All Publications

  • How sugar-sweetened beverage tax revenues are being used in the United States. Preventive medicine reports Krieger, J., Magee, K., Hennings, T., Schoof, J., Madsen, K. A. 2021; 23: 101388


    We sought to describe how revenues from sugar-sweetened beverage (SSB) excise taxes in 7 U.S. cities are being allocated, who is benefiting from these investments, and whether allocations are consistent with the original intent of tax legislation. We collected information from public documents and key informants about allocations in the most recent fiscal year available (ranging from 2018 to 2021). Across the 7 U.S. cities with taxes, the average annual revenue from SSB taxes totaled $133.9 M. In the fiscal year studied, cities allocated a total of $133.2 M in SSB tax revenues. Human and community capital investments totaled $89.6 M (67% of all allocations) funding early childhood development, community infrastructure improvements, and youth and workforce development. Health-related investments totaled $36.9 M (28% of total allocations), funding access to healthy foods and beverages; support for physical activity opportunities; promotion of overall physical, mental or social health and wellbeing; health and nutrition education; chronic-disease prevention and management; and reducing SSB consumption. In the 3 cities that specified how tax revenues would be spent, allocations were consistent with promised uses of revenues. In addition, 85% of aggregated revenues ($112.9 M) were targeted to support work and programs in impacted communities (communities that experience health inequities, discrimination and exclusion). SSB tax revenues are supporting initiatives to improve community health, develop human and community capital, and advance equity. These investments may yield additional health benefits beyond those resulting from lower SSB consumption. Consistent tracking and public reporting on revenue allocations would increase transparency and accountability.

    View details for DOI 10.1016/j.pmedr.2021.101388

    View details for PubMedID 34040929

    View details for PubMedCentralID PMC8141925

  • Barriers and Facilitators of Using Quality Improvement To Foster Locally Initiated Innovation in Palliative Care Services in India. Journal of general internal medicine Giannitrapani, K. F., Satija, A., Ganesh, A., Gamboa, R., Fereydooni, S., Hennings, T., Chandrashekaran, S., Mickelsen, J., DeNatale, M., Spruijt, O., Bhatnagar, S., Lorenz, K. A. 2020


    BACKGROUND: Quality improvement (QI) methods represent a vehicle for fostering locally initiated innovation cycles. We partnered with palliative care services from seven diverse practice settings in India to foster locally initiated improvement projects.OBJECTIVE: To evaluate the implementation experiences of locally initiated palliative care improvement projects at seven diverse sites and understand the barriers and facilitators of using QI to improve palliative care in India.PARTICIPANTS: We use a quota sampling approach to capture the perspectives of 44 local stakeholders in each of the following three categories (organizational leaders, clinic leaders, and clinical team members) through a semi-structured interview guide informed by the consolidated framework for implementation research (CFIR). We use standard qualitative methods to identify facilitators and barriers to using QI methods in seven diverse palliative care contexts.RESULTS: Across all sites, respondents emphasized the following factors important in the success of quality improvement initiative: leveraging clinic level data, QI methods training, provider buy-in, engaged mentors, committed leadership, team support, interdepartmental coordination, collaborations with other providers, local champions, and having a structure for accountability. Barriers to using QI methods to improve palliative care services included lack of designated staff, high patient volume, resources, patient population geographic constraints, general awareness and acceptance of palliative care, and culture.CONCLUSIONS: Empowering local leaders and medical personnel to champion, design, and iterate using QI methods represents a promising powerful tool to spread palliative care services in developing countries.

    View details for DOI 10.1007/s11606-020-06152-y

    View details for PubMedID 32901438

  • Palliative care clinicians and online education in India: a survey BMJ SUPPORTIVE & PALLIATIVE CARE Kiss-Lane, T., Spruijt, O., Day, T., Lam, V., Ramchandran, K. J., Chan, S., Hsin, G., Vallath, N., Bhatnagar, S., Rajagopal, M. R., Lorenz, K. A. 2019; 9 (4)