Community Prevention Efforts Research Articles

Share of Adult Suicides After Recent Jail Release

Although people released from jail have an elevated suicide risk, the potentially large proportion of this population in all adult suicides is unknown. To estimate what percentage of adults who died by suicide within 1 year or 2 years after jail release could be reached if the jail release triggered community suicide risk screening and prevention efforts. This cohort modeling study used estimates from meta-analyses and jail census counts instead of unit record data. The cohort included all adults who were released from US jails in 2019. Data analysis and calculations were performed between June 2021 and February 2024. The outcomes were percentage of total adult suicides within years 1 and 2 after jail release and associated crude mortality rates (CMRs), standardized mortality ratios (SMRs), and relative risks (RRs) of suicide in incarcerated vs not recently incarcerated adults. Taylor expansion formulas were used to calculate the variances of CMRs, SMRs, and other ratios. Random-effects restricted maximum likelihood meta-analyses were used to estimate suicide SMRs in postrelease years 1 and 2 from 10 jurisdictions. Alternate estimate was computed using the ratio of suicides after release to suicides while incarcerated. Included in the analysis were 2019 estimates for 7 091 897 adults (2.8% of US adult population; 76.7% males and 23.3% females) who were released from incarceration at least once, typically after brief pretrial stays. The RR of suicide was 8.95 (95% CI, 7.21-10.69) within 1 year after jail release and 6.98 (95% CI, 4.21-9.76) across 2 years after release. A total of 27.2% (95% CI, 18.0%-41.7%) of all adult suicide deaths occurred in formerly incarcerated individuals within 2 years of jail release, and 19.9% (95% CI, 16.2%-24.1%) of all adult suicides occurred within 1 year of release (males: 23.3% [95% CI, 20.8%-25.6%]; females: 24.0% [95% CI, 19.7%-36.8%]). The alternate method yielded slightly larger estimates. Another 0.8% of adult suicide deaths occurred during jail stays. This cohort modeling study found that adults who were released from incarceration at least once make up a large, concentrated population at greatly elevated risk for death by suicide; therefore, suicide prevention efforts focused on return to the community after jail release could reach many adults within 1 to 2 years of jail release, when suicide is likely to occur. Health systems could develop infrastructure to identify these high-risk adults and provide community-based suicide screening and prevention.

Examining the impact of legalization on the prevalence of driving after using cannabis: A comparison of rural and non-rural parts of Canada

Objective The purpose of this study was to examine the likelihood of driving after using cannabis, and of being a passenger with someone who is driving after using cannabis, in rural areas and non-rural areas before and after legalization. Methods A multi-wave analysis of Canada’s National Cannabis Survey was conducted using logistic regression with interactions to predict the prevalence of driving after using cannabis, and of being a passenger with someone who is driving after using cannabis, in relation to place of residence (rural or non-rural) and in the weeks and months before and after legalization. Three time points were compared: pre-legalization, two months following legalization and 1 year after legalization. Results At the national level, there are no significant differences between the predicted estimates of driving after using cannabis for those who live in rural and non-rural areas. However, when examining the impact of legalization, we found a significant increase in driving after using cannabis among rural residents directly following legalization. Furthermore, it was observed that this increase in driving after using cannabis returns to pre-legalization rates one year after legalization. By contrast, in the weeks and months following legalization, driving after using cannabis decreased among those living in non-rural areas, and slowly increased soon thereafter. No significant differences were observed, in either time period or group, in the prevalence of being a passenger with someone who is driving after using cannabis. Conclusions The finding of significantly higher risk of driving after use of cannabis soon after legalization in rural areas suggests a need for more attention to address immediate concerns for public safety. The increased potential for traffic injuries and deaths in other jurisdictions contemplating legalization supports the call for more and better targeted prevention efforts in rural communities that have far too often been overlooked and under-served.

High-risk HPV prevalence and vaccination coverage among Indigenous women in the Colombian Amazon: Implications for cervical cancer prevention. Cross-sectional study.

