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Liang LJ, Li L. Measuring health care continuum with multifaceted indicators for people who use drugs in Vietnam. AIDS Care 2024:1-7. [PMID: 38289581 DOI: 10.1080/09540121.2024.2308747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
Continuum of care is a concept that has been widely applied in HIV prevention and treatment studies. However, measuring care continuum can be challenging because it involves multiple stages and multiple components or domains at each stage of care. In this study, we introduced an analytical framework to (1) estimate intervention effects overall and by domain using a multi-level modeling approach, and (2) learn possible patterns of domains over time utilizing a multi-layer heatmap visualization. Longitudinal data from an intervention study conducted among people who use drugs in Vietnam were used to construct Seek, Test, Treat, and Retain (STTR) domain and overall scores. Findings from the adjusted analysis showed that people who use drugs in the intervention exhibited a significantly greater improvement in the overall STTR score than those in the control (p-values < .0001). The multi-layer heatmap revealed different patterns of the individual domains over time and the inter-relationships among the individual domains. This study demonstrates the feasibility of constructing a general fulfillment score and domain specific scores to measure care continuum among people who use drugs. The analytical framework can be readily extended to evaluate service fulfillment outcomes in health services and treatment studies for other key populations.
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Affiliation(s)
- Li-Jung Liang
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Li Li
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
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2
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Improving Post-Release Care Engagement for People Living with HIV Involved in the Criminal Justice System: A Systematic Review. AIDS Behav 2022; 26:1607-1617. [PMID: 34705154 DOI: 10.1007/s10461-021-03513-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 10/20/2022]
Abstract
Given sub-optimal HIV care outcomes for people living with HIV (PLWH) post-release from incarceration, we systematically searched peer-reviewed literature (2010-2021) describing controlled trial interventions aimed at improving Antiretroviral Therapy (ART) adherence and care linkage following release from correctional facilities for PLWH. Of 392 studies, 16 (4%) met the inclusion criteria. All studies were conducted in the United States and involved some form of intensive case management. Trials that scored highest in terms of study quality provided cell phones for engagement, reported sustained viral load suppression as a measurable outcome to infer ART adherence, and measured longitudinal data collected for at least 3-to-6 months following release. The two trials that demonstrated improved HIV viral load suppression involved Peer Navigators, and incentivized undetectable viral load, respectively. Facilitating support for addictions and addressing other social and structural barriers to achieving optimal health is also of vital importance in bridging care gaps for PLWH.
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Manderson G, King L. Mobile phone interventions to promote adherence to HIV treatment: mitigating the challenges. Nurs Stand 2022; 37:45-50. [PMID: 34866364 DOI: 10.7748/ns.2021.e11739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/09/2022]
Abstract
Mobile phone interventions are often used in healthcare for sharing information and interacting with patients regarding their treatment and care. In people with human immunodeficiency virus (HIV), antiretroviral treatment is crucial and mobile phone interventions are increasingly used to promote adherence to HIV treatment. However, such interventions have potential disadvantages, which nurses and other healthcare professionals need to recognise and mitigate. This article details a literature review that investigated the disadvantages of mobile phone interventions designed to promote adherence to treatment among people with HIV. Four themes were identified from the literature: issues with confidentiality of HIV diagnosis, frustrations associated with technical issues, lost or stolen mobile phones, and the importance of professional support. Nurses involved in caring for patients with HIV should seek to mitigate these disadvantages, regularly review the effectiveness of mobile phone interventions and ensure that each patient receives personalised support. Further research into existing and new mobile phone-based methods of patient support is warranted.
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Affiliation(s)
- Grace Manderson
- adult nursing, School of Nursing and Allied Health, Buckinghamshire New University, Uxbridge, England
| | - Liz King
- Senior lecturer, Division of Children's Nursing, Department of Nursing and Midwifery, Institute of Health and Social Care, London South Bank University, London, England
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4
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Abstract
BACKGROUND High rates of missed appointments for routine HIV care are associated with unsuppressed viremia, increasing morbidity. LOCAL PROBLEM The Clinic no-show rate ranged between 30% and 35%, and only 69% of patients were considered retained in care within a 24-month time frame. METHODS The Woodward Risk Prediction Tool was completed on all patients to stratify patient risk for missing the next appointment. INTERVENTIONS All patients were offered text message along with standard phone message appointment reminders, and patients who missed appointments were called within 24 hours to reschedule. Medium-risk patients received a previsit planning call to remove barriers to appointment attendance, and high-risk patients received a home visit from the peer navigator. RESULTS The project resulted in a 3.8% reduction rate in the overall no-show rate in the first 5 months of implementation. Using risk stratification and targeted interventions allowed valuable resources to be allocated where they were needed.
