George's County Research Articles

Community Health Workers Promote Health Literacy and COVID-19 Vaccine Equity

Summary: At the height of the COVID-19 pandemic, racial/ethnic minority residents of Prince George's County were disproportionately affected by the virus. This report from the field details an intervention that trained community health workers recruited from racial/ethnic minority communities to promote COVID-19 vaccination and health literacy among racially/ethnically diverse communities.

Increasing Access to Cardiac Rehabilitation Services Among Disadvantaged Populations.

The Prince George's County Health Department encountered several challenges to increasing access to cardiac rehabilitation (CR) services among disadvantaged populations. They include excessive patient out-of-pocket costs; requirements that CR orders must be signed by a physician; provider reluctance to refer patients to CR, with most primary care providers preferring to refer clients to cardiologists for the latter to determine whether the patient needs CR referral; limited availability of CR programs; and difficulty identifying patients eligible for CR services. Discussions with other local health departments and public health practitioners indicate that these challenges are not unique to Maryland but are indicative of policy and system barriers that prevent the optimal delivery of cardiovascular health services. This practice report documents the challenges and the Prince George's County Health Department's efforts to resolve them and provides recommendations for decision-makers seeking to make CR programs more accessible to disadvantaged populations.

Landscape changes and watershed erosion in Prince George's County, Maryland

AbstractThis study evaluated erosion rates and sediment production in streams, and factors potentially influencing them throughout the Anacostia, Patuxent, and Potomac (non‐Anacostia) River watersheds within Prince George's County, Maryland, US. As part of the County's watershed‐scale biological monitoring program, from approx. 1999 to 2008, permanent monuments were established to allow measurement of stream channel cross‐sectional (XS) area. The intent of this study was to characterize the intensity and spatial distribution of fluvial geomorphic instability across the county and use the results to target and plan stormwater management and stream restoration actions. For this study, 78 stream locations were re‐surveyed in 2020, representing a time lapse of from 12 to 21 years. Data collected included XS dimensions, modified Wolman 100‐particle pebble counts, and reach‐specific soil bulk density. Land use/land cover data were compiled from the National Land Cover Dataset (NLCD), precipitation from the National Weather Service Center for Environmental Information (NCEI), and soils from the Natural Resources Conservation Service Web Soil Survey (NRCS/WSS). We calculated percent change in XS area, rates of erosion, sediment yield, and assigned geomorphic classifications, and interpreted them in the context of spatial positions relative to changes in land cover characteristics. Sediment yields among the 78 reaches exhibited a combination of those undergoing enlargement/erosion (67.9%), reduction/deposition (25.6%), and the remaining 6.4% with essentially no change over the period of record. Of the top 20 most geomorphically active reaches surveyed in the County, 12 are in the Anacostia River basin, with the other scattered among the Patuxent River and Potomac River basins.

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.

Teachers’ Perception of Anchoring Phenomenon and Its Effect on Students’ Science Proficiency: An Input for a Training Program

This study explored teachers' perception of anchoring phenomena and its impact on students' science proficiency at Thomas Stone and Port Towns Elementary School in Prince George's County during the 2022-2023 school year. The research instrument was rigorously tested for reliability, and ethical clearance was obtained. Results indicate that most teachers have a positive interest in science, demonstrate mastery in teaching phenomena, and frequently incorporate anchoring phenomena in their science lessons. Students generally meet expectations in earth and space science, physical science, engineering, and technology but partially meet expectations in life science. The study also reveals a significant correlation between teachers' experience and their perception of anchoring phenomena. Furthermore, teachers' perception of anchoring phenomena significantly influences students' proficiency in all science units. These findings have implications for teacher training programs and the widespread adoption of the Anchoring Phenomenon approach in science education. One of the recommendations is to establish a teacher mentorship program and mentor-mentee training to maximize the use of anchoring phenomena. Additionally, a comprehensive review of life science lesson implementation is suggested to enhance pedagogical approaches in teaching life sciences.&#x0D;

State- and County-Level Geographic Variation in Opioid Use Disorder, Medication Treatment, and Opioid-Related Overdose Among Medicaid Enrollees

