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Meyerson BE, Treiber D, Brady BR, Newgass K, Bondurant K, Bentele KG, Samorano S, Arredondo C, Stavros N. Dialing for doctors: Secret shopper study of Arizona methadone and buprenorphine providers, 2022. J Subst Use Addict Treat 2024; 160:209306. [PMID: 38296033 DOI: 10.1016/j.josat.2024.209306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/30/2023] [Accepted: 01/24/2024] [Indexed: 02/06/2024]
Abstract
INTRODUCTION Methadone and buprenorphine are effective and safe treatments for opioid use disorder (OUD) and also reduce overdose and all-cause mortality. Identifying and reaching providers of medication for opioid use disorder (MOUD) has proven difficult for prospective patients and researchers. OBJECTIVES To assess the accuracy of government-maintained lists of Arizona (AZ) providers prescribing MOUD, and the extent to which these providers are accessible for treatment. METHODS A two-phase study used a listing of 2376 AZ MOUD providers obtained from the U.S. Drug Enforcement Administration and the Substance Abuse and Mental Health Services Administration. Phase 1 assessed the accuracy of the listing using internet confirmatory research from May-October 2022. Phase 2 used the resulting list of 838 providers to assess provider availability, type of MOUD treatment provided, and accepted payment through secret shopper calls between November 16 and 30, 2022. RESULTS Just over half (52.2 %, n = 1240) of providers were removed from the original listing during Phase 1. One quarter (25.9 %) were no longer in practice. Among the 833 eligible for the secret shopper Phase 2 study, 36.6 % (n = 307) were reached and identified as providing MOUD. A vast majority (88.1 %) of MOUD providers indicating treatment type were accepting new patients, however methadone was identified far more frequently than was likely permitted or provided for OUD. Providers were 5.5 times more likely to accept new patients if they accepted cash payment for services, and 4.9 times more likely if they accepted Medicaid. Rural areas remained underserved. CONCLUSIONS The active population of MOUD providers is far smaller than surmised. DEA and SAMHSA provider listings are not sufficiently accurate for survey research sampling. Other means of representative sampling will need to be devised, and trusted lists of providers for prospective patients should be promoted, publicly available, and regularly maintained for accuracy. Providers that offer treatment should assure that public-facing staff have basic information about the practice, the treatment offered, and conditions for taking new patients. Concerted efforts must assure rural access at the most local levels to reduce patient travel burden.
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Affiliation(s)
- B E Meyerson
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, AZ, United States of America; Department of Family and Community Medicine, University of Arizona College of Medicine, Tucson, AZ, United States of America; Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States of America.
| | - D Treiber
- Sonoran Prevention Works, Phoenix, AZ, United States of America; Drug Policy Research and Advocacy Board, AZ, United States of America
| | - B R Brady
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, AZ, United States of America; Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, United States of America; School of Interdisciplinary Health Programs, College of Health and Human Services, Western Michigan University, Kalamazoo, MI, United States of America
| | - K Newgass
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, AZ, United States of America; Southwest Recovery Alliance, Phoenix, AZ, United States of America; Drug Policy Research and Advocacy Board, AZ, United States of America
| | - K Bondurant
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, AZ, United States of America; Drug Policy Research and Advocacy Board, AZ, United States of America
| | - K G Bentele
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, AZ, United States of America; Southwest Institute for Research on Women, College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, United States of America
| | - S Samorano
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, AZ, United States of America; Drug Policy Research and Advocacy Board, AZ, United States of America
| | - C Arredondo
- Drug Policy Research and Advocacy Board, AZ, United States of America; El Rio Community Health Center, Tucson, AZ, United States of America
| | - N Stavros
- Drug Policy Research and Advocacy Board, AZ, United States of America; Community Medical Services, Phoenix, AZ, United States of America
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Eldridge LA, Meyerson BE, Agley J. Correction: Implementation Documentation and Process Assessment of the PharmNet Intervention: Observational Report. JMIR Form Res 2024; 8:e59427. [PMID: 38604612 PMCID: PMC11046388 DOI: 10.2196/59427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/13/2024] Open
Abstract
[This corrects the article DOI: 10.2196/54077.].
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Affiliation(s)
- Lori Ann Eldridge
- Department of Health Education and PromotionCollege of Health and Human PerformanceEast Carolina UniversityGreenville, NCUnited States
| | - Beth E Meyerson
- Harm Reduction Research Lab, Family and Community MedicineCollege of Medicine-TucsonUniversity of ArizonaTucson, AZUnited States
- Comprehensive Center for Pain and AddictionUniversity of Arizona Health SciencesUniversity of ArizonaTucson, AZUnited States
| | - Jon Agley
- Prevention Insights, Department of Applied Health ScienceSchool of Public Health BloomingtonIndiana University BloomingtonBloomington, INUnited States
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Meyerson BE, Bentele KG, Brady BR, Stavros N, Russell DM, Mahoney AN, Garnett I, Jackson S, Garcia RC, Coles HB, Granillo B, Carter GA. Insufficient Impact: Limited Implementation of Federal Regulatory Changes to Methadone and Buprenorphine Access in Arizona During COVID-19. AJPM Focus 2024; 3:100177. [PMID: 38312524 PMCID: PMC10835120 DOI: 10.1016/j.focus.2023.100177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Introduction This study examined the impact of federal regulatory changes on methadone and buprenorphine treatment during COVID-19 in Arizona. Methods A cohort study of methadone and buprenorphine providers from September 14, 2021 to April 15, 2022 measured the proportion of 6 treatment accommodations implemented at 3 time periods: before COVID-19, during Arizona's COVID-19 shutdown, and at the time of the survey completion. Accommodations included (1) telehealth, (2) telehealth buprenorphine induction, (3) increased multiday dosing, (4) license reciprocity, (5) home medications delivery, and (6) off-site dispensing. A multilevel model assessed the association of treatment setting, rurality, and treatment with accommodation implementation time. Results Over half (62.2%) of the 74-provider sample practiced in healthcare settings not primarily focused on addiction treatment, 19% practiced in methadone clinics, and 19% practiced in treatment clinics not offering methadone. Almost half (43%) were unaware of the regulatory changes allowing treatment accommodation. Telehealth was most frequently reported, increasing from 30% before COVID-19 to 80% at the time of the survey. Multiday dosing was the only accommodation substantially retracted after COVID-19 shutdown: from 41% to 23% at the time of the survey. Providers with higher patient limits were 2.5-3.2 times as likely to implement telehealth services, 4.4 times as likely to implement buprenorphine induction through telehealth, and 15.2-20.9 times as likely to implement license reciprocity as providers with lower patient limits. Providers of methadone implemented 12% more accommodations and maintained a higher average proportion of implemented accommodations during the COVID-19 shutdown period but were more likely to reduce the proportion of implemented accommodations (a 17-percentage point gap by the time of the survey). Conclusions Federal regulatory changes are not sufficient to produce a substantive or sustained impact on provider accommodations, especially in methadone medical treatment settings. Practice change interventions specific to treatment settings should be implemented and studied for their impact.
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Affiliation(s)
- Beth E Meyerson
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona
- Comprehensive Center for Pain and Addiction, The University of Arizona Health Sciences, Tucson, Arizona
| | - Keith G Bentele
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, Arizona
| | - Benjamin R Brady
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona
- Comprehensive Center for Pain and Addiction, The University of Arizona Health Sciences, Tucson, Arizona
- School of Interdisciplinary Health Programs, College of Health and Human Services, Western Michigan University, Kalamazoo, Michigan
| | - Nick Stavros
- Community Medical Services, Phoenix, Arizona
- Drug Policy Research and Advocacy Board, Tucson, Arizona
| | - Danielle M Russell
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona
- Drug Policy Research and Advocacy Board, Tucson, Arizona
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Arlene N Mahoney
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona
- Drug Policy Research and Advocacy Board, Tucson, Arizona
- Southwest Recovery Alliance, Phoenix, Arizona
| | - Irene Garnett
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona
- Drug Policy Research and Advocacy Board, Tucson, Arizona
| | | | | | | | - Brenda Granillo
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, Arizona
| | - Gregory A Carter
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine-Tucson, The University of Arizona, Tucson, Arizona
- Department of Community and Health Systems, Indiana University School of Nursing, Indiana University, Bloomington, Indiana
- Rural Center for AIDS/STD Prevention, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana
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Eldridge LA, Meyerson BE, Agley J. Implementation Documentation and Process Assessment of the PharmNet Intervention: Observational Report. JMIR Form Res 2024; 8:e54077. [PMID: 38498037 PMCID: PMC10985598 DOI: 10.2196/54077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/28/2023] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND The number of overdose deaths in the United States involving opioids continues to exceed 100,000 per year. This has precipitated ongoing declarations of a public health emergency. Harm reduction approaches, such as promoting awareness of, ensuring access to, and fostering willingness to use naloxone to reverse opioid overdose, are a key component of a larger national strategy to address the crisis. In addition, overdose reversal with naloxone directly and immediately saves lives. Because of pharmacies' ubiquity and pharmacists' extensive clinical training, community pharmacies are well-positioned, in principle, to facilitate naloxone access and education. OBJECTIVE In 2022, a single-site pilot study of PharmNet, a community pharmacy intervention incorporating naloxone distribution, awareness building, and referral, showed promising outcomes for both naloxone and resource distribution in the community. As a next step, this study was intended to be a pilot randomized controlled trial of PharmNet in 7 pharmacies. However, due to circumstances outside of the study team's control, data collection was unable to be fully completed as planned. In keeping with open research standards, we transparently report all available data from the study and discuss trial barriers and processes. We do so both to provide insights that may inform similar studies and to avoid the "file-drawer" (publication bias) problem, which can skew the aggregated scholarly literature through nonpublication of registered trial results or selective publication of findings affirming authors' hypotheses. METHODS This paper reports an in-depth implementation study assessment, provides the available observational data, and discusses implementation considerations for similar studies in independent (eg, nonchain) community pharmacies. RESULTS Retrospective assessment of study outcomes and fidelity data provided for robust discussion around how resource differences in independent community pharmacies (vs well-resourced chain pharmacies), as well as high demands on staff, can affect intervention implementation, even when leadership is highly supportive. CONCLUSIONS Community pharmacies, particularly independent community pharmacies, may require more support than anticipated to be successful when implementing a new intervention into practice, even if it might affect estimates of real-world effectiveness. Further implementation science research is needed specific to independent community pharmacies. All study elements are outlined in the International Registered Report Identifier (IRRID) PRR1-10.2196/42373. Although this paper reports results associated with that registration, results and conclusions should not be given the weight assigned to findings from a preregistered study. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/42373.
