Comparison Group Participants Research Articles

Reach and Weight Loss Among Comparison Group Participants Who Enrolled in the Active Intervention After a Diabetes Prevention Trial.

We examined participation rates, engagement, and weight-loss outcomes of comparison group participants in a diabetes prevention trial who enrolled in a digitally delivered diabetes prevention program (ie, an active intervention) after the original trial ended. We evaluated these outcomes by using the Wilcoxon signed-rank test and 1-sample z test. We found a high participation rate (73%) among comparison group participants and comparable weight-loss outcomes at 12 months (6.8 lb) after initiating participation in the active intervention relative to intervention group participants during the original trial. Findings support providing evidence-based interventions for comparison or control group participants post-trial. Findings also support examining the cost-effectiveness of post-trial interventions, regardless of the limitations of acquiring post-trial data on weight in an uncontrolled setting.

Promoting Late-Life Volunteering With Timebanking: A Quasi-Experimental Mixed-Methods Study in Hong Kong.

This study explores the impact of timebanking, where individuals earn time credits, nonmonetary currency, on promoting volunteerism among older adults. This study employed a quasi-experimental design with 116 timebank group (TBG) participants and 114 comparison group (CG) participants from 2021 to 2022. TBG received time credits to exchange for rewards, while CG received no time credits (i.e., volunteering as usual). The intervention of timebanking lasted for 1 year. Volunteering behaviors were tracked via an app, and intentions to volunteer were assessed at baseline (T0), after 6 months (the midpoint of the intervention, T1), and after 12 months (the endpoint of the intervention, T2). The use of rewards by TBG participants was also recorded (e.g., for personal use or sharing with others). Furthermore, focus group interviews were conducted to understand how rewards influenced participants' volunteerism. TBG had significantly higher weekly volunteer hours at T2 (β = 1.37, p = .021) and increased intent to volunteer at T1 (β = 0.54, p = .001) and T2 (β = 0.51, p = .001) compared with CG. Participants using rewards personally volunteered more at T2 (β = 2.09, p = .014), although sharing rewards with family and friends or donating rewards to others did not yield the same effect. The qualitative study suggested that a sense of feeling recognized generated by timebanking may encourage increased volunteering and that personal reward use enriched the volunteer experience, and individuals sharing rewards with family and friends experienced a sense of fulfillment and reinforcement of their prosociality. Timebanking effectively encourages late-life volunteering. The study provides practical implications for promoting volunteering among older people.

Effectiveness of distributing pocket cards in improving the behavior, attitude, and knowledge regarding proper medication use among junior high school students in Japan.

This study aimed to explore the effectiveness of distributing pocket cards with summaries of key information on appropriate medication usage after the implementation of a structured school-based medication education program for junior high school students in Japan. A total of 227 3rd-grade high school students participated in the intervention. Students who received the program without the provision of pocket cards in 2022 were included in the comparison group, and students who took the program with the provision of pocket cards in 2023 were included in the intervention group. After propensity score matching, the final sample of N = 116 comprised n = 58 comparison group participants and n = 58 intervention group participants. Questionnaires were administered at baseline, end-of-class, and 3-month follow-up to assess the changes in behavior, attitude, and knowledge scores. The matched intervention group showed significantly lower scores at the 3-month follow-up than the matched comparison group. The results of the multiple linear regression analysis showed that for both groups, only the attitude scores were significantly correlated with the behavior scores. In addition, regardless of the baseline scores, the matched intervention group demonstrated smaller or negative changes in scores at the 3-month follow-up. Overall, the results of this study did not support the effectiveness of distributing pocket cards after in-class intervention. However, the usefulness of medication education intervention was confirmed. These results emphasize the need to explore other supplemental teaching tools to further enhance the impact of structured medication education programs.

