Our overall goal was to enhance the usability and interactivity of the RE-AIM website (re-aim.org) and improve resources to support the application of the RE-AIM framework within the context of dissemination & implementation (D&I) research and practice.

We applied a mixed-methods approach to obtain user feedback from 24 D&I researchers and practitioners. Usability (System Usability Scale) and interactivity (Interactivity Scale) were assessed through validated surveys, at baseline and after two iterative rounds of website modifications (Phase 1 and Phase 2). We also conducted qualitative assessments at each phase.

Qualitative baseline and Phase 1 findings indicated a need to simplify organization, enhance information accessibility, provide concrete guidance on applying RE-AIM, and clarify contextual factors related to RE-AIM constructs. After streamlining website and homepage organization, Phase 2 qualitative results suggested improved user navigation experience; users also requested greater interactivity. Modifications included: new interactive planning tool and a video introduction of contextual factors influencing RE-AIM outcomes. Significant improvements were found in the SUS score from baseline to Phase 1(64.2[SD18.7] to 80.8 [SD 12.1] (p < .05) and remained higher in Phase 2(77.1[SD 15] (p = 0.08). Interactivity also improved from baseline to Phase 2(3.5[SD1.2] to 41[0.9], though not statistically significant.

User-centered feedback on online resources, as exemplified by this use case example of enhancements to the RE-AIM website, are important in bridging the gap between research and practice, and the revised website should be more accessible and useful to users.

Although dementia is a terminal condition, palliation can be a challenge for clinical services. As dementia progresses, people frequently develop behavioural and psychological symptoms, sometimes so severe they require care in specialist dementia mental health wards. Although these are often a marker of late disease, there has been little research on the mortality of people admitted to these wards.

We sought to describe the mortality of this group, both on-ward and after discharge, and to investigate clinical features predicting 1-year mortality.

First, we conducted a retrospective analysis of 576 people with dementia admitted to the Cambridgeshire and Peterborough National Health Service (NHS) Foundation Trust dementia wards over an 8-year period. We attempted to identify predictors of mortality and build predictive machine learning models. To investigate deaths occurring during admission, we conducted a second analysis as a retrospective service evaluation involving mental health wards for people with dementia at four NHS trusts, including 1976 admissions over 7 years.

Survival following admission showed high variability, with a median of 1201 days (3.3 years). We were not able to accurately predict those at high risk of death from clinical data. We found that on-ward mortality remains rare but had increased from 3 deaths per year in 2013 to 13 in 2019.

We suggest that arrangements to ensure effective palliation are available on all such wards. It is not clear where discussions around end-of-life care are best placed in the dementia pathway, but we suggest it should be considered at admission.

Inadequate recruitment and retention impede clinical trial goals. Emerging decentralized clinical trials (DCTs) leveraging digital health technologies (DHTs) for remote recruitment and data collection aim to address barriers to participation in traditional trials. The ACTIV-6 trial is a DCT using DHTs, but participants’ experiences of such trials remain largely unknown. This study explored participants’ perspectives of the ACTIV-6 DCT that tested outpatient COVID-19 therapeutics.

Participants in the ACTIV-6 study were recruited via email to share their day-to-day trial experiences during 1-hour virtual focus groups. Two human factors researchers guided group discussions through a semi-structured script that probed expectations and perceptions of study activities. Qualitative data analysis was conducted using a grounded theory approach with open coding to identify key themes.

Twenty-eight ACTIV-6 study participants aged 30+ years completed a virtual focus group including 1–4 participants each. Analysis yielded three major themes: perceptions of the DCT experience, study activity engagement, and trust. Participants perceived the use of remote DCT procedures supported by DHTs as an acceptable and efficient method of organizing and tracking study activities, communicating with study personnel, and managing study medications at home. Use of social media was effective in supporting geographically dispersed participant recruitment but also raised issues with trust and study legitimacy.

