COVID-19 Mortality Among American Indian and Alaska Native Persons - 14 States, January-June 2020.

American Indian/Alaska Native (AI/AN) persons experienced disproportionate mortality during the 2009 influenza A(H1N1) pandemic (1,2). Concerns of a similar trend during the coronavirus disease 2019 (COVID-19) pandemic led to the formation of a workgroup* to assess the prevalence of COVID-19 deaths in the AI/AN population. As of December 2, 2020, CDC has reported 2,689 COVID-19-associated deaths among non-Hispanic AI/AN persons in the United States.† A recent analysis found that the cumulative incidence of laboratory-confirmed COVID-19 cases among AI/AN persons was 3.5 times that among White persons (3). Among 14 participating states, the age-adjusted AI/AN COVID-19 mortality rate (55.8 deaths per 100,000; 95% confidence interval [CI] = 52.5-59.3) was 1.8 (95% CI = 1.7-2.0) times that among White persons (30.3 deaths per 100,000; 95% CI = 29.9-30.7). Although COVID-19 mortality rates increased with age among both AI/AN and White persons, the disparity was largest among those aged 20-49 years. Among persons aged 20-29 years, 30-39 years, and 40-49 years, the COVID-19 mortality rates among AI/AN were 10.5, 11.6, and 8.2 times, respectively, those among White persons. Evidence that AI/AN communities might be at increased risk for COVID-19 illness and death demonstrates the importance of documenting and understanding the reasons for these disparities while developing collaborative approaches with federal, state, municipal, and tribal agencies to minimize the impact of COVID-19 on AI/AN communities. Together, public health partners can plan for medical countermeasures and prevention activities for AI/AN communities.

Building Vaccine Literacy in a Pandemic: How One Team of Public Health Students Is Responding.

Students at schools and programs of public health will enter a workforce during the greatest public health crisis in the past century. The potential COVID-19 vaccine-one of the most promising tools to return to a new 'normal'-is held in doubt by many Americans. Vaccine literacy in the United States is a pressing issue that students of public health need to consider. We describe how a long-standing public health student crisis response team at Emory University is helping to address this challenge, and describe key principles we identify as worthy of study and focus for current public health students today. Schools and programs of public health have a timely opportunity to adapt their curricula to meet training needs of emerging public health students to equip them to address vaccine literacy while maintaining accreditation standards.

A Select Bibliography of Actions to Promote Vaccine Literacy: A Resource for Health Communication.

In this bibliography, the researchers provide an introduction to the available evidence base of actions to promote vaccine literacy. The research team organized interventions to create a tool that can inform health communicators and practitioners seeking a resource focused on strategy and implementation design for actions that support vaccine literacy. This scoping bibliography is honed specifically to respond to the urgency of the current pandemic, when supporting and increasing vaccine literacy offers promise for achieving the critically needed high levels of vaccination. Over the course of the coming months and year, this bibliography will be a dynamic and "living" document hosted and maintained on vaccineliteracy.com.

Evaluation of the Olweus Bullying Prevention Program: A large scale study of U.S. students in grades 3-11.

The purpose of this quasi-experimental study was to evaluate a large-scale implementation of the Olweus Bullying Prevention Program with children and youth in grades 3-11 in the U.S. Two major sets of analyses are presented, one following 210 schools over two years (Study 1; n = 70,998 at baseline) and the other following a subsample of 95 schools over three years (Study 2; n = 31,675 at baseline). Schools were located in 49 counties in central and western Pennsylvania. The Mplus 7.0 program was used to analyze the data which had a multilevel structure, with students nested in schools and program effects based on school-aggregated outcome variables. For almost all grades, there were clear reductions in the two key dimensions, being bullied and bullying other students. Average Absolute Change amounted to approximately 3%, implying that almost 2000 students had escaped being bullied in the two-year study. School-level Cohen's d's were large or fairly large. The longitudinal analyses documented increases in students' expressions of empathy with bullied peers, marked decreases in their willingness to join in bullying, and perceptions that their primary teacher had increased his or her efforts to address bullying. Overall, effects were stronger the longer the program had been in place. The analyses provided strong support for the effectiveness of the OBPP with U.S. students in elementary, middle, and early high school grades in Pennsylvania schools. Future research is warranted to assess program effectiveness in different racial/ethnic and community settings and to examine the relation between fidelity of implementation and outcomes.

