Jonathan Purtle
Jonathan Purtle
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Associate Professor of Public Health Policy & Management
Director of Policy Research at NYU’s Global Center for Implementation Science
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Professional overview
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Jonathan Purtle is Associate Professor of Public Health Policy & Management and Director of Policy Research at NYU’s Global Center for Implementation Science.
Dr. Purtle is a mental health policy researcher and implementation scientist. His work examines questions such as how the implementation of policies “on the books” can be improved in practice, how research evidence can be most effectively communicated to policymakers and is used in policymaking processes, and how social and political contexts affect mental health policymaking and policy implementation. He is also studies population-based approaches to mental health and suicide prevention.
Dr. Purtle’s work has been consistently funded by the National Institute of Mental Health (NIMH) and Robert Wood Johnson Foundation (RWJF). He is currently leading/recently led NIMH-funded projects focused on the implementation of financing policies related to the 988 Suicide & Crisis Lifeline (R01MH131649) and policies that earmark taxes for mental health services (R21MH125261) and understanding the dynamics of research evidence in mental health policymaking (P50MH113662). He also recently completed a RWJF-funded project that experimentally tested different ways of communicating evidence about child maltreatment to the public and policymakers.
He has published over 150 peer-reviewed journal articles, is an Associate Editor at Implementation Science, and Co-Chairs the Policy Advisory Board at Psychiatric Services. He is Core Faculty of the NIMH-funded Implementation Research Institute, was Chair of the Policy Section of the AcademyHeath/NIH Dissemination and Implementation in Heath Conference from 2017 to 2022, was awarded the 2018 Champion of Evidence-Based Interventions Award from the Association for Behavioral and Cognitive Therapies for his work on evidence use in mental health policymaking.
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Education
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BA, Psychology, Roger Williams UniversityMSc, Sociology, Universiteit van AmsterdamMPH, Drexel UniversityDrPH, Drexel University
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Publications
Publications
Association between local public housing authority policies related to criminal justice system involvement and sexually transmitted infection rates
AbstractPurtle, J., Tekin, E., Gebrekristos, L. T., Niccolai, L., & Blankenship, K. M. (n.d.).Publication year
2021Journal title
Health and JusticeVolume
9Issue
1AbstractThe policies of U.S. local public housing authorities influence which populations have access to stable housing, an important resource for health. We assessed whether the restrictiveness of local public housing authority policies related to people with criminal justice histories—a population at high risk for HIV/STIs—were associated with HIV/STI rates at the local-level. An ecological analysis was conducted using data from 107 local public housing authority jurisdictions. The independent variable was a score that quantified the presence/absence of eight policies related to the ability of people with criminal justice histories to obtain and retain public housing. The dependent variables were county-level rates of HIV, gonorrhea, syphilis, and chlamydia. Ordinary least squares regression with state fixed effects was used. We find that the restrictiveness of housing authority policies towards people with criminal justice histories were significantly associated with higher HIV and gonorrhea rates, but not syphilis or chlamydia. For example, local housing authorities with a policy score more restrictive than the median score had an additional 6.05 cases of HIV per 100,000 population (32.9% increase relative to the mean rate) and 84.61 cases of newly diagnosed gonorrhea (41.3% increase). Local public housing authority policies related to people with criminal justice histories could affect HIV/STI risk at the population-level. These policies should be considered in studies and interventions at the intersection of housing, health, and justice involved populations.Changes in legislator vaccine-engagement on Twitter before and after the arrival of the COVID-19 pandemic
AbstractEngel-Rebitzer, E., Stokes, D. C., Buttenheim, A., Purtle, J., & Meisel, Z. F. (n.d.).Publication year
2021Journal title
Human Vaccines and ImmunotherapeuticsVolume
17Issue
9Page(s)
2868-2872AbstractWidespread SARS-CoV-2 vaccine uptake will be critical to resolution of the COVID-19 pandemic. Politicians have the potential to impact vaccine sentiment and uptake through vaccine-related communication with the public. We used tweets (n = 6,201), abstracted from Quorum, a public affairs software platform, to examine changes in the frequency of vaccine-related communication by legislators on the social media platform, Twitter. We found an increase in vaccine-related tweets by legislators following the arrival of SARS-CoV-2 in the United States. In the pre-COVID-19 era the majority of vaccine-related tweets were generated by Democrat and state senators. The increase in tweets following the arrival of COVID-19, however, was greater among Republican and federal legislators than Democrat or state legislators. This suggests that legislators who were previously less engaged in public discussion of vaccination, became engaged following the arrival of SARS-CoV-2, which may have implications for COVID-19 vaccine uptake among their followers.Determinants of using children’s mental health research in policymaking: variation by type of research use and phase of policy process
AbstractPurtle, J., Nelson, K. L., Horwitz, S. M. C., McKay, M. M., & Hoagwood, K. E. (n.d.).Publication year
2021Journal title
Implementation ScienceVolume
16Issue