Data‐Driven Learning for Pronunciation: Perception and Production of Lexical Stress and Prominence in Academic English

AbstractIssues of intelligibility may arise amongst English learners when acquiring new words and phrases in North American academic settings, perhaps in part due to limited linguistic data available to the learner for understanding language use patterns. To this end, this paper examines the effects of Data‐Driven Learning for Pronunciation (DDLfP) on lexical stress and prominence in the US academic context. 65 L2 English learners in North American universities completed a diagnostic and pretest with listening and speaking items before completing four online lessons and a posttest on academic words and formulas (i.e., multi‐word sequences). Experimental group participants (n = 40) practiced using an audio corpus of highly proficient L2 speakers while comparison group participants (n = 25) were given teacher‐created pronunciation materials. Logistic regression results indicated that the group who used the corpus significantly increased their recognition of prominence in academic formulas. In the spoken tasks, both groups improved in their lexical stress pronunciation, but only the DDLfP learners improved their production of prominence in academic formulas. Learners reported that they valued DDLfP efforts for pronunciation learning across contexts and speakers. Findings have implications for teachers of L2 pronunciation and support the use of corpora for language teaching and learning.

Mézières Method as a practice of embodiment in patients with low back pain: a mixed study

Introduction The objectives of this study were to determine the effects of the Mézières Method (MM) on pain and disability related to low back pain (LBP), compared to a program of heat, massage and exercise, and to understand the meaning of the bodily experience with the MM. Patients and methods Mixed methods convergent parallel design, combining an equivalent randomized clinical trial with a qualitative phenomenological approach. Sixty-one participants aged 18–65 years with chronic non-specific LBP lasting more than 3 months. Patients were randomized into two groups: the MM group (n = 29) and the comparison group (CG) who received heat, massage plus flexibility and strengthening exercises (n = 31). MM and CG participants underwent 10 one-hour physical therapy sessions over a 5-week period and were evaluated three times: pre-intervention, post-intervention and follow-up at 6 weeks after the end of treatment. Results Both groups reported positive effects on LBP . MM group showed superior effects in pain relief in the short term (Cohen’s D 0.80; p = 0.004). Participants interpreted the interaction with the MM as a teaching–learning process that allowed body awareness. Conclusion Both treatment were similarly beneficial but MM had superior effects on pain in the short term. MM is perceived by the participants as a teaching–learning process focused on body awareness that facilitate effective management of LBP.

Social Connectivity and Coping Among Vulnerable Veterans During the COVID-19 Pandemic

Abstract: The coronavirus disease 2019 (COVID-19) pandemic dramatically changed how people socialized. However, little is known about the extent to which the pandemic changed the social connections of people with tenuous interpersonal relationships at baseline, including homeless-experienced people and people with psychotic disorders. We sought to understand how these populations experienced changes in their social connectivity and to identify coping strategies employed. We conducted 43 semi-structured interviews with 27 vulnerable participants (11 homeless-experienced people and 16 people with psychotic disorders) and 16 comparison group participants, all of whom used services at the Department of Veterans Affairs (VA). Vulnerable participants in both groups had sparse prepandemic social connectedness; few perceived pandemic-related social network changes. While many homeless-experienced participants struggled with transitioning to technology to communicate, participants with psychotic disorders used technology to stay connected. Resilience derived from military service experiences was adaptive during the pandemic, complemented by VA services that provided supports.

Evaluation of Midlife Educational Attainment Among Attendees of a Comprehensive Early Childhood Education Program in the Context of Early Adverse Childhood Experiences

