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Patients living with multiple myeloma (MM) have a substantial disease burden and face multiple barriers to care. Building upon our previous research using mixed methods, this focus group research aimed to identify patients' priorities regarding specific social and identity-related needs, map these prioritized needs to the disease journey, and describe patient-generated ideas to improve patient support. Participants noted that patients with MM need a range of emotional, social, and financial support throughout the disease journey. They identified initial MM diagnosis and treatment adherence as two critical points in the MM journey where patients need the most support and assistance. The findings of this research suggest that overall, patients with MM need comprehensive support, ideally from a multidisciplinary team consisting of health care providers, patient advocates, social workers, and psychologists to help patients understand their disease and treatment options, make informed treatment decisions, adhere to treatment, and ultimately reduce their disease burden and improve outcomes. This research revealed that patients with MM need varying types and levels of support, with the most common needs including information on disease and treatment, connections to financial resources and support systems, assistance with navigating insurance options, and transportation and logistical support for medical appointments. [ABSTRACT FROM AUTHOR]

The article discusses the goal of ending the HIV epidemic in the U.S. by increasing preexposure prophylaxis (PrEP) use to at least 50 percent of the estimated 1.2 million people in the country who are at risk for acquiring HIV by 2023. Topics include opportunities and pitfalls in PrEP access, PrEP education for health care providers, and evidence-based implementation approaches.

Background: Hospice care leads to improved patient and family outcomes. Hospice use among older adults with end‐stage kidney disease (ESKD) is markedly lower than among older adults with other serious illnesses, and the majority of those with ESKD who use hospice enroll in the last days of life. Here, our aim was to explore barriers to timely receipt of high‐quality hospice care for older adults with ESKD. Methods: Utilizing a qualitative study design, we conducted a secondary analysis focused on hospice, a theme that we identified in our larger overarching study that involved semi‐structured interviews with 20 nephrologists in the United States focused on treatment decision‐making in older adults with advanced chronic kidney disease. We analyzed the interview transcripts using emergent thematic analysis to develop an understanding of barriers to high‐quality hospice. Results: With a couple notable exceptions, nephrologists voiced general support for the concept of hospice, but few recalled patients of theirs who had received hospice. Nephrologists' interviews revealed two interrelated contributors to the lack of timely access to high‐quality hospice care for seriously ill older adults with ESKD: (1) nephrologists view dialysis and hospice as mutually exclusive models of care; (2) nephrologists feel unsure who should manage hospice care for patients with ESKD. The first contributor was rooted in nephrologists' narrow vision of when to consider hospice (informed, in part, by policy barriers) and, in a couple of cases, strong discomfort with hospice. The second stemmed from nephrologists' belief that neither they nor hospice are adequately prepared to provide hospice care for ESKD. Conclusions: Our findings suggest that, in addition to Medicare policy change, nephrologists need to receive more training in primary palliative care skills including in indications for hospice, initiating conversations about hospice with patients, and collaborating with hospice clinicians to care for these vulnerable patients. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigated HPV vaccination rates and associated factors among 265,554 patients aged 18–26 within a large healthcare system. Alarmingly, only 30% had completed the vaccine series, far below national averages and targets. Significant disparities were found, with males less likely to be vaccinated than females and Black Americans less likely to complete vaccination despite higher initiation rates. Many patients remained unvaccinated despite recent primary care visits, highlighting missed opportunities. Low uptake, particularly among males, and disparities emphasize the urgent need for targeted interventions to improve provider communication and community education around HPV risks and vaccine benefits to increase vaccination coverage in this population. Human papillomavirus (HPV) is a common sexually transmitted infection, with over 40% prevalence in the US. Oropharyngeal cancers (OPCs) driven by high-risk HPV are increasing (up to 90%), with HPV vaccination being the only prevention available. The aim of this study was to investigate HPV vaccination among patients aged between 18 and 26 years old with at least one encounter at a large healthcare system and identify sociodemographic factors associated with vaccine initiation and completion. A cross-sectional retrospective study was conducted between 2018 and 2021, including 265,554 patients identified from the Clinical Data Warehouse. HPV vaccination status by age, sex, race/ethnicity, insurance type, primary care (PCP) visits in the past year, alcohol, tobacco, illicit drug use, and age at vaccination was examined. Overall, 33.6% of females and 25.4% of males have completed the HPV vaccine. Black Americans were 35% more likely to initiate the vaccine than White Americans but were less likely to complete the entire course. Overall, HPV vaccination prevalence was far below the Health People 2030 goal of 80%, especially in young males. This low rate is troubling, since many patients had a PCP visit and remained unvaccinated, which serves as a missed opportunity for vaccination. [ABSTRACT FROM AUTHOR]

