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Sexual and gender minority individuals who attend collective sex venues (CSVs; establishments where people can have sex in groups or the presence of others) are at elevated risk for HIV and STIs. On-site sexual health interventions have been attempted at CSVs, but attendees' interest in receiving such services is under-investigated. This paper presents results from a 2020 online cross-sectional survey completed by 342 sexual and gender minority individuals who attended CSVs in New York City. Interest in services such as on-site testing for STIs, testing vans near CSVs, and informational referrals was overall high, particularly among younger participants. Among participants who reported being HIV negative, those of younger age and those who were not using PrEP reported being more likely to take an HIV test if it would be offered at CSVs. In open-text survey responses, participants expressed interest in CSVs providing free prevention services such as HIV/STI testing, PEP, PrEP, and STI medications or vaccination, as well as in ways to improve norms surrounding condom use and consent at these venues. Some participants expressed barriers to on-site services such as privacy concerns, preexisting access to health services, an emphasis on personal responsibility, and negative reactions to the presence of service providers. However, some participants also felt that these services could be delivered in a positive, acceptable, and non-judgmental way, especially by involving CSV organizers and attendees in their implementation. Findings from this study can inform future initiatives to develop sexual health interventions at CSVs. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has exposed the difficulty of the US public health system to respond effectively to vulnerable subpopulations, causing disproportionate rates of morbidity and mortality. New York Haredi-Orthodox Jewish communities represent a group that have been heavily impacted by Covid-19. Little research has examined their experience or perceptions toward Covid-19 and vaccines. We conducted a cross-sectional, observational study to explore the experience of Covid-19 among Haredim. Paper surveys were self-administered between December 2020 and January 2021 in Haredi neighborhood pediatricians' offices in Brooklyn, New York. Of 102 respondents, 43% reported either a positive SARS-CoV-2 viral or antibody test. Participants trusted their physicians, Orthodox medical organizations, and rabbinic leaders for medical information. Knowledge of Covid-19 transmission and risk was good (69% answered ≥ 4/6 questions correctly). Only 12% of respondents would accept a Covid-19 vaccine, 41% were undecided and 47% were strongly hesitant. Independent predictors of strong vaccine hesitancy included believing natural infection to be better than vaccination for developing immunity (adjusted odds ratio [aOR] 4.28; 95% confidence interval [CI] 1.23–14.86), agreement that prior infection provides a path toward resuming communal life (aOR 4.10; 95% CI 1.22–13.77), and pandemic-related loss of trust in physicians (aOR 5.01; 95% CI 1.05–23.96). The primary disseminators of health information for self-protective religious communities should be stakeholders who understand these groups' unique health needs. In communities with significant Covid-19 experience, vaccination messaging may need to be tailored toward protecting infection-naïve individuals and boosting natural immunity against emerging variants. [ABSTRACT FROM AUTHOR]

Background: New evidence has found breast and cervical cancer risk factors unique to African American women. Thus, there is a significant need to increase their knowledge and understanding of relevant risk factors and the potential protective benefits associated with breast‐feeding and HPV vaccination. The National Witness Project is a robust, evidence‐ and community‐based lay health advisor programme that uses group education, navigation and survivor narratives to increase cancer screening among diverse underserved women. Methods: A multi‐phase, community‐based participatory research study was conducted across three sites in Buffalo, NY, New York City and Arkansas between October 2016 and January 2017. Pre‐/post‐test surveys were administered during volunteer trainings and community programmes. An evaluation survey was also administered at the Annual Meeting for Education and Networking. Paired sample t tests were used to compare pre‐/post‐test survey scores. Results: Trainee survey results showed the overall mean per cent correct pre‐/post‐test scores were 47.7% (SD: 21.87) and 79.2% (SD: 16.14). Altogether, 31 educational programmes reached 332 community participants. Participants' breast and cervical cancer knowledge scores were significantly higher after the education programme (84.4%) than before (55.3%) with a mean change score of 29% (P ≤.001). Conclusion: This paper reveals the underlying complexities to update the educational curriculum content of a multi‐site, community‐based outreach organization. The new curriculum significantly improved African American women's knowledge about breast and cervical cancer by 10%‐36%, clearly demonstrating that this information was new to them. The need for education programming in African American communities to disseminate cancer prevention and risk information remains high. [ABSTRACT FROM AUTHOR]

This paper evaluates a patient navigation component of a multi-level program that helps HIV-positive members of a New York City Medicaid health plan sustain engagement in medical care. A proportional hazard analysis of 856 participants found that assignment to a patient navigator shortened the time to a medical care visit by 40%, but was not associated with time retained in care. These results demonstrate that a health plan can expedite connection to care through patient navigation services. They further suggest that to sustain retention in care, patient navigation may need to be continued after initial connection to care. [ABSTRACT FROM AUTHOR]

There is great interest in the development of executive function (EF) in the preschool period. Accordingly, multiple performance-based measures of EF have been developed for this age group, yet little is known about how they compare to one another. This study used a large and diverse sample of 3-to-5-year-old children (N = 846), who completed subtests of the National Institutes of Health's Toolbox Cognition Battery (NTCB), the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV), and the EF Touch battery. Scores across the three batteries were compared and associations with age, income, and race/ethnicity were examined. Results revealed that (1) the three tasks were moderately correlated (r = 0.44–0.51, all p < 0.001), but children had higher mean accuracy scores on EF Touch than on the NTCB or the WPPSI-IV. (2) Mean accuracy scores on all batteries were linearly associated with child age (all F > 32.68, all p < 0.0001). (3) Comparisons by income and race/ethnicity showed lower accuracy for low-income children on the WPPSI-IV and lower accuracy for White children on the NTCB. Across all batteries, there was consistently lower accuracy for Hispanic children. In conclusion, the three batteries we examined performed similarly across several metrics. EF Touch may be more appropriate for younger children, while the NTCB performed well with older children. [ABSTRACT FROM AUTHOR]

This paper reports the results of a survey study of foreign-born students' use of academic and public libraries. The researcher administered the survey at a public liberal arts college in the fall of 2014. The analysis shows that foreign-born students use both public and academic libraries with great frequency for academic tasks. Variables such as being a first-generation foreign-born student and being a foreign-born student of color also have a statistically significant effect on how these students use academic libraries as a social and study space. The author uses a theory from migration studies called "super-diversity" to discuss how multiple identities and categories of belonging are important variables when it comes to public services. A super-diversity approach involves a shift away from studying only one variable (such as ethnicity, language use, gender, or the like) and looks instead at the effects of multiple variables on an issue, in this case library use. In addition to incorporating super-diversity as part of the data analysis, the author also discusses how the Association of College and Research Libraries Diversity Standards provide guidelines for improving services to foreign-born students based on the insights from the survey and statistical analysis. [ABSTRACT FROM AUTHOR]

