Rand health quarterly最新文献

Evidence-based practices (EBPs) integrate clinical experience, recipient preferences, and the best available research evidence into best practices for health and human services. The use of EBPs plays an important role in delivering high-quality substance use services that improve youth outcomes. Yet there are many challenges to EBP implementation. During a March 2025 roundtable that was hosted at the Joint Meeting on Youth Prevention, Treatment, and Recovery national conference, policy actors with key roles in supporting state service systems discussed how to support the implementation of EBPs for youth substance use equitably and at scale. State service systems include a network of community-based prevention, treatment, and recovery programs for youth substance use that are primarily supported by public funds. Main topics of discussion included the role of federal and state policymakers in supporting the use of EBPs, opportunities and challenges in implementing and sustaining EBPs, and opportunities for partnerships to encourage the use of EBPs. Given the complexity of the topic, partnerships were viewed as key to successful progress in achieving policy action that supports EBP use. These proceedings should be of interest to federal, state, and local policymakers and other related groups, such as policy advocates, youth and their caregivers, and other individuals who are interested in improving the quality of substance use services.

Although progress in biological sciences and technologies will offer more opportunities to improve human well-being in the coming decades, this progress may also lower barriers that are blocking bad actors from engineering pathogens to cause destruction. In severe cases, the harms of future biological attacks may approach the magnitudes of the worst plagues of history-from the devastation wrought by the Black Death to the epidemics that decimated Mesoamerican societies after initial European contact. In this study, the authors offer initial frameworks for thinking about how the United States could achieve resilience against three biological threat scenarios: (1) a fast scenario, challenging countermeasures with a rapidly spreading outbreak of a lethal human-to-human-transmissible pathogen; (2) a silent scenario, challenging detection with a pathogen that infects much of the population before infected people display visible symptoms; and (3) a saturating scenario, challenging countermeasures involving a pathogen that replicates and persists in the environment. The authors recommend actions that governments and civil society can take to work toward resilience, including more in-depth research to better understand these scenarios and possible defenses.

This study documents the second phase of a project undertaken by the Australian Dental Council (ADC) to develop a framework for understanding and evaluating the impact of its dental education program-accreditation activities. This research builds on a first phase in which an impact framework, as well as a logic model undergirding it, were developed. The second phase captures and elevates key stakeholders' perspectives around the ADC's accreditation activities and proposed logic model for generating impact in greater detail. The applicability of the ADC's impact mechanisms, specified in the first research phase, is also examined. The authors developed recommendations for how these impact mechanisms can be leveraged in light of stakeholder perceptions and feedback so that the ADC can improve its impact according to its strategic and accreditation objectives that are aligned with public health outcomes.

Prescriptions made for GLP-1 agonists under various brand names (e.g., Ozempic, Wegovy) have more than tripled since 2020. However, research on their use and their side effects at the population level is in its infancy. This study presents descriptive findings from a 2025 survey fielded to a nationally representative sample of U.S. adults as part of RAND's American Life Panel that show prevalence rates of GLP-1 agonist use and side effects.

Since fall 2021, RAND researchers have conducted ongoing enumerations and surveys of people experiencing unsheltered homelessness in three Los Angeles, California, neighborhoods: Hollywood, Skid Row, and Venice. These data were obtained to provide policymakers with a deeper understanding of trends in the number of, demographics of, and services being provided to unsheltered people in areas known to be epicenters of the homelessness crisis in Los Angeles. The most recent full year of results from the ongoing Los Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS) study revealed a meaningfully different picture of unsheltered homelessness in 2024 compared with past years. The number of unsheltered people declined, likely driven by increased throughput to interim and permanent housing assets. However, multiple measures of acuity among people remaining on the street appear worse, suggesting that extending the past year's progress may require additional strategies.

Medicaid and the Children's Health Insurance Program together provide health insurance for 78.6 million low-income Americans, including 37.3 million children. This study describes inpatient utilization at select U.S. children's hospitals by Medicaid-insured patients. Legislation passed in July 2025 changed Medicaid eligibility requirements. For this study, RAND researchers processed hospital cost report data for policymakers to analyze.

Of the U.S. veterans enrolled with the Veterans Health Administration (VHA), 84 percent also have other sources of health care coverage. The author describes the most common other sources of coverage, why veterans may have multiple coverage options, and how other coverage interacts with VHA health care services. She discusses situations that may result in overpayments for coverage and presents future directions for research and policy options.

This study presents an evaluation of the University of Minnesota's BOLD Public Health Center of Excellence on Dementia Caregiving, which supports public health agencies in implementing dementia caregiving initiatives. The evaluation covers the Center's activities from 2021 to 2025, focusing on resources provided, usage by public health agencies, partnerships, equitable access, and agency capacity improvements.

Nearly 14.5 million individuals are enrolled in California's Medicaid program, better known as "Medi-Cal." Medi-Cal enrollees receive their primary care from both Federally Qualified Health Centers (FQHCs) and non-FQHC clinics and providers. However, not much is known about the extent to which subgroups of Medi-Cal enrollees use these different providers. Developing a better understanding of where different subgroups of Medi-Cal enrollees receive their primary care could inform efforts to improve support for primary care providers and the patients they serve. Using Medi-Cal data from 2022, RAND researchers identified and described the types of providers delivering primary care to Medi-Cal enrollees overall and by select patient characteristics, including race or ethnicity, age, geography, and levels of English-language proficiency. With these data, they were able to (1) identify the providers delivering primary care services to enrollees in FQHC and non-FQHC settings, (2) pinpoint key characteristics about these providers, (3) examine what percentage of providers deliver a high proportion of primary care visits to Medi-Cal enrollees, and (4) determine whether this percentage varies by Medi-Cal enrollee group and county.