Infertility Prevention and Health Promotion: The Role of Nurses in Public Health Initiatives.

Infertility is a growing public health concern, affecting millions of individuals and couples worldwide. Despite advancements in medical treatments, prevention remains a critical strategy for reducing the burden of infertility. Nurses, as frontline healthcare providers, play a pivotal role in infertility prevention and health promotion, particularly through public health initiatives. This review aims to explore the diverse roles of nurses in infertility prevention and their contributions to public health strategies. A review of existing literature was conducted to examine the epidemiology of infertility, key risk factors, and the preventive measures that can be employed by nursing professionals. Emphasis is placed on the role of nurses in health education, screening, early detection, and community-based interventions, which are essential in reducing infertility rates. In addition, this review identifies barriers that impede effective nurse-led infertility prevention, such as disparities in access to care, cultural sensitivity challenges, and policy constraints. Evidence suggests that nurses are well-positioned to lead public health campaigns, conduct reproductive health counseling, and advocate for policy reforms to improve infertility prevention. The review concludes with recommendations for future research, suggesting enhanced nursing education and training, as well as the need for stronger integration of nurses into public health policy-making. This study underscores the critical role of nurses in promoting reproductive health and preventing infertility, advocating for their inclusion in comprehensive public health strategies aimed at addressing infertility on a global scale.

Entomologists in the K-12 Classroom: A Scoping Review.

Engaging the public is a common practice in science disciplines and is deeply rooted in the discipline of entomology. These efforts to engage specific target groups within the general public are well studied, especially extension efforts to engage farmers and agricultural stakeholders, but this is not the case for K-12 educational spaces. Here, we conducted a scoping review to (1) determine the characteristics of entomology outreach efforts engaging K-12 populations and (2) identify opportunities for improvement based on the synthesis of those characteristics. We systematically searched five databases to identify 42 publications relevant to the parameters of this project. Analysis of characteristics indicated that entomology outreach efforts in K-12 classrooms tend to be reflective, are more often published in educationally focused journals, and rarely evaluate the interventions employed. Opportunities for improvement were identified from these trends, and from them we suggest that the practice of K-12 outreach benefits from (i) publishing in entomology-focused journals, (ii) including non-academic authors, (iii) evaluating interventions, (iv) including student data, and (v) considering axes of diversity and inclusion.

Assessing the Outputs, Outcomes, and Impacts of Science Communication: A Quantitative Content Analysis of 128 Science Communication Projects.

Few studies have explored how science communication projects are evaluated and what impact they have. This study aims to fill this gap by analyzing the results of science communication projects carried out by academics. Drawing on the theory of change and evaluation models, possible results of science communication projects are conceptually distinguished at the levels of outputs, outcomes, and impacts. The study draws on a dataset of 128 science communication projects funded by the Swiss National Science Foundation from 2012 to 2022. Quantitative content analysis reveals few rigorous evaluation designs and a focus on reporting outputs, while outcomes and societal impacts are often neglected.

Champions to enhance implementation of clinical and community-based interventions in cancer: a scoping review.

BACKGROUND: Champions are integral across research in cancer, yet studies exploring their roles are limited and have produced mixed results. The current review examines and synthesizes descriptions of how champions emerged and the types of activities they most often performed. By examining evidence from across the translational research continuum, this scoping review aims to characterize the role of champions and strategies that facilitate their involvement in the implementation of cancer care interventions in both clinical and community-based settings. METHODS: This scoping review was designed and implemented in compliance with PRISMA-ScR. The review focused on peer-reviewed articles in English-language journals. We searched five databases: PubMed (including MEDLINE), Scopus (including EMBASE), CINAHL, PsycINFO, and the Cochrane Library. Articles published from 1971 to 2022 were included. Two members of the team reviewed in duplicate each article and then a single member of the team extracted the data in Covidence, with a second member comparing the extraction to the original article. Qualitative and quantitative data were extracted and then synthesized. These data were used to summarize core champion activities and implementation strategies and to characterize barriers and facilitators to using champions in research. RESULTS: A total of 74 articles were included in the review. The qualitative synthesis highlighted facilitators and barriers to the effective use of champions. Facilitators included consideration of an individual's characteristics when identifying champions, time spent planning for the specific responsibilities of champions, working within a supportive environment, and identifying champions embedded in the target setting. Major barriers included constrained time, low self-efficacy among champions, inadequate training, high turnover rates of champions, and a lack of buy-in from organizational leadership toward the intervention. Champions also were mostly assigned their roles, had varied core activities, and used complementary strategies to empower their target populations. Champions' most frequent core activities include facilitation, outreach/promotion, and recruitment of participants into studies. CONCLUSIONS: Champions were used in research of many cancer types and often serve similar roles regardless of where they are located within the translational research process. Despite their critical role, evidence is lacking on the impact of champions specifically on outcomes of many of the research studies that include them. Future research is needed to understand the nuances of champion-driven approaches across diverse cancer care settings.

