Pilot Phase Research Articles

Addressing What Matters: A Pilot Study and Mixed Methods Evaluation of Patient Priorities Care in Four Clinical Settings.

Older adults with multiple chronic conditions face significant challenges with their health. Patient Priorities Care (PPC) is an Age-Friendly approach that explores 'what matters' by identifying values, care preferences, and health priorities, and aligning healthcare based on patients' health outcome goals. Patient priorities care was implemented in four clinical settings (Hospital in Home, a transitional care case management program and in two embedded clinics within specialty care settings) within a large academically affiliated Veteran Affairs hospital system. During the pilot phase, the structured PPC approach was deployed through multiple modalities within specialty practices, including telehealth, and descriptive measures were evaluated. During the evaluation phase, clinical process measures related to care alignment were assessed, and clinicians' perspectives on PPC were explored through semi-structured interviews, which were then coded and analyzed for themes. During the pilot phase, a total of 109 PPC conversations were conducted by telephone (48%), video (35%) and in-person (17%) across the four clinical settings. Participants were on average 80 ± 9 years old, white (89%), and male (94%). Multimorbidity (17 ± 8 chronic conditions per patient), cognitive impairment (39% of participants), and polypharmacy (15 ± 7 prescriptions per patient) were prevalent. During the evaluation phase, a total of 46 documented PPC conversations were reviewed. Clarifying preferences for life-sustaining treatment, modifying medications, and ordering durable medical equipment were the most common care alignment outcomes resulting from health priorities identification. Nine semi-structured interviews were conducted with clinicians responsible for continuing care alignment, and seven emergent themes were described, highlighting perceived barriers and promoters to utilizing the PPC framework. PPC is an Age-Friendly approach to addressing 'what matters' that is feasible to implement in various clinical settings and through multiple modalities, including telehealth. Continuing to expand the delivery of conversations about 'what matters' is essential for developing and scaling Age-Friendly care.

Cardiac damage after polytrauma: the role of systematic transthoracic echocardiography - a pilot study

BackgroundHeart injuries following polytrauma (PT) are identified as a predictor of poor outcome. The diagnostic algorithm of cardiac damage after trauma consists of the systemic measurement of cardiac damage markers, a 3-channel ECG and if there are any suspicious findings, the conduction of a transthoracic echocardiography (TTE). The aim of this study was to implement a systematic analysis of cardiac function using TTE in PT-patients.MethodsThis study is a prospective non-randomized study, conducted in a German Level 1 Trauma Centre between January and July 2024. All polytraumatized patients with an ISS ≥ 16 were included immediately after entering the emergency department. Blood samples were withdrawn at 6 timepoints, at the Emergency room, 24 h, 48 h, three, five and ten days after admission to the hospital. Cardiac damage was measured by Troponin T (TnT) ECLIA, as well as NT-proBNP measurements. Entering the intensive care unit, transthoracic echocardiography was performed at two time points (day 1 and 2), by an experienced Cardiologist.ResultsDuring the pilot phase, cardiac contusion was detected in 14.3% of patients, with significantly elevated TnT levels on arrival, after 24 (**p ≤ 0.01) and 48 h (*p ≤ 0.05) compared to patients without cardiac contusion. Echocardiographic findings revealed that 25% of all patients had wall motion abnormalities, and 20% showed relaxation disorders. Right ventricular function, measured by TAPSE (tricuspid annular plane systolic excursion), RVEDD (right ventricular end diastolic diameter) and sPAP (systolic pulmonary arterial pressure), was slightly impaired in trauma patients, while the left ventricular function (ejection fraction (EF) and left ventricular end diastolic diameter (LVEDD)) was preserved. We observed the increase of TnT and an increase of the heart failure marker NT-proBNP over the time. These biomarkers were associated with pre-existing cardiac risk factors, the ISS and changes in the right or left ventricular function. Mitral valve insufficiency (grade 1) was present in 50% and tricuspid valve (grade 1) insufficiency in 30%.ConclusionsTaken together, we conducted for the first time of our knowledge, a systematic TTE analysis in PT-patients. We observed a slightly reduced right ventricular function, as well as mitral and tricuspid valve regurgitations in the patients.

