High-risk Urban Population Research Articles

Uptake of COVID-19 vaccine among high-risk urban populations in Southern Thailand using the COM-B model.

The COVID-19 pandemic has imposed unprecedented suffering on social and individual levels worldwide. Vaccines against COVID-19 have been prioritized as a crucial strategy for ending the pandemic as well as minimizing its consequences. This study aimed to determine the uptake of COVID-19 vaccine among high-risk urban populations in Southern Thailand using the Capability, Opportunity, Motivation, and Behavior (COM-B) model. We conducted a web-based cross-sectional study in the Hat Yai district, Songkhla province in Southern Thailand, in September and October 2021. The questionnaire was composed of sections on sociodemographic characteristics, COVID-19 vaccination status, and COM-B constructs. We employed a multivariable logistic regression analysis to determine factors associated with the uptake of the COVID-19 vaccine. We set statistical significance at p < 0.05. In this study, females constituted 54.7% of the total participants (n = 358), and nearly half of the participants (45.8%) were in the younger age group (18-29). Of all the participants, 59.5% (95%CI: 54.2%-64.6%) received at least one dose of the COVID-19 vaccine. Factors associated with the uptake of COVID-19 vaccine and their adjusted OR (95% CI) were being married: 3.59 (2.06-6.24), having a graduate degree: 2.34 (1.38-3.96), gainfully employed: 3.30 (1.91-5.67), having a high level of opportunity: 2.90 (1.48-5.66), and having a high level of motivation: 2.87 (1.17-17.08). The uptake of COVID-19 vaccines was moderate in this population. Moreover, the results showed that the COM-B model is useful in predicting COVID-19 vaccine uptake. The findings of this study could be used to aid future public health interventions in any event of outbreaks similar to COVID-19 disease in Thailand and beyond.

Exclusive Breastfeeding in the Bronx-Successes and Shortcomings.

Despite efforts to encourage breastfeeding, exclusive breastfeeding (EBF) rates in the Bronx remain suboptimal. Hospital restrictions and uncertainty surrounding the side effects of coronavirus disease 2019 (COVID-19) greatly impacted the mother-infant dyad during the postpartum hospitalization. Preliminary studies found an initial decrease in EBF, but lasting effects remain unknown. This study aimed to investigate the effect of the COVID-19 pandemic on birth hospitalization EBF rates among a high-risk urban patient population. A retrospective chart review was conducted on all newborns admitted to the newborn nursery at an urban medical center between 2019 and 2021. Patients were separated into prepandemic and pandemic cohorts. Patient demographics, maternal comorbidities, length of stay, feeding method, and newborn characteristics, including status as high risk for hypoglycemia, were collected. EBF was defined as receiving only mother's milk during the birth hospitalization. Descriptive statistics and bivariate analysis were used to examine the data. A total of 630 prepandemic and 643 pandemic newborns were included. The cohorts did not differ in baseline maternal characteristics. Prepandemic newborns were less likely to be high risk (23.3 vs. 29.4%, p = 0.01), more likely to see the hospital lactation consultant (53.2 vs. 24.0%, p < 0.001), and had a longer average length of stay (63.4 vs. 54.5 hours, p < 0.001). Most infants in both cohorts received some breastmilk during the hospitalization (97.6 vs. 94.6%, not significant). There was no difference in EBF between cohorts among all newborns (9.5 vs. 11.4%, p = 0.29) or among nonhigh-risk newborns (12.2 vs. 15.0%, p = 0.22). EBF rates in the Bronx, NY did not change during the pandemic period, despite an increase in high-risk newborns. Further investigation into the effect of lactation consultation, maternal race, ethnicity, and primary language should be further explored to understand the implications of health care disparities on the mother-infant dyad. · The COVID-19 pandemic disrupted many aspects of the mother-infant dyad.. · EBF rates at an urban institution in the Bronx did not change during the COVID-19 pandemic.. · Further investigation is warranted to better understand the barriers to EBF in this population..