Cervical cancer, primarily caused by Human Papillomavirus (HPV) transmission through sexual contact, necessitates comprehensive strategies to combat its impact on women's health. Yet, certain underserved populations, such as low socioeconomic and ethnic minority groups, encounter barriers in accessing timely interventions and early diagnosis. This cross-sectional study was conducted with the aim of assessing HPV prevalence, genotype distribution, and co-infections among 280 adult women residing in a Colombian Indigenous Reserve within the Amazon region. The research adhered to a community-centric approach that respected cultural norms, native languages, and Indigenous authorities' permission. The study revealed an overall HPV infection prevalence of 31.1% (n = 87, 95% CI 25.7-36.8), with 22.5% (n = 63, 95% CI 17.7-27.8) of women infected by at least one high-risk HPV genotype and 15.0% (n = 42, 95% CI 11-19.7) infected by at least one LR genotype. These results align with the findings of other Colombian studies. Notable high-frequency genotypes included 16, 52, 66, 56, and 68, with the most common combinations being [66-52] and [66-58]. The study also assessed the prevalence of HPV vaccination, revealing a rate of 22.9%, lower than the national average. In vaccinated women, the prevalence of genotypes 16 and 18 was significantly reduced, as anticipated. Importantly, it was observed that 57.1% of all high-risk HPV infections could have been prevented with the use of the nonavalent vaccine. These findings underscore the critical need to enhance adherence to early cervical cancer detection and monitor positive cases to evaluate high-risk HPV persistence. Efforts should be directed toward continuing vaccination coverage against high-risk HPV 16 and 18 with the quadrivalent vaccine, while also striving to make the nonavalent vaccine accessible for inclusion in large-scale public health programs. Additionally, the study did not identify a specific pattern of co-infection. The study emphasizes the significance of adopting a locally tailored epidemiological approach to guide and promote cervical cancer prevention efforts in Indigenous communities.

PREVENTIVE MODEL FOR CHRONIC KIDNEY DISEASE IN COASTAL AREA ABELI HEALTH CENTRE IN KENDARI CITY

Background: Chronic kidney failure is an iceberg phenomenon whose cases are not known with certainty in the coastal community in the Abeli Health Center area, Kendari City. However, the visible risk factors are the high prevalence of hypertension and diabetes. Therefore, the development of a prevention strategy is urgently needed and this study aims to formulate a prevention model for chronic kidney failure in the coastal area of Kendari City. Methods: This study used a qualitative method with a case study design in 3 sub-districts in the coastal area of the Abeli Health Center, Kendari City. The study was conducted in May – June 2023. There were 15 informants who were interviewed in depth and most of them were women. The results of the interviews were transcribed verbatim and analyzed using theme analysis techniques. Visualization analysis and project map are used to formulate a community prevention model for chronic kidney disease. Results: The model of prevention efforts carried out by the community in the coastal area of the Abeli Health Center for the incidence of chronic kidney disease includes primary and secondary prevention. Primary prevention efforts include controlling food, checking health regularly, getting enough and regular rest, and doing enough physical activity. While the secondary prevention efforts are adequate and regular rest, stopping smoking, walking in the morning, doing activities at home. Conclusion: The results of this study are important to be followed up by the person in charge of the Abeli Health Center and the Southeast Sulawesi Provincial Health Office and the City of Kendari by developing policies that support strengthening community prevention efforts against chronic kidney disease in the Kendari City area.

