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Gonzalez Miranda LA, Shetty A, Ehlke D. Analyzing Alternative Behavioral Crisis Response Models in the U.S. J Community Health 2024; 49:324-329. [PMID: 37940735 DOI: 10.1007/s10900-023-01299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 11/10/2023]
Abstract
In the U.S., communities often rely on the criminal justice system to respond to, house, and treat individuals with mental health and substance use problems. This has resulted in a crisis response system that relies on police officers to respond to mental and behavioral health crisis due to a lack of options. Unfortunately, these encounters can be dangerous for individuals in need of help. Additionally, this has led to a disproportionate number of individuals with mental illness and substance use disorders being housed in prisons. Alternatives to our current crisis response system already exist in the form of community-based mobile crisis response teams that rely on mental health workers instead of law enforcement. This review examines such programs that have been enacted in multiple cities across the country. Analysis of these alternative crisis response models shows that community-based programs are more effective, efficient, and safer than the current standard that relies on law enforcement. This analysis highlights the need for the establishment of community-based crisis response teams as the national standard.
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Affiliation(s)
- Luis A Gonzalez Miranda
- School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, 11203, USA.
| | - Anuradha Shetty
- School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, 11203, USA
| | - Daniel Ehlke
- School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, 11203, USA
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Luna MJ, Abram KM, Aaby DA, Welty LJ, Teplin LA. Inequities in Mental Health Services: A 16-Year Longitudinal Study of Youth in the Justice System. J Am Acad Child Adolesc Psychiatry 2024; 63:422-432. [PMID: 37516236 PMCID: PMC10818024 DOI: 10.1016/j.jaac.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/30/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To examine: (1) if youth who have mental health disorders receive needed services after they leave detention-and as they age; and (2) inequities in service use, focusing on demographic characteristics and type of disorder. METHOD We used data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois in 1995. Participants were re-interviewed up to 13 times through 2015. Interviewers assessed disorders using structured diagnostic interviews and assessed service use using the Child and Adolescent Service Assessment and the Services Assessment for Children and Adolescents. RESULTS Less than 20% of youth who needed services received them, up to median age 32 years. Female participants with any disorder had nearly twice the odds of receiving services compared with male participants (OR: 1.82; 95% CI: 1.41, 2.35). Compared with Black participants with any disorder, non-Hispanic White and Hispanic participants had 2.14 (95% CI: 1.57, 2.90) and 1.50 (95% CI: 1.04, 2.15) times the odds of receiving services. People with a disorder were more likely to receive services during childhood (< age 18) than during adulthood (OR: 2.29; 95% CI: 1.32, 3.95). Disorder mattered: participants with an internalizing disorder had 2.26 times and 2.43 times the odds of receiving services compared with those with a substance use disorder (respectively, 95% CI: 1.26, 4.04; 95% CI: 1.49, 3.97). CONCLUSION Few youth who need services receive them as they age; inequities persist over time. We must implement evidence-based strategies to reduce barriers to services.
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Affiliation(s)
- María José Luna
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karen M Abram
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David A Aaby
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leah J Welty
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Linda A Teplin
- Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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Baser O, Rodchenko K, Zeng Y, Endrizal A. Mental health disparities in young adults with arrest history: a survey-based, cross-sectional analysis. HEALTH & JUSTICE 2024; 12:1. [PMID: 38165523 PMCID: PMC10759331 DOI: 10.1186/s40352-023-00257-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Over 4.53 million arrests were made in 2021 in the United States. People under 26 years of age were more likely to be arrested than older people. Although mental health disparities are prominent in the incarcerated population, the subject has not been closely examined among young adults specifically. OBJECTIVES This study examines how criminal justice involvement, specifically arrests, affects the mental health of adults between 18 and 25 years of age. METHODS We analyzed secondary data using the 2021 National Survey on Drug Use and Health (NSDUH). The study used a subsample of 13,494 people aged 18 to 25 years, including 7,330 women and 6,164 men. History of arrest was the key independent variable. Depression, serious mental illness (SMI), substance use, suicidal ideation, and suicide attempt were the outcome variables. We performed five multivariate logistic regression models for each outcome variable, controlling for race/ethnicity, income, and education level for men and women separately. RESULTS Of 13,494 respondents, 6.63% had a history of arrest. Among young women, a history of arrest was associated with significantly higher adjusted odds ratios for all mental health concerns. Most notably, a history of arrest increased the likelihood of substance use by a factor of 15.19, suicide attempts by 2.27, SMI by 1.79, suicidal ideation by 1.75, and depression by 1.52. Among young men, a history of arrest was associated with increased adjusted odds ratios (AORs) for substance use (AOR, 13.37; p < .001), suicidal ideation (AOR, 1.45; p = .011), and suicide attempt (AOR, 1.82; p = .044). CONCLUSIONS We found a strong relationship between young people having an arrest history and mental health concerns. More specifically, a history of arrest was associated with all mental health concerns among young women, while it was associated with only substance use and suicide among young men. Providing arrestees with appropriate mental health care would benefit them and the criminal justice system by decreasing the odds of recidivism.
