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Abstract Background Implementing evidence-informed population health interventions in new contexts often requires adaptations. While the need to adapt interventions to better fit new contexts is recognised, uncertainties remain regarding why and when to adapt (or not), and how to assess the benefits (or not) of adaptation. The ADAPT Study aims to develop comprehensive guidance on adaptation. This scoping review informs guidance development by mapping and exploring how adaptation has been undertaken in practice, in public health and health services research. Methods We searched seven databases from January 2000 and October 2018 to identify eligible studies for this scoping review and a related systematic review of adaptation guidance. We mapped the studies of adaptation by coding data from all eligible studies describing the methods, contexts, and interventions considered for adaptation. From this map, we selected a sample of studies for in-depth examination. Two reviewers extracted data independently into seven categories: description, key concepts, types, rationale, processes, evaluation methods, evaluation justification, and accounts of failures and successes. Results We retrieved 6694 unique records. From 429 records screened at full text, we identified 298 eligible studies for mapping and selected 28 studies for in-depth examination. The majority of studies in our map focused on micro- (i.e., individual-) level interventions (84%), related to transferring an intervention to a new population group within the same country (62%) and did not report using guidance (73%). Studies covered a range of topic areas, including health behaviour (24%), mental health (19%), sexual health (16%), and parenting and family-centred interventions (15%). Our in-depth analysis showed that adaptation is seen to save costs and time relative to developing a new intervention, and to enhance contextual relevance and cultural compatibility. It commonly follows a structured process and involves stakeholders to help with decisions on what to adapt, when, and how. Conclusions Adaptation has been undertaken on a range of health topics and largely in line with existing guidance. Significant gaps relate to adaptation of macro- (e.g., national-) level interventions, consideration of programme theories, mechanisms and contexts (i.e., a functional view of interventions), nuances around stakeholder involvement, and evaluation of the adapted interventions. Registration Open Science Framework, 2019, osf.io/udzma.

In the upper basin of the Guadiana River, especially in the sectors drained by its right-bank tributaries, the Bullaque and Becea rivers, important concentrations of Acheulean and Mousterian industries can be found in a superficial position. These industries have provided series containing tens of thousands of pieces. Deposits in stratigraphic position have also been identified, related to the fluvial terraces of the Guadiana and Jabalón rivers and some tributaries. Within the sector studied, in the province of Ciudad Real, the position of these deposits is related to alluvial fans developed on the slopes of the immediate reliefs. These fans, mainly composed of Lower and Middle Ordovician quartzite gravel, were eroded in their distal positions by the Bullaque and Becea rivers, forming very low terraces on which large concentrations of Acheulean and Mousterian lithic industry can be found. El Sotillo, the only known stratigraphic site in the area, was excavated in 2017–2019 and consists of several levels with Mousterian and Acheulean industry. We present the technological characteristics of the main Acheulean assemblage recognised at this site, for which numerical dates have been obtained placing its chronology in the second half of the Middle Pleistocene. The location of these sites, in surficial position and El Sotillo, allows us to recognise a territorial space with specific geographic characteristics and a very significant human impact.

Abstract Background Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interventions compared with interventions transported without adaptation, there are also examples of interventions which have been extensively adapted, yet have not worked in the new context. Decisions on when, to what extent, and how to adapt interventions therefore are not straightforward, particularly when conceptualising intervention effects as contingent upon contextual interactions in complex systems. No guidance currently addresses these questions comprehensively. To inform development of an overarching guidance on adaptation of complex population health interventions, this systematic review synthesises the content of the existing guidance papers. Methods We searched for papers published between January 2000 and October 2018 in 7 bibliographic databases. We used citation tracking and contacted authors and experts to locate further papers. We double screened all the identified records. We extracted data into the following categories: descriptive information, key concepts and definitions, rationale for adaptation, aspects of adaptation, process of adaptation, evaluating and reporting adapted interventions. Data extraction was conducted independently by two reviewers, and retrieved data were synthesised thematically within pre-specified and emergent categories. Results We retrieved 6694 unique records. Thirty-eight papers were included in the review representing 35 sources of guidance. Most papers were developed in the USA in the context of implementing evidence-informed interventions among different population groups within the country, such as minority populations. We found much agreement on how the papers defined key concepts, aims, and procedures of adaptation, including involvement of key stakeholders, but also identified gaps in scope, conceptualisation, and operationalisation in several categories. Conclusions Our review found limitations that should be addressed in future guidance on adaptation. Specifically, future guidance needs to be reflective of adaptations in the context of transferring interventions across countries, including macro- (e.g. national-) level interventions, better theorise the role of intervention mechanisms and contextual interactions in the replicability of effects and accordingly conceptualise key concepts, such as fidelity to intervention functions, and finally, suggest evidence-informed strategies for adaptation re-evaluation and reporting. Trial registration PROSPERO 2018, CRD42018112714.

