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The purpose of this exploratory, mixed-methods study was to investigate the relationship between nontraditional undergraduate students' curiosity and their experiences researching a topic. The author collected and analyzed survey data and annotated bibliography rubric scores from 59 students at a private, liberal arts university and conducted in-depth interviews to gather a fuller picture of the students' curiosity. Based on the study's findings, librarians and professors should create opportunities for students to select research topics to which they have a personal connection while intentionally offering supportive feedback to students as they refine their topics to reduce anxiety and frustration.

As the United States' population grows via migration and immigration, with this rise in diverse identities, there has been increasing concern regarding disparities for undocumented immigrants living in the U.S. with limited access to the health system. Given the various constraints involving communication and social structures that undocumented immigrants face, a culture-centered approach is drawn on to investigating how this group goes about navigating a dominant health system given their restricted access. I explore co-constructed themes that emerged through conversations with undocumented immigrants, (people without papers as I call them in this work) living in the United States to gain an understanding as to the structural and cultural limitations faced by this group. By doing qualitative semi-structured interviews with local participants living in the South Florida region, I describe the various features of a complex U.S. health system that undocumented immigrants (people without papers) deemed as important obstacles that limit their willingness to interact with official medical spaces. This work draws on narratives and accounts to shed light on the intersection of disparities this group has to overcome in order to consider entering a medical space to receive the treatment they might need. The findings of this article highlighted the structural violence that certain subaltern groups, such as people without papers experience due to their limited access to foundational systems in their environment. [ABSTRACT FROM AUTHOR]

A research paper by Card and Giuliano took advantage of a natural experiment in a large school district to explore the impact that universal screening policies had on the identification of historically underrepresented minorities in gifted and talented programs. The authors concluded that the universal screening system was more effective than the previous teacher and parent referral system in addressing the underidentification of African American, Hispanic, female, low socioeconomic status, and English learner students. However, the present article identified gaps in the system that allowed new inequities to emerge. This review of their study concludes that districts must be advocates for gifted and talented students who come from culturally and linguistically diverse backgrounds. Implementing universal screening procedures can be an important tool in ensuring fair access to gifted and talented services, but districts must manage the increased resource demands of such programs.

This dataset contains participant data related to the use of badging (achievement) feedback in pedagogical design. Two sections each of web-based graphic design and web design undergraduate courses were offered at the University of Central Florida. A badging system for achievements was included in one section of each. Performance, engagement and behavior-related data were collected. The dataset comprises complete data from 44 undergraduate students. This paper includes a justification for data collection, methodology and preexisting usage of the data. It also discusses limitations of the dataset.

Despite increased access to and improvements in contraceptives, unintended pregnancy continues to be a problem globally and is associated with adverse outcomes for mothers and infants. This paper seeks to unravel the mediators of intended versus unintended pregnancies among Black women living with HIV. The paper draws on survey data from a broader multi-country mixed methods study that used a community-based participatory research approach to investigate the psychosocial experiences of Black mothers living with HIV. The study participants were Black mothers living with HIV drawn through venue-based sampling from Ottawa, Canada (n = 89), Port Harcourt, Nigeria (n = 400), and Miami, Florida, United States (n = 201). We used Hierarchical Binary Logistic Regression Modelling (HBLM) to estimate the independent associations of pregnancy intention (intended versus unintended) with blocks of predictor variables (sociodemographic, sociocultural, and psychosocial predictors) at alpha level of 0.5. Specifically, 44.2%, 67.3%, and 17.7% of the women had unintended pregnancies in Ottawa, Miami, and Port Harcourt, respectively. There were important results from the HBLM. The odds of intended relative to unintended pregnancies were (i) reduced in larger households (OR = 0.56, 95% CI = 0.36/0.87), but increased with employment (OR = 7.84, 95% CI = 1.52/40.54) and HIV knowledge (OR = 3.13, 95% CI = 1.42/6.90) in Ottawa; (ii) reduced with age (OR = 0.93, 95% CI = 0.88/0.98), but increased with marriage (OR = 2.90, 95% CI = 1.43/5.88) and social support (pregnancy (OR = 3.77, 95% CI = 1.98/7.19) in Port Harcourt; (iii) reduced with social support (OR = 0.95, 95% CI = 0.91/1.00) but increased with HIV status disclosure (OR = 1.73, 95% CI = 1.01/2.97) and the influence of specific referent (OR = 1.68, 95% CI = 1.13/2.52) in Miami-FL. The incidence of unintended pregnancy is more prevalent among Black women living with HIV in the North American cities relative to the African city. Also, unique combinations of sociodemographic, sociocultural, and psychosocial factors influence pregnancy intention in each city. This implies that policy and practices to address reproductive health needs of WLHIV must consider these contextual issues. [ABSTRACT FROM AUTHOR]

Background: Immigrant Latinx transgender people often migrate to the United States because of a desire for increased safety and more opportunities. However, after migrating to the United States, immigrant Latinx transgender people often struggle to access basic needs, including health care, jobs, and stable finances. These struggles are exacerbated for undocumented immigrant Latinx transgender people. There is a gap in the literature regarding needed resources for immigrant Latinx transgender community members living in the United States. Aims: Utilizing a critical intersectionality framework, the aim of the present study was to investigate the resource needs of immigrant Latinx transgender community members living in the United States. Methods: A community sample of 18 immigrant Latinx transgender people living in a large metropolitan city in Florida participated in individual semi-structured interviews to explore their community resource needs. Results: Thematic analysis revealed five themes related to resources that participants needed including: 1) Transgender healthcare/resources, 2) Public education, 3) Financial aid resources, 4) Homelessness resources, and 5) Addictions care. Two resource need-related themes were identified that pertain specifically to undocumented immigrant Latinx transgender people, including: 1) Documentation papers for access, and 2) Legal aid. Conclusions: Findings suggest that immigrant Latinx transgender community members in this study provided guidance about broad resources needed to enhance their wellness and safety, and promote liberation of community members. Participants' resource needs suggest the importance of policy and structural level changes from institutions with power that consider and enhance the wellness of immigrant Latinx transgender people. Findings also suggest the need for more tailored interventions and case work to better support immigrant Latinx transgender people. [ABSTRACT FROM AUTHOR]

Purpose: Police officers are increasingly interacting with individuals with mental illnesses. Officers who encounter these persons have three choices: detain, arrest and transport to a correctional facility; resolve the situation informally; or initiate an involuntary psychiatric admission. The decision to place someone under an involuntary psychiatric admission is based on a variety of factors. This paper aims to collaborate with two metropolitan Police Departments in South Florida to explore individual and departmental factors that contribute to involuntary psychiatric admissions initiated by their officers. Design/methodology/approach: This investigation examined 1,625 police reports of involuntary psychiatric admissions in 2013, 2014 and 2015. Descriptive statistics for the entire sample were computed, and percentages of Crisis Intervention Team (CIT)-trained officers for both departments in each year were determined. Findings: Results highlighted differences in rates of involuntary commitments, CIT-trained officers and associated variables (e.g. mental health diagnoses, substance use) between the two cities. Practical implications: Implications of the findings, and directions that future research in this area might take, are discussed. Originality/value: There is a dearth of literature pertaining to involuntary psychiatric admissions in general and factors specific to involuntary psychiatric admissions initiated by police. This paper adds preliminary findings and implications to this body of research. [ABSTRACT FROM AUTHOR]

