J. Scott Ashwood

Neighborhood design and perceptions: relationship with active commuting.

PURPOSE Walking to and from school contributes to total physical activity levels. This study investigated whether perceived and actual neighborhood features were associated with walking to or from school among adolescent girls. METHODS A sample of geographically diverse eighth-grade girls (N = 890) from the Trial of Activity in Adolescent Girls (TAAG) study living within 1.5 miles of their middle school was recruited. Participants completed a self-administered survey on their neighborhood and walking behavior. Geographic information system data were used to assess objective neighborhood features. Nested multivariable logistic regression analyses were conducted to determine the contribution of perceived and objective measures of walking to or from school. RESULTS Fifty-six percent (n = 500) of the girls walked to or from school for at least 1 d in a week. White (42%) girls walked more frequently than Hispanic (25%) and African American (21%) girls. Girls were nearly twice as likely to walk to or from school if they perceived their neighborhoods as safe and perceived that they had places they liked to walk, controlling for other potential confounders. In addition, girls who lived closer to school, had more active destinations in their neighborhood, and had smaller-sized blocks were more likely to walk to or from school than those who did not. CONCLUSIONS Safety, land use, and school location issues need to be considered together when designing interventions to increase walking to and from school.

Assessing Patient Safety Practices and Outcomes in the U.S. Health Care System

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Payoffs for California College Students and Taxpayers from Investing in Student Mental Health

Reports results of a survey to assess the impact of CalMHSAs investments in mental health programs at California public colleges and estimates the return on investment in terms of student use of treatment, graduation rates, and lifetime earnings.

Evaluation Design Recommendations for the Certified Community Behavioral Health Clinic Demonstration Program

This article provides information and recommendations regarding the evaluation design of the Certified Community Behavioral Health Clinic (CCBHC) demonstration. Mandated by Congress in Section 223 of the Protecting Access to Medicare Act of 2014, the CCBHC is a new model of specialty behavioral health clinic, designed to provide comprehensive and integrated care for adults with mental health or substance-use disorders and children with serious emotional distress. Certification criteria for the CCBHCs have been specified by Substance Abuse and Mental Health Services Administration covering six core areas: staffing; accessibility; care coordination; scope of services; quality and other reporting; and organizational authority, governance, and accreditation. In addition, services provided to Medicaid enrollees in CCBHCs will be reimbursed through one of two alternative prospective payment systems. At present, 24 states have been awarded grants to begin the planning process for implementing CCBHCs. Of these states, eight will be selected to participate in the demonstration project beginning in January 2017. Results from the evaluation will inform mandated reports to Congress over the two-year demonstration period and the three years following the end of the demonstration, providing information to policymakers on the programs impact and value. In addition, the results can inform the direction of future efforts at integration of behavioral health into the health care system at this critical time of transformation.

Use Of Retail Clinics: The Authors Reply

Use Of Retail Clinics: The Authors Reply We thank James Bowman for his comments about our article (Mar 2016). In our analyses we did not find that a small group of “high utilizers” accounted for the majority of the increased visits to retail clinics. Our sampling method likely made this impossible. We focused only on patients who first visited a retail clinic in 2011 or 2012. In previous analyses using older data, we found few patients who visited a retail clinic numerous times. Nonetheless, this might change in the future as retail clinics become more popular. We completely agree with Bowman that health plans’ care management teams should be monitoring use of retail clinics just as they monitor use at other care sites.