Using the relationship between measured groundwater pressures in deep observation wells and total surface loading, a geological weighing lysimeter (geolysimeter) has the capability of measuring precipitation event totals independently of conventional precipitation gauge observations. Correlations between groundwater pressure change and event precipitation were observed at a co-located site near Duck Lake, SK, over a multi-year and multi-season period. Correlation coefficients (r2) varied from 0.99 for rainfall to 0.94 for snowfall. The geolysimeter was shown to underestimate rainfall by 7 % while overestimating snowfall by 9 % as compared to the unadjusted gauge precipitation. It is speculated that the underestimation of rainfall is due to unmeasured run-off and evapotranspiration within the response area of the geolysimeter during larger rainfall events, while the overestimation of snow is at least partially due to the systematic undercatch common to most precipitation gauges due to wind. Using recently developed transfer functions from the World Meteorological Organization's (WMO) Solid Precipitation Intercomparison Experiment (SPICE), bias adjustments were applied to the Alter-shielded, Geonor T-200B precipitation gauge measurements of snowfall to mitigate wind-induced errors. The bias between the gauge and geolysimeter measurements was reduced to 3 %. This suggests that the geolysimeter is capable of accurately measuring solid precipitation and can be used as an independent and representative reference of true precipitation.

This paper describes current research into the supply of spatial data to the end user in as close to real time as possible via the World Wide Web. The Spatial Data Infrastructure paradigm has been discussed since the early 1990s. The concept has evolved significantly since then but has almost always examined data from the perspective of the supplier. It has been a supplier driven focus rather than a user driven focus. The current research being conducted is making a paradigm shift and looking at the supply of spatial data as a supply chain, similar to a manufacturing supply chain in which users play a significant part. A comprehensive consultation process took place within Australia and New Zealand incorporating a large number of stakeholders. Three research projects that have arisen from this consultation process are examining Spatial Data Supply Chains within Australia and New Zealand and are discussed within this paper.

Abstract Isolated attosecond pulse (IAP) generation usually involves the use of short-medium gas cells operated at high pressures. In contrast, long-medium schemes at low pressures are commonly perceived as inherently unsuitable for IAP generation due to the nonlinear phenomena that challenge favourable phase-matching conditions. Here we provide clear experimental evidence on the generation of isolated extreme-ultraviolet attosecond pulses in a semi-infinite gas cell, demonstrating the use of extended-medium geometries for effective production of IAPs. To gain a deeper understanding we develop a simulation method for high-order harmonic generation (HHG), which combines nonlinear propagation with macroscopic HHG solving the 3D time-dependent Schrödinger equation at the single-atom level. Our simulations reveal that the nonlinear spatio-temporal reshaping of the driving field, observed in the experiment as a bright plasma channel, acts as a self-regulating mechanism boosting the phase-matching conditions for the generation of IAPs.

The National Collegiate Athletic Association (NCAA) established policies for the inclusion of transgender athletes to compete in collegiate sport that align with their gender identity. Despite this access, the extent to which collegiate sport environments are welcoming, inclusive and supportive of transgender athletes is unclear. Understanding coaches' perceptions and attitudes is particularly salient given the critical, and often personal, nature of coach-athlete relationships and the impact coaches have on sport environments [Kuhlin, F., Barker-Ruchti, N., & Stewart, C. (2020). Long-term impact of the coach-athlete relationship on development, health and wellbeing: stories from a figure skater. "Sports Coaching Review," 9(2), 208-230; Stirling, A. E., & Kerr, G. A. (2013). The perceived effects of elite athletes' experiences of emotional abuse in the coach-athlete relationship. "International Journal of Sport and Exercise Psychology," 11(1), 87-100]. NCAA coaches' perceptions of, and attitudes towards the inclusion of transgender athletes is unknown, and thus the degree to which coaches are creating safe, or harmful, environments for transgender athletes is unknown. The present study aims investigate coaches' perceptions to be able to inform policy and education for promoting inclusive, safe environments for transgender athletes. We asked NCAA coaches (N = 1358) to describe the reasoning for their beliefs regarding the inclusion of transgender athletes in collegiate sports. Through reflexive thematic analysis, we determined coaches' reasoning for their perceptions, within the context of five higher-order themes: (a) It's not right: Transgender identities as invalid, (b) A need to protect (cis) women's sports, (c) Transgender rights are human rights, (d) Sport's role in society and coaches' role in sport and (e) I am not sure what I believe. Analyses illuminate avenues for transgender athlete inclusion training for coaches.