Participation in school meals is associated with many benefits. However, participation in school meals served in the summer through the Summer Food Service Program (SFSP) is low due to many barriers, including program requirements such as congregate feeding. During COVID-19, these requirements were waived, allowing grab-and-go meals. The purpose of this study is to compare the number of SFSP breakfast and lunch meals served during the summers of grab-and-go meals (2020 and 2021) to prior summers of congregate feeding (2014–2019) in New York City (NYC). This study is an ecological study of NYC public school geographic districts (n = 32). The primary outcome is the total number of SFSP meals served per student. Using the repeated-measures ANOVA, the results show a significant increase in the number of SFSP meals served per student during the first summer (2020) of grab-and-go meals compared to summers 2016–2019 (p ≤ 0.01) but no significant differences during the second summer (2021) of grab-and-go meals compared to summers 2014–2019. However, there was a significant increase in the number of breakfast meals served in August per student during both the first and second summer of grab-and-go meals compared to summers 2014–2019 (p < 0.05). Among NYC public schools, the waivers may increase the reach of breakfast meals served in August, when there are fewer summer school activities. While there is a need for more research, policymakers may consider making waivers that allow grab-and-go meals permanent flexibilities for the SFSP to increase access to summer meals. [ABSTRACT FROM AUTHOR]

Introduction. In March 2020, after the COVID-19 pandemic surged in New York City, higher education had to either halt or immediately convert to fully online education. Physical therapy program directors in New York (NY) State and New Jersey (NJ) immediately recognized a need to understand the new challenges facing students. Purpose. the purpose of this paper was to identify the challenges that students in physical therapist (PT)/physical therapist assistant (PTA) programs in NY and NJ were experiencing and how institutions could respond to those challenges. Subjects. Students enrolled in a PTor PTA program in NY or NJ; N =934 (861 PT and 73 PTA). Methods. An online survey was distributed to PT/PTA programs in NY/NJ. the survey consisted of open-ended and closed-ended questions related to academic, financial, and nonacademic issues, transition to online learning, and how institutions could respond to student challenges. Descriptive statistics and thematic analysis were used. Results. the most important challenges that students identified were quality/quantity of hands-on experiences, lack of contact with classmates, personal physical and mental health/wellness, and affording tuition and fees. Some differences were found across geographical regions and graduating cohorts. Physical therapist and PTA student cohorts had the same top concerns. Five major themes emerged from open-ended questions: communication; safe return to campus for psycho-motor skills; additional academic resources; recognition of students' financial, mental, and physical health concerns; and, financial support. Discussion and Conclusion. Students in physical therapy education in NY and NJ faced similar challenges because of COVID-19 as observed by other universities worldwide. Physical therapy education can be stressful, and these additional challenges made this time extremely difficult. the findings of this survey can be used to develop a crisis management plan for university emergencies that require program modifications. [ABSTRACT FROM AUTHOR]

Objectives Group prenatal care results in improved birth outcomes in randomized controlled trials, and better attendance at group prenatal care visits is associated with stronger clinical effects. This paper's objectives are to identify determinants of group prenatal care attendance, and to examine the association between proportion of prenatal care received in a group context and satisfaction with care. Methods We conducted a secondary data analysis of pregnant adolescents (n = 547) receiving group prenatal care in New York City (2008-2012). Multivariable linear regression models were used to test associations between patient characteristics and percent of group care sessions attended, and between the proportion of prenatal care visits that occurred in a group context and care satisfaction. Results Sixty-seven groups were established. Group sizes ranged from 3 to 15 women (mean = 8.16, SD = 3.08); 87 % of groups enrolled at least five women. Women enrolled in group prenatal care supplemented group sessions with individual care visits. However, the percent of women who attended each group session was relatively consistent, ranging from 56 to 63 %. Being born outside of the United States was significantly associated with higher group session attendance rates [B(SE) = 11.46 (3.46), p = 0.001], and women who received a higher proportion of care in groups reported higher levels of care satisfaction [B(SE) = 0.11 (0.02), p < 0.001]. Conclusions Future research should explore alternative implementation structures to improve pregnant women's ability to receive as much prenatal care as possible in a group setting, as well as value-based reimbursement models and other incentives to encourage more widespread adoption of group prenatal care. [ABSTRACT FROM AUTHOR]

This paper examines whether family structure and its transitions are associated with internalizing and externalizing psychiatric disorders among Puerto Rican-origin children. It uses longitudinal data (three waves) from the Boricua Youth Study, which includes probability samples of children in the South Bronx (New York) and San Juan (Puerto Rico) (n = 2,142). We also examine factors which may explain how family structure and transitions may be related to child psychiatric disorders. Our results show that for both internalizing and externalizing disorders there were no significant differences between children of cohabiting (biological or step) parents or of single parents compared to children of married biological parents. In Puerto Rico only, transitioning once from a two-parent family to a single-parent family was related to child internalizing disorders. Family transitions were not associated with externalizing disorders at either site. Context may be an important factor shaping the risk that family dissolution is followed by an internalizing disorder among children. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College Health Association National College Health Assessment II (ACHA-NCHA II) paper survey and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 for frequencies and chi-square test of independence. Results: The sample population reported poor diet, low rates of physical activity, high rates of overweight/obesity, low rates of condom use for vaginal sex, multiple sexual partners, and unintentional pregnancy. Protective health behaviors included low rates of cigarette smoking and alcohol use, high rates of condoms use for anal sex, and high rates of human immunodeficiency virus (HIV) testing. Conclusion: Students are at high risk for health problems related to poor diet, lack of exercise, and risky sexual behaviors. Additional research is recommended to determine the most effective intervention strategies. [ABSTRACT FROM AUTHOR]

Crowdsourcing has seen a substantial increase in interest from researchers and practitioners in recent years. Being a new form of work facilitated by information technology, the rise of crowdsourcing calls for the development of new theoretical insights. Our focus in this article is on extra-role behavior-employees' voluntary activities, which are not part of their prescribed duties. Specifically, we explored how user interface design can help increase extra-role behavior among crowdsourcing workers. In a randomized experiment, we examined the joint effects of the presentation of a performance display to crowdsourcing workers and the personal attributes of these workers on the workers' likelihood to engage in extra-role behavior. The experimental setting included an image analysis task performed on an environmental monitoring website. We compared workers' behavior across the different experimental conditions and found that the interaction between the presence of a performance display and the workers' personality trait of curiosity has a significant impact on the likelihood of engaging in extra-role behavior. In particular, the presence of a performance display was associated with increased likelihood of extra-role behavior among low-curiosity workers, and no change in extra-role behavior was observed among high-curiosity users. Implications for design are discussed. [ABSTRACT FROM AUTHOR]

This paper reports on the 6-month follow-up outcomes of an effectiveness study testing a multiple family group (MFG) intervention for clinic-referred youth (aged 7-11) with disruptive behavior disorders (DBDs) and their families in socioeconomically disadvantaged families compared to services-as-usual (SAU) using a block comparison design. The settings were urban community-based outpatient mental health agencies. Clinic-based providers and family partner advocates facilitated the MFG intervention. Parent-report measures targeting child behavior, social skills, and impairment across functional domains (i.e., relationships with peers, parents, siblings, and academic progress) were assessed across four timepoints (baseline, mid-test, post-test, and 6-month follow-up) using mixed effects regression modeling. Compared to SAU participants, MFG participants reported significant improvement at 6-month follow-up in child behavior, impact of behavior on relationship with peers, and overall impairment/need for services. Findings indicate that MFG may provide longer-term benefits for youth with DBDs and their families in community-based settings. Implications within the context of a transforming healthcare system are discussed. [ABSTRACT FROM AUTHOR]

