Lessons from Two Latino Communities Working with Academic Partners to Increase Access to COVID-19 Testing

OBJECTIVE

We sought to examine the experiences of community partners in a community-academic partnership to promote COVID-19 testing in two majority Latino communities.

METHODS

We conducted semistructured, in-depth interviews in English and Spanish with community-based organization leaders and community health workers/promotoras (n = 10) from June to July 2021. Interviews focused on identifying partner roles in planning and testing implementation and evaluating communication among partners. Interviews were transcribed and analyzed in ATLAS.ti version 8.4.5. Analyses involved deductive and inductive approaches to identify key themes.

RESULTS

Participants described both strengths and challenges to the collaborative approach within each of three core themes: building relationships in the time of COVID-19; uplifting existing community leadership; and commitment of the academic partners and community-based organizations to conduct partnership activities in Spanish.

CONCLUSION

Community-academic partnerships that invest in strong relationships, community leadership, and a commitment to the community's preferred language offer a promising approach to addressing COVID-19 testing barriers. Findings provide direction for future research on how community members and academic partners can come together to inform strategies to continue addressing the COVID-19 pandemic.

Tobacco cessation and prevention interventions for sexual and/or gender minority-identified people and the theories that underpin them: A scoping review

INTRODUCTION

This scoping review takes stock of the social and behavior change theories that have underpinned tobacco interventions tailored to sexual and/or gender minority (SGM) people and reflects on the need to target contextually-based drivers of SGM tobacco use inequities.

METHODS

Data sources were Medline (Ovid), Scopus, PubMed, Google Scholar (01/01/1946 - 10/27/2022). Peer-reviewed publications in English from anywhere in the world describing SGM-tailored tobacco cessation and/or prevention interventions were independently identified by a librarian and screened by the first and third authors. 367 articles were extracted; an additional 2 were found by hand searching. 369 articles were assessed for eligibility. Exclusion criteria were: not an intervention, review article, not SGM-tailored or tobacco-focused. We documented intervention name, intervention components, theoretical frameworks cited in reference to intervention design and/or implementation, and evaluation outcomes. All authors provided input on theoretical framework categorization.

RESULTS

We identified 22 publications corresponding to 15 unique interventions. Individual-level behavior change theories (i.e., those focusing on within-person behavior change processes) were the most prominent. Among these, the Transtheoretical Model was the most frequently utilized, while Social Inoculation Theory, Theory of Reasoned Action, and Theory of Psychological Reactance were also employed. A minority of interventions referenced frameworks that more explicitly engaged with SGM people's social contexts, namely, Theory of Diffusion of Innovations and Minority Stress Model.

CONCLUSIONS

Future SGM-tailored tobacco interventions should leverage both the strengths of individual-level behavior change theories and those of frameworks that understand tobacco use inequities as indivisible from place, context, and policy.

IMPLICATIONS

This scoping review describes the theoretical underpinnings of sexual and/or gender minority (SGM)-tailored tobacco interventions published in the peer-review literature in English. It reflects on the need for greater utilization of social and behavior change theoretical frameworks that can engage with unique drivers of SGM tobacco use and barriers to cessation.

Smoke-Free Home Intervention in Permanent Supportive Housing: A Multifaceted Intervention Pilot

INTRODUCTION

Smoke-free homes (SFHs), the voluntary adoption of home smoking restrictions, are associated with reduced secondhand smoke exposure. However, SFHs are uncommon in permanent supportive housing (PSH) for formerly homeless adults, who have fivefold higher smoking rates than the general population. We pilot-tested a brief intervention to increase voluntary adoption of SFHs among PSH residents in the San Francisco Bay Area.

AIMS AND METHODS

We pilot-tested a brief intervention to increase voluntary adoption of SFHs among PSH residents in the San Francisco Bay Area. Rest of the methods, PSH residents (n = 100) and staff (n = 62) from 15 PSH sites participated in the intervention between October 2017 and February 2018. Research staff provided counseling to PSH residents on how to adopt an SFH and trained PSH staff on how to counsel residents on smoking cessation. The primary outcome was self-reported voluntary adoption of an SFH for ≥90 days, and the secondary outcome was carbon monoxide-verified PPA at 6-month follow-up. PSH staff completed the Smoking Knowledge, Attitudes, and Practices survey at baseline and 3-month follow-up.

