Community Prevention Research Articles

The Prevention and Management System of Public Emergencies based on Community

With the in flux of population and the increasingly complex changes of social structure, more and more public emergencies spread from the community grass‐roots level to all over the world. The occurrence of large‐scale public emergencies around the world makes its prevention and governance enter the research field of vision again. The role of grass‐roots communities in the prevention and response of public emergencies is becoming more and more important, because it is not only related to the life and health of grass‐roots people, but also of great significance to maintain that our country is and will be in the primary stage of socialism for a long time and the long‐term stable development of economy and society. This document makes a preliminary analysis and report on the prevention and management of community grass‐roots response to public emergencies, and these problems will attract extensive attention of the people, and improve the attention of grass‐roots communities to the disposal of public emergencies.

COMMUNITY POLICING AND CRIME PREVENTION IN NIGERIA

Community policing has emerged as a promising strategy for crime prevention and enhancing public safety around the world and in Nigeria. This is due to the difficult task of conventional policing, especially where the community is not actively involved in crime prevention. It has been realized that safety in any given community requires an investment not only of money, but also time and talent, and that sometimes the best solutions are found in understanding the underlying causes of crime and disorder. Nigeria is one of the countries in the world that has embraced the idea of community policing with great enthusiasm for about two decades ago. Consequently, Nigeria, has introduced several policy measures with the main aim of encouraging the community to take up some responsibility for their safety and security of their environment. Drawing on empirical research and case studies, this paper examines the key principles, approaches and challenges of implementing community policing initiatives, to highlight the significance and impact of collaboration between local communities and law enforcement agencies on crime prevention, trust-building and social cohesion in Nigerian communities. The paper also emphasizes the importance of capacity building, sustainable funding, and institutional support in strengthening the effectiveness of community policing in Nigeria.

Abstract B130: Partnership in persistent poverty neighborhoods: The Acres Homes Cancer Prevention Collaboration

Abstract Introduction: Rising obesity rates significantly contribute to increases in many types of cancer. The link between obesity, socioeconomic status, and cancer risk is evident, particularly in persistent poverty areas. The Acres Homes Cancer Prevention Collaboration (Acres Homes CPC), part of the Persistent Poverty Initiative (PPI) of the National Cancer Institute, is a dynamic partnership led by the University of Texas MD Anderson Cancer Center. This community-academic partnership, centered on the Acres Homes neighborhood in Houston, TX, that is impacted by persistent poverty, utilizes community-engaged strategies and transdisciplinary research to mitigate obesity-related cancer risks. Methods: Through multiple community partnerships, the CPC aims to alleviate persistent poverty effects, support early-career researchers, and test nutrition and physical activity interventions for reducing obesity-related cancer risk. Results: The Acres Homes CPC funds two research projects: a trial of a physical activity program for cancer survivors and a cluster-randomized trial of food distribution and nutrition education for elementary school children and their parents. We have funded seven pilot studies on topics such as food security, culinary medicine, physical activity and mild cognitive impairment, and the physical and safety environment of neighborhoods. Three community advisors guide and support all activities, and information on the initiative is provided monthly to a community steering committee. The Acres Homes CPC also supports pre- and postdoctoral fellows interested in research promoting cancer prevention and control in persistent poverty communities. Conclusions: This initiative aims to reduce cancer risk and improve cancer outcomes in persistent poverty communities by bridging the gap between research and practical implementation through community-based participatory research and partnership with the community to address obesity. Citation Format: Karen Basen-Engquist, Ruth Rechis, Michael Mackert, Brad Love, Shreela Sharma, Sanjay Shete, Qian Lu, Shine Chang, Margaret Raber, Miranda Baum, Crystal Roberson, Lorna McNeill. Partnership in persistent poverty neighborhoods: The Acres Homes Cancer Prevention Collaboration [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B130.