Educational attainment is a key social determinant of health and can be particularly consequential for racial and ethnic minority populations. Although the consequences of adverse childhood experiences (ACEs) are well established, there is little research on protective factors and policy-relevant strategies to mitigate ACE-related inequities. To examine associations between early ACEs, comprehensive early intervention, and midlife educational attainment in a cohort of predominantly Black participants. The Chicago Longitudinal Study is a prospective cohort study of Black and Latinx children from Chicago, Illinois. The intervention group included 989 children entering the Child-Parent Center (CPC) preschool Early Childhood Education (ECE) program in the 1980s. The comparison group comprised 550 children participating in usual early childhood services. All participants were followed up for 30 years after the end of the intervention. Analyses were conducted from July 1 to September 1, 2022. Attendance at the CPC preschool ECE program. A standard battery of early childhood ACEs (conventional ACEs), a set of early childhood ACEs more commonly associated with high-poverty contexts (expanded ACEs), and educational attainment at 35 years of age were measured from self-report and administrative records. The original Chicago Longitudinal Study sample comprised 1539 participants (1430 Black participants [92.9%]; 774 female participants [50.3%]). Data on educational attainment and ACEs were available for 1083 of 1467 living participants (73.8%). Participants in the present study (1013 Black participants [93.5%]; 594 female participants [54.9%]) were a mean (SD) age of 35.1 (0.3) years at completion of the midlife survey. For the comparison group but not the CPC intervention group, having 1 or more conventional or expanded ACEs in early childhood was associated with fewer years of education (β = -0.64; 95% CI, -1.02 to -0.26), reduced likelihood of attaining a bachelor's degree or higher (odds ratio, 0.26; 95% CI, 0.09-0.70), and reduced likelihood of attaining an associate's degree or higher (odds ratio, 0.26; 95% CI, 0.11-0.62) after adjusting for covariates. Moderation analyses indicated that CPC participants with either conventional or expanded ACEs in early childhood attained a bachelor's degree or higher and an associate's degree or higher at rates similar to CPC participants without early ACEs (15.4% vs 13.6% for bachelor's degree or higher; 22.4% vs 19.9% for associate's degree or higher). Conversely, comparison group participants with early ACEs had significantly lower rates of educational attainment than their counterparts without ACEs (3.7% vs 12.1% for bachelor's degree or higher; 5.6% vs 17.1% for associate's degree or higher). This cohort study suggests that early ACEs were associated with reduced educational attainment for the comparison group but not for the group participating in the CPC comprehensive early intervention. These results build on research suggesting that youths at higher risk can benefit most from intervention and support ECE as a tool for reducing ACE-related disparities.

549-P: Assessing Feasibility of a Diabetes Mellitus Program Using Behavioral Economics to Optimize Outreach and Self-Management Support with Technology—The DM-BOOST Project

Introduction: The DM-BOOST intervention was developed to enhance engagement with diabetes self-management training (DSMT). Participants received peer-written text message tips with nudges to reply with personal preferences. They then completed a video call with the DM-BOOST team to confirm patient portal access, review key functions, and set a diabetes behavior goal. This was later followed by receipt of a patient portal message with their goal, which they commit to sending to the DSMT provider they are scheduled to meet with. Methods: Adults with poorly controlled type 2 diabetes (HbA1c ≥ 8) received mailed invitations and a recruitment phone call. Participants (n=60) were randomized (1:1) to usual care or DM-BOOST. All participants received assistance obtaining a DSMT referral and scheduling a DSMT appointment. The primary outcome of interest was the DSMT appointment no-show/cancellation rate. Results: Enrolled participants (n=60) were 60.0% female with a mean age of 45.5 years (SD = 8.3). The average HbA1c at enrollment was 10.1% (SD = 1.8). All intervention participants (30/30) had a DSMT appointment scheduled compared to 86.7% of comparison participants (26/30). Intervention group participants had fewer DSMT no-shows/cancellations (3/30, 10%) compared to comparison group participants (10/26, 35%) (p = 0.01). Conclusions/Discussion: Technology-based interventions guided by behavioral economics can increase initial engagement with DSMT. Several system-level barriers, including challenges in obtaining referrals and scheduling appointments, were identified. Secondary outcomes, including patient-reported changes in diabetes self-efficacy, self-management skills, and treatment satisfaction are being evaluated. Future research efforts include cultural adaption of DM-BOOST for Spanish-speaking patients and rigorous implementation evaluation. Disclosure D.J.Amante: None. L.L.Shenette: None. G.Puerto: None. S.Lemon: None. D.M.Harlan: Advisory Panel; Novartis, Vertex Pharmaceuticals Incorporated, Diabeloop SA, Other Relationship; Stability Health, Wolters Kluwer Health. B.S.Gerber: Other Relationship; Abbott. Funding National Center for Advancing Translational Sciences (KL2TR001455); National Institute for Diabetes and Digestive and Kidney Diseases (1K01DK131318)

Peer-to-Patient-Aligned Care Team (Peer-to-PACT; P2P), a Peer-Led Home Visit Intervention Program for Targeting and Improving Long-term Care Services and Support for Veterans With High Needs and High Risk: Protocol for a Mixed Methods Feasibility Study.

