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Background: Hypertension is a significant risk factor for cardiovascular disease, with a higher prevalence among African Americans (AA) than other racial groups. The impact of community-based interventions on managing blood pressure (BP) in AA communities is not fully understood. The purpose of this review was to synthesize literature on community-based physical activity (PA) programs designed to manage BP in AA populations. Methods: We conducted a scoping review by searching 4 databases (PubMed, CINAHL, MEDLINE, and APA PsycInfo) and reference lists of studies. Search terms included community PA, community-based, hypertension, high BP, AA, Black Americans, PA, and exercise. Inclusion criteria were studies (1) conducted in the United States and (2) published in English language from January 2013 to September 2023, with community-based interventions that included PA for BP management among AA aged ≥18 years. Results: Search results yielded 260 studies, of which 11 met the inclusion criteria. BP decreased over time in studies that incorporated PA, faith-based therapeutic lifestyle changes with nutritional education. The duration of the PA interventions varied, with moderate to vigorous PAs implemented for 12 weeks or longer having a greater impact on BP management. Conclusions: Evidence suggests that community-based PA programs can potentially reduce BP among AA. PA programs incorporating faith-based therapeutic lifestyle change with nutritional education appear to reduce BP. Practitioners should consider multicomponent community-based PA initiatives to improve BP outcomes in AA communities. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to examine whether, drawing on the perception of their coaches, the application of the pedagogical model of sport education could be associated with satisfying the basic psychological needs of children from socially vulnerable backgrounds. Method: A 36-session sport education season was implemented within a community program for youths from disadvantaged environments. Three coaches, one researcher, and 31 children aged 9–11 years (17 boys and 14 girls) of diverse ethnicities participated. Qualitative data were obtained through four focus groups conducted during the program in addition to the research diary of the researcher, who played the role of participant observer. Results: The coaches observed a progressive evolution in the satisfaction of the basic psychological needs of competence, autonomy, relatedness, and the need referred to as novelty. Discussion/Conclusion: We may conclude that sport education can be a valuable tool to improve the satisfaction of these needs in children from socially vulnerable backgrounds. [ABSTRACT FROM AUTHOR]

This study, centered around a survey of library directors (N = 83), examines community health programming (CHP) in Michigan's public libraries within the broader context of national CHP initiatives. Reponses indicate that while physical activity classes and food skills programs are popular, there are still challenges to overcome. These findings led us to recommendations for cultivating partnerships that can help CHP grow and flourish. [ABSTRACT FROM AUTHOR]

Volunteers play a crucial role in sport organizations, particularly in the nonprofit context, but there is a need for theoretically informed studies to improve their experience and intentionally develop their skillsets. This study aimed to examine strategies for undergraduate volunteer engagement and management in a community-based sport-for-development (SFD) program. The strategies evaluated in this study were reflective journaling, daily debrief meetings, and autonomy-driven task design and responsibilities, guided by self-determination theory (SDT). Through analysis of semi-structured interviews with volunteers (n = 25) and their reflective journals, findings revealed that these strategies enhanced undergraduate volunteers' experiences by increasing their perceived competence, relatedness, and autonomy. This study highlights the importance of using SDT-aligned strategies to enhance volunteer engagement and program delivery. These findings have implications for student volunteer recruitment and retention, as well as improving the overall effectiveness of SFD organizations. [ABSTRACT FROM AUTHOR]

Adolescents in vulnerable living contexts (e.g., foster care, juvenile justice facilities, and experiencing homelessness) may be at increased risk of adolescent dating violence victimization (ADV) due to unstable environments and trauma exposure. They may also experience different protective factors. Yet, research is limited on ADV in these contexts. This study assessed differences in ADV experiences among adolescents (10–21 years) in vulnerable contexts compared to adolescents at home utilizing data from a sexual health education program serving communities facing health inequities in California. Descriptive analyses compared adolescents in vulnerable contexts (n = 1,951) with those living at home (n = 10,682). Multivariable logistic regression was used to estimate the odds of experiencing past year physical and/or sexual ADV by context, controlling for sociodemographic variables. We also examined two potential protective factors: meaningful communication with a parent/guardian and pro-social friendships. Significantly more adolescents in vulnerable contexts than at home identified as male (65.6% vs. 51.6%), 18 years or older (16.5% vs. 8.7%), non-Hispanic Black or African American (14.4% vs. 5%), and LGBTQ+ (15.3% vs. 10.8%). Among adolescents who dated in the past year, 21% in vulnerable contexts reported experiencing physical and/or sexual ADV, compared to 15% of those at home, and reported lower levels of protective factors. Adolescents experiencing homelessness/unstable housing and those in juvenile justice facilities had greater adjusted odds of ADV compared to adolescents at home (56% and 54% higher odds, respectively). It is critical to address systemic factors, which disproportionately impact the most marginalized and disadvantaged adolescents, in approaches for ADV prevention. [ABSTRACT FROM AUTHOR]

Recent national calls to transform undergraduate science education have centered on engaging students in scientific practices as a means to help them develop deeper insights into science. The three-dimensional framework for science education encapsulates the goals of these national calls by recommending that instructors integrate scientific practices, crosscutting concepts, and disciplinary core ideas throughout their courses. Prior research has found that introductory undergraduate biology exams contain few three-dimensional items suggesting that instructors likely face barriers in meeting the goals of national calls. To better understand these putative challenges, we explored factors potentially associated with three-dimensional alignment. Our generalized linear mixed model indicated that instructors who used three-dimensional items on their exams were more likely to use Bloom's Taxonomy when designing their exams and were more likely to write these items using a constructed-response format. We also found that professional development opportunities did not necessarily change the likelihood an instructor would employ three-dimensional items. We previously identified that few items in our sample fully aligned to scientific practices, making scientific practices the limiting dimension for three-dimensional alignment. Our subsequent analysis here revealed that most biology instructors had exam items that were at least partially aligned to scientific practices. Based on our results, we highlight the significant time and resources that instructors likely need to write and grade constructed-response assessments, suggest that instructors build on items that are mostly aligned to scientific practices to increase their three-dimensional alignment, and propose ways that professional development programs and communities might further support instructors in meeting national calls. [ABSTRACT FROM AUTHOR]

Background: Dance is a promising health resource for older adults, but empirical evidence remains inconsistent. The lack of synthesised evidence regarding program design, dose, and delivery limits understanding of factors influencing participation and health outcomes. This scoping review aimed to map the scope, range, and effectiveness of dance programs for older people, and identify gaps and opportunities for future research and practice. Methods: Searches across five databases (September 2023) identified 148 studies evaluating 116 dance programs (≥4 weeks) for older adults (≥55 years, N = 8060), Dance interventions delivered to clinical groups were excluded. Intervention design and delivery were charted against the TIDieR reporting checklist. Program outcomes including adherence, safety, and positive tests were charted into established taxonomies. Results: Demographic information, program details, and implementation were often insufficiently reported. Participant groups differed by age range, with underserved communities underrepresented. Programs varied extensively in key factors including dose, prospective 'active ingredients', delivery approach, facilitator expertise, and class size. While dance was physically safe, adherence rates in older adults are comparable to other community exercise programs. Less than 40% of health assessments showed positive change, with more consistent benefits to physical endurance, strength, and function, moderate impacts on psychosocial health, and limited benefits to cognitive and brain health, and falls and falls risk. Conclusion: Dance is a meaningful, safe, adaptable, and low-cost health resource for older adults. Key opportunities for advancing research include improved access for underserved groups, program suitability assessments, strategies to support adherence and engagement including theory-informed approaches, and incorporation of participant and practitioner insights. Identification of key 'active ingredients' and dance program factors may improve understanding of causal pathways and mechanisms to optimise engagement and health impacts. Stronger reporting practices will facilitate comparisons across studies and more robust evidence synthesis. This review provides a critical knowledge foundation to guide future approaches in dance for health and offers reporting recommendations. [ABSTRACT FROM AUTHOR]

