Support Program Research Articles

Abstract C058: The Impact of Preferred Language on Cancer WellBeing Screen Outcomes and Supportive Care Program Touch Points

Abstract Background: Preferred language is a potential barrier to linking patients to supportive resources. At a large health system, a Wellbeing Screen (WBS) is administered to identify needs and guide referral to the Patient & Family Support Program (PFSP). Abnormal WBS and number of PFSP physician touch points were compared among cancer patients with non-preferred English language (nPEL) vs. preferred English language (PEL). We hypothesized nPEL patients may have differing needs or provision of services. Methods: A single institution retrospective study evaluating WBS among all patients receiving ambulatory cancer care at one of 7 sites from 01/2021-12/2022 was performed. The WBS instrument assesses degree of impact for 15 wellbeing domains and is assigned to patients at each oncology-related visit if a WBS has not been completed within the last 30 days. PEL vs. nPEL patients were compared for percentage of abnormal screens defined as a response of moderate/severe impact on at least one domain. Number of touch points by PFSP physicians (Supportive Care Medicine; Rehabilitation; Psychiatry) were abstracted within 30 days after any abnormal WBS. Fisher’s exact test was used to calculate odds ratios and p-values. Results: A total of 12,642 patients were assigned at least one WBS during the study period, resulting in 56,821 assigned WBSs, of which 7,898 (13.9%) were assigned to nPEL patients. PEL patients were assigned a lower average number of WBSs compared to nPEL (4.4 vs. 5.3, p<0.001). Of all assigned WBSs, 20,191 (35.5%) were completed. Of these, 10,097 (50.0%) were abnormal with moderate/severe impact on at least one domain. WBSs completed by PEL patients had 1.42 higher odds of moderate/severe impact on at least one domain compared to nPEL (p<0.001) and higher odds of moderate/severe impact on 11 of the 15 individual domains (all p<0.01). There were 5,628 PFSP physician touch points within 30 days of the 10,097 abnormal WBS. The most frequent touch points were provided by Supportive Care Medicine (55.5%), followed by Rehabilitation (29.2%) and Psychiatry (15.4%). The nPEL group had 0.34 lower odds of having any PFSP physician touch point (p<0.001) and a lower average number of PFSP physician touch points (8.4 nPEL vs 16.5 PEL, p<0.001) compared to the PEL group. nPEL had significantly lower odds of having a touch point provided by Rehabilitation (OR 0.44) and Psychiatry (OR 0.33), but significantly higher odds of having a touch point provided by Supportive Care Medicine (OR 3.01) (all p<0.001). Conclusion: WBSs completed by PEL had higher odds of identifying moderate/severe impact on at least one wellbeing domain. The nPEL group had fewer PFSP physician touch points and differing odds of services from PFSP physicians compared to the PEL group. These differences may be due to bias in the screen, differences in understanding the value of services (ie., due to language barriers or cultural perception), or referral patterns. Further evaluation of non-physician PFSP services, such as Social Work, Clinical Nutrition, and Spiritual Care, is ongoing. Citation Format: Justin Kim, Scott Irwin, Kevin Tsang, Hongyu Liu, Nicholas Tatonetti, Margaret Liang. The Impact of Preferred Language on Cancer WellBeing Screen Outcomes and Supportive Care Program Touch Points [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C058.

Inclusive Higher Education in Kyrgyzstan for People with Physical and Intellectual Disabilities

