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Shapiro E, Mekonent S, Tanami N. Mental Health and Care Utilization Among Ethiopian-Israeli Immigrants During the Period of COVID-19. J Racial Ethn Health Disparities 2024; 11:739-754. [PMID: 36930452 PMCID: PMC10022572 DOI: 10.1007/s40615-023-01557-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
As well as affecting physical health, COVID-19 can impact mental health. Despite this, Israelis may not be getting needed mental health care because of culture-related barriers such as stigma and lack of knowledge about mental health and appropriate care. This is especially likely among vulnerable populations, such as Ethiopian immigrants, yet the topic has been understudied. This study aimed to examine to what extent COVID-19-related mental health stressors and issues are found among Ethiopian-Israelis and the extent of stigma and mental health literacy among Ethiopian-Israelis during the COVID-19 period. It also examined differences between the 1.5th and 2nd generations and potential interventions to improve their mental health. Online surveys were filled out by a convenience sample of 225 Ethiopian-Israelis recruited from a variety of sources in the fall of 2020. Over 40% expressed greater mental distress since COVID-19 started. Stigma and lack of mental health-related knowledge were found among many in this population, serving as potentially important barriers to getting appropriate mental health care. For example, only 52% disagreed with the statement that people with mental illness should not be given any responsibility and only 66% felt confident they could identify having a mental health problem requiring treatment. Variations were found by types of stressors, stigma, and lack of knowledge, as well as by immigration generation, for at least some measures. COVID-19 can negatively impact mental health and appropriate mental health care utilization, especially for a racial/ethnic minority group of immigrants such as Ethiopian-Israelis. Interventions are needed, such as increased education about mental health from a variety of sources, which can help decrease stigma and improve mental health care utilization among this group, especially when appropriately tailored.
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Affiliation(s)
- Ephraim Shapiro
- Department of Health Systems Management, Ariel University, Ariel, Israel
| | - Shimrit Mekonent
- Department of Health Systems Management, Ariel University, Ariel, Israel
| | - Noi Tanami
- Department of Health Systems Management, Ariel University, Ariel, Israel
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Langford R, Brockman R, Banks J, Jago R, Gillison F, Coulman K, Moore T, Nobles J. Co-designing adult weight management services: a qualitative study exploring barriers, facilitators, and considerations for future commissioning. BMC Public Health 2024; 24:778. [PMID: 38475750 DOI: 10.1186/s12889-024-18031-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Weight management services have not always benefitted everyone equally. People who live in more deprived areas, racially minoritised communities, those with complex additional needs (e.g., a physical or mental disability), and men are less likely to take part in weight management services. This can subsequently widen health inequalities. One way to counter this is to co-design services with under-served groups to better meet their needs. Using a case study approach, we explored how co-designed adult weight management services were developed, the barriers and facilitators to co-design, and the implications for future commissioning. METHODS We selected four case studies of adult weight management services in Southwest England where co-design had been planned, representing a range of populations and settings. In each case, we recruited commissioners and providers of the services, and where possible, community members involved in co-design activities. Interviews were conducted online, audio-recorded, transcribed verbatim, and analysed using thematic analysis. RESULTS We interviewed 18 participants (8 female; 10 male): seven commissioners, eight providers, and three community members involved in co-designing the services. The case studies used a range of co-design activities (planned and actualised), from light-touch to more in-depth approaches. In two case studies, co-design activities were planned but were not fully implemented due to organisational time or funding constraints. Co-design was viewed positively by participants as a way of creating more appropriate services and better engagement, thus potentially leading to reduced inequalities. Building relationships- with communities, individual community members, and with partner organisations- was critical for successful co-design and took time and effort. Short-term and unpredictable funding often hindered co-design efforts and could damage relationships with communities. Some commissioners raised concerns over the limited evidence for co-design, while others described having to embrace "a different way of thinking" when commissioning for co-design. CONCLUSIONS Co-design is an increasingly popular approach to designing health in services but can be difficult to achieve within traditional funding and commissioning practices. Drawing on our case studies, we present key considerations for those wanting to co-design health services, noting the importance of building strong relationships, creating supportive organisational cultures, and developing the evidence base.