Keeping older veterans with high needs and high risk (HNHR) who are at risk of long-term institutional care safely in their homes for as long as possible is a Department of Veterans Affairs priority. Older veterans with HNHR face disproportionate barriers and disparities to engaging in their care, including accessing care and services. Veterans with HNHR often have poor ability to maintain health owing to complicated unmet health and social needs. The use of peer support specialists (peers) is a promising approach to improving patient engagement and addressing unmet needs. The Peer-to-Patient-Aligned Care Team (Peer-to-PACT; P2P) intervention is a multicomponential home visit intervention designed to support older veterans with HNHR to age in place. Participants receive a peer-led home visit to identify unmet needs and home safety risks aligned with the age-friendly health system model; care coordination, health care system navigation, and linking to needed services and resources in collaboration with their PACT; and patient empowerment and coaching using Department of Veterans Affairs whole health principles. The primary aim of this study is to evaluate the preliminary effect of the P2P intervention on patient health care engagement. The second aim is to identify the number and types of needs and unmet needs as well as needs addressed using the P2P needs identification tool. The third aim is to evaluate the feasibility and acceptability of the P2P intervention delivered over 6 months. We will use a quantitative-qualitative convergent mixed methods approach to evaluate the P2P intervention outcomes. For our primary outcome, we will conduct an independent, 2-tailed, 2-sample t test to compare the means of the 6-month pre-post differences in the number of outpatient PACT encounters between the intervention and matched comparison groups. Qualitative data analysis will follow a structured rapid approach using deductive coding as well as the Consolidated Framework for Implementation Research. Study enrollment began in July 2020 and was completed in March 2022. Our sample size consists of 114 veterans: 38 (33.3%) P2P intervention participants and 76 (66.7%) matched comparison group participants. Study findings are expected to be published in late 2023. Peers may help bridge the gap between PACT providers and veterans with HNHR by evaluating veterans' needs outside of the clinic, summarizing identified unmet needs, and developing team-based solutions in partnership with the PACT. The home visit component of the intervention provides eyes in the home and may be a promising and innovative tool to improve patient engagement. DERR1-10.2196/46156.

A community-based contact isolation strategy to reduce the spread of Ebola virus disease: an analysis of the 2018–2020 outbreak in the Democratic Republic of the Congo

IntroductionDespite tremendous progress in the development of diagnostics, vaccines and therapeutics for Ebola virus disease (EVD), challenges remain in the implementation of holistic strategies to rapidly curtail outbreaks. We investigated...

Can a Home-Based Collaborative Care Model Reduce Health Services Utilization for Older Medicaid Beneficiaries Living with Depression and Co-occurring Chronic Conditions? A Quasi-experimental Study.

Depression remains a major public health issue for older adults, increasing risk of costly health services utilization. While home-based collaborative care models (CCM) like PEARLS have been shown to effectively treat depression in low-income older adults living with multiple chronic conditions, their economic impact is unclear. We conducted a quasi-experimental study to estimate PEARLS effect on health service utilization among low-income older adults. Our secondary data analysis merged de-identified PEARLS program data (N = 1106), home and community-based services (HCBS) administrative data (N = 16,096), and Medicaid claims and encounters data (N = 164) from 2011 to 2016 in Washington State. We used nearest neighbor propensity matching to create a comparison group of social service recipients similar to PEARLS participants on key determinants of utilization guided by Andersen's Model. Primary outcomes were inpatient hospitalizations, emergency room (ER) visits, and nursing home days; secondary outcomes were long-term supports and services (LTSS), mortality, depression and health. We used an event study difference-in-difference (DID) approach to compare outcomes. Our final dataset included 164 older adults (74% female, 39% people of color, mean PHQ-9 12.2). One-year post-enrollment, PEARLS participants had statistically significant improvements in inpatient hospitalizations (69 fewer hospitalizations per 1000 member months, p = 0.02) and 37 fewer nursing home days (p < 0.01) than comparison group participants; there were no significant improvements in ER visits. PEARLS participants also experienced lower mortality. This study shows the potential value of home-based CCM for participants, organizations and policymakers. Future research is needed to examine potential cost savings.

