Evaluation Of Prevention Programs Research Articles

Risk Factors Affecting the Psychological Resilience of Adolescents in Institutional Care: A Systematic Review.

Psychological resilience is defined as the resilience capacity and the power to recover in the face of stressful life events. Adolescents in institutional care have different individual, familial, and environmental risk factors that negatively affect their psychological resilience. This study aimed to comparatively examine studies that detect the risk factors affecting the resilience of adolescents living in institutional care and make recommendations regarding initiatives or specific outcomes related to this. This study systematically reviewed national and international literature databases such as PubMed, Web of Science, Science Direct, Medline, CINAHL, EBSCO host, Psychinfo, Cochrane Library, Turkish Ulakbim, Turkish Medical Directory, and Turkish Psychiatry Directory up to December 2021. Fourteen studies were included in this study. Many significant risk factors, such as adolescents' interpersonal relationships, self-confidence, self-esteem, self-efficacy levels, problem-solving skills, empathy skills, as well as parental abandonment, domestic violence, socioeconomic poverty, a history of abuse, peer rejection, lack of social support resources, and low academic performance, have been identified and discussed at individual, familial, and environmental levels. Adolescents in institutional care were more vulnerable and had more mental and behavioral problems than their peers. This systematic review found no studies evaluating preventive programs, interventions, or interventions designed to reduce the frequency and prevalence of future adverse events for children growing up in institutional care settings. Recommends the comprehensive inclusion and evaluation of preventive programs, practices, and assessments aimed at reducing the frequency and prevalence of risk factors affecting resilience.

CDC-Funded HIV Testing Services Outcomes in Ending the HIV Epidemic in the U.S. (EHE) and Non-EHE Jurisdictions, 2021.

Ending the HIV Epidemic in the U.S. (EHE) aims to end the HIV epidemic by focusing on 57 jurisdictions most impacted by HIV. Using 2021 data from the National HIV Prevention Program Monitoring and Evaluation system, we calculated distributions of CDC-funded HIV tests and HIV testing services outcomes in EHE and non-EHE jurisdictions. We conducted chi-square tests and robust Poisson regression to compare differences in outcomes. Of the 1,753,873 tests conducted, a greater proportion were conducted in EHE (65.7%) versus non-EHE (34.3%) jurisdictions (p<0.001). Greater number of persons newly diagnosed were identified in EHE (n=5,861) versus non-EHE (n=2,329) jurisdictions; newly diagnosed positivity was higher in EHE (0.5%) versus non-EHE (0.4%; PR=1.31, 95% CI: 1.25-1.38) jurisdictions. Among persons newly diagnosed, there were no differences in proportion of linkage to care within 30 days in EHE jurisdictions (77.9%) versus non-EHE jurisdictions (77.1%; PR=1.01, 95% CI: 0.95-1.07). Proportion of persons newly diagnosed interviewed for partner services was lower in EHE (69.0%) versus non-EHE (84.8%; PR=0.81, 95% CI: 0.76-0.87) jurisdictions. CDC-funded HIV testing services in EHE jurisdictions conducted more HIV testing and diagnosed more persons. Jurisdictions can further expand HIV testing and related services to continue striving toward EHE goals.

Sex Trafficking Perspectives among High School Students and School Personnel in the Midwest: A Focus Group Study to Inform Sex Trafficking Prevention Programming

Sex trafficking among youth is a growing concern, however, we know very little about how youth perceive sex trafficking, nuances of sex trafficking among youth, or how to work with youth or supportive adults to prevent sex trafficking among youth. Thus, we conducted focus group discussions with racially and ethnically diverse high school students and school personnel in an urban Midwestern city to delineate their knowledge and understanding of sex trafficking and to explore ideas for sex trafficking prevention education. The findings provide critical information necessary for the refinement of a sex trafficking prevention program and rigorous programmatic evaluation.

Development of the Vietnamese Rape Myths Acceptance Scales: A Web-Based Survey of Young Adults.

