Health outcomes reported by healthcare providers and clients of a community-based medically tailored meal program.

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA). METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' body mass index, systolic blood pressure, and hemoglobin A1C. These health outcomes, measured at program intake and 3-6 months later, were linked with administrative data for 1,959 clients who completed at least two months of MTM services in 2020, 2021, and 2022. RESULTS: Clients exhibited substantial heterogeneity in demographics and health status at intake. Self-reported malnutrition risk decreased significantly over program duration (p < .001). Nearly one-third of clients with poor health reported improvement over time. Over 60% of clients with obesity experienced stable BMI. Clients with hypertension experienced significant improvements in systolic blood pressure (p < .001). Clients with diabetes and available data (n = 45) demonstrated significant reduction in hemoglobin A1C (p = .005). CONCLUSION: We found evidence that participation in MANNA's MTM program was associated with favorable health outcomes for clients with serious illness and nutritional risk. Community-based organizations can maximize the completeness of their data by focusing on routinely collected internal data like validated health screeners and surveys.

Am I attached? A patient-partnered approach to creating infographics about attachment to primary care in Ontario, Canada.

BACKGROUND: Having a primary care provider is associated with better care experiences and lower care costs. In 2021, INSPIRE-PHC released Primary Care Data Reports - publicly available summaries of administrative billing data about how populations in each of Ontario's 60 health teams use primary care services. Given the characterization of Canadian primary care systems as 'in crisis', publicly available data about primary care at the regional level presented a significant opportunity for knowledge mobilization. An understandable resource could ground the public conversation about primary care access in data. Recognizing the role that lived experience plays in ensuring the public understands research findings, a partnership between patient advisors, Ontario Health Team representatives, researchers, and trainees was established to co-produce public-facing infographics based on primary care data. METHODS: Evidence-based guidelines for public health infographic creation and elements of transformative action research guided a six-meeting process to engage up to 14 patient advisors, three Ontario Health Team staff and two primary care trainees. Patient advisors were affiliated with a provincial patient-oriented primary health care research group or a Hamilton-based Ontario Health Team. Ninety-minute meetings were conducted virtually, and notes were shared with attendees to ensure they accurately reflected the conversation. Two consultations with Ontario Health Team-affiliated primary care providers provided direction and ensured project outputs aligned with local priorities. RESULTS: Project partners shared feedback on draft infographics, audience identification, priority elements from Primary Care Data Reports to include in the infographics, and aesthetic features (e.g., headings, colour scheme, charts). Project partners felt the most important metrics to convey to the public were those that simultaneously reinforced the benefits of primary care on individual health outcomes and health system costs. CONCLUSIONS: Patient engagement in research is becoming widespread, but co-developing knowledge products with patient and health system partners is less common. Our approach to engaging patients prevented both oversimplification and unnecessary complexity in a public-facing visual about attachment to primary care.

Primary care is the first point of contact for patients accessing the health care system. Primary care providers (i.e., family doctors and nurse practitioners ­ working individually or in teams of nurses, dieticians, pharmacists, social workers and others) ­ help patients and families manage health concerns over time by working to prevent, diagnose, and treat illnesses and link patients with specialist care when needed. Having a primary care provider is associated with better healthcare experiences and lower costs of care. In 2021, the Primary Care Data Reports were released to the public. The reports contain administrative data about how patients engage with primary care in each of the 58 Ontario Health Teams. Patient advisors, Ontario Health Team representatives, researchers, and trainees created an infographic to share this data in a way that can be understood by everyone. Infographics use images to help people process information faster, which can make health-related topics easier to understand. By understanding the value of primary care, people can participate in conversations about how to ensure primary care is accessible to everyone. Engaging patients is becoming common in research, but collaborating with patient advisors and health system partners to create visual summaries is less common. We had six virtual meetings that were 90 min each with up to 14 patient advisors, Ontario Health Team representatives, researchers and trainees. Patient advisors helped decide who the audience would be, which information from the Primary Care Data Reports to include, and how the infographic would look. Patient advisors felt it was most important to highlight the benefits patients can get from primary care, and the impact primary care can have to reduce health system costs. We consulted with primary care clinicians to ensure the infographic reflected local priorities. Working with patient advisors and Ontario Health Team representatives helped to create an infographic about Primary Care Data Reports data that is easy to understand by the public.

