David Grande
Biographic Data
| ID | 5135507 |
|---|---|
| NAME | David Grande |
| GIVEN NAMES | David |
| FAMILY NAME | Grande |
| SIGNATURE | GRANDE D |
| AFFILIATIONS | University of Pennsylvania |
| ORCID | 0000-0002-6717-6735 |
| VERIFIED | Yes |
| TOTAL WORKS | 15 |
| TOTAL CITATIONS | 15 |
| WORKS AS AUTHOR | 15 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2012 |
| LATEST PUBLICATION YEAR | 2021 |
| H-INDEX | 1 |
Variability in Primary Care Physician Attitudes Toward Medicaid Work Requirement Exemption Requests Made by Patients With Depression
In this survey study of primary care physicians, we found substantial variation regarding willingness to assist patients qualifying for a work requirement exemption where none should exist. Insofar as work requirements are implemented again, it is critical to proactively identify measures to ensure that patients qualifying for exemptions are not put at risk due to either the burdensomeness of exemption procedures, or physicians' political or pers…
The Affordable Care Act Attenuates Financial Strain According to Poverty Level
We use data from the 2011-2016 National Health Interview Survey to examine how the Patient Protection and Affordable Care Act (ACA) has influenced disparities in health care-related financial strain, access to care, and utilization of services by categories of the Federal Poverty Level (FPL). We use multivariable regression analyses to determine the ACA's effects on these outcome measures, as well as to determine how changes in these measures var…
Why Effective Interventions Do Not Work for All Patients
BACKGROUND: Half of all Americans have a chronic disease. Promoting healthy behaviors to decrease this burden is a national priority. A number of behavioral interventions have proven efficacy; yet even the most effective of these has high levels of nonresponse. OBJECTIVES: In this study, we explore variation in response to an evidence-based community health worker (CHW) intervention for chronic disease management. RESEARCH DESIGN: We used a conve…
Insurance Type and Access to Health Care Providers and Appointments Under the Affordable Care Act
BACKGROUND: Millions of adults have gained insurance through the Affordable Care Act (ACA). However, disparities in access to care persist. OBJECTIVE: This study examined differences in access to primary and specialty care among patients insured by private individual market insurance plans (both on-exchange and off-exchange) and Medicaid compared with those with employer-sponsored insurance. RESEARCH DESIGN: Using data from the 2014 and 2015 Cali…
Racial Differences in Prostate Cancer Treatment
These results stress the importance of examining racial disparities within geographic areas and highlight the unique associations that different measures of SES, particularly neighborhood SES and education, may have with prostate cancer treatment
Mutual Distrust
The production of health policy-relevant research is necessary, but not sufficient, to promote its utilization in policy. Our objective was to understand the perspectives of United States' state-level policy makers and health researchers on the barriers and facilitators to the translation of health evidence into the policy process, with a particular focus on issues related to relationship building. We conducted interviews with 215 US health servi…
Effect of Outreach Messages on Medicaid Enrollment
Objectives. To measure the impact of different outreach messages on health insurance enrollment among Medicaid-eligible adults. Methods. Between March 2015 and April 2016, we conducted a series of experiments using mail-based outreach that encouraged individuals to enroll in Pennsylvania’s expanded Medicaid program. Recipients were randomized to receive 1 of 4 different messages describing the benefits of health insurance. The primary outcome was…
Community Health Worker Support for Disadvantaged Patients With Multiple Chronic Diseases
Objectives. To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. Methods. We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013–2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hype…
Racial Differences in Geographic Access to Medical Care as Measured by Patient Report and Geographic Information Systems
BACKGROUND: Geographic access-the travel burden required to reach medical care-is an important aspect of care. Studies, which typically rely on geographic information system (GIS) calculated travel times, have found some evidence of racial disparities in spatial access to care. However, the validity of these studies depends on the accuracy of travel times by patient race. OBJECTIVES: To determine if there are racial differences when comparing pat…
New Medicaid Enrollees See Health and Social Benefits in Pennsylvania’s Expansion
Understanding how new Medicaid enrollees are approaching their own health and health care in the shifting health care landscape of the Affordable Care Act has implications for future outreach and enrollment efforts, as well as service planning for this population. The objective of this study was to explore the health care experiences and expectations of new Medicaid expansion beneficiaries in the immediate post-enrollment period. We conducted sem…
Penn Center for Community Health Workers
