Rollins Research Review: Demographic-Based Inequity in Insurance Claim Denial, Children’s Exposure to Pathogens in Animal Feces, and a Parenting Program Trial for Early Child Development

By Sarah Timbie

Last month, Rollins researchers authored papers on a wealth of public health topics. Find summaries of a few highlights below.

Title:Social Determinants of Health and Insurance Claim Denials for Preventive Care

Journal: JAMA Network

Rollins Authors: Michal Horny, PhD

Important Takeaways:

• Analyzes insurance claims data for privately insured patients, focusing on out-of-pocket costs stemming from administrative issues like claim denials.
• Certain groups, such as low-income individuals, those with lower educational attainment, and minoritized racial and ethnic populations, experienced higher rates of preventive care claim denials
• Marginalized groups were disproportionately affected by claim denials due to services not covered by insurance and billing errors caused by incorrect documentation or coding.
• Preventive care claim denials can reduce trust in the healthcare system and discourage the future use of medical services. This contributes to ongoing health inequities, particularly among vulnerable populations, further limiting their access to necessary preventive care.

Title: Multilevel Factors Drive Child Exposure to Enteric Pathogens in Animal Feces: A Qualitative Study in Northwestern Coastal Ecuador

Journal: PLOS Global Public Health

Rollins Authors: April Ballard, PhD; Nicholas Laramee; Jayden P. Gallagher; Regine Haardörfer, PhD; Matthew C. Freeman, PhD; Bethany A. Caruso, PhD.

Important Takeaways:

• Examined how children in northwestern Ecuador are exposed to enteric pathogens from animal feces. While most research focuses on human fecal exposure, animal feces pose significant health risks as well.
• Researchers found that children were at risk of exposure to animal feces regardless of whether their households had animals, as feces were widespread in the environment and children frequently interacted with animals in the community.
• This study identified several common community activities that may heighten exposure to animal feces and pathogens such as allowing animals to roam freely and forage for food. Especially when combined with the region’s limited sanitation infrastructure, these factors pose serious risks to health.

Title:A Parenting Program Delivered Through Existing Community-Based Peer Groups to Improve Early Child Development in Homabay and Busia Counties, Kenya: Study Protocol for a Cluster-Randomized Controlled Trial

Journal: BMC Pediatrics

Rollins Authors: Joshua Jeong, ScD, and Juliet K. McCann

Important Takeaways:

• Poor early childhood development is associated with worsened general health. It is common globally, especially in low- and middle-income countries.
• The research team developed a community-based group parenting program aimed at improving early childhood development in rural Kenya by leveraging existing peer groups to provide education for parents and caregivers.
• The parenting program will focus on early childhood development care and education, including areas such as responsive caregiving, child health, nutrition, and caregiver wellbeing.
• Once the study is conducted, findings will inform program adaptations and help provide recommendations for future parenting programs in Western Kenya and sub-Saharan Africa, which have not had as many evaluations of parenting intervention programs as other parts of the world.