Center for Health Equity

Interdisciplinary Team Creating Guidelines for Probation Officers as Change Agents

Mary Cunningham — Tue, 19 Apr 2022 19:23:28 +0000

Interdisciplinary Team Creating Guidelines for Probation Officers as Change Agents Mary Cunningham Tue, 04/19/2022 - 15:23

In This Story

Faye S. Taxman

Researchers from the Schar School of Policy and Government’s Center for Advancing Correctional Excellence! and the College of Health and Human Services are translating research into actionable guidelines to help probation officers support their clients to achieve better outcomes.

With probation officers providing services to nearly five million people on community supervision in the United States, they play a critical role in the criminal justice system. Finding proven, effective ways to enhance probation and parole practices is important in keeping people from returning to the correctional system, which will improve lives and reduce costs. Evidenced-based research exists to help probation/parole officers improve their practice; however, the research can be difficult for probation/parole agencies to implement.

University Professor and Director of the Center for Advancing Correctional Excellence (ACE) Faye S. Taxman and Associate Professor in the Department of Social Work JoAnn Lee are collaborating to build on evidence-based research to help make implementing the research easier to digest--after all what good is research if it sits on a shelf?

Faye S. Taxman

Taxman considered this question and got to work. Easier to use research would hopefully strengthen the relationship between officers and their clients, improve their clients' lives and support them to achieve better outcomes, and prevent further involvement in the court system. Together with an interdisciplinary team of graduate students, Taxman and Lee are writing practical guidelines for officers as positive change agents instead of disciplinarians.

Probation/parole can be given as a sentence to people convicted of certain crimes instead of jail time or ordered for a period of time after a person is released from prison. For this project, Taxman, the principal investigator, wanted to partner with Lee, the co-principal investigator, to bring an interdisciplinary approach.

Taxman thought it would be helpful to have a partner who was more grounded in social work principles and had direct service experiences helping others. Taxman knew that having an interdisciplinary team would be the best way to incorporate all angles in the guidelines so they would be as effective as possible.

JoAnn Lee

“Having an interdisciplinary team helps us combine translating the research and clinical practice into actionable items,” said Taxman. "It has improved the project to be able to work with people in many academic fields, as well as people working in various roles within the probation process.”

They are working with experienced probation officers and a team of criminologists, social workers, and psychologists with expertise in substance use treatment, mental health and probation, intimate partner violence, violence, and criminal thinking. Additionally, they have included several criminology and social work students into the project.

“We hope when we disseminate our guidelines to the field, we do it in a way that probation officers and agencies will use them and begin to talk about what do they need to improve their existing practice,” said Taxman, who is professor at the Schar School of Policy and Government. “We’ve taken existing evidence-based research and our own research from the field to create real-world guidelines.”

Creating Easy-to-Use Guidelines

Taxman and Lee began by looking at the existing research and identified where there were gaps that they needed to fill in order to provide complete guidelines. They also surveyed probation officers to get direct input from the field about what practices should be done, under what circumstances, and for whom. Researchers also turned to their interdisciplinary panel of academic experts to help provide missing guidance.

The result will be nearly 20 different actionable statements that are easy for probation/parole agencies and officers to apply in their day-to-day work. The statements include guidelines on how and when each guideline should be used and when it may be harmful. Topics include contacts and monitoring; screening for substance and mental health services and treatment services; electronic monitoring; contacting employers and family members; and fines, fees, and restitution. The project, “Developing Probation Guidelines Using Appropriateness Statements,” is funded by a $500,000 grant from the Arnold Ventures Foundation.

For example, motivational interviewing is a skill that can be used alone or integrated with other approaches that focus on preparing a client for behavior change. Evidence-based research might say “use motivational interviewing for substance misuse," but it does not tell probation officers how to use that skill or when it is most helpful. Taxman and Lee’s statements explain what motivational interviewing is, when to use it, and tips for how to use it.

“This is different because we’re clear about what are evidence-based practices and what are existing practices directly from those in the community supervision field,” says Lee. “Our statements identify when probation officers’ experiences and research agree about an effective technique. The voice of the audience is more integrated into the presentation and we believe this helps officers understand the ‘why’ behind the technique, which may make them more likely to include it into their practice.”

