Risk Behavior Assessment Research Articles

Assessing Chilgoza Pine (Pinus gerardiana) forest fire severity: Remote sensing analysis, correlations, and predictive modeling for enhanced management strategies

Forest fires represent a critical global threat to both humans and ecosystems. This study examines the intensity and impacts of Chilgoza (Pinus gerardiana) Pine Forest fires by using advanced remote sensing techniques comprising Normalized Burn Ratio (NBR) and Difference Normalized Burn Ratio (dNBR) analyses based on Landsat 9 datasets. The study highlights the severe effect of these fires, resulting in noteworthy losses of livestock and private properties and widespread damage to 10,156.53 acres of the Chilgoza Pine Forest. A comprehensive variable correlation analysis is conducted to gain deeper insights into the influencing factors causing forest fires. Spearman's Rank Correlation Coefficient was used to assess the association between burnt and unburnt areas and various independent factors. The analysis reveals compelling evidence of significant correlations with forest fire prevalence. This study found moderate negative (-0.532, p < 0.05) and positive (0.513, p < 0.05) correlations with elevation and Land Surface Temperature (LST), respectively, and a weak positive correlation (0.252, p < 0.05) with a Wind Speed (V). To predict forest fire susceptibility and better understand the contributing factors, three machine learning models, Random Forest (RF), XGBoost, and logistic regression, are applied to assess variable importance scores. Among the considered factors, LST is the most critical variable, with consistently high variable importance scores (100 %, 96 %, and 59 %) across all three models. Wind Speed (V) also proved influential in all models, with variable importance scores of 78 %, 83 %, and 61 % for RF, XGBoost, and logistic regression, respectively. Moreover, elevation significantly influences the frequency of forest fires, as evidenced by variable importance scores ranging from 26 % to 100 %. Comparatively, the Random Forest model outperforms XGBoost and Logistic Regression in predicting forest fire vulnerability. During the training stage, the Random Forest (RF) model achieves an impressive classification accuracy of 99.1 %, followed by XGBoost with 94.5 % and Logistic Regression with 85.6 %. On evaluation with the validation dataset, the accuracies remain promising, with RF at 96.4 %, XGBoost at 91.1 %, and Logistic Regression at 84.6 %. Based on the Random Forest model, the identified high-risk sites offer valuable insights for proactive fire management and prevention strategies. This study provides a robust predictive model and a comprehensive understanding of forest fire severity and impacts. Future research should consider climate change scenarios and account for human activities to enhance fire behavior predictions and risk assessment models.

Spatial distribution, environmental behavior, and health risk assessment of PAHs in soils at prototype coking plants in Shanxi, China: Stable carbon isotope and molecular composition analyses

To investigate the environmental behavior of and carcinogenic risk posed by 16 priority-controlled polycyclic aromatic hydrocarbons (PAHs), soil samples and air samples from the coke oven top were collected in two prototype coking plants (named PF and JD). The PF soils contained more PAHs than the JD soils because the PF plant employed the side-charging technique and had a lower coke oven height. The soils from both plants contained enough PAHs to pose a carcinogenic risk, and this risk was higher in the PF plant. Data were collected on the source characteristic spectrum of stable carbon isotopic composition (δ13C) of PAHs emitted from the coke oven top (δ13C values of −36.02‰ to −32.05‰ for gaseous PAHs and −34.09‰ to −25.28‰ for particulate PAHs), and these data fill a research gap and may be referenced for isotopic-technology-based source apportionment. Diagnostic ratios and isotopic technology revealed that the coking plant soils were mainly influenced by the coking process, followed by vehicle exhaust; the soils near the boundary of each plant were slightly affected by C3 plant burning. For most PAHs [excluding fluoranthene, benzo(k)fluoranthene, indeno(1,2,3-c,d)pyrene, and dibenzo(a,h)anthracene], the dominant migration process was the net volatilization of PAHs from soil to air. In the PF plant, 13C was depleted in gaseous PAHs during volatilization.