The opioid crisis disproportionately affects Medicaid enrollees, yet little systematic evidence exists regarding how prevalence of and health care utilization for opioid use disorder (OUD) vary across geographical areas. To characterize state- and county-level variation in claims-based prevalence of OUD and rates of medication treatment for OUD and OUD-related nonfatal overdose among Medicaid enrollees. This cross-sectional study used data from the Transformed Medicaid Statistical Information System Analytic Files from January 1, 2016, to December 31, 2018. Participants were Medicaid enrollees with or without OUD in 46 states; Washington, DC; and Puerto Rico who were aged 18 to 64 years and not dually enrolled in Medicare. The analysis was conducted between September 2022 and April 2023. Calendar-year OUD prevalence. The main outcomes were claims-based measures of OUD prevalence and rates of medication treatment for OUD and opioid-related nonfatal overdose. Individual records were aggregated at the state and county level, and variation was assessed within and across states. Of the 76 390 817 Medicaid enrollee-year observations included in our study (mean [SD] enrollee age, 36.5 [1.6] years; 59.0% female), 2 280 272 (3.0%) had a claims-based OUD (mean [SD] age, 38.9 [3.6] years; 51.4% female). Of enrollees with OUD, 41.2% were eligible due to Medicaid expansion, 46.4% had other substance use disorders, 55.8% had mental health conditions, 55.2% had claims indicating some form of OUD medication, and 5.8% had claims indicating an overdose during a calendar year. Claims-based outcomes exhibited substantial variation across states: OUD prevalence ranged from 0.6% in Arkansas and Puerto Rico to 9.7% in Maryland, rates of OUD medication treatment ranged from 17.7% in Kansas to 82.8% in Maine, and rates of overdose ranged from 0.3% in Mississippi to 10.5% in Illinois. Pronounced variation was also found within states (eg, OUD prevalence in Maryland ranged from 2.2% in Prince George's County to 21.6% in Cecil County). In this cross-sectional study of Medicaid enrollees from 2016 to 2018, claims-based prevalence of OUD and rates of OUD medication treatment and opioid-related overdose varied substantially across and within states. Further research appears to be needed to identify important factors influencing this variation.

Screening for Social Determinants of Health Among Medicare Beneficiaries in Primary Care During the Covid-19 Pandemic in Prince George's County, Maryland.

Primary care providers in Prince George's County, Maryland reported inconsistencies in their ability to identify and refer patients with social care needs. This project aimed to improve health outcomes of Medicare beneficiaries by implementing social determinant of health (SDOH) screening to identify unmet needs and improve rates of referral to appropriate services. Buy-in was achieved from providers and frontline staff via stakeholder meetings at a private primary care group practice. The Health Leads questionnaire was modified and integrated into the electronic health record. Medical assistants (MA) were trained to conduct screening and initiate care plan referrals prior to visits with the medical provider. During implementation, 96.25% of patients (n = 231) agreed to screening. Of these, 13.42% (n = 31) screened positive for at least one SDOH need, and 48.39% (n = 15) reported multiple social needs. Top needs included social isolation (26.23%), literacy (16.39%), and financial concerns (14.75%). All patients screening positive for one or more social needs were provided referral resources. Patients who identified as being of Mixed or Other race had significantly higher rates of positive screens (p = 0.032) compared to Caucasians, African Americans, and Asians. Patients were more likely to report SDOH needs during in-person visits (17.22%) compared to telehealth visits (p = 0.020). Screening for SDOH needs is feasible and sustainable and can improve the identification of SDOH needs and resource referrals. A limitation of this project was the lack of follow-up to determine whether patients with positive SDOH screens had been successfully linked to resources after initial referral.

Recognizing Local Champions in Infection Prevention and Control.

Recognizing Local Champions in Infection Prevention and Control.