Aims To gain knowledge of a nursing staff's perspectives and perceptions of hourly rounding in an acute care hospital setting. Background Research has shown hospitals that have successfully implemented hourly rounding have significant decreases in adverse patient events with improvements in patient and staff satisfaction. More recent studies and clinical observations by the author are revealing barriers and difficulties in translating this evidence-based practice to the bedside. Method An original survey was distributed to direct care staff on six inpatient units. Descriptive analysis of each survey item and subanalysis of the registered nurse ( n = 52) and patient care assistant ( n = 15) responses was reported and aggregated according to demographic data and Rogers' Theory of Diffusion of Innovation. Results Findings varied considerably between job category, shift worked, unit worked on and educational level of the registered nurses. Overall only 25% ( n = 13) of the registered nurses felt a sense of ownership of the hourly rounding initiative and only 23.1% ( n = 12) agreed that completion of the hourly rounding paper documentation tool was a true indication that hourly rounding was actually being done. Conclusions and implications for nursing management Results from this study may give nursing leadership and educators' insight on how to lead and sustain a new initiative or evidence-based practice. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has disproportionately affected some New York City (NYC) neighborhoods that primarily consist of Black, Indigenous, and Latinx residents. In comparison to the rest of NYC, these neighborhoods experienced high hospitalization and COVID-related death rates, which has been attributed to a longstanding history of structural racism and disinvestment. While stay-at-home orders were implemented to reduce the spread of COVID-19, this may have also affected access and utilization of non-COVID related healthcare services. This study aims to assess the prevalence of and reasons for the disruption of non-COVID related healthcare services during the first 18 months of the pandemic. Methods: From September 30, 2021 to November 4, 2021, the NYC Health Department administered the COVID-19 Community Recovery Survey to a subset of residents who were part of the NYC Health Panel a probability-based survey panel. This cross-sectional survey, which included closed and open-ended questions, was either self-administered online or completed via CATI (Computer Assisted Telephone Interviewing) in English, Spanish, and Simplified Chinese. Descriptive statistics were used to summarize responses and unweighted, weighted, age-adjusted percentages, and 95% Confidence Intervals (CIs) were calculated. Results: With a response rate of 30.3% (N = 1358), more than half of participants (54%) reported disruption to either routine physical healthcare or mental health services. Concern about getting COVID-19 (61%), stay-at-home policies (40%), belief that care could safely be postponed (35%), and appointment challenges (34%) were among reasons for delaying routine healthcare. Concern about getting COVID-19 (38%) and reduced hours of service (36%) were primary reasons for delaying mental healthcare. Reported reasons for the sustained delay of care past 18 months involved COVID concerns, appointment, and insurance challenges. Conclusions: Due to the pandemic, some disruption to healthcare was expected. However, most study participants either avoided or experienced a delay in healthcare. The delay of non-COVID related healthcare throughout the pandemic may result in the further widening of the health inequity gap among NYC residents dealing with a higher chronic disease burden before the start of the COVID-19 pandemic in March 2020. Findings from this study can support equitable COVID-19 recovery, and guide efforts with health promotion. [ABSTRACT FROM AUTHOR]

BACKGROUND: The state of New York expects to receive $115 million in 2022 alone from the U.S. Infrastructure Investment and Jobs Act to support the replacement of lead water service lines. OBJECTIVES: Our objective was to determine the number and proportion of potential lead water service lines across New York City (NYC) and to evaluate the association between census tract-level racial/ethnic composition, housing vulnerability, and child lead exposure vulnerability with service line type (Potential Lead, Unknown) for 푛=2,083 NYC tracts. METHODS: We conducted a descriptive analysis assessing water service line material recorded in the NYC Department of Environmental Protection’s Lead Service Line Location Coordinates database. We used conditional autoregressive Bayesian Poisson models to assess the relative risk [RR; median posterior estimates, and 95% credible interval (CrI)] of service line type per 20% higher proportion of residents in a given racial/ethnic group and per higher housing vulnerability and child lead exposure vulnerability index scores corresponding to the interquartile range. We also evaluated the associations in flexible natural cubic spline models. RESULTS: Out of 854,672 residential service line records, 136,891 (16.0%) were Potential Lead, and 227,443 (26.6%) were Unknown. In fully adjusted models, higher proportions of Hispanic/Latino residents and higher child lead exposure vulnerability were associated with Potential Lead service lines in flexible spline models and linear models [RR=1.15 (95% CrI: 1.11, 1.21) and RR=1.11 (95% CrI: 1.02, 1.20), respectively]. Associations were modified by borough; Potential Lead service lines were associated with higher proportions of non-Hispanic White and non- Hispanic Asian residents in the Bronx and Manhattan, and with higher proportions of non-Hispanic Black residents in Queens. DISCUSSION: NYC has a high number of Potential Lead and Unknown water service lines. Communities with a high proportion of Hispanic/Latino residents and those with children who are already highly vulnerable to lead exposures from numerous sources are disproportionately impacted by Potential Lead service lines. These findings can inform equitable service line replacement across New York state and NYC. [ABSTRACT FROM AUTHOR]

Adolescents from urban communities are at risk for unhealthy snacking behaviors. Youth advocacy interventions are shown to improve certain adolescent health behaviors, such as substance use. However, it remains unclear if youth advocacy is a feasible method to promote healthy snacking. As such, the aim of this study was to examine the feasibility of a youth advocacy program promoting healthy snacking among adolescents in New York City by conducting a mixed-methods process evaluation. Adolescents (12–18 years) at a Boys and Girls Club in New York City were recruited to participate in a 12-session adaptation of the Youth Engagement and Action for Health! program to advocate for the promotion of healthy snacks in corner stores. A mixed-methods process evaluation was conducted to assess recruitment, reach (attendance), dose delivered (amount of intervention delivered), fidelity (degree to which intervention was implemented according to curriculum) and dose received (participant engagement/satisfaction). Satisfaction was also evaluated through focus groups. Descriptive statistics were calculated for quantitative data, and focus groups were analyzed using thematic analysis. Participant retention (94.74%), attendance (93.52%), dose delivered (98.94%), fidelity (98.5%), engagement (4.97/5) and program satisfaction (4/5) were high. Focus groups (n  = 6; 28 participants) revealed that participants learned about nutrition, enjoyed being advocates and improved snacking behaviors. [ABSTRACT FROM AUTHOR]

The article presents a study on gaps in technology usage and accessibility that promote ways to use these technologies to improve overall health and wellness. Topics include sociodemographic data of the sample of older adults, technology use frequency of the sample of older adults, and limitations of the study.

The electrocardiogram (ECG) is a ubiquitous diagnostic modality. Convolutional neural networks (CNNs) applied towards ECG analysis require large sample sizes, and transfer learning approaches for biomedical problems may result in suboptimal performance when pre-training is done on natural images. We leveraged masked image modeling to create a vision-based transformer model, HeartBEiT, for electrocardiogram waveform analysis. We pre-trained this model on 8.5 million ECGs and then compared performance vs. standard CNN architectures for diagnosis of hypertrophic cardiomyopathy, low left ventricular ejection fraction and ST elevation myocardial infarction using differing training sample sizes and independent validation datasets. We find that HeartBEiT has significantly higher performance at lower sample sizes compared to other models. We also find that HeartBEiT improves explainability of diagnosis by highlighting biologically relevant regions of the EKG vs. standard CNNs. Domain specific pre-trained transformer models may exceed the classification performance of models trained on natural images especially in very low data regimes. The combination of the architecture and such pre-training allows for more accurate, granular explainability of model predictions. [ABSTRACT FROM AUTHOR]

