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There have been 188 rural hospital closures in the United States since 2010 with approximately 20% of these in Appalachia. Telehealth has become a way that nurses can reach rural patients who might not otherwise receive health care. The purpose of this paper is to (1) outline the federal policies enacted during COVID-19 for broadband expansion; and (2) suggest how advanced practice nursing care might be affected by broadband expansion and telehealth in the region. A search of PubMed was conducted in January 2023, using the search words, "policy", "telehealth", "broadband", and "Appalachia". New laws appropriated funds to expand broadband infrastructure that made it possible for telehealth to be used by nurses to deliver health care to rural patients. This discussion paper found that broadband legislation was instrumental in expanding telecommunications and telehealth by NPs. There is a great need for broadband to continue to expand and for trained nurses to provide care via telehealth. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has accelerated acceptance of learning from other countries, especially for high-income countries to learn from low- and middle-income countries, a practice known as global learning. COVID-19’s rapid disease transmission underscored how connected the globe is as well as revealed stark health inequities which facilitated looking outside of one’s borders for solutions. The Global Learning for Health Equity (GL4HE) Network, supported by Robert Wood Johnson Foundation, held a 3-part webinar series in December 2021 to understand the current state of global learning and explore how global learning can advance health equity in the post-COVID-19 era. This paper reflects on these cutting-edge discussions about the current state of global learning, drawing upon the highlights, perspectives, and conclusions that emerged from these webinars. The paper also comments on best practices for global learning, including adapting for context, addressing biases, funding considerations, ensuring bidirectional partnerships, community engagement, and adopting a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Background: Chinese American immigrants have been underrepresented in health research partly due to challenges in recruitment. Objectives: This study aims to describe recruitment and retention strategies and report adherence in a 7-day observational physical activity study of Chinese American immigrants with prior gestational diabetes during the COVID-19 pandemic. Methods: Foreign-born Chinese women aged 18--45 years, with a gestational diabetes index pregnancy of 0.5--5 years, who were not pregnant and had no current diabetes diagnosis were recruited. They wore an accelerometer for 7 consecutive days and completed an online survey. Multiple recruitment strategies were used: (a) culturally and linguistically tailored flyers, (b) social media platforms (e.g., WeChat [a popular Chinese platform] and Facebook), (c) near-peer recruitment and snowball sampling, and (d) a study website. Retention strategies included flexible scheduling and accommodation, rapid communications, and incentives. Adherence strategies included a paper diary and/or automated daily text reminders with a daily log for device wearing, daily email reminders for the online survey, close monitoring, and timely problem-solving. Results: Participants were recruited from 17 states; 108 were enrolled from August 2020 to August 2021. There were 2,479 visits to the study webpage, 194 screening entries, and 149 inquiries about the study. Their mean age was 34.3 years, and the mean length of U.S. stay was 9.2 years. Despite community outreach, participants weremainly recruited fromsocialmedia (e.g., WeChat). The majority were recruited via near-peer recruitment and snowball sampling. The retention rate was 96.3%; about 99% had valid actigraphy data, and 81.7% wore the device for 7 days. The majority of devices were successfully returned, and the majority completed the online survey on time. Discussion: We demonstrated the feasibility of recruiting and retaining a geographically diverse sample of Chinese American immigrants with prior gestational diabetes during the COVID-19 pandemic. Recruiting Chinese immigrants via social media (e.g., WeChat) is a viable approach. Nonetheless, more inclusive recruitment strategies are needed to ensure broad representation from diverse socioeconomic groups of immigrants. [ABSTRACT FROM AUTHOR]

Papers in the Special Section on Racial Disparities in Health Care stemmed from. the 60th Anniversary of Family Process Conference, The Heart of the Matter: Systemic Imperatives to Address Health Disparities and Racism in the Time of COVID, which took place in Washington, DC in September 2021. Of the 12 presenters at the conference, these four were asked to recreate their talks into articles. They address key issues that help to explain health disparities in people of color, particularly African Americans, in the United States, as well as suggest innovations to clinical interventions and health care delivery systems to better serve people who have suffered adversity from the racial inequities in the American system. [ABSTRACT FROM AUTHOR]

Socio-demographic inequities in health treatment and outcomes are not new. However, the COVID-19 pandemic presented new opportunities to examine and address biases. This article describes a scoping review of 170 papers published prior to the onset of global vaccinations and treatment (December 2021). We report differentiated COVID-19-related patient outcomes for people with various socio-demographic characteristics, including the need for intubation and ventilation, intensive care unit admission, discharge to hospice care, and mortality. Using the PROGRESS-Plus framework, we determined that the most researched socio-demographic factor was race/ethnicity/culture/language. Members of minoritized racial and ethnic groups tended to have worse COVID-19-related patient outcomes; more research is needed about other categories of social disadvantage, given the scarcity of literature on these factors at the time of the review. It is only by researching and addressing the causes of social disadvantage that we can avoid such injustice in future public health crises. [ABSTRACT FROM AUTHOR]

Objective The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). Method We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. Results The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. Conclusions More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic of 2020 was one of the rare events that shocked almost every world government simultaneously, thus creating an unusual opportunity to understand how political institutions shape policy decisions. There have been many analyses of what governments did. We focus instead on what they could do, focusing on the institutional politics of agency – how institutions empower rather than how they constrain, and how they affect public policy decisions. We examine public health measures in the first wave (March-September 2020) in Brazil, India, and the U.S. to understand how the interplay of institutions in a complex federal context shaped COVID-19 policy-responses. We find similar patterns of concentrated federal executive agency with limited constraints. In each case, when federal leadership failed public health policy responses, federated, subnational states were left to compensate for these inefficiencies without necessary resources. [ABSTRACT FROM AUTHOR]

The purpose of our essay is to examine strategic considerations for the two major U.S. health-oriented systems (public health and healthcare), which have traditionally been disparate in their respective missions, to contemplate the co-production of health for populations they serve. While both health sectors have previously collaborated, the recent COVID-19 environment highlighted social determinants of health as a major factor responsible for negative health outcomes and exacerbated existing health equity issues for multiple at-risk populations. Given the pervasiveness of these public health conditions and recognizing the sig-nificant positive advances of systems integration to produce aligned health systems, a multi-sector response is necessary for interdisciplinary prevention and mitigation approaches. We argue that it is necessary for the U.S.-based public health and healthcare systems in the community to integrate their missions and co-produce quality and affordable care for the populations they serve. The authors describe the essential role of population health as the integrating catalyst and present five strategic considerations for the co-production of health. A coproduction of health readiness checklist provides additional guidance. Health management faculty are encouraged to embed population health management concepts and competencies within their current curricula. [ABSTRACT FROM AUTHOR]