HUGS/Abrazos: A Novel Community Initiative to Improve Perinatal Mental Health in a High-Risk Urban Population

HUGS/Abrazos: A Novel Community Initiative to Improve Perinatal Mental Health in a High-Risk Urban Population

Metabolic Syndrome among Urban Slum Population of Pune City: A Pilot Study

Background: The metabolic syndrome (MetS) is a multiplex risk factor for atherosclerotic cardiovascular diseases. It is proven that genetic and certain modifiable factors are responsible for the syndrome. Objectives: To assess the prevalence of MetS in the high-risk urban slum population of Pune city and its association with various risk factors. Materials and Methods: A cross-sectional study was conducted among high-risk people for type 2 diabetes mellitus in the field practice area of the Urban Health Training Centre of a private medical college, Pune, India. Variables like age, waist circumference, and blood pressure (BP) and fasting parameters like triglyceride (TG), high-density lipoprotein (HDL) cholesterol, and blood glucose after 12 h overnight fast were tested. Results: Prevalence of MetS was 26.6%. It was maximum in the higher age group (53%), housewives (36.7%), subjects with secondary education (36.7%), and in the socioeconomic lower class (36%). Abdominal obesity, high TGs, low HDL, high BP, and raised blood glucose significantly contributed to an increased risk of MetS. Conclusion: The study shows that identification of even a single component of MetS should be considered and accordingly subject should be counseled to prevent further progression of the disease.

Individual head and neck screening: Initiating a dialogue about best approach

PurposeWe aim to investigate the true benefits of free individual HNC screening in a high-risk urban population as well as the associated risks. Materials and methodsThis is a retrospective descriptive study. Free HNC screening was performed from 2014 to 2019. Participants were issued a questionnaire at the time of screening. After exemption by the Institutional Review Board, completed screening questionnaires were entered into a database and descriptive statistics were generated. The primary outcome measure for this study was the detection rate for HNC. We hypothesized that screening would be low yield based on previous studies (Gogarty et al., 2016). ResultsThis was a volunteer sample with a total of 410 participants, and the highest yield screening year was 2019 (n = 187). For all years, the cancer detection rate was 0%. In 2019, 134 (77.9%) of participants did not recognize the early symptoms of HNC, and 120 (73.2%) reported the screening program increased their awareness of the disease. 13 (7.6%) reported HPV vaccination while 126 (71.2%) were unaware that HPV has been linked with head and neck cancer. ConclusionsHNC screening is an excellent opportunity for education regarding HNC risk factors. However, it is not a cost-effective use of physician time, does not increase detection rates even in high-risk segments of the general population, and is not completely without risk in the context of COVID-19. Perhaps the focus of HNC screening should shift from individualized screening to education and health promotion.

Determining Factors Associated with Sexual Behavior and Undesired Outcomes in Urban,Young, Adult Female Populations: A Comparative Study

Background Sexually transmitted infections (STIs) and unwanted pregnancies affect adolescent females annually. This study’s objective was to determine factors leading to disproportionate risk of STIs and unplanned pregnancies utilizing a survey to compare a presumed high-risk urban female population with an age-matched expected low-risk urban female population. Methods Adolescent women ages 18-24 were surveyed during 2017 utilizing a qualtrics survey. The survey was given at a local urban university and participating students received research credit. The survey was also given at an urban Emergency Department (ED) using an iPad to participants during their visit. The main outcomes measured were STI and unplanned pregnancy rates. Results The ED cohort had higher rates of chlamydia (52% vs 5%), gonorrhea (20% vs 0%), trichomoniasis (30% vs 2%), pregnancy (60% vs 2%), and perceived themselves to be a higher-risk for pregnancy (3.4 vs 1.9) than the University cohort. They were younger the first time they had vaginal sex (15.6 vs 16.3-years), though median age of first oral sex was similar between groups. The ED cohort was older (21.4-years-old vs 19.1-years-old) and more likely to be non-white (64% vs 6%). There were no differences between the cohorts in regard to educational background and sexual orientation. After adjustments were made, the University cohort was more likely to use condoms and had a lower rate of lifetime partners. Conclusion Young, urban females use condoms and birth control less frequently and have more male partners than an age-matched university population.

Cockroach-induced IL9, IL13, and IL31 expression and the development of allergic asthma in urban children

Cockroach-induced IL9, IL13, and IL31 expression and the development of allergic asthma in urban children

Barriers to Prevention and Timely Presentation of Diabetic Foot Ulcers: Perspectives of Patients from a High-risk Urban Population in the United States.

Diabetic foot amputation is a preventable complication that is increasing in incidence in the United States, with disparities across geography, race, ethnicity, and income. This qualitative study explored the experiences of people in a low-income urban area in the United States in preventing and obtaining care for foot ulcers. Sixteen adults with foot ulcers were identified through purposive sampling based on records of hospital stays and primary care visits. Semi-structured interviews were transcribed and analyzed for key themes. Participants described inadequate understanding of diabetic foot disease: many sought care only after developing advanced symptoms. They identified social and health system factors as barriers to timely access to care. Some participants described a realization of the seriousness of their condition and an ability to improve self-care after developing an ulcer. Patients' experiences can inform the design of amputation-reduction initiatives to achieve more desirable results, including enhanced self-management capabilities, timely access, and attention to social determinants.

