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Introduction: Not enough is known about the epidemiology of opioid poisoning to tailor interventions to help address the growing opioid crisis in the U.S. The objective of this study is to expand the current understanding of opioid poisoning through the use of data analytics to evaluate geographic, temporal, and sociodemographic differences of opioid poisoning- related hospital visits in a region of New York State with high opioid poisoning rates.Methods: This retrospective cohort study utilized patient-level New York State all-payer hospital data (2010-2016) combined with Census data to evaluate geographic, patient, and community factors for 9,714 Long Island residents with an opioid poisoning-related inpatient or outpatient hospital facility discharge. Temporal, 7-year opioid poisoning rates and trends were evaluated, and geographic maps were generated. Overall, significance tests and tests for linear trend were based upon logistic regression. Analyses were completed between 2017 and 2018.Results: Since 2010, Long Island and New York State opioid poisoning hospital visit rates have increased 2.5- to 2.7-fold (p<0.001). Opioid poisoning hospital visit rates decreased for men, white patients, and self-payers (p<0.001) and increased for Medicare payers (p<0.001). Communities with high opioid poisoning rates had lower median home values, higher percentages of high school graduates, were younger, and more often white patients (p<0.01). Maps displayed geographic patterns of communities with high opioid poisoning rates overall and by age group.Conclusions: Findings highlight the changing demographics of the opioid poisoning epidemic and utility of data analytics tools to identify regions and patient populations to focus interventions. These population identification techniques can be applied in other communities and interventions. [ABSTRACT FROM AUTHOR]

Objective: To determine whether a single exposure to a Manga comic (Japanese comic art) with multiple messages promoting fruit intake influenced snack selection in minority urban youth. Methods: Fifty-seven youth (mean age 10.8 y; 54% female; 74% black/African American) attending after-school programs in Brooklyn, NY participated in a pilot study in which they were randomly assigned to receive the comic or a non-health-related newsletter. After reading their media, participants were offered a snack and could choose from among healthy/unhealthy options. Secondary outcomes included knowledge, self-efficacy, and outcome expectations related to fruit intake and media transportation. Data were analyzed using regression and paired t test. Results: Comic group participants were significantly more likely to choose a healthy snack, compared to the Attention-control group (odds ratio = 3.6, 95% confidence interval: 1.1-12.1, P = .04). The Comic group reported increases in self-efficacy (P = .04) and greater transportation (immersion into media) (P = .006). Conclusions and Implications: Results suggest Manga comics may be a useful format to promote healthy snack selection in urban minority youth. [ABSTRACT FROM AUTHOR]

Objective: To examine purchase patterns at fast-food restaurants and their relation to restaurant characteristics, customer characteristics, and use of calorie information. Design: Cross-sectional survey. Setting: Fast-food restaurants in New York State. Participants: Adult fast-food restaurant customers (n = 1,094). Variables Measured: Restaurant characteristics (fast-food chain type, presence of calorie labels, and poverty of location), participant characteristics (demographics, calorie knowledge, awareness, and use), and customer purchasing patterns (ordering low-calorie or no beverage, small or no fries, or < 3 items) were used as predictors of total calories purchased. Analysis: Multiple regression. Results: In a regression model including restaurant and customer characteristics, fast-food chain customer age, sex, calorie use, and calorie awareness were independently associated with total calories purchased (all P < .05; model R2 = .19). When 3 purchasing patterns were added to the model, calorie use (P - .005), but not calorie awareness, remained associated with total calories purchased. The 3 purchase patterns collectively accounted for the majority of variance in calorie totals (Δ model R2 = .40). Conclusions and Implications: Promoting use of calorie information, purchase strategies, and calorie awareness represents complementary ways to support lower-calorie choices at fast-food chains. [ABSTRACT FROM AUTHOR]

