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American Journal of Public Health Mar 2016
Topics: Food Assistance; Humans; Medical Assistance; Public Health Practice
PubMed: 26885955
DOI: 10.2105/AJPH.2016.303086 -
International Journal For Equity in... Aug 2023Public assistance recipients have diverse and complex needs for health and social support in addition to financial support. Segmentation, which means dividing the...
BACKGROUND
Public assistance recipients have diverse and complex needs for health and social support in addition to financial support. Segmentation, which means dividing the population into subgroups (segments) with similar sociodemographic characteristics, is a useful approach for allocating support resources to the targeted segments. Clustering is a commonly used statistical method of segmentation in a data-driven marketing approach. This explanatory sequential mixed methods study applied a clustering technique, aiming to identify segments among older public assistance recipients quantitatively, and assess the meaningfulness of the identified segments in consultation and support activities for older recipients qualitatively.
METHODS
We identified the segments of older recipients in two municipalities using probabilistic latent semantic analysis, a machine learning-based soft clustering method. Semi-structured interviews were subsequently conducted with caseworkers to ask whether the identified segments could be meaningful for them in practice and to provide a reason if they could not think of any older recipients from the segment.
RESULTS
A total of 3,165 older people on public assistance were included in the analysis. Five distinct segments of older recipients were identified for each sex from 1,483 men and 1,682 women. The qualitative findings suggested most of identified segments reflected older recipients in practice, especially two of them: female Cluster 1 (facility residents aged over 85 years with disability/psychiatric disorder), and female Cluster 2 (workers). Some caseworkers, however, did not recall older recipients in practice when working with certain segments.
CONCLUSIONS
A clustering technique can be useful to identify the meaningful segments among older recipients and can potentially discover previously unrecognized segments that may not emerge through regular consultation practices followed by caseworkers. Future research should investigate whether tailored support interventions for these identified segments are effective.
Topics: Male; Humans; Female; Aged; Public Assistance; Social Support; Cluster Analysis; Latent Class Analysis; Mental Disorders
PubMed: 37537561
DOI: 10.1186/s12939-023-01959-7 -
Annals of Epidemiology Dec 2021The present study aimed to examine the substance use prevention education involvement in different social settings among adolescents receiving public assistance-cash or...
PURPOSE
The present study aimed to examine the substance use prevention education involvement in different social settings among adolescents receiving public assistance-cash or food voucher-for low household income (heretofore, "PA program enrollees") and preventive effects of each prevention educational setting on current substance use.
METHODS
Using data from a nationally-representative sample of PA program enrollees from the 2002-2017 National Survey on Drug Use and Health, we estimated the prevalence of substance use prevention education involvement in home, school, and neighborhood settings and the associations between involvement in each educational setting and current alcohol/illicit drug use.
RESULTS
Compared to nonenrollees, PA program enrollees reported significantly lower rates of involvement in all prevention education settings, including parent-child conversations (54.6% vs. 60.1%) and neighborhood prevention resources (71.3% vs. 79.3%). All educational setting were associated with lower odds of current substance use, with the largest effects found for parent-child conversations (AOR = 0.821 [P < .001] for alcohol use; AOR = 0.817 [P < .001] for illicit drug use).
CONCLUSIONS
To reduce the elevated risk of illicit drug use among PA program enrollees, special attention needs to be paid to promote parent-child conversation about substance use and increase access to prevention education in regular classes and preventive messages outside schools.
Topics: Adolescent; Alcohol Drinking; Humans; Public Assistance; Substance-Related Disorders
PubMed: 34416356
DOI: 10.1016/j.annepidem.2021.08.016 -
Health & Social Care in the Community Jul 2022Motherhood increases women's use of health and social services, presenting opportunities to identify and refer women with substance use disorder (SUD) to treatment. We...