Engaging with information beyond vision: hands-on approaches to computational thinking for blind and visually impaired learners

Introduction: This project develops accessible maker tools and activities to foster computational thinking (CT) skills in blind and visually impaired (BVI) learners, while investigating the experiences of two key groups: (1) BVI learners and (2) librarians and maker professionals who design and deliver accessible CT programs. Methods: The pilot phase designed and delivered an accessible electronics and coding curriculum to three BVI youth in a two-day summer camp. Data was collected through two debrief focus groups—one with BVI learners and one with the maker professionals who served as instructors. Analysis: All interviews were recorded and transcribed. The research team used a grounded theory approach to analyse the interview data. Results: Both learners and instructors highlighted the benefits of tactile and multi-sensory learning tools, though challenges emerged with the text-based coding platform. Learners self-reported increased confidence, autonomy, and interest in CT skills. Instructors adapted their approaches with detailed verbal descriptions and modifications to tools and lesson plans. Understanding the diverse needs of BVI learners and providing personalized assistance was crucial. Conclusion: Tactile and physical approaches to computational thinking show promise for previously marginalized learners, though challenges remain. Future research will explore how emerging technologies, including AI, can further enhance accessibility for BVI learners.

Standardizing ESP Pedagogy: A Critical Evaluation of Language Training for Law Enforcement Cadets

This article critically evaluates the English Language and Police Terminology textbook, developed for second-, third-, and fourth-year cadets at the Hellenic Police Officers School. Divided into three proficiency modules (B1, B2-C1, C2), the textbook delivers standardized English for Specific Purposes (ESP) materials aligned with law enforcement needs, incorporating scenario-based learning and specialized terminology for authentic contexts. The evaluation, conducted with 50 advanced-level cadets, used criteria such as adaptability to diverse policing contexts, comprehensiveness of specialized vocabulary, and the effectiveness of scenario-based learning tasks. Grammar assessments focused on tense application in police scenarios, while vocabulary retention was assessed through targeted exercises from the 'More Words You Need' sub-section. Early data showed notable improvements in grammar accuracy and vocabulary retention. Structured questionnaires indicated a positive reception, with cadets finding scenario-based tasks, such as simulating police interviews, engaging but challenging in role-playing exercises. This textbook marks the first systematic, textbook-based approach for teaching ESP to police cadets in Greece, offering a structured, progressive curriculum that hones all four language skills—reading, writing, speaking, and listening. This contrasts with previous ad hoc approaches, where materials were individually curated, leading to inconsistencies in instruction. As the pilot phase unfolds, this innovative effort has the potential to yield significant learning outcomes and serve as a model for uniformed academies domestically and abroad. Documenting the textbook’s early implementation, this article sets the stage for larger-scale studies and future adaptations for non-English speaking police academies.

European Prevention Curriculum (EUPC)-Two Years of Pilot Implementation in Austria.

The European Prevention Curriculum (EUPC) is a European initiative to promote professional and quality-assured substance use prevention. In Austria, the EUPC is trialled via a three-year pilot project to explore its appropriateness and long-term feasibility. We report on the first two years of EUPC project implementation as part of a Special Issue on EUPC implementation practice and lessons learnt. As of January 2025, four national trainers had delivered a total of four trainings (three in-person, one online), reaching over 70 professionals in Austria and six from neighbouring countries. EUPC training was offered free of charge, and a three-day format appeared to work best for the basic module. Participants recommended EUPC for continuation beyond the pilot phase, citing not only its potential to promote professionalisation, quality assurance and evidence-based work but also to facilitate exchanges of perspectives, networking and a common prevention language among different professionals. Existing prevention infrastructures were used to create a suitable system for project coordination and dissemination of EUPC. The pilot is jointly undertaken by two major stakeholders representing different contexts: the national public health institute and the national association of provincial addiction prevention units. Creating a shared vision for the project and securing necessary funding was initially challenging but was achieved through relationship-building, a shared commitment to 'quality in prevention' and a focus on the potential benefits of offering EUPC. These aspects also helped to successfully navigate the balance between a flexible approach to EUPC at the European level and the practical need for a structured approach in Austria. Our insights from a formative evaluation, routine data collection and team discussions can support further development of EUPC at the European level and in other countries.

Development and assessment of autoverification system for routine coagulation assays in inpatient and outpatient settings of tertiary care hospital: algorithm performance and impact on laboratory efficiency.