Introduction: Identifying effective strategies to enroll African American, Caribbean, and Hispanic/Latino adults ≥65 years of age in health research is a public health priority. This study aimed to explore intergenerational influence (IGI) among these populations living throughout Florida. Methods: African American, Caribbean, and Hispanic/Latino adults ≥65 years of age and a trusted family member/friend between 25–64 years participated in virtual listening sessions (LS). Culturally matched facilitators used a semi-structured guide to lead LS that was recorded, transcribed, and uploaded into NVivo©. The constant comparative method was used for analysis. Results: 363 African American, Caribbean, and Hispanic/Latino participated in LS. Five (5) themes relate to IGI emerged: (1) parent-child relationships; (2) family caregiving/parental illness experiences; (3) historical research maltreatment; (4) transfer of cultural knowledge; and (5) future generations. Discussion: Our findings support that IGI can be leveraged to increase the participation of African American, Caribbean, and Hispanic/Latino older adults in health research. [ABSTRACT FROM AUTHOR]

Development and implementation of policy, systems, and environmental (PSE) change is a commonly used public health approach to reduce disease burden. The Centers for Disease Control and Prevention's National Comprehensive Cancer Control Program conducted a demonstration with 13 programs to determine whether and to what extent dedicated resources would enhance the adoption of PSE strategies. This paper describes results of the qualitative portion of a longitudinal, mixed-methods evaluation of this demonstration. Case studies were conducted with a diverse subset of the 13 programs, and 106 in-depth interviews were completed with state/tribal program staff, community partners, and decision makers. Interviews addressed PSE change planning and capacity building, partnerships, local context, and how programs achieved PSE change. Dedicated PSE resources, including a policy analyst, helped increase PSE change capacity, intensify focus on PSE change overall, and accomplish specific PSE changes within individual jurisdictions. Stakeholders described PSE change as a gradual process requiring preparation and prioritization, strategic collaboration, and navigation of local context. Findings suggest that the demonstration program, including PSE-dedicated funds and a policy analyst, was successful in both increasing PSE change capacity and achieving PSE change itself. These results may be useful to other state, tribal, territorial, and public health organizations planning or implementing PSE change strategies. [ABSTRACT FROM AUTHOR]

Equivalency of test versions is often assumed by counselors and evaluators. This study examined two versions, paper–pencil and computer based, of the Driver Risk Inventory, a DUI/DWI (driving under the influence/driving while intoxicated) risk assessment. An overview of computer-based testing and standards for equivalency is also provided. Results of the study confirmed reliability, validity, and equivalency of the versions. [ABSTRACT FROM AUTHOR]

Latinos/as, the fastest-growing ethnic group in the United States, experience high cancer rates. Factors contributing to treatment decisions among Latinos diagnosed with cancer must be studied. This paper aims to identify treatment decisions among Latinos with cancer and examine factors influencing these decisions. A qualitative exploratory study using semi-structured interviews of 60 Latino/as diagnosed with cancer was conducted. Close-ended responses were analyzed using percentages and frequency distributions, while open-ended responses were analyzed using open coding and thematic categorization. Surgery was the most commonly chosen treatment among participants because it was perceived as providing the highest chance of prolonging life. Only 57% of participants were provided with treatment options. Latinos/as typically prefer modest, paternalistic patient-physician relationships. Therefore, providing culturally appropriate information is valuable. This study underscores the need for health providers to present all available treatment options to enhance cancer treatment outcomes [ABSTRACT FROM AUTHOR]

Hispanic women who experience intimate partner violence (IPV) face unique disparities. They have poorer health outcomes and are less likely to seek help than their non-Hispanic counterparts. When women remain in relationships where IPV occurs and refuse to disclose or seek treatment, they may resort to self-silencing, which can also worsen health outcomes. The purpose of this study was to develop a theory that explains how self-silencing evolves among Hispanic women who experience IPV. Participants were recruited from two research studies focused on Hispanic women's health, and from snowball sampling, which involved referrals by previously registered participants. Data were collected via Zoom® and included individual interviews. A total of 25 women participated in this study. Analysis followed constructive grounded theory levels of analysis described by Charmaz and constant comparative methods described by Glaser and Strauss. A grounded theory entitled Bearing (Aguantando) With Intimate Partner Violence emerged from the data. The theory explains the main strategy Hispanic women use to deal with violence while remaining in a relationship where IPV occurs. The theory is constructed of four categories with subcategories. The results of this study provide an initial framework to understand the self-silencing process among Hispanic women who experience IPV. In addition, this study identifies different levels of interventions that can be useful for researchers and healthcare providers to promote Hispanic women's ability to become empowered, use their voices, and seek help. [ABSTRACT FROM AUTHOR]

Nearly one-third of children in the United States (U.S.) are overweight or obese and at a higher risk for numerous comorbidities. School nurses are ideally positioned to contribute to strategic childhood obesity prevention (COP) efforts, but there are substantial variations with their involvement in COP practices. The research question posed was: "Are personal, professional, and/or job-related characteristics associated with school nurse engagement in child-level or school-level childhood obesity prevention practices?" In this descriptive cross-sectional study, Florida school nurses (N = 171) were recruited via email and two professional conferences to complete an anonymous online or paper survey. Items included questions about various characteristics and how often they performed certain COP practices. Engagement in COP practices was measured on a Likert-type scale with response options of 1 = never; 2 = rarely; 3 = sometimes; 4 = often. Data analyses included correlations, t tests, and ANOVA to determine associations between personal, professional, and job-related characteristics with child-level and school-level school nurse COP practices. Significant associations (p < 0.05) were found between school nurse COP practices and professional characteristics that indicated additional education (i.e., highest nursing degree, COP education, professional organization membership, and national certified school nurse certification). The number of students provided care, age, years in current position, and experience as a nurse and school nurse positively correlated to child-level COP practices, while socioeconomic levels of school(s) were inversely correlated to these practices. Findings support the need for funding and providing additional COP educational opportunities to increase school nurse involvement in preventing childhood obesity. [ABSTRACT FROM AUTHOR]