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Affiliation(s)
- Lori Ann Eldridge
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, United States
| | - Beth E Meyerson
- Harm Reduction Research Lab, Family and Community Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ, United States
- Comprehensive Center for Pain and Addiction, University of Arizona Health Sciences, University of Arizona, Tucson, AZ, United States
| | - Jon Agley
- Prevention Insights, Department of Applied Health Science, School of Public Health Bloomington, Indiana University Bloomington, Bloomington, IN, United States
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Russell DM, Meyerson BE, Mahoney AN, Garnett I, Ferrell C, Newgass K, Agley JD, Crosby RA, Bentele KG, Vadiei N, Frank D, Linde-Krieger LB. Come back when you're infected: pharmacy access to sterile syringes in an Arizona Secret Shopper Study, 2023. Harm Reduct J 2024; 21:49. [PMID: 38388463 PMCID: PMC10885601 DOI: 10.1186/s12954-024-00943-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Pharmacies are critical healthcare partners in community efforts to eliminate bloodborne illnesses. Pharmacy sale of sterile syringes is central to this effort. METHODS A mixed methods "secret shopper" syringe purchase study was conducted in the fall of 2022 with 38 community pharmacies in Maricopa and Pima Counties, Arizona. Pharmacies were geomapped to within 2 miles of areas identified as having a potentially high volume of illicit drug commerce. Daytime venue sampling was used whereby separate investigators with lived/living drug use experience attempted to purchase syringes without a prescription. Investigator response when prompted for purchase rationale was "to protect myself from HIV and hepatitis C." A 24-item instrument measured sales outcome, pharmacy staff interaction (hostile/neutral/friendly), and the buyer's subjective experience. RESULTS Only 24.6% (n = 28) of 114 purchase attempts across the 38 pharmacies resulted in syringe sale. Less than one quarter (21.1%) of pharmacies always sold, while 44.7% never sold. Independent and food store pharmacies tended not to sell syringes. There emerged distinct pharmacy staff interactions characterized by body language, customer query, normalization or othering response, response to purchase request and closure. Pharmacy discretion and pharmacy policy not to sell syringes without a prescription limited sterile syringe access. Investigators reported frequent and adverse emotional impact due to pharmacy staff negative and stigmatizing interactions. CONCLUSIONS Pharmacies miss opportunities to advance efforts to eliminate bloodborne infections by stringent no-sale policy and discretion about syringe sale. State regulatory policy facilitating pharmacy syringe sales, limiting pharmacist discretion for syringe sales, and targeting pharmacy-staff level education may help advance the achievement of public health goals to eliminate bloodborne infections in Arizona.
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Affiliation(s)
- Danielle M Russell
- Arizona State University, Tempe, AZ, USA
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- Drug Policy Research and Advocacy Board (DPRAB), University of Arizona, Tucson, AZ, USA
| | - Beth E Meyerson
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA.
- Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA.
- Center for Comprehensive Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, USA.
| | - Arlene N Mahoney
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- Southwest Recovery Alliance, Phoenix, AZ, USA
- Drug Policy Research and Advocacy Board (DPRAB), University of Arizona, Tucson, AZ, USA
| | - Irene Garnett
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- Drug Policy Research and Advocacy Board (DPRAB), University of Arizona, Tucson, AZ, USA
- Center for Comprehensive Pain and Addiction, University of Arizona Health Sciences, Tucson, AZ, USA
| | - Chris Ferrell
- Drug Policy Research and Advocacy Board (DPRAB), University of Arizona, Tucson, AZ, USA
- CAN Community Health, Phoenix, AZ, USA
| | - Kylee Newgass
- Southwest Recovery Alliance, Phoenix, AZ, USA
- Drug Policy Research and Advocacy Board (DPRAB), University of Arizona, Tucson, AZ, USA
| | - Jon D Agley
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Richard A Crosby
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- University of Kentucky College of Public Health, Lexington, KY, USA
| | - Keith G Bentele
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- Southwest Institute for Research On Women, University of Arizona, Tucson, AZ, USA
| | - Nina Vadiei
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - David Frank
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- School of Global Public Health, New York University, New York, USA
| | - Linnea B Linde-Krieger
- Harm Reduction Research Lab, University of Arizona College of Medicine-Tucson, Tucson, AZ, USA
- Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
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Frank D, Elliott L, Cleland CM, Walters SM, Joudrey PJ, Russell DM, Meyerson BE, Bennett AS. "As safe as possible": a qualitative study of opioid withdrawal and risk behavior among people who use illegal opioids. Harm Reduct J 2023; 20:158. [PMID: 37891630 PMCID: PMC10605476 DOI: 10.1186/s12954-023-00893-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Opioid withdrawal is a regular occurrence among many people who use illicit opioids (PWUIO) that has also been shown to increase their willingness to engage in risk-involved behavior. The proliferation of fentanyl in the illicit opioid market may have amplified this relationship, potentially putting PWUIO at greater risk of negative health outcomes. Understanding the relationship between withdrawal and risk-involved behavior may also have important implications for the ways that problematic drug use is conceptualized, particularly in disease models of addiction, which position risk behavior as evidence of pathology that helps to justify ontological distinctions between addicts and non-addicts. Examining withdrawal, and its role in PWUIO's willingness to engage in risk, may aid in the development of alternative theories of risk involvement and create discursive spaces for de-medicalizing and de-othering people who use illegal drugs. METHODS This article is based on 32 semi-structured interviews with PWUIO in the New York City area who also reported recent withdrawal experience. Interviews were conducted remotely between April and August 2022 and recorded for later transcription. Data were then coded and analyzed based on a combination of inductive and deductive coding strategies and informed by the literature. RESULTS Participants described a strong relationship between withdrawal and their willingness to engage in risk-involved behavior that was exacerbated by the proliferation of fentanyl. Yet, their descriptions did not align with narratives of risk as a product of bad decisions made by individuals. Rather, data demonstrated the substantial role of social and structural context, particularly drug policies like prohibition and criminalization, in the kinds of risks that PWUIO faced and their ability to respond to them. CONCLUSIONS Withdrawal should be taken more seriously both from an ethical perspective and as an important catalyst of risk behavior. However, theories that position activities taken to avoid withdrawal as irrational and as evidence of pathology are poorly aligned with the complexity of PWUIO's actual lives. We recommend the use of less deterministic and less medicalized theories of risk that better account for differences between how people view the world, and for the role of socio-structural forces in the production of risk.
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Affiliation(s)
- David Frank
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, 10003, USA.
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, 10003, USA.
- , Woodside, NY, 11377, USA.
| | - Luther Elliott
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, 10003, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Charles M Cleland
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, 10003, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, 10003, USA
| | - Suzan M Walters
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, 10003, USA
- Department of Epidemiology, School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Paul J Joudrey
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Danielle M Russell
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, 85711, USA
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, 85711, USA
| | - Beth E Meyerson
- Harm Reduction Research Lab, Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, 85711, USA
| | - Alex S Bennett
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, 10003, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, 10003, USA
- Center for Anti-Racism, Social Justice, and Public Health, 708 Broadway, 9th floor, New York, NY, 10003, USA
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Meyerson BE, Russell DM, Mahoney A, Garnett I, Samorano S. SI-CBPAR: Towards structural indicators of community-based participatory action research. Drug Alcohol Rev 2023. [PMID: 37872867 DOI: 10.1111/dar.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/06/2023] [Accepted: 10/01/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION Structural aspects of community-engaged research are not well measured yet have critical implications for community research empowerment. This is particularly so with people who use drugs. We introduce the Structural Indicators of Community-Based Participatory Action Research (SI-CBPAR) to measure structural indicators of community-research entity relationships. METHODS A three-phased process of iterative development, feasibility and applicability assessment was used to examine the instrument with community-engaged studies as a first stage of instrument development. The development team included people with university, non-government organisation and lived/ing drug use experience. Four studies on the health of people who use drugs were reviewed for indicator evidence followed by iterative discussion about construct and item discrepancies. Indicators were measured for the degree to which they were observed using a three-point scale. RESULTS All but two constructs were confirmed for meaning. Constructs of 'community' and 'coalition' required revision and explanation. The need for further exploration of power differentials between community and community-based organisations was identified. Indicator evidence was found for all six categories across studies. The instrument was deemed applicable and easy to use. It was observed that categories could apply to studies with various degrees of community engagement and to other research focal areas. DISCUSSION AND CONCLUSIONS SI-CBPAR applicability testing and initial category confirmation indicate its potential utility for community research collaboratives. The next phase of development involves cognitive interviewing with researchers from across community engaged research orientations, and with communities engaged in research beyond drug user health.
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Affiliation(s)
- Beth E Meyerson
- Harm Reduction Research Lab, University of Arizona, Tucson, USA
- Family and Community Medicine, College of Medicine, University of Arizona, Tucson, USA
- Comprehensive Pain and Addiction Center, University of Arizona Health Sciences, Tucson, USA
| | - Danielle M Russell
- Harm Reduction Research Lab, University of Arizona, Tucson, USA
- Justice Studies, Tempe, USA
- Drug Policy Research and Advocacy Board, Harm Reduction Research Lab, University of Arizona, Tucson, USA
| | - Arlene Mahoney
- Harm Reduction Research Lab, University of Arizona, Tucson, USA
- Drug Policy Research and Advocacy Board, Harm Reduction Research Lab, University of Arizona, Tucson, USA
- Southwest Recovery Alliance, Phoenix, USA
| | - Irene Garnett
- Drug Policy Research and Advocacy Board, Harm Reduction Research Lab, University of Arizona, Tucson, USA
| | - Savannah Samorano
- Drug Policy Research and Advocacy Board, Harm Reduction Research Lab, University of Arizona, Tucson, USA
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Meyerson BE, Russell DM, Downer M, Alfar A, Garnett I, Lowther J, Lutz R, Mahoney A, Moore J, Nuñez G, Samorano S, Brady BR, Bentele KG, Granillo B. Opportunities and Challenges : Hepatitis C Testing and Treatment Access Experiences Among People in Methadone and Buprenorphine Treatment During COVID-19, Arizona, 2021. AJPM Focus 2023; 2:100047. [PMID: 37789937 PMCID: PMC10546500 DOI: 10.1016/j.focus.2022.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction The purpose of this study was to characterize hepatitis C virus screening and treatment access experiences among people in treatment for opioid use disorder in Arizona during COVID-19. Methods Arizonans receiving treatment for opioid use disorder from methadone clinics and buprenorphine providers during COVID-19 were interviewed about hepatitis C virus testing, curative treatment, and knowledge about screening recommendations. Interviews were conducted with 121 people from August 4, 2021 to October 10, 2021. Qualitative data were coded using the categories of hepatitis C virus testing, knowledge of screening recommendations, diagnosis, and experiences seeking curative treatment. Data were also quantitated for bivariate testing with outcome variables of last hepatitis C virus test, diagnosis, and curative treatment process. Findings were arrayed along an adapted hepatitis C virus cascade framework to inform program and policy improvements. Results Just over half of the sample reported ever having tested for hepatitis C virus (51.2%, n=62) and of this group, 58.1% were tested in the past 12 months. Among those who were ever tested, 54.8% reported a hepatitis C virus diagnosis and 16.1% reported either being in treatment or having been declared cured of the hepatitis C virus. Among those who were diagnosed with hepatitis C, 14.7% indicated that they unsuccessfully tried to access curative treatment and would not attempt to again. Reasons cited for not accessing or receiving curative treatment included beliefs about treatment safety, barriers created by access requirements, natural resolution of the infection, and issues with healthcare coverage and authorization. Conclusions Structural barriers continue to prevent curative hepatitis C virus treatment access. Given that methadone and buprenorphine treatment providers serve patients who are largely undiagnosed or treated for hepatitis C virus, opportunities exist for them to screen their patients regularly and provide support for and/or navigation to hepatitis C virus curative treatment.