This study aimed to develop and implement autoverification (AV) system for routine coagulation assays, specifically prothrombin time (PT) and activated partial thromboplastin time (APTT), in tertiary care hospital. The efficiency, accuracy, and impact on turnaround time (TAT) were evaluated. AV rules were developed using historical data from 70,865 coagulation test results. The rules included pre-analytical, analytical, and post-analytical checks. The system underwent validation through data simulations, pilot phase, go-live implementation. Performance metrics included sensitivity, specificity, predictive values, passing rates, error rates, TAT. The AV system achieved 63.3 % overall passing rate (analyzed from 159,183 data), with outpatient settings showing higher rate (69.2 %) than inpatient settings (56.3 %). Final performance evaluation showed sensitivity, specificity, PPV, and NPV of 93.0 , 65.0, 59.7, and 94.4 %, respectively. Manual verification was required for 36 % of cases, mainly due to defective sample volumes (21.5 %). False negatives, primarily from partial clots, occurred in 0.1 % of cases. Integrating CBC clot alerts into AV rules halved the errors. The system increased tests completed within guaranteed TAT of 90 min by 2.4 %, from 89.7 to 92.1 % and reduced median TAT by 5 min. Outpatient TAT improved significantly, with a reduction over 19 min. The AV system for APTT and PT tests was successfully implemented, reducing manual verification, improving TAT, particularly in outpatient settings. This study highlights AV systems' potential to enhance laboratory performance for routine coagulation panels, which rely only on APTT and PT assays. Ongoing rule refinement and monitoring remain crucial for enhancing system accuracy and effectiveness.

The Pedagogical Potential of Affective Oral Histories: A Case Study of Student Interviewer Testimonies in the Health and Human Rights Oral History Project

ABSTRACT The Health and Human Rights Oral History Project (HHROHP) is a growing collection of video testimonies from diverse figures in the health and human rights movement, organized and overseen by the Institute of Inequalities in Global Health at the University of Southern California (USC IIGH). This article is part of an ongoing collaboration between USC IIGH and the University of the Witwatersrand, Johannesburg, to review the methodology of the pilot phase and consider its expansion as a new resource for teaching and research. In foregrounding the testimonies of the three student interviewers who had been involved in the pilot phase of the HHROHP, this article argues that cataloging student interviewers’ perceptions and reflections has embedded an additional primary source within the HHROHP archives, which can—and should—be used to engage with the subjectivity of the interviewer and the process of creating and curating archival collections. In engaging with the students’ reflections, it is clear that their personal perspectives and professional trajectories had been meaningfully affected by their involvement. The resulting sense of personal responsibility felt among the HHROHP’s student interviewers toward the promotion of health equity and justice work more broadly offers interesting implications for the employment of oral history in furthering the aims of the contemporary health and human rights movement, which this article aims to investigate.

Interventions that challenge established and accepted clinical practice: lessons learnt from a process evaluation of the STOP-APE trial.

Developing and implementing interventions that change clinical practice can be challenging and complex. Such interventions can be particularly difficult when attempting to change established behaviours and practices. While extensive literature on implementation of interventions that focus on changing clinical practice exists, understanding of the difficulties involved in implementing interventions that go against accepted clinical practice is limited. To describe the challenges involved in delivering a complex intervention that goes against established clinical practice, using a clinical trial assessing the balance of benefits and risks of withholding anticoagulation for subsegmental pulmonary embolism as an example. This study draws from a process evaluation conducted as part of a clinical trial. The evaluation utilised semistructured interviews with patients and clinicians during the trial's internal pilot phase to investigate the acceptability of withholding anticoagulant medication and participants' experiences within the trial. The data were analysed using the framework method. Eight patients with subsegmental pulmonary embolism (six females and two males) and three acute care clinicians (two males and one female) from five trial sites were interviewed. Our findings indicated that factors such as clinician equipoise, discomfort with certain patient characteristics, and effective patient communication are closely connected and significantly impact both the process of changing clinical practice and the conduct of the trial. Clinicians faced difficulties in approaching eligible patients for trial participation, especially when a diagnosis and treatment plan had already been provided by another clinician. The tension between maintaining clinical equipoise and addressing the needs of unwell patients further complicated decisions, particularly when withholding anticoagulation in those with severe symptoms or multiple comorbidities. Communication about the risks and benefits of non-medication strategies for pulmonary embolism was also challenging, with concerns about undermining patient trust. Patients, on the other hand, expressed considerable anxiety about not receiving anticoagulants, with their perspectives on study participation and treatment heavily influenced by their prior health experiences and ongoing medical conditions. The active involvement of clinicians in the consent process had a positive effect on patients' perceptions and experiences, with many feeling reassured in knowing they could contact clinical staff if needed. Small sample size of patients and clinicians across limited study sites; single method of data collection. Our results highlight the multifaceted challenges when attempting to conduct studies that challenge accepted practices and norms. These complexities are deeply intertwined, influencing both clinical decision-making and patient recruitment for those studies. Future research should focus on developing strategies to help clinicians maintain equipoise and communicate the risks and benefits of interventions, while also deepening the understanding of patients' experiences and perceptions to enhance recruitment strategies. Wales REC 6, Reference: 20/WA/0256, approved 30 September 2020. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR128073.

