Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): STATE, Policy/Guideline (State)

Intervention Description: Objectives We assessed the impact of varying levels of smokefree regulations on birth outcomes and prenatal smoking.

Intervention Results: Only more comprehensive smokefree regulations were associated with statistically significant favorable effects on birth outcomes in the full sample: Comprehensive (workplace/restaurant/bar ban) demonstrated increased birthweight (29 grams, p < 0.05) and gestational age (1.64 days, p < 0.01), as well as reductions in very low birthweight (−0.4 %, p < 0.05) and preterm birth (−1.5 %, p < 0.01); Restrictive (workplace/restaurant ban) demonstrated a small decrease in very low birthweight (−0.2 %, p < 0.05). Among less restrictive regulations: Moderate (workplace ban) was associated with a 23 g (p < 0.01) decrease in birthweight; Limited (partial ban) had no effect. Comprehensive’s improvements extended to most maternal groups, and were broadest among mothers 21+ years, non-smokers, and unmarried mothers. Prenatal smoking declined slightly (−1.7 %, p < 0.01) only among married women with Comprehensive.

Conclusion: Regulation restrictiveness is a determining factor in the impact of smokefree regulations on birth outcomes, with comprehensive smokefree regulations showing promise in improving birth outcomes. Favorable effects on birth outcomes appear to stem from reduced secondhand smoke exposure rather than reduced prenatal smoking prevalence. This study is limited by an inability to measure secondhand smoke exposure and the paucity of data on policy implementation and enforcement.

Study Design: Quasi experimental cross-sectional -regression analysis

Setting: State and local policies; State Vital Statistics record

Population of Focus: Health records of singleton births for West Virginia residents between 1995-2010

Data Source: WV Vital statistics data

Sample Size: 293715

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Patient Reminder/Invitation,

Intervention Description: - The intervention consisted of three strategies: 1) a standardized vaccine policy change to include HPV vaccine with other adolescent vaccines, 2) sending pre-visit emails to parents of teens to provide factual vaccine information, and 3) implementing a provider communication initiative to ensure consistent messages and effective cancer prevention recommendations for HPV vaccination ,[object Object],, ,[object Object],.

Intervention Results: - The post-intervention group demonstrated a substantial increase in HPV vaccine rates, from 17.8% to 63.6% ,[object Object],.

Conclusion: - The study concluded that strategically implementing standardized clinical vaccine policies and presumptive provider communication practices has implications for significantly increasing HPV vaccine uptake among teens and may be key to preventing cancer among future generations ,[object Object],.

Study Design: - The study utilized a pre/post design to compare vaccine rates, and data was obtained via electronic health records ,[object Object],.

Setting: - The project was completed at a private pediatric practice in a suburban location in New England ,[object Object],.

Population of Focus: - The target audience consisted of 11- and 12-year-old adolescents who had not previously been vaccinated for HPV ,[object Object],.

Sample Size: - The project included 128 patients, with 73 patients in the pre-intervention group and 55 in the post-intervention group. Most patients were 12 years old in both groups ,[object Object],.

Age Range: - The project included 128 patients, with 73 patients in the pre-intervention group and 55 in the post-intervention group. Most patients were 12 years old in both groups ,[object Object],.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Social Supports, Counseling (Parent/Family), Housing Prescriptions

Intervention Description: supportive housing program called Housing Prescriptions as Health Care

Intervention Results: the Housing Prescriptions as Health Care intervention led to improvements in child health and parental mental health over a six-month period for medically complex families in Boston who had experienced homelessness and housing instability. Specifically, there were decreases in the share of children in fair or poor health and in average anxiety and depression scores among parents in the intervention group compared to the control group

Conclusion: a population-specific model integrating health, housing, legal, and social services, such as the Housing Prescriptions as Health Care intervention, can improve health-related outcomes at the household level for medically complex families experiencing homelessness and housing instability. The findings suggest that addressing housing instability through a multifaceted supportive housing intervention can positively impact the health of both children and parents in these families

Study Design: pilot randomized controlled trial.

Setting: Boston, Massachusetts

Sample Size: seventy-eight homeless or housing-unstable families defined as "medically complex"; Sixty-seven families completed a six-month follow-up assessment

Age Range: mean age of the index child in the study was 2.8 years

Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, STATE, Policy/Guideline (State), Funding Support, Perinatal Committees/Councils

Intervention Description: Vital records data (1971 to 1978) were used to assess the change in neonatal and fetal mortality in Colorado in relationship to the regionalization of perinatal health care within the state.

Intervention Results: There has been a decrease in neonatal mortality rate from 13.4 to 6.9 during a period of time when there was a minimal decrease in the incidence of low-birth weight infants. The improved neonatal mortality has been associated with a shift in the frequency of birth of very low-birth weight (VLBW) infants to hospitals with level II and III perinatal services and relatively greater survival rates of VLBW infants born in these hospitals as compared to those born in level I hospitals. There was no decrease in fetal mortality in the same period of time.

Conclusion: These date suggest that outreach education in perinatal medicine should now emphasize current knowledge and methods for reducing antepartum deaths.

Study Design: QE: pretest-posttest

Setting: All Colorado hospitals Three level III, seven level II, remaining level I

Population of Focus: Infants born weighing greater than one lb.

Data Source: Data from the Bureau of Vital Records, Colorado State Health Department.

Sample Size: Pretest: 1.8% (n=2,818) Posttest: 1.8% (n=2,967) Infants born weighing one to four lbs.

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Public Insurance (State), Outreach (School Staff),

Intervention Description: The intervention is state Medicaid policies allowing 12 months of continuous eligibility for children, regardless of changes in family income that would otherwise end eligibility.

Intervention Results: Results show that continuous eligibility is associated with reduced rates of uninsurance, gaps in coverage, gaps due to application problems, and fair or poor health status. For children with special health care needs, it is also associated with increased preventive care, specialty care, and any medical care.

Conclusion: Continuous eligibility may be an effective strategy to reduce gaps in coverage for children and reduce paperwork burden on Medicaid agencies.

Study Design: Cross-sectional study analyzing data from a national survey.

Setting: The study analyzed data from children in all 50 states, focusing on those with incomes below 138% of the federal poverty level.

Population of Focus: The target audience is policymakers and Medicaid administrators.

Sample Size: The full sample size is 22,622 children. The sample of children with special health care needs is 6,081.

Age Range: The age range is 0-17 years.

Intervention Components (click on component to see a list of all articles that use that intervention): Outreach (Provider), Policy/Guideline (State)

Intervention Description: Provisions of the Patient Protection and Affordable Care Act (ACA) of 2010 hold promise for improving access to and receipt of preventive services for adolescents and young adults (AYAs). The Title V Block Grant transformation also includes a focus on improving adolescent preventive care. This brief report describes and discusses an inquiry of promising strategies for improving access and preventive care delivery identified in selected high-performing states.

Intervention Results: Seven top-performing states were selected: California, Colorado, Illinois, Iowa, Oregon, Vermont, and Texas; 27 stakeholders completed interviews. Four strategies were identified regarding insurance enrollment: use of partnerships; special populations outreach; leveraging laws and resources; and youth engagement. Four strategies were identified regarding quality preventive care: expand provider capacity to serve AYAs; adopt medical home policies; establish quality improvement projects; and enhance consumer awareness of well-visit. States focused more on adolescents than young adults and on increasing health insurance enrollment than the provision of preventive services.

Conclusion: This commentary identifies strategies and recommends areas for future action, as Title V programs and their partners focus on improving healthcare for AYAs as ACA implementation and the Title V transformation continues.

Study Design: Report

Setting: California, Colorado, Illinois, Iowa, Oregon, Vermont, and Texas

Data Source: Two data sources were used to identify top-performing states in insurance enrollment and preventive care delivery: National Survey of Children's Health for adolescents (ages 12-17 years) and Behavioral Risk Factors Surveillance System for young adults (ages 18-25 years)

Sample Size: N/A

Age Range: 12-17 and 18-25

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Access to Provider through Hotline, HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, STATE, Policy/Guideline (State), Consultation Systems (Inter-Hospital Systems), Consultation Systems (Hospital), Telemedicine Systems (Inter-Hospital Systems), Telemedicine Systems (Hospital)

Intervention Description: To examine the factors associated with delivery of preterm infants at neonatal intensive care unit (NICU) hospitals in Arkansas during the period 2001–2006, with a focus on the impact of a Medicaid supported intervention, Antenatal and Neonatal Guidelines, Education, and Learning System (ANGELS), that expanded the consulting capacity of the academic medical center's maternal fetal medicine practice.

Intervention Results: Perceived risk, age, education, and prenatal care characteristics of women affected the likelihood of use of the NICU. The perceived availability of local expertise was associated with a lower likelihood that preterm infants would deliver at the NICU. ANGELS did not increase the overall use of NICU, but it did shift some deliveries to the academic setting.

Conclusion: Perinatal regionalization is the consequence of a complex set of provider and patient decisions, and it is difficult to alter with a voluntary program.

Study Design: Time trend analysis

Setting: All Arkansas hospitals Five level III hospitals from 2001- 2005, six in 2006

Population of Focus: Infants born at <35 weeks GA

Data Source: Data from Medicaid claims for pregnancy linked to birth certificates for women covered by Medicaid in Arkansas

Sample Size: Total (n= 5,150) 2001 (n= 812) 2002 (n= 1,105) 2003 (n= 824) 2004 (n= 824) 2005 (n= 887) 2006 (n= 698) Infants born at <35 weeks GA

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Access to Provider through Hotline, HOSPITAL, Continuing Education of Hospital Providers, STATE, Policy/Guideline (State)

Intervention Description: In this longitudinal observational study, linked vital records and Medicaid claims records for 29,124 preterm births (April 2001–December 2012) to Medicaid covered women were used to examine factors predicting whether deliveries occurred at hospitals with neonatology-staffed NICUs. The factors associated with delivery are estimated and compared for baseline and three post-implementation periods.

Intervention Results: Rates for NICU preterm deliveries increased from 28 to 37% over the time period. Compared to baseline, adjusted NICU delivery rates in the middle and late implementation periods were statistically significant (p < 0.001). Negative impacts of long travel times were reduced, while impacts of obstetrician prenatal care changed from negative to positive association.

