scholarly journals Pharmacist attitudes and provision of harm reduction services in North Carolina: an exploratory study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Rachel A. Parry ◽  
William A. Zule ◽  
Christopher B. Hurt ◽  
Donna M. Evon ◽  
Sarah K. Rhea ◽  
...  
Keyword(s):  
North Carolina ◽  
Harm Reduction ◽  
Online Survey ◽  
Positive Impact ◽  
Healthcare Providers ◽  
The United States ◽  
Convenience Sample ◽  
Persons Who Inject Drugs ◽  
Hcv Screening ◽  
Pharmacist Attitudes

Abstract Background Pharmacists are among the most accessible healthcare providers in the United States and uniquely positioned to provide harm reduction services. The availability of pharmacy-based harm reduction services and pharmacist attitudes toward delivering these services have been understudied to date. We examine North Carolina (NC) pharmacists’ experiences with and attitudes about harm reduction services and explore differences between rural and urban pharmacists. Methods A convenience sample of NC pharmacists participated in an anonymous, online survey regarding harm reduction services: non-prescription syringe sales; naloxone dispensing; and human immunodeficiency virus (HIV) and hepatitis C virus (HCV) screening. Urban–rural differences were analyzed using Pearson’s chi-square or Fisher’s exact tests. Open-ended responses were analyzed thematically. Results Three hundred pharmacists responded to the survey; 68 (23%) practiced in rural counties. Dispensing non-prescription syringes and naloxone at least occasionally was reported by 77% (n = 231) and 88% (n = 263) pharmacists, respectively. Pharmacy-delivered HIV or HCV screening was rare. Urban pharmacists dispensed naloxone more frequently than rural pharmacies (p = 0.04). Only 52% of pharmacists agreed that persons who inject drugs should always be allowed to buy non-prescription syringes. Rural pharmacists’ attitudes toward harm reduction services for persons who inject drugs were statistically, though marginally, less supportive when compared to urban pharmacists’ attitudes. The most common barrier to non-prescription syringe access was requiring patients to provide proof of prescription injection medication use, which 21% of pharmacists reported was required by their pharmacy’s policy on non-prescription syringe sales. Conclusions Although most pharmacies distributed naloxone and sold non-prescription syringes, pharmacy store policies and personal beliefs inhibited naloxone and non-prescription syringe dispensing. NC community pharmacies infrequently offer HIV and HCV screening. Paired with disseminating the evidence of the positive impact of harm reduction on individual and public health outcomes to NC pharmacists, institutional and systems changes to practice and policy may be important to promote harm reduction service availability, particularly for rural NC residents. Trial registration: N/A.

scholarly journals Experiences and impact of international medical volunteering: a multi-country mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041599 ◽  
Author(s):  
Mary McCauley ◽  
Joanna Raven ◽  
Nynke van den Broek
Keyword(s):  
Low Income ◽  
Online Survey ◽  
Positive Impact ◽  
Healthcare Providers ◽  
International Medical ◽  
Middle Income ◽  
Use Of Resources ◽  
The Uk ◽  
Medical Volunteers ◽  
The Impact

ObjectiveTo assess the experience and impact of medical volunteers who facilitated training workshops for healthcare providers in maternal and newborn emergency care in 13 countries.SettingsBangladesh, Ghana, India, Kenya, Malawi, Namibia, Nigeria, Pakistan, Sierra Leone, South Africa, Tanzania, UK and Zimbabwe.ParticipantsMedical volunteers from the UK (n=162) and from low-income and middle-income countries (LMIC) (n=138).Outcome measuresExpectations, experience, views, personal and professional impact of the experience of volunteering on medical volunteers based in the UK and in LMIC.ResultsUK-based medical volunteers (n=38) were interviewed using focus group discussions (n=12) and key informant interviews (n=26). 262 volunteers (UK-based n=124 (47.3%), and LMIC-based n=138 (52.7%)) responded to the online survey (62% response rate), covering 506 volunteering episodes. UK-based medical volunteers were motivated by altruism, and perceived volunteering as a valuable opportunity to develop their skills in leadership, teaching and communication, skills reported to be transferable to their home workplace. Medical volunteers based in the UK and in LMIC (n=244) reported increased confidence (98%, n=239); improved teamwork (95%, n=232); strengthened leadership skills (90%, n=220); and reported that volunteering had a positive impact for the host country (96%, n=234) and healthcare providers trained (99%, n=241); formed sustainable partnerships (97%, n=237); promoted multidisciplinary team working (98%, n=239); and was a good use of resources (98%, n=239). Medical volunteers based in LMIC reported higher satisfaction scores than those from the UK with regards to impact on personal and professional development.ConclusionHealthcare providers from the UK and LMIC are highly motivated to volunteer to increase local healthcare providers’ knowledge and skills in low-resource settings. Further research is necessary to understand the experiences of local partners and communities regarding how the impact of international medical volunteering can be mutually beneficial and sustainable with measurable outcomes.

