An Innovative Approach for Community Engagement: Using an Audience Response System

Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge and technology among all population groups. ARS was implemented at a community town hall event sponsored by a National Institute on Minority Health and Health Disparities Exploratory Center of Excellence, the Center for Equal Health. Participants appreciated being able to see how everyone else answered and felt included in the research process. ARS is beneficial because the community can answer truthfully and provides instant research results. Additionally, researchers can collect large amounts of data quickly, in a non-threatening way while tracking individual responses anonymously. Audience Response Systems proved to be an effective tool for successfully accomplishing community-based participatory research

Substance Abuse Treatment in Correctional versus Non-Correctional Settings: Analysis of Racial/Ethnic and Gender Differences

Background Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants of treatment location (jail or prison versus non-correctional settings) among treatment-seeking adults. Methods We used repeated cross-sectional data from the National Survey on Drug Use and Health (2002-2016) to identify White, African American, and Hispanic past-year substance abuse treatment participants (n=6,435). We tested the modifying roles of race/ethnicity and gender on the association between several exposure variables and treatment locus using multiple logistic regression. Results Ten percent of treatment participants utilized treatment services in a jail or prison, which varied by race/ethnicity (9% of Whites, 15% of African Americans, 12% of Hispanics) and by gender (11% of men, 9% of women). In our fitted models, we found that educational attainment and past-year employment status varied in effect size between African Americans and Whites. The associations for both variables were strongest among African Americans (Any college vs. Less than high school – adjusted Odds Ratio [aOR] = 0.23, 95% Confidence Interval [95% CI] = 0.08, 0.70; Ever unemployed vs. Never unemployed in the past year – aOR = 5.32, 95% CI = 1.94, 14.60). Health insurance status was significantly associated with treatment in a jail or prison only among Whites (Private vs. No insurance – aOR = 0.37, 95% CI = 0.19, 0.69). Co-occurring mental health diagnosis was significant only among African Americans (Any mental health diagnosis vs. none – aOR = 3.91, 95% CI = 1.38, 11.09). Employment and health insurance status were significant only among men (aOR = 2.18, 95% CI = 1.26, 3.77; aOR = 0.39, 95% CI = 0.22, 0.70, respectively). Conclusion We identified modifying roles for race/ethnicity and gender in the relationship between several factors and treatment utilization in a jail or prison versus non-correctional treatment settings. More numerous factors and stronger effect sizes were identified among African Americans and men in particular. Health promotion interventions promoting the uptake of substance abuse treatment should tailor services to align with the needs of those with the highest risk for incarceration

The development of a college biology self-efficacy instrument for nonmajors

ABSTRACT: In an effort to test the effectiveness of teaching and learning strategies that may increase biological literacy for nonbiology majors, an NSF-funded research project called "The Slice of Life," was conducted from 1994 to 1998. In the present study, a selfefficacy instrument was constructed and designed specifically for the project to determine students' self-reported confidence in understanding and using biology in their lives. Based on social cognitive theory, the premise for developing such an instrument was that a specific measure of biological self-efficacy was deemed to be an important predictor of the change processes necessary to improve students' biological understanding. Results of this study indicate that the Biology Self-Efficacy Scale was a valid and reliable tool for studying nonbiology majors' confidence in mastering biological literacy. Factor analysis supported the contention that the Biology Self-Efficacy Scale was a multidimensional construct consisting of at least three dimensions: methods of biology; generalization to other biology/science courses and analyzing data; and application of biological concepts and skills. These dimensions represent three components of biological literacy that have been commonly described in the literature. The instrument may lead to further understanding of student behavior, which in turn can facilitate the development of strategies that may increase students' desire to understand and study biology. More specifically, by using the self-efficacy tool as a pre-and posttest indicator, instructors can gain insight into whether students' confidence levels increase as they engage in more complex tasks during the course, and, in addition, what type of teaching strategies are most effective in buildin

Assessment of the Perceived Role and Function of a Community Advisory Board in a NIH Center of Excellence: Lessons Learned

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; and board member knowledge and communication within the center. Conclusions: Lessons learned mainly focused on clarification of CAB roles as necessary for more effective and efficient communication. Based on feedback, communication channels between the board and center were developed, orientation packets clarifying center roles were provided, and annual retreats were completed. Additional lessons learned for conducting community-academic partnerships are provided

Ethical issues in pedagogic research

This presentation discusses the ethical issues identified by a research ethics committee (REC) over a three year period. The REC deals exclusively with proposals for pedagogic research. The purpose of the research was to identify the nature and frequency of ethical concerns expressed by the REC, in order to improve guidance for future applicants

“We Live on an Island:” Perspectives on Rural Family Caregiving for Adults with Alzheimer’s Disease and Related Dementias in the United States

As the United States’ aging population grows, there will be increased prevalence of individuals living with Alzheimer’s Disease and related dementias (ADRD), who largely rely on the support of their family caregivers. Family caregivers residing in rural areas face additional challenges with managing caregiving responsibilities and navigating support services. The purpose of this multilevel phenomenological qualitative study was to explore the assets, unique needs, and resources of rural-residing ADRD caregivers from the caregiver, provider, and policy influencers’ perspectives. The study took place between 2019 through 2021 in northern Arizona, a largely rural and geographically vast area home to caregivers from diverse backgrounds. Twenty-seven caregivers to a loved one with ADRD participated in focus groups. Twelve health and social services providers and twelve policy influencers, those involved in leadership positions for aging programs or advocacy groups, completed individual interviews. Caregivers demonstrate many assets which contribute to their ability to manage and cope with their caregiving role. However, caregivers face a series of issues related to their caregiving role and need early and ongoing education regarding ADRD. There is a lack of resources available in rural areas, in particular providers, making it challenging to obtain needed resources necessary to support their loved one with ADRD. Furthermore, there is a need for more providers trained in working with aging adults and those experiencing ADRD, and a need for more culturally relevant resources