Animal Resistance in the Global Capitalist Era

Animal Resistance in the Global Capitalist Era

A Question of Freedom: The Families Who Challenged Slavery from the Nation's Founding to the Civil War by William G. Thomas III

Reviewed by: A Question of Freedom: The Families Who Challenged Slavery from the Nation's Founding to the Civil War by William G. Thomas III Alice L. Baumgartner A Question of Freedom: The Families Who Challenged Slavery from the Nation's Founding to the Civil War. By William G. Thomas III. (New Haven and London: Yale University Press, 2020. Pp. [x], 418. Paper, $25.00, ISBN 978-0-300-26150-9; cloth, $35.00, ISBN 978-0-300-23412-1.) From the 1780s to the Civil War, enslaved people in Prince George's County, Maryland, filed over a thousand legal actions for their freedom. With careful research and beautiful prose, William G. Thomas III makes the powerful argument that freedom suits laid bare the uncertain legal foundations of slavery and, in the process, represented "a public counterpart of the Underground Railroad" (p. 9). In 1770, William and Mary Butler sued for their freedom on the grounds that their grandmother Eleanor Butler, or "Irish Nell," was a "free white woman" and indentured servant (p. 24). Although Eleanor had married an enslaved man in 1681, which, under a 1664 act, consigned her to bondage "for the duration of her husband's life," the Maryland General Assembly overturned this law shortly after Eleanor's marriage (p. 24). In their suit for freedom, William and Mary Butler argued that Eleanor's children were free because they were born after the repeal of the 1664 act. The provincial court decided in the Butlers' favor, but the court of appeals reversed the lower court's ruling, asserting that the 1664 act applied because Eleanor and Charles Butler were married under its terms. Undeterred, the next generation of Butlers filed lawsuit after lawsuit—and in the wake of the American Revolution, the Butlers started to win. Soon other enslaved people started to claim their freedom on the grounds that their ancestors were free. In 1791, Edward Queen sued for his freedom because his grandmother, Mary Queen, was a "free woman of color" from New Spain sold as an indentured servant (p. 168). Also in 1791, Charles [End Page 408] Mahoney filed a petition that he was descended from a free woman named Ann Joice. In response, the Maryland assembly made it more difficult for enslaved people to bring suits. In 1793, the legislature granted jurisdiction over petitions for freedom to lower district courts, which were often more favorable to slaveholders. Three years later, in 1796, the assembly required that attorneys representing enslaved people pay the court costs if their freedom suits were dismissed. The courts also handed down decisions that were unfavorable to enslaved people. In 1810, when Mina Queen claimed her freedom because she descended from Mary Queen, the District of Columbia Circuit Court ruled parts of a crucial deposition "hearsay" and, consequently, inadmissible (p. 171). The tightening of evidentiary standards made it more difficult for enslaved people to secure their freedom on the basis of ancestry. To make matters worse, the Jesuits sold 272 enslaved people to Louisiana in 1838, depriving those who remained in Maryland of crucial witnesses in freedom suits. As evidentiary standards tightened, and as enslaved people were sold from the Eastern Seaboard to the south-central United States, the opportunities for freedom on the basis of ancestry dwindled. But enslaved people continued to file petitions on other legal grounds. The most successful cases were of emancipated enslaved people who had been illegally imported into the District of Columbia. In 1828, Thomas Butler successfully sued for his freedom because he and his family had been sold in the district, violating Maryland's laws against the slave trade. Four years later, Ann Williams won her freedom on the same grounds. Enslaved people from Prince George's County secured their freedom not by escaping to Canada but by filing petitions with the courts. Thomas convincingly argues that these freedom suits were an important, if overlooked, route on the Underground Railroad. The "conductors" on this route were lawyers of mixed allegiances, like Joseph Bradley, himself a slaveholder, and Allen Bowie Duckett, Thomas's own ancestor. The heroes of this route were not the lawyers but the petitioners themselves, who, by ingenuity, perseverance, and legal acumen...

A Question of Freedom: The Families Who Challenged Slavery from the Nation's Founding to the Civil War by William G. Thomas III