Identifying physicians' needs in community-based palliative care consultation for cancer patients in palliative care specialist-deficient settings: a qualitative study.

BACKGROUND: Consultation with palliative care specialists can be beneficial in addressing the numerous demands of patients with cancers and their families within communities. In settings lacking palliative care specialists, establishing a new community-based palliative care consultation system necessitates gathering evidence to support its development. This study aimed to identify the specific palliative care consultation needs and the consultation methods requested by Japanese physicians in settings without palliative care specialists. METHODS: A qualitative descriptive study utilizing semi-structured virtual interviews. From August 2023 to October 2023, we conducted interviews with 11 physicians providing cancer treatment in hospitals or clinics in a prefecture within the Kanto region of Japan without palliative care specialists. Participants were asked about the specific palliative care consultation needs they have and the need for consultation methods. RESULTS: Of the 11 physicians, nine had completed the nationwide basic primary palliative care education program. The survey revealed three themes regarding their consultation needs: 'receiving specialized insight', 'inspiring confidence', and 'improving care capacity', Two themes emerged regarding the need for consultation methods: 'enhancing care collaboration' and 'improving accessibility'. CONCLUSIONS: Physicians require consultation systems to empower them and enhance the community care capacity, in addition to providing specialized knowledge. These systems would include collaboration with specialists through outreach consultations, utilization of information and communications technology, and the establishment of nurse-led consultation teams to improve access to palliative care teams.

Supporting Positive Learning Experiences for Veterinary Students on Rotations in Remote Indigenous Communities in Canada.

Many health care programs in medicine, nursing, social work, and physiotherapy include practicum rotations near the end of students' studies. Increasingly, veterinary education programs also offer community-based rotations in underserved or remote communities. While these opportunities in veterinary medicine provide many learning benefits, they can also be stressful if the students do not feel adequately supported. The purpose of this study was to explore how veterinary students are and can be supported during rotations in remote Indigenous communities in Canada. Annually, four veterinary students from the University of Calgary Faculty of Veterinary Medicine travel with a small veterinary team to five communities in the Northwest Territories, Canada. During the 4-week rotation, students spend 2.5 weeks providing veterinary services to companion animals in these communities. In this study, 11/20 veterinary students who participated in this rotation between 2015 and 2020 completed online surveys. Results from this study suggest that participants of the rotation often felt welcomed and supported by the communities they served and were well supported by and connected to the members of the veterinary team. Findings are applicable across community-based veterinary student learning experiences and highlight the importance of building relationships with the communities being served, picking the right team, and implementing debriefing and decompressing activities during downtime.

"They talk about it like it's an overdose crisis when in fact it's basically genocide": The experiences of Indigenous peoples who use illicit drugs in Vancouver's Downtown Eastside neighbourhood.

Indigenous Peoples who use illicit drugs (IPWUID) are disproportionately represented among toxic drug poisoning deaths in Canada. These drug-related harms are framed by the historical and ongoing trauma related to settler colonialism and are acutely visible in Vancouver, Canada's Downtown Eastside - a low-income neighbourhood that is an epicenter of the drug poisoning crisis and characterized by entrenched poverty, substance use, violence, and homelessness. This study was undertaken to examine the experiences and perspectives of IPWUID in the Downtown Eastside regarding the drug poisoning crisis and the responsiveness of harm reduction programs within the context of settler colonialism. Indigenous-led qualitative interviews were conducted with 16 IPWUID recruited by Indigenous peer researchers. Indigenous ways of knowing were embedded throughout the entire research design to ensure research was culturally congruent. Interview transcripts were analyzed thematically and interpreted by drawing on concepts of social violence and racial capitalism. Our analysis reviewed three key themes that centered the experiences of IPWUID in Vancouver's Downtown Eastside in relation to the drug poisoning crisis: (1) that the drug poisoning crisis is understood as a form of genocide toward Indigenous Peoples; (2) that the crisis is experienced within the context of pervasive distrust and adversarial relationships with police rooted in structurally racist experiences of place-based policing practices; and (3) that there is a desire for culturally-safe harm reduction care with Indigenous representation, cultural integration, and that addresses inequities and injustice stemming from colonialism and structural racism. Findings demonstrate how responses to the drug poisoning crisis among IPWUID need to respond to social and materials conditions perpetuated by colonialism and racial capitalism, while also centering IPWUID through the development and implementation of Indigenous-led and culturally safe harm reduction approaches.

