Mitchell Wong

• MD, PhD
• Professor (Full) at University of California, Los Angeles

This paper estimates the causal effects of enrollment in one of five oversubscribed high-quality Los Angeles charter schools using a lottery design. Enrolling in a charter school increased 11th-grade standardized test scores and enrollment and persistence in four-year colleges substantially, but had no effect on high school GPA. Charter students to...

Background: Some patterns of cannabis use may presage risk for long-term negative effects. We examined associations between a novel adolescent cannabis misuse scale and early-adult life course outcomes. Methods: We performed a secondary data analysis of a cohort of Los Angeles, CA high school students from grade 9 through age 21. Participants re...

The study identifies factors that limit effective institutional responses to domestic violence (DV) in Kyrgyzstan, in the context of recent legislative actions aimed at reducing DV through improvements in law enforcement, judicial processes and provision of social services. The study uses qualitative, grounded theory methods to analyse interviews a...

Background and objectives: Academic tracking is a widespread practice, separating students by prior academic performance. Clustering lower performing students together may unintentionally reinforce risky peer social networks, school disengagement, and risky behaviors. If so, mixing lower performing with high performing youth ("untracking") may be...

Background: Adolescent behaviors and academic outcomes are thought to be shaped by school climate. We sought to identify longitudinal associations between school climate measures and downstream health and academic outcomes. Methods: Data from a longitudinal survey of public high school students in Los Angeles were analyzed. Eleventh-grade health...

Importance Interventions directly targeting social factors, such as education, may have the potential to greatly improve health. Objective To examine the association of attending a high-performing public charter high school with rates of substance use disorder and physical and mental health. Design, Setting, and Participants This cohort study use...

[This corrects the article DOI: 10.1371/journal.pone.0251332.].

Adolescence is a critical transition period that sets the stage for adulthood and future health outcomes. Marked by key developmental milestones in brain maturation, increasing independence from parents, and greater connections to peers, adolescence is also a time of heightened risk for behavioral health problems, including substance use, violence,...

Objective To determine the frequency and predictors of antibiotic escalation in response to the inpatient sepsis screen at our institution. Design Retrospective cohort study. Setting Two affiliated academic medical centers in Los Angeles, California. Patients Hospitalized patients aged 18 years and older who had their first positive sepsis scree...

Objectives Although racial stigma in school is associated with adolescent risky health behaviors, there are no studies investigating how gender stigma relates to adolescent risky health behaviors among low-income, minority youth. We sought to determine whether gender stigma awareness is associated with adolescent risky health behaviors (delinquency...

Background Schools and school climate are thought to influence academic outcomes as well as child and adolescent development, health and well-being. We sought to examine the relationship between several aspects of the school climate with adolescent social-emotional health outcomes. Methods We analysed data from the Reducing Inequities through Soci...

In Reply In their Letter in response to our article,¹ Stankiewicz and colleagues offer a thoughtful clinical perspective on how differences in the whole-body volume status of patients who develop sepsis in the community vs in the hospital can affect subsequent requirements for sepsis management. Their argument provides a strong clinical rationale f...

Objective Chaos in the home is associated with worse childhood behaviors. We hypothesize chaos in the school environment might also be associated with teen risk behaviors. Methods We analyzed data from the Reducing Inequities through Social and Educational change follow up (RISE-UP) Study, a natural experiment designed to examine the impact of hig...

Importance The Early Management Bundle for Severe Sepsis/Septic Shock (SEP-1) is a quality metric based on a care bundle for early sepsis management. Published evidence on the association of SEP-1 with mortality is mixed and largely excludes cases of hospital-onset sepsis. Objective To assess the association of the SEP-1 bundle with mortality and...

Background Sepsis is the leading cause of in-hospital death. The SEP-1 sepsis bundle is a protocol for early sepsis care that requires providers to diagnose and treat sepsis quickly. Limited evidence suggests that adherence to the sepsis bundle is lower in cases of hospital-onset sepsis.Objective To compare sepsis bundle adherence in hospital-onset...

Background The SEP-1 sepsis bundle is a performance measure from the Centers for Medicare and Medicaid Services that requires blood cultures, serum lactate, broad-spectrum antibiotics, and IV fluids (in some cases) within 3 hours of onset of sepsis. Published evidence regarding an effect of SEP-1 on mortality is mixed and largely excludes cases of...