Buprenorphine prescription and treatment initiation through preemptive outreach and telehealth consultation with emergency medicine providers.

BACKGROUND: Persons with opioid use disorder (OUD) urgently need improved access to medications for opioid use disorder (MOUD) and long-term treatment. Promising options include initiating buprenorphine in the emergency department (ED), telemedicine, and proactive treatment referrals before overdose events. OBJECTIVE(S): We describe the process and outcomes of a novel referral path utilizing preemptive outreach and telemedicine to facilitate rapid access to MOUD and long-term treatment. METHODS: Participants were referred to telemedicine appointments with ED providers for buprenorphine initiation and to treatment agencies via an electronic referral network. Administrative data tracked participation at each stage of the process. Independent samples t-tests and chi-square tests assessed differences in process completion based on demographics. RESULTS: 163 persons with OUD or recent opioid overdose were referred, with high rates of participant follow-through, resulting in 126 new buprenorphine prescriptions and 114 linkages to long-term treatment. Of the 163 patients referred, 114 (69.9%) completed all steps. Participant demographics were not associated with significantly different completion rates. CONCLUSIONS: This model serves as a viable pathway to link people to treatment resources and MOUD, and novelly combines prospective client outreach with telemedicine to reach persons before they arrive in the ED following an overdose. Future studies should examine the impact of similar programs on subsequent opioid use rates and treatment retention.

Exploring virtual delivery of academic detailing to general practitioners compared with in-person delivery: a qualitative study.

BACKGROUND: Inappropriate prescribing may have detrimental consequences for the patient and increase healthcare utilisation and costs. Academic detailing (AD) is an interactive outreach method to deliver non-commercial evidence-based medical information to healthcare professionals, aiming to improve patient care. Performing AD virtually has recently become more relevant, especially with the COVID-19 pandemic. OBJECTIVES: The aim of this study was to explore general practitioners' (GP's) experiences and perceptions of virtually delivered AD. METHODS: We invited practicing GPs that had received virtual AD in Norway during autumn 2020. Semistructured individual interviews were audio and video recorded during February-May 2021. Interviews were transcribed and analysed applying thematic analysis according to Braun and Clarke. RESULTS: From interviews with nine GPs, we identified five themes concerning (1) informants' satisfaction with virtual AD and their opinions about the detailers and their characteristics, (2) factors that are important for participation in AD, with the campaign topic being the most important, (3) a paradox between the informants' desire for more time for discussion and the time constraint they are facing, (4) the many benefits of virtual AD compared with in-person AD and (5) the informants' perceived learning outcomes are unaffected by mode of AD delivery. CONCLUSION: Virtual AD worked very well in terms of scheduling the visit, using technology to facilitate the visit and achieving the same learning outcomes. Virtual AD should be offered to GPs as an alternative to the traditional in-person AD, especially in remote geographical areas or in circumstances when physical outreach is challenging.

Cultural Insiders and Graphic Stories to Promote Research Readiness Among the South Asian Community: A Focus on Purpose, Protection, and Participation.

South Asians living in the United States are frequently underrepresented in health research. Their lack of participation limits the generalizability of research to them and keeps them from receiving the high-quality care and innovation that some studies may offer. "Research Ready" is a five-panel, community co-created graphic-style story that encourages discussion around the purpose of research, safety/protection while participating, and why diverse participation-including South Asians-improves study results and leads to more effective interventions/treatments. This study leveraged trained young adult "cultural insiders" to invite attendees of a Midwestern South Asian Cultural Festival to read the story aloud together as the characters in English or Hindi and used a decision guide to invite discussion. Post-discussion surveys (N = 104) were analyzed using descriptive statistics. Participants spanned from 10 to 79 years, with 42% < 18 years and more females (61%). Only 18.3% indicated having prior research participation. Adults 40+ years (60%) requested the story/discussion in Hindi, compared to 2.3% of adolescents and 6.7% of younger adults. After the discussion, participants indicated their willingness to consider participation, with most being open to participating in surveys/interviews (95.2%); only 52.9% would consider studies requiring the taking of medicines. Adolescents, females, and adults with higher education were more willing to participate in medication studies. Nearly all (97.1%) said they would feel safe participating in research, and 88.5% shared that the discussion would help them better decide about future participation. In conclusion, "Research Ready" discussions shared by cultural insiders effectively encourage South Asians to consider future research participation.

