Regions Of Alabama Research Articles

Point-of-care STI testing in rural settings: A feasibility project.

Sexually transmitted infections (STIs) continue to be a health concern in the United States, particularly in rural settings. Point-of-care (POC) STI testing is useful in overcoming access barriers in these settings. The purpose of this project was to implement POC STI testing to increase access to care in rural settings and test the feasibility of this model. Six mobile health clinics were implemented by a nurse-led team in three rural communities in the Blackbelt region of Alabama utilizing the Binx IO® to test for chlamydia and gonorrhea. Mobile clinic volunteers participated in focus groups to determine provider satisfaction with clinic workflow. The mobile health clinics were a feasible way to increase access to STI testing in rural settings with reported provider and client satisfaction in work flow.

Postharvest evaluations of soil erosion, ground cover, and best management practice implementation on integrated biomass and conventional clearcut harvest sites

As demand for wood energy rises, it’s vital to understand the environmental impact of various harvest types, considering different best management practices (BMPs) and site conditions, for sustainable forest management. This study provides a comparative analysis of postharvest site characteristics between biomass and conventional harvest sites located in the Coastal Plain region of the southeastern US. A total of 30 recently harvest sites (15 each for biomass and conventional) were selected from the Coastal regions of Alabama, Georgia, and Florida. Erosion rates were estimated using the USLE-Forest method and ground cover was assessed as a percentage of the area covered by bare soil, litter, light slash, heavy slash, and piles. BMP implementation (%) was based on state-specific BMP surveys. The findings show that stream management zones (SMZs) and harvest areas were less prone to soil erosion, while forest roads, skid trails, and stream crossings were more prone to erosion, regardless of the harvest type. Conventional harvest sites had an overall weighted average erosion rate of 0.35 Mg/ha/year, with an average BMP implementation of 92.70 %, while biomass harvest sites had an overall weighted average erosion rate of 0.22 Mg/ha/year, with an average BMP implementation rate of 97.91 %. Average erosion rate (Mg/ha/year) from the harvest area (biomass=0.11, conventional=0.06) and SMZs (biomass=0.05, conventional=0.02) were not significantly different (p>0.05). Conversely, average erosion rate from roads (biomass=4.17, conventional=6.44), skid trails (biomass=2.15, conventional=3.73), decks (biomass=0.39, conventional=0.72), and stream crossings (biomass=1.53, conventional=5.31) were significantly higher in conventional harvest sites (p<0.05). BMP implementation rates for roads (biomass=98.09 %, conventional=93.71 %), stream crossings (biomass=95 %, conventional=71 %), and timber harvest (biomass=96.44 %, conventional=93.33 %) were significantly higher in biomass harvest sites, while waste management BMP (biomass=89.91 %, conventional=100 %) was significantly higher in conventional harvest sites. Regarding ground cover, conventional harvest sites had significantly larger areas covered by light slash, heavy slash, and piles than biomass harvest sites, while biomass harvest sites had significantly larger areas covered by green growth. Our research shows a significant negative correlation between overall BMP implementation and erosion rates (r=-0.67, p=0.0002), as well as site size (r=-0.38 p=0.0400), indicating that larger sites tend to have lower BMP implementation and increased erosion risk. In conclusion, biomass harvest sites in our study did not yield higher erosion rates in comparison to conventional harvest sites, provided that the current BMP recommendations were implemented properly and in adequate amounts. This study emphasizes the importance of site-specific management strategies to mitigate erosion in all harvest sites, irrespective of harvest type used.

Risk Factors for Enteric Pathogen Exposure among Children in Black Belt Region of Alabama, USA.

Risk Factors for Enteric Pathogen Exposure among Children in Black Belt Region of Alabama, USA.