Background: In Ghana, the use of illegal drugs and alcohol has been classified as endemic. To manage this menace, the Therapeutic Community model for Substance Use Disorders (SUD) was introduced in Ghana about a decade ago as an alternative to other existing strategies. However, the effectiveness of this treatment modality for substance use disorders in Pantang Mental Hospital and Accra Psychiatric Hospital has not been scientifically studied. Objective: This study, therefore, sought to explore the experiences of substance users or residents enrolled in the Therapeutic Community programme toward recovery from substance use disorders. Method: This research employed an explorative-descriptive design. Participants (N = 20) were enrolled purposively sampled and recruited into the study. Face-to-face interviews were conducted using a semi-structured guide and data were analyzed using Colaizzi's descriptive phenomenology data analysis process. Results: Two main themes emerged from the data: "Why I stayed" (Motivation), and "All things are new" (Life transformation). The study pointed out that residents or participants mainly expressed positive experiences in the programme, including experiencing a sense of belongingness, enhanced self-esteem/self-worth, and most importantly, developing hope of a life free of addiction. Conclusion: In conclusion, the study found that participants in the Therapeutic Community (TC) program generally had positive experiences and believed in its effectiveness for recovery. Factors such as a relaxed environment, supportive staff, and interactions with other residents contributed to their positive experience. The study discovered that motivation, a conducive environment for care, structured program activities, and relationships among residents were key factors that motivated participants to stay and actively participate in the therapeutic community program. These factors fostered hope and a sense of belonging, ultimately contributing to their recovery journey. However, participants expressed the need for self-actualization, which they hoped to achieve after completing the program and reintegrating into the community. [ABSTRACT FROM AUTHOR]

The article discusses the use of hierarchical endpoints analyzed using the win-ratio method in deprescribing trials for older adults with multimorbidity. Deprescribing, the process of discontinuing drugs when harms outweigh benefits, has shown potential to improve quality of life and reduce medication burden. The win-ratio method integrates patient priorities into composite outcomes, enhancing statistical power and accounting for competing risks like mortality. This approach can advance deprescribing research by focusing on patient-centered outcomes and improving study design for clinical trials. [Extracted from the article]

Background Methods Results Conclusions Community‐dwelling older adults are at high risk for unmet social service needs. We describe a novel partnership embedding county services case managers in the Emergency Department (ED) to connect older adults to community services alongside their medical care.Setting: A medium‐sized urban ED with 55,000 patient visits a year. Intervention: Case managers from the Franklin County, Ohio Office on Aging (OA) were embedded within the ED. The OA team worked with the ED social work team to identify community‐dwelling older patients, perform an in‐person intake assessment, and initiate needed community services (including home‐delivered meals, emergency response systems, house repairs, and transportation). Program logic model and development are reported in detail.From June to December 2023, there were 7284 ED visits for adults ≥60 years old. Referrals to the OA case manager ranged from 1 to 13 per day. The OA case managers performed 252 full intake assessments on unique patients. The population was 51% men. Only 11% (n = 28) were currently connected to OA services, and of those already connected 29% (n = 8) needed increased services. Of the remaining unconnected patients (n = 224), 8% (n = 20) were not county residents and the OA team connected them with other county OAs. Half 53% (n = 120) were accepting of services and had services from the OA or other community health programs initiated during the ED visit. The OA team made three new Adult Protective Services referrals and one referral to the long‐term care ombudsman. The program did not increase ED length of stay or hospital admission rates.Embedding county service enrollment within a community ED is a cost neutral intervention that reached a population without previous services. Future plans include expansion of the program and evaluation of the program's ability to detect elder mistreatment and self‐neglect. [ABSTRACT FROM AUTHOR]

The study examines community-based breeding schemes as a cost-effective method for enhancing the productivity of indigenous livestock breeds. While such projects offer benefits, their success varies in different locations. Drawing data from Uganda's Teso and Karamoja regions, the research reveals that investing in such projects yields positive outcomes for farmer groups. However, challenges such as limited access to veterinary services, high maintenance costs, and the failure of the exotic breeds to adapt to extreme temperatures and drought conditions hinder project success and continuity. The study emphasises the importance of collective resource mobilisation, effective group governance, and farmer involvement in breed selection to address these issues. It also recommends promoting income-generating activities within the groups, strengthening leadership structures, and fosteringmember commitment to collective efforts. These measures aim to enhance the effectiveness and sustainability of community-based breeding programs. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Discussion Community doulas are perinatal health workers who provide peer education, resource navigation, and support during pregnancy, childbirth, and the postpartum period. Evidence suggests that doulas improve the experience of care, reduce cesarean birth, and improve breastfeeding outcomes. However, people with low incomes cannot access affordable community doula support in most states due to lack of insurance reimbursement. To determine the affordability of Medicaid reimbursement for doula services, there is a need to fill a gap in research that employs real‐world data and a return‐on‐investment (ROI) analysis approach.We conducted a ROI analysis from the healthcare perspective of an enhanced community doula intervention, Best Beginnings for Babies (BBB). Healthcare and program cost data were collected alongside clinical outcomes from a randomized controlled trial of routine maternity care at Boston Medical Center with and without BBB. ROI was calculated as the net healthcare savings divided by the investment costs. Post‐COVID‐19 program costing estimates were also performed.Average healthcare costs per patient were $18,969 for the BBB group compared with $20,121 for routine care, a savings of $1,152. BBB program costs were an average of $971 per person. There was an 18% ROI. Lower costs for the birth hospitalization and NICU stays accounted for the largest areas of savings. Per‐person program costs using proposed MassHealth fees produced a positive return on investment, although 2023 hospital doula program wages and salaries did not.The BBB‐enhanced community doula program was cost‐saving to payers and increased access to doula support for low‐income people. Even with post‐COVID‐19 increases in program costs, analysis demonstrated doula support was still financially feasible. This study should reassure budget‐conscious Medicaid payers that doula services are affordable. [ABSTRACT FROM AUTHOR]

Research on community engagement largely focuses on the potential benefits of such activities for police services, policing as an industry, and the larger community, such as reduced disorder and anti-social behavior as well as increased confidence and trust in police. Absent from this conversation, however, are the officers who voluntarily initiate or participate in community engagement and the significance of these activities to them. To address this gap, this study examines officers’ engagement in community initiatives and what those activities mean to them. This study uses qualitative data from semi-structured interviews with 26 officers of various ranks who voluntarily initiated and/or participated in a community-based program(s) or event(s). A thematic analysis of the data reveals three overarching themes on what community engagement activities bring to or mean to officers: (1) community engagement represents an opportunity to build relationships with community members; (2) community engagement is a welcomed opportunity to feel like officers are helping the community; and (3) community activities contribute to officers’ mental wellbeing. This study demonstrates that community engagement is significant and meaningful to the individual officers involved. Thus, not only does community engagement benefit the police service and community (as per the existing literature), it also has potential benefits for officers. [ABSTRACT FROM AUTHOR]

Background: Due to poorer exercise tolerance, it may be challenging for frail older adults to engage in moderate- or vigorous-intensity exercise. While low-intensity exercise interventions may be more feasible, its effectiveness for such population group remains unclear. We examined the effectiveness and implementation of community-based Baduanjin Qigong, a low-intensity exercise program in older adults with varying frailty status. Methods: A two-arm, multicenter assessor-blind parallel group randomized controlled trial was conducted at three local senior activity centers. Fifty-six community-dwelling older adults with low handgrip strength were randomly allocated to either the intervention (IG) or wait-list control (CG) group. The IG underwent a supervised 16-week Baduanjin exercise program at a frequency of 2–3 × 60 min sessions/week. The CG was instructed to maintain their usual activity and received a monthly health education talk. The primary outcome measures were knee extension strength, vital exhaustion, and fear of falling. Secondary outcome measures include physiological falls risk, handgrip strength, gait speed, timed up and go test, 30-second sit-to-stand, quality of life, depression, and frailty. All outcome measures were assessed at baseline and 4-month follow-up. Results: Overall, there were no statistically significant differences in all outcome measures between CG and IG at 4-month follow-up. However, in exploratory compliance analysis, a statistically significant group x time interaction was found for vital exhaustion (B = -3.65, 95% CI [-7.13, -0.16], p =.047) among participants with at least 75% attendance. In post-hoc within-group comparisons, IG showed improved vital exhaustion by 4.31 points (95% CI [1.41, 7.20], d = 0.60). The average participant attendance rate was 81.3%. No major adverse events occurred, and all participants reported positive experiences with the exercise intervention. Conclusions: Our study demonstrated that Baduanjin is a safe, feasible, and acceptable exercise program that can be successfully implemented in community settings for older adults with varying frailty status. With good adherence, Baduanjin exercise could potentially be effective in alleviating vital exhaustion. However, the effectiveness of Baduanjin on physical performance, psychological measures and frailty in community-dwelling older adults remains equivocal. Trial registration: ClinicalTrials.gov NCT04549103. Registered September 16, 2020. [ABSTRACT FROM AUTHOR]

