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Article ; Online: Critical medical anthropology as a roadmap

Bayla Ostrach

Medicine Anthropology Theory, Vol 1, Iss

2021 Volume 1

Abstract: ... N/ ... ...

Abstract	N/A
Keywords	abortion ; catalonia ; catalunya ; critical medical anthropology ; health systems ; Anthropology ; GN1-890 ; Medicine (General) ; R5-920
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	University of Edinburgh Library
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Correction: "When people who use drugs can't differentiate between medical care and cops, it's a problem." Compounding risks of law enforcement harassment & punitive healthcare policies.

Ostrach, Bayla / Hixon, Vanessa / Bryce, Ainsley

Health & justice

2024 Volume 12, Issue 1, Page(s) 19

Language	English
Publishing date	2024-04-20
Publishing country	England
Document type	Published Erratum
ZDB-ID	2740401-8
ISSN	2194-7899
ISSN	2194-7899
DOI	10.1186/s40352-024-00270-z
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Article: "When people who use drugs can't differentiate between medical care and cops, it's a problem." Compounding risks of law Enforcement Harassment & Punitive Healthcare Policies.

Ostrach, Bayla / Hixon, Vanessa / Bryce, Ainsley

Health & justice

2024 Volume 12, Issue 1, Page(s) 3

Abstract: Background: Community-based harm reduction programming is widely recognized as an effective strategy for reducing the increased risks for and spread of HIV, HCV, and for reducing the growing rate of overdose deaths among people who use drugs (PWUD). ... ...

Abstract	Background: Community-based harm reduction programming is widely recognized as an effective strategy for reducing the increased risks for and spread of HIV, HCV, and for reducing the growing rate of overdose deaths among people who use drugs (PWUD). PWUD in the United States (US) are a highly justice-involved population, also at increased risk for law enforcement interaction, arrest, and incarceration. These risks compound and interact in the context of criminalization and law enforcement surveillance. Justice involvement increases risks for overdose and for riskier injecting behavior among PWUD, in turn increasing HCV and HIV risks. In Central and Southern Appalachia specifically, PWUD have identified fear of law enforcement harassment and arrest as a barrier to engaging in harm reduction behavior, and a deterrent to seeking help at the scene of an overdose. Moreover, stigmatizing and punitive treatment in healthcare settings can deter PWUD from seeking care, with life or death consequences. This evaluation research study assessing the successes and impacts of a grant-funded project to increase access to safer drug consumption supplies and overdose prevention education for PWUD, including justice-involved participants of a syringe access program (SAP), in public housing and beyond in a South-Central Appalachian setting used key informant and opportunistic sampling. Mixed-methods data were compiled and collected including secondary program data; primary interview and participant-observation data. Results: The evaluation research identified that grant deliverables were largely achieved, despite challenges presented by the COVID-19 pandemic. In addition, SAP participants and staff reported larger themes surrounding grant-funded activities, in which they perceived that widespread local law enforcement harassment of PWUD increased participants' risks for overdose death and infectious disease risks and that punitive local healthcare settings and policies acted as deterrents to care-seeking for many PWUD. Conclusions: Overall, the evaluation research found that participants' experiences with and perceptions of local law enforcement harassment combined with their understandings and experiences of local punitive healthcare settings and policies; together compounding and increasing overdose risks and negative health consequences for local justice-involved PWUD.
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2740401-8
ISSN	2194-7899
ISSN	2194-7899
DOI	10.1186/s40352-023-00256-3
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Article ; Online: Human-Centered Design for a Women's Health Screening Tool: Participant Experiences.

Ostrach, Bayla

Southern medical journal

2019 Volume 113, Issue 10, Page(s) 469–474

Abstract: Objectives: Screening is a priority in primary care and women's health, and increasingly used for intimate partner violence. Integrating such routine screening into primary care screening may be challenging for clinicians. Human-centered design (HCD) is ...

