The Population Health and Health Policy (PHHP) program at the Cutler Institute conducts policy-driven research, evaluation, policy analysis and technical assistance focusing on the public health system and the delivery of healthcare services. Our research is conducted in the areas of healthcare access, quality and financing; public health systems and practice; and rural health.

We focus our work in the following areas:

  • Healthcare Access, Quality, & Financing
  • Public Health Systems & Practice
  • The Maine Public Health Institute
  • Rural Health

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2021

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Experiences of Stigma among Individuals in Recovery from Opioid Use Disorder in a Rural Setting: A Qualitative Analysis, Amanda Burgess MPPM, MPH; Emily Bauer MPH; Shane Gallagher MS; Brianne Karstens BS; LeeAnna Lavoie MPH, CHES; Katherine A. Ahrens PhD; and Alane O'Connor DNP

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Opioid use disorder treatment in rural settings: The primary care perspective., Valerie S Harder, Andrea C Villanti, Sarah H Heil, Mary Lindsey Smith, Diann E Gaalema, Marjorie C Meyer, Nathaniel H Schafrick, and Stacey C Sigmon

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Harnessing the Combined Strengths of a National and a Local Funder to Bolster Maine Medicaid Expansion, Tara Oakman PhD, Barbara Leonard MPH, Kimberley S Fox MPA, Sara Kahn-Troster MPH, and Amanda Burgess MPPM

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Opioid-Related Visits to Rural Emergency Departments, Erika C. Ziller PhD, Jean A. Talbot PhD, Deborah Thayer MBA, and Carly Milkowski MPH

2020

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Maternal opioid use disorder at delivery hospitalization in a rural state: Maine, 2009-2018., Sarah M.B. Gabrielson, Jenny L. Carwile, A. B. O'Connor, and Katherine A. Ahrens PhD

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Engaging Critical Access Hospitals in Addressing Rural Substance Use, John A. Gale MS; Sara Kahn-Troster MPH; Zachariah T. Croll MPH; and Nathan L. First LCSW, MSW, MA

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Addressing Opioid Use in Rural Communities: Examples from Critical Access Hospitals, John A. Gale MS; Sara Kahn-Troster MPH; Karen B. Pearson MLIS, MA; and Nathan First LCSW, MSW, MA

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Supporting CAHs during the COVID-19 Pandemic: Results of a Survey of State Flex Coordinators, John Gale MS; Zachariah T. Croll MPH; Yvonne Jonk PhD; Sara Kahn-Troster MPH; and Karen Pearson MLIS, MA

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Supporting Critical Access Hospitals (CAHs) during the COVID-19 Pandemic: Summary Results of a Survey of State Flex Coordinators, John Gale MS; Zachariah T. Croll MPH; Yvonne Jonk PhD; Sara Kahn-Troster MPH; and Karen Pearson MLIS, MA

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Pent-Up Demand for Care among Dual-Eligible Victims of Elder Financial Exploitation in Maine, Yvonne Jonk PhD, Kimberly I. Snow MHSA, Deborah Thayer MBA, Catherine McGuire BS, Stuart Bratesman MPP, Charles A. Smith PhD, and Erika C. Ziller PhD

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Substance Use among Rural and Urban Youth and Young Adults, Jennifer D. Lenardson MHS, Nathan Paluso MPH, and Erika C. Ziller PhD

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Multiple COVID-19 Outbreaks Linked to a Wedding Reception in Rural Maine — August 7–September 14, 2020, Parag Mahale MBBS, PhD; Craig Rothfuss MPA, MPH; Sarah Bly; Megan Kelley; Siiri Bennett MD; Sara L. Huston PhD; and Sara Robinson

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Rural-Urban Differences in Hospitalizations for Opioid Use-Associated Infective Endocarditis in the United States, 2003-2016., E. Katherine Nenninger, Jenny L. Carwile, Katherine Ahrens PhD, Brett Armstrong, and Kinna Thakarar