Evaluating the impacts of vehicle-mounted Variable Message Signs on passing vehicles: implications for protecting roadside incident and service personnel

This study aims to evaluate the Variable Message Signs (VMS) mounted over the cab of emergency vehicles as a safety countermeasure to protect roadside incident and service personnel. The research team collaborated with the Alabama Department of Transportation’s Safety Service Patrol (SSP) program, specifically the Alabama Service Assistance Patrol (ASAP) in the West Central Alabama region, to collect video data from their service vehicles. Deep learning techniques were employed to detect vehicles in the recorded videos. A total of 11,338 passing vehicles were detected in 135,946 frames of video footage, and their trajectories were extracted for analysis. The study focused on examining the behaviors and movements of passing vehicles, including their speed and lane change behaviors, and developed statistical models to systematically investigate the impact of VMS on these behaviors. Random intercept models were utilized to account for unobserved factors associated with different stop locations. The modeling results revealed significant relationships between the use of VMS and the behaviors of passing motorists. When the VMS was active, drivers were more likely to change lanes and reduce their speed compared to situations where the VMS was not active. The odds of a vehicle changing lanes were found to be 95% higher when the VMS was in use. These findings suggest that the utilization of VMS can have a positive impact on traffic, particularly for passenger vehicles. The study outcomes imply that the use of VMS could be an effective countermeasure in protecting roadside incidents and ensuring the safety of service personnel.

Fern Cave: A Hotspot of Subterranean Biodiversity in the Interior Low Plateau Karst Region of Alabama in the Southeastern United States

The Fern Cave System, developed in the western escarpment of the Southern Cumberland Plateau of the Interior Low Plateau karst region in Northeastern Alabama, USA, is a global hotspot of cave-limited biodiversity as well as home to the largest winter hibernaculum for the federally endangered Gray Bat (Myotis grisescens). We combined the existing literature, museum accessions, and database occurrences with new observations from bioinventory efforts conducted in 2018–2022 to generate an updated list of troglobiotic and stygobiotic species for the Fern Cave System. Our list of cave-limited fauna totals twenty-seven species, including nineteen troglobionts and eight stygobionts. Two pseudoscorpions are endemic to the Fern Cave System: Tyrannochthonius torodei and Alabamocreagris mortis. The exceptional diversity at Fern Cave is likely associated with several factors, such as the high dispersal potential of cave fauna associated with expansive karst exposures along the Southern Cumberland Plateau, high surface productivity, organic input from a large bat colony, favorable climate throughout the Pleistocene, and location within a larger regional hotspot of subterranean biodiversity. Nine species are of conservation concern, including the recently discovered Alabama cave shrimp Palaemonias alabamae, because of their small range sizes, few occurrences, and several potential threats.

HPV and HPV Vaccine Awareness Among African Americans in the Black Belt Region of Alabama.

This study aims to examine the factors associated with the level of HPV infection and HPV vaccine awareness among rural African Americans living in the Black Belt region of Alabama. A cross-sectional survey on cancer screening and health behaviors was conducted in the Black Belt region of Alabama. Adults (18years or older) recruited through convenience sampling completed the self-administered survey. Binary logistic regressions were conducted to identify factors associated with HPV infection and HPV vaccine awareness among African American participants. Slightly more than half of the participants were aware of HPV (62.5%) and HPV vaccine (62.1%). Married or partnered participants had lower awareness of HPV or HPV vaccine. Family cancer history and self-reported health status were positively associated with both HPV and HPV vaccine awareness. In addition, employment was positively associated with HPV awareness, and participation in social groups was positively associated with HPV vaccine awareness. Tailored educational interventions that consider our findings might increase HPV and HPV vaccine awareness and contribute to better vaccine uptakes.

Abstract P378: Design of the Equity in Prevention and Progression of Hypertension by Addressing Barriers to Nutrition and Physical Activity (EPIPHANY) Study: A Cluster Randomized Trial