Achieving equitable access has been a central goal in healthcare for years; access by low-income Americans is a major concern for policymakers. We examined the differences in post-discharge primary care follow-up visits and 30-day post discharge ER visits across several characteristics. The results suggest that higher housing density, percent minority population, percent unemployed, and percent uninsured point to lower rates of PCP follow-up care and higher rates of post-discharge ER visits. These findings have implications for developing cost-effective programs targeting hospital to PCP communication, especially in densely populated areas. [ABSTRACT FROM AUTHOR]

Cardiovascular (CV) disease is the leading cause of death among women in the United States, making CV risk screening and management a women's health priority. Objectives were to elicit barriers and facilitators to CV risk identification and reduction among women veterans, and iteratively cocreate clinical tools to identify CV risk factors and promote goal-setting for lifestyle changes. We conducted three exploratory focus groups with 21 Veterans Health Administration primary care team members and piloted patient CV screeners with brief interviews with 19 patients from two Veterans Health Administration women's clinics to inform toolkit development. We then conducted two focus groups and one interview for feedback from a total of 12 staff on the proposed toolkit components. Transcripts were summarized, and a matrix analysis was used to synthesize qualitative findings. Provider-identified barriers included difficulties disseminating CV information in clinic, limited patient knowledge, and lack of organized resources for provider communication and available referrals. Women's complex health needs were notable challenges to CV risk reduction. Facilitators included having a single place to track patient CV risks (e.g., an electronic template note), a patient screening worksheet, and aids to complete referrals. Patient-identified barriers included difficulties balancing health, finances, and physical and mental health concerns. Facilitators included resources for accountability and gender-specific information about CV risks and complications. Providers requested easy, accessible tools in the electronic record with gender-specific CV data and resources linked. Patients requested lifestyle change supports, including trustworthy sources vetted by providers. Iteratively eliciting end-users' perspectives is critical to developing user-friendly, clinically relevant tools. CV risk reduction among women veterans will require multilevel tools and resources that meet providers' and women's needs. [ABSTRACT FROM AUTHOR]

Context: Kidney transplant is superior to dialysis for the treatment of end‐stage kidney disease, but accessing transplant requires high patient engagement to overcome barriers. We sought to develop an educational counselling intervention for patients along with their social support networks to help patients access the waiting list. Methods: Utilizing an Intervention Mapping approach, we established a conceptual framework to develop a behavioural intervention that can be reproduced across kidney transplant centres. The approach includes needs assessment, identifying behavioural determinants and process objectives and integrating targeted behavioural change theory. Results: The Intervention Mapping process resulted in the development of a group counselling session, titled Journey to Transplant (JtT). This intervention was designed for kidney transplant candidates along with members of their social support networks and guided by a transplant healthcare professional. The session begins with standardized educational information to improve knowledge and normalize emotional barriers to transplant. This education is followed by a tailored counselling intervention, including the presentation of the individual patient's calculated likely outcomes on the kidney transplant waiting list. Finally, JtT incorporates patient and support network goal setting to address the specific barriers for that patient in accessing kidney transplantation. Conclusion: A systematic Intervention Mapping approach to develop the JtT intervention helps ensure the intervention is efficacious, acceptable and feasible for transplant centres to implement. JtT engages the patient's social support network, targeting known barriers to transplant and utilizing established behaviour change theory to motivate concrete actions to improve the likelihood of kidney transplantation. Patient or Public Contribution: This study includes a patient and family advisory committee comprised of kidney transplant candidates and their family members to guide the final language and content of the intervention guide, and the conduct of the implementation and pilot testing of the intervention. However, patients and family members were not involved in the intervention mapping development process itself described in this manuscript, which was informed by focus group data from patient and family study participants. [ABSTRACT FROM AUTHOR]

The article offers a perspective on the attainability or desirability of the aspirational goal of healthiest nation that requires a culture change in all aspects of society. It identifies implications of striving to become the healthiest nation including promotion of the concepts of otherness and inequity and self-defeat by creation of a false sense of achievement and complacency. Emphasis is given on the need to know the limitations of health and to strive for continuous health maintenance.

