The prevalence of fire and CO safety amenities in Airbnb venues that permit smoking - Findings from 17 countries.

Airbnb hosts rent their homes to guests as an alternative to traditional hospitality settings. Airbnb venues are not uniformly regulated for allowing smoking or requiring fire-safety amenities. This study quantified the reported prevalence of fire-safety amenities in 413,339 Airbnb venues that allow smoking in 43 cities in 17 countries. Proportions of host-reported smoke detectors and carbon monoxide (CO) alarms, and those that allow smoking were calculated. Across the entire sample 9.3% (n = 38,525) allowed smoking. An overall evaluation of those venues shows that 46% (n = 17,569) had smoke detectors compared to 64% of the 374,814 venues that do not allow smoking, a statistically significant difference (X2 = 5277 p < 0.01). A similar difference is found between venues that allow smoking and had CO alarms (19%, n = 7176) and the 33% of venues that prohibit smoking (X2 = 3442, p < 0.01). Among this sample, most Airbnb venues that allow smoking are less likely to have safety amenities.

Reported fire safety and first-aid amenities in Airbnb venues in 16 American cities.

Airbnb helps hosts rent all or part of their home to guests as an alternative to traditional hospitality settings. Airbnb venues are not uniformly regulated across the USA. This study quantified the reported prevalence of fire safety and first-aid amenities in Airbnb venues in the USA. The sample includes 120 691 venues in 16 US cities. Proportions of host-reported smoke and carbon monoxide (CO) detectors, fire extinguishers and first-aid kits were calculated. The proportion of venues that reportedly contained amenities are as follows: smoke detectors 80% (n=96 087), CO detectors 57.5% (n=69 346), fire extinguishers 42% (n=50 884) and first-aid kits 36% (n=43 497). Among this sample of Airbnb venues, safety deficiencies were noted. While most venues had smoke alarms, approximately 1/2 had CO alarms and less than 1/2 reported having a fire extinguishers or first-aid kits. Local and state governments or Airbnb must implement regulations compliant with current National Fire Protection Association fire safety standards.

Combat Readiness, Harm Aversion, and Promotion Eligibility: A Qualitative Study of U.S. Servicemembers Views on Tobacco Use and Control in the Military.

INTRODUCTION: More than half a century after the first Surgeon General's Report on Smoking and Tobacco Use, tobacco use remains the leading cause of preventable disease for the U.S. military. Military tobacco use impairs troop readiness, decreases productivity, reduces servicemember physical performance, and leads to chronic illness in veterans. The Department of Defense (DoD) spends considerable effort to maintain a combat ready force, and tobacco use is contradictory to these efforts. U.S. servicemember tobacco use is estimated to cost the federal government more than $6.5 billion annually. The uniqueness of military culture allows for innovative means of tobacco regulation and prevention. Our study examines the U.S. Navy cultural and servicemember perceptions to inform future tobacco control research and policies. MATERIALS AND METHODS: We developed a behavioral model of tobacco use from existing literature. Using this model as a theoretical framework, our study qualitatively examined tobacco use in the active duty Navy population stationed in Okinawa, Japan. Thirty one-on-one interviews were conducted with active duty servicemembers. Sessions were recorded, transcribed, and analyzed in MAXQDA12. RESULTS: Multiple military-specific themes were identified. Themes: (1) tobacco use is a "right," (2) the military may limit active duty servicemembers' rights, (3) tobacco restrictions are justified if they prevent harm to others, (4) tobacco restrictions are not widely enforced, (5) smoke breaks are viewed as a legitimate reason to rest at work, and (6) the benefit of tobacco is as a stimulant. Novel tobacco cessation techniques suggested by our study include: (1) expand the buddy system to create an artificial support network for tobacco cessation and (2) tie promotion eligibility to tobacco use. CONCLUSIONS: This qualitative study identifies military-specific themes from the tobacco user perspective that help to guide research and policy in reducing tobacco use among military servicemembers. Possible interventions suggested by our findings may include replacing tobacco breaks with fitness breaks to relieve workplace stress and support the culture of fitness, expanding the use of pharmacologic stimulants to replace tobacco when used to maintain alertness, and gathering social support for tobacco cessation from non-healthcare unit members. Further study is needed to elucidate the effectiveness of proposed interventions suggested by our findings, with the ultimate aim of policy changes within the military to optimize health and military readiness, while decreasing long-term health effects and costs of tobacco use.

