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Introduction
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August 2008 - May 2013
Publications
Publications (113)
Background
Implementation strategies can help support the adoption and implementation of health interventions that are appropriate for a local context and acceptable to decision makers and community members. Implementation strategies should be designed to handle the complexity of the multi-level, dynamic contexts in which interventions are implemen...
Amidst the COVID-19 pandemic, prolonged periods of physical and social isolation imposed significant challenges on parents and children, disrupting their socioeconomic stability and psychological well-being. This study examined the effects of parenting stress on aspects of parents’ and children’s functioning during the COVID-19 pandemic. A comprehe...
Background
Psychiatric residential treatment facilities (PRTFs) are non-hospital inpatient treatment settings for children with severe behavioral health disorders. PRTFs are a restrictive and costly form of care that can potentially be avoided with community-based behavioral health services.
Methods
Statewide Medicaid enrollment and claims data f...
Adverse childhood experiences (ACEs) are conventionally measured using a cumulative-risk index without consideration of distinct measurement properties across racial and ethnic groups. Drawing from the 2018–2020 National Survey of Children's Health (N=93,759; 48% female; average age: 9.52years), we assess the measurement invariance of a latent-fact...
Amidst the COVID-19 pandemic, prolonged periods of physical and social isolation imposed significant challenges on parents and children, disrupting their socioeconomic stability and psychological well-being. This study examined the effects of parenting stress on aspects of parents' and children's functioning during the COVID-19 pandemic. A comprehe...
Importance:
Federal and state agencies granted temporary regulatory waivers to prevent disruptions in access to medication for opioid use disorder (MOUD) during the COVID-19 pandemic, including expanding access to telehealth for MOUD. Little is known about changes in MOUD receipt and initiation among Medicaid enrollees during the pandemic.
Object...
Objectives:
The purpose of this study was to measure sexually transmitted infection (STI) testing among Medicaid enrollees initiating preexposure prophylaxis (PrEP) to prevent human immunodeficiency virus. Secondary data are in the form of Medicaid enrollment and claims data in six states in the US South.
Methods:
Research partnerships in six st...
The history of the child welfare system and related institutions with American Indian children and families has been marked by numerous atrocities, including unnecessary separations, assimilation, and trauma. The Indian Child Welfare Act (ICWA) was enacted in 1978 to promote the stability and security of American Indian tribes and families. For chi...
Therapeutic foster care (TFC) is a service for children with high behavioral health needs that has shown promise to prevent entry into more restrictive and expensive care settings. The purpose of this study was to compare Medicaid expenditures associated with TFC with Medicaid expenditures associated with an enhanced higher-rate service called Inte...
Background:
Medication for opioid use disorder (MOUD) is evidence-based treatment during pregnancy and postpartum. Prior studies show racial/ethnic differences in receipt of MOUD during pregnancy. Fewer studies have examined racial/ethnic differences in MOUD receipt and duration during the first year postpartum and in the type of MOUD received dur...
Introduction:
Residential treatment is a key component of the opioid use disorder care continuum, but research has not measured well the differences in its use across states at the enrollee level.
Methods:
This cross-sectional observational study used Medicaid claims data from nine states to document the prevalence of residential treatment for o...
Background
Psychiatric residential treatment facilities (PRTFs) are a type of non-hospital inpatient treatment setting for children with severe behavioral health disorders. PRTFs are a restrictive and costly form of care that can potentially be avoided with community-based behavioral health services.
Methods
Statewide Medicaid enrollment and claim...
As part of the “Circuit-breaker” social distancing measure to address COVID-19, the government of Singapore closed schools and workplaces from April-May 2020. Although this helped reduce transmission rates, for working parents, this period had been a challenging experience of working from home while providing care for children full-time. Problems i...
Due to structural racism and income inequality, exposure to environmental chemicals is tightly linked to socioeconomic factors. In addition, exposure to psychosocial stressors, such as racial discrimination, as well as having limited resources, can increase susceptibility to environmentally induced disease. Yet, studies are often conducted separate...
