Mark A Strand

North Dakota State University | NDSU · College of Health Professions, Pharmacy Practice Department and Master of Public Health Department

Since their inception in 2000, the Millennium Development Goals (MDGs) have improved understanding of the global development process. Although the goals will not be significantly achieved on a global scale, each country has had accomplishments deserving of attention and analysis. With regard to the MDGs as they relate to children, China has made si...

Context: Diabetes care is being redesigned in many clinical practices. Few studies have characterized a cohort of diabetic patients in the midst of a process of clinical redesign. Purpose: This study aims to characterize a cohort of type 2 diabetes patients in rural North Dakota clinics, with a goal of identifying ways to improve individual patien...

As China undergoes urbanization, lifestyles and disease profiles are changing. In this study, metabolic syndrome (MetS) was discovered in 53.5% and 42.7% of men and women, respectively. In 3 age cohorts (44, 48, and 52 years), prevalence of MetS among women is 33.3%, 41.4%, and 50.8%, respectively (χ(2) = 10.27, P = .006), whereas among men it is 5...

Rates of rickets from 15.9 to 26.7% have been reported in China. Combining the methods of epidemiology and the behavioral sciences, this study investigated the prevalence of rickets in children in rural Shanxi Province, China. A total of 250 children age 12-24 months were examined physically for the presence of rickets, blood was drawn for laborato...

China has over 100 million people living with type 2 diabetes mellitus (T2DM). Interventions framed around pre-existing personal beliefs in the supernatural may improve T2DM self-management, but such interventions are lacking in China. This pilot randomized controlled trial (RCT) assessed the feasibility of a full-scale RCT to evaluate the efficacy...

Objective: The Opioid and Naloxone (ONE) Program focuses on community pharmacy-based patient screening and interventions to improve population health with regard to opioid use. The purpose of this paper is to reevaluate the ONE Program performance using the RE-AIM model, in comparison to the review performed in 2019. Methods: The program performanc...

Objective: The opioid epidemic poses a persistent public health threat to the United States. The objective of this research was to conduct an in-depth environmental scan of North Dakota's opioid policies in 2022 and 2023. The study aimed to assess the policies' alignment with best practice standards, identify strengths and weaknesses in each domain...

The opioid epidemic in the United States is a chronic epidemic; that is, it took 10 years for the enormity of the epidemic to emerge, and it will take 20 years to gain control of it. What's more, given the nature of substance use disorders, and the frequency of relapse, even while people are recovering, the best strategy is to prevent new cases of...

Context: COVID-19 exerted severe challenges on skilled nursing facility (SNF) residents and staff. A combination of internal and external factors predisposed SNFs to an increased propensity of COVID-19 spread. Objective: The purpose of this paper is to examine which facility characteristics may have contributed to COVID-19 outbreaks within urban a...

Objective: North Dakota (ND) had the highest COVID-19 case and mortality rate in the U.S. for nearly two months. This paper aims to compare three metrics ND used to guide public health action across its 53 counties. Methods: Daily COVID-19 case and death totals in North Dakota were evaluated using data from the COVID -tracker website provided by...

Home care clients have safety barriers related to medication storage, disposal, and safe use of opioids. Limited research is available regarding medication safety initiatives in the home care setting. This study evaluates a medication safety initiative, linked with opioid misuse and overdose prevention screening, for home care clients with differen...

Context: Public health professionals around the country faced significant challenges responding to the COVID-19 pandemic. Reflecting on their experience is an essential element in making sense of their experience and learning from it. Objective: The objective of this qualitative study was to (1) describe the lived experiences of public health pr...

Background: Pharmacist stigma via examination of social distance preference and negative attitudes toward persons who misuse opioids is prevalent and may lower the quality of care provided to patients. Few studies have previously extended beyond the immediate post-intervention period to examine stigma change. Methods: This longitudinal cohort study...

Poster presentation on the significance of past infectious disease outbreaks in Nigeria’s response to COVID-19. How the past infectious diseases informed the emergency preparedness plan of Nigeria against the COVID-19 outbreak through lessons learned, improvement of existing policies, infrastructure, personnel education, collaborations and more.