Government Support, Community Recreation Facilities, and Physical Activity in China: A Cross-Sectional Socioecological Analysis.

BACKGROUND: In the context of rising noncommunicable diseases, Chinese authorities emphasize the need for local governments to provide public sports services to support physical activity (PA). METHODS: Employing a socioecological theoretical framework, and drawing on a hierarchical data set synthesized from the China Health and Nutrition Survey, China Stock Market & Accounting Research Database, and Wind Financial Terminal from 2015, a multilevel analysis of the association between provincial government expenditure on culture, sports, and media from 12 provinces, the recreation facilities provided by 287 communities, and PA of n = 10,305 individuals is performed. The number of, and time allocated to, PAs undertaken as well as their METs equivalent in relation to World Health Organization guidelines are investigated. RESULTS: Controlling for a large set of individual confounders, the results show that community recreation facilities and provincial government expenditure have a significant positive association with PA participation that exceeds health guidelines. CONCLUSIONS: The results confirm the importance of government support for sport and the provision of community sport and PA facilities in China. This has implications for public health policy generally including the Western context. It remains, however, that the cultural context of engagement also needs further consideration.

Community-based participatory research (CBPR) approaches in vaccination promotion: a scoping review.

BACKGROUND: Community-based participatory research (CBPR) is a collaborative research approach that engages academic researchers and community stakeholders as equal partners in all research steps to address community concerns and achieve health equity. The CBPR approach has been widely used in vaccination promotion programmes. However, the elements and steps of CBPR-based programmes varied among studies. The purpose of this scoping review was to synthesize the elements and steps, and establish an implementation framework to guide the utilisation of CBPR approaches in vaccination promotion. METHODS: This scoping review was performed in accordance with Arksey and O'Malley's five-stage framework. A systematic search was conducted on a set of electronic databases and grey literature sources. The retrieved articles were screened according to the criteria of CBPR and vaccination promotion, and data were extracted and recorded on a calibrated and predefined form in terms of study characteristics and CBPR components. Two authors worked independently to complete literature search, study selection, and data extraction. A narrative summary was used in categorising characteristics, and the contents of the included studies were summarised through qualitative analysis. RESULTS: A total of 8557 publications were initially screened, and 23 articles were finally included. According to the CBPR conceptual model, the elements in each CBPR component specifically for vaccination promotion included (1) the establishment of community-academic partnership (CAP)s, (2) community capacity building by partner training vaccination knowledge, research literacy, and service abilities and skills, (3) development and implementation of community-based intervention and (4) Outcome evaluation. A CAP was established between academic researchers or institutes and eight types of partners, including community service organisation-related non-government organisations (NGOs), health service institution-related NGOs, religious organisations, government agencies, educational institutions, media agencies, business agencies, and community representatives. The maintenance of CAP was achieved with four key strategies, namely, strengthening communication, forming management groups, sharing resources and information, and providing incentives. Twelve studies provided comprehensive insights into the strategies employed for intervention development, utilising either quantitative surveys, qualitative methods or a combination of both approaches. The contents of interventions included health service supports, health education activities, social marketing campaigns, community mobilisation, interactive discussions, vaccination reminders and incentives. As for outcome evaluation, vaccination rate and the effectiveness of interventions were assessed. A considerable increase was observed in 95.7% of the included studies (22/23), and the highest increase (92.9%) was attained after the intervention. An implementation framework was generated to summarise the elements and steps of CBPR approaches for vaccination promotion. CONCLUSIONS: This review summarised current evidence and generated an implementation framework to elucidate the elements and steps in the development and application of CBPR approaches in vaccination promotion. CBPR approaches are recommended for future vaccination promotion programmes, involving community stakeholders and research professionals, to ensure equitable access to vaccinations across diverse populations.

Impact of sleep duration and dietary patterns on risk of metabolic syndrome in middle-aged and elderly adults: a cross-sectional study from a survey in Anhui, Eastern China.