Considering the importance of education as a socio-cultural human right, the issue of implementation of inclusive higher education for persons with disabilities is relevant, determined by a set of legal, socio-pedagogical, technical, and financial problems. The study aims to investigate specific organizational and pedagogical factors facilitating the implementation of an inclusive higher education model in the Kyrgyz Republic. The study employed methods that included questionnaires of the subjects of the educational process and statistical analysis of the data obtained in the course of the questionnaire. Including the understanding of inclusion, the role of educational institutions, and effective methodologies for implementing inclusive practices in the educational process, key theoretical aspects were identified as a result of the analysis of modern theoretical concepts and methodological approaches to inclusive higher education. Furthermore, challenges such as the lack of adaptive infrastructure required for students with disabilities, as well as the insufficient preparation of teaching staff to work with the diverse needs of students, were highlighted. The study also covered the social and legal aspects of inclusive higher education in Kyrgyzstan. The legislative framework regulating the rights of students with disabilities was analyzed, and public support and awareness of inclusion in education were assessed. Based on the findings, specific recommendations and strategies were developed to improve inclusive higher education in Kyrgyzstan. These recommendations cover various areas, including educational programs, the training of educators, the creation of accessible infrastructure, and the development of social support programs. The practical relevance of this work lies in the possibility of implementing the recommendations and strategies proposed in this work to improve inclusive higher education in Kyrgyzstan, which contributes to a more accessible and equitable educational environment for all students.

From Potential to Action: Strategies for Supporting Female Founders in the Pre-Start-Up Phase

In today’s global economy, the role of start-ups is recognized as crucial for a country's competitiveness. Creating a supportive entrepreneurial ecosystem is therefore essential to enable founders to realize their potential optimally. Notably, there is a significant gender disparity in start-ups, suggesting a vast untapped entrepreneurial potential among women. This research aims to enhance the utilization of female start-up potential by providing actionable recommendations, based on an empirical analysis of the pre-start-up process of (potential) female founders. Through a qualitative research methodology, this study investigates the factors influencing women's journey towards entrepreneurship, considering diverse biographies and life situations. Interviews with ten women showed the complexity of the pre-start-up phase and the necessity for a broad support system. The study identifies several key areas for action to foster female entrepreneurship. Firstly, increasing awareness and visibility of self-employment as a viable career path for women is crucial, requiring more female role models and media representation to challenge traditional gender roles and stereotypes. This could cultivate a natural inclination towards entrepreneurship and sectors with high start-up activity. Moreover, lessening the disproportionate burden of family responsibilities on women is essential, suggesting enhancements in childcare facilities and encouraging shared domestic duties. The research further suggests the implementation of support programs to reduce barriers and provide a realistic view of entrepreneurship, alongside the potential benefits of mentorship in both pre- and post-start-up phases. Women's risk-averse, cautious approach in the pre-start-up process often leads to hesitance in developing innovative projects. Encouraging a focus on market needs and early engagement with potential customers, alongside proactive network building, seeking co-founders, or outsourcing, can address knowledge gaps and reduce uncertainties, making self-employment a more attractive option. This study emphasizes the importance of a collaborative effort among various stakeholders in the entrepreneurial ecosystem to unlock the entrepreneurial potential among women.

Application of the Foresight Method in the Educational Process of Higher Education

In conditions of increasing life expectancy, declining fertility, increased migration and other demographic changes, the Foresight method can help families and society prepare for new challenges and opportunities. For example, anticipating an increase in the number of elderly people may prompt the state to develop a support program for this category of the population, and forecasting an increase in migration may contribute to the development of integration programs for new immigrants. The Foresight method is relevant in the context of demographic changes, as it allows you to predict possible scenarios for the future development of the family and society based on the analysis of current data and trends. This will make it possible to make more informed decisions and develop new tools for the state to improve the demographic situation in the country. The Foresight method is also of great relevance in education, especially in the context of technological innovations. Thus, the purpose of the article is to study the demographic situation of the Russian Federation by the Foresight method in sociology classes. The authors believe that the interest in the Foresight method lies in the fact that it allows the students of the Faculty of Economics and Management of VSTU to develope strategic thinking and planning skills, to apply those in the field of demography as well as in their future professional activity. The article presents the results of a survey of first-year students of Volgograd State Technical University (VSTU) in relation to the demographic situation in the country. The positive and negative factors affecting the demographic situation are considered. Some measures to improve the demography of the Russian Federation are proposed. The proposed Foresight method in the educational process may be of interest to teachers and methodologists of higher education engaged in the development of new approaches to training students.

