ABSTRACT
During the COVID-19 vaccination rollout from March 2021- December 2022, the Centers for Disease Control and Prevention funded 110 primary and 1051 subrecipient partners at the national, state, local, and community-based level to improve COVID-19 vaccination access, confidence, demand, delivery, and equity in the United States. The partners implemented evidence-based strategies among racial and ethnic minority populations, rural populations, older adults, people with disabilities, people with chronic illness, people experiencing homelessness, and other groups disproportionately impacted by COVID-19. CDC also expanded existing partnerships with healthcare professional societies and other core public health partners, as well as developed innovative partnerships with organizations new to vaccination, including museums and libraries. Partners brought COVID-19 vaccine education into farm fields, local fairs, churches, community centers, barber and beauty shops, and, when possible, partnered with local healthcare providers to administer COVID-19 vaccines. Inclusive, hyper-localized outreach through partnerships with community-based organizations, faith-based organizations, vaccination providers, and local health departments was critical to increasing COVID-19 vaccine access and building a broad network of trusted messengers that promoted vaccine confidence. Data from monthly and quarterly REDCap reports and monthly partner calls showed that through these partnerships, more than 295,000 community-level spokespersons were trained as trusted messengers and more than 2.1 million COVID-19 vaccinations were administered at new or existing vaccination sites. More than 535,035 healthcare personnel were reached through outreach strategies. Quality improvement interventions were implemented in healthcare systems, long-term care settings, and community health centers resulting in changes to the clinical workflow to incorporate COVID-19 vaccine assessments, recommendations, and administration or referrals into routine office visits. Funded partners' activities improved COVID-19 vaccine access and addressed community concerns among racial and ethnic minority groups, as well as among people with barriers to vaccination due to chronic illness or disability, older age, lower income, or other factors.
ABSTRACT
OBJECTIVES: To review reported chlamydia infection trends in the U.S. military and identify reasons for differences. METHODS: Defense Medical Surveillance System 2000-2008 reports for nondeployed, active duty members were studied. Incidence, rate ratios, and confidence intervals were generated. Age- and gender-specific rates were compared with US national rates. Screening and reporting policies and procedures were reviewed. RESULTS: Overall incidence was 922 cases per 100,000 person-years, with considerable service variability (392-1,431 cases per 100,000 person-years in the Navy and Army, respectively). Navy-Marine Corps rates increased more than 2 fold in 2008. Rates were higher among women, minorities, and members under 25 years. Military rates exceeded national rates. CONCLUSIONS: The 2008 increase in Navy-Marine Corps rates may be due to the implementation of web-based reporting. Demographic differences were consistent with published reports. The civilian-military disparity may reflect higher percentages of military at-risk women screened.
Subject(s)
Chlamydia Infections/epidemiology , Chlamydia trachomatis , Military Personnel , Adolescent , Adult , Female , Humans , Incidence , Male , Middle Aged , Military Personnel/statistics & numerical data , United States/epidemiology , Young AdultABSTRACT
In mid-May 2007, a respiratory disease outbreak associated with adenovirus, serotype B14 (Ad14), was recognized at a large military basic training facility in Texas. The affected population was highly mobile; after the 6-week basic training course, trainees immediately dispersed to advanced training sites worldwide. Accordingly, enhanced surveillance and control efforts were instituted at sites receiving the most trainees. Specimens from patients with pneumonia or febrile respiratory illness were tested for respiratory pathogens by using cultures and reverse transcription-PCR. During May through October 2007, a total of 959 specimens were collected from 21 sites; 43.1% were adenovirus positive; the Ad14 serotype accounted for 95.3% of adenovirus isolates. Ad14 was identified at 8 sites in California, Florida, Mississippi, Texas, and South Korea. Ad14 spread readily to secondary sites after the initial outbreak. Military and civilian planners must consider how best to control the spread of infectious respiratory diseases in highly mobile populations traveling between diverse geographic locations.