Reviewed by: A Question of Freedom: The Families Who Challenged Slavery from the Nation's Founding to the Civil Warby William G. Thomas III Ted Maris-Wolf (bio) Slavery, Antislavery, Abolition, Legal history A Question of Freedom: The Families Who Challenged Slavery from the Nation's Founding to the Civil War. By William G. Thomas III. (New Haven, CT: Yale University Press, 2020. Pp. 418. Cloth, $35.00.) [End Page 156]Rarely have white historians of slavery sought relationships with descendants of those enslaved by their very own ancestors, let alone authored a scholarly monograph detailing the horrors of slaveholding and violence in their family history. William Thomas has done both. The resulting study, A Question of Freedom: The Families Who Challenged Slavery from the Nation's Founding to the Civil War, is an ambitious and meticulously researched examination of slavery and law between the Revolution and the Civil War, as well as an unconventional and provocative call for historians to lead the way in fostering truth and racial reconciliation in today's society. Thomas challenges readers (especially those of us descended from enslavers) to reflect on our own relationships to the private and public pasts we inherit, study, and narrate. Are we open to hearing and acting on the calls of those enslaved by our own family members? Reckoning with revelations uncovered during the course of his research, Thomas asks, "How would I respond to the call of these ancestors? How would you?" (121). Thomas's unorthodox use of first-, second-, and third-person voice likely will inspire more scholars to follow his example (and that of others before him, including Saidiya Hartman, Edward Ball, and Thomas Norman DeWolf) in crafting more intimate historical explorations of the lives of the enslaved. Perhaps A Question of Freedomwill even precipitate the long-awaited moment when we historians of slavery acknowledge greater kinship with our cousins in anthropology by explicitly positioning ourselves (and our personal histories) to the subjects and people we study—something anthropologists have been doing for decades. It is just as likely, however, that Thomas's approach will alienate some who see his first-person interludes of "self-revelation" and attempts at racial reconciliation as distracting, overly personal, or even insulting, especially if they find these passages obscure the individuals at the center of the study—enslaved Black men and women who took the extraordinary step of petitioning for their freedom and challenging the very basis of legal slavery in Maryland, Washington, DC, and elsewhere (2). After all, must we be privy to the private ruminations and emotional journeys of the historian to appreciate brilliant scholarship? Thomas's bold narrative approach is reason enough to assign A Question of Freedomin any graduate seminar, but his remarkable archival detective work and resulting contributions make this one of the most [End Page 157]important recent works in legal history and, more broadly, the history of American slavery. Thomas recounts in painstaking detail the efforts of five generations of enslaved families of Prince George's County, Maryland, to secure their freedom and that of others by directing white lawyers to file hundreds of freedom suits on their behalf in various courts—county, state, even the U.S. Supreme Court. Through their personal involvement in the conception of these suits, the Queens, Mahoneys, Bells, and other enslaved families "accumulated a substantial reservoir of legal experience and knowledge" that not only secured freedom for many of their own petitioners between 1787 and 1861 but also rattled the foundations of the institution of slavery in Maryland and beyond (149). One of Thomas's most important contributions is advancing our understanding of an increasingly robust Black legal culture between the Revolution and the Civil War and the role of enslaved petitioners and their freedom suits in fostering this tradition. Thomas recounts the complicated situations of dozens of petitioners who creatively, persistently, and often repeatedly challenged the property claims of their enslavers through law. In several early suits in Maryland, enslaved families evoked the Somersetv. Stewartruling of 1772 to argue that because an ancestor of theirs had set foot in England, they and all descendants were free, according to English common law...

A comparison of BG Sentinel and CDC trap attractants for mosquito surveillance in urban and suburban areas of Montgomery and Prince George's Counties, Maryland, U.S.A.

Monitoring mosquito populations is crucial for vector-borne disease surveillance. Routine mosquito surveillance in many regions of the United States is performed either by vector abatement districts or public health departments. These surveillance programs often use multiple trap types and attractants to target key mosquito species, however setting different traps with varying attractants can be expensive and labor intensive. Because funding for mosquito control is highly variable throughout the U.S., some programs may be limited in their surveillance capabilities. To determine whether a single trap-attractant combination could provide specificity for key vector and nuisance species, as well as sensitivity for rare species, we compared the BG-Sentinel 2 and CDC miniature light traps paired with CO2, UV-LED, BG Lure, BG Sweetscent, octenol, or chicken feathers. Trapping was conducted biweekly from June/July-October 2019 and 2020 in Montgomery and Prince George's County, MD. BG traps collected significantly more Aedes albopictus than CDC traps when paired with BG Lure, Sweetscent, or octenol. BG/CO2 traps collected both the greatest number of total mosquitoes and Culex pipiens. BG/CO2, CDC/CO2, and CDC/UV traps provided the most diverse collections. Trapping with the CO2-baited BG-Sentinel is recommended as an effective strategy for general mosquito surveillance when resources are limited.