Background
Follow-up after residential treatment is considered best practice in supporting patients with opioid use disorder (OUD) in their recovery. Yet, little is known about rates of follow-up after discharge. The objective of this analysis was to measure rates of follow-up and use of medications for OUD (MOUD) after residential treatment among...
The US federal Earned Income Tax Credit (EITC) is an economic support program for low- and moderate-income workers. About 80% of individuals eligible for the EITC participate in the program. However, improving awareness and full uptake of the EITC program has proven a challenge, and few studies have examined factors associated with EITC participati...
Many youth with attention deficit hyperactivity disorder (ADHD) and disruptive behavior disorder (DBD) are treated with antipsychotic (AP) drugs. Among youth in foster care, a vulnerable group with high behavioral health service needs and utilization, the rate of AP prescribing is high, and is particularly so for youth with DBD. What is not clear i...
Background:
In the US, Medicaid covers over 80 million Americans. Comparing access, quality, and costs across Medicaid programs can provide policymakers with much-needed information. As each Medicaid agency collects its member data, multiple barriers prevent sharing Medicaid data between states. To address this gap, the Medicaid Outcomes Distribut...
Because of the Coronavirus (COVID-19) pandemic, “Circuit-breaker” safety distancing was implemented in Singapore from April to May 2020. Schools and workplaces were closed and parents had to balance telecommuting with parenting responsibilities. Coupled with the high degree of economic uncertainty and reduced social support, these circumstances are...
Background and Aims
Medication for opioid use disorder (MOUD) reduces harms associated with opioid use disorder (OUD), including risk of overdose. Understanding how variation in MOUD duration influences overdose risk is important as health care payers increasingly remove barriers to treatment continuation (e.g., prior authorization). This study mea...
Intensive Alternative Family Treatment (IAFT®) is an enhanced therapeutic foster care program that serves children and youth at risk for entry into a more restrictive level of care. The purpose of this study was to examine the effectiveness of IAFT in reducing first entry into psychiatric residential treatment compared to usual care. We linked IAFT...
Youths who are negatively affected by social determinants of health suffer adverse effects like increased risks of chronic health conditions and mental health issues. Part 3 of this series describes ways pediatricians can help fight these social determinants to promote health equity for our most vulnerable children. Available for purchase at https:...
Many youth in foster care are diagnosed with disruptive behavior disorder (DBD), a diagnosis indicative of aggression and behavior problems. These youth, who are at high risk for being placed in psychiatric residential treatment facilities (PRTF), are commonly prescribed antipsychotic (AP) medications off-label. However, treating children in the co...
In Brief
Among Medicaid-enrolled pregnant persons with opioid use disorder, one third are diagnosed with hepatitis C virus infection, but only 6% receive postpartum follow-up or medication treatment.
Open-ended survey questions crucially contribute to researchers’ understandings of respondents’ experiences. However, analyzing open-ended responses using human coders is labor-intensive. Structural topic modeling (STM) is a text mining method that discover topics from textual data. We demonstrate the use of STM to analyze open-ended survey respons...
This study examined how 7th to 12th-grade students’ educational aspirations influenced their school engagement and grade point average (GPA) a year later. Using data (n = 4368) from the National Longitudinal Study of Adolescent to Adult Health, this study used propensity score matching to address confounders due to family, parenting, and individual...
Introduction
The rates of syphilis among pregnant women and infants have increased in recent years, particularly in the U.S. South. Although state policies require prenatal syphilis testing, recent screening rates comparable across Southern states are not known. The purpose of this study is to measure syphilis screening among Medicaid enrollees wit...
Written in a conversational and applied style, Social Policy for Children and Families is an award-winning book that incorporates cutting-edge research across policy sectors in the human services. New editors William James Hall III and Paul J. Lanier, in collaboration with Jeffrey M. Jenson and Mark W. Fraser, have carefully crafted this 4th editio...
