Risk Information Research Articles

What does it mean to “do your own research?” A comparative content analysis of DYOR messages in Instagram and Facebook posts about reproductive health, food, and vaccines

Calls to “do your own research” (DYOR) on social media promote a range of claims, from expert-recommended treatments to conspiracy theories. Exploring how the slogan is used offers insight into how individuals navigate concerns about information accuracy in an abundant but low-trust media ecosystem. This quantitative content analysis investigates how DYOR messages in Facebook and Instagram posts about reproductive health, food and diet, and vaccination are used to raise alarms, promote personal agency, and disclaim responsibility. We additionally examine how DYOR messages are associated with content including risk information and product promotion. While DYOR messages sometimes raise alarms about suspected conspiracies and misinformation, more often they advocate for personal agency and education, encouraging people to become as informed as possible to make the best decisions for themselves. In this way, DYOR messages promote individual responsibility for navigating information risks and reflect wider concerns about (mis-)information and distrust of institutions.

A systematic review of strategies for enhancing pharmaceutical supply chain resilience in the U.S

This review aims to explore strategies for enhancing pharmaceutical supply chain resilience in the United States by addressing vulnerabilities exposed by recent global events, including the COVID-19 pandemic. The study identifies and analyzes eight key strategies: supplier diversification, increased inventory and safety stock, adoption of advanced technologies, improved forecasting and demand planning, vertical integration, reshoring and nearshoring, contingency planning and risk management, and collaboration and information sharing. Drawing on these strategies in the context of the United States, the review examines the advantages and potential challenges associated with them. The implementation of strategies such as supplier diversification and the adoption of advanced technologies shows positive effects, but these approaches require significant resources and face policy restrictions. This paper also analyzes the policy and industry implications of these strategies, emphasizing the need for collaboration between the government and industry. Various policy implications include the need to encourage supplier diversification, support for strategic stocking, and funding for technology implementation. For the industry, there is a need for operational adjustments such as redesigning supply chain networks with emphasis on enhancing risk management practices. Although implementing these strategies presents certain complexities, they hold great promise for improving the overall resilience of the US pharmaceutical supply systems and should be further explored in the future. Keywords: Supply Chain, Risk Management, Industry Disruption, Inventory Management, Blockchain Technology

AI at everyone’s fingertips? Identifying the predictors of health information seeking intentions using AI

ABSTRACT The advent of AI tools has the potential to transform how health information is sought, which increases the need for insights into why individuals turn to AI. The study, guided by channel-specific predictors covered by the Planned Risk Information Seeking Model, additionally considers trust and risk perceptions toward AI, and examines the predictors of one’s AI-seeking intention. The results of an online survey (N = 1,121) indicated that attitudes toward seeking, seeking-related norms, and perceived seeking control were significant predictors of individuals’ intention to seek health information from AI. In contrast, trust and risk perceptions were of minor relevance.

Molecular measurable residual disease monitoring and transplant indications in NPM1 mutated acute myeloid leukemia.

NPM1 mutated acute myeloid leukemia (AML) comprises roughly 30% of all AML cases and is mainly classified as favorable or intermediate-risk according to the European Leukemia Net stratification. Some patients, however, either have a poor response to initial intensive chemotherapy or ultimately relapse. NPM1 mutations are common, generally stable at early relapse and AML specific, features which make them ideal targets for measurable residual disease (MRD) monitoring. MRD monitoring via molecular analysis during the course of treatment can inform the role of allogeneic stem cell transplantation (HCT) in first remission in patients with NPM1 mutated AML with high-risk co-occurring mutations, particularly FLT3-ITD, and in favorable risk patients who do not achieve defined molecular milestones. In this review, we evaluate the prognostic role of MRD monitoring in NPM1 mutated AML and its use as a predictive biomarker to refine risk stratification and inform decision making regarding treatment. We explore the impact of pre-HCT MRD positivity on post-HCT outcomes in this AML subset, and how HCT-related factors such as conditioning intensity may influence this risk.