Integrating visual large language model and reasoning chain for driver behavior analysis and risk assessment

Driver behavior is a critical factor in driving safety, making the development of sophisticated distraction classification methods essential. Our study presents a Distracted Driving Classification (DDC) approach utilizing a visual Large Language Model (LLM), named the Distracted Driving Language Model (DDLM). The DDLM introduces whole-body human pose estimation to isolate and analyze key postural features—head, right hand, and left hand—for precise behavior classification and better interpretability. Recognizing the inherent limitations of LLMs, particularly their lack of logical reasoning abilities, we have integrated a reasoning chain framework within the DDLM, allowing it to generate clear, reasoned explanations for its assessments. Tailored specifically with relevant data, the DDLM demonstrates enhanced performance, providing detailed, context-aware evaluations of driver behaviors and corresponding risk levels. Notably outperforming standard models in both zero-shot and few-shot learning scenarios, as evidenced by tests on the 100-Driver dataset, the DDLM stands out as an advanced tool that promises significant contributions to driving safety by accurately detecting and analyzing driving distractions.

Residue behavior and consumer risk assessment of combination product of betacyfluthrin and imidacloprid on cucumber (Cucumis sativus L.)

Residue behavior and consumer risk assessment of combination product of betacyfluthrin and imidacloprid on cucumber (Cucumis sativus L.)

Understanding the Psychological and Financial Correlates for Consumer Credit Use

This study investigated the behavioural and cognitive predictors of consumer credit usage to develop a behavioural credit risk assessment procedure for a factoring company. Participants completed surveys measuring personality traits, self-esteem, material and monetary values, compulsive and impulsive buying tendencies, self-control, and impulsiveness. Financial surveys also assessed financial literacy and knowledge of financial concepts. The results indicated that extraversion, conscientiousness, emotional stability, and experiential self-control were significant predictors of consumer credit usage. These findings suggest that a finance company can use these personality traits and financial characteristics to develop a more accurate and effective credit risk assessment procedure, such as psychometric tests.

Social networks, secondary syringe exchange, and opioid agonist therapy retention among people who inject drugs in Hartford, CT

BackgroundOpioid agonist therapies (OAT) and harm reduction such as syringe service programs (SSP) have been shown to be effective in preventing adverse outcomes such as overdose deaths, HIV and Hepatitis C infections among people who inject drugs (PWID). The importance of social network influence on disease transmission is well established, yet the interplay between harm reduction and network structures is, generally, not well understood. This study aims to analyze how social networks can mediate the harm reduction effects associated with secondary exchange through syringe service programs (SSP) and opioid agonist therapies (OAT) among injection network members. MethodsSociometric data on networks on people who inject drugs from Hartford, CT, which were collected in 2012–2013, provided assessment of risk behaviors among 1574 injection network members, including participation in OAT and SSP. Subject's network characteristics were examined in relation to retention in OAT, as well as secondary syringe exchange using exponential random graph model (ERGM) and regression. ResultsBased on the analysis, we found that probability of individuals being retained in OAT was positively associated with the OAT retention status of their peers within the network. Using simulations, we found that higher levels of positive correlation of OAT retention among network members can result in reduced risk of transmission of HIV to network partners on OAT. In addition, we found that secondary syringe exchange engagement was associated with higher probability of sharing of paraphernalia and unsterile needles at the network level. ConclusionsUnderstanding how networks mediate risk behaviors is crucial for making progress toward ending the HIV epidemic.

Residue behaviour and health risk assessment of chlorpyrifos and mancozeb in apple fruits and soil.