Towards a health-conscious transportation planning: A framework for estimating health impacts of active transportation at local level

IntroductionThe inter-relationship between physical activity and health is well-documented in transportation and public health literature. Nevertheless, health impacts are rarely considered in transportation planning processes due to the lack of a robust mechanism to quantify such impacts. The Integrated Transport and Health Impact Modeling (ITHIM) framework provides an opportunity to systematically estimate health impacts of active travel as a result of variations in transportation infrastructure and policies that involve non-motorized modes. MethodsThis study applies ITHIM framework to Prince George's County, Maryland, to explore potential health impacts of improved active travel through hypothetical scenarios. ITHIM integrates data on travel behavior, health, demographics, road injuries and air quality. We constructed three What-If scenarios that reflect significant increases in walking and biking –a potential result of the ambitious infrastructure plans in place at the PG County – and decrease in personal vehicle miles. ResultsSignificant health and economic benefits are observed under three scenarios. We observed considerable health benefits in the scenarios where we made assumptions about increased active travel and reduced automobile usage, e.g. if everyone bikes 1.5 miles and drives 1.5 miles less per day, the county will save about 35 lives and 1,443 DALYs. We also observed significant monetary values of lifesaving in the economic analysis, indicating $117 million savings in the cost of illness (COI) for scenario1 (increased walking) and $34 million savings in COI as a result of scenario2 (increased biking) and scenario3 (increased biking and reduced driving). ConclusionThis study provides insight into a better understanding of the potential health impacts of various transportation planning scenarios and provides an example for including health impact estimates in evaluating transportation policies and plans at local level. It highlights the importance of policies that encourage people to walk and bike also need to adopt measures that increase safety.

Reckoning with Enslavement

For over seventy years, the enslaved families of Prince George's County, Maryland, filed hundreds of suits for their freedom against a powerful circle of slaveholders, taking their cause all the way to the Supreme Court. In this excerpt from A Question of Freedom: The Families Who Challenged Slavery from the Nation’s Founding to the Civil War (Yale University Press, 2020), William G. Thomas introduces a major theme of his book: the nation's present-day need to confront the legacy of slavery and to reckon with "real histories, with real families whose descendants live among us." Excerpted from the prologue with permission from Yale University Press.

A Failed Cardiac Surgery Program in an Underserved Minority Population County Reimagined: The Power of Partnership.

BackgroundPrince George's County Maryland, historically a medically underserved region, has a population of 909 327 and a high incidence of cardiometabolic syndrome and hypertension. Application of level I evidence practices in such areas requires the availability of highly advanced cardiovascular interventions. Donabedian principles of quality of care were applied to a failing cardiac surgery program. We hypothesized that a multidisciplinary application of this model supported by partnership with a university hospital system could result in improved quality care outcomes.Methods and ResultsA 6‐month assessment and planning process commenced in July 2014. Preoperative, intraoperative, and postoperative protocols were developed before program restart. Staff education and training was conducted via team simulation and rehearsal sessions. A total of 425 patients underwent cardiac surgical procedures. Quality tracking of key performance measures was conducted, and 323 isolated coronary artery bypass grafting procedures were performed from July 2014 to December 2019. Key risk factors in our patient demographic were higher than the Society of Thoracic Surgeons national mean. Risk‐adjusted outcome data yielded a mortality rate of 0.3% versus 2.2% nationally. The overall major complication rate was lower than expected at 7.1% compared with 11.5% nationally. Readmission rate was less than the Society of Thoracic Surgeons mean for isolated coronary artery bypass grafting (4.0% versus 10.1%, P<0.0001). Significant differences in 6 key performance outcomes were noted, leading to a 3‐star Society of Thoracic Surgeons designation in 7 of 8 tracking periods.ConclusionsExcellent outcomes in cardiac surgery are attainable following program renovation in an underserved region in the setting of low volume. The principles and processes applied have potential broad application for any quality improvement effort.

Home visiting: A lifeline for families during the COVID-19 pandemic

Home visiting: A lifeline for families during the COVID-19 pandemic

Amplifying Their Voices: Advice, Guidance, and Perceived Value of Cancer Biobanking Research Among an Older, Diverse Cohort.