Fostering newly resettled refugee-background adolescents’ self-efficacy and advocacy in a community-based youth program

PurposeThis study aims to explore the experiences of newly resettled refugee-background high school students participating in the Teen Response program, a community-based initiative to assist refugee-background adolescents (RBAs) in navigating educational and career opportunities in the midwestern USA.Design/methodology/approachUsing a mixed-methods approach, this study examined twenty-two RBAs through survey and focus groups.FindingsThe findings reveal significant growth and transformation in the students' self-efficacy and advocacy skills. This growth underscores the critical role of social support and community engagement in helping RBAs, empowering them to advocate for themselves and others in pursuing educational and career goals.Originality/valueThis study contributes new insights into the community-based support programs for RBAs, focusing on enhancing self-efficacy and advocacy. It offers valuable implications for developing effective support frameworks and recommends future research on these approaches.

Alfabetización Evaluativa: Acompañamiento docente para promover la evaluación auténtica

The literacy in assessment is a skill lacking in a significant number of teachers, negatively impacting students’ educational progress. Hence, this study aimed to analyse the impact of a literacy and support program for teachers through authentic assessment training. The research conducted was exploratory in nature. It involved three teachers from schools in different districts of Chile, teaching Language and Literature at the 1st year of high school level, and three accompanying researchers. To determine the level of literacy, pre and post-tests were conducted, measuring the dimension of “gathering learning information”. Additionally, to assess the effectiveness of the intervention, teachers were required to enhance their latest evaluation tool according to the parameters of authentic assessment. The results revealed that teachers had a moderate level of assessment literacy and were unfamiliar with authentic assessment. Furthermore, no improvement in their evaluative competencies was observed following the support provided. These findings underscore the urgency of enhancing teachers’ assessment literacy, emphasizing the need for specific training opportunities in this area.

Patients’ and stakeholders’ experiences of a personalized self-management SUPport program (P-SUP) for patients with type 2 diabetes mellitus and/or coronary heart disease: a qualitative process evaluation

BackgroundChronic diseases such as type 2 diabetes mellitus and coronary heart disease cause medical, social, and economic burdens worldwide. Disease management programs in Germany mostly lack components to improve patients’ self-management and health-promoting lifestyles despite clear guideline recommendations. Therefore, a Personalized Self-Management Support Program (P-SUP) was developed, which includes: (1) peer support groups; (2) telephone coaching; (3) feedback reports and, (4) a web portal. This study aims to explore patients’ and implementing stakeholders’ experiences in the implementation of P-SUP to identify barriers and facilitators to the implementation of the intervention.MethodsA qualitative study was conducted using face-to-face focus group interviews with participating patients and telephone-based one-to-one expert interviews with implementing stakeholders, involved in the delivery of the intervention. The transcribed interview reports were analyzed using qualitative content analysis, and the contents were categorized according to Donabedian’s Structure-Process-Outcome framework.ResultsA total of six themes among patients (N = 35) and five themes among implementing stakeholders (N = 32) represent the experiences. The patient themes were: (1) technical conditions, (2) indoor facilities, (3) group composition, (4) acceptance of digital components, (5) supervision and feedback and (6) impact on lifestyle behavior. The themes among the implementing stakeholders were: (1) multiprofessional approach, (2) human resources, (3) patient acceptance, (4) supervision and feedback and (5) impact on lifestyle behavior.ConclusionsMultiprofessional interventions such as P-SUP appear to be valuable for patients and implementing stakeholders. Although infrastructural barriers made the implementation of peer support and digital patient education difficult, patients rated the exchange with peers and experts on health-related topics positively. The lack of supervision and feedback during the course of the intervention might be compensated by regular telephone coaching. The findings from this study can be used in future studies to guide researchers and implementing stakeholders and to improve the feasibility and effectiveness of complex interventions in different contexts.Trial registrationThe P-SUP study was registered in the German Clinical Trials Register (DRKS) on 16/07/2020 under the registration number DRKS00020592.

Does perceived vaping addiction predict subsequent vaping cessation behaviour among adults who use nicotine vaping products regularly?