scholarly journals Pulse Knowledge, Attitudes, Practices, and Cooking Experience of Midwestern US University Students

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3499
Author(s):  
Donna M. Winham ◽  
Elizabeth D. Davitt ◽  
Michelle M. Heer ◽  
Mack C. Shelley
Keyword(s):  
College Students ◽  
Self Efficacy ◽  
Online Survey ◽  
Daily Intake ◽  
The United States ◽  
Chi Square ◽  
Convenience Sample ◽  
Attitudes And Practices ◽  
Positive Attitudes ◽  
Chi Square Analysis

Many American college students fail to meet dietary guideline recommendations for fruits, vegetables, and fiber. Pulses are a subgroup of legumes, harvested solely for dry grain seeds within a pod. Commonly consumed pulses include dry beans, dry peas, lentils, and chickpeas. Pulses are high in shortfall nutrients and could fill some nutritional gaps of college students. However, little is known about pulse intakes among young adults. The study aims were: (1) to identify knowledge, attitudes, and practices regarding pulse consumption; and (2) to describe experiences of preparing dry pulses among college students. A convenience sample of 1433 students aged 18–30 enrolled at a Midwestern university in the United States completed an online survey in April 2020. Demographic and attitude variables were compared by the monthly count of pulse types eaten using chi-square, analysis of variance, and logistic regression modeling to predict pulse type intakes. Higher numbers of pulse types eaten was associated with being White, vegetarian/vegan, higher cooking self-efficacy, positive attitudes toward pulses, and greater daily intake of fruits, vegetables, and fiber. Knowledge and experience of cooking dry pulses was low, with canned pulses purchased more often. College students may not be consuming pulses due to unfamiliarity with them, low knowledge of nutrition benefits, and a general lack of cooking self-efficacy. Increased familiarization and promotion surrounding pulses may increase their consumption.

scholarly journals Homeschoolers’ Vaccination Perception and Rate

2017 ◽  
Vol 15 (2) ◽  
pp. 46-58 ◽  
Author(s):  
Danika Troupe ◽  
Molly Carrol ◽  
Elin McWilliams ◽  
Paige Swift ◽  
Ying Li
Keyword(s):  
Private School ◽  
Online Survey ◽  
Critical Role ◽  
The United States ◽  
Vaccination Rate ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Immunization Policy ◽  
Vaccination Rates ◽  
School Population

Background and Purpose: School vaccination laws have played a critical role in ensuring the success of the United States' immunization policy. Recent outbreaks of vaccine-preventable diseases (VPDs) in homeschool populations have raised concerns that homeschoolers are under-vaccinated. Little vaccination-related research has been conducted within the homeschool population. To fill the void in the literature, this study explored homeschooling parents' opinions regarding vaccination and examined the vaccination rates of their children in comparison to public/private school population. Methods: A convenience sample of 137 homeschool and public/private school parents in Washington state participated in a 36-question cross-sectional online survey. Results: The homeschooling parents reported significantly lower vaccination rates of their children, lower perceived benefits of vaccination, lower perceived susceptibility to VPDs if unvaccinated, and higher perceived barriers in comparison to the public/private school parents. Overall the participants expressed a preference for less governmental regulation of vaccinations, though homeschooling parents express an even stronger preference for same. Conclusions: Homeschool and public/private school population differed in the vaccination rate and vaccination related opinions. Further research among homeschool population and examination of immunization policy is needed.

scholarly journals Reporting of Concussion-Like Symptoms After Cycling Crashes: A Survey of Competitive and Recreational Cyclists

2020 ◽  
Vol 55 (1) ◽  
pp. 11-16
Author(s):  
Sarah Rice ◽  
Mary Alexis Iaccarino ◽  
Saurabha Bhatnagar ◽  
Greg Robidoux ◽  
Ross Zafonte ◽  
...  
Keyword(s):  
Online Survey ◽  
Assessment Tool ◽  
Memory Loss ◽  
Signs And Symptoms ◽  
The United States ◽  
Loss Of Consciousness ◽  
Symptom Checklist ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Competitive Cyclists

