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People living with HIV who are seeking jobs experience unique barriers to obtaining employment at the individual, group, and community levels. Traditional employment assistance programs can provide support but may not be tailored to some people living with HIV who often experience barriers to work related to their social needs (such as housing instability) or their lack of consistent engagement in the workforce. To understand how people living with HIV return to work, in-depth interviews were conducted with 43 participants enrolled in interventions coordinating HIV care with housing and employment services at eight sites across the US. Four themes emerged on strategies to increase employment: (1) assessing and responding to employment needs that align with their socio-economic environment; (2) using social networks among family and friends for referrals and support; (3) engaging with navigators who are able to connect clients to skills building opportunities and job resources; and (4) addressing the system barriers such as helping with unmet basic needs (e.g. transportation), finding employers who can accommodate workers with income limits associated with public benefits, and helping immigrants, transgender individuals, and people experiencing homelessness secure legal documentsthat facilitate entry into employment by reducing stigmatized identities.

Purpose: Physical inactivity among adolescents in the United States continues to be a pervasive and growing problem, especially among low income and adolescents of color. Physical literacy is important for adolescents to engage in physical activity. However, few studies have assessed physical literacy among marginalized populations. The purpose of this study is to describe levels of physical literacy among marginalized adolescents in a Midwest City. Methods: Data were collected from 169 participants (85 adolescents and 84 parents). Adolescents included in the study were from 4 Kansas City (Missouri) public schools. Univariate statistics were calculated for 3 physical literacy domains (PLAYinventory, PLAYself, and PLAYparent). To assess for differences among groups, the authors conducted a single-factor analysis of variance (1-way analysis of variance). Results: The sample (N = 169) was primarily Hispanic (48.2% adolescents and 42.9% parents). Sedentary behaviors were self-reported as the highest overall activities adolescents participated in within the past 12 months. The mean physical literacy score for this sample was 71.9 among adolescent reported and 72.7 among parent reported. Analysis of variance of racial and ethnic groups for PLAYself and PLAYparent assessments showed no significant difference in values. Compared with other subscales of both the PLAYparent and PLAYself instrument, parents and adolescents showed a lack of confidence in adolescent's ability to be active in the 4 environments (land, water, ice, and snow). Conclusion: Physical literacy is shown to be important in maintaining physical activity throughout life; given this, it is important to understand how to increase confidence of seasonal specific skills in marginalized adolescents. [ABSTRACT FROM AUTHOR]

Purpose: The purposes of this study are to describe the costs of implementing an after-school physical activity intervention in three diverse, low-resourced, schools and to understand the potential aerobic impact of this program by cost. Design: We conducted a cost utilization study from an 8.5-month physical activity intervention. Setting: Three diverse, low-resourced, middle schools in the Midwest; The sample (N = 178) were mostly males (52.2%), African American or Black (54.8%), and divided between 6th, 7th, and 8th grades. Method: Costs were collected from contracts, invoices, payroll, and receipts. Metabolic equivalents were collected from past literature. Costs/MET-hour were calculated for the schools and entire program by dividing costs by total MET-hours engaged in physical activity. Results: Costs were $2.51/MET-hour, $8.96/MET-hour, and $10.73/MET-hour for the three schools. On average, the intervention had a cost of $4.73/MET-hour. Conclusions: Cost/MET-hour for the present study is comparable or lower than other school-based physical activity interventions that require additional staff time and programming outside of standard classroom activities. Scale-up of after-school programs may be one way to improve the costs of programs in both schools and districts. [ABSTRACT FROM AUTHOR]

