School-based Treatment Research Articles

How Does Treatment Coverage and Proportion Never Treated Influence the Success of Schistosoma mansoni Elimination as a Public Health Problem by 2030?

The 2030 target for schistosomiasis is elimination as a public health problem (EPHP), achieved when the prevalence of heavy-intensity infection among school-aged children (SAC) reduces to <1%. To achieve this, the new World Health Organization guidelines recommend a broader target of population to include pre-SAC and adults. However, the probability of achieving EPHP should be expected to depend on patterns in repeated uptake of mass drug administration by individuals. We employed 2 individual-based stochastic models to evaluate the impact of school-based and community-wide treatment and calculated the number of rounds required to achieve EPHP for Schistosoma mansoni by considering various levels of the population never treated (NT). We also considered 2 age-intensity profiles, corresponding to a low and high burden of infection in adults. The number of rounds needed to achieve this target depends on the baseline prevalence and the coverage used. For low- and moderate-transmission areas, EPHP can be achieved within 7 years if NT ≤10% and NT <5%, respectively. In high-transmission areas, community-wide treatment with NT <1% is required to achieve EPHP. The higher the intensity of transmission, and the lower the treatment coverage, the lower the acceptable value of NT becomes. Using more efficacious treatment regimens would permit NT values to be marginally higher. A balance between target treatment coverage and NT values may be an adequate treatment strategy depending on the epidemiological setting, but striving to increase coverage and/or minimize NT can shorten program duration.

The impact of community based interventions for the prevention and control of soil-transmitted helminths: A systematic review and meta-analysis.

Soil-transmitted helminths (STHs) are among the most common human infections worldwide and a major cause of morbidity. They are caused by different species of parasitic worms and transmitted by eggs released in faeces or when hookworm larvae penetrate the skin. The main control strategy in endemic regions is periodic treatment with deworming medication. In the last 10 years, there has been a scale-up of prevention and control activities with a focus on community-based interventions (CBIs). This review aims to systematically analyse the impact of CBIs on the prevalence and infection intensity of STHs. A systematic review was published on this topic in 2014, but there have subsequently been several new studies published which are included in this review. Electronic database search of MEDLINE (Ovid), Global Health Online (Ovid), Cochrane Library, Embase (Ovid) and Web of Science was conducted. Titles, abstracts, and full texts were screened by two independent reviewers according to predefined eligibility criteria. Data were extracted and a meta-analysis of included studies was conducted. A total of 11,954 de-duplicated titles were screened, and 33 studies were included in the review. 14 focussed on community-wide treatment, 11 studies investigated school-based interventions, and 3 studies investigating both. Results suggest that CBIs are effective in reducing the prevalence of Hookworm, Trichuris trichiura and Ascaris lumbricoides. School-based treatment and community-wide treatment, as well as annual and semi-annual deworming, all reduce STH prevalence significantly. Mass drug administration was effective in reducing the infection intensity of Hookworm (Mean difference: -211.36 [95% CI: -519.12, 96.39]), Trichuris trichiura (-736.69 [-1349.97, -123.42]) and Ascaris lumbricoides (-2723.34 [-5014.85, -431.84]). The results suggest that CBIs are effective in reducing the prevalence and intensity of STH infections. While most studies delivered preventive chemotherapy (PC), few studies explored the impact of interventions such as water, sanitation, and hygiene (WASH) or health education, which may be essential in preventing reinfection after PC.

