Participation Rates In Programs Research Articles

Impact of different age ranges on the benefits and harms of the breast cancer screening programme by the EU-TOPIA tool.

The recommendation for the implementation of mammography screening in women aged 45-49 and 70-74 is conditional with moderate certainty of the evidence. The aim of this study is to simulate the long-term outcomes (2020-50) of using different age range scenarios in the breast cancer screening programme of the Valencia Region (Spain), considering different programme participation rates. Three age range scenarios (S) were simulated with the EU-TOPIA tool, considering a biennial screening interval: S1, 45-69 years old (y); S2, 50-69 y and S3, 45-74 y. Simulations were performed for four participation rates: A = current participation (72.7%), B = +5%, C = +10% and D = +20%. Considered benefits: number (N°) of in situ and invasive breast cancers (BC) (screen vs. clinically detected), N° of BC deaths and % BC mortality reduction. Considered harms: N° of false positives (FP) and % overdiagnosis. The results showed that BC mortality decreased in all scenarios, being higher in S3A (32.2%) than S1A (30.6%) and S2A (27.9%). Harms decreased in S2A vs. S1A (N° FP: 236 vs. 423, overdiagnosis: 4.9% vs. 5.0%) but also benefits (BC mortality reduction: 27.9% vs. 30.6%, N° screen-detected invasive BC 15/28 vs. 18/25). In S3A vs. S1A, an increase in benefits was observed (BC mortality reduction: 32.2% vs. 30.6%), N° screen-detected in situ B: 5/2 vs. 4/3), but also in harms (N° FP: 460 vs. 423, overdiagnosis: 5.8% vs. 5.0%). Similar trends were observed with increased participation. As the age range increases, so does not only the reduction in BC mortality, but also the probability of FP and overdiagnosis.

A multi-component intervention increased access to smoking cessation treatment after hospitalization for atherosclerotic cardiovascular disease: a randomized trial.

To evaluate the effects of a multi-component intervention for smokers hospitalized for atherosclerotic cardiovascular disease (ASCVD) on the participation rate in community-based cessation programmes and the use of cessation drugs. Additionally, to explore the impact on the cessation rates at 6 months. A randomized parallel-group study was conducted at a Norwegian secondary care hospital in 2021. The intervention group was: (i) counselled using motivational interviewing techniques during hospitalization; (ii) given an information leaflet, detailing the cessation programme; and (iii) referred to the community-based smoking cessation treatment including a post-discharge pro-active telephone invitation. The control group received usual care and the same information leaflet containing clear contact details for initiating participation. Data were collected at baseline, 1, 3, and 6 months. Among 99 smokers hospitalized with ASCVD, 40 were excluded. Of 59 randomized patients, 4 were lost to follow-up and 55 completed the study. The mean age was 65.1 (standard deviation 9.3) years, 35% were female, and 88% had smoked >20 years. Co-morbidity was prevalent (mean Charlson score 4.8). The intervention group was more likely to participate in the smoking cessation treatment {48 vs. 7%, difference: 41% [95% confidence interval (CI): 14%, 63%]} and used cessation drugs more frequently [59 vs. 21%, difference: 38% (95% CI: 17%, 59%)]. At the 6 months point prevalence, we observed notable between-group differences in self-reported cessation rate (48 vs. 25%). The intervention significantly increased the participation rate at community-based smoking cessation programmes and the use of cessation drugs among multi-morbid smokers hospitalized for ASCVD.

Assessment of Public Financing on Participation Rates in Adult Literacy Programs in Nairobi County Kenya.

The purpose of this paper was to examine the influence of public financing on participation rates in adult literacy programs in Nairobi County. Kenya. The study sought to establish how financing influenced the running of the adult education centres. The study adopted a mixed method design whereby both qualitative and quantitative methods was utilized in this research. The study was guided by the Human capital theory as advocated by Adam smith. The target population comprised of 30 adult education centres in Nairobi County. The research targeted one adult education officer, 30 principals, one hundred and twenty (120) adult literacy teachers and four hundred (400) learners. Therefore, out of the targeted 30 principals a total of 3 principals were interviewed. Out of the 120 adult literacy teachers a sample equivalent to 30% or 36 teachers were selected randomly. Out of the target population of 400 adult learners, 120 adult learners which forms 30% of the population was randomly selected. Questionnaires were administered to the teachers and the adult learners. While interviews were conducted on the county director, and on the principals. The findings established that most of the adult education centres in Nairobi County received inadequate direct funding from the government, thereby making the centres to have a challenge in running the centres leading to low assess and participation of the learners. There is a significant relation between the funding of adult education centres and the participation rates of adults in the adult education centres. Based on the study findings it can be recommended that the Government of Kenya and other public financing agencies should increase their funding allocation to the adult education centres in order to increase and sustain assess and participation.it was concluded that the funding in adult education centres should be increased so that more adult learners can be able to assess and benefit more by them participating in the learning programs offered at the adult education centres.