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Affiliation(s)
- Onur Baser
- Department of Economics, Bogazici University, Istanbul, Türkiye.
- Graduate School of Public Health, City University of New York, New York, NY, USA.
- University of Michigan Medical School, Ann Arbor, MI, USA.
| | | | - Yixuan Zeng
- Columbia Data Analytics, New York, NY, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Webster KD, Gunter TD, Vohs JL, Breier A. Early phase psychosis and criminal conviction in United States adults. Early Interv Psychiatry 2023. [PMID: 38030574 DOI: 10.1111/eip.13483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/12/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
AIM Individuals experiencing early phase psychosis (EPP) are at increased risk for legal involvement. In prior studies, between 14% and 75% of individuals with EPP reported a history of criminal offending behaviour, criminal charges, or criminal convictions. To better understand the frequency of criminal conviction in a specialty treatment clinic serving EPP clients, the research team supplemented self-reported data from the clinic intake with information from publicly available databases. METHODS In this sample of 309 adults, approximately one quarter of patients (n = 76) self-reported a history of arrest, incarceration, probation, or parole within 6 months of enrolment in a treatment clinic. The research team expanded upon this and collected data from a public database of court proceedings in Indiana for all clinic participants before and after enrolment. RESULTS Thirty-nine percent (n = 122) had three or more traffic tickets or a conviction for an ordinance violation, misdemeanour, or felony in the state of Indiana as an adult. This is over two times the national average. Drug and alcohol related convictions were the most common single conviction type, and 29% (n = 89) of subjects experienced at least one incarceration. CONCLUSIONS These data highlight the need for specialty clinics to partner with professionals with expertise in the prevention and management of criminal behaviour. Future studies should examine risk factors for individuals experiencing EPP and criminal conviction.
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Affiliation(s)
- Kyle D Webster
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tracy D Gunter
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jenifer L Vohs
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alan Breier
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Dogan-Dixon J, Thrasher SS, Thorpe S, Wheeler P, Stevens-Watkins D. The roles of vicarious trauma exposure and perceived social support in codeine syrup misuse among Black men living in prisons. JOURNAL OF COMMUNITY PSYCHOLOGY 2023. [PMID: 37794735 DOI: 10.1002/jcop.23093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
Using General Strain Theory, this study investigates the effects of vicarious trauma exposure and perceived social support on nonmedical codeine syrup misuse among Black incarcerated men nearing community re-entry. Data were drawn from the Helping Incarcerated Men project, a study examining mental health, substance misuse, and human immunodeficiency virus (HIV) risk behaviors among Black men living in prisons who were within 180 days of release. A total of 200 Black men self-reported demographics (i.e., age and length of incarceration after age 18), vicarious trauma exposure (e.g., ever witnessing an assault with a weapon and a sudden accidental death), perceived social support, and nonmedical codeine syrup misuse. Findings from the logistic regression analysis showed witnessing an assault with a weapon and a sudden accidental death increased the likelihood of codeine syrup misuse. Perceived social support was not associated with codeine syrup misuse. Implications for practice and future research are discussed.
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Affiliation(s)
- Jardin Dogan-Dixon
- Department of Educational School and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
| | | | - Shemeka Thorpe
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
| | - Paris Wheeler
- Department of Educational School and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Danelle Stevens-Watkins
- Department of Educational School and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
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Murray CH, Contreras JL, Kelly CH, Padgett DK, Pollack HA. Behavioral Crisis and First Response: Qualitative Interviews with Chicago Stakeholders. Community Ment Health J 2023; 59:77-84. [PMID: 35751789 PMCID: PMC9243918 DOI: 10.1007/s10597-022-00990-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/18/2022] [Indexed: 01/07/2023]
Abstract
Improving interactions between first responders and individuals experiencing behavioral crisis is a critical public health challenge. To gain insight into these interactions, key informant qualitative interviews were conducted with 25 Chicago stakeholders. Stakeholders included directors and staff of community organizations and shelters that frequently engage first responders. Interviews included granular depictions related to the expectations and outcomes of 911 behavioral crisis calls, and noted areas requiring improved response. Stakeholders called 911 an average of 2 to 3 times per month, most often for assistance related to involuntary hospitalization. Engagements with first responders included unnecessary escalation or coercive tactics, or conversely, refusal of service. While stakeholders lauded the value of police trained through the city's Crisis Intervention Team program, they emphasized the need for additional response strategies that reduce the role of armed police, and underscored the need for broader social and behavioral health services for individuals at-risk of such crises.