A decade of shaking in the Garden City: the dynamics of preparedness, perceptions, and beliefs in Canterbury, New Zealand, and implications for earthquake information

IntroductionThis study explored earthquake preparedness over time—before, during, and 10 years after the Canterbury Earthquake Sequence (CES) in New Zealand (NZ; known as Aotearoa in te ao Māori).MethodSurveys of Canterbury residents were conducted in 2009, 2013, and 2021, using variables derived from Community Engagement Theory (CET). The surveys measured earthquake perceptions and beliefs, participation and engagement, and preparedness actions. Results were compared across the three samples.ResultsFindings indicate that perceptions and beliefs (e.g., risk perception, outcome expectancy beliefs), and types of preparedness actions taken (e.g., collection of survival items, structural preparedness, community and/or agency relationships), differed over time, depending on people's experiences before, during, and after the CES. For example, during and after the CES, people were more likely to believe that preparing provided a benefit to daily life, but less likely to think it could reduce property damage, perhaps due to people's experiences of disruption and damage during the earthquakes.DiscussionAn understanding of such dynamics can assist with the provision and timing of risk and preparedness information. This study highlights the importance of providing applicable and actionable preparedness information, that is relevant to people's experiences, throughout an earthquake sequence. Such information might evolve and change in focus over time depending on risks and needs. Focus could also be given to information that builds peoples beliefs and capacities to undertake preparedness in evolving situations. Understanding preparedness in the context of different experiences and timeframes is useful in helping update models such as the CET, where the dynamics of time might be better incorporated.

Communicating health risk in chronic kidney disease: a scoping review.

Communicating risk is a key component of shared decision-making and is vital for the management of advanced chronic kidney disease (CKD). Despite this, there is little evidence to suggest how best to communicate health risk information to people living with CKD. The aim of this review was to identify and understand the nature of evidence-based risk communication strategies for people living with CKD. We searched MEDLINE, CINAHL and Scopus databases for articles which described or evaluated the use of risk communication strategies within the renal population. Similar risk communication strategies were collated and summarised narratively. A total of 3700 sources were retrieved from the search, of which 19 were included in the review. Eleven studies reported primary research, and eight reported either narrative or systematic reviews. Seven main risk communication strategies were identified: framing, absolute versus relative risk, natural frequencies versus percentages, personalised risk estimates, qualitative risk communication, best-case/worst-case framework and use of graphs and graphics. There was a paucity of risk communication strategies specific to the CKD population. Evidence-based strategies to improve health risk communication for patients living with CKD are lacking. There is a need to establish the informational and communication preferences for patients living with CKD to better understand how to best communicate health risk information to individuals in this population.

Recurrent Hospitalizations for Fluid Overload in Diabetes with Kidney Failure Treated with Dialysis.

Background & Aims Diabetes Mellitus is the most common cause of end-stage kidney disease (ESKD) in Singapore. ESKD patients have high disease burden and are at increased risk of recurrent hospitalizations, including fluid overload. This study aimed to characterize the risk factors associated with readmissions for fluid overload that will identify high-risk hospitalizations for interventions to reduce readmissions. Methods Retrospective cohort study of all hospitalizations for fluid overload in adults with diabetes and ESKD on dialysis in SingHealth hospitals between 2018 and 2021. Fluid overload was defined by discharge codes for fluid overload, heart failure, pulmonary edema, and generalized edema until 30th December 2022. Multivariable Cox regression analysis using the Prentice, Williams and Peterson Total Time (PWP-TT) model was performed for the outcomes of readmissions for fluid overload within 30 days and 90 days of discharge. Results Among 3234 hospitalizations for fluid overload, readmission for fluid overload within 30-day and 90-day occurred in 585 (18.1%) and 967 (29.9%) hospitalizations, respectively. Ischemic heart disease, peripheral vascular disease and lower hemoglobin level were independently associated with readmissions for fluid overload within 30 and 90 days. Additionally, heart failure, hemodialysis (compared to peritoneal dialysis) and lack of statin at discharge were associated with increased 90-day readmission risk. Conclusion Modifiable (hemoglobin level, statin use) and non-modifiable factors (ischemic heart disease, peripheral vascular disease and heart failure) influenced the risk of readmission for fluid overload. These results may guide risk stratification and inform targeted interventions to reduce avoidable, unplanned readmissions for recurrent fluid overload among individuals with diabetes and ESKD.