How the science of injury prevention contributes to advancing home fire safety in the USA: successes and opportunities.

BACKGROUND: In the decades since the landmark report-America Burning-was published in 1973, the number of home fire deaths has shrunk from >5500 per year to 2650 in 2015. This paper: (1) describes how science and practice in injury prevention and fire and life safety contributed to successful interventions, and (2) identifies emerging strategies and future opportunities to prevent home fire-related deaths. METHODS: The aims are addressed through the lens of population health research, with a focus on the work of selected Centers for Disease Control and Prevention-funded Injury Control Research Centers. Results are organised using the Haddon Matrix and an ecological model. RESULTS: We found evidence to support interventions that address all components of both the matrix and the model, including: reduced ignition propensity cigarettes, stop smoking campaigns, housing codes, residential sprinkler systems, smoke alarms, community risk reduction, school-based educational programmes, and fire and burn response systems. Future reductions are likely to come from enhancing residential sprinkler and smoke alarm technology, and increasing their utilisation; expanding the use of community risk reduction methods; and implementing new technological solutions. Despite the successes, substantial disparities in home fire death rates remain, reflecting underlying social determinants of health. CONCLUSION: Most of the evidence-supported interventions were focused on changing the policy and community environments to prevent home fires and reduce injury when a fire occurs. Future prevention efforts should give high priority to addressing the continued disparities in home fire deaths.

The impact of policy, environmental, and educational interventions: a synthesis of the evidence from two public health success stories.

Motor vehicle safety and tobacco control are among the greatest public health achievements of the 20th century, according to the Centers for Disease Control and Prevention. As the number of miles traveled in the United States multiplied 10 times from the 1920s to the 1990s, the annual motor vehicle crash death rate per vehicle mile traveled decreased by 90%. Similarly, tobacco-related deaths from heart disease, stroke, and cancer were rapidly mounting over the first two thirds of the 20th century. Then, in the last third of the century, tobacco consumption decreased by more than 50%, and rates of heart disease and stroke deaths, and later cancer deaths, declined similarly. This analysis addresses the central question of what lessons can be learned from these success stories that will help public health professionals successfully tackle new and emerging health behavior problems of today and tomorrow? Surveillance, research, multilevel interventions, environmental modifications, and strong policies were key to reducing motor vehicle- and tobacco-related health problems. Generating public support and advocacy, and changing social norms also played critical roles in promoting the safer and smoke-free behaviors. Lessons learned include the need for evidence-based practices and interventions that are ecologically comprehensive with an emphasis on changing environmental determinants and capitalizing on the concept of reciprocal determinism. The analysis concludes with a description of how the PRECEDE-PROCEED planning framework can be used to apply the lessons from motor vehicle safety and tobacco control to other public health threats.

Using the theory of planned behavior to predict aggression and weapons carrying in urban African American early adolescent youth.

Aggressive and weapons carrying behaviors are indicative of youth violence. The theory of planned behavior is used in the current analysis to improve our understanding of violence-related behaviors. We examine the influence of perceived behavioral control (self-control and decision making) as a part of the overall framework for understanding the risk and protective factors for aggressive behaviors and weapons carrying. As the baseline assessment of an intervention trial, survey data were collected on 452 sixth-grade students (50% girls; 96.6% African American; mean age 12.0 years) from urban middle schools. A total of 18.4% carried a weapon in the prior 12 months, with boys more likely to carry a weapon than girls (22.5% vs. 14.2%, p = .02). Of the youth, 78.4% reported aggressive behaviors with no significant differences found between girls (81.3%) and boys (75.5%). In logistic regression models, having peers who engage in problem behaviors was found to be a significant risk factor. Youth with peers who engaged in numerous problem behaviors were five times more likely to be aggressive than those who reported little or no peer problem behaviors. Teens who reported that their parents opposed aggression (odds ratio [OR] = 0.76; confidence interval [CI] = 0.66, 0.88) and who used self-control strategies (OR = 0.59; CI = 0.39, 0.87) were found to report less aggressive behaviors. For weapons carrying, being a girl (OR = 0.56; CI = 0.32, 0.97) and self-control (OR = 0.52; CI = 0.29, 0.92) were protective factors. This study demonstrated that the theory of planned behavior may provide a useful framework for the development of violence prevention programs. Practitioners should consider integrating strategies for developing healthy relationships and improving self-control.

