Identifying Health Bright Spots in the Northeastern Region

Bright Spots are counties that are experiencing better-than-expected health outcomes. There have been a limited number of analyses exploring this concept. There are two research reports that have identified Bright Spots at the county level. The Institute for Healthcare Improvement (IHI) identified 17 counties nationally as Bright Spots. The “Creating a Culture of Health in Appalachia” initiative identified 15 urban counties and 27 rural counties as Bright Spots. In this study we reviewed these findings, and applied the methods used in these reports in an analysis of the Northeast Region of the US. The IHI published a summary report (Counties of Interest) for a 90-day research and development project in 2011. This summary report identified counties that were experiencing better health outcomes than predicted by social and economic factors in 2010. Counties of interest were identified as Bright Spots if their deleted t residual (the standardized difference between the expected vs. observed health outcome) was statistically significant (at the 90% significance level) based on a linear regression model using all counties in the same state (IHI, 2011, p. 7). The summary report identified 17 counties with better-than-expected health outcomes in the United States. No national comprehensive analysis has been done since the publication of this report. The research initiative “Creating a Culture of Health in Appalachia” published a statistical analysis executive summary (Identifying Bright Spots in Appalachian Health) in 2018. In this executive summary, Bright Spots were identified as those counties which were experiencing better-than-expected health outcomes given characteristics and resources in 2016. Bright spots were identified if a county’s standardized health outcome was in the top decile (10%) (Holmes et al, 2018, p. 5). The executive summary identified 15 urban counties and 27 rural counties as Bright Spots with better-than-expected health outcomes in the Appalachian region. These results are not comparable between urban and rural areas (Holmes et al, 2018, p. 5). This analysis only explored counties in the Appalachian region. There has not been an investigation of US counties with “better-than-expected” health outcomes (“Bright Spots”) since 2011. The aim of this Capstone was to update some of the information, by identifying Bright Spot counties as they now exist in the Northeastern region of the United States. Another goal of this Capstone analysis was to identify the top decile of metropolitan (urban) and nonmetropolitan (rural) counties with better-than-expected health outcomes for the Northeastern region. This Capstone’s analytical methods were developed based on the methods used in the IHI and Appalachian reports. The identification of Bright Spot counties in the Northeast region will allow future research to investigate the factors that drive health outcomes. The Capstone research can also be a resource for researchers who are interested in exploring the reasons or causes behind Bright Spot (i.e. health-outlier) counties

Cataloging Public Art in Lewiston and Auburn

This project explored the significance of public art to the cities of Lewiston and Auburn, Maine. It examines existing public art in the two cities, addresses issues of awareness and accessibility of public art in this community, and reviews the value of public art with respect to culture, history, sense of place, and community. This project involved the development of various devices (a database, walking tour, map, and literature review) to convey the information we collected with regards to the previous aims. To increase awareness of L/A’s public art within and outside outside of the local area, we compiled information about public art around Downtown Lewiston and Downtown Auburn. All of the information collected through this project is accessible through a website (https://lapublicart.wixsite.com/home) and brochure (with maps and suggested walking tour). The majority of the information collected for the project came from Lewiston, which is home to 86% of the area’s public art. Differences in regulation between the cities may be responsible for the lack of public art in Auburn. It was found that the majority of public art in Downtown Lewiston was created by a small number of the total artists identified by this project. An increase in accessibility of the creation of legal pieces of public art could inspire art that better reflects the voices and visual style of the broader community. This project aims to increase accessibility by producing artist and event pages on the website so that people from the community are better able to reach out or go to an event if they want to be involved with public art in L/A. Scholars have found that a person’s involvement in public art leads to an increase in sense of belonging and pride in a community. Through a synthesis of surveys sent out to artists and case studies from other cities with public art projects, this project discovered the value of public art to local artists and communities in cities similar to Lewiston and Auburn. Community engagement was the most important value identified through this process. This was followed by culture, which was always regarded as positively impacted by public art. The involvement of youth was another important value, as public art tends to empower youth within their communities and enhance their cultural experience. Incorporation of history was also identified as a valuable aspect of public art because it enables residents and visitors to reflect on the area’s rich past. Finally, economic development, though overlooked by most artists, was seen as a positive outcome of public art intertwined with the other identified values. Finally, this project recommends future steps for public art in Lewiston and Auburn. These include the creation of public art projects that involve community members, increased participation in public art creation and sponsorship by businesses and organizations, the adaptation and continuation of walking tours that highlight public art, ensuring that public art positively reflects the cultures present in L/A, encouragement of youth involvement in public art, and acknowledgement that public art can counteract negative stigmas toward residents and neighborhoods

SUPPORT for ME: Substance Use Disorder Prevalence and Treatment Capacity Assessment

The aim of this report was to understand the sociodemographic and geographic distribution of substance use disorder (SUD) prevalence in Maine, through a claims-based analysis which assessed current statewide capacity to address SUD by examining current SUD treatment and recovery infrastructure, service utilization patterns, and geographic distribution of services and usage throughout the state to identify any gaps in treatment and recovery capacity. The authors would like to note that this report was completed during the planning phase of the SUPPORT for ME project, which was funded by the Centers for Medicare & Medicaid Services (CMS) via the SUPPORT Act passed by Congress in 2018. This assessment utilized numerous data sources, one of which was Medicaid claims data from Maine’s Office of MaineCare Services. This was the first attempt to utilize claims data to estimate prevalence and capacity related to SUD in the State. In future work, the authors aim to have more engagement with clinical providers and data stakeholders which may lead to alterations or updates to the methodologies utilized to produce this report. FMI: Please contact M.Lindsey Smith, PhD at [email protected]