Thyroid Hormones in Pregnancy in Relation to Environmental Exposure to Organochlorine Compounds and Mercury

Polychlorinated biphenyls (PCBs), chlorinated pesticides, and mercury are global environmental contaminants that can disrupt the endocrine system in animals and humans. However, there is little evidence that they can interfere with endocrine status in pregnant women and neonates at low levels of exposure. The aim of this study was to examine thyroid hormone levels during pregnancy and in cord blood in relation to blood concentrations of organochlorine compounds (OCs) and Hg in healthy women recruited during pregnancy. We found a significant negative correlation between maternal total triiodothyronine levels and three non-coplanar congeners (PCB-138, PCB-153, and PCB-180), three pesticides (p,p′-DDE, cis-nanochlor, and hexachlorobenzene), and inorganic Hg independently, without any other changes in thyroid status. No significant relationships were observed between OCs and cord serum thyroid hormones. Cord serum free thyroxin was negatively correlated with inorganic Hg. These results suggest that at even low levels of exposure, persistent environmental contaminants can interfere with thyroid status during pregnancy

The National Competency Framework for registered nurses in adult critical care: An overview

In the years following the abolition of the English National Board for Nursing, Midwifery and Health Visiting (ENB) in 2002, concerns were raised within the Critical Care nursing community about a lack of consistency in post-registration education programmes. In response to this the Critical Care Network National Nurse Leads (CC3N) formed a sub-group, the Critical Care Nurse Education Review Forum (CCNERF) to address these concerns. A review of UK course provision confirmed marked inconsistency in the length, content and associated academic award. The CCNERF commenced a two phase project, first developing national standards for critical care nurse education such as length of course and academic credit level; followed by the development of a national competency framework1, 2. Following significant review and revision, version two of the National Competency Framework for Registered Nurses in Adult Critical Care was published by CC3N in 20153. This paper introduces the National Competency Framework and provides an overview of its background, development and implementation. It then considers the future direction of UK post-registration Critical Care nurse education

A nucleosomal function for IκB kinase-α in NF-κB-dependent gene expression

NF-κB is a principal transcriptional regulator of diverse cytokine-mediated processes and is tightly controlled by the IκB kinase complex (IKK-α/β/γ). IKK-β and IKK-γ are critical for cytokine-induced NF-κB function, whereas IKK-α is thought to be involved in other regulatory pathways. However, recent data suggest a role for IKK-α in NF-κB-dependent gene expression in response to cytokine treatment. Here we demonstrate nuclear accumulation of IKK-α after cytokine exposure, suggesting a nuclear function for this protein. Consistent with this, chromatin immunoprecipitation (ChIP) assays reveal that IKK-α was recruited to the promoter regions of NF-κB-regulated genes on stimulation with tumour-necrosis factor-α. Notably, NF-κB-regulated gene expression is suppressed by the loss of IKK-α and this correlates with a complete loss of gene-specific phosphorylation of histone H3 on serine 10, a modification previously associated with positive gene expression. Furthermore, we show that IKK-α can directly phosphorylate histone H3 in vitro, suggesting a new substrate for this kinase. We propose that IKK-α is an essential regulator of NF-κB-dependent gene expression through control of promoter-associated histone phosphorylation after cytokine exposure. These findings provide additional insight into the role of the IKK complex in NF-κB-regulated gene expression

Informing evaluation of a smartphone application for people with acquired brain injury: a stakeholder engagement study

Background Brain in Hand is a smartphone application (app) that allows users to create structured diaries with problems and solutions, attach reminders, record task completion and has a symptom monitoring system. Brain in Hand was designed to support people with psychological problems, and encourage behaviour monitoring and change. The aim of this paper is to describe the process of exploring the barriers and enablers for the uptake and use of Brain in Hand in clinical practice, identify potential adaptations of the app for use with people with acquired brain injury (ABI), and determine whether the behaviour change wheel can be used as a model for engagement. Methods We identified stakeholders: ABI survivors and carers, National Health Service and private healthcare professionals, and engaged with them via focus groups, conference presentations, small group discussions, and through questionnaires. The results were evaluated using the behaviour change wheel and descriptive statistics of questionnaire responses. Results We engaged with 20 ABI survivors, 5 carers, 25 professionals, 41 questionnaires were completed by stakeholders. Comments made during group discussions were supported by questionnaire results. Enablers included smartphone competency (capability), personalisation of app (opportunity), and identifying perceived need (motivation). Barriers included a physical and cognitive inability to use smartphone (capability), potential cost and reliability of technology (opportunity), and no desire to use technology or change from existing strategies (motivation). The stakeholders identified potential uses and changes to the app, which were not easily mapped onto the behaviour change wheel, e.g. monitoring fatigue levels, method of logging task completion, and editing the diary on their smartphone. Conclusions The study identified that both ABI survivors and therapists could see a use for Brain in Hand, but wanted users to be able to personalise it themselves to address individual user needs, e.g. monitoring activity levels. The behaviour change wheel is a useful tool when designing and evaluating engagement activities as it addresses most aspects of implementation, however additional categories may be needed to explore the specific features of assistive technology interventions, e.g. technical functions