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Curated

Addiction Health Evaluation and Disease (AHEAD) Management Study in Boston, Massachusetts, 2006-2010 (ICPSR 33581)

Released/updated on: 2017-03-31

Geographic coverage: United States, Massachusetts, Boston

Time period: 2006-09-01--2010-01-01

Substance dependence (SD) is a chronic disease that requires specialty drug and alcohol treatment, primary care (PC), and management of related problems. Although patients with SD may be linked with specialty care and PC, their health care often remains episodic and fragmented, rather than longitudinal, comprehensive, integrated, and coordinated. As a result, adults with SD often enter addiction treatment later and require acute medical care, rather than entering the system earlier when interventions of lower intensity but longer duration might prevent catastrophes. Chronic disease management (CDM) is a collaborative, longitudinal approach to treatment of certain chronic medical illnesses proven to be more effective than routine care. CDM addresses individual patient and health systems barriers to receipt of needed treatment. However, the effectiveness of CDM for SD has not been tested. The objective of this Addiction Health Evaluation and Disease management (AHEAD) study, was to test the effectiveness of CDM for SD in PC.

Subject identification and recruitment occurred primarily at a local detoxification center, as well as by self and physician referral from the Boston Medical Center primary and ambulatory care clinics, emergency department, urgent care center, inpatient settings, and the community. The study enrolled 320 adults with drug dependence and 320 adults with alcohol dependence who were not in SD treatment, and randomized them to a SD CDM program (the AHEAD Clinic) integrated into a real-world PC clinic or to referral to standard PC. All subjects were assessed regarding SD diagnosis, substance use and problems, readiness to change, health-related quality of life, and medical and drug treatment utilization. Subjects were evaluated 3, 6, and 12 months later, and health services utilization data were collected for 2 years from a statewide database. Additionally, in order to better understand and explain the implementation and fidelity of the AHEAD Clinic, the primary care providers (PCPs) of AHEAD Clinic patients were surveyed. Each PCP was presented with a letter from the Principal Investigator explaining the purpose of the survey, the reason why s/he was being asked to complete the survey, compensation for completing the survey, and details about confidentiality and anonymity. The survey itself consisted of questions asking providers about their satisfaction and their attitudes towards caring for patients with alcohol and drug problems, their knowledge of services that the AHEAD Clinic provides, and their experience working with the AHEAD Clinic.

Primary outcomes were illicit drug use, alcohol use, substance-related problems, emergency department visits, and hospitalizations. The proposal's hypothesis was that compared with standard care, a health services delivery intervention (CDM for SD integrated in PC) would decrease alcohol and illicit drug use and related problems, and improve health care utilization patterns. Improved outcomes using the AHEAD approach would support the adoption of a health services delivery strategy, CDM, to better care for patients with SD.

Dataset 1: 844 variables; 563 cases
Dataset 2: 607 variables; 500 cases
Dataset 3: 607 variables; 487 cases
Dataset 4: 713 variables; 532 cases
Dataset 5: 80 variables; 549 cases
Dataset 6: 59 variables; 1,435 cases
Dataset 7: 25 variables; 87 cases
Dataset 8: 25 variables; 87 cases
Dataset 9: 41 variables; 73 cases
Dataset 10: 9 variables; 11,018 cases
Dataset 11: 5 variables; 511 cases

Curated

Simple Crosstabs

Behavioral Risk Factor Surveillance System (BRFSS), 2003 (ICPSR 34085)

Released/updated on: 2013-08-05

Geographic coverage: Oregon, Vermont, Puerto Rico, Indiana, United States, Oklahoma, Maine, Utah, Nebraska, West Virginia, Massachusetts, North Dakota, Wisconsin, Arizona, Nevada, District of Columbia, Rhode Island, Montana, Hawaii, Kansas, New York (state), New Jersey, Michigan, Iowa, New Mexico, Illinois, Texas, Connecticut, New Hampshire, Louisiana, Ohio, Georgia, Virginia, Maryland

The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury. For many states, the BRFSS is the only available source of timely, accurate data on health-related behaviors. BRFSS was established in 1984 by the Centers for Disease Control and Prevention (CDC); currently data are collected monthly in all 50 states, the District of Columbia, Puerto Rico, the United States Virgin Islands, and Guam. More than 350,000 adults are interviewed each year, making the BRFSS the largest telephone health survey in the world. States use BRFSS data to identify emerging health problems, establish and track health objectives, and develop and evaluate public health policies and programs. The BRFSS is a cross-sectional telephone survey conducted by state health departments with technical and methodologic assistance provided by CDC. States conduct monthly telephone surveillance using a standardized questionnaire to determine the distribution of risk behaviors and health practices among adults. Responses are forwarded to CDC, where the monthly data are aggregated for each state, returned with standard tabulations, and published at the year's end by each state. The BRFSS questionnaire was developed jointly by CDC's Behavioral Surveillance Branch (BSB) and the states. When combined with mortality and morbidity statistics, these data enable public health officials to establish policies and priorities and to initiate and assess health promotion strategies.