Abstract	Objectives: Screening is a priority in primary care and women's health, and increasingly used for intimate partner violence. Integrating such routine screening into primary care screening may be challenging for clinicians. Human-centered design (HCD) is a participatory process emphasizing stakeholder input and is used increasingly in health care. A growing body of literature has examined the science of patient and community engagement in health research, yet few qualitative studies investigate how participants recruited to collaborate in designing screening tools perceive HCD processes. This study examined participants' perceptions of an HCD process used as an engagement tool to inform the development of a women's health screening tool. Methods: Qualitative study using data collected from community members and providers and staff recruited through a southern Appalachian medical education center and network of family medicine clinics and in the surrounding community. Using opportunistic and key informant sampling, study participants (some of whom were also intimate partner violence survivors) were part of an earlier HCD process undertaken to redesign a women's health/primary care screening tool and were invited to be interviewed about their perceptions of and experiences in the HCD process. Interviews were conducted using a semistructured guide. Interviews were audio-recorded, transcribed, hand-coded, and analyzed using modified grounded theory. Results: All of the participants reported that they valued the opportunity to be part of the HCD process; however, they reported divergent views of the process itself. Some found it easy to engage, whereas others found it confusing or embarrassing. All valued the opportunity to be part of determining the best process for screening, yet concerns were expressed about access to and full participation in the process. Community members reported more concerns; providers and staff reported fewer concerns about their own involvement and participation, although some expressed doubts about community members' full engagement. Conclusions: Although a promising option and valuable process, the HCD process was not equally comfortable for or accessible to all participants. Community engagement beyond the clinical team is important for improving practices in health screening and health care, but it must be undertaken thoughtfully.
MeSH term(s)	Female ; Humans ; Interviews as Topic ; Intimate Partner Violence/prevention & control ; Intimate Partner Violence/psychology ; Mass Screening/methods ; Stakeholder Participation ; Universal Design ; Women's Health
Language	English
Publishing date	2019-12-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.14423/SMJ.0000000000001157
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Article ; Online: "I'll tell you what's important to me…": lessons for women's health screening.

Ostrach, Bayla M M

BMC women's health

2021 Volume 21, Issue 1, Page(s) 73

Abstract: Background: Providers face increasing demands to screen for various health issues. Family medicine, primary care, and obstetric providers are encouraged to screen women universally for intimate partner violence, which could be challenging without ... ...

Abstract	Background: Providers face increasing demands to screen for various health issues. Family medicine, primary care, and obstetric providers are encouraged to screen women universally for intimate partner violence, which could be challenging without comprehensive screening tools. The screening expectations and demands motivated providers and staff in south-central Appalachia (U.S.) to engage community members in streamlining women's health screening tools, and integrating intimate partner violence screening questions, through a Human-Centered Design (HCD) process. The objective of this article is to present participants' experiences with and perceptions of the HCD process for developing screening tools for women's health. Methods: This was a qualitative, phenomenological study conducted with community members (n = 4) and providers and staff (n = 7) who participated in the HCD process. Sampling was purposive and opportunistic. An experienced qualitative researcher conducted open-ended, semi-structured interviews with participants. Interviews were transcribed and coded for thematic analysis. Results: Community members reported that in the HCD sessions they wanted clinicians to understand the importance of timing and trust in health screening. They focused on the importance of taking time to build trust before asking about intimate partner violence; not over-focusing on body weight as this can preclude trust and disclosure of other issues; and understanding the role of historical oppression and racial discrimination in contributing to healthcare mistrust. Providers and staff reported that they recognized the importance of these concerns during the HCD process. Conclusions: Community members provided critical feedback for designing appropriate tools for screening for women's health. The findings suggest that co-designing screening tools for use in clinical settings can facilitate communication of core values. How, when, and how often screening questions are asked are as important as what is asked-especially as related to intimate partner violence and weight.
MeSH term(s)	Disclosure ; Female ; Humans ; Intimate Partner Violence ; Mass Screening ; Pregnancy ; Trust ; Women's Health
Language	English
Publishing date	2021-02-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1472-6874
ISSN (online)	1472-6874
DOI	10.1186/s12905-021-01220-9
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Article ; Online: Health Inequities Among People Who Use Drugs in a Post-

Carroll, Jennifer J / Ostrach, Bayla / El-Sabawi, Taleed

The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics

2023 Volume 51, Issue 3, Page(s) 549–553

Abstract: Punitive policy responses to substance use and to abortion care constitute direct attacks on personal liberty and bodily autonomy. In this article, we leverage the concept of "syndemics" to anticipate how the already synergistic stigmas against people ... ...

Abstract	Punitive policy responses to substance use and to abortion care constitute direct attacks on personal liberty and bodily autonomy. In this article, we leverage the concept of "syndemics" to anticipate how the already synergistic stigmas against people who use drugs and people who seek abortion services will be further compounded the
MeSH term(s)	Humans ; Syndemic ; Substance-Related Disorders/epidemiology ; Health Inequities
Language	English
Publishing date	2023-12-13
Publishing country	England
Document type	Journal Article
ZDB-ID	1168812-9
ISSN	1748-720X ; 1073-1105 ; 0277-8459
ISSN (online)	1748-720X
ISSN	1073-1105 ; 0277-8459
DOI	10.1017/jme.2023.96
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Article ; Online: Syndemics and intersectionality: A response commentary.

