The Impact of Traumatic Brain Injury on the Receipt of Services Following Release from Prison

Traumatic brain injury (TBI) is found at substantially higher rates among incarcerated individuals compared to the general adult population. Individuals with TBI report a higher likelihood to experience a range of deleterious outcomes including substance abuse, depression, post-traumatic stress disorder, aggressive behavior, and violence. Thus, a history of TBI is likely to lead to the types of behaviors that will significantly increase the odds of an individual returning to incarceration post-release, as supported by recent research with a cohort of state prisoners. TBI has largely gone unaddressed by prison reentry programs that are integral to rehabilitating individuals returning to the community. Relatively little is known, however, about the effects of TBI on the receipt of services post-release. Additionally, few studies have examined sex differences in the prevalence of TBI in reentry populations. This chapter uses data from a multi-state prisoner reentry program randomized control trial to examine whether individuals with TBI are significantly different than their peers without TBI with respect to a variety of demographic and psychological metrics and in expressions of needs for and participation in services and programming during the transition from incarceration to the community

Estimation of Breast Cancer Incident Cases and Medical Care Costs Attributable to Alcohol Consumption Among Insured Women Aged <45 Years in the U.S.

This study estimated the percentage of breast cancer cases, total number of incident cases, and total annual medical care costs attributable to alcohol consumption among insured younger women (aged 18–44 years) by type of insurance and stage at diagnosis

Health economic design for cost, cost-effectiveness and simulation analyses in the HEALing Communities Study

•The HEALing Communities Study is designed to implement and evaluate the Communities That HEAL intervention to reduce opioid overdose deaths.•The HCS includes a health economics study.•Costs of CTH will be estimated for multiple perspectives.•The health economics study includes cost-effectiveness analyses and simulation modeling. The HEALing Communities Study (HCS) is designed to implement and evaluate the Communities That HEAL (CTH) intervention, a conceptually driven framework to assist communities in selecting and adopting evidence-based practices to reduce opioid overdose deaths. The goal of the HCS is to produce generalizable information for policy makers and community stakeholders seeking to implement CTH or a similar community intervention. To support this objective, one aim of the HCS is a health economics study (HES), the results of which will inform decisions around fiscal feasibility and sustainability relevant to other community settings. The HES is integrated into the HCS design: an unblinded, multisite, parallel arm, cluster randomized, wait list–controlled trial of the CTH intervention implemented in 67 communities in four U.S. states: Kentucky, Massachusetts, New York, and Ohio. The objectives of the HES are to estimate the economic costs to communities of implementing and sustaining CTH; estimate broader societal costs associated with CTH; estimate the cost-effectiveness of CTH for overdose deaths avoided; and use simulation modeling to evaluate the short- and long-term health and economic impact of CTH, including future overdose deaths avoided and quality-adjusted life years saved, and to develop a simulation policy tool for communities that seek to implement CTH or a similar community intervention. The HCS offers an unprecedented opportunity to conduct health economics research on solutions to the opioid crisis and to increase understanding of the impact and value of complex, community-level interventions

The HEALing (Helping to End Addiction Long-term SM) Communities Study: Protocol for a cluster randomized trial at the community level to reduce opioid overdose deaths through implementation of an integrated set of evidence-based practices

•HEALing Communities Study is a parallel-group cluster randomized controlled trial.•Communities That Heal intervention’s goal is to reduce opioid overdose deaths.•Structured consensus decision-making strategy guided study measure development.•More than 80 study measure specifications and a common data model were developed.•The study will provide methodology and longitudinal community data for research. Opioid overdose deaths remain high in the U.S. Despite having effective interventions to prevent overdose deaths, there are numerous barriers that impede their adoption. The primary aim of the HEALing Communities Study (HCS) is to determine the impact of an intervention consisting of community-engaged, data-driven selection, and implementation of an integrated set of evidence-based practices (EBPs) on reducing opioid overdose deaths. The HCS is a four year multi-site, parallel-group, cluster randomized wait-list controlled trial. Communities (n = 67) in Kentucky, Massachusetts, New York and Ohio are randomized to active intervention (Wave 1), which starts the intervention in Year 1 or the wait-list control (Wave 2), which starts the intervention in Year 3. The HCS will test a conceptually driven framework to assist communities in selecting and adopting EBPs with three components: 1) a community engagement strategy with local coalitions to guide and implement the intervention; 2) a compendium of EBPs coupled with technical assistance; and 3) a series of communication campaigns to increase awareness and demand for EBPs and reduce stigma. An implementation science framework guides the intervention and allows for examination of the multilevel contexts that promote or impede adoption and expansion of EBPs. The primary outcome, number of opioid overdose deaths, will be compared between Wave 1 and Wave 2 communities during Year 2 of the intervention for Wave 1. Numerous secondary outcomes will be examined. The HCS is the largest community-based implementation study in the field of addiction with an ambitious goal of significantly reducing fatal opioid overdoses