Organization and implementation of an oral cholera vaccination campaign in an endemic urban setting in Dhaka, Bangladesh

ABSTRACTBangladesh has historically been cholera endemic, with seasonal cholera outbreaks occurring each year. In collaboration with the government of Bangladesh, the Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) initiated operational research to test strategies to reach the high-risk urban population with an affordable oral cholera vaccine (OCV) “ShancholTM” and examine its effectiveness in reducing diarrhea due to cholera. Here we report a sub-analysis focusing on the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. We described how the vaccination program was planned, prepared and implemented using different strategies to deliver oral cholera vaccine to a high-risk urban population in Dhaka, Bangladesh based on administrative data and observations made during the program. The objective of this study is to evaluate the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. OCV administration by trained local volunteers through outreach sites and mop-up activities yielded high coverage of 82% and 72% of 172,754 targeted individuals for the first and second dose respectively, using national Expanded Program on Immunization (EPI) campaign mechanisms without disrupting routine immunization activities. The cost of delivery was low. Safety and cold chain requirements were adequately managed. The adopted strategies were technically and programmatically feasible. Current evidence on implementation strategies in different settings together with available OCV stockpiles should encourage at-risk countries to use OCV along with other preventive and control measures.

Identification of New Bacteria Scardovia wiggsiae in Caries Risk Indian Adolescent Population - Polymerase Chain Reaction Analysis

BACKGROUND: The independent association of S. mutans andScardovia wiggsiae and their association in ECC and as a risk indicator have been reported in the literature. Its prevalence in low and high caries risk of urban adolescent Indian population has not been reported so far. Hence the primary objective of the study is to identify the prevalence of new bacteria Scardovia wiggsiae in low and high caries risk urban adolescent population. METHODS: 50 adolescent subjects were screened based on ADA risk assessment criteria. Group 1(n=25) - Low caries risk (saliva, plaque) and Group 2 (n=25) - High caries risk (saliva, plaque and dentinal caries) were evaluated for the presence of Scardovia wiggsiae by PCR analysis. FINDINGS: Highest prevalent was found in dentinal caries followed by plaque and saliva samples of high caries risk subjects; whereas it was totally absent in both the samples of low risk caries subjects. INTERPRETATION: Scardovia wiggsiae could be one of the predominant microorganism for initiation and progression of caries and can be used as a risk indicator for dental caries assessment in a given population. Thus by identifying the actual predominant genera in the microbial communities, preventive strategies can be targeted specifically to decrease the level of prevalence, thereby lowering caries experience in a given population. FUNDING STATEMENT: The authors stated: Nil. DECLARATION OF INTERESTS: The authors have no financial interest in any of the companies or products mentioned in this article. ETHICS APPROVAL STATEMENT: Ethical clearance was obtained from Institutional Review Board (IRB) of S.R.M University (SRMDC/IRB/2014/MDS/No.307).

Revolving Loan Fund: A Novel Approach to Increasing Access to Long-Acting Reversible Contraception Methods in Community Health Centers.

The aim of this study was to assess the impact of a revolving loan fund (RLF) on timing of device insertion and long-acting reversible contraception (LARC) access among a high-risk urban population at 3 Boston community health centers. Three health centers were identified to implement a RLF. Each clinic received $5000 from the RLF to purchase LARC devices. Data collected through medical record review retrospectively 1 year prior to start of the RLF and prospectively for 1 year thereafter included patient demographics, type of LARC selected, patient's date of documented interest in a LARC device, and date of insertion. The effect of a RLF on delay to LARC insertion was tested using negative binomial regression, controlling for site and potential confounding variables between the pre- and post-RLF periods. Three urban community health centers. Reproductive-aged women who received family planning services at the 3 participating health centers. Increasing access to LARC and decreasing wait times to LARC insertion after implementation of the RLF. Data on 133 patients in the pre-RLF group and 205 in the post-RLF group were collected. There were no statistically significant differences in demographic or clinical characteristics between the 2 time periods. LARC uptake increased significantly from the pre- to post-RLF period, specifically among implant users. There was a statistically significant decrease in the mean number of days in delay from interest to insertion from the pre- to post-RLF period (pre-RLF: 31.3 ± 50.6 days; post-RLF: 13.6 ± 16.7 days, adjusted P < .001). The reasons for the delay did not differ significantly between the 2 time periods. The RLF decreased wait time for the devices and increased overall insertion rates. This may serve as a promising solution to improve LARC access in community health centers. This project could be expanded to include more health centers, creating a city wide RLF. This expansion could allow for further data analysis, including unintended pregnancy rates with LARC delay, LARC continuation rates, and sustainability of a RLF.