Bulled, Nicola / Singer, Merrill / Ostrach, Bayla

Social science & medicine (1982)

2022 Volume 295, Page(s) 114743

MeSH term(s)	Humans ; Intersectional Framework ; Syndemic
Language	English
Publishing date	2022-01-29
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	4766-1
ISSN	1873-5347 ; 0037-7856 ; 0277-9536
ISSN (online)	1873-5347
ISSN	0037-7856 ; 0277-9536
DOI	10.1016/j.socscimed.2022.114743
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Article ; Online: Examining differences in opioid deaths by race in North Carolina following the STOP Act, 2010-2019.

Hughes, Phillip M / Ostrach, Bayla / Tak, Casey R

Journal of substance use and addiction treatment

2023 Volume 155, Page(s) 209171

Abstract: Introduction: North Carolina's 2017 STOP Act implemented several measures to address the increasing opioid overdose death rate. However, due to racial differences prescription opioid use and treatment service access, the STOP Act may exhibit ... ...

Abstract	Introduction: North Carolina's 2017 STOP Act implemented several measures to address the increasing opioid overdose death rate. However, due to racial differences prescription opioid use and treatment service access, the STOP Act may exhibit differential impacts by race. This study examined the impact of the STOP Act on opioid overdose deaths by race. Methods: State-level secondary data were compiled for all 50 states. Race-stratified opioid overdose rates were obtained from the Centers for Disease Control and Prevention's WONDER database from 2010 to 2019. The study obtained state-level population characteristics from the Current Population Surveys from 2010 to 2016, the CDC's 2017 Drug Surveillance Report, the National Survey of Substance Abuse Treatment Services from 2011 to 2016, and the National Survey on Drug Use and Health from 2010 to 2016. We obtained outcomes from 2010 to 2019 and state characteristics were obtained for the pre-STOP Act period (2010-2016) as available. Using the synthetic control method, we created two synthetic North Carolinas, one Black/African American and one White, from a weighted average of other states similar to North Carolina in terms of pre-STOP Act race-stratified opioid overdose rates and population characteristics. Change was assessed as the difference in the race-stratified opioid overdose death rate for North Carolina the corresponding synthetic control. Results: The opioid overdose death rate among the White population decreased by 7.17 and 8.96 deaths/100 k in 2018 and 2019 following the STOP Act (overall decrease p = .0217); however, the study found no significant change in the opioid overdose death rate among the Black/African American population (overall decrease p = .1053), with decreases 1.68 and 3.2 deaths/100 k in 2018 and 2019, respectively. Conclusions: Our findings suggest that the STOP Act reduced the opioid overdose death rate in North Carolina among the White, but not Black/African American, population. This heterogeneous effect has implications for health equity and can inform the development of future substance use policies.
MeSH term(s)	Humans ; Analgesics, Opioid ; North Carolina/epidemiology ; Drug Overdose/epidemiology ; Opiate Overdose ; Opioid-Related Disorders
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2023-09-20
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ISSN	2949-8759
ISSN (online)	2949-8759
DOI	10.1016/j.josat.2023.209171
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Article ; Online: North Carolina pharmacists' willingness to sell fentanyl test strips: a survey study.

Marley, Grace T / Ostrach, Bayla / Carpenter, Delesha

Harm reduction journal

2023 Volume 20, Issue 1, Page(s) 10

Abstract: Background: Although fentanyl test strips (FTS) can accurately determine the presence of fentanyl in unregulated substances, access to FTS remains limited. This study aimed to examine North Carolina community pharmacists' attitudes and willingness to ... ...