Arkansas Transitional Employment Assistance (TEA) Program: Barriers to Aid for Low-Income Families

Literature reviews and secondary data analysis of the Arkansas Transitional Employment Assistance (TEA) program show systemic issues in its mission to serve low-income families. This review analyzes the program’s design, processes, and long-term trends which may contribute to barriers in accessibility and enrollment. Recommendations for improving program participation rates include increasing income eligibility standards, adopting nudge techniques, and simplifying the enrollment and benefits issuance process to overcome its structural barriers.

Bridging and bonding social capital for sustainable technology adoption, the Landcare program in the resource poor rural town of Claveria, Philippines

The important role of bonding and bridging social capital in technology adoption has been well documented. This holds true in the dissemination of soil conservation technologies in the town of Claveria under the Landcare program. Past studies unanimously attribute high adoption rates to the formation of farmer Landcare groups, which is a form of bonding social capital, and to the provision of human and physical resources through external networks, a form of bridging social capital. After more than 20 years since the project ended in the town, this study unpacks this relationship and illustrates how the two types of social capital are complementary for sustained technology adoption. Data from household surveys, focus group discussions, and key informant interviews illustrate that the training and physical resources provided through external organizations and partnerships greatly contributed to program participation and high adoption rates of technologies. When such external organizations left the town, adoption rates fell and some farmers reverted to their traditional farm practices. These findings contribute to the debate on the complementation of the two types of social capital in sustaining adoption as well as illustrate how the two types relate to each other for sustainable rural development programs.

Strengthening the Equity in Athletics Disclosure Act to Improve Gender Equity Transparency & Institutional Accountability in the Future

In 1994, the United States Congress enacted The Equity in Athletics Disclosure Act (EADA). The EADA requires colleges and universities receiving federal financial assistance to provide an annual public report on the number of athletic participation opportunities provided to men and women athletes at the varsity level and the allocation of resources and personnel made in support of those opportunities. The passage of the EADA occurred on the heels of the 20th anniversary of Title IX of the Education Amendments Act, a time marked by the realization that the vast majority of schools around the country were not in compliance with Title IX’s requirements as applied to athletic departments two decades after its passage (NCAA Staff, 1993). The purpose of the EADA when initially proposed in 1993 was to provide accessible information to stakeholders, most specifically prospective students, the public, and the U.S. Congress, that would allow interested parties to raise questions regarding the fair and equitable treatment of women athletes in the nation’s intercollegiate athletic programs. The annual report, colloquially referred to as the EADA report, is officially called The Report on Athletic Program Participation Rates and Financial Support Data. Three decades after the passage of the EADA and five decades after the passage of Title IX, there is reason to question whether the EADA has served its purpose. During Title IX’s 50th anniversary year, researchers and journalists uniformly reported a systemic failure to comply with Title IX in the area of athletics (Staurowsky et al., 2022; USA Today Staff, 2022; Wilson, 2022). Over the years, some have argued that the EADA should be eliminated (Keen, 2007), others have documented how valuable the information from the EADA is to researchers, journalists, and litigators (Tatos, 2019); others have recommended changes that would strengthen the data collection required under the EADA (Staurowsky et al, 2022); and others have argued that something akin to an EADA requirement needs to be adopted nationwide to help address sweeping gender inequities in athletics at the high school level (Green, 2008). This essay begins with an overview of the current state of Title IX compliance and gender equity in college sport, revisits the history of the EADA, provides an overview of what the EADA covers and who uses it, explores the criticisms and limitations of the EADA, and concludes with recommendations for making the EADA a more effective tool.