Rape myths-false but widely held beliefs that serve to deny and justify sexual aggression-present a major barrier to reporting and prevention of sexual violence in Vietnam and globally. Based on a parent study aimed at reducing sexual violence at two universities in Hanoi, we developed and assessed a contextualized measure of rape myths among young people in Vietnam. Items from previously validated rape myth acceptance (RMA) scales and data from qualitative research informed the development of 50 items, which were administered to Vietnamese 18-24-year-olds (n = 2,756 total, n = 1,798 cisgender women) via an anonymous link in February 2021. We used factor analysis to explore and test factor structure and multi-group factor analysis to assess measurement equivalence across gender. We calculated item-level discrimination and difficulty parameters and visualized information curves using item response theory analysis, informing the development of a short form. Four hypothesized subconstructs identified in the qualitative data emerged as factors: (1) "He didn't mean to"; (2) "She asked for it"; (3) "It wasn't really rape"; and (4) "Rape is a deviant event." A fifth factor, "She didn't protect herself," included four items from formative data. Confirming formative findings and prior literature, cisgender women had lower RMA than cisgender men, particularly on items related to victim-blaming. The Vietnamese Rape Myths Acceptance Scales were internally consistent and equivalent between cisgender men and women, capturing elements specific to the Vietnamese context and providing a tool for campus climate surveys and evaluations of sexual violence prevention programs.

Evaluations of countering violent extremism programs: Linking success to content, approach, setting, and participants

Since the September 11 attacks, prevention and countering violent extremism (P/CVE) programs have rapidly increased worldwide, garnering significant interest among researchers. This paper is a systematic review focusing on the evaluations of primary, secondary and tertiary prevention programs from 2001 until 2020. The review identified 74 program evaluations that included satisfactory measures and metrics. Only 32% of the studies deemed the intervention successful, 55% described limited success, and 8% deemed the program had failed. Many of the programs evaluated failed to reach their objectives; some generated negative outcomes such as community disdain and an increase in the likelihood of alienation and stigma. Success was largely a self-assessed measure by the facilitators or stakeholders of the programs or the evaluators of the study. Success indicators can be operationalized as the degree of enhanced sense of belonging (connectedness to the community, social connection), trust and willingness to engage in programs, development of critical thinking skills (integrative complexity theory), and a strong sense of worth (quest for significance). Without a generally accepted set of metrics and no cohesive framework for conducting evaluations, this review offers an important addition to the field on the evidence suitable for program evaluations. An important aim of this systematic review was to identify what makes an effective and successful countering violent extremism program. The key findings indicate that enhancing belonging, identity, trust and community engagement, acknowledging perceptions of injustice, religious mentoring, and the promotion of critical thinking/self-reflection are associated with successful programs. The findings press upon policymakers, funders, and researchers the need to consider and support high-quality evaluations of programs.

Design and Evaluation of a Collective Preventive Program for Musical Performance Anxiety (ConfiDance).

Musical performance anxiety (MPA) is considered a subtype of social phobia and affects musicians who must face musical exposure in public, potentially severely affecting their emotional stability and significantly impairing the quality of their performance. This research has utilized previous scientific knowledge on the issue and a qualitative approach to musicians' needs through focus groups in order to design a collective preventive program for MPA that could be implemented within the training curriculum of professional musicians. To evaluate the adequacy of the preventive program 'ConfiDance', a pilot test was conducted with a sample of 17 professional musicians in training, all post-graduate students in classical music performance. For the pilot test, a quasi-experimental model with a repeated measures methodology (pre-post and one-year follow-up after application) was carried out. The results indicate a significant decrease in MPA after the program implementation, with a notable improvement in effect one year post-application, demonstrating an even greater positive impact over time. These data should be interpreted cautiously due to sample limitations but represent an opportunity for the future implementation of a program that can prevent and treat MPA in music education centers.

Reliability and validity of rapid assessment tools for measuring 24-hour movement behaviours in children aged 0–5 years: the Movement Behaviour Questionnaire Baby (MBQ-B) and child (MBQ-C)