Mancozeb residue estimation was done using second derivative ultraviolet spectroscopy by Shimadzu ultraviolet-visible spectrophotometer, and chlorpyrifos was estimated by QuEChERS technique using GC-FPD. The persistence for chlorpyrifos was carried out at two locations, and for mancozeb, persistence studies were carried out at four locations. Initial deposits of mancozeb on apple fruits ranged from 1.33 to 1.63mg/kg at the recommended dose and from 2.55 to 3.26mg/kg at double the recommended dose at all four locations. Chlorpyrifos residues in apple fruits had an initial deposit of 0.94-0.99mg/kg at recommended dose and 1.75-1.92mg/kg at double the recommended dose. Mancozeb residues in apple fruit were below the detection limit (BDL) after 20days at recommended dose and after 25days at double the recommended dose at two locations, while mancozeb residue at the other two locations and the residues of chlorpyrifos at all locations reached BDL after 15 and 20days at recommended and double the recommended doses, respectively. Half-life of mancozeb varied from 3.07 to 4.02days at recommended dose and from 3.30 to 4.32days at double the recommended dose, whereas chlorpyrifos residues dissipated to half their initial concentration on 2.33-2.35days at recommended dose and 2.89-2.90days at double the recommended dose. The soil samples showed no presence of residues of chlorpyrifos and mancozeb at harvest. The risk assessment revealed that hazard quotient for the intake of mancozeb was in the range of 0.06-0.13% and 0.20-0.44% for rural and urban population, while for the intake of chlorpyrifos, hazard quotient was in the range of 0.10-0.12% for rural population and 0.33-0.38% for urban population, and theoretical maximum dietary intake (9.67 × 10-5mg/person and 3.18 × 10-4mg/person for rural population and urban population in case of mancozeb and 3.22 × 10-5mg/person and 1.06 × 10-4mg/person for rural population and urban population in case of chlorpyrifos) was also found to be less than maximum permissible intake (1.38mg/kg for mancozeb and 0.60mg/kg for chlorpyrifos). The results of risk assessment thereby indicated that apple consumption does not pose a risk to human health.

Evaluation of an application for the self-assessment of lifestyle behaviour in cardiac patients.

Currently, no uniform, well-validated and comprehensive lifestyle behaviour self-assessment instrument exists for patients with cardiovascular disease. To evaluate the usability of anovel mobile application (LifeStyleScore) based on validated instruments for the assessment of cardiovascular risk behaviours. Secondly, the application's acceptance by healthcare professionals (HCPs) and its association with improved patient activation and lifestyle behaviour was evaluated. In this single-centre, non-randomised observational pilot study, patients with coronary artery disease or atrial fibrillation entering cardiac rehabilitation (CR) completed the LifeStyleScore application, the Patient Activation Measure (PAM-13®), and the System Usability Scale (SUS) during the CR intake and after CR completion. Afocus group interview was performed with the HCPs involved. We analysed 20participants, 3of whom were women, with amean age of 61.9 ± 6.7years. The LifeStyleScore application was rated with aSUS score above average (> 68) before (69.6 ± 13.4) and after CR (68.6 ± 15.1). All HCPs (n = 8) found the application usable. Patient activation did not increase significantly after CR compared with baseline (62.0 ± 8.6 versus 59.2 ± 9.5, respectively, p = 0.28) and only physical activity levels improved significantly (2.4 ± 0.7 (standardised score) at baseline, 2.8 ± 0.4 after CR, p = 0.04). The LifeStyleScore application was found to be usable for patients receiving CR. Its use did not result in increased patient activation, and of the lifestyle behaviours only physical activity levels improved. Further research is needed to evaluate how such applications can be optimally incorporated in CR programmes.

Dissipation behavior and dietary risk assessment of cyclaniliprole and its metabolite in cabbage under field conditions.