The article discusses the highlights of the meeting conducted by the American Society of Health-System Pharmacists' (ASHP) Commission on Goals held in Bethesda, Maryland on March 12, 2024. Topics mentioned include the transformation of primary care delivery through innovative business models and technological advancements, the importance of leveraging the interprofessional workforce by optimization of equitable access to medical care, and other themes of the event.

Background: During October 2016 through May 2018, a learning community was convened to focus on policies and programs to increase access to the full range of contraceptive options for women of reproductive age. The Increasing Access to Contraception (IAC) Learning Community included 27 jurisdictions, with teams from each jurisdiction consisting of state health department leaders, program staff, and provider champions. At the kick-off meeting, teams from each jurisdiction created action plans that outlined their goals. Methods: We contacted jurisdictions during May–June 2019, 1 year after the learning community ended, and invited them to complete a post-assessment of goal achievement and sustainment through semi-structured interviews over the telephone or via email. Results: Follow-up information was collected from 26 jurisdictions (96%) that participated in the learning community. The teams from these jurisdictions had created 79 total goals. At the time of the learning community closing meeting in May 2018, 35 goals (44%) had been achieved. Three jurisdictions achieved all their goals by the close of the learning community. At the time of the post-assessment 1 year later, jurisdictions were sustaining efforts for 69 (87%) of the total goals. In every jurisdiction, work on at least one goal that originated in the learning community was sustained. Conclusions: The jurisdictions that participated in the IAC Learning Community continued the work of their action plan goals 1 year after the formal closure of the learning community, indicating sustainability of the learning community activities, beyond what jurisdictions accomplished during formal participation. [ABSTRACT FROM AUTHOR]

Purpose: This article reviews the missions of the U.S. Department of Veterans Affairs (VA) and the evolution of its electronic health record (EHR), the Veterans Health Information Systems and Technology Architecture (VistA). This system, along with its clinical graphical user interface the Computerized Patient Record System, form a key link in VA health care. A Veteran who receives healthcare through the VA can have their EHR accessed by clinicians at any VA healthcare facility across the United States and its territories. Data aggregated daily at a corporate data warehouse supports VA quality improvement and research. Organizing Construct: Serving over 9 million Veterans, the VA is one of the largest integrated healthcare systems in the United States. It has been a leader in the development and use of healthcare informatics, EHR, and big data analytics for over 30 years. Nurses engaged in major roles in the evolution of these developments. Conclusions: With over 500 nurses as members, the Office of Nursing Informatics' Field Alliance demonstrates the VA's continuing commitment to fostering nursing informatics. The commitment includes investment by the VA to develop nursing informaticists from among its own staff. Clinical Relevance: Exemplars of the impact of nursing informatics are shared. Future directions include an EHR that begins during military service and follows the Veteran into VA health care. [ABSTRACT FROM AUTHOR]

This article explores the gap between what Americans say we believe with respect to spending on child health and what we actually do, which falls short of norms in other developed countries. Three possible reasons are identified: a lack of information about the effectiveness of government programs affecting child health, the idea that "investments" in child health should pay for themselves, and ideological preferences that prioritize other goals and that may themselves be rooted in this country's racial history. These factors are not mutually exclusive, and all may be at play simultaneously. [ABSTRACT FROM AUTHOR]

Imagine practicing medicine without all the administrative burdens related to billing insurance. Here's how one physician made the switch. [ABSTRACT FROM AUTHOR]

Whereas advocacy was once the driving force for U.S. public support for HIV drug development and access, the nation's response to the global epidemic is now shaped by austerity. Extending past scholarship about the role of advocates and governments in support of drug development and access around the world, in this article I identify key shifts in U.S. public sector support over the past 40 years. During the early years of the AIDS epidemic, the U.S. government and civil society expedited drug development for antiretroviral therapy (ART). After the turn of the century, a new wave of advocacy expanded access for ART, including to low- and middle-income countries through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). On the heels of these accomplishments, advocates and governments set an ambitious agenda to 'End AIDS' by 2030. However, progress toward this goal has been limited by a new era of austerity, as demonstrated by U.S. government spending on HIV. [ABSTRACT FROM AUTHOR]

The article examines the goals outlined in the National Strategy for the COVID-19 Response and Pandemic Preparedness released by the administration of U.S. President Joseph Biden on January 21, 2021. Topics discussed include the strategies employed by the government to restore public trust such as establishing a national response structure that offers data tracking and public health campaigns, importance of data in the vaccination effort, and government efforts to expand emergency relief.

