Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-04-01DOI: 10.1177/00333549241236644
Gregory J Hall, Eric J Page, Min Rhee, Clara Hay, Amelia Krause, Emma Langenbacher, Allison Ruth, Steve Grenier, Alexander P Duran, Ibrahim Kamara, John K Iskander, Fahad Alsayyid, Dana L Thomas, Edward Bock, Nicholas Porta, Jessica Pharo, Beth A Osterink, Sharon Zelmanowitz, Corinna M Fleischmann, Dilhara Liyanage, Joshua P Gray
{"title":"Wastewater Surveillance of US Coast Guard Installations and Seagoing Military Vessels to Mitigate the Risk of COVID-19 Outbreaks, March 2021-August 2022.","authors":"Gregory J Hall, Eric J Page, Min Rhee, Clara Hay, Amelia Krause, Emma Langenbacher, Allison Ruth, Steve Grenier, Alexander P Duran, Ibrahim Kamara, John K Iskander, Fahad Alsayyid, Dana L Thomas, Edward Bock, Nicholas Porta, Jessica Pharo, Beth A Osterink, Sharon Zelmanowitz, Corinna M Fleischmann, Dilhara Liyanage, Joshua P Gray","doi":"10.1177/00333549241236644","DOIUrl":"10.1177/00333549241236644","url":null,"abstract":"<p><strong>Objectives: </strong>Military training centers and seagoing vessels are often environments at high risk for the spread of COVID-19 and other contagious diseases, because military trainees and personnel arrive after traveling from many parts of the country and live in congregate settings. We examined whether levels of SARS-CoV-2 genetic material in wastewater correlated with SARS-CoV-2 infections among military personnel living in communal barracks and vessels at US Coast Guard training centers in the United States.</p><p><strong>Methods: </strong>The Coast Guard developed and established 3 laboratories with wastewater testing capability at Coast Guard training centers from March 2021 through August 2022. We analyzed wastewater from barracks housing trainees and from 4 Coast Guard vessels for the presence of SARS-CoV-2 genes <i>N</i> and <i>E</i> and quantified the results relative to levels of a fecal indicator virus, pepper mild mottle virus. We compared quantified data with the timing of medically diagnosed COVID-19 infection among (1) military personnel who had presented with symptoms or had been discovered through contact tracing and had medical tests and (2) military personnel who had been discovered through routine surveillance by positive SARS-CoV-2 antigen or polymerase chain reaction test results.</p><p><strong>Results: </strong>Levels of viral genes in wastewater at Coast Guard locations were best correlated with diagnosed COVID-19 cases when wastewater testing was performed twice weekly with passive samplers deployed for the entire week; such testing detected ≥1 COVID-19 case 69.8% of the time and ≥3 cases 88.3% of the time. Wastewater assessment in vessels did not continue because of logistical constraints.</p><p><strong>Conclusion: </strong>Wastewater testing is an effective tool for measuring the presence and patterns of SARS-CoV-2 infections among military populations. Success with wastewater testing for SARS-CoV-2 infections suggests that other diseases may be assessed with similar approaches.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11504356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-05-23DOI: 10.1177/00333549241250223
Greer McCollum, Ashleigh Allgood, April Agne, Dave Cleveland, Cicily Gray, Eric Ford, Stefan Baral, Michael Mugavero, Allyson G Hall
{"title":"Associations Between Social Networks and COVID-19 Vaccine Uptake in 4 Rural Alabama Counties: Survey Findings.","authors":"Greer McCollum, Ashleigh Allgood, April Agne, Dave Cleveland, Cicily Gray, Eric Ford, Stefan Baral, Michael Mugavero, Allyson G Hall","doi":"10.1177/00333549241250223","DOIUrl":"10.1177/00333549241250223","url":null,"abstract":"<p><strong>Objectives: </strong>The COVID-19 pandemic demonstrated how vaccination decisions are influenced by misinformation, disinformation, and social pressures, leading to varied and inequitable uptake rates. In this study, we examined how COVID-19 vaccine messages received via social networks were associated with vaccine uptake in rural Alabama.</p><p><strong>Methods: </strong>From November 2021 through March 2022, we collected 700 responses to a telephone survey administered in 4 rural Alabama counties. We asked respondents to indicate whether certain social relationships (eg, family, businesses) tried to influence them to (1) obtain or (2) avoid a COVID-19 vaccine. We used χ<sup>2</sup> tests, Kruskal-Wallis tests, Mantel-Haenszel χ<sup>2</sup> tests, and Fisher exact tests to examine the associations between vaccination status and survey responses.