BackgroundThis study aimed to investigate whether perceived vaping addiction is a predictor of quitting nicotine vaping product (NVP) use among adults who have ever smoked and currently vape exclusively or predominantly in four countries: Australia, Canada, the US, and England. MethodData analysed (n = 574) came from participants (aged 18 + ) who completed the International Tobacco Control (ITC) Four Country Smoking and Vaping survey in 2018 and again in 2020. Baseline inclusion criteria were: (1) currently not smoking or non-daily smoking; and (2) using NVPs daily/weekly for a period of at least 4 months. Association of self-reported baseline levels of perceived vaping addiction with making any attempts to quit vaping and successful attempts reported at follow-up were examined using logistic regression models, controlling for potential sociodemographic and smoking/vaping-related confounders. ResultsParticipants who perceived themselves as being addicted to vaping were less likely to attempt to quit vaping than those who perceived themselves as not addicted. Among those who tried, those who perceived themselves being addicted were also less likely to succeed than those who perceived themselves as not addicted. No significant country differences in associations were observed for both outcomes. ConclusionsPerceived vaping addiction was shown to have predictive utility for vaping cessation behaviours, possibly acting as an indicator of task difficulty, and thus may serve as a useful screening tool for identifying NVP users who may benefit from tailored cessation support programs if they want to stop using these products.

Machine learning identifies a 5-serum cytokine panel for the early detection of chronic atrophy gastritis patients.

Chronic atrophy gastritis (CAG) is a high-risk pre-cancerous lesion for gastric cancer (GC). The early and accurate detection and discrimination of CAG from benign forms of gastritis (e.g. chronic superficial gastritis, CSG) is critical for optimal management of GC. However, accurate non-invasive methods for the diagnosis of CAG are currently lacking. Cytokines cause inflammation and drive cancer transformation in GC, but their utility as a diagnostic for CAG is poorly characterized. Blood samples were collected, and 40 cytokines were quantified using a multiplexed immunoassay from 247 patients undergoing screening via endoscopy. Patients were divided into discovery and validation sets. Each cytokine importance was ranked using the feature selection algorithm Boruta. The cytokines with the highest feature importance were selected for machine learning (ML), using the LightGBM algorithm. Five serum cytokines (IL-10, TNF-α, Eotaxin, IP-10 and SDF-1a) that could discriminate between CAG and CSG patients were identified and used for predictive model construction. This model was robust and could identify CAG patients with high performance (AUC = 0.88, Accuracy = 0.78). This compared favorably to the conventional approach using the PGI/PGII ratio (AUC = 0.59). Using state-of-the-art ML and a blood-based immunoassay, we developed an improved non-invasive screening method for the detection of precancerous GC lesions. Supported in part by grants from: Jiangsu Science and Technology Project (no. BK20211039); Top Talent Support Program for young and middle-aged people of Wuxi Health Committee (BJ2023008); Medical Key Discipline Program of Wuxi Health Commission (ZDXK2021010), Wuxi Science and Technology Bureau Project (no. N20201004); Scientific Research Program of Wuxi Health Commission (Z202208, J202104).

TAX LITERACY AND SOCIAL ENVIRONMENT : INFLUENCING TAX AWARENESS IN SURABAYA'S GENERATION Z

This study evaluates the influence of tax literacy and social environment on tax awareness among Generation Z in Surabaya, Indonesia, using a sample of 200 individuals. A quantitative methodology was applied with data collected through face-to-face surveys using a questionnaire designed to measure tax literacy, perceptions of the social environment, and tax awareness. Analysis using linear regression shows that tax literacy has a significant and dominant influence on tax awareness, while the social environment also contributes positively but with a lower intensity. These results suggest the importance of integrating tax literacy and social environment support in public policy and education programs to enhance tax awareness in future generations. These findings are relevant for policymakers and educational institutions in designing effective strategies to strengthen tax compliance among the youth.

The European Researchers' Network Working on Second Victim (ERNST) Policy Statement on the Second Victim Phenomenon for Increasing Patient Safety.