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Affiliation(s)
- Rebecca Langford
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK.
| | - Rowan Brockman
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - Jonathan Banks
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - Russell Jago
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Oakfield House, Oakfield Grove, BS8 2BN, Bristol, UK
| | - Fiona Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, BA2 7AY, Bath, UK
| | - Karen Coulman
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, BS8 1NU, Bristol, UK
| | - Theresa Moore
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - James Nobles
- Health, Nutrition & Environment, Leeds Beckett University, Calverley Building, City Campus, LS1 3HE, Leeds, UK
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Fang Q, Poon AWC, Fisher KR, Duong J, Lee JS. Coproduction with peer support groups: A new approach to culturally responsive social services. Am J Community Psychol 2024. [PMID: 38329016 DOI: 10.1002/ajcp.12734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 10/18/2023] [Accepted: 12/18/2023] [Indexed: 02/09/2024]
Abstract
The disparity of access to suitable social services for people from culturally diverse backgrounds is receiving increased attention. Coproduction between service users and providers has the potential as an approach to improve the cultural responsiveness of social services. What remains unknown is how social service organizations can facilitate and support coproduction with people from culturally diverse backgrounds. This article examines how three disability support organizations in Australia worked with peer support groups run by people with disability and their families from Chinese background to improve the organizations' service provision. We collected qualitative data through observations of activities in the groups and semistructured interviews with group members and organization staff. We found that organizing peer support groups facilitated knowledge exchange between people from culturally diverse backgrounds and organizations to inform practice development. Five contributors to the knowledge exchange were as follows: (1) assigning staff responsibility for exchange and trust with the group; (2) encouraging the group to challenge practice and cultural norms; (3) identifying and supporting the capacity of peer facilitators; (4) fostering trust within the group; and (5) collaborating with other organizations. Cultural responsiveness means incorporating people's cultural preferences in support provision and addressing the negative influences of cultural norms on people.
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Affiliation(s)
- Qian Fang
- UniSA Justice & Society, University of South Australia, Adelaide, South Australia, Australia
| | - Abner Weng Cheong Poon
- School of Social Sciences, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - Karen R Fisher
- Social Policy Research Centre, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | | | - Jung-Sook Lee
- School of Social Sciences, University of New South Wales (UNSW), Sydney, New South Wales, Australia
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Inge E, Pérez‐Aronsson A, Ibrahim K, Aljeshy R, Sarkadi A, Warner G. Ameliorating epistemic injustice in practice: Communication strategies in a research project with refugee youth coresearchers. Health Expect 2023; 27:e13926. [PMID: 38031659 PMCID: PMC10726263 DOI: 10.1111/hex.13926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/15/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Many researchers want to include seldom involved groups, such as refugees and youth, in patient and public involvement (PPI), but experience a number of barriers. The PPI research community calls for critical evaluations that are prospective, data-based and conducted by researchers and public contributors together. In this study, we conducted a longitudinal evaluation of a core activity in all collaborations: communication strategies. The aim was to evaluate the communication strategies adopted throughout a research project with refugee youth coresearchers. METHODS This article is based on the evaluation of a project where refugee youth were involved in the online adaptation of a group-based programme for youth with posttraumatic stress. Behavioural observations and field notes collected during the project were analysed with qualitative content analysis and a readability index, and discussed through the lens of epistemic injustice. The article was cowritten by researchers and refugee youth. FINDINGS Four manifest categories were identified: Facilitating engagement through coplanning and circumstantial flexibility; Different needs require different channels; It's not just about the channel-facilitation skills matter; Finding a common language opens a communicative flow. In addition, a latent underlying theme reflecting the role of trust was identified: Interactive moments facilitate trust-trust facilitates richer involvement. CONCLUSION At the core of the identified communication strategies were strengthening relationship-building and actively facilitating involvement. Establishing trusting relationships enabled refugee youth to share input. The communication strategies increased hermeneutical justice by contributing to a common understanding; thus, taking a step towards ameliorating epistemic injustice. PATIENT OR PUBLIC CONTRIBUTION This article is a participatory analysis of a PPI process; it was written in collaboration between researchers and refugee youth coauthors, who were all previously involved in the evaluated project.
