24 Mar In response to your peers, ask questions to increase the clarity of their response and your understanding. Also, provide your thoughts on how a public health organization could respond

Discussion 8

I selected the Healthy People Objective: reduce the proportion of people who had opioid use disorder in the past year. (Healthy People, 2023). Data from the National Survey on Drug Use and Health (NSDUH) was used for this topic. The target was to discover if opioid use disorder, defined as meeting DSM-IV criteria, in persons 12 years and over decreased or increased from 2018 to 2019. The data visualized in the graph below displayed percentages on the XXXX axis and years on the YYYY axis. Target was 0.50 percent, with a desired decrease each year. Statistically, the standard error was used to calculate a target base. In the graph, 2018 reveals 0.7%, CI:0.6/0.9, SE: 0.057, and 2019 reveals 0.6%, CI: 0.5/0.7, SE: 0.041 (Healthy People, 2023). Progress was made toward reducing opioid use disorder in persons 12 years and over by 1 percent over a year (7% to 6%). The standard error and confidence intervals together allow readers to interpret the percentage shown as accurate because it lies within those ranges of the expected values and says that they are 95% confident that the mean lies within those limits. Values outside those limits are improbable for that distribution. 

About the Healthy People Objective: reduce the proportion of people who had opioid use disorder in the past year; I chose a journal article focusing on eleven U.S. prevention strategies to help reduce opioid use and death. Both my Healthy People Objective and article focus on opioid use disorder in persons 12 years and older. Opioid use and overdose deaths are a significant public health crisis in the U.S., killing over 650,000 since 1999, with fatal overdoses reaching an all-time high in 2021 (Bearnot et al., 2022). The federal government spent millions to decrease access to prescription medication and increase access to lifesaving naloxone. However, synthetic opioids such as fentanyl dominate the opioid market increasing opioid use disorders and deaths. Bearnot et al. 2022, present an analysis of 11 strategies that could decrease the number of opioid use and related deaths and identifies which approaches lead to qualitative and positive shifts in reduction trends. The eleven strategies were simulated into four categories: opioid misuse and opioid misuse death prevention, buprenorphine treatment (ex: methadone and naltrexone), recovery support, and overdose harm prevention. In conclusion, the four strategies of fentanyl harm reduction, increased naloxone distribution, recovery support, and increasing buprenorphine provider capacity had the most extensive and modest impacts. 

Healthy Peoples data visualization concerning the Healthy People Objective: reduce the proportion of people who had opioid use disorder in the past year, would prompt me as an author to break down even further which of the four strategies worked best or which strategies combined to lower the use of opioid drugs by one percent. Policies currently in place do not account for the use of these strategies to reduce opioid use and could replace less effective or outdated policies as trends shift. With the finding from the article, there is potential to develop new and meaningful policies to reduce the percentage of persons even further with an opioid use disorder and further the deaths from overdose. 

The article concluded which 11 strategies provided the best outcome but did not break down the demographic’s characteristics. Bearnot et al. 2022 used data from the National Survey on Drug Use and Health (NSDUH) and the U.S. Center for Disease Control and Prevention. Demographics in research provide data regarding participants and are needed for determining if a study represents the entire population. Providing further demographic information allows a better understanding of background characteristics. In the case of opioid use, which were the standard variables? For example, which age group, race, gender, city, or state could benefit from these strategies presented?  

Reference

Bearnot, B., Beaulieu, E., Digennaro, C., Homer, J., Humphreys, K., Kathry, R., Stringfellow, E., & Wakeland, W. (2022). Reducing opioid use disorder and overdose deaths in the United States: A dynamic modeling analysis. Science advances,  8(25), eabm8147. https://doi.org/10.1126/sciadv.abm8147

Healthy People 2023. (2023). Reduce the proportion of people who had opioid use disorder in the past year — SU18. Retrieved from: https://health.gov/healthypeople/objectives-and-data/browse-objectives/drug-and-alcohol-use/reduce-proportion-people-who-had-opioid-use-disorder-past-year-su-18

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Good Afternoon Class,

The objective I chose form the Healthy People Website 2023 was “Children with Mental Health problems receiving treatment”.  ( Increase the Proportion of Children with Mental Health Problems Who Get Treatment — Data Methodology and Measurement – Healthy People 2030 | Health.gov, n.d.)  Utilizing the most recent data from 2019 shows the baseline of 70.7 percent of children between the ages of 4-17 with mental health issue received treatment.  The target percentage is 70.3% The target setting method was calculated using Cohen’s h effect size of 0.2.  “In statistics, Cohen’s   h, popularized by  Jacob Cohen, is a measure of distance between two proportions or  probabilities.” (Wikipedia Contributors, 2017) The Healthy People 2030 experts believed this to be a reasonable target due to the national resources that were being implemented to improve children’s mental health.

            The journal article I selected was “Is minimally adequate treatment really adequate? Investigating the effect of mental health treatment on quality of life for children with mental health problems” (Ride et al., 2020)The purpose of this study was to determine if children between the ages of 8-15 who received MAT (minimally adequate treatment) in the way of mental health gained any significant improvement. With a sample that consisted of 596 children using the Strengths and Difficulties Questionnaire (SDQ) which was completed by the children’s parents.  Results showed that minimally adequate treatment (MAT) for mental health in children had no statistically significant improvement or have better outcomes.

In comparison to the Health People Objective, it questions that even with the increase of treatment received by children for mental health is this treatment effective.  Treatment can be increased and still have no beneficial effects for the children.  In this case, more treatment is not healthier.  I would use this information to concentrate on the quality of mental health resources that are being presented to children not just quantity.

 Reference

Increase the proportion of children with mental health problems who get treatment — Data Methodology and Measurement – Healthy People 2030 | health.gov. (n.d.). Health.gov.  https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders/increase-proportion-children-mental-health-problems-who-get-treatment-mhmd-03/data-methodology

Ride, J., Huang, L., Mulraney, M., Hiscock, H., Coghill, D., Sawyer, M., Sciberras, E., & Dalziel, K. (2020). Is “minimally adequate treatment” really adequate? investigating the effect of mental health treatment on quality of life for children with mental health problems..  Journal of Affective Disorders,  276, 327–334. https://doi.org/10.1016/j.jad.2020.07.086

Wikipedia Contributors. (2017, February 19).  Cohen’s h. Wikipedia; Wikimedia Foundation. https://en.wikipedia.org/wiki/Cohen%27s_h