The second victim phenomenon refers to the emotional trauma healthcare professionals experience following adverse events (AEs) in patient care, which can compromise their ability to provide safe care. This issue has significant implications for patient safety, with AEs leading to substantial human and economic costs. Current evidence indicates that AEs often result from systemic failures, profoundly affecting healthcare workers. While patient safety initiatives are in place, the psychological impact on healthcare professionals remains inadequately addressed. The European Researchers' Network Working on Second Victims (ERNST) emphasizes the need to support these professionals through peer support programs, systemic changes, and a shift toward a just culture in healthcare settings. Key options include implementing peer support programs, revising the legal framework to decriminalize honest errors, and promoting just culture principles. These initiatives aim to mitigate the second victim phenomenon, enhance patient safety, and reduce healthcare costs. Addressing the second victim phenomenon is essential for ensuring patient safety. By implementing supportive policies and fostering a just culture, healthcare systems can better manage the repercussions of AEs and support the wellbeing of healthcare professionals.

Outcomes of a patient support programme for subcutaneous immunoglobulin therapy in patients with primary or secondary immunodeficiencies or chronic inflammatory demyelinating polyneuropathy.

Subcutaneous immunoglobulin (SCIg) therapy is important in the treatment of primary (PID) and secondary immunodeficiencies (SID) and chronic inflammatory demyelinating polyneuropathy (CIDP). Patient support programmes (PSPs) help patients self-administer medication regimens and play a more active role in the self-management of their medical conditions. To describe the effectiveness of the CSL Behring CARES PSP in optimising the quality use of SCIg in a hospital-free environment. This retrospective, observational study analysed records of patients enroled in the CSL Behring CARES PSP. Key outcomes were accessibility and effectiveness. Data were extracted from the patient database and analysed using descriptive methods. Seven hundred eighty-nine patients with PID (30.8%), SID (53.4%) and CIDP (15.8%) were enroled in the CARES PSP, 92.8% of whom were referred from public hospitals and the remaining from private hospitals. Of the total patient population, 697 (88.3%) received the nurse-led SCIg self-administration training and education (COACH), out of which 656 (94.1%) completed training and achieved competency after an average of 2.3 training sessions. The proportions of patients who achieved competency were similar across age groups and prior SCIg hospital education status. This is the largest real-world evidence study that describes the effectiveness of SCIg PSPs across three therapeutic disease states. These PSPs can optimise hospital resources such as infusion nurse time and allocation of infusion chairs that were once used for intravenous immunoglobulin infusions, improve patient access to SCIg therapy and enable patients self-administer SCIg outside a hospital environment.

Effects of COVID-19 nursing home restrictions on people with dementia involved in a Supportive Care programme

BackgroundSupportive Care is a person-centred approach encompassing non-pharmacological interventions targeted towards persons with dementia to contain the effects of their behavioural disorders, improving their quality of life.AimsTo investigate the effects of lockdown restrictions during the first wave of COVID-19 pandemic on behavioural symptoms of patients involved in a Supportive Care programme in an Italian nursing home.MethodsAnalysis is based on Neuropsychiatric Inventory (NPI) scores and related symptoms data collected before (October/November 2019) and after (July 2020) the introduction of COVID-19 restrictions on a non-random sample of 75 patients living in two units of the facility: 38 involved in a Supportive Care programme and 37 receiving standard care (Control). Group performances were compared over time according to univariate statistics and Latent Class Analysis (LCA).ResultsNPI scores and number of reported symptoms in NPI evaluations increased over time among Supportive Care patients with dementia and decreased in the Control group. Differences are statistically significant. LCA resulted in 3-classes and 5-classes specifications in the two time-occasions.DiscussionSupportive Care patients showed a worsening in behavioural and psychological symptoms after the first pandemic wave, as opposed to the elderly not involved in the programme. LCA showed that patients in the two groups differed according to the combinations of NPI symptoms.ConclusionsThe discontinuation of a Supportive Care programme due to COVID-19 restrictions had strong negative effects on nursing home persons with dementia involved in the programme: Supportive Care interventions are important in controlling the psycho-behavioural symptoms associated with dementia.