Context Cycling crashes are common among recreational and competitive riders and may result in head and bodily trauma. Information is limited regarding the signs and symptoms of head injury (HI) after cycling crashes, medical treatment, and recovery. Objectives To evaluate concussion-like symptom reporting after cycling crashes with or without HI in recreational and competitive cyclists and to assess crash characteristics and follow-up medical care. Design Cross-sectional study. Setting Voluntary online survey. Patients or Other Participants A convenience sample of 780 cyclists residing in the United States: 528 males, 249 females, 2 gender queer/nonbinary, and 1 transgender female. Main Outcome Measure(s) Survey-based, self-reported signs and symptoms of HI, including the third edition of the Sport Concussion Assessment Tool (SCAT3) symptom checklist, loss of consciousness, posttraumatic amnesia, and helmet damage. Results Of the participants, 403 reported crashes in the previous 2 years. Cyclists who self-reported no significant injury after their crash were excluded, leaving 77 HI reporters (HI group) and 260 trauma controls (TC group). The HI group more frequently reported experiencing 17 of the 22 symptoms on the SCAT3 symptom checklist. The HI group described a 4-fold higher incidence of loss of consciousness (HI = 13/77 [16.9%] versus TC = 11/2600 [4.2%]) and memory loss immediately after the crash (HI = 44/77 [57.1%] versus TC = 37/260 [14.2%]). The HI group reported major, noncosmetic helmet damage 2.5 times more frequently than the TC group (HI = 49/77 [63.6%] versus TC = 67/260 [25.8%]). Conclusions The findings suggest that a standardized concussion assessment is needed for cyclists who experience major trauma.

Advancing PrEP Delivery: A Randomized Controlled Trial for Use of ePrEP to Expand PrEP Access to Non-Urban Young Black MSM (Preprint)

2019 ◽  
Author(s):  
Aaron J Siegler ◽  
James B Brock ◽  
Christopher B Hurt ◽  
Lauren Ahlschlager ◽  
Karen Dominguez ◽  
...  
Keyword(s):  
United States ◽  
North Carolina ◽  
Randomized Controlled Trial ◽  
Interactive Video ◽  
Small Town ◽  
Positive Impact ◽  
Controlled Trial ◽  
Scale Up ◽  
The United States ◽  
Randomized Controlled

BACKGROUND Pre-exposure prophylaxis (PrEP) is highly efficacious for preventing HIV but has not yet been brought to scale among at-risk persons. In several clinical trials in urban areas, technology-based interventions have shown a positive impact on PrEP adherence. In rural and small-town areas in the United States, which often do not have geographically proximal access to PrEP providers, additional support may be needed. This may be particularly true for younger persons, who are more likely to face multiple barriers to accessing PrEP services. Home-based care, accomplished through a tailored smartphone application (app), specimen self-collection (SSC), and interactive video consultations, could increase both PrEP initiation and persistence in care. OBJECTIVE Our goal is to assess the initiation and persistence in PrEP care for those randomized to a home-care intervention (ePrEP) relative to those assigned to the standard of care (control) condition. We will conduct additional assessments, including quantitative and qualitative analyses, to contextualize trial results and facilitate scale-up. METHODS This two-arm, randomized controlled trial will enroll young men who have sex with men (YMSM) aged 18-24 from rural areas of Georgia, Mississippi, and North Carolina. The trial will seek to recruit a diverse sample, targeting 50% participation among highly impacted groups of Black or Latino MSM. Intervention participants will receive a study app that incorporates a messaging platform, a scheduling and milestone-based tracking system for PrEP care progress, electronic behavioral surveys, and interactive video consultations with a clinician. Complemented by SSC kits mailed to laboratories for standard PrEP-related monitoring, the ePrEP system will allow participants to access PrEP care without leaving their homes. YMSM randomized to the control condition will receive a listing of nearest local PrEP providers to receive standard PrEP care. Both groups will complete quarterly electronic surveys. The primary outcome, assessed at 6 and 12 months after randomization, will be the difference in the proportion of intervention versus control participants that achieve protective levels of the active metabolite of oral PrEP (tenofovir diphosphate). RESULTS Enrollment is anticipated to begin in March 2019, with study completion in 2022. CONCLUSIONS This trial will determine whether home PrEP care provided through an app-based platform is an efficacious means of expanding access to PrEP care for a diverse group of YMSM in rural and small town areas of the United States. CLINICALTRIAL University of North Carolina Institutional Review Board (#18-0107); ClinicalTrials.gov NCT03729570

scholarly journals 316. Hepatitis C and Engagement in Health Care Among Persons Who Inject Drugs and Persons Who Use Non-Injection Drugs, Philadelphia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S167-S168
Author(s):  
Eman Addish ◽  
Hannah Zellman ◽  
Jay Kostman ◽  
Kendra Viner ◽  
Danica Kuncio ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Use ◽  
Harm Reduction ◽  
Sexual Behaviors ◽  
The United States ◽  
Persons Who Inject Drugs ◽  
Hcv Transmission ◽  
Reduction Methods ◽  
Associated Risk Factors ◽  
Unsafe Injection

