Papers by Timothy Callaghan
Journal of Behavioral Medicine, May 11, 2022
Primary care physicians’ strategies for addressing COVID-19 vaccine hesitancy
Social Science & Medicine
Cureus
Background and objective Many international students often face challenges regarding their mental... more Background and objective Many international students often face challenges regarding their mental health, finances, and academics. The coronavirus disease 2019 (COVID-19) outbreak may have presented unprecedented challenges to many foreign students in these aspects. Our study examined the academic, financial, and mental health challenges encountered by international students residing in the United States due to the COVID-19 pandemic. It also examined the association between the mental health of the respondents and the academic and financial challenges they encountered. Method The study involved international students enrolled at Texas A&M University, who identified themselves as non-US citizens or non-permanent residents. We conducted a cross-sectional study by using Qualtrics® to explore the three domains of the study. Questions included in previous studies were modified to assess the academic and financial status while the Patient Health Questionnaire-4 (PHQ-4) score was used to assess the mental health of the respondents. We presented descriptive statistics for all domains and used an ordered logistic regression to further analyze the effect of the other domains on the mental health of the respondents. Results Of the 281 respondents, the majority (79%) experienced challenges with online classes; 91% reported having negative emotions and some students (24%) lost funding due to the pandemic. The inability to pay bills resulted in a threefold increase in the likelihood of reporting higher mental distress [adjusted odds ratios (aOR): 3.051, 95% CI: 1.665-5.591; p<0.001], and experiencing academic challenges led to a seven-fold increase in the likelihood of reporting higher mental distress (aOR: 7.236, 95% CI: 3.168-12.530; p<0.001). Conclusion The COVID-19 pandemic posed a major challenge to international students and its impact on the mental health of the participants was aggravated by concurrent academic and financial hardships.
Opportunities and Challenges of Using Carve-Outs to Fund Rural Public Health Initiatives: Evidence From the COVID-19 Pandemic
Public Health Reports
The Lancet
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Journal of Health Politics, Policy and Law
Context: Previous research has established the importance of primary care physicians in communica... more Context: Previous research has established the importance of primary care physicians in communicating public health directives. The implicit assumption is that, because of their expertise, doctors provide accurate and up-to-date information to their patients independent of partisan affiliation or media trust. Methods: The authors conducted an online survey of 625 primary care physicians and used the results to test (1) whether physician trust in media outlets is consistent with their political partisanship, and (2) whether trust in media outlets influences (a) personal concern that someone in their family will get sick, (b) perceptions about the seriousness of the pandemic as portrayed in the media, and (c) trust in federal government agencies and scientists. Findings: Physicians are better positioned to critically evaluate health-related news, but they are subject to the same biases that influence public opinion. Physicians' partisan commitments influence media trust, and media...
The Lancet
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Incentives for COVID-19 vaccination
The Lancet Regional Health - Americas, 2022
Childhood immunization during the COVID-19 pandemic in Texas
Vaccine, 2021
In 2020, the state of Texas implemented coronavirus disease 2019 (COVID-19) social distancing gui... more In 2020, the state of Texas implemented coronavirus disease 2019 (COVID-19) social distancing guidelines in order to prevent surges at Texas hospital emergency rooms and in intensive care units. As noted in other states, an unintended consequence of these activities was significant declines in childhood immunizations. After analyzing state-wide immunization register data for Texas, we observed a 47% relative decline in immunization rates between 2019 and 2020 among 5-month-olds and a 58% decline among 16-month-olds. We observed a small decline (5%) among 24-month-olds, and no decline in vaccines received at birth (Hepatitis B). Declines were larger in rural counties compared to urban. These declines are superimposed on increases in state vaccine exemptions over the last five years due to an aggressive anti-vaccine movement in Texas. There are concerns that continued declines in childhood immunization coverage due to COVID-19 could lead to co-endemics of measles and other vaccine preventable diseases.
Announcing the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA
The Lancet, 2021
The Centers for Disease Control and Prevention (CDC) play a central role in responding to communi... more The Centers for Disease Control and Prevention (CDC) play a central role in responding to communicable disease threats. Its authority to do so, however, has recently met significant political and legal opposition. Unpacking the dynamics of public support for CDC authority is an important question, as doing so can provide insight into whether policymakers might have an incentive to expand (or curtail) the agency's regulatory powers. In a demographically representative survey of 5,483 US adults, we find that most Americans support the CDC's role in responding to health crises, although self-identified conservatives are less likely to do so. Consistent with the idea that opposition to CDC-authority may result (in part) from receptivity to elite anti-CDC rhetoric, the effect of ideology holds when accounting for respondents' limited government and anti-expert attitudes; an effect we replicate in nationally representative data from the American National Election Study (ANES). Encouragingly, though, we find via a novel survey experiment that emphasizing the CDC's central role in combating the spread of COVID-19 is associated with significantly stronger levels of support on the ideological right. We conclude by discussing how these findings might influence effective health communication in the face of mounting political and legal challenges to CDC regulatory authority.
