Benefit-Cost Analysis of the HHS COVID-19 Campaign: April 2021-March 2022.

INTRODUCTION: This study estimated the benefits and costs of the U.S. Department of Health and Human Services' We Can Do This COVID-19 public education campaign (the Campaign) and associated vaccination-related impacts. METHODS: Weekly media market and national Campaign expenditures were used to estimate weekly first-dose vaccinations that would not have occurred absent the Campaign, weekly Campaign-attributed complete vaccinations, and corresponding COVID-19 cases, hospitalizations, and deaths averted. Benefits were valued using estimated morbidity and mortality reductions and associated values of a statistical life and a statistical case. Costs were estimated using Campaign paid media expenditures and corresponding vaccination costs. The net Campaign and vaccination benefit and return on investment were calculated. Analyses were conducted from 2022 to 2024. RESULTS: Between April 2021 and March 2022, an estimated 55.9 million doses of COVID-19 vaccines would not have been administered absent the Campaign. Campaign-attributed vaccinations resulted in 2,576,133 fewer mild COVID-19 cases, 243,979 fewer nonfatal COVID-19 hospitalizations, and 51,675 lives saved from COVID-19. The total Campaign benefit was $740.2 billion, and Campaign and vaccination costs totaled $8.3 billion, with net benefits of approximately $732.0 billion. For every $1 spent, the Campaign and corresponding vaccination costs resulted in benefits of approximately $89.54. CONCLUSIONS: The We Can Do This COVID-19 public education campaign saved more than 50,000 lives and prevented hundreds of thousands of hospitalizations and millions of COVID-19 cases, representing hundreds of billions of dollars in benefits in less than one year. Findings suggest that public education campaigns are a cost-effective approach to reducing COVID-19 morbidity and mortality.

Older Adult Falls in the Community: Does Unsafe Home Environment Have a Risk Role Through the Mediating Effect of Functional Limitations?

BACKGROUND AND OBJECTIVES: Fall incidents from unsafe home environments are frequent in older-adult homes but the literature is ambiguous whether it is the presence/absence, or the interplay of such conditions and physical functioning that is of salience. We therefore estimated whether unsafe home environment is adversely associated with subsequent falls among older adults and what proportion of this association was mediated through limitations in daily and instrumental activities of daily living (ADL/IADL). RESEARCH DESIGN AND METHODS: Using a nationally representative sample of community-dwelling Medicare beneficiaries (≥65 years) in the 2018-2019 National Health and Aging Trends Study (n = 2,599), we conducted bivariate and multivariable analyses. We examined baseline conditions of home disorders, unsafe bathroom settings, unsafe house/building features, and house disrepairs in 2018 and their relation with subsequent falls in 2019, after controlling for covariates. To assess whether ADL/IADL limitations mediated this relationship, we employed the Karlson-Holm-Breen methodology. RESULTS: In 2019, the self-reported prevalence of falls among older adults was estimated at 34.68%. Although baseline home disorders had both a direct (adjusted odds ratio [aOR]: 1.14, 95% confidence interval [CI]:1.03,1.26) and an indirect effect through limitations in ADL and IADL (aOR: 1.01; 95% CI: 1.00,1.03), the relation between unsafe bathroom settings and subsequent falls was unclear. Unsafe house/building features and house disrepairs were not statistically significantly related either directly or indirectly with subsequent falls. DISCUSSION AND IMPLICATIONS: Addressing home disorders through policy and housing assessments to highlight home environmental safety would be essential to address falls among older adults.

Interpreting COVID-19 deaths among nursing home residents in the US: The changing role of facility quality over time.

A report published last year by the Centers for Medicare & Medicaid Services (CMS) highlighted that COVID-19 case counts are more likely to be high in lower quality nursing homes than in higher quality ones. Since then, multiple studies have examined this association with a handful also exploring the role of facility quality in explaining resident deaths from the virus. Despite this wide interest, no previous study has investigated how the relation between quality and COVID-19 mortality among nursing home residents may have changed, if at all, over the progression of the pandemic. This understanding is indeed lacking given that prior studies are either cross-sectional or are analyses limited to one specific state or region of the country. To address this gap, we analyzed changes in nursing home resident deaths across the US between June 1, 2020 and January 31, 2021 (n = 12,415 nursing homes X 8 months) using both descriptive and multivariable statistics. We merged publicly available data from multiple federal agencies with mortality rate (per 100,000 residents) as the outcome and CMS 5-star quality rating as the primary explanatory variable of interest. Covariates, based on the prior literature, consisted of both facility- and community-level characteristics. Findings from our secondary analysis provide robust evidence of the association between nursing home quality and resident deaths due to the virus diminishing over time. In connection, we discuss plausible reasons, especially duration of staff shortages, that over time might have played a critical role in driving the quality-mortality convergence across nursing homes in the US.

The Development and Psychometric Evaluation of the Reasons for Disclosing Sexual and Intimate Partner Violence Scale.

A wide body of research has studied what happens when survivors disclose interpersonal violence (Ullman, 2010; Ullman & Filipas, 2001). Less studied is why survivors disclose their experiences. Although research in other disciplines has created measures to assess the reasons for disclosing other concealable identities (Derlega, Winstead, Folk-Barron, & Petronio, 2000), the present study aimed to fill a gap in the existing literature by creating a measure to assess the reasons for disclosing sexual and intimate partner violence. The Reasons for Disclosing Sexual and Intimate Partner Violence Scale was created after interviewing survivors and receiving feedback on the measure from crisis center advocates and experts in the field (i.e., content validity). The psychometric properties (i.e., dimensionality and reliability) of the measure were tested with a sample of 274 adult female survivors of sexual and intimate partner violence. The results suggested that reasons for disclosing sexual and intimate partner violence can be broken down into seven factors (e.g., safety and justice, image validation), and that these reasons vary from other concealable identities.

Posttraumatic Growth as a Mediator of Self-Blame and Happiness in the Context of Interpersonal Violence.

Sexual assault (SA) and intimate partner violence (IPV) occur at alarming rates in the United States. Prior research indicates that victims of traumatic events frequently experience both positive and negative changes as part of their recovery process. The present study aimed to further existing research by examining the relationship between self-blame, posttraumatic growth (PTG), and happiness when controlling for posttraumatic stress and time since victimization. The current study analyzed 357 women who had experienced at least one incident of SA or IPV. We found that PTG partially mediated the relationship between self-blame and happiness, suggesting that PTG only somewhat explains the impact of self-blame on victim happiness. Implications of these findings and directions for future research are discussed.