Conclusion: Findings validate the ANGELS initiative premise: academic specialists, working with community-based care providers, can improve perinatal regionalization.

Setting: Hospitals in Arkansas

Population of Focus: Medicaid-covered women in Arkansas

Intervention Components (click on component to see a list of all articles that use that intervention): Social Supports, Policy/Guideline (State), Counseling (Parent/Family),

Intervention Description: spotlights hardships and supportive factors for unhoused families led by single mothers who have successfully graduated from two transitional housing programs, one rural and one urban.

Intervention Results: Binary logistic regression results indicated education and social support as significant predictors of successful program completion. Qualitative findings further illustrate narratives surrounding supportive factors and program supports (i.e., assistance securing employment, education courses, sense of community), as well as policy implications.

Conclusion: Implications stress the need for enhancing supportive factors (i.e., education and social capital) in early prevention efforts (e.g., schools and community centers), as well as an intentional integration of addressing socio-emotional needs and resources within housing programs and services unique to rural and urban communities.

Study Design: mixed method study

Setting: Urban and Rural

Sample Size: entry and exit surveys (n = 241) as well as qualitative interviews (n = 11).

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Access,

Intervention Description: housing interventions for families experiencing homelessness

Intervention Results: Parents commonly viewed shelters as contributing to behavioral disruptions, with restored autonomy and routines after exiting shelters contributing to recovery in functioning. Parents offered long-term rental subsidies viewed having a stable, adequate place of their own as helping their children fare better from reduced family stress, improved routines, and changes in children’s expectations about stability.

Conclusion: Long-term rental subsidies helped families in homeless shelters regain stable housing in a place of their own and helped children fare better due to reduced family stress, improved routines, and changes in children’s expectations about stability. This study identifies specific ways by which expanding access to long-term rental subsidies could help improve outcomes for children who experience homelessness.

Study Design: randomized control trial

Setting: Homeless shelter

Sample Size: n=80 interviews with parents

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, HOSPITAL, Chart Audit and Feedback, Guideline Change and Implementation, Quality Improvement, Policy/Guideline (State), STATE, Collaboration with Local Agencies (Health Care Provider/Practice), Collaboratives, Policy/Guideline (Hospital)

Intervention Description: Hospitals participating in the MDPQC (Maryland Perinatal-Neonatal Quality Care Collaborative) agreed to implement practices from the "Safe Reduction of Primary Cesarean Births" patient safety bundle, developed by the Council on Patient Safety in Women's Health Care. As a requirement of participation, hospital teams sent at least one team member to each collaborative event. Activities included a June 2016 in-person kick off meeting for two to three representatives from each hospital to familiarize them with the cesarean delivery bundle and the requirements of participation, followed by conference calls that occurred every month in the first year and every 2 months in the second year. Additional in-person meetings for all hospital teams took place at 12 months and at the end of the collaborative (November 2018). Nice webinars on related clinical topics were presented throughout the 30-month period. The collaborative director provided facilitation support to site teams through calls and visits when requested by the site team or when site participation lapsed.

Intervention Results: Among the 26 bundle practices that were assessed, participating hospitals reported having a median of seven practices (range 0-23) already in place before the collaborative and implementing a median of four (range 0-17) new practices during the collaborative. Across the collaborative, the cesarean delivery rates decreased from 28.5% to 26.9% (P=.011) for all nulliparous term singleton vertex births and from 36.1% to 31.3% (P<.001) for nulliparous, term, singleton, vertex inductions. Five hospitals had a statistically significant decrease in nulliparous, term, singleton, vertex cesarean delivery rates and four had a significant increase. Nulliparous, term, singleton, vertex cesarean delivery rates were significantly lower across hospitals that implemented more practices in the "Response" domain of the bundle.

Conclusion: The MDPQC was associated with a statewide reduction in cesarean delivery rates for nulliparous, term, singleton, vertex births.

Setting: 31 Maryland birthing hospitals

Population of Focus: Among the 26 bundle practices that were assessed, participating hospitals reported having a median of seven practices (range 0–23) already in place before the collaborative and implementing a median of four (range 0–17) new practices during the collaborative. Across the collaborative, the cesarean delivery rates decreased from 28.5% to 26.9% (P5.011) for all nulliparous term singleton vertex births and from 36.1% to 31.3% (P,.001) for nulliparous, term, singleton, vertex inductions. Five hospitals had a statistically significant decrease in nulliparous, term, singleton, vertex cesarean delivery rates and four had a significant increase. Nulliparous, term, singleton, vertex cesarean delivery rates were significantly lower across hospitals that implemented more practices in the “Response” domain of the bundle.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The present study conducted an empowerment counseling session to counsel tobacco product retailers in refusing to sell tobacco products to minors.

Intervention Results: The three stages of this study were conducted from March 2015 to February 2017. The results revealed that 74% of retailers were selling tobacco products to minors at baseline, 40% at stage two and 15% at stage three. These represent significant reductions in selling tobacco products to minors (all stage differences p < 0.001).

Conclusion: The study concluded that empowerment counseling sessions had a significant impact on reducing the sale of tobacco products to minors. The results revealed that the strategies employed in the counseling program, such as building partnerships, listening, dialogue, reflection, action, and feedback, were effective in preventing tobacco products from being sold to minors.

Study Design: Pre-post intervention design

Setting: 18 towns in Southern Taiwan

Population of Focus: Researchers and tobacco retailers

Sample Size: 327 tobacco retailers in Southern Taiwan

Age Range: No age range given, only that "adolescents" were study participants

Intervention Components (click on component to see a list of all articles that use that intervention): Mini Grants, Access, Policy/Guideline (State)

Intervention Description: The Child Care and Development Fund (CCDF) is a federal program that provides funding to states, territories, and tribes to provide low-income families with access to affordable, high-quality child care services. The intervention provided by the CCDF program involves providing subsidies or vouchers to eligible families to help cover the cost of child care services. The CCDF program aims to improve the quality of child care services by requiring that providers meet certain health, safety, and quality standards in order to receive CCDF funds. This includes requirements for staff training and professional development, appropriate child-to-staff ratios, and the implementation of developmentally appropriate curricula and learning activities.

Intervention Results: It has helped provide access to affordable, high-quality child care for low-income families, which research shows can lead to improved learning and development outcomes for children. Investments in high-quality early care and education programs supported by CCDF have been linked to increased school readiness, better academic performance, reduced need for special education services, and improved social skills and behavior among children. Studies have found lasting effects of high-quality early childhood programs into adulthood, including higher rates of educational attainment, employment, and earnings for those who participated. The CCDF program has supported efforts to raise the quality of child care settings, such as increasing accreditation, providing workforce training, and implementing quality rating and improvement systems (QRIS).

Conclusion: The CCDF program plays a vital role in supporting the developmental needs of children, particularly those from low-income families. It emphasizes the importance of ensuring that CCDF-funded child care settings provide high-quality learning environments that promote children's cognitive, social, emotional, and physical development. The resource underscores the need for ongoing professional development and training for child care providers to build their skills in effectively supporting child growth and learning. Overall, it highlights the significant positive impacts that high-quality early childhood education and care facilitated by the CCDF program can have on children's development and long-term outcomes, including educational attainment, employment prospects, and economic stability. The conclusion affirms the CCDF program's crucial function in making these developmental opportunities accessible to families in need.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Individual Supports, Social Supports, Policy/Guideline (State),

Intervention Description: county-level Pay for Success initiative, Partnering for Family Success.

Intervention Results: explored implementation findings of treatment and control group clients participating in a randomized control trial of housing-unstable clients with children in out-of-home placement. Quantitative housing, public assistance, and child welfare administrative data findings, measured over three years were contextualized by qualitative content analyses of case management contacts, examinations of service patterns based on progress notes, and qualitative interviews

Conclusion: Determining what interventions are most effective for stabilizing housing-unstable, child welfare-involved families is a challenge that is increasingly being prioritized as society recognizes the high social and economic costs of both housing these families in emergency shelter and funding out of home placement for their children. Though our findings were mixed regarding quantitative indicators of client’s housing, public assistance receipt, and child welfare outcomes,

Study Design: convergent parallel mixed method design

Setting: County Level

Sample Size: treatment (N = 90) and control (N = 73)

Intervention Components (click on component to see a list of all articles that use that intervention): Access, Educational Material, Policy/Guideline (State)

Intervention Description: The report investigates and reports out on Enhancing perinatal health through quality, safety and performance initiatives

Intervention Results: Primary Recommendations: Assuring the uptake of robust perinatal quality improvement and safety initiatives Creating equity and decreasing disparities in perinatal care and outcomes Empowering women and families with information to enable the development of full partnerships between health care providers and patients and shared decision-making in perinatal care Standardizing the regionalization of perinatal services Strengthening the national vital statistics system

Conclusion: Ultimately, reaching a more efficient, more accountable system of perinatal care will require a level of collaboration, services integration and communication that lead to successful perinatal quality improvement initiatives, many of which are described throughout this book. In addition to the consistent collection of data and measurement and the application of evidence-based interventions, successful collaborations, like all perinatal quality improvement, depend on the engagement, support and commitment of everyone reading this book: health care professionals and hospital leadership, public health professionals and community-based service providers, research scientists, policymakers and payers, as well as patients and families. TIOP III is the call to action and the tool that can inspire and guide their efforts toward improving the outcome of pregnancy.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Prenatal Care Access, Policy/Guideline (State), Development/Improvement of Services,

Intervention Description: improving housing stability, access to healthcare, and support services could be beneficial for this vulnerable group

Intervention Results: The majority (81%) of the women identified as African American. Over 95% of the women were single, and 74 women reported a prior pregnancy. Almost half of the women reported being behind on rent at least one time in the last 6 months, and 43% indicated that they had lived in more than three places in the last year.

Conclusion: indicate a significant financial and maternity risk for pregnant women experiencing homelessness. The study emphasizes that addressing the needs of homeless pregnant women requires more than just standard case management and healthcare coordination. It recommends additional financial resources to address utility arrears, long-term rent support, higher security deposits, and intensive prenatal care that integrates prior preterm birth history and other health issues. The study underscores the importance of tailored interventions to support the maternal and child health of homeless pregnant women

Study Design: cross-sectional

Setting: Columbus, OH

Population of Focus: women who report pregnancy/unhoused.

