Los Alamos National Laboratory Research Articles

P-482 Construct validity of the donor conception identity questionnaire and its association with searching for and finding donor connections

Abstract Study question Is there an association between donor conception identity, psychological and social wellbeing, and searching for and finding donor connections? Summary answer Donor conceived individuals differ on key domains that tap into aspects of their donor conception identity. These relate to searching for and finding donor connections. What is known already There is variation in the ways that donor conceived individuals feel about their conception. Factors such as the age of disclosure are associated with how donor conceived individuals feel about being donor conceived. Associations have been found between donor conception identity and parent-child relationship quality among adolescents, suggesting that curiosity and negativity about donor conception are influenced by the valence of the parent-child relationship. The Donor Conception Identity Questionnaire (DCIQ) has not been previously validated. Study design, size, duration 88 donor conceived adults in the UK participated in a cross-sectional study using an online multi-method survey. Data were collected between January and August 2022. The survey was advertised by the Donor Conception Network and Donor Conceived Register Registrants’ Panel via mailing lists and social media and circulated by the research team and others on social media and university mailing lists. The present findings draw from a subsection of the data collected from this survey. Participants/materials, setting, methods Most participants identified as female (n = 65,74%) and were conceived using donor sperm (n = 79,90%). Participants completed the 25-item DCIQ (adapted from studies of donor conception and adoption identity), and the Mental Health Continuum, the Satisfaction with Life Scale, and adapted versions of the community connectedness and pride subscales of the Gender Minority Stress and Resilience Measure and the HIV Stigma Scale. Participants reported on whether they had searched for and/or found donor connections. Main results and the role of chance Factor analysis of items on the DCIQ identified four domains: 1. Concern and centrality, 2. Internalised stigma, 3. Pride and acceptance, and 4. Openness and understanding. ‘Concern and centrality’ correlated positively with community connectedness (r(86)= 283, p=.008), and stigma (r(86)= 280, p= .008), and negatively with pride (r(86) =-.398, p<.001). ‘Internalised stigma’ was positively correlated with stigma (r(86)=.858, p<.001) and negatively correlated with psychological wellbeing (r(85)=-.378, p <.001), satisfaction with life (r(86)= -.263, p=.013) and pride (r(86)=-716, p<.001). ‘Pride and acceptance’ was positively correlated with psychological wellbeing (r(85) = .276, p = .010), satisfaction with life (r(86)=.329, p =.002) and pride (r(86)=.800, p<.001), and negatively correlated with stigma (r(86)=-.396, p <.001). ‘Openness and understanding’ was positively correlated with psychological wellbeing (r(85)=.304, p=.004), satisfaction with life (r(86)=.316, p=.003), and pride (r(86)=.584, p<.001) and negatively correlated with stigma (r(86)=-.614, p<.001). Searchers scored higher than non-searchers on ‘concern and centrality’ F(1, 79) = 7.543, p= .007 and ‘internalised stigma’ (F(1, 79)=4.355, p=.040). Donor conceived individuals who had found donor connections scored lower on ‘internalised stigma’ F(1, 79) = 7.071, p=.009 and higher on ‘openness and understanding’ (F(1, 79)=6.083, p=0.016) compared to those who had not found their donor connections. Limitations, reasons for caution Lack of diversity within the sample with regards to participant gender, age, and donation type means that findings may not apply across donor conceived populations. The sample were self-selected. Causal relationships between variables cannot be established. Wider implications of the findings The DCIQ may be useful to understand variation in donor conceived people’s psychological health and interest in their donor. The value of the measure in a practical context (e.g., in counselling) should now be evaluated. Further work to validate the scale across different contexts and with different populations is recommended. Trial registration number the UK Economic and Social Research Council [New Investigator Award ES/S015426/1

Community Connections Committee: How the Joint Safety Team of the University of Minnesota Innovates Promoting Vertical Safety Engagement