Simple Summary: Management of stray cats in urban areas is an ongoing challenge in Australia, and many are euthanized, particularly in disadvantaged regions. The Australian Pet Welfare Foundation aimed to assess the impact of a free cat sterilization program in Ipswich, Queensland. Before that intervention, a situational analysis was conducted to evaluate cat and dog ownership behaviours. In a sample of 343 residents from the area, 35% owned cats, and 3% fed strays. Cats were mainly obtained from family or friends and shelters, while 53% of respondents owned dogs, mostly sourced from breeders and family acquaintances. A higher percentage of owned cats (91%; but only 74% for those aged 4 to <12 months) were sterilized compared to owned dogs (78%). Among cat owners, 51% contained their cats all the time and 18% at night. Our findings suggest that community-based sterilization programs targeting both owned and semi-owned cats, and assisting semi-owners in becoming owners, would assist in reducing unplanned litters and the stray cat population. It is also recommended that assistance with cat containment be provided where vulnerable native species are present in urban and peri-urban areas. These insights are crucial for developing effective policies aligned with One Welfare principles. Managing stray cats in urban areas is an ongoing challenge, and in Australia, many are euthanized. Most stray cats are from disadvantaged areas and are under 1 year of age. The Australian Pet Welfare Foundation intended to assess the impact of a free cat sterilization program in an area with high shelter intake of cats in the city of Ipswich, Queensland. The aims of this pre-intervention study were to undertake a situational analysis of cat ownership, semi-ownership and cat caring behaviours, and compare those in the same demographic with dog ownership and caring behaviours relating to sterilization rates, to provide a basis against which to assess the program's effectiveness. In a sample of 343 participants from that area, 35% owned cats and 3% fed stray cats. Cats were predominantly obtained from family or friends (31%) and shelters (20%). More respondents owned dogs (53%), which were most often sourced from breeders (36%) and family acquaintances (24%). More owned cats than owned dogs were sterilized (91% versus 78%). However, only 74% of cats aged 4 to <12 months were sterilized. Cat containment practices varied, with 51% of owners containing their cat(s) at all times, and a further 18% doing so at night. These results suggest the need for community-based programs that focus on sterilizing owned and semi-owned cats, and assisting semi-owners in becoming full owners to reduce stray cat populations and associated negative impacts. This includes assistance with cat containment where vulnerable native species are present. Public understanding of the causes and effective solutions for free-roaming cats, alongside legislative changes, are required to facilitate these efforts. Assistive programs aligned with One Welfare principles are expected to benefit the wellbeing of animals, humans and their environments. [ABSTRACT FROM AUTHOR]

AbstractThe issue of substance use disorders among college students is a growing problem that has been widely studied and reported on in recent years. However, the experiences of black college students in recovery have been largely underrepresented. Although white college students tend to have higher rates of substance use, black college students face unique challenges in accessing resources that support recovery from substance use disorders. This article will highlight the experiences of black college students in recovery, the barriers they face, the importance of collegiate recovery community programs in addressing these barriers, and the need for more programs that cater to these experiences. Through an exploration of literature and current efforts, this article aims to emphasize the significance of collegiate recovery among black college students and a need for the implementation of culturally sensitive and responsive programs at historically black colleges and universities. [ABSTRACT FROM AUTHOR]

Background: This study aims to explore the psychological effects of chronic exercise on mood and well-being in adults. Methods: A qualitative research design was employed, utilizing semi-structured interviews with 20 participants from Iran who engage in regular exercise routines for at least six months. Participants ranged in age from 22 to 58 years and represented a variety of occupations and exercise preferences. Data were collected until theoretical saturation was reached and analyzed using thematic analysis to identify key themes and subthemes related to the psychological effects of exercise. Results: The analysis revealed several key themes: psychological benefits, barriers to exercise, motivational factors, and challenges in sustaining exercise. Participants reported significant improvements in mood, self-esteem, emotional resilience, and cognitive functions such as focus and memory. Barriers to exercise included time constraints, physical barriers, lack of motivation, environmental factors, and financial constraints. Motivational factors were primarily health benefits, personal goals, social influence, psychological benefits, and habit formation. Challenges in sustaining exercise included monotony, physical fatigue, balancing life demands, health setbacks, lack of immediate results, and accessibility issues. Conclusion: Regular physical activity is associated with numerous psychological benefits, including improved mood, reduced anxiety, and enhanced cognitive function. However, barriers such as time constraints, lack of motivation, and financial constraints must be addressed to sustain these benefits. Community-based exercise programs, educational support for instructors, and public health campaigns can help overcome these challenges. Future research should include larger, more diverse samples and explore the long-term psychological effects of chronic exercise. [ABSTRACT FROM AUTHOR]

Aims: Many older persons do not think of themselves as "patients" but as persons wishing to live as actively as possible for as long as possible. However, most health-related quality of life (HRQL) measures were developed for use with clinical populations. The aim of this project was to fill that gap and to develop, for international use, a measure of what matters to older persons as they age and seek to remain as active as possible, Older Persons for Active Living (OPAL). Methods: For content development, interviews about active living were conducted with older persons from Canada, USA, UK, and the Netherlands in English, French, Spanish and Dutch, respectively with subsequent thematic analysis and harmonization. Results: Analyses of transcripts from 148 older persons revealed that active living was a "way of being" and not merely doing activities. Saturation was reached and a total of 59 content areas were identified. After grouping similar "ways" together and after conducting a consensus rating of importance, 19 unique and important "ways" remained. In some languages, formulating was challenging for three of the 19, resulting in changes to two English words and dropping two other words, yielding a final list of 17 "ways of being" with harmonized wording in 4 languages. Conclusion: This study underscores the significance of listening to older adults and highlights the importance of considering linguistic and cultural nuances in measure development. [ABSTRACT FROM AUTHOR]

Traumatic injury remains a significant public health problem, with the burden highest in low-middle income countries (LMICs) and rural areas.1,2 The far-western region of Nepal, which has the lowest human development index in the country, has a high burden of traumatic injuries.3-5 One hospital in the far-western district of Achham, Bayalpata Hospital, cares for the majority of patients with traumatic injuries – most of whom arrive without any pre-hospital care. The absence of a professionalized pre-hospital program, such as an established Emergency Medical Services (EMS) system, necessitates creative strategies to address this gap.6,7 In this context, implementing a trauma-training program for community health responders (CHRs) offers a promising solution, leveraging local resources to improve early-stage trauma care. [ABSTRACT FROM AUTHOR]

Background: An October, 2021 review of Public Health Ontario's COVID-19 guidance for congregate settings such as shelters and long-term care homes demonstrated that this guidance did not include references to ventilation or filtration. In April 2022, an interdisciplinary team with expertise in indoor air quality (IAQ), engineering, epidemiology, community programming and knowledge translation launched a virtual ventilation and filtration consultation program for community spaces in Toronto, Ontario. The program gives people working in community spaces direct access to IAQ experts through 25-min online appointments. The program aims to help reduce the risk of COVID-19 transmission in community spaces, and was designed to help compensate for gaps in public health guidance and action. Methods: Representatives from participating organizations (n. 27) received a link to an online survey via email in April 2023. Survey questions explored the impacts of the program on topics such as: purchase and use of portable air filters; maintenance and use of bathroom fans; and, maintenance and modification of HVAC systems. Survey participation was anonymous, and no demographic information was collected from participants. Results: Representatives from 11 organizations completed the survey (40%). Of those who responded, nine (82%) made changes as a result of the program, with eight (73%) making two or more changes such as purchasing portable air filters and increasing routine maintenance of HVAC systems. Conclusions: When presented with brief access to expert support and tailored plain language guidance, people working in community spaces increased their use of ventilation and filtration strategies for COVID-19 infection prevention and control. [ABSTRACT FROM AUTHOR]

Interventionists are critical components of community-based gang programs. One practice they employ is diffusing or interrupting situations that lead to homicide. How they accomplish this is unclear. This paper contextualizes retaliatory gang homicide interruptions performed by one interventionist within black communities in South Los Angeles over a 24-month period between 2016–2018. Data indicates the interventionist conducted 19 interruptions involving 24 gangs utilizing nine different techniques. Gang dynamics and the triggering events that spurred retaliation shaped the techniques utilized. At least one homicide was prevented as a result of each interruption, though the likelihood is that several were given the tit-for-tat nature of gang homicide. Methodological, theoretical, and practical applications of these and other study findings are provided. [ABSTRACT FROM AUTHOR]