</p><p><strong>Results: </strong>Respondents in majority-African American counties were significantly more likely than those in majority-White counties to have received ≥1 dose of COVID-19 vaccine (89.8% vs 72.3%; <i>P</i> < .001). Respondents who received ≥1 dose had a significantly higher mean age than those who had not (58.0 vs 39.0 years; <i>P</i> < .001). Respondents who were encouraged to get vaccinated by religious leaders were more likely to have received ≥1 dose (<i>P</i> = .001), and those who were encouraged to avoid vaccination by family (<i>P</i> = .007), friends (<i>P</i> = .02), coworkers (<i>P</i> = .003), and health care providers (<i>P</i> < .001) were less likely to have received ≥1 dose. Respondents with more interpersonal relationships that encouraged them to avoid vaccination were more likely to be unvaccinated (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>Interpersonal relationships and demographic characteristics appeared to be important in COVID-19 vaccine decision-making in rural Alabama. Further research needs to identify how to facilitate vaccine-positive interpersonal relationships, such as peer mentoring and trusted messenger interventions.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-05-23DOI: 10.1177/00333549241249339
Cristina A Sarmiento, Anna Furniss, Megan A Morris, Michelle L Stransky, Darcy A Thompson
{"title":"Disparities in Smoking and Heavy Drinking Behaviors by Disability Status and Age of Disability Onset: Secondary Analysis of National Health Interview Survey Data.","authors":"Cristina A Sarmiento, Anna Furniss, Megan A Morris, Michelle L Stransky, Darcy A Thompson","doi":"10.1177/00333549241249339","DOIUrl":"10.1177/00333549241249339","url":null,"abstract":"<p><strong>Objectives: </strong>People with childhood-onset disabilities are living into adulthood, and the prevalence of smoking and illicit drug use among adults with disabilities is high. We evaluated the relationship between disability status and age of disability onset, current cigarette smoking status, and heavy alcohol drinking.</p><p><strong>Methods: </strong>We conducted a secondary data analysis of the National Health Interview Survey (NHIS), a US survey on illness and disability. Among 2020 NHIS participants aged 22-80 years (n = 28 225), we compared self-reported prevalence of current cigarette smoking and heavy alcohol drinking among those with and without disabilities and among those with childhood- versus adult-onset disabilities. We used adjusted logistic regression analysis to calculate the adjusted odds ratios (AORs) of current smoking and heavy alcohol drinking based on disability status and age of disability onset.</p><p><strong>Results: </strong>Compared with adults without disabilities, adults with disabilities were significantly more likely to report current smoking (23.5% vs 11.2%; <i>P</i> < .001) and significantly less likely to report heavy alcohol drinking (5.3% vs 7.4%; <i>P</i> = .001). The prevalence of these behaviors did not vary significantly by age of disability onset. In adjusted logistic regression models, adults with disabilities had significantly higher odds of current smoking (AOR = 1.76; 95% CI, 1.53-2.03) and similar odds of heavy alcohol drinking (AOR = 0.82; 95% CI, 0.65-1.04) compared with adults without disabilities. The odds of these health behaviors did not vary significantly by age of disability onset.</p><p><strong>Conclusions: </strong>Adults with disabilities overall may be at high risk for these unhealthy behaviors, particularly smoking, regardless of age of disability onset. Routine screening and cessation counseling related to smoking and unhealthy alcohol use are important for all people with disabilities.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-05-23DOI: 10.1177/00333549241249922
Kyle Rosenblum, Christopher Dunphy, Jing Wang, Kessa Frantz, Rachel Hulkower, Sharon Wong
{"title":"Changes in State Laws on Suicide Prevention Training for School Staff, 2002-2022.","authors":"Kyle Rosenblum, Christopher Dunphy, Jing Wang, Kessa Frantz, Rachel Hulkower, Sharon Wong","doi":"10.1177/00333549241249922","DOIUrl":"10.1177/00333549241249922","url":null,"abstract":"<p><strong>Objectives: </strong>Youth suicide is an urgent public health problem. Gatekeeper training aims to prevent suicide by training people to identify warning signs and make referrals to appropriate services. Many states in the United States have enacted gatekeeper training laws (GTLs) to train school staff in suicide prevention. The objectives of this study were to describe the development of a dataset on GTLs and use the dataset to summarize trends in uptake of GTLs from 2002 through 2022 as well as differences in characteristics (eg, frequency and duration of training) of GTLs.</p><p><strong>Methods: </strong>We used publicly available legal databases from all 50 states and the District of Columbia to conduct a policy surveillance assessment of GTLs. We cross-checked data with the American Foundation for Suicide Prevention's <i>2022 Suicide Prevention in Schools (K-12)</i> issue brief and used Westlaw Edge to conduct a sensitivity analysis. We included the following data in the full dataset: type of laws (encouraged, mandatory, or conditional mandatory), date passed, effective date, frequency of training, and length of training.</p><p><strong>Results: </strong>In 2022, 49 states and the District of Columbia had GTLs, 31 of which were mandatory laws. In 2002, only 6 states had such laws, and none were mandatory.</p><p><strong>Conclusion: </strong>The growing proliferation of laws on suicide prevention training for school staff warrants evaluation of the laws' effectiveness. Our policy surveillance data may be used to better understand the role of these laws in a school-based approach to youth suicide prevention.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11504333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-05-23DOI: 10.1177/00333549241249675