Cyclaniliprole, a novel diamide insecticide, can successfully control Spodoptera litura (Fabricius, 1775) in cabbage. Understanding the residual level of cyclaniliprole in crops and the risk related to its dietary intake is imperative for safe application. Here, we established a simplified, sensitive method for simultaneous analysis of cyclaniliprole and its metabolite NK-1375 (3-bromo-2-((2-bromo-4H-pyrazolo[1,5-d]pyrido[3,2-b]-[1,4]oxazin-4-ylidene)amino)-5-chloro-N-(1-cyclopropylethyl)benzamide) in cabbage by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to investigate their dissipation behavior and residual characteristics. Cyclaniliprole showed rapid dissipation in cabbage and had a half-life of 1.8-2.7days. The highest residue of total cyclaniliprole (sum of cyclaniliprole and NK-1375) in cabbage from different pre-harvest intervals (3 and 5days) was 0.25mg/kg. Our results confirmed the generally low dietary risk quotient of cyclaniliprole (0.243-1.036%) among different age and gender groups in China. Therefore, cyclaniliprole did not pose an unacceptable risk to consumers. This study contributes to setting cyclaniliprole maximum residue limit in cabbage by assessing its dissipation fate and food safety risks.

Type of delivery, birthweight, breastfeeding and overweight: the 2019 Italian results

Abstract Introduction According to recent studies, childhood obesity can be affected by type of delivery, birthweight and breastfeeding. The data from the surveillance system OKkio alla SALUTE, coordinated by the Italian National Institute of Health, have been used to investigate this association. OKkio alla SALUTE, promoted by the Italian Ministry of Health, is part of the WHO European Childhood Obesity Surveillance Initiative. Methods The study population are children aged 8 or 9 years in the third grade of all primary schools. A stratified cluster sample design, with class as the sampling unit, was used. Children were weighed and measured by trained local health staff and were classified as overweight or obese using the age and sex-specific International Obesity Task Force cut-offs. Parents of children completed a brief questionnaire to assess risk behavior, including information about the birth and the first few months of life of their child. Results In 2019, the sixth round of data collection involved 47,219 children and 50,370 parents with a response rate higher than 94%. 20.4% (95% CI 19.9-20.9) of 8-9 years old children were overweight and 9.4% (95% CI 9.0-9.7) were obese. The prevalence of obesity has decreased steadily since 2008 to 2019. The prevalence of overweight and obesity was higher for children born by caesarean section (33% vs 27% by vaginal childbirth), increased with birthweight (for birthweight &amp;gt;4,000 kg: 39.4% vs for birthweight&amp;lt;2,500 kg: 25.1%) and among children who had been breastfed never or less than 1 month (33.6% vs breastfeeding 6 months and above: 28.9%). Logistic regression analysis confirms the association between characteristics at birth/breastfeeding and overweight/ obesity. Conclusions Type of delivery, birth weight and breastfeeding seem to play a role in the prevalence of childhood overweight and obesity. Although these results may be affected by recall bias, this is unlikely to materially affect the results. Key messages • Type of delivery, birth weight and breastfeeding seem to play a role in the prevalence of childhood overweight and obesity. • Information on breastfeeding and other characteristics at birth that might be associated with overweight and obesity is essential for tracking progress in countries.

Dissipation Behavior and Dietary Risk Assessment of Thiamethoxam, Pyraclostrobin, and Their Metabolites in Home-Style Pickled Cowpea.

In this study, the fate of two pesticides commonly used on cowpeas, thiamethoxam and pyraclostrobin, during the preparation of home-made pickled cowpeas was investigated using an improved QuEChERS method combined with UHPLC-MS/MS. Although pesticide residues were primarily distributed on cowpea samples, some were transferred to brine. The dissipation half-life of thiamethoxam on cowpea samples was significantly shorter than that of pyraclostrobin due to thiamethoxam's higher water solubility. Thiamethoxam demonstrated a half-life of 5.12 ± 0.66 days, whereas pyraclostrobin exhibited a longer half-life of 71.46 ± 7.87 days. In addition, the degradation half-lives of these two pesticides in the whole system (cowpea and brine) were 45.01 ± 4.99 and 70.51 ± 5.91 days, respectively. This result indicates that the pickling did not effectively promote the degradation of thiamethoxam and pyraclostrobin. The metabolite clothianidin of thiamethoxam was not produced throughout the pickling process, but the metabolite BF 500-3 of pyraclostrobin was detected in cowpea samples. The detection rates for thiamethoxam, pyraclostrobin, and BF 500-3 in the 20 market samples were 10%, 70%, and 45%, respectively. However, the risk quotient analysis indicated that the risk of dietary intake of thiamethoxam and pyraclostrobin in pickled cowpeas by Chinese consumers was negligible.