Bullying Prevention: a Summary of the Report of the National Academies of Sciences, Engineering, and Medicine : Committee on the Biological and Psychosocial Effects of Peer Victimization: Lessons for Bullying Prevention.

Long tolerated as a rite of passage into adulthood, bullying is now recognized as a major and preventable public health problem. The consequences of bullying-for those who are bullied, the perpetrators of bullying, and the witnesses-include poor physical health, anxiety, depression, increased risk for suicide, poor school performance, and future delinquent and aggressive behavior. Despite ongoing efforts to address bullying at the law, policy, and programmatic levels, there is still much to learn about the consequences of bullying and the effectiveness of various responses. In 2016, the National Academies of Sciences, Engineering, and Medicine published a report entitled Preventing Bullying Through Science, Policy and Practice, which examined the evidence on bullying, its impact, and responses to date. This article summarizes the report's key findings and recommendations related to bullying prevention.

Clinical and health promotion asthma management: an intervention for children and adolescents.

BACKGROUND: Asthma is the leading chronic condition among children. Given this international burden, clinicians and public health professionals applied the Expanded Chronic Care Model to address health adversities of pediatric patients with asthma. OBJECTIVE: This study examined the influence of a clinical health promotion initiative on asthma control and appropriate medication management among pediatric patients. METHODS: Patients (n = 304) were recruited and screened for participation in this study. All the patients participated in a motivational interview, received clinical care, and were monitored longitudinally. Eligible patients (n = 53) were referred to one or more intervention pathways regarding physical activity, nutrition, smoking cessation, and psychosocial wellness. A comparison group (n = 90) was eligible for an intervention but chose not to participate. This analysis focused on patients who were identified as needing a health intervention beyond asthma clinical care. RESULTS: Among patients who were invited to participate in the health promotion pathways, significant decreases in asthma exacerbation were achieved by the patients who participated in the intervention compared with those who did not participate (p = 0.018). Significant improvements in asthma exacerbation, activity limitations, and asthma control were attributed to the time in clinical care (p < 0.001). In this group, asthma control significantly improved with medication (p = 0.002), and age was associated with a significant decrease in asthma exacerbation (p = 0.011). CONCLUSIONS: This pilot study demonstrated preliminary benefits in a child asthma population. In addition, this experience addressed the chronicity of pediatric asthma through patient-centered care.

The implementation of a statewide bullying prevention program: preliminary findings from the field and the importance of coalitions.

Bullying in schools has become recognized as a significant public health problem. The Olweus Bullying Prevention Program (OBPP) has been identified as an effective means to reduce bullying behavior in schools. The goal of this large population-based initiative was to reduce bullying by producing a quantifiable change in school climate using an established program and standardized measurement tool. Program participants over a 2-year period included 56,137 students and more than 2,400 teachers from 107 schools in 49 counties across Pennsylvania. An age cohorts design was used, and data from two equivalent age cohorts of students were compared at two or more points in time. After 1 to 2 years of program implementation, across cohorts, there were reductions in student self-reports of bullying others, and improvements in student perceptions of adults' responsiveness, and students' attitudes about bullying. This study is the largest bullying prevention initiative to date in the United States. This initiative reaffirms the efficacy of the OBPP, emphasizes the importance of an identified coalition, and highlights several positive outcomes. It is recommended that the OBPP be implemented through the establishment of community partnerships and coalitions as consistent with the public health model.