Motherhood increases women's use of health and social services, presenting opportunities to identify and refer women with substance use disorder (SUD) to treatment. We pooled 4 years (2015-2018) of cross-sectional data from National Survey on Drug Use and Health on women of child-bearing age (18-44) in the United States (n = 64,346). (1) We compared the use of services (health, social and criminal justice involvement) by SUD and 'motherhood' (pregnant or has one or more children under 18). We used multivariable logistic regression models to estimate the association between motherhood, SUD and their interaction with the use of services. (2) We estimated the association between the use of different services and SUD treatment use among women with SUD. Among women of child-bearing age, 9.7% had SUD. Mothers who had SUD were more likely to use social services (AOR = 1.48 [95% CI: 1.22, 1.79]) and mental health services compared with non-mothers who did not have SUD (AOR = 1.40 [95% CI: 1.19, 1.65]). The following factors were associated with increased odds of receiving SUD treatment among mothers: mental health treatment utilisation (AOR = 1.94 [95% CI: 1.29, 2.93]); Medicaid coverage (AOR = 2.48 [95% CI: 1.64, 3.76]); and criminal justice involvement (AOR = 3.38 [95% CI: 1.97, 5.80]). To increase treatment access, it is important to address women's different stages in life, including how to best engage women in SUD care across different settings.
Topics: Child; Criminal Law; Cross-Sectional Studies; Female; Humans; Medicaid; Mental Health Services; Pregnancy; Substance-Related Disorders; United States
PubMed: 34363426
DOI: 10.1111/hsc.13534 -
Journal of Public Health Policy May 2016Loss of housing and income assistance among vulnerable youth has not been well described in the literature, yet it is a crucial issue for public health. This study...
Loss of housing and income assistance among vulnerable youth has not been well described in the literature, yet it is a crucial issue for public health. This study examines the prevalence and correlates of loss of income assistance as well as eviction among street-involved youth. We collected data from a prospective cohort of street-involved youth aged 14-26. Among 770 participants, 64.3 per cent reported having housing and 77.1 per cent reported receiving income assistance at some point during the study period. Further, 28.6 and 20.0 per cent of youth reported having been evicted and losing income assistance, respectively. In multivariable generalized estimating equations analysis, heavy alcohol use, unprotected sex, being a victim of violence, and homelessness were all independently associated with eviction. Separately, homelessness, recent incarceration, and drug dealing were independently associated with loss of income assistance. Eviction and loss of income assistance are common experiences among street-involved youth with multiple vulnerabilities. Our findings highlight the importance of improving continued engagement with critical social services.
Topics: Adolescent; Adult; Alcoholism; Canada; Drug Trafficking; Female; Homeless Youth; Humans; Male; Public Assistance; Social Welfare; Unsafe Sex; Violence; Young Adult
PubMed: 26961260
DOI: 10.1057/jphp.2016.12 -
Demography Dec 2019This study finds heterogeneous effects of teen childbearing on education and labor market outcomes across socioeconomic status and race. Using miscarriages to put bounds...
This study finds heterogeneous effects of teen childbearing on education and labor market outcomes across socioeconomic status and race. Using miscarriages to put bounds on the causal effects of teen childbearing, results show that teen childbearing leads to lower educational attainment, lower income, and greater use of welfare for individuals who come from counties with better socioeconomic conditions. However, there are no significant adverse effects for individuals who come from counties with worse socioeconomic conditions. Across race, teen childbearing leads to negative consequences for white teens but no significant negative effects for black or Hispanic and Latino teens.
Topics: Abortion, Spontaneous; Adolescent; Educational Status; Female; Fertility; Humans; Income; Longitudinal Studies; Pregnancy; Pregnancy Outcome; Pregnancy in Adolescence; Public Assistance; Risk Factors; Social Class
PubMed: 31713125
DOI: 10.1007/s13524-019-00830-1 -
American Journal of Public Health Jan 2021
Topics: Diet, Healthy; Food Assistance; Fruit; Health Promotion; Humans; Motivation; Poverty; United States; Vegetables
PubMed: 33326275
DOI: 10.2105/AJPH.2020.305987 -
BMJ Open Apr 2018Public involvement in research is considered good practice by European funders; however, evidence of its research impact is sparse, particularly in relation to...
Involving the public in epidemiological public health research: a qualitative study of public and stakeholder involvement in evaluation of a population-wide natural policy experiment.