They have been working on this project for about three years and plan to present the guidelines this summer at the American Probation and Parole Association annual training institute. Throughout the process, the team has published several papers (or are in the process of publishing) including in the Handbook of Issues in Criminal Justice Reform in the United States, Aggression and Violent Behavior, Federal Probation, and The Oxford Handbook of Psychology and Law.

The team is also sponsoring a special issue for Federal Probation about working with specific populations such as substance abusers, individuals with mental illness, individuals involved with intimate partner violence, and individuals that are considered violent or violent-prone.

“When we surveyed the field, there was very little attention to working with special populations,” said Lee. The issue will include practices, written by experts in the field, for working with specific populations such as young or violent offenders, those affected by intimate partner violence, and people with mental health challenges.

Topics

Schar School News April 2022

Mason Momentum

Research

In the George

Center for Health Equity

Risk of Homelessness or Incarceration among Foster Youth Varies by Type of Disability

Mary Cunningham — Wed, 30 Mar 2022 13:53:37 +0000

Risk of Homelessness or Incarceration among Foster Youth Varies by Type of Disability Mary Cunningham Wed, 03/30/2022 - 09:53

Ages 17-21 are important transitional years as young adults learn to become adults with more responsibilities. Many youth have family members who provide social and financial support to help them during this critical time; however many transitioning out of foster care lack these supports. Without social supports, they face a greater risk of homelessness, incarceration, and other socially isolating outcomes.

A new study shows that the likelihood of a foster youth with disabilities experiencing homelessness or incarceration during the transition to adulthood varies by type of disability. Associate professor of Social Work JoAnn Lee and associate professor of Health Administration and Policy Gilbert Gimm found that youth with emotional disabilities are more likely to experience homelessness and incarceration than those with other disabilities. However, after digging a little deeper, they found that there are other factors that explain the association between emotional disabilities and both homelessness and incarceration: “Our findings did not find statistical significance for an emotional disability when controlling for other variables, contrary to what we expected based on prior studies,” said Lee. “This is especially notable since emotional disability is the disability type people tend to focus on, if they differentiate the type of disability diagnosis.”

Previous studies either grouped everyone with a disability together or focused only on emotional disability. This study found that intellectual or developmental disability, visual/hearing disability, and physical disabilities are associated with a lower likelihood of homelessness and incarceration. Out of the disabilities analyzed, those with a physical disability reported the lowest rates of homelessness and incarceration and those with an emotional disability reported the highest rates.

“This study brought to light the need to tailor social supports and policies to the specific needs of young adults with disabilities, which can reduce barriers to services and improve community participation. In turn, improved access to services and social engagement can ultimately reduce the risk of homelessness and incarceration," said Lee.

Additionally, the research revealed that youth connections to school, employment, and extended foster care support were associated with lower likelihood of experiencing homelessness and incarceration. The study also identified a smaller group of youth who had not yet been evaluated and requires more study because they appear to have the worst overall outcomes.

In the study, nearly half (46%) of youth aging out of foster care were diagnosed with a disability. The majority had an emotional disability (36.8%) and a small percentage of youth aging out were diagnosed with an intellectual/developmental disability (4.3%), visual or hearing disability (6.3%), and a physical disability (1.1%). Nine percent of the study cohort had not been evaluated for a disability.

“We recommend two important policy implications based on our findings. First, transition services for high-risk youth should be bolstered. Second, extending transition services up to age 25 can help to reduce the risk of homelessness and incarceration,” said Gimm.

The paper titled “Assessing Homelessness and Incarceration Among Youth Aging Out of Foster Care, by Type of Disability” was published online in the Child and Adolescent Social Work Journal in February 2022. Researchers did an analysis to identify associations between disability type and both homelessness and incarceration while controlling for other demographic and child welfare system characteristics.

The study merged the administrative data from the 2014 cohort of the National Youth in Transition Database (NYTD) and Adoption and Foster Care Analysis Reporting System (AFCARS). The NYTD outcomes database interviewed youth when they were 17 years old, with follow-up interviews when they reached 19 and 21 years of age, respectively, to find out how they were doing as they age out of care and transition to adulthood.