Background: Textbook knowledge and clinical dogma are often insufficient for effective evidence-based decision making when treating musculoskeletal injuries in American football players, given the variability in presentation and outcomes across different sports and different levels of competition. Key evidence can be drawn directly from high-quality published articles to make the appropriate decisions and recommendations for each athlete's unique situation. Purpose: To identify and analyze the 50 most cited articles related to football-related musculoskeletal injury to provide an efficient tool in the arsenal of trainees, researchers, and evidence-based practitioners alike. Study Design: Cross-sectional study. Methods: The ISI Web of Science and SCOPUS databases were queried for articles pertaining to musculoskeletal injury in American football. For each of the top 50 most cited articles, bibliometric elements were evaluated: citation count and density, decade of publication, journal, country, multiple publications by the same first author or senior author, article content (topic, injury area), and level of evidence (LOE). Results: The mean ± SD number of citations was 102.76 ± 37.11; the most cited article, with 227 citations, was "Syndesmotic Ankle Sprains" published in 1991 by Boytim et al. Several authors served as a first or senior author on >1 publication, including J.S. Torg (n = 6), J.P. Bradley (n = 4), and J.W. Powell (n = 4). The American Journal of Sports Medicine published the majority of the 50 most cited articles (n = 31). A total of 29 articles discussed lower extremity injuries, while only 4 discussed upper extremity injuries. The majority of the articles (n = 28) had an LOE of 4, with only 1 article having an LOE of 1. The articles with an LOE of 3 had the highest mean citation number (133.67 ± 55.23; F = 4.02; P =.05). Conclusion: The results of this study highlight the need for more prospective research surrounding the management of football-related injury. The low overall number of articles on upper extremity injury (n = 4) also highlights an area for further research. [ABSTRACT FROM AUTHOR]

Background: New York State (NYS) is the 27th largest state and the 4th most populous state in the U.S., with close to 20 million people in 62 counties. Territories with diverse populations present the best opportunity to study health outcomes and associated covariates, and how these differ across different populations and groups. The County Health Ranking and Roadmaps (CHR&R) ranks counties by linking the population's characteristics and health outcomes and contextual factors in a synchronic approach. Methods: The goal of this study is to analyze the longitudinal trends in NYS counties of age-adjusted premature mortality rate and years of potential life loss rate (YPLL) from 2011–2020 using (CHR&R) data to identify similarities and trends among the counties of the state. This study used a weighted mixed regression model to analyze the longitudinal trend in health outcomes as a function of the time-varying covariates and clustered the 62 counties according to the trend over time in the covariates. Results: Four clusters of counties were identified. Cluster 1, which represents 33 of the 62 counties in NYS, contains the most rural counties and the least racially and ethnically diverse counties. Clusters 2 and 3 mirror each other in most covariates and Cluster 4 is comprised of 3 counties (Bronx, Kings/Brooklyn, Queens) representing the most urban and racial and ethnic diverse counties in the state. Conclusion: The analysis clustered counties according to the longitudinal trends of the covariates, and by doing so identified clusters of counties that shared similar trends among the covariates, to later examine trends in the health outcomes through a regression model. The strength of this approach lies in the predictive feature of what is to come for the counties by understanding the covariates and setting prevention goals. [ABSTRACT FROM AUTHOR]

Aims As a first step in developing a decision aid to support shared decision-making (SDM) for patients with atrial fibrillation (AF) to evaluate treatment options for rhythm and symptom control, we aimed to measure decision quality and describe decision-making processes among patients and clinicians involved in decision-making around catheter ablation for AF. Methods and results We conducted a cross-sectional, mixed-methods study guided by an SDM model outlining decision antecedents, processes, and outcomes. Patients and clinicians completed semi-structured interviews about decision-making around ablation, feelings of decision conflict and regret, and preferences for the content, delivery, and format of a hypothetical decision aid for ablation. Patients also completed surveys about AF symptoms and aspects of decision quality. Fifteen patients (mean age 71.1 ± 8.6 years; 27% female) and five clinicians were recruited. For most patients, decisional conflict and regret were low, but they also reported low levels of information and agency in the decision-making process. Most clinicians report routinely providing patients with information and encouraging engagement during consultations. Patients reported preferences for an interactive, web-based decision aid that clearly presents evidence regarding outcomes using data, visualizations, videos, and personalized risk assessments, and is available in multiple languages. Conclusion Disconnects between clinician efforts to provide information and bolster agency and patient experiences of decision-making suggest decision aids may be needed to improve decision quality in practice. Reported experiences with current decision-making practices and preferences for decision aid content, format, and delivery can support the user-centred design and development of a decision aid. [ABSTRACT FROM AUTHOR]

Purpose: In light of the importance of preschool oral narrative skills as precursors to literacy, this exploratory study examined expressive language skills among emergent bilingual Latine preschoolers using a naturalistic personal narrative task. To understand the factors that support language use in the personal narrative context for this population, we examined the contribution of children’s executive function (EF) skills to their narrative language abilities. Method: Children completed two subtests from the Preschool Self-Regulation Assessment to measure EF and produced two personal narratives in response to conversational prompts. A series of linear regressions were used to evaluate the relation between children’s EF skills and their narrative production ability, narrative organization, and expressive language skills derived from automated analyses of narrative samples. Results: EF was found to predict children’s ability to produce a personal narrative but not the language skills children demonstrated in these narratives. Conclusions: The current findings suggest that EF is implicated in emergent bilingual Latine children’s narrative abilities. At the preschool age, the contribution of EF to narrative language production is apparent in the global task of producing a narrative, rather than in the organizational or linguistic features of the narrative. As such, supporting both EF and narrative skills might be an important means of facilitating preliteracy among bilingual children. [ABSTRACT FROM AUTHOR]

This study examines the association of social factors with the intention to seek and behavior of obtaining additional prescription medication information after direct-to-consumer prescription medication advertisement (DTCA) exposure. Data were analyzed from 667 college students who were exposed to online social media advertisements. Subjective norms and trust were both positively associated with intentions and behavior. Bridging social capital was positively associated with intentions but not with behavior. Bonding social capital was negatively associated with intentions while it was positively associated with behavior. Pharmaceutical companies should consider subjective norms and trust when advertising prescription medications on online social media. [ABSTRACT FROM AUTHOR]

Background: A clinical study team performing three multicultural dementia screening studies identified the need to improve data management practices and facilitate data sharing. A collaboration was initiated with librarians as part of the National Library of Medicine (NLM) informationist supplement program. The librarians identified areas for improvement in the studies' data collection, entry, and processing workflows. Case Presentation: The librarians' role in this project was to meet needs expressed by the study team around improving data collection and processing workflows to increase study efficiency and ensure data quality. The librarians addressed the data collection, entry, and processing weaknesses through standardizing and renaming variables, creating an electronic data capture system using REDCap, and developing well-documented, reproducible data processing workflows. Conclusions: NLM informationist supplements provide librarians with valuable experience in collaborating with study teams to address their data needs. For this project, the librarians gained skills in project management, REDCap, and understanding of the challenges and specifics of a clinical research study. However, the time and effort required to provide targeted and intensive support for one study team was not scalable to the library's broader user community. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess changes in paid maternity leave before and after New York's (NY) Paid Family Leave (PFL) law went into effect (1/1/2018) and changes in disparities by maternal characteristics. Methods: We used specific data collected on maternity leaves by women who gave birth in 2016–2018 in NY State (outside NY City) participating in the Pregnancy Risk Assessment Monitoring System survey. Multiple logistic regressions were conducted to evaluate the effect of the PFL law on prevalence of paid leave taken by women after childbirth. Results: After NY's PFL law went into effect, there was a 26% relative increase in women taking paid leave after childbirth. Use of paid leave after childbirth increased among all racial and ethnic groups. The increases were greater among Black non-Hispanic or other race non-Hispanic women, compared to white non-Hispanic women, suggesting that NY's law was associated with more equitable use of paid leave following childbirth. Conclusions for Practice: Wider implementation and greater utilization of paid maternity leave policies would promote health equity and help reduce racial/ethnic disparities in maternal and child health outcomes. [ABSTRACT FROM AUTHOR]