1AbstractBackground: Research use in policymaking is multi-faceted and has been the focus of extensive study. However, virtually no quantitative studies have examined whether the determinants of research use vary according to the type of research use or phase of policy process. Understanding such variation is important for selecting the targets of implementation strategies that aim to increase the frequency of research use in policymaking. Methods: A web-based survey of US state agency officials involved with children’s mental health policymaking was conducted between December 2019 and February 2020 (n = 224, response rate = 33.7%, 49 states responding (98%), median respondents per state = 4). The dependent variables were composite scores of the frequency of using children’s mental health research in general, specific types of research use (i.e., conceptual, instrumental, tactical, imposed), and during different phases of the policy process (i.e., agenda setting, policy development, policy implementation). The independent variables were four composite scores of determinants of research use: agency leadership for research use, agency barriers to research use, research use skills, and dissemination barriers (e.g., lack of actionable messages/recommendations in research summaries, lack of interaction/collaboration with researchers). Separate multiple linear regression models estimated associations between determinant and frequency of research use scores. Results: Determinants of research use varied significantly by type of research use and phase of policy process. For example, agency leadership for research use was the only determinant significantly associated with imposed research use (β = 0.31, p < 0.001). Skills for research use were the only determinant associated with tactical research use (β = 0.17, p = 0.03) and were only associated with research use in the agenda-setting phase (β = 0.16, p = 0.04). Dissemination barriers were the most universal determinants of research use, as they were significantly and inversely associated with frequency of conceptual (β = −0.21, p = 0.01) and instrumental (β = −0.22, p = 0.01) research use and during all three phases of policy process. Conclusions: Decisions about the determinants to target with policy-focused implementation strategies—and the strategies that are selected to affect these targets—should reflect the specific types of research use that these strategies aim to influence.Disseminating evidence to policymakers
AbstractPurtle, J. (n.d.). In Networks, Knowledge Brokers, and the Public Policymaking Process: Accounting for audience heterogeneity (1–).Publication year
2021Page(s)
27-48AbstractDissemination strategies defined here as the targeted distribution of research evidence to policymakers can improve evidence-informed policymaking when activities are informed by theory, data, and when the right messenger delivers the right message to the right policymaker at the right time. This chapter presents evidence from surveys of state legislators, city mayors, and agency administrators in the United States to illustrate heterogeneity among policymakers in terms of the sources they turn to for evidence, the sources they perceive as reliable, and the attributes of evidence they perceive as most important. The chapter also reviews three broad types of dissemination strategies that can help account for audience heterogeneity and enhance the effectiveness of dissemination efforts: audience segmentation analysis, message tailoring, and framing.Does rental assistance improve mental health? Insights from a longitudinal cohort study
AbstractDenary, W., Fenelon, A., Schlesinger, P., Purtle, J., Blankenship, K. M., & Keene, D. E. (n.d.).Publication year
2021Journal title
Social Science and MedicineVolume
282AbstractAlmost half of renters in the United States are rent-burdened, meaning that they pay more than 30% of their income toward housing costs. Rental assistance through programs administered by the U.S. Department of Housing and Urban Development, alleviates these financial strains for around 5 million households. However, due to budgetary constraints, fewer than one in four eligible households actually receive this assistance and waitlists average two years nationally. Using longitudinal data from a cohort of 400 low-income adults living in New Haven, CT, this paper investigates how access to rental assistance affects mental health through two analytical methods that address selection into rental assistance. First, we performed a cross-sectional analysis to identify how psychological distress differs among those receiving and those on a waitlist for rental assistance. Second, we used a within-person fixed-effects analysis to compare changes in individuals following entry into rental assistance. We find that those receiving rental assistance report significantly less psychological distress than those on waiting lists and that transitions into rental assistance are associated with statistically non-significant decreases in psychological distress. Our findings suggest that expanding rental assistance may be one potential step toward improving the mental health of low-income individuals in the United States.Impact of the COVID-19 pandemic on child and adolescent mental health policy and practice implementation
AbstractPalinkas, L. A., De Leon, J., Salinas, E., Chu, S., Hunter, K., Marshall, T. M., Tadehara, E., Strnad, C. M., Purtle, J., Horwitz, S. M., McKay, M. M., & Hoagwood, K. E. (n.d.).Publication year
2021Journal title
International journal of environmental research and public healthVolume
18Issue