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Evaluation of Maine DOC's Medication-Assisted Treatment Pilot Program, M. Lindsey Smith PhD, George Shaler MPH, Olivia Dooley MPA, and Evelyn Ali

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Telebehavioral health (TBH) use among rural medicaid beneficiaries: Relationships with telehealth policies, Jean A. Talbot PhD, Yvonne Jonk PhD, Amanda Burgess MPPM, Deborah Thayer, Nathan Paluso MPH, and Andrew F. Coburn PhD

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Virtually possible: using telehealth to bring reproductive health care to women with opioid use disorder in rural Maine, Terri-Ann Thompson, Katherine A. Ahrens PhD, and Leah Coplon

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Health Care Use and Access among Rural and Urban Nonelderly Adult Medicare Beneficiaries, Erika C. Ziller PhD, Amanda Burgess MPPM, and Deborah Thayer MBA

2019

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What Is Rural? Challenges and Implications of Definitions that Inadequately Encompass Rural People and Places., Kevin J Bennett PhD; Tyrone F Borders PhD; George M. Holmes PhD; Katy Backes Kozhimannil PhD, MPA; and Erika C. Ziller PhD

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Long-Term Services and Supports Use Among Older Medicare Beneficiaries in Rural and Urban Areas, Andrew F. Coburn PhD; Erika C. Ziller PhD; Nathan Paluso MPH; Deborah Thayer MBA; and Jean A. Talbot PhD, MPH

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What to Expect with MaineCare Expansion [OpEd], Zachariah T. Croll BA

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Health Status and Access to Care among Maine's Low-Income Childless Adults: Implications for State Medicaid Expansion, Zachariah T. Croll MPH and Erika C. Ziller PhD

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Sociodemographic and Health Status Characteristics of Maine's Newly Eligible Medicaid Beneficiaries [Data Brief], Zachariah T. Croll MPH, Erika C. Ziller PhD, and Barbara Leonard MPH

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Community Impact and Benefit Activities of Critical Access, Other Rural, and Urban Hospitals, 2017, Zach T. Croll MPH, John A. Gale MS, and Jeremy Zuckero

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Association Between Rurality and Lung Cancer Treatment Characteristics and Timeliness, Kathleen M Fairfield MD, MPH, DrPH; Adam W. Black; F. Lee Lucas PhD; Kimberly Murray MPP; Erika C. Ziller PhD; Neil Korsen MDMS; Leo B. Waterston MA; and Paul K. J. Han MD, MA, MPH

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Using Public Cost Information During Low Back Pain Visits: A Qualitative Study., Kimberley S Fox, Carolyn E. Gray, Martha Elbaum Williamson, and Jennifer A. MacKenzie

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Rural Health Clinic Costs and Medicare Reimbursement, John A. Gale MS, Zachariah T. Croll MPH, and Andrew F. Coburn PhD

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Behavioral Health in Rural America: Challenges and Opportunities [EXECUTIVE SUMMARY], John A. Gale MS; Jaclyn Janis BSN, RN; and Andrew F. Coburn PhD

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Behavioral Health in Rural America: Challenges and Opportunities, John A. Gale MS; Jaclyn Janis BSN, RN; Andrew F. Coburn PhD; and Hanna Rochford MPH

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Implementation and Early Results of the Flex Program's Innovative Models Program Area (Briefing Paper #42), John A. Gale MS, Sara Kahn-Troster MPH, and Andrew F. Coburn PhD

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Implementation of the Flex Program's Innovative Models Program Area: Final Evaluation Report, John A. Gale MS, Sara Kahn-Troster MPH, and Andrew F. Coburn PhD

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Using Local Data on Adults Aged 18 to 64 to Tailor Interventions for Blood Pressure Medication Adherence in Maine., Caitlin Pizzonia MPH, CPH; David Pied; Sara L Huston PhD; Pamela Foster Albert; Gregory Parent; and Nathan Morse