Background: We assessed whether participation in Healthy Start Brooklyn's By My Side Birth Support Program—a maternal‐health program providing community‐based doula support during pregnancy, labor and delivery, and the early postpartum period—was associated with improved birth outcomes. By My Side takes a strength‐based approach that aligns with the doula principles of respecting the client's autonomy, providing culturally appropriate care without judgment or conditions, and promoting informed decision making. Methods: Using a matched cohort design, birth certificate records for By My Side participants from 2010 through 2017 (n = 603) were each matched to three controls who also lived in the program area (n = 1809). Controls were matched on maternal age, race/ethnicity, education level, and trimester of prenatal‐care initiation, using the simple random sampling method. The sample was restricted to singleton births. The odds of preterm birth, low birthweight, and cesarean birth were estimated, using conditional logistic regression. Results: By My Side participants had lower odds of having a preterm birth (5.6% vs 11.9%, P <.0001) or a low‐birthweight baby (5.8% vs 9.7%, P =.0031) than controls. There was no statistically significant difference in the odds of cesarean delivery. Conclusion: Participation in the By My Side Birth Support Program was associated with lower odds of preterm birth and low birthweight for participants, who were predominantly Black and Hispanic. Investing in doula services is an important way to address birth inequities among higher risk populations such as birthing people of color and those living in poverty. It could also help shape a new vision of the maternal‐health system, placing the needs and well‐being of birthing people at the center. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is the most fundamental challenge to the healthcare system in current generations. Physical therapists (PTs), as essential members of the healthcare team, were impacted substantially. Understanding their experiences during this unique and challenging time would help PTs manage the pandemic and future crises in healthcare. It may also reveal professional changes that may persist through the pandemic and beyond. To describe the experiences of PTs in the New York metropolitan area during the initial wave of the pandemic. This was an interpretive phenomenological study. Data were collected during 8 focus groups of 2–3 PTs each in August and September 2020 via videoconference. Audio recordings of the groups were transcribed, and data were coded in 3 rounds. Twenty-two PTs from a range of settings participated. Four themes were identified: (1) Everything was disrupted; (2) It was not safe; (3) It was overwhelming; and (4) There was a professional transformation. In hospitals, participants described chaos, poor communication, and unsafe working environments. In outpatient settings, participants described job instability and challenges adapting to telehealth. As the pandemic progressed inpatient PTs felt safer, gained confidence, and became critical members of interdisciplinary care teams. Outpatient therapists adapted to telehealth and experienced rising caseloads as patients returned to therapy. Physical therapists experienced a variety of challenges during the initial phases of the pandemic. As the pandemic progressed, they redefined practice. [ABSTRACT FROM AUTHOR]

The specific aim was to characterize retail purchases of red and processed meat and other major protein-rich foods in the U.S. and by state. Supermarket scanner data from grocery stores, supermarkets, and big box stores collected from 2017-2019 (NielsenIQ, New York, NY) was used to characterize retail purchases of red meat, processed meat, and other protein-rich foods in thirty-one states representative of US retail food sales. Red meat, processed meat, poultry, seafood, eggs, other meats, and non-meat foods (beans, nuts, seeds, meat alternatives) by weight accounted for 25.9%, 20.4%, 25.8%, 5.9%, 12.6%, 1.3%, and 10.1%, respectively of total sales in 2017-2019. Mean per capita purchases of red meat by weight was 30.1 g/d, ranging from 45.4 g/d in Mississippi to 21.9 g/d in New York. Mean per capita purchases of processed meat by weight was 23.8 g/d, ranging from 36.6 g/d in Mississippi to 15.2 g/d in California. We observed statistically significant correlations between red and processed meat purchases with cardiovascular mortality and colorectal cancer by state. Per capita retail purchases of red and processed meat appear to reflect a dietary pattern that is not consistent with current national and international dietary recommendations. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the speech acoustic characteristics of Jamaican Creole (JC) and English in bilingual preschoolers and adults using acoustic duration measures. The aims were to determine if, for JC and English, (a) child and adult acoustic duration characteristics differ, (b) differences occur in preschoolers’ duration patterns based on the language spoken, and (c) relationships exist between the preschoolers’ personal contextual factors (i.e., age, sex, and percentage of language [%language] exposure and use) and acoustic duration. Method: Data for this cross-sectional study were collected in Kingston, Jamaica, and New York City, New York, United States, during 2013–2019. Participants included typically developing simultaneous bilingual preschoolers (n = 120, ages 3;4–5;11 [years; months]) and adults (n = 15, ages 19;0–54;4) from the same linguistic community. Audio recordings of single-word productions of JC and English were collected through elicited picture-based tasks and used for acoustic analysis. Durational features (voice onset time [VOT], vowel duration, whole-word duration, and the proportion of vowel to whole-word duration) were measured using Praat, a speech analysis software program. Results: JC-English–speaking children demonstrated developing speech motor control through differences in durational patterns compared with adults, including VOT for voiced plosives. Children’s VOT, vowel duration, and whole-word duration were produced similarly across JC and English. The contextual factor %language use was predictive of vowel and whole-word duration in English. Conclusions: The findings from this study contribute to a foundation of understanding typical bilingual speech characteristics and motor development as well as schema in JC–English speakers. In particular, minimal acoustic duration differences were observed across the post-Creole continuum, a feature that may be attributed to the JC–English bilingual environment. [ABSTRACT FROM AUTHOR]

Previous research shows a greater prevalence of substance use among childhood sexual abuse (CSA) survivors. Transgender women experience CSA at a significantly higher rate compared to the general population. Previous studies show a high prevalence of substance use and find that CSA predicts increased drug use among transgender women. It is proposed that the process through which CSA influences substance use behaviour, is mediated by depression. Further, research has shown that secure attachment may buffer against these associations.Participants were 213 transgender women participating in a behavioural intervention to reduce sexual risk and substance use. A moderated mediation model, including a three-way interaction, examined the indirect effect of CSA, through depression, on both substance use problems and alcohol use disorder, as well as the protective effect of secure attachment on these pathways. Findings from the moderated mediation analysis provide evidence to support our hypothesis that depression mediates the pathways from CSA to both substance use problems and alcohol use disorder for transgender women. We also observed a significant three-way interaction (e.g. attachment anxiety x attachment avoidance x CSA) indicating that secure attachment buffered against the association between CSA and symptoms of depression, as well as CSA and substance use problems. [ABSTRACT FROM AUTHOR]