Social Functioning Outcomes of a High School-Based Treatment Program for Adolescents with ADHD

ABSTRACT Objective We evaluated the extent to which receiving the multi-component treatment of the Challenging Horizons Program (CHP) would lead to significant improvements in social functioning, as well as in inattention, internalizing symptoms, parent stress, and emotion dysregulation for high-school-aged adolescents with attention-deficit hyperactivity disorder (ADHD). Method Participants were 186 high-school-aged adolescents (74% White) with a diagnosis of ADHD who were randomly assigned to either CHP (n = 92; 80% boys; M age = 15.0; SD = 0.8) or Community Care (CC; n = 94; 78% boys; M age = 15.1; SD = 0.9) within each of 12 participating schools. Parent and adolescent reports of social functioning were the primary outcome measures. Secondary outcomes included ratings of symptoms of ADHD and related disorders, parent stress, and emotion regulation. Results Intent-to-treat analyses using hierarchical linear modeling revealed significant group-by-time interactions of medium magnitude (d range = .40 to .52) on parent-rated social skills. Significant group-by-time benefits were also identified for adolescent self-rated social skills as well as the secondary outcomes of parent-rated inattention symptoms, emotion regulation, and parenting stress. Discussion CHP appears to benefit social skills along with related characteristics for adolescents with ADHD. Understanding these unique findings for this population informs additional research related to treatment mechanisms and effectiveness trials.

Developing a Program Model for School-Based Day Treatment for Social, Emotional, and Behavioral Difficulties

School-based day treatment is an intensive mental health service for children with social, emotional, and behavioral difficulties. Research on day treatment is scarce and descriptions of program models are lacking. We used stimulated recall interviews to explore the moment-to-moment processes and strategies of classroom staff in a day treatment program for children in kindergarten and Grade 1. Several processes and strategies used by staff emerged from the thematic analysis of the interviews. These included a process of individualized intervention, characterized by a continual and cyclical process of attunement, responsiveness, assessment, and evaluation, using a team-based approach, noticing positives about children, a climate of positive relationships, staff regulating their own emotions, being flexible while also being firm and consistent, and seeing children from a developmental perspective. More specific strategies used by staff (e.g., token economy) also emerged from the interviews. Implications for future research and teacher training are discussed.

Guidelines for implementing and adapting evidence-based interventions with marginalized youth in schools.

With growing diversity within the U.S. population and notable barriers to accessing behavioral health care, marginalized youth are placed at risk for developing psychosocial and mental health problems. Promoting evidence-based interventions (EBIs) through school-based mental health services may improve accessibility and quality of care for marginalized youth facing mental health disparities. Culturally sensitive interventions (CSIs) may further improve engagement with and effectiveness of EBIs with marginalized youth. In this article, we provide guidelines for advancing CSIs when implementing and adapting EBIs with marginalized youth in schools. First, we emphasize inclusive strategies for advancing CSIs with marginalized youth in schools, focusing on antiracist adaptations to interventions and using a community-based participatory research approach when implementing EBIs. Following, we discuss techniques for tailoring CSIs to more effectively support marginalized youth and their families with school-based prevention and treatment. Specifically, we recommend using the Adapting Strategies for Promoting Implementation Reach and Equity framework as a guide to promote equitable implementation as well as key strategies for engaging marginalized youth and their families with school-based EBIs. Ultimately, we offer these guidelines to address disparities and inform more equitable practice in youth mental health care-and to motivate future studies advancing culturally responsive services with marginalized youth in schools. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Impact of Implicit Bias on Black and Latinx Students.

The Impact of Implicit Bias on Black and Latinx Students.

Impact of school-based malaria intervention on primary school teachers’ time in Malawi: evidence from a time and motion study

