JAMA internal medicine
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JAMA internal medicine · Oct 2021
Effectiveness of App-Delivered, Tailored Self-management Support for Adults With Lower Back Pain-Related Disability: A selfBACK Randomized Clinical Trial.
Lower back pain (LBP) is a prevalent and challenging condition in primary care. The effectiveness of an individually tailored self-management support tool delivered via a smartphone app has not been rigorously tested. ⋯ Among adults who sought care for LBP in a primary care or an outpatient spine clinic, those who used the selfBACK system as an adjunct to usual care had reduced pain-related disability at 3 months. The improvement in pain-related disability was small and of uncertain clinical significance. Process evaluation may provide insights into refining the selfBACK app to increase its effectiveness.
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JAMA internal medicine · Oct 2021
Association Between Prison Crowding and COVID-19 Incidence Rates in Massachusetts Prisons, April 2020-January 2021.
COVID-19 incidence and mortality are higher among incarcerated persons than in the general US population, but the extent to which prison crowding contributes to their COVID-19 risk is unknown. ⋯ This longitudinal ecological study found that within 14 Massachusetts state prisons, increased crowding was associated with increased incidence rates of COVID-19. Researchers and policy makers should explore strategies that reduce prison crowding, such as decarceration, as potential ways to mitigate COVID-19 morbidity and mortality among incarcerated persons.
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JAMA internal medicine · Oct 2021
Association of Surprise-Billing Legislation with Prices Paid to In-Network and Out-of-Network Anesthesiologists in California, Florida, and New York: An Economic Analysis.
Several states have passed surprise-billing legislation to protect patients from unanticipated out-of-network medical bills, yet little is known about how state laws influence out-of-network prices and whether spillovers exist to in-network prices. ⋯ This retrospective study found that prices paid to in-network and out-of-network anesthesiologists in hospital outpatient departments and ambulatory surgery centers decreased after the introduction of surprise-billing legislation, providing early insights into how prices may change under the federal No Surprises Act and in states that have recently passed their own legislation.
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JAMA internal medicine · Aug 2021
Multicenter StudyAssessing the Association Between Social Gatherings and COVID-19 Risk Using Birthdays.
Many policies designed to stop the spread of COVID-19 address formal gatherings, such as workplaces and dining locations. Informal social gatherings are a potentially important mode of SARS-CoV-2 transmission, but studying their role in transmission is challenged by data and methodological limitations; birthdays offer an opportunity to empirically quantify the potential role of small social gatherings in COVID-19 spread. ⋯ This cross-sectional study suggests that birthdays, which likely correspond with social gatherings and celebrations, were associated with increased rates of diagnosed COVID-19 infection within households in counties with high COVID-19 prevalence.