A survey of North American drug checking services operating in 2022

BackgroundDrug overdose deaths have reached record-breaking levels in North America. Drug checking services (DCS) provide localized information on the contents of drugs to individuals and communities. Depending on the design, individuals can submit drug samples for onsite “real-time” testing or offsite testing. The results can shed light on emerging drugs in the community and support ongoing prevention and surveillance efforts. We sought to describe and report aggregate outcomes of DCS operating in North America. MethodsThe North American Drug Checking Survey was launched in 2022 to characterize and monitor DCS operating in the region. Sixteen organizations from the US (n = 9), Canada (n = 5), and Mexico (n = 2) responded to the survey. Each organization reported on their program's operations and provided service delivery outcomes (site- or program-level) in the aggregate. ResultsParticipating organizations reported testing a total of 49,786 drug samples between 2014 and 2022. DCS were run by community-led organizations (44%), health departments (25%), universities (19%), or clinical/private laboratories (19%). The types of samples tested differed between programs (e.g., solids vs. liquids, drug paraphernalia accepted). While most organizations tested onsite using fentanyl test strips (88%) and Fourier-transform infrared (FTIR) spectroscopy (63%), many sent samples offsite for confirmatory testing (63%), most often with mass spectrometry. Common facilitators of operating a DCS included: interest of clients (69%), interest of service providers (63%), and receiving external technical assistance (63%). Barriers included: the lack of funding (81%) or staff (50%), gaps in technical expertise (38%), as well as laws banning the possession and/or distribution of illicit drug samples, drug paraphernalia, or drug checking equipment (38%). ConclusionDCS are scaling up in North America. Given the evolving and localized nature of illicit drug supplies, supporting the establishment and operations of DCS could enhance the public's understanding of local drug supplies to reduce drug-related harms over time.

Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage

BackgroundIn the context of the current U.S. injection drug use epidemic, targeted public health harm reduction strategies have traditionally focused on overdose prevention and reducing transmission of blood-borne viral infections. Severe bacterial infections (SBI) associated with intravenous drug use have been increasing in frequency in the U.S. over the last decade. This qualitative study aims to identify the risk factors associated with SBI in hospitalized individuals with recent injection drug use.MethodsQualitative analysis (n = 15) was performed using an in-depth, semi-structured interview of participants admitted to Bellevue Hospital, NYC, with SBI and recent history of injection drug use. Participants were identified through a referral from either the Infectious Diseases or Addition Medicine consultative services. Interviews were transcribed, descriptively coded, and analyzed for key themes.ResultsParticipants reported a basic understanding of prevention of blood-borne viral transmission but limited understanding of SBI risk. Participants described engagement in high risk injection behaviors prior to hospitalization with SBI. These practices included polysubstance use, repetitive tissue damage, nonsterile drug diluting water and multipurpose use of water container, lack of hand and skin hygiene, re-use of injection equipment, network sharing, and structural factors leading to an unstable drug injection environment. Qualitative analysis led to the proposal of an Ecosocial understanding of SBI risk, detailing the multi-level interplay between individuals and their social and physical environments in producing risk for negative health outcomes.ConclusionsStructural factors and injection drug use networks directly impact drug use, injection drug use practices, and harm reduction knowledge, ultimately resulting in tissue damage and inoculation of bacteria into the host and subsequent development of SBI. Effective healthcare and community prevention efforts targeted toward reducing risk of bacterial infections could prevent long-term hospitalizations, decrease health care expenditures, and reduce morbidity and mortality.

Knowledge and Practices of The Gandu Village, Sleman Community Againts Covid-19

Background: The Covid-19 pandemic caused by infection with the CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) virus has become an event that threatens public health throughout the world. The disease caused by the corona virus is a new type of disease that was discovered in 2019 and has never been identified to infect humans before. Methods: quantitative research with a cross sectional design. The sample in this study was 180 respondents selected by purposive sampling technique. Knowledge and behavior data from respondents were collected through online and offline questionnaires distributed from August to October 2021. Data analysis used bivariate analysis. Results : the results showed that the majority of people showed good levels of knowledge about the pandemic Covid-19 (87,7%) and good practices (77,2%). Statistic results have shown p=0,000 meaning that there is a relationship between knowledge and prevention practices. Conclusions: Knowledge can influence the behavior of Indonesian people. Providing valid and well-targeted knowledge has an impact on improving behavior in community prevention efforts against Covid-19 infection.