RESULTS

At 6 months, 31.3% of PSH residents had adopted an SFH (vs. 13.0% at baseline) and 16.9% reported carbon monoxide-verified PPA. A positive attitude toward an SFH policy was associated with increased odds of SFH adoption (adjusted odds ratio = 8.68, 95% confidence interval: 2.42, 31.17). Voluntary SFH adoption was associated with increased PPA (adjusted odds ratio = 26.27, 95% confidence interval: 3.43, 201.30). PSH staff reported improved attitudes toward and self-efficacy in delivering cessation care, and decreased barriers to discussing smoking cessation among PSH residents between baseline and 3-month follow-up.

CONCLUSIONS

In this single-arm study, a brief intervention increased SFH adoption and PPA among PSH residents.

IMPLICATIONS

To date, few interventions have addressed SFHs and their association with tobacco use among PSH residents. A "ground-up" approach that relies on buy-in from residents and that promotes voluntary SFHs is an innovative way to increase smoke-free living environments in PSH. This approach could pave a pathway for smoke-free policy implementation in these sites. PSH can play a role in reducing the burden of tobacco use by empowering its residents to adopt voluntary SFHs, which could increase smoking cessation among residents.

Responses to Graphic Warning Labels among Low-income Smokers

Objective: Graphic warning labels (GWLs) are effective in communicating tobacco-related harms. Methods: In this mixed-methods study, we used purposive sampling to recruit 100 low-income smokers in the San Francisco Bay Area between October 2017 and February 2018 to participate in an intervention promoting smoke-free homes. We presented the 2009 Food and Drug Administration-proposed GWLs and explored perceptions of affect, efficacy, and appeal using questionnaires at baseline, 3- and 6-months follow-up. Because of participants' interest in this topic, we subsequently conducted a qualitative sub-study among 20 participants exploring perceived efficacy of GWLs on smoking cessation. Results: In all, 87.3% and 59.2% agreed that GWLs were useful and would motivate cessation behaviors, respectively, at baseline. We found that the most common responses were shock (61.8%) and disgust (55.3%), whereas anger (29.0%) and annoyance (19.7%) were less common. Participants also reported that GWLs unequivocally illustrating smoking's harmful effects were more appealing than non-specific images, as were images that depicted positive cessation-related effects. Conclusions: GWLs appear to be an important health communication among low-income smokers. Future studies on GWLs should examine the association of negative affect and cessation among this population.

Representations of cancer recurrence risk, recurrence worry, and health-protective behaviours: an elaborated, systematic review

An expanded Common-Sense Model (CSM) contextualised to the self-regulation of cancer recurrence risk identifies risk representational attributes and recurrence worry as primary processes motivating protective behaviours in cancer survivors. A systematic review examined evidence for CSM hypotheses regarding how these processes influence diet and physical activity (PA) among survivors. A research agenda is outlined and used to evaluate the evidence base. Common databases were searched for eligible, peer-reviewed, English language reports, yielding 18 studies quantitatively testing hypothesised relationships among representations of prior cancer, recurrence risk representations, recurrence worry, and diet and PA. The findings provide promising, but mixed and limited evidence for some of the hypothesised associations of specific risk recurrence attributes with recurrence worry, and risk recurrence attributes and recurrence worry with diet and PA. Findings support the distinction of recurrence risk representations and illness representations of the prior cancer, with each showing different relationships with recurrence worry and behaviours. We discuss the status of the evidence base in relation to assessment, design, and analysis priorities and propose strategies that can yield more sensitive, rigorous tests of the CSM for cancer recurrence risk as applied to diet and PA.

