Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-7 (of 7 Records) |
Query Trace: Milstein B [original query] |
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The American Heart Association 2030 Impact Goal: A Presidential Advisory From the American Heart Association
Angell SY , McConnell MV , Anderson CAM , Bibbins-Domingo K , Boyle DS , Capewell S , Ezzati M , de Ferranti S , Gaskin DJ , Goetzel RZ , Huffman MD , Jones M , Khan YM , Kim S , Kumanyika SK , McCray AT , Merritt RK , Milstein B , Mozaffarian D , Norris T , Roth GA , Sacco RL , Saucedo JF , Shay CM , Siedzik D , Saha S , Warner JJ . Circulation 2020 141 (9) e120-e138 Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA's new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force's main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success. |
Multidrug-resistant tuberculosis treatment failure detection depends on monitoring interval and microbiological method
Mitnick CD , White RA , Lu C , Rodriguez CA , Bayona J , Becerra MC , Burgos M , Centis R , Cohen T , Cox H , D'Ambrosio L , Danilovitz M , Falzon D , Gelmanova IY , Gler MT , Grinsdale JA , Holtz TH , Keshavjee S , Leimane V , Menzies D , Migliori GB , Milstein MB , Mishustin SP , Pagano M , Quelapio MI , Shean K , Shin SS , Tolman AW , van der Walt ML , Van Deun A , Viiklepp P . Eur Respir J 2016 48 (4) 1160-1170 Debate persists about monitoring method (culture or smear) and interval (monthly or less frequently) during treatment for multidrug-resistant tuberculosis (MDR-TB). We analysed existing data and estimated the effect of monitoring strategies on timing of failure detection.We identified studies reporting microbiological response to MDR-TB treatment and solicited individual patient data from authors. Frailty survival models were used to estimate pooled relative risk of failure detection in the last 12 months of treatment; hazard of failure using monthly culture was the reference.Data were obtained for 5410 patients across 12 observational studies. During the last 12 months of treatment, failure detection occurred in a median of 3 months by monthly culture; failure detection was delayed by 2, 7, and 9 months relying on bimonthly culture, monthly smear and bimonthly smear, respectively. Risk (95% CI) of failure detection delay resulting from monthly smear relative to culture is 0.38 (0.34-0.42) for all patients and 0.33 (0.25-0.42) for HIV-co-infected patients. Failure detection is delayed by reducing the sensitivity and frequency of the monitoring method. Monthly monitoring of sputum cultures from patients receiving MDR-TB treatment is recommended. Expanded laboratory capacity is needed for high-quality culture, and for smear microscopy and rapid molecular tests. |
Out-of-school-time academic programs to improve school achievement: a Community Guide health equity systematic review
Knopf JA , Hahn RA , Proia KK , Truman BI , Johnson RL , Muntaner C , Fielding JE , Jones CP , Fullilove MT , Hunt PC , Qu S , Chattopadhyay SK , Milstein B . J Public Health Manag Pract 2015 21 (6) 594-608 CONTEXT: Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education. OBJECTIVE: This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority families, can improve academic achievement. Because most OSTA programs serve low-income and ethnic/racial minority students, programs may improve health equity. DESIGN: Methods of the Guide to Community Preventive Services were used. An existing systematic review assessing the effects of OSTA programs on academic outcomes (Lauer et al 2006; search period 1985-2003) was supplemented with a Community Guide update (search period 2003-2011). MAIN OUTCOME MEASURE: Standardized mean difference. RESULTS: Thirty-two studies from the existing review and 25 studies from the update were combined and stratified by program focus (ie, reading-focused, math-focused, general academic programs, and programs with minimal academic focus). Focused programs were more effective than general or minimal academic programs. Reading-focused programs were effective only for students in grades K-3. There was insufficient evidence to determine effectiveness on behavioral outcomes and longer-term academic outcomes. CONCLUSIONS: OSTA programs, particularly focused programs, are effective in increasing academic achievement for at-risk students. Ongoing school and social environments that support learning and development may be essential to ensure the longer-term benefits of OSTA programs. |
Programs to increase high school completion: a Community Guide systematic health equity review
Hahn RA , Knopf JA , Wilson SJ , Truman BI , Milstein B , Johnson RL , Fielding JE , Muntaner CJ , Jones CP , Fullilove MT , Moss RD , Ueffing E , Hunt PC . Am J Prev Med 2015 48 (5) 599-608 CONTEXT: High school completion (HSC) is an established predictor of long-term morbidity and mortality. U.S. rates of HSC are substantially lower among students from low-income families and most racial/ethnic minority populations than students from high-income families and the non-Hispanic white population. This systematic review assesses the effectiveness of programs to increase HSC and the potential of these programs to improve lifelong health among at-risk students. EVIDENCE ACQUISITION: A search located a meta-analysis (search period 1985-2010/2011) on the effects of programs to increase HSC or General Educational Development (GED) diploma receipt; the meta-analysis was concordant with Community Guide definitions and methodologic standards. Programs were assessed separately for the general student population (152 studies) and students who were parents or pregnant (15 studies). A search for studies published between 2010 and August 2012 located ten more recent studies, which were assessed for consistency with the meta-analysis. Analyses were conducted in 2013. EVIDENCE SYNTHESIS: The review focused on the meta-analysis. Program effectiveness was measured as the increased rate of HSC (or GED receipt) by the intervention group compared with controls. All assessed program types were effective in increasing HSC in the general student population: vocational training, alternative schooling, social-emotional skills training, college-oriented programming, mentoring and counseling, supplemental academic services, school and class restructuring, multiservice packages, attendance monitoring and contingencies, community service, and case management. For students who had children or were pregnant, attendance monitoring and multiservice packages were effective. Ten studies published after the search period for the meta-analysis were consistent with its findings. CONCLUSIONS: There is strong evidence that a variety of HSC programs can improve high school or GED completion rates. Because many programs are targeted to high-risk students and communities, they are likely to advance health equity. |
Effects of full-day kindergarten on the long-term health prospects of children in low-income and racial/ethnic-minority populations: a Community Guide systematic review
Hahn RA , Rammohan V , Truman BI , Milstein B , Johnson RL , Muntaner C , Jones CP , Fullilove MT , Chattopadhyay SK , Hunt PC , Abraido-Lanza AF . Am J Prev Med 2014 46 (3) 312-23 CONTEXT: Children from low-income and minority families are often behind higher-income and majority children in language, cognitive, and social development even before they enter school. Because educational achievement has been shown to improve long-term health, addressing these delays may foster greater health equity. This systematic review assesses the extent to which full-day kindergarten (FDK), compared with half-day kindergarten (HDK), prepares children, particularly those from low-income and minority families, to succeed in primary and secondary school and improve lifelong health. EVIDENCE ACQUISITION: A meta-analysis (2010) on the effects of FDK versus HDK among U.S. children measured educational achievement at the end of kindergarten. The meta-analysis was concordant with Community Guide criteria. Findings on the longer-term effects of FDK suggested "fade-out" by third grade. The present review used evidence on the longer-term effects of pre-K education to explore the loss of FDK effects over time. EVIDENCE SYNTHESIS: FDK improved academic achievement by an average of 0.35 SDs (Cohen's d; 95% CI=0.23, 0.46). The effect on verbal achievement was 0.46 (Cohen's d; 95% CI=0.32, 0.61) and that on math achievement was 0.24 (Cohen's d; 95% CI=0.06, 0.43). Evidence of "fade-out" from pre-K education found that better-designed studies indicated both residual benefits over multiple years and the utility of educational boosters to maintain benefits, suggesting analogous longer-term effects of FDK. CONCLUSIONS: There is strong evidence that FDK improves academic achievement, a predictor of longer-term health benefits. To sustain early benefits, intensive elementary school education is needed. If targeted to low-income and minority communities, FDK can advance health equity. |
Why behavioral and environmental interventions are needed to improve health at lower cost
Milstein B , Homer J , Briss P , Burton D , Pechacek T . Health Aff (Millwood) 2011 30 (5) 823-32 We used a dynamic simulation model of the US health system to test three proposed strategies to reduce deaths and improve the cost-effectiveness of interventions: expanding health insurance coverage, delivering better preventive and chronic care, and protecting health by enabling healthier behavior and improving environmental conditions. We found that each alone could save lives and provide good economic value, but they are likely to be more effective in combination. Although coverage and care save lives quickly, they tend to increase costs. The impact of protection grows more gradually, but it is a critical ingredient over time for lowering both the number of deaths and reducing costs. Only protection slows the growth in the prevalence of disease and injury and thereby alleviates rather than exacerbates demand on limited primary care capacity. When added to a simulated scenario with coverage and care, protection could save 90 percent more lives and reduce costs by 30 percent in year 10; by year 25, that same investment in protection could save about 140 percent more lives and reduce costs by 62 percent. |
Analyzing national health reform strategies with a dynamic simulation model
Milstein B , Homer J , Hirsch G . Am J Public Health 2010 100 (5) 811-9 Proposals to improve the US health system are commonly supported by models that have only a few variables and overlook certain processes that may delay, dilute, or defeat intervention effects. We use an evidence-based dynamic simulation model with a broad national scope to analyze 5 policy proposals. Our results suggest that expanding insurance coverage and improving health care quality would likely improve health status but would also raise costs and worsen health inequity, whereas a strategy that also strengthens primary care capacity and emphasizes health protection would improve health status, reduce inequities, and lower costs. A software interface allows diverse stakeholders to interact with the model through a policy simulation game called HealthBound. |
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