Sample Size: n=100

Age Range: 25.5 years, with a standard deviation of 4.6 years

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: This study examines the extent to which state cigarette taxes affect smoking behaviour and disparities in smoking among adolescents by gender, socioeconomic status (SES) and race/ethnicity.

Intervention Results: This study examines the extent to which cigarette taxes affect smoking behaviour and disparities in smoking among adolescents by gender, socioeconomic status (SES) and race/ethnicity.

Conclusion: We conclude that higher taxes were associated with reduced smoking among adolescents, with little difference by gender, SES and racial/ethnicity groups. While effective at reducing adolescent smoking, taxes appear unlikely to reduce smoking disparities among youth.

Study Design: Cross-sectional design

Setting: USA (Nationwide)

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: Noted as a "nationally representative sample": but no specific figure given

Age Range: ages 13-18

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The study aimed to characterize the determinants of uptake of the influenza vaccine in young Australian children and assess the impact of state/territory government initiatives on vaccine uptake

Intervention Results: - The study found significant differences in beliefs and attitudes among parents who immunized, partially immunized, or did not immunize their children against influenza 4. - The primary source of information about the influenza vaccine was the formal health sector, with GPs being the most accessed (68.2%) 4. - Knowing the vaccine was free for their child and being influenced by a pharmacist significantly increased the likelihood of childhood influenza vaccine uptake 4. - Conversely, not receiving a vaccine recommendation from a health professional and being influenced by a non-government Internet site significantly decreased the likelihood of childhood influenza vaccine uptake

Conclusion: - The study aimed to inform future influenza vaccine programs and ensure optimal protection against seasonal and pandemic influenza 2. - The findings provide insights into the factors influencing parents' decisions regarding influenza vaccination for their children

Study Design: A national quantitative cross-sectional survey was conducted in November 2018

Setting: The study was conducted in Australia, encompassing various states and territories

Population of Focus: Australian parents aged 18 years and older with at least one child aged between 6 months and 5 years

Sample Size: A total of 1002 Australian parents participated in the study

Age Range: The study focused on children aged between 6 months and <5 years

Intervention Components (click on component to see a list of all articles that use that intervention): Public Insurance (State), Policy/Guideline (State), Medicaid,

Intervention Description: To assess the impact of parental health insurance expansions from 1999 to 2012 on the likelihood that parents are insured; their children are insured; both the parent and child within a family unit are insured; and the type of insurance. Cross-state and within-state multivariable regression models estimated the effects of health insurance expansions targeting parents using 2-way fixed effect modeling and difference-in-difference modeling. All analyses controlled for household, parent, child, and local area characteristics that could affect insurance status

Intervention Results: Expansions increased parental coverage by 2.5 percentage points and increased the likelihood of both parent and child being insured by 2.1 percentage points. Substantial variation was observed by type of expansion. Public expansions without premiums and special subsidized plan expansions had the largest effects on parental coverage and increased the likelihood of jointly insuring both the parent and child. Higher premiums were a substantial deterrent to parents’ insurance. Our findings suggest that premiums and the type of insurance expansion can have a substantial impact on the insurance status of the family. The most effective expansions for parental insurance coverage were those for traditional Medicaid coverage without premiums and for special subsidized plans that subsidized costs for individuals to purchase state-sponsored plans. These findings can help inform states as they continue to make decisions about expanding Medicaid under the Affordable Care Act to cover all family members.

Conclusion: Our findings suggest that premiums and the type of insurance expansion can have a substantial impact on the insurance status of the family. These findings can help inform states as they continue to make decisions about expanding Medicaid under the Affordable Care Act to cover all family members.

Study Design: Cross-sectional analysis of data

Setting: Policy (States)

Population of Focus: Parents and Children

Sample Size: 19 expansion states (representing 28 expansions) and 22 control states without a parental expansion during the study period

Age Range: Parents and children; specific ages not stated

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Access to Provider through Hotline, HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, Consultation Systems (Inter-Hospital Systems), Consultation Systems (Hospital), Telemedicine Systems (Inter-Hospital Systems), Telemedicine Systems (Hospital), STATE, Policy/Guideline (State)

Intervention Description: Telemedicine has been used successfully for medical care and education but it has never been utilized to modify patterns of delivery in an established state network.

Intervention Results: Medicaid deliveries at the regional perinatal centers increased from 23.8% before the intervention to 33% in neonates between 500 and 999 grams (p<0.05) and was unchanged in neonates between 2001-2500 grams.

Conclusion: Telemedicine is an effective way to translate evidence based medicine into clinical care when combined with a general educational conference. Patterns of deliveries appear to be changing so that those newborns at highest risk are being referred to the regional perinatal centers.

Study Design: Time trend analysis

Setting: All Arkansas hospitals

Population of Focus: Infants born weighing 500-2499 gm. Data not given for other study years.

Data Source: Data from Arkansas Vital Statistics Data System linked with corresponding hospitalization records from Arkansas Hospital Discharge Data System.

Sample Size: Total (n= 12,258) 2001 (n= 2,965) 2004 (n= 3,154)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): STATE, Policy/Guideline (State)

Intervention Description: To estimate the effects of smoking bans on neonatal health outcomes and maternal smoking behavior during pregnancy.

Intervention Results: Results of the overall and stratified by maternal smoking status, educational level, and age regression analyses suggested no appreciable effect of smoking bans on neonatal health. Smoking bans had also no effect on maternal smoking behavior.

Conclusion: While there are health benefits to the general population from smoking bans, their effects on neonatal health outcomes and maternal smoking during pregnancy seem to be limited.

Study Design: Quasi experimental cross sectional

Setting: Statewide and community: State, city, county, local, workplace and bar/restaurant smoking bans

Population of Focus: Smoking mothers over age 19 with singleton births and those that occurred in the same county as mother’s county of residence

Data Source: Restricted-use 1991–2009 Natality Detail Files, a Clean Air Dates Table Report, and the Tax Burden of Tobacco- self-report number of cigarettes smoked per day

Sample Size: Level of observation by county= 3,141

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State)

Intervention Description: A 12-week mindfulness training program was implemented to address stress and anxiety in high school students. The program included weekly group sessions focused on meditation, breathing exercises, and body awareness techniques. Students learned to identify and manage negative thought patterns and cultivate a sense of calm in their daily lives. Homework assignments encouraged daily practice of these techniques to solidify the learned skills.

Intervention Results: The program showed significant positive outcomes. Compared to a control group, students who participated in the mindfulness training reported a decrease in self-reported stress and anxiety levels. Additionally, they demonstrated improved focus and concentration in academic settings. Interestingly, teachers noted a positive shift in classroom behavior, with participating students exhibiting better emotional regulation and increased social interaction.

Conclusion: These findings suggest that mindfulness training can be a valuable intervention for promoting emotional well-being in high school students. By equipping students with stress management tools, the program fostered a more positive learning environment and enhanced overall student success. Further research can explore the long-term effects of mindfulness practices on academic achievement and social-emotional development.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: This study assessed whether the recruited CACFP-funded child-care centers in this study were meeting the updated (2017) CACFP requirements regarding foods served for lunch and whether children attending these child-care centers were meeting age- and sex-specific DGA recommendations regarding foods consumed.

Intervention Results: The recruited child-care centers were meeting the updated CACFP requirements regarding foods served but showed limited adherence to the best practice recommendations during the observed lunches. However, the overall mean intake for grains, fruits, and vegetables was significantly lower (P<0.01) than DGA recommendations. In addition, approximately 25% of the children did not consume any vegetables during their meal.

Conclusion: Although child-care centers were meeting the updated CACFP requirements by serving the recommended amounts of foods, children were not meeting DGA-recommended intakes. Future studies are needed to explore ways to improve adherence to best practice recommendations to improve children's consumption of healthy foods in child-care centers.

Study Design: Cross-sectional study

Setting: Child care centers

Population of Focus: Children attending child care centers

Sample Size: 108

Age Range: 3/5/2024

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Media Campaign (Print Materials, Radio, TV), STATE, Campaign, Policy/Guideline (State), Mass Media

Intervention Description: This study examined the impact of antismoking activities targeting the general population and an advertising campaign targeting smoking during pregnancy on the prevalence of smoking during pregnancy in New South Wales (NSW), Australia.

Intervention Results: Prevalence of smoking during pregnancy decreased from 2003 to 2011 overall (0.39% per month), and for all strata examined. For pregnancies overall, none of the evaluated initiatives was associated with a change in the trend of smoking during pregnancy. Significant changes associated with increased tobacco tax and the extension of the smoking ban (in combination with graphic warnings) were found in some strata.

Conclusion: The declining prevalence of smoking during pregnancy between 2003 and 2011, while encouraging, does not appear to be directly related to general population antismoking activities or a pregnancy-specific campaign undertaken in this period.

Study Design: Quasi experimental cross sectional

Setting: Statewide and community: national antismoking campaigns

Population of Focus: Health records of all pregnancies resulting in a live birth between 2003 to 2011 in one state (New South Wales)

Data Source: Health records for all pregnancies resulting in birth in New South Wales

Sample Size: 800,619 pregnancies among 534,513 women in New South Wales

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, STATE, Policy/Guideline (State)

Intervention Description: We examined the impact of state breastfeeding laws on breastfeeding initiation and duration as well as on disparities in these infant feeding practices.

Intervention Results: Breastfeeding initiation was 1.7 percentage points higher in states with new laws to provide break time and private space for breastfeeding employees (p=0.01), particularly among Hispanic mothers (adjusted coefficient 0.058). While there was no overall effect of laws permitting mothers to breast feed in any location, among Black mothers we observed increases in breastfeeding initiation (adjusted coefficient 0.056). Effects on breastfeeding duration were in the same direction, but slightly weaker.

Conclusion: State laws that support breast feeding appear to increase breastfeeding rates. Most of these gains were observed among Hispanic and Black women and women of lower educational attainment suggesting that such state laws may help reduce disparities in breast feeding.

Study Design: QE: pretest-posttest

Setting: National

Population of Focus: All mothers at 4 months postpartum

Data Source: Pregnancy Risk Assessment Monitoring System (PRAMS)

Sample Size: 2000 (n=30,899) 2008 (n=36,512)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), STATE

Intervention Description: We conducted conditional mixed-process models to examine the impact of tobacco control policies on prenatal smoking and quitting, then on the associated changes in birth outcomes. We included interactions between race/ethnicity, education, and taxes and present average marginal effects.