BackgroundSchool-based health (SBH) programmes that are contingent on primary school teachers are options to increase access to malaria treatment among learners. However, perceptions that provision of healthcare by teachers may be detrimental to teaching activities can undermine efforts to scale up school-based malaria control. The objective of this study was to assess the impact of school-based malaria diagnosis and treatment using the Learner Treatment Kit (LTK) on teachers’ time.MethodsA time and motion study was conducted in 10 primary schools in rural Malawi. Teachers who had been trained to diagnose and treat uncomplicated malaria were continuously observed in real time during school sessions and the time they spent on all activities were recorded by independent observers before and after LTK implementation. A structured form, programmed digitally, was used for data collection. Paired sample t-tests were used to assess pre-post differences in average hours teachers spent on the following key activities: direct teaching; indirect teaching; administration; LTK and non-teaching tasks. Multivariable repeated measures mixed regression models were used to ascertain impact of LTK on average durations teachers spent on the key activities.ResultsSeventy-four teachers, trained to use LTK, were observed. Their mean age and years of teaching experience were 34.7 and 8.7, respectively. Overall, 739.8 h of teacher observations took place. The average time teachers spent in school before relative to after LTK was 5.8 vs. 4.8 h, p = 0.01. The cumulative percentage of time teachers spent on core teaching activities (teaching and administration) was approximately 76% and did not change substantially before and after LTK. Some 24.3% of teachers’ time is spent on non-teaching activities. On average, teachers spent 2.9% of their time providing LTK services daily. Per day, each teacher spent less time on administrative (0.74 vs. 1.07 h, p = 0.02) and non-teaching activities (0.96 vs. 1.41 h, p = 0.01) during LTK compared with the period before LTK.ConclusionSchool-based health (SBH) programmes are not detrimental to teaching activities. Teachers manage their time to ensure additional time required for SBH services is not at the expense of teaching duties. Programming and policy implications of tasking teachers with SBH does not have substantial opportunity costs. Teachers should continue delivering SBH programmes to promote learners’ health.

Supporting Childhood Bereavement Through School-Based Grief Group.

With 7.3% of children under the age of 18 experiencing the death of a parent and more who experience a loss of a loved one bereavement is a common experience in the lives of children and youth. The current study sought to evaluate the effectiveness of an 8-week, school-based grief group treatment program in reducing symptoms of grief, dysregulation, and improving social support. A total of 296 children and youth (age 11-18) participated in the grief programming provided by a local hospice agency. With a retention rate of 76% the researchers identified a significant reduction in grief symptomology, frequency of emotion dysregulation, and a significant increase in perceived social support from pre- to post-8-week school-based grief programming. A reduction in intensity of dysregulation was not significant. Implications for school personnel and parental support of children and youth experiencing loss are discussed.

SCHOOL’S OUT: WHAT HAPPENED TO SCHOOL-BASED MENTAL HEALTH SERVICES (SBMHS) IN THE COVID-19 ERA?

Prior to the COVID-19 pandemic, over 90% of students in the United States attended “brick and mortar” public schools (PS). The reach of PS has facilitated school-based mental health services (SBMHS). In March 2020, schools closed abruptly and students transitioned to virtual learning. Numerous studies indicate a surge in child mental illness (CMI) during COVID-19 with an increase in the need for SBMHS. This Clinical Perspectives examines the impact of COVID-19 on the functioning of SBMHS in 4 states and nationally. After the panel introduction, the impact of COVID-19 on children’s mental health (CMH) and mechanisms to identify at-risk children will be briefly reviewed by Shirley Alleyne, MB, BS, and David Pruitt, MD. Next, each presenter will describe the impact of COVID-19 on SBMHS in their state, focusing on adaptations in the services offered and delivery methods, changes in SBMHS referral and attendance rates, and treatment outcomes. The presentations include: Dr. Alleyne, Quantum Leap: The Metamorphosis of a School-Based Mental Health Clinic in the COVID-19 Era; Brandon Johnson, MD, Supporting Our Most Vulnerable: The Pandemic's Impact on School-Based Day Treatment and LGBTQ Teens; Erika Ryst, MD, Flexible Adaptation of School Psychiatry Consultation to Meet the Needs of Schools During COVID-19; and Kristie Ladegard, MD, Sustaining the Mental Health of Our Youth: The Rapid Adaptation of School-Based Health Clinics During COVID-19. They will share recommendations to optimize SBMHS during periods of crisis. Participants will share their experiences with COVID-19 SBMHS. Sharon Hoover, PhD, will synthesize the presentations, reflecting on national changes in the delivery of SBMHS during COVID-19 and implications for future policy. The panel will then hold a Q&A session. SBMHS is essential to identifying and treating CMI during the COVID-19 pandemic. The use of telehealth and other innovative measures facilitated continuity of SBMHS with a decline in access to external CMH services. SBMHS referral and attendance rates varied across states with some common trends. COVID-19 has reinforced the critical importance of SBMHS to CMH. Concurrently, when a school is closed, its unique strength (being school-based) becomes its Achilles' heel. Policy considerations are necessary to maintain SBMHS during national crises, when its need is greatest.