Introduction: High rates of hypertension and poverty in the rural South contribute to health disparities with Black adults experiencing higher rates of cardiovascular disease than White adults. Clinical trials have shown that lifestyle interventions like the Dietary Approaches to Stop Hypertension diet and increasing physical activity reduce the risk for hypertension. However, suboptimal implementation indicates a need to identify mechanisms of prevention in rural populations impacted by negative social determinants of health that can make achieving healthy lifestyle behaviors more challenging. Methods and Results: The EPIPHANY (Equity in Prevention and Progression of Hypertension by Addressing barriers to Nutrition and Physical activitY) Study is a cluster randomized controlled trial testing a multilevel intervention designed to reduce community and individual barriers to a healthy lifestyle to lower blood pressure (BP) among rural, Black adults. EPIPHANY is enrolling and randomizing 20 churches in the Black Belt region of Alabama. Health education fairs offered to all churches are being used to screen and enroll Black adults with elevated BP or stage 1 hypertension (120-139 mm Hg and diastolic BP &lt;90 mm Hg) who are not recommended for antihypertensive medication, according to the 2017 American College of Cardiology/ American Heart Association BP guideline. Participants (n=240) in churches randomized to the control condition are offered access to online resources including cooking demonstrations and exercise classes. Participants (n=240) in churches randomized to the intervention are receiving access to online resources; telephone-based peer support for lifestyle modification, goal setting and problem solving; funding for churches to develop programs to address food access and/or barriers to physical activity; and training of church members to serve as peer health advocates to deliver training for church members on lifestyle modification. We will employ a Type 1 Hybrid Implementation-effectiveness design to assess the effectiveness and implementation of this multi-level intervention, using the RE-AIM framework. BP, social determinants of health, psychosocial factors, physical activity and diet are being assessed. The EPIPHANY trial began recruitment in August 2022 and has enrolled 18 and 25 Black adults in the first two churches randomized to the control and intervention conditions, respectively, and recruited four churches for the next wave of screenings. Conclusion: The EPIPHANY study is designed to prevent hypertension among rural, Black adults by addressing structural and individual barriers to lifestyle modification through peer support. The study could provide evidence for a feasible, scalable and sustainable approach to preventing hypertension in rural, underserved communities.

From machine learning to deep learning: A comprehensive study of alcohol and drug use disorder

This study aims to train and validate machine learning and deep learning models to identify patients with risky alcohol and drug misuse in a Screening, Brief Intervention, and Referral to Treatment (SBIRT) program. An observational cohort of 6978 adults was admitted in the western region of Alabama at three medical facilities between January and December of 2019. Data were cleaned and pre-processed using data imputation techniques and an augmented sampling data method. The primary analysis involved the multi-class classification of alcohol and drug misuse. Our study shows that accurate identification of alcohol and drug use screening instrument scores was best accomplished with mixed-effects models following the imputation of missing data using the Generative Adversarial Imputation Networks (GAIN) method and then followed by applying the Synthetic Minority Over-sampling TEchnique-Nominal Continuous (SMOTE-NC) data augmentation method. Although mixed models are commonly employed in studies of electronic health records (EHRs), using the GAIN method followed by SMOTE-NC for diagnosing alcohol and drug use disorder is novel and original.

A maximum entropy and GIS approach to predict potential habitat for northern bobwhites in the Black Belt prairie physiographic region of Alabama

Northern bobwhite (Colinus virginianus) populations have sustained precipitous declines throughout their range. The North American Breeding Bird Survey for Alabama indicates a rate of decline of over 6% per year since 1966. Declining bobwhite populations have been associated with large-scale habitat loss and a reduction in habitat quality due to advances in ecological succession, intensive monoculture agriculture, and intensive timber management practices. Once a very diverse region, modern land-use practices throughout the Black Belt Prairie physiographic region have created a simplified landscape that have left few places where bobwhites can live and thrive. Despite extensive research on bobwhites, there is insufficient knowledge on the spatial distribution of bobwhite habitat on a regional scale, including the Black Belt Prairie physiographic region. Knowing the spatial distribution of suitable bobwhite habitat will allow conservation planners to prioritize efforts and direct limited resources to achieve conservation goals for the region. The goals of this study were to 1) evaluate the maximum entropy modeling approach for predicting northern bobwhite habitat in the Black Belt Prairie physiographic region, and 2) develop a northern bobwhite habitat suitability map for the Black Belt Prairie physiographic region. The results showed that deciduous 1.8 km (1.8 km is the dispersal distance of bobwhites) neighborhood was the most important habitat variable, followed by water 1.8 km neighborhood. Developed 1.8 km neighborhood was the most important anthropogenic variable, ranking third in overall importance. The resultant model denotes potential habitat in the region and forms the basis for using the maximum entropy and geographic information system approach to predict suitable habitat and prioritize areas for conservation.

Training and Dissemination of Lung Cancer Education Curriculum Among Community Health Advisors in the Deep South: a Program Evaluation.