Codesigning a Digital Type 2 Diabetes Risk Communication Tool in Singapore: Qualitative Participatory Action Research Approach.

Diabetes is a serious public health concern worldwide. Despite public health efforts encouraging early screening and improving knowledge of effective interventions for those at increased risk of type 2 diabetes (T2D), the incorporation of preventative behaviors into an individual's daily life remains suboptimal. Successfully and accurately increasing risk perception has been demonstrated to increase behavioral intention. The study aims to codesign a T2D risk communication tool by engaging public participants to (1) identify key characteristics that contribute to an effective risk communication tool and (2) test and iterate to develop a culturally sensitive and meaningful risk communication tool that can motivate T2D preventative behaviors. We adopted a novel methodology, "Patient and Public Involvement (PPI) Hawkers," where we approached patrons at hawker centers and public eateries frequented by all local residents to evaluate and test 3 prototypes for the tool. The three prototypes were (1) "Diabetes Onset"-estimated age of diabetes onset of T2D based on one's risk factors, (2) "Relative Risk"-the relative risk of T2D is presented in a 1-10 scale indicating where one's risk score lie in relation to others, and (3) "Metabolic Age"-the median age of the risk category based on one's risk factors, presented to be compared against their chronological age. We gathered reactions and feedback through rapid testing and iteration to understand which risk result presentation would be received the best. All the collected data were revisited and analyzed using an inductive thematic analysis to identify the key characteristics contributing to an effective risk communication tool. We engaged with 112 participants (female: n=59, 56%) across 6 hawker centers. The key characteristics that were important to participants emerged in four main themes: (1) appeal and user experience, in terms of format and readability; (2) trust and validity of the institution providing the tool and the accuracy of the risk result; (3) threat appraisal: salience of risk information, which influenced their risk perception; and (4) coping appraisal: facilitators for behavior change, which impacted their intention for implementing T2D preventative behaviors. The predictive nature of the prototype entitled "Diabetes Onset" was poorly received and removed after the first iteration. The Relative Risk prototype was valued for being straightforward but feared to be boring. The Metabolic Age prototype was anticipated to be more motivating for behavior change, but there were some concerns that the terminology may not be understood by everyone. Participants were divided on which of the 2 prototypes, "Metabolic Age" or "Relative Risk," they would favor adopting. Further testing is now required to determine which prototype will be more effective in motivating behavior change. This study's insights on the design process and valued characteristics of a risk communication tool will inform future development of such interventions.

Impact of Genetic Risk Information for Cardiovascular Disease on Behavioural, Psychological Responses, and Risk Factor Modification: A Systematic Review.

Cardiovascular disease (CVD) remains a significant public health concern, influenced by both genetic susceptibility and lifestyle factors. Integrating genetic risk information into clinical practice shows promise but has yielded mixed results regarding its impact on CVD prevention and management. This systematic review aimed to assess the impact of providing genetic CVD risk information on health behaviours, psychological outcomes, and risk factors. Following JBI methodology and PRISMA 2020 guidelines, four electronic databases and two trial registries were searched for randomised controlled trials evaluating the impact of genetic risk information on the CVD risk profile. Data was synthesised using a narrative synthesis approach. Of the 3,596 articles retrieved, 11 studies were eligible. Genetic risk information showed modest improvements in dietary behaviour but had inconclusive effects on physical activity and medication adherence. Minimal changes in psychological outcomes were noted, including a slight decrease in depression. The impact on traditional risk factors, such as systolic blood pressure and total cholesterol was also limited. Bias across all studies was noted. Genetic CVD risk information has limited effects on clinical outcomes and psychological factors, despite its potential to encourage some health behaviour changes. These findings suggest that genetic risk information alone may not be sufficient to significantly reduce cardiovascular risk, highlighting the need for further research to better understand its long-term effects.

