Health And Human Services Research Articles

Evaluation of "Catch Up to Get Ahead" efforts on administration of routine childhood vaccinations during COVID-19 pandemic, United States Indian Health Service, 2020.

Routine immunization rates in the United States (US) declined immediately after the US declared COVID-19 a public health emergency in March 2020. Decreases in childhood vaccination place children at risk for vaccine-preventable diseases and communities at risk for outbreaks from these diseases. The US Department of Health and Human Services (HHS) launched "Catch Up to Get Ahead" in August 2020 to promote routine childhood immunization. The decline in mean coverage of the combined 7-vaccine series among children aged 19-35months was less in Indian Health Service (IHS) federal health centers that implemented "Catch Up to Get Ahead" compared to IHS federal health centers that did not. The effort to promote catch-up vaccination may have showed promise in minimizing the decline in childhood vaccination coverage during the pandemic. However, the effort was not enough to reach pre-pandemic levels, indicating the need for more robust and sustained efforts to catch children up on all delayed immunizations.

Post-Pandemic Telehealth: An Unhealthy Privacy Prescription

The COVID-19 pandemic catapulted the use of telehealth services across the United States (US). In response to the public health emergency, the Office for Civil Rights (OCR) at the US Department for Health and Human Services (HHS) issued a notice relaxing privacy and security safeguards outlined in the Health Insurance Portability and Accountability Act (HIPAA). During the past two years, several novel legal issues have arisen due to these lenient standards. The US government has not adequately considered standardizing rules for remote telehealth consultations and regulating the flow of sensitive patient data in a post-COVID world. This article addresses key legal issues associated with telehealth services while recommending national standards to mitigate physician liability while prioritizing patient care.

Notes From the Field: Dispensing of Oral Antiviral Drugs for Treatment of COVID-19 by Zip Code-Level Social Vulnerability - United States, December 23, 2021-August 28, 2022.

Equitable access to COVID-19 therapeutics is a critical aspect of the distribution program led by the U.S. Department of Health and Human Services (HHS).* Two oral antiviral products, nirmatrelvir/ritonavir (Paxlovid)† and molnupiravir (Lagevrio),§ received emergency use authorization (EUA) from the Food and Drug Administration (FDA) in December 2021, to reduce the risk for COVID-19-associated hospitalization and death for those patients with mild to moderate COVID-19 who are at higher risk for severe illness (1,2). HHS has been distributing these medications at no cost to recipients since their authorization. Data collected from provider sites during December 23, 2021-May 21, 2022, indicated substantial disparities in the population-adjusted dispensing rates in high social vulnerability (high-vulnerability) zip codes compared with those in medium- and low-vulnerability zip codes (3). Specifically, dispensing rates for the 4-week period during April 24-May 21, 2022, were 122 per 100,000 residents (19% of overall population-adjusted dispensing rates) in high-vulnerability zip codes compared with 247 (42%) in medium-vulnerability and 274 (39%) in low-vulnerability zip codes. This report provides an updated analysis of dispensing rates by zip code-level social vulnerability and highlights important intervention strategies.

Receipt of First and Second Doses of JYNNEOS Vaccine for Prevention of Monkeypox - United States, May 22-October 10, 2022.