Background: Elder abuse in long-term care has received considerable attention; however, resident-to-resident elder mistreatment (R-REM) has not been well researched. Preliminary findings from studies of R-REM suggest that it is sufficiently widespread to merit concern, and is likely to have serious detrimental outcomes for residents. However, no evidence-based training, intervention and implementation strategies exist that address this issue. Objectives: The objective was to evaluate the impact of a newly developed R-REM training intervention for nursing staff on knowledge, recognition and reporting of R-REM. Design: The design was a prospective cluster randomized trial with randomization at the unit level. Methods: A sample of 1405 residents (685 in the control and 720 in the intervention group) from 47 New York City nursing home units (23 experimental and 24 control) in 5 nursing homes was assessed. Data were collected at three waves: baseline, 6 and 12 months. Staff on the experimental units received the training and implementation protocols, while those on the comparison units did not. Evaluation of outcomes was conducted on an intent-to-treat basis using mixed (random and fixed effects) models for continuous knowledge variables and Poisson regressions for longitudinal count data measuring recognition and reporting. Results: There was a significant increase in knowledge post-training, controlling for pretraining levels for the intervention group (p < 0.001), significantly increased recognition of R-REM (p < 0.001), and longitudinal reporting in the intervention as contrasted with the control group (p = 0.0058). Conclusions: A longitudinal evaluation demonstrated that the training intervention was effective in enhancing knowledge, recognition and reporting of R-REM. It is recommended that this training program be implemented in long-term care facilities. [ABSTRACT FROM AUTHOR]

Objectives: The aim was to conduct a comparative effectiveness research study to estimate the effects on falls, negative affect and behavior, and the associated societal costs of implementing evidence-based education and best practice programs in nursing homes (NHs). Design: A quasi-experimental design, a variant of a cluster randomized trial of implementation research examining transfer of research findings into practice, was used to compare outcomes among three groups of residents in 15 nursing homes per group. Methods: Forty-five NHs participated in one of three conditions: (1) standard training, (2) training and implementation modules provided to facility staff, or (3) staff training and implementation modules augmented by surveyor training. After application of exclusion and matching criteria, nursing homes were selected at random within three regions of New York State. Outcomes were assessed using medical records and the Minimum Data Set (MDS). Results: The main finding was of a significant reduction of between 5 and 12 annual falls in a typical nursing home. While both intervention groups resulted in fall reduction, the larger and significant reduction occurred in the group without surveyor training. A significant reduction in negative affect associated with training staff and surveyors was observed. Net cost savings from fall prevention was estimated. Conclusions: A low cost intervention targeting dissemination of evidence-based best practices in nursing homes can result in the potential for fall reduction, and cost savings. [ABSTRACT FROM AUTHOR]

Objective: To assess the extent to which nutrition education is implemented in selected counties in New York State elementary schools (kindergarten through fifth grade) and explore how nutrition knowledge is presented in the classroom and what factors support it. Design: Cross-sectional, self-administered survey. Setting: New York State elementary schools in selected counties. Participants: New York State elementary school teachers (n = 137). Main Outcome Measures: Hours spent teaching nutrition; nutrition topics, methods of teaching, education resources, and aspects of the school environment that may influence nutrition education. Analysis: Crosstabs with a chi-square statistic and ANOVA. Results: Eighty-three percent of teachers taught some nutrition (9.0 ± 10.5 hours) during the academic year. Teachers taught lessons about finding and choosing healthy food (61%), relationship between diet and health (54%), and MyPyramid (52%) most often. Suburban teachers (12.4 ± 12.5 hours) taught significantly (P = .006) more hours of nutrition than rural teachers (4.2 ± 3.9 hours). Teachers at schools with fewer than 80% nonwhite students taught significantly (P = .02) more (10.4 ±11.4 hours) compared to schools with greater than 80% nonwhite students (5.6 ± 6.4 hours). Conclusions and Implications: Teachers reported that nutrition education is important and that they are willing to teach nutrition. Efforts should be made that support integrated nutrition topics, methods of instruction, and availability of resources. [ABSTRACT FROM AUTHOR]

Abstract: This paper is one of two in a series that reports detailed findings from a larger study that simultaneously explored individual, family and neighborhood level predictors of victimization and offending among youth. The current analysis aims to identify which neighborhood level factors have better predictive power with regard to type of victimization (direct and vicarious measures) and total offending overtime (Wave 1 and Wave 2). Methods: Path analysis was conducted using data from a multi-wave, panel study (N=625) of youth ages 16–19 at Wave 1. A best fitting model was determined showing causal pathways from neighborhood level factors including crime and perception of safety, to direct and vicarious victimization through exposure to violence, and subsequent offending. Findings: Neighborhood crime significantly predicted property victimization. Neighborhood crime and perception of safety significantly predicted vicarious victimization by exposure to violence in the neighborhood. Neighborhood crime and perception of safety were significantly associated with Wave 1 offending. Findings highlight the need for professionals who work with youth to be cognizant of how their environments influence their lives. Prevention and intervention models seeking to create sustainable change among youth should consider mezzo and macro level components that build and strengthen neighborhood capacity through community partnerships. [Copyright &y& Elsevier]