Briana Moreland, Tessa Clemens, Nimi Idaikkadar
{"title":"Syndromic Surveillance of Emergency Department Visits Related to Unintentional Drowning, United States, 2019-2022.","authors":"Briana Moreland, Tessa Clemens, Nimi Idaikkadar","doi":"10.1177/00333549241249675","DOIUrl":"10.1177/00333549241249675","url":null,"abstract":"<p><strong>Objectives: </strong>To improve national drowning surveillance efforts, we developed and evaluated a definition for unintentional drowning for use in the National Syndromic Surveillance Program's ESSENCE platform (Electronic Surveillance System for the Early Notification of Community-Based Epidemics) and described drowning-related emergency department (ED) visits from 2019 through 2022 using the new definition.</p><p><strong>Methods: </strong>We adapted an unintentional drowning definition from a previous version, which included all drowning-related ED visits regardless of intent (including drowning related to assault and suicide, as well as unintentional drowning). We reviewed a random sample of 1000 visits captured by the new definition of unintentional drowning and categorized visits as likely, possibly, and unlikely to be related to unintentional drowning. We compared monthly drowning-related ED visits from 2020, 2021, and 2022 with monthly drowning ED visits from 2019, overall and by sex and age group.</p><p><strong>Results: </strong>A total of 35 431 ED visits related to unintentional drowning (10.71 per 100 000 ED visits) occurred from 2019 through 2022. Most visits (86%) captured by the new definition and manually reviewed were likely related to unintentional drowning. Rates were highest among males (14.04 per 100 000 ED visits) and children aged <1 to 4 years (65.61 per 100 000 ED visits). The number of drowning-related ED visits was higher in May and August 2020, May and June 2021, and May 2022 as compared with the same months in 2019 among people aged 18 to 44 years.</p><p><strong>Conclusions: </strong>The definition for unintentional drowning is available in the National Syndromic Surveillance Program's ESSENCE platform for state and local jurisdictions to use to monitor unintentional drowning-related ED visits in near-real time to inform prevention strategies.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-05-23DOI: 10.1177/00333549241251982
Nazish Masud, Whitney Hamilton, Yelena Tarasenko
{"title":"Prevalence of Cigarette Smoking, E-cigarette Use, and Dual Use Among Urban and Rural Women During the Peripartum Period, PRAMS 2015-2020.","authors":"Nazish Masud, Whitney Hamilton, Yelena Tarasenko","doi":"10.1177/00333549241251982","DOIUrl":"10.1177/00333549241251982","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence has emerged on the health dangers of electronic cigarette (e-cigarette) use among pregnant women and neonates. We examined whether rural residence is a risk factor for smoking and e-cigarette use among women during the peripartum period in the United States.</p><p><strong>Methods: </strong>This study was based on pooled cross-sectional 2015-2020 data from the Pregnancy Risk Assessment Monitoring System. The outcome was exclusive smoking, exclusive e-cigarette use, and use of both products (ie, dual use) versus use of neither tobacco product by women with live infants aged 2 to 6 months. We examined rural-urban differences in outcome by using univariate and multivariable multinomial logistic regressions with post hoc contrasts and marginal analyses, adjusting for complex survey design and nonresponse.</p><p><strong>Results: </strong>During the peripartum period, 5.0% of women were smoking combustible cigarettes, 5.0% were using e-cigarettes, and 1.9% were using both tobacco products. The crude prevalence of e-cigarette use was 1.1 percentage point higher, and the adjusted prevalence was 0.8 percentage points lower for rural versus urban women (<i>P</i> < .001 for both). Among rural women, 6.7% (95% CI, 6.3%-7.1%) smoked combustible cigarettes exclusively and 2.6% (95% CI, 2.3%-2.8%) used both products, as compared with 4.5% (95% CI, 4.4%-4.8%) and 1.7% (95% CI, 1.6%-1.8%) of urban women, respectively, adjusting for sociodemographic and health-related characteristics.</p><p><strong>Conclusions: </strong>Maternal sociodemographic and health-related characteristics differed by combustible smoking versus e-cigarette use during the peripartum period. The effect of residence on e-cigarette use was significantly confounded by sociodemographic and health-related characteristics, resulting in clinically comparable prevalence of e-cigarette use in rural and urban mothers with live infants aged 2 to 6 months.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-05-23DOI: 10.1177/00333549241247708