Topics

Center for Health Equity

Combining Black Racial Groups Hides Health Disparities in Breastfeeding

John Brandon Cantrell — Wed, 23 Mar 2022 15:19:30 +0000

Combining Black Racial Groups Hides Health Disparities in Breastfeeding John Brandon C… Wed, 03/23/2022 - 11:19

In This Story

Amira Roess, PhD, MPH

A new study from Amira Roess in the Department of Global and Community Health highlights the differences in breastfeeding initiation between African Americans and Black immigrants enrolled in the Washington, D.C. WIC supplemental nutrition program.

Illnesses such as sudden infant death syndrome, asthma, and obesity disproportionally affect African American populations, and researchers have long underscored that lower breastfeeding among African Americans is a reason why. A goal of the Centers for Disease Control (CDC) is to address this disparity in breastfeeding rates. However, the current way data are reported hides important differences among Black American subgroups and biases data. To understand the potential differences in breastfeeding initiation within this population, a group of researchers are comparing patterns in breastfeeding initiation between two Black subgroups, African Americans and Black immigrants, for clues.

A new study from Amira Roess, professor in the Department of Global and Community Health, showed that breastfeeding rates are significantly lower for African Americans compared to Black Immigrants and other race/ethnic groups.

“By looking more carefully at African Americans and Black immigrants we can see that combining the two can hide important health disparities since Black immigrant populations tend to have higher breastfeeding rates,” said Roess. “Without detailed breastfeeding initiation data by more nuanced race/ethnicity definitions, the potential for poorly targeted interventions and policies exists, and opportunities to improve breastfeeding may be missed.”

This research gathered data from participants in Washington, DC’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from 2007-19. The Centers for Disease Control’s Healthy People 2020 provided 10-year objectives (ending in 2020) to increase American’s health, and one goal was to increase the number of infants who were breastfed. This goal was met nationally (81.9%), but not met for all racial subgroups. People in the non-Hispanic Black demographic had the lowest reported breastfeeding initiation (73.7%), which fell well below the Healthy People 2020’s goals. Roess’s study further dissected the non-Hispanic Black demographic into subgroups and found that African Americans have a lower breastfeeding rate (39.9%) than Black immigrants (69.6%). Overall, breastfeeding initiation for both groups increased over time in the study population, which mirrored the national trend, but at lower rates.

The paper titled “Disparities in Breastfeeding Initiation Among African American and Black Immigrant WIC Recipients in the District of Columbia, 2007–2019” was published online in March 2022 in the American Journal of Public Health.

The study defined African Americans as those self-reporting as African American, not Hispanic, and speaking English only. Black immigrants were defined as those self-reporting as African American and speaking a language other than English. Researchers acknowledged this definition may underestimate the Black immigrant population, especially because some may come from English-language countries.

The research team included Rebecca C. Robert from the Conway School of Nursing, Catholic University of America; Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson from the DC Department of Health, District of Columbia Women Infant Child State Agency; and Nwanneamaka Ume and Brianna Ericson from Milken Institute School of Public Health, George Washington University. Ume was supported by a fellowship from the Clara Schiffer Project on Women’s Health.

Topics

African American/Black

Center for Health Equity

NIHCM grant recipients takes collaborative approach on health equity, medicaid telehealth policy

Colleen Rich — Wed, 09 Feb 2022 15:16:26 +0000

NIHCM grant recipients takes collaborative approach on health equity, medicaid telehealth policy Colleen Rich Wed, 02/09/2022 - 10:16

In This Story

Alison Evans Cuellar, PhD, MBA

Alison Cuellar. Photo provided

��AV’s Alison Cuellar and Leah Adams have received a $54,918 grant from the National Institute for Health Care Management (NIHCM) Foundation for their study on health equity and the impact of Medicaid telehealth policy.

“NIHCM looks for projects with high potential to inform improvements to the U.S. health care system, so we are honored to be included [among the 38 grantees]," said Cuellar, a professor of health administration and policy in the College of Health and Human Services.

Adams, assistant professor in the Department of Psychology and the Women and Gender Studies Program in the College of Humanities and Social Sciences, said they plan to focus on two studies evaluating the degree to which and how expanding telehealth services can improve health equity across a diverse set of populations within Virginia.