Confucian Culture, Climate Risk, and Corporate Environmental Information Disclosure Quality: Evidence from China

Confucian Culture, Climate Risk, and Corporate Environmental Information Disclosure Quality: Evidence from China

Effects of risk information on pedestrian evacuation during fire emergencies: Virtual experiments and survey

In fire emergencies, pedestrians often face uncertainty about the safety of evacuation routes due to a lack of risk information, which makes the emergency evacuation highly challenging. Although risk information is crucial for effective evacuation, the effect of varying levels of risk information on fire evacuation remains insufficiently explored. This study aims to address this gap by investigating the influence of different levels of risk information on pedestrian evacuation through virtual experiments and survey. We conducted a series of multiplayer fire evacuation experiments in Minecraft. The risk information provided to pedestrians before evacuation was controlled at three levels: no risk information, partial risk information, and complete risk information, by giving different risk information cues. The results of experiments indicated that risk information can improve pedestrian evacuation efficiency during fire emergencies, while more complete risk information can further improve pedestrian evacuation efficiency. Additionally, an information transfer phenomenon was observed during fire evacuations, in which pedestrians adjusted their behaviour based on perceived fire, leading others to avoid the fire in advance. The analysis of pedestrian behaviour revealed that pedestrians did not exhibit imitative behaviour in evacuation direction choices during fire emergencies. Pedestrian route choices were significantly influenced by the initial distance of pedestrians relative to the exits. Moreover, complete risk information cues did not significantly influence pedestrians’ route choices compared with partial risk information cues. A post-experimental survey was conducted to assess pedestrians’ route choice preferences under different risk information cue scenarios. The results showed that pedestrians preferred the nearest route.

The risk information and skin-cancer education for undergraduate prevention (RISE-UP) study: Protocol for a trial of personalized sun protection interventions for skin cancer prevention among undergraduate students

BackgroundAddressing the increasing incidence of skin cancer among young adults is a priority. The objective of the Risk Information and Skin-cancer Education for Undergraduate Prevention (RISE-UP) study is to identify personalized intervention components to prevent sunburn, a clinically significant outcome highly associated with skin cancer, in college students. MethodsGuided by the Elaboration Likelihood Model, the study will use Multiphase Optimization Strategy (MOST) methodology to test three intervention components (ultraviolet photography, MC1R genetic testing, and action planning) each with two levels (yes v. no) in a full-factorial experiment to evaluate unique and combined effects of these components to improve outcomes over the longer-term, with seasonally timed follow-up. At-risk University of Utah students (N = 528) will be recruited. Eligibility criteria include self-reported sunburn or tanning in the past year, or not utilizing recommended sun protection. After baseline assessment, participants will be randomized to intervention group, stratified by sex. Assessments will be completed at (1) Baseline; (2) Intervention; (3) 1 month after intervention; (4) 4 months after intervention (the end of the first summer); and (5) 15 months after intervention (the end of the second summer). The primary outcome will be participants' self-reported number of sunburns. Secondary outcomes will include self-reported sun protection and tanning behaviors and, in a randomly selected subgroup, an objective measure of ultraviolet radiation (UVR) exposure. ConclusionThe RISE-UP study will determine the efficacy of different combinations of personalized skin cancer preventative interventions for young adults and determine the optimal combination of intervention components to prevent skin cancer.Clinical Trial Registration:NCT05634252

Satellite-Derived, Smartphone-Delivered Geospatial Cholera Risk Information for Vulnerable Populations.