Community-engaged researchers who work with low-income communities can be reliant on grant funding. We use the illustrative case of the Penn Center for Community Health Workers (PCCHW) to describe a step-by-step framework for achieving financial sustainability for community-engaged research interventions. PCCHW began as a small grant-funded research project but followed an 8-step framework to engage both low-income patients and funders, determine…
Latino Population Growth and Hospital Uncompensated Care in California
Objectives. We examined the association between the size and growth of Latino populations and hospitals’ uncompensated care in California. Methods. Our sample consisted of general acute care hospitals in California operating during 2000 and 2010 (n = 251). We merged California hospital data with US Census data for each hospital service area. We used spatial analysis, multivariate regression, and fixed-effect models. Results. We found a significan…
Prior Experiences of Racial Discrimination and Racial Differences in Health Care System Distrust
PURPOSE: Factors contributing to racial differences in health care system distrust (HCSD) are currently unknown. Proposed potential contributing factors are prior experiences of racial discrimination and racial residential segregation. METHODS: Random digit dialing survey of 762 African American and 1267 white adults living in 40 US metropolitan statistical areas. Measures included the Revised Health Care System Distrust scale, the Experiences of…
Perceived Community Commitment of Hospitals
Hospitals assume broad social roles in their communities as major health service institutions, large employers, and in some cases as philanthropic organizations. These roles create perceptions about the community commitment of hospitals to a local community. How these perceptions toward hospitals influence patients' decisions in choosing a hospital for care and trust in the health care system more generally has not been explored. As part of a stu…
The Influence of Health Care Policies and Health Care System Distrust on Willingness to Undergo Genetic Testing
PURPOSE: As the potential role of genetic testing in disease prevention and management grows, so does concern about differences in uptake of genetic testing across social and racial groups. Characteristics of how genetic tests are delivered may influence willingness to undergo testing and, if they affect population subgroups differently, alter disparities in testing. METHODS: Conjoint analysis study of the effect of 3 characteristics of genetic t…
Community Health Worker Support for Disadvantaged Patients With Multiple Chronic Diseases
Objectives. To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. Methods. We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013–2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hype…
Penn Center for Community Health Workers
Community-engaged researchers who work with low-income communities can be reliant on grant funding. We use the illustrative case of the Penn Center for Community Health Workers (PCCHW) to describe a step-by-step framework for achieving financial sustainability for community-engaged research interventions. PCCHW began as a small grant-funded research project but followed an 8-step framework to engage both low-income patients and funders, determine…
The Influence of Health Care Policies and Health Care System Distrust on Willingness to Undergo Genetic Testing
PURPOSE: As the potential role of genetic testing in disease prevention and management grows, so does concern about differences in uptake of genetic testing across social and racial groups. Characteristics of how genetic tests are delivered may influence willingness to undergo testing and, if they affect population subgroups differently, alter disparities in testing. METHODS: Conjoint analysis study of the effect of 3 characteristics of genetic t…
Prior Experiences of Racial Discrimination and Racial Differences in Health Care System Distrust
PURPOSE: Factors contributing to racial differences in health care system distrust (HCSD) are currently unknown. Proposed potential contributing factors are prior experiences of racial discrimination and racial residential segregation. METHODS: Random digit dialing survey of 762 African American and 1267 white adults living in 40 US metropolitan statistical areas. Measures included the Revised Health Care System Distrust scale, the Experiences of…
Perceived Community Commitment of Hospitals
Hospitals assume broad social roles in their communities as major health service institutions, large employers, and in some cases as philanthropic organizations. These roles create perceptions about the community commitment of hospitals to a local community. How these perceptions toward hospitals influence patients' decisions in choosing a hospital for care and trust in the health care system more generally has not been explored. As part of a stu…
Latino Population Growth and Hospital Uncompensated Care in California
Objectives. We examined the association between the size and growth of Latino populations and hospitals’ uncompensated care in California. Methods. Our sample consisted of general acute care hospitals in California operating during 2000 and 2010 (n = 251). We merged California hospital data with US Census data for each hospital service area. We used spatial analysis, multivariate regression, and fixed-effect models. Results. We found a significan…
New Medicaid Enrollees See Health and Social Benefits in Pennsylvania’s Expansion