The quantitative study focuses on Medicaid claims data and the qualitative study focuses on barriers, facilitators, special concerns, and overall effectiveness of providing services via telehealth, they said.

For this qualitative component, Adams said they plan to seek the perspectives of a range of stakeholders including health care providers, patients, and advocacy organizations. She hopes this collaborative approach, which will draw on expertise from multiple fields, is a good example of how issues critical to public health can be addressed.

Access to health care is an issue that contributes to health disparities in Black, Latino, and low-income populations. “We hope to explore concrete steps that agencies and policy-makers can take to reduce and eliminate disparities in care,” said Adams.

Leah Adams. Photo by Shelby Burgess/Strategic Communications

The findings of the study are expected to inform deliberations of federal and state policymakers as they consider whether and how to extend the more liberal telehealth policies and to identify remaining policy gaps—particularly among marginalized/minoritized communities.

“I was drawn to the chance to examine this big policy issue from a variety of stakeholders' perspectives to see where there is synergy for creating positive change,” said Adams.

“Policymakers across the country are trying to figure out how to support telehealth and retain high quality care at the same time,” said Cuellar. “For our study, we want to look at these issues through a health equity lens.”

Adams said they’re lucky to have students involved at multiple levels, including Constance Owens, a doctoral student in health services research, and several undergraduates through the Office of Student Scholarship, Creative Activities, and Research (OSCAR).

“Our study includes data analysis and interviews with key stakeholders, so we recently added a few students onto our team to help with our interviews with clinicians, consumers, and others,” Cuellar said.

This is a one-year research project, with preliminary results expected by January 2023.

Topics

Research

College of Health and Human Services

College of Humanities and Social Sciences

CHHS Research

Center for Health Equity

Mason researchers partner with a community-based organization to develop the first social media-based intervention to promote Hepatitis B screening among Korean Americans

John Brandon Cantrell — Thu, 03 Feb 2022 13:47:36 +0000

Mason researchers partner with a community-based organization to develop the first social media-based intervention to promote Hepatitis B screening among Korean Americans John Brandon C… Thu, 02/03/2022 - 08:47

Culturally-targeted social media campaign increases HBV awareness among Korean Americans, one of the highest risk groups for an HBV infection.

The Hepatitis B virus (HBV) infection is the leading cause of cirrhosis and primary liver cancer, globally affecting nearly 300 million people. In the United States, Asian Americans account for 7% of the total population, but more than 50% of all HBV infections. Foreign-born Asian Americans face tremendous barriers to HBV screening, vaccination, and treatment because of lack of HBV-related knowledge, stigma, and limited access to health care due to language barriers and immigrant status.

There are limited culturally-tailored linguistically-appropriate interventions to promote HBV screening among Asian Americans. To address this public health need, ��AV researchers Dr. Alicia Hong, professor of Health Administration and Policy; Dr. Sojung Claire Kim, assistant professor in the Department of Communication; Dr. Pramita Bagchi, assistant professor in the Department of Statistics; and the Korean American Outreach Group collaboratively developed “Let’s talk about liver cancer,” a mHealth (mobile health) program for Korean Americans.

“The high prevalence of HBV infection and liver cancer mortality rates in Asian Americans is one of the most neglected and understudied cancer disparities,” said Hong. “We advocate for more research and practice to deliver culturally-tailored public health programs for underserved populations via social media apps used by the target groups.”

Most HBV-infected individuals are not aware of their condition because of its asymptomatic nature. Due to high rates of chronic HBV infection, Asian Americans have the highest liver cancer incidence and mortality rates of all racial or ethnic groups. HBV prevalence in Asian Americans is 10 times that of non-Hispanic White Americans (NHW). Asian American liver cancer mortality rates are two-to-three times that of NHW counterparts. Ninety-one percent of Asian Americans living with HBV are foreign-born.

As the COVID-19 pandemic continues, researchers seek to increase digital intervention in campaigns that previously had been community-based and in-person. The “Let’s talk about liver cancer” campaign was delivered via Kakao Talk, a social media app used by more than 95% of Koreans. The campaign was a four-week program that consisted of social video clips and pictorial messages tailored for Korean Americans with limited English proficiency and low level of health literacy. The program was adapted from a previous Centers for Disease Control HBV mass-media campaign.