Vaccination with JYNNEOS vaccine (Modified Vaccinia Ankara vaccine, Bavarian Nordic) to prevent monkeypox commenced shortly after confirmation of the first monkeypox case in the current outbreak in the United States on May 17, 2022 (1). To date, more than 27,000 cases have been reported across all 50 states, the District of Columbia (DC), and Puerto Rico.* JYNNEOS vaccine is licensed by the Food and Drug Administration (FDA) as a 0.5-mL 2-dose series administered subcutaneously 28 days apart to prevent smallpox and monkeypox infections (2) and has been found to provide protection against monkeypox infection during the current outbreak (3). The U.S. Department of Health and Human Services (HHS) allocated 1.1 million vials of JYNNEOS vaccine from the Strategic National Stockpile, with doses allocated to jurisdictions based on case counts and estimated size of population at risk (4). However, initial vaccine supplies were severely constrained relative to vaccine demand during the expanding outbreak. Some jurisdictions with highest incidence responded by prioritizing first dose administration during May-July (5,6). The FDA emergency use authorization (EUA) of 0.1 mL dosing for intradermal administration of JYNNEOS for persons aged ≥18 years on August 9, 2022, substantially expanded available vaccine supply† (7). The U.S. vaccination strategy focuses primarily on persons with known or presumed exposures to monkeypox (8) or those at high risk for occupational exposure (9). Data on monkeypox vaccine doses administered and reported to CDC by U.S. jurisdictions were analyzed to assess vaccine administration and completion of the 2-dose series. A total of 931,155 doses of JYNNEOS vaccine were administered and reported to the CDC by 55 U.S. jurisdictions during May 22-October 10, 2022. Among persons who received ≥1 dose, 51.4% were non-Hispanic White (White), 22.5% were Hispanic or Latino (Hispanic), and 12.6% were non-Hispanic Black or African American (Black). The percentages of vaccine recipients who were Black (5.6%) and Hispanic (15.5%) during May 22-June 25 increased to 13.3% and 22.7%, respectively, during July 31-October 10. Among 496,888 persons who received a first dose and were eligible for a second dose during the study period, 57.6% received their second dose. Second dose receipt was highest among older adults, White persons, and those residing in the South U.S. Census Bureau Region. Tracking and addressing disparities in vaccination can reduce inequities, and equitable access to and acceptance of vaccine should be an essential factor in planning vaccination programs, events, and strategies. Receipt of both first and second doses is necessary for optimal protection against Monkeypox virus infection.

Current Challenges and Perspectives on Developing a Clinical Trial Design for ADPKD.

Current Challenges and Perspectives on Developing a Clinical Trial Design for ADPKD.

Perspectives on Drug Development in Early ADPKD.

Perspectives on Drug Development in Early ADPKD.

173 Leveraging Syndromic Surveillance Data to Create Emergency Department COVID19 Data Visualization Tool

173 Leveraging Syndromic Surveillance Data to Create Emergency Department COVID19 Data Visualization Tool

161 Multicenter Interobserver Agreement of Lung Ultrasound Findings in COVID-19 Patients

161 Multicenter Interobserver Agreement of Lung Ultrasound Findings in COVID-19 Patients

92 Burn Injury Assessment Study: How Good Are We at Assessing Burn Injury?

92 Burn Injury Assessment Study: How Good Are We at Assessing Burn Injury?

HHS outlines approaches to behavioral integration

The U.S. Department of Health and Human Services (HHS) this month released an issue brief that outlines approaches toward achieving the goals set out in President Biden's strategy to address the national mental health crisis. The HHS Roadmap for Behavioral Health Integration lists a combination of existing programs and new initiatives that federal agencies have announced since the president unveiled the strategy in his first State of the Union address earlier this year.

Incidental Findings in Study Participants: What Is the Researcher's Obligation?

Background: As technology advances and genomic testing becomes commonplace, incidental findings, or the discovery of unrelated results, have increased. The American College of Genetics and Genomics (ACMG) established recommendations for the return of pathologic variants in 78 genes in the clinical setting based on medically actionable conditions from genes linked with preventable or treatable diseases. However, the lack of policy in the research setting poses a serious ethical dilemma for researchers, potentially threatening the participant’s trust and willingness to contribute to a process with more significant risk than benefit. Purpose: Our goal was to determine the preferred ethical approach to handling incidental research findings and suggest a new standard for investigators and participants. Methods: By employing Wueste’s IAJD Framework of ethical evaluation, the current research policy, as well as a proposed policy, were analyzed, and then a policy analysis was employed to ascertain feasibility. Results and Discussion: The current policy of leaving the decision of returning incidental findings up to the researcher’s discretion is an ethical failure from the consequential, deontological, and intellectual freedom perspectives. However, the proposed policy of implementing the ACMG guidance for researchers to satisfy ethical demands reinforces its moral fortitude. In a period of increasing public awareness, the community, which is the prospective research pool, has increased demands for autonomy and less paternalistic behavior from medicine and science. This paper synthesizes recommendations by numerous organizations to establish a mutually beneficial policy that will ensure the U.S. Department of Health and Human Services (HHS) goal, stated in the 2014 Joint Rule, of making participants “partners” in research a reality.