Subject(s)
Adenovirus Infections, Human/transmission , Adenoviruses, Human/isolation & purification , Military Personnel , Adenovirus Infections, Human/epidemiology , Adenovirus Infections, Human/virology , Adolescent , Adult , Disease Outbreaks , Female , Geography , Humans , Male , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Population Surveillance , Republic of Korea/epidemiology , Time Factors , Travel , United States/epidemiologyABSTRACT
This study examined the frequency of peer victimization and psychological symptom correlates among youth with obsessive-compulsive disorder (OCD). The Schwartz Peer Victimization Scale, Children's Depression Inventory, and Asher Loneliness Scale were administered to 52 children and adolescents diagnosed with OCD. The child's parent or guardian completed the Child Behavior Checklist, and a trained clinician administered the Children's Yale-Brown Obsessive-Compulsive Scale (CY- BOCS). Fifty-two healthy controls and 52 children with Type 1 diabetes (T1D) who were administered the Schwartz Peer Victimization Scale as part of another study were included for comparison purposes. Greater rates of peer victimization were reported in youth with OCD relative to healthy controls and children with Type 1 diabetes (T1D). Peer victimization in the OCD sample was positively related to loneliness, child-reported depression, parent-reported internalizing and externalizing symptoms, and clinician-rated OCD severity. Peer victimization fully mediated the relation between OCD severity and both depression and parent reports of child externalizing behaviors and partially mediated the relation between OCD severity and loneliness. Recognition of the magnitude of the problem and contribution problematic peer relations may play in comorbid psychological conditions is important for clinicians who see children with OCD.
Subject(s)
Crime Victims/psychology , Mental Disorders/psychology , Obsessive-Compulsive Disorder/psychology , Peer Group , Adolescent , Agonistic Behavior , Child , Depressive Disorder/psychology , Diabetes Mellitus, Type 1/psychology , Female , Florida , Humans , Internal-External Control , Loneliness/psychology , Male , Parents/psychology , Psychiatric Status Rating Scales/statistics & numerical data , Severity of Illness Index , Social BehaviorABSTRACT
The children's Yale-Brown obsessive-compulsive scale (CY-BOCS) is a commonly used, psychometrically sound clinician-rated instrument of pediatric obsessive-compulsive disorder (OCD) severity. Given the relatively direct rating format and potential benefits of alternative versions that could be easily administered to patients and parents, we developed and examined the psychometric properties of child- and parent-report formats of the CY-BOCS severity items. A total of 53 children and adolescents (8-17 years old) with OCD and their parents was administered the CY-BOCS, children's Yale-Brown obsessive-compulsive scale-child report (CY-BOCS-CR), children's Yale-Brown obsessive-compulsive scale-parent report (CY-BOCS-PR), and other measures of obsessive-compulsive symptoms, internalizing, and externalizing symptoms. In general, reliability and convergent and divergent validity of the CY-BOCS-CR/PR were satisfactory. Psychometric properties for the CY-BOCS-CR in those children and adolescents with externalizing behavior problems were lower relative to those without externalizing problems. Exploratory factor analyses identified a two-factor structure in both measures comprised of disturbance and severity factors. This study provides preliminary support for the use of child- and parent-report versions of the CY-BOCS.
Subject(s)
Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/epidemiology , Parents , Surveys and Questionnaires , Adolescent , Child , Female , Humans , Male , Observer Variation , Psychometrics/statistics & numerical data , Severity of Illness IndexABSTRACT
This study examined the psychometric properties of the Obsessive-Compulsive Scale (OCS) of the Child Behavior Checklist (CBCL). Participants included 48 youth with obsessive-compulsive disorder (OCD), 41 with a non-OCD internalizing disorder, and 101 with an externalizing disorder. Confirmatory factor analysis of the 8-item OCS did not result in an adequate fit. Exploratory factor analysis identified a 1-factor model consisting of 6 items. Adequate internal consistency for the revised OCS (OCS-R) was obtained, and convergent validity was supported by moderate relationships with other OCD indices. The OCS-R had stronger associations with measures of OCD symptoms than with measures of depression and externalizing behaviors. Youth with OCD had significantly higher OCS-R scores than those with internalizing and externalizing disorders. Suggestions for cutoff scores are provided using results from ROC analyses. Overall, these findings suggest that the OCS-R is a reliable and valid instrument for the assessment of pediatric OCD.
