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In 2017, the Michigan Institute for Clinical and Health Research (MICHR) and community partners in Flint, Michigan collaborated to launch a research funding program and evaluate the dynamics of those research partnerships receiving funding. While validated assessments for community-engaged research (CEnR) partnerships were available, the study team found none sufficiently relevant to conducting CEnR in the context of the work. MICHR faculty and staff along with community partners living and working in Flint used a community-based participatory research (CBPR) approach to develop and administer a locally relevant assessment of CEnR partnerships that were active in Flint in 2019 and 2021.
Surveys were administered each year to over a dozen partnerships funded by MICHR to evaluate how community and academic partners assessed the dynamics and impact of their study teams over time.
The results suggest that partners believed that their partnerships were engaging and highly impactful. Although many substantive differences between community and academic partners’ perceptions over time were identified, the most notable regarded the financial management of the partnerships.
This work contributes to the field of translational science by evaluating how the financial management of community-engaged health research partnerships in a locally relevant context of Flint can be associated with these teams’ scientific productivity and impact with national implications for CEnR. This work presents evaluation methods which can be used by clinical and translational research centers that strive to implement and measure their use of CBPR approaches.
OBJECTIVES/GOALS: During earlier periods of the pandemic, Black and Latinx populations in Michigan have suffered higher rates of infection, hospitalization, and deaths when compared to Whites. We conducted this study to understand how Black and Latinx residents perceived this disproportionate burden. METHODS/STUDY POPULATION: In 2021, 40 semi-structured interviews were conducted virtually in English or Spanish with Black (n=24) and Latinx (n=16) residents in Michigan areas highly impacted by COVID-19: Genesee, Kent, Washtenaw, and Wayne counties. Using a Community-Based Participatory Research (CBPR) approach, we partnered with leaders from 15 community-based organizations and health and human service agencies to develop research questions, an interview protocol, and to interpret the data. We used the data analysis software Dedoose (ver 4.12) for inductive coding (IRR=0.81). This study is a part of the NIH Community Engagement Alliance (CEAL) Against COVID-19 initiative. RESULTS/ANTICIPATED RESULTS: Participants described the significant impact of the pandemic in terms of physical and mental health, job security, and the sheer number of deaths among loved ones. They attributed the impact to comorbidities and social determinants of health disparities exacerbated by the pandemic, including income, housing, access to healthcare, as well as systemic racism. They noted being overrepresented among frontline workers with higher exposure to COVID-19, limited or misinformation about the virus, language barriers, and difficulty with social distancing. Cultural norms that promote being in close proximity, such as intergenerational households, and loss of trusted community leaders were also noted. DISCUSSION/SIGNIFICANCE: Findings reflect the needs of Black and Latinx community members in Michigan and the discussions they feel are important to highlight. We must work strategically with partners and the community to provide transparency and effective leadership, and prioritize addressing systemic disparities in SDoH.
OBJECTIVES/GOALS: COVID-19 vaccines were met with both public excitement and concern. Our goal was to understand individual’s attitudes about COVID-19 vaccines within Black and Latino communities deeply impacted by COVID-19, in an effort to highlight their potential similarities and differences. METHODS/STUDY POPULATION: Using a community-based participatory approach, we partnered with 16 leaders from community-based organizations to conduct a mixed-methods study examining the perspectives of Black and Latino communities regarding their vaccine acceptance or hesitancy. We focused on Michigan counties highly impacted by COVID-19 infection and deaths. In 2021, we interviewed 24 Black and 16 Latino residents in English or Spanish. We combined this with survey data on vaccine attitudes and behavior from the Detroit Metro Area Communities Study (n=1,800). This research is part of the NIH Community Engagement Alliance Against COVID-19. RESULTS/ANTICIPATED RESULTS: Qualitative and quantitative analysis highlight that Black participants expressed greater mistrust and hesitance around vaccines and less willingness to get vaccinated, often citing historical mistreatment as a contributing factor. The desire to keep themselves, their families and community safe was cited as the most important factor shaping vaccine decisions among both groups. Trust in information and in science was rated as a stronger reason for vaccination among Latinx participants; however, they also appeared to highlight the issue of vaccine access more often than Black participants. Fear of side effects and risks were equally cited as factors that influenced their vaccine hesitancy. DISCUSSION/SIGNIFICANCE: Despite being labeled as minority communities, these two groups have important differences regarding their perspective of COVID-19 vaccines. Our results suggest that public health interventions must be tailored to address the concerns, differences in attitudes, and beliefs among Blacks and Latinos.
The aim of this quality improvement project is to improve identification and management of mood disorder in patients over 65 years admitted to Royal Surrey County Hospital (RSCH) with hip fractures by introducing a standardised assessment tool to guide appropriate interventions.
