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  1. Article ; Online: Calculating access to parks and other polygonal resources: A description of open-source methodologies.

    Spangler, Keith R / Brochu, Paige / Nori-Sarma, Amruta / Milechin, Dennis / Rickles, Michael / Davis, Brandeus / Dukes, Kimberly A / Lane, Kevin J

    Spatial and spatio-temporal epidemiology

    2023  Volume 47, Page(s) 100606

    Abstract: Public health studies routinely use simplistic methods to calculate proximity-based "access" to greenspace, such as by measuring distances to the geographic centroids of parks or, less frequently, to the perimeter of the park area. Although ... ...

    Abstract Public health studies routinely use simplistic methods to calculate proximity-based "access" to greenspace, such as by measuring distances to the geographic centroids of parks or, less frequently, to the perimeter of the park area. Although computationally efficient, these approaches oversimplify exposure measurement because parks often have specific entrance points. In this tutorial paper, we describe how researchers can instead calculate more-accurate access measures using freely available open-source methods. Specifically, we demonstrate processes for calculating "service areas" representing street-network-based buffers of access to parks within set distances and mode of transportation (e.g., 1-km walk or 20-minute drive) using OpenRouteService and QGIS software. We also introduce an advanced method involving the identification of trailheads or parking lots with OpenStreetMap data and show how large parks particularly benefit from this approach. These methods can be used globally and are applicable to analyses of a wide range of studies investigating proximity access to resources.
    MeSH term(s) Humans ; Walking ; Transportation ; Public Health
    Language English
    Publishing date 2023-07-16
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2515896-X
    ISSN 1877-5853 ; 1877-5845
    ISSN (online) 1877-5853
    ISSN 1877-5845
    DOI 10.1016/j.sste.2023.100606
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Modeling health and well-being measures using ZIP code spatial neighborhood patterns.

    Jain, Abhi / LaValley, Michael / Dukes, Kimberly / Lane, Kevin / Winter, Michael / Spangler, Keith R / Cesare, Nina / Wang, Biqi / Rickles, Michael / Mohammed, Shariq

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 9180

    Abstract: Individual-level assessment of health and well-being permits analysis of community well-being and health risk evaluations across several dimensions of health. It also enables comparison and rankings of reported health and well-being for large ... ...

    Abstract Individual-level assessment of health and well-being permits analysis of community well-being and health risk evaluations across several dimensions of health. It also enables comparison and rankings of reported health and well-being for large geographical areas such as states, metropolitan areas, and counties. However, there is large variation in reported well-being within such large spatial units underscoring the importance of analyzing well-being at more granular levels, such as ZIP codes. In this paper, we address this problem by modeling well-being data to generate ZIP code tabulation area (ZCTA)-level rankings through spatially informed statistical modeling. We build regression models for individual-level overall well-being index and scores from five subscales (Physical, Financial, Social, Community, Purpose) using individual-level demographic characteristics as predictors while including a ZCTA-level spatial effect. The ZCTA neighborhood information is incorporated by using a graph Laplacian matrix; this enables estimation of the effect of a ZCTA on well-being using individual-level data from that ZCTA as well as by borrowing information from neighboring ZCTAs. We deploy our model on well-being data for the U.S. states of Massachusetts and Georgia. We find that our model can capture the effects of demographic features while also offering spatial effect estimates for all ZCTAs, including ones with no observations, under certain conditions. These spatial effect estimates provide community health and well-being rankings of ZCTAs, and our method can be deployed more generally to model other outcomes that are spatially dependent as well as data from other states or groups of states.
    MeSH term(s) Humans ; Male ; Female ; Residence Characteristics ; Neighborhood Characteristics ; Adult ; Middle Aged ; Health Status ; Models, Statistical ; Aged
    Language English
    Publishing date 2024-04-22
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-58157-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Individual, community, and structural factors associated with linkage to HIV care among people diagnosed with HIV in Tennessee.

    Ahonkhai, Aima A / Rebeiro, Peter F / Jenkins, Cathy A / Rickles, Michael / Cook, Mekeila / Conserve, Donaldson F / Pierce, Leslie J / Shepherd, Bryan E / Brantley, Meredith / Wester, Carolyn

    PloS one

    2022  Volume 17, Issue 3, Page(s) e0264508

    Abstract: Objective: We assessed trends and identified individual- and county-level factors associated with individual linkage to HIV care in Tennessee (TN).: Methods: TN residents diagnosed with HIV from 2012-2016 were included in the analysis (n = 3,751). ... ...