Lung cancer is the leading cause of cancer mortality in the USA. In the rural Black Belt region of Alabama, high rates of lung cancer incidence and mortality coupled with disproportionate lack of access to health services stresses the need for navigating high risk and disproportionately affected groups towards successfully obtaining lung cancer screenings. We utilized our well-accepted Community Health Advisor (CHA) model for education and awareness. This study seeks to evaluate the results of the Alabama Lung Cancer Awareness, Screening, and Education (ALCASE) training on CHAs, program evaluation, and lessons learned. A total of 202 participants were eligible and enrolled for CHA training. One hundred thirty CHAs were included for the final analyses. Descriptive statistics were computed; differences in pre-test and post-test scores were compared across demographic characteristics of the participants using paired t-test/one-way ANOVA. Of the 130 CHAs, 46% were 65years or older; 98% were African Americans, and 87% were female; 17% of participants were cancer survivors. The mean post-test scores were 2.2 points greater than mean pre-test scores, and the difference was significant (mean (SD): pre-test = 20.8 (2.8) versus post-test = 23 (2.2); p = 0.001). No notable difference in pre-test and post-test scores were observed by CHA's demographic characteristics except by their county of residence or work (p = 0.0019). We demonstrate the capability and value of successfully recruiting and training motivated community members to be able to serve educators to better reach medically underserved and historically excluded communities.

Within-Field Variability in Nutrients for Site-Specific Agricultural Management in Irrigated Cornfield

HighlightsPhosphorus and nitrogen in soil and plants varied during the growing season across the cornfield.Spatial variability in nutrients caused spatial variability in plant growth and crop yield across the cornfield.Hydrological characteristics and soil hydraulic properties were responsible for spatial variability in nutrients.Need to consider spatial variability in nutrients in delineating management zones before adopting management practices.Abstract. The adoption of precision agricultural practices in Alabama has been increasing in recent years. Although challenging, understanding nutrient variability in agricultural fields is important for site-specific management. This study investigated phosphorus (P) and nitrogen (N) variability in an irrigated cornfield located in the Town Creek Watershed of Tennessee Valley Region of Alabama, USA during the 2019 growing season. Three different irrigation management zones (high yield-HY, moderate yield-MY, and low yield-LY) were delineated based on ten years of historical records of crop yield, soil texture, and measured topography using the Management Zone Analyst (MZA) software. The soil samples at 0 to 15 cm, 15 to 30 cm, and 30 to 60 cm depths were collected five different times during the 2019 growing season. Both manure and inorganic fertilizer were uniformly applied during the growing season. At all soil depths, HY and MY zones had higher soil nutrient concentrations than the field average nutrient concentration. However, the LY zone had below field average soil nutrient concentration in the entire soil profile. The plants (above-ground) in HY and MY zones had higher than average nutrient concentrations and the plants in the LY zone had lower than average nutrient concentrations throughout the cornfield. This site-specific nutrient variation in these zones was due to within-field terrain attributes, differences in soil properties, and surface runoff losses. A significant difference was recorded in the corn yield in the HY and LY zones of the field. Two extreme groups of nutrients were found in the cornfield similar to irrigation management zones (HY and LY). A zone with a higher yield also had higher soil and plant nutrients in the zone (HY), and a zone with a lower yield also had lower soil and plant nutrients in the zone (LY). Incorporating nutrient variability for site-specific management in management zone delineation can help with reducing nutrient application, nutrient loss, and improving yield. This study supports the adopting of precision agricultural management practices based on in-field nutrient variability. Keywords: Corn, Crop yield variability, Irrigation, Management zones, Nitrogen, Nutrient variability, Phosphorus, Site-specific management, Topographical wetness index (TWI).