Background: Pharmacy practice continues to expand in scope, and technology platforms to assist with meeting the standards for documentation of billable services are needed. The ONE Program (Opioid and Naloxone Education) is an initiative centered on the community pharmacy focused on opioid risk screening for patients receiving opioid prescriptions....

In 2018, the ONE program (Opioid and Naloxone Education) was developed in response to this crisis, with the intention of engaging pharmacists in the effort to mitigate the epidemic through primary prevention of opioid misuse. The program set out to provide enhanced education to pharmacists about substance use disorders and safe use of opioid medica...

Introduction: Community pharmacies nationwide have adopted new strategies to combat the opioid epidemic. One strategy to prevent opioid misuse and accidental overdose is patient screening to identify those at risk. The purpose of our study was to determine whether such screening in community pharmacies led pharmacy personnel to intervene with pati...

Objective The objective for this paper is to report on the utility of the Opioid Risk Tool (ORT) to identify patients at elevated risk for opioid misuse and deliver medication safety-related services to them. Patient characteristics based on ORT risk stratification are also described. Methods Data from patients screened from September 17, 2018 to...

Pharmacists tend to provide care to patients with psychiatric disorders less frequently than to other types of patients, yet patients with psychiatric disorders experience more drug-related problems and use more opioids than those without psychiatric disorders. The Opioid and Naloxone Education (ONE) program equipped pharmacists to screen for opioi...

Objective: During the COVID-19 pandemic in the United States, mitigation measures were implemented on a state-by-state basis. Governors were responsible for establishing interventions appropriate for their states and the timing of implementation. This paper evaluated the association between the presence and timing of a mask mandate and the severity...

Background Pharmacist-implemented screening programs can be improved though continuous program evaluation. Pharmacists are in a position to determine whether interventions are realistic and efficacious when used in practice Objective The purpose of this study is to evaluate how community pharmacists perceive the use of an opioid risk screening for...

Introduction: Hepatitis C virus (HCV) infection is a public health epidemic. People who inject drugs (PWID) are at high risk for transmitting and contracting HCV. The objective of this study was to assess the effectiveness of a multifaceted intervention at a federally qualified health center in the US Midwest to improve HCV screening rates among P...

Background Health professionals may stigmatize and prefer social distance from patients with opioid misuse, leading to poorer quality of care provided. The degree to which pharmacists prefer social distance from patients with opioid misuse and opioid use disorder (OUD) is not known. Methods Pharmacists ( n = 187) completed a survey comprised of de...

In the early stages of the COVID-19 pandemic in the United States, people were keen to receive information but overwhelmed by the volume of it. Furthermore, many were anxious and unable to feel confident in the reliability and the benefit of the information they were receiving. In response to a perceived need in the public, the author produced a se...

Continuing quality improvement of teaching strategies is a necessity to ensure effective content delivery, high student engagement, and optimal preparation of students for their future roles as healthcare professionals. Strategies such as case studies and team-based learning approaches have been shown to be effective at information retention in stu...

Background: The COVID-19 pandemic has required every country in the world to implement mitigation measures to minimize the economic and human toll of the pandemic. Most countries have struggled to respond in an expeditious and well-coordinated manner and have had to make decisions simultaneously with trying to understand the pandemic. In order to a...

Background: Continuing education (CE) provides educational opportunities for health professionals to adequately respond to issues in practice but infrequently evaluate sustained practice change. The opioid epidemic has risen to the forefront of health priorities in our nation. The Opioid and Naloxone Education (ONE Rx) CE program provides pharmaci...

Background: A statewide opioid risk screening program was introduced to pharmacists to provide them with resources to screen patients who are prescribed an opioid medication. Using opioid risk screening equips pharmacists to deliver education and patient-centered interventions for opioid harm reduction. Nearly 50% of pharmacists that enrolled thei...

Background: North Dakota Department of Health (NDDoH) Maternal and Child Health (MCH) Title V funds were allocated through a competitive process. Each of the six grantees were required to report quarterly on their identified objectives. Originally, grantee progress was reported in text format with minimal guidance on format or quantitative data req...