    Abstract Objective: We assessed trends and identified individual- and county-level factors associated with individual linkage to HIV care in Tennessee (TN).
    Methods: TN residents diagnosed with HIV from 2012-2016 were included in the analysis (n = 3,751). Individuals were assigned county-level factors based on county of residence at the time of diagnosis. Linkage was defined by the first CD4 or HIV RNA test date after HIV diagnosis. We used modified Poisson regression to estimate probability of 30-day linkage to care at the individual-level and the contribution of individual and county-level factors to this outcome.
    Results: Both MSM (aRR 1.23, 95%CI 0.98-1.55) and women who reported heterosexual sex risk factors (aRR 1.39, 95%CI 1.18-1.65) were more likely to link to care within 30-days than heterosexual males. Non-Hispanic Black individuals had poorer linkage than White individuals (aRR 0.77, 95%CI 0.71-0.83). County-level mentally unhealthy days were negatively associated with linkage (aRR 0.63, 95%CI: 0.40-0.99).
    Conclusions: Racial disparities in linkage to care persist at both individual and county levels, even when adjusting for county-level social determinants of health. These findings suggest a need for structural interventions to address both structural racism and mental health needs to improve linkage to care and minimize racial disparities in HIV outcomes.
    MeSH term(s) Female ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; Homosexuality, Male ; Humans ; Male ; Sexual and Gender Minorities ; Tennessee/epidemiology ; White People
    Language English
    Publishing date 2022-03-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0264508
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Use of Well-Being in Identification of Members With Future Health Risk Factors and Future Diagnosed Chronic Disease.

    Hamar, Brent / Jones, Ashlin / Rickles, Michael / Coberley, Carter / Rula, Elizabeth Y

    Journal of occupational and environmental medicine

    2018  Volume 61, Issue 2, Page(s) 168–176

    Abstract: Objective: To evaluate if well-being is associated with the development of future health risks or incidence of new chronic disease.: Methods: A retrospective cohort study was employed using longitudinal well-being assessment survey data from ... ...

    Abstract Objective: To evaluate if well-being is associated with the development of future health risks or incidence of new chronic disease.
    Methods: A retrospective cohort study was employed using longitudinal well-being assessment survey data from participants of a Fortune 500 US company wellness program, claims based International Classification of Diseases, Ninth Revision diagnoses, and Cox proportional hazards models to assess associations between well-being and well-being change with future health risk and chronic disease incidence.
    Results: Individuals who maintained high well-being and those who increased their level of well-being displayed a significantly decreased hazard of accruing new health risk and new chronic disease incidence; those whose well-being worsened over time showed significant increases in health risk and hazard of new chronic disease incidence.
    Conclusions: Well-being levels and change over time are significantly associated with future development of health risk and disease incidence.
    MeSH term(s) Adult ; Chronic Disease/epidemiology ; Female ; Forecasting ; Health Status ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Surveys and Questionnaires ; United States
    Language English
    Publishing date 2018-12-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1223932-x
    ISSN 1536-5948 ; 1076-2752
    ISSN (online) 1536-5948
    ISSN 1076-2752
    DOI 10.1097/JOM.0000000000001524
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Low hepatitis C antibody screening rates among an insured population of Tennessean Baby Boomers.

    Carlucci, James G / Farooq, Syeda A / Sizemore, Lindsey / Rickles, Michael / Cosley, Brandon / McCormack, Leigh / Wester, Carolyn

    PloS one

    2017  Volume 12, Issue 11, Page(s) e0188624

    Abstract: Introduction: Chronic Hepatitis C Virus (HCV) infection is common and can cause liver disease and death. Persons born from 1945 through 1965 ("Baby Boomers") have relatively high prevalence of chronic HCV infection, prompting recommendations that all ... ...

