Allison L. Diamant

This policy brief describes two types of walking among California adults: walking for transportation and walking for leisure. Using data from the 2003 and 2013-14 California Health Interview Surveys, the study found that the prevalence of both types of walking has increased since 2003. The prevalence of walking for both transportation and leisure varies with age, income, race/ethnicity, and neighborhood safety and cohesion. Additional efforts by state and local policymakers, as well as by communities, are needed to reduce disparities and promote walking among adults.

This policy brief was funded by The California Endowment.

Publication Authors:

• Susan H. Babey, PhD
• Joelle Wolstein, PhD, MPP, MA
• Allison L. Diamant, MD, MSHS

​This policy brief describes physical activity among California children and adolescents. Using data from the California Health Interview Survey (CHIS) from 2013-14, the study found that only 31 percent of children ages 5-11 and 18 percent of adolescents ages 12-17 meet the physical activity guidelines of engaging in at least one hour of physical activity every day. Neighborhood characteristics, including safety and proximity to parks, are related to physical activity levels among youth. Also, among older children, boys are more active than girls. Additional efforts by state and local policymakers, as well as communities, are needed to promote physical activity to increase the proportion of children and adolescents achieving recommended amounts of physical activity.

This policy brief was funded by The California Endowment.

• Susan H. Babey, PhD
• Joelle Wolstein, PhD, MPP, MA
• Allison L. Diamant, MD, MSHS

​A randomized clinical trial of 377 primary care patients with opioid and/or alcohol use disorders (OAUD) was conducted in 2 clinics in a federally qualified health center to determine whether collaborative care (CC) for OAUD improves delivery of evidence-based treatments for OAUD and increases self-reported abstinence compared with usual primary care. Collaborative care was a system-level intervention, designed to increase the delivery of either a 6-session brief psychotherapy treatment and/or medication-assisted treatment with either sublingual buprenorphine/naloxone for opioid use disorders or long-acting injectable naltrexone for alcohol use disorders. Usual care participants were told that the clinic provided OAUD treatment and given a number for appointment scheduling and list of community referrals.

After 6 months, the proportion of participants who received any OAUD treatment was higher in the CC group compared with usual care (39.0% vs. 16.8%); A higher proportion of CC participants reported abstinence from opioids or alcohol at 6 months (32.8% vs 22.3%). In secondary analyses, the proportion meeting the Healthcare Effectiveness Data and Information Set (HEDIS) initiation and engagement measures was also higher among CC participants (initiation, 31.6% vs 13.7%; engagement, 15.5% vs 4.2%) as was abstinence from opioids, cocaine, methamphetamines, marijuana, and any alcohol (26.3% vs 15.6%). The study was conducted by the RAND.

• Katherine E. Watkins
• Allison J. Ober
• Karen Lamp
• Allison L. Diamant, MD, MSHS
• et al

In California, more than 13 million adults (46 percent of all adults in the state) are estimated to have prediabetes or undiagnosed diabetes. An additional 2.5 million adults have diagnosed diabetes. Altogether, 15.5 million adults (55 percent of all California adults) have prediabetes or diabetes. Although rates of prediabetes increase with age, rates are also high among young adults, with one-third of those ages 18-39 having prediabetes.

In addition, rates of prediabetes are disproportionately high among young adults of color, with more than one-third of Latino, Pacific Islander, American Indian, African-American, and multiracial Californians ages 18-39 estimated to have prediabetes. Policy efforts should focus on reducing the burden of prediabetes and diabetes through support for prevention and treatment. This study uses data from the 2013-14 California Health Interview Survey.