Piloting a Peer Support Program for Patients Who Screen Positive for Intimate Partner Violence, Suicidal Ideation, and Depression.

Peer support programs have been utilized for a variety of mental-health-related needs, including suicidality and depression. In this pilot program, we developed a peer support network to address multimorbidity involving intimate partner violence (IPV), suicidal ideation, and depression. Over one year, our Suicide Obviation Support (SOS) navigators enrolled and provided at-elbow support to 108 patients (67.6% women) who screened positive for IPV, many of whom also screened at moderate or high risk for suicidality (64.8%) and/or exhibited depression symptoms. At a 6-month follow-up, 63 participants (58.3%) were retained. Those who stayed enrolled in the program for six months were less likely to report IPV and depression symptoms and were at a lower risk for suicide than the original sample, and analyses showed that IPV, depression, and suicide risk scores declined significantly in this group. The SOS navigators provided direct support and continuity of care for these high-risk patients, which included referrals to mental health treatment and other types of support services, such as transportation and emergency housing. This program provides a model for healthcare systems that desire to implement peer support programs servicing individuals who face multiple, acute mental health care needs.

Health Research in the Wake of Disasters: Challenges and Opportunities for Sensor Science.

BACKGROUND: Disaster events adversely affect the health of millions of individuals each year. They create exposure to physical, chemical, biological, and psychosocial hazards while simultaneously exploiting community and individual-level vulnerabilities that allow such exposures to exert harm. Since 2013, the National Institute of Environmental Health Sciences (NIEHS) has led the development of the Disaster Research Response (DR2) program and infrastructure; however, research exploring the nature and effects of disasters on human health is lacking. One reason for this research gap is the challenge of developing and deploying cost-effective sensors for exposure assessment during disaster events. OBJECTIVES: The objective of this commentary is to synergize the consensus findings and recommendations from a panel of experts on sensor science in support of DR2. METHODS: The NIEHS convened the workshop, "Getting Smart about Sensors for Disaster Response Research" on 28 and 29 July 2021 to discuss current gaps and recommendations for moving the field forward. The workshop invited full discussion from multiple viewpoints, with the goal of identifying recommendations and opportunities for further development of this area of research. The panel of experts included leaders in engineering, epidemiology, social and physical sciences, and community engagement, many of whom had firsthand experience with DR2. DISCUSSION: The primary finding of this workshop is that exposure science in support of DR2 is severely lacking. We highlight unique barriers to DR2, such as the need for time-sensitive exposure data, the chaos and logistical challenges that ensue from a disaster event, and the lack of a robust market for sensor technologies in support of environmental health science. We highlight a need for sensor technologies that are more scalable, reliable, and versatile than those currently available to the research community. We also recommend that the environmental health community renew efforts in support of DR2 facilitation, collaboration, and preparedness. https://doi.org/10.1289/EHP12270.

Adapting to Climate Change: Leveraging Systems-Focused Multidisciplinary Research to Promote Resilience.

Approximately 2000 official and potential Superfund sites are located within 25 miles of the East or Gulf coasts, many of which will be at risk of flooding as sea levels rise. More than 60 million people across the United States live within 3 miles of a Superfund site. Disentangling multifaceted environmental health problems compounded by climate change requires a multidisciplinary systems approach to inform better strategies to prevent or reduce exposures and protect human health. The purpose of this minireview is to present the National Institute of Environmental Health Sciences Superfund Research Program (SRP) as a useful model of how this systems approach can help overcome the challenges of climate change while providing flexibility to pivot to additional needs as they arise. It also highlights broad-ranging SRP-funded research and tools that can be used to promote health and resilience to climate change in diverse contexts.

Enhancing Data Integration, Interoperability, and Reuse to Address Complex and Emerging Environmental Health Problems.

Environmental health sciences (EHS) span many diverse disciplines. Within the EHS community, the National Institute of Environmental Health Sciences Superfund Research Program (SRP) funds multidisciplinary research aimed to address pressing and complex issues on how people are exposed to hazardous substances and their related health consequences with the goal of identifying strategies to reduce exposures and protect human health. While disentangling the interrelationships that contribute to environmental exposures and their effects on human health over the course of life remains difficult, advances in data science and data sharing offer a path forward to explore data across disciplines to reveal new insights. Multidisciplinary SRP-funded teams are well-positioned to examine how to best integrate EHS data across diverse research domains to address multifaceted environmental health problems. As such, SRP supported collaborative research projects designed to foster and enhance the interoperability and reuse of diverse and complex data streams. This perspective synthesizes those experiences as a landscape view of the challenges identified while working to increase the FAIR-ness (Findable, Accessible, Interoperable, and Reusable) of EHS data and opportunities to address them.

Understanding exposures and latent disease risk within the National Institute of Environmental Health Sciences Superfund Research Program.