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Affiliation(s)
- Beth E. Meyerson
- Family & Community Medicine, College of Medicine Tucson, The University of Arizona, Tucson, Arizona
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, Arizona
| | | | | | - Amirah Alfar
- Drug Policy Research & Advocacy Board, The University of Arizona, Tucson, Arizona
| | - Irene Garnett
- Drug Policy Research & Advocacy Board, The University of Arizona, Tucson, Arizona
| | - John Lowther
- Drug Policy Research & Advocacy Board, The University of Arizona, Tucson, Arizona
| | | | | | - Julie Moore
- Drug Policy Research & Advocacy Board, The University of Arizona, Tucson, Arizona
| | - Greg Nuñez
- Drug Policy Research & Advocacy Board, The University of Arizona, Tucson, Arizona
| | - Savannah Samorano
- Drug Policy Research & Advocacy Board, The University of Arizona, Tucson, Arizona
| | - Benjamin R. Brady
- Comprehensive Pain and Addiction Center, The University of Arizona, Tucson, Arizona
- Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson; Arizona
| | - Keith G. Bentele
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, Arizona
| | - Brenda Granillo
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, Arizona
| | - Arizona Drug Policy Research & Advocacy Board
- Family & Community Medicine, College of Medicine Tucson, The University of Arizona, Tucson, Arizona
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, Arizona
- School of Social Transformation, Arizona State University, Tempe, Arizona
- Southwest Recovery Alliance, Phoenix, Arizona
- Drug Policy Research & Advocacy Board, The University of Arizona, Tucson, Arizona
- CAN Community Health Services, Phoenix, Arizona
- Comprehensive Pain and Addiction Center, The University of Arizona, Tucson, Arizona
- Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson; Arizona
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Eldridge LA, Meyerson BE, Agley J. Pilot implementation of the PharmNet naloxone program in an independent pharmacy. J Am Pharm Assoc (2003) 2023; 63:374-382.e12. [PMID: 36209035 DOI: 10.1016/j.japh.2022.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/29/2022] [Accepted: 09/04/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The U.S. overdose epidemic has continued to escalate with more than 100,000 deaths per year in the past several years, most of which involve opioids. Widespread availability of naloxone is part of a national solution to the crisis, and community pharmacies are well-poised to facilitate such distribution and provide additional harm reduction services. OBJECTIVES The primary objectives of this study were to (a) examine the usability of each of the separate intervention components prepared for PharmNet, (b) observe intervention fidelity through regularly scheduled site visits, and (c) explore the association between PharmNet implementation and the volume of naloxone sales and distribution in the pilot site. PRACTICE DESCRIPTION Here, we describe a carefully designed and tailored pharmacy harm reduction intervention called PharmNet that is designed to maximize harm reduction impact while minimizing utilization of pharmacist resources. It is a pragmatic awareness, service provision, and referral program that was developed through careful, iterative feasibility studies with pharmacists. PRACTICE INNOVATION PharmNet procedures include tools and steps to create awareness (e.g., yard signs and messaging for patients, reminder tools for pharmacists), facilitation of naloxone delivery from nonprofits, and provision of referral cards featuring local resources. EVALUATION METHODS Evaluation included direct data collection and randomly scheduled fidelity site visits. RESULTS The intervention was associated with an increase of 3.33 naloxone doses/mo being dispensed at cost (34.4% relative increase) and an overall increase of 9.33 naloxone doses/mo being dispensed via any mechanism (96.48% relative increase). Around 2.85 referral cards were issued to patients daily. Intervention fidelity was moderate, and the study provides valuable information for how to modify the study prior to a randomized trial. CONCLUSION With modifications informed by this pilot study, the PharmNet intervention merits a randomized trial to determine whether it causes increased naloxone dispensing in independent community pharmacies.
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Eldridge LA, Agley J, Meyerson BE, Golzarri-Arroyo L. The PharmNet Harm Reduction Intervention for Community Pharmacies: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e42373. [PMID: 36279161 PMCID: PMC9641511 DOI: 10.2196/42373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/10/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
Background The overdose epidemic in the United States has continued to worsen despite substantial efforts to mitigate its harms. The opioid antagonist naloxone has been identified as a key means of reducing the prevalence of fatal overdoses. An important evidence-based approach to optimizing naloxone’s impact is to seed it throughout the community, because bystanders are often able to reverse overdoses more quickly than first responders and sometimes are the only possible means of overdose reversal. As part of a multipronged approach to distributing naloxone nationwide, community pharmacies have been identified as ideal venues for naloxone dispensing, especially under standing orders. However, dispensing rates remain surprisingly low, and there is a need to understand how best to engage community pharmacies in naloxone-based harm reduction services. Objective The objective of this trial is to determine whether a tailored, pragmatic pharmacy intervention (PharmNet) results in greater naloxone dispensing relative to baseline (the prior 3 months) compared to a control condition. This pilot trial is intended to determine whether it is appropriate to invest the substantial resources that would be required to conduct a full-scale, randomized controlled study of PharmNet. Methods We will conduct a 3-month randomized controlled pilot trial consisting of 2 parallel groups with a 4:3 allocation ratio. A group of 7 independent pharmacies from rural areas in Indiana will be randomly assigned to either the PharmNet intervention arm (n=4) or the control arm (n=3). The primary outcome will be overall naloxone dispensing (both at cost and free), and secondary outcomes will include the distribution of referral cards and multiple variables at the level of individual staff members. Dispensing data will be collected for the 3 months prior to the intervention and the 3 months of the intervention, and all other data will be collected using a pretest-posttest design. The primary analysis will be a generalized linear mixed model with a Poisson distribution with fixed effects for group, time, and their interaction and a random effect for pharmacy ID to account for repeated measures within pharmacies. Results This study was approved by the Indiana University institutional review board in 2 phases (August 2, 2021, and April 26, 2022) and was funded by the Indiana University Grand Challenge: Responding to the Addictions Crisis. Conclusions If this study produces evidence that the PharmNet intervention results in increased naloxone dispensing relative to control pharmacies, it will be both appropriate and important to study it in a large, full-scale randomized controlled trial. International Registered Report Identifier (IRRID) PRR1-10.2196/42373
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Affiliation(s)
| | - Jon Agley
- Prevention Insights, Department of Applied Health Science, School of Public Health Bloomington, Indiana University Bloomington, Bloomington, IN, United States
| | - Beth E Meyerson
- Harm Reduction Research Lab, Southwest Institute for Research on Women, College of Social & Behavioral Sciences, University of Arizona, Tucson, AZ, United States
- Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Lilian Golzarri-Arroyo
- Biostatistics Consulting Center, School of Public Health Bloomington, Indiana University Bloomington, Bloomington, IN, United States
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11
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Agley J, Meyerson BE, Eldridge LA, Crosby RA, Bentele KG, Jun M, Vadiei N, Kennedy A, Anderson K. Exploration of pharmacist comfort with harm reduction behaviors: Cross-sectional latent class analysis. J Am Pharm Assoc (2003) 2021; 62:432-440. [PMID: 34742654 DOI: 10.1016/j.japh.2021.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Pharmacists are positioned to play important roles in implementing evidence-based prevention and harm reduction approaches for opioid misuse and related health care outcomes such as human immunodeficiency virus (HIV) and hepatitis C. More research is needed to understand how best to facilitate harm reduction practices among pharmacists. OBJECTIVES This hypothesis-generating study investigated (1) whether subgroups (latent classes) were observable among pharmacists based on self-reported comfort with specific harm reduction behaviors, (2) whether having reported expertise in key content areas was associated with any latent classes that might be identified, and (3) whether comfort and training were associated with actually having dispensed syringes for likely nonprescription drug use. METHODS This was a statewide census of community managing pharmacists in Arizona conducted from December 2018 to May 2019. Participants reported their degree of comfort with 10 harm reduction behaviors, their expertise (e.g., recent continuing pharmacy education or specialization) in selected content areas, and their syringe dispensing behavior. Additional sociodemographic information was also collected. Subgroups related to harm reduction were computed using latent class analysis, and associations between study variables were assessed using the Fisher's exact tests. RESULTS Data suggested the existence of 4 latent, comfort-based harm reduction classes: high comfort, moderate comfort, and clinical comfort, and opioid prevention only. Reported expertise in pre-exposure prophylaxis for HIV was likely associated with harm reduction class. However, class membership was not associated with reporting having dispensed nonprescription syringes, although the single comfort item for syringe dispensing, by itself, was associated therewith. CONCLUSION Comfort with harm reduction likely clusters, so pharmacists may be broadly comfortable with topics or methods of harm reduction; however, comfort with a specific harm reduction pharmacy practice may be a better predictor of engaging in that behavior than harm reduction comfort class. In contrast, strategies to improve comfort, such as intervention development, might successfully be informed by pharmacists' latent class.
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Abstract
BACKGROUND Community pharmacists are at the frontline of patient care, yet their role in the opioid epidemic remains unclear. This qualitative study examines the perception of community pharmacists about their role in the opioid epidemic and challenges to fulfilling this role. Methods: A secondary analysis of cross-sectional survey data from an Indiana census of community managing pharmacists was conducted. Qualitative data were coded using a priori and emergent themes. A priori categories included the perceived role of pharmacists in the opioid epidemic and perception of practice barriers. Results: A total of 215 Indiana community managing pharmacists participated in this study. Pharmacists understood themselves as gatekeepers in preventing opioid misuse and overdose. Reported pharmacy practices included providing patient education and communicating with prescribers. Challenges to fulfilling this role included pharmacy structure and operation, lack of patient and provider clarity about pharmacist scope of practice, and pharmacist perception that that there is no available discretionary time to support additional services. Conclusion: Pharmacists believe they have a vital role in combatting opioid misuse and overdose but are hampered by structural aspects of pharmacy practice and lack of recognition of their role. Pharmacy associations and policy partners are encouraged to identify opportunities to address these barriers.
