COVID-19 Response of the Journal Public Health Reports (PHR), March 2020-March 2023.

OBJECTIVE: Publication science is the scholarly study of various aspects of the academic publishing process. Its applications to COVID-19 literature have been limited. Here, we describe COVID-19 submissions to, and resulting articles published by, the journal Public Health Reports (PHR), an important resource for US public health practice. METHODS: We reviewed PHR's COVID-19 submissions and articles published between March 27, 2020, and March 27, 2023. We coded each article for article type, author affiliation, the categories listed in PHR's call for COVID-19 papers, and the public health emergency preparedness and response capabilities from the Centers for Disease Control and Prevention (CDC). RESULTS: During the study period, PHR received 1545 COVID-19 submissions and published 190 of those articles in a collection, COVID-19 Response. The COVID-19 Response collection included 102 research articles, 29 case study/practice articles, and 24 commentaries. The corresponding author of more than half (52.1%; n = 99) of the articles was affiliated with academia. By the categories listed in PHR's call for COVID-19 papers, 51 articles addressed health disparities, 38 addressed public health surveillance, and 34 addressed COVID-19 vaccination. By the CDC public health emergency preparedness and response capabilities, 87 articles addressed public health surveillance and epidemiologic investigation, 38 addressed community preparedness, and 32 addressed community recovery. The percentage of articles focused on policy/law was higher early in the pandemic (2020-2021) than later (2022-2023) (9.5% vs <3.0%). During the latter period, articles largely focused on vaccination (12.8%) and contact tracing (10.6%). CONCLUSIONS: Articles published in PHR's COVID-19 Response collection covered a broad range of topics and were authored by contributors from diverse organizations. Our characterization of the COVID-19 output of a representative US public health practice journal can help academic publishing better address informational needs of public health responders.

Editors in Chief of Public Health Reports, 1878-2022: Men and Women Who Shaped the Discussion of Public Health Practice From 1918 Influenza to COVID-19.

OBJECTIVES: Public Health Reports (PHR), the official journal of the Office of the US Surgeon General and US Public Health Service, is the oldest public health journal in the United States. Considering its heritage through the eyes of its past editors in chief (EICs), many of whom have been influential public health figures, can provide a fresh point of view on US public health history, of which the journal has been an integral part. Here, we reconstruct the timeline of past PHR EICs and identify women among them. METHODS: We reconstructed the PHR EIC timeline by reviewing the journal's previous mastheads and its articles describing leadership transitions. For each EIC, we identified dates in office, concurrent job titles, key contributions, and other important developments. RESULTS: PHR had 25 EIC transitions in 109 years of its history, during which a single individual in charge of the journal could be identified. Only 5 identifiable EICs were women, who served as EIC for approximately one-quarter of the journal's traceable history (28 of 109 years). PHR's longest-serving EIC was a woman named Marian P. Tebben (1974-1994). CONCLUSIONS: PHR history revealed frequent EIC transitions and a low representation of women among its EICs. Mapping the timeline of past EICs of a historic public health journal can yield valuable insights into the workings of US public health, especially in the area of building a research evidence base.

Informing COVID-19 Response and Health Equity Agenda: Collection of Public Health Reports Articles on Emerging Viral Epidemics in the United States, 1878-2021.