Using the RE-AIM framework to evaluate the feasibility of a parent-focused intervention targeting childhood obesity

BackgroundChildhood obesity remains a serious public health concern. Community-based childhood obesity treatment interventions have the potential to improve health behaviors and outcomes among children, but require thorough evaluation to facilitate translation of research into practice. The purpose of the current study was to determine the feasibility of a community-based, parent-focused childhood obesity intervention (“C.H.A.M.P. Families”) using the RE-AIM framework, an evaluation tool for health interventions.MethodsA single-group, non-randomized, repeated measures feasibility study was conducted. Participants (n = 16 parents/caregivers of 11 children with obesity) completed a 13-week parent-focused education intervention. The intervention consisted of three main components: (a) eight group-based (parent-only) education sessions; (b) eight home-based (family-centered) activities; and (c) two group-based follow-up support sessions for parents and children. The five dimensions of RE-AIM—reach, effectiveness, adoption, implementation, and maintenance—were assessed using various measures and data sources (e.g., child, parent/caregiver, costing, census) obtained throughout the study period. Outcome variables were measured at baseline, mid-intervention, post-intervention, and at a 6-month follow-up.ResultsOverall, the C.H.A.M.P. Families intervention reached approximately 0.09% of eligible families in London, Ontario. Despite the small number, participants were generally representative of the population from which they were drawn, and program participation rates were high (reach). Findings also suggest that involvement in the program was associated with improved health-related quality of life among children (effectiveness/individual-level maintenance). In addition, the intervention had high fidelity to protocol, attendance rates, and cost-effectiveness (implementation). Lastly, important community partnerships were established and maintained (adoption/setting-level maintenance).ConclusionsBased on a detailed and comprehensive RE-AIM evaluation, the C.H.A.M.P. Families intervention appears to be a promising parent-focused approach to the treatment of childhood obesity.Trial registrationISRCTN Registry, Study ID ISRCTN 10752416. Registered 24 April 2018.

Highlights From the Circulation Family of Journals.

Highlights From the Circulation Family of Journals.

Changes in Body Mass Index Among School-Aged Youths Following Implementation of the Healthy, Hunger-Free Kids Act of 2010

The prevalence of obesity among youths 2 to 19 years of age in the US from 2017 to 2018 was 19.3%; previous studies suggested that school lunch consumption was associated with increased obesity. The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) strengthened nutritional standards of school-based meals. To evaluate the association between the HHFKA and youth body mass index (BMI). This cohort study was conducted using data from the Environmental Influences on Child Health Outcomes program, a nationwide consortium of child cohort studies, between January 2005 and March 2020. Cohorts in the US of youths aged 5 to 18 years with reported height and weight measurements were included. Full implementation of the HHFKA. The main outcome was annual BMI z-score (BMIz) trends before (January 2005 to August 2016) and after (September 2016 to March 2020) implementation of the HHFKA, adjusted for self-reported race, ethnicity, maternal education, and cohort group. An interrupted time-series analysis design was used to fit generalized estimating equation regression models. A total of 14 121 school-aged youths (7237 [51.3%] male; mean [SD] age at first measurement, 8.8 [3.6] years) contributing 26 205 BMI measurements were included in the study. Overall, a significant decrease was observed in the annual BMIz in the period following implementation of the HHFKA compared with prior to implementation (-0.041; 95% CI, -0.066 to -0.016). In interaction models to evaluate subgroup associations, similar trends were observed among youths 12 to 18 years of age (-0.045; 95% CI, -0.071 to -0.018) and among youths living in households with a lower annual income (-0.038; 95% CI, -0.063 to -0.013). In this cohort study, HHFKA implementation was associated with a significant decrease in BMIz among school-aged youths in the US. The findings suggest that school meal programs represent a key opportunity for interventions to combat the childhood obesity epidemic given the high rates of program participation and the proportion of total calories consumed through school-based meals.

Improving colonoscopy prioritisation and promoting the National Bowel Cancer Screening Program: keys to reducing bowel cancer burden.