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Affiliation(s)
- Nina Vadiei
- Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, AZ, USA
| | - Lori Ann Eldridge
- Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA.,Prevention Insights, Institute for Research on Addictive Behavior, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA
| | - Beth E Meyerson
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, AZ, USA.,Family & Community Medicine, College of Medicine, The University of Arizona, Tucson, AZ, USA
| | - Jon Agley
- Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA.,Prevention Insights, Institute for Research on Addictive Behavior, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA
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13
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Meyerson BE, Russell DM, Kichler M, Atkin T, Fox G, Coles HB. I don't even want to go to the doctor when I get sick now: Healthcare experiences and discrimination reported by people who use drugs, Arizona 2019. International Journal of Drug Policy 2021; 93:103112. [DOI: 10.1016/j.drugpo.2021.103112] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/23/2020] [Accepted: 01/03/2021] [Indexed: 01/11/2023]
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14
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Dutta T, Agley J, Meyerson BE, Barnes PA, Sherwood-Laughlin C, Nicholson-Crotty J. Perceived enablers and barriers of community engagement for vaccination in India: Using socioecological analysis. PLoS One 2021; 16:e0253318. [PMID: 34170920 PMCID: PMC8232440 DOI: 10.1371/journal.pone.0253318] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 06/02/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is high level policy consensus in India that community engagement (CE) improves vaccination uptake and reduces burden of vaccine preventable diseases. However, to date, vaccination studies in the country have not explicitly focused on CE as an outcome in and of itself. Therefore, this study sought to examine the barriers and enablers of community engagement for vaccination in India. METHODS Employing qualitative methods, twenty-five semi-structured elite interviews among vaccine decisionmakers' were triangulated with twenty-four national-level vaccine policy documents and researcher field notes (December 2017 to February 2018). Data collected for this study included perceptions and examples of enablers of and barriers to CE for vaccination uptake. Concepts, such as the absence of formal procedures or data collection approaches related to CE, were confirmed during document review, and a final convening to review study results was conducted with study respondents in December 2018 and January 2019 to affirm the general set of findings from this study. The Social Ecological Model (SEM) was used to organize and interpret the study findings. RESULTS Although decisionmakers and policy documents generally supported CE, there were more CE barriers than facilitators in the context of vaccination, which were identified at all social-ecological levels. Interviews with vaccine decisionmakers in India revealed complex systemic and structural factors which affect CE for vaccination and are present across each of the SEM levels, from individual to policy. Policy-level enablers included decisionmakers' political will for CE and policy documents and interviews highlighted social mobilization, whereas barriers were lack of a CE strategy document and a broad understanding of CE by decisionmakers. At the community level, dissemination of Social-behavioral Change Communication (SBCC) materials from the national-level to the states was considered a CE facilitator, while class, and caste-based power relations in the community, lack of family-centric CE strategies, and paternalistic attitude of decisionmakers toward communities (the latter reported by some NGO heads) were considered CE barriers. At the organizational level, partnerships with local organizations were considered CE enablers, while lack of institutionalized support to formalize and incentivize these partnerships highlighted by several decisionmakers, were barriers. At the interpersonal level, SBCC training for healthcare workers, sensitive messaging to communities with low vaccine confidence, and social media messaging were considered CE facilitators. The lack of strategies to manage vaccine related rumors or replicate successful CE interventions during the during the introduction and rollout of new vaccines were perceived as CE barriers by several decisionmakers. CONCLUSION Data obtained for this study highlighted national-level perceptions of the complexities and challenges of CE across the entire SEM, from individual to systemic levels. Future studies should attempt to associate these enablers and barriers with actual CE outcomes, such as participation or community support in vaccine policy-making, CE implementation for specific vaccines and situations (such as disease outbreaks), or frequency of sub-population-based incidents of community resistance and community facilitation to vaccination uptake. There would likely be value in developing a population-based operational definition of CE, with a step-by-step manual on 'how to do CE.' The data from this study also indicate the importance of including CE indicators in national datasets and developing a compendium documenting CE best-practices. Doing so would allow more rigorous analysis of the evidence-base for CE for vaccination in India and other countries with similar immunization programs.
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Affiliation(s)
- Tapati Dutta
- Public Health Department, Fort Lewis College, Durango, CO, United States of America
| | - Jon Agley
- Department of Applied Health Science, Deputy Director of Research, Prevention Insights, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, United States of America
| | - Beth E. Meyerson
- Research Professor at University of Arizona, Southwest Institute for Research on Women (SIROW), Tucson, AZ, United States of America
| | - Priscilla A. Barnes
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States of America
| | - Catherine Sherwood-Laughlin
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States of America
| | - Jill Nicholson-Crotty
- School of Public and Environmental Affairs, Indiana University, Bloomington, IN, United States of America
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15
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Reno H, Fox B, Highfill C, McKee A, Trolard A, Liang SY, Stoner BP, Meyerson BE. The Emerging Intersection Between Injection Drug Use and Early Syphilis in Nonurban Areas of Missouri, 2012-2018. J Infect Dis 2021; 222:S465-S470. [PMID: 32877535 DOI: 10.1093/infdis/jiaa056] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The national rate of syphilis has increased among persons who inject drugs (PWID). Missouri is no exception, with increases in early syphilis (ES), congenital syphilis, and PWID, especially in nonurban counties. METHODS Disease intervention specialist records for ES cases in Missouri (2012-2018) were examined. Drug use was classified as injection drug use (IDU) (opioid or methamphetamine) or non-IDU (opioid, methamphetamine, or cocaine). Rates were compared based on residence, sex of sex partner, and drug use. RESULTS Rates of ES in Missouri increased 365%, particularly in small metropolitan and rural areas (1170%). Nonurban areas reported a higher percentage of persons with ES who used injection drugs (12%-15%) compared with urban regions (2%-5%). From 2012 to 2018, women comprised an increasing number of ES cases (8.3%-21%); 93% of women were of childbearing age. Increasingly more women in rural areas with ES also reported IDU during this time (8.4%-21.1%). CONCLUSIONS As syphilis increases in small metropolitan and rural regions, access to high-quality and outreach-based sexual health services is imperative. Healthcare policy to equip health departments with harm reduction services and drug treatment resources offers an opportunity to impact both syphilis increases as well as health outcomes associated with IDU.
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Affiliation(s)
- Hilary Reno
- Division of Infectious Diseases, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Branson Fox
- Institute of Public Health, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Craig Highfill
- Bureau of HIV, STD, and Hepatitis, Missouri Department of Health and Senior Services, Jefferson City, Missouri, USA
| | - Angela McKee
- Bureau of Reportable Disease Informatics, Missouri Department of Health and Senior Services, Jefferson City, Missouri, USA
| | - Anne Trolard
- Institute of Public Health, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Stephen Y Liang
- Division of Infectious Diseases, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.,Division of Emergency Medicine, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bradley P Stoner
- Division of Infectious Diseases, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA.,Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Beth E Meyerson
- Southwest Institute for Research on Women (SIROW), University of Arizona, Tucson, Arizona, USA
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16
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Meyerson BE, Moehling TJ, Agley JD, Coles HB, Phillips J. Insufficient Access: Naloxone Availability to Laypeople in Arizona and Indiana, 2018. J Health Care Poor Underserved 2021; 32:819-829. [PMID: 34120979 DOI: 10.1353/hpu.2021.0107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To understand naloxone availability to laypeople in Arizona (Ariz.) and Indiana (Ind.). METHODS Multi-source search conducted from May-December 2018 identifi ed the extent of naloxone availability to laypeople. Internet searches, email follow up, and phone interviews occurred with registered naloxone providers. RESULTS Th ere were 89 naloxone providers in each state. Laypeople were ineligible for access for over half of registered naloxone providers in Ariz. (60.7%) and Ind. (55.1%). Naloxone access was mostly (67.4%) passive in Ariz. but was actively distributed in Ind. (67.4%). Syringe service programs (SSP) were the most frequently identifi ed providers of naloxone to laypeople in Ariz. (20.0%). In Ind., local health departments were most frequently identifi ed as layperson naloxone providers (75.0%). CONCLUSIONS Less than half of registered naloxone providers allowed layperson access in Arizona and Indiana. Th e lack of layperson access highlights the need to review organization practice and state policy to ensure increased layperson access.
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Dutta T, Meyerson BE, Agley J, Barnes PA, Sherwood-Laughlin C, Nicholson-Crotty J. A qualitative analysis of vaccine decision makers' conceptualization and fostering of 'community engagement' in India. Int J Equity Health 2020; 19:185. [PMID: 33081792 PMCID: PMC7574459 DOI: 10.1186/s12939-020-01290-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, and in India, research has highlighted the importance of community engagement in achieving national vaccination goals and in promoting health equity. However, community engagement is not well-defined and remains an underutilized approach. There is also paucity of literature on community engagement's effectiveness in achieving vaccination outcomes. To address that gap, this study interviewed Indian vaccination decision makers to derive a shared understanding of the evolving conceptualization of community engagement, and how it has been fostered during India's Decade of Vaccines (2010-2020). METHODS Semi-structured interviews were conducted with 25 purposefully sampled national-level vaccine decision makers in India, including policymakers, immunization program heads, and vaccine technical committee leads. Participants were identified by their 'elite' status among decisionmakers in the Indian vaccination space. Schutz' Social Phenomenological Theory guided development of an a priori framework derived from the Social Ecological Model. The framework helped organize participants' conceptualizations of communities, community engagement, and related themes. Inter-rater reliability was computed for a subsample of coded interviews, and findings were validated in a one-day member check-in meeting with study participants and teams. RESULTS The interviews successfully elucidated participants' understanding of key terminology ("community") and approaches to community engagement propagated by the vaccine decision makers. Participants conceptualized 'communities' as vaccine-eligible children, their parents, frontline healthcare workers, and vaccination influencers. Engagement with those communities was understood to mean vaccine outreach, capacity-building of healthcare workers, and information dissemination. However, participants indicated that there were neither explicit policy guidelines defining community engagement nor pertinent evaluation metrics, despite awareness that community engagement is complex and under-researched. Examples of different approaches to community engagement ranged from vaccine imposition to empowered community vaccination decision-making. Finally, participants proposed an operational definition of community engagement and discussed concerns related to implementing it. CONCLUSIONS Although decision makers had different perceptions about what constitutes a community, and how community engagement should optimally function, the combined group articulated its importance to ensure vaccination equity and reiterated the need for concerted political will to build trust with communities. At the same time, work remains to be done both in terms of research on community engagement as well as development of appropriate implementation and outcome metrics.