Discharge and Temperature Controls of Dissolved Organic Matter (DOM) in a Forested Coastal Plain Stream

Streams in the southeastern United States Coastal Plains serve as an essential source of energy and nutrients for important estuarine ecosystems, and dissolved organic matter (DOM) exported from these streams can have profound impacts on the biogeochemical and ecological functions of fluvial networks. Here, we examined hydrological and temperature controls of DOM during low-flow periods from a forested stream located within the Coastal Plain physiographic region of Alabama, USA. We analyzed DOM via combining dissolved organic carbon (DOC) analysis, fluorescence excitation–emission matrix combined with parallel factor analysis (EEM-PARAFAC), and microbial degradation experiments. Four fluorescence components were identified: terrestrial humic-like DOM, microbial humic-like DOM, tyrosine-like DOM, and tryptophan-like DOM. Humic-like DOM accounted for ~70% of total fluorescence, and biodegradation experiments showed that it was less bioreactive than protein-like DOM that accounted for ~30% of total fluorescence. This observation indicates fluorescent DOM (FDOM) was controlled primarily by soil inputs and not substantially influenced by instream production and processing, suggesting that the bulk of FDOM in these streams is transported to downstream environments with limited in situ modification. Linear regression and redundancy analysis models identified that the seasonal variations in DOM were dictated primarily by hydrology and temperature. Overall, high discharge and shallow flow paths led to the enrichment of less-degraded DOM with higher percentages of microbial humic-like and tyrosine-like compounds, whereas high temperatures favored the accumulation of high-aromaticity, high-molecular-weight, terrestrial, humic-like compounds in stream water. The flux of DOC and four fluorescence components was driven primarily by water discharge. Thus, the instantaneous exports of both refractory humic-like DOM and reactive protein-like DOM were higher in wetter seasons (winter and spring). As high temperatures and severe precipitation are projected to become more prominent in the southeastern U.S. due to climate change, our findings have important implications for future changes in the amount, source, and composition of DOM in Coastal Plain streams and the associated impacts on downstream carbon and nutrient supplies and water quality.

Influence of cover crop mixtures on soil health in southeastern crop production systems

AbstractThe restoration of soil health is a crucial step to maximize productivity in historically eroded soils of the southeastern United States. Cover crops have been known to improve soil health over time; therefore, studies were conducted from 2017 to 2019 in the Tennessee Valley (TVREC) and Wiregrass (WREC) Research and Extension Center regions of Alabama to examine the impact of cover crops on dynamic soil health indicators. Treatments including fallow, along with monocultures and combinations of cereal rye (Secale cereale L.), crimson clover (Trifolium incarnatum L.), and Daikon radish (Raphanus sativus L.) were arranged in a randomized complete block design in cotton (Gossypium hirsutum L.)–legume cash crop rotations. Soil health indicators included permanganate oxidizable C (POXC), total C (TC), water stable aggregates (WSA), and soil strength (area under the curve for cone index [AUCCI]). Cover crops did not increase WSA compared with fallow after 2 yr of treatment. At TVREC, POXC in the 10‐to‐15‐cm depth increased 60.6% under crimson clover compared with fallow. At TVREC, TC increased in the top 15 cm of soil after 2 yr of crimson clover, rye–clover, and rye–radish compared with fallow by 14.3, 11.6, and 15.2%, respectively. No differences in AUCCI occurred between treatments in 2018 at either location. In 2019, AUCCI at TVREC was higher under fallow and radish treatments compared with rye and rye–radish, whereas AUCCI at WREC in 2019 was higher under clover‐containing treatments compared with fallow and rye. Overall, some improvements in soil health indicators were observed after 2 yr of cover crop utilization, but long‐term cover crop use may be necessary to observe more consistent soil health changes.

Geographical Residency and Quality of Life in Adults with and without Hearing Loss

There is an increased interest in the impact that hearing loss has on general well-being, including overall quality of life (QOL). The Quality of Life Inventory (QOLI), the Charlson Comorbidity Index and an Accessibility to Health Care questionnaire were administered to 108 participants. For adults with hearing loss who did not have access to hearing health care, lower QOL scores were reported compared to those with access to hearing health care, but this finding was not significant. Effect size calculations indicated that adults with hearing loss who lived in the most rural regions of Alabama, had lower reported QOL scores than their counterparts who had hearing within normal limits. Finally, those with higher incomes, who were older, and who had fewer physical disorders reported higher QOL compared to those with lower incomes, were younger, and who had more physical ailments. Part of a symposium sponsored by the Mental Health Practice and Aging Interest Group.