Evaluation of opioid usage and identification of risk factors in a high risk urban population

Evaluation of opioid usage and identification of risk factors in a high risk urban population

Automated Adherence Reminders for High Risk Children With Asthma: A Research Protocol.

BackgroundThe use of inhaled corticosteroid (ICS) medications has been shown to improve asthma control and reduce asthma-related morbidity and mortality. Two recent randomized trials demonstrated dramatic improvements in ICS adherence by monitoring adherence with electronic sensors and providing automated reminders to participants to take their ICS medications. Given their lower levels of adherence and higher levels of asthma-related emergency department (ED) visits, hospitalizations, and death, urban minority populations could potentially benefit greatly from these types of interventions.ObjectiveThe principal objective of this study will be to evaluate the feasibility, acceptability, and limited efficacy of a text message (short message service, SMS) reminder intervention to enhance ICS adherence in an urban minority population of children with asthma. We will also assess trajectories of ICS adherence in the 2 months following asthma hospitalization.MethodsParticipants will include 40 children aged 2-13 years, who are currently admitted to the Children’s Hospital of Philadelphia (CHOP) for asthma, and their parent or legal guardian. Participants will be assigned to intervention and control arms using a 1:1 randomization scheme. The intervention arm will receive daily text message reminders for a 30-day intervention phase following hospitalization. This will be followed by a 30-day follow-up phase, in which all participants may choose whether or not to receive the text messages. Feasibility will be assessed by measuring (1) retention of the participants through the study phases and (2) perceived usefulness, acceptability, and preferences regarding the intervention components. Limited efficacy outcomes will include percent adherence to prescribed ICS regimen measured using Propeller Health sensors and change in parent-reported asthma control. We will perform an exploratory analysis to assess for discrete trajectories of adherence using group-based trajectory modeling (GBTM).ResultsStudy enrollment began in December 2015 and the intervention and follow-up phases are ongoing. Results of the data analysis are expected to be available by December 2016.ConclusionsThis study will add to the literature by providing foundational feasibility data on which elements of a mobile health text-message reminder intervention may need to be modified to suit the needs and constraints of high-risk urban minority populations.Trial RegistrationClinicaltrials.gov NCT02615743; https://www.clinicaltrials.gov/ct2/show/study/NCT02615743 (Archived with WebCite at http://www.webcitation.org/6ji59rAXN)

Public health campaigns and their effect on stroke knowledge in a high-risk urban population: A five-year study.

Background The level of knowledge of stroke risk factors and stroke symptoms within a population may determine their ability to recognize and ultimately react to a stroke. Independent agencies have addressed this through extensive awareness campaigns. The aim of this study was to determine the change in baseline knowledge of stroke risk factors, symptoms, and source of stroke knowledge in a high-risk Toronto population between 2010 and 2015. Methods Questionnaires were distributed to adults presenting to cardiovascular clinics at the University of Toronto in Toronto, Canada. In 2010 and 2015, a total of 207 and 818 individuals, respectively, participated in the study. Participants were identified as stroke literate if they identified (1) at least one stroke risk factor and (2) at least one stroke symptom. Results A total of 198 (95.6%) and 791 (96.7%) participants, respectively, completed the questionnaire in 2010 and 2015. The most frequently identified risk factors for stroke in 2010 and 2015 were, respectively, smoking (58.1%) and hypertension (49.0%). The most common stroke symptom identified was trouble speaking (56.6%) in 2010 and weakness, numbness or paralysis (67.1%) in 2015. Approximately equal percentages of respondents were able to identify ≥1 risk factor (80.3% vs. 83.1%, p = 0.34) and ≥1 symptom (90.9% vs. 88.7%, p = 0.38). Overall, the proportion of respondents who were able to correctly list ≥1 stroke risk factors and stroke symptoms was similar in both groups.(76.8% vs. 75.5%, p = 0.70). The most commonly reported stroke information resource was television (61.1% vs. 67.6%, p = 0.09). Conclusion Stroke literacy has remained stable in this selected high-risk population despite large investments in public campaigns over recent years. However, the baseline remains high over the study period. Evaluation of previous campaigns and development of targeted advertisements using more commonly used media sources offer opportunities to enhance education.

