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Abstract BackgroundPatient portals are being increasingly used by health systems in the United States. Although some patients use portals for clinical use, patient perspectives on using portals for research-related activities, to complete health screenings, and to request at-home self-test kits are unclear. ObjectiveWe aimed to understand patient perspectives on using electronic health portals for research; health-related screenings; and patient-initiated, home-based self-testing. MethodsPatients (N=105) from the Patient Engaged Research Center at a large, urban, midwestern health system completed a 23-item web-based survey on patient portal (MyChart) use and willingness to use the patient portal for research, risk assessments, and self-test kits. Frequencies and percentages were generated. ResultsAlmost all participants (102/105, 97.1%) had accessed MyChart at least once, with most (44/102, 43.1%) indicating they logged in at least once per month. Participants indicated logging into MyChart to check laboratory results or other health data (89/105, 84.8%), because they received a message to log in (85/105, 81%), and to message their health care professional (83/105, 79%). Fewer participants logged in to see what medications they had been prescribed (16/105, 15.2%) and to learn more about their health conditions (29/105, 27.6%). Most participants indicated logging into MyChart on a computer via a website (70/105, 66.7%) or on a smartphone via an app (54/105, 51.4%). When asked about how likely they would be to participate in different types of research if contacted via MyChart, most (90/105, 85.7%) said they would be likely to answer a survey, fill out a health assessment (87/105, 82.9%), or watch a video (86/105, 81.9%). Finally, participants would be willing to answer risk assessment questions on MyChart regarding sleep (74/101, 73.3%), stress (65/105, 61.9%), diabetes (60/105, 57.1%), anxiety (59/105, 56.2%), and depression (54/105, 51.4%) and would be interested in receiving an at-home self-test kit for COVID-19 (66/105, 62.9%), cholesterol (63/105, 60%), colon cancer (62/105, 59%), and allergies (56/105, 53.3%). There were no significant demographic differences for any results (all P ConclusionsPatient portals may be used for research recruitment; sending research-related information; and engaging patients to answer risk assessments, read about health information, and complete other clinical tasks. The lack of significant findings based on race and gender suggests that patient portals may be acceptable tools for recruiting research participants and conducting research. Allowing patients to request self-test kits and complete risk assessments in portals may help patients to take agency over their health care. Future research should examine if patient portal recruitment may help address persistent biases in clinical trial recruitment to increase enrollment of women and racial minority groups.

Despite the prevalence of trauma among children in foster care, child welfare agencies rarely screen for a history of trauma exposure and associated symptoms. This study aimed to examine (1) the adherence to the universal implementation of trauma and mental health screening in urban Treatment Foster Care programs and (2) the changes in children's mental health and trauma symptom screening scores in agencies participating in a broad range of trauma-informed activities. Overall, the screening rates in this study were low, reflecting challenges that should be considered by foster programs looking to implement trauma screening protocols. However, changes in mental health and trauma symptom scores were observed among children in participating agencies, suggesting the potential impact of trauma-informed care., In 2018, more than 400,000 children spent time in foster care in the United States (U.S. Department of Health and Human Services, 2019). Children in foster care are disproportionally affected [...]

Hypertension, compounded by obesity, contributes to cardiovascular disease and mortality. Data describing hypertension prevalence in adults with short stature skeletal dysplasias are lacking, perhaps due to poor fit of typical adult blood pressure cuffs on rhizomelic or contracted upper extremities. Through health screening research, blood pressure was measured in short stature adults attending support group meetings and skeletal dysplasia clinics. Blood pressure was measured with a commercially available, narrower adult cuff on the upper and/or lower segment of the arm. Height, weight, age, gender, diagnosis, exercise, and medications were collected. Subjects were classified as normotensive, prehypertensive, or hypertensive for group analysis; no individual clinical diagnoses were made. In 403 short stature adults, 42% were hypertensive (systolic >140, diastolic >90 OR taking antihypertensive medications). For every BMI unit and 1 kg weight increase in males, there was a 9% and an 8% increase, respectively, in the odds of hypertension versus normotension. In females, the increase was 10% and 6%, respectively. In those with achondroplasia, the most common short stature dysplasia, males (n = 106) had 10% greater odds of hypertension versus normotension for every BMI unit and kilogram increase. In females with achondroplasia (n = 128), the odds of hypertension versus normotension was 8% greater for each BMI unit and 7% for each additional kilogram. These data suggest a high population prevalence of hypertension among short stature adults. Blood pressure must be monitored as part of routine medical care, and measuring at the forearm may be the only viable clinical option in rhizomelic short stature adults with elbow contractures. [ABSTRACT FROM AUTHOR]

