Engaging the community served: a U.S. Cancer Center's Facebook live cancer awareness campaign for Spanish-speaking Latinos during COVID-19.

Cancer is the leading cause of mortality in U.S. Latino adults, a group with limited access to screening, higher rates of advanced disease, and prone to online misinformation. Our project created a Facebook Live social media video campaign on general cancer prevention, screening, risk, information, and resources, targeting Spanish-monolingual Latinos during the COVID-19 pandemic. Content was delivered in Spanish by fluent, ethnically concordant topic experts and cancer center staff. Four prerecorded and three livestream interview videos were produced, amassing over 161 shares, 1,000 engagements, 12,000 views, 19,000 people reached, and 34,000 impressions in a span of four months. Strengths of this project included developing community partnerships and collaborations, providing evidence-based cancer information in a culturally responsive manner to often-excluded community members during COVID-19 pandemic, and presenting our cancer center as an accessible resource to the wider community. Future directions include formalizing evaluation strategies to capture medical engagement via cancer screening and detection rates, delivering focused cancer discussions by disease sites, and further expanding audience base through mixed media formats.

The anatomy of a community health center system-level intervention for intimate partner violence.

The US Preventive Services Task Force (USPSTF) now recommends screening for intimate partner violence (IPV) as part of routine preventive services for women. However, there is a lack of clarity as to the most effective methods of screening and referral. We conducted a 3-year community-based mixed-method participatory research project involving four community health centers that serve as safety net medical providers for a predominately indigent urban population. The project involved preparatory work, a multifaceted systems-level demonstration project, and a sustainability period with provider/staff debriefing. The goal was to determine if a low-tech system-level intervention would result in an increase in IPV detection and response in an urban community health center. Results highlight the challenges, but also the opportunities, for implementing the new USPSTF guidelines to screen all women of childbearing years for intimate partner violence in resource-limited primary care settings.

Practitioner-recommended policies and procedures for children exposed to domestic violence.

Children exposed to domestic violence experience higher rates of psychosocial, behavioral, and physical problems. Current policy recommendations are that health care providers offer regular screening and treatment for childhood exposure to domestic violence (CEDV). However, screening recommendations have been slow to take hold. The purpose of this study was to identify recommended practices of CEDV, as reported by practitioners. Interviews were held with 24 experienced service providers from 14 agencies. Respondents provided practical suggestions for CEDV screening and intervention. Suggestions included refinement of screening tools for maximum validity and reliability, improved integration of DV education into medical training and practice, on-site DV resources in pediatric settings, and establishment of formal partnerships between human service organizations that promoted ongoing collaborative activities. Next steps are to evaluate outcomes for evidence-based practice.

Results of a multifaceted Intimate Partner Violence training program for pediatric residents.

OBJECTIVE: To evaluate the efficacy of a multifaceted Intimate Partner Violence (IPV) intervention on knowledge, attitudes, and screening practices of pediatric residents. METHODS: The intervention included: an on-site IPV counselor, IPV training for attending physicians, residents and social workers, and screening prompts. Evaluation included baseline and post-training surveys of residents, assessing their knowledge, attitudes, and comfort with IPV screening, patient chart reviews at baseline, 3 months, and 8 months for documentation of IPV screening, and review of the IPV counselor's client charts. RESULTS: Baseline chart review showed screening rates of less than 1%. Screening rates were 36.2% at 3 months and 33.1% at 8 months. After training, residents were more likely to know: IPV screening questions (47.1% vs. 100%); referral sources (34.3% vs. 82.9%); and the relationship between child abuse and IPV (52.9% vs. 97.1%). At baseline, barriers to IPV screening included time (50%), lack of knowledge of how to screen (26.5%) and where to refer (23.5%). Post-training, barriers were time (44%), presence of children (25.9%) or other adults (18.5%) in the room, and inappropriate location (18.5%). Post-training, none of the residents listed "lack of knowledge" or "lack of referral sources" as barriers to IPV screening. After 12 months, 107 victims of IPV were identified; most referred from inpatient units and subspecialty clinics. CONCLUSION: A multifaceted IPV intervention increased identification of IPV victims and markedly improved attitudes, comfort, and IPV screening practices of pediatric residents. IPV screening rates were sustainable with minimal ongoing training. PRACTICE IMPLICATIONS: Consideration should be given to the training and practice supports necessary to encourage IPV screening in the pediatric setting. Educational efforts that familiarize pediatricians with the content surrounding the risk and potential impact of IPV to children and families along with practice supports that make incorporating screening for IPV as easy as possible have the potential to increase the identification of this problem and promote referrals to IPV agencies for follow-up and intervention where needed.

Medullary carcinoma of the thyroid with metastasis to the pituitary gland.

A case of metastatic medullary thyroid carcinoma presenting with anterior pituitary dysfunction is reported. Initial evaluation revealed an intrasellar mass at a time when serum calcitonin and carcinoembryonic antigen levels were elevated, and histological analysis of resected tissue demonstrated the presence of metastatic medullary carcinoma of the thyroid. Immunohis-tochemical analysis confirmed the presence of calcitonin in the tumor cells. Like other malignant processes, metastatic medullary carcinoma of the thyroid may involve the pituitary gland and should be included in the differential diagnosis in the appropriate clinical setting.