OBJECTIVE: Public Health Reports (PHR) is the oldest public health journal in the United States and has reported on viral epidemics since the 19th century. We describe the creation and analysis of a collection of historic PHR articles on emerging viral epidemics in the United States to inform public health response to COVID-19 and future epidemics. METHODS: We searched databases from 1878 through 2021 using custom search strings and conducted a manual search for articles published under previously used names for PHR. We evaluated all articles based on inclusion/exclusion criteria and coded the final list for virus/disease, article type, public health emergency preparedness and response capabilities from the Centers for Disease Control and Prevention (CDC), and PubMed citation count. RESULTS: We identified 349 relevant articles including 130 commentaries/reviews/editorials, 79 epidemiologic reports, 75 research articles, and 65 case study/practice articles. The collection focused on influenza (n = 244), COVID-19 (n = 75), dengue (n = 14), and other emerging viruses, such as Zika and Ebola (n = 25). The collection included 48 articles on health disparities/health of various disadvantaged populations, highlighting such disparities as race and ethnicity (n = 22), socioeconomic status (n = 17), and age (n = 15). When we categorized articles by CDC public health emergency preparedness and response capabilities, we found that 207 addressed surveillance and epidemiologic investigation, 36 addressed community preparedness, and 28 addressed medical countermeasure dispensing and administration. The articles addressing surveillance and epidemiologic investigation, nonpharmaceutical interventions, and community preparedness had the most PubMed citations (799, 334, and 308, respectively). CONCLUSIONS: PHR's historic articles on US emerging viral epidemics covered a range of virus/disease types, emergency preparedness and response capabilities, and contribution types and were widely cited in the scholarly literature. This publicly available and continuously updated collection is a valuable resource for pandemic planning and response.

Leading Organizational Change: Improved Leadership Behaviors Among Public Health Leaders After Receiving Multirater Feedback and Coaching.

BACKGROUND: Leading Change is one of five Executive Core Qualifications (ECQs) used in developing leaders in the federal government. Leadership development programs that incorporate multirater feedback and executive coaching are valuable in developing competencies to lead change. METHODS: We examined the extent by which coaching influenced Leading Change competencies and identified effective tools and resources used to enhance the leadership capacity of first- and midlevel leaders at Centers for Disease Control and Prevention's National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention. Data included qualitative data collected via semi-structured interviews that focused on leadership changes made by leaders in the Coaching and Leadership Initiative (CaLI), a leadership development program for Team Leads and Branch Chiefs. FINDINGS: Ninety-six participants completed leadership coaching; 94 (98%) of whom completed one or more interviews. Of those 94 respondents, 74 (79%) reported improvements in their ability to lead change in 3 of 4 leading change competencies: creativity and innovation, flexibility, and resilience. All respondents indicated tools and resources that were effective in leading change: 49 (52%) participated in instructor-led activities during their CaLI experience; 33 (35%) experiential activities; 94 (100%) developmental relationships, assessment, and feedback; and 25 (27%) self-development. CONCLUSIONS/APPLICATION TO PRACTICE: First- and midlevel leaders in a public health agency benefitted from using leadership coaching in developing competencies to lead organizational change. Leadership development programs might benefit from examining Leading Change competencies and including instructor-led and experiential activities as an additional component of a comprehensive leadership development program.

Changing Leadership Behaviors in a Public Health Agency Through Coaching and Multirater Feedback.

CONTEXT: Public health managers' leadership skills can be improved through multirater feedback and coaching. OBJECTIVE: To explore to what extent participation in a coaching intervention influences leadership behaviors of first- and second-level leaders in a federal public health agency. DESIGN: Team leads and branch chiefs in the Centers for Disease Control and Prevention's (CDC's) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) were invited to participate in the Coaching and Leadership Initiative (CaLI), which incorporates the US Office of Personnel Management (OPM) Leadership 360 assessment, 6 coaching sessions, and 2 in-depth interviews. SETTING: NCHHSTP is one of 16 CDC national centers, institute, and offices. PARTICIPANTS: Staff serving as team leads or branch chiefs. MAIN OUTCOME MEASURES: Two in-depth interviews explored CaLI's influence on leadership behaviors regarding the government-wide Leading People executive core qualification. RESULTS: A total of 103 (93%) CaLI participants completed the OPM 360 feedback, 82 (80%) completed leadership coaching; 71 of 82 (87%) completed phase 1 interview, and 46 of 71 (65%) completed phase 2 interview. Eighty unique participants completed 1 or more interviews; all indicated that CaLI helped provide new perspectives, practices, and approaches that led to better communication and relationships, different approaches to conflict resolution, and awareness of individual leadership practices. Of the 71 participants who completed phase 1 evaluation, 66 (93%) said they made changes in developing others, 56 (79%) completed conflict management and team building, and 16 (23%) completed leveraging diversity. Of the 46 participants who completed both phase 1 and phase 2 interviews and among those who made changes post-CaLI, 23 of 26 (88%) sustained those leadership changes in developing others, 21 of 27 (78%) in team building; 24 of 34 (71%) in conflict management; and 5 of 10 (50%) in leveraging diversity. CONCLUSIONS: This study demonstrates the benefits and effectiveness of using multirater feedback and leadership coaching for first- and midlevel public health leaders.

