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Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Case Study, Peer Review Study
Practice strategy involves including unhoused peer ambassadors in outreach plans to encourage vaccination against Covid-19 in homeless encampments/shelters. Peer ambassadors were found to be effective in promoting vaccination among their peers. However, some concerns existed around the ethics of exploiting the trust unhoused PAs had with their communities, as well as apathy and frustration towards the academic and bureaucratic nature of the research study.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Toolkit
Program to Encourage Active, Rewarding Lives is designed to support older adults thorough depression education and skill building to increase self sufficiency and active living. The program is structured over 6-8 weeks of sessions and is designed to be administered by staff who have no previous counseling or mental health education. The program originally started in the 1990’s in Washington state and has since been implemented with a wide range of minority and hard-to-reach populations.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study focuses on the health inequalities experienced by older adults during the COVID-19 pandemic. The study identifies six types of inequality amplifiers experienced by this population: 1) expansion of riskscape, 2) reduction of social ties, 3) uncertainty of future, 4) losing trust in institutions, 5) coping with new knowledge, and 6) straining on public spending.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study develops a microsimulation model of COVID-19 transmission in a homeless shelter and calibrated it to data from surveys conducted during COVID-19 outbreaks in five homeless shelters in three US cities from March 28 to April 10, 2022. The study estimates the probability of averting a COVID-19 outbreak when an exposed individual is introduced into a representative homeless shelter of 250 residents and 50 staff over 30 days under different infection control strategies. The results show that within communities with high COVID-19 community incidence are unable to prevent a large outbreak, despite extensive infection control strategies. This study suggests a need for non-congregate housing in high-risk settings, is needed to avoid outbreaks within these settings.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study sought to assess the correlation between population and spatial characteristics of COVID-19 by examining positive COVID-19 data from New York City with ZIP Code Tabulation Areas to determine what social determinants of health increase an individual’s risk of contracting COVID-19. Results showed that neighborhoods with larger proportions of Black people, people older than 65, people with heart disease, and people living in densely populated housing are at higher risk of contracting COVID-19.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Summary Report/Recommendations
In this project, RAND Corporation researchers identified existing health equity measurement approaches that might fit with Medicare’s VBP programs, quality reporting efforts, and confidential reports. The project had two objectives: identify health equity measurement approaches, and decide which of these approaches merit consideration for inclusion in Medicare’s VBP programs, quality reporting efforts, and confidential reports. This report describes the methods and findings of the project and delineates potential first steps for the U.S. Department of Health and Human Services to consider as it continues to evaluate the prospect of incorporating health equity measures and domains in Medicare’s VBP and reporting programs.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study uses electronic medical records to categorize ethnic differences in clinical presentation and outcomes from COVID-19 among older adults. The data showed no difference in outcomes, hospitalizations, or death between older Hispanic adults and non-Hispanic patients with COVID-19.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study examined telemedicine utilization patterns for one healthcare system during the COVID-19 pandemic to determine if environmental, racial or ethnic, or other social determinants of health impact an individual’s access and usage of telemedicine. Results showed that older age, rural status, and lower socioeconomic status, as well as Asian, Black, and Hispanic ethnicities are most likely to be associated with a lower telemedicine use. Efforts toward digital literary outreach and distribution of telemedicine infrastructure are needed.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study used data from Mass General Brigham in Boston, Mass., to identify the drivers of differences in use of telemedicine and telehealth during the COVID-19 pandemic. Results found that Hispanic adults older than 65 with limited English proficiency were more likely to experience a digital divide in health care.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Case Study, Key Informant Interview
This case study discusses how Hawaii’s Behavioral Health Administration (BHA) partnered with state housing services to organize isolation and quarantine services for people experiencing homelessness. This department also focused on substance use disorder and mental illness, so they worked to build partnerships with treatment centers that individuals could enter after quarantine. The BHA has also focused on braiding funding sources between substance use disorder and homelessness efforts to provide more wraparound services and combat the siloization of different departments.