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The Health Care Costs of Financial Exploitation in Maine, Kimberly I. Snow MHSA, Yvonne Jonk PhD, Deborah Thayer MBA, Catherine McGuire BS, Stuart Bratesman MPP, Charles A. Smith PhD, and Erika C. Ziller PhD

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Advancing Tobacco Prevention and Control in Rural America, Jean A. Talbot PhD; Martha Elbaum Williamson MPA; Karen B. Pearson MLIS, MA; Jennifer D. Lenardson MHS; Erika C. Ziller PhD; Frances Jimenez; Nathan Paluso MPH; Louisa Munk; Jaclyn Janis BSN, RN; and Paula F. Clayton MS, RDN, LD

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Advancing Tobacco Prevention and Control in Rural America: Executive Summary, Jean A. Talbot PhD; Martha Elbaum Williamson MPA; Karen B. Pearson MLIS, MA; Jennifer D. Lenardson MHS; Erika C. Ziller PhD; Frances Jimenez; Nathan Paluso MPH; Louisa Munk; Jaclyn Janis BSN, RN; and Paula F. Clayton MS, RDN, LD

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Growing Up Rural [Podcast], Erika C. Ziller PhD and Yvonne Jonk PhD

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How Did We Get Here? Rural Health Challenges in America [Podcast], Erika C. Ziller PhD and Yvonne Jonk PhD

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Rural Health in Maine and America vs. the World, Erika C. Ziller PhD and Yvonne Jonk PhD

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Preventive Health Service Use among Rural Women, Erika C. Ziller PhD; Jennifer D. Lenardson MHS; Nathan Paluso MPH; and Jaclyn Janis BSN, RN

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Rural-Urban Differences in the Decline of Adolescent Cigarette Smoking., Erika C. Ziller PhD, Jennifer D. Lenardson MHS, Nathan Paluso MPH, Jean A. Talbot PhD, and Angela Daley PhD

2018

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Strategies to Combat Opioid Use in Rural Communities, John A. Gale MS

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The Role of Rural Hospitals in Addressing Opioid and Other Substance Use Problems, John A. Gale MS

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Rural Health Clinic Participation in the Merit-Based Incentive System and Other Quality Reporting Initiatives: Challenges and Opportunities, John A. Gale MS, Zachariah T. Croll MPH, and Andrew F. Coburn PhD

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CAHs' Community Health Needs Assessments and Implementation Plans: How Do They Align? (FMT Briefing Paper #39), John A. Gale MS, Zach T. Croll BA, Lauren Zoll MPH, and Andrew F. Coburn PhD

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An Interim Evaluation Report of the Innovative Projects Portfolio of the Flex Program (FMT Briefing Paper #37), Sara Kahn-Troster MPH; John A. Gale MS; Anush Yousefian Hansen MS,MA; and Andrew F. Coburn PhD

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Residential Settings and Healthcare Use of the Rural "Oldest-Old" Medicare Population, Nathan Paluso MPH; Zachariah T. Croll MPH; Deborah Thayer MBA; Jean A. Talbot PhD, MPH; and Andrew F. Coburn PhD

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Patterns of Telehealth Use Among Rural Medicaid Beneficiaries, Jean A. Talbot PhD, Amanda Burgess MPPM, Deborah Thayer MBA, Lily Parenteau, Nathan Paluso MPH, and Andrew F. Coburn PhD

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Low-Income, Uninsured Mainers Face Substantial Challenges Getting Health Care, Erika C. Ziller PhD, Amanda Burgess MPPM, and Barbara Leonard MPH

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Health Equity Challenges in Rural America, Erika C. Ziller PhD and Andrew F. Coburn PhD

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Access to Health Care Services for Adults in Maine [Policy Brief], Erika C. Ziller PhD, Barbara Leonard MPH, Amanda Burgess MPPM, and Nathan Paluso MPH

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Medicaid Income Eligibility Transitions Among Rural Adults, Erika C. Ziller PhD, Deborah Thayer, and Jennifer D. Lenardson MHS