Current Role at Stanford
Research Assistant, Primary Care and Population Health
Education & Certifications
B.A, Duke University (2021)
The Impacts of Donor Transitions on Health Systems in Middle-Income Countries: A Scoping Review.
Health policy and planning
INTRODUCTION: As countries graduate from low-income to middle-income status, many face losses in development assistance for health, and must "transition" to greater domestic funding of their health response. If improperly managed, donor transitions in middle-income countries (MICs) could present significant challenges to global health progress. No prior knowledge synthesis has comprehensively surveyed how donor transitions can affect health systems in MICs.METHODS: We conducted a scoping review using a structured search strategy across five academic databases and 37 global health donor and think tank websites for literature published between January 1990 and October 2018. We used the WHO health system "building blocks" framework to thematically synthesize and structure the analysis.RESULTS: Following independent screening, 89 publications out of 11,236 were included for data extraction and synthesis. Most of this evidence examines transitions related to HIV/AIDS (n=45, 50%) and immunization programs (n=14, 16%), with a focus on donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria (n=26, 29%), and Gavi, the Vaccine Alliance (n=15, 17%). Donor transitions are influenced by the actions of both donors and country governments, with impacts on every component of the health system. Successful transition experiences show that leadership, planning, and pre-transition investments in a country's financial, technical, and logistical capacity are vital to ensuring smooth transition. In the absence of such measures, shortages in financial resources, medical product and supply stockouts, service disruptions, and shortages in human resources were common, with resulting implications not only for program continuation, but also for population health.CONCLUSION: Donor transitions can affect different components of the health system in varying and interconnected ways. More rigorous evaluation of how donor transitions can affect health systems in MICs will create an improved understanding of the risks and opportunities posed by donor exits.
View details for DOI 10.1093/heapol/czac063
View details for PubMedID 35904274
- Safekeeping of Pregnant People Experiencing Incarceration WOMEN & CRIMINAL JUSTICE 2022
Access to treatment for pregnant incarcerated people with opioid use disorder: Perspectives from community opioid treatment providers
Journal of Substance Abuse Treatment
View details for DOI 10.1016/j.jsat.2021.108338
Implementation of Electronic Patient-Reported Outcomes in Routine Cancer Care at an Academic Center: Identifying Opportunities and Challenges
JCO Oncology Practice
Electronic patient-reported outcomes (ePROs) can help clinicians proactively assess and manage their patients' symptoms. Despite known benefits, there is limited adoption of ePROs into routine clinical care as a result of workflow and technologic challenges. This study identifies oncologists' perspectives on factors that affect integration of ePROs into clinical workflows.We conducted semistructured qualitative interviews with 16 oncologists from a large academic medical center, across diverse subspecialties and cancer types. Oncologists were asked how they currently use or could imagine using ePROs before, during, and after a patient visit. We used an inductive approach to thematically analyze these qualitative data.Results were categorized into the following three main themes: (1) selection and development of ePRO tool, (2) contextual drivers of adoption, and (3) patient-facing concerns. Respondents preferred diagnosis-based ePRO tools over more general symptom screeners. Although they noted information overload as a potential barrier, respondents described strong data visualization and ease of use as facilitators. Contextual drivers of oncologist adoption include identifying target early adopters, incentivizing uptake through use of ePRO data to support billing and documentation, and emphasizing benefits for patient care and efficiency. Respondents also indicated the need to focus on patient-facing issues, such as patient response rate, timing of survey distribution, and validity and reliability of responses.Respondents identified several barriers and facilitators to successful uptake of ePROs. Understanding oncologists' perspectives is essential to inform both practice-level implementation strategies and policy-level decisions to include ePROs in alternative payment models for cancer care.
View details for DOI 10.1200/op.20.00357