Abstract B046: Factors influencing patient decision-making to complete Low Dose CT screening for lung cancer

Abstract As part of a randomized, controlled trial (RCT) to increase lung cancer screening (LCS) with low-dose CT scan (LDCT) within the Choctaw Nation of Oklahoma’s tribal health system, we conducted a qualitative study to explore the barriers behind patient decisions to forego screening. Thirty eligible participants who had been in the RCT for at least one year were identified as LCS completers (n=7) or non-completers (n=23). A single interviewer completed all interviews using a semi-structured interview guide, designed to explore experiences, barriers/facilitators to LCS, factors influencing screening decisions, and suggested strategies for expanding the LCS program into the community. Interviews were recorded and transcribed verbatim. Data were analyzed using conventional content analysis. Most non-completers reported having no conversations about the availability of LCS with their primary care provider (PCP) or receiving any information about the LCS program. In contrast, the completers all reported PCP-initiated discussions about the LCS program, their risk factors, and an overview of the testing process. Key themes that emerged included fears, e.g., being unsure about what the test involves, afraid of being diagnosed with lung cancer and what might follow, and afraid of dying. Some voiced concerns, e.g., feeling guilty as active smokers and being stigmatized should they be diagnosed with lung cancer. Many participants posited that there was no reason for screening without symptoms. Lack of understanding, especially about cancer care, was identified as a contributing factor. Suggested strategies to increase the reach into the community included using existing infrastructure within Choctaw Nation, such as disseminating information through the tribal newsletter, inserts in prescription refills, and notifications via the patient portal. Community education programs at local community centers, particularly around senior citizen meals, were offered as strategies to change the perception that lung cancer is a death sentence. Hosting an informational booth at the annual tribal Labor Day festival was commonly suggested. In conclusion, multiple reasons were cited for forgoing LDCT screening. In this tribal setting, findings are similar to ones documented in other settings. This suggests that interventions to overcome these challenges may build off known evidence-based interventions, such as the recommendations for cancer prevention documented by the Community Preventive Services Task Force. Addressing fears through multiple educational approaches and adapting strategies from the American Lung Association to address stigma could lead to enhanced interventions. Finally, capitalizing on tribal resources (newsletter) and tribal events to increase LCS awareness may be promising strategies to improve screening in the local tribal setting. Citation Format: Kathleen Dwyer, Zsolt Nagykaldi, Mark Doescher, Dorothy A. Rhoades. Factors influencing patient decision-making to complete Low Dose CT screening for lung cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B046.

Report on Cardiovascular Health and Diseases in China 2023: An Updated Summary.

Since 1990, China has made considerable progress in resolving the problem of "treatment difficulty" of cardiovascular diseases (CVD). The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors, and this situation is further worsened due to the accelerated aging population in China. CVD remains one of the greatest threats to the health of Chinese residents. In terms of the proportions of disease mortality among urban and rural residents in China, CVD has persistently ranked first. In 2021, CVD accounted for 48.98% and 47.35% of deaths in rural and urban areas, respectively. Two out of every five deaths can be attributed to CVD. To implement a national policy "focusing on the primary health institute and emphasizing prevention" and truly achieve a shift of CVD prevention and treatment from hospitals to communities, the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the "Report on Cardiovascular Health and Diseases in China" annually since 2005. The 2024 report is established based on representative, published, and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys, randomized controlled clinical trials, large sample registry studies, and typical community prevention and treatment cases, along with data from some projects undertaken by the National Center for Cardiovascular Diseases. These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

Sosialisasi DBD Bentuk Upaya Pencegahan dan Penurunan Kasus Demam Berdarah di Desa Kebonadem

Socialization on the prevention of Dengue Hemorrhagic Fever (DBD) in Kebonadem Village on July 20 2024 aims to increase public awareness about the dangers of DBD and steps to prevent it. The main problem faced is the high risk of dengue fever transmission due to population density and community behavior that does not maintain environmental cleanliness, which supports the breeding of the Aedes aegypti mosquito. The urgency of this outreach is very high considering that dengue fever cases often cause Extraordinary Events (KLB) and the fatal impacts they can have. The results of this outreach show a significant increase in public understanding regarding preventive measures such as the application of 3M Plus (Draining, Covering, Burying and Sprinkling abate powder) as well as the early signs of dengue fever. Active participation in discussions and implementing new habits, such as cleaning water reservoirs, indicates the positive impact of this activity. Despite progress, consistency in implementing prevention habits and ongoing support from various parties is still needed to ensure long-term success. Regular evaluations will help assess the effectiveness of the program and reduce the number of dengue cases in the village, making it an example of success in dengue prevention in other communities.