BACKGROUND
Public involvement in research is considered good practice by European funders; however, evidence of its research impact is sparse, particularly in relation to large-scale epidemiological research.
OBJECTIVES
To explore what difference public and stakeholder involvement made to the interpretation of findings from an evaluation of a natural policy experiment to influence the wider social determinants of health: 'Flexicurity'.
SETTING
Stockholm County, Sweden.
PARTICIPANTS
Members of the public from different occupational groups represented by blue-collar and white-collar trade union representatives. Also, members of three stakeholder groups: the Swedish national employment agency; an employers' association and politicians sitting on a national labour market committee. Total: 17 participants.
METHODS
Qualitative study of process and outcomes of public and stakeholder participation in four focused workshops on the interpretation of initial findings from the flexicurity evaluation.
OUTCOME MEASURES
New insights from participants benefiting the interpretation of our research findings or conceptualisation of future research.
RESULTS
Participants sensed more drastic and nuanced change in the Swedish welfare system over recent decades than was evident from our literature reviews and policy analysis. They also elaborated hidden developments in the Swedish labour market that were increasingly leading to 'insiders' and 'outsiders', with differing experiences and consequences for financial and job security. Their explanation of the differential effects of the various collective agreements for different occupational groups was new and raised further potential research questions. Their first-hand experience provided new insights into how changes to the social protection system were contributing to the increasing trends in poverty among unemployed people with limiting long-standing illness. The politicians provided further reasoning behind some of the policy changes and their intended and unintended consequences. These insights fed into subsequent reporting of the flexicurity evaluation results, as well as the conceptualisation of new research that could be pursued in a future programme.
Topics: Employment; Epidemiologic Methods; Health Policy; Health Status Disparities; Humans; Outcome and Process Assessment, Health Care; Patient Participation; Policy Making; Public Assistance; Public Health; Qualitative Research; Stakeholder Participation; Sweden
PubMed: 29678973
DOI: 10.1136/bmjopen-2017-019805 -
BMJ Open May 2022Although several individual risk factors of frequent outpatient attendance (FOA) have previously been reported, identifying a specific risk profile is needed to provide...
OBJECTIVES
Although several individual risk factors of frequent outpatient attendance (FOA) have previously been reported, identifying a specific risk profile is needed to provide effective intervention for impoverished citizens with complex biopsychosocial needs. We aimed to identify potential risk profiles of FOA among public assistance recipients in Japan by using classification and regression trees (CART) and discussed the possibilities of applying the CART to policypractice as compared with the results of conventional regression analyses.
DESIGN
We conducted a retrospective cohort study.
SETTING
We used secondary data from the public assistance databases of six municipalities in Japan.
PARTICIPANTS
The study population included all adults on public assistance in April 2016, observed until March 2017. We obtained the data of 15 739 people on public assistance. During the observational period, 435 recipients (2.7%) experienced FOA.
OUTCOME MEASURE
We dichotomised a cumulative incidence of FOA during the study period into a binary variable of exhibiting FOA or not. We adopted the definition of FOA by the Ministry of Health, Labour, and Welfare: visiting the same medical institution more than 15 days a month.
RESULTS
The results of the CART showed that an employed subpopulation with mental disabilities exhibited the highest risk of FOA (incidence proportion: 16.7%). Meanwhile, multiple Poisson regression showed that the adjusted incidence ratio of being unemployed (vs employed) was 1.71 (95% CI 1.13 to 2.59).
CONCLUSIONS
Using the CART model, we could identify specific risk profiles that could have been overlooked when considering only the risk factors obtained from regression analysis. Public health activities can be provided effectively by focusing on risk factors and the risk profiles.
Topics: Adult; Algorithms; Humans; Japan; Outpatients; Public Assistance; Retrospective Studies
PubMed: 35618333
DOI: 10.1136/bmjopen-2021-054035 -
Journal of Public Health Management and... 2020
Topics: Anniversaries and Special Events; Food Assistance; Humans; Program Development
PubMed: 31764571
DOI: 10.1097/PHH.0000000000001110