Background Community pharmacists are in a unique position to prevent opioid-related deaths through the provision of naloxone. However, for those identified as candidates for take-home naloxone, the acceptance rate remains low. Value would be gained from knowing what patient demographics and pharmacist actions are associated with increased patient a...

Success in health care is increasingly being measured by improvements in population health outcomes in response to interventions rather than by services delivered. In this new landscape, cross-sectoral collaboration is paramount, and the profession of pharmacy is an often-overlooked partner. Our vision is that pharmacists and the profession of phar...

Community pharmacists assist patients to manage disease and prevent complications. Despite the enormous challenge the coronavirus disease 2019 (COVID-19) pandemic has dealt to the health care system, community pharmacists have maintained the delivery of critical health services to communities, including those most at risk for COVID-19. Community ph...

This study examined Denver, Colorado area grocery stores to identify if significant differences in food price, availability, or quality existed for different population groups. Thirty stores were randomly selected and analyzed using Nutritional Environmental Measure Survey for Supermarkets (NEMS-S). Results showed there was no significant relations...

This letter to the editor explains the importance of preventing opioid misuse rather than waiting to treat people after they have developing a disorder.

To create a culture of deep learning needed to prepare pharmacy students for their roles involving patient care and team-based clinical decision-making concept mapping strategies were integrated in an entry-level and advanced-level pharmacy doctorate courses. Findings indicated that concept mapping strategies can help students build and represent c...

Introduction: Continuing education is needed for health professionals to take an active role in reversing the opioid crisis. This report describes the results of training to promote behavioral change by altering pharmacists' perceptions toward opioid misuse through the provision of content-related education. Methods: A free 3-hour opioid misuse...

Objective: Opioid and Naloxone Education (ONE Rx) is a program that focuses on community pharmacy-based patient screening and interventions to improve population health with regard to opioid use. The objective for this paper is to describe how ONE Rx was implemented, report on the populations impact using the Reach, Effectiveness, Adoption, Impleme...

The metabolic syndrome (MetS) is a cluster of risk factors, which have been shown to increase the risk for development of chronic diseases. This study assessed the prevalence of MetS among 383 middle-aged Chinese persons and the predictive ability of MetS for the incidence of type 2 diabetes, myocardial infarction (MI), stroke, hyperlipidemia and h...

Objective: To describe the implementation of a statewide pharmacy program called ONE Rx (Opioid and Naloxone Education) within community pharmacies. Setting: Thirty community pharmacies. Practice description: Community pharmacies throughout the state of North Dakota were invited to participate. Pharmacists in North Dakota can legally prescribe...

High prevalence of diabetes and prediabetes has emerged as a concern in China. The Pathway to Health Program was designed to prevent type 2 diabetes onset in prediabetic women in a north China urban community. This process evaluation of a randomized controlled trial analysed participant surveys at the 6- and 12-month assessment times, participant w...

High prevalence of diabetes and prediabetes has emerged as a concern in China. The Pathway to Health Program was designed to prevent type 2 diabetes onset in prediabetic women in a north China urban community.This process evaluation of a randomized controlled trial analysed participant surveys at the 6- and 12-month assessment times, participant we...

This paper has broken new ground by describing an upstream approach to the opioid epidemic, with a particular focus on the role of the community pharmacist. This is an example of the application of public health best practices to pharmacy, a discipline that is more individual patient-focused, but with huge potential to make contributions to improve...

Researchers at pharmacy schools are designing tools that allow pharmacists to deliver evidence-based care to patients who use opioids.

This poster reports on changes in social distance among pharmacists trained in substance use disorders.

Type 2 diabetes, depression and alcohol abuse exist in many populations as co-morbidities. These conditions contribute to worsened health status and lost productivity. Such diseases also contribute to high medical expenses and other societal costs. Diabetes, depression and alcohol abuse are individually associated with compromised financial status....

Undiagnosed and uncontrolled hypertension and stroke in north China： ： A longitudinal study) in urban China. Both hemorrhagic stroke and ischemic stroke events were self-reported. Blood pressure status was categorized into four groups: normal, pre-hypertensive (130-140/80-90), undiagnosed hypertension. (>140/90), and reported hypertension. Results:...