Background Excess nitrogen (N) loading to coastal ecosystems impairs estuarine water quality. Land management decisions made within estuarine watersheds have a direct impact on downstream N delivery. Natural features within watersheds can act as landscape sinks for N, such as wetlands, streams and ponds that transform dissolved N into gaseous N, effectively removing it from the aquatic system. Identifying and evaluating these landscape sinks and their spatial relationship to N sources can help managers understand the effects of alternative decisions on downstream resources. Methods The N-Sink approach uses widely available GIS data to identify landscape sinks within HUC-12 (or larger) catchments, estimate their N removal potential and map the effect of those sinks on N movement through the catchment. Static maps are produced to visualize N removal efficiency, transport and delivery, the latter in the form of an index. The R package nsink was developed to facilitate data acquisition, processing and visualization. Results nsink creates static maps for a specific HUC-12, or users can visit the University of Connecticut website to explore previously mapped areas. Users can investigate specific flowpaths interactively by clicking on any location within the catchment. A flowpath is generated with a table describing N removal along each segment. We describe the motivation behind developing nsink, discuss implementation in R, and present two use case examples. nsink is available from https://github.com/USEPA/nsink. Conclusions N-Sink is a decision support tool created for local decision-makers and NGOs to facilitate better understanding of the relationship between land use and downstream N delivery. Local decision-makers that have prioritized N mitigation in their long-term planning can use nsink to better understand the potential impact of proposed development projects, zoning variances, and land acquisition or restoration. nsink also allows resource economists to investigate the tradeoffs among different, often costly, N reduction strategies.

Abstract Introduction Following NOVA (part 1) and the approval of the subcutaneous (SC) route of administration of natalizumab by the European Medicines Agency, an extension phase of the NOVA phase IIIb study (part 2) was initiated to collect patient preference data for SC versus intravenous (IV) dosing in patients receiving every-6-week (Q6W) dosing of natalizumab. This study was performed to evaluate patient preference for SC versus IV natalizumab administration and explore the efficacy, safety, and pharmacology characteristics of both routes of administration. Methods In part 2, participants received natalizumab (Tysabri®) 300 mg via IV infusion Q6W for 36 weeks and then were randomized to 48 weeks of crossover treatment (24 weeks SC Q6W and 24 weeks IV Q6W, or vice versa). The primary endpoint was the proportion of participants who indicated a preference for natalizumab SC administration on the Patient Preference Questionnaire. Results A total of 153 participants were randomized in NOVA part 2. Of 123 with patient preference data, 108 (87.8%) preferred the SC route of administration for natalizumab over the IV route; 102 (82.9%) specified “requires less time in the clinic” as the reason for the SC preference. Conclusion In NOVA (part 2), most participants on Q6W dosing of natalizumab preferred SC administration versus IV administration. ClinicalTrials.gov NCT03689972. Infographic

Employing the robust framework of the Social Ecological Model (SEM) and drawing insights from the Social Determinants of Health (SDOH), this research sought to uncover the interplay between SDOH and mental health among adolescents. With a focus on depression, the study unraveled how various social determinants, both individually and collectively, shape the mental well-being of adolescents, leveraging the rich dataset provided by the National Survey of Children’s Health 2018. Utilizing advanced statistical techniques, the study revealed the predictive power of SDOH in understanding adolescent mental health. Results illuminate the significant influence of social determinants on depression, underscoring the imperative for a comprehensive approach to mental health interventions. Notably, the findings highlight how the absence of adverse determinants mitigates the risk of negative mental health outcomes among adolescents, while also shedding light on the correlation between adverse determinants and depression. These findings underscore the critical role of interdisciplinary collaboration among healthcare professionals in minimizing the detrimental impact of adverse determinants on adolescent mental health. By recognizing and addressing the multifaceted influences of social determinants, stakeholders can work together to foster environments conducive to positive mental well-being among adolescents.