Home-based pediatric palliative and hospice care (PPHC) supports the hundreds of thousands of children with serious illness and complex care needs and their families in the home setting. Considerable variation, however, exists in the provision and quality of home-based PPHC in the U.S. Ensuring equitable, high-quality home-based PPHC for all children requires the evaluation of families' care experiences and assessment of whether these experiences are aligned with their needs and priorities. To evaluate the psychometric properties of the previously developed 23-item home-based PPHC EXPERIENCE Measure for use with families of children receiving home-based PPHC in the United States. Participants included families recruited from the Children's Hospital of Philadelphia, Courageous Parents Network, and several other hospital- and community-based PPHC programs across the U.S. who provide home-based PPHC services. Participants completed the EXPERIENCE Measure at baseline and again at retest. We evaluated the factor structure of the EXPERIENCE Measure, as well as evidence regarding score reliability and validity. Eighty-two family participants completed the baseline and 53 completed the retest questionnaire from 15 states across the U.S. We found evidence for the score reliability and validity of a four-domain EXPERIENCE measure. The EXPERIENCE Measure is a tool with evidence for reliable and valid scores to evaluate family-reported home-based PPHC experiences at the time care is being received. Future work will evaluate the usability (i.e., acceptability, feasibility, and clinical actionability) of EXPERIENCE, including the sensitivity of the instrument to change over time and its impact on real-time clinical actions. [ABSTRACT FROM AUTHOR]

Community-based programs serve a critical need for vulnerable youth and families. In recent years, researchers and practitioners have urged programs to adopt a trauma-informed care (TIC) approach to address adversity in young people's lives. The purpose of this article is to describe the implementation and outcomes of the Trauma Ambassador (TA) Program, a pilot youth leadership program guided by a community-university partnership that utilized a TIC approach in an underserved East North Philadelphia neighborhood. Fourteen youth engaged in interactive trainings to build their understanding of trauma and develop practical tools to support encounters with individuals with trauma histories. Focus groups and individual interviews were conducted to better understand program implementation and outcomes. Rich data emerged that identifies a myriad of ways that youth and their community might benefit from a program like the one described. The program successfully impacted participants, as TAs recognized their own trauma and were motivated to help others who may have trauma histories. This program provided quality youth development experiences, particularly with respect to trauma-informed care, and results support taking a holistic, healing-centered approach to foster well-being for youth and adult mentors. [ABSTRACT FROM AUTHOR]

The Tourette OCD Alberta Network (TOAN) supports mental health therapists to improve the delivery of care to patients with Tourette syndrome (TS) and OCD in Alberta. We evaluated the professional development needs of health care workers to develop a continuing professional development (CPD) webinar series. Health care workers demonstrated an urgent need to access a CPD program grounded in evidenced based knowledge about TS and OCD. While 80% of health care workers treated children with TS and OCD, 50% had no formal training. A curriculum consisting of a series of twelve live, online webinars was developed and delivered between September 2020 and June 2021, covering a range of clinical topics. The webinars were attended on average by 63 attendees, with the outcome of a positive knowledge gain. In future, the educational program will need to reflect the ongoing developing clinical understanding of TS and OCD. [ABSTRACT FROM AUTHOR]

Purpose: Community health needs assessments are required for most state and local public health agencies and non-profit hospitals. Typically based on community health improvement planning models, these assessments encompass overall community health and multiple diseases to inform program planning. National Cancer Institute (NCI)-designated Cancer Centers and community-based cancer-focused programs share the goal of reducing cancer burden in the catchment areas they serve. However, to date, no published models exist to guide cancer-specific needs assessments for a determined geographic area that can inform both public health and research initiatives. The purpose of this article is to outline a cancer needs assessment (CNA) framework and community-engaged, mixed-methods process, along with a case study of how we applied it in Kentucky. Methods: We convened a steering committee of key organizational partners to provide input throughout the process. We developed a conceptual framework of multi-level determinants affecting cancer-related outcomes. We incorporated both quantitative and qualitative data gathered through a variety of means, including a novel application of group concept mapping to guide definition of priorities. Results: The resulting CNA has helped guide strategic planning and priorities for Kentucky's Cancer Action Plan, Markey Cancer Center, state agencies, and community-based organizations. Conclusion: This framework and process can be used collaboratively by cancer center Community Outreach and Engagement offices, public health agencies, oncology programs, and community partners to plan impactful cancer control programs and research in their catchment areas. Universities can also use them to inform the planning of community engagement and health equity research efforts. [ABSTRACT FROM AUTHOR]

Background: Electronic Prospective Surveillance Models (ePSMs) remotely monitor the rehabilitation needs of people with cancer via patient-reported outcomes at pre-defined time points during cancer care and deliver support, including links to self-management education and community programs, and recommendations for further clinical screening and rehabilitation referrals. Previous guidance on implementing ePSMs lacks sufficient detail on approaches to select implementation strategies for these systems. The purpose of this article is to describe how we developed an implementation plan for REACH, an ePSM system designed for breast, colorectal, lymphoma, and head and neck cancers. Methods: Implementation Mapping guided the process of developing the implementation plan. We integrated findings from a scoping review and qualitative study our team conducted to identify determinants to implementation, implementation actors and actions, and relevant outcomes. Determinants were categorized using the Consolidated Framework for Implementation Research (CFIR), and the implementation outcomes taxonomy guided the identification of outcomes. Next, determinants were mapped to the Expert Recommendations for Implementing Change (ERIC) taxonomy of strategies using the CFIR-ERIC Matching Tool. The list of strategies produced was refined through discussion amongst our team and feedback from knowledge users considering each strategy's feasibility and importance rating via the Go-Zone plot, feasibility and applicability to the clinical contexts, and use among other ePSMs reported in our scoping review. Results: Of the 39 CFIR constructs, 22 were identified as relevant determinants. Clinic managers, information technology teams, and healthcare providers with key roles in patient education were identified as important actors. The CFIR-ERIC Matching Tool resulted in 50 strategies with Level 1 endorsement and 13 strategies with Level 2 endorsement. The final list of strategies included 1) purposefully re-examine the implementation, 2) tailor strategies, 3) change record systems, 4) conduct educational meetings, 5) distribute educational materials, 6) intervene with patients to enhance uptake and adherence, 7) centralize technical assistance, and 8) use advisory boards and workgroups. Conclusion: We present a generalizable method that incorporates steps from Implementation Mapping, engages various knowledge users, and leverages implementation science frameworks to facilitate the development of an implementation strategy. An evaluation of implementation success using the implementation outcomes framework is underway. [ABSTRACT FROM AUTHOR]

The paper addresses the often-neglected economic impacts associated with the supply of hydraulic infrastructure in rural and under-serviced communities in developing countries. We rely on a rich panel dataset including 1319 Senegalese rural households collected in 2016 and 2020, during the deployment of the first phase of the Emergency Program for Community Development (PUDC). By combining propensity score matching (PSM), inverse probability weighting, difference-in-differences, and quantile regression, we find that access to piped water improves employment in the agricultural sector but has no significant impact on household expenditures. After controlling for attrition, through PSM, we find that the employment effect operates through access to a greater quantity of water and a reduction in the time women devote to water fetching chores. Moreover, when bundled with complementary infrastructure interventions such as the construction of rural roads, we find that access to water services generates an even higher impact. The quantile analysis shows that non-poor households seem to benefit more from the provided water supply infrastructure compared to poor households. Finally, when comparing the welfare effect of government-led PUDC water supply with that of community-led initiatives, our findings advocate for the widespread implementation of the former for reasons of cost-effectiveness. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionsClinical ImplicationsThe present study is a cross-validation of the Financial Exploitation Vulnerability Scale (FEVS), a measure of contextual risk for financial exploitation.The sample was drawn from both the community and the SAFE program, a service for older adults who have been financially scammed. FEVS was administered within a larger assessment battery. The total score ability to differentiate exploitation groups and its correlates were examined. ROC analysis and logistic regression evaluated the clinical utility of the FEVS to detect exploitation. Results were compared to the initial validation study.FEVS score was significantly higher for those who were exploited and correlated with age. ROC analysis revealed adequate detection of financial exploitation. FEVS total score remained a strong predictor of exploitation when compared to demographic factors and several measures of cognitive functioning.Cross-validation demonstrates strong evidence that the FEVS detects financial exploitation in older adults, beyond the ability of many known risk factors.FEVS is an evidence-based tool for identifying exploitation and is accessible to many professionals working with older adults. Items query contextual factors that allow professionals to support clients with the appropriate standard of care. [ABSTRACT FROM AUTHOR]