Objectives Perinatal mortality prevention strategies that target fetal deaths often utilize vital records data sets shown to contain critical quality deficiencies. To understand the causes of deficient data, we linked survey responses of fetal death reporters with facility fetal death data quality indicators. Methods In 2011, we surveyed the person most responsible for fetal death reporting at New York City healthcare facilities on their attitudes, barriers, and practices regarding reporting. We compared responses by 2 facility data quality indicators (data completeness and ill-defined cause of fetal death) for third trimester fetal death registrations using Chi squared tests. Results Thirty-nine of 50 facilities completed full questionnaires (78 % response rate); responding facilities reported 84 % (n = 11,891) of all 2011 fetal deaths, including 329 third trimester fetal deaths. Facilities citing ≥1 reporting barrier were approximately five times more likely to have incomplete third trimester registrations than facilities citing no substantial barriers (37.5 vs 7.9 %; RR 4.7; 95 % CI [1.6-14.2]). Reported barriers included onerous reporting requirements (n = 10; 26 %) and competing physician priorities (n = 11; 28 %). Facilities citing difficulty involving physicians in reporting were more likely to report fetal deaths with nonspecific cause-of-death information (70.9 vs 56.6 %; RR 1.3; 95 % CI [1.1-1.5]). Conclusions Self-reported challenges correlate with completeness and accuracy of reported fetal death data, suggesting that such barriers are likely contributing to low quality data. We identified several improvement opportunities, including in-depth training and reducing the information collected, especially for early fetal deaths (<20 weeks' gestation), the majority of events reported. [ABSTRACT FROM AUTHOR]

Objectives. We evaluated the use of New York City's (NYC's) electronic death registration system (EDRS) to conduct mortality surveillance during and after Hurricane Sandy. Methods. We used Centers for Disease Control and Prevention guidelines for surveillance system evaluation to gather evidence on usefulness, flexibility, stability, timeliness, and quality. We assessed system components, interviewed NYC Health Department staff, and analyzed 2010 to 2012 death records. Results. Despite widespread disruptions, NYC's EDRS was stable and collected timely mortality data that were adapted to provide storm surveillance with minimal additional resources. Direct-injury fatalities and trends in excess all-cause mortality were rapidly identified, providing useful information for response; however, the time and burden of establishing reports, adapting the system, and identifying indirect deaths limited surveillance. Conclusions. The NYC Health Department successfully adapted its EDRS for near real-time disaster-related mortality surveillance. Retrospective assessment of deaths, advanced methods for case identification and analysis, standardized reports, and system enhancements will further improve surveillance. Local, state, and federal partners would benefit from partnering with vital records to develop EDRSs for surveillance and to promote ongoing evaluation. [ABSTRACT FROM AUTHOR]

This article reports on the development and initial psychometric properties of the School Interference Questionnaire (SIQ), a questionnaire designed to assess both academic functional impairment related to mental health problems and the type and frequency of school refusal behavior. Participants were 110 youth ages 13 to 18 years (M = 15.41 years, SD = 1.42) admitted to an adolescent partial hospitalization program. The majority of participants identified as female (57.3%), Caucasian (59.1%), and non-Latino (70.0%). Internal consistency of the 12 SIQ core interference items was excellent (Cronbach's α =.91). The factor structure suggested that a single factor was appropriate for the 12 school interference items. Correlations between the SIQ and other measures in this study provided support for construct validity. The average SIQ core interference item score showed evidence of convergent validity via correlations with measures of school refusal, global disability, and internalizing symptoms. The SIQ also exhibited no significant association with timing of study enrollment, suggesting evidence for divergent validity. Results provide initial evidence supporting the psychometric properties of this novel measure. [ABSTRACT FROM AUTHOR]

Background: Rates of participation in HIV care, medication uptake, and viral suppression are improving among persons living with HIV (PLWH) in the United States. Yet, disparities among African American/Black and Latino PLWH are persistent, signaling the need for new conceptual approaches. To address gaps in services and research (e.g., insufficient attention to structural/systemic factors, inadequate harm reduction services and autonomy support) and improve behavioral interventions, we integrated critical race theory, harm reduction, and self-determination theory into a new conceptual model, then used the model to develop a set of six intervention components which were tested in a larger study. The present qualitative study explores participants' perspectives on the study's acceptability, feasibility, and impact, and the conceptual model's contribution to these experiences. Methods: Participants in the larger study were African American/Black and Latino PLWH poorly engaged in HIV care and with non-suppressed HIV viral load in New York City (N = 512). We randomly selected N = 46 for in-depth semi-structured interviews on their experiences with and perspectives on the study. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using directed qualitative content analysis. Results: On average, participants were 49 years old (SD = 9) and had lived with HIV for 19 years (SD = 7). Most were male (78%) and African American/Black (76%). All had taken HIV medication previously. Challenging life contexts were the norm, including poverty, poor quality/unstable housing, trauma histories exacerbated by current trauma, health comorbidities, and substance use. Participants found the study highly acceptable. We organized results into four themes focused on participants' experiences of: 1) being understood as a whole person and in their structural/systemic context; 2) trustworthiness and trust; 3) opportunities for self-reflection; and 4) support of personal autonomy. The salience of nonjudgment was prominent in each theme. Themes reflected grounding in the conceptual model. Participants reported these characteristics were lacking in HIV care settings. Conclusions: The new conceptual model emphasizes the salience of systemic/structural and social factors that drive health behavior and the resultant interventions foster trust, self-reflection, engagement, and behavior change. The model has potential to enhance intervention acceptability, feasibility, and effectiveness with African American/Black and Latino PLWH. [ABSTRACT FROM AUTHOR]

Background: The differential impact of the coronavirus disease 2019 (COVID-19) pandemic across race, ethnicity, and socioeconomic status remains poorly understood. While recent explorations into birthrates during the pandemic have revealed significant declines, how birthrates may have differed between racial and socioeconomic subgroups during the pandemic remains to be detailed. Methods: Using electronic health records from a large hospital network in New York serving a racially and socioeconomically diverse population, we explored birthrates associated with conceptions that occurred during the COVID-19 pandemic lockdown for demographic and obstetric differences. Results: Two thousand five hundred twenty-three unique patient deliveries corresponded with conceptions that occurred during the COVID-19 pandemic lockdown in New York. Compared to the same period the previous year, there was a 22.85% decrease in births. Explorations into differences in birthrates by socioeconomic status revealed that much of the decline could be explained by fewer births among individuals living in higher socioeconomic status as opposed to individuals living in urban economic poverty [χ2(n = 5588) = 18.35, p < 0.01]. Conclusion: On March 22, 2020, New York instituted a prohibition of all nonessential social gatherings and the closure of all nonessential businesses. Although the full impact of the COVID-19 pandemic on reproductive health and outcomes remains largely unknown, the decreased birthrate associated with the initial COVID-19 wave in New York was not entirely unexpected. While the mechanisms that drive health disparities are complex and multifactorial, most of the decrease occurred among those living in higher socioeconomic status. This finding has important implications for understanding health behaviors and disparities among minorities living in low socioeconomic status. [ABSTRACT FROM AUTHOR]

Current use of vaping products has increased in recent years among youth in the United States. We conducted cross-sectional surveys of vaping product users aged 15–17 in New York in 2017 and 2019 to assess vaping freqency, reported nicotine content of vaping products used, risk perceptions of vaping and openness to vaping cannabis (2019 survey only). Between 2017 and 2019, the proportion of youth vapers who were frequent vaping product users increased from 16.8% to 26.2% (P  < 0.05). The proportion of youth vapers who usually used high-nicotine vaping products also increased, from 12.6% to 40.0% (P  < 0.05). In both years, the use of high-nicotine vaping products was positively associated with frequent use (P  < 0.05). The perceived likelihood of harm from vaping increased (P  < 0.05), but respondents' perception of harm from using tobacco-flavored vaping products remained higher than that from using menthol/mint or sweet flavors. In 2019, 60.6% of respondents reported having tried vaping cannabis. Results suggest shifts in youth vaping behavior toward more frequent use and use of higher nicotine vaping products, support previous findings about youth misperceptions about health risks of flavored vaping products and highlight openness to vaping cannabis among youth vaping product users. [ABSTRACT FROM AUTHOR]