The signs of depression in the elderly can be subtle and often go unnoticed. The multidisciplinary team (MDT) at RSCH observed that low mood could negatively impact on a patient's recovery, affecting pain thresholds and leading to poor engagement with rehabilitation. Proactive identification and management of mood disorder is an important part of Comprehensive Geriatric Assessment but not routinely performed in patients with hip fracture admitted to RSCH.
Notes and discharge summaries of patients with hip fracture admitted over a four-month period were retrospectively reviewed to establish if patients were screened for low mood. A mood screening tool was chosen and implemented prospectively over a four-month period. Occupational therapists and junior doctors completed a Cornell Score for all patinets. Those identified with depression or probable depression were issued verbal advice, an information leaflet and follow-up arranged.
Ninety-eight patients were included in the retrospective cohort. No patients were formally identified as having depression or probable depression, and there was no indication that mood was considered or assessed at any point during admission. During the four-month prospective period, 90 patients were admitted to RSCH with hip fracture and 86 patients (96%) were screened for low mood. Four patients were excluded due to a terminal prognosis. Of the patients screened, 9% had major depression and 16% probable depression. Feedback from our occupational therapists and doctors was positive, with the tool being relatively easy to use in patients with or without cognitive impairment. Much of the assessment could be incorporated into their initial assessment or in gaining collateral history from next of kin. Anecdotally, considering patients psychological well-being had a positive impact on inpatient therapy sessions guided the MDT in supporting the patient appropriately.
Implementation of a standardised and validated mood screening tool enabled us to identify that a quarter (25%) of the patients admitted following a hip fracture had, or probably had depression. This allowed us to intervene with simple measures such as verbal advice and an information leaflet and consider pharmacological intervention where appropriate.
ABSTRACT IMPACT: This study identifies potential areas for community and clinical interventions to improve eye and vision health. OBJECTIVES/GOALS: The ‘All Eyes on Us’ study sought to understand perceptions of and barriers to eye and vision care, of residents over the age of 40 in the Broadway/Slavic Village neighborhood in Cleveland, Ohio. The goal of this study was to identify potential areas for community and clinical interventions to improve eye health. METHODS/STUDY POPULATION: Residents of the Broadway/Slavic Village neighborhood, an ethnically diverse, low socioeconomic status, neighborhood in Cleveland, Ohio were recruited from, and with the assistance of, University Settlement, a nonprofit that has been providing services to the neighborhood since 1926. The project’s Community Advisory Board assisted with the development of a semi-structured interview guide over the course of three meetings. Sixty interviews were completed, 30 with self-identified European Americans and 30 with self-identified African-Americans, all over the age of 40. Two research team members coded the interview transcripts and a thematic analysis was conducted. RESULTS/ANTICIPATED RESULTS: Participants identified barriers to obtaining eye and vision care for themselves as well as perceived barriers for others, including transportation, cost, insurance status, clinic locations, lack of education around eye and vision care, fear, forgetfulness, and priority management. To encourage people to go to the eye doctor more often, participants mentioned strategies related to access issues including lowering the cost of exams, operating on a sliding scale, improving insurance coverage, transportation services, and having mobile units that deployed to specific neighborhoods or senior centers. Additionally, participants suggested education and increasing awareness about the importance of eye and vision care. DISCUSSION/SIGNIFICANCE OF FINDINGS: Participants in this study identified that accessibility to and awareness about eye health and eye care is an issue. Interventions to address both access issues such as location, cost, and insurance as well as those that increase education could increase engagement with eye and vision care.
Public-Private Innovation Partnerships (PPIPs) are increasingly used as a tool for addressing ‘wicked’ public sector challenges. ‘Innovation’ is, however, frequently treated as a ‘magic’ concept: used unreflexively, taken to be axiomatically ‘good’, and left undefined within policy programmes. Using McConnell’s framework of policy success and failure and a case study of a multi-level PPIP in the English health service (NHS Test Beds), this paper critically explores the implications of the mobilisation of innovation in PPIP policy and practice. We highlight how the interplay between levels (macro/micro and policy maker/recipient) can shape both emerging policies and their prospects for success or failure. The paper contributes to an understanding of PPIP success and failure by extending McConnell’s framework to explore inter-level effects between policy and innovation project, and demonstrating how the success of PPIP policy cannot be understood without recognising the particular political effects of ‘innovation’ on formulation and implementation.
To examine public commitments for encouraging United States consumers to make healthy dietary purchases with their Supplemental Nutrition Assistance Program (SNAP) benefits among of prevalent SNAP-authorised retailers.
National SNAP-authorised retail landscape in addition to stores located in California and Virginia, two states targetted for a Partnership for a Healthier America pilot social marketing campaign.
SNAP-authorised retailers with the most store locations in selected settings.