18AbstractBackground: The impact of the 2019 coronavirus pandemic on the mental health of millions worldwide has been well documented, but its impact on prevention and treatment of mental and behavioral health conditions is less clear. The COVID-19 pandemic also created numerous challenges and opportunities to implement health care policies and programs under conditions that are fundamentally different from what has been considered to be usual care. Methods: We conducted a qualitative study to determine the impact of the COVID-19 pandemic on implementation of evidence-based policy and practice by State Mental Health Authorities (SMHA) for prevention and treatment of mental health problems in children and adolescents. Semi-structured interviews were conducted with 29 SMHA representatives of 21 randomly selected states stratified by coronavirus positivity rate and rate of unmet services need. Data analysis with SMHA stakeholders used procedures embedded in the Rapid Assessment Procedure—Informed Community Ethnography methodology. Results: The need for services increased during the pandemic due primarily to family stress and separation from peers. States reporting an increase in demand had high coronavirus positivity and high unmet services need. The greatest impacts were reduced out-of-home services and increased use of telehealth. Barriers to telehealth services included limited access to internet and technology, family preference for face-to-face services, lack of privacy, difficulty using with young children and youth in need of substance use treatment, finding a Health Insurance Portability and Accountability Act (HIPAA)-compliant platform, training providers and clients, and reimbursement challenges. Policy changes to enable reimbursement, internet access, training, and provider licensing resulted in substantially fewer appointment cancellations or no-shows, greater family engagement, reduction in travel time, increased access for people living in remote locations, and increased provider communication and collaboration. States with high rates of coronavirus positivity and high rates of unmet need were most likely to continue use of telehealth post-pandemic. Despite these challenges, states reported successful implementation of policies designed to facilitate virtual services delivery with likely long-term changes in practice. Conclusions: Policy implementation during the pandemic provided important lessons for planning and preparedness for future public health emergencies. Successful policy implementation requires ongoing collaboration among policy makers and with providers.Linking Data on Constituent Health with Elected Officials’ Opinions: Associations Between Urban Health Disparities and Mayoral Officials’ Beliefs About Health Disparities in Their Cities
AbstractPurtle, J., Joshi, R., Lê-Scherban, F., Henson, R. M., & Diez Roux, A. V. (n.d.).Publication year
2021Journal title
Milbank QuarterlyVolume
99Issue
3Page(s)
794-827AbstractPolicy Points Mayoral officials’ opinions about the existence and fairness of health disparities in their city are positively associated with the magnitude of income-based life expectancy disparity in their city. Associations between mayoral officials’ opinions about health disparities in their city and the magnitude of life expectancy disparity in their city are not moderated by the social or fiscal ideology of mayoral officials or the ideology of their constituents. Highly visible and publicized information about mortality disparities, such as that related to COVID-19 disparities, has potential to elevate elected officials’ perceptions of the severity of health disparities and influence their opinions about the issue. Context: A substantive body of research has explored what factors influence elected officials’ opinions about health issues. However, no studies have assessed the potential influence of the health of an elected official's constituents. We assessed whether the magnitude of income-based life expectancy disparity within a city was associated with the opinions of that city's mayoral official (i.e., mayor or deputy mayor) about health disparities in their city. Methods: The independent variable was the magnitude of income-based life expectancy disparity in US cities. The magnitude was determined by linking 2010-2015 estimates of life expectancy and median household income for 8,434 census tracts in 224 cities. The dependent variables were mayoral officials’ opinions from a 2016 survey about the existence and fairness of health disparities in their city (n = 224, response rate 30.3%). Multivariable logistic regression was used to adjust for characteristics of mayoral officials (e.g., ideology) and city characteristics. Findings: In cities in the highest income-based life expectancy disparity quartile, 50.0% of mayoral officials “strongly agreed” that health disparities existed and 52.7% believed health disparities were “very unfair.” In comparison, among mayoral officials in cities in the lowest disparity quartile 33.9% “strongly agreed” that health disparities existed and 22.2% believed the disparities were “very unfair.” A 1-year-larger income-based life expectancy disparity in a city was associated with 25% higher odds that the city's mayoral official would “strongly agree” that health disparities existed (odds ratio [OR] = 1.25; P =.04) and twice the odds that the city's mayoral official would believe that such disparities were “very unfair” (OR = 2.24; P <.001). Conclusions: Mayoral officials’ opinions about health disparities in their jurisdictions are generally aligned with, and potentially influenced by, information about the magnitude of income-based life expectancy disparities among their constituents.Partisan differences in twitter language among US legislators during the COVID-19 pandemic: Cross-sectional study
AbstractGuntuku, S. C., Purtle, J., Meisel, Z. F., Merchant, R. M., & Agarwal, A. (n.d.).Publication year
2021Journal title
Journal of medical Internet researchVolume
23Issue