Factors Associated With HIV Testing Among Atlanta's Homeless Youth.

Homeless youth experience increased risk of contracting HIV, making HIV testing imperative in this population. We analyzed factors associated with HIV testing among homeless youth in Atlanta, Georgia using data from the 2015 Atlanta Youth Count and Needs Assessment. The analysis included 693 homeless youth aged 14-25 years, of whom 88.4% reported ever being tested for HIV, and 74.6% reported being tested within the previous year. Prevalence of ever testing for HIV was significantly higher among youth who reported risk factors for HIV (sexually active, transactional sex, or ever having an STI). Higher prevalence of testing within the last year was significantly associated with experiencing physical abuse or transactional sex. However, reporting ≥ 4 sexual partners or not using condoms were not associated with higher testing. Although testing prevalence among homeless youth was high, homeless youth engaging in certain high risk behaviors could benefit from further promotion of HIV testing.

Differential Association of HIV Funding With HIV Mortality by Race/Ethnicity, United States, 1999-2017.

OBJECTIVE: Federal funds have been spent to reduce the disproportionate effects of HIV/AIDS on racial/ethnic minority groups in the United States. We investigated the association between federal domestic HIV funding and age-adjusted HIV death rates by race/ethnicity in the United States during 1999-2017. METHODS: We analyzed HIV funding data from the Kaiser Family Foundation by federal fiscal year (FFY) and US age-adjusted death rates (AADRs) by race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander and American Indian/Alaska Native [API+AI/AN]) from Centers for Disease Control and Prevention WONDER detailed mortality files. We fit joinpoint regression models to estimate the annual percentage change (APC), average APC, and changes in AADRs per billion US dollars in HIV funding, with 95% confidence intervals (CIs). For 19 data points, the number of joinpoints ranged from 0 to 4 on the basis of rules set by the program or by the user. A Monte Carlo permutation test indicated significant (P < .05) changes at joinpoints, and 2-sided t tests indicated significant APCs in AADRs. RESULTS: Domestic HIV funding increased from $10.7 billion in FFY 1999 to $26.3 billion in FFY 2017, but AADRs decreased at different rates for each racial/ethnic group. The average rate of change in AADR per US billion dollars was -9.4% (95% CI, -10.9% to -7.8%) for Hispanic residents, -7.8% (95% CI, -9.0% to -6.6%) for non-Hispanic black residents, -6.7% (95% CI, -9.3% to -4.0%) for non-Hispanic white residents, and -5.2% (95% CI, -7.8% to -2.5%) for non-Hispanic API+AI/AN residents. CONCLUSIONS: Increased domestic HIV funding was associated with faster decreases in age-adjusted HIV death rates for Hispanic and non-Hispanic black residents than for residents in other racial/ethnic groups. Increasing US HIV funding could be associated with decreasing future racial/ethnic disparities in the rate of HIV-related deaths.

Supporting Public Health Employee Engagement and Retention: One U.S. National Center's Analysis and Approach.