Subject(s)
Obsessive-Compulsive Disorder/diagnosis , Psychiatric Status Rating Scales , Adolescent , Child , Child, Preschool , Factor Analysis, Statistical , Female , Humans , Male , Psychometrics , Reproducibility of Results , United StatesSubject(s)
Adenovirus Infections, Human/diagnosis , Adenoviruses, Human/isolation & purification , Military Medicine , Military Personnel , Adenovirus Infections, Human/epidemiology , Adenovirus Infections, Human/prevention & control , Disease Outbreaks , Humans , Public Health , United States/epidemiologyABSTRACT
Little evidence is available regarding recommended practices for domestic violence and sexual assault services. Although there is a literature concerned with these services, few studies have investigated recommended practices from the perspective of community providers. In addition, researchers have not yet investigated the utility of specific domestic violence and sexual assault service delivery strategies. To help address these knowledge needs, the authors investigated agency directors' perspectives on six types of services typically offered by domestic violence and sexual assault agencies including crisis, legal advocacy, medical advocacy, support group, individual counseling, and shelter. The authors also examined the extent to which directors' opinions about service delivery practices differed based on key agency's characteristics, specifically the services offered (i.e., domestic violence, sexual assault, or both) and agency location (i.e., rural, suburban, or urban). A sample of 97 (94% response rate) North Carolina agency directors completed a survey on recommended service delivery practices. The authors conducted descriptive analyses to identify directors' overall opinions about service delivery practices and used multivariate analysis of variance to examine whether directors' opinions about service delivery practices differed according to agency characteristics. Findings showed differences in directors' opinions about service delivery practices based on their agency's service location. Practice recommendations were garnered from the study's results.
Subject(s)
Domestic Violence/prevention & control , Sex Offenses/prevention & control , Social Work , Survivors/psychology , Adolescent , Adult , Attitude of Health Personnel , Consumer Advocacy , Counseling , Crisis Intervention , Female , Health Care Surveys , Humans , Male , Multivariate Analysis , North Carolina , Referral and Consultation , Residential Facilities , Self-Help Groups , Social Work/methods , Social Work/organization & administrationABSTRACT
International sex trafficking into the United States appears to be a serious and growing problem, although the evidence regarding prevalence, risk, and consequences is incomplete. Nonetheless, human service providers are increasingly being asked to offer services to sex trafficking survivors. Consequently, providers need information to guide services and program development in this emerging practice area. To address this knowledge need, we systematically reviewed and synthesized 20 documents addressing the needs of and services for international survivors of sex trafficking into the United States. The main finding from the review shows the importance of a continuum of aftercare services to address survivors' changing needs as they move from initial freedom to recovery and independence. Based on our synthesis of the reviewed literature, we present a service delivery framework to guide providers' development of services for survivors.
Subject(s)
Aftercare/methods , Crime Victims/rehabilitation , Health Services , Program Development/methods , Sex Offenses , Survivors , Humans , Internationality , Sex Work , United StatesABSTRACT
We investigated agency directors' perspectives about how service goals should be prioritized for domestic violence and sexual assault service subtypes, including crisis, legal advocacy, medical advocacy, counseling, support group, and shelter services. A sample of 97 (94% response rate) North Carolina domestic violence and/or sexual assault agency directors completed a survey asking participants to rank the importance of service goals. Overall, participants considered emotional support provision to be a critical service goal priority across all service types. Social support and self-care service strategies were deemed less important. However, prioritization of other service goals varied depending on the service type. Statistically significant differences on service goal prioritization based on key agency characteristics were also examined, and agency characteristics were found to relate to differences in service goal prioritization.