Understanding the health effects of exposures when there is a lag between exposure and the onset of disease is an important and challenging topic in environmental health research. The National Institute of Environmental Health Sciences (NIEHS) Superfund Basic Research and Training Program (SRP) is a National Institutes of Health (NIH) grant program that uses a multidisciplinary approach to support biomedical and environmental science and engineering research. Because of the multidisciplinary nature of the program, SRP grantees are well-positioned to study exposure and latent disease risk across humans, animal models, and various life stages. SRP-funded scientists are working to address the challenge of connecting exposures that occur early in life and prior to conception with diseases that manifest much later, including developing new tools and approaches to predict how chemicals may affect long-term health. Here, we highlight research from the SRP focused on understanding the health effects of exposures with a lag between exposure and the onset of the disease as well as provide future directions for addressing knowledge gaps for this highly complex and challenging topic. Advancing the knowledge of latency to disease will require a multidisciplinary approach to research, the need for data sharing and integration, and new tools and computation approaches to make better predications about the timing of disease onset. A better understanding of exposures that may contribute to later-life diseases is essential to supporting the implementation of prevention and intervention strategies to reduce or modulate exposures to reduce disease burden.

Focus on asthma 3: the psychosocial effects of asthma on the child and the family.

This article is the third in a series on asthma. The first article explored global and UK trends in asthma and asthma care as they relate to children and young people, while the second article identified the adverse effects of air pollution on children, particularly those with asthma. This article explores the potentially significant psychosocial effects of asthma on the child and the family. A family-centred approach to care relies on healthcare professionals listening to and understanding families' health beliefs and narratives to target asthma education and aid self-efficacy, which can improve asthma control and quality of life.

Greater than the sum of its parts: focusing SRP research through a systems approach lens.

The National Institute of Environmental Health Sciences Superfund Research Program (SRP) funds diverse transdisciplinary research to understand how hazardous substances contribute to disease. SRP research focuses on how to prevent these exposures by promoting problem-based, solution-oriented research. SRP's mandate areas encompasses broad biomedical and environmental science and engineering research efforts and, when combined with research translation, community engagement, training, and data science, offers broad expertise and unique perspectives directed at a specific big picture question. The purpose of this commentary is to adapt a systems approach concept to SRP research to accommodate the complexity of a scientific problem. The SRP believes a systems approach offers a framework to understand how scientists can work together to integrate diverse fields of research to prevent or understand environmentally-influenced human disease by addressing specific questions that are part of a larger perspective. Specifically, within the context of the SRP, a systems approach can elucidate the complex interactions between factors that contribute to or protect against environmental insults. Leveraging a systems approach can continue to advance SRP science while building the foundation for researchers to address difficult emerging environmental health problems.

Focus on asthma 1: the state of care for children and young people in the UK and globally.

This is the first in a series of articles on asthma, the most prevalent long-term condition in children with a significant burden of disease. This first article presents an overview of the state of asthma and asthma care in the UK and globally, especially as it relates to children and young people. It considers prevalence, age and sex comparisons, causation, morbidity and mortality rates, cost and the quality of care. It also outlines what children and young people wish for their asthma care.

Focus on asthma 2: air pollution and its effects on children and young people.

This article is the second in a series on asthma. The first article identified that the UK is experiencing an 'epidemic' of childhood asthma and one of the major culprits is air pollution. This article examines the main causes of air pollution and how they affect the lung health of children from before birth and onwards. It considers the contribution of indoor and outdoor air pollution, how these have changed over time and the unequal effect they may have on vulnerable populations. The nurse's role is discussed, not only in terms of clinical care, but also as adviser to families and schools on what actions to take to limit their exposure and reduce their own emissions of pollutants.

Benefits of basic research from the Superfund Research Program.

The National Institutes of Health (NIH), National Institute of Environmental Health Sciences (NIEHS) Hazardous Substances Basic Research and Training Program [Superfund Research Program (SRP)] funds transdisciplinary research projects spanning the biomedical and environmental sciences to address issues related to potentially hazardous substances. We used a case study approach to identify how SRP-funded basic biomedical research has had an impact on society. We examined how transdisciplinary research projects from the SRP have advanced knowledge and led to additional clinical, public health, policy, and economic benefits. SRP basic biomedical research findings have contributed to the body of knowledge and influenced a broad range of scientific disciplines. It has informed the development of policies and interventions to reduce exposure to environmental contaminants to improve public health. Research investments by the SRP have had a significant impact on science, health, and society. Documenting the benefits of these investments provides insight into how basic research is translated to real-world applications.

Sharing SRP data to reduce environmentally associated disease and promote transdisciplinary research.