Prior research has highlighted important healthcare access and utilization issues among new forced immigrants. We aimed to explore the role that public and patient involvement (PPI) might play in enhancing accessibility and specific contributions to migration health studies. We conducted open and in-depth interactive virtual discussions with asylum seekers and refugees from Eritrea and Syria in Switzerland. The PPI establishment consisted of three phases: inception, training and contribution. Prior to training, the concept of PPI was not straightforward to grasp, as it was a new approach—however, after training and consecutive discussions, participants were ardent to engage actively. We conclude that PPI holds promise in regard to raising awareness, improving healthcare system accessibilities and utilization, and enhancing and strengthening migration health research. Indeed, PPI volunteers were keen to raise their community's awareness through their networks and bridge an important gap between researchers and the public. [ABSTRACT FROM AUTHOR]

Orientation: South Africa carries a high burden of mental ill-health. Screening to identify individuals for further referral is emerging as one pathway to promote access to mental health interventions. Existing occupational health surveillance infrastructure may be a useful mechanism for clinical mental health screening. Research purpose: This study explored the clinical validity of a range of brief mental health measures in the context of occupational health surveillance. Motivation for the study: To meaningfully screen for mental health as part of occupational health surveillance, tools are required that are empirically validated, clinically useful, locally available and practical to administer. Research approach/design and method: Workers (n = 1816), recruited through workplace occupational health surveillance programmes, completed the Patient Health Questionnaire-9, Brief Symptom Inventory 18-somatisation subscale, Generalised Anxiety Disorder scale-7, Primary Care Post-Traumatic Stress Disorder Screen, Intense (panic-like) anxiety scale and CAGE scale and partook in a diagnostic interview with a clinical psychologist. Main findings: Basic psychometric characteristics were reported, including confirmatory factor analyses, measurement invariance, internal consistencies and socio-demographic effects. Clinical utility was explored through receiver operating/operator characteristics curve analyses, and calculations of positive and negative predictive values, as well as sensitivity and specificity. These indicators provided evidence of clinical validity in the study context. Practical/managerial implications: The findings support the use of psychological screening as a brief, practicable and easily accessible mode of occupational mental health support. Contribution/value-add: This article presented evidence of structural and criterion validity for these scales and described their clinical application for practical use in occupational mental health surveillance. [ABSTRACT FROM AUTHOR]

The relationship between exposure to toxins at work and lung diseases continues to be significantly under-recognised in Australia. Medical practitioners are well placed to identify occupational risk factors for disease. They can therefore play a vital role in informing regulatory responses, highlighting dangerous workplaces and supporting access to compensation to assist with better health outcomes for their patients. Increased awareness among medical practitioners of occupational factors can aid early diagnosis and improve patient outcomes by improving access to justice. Medical practitioners should be cognisant of the occupational causes of lung disease in Australia to support appropriate specialist referral and ensure patients can access additional support systems available through legal compensation systems. More broadly, medical professionals and lawyers assisting workers share the common aim of highlighting preventable diseases and advocating for change to help make workplaces safer. [ABSTRACT FROM AUTHOR]