AACAP Sidney Berman, MD, Award for the School-Based Study and Treatment of Learning Disorders and Mental Illness: “Is the Next School Shooter Sitting Before Me?” Lessons Learned Over Two Decades of Psychiatric Threat Assessment

AACAP Sidney Berman, MD, Award for the School-Based Study and Treatment of Learning Disorders and Mental Illness: “Is the Next School Shooter Sitting Before Me?” Lessons Learned Over Two Decades of Psychiatric Threat Assessment

School Bullying from Multiple Perspectives: "A Qualitative Study"

The study aim to identify the reality of school bullying from the perspective of the victims, bullies, educators, and workers in one of the private schools at Nablus city. The researchers employed the qualitative research method that was based on face-to-face interviews. Moreover, the age range of the selected sample was between 13-16 years old. The study's findings revealed the forms of bullying at the school, its causes, and the school policy to tackle it. Most of the results were characterized by having a problematic definition of "bullying." Moreover, the school was confused about dealing with bullying in all its forms, and there was a clear strategy to address the problem. The study recommend the necessity of school-based bullying prevention and treatment programs designed to reduce the bullying phenomenon at schools.

Organization interventions as a mediator of change in grades in the Challenging Horizons Program

This study evaluated whether an organization intervention was a mediator of change for grade point average (GPA) in a randomized clinical trial of a school-based treatment program for adolescents with attention deficit hyperactivity disorder (ADHD). A demographically diverse sample of 148 participants (105 males) with a diagnosis of ADHD were recruited from nine middle schools. Comprehensive diagnostic evaluations were completed and participants were randomized into one of three conditions (two active treatment conditions, one control condition) for a randomized clinical trial that lasted an entire school year. The results of the trial are reported elsewhere (Evans et al., 2016; Schultz et al., 2017); in this study we evaluated four of the criteria for determining mediation as reported by Kazdin (2007) to determine whether response to the organization intervention in this school-based treatment program mediated the relationship between dosage and GPA beyond previous GPA. The results provided evidence that response to the organization intervention mediated the relationship between intervention dosage and change in GPA.

Using a Nonconcurrent Multiple-Baseline Across-Participants Design to Examine the Effects of Individualized ACT at School.

The purpose of the current study was to examine the effectiveness of implementing acceptance and commitment therapy (ACT) with three students who displayed disruptive and off-task behaviors in a classroom. A nonconcurrent multiple-baseline across-participants design with an embedded reversal was used to compare the effects of individualized ACT exercises and treatment-control conditions on classroom behaviors that included on-task behavior, vocal disruption, physical aggression, and classroom disruption. Classroom behaviors were measured during 5-min direct observations using continuous 30-s interval recording. During baseline, all participants displayed low levels of on-task engagement and high or varying rates of challenging behaviors. When the individualized ACT intervention was implemented, participants' on-task and challenging behaviors improved compared to baseline and treatment-control conditions; treatment-control conditions produced mixed results. Implications for school-based treatment programs and collaborative transdisciplinary intervention strategies are discussed.

Deworming women of reproductive age during adolescence and pregnancy: what is the impact on morbidity from soil-transmitted helminths infection?

