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Publications from RAND Health Care Researchers

Options for Improving Timely Access to Care Reporting in California 2019

Jeanne S. Ringel, Glenn Melnick, Claude Messan Setodji, Robert Reddick, Susan M. Paddock
The state of California has taken the lead in developing metrics, standards, and a methodology for collecting the needed data for monitoring timely access to health care, but health plans have faced numerous challenges in collecting and reporting this information. This report focuses on specific concerns with the methodology; the authors use a multipronged approach to describe and document these issues and identify and assess potential solutions.
Rural-Urban Disparities in Access to Home- and Community-Based Services and Supports: Stakeholder Perspectives From 14 States 2019

Daniel Siconolfi, Regina A. Shih, Esther M. Friedman, Virginia Kotzias, Sangeeta C. Ahluwalia, Jessica Phillips, Debra Saliba
This paper presents findings from a qualitative study examining the impact of the Medicaid Balancing Incentive Program. The analysis in this paper examines factors associated with rural disparities in access to home and community-based services.
Federal Block Grants to States for Mental Health, Substance Abuse, and Homelessness: Potential Improvements to Funding Formulas 2019

J. Scott Ashwood, Karen Chan Osilla, Maria DeYoreo, Joshua Breslau, Jeanne S. Ringel, Cheryl K. Montemayor, Nima Shahidinia, David M. Adamson, Margaret Chamberlin, M. Audrey Burnam
RAND researchers analyzed the formulas for distributing funds to states under three block grants for services related to mental health, substance abuse, and homelessness (unchanged since 1992) to determine whether they should be modified.
Review and Evaluation of the Substance Abuse, Mental Health, and Homelessness Grant Formulas 2019

J. Scott Ashwood, Karen Chan Osilla, Maria DeYoreo, Joshua Breslau, Jeanne S. Ringel, Cheryl K. Montemayor, Nima Shahidinia, David M. Adamson, Margaret Chamberlin, M. Audrey Burnam
The formulas for distributing funds to states under three block grants (the Community Mental Health Services Block Grant, the Substance Abuse Prevention and Treatment Block Grant, and the Projects for Assistance in Transition from Homelessness program) have not been updated since 1992. RAND researchers conducted this congressionally mandated study to determine whether the formulas should be modified.
Identifying Safety-Net Resources at Health Centers to Prevent Infectious Disease Transmission Resulting from the Opioid Epidemic 2019

Joshua Breslau, Ryan K. McBain, Molly Simmons
This study highlights factors that affect Community Health Centers' ability to reduce infectious disease transmission related to the opioid epidemic. The emphasis is on rural areas, which have suffered disproportionately from the opioid epidemic and lack resources to address the complex social and medical issues related to opioid use, opioid use disorder, and risk for infectious diseases.
Depression Subtypes in Persons with or at Risk for Symptomatic Knee Osteoarthritis 2019

Alan M. Rathbun, Megan S. Schuler, Elizabeth A. Stuart, Michelle D. Shardell, Michelle S. Yau, Joseph J. Gallo, Alice S. Ryan, Marc C. Hochberg
Among persons with or at-risk for symptomatic knee OA, there is evidence of depression subtypes characterized by distinct clusters of depressive symptoms that have differential effects on reports of pain and disability overtime.
Sexual Minority Disparities in Opioid Misuse, Perceived Heroin Risk and Heroin Access Among a National Sample of US Adults 2019

Megan S. Schuler, Andrew W. Dick, Bradley D. Stein
LGB opioid disparities varied significantly by sexual identity &gender. All LGB subgroups had elevated lifetime pain reliever misuse. Bisexual women uniquely had elevated OUD rates and lifetime injection heroin use.
Associations of Longitudinal Sleep Trajectories with Risky Sexual Behavior During Late Adolescence 2019

Wendy M. Troxel, Anthony Rodriguez, Rachana Seelam, Joan S. Tucker, Regina A. Shih, Elizabeth J. D'Amico
Insufficient sleep in adolescents may increase risk for sexual risk-taking and may set the stage for accelerated health risk trajectories into adulthood.
Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain 2019

Patricia M. Herman, Mallika Kommareddi, Melony E. Sorbero, Carolyn M. Rutter, Ron D. Hays, Lara Hilton, Gery W. Ryan, Ian D. Coulter
This study describes the characteristics of a large sample of chronic low back pain and chronic neck pain patients in the United States who use chiropractic care for their chronic low back pain and chronic neck pain.
The Use of Complementary and Integrative Health Approaches for Chronic Musculoskeletal Pain in Younger US Veterans: An Economic Evaluation 2019

Patricia M. Herman, Anita H. Yuan, Matthew Cefalu, Karen Chu, Qing Zeng, Nell J. Marshall, Karl Lorenz, Stephanie L. Taylor
Chronic pain is prevalent among Veterans in general, but especially among younger Veterans, including participants in Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn. Musculoskeletal pain is the most common type of chronic pain. This pain also often co-occurs with conditions such as anxiety, depression, post-traumatic stress disorder, and substance abuse.
Yoga Versus Education for Veterans With Chronic Low Back Pain: Study Protocol For a Randomized Controlled Trial 2019

