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Deaf, deafblind, and hard of hearing (DDBHH) individuals experience barriers to accessing cancer screening, including ineffective patient-physician communication when discussing screening recommendations. For other underserved communities, culturally and linguistically aligned community health navigators (CHNs) have been shown to improve cancer screening and care. A needs assessment study was conducted to identify barriers and gather recommendations for CHN training resources. A community-based participatory needs assessment was conducted from May 2022 to June 2022 using three focus groups. Eight were cancer survivors, six advocates/navigators, and three clinicians. All questions were semi-structured and covered screening barriers, observations or personal experiences, perceived usefulness of having a CHN to promote cancer screening adherence, and training resources that may be useful to American Sign Language (ASL)-proficient CHNs, who are also culturally and linguistically aligned. Out of 20 focus group participants, seven self-identified as persons of color. Data highlighted systemic, attitudinal, communication, and personal-level barriers as recurrent themes. The most frequently cited barrier was access to training that supports the role and competencies of CHNs, followed by cultural considerations, access to cancer guidelines in ASL, dialect diversity in sign language, and the health system itself. Unaddressed barriers can contribute to health disparities, such as lower preventive cancer screening rates amongst DDBHH individuals. The next step is to translate recommendations into actionable tasks for DDBHH CHN training programs. As a result, CHNs will be well-equipped to help DDBHH individuals navigate and overcome their unique barriers to cancer screening and healthcare access.

BACKGROUND: The exposome serves as a popular framework in which to study exposures from chemical and nonchemical stressors across the life course and the differing roles that these exposures can play in human health. As a result, data relevant to the exposome have been used as a resource in the quest to untangle complicated health trajectories and help connect the dots from exposures to adverse outcome pathways. OBJECTIVES: The primary aim of this methods seminar is to clarify and review preprocessing techniques critical for accurate and effective external exposomic data analysis. Scalability is emphasized through an application of highly innovative combinatorial techniques coupled with more traditional statistical strategies. The Public Health Exposome is used as an archetypical model. The novelty and innovation of this seminar's focus stem from its methodical, comprehensive treatment of preprocessing and its demonstration of the positive effects preprocessing can have on downstream analytics. DISCUSSION: State-of-the-art technologies are described for data harmonization and to mitigate noise, which can stymie downstream interpretation, and to select key exposomic features, without which analytics may lose focus. A main task is the reduction of multicollinearity, a particularly formidable problem that frequently arises from repeated measurements of similar events taken at various times and from multiple sources. Empirical results highlight the effectiveness of a carefully planned preprocessing workflow as demonstrated in the context of more highly concentrated variable lists, improved correlational distributions, and enhanced downstream analytics for latent relationship discovery. The nascent field of exposome science can be characterized by the need to analyze and interpret a complex confluence of highly inhomogeneous spatial and temporal data, which may present formidable challenges to even the most powerful analytical tools. A systematic approach to preprocessing can therefore provide an essential first step in the application of modern computer and data science methods. https://doi.org/10.1289/EHP12901, Introduction The exposome is generally viewed as a measure of all the environmental exposures an individual has had over a lifetime. The systematic stratagem of capturing these exposures under a [...]

Objectives To reflect on the achievements of the Agency for Healthcare Research and Quality's (AHRQ) Digital Healthcare Research Program over the past 20 years, evaluate its impact on US healthcare quality and safety, and outline current and future priorities for digital healthcare research and innovation. Process The article reviews key milestones in AHRQ's digital healthcare initiatives, including its founding and its advances in telehealthcare and clinical decision support. It highlights AHRQ's contributions to advancing technology integration in healthcare, promoting patient safety, and addressing equity gaps. The article also examines the evolving role of artificial intelligence (AI) in healthcare delivery. Conclusions AHRQ's Digital Healthcare Research Program has significantly contributed to improving healthcare quality. As digital technologies evolve, particularly with AI, the program remains focused on enhancing safety, equity, and efficiency in healthcare. Continued research and investment will be essential to maintaining progress and addressing new challenges. [ABSTRACT FROM AUTHOR]

