Sean Haley
CUNY School of Public Health, Health Policy and Management, Faculty Member
Alcohol outlets tend to cluster in lower income neighborhoods and do so disproportionately in areas with more residents of color. This study explores the association between on- and off-premise alcohol outlet density and history of... more
Alcohol outlets tend to cluster in lower income neighborhoods and do so disproportionately in areas with more residents of color. This study explores the association between on- and off-premise alcohol outlet density and history of redlining with violent crime in New York City between 2014 and 2018. Alcohol outlet density was calculated using a spatial accessibility index. Multivariable linear regression models assess associations between the history of redlining, on-premise and off-premise alcohol outlet density with serious crime. Each unit increase in on- and off-premise alcohol density was associated with a significant increase in violent crime (β = 3.1, p < 0.001 on-premise and β = 33.5, p < 0.001 off premise). In stratified models (redlined vs not redlined community block groups) the association between off-premise alcohol outlet density and violent crime density was stronger in communities with a history of redlining compared to those without redlining (β = 42.4, p <...
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Background Among the foreign-born in the United States (US) dietary acculturation and eating out may increase obesity risk. Using the 2004 (N = 1952) and 2013/14 (N = 1481) New York City (NYC) Health and Nutrition Examination Surveys, we... more
Background Among the foreign-born in the United States (US) dietary acculturation and eating out may increase obesity risk. Using the 2004 (N = 1952) and 2013/14 (N = 1481) New York City (NYC) Health and Nutrition Examination Surveys, we compared for the foreign-born and US-born by survey year: 1) odds of obesity; 2) association between eating out and obesity and 3) effect of age at arrival and duration of residence among the foreign-born. Weighted logistic regression estimated odds of obesity. Results Compared to the US-born, the foreign-born had lower odds of obesity in 2004, (aOR = 0.51 (95%CI 0.37–0.70), P =
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The purpose of this study was to inform public policy opportunities to reduce childhood obesity by identifying parents&amp;amp;amp;amp;amp;amp;#39; perceptions of factors contributing to childhood obesity, attribution of... more
The purpose of this study was to inform public policy opportunities to reduce childhood obesity by identifying parents&amp;amp;amp;amp;amp;amp;#39; perceptions of factors contributing to childhood obesity, attribution of responsibility, and the extent of their support for public prevention policies with attention to socio-economic status. In 2015, 2066 parent-child dyads across socio-economic strata from 43 randomly selected schools in Ankara completed surveys and measurements to examine perceptions, attribution, and prevention policies related to childhood obesity. Parents across the socio-demographic spectrum recognized obesity as a serious problem. Unhealthy food availability was identified as the leading cause of while industry and media were credited with having the greatest responsibility for childhood obesity. There was strong public support for policy strategies targeting schools, marketing, and the built environment, though support tempered as socio-economic status and parental education decreased. This survey provided insight into parents&amp;amp;amp;amp;amp;amp;#39; knowledge and beliefs surrounding childhood obesity as well as their endorsement of related prevention strategies. Educational messages that address variations in SES to describe the causes of childhood obesity and connect those causes to actionable community prevention strategies may improve community support for enhanced policy actions within and beyond school settings.
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The U.S. spends just 5% of its health care budget to prevent morbidity and mortality. This study surveyed N.Y. State community health centers' (CHCs) population health activities aligned with the N.Y. Prevention Agenda (response rate... more
The U.S. spends just 5% of its health care budget to prevent morbidity and mortality. This study surveyed N.Y. State community health centers' (CHCs) population health activities aligned with the N.Y. Prevention Agenda (response rate of 72%). More than half of CHCs considered population health a high priority. Chronic disease and reducing preventable infections were the leading activity areas. One third of activities were dedicated to patient treatment follow-up. Community health centers reported that more than two-thirds of all activities received no funding. Despite a commitment to population health among CHCs, widespread improvements in population health may remain limited without an increase in dedicated funding to support community-based prevention strategies.
