Mari‐lynn Drainoni
Biographic Data
| ID | 4871416 |
|---|---|
| NAME | Mari‐lynn Drainoni |
| GIVEN NAMES | Mari‐lynn |
| FAMILY NAME | Drainoni |
| SIGNATURE | DRAINONI M L |
| AFFILIATIONS | Boston University |
| ORCID | 0000-0001-7214-8037 |
| VERIFIED | Yes |
| TOTAL WORKS | 39 |
| TOTAL CITATIONS | 32 |
| AUTHOR COUNT | 39 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1995 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Immigrant perspectives on navigating the US healthcare system in the Post-Covid-19 landscape
Introduction The experiences of immigrants navigating the United States (US) healthcare system in the post-COVID-19 pandemic era are unknown. This study explores the experiences of recently arrived Haitian and Ugandan immigrants navigating this greatly changed system. Methods This single-center study used photo-elicitation, a qualitative method in which photos taken by participants served as an interview guide. Participants were recruited between…
Exploring Perspectives on HIV Vulnerability Communication among Transgender and Gender Diverse Patients and Primary Care Providers
“They call us amaphara (junkies)”
Stigma acts as a barrier to the diagnosis and effective treatment of tuberculosis (TB). Individuals with TB who also use alcohol or drugs (AODs), including methamphetamine, may experience intersectional stigma. Further, the nature and intensity of these intersecting stigmas may be compounded by co-morbidities like HIV and marginalized social status. Despite this, AOD use stigma has rarely been studied in the context of TB and other co-occurring c…
A Qualitative Study of Health Equity’s Role in Community Coalition Development
Opioid overdose deaths are dramatically increasing in the United States and disproportionately affecting minority communities, with the increasing presence of fentanyl exacerbating this crisis. Developing community coalitions is a long-standing strategy used to address public health issues. However, there is a limited understanding of how coalitions operate amid a serious public health crisis. To address this gap, we leveraged data from the HEALi…
‘It opened my eyes, my ears, and my heart’
BACKGROUND: Pregnant and parenting women have low engagement and poor retention in substance use disorder (SUD) treatment. The aim of this study was to analyse the implementation of an adapted experience-based codesign (EBCD) process involving SUD treatment staff and pregnant or parenting women with lived experience (WWLE) of SUD to launch a residential treatment service where women could coreside with their children and receive long term compreh…
Patient and provider perceptions of the relationship between alcohol use and TB and readiness for treatment
Findings support strengthening accessible, specialized services for the identification and provision of interventions and psychosocial services for unhealthy alcohol use among those with TB
At the intersection of trust and mistrust
INTRODUCTION: The underrepresentation of Black, Indigenous, and People of Color (BIPOC) individuals in healthcare research limits generalizability and contributes to healthcare inequities. Existing barriers and attitudes toward research participation must be addressed to increase the representation of safety net and other underserved populations. METHODS: We conducted semi-structured qualitative interviews with patients at an urban safety net hos…
Effects of Experienced Discrimination in Pediatric Sickle Cell Disease
For Black children with sickle cell disease (SCD) and their families, high disease stigmatization and pervasive racism increase susceptibility to discrimination in healthcare settings. Childhood experiences of discrimination can result in medical nonadherence, mistrust of healthcare providers, and poorer health outcomes across the lifespan. Caregivers and medical providers are essential to childhood SCD management and are therefore well-positione…
Community members have more impact on their neighbors than celebrities”
This study illustrates a need for community-engaged COVID-19 vaccine messaging which reflects the nuances of the COVID-19 vaccine and pandemic without oversimplifying information. In highlighting common concerns of the Greater Boston Area which contribute to a lack of confidence in the COVID-19 vaccine, we underscore important considerations for public health and healthcare leadership in the development of initiatives which work to advance health…
Community-level determinants of stakeholder perceptions of community stigma toward people with opioid use disorders, harm reduction services and treatment in the Healing Communities Study
I think providers see trans people as unstable patients”
Numerous studies have linked minority stress to substance use among transgender and gender diverse (TGD) individuals. Yet there has been limited research on how TGD patients experience alcohol, tobacco, and substance use communication with their providers. We used qualitative interviews to explore the substance use communication experiences of transgender and gender diverse adults with their primary care providers. We interviewed 25 TGD adults fr…