Abstract Background The growing opioid epidemic is driving increasing rates of hepatitis C virus (HCV) infections in the United States. HCV transmission is most frequently attributed to unsafe injection behaviors, but can occur via other unsafe drug use and sexual behaviors. Differences in demographics, HCV rates and associated risk factors in non-injecting PWUD (NIPWUD), compared with people who inject drugs (PWID) must be understood in order to target elimination strategies. Methods Change is Philadelphia’s program to eliminate HCV among PWUD and enrollment includes HCV testing, linkage services, and an interviewer-administered survey including risk behaviors and healthcare engagement. This interim analysis includes the first 835 enrollees that identified as PWUD. For this analysis, PWID are enrollees who indicated ever injecting drugs and those who had not are NIPWUD. Results Among enrollees, 76% (N = 637) reported ever injecting drugs. PWIDs were younger and non-Hispanic (NH) white while NIPWUD were older and NH Black (age: P = 0.003; race/ethnicity: P < 0.0001). NIPWUDs had a high seropositivity rate though significantly lower than PWIDs (24% vs. 85%, respectively; P < 0.0001). Among PWID enrollees, 94% (N = 596) ever snorted. Of enrollees, 63% (N = 124) of NIPWUD and 56% (N = 356) of PWID identified having a PCP (P =0.07). PWIDs are more likely than NIPWUD to have overdosed (OD) (40% vs. 9%; P < 0.0001) though high rates of both groups ever witnessed an OD (84% vs. 67%, respectively). While 80% (N = 105) of NIPWUDs know how to use Narcan, 60% (N = 79) carry it, {94% (N = 503) and 71%(N = 381) in PWID, respectively}. NIPWUDs are more likely to be interested in drug treatment (P < 0.0001) and to have received it in the last 12 months (P = 0.0008). Conclusion Notable HCV infection exists among non-injecting PWUD reinforcing the need for harm reduction counseling and access to drug use equipment used for smoking and snorting. NIPWUD may be able to access drug and HCV treatment through PCPs and fatal ODs may be prevented by ensuring NIPWUDs have access to Narcan. In addition, PWID are likely to snort as well and should be counseled on non-injecting harm reduction methods. To succeed in micro elimination among PWUD, a focus on NIPWUDs as well as PWIDs is necessary to mitigate transmission of HCV. Disclosures All authors: No reported disclosures.

Agriculture-based community engagement in rural libraries

2021 ◽  
pp. 096100062110157
Author(s):  
Vandana Singh ◽  
Bharat Mehra ◽  
Everett Scott Sikes
Keyword(s):  
United States ◽  
Community Engagement ◽  
Online Survey ◽  
Positive Impact ◽  
Community Gardens ◽  
The United States ◽  
Limited Resources ◽  
Farmers Market ◽  
Library Community ◽  
Rural Libraries

Community engagement in rural libraries receives little focus and is an overlooked area of research. In this article, we report exemplars of agriculture-based community engagement in rural and Southern and Central Appalachian region of the United States. An online survey of rural library professionals demonstrates the positive impact of agriculture-based engagement activities on the overall community-engagement initiatives in this region. This article synthesizes eight distinct agriculture-based initiatives with many subprojects, lists an inventory of stakeholders involved in agriculture-based community-engagement initiatives, and highlights the challenges faced by the rural libraries. Three successful examples, namely, seed library, community gardens, and farmers’ market initiatives, are presented with details to help other libraries adopt these successful community-engagement initiatives. The results show that rural libraries are very creative with their limited resources and they hit many areas of impact in the community through their community-engagement activities.

scholarly journals Predictors of household food insecurity in the United States during the COVID-19 pandemic

2020 ◽  
Author(s):  
Brianna N Lauren ◽  
Elisabeth R Silver ◽  
Adam S Faye ◽  
Jennifer A Woo Baidal ◽  
Elissa M Ozanne ◽  
...  
Keyword(s):  
United States ◽  
Food Insecurity ◽  
Online Survey ◽  
Multivariable Analysis ◽  
The United States ◽  
Economic Stress ◽  
Household Food Security ◽  
Household Food Insecurity ◽  
Convenience Sample ◽  
Household Food