Dissipation Behavior and Dietary Risk Assessment of Abamectin, Pyraclostrobin and Boscalid in Apple Fruit.

Dissipation Behavior and Dietary Risk Assessment of Abamectin, Pyraclostrobin and Boscalid in Apple Fruit.

Residual behavior and dietary risk assessment of albendazole as fungicide in citrus orchards.

Albendazole is a broad-spectrum fungicide that shows great potential in controlling fungal diseases in citrus. To quantify the dissipation behavior, residue distribution, and dietary risk of albendazole in citrus, we developed an UPLC-MS/MS analysis protocol. The average recovery rate of albendazole in whole citrus and citrus pulp ranged from 74 to 105% with an RSD of 3 to 8%, and a limit of quantification of 0.01mgkg-1. The degradation half-lives were 2.8-3.0 and 5.7-17.0days in whole citrus and citrus pulp, respectively, and the final residues of albendazole were <0.059mgkg-1 with a risk quotient of <1. This study not only demonstrates that the dietary risk of albendazole in citrus is negligible, but also provides empirical data to establish the maximum residual limit (MRL) for the safe application of albendazole in citrus orchards to meet the requirements for food safety as well as international trade.

A mixed methods exploration of injection drug use risk behaviors and place-based norms in Ukraine

IntroductionDespite global reductions in HIV incidence and significant investment in local harm reduction services, Ukraine continues to experience high HIV and HCV prevalence among people who inject drugs (PWID). Place-based factors and social norms affect drug use–related risk factors, but research has paid little attention to the relationship between drug use practices and place in Ukraine, including how these factors may contribute to or protect against HIV/HCV risk. MethodsThis project used a sequential mixed methods design. Between March and August 2018, we interviewed 30 PWID in Dnipro, Ukraine. Participants completed a single in-depth interview in which they described where and with whom they lived; how they generated income; and where, when, how, and with whom they purchased and used drugs. Between May 2019 and March 2020, we recruited 150 PWID in Dnipro to complete a survey that was designed based on interview findings and consisted of three components: an activity space inventory, an egocentric social network inventory, and an HIV risk behavior assessment. ResultsBoth interview and survey respondents reported consistent use of pharmacies to acquire syringes and nearly universal use of new syringes when injecting. Interview participants reflected that while syringe sharing was previously considered a “common practice,” PWID now viewed it as infrequent and unacceptable. However, interview respondents enumerated the contexts in which needle and syringe reuse occurred, including purchasing drugs directly from a dealer and chipping in with other PWID to prepare drugs bought through a stash. ConclusionParticipants described relatively easy access to new needles and syringes through pharmacies and expressed strong social sanctioning against reusing needles or syringes. However, equipment sharing behaviors and norms persisted in certain contexts, creating an opportunity for further harm reduction campaigns that incorporate changing norms in these situations to “close the gap” and further reduce HIV and other infections among PWID.