Australia's National Bowel Cancer Screening Program (NBCSP) has the potential to prevent almost 84 000 bowel cancer deaths if 60% program participation rates could be reached and maintained over the next two decades. Immunochemical faecal occult blood test (iFOBT) is used as an initial screening tool. Participants who test positive are referred for colonoscopy for diagnostic assessment. Concerns about colonoscopy capacity and lengthy wait times between positive iFOBT and colonoscopy have hampered efforts to promote the program. However, a separate research paper published in this issue of PHRP shows that only an estimated 10-14% of Medicare-funded colonoscopies (almost 75% of all colonoscopies) in Australia are generated by the NBCSP. Inappropriate use of colonoscopy as a primary screening tool and failure to prioritise NBCSP participants may be the main reasons for long colonoscopy wait times associated with the program. Promoting clinical practice guidelines, and the Direct Access Colonoscopy initiative for priority patients, are key to reducing colonoscopy wait times and proactive promotion of the NBCSP.

New South Wales sheep producers’ perceptions regarding lamb mortality and the adoption of pregnancy scanning

Context Proven strategies to address lamb mortality include pregnancy scanning and the differential management of single- and twin-bearing ewes. However, current adoption rates of this best-practice management by Australian producers remain low at ~20%. Aims We explored producer perceptions about lamb mortality and the adoption of pregnancy scanning, and analysed whether producer characteristics, demographics, beliefs or management practices have an influence on perceptions towards pregnancy scanning or lamb survival. Methods Data were collected through an on-line self-administered survey of lamb producers in New South Wales, Australia. Descriptive and inferential statistics were used to summarise the data and test for interdependence of variables. Key results The survey results revealed that New South Wales sheep producers have low participation rates in extension programs and low engagement in record-keeping practices. Only 4% of respondents considered current lamb mortality rates acceptable and the majority agreed that lamb mortality poses a threat to Australia’s sheep industry. Findings identified numerous significant relationships between producer characteristics, demographics, beliefs, management practices, non-participation in extension programs, and perceptions towards pregnancy scanning, lamb mortality and sheep welfare. Survey participants were more likely to have adopted pregnancy scanning if they had participated in extension programs. Conclusions Further extension efforts should be focused on producers who have not adopted any record-keeping practices or previously participated in extension programs. Extension should be tailored to different enterprises, owing to the influence of enterprise focus on beliefs, while also considering producer demographics. Implications A strong case exists for continued investment in future marketing, education, and research, development and extension to increase the capacity of Australia’s sheep industry and, in particular, to increase the adoption of pregnancy scanning.

Sustaining telehealth among cardiac and pulmonary rehabilitation services: a qualitative framework study.

Semi-structured interviews (n = 8) and focus groups (n = 7) were conducted with 27 cardiac and pulmonary clinicians and managers from health services across Queensland between June-August 2021. Interview questions were guided by Greenhalgh's Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework. Hybrid inductive/deductive framework analysis elicited six main themes: 1. Variable levels of readiness; 2. Greater telehealth uptake in pulmonary versus cardiac rehabilitation; 3. Safety and risk management; 4. Client willingness - targeted support required; 5. Equity and access; and, 6. New models of care. We found sustained integration of telehealth in cardiac and pulmonary rehabilitation will require contributions from all stakeholders: consumers (e.g., co-design), clinicians (e.g. shared learning), health services (e.g., increasing platform functionality), and the profession (e.g., sharing resources). There are opportunities for telehealth programs servicing large geographic areas, and to increase program participation rates more broadly. Centralised models of care serving large geographic areas could maximise sustainability with current resource limitations; however, realising the full potential of telehealth will require additional funding for supporting infrastructure and workforce. Individuals and organisations both have roles to play in sustaining telehealth in cardiac and pulmonary services.

Health of the Food Environment Is Associated With Heart Failure Mortality in the United States.

Food environment factors contribute to cardiovascular disease, but their effect on population-level heart failure (HF) mortality is unclear. We utilized the National Vital Statistics System and USDA Food Environment Atlas to collect HF mortality rates (MR) and 2 county food environment indices: (1) food insecurity percentage (FI%) and (2) food environment index (FEI), a scaled index (0-10, 10 best) incorporating FI% and access to healthy food. We used linear regression to estimate the association between food environment and HF MR Results: Mean county FI% and FEI were 13% and 7.8 in 2956 included counties. Counties with FI% above the national median had significantly higher HF MR (30.7 versus 26.7 per 100 000; P<0.001) compared with FI% below the national median. Counties with HF MR above the national median had higher FI%, lower FEI, lower density of grocery stores, poorer access to stores among older adults, and lower Supplemental Nutrition Assistance Program participation rate (P<0.001 for all). Lower county FI% (β=-1.3% per 1% decrease) and higher county FEI (β=-3.6% per 1-unit increase in FEI) were significantly associated with lower HF MR after adjustment for county demographic, socioeconomic, and health factors. This association was stronger for HF MR compared with non-HF cardiovascular disease MR and all-cause MR The relationship between food environment and HF MR was stronger in counties with the highest income inequity and poverty rate. Healthier food environment is significantly associated with lower HF mortality at the county level. This reinforces the role of food security on cardiovascular outcomes.