Objectives. To test whether providing information to parents about their child’s academic performance and behavior in school will lead to lower rates of adolescent substance use. Methods. We performed a randomized controlled trial in Los Angeles, California. We enrolled 318 seventh graders and their parents in 2014 and collected data through 2016....

Objectives Schools are thought to have an important impact on adolescent behaviors, but the mechanisms are not well understood. We hypothesize that there are measurable constructs of peer- and teacher-related extrinsic motivations for adolescent behaviors and sought to develop measures of school culture that would capture these constructs. Methods...

In Reply In a Letter to the Editor, Odom insightfully notes that school mobility is an understudied factor that may influence adolescent health by disrupting adolescent social networks and reducing their social capital. Alternatively, mobility may be a marker for risky behaviors, as students often change schools because of academic or behavioral di...

Background Every hour of delay between onset of sepsis and administration of the sepsis bundle increases sepsis mortality. Hospital-onset sepsis is known to have higher mortality than community-onset sepsis, but the differences in care between cases of hospital-onset and community-onset sepsis have not been characterized. The purpose of this study...

Importance Although school environments are thought to influence health behaviors, experimental data assessing causality are lacking, and which aspects of school environments may be most important for adolescent health are unknown. Objective To test whether exposure to high-performing schools is associated with risky adolescent health behaviors....

Nationally-representative data suggest an association between lack of insurance and in-hospital death from sepsis (Kumar et al., 2014). It remains to be determined whether this association is attributable to differences in baseline health, care-seeking behaviors, hospital care, or other factors. Purpose: To determine whether organ dysfunction pre...

Competing priorities between subsistence needs and health care may interfere with HIV health. Longitudinal data from the Los Angeles-based HIV Outreach Initiative were analyzed to examine the association between competing subsistence needs and indicators of poor retention-in-care among hard-to-reach people with HIV. Sacrificing basic needs for heal...

Purpose: Parenting style is strongly associated with adolescent health. However, little is known about how school disciplinary style relates to health. We categorized adolescents' perceptions of their schools as authoritative, authoritarian, permissive, or neglectful, and test whether perceived school disciplinary style is associated with health....

Purpose: We examined whether standardized test scores and grades are related to risky behaviors among low-income minority adolescents and whether social networks and social-emotional factors explained those relationships. Methods: We analyzed data from 929 high school students exposed by natural experiment to high- or low-performing academic env...

Objectives: To determine whether a treating oncologist's characteristics are associated with variation in use of chemotherapy for patients with advanced non-small cell lung cancer (aNSCLC) at the end of life. Study design: Retrospective cohort. Methods: Using the 2009 Surveillance, Epidemiology, and End Results-Medicare database, we studied ch...

Objective: "What do you want to be when you grow up?" is a simple, commonly asked question that might provide insight into adolescent well-being. Career aspirations might reflect an adolescent's sense of identity, hope for the future, and self-efficacy, all of which are critical to identifying at-risk youth and intervening on risky behaviors. Howe...

Objective: Studies suggest adolescent substance use aligns with academic and behavioral self-concept (whether teens think of themselves as good or bad students and as rule followers or rule breakers) as well as peer and adult social networks. Schools are an important context in which self-concept and social networks develop, but it remains unclear...

Background: Poor academic (eg, "I am a bad student") and behavioral (eg, "I am a troublemaker") self-concepts are strongly linked to adolescent substance use. Social networks likely influence self-concept. However, little is understood about the role teachers and athletic coaches play in shaping both academic and behavioral self-concepts. Methods...

Background: Despite a large body of research showing racial/ethnic and socioeconomic disparities in cancer treatment quality, the relative role of physician-level variations in care is unclear. Objective: To examine the effect of physicians on disparities in breast and colorectal cancer care. Subjects: Linked SEER Medicare data were used to id...

Purpose: Grit, defined as "working strenuously toward challenges, maintaining effort and interest over years despite failure, adversity, and plateaus in progress," is strongly associated with academic achievement and life success and may also be associated with health outcomes and behaviors. We examined predictors of grit, and the association betw...