Understanding how new Medicaid enrollees are approaching their own health and health care in the shifting health care landscape of the Affordable Care Act has implications for future outreach and enrollment efforts, as well as service planning for this population. The objective of this study was to explore the health care experiences and expectations of new Medicaid expansion beneficiaries in the immediate post-enrollment period. We conducted sem…
Penn Center for Community Health Workers
Community-engaged researchers who work with low-income communities can be reliant on grant funding. We use the illustrative case of the Penn Center for Community Health Workers (PCCHW) to describe a step-by-step framework for achieving financial sustainability for community-engaged research interventions. PCCHW began as a small grant-funded research project but followed an 8-step framework to engage both low-income patients and funders, determine…
Racial Differences in Prostate Cancer Treatment
These results stress the importance of examining racial disparities within geographic areas and highlight the unique associations that different measures of SES, particularly neighborhood SES and education, may have with prostate cancer treatment
Mutual Distrust
The production of health policy-relevant research is necessary, but not sufficient, to promote its utilization in policy. Our objective was to understand the perspectives of United States' state-level policy makers and health researchers on the barriers and facilitators to the translation of health evidence into the policy process, with a particular focus on issues related to relationship building. We conducted interviews with 215 US health servi…
Effect of Outreach Messages on Medicaid Enrollment
Objectives. To measure the impact of different outreach messages on health insurance enrollment among Medicaid-eligible adults. Methods. Between March 2015 and April 2016, we conducted a series of experiments using mail-based outreach that encouraged individuals to enroll in Pennsylvania’s expanded Medicaid program. Recipients were randomized to receive 1 of 4 different messages describing the benefits of health insurance. The primary outcome was…
Community Health Worker Support for Disadvantaged Patients With Multiple Chronic Diseases
Objectives. To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. Methods. We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013–2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hype…
Racial Differences in Geographic Access to Medical Care as Measured by Patient Report and Geographic Information Systems
BACKGROUND: Geographic access-the travel burden required to reach medical care-is an important aspect of care. Studies, which typically rely on geographic information system (GIS) calculated travel times, have found some evidence of racial disparities in spatial access to care. However, the validity of these studies depends on the accuracy of travel times by patient race. OBJECTIVES: To determine if there are racial differences when comparing pat…
The Affordable Care Act Attenuates Financial Strain According to Poverty Level
We use data from the 2011-2016 National Health Interview Survey to examine how the Patient Protection and Affordable Care Act (ACA) has influenced disparities in health care-related financial strain, access to care, and utilization of services by categories of the Federal Poverty Level (FPL). We use multivariable regression analyses to determine the ACA's effects on these outcome measures, as well as to determine how changes in these measures var…
Why Effective Interventions Do Not Work for All Patients
BACKGROUND: Half of all Americans have a chronic disease. Promoting healthy behaviors to decrease this burden is a national priority. A number of behavioral interventions have proven efficacy; yet even the most effective of these has high levels of nonresponse. OBJECTIVES: In this study, we explore variation in response to an evidence-based community health worker (CHW) intervention for chronic disease management. RESEARCH DESIGN: We used a conve…
Insurance Type and Access to Health Care Providers and Appointments Under the Affordable Care Act
BACKGROUND: Millions of adults have gained insurance through the Affordable Care Act (ACA). However, disparities in access to care persist. OBJECTIVE: This study examined differences in access to primary and specialty care among patients insured by private individual market insurance plans (both on-exchange and off-exchange) and Medicaid compared with those with employer-sponsored insurance. RESEARCH DESIGN: Using data from the 2014 and 2015 Cali…
Variability in Primary Care Physician Attitudes Toward Medicaid Work Requirement Exemption Requests Made by Patients With Depression
In this survey study of primary care physicians, we found substantial variation regarding willingness to assist patients qualifying for a work requirement exemption where none should exist. Insofar as work requirements are implemented again, it is critical to proactively identify measures to ensure that patients qualifying for exemptions are not put at risk due to either the burdensomeness of exemption procedures, or physicians' political or pers…
Medicine (13 works) · Environmental health (9 works) · Health care (9 works) · Healthcare Policy and Management (9 works) · Family medicine (8 works) · Gerontology (8 works) · Gerontology (8 works) · Medicaid (6 works) · Political science (6 works) · Population (6 works)