Background: Workers fabricating engineered stone face high risk for exposure to respirable crystalline silica (RCS) and subsequent development of silicosis. In response, the California Division of Occupational Safety and Health (Cal/OSHA) performed targeted enforcement inspections at engineered stone fabrication worksites. We investigated RCS exposures and employer adherence to Cal/OSHA's RCS and respiratory protection standards from these inspections to assess ongoing risk to stone fabrication workers. Methods: We extracted employee personal air sampling results from Cal/OSHA inspection files and calculated RCS exposures. Standards require that employers continue monitoring employee RCS exposures and perform medical surveillance when exposures are at or above the action level (AL; 25 μg/m3); exposures above the permissible exposure limit (PEL; 50 μg/m3) are prohibited. We obtained RCS and respiratory protection standard violation citations from a federal database. Results: We analyzed RCS exposures for 152 employees at 47 workplaces. Thirty‐eight (25%) employees had exposures above the PEL (median = 89.7 μg/m3; range = 50.7–670.7 μg/m3); 17 (11%) had exposures between the AL and PEL. Twenty‐four (51%) workplaces had ≥1 exposure above the PEL; 7 (15%) had ≥1 exposure between the AL and PEL. Thirty‐four (72%) workplaces were cited for ≥1 RCS standard violation. Twenty‐seven (57%) workplaces were cited for ≥1 respiratory protection standard violation. Conclusions: Our investigation demonstrates widespread RCS overexposure among workers and numerous employer Cal/OSHA standard violation citations. More enforcement and educational efforts could improve employer compliance with Cal/OSHA standards and inform employers and employees of the risks for RCS exposure and strategies for reducing exposure. [ABSTRACT FROM AUTHOR]

Silicosis is a progressive and irreversible fibrotic occupational lung disease caused by inhalation of respirable crystalline silica (RCS). Recently, outbreaks have been reported in industries involving direct work with high silica-containing materials, such as artificial stone. Here, we describe an unexpected diagnosis made in an asymptomatic 33-year-old female worker employed for 4 years at a quarry for rhyodacite and rhyolite which contain 70% silicon dioxide. Chest computed tomography demonstrated small nodules in the upper lobes and larger ill-defined areas of opacity. Bronchoalveolar lavage revealed fine birefringent material within the cytoplasm of alveolar macrophages, representing silica. Transbronchial biopsies of lung parenchyma and endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal lymph nodes did not reveal features of sarcoidosis, tuberculosis, or malignancy. As such, a diagnosis of accelerated silicosis was confirmed and represents the first reported case in a female worker at a rhyodacite and rhyolite quarry. [ABSTRACT FROM AUTHOR]

Silicosis not a disease of the past. It is an irreversible, fibrotic lung disease specifically caused by exposure to respirable crystalline silica (RCS) dust. Over 20,000 incident cases of silicosis were identified in 2017 and millions of workers continue to be exposed to RCS. Identified case numbers are however a substantial underestimation due to deficiencies in reporting systems and occupational respiratory health surveillance programmes in many countries. Insecure workers, immigrants and workers in small businesses are at particular risk of more intense RCS exposure. Much of the focus of research and prevention activities has been on the mining sector. Hazardous RCS exposure however occurs in a wide range of occupational setting which receive less attention, in particular the construction industry. Recent outbreaks of silicosis associated with the fabrication of domestic kitchen benchtops from high‐silica content artificial stone have been particularly notable because of the young age of affected workers, short duration of RCS exposure and often rapid disease progression. Developments in nanotechnology and hydraulic fracking provide further examples of how rapid changes in technology and industrial processes require governments to maintain constant vigilance to identify and control potential sources of RCS exposure. Despite countries around the world dealing with similar issues related to RCS exposure, there is an absence of sustained global public health response including lack of consensus of an occupational exposure limit that would provide protection to workers. Although there are complex challenges, global elimination of silicosis must remain the goal. See relatedEditorial [ABSTRACT FROM AUTHOR]

Schools are well positioned to facilitate early identification and intervention for youth with emerging mental health needs through universal mental health screening. Early identification of mental health concerns via screening can improve long‐term student development and success, but schools face logistical challenges and lack of pragmatic guidance to develop local screening policies and practices. This study summarizes mental health screening practices tested by six school districts participating in a 15‐month learning collaborative. Qualitative analysis of 42 Plan‐Do‐Study‐Act cycles revealed that districts tested quality improvement changes across seven screening practice areas, with all teams conducting at least one test to (1) build a foundation and (2) identify resources, logistics, and administration processes. Quantitative data indicated that the average percentage of total students screened increased from 0% to 22% (range = 270–4850 students screened at follow‐up). Together, these results demonstrate how school districts not currently engaged in mental health screening can apply small, specific tests of change to develop a locally‐tailored, practical, and scalable process to screen for student mental health concerns. Lessons learned are provided to inform future directions for school‐based teams. Key Points: Mental health screening in schools optimizes early identification of individual student mental health needs and can inform service planning for mental health promotion, prevention, early intervention, and treatment.Schools or districts interested in mental health screening can get started by screening a few students first, then scaling up to a classroom or grade level at a time to develop a sustainable set of practices.Mental health screening practices in schools should be informed by feedback from school administrators, educators, mental health providers, students, and families. [ABSTRACT FROM AUTHOR]