Downeast Maine MAT Expansion Project: Year 3 Final Data Summary

This report summarizes the collaborative effort of Healthy Acadia, its providers, the Downeast Substance Treatment Network, and Downeast Substance Use Response Coalition, to combat opioid use disorder (OUD) in Downeast Maine through multiple evidence-based strategies. Project goals included the reduction of barriers to accessing medication-assisted treatment (MAT) and the enhancement of MAT services by improving provider capacity through training and implementation of best practice treatment. For more information, please contact M. Lindsey Smith, PhD, [email protected]

Medication Assisted Treatment: Prescription Drug and Opioid Addiction Expansion Project

Greater Portland Health (GPH) in collaboration with Preble Street Resource Center was awarded a Medication Assisted Treatment: Prescription Drug & Opioid Addiction (MOUD-PDOA) grant from SAMHSA. The GPH MOUD-PDOA project will include a mixed-methods evaluation led by Catherine E. Cutler Institute. The evaluation team will build knowledge and provide feedback to inform the implementation and refinement of the GPH MOUD-PDOA Program. Evaluation Goals: Document program strategies and identify barriers and facilitators to implementation Examine the efficacy of using a continuum of treatment services to increase access to MOUD among vulnerable populations in underserved communities Assess the impact of the intervention strategies on patient engagement and outcomes This report highlights the process and outcome evaluation data collected during Year 1. For more information, please contact M.Lindsey Smith or Kat Knight

HOUSE: Homeless Opioid User Service Engagement Program. Year 1 Report

Homelessness and lack of stable housing is often a barrier to achieving stability for individuals who are experiencing homelessness (IWAEH) with an OUD. In order to meet the complex needs of IWAEH with OUD, the Department of Health and Human Services funded a pilot program in 2021, the Homeless Opioid Users Service Engagement (HOUSE) Program; clinicians at Greater Portland Health provide clients with low-barrier Medication Assisted Treatment (MAT), while staff at Preble Street provide casework support and rapid housing assistance to individuals who have been identified as being at high risk of overdose, are experiencing homelessness, and are diagnosed with an OUD. . The services resulting from this pilot are intended to provide comprehensive treatment, case management, housing services and peer support in an effort to support long-term recovery and reduced opioid related morbidity and mortality among IWAEH with OUD. The primary goals of the HOUSE Program evaluation are to: (1) document implementation strategies and identify barriers and facilitators to implementation; (2) evaluate the efficacy of the intervention strategies at increasing access to prevention, treatment and recovery supports for IWAEH with OUD; (3) examine the impact of housing liaison services and Assistance Funds on housing stability among IWAEH with OUD; (4) assess the cost effectiveness and return on investment of the intervention strategies and (5) examine the impact of the intervention strategies on participant engagement and outcomes. Early learnings from the mixed methods approach indicate that the first year of the initiative demonstrate that while there remain challenges to engaging this population, the use of evidence-based treatments in combination with intensive case management and peer supports can be an effective way to maintain stabilize patients and address both their medical and housing needs

EcoEvo-MAPS: An Ecology and Evolution Assessment for Introductory through Advanced Undergraduates

A new assessment tool, Ecology and Evolution–Measuring Achievement and Progression in Science or EcoEvo-MAPS, measures student thinking in ecology and evolution during an undergraduate course of study. EcoEvo-MAPS targets foundational concepts in ecology and evolution and uses a novel approach that asks students to evaluate a series of predictions, conclusions, or interpretations as likely or unlikely to be true given a specific scenario. We collected evidence of validity and reliability for EcoEvo-MAPS through an iterative process of faculty review, student interviews, and analyses of assessment data from more than 3000 students at 34 associate’s-, bachelor’s-, master’s-, and doctoral-granting institutions. The 63 likely/unlikely statements range in difficulty and target student understanding of key concepts aligned with the Vision and Change report. This assessment provides departments with a tool to measure student thinking at different time points in the curriculum and provides data that can be used to inform curricular and instructional modifications

SUPPORT for ME Needs Assessment Summary.

Maine Department of Health and Human Services contracted with the Catherine Cutler Institute at the University of Southern Maine to conduct a baseline needs assessment. The overall goal was to better understand the current capacity to address substance use in Maine; find barriers to receiving and utilizing SUD treatment and recovery services; and identify any gaps in SUD-related services in the state. The Cutler team conducted interviews, surveys, community listening sessions and focus groups with healthcare key informants (leadership from health systems, residential care, recovery housing, behavioral health agencies), providers (medical, behavioral health, first responders, residential treatment, law enforcement, opioid treatment), youth ages 12-21, and community members across Maine. The team also analyzed health claims data to identify how common substance misuse is among MaineCare (Medicaid) members and what types of substance use disorder (SUD) treatment and support services MaineCare members use. For more information, please contact the principal investigator, M. Lindsey Smith, PhD, at [email protected]

Welsh automatic text summarisation

Text summarisation is a digital approach to summarising ‘key’ information contained within texts, and the creation of shortened versions of texts based on this content. Text summarisation function is to provide succinct and coherent summaries to users, something that is often time-consuming and difficult to conduct manually. This is useful in the modern digital world where the creation and sharing of text is ever-increasing, as it enables users to navigate, and make sense of, the dearth of digital information that is available, with ease. This paper reports on work on a project which aims to develop an online Automatic Text Summarisation tool for the Welsh language, ACC (Adnodd Creu Crynodebau). This paper contextualises the need for this text summarisation tool, underlines how a dataset for training and testing the methods was created, and outlines plans for the development of the summariser