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Bergmark, Regan

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Bergmark

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Regan

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Bergmark, Regan

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Now showing 1 - 4 of 4
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    Disparities in health in the United States: An overview of the social determinants of health for otolaryngologists
    (John Wiley and Sons Inc., 2017) Bergmark, Regan; Sedaghat, Ahmad
    Objectives: Social determinants of health include social and demographic factors such as poverty, education status, race and ethnicity, gender, insurance status, and other factors that influence (1) development of illness, (2) ability to obtain and utilize healthcare, and (3) health and healthcare outcomes. In otolaryngology, as in other subspecialty surgical fields, we are constantly confronted by patients’ social and demographic circumstances including poverty, language barriers, and lack of health insurance and yet there is limited research on how these factors impact health equity in our field, or how attention to these patient characteristics may improve health equity. This review provides the reader with a framework to understand the social determinants of health including how socioeconomic status, insurance status, race, gender, and other factors impact health. Data Sources and Review Methods Foundational papers on the social determinants of health are reviewed, as well as otolaryngology publications focused on health and healthcare disparities. Results: The social determinants of health have a major impact on patient health as well as healthcare utilization, but there is a relative lack of data on these factors and how they can be addressed within otolaryngology. Incorporating tools to measure social and demographic characteristics and actually report on these measures is a first simple step to increase the data on the social determinants of health as they pertain to otolaryngology. Conclusion: More research is needed on the social determinants of health, and how they impact otolaryngic disease. Medicare's Accountable Care Organization models will increasingly change the way in which physicians are reimbursed, making the social determinants of health central not only to our moral conscience but also the bottom line. Level of Evidence 4
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    US medical specialty global health training and the global burden of disease
    (Edinburgh University Global Health Society, 2013) Kerry, Vanessa B.; Walensky, Rochelle; Tsai, Alexander; Bergmark, Regan; Bergmark, Brian; Rouse, Chaturia; Bangsberg, David R.
    Background: Rapid growth in global health activity among US medical specialty education programs has lead to heterogeneity in types of activities and global health training models. The breadth and scope of this activity is not well chronicled. Methods: Using a standardized search protocol, we examined the characteristics of US medical residency global health programs by number of programs, clinical specialty, nature of activity (elective, research, extended curriculum based field training), and geographic location across seven different clinical medical residency education specialties. We tabulated programmatic activity by clinical discipline, region and country. We calculated the Spearman's rank correlation coefficient to estimate the association between programmatic activity and country–level disease burden. Results: Of the 1856 programs assessed between January and June 2011, there were 380 global health residency training programs (20%) working in 141 countries. 529 individual programmatic activities (elective–based rotations, research programs, extended curriculum–based field training, or other) occurred at 1337 specific sites. The majority of the activities consisted of elective–based rotations. At the country level, disease burden had a statistically significant association with programmatic activity (Spearman's ρ = 0.17) but only explained 3% of the total variation between countries. Conclusions: There were a substantial number of US medical specialty global health programs, but a relative paucity of surgical and mental health programs. Elective–based programs were more common than programs that offer longitudinal experiences. Despite heterogeneity, there was a small but statistically significant association between program location and the global burden of disease. Areas for further study include the degree to which US–based programs develop partnerships with their program sites, the significance of this activity for training, and number and breadth of programs in medical specialty global health education in other countries around the world.
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    Texting while driving: the development and validation of the distracted driving survey and risk score among young adults
    (Springer International Publishing, 2016) Bergmark, Regan; Gliklich, Emily; Guo, Rong; Gliklich, Richard
    Background: Texting while driving and other cell-phone reading and writing activities are high-risk activities associated with motor vehicle collisions and mortality. This paper describes the development and preliminary evaluation of the Distracted Driving Survey (DDS) and score. Methods: Survey questions were developed by a research team using semi-structured interviews, pilot-tested, and evaluated in young drivers for validity and reliability. Questions focused on texting while driving and use of email, social media, and maps on cellular phones with specific questions about the driving speeds at which these activities are performed. Results: In 228 drivers 18–24 years old, the DDS showed excellent internal consistency (Cronbach’s alpha = 0.93) and correlations with reported 12-month crash rates. The score is reported on a 0–44 scale with 44 being highest risk behaviors. For every 1 unit increase of the DDS score, the odds of reporting a car crash increases 7 %. The survey can be completed in two minutes, or less than five minutes if demographic and background information is included. Text messaging was common; 59.2 and 71.5 % of respondents said they wrote and read text messages, respectively, while driving in the last 30 days. Conclusion: The DDS is an 11-item scale that measures cell phone-related distracted driving risk and includes reading/viewing and writing subscores. The scale demonstrated strong validity and reliability in drivers age 24 and younger. The DDS may be useful for measuring rates of cell-phone related distracted driving and for evaluating public health interventions focused on reducing such behaviors.
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    Texting while driving: A study of 1211 U.S. adults with the Distracted Driving Survey
    (Elsevier, 2016) Gliklich, Emily; Guo, Rong; Bergmark, Regan
    Texting and other cell-phone related distracted driving is estimated to account for thousands of motor vehicle collisions each year but studies examining the specific cell phone reading and writing activities of drivers are limited. The objective of this study was to describe the frequency of cell-phone related distracted driving behaviors. A national, representative, anonymous panel of 1211 United States drivers was recruited in 2015 to complete the Distracted Driving Survey (DDS), an 11-item validated questionnaire examining cell phone reading and writing activities and at what speeds they occur. Higher DDS scores reflect more distraction. DDS scores were analyzed by demographic data and self-reported crash rate. Nearly 60% of respondents reported a cell phone reading or writing activity within the prior 30 days, with reading texts (48%), writing texts (33%) and viewing maps (43%) most frequently reported. Only 4.9% of respondents had enrolled in a program aimed at reducing cell phone related distracted driving. DDS scores were significantly correlated to crash rate (p < 0.0001), with every one point increase associated with an additional 7% risk of a crash (p < 0.0001). DDS scores were inversely correlated to age (p < 0.0001). The DDS demonstrated high internal consistency (Cronbach's alpha = 0.94). High rates of cell phone-related distraction are reported here in a national sample. Distraction is associated with crash rates and occurs across all age groups, but is highest in younger drivers. The DDS can be used to evaluate the impact of public health programs aimed at reducing cell-phone related distracted driving.