Behavioral Health and Learner-Centered Outcomes in Geriatric Primary Care or Community Settings

This symposium presents data from interdisciplinary behavioral health training and research conducted in primary geriatrics care or community settings in the Deep South. The first paper describes mixed-method learner-centered outcomes from interprofessional education case sessions. Survey and qualitative data revealed the most important experiential learning derived from collaboration, problem solving, and learning about various disciplines’ professional roles. The second paper presents longitudinal patient cognitive outcome data from the primary care, outpatient geriatrics clinic in which most of these interprofessional learners learn. Results show that only 26.2% of patients had scores indicating cognitive functioning within normal limits; 32.6% had scores indicative of mild neurocognitive disorder, and 41.2% had scores indicative of dementia. Over 30% of patients reported clinically significant levels of depression or anxiety, and 16.5% of patients reported at least one indicator of hazardous alcohol use at their baseline assessment. The third paper demonstrates that psychological inflexibility is associated with depression and anxiety at baseline, and that symptoms of depression and anxiety do not change one year later. The fourth and final paper considers the impact of hearing loss on quality of life in community-dwelling older adults. Effect size calculations indicated that adults with hearing loss who lived in the most rural regions of Alabama, had lower reported QOL scores than their counterparts who had hearing within normal limits This symposium will show why age matters in behavioral health training. Mental Health Practice and Aging Interest Group Sponsored Symposium.

Through space and time: Predicting numbers of an eruptive pine tree pest and its predator under changing climate conditions

Forest biotic populations and communities are undergoing irreversible changes due to climatic perturbations, and these effects may be exacerbated by insect pests. In the southeastern United States (U.S.), Dendroctonus frontalis is one of the most important forest pests that can cause substantial tree mortality over large geographic areas. As life-history of D. frontalis is dependent on environmental conditions, our objective was to determine the effects of climatic variables on the species occurrence of D. frontalis and their main predator, Thanasimus dubius. U.S. Department of Agriculture - Forest Service beetle trapping data (proxy for true abundance) for 2014–2018 were assessed with nine climatic variables including: (1) average monthly minimum, maximum, and mean temperatures; (2) mean winter temperature; (3) minimum, maximum and mean annual temperature; and (4) cumulative winter and annual precipitation. Variable selection was performed using least absolute selection and shrinkage operator (LASSO), and selected variables were fit to varying coefficient generalized additive models (GAMs). Minimum temperatures for February and March and maximum temperatures for January and prior year August were found to have a significant effect on D. frontalis numbers, and model accuracy was ~89%. Beetle suitability was assessed for 1981–2100 under three different shared socioeconomic pathways (SSP). The model indicated that the suitability of D. frontalis has increased from 1981 to 2019 in certain regions of Alabama, Mississippi, and Georgia, while Arkansas, Kentucky, Louisiana, North Carolina, Tennessee, East Texas, and Virginia had low suitability. Future projections indicated comparable D. frontalis numbers to current numbers under the lowest SSP of 2.1 °C by year 2100, but D. frontalis may decrease under higher warming projections. The same climatic predictors influenced T. dubius, except average September maximum temperature replaced August maximum temperatures in the model. Understanding how these abiotic factors influence forest pest populations may better guide prevention and management practices aimed at identifying high risk areas and reducing pest outbreaks.

187 Utilizing Working Groups to Provide Hands-On Learning Opportunities for Experienced Beef Cattle Producers

Abstract The Systems 360° Working Group program was created for experienced beef cattle producers who desired to learn more about timely topics related to beef cattle production than could be covered in a single night meeting. To aid in developing these working groups, the Alabama Extension Animal Science and Forages Team developed curriculum regarding grazing management, watering systems, marketing, handling facilities, and animal management. Regional animal science and forages agents then coordinated planned visits to producer farms and Auburn University research centers that highlighted specific management practices surrounding these topics, and facilitated group discussion at those sites to encourage peer-to-peer learning experiences. A working group consisted of beef cattle producers (n = 10–25 participants per group) sharing a common interest in learning more in-depth about strategies to improve their respective operations. Four working groups were organized in different regions of Alabama and met five times throughout 2018–2019. The closing survey (n = 50 responses) for the working groups indicated that 100% of participants felt this program met expectations, and given the opportunity they would join another working group. Overall, 94% of respondents indicated that they planned to adopt one of more of the management practices discussed in the group in the next 12 months. Top practices that producers planned to implement included improved winter grazing strategies, rotational stocking, water resource management and testing, and facilities design/animal handling. Producers indicated that they learned the most from farm-visits and speakers/discussion leaders as part of the program. Participants reported that knowledge gained from this program could potentially lead to a total farm economic impact averaging $6,095 per operation. These data indicate that Systems Working Groups are an effective means to disseminate knowledge, engage producers in peer-based learning opportunities and improve herd profitability among experienced beef cattle producers.