Study protocol of a mixed method pragmatic quasi-experimental trial to evaluate the day activity services targeted at older home care clients in Finland

BackgroundIn Finland, the ‘day activity service’ is targeted at older home care clients who are unable to participate in other available activities due to poor health or functional disabilities. The aim of the day activity service is to support home care client’s ability to live at home and to enhance their wellbeing and social inclusion. This mixed method study examines the effectiveness, cost-effectiveness and process of the day activity service.MethodsThe target sample size is 200 participants. The intervention group (n = 100) is composed of home care clients who begin to participate in the day activity service. The comparison group (n = 100) are home care clients who do not participate in the day activity service, and whose functioning and care needs are similar to the participants of the intervention group. The primary outcome is social inclusion (ESIS-scale). Secondary outcomes are loneliness (single item and De Jong Gierveld Loneliness Scale) and social care related quality of life (ASCOT). Baseline, three-month and six-month follow-up surveys are gathered from intervention and comparison group participants in order to compare outcomes between groups pre- and post-intervention.Costs of health and social services, based on administrative data, and the costs of the intervention are utilized in examining the cost-effectiveness of the intervention with the above-described measurements. Qualitative data are collected by interviewing the intervention participants (n = 10) and professionals working at the day activity centres and older people’s services (4 focus groups) to explore the perceived outcomes and process of the intervention to find out how and why the intervention is effective or ineffective.DiscussionThe study seeks to produce a comprehensive understanding of the effectiveness, cost-effectiveness and implementation process of the day activity service.Trial registrationISRCTN13146087, Registration date 03/04/2022.

Integrating primary, behavioral and spiritual health care to improve patient outcomes

Background: Residents of Webb County, Texas, along the U.S.-Mexico border suffer from health disparities which stem from extreme poverty, lower levels of educational attainment, and inadequate access to basic health care. The scarcity of primary care and behavioral health service providers is a key factor influencing higher-than-average disease prevalence and unfavorable disease management in the region. In 2015 Mercy Ministries of Laredo became one of eight subgrantees of a grant awarded by the Social Innovation Fund to Methodist Healthcare Ministries of San Antonio to enhance/expand integrated primary care and behavioral health care services in medically underserved areas of South Texas. Methods: Mercy’s project embodied a 3-dimensional model of health and healthcare, to include physical, behavioral and spiritual needs and interventions. With strong support from a research design and analysis group, this small clinic was able to demonstrate statistically significant improved health outcomes of several interventions. A non-randomized quasi experimental design (QED) was used and participants chose whether to participate in the intervention (207) or control (203) group. Common variables for all eight subgrantees included five overarching measures (HbA1C, blood pressure, BMI, PHQ-9 and quality of life score) and depression outcomes were used to statistically power all subgrantee studies. Results: Intervention group participants had significantly greater improvements in quality of life and anxiety symptoms when compared with comparison group participants. Intervention participants had a Duke General Health score 4.01 points higher and a GAD-7 score 0.79 points lower than those in the comparison group. There were also significant improvements for intervention participants over time for these two outcomes as well as depression symptoms. Conclusions: Grant funded resources enhanced health outcomes and prompted this small clinic to expand integrated primary and behavioral health services to serve the entire clinic population and promote integrated primary and behavioral health care for other underserved populations.

Association between Temporomandibular Joint Disorder and Weight Changes: A Longitudinal Follow-Up Study Using a National Health Screening Cohort.

This study aimed to investigate BMI changes following a temporomandibular joint disorder (TMJD) diagnosis. The Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 was used. In Study I, 1808 patients with TMJD (TMJD I) were matched with 7232 participants in comparison group I. The change in BMI was compared between the TMJD I and comparison I groups for 1 year. In study II, 1621 patients with TMJD (TMJD II) were matched with 6484 participants in comparison group II participants. The change in BMI was compared between the TMJD II and comparison II groups for 2 years. In Study I, the BMI change was not associated with TMJD. In Study II, the BMI change was associated with TMJD in the interaction of the linear mixed model (p = 0.003). The estimated value (EV) of the linear mixed model was −0.082. The interaction was significant in women < 60 years old, women ≥ 60 years old, and the obese I category. TMJD was not associated with BMI changes after 1–2 years in the overall population. In women and obese patients, TMJD was associated with a decrease in BMI after 2 years.

