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Hepatitis C virus (HCV) elimination requires treatment access expansion, especially for underserved populations. Telehealth has the potential to improve HCV treatment access, although data are limited on its incorporation into standard clinical practice. We conducted a cross‐sectional, email survey of 598 US HCV treatment providers who had valid email addresses and (1) were located in urban areas and had written ≥ 20 prescriptions for HCV treatment to US Medicare beneficiaries in 2019–2020 or (2) were located in non‐urban areas and wrote any HCV prescriptions in 2019–2020. Through email, we notified providers of a self‐administered electronic 28‐item survey of clinical strategies and attitudes about telemedicine for HCV. We received 86 responses (14% response rate), of which 75 used telemedicine for HCV in 2022. Of those 75, 24% were gastroenterologists/hepatologists, 23% general medicine, 17% infectious diseases and 32% non‐physicians. Most (82%) referred patients to commercial laboratories, and 85% had medications delivered directly to patients. Overwhelmingly, respondents (92%) felt that telehealth increases healthcare access, and 76% reported that it promotes or is neutral for treatment completion. Factors believed to be 'extremely' or 'very' important for telehealth use included patient access to technology (86%); patients' internet access (74%); laboratory access (76%); reimbursement for video visits (74%) and audio‐only visits (66%). Non‐physician licensing and liability statutes were rated 'extremely' or 'very' important by 43% and 44%, respectively. Providers felt that telehealth increases HCV treatment access. Major limitations were technological requirements, reimbursement, and access to ancillary services. These findings support the importance of digital equity and literacy to achieve HCV elimination goals. [ABSTRACT FROM AUTHOR]

Introduction: Few studies have examined the association of loneliness and cognitive functioning in the US. We used two common measures of loneliness and examined their association in a large sample of US Black, Latino, and White adults (ages = 50). Methods: We analyzed Wave 3 of the National Social Life, Health, and Aging Project (N = 2,757). We examined loneliness using one item from the CES-D and the Felt Loneliness Measure (NFLM); cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA) tool, where higher scores indicated better functioning. We used weighted ordinary least squares regressions to examine the effects of loneliness (CES-D loneliness and NFLM in separate models) on MoCA scores. In exploratory analyses, we examined if these relationships varied by race and ethnicity. We adjusted all models for sociodemographic and other salient factors (e.g., chronic disease, depressive symptoms, living alone). Results: Mean age was 63.49 years, 52% were female, and 9% were Black and 6% Latino persons. Approximately 54% endorsed feeling lonely on at least one measure; 31% (CES-D) and 46% (NFLM). The relationship between loneliness measures was positive and significant, X2 (1, N = 2,757) = 435.493 p < 0.001. However, only 40% of lonely individuals were identified as lonely on both assessments. CES-D loneliness was inversely (β& = -0.274, p = 0.032) associated with MoCA scores and this association did not vary by race and ethnicity. Greater NFLM loneliness was positively associated (β^ = 0.445, p < 0.001) with higher MoCA scores for Latino participants only. Discussion: Loneliness appears to be an important predictor of cognitive functioning. However, the association of loneliness and cognitive functioning varied when using the CES-D loneliness item or the NFLM. Future work is needed to understand how loneliness and its clinically relevant dimensions (social, emotional, existential, chronicity) relate to global and individual cognitive domains. Research is needed with racially and ethnically diverse midlife and older adults, particularly to understand our counterintuitive finding for Latino participants. Finally, findings also support the need for research on interventions to prevent cognitive decline targeting loneliness. [ABSTRACT FROM AUTHOR]

Computerized training platforms could be an accessible means for older adults to maintain cognitive health, and several such tools are already commercially available. However, it remains unclear whether older adults use these tools if training is not externally prescribed. We explored older adults' self-initiated experiences with cognitive training. We conducted semi-structured interviews with 13 community-dwelling adults aged 58–85 years, comprising university retirees (N = 8) and public housing residents (N = 5). Interviews were analyzed by thematic analysis. No participants voluntarily used cognitive training, and those who had done so previously reported negative experiences. Several factors shaped older adults' engagement with cognitive training, especially a preference for stimulating activities that are organic and inherently enjoyable. We reveal a mismatch between older adults' priorities and the interventions currently available and uncover issues of access and interest among low-income and minority individuals. We suggest ways to better align future interventions with older adults' priorities. [ABSTRACT FROM AUTHOR]