An outreach strategy to increase uptake of vaginal self-sampling for cervical cancer screening in older French women: The RIDECA interventional research protocol.

BACKGROUND: In France, approximately 40% of women, including menopausal women, do not participate in cervical cancer screening. Many studies and meta-analyses have shown that self-sampling devices for high-risk human papillomavirus (HR-HPV) testing are valuable tools to increase participation. The success of self-sampling screening strategies depends on several factors, including the manner and circumstances in which the women are invited to participate. The acceptability and effectiveness of these strategies should be evaluated before further implementation. OBJECTIVES: The primary objective is to evaluate the uptake of cervical cancer screening in under-screened women, based on a direct offer of a vaginal self-sampling device by a midwife. DESIGN: RIDECA is an interventional research project located in the South of France. METHODS AND ANALYSIS: Six hundred women aged 50-65 with no cervical smear or HR-HPV test for 3 years or more will be recruited at two sites. The device will be offered to enrolled women to utilize at home and return to the Montpellier Hospital laboratory for HR-HPV testing. Completion of self-sampling by women who have accepted the device and follow-up of those with positive HR-HPV DNA tests will be monitored. During recruitment, participants will complete questionnaires on their socio-economic environment and motivational factors based on the psychosocial I-Change model. Semi-structured interviews will be conducted with a sub-group to identify barriers and levers to participation. Statistical analyses will be conducted for the full research sample and for each recruitment site. ETHICS: The project was approved by the Ethical Research Committee Ile de France VI and by the French Data Protection Authority. DISCUSSION: The results will provide useful information on the effectiveness (acceptability, efficiency) of this outreach strategy and identify barriers and levers that facilitate its implementation. REGISTRATION: ClinicalTrials.gov (NCT04716127), January 20, 2021.

Can we improve postmenopausal women's adherence to cervical cancer screening by using vaginal self-sampling and a direct approach by a midwife?Why is this study being done?In France, 40% of women, especially postmenopausal women, do not participate in cervical cancer screening. We already know that vaginal self-collection with HPV testing is highly accepted by women and increases their participation in screening. Different strategies have been proposed as the most appropriate approach to utilize when offering the vaginal self-sampling option to women.What are the researchers doing?The study, set up in the Occitania region of France, is still ongoing and is targeting women aged 50­65 who have not been screened for cervical cancer. The aim of the study is to assess whether reaching women in their everyday environment and offering them a vaginal self-collection device during an educational session with a midwife improves their adherence to and participation in cervical cancer screening.To answer these questions, we will recruit six hundred women aged 50­65 who have not been screened for cervical cancer for three years or more at two sites:- In the department of Hérault, where midwives will approach women visiting a mobile breast cancer screening unit,- in the department of Aude, where a midwife can easily arrange appointments for interested women, following an information campaign.Participants who agree to take part will receive a self-sampling kit to use at home and return to the laboratory for HR-HPV testing. During recruitment, we will also use questionnaires and interviews to assess women's socio-economic situation and motivations for participating (or not) in cervical cancer screening.What are the expected results?This study will allow us to assess women's adherence to this "direct" "face-to-face" cervical screening strategy and the potential influence of socio-economic and motivational factors on adherence. Through gaining these vital insights, we hope to identify the barriers and levers that will facilitate its implementation.

A perspective on integration and outreach: Guiding concepts in the evolution of health informatics.

BACKGROUND: The National Library of Medicine's Integrated Academic/Advanced Information Management Systems (IAIMS) initiative played a central role in the evolution of health informatics over the project's lifetime (1983-2009) and continues to do so. AIM: Our objective is to demonstrate how IAIMS and two key IAIMS concepts, integration and outreach, have functioned at very different times during this evolutionary process. APPROACH: Using a framework drawn from Lorenzi and Stead's 2021 history of IAIMS, we examine the role of integration and outreach in work at the University of Maryland Baltimore (UMB) in the early 1980s and at the University of Texas Arlington (UTA) in 2020. RESULTS: Guided by these concepts, UMB implemented a campus-wide information utility, while UTA established a center to accelerate research and innovation. CONCLUSIONS: Outreach and integration have been formative in the evolution of health informatics and will continue to hold their power.

