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Taxi and for-hire vehicle (FHV) drivers are a predominantly immigrant population facing a range of occupational stressors, including lack of workplace benefits and increasing financial strain from tumultuous industry changes and now COVID-19’s devastating impact. Bilingual research staff surveyed 422 New York City taxi/FHV drivers using a stratified sampling approach in driver-frequented locations to examine drivers’ health and financial planning behaviors for the first time. Drivers lacked health insurance at double the NYC rate (20% vs. 10%). Life insurance and retirement savings rates were lower than U.S. averages (20% vs. 60%, 25% vs. 58%, respectively). Vehicle ownership was a significant predictor of health insurance, life insurance, and retirement savings. Compared to South Asian drivers, Sub-Saharan African drivers were significantly less likely to have health insurance and North African, and Middle Eastern drivers were significantly less likely to have retirement savings. Although most drivers indicated the importance of insurance and benefits

OBJECTIVES: To examine nutrition benefit under-enrollment in Latinx American immigrant families. METHODS: We administered a survey to 100 adults attending a NY Latinx American community serving organization. We used a logistic regression approach to analyze misinformation impact on enrollment, and examined non-enrollment explanations, among participants in whose families a child or pregnant or breastfeeding woman appeared SNAP- or WIC-eligible. RESULTS: Among households (N=51) with ≥1 SNAP-eligible child, 49% had no child enrolled. Reasons included repercussion fears (e.g. payback obligation, military conscription, college aid ineligibility, child removal, non-citizen family member penalties), and logistical barriers. In multivariable regression models, having heard the rumor that SNAP/WIC participation makes unauthorized status family members vulnerable to being reported to the government was associated with an 85% lower enrollment rate (OR 0.15, CI 0.03, 0.94). CONCLUSIONS: Misinformation impedes nutrition benefit participation. A multi-level intervention is necessary to inform potential applicants and providers regarding eligibility criteria and erroneous rumors, along with an informed discussion of the risks versus benefits of using resources, especially as public charge criteria change.

In the U.S. and Canada, Traditional Chinese Medicine (TCM) use has become increasingly common; Chinese immigrants have particularly high rates of TCM use. In this study, we used a cross sectional survey study design to assess the specific types of Traditional Chinese Herbal Medicine (TCHM) used, the concurrent use of TCHM and conventional cancer treatment, and communication with providers about TCHM use, among Chinese immigrant cancer patients in New York City (NYC). We surveyed 114 patients from several community and clinical settings in NYC. The mean age was 63, 59% were female, and 83% originated from mainland China. Breast (18%) and lung (21%) cancer were the most common cancer diagnoses, and 60% were receiving conventional cancer treatment at the time of the survey. 75% reported ever using TCHM since their most recent primary cancer diagnosis. 68% of those who used herbs reported concurrent use of TCHM with conventional cancer treatment. Only 13% of those who used herbs reported sharing TCHM use with a provider, and only 19% reported that a provider had ever discussed TCHM use with them. Our findings demonstrated an alarmingly high rate of concurrent use of TCHM and conventional cancer treatment and low rate of communication with providers about TCHM use. A wide variety of herbs were used, including those with potentially negative interactions with conventional treatment. This study highlights the urgent need for the development of interventions to assist providers and patients in improving communication around this important topic.

Discrimination is associated with poorer mental and physical health outcomes. Taxi drivers have a higher risk of exposure to discrimination and higher rates of chronic conditions. A cross-sectional needs assessment was conducted with a multilingual group of 535 male taxi drivers in New York City. Drivers reporting higher discrimination were more likely to have higher perceived stress and were more likely to have anxiety/depression and chronic pain, adjusting for confounders. Workplace-based interventions designed to help drivers cope with discrimination, stress, and chronic health conditions, interventions to educate the taxi-riding public, and greater attention to these issues from administrative agencies are warranted.

Immigrant taxi drivers in metropolitan cities are exposed to experiences of discrimination and occupation-based health risks. Given the structural differences in health care systems in the United States and Canada, we investigated the differences in reports of discrimination, health conditions and concern about health conditions between taxi drivers in New York City and Toronto, Ontario. Participants were recruited for a taxi driver Needs Assessment Survey as part of a Taxi Network needs assessment project using a street side convenience sampling technique in New York City and Toronto. The matched sample contained 33 drivers from Toronto and 33 drivers from NYC. All Toronto drivers in our sample reported having health insurance while over a quarter of NYC drivers did not have health insurance. Toronto drivers reported greater everyday and workplace discrimination. Drivers in both cities experienced higher rates than average, and reported concern about, major health conditions. We also found preliminary evidence suggesting a relationship between experiencing discrimination and reporting chronic pain. Our findings suggest the need for future research to more closely examine the associations between discrimination and health among the taxi driver population.

Investigators have proposed a "transdiagnostic vulnerability framework" that examines the relationship between smoking and broader emotional factors, including anhedonia, anxiety sensitivity, and distress tolerance. Because smoking and depression are more common in persons living with HIV and AIDS (PLWHA) than in the general population, understanding the relationship between smoking and mental health is critical. The following study aims to characterize levels of clinically significant depressive symptoms and these broader emotional factors as well as the relationship between these factors and smoking-related variables in a sample of PLWHA. This cross-sectional study employed convenience sampling to survey adult clients who attended one of three AIDS service organizations in New York City. The questionnaires assessed sociodemographic and HIV health care variables, tobacco use, and anxiety - and depression-related constructs. 150 PLWHA completed surveys. Among the 118 smokers, the prevalence of clinically depressive symptoms was 53%. Participants with clinically significant depressive symptoms had significantly higher mean anhedonia scores and anxiety sensitivity scores and lower mean distress tolerance total scores compared to participants without clinically significant depressive symptoms (p 0.001). Smoking cessation treatment for persons with co-morbid psychiatric disorders has been suboptimal and treatment for co-morbid mental health conditions tends to align with disorder-specific treatment. Given that PLWHA are a priority population, further research should address how to best tailor interventions to a group with multiple obstacles to successful tobacco cessation.