Evaluation of 2 Intervention Models to Integrate Family Planning Into Worker Health and Livelihood Programs in Egypt: A Difference-in-Differences Analysis.

Recent increases in fertility rates in Egypt and an increase in desired fertility among unmarried young people highlight the need for renewed attention to awareness of and demand for family planning (FP) among young people. Between 2017 and 2018, the United States Agency for International Development-funded Evidence Project tested 2 intervention models to increase awareness of and demand for FP and reproductive health (RH) services among people aged 18-35 years in Souhag and Port Said governorates, Egypt. In Souhag, FP/RH information was integrated into a 5-day livelihood training program for job seekers. In Port Said, garment factory workers received FP/RH information through trained peer educators, social and behavior change materials, and social media. Workshop participants and factory workers interested in FP services were referred to private project-trained physicians and pharmacists. We present the results of an evaluation of the impact of each intervention on young people's reported exposure to FP messages and their FP knowledge, attitudes, and behaviors. Phone interviews were conducted with participants in intervention and comparison groups before and after the intervention. In Souhag, 1,519 intervention group participants (778 at baseline; 741 at endline) and 1,082 comparison group participants (699 at baseline; 383 at endline) completed the phone interview. In Port Said 1,958 participants from intervention factories (1,145 at baseline; 813 at endline) and 1,047 participants from comparison factories (621 at baseline; 426 at endline) completed the phone interview. A difference-in-differences analysis compared intervention and comparison groups between baseline and endline. Results showed significant differences in knowledge and attitudes over time between the intervention and comparison groups in Souhag but less so in Port Said. FP use did not change among project participants in either governorate. We discuss lessons learned from integrating FP into worker health and livelihood training programs and methodological considerations for evaluating such interventions.

Work productivity loss in breast cancer survivors and its effects on quality of life.

Return to work is an important process for many breast cancer survivors (BCSs) that acts as a positive step towards their reintegration into society. This study examined whether work productivity loss due to presenteeism could predict the quality of life (QOL) of employed BCSs. This study used a cross-sectional design. Seventy-five BCSs and seventy-five participants in the Non-Cancer Comparison (NCC) group were surveyed. The main outcome measures were productivity loss (as measured by the Work Limitations questionnaire) and quality of life (as measure by the European Organization for Research and Treatment Quality of Life questionnaire C30). Other measures included psychological distress (as measured by the Hospital Anxiety and Depression Scale) and cognitive limitation at work (as measured by the Cognitive Symptom Checklist). The BCS group had a lower summary score, a lower global health related score and greater work limitation in all domains than the NCC group. The productivity loss due to presenteeism of the BCS group was 8%. The multiple regression model shows that work productivity loss and level of job stress were the significant predictors of quality of life in the BCS group. These findings raise questions about the effects of level of job stress and work productivity loss on the QOL of BCSs. Longitudinal studies are needed to map these relationships.

Long-term effects of a job search intervention for transition-age youth with visual impairments

BACKGROUND: Research supports the short-term benefits of a job search intervention for youth with visual impairments, but its effectiveness over time has not been explored. OBJECTIVE: We examined the long-term effects of a research-based job search intervention on job search knowledge, job search behavior, job search self-efficacy, and employment outcomes. METHODS: We conducted a longitudinal study with 92 youth with visual impairments using a two-group, quasi-experimental repeated-measures design. The intervention group received 35–40 hours of job search skills training, and the comparison group received usual services. Data collection included telephone surveys at pretest, posttest, 8-month follow-up, and 14-month follow-up. RESULTS: Intervention group participants had increases in job search knowledge, job search behavior, and job search behavior self-efficacy at posttest; they maintained increases in knowledge and self-efficacy, but not behavior. Comparison group participants also had increases in job search behavior and job search behavior self-efficacy at the end of the study. Changes in job search outcomes self-efficacy were not evident for either group; neither were differences in post-intervention employment. CONCLUSIONS: The intervention had lasting effects on job search knowledge, but findings for other outcomes over time were mixed. Both groups had low employment rates throughout the study.