Background: Employee engagement, exemplified by positive perceptions of supervisors, workplace, and job, improves productivity and employee retention. We identified the extent of and barriers to employee engagement at Centers for Disease Control and Prevention's (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Methods: In 2015, NCHHSTP's leadership collected baseline data through a centerwide Employee Engagement Pulse Survey (EEPS) from NCHHSTP's full-time Civil Service employees, U.S. Public Health Service Commissioned Corps officers, and Title 42 service fellows. EEPS included six demographic questions; nine Likert-type scale questions measuring 26 perceptions related to immediate supervisors, the work environment, and job satisfaction; and four open-ended questions soliciting recommendations for improvement. Findings: Among 727 of 1,171 staff (response rate = 62%), positive perceptions of supervisors ranged from a high of 94% (supervisor conducts performance reviews) to a low of 63% (supervisor assists employees with career development). Perceptions of work experience ranged from 98% (respondents were willing to put in extra effort to get a job done) to 68% (respondents' talents were used well in the workplace). Perceptions of job satisfaction ranged from 87% (support from their coworkers) to 69% (satisfaction with opportunities to learn or grow professionally). Conclusion/Application to Practice: Overall, NCHHSTP staff have positive perceptions of their work, their leaders, and the agency. Other public- and private-sector employers might be able to improve their employees' engagement and retention by listening to their opinions and needs and frequently recognizing their individual achievements. NCHHSTP's workforce development initiatives can be used as a model for assessing a baseline of their employees' engagement.

Ending the HIV Epidemic in the United States.

A new initiative aims to reduce new infections by 75% within five years.

Trends in Prevalence of Protective Levels of Hepatitis B Surface Antibody Among Adults Aged 18-49 Years With Risk Factors for Hepatitis B Virus Infection-United States, 2003-2014.

BACKGROUND: Hepatitis B virus (HBV) infection can be prevented through vaccination. However, previous data show that only about 24%-45% of US adults at high risk of HBV infection are protected. Our aims were to assess prevalence and trends in protective levels of hepatitis B surface antibody (anti-HBs) from 2003 to 2014 and explore factors associated with protection among adults at high risk. METHODS: Data were taken from the 2003-2014 National Health and Nutrition Examination surveys. Our sample included adults aged 18-49 years who were tested for HBV and reported at least 1 of the following infection risks: history of sexually transmitted disease, sex with men (for men), infection with human immunodeficiency virus, and injection drug use. We calculated the prevalence of anti-HBs (≥10 mIU/mL), indicative of immunity from vaccination, among respondents for three 4-year time intervals (2003-2006, 2007-2010, and 2011-2014) and applied the Cochran-Mantel-Haenszel test to assess trends. Using multivariable logistic regression, we examined factors associated with positive anti-HBs serology. RESULTS: The prevalence of positive anti-HBs serology was 23.4%. Prevalence increased from 2003-2006 (16.3%) to 2007-2010 (27.3%), but no change occurred from 2007-2010 (27.3%) to 2011-2014 (28.1%). Among factors predicting positive anti-HBs serology were young age and higher education. CONCLUSIONS: By 2014, less than one-third of adults aged 18-49 years at risk of infection exhibited protective antibodies ≥10 mIU/mL. Because these adults account for a majority of unprotected adults, targeted intervention strategies are essential to achieve the hepatitis B elimination goal.

Socioeconomic, Behavioral, and Clinical Characteristics of Persons Living with HIV Who Experience Homelessness in the United States, 2015-2016.

Homelessness is a substantial barrier to consistent, recommended HIV care, access and adherence to antiretroviral therapy (ART), and sustained viral suppression, thus increasing the risk for morbidity and transmission. We used data from the Medical Monitoring Project for June 1, 2015-May 31, 2017 to estimate the weighted prevalence of homelessness among persons with diagnosed HIV (PWH) (N = 7665) overall and by selected sociodemographic, behavioral, and clinical characteristics. Prevalence of homelessness was 8.5%. PWH experiencing homelessness were > 3 times as likely to have needed and not received shelter or housing services (32% vs. 10%), > 4 times as likely to inject drugs (9% vs. 2%), and > 7 times as likely to engage in exchange sex (10% vs. 1%), respectively, compared with PWH who did not experience homelessness. Homelessness was associated with lower HIV care retention, ART dose adherence, and sustained viral suppression. This analysis demonstrates substantial need for enhanced treatment, care, and service delivery for PWH experiencing homelessness. Research has demonstrated that housing assistance programs improve HIV-related outcomes and diminish HIV risk behaviors; therefore, housing assistance for PWH should be prioritized in public health policies and practice.