Background: Healthy People 2020 has made achieving health equity one of its overarching goals; another goal is increasing the number of accredited local agencies that have Community Health Improvement Plans (CHIPs). Community Health Improvement Plans are meant to serve agencies as guiding documents for multiple years. Objectives: This study investigates the prevalence with which health disparities are addressed within CHIPs and the specific health disparities targeted by these objectives. Methods: Researchers analyzed 4,094 objectives from CHIPs of 280 local Public Health Accreditation Board (PHAB)-accredited and nonaccredited public health agencies in the United States. Results: Despite the PHAB's focus on addressing health equity, not all PHAB-accredited agencies addressed health disparities (85.4% of CHIPs analyzed). However, more accredited than nonaccredited agencies (73.9%) contained at least one objective focused on health disparities. Discussion: Findings indicate that if health equity is truly a goal of national initiatives, agencies' planning documents (e.g., CHIPs) can do a better job addressing commonly ignored populations. [ABSTRACT FROM AUTHOR]

Each decade since 1979, the Healthy People initiative establishes the national prevention agenda and provides the foundation for disease prevention and health promotion policies and programs. Law and policy have been included in Healthy People objectives from the start, but not integrated into the overall initiative as well as possible to potentially leverage change to meet Healthy People targets and goals. This article provides background on the Healthy People initiative and its use among various stakeholder groups, describes the work of a project aiming to better integrate law and policy into this initiative, and discusses the development of Healthy People 2030 — the next iteration of health goals for the nation. Lessons from the preliminary stages of developing Healthy People by the HHS Secretary's Advisory Committee (Committee) on National Health Promotion and Disease Prevention Objectives for 2030 and a Federal Interagency Workgroup will be included. Efforts by the Committee focused on the role of law and policy as determinants of health and valuable resources around health equity are also shared. Finally, the article discusses ways that law and policy can potentially be tools to help meet Healthy People targets and to attain national health goals. [ABSTRACT FROM AUTHOR]

The authors explore how nurses can contextualize the United Nations 17 Sustainable Development Goals within their daily practice and create holistic plans of care for patients, families, communities, and nations. While health care often focuses on acute or chronic illness, the elements necessary for good health are far more complex than we tend to recognize. Florence Nightingale understood this complexity and wrote extensively on the myriad social and environmental factors that influence well-being. Today these factors are termed "health determinants" and undergird the United Nations 17 Sustainable Development Goals (SDGs). This article explores how nurses can contextualize the SDGs within their daily practice and create holistic plans of care for patients, families, communities, and nations. [ABSTRACT FROM AUTHOR]

The American Academy of Social Work and Social Welfare (AASWSW) identified 12 Grand Challenges of Social Work to unify the profession with focused research, practice and policy applications for the most pressing social issues. Virtual Reality (VR), specifically three-dimensional immersive computer-generated environments, has a history of research and applications to address social and behavioral problems. VR is becoming more readily available, as the technology is becoming more common in mainstream platforms such as mobile technology. While social work interventions are often tailored for vulnerable populations that may not have access to VR computing, it appears that virtual reality is gaining accessibility with these advances. Within the framework of the 12 Grand Challenges of Social Work, researchers from three social work virtual reality laboratories in the United States, Texas State University, the University of Houston, and the University of Alabama, review applications previously tested and currently in development to focus future research and intervention in social work practice. [ABSTRACT FROM AUTHOR]

The United States (US) federal government allocates hundreds of billions of dollars to provide resources to Americans with disabilities, older adults, and the poor. The American Community Survey (ACS) influences the distribution of those resources. The specific aim of the project is to introduce health researchers to Public Use Microdata Sample file from 2009 to 2011. The overall goal of our paper is to promote the use of ACS data relevant to disability status. This study provides prevalence estimates of three disability related items for the population at or over the age of 15 years who reside in one of the continental states. When population weights are applied to the 7,198,221 individuals in the sample under analysis, they are said to represent 239,641,088 of their counterparts in the US population. Detailed tabulations by state (provided as Microsoft Excel® spreadsheets in ACS output) clearly show disability prevalence varies from state-to-state. Because analyses of the ACS data have the ability to influence resources aiding individuals with physical mobility challenges, its use should be promoted. Particular attention should be given to monetary allocations which will improve accessibility of the existing built environment for the individuals with mobility impairment. [ABSTRACT FROM AUTHOR]