Community Connections Committee: How the Joint Safety Team of the University of Minnesota Innovates Promoting Vertical Safety Engagement

“By Any Means Necessary”: A Case Study Examining How School Leaders Facilitated Community Connectedness in the Early Years of Elementary School

ABSTRACT Elementary school principals play a central role in inducting families into their school communities. As early childhood programs, such as prekindergarten, increasingly become part of elementary schools, this role is expanding. Yet, principals often struggle to establish and maintain such relationships, particularly with many of the historically disenfranchised communities that prekindergarten programs are often designed to serve; these struggles are troubling because success in the early years of schooling can lead to sustained and positive impacts for students as they progress through schooling. Furthermore, few studies have investigated this issue. In this article, we do so by employing Yosso’s Communities of Cultural Wealth to examine how a collection of principals working in Texas described their interactions with the children and families as they entered the early grades of their schools and what these principals hoped these children and families would gain from their early childhood education programs. Our findings revealed strengths and growth areas in their descriptions of fostering the cultural wealth of the children and families entering their schools, which provides an opportunity to consider how to support and train principals as well as the structural changes that need to be addressed to support principals in these activities.

The HIV Environmental Riskscape: The Roles of HIV Sexual Risk and Resilience Factors among Black Men Who Have Sex with Men: Findings from the Real Talk Project.

Black and African American men who have sex with men (Black MSM) experience the greatest proportion of new HIV infections in the United States. To address this challenge, a better understanding of the HIV environment riskscape including both risk and resilience factors is warranted among Black MSM. Research indicates that stress is associated with increased HIV sexual risk behaviors. Further, behavioral factors such as serosorting and community level factors including social support and community connection are resilience factors that protect against risk behaviors. The present study examines whether everyday stress is associated with HIV sexual risk behavior, as well as the role of risk and resilience factors among 125 Black MSM recruited in the Real Talk study. The Real Talk project examined the relationships between resilience, HIV risk behaviors, and HIV prevention strategy among a sample of Black MSM. Using generalized estimating equations, our results indicate a positive association between everyday stress and engaging in condomless anal intercourse only after adjusting for risk, resilience, and correlate variables. Similarly, having multiple sex partners and using substances during sex also show positive associations with condomless anal intercourse. Resilience factors of engaging in serosorting and being connected to both the Black and gay communities were negatively associated with condomless anal intercourse. Future prevention research and programming should focus on both risk and resilience factors to mitigate new HIV infections among Black MSM.

The mental and behavioral health crisis in youth: Strategic solutions post COVID-19 pandemic: An American Academy of Nursing consensus paper

The COVID-19 pandemic wrought significant negative impacts on youth well-being, particularly among Black, Hispanic, American Indian, Alaska Native, and LGBTQ+ (Lesbian, gay, bisexual, transgender, queer or questioning) youth. The pandemic disrupted connections to family, school, and community, which are essential supports for youth mental health. Lessons learned from the pandemic suggest the role of stress and windows of opportunity to build resiliency. Drawing from a policy dialog on the youth mental health crisis conducted by 4 American Academy of Nursing Expert Panels, we present approaches to the current increase in youth mental health problems. Included is emerging literature on building youth resilience, particularly via re-establishing school and community connections. The role of families, schools, and community support is emphasized, particularly by creating a healing school environment and the pivotal role of school nurses. Recommendations include increased support for families, engaging the school nurse role, and developing school-based innovative programs to build connections and youth wellness.