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Uhrig Castonguay BJ, Cressman AE, Kuo I, Patrick R, Trezza C, Cates A, Olsen H, Peterson J, Kurth A, Bazerman LB, Beckwith CG. The Implementation of a Text Messaging Intervention to Improve HIV Continuum of Care Outcomes Among Persons Recently Released From Correctional Facilities: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e16220. [PMID: 32053119 PMCID: PMC7055782 DOI: 10.2196/16220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/19/2019] [Accepted: 10/20/2019] [Indexed: 01/19/2023] Open
Abstract
Background Previously incarcerated individuals have suboptimal linkage and engagement in community HIV care. Mobile health (mHealth) interventions have been shown to be effective in addressing these gaps. In Washington, District of Columbia (DC), we conducted a randomized trial of an SMS text messaging–based mHealth intervention (CARE+ Corrections) to increase linkage to community HIV care and antiretroviral treatment adherence among HIV-infected persons involved in the criminal justice system. Objective This study aimed to describe the SMS text messaging–based intervention, participant use of the intervention, and barriers and facilitators of implementation. Methods From August 2013 to April 2015, HIV-positive incarcerated individuals were recruited within the DC Department of Corrections, and persons released in the past 6 months were recruited within the community via street-based recruitment, community partnerships, and referrals. Participants were followed for 6 months and received weekly or daily SMS text messages. Formative research resulted in the development of the content of the messages in 4 categories: HIV Appointment Reminders, Medication Adherence, Prevention Reminders, and Barriers to Care following release from jail. Participants could customize the timing, frequency, and message content throughout the study period. Results Of the 112 participants enrolled, 57 (50.9%) were randomized to the intervention group and 55 (49.1%) to the control group; 2 control participants did not complete the baseline visit, and were dropped from the study, leaving a total of 110 participants who contributed to the analyses. Study retention was similar across both study arms. Median age was 42 years (IQR 30-50), 86% (49/57) were black or African American, 58% (33/57) were male, 25% (14/57) were female, and 18% (10/57) were transgender. Median length of last incarceration was 4 months (IQR 1.7-9.0), and median lifetime number of times incarcerated was 6.5 (IQR 3.5-14.0). Most participants (32/54, 59%) had a baseline viral load of <200 copies/mL. Nearly all participants (52/57, 91%) chose to use a cell phone provided by the study. The most preferred Appointment Reminder message was Hey how you feeling? Don’t forget to give a call and make your appointment (19/57, 33%). The most preferred Medication Adherence message was Don’t forget your skittles! (31/57, 54%), and 63% (36/57) of participants chose to receive daily (vs weekly) messages from this category at baseline. The most preferred Prevention Reminder message was Stay strong. Stay clean (18/57, 32%). The most preferred Barriers to Care message was Holla at your case manager, they’re here to help (12/57, 22%). Minor message preference differences were observed among participants enrolled in the jail versus those from the community. Conclusions Participants’ ability to customize their SMS text message plan proved helpful. Further large-scale research on mHealth platforms is needed to assess its efficacy among HIV-infected persons with a history of incarceration. Trial Registration ClinicalTrials.gov NCT01721226; https://clinicaltrials.gov/ct2/show/NCT01721226
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Affiliation(s)
- Breana J Uhrig Castonguay
- University of North Carolina Center for AIDS Research, Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Andrew E Cressman
- The Center for Prisoner Health and Human Rights, Providence, RI, United States.,Brown University School of Public Health, Providence, RI, United States
| | - Irene Kuo
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States.,District of Columbia Center for AIDS Research, Washington, DC, United States
| | - Rudy Patrick
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, United States
| | - Claudia Trezza
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Alice Cates
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Halli Olsen
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - James Peterson
- Milken Institute School of Public Health, George Washington University, Washington, DC, United States.,District of Columbia Center for AIDS Research, Washington, DC, United States
| | - Ann Kurth
- Yale University School of Nursing, New Haven, CT, United States
| | | | - Curt G Beckwith
- The Miriam Hospital, Providence, RI, United States.,Division of Infectious Diseases, Alpert Medical School of Brown University, Providence, RI, United States