Introduction: Church-based interventions have been shown to improve the dietary health of underserved populations, yet few studies have examined sustainability of health behavior change over time. This paper examines dietary outcomes over a 24-month period (baseline and 6, 18, and 24 months) for fruit and vegetable and fat consumption behaviors of African-American participants in the Health for Hearts United church-based intervention in North Florida.Study Design: This quasi-experimental, longitudinal trial was conducted from 2009 to 2012. Data were analyzed in 2018.Setting/participants: Six churches in a 2-county area (3 treatment, 3 comparison) were selected for the study using community-based participatory research approaches. Participants were African-American adults (aged ≥45 years; n=211 at baseline) randomly selected from the churches, stratified by age and sex.Intervention: Health for Hearts United intervention was developed by the 3 treatment churches. The 18-month intervention was implemented in 3 6-month phases, framed around 3 conceptual components, which included 4 types of programs and 4 key messages.Main Outcome Measures: Fruit and vegetable consumption was assessed using a single item (fruit and vegetable intake) and the National Cancer Institute Fruit and Vegetable Screener. Fat consumption was determined using a single item (fat intake) and the National Cancer Institute Fat Screener. Background characteristics included age, sex, educational level, and marital status.Results: Significant time effects only were found for daily fruit and vegetable intake (p<0.001), fat intake (p<0.001), and the Fat Screener (p<0.001) with dietary improvements in both treatment and comparison groups across the intervention phases. Fruit and Vegetable Screener results showed that time (p<0.001) and the interaction between time and treatment (p<0.01) were significant, with increases in fruit and vegetable consumption over time for both the treatment and comparison groups and with the increase differing between groups. Post hoc analysis revealed that the treatment group had greater increases in fruit and vegetable consumption than the comparison group between Phases 1 and 3 (p=0.03).Conclusions: Dietary behaviors of mid-life and older African Americans can be improved and sustained over 24 months using a church-based heart health intervention, with similar improvements noted for both comparison and treatment participants.Trial Registration: This study is registered at www.clinicaltrials.govNCT03339050. [ABSTRACT FROM AUTHOR]

Burnout and pay satisfaction were associated with intention to leave the profession; however, overall compensation dollar amount was not correlated with intention to leave. Approaches to nurse retention should employ a multifaceted approach to effectively enhance retention rates. [ABSTRACT FROM AUTHOR]

Previous patient-centered concept models of Angelman syndrome (AS) are integral in developing our understanding of the symptoms and impact of this condition with a holistic perspective and have highlighted the importance of motor function. We aimed to develop the motor and movement aspects of the concept models, to support research regarding motor-related digital outcomes aligned with patients' and caregivers' perspectives. We conducted a qualitative analysis of semi-structured interviews of 24 caregivers to explore AS motor-related features, factors influencing them and their impact on patients and caregivers.The most impacted motor features were gait, walking and stair-climbing. Half of caregivers ranked motor symptoms as one of the most burdensome symptoms of AS. Caregivers frequently reported physical therapy, motivation, medical management and age as factors influencing motor function in AS and reported that impaired motor function affected both patients and caregivers. Measures of lower-limb motor function were identified as relevant to monitor drug effectiveness in AS. Caregivers discussed expected benefits of a digital outcome and potential issues with wearable technology in the context of AS. We propose a new motor function patient-centered concept model, providing insights for the development of relevant, motor-related, digital outcomes in AS. [ABSTRACT FROM AUTHOR]

Relocating and starting a new life in a foreign country may entail a constellation of new stressors for Haitian immigrants; thus, research that enhances our understanding of how this vulnerable population contextualizes migration-related stress is necessary. The objectives of this study were to: (a) identify what factors are associated with migration-related stress, and (b) describe which and why specific migration-related stressors were most significant from the perspective of those suffering from high migration-related stress post migration via the stress proliferation lens of the stress process model. In this mixed-methods, sequential, explanatory pilot study, first-generation Haitian immigrants (N = 76) were recruited to operationalize migration-related stress, using the Demands of Immigration Scale (DIS). Participants (n = 8), who scored 25 or higher on the DIS, completed an in-depth audio-recorded follow-up interview that consisted of open-ended questions and a stressor-ranking questionnaire. Descriptive statistics, Pearson correlations, multiple linear regression (quantitative), and thematic analysis with a double-coded approach (qualitative) were employed to analyze the data. Female gender, older age, English fluency, and migration after the age of 18 years were associated with higher migration-related stress. However, only gender and English fluency predicted migration-related stress. In interviews, participants ranked five migration-related stressors as most stressful: language barriers, financial strains, loss of social networks, family conflicts, and exposure to discrimination/stigma. A nuanced depiction of migration-related stressors and proliferation mechanisms of migration-related stress may help identify areas where support and preventive efforts should be directed to improve social integration, stress levels, and mental well-being among immigrants. [ABSTRACT FROM AUTHOR]

Home visitation programs offer a unique opportunity to implement a novel digital early childhood obesity prevention program. Evaluate usability of a digital infant feeding nutrition education module with key stakeholders (N=21) of a home visiting program in Florida. Home visitors (n=11) and enrolled mothers (n=10) of a home visiting program in Florida participated in a one-time, 45-minute qualitative interview via Zoom with a trained researcher using a semi-structured script based on constructs from the Technology Acceptance Model (TAM) and Social Cognitive Theory (SCT). Participants also completed a modified version of the mHealth App Usability Questionnaire (MAUQ). Interviews were audio-recorded, deidentified, transcribed verbatim and coded by two trained researchers using an inductive thematic analysis approach based on TAM and SCT constructs to develop themes. MAUQ subscales were analyzed using descriptive statistics. Most participants noted that they liked the digital format, and specifically mentioned the visual or interactive components, convenience and accessibility of the information, and general preference for digital information over paper handouts. Home visitors were interested in content related to food allergies and readiness for solid foods, whereas mothers were interested in all of the infant feeding topics. Nonetheless, the majority (90%) reported that they would be very likely to use information in the learning modules as part of home visits. Usability of the module was high across all three MAUQ subscales (mean ratings out of 7±SD: ease of use = 6.88±0.2, interface and satisfaction = 6.90±0.4, usefulness = 6.78±0.1). Limited access to technology by parents, compatibility of the module with various phone types, and necessity of keeping information updated were mentioned by home visitors as limitations that may impact usability. The results revealed that a digital nutrition education module to prevent early childhood obesity was deemed usable by both staff and parents of a home visiting program. Future research is needed to determine impact on parental feeding behaviors and child health outcomes. University of Florida Mowery Innovative Research Fund [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic significantly disrupted education systems in the United States as evidenced by school closures, the rapid implementation of online learning, physical distancing policies, and restrictions on extracurricular activities. Youth in foster care are a vulnerable population in need of school-based services and supports to ensure positive educational outcomes. This qualitative interview study assessed the pandemic's impact on the educational experiences of foster youth from the perspectives of their caseworkers. Participant caseworkers discussed how the pandemic affected the academic progress and social/emotional development of youth in foster care and highlighted some challenges of online learning. They also described how the pandemic impacted classroom management, communication and relationships, and special education services. Overall, caseworkers believed many of the educational challenges caused by the pandemic would not have long-term implications, and they highlighted several positive outcomes resulting from the changes in school operations. Results suggest that caseworkers can mitigate some of the short-term negative effects by ensuring these students have reliable access to technology and that screenings and referrals for therapeutic services are completed in a timely manner. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic profoundly impacted psychological well-being worldwide. Oncology health care professionals' (OHCPs') perceptions of psychological effects of COVID-19 among people in active cancer treatment were explored. Semi-structured interviews with a purposive sample of OHCPs actively providing care were conducted. Interviews were audio-recorded, transcribed, and coded using Atlas.ti v8 and thematic analysis. In total, 30 OHCPs participated. Most were registered nurses (70%), worked in outpatient setting (56.7%) and were in their current position 1–5 years (53.3%). Overarching themes are as follows: (a) cancer treatment disrupted due to patients' fear of exposure to COVID-19; (b) social distancing restrictions caused discontinued social support and supportive services that exacerbated psychological distress; (c) pandemic-related stressors led to overwhelmed coping skills; and (d) OHCPs played a vital role in providing emotional support and connecting patients with family/friends through technology. Behavioral health interventions should focus within the "new world of COVID-19" of reduced face-to-face support and increased online support for patients. [ABSTRACT FROM AUTHOR]

