Ji E Chang
Ji E Chang
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Associate Professor of Public Health Policy and Management
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Professional overview
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Ji Eun Chang, Ph.D., is an Associate Professor in the Department of Public Health Policy and Management at the New York University School of Global Public Health, where she also serves as the public health policy and management concentration director for the Ph.D. program. Professor Chang uses mixed-methods research designs and draws from qualitative, quantitative, and geospatial data to demonstrate disparities and highlight barriers faced by safety net providers and underserved patients in accessing equitable care.
Professor Chang is the principal investigator of the AI4Healthy Cities Initiative in New York City, a multi-city collaboration between the Novartis Foundation, Microsoft AI4Health, and local health officials to reduce cardiovascular health inequities through big data analytics. Dr. Chang is also the co-principal investigator of an NIH NIDA-funded study to support implementing transitional opioid programs in safety net hospitals. Dr. Chang received a B.A. in Economics from the University of California at Berkeley, an M.S. in Public Policy and Management from Carnegie Mellon University, and a Ph.D. in Public Administration from New York University in 2016. -
Education
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BA, Economics, University of California at Berkeley, Berkeley, CAMS, Public Policy and Management, Carnegie Mellon University, Pittsburgh, PAPhD, Public Administration, New York University, New York, NY
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Honors and awards
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Governor’s Scholar (2007)Regents and Chancellors’ Scholar (2005)
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Areas of research and study
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Cardiovascular DiseaseHealth DisparitiesHealth EquityPublic Health ManagementPublic Health ManagementSafety Net Providers and PatientsSubstance Use Disorders
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Publications
Publications
Telephone vs. video visits during COVID-19 : Safety-net provider perspectives
AbstractChang, J. E., Lindenfeld, Z., Albert, S. L., Massar, R., Shelley, D., Kwok, L., Fennelly, K., & Berry, C. A. (n.d.).Publication year
2021Journal title
Journal of the American Board of Family MedicineVolume
34Issue
6Page(s)
1103-1114AbstractObjective: To review the frequency as well as the pros and cons of telephone and video-enabled telemedicine during the first 9 months of the Coronavirus disease 2019 (COVID-19) pandemic as experienced by safety net providers across New York State (NYS). Methods: Analysis of visits to 36 community health centers (CHCs) in NYS by modality (telephone vs video) from February to November 2020. Semi-structured interviews with 25 primary care, behavioral health, and pediatric providers from 8 CHCs. Findings: In the week following the NYS stay-at-home order, video and telephone visits rose from 3.4 and 0% of total visits to 14.9 and 22.3%. At its peak, more than 60% of visits were conducted via telemedicine (April 2020) before tapering off to about 30% of visits (August 2020). Providers expressed a strong preference for video visits, particularly for situations when visual assessments were needed. Yet, more visits were conducted over telephone than video at all points throughout the pandemic. Video-specific advantages included enhanced ability to engage patients and use of visual cues to get a comprehensive look into the patient’s life, including social supports, hygiene, and medication adherence. Telephone presented unique benefits, including greater privacy, feasibility, and ease of use that make it critical to engage with key populations and as a backup for when video was not an option. Conclusions: Despite challenges, providers reported positive experiences delivering care remotely using both telephone and video during the COVID-19 pandemic and believe both modalities are critical for enabling access to care in the safety net.Difficulty Hearing Is Associated With Low Levels of Patient Activation
AbstractChang, J. E., Weinstein, B. E., Chodosh, J., Greene, J., & Blustein, J. (n.d.).Publication year
2019Journal title
Journal of the American Geriatrics SocietyAbstractBACKGROUND/OBJECTIVES: Patient activation encompasses the knowledge, skills, and confidence that equip adults to participate actively in their healthcare. Patients with hearing loss may be less able to participate due to poor aural communication. We examined whether difficulty hearing is associated with lower patient activation. DESIGN: Cross-sectional study. SETTING/PARTICIPANTS: A nationally representative sample of Americans aged 65 years and older (n = 13 940) who participated in the Medicare Current Beneficiary Survey (MCBS) during the years 2011 to 2013. MEASUREMENT: Self-reported degree of difficulty hearing (“no trouble,” “a little trouble,” and “a lot of trouble”) and overall activation based on aggregated scored responses to 16 questions from the MCBS Patient Activation Supplement: low activation (below the mean minus 0.5 SDs), high activation (above the mean plus 0.5 SDs), and medium activation (the remainder). Sociodemographic and self-reported clinical measures were also included. RESULTS: “A little trouble” hearing was reported by 5655 (40.6%) of respondents, and “a lot of trouble” hearing was reported by 893 (6.4%) of respondents. Difficulty hearing