The Effect of Race and Dementia Prevalence on a COVID-19 Infection Control Intervention in Massachusetts Nursing Homes

Background Nursing home (NH) residents, especially those who were Black or with dementia, had the highest infection rates during the COVID-19 pandemic. A 9-week COVID-19 infection control intervention in 360 Massachusetts NHs showed adherence to an infection control checklist with proper personal protective equipment (PPE) use and cohorting was associated with declines in weekly infection rates. NHs were offered weekly webinars, answers to infection control questions, resources to acquire PPE, backup staff, and SARS-CoV-2 testing. We asked whether the effect of this intervention differed by racial and dementia composition of the NHs. Methods Data were obtained from 4 state audits using infection control checklists, weekly infection rates, and Minimum Data Set variables on race and dementia to determine whether adherence to checklist competencies was associated with decline in average weekly rates of new COVID-19 infections. Results Using a mixed-effects hurdle model, adjusted for county COVID-19 prevalence, we found the overall effect of the intervention did not differ by racial composition, but proper cohorting of residents was associated with a greater reduction in infection rates among facilities with ≥20% non-Whites (n = 83). Facilities in the middle (>50%–62%; n = 121) and upper (>62%; n = 115) tertiles of dementia prevalence had the largest reduction in infection rates as checklist scores improved. Cohorting was associated with greater reductions in infection rates among facilities in the middle and upper tertiles of dementia prevalence. Conclusions Adherence to proper infection control procedures, particularly cohorting of residents, can reduce COVID-19 infections, even in facilities with high percentages of high-risk residents (non-White and dementia).

Effect of Race and Dementia Prevalence on a COVID-19 Infection Control Intervention in Massachusetts Nursing Homes

Nursing home (NH) residents, especially those who were Black or had dementia, had the highest infection rates during the COVID-19 pandemic. A 9-week COVID-19 infection control intervention in 360 Massachusetts NHs showed that adherence to an infection control checklist with proper PPE use and cohorting, was associated with declines in weekly infection rates. NHs were offered weekly webinars, answers to infection control questions, resources to acquire personal protective equipment, backup staff, and SARS-CoV-2 testing. We asked whether the effect of this intervention differed by racial and dementia composition of the NHs. Data were obtained from 4 state audits using infection control checklists, weekly infection rates, and Minimum Data Set variables on race and dementia to determine whether adherence to the checklist competencies was associated with decline in average weekly rates of new COVID-19 infections. Using a mixed effects hurdle model, adjusted for county COVID-19 prevalence, we found that the overall effect of the intervention did not differ by race, but proper cohorting of residents was associated with a greater reduction in infection rates among facilities with ≥20% non-whites (n=83). Facilities in the middle (50-61%; n=116) and upper (>61%; n=118) tertiles of dementia prevalence had the largest reduction in infection rates as checklist scores improved. Cohorting was associated with greater reductions in infection rates among facilities in the middle and upper tertiles of dementia prevalence. Thus, adherence to proper infection control procedures, particularly cohorting, can reduce COVID-19 infections, even in facilities with high percentages of high-risk residents (non-white and dementia).

Long-Term and Transfer Effects of an Action Control Intervention in Overweight Couples: A Randomized Controlled Trial Using Text Messages

Keeping a physically active lifestyle requires consistent self-regulatory effort such as action control (e.g., continuously monitoring and evaluating a behavior in terms of one’s goals). Involving the romantic partner in interventions might be particularly effective in the long run. The present study examined the long-term and transfer effects of an action control intervention in couples using text messaging for promoting target persons’ and partners’ physical activity, anthropometric measures and physical fitness 6 months post baseline. A total of 121 overweight and obese romantic couples, randomly allocated to an intervention (n = 60; information + action control text messages) or a control group (n = 61; information only) and to participating as target person or partner, completed baseline assessments (T1). 100 couples (82.6%) completed the 6-month follow-up (T3) assessment. Primary outcomes included self-reported moderate-to-vigorous physical activity (MVPA) and objective MVPA and MVPA adherence using triaxial accelerometers across a diary period of 14 days after T3. Secondary outcomes included BMI, waist-to-hip circumference and physical fitness (target persons only) using a submaximal aerobic cycle test. At T3, there were no significant between-group differences between target persons and partners with regard to their objective MVPA, self-reported MVPA, BMI, waist-hip ratio or physical fitness. No significant changes in outcomes were observed from T1 to T3; however, changes in BMI from T1 to T3 between target persons and partners in the intervention group were associated. Overall, the brief 14-days action control intervention was not effective in improving target person’s physical activity, body measures and physical fitness in the long-term. Moreover, no long-term benefits for partners emerged. While brief ecological momentary interventions might be a promising tool for short-term effects, future studies are needed to test features enhancing long-term effectiveness. Associations in romantic partners’ changes suggest that dyadic interventions can be a promising approach, as changes induced in one partner may then transfer over to the other (controlled-trials.com ISRCTN15705531).