Introduction: Intravenous (IV) vancomycin requires therapeutic drug monitoring and line placement and may prolong hospital stay. Linezolid requires less monitoring, is orally bioavailable, and may expedite transitions of care. This study assessed the impact of a pharmacist-led antibiotic timeout for the transition from IV vancomycin to oral linezolid. Methods: This single-center, quasi-experimental study included admitted adult patients receiving IV vancomycin for over 48 hours. Patients receiving vasopressors, of immunocompromised status, or with specific antibiotic indications were excluded. The primary outcome was the pharmacist intervention acceptance rate. Secondary outcomes included median hospital length of stay, median antibiotic treatment days, and incidence of adverse effects. Results: Of the 317 screened patients, 94 were eligible for the antibiotic time-out assessment, of which 66 met the criteria for oral linezolid. Of those meeting the criteria, 27 interventions were made, of which 20 (74%) were accepted. The median length of antibiotic treatment days was six days between both groups (p = .352). No differences in safety outcomes were observed. Discussion: A pharmacist-led antibiotic timeout for IV vancomycin to oral linezolid resulted in a high intervention acceptance rate and increased oral linezolid use without impacting safety outcomes. These results support the use of this strategy for antimicrobial stewardship. Conclusion: This study illustrates the impact of a pharmacist-led antibiotic timeout for the transition from IV vancomycin to oral linezolid therapy as an antimicrobial stewardship tool. [ABSTRACT FROM AUTHOR]

Objective: Adolescents with type 1 diabetes (T1D) frequently experience psychosocial concerns, and mental health screening is becoming increasingly common in routine diabetes care. However, little is known about what adolescents or their caregivers think about the role of mental health screening and intervention within the context of comprehensive diabetes care, or how their diabetes care providers should be involved in navigating mental health concerns. This study used qualitative methods to obtain the perspectives of adolescents with T1D and their caregivers regarding these issues. Methods: Participants were 13 adolescents with T1D (ages 12–19 years; M = 15.1 years; 53.8% female; 61.5% Hispanic/Latinx White) and 13 mothers, recruited from an outpatient pediatric endocrinology clinic in South Florida, who participated in semi‐structured interviews via video teleconference. Thematic content analysis was used to evaluate participants' responses. Results: Adolescents and their mothers reported positive experiences with the clinic's psychosocial screening procedures and appreciated meeting with the psychology team during visits. They wanted the clinic to offer more opportunities for peer support. Mothers highlighted barriers to seeking mental health care outside of the clinic and the importance of mental health professionals understanding diabetes. Mothers also wanted the clinic to offer more on‐site therapeutic services. Discussion: Study participants valued psychosocial screening and supported addressing mental health as a routine part of diabetes comprehensive care. [ABSTRACT FROM AUTHOR]

Aims: In recent years, studies have indicated that consumers of alcohol mixed with energy drink (AmED) are more likely to drink heavily and experience more negative consequences than consumers who avoid these beverages. Although researchers have identified a number of plausible hypotheses that explain how alcohol-energy drink co-ingestion could cause greater alcohol consumption, there has been no postulation about reverse causal relations. This paper identifies several plausible hypotheses for the observed associations between AmED consumption and greater alcohol consumption, and provides initial evidence for one such hypothesis suggesting that heavy drinking may be a determinant of AmED use.Method: Data collected from 511bar patrons were used to examine the plausibility of one of the proposed hypotheses, i.e., AmED is an artifact of heavy drinking. Associations between the consumption of an assortment of alcoholic beverage types and total alcohol consumption were examined at the event-level, to assess whether AmED is uniquely related with greater alcohol consumption.Results: Increased alcohol consumption was associated with greater odds of consuming most alcoholic beverage types; this association was not unique to AmED.Conclusions: Results support the overlooked hypothesis that AmED use is an artifact of heavy drinking. Thus, AmED consumption may be a consequence or marker of heavier drinking. Much of the existing research on alcoholic beverage types is limited in its ability to implicate any specific type of drink, including AmED, as a cause of increased alcohol consumption and related harm. More rigorous study designs are needed to examine causal relationships. [ABSTRACT FROM AUTHOR]

Introduction: Technology has transformed our lifestyles in dramatic and significant ways, including new and less expensive options for recruiting study participants. This study examines cost and participant differences between two recruitment sources, Craigslist (CL), and print newspapers (PNs). This paper also reviewed and compared studies involving clinical trials published since 2010 that recruited participants using CL alone or in combination with other methods.Method: Secondary data analyses from a parent study involving a randomized controlled trial of a mail-based intervention to promote self-change with problem drinkers.Results: Significant differences were found between CL and PN participants on most demographic and pretreatment drinking variables. While all participants had AUDIT scores suggestive of an alcohol problem and reported drinking at high-risk levels, CL participants had less severe drinking problem histories, were considerably younger, and had a higher socioeconomic status than PN participants. The total advertising costs for the 65 CL ads ($275) were significantly less than the 69 PN ads ($33, 311). The recruiting cost per eligible participant was vastly less expensive using CL ($1.46) compared to print newspaper ads ($116.88).Conclusions: Using CL is a viable recruitment method for soliciting participants, particularly those that are younger, for alcohol intervention studies. It is also less expensive than newspaper ads. When CL participants were recruited, they reported being slightly more confident to change their drinking than PN participants. Limitations of using CL are discussed, including that some initial ad responders gave inconsistent answers to similar questions and a few tried to enter the study more than once. [ABSTRACT FROM AUTHOR]