Abstract	Background: Although fentanyl test strips (FTS) can accurately determine the presence of fentanyl in unregulated substances, access to FTS remains limited. This study aimed to examine North Carolina community pharmacists' attitudes and willingness to engage in various behaviors related to FTS sales and distribution. Methods: A convenience sample of community pharmacists completed an online survey that assessed: (1) comfort initiating an FTS conversation; (2) willingness to sell FTS, distribute FTS instructions, counsel on FTS, refer patients to harm reduction organizations, and advertise FTS; (3) perceived barriers and benefits of selling FTS; and (4) interest in FTS training. Data were collected from March to May 2022. Descriptive statistics were calculated. Results: Of the 592 pharmacists who participated, most were somewhat or very willing to refer patients to harm reduction organizations for FTS (514, 86.9%), counsel on FTS (485, 81.9%), distribute FTS instructions (475, 80.2%), sell FTS (470, 79.3%), and advertise FTS for sale (372, 62.9%). The most commonly reported benefits of selling FTS were reducing overdose deaths in the community (n = 482, 81.4%) and participating in community harm reduction efforts (n = 455; 76.9%). Barriers commonly reported to selling FTS were: not knowing where to order FTS (n = 295, 49.8%) and discomfort initiating a conversation about FTS (n = 266, 44.9%). Most respondents (88.3%) were interested in FTS training. Conclusion: North Carolina community pharmacists are willing to engage in various behaviors related to FTS sales and distribution. Most pharmacists were interested in receiving FTS training, which should be created to address pharmacist-reported barriers to FTS sales. Pharmacist distribution of FTS could increase access to FTS at the community level and has the potential to change drug use behavior and reduce overdose deaths.
MeSH term(s)	Humans ; Fentanyl ; Pharmacists ; North Carolina ; Surveys and Questionnaires ; Substance-Related Disorders ; Drug Overdose/prevention & control ; Drug Overdose/drug therapy
Chemical Substances	Fentanyl (UF599785JZ)
Language	English
Publishing date	2023-01-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2146691-9
ISSN	1477-7517 ; 1477-7517
ISSN (online)	1477-7517
ISSN	1477-7517
DOI	10.1186/s12954-023-00739-4
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Article ; Online: Addressing buprenorphine bottlenecks in the context of MAT Act implementation: A shared responsibility.

Ostrach, Bayla / Hill, Lucas / Carpenter, Delesha / Pollini, Robin

Journal of the American Pharmacists Association : JAPhA

2023 Volume 63, Issue 4, Page(s) 1044–1048

Abstract: Medications for opioid use disorder (OUD) such as buprenorphine reduce overdose mortality and other opioid related acute health events but have historically been highly regulated. The recent Mainstreaming Addiction Treatment (MAT) Act ended the ... ...

Abstract	Medications for opioid use disorder (OUD) such as buprenorphine reduce overdose mortality and other opioid related acute health events but have historically been highly regulated. The recent Mainstreaming Addiction Treatment (MAT) Act ended the requirement clinicians complete a specified training and apply for a DATA 2000 ("X") waiver on their Drug Enforcement Administration (DEA) number, to prescribe buprenorphine. With the MAT Act, any practitioner with Schedule III prescribing authority (a regular DEA number) can now prescribe buprenorphine for OUD. While this has potential to improve OUD treatment access, the impact will depend on implementation. Though the MAT Act may facilitate increased buprenorphine prescribing, ensuring adequate buprenorphine dispensing is also critical to improving Medications for opioid use disorder. Recognized buprenorphine bottlenecks arise from a complex convergence of factors in community pharmacies, threatening to undercut the benefits of the MAT Act. If prescribing increases but is not matched by increased dispensing, bottlenecks may worsen. Any worsening of buprenorphine bottlenecks could have a disproportionate impact in rural areas where residents may rely on fewer pharmacies to fill prescriptions for people in larger geographic area and where larger prescribing-dispensing gaps already exist such as in Southern states. Rigorous research will be needed to document the overall impact of the MAT Act on community pharmacists and their patients. At the federal level, pharmacists and their professional organizations should lobby the DEA to de-schedule or re-schedule buprenorphine. The DEA should announce a moratorium on enforcement actions against wholesalers and pharmacies related to buprenorphine distribution and dispensing. More supports should be offered to community pharmacies by state pharmacy boards and associations including continuing pharmacy education and technical assistance for advocating with wholesalers to increase buprenorphine order sizes, and to more effectively communicate with prescribers. Pharmacies should not have to face these challenges alone. Regulators, wholesalers, and researchers must join together with community pharmacies to further reduce regulatory barriers to dispensing, provide evidence-based interventions where needed to support pharmacy dispensing efforts, conduct rigorous implementation research, and be constantly vigilant in identifying and addressing multi-level buprenorphine bottlenecks in the wake of the MAT Act.
MeSH term(s)	Humans ; Buprenorphine/therapeutic use ; Opioid-Related Disorders/drug therapy ; Analgesics, Opioid/adverse effects ; Pharmacists ; Prescriptions ; Opiate Substitution Treatment
Chemical Substances	Buprenorphine (40D3SCR4GZ) ; Analgesics, Opioid
Language	English
Publishing date	2023-05-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2118585-2
ISSN	1544-3450 ; 1544-3191 ; 1086-5802
ISSN (online)	1544-3450
ISSN	1544-3191 ; 1086-5802
DOI	10.1016/j.japh.2023.04.029
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