Interventions to promote mental health in the Occupied Palestinian Territories and Palestinian refugees: A scoping review

Background: The long history of the Palestinian-Israeli conflict has resulted in a public and mental health crisis. Despite the significant mental health burdens facing the Palestinian population in the Occupied Palestinian Territories (OPT) and refugee camps, this issue remains comprehensively unexplored. Aims: This scoping review identified mental health interventions and assessed their effectiveness among populations in the OPT and Palestinian refugee camps, while addressing delivery challenges. Method: A scoping review was conducted using 14 databases to include relevant studies published through March 2024 using PRISMA guidelines for scoping reviews. Results: Analyzing 31 intervention studies meeting the inclusion/exclusion criteria, revealed varied outcomes in interventions targeting post-traumatic stress disorder, depression, and overall mental well-being. Conclusions: While some interventions showed potential, others had limited effectiveness, underscoring the complexity of mental health needs in conflict zones. Gender- and risk-specific effectiveness was observed, emphasizing the need for tailored approaches. Challenges like low attendance rates and systemic barriers hindered intervention success. The profound impact of war on children stresses the urgency for targeted interventions. Empowerment and community connectedness are vital for resilience, along with the importance of family and community involvement and research that balances the need for strong evaluation designs with the need for ongoing mental health services. Advocacy for systemic changes is crucial to implement the complex sustainable interventions necessary to assure mental health in any population. This review highlights the importance of holistic, contextually relevant approaches for mental health intervention in OPT and refugee camps, emphasizing rigorous evaluations and community-driven approaches.

Remediation of isoproturon-contaminated soil by Sphingobium sp. strain YBL2: Bioaugmentation, detoxification and community structure

The widely used phenylurea herbicide isoproturon (IPU) and its residues can inhibit the growth of subsequently planted crops. However, reports on bioremediation of IPU-contaminated soil are scarce. In this study, Sphingobium sp. strain YBL2-gfp (a derivative of the IPU-degrading Sphingobium sp. strain YBL2 isolated by our lab) was constructed to bioremediate IPU-contaminated soil. In pot experiments, strain YBL2-gfp colonized the roots of wheat and eliminated IPU residues in the soil within 21 d, effectively alleviating its toxicity and restoring wheat growth. IPU treatment reduced the richness and diversity of soil bacteria, while inoculation YBL2-gfp mainly affected richness with less impact on diversity. The high concentrations of IPU and inoculation of YBL2-gfp alone reduced the soil microbial community connections, while bioaugmentation treatment enhanced the soil microbial community connections. Additionally, strain YBL2-gfp stimulated the metabolic capacity of the indigenous microbes, promoting the degradation of IPU and reducing the negative impact of high concentrations of IPU on microbial community. Taken together, this study offers relatively comprehensive insights into the practical application of bioaugmentation, demonstrating that strain YBL2 has the potential to remediate IPU-contaminated soils.

Particle size shapes prokaryotic communities and vertical connectivity in the water columns of the slope and central basin of the South China Sea

Sinking of organic matter represents an essential mechanism for sequestration of carbon that is exported from the ocean surface to deeper depths. While recent studies have highlighted the important role of microorganisms in the biological pump, the impact of sinking particles on the vertical connectivity of microbial communities has received limited attention. In this study, we present the microbial profile of sinking particles in the northern slope and the central basin of the marginal South China Sea (SCS) using an in-line size-fractionated water filtration and Illumina high-throughput 16S rRNA amplicon sequencing. We investigate the microbial community composition within organic particles of different size fractions (30, 5, 3, 0.22 μm), and we reveal significant differences in the microbial community structure between these two distinct areas of SCS. The vertical connectivity of microbial communities in the slope and the central basin of SCS shows distinct patterns of microbial dispersal along the water column that occurs via the sinking of organic particles. We find that the microbial communities have different abundances on the different examined particle size fractions and which highlights the role of sinking particles in shaping microbial lifestyles along the water column. Our study underscores the influence of environmental variations on the vertical connectivity of microorganisms and provides additional insights into the marine biological pump under different environmental conditions.