BackgroundThe development of validated “fit-for-purpose” rapid assessment tools to measure 24-hour movement behaviours in children aged 0–5 years is a research priority. This study evaluated the test-retest reliability and concurrent validity of the open-ended and closed-ended versions of the Movement Behaviour Questionnaire for baby (MBQ-B) and child (MBQ-C).Methods300 parent-child dyads completed the 10-day study protocol (MBQ-B: N = 85; MBQ-C: N = 215). To assess validity, children wore an accelerometer on the non-dominant wrist (ActiGraph GT3X+) for 7 days and parents completed 2 × 24-hour time use diaries (TUDs) recording screen time and sleep on two separate days. For babies (i.e., not yet walking), parents completed 2 × 24-hour TUDs recording tummy time, active play, restrained time, screen time, and sleep on days 2 and 5 of the 7-day monitoring period. To assess test-retest reliability, parents were randomised to complete either the open- or closed-ended versions of the MBQ on day 7 and on day 10. Test-retest intraclass correlation coefficients (ICC’s) were calculated using generalized linear mixed models and validity was assessed via Spearman correlations.ResultsTest-retest reliability for the MBQ-B was good to excellent with ICC’s ranging from 0.80 to 0.94 and 0.71–0.93 for the open- and closed-ended versions, respectively. For both versions, significant positive correlations were observed between 24-hour diary and MBQ-B reported tummy time, active play, restrained time, screen time, and sleep (rho = 0.39–0.87). Test-retest reliability for the MBQ-C was moderate to excellent with ICC’s ranging from 0.68 to 0.98 and 0.44–0.97 for the open- and closed-ended versions, respectively. For both the open- and closed-ended versions, significant positive correlations were observed between 24-hour diary and MBQ-C reported screen time and sleep (rho = 0.44–0.86); and between MBQ-C reported and device-measured time in total activity and energetic play (rho = 0.27–0.42).ConclusionsThe MBQ-B and MBQ-C are valid and reliable rapid assessment tools for assessing 24-hour movement behaviours in infants, toddlers, and pre-schoolers. Both the open- and closed-ended versions of the MBQ are suitable for research conducted for policy and practice purposes, including the evaluation of scaled-up early obesity prevention programs.

Scoping Review: Reducing Musculoskeletal Injury Risk Factors for Adaptive Sport Athletes Through Prevention Programs.

The purpose of this scoping review was to identify existing strategies to reduce modifiable risk factors for musculoskeletal (MSK) injury in adaptive athletes. Medline, Embase, Web of Science, and CINAHL were searched. Inclusion criteria required studies written in English, samples of adaptive athletes, and evaluation of any injury prevention programs that would reduce risk factors associated with MSK injury. The literature search resulted in 785 unique articles. Thirty-two full text articles were screened for inclusion. Four studies of wheelchair basketball and wheelchair rugby injury prevention programs were included in the final analysis, and these studies demonstrated increase in shoulder range of motion, decreased shoulder pain, and decreased cumulative traumatic disorders; all of which was proposed to reduce risk of shoulder injury. However, these studies were small and did not include control groups. Future research is needed to implement programs that reduce risk factors of MSK injuries and reduce health disparities for adaptive athletes.

CDC-Funded HIV Testing and Undiagnosed HIV Infection in Ending the HIV Epidemic in the U.S. Jurisdictions.

Approximately 13% of persons with HIV (PWH) are unaware of their status. To help end HIV, it is important to understand the relationship between the rates of HIV testing and undiagnosed HIV infection. Ending the HIV in the U.S. (EHE) jurisdictions. Using 2021 data from the National HIV Surveillance System and the National HIV Prevention Program Monitoring and Evaluation system, we calculated estimated rates of undiagnosed HIV infections per 100,000 population and rates of CDC-funded HIV tests per 1,000 population. We assessed the association between the two rates using Spearman's rank correlation. We also calculated a rank difference between the two rates for each EHE jurisdiction to help identify jurisdictions with greater unfilled needs for HIV testing. Overall, CDC-funded HIV tests per 1,000 population were positively associated with estimated rate of undiagnosed HIV infection per 100,000 population (rho=0.55, p<0.001). EHE jurisdictions with the greatest magnitude of negative rank differences (i.e., higher undiagnosed HIV infection per 100,000 population and lower CDC-funded HIV tests per 1,000 population) were Prince George's County, MD; Mecklenburg County, NC; Hudson County, NJ; Bronx County, NY, and Hamilton County, OH. In general, CDC-funded HIV testing is being conducted in jurisdictions with the greatest needs. However, we also found large discrepancies between CDC-funded HIV testing and undiagnosed HIV infection rates for some jurisdictions. These jurisdictions may want to identify barriers to their HIV testing services and expand their programs to ensure that all PWH in their jurisdictions are diagnosed.