Suboptimal vaccination rates are a significant problem in many countries today, in spite of improved access to vaccine services. As a result, there has been a recent expansion of research on how best to communicate about vaccines. The purpose of the present article is to provide an updated review of published, peer-reviewed empirical studies that examined the effectiveness of gain versus loss framing (i.e., goal framing) in the context of vaccine communication. To locate studies, we examined the reference list from the previous meta-analytic review (O’Keefe & Nan, 2012), and we conducted systematic searches across multiple databases. We included 34 studies in the qualitative synthesis. The relative effectiveness of goal-framed vaccine messages was often shown to depend on characteristics of the message recipient, perceived risk, or situational factors, yet most effects were inconsistent across studies, or simply limited by an insufficient number of studies. Methodological characteristics and variations are noted and discussed. The review points to several directions concerning moderators and mediators of framing effects where additional rigorous studies would be needed. [ABSTRACT FROM PUBLISHER]

Global disparities in the quantity, distribution, and skills of health workers worldwide pose a threat to attainment of the Sustainable Development Goals by 2030 and deepens already existing global health inequities. Rwanda and other low-resource countries face a critical shortage of health professionals, particularly nurses and midwives. This article describes the Human Resources for Health (HRH) Program in Rwanda, a collaboration between the Ministry of Health of Rwanda and a U.S. consortium of academic institutions. The ultimate goal of the HRH Program is to strengthen health service delivery and to achieve health equity for the poor. The aim of this article is to highlight the HRH nursing and midwifery contributions to capacity building in academic and clinical educational programs throughout Rwanda. International academic partnerships need to align with the priorities of the host country, integrate the strengths of available resources, and encourage a collaborative environment of cultural humility and self-awareness for all participants. [ABSTRACT FROM AUTHOR]

Background and aims Contingency management (CM) is one of the most effective behavioral interventions to promote drug abstinence, but availability of this treatment is limited. We evaluated the efficacy and acceptability of internet-based CM relative to an internet-based monitoring and goal-setting control group in a nationwide sample of cigarette smokers. Design Randomized controlled trial with 3- and 6-month follow-ups. Setting United States. Participants Smokers ( n = 94) from 26 states were enrolled (mean age 36, 56% female). Intervention and comparator Participants were randomized to earn financial incentives (up to $480 over 7 weeks) based on video-verified abstinence using breath carbon monoxide (CO) output ( n = 48; abstinent contingent group, AC), or based on submitting CO samples ( n = 46, submission contingent, SC). Both groups also received the same CO-based goals. A $50 deposit was required in both groups that could be recouped from initial earnings. Measures The primary outcome was point prevalence at week 4. Secondary outcomes were point prevalence at the 3- and 6-month follow-ups, percentages of negative CO samples, adherence to the CO sampling protocol, and treatment acceptability ratings on a 0-100-mm visual analog scale. Findings Abstinence rates differed at 4 weeks between the AC (39.6%) and SC (13.0%) groups [odds ratio (OR) = 4.4, 95% confidence interval (CI) = 1.6-12.3], but not at the 3- (29.2% AC and 19.6% SC, OR = 1.7, 95% CI = 0.6-4.4) or 6- (22.9% AC and 13.0% SC, OR = 2.0, 95% CI = 0.7-5.9) month follow-ups. During the two main treatment phases, there were significant differences in negative COs (53.9% AC and 24.8% SC, OR = 3.5, 95% CI = 3.1-4.0; 43.4% AC and 24.6% SC, OR = 2.3, 95% CI = 1.6-3.4). Adherence to the CO submission protocol was equivalent (78% AC and 85% SC, difference = 7.0%, 95% CI = −10.3 to 23.8 %, F < 1, P = 0.39). The lowest acceptability ratings were for the items assessing the deposit, whereas the highest ratings concerned the ease of the intervention, the graph of CO results, and earning money. Conclusions A contingency management/financial incentive program delivered via the internet improved short-term abstinence rates compared with an internet program without the incentives. [ABSTRACT FROM AUTHOR]

This paper examines the importance and increasing need for health care practitioners to develop cultural competence in an effort to engage patients in their care to minimize the health disparities that are found in predominately ethnic minority populations. Although Meaningful Use requires data collection related to race and ethnicity, there is no evidence to support that the data is being used to engage patients in a culturally competent way. Lessons learned from the field of education regarding strategies used to develop cultural competence in the teaching profession can be applied in the health care field. This paper argues that cultural competence and patient engagement are clearly linked. [ABSTRACT FROM AUTHOR]

The article looks at approaches in fulfilling the health equity targets set by the National HIV/AIDS Strategy for the U.S. to benefit minority communities. Topics discussed include factors that could cause differences in HIV rates among communities like poverty rates, education levels and assortative sexual-partner selection, and recommended solutions like cross-agency partnerships among federal agencies and expand awareness of HIV status among minority people with the virus.