Cholera, an acute waterborne diarrheal disease, remains a major global health challenge. Despite being curable and preventable, it can be fatal if left untreated, especially for children. Bangladesh, a cholera-endemic country with a high disease burden, experiences two peaks annually, during the dry pre-monsoon spring and the wet post-monsoon fall seasons. An early warning system for disseminating cholera risk, which has potential to reduce the disease burden, currently does not exist in Bangladesh. Such systems can raise timely awareness and allow households in rural, riverine areas like Matlab to make behavioral adjustments with water usage and around water resources to reduce contracting and transmitting cholera. Current dissemination approaches typically target local government and public health organizations; however, the vulnerable rural populations largely remain outside the information chain. Here, we develop and evaluate the accuracy of an early warning system-CholeraMap that uses high-resolution earth observations to forecast cholera risk and disseminate geocoded risk maps directly to Matlab's population via a mobile smartphone application. Instead of relying on difficult to obtain station-based environmental and hydroclimatological data, this study offers a new opportunity to use remote sensing data sets for designing and operating a disease early warning system. CholeraMap delivers monthly, color-coded geospatial maps (1km×1km spatial resolution) with household and community cholera risk information. Our results demonstrate that the satellite-derived local-scale risk model satisfactorily captured the seasonal cholera pattern for the Matlab region, and a detailed high-resolution picture of the spatial progression of at-risk areas during outbreak months.

Factors affecting the effectiveness of internal control systems in small and medium enterprises operating in the trade and service sector in Binh Duong Province

This study aims to identify the factors affecting the effectiveness of internal control systems (ICS) in small and medium-sized enterprises (SMEs) operating in the trade and service sector in Binh Duong Province, Vietnam. The key factors examined include risk assessment, control environment, information and communication, control activities, and monitoring. The survey of 155 samples and multivariate regression analysis indicate that four main factors influence ICS effectiveness: risk assessment, control environment, control activities, and monitoring, with the control environment being the most impactful. Based on these findings, the study proposes management implications to enhance ICS for SMEs, including the development and implementation of appropriate ICS systems. This contributes to improved management efficiency and aids SMEs in achieving their operational, reporting, and compliance objectives. Keywords: Internal Control Systems, Trade Enterprises, Effectiveness, And Binh Duong

The physician-AI relationship: partnering for precision medicine via clinical decision support

Abstract Background Clinical decision support systems (CDSSs) can enhance physician decision-making, but successful adoption depends on positive user attitudes. Understanding Israeli physicians’ attitudes toward CDSSs is crucial for overcoming implementation barriers and refining training. Methods Semi-structured interviews explored knowledge, experiences, perceived benefits/drawbacks, and potential barriers/facilitators to CDSS use among 25 Israeli physicians across specialties, roles, settings, and experience levels selected via stratified sampling. Individual 45-minute video interviews were conducted in January-July 2023. Results Familiarity and CDSS experience varied substantially across medical specialties. While risk calculators, information systems, and expert systems disseminating contemporary research insights are widespread, AI-based system adoption is relatively low outside radiology. Physicians expressed positive attitudes, recognizing CDSSs’ potential to enhance clinical work, reduce errors, and alleviate burdens. However, concerns included AI systems’ impact on workload, patient relationships, skill erosion, and overreliance. Key implementation barriers involved technological infrastructure, organizational processes, physician perceptions, and system features. Facilitating factors included tailored design, focused training, continuous accuracy/reliability validation, and clear autonomy/liability guidelines. Conclusions Addressing key concerns around transparency, trustworthiness and responsible use is crucial for AI-CDSS to fulfill its promise of enhancing quality and outcomes. Insights from Israeli clinicians provide guidance on priorities like transparency of data and algorithms as well as ensuring AI behaves ethically. Collaboration among technology designers, healthcare professionals and stakeholders can help develop systems that physicians trust to improve care while safeguarding patients. Ongoing evaluation is also needed to optimize AI-CDSS over time. Key messages • Understanding physician attitudes is key to overcoming barriers to clinical decision support system adoption and optimizing training protocols. • Addressing transparency, trustworthiness, and ethical considerations around AI clinical decision support systems is crucial for enhancing quality care.