6AbstractBackground: As policy makers continue to shape the national and local responses to the COVID-19 pandemic, the information they choose to share and how they frame their content provide key insights into the public and health care systems. Objective: We examined the language used by the members of the US House and Senate during the first 10 months of the COVID-19 pandemic and measured content and sentiment based on the tweets that they shared. Methods: We used Quorum (Quorum Analytics Inc) to access more than 300,000 tweets posted by US legislators from January 1 to October 10, 2020. We used differential language analyses to compare the content and sentiment of tweets posted by legislators based on their party affiliation. Results: We found that health care–related themes in Democratic legislators’ tweets focused on racial disparities in care (odds ratio [OR] 2.24, 95% CI 2.22-2.27; P<.001), health care and insurance (OR 1.74, 95% CI 1.7-1.77; P<.001), COVID-19 testing (OR 1.15, 95% CI 1.12-1.19; P<.001), and public health guidelines (OR 1.25, 95% CI 1.22-1.29; P<.001). The dominant themes in the Republican legislators’ discourse included vaccine development (OR 1.51, 95% CI 1.47-1.55; P<.001) and hospital resources and equipment (OR 1.22, 95% CI 1.18-1.25). Nonhealth care–related topics associated with a Democratic affiliation included protections for essential workers (OR 1.55, 95% CI 1.52-1.59), the 2020 election and voting (OR 1.31, 95% CI 1.27-1.35), unemployment and housing (OR 1.27, 95% CI 1.24-1.31), crime and racism (OR 1.22, 95% CI 1.18-1.26), public town halls (OR 1.2, 95% CI 1.16-1.23), the Trump Administration (OR 1.22, 95% CI 1.19-1.26), immigration (OR 1.16, 95% CI 1.12-1.19), and the loss of life (OR 1.38, 95% CI 1.35-1.42). The themes associated with the Republican affiliation included China (OR 1.89, 95% CI 1.85-1.92), small business assistance (OR 1.27, 95% CI 1.23-1.3), congressional relief bills (OR 1.23, 95% CI 1.2-1.27), press briefings (OR 1.22, 95% CI 1.19-1.26), and economic recovery (OR 1.2, 95% CI 1.16-1.23). Conclusions: Divergent language use on social media corresponds to the partisan divide in the first several months of the course of the COVID-19 public health crisis.Perceived Persuasiveness of Evidence About Adverse Childhood Experiences: Results From a National Survey
AbstractPurtle, J., Nelson, K. L., Srivastav, A., & Gollust, S. E. (n.d.).Publication year
2021Journal title
Academic PediatricsVolume
21Issue
3Page(s)
529-533AbstractObjective: Advocates must make decisions about the types of evidence they emphasize when communicating to cultivate support for adverse childhood experience (ACE) prevention policies. This study sought to characterize public perceptions of the persuasiveness of 12 ACE evidence statements and assess differences by ideology in the strength of these evidence messages as rationales for ACE prevention policies. Methods: A web-based survey of a nationally representative sample of US adults was conducted using the KnowledgePanel (N = 503, completion rate = 60.5%). Respondents read ACE evidence statements and answered questions about the extent to which each was perceived as persuasive. Data were collected and analyzed in 2019. Results: The evidence statements perceived as most persuasive (scoring range 3–17) were those about ACEs as risk factors for mental health and substance use conditions (mean = 12.39) and suicide (mean = 12.14); ACEs generating financial costs for society (mean = 12.03); and the consequences of ACEs being preventable by a supportive adult (mean = 11.97). The evidence statements perceived as least persuasive were about ACEs generating health care costs for individuals (mean = 9.42) and ACEs as risk factors for physical health conditions (mean = 9.47). A larger proportion of liberals than conservatives rated every statement as providing a “strong reason” for ACE prevention policies. These differences were largest for evidence about ACEs generating financial costs for society (84.6% vs 42.8%, P <.0001) and socioeconomic disparities in ACEs (65.1% vs 32.9%, P <.0001). Conclusions: Many ACE evidence statements commonly used in policy advocacy differ from those perceived as most persuasive among a nationally representative sample of US adults.Posttraumatic stress, depression, and sleep among young survivors of violence
AbstractCorbin, T., Tabb, L. P., Waite, D., Purtle, J., Harris, E., Gardner, J., Gentile, N., Rowhani-Rahbar, A., & Rich, J. (n.d.).Publication year
2021Journal title
Journal of health care for the poor and underservedVolume
32Issue
3Page(s)
1339-1358AbstractSurvivors of violence often suffer psychological harm in addition to physical wounds. This study explored (1) the prevalence of Posttraumatic Stress Disorder (PTSD) symptoms, depression symptoms, and disordered sleep among young, violently injured, emergency department patients; and (2) how PTSD and depression symptoms are associated with sleep quality. Clinical scales for PTSD (PCL-5), depression (PHQ-8), and sleep (PROMIS®) were completed by 88 survivors of violent assault (gunshot, stabbing or assault) one month or less after presenting to an urban emergency department. High proportions of participants met criteria for prospective PTSD (59.1%), major depression (44.3%) or disordered sleep (34.1%), with 27.3% meeting criteria for all three conditions. Poorer sleep quality was correlated with higher levels of depression symptoms and PTSD symptoms. Survivors of violence experience symptoms that may further impair their sleep and behavioral health. Emergency providers should ask survivors about sleep/trauma symptoms and consider referral to trauma-informed behavioral health care.State Legislators’ Divergent Social Media Response to the Opioid Epidemic from 2014 to 2019: Longitudinal Topic Modeling Analysis
AbstractStokes, D. C., Purtle, J., Meisel, Z. F., & Agarwal, A. K. (n.d.).Publication year
2021Journal title
Journal of general internal medicineVolume
36Issue
11Page(s)
3373-3382AbstractBackground: The opioid epidemic is widely recognized as a legislative priority, but there is substantial variation in state adoption of evidence-based policy. State legislators’ use of social media to disseminate information and to indicate support for specific initiatives continues to grow and may reflect legislators’ openness to opioid-related policy change. Objective: We sought to identify changes in the national dialogue regarding the opioid epidemic among Democratic and Republican state legislators and to estimate changing partisanship around understanding and addressing the epidemic over time. Design: Longitudinal natural language processing analysis. Participants: A total of 4083 US state legislators in office between 2014 and 2019 with any opioid-related social media posts. Main Measures: Association between opioid-related post volume and state overdose mortality, as measured by Kendall’s rank correlation coefficient. Latent Dirichlet allocation analysis of all social media posts to identify key opioid-related topics. Longitudinal analysis of differences in the