This exploratory, qualitative study evaluated the impact of the Critical Ongoing Resource Family Education Teen Edition (CORE-Teen) post-licensure foster parent training curriculum designed to support foster/kinship caregivers caring for youth ages 12–20 years in the foster care system. A pilot study of the curriculum was implemented in three states (Florida, Pennsylvania, and Tennessee). Five semi-structured focus groups (three groups received CORE Teen training and the other two did not) were conducted with a total of 61 foster parents to explore the differences in parenting knowledge and practices among foster parents trained in CORE Teen versus those who were not. A thematic content analysis of the transcripts from the focus groups revealed three themes: (1) understanding what is considered normal teen behavior; (2) understanding and managing teen trauma and mental health; and (3) recommendations for building foster parents' skills to prepare for their role. Overall, CORE Teen-trained foster/kinship caregivers seemed to have deeper insight into normal teen behaviors, as well as how trauma and mental health challenges can underlie challenging behaviors. CORE Teen foster/kinship caregivers also seemed more satisfied with the training they had received to prepare them for caring for teens. The CORE Teen training curriculum offers promise for building the unique skills that foster/kinship caregivers need in order to effectively care for older youth in the foster care system. [ABSTRACT FROM AUTHOR]

This mixed methods study examined kinship caregivers' perspectives of the Florida Guardianship Assistance Program (GAP) to understand how the program initially supported the needs of the child, caregiver, and family as they navigate permanent guardianship. Specifically, this study examined caregivers' knowledge of the GAP; decision to apply for the GAP; perceptions of the GAP from families who had successfully closed cases to permanent guardianship; perceptions of the GAP from families who held active cases and had not yet closed to permanent guardianship; and perceptions of how children were adjusting in their home, comparing licensed and non-licensed foster care homes. Findings indicate that 47% of respondents first heard about the GAP when the child was initially placed with them, while 16% had never heard of the GAP until receiving the survey letter for this evaluation. The majority (56%) of those who had heard about the GAP were first told about it by the child's caseworker. Among respondents who both knew about the GAP and who indicated whether or not they pursued GAP, 87% decided to apply for the GAP, and 90% of those who applied for licensing were eligible. Of those caregivers whose children's cases had closed to permanent guardianship, the majority (63%) indicated that the licensing process was very easy or somewhat easy. Overall, the majority of caregivers indicated that the children were doing better since being initially placed in their care, but caregivers who were not licensed reported a slightly higher percentage of children who were doing worse. [ABSTRACT FROM AUTHOR]

There is a limited understanding of how toxic exposures to agrichemicals vary relative to international migration over the life course. A life history calendar (LHC) was piloted to explore sequences of agrichemical exposure relative to international migration. LHCs were administered to 41 foreign born individuals from Mexico and Central America who had agricultural work experience during their lifetime and who were living in South Florida. Social sequence analysis was used to explore occupation-by-agrichemical events relative to migration. A three-cluster solution was used to classify low, moderate, and high lifetime exposure sequences. The odds of any perceived effects of agrichemicals on the body increased with time prior to migration in the moderate and high exposure sequence clusters and continued to increase 20% with each year following migration in the moderate exposure cluster. Workers with high lifetime agrichemical exposures prior to migrating internationally showed lower likelihoods of a perceived effect on the body following migration despite continued exposure. Further research on instrument validity is warranted. [ABSTRACT FROM AUTHOR]

Objectives: To inform updates to the Pregnancy Risk Assessment Monitoring System (PRAMS) design and processes, African American/Black and Hispanic/Latina women in Florida provided feedback on their awareness and perceptions of the PRAMS survey, and preferences for survey distribution, completion, design and content. Methods: Focus groups were conducted in English and Spanish with 29 women in two large metropolitan counties. Participants completed a brief survey, reviewed the PRAMS questionnaire and recruitment materials, engaged in discussion, and gave feedback directly onto cover design posters. Results: Participants reported limited awareness of PRAMS. Preferences for survey distribution and completion varied by participant lifestyle. Interest in topics covered by PRAMS was as a motivator for completion, while distrust and confidentiality concerns were deterrents. Participants were least comfortable answering questions about income, illegal drug use, and pregnancy loss/infant death. Changes to the length of the survey, distribution methods, and incentives/rewards for completion were recommended. Conclusions for Practice: Results highlight the need to increase PRAMS awareness, build trust, and consider the design, length and modality for questionnaire completion as possible avenues to improve PRAMS response rates. [ABSTRACT FROM AUTHOR]

To inform the development of a combined diabetes prevention and self-management intervention in partnership with church communities, this study sampled African American church leaders and members ( N = 44) to qualitatively study religious beliefs and practices, diabetes prevention and self-management behaviors, and related community actions. Prior to commencing the study, internal review board approval was obtained. Although not required, community consent was officially provided by the church pastors. Individual consent was subsequently obtained from eligible community members who expressed an interest in participating in the study. Following a participatory action research approach, the inquiry group method was used. Qualitative data were analyzed with content analysis. Findings revealed Christian worldview, medical distrust and self-management as prominent themes. Findings suggest that diabetes providers address religious orientation in the provision of care with attention to rebuilding trust with the African-American community to improve health outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The "Village" model has become an emerging, community-based, social initiative to help older adults age in place. This study aims to examine neighborhood social cohesion (NSC), or social connectedness and quality of life, from the perspective of village members. Design/methodology/approach: A mixed-method evaluation was used to examine two Florida villages, a master-planned village (FV1) and a diverse neighborhood village (FV2). Both are full members of the National Village to Village Network. Findings: The quantitative and qualitative data provided complementary and deeper understanding. Quantitative findings showed that FV1 members scored higher at NSC, and qualitative findings further confirmed that village program social activities were critical to building connections, especially for those who have lost loved ones and were single. Research limitations/implications: Findings should be interpreted considering the predominantly white racial makeup and affluence of village participants. Practical implications: Findings point to the importance of NSC as older adults age and suggest that programs should prioritize activities that strengthen social connectiveness. Originality/value: This is one of the first mixed-methods evaluations examining NSC and quality of life among village participants. [ABSTRACT FROM AUTHOR]

The primary purpose of this study was to understand the life satisfaction experienced by childfree women over the age of 65, considering some assumption in society that parenthood is the best path to fulfillment. This study used a qualitative-dominant approach to look at the life satisfaction experiences of 14 childfree women over the age of 65 using semi-structured interview questions while furthering results with the Satisfaction With Life Scale (SWLS). Participants included women gathered through community agencies in South Florida. A thematic analysis was used to analyze data from the interviews while basic SPSS calculations were used to calculate measures of central tendency. 13 of the 14 women reported life satisfaction in interviews, which was consistent with their scores on the SWLS. This study updates the literature that examines the life fulfillment of those who do not have children. Most specifically, it furthers the understanding of how those who have remained childfree feel in the final stages of their lives. [ABSTRACT FROM AUTHOR]