Background: Prescription opioids are known to be highly addictive, contributing to the opioid epidemic which continues to besiege victims in the United States. Pharmacists are gatekeepers straddling the prescribers of opioids and their patients; therefore they are in the ideal position to screen for opioid misuse among patients receiving opioid pr...

Objectives: The purpose of this study was to determine effects of road dust on human health. Methods: A PubMed search was used to extract references that included the words Road Dust and Health, Fugitive Dust and Health in the title or abstract. A total of 45 references were extracted and selected for the literature review after the primary scre...

Background The prevalence of both obesity and type 2 diabetes has been on the rise in China. This randomized controlled trial was conducted to test the feasibility and effectiveness of an evidence-based diabetes prevention program in Yuci, Shanxi Province, China from 2012 to 2014. Methods Women with pre-diabetes, ages 25–65 y, were assigned rando...

Background: Pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objectives: To assess Iowa, North Dakota and Manitoba pharmacists’ level of involvement in implementing the delivery of public health services. Methods: This study implemented an on-line survey sent t...

Purpose: Dust exposure is detrimental to human health, particularly respiratory disease. The population of Western North Dakota has been exposed to increasing amounts of dust due to the rapid increase in oil production-related traffic. However, nothing is known about the association between road dust and the health of residents in Western North D...

Context To assess the global burden of late and/or poor management of severe neonatal jaundice (SNJ), a common problem worldwide, which may result in death or irreversible brain damage with disabilities in survivors. Population-based data establishing the global burden of SNJ has not been previously reported. Objective Determine the burden of SNJ...

Objective: To describe components fundamental to the process of linking pharmacy to the delivery of public health services in a sustainable way. Summary: Pharmacists deliver public health services with varying frequency. A literature review was conducted to create a set of fundamental links necessary for pharmacists to deliver public health serv...

Dust and human health

Background: Pharmacists have contributed to improved population health through the delivery of public health services, but their contributions often go unrecognized within the larger health care system. Objectives: To determine pharmacist perceptions of their contributions to the 10 essential services of public health and to compare those contri...

Participants in the comparison group improved their dietary habits and physical activity in a manner similar to the intervention group. Therefore our results suggest that a simplified form of DPP curriculum implemented in a CHC setting may be adequate to meet diabetes prevention goals. Intensive behavioral modification for prediabetic women can ach...

Background The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health,...

Worldwide, nutritional rickets continues to be an evolving problem with several causes. This paper provides an updated literature review characterising the prevalence, aetiology, pathophysiology and treatment of nutritional rickets worldwide. A systematic review of articles on nutritional rickets from various geographical regions was undertaken. Fo...

One of the challenges facing international healthcare missionaries is that of maintaining up-to-date knowledge and staying current with professional certification. Since 1978, annual programs by the Christian Medical and Dental Associations have offered professional continuing education to thousands of US healthcare professionals serving as mission...

Objectives: To determine medication use patterns and associated health outcomes in Chinese individuals with diabetes, hypertension or hyperlipidaemia. Methods: This community-based cross-sectional study was done in a north China city of 300 000 people. Participants were recruited by poster and phone call through Community Health Centres. Data we...

The pharmacy profession fills important roles and responsibilities relevant to public health, and therefore, must ensure that student pharmacists are appropriately educated and trained to serve in these essential roles. Public health as a discrete entity is mentioned in the glossary, but not specifically identified within the Center for Advancement...

Purpose: Evidence-based guidelines recommend regular depression screening among individuals with type 2 diabetes mellitus (T2DM). The purpose of this study is to examine depression screening patterns among a primary care population with T2DM, through use of the Patient Health Questionnaire-9 (PHQ-9). Methods: In total, 1817 patients with T2DM we...

The pharmacy profession fills important roles and responsibilities relevant to public health, and therefore, must ensure that student pharmacists are appropriately educated and trained to serve in these essential roles. Public health as a discrete entity is mentioned in the glossary, but not specifically identified within the Center for Advancement...