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Affiliation(s)
- Tapati Dutta
- Room No. 469, Berndt Hall, Public Health Department, Health Sciences Division, Fort Lewis College, Durango, CO, 81301, USA.
| | - Beth E Meyerson
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, Family & Community Medicine, College of Medicine, University of Arizona, Tucson, USA
| | - Jon Agley
- Department of Applied Health Science, Prevention Insights, Indiana University School of Public Health-Bloomington, 809 E 9th Street, Room 101, Bloomington, IN, 47405, USA
| | - Priscilla A Barnes
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 809 E 9th Street, Room 203, Bloomington, IN, 47405, USA
| | - Catherine Sherwood-Laughlin
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 801 E 7th Street, Room 102, Bloomington, IN, 47405, USA
| | - Jill Nicholson-Crotty
- School of Public and Environmental Affairs, Indiana University, Room 351, 1315 E 10th Street, Bloomington, IN, 47405, USA
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18
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Meyerson BE, Agley JD, Jayawardene W, Eldridge LA, Arora P, Smith C, Vadiei N, Kennedy A, Moehling T. Feasibility and acceptability of a proposed pharmacy-based harm reduction intervention to reduce opioid overdose, HIV and hepatitis C. Res Social Adm Pharm 2019; 16:699-709. [PMID: 31611071 DOI: 10.1016/j.sapharm.2019.08.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Evidence-based harm reduction intervention components which might benefit pharmacy patients have not been integrated and studied. OBJECTIVE To investigate the feasibility and acceptability of a proposed pharmacy-based harm reduction intervention to reduce opioid overdose, HIV and hepatitis C called PharmNet. METHODS Indiana managing pharmacists were surveyed in 2018 to assess the feasibility and acceptability of an intervention for opioid misuse screening, brief intervention, syringe and naloxone dispensing, and referrals provision. The Consolidated Framework for Implementation Research informed the survey development and analysis. RESULTS The sample included 303 (30.8%) pharmacists; 215 (70.9%) provided detailed written comments. Intervention Characteristics: 83.3% believed PharmNet would benefit patients, and that staff could deliver the intervention with adequate training (70.0%). Inner Setting: While 77.2% believed their pharmacy culture supported practice change, 57.5% of chain pharmacists believed their pharmacies would not have time for PharmNet. Outer Setting: 73.3% believed additional addiction and overdose screening is needed in their community, and pharmacies should offer new services to help reduce opioid overdose and addiction among their patients (79.5%). A vast majority (97.7%) were asked by patients in the past 2 years about syringe related issues; 67.7% were asked about syringes for non-prescription injection drug use. Individuals Involved: While 62.4% believed PharmNet was within pharmacy scope of practice and 90.1% were comfortable consulting about syringe use, pharmacists reported that they had limited control over the implementation environment. PROCESS 38.0% of pharmacists indicated interest in advising the development of PharmNet. CONCLUSIONS An implementation trial of a modified version of PharmNet is likely feasible; yet will be challenged by structural pressures particularly in chain pharmacies. Successful implementation will involve the development of resources and policy components to manage outer and inner setting characteristics and align the intervention to the implementation environment.
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Affiliation(s)
- B E Meyerson
- Indiana University School of Public Health-Bloomington, Indiana, USA; Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, Indiana, USA; Southwest Institute for Research on Women, University of Arizona, Tucson, AZ, USA.
| | - J D Agley
- Indiana University School of Public Health-Bloomington, Indiana, USA; Institute for Research on Addictive Behavior, Indiana University School of Public Health-Bloomington, Indiana, USA
| | - W Jayawardene
- Indiana University School of Public Health-Bloomington, Indiana, USA; Institute for Research on Addictive Behavior, Indiana University School of Public Health-Bloomington, Indiana, USA
| | - L A Eldridge
- Indiana University School of Public Health-Bloomington, Indiana, USA; Institute for Research on Addictive Behavior, Indiana University School of Public Health-Bloomington, Indiana, USA
| | - P Arora
- College of Pharmacy and Health Sciences Butler University, Indianapolis, IN, USA
| | - C Smith
- College of Pharmacy and Health Sciences Butler University, Indianapolis, IN, USA
| | - N Vadiei
- College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - A Kennedy
- College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - T Moehling
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Public Health Graduate Program, Purdue University, West Lafayette, IN, USA
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- Indiana University School of Public Health-Bloomington, Indiana, USA
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Abstract
A cross-sectional analysis of human papillomavirus (HPV) vaccine statutes and regulations from states and the District of Columbia in the United States (U.S.) was conducted from September–November 2018 to advance analyses of policy impact on HPV vaccination uptake. A search was conducted using WestlawNext, a legal research database. Statutes and regulations relevant to the study were analyzed and coded based on their legal attributes into ten broad coding questions and several sub-questions. Of the 212 laws identified by the initial search string, 93 (43.9%) reference HPV vaccination in statute or regulation. An additional three laws were added following subsequent review. There was a total of 52 statutes and 44 regulations from 34 states and the District of Columbia. Most laws were related to developing and distributing HPV vaccination materials for parents, and mechanisms to fund and reimburse for the vaccination. This study can be used by policymakers in jurisdictions that are considering establishing HPV vaccination promotion interventions in state law and highlighting the limited statutory and regulatory efforts that have been implemented to promote HPV vaccination. Importantly, this study can also be used to conduct evaluations of the efficacy of statutory and regulatory strategies in increasing HPV vaccination rates.
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Affiliation(s)
- Aila Hoss
- a Hall Center for Law and Health, Indiana University Robert H. McKinney School of Law , Indianapolis , Indiana
| | - Beth E Meyerson
- b Department of Applied Health Science and the Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington , Bloomington , Indiana.,c Center for HPV Research, Indiana University Purdue University Indianapolis , Indianapolis , Indiana
| | - Gregory D Zimet
- c Center for HPV Research, Indiana University Purdue University Indianapolis , Indianapolis , Indiana.,d Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine , Indianapolis , Indiana
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Meyerson BE, Dinh PC, Agley JD, Hill BJ, Motley DN, Carter GA, Jayawardene W, Ryder PT. Predicting Pharmacist Dispensing Practices and Comfort Related to Pre-exposure Prophylaxis for HIV Prevention (PrEP). AIDS Behav 2019; 23:1925-1938. [PMID: 30607758 PMCID: PMC8274484 DOI: 10.1007/s10461-018-02383-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
To identify factors associated with pharmacist dispensing practice and comfort counseling patients about pre-exposure prophylaxis for HIV prevention (PrEP). Cross-sectional 2016 census of Indiana managing pharmacists measured PrEP awareness, comfort dispensing and counseling patients. Modified Poisson models with robust error variance estimated relative risks and confidence intervals. 15.8% of 284 pharmacists had dispensed PrEP and 11.6% had consulted about it. Dispensing and comfort counseling were associated with confidence in knowledge about PrEP medication adherence and adverse effects of PrEP medication; awareness about PrEP before the survey, number of full time pharmacists in their pharmacy, and increases in new HIV cases from 2015 to 2016 in communities served. Comfort counseling about PrEP was associated with the belief that pharmacists can be an important resource for HIV and HCV treatment.
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Affiliation(s)
- B E Meyerson
- Indiana University School of Public Health-Bloomington, 1025 E. 7th street, Bloomington, IN, 47405, USA.
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA.
| | - P C Dinh
- Indiana University School of Public Health-Bloomington, 1025 E. 7th street, Bloomington, IN, 47405, USA
- Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - J D Agley
- Indiana University School of Public Health-Bloomington, 1025 E. 7th street, Bloomington, IN, 47405, USA
- Indiana Prevention Research Center, Indiana University, Bloomington, IN, USA
- Institute for Research on Addictive Behavior, Indiana University, Bloomington, USA
| | - B J Hill
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), The University of Chicago, Chicago, IL, USA
- Planned Parenthood Great Plains, Overland Park, KS, USA
| | - D N Motley
- Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), The University of Chicago, Chicago, IL, USA
| | - G A Carter
- Indiana University School of Nursing, Bloomington, IN, USA
| | - W Jayawardene
- Indiana University School of Public Health-Bloomington, 1025 E. 7th street, Bloomington, IN, 47405, USA
- Indiana Prevention Research Center, Indiana University, Bloomington, IN, USA
- Institute for Research on Addictive Behavior, Indiana University, Bloomington, USA
| | - P T Ryder
- Larkin University College of Pharmacy, Miami, FL, USA
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Meyerson BE, Davis A, Reno H, Haderxhanaj LT, Sayegh MA, Simmons MK, Multani G, Naeyaert L, Meador A, Stoner BP. Existence, Distribution, and Characteristics of STD Clinics in the United States, 2017. Public Health Rep 2019; 134:371-378. [PMID: 31112071 DOI: 10.1177/0033354919847733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Studies of sexually transmitted disease (STD) clinics have been limited by the lack of a national list for representative sampling. We sought to establish the number, type, and distribution of STD clinics and describe selected community characteristics associated with them. METHODS We conducted a 2-phased, multilevel, online search from September 2014 through March 2015 and from May through October 2017 to identify STD clinics in all 50 US states and the District of Columbia. We obtained data on clinic name, address, contact information, and 340B funding status (which requires manufacturers to provide outpatient drugs at reduced prices). We classified clinics by type. We also obtained secondary county-level data to compare rates of chlamydia and HIV, teen births, uninsurance and unemployment, and high school graduation; ratios of primary care physician to population; health care costs; median household income; and percentage of population living in rural areas vs nonrural areas. We used t tests to examine mean differences in characteristics between counties with and without STD clinics. RESULTS We found 4079 STD clinics and classified them into 10 types; 2530 (62.0%) clinics were affiliated with a local health department. Of 3129 counties, 1098 (35.1%) did not have an STD clinic. Twelve states had an STD clinic in every county, and 34 states had ≥1 clinic per 100 000 population. Most STD clinics were located in areas of high chlamydia morbidity and where other surrogate needs were greatest; rural areas were underserved by STD clinics. CONCLUSIONS This list may aid in more comprehensive national studies of clinic services, STD clinic adaptation to external policy changes (eg, in public financing or patient access policy), and long-term clinic survival, with special attention to clinic coverage in rural areas.