Background and purpose: Patient acceptance of implantable cardioverter defibrillators (ICDs) is one of the factors influencing clinical outcomes. This study aimed to develop a Japanese version of the Florida Patient Acceptance Survey (FPAS; a measure of acceptance of ICDs), examine its reliability and validity, and test instrument reliability and ability to generate valid data in a new population. Methods: 122 outpatients with ICD, cardiac resynchronization therapy defibrillator (CRTD) completed the FPAS, the 12-Item Short-Form Health Survey developed for the Medical Outcomes Study, and the Hospital Anxiety and Depression Scale. Results: Confirmatory and exploratory factor data analyses yielded a three-factor model with nine items. This version of the FPAS had high internal consistency, both for the single factor scale and all other subscales; Cronbach's α ranged from.78 to. 84. Conclusion: The scale was shown to be valid and reliable for assessing device acceptability in Japanese patients with ICD. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has showcased the United States' reliance on essential workers, or those deemed necessary to continue critical societal functions. Black women remain overrepresented in essential positions and are on the frontlines of two pandemics: COVID-19 and racism. Using a phenomenological research design, we conducted semi-structured interviews to examine the experiences of 22 Black women essential workers navigating these dual pandemics. Salient themes of these experiences included: desire to and fear of protest; navigating extreme emotions; mixed levels of understanding from colleagues; and a rise in blatantly racist confrontations in the workplace. Further reflection is needed to understand the complex dynamics these women faced. [ABSTRACT FROM AUTHOR]

Making use of the method and the results of Herbert Eugene Bolton, founder of the Latin American Historical Review who proved that Spanish heritage is crucial for understanding American history, the article examines some of the main questions every researcher studying 16th-centiry Spanish Florida is confronted with. The author identifies important methodological problems regarding the topic and proposes some solutions, while also initiating specific debates on the development and Christianization of Spanish Florida during the 16th to the 18th centuries. The methodological conviction of the article is that scientists cannot avoid historicism; it also shows specific problems of the narrative and typological method, as well as the potential for further analysis of such methods as source studies and documentary. One also discusses the cartographic problem and the periodization of what is considered Spanish Florida in the 16th century. [ABSTRACT FROM AUTHOR]

Parents play a critical role in the progression and outcomes of juvenile dependency (child welfare court) cases. Yet, very little is known about these parents' knowledge, attitudes, and experiences. We examined legal understanding and attitudes among 201 parents involved in ongoing dependency cases in California and Florida via semi-structured, in-person interviews. We expected parents' understanding to be low and attitudes to be negative, particularly among parents of color and low SES parents. We expected greater dependency understanding to be related to more positive justice attitudes, and procedural and distributive justice attitudes to be indistinguishable in this population. Findings partially confirmed expectations. Parents' understanding of the system was low, especially among parents of color and less educated parents. Parents felt less than satisfied about the fairness of procedures and decisions. However, procedural and distributive justice attitudes were distinguishable. Finally, and unexpectedly, parents' knowledge and attitudes were negatively related. The consistently low levels of knowledge across CA and FL suggest the critical need to increase parental knowledge. It is also important to promote fair court procedures and decision-making to improve parents' attitudes about procedural and distributive justice, which were found to be distinct and important factors among parents navigating juvenile dependency cases. [ABSTRACT FROM AUTHOR]

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Introduction: Wor kplace incivility and bullying ar e concer ning issues in healthcar e with detrimental consequences for healthcare workers (HCW) and healthcare organizations. Organizational leaders' recognition of incivility/bullying within healthcare organizations, and their sources, is imperative to prevent and/or address issues by creating "zero tolerance" work environments. The purpose of this cross-sectional, descriptive study was to explore HCWs' experiences with incivility and bullying at a South Florida community hospital. Methods: A convenience sample of HCWs at a South Florida community hospital were recruited to voluntarily complete the Nursing Incivility Scale. Results: A sample of 325 HCWs responded to the survey. The results showed general incivility as the highest source across all HCWs, with certified nursing assistants having the highest level of incivility across all sources (general, nurse, supervisor, physician, and patients). Correlative analysis showed statistically significant relationships between a) several sources of incivility (general, supervisor, physician, and patient; r = .250 to .390) for those reporting past experiences with incivility/bullying, and b) healthcare role and physician incivility (r = -.224). Independent t tests and one-way ANOVA showed statistically significant differences. Of note, compared to other HCW roles, registered nurses reported physicians as their highest source of incivility. Discussion: Workplace incivility/bullying is a serious issue in healthcare across all disciplines and roles, requiring healthcare organization leaders' awareness and subsequent interventions to prevent and address its occurrence. The results of this study provide necessary insight for hospital organization leaders as they endeavor to create and nurture "zero tolerance" work environments. [ABSTRACT FROM AUTHOR]

Biomedical research often enrolls people living with HIV (PLWH) receiving effective treatment to complete invasive procedures. This mixed methods study characterized determinants of willingness to undergo specific biomedical procedures among PLWH. In 2017, 61 participants (77% Black) from Miami completed a quantitative assessment examining willingness to participate. A subset of 19 participants completed an in-depth qualitative interview. Across all procedures, there was greater willingness to participate if asked by a primary care provider and if experimental results were shared. However, half of participants reported that they would experience undue influence (i.e., excessive persuasion) to participate from their primary care provider. In thematic analyses, altruism and personal benefit were identified as facilitators while medication changes, confidentiality, and perceived stigma were identified as barriers to participation in HIV biomedical research. Addressing participants' expectations and mitigating potential undue influence from primary care providers could optimize the ethical conduct of HIV biomedical studies. [ABSTRACT FROM AUTHOR]

Attachment to a caregiver is considered a major component of youth well-being, but currently few measures are available to assess attachment in youths. The purpose of this study was to examine the psychometric properties of the Connection to Caregiver (CtC) instrument, a measure of connection to a caregiver similar to the Inventory of Parent and Peer Attachment (IPPA). The study was driven by a need to assess connection to a caregiver and the appeal of creating a scale from an existing survey that allows a great deal of longitudinal research on already existing data. The psychometric properties of the new measure, which consists of a set of items used in the National Survey of Child and Adolescent Well-Being study, were examined among high school students. Confirmatory factor analysis of the three-factor model showed excellent fit. Concurrent validity of the CtC with the equivalent subscales of the IPPA and convergent validity of each of the scales with the depressive symptoms were good. The results suggest that the CtC instrument is a valid tool for use in research with adolescents. [ABSTRACT FROM AUTHOR]

HIV testing/counseling is a critical point during which non-clinical staff could intervene, discuss and/or refer clients for pre-exposure prophylaxis (PrEP). This analysis investigated the contextual factors affecting PrEP implementation within HIV testing sites. Two generalized linear mixed models were conducted to estimate PrEP implementation as a function of constructs from the Consolidated Framework for Implementation Research (CFIR). Qualitative interviews were analyzed thematically. Data integration occurred via joint analysis and triangulation. Constructs from the CFIR domain Characteristics of Individuals did not predict PrEP implementation when controlling for demographic characteristics; qualitative data signaled divergent findings in PrEP knowledge. Within the CFIR domains Inner and Outer Settings, relevant priority and available resources predicted PrEP implementation; qualitative data confirmed the importance of available resources and provided insight into the impact of cosmopolitanism and leadership. Addressing the contextual factors that affect PrEP implementation may help HIV testing staff to better implement PrEP programs. [ABSTRACT FROM AUTHOR]

