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Bradley Stein

@bradleydstein.bsky.social
1.3K followers 870 following 142 posts

Child psychiatrist/ health services/policy researcher at RAND, studying improving access, treatment, and outcomes for individuals with mental health and substance use disorders. Often found at youth soccer games and finding recipes to try in my smoker

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Bradley Stein @bradleydstein.bsky.social · 21/06/2026
Congratulations! You are joining a tremendous team. Can’t wait to see what you do next
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Bradley Stein @bradleydstein.bsky.social · 15/05/2026
See the full NIH funded study with coauthors @jcmecon.bsky.social and Ashley Kranz here: publications.aap.org/pediatrics/a...
publications.aap.org
State Paid Sick Leave Mandates and Receipt of Pediatric Preventive Dental Care
10.1542/6390794478112Video AbstractPEDS-VA_2025-0742766390794478112BACKGROUND AND OBJECTIVES. Biannual preventive dental visits are recommended to promote good oral health and identify problems, yet children in many families do not receive this care due to time-related barriers. Paid sick leave mandates have the potential to relieve parental time constraints and facilitate scheduling and attending pediatric dental visits; thus, we sought to evaluate the effects of state paid sick leave mandates on children’s receipt of preventive dental care.METHODS. Using 2016 to 2023 National Survey of Children’s Health data and a difference-in-differences approach, we compared trends in children’s receipt of preventive dental care in states that did and did not implement paid sick leave mandates.RESULTS. Pre-implementation of paid sick leave mandates, children residing in states that later implemented these policies were more likely to have received preventive dental care, to be non-Hispanic white, to have private health insurance, and to have parents with more than a high school education, relative to children residing in states that never implemented paid sick leave mandates. State paid sick leave mandates were associated with a 3.2% relative increase (95% CI: 0.2%, 6.2%) in rates of children receiving preventive dental care, controlling for time-varying demographic and policy characteristics, with state and year fixed effects.CONCLUSIONS. State-paid sick leave mandates may alleviate competing parental work and caregiving responsibilities and provide parents with additional time and flexibility to obtain dental care for their children.
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Bradley Stein @bradleydstein.bsky.social · 15/05/2026
The bottom line: time is a real barrier to preventive care. When parents get protected time off, more kids make it into the dental chair for check‑ups, cleanings, and fluoride treatments.
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Bradley Stein @bradleydstein.bsky.social · 15/05/2026
This effect is similar in size to what prior work finds from increasing Medicaid payments to dentists, suggesting PSL mandates can be a complementary lever alongside reimbursement policy.
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Bradley Stein @bradleydstein.bsky.social · 15/05/2026
That 2.5‑point bump sounds small, but at population scale it isn’t: if every state had a PSL mandate, about 2.3 million more children would have gotten preventive dental care in 2023.
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Bradley Stein @bradleydstein.bsky.social · 15/05/2026
After states implemented paid sick leave mandates, children were 2.5 percentage points more likely to receive preventive dental care (a 3.2% relative increase, from 78.9% to 81.4%).
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Bradley Stein @bradleydstein.bsky.social · 15/05/2026
Preventive dental care was fairly high overall (~79%), but far from universal—especially for young kids, children with public insurance, and families with lower parental education.
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Bradley Stein @bradleydstein.bsky.social · 15/05/2026
Using 2016–2023 National Survey of Children’s Health data, we followed >300k kids ages 1–17 across states that did and did not adopt paid sick leave mandates.
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Bradley Stein @bradleydstein.bsky.social · 15/05/2026
New in @ameracadpeds.bsky.social journal Pediatrics: state paid sick leave (PSL) mandates aren’t just labor policy—they’re getting more kids to the dentist. Led by rising star Alex Skinner from @brownpublichealth.bsky.social with colleagues from @georgemasonu.bsky.social and @rand.org
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Bradley Stein @bradleydstein.bsky.social · 11/11/2025
Want to know more? Find details and recommendations from our NIMH supported research with colleagues from @rand.org @harvardmed.bsky.social @deptpopmed.bsky.social @bostonchildrens.bsky.social @brownpublichealth.bsky.social here: jamanetwork.com/journals/jam...
jamanetwork.com
Use of Generative AI for Mental Health Advice Among Adolescents and Young Adults
This cross-sectional study surveyed US adolescents and young adults on their use of generative artificial intelligence (AI) for mental health advice, including frequency and perceived helpfulness.
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Bradley Stein @bradleydstein.bsky.social · 11/11/2025
Our research spotlights both promise and pitfalls. Parents, clinicians, and tech companies must work together to ensure AI support is trustworthy, safe, and effective
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Bradley Stein @bradleydstein.bsky.social · 11/11/2025
But there are risks: Without oversight, chatbots may give advice that isn’t always safe, accurate, or appropriate—especially for those with serious needs
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Bradley Stein @bradleydstein.bsky.social · 11/11/2025
The upside? AI tools are accessible and may help fill support gaps when traditional mental health care isn’t available
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Bradley Stein @bradleydstein.bsky.social · 11/11/2025
Most who turn to AI for help do so regularly- monthly or more. For millions of young people, chatbots are now likely part of coping and support routines
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Bradley Stein @bradleydstein.bsky.social · 11/11/2025
The vast majority of users find this advice useful. But this varies by groups. Black respondents reported benefits less often than their White peers
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Bradley Stein @bradleydstein.bsky.social · 11/11/2025
13.1%—about 1 in 8—of US youths have asked an AI chatbot for advice during tough times. Among 18–21-year-olds, this rises to more than 1 in 5.