Exploring the Relationships Between Body Image, Sexual Well-Being, and Community Connectedness among Gay, Bisexual and Queer+ Men

ABSTRACT Sexual minority (SM) men are more likely than heterosexual men to experience body dissatisfaction due to prevailing body ideals (e.g. lean and muscular) within the SM community. Negative body image can have harmful effects on well-being, and, by extension, sexual well-being. The current study aimed to investigate whether SM men’s minority identification and LGBTQ+ community connectedness moderates the relationship between drives for muscularity and sexual anxiety. To address this aim, 298 Australian-residing SM men completed an online survey that examined drive for muscularity, sexual anxiety, and connectedness or identification with the LGBTQ+ and SM-specific communities. As hypothesized, the results showed a positive relationship between drive for muscularity and sexual anxiety. Additionally, LGBTQ+ community connectedness, but importantly not SM identification, was found to moderate this relationship, showing a positive association only when connection was at low or average levels. These results highlight the beneficial effects that LGBTQ+ community connection can have for SM men, such as protecting them against the harmful impacts of poor body image on sexual well-being. These results also provide preliminary insights into the need to expand the understandings of bodily diversity, and diversity of sexual well-being experiences, among SM men less connected to the broader LGBTQ+ community.

LGBTQ+ Sociopolitical Engagement: Examining the Role of House Ball Community Involvement and LGBTQ+ Community Connection.

Recent events such as the Black Lives Matter movement, COVID-19, and political elections have highlighted the power of a socially and politically engaged society. One under-researched cultural pillar at the core of sociopolitical resistance for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people of color (POC) has been the House Ball Community, a dynamic subculture made up of intricate social networks. This study uses data collected for the Social Justice Sexuality Project (N = 246) to examine LGBTQ+ community connection and House Ball Community involvement as predictors of LGBTQ+ and intersectional LGBTQ+ sociopolitical engagement. Two continuous variables, community connection and sociopolitical engagement (consisting of separate scales about LGBTQ+ individuals and LGBTQ+ POC), were included in the analysis. Multivariate linear regression analyses were performed to examine the relationships between these variables. While community connection was significantly associated with both scales of sociopolitical engagement, House Ball involvement was only associated with intersectional LGBTQ+ sociopolitical engagement. Relative to community connection, House Ball involvement was more strongly associated with intersectional LGBTQ+ sociopolitical engagement. Findings suggest that House Ball involvement may influence behavior for LGBTQ+ POC. Authors discuss implications for intersectionality in social movements and culturally responsive direct, community, and systems-level social work practice within the current U.S. sociopolitical landscape.

Antarctica is less isolated with increasing depth - evidence from pycnogonids

No other group of animals typifies the uniqueness of Antarctic life more than Pycnogonida (sea spiders), with 20% of all known species found in the Southern Ocean, and 64% of these endemic to the Antarctic. Despite nearly 200 years of research into pycnogonids and other benthic phyla in Antarctica, the parameters which drive the distribution and diversity of benthic fauna are still poorly understood. This study aimed to investigate the diversity and connectivity of pycnogonid communities on either side of the Antarctic Polar Front, with an emphasis on the role of water depth, using an occurrence dataset containing 254 pycnogonid species from 2187 sampling locations. At depths shallower than 1000 m, communities to the north and south of the Antarctic Polar Front were distinct, while below this depth this geographic structure disintegrated. The Polar Front, or the expanse of deep ocean it bisects, seemingly acts as a semipermeable barrier to species exchange between well-sampled shallow communities. The less sampled and less understood deep sea appears to be better connected, with high levels of shared species following the northward flow of Antarctic Bottom Water. The exceptionally high diversity and endemism of Antarctic pycnogonids may reflect an apparent competitive advantage in cold waters which leaves them vulnerable to ongoing ocean warming, with increased competition and predation pressures.

Stigma and lesbian, gay, bisexual, transgender, and queer (and additional identities) (LGBTQ+) parent socialization self-efficacy: Mediating roles of identity and community.

