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Unraveling R0: Considerations for Public Health Applications
We assessed public health use of R0, the basic reproduction number, which estimates the speed at which a disease is capable of spreading in a population. These estimates are of great public health interest, as evidenced during the 2009 influenza A (H1N1) virus pandemic. We reviewed methods commonly used to estimate R0, examined their practical utility, and assessed how estimates of this epidemiological parameter can inform mitigation strategy decisions. In isolation, R0 is a suboptimal gauge of infectious disease dynamics across populations; other disease parameters may provide more useful information. Nonetheless, estimation of R0 for a particular population is useful for understanding transmission in the study population. Considered in the context of other epidemiologically important parameters, the value of R0 may lie in better understanding an outbreak and in preparing a public health response.
Journal Article
Evaluating clinical and public health interventions : a practical guide to study design and statistics
\"Whether you are evaluating the effectiveness of a drug, a medical device, a behavioral intervention, a community mobilization, or even a new law, this is the book for you. Written in plain language, it simplifies the process of designing interventions, analyzing the data, and publishing the results. Because the choice of research design depends on the nature of the intervention, the book covers randomized and nonrandomized designs, prospective and retrospective studies, planned clinical trials and observational studies. In addition to reviewing standard statistical analysis, the book has easy-to-follow explanations of cutting edge techniques for evaluating interventions, including propensity score analysis, instrumental variable analysis, interrupted time series analysis and sensitivity analysis. All techniques are illustrated with up-to-date examples from medical and public health literature. This will be essential reading for a wide range of healthcare professionals involved in research as well as those more specifically interested in public health issues and epidemiology\"--Provided by publisher.
Book
The National Institute on Minority Health and Health Disparities Research Framework
We introduce the National Institute on Minority Health and Health Disparities (NIMHD) research framework, a product that emerged from the NIMHD science visioning process. The NIMHD research framework is a multilevel, multidomain model that depicts a wide array of health determinants relevant to understanding and addressing minority health and health disparities and promoting health equity. We describe the conceptual underpinnings of the framework and define its components. We also describe how the framework can be used to assess minority health and health disparities research as well as priorities for the future. Finally, we describe how fiscal year 2015 research project grants funded by NIMHD map onto the framework, and we identify gaps and opportunities for future minority health and health disparities research.
Journal Article
Functions, methods and concepts in evaluation research
\"Evaluation research has been subject to a tremendous boom in recent years advancing to become an important instrument for analysing the effectiveness of government programmes as well as reviewing the performance of and auditing both public and private sector organisations. The purpose of this book is to explore the advances that have taken place in evaluation research and to place these advances in their correct context thus providing a comprehensive and impelling overview of the subject. As well as exploring various concepts, theories and methods used in evaluation, this volume also presents the societal function of evaluation and the social processes associated with performing effective evaluations. By using examples from all over the world the books shows the typical way in which evaluations are processed and how they can be used in a variety of policy fields. It is a must-read for students and scholars with a background in evaluation as well as newcomers to the subject who will find this new contribution to the literature on the subject an invaluable tool\"-- Provided by publisher.
Book
From Race and Ethnicity as Proxy Variables to Measuring What It Means: The Next Evolution of Health Equity Research
[...]critical health disparities were often masked, sometimes to meet statistical assumptions rather than being empirically informed, which stalled progress toward health equity. According to the 2020 US Census, about 17% of Asians and over half of NHPIs identify with more than one race, yet many may choose their respective Asian ог NHPI identity as primary. Using 2021 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data and treating all possible race/ethnicity combinations as the gold standard, researchers found that although both models performed similarly in predicting patient experience outcomes, the additive model approach was better at capturing differences related to social determinants of health, such as age, education, and mental health. Comparison of alternative approaches to using race-and-ethnicity data in estimating differences in health care and social determinants of health.
Journal Article
COVID-19 and the Drug Overdose Crisis: Uncovering the Deadliest Months in the United States, January‒July 2020
Objectives. To determine the magnitude of increases in monthly drug-related overdose mortality during the COVID-19 pandemic in the United States. Methods. We leveraged provisional records from the Centers for Disease Control and Prevention provided as rolling 12-month sums, which are helpful for smoothing, yet may mask pandemic-related spikes in overdose mortality. We cross-referenced these rolling aggregates with previous monthly data to estimate monthly drug-related overdose mortality for January through July 2020. We quantified historical errors stemming from reporting delays and estimated empirically derived 95% prediction intervals (PIs). Results. We found that 9192 (95% PI = 8988, 9397) people died from drug overdose in May 2020—making it the deadliest month on record—representing a 57.7% (95% PI = 54.2%, 61.2%) increase over May 2019. Most states saw large-magnitude increases, with the highest in West Virginia, Kentucky, and Tennessee. We observed low concordance between rolling 12-month aggregates and monthly pandemic-related shocks. Conclusions. Unprecedented increases in overdose mortality occurred during the pandemic, highlighting the value of presenting monthly values alongside smoothed aggregates for detecting shocks. Public Health Implications. Drastic exacerbations of the US overdose crisis warrant renewed investments in overdose surveillance and prevention during the pandemic response and postpandemic recovery efforts.
Journal Article
The RE-AIM Framework: A Systematic Review of Use Over Time
We provided a synthesis of use, summarized key issues in applying, and highlighted exemplary applications in the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. We articulated key RE-AIM criteria by reviewing the published literature from 1999 to 2010 in several databases to describe the application and reporting on various RE-AIM dimensions. After excluding nonempirical articles, case studies, and commentaries, 71 articles were identified. The most frequent publications were on physical activity, obesity, and disease management. Four articles reported solely on 1 dimension compared with 44 articles that reported on all 5 dimensions of the framework. RE-AIM was broadly applied, but several criteria were not reported consistently.
Journal Article
The National Health and Nutrition Examination Survey (NHANES), 2021–2022: Adapting Data Collection in a COVID-19 Environment
The National Health and Nutrition Examination Survey (NHANES) is a unique source of national data on the health and nutritional status of the US population, collecting data through interviews, standard exams, and biospecimen collection. Because of the COVID-19 pandemic, NHANES data collection was suspended, with more than a year gap in data collection. NHANES resumed operations in 2021 with the NHANES 2021–2022 survey, which will monitor the health and nutritional status of the nation while adding to the knowledge of COVID-19 in the US population. This article describes the reshaping of the NHANES program and, specifically, the planning of NHANES 2021–2022 for data collection during the COVID-19 pandemic. Details are provided on how NHANES transformed its participant recruitment and data collection plans at home and at the mobile examination center to safely collect data in a COVID-19 environment. The potential implications for data users are also discussed. (Am J Public Health. 2021;111(12):2149–2156. https://doi.org/10.2105/AJPH.2021.306517 )
Journal Article