Influence of mental health on information seeking, risk perception and mask wearing self-efficacy during the early months of the COVID-19 pandemic: a longitudinal panel study across 6 U.S. States

BackgroundUnderstanding factors that influence information seeking, assessment of risk and mitigation behaviors is critical during a public health crises. This longitudinal study examined the influence of self-reported mental health during the early months of the COVID-19 pandemic on information seeking, risk perception and perceived mask wearing ability. Mental health screener items included fear, anger, and hopelessness in addition to avoidance, diminished functional ability and global distress. Theoretical models inform hypotheses linking mental health items and outcomes.MethodsThe research employed a longitudinal 6-state 3-wave online panel survey, with an initial sample of 3,059 participants (2,232 included in longitudinal analyses). Participants roughly represented the states’ age, race, ethnicity, and income demographics.ResultsWomen, those who identified as Hispanic/Latinx, Black Americans and lower income participants reported higher overall rates of distress than others. Information seeking was more common among older persons, Democrats, retirees, those with higher education, and those who knew people who had died of COVID-19. Controlling for such demographic variables, in multivariable longitudinal models that included baseline mental health measures, distress and fear were associated with increased information seeking. Distress and fear were also associated with increased risk perception, and feelings of hopelessness were associated with lower reported mask-wearing ability.ConclusionsResults advance understanding of the role mental health can play in information seeking, risk perception and mask wearing with implications for clinicians, public health practitioners and policy makers.

A Study to Assess Risk Behavior and Attitude towards Trauma Prevention among Urban and Rural Adolescents in Selected Area of Surat

A Study to Assess Risk Behavior and Attitude towards Trauma Prevention among Urban and Rural Adolescents in Selected Area of Surat

Health and Wellness Coaching and Sustained Gains: A Rapid Systematic Review.

The Transtheoretical Model of Change identifies key stages in behavior change, including a maintenance stage occurring when a behavior has been upheld for at least 6months. Health and wellness coaching has demonstrated support for health behavior change, but maintenance of gains has received little attention. Our rapid systematic literature review characterizes both the research exploring sustained gains with health and wellness coaching and what is known about sustained gains after the completion of a health and wellness coaching engagement. Guided by The Cochrane Rapid Reviews Methods Group "Interim Guidance," we drew 231 studies from the 2018 and 2020 Sforzo et al "Compendium of the health and wellness coaching literature," and "Addendum…" appendices. Initial screening and coding for inclusion and exclusion criteria yielded 28 studies for data extraction. We examined studies across outcome categories (physiological, behavioral, psychological, and health risk assessment) to determine whether outcome measures were: not sustained; partially sustained; fully sustained; or improved from immediate post-intervention to a later follow-up period. Twenty-five of the 28 studies reviewed demonstrated partially, or fully, sustained or improved outcomes in one or more variables studied, with sustained gains demonstrated across outcome categories, strengthening confidence in HWC as a facilitator of lasting change.

Short- and medium-chain chlorinated paraffins in agricultural and industrial soils from Shanghai, China: surface and vertical distribution, penetration behavior, and health risk assessment.

The widespread contamination of chlorinated paraffins (CPs) of the soil environment has raised global concern due to their highly persistent and toxic properties. However, little information is available regarding these industrial toxicants' spatial-vertical distribution and penetration potentials. In this study, short- and medium-chain chlorinated paraffins (SCCPs and MCCPs, respectively) were analyzed in pooled surface and core soils (0-45cm) samples collected from agricultural and industrial areas in Shanghai. ∑SCCP concentrations in agricultural and industrial surface soils ranged from 52.6 to 237.6 and 98.3 to 977.1ng/g dry weight (dw), respectively. ∑MCCP levels were comparatively higher and ranged from 417.2 to 1690.8 and 370.9 to 10,712.7ng/g dw in agricultural and industrial soils, respectively. C10Cl5-10 SCCPs and C14-15Cl5-7 MCCPs were the predominant homologues in all samples. Analysis of the soil vertical profiles revealed that MCCP concentrations decreased significantly with depth (P < 0.01). SCCPs more efficiently penetrated into thesoils than MCCPs because of their higher water solubility and less octanol-water partition coefficient (Kow) values. A preliminary risk assessment suggested no potential health risks caused by non-dietary exposure. The daily exposure doses of CPs via ingestion were significantly (P < 0.01) higher for children (5.41 ± 2.11 × 10-3 and 1.68 ± 1.03 × 10-2μgkg-1day-1) and adults (2.56 ± 0.99 × 10-4 and 7.94 ± 4.87 × 10-4μgkg-1day-1) than dermal permeation exposure. Furthermore, CPs at current levels posed low ecological risks (0.1 ≤ RQ < 1) according to the risk quotient model. This study enhanced our understanding of the fates and behaviors of CPs in the terrestrial environment.

