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We present findings from qualitative interviews (N = 67) with 36 staff and 31 participants of nine distinct individual and/or group level interventions to engage transgender women of color (TWOC) in HIV care in the U.S. We examine the commonalities amongst the intervention services (addressing unmet basic needs, facilitating engagement in HIV care, health system navigation, improving health literacy, emotional support), and the relationships formed during implementation of the interventions (between interventionists and participants, among participants in intervention groups, between participants and peers in the community). Interventionists, often TWOC themselves, who provided these services developed caring relationships, promoted personal empowerment, and became role models for participants and the community. Intervention groups engaged participants to reinforce the importance of health and HIV care and provided mutual support. Gender affirming services and caring relationships may be two key characteristics of interventions that address individual and structural-level barriers to engage TWOC in HIV care.

Abstract Background COVID-19 has impacted the health and social fabric of individuals and families living across the USA, and it has disproportionately affected people living in urban communities with co-morbidities, those working in high-risk settings, refusing or unable to adhere to CDC guidelines, and more. Social determinants of health (SDH), such as stigmatization, incarceration, and poverty, have been associated with increased exposure to COVID-19 and increased deaths. While vaccines and booster shots are available, it will take time to reach herd immunity, and it is unclear how long newly developed vaccines provide protection and how effective they are against emerging variants. Therefore, prevention methods recommended by the Centers for Disease and Control (CDC)—i.e., testing, hand-washing, social distancing, contact tracing, vaccination and booster shots, and quarantine—are essential to reduce the rates of COVID-19 in marginalized communities. This project will adapt and test evidence-based HIV interventions along the prevention and treatment cascade to help address COVID-19 prevention needs. Methods The study aims to (1) optimize an adaptive intervention that will increase rates of testing and adherence to New Jersey State COVID-19 recommendations (testing, social distancing, quarantine, hospitalization, contact tracing, and acceptance of COVID-19 vaccination and booster shots) among high-risk populations and (2) identify predictors of testing completion and adherence to New Jersey recommendations. This study follows Community Based Participatory Research (CBPR) principles to conduct a Sequential, Multiple Assignment Randomized Trial (SMART) with 670 COVID-19 medically/socially vulnerable people. Participants will be recruited using a variety of strategies including advertisements on social media, posting fliers in public places, street outreach, facility-based, and snowball sampling. Participants complete a baseline survey and are randomized to receive navigation services or an electronic brochure. They then complete a follow-up 7 days after baseline and are randomized again to either continue with their original assignment or switch to the other intervention or critical dialog or brief counseling. Participants then complete a 5-week post-baseline follow-up. Guided by the COVID-19 Continuum of Prevention, Care, and Treatment, the analysis will explore the factors associated with COVID-19 testing within 7 days of the intervention. Discussion This paper describes the protocol of the first study to use SMART following CBPR to adapt evidence-based HIV prevention interventions to COVID-19. The findings will inform the development of an effective and scalable adaptive intervention to increase COVID-19 testing and adherence to public health recommendations, including vaccination and booster shots, among a marginalized and difficult-to-engage population. Trial registration ClinicalTrials.gov NCT04757298 . Registered on February 17, 2021.

This article introduces the Database for Estimation of Road Network Performance (DERNP) to enable wide-scale estimation of relevant Road Network Performance (RNP) factors for major German cities. The methodology behind DERNP is based on a randomized route sampling procedure that utilizes the Worldwide Harmonized Light Vehicles Test Procedure (WLTP) in combination with the tile-based HERE Maps Traffic API v7 and a digital elevation model provided by the European Union's Earth Observation Programme Copernicus to generate a large set of independent and realistic routes throughout OpenStreetMap road networks. By evaluating these routes using the PHEMLight5 framework, a comprehensive list of RNP parameters is estimated and translated into polynomial regression models for general usage. The applicability of these estimations is demonstrated based on a case study of four major German cities. This case study considers network characteristics in terms of detours, infrastructure, traffic congestion, fuel consumption, and CO2 emissions. Our results show that DERNP and its underlying randomized route sampling methodology overcomes major limitations of previous wide-scale RNP approaches, enabling efficient, easy-to-use, and region-specific RNP comparisons. [ABSTRACT FROM AUTHOR]