Richard W Puddy, Megan A Kelly, Christopher Nelson, Alexandra H Ntazinda, Sameer Siddiqi, Diane Hall, Christian T Murray, James E Kucik
{"title":"Advancing Evidence-Based Public Health Policy: How Core Component Thinking Can Illuminate the Multilevel Nature of Public Health Policy.","authors":"Richard W Puddy, Megan A Kelly, Christopher Nelson, Alexandra H Ntazinda, Sameer Siddiqi, Diane Hall, Christian T Murray, James E Kucik","doi":"10.1177/00333549241247708","DOIUrl":"10.1177/00333549241247708","url":null,"abstract":"<p><p>A growing body of literature uses the concept of core components to better understand small-scale programmatic interventions. Instead of interventions being viewed as unitary \"black boxes,\" interventions are viewed as configurations of core components, which are the parts of interventions that carry their causal potential and therefore need to be reproduced with fidelity to produce the intended effect. To date, the concept of core components has not been as widely applied to public health policy interventions as it has to programmatic interventions. The purpose of this topical review is to familiarize public health practitioners and policy makers with the concept of core components as applied to public health policy interventions. Raising the profile of core component thinking can foster mindful adaptation and implementation of public health policy interventions while encouraging further research to enhance the supporting evidence base. We present 3 types of multilevel interactions in which the core components of a public health policy intervention produce effects at the population level by (1) seeking to directly affect individual behavior, (2) facilitating adoption of programmatic interventions by intermediaries, and (3) encouraging intermediaries to take action that can shape changes in upstream drivers of population health. Changing the unit of analysis from whole policies to core components can provide a basis for understanding how policies work and for facilitating novel evidence-generating strategies and rapid evidence reviews that can inform future adaptation efforts.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-06-01DOI: 10.1177/00333549241253092
Anna Satcher Johnson, Anne Peruski, Alexandra M Oster, Alexandra Balaji, Azfar-E-Alam Siddiqi, Patricia Sweeney, Angela L Hernandez
{"title":"Enhancements to the National HIV Surveillance System, United States, 2013-2023.","authors":"Anna Satcher Johnson, Anne Peruski, Alexandra M Oster, Alexandra Balaji, Azfar-E-Alam Siddiqi, Patricia Sweeney, Angela L Hernandez","doi":"10.1177/00333549241253092","DOIUrl":"10.1177/00333549241253092","url":null,"abstract":"<p><p>HIV infection is monitored through the National HIV Surveillance System (NHSS) to help improve the health of people with HIV and reduce transmission. NHSS data are routinely used at federal, state, and local levels to monitor the distribution and transmission of HIV, plan and evaluate prevention and care programs, allocate resources, inform policy development, and identify and respond to rapid transmission in the United States. We describe the expanded use of HIV surveillance data since the 2013 NHSS status update, during which time the Centers for Disease Control and Prevention (CDC) coordinated to revise the HIV surveillance case definition to support the detection of early infection and reporting of laboratory data, expanded data collection to include information on sexual orientation and gender identity, enhanced data deduplication processes to improve quality, and expanded reporting to include social determinants of health and health equity measures. CDC maximized the effects of federal funding by integrating funding for HIV prevention and surveillance into a single program; the integration of program funding has expanded the use of HIV surveillance data and strengthened surveillance, resulting in enhanced cluster response capacity and intensified data-to-care activities to ensure sustained viral suppression. NHSS data serve as the primary source for monitoring HIV trends and progress toward achieving national initiatives, including the US Department of Health and Human Services' Ending the HIV Epidemic in the United States initiative, the White House's National HIV/AIDS Strategy (2022-2025), and Healthy People 2030. The NHSS will continue to modernize, adapt, and broaden its scope as the need for high-quality HIV surveillance data remains.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health ReportsPub Date : 2024-11-01Epub Date: 2024-05-28DOI: 10.1177/00333549241253419
Victoria M Nielsen, W W Sanouri Ursprung, Glory Song, Gail Hirsch, Theresa Mason, Claire Santarelli, Erica Guimaraes, Erica Marshall, Caitlin G Allen, Pei-Pei Lei, Diane Brown, Bittie Behl-Chadha