Evaluation of infection prevention and control programmes according to the European Centre for Disease Prevention and Control and the World Health Organization in Spain 2012–2022: indicators of core component 1

Key and core components of effective infection prevention and control programmes (IPCPs) issued by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) have been described. WHO core component 1 relates to the structure, organization and management of IPCPs. The objective of this study was to assess the status and the time trends of some indicators of core component 1 of IPCPs in acute hospitals in Spain throughout the period 2012-2022. Hospital-level data from the Spanish point prevalence survey for years 2012-2022 were analysed. Core component 1 indicators were calculated and tested for association to healthcare-associated infections (HAIs). In addition, trends were also examined. Overall, 67.0% and 57.2% of Spanish hospitals reported having an annual infection prevention and control (IPC) plan and an annual IPC report that was approved by the hospital managing director, respectively. The global median number of full-time equivalent (FTE) IPC nurses per 250 beds for the period was 0.87 and the global median number of FTE IPC doctors was 0.70. The rates of blood cultures and stool tests for Clostridioides difficile were 39.9 and 6.1 per 1000 patient-days, respectively. No significant correlation was found between core component 1 indicators and HAI prevalence. Spain is currently at a basic level on the structure, organization and management of IPCPs. Profound differences were found between hospitals depending on size and type.

Contexts and Characteristics of Imaged-Based Sexual Exploitation and Abuse of Children: Incident Dynamics in a National Sample.

This paper describes incident characteristics and dynamics associated with six specific forms of image-based sexual exploitation and abuse of children (IBSEAC). Data were collected on a national sample of 2639 individuals aged 18-to-28 from a probability-based online panel. Respondents completed a self-administered survey questionnaire, providing detailed follow-up information on their experiences of image-based sexual victimization before the age of 18. A total of 607 incidents of IBSEAC were included in the analyses. Findings show substantial diversity in incident characteristics within and across the six forms of IBSEAC (nonconsensual sharing of sexual images, nonconsensual taking or making of images, forced image recruitment, threatened sharing, voluntary image sharing with an older adult, and commercial sexual exploitation involving images). Some notable patterns include frequent involvement of perpetrators who are other youth or young adults, who are known in-person to the victim, and who are intimate partners. The diversity and complexity of dynamics revealed in this study underscores the need for careful design and evaluation of prevention programs and the core messages directed at youth.

Cost-Effectiveness of an Individualised Management Program after Stroke: A Trial-Based Economic Evaluation

Introduction: Evidence on the cost-effectiveness of comprehensive post-stroke programs is limited. We assessed the cost-effectiveness of an individualised management program (IMP) for stroke or transient ischaemic attack (TIA). Methods: A cost-utility analysis alongside a randomised controlled trial with a 24-month follow-up, from both societal and health system perspectives, was conducted. Adults with stroke/TIA discharged from hospitals were randomised by primary care practice to receive either usual care (UC) or an IMP in addition to UC (intervention). An IMP included stroke-specific nurse-led education and a specialist review of care plans at baseline, 3 months, and 12 months, and telephone reviews by nurses at 6 months and 18 months. Costs were expressed in 2021 Australian dollars (AUD). Costs and quality-adjusted life years (QALYs) beyond 12 months were discounted by 5%. The probability of cost-effectiveness of the intervention was determined by quantifying 10,000 bootstrapped iterations of incremental costs and QALYs below the threshold of AUD 50,000/QALY. Results: Among the 502 participants (65% male, median age 69 years), 251 (50%) were in the intervention group. From a health system perspective, the incremental cost per QALY gained was AUD 53,175 in the intervention compared to the UC group, and the intervention was cost-effective in 46.7% of iterations. From a societal perspective, the intervention was dominant in 52.7% of iterations, with mean per-person costs of AUD 49,045 and 1.352 QALYs compared to mean per-person costs of AUD 51,394 and 1.324 QALYs in the UC group. The probability of the cost-effectiveness of the intervention, from a societal perspective, was 60.5%. Conclusions: Care for people with stroke/TIA using an IMP was cost-effective from a societal perspective over 24 months. Economic evaluations of prevention programs need sufficient time horizons and consideration of costs beyond direct healthcare utilisation to demonstrate their value to society.

