Prevention can be grouped into three levels: primary prevention, secondary prevention, and tertiary prevention. Primary prevention refers to taking precautions to remove or reduce disease risk factors (e.g., immunization, ceasing or not starting smoking). Secondary prevention refers to early detection of diseases in order to reverse or slow the course and improve prognosis (e.g., routine measurement of blood pressure, or HPV screening for cervical cancer). Lastly, tertiary prevention refers to minimizing the effects of established disease (e.g., improving lipid profiles in patients with cardiovascular disease).
What We Do
Disease Screening
Mass screening of asymptomatic individuals can diagnose diseases at most treatable earlier stages. From society's perspective, while a small fraction of the population (i.e., patients who have disease) benefits from screening as a result of early detection and improved survival, the vast majority of the remaining population (i.e., the disease-free population) receives little or no benefit. In addition, mass screening is costly and false-positive test results may trigger unnecessary invasive diagnostic procedures (e.g., biopsy following a false-positive mammogram), complications from the screening procedures resulting in morbidity and mortality (e.g., perforation during a colonoscopy), and overtreatment (i.e., detecting and treating cancers that would not surface in the absence of screening). Hence, tailoring screening strategies based on patients' needs and expectations can improve overall health outcomes and patient satisfaction, and appropriate allocation of medical resource for screening is important for the public, payers, and policymakers. We develop optimization models, carefully calibrated with statistical tools to rigorously analyze patients' data, to allow capturing several important dynamics in disease screening decisions and provide a framework to analyze and answer important policy questions.
Access to Pediatric Primary Care
Child development affects subsequent life chances through the risks of unhealthy behaviors, chronic diseases, malnutrition, mental-health problems, and criminality in later life. Along with good nutrition and wellness, primary care is a paramount ingredient for healthy child development. Ensuring equitable and effective access to pediatric primary care offers health policy makers significant opportuni¬ties for improvement because investments during the early years of life have the greatest poten¬tial to reduce health disparities within a generation. We focus on three directions in assisting policy makers in their endeavor to improve access to primary care for all children. We derive small area estimates for two access dimensions, accessibility and availability, which offer opportunities for interventions at a low geographic granularity. We identify specific populations and communities in most need for improvement. Last, we match potential policy interventions with the communities in need of intervening in improving pediatric primary care.
Publications
Journals
Johnson, B., Serban, N., Griffin, P., Tomar, S. (Submitted March 2018) Does Silver Diamine Fluoride Reduce Caries Treatment Expenditures in US Children? Journal of Public Health Dentistry, under 2nd review.
Lee, I., Monahan, S., Serban, N., Griffin, P., Tomar, S. (2017) Estimating the Cost Savings of Preventive Dental Services Delivered to Medicaid-Enrolled Children in Six Southeastern States, Health Services Research, in press.
Pujol, T., Serban, N., Swann, J., Kottke, M. (Accepted August 2018) Determining the Uptake of CDC MEC Guidelines for Contraceptive Usage of Chronically Ill Women, Preventive Disease Control, in press.
Cao, S., Gentili, M., Griffin, P., Griffin, S., Serban, N. (2017). Disparities in Access to Preventive Dental Care between Publicly and Privately Insured Children in Georgia. Preventive Disease Control, 14:170176.
Harati, P., Gentili, M., Serban, N. (2016) Projecting the Impact of the Affordable Care Act Provisions on Accessibility and Availability of Primary Care for the Adult Population in Georgia, Journal of the American Public Health, 106(8):1470-6..
Davila-Payan, C., Johnson, K., DeGuzman, M., Serban, N. and Swann, J. (2015), ``Estimating Prevalence of Overweight and Obese Children in Small Geographical Areas using Publicly Available Data", Preventing Chronic Diseases, Volume 12, 140229.
Yan, R., Bastian, N.D., and Griffin, P.M. (2015), “Association of Food Environment and Food Retailers with Obesity in US Adults”, Health and Place, 33, 19-24.
Gentili, M., Isett, K., Serban, N., Swann, J. (2015) Small-Area Estimation of Spatial Access to Pediatric Primary Care and Its Implications for Policy. Journal of Urban Health, 92(5):864-909.
M. Nobles, N. Serban, J. Swann (2014), Spatial Accessibility of Pediatric Primary Healthcare: Measurement and Inference, Annals of Applied Statistics, 8 (4), 1922-1946.
Griffin, S.O., Bailey, W., Brunson, D., Griffin, P.M., Jones, J. (2012). “Burden of Oral Disease among Older Adults and Implications for Public Health Priorities”, American Journal of Public Health, Vol. 102, pp. 411-418.
Faissol, D.M., Griffin, P.M., Kirkizlar, E., and Swann, J.L. (2010). “Timing of Testing and Treatment for Asymptomatic Diseases”, Mathematical Biosciences, Vol. 226, pp. 28-37
Hagtvedt, R., Griffin, P.M., Keskinocak, P., Roberts, R. (2009). “A Simulation Model to Compare Strategies for the Reduction of Healthcare Acquired Infections,” Interfaces, Vol. 39, No. 3, pp. 256-270
Griffin, S.O., Regnier, E., Griffin, P.M., and Huntley, V. (2007), “Effectiveness of Fluoride in Preventing Caries in Adults“, Journal of Dental Research, Vol 86, 410-415
Griffin, S.O., Griffin, P.M., Gooch, B.F., and Barker, L.K. (2002), “Comparing the Costs of Three Sealant Delivery Strategies,” Journal of Dental Research, Vol. 81, 641-645