Cultural and Linguistic Adaptation of a Healthy Diet Text Message Intervention for Hispanic Adults Living in the United States

Hispanics represent a critical target for culturally adapted diet interventions. In this formative research, we translated HealthyYouTXT, an mHealth program developed by the U.S. National Cancer Institute, into HealthyYouTXT en Español, a linguistically and culturally appropriate version for Spanish speakers in the United States. We report a three-stage, mixed-methods process through which we culturally adapted the text messages, evaluated their acceptability, and revised the program based on the findings. In Stage 1, we conducted initial translations and adaptations of the text libraries using an iterative, principle-guided process. In Stage 2, we used mixed methods including focus groups and surveys with 109 Hispanic adults to evaluate the acceptability and cultural appropriateness of the program. We used survey data to evaluate whether self-determination theory (SDT) factors (used to develop HealthyYouTXT) of autonomous motivation, controlled motivation, and amotivation and Hispanic cultural beliefs about familism, fatalism, and destiny predict program interest and its perceived efficacy. Mixed-methods analyses revealed substantial interest in HealthyYouTXT, with most participants desiring to use it and viewing it as highly efficacious. Both cultural beliefs (i.e., beliefs in destiny and, for men, high familism) and SDT motivations (i.e., autonomy) predicted HealthyYouTXT evaluations, suggesting utility in emphasizing them in messages. Higher destiny beliefs predicted lower interest, suggesting that they could impede program use. In Stage 3, we implemented the mixed-methods findings to finalize HealthyYouTXT en Español. The emergent linguistic principles and multistage, multimethods process can be applied in health communication adaptations.

Clinical and genetic analysis of a distinct autosomal dominant spinocerebellar ataxia

OBJECTIVE

To characterize a distinct form of spinocerebellar ataxia (SCA) clinically and genetically.

BACKGROUND

The SCAs are a genetically heterogeneous group of neurodegenerative disorders affecting the cerebellum and its connections. The mutations for SCA1, 2, 3, 6, and 7 have been identified and shown to be due to expansion of a CAG repeat in the coding region of these genes. Two additional SCA loci on chromosomes 16 and 11 have been designated SCA4 and SCA5. However, up to 20% of individuals with autosomal dominant forms of ataxias cannot be assigned any of these genotypes, implying the presence of other unidentified genes that may be involved in the development of ataxia.

METHODS

We ascertained and clinically characterized a six-generation pedigree segregating an autosomal dominant trait for SCA. We performed direct mutation analysis and linkage analysis for all known SCA loci.

RESULTS

The mutation analysis excludes SCA1, 2, 3, 6, and 7, and genetic linkage analysis excludes SCA4 and SCA5 (multipoint location scores < -2 across the candidate region). Clinical analysis of individuals in this family shows that all affected members have dysarthria, gait and limb ataxia, and nystagmus. No individuals have major brainstem or long-tract findings. Analysis of age at disease onset through multiple generations suggests anticipation.

CONCLUSION

This pedigree represents a genetically distinct form of SCA with a phenotype characterized by predominantly cerebellar symptoms and signs.

[Distraction as a stimulus of bone formation]

In orthopaedics limb length discrepancy and bone lost from infection are more frequent and difficult to resolve at the moment G. Ilizarov showed new bone formation with slow distraction stimulation in a well vascularization an rigidly fixed bone. Good patient selection, surgical technique, complete post-operative care and patient collaboration are necessary to get excellent or good results. This paper involves 50 patients, 39 with limb lengthening and 11 with infection and bone loss. We obtained excellent and good results in 37 cases of lengthening and 10 in the second one. At the moment the complications with external fixators may be used and we advised their use.

Neuropsychological and behavioral abnormalities in an adolescent with frontal lobe seizures

A 13-year-old girl had a reversible frontal syndrome secondary to partial complex seizures. She developed sudden and dramatic behavioral changes including sexual disinhibition, loss of concern for personal hygiene, physical and verbal aggression, and pressured and tangential speech. Although the basic neurologic examination was normal, neuropsychological testing revealed selective impairment on tasks sensitive to frontal dysfunction with relatively normal performance on other tests. This case demonstrates that a frontal syndrome can be caused by partial complex seizures and that behavior comparable to that observed in adults with frontal dysfunction may occur in young adolescents.