The aim of this study was to assess the sleep status of middle-aged and elderly adults in Bengbu City, Anhui Province, China, to identify the major dietary patterns, and to analyze the association of different sleep duration and dietary patterns with metabolic syndrome (MetS) and its related influencing factors, as well as to explore the predictive value of sleep duration and dietary patterns. A cross-sectional analysis was performed utilizing data collected from the Community-based Cardiovascular and Health Promotion Study 2019 (COCHPS 2019) conducted in Bengbu. The definition of MetS adhered to the criteria of Guidelines for the Prevention and Treatment of Dyslipidemia in Chinese Adults (2016 Revision). Dietary information was obtained using the Food Frequency Questionnaire (FFQ) to assess dietary intake over the past year. Principal component analysis (PCA) was performed to identify dominant dietary patterns. A logistic regression model was developed to analyze the associations among sleep duration, dietary patterns, and MetS, and a decision tree (DT) model was developed to compare factors affecting MetS and screen people at high risk for MetS. The prevalence of MetS was 13.4% among the 9132 middle-aged and elderly residents over 45 years of age included in COCHPS 2019. Participants were divided into short (< 6 h/d), normal (6-8 h/d), and long (> 8 h/d) groups based on their daily sleep duration. Three dietary patterns were identified by PCA, the fruit-milk pattern, the tubers-meat pattern, and the vegetable-cereal pattern. After adjusting for covariables, logistic regression analysis showed that long sleep duration was significantly negatively associated with MetS. The fruit-milk and vegetable-cereal patterns were negatively associated with MetS, whereas the tubers-meat pattern was positively correlated with MetS. The results of the DT model analysis showed that the vegetable-cereal pattern is the most important factor impacting MetS, followed by marital status, the tubers-meat pattern, the fruit-milk pattern, exercise, sleep duration, and gender. The DT model also screened out five types of MetS high-risk groups. The results of our study indicate that normal sleep duration and consumption of either a fruit-milk or vegetable-cereal diet may lower the likelihood of developing MetS in middle-aged and elderly adults.

Exploring the barriers to healthcare access among persons with disabilities: a qualitative study in rural Luuka district, Uganda.

OBJECTIVE: The aim of the research was to explore the barriers to healthcare access for persons with various disabilities in rural Luuka district of Uganda. The findings will assist in appreciating the challenges persons with disabilities face in accessing Healthcare in a rural setting. These insights will contribute to the development of an intervention to improve healthcare access that is affordable, timely and acceptable. DESIGN AND PARTICIPANTS: This qualitative study formed the exploratory formative phase of the 'Missing Billion' project. A total of 27 participants with disabilities-visual impairment (n=5), physical impairment (n=5), multiple impairments (n=6) and intellectual/ cognitive impairment (n=5) were purposively selected to participate in in-depth interviews conducted by two experienced researchers. Participants were identified through contact lists provided by the district disability focal person and local disability associations, with additional participants identified through snowball sampling. Interviews with persons with hearing impairment (n=6) were conducted by a researcher with hearing impairment. The interviews were audio/video recorded and transcribed to facilitate thematic data analysis. We used the disability-inclusive health 'Missing Billion' framework to map and inform the barriers. SETTING: The study was conducted between September and November 2022 in rural communities in Luuka district, Eastern Uganda. FINDINGS: On the demand side, challenges revolved around autonomy and awareness, limited access to health information, lack of financial capacity and dependence on caregivers for healthcare choices left persons with disabilities feeling disempowered. On the supply side, discrimination and negative attitudes from healthcare workers were reported as prevalent. Absence of healthcare workers and service delivery delays impacted on healthcare access, resulting in poor care. Inaccessible healthcare facilities compounded issues, as they had limited accessibility features. CONCLUSIONS: Complex and interconnected barriers underscore the pressing need for systemic changes to ensure equitable healthcare access for persons with disabilities in rural Uganda.

Environmental Health Assessment by Local Environmental Justice Experts for Evidence-based Decision-making in an Agricultural Community of Northern California.

