Past Events

2016 Feb 23

Transitions Care Conference

Location

Brigham and Women's Hospital - Eppinger Conference Room

Questions:

Niraj Sharma, MD, MPH, nsharma5@partners.org;
Kitty O’Hare, MD frances.ohare@childrens.harvard.edu

Directions: Upon entering the BWH lobby at 75 Francis Street, continue straight down the...

2016 Jan 19

Transitions Care Conference

Location

Brigham and Women's Hospital - Eppinger Conference Room

Questions:

Niraj Sharma, MD, MPH, nsharma5@partners.org;
Kitty O’Hare, MD frances.ohare@childrens.harvard.edu

Directions: Upon entering the BWH lobby at 75 Francis Street, continue straight down the...

2015 Nov 04

Impact of Dependent Coverage Expansion and an Individual Mandate on Adolescent and Young Adult Insurance Coverage

Location

Chicago, IL

Medical Care Section Abstract 322088: Impact of Dependent Coverage Expansion and an Individual Mandate on Adolescent and Young Adult Insurance Coverage

Session 5118.0: Health care coverage, services...

2015 Nov 03

Comparing Substance Use Risks among a National Sample of Youth with and without Chronic Medical Conditions

Location

Chicago, IL

Epidemiology Abstract 334234: Comparing Substance Use Risks among a National Sample of Youth with and without Chronic Medical Conditions

Session 4222.0: Chronic Disease in special Populations

Schedul...

Wisk L, Peltz A, Galbraith AA. Changes in Health Care-Related Financial Burden for US Families With Children Associated With the Affordable Care Act. JAMA Pediatr. 2020;174(11):1-9.

See also: Family Health, Financial Burden, Health Services Research

Publisher's Version

Abstract

Importance: The Affordable Care Act (ACA) sought to improve access and affordability of health insurance. Although most ACA policies targeted childless adults, the extent to which these policies also impacted families with children remains unclear. Objective: To examine changes in health care-related financial burden for US families with children before and after the ACA was implemented based on income eligibility for ACA policies. Design, Setting, and Participants: Data used for this cohort study were obtained from the 2000-2017 Medical Expenditure Panel Survey, a nationally representative, population-based survey. Multivariable regression with a difference-in-differences estimator was used to examine changes in family financial burden before and after ACA implementation according to income-based ACA eligibility groups (≤138% [lowest-income], 139%-250% [low-income], 251%-400% [middle-income], and >400% [high-income] federal poverty level). The cohort included 92 165 families with 1 or more children (age ≤18 years) and 1 or more adult parents/guardians. Exposures: Income-based eligibility groups during post-ACA years (calendar years 2014-2017) vs pre-ACA years (calendar years 2000-2013). Main Outcomes and Measures: Family annual out-of-pocket (OOP) health care and premium cost burden relative to income. High OOP burden was determined based on a previously validated algorithm with relative cost thresholds that vary across incomes, and extreme OOP burden was defined as costs exceeding 10% of income. Premiums exceeding 9.5% of income were classified as burdensome and premiums relative to median household income defined an unaffordability index. Results: Compared with high-income families who experienced a lesser change post-ACA implementation (high OOP burden, 1.1% pre-ACA vs 0.9% post-ACA), the lowest-income families saw the greatest reduction in high OOP burden (35.6% pre-ACA vs 23.7% post-ACA; difference-in-differences: -11.4%; 95% CI, -13.2% to -9.5%) followed by low-income families (24.6% pre-ACA vs 17.3% post-ACA, difference-in-differences: -6.8%; 95% CI, -8.7% to -4.9%) and middle-income families (6.1% pre-ACA vs 4.6% post-ACA, difference-in-differences: -1.2%; 95% CI, -2.3% to -0.01%). Although premiums rose for all groups, premium unaffordability was the least exacerbated for the lowest-, low-, and middle-income families compared with higher-income families. Conclusions and Relevance: The findings of this study suggest that low- and middle-income families with children who were eligible for ACA Medicaid expansions and Marketplace subsidies experienced greater reductions in health care-related financial burden after the ACA was implemented compared with families with higher incomes. However, despite ACA policies, many low- and middle-income families with children appear to continue to face considerable financial burden from premiums and OOP costs.

PMID :
32986093

doi :
10.1001/jamapediatrics.2020.3973

Last updated on 02/25/2023
Harstad E, Sideridis G, Kaye D, Wisk L, Weitzman E, Levy S. Parental Perceptions About Alcohol Use for Their Adolescent with Attention-Deficit/Hyperactivity Disorder. J Dev Behav Pediatr. 2020;41(5):366-372.