Background: Bottle feeding should be avoided since it interferes with optimal breastfeeding and it causes diarrheal-related morbidity and mortality. Despite the WHO's recommendation that children to avoid bottle feeding, it is still widely practiced in developing countries including our country, Ethiopia. Therefore, this study aimed to assess the spatial variations, and determinants of bottle feeding among children aged 0–23 months using the recent demographic and health survey data for Ethiopia. Methods: A secondary data analysis was conducted using the 2019 Ethiopian mini demographic and health survey data. The total weighted sample of 2067 children aged 0–23 months was included in this study. Spatial analysis was done to identify the hotspot areas of bottle feeding among children in Ethiopia. Multivariable multilevel logistic regression was used to identify predictors of bottle feeding. The spatial analysis was done using ArcGIS 10.7 and Sat Scan 9.6 software. Result: The prevalence of bottle feeding among children aged 0–23 months was 21.52% with 95% CI(19.80%, 23.34%). Age of the child from 6–11 months, and 12–23 months age, having secondary and above education [AOR = 2.09; 95%CI; 1.31, 3.32], being from middle and rich household [AOR = 2.14; 95%CI; 1.37, 3.34] and [AOR = 2.30; 95%CI; 1.46, 3.63], and twin birth [AOR = 8.06; 95%CI; 2.87, 22.58] were significant predictors of bottle feeding. Hotspot areas of bottle feeding were observed in Addis Ababa, Dire Dawa, Harari, and Afar regions of Ethiopia. Conclusion: Bottle feeding practice was found to be spatially clustered in Ethiopia. Education, wealth index, parity, and child's age were significant predictors of bottle feeding. Hotspot areas of bottle feeding were observed in Addis Ababa, Dire Dawa, Harari, and Afar regions. Special attention should be directed towards mothers residing in hotspot areas, educated mothers, mothers of multiple births, and mothers from rich households through community education programs focused on child feeding practices to reduce the practice of bottle-feeding in Ethiopia. [ABSTRACT FROM AUTHOR]

The United States has seen increasing trends of maternal mortality in recent years. Within this health crisis there are large disparities whereby underserved and minoritized populations are bearing a larger burden of maternal morbidity and mortality. While new interventions to improve maternal health are being developed, there are opportunities for greater integration of existing evidence-based interventions into routine practice, especially for underserved populations, including those residing in maternity care deserts. In fact, over 80 percent of maternal deaths are preventable with currently available interventions. To spur equitable implementation of existing interventions, the National Heart, Lung, and Blood Institute launched the Maternal-Health Community Implementation Program (MH-CIP) in 2021. In 2023, the National Institutes of Health's Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) initiative partnered with the NHLBI to launch the IMPROVE Community Implementation Program (IMPROVE-CIP). By design, CIPs engage disproportionately impacted communities and partner with academic researchers to conduct implementation research. This commentary overviews the impetus for creating these programs, program goals, structure, and offers a high-level overview of the research currently supported. Lastly, the potential outcomes of these programs are contextualized within the landscape of maternal health initiatives in the United States. [ABSTRACT FROM AUTHOR]

This study aims to figure out how social orientation and community extension initiatives affect core values. Community extension projects are initiatives designed to include communities in activities that enhance their social, economic, and cultural growth. The ability to interact with others successfully in a variety of social situations is referred to as social orientation. The study utilizes a mixed methods approach to collect data from a sample of people who have taken part in social orientation training and community extension initiatives, including a survey and focus group discussions. The findings of this research illustrate how social responsibility education and programs for community engagement may enhance basic characteristics like leadership, volunteerism, and social responsibility. Participants in social orientation training and community extension activities showed a greater understanding of cultural diversity and a stronger feeling of social responsibility. Discussions also showed that they were far better at working in teams and demonstrating empathy for persons from different backgrounds. The study concludes that social orientation training and community extension initiatives can be efficient instruments for promoting basic ideals in both individuals and communities. The findings indicate that these initiatives can contribute to the development of a more unified, understanding, and socially engaged society. The study's significant implications should be noted by lawmakers, students, and community improvement professionals who try to promote beneficial social change through programs that encourage community engagement and values education. [ABSTRACT FROM AUTHOR]

Background: The rising number of children identified with autism has led to exponential growth in for-profit applied behavior analysis (ABA) agencies and the use of highly structured approaches that may not be developmentally appropriate for young children. Multiple clinical trials support naturalistic developmental behavior interventions (NDBIs) that integrate ABA and developmental science and are considered best practices for young autistic children. The Early Start Denver Model (ESDM) is a comprehensive NDBI shown to improve social communication outcomes for young autistic children in several controlled efficacy studies. However, effectiveness data regarding NDBI use in community-based agencies are limited. Methods: This study uses a community-partnered approach to test the effectiveness of ESDM compared to usual early behavioral intervention (EBI) for improving social communication and language in autistic children served by community agencies. This is a hybrid type 1 cluster-randomized controlled trial with 2 conditions: ESDM and EBI. In the intervention group, supervising providers will receive training in ESDM; in the control group, they will continue EBI as usual. We will enroll and randomize 100 supervisors (50 ESDM, 50 EBI) by region. Each supervisor enrolls 3 families of autistic children under age 5 (n = 300) and accompanying behavior technicians (n = 200). The primary outcome is child language and social communication at 6 and 12 months. Secondary outcomes include child adaptive behavior, caregiver use of ESDM strategies, and provider intervention fidelity. Child social motivation and caregiver fidelity will be tested as mediating variables. ESDM implementation determinants will be explored using mixed methods. Discussion: This study will contribute novel knowledge on ESDM effectiveness, the variables that mediate and moderate child outcomes, and engagement of its mechanisms in community use. We expect results from this trial to increase community availability of this model and access to high-quality intervention for young autistic children, especially those who depend on publicly funded intervention services. Understanding implementation determinants will aid scale-up of effective models within communities. Trail registration: Clinicaltrials.gov identifier number NCT06005285. Registered on August 21, 2023. Protocol version: Issue date 6 August 2024; Protocol amendment number: 02. [ABSTRACT FROM AUTHOR]

AbstractAlthough writing is an essential skill for graduate students (in and beyond their degree programs), limited programmatic support exists to help students develop mindsets and habits needed to become effective, scholarly writers. Furthermore, attrition rates are on the rise in the U.S., with many students dropping out at the “all but dissertation” stage. The timing of departure indicates writing may be a widespread issue warranting direct intervention. We developed a campus-wide, six-week learning community and certificate program intended to increase students’ self-efficacy in academic writing, using readings, reflection, and discussion among graduate students. Pilot results from 32 participants indicate that a noncredit-bearing, short course can have positive impacts on graduate students’ emotions about writing, their literature management approaches, awareness of the social context of writing, and their understanding of writing resources and academic voice. Potential exists for this low-budget model to be applied more broadly and thereby improve efforts to retain and support graduate students. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONManual wheelchair skills training programs are novel developments, particularly in the United States. As perceived by the caregivers of participants, this study aimed to examine the long-term impact of the Skills on Wheels program on participants’ occupational engagement and quality of life at home, at school, and in the community. Secondly, this study investigated the caregivers’ perspectives of the program design of Skills on Wheels. This was a qualitative inquiry based upon thematic analyses of semi-structured interviews after participation in a pediatric wheelchair skills training program. The study participants were 9 caregivers whose children participated in this program over the 2021 and 2022 implementation years. Caregivers were given a 10-question semi-structured interview. The five overarching topics included program impact: (i) occupational engagement, (ii) program impact: quality of life factors, (iii) program resources/design, (iv) novelty/importance of program/wheelchair skills training, and (v) desired continued wheelchair skills practice in the future. Results provided tangible feedback to integrate into program design and supported the Skills on Wheels program’s positive value as it relates to impact on quality of life and occupational engagement for participants.Wheelchair skills training programs are important for children with disabilities to fill in service gaps related to community mobility.When developing community programs in general, it is necessary to gain the understanding of the impact on caregivers of children with disabilities.This paper provides insight into how a pediatric wheelchair skills training program is viewed by the caregivers of participating children.Therapists and researchers can see the caregiver impact of programs or training such as that described in this study.Wheelchair skills training programs are important for children with disabilities to fill in service gaps related to community mobility.When developing community programs in general, it is necessary to gain the understanding of the impact on caregivers of children with disabilities.This paper provides insight into how a pediatric wheelchair skills training program is viewed by the caregivers of participating children.Therapists and researchers can see the caregiver impact of programs or training such as that described in this study. [ABSTRACT FROM AUTHOR]