“This is one of the first social media-based liver cancer prevention programs designed specifically for Korean Americans,” Hong remarked. “It’s amazing that we successfully piloted it during the pandemic, as it was delivered via a popular social media app.”

The paper, “Social media-based intervention to promote HBV screening and liver cancer prevention among Korean Americans: Results of a pilot study,” was published in Digital Health.

Hong led a multidisciplinary team to pilot test the campaign among 100 Korean Americans with 84% having limited English proficiency. The intervention had a 95% retention rate and significantly improved participants’ HBV-related knowledge, liver cancer prevention knowledge, perceived benefits of HBV testing, perceived risks of HBV infection, social norms of HBV testing, and self-efficacy of HBV testing. The results were comparable to the existing in-person community-based HBV promotion interventions.

Other team members in the study include Ms. Yee Soo of Korean American Outreach Group, Dr. Hee-soon Juon from Thomas Jefferson University, and Dr. Daisy Le from George Washington University. The team is thankful for the support from Korean American communities in the Greater Washington, D.C. area. The study was supported by the Potomac Health Foundation and a start-up fund grant from ��AV College of Health and Human Services. The study protocol was approved by the Institutional Review Board of ��AV.

Topics

Behavioral Intervention

Asian Americans

Hepatitis B

Center for Health Equity

Hong Finds Disparities in Clinical Trial Participation in America

John Brandon Cantrell — Tue, 01 Feb 2022 20:43:37 +0000

Hong Finds Disparities in Clinical Trial Participation in America John Brandon C… Tue, 02/01/2022 - 15:43

Clinical trial participation in America remains low and improving equity in clinical trials is essential to reducing health disparities

Public participation in clinical trials are the foundation of clinical research and the cornerstone for the discovery of new treatments. Even though most Americans view clinical trials favorably, the rate of participation remains low and significant gaps exist. For example, minorities and people of low socioeconomic status are less likely to participate in clinical trials. In addition, over the past two decades the internet has reshaped how people seek health information, but it is unknown if clinical trial participation has changed with the rise of the eHealth movement, which has led people to use more telehealth and online health communications.

Data from a national representative survey, led by Dr. Alicia Hong, professor of Health Administration and Policy at ��AV, suggest that American participation in clinical trials remains low and a significant disparity exists. People who have used eHealth tools are more likely to participate in clinical trials, and doctors who practice patient-centered communication can facilitate such participation.

The study is one of the first to report American participation in clinical trials using a large survey. Hong found that about 5% of American adults have ever participated in a clinical trial. Participation is associated with being female, white, and having a higher level of education. Data showed that health disparities in clinical trial participation remain persistent.

“Those who are more engaged in eHealth, for example, searching health information online, communicating with doctors via patient portals, using apps, or wearable devices to track health, are more likely to participate in clinical trials,” Hong said.

“We also found that if people feel their doctors or health care providers practice patient-centered communication, or when patients and providers have trusting relationships, the effect of eHealth engagement in clinical trial participation is amplified.”

“Given that significant disparities exist in American participation in clinical trials,” Hong commented, “We advocate for more targeted interventions in underserved communities. In the current context of eHealth movement, it’s critical to address the digital divide, and to enhance patient-provider communication.”

The study was partially supported by Alzheimer's and Related Diseases Research Award Fund of Virginia Center for Aging.

Clinical trial participation in America: The roles of eHealth engagement and patient–provider communication - Shaohai Jiang, Y. Alicia Hong, 2021 (sagepub.com)

Topics

Center for Health Equity

Notification of Social Security Disability Insurance Overpayment Debt Discourages Beneficiaries from Working

John Brandon Cantrell — Wed, 26 Jan 2022 20:18:36 +0000

Notification of Social Security Disability Insurance Overpayment Debt Discourages Beneficiaries from Working John Brandon C… Wed, 01/26/2022 - 15:18

In This Story

Priyanka Anand, PhD

New study finds that Social Security Disability Insurance beneficiaries who are notified of work-related overpayment debt report a 4-8% decline in work in the two months following notification.