Breaking barriers: acceptability and feasibility of HPV self-sampling for cervical cancer prevention in rural communities of Ecuador

Breaking barriers: acceptability and feasibility of HPV self-sampling for cervical cancer prevention in rural communities of Ecuador

Changes in roles and feelings among "Kaigoyobou leaders" responsible for community prevention activities over 10 years

Objectives Community residents experience changes over time, including those in the care prevention system, governmental expectations, and their motivations. To support community-based prevention activities, it is necessary to clarify these changes. This study used a qualitative research method to examine changes in roles and feelings among "Kaigoyobou leaders" who had been involved in community-based care prevention activities for 10 years.Methods The study participants were nine leaders (six men and three women) who had been active in community-based care prevention for approximately 10 years. Through one-hour semi-structured interviews, we explored their current activities, reasons for taking the leader training course, changes in the content of their activities since completing the course, changes in their roles in activities and feelings about the activities, and what they recognized as important in their activities. Interviews were transcribed verbatim and analyzed using a modified grounded theory approach. From the transcripts, we extracted "concepts" related to changes among the leaders and generated "categories" to summarize the concepts.Results The analysis identified 28 concepts summarized into 12 categories. The categories included: "belief in the activities" (e.g., "focusing on preventive effects"), "learning through trial and error" (e.g., "learning continuously"), "developing the activities" (e.g., "expanding the activities"), "commitment to the community" (e.g., "valuing connections with people involved in the activities"), "increasing required roles" (e.g., "taking consultations from juniors"), "relationship with the government" (e.g., "responding to requests from the government"), "benefits from the activities" (e.g., "receiving a sense of accomplishment and satisfaction from the activities"), "burden due to the activities" (e.g., "a shortage of group members"), "aging of stakeholders" (e.g., "increasing age of the participants"), "preparing for continuity" (e.g., "new people wishing to participate"), "considering ending activities" (e.g., "reducing activities due to increasing age of the leaders themselves"), and "impact of the coronavirus."Conclusion Leaders' strong belief in their activities and their ability to adapt based on successful experiences were crucial. They responded effectively to environmental changes, including evolving government relationships. Fostering leadership belief, highlighting the benefits of activities, and supporting collaborative responses to environmental changes are essential for ongoing success.

Descriptive analyses of knowledge, attitudes, and practices regarding rabies transmission and prevention in rural communities near wildlife reserves in Uganda: a One Health cross-sectional study

BackgroundDespite urban (domestic dog) rabies cycles being the main target for rabies elimination by 2030, sylvatic (wildlife) rabies cycles can act as rabies spillovers especially in settlements contiguous to wildlife reserves. Rural communities next to wildlife reserves are characterized by unique socio-demographic and cultural practices including bat consumption, hunting for bushmeat, and non-vaccination of hunting dogs against rabies among others. This study aimed to compare the knowledge, attitudes, and practices (KAPs) related to rabies transmission and prevention in the three districts of Uganda; (1) Nwoya, neighboring Murchison Falls National Park (MFNP) in the north, (2) Kamwenge neighboring Kibaale National Park (KNP), Queen Elizabeth National Park (QENP) and Katonga Game Reserve (KGR) in the west, and (3) Bukedea, neighboring Pian Upe Game Reserve (PUGR) in the east of Uganda.MethodsA community-based cross-sectional survey was conducted in settlements contiguous to these wildlife reserves. Using a semi-structured questionnaire, data were collected from 843 households owning dogs and livestock. Data were collected between the months of January and April 2023. Stratified univariate analyses by district were carried out using the Chi-square test for independence and Fisher’s exact test to compare KAPs in the three study districts.ResultsThe median age of study participants was 42 years (Q1, Q3 = 30, 52) with males comprising the majority (67%, n = 562). The key findings revealed that participants from the Nwoya district in the north (MFNP) had little knowledge about rabies epidemiology (8.5%, n = 25), only 64% (n = 187) of them knew its signs and symptoms such as a rabid dog presenting with aggressiveness and showed negative attitudes towards prevention measures (15.3%, n = 45). Participants in the Kamwenge district-west (KNP, QENP, and KGR) had little knowledge and negative attitude towards wildlife–human interaction pertaining to rabies transmission and prevention especially those with no or primary level of education (20.9%, n = 27) while participants from Bukedea in the east (PUGR) had remarkedly poor practices towards rabies transmission, prevention, and control (37.8%, n = 114).ConclusionsRabies from sylvatic cycles remains a neglected public health threat in rural communities surrounding national parks and game reserves in Uganda. Our study findings highlight key gaps in knowledge, attitudes, and practices related to rabies transmission and prevention among such communities. Communication and action between veterinary services, wildlife authority, public health teams, social science and community leaders through available community platforms is key in addressing rabies among the sympatric at-risk communities in Uganda.