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Bradley Stein @bradleydstein.bsky.social · 11/11/2025
New research alert: How are teens and young adults really using AI? Our national survey led by Ryan McBain in @jamanetworkopen.com helps offer a clear, data-driven answer.
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Bradley Stein @bradleydstein.bsky.social · 15/10/2025
Really important research about a school mental health intervention. Studies without significant findings often have a hard time getting published, but its just as important to know what interventions don't seem to have a significant benefit as knowing what interventions do.
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Bradley Stein @bradleydstein.bsky.social · 13/10/2025
Read the full NIMH supported study with my @rand.org colleagues Amy Mahler and Rosanna Smart here: www.jaacap.org/article/S089...
jaacap.org
Teachers’ Reports of Attention-Deficit/Hyperactivity Disorder Medication Changes During Stimulant Shortages: National Survey Results
Attention-deficit/hyperactivity disorder (ADHD), a common childhood-onset disorder, is associated with impulsivity, impaired attention and executive function, and poor academic performance.1 Stimulant...
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Bradley Stein @bradleydstein.bsky.social · 13/10/2025
Pediatricians, child psychiatrists and educators need to work together to help families find solutions—like pharmacy navigation and behavioral supports—so kids don’t fall behind during medication shortages
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Bradley Stein @bradleydstein.bsky.social · 13/10/2025
These differences mean the shortage could deepen existing gaps in academic achievement and behavioral health for children already facing challenges and barriers to care
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Bradley Stein @bradleydstein.bsky.social · 13/10/2025
Teachers in these schools were significantly more likely to report students having to stop their medication—over 77% in majority-minority schools and 76% in schools with mostly low-income students.
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Bradley Stein @bradleydstein.bsky.social · 13/10/2025
New research alert: The nationwide stimulant shortage didn’t affect all schools equally. Our new national study in JAACAP found much higher rates of ADHD medication interruption in schools where most students are from racial/ethnic minorities or low-income backgrounds.
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Reposted by Bradley Stein
RAND @rand.org · 11/10/2025
The number of people initiating and continuing medication treatment for opioid use disorder declined in the six months after Medicaid unwinding began. New study: bit.ly/42vlomV
rand.org
Medicaid Unwinding Associated with Less Medication Treatment for Opioid Use Disorder
The end of pandemic-era enrollment enhancements for Medicaid was associated with a rise in the number of people ending medication treatment for opioid use disorder, as well as a decrease in the number...
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Bradley Stein @bradleydstein.bsky.social · 08/10/2025
Read the full NIMH supported study here with co-authors Skyler Hulser and Brendan Saloner from @brownpublichealth.bsky.social : www.healthaffairs.org/doi/full/10....
healthaffairs.org
Health Affairs Journal
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Bradley Stein @bradleydstein.bsky.social · 08/10/2025
These treatment settings all matter for recovery, meaning broader Medicaid access offered more pathways for people with SUD to get help when needed most, critical when the overdose crisis was intensifying
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Bradley Stein @bradleydstein.bsky.social · 08/10/2025
Even 6+ years later, treatment rates remained higher than pre-expansion, showing sustained improvements—not just a one-time bump.
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Bradley Stein @bradleydstein.bsky.social · 08/10/2025
Treatment episodes for SUD surged across the board in the first 2-3 years after expansion: overall rates up 39–40% after 2–5 years, with strong gains across the board, in residential, intensive outpatient, and non-intensive outpatient care.
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Bradley Stein @bradleydstein.bsky.social · 08/10/2025
New research led by @jcmecon.bsky.social of @georgemasonu.bsky.social in @healthaffairs.bsky.social finds Medicaid expansion has yielded lasting gains in access to specialty substance use disorder (SUD) treatment—benefiting thousands experiencing drug or alcohol problems.
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Bradley Stein @bradleydstein.bsky.social · 07/10/2025
See the full paper with co-authors Jon Cantor, Ryan McBain, Aaron Kofner, Fang Zhang, Alyssa Burnett, Josh Breslau. Melissa Kilberti, Ateev Mehrota from @brownpublichealth.bsky.social and Hao Yu from @deptpopmed.bsky.social here: jamanetwork.com/journals/jam...
jamanetwork.com
Cell Phone Bans in a National Sample of US Public School Principals
This cross-sectional study reports the national prevalence of public-school cell phone bans and how they vary by school characteristics.
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Bradley Stein @bradleydstein.bsky.social · 07/10/2025
Thanks to the NIMH for funding this work and shout-out to all the school leaders who responded to the @rand.org American School Leader Panel!