Objective: To assess the feasibility and acceptability of the Oshawa Senior Community Centres (OSCC55 +) virtual programs (VP) in addressing the needs for social connection and interaction for people with dementia (PWD) and their informal caregivers (ICG). Background: During the pandemic, PWD faced increased loneliness and reduced social interaction due to a loss of community programs. The OSCC55 + developed VPs to combat social isolation and provide respite for ICG. These efforts highlight the importance of accessible, and technology-based VPs for maintaining social connectedness for PWD. Methods: A qualitative interpretive research design with PWD (n = 14) interviews and ICG focus group and one-on-one interviews (n = 11). This research explored the lived experiences of PWD and their ICG, examining the feasibility and acceptability of the VPs. Results: The PWD and ICG interviews provided insight into the positive impacts of VP, challenges of VP, program barriers, program facilitating factors, and suggestions for future improvement for the OSCC55 + VPs. Participants highlighted that the VP created an option for them to remain socially connected to their community; while also outlining the positive impact on reducing loneliness, challenges with technology use, the importance of involving younger generations and volunteers, and the need for more culturally inclusive programs. Conclusions: The VP developed by OSCC55 + were perceived as effective and useful for PWD and their ICG, helping to reduce feelings of loneliness and relieving caregiving tasks. These findings suggest that VP can complement in-person programs in the future, offering a hybrid model that leverages the strengths of both approaches to better meet the needs of PWD and ICG. [ABSTRACT FROM AUTHOR]

Background: People with mobility limitations have a disproportionately higher rate of acquiring secondary conditions such as obesity, cardiovascular comorbidity, pain, fatigue, depression, deconditioning, and type 2 diabetes. These conditions often result from poor access to home and community-based health promotion/wellness programs. The aim of this project was to determine the feasibility of delivering an online community membership-based fitness program for individuals with mobility impairments. Methods: For this prospective single-arm study, participants were recruited from members of a community fitness facility that serves people with physical disabilities and chronic health conditions. While all members had access to the online platform, individuals had to opt-in to participate in the research component. Activity options included 16 pre-recorded videos and 9 live exercise classes. During the 8-week program, participants had an opportunity to earn three exercise incentives for reaching certain activity milestones. Enrollment percentage, attendance, and attrition were tracked to assess program feasibility and acceptability. Changes in participant-reported outcomes including self-reported physical activity, psychosocial outcomes, and health-related quality of life (HRQOL) were examined using non-parametric analyses. Results: A total of 146 eligible individuals were screened of which 33 enrolled (22.6%). Two participants withdrew from the study, so a total of 31 were used for analyses. Participants included 29 women and 12 Black people with an average age of 60 (± 15.9) years. Health conditions included stroke, post-polio, arthritis, neuropathy, cerebral palsy, and obesity. Ten participants used an assistive device to get around inside the home. Twenty-six participants (78.8%) completed the online program, and 5 participants earned all 3 participation incentives. The mean number of live Zoom exercise classes attended by the participants was 12.8 (range = 0–43) over 8 weeks; 3 of 31 participants did not attend any classes. On average, participants watched 128 min (range = 0–704 min) of pre-recorded videos; 6 of 31 participants did not view any pre-recorded videos. Self-reported physical activity showed the largest improvement (11.15 units; 95% CI, 3.08, 19.56) with an effect size of 0.51 (Cohen's d). Conclusions: This pilot study of an online membership-based fitness program for people with mobility impairments demonstrated preliminary effectiveness in increasing physical activity and was found to be feasible and acceptable. Feasibility endpoints do indicate potential to improve retention. These results suggest that online delivery of exercise programs can broaden the reach of specialized community fitness programs and is a promising direction for future work and fully powered trials are warranted to assess intervention efficacy. Trial registration: ClinicalTrials.gov, NCT05138809. Registered September 2, 2021, ClinicalTrials.gov PRS: Record Summary NCT05138809. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections are a significant, and growing, public health problem in this country – particularly among youth. Innovative strategies are needed to reduce the community burden of infection. Preliminary studies indicate that individuals involved in the criminal legal system have high rates of infection. While gaps exist in providing screening for incarcerated individuals, there are minimal efforts that have been initiated to screen individuals diverted from incarceration. In this study, we examined the STI risk profile and feasibility of screening for sexually transmitted infections for youth who were attending an alternative sentencing program after arrest for a minor offense. Youth were screened for chlamydia and gonorrhea using urine-based nucleic acid amplification tests. Results: Of the 307 participants engaged in a program providing supportive services for criminal legal system involved youth at the Brooklyn Court House in New York City, 186 agreed to screening for sexually transmitted infections, and 8% were positive for chlamydia, gonorrhea, or both. Conclusions: Screening programs within carceral settings have proven effective in identifying individuals with STIs. However, with policy changes diverting more young people away from incarceration and into community-based programs, innovative programs are needed to identify STIs among youth in these settings. Our findings indicate that it is feasible to conduct venue-based screening in these settings, and, doing so may identify youth in need of treatment and further evaluation. [ABSTRACT FROM AUTHOR]

AbstractThe United States is battling an opioid overdose epidemic, and Veterans are at almost double the risk compared to the general population. Veterans Health Administration (VHA) recognizes the critical role naloxone plays as a risk mitigation strategy in opioid prescribing; however, there was not a standardized process within the Kansas City VA Medical Center’s (KCVAMC) community care program. This quality improvement project included Veterans that received opioids through community care from 2022 to 2023. The Stratification Tool for Opioid Risk Mitigation and chart review were used along with descriptive statistics. Results found 11% (22 of 206) of Veterans were dispensed naloxone within one year prior to receiving their opioid prescription. This data indicated the importance of expanding access to naloxone in Veterans receiving opioids from community care providers. As a result of this data, the KCVAMC implemented an outpatient pharmacy protocol to dispense naloxone to appropriate Veterans that receive an opioid through the community care program. The protocol was initiated on March 29, 2023. From the end of March through 2023, naloxone dispensing for these Veterans increased from 11% to 67%. [ABSTRACT FROM AUTHOR]

Background/Objectives: Population aging poses many challenges to public health, highlighting loneliness and social isolation as severe problems that affect the physical and mental health of older adults. During the COVID-19 pandemic, these became aggravated. The objective of the present study was to assess the prevalence of loneliness and its relationship with social isolation, depression, cognitive deterioration, sleep quality, and the level of physical mobility and functioning of older adults in Health Area 3 of the Region of Murcia. Methods: A descriptive, observational, and cross-sectional study was performed. The inclusion criteria were age ≥ 65, living in Health Area 3 of the Region of Murcia, and not being institutionalized. The following variables were evaluated: sociodemographic variables, loneliness (UCLA scale), social isolation (DUFSS), depression (GDS), cognitive deterioration (Pfeiffer), sleep quality (PSQI), and mobility (Barthel index). A univariate and multivariate regression model was created to examine how the dependent variable was related to the independent variables. Results: A total of 102 older adults participated in the study. Of these, 31.4% perceived unwanted loneliness and 14.7% low social support. The multivariate regression analysis showed that social isolation, geriatric depression, and cognitive deterioration were significant predictors of loneliness. Conclusions: The findings highlight the importance of developing multifaceted interventions that address not only social isolation but also other interrelated factors such as depression, cognitive deterioration, and sleep quality. The strategies should be centered on community programs and support networks. It is fundamental to perform longitudinal studies to better understand the causal relationships between these variables. [ABSTRACT FROM AUTHOR]