To realize the promise of genomic medicine, harness the power of genomic technologies, and capitalize on the extraordinary pace of research linking genomic variation to disease risks, healthcare systems must embrace and integrate genomics into routine healthcare. We have implemented an innovative pilot program for genomic population health screening for any-health-status adults within the largest health system in Vermont, United States. This program draws on key research and technological advances to safely extract clinical value for genomics in routine health care. The program offers no-cost, non-research DNA sequencing to patients by their primary care providers as a preventive health tool. We partnered with a commercial clinical testing company for two next generation sequencing gene panels comprising 431 genes related to both high and low-penetrance common health risks and carrier status for recessive disorders. Only pathogenic or likely pathogenic variants are reported. Routine written clinical consultation is provided with a concise, clinical "action plan" that presents core messages for primary care provider and patient use and supports clinical management and health education beyond the testing laboratory's reports. Access to genetic counseling is free in most cases. Predefined care pathways and access to genetics experts facilitates the appropriate use of results. This pilot tests the feasibility of routine, ethical, and scalable use of population genomic screening in healthcare despite generally imperfect genomic competency among both the public and health care providers. This article describes the program design, implementation process, guiding philosophies, and insights from 2 years of experience offering testing and returning results in primary care settings. To aid others planning similar programs, we review our barriers, solutions, and perceived gaps in the context of an implementation research framework. [ABSTRACT FROM AUTHOR]

There is a lack of knowledge about the practice of physical activity, exercise, and sports in people with skeletal dysplasia (SD). This study aimed to characterize the physical fitness of people with SD; investigate the benefits of physical activity, exercise, or sports programs for people with SD; identify the adapted physical activities that can be prescribed to individuals with SD; and identify the most common and effective structural characteristics and guidelines for the evaluation of individuals with SD and corresponding activity prescriptions. Electronic searches were carried out in the PubMed, Scopus, SPORTDiscus, Psycinfo, and Web of Science databases in October 2021 and March 2022 and included papers published until 3 March 2022. The search strategy terms used were "dwarfism", "dwarf", "skeletal dysplasia", "achondroplasia", "pseudoachondroplasia", "hypochondroplasia", "campomelic dysplasia", "hair cartilage hypoplasia", "x-linked hypophosphatemia", "metaphyseal chondrodysplasia schmid type", "multiple epiphyseal dysplasia", "three M syndrome", "3-M syndrome", "hypophosphatasia", "fibrodysplasia ossificans progressive", "type II collagen disorders", "type II collagenopathies", "type II collagenopathy", "physical activity", "exercise", "sport", "training", and "physical fitness", with the Boolean operators "AND" or "OR". After reading the full texts of the studies, and according to previously defined eligibility criteria, fifteen studies met the inclusion criteria; however, there was not a single intervention study with physical exercise. Several cross-sectional, review, or qualitative studies presented a set of essential aspects that future intervention studies can consider when evaluating, prescribing, and implementing physical exercise programs, as they allowed the physical characterization of the SD population. This study demonstrated an apparent scarcity in the literature of experimental studies with physical exercise implementation in the SD population. [ABSTRACT FROM AUTHOR]

Schools are an essential setting for mental health supports and services for students. To support student well-being, schools engage in universal mental health screening to identify students in need of support and to provide surveillance data for district-wide or state-wide policy changes. Mental health data have been collected via anonymous and self-identified response formats depending on the purpose of the screening (i.e., surveillance and screening, respectively). However, most surveys do not provide psychometric evidence for use in both types of response formats. The current study examined whether responses to the Social Emotional Health Survey–Secondary (SEHS-S), a school mental health survey, are comparable when administered using anonymous versus self-identified response formats. The study participants were from one high school and completed the SEHS-S using self-identified (n = 1,700) and anonymous (n = 1,667) formats. Full measurement invariance was found across the two response formats. Both substantial and minimal latent mean differences were detected. Implications for the use and interpretation of the SEHS-S for schoolwide mental health are discussed. [ABSTRACT FROM AUTHOR]