Childhood Victimization and Adult Incarceration: A Review of the Literature

A growing body of work estimates the prevalence of childhood victimization among incarcerated people. The present study seeks to descriptively and quantitatively summarize this abundant literature by reviewing studies that report childhood victimization prevalence among people incarcerated in the United States. The review includes any study of childhood victimization that uses a sample of incarcerated adults (age eighteen or older) and that reports the proportion of the sample that experienced child abuse and/or neglect. Sixty-seven studies met these criteria and were analyzed, encompassing 1,187,044 incarcerated individuals. The studies vary in sample characteristics, methodological features, and employ an exceedingly wide range of victimization measures. Meta-analyses for pooled prevalence rates revealed that the inter-study heterogeneity was too great to draw conclusive summary estimates of childhood victimization from this literature, even when disaggregating by victimization type. Exploratory t-tests and correlation analyses suggest that a study’s sample size, racial, ethnic, and gender composition, and variation in victimization measurement can influence reported child abuse and neglect, but more research is needed to fully assess how study characteristics influence reported victimization prevalence. Understanding the extensiveness of childhood victimization histories among incarcerated people emphasizes the need for robust screening and treatment for people within correctional facilities, as well as improved community prevention and intervention efforts.

Common Mental Disorders and Economic Uncertainty: Evidence from the COVID-19 Pandemicin the U.S.

Mental health disorders represent an enormous cost to society, are related to economic outcomes, and have increased markedly since the COVID-19 outbreak. Economic activity contracted dramatically on a global scale in 2020, representing the worst crisis since the Great Depression. This study used the COVID Impact Survey to provide insights on the interactions of mental illness and economic uncertainty during COVID-19. We used a probability-based panel survey, COVID Impact Survey, conducted in the U.S. over three waves in the period April-June 2020. The survey covered individual information on employment, economic and financial uncertainty, mental and physical health, as well as other demographic information. The prevalence of moderate mental distress was measured using a Psychological Distress Scale, a 5-item scale that is scored on a 4-point scale (total range: 0–15). The mental distress effect of employment, economic, and financial uncertainty, was assessed in a logit regression analysis conditioning for demographic and health information. It is found that employment, health coverage, social security, and food provision uncertainty are additional stressors for mental health. These economic factors work in addition to demographic effects, where groups who display increased risk for psychological distress include: women, Hispanics, and those in poor physical health. A decrease in employment and increases in economic uncertainty are associated with a doubling of common mental disorders. The population-representative survey evidence presented strongly suggests that economic policies which support employment (e.g., job keeping, job search support, stimulus spending) provide not only economic security but also constitute a major health intervention. Moving forward, the economic uncertainty effect ought to be reflected in community level intervention and prevention efforts, which should include strengthening economic support to reduce financial and economic strain.

Optimizing health leadership in early prevention efforts in village communities

This study aims to optimize health leadership in preventing Covid-19 from an early age in the village. The author believes that health status is determined by treatment; prevention can be more effective and efficient. We collect public health literature from many databases of public health publications. We start from the journal Esavier, Medpub, Google Book, and several websites that discuss public health issues at home and abroad. We are targeting based data published in the last ten years to find the latest data and validity. The research involves a data coding system, high evaluation, and conclusion drawing in order to be able to answer research questions with high reliability. We conclude that health leadership is characteristic of how medical roles lead people to health. Value health and maintain it until community members find physical and mental health. The medical team minimizes stress by communicating openly and creating a healthy and safe environment for its citizens' creative thinking and expression. These results are helpful for the development of literature and public health applications.

Adolescent Experiences of Violence Victimizations Among Minors Who Exchange Sex/Experience Minor Sex Trafficking.