The use of biobanks may accelerate scientists' chances of developing cures and treatments that are tailored to individuals' biological makeup-a function of the precision medicine movement. However, given the underrepresentation of certain populations in biobanks, the benefits of these resources may not be equitable for all groups, including older, multi-ethnic populations. The objective of this study was to better understand older, multi-ethnic populations' (1) perceptions of the value of cancer biobanking research, (2) study design preferences, and (3) guidance on ways to promote and increase participation. This study was designed using a community-based participatory research (CBPR) approach and involved eight FGDs with 67 older (65-74 years old) black and white residents from Baltimore City and Prince George's County, MD. FGDs lasted between 90 and 120 min, and participants received a $25 Target gift card for their participation. Analysis involved an inductive approach in which we went through a series of open and axial coding techniques to generate themes and subthemes. Multiple themes emerged from the FGDs for the development of future cancer-related biobanking research including (1) expectations/anticipated benefits, (2) biobanking design preferences, and (3) ways to optimize participation. Overall, most participants were willing to provide biospecimens and favored cancer-related biobank. To increase participation of older, diverse participants in biobanking protocols, researchers need to engage older, diverse persons as consultants in order to better understand the value of biobanking research to individuals from the various populations. Scientists should also incorporate suggestions from the community on garnering trust and increasing comfort with study design.

The Death of Freddie Gray and Its Impact on Homicides in Baltimore and Maryland.

This study evaluated the impact that Freddie Gray's death on April, 19, 2015, had on homicides within Baltimore, Prince George's County, and the rest of Maryland. The numbers of these deaths were compared in the 2 years prior and after his death. The average number of homicide per month in Baltimore and Prince George's County, but not the rest of Maryland, showed a statistically significant increase in the 2 years after his death, with a sudden spike in homicides in Baltimore immediately following his death. Spatial density ("heat") maps of homicides showed an increase in clustering of deaths after Freddie Gray's demise in portions of Baltimore, particularly near his arrest site. Hot spot maps showed a massive expansion of statistically significant clusters of homicides in areas of West and East Baltimore after his death. An emerging hot spot analysis revealed consecutive hot spots in large areas of West Baltimore with new hot spots prominent along the southern edge of this area. A review of the history of Baltimore, as well as discussions with Baltimore homicide detectives, revealed that prior socioeconomic and political trends likely primed Baltimore for the protests and violence that occurred after Freddie Gray's death. It is probable that a perceived "overcharging" of officers involved in his death by the State's Attorney resulted in a "pullback" from policing that directly led to increased homicides in Baltimore.

Understanding Misdemeanor Enforcement: The Roles of Calls for Service and Community Characteristics.

This study examines the roles of calls for service (i.e., police-related 911 calls) and community characteristics in explaining variation in enforcement rates for low-level, misdemeanor offenses, which make up the large majority of police enforcement activity. The study site is Prince George's County, Maryland, and the unit of analysis is the police department's 65 patrol beats, studied over a 10-year period, during 2006-2015. Overall, misdemeanor enforcement rates vary at the beat level, and that variation can be largely explained using a combination of indicators about community characteristics and calls for service. The findings indicate, though, that the calls for service rate is the most important variable in explaining misdemeanor enforcement variation. These findings inform both future research on police activity, and current policy debates about what drives enforcement rates and the role of discretion in enforcement outcomes.

Community Engagement to Address Cancer Health Disparities: A Process EVALUATION using the Partnership Self-Assessment Tool.

African Americans suffer disproportionately from cancer health disparities, and population-level prevention is needed. A community-academic partnership to address cancer health disparities in two predominately African American jurisdictions in Maryland was evaluated. The Partnership Self-Assessment Tool (PSAT) was used in a process evaluation to assess the partnership in eight domains (partnership synergy, leadership, efficiency, management, resources, decision making, participation, and satisfaction). Mean scores in each domain were high, indicative of a functional and synergistic partnership. However, scores for decision making (Baltimore City's mean score = 9.3; Prince George's County's mean score = 10.8; p = .02) and participation (Baltimore City's mean score = 16.0; Prince George's County's mean score = 18.0; p = .04) were significantly lower in Baltimore City. Community-academic partnerships are promising approaches to help address cancer health disparities in African American communities. Factors that influence decision making and participation within partnerships require further research.