See also: Adolescent and Young Adult Health, Family Health

Publisher's Version

Abstract

OBJECTIVE: Alcohol use can worsen attention-deficit/hyperactivity disorder (ADHD) symptoms, interfere with treatment, and worsen outcomes. Our objective was to describe parental perceptions of alcohol use for their adolescents with ADHD. METHODS: Parents of adolescents with ADHD completed an online survey about perceptions of adolescent alcohol use for adolescents with ADHD. We described the level of parental concern about the impacts of alcohol use on their adolescent's functioning. We assessed whether specific covariates were associated with the level of parental concern. RESULTS: Of 290 parents who completed the survey, 96.5% were women, and 66.1% had an educational attainment of college degree or higher. Most adolescents (75.4%) took ADHD medication, and 59.9% had comorbid anxiety or depression. Almost one-third (30.3%) of parents perceived that their adolescent was more likely to use alcohol because of ADHD, whereas 34.8% of parents disagreed with this and 34.8% of parents were neutral. Parents who suspected their adolescent regularly used alcohol were less likely to report concern about the impact of alcohol on their adolescent's school performance or ADHD medication effectiveness compared with parents who did not suspect regular adolescent alcohol use. Almost half of the parents (48.5%) did not report discussing the impact of alcohol use on ADHD with their adolescent. CONCLUSION: Many parents of adolescents with ADHD do not understand the unique risks of alcohol use for their adolescents. In addition, if alcohol use harm is not obvious, parents may not perceive there to be concerns about alcohol use on functioning. Parental education about alcohol use and ADHD is needed.

PMID :
32168259

DOI :
10.1097/DBP.0000000000000794

Last updated on 02/25/2023
Study shows that online data closely match formal, large-scale surveillance data and could help monitor the effects of local alcohol control policies

December 02, 2019

Read more here: https://www.eurekalert.org/pub_releases/2019-12/bch-anw120219.php

and here: https://medicalxpress.com/news/2019-12-nimbler-track-alcohol-useby-twitter.html
Tweets and online searches provide a faster way to track alcohol use

December 02, 2019

Collecting rigorous public health data through large survey-based studies is a slow, expensive process.

New research from Boston Children's Hospital shows that mining people's alcohol-related tweets and online searches offers a more immediate, localized information source to complement traditional methods, offering public health professionals the opportunity to spot emerging trends and measure the effects of alcohol-related interventions.

Findings appear December 2 in the American Journal of Preventive Medicine.

Read more here: https://www.news-medical.net/news/20191202/Tweets-and-online-searches-provide-a-faster-way-to-track-alcohol-use.aspx
A nimbler way to track alcohol use: mining Twitter and Google searches

December 02, 2019

Large, survey-based studies are a slow, expensive way to collect rigorous public health data. New research, focusing on alcohol use, shows that mining Twitter and online searches could enable public health professionals to get immediate, localized insights, spot emerging trends, and even measure the effects of interventions.

The study, published in the American Journal of Preventive Medicine, shows that online data closely match formal, large-scale surveillance data and could help monitor the effects of local alcohol control policies.

Read more about the study here.
Wisk L, Magane K, Levy S, Weitzman E. Alcohol Use Behaviors and Reasons to Abstain from or Limit Drinking among Medically Vulnerable Youth. Journal of Addiction Medicine. 2020;14(4):311-318.

See also: Adolescent and Young Adult Health, Chronic Disease Epidemiology

Publisher's Version

Abstract

Background: Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, we sought to identify clusters of RALD and test associations with use behaviors.

Methods: Eligible YCMC (ages 9-18) recruited from outpatient clinics reported their use behaviors and importance of potential RALD. Cluster analysis was used to discern RALD patterns, which were examined as predictors of alcohol use using multivariate regression.

Results: Among 398 participants, 30.9% reported past year alcohol use. Concerns about impacts on medications, school, and disease status were the most frequently endorsed RALD; prior negative experiences with alcohol and family history were the least frequently endorsed. Five RALD clusters were identified for all YCMC and 2 for recent drinkers. Compared to the cluster with high endorsement of multiple general and health-related RALD, those predominantly citing concerns about addiction and those not strongly endorsing any RALD consistently reported greater alcohol use. Among recent drinkers, the cluster characterized by low concern across multiple RALD also consistently reported greater alcohol use compared to their counterparts expressing moderate concern.

Conclusions: For YCMC, RALD are complex but endorsement of multiple general and health-related RALD is associated with less use, and health concerns are especially prevalent. More research is needed to understand how salient RALD can inform tailored interventions that aim to delay and reduce substance use and improve health outcomes for YCMC.

PMID :
31985512

DOI :
10.1097/ADM.0000000000000603

Last updated on 02/25/2023

Lauren E. Wisk, PhD

Past Events