While participants in this qualitative study viewed the DCT-with-DHT approach as reasonably efficient and engaging, they also identified challenges to address. Understanding facilitators and barriers to DCT participation and DHT interaction can help improve future research design.

Agricultural workers such as migrant and seasonal farmworkers are a population uniquely vulnerable to the negative effects of climate-related disasters. The primary aim of this study was to assess how counties in eastern North Carolina (NC) incorporated best practices related to agricultural workers in emergency preparedness planning.

The authors conducted a quantitative content analysis of 47 emergency preparedness plans from 41 eastern NC counties between November 2022 and March 2023. The research team developed a codebook based on recommended best practices from the Centers for Disease Control and Prevention, Farmworker Advocacy Network, Federal Emergency Management Agency, and National Center for Farmworker Health. Best practices included having materials in Spanish language, mapping vulnerable populations, and garnering input from agricultural workers.

Of the 47 plans evaluated, most lacked inclusion of agricultural workers in emergency preparedness planning. Furthermore, plans demonstrated few relevant best practices that address agricultural workers’ specific challenges in preparation for and recovery from climate-related disasters.

Public emergency preparedness plans in eastern NC rarely include mention of recommended best practices related to agricultural workers. Local emergency preparedness officials should consider collaboration with advocacy groups, community health workers, and federal emergency management agencies to build disaster resilience.

Emerging evidence suggests that routine physical activity may improve exercise capacity, long-term outcomes, and quality of life in individuals with Fontan circulation. Despite this, it is unclear how active these individuals are and what guidance they receive from medical providers regarding physical activity. The aim of this study was to survey Fontan patients on personal physical activity behaviours and their cardiologist-directed physical activity recommendations to set a baseline for future targeted efforts to improve this.

An electronic survey assessing physical activity habits and cardiologist-directed guidance was developed in concert with content experts and patients/parents and shared via a social media campaign with Fontan patients and their families.

A total of 168 individuals completed the survey. The median age of respondents was 10 years, 51% identifying as male. Overall, 21% of respondents spend > 5 hours per week engaged in low-exertion activity and only 7% spend > 5 hours per week engaged in high-exertion activity. In all domains questioned, pre-adolescents reported higher participation rates than adolescents. Nearly half (43%) of respondents reported that they do not discuss activity recommendations with their cardiologist.

Despite increasing evidence over the last two decades demonstrating the benefit of exercise for individuals living with Fontan circulation, only a minority of patients report engaging in significant amounts of physical activity or discussing activity goals with their cardiologist. Specific, individualized, and actionable education needs to be provided to patients, families, and providers to promote and support regular physical activity in this patient population.

This study aims to determine whether ultra-processed foods (UPFs) are being discussed in news media in Australia and whether this terminology, as described in the NOVA system, is being applied accurately.

Interpretive content analysis of online and print media articles that mentioned UPFs from 2009 to 2023 in Australia.

Australia.

Online and print media articles.

A total of two hundred ninety-eight Australian media articles were captured. A substantial increase in the number of UPF articles was observed between 2017–2019 and 2021–2023. The UPF concept was inaccurately explained or defined in 32 % of the articles and was frequently used interchangeably with other descriptors, such as ‘highly or heavily processed food’, ‘junk food’, ‘unhealthy food’, ‘packaged food’ and ‘discretionary food’. Most of the articles had a health focus; however, sustainability interest increased, particularly in the past 18 months.

UPFs are increasingly being discussed in news media in Australia; however, the concept is still incorrectly presented in over a third of articles. This highlights the importance of improving the literacy about UPFs to ensure that messages are communicated in a way that is salient, accessible and accurate.

Much of the pediatric concussion literature focuses on sports and recreation related injuries, while there is a relative paucity of research on the cognitive and psychological sequelae associated with assault. However, it is understood that children with assault-related injuries demonstrate a longer recovery time. This case series reviews the data of four teenagers who were administered cognitive, emotional, and behavioral screeners after sustaining an assault related concussion.