Embedding Big Qual and Team Science Into Qualitative Research
Background: A major part of the HEALing Communities Study (HCS), launched in 2019 to address the growing opioid epidemic, is evaluating the study's intervention implementation process through an implementation science (IS) approach. One component of the IS approach involves teams with more than 20 researchers collaborating across four research sites to conduct in-depth qualitative interviews with over 300 participants at four time points. After c…
Enhancing community integration after incarceration
A Participatory Curricula for Community Health Workers and Supervisors to Increase HIV Health Outcomes
Community Health Workers (CHWs) are becoming essential members of the HIV workforce as emerging evidence demonstrates their effectiveness in engaging people with HIV into care and treatment. In 2018, among the estimated 37,000 persons who received an HIV diagnosis, the majority were from racial ethnic minority communities. CHWs serve as a bridge between the community and health care system and have the potential to address structural inequities a…
Client Satisfaction with Community Health Workers in HIV Care Teams
Part of getting to where we are is because we have been open to change” integrating community health workers on care teams at ten Ryan White HIV/Aids program recipient sites
Wrapped up in the implementation experience of the sites there were some underlying issues that pose challenges for healthcare organizations. Organizational policies and the ability to adapt proved significant in facilitating CHW program implementation. The integration of the CHWs in the delivery of HIV care requires clearly distinguishing their role from the roles of other members of the healthcare delivery team
Examining the implementation of police-assisted referral programs for substance use disorder services in Massachusetts
Opening the door to somebody who has a chance.” – The experiences and perceptions of public safety personnel towards a public restroom overdose prevention alarm system
Overdose response in public restrooms has been incorporated into the daily duties of public safety personnel at an academic medical center. Anti-motion alarm systems are an innovation with potential to improve overdose response and safety, though the technology warrants ongoing development and unintended consequences should be assessed. To optimize restroom safety in the midst of fentanyl use, more research is needed among first responders, peopl…
You need money to get high, and that's the easiest and fastest way
Medication for addiction treatment and acute care utilization in HIV-positive adults with substance use disorders
Medication for addiction treatment (MAT) could reduce acute care utilization in HIV-positive individuals with substance use disorders. The study objective was to determine if HIV-positive people with substance use disorders treated with MAT report less acute care utilization than those not receiving MAT. We assessed the association between MAT and acute care utilization among HIV-positive individuals with alcohol or opioid use disorder. Acute car…
Are missed- and kept-visit measures capturing different aspects of retention in HIV primary care
The literature recognizes six measures of retention in care, an integral component of the HIV Continuum of Care. Given prior research showing that different retention measures are differentially associated with HIV health outcomes (e.g., CD4 count and viral suppression), we hypothesized that different groups of people living with HIV (PLWH) would also have differential retention outcomes based on the retention measure applied. We conducted a cros…
Coordinating across correctional, community, and VA systems
A novel application of process mapping in a criminal justice setting to examine implementation of peer support for veterans leaving incarceration
BACKGROUND: Between 12,000 and 16,000 veterans leave incarceration every year, yet resources are limited for reentry support that helps veterans remain connected to VA and community health care and services after leaving incarceration. Homelessness and criminal justice recidivism may result when such follow-up and support are lacking. In order to determine where gaps exist in current reentry support efforts, we developed a novel methodological ad…
A missing perspective
The efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention has been established among people who inject drugs (PWID). HIV uninfected, at risk PWID, could likely benefit from long-acting injectable formulations of PrEP ("LAI-PrEP"); however, its acceptability in this population has not been previously documented. Thirty-three HIV-uninfected PWID in the U.S. Northeast completed an in-depth interview regarding perceived acceptability of LAI-…