A Review of Interventions to Increase WIC Enrollment and Participation.

Our goal was to identify strategies aimed at increasing Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment and participation rates. The WIC program provides many health benefits for pregnant women, mothers, and children. WIC offers nutrition education, formula, fruits and vegetables, and other food to pregnant and postpartum women and their children until they reach the age of five. Despite the availability of this program nationwide, enrollment and participation rates remain low across the country. Several states have tried various interventions to combat this deficiency of engagement with the goal of increasing WIC enrollment and participation. We conducted a scoping review to identify articles based on pre-specified inclusion and exclusion criteria. Two reviewers independently identified and screened articles. Subsequently, three reviewers independently extracted study details and outcomes related to WIC enrollment and participation rate changes. We included 14 studies reporting on 12 interventions from 3945 citations reviewed. Seven of these were published papers, while the others were final reports of USDA WIC Special Grant Projects. All the observed interventions had some success increasing WIC participation. Virtual interventions demonstrated the most success based on preliminary evidence. Successful interventions showed percentage gains in enrollment close to 8% and changes in participation over 9%. Overall, the literature surrounding WIC enrollment interventions reveal a mixed impact on improving participation. Many successful interventions involve an online or virtual engagement component which can provide educational resources on WIC benefits, nutrition, and living a healthy lifestyle.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10900-022-01131-2.

Effectiveness of nationwide programmatic testing and treatment for latent tuberculosis infection in migrants in England: a retrospective, population-based cohort study

SummaryBackgroundIn low-incidence countries, tuberculosis mainly affects migrants, mostly resulting from reactivation of latent tuberculosis infection (LTBI) acquired in high-incidence countries before migration. A nationwide primary care-based LTBI testing and treatment programme for migrants from high-incidence countries was therefore established in high tuberculosis incidence areas in England. We aimed to assess the effectiveness of this programme.MethodsWe did a retrospective, population-based cohort study of migrants who registered in primary care between Jan 1, 2011, and Dec 31, 2018, in 55 high-burden areas with programmatic LTBI testing and treatment. Eligible individuals were aged 16–35 years, born in a high-incidence country, and had entered England in the past 5 years. Individuals who tested interferon-γ release assay (IGRA)-negative were advised about symptoms of tuberculosis, whereas those who tested IGRA-positive were clinically assessed to rule out active tuberculosis and offered preventive therapy. The primary outcome was incident tuberculosis notified to the national Enhanced Tuberculosis Surveillance system.FindingsOur cohort comprised 368 097 eligible individuals who had registered in primary care, of whom 37 268 (10·1%) were tested by the programme. 1446 incident cases of tuberculosis were identified: 166 cases in individuals who had IGRA testing (incidence 204 cases [95% CI 176–238] per 100 000 person-years) and 1280 in individuals without IGRA testing (82 cases [77–86] per 100 000 person-years). Overall, in our primary analysis including all diagnosed tuberculosis cases, a time-varying association was identified between LTBI testing and treatment and lower risk of incident tuberculosis (hazard ratio [HR] 0·76 [95% CI 0·63–0·91]) when compared with no testing. In stratified analysis by follow-up period, the intervention was associated with higher risk of tuberculosis diagnosis during the first 6 months of follow-up (9·93 [7·63–12·9) and a lower risk after 6 months (0·57 [0·41–0·79]). IGRA-positive individuals had higher risk of tuberculosis diagnosis than IGRA-negative individuals (31·9 [20·4–49·8]). Of 37 268 migrants who were tested, 6640 (17·8%) were IGRA-positive, of whom 1740 (26·2%) started preventive treatment. LTBI treatment lowered the risk of tuberculosis: of 135 incident cases in the IGRA-positive cohort, seven cases were diagnosed in the treated group (1·87 cases [95% CI 0·89–3·93] per 1000 person-years) and 128 cases were diagnosed in the untreated group (10·9 cases [9·16–12·9] per 1000 person-years; HR 0·14 [95% CI 0·06–0·32]).InterpretationA low proportion of eligible migrants were tested by the programme and a small proportion of those testing positive started treatment. Despite this, programmatic LTBI testing and treatment of individuals migrating to a low-incidence region is effective at diagnosing active tuberculosis earlier and lowers the long-term risk of progression to tuberculosis. Increasing programme participation and treatment rates for those testing positive could substantially impact national tuberculosis incidence.FundingNational Institute for Health Research Health Protection Research Unit in Respiratory Infections.