A review of retailers’ publicly available business information was conducted (November 2016–February 2017). Webpages and grey literature sources were accessed to identify corporate social responsibility (CSR) reports and commitments describing strategies to encourage healthy consumer purchases aligned with the 2015–2020 Dietary Guidelines for Americans. Evidence was organised using a marketing-mix and choice-architecture (MMCA) framework to characterise strategies used among eight possible types (i.e. place, profile, portion, pricing, promotion, priming, prompting and proximity).
Of the SNAP-authorised retailers (n 38) reviewed, more than half (n 20; 52·6 %) provided no information in the public domain relevant to the research objective. Few retailers (n 8; 21·1 %) had relevant CSR information; grey literature sources (n 52 articles across seventeen retailers) were more commonly identified. SNAP-authorised retailers in majority committed to increasing the number of healthy products available for purchase (profile).
Substantial improvements are needed to enhance the capacity and commitments of SNAP-authorised retailers to use diverse strategies to promote healthy purchases among SNAP recipients. Future research could explore feasible approaches to improve dietary behaviours through sector changes via public–private partnerships, policy changes, or a combination of government regulatory and voluntary business actions.
Prenatal exposure to persistent organic pollutants (POPs) has been associated with the development of metabolic syndrome-related diseases in offspring. According to epidemiological studies, father’s transmission of environmental effects in addition to mother’s can influence offspring health. Moreover, maternal prenatal dietary folic acid (FA) may beneficially impact offspring health. The objective is to investigate whether prenatal FA supplementation can overcome the deleterious effects of prenatal exposure to POPs on lipid homeostasis and inflammation in three generations of male rat descendants through the paternal lineage. Female Sprague-Dawley rats (F0) were exposed to a POPs mixture (or corn oil) +/− FA supplementation for 9 weeks before and during gestation. F1 and F2 males were mated with untreated females. Plasma and hepatic lipids were measured in F1, F2, and F3 males after 12-h fast. Gene expression of inflammatory cytokines was determined by qPCR in epididymal adipose tissue. In F1 males, prenatal POPs exposure increased plasma lipids at 14 weeks old and hepatic lipids at 28 weeks old and prenatal FA supplementation decreased plasma total cholesterol at 14 weeks old. Prenatal POPs exposure decreased plasma triglycerides at 14 weeks old in F2 males. No change was observed in inflammatory markers. Our results show an impact of the paternal lineage on lipid homeostasis in rats up to the F2 male generation. FA supplementation of the F0 diet, regardless of POPs exposure, lowered plasma cholesterol in F1 males but failed to attenuate the deleterious effects of prenatal POPs exposure on plasma and hepatic lipids in F1 males.
We review the various functional cognitive disorders (FCDs) – complaints about memory function or another cognitive process in the absence of relevant neuropathology. These are increasingly coming to the attention of psychiatrists and neurologists and FCD encompasses some newly recognised conditions in addition to classic types such as pseudodementia and psychogenic amnesia. The clinical features, neuropsychological findings and treatment are presented and discussed.
After reading this article you will be able to:
• describe clinical features of FCD and how it differs from neurodegenerative causes of cognitive impairment
• be able to subclassify cases of FCD using the proposed nosology
• understand how to discuss the diagnosis with the patient and explain how the symptoms arise.
OBJECTIVES/SPECIFIC AIMS: o To review the community’s recommendations on how to rebuild trust in the Flint community. o To review effective community engagement strategies utilized with the Flint Special Projects for project conceptualization, participant recruitment, data analysis, project oversight, and dissemination. METHODS/STUDY POPULATION: The study population includes nearly two hundred residents representing seniors, youth and diverse ethnicities recruited to participate in eleven focus group meetings. The population also represents the general public who attended informational meetings in Flint, Michigan to learn about the crisis and allow residents to voice their opinions and concerns during the onset of the crisis. The project is a mixed methods community based participatory research effort that utilized community decision making in all phases of the effort such as pre-conception, implementation, dissemination and advocacy to encourage the community’s recommendations are adopted at policy and institutional responsiveness levels. It includes three community engaged research efforts: (project 1) A qualitative analysis of community sentiment provided during 17 recorded legislative, media and community events, and (projects 2-3) two mixed methods efforts utilizing purposive sampling of stakeholders whose voice may not have been heard. RESULTS/ANTICIPATED RESULTS: The project presents a qualitative analysis of the community’s voice during the onset of the man-made disaster when the community first became aware of the emergency manager’s plans to switch the water source. It also reflects current perspectives of community voice since the projects are scheduled to end late February 2019. Findings from a trust measure administered to nearly two hundred residents will be presented, along with a qualitative analysis of focus group findings among segments of the population (seniors, youth, and diverse ethnicities) who may have been left out of narratives on the water crisis. Finally, the project will compare empowerment and resiliency approaches being utilized in Flint, Michigan to recover from the disaster with other approaches grounded in literature and theory. DISCUSSION/SIGNIFICANCE OF IMPACT: Communities of color often experience social determinants of health which negatively impact their health, well-being and human rights. Some Flint citizens are experiencing negative health consequences (i.e., rashes, brain and behavioral sequelle, fertility, etc.) as a result of the disaster, and are uncertain of health outcomes in the future. This is the first project to rigorously document and analyze levels of trust and mistrust in the city of Flint since the water disaster occurred. The qualitative research will guide future clinical research that will benefit this traumatized community experiencing high levels of mistrust (i.e., government, elected officials, etc.). The community engaged methodology involved residents and study participants in all phases of the project including project oversight, validating and analyzing data, and dissemination. This methodology will contribute to existing literature and theory on community based participatory research, community engaged research, team science and citizen science. The approaches empowered a call to action among residents, for example, seniors who attended two senior focus group sessions shared “they are hopeful and have a purpose,” resulting in the creation of a council (with officers) at their housing complex to advocate for the well-being of seniors during the recovery process. Recruitment methodologies were extremely successful due to resident level trust in community leaders and community partner organizations. Finally, the project’s examination of approaches encouraging empowerment and resiliency will provide lessons learned for other communities challenged with crisis.