Social Security Disability Insurance (SSDI) overpayment debt can cause undue hardship for SSDI recipients, result in increased administrative costs for the federal government, and break down the public’s trust of the government program. Though there have been efforts to reduce overpayments, little is known about the impact of overpayments on labor force participation. Findings of a behavioral response to overpayments could benefit SSDI recipients, the program, and possibly even other government programs.

A new study from Priyanka Anand, associate professor in the Department of Health Administration and Policy, found that notifications of debt related to work-related overpayment discourage work among SSDI beneficiaries.

SSDI is one of the largest federal programs for people with disabilities. It provides cash benefits to qualifying beneficiaries who are not able to engage in substantial gainful work due to a disability. The Social Security Administration (SSA), which operates SSDI, encourages people in the program to work if they are able; however, benefits will decrease if they earn more than a specified amount. If the organization is unaware of these earnings, it may inadvertently issue monthly benefits to these workers—known as a work‐related overpayment. Beneficiaries typically must pay back the overpayment.

In the two months after receiving notification of an overpayment, beneficiaries engaging in substantial work declined by 8%. In the months prior to notification, the average work decline in SSDI recipients was already declining, therefore only about half of the 8% decline two months after notification can be attributed to the overpayment notification. The study compared work activity in overpaid beneficiaries before and after their notification of overpayment using SSA administrative data from 2007 to 2016. The analysis revealed that the decline in work associated with the two months following overpayment debt notifications was the largest decline observed in the 6 months preceding the notification and the 6 months after.

“This evidence that overpayment debt notification discourages work highlights the need for policies to curtail overpayments,” says Anand. The decrease in work may be for many reasons, including reducing future debt and unease about SSA’s ability to pay them accurately while they work. The reduced motivation to work detracts from the SSA’s mission to support the employment goals of its beneficiaries.

Findings indicated that groups that are more dependent on SSDI benefits are more sensitive to overpayment debt. These groups include individuals with less than a high school education, age 45 years or older, who received benefits of $1000 or more, and who had back or other musculoskeletal conditions as their primary impairment.

“Very little is known about the impact of overpayment on labor force participation,” says Anand. “There are some studies that have explored these relationships qualitatively, but our study is the first to use administrative data to quantitatively estimate the extent to which Social Security Disability Insurance beneficiaries change their work behavior in response to an overpayment notification.”

People who have worked long enough and paid social security taxes on their earnings can apply for SSDI if they have a medical condition that prevents them from working for at least 12 months or is expected to end in death. More than 10 million people received SSDI benefits in 2017, totaling over $11 billion per month.

The article “Labor supply response to overpayment notifications: evidence from Social Security Disability Insurance” is available online in Contemporary Economic Policy now and will be published in a future print edition. Denise Hoffman of Mathematica, John T. Jones of SSA, and Siarhei Lukashanets of Mathematica are co-authors. The study was funded by the Social Security Administration Disability Research Consortium Grants.

Topics

Center for Health Equity

Mason Researchers Create Digital Health Solution for Students Experiencing Academic, Mental Health Concerns

John Brandon Cantrell — Wed, 05 Jan 2022 14:33:33 +0000

Mason Researchers Create Digital Health Solution for Students Experiencing Academic, Mental Health Concerns John Brandon C… Wed, 01/05/2022 - 09:33

Topics

Center for Health Equity

In This Story

Lawrence J. Cheskin, MD

Hong Xue, PhD

The intervention tool uses machine learning and artificial intelligence (AI) algorithms to detect a decline in undergraduate students' mental health and academic performance.

Students continue to feel the impact of the COVID-19 pandemic, which has created additional barriers to their academic success and mental well-being. A team of researchers in the College of Health and Human Services is working to address these concerns with an early intervention tool specifically designed for students from underserved and underrepresented backgrounds.

The research team includes Lawrence Cheskin, Hong Xue, Erika Kennedy, Xiaolu Cheng, and Shuo-yu Lin.

The team has created a predictive mobile app that integrates machine learning and artificial intelligence algorithms to detect when students are encountering academic and mental health challenges. The app connects students who are exhibiting risk factors to appropriate resources, such as Mason’s Counseling and Psychological Services and students’ academic advisors.

Data suggests that minority and low-income students have a greater risk for developing a mental illness and a higher need for COVID-19 related interventions.