Curated

Simple Crosstabs

Computer Assisted Quality of Life and Symptom Assessment of Complex Patients from April 2011-August 2012: Chicago, Illinois (ICPSR 34543)

Released/updated on: 2013-03-21

Geographic coverage: United States, Chicago, Illinois

Time period: 2011-04-08--2012-08-31

The purpose of this study was to expand the research capacity for comparative effectiveness evaluations of patients with multiple chronic conditions. Researchers administered a generic Quality of Life (QOL) instrument, physical symptom assessment, patient health questionnaire, and a tobacco screen through audio computer-assisted self-interviews (ACASI) and linked the responses to their electronic medical records (EMR) data. Researchers also calculated two co-morbidity indices (Chronic Disease Score and Charlson Co-morbidity Index).

Curated

Positive Connections: Connecting HIV-Infected Patients to Care, 2004-2006 [United States] (ICPSR 22482)

Released/updated on: 2010-06-16

Geographic coverage: United States, New England

Time period: 2004-01-01--2006-01-01

The research study Positive Connections tested the Health Systems Navigation (HSN) model, an intervention linking near-peer interventionists with underserved HIV-infected individuals to assist them to become engaged and retained in HIV medical care through supportive services and facilitated referrals. Working with a core group of local AIDS service organizations to identify unstable and out-of-care HIV-positive individuals, the HSN will enroll and provide health system navigation to participants. The principal goal was to enhance the probability that individuals from historically underserved populations would become engaged and retained in high quality, culturally competent HIV care. The theoretical basis for this intervention included individual behavior change models, social and community networks, and provider cultural competence. This project also sought to improve the understanding and the measurement of health care access problems by seeking to determine which problems have indicators and which do not, and to identify steps that can be taken to develop a reliable access monitoring system. The concept of Health Systems Navigator has been developed by the Multicultural AIDS Coalition.

Curated

Retention Challenges for HIV-Infected Primary Care Patients 2001-2004 [United States] (ICPSR 22220)

Released/updated on: 2010-08-30

Geographic coverage: Vermont, Rhode Island, United States, Massachusetts, Maine, Connecticut, New Hampshire

Time period: 2001-01-01--2004-01-01

This project examined HIV-infected patients who were lost to follow-up during calendar years 2001-2004 in order to identify reasons patients were leaving care. Sustaining and retaining HIV-infected patients in care has been a consistent challenge to primary care health systems. Continuity, enhancing wellness, and patient engagement are long-term goals in primary care. Factors that influence clients to disengage from care frequently result in patterns of episodic utilization that may compromise the patient's health status and increase their psychosocial vulnerability. The standard of care suggests that HIV-infected patients return for medical follow-up primary care visits four times a year. Since 2001, there have been over 495 patients that have been determined inactive. The project administered telephone and mail surveys to HIV-infected patients that no longer receive care at Fenway Health Center. The survey includes demographic questions, insurance questions, potential reasons for stopping care, and whether the participant is receiving care at another facility. Subsequently, the project connected interviewees into the Health System Navigation (HSN) Project to assist them with seeking HIV medical care. This was accomplished by including prescreener questions in the survey. If a patient is determined to be eligible, they will be invited to participate in the HSN Project.

Curated

United States Hospital AIDS/HIV and Pediatric AIDS/HIV Care Survey, 1988, 1989, AND 1991 (ICPSR 6455)

Released/updated on: 2006-01-12

Geographic coverage: United States

The purpose of this study was to obtain information on hospital-based treatment of persons with Acquired Immune Deficiency Syndrome (AIDS) and other Human Immunodeficiency Virus (HIV)-related illnesses. Aggregate data were obtained from each surveyed hospital, with the hospital as the unit of observation. Topics covered included patient demographics, service volume and structure, sources of payment, and types of services and treatments rendered. Information was also solicited on inpatient and outpatient AIDS/HIV hospital utilization, patient discharge disposition and likely mode of exposure, hospital community AIDS/HIV education programs, and policies for the treatment of AIDS/HIV patients, for employees with AIDS/HIV, and for the confidentiality of AIDS/HIV patients. Additionally, hospital administrators were queried about monitoring and tracking of outpatient services and the existence of special hospital-operated AIDS/HIV outpatient clinics. Financial characteristics covered included net revenues, costs, and charges for inpatient and outpatient AIDS/HIV services, payer source, and methods used to determine costs. In 1989 and 1991, separate data were obtained for pediatric AIDS/HIV patients.