Robert B. Saper, Chelsey M. Lemaster, A. Rani Elwy, Ruth Paris, Patricia M. Herman, Dorothy N. Plumb, Karen J. Sherman, Erik J. Groessl, Susan V Lynch, Shihwe Wang, et al.
This study will help determine if yoga can become an effective treatment for Veterans with chronic low back pain and psychological comorbidities.
Use of Complementary and Integrated Health: A Retrospective Analysis of U.S. Veterans with Chronic Musculoskeletal Pain Nationally 2019

Stephanie L. Taylor, Patricia M. Herman, Nell J. Marshall, Qing Zeng, Anita H. Yuan, Karen Chu, Yijun Shao, Craig Morioka, Karl Lorenz
This article addresses the use of a variety of nonherbal CIH therapies among any large patient population having chronic pain by exploring the frequency and predictors of CIH therapy use among a national population of VHA users with chronic musculoskeletal pain.
Manipulation and Mobilization for Treating Chronic Nonspecific Neck Pain: A Systematic Review and Meta-Analysis for an Appropriateness Panel 2019

Ian D. Coulter, C. J. Crawford, Howard Vernon, Eric Hurwitz, Raheleh Khorsan, Marika Booth, Patricia M. Herman
The purpose of this systematic review was to evaluate the randomized controlled trials published from January 2000 through September 2017 on chronic nonspecific neck pain, comparing the effects of manipulation and/or mobilization as therapies to those of other active therapies (such as acupuncture, massage therapy, exercise, etc.) to sham or no treatment, and when combined with other therapies such as exercise or advice commonly seen in practice.
Randomized Controlled Dissemination Study of Community-to-Clinic Navigation to Promote CRC Screening: Study Design and Implications 2019

Linda Larkey, Laura Szalacha, Patricia M. Herman, Julie Gonzalez, Usha Menon
The purpose of this study is to extend the pilot study in a group-randomized controlled trial to test the effectiveness of tailored messaging delivered by Community Health Navigators to guide individuals from especially hard-to-reach, multicultural, and underinsured communities into primary care clinics for referral for CRC screening (Phase I) and to continue navigation after referral to track effects of the intervention on completion of CRC screening (Phase II).
Naturopathic Medicine for the Prevention of Cardiovascular Disease: A Randomized Clinical Trial 2019

Dugald Seely, Orest Szczurko, Kieran Cooley, Heidi Fritz, Serenity Aberdour, Craig Herrington, Patricia M. Herman, Philip Rouchotas, David Lescheid, Ryan Bradley, et al.
To evaluate the effectiveness of representative naturopathic approaches to reducing the risk of cardiovascular disease, we conducted a randomized clinical trial of a multimodality nutritional and physical activity intervention in a workplace setting.
Community Health Workers as Focus Group Facilitators: A Participatory Action Research Method to Improve Behavioral Health Services for Farmworkers in a Primary Care Setting 2019

Maia Ingram, Lucy Murrieta, Jill de Zapien, Patricia M. Herman, Scott Carvajal
Since 1965, Federally Qualified Health Centers have provided a safety net for the uninsured and major source of care to those enrolled in public health insurance programs. The distinguishing characteristic of the program is the concept of community governance in achieving the main objective to provide holistic, comprehensive, and culturally competent primary care to low-income and medically underserved areas.
The Problematic Economics of Integrative Oncology 2019

Patricia M. Herman
The economics of integrative oncology are problematic because of the lack of good studies, the lack of historic incentives for efficiency, and the high cost of cancer care and its financial toxicity on patients. However, these problems can be overcome, with help from one good economic evaluation at a time.
Clinical Scenarios for Which Spinal Mobilization and Manipulation Are Considered by an Expert Panel to Be Inappropriate (and Appropriate) for Patients With Chronic Low Back Pain 2019

Patricia M. Herman, Eric Hurwitz, Paul G. Shekelle, Margaret D. Whitley, Ian D. Coulter
This study used the RUAM to determine the appropriateness of spinal mobilization and manipulation for different types of patients with CLBP, and the key patient characteristics associated with appropriateness.
Patient Willingness to Pay for Reductions in Chronic Low Back Pain and Chronic Neck Pain 2019

Patricia M. Herman, Jill E. Luoto, Mallika Kommareddi, Melony E. Sorbero, Ian D. Coulter
This study provides estimates of reported WTP for pain reduction from a large sample of patients using chiropractic care to manage their chronic spinal pain and compares these estimates to what these patients do for care over the next 3 months, to inform coverage policies for ongoing care.
Researching the Appropriateness of Care in the Complementary and Integrative Health Professions: Part I 2019

Ian D. Coulter, Patricia M. Herman, Gery W. Ryan, Ron D. Hays, Lara Hilton, Margaret D. Whitley
In this series of articles, we describe how we gathered the varied and detailed data required to achieve the following study objectives: (1) to measure the appropriateness of M/M for CLBP and CCP and (2) to determine whether patient preferences and costs affect appropriateness, and further, whether appropriateness affects outcomes.

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