Taking Financial Literacy Downtown: Leveraging Community Partnerships to Increase Communication of Essential Financial Information in an Urban Area

Financial illiteracy is a systemic issue across the country, especially among lower-income individuals in urban communities. This low level of financial literacy often leads to higher levels of debt, lower credit scores, less wealth accumulation, and poor retirement planning. Increasing financial literacy in these priority populations can be effective in combatting some of these negative financial outcomes. This study emerged from a partnership between community organizations in a large urban metropolitan area and scholars from diverse disciplinary backgrounds. Guided by formative research principles, this manuscript reports on research findings derived from several focus groups with community members. These focus groups helped to identify existing perceived financial knowledge levels, categorize barriers to enhancing financial literacy, and illuminate potentially pathways to effective financial literacy program development.

Biodiversity Hotspots for Conservation of Hancornia speciosa GOMES

Hancornia speciosa is the target of research on genetic diversity, ethnobotanical and medicinal studies. However, information on the genetic variability of populations associated with modeling the potential distribution in the state of Sergipe has not yet been performed. The objective of this study was to predict the potential occurrence of H. speciosa in areas of high use of their fruits. The maximum entropy method was used to detect the distribution patterns of H. speciosa in variable environments. The diversity of four natural populations, situated in areas of extractivist, was determined by ISSR molecular markers. The species occurs more densely in the coastal regions of Sergipe. The prediction of occurrence indicates that the species reduces areas of occurrence, mainly due to anthropic actions. It is suggested that the species needs public policies aimed at its conservation and the priority populations for conservation.

The changing retail landscape for tobacco: dollar stores and the availability of cheap cigarettes among tobacco-related priority populations

IntroductionDollar stores are rapidly altering the retail landscape for tobacco. Two of the three largest chains sell tobacco products in more than 24 000 stores across the USA. We sought to examine whether dollar stores are more likely to be located in disadvantaged neighbourhoods and whether dollar stores charge less for cigarettes than other tobacco retailers.MethodsData were collected from a statewide random sample of licensed tobacco retailers in California (n=7678) in 2019. Logistic regression modelled odds of a census tract containing at least one dollar store as a function of tract demographics. Linear mixed models compared price of the cheapest cigarette pack by store type, controlling for tract demographics.ResultsCensus tracts with lower median household income, rural status and higher proportions of school-age youth were more likely to contain at least one dollar store. The cheapest cigarette pack cost less in dollar stores compared with all store types examined except tobacco shops. Estimated price differences ranged from $0.32 (95% CI: 0.14 to 0.51) more in liquor stores and $0.39 (95% CI: 0.22 to 0.57) more in convenience stores, to $0.82 (95% CI: 0.64 to 1.01) more in small markets and $1.86 (95% CI: 1.61 to 2.11) more in stores classified as ‘other’.ConclusionsDollar stores may exacerbate smoking-related inequities by contributing to the availability of cheaper cigarettes in neighbourhoods that are lower income, rural and have greater proportions of youth. Pro-equity retail policies, such as minimum price laws and density reduction policies, could mitigate the health consequences of dollar stores’ rapid expansion.

Challenging the HIV Epidemic in Ontario Through PrEP and HIV Testing

The Ontario HIV Treatment Network (OHTN) is a non-profit network which collaborates with health clinics, AIDS service and community organizations, and policy leaders in order to improve the health and wellbeing of people living with and at risk of HIV. I joined the OHTN as a member of the Collective Impact team, with a focus on examining the barriers and facilitators to Pre-Exposure Prophylaxis (PrEP) uptake in Ontario. PrEP is a once-daily pill which is highly effective in preventing HIV infections for HIV-negative people, however usage remains relatively low in Ontario. In this role, I liaised with the Knowledge Synthesis team at OHTN to collect, analyse, and synthesize recent scientific literature on Pre and Post-exposure prophylaxis (PEP) in order to create a comprehensive annotated bibliography on PrEP research. Key findings were drawn from the research to identify potential next steps to increase PrEP use for priority populations in Ontario. Findings from the annotated bibliography were presented to OHTN staff, and have been used to assist in the development of two PrEP study proposals; 1) a cisgender and transgender women-focused PrEP education package and HIV risk screening tool, and 2) a pharmacist-led PrEP delivery pilot. I also worked with the Testing and Clinical Initiatives team at the OHTN, to aid in the implementation and evaluation of two HIV-testing projects: the GetaTest pharmacy-based HIV-testing study, and the GetaKit HIV self-testing pilot program. In this role I drafted health communication materials; analysed survey data and drafted project reports for stakeholders; and provided perspectives on the HIV-care continuum, particularly on PrEP initiation, adherence, and efficacy. My work with the OHTN was important to public health because it sought to expand access to HIV testing and prevention services for priority populations in Ontario, including men who have sex with men, and cis and trans women.