Objective: To forecast oropharyngeal carcinoma (OPC) incidence with otolaryngologist and radiation oncologist numbers per population by rural and urban counties through 2030. Methods: Incident OPC cases were abstracted from the Surveillance, Epidemiology, and End Results 19 database, and otolaryngologists and radiation oncologists from the Area Health Resources File by county from 2000 to 2018. Variables were analyzed by metropolitan counties with over 1,000,000 people (large metros), rural counties adjacent to a metro (rural adjacent), and rural counties not adjacent to a metro (rural not adjacent). Data were forecasted via an unobserved components model with regression slope comparisons. Results: Per 100,000 population, forecasted OPC incidence increased from 2000 to 2030 (large metro: 3.6 to 10.6 cases; rural adjacent: 4.2 to 11.9; rural not adjacent: 4.3 to 10.1). Otolaryngologists remained stable for large metros (2.9 to 2.9) but declined in rural adjacent (0.7 to 0.2) and rural not adjacent (0.8 to 0.7). Radiation oncologists increased from 1.0 to 1.3 in large metros, while rural adjacent remained similar (0.2 to 0.2) and rural not adjacent increased (0.2 to 0.6). Compared to large metros, regression slope comparisons indicated similar forecasted OPC incidence for rural not adjacent (p = 0.58), but greater for rural adjacent (p < 0.001, r = 0.96). Otolaryngologists declined for rural regions (p < 0.001 and p < 0.001, r = −0.56, and r = −0.58 for rural adjacent and not adjacent, respectively). Radiation oncologists declined in rural adjacent (p < 0.001, r = −0.61), while increasing at a lesser rate for rural not adjacent (p = 0.002, r = 0.96). Conclusions: Rural OPC incidence disparities will grow while the relevant, rural health care workforce declines. Level of Evidence: NA Laryngoscope, 134:136–142, 2024 [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate a weekly school-based fruit and vegetable delivery via a mobile market on urban middle schoolers' nutrition behaviors. Design: One-group, pretest-posttest design, quasi-experimental intervention in middle schoolers (6th-8th graders, N = 158) in Kansas City, MO Intervention: Weekly delivery of free produce via a mobile market over 12 weeks. Measures: A self-administered survey to assess self-report consumption of fruits, vegetables, soda, and sports drinks. Analysis: Univariate and bivariate analyses were used. Proportions were compared and chi-square tests were conducted to compare youth at baseline and 12 weeks. Results: More youth reported consuming fresh fruit (73.8% to 83.3%; χ2 = 7.76, P =.005) and vegetables (66.4% to 71.3%; χ2 = 13.55, P = <.001) from baseline to follow-up. Less youth reported soda (49.0% to 52.8%; χ2= 6.33, P =.012) and sports drinks (41.8% to 38.2%; χ2= 12.32, P <.001) from baseline to follow-up. Conclusions: A mobile produce delivery intervention, like the Healthy Harvest Mobile Market, may be an effective strategy to increase fruit and vegetable consumption for adolescents. [ABSTRACT FROM AUTHOR]

Background: With rates of childhood obesity continually increasing, effective physical activity and nutrition interventions are needed. Formative research is used to tailor interventions to different cultural and geographic contexts and can be vital in adapting intervention strategies in the face of significant disruptive circumstances (like COVID-19). Objective: We conducted formative research via in-person and web-based focus groups among middle schoolers and parents to better understand the facilitators and barriers to physical activity and fruit and vegetable consumption and to inform the design of a large intervention for a low-income, urban setting in the US Midwest. Methods: We conducted 2 phases of qualitative focus groups with parents (n=20) and 6th-9th grade middle schoolers (n=23). Phase 1 was conducted prior to the COVID-19 pandemic in late 2019, and phase 2 was conducted during the COVID-19 pandemic in the summer of 2020. Focus groups were transcribed and thematically coded using the Dedoose software. Results: The main facilitators of physical activity prior to the pandemic included the opportunity to have fun, peer influence, competition (for some), and incentives, while the main barriers to physical activity were time constraints and social discomfort. The main facilitators of eating fruits and vegetables included parental influence, preparation technique, and convenience, while barriers included dislike of vegetables, time constraints, and preparation or freshness. During the pandemic, facilitators of physical activity remained the same, while additional barriers to physical activity such as lack of motivation and limited time spent outside of the home were reported. For fruit and vegetable consumption, both facilitators and barriers remained the same for both time periods. Additionally, for some participants, the pandemic offered an opportunity to offer more fruits and vegetables to middle schoolers throughout the day. Conclusions: Some themes identified were common to those reported in previous studies, such as peer influence on physical activity and parental influence on fruit and vegetable consumption. Novel themes such as lack of motivation to be active and limited time outside the home helped improve intervention adaptation, specifically during the COVID-19 pandemic. The continuity of formative research after a major unexpected change in the intervention context can be essential in targeting areas of an intervention that can be retained and those that need to be adjusted. [ABSTRACT FROM AUTHOR]

Research has suggested that men in relationships are more physically active than men who are single. This study provides a weighted analysis of physical activity by coupling status for men of different sexual orientations. Aggregated data from the United States 2013-2014 National Health Interview Survey were used to conduct multivariate logistic regression analyses. Compared to straight men ( n = 29,926), gay men ( n = 623) were less likely to be in a relationship (AOR 0.32, CI: 0.25-0.41). Coupled gay men did more physical activity than coupled straight men and were 1.62 (CI: 1.05-2.50) times more likely to be active, 1.67 (CI: 1.10-2.51) times more likely to be high active, 1.89 (CI: 1.24-2.89) times more likely to engage in muscle-strengthening activities, and 2.00 (CI: 1.28-3.11) times more likely to meet aerobic and muscle-strengthening recommendations. Coupling facilitates physical activity for men. However, more research is needed to help explore underlying mechanisms for differences by sexuality.