Abstract Objective To identify gut microbiome features associated with MRI lesion burden in persons with pediatric‐onset multiple sclerosis (symptom onset 0.08). At the phylum level, high Tenericutes (relative abundance) was associated with higher T1 and T2 volumes (β coefficient = 0.25, 0.37) and high Firmicutes, Patescibacteria or Actinobacteria with lower lesion volumes (β coefficient = −0.30 to −0.07). At the genus level, high Ruminiclostridium, whereas low Coprococcus 3 and low Erysipelatoclostridium were associated with higher lesion volumes. Interpretation Our study characterized the gut microbiota features associated with MRI lesion burden in pediatric‐onset MS, shedding light onto possible pathophysiological mechanisms.

Background Excess nitrogen (N) loading to coastal ecosystems impairs estuarine water quality. Land management decisions made within estuarine watersheds have a direct impact on downstream N delivery. Natural features within watersheds can act as landscape sinks for N, such as wetlands, streams and ponds that transform dissolved N into gaseous N, effectively removing it from the aquatic system. Identifying and evaluating these landscape sinks and their spatial relationship to N sources can help managers understand the effects of alternative decisions on downstream resources. Methods The N-Sink approach uses widely available GIS data to identify landscape sinks within HUC-12 (or larger) catchments, estimate their N removal potential and map the effect of those sinks on N movement through the catchment. Static maps are produced to visualize N removal efficiency, transport and delivery, the latter in the form of an index. The R package nsink was developed to facilitate data acquisition, processing and visualization. Results The R package creates static maps for a specific HUC-12, or users can visit the University of Connecticut website to explore previously mapped areas. Users can also investigate specific flowpaths interactively by clicking on any location within the catchment. A flowpath is generated with a table describing N removal along each segment. We describe the motivation behind developing nsink, discuss implementation in R, and present two use case examples. nsink is available from https://github.com/USEPA/nsink. Conclusions N-Sink is a decision support tool created for local decision-makers to facilitate better understanding of the relationship between land use and downstream N delivery. Local decision-makers that have prioritized N mitigation in their long-term planning can use nsink to better understand the potential impact of proposed development projects and zoning variances. Similarly, land trusts and other NGOs interested in N mitigation can use nsink to identify high priority areas for acquisition or restoration.

Background: Children with cerebral palsy often have weak ankle muscles and reduced ankle dorsiflexion, which leads to activity limitations and eventually affects quality of life. Robotic ankle training was recently developed to facilitates muscle function through a high repetition of exercises. This study investigated the effect of six-week ankle training using the Anklebot device to improve lower limb structural and functional impairments and the resulting impact on quality of life. Methods: Five children with spastic cerebral palsy aged between 4 and 11 years participated in six weeks of bilateral ankle assistive training using the Anklebot device. All lower limb muscle strength was measured with a hand-held dynameter, and range of motion was measured with a goniometer, at four different time points. Muscle architecture was assessed using a portable diagnostic ultrasound device, and quality of life was assessed using the Life Habits for Children scale, at two points in time only. Results: Muscle strength and range of motion for all lower limb joints demonstrated significant improvement on both sides after training. The ankle muscle architecture showed non-significant improvement, while an overall significant improvement in the total score of the Life Habits for Children scale was detected after training. Conclusion: Robot-assisted task-specific ankle training provides promising effects by allowing the required repetition to improve structural and functional muscle and joint impairments, which has a positive influence on the children’s quality of life. However, due to a limited sample size, these results should be considered as preliminary; further study is needed.