Implementation of culturally competent and peer-driven counseling to increase breast and cervical cancer screening in the Gulf Coast region of Alabama

Objective: In Alabama, women have been shown to have mortality from breast cancer higher than the U.S. average, and black women are twice as likely as white women to die from cervical cancer. Despite the Alabama Breast and Cervical Cancer Early Detection Program (ABCCEDP) providing free screenings to eligible women, screening rates have remained unchanged in recent years. This project seeks to demonstrate that provision of peer support may address cultural and health literacy needs for cancer prevention education, increase motivation for screening attendance, and improve cancer screening adherence.

Access to Hearing Health Care, Geographical Residency, and Quality of Life in Adults with and without Hearing Loss.

There is an increased interest in the impact that hearing loss has on general well-being, including overall quality of life (QOL), to improve and expand care that is provided to individuals with hearing loss. To evaluate QOL in adults with and without access to hearing health care (HHC). A cross-sectional study examined QOL across groups of individuals with and without hearing loss. One hundred eight participants from West Central and South Alabama received pure-tone hearing evaluations. Thirty-two adults had hearing within normal limits and 76 had at least a mild hearing loss in one ear. The Quality of Life Inventory (QOLI), the Charlson Comorbidity Index, and an Accessibility to Health Care questionnaire were administered to all participants. The QOLI outcomes were used as the dependent variable for the analysis of covariance (ANCOVA) statistical procedures. For adults with hearing loss who did not have access to HHC, lower QOL scores were reported compared with those with access to HHC, but this finding was not significant. Although ANCOVA results did not suggest QOL differences across geographical regions, effect size calculations indicated that adults with hearing loss who lived in the most rural regions of Alabama had lower reported QOL scores than their counterparts who had hearing within normal limits. Finally, those with higher incomes, who were older, and who had fewer physical disorders reported higher QOL than those with lower incomes, who were younger, and who had more physical ailments. Adults with hearing loss who live in regions without access to HHC might be at risk for decreased QOL. A number of models for improving access to HHC will be necessary to decrease this potential risk.

Identifying Promising Messages to Increase Hurricane Mitigation Among Coastal Homeowners in the United States.

Hurricanes threaten the physical and financial well-being of coastal residents throughout the United States. Though hurricane-related losses are largely avoidable through property mitigation (e.g., structural modifications to existing homes), few homeowners invest in mitigation. Communication campaigns, which have influenced risk-related behaviors in other domains, hold promise for persuading coastal residents to engage in hurricane mitigation. The development of successful campaign messages relies, in part, on formative research to assess the potential influence of candidate message strategies. We present results from mixed-methods, theory-driven research to identify promising beliefs for persuading homeowners in coastal/coastal-adjacent regions of Alabama and Florida to install a high wind-resistant (HWR) roof. In Study 1, we elicited homeowners' (n = 74) salient behavioral, normative, and control beliefs about installing an HWR roof. Using established procedures, we content analyzed open-ended responses and categorized them by thematic content. In Study 2, we surveyed another sample of homeowners (n = 533) to examine the extent to which salient beliefs/themes about installing an HWR roof (elicited in Study 1) are promising targets for a communication campaign, given their associations with homeowners' intentions to retrofit. Results demonstrate that across elicited beliefs, common themes include the protection and property resilience reroofing affords, and anticipated expenses and financial barriers associated with reroofing. The most promising beliefs include behavioral beliefs that installing an HWR roof will protect oneself and one's family, and normative beliefs about the likelihood that one's family and community will install an HWR roof. We discuss the implications of findings for the development of hurricane mitigation messaging.