SUMMARY: This article gives a general overview of the current situation in relation to a range of widely recognised and also newly identified types of child maltreatment. The academic and clinical evidence relating to the impact of child maltreatment on the mental and physical health of child victims is substantial and steadily increasing in volume. New types of abuse are being identified, and changing environmental circumstances, which exacerbate the possibility of widely recognised types of child maltreatment occurring, are also being described. These include multi-type maltreatment, female genital mutilation and online child maltreatment. Serious questions may arise regarding neglect of the moral and social development of children and young people who become addicted to online gaming and pornography. Multiple national and local definitions of each of these existing and new forms of maltreatment have been created, some of which are covered here. The impact of these abuses on the physical and mental health and development of child victims in families or settings where abuse or neglect has occurred is discussed. [ABSTRACT FROM AUTHOR]

Orientation: South Africa carries a high burden of mental ill-health. Screening to identify individuals for further referral is emerging as one pathway to promote access to mental health interventions. Existing occupational health surveillance infrastructure may be a useful mechanism for clinical mental health screening. Research purpose: This study explored the clinical validity of a range of brief mental health measures in the context of occupational health surveillance. Motivation for the study: To meaningfully screen for mental health as part of occupational health surveillance, tools are required that are empirically validated, clinically useful, locally available and practical to administer. Research approach/design and method: Workers (n = 1816), recruited through workplace occupational health surveillance programmes, completed the Patient Health Questionnaire-9, Brief Symptom Inventory 18-somatisation subscale, Generalised Anxiety Disorder scale-7, Primary Care Post-Traumatic Stress Disorder Screen, Intense (panic-like) anxiety scale and CAGE scale and partook in a diagnostic interview with a clinical psychologist. Main findings: Basic psychometric characteristics were reported, including confirmatory factor analyses, measurement invariance, internal consistencies and socio-demographic effects. Clinical utility was explored through receiver operating/operator characteristics curve analyses, and calculations of positive and negative predictive values, as well as sensitivity and specificity. These indicators provided evidence of clinical validity in the study context. Practical/managerial implications: The findings support the use of psychological screening as a brief, practicable and easily accessible mode of occupational mental health support. Contribution/value-add: This article presented evidence of structural and criterion validity for these scales and described their clinical application for practical use in occupational mental health surveillance.

In the last decade, there has been an explosion in the use of online survey tools. Online data collection tools have lowered the cost of data collection and removed barriers to entry for carrying out research. While a number of questions have been raised about the general reliability of internet survey research, one specific use of the web for survey work has been in reaching niche populations that are difficult to access using traditional survey tools - so-called 'rare samples'. In this paper, we present an approach to accessing such hard-to-reach populations using search engine pay-per-click (PPC) advertising. We carried out a study that makes uses of PPC advertising on search engines as an alternative means of developing sample for a hard-to-reach group of health consumers. Based on a sample of 466 consumer responses, we discuss the effectiveness of this technique for reaching such rare populations. [ABSTRACT FROM AUTHOR]

This mixed-methods study aims to inform the development of a ‘Park Prescription’ intervention, including face-to-face counseling on physical activity and park use and providing weekly structured exercise sessions in the park to promote physical activity. Participants aged 40–65 years were recruited from regional health screening events in Singapore where they completed a questionnaire (N = 97) and consented to focus group (FG) participation (N = 16). The questionnaire assessed current park use, and the type, duration, and intensity of park-based activities that would be of interest. FGs explored the barriers and facilitators of physical activity (in parks). Short interviews (N = 16) with ‘doers’, i.e., people already engaging in park-based physical activity, identified motivational factors and ways to overcome common barriers. Participants acknowledged the health benefits of parks and valued them because of their pleasant landscapes, greenery and facilities. However, few participants engaged in physical activity at the parks, because they were too busy or too tired. Participants mostly indicated doing informal activities, such as walking, cycling or playing traditional Asian games when using the parks for exercise. A variety of low-to-moderate intensity park-based activities such as walking, cycling or aerobics were of interest to participants who expressed the willingness to engage in structured exercise sessions on weekday evenings or weekend mornings. Strategies to increase physical activity in parks included: encourage planning, create social support, identify alternatives for bad weather, improve proximity/accessibility to parks and park safety. The effectiveness of the Park Prescription intervention in promoting physical activity, park use, as well as physical and mental well-being will be tested in a one-year Randomized Controlled Trial. [ABSTRACT FROM AUTHOR]