In the United States, cultural forces have led to the stigmatization of lesbian, gay, bisexual, transgender, and queer (and additional identities) (LGBTQ+) parenthood. However, pushing back against this stigmatization, developing a positive LGBTQ+ identity, and investing in one's LGBTQ+ community may inform empowering narratives of future parenthood and related constructs, such as LGBTQ+ parent socialization. Perceived self-efficacy related to preparation for bias (i.e., discussions of discrimination, prejudice, or bias-based bullying) socialization is likely associated with an individual's own perceptions or experiences of stigmatization given the conceptual overlap of bias and stigma. However, other constructs related to stigmatization and socialization self-efficacy, such as positive LGBTQ+ identity or community connectedness, have yet to be simultaneously considered (to our knowledge). Further, previous research has rarely included different assessments of stigma (i.e., perceived and enacted) and/or dimensions of positive LGBTQ+ identity (i.e., authenticity and self-awareness). Thus, this study aimed to rectify these gaps and provide a greater understanding of sexual stigma and LGBTQ+ parent socialization self-efficacy. Using data from a survey-based, online, cross-sectional study of LGBTQ+ childfree adults (N = 433; Mage = 29.85 years old) in the United States, we found that experiences of enacted or perceived sexual stigma were differentially associated with LGBTQ+ parent socialization preparation for bias self-efficacy. Further, positive LGBTQ+ identity authenticity and self-awareness, as well as LGBTQ+ community connectedness played distinct roles as mediators of the relationships between sexual stigma and LGBTQ+ parent socialization self-efficacy. These findings have implications for how we might understand the role of stigma, identity, community, and socialization among future LGBTQ+ parents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Being out in high school: Positive implications for well-being in three U.S. cohorts of sexual minority adults.

For lesbian, gay, bisexual, or queer (i.e., sexual minority [SM]) youth, coming out is an important developmental milestone and is typically associated with positive well-being. However, coming out in high school may entail a higher risk of school-based victimization. Due to the greater risk of homophobic bullying, the implications of being out in adolescence and well-being later in adulthood remain unclear. Using data from a national probability survey (Generations Study) of three distinct age cohorts of SM adults (N = 1,474) in the United States, this study (a) examined how being out at school in adolescence affects general well-being in adulthood and (b) SM-specific well-being in adulthood, and (c) examined if these associations differ by cohort. Results from multivariate regression analyses demonstrated that being out in adolescence was not significantly associated with general well-being, but was significantly associated with SM-specific well-being: higher rates of identity centrality and community connectedness, and lower rates of internalized homophobia. There were no cohort differences in the associations between outness in high school, general well-being, and SM well-being. The findings from this national probability sample of SM adults provide novel insight into implications of being out across the life course, including the positive implications of being out at school in adolescence for SM-specific well-being in adulthood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of IoT on Smart City Infrastructure in India

Today, we live in a society where digital communication systems are so advanced that by the mid 2050’s the world will be completely filled by smart buildings on the internet highway like those portrayed in science fiction movies. This is possible because of tech savvy tiny sensors or Internet of Things (IoT) devices embedded in the smart network in order to collect meaningful information about the citizens and their interaction with the ubiquitous environment. Smart sustainable cities are modelled on the Internet of Things blending ICT for better standard of living and citizen services. IoT will modify indoor temperatures and switch off unnecessary lights in homes, detect snags in equipment and fix machines remotely, and provide commuters with information on traffic jams on the go. IoT in smart cities can be implemented by the development authorities but the stake holders of this task are citizens, the municipal government and private organizations engaged in this partnership. Using sophisticated ICT systems makes the city smarter and improves community building and connectivity by interweaving all the components of a city. Privacy and security are the two watch words when it comes to capturing citizens’ data. This data needs to be anonymised before it reaches the civic authorities. This study evaluates the advantages and disadvantages of using IoT in Indian smart cities after discussing an international case study of a smart sustainable city.