Intervention Results: Among white and black mothers with less than a high school degree, 36.0% and 14.1%, respectively, smoked during the first trimester and their babies had the poorest birth outcomes. However, they were the most responsive to cigarette taxes. Every $1.00 increase in taxes was associated with a 3.45 percentage point decrease in prenatal smoking among white mothers and a 1.20 percentage point decrease among black mothers. These reductions translated to increases in birth weight by 4.19 g for babies born to white mothers and 0.89 g for babies born to black mothers. Among smokers, there was some evidence that taxes increased quitting and improved birth outcomes, although most associations were not statistically significant. We found limited effects of smoke-free legislation on smoking, quitting or birth outcomes.

Conclusion: Cigarette taxes continue to have important downstream effects on reducing prenatal smoking and improving birth outcomes among the most vulnerable mothers and infants.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The study assessed the associations between the Affordable Care Act (ACA), Advisory Committee on Immunization Practices (ACIP) recommendation for males, and ACA-related health insurance reforms with HPV vaccine initiation rates by sex and health insurance type

Intervention Results: The study found that both ACA provisions and the ACIP recommendation were associated with significant increases in HPV vaccine initiation rates among males in NH, MA, and ME, closing the gender gap. However, females and youth on private insurance did not exhibit the same changes in HPV vaccine uptake over the study period

Conclusion: The study concluded that further research is needed to examine whether these policy effects translate to other states as well as their longer-term impacts on HPV vaccine initiation and completion of the vaccine series

Study Design: The study employed a population-based observational design using health insurance claims data from APCDs of NH, ME, and MA

Setting: The study utilized All-Payer Claims Databases (APCDs) from New Hampshire (NH), Maine (ME), and Massachusetts (MA) to assess the relationships between policy changes and HPV vaccine uptake

Population of Focus: The target audience includes individuals aged 9 to 26 years, with a focus on assessing HPV vaccine initiation rates by sex and health insurance type

Sample Size: The study restricted the analytic sample to children and young adults aged 9 to 26 years

Age Range: The study focused on individuals from ages 9 to 26 years (referred to as youth)

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The study examined the impact of two sets of Affordable Care Act policy changes, including the 2010 provisions and the 2014 insurance expansions, on HPV vaccine completion rates by sex and health insurance type

Intervention Results: The results of the study indicated that insurance-related Affordable Care Act policy changes were associated with increased HPV vaccine completion rates, particularly among specific demographic and insurance subgroups

Conclusion: The study concluded that the Affordable Care Act policy changes were linked to improvements in HPV vaccine completion rates, highlighting the potential impact of health insurance expansions and private insurance coverage with no cost-sharing on preventive health behaviors

Study Design: The study utilized a retrospective observational design, analyzing claims data to assess the associations between Affordable Care Act policy changes and HPV vaccine completion rates

Setting: The study was conducted using data from Massachusetts, Maine, and New Hampshire, covering the period from January 2009 through December 2015

Population of Focus: The target audience for this study includes researchers, policymakers, and public health professionals interested in understanding the impact of insurance-related policy changes on HPV vaccine completion rates.

Sample Size: The analytic sample included 383,297 individuals aged 9 to 26 years who had received at least one dose of the HPV vaccine during the study period

Age Range: The study included children and young adults aged 9 to 26 years

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Multicomponent Approach,

Intervention Description: Housing Assistance Programs; Medical-Legal Partnerships; Supportive Housing Programs; Subsidized Housing

Intervention Results: A total of 88 862 births to 45 122 mothers (mean [SD] age, 26.26 [5.76] years) who experienced 99 517 evictions were identified during the study period, including 10 135 births to women who had an eviction action during pregnancy and 78 727 births to mothers who had experienced an eviction action when not pregnant. Compared with mothers who experienced eviction actions at other times, eviction during pregnancy was associated with lower infant birth weight (difference, −26.88 [95% CI, −39.53 to 14.24] g) and gestational age (difference, −0.09 [95% CI, −0.16 to −0.03] weeks), increased rates of LBW (0.88 [95% CI, 0.23-1.54] percentage points) and prematurity (1.14 [95% CI, 0.21-2.06] percentage points), and a nonsignificant increase in mortality (1.85 [95% CI, −0.19 to 3.89] per 1000 births). The association of eviction with birth weight was strongest in the second and third trimesters of pregnancy, with birth weight reductions of 34.74 (95% CI, −57.51 to −11.97) and 35.80 (95% CI, −52.91 to −18.69) g, respectively.

Conclusion: Eviction during pregnancy, particularly during the second and third trimester, was associated with reductions in infants’ weight and gestational age at birth compared with maternal eviction at any other time.

Study Design: case-control study

Setting: Georgia

Population of Focus: Pregnant women facing eviction

Sample Size: 88 862 births

Age Range: 26 yrs

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Expanded Insurance Coverage, Other (Provider Practice),

Intervention Description: The intervention described in the study involved the implementation of two policy changes in Nova Scotia, Canada: 1) the implementation of a publicly-funded universal influenza vaccination program in the 2010–2011 influenza season, and 2) the addition of pharmacists as immunizers in 2013. The aim of these changes was to improve vaccine uptake by eliminating cost as a barrier and increasing convenience and possibly access ,[object Object],. The study aimed to investigate any changes in influenza vaccine coverage following the implementation of each policy change ,[object Object],. The study compared influenza vaccine coverage between the pre-universal program period, the universal publicly funded program period, and the universal publicly funded program with the addition of pharmacists period ,[object Object],.

Intervention Results: The results of the study showed an increase in influenza vaccine coverage immediately following the implementation of the two studied policy changes. Vaccine coverage increased from 36.4% to 38% following the implementation of the universally funded vaccine policy. Following the implementation of pharmacists as immunizers, coverage increased from 35.7% to 41.7% ,[object Object],. Despite the initial increase in coverage observed, a reduction in coverage was observed in the two years following the addition of pharmacists as immunizers ,[object Object],. The study also found that coverage in individuals aged 65 years and older remained relatively consistent with the addition of a universally funded vaccination program compared to the pre-universal study years ,[object Object],.

Conclusion: The addition of a universally funded vaccination policy and the addition of pharmacists as providers of the influenza vaccine resulted in increases in vaccine coverage initially. Additional research is needed to determine the long-term impacts of the policy changes on vaccination coverage and to identify other important factors affecting vaccine uptake.

Study Design: the main study discussed in the file aimed to compare influenza vaccine coverage between three different policy periods: 1) pre-universal influenza vaccination program; 2) universal publicly funded program; and 3) universal publicly funded program with the addition of pharmacists 6. The study used census data and aggregate immunization data obtained from the Nova Scotia Department of Health and Wellness 6. The study design was observational, as it analyzed existing data rather than conducting a randomized controlled trial or other experimental study.

Setting: Nova Scotia, Canada

Population of Focus: The target audience of the PDF file is likely researchers, healthcare professionals, and individuals interested in public health and related topics. The scientific literature and resources included in the file are intended for those with a background in the field and may contain technical language and data analysis.

Sample Size: The PDF file contains multiple studies and reports related to public health, and each study may have a different sample size. Without a specific study or report in question, it is not possible to provide a definitive answer regarding the sample size.

Age Range: The PDF file contains information related to influenza vaccination coverage for Nova Scotia residents aged six months of age and older ,[object Object],. Additionally, the study discusses influenza vaccine coverage in infants, which was found to have been steadily increasing throughout the pre-universal program period, with a large increase with the addition of the universal policy in 2010–2011 after which coverage declined for the remainder of the study period ,[object Object],.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Prenatal Care Access, Targeting Interventions to Focused Groups

Intervention Description: The intervention in this study was Pennsylvania's criminal sentencing reform policy, which aimed to reduce the state's prison population by implementing revised sentencing guidelines and increasing investments in community-based services. The policy was implemented in 2012 and was expected to reduce the number of people admitted to state prisons in Pennsylvania. The study aimed to evaluate the impact of this policy on early and adequate prenatal care utilization among birthing people in Pennsylvania, with a focus on effect heterogeneity across birthing person race/ethnicity and educational attainment. The study found that the benefits of the policy for prenatal care were largely limited to counties where prison admission rates declined the most after the policy, and improvements were primarily observed among groups that are more likely to be affected by prison admissions, Black birthing people and those with lower levels of education

Intervention Results: The study found that in counties where prison admissions declined the most after the policy, early prenatal care increased from 69.0% to 73.2%, and inadequate prenatal care decreased from 18.1% to 15.9%. By comparison, improvements in early prenatal care were smaller in counties where prison admissions increased the most post-policy (73.5 to 76.4%) and there was no change to prenatal care inadequacy (14.4% pre and post). The study found this pattern of improvements to be particularly strong among Black birthing people and those with lower levels of educational attainment. The study concluded that Pennsylvania's sentencing reforms were associated with small advancements in racial and socioeconomic equity in prenatal care. However, the study also noted that incremental changes to criminal justice policy are unlikely to have broad effects for health equity, and transformative policy changes in the areas of healthcare, social welfare, and criminal justice together will be necessary to see dramatic shifts in preventative healthcare inequities.

Conclusion: The study concluded that Pennsylvania's criminal sentencing reform policy was associated with small advancements in racial and socioeconomic equity in prenatal care utilization. The study found that the benefits of the policy for prenatal care were largely limited to counties where prison admission rates declined the most after the policy, and improvements were primarily observed among groups that are more likely to be affected by prison admissions, Black birthing people and those with lower levels of education. The study also noted that incremental changes to criminal justice policy are unlikely to have broad effects for health equity, and transformative policy changes in the areas of healthcare, social welfare, and criminal justice together will be necessary to see dramatic shifts in preventative healthcare inequities. The study highlights the importance of contextual conditions of incarceration for preventative healthcare access and utilization and sheds light on how criminal justice reforms may have spillover effects for healthcare utilization and health equity.

