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Community violence is a major cause of injury and death in the USA. Empirical studies have identified that some place-based interventions of urban private places, such as remediations of vacant lots and buildings, are associated with reductions in community violence in surrounding areas. The aim of this study was to examine whether routine maintenance and repair of urban public places (e.g., street construction projects) are also associated with reductions in community violence, proxied by violent crime incidents. This staggered adoption difference-in-difference analysis investigated the association between street construction projects and community violence in New York City from 2010 to 2019, divided into 40 calendar quarters. The units of analysis were street-quarters (n = 155,280). Intervention street-quarters were those with completed projects in 2010-2019; control streets were those where projects were scheduled but not completed before 2019. The outcome of community violence was proxied by counts of crime and violence incidents reported to the New York Police Department, within street-quarters. There were 81,904 street-quarters with any community violence incidents (52.7%). We found that street construction projects were associated with a decrease in reckless endangerment (ATT = - 1.3%; 95% CI = - 2.1%, - 0.4%), robbery (ATT = - 3.4%; 95% CI = - 6.1%, - 0.7%), and weapons offenses (ATT = - 1.6%; 95% CI = - 3.0, - 0.08%) occurring on street-quarters. Street construction projects may be yet another type of place-based intervention to reduce community violence., Competing Interests: Declarations. Disclaimer: The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the funders. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication., (© 2025. The New York Academy of Medicine.)

Introduction: Firearm violence is a major public health issue in the USA. There is growing evidence that firearm violence is associated with higher ambient temperatures. The aim of this study was to test competing hypotheses that could explain associations between temperature and firearm violence: temperature-aggression theory and routine activities theory., Methods: We examined associations between elevated daily temperatures and shooting incidents in four US cities: Chicago, Illinois; Cincinnati, Ohio; New York, New York and Philadelphia, Pennsylvania. Temperature was operationalised using two different measures: daily maximum temperature and deviations of the daily maximum temperature from 30-year averages. Generalised linear autoregressive moving average models related temperature to shooting incidence while controlling for seasonal effects., Results: As maximum daily temperature deviates from the expected, there was an association with increased shooting incidents in all four cities (eg, New York: b=0.014, 95% CI=0.011 to 0.017). An interaction term created by multiplying daily maximum temperature by the daily difference of maximum temperature from a 30-year average was also found to have a positive association in all four cities (eg, New York: b=0.020, 95% CI=0.016 to 0.025)., Discussion: These findings accord with previous studies demonstrating a positive relationship between temperature and firearm violence and further support temperature-aggression theory as the primary causal mechanism., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Community violence is a major cause of injury and death in the United States. Empirical studies have identified that some place-based interventions of urban private places, such as remediations of vacant lots and buildings, are associated with reductions in community violence in surrounding areas. The aim of this study was to examine whether routine maintenance and repair of urban public places (e.g., street construction projects) are also associated with reductions in community violence, proxied by violent crime., Method: This staggered adoption difference-in-difference analysis investigated the association between street construction projects and community violence in New York City from 2010-2019, divided into 40 calendar quarters. The units of analysis were street-quarters (n = 155,280). Intervention street-quarters were those with completed projects in 2010-2019; control streets were those where projects were scheduled but not completed before 2019. The outcome of community violence was proxied by counts of crime and violence incidents reported to the New York Police Department, within street-quarters., Results: There were 79,592 street-quarters with any community violence incidents (51.2%). We found that street construction projects were associated with a decrease in reckless endangerment (ATT = -0.013; 95% CI = -0.021, -0.004), robbery (ATT = -0.035; 95% CI = -0.063, -0.007), and weapons offenses (ATT = -0.016; 95% CI = -0.031, -0.001) occurring on street-quarters., Conclusion: Street construction projects may be yet another type of place-based intervention to reduce community violence.