The National Institute of Environmental Health Sciences (NIEHS) Superfund Basic Research and Training Program (SRP) funds a wide range of projects that span biomedical, environmental sciences, and engineering research and generate a wealth of data resulting from hypothesis-driven research projects. Combining or integrating these diverse data offers an opportunity to uncover new scientific connections that can be used to gain a more comprehensive understanding of the interplay between exposures and health. Integrating and reusing data generated from individual research projects within the program requires harmonization of data workflows, ensuring consistent and robust practices in data stewardship, and embracing data sharing from the onset of data collection and analysis. We describe opportunities to leverage data within the SRP and current SRP efforts to advance data sharing and reuse, including by developing an SRP dataset library and fostering data integration through Data Management and Analysis Cores. We also discuss opportunities to improve public health by identifying parallels in the data captured from health and engineering research, layering data streams for a more comprehensive picture of exposures and disease, and using existing SRP research infrastructure to facilitate and foster data sharing. Importantly, we point out that while the SRP is in a unique position to exploit these opportunities, they can be employed across environmental health research. SRP research teams, which comprise cross-disciplinary scientists focused on similar research questions, are well positioned to use data to leverage previous findings and accelerate the pace of research. Incorporating data streams from different disciplines addressing similar questions can provide a broader understanding and uncover the answers to complex and discrete research questions.

Evaluation of a Choir as a Non-Medical Intervention for Children with Asthma: BreathStars.

A shift in the current health policy has seen heightened focus on non-medical interventions which can be delivered out with formal health-care settings, to complement and enhance the clinical care of people with long-term conditions. Asthma is a common long-term condition managed by pharmacological and non-pharmacological interventions. Recent research activity has focused on the use of singing for respiratory health due to its similarity with the more well-known intervention of breathing exercises. The aim of this study was to determine if singing improved breathing in children with asthma. A realist evaluation study design with a mixed methods approach was adopted to evaluate a singing group for children aged 7-12. Results obtained through framework analysis of the data indicated notable improvement in asthma control with the added impact on self-esteem. Enjoyment of the singing group within a family centered approach was seen as a positive alongside the community benefit of wider asthma education. Lessons can be learnt from this evaluation which could inform future initiatives relevant to the current agenda of asset-based approaches such as social prescribing within the context of the current devolution of the health and social care budget in the North West of England.

The Importance of Community Engagement and Research Translation within the NIEHS Superfund Research Program.

The National Institute of Environmental Health Sciences Superfund Research Program (SRP) funds university-based, solution-oriented research to understand how hazardous substances contribute to disease and how to prevent exposures to these hazardous substances. A unique aspect of the SRP is that, beyond the biomedical, environmental sciences, and engineering research projects, SRP-funded centers are required to include community engagement to build partnerships with affected communities and research translation to communicate and facilitate the use of research findings. The SRP views both as effective ways to inform and advance science for protection of public health. The purpose of community engagement within the centers is to ensure bidirectional communication between the researchers and the community, identify best practices and activities in community engagement for prevention and intervention activities, enhance knowledge, and support the needs of the communities impacted by hazardous waste sites. The SRP views research translation as communicating and facilitating the use of research findings emanating from the center in a manner most appropriate for their application and for the advancement of a center's research objectives. The SRP has a strong history of seeking opportunities to work with communities and stakeholders, by translating and sharing research findings in an impactful and informative manner with long-lasting benefits to improve public health.

Assessing the Economic and Societal Benefits of SRP-Funded Research.

BACKGROUND: The National Institute of Environmental Health Sciences (NIEHS) Superfund Basic Research and Training Program (SRP) funds a wide range of transdisciplinary research projects spanning the biomedical and environmental sciences and engineering, supporting and promoting the application of that research to solving real-world problems. OBJECTIVES: We used a case study approach to identify the economic and societal benefits of SRP-funded research, focusing on the use of potentially hazardous substance remediation and site monitoring tools. We also identified successes and challenges involved in translating SRP grantees' research findings and advances into application. DISCUSSION: We identified remediation and detection research projects supported by the SRP with the most potential for economic and societal benefits and selected 36 for analysis. To examine the benefits of these applied technologies, we interviewed 28 SRP-supported researchers and 41 partners. Five case studies emerged with the most complete information on cost savings-total savings estimated at >$100 million. Our analysis identified added societal benefits such as creation of small businesses, land and water reuse, sustainable technologies, exposure reduction, and university-industry partnerships. CONCLUSIONS: Research funded by the SRP has yielded significant cost savings while providing additional societal benefits. https://doi.org/10.1289/EHP3534.

The National Institute of Environmental Health Sciences Superfund Research Program: a model for multidisciplinary training of the next generation of environmental health scientists.