988 call volume, wait times improved compared with last year

In the days following an announcement by the U.S. Department of Health and Human Services (HHS) that use of the 988 suicide and crisis lifeline, launched July 16, increased in call volume by 45%, along with improved answer rates and wait times compared with the 10‐digit National Suicide Prevention Lifeline one year ago, suicide prevention and mental health experts gathered to discuss the evolution of 988, its impact on individuals, and hopes for the future.

Analysis of Insider Threats in the Healthcare Industry: A Text Mining Approach

To address rapidly growing data breach incidents effectively, healthcare providers need to identify various insider and outsider threats, analyze the vulnerabilities of their internal security systems, and develop more appropriate data security measures against the threats. While there have been studies on trends of data breach incidents, there is a lack of research on the analysis of descriptive contents posted on the data breach reporting website of the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR). Hence, this study develops a novel approach to the analysis of descriptive data breach information with the use of text mining and visualization. Insider threats, vulnerabilities, breach incidents, impacts, and responses to the breaches are analyzed for three data breach types.

Trends in Collection of Disaggregated Asian American, Native Hawaiian, and Pacific Islander Data: Opportunities in Federal Health Surveys.

Collection of data for Asian American, Native Hawaiian, and Pacific Islander (AANHPI) persons that is disaggregated by ethnic subgroup may identify disparities that are not apparent in aggregated data. Using content analysis, we identified national population surveys administered by the US Department of Health and Human Services (HHS) and evaluated trends in the collection of disaggregated AANHPI data between 2011 and 2021. In 2011, 4 of 15 surveys (27%) collected disaggregated data for Asian American, 2 of 15 surveys (13%) collected data on Native Hawaiian, and 2 of 15 surveys (13%) collected disaggregated data for Pacific Islander people. By 2019, 14 of 21 HHS-administered surveys (67%) collected disaggregated data for Asian American (6 subgroups), 67% collected data on Native Hawaiian, and 67% collected disaggregated data on Pacific Islander (3 subgroups) people. Collection of disaggregated AANHPI data in HHS-administered surveys increased from 2011 to 2021, but opportunities to expand collection and reporting remain. Strategies include outreach with community organizations, increased language assistance, and oversampling approaches. Increased availability and reporting of these data can inform health policies and mitigate disparities. (Am J Public Health. 2022;112(10):1429-1435. https://doi.org/10.2105/AJPH.2022.306969).

How public investment fuels innovation: Clues from government-subsidized USPTO patents

• This study is among the first attempts to depict a full picture of the public-subsidized innovation scheme. • This study proposes a multi-dimension framework for learning public-subsidized innovation schemes—the innovation promotor, innovator, and innovation area. • Government agencies are more and more involved in collaborative relationships. • Non-government innovators have shown more powerful vitality than government innovators. • Federal agencies vary in preferences to select subsidized recipients and technological fields. Considerably little effort has been devoted to systematically exploring the landscape of government-funded innovation schemes, leaving policymakers and academics little empirical evidence with which to grasp the overall situation of national R&D funding strategies. In the United States (US), patents with a government right or financial interest are flagged, offering a window through which we can examine the landscape of today's patterns of government support for innovation. We conduct the examination from the perspectives of the leading government agencies, the promotor-recipient relationship, and the common concerns of different participants. The results show that the R&D project funding by federal agencies has, among other factors, contributed to the growth in the number of patent records. The Departments of Defense (DoD), Energy (DoE), and Health and Human Services (HHS), and the National Science Foundation (NSF) have issued the most funding and hold rights to more patent records than any other agencies. Moreover, reforms to the US patent system made 40 years ago to afford more protection to non-government assignees appear to have significantly impacted patenting activity. Universities, companies, and individuals have become far more active in fulfilling government-funded projects, with remarkable innovations as a result. In recent years, funding priorities have shifted toward research in biomedicine, fields related to human life, and computer science. However, the four dominant agencies responsible for most government funding differ in their investment priorities and frequently adjust which areas of innovation they support. This study is among the first attempts to support the landscape of the public-invested innovation using the full government-subsidized patent dataset. The analyses in this paper are instructive in understanding the dynamics of US government funding for innovation and informing effective policymaking around innovation.