BRIDGING THE GAP - EARLY COMMUNITY OUTREACH AS AN INITIATIVE TO INCREASE REPRESENTATION IN RADIOLOGY.

RATIONALE AND OBJECTIVES: Underrepresentation of minorities is a worsening issue in the field of radiology. Early educational interventions are a promising approach to mitigating this disparity. We present an approach for a radiology department to increase community outreach via establishment of an educational program for local public high school students and building a mentorship pipeline for radiology education. MATERIALS AND METHODS: The department of radiology committee for Inclusion Diversity and Equity (IDE), in collaboration with the Office of Outreach, Education and Research (OER), invited yearly cohorts of 25 and 24 public high school students in 2022 and 2023, respectively, to an on-site educational event featuring rotating small group hands-on workshops in a multi-stage format. The event inspired students to consider various careers in radiology and their corresponding academic pathways after high school. Post-workshop surveys featuring Likert scale and open-ended questions were administered to collect student reflections and feedback. Analysis was conducted to assess student understanding, interest in radiological careers, and opportunities for future event improvements. Longitudinal mentorship was established between students and point-persons to provide continued career guidance. RESULTS: For two consecutive cohort years, the program received high scores on clarity of presentations and increased student awareness of opportunities within radiology. Standout positive elements included interactive sessions, hands-on activities, and the discovery of radiology as a collaborative field. Of the initial student group, one student went on to enroll in a radiography program. To date, five participants have returned for shadowing experiences, three of whom are currently enrolled in science undergraduate programs, including one pre-medical student. CONCLUSION: We present an accessible and effective approach for a radiology department to collaboratively increase community outreach and improve minority representation through early educational programming and establishing a longitudinal pipeline mentorship program for public high school students.

The Neuroscience Research Opportunities to Increase Diversity Program: Transformative and Successful Research Training Strategies for Undergraduate Students within Hispanic Serving Institutions.

Over the past 14 years, the Neuroscience Research Opportunities to Increase Diversity (NeuroID) program, funded by the National Institute of Neurological Diseases and Stroke (NINDS), has played a transformative role in training numerous undergraduate Hispanic students within The University of Puerto Rico-Rio Piedras (UPR-RP). This innovative Neuroscience-based research training initiative has successfully guided dozens of Hispanic students toward graduate programs in Neuroscience, significantly contributing to the enhancement of diversity within the academic and scientific fields. The achievements of the NeuroID program can be attributed to three key objectives. Firstly, the establishment of a comprehensive and innovative program has provided Hispanic undergraduate students with invaluable insights into various facets of a research career in neuroscience. Secondly, the program has fostered a robust mentorship network that supports selected students throughout their journey to become neuroscientists. Thirdly, it has strengthened the neuroscience network in Puerto Rico by bridging the gap between undergraduate teaching universities and research laboratories in top-tier institutions across the mainland United States.

Bridging the gap: Leveraging telemedicine and IT infrastructure to connect outpatient oncology practices with specialized expert teams in the management of rare tumors.

Objectives: The treatment of rare tumors often necessitates the involvement of highly specialized teams, typically based in larger medical centers or university hospitals, which are often lacking in rural areas. The German TARGET (the Trans-sectoral Personalized Care Concept for Patients with Rare Cancers) project aims to improve the network between outpatient oncology practices and more centralized expert teams via telemedicine. Methods: The primary work involved conceptualizing the implementation of project requirements based on feedback from various TARGET project teams, and ultimately, the method of implementation using the software CentraXX. Key requirements included the utilization of an electronic health record (EHR), incorporating appropriate access mediums such as smartphones, and utilizing user-specific certificates to ensure secure and tailored access. The implementation considered technical aspects, data protection regulations, and the need for user-friendly interfaces, particularly for older patients with cancer with limited technological proficiency. Results: The results detail the successful implementation of the project requirements using CentraXX, which facilitated the implementation of an EHR, access mediums (patient app), and browser access for outpatient doctors, addressing the project's technical, security, and usability needs. Conclusion: This article presents an overview of the requirements associated with the TARGET project and outlines how they were met in terms of the IT infrastructure. By focusing on the IT implementation rather than the medical trial results, this work aims to provide valuable insights and guidance for similar projects seeking to improve telemedicine networks and digital information exchange in the context of rare cancer treatment.