Epidemiologic and Spatiotemporal Characterization of Influenza and Severe Acute Respiratory Infection in Uganda, 2010-2015.

Little is known about the epidemiology of severe acute respiratory infection (SARI) or influenza in sub-Saharan Africa. Characterization of influenza transmission dynamics and risk factors for severe disease and mortality is critical to inform prevention and mitigation strategies. To characterize the epidemiology and transmission dynamics of influenza and risk factors for influenza-associated severe respiratory infection in Uganda. Clinicians at 12 sentinel surveillance sites prospectively collected clinical data and upper respiratory tract samples from consecutive patients who met criteria for SARI and influenza-like illness (ILI). Samples were tested for influenza A and B viruses using real-time reverse transcription-polymerase chain reaction. Spatial and spatiotemporal cluster modeling was performed to identify loci of increased influenza transmission. Morbidity and mortality were assessed through chart review in a defined subset of patients. Univariable and multivariable analyses were used to identify risk factors for severe respiratory infection, prolonged hospitalization, and in-hospital mortality. From October 2010 to June 2015, 9,978 patients met case definitions for SARI and ILI and had samples tested for influenza A and B. Of the 9,978 patient samples tested, 1,113 (11.2%) were positive for influenza. Among 6,057 patients with ILI, 778 samples (12.8%) were positive, and among 3,921 patients with SARI, 335 samples (8.5%) were positive. Significant clustering of influenza cases was observed in urban and periurban areas and during rainy seasons. Among 1,405 cases of SARI with available outcome data, in-hospital mortality was 1.6%. Infection with the 2009 pandemic A/H1N1 subtype and prolonged time to presentation were independently associated with SARI among influenza cases. Influenza is associated with a substantial proportion of acute respiratory infection in Uganda. As influenza vaccination programs are developed in East Africa, timing campaigns to confer protection during rainy seasons should be considered, particularly among high-risk urban populations.

Cord blood lead level in an urban inner-city hospital.

Lead levels were measured by inductively coupled plasma mass spectrometry (ICP-MS) in umbilical cord blood samples of 150 neonates in an urban inner-city hospital. The mean (SD) gestation and birth weight of our cohort were 38.8 (1.7) weeks and 3,217 (519) grams. There were 89% African-Americans, 53% males and 79% were born via vaginal delivery. Mean (SD) maternal age was 24.5 (5.8) years. History of drug abuse and smoking was reported in 8.7% and 10.7% respectively, with only 1 mother reporting a history of high lead level in childhood. Prenatal vitamin intake was reported in 99.3%. Cord blood lead level was available in 144 patients, with lead level of <1μg/dL seen in 141 (97.9%) and>1 in 3 (2.1%) patients. No patient had cord blood lead level of >2μg/dL. High lead levels during childhood in high-risk urban population, however, suggest the need for intensive efforts for prevention of environmental exposure to lead in early childhood.

Abstract B70: Perception of contraceptive use among black people infected with prostate cancer in high risk urban poor population in Africa

Abstract Prostate cancer is a growing public health challenge in Africa, the pandemic affects every individual including healthy person especially the black people. To combat sexually transmitted infections among prostate cancer infected black people, contraceptive-use is effective measure to interrupt any transmission. However, perception of black people about contraceptive usefulness has been limited to research. This study therefore examined prostate cancer among black population in Africa The study was cross-sectional in design. A multi-stage-stratified-random-sampling technique were adopted to select 400 adults aged 25years and above in Nigeria. A pre-tested questionnaire developed from results of 10 focus-group-discussions (FGD) was used to collect information. FGD and questionnaire data were analyzed thematically and descriptively using chi-square statistics respectively. Twenty-five percent of the participants who were sexually active, one year preceding the study had multiple premarital-sex. Among the subgroup that had multiple premarital-sex, only few (6.8%) used a contraception in the episode. More males (5.3%) than females (1.5%) used contraception in last premarital-sex (p&amp;lt;0.5). Non-contraceptive use was due to confidence in traditional herbs perceived to prevent prostate cancer. Similarly, FGD participants were unanimous in their opinion visiting tradomedicine dealers and the believe (10.3%) herbs/concussion-use could prevent prostate cancer. Risky sexual engagement among black people could be a distortion to prostate cancer reduction, because safe sex practices among this population was unimportant based on perception. In order to mitigate prostate cancer in Africa, information on safe-sex practices among young people are needed to address this misconception. Note: This abstract was not presented at the conference. Citation Format: King Odor Odor. Perception of contraceptive use among black people infected with prostate cancer in high risk urban poor population in Africa. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B70.

