Drug Treatment Program Ownership, Medicaid Acceptance, and Service Provision.

The Institute of Medicine noted that effective substance abuse treatment (SAT) programs integrate individual therapeutic approaches with transitional/ancillary services. In addition, research suggests that type of ownership impacts SAT services offered and that Medicaid plays a key role in SAT access. Data from the National Survey of Substance Abuse Treatment Services for the years 2000 and 2002–2006 were used to examine relationships among SAT program Medicaid acceptance, program ownership, and transitional/ancillary service accessibility. Multivariate logistic regression models controlling for state- and program-level contextual factors were used to analyze the data. Nonprofit SAT programs were significantly more likely to offer transitional/ancillary services than for-profit programs. However, programs that accepted Medicaid, regardless of ownership, were significantly more likely to offer most transitional/ancillary services. The data suggest that Medicaid may play a significant role in offering key transitional/ancillary services related to successful treatment outcome, regardless of program ownership type

Effects of countdown displays in public transport route choice under severe overcrowding

The paper presents a route choice model for dynamic assignment in congested, i.e. overcrowded, transit networks where it is assumed that passengers are supported with real-time information on carrier arrivals at stops. If the stop layout is such that passenger congestion results in First-In-First-Out (FIFO) queues, a new formulation is devised for calculating waiting times, total travel times and route splits. Numerical results for a simple example network show the effect of information on route choice when heavy congestion is observed. While the provision of information does not lead to a remarkable decrease in total travel time, with the exception of some particular instances, it changes the travel behaviour of passengers that seem to be more averse to queuing at later stages of their journey and, thus, prefer to interchange at less congested stations

Insights on the Intersection of Health Equity and School Nutrition Policy Implementation: An Exploratory Qualitative Secondary Analysis

Background. Recent federal policies aimed to ensure that all children have equitable access to healthy school nutrition environments. However, historically, disparities have persisted in the quality of school nutrition environments across geographic and socioeconomic groups. There is limited literature addressing if and how recent efforts to reform the school nutrition environment have influenced such disparities. The main objective of this study was to explore stakeholders’ insights on how school nutrition reform intersected with issues of inequity. Method. Qualitative secondary analysis (QSA) offers a unique method to examine existing data with a related but distinct inquiry. This QSA analyzed three primary studies, including stakeholder interviews and focus group data with school professionals and students (total 60 transcripts). Two trained analysts iteratively coded all transcripts in Atlas.ti Version 7 and followed principles of constant comparative analysis. Measures to enhance “trustworthiness” were built into the primary studies and the QSA. Results. Broadly, stakeholders’ complex insights about the school food environments’ ability to compensate for healthy dietary options and “whole child” education that were perceived to be lacking in home environments. Despite the majority of respondents’ positive perceptions of reforms, they also noted the challenges of addressing disparities due to family home environments and complex socioeconomic conditions. Overall, respondents reported that school food reform and nutrition education had the potential for long-term impacts on students’ health, including the potential to improve disparities through enhanced academic achievement for disadvantaged populations. Discussion and Conclusion. QSA allowed for inquiry into frontline stakeholders’ understandings of how school nutrition reform may affect health inequities. Qualitative methods allowed for the examination of complex motivations and perspectives involved in policy implementation. Understanding frontline stakeholders’ perspectives is key to advance school nutrition reform in a sustainable manner, especially in light of the federal local school wellness policy final rule. © 2017, © 2017 Society for Public Health Education

Controlling Methamphetamine Precursors: From Policy to Practice – An Overview of Findings.

Small toxic lab (STL) methamphetamine production is a significant community health and safety issue involving manufacturer, property, and general public toxic chemical exposure. Most policy attempts to reduce the prevalence and consequences of STLs have focused on controlling access to precursor chemicals and have occurred at the state and, more recently, Federal level. We present variance in the types of state and federal precursor policies, key informant perspectives on policy impact, data on changes in STL seizures after the implementation of state precursor policies, and public health implications of state policies. The first presentation will describe state methamphetamine precursor policies and will focus on the types and amounts of chemicals restricted for sale and possession, product placement restrictions, and penalties and other enforcement requirements associated with violations of the restrictions as well as the relationship between the state policies and current federal law. The second presentation will focus on key informant perspectives in five states on the impact of these policies (key informants include legislators and other state policy makers, law enforcement personnel, and independent pharmacists). The third presentation will focus on changes in STL seizures before and after implementation of state methamphetamine precursor policies, examining numbers of seizures, chemicals seized and changes in other health and safety variables. The final presentation will focus on the public health policy implications of the findings. A National Institute of Justice (our project sponsor) discussant will focus on national implications of the reported findings

The Relationship between Drug Treatment Program Ownership, Medicaid Acceptance and Types of Service Provision

The Institute of Medicine noted that effective substance abuse treatment (SAT) programs integrate individual therapeutic approaches with transitional/ancillary services. In addition, research suggests that type of ownership impacts SAT services offered and that Medicaid plays a key role in SAT access. Data from the National Survey of Substance Abuse Treatment Services for the years 2000 and 2002-2006 were used to examine relationships among SAT program Medicaid acceptance, program ownership, and transitional/ancillary service accessibility. Multivariate logistic regression models controlling for state- and program-level contextual factors were used to analyze the data. Nonprofit SAT programs were significantly more likely to offer transitional/ancillary services than for-profit programs. However, programs that accepted Medicaid, regardless of ownership, were significantly more likely to offer most transitional/ancillary services. The data suggest that Medicaid may play a significant role in offering key transitional/ancillary services related to successful treatment outcome, regardless of program ownership type

Smurfing in Small Toxic Meth Labs: Impact of State Methamphetamine Precursor Policies

Over the past 12 years, 31 states have implemented a wide variety of policies to curb methamphetamine production in small toxic labs. This qualitative study explores the perceived impact of methamphetamine precursor laws in five states. Researchers conducted individual and focus group interviews with 77 key state policy makers and law enforcement personnel. Themes included barriers to development, perceived effectiveness and impact, effective provisions, and unintended consequences. Researchers suggest policy recommendations in light of renewed calls by policy makers and law enforcement personnel to address the recent rapid rise in small toxic lab seizures