Risk Factors for Central Obesity in Women 45-54 Years of Age in Indonesia (Riskesdas 2018 Analysis)

The prevalence of central obesity in Indonesia, especially in women aged 45-54 years, has increased according to the results of the Basic Health Research (Riskesdas, Riset Kesehatan Dasar). Central obesity is associated with a higher risk of diseases such as diabetes, cardiovascular disease, dyslipidemia, and hypertension. This study aimed to identify factors associated with the incidence of central obesity in women aged 45-54 years in Indonesia using the 2018 Riskesdas data with a cross-sectional study design. The study sample consisted of 60,557 individuals, with 64.54% having central obesity. Marital status (PR=1.12; 95%CI 1.09-1.15), low physical activity (PR=1.18; 95%CI 1.14-1.21), and consumption of high-risk foods (PR=1.03; 95%CI 1.01-1.05) were found to be associated with an increased risk of central obesity. In contrast, primary education (PR=0.86; 95%CI 0.83-0.89), employment status (PR=0.91; 95%CI 0.90-0.93), and smoking status (PR=0.89; 95%CI 0.84-0.95) acted as protective factors against central obesity. The results of this study suggest the need for increased nutrition education and physical activity in women aged 45-54 years as well as health support programs for married women.

Impact of the COVID-19 pandemic on Canadian performing and creative artists: An interpretive descriptive study using the social-ecological model.

Public health restrictions during the Coronavirus-2019 (COVID-19) pandemic in Canada have substantially reduced the work and income of performing and creative artists. We aimed to understand how factors at the public policy, community, organizational, interpersonal and individual levels affected Canadian performing and creative artists' health and livelihood during the pandemic. We interviewed 14 creative and performing artists from an academic hospital-based healthcare center in Toronto, Canada. In addition, we conducted secondary data analysis on an existing set of 17 transcribed interviews from a quality improvement study that included relevant information to answer the present study's research question. We applied an interpretive descriptive approach to our qualitative inquiry and used the social-ecological model (SEM) as our analytic framework. We identified factors at all levels of the SEM that tended to synergistically affect the health and livelihood of artists during the COVID-19 pandemic. Public health restrictions and government financial assistance programs have downstream effects on other levels. During the pandemic, many artists sensed an overwhelming loss of community, financial instability, and limited access to healthcare; which in turn affected their health. For those who accessed financial assistance programs, the stability of income afforded time for rest without the stress of food insecurity or housing instability. Use of the SEM as an analytic framework reflects the multidirectional intricacy and dynamic interplay among factors operating within and across all five levels, bringing to light potential areas of improvement at various levels to strengthen resilience and reduce risk factors associated with artists' health and healthcare access. Findings also accentuated the fragility of precarious work that inundates the performing arts industry, which emphasizes the need for interventions and policies to address this issue. Such interventions might include financial support programs for artists, access to affordable healthcare services, and efforts to strengthen social support networks within the arts community.

Sociodemographic associated factors with non-disclosure of HIV sero-status to sexual partners in Maputo, Mozambique

The HIV prevalence in Maputo city is 16.2%. There is a lack of data describing associated factors with disclosure or non-disclosure of HIV-positive sero-status to sexual partners. This analysis describes associated factors of non-disclosure of HIV sero-status to sexual partners among people living with HIV (PLHIV) participating in a serostatus disclosure support program at three health facilities in Maputo, Mozambique. We used a cross-sectional design of PLHIV aged over 18 years. Datas were collected between December 2019 and September 2020. Univariate and multivariable logistic regression models were used to evaluate factors associated of non-disclosure of HIV sero-status. A total of 377 patients were enrolled in the HIV sero-status disclosure Program. Of these, nearly two-thirds (61.5%) were women, 52.9% had completed secondary school, 47.7% were 25–34 years old, 50.9% had informal employment with low income, and 73.2% were married. Univariate logistic regression model showed greater odds of non-disclosure among patients who had an employment contract with a maximum wage (Crude Odds Ratio [cOR] 2.02, 95% confidence interval [CI] 1.15–3.55, p = 0.015); were single (cOR 3.85, 95% CI 2.22–6.69, p < 0.001); were living with parents (cOR 2.30, 95% CI 1.07–4.93, p = 0.033); received financial support for their monthly household expenses from parents or a close relative (cOR 7.15, 95% CI 2.19–23.36, p = 0.001); or brought a parent/close relative and/or a friend as a confidant during HIV care(cOR 3.17, 95% CI 1.74–5.76, p < 0.001; and cOR 5.97, 95% CI 1.57–22.66, p = 0.009, respectively). Multivariable logistic regression model showed: from parents/close relative and from partner (Adjusted Odds Ratio [aOR] 8.19, 95% CI 1.44–46.46, p = 0.018; and aOR 4.34, 95% CI 1.05–17.17, p = 0.043), respectively); in those who brought a parent/close relative and/or a friend as a confidant during HIV care (aOR 8.86, 95% CI 2.16–36.31, p = 0.002; and 195 aOR 21.68, 95% CI 3.02–155.87, p = 0.002, respectively). Non-disclosure of serostatus is a critical issue for HIV care and treatment programs, given that non-disclosure of HIV serostatus increases risk of HIV transmission. Understanding the factors associated with non-disclosure is crucial for designing strategies to address these factors and end the HIV epidemic by 2030. Our findings suggest that HIV serostatus disclosure programs might target the sociodemographic factors strongly associated with non-disclosure.