Introduction: This study examined the effectiveness of three physical environmental roadway interventions (enhanced crossings, speed humps, and turn traffic calming) in preventing crashes involving pedestrian and cyclist injury and mortality in New York City., Methods: We examined crashes that occurred within a 100-foot radius of intervention and control sites from 2015 to 2019. We used a staggered difference-in-difference design to estimate the association between each intervention type and pedestrian and cyclist crash outcomes., Results: Estimates for enhanced crossings and speed humps included the possibility of no association with crashes, but estimates for turn traffic calming interventions showed reduced odds of crashes involving pedestrian injury by 16% (OR 0.84, 95% CI 0.74 to 0.95) and crashes involving pedestrian fatality by 80% (OR 0.20, 95% CI 0.08 to 0.47). When stratifying by street segment length as a proxy for areas with high speeding risk, turn traffic calming treatments appeared to be most effective at intersections connected to long street segments., Discussion: Turn traffic calming may substantially reduce crash risks for pedestrians. Municipalities can prioritise this physical environmental intervention, especially at turns near long street segments, as a low-cost intervention with substantial public health impact., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Public transportation use is influenced by perceptions of safety. Concerns related to crime on New York City (NYC) transit have risen following NYC's COVID-19 pandemic state of emergency declaration in 2020, leading to declines in subway ridership. In response, the most recent mayoral administration implemented a Subway Safety Plan in 2022. This study aimed to quantify the effects of the COVID-19 pandemic and the Subway Safety Plan on rates of complaints to and arrests by the New York City Police Department (NYPD) Transit Bureau., Methods: Using publicly available data on complaints and arrests, we conducted interrupted time-series analyses using autoregressive integrated moving average models applied to monthly data for the period from September 2018 to August 2023. We estimated changes in the rates of complaints to and arrests by the NYPD Transit Bureau before and after: (1) the COVID-19 pandemic state of emergency declaration (i.e., March 2020), and (2) the announcement of the Subway Safety Plan (i.e., February 2022). We also examined trends by complaint and arrest type as well as changes in proportion of arrests by demographic and geographic groups., Results: After the COVID-19 pandemic declaration, there was an 84% increase (i.e., an absolute increase of 6.07 per 1,000,000 riders, CI 1.42, 10.71) in complaints to the NYPD Transit Bureau, including a 99% increase (0.91 per 1,000,000 riders, CI 0.42, 1.41) in complaints for assault and a 125% increase in complaints for harassment (0.94 per 1,000,000 riders, CI 0.29, 1.60). Following the Subway Safety Plan there was an increase in the rate of arrests for harassment (0.004 per 1,000,000 riders, CI 0.001, 0.007), as well as decreases in the proportion of arrests for individuals racialized as White (- 0.02, CI - 0.04, - 0.01) and proportion of arrests in the borough of Manhattan (- 0.13, CI - 0.17, - 0.09)., Conclusions: The increased rates of complaints to the NYPD Transit Bureau following the onset of the COVID-19 pandemic remained elevated following the enactment of the Subway Safety Plan. Further evaluation efforts can help identify effective means of promoting safety on public transportation., (© 2024. The Author(s).)

Importance: Interstate gun flow has critical implications for gun violence prevention, as gun transfers across state lines can undermine local gun control policies., Objective: To identify possible gun trafficking routes along interstate highways in the US., Design, Setting, and Participants: This repeated-measures, ecological, cross-sectional study used data from the Bureau of Alcohol, Tobacco, Firearms and Explosives from January 1, 2010, to December 31, 2019, to examine associations between interstate connections via 13 highways that each spanned at least 1000 miles and interstate traced gun transfer counts for the 48 contiguous United States. Analyses were completed in November 2023., Exposures: Characteristics of the origin states and the transportation connections between the destination state and the origin states., Main Outcomes and Measures: The main outcome was the total count of guns used in crimes in each destination state per year that were originally purchased in the origin state. Bayesian conditional autoregressive Poisson models were used to examine associations between the count of guns used in crime traced to interstate purchases and interstate highway connections between origin and destination states., Results: Between 2010 and 2019, 526 801 guns used in crimes in the contiguous 48 states were traced to interstate purchases. Northbound gun transfers along the Interstate 95 corridor were greater than expected to New Jersey (incidence rate ratio [IRR], 2.80; 95% credible interval [CrI], 1.01-7.68) and Maryland (IRR, 3.07; 95% CrI, 1.09-8.61); transfers were similarly greater along Interstate 15 southbound, Interstate 25 southbound, Interstate 35 southbound, Interstate 75 northbound and southbound, Interstate 10 westbound, and Interstate 20 eastbound and westbound., Conclusions and Relevance: This repeated-measures, ecological, cross-sectional study identified that guns used in crimes traced to interstate purchases moved routinely between states along multiple major transportation routes. Interstate gun transfers are a major contributor to gun crime, injury, and death in the US. National policies and interstate cooperation are needed to address this issue.