Identifying and Addressing Language Needs in Primary Care
Cross-Disability Experiences of Barriers to Health-Care Access
In this article, we present the results of a series of focus groups with people with disabilities, in which we took a cross-disability, lifespan perspective of disability. Consumers were asked about a broad set of barriers, such as problems with communication, transportation, and insurance, as well as about barriers related to physical accessibility. We used the Institute of Medicine's framework to categorize barriers as either structural, financ…
Mental and Physical Health Status and Alcohol and Drug Use Following Return From Deployment to Iraq or Afghanistan
Objectives. We examined (1) mental and physical health symptoms and functioning in US veterans within 1 year of returning from deployment, and (2) differences by gender, service component (Active, National Guard, other Reserve), service branch (Army, Navy, Air Force, Marines), and deployment operation (Operation Enduring Freedom/Operation Iraqi Freedom [OEF/OIF]). Methods. We surveyed a national sample of 596 OEF/OIF veterans, oversampling women …
In our stories
A qualitative study among women living with HIV assessed the aspects of an evidence-based intervention targeting HIV transmission risk reduction (Women Involved in Life Learning from Other Women [WiLLOW]) that women valued and how their lives were impacted. Thirty-one women (80.6% African American) completed interviews. Women valued the personal stories and positive group dynamics (i.e. safety, trust, openness, getting feedback, bonding, and soci…
Barriers to Accessible Health Care for Medicaid Eligible People With Disabilities
People with disabilities (PWD) are more likely than those without disabilities to experience barriers when accessing healthcare, often leading to unmet needs. The chasm between what providers perceive as adequate care for PWD and the actual health care needs as perceived by PWD remains significant. Using data from 360 health care providers and 540 Medicaid eligible PWD, we compared perceived barriers to care faced by PWD from the perspective of b…
Effectiveness of a Risk Screener in Identifying Hepatitis C Virus in a Primary Care Setting
Objectives. We evaluated an intervention designed to identify patients at risk for hepatitis C virus (HCV) through a risk screener used by primary care providers. Methods. A clinical reminder sticker prompted physicians at 3 urban clinics to screen patients for 12 risk factors and order HCV testing if any risks were present. Risk factor data were collected from the sticker; demographic and testing data were extracted from electronic medical recor…
Provider Perceptions of Their Capacity to Offer Accessible Health Care for People With Disabilities
The purpose of this article is to provide preliminary data about the results of a comprehensive survey of providers regarding their perceptions of access to health care for people with a broad range of disabilities. We conducted a mail and telephone follow-up survey of providers that contract with two managed care organizations, the Massachusetts Division of Medical Assistance, and the Assisted Living Association (36% response rate). Data were an…
Overcoming Treatment Barriers to Providing Services for Adults With Dual Diagnosis
A large and growing proportion of individuals with permanent and total disability are adults dually diagnosed with mental illness and substance-abuse disorders. These dually diagnosed individuals are frequently hospitalized, often unable to work, and thus are dependent on public systems for care. As the prevalence of clients with dual diagnosis continues to increase, states must examine how to best manage services for these individuals. This pape…
Overcoming Treatment Barriers to Providing Services for Adults With Dual Diagnosis
A large and growing proportion of individuals with permanent and total disability are adults dually diagnosed with mental illness and substance-abuse disorders. These dually diagnosed individuals are frequently hospitalized, often unable to work, and thus are dependent on public systems for care. As the prevalence of clients with dual diagnosis continues to increase, states must examine how to best manage services for these individuals. This pape…
Substance Abuse Treatment Services for People with Disabilities
The authors present results from an exploratory study conducted to learn more about how Medicaid managed-care plans meet the needs for substance abuse treatment among people with disabilities. These results suggest that capitated health plan staff members are more likely to be knowledgeable about the special needs of people with disabilities who also experience substance abuse problems. Staff members of smaller and more focused health plans demon…