1206Will access to Covid-19 vaccine in Aotearoa be equitable for priority populations?

Background This research examines the equity implications of the geographic distribution of COVID-19 vaccine delivery locations in Aotearoa New Zealand under five potential scenarios: (1) stadium mega-clinics; (2) Community Based Assessment Centres; (3) GP clinics; (4) community pharmacies; and (5) schools. Methods We mapped the distribution of Aotearoa New Zealand’s population and the location of potential vaccine delivery facilities under each scenario. Geostatistical techniques identified population clusters for Māori, Pacific and people aged 65 years and over. We calculated travel times between all potential facilities and each Statistical Area 1 in the country. Descriptive statistics indicate the size and proportion of populations that could face significant travel barriers when accessing COVID-19 vaccinations. Results Several areas with significant travel times to potential vaccine delivery sites were also communities identified as having an elevated risk of COVID-19 disease and severity. All potential scenarios for vaccine delivery, with the exception of schools, resulted in travel barriers for a substantial proportion of the population. Overall, these travel time barriers disproportionately burden Māori, older communities and people living in areas of high socioeconomic deprivation. Conclusions The equitable delivery of COVID-19 vaccines is key to an elimination strategy. However, if current health services and facilities are used without well-designed and supported outreach services, then access to vaccination is likely to be inequitable. Key messages Organisations need to proactively plan for equity, including the delivery of COVID-19 vaccines. A social justice approach should be prioritised, and in Aotearoa Te Tiriti o Waitangi obligations must be met.

Spatial equity of COVID-19 vaccination services in Aotearoa

Aim: This research examines the spatial equity, and associated health equity implications, of the geographic distribution of Covid-19 vaccination services in Aotearoa New Zealand. Method: We mapped the distribution of Aotearoa's population and used the enhanced-two-step-floating-catchment-method (E2SFCA) to estimate spatial access to vaccination services, taking into account service supply, population demand, and distance between populations and services. We used the Gini coefficient and both global and local measures of spatial autocorrelation to assess the spatial equity of vaccination services across Aotearoa. Additional statistics included an analysis of spatial accessibility for priority populations, including Māori (Indigenous people of Aotearoa), Pacific, over 65-year-olds, and people living in areas of high socioeconomic deprivation. We also examined vaccination service access according to rurality, and by District Health Board region. Results: Spatially accessibility to vaccination services varies across Aotearoa, and appears to be better in major cities than rural regions. A Gini coefficient of 0.426 confirms that spatial accessibility scores are not shared equally across the vaccine-eligible population. Furthermore, priority populations including Māori, older people, and residents of areas with socioeconomic constraint have, on average, statistically significantly lower spatial access to vaccination services. This is also true for people living in rural areas. Spatial access to vaccination services, also varies significantly by District Health Board (DHB) region as does equality of access, and the proportion of DHB priority population groups living in areas with poor access to vaccination services. A strong and significant positive correlation was identified between average spatial accessibility and the Māori vaccination rate ratio of DHBs. Conclusion: Covid-19 vaccination services in Aotearoa are not equitably distributed. Priority populations, with the most pressing need to receive Covid-19 vaccinations, have the worst access to vaccination services.