Introduction: Transitional-aged youth (TAY) are at a vulnerable stage of their development in which mental health and/or addiction (MHA) issues tend to manifest and/or increase in severity. These youth also tend to find themselves caught in the gap between child and adult MHA services, often resulting in sub-optimal access to and transition through MHA services. Navigation services may be one way to close this and other system gaps and improve service utilization and supports for TAY. The objective of this study was to explore the perspectives of TAY, family members, and system providers regarding the support that can be provided by navigation services in addressing the needs and barriers encountered during transitions in MHA care., Methods: This is a descriptive qualitative study of TAY, family, and provider perspectives on the role of navigation as it pertains to transitions in care for TAY with MHA concerns. Focus groups and semi-structured interviews were conducted with 63 participants with varying levels of familiarity with navigation. Participants were asked about their experiences with navigating transitions through the MHA system and their views on the role of navigation services in supporting transitions in care. Data was analyzed utilizing a thematic analysis approach., Results: Five themes emerged during data analysis: navigation to traverse difficult pathways, navigation to ensure appropriate and comprehensive care, navigation to sustain continuity of care, navigation to support informed care, and navigation to facilitate TAY and family involvement., Discussion: These findings contribute to an understanding of how navigation services can be meaningful in mitigating the challenges faced by TAY and their families when seeking help for MHA issues. Navigation services have the potential to support MHA system transformation for enhanced transitions in care for TAY with MHA concerns and their families., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

The project presents a methodology for choosing the optimal architecture using, as an example, global navigation satellite system, namely its space segment. Several architectures of the GLONASS system were taken as an example for testing the methodology. The usage of traditional methods of multi-criteria analysis in this case is too way difficult due to the presence of a large number of particular navigation tasks, that often put forward contradictory and uncertain requirements for their resolution, the presence of a large number of private criteria, the need to involve a large number of decision makers (DM), and as a consequence, a conflict of interests, difficulty in setting weights, determining preferences, etc. The confident judgment method was used to implement the task. The system of private criteria was structured, taking into account the requirements of specific narrow segments, and their preferences were formed. After that, tables were built for each structure, according to the required number of criteria and for three different particular tasks, as well as to normalize and collapse the criteria for each task into one criterion. Then a set of Pareto-rational solutions and a rating of alternatives were formed. The final appearance of the system satisfied the requirements imposed by the consumer segment. Keyword

Interest in navigation services in the mental health and/or addiction (MHA) sphere has grown over the past decade. However, little is known about the value of caregiver peer support in enhancing the navigation process. The Parent Advocate with Lived experience (PAL) service at the Family Navigation Project (FNP) provides peer support to caregivers supporting youth with MHA concerns. Caregivers (n = 26) were asked to rate their perceptions of their caregiver experience retrospectively and then 7 weeks following contact with FNP. A repeated-measures MANOVA comparing participants who had and had not accessed PAL services demonstrated a significant main effect of time, (F(15, 8) = 5.82, p =.008, η p 2 =.916), and a significant time-by-group interaction, (F(15, 8) = 3.69, p =.034, η p 2 =.874), signifying participants who accessed PAL services had more positive perceptions about their caregiving experience compared to participants who had not accessed PAL service. These findings support the future development of caregiver peer support roles within MHA services. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has impacted the health and social fabric of individuals and families living across the USA, and it has disproportionately affected people living in urban communities with co-morbidities, those working in high-risk settings, refusing or unable to adhere to CDC guidelines, and more. Social determinants of health (SDH), such as stigmatization, incarceration, and poverty, have been associated with increased exposure to COVID-19 and increased deaths. While vaccines and booster shots are available, it will take time to reach herd immunity, and it is unclear how long newly developed vaccines provide protection and how effective they are against emerging variants. Therefore, prevention methods recommended by the Centers for Disease and Control (CDC)-i.e., testing, hand-washing, social distancing, contact tracing, vaccination and booster shots, and quarantine-are essential to reduce the rates of COVID-19 in marginalized communities. This project will adapt and test evidence-based HIV interventions along the prevention and treatment cascade to help address COVID-19 prevention needs.Methods: The study aims to (1) optimize an adaptive intervention that will increase rates of testing and adherence to New Jersey State COVID-19 recommendations (testing, social distancing, quarantine, hospitalization, contact tracing, and acceptance of COVID-19 vaccination and booster shots) among high-risk populations and (2) identify predictors of testing completion and adherence to New Jersey recommendations. This study follows Community Based Participatory Research (CBPR) principles to conduct a Sequential, Multiple Assignment Randomized Trial (SMART) with 670 COVID-19 medically/socially vulnerable people. Participants will be recruited using a variety of strategies including advertisements on social media, posting fliers in public places, street outreach, facility-based, and snowball sampling. Participants complete a baseline survey and are randomized to receive navigation services or an electronic brochure. They then complete a follow-up 7 days after baseline and are randomized again to either continue with their original assignment or switch to the other intervention or critical dialog or brief counseling. Participants then complete a 5-week post-baseline follow-up. Guided by the COVID-19 Continuum of Prevention, Care, and Treatment, the analysis will explore the factors associated with COVID-19 testing within 7 days of the intervention.Discussion: This paper describes the protocol of the first study to use SMART following CBPR to adapt evidence-based HIV prevention interventions to COVID-19. The findings will inform the development of an effective and scalable adaptive intervention to increase COVID-19 testing and adherence to public health recommendations, including vaccination and booster shots, among a marginalized and difficult-to-engage population.Trial Registration: ClinicalTrials.gov NCT04757298 . Registered on February 17, 2021. [ABSTRACT FROM AUTHOR]