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Affiliation(s)
- Beth E Meyerson
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Alissa Davis
- 3 Columbia University School of Social Work, New York, NY, USA
| | - Hilary Reno
- 4 Division of Infectious Disease, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Laura T Haderxhanaj
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - M Aaron Sayegh
- 5 Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Megan K Simmons
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Gurprit Multani
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Lindsey Naeyaert
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Audra Meador
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Bradley P Stoner
- 6 Departments of Anthropology and Medicine, Washington University in St. Louis, St. Louis, MO, USA.,7 St. Louis STD/HIV Prevention Training Center, St. Louis, MO, USA
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Francis HM, Garcia JR, Meyerson BE, Chomistek AK, Abbruzzi E. They Shall Be One: Sexual Satisfaction Among Men and Women Married in the LDS Faith. J Sex Marital Ther 2019; 45:60-72. [PMID: 30040547 DOI: 10.1080/0092623x.2018.1484402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Sexual satisfaction is understudied among highly religious communities, such as the Church of Jesus Christ of Latter-day Saints (LDS). Through an Internet-based self-report survey, this study (N = 266) examined potential predictors of sexual satisfaction among adults living in Utah who had married in the LDS faith, regardless of current faith practice. Both men and women reported their perceived partner satisfaction as the top contributing factor to their own overall sexual satisfaction. These findings have implications for clinicians, educators, and researchers evaluating the sexual lives, including sexual satisfaction, of men and women who have married in the LDS faith.
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Affiliation(s)
- Heather M Francis
- a The Kinsey Institute for Research in Sex, Gender, and Reproduction , Indiana University , Bloomington , Indiana , USA
- b Department of Applied Health Science , Indiana University School of Public Health-Bloomington , Bloomington , Indiana , USA
| | - Justin R Garcia
- a The Kinsey Institute for Research in Sex, Gender, and Reproduction , Indiana University , Bloomington , Indiana , USA
- c Department of Gender Studies , Indiana University , Bloomington , Indiana , USA
| | - Beth E Meyerson
- d Rural Center for AIDS/STD Prevention , Indiana University School of Public Health-Bloomington , Bloomington , Indiana , USA
- e Center for HPV Research , Indiana University Medical School , Indianapolis , Indiana , USA
| | - Andrea K Chomistek
- f Department of Epidemiology and Biostatistics , Indiana University School of Public Health-Bloomington , Bloomington , Indiana , USA
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Meyerson BE, Haderxhanaj LT, Comer K, Zimet GD. Learning in the zone: toward workforce development of evidence-based public policy communication. BMC Public Health 2018; 18:700. [PMID: 29871602 PMCID: PMC5989410 DOI: 10.1186/s12889-018-5617-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 05/28/2018] [Indexed: 11/10/2022] Open
Abstract
Background Evidence-based policy communication (EBPC) is an important, emerging focus in public health research. However, we have yet to understand public health workforce ability to develop and/or use it. The study objective was to characterize capacity to develop and use EBPC and identify cooperative learning and development opportunities using the case of Human papillomavirus (HPV). Methods Vygotsky’s Zone of Proximal Development (ZPD) informed guided interviews with 27 advocates in Indiana from government, industry, research, state associations and individuals. Participants focused on HPV, cancer, women’s health, school health and minority health. Results Capacity to develop and use EBPC was reported to develop through cooperative learning opportunities on the job or in advocacy focused coalitions. Coalition learning appeared to translate across health topics. Notably, policy experience did not assure understanding or use of EBPC. Conclusions The ZPD framework can inform workforce EBPC interventions by focusing on actual development, potential development and factors for learning and development in the ZPD. Future studies should further clarify and evaluate emerging indicators in additional public health policy areas with a larger sample.
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Affiliation(s)
- Beth E Meyerson
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA. .,Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA. .,Center for HPV Research, Indiana University School of Medicine, Indianapolis, Indiana, USA.
| | - Laura T Haderxhanaj
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA.,Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA.,Center for HPV Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Karen Comer
- The Polis Center, Indiana University Purdue University at Indianapolis, Indianapolis, Indiana, USA
| | - Gregory D Zimet
- Center for HPV Research, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Adolescent Medicine, Center for HPV Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Meyerson BE, Davis A, Agley JD, Shannon DJ, Lawrence CA, Ryder PT, Ritchie K, Gassman R. Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions. Int J Drug Policy 2018; 56:46-53. [PMID: 29558701 PMCID: PMC6375077 DOI: 10.1016/j.drugpo.2018.02.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/09/2018] [Accepted: 02/25/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pharmacies have much to contribute to the health of people who inject drugs (PWID) and to community efforts in HIV and hepatitis C (HCV) prevention through syringe access. However, little is known about what predicts pharmacy syringe sales without a prescription. OBJECTIVE To identify factors predicting pharmacy syringes sales to PWID. METHODS A hybrid staggered online survey of 298 Indiana community pharmacists occurred from July-September 2016 measuring pharmacy policy, practice, and pharmacist perceptions about syringe sales to PWID. Separate bivariate logistical regressions were followed by multivariable logistic regression to predict pharmacy syringe sales and pharmacist comfort dispensing syringes to PWID. RESULTS Half (50.5%) of Indiana pharmacies sold syringes without a prescription to PWID. Pharmacy syringe sales was strongly associated with pharmacist supportive beliefs about syringe access by PWID and their comfort level selling syringes to PWID. Notably, pharmacies located in communities with high rates of opioid overdose mortality were 56% less likely to sell syringes without a prescription than those in communities with lower rates. Pharmacist comfort dispensing syringes was associated with being male, working at a pharmacy that sold syringes to PWID and one that stocked naloxone, having been asked about syringe access by medical providers, and agreement that PWID should be able to buy syringes without a prescription. CONCLUSIONS As communities with high rates of opioid overdose mortality were less likely to have pharmacies that dispensed syringes to PWID, a concerted effort with these communities and their pharmacies should be made to understand opportunities to increase syringe access. Future studies should explore nuances between theoretical support for syringe access by PWID without a prescription and actual dispensing behaviors. Addressing potential policy conflicts and offering continuing education on non-prescription syringe distribution for pharmacists may improve comfort distributing syringes to PWID, and therefore increase pharmacy syringe sales.
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Affiliation(s)
- Beth E Meyerson
- Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405 USA; Rural Center for AIDS/STD Prevention, Indiana University, 1025 E. 7th Street, Bloomington, IN 47405 USA.
| | - Alissa Davis
- HIV Center for Clinical and Behavioral Studies, Columbia University Medical Center and New York Psychiatric Institute, 1051 Riverside Dr # 15, New York, NY 10032, USA; Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Ave, New York, NY 10027, USA.
| | - Jon D Agley
- Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405 USA; Indiana Prevention Research Center, Indiana University, 501 N Morton St # 110, Bloomington, IN 47404, USA; Institute for Research on Addictive Behavior, Indiana University, 501 N Morton St # 110, Bloomington, IN 47404, USA.
| | - David J Shannon
- Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405 USA; Rural Center for AIDS/STD Prevention, Indiana University, 1025 E. 7th Street, Bloomington, IN 47405 USA.
| | - Carrie A Lawrence
- Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405 USA; Rural Center for AIDS/STD Prevention, Indiana University, 1025 E. 7th Street, Bloomington, IN 47405 USA.
| | - Priscilla T Ryder
- Larkin University College of Pharmacy, 18301 N Miami Ave Suite 1, Miami, FL 33169, USA; Butler University College of Pharmacy and Health Sciences, 4600 Sunset Ave, Indianapolis, IN 46208, USA.
| | - Karleen Ritchie
- Butler University College of Pharmacy and Health Sciences, 4600 Sunset Ave, Indianapolis, IN 46208, USA.
| | - Ruth Gassman
- Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN 47405 USA; Indiana Prevention Research Center, Indiana University, 501 N Morton St # 110, Bloomington, IN 47404, USA; Institute for Research on Addictive Behavior, Indiana University, 501 N Morton St # 110, Bloomington, IN 47404, USA.
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Venetis MK, Meyerson BE, Friley LB, Gillespie A, Ohmit A, Shields CG. Characterizing Sexual Orientation Disclosure to Health Care Providers: Lesbian, Gay, and Bisexual Perspectives. Health Commun 2017; 32:578-586. [PMID: 27327038 DOI: 10.1080/10410236.2016.1144147] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This study examines lesbian, gay, and bisexual patients' disclosure patterns of sexual orientation to health care providers. Using a semistructured interview format, researchers conducted interviews with 24 lesbian, gay, bisexual, and queer (LGBQ) adults about sexual orientation disclosure strategies. All interviews were transcribed and independently coded using thematic analysis. Results suggest that patient sexual orientation disclosure may be patient initiated and may occur to clarify or correct provider misinformation. Participants disclosed their orientation early in the medical visit during introductions, during small talk with the provider, and during the history-taking phase of the visit. Participants characterized sexual orientation disclosures as presented with minimal information, casually, and often indirectly. Practical and theoretical implications are discussed.
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Affiliation(s)
| | - Beth E Meyerson
- b School of Public Health , Indiana University , Bloomington
| | - L Brooke Friley
- c Department of Communication and Media , Texas A&M University Corpus Christi
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Abstract
Indiana recently passed legislation allowing local governments to establish syringe exchanges. While the effectiveness of syringe exchange programming is established, there is a dearth of studies about associated policy adoption and implementation. This study documents the experiences of 24 Indiana counties engaged in the process of establishing syringe exchange programming under new state law. A mixed method, qualitative, exploratory case study was conducted from May 2015 to April 2016. We observed rapid and widespread policy adoption interest, and yet counties reported significant policy ambiguity, epidemiologic and resource capacity issues. The emergence of health commons involving information and tangible resource sharing networks allowed institutional rearrangement in the midst of resource scarcity; however, such rearrangement appeared to be a central threat to policy adoption and implementation given state structural barriers. The emerging commons could be a critical policy success factor, as it would achieve efficiencies not possible in the current resource environment, and can help achieve institutional rearrangement for the improvement of population health. Several recommendations for improvement are offered.