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Randomized controlled trials (RCTs) are the gold standard within evidence-based research. Low participant accrual rates, especially of underrepresented groups (e.g., racial-ethnic minorities), may jeopardize clinical studies'... more
Randomized controlled trials (RCTs) are the gold standard within evidence-based research. Low participant accrual rates, especially of underrepresented groups (e.g., racial-ethnic minorities), may jeopardize clinical studies' viability and strength of findings. Research has begun to unweave clinical trial mechanics, including the roles of clinical research coordinators, to improve trial participation rates. Two semi-structured focus groups were conducted with a purposive sample of 29 clinical research coordinators (CRCs) at consecutive international stroke conferences in 2013 and 2014 to gain in-depth understanding of coordinator-level barriers to racial-ethnic minority recruitment and retention into neurological trials. Coded transcripts were used to create themes to define concepts, identify associations, summarize findings, and posit explanations. Barriers related to translation, literacy, family composition, and severity of medical diagnosis were identified. Potential strate...
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BHbusiness is a Substance Abuse Mental Health Services Administration (SAMHSA) funded project to improve business practices of mental health and substance abuse treatment agencies across the U.S in advance of full implementation of the... more
BHbusiness is a Substance Abuse Mental Health Services Administration (SAMHSA) funded project to improve business practices of mental health and substance abuse treatment agencies across the U.S in advance of full implementation of the Affordable Care Act. Five business practice areas were identified for improvement (strategic planning, third party billing, third party contracting, meaningful use of health information technology and patient eligibility and enrollment). No similar project of this scale has ever been attempted by SAMHSA. BHbusiness featured three core components to maximize participants’ improvement efforts: peer networks, coaches and an on-line curriculum corresponding to each topic area. At the conclusion of Year 1, a participant assessment was conducted including document reviews, electronic inquiries and semi-structured interviews of coaches and project leaders. Inquiry response rates were 17%, 50%, and 96% for participants, conveners and coaches, respectively. By...
It is expected coverage for substance use disorders will expand under the Patient Protection and Affordable Care Act. In turn, it is also expected that there will be an uptake in the use of medication assisted treatment (MAT) under both... more
It is expected coverage for substance use disorders will expand under the Patient Protection and Affordable Care Act. In turn, it is also expected that there will be an uptake in the use of medication assisted treatment (MAT) under both public payors and private insurers as a standard of care. The intent of this study was to describe the development of national performance measures for MAT as well as 5 States' ability to extract public data to calculate the draft measures. Generally, of the 5 States that participated in the study, most were able to capture data and report on measures related to opioid medications. Amongst opioid treatment patients, States were better at capturing information about methadone than buprenorphine. Unlike opioid MAT, with one exception, States' ability to capture services related to alcohol medications appeared quite limited. In addition, States appeared more able to capture measures that align with earlier stages in the MAT process but were more...
Patients with chronic HCV have predictable overlapping comorbidities that reduce access to care. The Affordable Care Act (ACA) presents an opportunity to focus on the benefits of the medical home model for integrated chronic disease... more
Patients with chronic HCV have predictable overlapping comorbidities that reduce access to care. The Affordable Care Act (ACA) presents an opportunity to focus on the benefits of the medical home model for integrated chronic disease management. New, highly effective HCV treatment regimens in combination with the medical home model could reduce disease prevalence. We sought to address challenges posed by comorbidities in patients with chronic HCV infection and limitations within our health care system, and recommend solutions to maximize the public benefit from ACA and the new drug regimen.
Research Interests: Poverty, Comorbidity, Hepatitis B, Humans, United States, and 15 moreMental Disorders, Risk factors, Patient Protection and Affordable Care Act, Prevalence, Genotype, Adult, Combination drug therapy, Risk Factors, Antiviral Agents, Insurance Coverage, Health Services Accessibility, Sulfonamides, Medical and Health Sciences, HIV infections, and Population surveillance
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... This study suggests that context measures are necessary to accurately measures SMY's risk behaviors. ... If your library subscribes to the ProQuest Dissertations & Theses (PQDT) database,you may be entitled to a free... more
... This study suggests that context measures are necessary to accurately measures SMY's risk behaviors. ... If your library subscribes to the ProQuest Dissertations & Theses (PQDT) database,you may be entitled to a free electronic version of this graduate work. ...