    Abstract Introduction: Chronic Hepatitis C Virus (HCV) infection is common and can cause liver disease and death. Persons born from 1945 through 1965 ("Baby Boomers") have relatively high prevalence of chronic HCV infection, prompting recommendations that all Baby Boomers be screened for HCV. If chronic HCV is confirmed, evaluation for antiviral treatment should be performed. Direct-acting antivirals can cure more than 90% of people with chronic HCV. This sequence of services can be referred to as the HCV "cascade of cure" (CoC). The Tennessee (TN) Department of Health (TDH) and a health insurer with presence in TN aimed to determine the proportion of Baby Boomers who access HCV screening services and appropriately navigate the HCV CoC in TN.
    Methods: TDH surveillance data and insurance claim records were queried to identify the cohort of Baby Boomers eligible for HCV testing. Billing codes and pharmacy records from 2013 through 2015 were used to determine whether HCV screening and other HCV-related services were provided. The proportion of individuals accessing HCV screening and other steps along the HCV CoC was determined. Multivariable analyses were performed to identify factors associated with HCV screening and treatment.
    Results: Among 501,388 insured Tennessean Baby Boomers, 7% were screened for HCV. Of the 40,019 who received any HCV-related service, 86% were screened with an HCV antibody test, 20% had a confirmatory HCV PCR, 9% were evaluated for treatment, and 4% were prescribed antivirals. Hispanics were more likely to be screened and treated for HCV than non-Hispanic whites. HCV screening was more likely to occur in the Nashville-Davidson region than in other regions of TN, but there were regional variations in HCV treatment.
    Conclusions: Many insured Tennessean Baby Boomers do not access HCV screening services, despite national recommendations. Demographic and regional differences in uptake along the HCV CoC should inform public health interventions aimed at mitigating the effects of chronic HCV.
    MeSH term(s) Antibodies, Viral/blood ; Female ; Hepacivirus/genetics ; Hepacivirus/immunology ; Hepatitis C, Chronic/diagnosis ; Humans ; Insurance Coverage ; Insurance, Health ; Male ; Middle Aged ; Polymerase Chain Reaction ; Prospective Studies ; Tennessee
    Chemical Substances Antibodies, Viral
    Language English
    Publishing date 2017-11-30
    Publishing country United States
    Document type Journal Article ; Observational Study
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0188624
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  6. Article ; Online: Tennessee's In-state Vulnerability Assessment for a "Rapid Dissemination of Human Immunodeficiency Virus or Hepatitis C Virus Infection" Event Utilizing Data About the Opioid Epidemic.

    Rickles, Michael / Rebeiro, Peter F / Sizemore, Lindsey / Juarez, Paul / Mutter, Mitchell / Wester, Carolyn / McPheeters, Melissa

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2017  Volume 66, Issue 11, Page(s) 1722–1732

    Abstract: Background: Knowing which factors contribute to county-level vulnerability to a human immunodeficiency virus (HIV)/hepatitis C virus (HCV) outbreak, and which counties are most vulnerable, guides public health and clinical interventions. We therefore ... ...

    Abstract Background: Knowing which factors contribute to county-level vulnerability to a human immunodeficiency virus (HIV)/hepatitis C virus (HCV) outbreak, and which counties are most vulnerable, guides public health and clinical interventions. We therefore examined the impact of locally available indicators related to the opioid epidemic on prior national models of HIV/HCV outbreak vulnerability.
    Methods: Tennessee's 95 counties were the study sample. Predictors from 2012 and 2013 were used, mirroring prior methodology from the US Centers for Disease Control and Prevention (CDC). Acute HCV incidence was the proxy measure of county-level vulnerability. Seventy-eight predictors were identified as potentially predictive for HIV/HCV vulnerability. We used multiple dimension reduction techniques to determine predictors for inclusion and Poisson regression to generate a composite index score ranking county-level vulnerability for HIV/HCV.
    Results: There was overlap of high-risk counties with the national analysis (25 of 41 counties). The distribution of vulnerability reinforces earlier research indicating that eastern Tennessee is at particularly high risk but also demonstrates that the entire state has high vulnerability.
    Conclusions: Prior research placed Tennessee among the top states for opioid prescribing, acute HCV infection, and greatest risk for an HIV/HCV outbreak. Given this confluence of risk, the Tennessee Department of Health expanded upon prior work to include more granular, local data, including on opioid prescribing. We also explored nonfatal and fatal overdoses. The more complete statewide view of risk generated, not only in eastern counties but also in the western corridor, will enable local officials to monitor vulnerability and better target resources.
    MeSH term(s) Epidemics/statistics & numerical data ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Hepatitis C/epidemiology ; Hepatitis C/prevention & control ; Humans ; Opioid-Related Disorders/epidemiology ; Opioid-Related Disorders/mortality ; Risk Factors ; Tennessee
    Language English
    Publishing date 2017-12-08
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/cix1079
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