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Bradley Stein @bradleydstein.bsky.social · 07/10/2025
Policymakers and school boards: are you considering neighborhood context when crafting phone policies? Open dialogue with parents, teachers, and students is key to making effective rules
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Bradley Stein @bradleydstein.bsky.social · 07/10/2025
These differences raise important questions on equity and the impacts for different student populations— teens using phones more freely at school could see impacts on learning and mental health. Middle and high school principals face tough choices balancing safety, independence, and distractions.
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Bradley Stein @bradleydstein.bsky.social · 07/10/2025
And most elementary schools stick to strict bans: over 81% only allow phones on campus if students keep them put away all day. By high school, policies get much looser—many let students use phones outside class or at teacher discretion.
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Bradley Stein @bradleydstein.bsky.social · 07/10/2025
Our national analysis found schools in higher-income communities are more likely to allow phones than those in high-poverty neighborhoods.
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Bradley Stein @bradleydstein.bsky.social · 07/10/2025
New Research Alert: Did you know nearly all U.S. public schools restrict student cell phone use—but the types of bans are very different depending on the school? Our recent paper, led by led by my @rand.org colleague Jon Cantor, just published in @jamahealthforum.com examines this issue
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Bradley Stein @bradleydstein.bsky.social · 01/10/2025
Such an important topic. Great to see @parcka.bsky.social diving into this with my @rand.org colleague Liz!
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Bradley Stein @bradleydstein.bsky.social · 30/09/2025
Want all the numbers? Check out the NIDA and Foundation for Opioid Response Efforts supported study here: journals.lww.com/journaladdic...
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Bradley Stein @bradleydstein.bsky.social · 30/09/2025
Bottom line: Medicaid unwinding wasn’t just a paperwork issue- it disrupted effective treatment of opioid use disorder for thousands. Policymakers must find ways to protect coverage and care continuity as insurance rules evolve.
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Bradley Stein @bradleydstein.bsky.social · 30/09/2025
Did other insurance types like commercial insurance and Medicare, or paying out-of-pocket pocket fill the gap? Turns out, they didn’t: overall, more people ended up going without effective treatment.
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Bradley Stein @bradleydstein.bsky.social · 30/09/2025
In states with the greatest Medicaid disenrollment, the changes were greatest: ending episodes rose +5.5%, and new starts fell nearly -4% after unwinding.
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Bradley Stein @bradleydstein.bsky.social · 30/09/2025
Our national study led by @rand.org colleague Rachel Landis in the American Society of Addiction Medicine’s Journal of Addiction Medicine found that after unwinding, more Medicaid buprenorphine treatment episodes ended (+3%), and fewer Medicaid treatment episodes started (-2.6%).
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Bradley Stein @bradleydstein.bsky.social · 30/09/2025
New research alert: Medicaid covers nearly 40% of treatment for opioid use disorder (OUD), but recent “unwinding” of pandemic-era enrollment protections led many to lose coverage nationwide. How did this affect life-saving buprenorphine treatment?
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Bradley Stein @bradleydstein.bsky.social · 16/09/2025
Want the details? Find the full NIDA supported research with @rand.org colleagues @rosannasmart.bsky.social @phoebelevine.bsky.social, Rachel Landis, Abigail Kessler and @schaeffer.usc.edu colleague @rlpacula.bsky.social here: jamanetwork.com/journals/jam...
jamanetwork.com
Over-the-Counter Retail Naloxone Sales
This cross-sectional study examines first-year over-the-counter naloxone sales trends independently and in association with pharmacy-dispensed and program-distributed naloxone.
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Bradley Stein @bradleydstein.bsky.social · 16/09/2025
High cost (average price nearly $45) may have limited OTC demand. But the bottom line is that while OTC approval increased naloxone availability, most people still get naloxone from pharmacies (often using insurance) or community programs
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Bradley Stein @bradleydstein.bsky.social · 16/09/2025
States averaged a total of ~400 OTC units per million residents. By comparison, pharmacies and community programs each distributed more than 15 times as many units/million over a similar period. OTC sales were higher in some states but still fell far short of pharmacy and community distribution.
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Bradley Stein @bradleydstein.bsky.social · 16/09/2025
In the first year, sales peaked around 23 units per million people and soon stabilized below 15 units per million.
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Bradley Stein @bradleydstein.bsky.social · 16/09/2025
New research alert: Naloxone can stop opioid overdoses and save lives. When it went over-the-counter in Sept 2023, did Americans start buying it? We examined this question in a study now out in @jamainternalmed.com
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Bradley Stein @bradleydstein.bsky.social · 28/08/2025
School-based teams are encouraged to use TRS-IA results and action planning guides to facilitate strategic planning, team collaboration, and continuous quality improvement. Try it out or read more : psycnet.apa.org/fulltext/202...
psycnet.apa.org
APA PsycNet
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Bradley Stein @bradleydstein.bsky.social · 28/08/2025
School staff across 47 states rated the TRS-IA domains as highly important, but slightly less applicable in practice. This gap between importance and applicability reflects common implementation challenges for new practices.
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