Receipt, uptake, and satisfaction with tailored DVD and patient navigation interventions to promote cancer screening among rural women.

Process evaluation is essential to understanding and interpreting the results of randomized trials testing the effects of behavioral interventions. A process evaluation was conducted as part of a comparative effectiveness trial testing a mailed, tailored interactive digital video disc (DVD) with and without telephone-based patient navigation (PN) to promote breast, cervical and colorectal cancer screening among rural women who were not up-to-date (UTD) for at least one screening test. Data on receipt, uptake, and satisfaction with the interventions were collected via telephone interviews from 542 participants who received the tailored interactive DVD (n = 266) or the DVD plus telephone-based PN (n = 276). All participants reported receiving the DVD and 93.0% viewed it. The most viewed sections of the DVD were about colorectal, followed by breast, then cervical cancer screening. Most participants agreed the DVD was easy to understand, helpful, provided trustworthy information, and gave information needed to make a decision about screening. Most women in the DVD+PN group, 98.2% (n = 268), reported talking with the navigator. The most frequently discussed cancer screenings were colorectal (86.8%) and breast (71.3%); 57.5% discussed cervical cancer screening. The average combined length of PN encounters was 22.2 minutes with 21.7 additional minutes spent on coordinating activities. Barriers were similar across screening tests with the common ones related to the provider/health care system, lack of knowledge, forgetfulness/too much bother, and personal issues. This evaluation provided information about the implementation and delivery of behavioral interventions as well as challenges encountered that may impact trial results.

Two interventions to promote cervical, breast, and colorectal cancer screening among rural women who were not up-to-date (UTD) for at least one screening test were evaluated by rural women who received them as part of the randomized trial. Participants who received the tailored interactive digital video disc (DVD; n = 266) or the DVD plus telephone-based patient navigation (PN; n = 276) were interviewed by phone about their engagement and satisfaction with the interventions. All participants reported receiving the DVD and 93.0% viewed it. Most agreed the DVD was easy to understand, helpful, provided trustworthy information, and gave information needed to get screened. Almost all women in the DVD+PN group, 98.2% (n = 268) talked with the navigator. The most common cancer screenings discussed with navigators were colorectal (86.8%), followed by breast (71.3%) and cervical (57.5%). The average length of encounters with the navigators was 22.2 minutes; navigators spent 21.7 additional minutes on coordinating activities. Barriers discussed were similar across screening tests. The most common were related to the healthcare provider/system, lack of knowledge, forgetfulness/too much bother, and personal issues. This study provided important information about receipt, uptake, and satisfaction with two behavioral interventions, along with challenges encountered that may impact results.

Daily Stress and Use of Aggressive Discipline by Parents during the COVID-19 Pandemic.

To assess the relationship between stress throughout the day and aggressive discipline practices by parents during COVID-19 stay at home orders. For this study, participants took baseline survey online, then provided data three times a day (10 a.m., 3 p.m., and 9 p.m.) for 14 consecutive days using Ecological Momentary Assessment procedures. Data were collected from 323 participants, covering 9,357 observations from April 13 to May 27, 2020 in Central Ohio during stay-at-home orders due to COVID-19. Use of aggressive discipline, including corporal punishment and psychological aggression, was measured using the Dimensions of Discipline Inventory. For each higher level of stress, parents had 1.3 greater odds of using aggressive discipline. Having used aggressive discipline at baseline was related to three times greater odds of using it during the study period. Higher situational stress was associated with use of aggressive parenting. When combined with less contact with mandatory reporters, this places children at risk for abuse and neglect that may go without detection and intervention for longer time-periods. First responders and medical professionals become more important in identifying and reporting suspected child maltreatment, as this may be a child's only contact with a mandated professional for six months to a year. Well child visits, routine vaccinations, and problem-focused care are important opportunities to assess parents' stress and discipline practices that may be suggestive of abuse or neglect.

Hearing loss among Ohio farm youth: a comparison to a national sample.

BACKGROUND: Hearing loss is prevalent among adults in the farming community, with some evidence it begins in childhood. Our objective was to compare hearing thresholds of Ohio farm youth to published data on national norms. METHODS: Baseline data were collected on youth (n = 212) in 1994-1996 with follow-up (n = 132) in 2003-2004 including pure-tone air conduction thresholds at 0.5, 1, 2, 3, 4, 6, and 8 kHz. RESULTS: When compared to nationally-representative data, study youth had a higher prevalence of hearing loss. The high-frequency range was most affected, particularly at 6 kHz where nearly 50% of the farm youth exhibited some degree of hearing loss at baseline testing. The prevalence of noise-induced threshold shifts, characterized by an audiometric notch, was nearly twice that of the national sample. CONCLUSIONS: These data suggest that hearing loss, which is common among adult farmers, may be problematic for farm youth as well.