Objective: To examine associations between sociodemographic and mental health characteristics with household food insecurity as a result of the COVID-19 outbreak. Design: Cross-sectional online survey analyzed using univariable tests and a multivariable logistic regression model. Setting: The United States during the week of March 30, 2020. Participants: Convenience sample of 1,965 American adults using Amazon's Mechanical Turk (MTurk) platform. Participants reporting household food insecurity prior to the pandemic were excluded from analyses. Results: 1,517 participants reported household food security before the COVID-19 outbreak. Among this subset, 30% reported food insecurity after the COVID-19 outbreak, 53% were women and 72% were white. On multivariable analysis, race, income, relationship status, anxiety, and depression were significantly associated with incident household food insecurity. Black respondents, Hispanic/Latino respondents, and respondents with annual income less than $100,000 were significantly more likely to experience incident household food insecurity. Individuals experiencing incident household food insecurity were 2.09 (95% CI 1.58-2.83) times more likely to screen positively for anxiety and 1.88 (95% CI 1.37-2.52) times more likely to screen positively for depression. Conclusions: Food insecurity due to the COVID-19 pandemic is common, and certain populations are particularly vulnerable. There are strong associations between food insecurity and anxiety/depression. Public health interventions to increase the accessibility of healthful foods, especially for Black and Hispanic/Latino communities, are crucial to relieving the economic stress of this pandemic.

scholarly journals We Must Do Better: Addressing HCV Treatment Barriers in Persons Who Inject Drugs in the United States

2020 ◽  
Vol 222 (Supplement_9) ◽  
pp. S773-S781
Author(s):  
Stacey B Trooskin ◽  
Gregory Dore ◽  
Jay Kostman
Keyword(s):  
United States ◽  
Harm Reduction ◽  
The United States ◽  
Treatment Barriers ◽  
Treatment Programs ◽  
Opioid Epidemic ◽  
Hcv Treatment ◽  
Persons Who Inject Drugs ◽  
Care Services ◽  
Chronic Hcv

Abstract The opioid epidemic in the United States, along with a lack of adequate harm reduction services, has contributed to a sharp rise in hepatitis C virus (HCV) infections. Despite considerable evidence of the effectiveness of HCV treatment in people who inject drugs (PWID), and recommendations from clinical guidelines to prioritize treatment in PWID, there are multiple barriers to broad uptake of HCV treatment. These barriers exist at the systems level, as well as at the level of medical providers and patients. Interventions to remove treatment barriers in the United States include harm reduction services, simplifying HCV testing algorithms, improved linkage to HCV care services, and application of new treatment models including colocating services at substance use disorder treatment programs. By following the lead of other countries who have addressed the barriers to HCV treatment, the United States has opportunities to do better in addressing the consequences of the opioid epidemic, including chronic HCV infection.

scholarly journals Situational Use of Child Restraint Systems and Carpooling Behaviors in Parents and Caregivers

2018 ◽  
Vol 15 (8) ◽  
pp. 1788 ◽  
Author(s):  
Catherine McDonald ◽  
Erin Kennedy ◽  
Linda Fleisher ◽  
Mark Zonfrillo
Keyword(s):  
Online Survey ◽  
Motor Vehicle ◽  
The United States ◽  
Motor Vehicle Crash ◽  
Descriptive Statistics ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Booster Seat ◽  
Booster Seats ◽  
Child Restraint

Suboptimal compliance with child restraint system (CRS) recommendations can increase risk for injury or death in a motor vehicle crash. The purpose of this study was to examine scenarios associated with incomplete CRS use and non-use in children ages 4–10 years. We used a cross-sectional online survey with a convenience sample of parent/caregivers from the United States, age ≥18 years, with a child age 4–10 years in their home, who could read and spoke English, and drove child ≥6 times in previous three months. We used descriptive statistics and Mann-Whitney U to describe and compare the distribution of responses to situational use of CRSs among car seat users and booster seat users. We also used descriptive statistics and the Mann-Whitney U to describe and compare the distribution of responses to carpooling items among booster seat users and non-booster seat users. There were significant differences among those who reported most often using booster seats (n = 282) and car seats (n = 127) in situations involving rental cars, driving just around the corner, car too crowded to fit the CRS, not enough CRSs in the vehicle, the CRS is missing from the car, or the child is in someone else’s car without a CRS (p < 0.05). Among those who reported most often using booster seats and who carpooled other children (n = 159), 71.7% (n = 114) always used a booster seat for their own child. When carpooling other children, booster seat users were significantly more likely to use booster seats for other children ages 4–10 than the non-booster seat users (p < 0.01). Continued education and programs surrounding CRS use is critical, particularly for children who should be in booster seats.

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