Environmental justice research driven by academics and policymakers often overlooks the valuable insights and leadership of the communities most impacted by environmental hazards. When institution-led research approaches are employed, inadequate community ownership and limited institutional accountability hinder the effectiveness of environmental public health interventions. In contrast, a community-owned and -managed approach to environmental justice research can guide community members in developing evidence-based interventions. This paper outlines a community-led environmental health assessment survey (sample= 100) and resulting community actions over six years (2017 to 2023) in a Northern California farmworker community with a perceived high prevalence of cancer and exposure to environmental hazards in households, neighborhoods, and job sites. Local resident experts in Knights Landing, CA, documented community risk factors and exposures in collaboration with interdisciplinary undergraduate and graduate student-researchers. The survey instrument focused on environmental hazards identified by local resident experts including vehicular and agricultural pollution, occupational pesticide contact, and sun exposure. Survey findings highlighted the need for targeted interventions to reduce environmental health risks, such as academic outreach programs, county investments in public services, and community-led mutual aid initiatives. Despite academic reservations about our non-random sampling method and data collection by local resident experts, our project sparked substantial actions and investments with minimal personnel and financial resources. Local leaders working with student-researchers developed more effective environmental public health interventions through a community-owned and -managed approach that went beyond the efforts of local regulatory and research institutions.

Factors associated with perceived social support among adolescents in Gamo Zone, Southern Ethiopia: a community-based cross-sectional study.

Introduction: Perceived social support plays a crucial role in adolescent development, health, well-being, and resilience. Understanding the factors associated with perceived social support among adolescents is essential for designing effective interventions. However, research in this area, particularly within specific contexts, remains limited. Therefore, this study aims to identify the factors associated with perceived social support among adolescents in the Gamo Zone, South Ethiopia Regional State. Method: A community-based cross-sectional study was conducted, involving 1172 adolescents selected through a stratified multi-stage sampling method. Structured face-to-face interviews were employed for data collection. Summary statistics were utilized for data presentation. Multiple linear regressions were then performed to identify factors associated with perceived social support. The strength and direction of associations were presented using ß coefficients and 95% confidence intervals (CIs). The level of statistical significance was set at alpha 5%. Result: The total mean for perceived social support among adolescents was 57.02 ± 12.68. Adolescents living with their biological parents reported significantly higher levels of perceived social support (ß = 4.17, 95% CI: 2.00 to 6.34) compared to their counterparts. Similarly, adolescents engaged in paid work within the last 12 months reported higher perceived social support (ß = 3.43, 95% CI: 1.39 to 5.46). Higher levels of parental monitoring were also associated with increased perceived social support (ß = 3.03, 95% CI: 1.23 to 4.82). Additionally, adolescents who perceived risks for sexual and reproductive health (SRH) problems reported higher levels of perceived social support (ß = 2.76, 95% CI: 0.84 to 4.69). Moreover, adolescents with good knowledge about SRH rights exhibited increased perceived social support (ß = 2.46, 95% CI: 0.89 to 4.02). Furthermore, adolescents residing in rural areas reported higher levels of perceived social support compared to those in urban areas (ß = 1.56, 95% CI: 0.16 to 3.11). Conclusion: The findings of this study reveal that factors such as living arrangements, employment status, parental monitoring, perceived risks for SRH problems, knowledge about SRH rights, and geographical context emerged as important predictors of perceived social support. Therefore, implementing interventions and initiatives to address these identified factors holds promise for nurturing resilient adolescent social support networks.

Participatory developed school-based interventions targeting physical activity and sedentary behaviour among children and adolescents: A scoping review.

AIMS: A significant number of children and adolescents are insufficiently physically active and have a sedentary lifestyle, which is associated with adverse health outcomes, necessitating effective interventions. Using a participatory approach, which engages youth in intervention development, may enhance intervention effectiveness, as such interventions are believed to be more tailored to the needs of the target group. This scoping review aimed to provide an overview of the results of process and effect evaluations of studies that developed school-based physical activity and/or sedentary behaviour interventions using a participatory approach among children and adolescents. METHODS: Six databases (MEDLINE, Embase, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus and SPORTDiscus) were searched. Studies were included when they evaluated the participatory process, intervention implementation or health-related intervention effects. A quality assessment was completed using two QualSyst checklists. Extracted data included characteristics of studies, interventions, and participatory processes; characteristics of participants from whom data were collected; outcomes measured and measurement methods used; and key findings. RESULTS: Twenty-five papers, covering 18 original studies, were included. Studies suggested that participatory processes were generally perceived positively, resulting in pupils feeling empowered, experiencing ownership and gaining certain skills. Participatory developed interventions also seemed to be generally well received, although the intervention dose delivered and intervention reach seemed to vary between studies. Finally, studies generally tended to report no effects on health. CONCLUSIONS: Although a participatory approach could be promising in empowering pupils and promoting intervention acceptance, apparent differences in intervention implementation and limited effectiveness highlight the need to enhance participatory processes and intervention effectiveness.