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Affiliation(s)
- Conor H. Murray
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
- Urban Health Lab, University of Chicago, Chicago, USA
| | - Juan L. Contreras
- Urban Health Lab, University of Chicago, Chicago, USA
- Crown Family School of Social Work Policy and Practice, University of Chicago, 969 E 60th St, Chicago, IL 60637 USA
| | - Caroline H. Kelly
- Urban Health Lab, University of Chicago, Chicago, USA
- Crown Family School of Social Work Policy and Practice, University of Chicago, 969 E 60th St, Chicago, IL 60637 USA
| | - Deborah K. Padgett
- Silver School of Social Work, New York University, 1 Washington Square N, New York, NY 10003 USA
| | - Harold A. Pollack
- Urban Health Lab, University of Chicago, Chicago, USA
- Crown Family School of Social Work Policy and Practice, University of Chicago, 969 E 60th St, Chicago, IL 60637 USA
- Department of Public Health Sciences, University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 USA
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Palis H, Hu K, Rioux W, Korchinski M, Young P, Greiner L, Nicholls T, Slaunwhite A. Association of Mental Health Services Access and Reincarceration Among Adults Released From Prison in British Columbia, Canada. JAMA Netw Open 2022; 5:e2247146. [PMID: 36520435 PMCID: PMC9856264 DOI: 10.1001/jamanetworkopen.2022.47146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Diagnosis of mental disorder is prevalent among people who have been incarcerated. Nevertheless, community mental health services are often limited following release from prison, and reincarceration rates are high. The prevalence of mental disorders is growing among people who are incarcerated in British Columbia (BC), Canada, increasing the urgency of timely and accessible mental health services after release. OBJECTIVE To examine the association of mental health services access and timeliness of services access with reincarceration risk among people released from prison. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, mental disorder diagnoses were derived from International Classification of Diseases, Ninth Revision or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes in administrative health records. Data on prison release and reincarceration were retrieved from corrections records. Population-based health and corrections data were retrieved from the BC Provincial Overdose Cohort, which contains a 20% general population random sample of 1 089 677 BC residents. This study examined releases from provincial prisons between January 1, 2015, and December 31, 2018, among people in the 20% random sample who had a mental disorder diagnosis in the year before their release. Analyses were performed from January to June 2022. EXPOSURES Mental health services access (primary care, emergency department visits, or hospitalization) and sociodemographic, health, and incarceration characteristics. MAIN OUTCOMES AND MEASURES A multistate modeling approach was taken. Cox proportional hazards models were stratified by transition, from release to reincarceration, with and without mental health services access. A state arrival extended model examined the influence of timeliness of mental health services access on subsequent hazard of reincarceration. RESULTS A total of 4171 releases among 1664 people (3565 releases among male individuals [84.6%]; 2948 releases [70.7%] among people <40 years old; 2939 releases [70.5%] among people with concurrent substance use disorder diagnosis) were identified. The total study follow-up time was 2834.53 person-years, with a mean (SD) of 0.68 (0.93) years and median (IQR) of 0.25 (0.07-0.84) years per release. Mental health services access was associated with a reduction in the hazard of reincarceration (hazard ratio, 0.61; 95% CI, 0.39-0.94). For each additional month between release and mental health services access, the hazard of reincarceration was increased by 4% (hazard ratio, 1.04; 95% CI, 1.01-1.07). CONCLUSIONS AND RELEVANCE In this cohort study of people with mental disorder diagnoses released from prison in BC, mental health services access was associated with reduced reincarceration risk. These findings suggest that these services may have the greatest impact on reducing reincarceration risk when they are available in a timely manner in the days and weeks immediately following release.
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Affiliation(s)
- Heather Palis
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kevin Hu
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - William Rioux
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Mo Korchinski
- Unlocking the Gates Services Society, Maple Ridge, British Columbia, Canada
| | - Pam Young
- Unlocking the Gates Services Society, Maple Ridge, British Columbia, Canada
| | | | - Tonia Nicholls
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- BC Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
| | - Amanda Slaunwhite
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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Magee LA, Dennis Fortenberry J, Aalsma MC, Gharbi S, Wiehe SE. Healthcare utilization and mental health outcomes among nonfatal shooting assault victims. Prev Med Rep 2022; 27:101824. [PMID: 35656226 PMCID: PMC9152773 DOI: 10.1016/j.pmedr.2022.101824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
Victims of nonfatal shooting (NFS) assaults suffer from emotional and physical trauma; however, little is understood about clinical care utilization patterns among victims. This study examines the healthcare utilization and mental health outcomes before and after an index NFS victimization. A longitudinal dataset of police and clinical data were linked at the individual level to define a cohort of NFS victims with one or more clinical encounter in the 24-months preceding an index NFS injury (N = 2,681) in Indianapolis, Indiana between 2005 and 2018. Mental health was defined using ICD diagnosis codes from any emergency department, inpatient, or outpatient encounter and clinical care utilization was the number of unique encounters within the 24-months preceding and following an index NFS injury. Multivariable logistic regression was conducted to examine factors associated with a mental health diagnosis in the post injury period. Analyses were conducted in October 2021-March 2022. Overall clinical care utilization (Mean: pre = 277.7 (SD 235.3) vs. post = 333.9 (SD 255.1), p < 0.001) and mental health prevalence (14.4% pre vs. 18.8% post, p < 0.001) increased in the 24-months following an index NFS compared to the prior 24-months. Preinjury mental health utilization increased the odds of receiving a mental health diagnosis in the 24-months following an index NFS injury - particularly for Black victims (Odds Ratio 1.69, 95% CI 1.01, 2.85). The findings indicate missed opportunities within the healthcare system to connect NFS victims with needed mental health services, as well as the importance of premorbid connection to mental health care.