{"title":"The Launch of Massachusetts Community Health Worker Certification: Findings From the Massachusetts Community Health Worker Workforce Surveys.","authors":"Victoria M Nielsen, W W Sanouri Ursprung, Glory Song, Gail Hirsch, Theresa Mason, Claire Santarelli, Erica Guimaraes, Erica Marshall, Caitlin G Allen, Pei-Pei Lei, Diane Brown, Bittie Behl-Chadha","doi":"10.1177/00333549241253419","DOIUrl":"10.1177/00333549241253419","url":null,"abstract":"<p><strong>Objectives: </strong>The launch of state certification for community health workers (CHWs) in Massachusetts in 2018 aimed to promote and champion this critical workforce. However, concerns exist about unintentional adverse effects of certification. Given this, we conducted 2 cross-sectional surveys to evaluate this certification policy.</p><p><strong>Methods: </strong>We conducted surveys of CHW employers and CHWs in 3 sample frames: community health centers and federally qualified health centers, acute-care hospitals, and community-based organizations. We administered the surveys in 2016 (before certification launch) and 2021 (after certification launch) to answer the following questions: Was certification associated with positive outcomes among CHWs after its launch? Did harmful shifts occur among the CHW workforce and employers after certification launch? Was certification associated with disparities among CHWs after its launch?</p><p><strong>Results: </strong>Certification was associated with higher pay among certified (vs noncertified) CHWs, better perceptions of CHWs among certified (vs noncertified) CHWs, and better integration of certified (vs noncertified) CHWs into care teams. We found no adverse shifts in CHW workforce by sociodemographic variables or in CHW employer characteristics (most notably CHW employer hiring requirements) after certification launch. After certification launch, certified and uncertified CHWs had similar demographic and educational characteristics. However, certified CHWs more often worked in large, clinical organizations while uncertified CHWs most often worked in medium-sized community-based organizations.</p><p><strong>Conclusions: </strong>Our evaluation of Massachusetts CHW certification suggests that CHW certification was not associated with workforce disparities and was associated with positive outcomes. Our study fills a notable gap in the research literature and can guide CHW research agendas, certification efforts in Massachusetts and other states, and program efforts to champion this critical, grassroots workforce.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Contributions of the Community-Based Organization Program Funded by the Centers for Disease Control and Prevention to Linkage to HIV Medical Care.","authors":"Mariette Marano-Lee, Weston Williams, Songli Xu, Jonny Andia, Ekaterine Shapatava","doi":"10.1177/00333549241252579","DOIUrl":"10.1177/00333549241252579","url":null,"abstract":"<p><strong>Objective: </strong>Linkage to HIV medical care is important in the continuum of HIV care and health outcomes for people with HIV. The objective of this analysis was to identify how the community-based organization (CBO) program contributes to linkage to HIV medical care among people with newly diagnosed HIV in the Centers for Disease Control and Prevention's (CDC's) HIV testing program.</p><p><strong>Methods: </strong>We analyzed HIV linkage-to-care data submitted to CDC from 2019 through 2021. Linkage was defined as confirmation that an individual attended their first HIV medical care appointment within 30 days of their HIV test date. We included in the analysis data submitted from the health department (HD) program that included 61 state and local HDs in the United States, Puerto Rico, and the US Virgin Islands and the CBO program that included 150 CBOs.</p><p><strong>Results: </strong>The CBO program linked a higher proportion of people to HIV medical care within 30 days of diagnosis (86.7%) than the HD program (73.7%). By population group, the proportion linked in the CBO program was higher than the proportion linked in the HD program among men who have sex with men (prevalence ratio [PR] = 1.13; <i>P</i> < .001), men who have sex with men/people who inject drugs (PR = 1.29; <i>P</i> < .001), transgender people (PR = 1.28; <i>P</i> < .001), and those reporting no sexual contact or injection drug use (PR = 1.34; <i>P</i> < .001). In the Cox proportional hazards model, time to linkage in the CBO program was significantly shorter than in the HD program (hazard ratio = 0.63; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>This analysis shows that the CBO program fills a vital need in linking newly diagnosed HIV-positive people to HIV medical care, which is important in the HIV care continuum and for viral suppression.</p>","PeriodicalId":20793,"journal":{"name":"Public Health Reports","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}