How Other Specialists See Palliative Care Uncovering Their Deep Metaphors to Improve Our Initial Outreach Strategies.

Many patients who could benefit from palliative care (PC) do not access it because of the timing and tenor of the introduction provided by their specialist. A barrier to improving specialists' (from disciplines other than PC) engagement with PC services may be an inadequate understanding of how those specialists view PC. As part of a larger project to develop public messaging for advance care planning, PC, and hospice, we conducted a qualitative market research study aimed at identifying the "deep metaphors" held by specialists about PC to provide an empirical foundation for more effective outreach and messaging. To identify deep metaphors, we used the qualitative Zaltman Metaphor Elicitation Technique to uncover thought patterns from participants' images and interview responses, revealing deeper emotional meanings and unconscious mental orientations. We enrolled 20 provider-level clinicians from a variety of professional disciplines and specialties to participate in a one-hour semi-structured interview that required prework. The interviews were videorecorded and transcribed and were analyzed along with images brought by participants using a variation of the constant comparative method. The themes included: Having to tell patients the "right" information and path; Not allowing myself to make mistakes; Depending on algorithms so I can give my patients the best care; Putting the patient in charge can challenge clinical algorithms; Observing that PC seems to lack an objectively "right" decision; Consulting PC invites subjectivity best contained at the end of the algorithm. These themes can inform strategies for outreach and messaging to other serious illness specialist clinicians to lower reluctance to consult PC, increasing patient access.

Utilizing machine learning to predict participant response to follow-up health surveys in the Millennium Cohort Study.

The Millennium Cohort Study is a longitudinal study which collects self-reported data from surveys to examine the long-term effects of military service. Participant nonresponse to follow-up surveys presents a potential threat to the validity and generalizability of study findings. In recent years, predictive analytics has emerged as a promising tool to identify predictors of nonresponse. Here, we develop a high-skill classifier using machine learning techniques to predict participant response to follow-up surveys of the Millennium Cohort Study. Six supervised algorithms were employed to predict response to the 2021 follow-up survey. Using latent class analysis (LCA), we classified participants based on historical survey response and compared prediction performance with and without this variable. Feature analysis was subsequently conducted on the best-performing model. Including the LCA variable in the machine learning analysis, all six algorithms performed comparably. Without the LCA variable, random forest outperformed the benchmark regression model, however overall prediction performance decreased. Feature analysis showed the LCA variable as the most important predictor. Our findings highlight the importance of historical response to improve prediction performance of participant response to follow-up surveys. Machine learning algorithms can be especially valuable when historical data are not available. Implementing these methods in longitudinal studies can enhance outreach efforts by strategically targeting participants, ultimately boosting survey response rates and mitigating nonresponse.

"In a word, partnership"-lessons from a student-led health fair.

In this narrative account, we describe our experiences as medical students coordinating a health fair in collaboration with a student-led free clinic. We gain insights into the challenges of delivering healthcare beyond the walls of a clinic or hospital. This article explores the importance of integrating community-based initiatives into medical student education.

Enhancing stroke knowledge among youth: Insights from Stroke Busters.

INTRODUCTION: Community stroke education has shown promising results with sustained stroke knowledge and behavioral changes; however less is known about the effects of targeted education towards youth. We developed an interactive educational program for high school students, Stroke Busters, that focuses on stroke prevention, recognizing warning signs, and the importance of seeking prompt care. METHODS: This is a prospective cohort study where students are offered a stroke education program, 'Stroke Busters', through the Yale Pathways to Science Program, a Science, Technology, Engineering and Math (STEM) pipeline program for high school students living near New Haven, Connecticut. Students filled out a stroke knowledge survey before, after, and 8-months-post program. Data from four separate sessions were collected (two 5-day programs and two 1-day programs) and scores were compared. Students who returned to help teach were also evaluated with an additional post-test. RESULTS: The average pre-program score was 36.9% and post-program was 62.5% (N=67, p<0.001) across all sessions. Between sessions, scores were not significantly different. 8-month post-program scores (n=5) were not significantly different from immediate post-program scores. Students in the role of teaching-assistant had post-program scores of 85.7%. DISCUSSION: High school students who participated in Stroke Busters retained stroke knowledge for up to 8 months. The 1-day program showed similar results to the 5-day program, which suggests providing shorter programs to high school students may represent a more feasible opportunity for community stroke prevention. Additionally, including students in a teaching role is a promising way to increase enthusiasm and stroke knowledge for youth. CONCLUSION: Stroke Busters was successfully able to educate high school youth about stroke and programs of both 1 and 5-day are equally effective.