Objective: To determine whether effectiveness of a diet intervention for family members of cardiovascular disease patients varies by participant sex, race/ethnicity, or age because these characteristics have been associated with unique barriers to diet change. Design: Randomized controlled trial. Setting and Participants: University medical center. Healthy adult family members of patients hospitalized with cardiovascular disease (n = 501 ; 66% women; 36% racial/ethnic minorities; mean age 48 years). Intervention: A special screening and educational intervention (SI) vs control intervention (CI) to reduce dietary saturated fat and cholesterol intake throughout 1 year. Main Outcome Measures: Absolute change in MEDFICTS (meats, eggs, dairy, fried foods, fat in baked goods, convenience foods, fats added at the table and snacks) diet score, saturated fat, and dietary cholesterol in the SI vs CI from baseline to 1 year. Analysis: t tests stratified by sex, race/ethnicity, and age group; linear regression. Significance set at P < .05. Results: The SI was effective to improve MEDFICTS score independent of sex, race/ethnicity, and age group (ß = -6.7; P < .001). There was no interaction between the SI and sex (ß = .9; P = .84), race/ ethnicity (ß = -1.1; P = .81), or age group (ß = -.6; P = .89) on change in MEDFICTS score or change in saturated fat or dietary cholesterol intake from baseline to 1 year. Conclusions and Implications: Results support the potential for a hospital-based screening and education program to improve diet in diverse populations of cardiovascular disease patient family members. [ABSTRACT FROM AUTHOR]

Objective: To examine the influence of body mass index (BMI), sex, and race on college students' optimistic bias (OB) concerning the healthiness of their own lifestyles relative to the "average college student" and best friends. Design: Cross-sectional survey. Setting: Large university campus. Participants: College students recruited from first-year classes (1,398 female, 985 male). Variables Measured: Student height, weight, sex, race, and assessments of lifestyle healthfulness for self, best friends, and the "average college student." Analysis: Paired 2-way t tests compared lifestyle ratings for self and others. One-way analyses of variance compared differences between BMI categories. Tukey Honestly Significant Difference tests tested all pair- wise comparisons. Analyses of covariance controlling for BMI scores tested sex and race differences (P < .05). Results: College students in all BMI categories were optimistically biased in comparisons to the average college student. Optimistic bias differences were significantly smaller, however, for self and close friends. Sex and race also influenced the extent and nature of OB judgments. Conclusions and Implications: Optimistic bias may limit students' willingness to adopt and maintain more healthful behaviors. Optimistic bias can be reduced or even eliminated if close friends are specified as comparative targets. Health education campaigns, particularly those using socially normative approaches, should consider the impact of comparative target, sex, and race on OB. [ABSTRACT FROM AUTHOR]

Objective: This paper presents the reliability and validity of a "competing food choice" construct designed to assess whether factors related to consumption of less-healthful food were perceived to be barriers to fruit and vegetable consumption in college freshmen. Design: Cross-sectional, self-administered survey. Setting: An urban public college with a large, diverse student population. Participants: A convenience sample of 408 college freshmen. Variables Measured: A "competing food choice" construct and fruit and vegetable intake. Analyses: Factor analysis, Cronbach α, and correlation coefficients were used to determine the reliability and validity of the construct. Results: Three factors were produced from the factor analysis of the 11-item competing food choice construct: "competitive food" barriers (Cronbach α = 0.73), fruit and vegetable-related "time" barriers (Cronbach α = 0.67), and "quality" barriers (Cronbach α = 0.64). Construct validity assessments revealed significant inverse correlations between fruit and vegetable consumption and competitive food barriers (r = -0.15, p < .01 current and r = -0.25, P < .01 prior) and time barriers (r = -0.12, P < .05 current and r -0.10, P < .05 prior). Conclusions and Implications: This "competing food choice" construct demonstrated satisfactory reliability and construct validity among college freshmen. [ABSTRACT FROM AUTHOR]