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Affiliation(s)
- Elin Inge
- Department of Public Health and Caring ScienceChild Health and Parenting (CHAP), Uppsala UniversityUppsalaSweden
| | - Anna Pérez‐Aronsson
- Department of Public Health and Caring ScienceChild Health and Parenting (CHAP), Uppsala UniversityUppsalaSweden
| | - Kalid Ibrahim
- Department of Public Health and Caring ScienceChild Health and Parenting (CHAP), Uppsala UniversityUppsalaSweden
| | - Reem Aljeshy
- Department of Public Health and Caring ScienceChild Health and Parenting (CHAP), Uppsala UniversityUppsalaSweden
| | - Anna Sarkadi
- Department of Public Health and Caring ScienceChild Health and Parenting (CHAP), Uppsala UniversityUppsalaSweden
| | - Georgina Warner
- Department of Public Health and Caring ScienceChild Health and Parenting (CHAP), Uppsala UniversityUppsalaSweden
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Kilander H, Sorcher R, Berglundh S, Petersson K, Wängborg A, Danielsson KG, Iwarsson KE, Brandén G, Thor J, Larsson EC. IMplementing best practice post-partum contraceptive services through a quality imPROVEment initiative for and with immigrant women in Sweden (IMPROVE it): a protocol for a cluster randomised control trial with a process evaluation. BMC Public Health 2023; 23:806. [PMID: 37138268 PMCID: PMC10154759 DOI: 10.1186/s12889-023-15776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/27/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Immigrant women's challenges in realizing sexual and reproductive health and rights (SRHR) are exacerbated by the lack of knowledge regarding how to tailor post-partum contraceptive services to their needs. Therefore, the overall aim of the IMPROVE-it project is to promote equity in SRHR through improvement of contraceptive services with and for immigrant women, and, thus, to strengthen women's possibility to choose and initiate effective contraceptive methods post-partum. METHODS This Quality Improvement Collaborative (QIC) on contraceptive services and use will combine a cluster randomized controlled trial (cRCT) with a process evaluation. The cRCT will be conducted at 28 maternal health clinics (MHCs) in Sweden, that are the clusters and unit of randomization, and include women attending regular post-partum visits within 16 weeks post birth. Utilizing the Breakthrough Series Collaborative model, the study's intervention strategies include learning sessions, action periods, and workshops informed by joint learning, co-design, and evidence-based practices. The primary outcome, women's choice of an effective contraceptive method within 16 weeks after giving birth, will be measured using the Swedish Pregnancy Register (SPR). Secondary outcomes regarding women's experiences of contraceptive counselling, use and satisfaction of chosen contraceptive method will be evaluated using questionnaires completed by participating women at enrolment, 6 and 12 months post enrolment. The outcomes including readiness, motivation, competence and confidence will be measured through project documentation and questionnaires. The project's primary outcome involving women's choice of contraceptive method will be estimated by using a logistic regression analysis. A multivariate analysis will be performed to control for age, sociodemographic characteristics, and reproductive history. The process evaluation will be conducted using recordings from learning sessions, questionnaires aimed at participating midwives, intervention checklists and project documents. DISCUSSION The intervention's co-design activities will meaningfully include immigrants in implementation research and allow midwives to have a direct, immediate impact on improving patient care. This study will also provide evidence as to what extent, how and why the QIC was effective in post-partum contraceptive services. TRIAL REGISTRATION NCT05521646, August 30, 2022.
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Affiliation(s)
- Helena Kilander
- Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden.