Background: The patient-centered medical home (PCMH) model, an important component of healthcare transformation in the United States, is an approach to primary care delivery with the goal of improving population health and the patient care experience while reducing costs. PCMH research most often focuses on system level indicators including healthcare use and cost; descriptions of patient and provider experience with PCMH are relatively sparse and commonly limited in scope. This study, part of a mixed-methods evaluation of a multi-year New York State initiative to refine and expand the PCMH model, describes patient and provider experience with New York State PCMH and its key components. Methods: The qualitative component of the evaluation included focus groups with patients of PCMH practices in 5 New York State counties (n = 9 groups and 67 participants) and interviews with providers and practice administrators at New York State PCMH practices (n = 9 interviews with 10 participants). Through these focus groups and interviews, we elicited first-person descriptions of experiences with, as well as perspectives on, key components of the New York State PCMH model, including accessibility, expanded use of electronic health records, integration of behavioral health care, and care coordination. Results: There was evident progress and some satisfaction with the PCMH model, particularly regarding integrated behavioral health and, to some extent, expanded use of electronic health records. There was less evident progress with respect to improved access and reasonable wait times, which caused patients to continue to use urgent care or the emergency department as substitutes for primary care. Conclusions: It is critical to understand the strengths and limitations of the PCMH model, so as to continue to improve upon and promote it. Strengths of the model were evident to participants in this study; however, challenges were also described. It is important to note that these challenges are difficult to separate from wider healthcare system issues, including inadequate incentives for value-based care, and carry implications for PCMH and other models of healthcare delivery. [ABSTRACT FROM AUTHOR]

Attribution theory focuses on the fundamental need for people to explain the underlying causes of important event outcomes (Weiner, 1985). From a sport perspective, it has been determined that fans and athletes tend to attribute wins to internal, stable, and controllable factors and losses to external, unstable, and uncontrollable factors. This phenomenon is known as the team-serving bias. Previous research in this area has been limited to single game assessments and has yet to examine the impact of an entire season. The purpose of this paper was to investigate the moderating impact of team identification on the attributional bias of two groups of sport team fans that experienced opposite seasonal outcomes. The 2011-2012 seasons 'of New York Jets and New York Giants were examined. Four internal and three external attributes were devised based on the work of Wann and Dolan (2002). The results suggested the seasonal impact of success/failure followed previous theory for internal attribution, but not for external. In addition, the impact of team identification was not statistically significant. The discussion provides implications as well as study limitations and suggestions for future research. [ABSTRACT FROM AUTHOR]

This study examined predictors to mask mandate support and racial justice protest participation across Asian (n = 103), Black (n = 102), white (n = 102) New York City residents, using binary logistic regressions. Participants with positive feelings about the racial justice movement were more likely to participate in the protests. White and Asian respondents were more likely to support the mask mandates over Black respondents. Asian respondents were less likely to participate in public protests over white respondents. Our findings offer a model for social workers to understand how race, political participation and COVID-19 intersect to create racially just responses to health and justice matters. [ABSTRACT FROM AUTHOR]

Testing for sexually transmitted infections (STIs) remains low among sexual and gender minority populations. We assessed STI testing history using a retrospective survey among 129 HIV-negative cisgender men who have sex with men (cMSM) and transgender women who have sex with men (tWSM) who were at high risk for STI acquisition. All participants were enrolled in a parent study on self- and partner-testing for HIV and syphilis, and reported condomless anal intercourse with multiple partners during the prior 3 months. We additionally used bivariate tests to evaluate participants' STI testing by their history of using pre-exposure prophylaxis (PrEP). One-in-seven respondents (n = 18) reported having never tested for an STI, one-quarter (n = 33) had not tested in the past year, and two-thirds (n = 83) had never used PrEP. PrEP-naïve respondents were less likely to report recent STI testing (47% vs. 85%). "Routine doctor's visit" was the most prevalent reason for testing, but was less common among PrEP-naïve respondents (83% vs. 100%). Testing was remarkably low given the sample's high risk of HIV and STI infection. Findings suggest that STI testing is more frequent among those who have ever used PrEP, but the risk of selection bias warrants evaluation in a larger probability sample. [ABSTRACT FROM AUTHOR]

Background: There are limited epidemiologic data examining the incidence of pediatric anterior cruciate ligament reconstruction (ACLR) over the past decade. Purpose: To examine statewide population trends in the incidence of ACLR in a pediatric population. Study Design: Descriptive epidemiology study. Methods: Inpatient and outpatient claims for pediatric patients who underwent ACLR between 2009 and 2017 were identified in the New York Statewide Planning and Research Cooperative System database via International Classification of Diseases (ICD), Revision 9, Clinical Modification; ICD, Revision 10, Clinical Modification and Procedural Classification System; or Current Procedural Terminology codes. New York population data for each year between 2009 and 2017 were used from the New York State Department of Health to calculate the rates of ACLR per 100,000 people aged 3 to 19 years and determine the 95% confidence limits. The rates were then stratified by age, sex, and insurance. Two-year rates of revision and contralateral ACLR were also analyzed by sex. Results: Between 2009 and 2017, 20,170 pediatric ACLRs were identified. The rates of pediatric ACLR increased steadily from 49.3 per 100,000 in 2009 (95% CI, 47.2-51.4) to a peak of 61.0 (95% CI, 58.6-63.4) in 2014 and decreased to 51.8 (95% CI, 49.6-54.1) by 2017. The age group 15 to 17 years had the highest rates of ACLR of all age groups, peaking at 198.5 (95% CI, 188.3-208.7) per 100,000. Analysis by sex showed that ACLR rates between males and females were not different. Males had a 2-year ipsilateral revision rate of 4.3%, while females had a rate of 3.3% (P =.0001). Females had a contralateral ACLR rate of 4.0%, while males had a rate of 2.6% (P =.0002). Conclusion: Pediatric ACLR rates continued to rise until 2014, but there was a demonstrable decrease in rates after 2014. This decline in pediatric ACLR may point to the efficacy of injury prevention programs or changes in practice management. The high revision rate in males and high contralateral surgery rate in females can help guide patient counseling for return to play and complication risk. Clinical Relevance: This study showed that ACLR in pediatric patients may be decreasing in recent years. There were differences in revision and contralateral ACLR by sex. [ABSTRACT FROM AUTHOR]