Lesbian, gay, bisexual, and pansexual (LGB+) individuals have disproportionate rates of mental illness. Minority stress and sexual identity stigma are posited as the primary social determinants of LGB+ mental health disparities. Discussions in the literature have questioned the impact of sexual identity stigma in a world increasingly accepting of s...
Background
The lack of consensus on how to measure ACEs limits our estimation of their impact on health outcomes and understanding of which ACE clusters drive unmet care coordination (CC) needs.
Objectives
1) Identify latent classes of ACEs among a representative group of U.S. children; 2) Examine the association between these classes and unmet ne...
Objectives
Given recent advances toward universal screening for Adverse Childhood Experiences (ACEs), our objective was to investigate whether children with higher ACEs experience poorer quality of provider care and greater challenges accessing needed mental health treatment.
Methods
This study uses a nationally representative sample of US childre...
Adverse childhood experiences (ACEs) have been consistently linked to a reduction in healthy psychological adjustment among youth. Emergent evidence suggests that there are culturally specific ACEs, such as racial discrimination, that are particularly harmful to the mental health of Black youth. However, the psychological impact of racial discrimin...
Ensuring access to pre-kindergarten (Pre-K) education remains a pressing policy issue in the United States. Prior research has shown the positive effects that Pre-K has on children's cognitive development. However, studies on its effects on children's health outcomes are scarce. This study aimed to investigate the effects of the Pre-K program on pe...
Parents' use of spanking with infants and toddlers is of concern because this early onset of spanking may escalate over early childhood heightening the risk for child abuse. This study has two goals. First, using latent growth modelling, we examined the changes in parents' use of spanking across 6 years starting from infancy. Second, we identified...
Importance
There is limited information about trends in the treatment of opioid use disorder (OUD) among Medicaid enrollees.
Objective
To examine the use of medications for OUD and potential indicators of quality of care in multiple states.
Design, Setting, and Participants
Exploratory serial cross-sectional study of 1 024 301 Medicaid enrollees...
Background:
Decision makers face challenges in estimating local risk for child maltreatment and how best to prioritize which factors to intervene upon.
Methods:
Using US Census and survey data for all US counties (N = 3141), we derived US county profiles characterized by the severity of child maltreatment risk factors observed at the county leve...
Objective: Open-ended survey questions crucially contribute to researchers’ understandings of respondents’ experiences. However, analyzing open-ended responses using human coders is labor-intensive and prone to inconsistencies. Structural topic modeling (STM) is a text mining method that discover topics from textual data. We demonstrate the use of...
Background
Intimate partner violence can lead to deaths of one or both partners and others (i.e., corollary victims). Prior studies do not enumerate the societal cost of intimate partner violence-related fatalities, exclude corollary victims from most analyses, and do not describe groups who bear the highest societal costs from intimate partner vio...
Objectives:
State Medicaid programs are the largest single provider of healthcare for pregnant persons with opioid use disorder (OUD). Our objective was to provide comparable, multistate measures estimating the burden of OUD in pregnancy, medication for OUD (MOUD) in pregnancy, and related neonatal and child outcomes.
Methods:
Drawing on the Med...
This study used longitudinal data to examine the transactional associations between mothers’ spanking and mother–child relationship quality with children’s externalizing behaviors in the context of intimate partner violence (IPV). Data came from a sample of 1,152 low-income mothers with children age 10–14 years. Results showed that past-year IPV tr...
Children and youth with high behavioral health needs can receive care in a psychiatric residential treatment facility (PRTF). Overutilization of PRTFs is concerning because they are highly restrictive and costly residential care settings. Intensive Alternative Family Treatment (IAFT®) is an intensive therapeutic foster care program combined with se...