Cross-Disability Experiences of Barriers to Health-Care Access
In this article, we present the results of a series of focus groups with people with disabilities, in which we took a cross-disability, lifespan perspective of disability. Consumers were asked about a broad set of barriers, such as problems with communication, transportation, and insurance, as well as about barriers related to physical accessibility. We used the Institute of Medicine's framework to categorize barriers as either structural, financ…
Provider Perceptions of Their Capacity to Offer Accessible Health Care for People With Disabilities
The purpose of this article is to provide preliminary data about the results of a comprehensive survey of providers regarding their perceptions of access to health care for people with a broad range of disabilities. We conducted a mail and telephone follow-up survey of providers that contract with two managed care organizations, the Massachusetts Division of Medical Assistance, and the Assisted Living Association (36% response rate). Data were an…
Health Services Utilization for People with HIV Infection
BACKGROUND: Many persons with HIV infection do not receive consistent ambulatory medical care and are excluded from studies of patients in medical care. However, these hard-to-reach groups are important to study because they may be in greatest need of services. OBJECTIVE: This study compared the sociodemographic, clinical, and health care utilization characteristics of a multisite sample of HIV-positive persons who were hard to reach with a natio…
Designing and Delivering a Prevention Project within an HIV Treatment Setting
Measuring Retention in HIV Care
BACKGROUND: Measuring retention in HIV primary care is complex, as care includes multiple visits scheduled at varying intervals over time. We evaluated 6 commonly used retention measures in predicting viral load (VL) suppression and the correlation among measures. METHODS: Clinic-wide patient-level data from 6 academic HIV clinics were used for 12 months preceding implementation of the Centers for Disease Control and Prevention/Health Resources a…
Barriers to Accessible Health Care for Medicaid Eligible People With Disabilities
People with disabilities (PWD) are more likely than those without disabilities to experience barriers when accessing healthcare, often leading to unmet needs. The chasm between what providers perceive as adequate care for PWD and the actual health care needs as perceived by PWD remains significant. Using data from 360 health care providers and 540 Medicaid eligible PWD, we compared perceived barriers to care faced by PWD from the perspective of b…
Mental and Physical Health Status and Alcohol and Drug Use Following Return From Deployment to Iraq or Afghanistan
Objectives. We examined (1) mental and physical health symptoms and functioning in US veterans within 1 year of returning from deployment, and (2) differences by gender, service component (Active, National Guard, other Reserve), service branch (Army, Navy, Air Force, Marines), and deployment operation (Operation Enduring Freedom/Operation Iraqi Freedom [OEF/OIF]). Methods. We surveyed a national sample of 596 OEF/OIF veterans, oversampling women …
Effectiveness of a Risk Screener in Identifying Hepatitis C Virus in a Primary Care Setting
Objectives. We evaluated an intervention designed to identify patients at risk for hepatitis C virus (HCV) through a risk screener used by primary care providers. Methods. A clinical reminder sticker prompted physicians at 3 urban clinics to screen patients for 12 risk factors and order HCV testing if any risks were present. Risk factor data were collected from the sticker; demographic and testing data were extracted from electronic medical recor…
The Contribution of Missed Clinic Visits to Disparities in HIV Viral Load Outcomes
Objectives. We explored the contribution of missed primary HIV care visits (“no-show”) to observed disparities in virological failure (VF) among Black persons and persons with injection drug use (IDU) history. Methods. We used patient-level data from 6 academic clinics, before the Centers for Disease Control and Prevention and Health Resources and Services Administration Retention in Care intervention. We employed staged multivariable logistic re…
Caring for Young Children with Asthma
In our stories
A qualitative study among women living with HIV assessed the aspects of an evidence-based intervention targeting HIV transmission risk reduction (Women Involved in Life Learning from Other Women [WiLLOW]) that women valued and how their lives were impacted. Thirty-one women (80.6% African American) completed interviews. Women valued the personal stories and positive group dynamics (i.e. safety, trust, openness, getting feedback, bonding, and soci…
Evaluation of a computer-based and counseling support intervention to improve HIV patients’ viral loads
