Month: March 2018

Duke Expert Discusses Racial Disparity in School Discipline

Last Saturday, Duke professor Dr. Keisha Bentley-Edwards joined Wake County Board of Education member Keith Sutton on the April 24th airing of Education Matters. The conversation centered around a particularly troubling problem in North Carolina, and indeed nationwide: African American students get suspended more frequently, and for longer periods of time, than their peers. Even more alarming is that the discipline disparity starts as early as pre-kindergarten.

While the problem is well documented, more resources are required to start tackling the discipline disparity in a meaningful way. Dr. Bentley-Edwards reminded viewers that the underlying problem is one of structural racism, saying “if your practices have a disparate impact, and you do nothing about it, then that’s where you’re supporting some institutional racism.” She highlighted the importance of training teachers to properly deal with children who have had Adverse Childhood Experiences (ACES).

In fact, schools with behavioral specialists or dedicated psychologists have fewer suspensions because they can train teachers how to properly deal with students who misbehave – and it doesn’t usually entail sending them home where they lose additional instruction time and fall further behind.

Dr. Bentley-Edwards is an Assistant Professor at Duke University School of Medicine and Associate Director of Research at the Samuel DuBois Cook Center on Social Inequality. To learn more about her latest research, check Dr. Bentley-Edwards’ website here.

2nd Article Published in our Duke Today Series

With Policy Bridge’s latest Duke Today story, we’re continuing to highlight policy-relevant research driven by faculty and researchers around campus. Thursday’s article explores the work of public policy professor, Manoj Mohanan, who collaborates with the government of Uttar Pradesh (India) and the World Bank to understand how communities can create something known as social accountability (SA).

SA aims to foster accountability by providing information about entitled benefits under publicly funded programs and bringing community members together in regular meetings to learn about resources and engage with healthcare providers and local officials to redress grievances. Since the project’s official start in May 2016, about 2,000 meetings are taking place every month in targeted communities. Keep an eye out for updates, the project is scheduled to be reviewed in May 2019!

Would you like us to highlight your research in the next installment? To inquire about our engagement story series, email patience.wall@duke.edu.

Drug Costs and Heart Attack Treatment: Duke Professor Presents Preliminary Findings

Earlier this month at an American College of Cardiology meeting, Dr. Tracy Wang, Associate Professor at Duke School of Medicine, presented preliminary findings on a study involving 11,000 heart attack patients in 300 U.S. hospitals. Funded by the drug maker AstraZeneca, the ARTEMIS study aimed to understand which blood-thinning drugs patients were being prescribed in the wake of their heart attacks and how well those patients stuck to the prescribed medicine over the course of a year. In particular, researchers wanted to understand if the high-cost but more effective brand-name drug (ticagregol) would be more commonly prescribed and used if patients were provided a voucher to offset its extra cost compared to an older generic therapy called clopidogrel.

Hospitals were randomly assigned to a “care as usual” arm and a “co-pay intervention arm” – in the latter, price-equalizing vouchers were available for all patients and doctors were given discretion to prescribe either type of treatment. As expected, clinicians were more likely to prescribe the more effective brand-name drug when they knew patients would not be facing a higher cost. Additionally, patients who received vouchers and used them were more likely to continue taking the medication as prescribed over the course of a year. However, there was no difference in death rates, heart attacks, or strokes between those in the voucher group and the “care as usual” group.

The preliminary results indicate that cost is a huge factor when doctors choose which treatments to prescribe and when patients decide to fill – or not fill – prescriptions. However, reducing cost alone is not sufficient to improve health outcomes. Broader interventions are needed to improve patient health and co-payment reduction can be an important piece of a multi-pronged approach. As Dr. Wang explained, “Our study confirms some of our thoughts on how drug prices affect doctors’ and patients’ behaviors, but we still have a lot of work to do to understand how we can both measure and improve treatment adherence.”

Interested in learning more about the ARTEMIS study? Watch Dr. Wang’s informative overview of the study or read this detailed coverage of the preliminary results.

Save the Date: APPAM Forum

State and Research University Partnerships in the Opioid Crisis

Continuing the dialogue around evidence-based policymaking discussed at last spring’s APPAM Institutional Member Forum, Duke Policy Bridge at the Sanford School of Public Policy will host a 2018 topical forum on how to build research and policy partnerships around the prevailing national issue of opioid misuse.

Opioid misuse is a major epidemic across the nation. Local and state officials bear the burden of responses to the epidemic and need assistance coordinating research and resources. As observed through Duke’s and other institution’s collaborations with state government on this issue, research universities can provide valuable resources and expertise to government leaders.

This Institutional Forum, held at Duke University, will connect the worlds of research and policy across this escalating public health epidemic, and will be a valuable opportunity for academics, researchers, and policy officials to exchange best practices for research and policy support in the face of this crisis.

Break out topics will focus on the key areas of:

  • Providing support services for children in households with substance use
  • Assisting state officials with data science inquiries
  • Embedding networks for treatment after overdose
  • Providing a system of care in underserved and rural communities

Speaker details and registration are located here http://www.appam.org/member-forum-state-and-research-university-partnerships-in-the-opioid-crisis/.

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