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BACKGROUND: New York City's (NYC's) taxi/for-hire vehicle (FHV) drivers have occupational and demographic characteristics associated with food insecurity (low income, comorbidities, minority race/ethnicity). OBJECTIVE: To analyze food insecurity rates in a sample of NYC drivers and to identify associated factors. METHODS: At health fairs, we recruited a cross-sectional sample of licensed taxi/FHV drivers willing to receive study text messages. Most lacked a primary care provider. Food insecurity prevalence and associations with health and economic indicators were analyzed. RESULTS: Of 503 participants who completed a 2-item food security screener, 39.2% were food insecure. Significantly fewer food insecure than food secure drivers reported a doctor visit within the past year (48% vs 25%; P <.001). Food insecure drivers had greater weekly traffic ticket expenditure ($34 vs $24; P =.02) and were more likely to report insufficient household income (61% vs 39%; P <.001) and history of depression (14% vs 7%; P =.02), to have elevated (>200) measured total cholesterol (50% vs 37%; P =.02), and to have Perceived Stress Scale scores indicating greater stress than food secure drivers (14 vs 11; P =.002). In a binary logistic regression analysis, drivers who reported that their total household income was enough to meet their basic needs had significantly lower odds of being food insecure (0.695 odds ratio; P =.016). CONCLUSION: Food insecurity was high in this group of taxi/FHV drivers. Food insecurity interventions are needed and could be occupationally based, with worksite screening and resource navigation. Policies should address improving wages and healthcare access. [ABSTRACT FROM AUTHOR]

Purpose: Food insecurity, which leads to adverse health outcomes, has even more severe implications for cancer patients. Yet medically underserved cancer patients are more likely to be food insecure than the general population. Methods: This study is a cross-sectional analysis of intake data from patients who participated in the Integrated Cancer Care Access Network (ICCAN). ICCAN is a specialized program that addresses socioeconomic barriers to cancer care among underserved cancer patients in NYC. This study utilized ICCAN data from 2011 to 2017. The USDA food insecurity score, self-reported SNAP receipt, and SNAP eligibility based on household income were compared between SNAP and non-SNAP recipients. Results: 681 patients were assessed for food insecurity. Sixty-nine percent of participants lived in food insecure households. Despite SNAP assistance, most SNAP recipients (68%) were food insecure; 69% of respondents who did not receive SNAP were also food insecure. Conclusions: Underserved cancer patients who receive SNAP are still food insecure, hence at more significant risk for its associated negative outcomes. Supplemental programs for patients with chronic diseases are needed in clinics with large low income populations. SNAP benefits should account for the additional financial burden posed by treatment costs and exceptional circumstances faced by cancer patients. [ABSTRACT FROM AUTHOR]

Background: Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills., Methods: A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty. An educational curriculum composed of online learning modules and an in-person "boot camp" featuring simulations with standardized patients was developed, along with assessments of clinician knowledge, confidence levels, and communication skills. Nurses, physical therapists, physician assistants, residents, fellows, and attending surgeons were encouraged to participate. The intervention spanned a 5-month period in 2015 with a mean time of 18.4 weeks between baseline assessments and the time of the latest follow-up., Results: Online modules were completed by 322 individuals, boot camp was completed by 70 individuals, and latest assessments were completed by 38 individuals. The percentage correct on the knowledge assessment increased from 74.5% before the learning modules to 89.5% immediately after (p < 0.001) but degraded over time such that there was no significant difference between baseline and the latest follow-up scores (p = 0.11). Over the course of the boot camp, physician assistants and residents successfully performed approximately 91% of the indicated actions on the scoring rubric; physical therapists and nurses successfully performed 78%. Scores on the communication skills assessment showed a significant mean increase (p = 0.02) over the course of the intervention from 30.32 to 32.50, and the mean self-assessed confidence survey scores increased by 16.7%, from 7.2 to 8.4 (p < 0.001)., Conclusions: A multimodality educational curriculum aimed at quality improvement can produce significant knowledge improvements, but these gains may not be maintained over time without further instruction. Gains in confidence and communication skills appear to be more long-lasting.