The article discusses the possibility that bipartisan health care reform can be achieved in America as of 2017, and it mentions efforts to repeal and replace the U.S. Patient Protection and Affordable Care Act, as well as information about the health policy-related priorities of Democrat and Republican state legislators. U.S. surveys are examined, along with goals regarding medical care cost reductions and limits on government involvement in health care.

In July, 2010, President Barack Obama released the National HIV/AIDS Strategy (NHAS). The NHAS set forth ambitious goals for the year 2015. These goals were potentially achievable had the appropriate level of resources been invested; however, investment at the necessary scale has not been made and the 2015 goals now may well be out of reach. Therefore, we propose that an updated NHAS be developed with goals for the year 2020 clearly articulated. For the purposes of fostering discussion on this important topic, we propose bold yet achievable quantitative 2020 goals based on previously published economic and mathematical modeling analyses. [ABSTRACT FROM AUTHOR]

Health reform is bringing about changes in the healthcare environment, but an equally significant transformation is occurring in science with the sequencing of the human genome and the increasing role of personalized medicine in the delivery of new cancer therapies. These changes directly affect the ability of hospitals to provide value-based, state-of-the-art care and represent major strategic decisions that must be made by management. In the United States, an estimated 85% of cancer patients receive care in community settings, but patients' outcomes are often not equivalent to those achieved in academic health centers. Care of cancer patients in the community is often fragmented, as most oncologists are in private practice and have limited access to formal mechanisms for coordinating care across specialties or with primary care physicians. Furthermore, genetic analysis, advanced diagnostic tests, and clinical trials are not always available to patients in these settings. The evolution of cancer care requires a reconfiguration of processes and investment in new services. In response, the National Cancer Institute launched the Community Cancer Centers Program in 2007 as a public-private partnership with 16 community hospitals. This article draws on the results of an external evaluation of the pilot program and assesses the role of such a partnership as a means of facilitating the translation of the developing science to the community setting, with reference to the role of management in the implementation of such partnerships. [ABSTRACT FROM AUTHOR]

The Centers for Medicare & Medicaid Services will test integrated financing for Medicare and Medicaid services through two models in the Financial Alignment Demonstration, a capitated model and a managed fee-for-service model. The goal of integrating financing is to better align incentives to efficiently deliver needed services to Medicare-Medicaid enrollees. This article discusses the characteristics of the models, what integrated financing means under each model, how savings may be achieved, challenges to implementation, and the potential for long-term reform and integrated payment. [ABSTRACT FROM AUTHOR]

The quality of health care is measured today using performance measures that calculate the percentage of people whose health conditions are managed according to specified processes or who meet specified treatment goals. This approach has several limitations. For instance, each measure looks at a particular process, risk factor, or biomarker one by one, and each uses sharp thresholds for defining "success" versus"failure." We describe a new measure of quality called the Global Outcomes Score (GO Score), which represents the proportion of adverse outcomes expected to be prevented in a population under current levels of care compared to a target level of care, such as 100 percent performance on certain clinical guidelines. We illustrate the use of the GO Score to measure blood pressure and cholesterol care in a longitudinal study of people at risk of atherosclerotic diseases, or hardening of the arteries. In that population the baseline GO Score was 40 percent, which indicates that the care being delivered was 40 percent as effective in preventing myocardial infarctions and strokes as our target level of care. The GO Score can be used to assess the potential effectiveness of different interventions such as prevention activities, tests, and treatments. [ABSTRACT FROM AUTHOR]

The authors focus on palliative care as a paradigm of care that expands the traditional model of treatment to include suffering associated with life-threatening illness. They reflect on the similarities and differences of palliative and hospice care as well as the rising demand for such care in the U.S. and the world. The role of advance practice nurses in palliative care is examined together with an exemplary action plan implemented in the state of Maryland within the context of cancer care.