Objective To understand how changes in low-income mothers' work, home, and childcare environments impact their food practices for young children. Methods The grounded theory, theory-guided, design included two in-depth qualitative interviews (6 to 8 months apart) with each of 19 low income, working/student mothers of Head Start children, living in a rural county in Upstate New York. Interviews covered mothers' experiences of employment, school, family, household, and childcare events over one school year and whether and how events changed child food practices. Emergent themes related to mothers' experiences of life events, with attention to influences on child food practices, were open-coded using a constant comparative approach. A life course approach and a transactional model of the stress process informed interpretation. Results Within the study period, most mothers reported at least one life event, with many experiencing one or more changes in employers, job schedules, residence, household members, or childcare situation. Emergent patterns of adjustment in child food practices linked with life events were shaped by mothers' appraisals of life events, the availability of coping resources, and their adaptations to events, based on temporal, financial, and social resources. The findings support a view of child feeding informed by the transactional model of stress. Conclusions Instability in work, family, household, and childcare highlight changing contexts for child food practices in daily life. Research and practice should acknowledge the changing nature of the child feeding context and the need for children's caregivers to make adjustments in response to changing resources., Author(s): Tara Agrawal [sup.1] , Tracy Jean Farrell [sup.2] , Elaine Wethington [sup.3] , Carol M. Devine [sup.4] Author Affiliations: (Aff1) 0000 0004 0378 8438, grid.2515.3, Office of Community Health, [...]

We draw on the theory of allostasis to develop an integrative model of the current stress process that highlights the brain as a dynamically adapting interface between the changing environment and the biological self. We review evidence that the core emotional regions of the brain constitute the primary mediator of the well-established association between stress and health, as well as the neural focus of wear and tear due to ongoing adaptation. This mediation, in turn, allows us to model the interplay over time between context, current stressor exposure, internal regulation of bodily processes, and health outcomes. We illustrate how this approach facilitates the integration of current findings in human neuroscience and genetics with key constructs from stress models from the social and life sciences, with implications for future research and the design of interventions targeting individuals at risk. (Contains 6 figures and 7 footnotes.)

Objective: How work conditions relate to parents' food choice coping strategies. Design: Pilot telephone survey. Setting: City in the northeastern United States (US). Participants: Black, white, and Hispanic employed mothers (25) and fathers (25) randomly recruited from low-/moderate-income zip codes; 78% of those reached and eligible participated. Main Outcome Measures: Sociodemographic characteristics; work conditions (hours, shift, job schedule, security, satisfaction, food access); food choice coping strategies (22 behavioral items for managing food in response to work and family demands (ie, food prepared at/away from home, missing meals, individualizing meals, speeding up, planning). Analysis: Two-tailed chi-square and Fisher exact tests (P [less than or equal to] 0.05, unless noted). Results: Half or more of respondents often/sometimes used 12 of 22 food choice coping strategies. Long hours and nonstandard hours and schedules were positively associated among fathers with take-out meals, missed family meals, prepared entrees, and eating while working; and among mothers with restaurant meals, missed breakfast, and prepared entrees. Job security, satisfaction, and food access were also associated with gender-specific strategies. Conclusions and Implications: Structural work conditions among parents such as job hours, schedule, satisfaction, and food access are associated with food choice coping strategies with importance for dietary quality. Findings have implications for worksite interventions but need examination in a larger sample. (Contains 2 tables.)

Purpose: On the basis of the experience of an extensive community-based research partnership in New York City, we developed an innovative process for bridging the gap between aging-related research and practice, using a consensus-workshop model. Design and Methods: We adapted the traditional scientific consensus-workshop model to include translation of the research into nontechnical language and the involvement of practitioners in the process. We then applied the model to the specific issue of falls prevention among community-dwelling older adults. Results: The dialogue and interaction among researchers and practitioners provided new insights beyond a traditional research review. Practitioners offered astute guidance for future research based on their day-to-day field experience. Implications: The recommendations that emerged from the workshop demonstrated the value of close interaction between the aging-related research and practice communities. The consensus-conference model has significant potential to establish a bridge between the worlds of research and practice in a variety of settings.