Neoadjuvant chemotherapy plus anlotinib in the treatment of resectable head and neck squamous cell carcinoma: A pilot phase II trial.

Neoadjuvant chemotherapy plus anlotinib in the treatment of resectable head and neck squamous cell carcinoma: A pilot phase II trial.

Benchmarking Sustainable, Low-Carbon Transport in Low- and Middle-Income Countries Through a Novel Indicator Assessment

The Transport Decarbonisation Index (TDI) is a novel indicator-based diagnostic toolkit designed to help low- and middle-income countries benchmark their surface transport systems’ readiness for sustainability and decarbonisation. The TDI employs 30 indicators, classified into eight dimensions covering sustainable, low-carbon transport. The dimensions were identified using a four-phase approach. Through pilot testing in 12 countries across Sub-Saharan Africa and South Asia, the TDI benchmarks transport performance, enabling policymakers to prioritise actions to reduce emissions and enhance transport sustainability. While the pilot countries scored relatively well based on the defined ranges and thresholds on indicators such as per capita transport greenhouse gas emissions and finance, they performed less well on public transport availability and electrification. The pilot phase revealed significant gaps for African countries in freight transport activity data and highlighted the need for improved data collection. Additionally, several metrics, including equity and informal transport, were not readily available. The TDI can be a valuable tool for benchmarking performance and informing policy decisions by offering a nuanced understanding of key transport dimensions and policy options. Although the TDI provides insights for policymaking, it is not a standalone solution and requires further analysis and stakeholder engagement for effective implementation.

District Functional Unit for Adolescents 2022: a pilot project in Italy to detect mental health strengths and difficulties among youth.

The COVID-19 pandemic significantly impacted young people's mental health, leading to increased distress and reduced life satisfaction worldwide. Among the worst-hit countries, Italy saw mental health services shift online, prioritizing urgent cases. Consequently, therapy for many individuals was interrupted, leaving young people largely neglected. In response, the Italian government allocated €8 million for youth mental health initiatives during the pandemic, and the Veneto region utilized €2 million to establish the District Functional Unit for Adolescents (UFDA) within its public Child and Adolescent Mental Health Services to provide specialized care for young people. The pilot phase was implemented between April and December 2022. This study reports preliminary findings on UFDA's effectiveness in Padua's Local Health Unit. The main objectives include describing patient characteristics and assessing the intervention outcomes. The study involved 255 youths, representing 71.43% of patients at UFDA (mean: 14.4; range: 12-24 years), and 170 parents. Self- and informant-report versions of the Strengths and Difficulties Questionnaire (SDQ) were administered. A regional questionnaire was used to describe the patient profiles, and the intervention progress record documented anamnestic data and clinical progress of patients. The study revealed positive intervention outcomes despite the limited number of psychotherapy sessions. Results of the SDQ highlighted improvements in all difficulty scales after the intervention. The UFDA pilot project underscores the potential of a preventive, youth-centered approach to address young people's mental health needs. The insights from this study can inform strategies to enhance youth mental health care in post-COVID-19 Italy.

Barriers and Facilitators to the Preadoption of a Computer-Aided Diagnosis Tool for Cervical Cancer: Qualitative Study on Health Care Providers' Perspectives in Western Cameroon.