Background: People living with HIV have long life expectancy and are experiencing more comorbid conditions, being at an increased risk for developing cardiovascular disease (CVD) and diabetes, further exacerbated due to the HIV or inflammatory process. One effective intervention shown to decrease mortality and improve health outcomes related to CVD and diabetes in people living with HIV is increased regular physical activity. However, people living with HIV often fall short of the daily recommended physical activity levels. While studies show that mobile health (mHealth) can potentially help improve people's daily activity levels and reduce mortality rates due to comorbid conditions, these studies do not specifically focus on people living with HIV. As such, it is essential to understand how mHealth interventions, such as wearables, can improve the physical activity of people living with HIV., Objective: This study aimed to understand participants' experiences wearing a fitness tracker and an app to improve their physical activity., Methods: In total, 6 focus groups were conducted with participants who completed the control arm of a 6-month randomized controlled trial (ClinicalTrials.gov NCT03205982). The control arm received daily walk step reminders to walk at least 5000 steps per day and focused on the overall wellness of the individual. The analysis of the qualitative focus groups used inductive content analysis using the theory of planned behavior as a framework to guide and organize the analysis., Results: In total, 41 people living with HIV participated in the focus groups. The majority (n=26, 63%) of participants reported their race as Black or African American, and 32% (n=13) of them identified their ethnicity as Hispanic or Latino. In total, 9 major themes were identified and organized following the theory of planned behavior constructs. Overall, 2 major themes (positive attitude toward tracking steps and tracking steps is motivating) related to attitudes toward the behavior, 2 major themes (social support or motivation from the fitness tracker and app and encouragement from family and friends) related to participant's subjective norms, 1 theme (you can adjust your daily habits with time) related to perceived behavioral control, 2 themes (reach their step goal and have a healthier lifestyle) related to participant's intention, and 2 themes (continuing to walk actively and regularly wearing the fitness tracker) related to participant's changed behavior. Participants highlighted how the mHealth interface with the avatar and daily step tracking motivated them to both begin and continue to engage in physical activity by adjusting their daily routines., Conclusions: Findings from this study illustrate how features of mHealth apps may motivate people living with HIV to start and continue sustained engagement in physical activities. This sustained increase in physical activity is crucial for reducing the risk of comorbid conditions such as diabetes or CVD., Trial Registration: ClinicalTrials.gov NCT03205982; https://classic.clinicaltrials.gov/ct2/show/NCT03205982., (©Gabriella Sanabria, Brady Bushover, Sarah Ashrafnia, Evette Cordoba, Rebecca Schnall. Originally published in JMIR Formative Research (https://formative.jmir.org), 14.09.2023.)

Importance: Firearm injury is a major public health burden in the US, and yet there is no single, validated national data source to study community firearm violence, including firearm homicide and nonfatal shootings that result from interpersonal violence., Objective: To assess the validity of the Gun Violence Archive as a source of data on events of community firearm violence and to examine the characteristics of individuals injured in shootings., Design, Setting, and Participants: This cross-sectional observational study compared data on community firearm violence from the Gun Violence Archive with publicly available police department data, which were assumed to be the reference standard, between January 1, 2015, and December 31, 2020. Cities included in the study (Philadelphia, Pennsylvania; New York, New York; Chicago, Illinois; and Cincinnati, Ohio) had a population of greater than 300 000 people according to the 2020 US Census and had publicly available shooting data from the city police department. A large city was defined as having a population greater than or equal to 500 000 (ie, Philadelphia, New York City, and Chicago). Data analysis was performed in December 2022., Main Outcomes and Measures: Events of community firearm violence from the Gun Violence Archive were matched to police department shootings by date and location. The sensitivity and positive predictive value of the data were calculated (0.9-1.0, excellent; 0.8-0.9, good; 0.7-0.8, fair; 0.6-0.7, poor; and <0.6, failed)., Results: A total of 26 679 and 32 588 shooting events were documented in the Gun Violence Archive and the police department databases, respectively, during the study period. The overall sensitivity of the Gun Violence Archive over the 6-year period was 81.1%, and the positive predictive value was 99.0%. The sensitivity steadily improved over time. Shootings involving multiple individuals and those involving women and children were less likely to be missing from the Gun Violence Archive, suggesting a systematic missingness., Conclusions and Relevance: These findings support the use of the Gun Violence Archive in large cities for research requiring its unique advantages (ie, spatial resolution, timeliness, and geographic coverage), albeit with caution regarding a more granular examination of epidemiology given its apparent bias toward shootings involving multiple persons and those involving women and children.