This work investigates the associations between experiences of domestic minor sex trafficking and adolescent interpersonal violence victimizations, including intimate partner violence (IPV) and community violence. Abuse and violence in childhood are commonly proposed as risk factors for domestic minor sex trafficking. However, less is known about how interpersonal violence victimizations in adolescence connect to domestic minor sex trafficking experiences. The poly-victimization framework provides a means to understand domestic minor sex trafficking as a type of violence amid a web of additional interconnected violence victimizations. Efforts to better understand the interpersonal violence experienced by survivors of domestic minor sex trafficking are valuable in contextualizing trafficking experiences for adolescents. Data from The National Longitudinal Study of Adolescent to Adult Health, a population-based sample of adolescents in the United States (n = 12,605) were used to examine experiences of domestic minor sex trafficking for minor respondents, as measured through questions about exchanging sex for money or drugs. A multivariable logistic regression model was used to estimate the associations between domestic minor sex trafficking and IPV or community violence, while controlling for demographic variables and adolescent risk behaviors. Minors who experience community violence had significantly greater odds of having exchanged sex (aOR: 1.86; 95% CI: 1.32 -2.64). However, IPV was not significantly associated with minors’ experiences of sex exchange (aOR: 1.14; 95% CI: 0.85 -1.54). Alcohol or drug use (aOR: 1.87; 95% CI: 1.32 -2.65) and having run away (aOR: 2.04; 95% CI: 1.53 -2.72) were also significantly associated with minor sex exchange. As experiences of domestic minor sex trafficking were significantly associated with community violence victimizations, prevention and intervention efforts targeting youth at high risk for or survivors of domestic minor sex trafficking should consider how community violence victimizations impact these adolescent populations, and programming/messaging should be adjusted to account for these additional violence victimizations.

Cigarette Use and Cannabis Use Disorder Onset, Persistence, and Relapse: Longitudinal Data From a Representative Sample of US Adults.

Objective: The current study prospectively investigated the relationship between cigarette use and the onset of, persistence of, and relapse to cannabis use disorder (CUD) 3 years later among adults in the United States.Methods: Analyses included respondents who completed Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002 and 2004-2005, respectively) and responded to questions about cigarette use, cannabis use, and CUD (n = 34,653). CUDs were defined by DSM-IV criteria using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic Version IV. Multivariable logistic regression models were used to calculate the odds of CUD onset, persistence, and relapse at Wave 2 by Wave 1 cigarette use status. Analyses were adjusted for sociodemographics, psychiatric disorders, nicotine dependence, and alcohol and other substance use disorders.Results: Cigarette use at Wave 1 was associated with onset of CUD at Wave 2 among those without Wave 1 cannabis use (adjusted odds ratio [AOR] = 1.62; 95% CI, 1.35-1.94) but not among those with Wave 1 cannabis use (AOR = 1.00; 95% CI, 0.83-1.19). Cigarette use at Wave 1 was also associated with persistence of CUD at Wave 2 among those with CUD at Wave 1 (AOR = 1.63; 95% CI, 1.30-2.00) and relapse to CUD at Wave 2 among those with remitted CUD at Wave 1 (AOR = 1.23; 95% CI, 1.09-1.45).Conclusions: Among adults, cigarette use is associated with increased onset and persistence of and relapse to CUD 3 years later. Additional attention to cigarette use in community prevention and clinical treatment efforts aimed at reducing CUD may be warranted.

Molecular Epidemiological Analysis of the Origin and Transmission Dynamics of the HIV-1 CRF01_AE Sub-Epidemic in Bulgaria.

HIV-1 subtype CRF01_AE is the second most predominant strain in Bulgaria, yet little is known about the molecular epidemiology of its origin and transmissibility. We used a phylodynamics approach to better understand this sub-epidemic by analyzing 270 HIV-1 polymerase (pol) sequences collected from persons diagnosed with HIV/AIDS between 1995 and 2019. Using network analyses at a 1.5% genetic distance threshold (d), we found a large 154-member outbreak cluster composed mostly of persons who inject drugs (PWID) that were predominantly men. At d = 0.5%, which was used to identify more recent transmission, the large cluster dissociated into three clusters of 18, 12, and 7 members, respectively, five dyads, and 107 singletons. Phylogenetic analysis of the Bulgarian sequences with publicly available global sequences showed that CRF01_AE likely originated from multiple Asian countries, with Vietnam as the likely source of the outbreak cluster between 1988 and 1990. Our findings indicate that CRF01_AE was introduced into Bulgaria multiple times since 1988, and infections then rapidly spread among PWID locally with bridging to other risk groups and countries. CRF01_AE continues to spread in Bulgaria as evidenced by the more recent large clusters identified at d = 0.5%, highlighting the importance of public health prevention efforts in the PWID communities.