Computer-aided detection and diagnosis (CAD) systems can enhance the objectivity of visual inspection with acetic acid (VIA), which is widely used in low- and middle-income countries (LMICs) for cervical cancer detection. VIA's reliance on subjective health care provider (HCP) interpretation introduces variability in diagnostic accuracy. CAD tools can address some limitations; nonetheless, understanding the contextual factors affecting CAD integration is essential for effective adoption and sustained use, particularly in resource-constrained settings. This study investigated the barriers and facilitators perceived by HCPs in Western Cameroon regarding sustained CAD tool use for cervical cancer detection using VIA. The aim was to guide smooth technology adoption in similar settings by identifying specific barriers and facilitators and optimizing CAD's potential benefits while minimizing obstacles. The perspectives of HCPs on adopting CAD for VIA were explored using a qualitative methodology. The study participants included 8 HCPs (6 midwives and 2 gynecologists) working in the Dschang district, Cameroon. Focus group discussions were conducted with midwives, while individual interviews were conducted with gynecologists to comprehend unique perspectives. Each interview was audio-recorded, transcribed, and independently coded by 2 researchers using the ATLAS.ti (Lumivero, LLC) software. The technology acceptance lifecycle framework guided the content analysis, focusing on the preadoption phases to examine the perceived acceptability and initial acceptance of the CAD tool in clinical workflows. The study findings were reported adhering to the COREQ (Consolidated Criteria for Reporting Qualitative Research) and SRQR (Standards for Reporting Qualitative Research) checklists. Key elements influencing the sustained use of CAD tools for VIA by HCPs were identified, primarily within the technology acceptance lifecycle's preadoption framework. Barriers included the system's ease of use, particularly challenges associated with image acquisition, concerns over confidentiality and data security, limited infrastructure and resources such as the internet and device quality, and potential workflow changes. Facilitators encompassed the perceived improved patient care, the potential for enhanced diagnostic accuracy, and the integration of CAD tools into routine clinical practices, provided that infrastructure and training were adequate. The HCPs emphasized the importance of clinical validation, usability testing, and iterative feedback mechanisms to build trust in the CAD tool's accuracy and utility. This study provides practical insights from HCPs in Western Cameroon regarding the adoption of CAD tools for VIA in clinical settings. CAD technology can aid diagnostic objectivity; however, data management, workflow adaptation, and infrastructure limitations must be addressed to avoid "pilotitis"-the failure of digital health tools to progress beyond the pilot phase. Effective implementation requires comprehensive technology management, including regulatory compliance, infrastructure support, and user-focused training. Involving end users can ensure that CAD tools are fully integrated and embraced in LMICs to aid cervical cancer screening.

Effect of Medication Management at Home via Pharmacist-Led Home Televisits: Protocol for a Cluster Randomized Controlled Trial.

Older adults are more likely to have multiple chronic conditions, be prescribed multiple medications, and be more susceptible to adverse drug reactions (ADRs) to their medications. In addition, older adults often use over-the-counter medications and supplements, further complicating their medication regimens. Complex medication regimens are potentially harmful to older adults. Interventions aimed at reducing medication discrepancy in the ambulatory clinic setting, such as reviews of medication lists and the implementation of "brown bag" reconciliation, continue to be challenging, with limited success. Pharmacist-led interventions to improve appropriate medication use in older adults have demonstrated effectiveness in reducing ADRs. Video visits have the potential to provide direct visualization of medications in older adults' homes, thereby reducing medication discrepancy and increasing medication adherence. Pharmacist-led management of older adults' medication regimens may improve appropriate medication use in older adults. The objective of this study is to examine the effect of pharmacist-led medication through home televisits compared to usual care on appropriate medication use, medication discrepancies, medication adherence, and ADRs. We will conduct a 2-site cluster randomized controlled trial (RCT). The intervention will be a pharmacist-led home televisit including medication reconciliation and assessment of actual medication use. The cluster RCT was iteratively adapted after a pilot test. The primary outcome of medication appropriateness of the intervention will be measured using the STOPP (Screening Tool of Older Persons' Prescriptions) criteria for potentially inappropriate medications (PIMs) at 6 months. Medication lists obtained will be compared against electronic medical records (EMRs) by a clinician to establish discrepancies in medications. The clinician will review medications using the validated Medication Appropriateness Index (MAI). This project has been peer-reviewed and selected for support by the Veterans Affairs (VA) Health Services Research Service. The pilot phase of the study was completed December 2021 with 20 veterans and was primarily informed by the Steinman model of the prescribing process adapted to include system- and provider-level factors. The last date of enrollment was August 6, 2021. We anticipate the completion of the ongoing trial in spring 2025. The first results are expected to be submitted for publication in 2025. The cluster RCT will provide evidence on medication management through televisits. If found effective in improving the use of medications, the intervention has the potential to impact older adults with multiple chronic conditions and polypharmacy. ClinicalTrials.gov NCT04340570; https://clinicaltrials.gov/study/NCT04340570. PRR1-10.2196/65141.