Diagnosis codes are used to study SARS-CoV2 infections and COVID-19 hospitalizations in administrative and electronic health record (EHR) data. Using EHR data (April 2020–March 2021) at the Yale-New Haven Health System and the three hospital systems of the Mayo Clinic, computable phenotype definitions based on ICD-10 diagnosis of COVID-19 (U07.1) were evaluated against positive SARS-CoV-2 PCR or antigen tests. We included 69,423 patients at Yale and 75,748 at Mayo Clinic with either a diagnosis code or a positive SARS-CoV-2 test. The precision and recall of a COVID-19 diagnosis for a positive test were 68.8% and 83.3%, respectively, at Yale, with higher precision (95%) and lower recall (63.5%) at Mayo Clinic, varying between 59.2% in Rochester to 97.3% in Arizona. For hospitalizations with a principal COVID-19 diagnosis, 94.8% at Yale and 80.5% at Mayo Clinic had an associated positive laboratory test, with secondary diagnosis of COVID-19 identifying additional patients. These patients had a twofold higher inhospital mortality than based on principal diagnosis. Standardization of coding practices is needed before the use of diagnosis codes in clinical research and epidemiological surveillance of COVID-19. [ABSTRACT FROM AUTHOR]

Objective. This study evaluates a video-feedback program's effectiveness in promoting responsive and sensitive parenting for families in care in a community health center located in the South Bronx, New York City. Methods. Change in measures of parent responsiveness/sensitivity (Global Rating Scale), depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder 7), and parenting stress (Parenting Stress Index-Short Form) were analyzed for mother-infant dyads (N=34) completing a six-session videofeedback program between 2014 and 2016. Results. Participants were primarily mothers of color (30% African American; 63% Hispanic) with young infants (mean age 8 months). At program completion, mothers demonstrated a significant improvement of 19% in maternal responsiveness and fewer depressive and anxious symptoms. Conclusion. Cost-effectiveness studies are needed to compare parenting interventions by setting (community health center, home, or mental health facility) for acceptability and effectiveness to determine best practice models for communities challenged by poverty, trauma, and health disparities. [ABSTRACT FROM AUTHOR]

A systematic assessment of the effect of COVID-19 on the food retail environment—an important determinant of health—has not been conducted. Our objective was to assess the impact of COVID-19 on closures of restaurants, food retail stores, and fresh produce vendors in New York City (NYC). We conducted a cross-sectional study following the peak of COVID-19 in six neighborhoods in NYC. Two Chinese ethnic neighborhoods and four higher/lower resourced comparison neighborhoods were selected a priori based on 14 sociodemographic indicators. The primary outcome was indefinite/temporary closures or absence of food businesses. Of 2720 food businesses identified, produce vendors and restaurants were more likely to close than food retail stores. A higher proportion of food businesses closed in Chinese ethnic neighborhoods vs. comparison neighborhoods. COVID-19 impacted food businesses in six NYC neighborhoods examined in this period, with the greatest effect observed for Chinese ethnic neighborhoods. [ABSTRACT FROM AUTHOR]

The use of policing to enforce public health guidelines has historically produced harmful consequences, and early evidence from the police enforcement of COVID-19 mandates suggested Black New Yorkers were disproportionately represented in arrests. The over-policing of Black and low-income neighborhoods during a pandemic risks increased transmission, potentially exacerbating existing health inequities. To assess racialized and class-based inequities in the enforcement of COVID-19 mandates at the ZIP-code-level, we conducted a retrospective spatial analysis of demographic factors and public health policing in New York City from 12 March–24 May 2020. Policing outcomes (COVID-19 criminal court summonses and public health and nuisance arrests) were measured using publicly available police administrative data. After controlling for two measures of social distancing compliance, a standard deviation increase in percentage of Black residents was associated with a 73% increase (95% CI: 35%, 123%) in the COVID-19-specific summons rate and a 34% increase (95% CI: 17%, 53%) in the public health and nuisance arrest rate. Percentage of Black residents and historical stop-and-frisk rates had stronger associations with COVID-19 summons rates than multiple measures of social distancing compliance. Findings demonstrate pronounced spatial and racialized inequities in pandemic policing of public health that mimic historical policing practices deemed racially discriminatory. If the field of public health supports criminalization and punishment as public health strategies, it risks reinscribing racialized health inequities. [ABSTRACT FROM AUTHOR]

Background: Prior research has indicated that posttraumatic growth (PTG) often co-occurs with symptoms of posttraumatic stress disorder (PTSD). However, it is yet unclear what longitudinal patterns of posttraumatic symptom levels may predict the development of PTG. Methods: World Trade Center (WTC) rescue and recovery workers (2038 police and 2103 non-traditional responders) were assessed an average of 3, 6, 8, and 12 years post-9/11/2001. Responders' WTC-related PTSD symptoms were characterized by No/Low Symptom, Worsening/Subtly Worsening, Steeply Worsening (only for non-traditional responders), Improving, and Chronic trajectories. PTSD symptom trajectories were examined as predictors of PTG, which was assessed using total scores on the Posttraumatic Growth Inventory-Short Form. Results: Across both occupational groups, being female, older, Hispanic, and experiencing more post-9/11 traumatic events were independently associated with self-reported PTG. Among police responders, a greater number of WTC exposures and supportive family members while working at the WTC site were linked to higher PTG. Among non-traditional responders, Black race/ethnicity, less education, fewer pre-9/11 traumatic events, and the presence of support while working at the WTC site were additionally linked to higher PTG. Only the moderate PTSD symptom trajectories (ie, worsening and improving) for police responders and all symptomatic trajectories for non-traditional responders were associated with higher levels of PTG. Conclusions: Symptomatic 12-year trajectories of PTSD symptoms and certain sociodemographic characteristics, stressor exposures, and supportive resources were associated with PTG in traditional and non-traditional WTC responders. Results provide insight into subgroups of WTC responders who may benefit from PTG-promoting interventions, as well as potentially modifiable targets to help foster PTG in this population. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of a nurse-led intervention on the household emergency preparedness (HEP) level of parents with newborns and describe the nurses' perceived facilitators/barriers to providing this intervention. Design: A non-randomized, non-blinded, quasi-experimental pilot study conducted with maternal/child nurses and neonatal parents. The intervention used an educational booklet on what is needed to prepare for disasters and how to develop evacuation and communication plans. Parents completed booklets during their infant's hospital stay, after which they received a free disaster kit from the nurses. Sample: 68 parents, 13 maternal/child nurses. Main Outcome Variable: Level of HEP. Results: HEP scores increased from 4.75 to 10.66 out of 11 from pre- to post-intervention (p <.001). Barriers to implementing this intervention included the weight of the disaster kit, parent anxiety, and need for follow-up with parents. Facilitators included the booklet, disaster kit, and speed/cost of the intervention. [ABSTRACT FROM AUTHOR]

This study aimed to assess the coronavirus disease (COVID-19) school-related information New York City residents sought through the 311 Call Center. July to November inquiries were downloaded from the NYC Open Data website for 2018–2020. Calls were categorized as related to "Schools", "Access", "Food", "Hospitals", "Transportation", and "Unemployment". Overall call types, and among school-related calls, detailed call types, were compared over the years, using chi-squared tests. School-related inquiries increased by 71% from 2018 to 2020. During 2020, the most common (49%, n = 22,471) call description was "Coronavirus and Schools", encompassing calls about learning options, safety, and resources. Spikes in these calls corresponded to official announcements, including those about Fall reopening plans (August 31: n = 678; September 1: n = 624) and schedules and staffing (September 16th: n = 1043; September 17th: n = 713), and after the start of in-person learning (September 21: n = 680). This study demonstrates that as government officials updated NYC schooling plans for Fall 2020, there were increased concerns among NYC residents. Future COVID-19 schooling changes need to be conveyed clearly and disseminated effectively in order to avoid confusion about NYC's pandemic learning strategy and to address health and safety concerns. [ABSTRACT FROM AUTHOR]