was significantly associated with low patient activation: in analyses using multivariable multinomial logistic regression, respondents with “a little trouble” hearing had 1.42 times the risk of low vs high activation (95% confidence interval [CI] = 1.27-1.58), and those with “a lot of trouble” hearing had 1.70 times the risk of low vs high activation (95% CI = 1.29-2.11), compared with those with “no trouble” hearing. CONCLUSIONS: Nearly half of people aged 65 years and older reported difficulty hearing, and those reporting difficulty were at risk of low patient activation. That risk rose with increased difficulty hearing. Given the established link between activation and outcomes of care, and in view of the association between hearing loss and poor healthcare quality and outcomes, clinicians may be able to improve care for people with hearing loss by attending to aural communication barriers.Hearing loss is associated with low patient activation
AbstractBlustein, J., Chang, J. E., Weinstein, B., Greene, J., & Chodosh, J. (n.d.).Publication year
2019Journal title
Journal of the American Geriatrics SocietyAbstract~Coordination across ambulatory care a comparison of referrals and health information exchange across convenient and traditional settings
AbstractChang, J. E., Chokshi, D., & Ladapo, J. (n.d.).Publication year
2018Journal title
Journal of Ambulatory Care ManagementVolume
41Issue
2Page(s)
128-137AbstractUrgent care centers have been identified as one means of shifting care from high-cost emergency departments while increasing after-hours access to care. However, the episodic nature of urgent care also has the potential to fragment care. In this study, we examine the adoption of 2 coordination activities—referrals and the electronic exchange of health information—at urgent care centers and other ambulatory providers across the United States. We find that setting is significantly associated with both health information exchange and referrals. Several organization-level variables and environment-level variables are also related to the propensity to coordinate care.Hospital Readmission Risk for Patients with Self-Reported Hearing Loss and Communication Trouble
AbstractChang, J. E., Weinstein, B., Chodosh, J., & Blustein, J. (n.d.).Publication year
2018Journal title
Journal of the American Geriatrics SocietyVolume
66Issue
11Page(s)
2227-2228Abstract~Roles of Home Healthcare Agency Characteristics and Regional Health Resources in Patient Outcomes
AbstractMa, C., & Chang, J. E. (n.d.).Publication year
2018Abstract~Health reform and the changing safety net in the United States
AbstractChokshi, D. A., Chang, J. E., & Wilson, R. M. (n.d.).Publication year
2016Journal title
New England Journal of MedicineVolume
375Issue
18Page(s)
1790-1796Abstract~Convenient ambulatory care-promise, pitfalls, and policy
AbstractChang, J. E., Brundage, S. C., & Chokshi, D. A. (n.d.).Publication year
2015Journal title
New England Journal of MedicineVolume
373Issue
4Page(s)
382-388Abstract~Convenient care: retail clinics and urgent care centers in New York state
AbstractChang, J. E., Brundage, S. C., Burke, G., & Chokshi, D. A. (n.d.).Publication year
2015Abstract~Community health worker integration into the health care team accomplishes the triple aim in a patient centered medical home
AbstractFindley, S., Matos, S., Hicks, A., Chang, J. E., & Reich, D. (n.d.).Publication year
2014Journal title
Journal of Ambulatory Care ManagementVolume
37Issue
1Page(s)
82Abstract~Preventing early readmissions
AbstractChokshi, D. A., & Chang, J. E. (n.d.).Publication year
2014Journal title
JAMA - Journal of the American Medical AssociationVolume
312Issue
13Page(s)
1344-1345AbstractResults In 42 trials, the tested interventions prevented early readmissions (pooled random-effects relative risk, 0.82 [95%CI, 0.73-0.91]; P < .001; I2 = 31%), a finding thatwas consistent across patient subgroups. Trials published before 2002 reported interventions thatwere 1.6 times more effective than those tested later (interaction P = .01). In exploratory subgroup analyses, interventions with many components (interaction P = .001), involving more individuals in care delivery (interaction P = .05), and supporting patient capacity for self-care (interaction P = .04)were 1.4, 1.3, and 1.3 times more effective than other interventions, respectively. A post hoc regression model showed incremental value in providing comprehensive, postdischarge support to patients and caregivers.Conclusions and Relevance Tested interventions are effective at reducing readmissions, but more effective interventions are complex and support patient capacity for self-care. Interventions tested more recently are less effective.Jamainternal Medicine Preventing 30-Day Hospital Readmissions: A Systematic Reviewand Meta-analysis of Randomized Trials Aaron L. Leppin, MD; Michael R. Gionfriddo, PharmD; Maya Kessler, MD; Juan Pablo Brito, MBBS; Frances S. Mair, MD; Katie Gallacher, MBChB; ZhenWang, PhD; Patricia J. Erwin, MLS; Tanya Sylvester, BS; Kasey Boehmer, BA; Henry H. Ting, MD, MBA; M. Hassan Murad, MD; Nathan D. Shippee, PhD; Victor M. Montori, MD.Importance Reducing early (Aboriginal employment and training: moving beyond supply and demand
AbstractCavazos, R., & Chang, J. E. (n.d.).Publication year
2012Abstract~Indian health service health promotion/disease prevention cooperative agreement final evaluation report
AbstractCavazos, R., Chang, J. E., & Patel, N. (n.d.).Publication year
2012Abstract~Presenting Author: Substance use disorder program availability in safety-net and non-safety-net hospitals in the United States
AbstractChang, J. E. (n.d.).Abstract~