Using Social Media as a Marketing Communication Strategy: Perspectives from Health-Related Non-Profit Organizations

ABSTRACT The continued growth of nonprofit organizations (NPOs) has caused major competition to create awareness of their funding needs and services. Consequently, NPOs have begun to increase the use of social media as a marketing communication strategy. Therefore, the main aim of the study is to examine the drivers and barriers associated with using social media marketing communication tools among health-related NPOs in South Africa. The study employed a qualitative method and conducted semi-structured interviews with 13 marketing professionals from selected NPOs. The results propose that the allure of cost-effectiveness and fundraising potential, as well as fostering donor relationships and deeper community connections, serve as drivers for social media usage in marketing communication activities. Conversely, limited knowledge, budget constraints, time restrictions, and prevailing circumstances are noteworthy barriers. The study makes an important contribution to the drivers and barriers associated with using social media among health-related NPOs in a developing-nation context.

The influence of an agricultural intervention on social capital and water insecurity coping strategies: Qualitative evidence from female smallholder farmers living with HIV in western Kenya

BackgroundGreater social capital is associated with positive health outcomes and better HIV management. The ways by which social capital may influence household water insecurity (HHWI), a critical determinant of health among persons living with HIV, remain underexplored. Further, despite the importance of reliable water access and use for health and agricultural productivity, few studies have described the strategies smallholder farmers living with HIV use to manage water insecurity. ObjectiveWe qualitatively explored how an agricultural intervention (provision of a treadle pump for irrigation) influenced HHWI coping strategies through its impacts on social capital among smallholder farmers living with HIV in western Kenya. MethodIn 2018, we purposively recruited participants from the Shamba Maisha study, a randomized agricultural intervention (NCT02815579) that provided irrigation pumps to improve treatment outcomes and food security among smallholder farmers living with HIV in western Kenya (n = 42). Participants shared their experiences with water insecurity through go-along and photo-elicitation interviews. Data were thematically analyzed using inductively developed codes. ResultsParticipants described diverse strategies for coping with agricultural water insecurity. Dimensions of social capital such as feelings of belonging, connectedness, and trust influenced the use of the treadle water pump and other water access behaviors. For instance, participants reported borrowing or sharing water pumps with friends and neighbors if they felt they had a good rapport. In addition, participants indicated a willingness to engage in collective activities, such as supporting the operation of the irrigation pump during planting, when they felt sufficiently connected to a larger group. Overall, individuals in the intervention arm described greater social cohesion, reciprocity, and community connectedness than those in the control arm. ConclusionThe impact of an agricultural intervention on water access and use was described as being modified by social capital among female smallholder farmers living with HIV. Findings suggest that social capital may create an enabling environment for implementing strategies that improve the management and reduce the burden of HIV. Measuring these strategies and their associations with HIV outcomes may strengthen our understanding of resilience among female smallholder farmers living with HIV. The development of a coping strategies index and its use in a longitudinal study could help to identify pathways through which social capital influences health and the effectiveness of livelihood interventions.

Traversing the Challenges of Community Engagement in South Africa: Emerging Researchers’ Perspectives

With the growing emphasis being placed on community engagement, many emerging scholars have found themselves in the field with much to learn beyond the research that they are conducting. Community engagement is guided by principles such as the mutual exchange of knowledge, collaboratively identifying community priorities and an ongoing focus on strengthening and sustaining communities. In practice, community engagement is fraught with various challenges that need to be navigated. These challenges present themselves in different ways to different researchers. In this article, we draw on our experiences as three emerging researchers navigating community-engaged research across two geographic spaces in South Africa, namely, the Western Cape and Gauteng, two of the country’s nine national provinces. The objectives of this article are to explore our experiences of relationship building, to determine the role our positionalities have played in our engaged scholarship, and to explore feelings of disconnectedness as young academics. Following a qualitative reflexive approach, we identified three themes that speak to these objectives, namely, navigating newcomer status and building relationships in community-engaged spaces, reflections on researcher positionality in the field, and the dilemma of (dis)connectedness in engaged scholarship. Our findings highlight the need for support such as mentorship from experienced community-engaged scholars, resources for establishing community connections, guidance in navigating cultural nuances, and training for effective communication and relationship building in communities.