Importance: Progression of HIV disease, the transmission of the disease, and premature deaths among persons living with HIV (PLWH) have been attributed foremost to poor adherence to HIV medications. mHealth tools can be used to improve antiretroviral therapy (ART) adherence in PLWH and have the potential to improve therapeutic success., Objective: To determine the efficacy of WiseApp, a user-centered design mHealth intervention to improve ART adherence and viral suppression in PLWH., Design, Setting, and Participants: A randomized (1:1) controlled efficacy trial of the WiseApp intervention arm (n = 99) versus an attention control intervention arm (n = 101) among persons living with HIV who reported poor adherence to their treatment regimen and living in New York City., Interventions: The WiseApp intervention includes the following components: testimonials of lived experiences, push-notification reminders, medication trackers, health surveys, chat rooms, and a "To-Do" list outlining tasks for the day. Both study arms also received the CleverCap pill bottle, with only the intervention group linking the pill bottle to WiseApp., Results: We found a significant improvement in ART adherence in the intervention arm compared to the attention control arm from day 1 (69.7% vs 48.3%, OR = 2.5, 95% CI 1.4-3.5, P = .002) to day 59 (51.2% vs 37.2%, OR = 1.77, 95% CI 1.0-1.6, P = .05) of the study period. From day 60 to 120, the intervention arm had higher adherence rates, but the difference was not significant. In the secondary analyses, no difference in change from baseline to 3 or 6 months between the 2 arms was observed for all secondary outcomes., Conclusions: The WiseApp intervention initially improved ART adherence but did not have a sustained effect on outcomes., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Sobriety checkpoints are a form of proactive policing in which law enforcement officers concentrate at a point on the roadway to systematically perform sobriety tests for all passing drivers. We investigated whether sobriety checkpoints unintentionally reduce assaults in surrounding areas., Methods: Exposures of interest were sobriety checkpoints conducted by the Los Angeles Police Department between 2012 and 2017. Comparison units were matched 1:2 to sobriety checkpoints, selected as the same point location temporally lagged by exactly ±168 hours. The outcome was the density of police-reported assaults around the checkpoint location., Results: In mixed effects regression analyses, assault incidence was lower when sobriety checkpoints were in operation compared to the same location ±168 hours [b= -0.0108, 95% CI: (-0.0203, -0.0012)]., Conclusions: Sobriety checkpoints were associated with decreased assault incidence, but estimated effect sizes were small and effects did not endure long after checkpoints ended., Competing Interests: Declaration of Competing Interest We have no conflicts of interest to report., (Copyright © 2023. Published by Elsevier Ltd.)

