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A growing body of evidence demonstrates potential adverse mental health outcomes associated with exposure to occupational trauma among first responders. In response, policymakers nationwide are eager to work on these issues as evidenced by the number of states covering or considering laws for mental health conditions for first responders. Yet, little information exists to facilitate understanding of the impact of mental health-related policies in the United States on this important population. This study aims to identify and synthesize relevant state-level policies and related research on first responder mental health in the United States. Using a scoping review framework, authors searched the empirical and policy literature. State level policies were identified and grouped into two categories: (1) Workers' Compensation-related policies and (2) non-Workers' Compensation (WC) related policies. While benefits levels and other specifics vary greatly by state, 28 states cover certain first responder mental health claims under WC statutes. In addition, at the time of this study, 28 states have policies governing first responder mental health outside of WC. Policies include requiring mental health assessments, provisions for counseling and critical incident management, requiring education and training, providing funding to localities for program development, bolstering peer support initiatives and confidentiality measures, and establishing statewide offices of responder wellness, among others. Authors found a dearth of outcomes research on the impact of state level policies on first responder mental health. Consequently, more research is needed to learn about the direct impact of legislation and establish best practice guidelines for implementing state policy on first responder mental health. By conducting systematic evaluations, researchers can lay the foundation for an evidence-based approach to develop more integrated systems that effectively deliver and finance mental health care for first responders who experience work-related trauma. Such evaluations are crucial for building an understanding of the impact of policies and facilitating improvements in the support provided to first responders in managing mental health challenges arising from their work. [ABSTRACT FROM AUTHOR]

Background: Each year, medication-related adverse events account for over 1 million emergency department visits according to the Office of Disease Prevention and Health Promotion. Medication therapy management (MTM), a service most commonly performed by health professionals, identifies and resolves medication-related problems and has been shown to both reduce healthcare costs and improve clinical outcomes. Objective: The objective of our project was to expand the use of MTM by developing a training program for health professionals to increase medication adherence for low-income patients at Federally Qualified Health Centers (FQHCs) specifically targeting individuals with hypertension and diabetes. Methods: A needs assessment survey was developed and administered to licensed pharmacists across the state of Florida. Based on the results of the survey, an MTM training program was developed to support pharmacists who serve patients with hypertension and diabetes. The second phase included a pre-assessment administered to the FQHC. The training program was modified based on responses to the pre-assessment. Results: Based on the FQHC pre-assessment, the team developed MTM support training for health professionals that included 7 modules. These modules were Principles of Chronic Disease Self-Management, Team-Based Care, Client Self-Advocacy, Health Equity, Cultural Competency, Social Determinants of Health, and the Benefits of MTM Services. Conclusion: Expanding MTM support training to other health professionals is expected to provide greater access to chronic disease management support, improve patient outcomes and reduce the cost of care for patients. It is also expected over time to reduce the demand for additional chronic disease–related services. [ABSTRACT FROM AUTHOR]

Objective: This research examines health information (HI) seeking and use among middle-aged and older adults with chronic health conditions. Method: We used logistic regression models to analyze HI seeking (N = 7,822) and use (N = 4,541-4,547) among participants (aged 45+ years) with chronic conditions from the nationally-representative Health Tracking Household Survey. Results: Adults aged 45+ years with chronic conditions were significantly more likely to seek and use HI; however, these results varied based on the age and education. Compared with Whites, Latinos were less likely to seek HI but more likely to use HI to treat illness, and African Americans were more likely to use HI to maintain health. Conclusion: Middle-aged and older adults with chronic conditions are prominent HI seekers and users. Proficient HI seeking and use may have the potential to enhance control over one's own health, maintain independence in the community, and reduce the impact of negative health consequences on the health care system. [ABSTRACT FROM AUTHOR]