The implementation of genome sequencing in rare genetic diseases diagnosis: a pilot study from the Hong Kong genome project.

The implementation of genome sequencing in rare genetic diseases diagnosis: a pilot study from the Hong Kong genome project.

Pathway Of Low Anterior Resection syndrome (LARS) relief after Surgery (POLARiS): protocol for an international, open-label, multi-arm, phase 3 randomised superiority trial within a cohort, with economic evaluation, process evaluation and qualitative sub-study, to explore the natural history of LARS and compare transanal irrigation and sacral neuromodulation to optimised conservative management for people with major LARS following a high or

IntroductionAs a result of improving survival rates, the adverse consequences of rectal cancer surgery are becoming increasingly recognised. Low anterior resection syndrome (LARS) is one such consequence and describes a...

Abstract TMP118: Validation and Reliability of the SPAN Score for Assessing Neurological Function in Mouse Stroke Models following MCAO

Introduction: Neuroanatomy-based functional examinations are crucial for understanding the extent and effects of infarcts in stroke studies. Despite the importance of correlating neurological function with brain anatomy, a comprehensive neurological score that correlates with infarction volume and location following middle cerebral artery occlusion (MCAO) in mice is lacking. During the pilot phase of the Stroke Preclinical Assessment Network (SPAN), a new scoring system—SPAN score—was developed. This study aims to evaluate the reliability and validity of the SPAN score, a 9-item tool rated on a 0-3 Likert scale. Methods: The SPAN 2.0 pilot database was utilized for analysis. Reliability was assessed using Cronbach's alpha (α) and intraclass correlation coefficient (ICC) for individual items and the total score. Multivariate regression was performed for item selection and to determine the weight of each item. Concurrent validity was examined by correlating post-operative day 2 infarction volume, as measured by MRI, with the SPAN score. Results: The total SPAN score demonstrated acceptable reliability, with Cronbach's α and ICC both at 0.751. Item-total correlation coefficients of each item ranged from 0.092 to 0.638. The Pearson correlation coefficient between the total SPAN score and infarction volume was 0.539. Notably, spontaneous activity showed a reversed relationship with other items; excluding this item increased Cronbach's α to 0.766. Conclusion: The SPAN score proves to be a reliable and valid tool for neuroanatomy-based functional assessment in mouse stroke models following MCAO. Ongoing analysis will focus on refining the score by reducing the number of items, adjusting the Likert scale, incorporating lesion area, and further exploring item relationships.

P-1327. Enhancing Sexual Health Access for Hispanic and Latino Men in the Southern U.S through a Bilingual Peer-Navigation Campaign