Background: Although physician-scientists generally contribute to the scientific enterprise by providing a breadth of knowledge complementary to that of other scientists, it is a challenge to recruit, train, and retain physicians in a research career pathway. Objective: To assess the outcomes of a novel program that combines graduate coursework...

Objective: To determine the relationship between household chaos and substance use, sexual activity, and violence-related risk behaviors in adolescents. Study design: We analyzed cross-sectional data among 929 high-school students in Los Angeles who completed a 90-minute interview that assessed health behaviors and household chaos with the 14-qu...

Objectives: We examined whether exposure to high-performing schools reduces the rates of risky health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors. Methods: By using a natural experimental study design, we used the random admissions lottery into high-perf...

Objectives: We examined multiple variables influencing school truancy to identify potential leverage points to improve school attendance. Methods: A cross-sectional observational design was used to analyze inner-city data collected in Los Angeles County, California, during 2010 to 2011. We constructed an ordinal logistic regression model with cl...

South Asians are disproportionately impacted by cardiovascular disease (CVD). Our objective was to examine the association between duration of residence in the US and CVD risk factors among South Asian adult immigrants. Multivariate logistic regression analyses using pooled data from the 2005, 2007, 2009 California Health Interview Surveys. Duratio...

Background Fall-related injuries are a well-described cause of morbidity and mortality in the community-dwelling elderly population, but have not been well described in patients with cancer. Cancer treatment with chemotherapy can result in many unwanted side effects, including peripheral neuropathy if the drugs are potentially neurotoxic. Periphera...

Objective: The aim of this study was to examine the association between religiosity and overweight or obese body mass index among a multi-religious group of Asian Indian immigrants residing in California. Methods: We examined cross-sectional survey data obtained from in-language telephone interviews with 3228 mostly immigrant Asian Indians in th...

To explore state patterns in the racial life expectancy gap. The 1997-2004 Multiple Cause of Death PUF, 2000 U.S. Census. We calculated life expectancy at birth for black and white men and women. Data were obtained by the NCHS and U.S. Census Bureau. States with small racial differences are due to higher-than-expected life expectancy for blacks or...

• To improve insecticide-treated net use for the prevention of malaria by involving the community in the creation and implementation of an intervention. • Malaria is the leading cause of illness and death in children younger than 5 years and pregnant women in sub-Saharan Africa. • If used, ITNs reduce malaria cases by more than half and all-cause m...

Malaria is the leading cause of morbidity and mortality in children younger than 5 years old and pregnant women in sub-Saharan Africa. Insecticide-treated nets (ITNs) reduce clinical malaria by more than 50% and all cause mortality in young children by 15% to 30%. However, use of these nets is poor across sub-Saharan Africa, limiting the potential...

Current guidelines recommend prophylactic use of granulocyte-colony stimulating factors (G-CSF) when febrile neutropenia (FN) risk is greater than 20%. Advanced age is a risk factor for FN; however, little is known about the impact of other factors on the incidence of FN in an older population. We analyzed SEER-Medicare data (1994-2005) to develop...

The stigma of HIV-infection may profoundly affect the lives of persons living with HIV/AIDS (PLHA). However few studies have examined the association of HIV stigma with multiple components of HIV treatment and care. To estimate the association between HIV stigma and: self-reported access to care, regular source of HIV care, and antiretroviral thera...

To determine if granulocyte-colony-stimulating factor (G-CSF) primary prophylaxis is associated with a lower risk of febrile neutropenia (FN) than non-primary prophylaxis. This was a retrospective, cohort study of medical records from a random sample of patients with solid tumours and lymphomas treated in 99 community oncology practices in 2003 (n=...

BACKGROUND African Americans have higher cancer mortality rates than whites. Understanding the relative contribution of cancer incidence, stage at diagnosis and survival after diagnosis to the racial gap in life expectancy has important implications for directing future health disparity interventions toward cancer prevention, screening and treatmen...

CD4 cell count and viral load are the most widely used markers of Human Immunodeficiency Virus (HIV). Obtaining accurate measures of these laboratory markers can be challenging. The purpose of this study was to assess the reliability and validity of self-reported and abstracted paper medical record CD4 counts, viral load, and outpatient visits usin...