prevalence of key topics among Democrats and Republicans over time. Key Results: In total, 43,558 social media posts met inclusion criteria, with the vast majority to Twitter (n=28,564; 65.6%) or Facebook (n=14,283; 32.8%). Posts were more likely to mention fentanyl and less likely to mention heroin over time. The volume of opioid-related content was positively associated with state-level unintentional overdose mortality among both Democrats (tau=0.42, P<.001) and Republicans (tau=0.39, P<.001). Democrats’ social media content has increasingly spoken to holding pharmaceutical companies accountable, while Republicans’ social media content has increasingly spoken to curbing illicit drug trade. Overall, partisanship across topics increased from 2016 to 2019. Conclusion: The volume of opioid-related social media posts by US state legislators between 2014 and 2019 is associated with state-level overdose mortality, but the content across parties is significantly different. Democrats’ and Republicans’ social media posts may reflect growing partisanship regarding how best to address the overdose epidemic.The effect of caregiver key opinion leaders on increasing caregiver demand for evidence-based practices to treat youth anxiety: protocol for a randomized control trial
AbstractCrane, M. E., Atkins, M. S., Becker, S. J., Purtle, J., Olino, T. M., & Kendall, P. C. (n.d.).Publication year
2021Journal title
Implementation Science CommunicationsVolume
2Issue
1AbstractBackground: Research has identified cognitive behavioral therapy with exposures (CBT) as an effective treatment for youth anxiety. Despite implementation efforts, few anxious youth receive CBT. Direct-to-consumer marketing offers a different approach to address the unmet need for youth receiving effective treatments. Involving a local caregiver key opinion leader in direct-to-consumer initiatives may be an effective strategy to increase caregiver demand for CBT. Research indicates that key opinion leaders improve health promotion campaigns, but key opinion leaders have not been studied in the context of increasing caregiver demand for evidence-based treatments. Method: Project CHAT (Caregivers Hearing about Anxiety Treatments) will test the role of key opinion leader participation in conducting outreach presentations to increase caregiver desire to seek CBT for their youth’s anxiety. Caregiver attendees (N = 180) will be cluster randomized by school to receive one of two different approaches for presentations on CBT for youth anxiety. Both approaches will involve community outreach presentations providing information on recognizing youth anxiety, strategies caregivers can use to decrease youth anxiety, and how to seek CBT for youth anxiety. The researcher-only condition will be co-facilitated by two researchers. In the key opinion leader condition, a caregiver key opinion leader from each local community will be involved in tailoring the content of the presentation to the context of the community, co-facilitating the presentation with a researcher, and endorsing strategies in the presentation that they have found to be helpful. In line with the theory of planned behavior, caregiver attendees will complete measures assessing their knowledge of, attitudes towards, perceived subjective norms about, and intention to seek CBT pre- and post-presentation; they will indicate whether they sought CBT for their youth at 3-month follow-up. Results will be analyzed using a mixed method approach to assess the effectiveness of a key opinion leader to increase caregiver demand for CBT. Discussion: This study will be the first to examine the potential of key opinion leaders to increase caregiver demand for CBT. If proven effective, the use of key opinion leaders could serve as a scalable dissemination strategy to increase the reach of evidence-based treatments. Trial registration: This trial was registered on clinicaltrials.gov (NCT04929262) on June 18, 2021. At the time of trial registration, pre/post-presentation data had been collected from 17 participants; thus, it was retrospectively registered.The Intersection of Dissemination Research and Acupuncture: Applications for Chronic Low Back Pain
AbstractRoseen, E. J., Purtle, J., Zhang, W., Miller, D. W., Schwartz, A. W., Ramanadhan, S., & Sherman, K. J. (n.d.).Publication year
2021Journal title
Global Advances In Health and MedicineVolume
10AbstractBackground: Dissemination research is the study of distributing information and intervention materials to a specific clinical practice or public health audience. Acupuncture, a healthcare practice involving the stimulation of certain body points, often with thin needles, is considered an evidence-based treatment for low back pain (LBP), but is underutilized in the United States. Body: We will use the example of acupuncture for LBP to identify opportunities to leverage dissemination research to increase utilization of acupuncture. Deficits in the awareness or knowledge of acupuncture may limit its adoption by patients and other stakeholders. Thus, we summarize methods to gather data on stakeholder awareness and knowledge of acupuncture for LBP, i.e., audience research. Engaging multiple stakeholder audiences (e.g., health system leaders, primary care providers, patients), is needed to generate knowledge on promising dissemination strategies for each audience. Audience segmentation is important for identifying population subgroups for whom adoption of acupuncture may require a more intensive or tailored dissemination strategy. To illustrate potential audience ‘segments’, our research discussion focused on developing dissemination strategies by age (i.e., older adults – those age 65 years or older, and younger adults – those under age 65). This decision was prompted by Medicare’s recent policy covering acupuncture for chronic LBP. We leverage current knowledge of barriers and facilitators of acupuncture use to discuss how further tailoring of dissemination strategies might optimize adoption of acupuncture in both groups of adults. Experimental study designs could then be used to compare the effectiveness of such strategies to increase awareness, knowledge, or adoption of acupuncture. Conclusions: Conducting dissemination research may improve awareness and knowledge of acupuncture, and ultimately the adoption of acupuncture in biomedical settings. We anticipate that the concepts highlighted in this manuscript will also be helpful for those disseminating information about other complementary and integrative health approaches.The Other US Border: Health Insurance Coverage Among Latino Immigrants In Puerto Rico