As professors, we seek not only to impart knowledge about issues and concepts in American politics but also to engage and inspire students to become more knowledgeable and more active in politics. This article explains how a student-run exit poll conducted on Election Day 2016 accomplished both goals. Seven faculty members from four universities pooled our students and carried out an exit poll in the District of Columbia, Maryland, Virginia, and Ohio. By the time the polls closed, our students had spoken to more than 2,300 respondents, providing a memorable experience and creating a shared dataset that served as the centerpiece for many final class projects. Through this project, students gained hands-on experience in survey design, sampling, research ethics, polling, and data analysis.
The High Plateaus of Utah include seven separate mountain ranges that supported glaciers during the Pleistocene. The Fish Lake Plateau, located on the eastern edge of the High Plateaus, preserves evidence of at least two glacial advances. Four cosmogenic 3He exposure ages of boulders in an older moraine range from 79 to 159 ka with a mean age of 129 ± 39 ka and oldest ages of 152 ± 3 and 159 ± 5 ka. These ages suggest deposition during the type Bull Lake glaciation and Marine Oxygen Isotope Stage (MIS) 6. Twenty boulder exposure ages from four different younger moraines indicate a local last glacial maximum (LGM) of ~ 21.1 ka, coincident with the type Pinedale glaciation and MIS 2. Reconstructed Pinedale-age glaciers from the Fish Lake Plateau have equilibrium-line altitudes ranging from 2950 to 3190 m. LGM summer temperature depressions for the Fish Lake Plateau range from −10.7 to −8.2°C, assuming no change in precipitation. Comparison of the Fish Lake summer temperature depressions to a regional dataset suggests that the Fish Lake Plateau may have had a slight increase (~ 1.5× modern) in precipitation during the LGM. A series of submerged ridges in Fish Lake were identified during a bathymetric survey and are likely Bull Lake age moraines.
The series of events in the 2011 Penn State sexual abuse scandal were tumultuous and complex. Alderfer's (2013) focal article on the group-level phenomena surrounding the scandal provides a unique lens to view these events. However, questions remain about how relationships both within and between the groups involved in the scandal resulted in these outcomes. In particular, why did members of groups within Penn State fail to act, whereas people who belonged to other social groups took action? In short, we agree that group and intergroup boundaries were important in this situation, but would like to further elaborate on the underlying mechanisms behind their significance. Beyond the fact that individuals belonged to different groups, what aspects of group dynamics explain the differences in their perceptions, attitudes, and behaviors in this scandal?
We present images of Mars obtained in the 2.0 μm CO2 band with the United Kingdom Infrared Telescope (UKIRT). The images reveal topographic features of the Martian surface that are usually invisible in direct albedo images at visible or IR wavelengths, but agree remarkably well with the topography of the planet as mapped by the MOLA instrument on Mars Global Surveyor. The CO2 band depth is a measure of the absorbing column of CO2 and hence determined primarily by the surface atmospheric pressure. The surface pressure variations are detected with a sensitivity of 4–5 Pa. We compare our data with radiative transfer models and find that the measured CO2 variation with pressure is consistent with the models. We discuss the possibility that similar observations might be used to observe atmospheric pressure changes due to Martian weather systems.
Norovirus is highly infectious and can spread rapidly in healthcare settings, consuming resources and resulting in longer hospital stays. Although the economic impact of specific past outbreaks has been reported (eg, a 2007 outbreak of norovirus infection at Johns Hopkins Hospital cost an estimated $650,000), these costs may not be generalizable. We developed an economic computer simulation model to assist policy makers, hospital administrators, infection control professionals, and other healthcare workers in determining how much to invest in norovirus prevention and control interventions above and beyond existing infection control measures.