Do prehospital criteria optimally assign injured children to the appropriate level of trauma team activation and emergency department disposition at a level I pediatric trauma center?

PURPOSE: To examine the association of prehospital criteria with the appropriate level of trauma team activation (TTA) and emergency department (ED) disposition among injured children at a level I pediatric trauma center. METHODS: Injured children younger than 15 years and transported by emergency medical services (EMS) from the scene of injury between January 1, 2008 and December 31, 2011 were identified using the institution's trauma registry. Logistic regression was used to study the main outcomes of interest, full TTA (FTTA) and ED disposition. RESULTS: Out of 3,213 children, 1,991 were eligible and analyzed. Only 279 children initiated the FTTA and 73.9% were admitted. Having a chest injury, abnormal heart rate or Glasgow Coma Scale less than 9 (GCSLT9) in the field was associated with higher odds of initiating the FTTA (odds ratio [OR] = 3.33, 95% confidence interval [CI] 1.54-7.20; OR = 2.59, CI 1.15-5.79 and OR = 2.67, CI 1.14-6.22, respectively). Children with the criteria above in addition to abdominal injury were more likely to be discharged to the ICU, OR or morgue compared to those without them. CONCLUSION: Children with GCSLT9, abnormal heart rate, chest and abdominal injury showed a strong association with FTTA and higher resource utilization.

Transforming the healthcare response to intimate partner violence and taking best practices to scale.

BACKGROUND: Intimate partner violence (IPV) is prevalent among adolescent and adult women, with significant physical, sexual, and mental health consequences. In 2011, the Institute of Medicine's Clinical Preventive Services for Women consensus report recommended universal screening for violence as a component of women's preventive services; this policy has been adopted by the Health Resources and Services Administration (HRSA). These policy developments require that effective clinic-based interventions be identified, easily implemented, and taken to scale. METHODS: To foster dialogue about implementing effective interventions, we convened a symposium entitled "Responding to Violence Against Women: Emerging Evidence, Implementation Science, and Innovative Interventions," on May 21, 2012. Drawing on multidisciplinary expertise, the agenda integrated data on the prevalence and health impact of IPV violence, with an overview of the implementation science framework, and a panel of innovative IPV screening interventions. Recommendations were generated for developing, testing, and implementing clinic-based interventions to reduce violence and mitigate its health impact. RESULTS: The strength of evidence supporting specific IPV screening interventions has improved, but the optimal implementation and dissemination strategies are not clear. Implementation science, which seeks to close the evidence to program gap, is a useful framework for improving screening and intervention uptake and ensuring the translation of research findings into routine practice. CONCLUSIONS: Findings have substantial relevance to the broader research, clinical, and practitioner community. Our conference proceedings fill a timely gap in knowledge by informing practitioners as they strive to implement universal IPV screening and guiding researchers as they evaluate the success of implementing IPV interventions to improve women's health and well-being.

An innovative faith-based healthy eating program: from class assignment to real-world application of PRECEDE/PROCEED.