The effectiveness of a brief intervention to increase the likelihood of advance care planning among college students

Advance care planning (ACP) is atypical in the United States, especially among young adults. We designed and evaluated the effectiveness of a brief intervention about the benefits of perceived control and planning for end-of-life. Participants (N = 188) were randomized into three conditions and completed a cross-sectional questionnaire. Participants who received the intervention were less likely to worry about not getting enough care and more likely to anticipate completing verbal and written ACP within three months than were comparison group participants. Findings suggest the potential of brief interventions to raise awareness about the benefits of ACP and enhance completion among young adults.

Improving forensics: Characterizing injuries among community-dwelling physically abused older adults.

Physical elder abuse affects a substantial number of older adults, leaving victims at increased risk for negative health outcomes. Improved detection of abuse-related injuries may increase victim access to professional support, but providers report difficulties distinguishing between accidental and abuse-related injuries, due in part to victims' pre-existing health conditions and medication use. To describe the spectrum and characteristics of injuries among physically abused older adults and identify injury characteristics associated with abuse. Case-control study. Physically abused adult protective services clients were interviewed in their home; non-abused comparison group participants were interviewed in an outpatient geriatrics clinic. Sample included 156 community-dwelling adults aged 65 and older, including 57 physically abused and 99 non-abused individuals. Self-reported abuse history was confirmed through independent case assessment by a LEAD (Longitudinal, Expert All-Data) panel of clinicians with family violence expertise. Full-body assessments were conducted, documenting injury incidence, diagnosis, and location. We also collected sociodemographic characteristics, level of social support, functional ability, medical history, and medication use. Physically abused older adults were more likely to be injured upon assessment (79.0% vs 63.6%; p < 0.05) and have a greater number of injuries ( vs , p < 0.05). Injuries seen more often among abused individuals included: upper extremity ecchymoses (42.1% vs 26.3%; p < 0.05), abrasions (31.6% vs 11.1%; p < 0.01), and areas of tenderness (8.8% vs 0.0%; p < 0.01); and head/neck/maxillofacial ecchymoses (15.8% vs 2.0%; p < 0.01) and tenderness (15.8% vs 0.0%; p < 0.001). Lower extremity abrasions (12.3%) were common but unrelated to abuse status. While physical abuse does not always result in physical injury, victims more commonly display head/neck/maxillofacial ecchymoses or tenderness and upper extremity abrasions, ecchymoses, or tenderness. Detection of these injuries among older adults warrants further interview and examination.

Preschool and Kindergarten Impacts of the Midwest Expansion of the Child-Parent Centers in the Saint Paul Public Schools.

The Midwest Child-Parent Center (CPC) Expansion began preschool implementation in fall 2012 in five Minnesota and Illinois districts. This study reports preschool and kindergarten impact findings for the Saint Paul Public School District. It is the first impact study of CPC outside of Chicago. After documenting that implementation quality was relatively high on the six CPC elements (effective learning, collaborative leadership, aligned curriculum, parent involvement, professional development, and continuity and stability), matched-group analyses of 433 students utilizing propensity score weighting indicated that CPC participants had significantly higher levels of language and literacy proficiency in both preschool and kindergarten than comparison-group participants in the usual district preschool and kindergarten programs. Overall composite effect sizes were .51 SD at the end of preschool and .36 SD at the end of kindergarten, which translate to performance gains of nearly half of a year. At the end of kindergarten, 61.0% of CPC participants met the district's literacy benchmark compared to 47.4% for the comparison group. We also found that parents of CPC participants attended a significantly greater number of school events and workshops. However, no differences favoring CPC were detected for preschool or kindergarten attendance. Impacts were generally similar for Dual Language Learners. Students with two years of CPC (preschool and kindergarten) showed better performance in kindergarten reading stage and fluency than comparison group but not compared to the 1-year group. This was similar for Dual Language Learners. Findings indicate that the CPC program shows evidence that it can be effectively scaled and that the program yields impacts in preschool and kindergarten that exceed the usual early childhood programming in Saint Paul.