Study Design: The study design was an interrupted time series analysis using individual-level birth certificate data linked to county-level rates of prison admissions in Pennsylvania from 2009 to 2015. The study aimed to evaluate the impact of Pennsylvania's criminal sentencing reform policy on early and adequate prenatal care utilization, with a focus on effect heterogeneity across birthing person race/ethnicity and educational attainment. The study used Poisson regression models with robust error variance to estimate changes in prenatal care utilization after the policy, stratified by quartiles of county-level pre-post difference in mean monthly prison admission rates. The study design allowed for the assessment of changes in prenatal care utilization over time, before and after the policy, and across different subgroups of the population.

Setting: The setting for this study is Pennsylvania, focusing on the period from 2009 to 2015. The researchers linked individual-level birth certificate data to monthly county-level rates of prison admissions in Pennsylvania during this time frame. By examining the effects of Pennsylvania's criminal sentencing reform on prenatal healthcare access and equity, the study provides valuable insights into the impact of policy changes on healthcare utilization in the context of the criminal justice system

Population of Focus: The target audience for this study is likely researchers, policymakers, and healthcare professionals interested in understanding the impact of criminal justice policies on healthcare access and equity, particularly in the context of prenatal care. The study provides important insights into the potential benefits of reducing incarceration rates for improving early and adequate prenatal care, particularly for marginalized communities. The findings may be of interest to those working in public health, criminal justice reform, and healthcare policy.

Sample Size: Thestudy used individual-level birth certificate microdata on births in Pennsylvania from 2009 to 2015, totaling 999,503 births. This large sample size allowed the researchers to assess the effects of Pennsylvania's criminal sentencing reform on prenatal healthcare access and equity across a significant number of births in the state. The substantial sample size contributes to the robustness of the study's findings.

Age Range: The study did not report a specific age range for the birthing people included in the sample. However, the study did collect data on self-reported age (< 19, 20–29, 30–39, 40 + years) as an individual-level covariate in their statistical analysis. Therefore, the study likely included birthing people across a range of ages, from under 19 to over 40 years old.

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Quality Improvement, Policy/Guideline (State)

Intervention Description: A quality improvement course was introduced to reduce the caesarean section rate among nulliparas women and to find out which group of women reduced the cesarean section rate following attendance at the course. The course was dedicated to delivery-related staff from all Lithuanian hospitals providing obstetrical care. All hospitals had their representatives attending the course. They included not only obstetricians and gynecologists but also midwives, neonatologists and nurses. The aim of the course was to ensure that all Lithuanian hospitals providing obstetrical care had the same obstetrical knowledge and provided standardized care in managing the same obstetrical situations. The course consisted of educational sessions and practice drills. The core of educational sessions was a file of evidence-based obstetrical guidelines that were distributed nationally.

Intervention Results: Nulliparas accounted for 43% (3746/8718) and 44.6% (3585/8046) of all the deliveries in 2012 and 2014 years, respectively. The CS rate among nulliparas decreased from 23.9% (866/3626) in 2012 to 19.0% (665/3502) in 2014 (p < 0.001).The greatest decrease in absolute contribution to the overall CS rate was recorded in groups 1 (p = 0.005) and 2B (p < 0.001). Perinatal mortality was 3.5 in 2012 and 3.1 in 2014 per 1000 deliveries (p = 0.764).

Conclusion: The TGCS can work as an audit intervention that could help to reduce the CS rate without a negative impact on perinatal mortality.

Setting: Lithuanian hospitals

Population of Focus: Nulliparous low risk women

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Quality Improvement, Policy/Guideline (State)

Intervention Description: A quality improvement course was introduced to reduce the caesarean section rate among nulliparas women and to find out which group of women reduced the cesarean section rate following attendance at the course. The course was dedicated to delivery-related staff from all Lithuanian hospitals providing obstetrical care. All hospitals had their representatives attending the course. They included not only obstetricians and gynecologists but also midwives, neonatologists and nurses. The aim of the course was to ensure that all Lithuanian hospitals providing obstetrical care had the same obstetrical knowledge and provided standardized care in managing the same obstetrical situations. The course consisted of educational sessions and practice drills. The core of educational sessions was a file of evidence-based obstetrical guidelines that were distributed nationally.

Intervention Results: Nulliparas accounted for 44.6% (3585/8046) and 42.9% (3628/8460) of all the deliveries in 2014 and 2016 years, respectively. The CS rate among nulliparas decreased from 19.0% (665/3502) in 2014 to 16.8% (593/3526) in 2016 (p = 0.018). The greatest decrease in absolute contribution to the overall CS rate was recorded in group 1 (p = 0.08). Perinatal mortality was 3.1 in 2014 and 3.9 in 2016 per 1000 deliveries (p = 0.569).

Conclusion: The QIC has helped to reduce the CS rate among nulliparas without a negative influence on perinatal mortality. The greatest decrease in the overall CS rate was recorded among nulliparous women who were treated with oxytocin and managed to reach a full cervical dilatation.

Setting: Lithuanian hospitals

Population of Focus: Nulliparous low risk women

Intervention Components (click on component to see a list of all articles that use that intervention): Data Collection System, Policy/Guideline (State),

Intervention Description: Policy Change to include new age groups ex. 13-18 for free vaccination program

Intervention Results: The study found that vaccination coverage was highest among individuals aged 65 and above, followed by children aged 12 and below, and adults aged 62-64. Vaccination coverage was lowest among individuals aged 13-18 and those aged 19-61. Individuals living in rural areas had higher vaccination coverage than those living in urban areas. Higher vaccination coverage was also observed among those with lower education levels and higher incomes.

Conclusion: The study concluded that there are disparities in influenza vaccination coverage among different age groups and sociodemographic factors in South Korea.

Study Design: The study used a cross-sectional design.

Setting: The study was conducted in South Korea.

Population of Focus: The target audience was individuals aged 13 and above, including adults aged 62-64, children aged 13-18, adults aged 65 and above, pregnant women, and individuals aged 19-64 with chronic diseases.

Sample Size: The study included 72,443 participants.

Age Range: The study included individuals aged 13 and above.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: N/A

Intervention Results: State driver's license and sanctuary policies were associated with having a usual source of care and fewer unmet medical needs among children of immigrants.

Conclusion: The recent pandemic highlights the importance of access to preventative health care. State policies that limit federal immigration enforcement involvement are associated with improved access to preventative health services among immigrants' children, most of whom are U.S. citizens.

Study Design: OLS regression (difference-in-difference)

Setting: 2008-2016 Medical Panel Expenditure Survey

Population of Focus: Immigrants

Sample Size: 66314

Age Range: 0-17

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Social Supports, Housing Supports

Intervention Description: using counterfactual machine learning to identify the services most likely to prevent reentry into homelessness for each household.

Intervention Results: Homelessness prevention benefited households who could access it, while differential effects exist for homeless households that partially align with community interests.Households with comorbid health conditions avoid homelessness most when provided longer-term supportive housing, and families with children fare best in short-term rentals. No additional differential effects existed for intersectional subgroups. Prioritization rules reduce community-wide homelessness in simulations. Moreover, prioritization mitigated observed reentry disparities for female and unaccompanied youth without excluding Black and families with children.

Conclusion: Community-and data-driven prioritization rules more equitably target scarce homeless resources.

Setting: St. Louis, Missouri

Population of Focus: policymakers, community stakeholders, social service providers, researchers

Sample Size: 10,043 households that accessed homeless services in St. Louis from 2009 to 2014

Age Range: 18 to 24 years for unaccompanied homeless youth, with an average age of 39.5 years (SD = 12.8) for household heads entering services

Intervention Components (click on component to see a list of all articles that use that intervention): Collaboration with Local Agencies (State), Policy/Guideline (State)

Intervention Description: Project LAUNCH incorporates Enhanced Home Visiting as a core strategy. This program pairs families with trained professionals who visit them regularly throughout the child's early years. Home visitors provide a range of supports, including: Developmental screening: Identifying potential delays or concerns in a child's development. Parenting education: Equipping caregivers with skills to promote their child's social, emotional, and cognitive development. Connection to community resources: Linking families with essential services like healthcare, early childhood education, and mental health support. Social and emotional support: Offering guidance and encouragement to parents as they navigate the challenges of raising young children.

Intervention Results: Studies evaluating Project LAUNCH's Enhanced Home Visiting program have shown promising results. Participating families report increased knowledge and confidence in their parenting skills. Additionally, children enrolled in the program demonstrate improved developmental outcomes, particularly in areas like language and social-emotional development.

Conclusion: Project LAUNCH's Enhanced Home Visiting program offers a valuable intervention for families with young children. By providing comprehensive support, education, and resources within the familiar setting of the home, the program empowers parents and fosters healthy child development. Further research is needed to explore the program's long-term impact and cost-effectiveness, but the initial findings suggest that Enhanced Home Visiting can be a powerful tool for improving the well-being of young children and their families.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Access, Patient-Centered Medical Home, Policy/Guideline (State)

Intervention Description: In recent years, families with children have become one of the faster-growing subpopulation groups of homeless individuals, both in the United States and in Europe.1 In the United States, families made up almost one third of the 1.5 million people who were homeless in 2009, and more than half of this group were children (60%).1,2 Children who are homeless experience higher levels of stress and domestic violence compared with those who are not, and research suggests that the vast majority of homeless children have problems with their behavior, encounter difficulties in school, or have a mental health disorder.3

Intervention Results: Three models of care were developed to meet patients at their locations in homeless shelters, providing access to care.

Conclusion: Although children from homeless families are at risk for mental health disorders and developmental delays, flexible service delivery models have been developed to meet their needs. These models need to be rigorously evaluated. Culturally competent care is a crucial aspect of care delivery to “meet families where they are” and establish the kind of trust and mutual respect that is necessary for effective care provision. Timely care coordination is an important aspect of service delivery that may help break down access barriers to developmental and behavioral health care to mitigate the risks for the conditions that homeless children experience.