An Impactful Health Fair in a Semi-Urban Community: Awolowo Town Case Study

Background: Even though most communities in developing countries understand the importance of disease prevention, they do not know how to do so. Beneficial programmes, like Health Fairs, even when relatively free, are often scorned. Understanding the importance of hypertension prevention in rural communities in developing nations is under-utilized. This study aimed to get the Awolowo community to come to terms with the benefits of an impactful Health Fair and generate convincing health information. It addressed how to motivate, generate interest and participate. Thus bridging knowledge gap and experience regarding disease prevention and medical screening. Methodology: This was a prospective study conducted over three days during a health fair at Awolowo town, Osun State, South-western Nigeria. A total of 178 Participants (18 years and above) were divided into three groups. Each group went through eight (8) different stations of specialized Health screening format. Blood pressure, Body mass index (BMI), and demographics were collected. Regression analyses was carried out on IBM SPSS (version 21) to examine the relationship between demographic features and blood pressure. Results: Our study found a high prevalence of pre-hypertension (41.6%) among participants. The study highlighted the rising rates of overweight (22.5%) and obesity (14%) in the population. Also, about 33% had hypertension, while increasing age was identified as a significant factor in its prevalence. The data demonstrates a strong correlation between obesity/overweight and hypertension. Conclusion: The specialized Health screening format and seminars/workshops served as motivation and interest generation. This should be adopted for similar studies. This study emphasizes the need for community interventions to address the growing prevalence of hypertension and obesity in Awolowo town and environ. Early diagnosis, heightened awareness, and lifestyle modifications are crucial approaches to mitigate health risks related to these conditions and enhance the overall health and well-being of the community.

The roles of dating and victimization on adverse mental health among teens: Survey findings during the COVID-19 pandemic.

The relationship between romantic involvement, dating violence, other victimizations, and mental health among adolescents in the context of the COVID-19 pandemic is understudied. This study analyzed 2021 survey data collected from a representative sample of 9th-12th grade students (n = 10,792) from 24 high schools in a US Midwestern state. Most respondents identified as White, heterosexual, and US-born, with more than three-quarters aged 15-17 years. Guided by the poly-victimization framework, this study explored: (a) How do youth victimizations and mental health concerns differ by their experience of dating and dating violence? (b) What are the associations between youth mental health concerns, victimizations, and dating? Youths reported mental health concerns and victimizations at considerable rates during the COVID-19 pandemic when in-person interactions were limited. Those who experienced dating violence were at a higher risk of reporting other victimizations (i.e., unwanted sexual comments, unwanted sexual contact, sexual photos/videos, sex trading for compensation, discrimination, and bullying). The number of victimizations demonstrated a cumulative effect on teen mental health. Most individual victimizations showed significant net associations with mental health concerns, even when controlling for other differing victimizations. Dating violence plays a critical role in the interconnectedness of victimizations, and the number of victimizations has a cumulative effect on teen mental health. The high prevalence of youth victimizations during the time when in-person interactions were limited suggests that victimizations may transfer from in-person forms to virtual forms and occur offline. Implications for individual and community prevention and interventions are discussed.

The Recent 2023 Earthquake in Nepal: A Global Health Perspective.