Abstract PO-041: The impact of COVID-19 on cancer care in the Latinx community in Northern California: A mixed method community-engaged research study

Abstract The COVID-19 pandemic has negatively impacted cancer care including delayed diagnosis, procedures, and patient fears of COVID-19 infection. However, less is known about the impact on specific populations, including Latinx adults, who have been disproportionately affected by COVID-19. Cancer is the leading cause of death among Latinx adults. Alarmingly, they have low participation rates in cancer prevention programs and face multiple barriers in accessing healthcare, even before the pandemic. Rigorous methods and community-engaged approaches are needed to uncover key barriers and facilitators to cancer care across the socio-ecological spectrum and to translate findings into culturally congruent educational strategies and dissemination efforts. The present mixed methods study entails a bi-directional partnership between the Stanford Medicine Office of Community Engagement and Latinas Contra Cancer, a community-based organization increasing equitable cancer care access for Latinxs. This study aims to determine barriers and facilitators of cancer screening, diagnostics, and treatment in the Latinx community as a result of COVID-19 using a community-based survey (n=500) in Northern California. To gain a deeper understanding of the lived experience of Latinxs obtaining cancer-related care during the pandemic, we will conduct focus groups (n=4) with study participants stratified by barriers and facilitators they endorse across the socio-ecological spectrum, as well as by key demographics (e.g., socioeconomic status, nativity, health literacy). Moreover, medical providers and community clinics will be interviewed (n=15) to understand their unique circumstances during this pandemic (e.g., changing healthcare system logistics, telehealth challenges). Data collection is ongoing and expected to be complete by the end of the summer. We will present descriptive data and statistical analysis (e.g., chi-square tests, logistic regressions) exploring associations key sociocultural and demographic participants characteristics and their endorsement of a variety of barriers and facilitators to care. We will also present key themes from the qualitative data to further contextualize survey findings and gain deeper meaning of the complexities of cancer related care during the pandemic. Study findings will allow us to understand the complexity of barriers and facilitators of cancer prevention and care for Latinxs adults, inform the development of health promotion resources, and guide policy and solutions to reduce excess cancer burden for Latinxs communities. Citation Format: Patricia Rodriguez Espinosa, Darcie Green, Yessica Martinez Mulet, Miriam L. Trigo, Natalia M. Zamora Zeledon, Eric Meléndez, Lisa G. Rosas. The impact of COVID-19 on cancer care in the Latinx community in Northern California: A mixed method community-engaged research study [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-041.

Transitioning to virtual interaction during the COVID-19 pandemic: Impact on the family connects postpartum home visiting program activity.

In this paper, we analyze program activity for Family Connects (FC), an evidence‐based postpartum home‐visiting intervention, during the COVID‐19 pandemic. When the pandemic began, FC transitioned to a virtual protocol which maintains key psychosocial components of the in‐person protocol and adjusts health assessments to address the lack of in‐person contact. Program performance is contrasted for periods before the pandemic onset (April 2019–March 2020) and after the onset (April 2020–March 2021), involving 10,280 scheduled visits and 6696 visited families (46% non‐Hispanic white; 20% non‐Hispanic Black; 23% Hispanic; and 10% other race). Post‐pandemic onset, FC program participation rates were at 89.8% of pre‐pandemic levels. Home visitors observed post‐onset increases in families’ concerns about home safety but declines in families’ needs related to infant care. Community connections were facilitated for 42.9% of visited families post‐pandemic onset compared to 51.1% pre‐pandemic onset. We conclude that post‐pandemic onset virtual delivery rates of FC declined but are high enough to merit continued implementation during a period when some families will decline in‐person visits. When in‐person visits are deemed safe per public health guidelines, the findings suggest a hybrid approach that could maximize program outreach by prioritizing in‐person contact and offering virtual delivery as a second choice.