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Affiliation(s)
- Beth E Meyerson
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN, USA.
| | - Carrie A Lawrence
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN, USA
| | - Laura Miller
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN, USA
| | - Anthony Gillespie
- Indiana Minority Health Coalition, 3737 North Meridian Street, Indianapolis, IN, 46208, USA
| | - Daniel Raymond
- Harm Reduction Coalition, 22 West 27th Street, 5th Floor, New York, NY, 10001, USA
| | - Kristen Kelley
- Prescription Drug Abuse Prevention Task Force, Office of the Indiana Attorney General, 302 West Washington Street, 5th Floor, Indianapolis, IN, 46204, USA
| | - D J Shannon
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, 1025 E. 7th Street, Bloomington, IN, USA
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Agley J, Meyerson BE, Shannon D, Ryder PT, Ritchie K, Gassman RA. Using the hybrid method to survey U.S. pharmacists: Applying lessons learned to leverage technology. Res Social Adm Pharm 2017; 13:250-252. [DOI: 10.1016/j.sapharm.2016.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022]
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Davis A, Meyerson BE, Aghaulor B, Brown K, Watson A, Muessig KE, Yang L, Tucker JD. Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China. Int J Equity Health 2016; 15:170. [PMID: 27741947 PMCID: PMC5064915 DOI: 10.1186/s12939-016-0453-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increased trade between China and Uganda has fueled trafficking of female Ugandans into China. These women may face challenges accessing health services. This study focused on examining barriers to health care access among female Ugandan sex workers in China. METHODS In 2014, we undertook in-depth interviews with 19 female Ugandan sex workers in Guangzhou, China. Interviews focused on barriers to health service access and were analyzed using an a priori coding framework followed by open-coding to capture emergent themes. RESULTS Out of 19 women, 12 women reported a history of being trafficked into China. None of the women had a valid Chinese visa. Fear of being arrested for lack of documentation discouraged women in this sample from accessing hospital services. Low pay, housing exploitation, and remittances contributed to participants' lack of financial resources, which further inhibited their ability to access health services. Participants expressed feeling social isolation from the local community and reported mistrust of local individuals and organizations, including hospitals. CONCLUSION Ugandan sex workers in China faced substantial structural barriers that limited health service access. Policy changes and the development of new programs are urgently needed to ensure these women have improved access to health services.
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Affiliation(s)
- Alissa Davis
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality & Health, Columbia University and the New York State Psychiatric Institute, 1051 Riverside Dr, Unit 15, New York, NY 10032 USA
- UNC-Project China, 2 Lujing Road, Guangzhou, China
| | - Beth E. Meyerson
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 1025 E 7th St. Rm PH116, Bloomington, IN 47405 USA
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health-Bloomington, Bloomington, USA
| | - Blessing Aghaulor
- School of Medicine, University of North Carolina-Chapel Hill, 321 S Columbia Street, Chapel Hill, NC 27516 USA
| | - Katherine Brown
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California-San Francisco, 505 Parnassus Avenue, Rm. 1483, San Francisco, CA 94143 USA
| | | | - Kathryn E. Muessig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 306 Rosenau, Campus Box 7440, Chapel Hill, NC 27599 USA
| | - Ligang Yang
- Guangdong Provincial STD Control Center, 2 Lujing Road, 11th Floor, Guangzhou, 510095 China
| | - Joseph D. Tucker
- UNC-Project China, 2 Lujing Road, Guangzhou, China
- School of Medicine, University of North Carolina-Chapel Hill, 321 S Columbia Street, Chapel Hill, NC 27516 USA
- Guangdong Provincial STD Control Center, 2 Lujing Road, 11th Floor, Guangzhou, 510095 China
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Meyerson BE, Carter G, Lawrence C, Jimison L, Rush N, Carter C, Coleman D, King A, Buckner D, Harvey R, Parker T, Gillespie A, Ohmit A. Expanding HIV Testing in African American Communities Through Community-Based Distribution of Home-Test Vouchers. AIDS Patient Care STDS 2016; 30:141-5. [PMID: 26895115 DOI: 10.1089/apc.2015.0243] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We investigated the implementation feasibility and effectiveness of community-based HIV home-test voucher distribution in three Indianapolis African American communities. Community-based organizations augmented traditional outreach methods to distribute vouchers for home HIV tests redeemable at three pharmacies during three distribution waves from February to April 30, 2015. Voucher redemption served as a proxy indicator of intent to test for HIV. 315 vouchers were distributed and 47 vouchers were redeemed for a 14.9% redemption rate. Distribution was 46% of plan. Vouchers were redeemed at all three pharmacies, and 21% of visits involved redemption of more than one voucher. The original team of seven distributors in three organizations reduced to a remaining five distributors in two organizations by wave 2. This study suggests that outreach organizations could implement HIV home test voucher distribution, and that people would redeem the vouchers at a pharmacy for an HIV test. Future studies should explore how voucher distribution can expand the current HIV testing system.
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Affiliation(s)
- Beth E. Meyerson
- Indiana University School of Public Health-Bloomington, Department of Applied Health Science, Bloomington, Indiana
- Rural Center for AIDS/STD Prevention, Bloomington, Indiana
| | - Gregory Carter
- Indiana University School of Public Health-Bloomington, Department of Applied Health Science, Bloomington, Indiana
- Rural Center for AIDS/STD Prevention, Bloomington, Indiana
- Indiana University School of Nursing, Indiana University, Bloomington, Indiana
| | - Carrie Lawrence
- Indiana University School of Public Health-Bloomington, Department of Applied Health Science, Bloomington, Indiana
- Rural Center for AIDS/STD Prevention, Bloomington, Indiana
| | | | - Nate Rush
- Bethlehem House, Indianapolis, Indiana
| | | | | | | | - Debra Buckner
- Marion County Health and Hospitals Corporation, Indianapolis, Indiana
| | | | | | | | - Anita Ohmit
- Indiana Minority Health Coalition, Inc., Indianapolis, Indiana
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Meyerson BE, King J, Comer K, Liu SS, Miller L. It's Not Just a Yes or No Answer: Expressions of Local Health Department Accreditation. Front Public Health 2016; 4:21. [PMID: 26909344 PMCID: PMC4754618 DOI: 10.3389/fpubh.2016.00021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/02/2016] [Indexed: 11/13/2022] Open
Abstract
The identification and exploration of moderators of health department accreditation remain limited by current dichotomous conceptualizations of pursuit.
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Affiliation(s)
- Beth E Meyerson
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington , Bloomington, IN , USA
| | - Jerry King
- Indiana Public Health Association , Indianapolis, IN , USA
| | - Karen Comer
- The Polis Center, Indiana University-Purdue University at Indianapolis , Indianapolis, IN , USA
| | - Sandra S Liu
- College of Health and Human Sciences, Purdue University , West Lafayette, IN , USA
| | - Laura Miller
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington , Bloomington, IN , USA
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Meyerson BE, Barnes PR, King J, Degi LS, Halverson PK, Polmanski HF. Measuring Accreditation Activity and Progress: Findings from a Survey of Indiana Local Health Departments, 2013. Public Health Rep 2015; 130:447-52. [PMID: 26327722 DOI: 10.1177/003335491513000507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 2013 survey of Indiana local health departments (LHDs) measured accreditation activity and progress. Reported activities were categorized using the Public Health Accreditation Board's (PHAB's) accreditation steps as a guiding framework and matched with selected sociodemographic, organizational, and technical assistance variables. Findings indicated that 42 (59.2%) of responding Indiana LHDs reported pursuing accreditation. Of LHDs pursuing accreditation, 21 were at the initial introductory step, 18 were at the prerequisite step, one reported submitting an application to PHAB, and two reported no activity, yet intent to pursue accreditation. Reported receipt of technical assistance was associated with accreditation progress (p=0.01) and, specifically, with being at the prerequisite step. Facilitating the pursuit of LHD accreditation in states with low public health investment is possible with targeted accreditation resources. Finding meaningful measures of accreditation progress will help advance the study of factors associated with LHD accreditation on a broad scale and for the long term.
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Affiliation(s)
- Beth E Meyerson
- Indiana University Bloomington, School of Public Health-Bloomington, Bloomington, IN ; Indiana University, Rural Center for AIDS/STD Prevention, Bloomington, IN
| | - Priscilla R Barnes
- Indiana University Bloomington, School of Public Health-Bloomington, Bloomington, IN
| | - Jerry King
- Indiana Public Health Association, Indianapolis, IN
| | - Lindsey S Degi
- Indiana University Bloomington, School of Public Health-Bloomington, Bloomington, IN
| | - Paul K Halverson
- Indiana University-Purdue University Indianapolis, Fairbanks School of Public Health, Indianapolis, IN
| | - Haley F Polmanski
- Indiana University Bloomington, School of Public Health-Bloomington, Bloomington, IN
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Meyerson BE, Zimet GD, Multani GS, Levell C, Lawrence CA, Smith JS. Increasing Efforts to Reduce Cervical Cancer through State-Level Comprehensive Cancer Control Planning. Cancer Prev Res (Phila) 2015; 8:636-41. [PMID: 25943743 DOI: 10.1158/1940-6207.capr-15-0004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/16/2015] [Indexed: 11/16/2022]
Abstract
Reducing cervical cancer disparities in the United States requires intentional focus on structural barriers such as systems and policy that impact access to human papillomavirus (HPV) vaccination, cervical cancer screening, and treatment. Such changes are difficult and often politicized. State comprehensive cancer control (CCC) plans are vehicles that, if designed well, can help build collective focus on structural changes. Study objectives were to identify the prioritization of cervical cancer in state CCC plans, the conceptualization of HPV within these plans, and the focus of plans on structural changes to reduce cervical cancer disparities. Data were gathered by systematic content analysis of CCC plans from 50 states and the District of Columbia from February-June 2014 for evidence of cervical cancer prioritization, conceptualization of HPV, and focus on structural barriers to cervical cancer vaccination, screening or treatment. Findings indicate that prioritization of cervical cancer within state CCC plans may not be a strong indicator of state efforts to reduce screening and treatment disparities. While a majority of plans reflected scientific evidence that HPV causes cervical and other cancers, they did not focus on structural elements impacting access to evidence-based interventions. Opportunities exist to improve state CCC plans by increasing their focus on structural interventions that impact cervical cancer prevention, detection, and treatment, particularly for the 41% of plans ending in 2015 and the 31% ending between 2016 and 2020. Future studies should focus on the use of policy tools in state CCC plans and their application to cervical cancer prevention and treatment.