AbstractRivera-González, A. C., Stimpson, J. P., Roby, D. H., Canino, G., Purtle, J., Bellamy, S. L., & Ortega, A. N. (n.d.).Publication year
2021Journal title
Health AffairsVolume
40Issue
7Page(s)
1117-1125AbstractPuerto Rico is a US territory and a popular destination for Latino immigrants in the Caribbean. Even with few language and cultural barriers, however, many Latino immigrants in Puerto Rico are uninsured. Using data from the 2014–19 Puerto Rico Community Survey, we examined inequities in health insurance coverage for non–Puerto Rican Latinos ages 18–64 living in Puerto Rico according to citizenship status and Latino subgroup (Dominican, Cuban, Mexican, and other Latino). After controlling for potential confounders, we found that noncitizen Dominicans had a significantly lower probability of having any health insurance (57.2 percent) and having any private insurance (31.5 percent). Regardless of similarities in culture and language, Latino immigrants on the island, particularly Dominicans, experience major health insurance coverage inequities. Considering that Puerto Rico’s immigration system is regulated by US federal statute, both federal and local policy makers should acknowledge and focus on reducing these immigrant disparities in health insurance coverage.Who Is Talking About Adverse Childhood Experiences? Evidence From Twitter to Inform Health Promotion
AbstractSrivastav, A., Park, K., Koziarski, A., Strompolis, M., & Purtle, J. (n.d.).Publication year
2021Journal title
Health Education and BehaviorVolume
48Issue
5Page(s)
615-626AbstractBackground: Growing availability of research about addressing adverse childhood experiences (ACEs) has recently been embraced by the mainstream media and public. Social media, especially Twitter, provides a unique forum and platform for the public to access and share information about this topic. Objective: This study aims to better understand how the public is framing, sharing, and using research about ACEs on Twitter and to examine the information being commonly discussed about ACEs. Method: We obtained tweets on the topics of ACEs, childhood resilience, and childhood trauma between January 1, 2018, and December 31, 2019. This timeframe was determined based on key related events in the mainstream media. Crimson Hexagon, a social media analytics system using Boolean logic, was used to identify salient topics, influencers, and conduct a content analysis. Results: A total of 195,816 relevant tweets were obtained from our search. The weekly volume was approximately 1,864 tweets. Key topics included general use of the term ACEs (23%), trauma and ACEs (19%), long-term impact of ACEs (12%), preventing ACEs (11%), short-term effects of ACEs (8%), the 1997 ACE Study (5%), and students with ACEs (5%). The top two sentiments were fear and joy. Top conversation influencers included pediatricians, child health advocacy organizations, California’s state government, the Centers for Disease Control and Prevention, and National Public Radio. Conclusion: This analysis provides insight to the ways the public is conversing about ACEs and related topics. Results indicated that conversations focus on increasing awareness of ACEs by content experts and public health organizations. This presents an opportunity to leverage social media tools to increase public engagement and awareness.Aligning dissemination and implementation science with health policies to improve children’s mental health.
AbstractHoagwood, K. E., Purtle, J., Spandorfer, J., Peth-Pierce, R., & Horwitz, S. M. C. (n.d.).Publication year
2020Journal title
American PsychologistVolume
75Issue
8Page(s)
1130-1145AbstractThe prevalence of mental health problems among children (ages 0–21) in the United States remains unacceptably high and, post-COVID-19, is expected to increase dramatically. Decades of psychological knowledge about effective treatments should inform the delivery of better services. Dissemination and implementation (D&I) science has been heralded as a solution to the persistent problem of poor quality services and has, to some extent, improved our understanding of the contexts of delivery systems that implement effective practices. However, there are few studies demonstrating clear, population-level impacts of psychological interventions on children. Momentum is growing among communities, cities, states, and some federal agencies to build “health in all policies” to address broad familial, social, and economic factors known to affect children’s healthy development and mental health. These health policy initiatives offer a rare opportunity to repurpose D&I science, shifting it from a primary focus on evidence-based practice implementation, to a focus on policy development and implementation to support child and family health and well-being. This shift is critical as states develop policy responses to address the health and mental health impacts of the COVID-19 pandemic on already-vulnerable families. We provide a typology for building research on D&I and children’s mental health policy. (PsycInfo Database Record (c) 2020 APA, all rights reserved)<strong xmlns:lang="en">Public Significance Statement—The prevalence of mental health problems among children remains unacceptably high. Communities, cities, states, and some federal agencies are building “health in all policies” initiatives that address broad familial, social, and economic factors known to affect children’s healthy development. These initiatives offer a rare opportunity to repurpose D&I science and shift it from a primary focus on evidence-based practice implementation, to a focus on policy dissemination and implementation.Association of Vaccine-Preventable Disease Incidence with Proposed State Vaccine Exemption Legislation