Efficacy of a Community-Based Trauma Recovery Program after a Fire Disaster

As industries develop, fire disasters and their associated damage are increasing. Investigating the mental health of victims is imperative because this is an essential issue for community recovery after a disaster. This study was conducted to determine the efficacy of a program implemented by a community mental health center based on the investigation of the victims’ depression and post-traumatic stress disorder (PTSD) levels immediately after the disaster and at one-year follow-up. As a result, victims’ depression and PTSD recovered over time, and more changes were confirmed. In particular, the high-risk group for PTSD showed a high program participation rate, and there was significant recovery over time compared with the group without PTSD. Based on these results, community mental health programs are an effective way to increase community mental health after disasters. In the future, community-based recovery programs after disasters should be expanded, and administrative support for them should be developed.

Hepatitis B screening among immigrants: How to successfully reach the Moroccan community.

Immigrants show relatively low participation rates in screening programs due to lack of awareness and knowledge. To promote screening for chronic hepatitis B, Dutch Municipal Public Health Services need evidence on how to reach and inform immigrants. Our aims were to describe the performance of respondent-driven sampling (RDS) to reach Moroccan-Dutch, and to estimate their awareness, knowledge, and information needs on hepatitis B and its screening. With this in mind, invitation and information strategies that suit Moroccan-Dutch the best can be developed adequately. Between February and November 2019, first- and second-generation Moroccan-Dutch were asked, using RDS, to complete paper-based questionnaires and forward them to peers. Population estimates were calculated. We invited 21 persons ("seeds") of whom 10 were successful in peer-recruitment. We reached 14 waves and 295 Moroccan immigrants. Of all respondents, 63.7% were willing to peer-recruit, of whom 40.7% succeeded. However, support from the researchers was often needed. Of the total population of Moroccans in the Netherlands, 76.6% [95% CI 67.7 - 85.5] had ever heard of hepatitis B and 23.1% [95% CI 14.2 - 31.9] of its screening. About half (48.2% [95% CI 42.3 - 54.1]) had sufficient knowledge and 39.4% [95% CI 30.4 - 48.4] had an information need. In conclusion, although extra time and effort from the researchers were required, RDS offers a promising method for Municipal Public Health Services to reach otherwise hard-to-reach Moroccan immigrants. Knowledge on hepatitis B and its screening is limited, and there is an information need. Future information materials should focus on the asymptomatic nature of the disease, as it could potentially increase immigrants' future screening participation rates.

Evaluating the Sustainability of Urban Food Recovery Programs: A Quantitative Assessment in Chicago

This study demonstrates the critical need for strategic transportation planning for sustainable food waste management in urban regions. The majority of food waste is generated from non-industrial sectors (i.e., residential, commercial, and institutional sectors that cluster in cities), while over two-thirds of discarded food could have been edible. Food recovery programs (FRPs) can help reduce food wastage, avoid the negative impacts of landfill disposal, and mitigate food insecurities. Notably, FRPs shift long-haul waste transport services destined for a central landfill location to local, short, and time-sensitive pick-up and delivery trips, which have not been carefully studied. This study quantifies the economic efficiency (i.e., cost) and environmental impact (i.e., emissions) of urban FRP scenarios by incorporating the characteristics of surplus food pick-up options, fleet, urban built environment, and donor program participation rates. The results of an empirical study in Chicago, U.S., show that urban FRPs can be both economically efficient and environmentally beneficial, although the preferred strategy for FRPs may vary by neighborhood characteristics. With strategic planning and management, the transportation cost could be as low as $ 0.06/lb of recovered food. Meanwhile, diverting 1 ton of edible food from landfills, on average, reduces greenhouse gas emissions by 97%, or 0.51 MTCO2e. If the estimated volume of 10,000 tons of surplus food in Chicago can be fully recovered, the regional net emission reduction can reach 5,100 MTCO2e, which is equivalent to removing 1,110 vehicles from the roads. This study is anticipated to provide planning insights into initiating and scaling up city-wide FRPs.