Psychological Health and Wellness and the Impact of a Supportive Text Messaging Program (Wellness4MDs) Among Physicians and Medical Learners in Canada: Protocol for a Longitudinal Study.

Burnout, anxiety, and depression continue to affect physicians, postgraduate medical trainees, and medical students globally and in Canada particularly after the COVID-19 pandemic. The primary goal of this project is to design, implement, monitor, and evaluate a daily supportive SMS text messaging program (Wellness4MDs, Global Psychological e-Health Foundation). The program aims to reduce the prevalence and severity of burnout, anxiety, and depression symptoms among physicians, postgraduate medical trainees, and medical students in Canada. This longitudinal study represents a multistakeholder, mixed methods, multiyear implementation science project. Project evaluation will be conducted through a quantitative prospective longitudinal approach using a paired sample comparison, a naturalistic cross-sectional controlled design, and satisfaction surveys. Prevalence estimates for psychological problems would be based on baseline data from self-completed validated rating scales. Additional data will be collected at designated time points for paired comparison. Outcome measures will be assessed using standardized rating scales, including the Maslach Burnout Inventory for burnout symptoms, the 9-item Patient Health Questionnaire for depression symptoms, the 7-item Generalized Anxiety Disorder scale for anxiety symptoms, and the World Health Organization-Five Well-Being Index. The project launched in the last quarter of 2023, and program evaluation results will become available within 36 months. The Wellness4MDs program is expected to reduce the prevalence and severity of psychological problems among physicians in Canada and achieve high subscriber satisfaction. The results from the Wellness4MDs project evaluation will provide key information regarding the effectiveness of daily supportive SMS text messages and links to mental health resources on these mental health parameters in Canadian physicians, postgraduate trainees, and medical students. Information will be useful for informing policy and decision-making concerning psychological interventions for physicians in Canada. PRR1-10.2196/44368.

Korean Immigrant Parents Are Validated in Their Perceptions of Deficits in Library Resources Supporting Korean Immigrants in Three Southeastern Suburban Counties