BACKGROUND: Language barriers can influence the quality of healthcare and health outcomes of LEP patients with cancer. The use of medical interpretation services can be a valuable asset for improving communications in emergency care settings. OBJECTIVE: To evaluate whether a mobile translation application increased call frequency to interpreter services among providers in an Urgent Care Center (UCC) at a comprehensive cancer center and to assess provider satisfaction of the mobile application. RESEARCH DESIGN: Prospective pre-post non-randomized intervention of a mobile translation application with access to an over the phone interpreter (OPI) service at the push of a button and post-study satisfaction survey. SUBJECTS: 65 clinicians working at the UCC in a cancer center in New York City. MEASURES: Mean call frequency to OPI services, tested by the nonparametric Wilcoxon Mann Whitney test, and self-reported provider satisfaction descriptives. RESULTS: The mobile application contributed to increasing the frequency of phone calls to OPI services during the intervention period (mean = 12.8; p = .001) as compared to the pre-intervention period (mean = 4.3), and showed continued use during the post-intervention period (mean = 5.7). Most clinicians were satisfied with the use of the mobile application and access to the OPI services. CONCLUSIONS: The results suggest that mobile application tools contribute to increasing the use and ease of access to language services. This has the potential to improve the quality of communication between medical providers and LEP patients in the delivery of cancer care in urgent care settings.

Background Internet search query trends have been shown to correlate with incidence trends for select infectious diseases and countries. Herein, the first use of Google search queries for malaria surveillance is investigated. The research focuses on Thailand where real-time malaria surveillance is crucial as malaria is re-emerging and developing resistance to pharmaceuticals in the region. Methods Official Thai malaria case data was acquired from the World Health Organization (WHO) from 2005 to 2009. Using Google correlate, an openly available online tool, and by surveying Thai physicians, search queries potentially related to malaria prevalence were identified. Four linear regression models were built from different sub-sets of malaria-related queries to be used in future predictions. The models’ accuracies were evaluated by their ability to predict the malaria outbreak in 2009, their correlation with the entire available malaria case data, and by Akaike information criterion (AIC). Results Each model captured the bulk of the variability in officially reported malaria incidence. Correlation in the validation set ranged from 0.75 to 0.92 and AIC values ranged from 808 to 586 for the models. While models using malaria-related and general health terms were successful, one model using only microscopy-related terms obtained equally high correlations to malaria case data trends. The model built strictly of queries provided by Thai physicians was the only one that consistently captured the well-documented second seasonal malaria peak in Thailand. Conclusions Models built from Google search queries were able to adequately estimate malaria activity trends in Thailand, from 2005–2010, according to official malaria case counts reported by WHO. While presenting their own limitations, these search queries may be valid real-time indicators of malaria incidence in the population, as correlations were on par with those of related studies for other infectious diseases. Additionally, this methodology provides a cost-effective description of malaria prevalence that can act as a complement to traditional public health surveillance. This and future studies will continue to identify ways to leverage web-based data to improve public health.

NURSING STANDARD The ‘theory-practice gap’ is a constant feature in debates about nurse education. Students can feel that the skills lab is a far cry from the hustle and bustle of the hospital ward, and that what they learn in the lecture theatre is not what they experience on placements. Sometimes it seems as if theory or evidence tells them the right way to do things, but that practice in the real world is subject to many constraints: insufficient time or money, or people saying ‘this is the way we have always done it’. Adrian Debney, the practice development nurse at the Queen Elizabeth Hospital King’s Lynn, offers nursing students a solution to help bridge the gap between theory and practice. A few years ago, Mr Debney developed a learning forum that provides weekly teaching sessions for students on placement in a stroke unit. Feedback from these students showed that they enjoyed these opportunities to learn from an experienced specialist. When other students said they were interested in attending the sessions, Mr Debney started a small programme. For example, third-year students were anxious about breaking bad news to patients so Mr Debney organised a workshop to encourage reflection. Since then, he has worked with other specialist nurses and guest speakers, co-ordinating weekly study sessions for students. These are well attended, even though they have been promoted mainly by word of mouth – and by the offer of free sweets. Each session takes account of students’ training needs and learning outcomes. The knowledge and enthusiasm of the speakers help students to see the clinical relevance of what might otherwise seem like dry topics. Speakers draw on their experience and provide examples of particular issues that may arise. The study sessions offer much more than teaching – they are a form of peer support and an opportunity to gain insight into specialist areas of nursing. They assist evidence-based nursing and help to increase students’ confidence. A new development is the increased participation of former service users. The deputy director of nursing also attends and gathers feedback from students. ‘Feedback from the students is very positive,’ says Mr Debney. ‘Many feel able to ask questions that they would not ask in a larger forum of qualified staff. They also value having sessions dedicated solely to learning and reflection. ‘An unexpected extra is being able to mix with other students. Many confide difficulties or personal challenges, and value confidential reflection with an experienced practitioner from outside the ward. ‘The programme has developed to a point where it has become part of the learning culture at the hospital. Several students said the sessions had led to them to consider working here as qualified nurses’ NS