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Dr. Steffani Bailey is an affiliate investigator at OCHIN. Additionally, she is an associate professor in the Department of Family Medicine at Oregon Health & Science University (OHSU) and a licensed psychologist in the state of Oregon. Her goal is to eliminate disparities in substance use disorder treatment access and outcomes. She has >90 peer-reviewed publications, most utilizing OCHIN electronic health record (EHR) data to examine factors (including public health policies) that impact health care use and health outcomes among our most vulnerable populations, including certain racial and ethnic minority groups and those of lower socioeconomic status. She currently has a National Cancer Institute (NCI)-funded R01 that examines the impact of academic detailing on the reach and effectiveness of a tobacco quitline electronic referral system in safety-net clinics, a Veterans Rural Health Resource Center grant to pilot a tobacco cessation intervention for rural veterans seeking elective surgery, and a National Institute on Minority Health and Health Disparities (NIMHD)-funded R01 that assesses the impact of a Medicaid policy requiring smoking cessation prior to elective surgeries on smoking- and surgery-related outcomes. Given the rise in opioid overdoses, her research has expanded to include primary care-based treatment of opioid use disorders. In 2021, she was awarded a National Institute on Drug Abuse (NIDA)-funded R21 to examine the impact of telehealth on opioid use disorder care in two safety-net settings. She is also the health systems liaison for the Western States Node of the NIDA Clinical Trials Network and served as the OHSU principal investigator (PI) of a NIDA-funded R43 to conduct feasibility testing of a mobile- and desktop-friendly web-application to enable accelerated take-home methadone regimens.
Opioid use disorder continues to be an epidemic in the United States. Opioid use disorder can be treated in primary care settings; however, little is known about predictors of treatment initiation and retention in safety-net settings and optimal models of care. Steffani has contributed (as PI) to multiple papers that have demonstrated the feasibility of using EHR data and qualitative data to further our understanding of substance use disorders among socioeconomically disadvantaged patients.
Survey data and claims data have been used to examine health policy impacts on access and utilization of health care services, such as the Oregon Experiment, Children’s Health Insurance Program expansions, and the Affordable Care Act. As a PI and a co-investigator on multiple projects, they have pioneered the use of electronic health records data for examining the impact of health policy changes on healthcare utilization and insurance coverage patterns among patients in federally qualified health centers.
Steffani has contributed as a co-investigator to our understanding of disparities that exist in the receipt of preventive care services among patients seeking care in safety-net settings. This information is vital to developing interventions to ensure provision of evidence-based preventive care services to all patients.
Despite evidence that brief primary care interventions are effective, delivery of appropriate cessation services among health care providers remains low. Two goals of Healthy People 2030 are to increase the proportion of adults who receive advice to quit smoking from a health care provider and to increase use of cessation medications and counseling among adults who smoke. As the PI of a K23 award and as a co-investigator, Steffani has contributed to multiple papers that have increased our understanding of assessment and treatment of tobacco use among primary care patients.
Nicotine dependence in adolescence remains a public health concern, as teens who smoke on a regular basis are likely to continue this behavior into adulthood. Steffani has elucidated how the smoking patterns of adolescents might differ from their adult counterparts and first-authored one of the only studies to examine the efficacy of extended treatment for adolescent smokers. She contributed to the U.S. Preventive Services Task Force Evidence Report for primary care–relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents and led a paper on the assessment of smoking among adolescents in primary care settings. These findings can inform future smoking cessation treatments that are tailored to this specific population.
OCHIN Connections is a monthly newsletter featuring the latest OCHIN news and perspectives supporting our mission to drive health equity.