As a seismic hotspot, Nepal has endured many catastrophic earthquakes, including the 2023 Jajarkot quake. These quakes worsen the existing fragilities, resulting in difficulties in accessing healthcare, outbreaks of infectious diseases, mental health problems, and nutritional shortfalls. The article examines the complex web of health consequences, such as infectious and non-infectious diseases and malnutrition, highlighting the need for a global health lens in tackling these issues. It also reveals the long-term health effects, such as mental health disorders and increased disease susceptibility, that emerge after the quake and the importance of enhancing coordination and communication, enforcing building codes, and assisting affected communities in response to the seismic hazards. The article identifies mitigation strategies, community involvement, and international cooperation as key elements in building resilience against future quakes. It discusses the role of climate change in seismic risks and the need for research, innovation, and adaptability in global health interventions, suggesting measures such as strengthening primary healthcare, preventing avoidable health problems through education, and improving supply chains. The article calls for a holistic approach to building resilient health systems, emphasizing community engagement, prevention, and preparedness to protect the health of vulnerable groups in seismic regions.

Development of a Community-Driven Waste Reduction Education and Action Program

Mismanaged and excessive waste has adverse effects on natural environments, economies, and human health. To address these waste issues, the Sustainability with Awareness and Prevention Solutions Program was developed and implemented in communities along the Mississippi Gulf Coast (USA) with the aim to provide the knowledge and actions needed to reduce or eliminate mismanaged and excessive waste. The program uses four educational modules focused on (1) microplastics in the watershed, (2) food waste, (3) single-use plastics, and (4) involvement in community prevention and removal programs. The program curriculum was written to meet education standards in Mississippi for 5th grade gifted, 6–8th grades, and 9–12th grades, and can be easily adapted to other states’ curriculums. The program provides material incentives to participants so knowledge learned can immediately be translated to behavior change. The program is continually being developed to find the best methods to implement behavior change at multiple scales.

Healthcare disparities are associated with eligibility and enrollment in clinical trials in Louisiana.

e13728 Background: Clinical trials offer an opportunity to evaluate novel therapeutic strategies and modalities of care. Overall enrollment is low for clinical trials, but previous literature has highlighted lower rates of enrollment among underrepresented populations. A disproportionately low accrual of minority or other populations will result in reducing the ability of such clinical trials to prove general benefit to the overall population. This study aims to evaluate the population of those able or unable to qualify for and enroll in the Gulf South Clinical Trials network, a minority/underserved NCORP community site. Methods: Patient data was collected through interviews using a screening tool developed by the National Cancer Institute’s Community Oncology and Prevention Trials Research Group and active enrollment of ongoing clinical trials. Patients were interviewed regarding demographic data and tumor staging. Reason for ineligibility or non-enrollment was documented by the clinical staff. Clinical trials were categorized between Cancer-Control and Cancer Care Delivery Research (CC-CCDR) Trials and Cancer Treatment Trials from 2017 and 2023. Rates of eligibility and enrollment were compared via Fisher’s Exact tests. Results: CC-CCDR Trials had 363 participants while Cancer Treatment had 550 participants. CC-CCDR Trials resulted in 19% (n=69) of patients being ineligible with 81% (n=294) being eligible with a higher proportion of Whites (p<.001), non-rural (p = .021), low income (p=.007), private insurance (p=<.001), stage 1 tumors (p<.001), and having a genetic predisposition (p<.001) being ineligible. From the patients that were eligible, 13% (n= 39) of patients were not enrolled with 87% (n=255) of patients enrolled. Cancer Treatment Trials resulted in 23% (n=129) of ineligible patients and 76.5% (n=421) of eligible patients, with a higher proportion of low income (p=.002), private insurance (p=.035), and those not having genetic predispositions (p=.022) being ineligible. From the participants that were eligible, 20% (n=85) of patients were not enrolled with 80% (n=336) of patients enrolled, with a higher proportion of female (p= .002) patients not enrolled. Conclusions: Disparities in socioeconomic factors and female gender are associated with lower rates of eligibility and enrollment in clinical trials in community oncology settings. Future research identifying modifiable underlying factors can assist in developing strategies to improve enrollment in underserved populations.