Abstract Bone quality is commonly used to diagnose bone diseases such as osteoporosis, with many studies focusing on microarchitecture for fracture prediction. In this study a bovine distal femur was imaged using both micro-computed tomography (µCT) and tomosynthesis using focal construct geometry (FCG) for comparison of microarchitectural parameters. Six regions of interest (ROIs) were compared between the two imaging modalities, with both global and adaptive methods used to binarize the images. FCG images were downsampled to the same pixel size as the µCT images. Bone morphometrics were determined using BoneJ, for each imaging modality, binarization technique and ROI. Bone area/total area was found to have few significant differences between FCG and µCT (p

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to a global pandemic of coronavirus disease 2019 (COVID-19). Early in the pandemic, efforts were made to test the SARS-CoV-2 antiviral efficacy of repurposed medications that were already approved and available for other indications, including hydroxychloroquine (HCQ) and azithromycin (AZI). To reduce the risk of SARS-CoV-2 exposure for clinical-trial study participants and to conform with lockdowns and social distancing guidelines, biospecimen collection for HCQ and AZI included at-home dried blood spot (DBS) collection rather than standard venipuncture by trained clinicians. In this study, we developed and validated the first sensitive and selective simultaneous LC–MS/MS method to accurately quantitate the concentration of HCQ, HCQ metabolites (Desethylchloroquine [DCQ], Bisdesethylchloroquine [BDCQ], Monodesethylhydroxychloroquine [DHCQ]) and AZI extracted from DBS. The validated method was successfully applied for the quantification of over 2000 DBS specimens to evaluate the pharmacokinetic profile of AZI, HQC, and its metabolites. This new method has a small sample volume requirement (~ 10 µL), results in high sensitivity (1 ng/mL), and would facilitate remotely conducted therapeutic drug monitoring.

Assessing the timing of skeletal trauma significantly impacts the reconstruction of events surrounding death and deposition in forensic cases. However, there are no absolute time frames in which the characteristics of wet bone (peri-mortem) fractures transition to dry (post-mortem) fractures. The aim of this study was to attempt to identify a point within the post-mortem interval in which the characteristics of bone change from wet to dry bone properties. A total of 32 deer ribs were placed in a laboratory burial environment and a set of three were fractured with blunt force trauma every week during a ten-week period. All samples and the inflicted trauma effects were documented and analysed by macroscopic observation, scanning electron microscope (SEM) analysis, thermal analysis, biomechanical analysis, and attenuated total reflectance–Fourier transform infrared spectroscopy (ATR-FTIR). No significant difference was found in the macroscopic, microscopic, thermal, and biomechanical analyses of the trauma inflicted over the 10-week period. A significant difference was only found in the carbonate-to-phosphate ratio in analytical chemistry. The results suggest that interpreting wet bone characteristics in forensic anthropology as having been inflicted during the peri-mortem period (around the time of death) should also consider that these, in fact, could be inflicted well after death (post-mortem) as wet bone properties as this study has shown persist at least 10 weeks after death in a burial environment.

Abstract Electrons photoemitted by extreme ultraviolet attosecond pulses derive spatially from the first few atomic surface layers and energetically from the valence band and highest atomic orbitals. As a result, it is possible to probe the emission dynamics from a narrow 2D region in the presence of optical fields, as well as obtain elemental specific information. However, combining this with spatially‐resolved imaging is a long‐standing challenge because of the large inherent spectral width of attosecond pulses, as well as the difficulty of making them at high repetition rates. Here, this work demonstrates an attosecond interferometry experiment on a zinc oxide (ZnO) surface using spatially and energetically resolved photoelectrons. Photoemission electron microscopy is combined with near‐infrared pump ‐ extreme ultraviolet probe laser spectroscopy and the instantaneous phase of an infrared field is resolved with high spatial resolution. Results show how the core level states with low binding energy of ZnO are well suited to perform spatially resolved attosecond interferometry experiments. A distinct phase shift of the attosecond beat signal is observed across the laser focus which is attributed to wavefront differences between the pump and the probe fields at the surface. This work demonstrates a clear pathway for attosecond interferometry with high spatial resolution at atomic scale surface regions opening up for a detailed understanding of nanometric light‐matter interaction.

We investigate the spatial characteristics of high-order harmonic radiation generated in argon and observe cross-like patterns in the far field. An analytical model describing harmonics from an astigmatic driving beam reveals that these patterns result from the order and generation position-dependent divergence of harmonics. Even small amounts of driving field astigmatism may result in cross-like patterns, coming from the superposition of individual harmonics with spatial profiles elongated in different directions. By correcting the aberrations using a deformable mirror, we show that fine-tuning the driving wavefront is essential for optimal spatial quality of the harmonics.