BackgroundSoil-transmitted helminths (STHs) are a major cause of poor health in low- and middle-income countries. In particular, hookworm is known to cause anaemia in children and women of reproductive age (WRA). One goal of the World Health Organization’s (WHO) 2030 roadmap for neglected tropical diseases is to reduce STH-related morbidity in WRA. As a minimal intervention, the WHO recommends deworming adolescent girls annually during human papilloma virus vaccination programmes and WRA during pregnancy and lactation. These routine interventions are low cost and can be implemented even by the most basic health services in endemic countries. In this study we use a cohort model to investigate the potential impact on STH-related morbidity in WRA.ResultsAnnual deworming treatment of adolescent girls reduces the prevalence of moderate- and heavy-intensity infections in this age group by up to 60% in moderate transmission settings and by 12–27% in high transmission settings. Treatment of WRA during pregnancy and lactation on its own has a small (< 20%) but significant effect on morbidity although it does not lead to the achievement of the morbidity target (< 2% moderate- to high-intensity infections) in this age group. However, depending on the age-intensity profile of infection, which may vary geographically, and assumptions on the density-dependence of egg production by fertilised female worms, continued school-based treatment may be able to reduce the force of infection acting on WRA, both through an indirect effect on the overall population-based force of infection and via reducing the burden of infection as children age and move into the WRA age classes. As a result, morbidity in WRA may be eliminated.ConclusionWhile deworming during pregnancy and lactation does not lead to the achievement of the morbidity target in WRA and its efficacy may vary by setting, it is still expected to be beneficial for maternity and child health. Monitoring of any WRA-based intervention is recommended to evaluate its effectiveness.Graphical

School-based screening and treatment may reduce P. falciparum transmission

In areas where malaria remains entrenched, novel transmission-reducing interventions are essential for malaria elimination. We report the impact screening-and-treatment of asymptomatic Malawian schoolchildren (n = 364 in the rainy season and 341 in the dry season) had on gametocyte—the parasite stage responsible for human-to-mosquito transmission—carriage. We used concomitant household-based surveys to predict the potential reduction in transmission in the surrounding community. Among 253 students with P. falciparum infections at screening, 179 (71%) had infections containing gametocytes detected by Pfs25 qRT-PCR. 84% of gametocyte-containing infections were detected by malaria rapid diagnostic test. While the gametocyte prevalence remained constant in untreated children, treatment with artemether-lumefantrine reduced the gametocyte prevalence (p < 0.0001) from 51.8 to 9.7% and geometric mean gametocyte density (p = 0.008) from 0.52 to 0.05 gametocytes/microliter. In community surveys, 46% of all gametocyte-containing infections were in school-age children, who comprised only 35% of the population. Based on these estimates six weeks after the intervention, the gametocyte burden in the community could be reduced by 25–55% depending on the season and the measure used to characterize gametocyte carriage. Thus, school-based interventions to treat asymptomatic infections may be a high-yield approach to not only improve the health of schoolchildren, but also decrease malaria transmission.

Effectiveness of school-based preventive chemotherapy strategies for sustaining the control of schistosomiasis in Côte d'Ivoire: Results of a 5-year cluster randomized trial.