Feasibility of portable sleep monitors to detect obstructive sleep apnea (OSA) in a vulnerable urban population.

Portable sleep monitors may offer a convenient method to expand detection of obstructive sleep apnea (OSA), yet few studies have evaluated this technology in vulnerable populations. We therefore aimed to assess the feasibility and acceptability of portable sleep monitors for detection of OSA in a prediabetic, urban minority population. We recruited a convenience sample of participants at their 12-month follow-up for a community-partnered, peer-led lifestyle intervention aimed to prevent diabetes in prediabetic and overweight patients in this prospective mixed-methods pilot study. All participants wore portable sleep monitors overnight at home. We qualitatively explored perceptions about OSA and portable monitors in a subset of participants. We tested 72 people, predominantly non-White, female, Spanish speaking, uninsured, and of low income. Use of portable sleep monitors was feasible: 100% of the monitors were returned and all participants received results. We detected OSA in 49% (defined as an Apnea-Hypopnea Index [AHI] >5) and moderate-severe OSA in 14% (AHI >15) requiring treatment in 14%. In 21 qualitative interviews, participants supported increased use of portable sleep monitors in their community, were appropriately concerned that OSA could cause progression to diabetes, and thought weight loss could prevent or improve OSA. Portable sleep monitors may represent a feasible method for detecting OSA in high-risk urban minority populations.

Text Message Appointment Reminders as a Tool to Improve PPV Show Rates in an Urban Resident Clinic

INTRODUCTION: The objective of this research is to determine if text messaging can improve access to postpartum care for an urban clinic population by decreasing no-show rates. Last year's PPV rate at Women's Ambulatory Health Services at Hartford Hospital (71%) falls below the national average of 88.7% noted by the Centers for Disease Control and Prevention in 2004 with a 30% no-show rate. METHODS: Scheduled PPVs are randomized to a text message reminder 4 days in advance, one day in advance, or no reminder. Reminders are sent through a free SMS web site with a standardized message in English or Spanish including instructions to reschedule if needed. The electronic medical record is reviewed to determine if a PPV occurred. RESULTS: The study is powered to require 750 scheduled visits obtained by Spring 2014; at this interim analysis, we have reached 20% and note trends; the overall PPV show rate remains 71%. The current no-show rate is 19.7%. In the group randomized to no text message, 67% had PPVs, 22% no-showed, and five patients rescheduled. In the group receiving a text message 1 day before their appointment, 63% had PPVs, 22% no-showed, and 14% rescheduled. In the group receiving a text message 4 days in advance, 83% had PPVs, 13% no-showed, and two rescheduled. CONCLUSIONS: Preliminary results suggest that 4-day advance text message reminders improve PPV rates and decrease no-show rates. In a high-risk urban population for whom preventive and interconception services are particularly important, automated reminders may be a worthy investment.

Community-based HCV screening: knowledge and attitudes in a high risk urban population

BackgroundIn an attempt to curtail the rising morbidity and mortality from undiagnosed HCV (hepatitis C virus) in the United States, screening guidelines have been expanded to high-risk individuals and persons born 1945–1965. Community-based screening may be one strategy in which to reach such persons; however, the acceptance of HCV testing, when many high-risk individuals may not have access to HCV specific medications, remains unknown.MethodsWe set out to assess attitudes about HCV screening and knowledge about HCV disease at several community-based testing sites that serve high-risk populations. This assessment was paired with a brief HCV educational intervention, followed by post-education evaluation.ResultsParticipants (n = 140) were surveyed at five sites; two homeless shelters, two drug rehabilitation centers, and a women’s "drop-in" center. Personal acceptance of HCV testing was almost unanimous, and 90% of participants reported that they would still want to be tested even if they were unable to receive HCV treatment. Baseline hepatitis C knowledge was poor; however, the brief educational intervention significantly improved knowledge and increased acceptability of testing when medical access issues were explicitly stated.ConclusionsDespite inconsistencies in access to care and treatment, high-risk communities want to know their HCV status. Though baseline HCV knowledge was poor in this population, a brief on-site educational intervention improved both knowledge and acceptability of HCV testing and care. These data support the establishment of programs that utilize community-based screening, and also provide initial evidence for acceptance of the implementation of the recently expanded screening guidelines among marginalized communities.