Associations between diabesity and mortality over 7 years: a Maltese population-level case study

Abstract Introduction Diabesity presents a growing global epidemic. Demographic and socioeconomic associations have been documented, yet, the literature on mortality risk associated with diabesity is scarce. The aim of this study was to assess whether diabetes and/or diabesity increas the risk of all-cause mortality across a period of 7 years at a population level. Methods A nation-wide health examination survey in Malta was conducted between 2014 and 2016. This collected sociodemographic information, bio-anthropometric measurements (waist circumference, body mass index [BMI], body adiposity index [BAI]) and blood samples. Mortality information was acquired in 2021 by cross-referencing with the national mortality register. Statistical analysis was conducted using chi-square tests and Cox proportional hazard models. Results A mortality rate of 1.67% was observed (n = 3947), with diabetes and obesity being responsible for 6.06% and 3.03% of deaths, respectively. Examining the deceased individuals alongside their baseline characteristics (2014-2015) revealed that 25.76% (CI95%: 16.75 - 37.44) had diabetes, and 30.30% (CI95%: 20.55 - 42.22) were obese. Diabetes was associated with significant mortality risk (HR: 2.65 CI95%: 1.20 - 5.85; p = 0.02), while diabesity showed borderline significance (p = 0.06). After adjustment for potential confounding factors the mortality risk linked to diabetes remained significant and BAI was the only anthropometric measurement positively associated with mortality. Conclusions These findings emphasise the urgency for comprehensive public health policies targeting the concurrent prevention and management of diabetes and obesity at a population level. Our results also indicate that incorporating body adiposity index (BAI) into risk assessment protocols may provide valuable insights into mortality risk prediction and inform tailored interventions. Key messages • Diabetes and a high BAI score were significantly associated with mortality in the Maltese population, while diabesity had moderate significance, emphasising the urgency of tackling this epidemic. • These findings call for broad health policies to address diabesity at a population level and suggest integrating BAI into risk assessment for better mortality prediction and tailored interventions.

Is pulmonary vascular remodeling an intermediate link between hyperglycemia and adverse outcomes in patients with idiopathic pulmonary arterial hypertension? Insights from a multi-center cohort study

BackgroundHyperglycemia upon admission is associated with poor prognosis of many cardiovascular diseases. However, the relationship of stress hyperglycemia ratio (SHR), admission blood glucose (ABG), and hemoglobin A1c (HbA1c) with pulmonary hypertension has not been reported. This study aimed to explore the association of hyperglycemia indices with disease severity and long-term adverse outcomes in patients with idiopathic pulmonary arterial hypertension (IPAH).MethodsThis multi-center cohort study included 625 consecutive patients diagnosed with or treated for IPAH between January 2015 and June 2023. SHR was calculated using the followings: ABG (mmol/L)/(1.59 × HbA1c [%] − 2.59). The primary endpoint was defined as clinical worsening events. Multivariable Cox regression and restricted cubic spline analyses were employed to evaluate the association of SHR, ABG, and HbA1c with endpoint events. The mediating effect of pulmonary hemodynamics was evaluated to investigate the potential mechanism between hyperglycemia and clinical outcomes.ResultsDuring a mean follow-up period of 3.8 years, 219 (35.0%) patients experienced all-cause death or clinical worsening events. Hyperglycemia indices correlated with well-validated variables that reflected the severity of IPAH, such as the World Health Organization functional class, 6-min walk distance, and N-terminal pro-brain natriuretic peptide levels. Multivariable Cox regression analyses indicated that SHR (hazard ratio [HR] 1.328, 95% confidence intervals [CI]: 1.185, 1.489 per 0.1-unit increment, P < 0.001) and ABG (HR 1.317, 95% CI: 1.134, 1.529 per 1.0-unit increment, P < 0.001) were independent predictors of primary endpoint events. Mediation analysis indicated that pulmonary vascular resistance mediated 5.65% and 14.62% of the associations between SHR and ABG and clinical worsening events, respectively. The addition of SHR significantly improved reclassification, discrimination ability, and model fit beyond the clinical risk prediction model.ConclusionsSHR is positively associated with clinical worsening in patients with IPAH. The association appeared to be partially mediated through the pathway of pulmonary vascular remodeling, indicating that SHR may serve as a valuable indicator for providing additional risk information.