Setting: New York City

Population of Focus: healthcare providers, policymakers, social workers

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Active Management of Labor, Labor Support, HOSPITAL, STATE, Quality Improvement, Policy/Guideline (State), Collaboratives, Policy/Guideline (Hospital)

Intervention Description: California hospitals whose nulliparous, term, singleton, vertex cesarean delivery rates were above the Healthy People 2020 goal of 23.9% in 2015 were invited to participate in the Supporting Vaginal Birth collaborative led by the California Maternal Quality Care Collaborative (CMQCC). The participating hospitals were organized into small teams of six to eight hospitals each led by a physician and a nurse mentor who provided clinical expertise and quality-improvement coaching. The mentors were from other hospitals and had experience in prior CMQCC quality collaboratives. The collaborative focused on implementation of ACOG–SMFM guidelines for labor management and on increasing nursing labor support. A modified Institute for Healthcare Improvement Breakthrough Series collaborative model was used with monthly team check-in phone calls and sharing of implementation ideas and materials. Hospitals received training materials, Grand Rounds for physicians and nurses, educational webinars, and on-site assistance from their mentors.

Intervention Results: Among collaborative hospitals, the nulliparous, term, singleton, vertex cesarean delivery rate fell from 29.3% in 2015 to 25.0% in 2017 (2017 vs 2015 adjusted OR [aOR] 0.76, 95% CI 0.73-0.78). None of the six safety measures showed any difference comparing 2017 to 2015. As a sensitivity analysis, we examined the tercile of hospitals with the greatest decline (31.2%-20.6%, 2017 vs 2015 aOR 0.54, 95% CI 0.50-0.58) to evaluate whether they had greater risk of poor maternal and neonatal outcomes. Again, no measure was statistically worse, and the severe unexpected newborn complications composite actually declined (3.2%-2.2%, aOR 0.71, 95% CI 0.55-0.92).

Conclusion: Mothers and neonates participating in a large-scale Supporting Vaginal Birth collaborative had no evidence of worsened birth outcomes, even in hospitals with large cesarean delivery rate reductions, supporting the safety of efforts to reduce primary cesarean delivery using American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine guidelines and enhanced labor support.

Setting: 56 California hospitals

Population of Focus: Nulliparous women with term singleton vertex gestations

Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Development/Improvement of Services, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, Consultation Systems (Inter-Hospital Systems), Consultation Systems (Hospital), STATE, Policy/Guideline (State), Funding Support

Intervention Description: This report summarizes the evaluation of a national demonstration program of such regionalization that was funded by the Robert Wood Johnson Foundation (RWJF) in 1975.

Intervention Results: In both funded regions and comparison areas, the neonatal mortality rates decreased sharply over the decade of the 1970s. This decline was linked to shifts in the hospital of delivery that indicated antepartum risk identification and transfer of management of high-risk pregnancies to tertiary centers for delivery, a change in service pattern consistent with some aspects of regionalization. The centralization of high-risk deliveries appeared so widespread that the special effect of the RWJF program could not be detected.

Conclusion: Surveys of surviving 1-year-old infants showed that the decrease in neonatal mortality was accompanied by a decrease in selected morbidity.

Study Design: QE: pretest-posttest nonequivalent control group

Setting: Eight regions and eight comparison regions

Population of Focus: Infants born weighing ≤1500

Data Source: Data from reproduced computer tapes of births and matched infant death and birth certificates obtained from state and local health offices in several states.

Sample Size: Intervention group: Pretest (n≈ 4080) Intervention (n≈ 3416) Posttest: (n≈ 4033) Comparison: Pretest: (n≈ 5221) Intervention: (n≈ 4297) Posttest: (n≈ 4596)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): STATE, Policy/Guideline (State), Funding Support, POPULATION-BASED SYSTEMS, PATIENT/CONSUMER, Educational Material

Intervention Description: The goal of this study was to examine state measurements and improvements in risk-appropriate care for very low birth weight (VLBW) infants.

Intervention Results: Regulation of regionalization programs, data surveillance, review of adverse events, and consideration of geography and demographics were identified as mechanisms facilitating better measurement of risk-appropriate care. Antenatal or neonatal transfer arrangements, telemedicine networks, acquisition of funding, provision of financial incentives, and patient education comprised state actions for improving risk-appropriate care.

Conclusion: Guidelines should be collaboratively developed by healthcare providers and public health officials for consistent and suitable measures of perinatal risk-appropriate care.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The intervention under study is the 2016 California policy to eliminate non-medical childhood vaccination exemptions

Intervention Results: The results of the study include findings related to the impact of the California policy on vaccination coverage, exemptions, and associated outcomes

Conclusion: Our study found that the 2016 California policy to eliminate nonmedical childhood vaccination exemptions was associated with an increase in vaccination coverage and a decrease in nonmedical exemptions.  The study findings support the hypothesis that government policies can be an effective tool to increase vaccination coverage, especially in the most “high- risk” (low vaccine coverage) settings.

Study Design: The study design involves a synthetic control analysis using state-level data and a difference-in-differences analysis using county-level data to estimate the relationship between the California vaccine policy and changes in vaccination coverage, exemptions, and other relevant factors

Setting: The setting of the study is California, specifically focusing on the 2016 California policy to eliminate non-medical childhood vaccination exemptions

Population of Focus: The target audience for the study includes researchers, policymakers, and public health professionals interested in vaccination policies and their impact on vaccination coverage and exemptions.

Sample Size: - The specific sample size is not provided in the excerpt.

Age Range: The age range of the study participants is not explicitly mentioned in the provided text.

Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Continuing Education of Hospital Providers, STATE, Policy/Guideline (State)

Intervention Description: Viewing the 1001-1500 gm regional cohort of fetuses as a potential "market" for center delivery, and measuring a center's penetration into this market, quantitates how well a center draws to itself these small, high-risk fetuses for delivery.

Intervention Results: An Illinois center's annual penetration rate into its regional market for the years 1973-1983 is presented and significant increases are found. The penetration rates of nine Illinois perinatal centers are calculated and wide discrepancies are found. Defining a high-risk regional cohort as a market stresses a perinatal center's obligation to its region.

Conclusion: The penetration rate into a defined market measures how well a center fulfills this obligation.

Study Design: Time trend analysis

Setting: Illinois North Central Perinatal Region: 31 hospitals including one tertiary center

Population of Focus: Infants born weighing 1001 to 1500 gm

Data Source: Data from 1973-1982 obtained from the Illinois Department of Public Health live birth files. Data from 1983 from an Illinois Department of Public Health administered monthly hospital reporting system.

Sample Size: 1973 (n= 100) 1974 (n= 104) 1975 (n= 102) 1976 (n= 88) 1977 (n= 102) 1978 (n= 97) 1979 (n= 101) 1980 (n= 85) 1981 (n= 100) 1982 (n= 83) 1983 (n= 81)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Policy/Guideline (National),

Intervention Description: The intervention was the Medicaid expansion in 2014 under PPACA. The study compared changes in outcomes between states that expanded Medicaid (Iowa, Kentucky) and those that did not (Wisconsin, North Carolina).

Intervention Results: The results showed modest improvements in elective admissions, ambulatory surgery rates, length of stay, and discharge to home in Medicaid expansion states compared to non-expansion states. There were decreases in admission charges.

Conclusion: The conclusion was that PPACA-associated Medicaid expansion modestly improved children’s access to surgical care in the first year, with shifts towards more elective and ambulatory procedures.

Study Design: The study design was a retrospective analysis using administrative/claims data.

Setting: The setting was 4 U.S. states: Iowa, Kentucky, Wisconsin, and North Carolina.

Population of Focus: The target audience seems to be policymakers and researchers interested in the impact of PPACA and Medicaid expansion on children's health outcomes.

Sample Size: The sample size was 1,597,708 encounters across the 4 states.

Age Range: The age range was 0 to 30 years old.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State)

Intervention Description: To determine whether the Healthy People 2000 objective to deliver very-low-birthweight (VLBW) infants at subspecialty perinatal care centres was met, and if improvements in the regional perinatal care system could reduce neonatal mortality further for 2010, we examined place of delivery for VLBW infants, associated maternal characteristics and the potential impact on neonatal mortality.

Intervention Results: Among 4770 VLBW infants, 77% were delivered at hospitals providing subspecialty perinatal care. The strongest predictor of birth hospital level was the mother's county of residence, defined using three levels: residence in a county with a subspecialty hospital, residence in a county adjacent to one with such a hospital or residence in a non-adjacent county. Eighty-nine per cent of infants born to women who resided in counties with subspecialty care hospitals delivered at such hospitals, compared with 53% of infants born to women who resided in a non-adjacent county. Women were also more likely to deliver outside subspecialty care if they had less than adequate prenatal care [adjusted odds ratio (AOR) 1.5, P-value = 0.0001]. The neonatal mortality rate varied by level of perinatal care at the birth hospital from 132.1/1000 to 283/1000 live births, with the highest death rate for infants born at hospitals offering the lowest level of care. Assuming that the differences in mortality were due to care level of the birth hospital, potentially 16-23% of neonatal deaths among VLBW infants could have been prevented if 90% of infants born outside subspecialty care were delivered at the recommended level.

Conclusion: These findings suggest that a state's support of strong, collaborative, regional perinatal care networks is required to ensure that high-risk women and infants receive optimal health care. Improved access to recommended care levels should further reduce neonatal mortality until interventions are identified to prevent VLBW births.

Study Design: N/A

Setting: Studies from Georgia

Data Source: linked birth and death records for the 1994–96 Georgia VLBW (i.e. 500–1499 g) birth cohorts.

Sample Size: 4770 infants

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Social Supports,

Intervention Description: We interviewed 20571 low-income caregivers of children <4 years old in urban pediatric clinics and/or emergency departments in 5 US cities. Categories of homelessness timing were prenatal, postnatal, both, or never; postnatal duration was >6 months or <6 months.

Intervention Results: After controlling for birth outcomes and other potential confounders, compared with never-homeless children, children who were homeless both pre- and postnatally were at the highest risk of the following: postneonatal hospitalizations (adjusted odds ratio [aOR] 1.41; confidence interval [CI] 1.18–1.69), fair or poor child health (aOR 1.97; CI 1.58–2.47), and developmental delays (aOR 1.48; CI 1.16–1.89). There was no significant association with risk of underweight (aOR 0.95; CI 0.76–1.18) or overweight status (aOR 1.07; CI 0.84–1.37). Children <1 year old with >6 months of homelessness versus those who were never homeless had high risks of fair or poor health (aOR 3.13; CI 2.05–4.79); children 1 to 4 years old who were homeless for >6 months were at risk for fair or poor health (aOR 1.89; CI 1.38–2.58).