Trends in Geographic Rates of HIV Diagnoses Among Black Females in the United States, 2010-2015.

BACKGROUND: HIV diagnoses among females in the United States declined 22% from 2010 to 2015, including a 27% decline in diagnoses among black females. Despite this progress, disparities persist. Black females accounted for 60% of new HIV diagnoses among females in 2015. Geographic disparities also exist. This article describes geographic differences in HIV diagnoses among black females in the United States, from 2010 to 2015. MATERIALS AND METHODS: We examined HIV surveillance data from 2010 to 2015 to determine in which geographic areas decreases or increases in HIV diagnoses occurred. We used data from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's (NCHHSTP) AtlasPlus to calculate percent changes in HIV diagnosis rates by geographic region for black females ≥13 years of age. RESULTS: The number of new HIV diagnoses declined 27% among black females from 2010 to 2015. The highest rates of HIV diagnosis per 100,000 population of black females, from 2010 to 2015, were in the Northeast and the South. In 2015, five of the eight states reporting the highest rates of HIV diagnosis (i.e., the highest quartile) were in the South. CONCLUSIONS: HIV diagnosis rates decreased nationally among black females, but the decreases were not uniform within regions or across the United States. Some states experienced increases, and black females in the South and Northeast remain disproportionately affected. Additional research is needed to ascertain factors associated with the increases to continue progress toward reducing HIV-related disparities among females in the United States.

Differences Between U.S.-Born and Non-U.S.-Born Black Adults Reported with Diagnosed HIV Infection: United States, 2008-2014.

Despite improvements in its treatment, HIV infection continues to affect Blacks disproportionally. Using National HIV Surveillance System data from 50 U.S. states and the District of Columbia, we examined demographic and epidemiologic differences between U.S.-born and non-U.S.-born Black adults. Of 110,452 Black adults reported with diagnosed HIV during 2008-2014 with complete country of birth information, 11.1% were non-U.S.-born. Non-U.S.-born were more likely to be older, female, have HIV infection attributed to heterosexual contact, have been diagnosed late, and live in the northeastern U.S. region. During 2014, the HIV diagnosis rate among African-born Black females was 1.4 times the rate of U.S.-born Black males, 2 times the rate of African-born Black males, and 5.3 times the rate of U.S.-born Black females. We elucidate the differences between U.S.-born and non-U.S.-born Blacks on which to base culturally appropriate HIV-prevention programs and policies.

HIV Infection-Related Care Outcomes among U.S.-Born and Non-U.S.-Born Blacks with Diagnosed HIV in 40 U.S. Areas: The National HIV Surveillance System, 2016.

HIV care outcomes must be improved to reduce new human immunodeficiency virus (HIV) infections and health disparities. HIV infection-related care outcome measures were examined for U.S.-born and non-U.S.-born black persons aged ≥13 years by using National HIV Surveillance System data from 40 U.S. areas. These measures include late-stage HIV diagnosis, timing of linkage to medical care after HIV diagnosis, retention in care, and viral suppression. Ninety-five percent of non-U.S.-born blacks had been born in Africa or the Caribbean. Compared with U.S.-born blacks, higher percentages of non-U.S.-born blacks with HIV infection diagnosed during 2016 received a late-stage diagnoses (28.3% versus 19.1%) and were linked to care in ≤1 month after HIV infection diagnosis (76.8% versus 71.3%). Among persons with HIV diagnosed in 2014 and who were alive at year-end 2015, a higher percentage of non-U.S.-born blacks were retained in care (67.8% versus 61.1%) and achieved viral suppression (68.7% versus 57.8%). Care outcomes varied between African- and Caribbean-born blacks. Non-U.S.-born blacks achieved higher care outcomes than U.S.-born blacks, despite delayed entry to care. Possible explanations include a late-stage presentation that requires immediate linkage and optimal treatment and care provided through government-funded programs.