Fungicide Dissipation Kinetics and Dietary Exposure Risk Assessment in Squash Fruit and Leaf.

The dissipation behavior and dietary exposure risk assessment of four fungicides (dimethomorph, mandipropamid, myclobutanil, and metalaxyl) was performed in fruits and leaves of squash grown under greenhouse conditions. Squash fruit and leaf samples were randomly collected at 0, 3, 5, 7, and 14 days after the last pesticide application. Analysis was performed using ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS). The quick, easy, cheap, effective, rugged, and safe (QuEChERS) method was used for sample preparation. Recovery rates at two spiked levels (0.01 and 0.1 mg/kg) were found to be in the range of 76.4%-101.9% for the analyzed pesticides and their relative standard deviations were ≤4%. Pesticide half-lives were 2.1 and 4.9 days for dimethomorph, 4.6 and 8.1 days for mandipropamid, 4.7 and 8.2 days for myclobutanil, and 2.7 and 5 days for metalaxyl in squash fruit and leaf, respectively. Regarding the total surveyors, hazard quotient values for squash fruit and leaf were ≤1.03 × 10-3 and ≤2.39 × 10-3, respectively. These values in the case of true consumers were ≤3.14 × 10-3 and ≤3.91 × 10-1, respectively.

Barriers to and strategies for early implementation of pharmacy-delivered HIV PrEP services in Kenya: An analysis of routine data.

For individuals who face challenges accessing clinic-based HIV pre-exposure prophylaxis (PrEP), differentiated service delivery models are needed to expand access and reach. During a pilot study testing a novel pharmacy-delivered oral PrEP model in Kenya, we used routine programmatic data to identify early implementation barriers and actions that providers and study staff took in response to the barriers. We trained pharmacy providers at five private pharmacies in Kisumu and Kiambu Counties to initiate and continue clients at risk of HIV acquisition on PrEP for a fee of 300 KES per visit (∼$3 USD) using a prescribing checklist with remote clinician oversight. Research assistants stationed at the pharmacies completed weekly observation reports of pharmacy-delivered PrEP services using a structured template. We analyzed reports from the first 6 month of implementation using content analysis and identified multi-level early implementation barriers and actions taken to address these. We then organized the identified barriers and actions according to the Consolidated Framework for Implementation Research (CFIR). From November 2020 to May 2021, research assistants completed 74 observation reports (∼18/pharmacy). During this period, pharmacy providers screened 496 potential PrEP clients, identified 425 as eligible for pharmacy-delivered PrEP services, and initiated 230 (54%) on PrEP; 125 of 197 (63%) clients eligible for PrEP continuation refilled PrEP. We identified the following early implementation barriers to pharmacy-delivered PrEP services (by CFIR domain): high costs to clients (intervention characteristics), client discomfort discussing sexual behaviors and HIV testing with providers (outer setting), provider frustrations that PrEP delivery was time-consuming and disruptive to their workflow (inner setting), and provider hesitancy to deliver PrEP due to concerns about encouraging sexual promiscuity (characteristics of individuals). To help address these, pharmacy providers implemented a self-screening option for behavioral HIV risk assessment for prospective PrEP clients, allowed flexible appointment scheduling, and conducted pharmacy PrEP trainings for newly hired staff. Our study provides insight into early barriers to implementing pharmacy-delivered PrEP services in Kenya and potential actions to mitigate these barriers. It also demonstrates how routine programmatic data can be used to understand the early implementation process.