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Christopoulos KA, Riley ED, Carrico AW, Tulsky J, Moskowitz JT, Dilworth S, Coffin LS, Wilson L, Peretz JJ, Hilton JF. A Randomized Controlled Trial of a Text Messaging Intervention to Promote Virologic Suppression and Retention in Care in an Urban Safety-Net Human Immunodeficiency Virus Clinic: The Connect4Care Trial. Clin Infect Dis 2019; 67:751-759. [PMID: 29474546 DOI: 10.1093/cid/ciy156] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 02/20/2018] [Indexed: 01/29/2023] Open
Abstract
Background Text messaging is a promising strategy to support human immunodeficiency virus (HIV) care engagement, but little is known about its efficacy in urban safety-net HIV clinics. Methods We conducted a randomized controlled trial of a supportive and motivational text messaging intervention, Connect4Care (C4C), among viremic patients who had a history of poor retention or were new to the clinic. Participants were randomized (stratified by new or established HIV diagnosis status) to receive either of the following for 12 months: (1) thrice-weekly intervention messages, plus texted primary care appointment reminders and a monthly text message requesting confirmation of study participation or (2) texted reminders and monthly messages alone. Viral load was assessed at 6 and 12 months. The primary outcome was virologic suppression (<200 copies/mL) at 12 months, estimated via repeated-measures log-binomial regression, adjusted for new-diagnosis status. The secondary outcome was retention in clinic care. Results Between August 2013 and November 2015, a total of 230 participants were randomized. Virologic suppression at 12 months was similar in intervention and control participants (48.8% vs 45.8%, respectively), yielding a rate ratio of 1.07 (95% confidence interval, .82-1.39). Suppression was higher in those with newly diagnosed infection (78.3% vs 45.3%). There were no intervention effects on the secondary outcome. Exploratory analyses suggested that patients with more responses to study text messages had better outcomes, regardless of arm. Conclusions The C4C text messaging intervention did not significantly increase virologic suppression or retention in care. Response to text messages may be a useful way for providers to gauge risk for poor HIV outcomes. Clinical Trials Registration NCT01917994.
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Affiliation(s)
| | - Elise D Riley
- Division of HIV, ID and Global Medicine, University of California San Francisco
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami, Florida
| | - Jacqueline Tulsky
- Division of HIV, ID and Global Medicine, University of California San Francisco
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Samantha Dilworth
- Division of HIV, ID and Global Medicine, University of California San Francisco
| | - Lara S Coffin
- Division of Prevention Science, University of California San Francisco
| | - Leslie Wilson
- Departments of Medicine and Clinical Pharmacy, University of California San Francisco
| | | | - Joan F Hilton
- Department of Epidemiology and Biostatistics, University of California San Francisco
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Khawcharoenporn T, Cole J, Claus J, Bell T, Lewis A, Zawitz C, Kessler H. A randomized controlled study of intervention to improve continuity care engagement among HIV-infected persons after release from jails. AIDS Care 2018; 31:777-784. [PMID: 30304936 DOI: 10.1080/09540121.2018.1533236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Short-term stay, multiple jail admissions and social and financial difficulties are significant obstacles for continuity care engagement (CCE) after release among HIV-infected jail detainees. However, data existing on interventions or strategies to increase post-release CCE among this population are limited. We conducted a randomized controlled study among HIV-infected detainees at Cook County Jail during 2011-2014. The intervention group received telephone contact within 2-4 days of release by a continuity clinic coordinator, who scheduled and informed the ex-detainees of their appointment date within 6 weeks post-release plus standard of care, while the control group received standard of care. The standard of care included comprehensive discharge planning, offering substance abuse treatment and provision of information on how to self-schedule an appointment with the chosen clinics. Of the 166 detainees enrolled, 56 were excluded due to being sent to prison or re-incarcerated within 6 weeks. The final cohort included 55 detainees in each of the groups. The rate of CCE within 6 weeks after release was significantly higher in the intervention group compared to the control group (58% vs. 33%; P = .007). In multivariable logistic regression analysis, being in the control group was the only factor associated with no CCE within 6 weeks (adjusted odds ratio 2.66; 95% confidence interval 1.18-6.00; P = .02). The study findings suggest that the simple telephone contact intervention significantly improved CCE among HIV-infected jail detainees.