Abstract PO-023: The Virginia Living Well Research and Registry: A community registry to assess cancer screening and lifestyle behaviors among rural Virginia residents

Abstract Background: Rural counties in Virginia have significantly higher overall cancer mortality compared to the state. Virginia is one of a few states that has both breast and colorectal cancer hotspots, driven primarily by mortality rates among African Americans. The Virginia Living Well Research and Registry (VALW), a community registry, was developed in collaboration with community partners to collect critical patient reported outcomes, including cancer protective and risk behaviors that can be tracked longitudinally. We assessed participation in cancer screening and five cancer protective behaviors, with comparison by geographical residence and race. Method: In-person and electronic recruitment by community-based staff enrolled adults (18+ years) living in Virginia, focusing on predominantly rural counties. Surveys were completed in-person, by phone or online. Questions included cancer screening (breast, cervical, colorectal), five cancer protective behaviors (physical activity, sleep, alcohol, BMI, smoking status) and demographics. Rural residence was defined using RUCC codes and calculated from mailing addresses. Results: To date, 586 participants are enrolled; 74% are rural (RUCC 4-9), 47% are Black/African American and 70% identify as female. Rural residents reported significantly lower household income (Χ2=25[1]:p< .000), greater use of Medicare (Χ2=4.5[1]:p=.034) and lower (pre-COVID) unemployment (Χ2=7.1[1]:p=.008) compared to urban participants. White participants reported significantly more alcohol use (Χ2=5.6[1]:p=.003), greater sleep disturbance (Χ2=5.6[1]:p=.018) and lower BMI(Χ2=33.4[1]:p<.000) compared to Black participants. Screening rates among those eligible were 82% biennial mammography, 72.3% pap (every 3yr.), 11% annual FIT tests and 77% colonoscopy. 18% reported current tobacco use. No differences in cancer screening, smoking or physical activity were identified by race or rural residence. Only 26% engaged in 4/5 or 5/5 of the assessed cancer protective behaviors. Conclusion: In this geographically and racially diverse sample, engagement in cancer screening was high with no identified racial or geographical disparities, reflecting in part, our long-term community engagement and strong community partnerships. Overall engagement in multiple cancer protective behaviors was low, while tobacco use was higher than the national rate. In addition to screening promotion, cancer prevention efforts in rural communities could leverage successful approaches used to promote screening to also address modifiable lifestyle factors. Finally, the geographical and racial diversity of this sample is strength. Citation Format: Maria D. Thomson, A. Williams, M.A. Preston, A.L. Sutton, V.B. Sheppard. The Virginia Living Well Research and Registry: A community registry to assess cancer screening and lifestyle behaviors among rural Virginia residents [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-023.

A Systems Thinking Methodology for Studying Prevention Efforts in Communities

The turn to complexity in public health over the past 20 years has come as practitioners, policy makers and scholars lament the lack of progress in addressing wicked problems such as obesity, chronic disease and the social determinants of health Systems science may be well suited to tackle such wicked problems While there is a growing application of systems thinking tools and resources in public health, there are fewer examples that incorporate both systems tools and systemic inquiry processes Prevention Tracker offered an opportunity to trial the combination of systems tools and systems thinking at the level of community chronic disease prevention efforts Our methodology comprised four Domains of Inquiry 1 Describing a prevention system 2 Guiding system change efforts 3 Monitoring change 4 Cross case comparison We applied systems tools and methods to investigate each domain of inquiry such as group model building, social network analysis, graphic illustration, causal loop diagrams and system action learning These methods were connected through the application of systemic inquiry processes that elevated the ongoing interrogation of boundary judgments, awareness of diverse and multiple perspectives, interrelationships and the importance of social learning Prevention Tracker demonstrated that it is possible to apply a range of systems methods while also keeping focus on the overall systems science and the need for theoretical consistency The four domains of inquiry enabled flexibility to adapt our approach in each context to learn and improve This methodological capacity to learn and adapt may also be useful in tackling other health and social problems, such as the COVID19 pandemic The overall findings from the study will be presented in separate publications © 2020, Springer Science+Business Media, LLC, part of Springer Nature