Prevalence and antibiotic susceptibility patterns of Escherichia coli and Staphylococcus aureus isolated from bioaerosols of local markets located in Agulu, Anambara State

There is a need for improved understanding of aerosol-acquired disease due to the increasing environmental load of antibiotic resistant bacteria. Multidrug-resistant Escherichia coli and Staphylococcus aureus are examples of bacteria for which the role of exposure to aerosolized organisms in disease transmission should be more closely evaluated globally. This study is aimed at evaluating the prevalence and antibiogram of S. aureus and E. coli present in market bioaerosols, located in Nwagu-Agulu, Anambra Nigeria. Impaction sample collection method was used to collect bioaerosol samples within the market using nutrient agar as the collection media, A combination of the cultural and microscopic features as well as selected biochemical tests were employed to identify the isolates. The Kirby-Bauer disk diffusion method was used to determine antibiotic resistance to selected commonly used antibiotics. A total of 76 S. aureus and 24 E. coli were isolated. Both organisms have been implicated in community-acquired infections. The most common bacteria isolated were Staphylococcus aureus. Varying levels of resistance were observed by these isolates to selected commonly use antibiotics. There is high prevalence of S. aureus and E. coli within Nwagu market Agulu, Anambra State, Eastern region of Nigeria. The organisms have very high rates of resistance to antibiotics (MDR) as reported by other workers. The government as well as Health professionals must play an important role in the prevention of community acquired infections via regular environmental monitoring of open markets bioaerosol and establishing a common permissible limits or concentration for bioaerosols within the markets.

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.

A protocol of a pilot randomised trial (Action-RESPOND) to support rural and regional communities with implementing community-based systems thinking obesity prevention initiatives.

Over a quarter of children aged 2-17 years living in Australia are overweight or obese, with a higher prevalence reported in regional and remote communities. Systems thinking approaches that seek to support communities to generate and implement locally appropriate solutions targeting intertwined environmental, political, sociocultural, and individual determinants of obesity have the potential to ameliorate this. There have however been reported challenges with implementation of such initiatives, which may be strengthened by incorporating implementation science methods. This pilot randomised controlled trial protocol outlines the development and proposed evaluation of a multicomponent implementation strategy (Action-RESPOND). to increase the implementation of community-based systems thinking child obesity prevention initiatives The target of this intervention is ten rural and regional communities (or local government areas as the unit of allocation) within Northeast Victoria who were participants in a whole-of-systems intervention (RESPOND). Action-RESPOND builds on this intervention by assessing the impact of offering additional implementation strategies to five communities relative to usual care. The development of the multicomponent implementation strategy was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework and consists of seven implementation strategies primarily delivered via 'facilitation' methods. Implementation strategies aimed to ensure initiatives implemented are i) evidence-based, ii) address community's specific needs and iii) are suitable for local context. Strategies also aimed to increase the community's capacity to implement, through iv) improving the health promotion team's implementation knowledge and skills, fostering v) leadership, vi) physical resources and vii) community culture to drive implementation. The feasibility, acceptability, potential impact, and cost of the strategy will be assessed at baseline and follow up using surveys administered to key representatives within the community and internal records maintained by the research team. By leveraging an existing community-based whole-of-systems intervention, Action-RESPOND offers a unique opportunity to collect pilot feasibility and early empirical data on how to apply implementation and systems science approaches to support obesity prevention in rural and regional communities in Victoria.

Evidence-Based Strategies for Injury Prevention and Exercise Prescription in Elderly Communities: The Physical Therapist's Perspective

Injury prevention and exercise prescription are critical components of healthcare for older adults. Physical therapists play a critical role in fall risk screening, assessment, and prevention in elderly communities. By incorporating STEADI (Stopping Elderly Accidents, Deaths, and Injuries) and other evidence-based tools and resources, physical therapists can help identify and address fall risk factors, link older adults with community-based programs and resources, and reduce the incidence of falls and related injuries in this population. Evidence-based interventions for fall prevention include exercise interventions that are tailored and include a combination of exercise types, considering individual abilities and preferences. Exercise programs can reduce falls in older people living in residential aged care facilities, but exercise has little or no lasting effect on falls after the end of a program. Physical therapists should consider the patient's fall risk, functional limitations, and comorbidities when prescribing exercises for balance and falls prevention. Physical therapists can help elderly communities implement evidence-based strategies for injury prevention and exercise prescription by adopting a person-centered approach, challenging ageist stereotypes, using sound outcome measures, prioritizing physical activity, and collaborating with other healthcare professionals. By doing so, physical therapists can promote the health, independence, and well-being of older adults, and help them lead active, fulfilling lives. A combination of strength, balance, and functional training exercises, as well as other evidence-based strategies, can significantly reduce the risk of falls in elderly communities. Physical therapists and healthcare providers should consider these interventions when developing fall prevention programs for older adults. Exercise interventions for preventing falls in elderly communities should be implemented regularly, with a frequency of at least three sessions per week, and for a duration of up to 12 months. Keywords: Elderly communities, injury prevention, exercise prescription in elderly, falls prevention, aging

Evaluating the Reach of a Patient Navigation Program for Follow-up Colonoscopy in a Large Federally Qualified Health Center.