In this study, we assessed health needs and insurance coverage among a rural Latino population. A health needs survey was conducted in 2015 with approximately 100 Latino residents living in a rural Florida county. The survey included questions on socio-economic characteristics, type of insurance coverage, lapses in coverage, delays in care and satisfaction with health services. Only 15% of respondents had insurance through their employer, and 11% had Medicaid. Over 45% of participants had no health insurance, and 20% had no insurance for more than three years. One in ten had a medication delay due to lack of coverage/money, and 17% expressed they had medical bills they were paying off. Gaps in coverage highlight the need for targeted outreach efforts, while gaps in access and affordability highlight the need for new strategies to address barriers to care and out of pocket expenses for those with health insurance. [ABSTRACT FROM AUTHOR]

Objective: Increases in body weight and declining physical activity that may accompany aging are linked to a range of problems affecting daily life (i.e., decreased mobility and overall quality of life). This study investigates the actual and perceived neighborhood environment on overweight and obese urban older adults. Method: We selected 217 individuals aged 65+ who answered questions about their neighborhood on the 2009 Speak to Your Health survey. Using multinomial regression models and geospatial models, we examined relationships between neighborhood environment and BMI. Results: We found that obese older adults were 63% less likely to have a park within their neighborhood (p = .04). Our results also show that older adults who perceive their neighborhood crime as very high are 12 times more likely to be overweight (p = .04). Discussion: Findings suggest that parks may affect BMI in older adults; however, neighborhood perceptions play a greater role. [ABSTRACT FROM AUTHOR]

Background: Despite the overall gains in reducing colorectal cancer (CRC) deaths due to the increase in screening, minority racial/ethnic groups who have disparately higher rates of death compared to Whites, also have disproportionately lower screening rates. Patient-provider communication about screening has a strong influence on the uptake of screening. In much the same way that gradual impact was made after the 1996 implementation of guidelines recommending screening starting at age 50 for those at average risk, it may be expected that the American College of Gastroenterology (ACG) guidelines suggesting screening start at 45 for Blacks combined with a recent trend toward increasing incidence of cancer in persons below the age of 50 might influence practitioners to offer screening with greater frequency to those younger minority groups. Methods: This study examines HINTS Cycle 4 data to examine the nationally representative rates at which providers offer patients the option to be screened for CRC, with emphasis on Blacks ages 45-49. We looked for a trend in these rates over time, compared the pooled proportion estimates across racial/ethnic groups aged 45-49, and compared the proportion of Black individuals in this age group to those between ages 50 and 75 who had been told they could choose to have a CRC screening. Results: Approximately 27.14% of Black individuals aged 45-49 had been offered the option of CRC screening by a healthcare provider compared to 32.57% of White individuals of the same age group and 43.53% of Black individuals age 50-75. Discussion: There is not yet any evidence of an increase in adherence to the ACG guidelines for the Black population aged 45-49 and there remains a significant racial disparity in discussion of the CRC screening option. Earlier information regarding the option to be screened may have the potential to reduce disparities CRC screening and mortality, as well as potentially halt a disturbing trend toward early cancers. [ABSTRACT FROM AUTHOR]

Background: Florida became the first state in the U.S. South to legalize the use of medical marijuana to treat a variety of health conditions including chronic pain, epilepsy, and spasticity symptoms from multiple sclerosis. While there are over 200,000 medical marijuana patients in Florida, there remain financial, psychological, and insurance coverage barriers which reduce access for many patients., Purpose: This scoping review, with a focus on state health policy, first describes some clinical studies examining the therapeutic benefits of medical marijuana. Next, there is a discussion of the Florida regulatory environment and major legislation. Also, the review describes how the current Florida policy landscape presents challenges for physicians and patients., Methods: A scoping review of the literature was conducted in PubMed and Google Scholar using the search terms, "medical marijuana" and "medical cannabis" to identify research articles, newspaper reports, and government documents. The purpose of the review was to identify research investigating the therapeutic efficacy of medical marijuana and state policies affecting physician practice., Results: The review concluded there was general scientific consensus of therapeutic benefits for patients, especially for chronic pain, from the use of medical marijuana. The review also identified several barriers for physicians and patients around cost, stigma, and lack of insurance coverage which constrains use and access., Discussion: The review discusses several directions for future medical marijuana policy and research with the aim to improve therapeutic benefits for Florida patients., Competing Interests: The authors have no financial disclosures and no conflicts of interest to report.