Abstract Background Hispanic and Latino Gay and Bisexual Men (HLGBM) are disproportionately impacted by HIV and face structural barriers in accessing sexual health services. To address these barriers, we developed an online sexual health outreach campaign linked to bilingual peer-navigation services in metro Atlanta.Figure 1illustrates examples from our sexual health campaign, featuring our trained bilingual navigator. The campaign emphasized the availability of free or low-cost sexual health services, aiming to increase awareness and accessibility among the community. Methods In partnership with local organizations, health departments, and Latino-focused advertising agencies, we developed an online outreach campaign in Spanish to increase awareness of sexual health services among HLGBM. This campaign also connected individuals with a trained bilingual Latino peer navigator for service access (Figure 1). The campaign was piloted from May 22 to August 21, 2023 (Pilot Phase), it was later adopted by a local health department starting September 1, 2023. We systematically recorded data including the number of individuals contacting the peer navigator, city locations, weekly contacts, referral types, and self-reported outcomes until February 29, 2024 (Post-implementation Phase).Figure 2lists the cities of individuals who have contacted the navigator. Cities with two or fewer individuals are grouped under "Other." "Out of State" includes contacts primarily from Tennessee, Alabama, North Carolina, and South Carolina. In the figure, red circles represent the locations from which contacts were made. The size of each circle is proportional to the number of contacts originating from that area. Results A total of 259 individuals responded to the campaign by contacting the navigator – 70 during the pilot phase and 189 during the post-implementation phase. The campaign reached individuals from several locations with high Hispanic/Latino populations in the Atlanta area (Figure 2). HIV/STI testing and HIV Pre-Exposure Prophylaxis (PrEP) were the most requested services. Participants initially requesting testing HIV/STI only were also provided with PrEP education and referrals. Importantly, a total of 28 participants requested linkage or re-engagement to HIV care (Table 1). During the pilot, 57% of all enrolled participants were successfully linked to services, while 85% did so post-implementation, reaching a higher linkage proportion (Table 1). On average 6 (range 1-19) individuals contacted the navigator per week (Figure 3).Table 1categorizes the types of services requested by individuals through the navigator. Services are grouped by demand frequency. Referral outcomes as reported by the client or the referral agency. “Completed” refers to cases where the patient received the intended service or referral. “Lost to Follow Up” indicates cases where the patient did not continue communication with the navigator, and “Pending” refers to ongoing referrals that have not yet concluded. *Only 50/70 patients in the pilot phase were followed for completion of services. Conclusion Our campaign and navigation program successfully reached HLGBM and linked them to local sexual health services. The pilot’s success led to the adoption of the campaign and navigation system by a local health department, with early data suggesting continued community engagement and service linkage, affirming the impact of culturally tailored public health interventions.Figure 3Displays the weekly contacts to the navigator during the pilot and post implementation phase. The arrow indicates when the navigator program was adopted by the Fulton County Board of Health. Data reflects sustained levels of interaction between individuals and the navigator throughout both phases, indicating robust engagement over time. Disclosures All Authors: No reported disclosures

Microbiota, parasitic infections and their relationship with nutritional status and neurocognitive functioning in children from Ecuador-Proyecto Guagua: research protocol for a cross-sectional study.

This protocol outlines the Proyecto Guagua, which aims to explore the relationship between the characteristics of the gut microbiota, parasitic infections, nutritional status, and neurocognitive functioning in school-age children in Ecuador. Proyecto Guagua is a cross-sectional observational study funded by the Escuela Superior Politécnica de Chimborazo. It is being carried out in several counties across different geographical regions in Ecuador, including Galápagos. The study targets children regularly attending school, aged 6-12. We aim to recruit 450 children, with data already collected from nearly 300 participants (67%). Enrolled children undergo comprehensive evaluations assessing nutritional status, body composition, motor learning, social skills, cognitive ability, sleep habits, and physical activity. Caretakers and school teachers are interviewed regarding hygiene, eating habits, and food handling. Stool samples are collected to analyze the gut microbiota and determine the presence of parasites. In the analysis phase, we aim to describe differences in microbiota population structure and diversity among undernourished and obese/overweight children, and children with parasitosis compared to their peers. We also plan to test the hypothesis that an altered microbiota mediates the influence of malnutrition on neurocognitive functioning and parasitosis. Proyecto Guagua received ethical approval from the Ethics Committee of Universidad de Cuenca in July 2022. Following the pilot phase, an addendum and minor changes to the study design were approved in October 2022. Written consent was obtained from parents before enrolling their children in the study. Parents and children were informed of their right to withdraw from the study at any time. The findings of "Proyecto Guagua" will be disseminated through open-access, peer-reviewed publications and presented at local and international scientific events.