The Importance of Physical Therapy in the Evaluation of Fall Prevention Programs in Older Adults

The rapidly growing population of elderly individuals worldwide poses a significant public health concern due to the increased risk of falls and their associated consequences. Falls affect up to 30% of those older than 60 years and are the leading cause of injuries in this age group, with the oldest old being the most vulnerable. This review summarizes fall risk assessment methods and fall prevention programs for elderly individuals. This scoping review aims to identify exercise protocols aimed at reducing the risk of falling in elderly individuals. The authors used the PRISMA-ScR recommendation for scoping reviews and searched several databases for studies published between 2010 and 2020. Twelve studies met the inclusion criteria and were assessed for methodological quality and risk of bias using the PEDro scale. All selected articles presented strong data for the reduction and prevention of falls in the elderly individuals by using specific training programs based on strength and muscle balance exercises. The best results were those protocols lasting more than 18 weeks, performed 2 to 3 times a week, with 60 minutes' duration. Physiotherapeutic exercise protocols are, therefore, an excellent option for reducing the risk of falls in elderly individuals, in addition to promoting a better quality of life.

Nationwide Improvement of IPC Practices in Honduran Hospitals: a Baseline Assessment

Abstract Background Healthcare-acquired infections (HAIs) are one of the most common adverse events related to the provision of healthcare services. They constitute a significant public health problem and lead to increased morbidity and mortality, costs, and prolonged hospitalization. Essential to reducing HAIs is creating a safety culture where no infection is perceived as acceptable by the healthcare worker. Critical to prioritizing actions and implementing improvement strategies is the development of a baseline situation analysis. The World Health Organization′s IPC and Hand Hygiene assessment frameworks allow hospitals to gain understanding regarding resources and practices. Methods A survey was conducted between June 2021 and May 2022 using the World Health Organization′s Frameworks for IPC and Hand Hygiene. The IPC framework evaluates eight core components, and the hand hygiene self-assessment evaluates five. With technical assistance from the Health Policy Plus Project and the National Panamerican Health Organization, the Honduran MoH conducted the assessment in 20 public hospitals. The hospitaĹs staff involved in IPC activities attended the virtual meetings. The results were categorized into four levels of IPC promotion and practices. The results supported the identification of strengths and weaknesses that were essential to the development of improvement plans. Results Twenty of 32 (62.5%) hospitals of the Honduran MoH were evaluated, covering 75% of the health regions. Evaluation of Hand Hygiene Programs Hospitals obtained an overall median result of 353/500 points (IQR: 259-382). Ten (50%) were in the Intermediate category, 6 (30%) in the Advanced category, 3 (15%) in basic category and 1 (5%) was inadequate. After a close evaluation of each component, Component 5 Institutional safety climate for Hand Hygiene (median: 55/100) had the lowest score, followed by component 3 - Evaluation and feedback (median: 65/100). Higher scores were obtained for component 1 System Change (median: 80/100). Evaluation of Infection Prevention and Control Programs at the facility level The median score was 567/800 points, (IQR: 448-630). Eleven (55%) hospitals were in the Intermediate category, and 7 (35%) in the Advanced category. After a close evaluation, Core Component 7, Workload, staffing and bed occupancy (median: 40/100) had the lowest score, followed by Core Component 3: Education and training IPC (median: 65/100). Higher scores were obtained for Core Component 5: Multimodal strategies for implementation of infection prevention and control interventions (median: 82/100) and Core Component 6: Monitoring/auditing of IPC practices and feedback (median: 81/100). Only 3 (15%) hospitals reported having staff dedicated exclusively to IPC activities (1 per &amp;lt;250 beds). Only 10 (50%) hospitals reported having trained professionals responsible for surveillance activities (basic epidemiology, surveillance, and IPC). Table 1: Infection Prevention and Control Assessment Framework Results Conclusions This is the first IPC nationwide assessment conducted in hospitals in Honduras. Results prove that IPC promotion and practices require improvement. Baseline results allow us to understand the IPC situation to promote data-driven decision-making to improve and foster a safety culture in Honduran hospitals.

Trauma-informed prevention programmes for depression, anxiety, and substance use among young people: protocol for a mixed-methods systematic review