Vaccine Uptake and Hesitancy in Rural America in the Wake of the COVID-19 Pandemic
American Journal of Public Health
Journal of Health Politics, Policy and Law
Context: The Medicaid program provides health insurance coverage to a diverse set of demographics... more Context: The Medicaid program provides health insurance coverage to a diverse set of demographics. We know little about how the policy community describes these populations in places like Medicaid-related websites, public opinion polls, and policy writings, and whether and how these descriptions may affect perceptions of the program, its beneficiaries, and potential policy changes. Methods: To investigate this issue, we developed and fielded a nationally representative survey of 2,680 Americans that included an experiment that primed respondents by highlighting different combinations of target populations of the Medicaid program as found in the Medicaid policy discourse. Findings: Overall, we find that Americans view Medicaid and its beneficiaries rather favorably. However, there are marked differences based on partisanship and racial animosity. Emphasizing citizenship and residency requirements at times improved perceptions. Conclusions: Racial perceptions and partisanship are impo...
Suicide and non-fatal self-injury-related emergency department visits among individuals with autism spectrum disorder
Autism
We analyzed the Healthcare Cost and Utilization State Emergency Department (ED) Databases and Sta... more We analyzed the Healthcare Cost and Utilization State Emergency Department (ED) Databases and State Inpatient Databases for all individuals who were 2 years of age or older with at least one ED visit from 2011 to 2016 in New York to estimate the association between suicide and non-fatal injury-related ED visits and autism spectrum disorder (ASD). Our study included 14.4 million individuals with 43.5 million ED visits. Of those, 31,946 (0.2%) individuals had ASD accounting for 162,440 ED visits (0.4%). Compared to those without ASD, individuals with ASD had 2.1 more ED visits on average, higher shares of inpatient ED visits, more years of ED utilization, and higher prevalence of mental health-related comorbidities and diagnoses and self-injury-related ED visits. Among the ASD cohort, 6.1% had at least one self-injury-related ED visit compared to 2.2% among those without ASD. Using multivariable regressions adjusted for sociodemographic, clinical, contextual, and visit-level character...
Throughout the COVID-19 pandemic, researchers have studied how Americans' attitudes toward he... more Throughout the COVID-19 pandemic, researchers have studied how Americans' attitudes toward health experts influence their health behaviors and policy opinions. Fewer, however, consider the potential gap between individual and expert opinion about COVID-19, and how that might shape health attitudes and behavior. This omission is notable, as discrepancies between individual and expert opinion could help explain why some Americans fail to take action to protect themselves and others from the virus. In novel demographically representative surveys of the US adult population (N = 5,482) and primary care physician subpopulations (PCPs; N = 625), we contrast the relationship between: (1) Americans’ and (2) PCPs' preferences regarding who ought to be responsible for taking action to combat the spread of COVID-19, as well as (3) Americans' perceptions of PCP preferences ("PCP meta-opinion"). In the aggregate, we find that Americans are far less likely than PCPs to see a ...
Exploring the role of discretionary income as a social determinant of health
Health Services Research
Report on Health Reform Implementation Why States Expand Medicaid: Party, Resources, and History
This week the Biden administration requested a halt to a Trump-era Supreme Court challenge to sta... more This week the Biden administration requested a halt to a Trump-era Supreme Court challenge to state Medicaid work requirements. But how do Americans feel about work requirements for Medicaid recipients? In new research, Simon F. Haeder, Steven Sylvester and Timothy H. Callaghan find that while Americans are split in their support or opposition to Medicaid work requirements, public opinion is more nuanced when the public is asked who should be exempted from these requirements.
Rural healthy people 2030: New decade, new challenges
Preventive Medicine Reports
The Changing Nature of Telehealth Use by Primary Care Physicians in the United States
Journal of Primary Care & Community Health
Introduction: Prior to the COVID-19 pandemic, telehealth utilization was growing slowly and stead... more Introduction: Prior to the COVID-19 pandemic, telehealth utilization was growing slowly and steadily, although differentially across medical specialties in the United States. The pandemic dramatically expanded physician use of telehealth, but our understanding of how much telehealth use has changed in primary care in the United States, the correlates of physician telehealth uptake, and the frequency with which primary care physicians intend to use telehealth after the pandemic are unknown. This paper is designed to assess these important questions. Methods: Using data from an original national survey of 625 primary care physicians conducted from May 14 to May 25, 2021, we investigate the frequency of physician telehealth use before and during the pandemic and intended use after the pandemic. We also assess the correlates of changes in telehealth use by physicians, comparing telehealth use before the pandemic to use during and after the pandemic. Results: The proportion of primary ca...
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Papers by Timothy Callaghan