Latest paper from IBH-PC appears as "abstract in press"

 

This just appeared in the "Abstracts in press" section of the Journal of the American Board of Family Medicine. Stay tuned for the full article...

Walking Habits During the COVID-19 Pandemic Are Associated with Mental and Physical Health Among Primary Care Patients Managing Multiple Chronic Conditions

Levi N. Bonnell; Jessica Clifton; Mariana Wingood; Nancy Gell; Benjamin Littenberg

Section: Brief Report

Publication Date: TBD

BACKGROUND: COVID-19 policies such as quarantining, social isolation, and lockdowns are an essential public health measure to reduce the spread of disease, but may lead to reduced physical activity. Little is known if these changes are associated with changes in physical or mental health.

METHODS: Between September 2017 and December 2018 (baseline) and March 2020 and February 2021 (Follow-up), we obtained self-reported demographic, health, and walking (only at follow-up) data on 2,042 adults in primary care with multiple chronic health conditions. We examined whether the perceived amount of time engaged in walking was different compared to pre-pandemic levels, and if this was associated with changes in PROMIS-29 mental and physical health summary scores. Multivariable linear regression controlling for demographic, health, and neighborhood information were used to assess this association.

RESULTS: Of the 2,042 participants, 9% reported more walking, 28% reported less, and 52% reported the same amount compared to pre-pandemic levels. Nearly a third of participants reported less walking during the pandemic. Multivariable models revealed that walking less or not at all was associated with negative changes in mental (ß= -1.0; 95% CI -1.6, -0.5; ß= -2.2; 95% CI -2.9, -1.4) and physical (ß= -0.9; 95% CI -1.5, -0.3; ß= -3.1; 95% CI -4.0, -2.3) health, respectively. Increasing walking was significantly associated with a positive change in physical health (ß=1.3; 95% CI 0.3, 2.2).

CONCLUSIONS: These findings demonstrate the importance of walking during the COVID-19 pandemic. Promotion of physical activity should be taken into consideration when mandating restrictions to slow the spread of disease. Primary care providers can assess patient’s walking patterns and implement brief interventions to help patients improve their physical and mental health through walking.

 

IBHPC Data are now all on-line!

Thanks to data wizard Levi Bonnell, the complete analyzable data set from all waves of data collection is now on-line at The Harvard Dataverse. It is available to all with no fees or access restrictions. There are two files. The first is the data dictionary: a list of all 553 variables with their format and definition. The second is big spreadsheet with a column for each variable and a row for each of 3,929 participants. Both are Excel files in comma-separated-value format.

You can find the data here: https://doi.org/10.7910/DVN/CT9PY6

Please remember that any analyses from these data done by anyone on the IBHPC team needs to be approved by the IBHPC Executive Team, cite the funder correctly, etc.

Thanks,

Ben

Support for NIH Clinical Trial Diversity Act (H.R. 7845)

Florence Fee (No Health without Mental Health), along with many other leaders of professional organizations associated with health care such as American Academy of Family Physicians, American Cancer Society Cancer Action Network, American College of Physicians, American Medical Association
American Psychiatric Association, American Psychological Association, have written a thoughtful, supportive letter commending key leaders in the US House of Representatives for bipartisan leadership in advancing the Food and Drug Amendments of 2022, and specifically the inclusion of Food and Drug Administration (FDA) policies to improve clinical trial diversity.

Their goal is to ask the members of the Energy and Commerce Committee to take steps to complement these policies by enacting policies to improve clinical trial diversity across a wide range of clinical research funded by the National Institutes of Health (NIH).  For more information, please check out https://www.congress.gov/bill/117th-congress/house-bill/7845/actions?r=1&s=1 or contact Florence at florencefee@nhmh.org.

Bonnell on the association of post-lung transplant mortality with pre-transplant kidney function

 Congratulations to Levi Bonnell, MPH on this recent publication:

Abhishek Kumar, Levi N Bonnell, Michael Eberlein, Christie P Thomas. The U-shaped association of post-lung transplant mortality with pre-transplant eGFR underscores possible limitations of creatinine-based estimation equations for risk stratification. The Journal of Heart and Lung Transplantation,
2022, https://doi.org/10.1016/j.healun.2022.05.018.
(https://www.sciencedirect.com/science/article/pii/S1053249822019738)

Abstract: Background: Pre-existing chronic kidney disease (CKD) may have an impact on post-lung transplant survival and the development of end stage kidney disease (ESKD).
Methods: We analyzed the US transplant database from 2006 to 2020. Adult patients who received their first lung transplant and were not on dialysis were included. Multivariable Cox regression was used to assess the effect of pretransplant eGFR on mortality and cumulative incidence competing risk was used to explore the effect on ESKD.
Results: The adjusted hazard ratio (aHR) for mortality showed a “U” shaped association with eGFR with a rising mortality at <60 and >100 ml/min/1.73m2. The increase in mortality with higher eGFR was only seen in those < 30 year and were primarily in whites with a lower body mass index and in patients with cystic fibrosis (CF). The aHR for ESKD increased below an eGFR of 100 rising to 1.74 at an eGFR of 60. Any decrease in eGFR between listing and transplant >10% was associated with higher risk of ESKD.
Conclusions: The U-shaped association of pretransplant eGFR with post-transplant mortality correlated with younger age, lower BMI and a diagnosis of CF. The aHR for ESKD following lung transplantation increased exponentially with worsening eGFR pretransplant.

Press Release on Bipartison IBH Bill from Florence Fee, NHMH

 Press release on Bipartisan IBH bill in U.S. Senate

The above link is a May 26, 2022 press release on a newly introduced bipartisan Senate bill on behavioral integration in primary care (S. 4306).  Lead sponsors are Sen. Tina Smith (D-MN) and Sen. Jerry Moran (R-KS), both members of the Senate HELP Committee where the bill has been sent. The bill would establish a federal grant program to enable PC practices to deploy evidence-based behavioral integration services.  Priority would be given to small (<15 clinicians) practices.

In addition to No Health without Mental Health (NHMH), the bill is endorsed by many key players in the DC IBHPC policy space, with particular support from the Bipartisan Policy Center (BPC).  The BPC's March 2021 landmark BHI Report with Policy Recommendations to Congress are currently forming the basis for another important bipartisan (Sen. Ron Wyden (D-OR) and Sen. Mike Crapo (R-ID) Senate bill now being in the Senate Finance Committee responsible for all Congressional legislation regarding Medicare and Medicaid programs.

From Florence Fee: new national MH/SUDs hotline starts next month

 In July 2022, the National Suicide Prevention Lifeline will officially become 988 – the National Suicide and Crisis Lifeline – a new, nationwide three-digit number for suicide response and mental health crisis care. 

This shift represents a dramatic moment in terms of access to crisis care and enhanced integration of services across the crisis continuum. For example, the critical work of mental health and substance use treatment organizations will become more visible, utilization of mobile crisis teams and crisis stabilization units will continue to expand and volume to the Lifeline via calls, chats and texts is likely to increase.  To develop shared understanding and ensure maximum engagement with these new services, coordinated and aligned messaging is key. Join the National Council and Vibrant Emotional Health on Wednesday, June 15, 3-4 p.m. ET for our webinar, Framework and Tools for Successfully Messaging 988. Speakers from the National Action Alliance for Suicide Prevention (NAASP), the Substance Abuse and Mental Health Services Administration (SAMHSA) and Vibrant will provide an overview of the 988 messaging framework, as well as walkthroughs of tools that can help organizations, providers and officials successfully message 988.