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Rachael Sorcher
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Sofia Berglundh
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Kerstin Petersson
- Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden
| | - Anna Wängborg
- Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden
| | - Kristina Gemzell- Danielsson
- Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Emtell Iwarsson
- Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden
| | - Gunnar Brandén
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Center for Epidemiology and Social Medicine, Region Stockholm, Sweden
| | - Johan Thor
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Elin C Larsson
- Department of Women's and Children's Health, Karolinska Institutet, and the WHO Collaborating Centre, Karolinska University Hospital, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
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Radl-Karimi C, Nielsen DS, Sodemann M, Batalden P, Von Plessen C. “What it really takes” – a qualitative study of how professionals coproduce healthcare service with immigrant patients. J Migr Health 2022; 5:100101. [PMID: 35480876 PMCID: PMC9036136 DOI: 10.1016/j.jmh.2022.100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/15/2022] [Accepted: 04/02/2022] [Indexed: 10/27/2022] Open
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Pedersen MRL, Stougaard MS, Ibsen B. Transferring Knowledge on Motor Development to Socially Vulnerable Parents of Infants: The Practice of Health Visitors. Int J Environ Res Public Health 2021; 18:ijerph182312425. [PMID: 34886151 PMCID: PMC8657119 DOI: 10.3390/ijerph182312425] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
Parents are a determinant factor in a child’s development of motor skills. Studies show that programmes in which health visitors supervise parents may improve infants’ motor skills. This study examines which factors health visitors have found to enhance and hamper the implementation of a motor development programme among socially vulnerable parents of infants. The data consist of three group interviews with 4 health visitors in each (12 health visitors in total) and a subsequent member check with 27 health visitors. All were audio-recorded and transcribed verbatim, and a thematic analysis was conducted. The results show that according to the health visitors, the programme increases the ability and willingness of parents to engage in co-producing its implementation. In particular, the materials that they hand out to the parents enhance the implementation. On the other hand, they perceive the limited time provided for the implementation, together with the many pressing needs of the families, as hampering the implementation. Consequently, the study can inform future policies and programmes for frontline workers and socially vulnerable parents of infants.
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Affiliation(s)
- Marlene Rosager Lund Pedersen
- Centre for Sports, Health and Civil Society, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
- Correspondence:
| | - Marianne Staal Stougaard
- Department of Health, Social Work, and Welfare Research, UCL University College, Niels Bohrs Allé 1, 5230 Odense, Denmark;
| | - Bjarne Ibsen
- Centre for Sports, Health and Civil Society, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
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Pelters P, Lindgren EC, Kostenius C, Lydell M, Hertting K. Health-related integration interventions for migrants by civil society organizations: an integrative review. Int J Qual Stud Health Well-being 2021; 16:1927488. [PMID: 34053417 PMCID: PMC8168756 DOI: 10.1080/17482631.2021.1927488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: Migrants are a vulnerable group concerning health and integration. Civil society organizations are deemed important for the integration and health of migrants and have been encouraged to help. This study explored health and acculturation, as expressed in research into health-related integration interventions for migrant groups provided by civil society organizations. Methods: Databases, journal websites and reference lists were searched in an integrative review. Thirteen articles were found and analysed using concepts of health strategies/perspectives and of acculturation with regard to general and health culture. Results: Studies were divided between two primary spectrums: 1) assimilation-integration and 2) integration-separation spectrum. Spectrum 1 interventions tend to promote assimilation into the present host culture and into a Western view of health. They are mostly driven by representatives of the host culture. Spectrum 2 interventions are characterized by a greater openness concerning the home-culture understandings of health, alongside an appreciation of the home culture in general. They are mostly migrant-driven. Conclusions: The different acculturating approaches in migrant and native-driven civil society organizations call for an awareness of their guiding health and acculturation assumptions and their applied perspectives and strategies. This awareness is considered crucial in order to achieve desired health and acculturation outcomes.
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Affiliation(s)
- Pelle Pelters
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.,Department of Education, University of Stockholm, Stockholm, Sweden
| | - Eva-Carin Lindgren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.,Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Catrine Kostenius
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.,Division: Health and Rehabilitation, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.,Norrbotten Association of Local Municipalities, Luleå, Sweden
| | - Marie Lydell
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Krister Hertting
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Lachman P, Nelson EC. Policy, accreditation and leadership: Creating the conditions for effective coproduction of health, healthcare and science. Int J Qual Health Care 2021; 33:ii1-ii3. [PMID: 33822945 DOI: 10.1093/intqhc/mzab065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/20/2021] [Accepted: 04/05/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Eugene C Nelson
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth; The Health Assessment Lab/Medical Outcomes Trust
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