BackgroundPreventive chemotherapy using praziquantel is the mainstay for schistosomiasis control. However, there is little evidence on what is supposed to be the most effective school-based treatment strategy to sustain morbidity control. The aim of this study was to compare differences in Schistosoma mansoni prevalence and infection intensity between three different schedules of school-based preventive chemotherapy in an area with moderate prevalence of S. mansoni in Côte d’Ivoire.MethodologySeventy-five schools were randomly assigned to one of three intervention arms: (i) annual school-based preventive chemotherapy with praziquantel (40 mg/kg) over four years; (ii) praziquantel treatment only in the first two years, followed by two years whithout treatment; and (iii) praziquantel treatment in years 1 and 3 without treatment in-between. Cross-sectional parasitologic surveys were carried out prior to each round of preventive chemotherapy. The difference in S. mansoni prevalence and infection intensity was assessed by multiple Kato-Katz thick smears, among children aged 9–12 years at the time of each survey. First-grade children, aged 5–8 years who had never received praziquantel, were also tested at baseline and at the end of the study.Principal findingsOverall, 7,410 children aged 9–12 years were examined at baseline and 7,223 at the final survey. The baseline prevalence of S. mansoni was 17.4%, 20.2%, and 25.2% in arms 1, 2, and 3, respectively. In the final year, we observed the lowest prevalence of 10.4% in arm 1, compared to 18.2% in arm 2 and 17.5% in arm 3. The comparison between arms 1 and 2 estimated an odds ratio (OR) of 0.52 but the difference was not statistically significant (95% confidence interval (CI) = 0.23–1.16). Likewise the difference between arms 1 and 3 lacked statistical significance (OR = 0.55, 95% CI = 0.23–1.29). There was no noteworthy difference observed between arms 2 and 3 (OR = 1.06, 95% CI = 0.64–1.75). The lowest S. mansoni fecal egg counts in the final year survey were observed in arm 1 (7.9 eggs per gram of stool (EPG)). However, compared with 11.5 EPG in arm 2 and 15.4 EPG in arm 3, the difference lacked statistical significance. There were 4,812 first-grade children examined at baseline and 4,513 in the final survey. The overall prevalence of S. mansoni in these children slightly decreased in arms 1 (from 4.5% to 3.6%) and 2 (from 4.7% to 4.3%), but increased in arm 3 (from 6.8% to 7.9%). However, there was no significant difference in prevalence and infection intensity observed between study arms.Conclusions/significanceThe three treatment schedules investigated led to a reduction in the prevalence and intensity of S. mansoni infection among children aged 9–12 years. Comparing intervention arms at the end of the study, no statistically significant differences were observed between annual treatement and the other two treatment schedules, neither in reduction of prevalence nor intensity of infection. It is important to combine our results with those of three sister trials conducted simultaneously in other African countries, before final recommendations can be drawn.

Analysis of a School-Based Behavioral Health Program: Exploring the Value of Mental Health Services for Vulnerable Students

This paper explores the effectiveness of public school-based mental health treatment for K-12 students. Extant clinical data from 2017- 2018 for behavioral health service recipients (n = 874) was used in this analysis. Relationships among clinical diagnosis at discharge, duration in treatment, student participation, and status of mental health improvement were examined. Logistic regression explored associations among variables of interest. Results indicate 74.3% (n = 649) of students were identified by clinicians with improvement in mental health status at discharge. The most prominent mental health diagnoses being treated in the schools were depression, anxiety, and trauma. Students involved in treatment were over 15 times more likely to be categorized as having an improved mental health status; students who lacked participation were 63% less likely to improve. Our results highlight the necessity for school administrators to prioritize and support school-based mental health services. The findings provide school administrators guidance, evidence, and impetus for implementing effective school-based mental health programs.

Evaluating the impact of biannual school-based and community-wide treatment on urogenital schistosomiasis in Niger

BackgroundThe Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) coordinated a five-year study implemented in several countries, including Niger, to provide an evidence-base for programmatic decisions regarding cost-effective approaches to preventive chemotherapy for schistosomiasis control.MethodsThis was a cluster-randomised trial investigating six possible combinations of annual or biannual community-wide treatment (CWT), school-based treatment (SBT), and holidays from mass treatment over four years. The most intense arm involved two years of annual CWT followed by 2 years of biannual CWT, while the least intensive arm involved one year of annual SBT followed by a year without treatment and two more years of annual SBT. The primary outcome of interest was prevalence and intensity of Schistosoma haematobium among 100 children aged 9–12 years sampled each year. In addition, 100 children aged 5–8 years in their first year of school and 50 adults (aged 20–55 years) were tested in the first and final fifth year of the study.ResultsIn total, data were collected from 167,500 individuals across 225 villages in nine districts within the Niger River valley, Western Niger. Overall, the prevalence of S. haematobium decreased from baseline to Year 5 across all study arms. The relative reduction of prevalence was greater in biannual compared with annual treatment across all arms; however, the only significant difference was seen in areas with a high starting prevalence. Although adults were not targeted for treatment in SBT arms, a statistically significant decrease in prevalence among adults was seen in moderate prevalence areas receiving biannual (10.7% to 4.8%) SBT (P < 0.001). Adults tested in the annual SBT group also showed a decrease in prevalence between Year 1 and Year 5 (12.2% to 11.0%), but this difference was not significant.ConclusionsThese findings are an important consideration for schistosomiasis control programmes that are considering elimination and support the idea that scaling up the frequency of treatment rounds, particularly in areas of low prevalence, will not eliminate schistosomiasis. Interestingly, the finding that prevalence decreased among adults in SBT arms suggests that transmission in the community can be reduced, even where only school children are being treated, which could have logistical and cost-saving implications for the national control programmes.Graphical

