or not.  According to the reviewer, this is

"a helpful guide to navigating a world full of doubtful claims based on spurious data. Using clever anecdotes, nods to online culture and allusions to ancient philosophy, the book tells ordinary readers how to spot nonsense—even if they are not numerical whizzes. As well as sketching the difference between correlation and causality, the authors outline visualisation techniques and explain machine learning to arm people against assertions that seem, and so probably are, either “too good or too bad to be true”."

 It sounds like the sort of book we read a few years ago: "Weapons of Math  Destruction" by Cathy O'Neil.  That was a very helpful read; this one might be as well.  

Link to the review: https://www.economist.com/books-and-arts/2020/07/30/how-to-debunk-dodgy-data

FW: [HRS Data Alert] Recent HRS Data Releases and Updates

News and Announcements Recent HRS Data Releases and Updates The following data products are now available on the HRS website: Restricted Data Releases and Updates The Child Zip Codes (2004-2016) file V7.0 has been updated to include data through 2016. This data set contains location information (city, state and zip code) reported by respondents about children living more than 10 miles from the respondents. Refer to the Data Description for more information.  The Industry and Occupation Data (V5) now includes data through 2016. This restricted data product contains one dataset that provides detailed respondent-level industry and occupation information for interview years 1992 through 2016. These variables are masked in all public files. The Health and Retirement Study Contextual Data Resource (HRS-CDR) is a collection of user-friendly datasets that enable researchers to study the impact of place on health and well-being among HRS respondents. Recent HRS-CDR releases are listed below.  The  COVID-19 US State Policy Database (CUSP)  is maintained by researchers from Boston University School of Public Health and is available for linkage to HRS for users approved for state-level geography. The COVID-19 US State Policy Database contains state-wide policies related to COVID-19 mitigation and control, including stay at home orders, closing of non-essential businesses, and school closures. The database also contains policies that aim to protect vulnerable populations from the wide range of health and economic consequences of the pandemic, including changes to Medicaid, eviction freezes, and changes to unemployment insurance. For each policy in question, research assistants collect the date it went into effect in each state based on executive orders, mandates, and/or press releases. This data product will be periodically updated in consultation with researchers from Boston University. The HRS-CDR Uniform Crime Reporting Program data (V2) were created by a joint project of the University of Southern California and the University of Michigan, sponsored by the National Institute on Aging. The data includes county-level counts of offenses for the Uniform Crime Reports (UCR) index crimes including murder, rape, robbery, aggravated assault, burglary, larceny, auto theft, and arson. Data are available at county level and organized by time (year: 1994-2016). The HRS-CDR USDA Food Access Information dataset (V2) contains information from the United States Department of Agriculture related to food access at the state, census tract and county level. This information is linked to HRS detailed geographic indicators derived from respondent addresses. Questions, comments or concerns about the above data products should be directed to the HRS Help Desk at hrsquestions@umich.edu. Health and Retirement Study Survey Research Center 426 Thompson Street Ann Arbor, MI 48104 Add us to your address book You are receiving this email because you opted in to email announcements at the HRS website. Unsubscribe Update your preferences     The Health and Retirement Study is supported by the National Institute on Aging (NIA U01AG009740) and the Social Security Administration.

FW: Registration in now OPEN for the MEPS Virtual Data Users' Workshop in September

Workshop Registration is now open for the upcoming VIRTUAL MEPS Data Users' Workshop on September 15-17, 2020. For registration and more information, visit the Workshops & Events page on the MEPS Web site at: https://meps.ahrq.gov/mepsweb/about_meps/workshops_events.jsp

How to Think Like an Epidemiologist

 

This is a lovely low-math introduction to Bayesian thinking from the New York Times. 

How to Think Like an Epidemiologist

https://www.nytimes.com/2020/08/04/science/coronavirus-bayes-statistics-math.html?referringSource=articleShare

(Hat tip to Justine Dee!)

Latest from Abby Crocker on long-term outcomes of "opioid babies"

Congratulations to Abigail Crocker, PhD, Assistant Professor of Mathematics and Statistics on this publication:

Crocker A, Geller W, Metayer J, Littenberg B, Meyer M. Educational outcomes of children born to women in treatment for opioid use disorder. Pediatrics. 2020;146: 116-8.      

Purpose: Opioid use in pregnancy continues to increase. The data on long term outcomes of children exposed to maternal medication assisted therapy (MAT) during pregnancy are limited, with most studies including all types of in utero opioid exposure in the outcomes. The goal of this project was to examine the educational outcome of children exposed to methadone or buprenorphine in the context of maternal comprehensive treatment for opioid use disorder compared to control children without known exposure to opioids. We hypothesized that, if comprehensive perinatal care with MAT is safe and effective, outcomes will be similar in the two groups. Methods: We identified children delivered to mothers that received Medicaid insurance in a single hospital between 2006-2010 exposed to MAT (n=429) and not exposed to MAT or opioids (n=1009) and were in the state educational database. The educational outcome was assessed by linking health records to data stewarded by the state Agency of Education. Deliveries <37 weeks gestation or major congenital anomalies were excluded. The primary outcome was whether a child received an Individualized Education Plan (IEP) in kindergarten or not. We compared the proportion with an IEP in each group using multivariate logistic regression to control for potential confounders. Secondary outcomes included third grade IEP utilization and whether a child was scored as “proficient” by a standardized test at grade three. Potential confounders included sex, birth weight, maternal age, maternal education level, in utero tobacco exposure, and free or reduced lunch eligibility status. Institutional Review Board approval was obtained for all analyses. Results: We found no statistically significant difference in kindergarten or third grade IEP utilization (MATE: 15.5%; MATNo 15%; OR = 1.1, 95% CI: 0.91, 1.34; P=0.33) or standardized test proficiency at grade 3 (proficient MATE: 35%; MATNo 38%, OR = 1.18; 95% CI: 0.89, 1.47; P=0.28) between children born to women receiving comprehensive perinatal care with MAT and an economically similar comparison group, while controlling for potential confounders. Conclusions: In spite of concerns about the long-term impact of in utero opioid exposure, maternal use of prescribed opioids as part of comprehensive, coordinated perinatal care did not impair educational outcomes in the early grades. Clinicians and policy makers at the state and federal levels should be encouraged to support access to coordinated, comprehensive perinatal care with MAT as an effective secondary prevention strategy with positive long- and short-term impacts.

https://pediatrics.aappublications.org/content/146/1_MeetingAbstract/116