Older persons with serious illnesses living in rural communities are an underserved population. They often live with heavy symptom burden and poor quality of life with limited access to resources. Nav-CARE (Navigation: Connecting Accessing Resourcing and Engaging) was developed to specially train and mentor volunteer navigators who help connect older persons with serious illness to the resources and information they need. Aims: This mixed methods longitudinal study evaluated Nav-CARE for feasibility, acceptability, ease of use, and satisfaction by older persons and volunteers. Methods: Nine volunteer navigators visited 23 older persons with serious illness every 3 to 4 weeks for 1 year. Data were collected from volunteer navigators, and older person participants at baseline, during the year- long implementation and post implementation. Results: Volunteer navigators and older persons reported Nav-CARE was easy to use, feasible and acceptable. The majority of older persons agreed or strongly agreed that they were satisfied with the navigation services (100%; 8/8), that navigation services were important to them (87%; 7/8), that they would recommend the program to someone else (87%; 7/8), and would participate in the program again (75%; 6/8). Similarly, volunteer navigators reported 100% (9/9) satisfaction with the program, 100% (9/9) would recommend it to others, and 67% (6/8) would participate again. Conclusions: Nav-CARE appears to be a feasible, acceptable, and satisfactory program for older persons with serious illness and volunteer navigators. [ABSTRACT FROM AUTHOR]

Pedestrian networks play an important role in various applications, such as pedestrian navigation services and mobility modeling. This paper presents a novel method to extract pedestrian networks from crowdsourced tracking data based on a two-layer framework. This framework includes a walking pattern classification layer and a pedestrian network generation layer. In the first layer, we propose a multi-scale fractal dimension (MFD) algorithm in order to recognize the two different types of walking patterns: walking with a clear destination (WCD) or walking without a clear destination (WOCD). In the second layer, we generate the pedestrian network by combining the pedestrian regions and pedestrian paths. The pedestrian regions are extracted based on a modified connected component analysis (CCA) algorithm from the WOCD traces. We generate the pedestrian paths using a kernel density estimation (KDE)-based point clustering algorithm from the WCD traces. The pedestrian network generation results using two actual crowdsourced datasets show that the proposed method has good performance in both geometrical correctness and topological correctness. [ABSTRACT FROM AUTHOR]

Considering climate change, recent political debates often focus on measures to reduce CO2 emissions. One key component is the reduction of emissions produced by motorized vehicles. Since the amount of emission directly correlates to the velocity of a vehicle via energy consumption factors, a general speed limit is often proposed. This article presents a methodology to combine openly available topology data of road networks from OpenStreetMap (OSM) with pay-per-use API traffic data from TomTom to evaluate such measures transparently by analyzing historical real-world circumstances. From our exemplary case study of the German motorway network, we derive that most parts of the motorway network on average do not reach their maximum allowed speed throughout the day due to traffic, construction sites and general road utilization by network participants. Nonetheless our findings prove that the introduction of a speed limit of 120 km per hour on the German autobahn would restrict 50.74% of network flow kilometers for a CO2 reduction of 7.43% compared to the unrestricted state. [ABSTRACT FROM AUTHOR]