584. Implementation and Evaluation of an Interactive Infectious Diseases Online Curriculum for Trainees on ID electives

Abstract Background Infectious Diseases Online Curriculum (IDOC) is an online asynchronous interactive educational resource for trainees on ID electives to augment their ID knowledge and complement their clinical training. The curriculum mapping with details of modules and methods of assessment are elaborated in TABLE 1. A program evaluation of the IDOC with the aim to analyze program outcomes was done in 2023.Table 1:Curriculum mapping including goals, objectives, conceptual framework, educational strategies and assessments for Infectious Diseases Online Curriculum Methods IDOC was piloted with medical students and residents from August 2022 to December 2022 and assesses Kirkpatrick level 2 learning. The primary assessment was of Program Outcome, set up using a Pragmatism paradigm with Mixed Methods research methodology to assess quantitative and qualitative data. Following IRB approval, data collection was conducted through web-based surveys (Qualtrics). Each surveyor was asked to assign a unique alphanumeric number to their pre and post survey so these could be used for comparison. The primary outcome assessed was change in knowledge. Each question in the pre- and post-assessment was awarded 1 for correct answer and 0 for incorrect answer. A paired sample t test was used to compare pre and post cumulative scores and analyzed using SPSS v26.Table 2:Paired sample T test analysis of quantitative outcomes Results During the pilot phase 16 pre- and 20 post assessment surveys were received (8 phase-3 students, 4 phase-2, 3 phase-1, 3 interns, 2 with no level of training). 11 respondents had allotted the same alphanumeric number to both pre- and post-surveys and these were used for comparative analyses of knowledge change. Interest in pursuing ID as a career prior to and after revision of modules was sought on a 5-point Likert scale and received 12 responses. Paired t test showed significant improvement in knowledge and increase in interest of trainees to pursue ID as a career (TABLE 2). Majority of trainees also rated the modules to be extremely clear and relevant to clinical practice (TABLE 3). Qualitative feedback was overwhelmingly positive (TABLE 4).Table 3:Results of self-perceived clarity and self perceived relevance of the modules by the trainees Conclusion IDOC functions as a novel, accessible, quick, engaging, and effective way to improve ID related knowledge in trainees and is an adjunct to their clinical elective experience. Although this was a small study, the results are significant and transferable, and IDOC can be disseminated to smaller training programs where educators and ID learning resources are not available.Table 4:Qualitative feedback for Infectious Diseases Online Curriculum as well as individual interview response from trainee Disclosures All Authors: No reported disclosures

Formative Research for Adapting the Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7) Water Treatment and Hygiene Mobile Health Program for Scalable Delivery in Rural Bangladesh.

The Cholera-Hospital-based-Intervention-for-7-Days (CHoBI7) mobile health (mHealth) program is a targeted water treatment and hygiene (WASH) program for the household members of diarrhea patients, initiated in the healthcare facility with a single in-person visit and reinforced through weekly voice and text messages for 3 months. A recent randomized controlled trial of the CHoBI7 mHealth program in urban Dhaka, Bangladesh, found that this intervention significantly increased WASH behaviors and reduced diarrhea prevalence. The objective of this present study was to conduct formative research using an implementation science framework to adapt the CHoBI7 mHealth program for scalable implementation in rural Bangladesh, and to promote construction of self-made handwashing stations (CHoBI7 Scale-up program). We conducted a 3-month multi-phase pilot with 275 recipients and 25 semi-structured interviews, 10 intervention planning workshops, and 2 focus group discussions with intervention recipients and program implementers. High appropriateness, acceptability, and adoption of the CHoBI7 Scale-up program was observed, with most recipients constructing self-made handwashing stations (90%) and chlorinating drinking water (63%) and 50% of participants observed handwashing with soap in the final pilot phase. At the recipient level, facilitators included weekly voice and text messages with videos on handwashing station construction, which served as reminders for the promoted water treatment and hand hygiene behaviors. Barriers included perceptions that self-made iron filters commonly used in households also removed microbial contamination from water and therefore chlorine treatment was not needed, and mobile messages not always being shared among household members. At the implementer level, facilitators for program implementation included follow-up phone calls to household members not present at the healthcare facility at the time of intervention delivery, and the promotion of multiple self-made handwashing station designs. Barriers included high patient volume in healthcare facilities, as well as the high iron in groundwater in the area that reduced chlorination effectiveness. These findings provide valuable evidence for adapting the CHoBI7 mHealth program for a rural setting, with a lower-cost, scalable design, and demonstrated the important role of formative research for tailoring WASH programs to new contexts.