Head Start/Early Head Start (HS/EHS) programs deliver comprehensive early childhood services in the U.S. to support low-income families to improve a range of early childhood outcomes and to develop positive parenting and parent-child relationships. From the beginning of the program, increasing fathers’ involvement with their children in HS/EHS has...
Decision-makers need to consider a range of factors when selecting evidence-based programs (EBPs) for implementation, which can be especially challenging when addressing complex issues such as child maltreatment prevention. Multi-criteria decision analysis (MCDA) frameworks and tools are useful for evaluating such complex decisions. We describe the...
Objectives:
With this study, we seek to understand the relationship between prebirth household challenges and the child's adverse childhood experiences (ACEs) score by age 3 in a statewide-representative birth cohort to inform primary prevention strategies.
Methods:
We used a longitudinally linked data set from the Alaska 2009-2011 Pregnancy Ris...
The Impact of Intimate Partner Violence on Parenting and Children’s Externalizing Behaviors: Transactional Processes Over Time.
Parenting During COVID-19
Open-ended survey questions are used to gather new information about an experience or topic or to explain or clarify quantitative findings. But analysis of open-ended data are relatively rare and when conducted are almost exclusively done through human coding.
This study uses a text-analytical method, structural topic modeling, to analyze text da...
Objective: To identify profiles of parents' work-family balance (WFB) and social support and examine their links with parenting stress and marital conflict. Background: As part of the "Circuit-breaker" social distancing measure to address COVID-19, the government of Singapore closed schools and workplaces from April-May 2020. Although this helped r...
Purpose: Because of the Coronavirus (COVID-19) pandemic, "Circuit-breaker" safety distancing was implemented in Singapore from April to May 2020. Schools and workplaces were closed and parents had to balance telecommuting with parenting responsibilities. Coupled with the high degree of economic uncertainty and reduced social support, these circumst...
Home visiting (HV) programs have the potential to improve maternal and child health. As federal and state initiatives expand the reach of these programs, understanding what factors enhance uptake and retention of the services becomes increasingly important. This qualitative study used a Reasoned Action Model (RAM) and a cultural lens to explore fac...
Research Brief on Parenting During COVID-19 Circuit-breaker in Singapore
A Research Brief on Parenting in Singapore During COVID-19unc
We examined the impact of the implementation of The Triple P-Positive Parenting Program in North Carolina (NC) on reducing child maltreatment, a serious public health problem in the US with lasting harmful effects on children. In 2012 and 2013, 34 of 100 counties in NC implemented Triple P. A panel data set with county-level child welfare data and...
Objective
The purpose of this systematic review was to synthesize quantitative or mixed-method studies that evaluate the efficacy of interventions with youth in the context of psychiatric residential treatment facilities (PRTFs) in the United States.
Methods
Systematic review procedures were conducted to identify relevant studies, both published a...
Infant maltreatment is a devastating social and public health problem. Birth Match is an innovative policy solution to prevent infant maltreatment that leverages existing data systems to rapidly predict future risk through linkage of birth certificate and child welfare data then initiate a child protection response. Birth Match is one example of ch...
Exposure to childhood victimization and adversity (CVA) is pervasive for child welfare (CW) involved youth. However, most research with CW samples has focused on types of maltreatment and fails to recognize the additive influence of exposure to CVA beyond maltreatment. A subsample aged 8 to 17 ( n = 1,887) was drawn from the National Survey of Chil...
The purpose of this commentary on Rose (2018) is to address several important reasons why credible causal frameworks are critical to the success of family violence research. The commentary addresses three topics: intervention, prediction, and imagination. These three areas provide justification for why an improvement in causal inference will also y...
Context:
Screening children for social determinants of health (SDOHs) has gained attention in recent years, but there is a deficit in understanding the present state of the science.
Objective:
To systematically review SDOH screening tools used with children, examine their psychometric properties, and evaluate how they detect early indicators of...