The Department of Health and Human Services (HHS) recently unveiled the most comprehensive federal commitment yet to reducing racial and ethnic health disparities. The 2011 HHS Action Plan to Reduce Racial and Ethnic Health Disparities not only responds to advice previously offered by stakeholders around the nation, but it also capitalizes on new and unprecedented opportunities in the Affordable Care Act of 2010 to benefit diverse communities. The Action Plan advances five major goals: transforming health care; strengthening the infrastructure and workforce of the nation's health and human services; advancing Americans' health and well-being; promoting scientific knowledge and innovation; and upholding the accountability of HHS for making demonstrable progress. By mobilizing HHS around these goals, the Action Plan moves the country closer to realizing the vision of a nation free of disparities in health and health care. [ABSTRACT FROM AUTHOR]

Thirty years ago, the Centers for Disease Control and Prevention reported the first cases of AIDS in the United States. Since then, more than half a million Americans have died of AIDS, and 1.1 million people are currently living with HIV in the United States. In an attempt to reinvigorate the domestic response to the HIV epidemic, the Obama administration developed and released the National HIV/AIDS Strategy for the United States (NHAS). The NHAS has 3 focus areas: reducing new infections, improving access to care and health outcomes, and reducing HIV-related disparities. With ambitious five-year targets set for each goal, the NHAS requires significant fiscal investment to achieve its desired impact on the domestic HIV epidemic. [ABSTRACT FROM AUTHOR]

This 2009 survey of primary care doctors in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States finds wide differences in practice systems, incentives, perceptions of access to care, use of health information technology (IT), and programs to improve quality. Response rates exceeded 40 percent except in four countries: Canada, France, the United Kingdom, and the United States. U.S. and Canadian physicians lag in the adoption of IT. U.S. doctors were the most likely to report that there are insurance restrictions on obtaining medication and treatment for their patients and that their patients often have difficulty with costs. We believe that opportunities exist for cross-national learning in disease management, use of teams, and performance feedback to improve primary care globally. [ABSTRACT FROM AUTHOR]

Haiti lacks health programmes and facilities for kidney disease. However, Brown, Remillard, and their Haitian colleagues know that screening, a few more machines, and training will not solve Haiti's kidney disease crisis by themselves. [Extracted from the article]

The author shares some lessons learned concerning the Executive Order signed on July 10, 2019 and the goals set forth by the U.S. Department of Health and Human Services. Topics mentioned include a transition from managing kidney disease to promoting kidney health, the American Society of Nephrology Kidney Week in October 2019, and exposure of future generations of registered nurses and advanced practice registered nurses to nephrology nursing.

The arts—and the arts and culture sector—offer fertile ground for achieving a culture of health in the United States. The arts and artists are agents of change and can help enable this vision and also address the most critical public health issues we are contending with, including COVID-19 and racism. The arts provide means for engaging dialogue, influencing behaviors, disrupting paradigms and fueling social movements. The arts uncover and illuminate issues. They engage us emotionally and intellectually. They challenge assumptions. They call out injustice. They drive collective action. They heal—making arts + public health collaboration very relevant in this historic moment. In this special Health Promotion Practice supplement on arts in public health, you'll find powerful examples and evidence of how cross-sector collaboration between public health and the arts can advance health promotion goals and impacts, and make health promotion programs not only more accessible to diverse populations but also more equitable and effective in addressing the upstream systems, policies, and structures that create health disparities. You will see how the arts can empower health communication, support health literacy, provide direct and measurable health benefits to individuals and communities, and support coping and resilience in response to COVID-19. This issue itself exemplifies cross-sector collaboration, as it was created through partnership between Health Promotion Practice, the Society for Public Health Education, ArtPlace America, and the University of Florida Center for Arts in Medicine, and presents voices from across the public health, arts, and community development sectors. [ABSTRACT FROM AUTHOR]

An introduction to articles in the issue is presented on topics including the changes made by the U.S. Centers for Disease Control and Prevention (CDC) to manage the Secretary's Minority AIDS Initiative Fund demonstration projects, the effectiveness of the Enhanced Comprehensive HIV Prevention Planning Project planning activities, and increases in high-impact HIV prevention programs for populations disproportionately affected by HIV.

An introduction to the journal is presented in which the editor discusses topics related to the President's Emergency Plan for AIDS Relief (PEPFAR).