The National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) funds university-based, multidisciplinary research on human health and environmental science and engineering with the central goals to understand how hazardous substances contribute to disease and how to prevent exposures to these environmental chemicals. This multi-disciplinary approach allows early career scientists (e.g. graduate students and postdoctoral researchers) to gain experience in problem-based, solution-oriented research and to conduct research in a highly collaborative environment. Training the next generation of environmental health scientists has been an important part of the SRP since its inception. In addition to basic research, the SRP has grown to include support of broader training experiences such as those in research translation and community engagement activities that provide opportunities to give new scientists many of the skills they will need to be successful in their field of research. Looking to the future, the SRP will continue to evolve its training component by tracking and analyzing outcomes from its trainees by using tools such as the NIEHS CareerTrac database system, by increasing opportunities for trainees interested in research that goes beyond US boundaries, and in the areas of bioinformatics and data integration. These opportunities will give them the skills needed to be competitive and successful no matter which employment sector they choose to enter after they have completed their training experience.

Evaluating a community-led project for improving fathers' and children's wellbeing in England.

Although under-researched and under-theorized compared to other settings, there is potential for the family setting to be harnessed to support the development of healthy children and societies and to reduce health inequalities. Within this setting, the role of fathers as health facilitators has yet to be fully understood and considered within health promotion. This paper draws on a two year evaluation of a community embedded intervention for fathers and children in an area of multiple deprivation in North West England. The evaluation integrated a variety of qualitative methods within a participatory evaluation framework to help understand the development and impact of a programme of work co-created by a social enterprise and fathers from within the community. Findings suggest that allowing fathers to define their own concerns, discover solutions to these and design locally appropriate ways to share these solutions can result in significant change for them, their children and the wider community. The key to this process is the provision of alternative spaces where fathers feel safe to share the substantial difficulties they are experiencing. This improved their confidence and had a positive impact on their relationships with their children and with significant others around them. However, this process required patience, and a commitment to trusting that communities of men can co-create their own solutions and generate sustainable success. We suggest that commissioning of services delivered 'to' people could be replaced, or supplemented, by commissioning appropriate organisations to work with communities to co-create solutions to the needs they themselves have recognized.

Use social media to motivate patients.

There are challenges and risks in using social media that are well documented in guidance from the Nursing and Midwifery Council, the RCN and online platforms such as WeCommunities. Confidentiality, boundaries, appropriate use by vulnerable groups, and responsible and sensitive communication are recurrent themes. The unintended consequence of this may be to deter some nurses from using social media in their professional lives.

From treating need to creating wellness.

Six years ago I lost my job as a deputy director of commissioning due to compulsory redundancy. In the run-up to leaving the NHS I had been introduced to one of the most inspirational nurses I've ever met, Hazel Stuteley.

Sustainable exposure prevention through innovative detection and remediation technologies from the NIEHS Superfund Research Program.

Innovative devices and tools for exposure assessment and remediation play an integral role in preventing exposure to hazardous substances. New solutions for detecting and remediating organic, inorganic, and mixtures of contaminants can improve public health as a means of primary prevention. Using a public health prevention model, detection and remediation technologies contribute to primary prevention as tools to identify areas of high risk (e.g. contamination hotspots), to recognize hazards (bioassay tests), and to prevent exposure through contaminant cleanups. Primary prevention success is ultimately governed by the widespread acceptance of the prevention tool. And, in like fashion, detection and remediation technologies must convey technical and sustainability advantages to be adopted for use. Hence, sustainability - economic, environmental, and societal - drives innovation in detection and remediation technology. The National Institute of Health (NIH) National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) is mandated to advance innovative detection, remediation, and toxicity screening technology development through grants to universities and small businesses. SRP recognizes the importance of fast, accurate, robust, and advanced detection technologies that allow for portable real-time, on-site characterization, monitoring, and assessment of contaminant concentration and/or toxicity. Advances in non-targeted screening, biological-based assays, passive sampling devices (PSDs), sophisticated modeling approaches, and precision-based analytical tools are making it easier to quickly identify hazardous "hotspots" and, therefore, prevent exposures. Innovation in sustainable remediation uses a variety of approaches: in situ remediation; harnessing the natural catalytic properties of biological processes (such as bioremediation and phytotechnologies); and application of novel materials science (such as nanotechnology, advanced membranes, new carbon materials, and materials reuse). Collectively, the investment in new technologies shows promise to reduce the amount and toxicity of hazardous substances in the environment. This manuscript highlights SRP funded innovative devices and tools for exposure assessment and remediation of organic, inorganic, and mixtures of contaminants with a particular focus on sustainable technologies.

Public health nursing needs to reach out.

In one of her first acts after taking office in July, prime minister Theresa May announced an equalities audit of public services. The audit will cover how minorities and white working class people are treated in health, education, employment, welfare, skills and criminal justice. The prime minister said the review would 'shine a light on injustices'.