Abstract INTRODUCTION Hearing loss is highly prevalent among older adults and independently associated with cognitive decline. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study is a multicenter randomized control trial (partially nested within the infrastructure of an observational cohort study, the Atherosclerosis Risk in Communities [ARIC] study) to determine the efficacy of best‐practice hearing treatment to reduce cognitive decline over 3 years. The goal of this paper is to describe the recruitment process and baseline results. METHODS Multiple strategies were used to recruit community‐dwelling 70–84‐year‐old participants with adult‐onset hearing loss who were free of substantial cognitive impairment from the parent ARIC study and de novo from the surrounding communities into the trial. Participants completed telephone screening, an in‐person hearing, vision, and cognitive screening, and a comprehensive hearing assessment to determine eligibility. RESULTS Over a 24‐month period, 3004 telephone screenings resulted in 2344 in‐person hearing, vision, and cognition screenings and 1294 comprehensive hearing screenings. Among 1102 eligible, 977 were randomized into the trial (median age = 76.4 years; 53.5% female; 87.8% White; 53.3% held a Bachelor's degree or higher). Participants recruited through the ARIC study were recruited much earlier and were less likely to report hearing loss interfered with their quality of life relative to participants recruited de novo from the community. Minor differences in baseline hearing or health characteristics were found by recruitment route (i.e., ARIC study or de novo) and by study site. DISCUSSION The ACHIEVE study successfully completed enrollment over 2 years that met originally projected rates of recruitment. Substantial operational and scientific efficiencies during study startup were achieved through embedding this trial within the infrastructure of a longstanding and well‐established observational study. Highlights The ACHIEVE study tests the effect of hearing intervention on cognitive decline. The study is partially nested within an existing cohort study. Over 2 years, 977 participants recruited and enrolled. Eligibility assessed by telephone and in‐person for hearing, vision, and cognitive screening. The ACHIEVE study findings will have significant public health implications.

We propose a continuous variable quantum state tomography protocol of electrons which result from the ionization of atoms or molecules by the absorption of extreme ultraviolet light pulses. Our protocol is benchmarked against a direct calculation of the quantum state of photoelectrons ejected from helium and argon in the vicinity of a Fano resonance. In the latter case, we furthermore distill ion-photoelectron entanglement due to spin-orbit splitting. This opens routes toward the investigation of quantum coherence and entanglement properties on the ultrafast timescale.

Using a spectrally resolved electron interferometry technique, we measure photoionization time delays between the 3s and 3p subshells of argon over a large 34-eV energy range covering the Cooper minima in both subshells. The observed strong variations of the 3s−3p delay difference, including a sign change, are well reproduced by theoretical calculations using the two-photon two-color random-phase approximation with exchange. Strong shake-up channels lead to photoelectrons spectrally overlapping with those emitted from the 3s subshell. These channels need to be included in our analysis to reproduce the experimental data. Our measurements provide a benchmark for multielectronic theoretical models aiming at an accurate description of interchannel correlation.

We examined COVID-19 concerns, vaccine acceptance, and trusted sources of information among patients in a safety-net health system in Louisiana. The participants were surveyed via structured telephone interviews over nine months in 2021. Of 204 adult participants, 65% were female, 52% were Black, 44.6% were White, and 46.5% were rural residents. The mean age was 53 years. The participants viewed COVID-19 as a serious public health threat (8.6 on 10-point scale). Black adults were more likely to perceive the virus as a threat than White adults (9.4 vs. 7.6 p < 0.0001), urban residents more than rural (9.0 vs. 8.2 p = 0.02), females more than males (8.9 vs. 8.1 p = 0.03). The majority (66.7%) had gotten the COVID-19 vaccine, with females being more likely than males (74.7 vs. 54.5% p = 0.02). There was no difference by race or rural residence. Overall, participants reported that physicians were the most trusted source of COVID-19 vaccine information (77.6%); followed by the CDC/FDA (50.5%), State Department of Health (41.4%), pharmacists (37.1%), nurses (36.7%); only 3.8% trusted social media. All sources were more trusted among black adults than White adults except family and social media. These findings could help inform efforts to design trustworthy public health messaging and clinical communication about the virus and vaccines.