Community-based infant hearing screening: Outcomes of a rural pilot programme.

BACKGROUND:  Community-based universal newborn hearing screening (UNHS) has not been fully realised in South Africa despite the availability of contextually relevant early hearing detection and intervention guidelines. Research has confirmed the feasibility of implementing UNHS programmes in urban contexts; however, limited information exists for rural contexts. OBJECTIVES:  The aim of the study was to describe the outcomes in terms of coverage rate, referral rate and follow-up rate of a 1-year UNHS pilot programme implemented at three primary health care (PHC) clinics in the Limpopo province. METHOD:  A descriptive retrospective review of 2 302 audiological records of infants who underwent NHS between July 2014 to June 2015 was conducted. RESULTS:  The mean age at first-stage screen was 112 days (16 weeks). The coverage rate was 87% for the infants screened at 3- and 10- days clinic visits and 27% for infants screened at the 6-week immunisation visit. The first-stage referral rate was 33.9% and 8.3% for the overall second stage referral for diagnostic audiology services. The follow-up rate for rescreens at the clinical level was 77%, while for initial diagnostic assessments, it was 26%. CONCLUSION:  Although not all benchmarks were met within the first year of implementation, the high coverage- and low referral rates, especially in the last 6 months, are the first steps in improving the outcomes of the screening programme.Contribution: The findings confirm the feasibility of implementing community-based UNHS programmes in rural areas in South Africa. Regular monitoring and evaluation contribute to the success of screening programmes.

Effect of a Physical Exercise Intervention on Physical Function Parameters and Blood Analytical Changes in Lung Cancer Survivors: A Feasibility Study.

Background: Lung cancer carries a high burden of systemic symptoms, including in survivors, leading to a reduced quality of life (QoL). We assessed whether a 12-week multicomponent supervised exercise programme, including muscular strength and aerobic training, was beneficial in patients who had undergone surgery for early non-small cell lung cancer (NSCLC) in terms of physical performance, QoL, and metabolic and nutritional analytical parameters. Methods: Physical performance was measured by gait speed, handgrip strength, 30 s sit-to-stand (30s-STS) test repetitions, distance covered in the 6 min walk test (6MWT), and the Short Physical Performance Battery (SPPB) score. QoL was assessed with the EORTC-QLQ-C30 questionnaire. Blood glucose, cholesterol, triglycerides, total proteins, albumin, pre-albumin, creatinine, c-reactive protein, insulin-growth factor 1 (IGF-1), and the haemoglobin and hematocrit percentages were measured before and after the intervention in order to observe any beneficial effects related to metabolic markers. Results: After the intervention, the mean scores for the 6MWT (p < 0.001), STS (p < 0.001), 6MWT (p < 0.01), and SPPB (p < 0.01) had significantly improved. However, handgrip strength and nutritional analytical were unchanged. The EORTC-QLQ-C30 functions and symptoms significantly improved after the intervention (p < 0.05 and p < 0.01, respectively). A significant decrease in cholesterol, triglycerides, and IGF-1 and a significant increase in pre-albumin in blood was also observed post-intervention (p < 0.05). Conclusions: This supervised, community-based 12-week multicomponent was feasible (adherence rate 70.35%) and provided benefits not only to physical performance but also to the quality of life of patients with NSCLC.

Equitable community-based participatory research engagement with communities of color drives All of Us Wisconsin genomic research priorities.

