There goes the neighborhood? The public safety enhancing effects of a mobile harm reduction intervention.

BACKGROUND: Buprenorphine is a gold-standard treatment for opioid use disorders, but most people with these disorders do not access it. Barriers to treatment access may be diminished by low-threshold mobile treatment programs but concern regarding their impact on local public safety challenges their adoption. METHODS: This quasi-experimental study uses difference-in-differences analyses to measure the impact of four mobile buprenorphine clinics in Pittsburgh on neighborhood arrest rates. The study period spans 2018 to 2022, with a pre-intervention period of 11 to 12 quarters and a post-intervention period of 7 to 8 quarters (dependent on neighborhood). A treatment group of 84 census block groups in the areas surrounding clinics during the time period after their establishment were compared to a control group of city census blocks not within one mile of a clinic plus treated block groups in the two years prior to clinic establishment. Outcome variables include drug, non-drug, and total arrests, measured quarterly per 100 in population. RESULTS: Compared to block groups further than 1 mile from a clinic, arrests fell by 34.13 % (b = -0.358, 95 % CI = -0.557, -0.158), drug arrests by 33.85 % (b = -0.087, 95 % CI = -0.151, -0.023), and non-drug related arrests by 22.29 % (b = -0.179, 95 % CI = -0.302, -0.057). Drug arrests declined significantly on days when the clinics were not present (b = -0.015, 95 % CI = -0.025, -0.006), with no significant change on clinic operational days (b = -0.002, 95 % CI = -0.016, -0.013). Total arrests declined significantly on days when clinics were and were not present (b = -0.045, 95 % CI = -0.078, -0.012; and b = -0.052, CI = -0.082, -0.023, respectively). CONCLUSIONS: Mobile clinics providing medication for opioid use disorders were associated with reduced neighborhood arrest rates. Expansion of mobile services could promote health equity and public safety.

Sex Differences in Depression as a Risk Factor for Alzheimer's Disease: A Systematic Review.

BACKGROUND AND OBJECTIVES: Depression is an important risk factor for Alzheimer's disease (AD) but little is known about the mechanisms of this association. Given sex differences in both AD and depression, we sought to conduct a systematic review and meta-analysis to examine whether there are sex differences in their association, as this may improve understanding of underlying mechanisms. RESEARCH DESIGN AND METHODS: MEDLINE, PsycINFO, and Cochrane Reviews were searched for observational studies including both sexes and examining the association between history of depression and AD. RESULTS: Forty studies, including 62,729 women and 47,342 men, were identified. Meta-analysis was not possible because only 3 studies provided sufficient data. Seven studies provided information about the influence of sex for a qualitative synthesis. Two found an association in men only, 2 in women only, and 3 reported no sex differences. The 2 studies finding an association in women only were unique in that they had the shortest follow-up periods, and were the only clinic-based studies. DISCUSSION AND IMPLICATIONS: The findings of our systematic review show that there are important methodological differences among the few studies providing data on the influence of sex on depression as a risk factor for AD. Had all 40 studies provided sex-segregated data, these methodological differences and their impact on sex effects could have been examined quantitatively. We encourage researchers to report these data, as well as potential moderating factors, so that the role of sex differences can be better understood.

Telenovela: an innovative colorectal cancer screening health messaging tool.

BACKGROUND: Alaska Native people have nearly twice the rate of colorectal cancer (CRC) incidence and mortality as the US White population. OBJECTIVE: Building upon storytelling as a culturally respectful way to share information among Alaska Native people, a 25-minute telenovela-style movie, What's the Big Deal?, was developed to increase CRC screening awareness and knowledge, role-model CRC conversations, and support wellness choices. DESIGN: Alaska Native cultural values of family, community, storytelling, and humor were woven into seven, 3-4 minute movie vignettes. Written post-movie viewing evaluations completed by 71.3% of viewers (305/428) were collected at several venues, including the premiere of the movie in the urban city of Anchorage at a local movie theater, seven rural Alaska community movie nights, and five cancer education trainings with Community Health Workers. Paper and pencil evaluations included check box and open-ended questions to learn participants' response to a telenovela-style movie. RESULTS: On written-post movie viewing evaluations, viewers reported an increase in CRC knowledge and comfort with talking about recommended CRC screening exams. Notably, 81.6% of respondents (249/305) wrote positive intent to change behavior. Multiple responses included: 65% talking with family and friends about colon screening (162), 24% talking with their provider about colon screening (59), 31% having a colon screening (76), and 44% increasing physical activity (110). CONCLUSIONS: Written evaluations revealed the telenovela genre to be an innovative way to communicate colorectal cancer health messages with Alaska Native, American Indian, and Caucasian people both in an urban and rural setting to empower conversations and action related to colorectal cancer screening. Telenovela is a promising health communication tool to shift community norms by generating enthusiasm and conversations about the importance of having recommended colorectal cancer screening exams.