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Affiliation(s)
- Thana Khawcharoenporn
- a Division of Infectious Diseases, Faculty of Medicine , Thammasat University , Pathumthani , Thailand.,b Rush University Medical Center , Chicago , IL , USA
| | - Joanna Cole
- b Rush University Medical Center , Chicago , IL , USA
| | | | - Thom Bell
- c The Ruth M. Rothstein CORE Center, Cook County Jail , Chicago , IL , USA
| | | | - Chad Zawitz
- c The Ruth M. Rothstein CORE Center, Cook County Jail , Chicago , IL , USA.,d Cermak Health Service Division, Cook County Jail , Chicago , IL , USA
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Spaulding AC, Drobeniuc A, Frew PM, Lemon TL, Anderson EJ, Cerwonka C, Bowden C, Freshley J, del Rio C. Jail, an unappreciated medical home: Assessing the feasibility of a strengths-based case management intervention to improve the care retention of HIV-infected persons once released from jail. PLoS One 2018; 13:e0191643. [PMID: 29601591 PMCID: PMC5877830 DOI: 10.1371/journal.pone.0191643] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 12/22/2017] [Indexed: 12/23/2022] Open
Abstract
Background Linkage to and retention in care for US persons living with HIV (PLWH) after release from jail usually declines. We know of no rigorously evaluated behavioral interventions that can improve this. We hypothesized that a strengths-based case management intervention that we developed for PLWH leaving jail would increase linkage/retention in care (indicated by receipt of laboratory draws) and a suppressed HIV viral load (VL) in the year following release. Methods and findings We conducted a quasi-experimental feasibility study of our intervention for PLWH jailed in Atlanta. We recruited 113 PLWH in jail starting in 2014. “SUCCESS” (Sustained, Unbroken Connection to Care, Entry Services, and Suppression) began in jail and continued post-release. Subjects who started the intervention but subsequently began long-term incarcerations were excluded from further analysis. Persons who were retained in the intervention group were compared to contemporaneously incarcerated PLWH who did not receive the intervention. Identities were submitted to an enhanced HIV/AIDS reporting system (eHARS) at the state health department to capture all laboratories drawn. Both community engagement and care upon jail return were assessed equally. For 44 intervention participants released to Atlanta, 50% of care occurred on subsequent jail stays, as documented with EventFlow software. Forty-five receiving usual services only were recruited for comparison. By examining records of jail reentries, half of participants and 60% of controls recidivated (range: 1–8 returns). All but 6 participants in the intervention and 9 subjects in the comparison arm had ≥1 laboratory recorded in eHARS post-release. Among the intervention group, 52% were retained in care (i.e., had two laboratory studies, > = 3 months apart), versus 40% among the comparison group (OR = 1.60, 95% CI (0.71, 3.81)). Both arms showed improved viral load suppression. Conclusions There was a trend towards increased retention for PLWH released from jail after SUCCESS, compared to usual services. Measuring linkage at all venues, including jail-based clinics, fully captured engagement for this frequently recidivating population. Trial registration ClinicalTrials.gov NCT02185742
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Affiliation(s)
- Anne C. Spaulding
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Ana Drobeniuc
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Paula M. Frew
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Tiffany L. Lemon
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Emeli J. Anderson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Colin Cerwonka
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Chava Bowden
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - John Freshley
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Carlos del Rio
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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Cunningham M, Bull S, McNulty MC, Colborn K, Chavez C, Berman S, McSpadden J, Wigdor J, Allison MA. Does a text-messaging program to promote early childhood development reach the highest risk families? Mhealth 2018; 4:55. [PMID: 30596079 PMCID: PMC6286891 DOI: 10.21037/mhealth.2018.11.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 11/14/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Bright by Three (BB3), a non-profit organization that promotes caregiver behaviors to support language development in young children was augmented with a text-messaging program, Bright by Text (BBT), in 2015. While some evidence suggests that text-messaging can promote early development, it is unknown if these interventions are reaching children at increased sociodemographic risk for developmental delay. The purpose of this study is to compare socio-demographic characteristics of caregivers who did and did not enroll in BBT. METHODS Retrospective analysis of caregivers who received BB3 written materials and were eligible to sign up for BBT in 2016. Outcomes: (I) provision of a mobile phone number; (II) enrollment in BBT (receipt of 3+ messages). Predictors: education, marital status, race/ethnicity, insurance, language, and urban vs. rural residence. A multivariable generalized linear model was used to determine characteristics of caregivers more likely to sign up for BBT. RESULTS A total of 18,145 caregivers received BB3 written materials; 10,843 (60%) provided a mobile phone number and 2,314 (21%) enrolled in BBT. The relative risk (RR) of enrollment was higher for caregivers who were non-minority (RR 1.15, 95% CI, 1.04-1.28), had higher education (1.60, 1.35-1.89), had private insurance (1.15, 1.15-1.28) and lived in urban areas (1.21, 1.06-1.37). Non-English speaking caregivers were less likely to enroll (0.73, 0.59-0.90). CONCLUSIONS Caregivers with lower incomes and education, minorities and non-English speakers were less likely to enroll in BBT. Future research could identify ways to increase engagement among these populations and determine if BBT is effective in changing parent behavior and improving children's development.
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Affiliation(s)
- Maureen Cunningham
- Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO, USA
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
| | - Sheana Bull
- Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, USA
| | - Monica C. McNulty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, CO, USA
| | - Kathryn Colborn
- Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, USA
| | - Catia Chavez
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, CO, USA
| | - Stephen Berman
- Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO, USA
- Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
| | | | | | - Mandy A. Allison
- Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO, USA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, Aurora, CO, USA
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