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Affiliation(s)
- Beth E Meyerson
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana. Indiana University-Purdue University Indianapolis (IUPUI) Center for HPV Research, Indianapolis, Indiana. Rural Center for AIDS/STD Prevention, Bloomington, Indiana.
| | - Gregory D Zimet
- Indiana University-Purdue University Indianapolis (IUPUI) Center for HPV Research, Indianapolis, Indiana. Indiana University School of Medicine, Indianapolis, Indiana
| | - Gurprit S Multani
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana. Rural Center for AIDS/STD Prevention, Bloomington, Indiana
| | - Caleb Levell
- Indiana Cancer Consortium, Indianapolis, Indiana
| | - Carrie A Lawrence
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana. Rural Center for AIDS/STD Prevention, Bloomington, Indiana
| | - Jennifer S Smith
- Indiana Cancer Consortium, Indianapolis, Indiana. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
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Meyerson BE, Sayegh MA, Davis A, Arno JN, Zimet GD, LeMonte AM, Williams JA, Barclay L, Van Der Pol B. Cervical cancer screening in a sexually transmitted disease clinic: screening adoption experiences from a midwestern clinic. Am J Public Health 2015; 105 Suppl 2:e8-14. [PMID: 25689199 DOI: 10.2105/ajph.2014.302272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined whether a sexually transmitted disease (STD) clinic could reach women who had not received a Papanicolau (Pap) test in the past 3 years. We also explored staff attitudes and implementation of cervical cancer screening. METHODS Women (n = 123) aged 30 to 50 years were offered cervical cancer screening in an Indiana STD clinic. We measured effectiveness by the patients' self-reported last Pap test. We explored adoption of screening through focus groups with 34 staff members by documenting their attitudes about cervical cancer screening and screening strategy adaptation. We also documented recruitment and screening implementation. RESULTS Almost half (47.9%) of participants reported a last Pap test 3 or more years previously; 30% had reported a last Pap more than 5 years ago, and 11.4% had a high-risk test outcome that required referral to colposcopy. Staff supported screening because of mission alignment and perceived patient benefit. Screening adaptations included eligibility, results provision, and follow-up. CONCLUSIONS Cervical cancer screening was possible and potentially beneficial in STD clinics. Future effectiveness-implementation studies should expand to include all female patients, and should examine the degree to which adaptation of selected adoption frameworks is feasible.
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Affiliation(s)
- Beth E Meyerson
- Beth E. Meyerson is with the Indiana University School of Public Health-Bloomington. M. Aaron Sayegh and Alissa Davis are with Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington. Janet N. Arno is with the Marion County Health and Hospital Corporation, Bell Flower Clinic, Indianapolis, IN. Gregory D. Zimet is with the Center for HPV Research, School of Medicine, Indiana University, Indianapolis. Ann M. LeMonte and James A. Williams are with the Infectious Disease Laboratory, Indiana University, Indianapolis. Lynn Barclay is with the American Sexual Health Association, Research Triangle Park, NC. Barbara Van Der Pol is with the University of Alabama, Birmingham
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Abstract
Objectives. We assessed routine HIV testing in Indiana community health centers (CHCs). Methods. CHC medical directors reported HIV services, testing behaviors, barriers, and health center characteristics via survey from April to May 2013. Standard of care testing was measured by the extent to which CHCs complied with national guidelines for routine HIV testing in clinical settings. Results. Most (85.7%) CHCs reported HIV testing, primarily at patient request or if the patient was symptomatic. Routine HIV testing was provided for pregnant women by 60.7% of CHCs. Only 10.7% provided routine testing for adolescents to adults up to age 65 years. Routine testing was reported by 14.3% for gay and bisexual men, although 46.4% of CHCs reported asking patients about sexual orientation. Linkage to care services for HIV-positive patients, counseling for HIV treatment adherence, and partner testing generally was not provided. Conclusions. Most CHCs reported HIV testing, but such testing did not reflect the standard of care, because it depended on patient request or symptoms. One approach in future studies may be to allow respondents to compare current testing with standard of care and then reflect on barriers to and facilitators of adoption and implementation of routine HIV testing.
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Affiliation(s)
- Beth E Meyerson
- Beth E. Meyerson and Shalini M. Navale are with Indiana University School of Public Health-Bloomington. Anthony Gillespie and Anita Ohmit are with Indiana Minority Health Coalition, Inc, Indianapolis
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Meyerson BE, Emetu RE, Sanders SA, Bailey MM, Ryder PT, Armstrong J. Preferences of Gay and Bisexual Men for Pharmacy-Based HIV Testing and Over-the-Counter HIV Tests. LGBT Health 2014; 1:225-8. [DOI: 10.1089/lgbt.2014.0010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Beth E. Meyerson
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health–Bloomington, Bloomington, Indiana
- Department of Applied Health Science, Indiana University School of Public Health–Bloomington, Bloomington, Indiana
| | - Roberta E. Emetu
- Rural Center for AIDS/STD Prevention, Indiana University School of Public Health–Bloomington, Bloomington, Indiana
- Department of Applied Health Science, Indiana University School of Public Health–Bloomington, Bloomington, Indiana
| | - Stephanie A. Sanders
- The Kinsey Institute, Indiana University School of Public Health–Bloomington, Bloomington, Indiana
| | - Marlon M. Bailey
- Department of Gender Studies, Indiana University, Bloomington, Indiana
| | - Priscilla T. Ryder
- Butler University College of Pharmacy and Health Sciences, Indianapolis, Indiana
| | - James Armstrong
- Department of Applied Health Science, Indiana University School of Public Health–Bloomington, Bloomington, Indiana
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Abstract
OBJECTIVE To assess the feasibility, readiness, and acceptability of offering rapid human immunodeficiency virus (HIV) testing in community pharmacies. DESIGN Qualitative study. SETTING Community pharmacies in Indiana from May to September 2012. PARTICIPANTS 17 licensed community pharmacists. INTERVENTION Semistructured interviews among a convenience sample of community pharmacists. MAIN OUTCOME MEASURES Community pharmacists' self-reported attitudes toward rapid HIV testing in community pharmacies, perceptions of peer acceptability, and opinions about readiness for implementation of the practice in community pharmacies. RESULTS Participants accepted the idea of pharmacy-based HIV testing, describing it as accessible, convenient, and nonstigmatizing. Acceptability was closely linked to positive patient relationships and pharmacist comfort with consultation. Identified challenges to pharmacy-based HIV testing included staffing issues, uneasiness with delivering positive test results, lack of information needed to link patients to care, insufficient consulting space, and need for additional training. Participants indicated that peer beliefs about the acceptability of pharmacist-based HIV testing would vary but that more recently trained pharmacists likely would be more accepting of the practice. CONCLUSION Most participants felt that offering HIV testing was a reasonable addition to the evolving role of the community pharmacist, pending resolution of personal and institutional barriers.
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Affiliation(s)
- Beth E Meyerson
- Indiana University School of Public Health-Bloomington, Rural Center for AIDS/STD Prevention, Bloomington, IN 47405, USA.
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Meyerson BE, Lawrence CA, Smith JS. P6.075 Attend to the “Small P” Policy Issues: State Policy Issues Preventing Effective Cervical Cancer Efforts. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Meyerson BE, Ryder PT, Hippel CV, Coy K. P5.026 More Than Just Selling the Test: Pharmacist Opinion About the Sale of Over the Counter HIV Rapid Tests. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Meyerson BE, Ryder PT, von Hippel C, Coy K. We can do more than just sell the test: pharmacist perspectives about over-the-counter rapid HIV tests. AIDS Behav 2013; 17:2109-13. [PMID: 23417643 DOI: 10.1007/s10461-013-0427-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Pharmacist attitudes about the over-the-counter (OTC) sale of HIV rapid tests in pharmacies were explored through interviews conducted among 17 licensed community pharmacists in a Midwestern, moderate HIV incidence state between May and September 2012. Participants recognized that OTC rapid HIV tests would increase the number of people aware of their HIV status. Concerns included linkage to care and results consultation for those who test HIV-positive. Point of sale was identified as an opportunity for consultation about the test and to establish a relationship for future discussion about results and linkage to care. Pharmacists could provide initial test consultation or information, and consultation about the test results in order to provide post diagnosis support and facilitate linkage to care.
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Meyerson BE, Pol BVD, Arno JN, Zimet GD, Barclay L, Rivera I. P5.039 Title: Can STD Clinics Ride the Cervical Cancer Screening Bike? Experiences from an Urban STD Clinic. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meyerson BE, Crosby RA, Van Der Pol BJ, Zimet GD. Thinking differently about cervical cancer screening in high-risk populations. Am J Prev Med 2012; 43:221-4. [PMID: 22813689 DOI: 10.1016/j.amepre.2012.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 04/23/2012] [Accepted: 04/27/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Beth E Meyerson
- Department of Applied Health Science, Indiana University, Bloomington, 47405, USA.
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Abstract
This study integrated healthcare information from multiple data sources to measure access to HIV primary care in the St. Louis, Missouri area between 1998-2002. We describe the process of creating the collective database and the degree to which each dataset contributed to the calculation of global variables such as evidence of HIV primary care. Descriptive analyses were used to measure evidence of HIV primary among the included data sources. This study was the first of its kind to study HIV primary healthcare access over a period of five years with integrated databases. Findings reinforce the importance of HIV laboratory values as indicators of access to HIV primary healthcare, particularly in the absence of other health data sets. Limitations to the study were posed by data availability and integration of data sources with varying purposes and sophistication.
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Affiliation(s)
- D Perkins
- School of Public Health, Formerly of Saint Louis University, St. Louis, MO, USA
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Abstract
OBJECTIVES We sought to achieve a more comprehensive picture of access to medical care for the treatment of HIV (HIV primary care) by combining evidence of medical services used (health utilization) and epidemiological client-level data. METHODS This study integrated health information from several data sources to measure utilization of HIV primary care in the St Louis, Mo, area between 1998 and 2002. Data from disparate HIV health utilization databases were combined with data from the Missouri HIV and AIDS Reporting System database and then deidentified to measure client-level utilization of HIV primary care over time. RESULTS About half of those with HIV showed evidence of having utilized HIV primary care in a given year. Although most of this group utilized HIV primary care in the first year after they received their HIV diagnosis, evidence of subsequent utilization was inconsistent. Utilization of primary care was most strongly associated with an AIDS diagnosis. About one quarter of people diagnosed with HIV after 1997 had an AIDS diagnosis when they first tested positive for HIV. CONCLUSIONS This study was the first of its kind to integrate several databases to understand HIV primary health care utilization over a period of years. Our findings reinforce the importance of CD4 and viral load values as indicators of utilization of HIV primary health care, particularly in the absence of other health data sets. The lack of available data and the way in which source data were available limited the study.
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Meyerson BE. Policy and Program Coordination: A Shared Challenge with Miles Yet to Go. Public Health Rep 2004; 119:2-3. [PMID: 15147640 PMCID: PMC1502250 DOI: 10.1177/003335490411900102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
BACKGROUND Generating state policy support for sexually transmitted disease (STD) prevention is crucial; however, little is known about policy activity by STD programs. GOALS The goals of the study were to identify state-level policy behaviors by state STD programs and to examine the association between policy behavior and selected state characteristics. STUDY DESIGN Information was gathered through a survey of STD directors in 2001. Policy activities were recalled for 1995 and 2000 and compared with several state characteristics. RESULTS A majority of state STD programs reported at least one policy behavior in the state policy process for 1995 and for 2000. An increase was observed with the provision of state legislative testimony, participation in STD coalitions, and dissemination of information to policy-makers by STD programs. CONCLUSION Reported policy activity may be evidence of an emerging environment enabling state STD directors to engage in public policy activity. An opportunity exists to improve state and local support for STD prevention.
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