The research team leveraged data from the ongoing Health Starts Here research project to refine the machine learning analytics. The Health Starts Here cohort study collected information on 155 diverse undergraduate students’ mental health challenges caused by the pandemic. The team will compare that data with a new cohort of 582 Mason undergraduate students using the app throughout the fall 2021 and spring 2022 semesters.

"Offering earlier assistance through the app will increase retention rates of vulnerable populations, improve mental well-being, and provide new insight into the daily lived experiences of these groups," says Erika Kennedy, a Master of Public Health student and the user interface design editor for the app.

Lawrence Cheskin, chair of the Department of Nutrition and Food Studies, and Hong Xue, associate professor in the Department of Health Administration and Policy, serve as co-principal investigators for the research project. The research team also includes Mason alumna and former postdoctoral researcher Xiaolu Cheng and PhD candidate Shuo-yu Lin.

“Users are asked some pre-screen questions about their age, employment, how many credits they are taking, and so on,” says Cheng, who developed the app. “Upon completing the pre-screen, users access a survey about mental health within the app once per week.”

The app is programmed to detect inconsistencies in participants' survey responses, allowing for intervention if the app recognizes a student exhibits behavioral, emotional, and academic risk factors that will need addressing. All information that the app collects will be securely stored on Amazon Web Services (AWS).

“We chose to use the secure AWS environment to process, maintain, and store protected health information,” Cheng said.

The group of researchers examines the data to determine if the app is effective on undergraduate student success and mental well-being throughout the COVID-19 pandemic. The team is also analyzing demographic differences, such as race, in student success when accessing the digital health solution.

"Now that the app has been developed, the next step is focusing on [sharing] the tool so that other universities and students nationwide can access and benefit from it," says Kennedy.

Ending Market Exclusivity for Statins Saves U.S. $12 Billion and Individuals Nearly $1,000 Annually

mthomp7 — Wed, 17 Nov 2021 18:09:21 +0000

Ending Market Exclusivity for Statins Saves U.S. $12 Billion and Individuals Nearly $1,000 Annually mthomp7 Wed, 11/17/2021 - 13:09

In This Story

Hong Xue, PhD

Alison Evans Cuellar, PhD, MBA

New study from ��AV is first to comprehensively assess the economic impact of generic competition for statins.

Prescription drug costs represent nearly 10 percent of total health care expenses for Americans, pushing the issue to the forefront of national health care policy conversations. With rising costs an ongoing concern, a paper released today in JAMA Network Open, published by the American Medical Association, shows the impact that introducing generic medications to the marketplace can have on bringing down prices.

In a recent study, ��AV Associate Professor Hong Xue, PhD, in the College of Health and Human Services Department of Health Administration and Policy (HAP), and colleagues including doctoral students Shuo-yu Lin and Weiyu Zhou, evaluated the impact of ending market exclusivity for brand-name statin drugs on generic statin purchases. Statin drugs are used to lower cholesterol to prevent and treat cardiovascular disease, a leading cause of death for men and women across racial and ethnic groups.

“Generic competition is effective for reducing prescription prices in the United States. Encouraging generic competition and access to generic medication should be considered as important regulatory policy options to reduce health expenditures,” according to Xue and Lin.

On average, more than 21 million statin prescriptions were purchased annually during the study’s 17-year period. After the market introduction of the generics, brand-name statin purchases decreased by 90.9 percent nationally and 27.4 percent individually. The study found that average annual cost savings per individual were $370.0 for private insurers, $281.0 for Medicare, $72.34 for Medicaid, and $211.9 for out-of-pocket, translating to an $11.9 billion savings for the US.

This study is the first to comprehensively assess the economic impact of generic competition for all available statins. The research team used a difference-in-difference design with data drawn from the annual nationwide Medical Expenditure Panel Survey for the years 2002 to 2018. The paper is entitled “Trends in utilization and expenditures for brand-name statins following introduction of generic statins in the United States, 2002-2018.”

The Center for Drug Evaluation and Research estimates that the average generic drug price is 49 percent of the corresponding brand-name drug. When six or more generic competitors exist, the amount saved is up to 95 percent. The authors note that there were seven brand-name statin drugs available prior to the end of market exclusivity. The study tracks market entry of five generic statins.