Background: Black men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities. To address these critical disparities, the Socioecological Model (SEM) was employed to develop comprehensive recommendations to overcome barriers and implement equitable strategies to engage Black males in PCA GT. Methods: Clinical/research experts, national organization leaders, and community stakeholders spanning multiple regions in US and Africa participated in developing a framework for equity in PCA GT grounded in the SEM. A novel mixed-methods approach was employed to generate key areas to be addressed and informed statements for consensus consideration utilizing the modified Delphi model. Statements achieving strong consensus (> =75% agreement) were included in final equity frameworks addressing clinical/community engagement and research engagement. Results: All societal levels of the SEM (interpersonal, institutional, community, and policy/advocacy) must deliver information about PCA GT to Black males that address benefits/limitations, clinical impact, hereditary cancer implications, with acknowledgment of mistrust (mean scores [MS] 4.57-5.00). Interpersonal strategies for information delivery included engagement of family/friends/peers/Black role models to improve education/awareness and overcome mistrust (MS 4.65-5.00). Institutional strategies included diversifying clinical, research, and educational programs and integrating community liaisons into healthcare institutions (MS 4.57-5.00). Community strategies included partnerships with healthcare institutions and visibility of healthcare providers/researchers at community events (MS 4.65–4.91). Policy/advocacy included improving partnerships between advocacy and healthcare/community organizations while protecting patient benefits (MS 4.57-5.00). Media strategies were endorsed for the first time at every level (MS 4.56-5.00). Conclusion: The SEM-based equity frameworks proposed provide the first multidisciplinary strategies dedicated to increase engagement of Black males in PCA GT, which are critical to reduce disparities in PCA-mortality through informing tailored screening, targeted therapy, and cascade testing in families. [ABSTRACT FROM AUTHOR]

Background: Poor early childhood development (ECD) is a major global health concern that is associated with various adverse outcomes over the lifecourse. Parenting interventions especially during the earliest years of life can benefit ECD. However, there is limited evidence from Kenya about the effectiveness of parenting interventions for improving ECD outcomes especially across rural disadvantaged communities. This paper describes the study protocol for an impact and implementation evaluation of a community-based group parenting program that aims to improve ECD in rural Kenya. Methods: We will conduct a cluster-randomized controlled trial to determine the effectiveness of a parenting program for caregivers of young children in Homabay and Busia counties in Western Kenya. Sixty-four village clusters will be randomly assigned to either the parenting intervention arm or the waitlist control arm with stratification by county. In each village, 10 primary caregivers with a child aged 0–24 months will be enrolled. The parenting program will be delivered through existing peer groups within communities whereby caregivers will receive counseling and psychosocial support to enhance their parenting skills and wellbeing to in turn promote ECD. The intervention curriculum comprises 21 sessions targeting various nurturing care messages, including early learning, responsive caregiving, child nutrition, health, protection, and caregiver mental health. Group sessions are facilitated by a trained volunteer biweekly for a total of 11 months. The primary trial outcome is an overall measure of ECD using the Global Scales of Early Development long form version. Secondary outcomes include various caregiver outcomes (e.g., parenting practices, mental health) and other child outcomes (e.g., socioemotional development, dietary diversity). All outcomes will be assessed at baseline and endline. We will also conduct a qualitative implementation evaluation at endline and interview various stakeholders to assess program fidelity, quality, and sustainability. Discussion: This trial will evaluate the effectiveness of a parenting intervention on ECD and caregiving outcomes and assess program implementation quality as delivered through existing community-based peer groups. This study will provide rigorous evidence that can be used to inform scale-up of this program model that leverages existing community social networks and resources for improving caregivers' parenting skills and promoting ECD in rural Kenya and other similar settings across LMICs. Trial registration: ClinicalTrials.gov #NCT06165315. Registered on December 11, 2023. [ABSTRACT FROM AUTHOR]

Background: The fear of falling is a common issue among older adults that negatively affects physical and psychological aspects of health-related quality of life, regardless of actual fall events. Interventions aimed at reducing fear of falling, independent of falls, may improve older adults' quality of life. This study examined the moderated mediation effect of physical activity in how fear of falling affects health-related quality of life through depression in community-dwelling older adults. Methods: This study used secondary data from the Korea Centers for Disease Control and Prevention's 2019 Community Health Survey. The study included 73,738 adults aged 65 years or older. The researchers used the fear of falling scale, International Physical Activity Questionnaire, Patient Health Questionnaire-9, and EuroQol 5 Dimension as research tools, and performed descriptive statistics, Pearson's correlation coefficient, and SPSS PROCESS macro analysis. The study used the bootstrapping method to assess the adjusted mediating effect by resampling 5,000 times, and determined statistical significance with a 95% confidence interval. Results: In the model in which fear of falling affects health-related quality of life by mediating depression, the moderated mediation effect of physical activity was statistically significant, as the bootstrapping result did not include 0 in the 95% confidence interval (Index of moderated mediation [95% CI] = 0.006 [0.004–0.007], 0.008 [0.006–0.009]). Depression and health-related quality of life impairment decreased as the level of physical activity increased through inactivity, minimal activity, and health promotion activities, as the negative mediating effects decreased. Conclusion: Physical activity reduces depression and improves health-related quality of life by influencing older adults' fear of falling. Community-based programs are needed to encourage and support older adults in maintaining moderate physical activity to manage the depression caused by fear of falling, which is common among older adults, and to improve their health-related quality of life. [ABSTRACT FROM AUTHOR]

Background: Data are needed on differences in community-dwelling populations with bipolar disorder (BP) regarding trust in research and access to care. We characterized community members by lifetime history of bipolar disorder. We hypothesized that those with BP would have less trust in research, visit a health provider less, and participate less in research than those without BP. We also hypothesized that those with BP would be more likely to have a history of marijuana (MJ) use. Methods: A cross-sectional design was used for this analysis. The study population consisted of 12,489 members (78.0%) from the HealthStreet community engagement program who were interviewed by a Community Health Worker about health history and demographics. Results: Among the sample, the rate of BP was 10.6% (n = 1326). Those reporting BP were more likely than those who did not (n = 11,163), to report muscle, bone, and mental health problems, to be younger, female, to have visited the doctor in the past 12 months, to be interested in participating in research, and be current MJ users. Trust did not differ between BP groups. Conclusions: Our analysis found that persons with BP had higher access to care and more interest in research, thus our primary hypothesis was rejected. Our secondary hypothesis, that persons with BP were more likely to have a history of MJ use was upheld. These findings are important because they address a crucial gap in the literature surrounding BP and lay the groundwork for future community-level research. [ABSTRACT FROM AUTHOR]

Background: One-fifth of the global population is infected with soil-transmitted helminths (STH). Mass drug administration (MDA) with deworming medication is widely implemented to control morbidity associated with STH infections. However, surveillance of human infection prevalence by collecting individual stool samples is time-consuming, costly, often stigmatized, and logistically challenging. Current methods of STH detection are poorly sensitive, particularly in low-intensity and low-prevalence populations. Methodology/Principal findings: We aimed to develop a sensitive and specific molecular method for detecting STH DNA in large volumes of soil (20 g) by conducting laboratory and proof of concept studies across field sites in Kenya, Benin, and India. We collected human stool (n = 669) and soil (n = 478) from 322 households across the three study sites. We developed protocols for DNA extraction from 20 g of soil and qPCR to detect Ascaris lumbricoides, Trichuris trichiura, Necator americanus, and Ancylostoma duodenale. Agreement between detection of STH via qPCR, digital droplet PCR (ddPCR), and microscopy-based methods was assessed using the Cohen's Kappa statistic. Finally, we estimated associations between soil characteristics and detection of STH in soil by qPCR, as well as between STH detected in soil and STH detected in stool from matched households, adjusting for soil characteristics. The overall prevalence of STH in soil by qPCR was 31% for A. lumbricoides, 3% for T. trichiura, and 13% for any hookworm species. ddPCR and qPCR performed similarly. However, there was poor agreement between STH detected in soil by qPCR versus light microscopy. Microscopy underestimated the prevalence of A. lumbricoides and N. americanus and overestimated T. trichiura. Detection of an STH species in household soil was strongly associated with increased odds of a household member being infected with that same species. Conclusions/Significance: Soil surveillance for STH has several benefits over stool-based surveillance, including lower cost and higher success rates for sample collection. Considering that delivery of MDA occurs at the community level, environmental surveillance using molecular methods could be a cost-effective alternate strategy for monitoring STH in these populations. Author summary: Soil surveillance to determine soil-transmitted helminth (STH) prevalence in communities with MDA programs could be cost-effective. Though microscopic methods for the detection of STH in soil exist, they are laborious. With recent increased availability of DNA extraction kits and polymerase chain reaction (PCR) reagents, using molecular assays are promising and provide the ability to discriminate between closely related helminth species. In this study, we developed a sensitive and specific molecular method for the detection of STH in large quantities of soil and field-tested it in three countries. [ABSTRACT FROM AUTHOR]