We sought to integrate a brief computer and counseling support intervention into the routine practices of HIV clinics and evaluate effects on patients' viral loads. The project targeted HIV patients in care whose viral loads exceeded 1000 copies/ml at the time of recruitment. Three HIV clinics initiated the intervention immediately, and three other HIV clinics delayed onset for 16 months and served as concurrent controls for evaluating outcomes. …
Coordinating across correctional, community, and VA systems
A novel application of process mapping in a criminal justice setting to examine implementation of peer support for veterans leaving incarceration
BACKGROUND: Between 12,000 and 16,000 veterans leave incarceration every year, yet resources are limited for reentry support that helps veterans remain connected to VA and community health care and services after leaving incarceration. Homelessness and criminal justice recidivism may result when such follow-up and support are lacking. In order to determine where gaps exist in current reentry support efforts, we developed a novel methodological ad…
A missing perspective
The efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention has been established among people who inject drugs (PWID). HIV uninfected, at risk PWID, could likely benefit from long-acting injectable formulations of PrEP ("LAI-PrEP"); however, its acceptability in this population has not been previously documented. Thirty-three HIV-uninfected PWID in the U.S. Northeast completed an in-depth interview regarding perceived acceptability of LAI-…
Identifying and Addressing Language Needs in Primary Care
Medication for addiction treatment and acute care utilization in HIV-positive adults with substance use disorders
Medication for addiction treatment (MAT) could reduce acute care utilization in HIV-positive individuals with substance use disorders. The study objective was to determine if HIV-positive people with substance use disorders treated with MAT report less acute care utilization than those not receiving MAT. We assessed the association between MAT and acute care utilization among HIV-positive individuals with alcohol or opioid use disorder. Acute car…
Are missed- and kept-visit measures capturing different aspects of retention in HIV primary care
The literature recognizes six measures of retention in care, an integral component of the HIV Continuum of Care. Given prior research showing that different retention measures are differentially associated with HIV health outcomes (e.g., CD4 count and viral suppression), we hypothesized that different groups of people living with HIV (PLWH) would also have differential retention outcomes based on the retention measure applied. We conducted a cros…
A Participatory Curricula for Community Health Workers and Supervisors to Increase HIV Health Outcomes
Community Health Workers (CHWs) are becoming essential members of the HIV workforce as emerging evidence demonstrates their effectiveness in engaging people with HIV into care and treatment. In 2018, among the estimated 37,000 persons who received an HIV diagnosis, the majority were from racial ethnic minority communities. CHWs serve as a bridge between the community and health care system and have the potential to address structural inequities a…
Client Satisfaction with Community Health Workers in HIV Care Teams
Part of getting to where we are is because we have been open to change” integrating community health workers on care teams at ten Ryan White HIV/Aids program recipient sites
Wrapped up in the implementation experience of the sites there were some underlying issues that pose challenges for healthcare organizations. Organizational policies and the ability to adapt proved significant in facilitating CHW program implementation. The integration of the CHWs in the delivery of HIV care requires clearly distinguishing their role from the roles of other members of the healthcare delivery team
Examining the implementation of police-assisted referral programs for substance use disorder services in Massachusetts
Opening the door to somebody who has a chance.” – The experiences and perceptions of public safety personnel towards a public restroom overdose prevention alarm system
Overdose response in public restrooms has been incorporated into the daily duties of public safety personnel at an academic medical center. Anti-motion alarm systems are an innovation with potential to improve overdose response and safety, though the technology warrants ongoing development and unintended consequences should be assessed. To optimize restroom safety in the midst of fentanyl use, more research is needed among first responders, peopl…
Medicine (36 works) · Psychology (24 works) · Family medicine (21 works) · Health care (19 works) · Nursing (17 works) · Psychiatry (16 works) · HIV/AIDS Research and Interventions (14 works) · HIV, Drug Use, Sexual Risk (11 works) · Environmental health (10 works) · Gerontology (10 works)