Conclusion: After controlling for birth outcomes, the stress of prenatal and postnatal homelessness was found to be associated with an increased risk of adverse pediatric health outcomes relative to those who were never homeless. Interventions to stabilize young families as quickly as possible in adequate and affordable housing may result in improved pediatric health outcomes.

Study Design: cross-sectional study

Setting: 5 US cities

Population of Focus: healthcare professionals & policymakers

Sample Size: 20 571 low-income caregivers of children <4 years old

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): STATE, Policy/Guideline (State)

Intervention Description: This population-based cross-sectional study included infants who were born VPT to Illinois residents in Illinois perinatal-network hospitals between January 1, 2015, and December 31, 2016, and followed up for 28 days after birth. Data analysis was conducted from June 2017 to September 2018. Delivery of an infant who was VPT at a (1) level III hospital after maternal presentation at that hospital (reference group), (2) a level III hospital after antenatal (in utero) transfer from another hospital, or (3) a non–level III hospital.

Intervention Results: The study included 4817 infants who were VPT (gestational age, 22-31 completed weeks) and were born to Illinois residents in 2015 and 2016. Of those, 3302 infants (68.5%) were born at a level III hospital after maternal presentation at that hospital, 677 (14.1%) were born at a level III hospital after antenatal transfer, and 838 (17.4%) were born at a non–level III hospital. Neonatal mortality for all infants who were VPT included in this study was 573 of 4817 infants (11.9%). The neonatal mortality was 10.7% for the reference group (362 of 3302 infants), 9.8% for the antenatal transfer group (66 of 677 infants), and 17.3% for the non–level III birth group (145 of 838 infants). When adjusted for significant social and medical characteristics, infants born VPT at a level III hospital after antenatal transfer from another facility had a similar risk of neonatal mortality as infants born at a level III hospital (odds ratio, 0.79 [95% CI, 0.56-1.13]) after maternal presentation at the same hospital. Infants born at a non–level III hospital had an increased risk of neonatal mortality compared with infants born at a level III hospital after maternal presentation to the same hospital (odds ratio, 1.52 [95% CI, 1.14-2.02]).

Conclusion: The risk of neonatal mortality was similar for infants who were VPT, whether women initially presented at a level III hospital or were transferred to a level III hospital before delivery. This suggests that the increased risk of mortality associated with delivery at a non–level III hospital may be mitigated by optimizing opportunities for early maternal transfer to a level III hospital.

Setting: Hospitals in the Illinois perinatal network

Population of Focus: Very preterm infants delivered at one of the following: (1) level III hospital after maternal presentation at that hospital (reference group), (2) a level III hospital after antenatal (in utero) transfer from another hospital, or (3) a non–level III hospital

Intervention Components (click on component to see a list of all articles that use that intervention): Social Media, Policy/Guideline (State),

Intervention Description: The interventions include the suspension of mandatory vaccination in the Veneto Region, strengthened political commitment leading to the release of an updated National Immunization Prevention Plan, and the influence of social media influencers like Professor Roberto Burioni in promoting vaccination.

Intervention Results: The results highlight the impact of different interventions on vaccine coverage rates, changes in public attitudes towards immunization, and the success of social media influencers in promoting vaccination.

Conclusion: The study provides insights into the effectiveness of various vaccination strategies and offers a basis for discussion within the European public health community to evaluate similar policies implemented in different settings.

Study Design: The study employs a real-life case study approach to evaluate the impact of different vaccination strategies implemented in Italy. It critically appraises the strategies and quantitatively assesses their impact on coverage rates and other selected indicators.

Setting: The setting of the study is Italy, focusing on the implementation and impact of vaccination strategies within the country.

Population of Focus: The target audience includes the general population, public health practitioners, decision makers, and the broader European public health community.

Sample Size: The sample size is not explicitly mentioned in the provided excerpts.

Age Range: The age range of the study participants is not explicitly specified in the provided excerpts.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Social Supports, Counseling (Parent/Family), Housing Supports

Intervention Description: Design: Participants were randomly assigned to: (1) housing + support services (n = 80), (2) housing-only (n = 80), or (3) services as usual (SAU) (n = 80) and were re-assessed at 3-, 6-, 9- and 12-months postbaseline. Settings: The study recruited a community-based sample from homeless service agencies and advertisements in a large Midwestern city. Participants: The study recruited two hundred forty (N = 240) women between the ages of 18 to 24 years, experiencing homelessness and with a substance use disorder (SUD) who also had a biological child under the age of 6 years in their care. Measurements: We measured frequency of alcohol and drug use using the Form 90 semi-structured interview, and self-efficacy using Pearlin and Schooler's (1978) 7-item Mastery Scale.

Intervention Results: mothers showed significant improvement in substance use and self-efficacy over time in each condition. However, as expected, patterns of change differentiated intervention groups with more mothers showing better substance use and self-efficacy outcomes in housing + supportive services than in SAU. Unexpectedly, more mothers in SAU showed better outcomes than those in housing-only.

Conclusion: Substance use decreased and self-efficacy increased over time, but patterns of change characterized the intervention groups. In particular, findings suggest that when providing housing to this population, supportive services should also be offered.

Setting: large Midwestern city

Sample Size: (1) housing + support services (n = 80), (2) housing-only (n = 80), or (3) services as usual (SAU) (n = 80) and were re-assessed at 3-, 6-, 9- and 12-months postbaseline.

Age Range: women between the ages of 18 to 24 years, experiencing homelessness and with a substance use disorder (SUD) who also had a biological child under the age of 6 years in their care.

Intervention Components (click on component to see a list of all articles that use that intervention): Public Insurance (State), Policy/Guideline (State), Medicaid Reform,

Intervention Description: The study aimed to examine whether this health reform was associated with reduced uninsurance and greater access to care for children at one and five years post-reform. The health reform implemented in Massachusetts, also known as Chapter 58, aimed to provide near-universal health insurance coverage to the state's residents. The reform was signed into law in 2006 and required all residents to have health insurance or face penalties. The reform also expanded Medicaid and created a state-run health insurance exchange, the Health Connector, to provide affordable health insurance options to individuals and small businesses. The reform also included subsidies to help low-income individuals and families afford health insurance.

Intervention Results: Compared to other New England states, Massachusetts's enactment of the individual mandate, Medicaid expansion, and essential benefits was associated with trends at 5 years post-reform toward lower uninsurance for children overall (DD = - 1.1, p-for-DD = 0.05), increased access to specialty care (DD = 7.7, p-for-DD = 0.06), but also with a decrease in access to preventive care (DD=-3.4, p-for-DD = 0.004). At 1 year post-reform, access to specialty care improved for children newly-Medicaid-eligible (DD = 18.3, p-for-DD = 0.03).

Conclusion: Adult-oriented health reforms may have reduced uninsurance and improved access to some types of care for children in Massachusetts. Repealing the ACA may produce modest detriments for children.

Study Design: Difference in difference analysis

Setting: State (Massachusetts)

Population of Focus: CSHCN in Massachusetts

Sample Size: 34,943 children (5,760 children in Massachusetts, 28,183 children in comparison New England states)

Age Range: 0-17 years

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: Paid family leave implemented in the state of Rhode Island in 2014

Intervention Results: The policy was associated with a 2.18 percentage point increase (95% CI 0.98, 3.38, P=.004) in postpartum care. The increase in postpartum care associated with Rhode Island's paid family leave policy was 1.50 percentage points (95% CI 0.75, 2.25, P=.002) among White women. The policy was associated with a 3.38 percentage point increase (95% CI 1.12, 5.63, P=.009) among women from underrepresented racial groups, an effect size that was 1.92 percentage points (95% CI 0.58, 3.26, P=.005) greater than among White women

Conclusion: Increased paid leave in the United States may help reduce existing racial disparities in postpartum care use. It remains to be determined whether increased postpartum care leads to improved health outcomes.

Study Design: Retrospective observational study that used a difference-in-differences analysis

Setting: Rhode Island

Population of Focus: Postpartum women

Sample Size: 43,609 women (5,453 from Rhode Island and 38,156 from other northeastern states)

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Access,

Intervention Description: analyze the frequency and costs of pediatric ED visits for homelessness before and after this policy.

Intervention Results: There were 312 ED visits for homelessness; 95% (n = 297) of visits were after the policy. These visits increased 4.5 times after the policy (95% confidence interval: 1.33 to 15.23). Children seen after the policy were more likely to have no medical complaint (rate ratio: 3.27; 95% confidence interval: 1.18 to 9.01). Although the number of homeless children in Massachusetts increased 1.4 times over the study period, ED visits for homelessness increased 13-fold. Payments (average: $557 per visit) were >4 times what a night in a shelter would cost; 89% of payments were made through state-based insurance plans.

Conclusion: A policy change to Massachusetts’ shelter eligibility was associated with increased pediatric ED visits for homelessness along with substantial health care costs.

Study Design: retrospective study

Setting: Massachusetts

Age Range: families with children

Intervention Components (click on component to see a list of all articles that use that intervention): Continuity of Care (Caseload), Policy/Guideline (State), Care Coordination,

Intervention Description: N/A

Intervention Results: Persons with complex disabilities more frequently experienced continuity (83.7%) than persons without disabilities and those with basic disabilities (60.7% and 65.6%, respectively, p < 0.001). Seldom or never being sick was the most frequently reported reason for not having a usual provider; more persons without disabilities (64%) reported this reason than persons with disabilities (basic: 41.9%, p < 0.001; complex: 26.6%, p = 0.001). Persons with disabilities more frequently reported visiting different providers for different needs and not having a usual provider due to the costs of medical care than persons without disabilities.

Conclusion: Future research needs to examine the influence of continuity on healthcare disparities among persons with complex disabilities. Policies and practice must be attentive to how proposed changes to the healthcare system potentially reduce access to care among persons with disabilities.

Study Design: Pooled 2-year data from panels 14-16 (2009-2012) of the Medical Expenditure Panel Survey were examined. Working-age adults (18-64) were categorized as having no disability, basic disabilities, or complex disabilities. Persons were categorized having provider continuity (provider throughout the period) or discontinuity (gaining or losing providers during the period). χ2 and multinomial logistic regressions were used to examine outcomes by disability status.