The Effect of Single Sessions of Music Therapy on the Level of Anxiety in Older Persons with Psychiatric Disorders: A Pilot Study

<p>This pilot study examined the effects of single sessions of music therapy on the level of anxiety in older persons with psychiatric disorders. The studied intervention was a 30 minute music therapy group and the control intervention was a verbal therapeutic intervention in the form of a reminiscence group. Participants acted as their own control. The measurement tool was the state part of a "State Trait Anxiety Inventory". It was administered a total of four times, pre- and post- the music therapy intervention and pre- and post- the reminiscence therapy (control) group. A total of 9 participants were recruited for the study. The results indicated that single sessions of music therapy significantly reduced the level of anxiety for older persons with psychiatric disorders [t(8)=4.626, p<0.0017] as compared to the control intervention as measured by the state part of the "State Trait Anxiety Inventory". There was no evidence for a significant carryover effect since the baselines prior to each intervention did not differ significantly (p=0.55). These results can be considered to be a part of a pilot study and early inquiry into this field since methodological difficulties and the time limitation of the research resulted in some necessary deviations from the original protocol. A major limitation of the study was the choice of a measurement tool, which required the client to be cognitively high functioning. Thus these results are limited to cognitively able clients, which is a relatively small proportion of this client group that could potentially benefit from music therapy. It is suggested that for future research with this client group the measured variable be physical relaxation, rather than anxiety.</p>

The Effect of Single Sessions of Music Therapy on the Level of Anxiety in Older Persons with Psychiatric Disorders: A Pilot Study

<p>This pilot study examined the effects of single sessions of music therapy on the level of anxiety in older persons with psychiatric disorders. The studied intervention was a 30 minute music therapy group and the control intervention was a verbal therapeutic intervention in the form of a reminiscence group. Participants acted as their own control. The measurement tool was the state part of a "State Trait Anxiety Inventory". It was administered a total of four times, pre- and post- the music therapy intervention and pre- and post- the reminiscence therapy (control) group. A total of 9 participants were recruited for the study. The results indicated that single sessions of music therapy significantly reduced the level of anxiety for older persons with psychiatric disorders [t(8)=4.626, p<0.0017] as compared to the control intervention as measured by the state part of the "State Trait Anxiety Inventory". There was no evidence for a significant carryover effect since the baselines prior to each intervention did not differ significantly (p=0.55). These results can be considered to be a part of a pilot study and early inquiry into this field since methodological difficulties and the time limitation of the research resulted in some necessary deviations from the original protocol. A major limitation of the study was the choice of a measurement tool, which required the client to be cognitively high functioning. Thus these results are limited to cognitively able clients, which is a relatively small proportion of this client group that could potentially benefit from music therapy. It is suggested that for future research with this client group the measured variable be physical relaxation, rather than anxiety.</p>

The Role of Community Health Advisors’ Cancer History in Implementation and Efficacy of a Cancer Control Intervention

Purpose: Community health advisors (CHAs) play a key role in promoting health in medically underserved communities, including in addressing cancer disparities. There is a need to expand the research on what criteria makes for an effective CHA. We examined the relationship between CHAs’ personal and family history of cancer, and implementation and efficacy outcomes in a cancer control intervention trial.Methods: Twenty-eight trained CHAs implemented a series of three cancer educational group workshops for N=375 workshop participants across 14 churches. Implementation was operationalized as participant attendance at the educational workshops and efficacy as workshop participants’ cancer knowledge scores at 12-month follow-up, controlling for baseline scores. Results: CHA’s personal history of cancer was not significantly associated with implementation, nor knowledge outcomes. However, CHAs with family history of cancer had significantly greater participant attendance at the workshops than CHAs without family history of cancer (p=.03). In addition, there was a significant, positive association between male CHAs’ family history of cancer and male workshop participants’ prostate cancer knowledge scores at 12 months (estimated beta coefficient=0.49, p<.01) after adjusting for workshop participant baseline knowledge scores, the CHAs’ competence score, and the CHAs’ education levels. Conclusions: Findings suggest CHAs with family history of cancer may be particularly suitable for cancer peer education, though further research is needed to confirm this and identify other factors conducive to CHAs’ success.

A Yeast RNA-Interference Pesticide Targeting the Irx Gene Functions as a Broad-Based Mosquito Larvicide and Adulticide

Concerns for widespread insecticide resistance and the unintended impacts of insecticides on nontarget organisms have generated a pressing need for mosquito control innovations. A yeast RNAi-based insecticide that targets a conserved site in mosquito Irx family genes, but which has not yet been identified in the genomes of nontarget organisms, was developed and characterized. Saccharomyces cerevisiae constructed to express short hairpin RNA (shRNA) matching the target site induced significant Aedes aegypti larval death in both lab trials and outdoor semi-field evaluations. The yeast also induced high levels of mortality in adult females, which readily consumed yeast incorporated into an attractive targeted sugar bait (ATSB) during simulated field trials. A conserved requirement for Irx function as a regulator of proneural gene expression was observed in the mosquito brain, suggesting a possible mode of action. The larvicidal and adulticidal properties of the yeast were also verified in Aedes albopictus, Anopheles gambiae, and Culexquinquefasciatus mosquitoes, but the yeast larvicide was not toxic to other nontarget arthropods. These results indicate that further development and evaluation of this technology as an ecofriendly control intervention is warranted, and that ATSBs, an emerging mosquito control paradigm, could potentially be enriched through the use of yeast-based RNAi technology.