Diffusion of sylvatic yellow fever in the state of São Paulo, Brazil

We investigated the sylvatic yellow fever (SYF) diffusion process in São Paulo (SP) between 2016 and 2019. We developed an ecological study of SYF through autochthonous human cases and epizootics of non-human primates (NHPs) that were spatiotemporally evaluated. We used kriging to obtain maps with isochrones representative of the evolution of the outbreak and characterized its diffusion pattern. We confirmed 648 human cases of SYF in SP, with 230 deaths and 843 NHP epizootics. Two outbreak waves were identified: one from West to East (2016 and 2017), and another from the Campinas region to the municipalities bordering Rio de Janeiro, Minas Gerais, and Paraná and those of the SP coast (2017–2019). The SYF outbreak diffusion process was by contagion. The disease did not exhibit jumps between municipalities, indicating that the mosquitoes and NHPs were responsible for transmitting the virus. There were not enough vaccines to meet the population at risk; hence, health authorities used information about the epizootic occurrence in NHPs in forest fragments to identify priority populations for vaccination.

Promoting Safe Sleep, Tobacco Cessation and Breastfeeding to Rural Women during the COVID-19 Pandemic (Preprint)

BACKGROUND Safe Sleep Community Baby Showers address strategies to prevent sleep-related infant deaths. Due to the COVID-19 pandemic, these events transitioned from in-person to virtual. OBJECTIVE This study seeks to describe the outcomes of transitioning Safe Sleep Community Baby Showers to a virtual format and comparing outcomes to previous in-person events. METHODS Participants from four rural Kansas counties were emailed the pre-survey, provided educational materials (videos, live-stream or digital documents), and completed a post-survey. Those who completed both surveys received a portable crib and wearable blanket. Within group comparisons were assessed between pre- and post-surveys; between group comparisons (virtual vs in-person) were assessed by post-surveys. RESULTS Based on data from 74 virtual and 143 in-person participants, virtual participants were more likely to be married (p<.001), have private insurance (p<.001), and less likely to report tobacco use (p<.001). Both event formats significantly increased knowledge and intentions regarding safe sleep and avoidance of second-hand smoke (all p≤.001). Breastfeeding intentions did not change. Differences were observed between virtual and in-person participants regarding confidence in ability to avoid second-hand smoke (72% vs 84%; p=.031), intention to breastfeed ≥6 months (79% vs 62%; p=.008) and confidence in ability to breastfeed ≥6 months (64% vs 47%; p=.02). CONCLUSIONS While both event formats demonstrated increase knowledge/intentions to follow safe sleep recommendations, virtual events may further marginalize groups who are high risk for poor birth outcomes. Strategies to increase technology access, recruit priority populations and ensure disparities are not enhanced will be critical for implementation of future virtual events.

Initial implementation of PrEP in Zambia: health policy development and service delivery scale-up

IntroductionDaily pre-exposure prophylaxis (PrEP) for HIV prevention is highly effective, but not yet widely deployed in sub-Saharan Africa. We describe how Zambia developed PrEP health policy and then successfully implemented national PrEP service delivery.Policy developmentZambia introduced PrEP as a key strategy for HIV prevention in 2016, and established a National PrEP Task Force to lead policy advocacy and development. The Task Force was composed of government representatives, regulatory agencies, international donors, implementation partners and civil society organisations. Following an implementation pilot, PrEP was rolled out nationally using risk-based criteria alongside a national HIV prevention campaign.National Scale-upIn the first year of implementation, ending September 2018, 3626 persons initiated PrEP. By September 2019, the number of people starting PrEP increased by over sixfold to 23 327 persons at 728 sites across all ten Zambian provinces. In the first 2 years, 26 953 clients initiated PrEP in Zambia, of whom 31% were from key and priority populations. Continuation remains low at 25% and 11% at 6 and 12 months, respectively.Lessons learntRisk-based criteria for PrEP ensures access to those most in need of HIV prevention. Healthcare worker training in PrEP service delivery and health needs of key and priority populations is crucial. PrEP expansion into primary healthcare clinics and community education is required to reach full potential. Additional work is needed to understand and address low PrEP continuation. Finally, a task force of key stakeholders can rapidly develop and implement health policy, which may serve as a model for countries seeking to implement PrEP.