Cancer survivors often turn to religion, spirituality, and complementary and alternative medicine (CAM) because they perceive these areas as being more holistic and patient-centered than conventional medicine. Because increased religiosity and spirituality have been found to be associated with higher CAM use in the general population, it was hypoth...

To examine whether having a case manager is associated with better physical and mental health scores. HIV/AIDS is a condition characterized by a variety of medical and social needs that vary between individuals and over time. Case management has been advocated as a means to improve problems of access, cost and outcomes of HIV/AIDS care. We analyzed...

Whether having a stable and predictable lifestyle is associated with health care use and health status among HIV patients is unknown. To develop and test the reliability and validity of a measure of life chaos for adults with HIV and examine its association with health care use and health status. Prospective cohort study. Two hundred twenty HIV-inf...

Perceived stigma in clinical settings may discourage HIV-infected individuals from accessing needed health care services. Having good access to care is imperative for maintaining the health, well being, and quality of life of persons living with HIV/AIDS (PLWHAs). The purpose of this prospective study, which took place from January 2004 through Jun...

The purpose of this study was to examine time trends of failure to return for HIV test results among a mobile van population in Los Angeles. This study examined administrative records from 9340 patients of the Mobile HIV Testing van between January 1997 and December 2004. Between 1997 and 2004, a worsening trend was found in the percentage of clien...

This cross-sectional study examined factors associated with the receipt of HIV medical care among people who know their HIV status and are not newly diagnosed with HIV. Interviews were conducted with 1133 HIV-positive individuals between October 2003 and July 2005 who enrolled in 1 of 10 outreach programs across the country. The sample was predomin...

Colony-stimulating factors (CSFs) significantly decrease the risk of febrile neutropenia (FN), a common complication of myelosuppressive chemotherapy. Pegfilgrastim (6 mg), introduced in 2002, has a sustained duration of action, with a single dose comparable in efficacy to daily injections of filgrastim (5 g per kg per day) for 10 to 11 days; both...

Previous studies have examined the impact of physician gender and gender concordance on preventive care, satisfaction, and communication. Less is known about how physician gender and gender concordance affect care for chronic illnesses, including HIV. This study sought to determine whether patient-clinician gender concordance (patient and clinician...

To benefit from HIV treatment advances individuals must utilize ambulatory primary care services. Few studies focus on marginalized populations, which tend to have poor health care utilization patterns. This study examined factors associated with health care utilization in hard-to-reach marginalized HIV-infected individuals. As part of a multisite...

Engagement in HIV primary care and the receipt of antiretroviral therapy when clinically indicated offers patients the opportunity to experience HIV disease as a chronic illness. Yet many people, particularly those with comorbid mental health or substance abuse conditions and those who face multiple barriers to care, cycle in and out of care and th...

Approximately 28% of HIV-infected people in treatment in the United States report using illicit drugs. Illicit drug users have poorer course of HIV disease than non-drug users, which is thought to be due to their irregular use of HIV medical services. We examined associations between type (cocaine versus opioids) and pattern of drug use (drug use a...

Acculturation and access to conventional health care have been found to be predictors of complementary and alternative medicine (CAM) use in the general population. We hypothesized that these factors would be predictors of CAM use in Asian-American subgroups. Because of differences in health and cultural beliefs, we also hypothesized that patterns...

Men have higher mortality rates than women for most causes of death. This study was conducted to determine the contribution of specific causes of death to the sex difference in years of potential life lost (YPLL). The authors examined data from the National Health Interview Survey with linked mortality data through 1997. Using survival analysis est...

Many persons with HIV infection do not receive consistent ambulatory medical care and are excluded from studies of patients in medical care. However, these hard-to-reach groups are important to study because they may be in greatest need of services. This study compared the sociodemographic, clinical, and health care utilization characteristics of a...

To use logistic regression modeling to identify factors associated with high self-efficacy for sexual negotiation and condom use in a sample of South African youth. The Reproductive Health and HIV Research Unit (RHRU) National Youth Survey examined a nationally representative sample of 7409 sexually active South African youth aged 15 to 24 years. W...