The Artist’s Statement—Economic Reconciliation

The outline of the tipi symbolizes community connectedness and a place of warmth, security, wellness, and sacred tradition and value. Inside the tipi, two individual vines intertwine: one representing corporate Canada and the government, and the other representing Indigenous peoples. The intertwining vines embody reconciliation between these two groups through acceptance, balance, understanding, and engagement. Both vines show a similar level of support, highlighting that Indigenous peoples are equally capable, powerful, knowledgeable, and hard-working as mainstream society. Together, through reconciliation, we can contribute greatly to the Canadian economy through our history, land, and resources. That’s why I chose to have the intertwined vines holding up the Earth (economy). The “Turtle Island” landmass on the Earth acknowledges the land of Indigenous peoples, affirming our equal right to be involved in shaping the economy. With a call to action, we can make it happen and increase opportunities for ourselves in the process. The image represents the vision of economic reconciliation, with the value of this vision held within the tipi. Through the intertwined vines and acknowledgment of Turtle Island, the image conveys the message that Indigenous peoples have an equal right to shape the Canadian economy. By taking action, we can make this vision a reality and increase opportunities for ourselves.

Functional vertical connectivity of microbial communities in the ocean.

Sinking particles are a critical conduit for the transport of surface microbes to the ocean's interior. Vertical connectivity of phylogenetic composition has been shown; however, the functional vertical connectivity of microbial communities has not yet been explored in detail. We investigated protein and taxa profiles of both free-living and particle-attached microbial communities from the surface to 3000 m depth using a combined metaproteomic and 16S rRNA amplicon sequencing approach. A clear compositional and functional vertical connectivity of microbial communities was observed throughout the water column with Oceanospirillales, Alteromonadales, and Rhodobacterales as key taxa. The surface-derived particle-associated microbes increased the expression of proteins involved in basic metabolism, organic matter processing, and environmental stress response in deep waters. This study highlights the functional vertical connectivity between surface and deep-sea microbial communities via sinking particles and reveals that a considerable proportion of the deep-sea microbes might originate from surface waters and have a major impact on the biogeochemical cycles in the deep sea.

Experience of Public Health Departments in Implementation of COVID-19 Case Investigation and Contact Tracing Programs.

Case investigation and contact tracing (CI/CT) are fundamental public health efforts widely used during the COVID-19 pandemic to mitigate transmission. This study investigated how state, local, and tribal public health departments used CI/CT during the COVID-19 pandemic, including CI/CT methodology, staffing models, training and support, and efforts to identify or prioritize populations disproportionately affected by COVID-19. During March and April 2022, we conducted key informant interviews with up to 3 public health officials from 43 state, local, and tribal public health departments. From audio-recorded and transcribed interviews, we used the framework method to analyze key themes. Major adjustments to CI/CT protocols during the pandemic included (1) prioritizing populations for outreach; (2) implementing automated outreach for nonprioritized groups, particularly during COVID-19 surges; (3) discontinuing contact tracing and focusing exclusively on case investigation; and (4) adding innovations to provide additional support. Key informants also discussed the utility of having backup staffing to support overwhelmed public health departments and spoke to the difficulty in "right-sizing" the public health workforce, with COVID-19 surges leaving public health departments understaffed as case rates rose and overstaffed as case rates fell. When addressing future epidemics or outbreaks, public health officials should consider strategies that improve the effectiveness of CI/CT efforts over time, such as prioritizing populations based on disproportionate risk, implementing automated outreach, developing models that provide flexible additional staffing resources as cases rise and fall among local public health departments, incorporating demographic data in laboratory reporting, providing community connections and support, and having a system of self-notification of contacts.