Sosialisasi bahaya dan upaya pencegahan infeksi corona virus disease (COVID-19) di Kelurahan Koja, Jakarta Utara

Corona virus Disease (COVID-19) began with a report on December 31, 2019, in Wuhan City of China about pneumonia cluster cases that have not yet been identified. The number of COVID-19 cases has increased and has spread to almost all. The World Health Organization (WHO) has stated that COVID-19 is an international health problem and established as a pandemic. COVID-19 case in Indonesia was first reported on March 2, 2020, and spread in 34 provinces in Indonesia. Treatment and vaccination for the prevention of COVID-19 are still in the process of research. So far preventive measures such as maintaining distance, wearing masks, improving the immune system, and hand hygiene are expected to break the chain of transmission of COVID-19. The COVID-19 socialization aims to provide adequate information to the public about the dangers and efforts to prevent COVID-19 that can be carried out by individuals and the community. The socialization was held in Koja Village, North Jakarta on March 8, 2020. The activity was carried out by the Regional Management of Keluarga Alumni Universitas Gadjah Mada (KAGAMA) DKI Jakarta in collaboration with the Health Sub-Department and the Koja District Government, North Jakarta. The main part of the activity is the delivery of COVID-19 material followed by interactive discussions between participants and resource persons. Individual and community prevention efforts are very important in reducing the number of cases and breaking the chain of transmission so that cases do not increase.

Substance Use Prevention Programming for Adolescents and Young Adults: A Mixed-Method Examination of Substance Use Perceptions and Use of Prevention Services

Background Although substance use problems are highly prevalent among adolescents and emerging adults, this population does not regularly receive substance use prevention programming in their communities. Low perceived risk of substance use, which is linked to actual behavior, may contribute to low rates of engagement in community prevention efforts for substance use. To examine this, the current study used a mixed methods approach to: (1) examine the relationship between engagement in prevention education and substance use; and, (2) analyze qualitative data on education programs offered in the community to help identify strengths and gaps in prevention resources. Method: Quantitative and qualitative data were collected from adolescents (age 13-18) and young adults (age 19-25) living in the Southeast, recruited from local schools and community events to participate in a preventive intervention focused on prevention of HIV, substance use, and other risky behaviors. Prior to engagement in this intervention, self-report questionnaires were completed by adolescents assessing: substance use, perceived risk, and engagement in substance use education classes. Focus groups were also conducted with adolescents recruited from a local high school and young adults recruited from local colleges to obtain additional information about engagement in education programs. Results: Regarding perceived risk, 71.8% of adolescents reported moderate to great risk in having five or more drinks once or twice a week and 43% of adolescents reported moderate to great risk in smoking cannabis once or twice a week. Forty-four percent of adolescents had talked to one of their parents about the dangers of tobacco, alcohol, or drug use in the past year. Further, 18% of adolescents had been to a class or program on prevention of alcohol and other drug abuse in the past month and 50.7% had heard, read, or watched an advertisement about prevention of substance use in the past year. Qualitative results Eight overarching themes, each with its own sub-themes, emerged from the participant’s responses during the focus groups. Each is described below with representative quotes provided throughout for illustrative purposes. Conclusions: Findings revealed several gaps in resources identified by adolescents and young adults that are needed to adequately address substance use, which provide important next steps for substance use prevention among youth.

"Talk About Cancer and Build Healthy Communities": How Visuals Are Starting the Conversation About Breast Cancer Within African-American Communities.