The Fostering African American Improvement in Total Health! (FAITH!) Nutrition Education Program is a theory-based, multicomponent health intervention developed and operated in partnership with an East Baltimore church. The program aims to improve eating habits, as well as knowledge and beliefs about healthy eating, among African American adults in order to prevent diseases related to dietary choices. This article addresses the development, design, and formative research that informed the FAITH! program. The main program components are also discussed. Program design used a framework for strategic intervention planning (PRECEDE-PROCEED), and health education theories informed the evaluation process. Formative research was conducted to incorporate the needs and assets of the priority population. The main program components are culturally tailored educational materials, lectures and discussions on diet and related diseases, video presentations on healthy eating, healthy cooking demonstrations/food samples, evaluation, and a church-run healthy food pantry.

Neighborhood violence and its association with mothers' health: assessing the relative importance of perceived safety and exposure to violence.

This paper presents a cross-sectional study examining the influence of neighborhood violence on multiple aspects of mothers' health. While the influence of neighborhood violence on health is important to understand for all populations, mothers are especially important as they play a key role in protecting their children from the consequences of violence. Three hundred and ninety-two Baltimore City mothers of children 5 years and younger completed a self-administered survey that included questions about perceptions of their safety as well as their personal experiences with neighborhood violence. Separate models were run to compare the relationship between each measurement of neighborhood violence and five diverse health-related determinants and outcomes: self-reported health status, smoking, exercise, average hours of sleep a night, and sleep interruption. Controlling for mother's age, child's age, maternal education, and marital status, mothers with high exposure to neighborhood violence were twice as likely to report poorer health, smoking, never exercising, and poor sleep habits. Maternal perception of neighborhood safety was not related to any of the assessed health-related determinants and outcomes. This study emphasizes the importance of measuring exposure to neighborhood violence rather than solely assessing perceived safety. Neighborhood violence was a common experience for mothers in this urban sample, and should be considered by health professionals in trying to understand and intervene to improve the health of mothers and their children.

A qualitative exploration of the community partner experience in a faith-based breast cancer educational intervention.

Although community partner engagement is a key component in faith-based health promotion/disease prevention intervention research, the perspective of community partners on their experiences in the intervention process has been infrequently investigated. Semi-structured in-depth interviews were conducted with 12 African-American community partners [i.e. four pastors and eight lay health co-ordinators (LHCs)] from eight churches in greater Baltimore, MD, USA, that engaged in a breast cancer educational intervention that followed a community-based participatory research (CBPR) approach. Audiotaped interviews were transcribed, coded and content analysis was used to identify themes across the codes. Findings show that pastors support a holistic approach to health and that LHCs act as a link between the pastors, participants and academic researchers. In addition, pastors and LHCs emphasized that the religious and/or spiritual program elements should not overpower the importance of reaching participants with critical health information regardless of their religious or spiritual beliefs. Study findings suggest that faith-based educational intervention efforts that follow a CBPR approach are important in promoting cancer awareness in the African-American community. Including community partner assessment can further elucidate critical intervention impacts and helps to address health disparities in underserved communities.

Potential lessons from public health and health promotion for the prevention of child abuse.

Two successful public health efforts of the last third of the twentieth century-tobacco control and automobile injury control-are reviewed for relevance to the problem of child abuse. Potential lessons for child abuse prevention are identified and the following approaches are suggested: Investigate varied logic models or conceptual frameworks to identify new opportunities for effective intervention. Use a multidisciplinary, multi-sector approach. Normalize desired behaviors and denormalize undesirable behaviors. Balance efficacy, feasibility, and cultural appropriateness. Develop strategies for effective policy advocacy based upon who benefits and who shoulders most of the burden.

The relationships among sexually transmitted infection, depression, and lifetime violence in a sample of predominantly African American women.

This study was a secondary analysis of the relationships among lifetime experiences of violence, depressive symptoms, substance use, safer sex behaviors use, and past-year sexually transmitted infection (STI) treatment among a sample of 445 low income, primarily African American women (257 HIV-, 188 HIV+) reporting a male intimate partner within the past year. Twenty-one percent of HIV- and 33% of HIV+ women reported past-year STI treatment. Violence victimization increased women's odds of past-year STI treatment, controlling for HIV status and age. Depressive symptoms increased, and use of safer sex behaviors decreased, women's odds of past-year STI treatment. Results suggest that positive assessment for violence and/or depression indicates need for STI screening.