The transdisciplinary research team included Alison Evans Cuellar, PhD (HAP) and Weiyu Zhou from Mason’s Department of Statistics; Kyle Baumann, DO, from the University of Minnesota Medical School; and Chenxuan Zhou, Master of Finance, from the Virginia Commonwealth University School of Medicine.

Topics

Health Policy

prescription costs

College of Health and Human Services Department of Health Administration and Policy

Research

CHHS News

faculty spotlight

Center for Health Equity

New Study Helps Those With Depression Pick Antidepressant Based on Health History

mthomp7 — Sat, 23 Oct 2021 13:12:32 +0000

New Study Helps Those With Depression Pick Antidepressant Based on Health History mthomp7 Sat, 10/23/2021 - 09:12

In This Story

Farrokh Alemi, PhD

The study, by Farrokh Alemi, PhD and collaborators, analyzed data from more than 3.6 million patients with major depression who had more than 10 million antidepressant treatments.

Web site developed based on the study can help alleviate depression symptoms more effectively.

Although antidepressants are one of the most frequently taken medications in the United States (11% of the population takes antidepressants)[i] [ii], 60% of depressed patients do not benefit from their first antidepressant.[iii] The sales of antidepressants exceed several billion dollars annually.[iv]

According to a new study published today from ��AV, a person’s existing medical conditions can have an influence on which antidepressant may work best. The data from the study can help millions alleviate depression symptoms more effectively and is now available to clinicians and patients in an online database.

“Effectiveness of Common Antidepressants: A Post Market Release Study,” released today in EClinical Medicine (published by The Lancet), summarizes the experiences of patients who have multiple comorbidities, or medical conditions, with using 15 different antidepressants. The study, by Farrokh Alemi, PhD, professor in Mason College of Health and Human Services Department of Health Administration and Policy and collaborators, analyzed data from more than 3.6 million patients with major depression who had more than 10 million antidepressant treatments. Patients were broken into more than 16,000 subgroups based on conditions, demographic information, and prescribed medications to analyze their experiences using antidepressants.

Janusz Wojtusiak, PhD, associate professor, used the data to build a Web site designed to help individuals with depression find what will work best for them. By entering a patient’s medical history into the site, users can find similar cases in the data and receive recommendations for antidepressants based on the experience of symptom remission in other patients. Patients can share those recommendations with their clinicians to ensure their appropriateness for their individual case.

“Unlike with previously published randomized studies, the remission rates in the study differed significantly based on the subgroup’s medical history,” says Alemi. “The choice of the optimal antidepressant depended on the subgroup matched to the patient’s medical history.”

As an example, Alemi says, in the age and gender subgroups, the best antidepressant had an average remission rate of 50.78 percent, 1.5 times higher than the average antidepressant, which has a 30.3 percent remission rate. This was 20 times higher than the worst antidepressant used in the age and gender subgroup.

Alemi’s Mason colleagues in the study included Hua Min, PhD, associate professor, and Janusz Wojtusiak, PhD, associate professor in the Department of Health Administration and Policy; Melanie Yousefi, DNP, assistant professions in the School of Nursing. Laura Becker, MS, Christopher Hane, PhD, and Vijay Nori, PhD, from OptumLabs also collaborated. Alemi was also a visiting fellow at OptumLabs.

The researchers received a grant from the Robert Wood Johnson Foundation for the study. Virginia’s Commonwealth Health Research Board provided additional funds for the related website.

[i] Urquhart L. Top companies and drugs by sales in 2019. Nat Rev Drug Discov. 2020 Apr; 19(4): 228.

[ii] Piek E, van der Meer K, Nolen WA. Guideline recommendations for long-term treatment of depression with antidepressants in primary care--a critical review. Eur J Gen Pract. 2010 Jun;16(2):106-12.

[iii] Cheung AH, Zuckerbrot RA, Jensen PS, Ghalib K, Laraque D, Stein RE; GLAD-PC Steering Group. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): II. Treatment and ongoing management. Pediatrics. 2007 Nov;120(5):e1313-26.

[iv] Gautam S, Jain A, Gautam M, Vahia VN, Grover S. Clinical Practice Guidelines for the management of Depression. Indian J Psychiatry. 2017 Jan;59(Suppl 1):S34-S50.

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