OBJECTIVE: The NIH All of Us Research Program aims to advance personalized medicine by not only linking patient records, surveys, and genomic data but also engaging with participants, particularly from groups traditionally underrepresented in biomedical research (UBR). This study details how the dialogue between scientists and community members, including many from communities of color, shaped local research priorities. MATERIALS AND METHODS: We recruited area quantitative, basic, and clinical scientists as well as community members from our Community and Participant Advisory Boards with a predetermined interest in All of Us research as members of a Special Interest Group (SIG). An expert community engagement scientist facilitated 6 SIG meetings over the year, explicitly fostering openness and flexibility during conversations. We qualitatively analyzed discussions using a social movement framework tailored for community-based participatory research (CBPR) mobilization. RESULTS: The SIG evolved through CBPR stages of emergence, coalescence, momentum, and maintenance/integration. Researchers prioritized community needs above personal academic interests while community members kept discussions focused on tangible return of value to communities. One key outcome includes SIG-driven shifts in programmatic and research priorities of the All of Us Research Program in Southeastern Wisconsin. One major challenge was building equitable conversations that balanced scientific rigor and community understanding. DISCUSSION: Our approach allowed for a rich dialogue to emerge. Points of connection and disconnection between community members and scientists offered important guidance for emerging areas of genomic inquiry. CONCLUSION: Our study presents a robust foundation for future efforts to engage diverse communities in CBPR, particularly on healthcare concerns affecting UBR communities.

Risk Factors of Hepatitis Associated With Time to Adopting a New Cancer Screening Model Under Diffusion of Innovation Theory-A 10-Year Cohort Study in Taiwan.

BACKGROUND: Hepatitis is a serious global health issue. To reduce mortality, early screening for liver disease has been recommended in community health policies, particularly for asymptomatic individuals. AIM: This study explored the link between liver function biomarkers and how quickly people adopt a new multiple cancer screening program, using the diffusion of innovation (DOI) Theory. METHODS: The study included 57,939 participants from a community-based screening program in Keelung, Taiwan, between January 1, 2001, and December 31, 2010. Data on demographics and lifestyle habits were collected through questionnaires, and blood samples were analyzed to measure biomarkers related to liver function. RESULTS: On average, participants took 3.48 years to accept the new screening program. People with healthier lifestyles, such as those who drank alcohol less often, were more likely to adopt the screening early. Additionally, those with higher levels of liver-related biomarkers like albumin, total protein, and ALT joined even sooner. In conclusion, using DOI theory, the study found that personal lifestyle and liver function play a role in how quickly individuals adopt a new screening system. CONCLUSION: These insights can help healthcare providers improve early screening efforts, particularly for people at risk of hepatitis and liver cancer, potentially reducing related deaths.

An exploration of factors leading to readiness for organizational health literacy change in community-based health organizations.

INTRODUCTION: Healthcare systems have a responsibility to improve organizational health literacy (OHL) to increase health equity. This study explored two organizational cultural factors, leadership support and staff buy-in, for organizations planning OHL change. METHODS: Ten community-based health organizations participated in an OHL program. The study design was mixed methods. The qualitative inquiry was interviews with senior leaders to explore awareness of OHL and: impetus to transform, leadership commitment, staff engagement, alignment to organizational goals, and integration of health literacy change with current practices. The quantitative assessment was the Organizational Readiness for Implementing Change (ORIC) questionnaire to assess staff's perceptions about OHL change readiness. RESULTS: Senior leaders articulated the effects of low health literacy in their patient and client population. Support for OHL change was seen at both leadership and staff levels. Impetus for change was primarily a response to a community need or for quality improvement. Most of the non-clinical organizations had higher ORIC scores than the clinical organizations, indicating a perceived higher level of readiness for OHL change. CONCLUSION: Leadership commitment and staff buy-in are important factors of readiness for OHL change. A novel finding is that community-based health organizations are able and willing to engage in OHL change.

Level of option B+PMTCT drug adherence with male partner involvement and associated factors among breastfeeding women until 18 months in North Gojjam Zone, Amhara region, Northwest Ethiopia, 2022: a multicentre cross-sectional study.