BackgroundMental ill-health and substance use bear a substantial burden and harm on young people and often arise from co-occurring and compounding risk factors, such as traumatic stress. Trauma-informed prevention of mental ill-health and substance use demonstrates significant promise in reducing this burden. A systematic literature review is required to identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental ill-health and/or substance use prevention programmes for young people aged 12–24 years.MethodsMEDLINE, Embase, CINAHL, PsychINFO, and Cochrane Library will be searched from 2012 through September 2022. Reference lists of included articles will be citation-chained. Title and abstracts will be screened and two reviewers will review articles full-text. One reviewer will extract data from eligible articles using a piloted data extraction form, and 20% of the data will be verified by a second reviewer. Risk of bias will be assessed using the Cochrane risk-of-bias tool for randomised trials (RoB 2), Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I), and The Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies and The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (CASP), depending on the study type. Characteristics of existing trauma-informed mental ill-health and/or substance use prevention programmes for young people will be summarised narratively. Effectiveness, feasibility, and acceptability will be qualitatively described and summarised, with proportions and effect sizes quantitatively synthesised, where possible.DiscussionTrauma-informed approaches to prevention demonstrate significant promise, yet to date, no study has systematically summarised and synthesised the available literature. To fill this gap, the present review will systematically identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental health and/or substance use prevention programmes for young people aged 12–24. This review will inform the development, adaptation, evaluation, and implementation of future trauma-informed mental ill-health and substance use prevention programmes for young people. Findings will inform critical efforts to interrupt and prevent already elevated trajectories of mental ill-health, substance use, and related harms among those young people exposed to adversity.Systematic review registrationPROSPERO CRD42022353883.

Data collection and analysis on the burden of injuries: Lessons learned from the IDB network

Abstract The EU-IDB (European Injury Database) contains cross-national data on the external causes and circumstances of injuries treated in the emergency departments of hospitals. Its primary purpose is to facilitate the development and evaluation of injury prevention policies and programmes, which aim to control external risks. The information is complementary to death and hospital discharge statistics and specific surveillance systems on road and workplace accidents. Unique is the wealth of information about external circumstances of injuries as needed for evidence-based prevention actions. The IDB data are collected by dedicated national agencies and provided to the Italian National Institute of Health (ISS) which hosts the databank. As part of the EU BRIDGE-Health initiative 2017 (WP9-Injury Surveillance Platform), the EU-IDB Network was commissioned to generate comparable burden of injury estimates across Europe: “Disability Adjusted Life Year (DALY) estimates for injury utilising the European Injury Data Base (IDB)”. DALY estimates were generated for IDB countries and years where both fatal and non-fatal injury data were available. Non-fatal injury data were acquired from Emergency Department data recorded in the IDB Minimum Data Set (MDS), fatal data were obtained from the European Detailed Mortality Database (EDMD). The general approach to calculating DALYs followed that of the Global Burden of Disease (GBD) study but utilised new and different disability weights created by the the Injury-VIBES cohort and detailed injury incidence data from nineteen countries. DALY estimates were between 2-10 times larger than estimates generated by previous studies such as the GBD study, due to much higher incidence figures and larger disability weights. In the workshop, the most recent results of the EU-IDB and the respective DALY estimates will be presented and discussed.

The associations of income and Black-White racial segregation with HIV outcomes among adults aged ≥18 years-United States and Puerto Rico, 2019.

To examine associations between Index of Concentration at the Extremes (ICE) measures for economic and racial segregation and HIV outcomes in the United States (U.S.) and Puerto Rico. County-level HIV testing data from CDC's National HIV Prevention Program Monitoring and Evaluation and census tract-level HIV diagnoses, linkage to HIV medical care, and viral suppression data from the National HIV Surveillance System were used. Three ICE measures of spatial polarization were obtained from the U.S. Census Bureau's American Community Survey: ICEincome (income segregation), ICErace (Black-White racial segregation), and ICEincome+race (Black-White racialized economic segregation). Rate ratios (RRs) for HIV diagnoses and prevalence ratios (PRs) for HIV testing, linkage to care within 1 month of diagnosis, and viral suppression within 6 months of diagnosis were estimated with 95% confidence intervals (CIs) to examine changes across ICE quintiles using the most privileged communities (Quintile 5, Q5) as the reference group. PRs and RRs showed a higher likelihood of testing and adverse HIV outcomes among persons residing in Q1 (least privileged) communities compared with Q5 (most privileged) across ICE measures. For HIV testing percentages and diagnosis rates, across quintiles, PRs and RRs were consistently greatest for ICErace. For linkage to care and viral suppression, PRs were consistently lower for ICEincome+race. We found that poor HIV outcomes and disparities were associated with income, racial, and economic segregation as measured by ICE. These ICE measures contribute to poor HIV outcomes and disparities by unfairly concentrating certain groups (i.e., Black persons) in highly segregated and deprived communities that experience a lack of access to quality, affordable health care. Expanded efforts are needed to address the social/economic barriers that impede access to HIV care among Black persons. Increased partnerships between government agencies and the private sector are needed to change policies that promote and sustain racial and income segregation.

