Using Implementation Mapping to increase uptake and use of Salud en Mis Manos: A breast and cervical cancer screening and HPV vaccination intervention for Latinas.

Background: Despite CDC recommendations for breast and cervical cancer screening and HPV vaccination, cancer control behaviors are underutilized among low-income Latinas. Salud en Mis Manos (SEMM), adapted from Cultivando La Salud, is a community health worker- (CHW-) delivered evidence-based intervention (EBI), shown to increase breast and cervical cancer screening. Methods: We used Implementation Mapping to create SEMM-Dissemination and Implementation Assistance (SEMM-DIA), a set of implementation strategies designed to support implementation and maintenance of SEMM in clinic settings. Specifically, we used Implementation Mapping's five iterative tasks to guide the use of theories and frameworks, evidence, new data, and stakeholder input to develop strategies to accelerate and improve implementation fidelity, reach, and maintenance of the SEMM intervention. The resulting implementation mapping logic model also guides the SEMM-DIA evaluation plan to assess reach, effectiveness, implementation, and maintenance. Discussion: Increased use of implementation planning frameworks is necessary to accelerate the translation of EBIs to public health practice. This work demonstrates the application of Implementation Mapping to develop SEMM-DIA, providing a model for the development of other implementation strategies to support translation of evidence-based health promotion interventions into clinic settings.

An interdisciplinary team-based approach for significantly reducing lower-level lead poisoning in U.S. children.

Child lead poisoning damages central nervous system, immune, and renal function, and is the longest-standing public health epidemic in U.S. history. While primary prevention is the ultimate goal, secondary intervention is critical for curbing effects among children already exposed. Despite the lowering of child blood lead level (BLL) reference value in 2012 and again in 2021, few changes to secondary intervention approaches have been discussed. This study tested a novel interdisciplinary approach integrating ongoing child BLL-monitoring with education and home mitigation for families living in neighborhoods at high-risk of child lead exposure. In children ages 6 months to 16 years, most of whom had lowest range exposures, we predicted significantly reduced BLLs following intervention. Methods: Twenty-one families with 49 children, were offered enrollment when at least 1 child in the family was found to have a BLL > 2.5 µg/dL. Child BLLs, determined by ICPMS, were monitored at 4- to 6-month intervals. Education was tailored to family needs, reinforced through repeated parent engagement, and was followed by home testing reports with detailed case-specific information and recommendations for no-cost/low-cost mitigation. Results: Ninety percent of enrolled families complied with the mitigation program. In most cases, isolated, simple-to-mitigate lead hazard sources were found. Most prevalent were consumer products, found in 69% (11/16) of homes. Lead paint was identified in 56% (9/16) of homes. Generalized linear regression with Test Wave as a random effect showed that children's BLLs decreased significantly following the intervention despite fluctuations. Conclusion: Lower-level lead poisoning can be reduced through an interdisciplinary approach that combines ongoing child BLL monitoring; repeated, one-on-one parent prevention education; and identification and no-cost/low-cost mitigation of home lead hazards. Biannual child BLL monitoring is essential for detecting and responding to changes in child BLLs, particularly in neighborhoods deemed high-risk for child lead poisoning.

In the company of my sisters: sister circles as an anxiety intervention for professional African American women.

BACKGROUND: Sister circles have been used within African American communities to raise awareness about physical health. The possibility exists that sister circles could be used to educate and teach women strategies about managing anxiety and panic. In this paper we examine professional Black women's conceptualization of panic attacks and other related anxiety issues. Then, we explore the feasibility of sister circles as a psycho-educational anxiety intervention for African American professional women. METHODS: Four focus groups (n=37) were conducted. Focus group interviews were transcribed and were coded into three categories: (a) a major theme; (b) a minor theme; or (c) an off-topic comment. Specifically, we generate information regarding the key content and research components of a sister circle for African American female professionals. RESULTS: Focus group members saw a distinct difference between anxiety and panic. The number of African American women who experienced was seen as low. Women felt sister circles were a nice vehicle for helping African American women manage their anxiety and panic. Confidentially was a key component. Sister circles for anxiety and panic were seen as a natural outgrowth of African American women's professional networks. LIMITATIONS: Limited data were collected on participant's anxiety levels. CONCLUSIONS: Overall, sister circles were seen as feasible interventions for African American professional women. The data from the focus groups were used to enhance the development of a sister circle intervention for anxious professional African American women.