Objective: Disparities in type 1 diabetes related to use of technologies like continuous glucose monitors (CGMs) and utilization of diabetes care are pronounced based on socioeconomic status (SES), race, and ethnicity. However, systematic reports of perspectives from patients in vulnerable communities regarding barriers are limited.Research Design and Methods: To better understand barriers, focus groups were conducted in Florida and California with adults ≥18 years old with type 1 diabetes with selection criteria including hospitalization for diabetic ketoacidosis, HbA1c >9%, and/or receiving care at a Federally Qualified Health Center. Sixteen focus groups were conducted in English or Spanish with 86 adults (mean age 42 ± 16.2 years). Transcript themes and pre-focus group demographic survey data were analyzed. In order of frequency, barriers to diabetes technology and endocrinology care included 1) provider level (negative provider encounters), 2) system level (financial coverage), and 3) individual level (preferences).Results: Over 50% of participants had not seen an endocrinologist in the past year or were only seen once including during hospital visits. In Florida, there was less technology use overall (38% used CGMs in FL and 63% in CA; 43% used pumps in FL and 69% in CA) and significant differences in pump use by SES (P = 0.02 in FL; P = 0.08 in CA) and race/ethnicity (P = 0.01 in FL; P = 0.80 in CA). In California, there were significant differences in CGM use by race/ethnicity (P = 0.05 in CA; P = 0.56 in FL) and education level (P = 0.02 in CA; P = 0.90 in FL).Conclusions: These findings provide novel insights into the experiences of vulnerable communities and demonstrate the need for multilevel interventions aimed at offsetting disparities in diabetes. [ABSTRACT FROM AUTHOR]

Purpose: Patients are frequently asked to share their personal health information. The objective of this study was to compare the effects on patient experiences of 3 electronic consent (e-consent) versions asking patients to share their health records for research.Methods: A multi-arm randomized controlled trial was conducted from November 2017 through November 2018. Adult patients (n = 734) were recruited from 4 family medicine clinics in Florida. Using a tablet computer, participants were randomized to (1) a standard e-consent (standard), (2) an e-consent containing standard information plus hyperlinks to additional interactive details (interactive), or (3) an e-consent containing standard information, interactive hyperlinks, and factual messages about data protections and researcher training (trust-enhanced). Satisfaction (1 to 5), subjective understanding (0 to 100), and other outcomes were measured immediately, at 1 week, and at 6 months.Results: A majority of participants (94%) consented to future uses of their health record information for research. No differences in study outcomes between versions were observed at immediate or 1-week follow-up. At 6-month follow-up, compared with the standard e-consent, participants who used the interactive e-consent reported greater satisfaction (B = 0.43; SE = 0.09; P <.001) and subjective understanding (B = 18.04; SE = 2.58; P <.001). At 6-month follow-up, compared with the interactive e-consent, participants who used the trust-enhanced e-consent reported greater satisfaction (B = 0.9; SE = 1.0; P <.001) and subjective understanding (B = 32.2; SE = 2.6, P <.001).Conclusions: Patients who used e-consents with interactive research details and trust-enhancing messages reported higher satisfaction and understanding at 6-month follow-up. Research institutions should consider developing and further validating e-consents that interactively deliver information beyond that required by federal regulations, including facts that may enhance patient trust in research. [ABSTRACT FROM AUTHOR]

Objectives: From 2016 to 2018 Florida documented 1471 cases of Zika virus, 299 of which were pregnant women (Florida Department of Health, https://www.floridahealth.gov/diseases-and-conditions/mosquito-bornediseases/surveillance.html, 2019a). Florida's response required unprecedented rapid and continuous cross-sector communication, adaptation, and coordination. Zika tested public health systems in new ways, particularly for maternal child health populations. The systems are now being challenged again, as the Coronavirus COVID-19 pandemic spreads throughout Florida. This qualitative journey mapping evaluation of Florida's response focused on care for pregnant women and families with infants exposed to Zika virus. Methods: Fifteen focus groups and interviews were conducted with 33 public health and healthcare workers who managed outbreak response, case investigations, and patient care in south Florida. Data were thematically analyzed, and the results were framed by the World Health Organization's (WHO) Healthcare Systems Framework of six building blocks: health service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership and governance (World Health Organization, https://www.who.int/healthsystems/strategy/everybodys%5fbusiness.pdf, 2007, https://www.who.int/healthinfo/systems/monitoring/en/, 2010). Results: Results highlighted coordination of resources, essential services and treatment, data collection, communication among public health and healthcare systems, and dissemination of information. Community education, testing accuracy and turnaround time, financing, and continuity of health services were areas of need, and there was room for improvement in all indicator areas. Conclusions: The WHO Framework encapsulated important infrastructure and process factors relevant to the Florida Zika response as well as future epidemics. In this context, similarities, differences, and implications for the Coronavirus COVID-19 pandemic response are discussed. [ABSTRACT FROM AUTHOR]