Although racial segregation is associated with health status, few studies have examined this relationship among Latinos. We examined the effect of race/ethnic group concentration of Latinos, blacks and whites on all-cause mortality rates within a highly segregated metropolitan area, New York City (NYC). We linked NYC mortality records from 1999 and...

The use of complementary and alternative medicine (CAM) is likely to vary among racial/ethnic groups because its use is related to cultural and health beliefs. Understanding patterns of CAM use among ethnic groups could inform clinical practice and the study of CAM use in a diverse population. The authors compared CAM use among Asian-Americans, Ame...

Previous studies have shown that HIV-positive women underuse highly active antiretroviral therapy (HAART), but the reasons for this gender disparity are not completely understood. We examined whether one reason for this disparity is that women are less likely to use HAART when they have difficulty taking HIV medications openly at home. This was a p...

Understanding differences in cause-specific mortality between Latinos and whites is important for targeting future public health interventions and research aimed at eliminating health disparities. We sought to determine the contribution of specific causes of death to Latino-white differences in mortality. Using nationally representative data, we es...

New strategies to increase physical activity among sedentary older adults are urgently needed. To examine whether low expectations regarding aging (age-expectations) are associated with low physical activity levels among older adults. Cross-sectional survey. Six hundred and thirty-six English- and Spanish-speaking adults aged 65 years and above att...

To compare the utilization of health care resources and patterns of chronic disease care by patients of medical residents and patients of their attending physicians. This study involved a longitudinal cohort of 14,554 patients seen over a 1-year period by 149 residents and 36 attendings located in an urban academic medical center. Data were acquire...

We evaluated physicians' training, experience, and practice characteristics and examined associations between their attitudes toward human immunodeficiency virus (HIV)-infected persons who are injection drug users (IDUs) and quality of care. Cross-sectional surveys were conducted among a probability sample of noninstitutionalized HIV-infected indiv...

Compared to whites, African Americans have been found to have greater morbidity and mortality from HIV, partly due to their lower use of effective antiretroviral therapy. Why racial disparities in antiretroviral use exist is not completely understood. We examined whether racial concordance (patients and providers having the same race) affects the t...

To examine racial and ethnic differences in patients' preferences for initial care by specialists, and to determine whether trust in the physician and health beliefs account for these differences. We conducted a cross-sectional study of 646 patients in the waiting room of three academic-based internal medicine outpatient practices. We asked subject...

Current HIV treatment guidelines recommend delaying antiretroviral therapy for nonadherent patients, which some fear may disproportionately affect certain populations and contribute to disparities in care. To examine the relationship of physician's attitude toward prescribing protease inhibitors (PIs) to nonadherent patients with disparities in PI...

HIV-infected patients commonly use complementary and alternative medicine (CAM), but it is not known how often CAM is used as a complement or as a substitute for conventional HIV therapy. To evaluate the prevalence and factors associated with CAM use with potential for adverse effects and CAM substitution for conventional HIV medication. Cross-sect...

Background: HIV-infected patients commonly use complementary and alternative medicine (CAM), but it is not known how often CAM is used as a complement or as a substitute for conventional HIV therapy. Objectives: To evaluate the prevalence and factors associated with CAM use with potential for adverse effects and CAM substitution for conventional HI...

BACKGROUND: Since the introduction of the first protease inhibitor in January 1996, there has been a dramatic change in the treatment of persons infected with HIV. The changing nature of HIV care has important implications for the types of physicians that can best care for patients with HIV infection. OBJECTIVE: To assess the association of special...

Mortality from all causes is higher for persons with fewer years of education and for blacks, but it is unknown which diseases contribute most to these disparities. We estimated cause-specific risks of death from data from the National Health Interview Survey conducted from 1986 through 1994 and from linked vital statistics. Using these risk estima...

This study sought to determine the effect of cost sharing on medical care use for acute symptoms and on health status among chronically ill adults. Data from the Medical Outcomes Study were used to compare (1) rates of physician care use for minor and serious symptoms and (2) 6- and 12-month follow-up physical and mental health status among individ...

To compare primary care and traditional Internal Medicine residents in their adherence to preventive medicine guidelines, performance in the management of chronic diseases, and utilization of resources. Prospective cohort study. Urban Internal Medicine residency program. Sixteen primary care and 137 traditional Internal Medicine residents who took...