African-American (AA) women are at higher risk of breast cancer mortality than women of other races. Factors influencing breast cancer risk, including exogenous environmental exposures, and debate around timing of exposure and dose-response relationship, can cause misunderstanding. Collaboration with priority populations encourages culturally relevant health messaging that imparts source reliability, influences message adoption, and improves understanding. Through six focus groups with AA individuals in rural and urban counties in the southeastern United States, this study used a community-engaged participatory approach to design an innovative visual tool for disseminating breast cancer information. Results demonstrated that participants were generally aware of environmental breast cancer risks and were willing to share new knowledge with families and community members. Recommended communication channels included pastors, healthcare providers, social media, and the Internet. Participants agreed that a collaboratively designed visual tool serves as a tangible, focused "conversation starter" to promote community prevention and education efforts.

Perceptions of Active Shooter Prevention and Preparation Strategies in Pennsylvania: Links to Self-Protective Behavior.

In this study, I document how members of the public perceive active shooter risk in their communities and their perceptions of the effectiveness of common efforts to prevent and respond to active shooters. I further investigate how news media exposure shapes these perceptions. I applied Protection Motivation Theory (PMT) to explore how perceptions and news media exposure might shape self-protective actions taken by individuals and their households. Data were obtained in 2019 from a cross-sectional, state-representative sample of 668 Pennsylvania adults who completed a web survey. Those who perceived higher community active shooter risk and those who felt community prevention and preparation efforts were effective were more likely to take self-protective steps themselves. Increased news exposure through apps, social media, family and friends was associated with increased perceived risk and effectiveness of prevention and preparation strategies. These results suggest that self-selected news and news through personal ties are linked to active shooter perceptions while other news mediums, like television or radio broadcasts, are not. News exposure was largely unrelated to self-protection. Those who felt community efforts were effective in prevention or preparation, however, were more likely to take self-protective actions. This finding indicates that community efforts may be more influential than news media in directing personal behavior.

4104 Development and validation of parental empathy analog tasks

OBJECTIVES/GOALS: Parents’ empathy toward their children affects their parenting, which can in turn impact child outcomes. Although parental empathy is theoretically distinct from trait empathy, current literature relies on largely self-report measures of parents’ trait empathy. Thus, the current study evaluated new analog assessments of parental empathy. METHODS/STUDY POPULATION: One parental empathy analog measure (Empathy Measure for Parents Analog Task, Emotion Script; EMPAT-ES) was created based on parents’ responses to open ended prompts describing scenarios that elicit different emotions (e.g., happy, mad, sad, scared) in children. These responses were used to create short scripts. A second analog task (EMPAT, Emotion Audio) was created using 20 sec audio clips of children expressing the different emotions wherein participants respond with how they feel hearing the emotions and separately, how they believe the child feels. After an initial pilot, both versions of the EMPAT-E were administered to 120 families enrolled in a prospective longitudinal study. Parents completed self-report measures of trait empathy and parental empathy, as well as the EMPAT-ES and EMPAT-EA analog tasks. RESULTS/ANTICIPATED RESULTS: Internal consistency of both the EMPAT-ES and EMPAT-EA tasks are expected to be robust, demonstrating the reliability of these novel assessments of parental empathy. Results are also expected to demonstrate the construct and convergent validity of both analog tasks. These new measures of parental empathy are expected to be significantly associated with measures of trait empathy. Specifically, parents’ responses indicating how they believe the child feels in the analog are expected to be strongly related to their reported emotion recognition abilities and responses indicating how analog items made parents feel are expected to be related to parents’ empathic concern. Finally, parents’ responses to the analog tasks are anticipated to be strongly associated with parents’ self-reported parental empathy. DISCUSSION/SIGNIFICANCE OF IMPACT: Valid, novel assessments of parental empathy can impact the parenting literature as well as community intervention and prevention efforts with parents. Such analog tasks can bolster parenting research but they may also be translated to the community setting as a training tool wherein parents are taught new skills that promote more positive parenting.