American journal of preventive medicine
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In 2016, the California Department of Health Care Services issued All Plan Letter 16-014 to the Medi-Cal Managed Care plans to provide information on requirements for comprehensive tobacco-cessation services. Researchers at the University of California, San Diego set out to (1) examine Medi-Cal's Managed Care plans' progress in implementing each section of All Plan Letter 16-014, (2) understand various factors related to implementation of the All Plan Letter, and (3) make recommendations to improve implementation. ⋯ Although All Plan Letter 16-014 was successful in creating more comprehensive and consistent benefits across Managed Care plans, 95% of Managed Care plans have not fully implemented it. Further guidance from the Department of Health Care Services and integration with the California Smokers' Helpline may be needed to achieve full implementation.
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Transgender and gender diverse people often face discrimination and may experience disproportionate emotional distress that leads to suicide attempts. Therefore, it is essential to estimate the frequency and potential determinants of suicide attempts among transgender and gender diverse individuals. ⋯ Among transgender and gender diverse individuals, younger people, people with previous suicidal ideation or attempts, and people with multiple mental health diagnoses are at a higher risk for suicide attempts. Future research should examine the impact of gender-affirming healthcare use on the risk of suicide attempts and identify targets for suicide prevention interventions among transgender and gender diverse people in clinical settings.
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This study examines COVID-19-associated discrimination regardless of infection status. It evaluates the contribution of various risk factors (e.g., race/ethnicity and wearing a face mask) and the relationship with mental distress among U.S. adults in March and April 2020, when the pandemic escalated across the country. ⋯ Perception of COVID-19-associated discrimination was relatively low but increased with time. Perceived discrimination was associated with race/ethnicity and wearing face masks and may contribute to greater mental distress during early stages of the pandemic. The long-term implications of this novel form of discrimination should be monitored.
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Unaddressed social risks among hospitalized patients with chronic conditions contribute to costly complications and preventable hospitalizations. This study examines whether the Centers for Medicaid and Medicare Services State Innovation Models initiative, through payment and delivery system reforms, accelerates the diagnosis of social risk factors among hospitalized adults with diabetes. ⋯ The State Innovation Models initiative slightly but significantly improved the diagnosis of social risks among hospitalized adults with diabetes. State-led delivery system and payment reform may help support movement of hospitals toward better recognition and management of social determinants of health.
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Community detection, the process of identifying subgroups of highly connected individuals within a network, is an aspect of social network analysis that is relevant but potentially underutilized in prevention research. Guidance on using community detection methods stresses aligning methods with specific research questions but lacks clear operationalization. The Question Alignment approach was developed to help address this gap and promote the high-quality use of community detection methods. ⋯ As prevention research incorporating social networks increases, researchers can use the Question Alignment approach to produce more theoretically meaningful results and potentially more useful results for practice. Future research should focus on assessing whether the Question Alignment approach translates into improved intervention results.