4493 New module supporting Community Engaged Research added to COALESCE (teamscience.net) online training for interdisciplinary research teams

OBJECTIVES/GOALS: A new researcher-facing module to support community engaged research has been added to the updated COALESCE website and user traffic was tracked since last reporting. We describe the process of development and the features of the new module, past 2-year traffic, and plans to develop a community facing module. METHODS/STUDY POPULATION: We monitored the number of unique users of COALESCE (teamscience.net) between 2017 and 2019 to determine if traffic slowed, stayed the same, or increased since teamscience.net was physically updated to function on mobile devices. In December 2019, a new module was launched to introduce researchers to the stages of team science community engaged research. To develop the module, we collaborated with academic partners at University of Illinois-Chicago to identify 3 local historic research case studies in and to characterize how each exemplified a team science stage: assembly, launch, or maturation. After interviewing key team members from each study, we iterated storyboards and scripts in collaboration with community engaged research experts and case study team members. The module was built, tested, and launched. RESULTS/ANTICIPATED RESULTS: In the 6 years between 2011 through 2017, the site attracted 16,016 unique visitors (approximately 2699 per year). In 2 years from 2017 through 2019, since the modernization of the website, user traffic has held steady or grown, attracting 6992 unique visitors (approximately 3496 per year). Our newly posted researcher-facing module highlights team assembly in the case a task force charged with reducing disparity in breast cancer outcomes in Chicago, team launch in a study to improve asthma management in a local FQHC, and team maturation in a study comparing clinic-based to public school-based treatment of disruptive behavior. We will soon create a companion community-facing module and resources to address identified needs for community partners engaging in research with academic institutions. DISCUSSION/SIGNIFICANCE OF IMPACT: COALESCE (teamscience.net) remains the first and only open-access, online training in team science for health professionals. Recent updates have improved usability and expanded available resources. We launched a comprehensive module for academics interested in community engaged research; future work will develop parallel community facing resources.

Causes of vision loss at China's largest blind school during a period of significant economic growth: 2008-2016

To investigate the different causes of vision loss and school-based treatment regimens at Quanzhou Blind School (QBS), China's largest blind school, in 2008 and2016. In 2008, 144 students received comprehensive eye examinations along with a complete family and ophthalmic history; in 2016, 125 students were examined. Vision loss was categorized into visual impairment and blindness classifications based on WHO guidelines. The etiologies of impairment and blindness in 2008 were compared to those in 2016 using the Fisher exact test. The prevalence and type of visual aids were also analyzed during this period. The leading cause of visual impairment significantly shifted from corneal scarring in 2008 to retinopathy of prematurity (ROP) in 2016 (P=0.020). Congenital cataracts remained the leading cause of blindness in 2008 and 2016. In 2016 there was a significant increase in the use of visual aids, with 63.2% of students using them in 2016 compared to 8.3% in 2008 (P=0.0001). Between 2008 and 2016, the leading cause of visual impairment shifted from corneal scarring to ROP, while congenital cataracts remained the leading cause of blindness.