Purpose: In designing a Project ECHO™ type 1 diabetes (T1D) program in Florida and California, the Neighborhood Deprivation Index (NDI) was used in conjunction with geocoding of primary care providers (PCPs) and endocrinologists in each state to concurrently identify areas with low endocrinology provider density and high health risk/poverty areas. The NDI measures many aspects of poverty proven to be critical indicators of health outcomes.Methods: The data from the 2013-2017 American Community Survey (ACS) 5-year estimates were used to create NDI maps for California and Florida. In addition, geocoding and 30-minute drive-time buffers were performed using publicly available provider directories for PCPs and endocrinologists in both states by Google Geocoding API and the TravelTime Search Application Programming Interface (API).Results: Based on these findings, we defined high-need catchment areas as areas with (1) more than a 30-minute drive to the nearest endocrinologist but within a 30-minute drive to the nearest PCP; (2) an NDI in the highest quartile; and (3) a population above the median (5199 for census tracts, and 1394 for census block groups). Out of the 12 181 census tracts and 34 490 census block groups in California and Florida, we identified 57 tracts and 215 block groups meeting these criteria as high-need catchment areas.Conclusion: Geospatial analysis provides an important initial methodologic step to effectively focus outreach efforts in diabetes program development. The integration of the NDI with geocoded provider directories enables more cost-effective and targeted interventions to reach the most vulnerable populations living with T1D. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B (HBV), the leading cause of hepatocellular carcinoma (HCC) worldwide, disproportionately affects minorities in the USA. Undiagnosed HBV precludes HCC screening and contributes to late-stage cancer presentation and decreased survival. Barriers to HBV and HCC screening include lack of insurance and limited diffusion of guidelines. We aimed to assess knowledge about HBV and HCC screening indications and explore barriers to screening.Methods: We surveyed trainees from the University of Miami/Jackson Memorial Hospitals, Palmetto General Hospital, and Mount Sinai Medical Center. We assessed knowledge using clinical vignettes. We performed bivariate and Chi-squared analyses.Results: There were 183 respondents; median age was 31 and 52% were male. The sample was 35% Hispanic, 29% White, 18% Asian, and 9% Black. Training department was Internal Medicine, 71%; Family Medicine, 11%; Infectious Diseases, 6%; or Gastroenterology, 7%. Only 59% correctly estimated national HBV prevalence; 25% correctly estimated global prevalence. In vignettes with behavioral risk factors, trainees correctly advised screening, 63-96%. However, when the risk factor was the birthplace, correct responses ranged from 33 to 53%. Overall, 45% chose an incorrect combination of HBV screening tests. Perceived barriers to screening included limited expertise in screening of immigrants and limited patient education. Respondents were more likely to recommend HCC screening in cirrhotic patients versus non-cirrhotic HBV patients. Key barriers to HCC screening included uncertainty about HCC guidelines and patient financial barriers.Conclusions: Knowledge of HBV and HCC screening recommendations is suboptimal among trainees. Efforts to broadly disseminate HBV and HCC guidelines through targeted educational interventions are needed. [ABSTRACT FROM AUTHOR]

Introduction and Aims: People with opioid use disorder are prevalent in criminal problem-solving courts and dependency courts, which have rehabilitative aims. Medication for opioid use disorder (MOUD) is the standard of care. Court staff set treatment policies for court clients. They may receive training from MOUD manufacturers, but no studies have examined court staff receipt of such training.Design and Methods: To examine receipt of training from MOUD manufacturers, we designed a cross-sectional survey for court staff. We distributed it online to all Florida court staff in criminal problem-solving or dependency courts (n = 585). Outcome variables were receipt of training from one or more MOUD manufacturers and training source. Covariates included dichotomous measures of court type, staff role, gender and rurality. Logistic regression models estimated the relationship between receipt of training and covariates.Results: Twenty-one percent of Florida criminal problem-solving and dependency court staff completed the survey. The most common receipt of training was from the manufacturer of extended-release naltrexone (36%), followed by buprenorphine (24%) and methadone (11%). Fifty-seven percent of those who received training received it from more than one MOUD manufacturer. Criminal problem-solving court staff were more likely than dependency court staff to receive training from MOUD manufacturers. Court program co-ordinators were more likely than other staff roles to receive training from MOUD manufacturers.Discussion and Conclusions: A large minority of respondents received training from a MOUD manufacturer, primarily from extended-release naltrexone's manufacturer, raising concerns regarding information accuracy and conflicts of interest. Court staff should seek MOUD training from academic institutions and non-profit organisations instead. [ABSTRACT FROM AUTHOR]

Introduction: Community needs assessments (CNAs) assess services that residents need and the programs and policies that can address these needs. Recent CNAs have identified a high demand for behavioral health services. A case example is Hillsborough County, FL and this specific need has had significant impacts on local programs and policies. Methods: A 2018 social services mixed methods CNA of eight socio-economically disadvantaged neighborhoods revealed details on social determinant factors driving the need for behavioral health services. Results: Survey data illustrated several barriers and challenges to meeting the local needs. Residents report an inability to access necessary mental health services. Community listening sessions provided themes on how behavioral health disorders have made life difficult for lower-income residents. Discussion: The community-based participatory process of this CNA drew out important themes on social service needs that, when unmet, are contributing to and compounding, the mental health challenges and needs for services in lower-income communities. Conclusions: Various policy and program factors emerge from this case example based on the methodology used and serves as an exemplary model where academia and government agency collaboration can extract new insights that support government policy innovation to meet local mental health service needs. [ABSTRACT FROM AUTHOR]

Purpose: While the benefits of participating in stuttering support groups are well known, the factors that motivate adults who stutter (AWS) to continue attending these meetings are not documented. The purpose of this exploratory study is to investigate the narratives of AWS and identify their individual motivations for regularly attending stuttering support groups. Method: Seven AWS, ages 23--54 years, who attended more than one stuttering support group meeting participated in a semistructured interview about their stuttering and their experiences participating in a stuttering support group. Thematic analysis procedures were followed to investigate descriptions of motivating factors in each participant's narrative. Result: Four major themes emerged from the data including "Mutual Understanding and Common Ground," "Support Group Format," "Positive Changes," and "Give and Take of the Support Group." The support group served as a place to gain new perspectives by watching others who stutter more severely communicate while also creating a sense of not being "alone." Opportunities to speak and/or stutter freely as well as the role chapter leaders take in facilitating conversation were motivating factors in terms of the support group format. Positive changes in emotional well-being and socialization were reported. Participants also stated that they attend support groups because the group provides them with an opportunity to help others and learn from others. Conclusion: This exploratory study uncovered particular aspects of support groups, including group members and the structure of meetings, that motivate AWS to attend. Findings support the literature in that participants reported benefiting from participating in support groups. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) printing now allows rehabilitation professionals to design and manufacture assistive technologies in a few hours. However, there is limited guidance for researchers and clinicians for implementing 3D printing assistive technology interventions and measuring their outcomes. The goal of this study was to develop a standardized 3D printing assistive technology intervention and a research methodology, using pillboxes as an example. Fourteen pillbox users engaged in a study comparing their use of an off-the-shelf pillbox to a customized 3D printed pillbox. Study outcomes were evaluated on feasibility (recruitment capability, study procedures and outcome measures, acceptability of the study procedures, the research team's ability to manage and implement the study, and the participant's preliminary response to intervention). Participant outcomes were measured on satisfaction with the device and medication adherence. Fourteen participants completed the study and received customized 3D printed pillboxes. The study design performed well on all aspects of feasibility except the research team's ability to manage and implement the study, as they experienced several technical issues. Notably, the participants reported improved device satisfaction and medication adherence with the 3D printed device with large effect sizes. The 3D printed assistive technology intervention is a replicable process that supports professionals in printing their own assistive technologies. Recommendations are made to further enhance feasibility of 3D printing assistive technology studies. Future research is warranted. 3D printing is an increasingly feasible approach allowing for the design and manufacture of customized assistive technology Evaluation for assistive technology that will be 3D printed should include information about the person's activities, routines, skills, abilities, and preferences. Evaluation of outcomes should include satisfaction with the device and a functional measure. 3D printed assistive technology interventions should include the collaboration between the assistive technology professional and client. It should also include device training. Future 3D printing research studies should report pragmatic data including printing device, time to print, and number of errors. [ABSTRACT FROM AUTHOR]