Four pediatric female patients (ages 13,14,15,15) with a recent history of concussion due to physical assault presented for evaluation at a hospital-based concussion clinic. All four patients were administered a computerized cognitive screener as well as self-report measures for mood, anxiety, post-traumatic stress disorder (PTSD), and sleep disturbance.

All four of the pediatric cases reported significant symptoms of PTSD, depression, anxiety, and sleep disturbance. For all four patients, the most notable problems across cognitive performance measures were observed in the areas of simple and complex attention.

Results of this case series revealed clinically significant anxiety, depression, PTSD-symptoms, and sleep disturbance in conjunction with poor simple and complex attention. These pediatric cases illustrate the potential link between assault-related concussions, emotional and behavioral symptoms, and cognitive functioning. Furthermore, assault-related concussions may elevate risk toward attentional problems associated with psychological distress. Early evaluation of PTSD and mood related symptomatology is suggested to best support treatment planning and recovery in this population. Future studies are needed to explore the nature of the relationship between cognitive and emotional sequelae in patients who present with assault-related concussions.

hough there is much that is unknown about “post-COVID conditions” the Center for Disease Control (CDC) recognizes that these conditions represent a wide array of new, returning, or ongoing health issues in individuals who have been infected with the novel corona virus, COVID-19. This case series describes the emotional and cognitive screening of three females in their 50's who contracted COVID-19, and were hospitalized during the course of their illness. This case series hopes to provide an initial framework to discuss the recovery trajectory of post-COVID patients who were hospitalized, who have experienced residual post-traumatic stress and cognitive symptoms.

Three middle-aged female patients (ages 52, 53, 55) were screened in an outpatient post-COVID recovery center for initial and post-COVID emotional, cognitive, and physical symptoms. All three women reported being hospitalized during their illness. The Post-Traumatic Stress Disorder - Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) was administered via clinical interview and the patients were asked about subjective cognitive complaints related to concentration, memory, and word finding.

All three women reported persisting cognitive problems, including difficulties with concentration, problems with memory, and word finding difficulties. They also endorsed symptoms of post-traumatic stress, such as avoidance of thoughts and events, as well as recurrent nightmares related to the course of their illness.

The CDC notes that there are no tests that specifically evaluate the multitude of post-COVID conditions. Regardless, this case series suggests that emotional and cognitive screeners may assist in treatment planning and support recovery in this population. Future research should examine the exact nature of the relationship between hospitalization, emotional symptoms, and cognitive functioning in post-COVID patients.

The slow adoption of evidence-based interventions reflects gaps in effective dissemination of research evidence. Existing studies examining designing for dissemination (D4D), a process that ensures interventions and implementation strategies consider adopters’ contexts, have focused primarily on researchers, with limited perspectives of practitioners. To address these gaps, this study examined D4D practice among public health and clinical practitioners in the USA.

We conducted a cross-sectional study among public health and primary care practitioners in April to June 2022 (analyzed in July 2022 to December 2022). Both groups were recruited through national-level rosters. The survey was informed by previous D4D studies and pretested using cognitive interviewing.

Among 577 respondents, 45% were public health and 55% primary care practitioners, with an overall survey response rate of 5.5%. The most commonly ranked sources of research evidence were email announcements for public health practitioners (43.7%) and reading academic journals for clinical practitioners (37.9%). Practitioners used research findings to promote health equity (67%) and evaluate programs/services (66%). A higher proportion of clinical compared to public health practitioners strongly agreed/agreed that within their work setting they had adequate financial resources (36% vs. 23%, p < 0.001) and adequate staffing (36% vs. 24%, p = 0.001) to implement research findings. Only 20% of all practitioners reported having a designated individual or team responsible for finding and disseminating research evidence.

Addressing both individual and modifiable barriers, including organizational capacity to access and use research evidence, may better align the efforts of researchers with priorities and resources of practitioners.