Career service in cross-cultural healthcare mission work is the ambition of many people around the world. However, premature termination of this expected long-term service mitigates against achieving the goals of the individual and the organization. The lingering challenge of high rates of missionary attrition impacts the long-term effectiveness of...

Objective: Major depressive disorder and type 2 diabetes commonly co-occur and disease control tends to be poorer when both conditions are present. However, little research has examined the disease characteristics of patients with diabetes and more severe depressive symptoms. Methods: We report a retrospective observational study of 517 patients...

Objectives To characterize baseline public health knowledge and to evaluate changes in pharmacy student performance after participation in one semester of didactic and experiential public health coursework. Methods Third-year professional students were surveyed before and after fall semester 2013, a semester in which they completed two public heal...

Background: Rising incidence of chronic diseases is a global phenomenon re- sponsible for the greatest increase in burden of disease. Objective: To determine the prevalence of the metabolic syndrome (MetS) in a sample of middle- aged Chinese individuals and the onset of incident diabetes, hypertension, and hyperlipidemia in the ensuing 4 years. S...

In this study of career healthcare missionaries (N = 393), 47.9% of female missionaries and 42.1% of male missionaries reported experiencing anxiety, while 32.5% of female missionaries and 27.5% of male missionaries reported experiencing depression. For both females and males, depression severity scores showed a bimodal distribution of more and les...

The purpose of the current study was to assess the frequency and distribution of the Patient Health Questionnaire-9 (PHQ-9) among individuals with type 2 diabetes with and without depression. The current case-control study used electronic medical record data from two primary care institutions. The sample was divided into cases with coexisting depre...

Accessible at this website: www.idf.org/bridges/publications

Healthcare missionaries (n=393) from 18 English-speaking countries, serving in 67 countries, were surveyed. With an average of 11 years of field experience and working primarily in the local language, participants in this study were able to report on healthcare situations and experience for expatriate healthcare missionaries in their countries of s...

Local public health units around the country are under significant financial constraints. Seven counties in the Southeast Central Region of North Dakota established a cross-jurisdictional collaborative to increase financial efficiency through shared delivery of public health services. This paper reports on the cost-benefit analysis instrument desig...

Background: Type 2 diabetes and major depressive disorder are co-morbidities that contribute to decreased quality of life and complex clinical management. Objective: To explain the relationship between severity of depression, as measured by PHQ-9 score, and glycemic control, as well as cardiovascular disease risk factors, among type 2 diabetes pat...

In an environment in which local public health has many competing priorities, limited resources and varying levels of expertise, local public health departments need to find more efficient and effective ways to deliver the Ten Essential Services. North Dakota law allows local public health departments to form regional public health networks through...

Purtle and Roman's commentary "Health Awareness Days: Sufficient Evidence to Support the Craze?" was a balanced critique of an otherwise harmless and popular trend.(1) I would like to support the authors' concern by exploring three possible presuppositions underlying the current approach to health awareness days. (Am J Public Health. Published onli...

It is known that pharmacists are currently contributing to public health; however, the extent of this contribution as reported in the literature has not been examined. Investigating the ways that pharmacists are currently participating in public health is critical for the profession of pharmacy, pharmacy educators, and the public health community....

Objective: There is a need to improve population health outcomes among diabetes patients with co-morbid major depressive disorder. This study set out to compare health service frequency and health outcomes among diabetic patients with and without diagnosed depression, at two different primary care sites. The purpose was to identify opportunities fo...

This poster reports on a longitudinal study examining the progression of Metabolic Syndrome (MetS) in Chinese men and women. MetS is a significant predictor of many metabolic diseases. This study showed that MetS rate plateaus for men in their 40s, whereas for women it increases prior to and beyond menopause. A better understanding of MetS, includi...

This longitudinal study investigated the prevalence of the Metabolic Syndrome (MetS) in middle-aged (44-56 years) men and women in China. The presence of the components of the MetS was determined in a cohort of 643 persons born in 1956, 1960-1961, and 1964 in Shanxi Province China in 2008 and 2012. The rate of MetS in 2008 was 51.63% (95% CI [44.73...