Recent studies hypothesize that some submarine slides fail via pressure-driven slow-slip deformation. To test this hypothesis, this study derives pore pressures in failed and adjacent unfailed deep marine sediments by integrating rock physics models, physical property measurements on recovered sediment core, and wireline logs. Two drill sites (U1394 and U1399) drilled through interpreted slide debris; a third (U1395) drilled into normal marine sediment. Near-hydrostatic fluid pressure exists in sediments at site U1395. In contrast, results at both sites U1394 and U1399 indicate elevated pore fluid pressures in some sediment. We suggest that high pore pressure at the base of a submarine slide deposit at site U1394 results from slide shearing. High pore pressure exists throughout much of site U1399, and Mohr circle analysis suggests that only slight changes in the stress regime will trigger motion. Consolidation tests and permeability measurements indicate moderately low (~10-16-10-17 m2) permeability and overconsolidation in fine-grained slide debris, implying that these sediments act as seals. Three mechanisms, in isolation or in combination, may produce the observed elevated pore fluid pressures at site U1399: (1) rapid sedimentation, (2) lateral fluid flow, and (3) shearing that causes sediments to contract, increasing pore pressure. Our preferred hypothesis is this third mechanism because it explains both elevated fluid pressure and sediment overconsolidation without requiring high sedimentation rates. Our combined analysis of subsurface pore pressures, drilling data, and regional seismic images indicates that slope failure offshore Martinique is perhaps an ongoing, creep-like process where small stress changes trigger motion.

American Indian and Alaska Natives (AIAN) comprise about 2% of the US population and 0.5% of the faculty in higher education. While scholars have documented the experiences of underrepresented minority (URM) faculty, the perspectives of AIAN faculty at elite universities are largely absent. Although AIAN faculty share many of the same barriers to success as URM colleagues, their unique status as Tribal peoples and their relationship to settler colonialism pose particular challenges and resistance strategies. Findings from a mixed methods study of 25 AIAN faculty at research universities, employing a decolonizing, survivance-oriented framework, examines their lived institutional experiences. The data yielded five themes regarding (1) institutional climate, (2) mentorship, (3) family--work balance, (4) cultural taxation and role stress, and (5) discrimination. The authors conclude that decolonization involves the repatriation of Indigenous epistemologies and Indigenous 'place' in the growth of science, research, and knowledge production, creating liberatory spaces within the academy.

The study evaluated a theory-based breast cancer control program specially developed for less acculturated Latinas. The authors used a quasi-experimental design with random assignment of Latinas into experimental (n = 51) or control (n = 37) groups that completed one pretest and two posttest surveys. The experimental group received the educational program, which was based on Bandura's self-efficacy theory and Freire's empowerment pedagogy. Outcome measures included knowledge, perceived self-efficacy, attitudes, breast self-examination (BSE) skills, and mammogram use. At posttest 1, controlling for pretest scores, the experimental group was significantly more likely than the control group to have more medically recognized knowledge (sum of square [SS] = 17.0, F = 6.58, p < .01), have less medically recognized knowledge (SS = 128.8, F = 39.24, p < .001), greater sense of perceived self-efficacy (SS = 316.5, F = 9.63, p < .01), and greater adeptness in the conduct of BSE (SS = 234.8, F = 153.33, p < .001). Cancer control programs designed for less acculturated women should use informal and interactive educational methods that incorporate skill-enhancing and empowering techniques.

We conducted a telephone survey of randomly selected Latinas (n = 208) and Anglo women (n = 222) to determine predictors of mammography use. The cooperation rate was 78.5%. Relatively high proportions of Latinas (61%) and Anglo women (79%) reported mammography use within the past 2 years. A logistic regression analysis revealed that knowledge and attitudes did not independently predict use. On the other hand, having health insurance, being married, and being Latino were consistent independent predictors. We conclude that mammography use among Latinas and Anglo women is increasing. However, further gains in use must address difficult barriers such as lack of health insurance.