Patient follow-up after discharge from the paediatric intensive care unit: A scoping review.

BACKGROUND: Most children admitted to a paediatric intensive care unit (PICU) now survive because of improvements in care. Many studies have identified the psychological, functional, cognitive and social impact of PICU admission on a child and their family. However, expert recommendations on follow-up are lacking. AIM: To identify the strategies of clinical follow-up after PICU discharge performed from 2001 to 2021. STUDY DESIGN: This scoping review was undertaken between January and April 2021 using three databases: PubMed, EMBASE and CINAHL. The search strategy consisted of a combination of keywords, including PICU, post-PICU discharge and follow-up in articles published between 2001 and 2021. The results are reported according to PRISMA-ScR guidelines. RESULTS: Six-hundred and fifty-two articles were identified and 68 were analysed. Median age was 4.5 years and the two main reasons for PICU admission were cardiorespiratory failure and sepsis. Median length of PICU stay was 8 days. Most follow-up was carried out by research units (88%), while 6% of studies reported follow-up by a multidisciplinary PICU team. The most common follow-up schedule included an assessment at PICU discharge, and then at 3, 6 and 12 months. Follow-up for >1 year was reported in 20% of studies. One third of studies focused on follow-up quality of life and neurological outcomes. Parental emotional impact was assessed in 7% of studies. CONCLUSION: Follow-up after PICU discharge was highly heterogeneous regarding timing, health care professionals involved and assessment methods. There is an urgent need for standardization and coordination of PICU follow-up because of the increasing number of patients impacted by a PICU stay. RELEVANCE TO CLINICAL PRACTICE: Although most patients admitted to a paediatric intensive care unit (PICU) now survive; they may develop paediatric post-intensive care syndrome (PICS-P). To our knowledge, there are currently no clinical guidelines regarding follow-up after PICU discharge. This review summarizes current approaches to follow-up after PICU discharge, including how it is carried out, who is involved and what the main aims of assessment are.

Socioeconomic inequalities in uptake of outreach mammography before and after accessibility improvement of Taiwan's national universal breast cancer screening policy.

BACKGROUND: Taiwan implemented the Cancer Screening Quality Improvement Program (CAQIP) in 2010. The program sought to enhance mass breast cancer screening accessibility. This study aimed to examine socioeconomic disparities in outreach screening utilization pre-CAQIP (2005-2009) and post-CAQIP (2010-2014). METHOD: We conducted a nationwide population-based observational study in Taiwan, analyzing four population databases to evaluate socioeconomic disparities among women aged 50 to 69 years undergoing their first mammography screening pre-CAQIP. Multivariate logistic regression was used to examine changes in utilization of outreach screening pre- and post-CAQIP implementation, and to estimate the Slope Index of Inequity (SII) and Relative Index of Inequity (RII) values. RESULTS: Utilization of outreach screening through mobile mammography units (MMUs) increased from 6.12 to 32.87% between the two periods. Following CAQIP, a higher proportion of screened women were older, less educated, and from suburban or rural areas. The SII and RII for age, income, and urbanization levels decreased post-CAQIP. However, regarding education level, SII was - 0.592 and RII was 0.392 in the pre-CAQIP period, increasing to -0.173 and 0.804 post-CAQIP, respectively. CONCLUSIONS: Our study observed that utilization of outreach screening through MMUs increased after CAQIP. The MMUs made outreach screening services more accessible in Taiwan. Expanding outreach screening services and educational programs to promote mammography uptake in local communities could help reduce the potential effect of socioeconomic disparities, and thus may enhance early detection of breast cancer. Further study could focus on the accessibility of outreach screening and breast cancer outcomes.

An Assertive Community Intervention to Engage Youth with Opioid Use Disorder and Their Families.

Medications for opioid use disorder (MOUD) are the most effective treatment for OUD. Many patients struggle with adherence, but young adults face unique developmental barriers and experience higher relapse rates. The Youth Opioid Recovery Support (YORS) intervention is a developmentally informed behavioral approach to increase medication adherence through assertive outreach, family involvement, low-barrier access to extended-release MOUD, and contingency management. Early studies have shown promising results, and a randomized controlled trial is underway. Here we describe the implementation of YORS using case examples, offer guidance on adapting YORS to real-world clinical settings, and explore future directions for research and practice.