Goldstein, N. D., Purtle, J., & Suder, J. S. (n.d.). In JAMA Pediatrics (1–).Publication year
2020Volume
174Issue
1Page(s)
88-89Dissemination of urban health research to maximize impact
Kolker, J., Slesinski, C., Carroll-Scott, A., & Purtle, J. (n.d.). In Urban Public Health (1–).Publication year
2020Page(s)
314-335Dissemination Strategies to Accelerate the Policy Impact of Children’s Mental Health Services Research
AbstractPurtle, J., Nelson, K. L., Bruns, E. J., & Hoagwood, K. E. (n.d.).Publication year
2020Journal title
Psychiatric ServicesVolume
71Issue
11Page(s)
1170-1178AbstractThe United States is in the midst of a children’s mental health crisis, with rates of depression, anxiety, and suicide increasing precipitously. Evidence produced by children’s mental health services research can help address this crisis by informing public policy decisions about service delivery, system design, and investments in the social determinants of mental health. Unfortunately, the policy impact of children’s mental health services research is limited because evidence often fails to reach policy makers, be responsive to their needs, resonate with their worldview, or reflect the contexts in which they make decisions. Dissemination strategies—defined as the development and targeted distribution of messages and materials about research evidence pertaining to a specific issue or intervention—can help address these challenges. Yet, limited integrated guidance exists to inform the design of such strategies. This article addresses this need by synthesizing the results of empirical studies to provide guidance about how to enhance the dissemination of children’s mental health services research to policy makers. The article provides four recommendations about the content of policy maker–focused dissemination materials, discusses how strategic framing and message tailoring can increase the chances that evidence is persuasive to policy makers, and highlights strategies to ensure that evidence reaches policy makers.Earmarked taxes as a policy strategy to increase funding for behavioral health services
AbstractPurtle, J., & Stadnick, N. A. (n.d.).Publication year
2020Journal title
Psychiatric ServicesVolume
71Issue
1Page(s)
100-104AbstractEarmarking taxes for behavioral health services is a policy strategy that many jurisdictions have implemented to increase funding for behavioral health systems. However, little has been written about these taxes, and limited guidance exists for policy makers who are pursing or implementing such taxes. This column summarizes approaches to designing earmarked behavioral health taxes, evidence of their impact, strategies to enhance implementation, and future directions for research. The column focuses on two jurisdictions: California, which imposes an additional 1% tax on all household income exceeding $1 million, and Washington State, which provides counties with the option of increasing sales tax by 0.1%.Factors associated with state legislators’ support for opioid use disorder parity laws
AbstractNelson, K. L., & Purtle, J. (n.d.).Publication year
2020Journal title
International Journal of Drug PolicyVolume
82AbstractBackground: In the United States, state behavioral health parity laws play a crucial role in ensuring equitable insurance coverage and access to substance use disorder treatment and services for people that need them. State legislators have the exclusive authority to adopt these laws. The purpose of this study was to identify legislator beliefs independently associated with “strong support” for opioid use disorder (OUD) parity. Methods: Data were from a 2017 cross-sectional, state-stratified, multi-modal survey of state legislators (N = 475). The dependent variable was “strong support” for OUD parity. Primary independent variables were beliefs about state parity laws. Bivariate analyses and mixed effects logistic regression were conducted. Results: Legislators who “strongly supported” OUD parity were significantly more likely than legislators who did not “strongly support” OUD parity to be female (64.1% vs. 46.5%, p<.001), Democrat (76.2% vs. 29.3%, p<.001), and have liberal, compared to conservative, ideology (85.6% vs. 27.1%, p<.001). After adjusting for legislator demographics and state-level covariates, beliefs such as agreeing that state parity laws do not increase health insurance premium costs (aOR=6.77, p<.01) and that substance use disorder treatments can be effective (aOR=5.00, p<.001) remained associated with “strong support” for OUD parity. These state legislators’ beliefs were more strongly associated with “strong support” for OUD parity than political party, ideology, and other demographic and state-level characteristics. Conclusions: Dissemination materials and communication strategies to cultivate support for OUD parity laws among state legislators should focus on the fiscal impacts of parity laws and the effectiveness of substance use disorder treatments.Mental illness and bipolar disorder on Twitter: implications for stigma and social support
AbstractBudenz, A., Klassen, A., Purtle, J., Yom Tov, E., Yudell, M., & Massey, P. (n.d.).Publication year
2020Journal title
Journal of Mental HealthVolume
29Issue
2Page(s)
191-199AbstractBackground: Mental illness (MI), and particularly, bipolar disorder (BD), are highly stigmatized. However, it is unknown if this stigma is also represented on social media. Aims: Characterize Twitter-based stigma and social support messaging (“tweets”) about mental health/illness (MH)/MI and BD and determine which tweets garnered retweets. Methods: We collected tweets about MH/MI and BD during a three-month period and analyzed tweets from dates with the most tweets (“spikes”), an indicator of topic interest. A sample was manually content analyzed, and the remainder were classified using machine learning (logistic regression) by topic, stigma, and social support messaging. We compared stigma and support toward MH/MI versus BD and used logistic regression to quantify tweet features associated with retweets, to assess tweet reach. Results: Of the 1,270,902 tweets analyzed, 94.7% discussed MH/MI and 5.3% discussed BD. Spikes coincided with a celebrity’s death and a MH awareness campaign. Although the sample contained more support than stigma messaging, BD tweets contained more stigma and less support than MH/MI tweets. However, stigma messaging was infrequently retweeted, and users often retweeted personal MH experiences. Conclusions: These findings demonstrate opportunities for social media advocacy to reduce stigma and increase displays of social support towards people living with BD.Public opinion about evidence-informed health policy development in U.S. Congress