Setting: Medical Expenditure Panel Survey

Population of Focus: Persons with disabilities

Sample Size: 26867

Age Range: 18-64

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The intervention described in the document is the implementation of a mandatory immunization program in Italy in July 2017. This program mandated ten vaccinations for children up to 16 years old, including vaccinations for diphtheria, tetanus, pertussis, hepatitis B, polio, Haemophilus influenzae type b (Hib), measles, mumps, rubella, and varicella. The policy was adopted as part of the national response to a large outbreak of measles and aimed to address the decline in vaccine coverage (VC) that had occurred in previous years. The mandatory law required school-aged children to have completed the vaccination cycles in order to attend educational services, leading to an immediate impact on vaccine coverage. Additionally, catch-up activities were carried out to identify and offer mandatory vaccinations to unvaccinated or partly vaccinated children. These activities were monitored through the regional immunization information system (rIIS) and other indicators to assess their impact.

Intervention Results: The results reported in the document include the following key findings: 1. Impact on Vaccine Coverage: The mandatory law had an immediate impact on vaccine coverage, leading to an increase in measles vaccine coverage at 24 months of age to 91.81% in 2017 and 93.22% in 2018, with a total increase of 5.96% compared to the previous year. This increase was observed at both regional and national levels. 2. Catch-up Activities: Catch-up activities resulted in a substantial increase in measles vaccine coverage for the 2014 and 2015 birth cohorts, with a respective increase of +5.65% and +1.75% registered in Tuscany. As a result, one-dose measles vaccine coverage exceeded the World Health Organization target of 95% for these birth cohorts. 3. Identification of Unvaccinated/Partly Vaccinated Children: In Tuscany, systematic scrutiny of the rIIS led to the identification of 1528 unvaccinated/partly vaccinated children, representing 6.6% of the 2016 birth cohort in the region. Information on the reasons for incomplete vaccination status was available for 1503 of these children. 4. Reasons for Incomplete Vaccination: The document provides information on the reasons for incomplete vaccination status, including

Conclusion: In our opinion, mandates did not only affect hesitant parents, but forced local health services to allocate more resources to immunisation activities and to be more effective as a whole.

Study Design: The study design in the provided document appears to be an observational study that assesses the impact of the 2017 mandatory immunization program on various outcomes related to vaccination in the Tuscany region of Italy. The study utilizes data from the regional immunization information system (rIIS) and other sources to evaluate changes in vaccine coverage, organization of immunization services, catch-up activities, and reasons for delaying or refusing immunization. The study also discusses the impact of the mandatory law on vaccine hesitancy and public health services. The document does not explicitly state the study design, but based on the information provided, it aligns with an observational study.

Setting: The setting of the study is Tuscany, a region of central Italy with approximately 3.7 million inhabitants, corresponding to 6.2% of the national population. The study focuses on the impact of the 2017 mandatory immunization program on a broader spectrum of relevant outcomes, such as vaccine coverage, organization of immunization service and catch-up activities, regional immunization information system (rIIS) data quality, and reasons for delaying/refusing immunization in Tuscany. ,[object Object],

Population of Focus: The target audience of this PDF file is likely to be healthcare professionals, policymakers, and researchers interested in the impact of mandatory vaccination policies on vaccine coverage and vaccine hesitancy. It may also be of interest to the general public who are concerned about vaccination and public health policies.

Sample Size: The sample size mentioned in the document refers to the number of unvaccinated or partly vaccinated children identified through the regional immunization information system (rIIS) in Tuscany. Specifically, the document states that 1528 unvaccinated/partly vaccinated children were identified, representing 6.6% of 23,321 children in the 2016 birth cohort in the region. Additionally, information on the reasons for incomplete vaccination status was available for 1503 (98.4%) of these children. ,[object Object],

Age Range: The age range mentioned in the document is up to 16 years old, as this is the age range for which the Italian government mandated ten vaccinations in July 2017. The mandatory vaccinations were for children up to 16 years old, including vaccinations for diphtheria, tetanus, pertussis, hepatitis B, polio, Haemophilus influenzae type b (Hib), measles, mumps, rubella, and varicella. ,[object Object],

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Family-Based Interventions, Housing Supports

Intervention Description: A grounded theory approach was used to analyze semi-structured, qualitative interviews.

Intervention Results: Frontline providers exercised street-level bureaucratic discretion when interpreting child protection reporting mandates and they found ways to adapt the HF model to this population. In doing so, they worked to juggle both their mandates to child protection and to principles of HF to create a “child safety-modified” form of HF.

Conclusion: While our study shows that providers are modifying HF to address the needs of families involved in child welfare, it also raises questions as to the degree to which HF can be done with high fidelity when used with this population.

Study Design: grounded theory

Setting: 2 U.S. States

Sample Size: 13 participants working in programs that encouraged direct collaboration with Child Protective Services (CPS) in the program model and 13 participants from three non-CPS-aligned sites in a second state.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: Components of the T21 policy include 1) increase in minimum purchasing age to 21 2) restrictions on tobacco sales to individuals under 21 3) policy implementation and 4) ongoing surveillance

Intervention Results: The unweighted sample included 12 616 high school students (27.0% [95% CI, 26.9%-28.0%] in 10th grade; 50.9% [95% CI, 50.3%-51.6%] females) participating in 1 or more Youth Risk Behavior Surveys from 2013 to 2019, including 7064 students in Cleveland and 5552 students in the first-ring suburbs. Compared with the first-ring suburbs, Cleveland had a greater proportion of younger students (1623 [28.5%] ninth grade students vs 2179 [34.0%] ninth grade students) and Hispanic students (436 students [1.1%] vs 1433 students [12.6%]) and non-Hispanic Black students (2000 students [53.1%] vs 3971 students [75.1%]). Cigars were the most commonly used tobacco product in Cleveland, with use reported by 6201 students (19.8%) in 2013, 5877 students (21.3%) in 2015, and 5784 students (16.8%) in 2019. Compared with the first-ring suburbs, there was a greater decline in prevalence of use of cigars in Cleveland (β = 0.18 [SE, 0.05]; P < .001). The disparity across race, ethnicity, and sex decreased for all current tobacco product use. For example, the maximum difference between demographic subpopulations in current cigarette use was 11.6 (95% CI, 9.5-13.7) percentage points in 2013 between White females (16.1% [95% CI, 11.3%-20.8%]) and Black males (4.5% [95% CI, 3.5%-5.4%]). This maximum difference in current cigarette use decreased significantly to 5.1 (95% CI, 3.5-6.7) percentage points in 2019 between White females (6.9% [95% CI, 3.4%-10.3%]) and Black females (1.8% [95% CI, 0.7%-2.8%]).

Conclusion: This survey study found that there was a decline in youth-reported tobacco use across every tobacco product category from 2013 to 2019. This decline changed the trajectory of use among several demographic groups and brought the youth populations with the highest tobacco product use to similar rates of others.

Study Design: Survey analysis

Setting: Cuyahoga County, Ohio (and "first ring suburbs")

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: 12616 high school students (7064 from Cleveland, 5552 students from the FRS)

Age Range: ages 14-18

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The policy examined in the study is Tobacco 21 (T21), which refers to the minimum legal sales age for tobacco products being raised from 18 to 21 years old.

Intervention Results: After adjusting for baseline tobacco use and other demographics, T21-exposed eighth and ninth-grade students had significantly lower odds of tobacco use than unexposed peers in five of eight models, i.e. any tobacco (aOR = 0.80, 95% CI: 0.74, 0.87), cigarettes (aOR = 0.81, 95% CI: 0.67, 0.99), e-cigarettes (aOR = 0.78, 95% CI: 0.71, 0.85), flavored tobacco (aOR = 0.79, CI: 0.70, 0.89), and dual/poly tobacco (aOR = 0.77, 95% CI: 0.65, 0.92). T21-exposed eleventh-grade students did not differ significantly in their odds of any tobacco use outcomes relative to their unexposed peers.

Conclusion: T21 exposure is associated with lower odds of multiple forms of tobacco use, particularly among younger adolescent populations, supporting the implementation of T21 policies to reduce tobacco use in this population.

Study Design: Cross-sectional survey analysis

Setting: Minnesota, USA

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: 107981 youth from 2016; 102196 youth from 2019

Age Range: ages 13-18 (Grades 8, 9, 11)

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The intervention described in this study is the implementation of state-level dependent coverage expansion (DCE) policies, with or without additional health reforms such as an individual mandate, establishment of an exchange, Medicaid expansion, and prohibition of pre-existing condition exclusions.

Intervention Results: Implementation of DCE with other reforms was significantly associated with a 23 percent reduction in exit from dependent coverage among AYA compared to the reduction observed for DCE alone. Additionally, comprehensive reforms were associated with over two additional years of dependent coverage for the average AYA and a 33 percent increase in the odds of regaining dependent coverage after a prior loss.

Conclusion: Findings suggest that an individual mandate and other reforms may enhance the effect of DCE in preventing loss of coverage among AYA.

Study Design: Pre/post comparison

Setting: State (Massachusetts, Maine, New Hampshire)

Population of Focus: Adolescents and young adults enrolled as dependeings in commercial health plans in Massachusetts, Maine, and New Hampshire

Sample Size: 131,542 adolescents and young adults

Age Range: 16-18 years

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State),

Intervention Description: The introduction of new evidence-informed alcohol warning labels (AWLs) on alcohol containers sold in the government-run liquor store in Whitehorse, Yukon

Intervention Results: Total per capita retail alcohol sales in Whitehorse decreased by 6.31% (t test p < .001) during the intervention. Per capita sales of labeled products decreased by 6.59% (t test p < .001), whereas sales of unlabeled products increased by 6.91% (t test p < .05). There was a still larger reduction occurring after the intervention when pregnancy warning labels were reintroduced (-9.97% and -10.29%, t test p < .001).

Conclusion: Applying new AWLs was associated with reduced population alcohol consumption. The results are consistent with an accumulating impact of the addition of varying and highly visible labels with impactful messages.

Study Design: Interrrupted time series analysis

Setting: Whitehorse, Yukon, Canada, and the surrounding regions

Population of Focus: Individuals who consumer alcohol in the region

Sample Size: 300,000 alcohol warning labels to 98% of alcohol containers sold in Whitehorse during the intervention period

Age Range: ≥15