BACKGROUND: Adherence to option B+antiretroviral therapy medication is crucial for the effective implementation of the Prevention of Mother-to-Child Transmission (PMTCT) programme. Ethiopia has adopted the WHO's target of achieving over 95% adherence. However, research conducted in southern Ethiopia found that only 81.4% of women adhered to option B+medication, which reflects a poor level of adherence and remains a concern. OBJECTIVE: The objective of the study was to assess the level of option B+PMTCT drug adherence and associated factors among women who were breast feeding for up to 18 months in government health facilities of North Gojjam Zone, Amhara region, Northwest Ethiopia, 2022 DESIGN: An institution-based cross-sectional study was conducted. SETTING: The study was carried out in hospitals located in the North Gojjam Zone of Northwest Ethiopia. PARTICIPANTS: The study was conducted with 223 HIV-positive women who were breast feeding for up to 18 months, from 1 March 2022 to 30 April 2022. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was to assess the level of option B+PMTCT drug adherence, while the secondary outcome was to identify factors associated with option B+PMTCT drug adherence among HIV-positive women who were breast feeding for up to 18 months. Associations between variables were analysed using both bivariate and multivariable logistic regression models, with a p<0.05 considered statistically significant at the 95% confidence level. RESULTS: A total of 223 participants were included, yielding a response rate of 97.8%. The adherence to option B+PMTCT drugs was 62.8%. The type of health facility (adjusted OR, AOR=0.17 (95% CI: 0.008 to 0.35)), partner support involvement (AOR=3.03 (95% CI: 1.12 to 9.13)) and the time taken to reach the facility from home (AOR=6.34 (95% CI: 2.92 to 13.75)) were significantly associated with the level of option B+PMTCT drug adherence. CONCLUSION: Option B+PMTCT drug adherence was lower than the recommended level. The type of health facility, partner support and the time required to travel from home to the facility were factors associated with adherence to option B+PMTCT medication. Support from a partner is crucial for improving adherence to option B+medication.

Epidemiology of human metapneumovirus in Taiwan from 2013 to 2023.

Human metapneumovirus (HMPV) is a member of the genus Metapneumovirus in the family Pneumoviridae of the order Mononegavirales that can cause upper and lower respiratory tract disease. This retrospective study describes the epidemiology of hMPV based on community viral surveillance results from sentinel sites across Taiwan from 2013 to 2023. A total of 114 hMPV strains were isolated and analyzed to assess viral evolution through sequencing of their fusion protein genes. This study revealed that hMPV cases occur almost year-round in Taiwan, with a peak occurring during spring (March to May). Of the 114 infected patients, 68.4% were children under 4 years old. The geographical distribution of hMPV positivity was highest in Penghu County, followed by Changhua County and Hsinchu County. The clinical symptoms of hMPV infection are nonspecific, with fever (56.1%), cough (44.7%), rhinorrhea (21.1%), and sore throat (14.9%) being the most common. However, a few patients also developed severe central nervous system symptoms (1.8%) or dyspnea (0.9%). Phylogenetic analysis revealed genetic diversity among the 114 isolated hMPV strains, with the A2 lineage (57.9%) being the most frequently observed, followed by the B2 lineage (33.3%), in the Taiwanese community from 2013 to 2023. In conclusion, hMPV causes a serious acute respiratory disease in Taiwan that should not be neglected. Further epidemiological surveillance and investigations of the clinical characteristics of hMPV should be performed continually for prevention and control of this virus.

Early Exposure of Medical Students to a Formal Research Program Promotes Successful Scholarship in a Multi-Campus Medical School.

Objectives: Many physicians today struggle to learn the complexities of the biological basis for evidence-based medicine. To bridge this gap, the Medical Scholar Research Pathway Program (MSRPP) founded in 2019 prepares medical students for analytical reasoning and critical thinking while engaging in faculty-mentored research projects in a community-based public medical school. Methods: MSRPP is an application-based extracurricular research program, designed for novice and experienced medical students. Three distinct pathways offer ample opportunities for pre-clinical and clinical students to participate in research on a flexible schedule. The program director guides students in one-on-one coaching meetings to set achievable goals with their faculty mentor, and plan their research deliverables, considering their interests and residency plans. Results: We report the implementation of a multi-year and multi-campus research training program for medical students across five campuses. Our results show that five class cohorts (2021-2025) of MSRPP students were twice as likely to seek formal research support than students not in the program. MSRPP students continuously growth their self-confidence to disseminate their research by practicing oral communication in monthly Launch talk research reports and bi-annual research conferences. Moreover, students report they learn technical communication skills and feel inspired to participate in research by interacting with invited faculty seminars. MSRPP students have a significantly higher scholarship output as compared to non-MSRPP students. Early indicators show that students that participate in formal research programs have a measurable difference for matching into competitive residencies. Conclusions: MSRPP students report that they have gained research competencies and technical skills to establish a baseline to promote their future research engagement. This study provides other peer medical schools with strategies to create the infrastructure to support and promote medical student research. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-024-02098-6.