AbstractPurtle, J. (n.d.).Publication year
2020Journal title
Translational Behavioral MedicineVolume
10Issue
6Page(s)
1549-1553AbstractPromoting evidence-informed health policymaking is a priority of the Society of Behavioral Medicine and other professional societies. However, politics often impede the translation of research into policy. Public opinion is an important feature of political context that influences policymakers' behaviors, but prior research has not examined public opinion about evidence-informed health policy development. This exploratory study sought to characterize public opinion about the influence that evidence should, and does, have on health policy development in U.S. Congress relative to other factors and examine differences by political party affiliation. A public opinion survey was conducted in 2018 using the SSRS Probability Panel (N = 532). Respondents separately rated the extent to which six factors (e.g., evidence, budget impact, industry interests) "should have"and "currently have"influence on U.S. congresspersons' health policy decisions. Evidence (59%) was the most frequently identified factor that should have "a lot of influence"on health policy development, but only 11% of respondents thought that evidence currently has "a lot of influence"(p <. 001). Opinions about evidence did not vary significantly by political party. The interests of insurance and pharmaceutical companies were identified as factors that should have the least influence on policy development, but were perceived as having the most influence (p <. 001). There is strong bipartisan public support for evidence to have much more influence on health policy development in U.S. Congress. Efforts that aim to improve evidence-informed health policymaking should consider harnessing the power of public opinion to change elected policymakers' behaviors.Public transit and depression among older adults: Using agent-based models to examine plausible impacts of a free bus policy
AbstractYang, Y., Langellier, B. A., Stankov, I., Purtle, J., Nelson, K. L., Reinhard, E., Van Lenthe, F. J., & Diez Roux, A. V. (n.d.).Publication year
2020Journal title
Journal of Epidemiology and Community HealthVolume
74Issue
11Page(s)
875-881AbstractBackground Daily transport is associated with mental health. A free bus policy (FBP) may be effective in promoting the use of public transit in older adults and be associated with reductions in depressive symptoms. Methods We developed an agent-based model and grounded it using empirical data from England to examine the impact of an FBP on public transit use and depression among older adults. We also used the model to explore whether the impact of the FBP bus use and depression is modified by the type of income segregation or by simultaneous efforts to improve attitudes towards the bus, to reduce waiting times or to increase the cost of driving via parking fees or fuel price. Results Our model suggests that improving attitudes towards the bus (eg, campaigns that promote bus use) could enhance the effect of the FBP, especially for those in proximity to public transit. Reducing wait times could also significantly magnify FPB impacts, especially in those who live in proximity to public transit. Contrary to expectation, neither fuel costs nor parking fees significantly enhanced the impact of the FBP. The impact of improving attitudes towards the bus and increasing bus frequency was more pronounced in the lower-income groups in an income segregation scenario in which destination and public transit are denser in the city centre. Conclusion Our results suggest that the beneficial mental health effects of an FBP for older adults can be magnified when combined with initiatives that reduce bus waiting times and increased spatial access to transit.Quantifying the Restrictiveness of Local Housing Authority Policies Toward People with Criminal Justice Histories: United States, 2009-2018
AbstractPurtle, J., Gebrekristos, L. T., Keene, D., Schlesinger, P., Niccolai, L., & Blankenship, K. M. (n.d.).Publication year
2020Journal title
American journal of public healthVolume
110Page(s)
S137-S144AbstractObjectives. To quantify variation in the restrictiveness of local public housing authority policies related to the admission and eviction of people with criminal justice histories. Methods. We conducted content analysis of housing authority policy documents for US cities with a population of 100 000 or more (n = 152). Factor analysis identified policy provisions to create a restrictiveness score (range = 0-8). We explored associations between restrictiveness scores and city-level measures of racial/ethnic diversity, racial/ethnic neighborhood segregation, ideology, and public housing scarcity. Results. Eight policy provisions, 6 relating to consideration of mitigating circumstances, explained 71.0% of the variance in housing authority policy provisions related to criminal justice histories. We observed small but significant positive associations between restrictiveness scores and racial/ethnic diversity (r = 0.22) and neighborhood segregation (r = 0.18). There was no correlation between restrictiveness scores of housing authorities within the same state (intraclass correlation = 0.0002). Conclusions. Housing authority policies vary substantially regarding the circumstances under which people with criminal justice histories can obtain and retain public housing. Exposure to constellations of policy provisions that might institutionalize health inequities and increase health risk among people with criminal justice histories can be quantified through a systematic process. (Am J Public Health. 2020;110:S137-S144. doi: 10.2105/AJPH.2019.305437).