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Affiliation(s)
- Lauren A. Magee
- O’Neill School of Public and Environmental Affairs, Indiana University Purdue University – Indianapolis, 801 W. Michigan Street, Indianapolis, IN 46204, USA
| | - J. Dennis Fortenberry
- Department of Adolescent Medicine, Indiana University School of Medicine, 410 W. 10 Street, Indianapolis, IN 46204, USA
| | - Matthew C. Aalsma
- Department of Pediatrics, Indiana University School of Medicine, 410 W. 10 Street, Indianapolis, IN 46204, USA
| | - Sami Gharbi
- Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine, 410 W. 10 Street, Indianapolis, IN 46204, USA
| | - Sarah E. Wiehe
- Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine, 410 W. 10 Street, Indianapolis, IN 46204, USA
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Magee LA, Ranney ML, Fortenberry JD, Rosenman M, Gharbi S, Wiehe SE. Identifying nonfatal firearm assault incidents through linking police data and clinical records: Cohort study in Indianapolis, Indiana, 2007-2016. Prev Med 2021; 149:106605. [PMID: 33992657 PMCID: PMC8238077 DOI: 10.1016/j.ypmed.2021.106605] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/12/2021] [Accepted: 05/06/2021] [Indexed: 11/24/2022]
Abstract
Nonfatal firearm assault incidents are more prevalent than gun homicides, however, little is understood about nonfatal firearm assault incidents due to a lack of accurate data in the United States. This is a descriptive study of all nonfatal firearm assault incidents identified through police and clinical records from 2007 to 2016 in Indianapolis, Indiana. Records were linked at the incident level to demonstrate the overlap and non-overlap of nonfatal firearm assault incidents in police and clinical records and describe differences in demographic characteristics of the victims. Incidents were matched within a 24-h time window of the recorded date of the police incident. Data were analyzed in fall 2020. There were 3797 nonfatal firearm assault incidents identified in police reports and 3131 clinical encounters with an ICD 9/10 diagnosis-based nonfatal firearm-related injury. 62% (n = 2366) of nonfatal firearm assault incidents matched within 24 h to a clinical encounter, 81% (n = 1905) had a firearm related ICD code: 40% (n = 947) were coded as a firearm-related assault, 32% (n = 754) were coded as a firearm-related accident; and 8.6% (n = 198) were coded as undetermined, self-inflicted or law enforcement firearm-related. The other 20% (n = 461) did not have an ICD firearm related diagnosis code. Results indicate most nonfatal firearm assault incidents overlap between police and clinical records systems, however, discrepancies between the systems exist. These findings also demonstrate an undercounting of nonfatal firearm assault incidents when relying on clinical data systems alone and more efforts are needed to link administrative police and clinical data in the study of nonfatal firearm assaults.
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Affiliation(s)
- Lauren A Magee
- Indiana University Purdue University Indianapolis, O'Neill School of Public and Environmental Affairs, 801 W. Michigan Street, Indianapolis, IN 46204, United States.
| | - Megan L Ranney
- Brown University and Rhode Island Hospital, Providence, Rhode Island, 593 Eddy Street, Claverick 2, Providence, RI 02903, United States
| | - J Dennis Fortenberry
- Indiana University School of Medicine, Department of Adolescent Medicine, 410 W. 10(th) Street, Suite 1000, Indianapolis, IN 46204, United States
| | - Marc Rosenman
- Department of Pediatrics, Lurie Children's Hospital, Northwestern University, 225 E. Chicago Ave, Chicago, IL 60611, United States
| | - Sami Gharbi
- Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, 410 W. 10(th) Street, Suite 2000, Indianapolis, IN 46204, United States
| | - Sarah E Wiehe
- Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, 410 W. 10(th) Street, Suite 2000, Indianapolis, IN 46204, United States
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