Incidence and prevalence of traumatic spinal cord injury in Canada using health administrative data.

Incidence and prevalence data are needed for the planning, funding, delivery and evaluation of injury prevention and health care programs. The objective of this study was to estimate the Canadian traumatic spinal cord injury (TSCI) incidence, prevalence and trends over time using national-level health administrative data. ICD-10 CA codes were used to identify the cases for the hospital admission and discharge incidence rates of TSCI in Canada from 2005 to 2016. Provincial estimates were calculated using the location of the admitting facility. Age and sex-specific incidence rates were set to the 2015/2016 rates for the 2017 to 2019 estimates. Annual incidence rates were used as input for the prevalence model that applied annual survivorship rates derived from life expectancy data. For 2019, it was estimated that there were 1,199 cases (32.0 per million) of TSCI admitted to hospitals, with 123 (10% of admissions) in-hospital deaths and 1,076 people with TSCI (28.7 per million) were discharged in Canada. The estimated number of people living with TSCI was 30,239 (804/million); 15,533 (52%) with paraplegia and 14,706 (48%) with tetraplegia. Trends included an increase in the number of people injured each year from 874 to 1,199 incident cases (37%), an older average age at injury rising from 46.6 years to 54.3 years and a larger proportion over the age of 65 changing from 22 to 38%, during the 15-year time frame. This study provides a standard method for calculating the incidence and prevalence of TSCI in Canada using national-level health administrative data. The estimates are conservative based on the limitations of the data but represent a large Canadian sample over 15 years, which highlight national trends. An increasing number of TSCI cases among the elderly population due to falls reported in this study can inform health care planning, prevention strategies, and future research.

CDC-Funded HIV Testing Services Outcomes and Social Determinants of Health in Ending the HIV Epidemic in the U.S. Jurisdictions.

We performed an ecological analysis to examine associations between CDC-funded HIV testing services outcomes and social determinants of health (SDOH) among Ending the HIV Epidemic in the U.S. jurisdictions. Using National HIV Prevention Program Monitoring & Evaluation (2020) and American Community Survey (2016-2020) data, we ran robust Poisson models (adjusted for race/ethnicity). In healthcare settings, a 10% absolute increase in percentage without health insurance was associated with a 40% lower prevalence of newly diagnosed positivity (aPR = 0.60, 95% CI: 0.43-0.83); a $5,000 increase in median household income (aPR = 1.04, 95% CI: 1.03-1.06) and a 10% absolute increase in percentage unemployed (aPR = 1.80, 95% CI: 1.31-2.46) were associated with 4% and 80%, respectively, higher prevalence of percentage linked to HIV medical care within 30 days of diagnosis (i.e., linkage). In non-healthcare settings, a 10% absolute increase in percentage with less than high school diploma (aPR = 0.53, 95% CI: 0.29-0.96) was associated with a 47% lower prevalence of newly diagnosed positivity, whereas a 10% absolute increase in percentage without health insurance (aPR = 1.92, 95% CI: 1.29-2.88) was associated with a 92% higher prevalence of newly diagnosed positivity; a 10% absolute increase in percentage with less than high school diploma was associated with a 35% lower prevalence of linkage (aPR = 0.65, 95% CI: 0.43-0.97). Addressing SDOH in HIV prevention programs will play an important role in ending the HIV epidemic.

Evaluación de un programa para la prevención de la violencia en el noviazgo en la adolescencia

The objective of this research was to evaluate the effects of a program for the management of couple relationships in adolescence, entitled “I Love Me, I Love You” which is based in previous research what empirically evaluated prevention programs of dating violence (DV). This program was evaluated through a pre-test post-test design of a single group and a follow-up measurement was included one month after its finalization. The participants were 70 middle-school students (32 women and 38 men), aged 13 to 17 years (M=14.73; SD=1.102). The instruments used to evaluate the program were the CADRI, AADS and STAXI-2. The results show a statistically significant decrease in state, trait and in expression and control of anger, after completion of the program, decreases that were maintained in the follow-up measure. It also showed a decrease in attitudes in favor of DV regarding its manifestation among women, which in the follow-up measure extended to attitudes in favor of such violence among men. In the follow-up measurement, a decrease was also shown in the verbal-emotional type of DV exerted by the partner. These results indicate that the program could have positive effects and that its evaluation should continue with other designs and samples.