SAMHSA's new 988 “lifeline” not just for suicide

This month the Substance Abuse and Mental Health Services Administration (SAMHSA) is beginning the transition from the 10‐digit National Suicide Prevention Lifeline (Lifeline) to the three‐digit 988. This number is not just for suicide, but all kinds of mental health and other crises. The launch follows a three‐year joint effort by the U.S. Department of Health and Human Services (HHS), Federal Communications Commission (FCC), and the U.S. Department of Veterans Affairs (VA) to make crisis care more available and is part of President Biden's strategy to address the mental health crisis in the country. The cost was $432 million. Initially, the investment was only $24 million.

988 crisis care implementation: ‘A good first step’

In the two days since 988, the three‐digit number for 24/7 crisis care, went live, the U.S. Health and Human Services (HHS) Secretary Xavier Becerra, called the launch a “good day” during a July 18 stakeholder briefing on the National Suicide Prevention Lifeline's transition to 988. The hope is for more good days in addressing crisis care, he added.

How Do We Define and Measure Health Equity? The State of Current Practice and Tools to Advance Health Equity.

Introduction:Healthy People establishes national goals and specific measurable objectives to improve the health and well-being of the nation. An overarching goal of Healthy People 2030 is to “eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.” To inform Healthy People 2030 health equity and health disparities content and products, the US Department of Health and Human Services (HHS) Office of Disease Prevention and Health Promotion (ODPHP), in collaboration with NORC at the University of Chicago, conducted a review of peer-reviewed and gray literature to examine how health equity is defined, conceptualized, and measured by public health professionals.Methods:We reviewed (1) peer-reviewed literature, (2) HHS and other public health organization Web sites, and (3) state and territorial health department plans. We also conducted targeted searches of the gray literature to identify tools and recommendations for measuring health equity.Results:While definitions of health equity identified in the scan varied, they often addressed similar concepts, including “highest level of health for all people,” “opportunity for all,” and “absence of disparities.” Measuring health equity is challenging; however, strategies to measure and track progress toward health equity have emerged. There are a range of tools and resources that have the potential to help decision makers address health equity, such as health impact assessments, community health improvement plans, and adapting a Health in All Policies approach. Tools that visualize health equity data also support data-driven decision making.Discussion:Using similar language when discussing health equity will help align and advance efforts to improve health and well-being for all. Healthy People objectives, measures, and targets can help public health professionals advance health equity in their work. HHS ODPHP continues to develop Healthy People tools and resources to support public health professionals as they work with cross-sector partners to achieve health equity.

Rising to the Challenge: How Medical Reserve Corps Volunteers Serve as a Scalable Workforce for Local Health Departments in Response to COVID-19 and Beyond.

Rising to the Challenge: How Medical Reserve Corps Volunteers Serve as a Scalable Workforce for Local Health Departments in Response to COVID-19 and Beyond.

Improving Care During Peacetime, War, and Disasters: A Call for Agile Military Civilian Strategic Alliances.

Improving Care During Peacetime, War, and Disasters: A Call for Agile Military Civilian Strategic Alliances.