Artificial Intelligence (AI), when combined with statistical techniques such as predictive analytics, has been increasingly applied in high stakes decision making systems seeking to predict and/or classify the risk of clients experiencing negative behavioral outcomes. One such system is child welfare, where the disproportionate involvement of margi...
As states have embraced additional flexibility to change coverage of and payment for Medicaid services, they have also faced heightened expectations for delivering high-value care. Efforts to meet these new expectations have increased the need for rigorous, evidence-based policy, but states may face challenges finding the resources, capacity, and e...
Objectives
Childhood exposure to intimate partner violence (IPV) is associated with numerous negative outcomes such as externalizing behavior problems, including bullying. However, most prior research examining the relationship between IPV exposure and bullying has relied on relatively small, unrepresentative samples and did not examine this relati...
Objectives
The father–child relationship is an important factor in child development. Improving protective factors for fathers, such as access to social support, is one strategy to enhance these critical relationships. Few studies have examined parenting strategies for fathers specifically, and fewer have examined programs delivered in early childh...
Parental involvement in their adolescents' education plays an important role in promoting their children's academic outcomes. Yet, more research is needed to examine the relationship between parenting practices and parental warmth as well as to consider the potential joint contribution of warmth from both fathers and mothers. Thus, the primary purp...
Many researchers have examined the cumulative effects of adverse childhood experiences (ACEs) and found that higher levels of ACEs increase the risk for worsening health conditions. Recent research has moved beyond the simple counting of ACEs, to develop a more nuanced understanding of the ways in which ACEs are experienced. Despite evidence that A...
Although child corporal punishment can lead to adverse health outcomes in children, this practice remains prevalent in Japan. This study investigates whether, under Asian family norms, fathers’ job stress is a risk factor for mothers’ frequent use of child corporal punishment. A study sample of 522 children ages 0 to 6 years was obtained from a pop...
Evidence-based behavioral parent training (BPT) programs are the most effective way to address children’s behavior disorders and participant engagement is essential to achieving positive treatment outcomes. However, there is limited understanding of the factors that contribute to engagement, particularly for at-risk families. This qualitative study...
Despite a rapidly growing U.S. Latinx child population and this group’s representation in the child welfare system (CWS), limited research exists on Latinx children reported to the CWS for child sexual abuse (CSA). This study examined how the intersection of race/ethnicity, age, and biological sex impact case substantiation among Latinx, Black, and...
Objective:
Child maltreatment is an adverse childhood experience associated with reductions in child well-being. This study examines whether an evidence-based parenting intervention delivered to families served by the child welfare system (CWS) affects pediatric health-related quality of life (HRQoL).
Method:
This study is a randomized controlle...
An accurate assessment of fidelity, combined with a high degree of fidelity to the intervention, is critical to the reliability, validity, replicability, and scale-up of the results of an intervention research study. However, extant measures of fidelity are infrequently applicable to the program or intervention being studied, and the literature lac...
Given the overlap between intimate partner violence (IPV) and child maltreatment, IPV-exposed child participants in research might disclose instances of child maltreatment. Such disclosures might require researchers to report the maltreatment to child protective services (CPS). However, the literature provides minimal guidance on how to navigate th...
Objectives This study seeks to further the work exploring adverse childhood experiences (ACEs) by proposing a novel approach to understanding the impact of ACEs through applying advanced analytical methods to examine whether combinations of ACEs differentially impact child health outcomes. Methods Using National Survey of Children’s Health data, we...
Background:
Health informatics projects combining statewide birth populations with child welfare records have emerged as a valuable approach to conducting longitudinal research of child maltreatment. The potential bias resulting from linkage misspecification, partial cohort follow-up, and outcome misclassification in these studies has been largely...
The child welfare system is an access point for children’s mental health services. Psychiatric
residential treatment facilities (PRTFs) are the most restrictive, and most expensive setting for
children to receive long-term care. Given the high rates of behavioral health concerns among
maltreated children in out-of-home care, research is needed to e...