A Review of: Kim, Y., Kim, H. C. L., &amp; Kim, J. (2023). Korean immigrants’ perceptions of library services and library multicultural programs for Asian communities before and during COVID-19. Frontiers in Education, 8, Article 1081143. https://doi.org/10.3389/feduc.2023.1081143 Objective – To explore Korean immigrant parents’ use and perceptions of public libraries and to analyze the resources and programs offered by public libraries that specifically support multiculturalism and the needs of immigrants. Design – Descriptive case study using a questionnaire for parents and additional analysis of library resources and programs. Setting – Three public library systems within three counties in a metropolitan area of a southeastern U.S. state. Subjects – 141 Korean immigrant parents, as well as library resources and 318 programs offered across the three public library systems. Methods – Respondents were recruited among parents of children enrolled in nonprofit summer camps at three local Korean American churches. The questionnaire included two open-ended questions and six closed questions and was completed prior to the COVID-19 pandemic. It was analyzed with quantitative methods including Chi-square test and correlation and Spearman’s rank order correlation. SPSS was used to conduct an inferential analysis of the responses. The analyzed library resources and programs were divided into two different time periods; phase 1 or the “before COVID-19” phase consisted of data collection from January to April 2018, and phase 2 or the “during COVID-19” phase consisted of data collection from January to April 2021. The number of books and digital media in Korean, as well as the number of multicultural programs offered, were counted, and qualitative methods were used to classify the programs into categories for analysis. Main Results – Key results of the questionnaire include that 79% of the respondents resided in one of the three counties within the public library systems being analyzed, and 79% spent time at the library at least once per year. Reasons for visiting the library included children’s books (97%), study spaces (18%), books for parents’ needs (12%), and library programs (8%). Most respondents (82%) did not think or did not know if libraries offered programs for immigrants. Of parents who were aware of programs for immigrants, only 7% (n=1) were aware of being able to borrow books in Korean, and 53% (n=8) were aware of programs such as ESL classes. Correlation analysis showed that the more time a respondent spent at a library, the more they believed that the libraries offered programs for immigrants. Some respondents (43%, n=61) provided reasons for library dissatisfaction, which included language barriers (38%), lack of Korean resources (38%), lack of cultural events (25%), lack of knowledge about how to use the library (10%), and staff unkindness (7%). Respondents who listed future needs (23%, n=33) asked for academic support programs for their children (33%) and more services for adults (61%), including ESL classes (30%), cultural events (12%), adult classes (9%), and books in Korean (6%). The analysis of library resources across library systems A, B, and C respectively showed 371 (0.27% of total collection), 636 (0.27%), and 1 (0.04%) books in Korean, and 16, 89, and 0 electronic resources in Korean, with less than 4% of the total resources in Korean being published since 2009. The analysis of multicultural programs at library systems B and C was divided into analysis of programs for children and adults and included the number and frequency of programs within multiple categories. Multicultural programs were more likely to be offered to adults than to children, and the total adult multicultural programs increased during COVID-19 compared to before COVID-19. However, the percentage of specifically Asian American programming decreased during COVID-19 in System B (from 6.3% to zero) and increased in System C (from zero to 3%). Conclusion – Amongst the respondents, libraries were especially valued for access to books for their children. The respondents' perceptions of the lack of availability of multicultural programming, as well as resources specifically for the Korean community, was reflected in the analysis of programs offered, which showed that there were few programs offered specifically in support or celebration of Asian or Asian American communities. The analysis of books and electronic resources documents a lack of Korean-language resources, especially recently published resources. The number of resources at the libraries does not adequately reflect the percentage of Korean Americans in the larger community.

Improving State policy in the field of alternative energy

Subject. This article discusses the features of the development of alternative energy in Russia. Objectives. The article aims to summarize the foreign practices of implementing government policy in the field of alternative energy. Methods. For the study, we used systematization and generalization. Results. The article shows that in Russia, programmes of government support for alternative energy are aimed at attracting private investment and improving the efficiency of resource use. The main problems are related to the legal regulation and assessment of the efficiency of alternative energy sources. Conclusions. Programmes aimed at enhancing the attractiveness of alternative energy for the end consumer, as well as projects for the development of single large projects that can be scaled up over time, are the most relevant for Russia.

Risk of anxiety-related sleep disorder in nursing students

Introduction: Anxiety affects 29% of the world's population, with higher incidence in females (77%) and this begins before the age of 18 years. Academic pressure aggravates anxiety and can lead to severe or serious mental health problems. Objective: To correlate anxiety and sleep disorders in university students. Methods: This quantitative, descriptive, cross-sectional study seeks to test hypotheses about anxiety and sleep disorders in 100 nursing students of the Technical University of Ambato through surveys, analyzing data in SPSS and Excel. Results: 85% of the students experience severe levels of anxiety, which can negatively affect their sleep quality and general well-being. Conclusion: Anxiety in university students, especially in health areas, can lead to more serious mental health problems and affect their academic performance and clinical skills. Implementing psychological support and stress management programs is essential to improve their well-being and academic performance.