Modeling the predictors of health information avoidance behavior: Implications from the stimulus organism response (S-O-R) theory

The study aimed at modeling the factors that influence health information avoidance behavior, as well as measuring and validating the stimulus organism response (S-O-R) theory. A seven-factor (information overload, information sources exposure, risk perception, health information anxiety, cognitive dissonance, sadness, and health information avoidance) measurement model was used to estimate the health information avoidance behavior using the structural equation modeling (SEM). The findings show that risk perception had a significant positive influence on sadness (β = 0.492, CR = 7.445, p &lt; 0.05), information overload exerts a significant positive impact on cognitive dissonance (β = 0.174, CR = 2.192, p &lt; 0.05) and sadness significantly influence health information avoidance (β = 0.174, CR = 2.342, p &lt; 0.05). Information overload exhibits a positive, but statistically non-significant influence on health information anxiety (β = 0.83, CR = 1.094, p &gt; 0.05). The findings of SEM demonstrate acceptable model fit indices: χ2 = 1.493, DF = 732; p = 0.000; IFI = 0.931; and TLI = 0.925, CFI = 0.930, SRMR = 0.045, RMSEA = 0.044. The study concludes that risk perception, sadness, and information overload are the main predictors of health information avoidance behavior. Other factors such as health information anxiety, exposure to different information sources, and cognitive dissonance had a non-significant impact on information avoidance behavior. The findings hold significant global relevance, potentially contributing to improved information-seeking behavior research. Our study also contributes to the advancement of the S-O-R (Stimulus-Organism-Response) framework

Extreme Heat and Air Quality: Community Leader Perspectives on Information Barriers and Opportunities in Two Environmental Justice Communities.

Extreme heat and air pollution exposure are leading causes of adverse cardiorespiratory health outcomes. Exposure reduction strategies are often focused at the local level. This study examined critical challenges community leaders face in understanding and sharing environmental exposure and health information. We conducted interviews with 19 community leaders of two urban environmental justice communities in Massachusetts, United States. Using directed content analysis, we examined air quality and heat perceptions, information and data resources, and barriers to understanding and communicating relevant local information. Participants shared concerns about both poor air quality and extreme heat. They also expressed the opinion that exposure risk information about these topics is siloed; heat and air quality data can be hard to access, interpret, and effectively communicate with community members. Solutions recommended by participants included community engagement, open-data portals, and creative science communication. Increasing sustainable collaborations among academic, government, healthcare, and nonprofit sectors is recommended.

“Everyone Does Cocaine”: The Impact of Normalization on Practices of Club Drug Use and Risk Management

Background: While many have argued that recreational drug use is becoming increasingly normalized within youth culture, little has been done to explore what this means for risk management. Methods: Drawing on 2 years of ethnographic research with people who use club drugs in the Toronto Electronic Dance Music scene, this study explores how normalization impacts risk-taking and risk management practices of club drug use. Results: It finds that the relationship is complex, as normalization both facilitates and hinders the adoption of risk management practices. The nuances of this relationship are explored by focusing on three key themes: expectation of use, moderation of use, and sharing of risk information and advice. Conclusion: The findings are interpreted with reference to Rhodes’ “risk environment” framework and with particular attention to the need for harm reduction interventions that consider how risk behaviors are shaped by broader social and cultural contexts.