Background: We estimated the short-term effects of an educational workshop and 10-week outdoor walk group (OWG) compared to the workshop and 10 weekly reminders (WR) on increasing outdoor walking (primary outcome) and walking capacity, health-promoting behavior, and successful aging defined by engagement in meaningful activities and well-being (secondary outcomes) in older adults with difficulty walking outdoors. Methods: In a 4-site, parallel-group randomized controlled trial, two cohorts of community-living older adults (≥ 65 years) reporting difficulty walking outdoors participated. Following a 1-day workshop, participants were stratified and randomized to a 10-week OWG in parks or 10 telephone WR reinforcing workshop content. Masked evaluations occurred at 0, 3, and 5.5 months. We modeled minutes walked outdoors (derived from accelerometry and global positioning system data) using zero-inflated negative binomial regression with log link function, imputing for missing observations. We modeled non-imputed composite measures of walking capacity, health-promoting behavior, and successful aging using generalized linear models with general estimating equations based on a normal distribution and an unstructured correlation matrix. Analyses were adjusted for site, participation on own or with a partner, and cohort. Results: We randomized 190 people to the OWG (n = 98) and WR interventions (n = 92). At 0, 3, and 5.5 months, median outdoor walking minutes was 22.56, 13.04, and 0 in the OWG, and 24.00, 26.07, and 0 in the WR group, respectively. There was no difference between groups in change from baseline in minutes walked outdoors based on incidence rate ratio (IRR) and 95% confidence interval (CI) at 3 months (IRR = 0.74, 95% CI 0.47, 1.14) and 5.5 months (IRR = 0.77, 95% CI 0.44, 1.34). Greater 0 to 3-month change in walking capacity was observed in the OWG compared to the WR group (βz-scored difference = 0.14, 95% CI 0.02, 0.26) driven by significant improvement in walking self-efficacy; other comparisons were not significant. Conclusions: A group, park-based OWG was not superior to WR in increasing outdoor walking activity, health-promoting behavior or successful aging in older adults with difficulty walking outdoors; however, the OWG was superior to telephone WR in improving walking capacity through an increase in walking self-efficacy. Community implementation of the OWG is discussed. Trial registration: ClinicalTrials.gov NCT03292510 Date of registration: September 25, 2017. [ABSTRACT FROM AUTHOR]

Background: Mobile Integrated Health-Community Paramedicine (MIH-CP) is a novel approach that may reduce the rural-urban disparity in vaccination uptake in the United States. MIH-CP providers, as physician extenders, offer clinical follow-up and wrap-around services in homes and communities, uniquely positioning them as trusted messengers and vaccine providers. This study explores stakeholder perspectives on feasibility and acceptability of community paramedicine vaccination programs. Methods: We conducted semi-structured qualitative interviews with leaders of paramedicine agencies with MIH-CP, without MIH-CP, and state/regional leaders in Indiana. Interviews were audio recorded, transcribed verbatim, and analyzed using content analysis. Results: We interviewed 24 individuals who represented EMS organizations with MIH-CP programs (MIH-CP; n = 10), EMS organizations without MIH-CP programs (non-MIH-CP; n = 9), and state/regional administrators (SRA; n = 5). Overall, the sample included professionals with an average of 19.6 years in the field (range: 1–42 years). Approximately 75% (n = 14) were male, and all identified as non-Hispanic white. MIH-CPs reported they initiated a vaccine program to reach underserved areas, operating as a health department extension. Some MIH-CPs integrated existing services, such as food banks, with vaccine clinics, while other MIH-CPs focused on providing vaccinations as standalone initiatives. Key barriers to vaccination program initiation included funding and vaccinations being a low priority for MIH-CP programs. However, participants reported support for vaccine programs, particularly as they provided an opportunity to alleviate health disparities and improve community health. MIH-CPs reported low vaccine hesitancy in the community when community paramedics administered vaccines. Non-CP agencies expressed interest in launching vaccine programs if there is clear guidance, sustainable funding, and adequate personnel. Conclusions: Our study provides important context on the feasibility and acceptability of implementing an MIH-CP program. Findings offer valuable insights into reducing health disparities seen in vaccine uptake through community paramedics, a novel and innovative approach to reduce health disparities in rural communities. [ABSTRACT FROM AUTHOR]

Oral myiasis, caused by the infestation of dipteran larvae, particularly Chrysomya bezziana, is a rare yet significant condition that poses challenges in its management. The infestation of live maggots in the oral cavity can lead to tissue destruction, secondary infections, and psychological distress. Prompt recognition and a multidisciplinary approach involving larvae removal, wound debridement, antibiotic therapy, oral hygiene education, and psychological support are essential in addressing this condition. In addition, addressing the underlying factors contributing to poor oral hygiene and infrequent dental care is crucial in preventing the recurrence of oral myiasis. This review underscores the importance of collaborative efforts among healthcare professionals, public health initiatives, and community education programs to raise awareness and promote preventive measures against oral myiasis caused by Chrysomya bezziana. [ABSTRACT FROM AUTHOR]

Background: The purpose of this paper is to report on the process for developing an online RE-AIM evaluation toolkit in partnership with organizations that provide physical activity programming for persons with disabilities. Methods: A community-university partnership was established and guided by an integrated knowledge translation approach. The four-step development process included: (1) identify, review, and select knowledge (literature review and two rounds of Delphi consensus-building), (2) adapt knowledge to local context (rating feasibility of outcomes and integration into online platform), (3) assess barriers and facilitators (think-aloud interviews), and (4) select, tailor, implement (collaborative dissemination plan). Results: Step 1: Fifteen RE-AIM papers relevant to community programming were identified during the literature review. Two rounds of Delphi refined indicators for the toolkit related to reach, effectiveness, adoption, implementation, and maintenance. Step 2: At least one measure was linked with each indicator. Ten research and community partners participated in assessing the feasibility of measures, resulting in a total of 85 measures. Step 3: Interviews resulted in several recommendations for the online platform and toolkit. Step 4: Project partners developed a dissemination plan, including an information package, webinars, and publications. Discussion: This project demonstrates that community and university partners can collaborate to develop a useful, evidence-informed evaluation resource for both audiences. We identified several strategies for partnership when creating a toolkit, including using a set of expectations, engaging research users from the outset, using consensus methods, recruiting users through networks, and mentorship of trainees. The toolkit can be found at et.cdpp.ca. Next steps include disseminating (e.g., through webinars, conferences) and evaluating the toolkit to improve its use for diverse contexts (e.g., universal PA programming). Plain English summary: Organizations that provide sport and exercise programming for people with disabilities need to evaluate their programs to understand what works, secure funding, and make improvements. However, these programs can be difficult to evaluate due to lack of evidence-informed tools, low capacity, and few resources (e.g., money, time). For this project, we aimed to close the evaluation gap by creating an online, evidence-informed toolkit that helps organizations evaluate physical activity programs for individuals with disabilities. The toolkit development process was guided by a community-university partnership and used a systematic four-step approach. Step one included reviewing the literature and building consensus among partners and potential users about indicators related to the success of community-based programs. Step two involved linking indicators with at least one measure for assessment. Step three involved interviews with partners who provided several recommendations for the online toolkit. Step four included the co-creation of a collaborative plan to distribute the toolkit for academic and non-academic audiences. Our comprehensive toolkit includes indicators for the reach, effectiveness, adoption, implementation, and maintenance of physical activity programs for individuals with disabilities. This paper provides a template for making toolkits in partnership with research users, offers strategies for community-university partnerships, and resulted in the co-creation of an evidence-informed evaluation resource to physical activity organizations. Users can find the toolkit at et.cdpp.ca. [ABSTRACT FROM AUTHOR]

Stunting, a consequence of chronic malnutrition, particularly affects children aged 0-24 months, impacting child mortality and development. This review aims to explore stunting prevention interventions in this age group, focusing on caregiving during the first 1000 days of life. A systematic search yielded 18 relevant studies published between 2019 and 2023, diverse in location and intervention approaches. Interventions varied from supplementation to community and healthcare programs. Integrating nutrition education with maternal support proved crucial. The review stresses the need for sustainable, context-specific approaches tailored to local contexts. Recommendations include integrating nutrition education into healthcare and community interventions. Continuous evaluation is vital. This review offers insights into stunting prevention, aiding evidence-based strategies globally. Future research should explore caregiving complexities and intervention sustainability. Nursing practitioners are key in implementing holistic approaches to stunting prevention and improving child health outcomes. [ABSTRACT FROM AUTHOR]