Patient navigation (PN) has been shown to improve participation in cancer screening, including colorectal cancer screening, and is now a recommended practice by the Community Preventive Services Task Force. Despite the effectiveness of PN programs, little is known about the number of contacts needed to successfully reach patients or about the demographic and healthcare utilization factors associated with reach. PRECISE was an individual randomized study of PN versus usual care conducted as a partnership between two large health systems in the Pacific Northwest. The navigation program was a six-topic area telephonic program designed to support patients with an abnormal fecal test result to obtain a follow-up colonoscopy. We report the number of contact attempts needed to successfully reach navigated patients. We used logistic regression to report the demographic and healthcare utilization characteristics associated with patients allocated to PN who were successfully reached. We identified 1,200 patients with an abnormal fecal immunochemical test result, of whom 970 were randomized into the study (45.7% were female, 17.5% were Spanish-speaking, and the mean age was 60.8 years). Of the 479 patients allocated to the PN intervention, 382 (79.7%) were reached within 18 call attempts, and nearly all (n = 356; 93.2%) were reached within six contact attempts. Patient characteristics associated with reach were race, county of residence, and body mass index. Our findings can guide future efforts to optimize the reach of PN programs. Prevention Relevance: The findings from this large study can inform clinic-level implementation of future PN programs in Federally Qualified Health Centers to improve the reach of patients needing cancer screenings, optimize staff resources, and ultimately increase cancer screenings.

252 Psychosocial factors influencing the maintenance of a healthy lifestyle among African American adults during the COVID-19 Pandemic

OBJECTIVES/GOALS: The COVID-19 pandemic disrupted established social support networks (faith-based, community, family, friends), resulting in unprecedented health-related, financial, and employment challenges among African Americans (AAs). This study explores the psychosocial influences of the pandemic on the health and wellness of AAs. METHODS/STUDY POPULATION: The FAITH! (Fostering African-American Improvement in Total Health!) Program, an academic-community partnership with AA churches, shifted focus to COVID-19 prevention in AA communities. Funded by the Mayo Clinic Center for Clinical and Translation Sciences, this cross-sectional study recruited AA adults from FAITH!-affiliated churches and social media to complete a survey exploring the personal impact of the pandemic from hardships (e.g., food and housing insecurity, paying utilities) on healthy lifestyle (HL). The primary outcome was difficulty maintaining a HL during the pandemic. Logistic regression (odds ratios and associated 95% confidence intervals (CIs)) was used to examine the associations between difficulty maintaining a HL and factors including COVID-19 hardships and mental health. RESULTS/ANTICIPATED RESULTS: Participants (N=169, 71.4% female, 41.4% essential workers) had a mean age [SD] of 49.4 [14.9] years. Over half (91/169, 54%) reported difficulty maintaining a HL. Those reporting unemployment (OR 2.3; 95% CI [1.2,4.4]; p=0.008), difficulty paying rent (OR 4.1; 95% CI [2.1,8.6]; p<0.001), or food/utilities (OR 5.5; 95% CI [2.7,11.5]; p<0.001) all had greater odds of difficulty maintaining a HL. High stress (≥5/10, scale 1-10) was associated with difficulty maintaining a HL (OR 4.1; 95% CI [2.1,8.5]; p<0.001) compared to AAs with low stress. Negative mental health (depression (OR 3.4; 95% CI [1.0,13.7]; p<0.001), anger (OR 2.5; 95% CI [0.5,18.9]; p=0.005), and nervousness (OR 4.1; 95% CI [1.1,19.5]; p=0.003) was associated with difficulty maintaining a HL compared to AAs with positive mental health. DISCUSSION/SIGNIFICANCE: Our study findings revealed that COVID-19 hardships, stress, and negative mental health impacted the ability of AAs to maintain a HL. These issues should be considered in the design and implementation of community-based health programs to promote healthy living during future public health emergencies.