Introduction: Individual-, school-, and neighborhood-level support and connectedness may help to mitigate against school suspensions, which have profound health and social consequences. Most research on social connectedness and suspension has focused only on school connectedness, and much less is known about the effects of individual social support and neighborhood-level connectedness on suspension., Methods: We examined associations between all three levels of connectedness and suspension in a cross-sectional analysis of a population-based youth sample in Allegheny County, Pennsylvania. The Healthy Allegheny Teen Survey, a county-wide survey of 1813 male and female youth ages 14 to 19, assessed health risk/protective behaviors through random-digit-dialing in 2014. This survey included validated items evaluating each type of support as well as items assessing lifetime history of suspension. Logistic regression models examined associations between suspension and social support, school connectedness, and neighborhood-level cohesion., Results: In fully adjusted logistic regression models examining associations between suspension and each type of support, youth with high social support had 0.38 times the odds of school suspension compared to youth with low social support (95% confidence interval [CI] 0.19-0.74). High levels of school connectedness and neighborhood-level cohesion were also associated with significantly lower odds of suspension (odds ratio [OR] 0.31, 95% CI 0.18-0.53; OR 0.28, 95% CI 0.16-0.47, respectively). Examining all 3 types of support jointly, school connectedness and neighborhood-level cohesion were significantly inversely related to suspension (OR 0.41, 95% CI 0.24-0.71; OR 0.41, 95% CI 0.23-0.74, respectively)., Conclusions: Programs that foster connectedness at the individual-, school-, and neighborhood-level may help reduce school suspension., (Copyright © 2022. Published by Elsevier Inc.)

Improving access to HIV testing among youth at high risk is essential for reaching those who are most at risk for HIV and least likely to access health care services. This study evaluates the usability of mLab, an app with image-processing feature that analyzes photos of OraQuick HIV self-tests and provides real-time, personalized feedback. mLab includes HIV prevention information, testing reminders, and instructions. It was developed through iterative feedback with a youth advisory board ( N = 8). The final design underwent heuristic ( N = 5) and end-user testing ( N = 20). Experts rated mLab following Nielsen's heuristic checklist. End-users used the Health Information Technology Usability Evaluation Scale. While there were some usability problems, overall study participants found mLab useful and user-friendly. This study provides important insights into using a mobile app with imaging for interpreting HIV test results with the goal of improving HIV testing and prevention in populations at high risk.

Purpose: Examine associations between features of the built environment and violence perpetration among male youth., Methods: We enrolled 866 male adolescents, ages 13-19 years, as part of a violence prevention study in 20 lower-resource neighbourhoods in Pittsburgh, Pennsylvania, USA. Exposure to built environmental features was defined using participants' neighbourhood study site. Violence perpetration was measured by three survey items: physical fighting, threatening someone with a weapon, and injuring someone with a weapon. Logistic regression models examined associations between each environmental feature and violence perpetration., Results: Better neighbourhood walkability was associated with significantly lower odds of fighting (adjusted odds ratio (AOR)=0.86, 95% CI 0.76 to 0.99). Alcohol and tobacco outlets were associated with slightly lower odds of violence perpetration (AORs=0.89-0.96)., Conclusions: This work extends previous studies from large urban centres to a mid-sized city context and suggests that walkable neighbourhoods create opportunities for social interactions and may serve as a protective factor in youth violence., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Individual social support is positively related to physical activity participation. However, less is known about how neighborhood-level social structures relate to physical activity participation., Methods: We analyzed 2017 National Health Interview Survey data for adult participants who completed all questions on physical activity and neighborhood cohesion (N = 23,006). Each cohesion question was binary coded (cohesion or not) and used as a predictor individually and for a composite score measuring total social cohesion. We used linear regression to estimate minutes of moderate aerobic activity, and we used logistic regression to estimate the odds of meeting aerobic guidelines (≥150 min/wk), strength guidelines (≥2 d/wk of muscle strengthening exercises), or both guidelines, predicted by the 5 definitions of cohesion (composite cohesion and the 4 questions separately). Models were adjusted for sex, age, race/ethnicity, family-income-to-poverty ratio, education, nativity, language, and neighborhood tenure., Results: Respondents who reported having more social cohesion had 45.0 more minutes of aerobic activity and increased odds of meeting aerobic, strength, and combined guidelines (odds ratio [OR] = 1.22, OR = 1.13, and OR = 1.14, respectively; P < .01 for all). Reporting having availability of help when needed, neighbors to count on, trustworthy neighbors, and close-knit neighbors all resulted in increased odds of meeting aerobic guidelines but not increased odds for meeting strength guidelines in the latter 3 components or combined guidelines for the latter 2 components., Conclusions: Having neighborhood social cohesion or select individual components of neighborhood cohesion are positively related to meeting aerobic, strength, and combined guidelines.