Highly efficacious and tolerable treatments that cure hepatitis C viral (HCV) infection exist today, increasing the feasibility of disease elimination. However, large healthcare systems may not be fully prepared for supporting recommended actions due to knowledge gaps, inadequate infrastructure and uninformed policy direction. Additionally, the HCV cascade of care is complex, with many embedded barriers, and a significant number of patients do not progress through the cascade and are thus not cured. The aim of this retrospective cohort study was to evaluate a large healthcare system’s HCV screening rates, linkage to care efficiency, and provider testing preferences. Patients born during 1945–1965, not previously HCV positive or tested from within the Electronic Health Record (EHR), were identified given that three-quarters of HCV-infected persons in the United States are from this Birth Cohort (BC). In building this HCV testing EHR prompt, non-Birth Cohort patients were excluded as HCV-specific risk factors identifying this population were not usually captured in searchable, structured data fields. Once completed, the BC prompt was released to primary care locations. From July 2015 through December 2016, 11.5% of eligible patients (n = 9,304/80,556) were HCV antibody tested (anti-HCV), 3.8% (353/9,304) anti-HCV positive, 98.1% (n = 311/317) HCV RNA tested, 59.8% (n = 186/311) HCV RNA positive, 86.6% (161/186) referred and 76.4% (n = 123/161) seen by a specialist, and 34.1% (n = 42/123) cured of their HCV. Results from the middle stages of the cascade in this large healthcare system are encouraging; however, entry into the cascade–HCV testing–was performed for only 11% of the birth cohort, and the endpoint–HCV cure–accounted for only 22% of all infected. Action is needed to align current practice with recommendations for HCV testing and treatment given that these are significant barriers toward elimination. [ABSTRACT FROM AUTHOR]

Background: In Spain, women invited to breast screening are not usually informed about potential harms of screening. The objective of the InforMa study is to assess the effect of receiving information about the benefits and harms of breast screening on informed choice and other decision-making outcomes, in women approaching the age of invitation to mammography screening. Methods: Two-stage randomised controlled trial. In the first stage, 40 elementary territorial units of the public healthcare system were selected and randomised to intervention or control. In the second stage, women aged 49-50 years were randomly selected. The target sample size was 400 women. Women in the intervention arm received a decision aid (DA) with detailed information on the benefits and harms of screening. Women in the control arm received a standard leaflet that did not mention harms and recommended accepting the invitation to participate in the Breast Cancer Screening Program (BCSP). The primary outcome was informed choice, defined as adequate knowledge and intentions consistent with attitudes. Secondary outcomes included decisional conflict, worry about breast cancer, time perspective, opinions about the DA or the leaflet, and participation in the BCSP. Results: In the intervention group, 23.2% of 203 women made an informed choice compared to only 0.5% of 197 women in the control group (p < 0.001). Attitudes and intentions were similar in both study groups with a high frequency of women intending to be screened, 82.8% vs 82.2% (p = 0.893). Decisional conflict was significantly lower in the intervention group. No differences were observed in confidence in the decision, anxiety, and participation in BCSP. Conclusions: Women in Spain lack knowledge on the benefits and harms of breast screening. Providing quantitative information on benefits and harms has produced a considerable increase in knowledge and informed choice, with a high acceptance of the informative materials. Trial registration: Trial identifier at ClinicalTrials.gov registry. Registered on February 4 2017. Trial name: InforMa study. [ABSTRACT FROM AUTHOR]

The present study examined whether high school students' (N = 1,658) self-reported social-emotional strengths collected at the beginning of the school year via schoolwide screening could predict student membership in one of three truancy categories (low, moderate, and high to chronic truancy) using discriminant analysis. Results indicated that student self-reported scores for the social-emotional domains belief-in-self and belief-in-others contributed significantly to the discriminant analysis function for predicting students' truancy severity classification. In addition, multivariate ANOVA was also conducted to identify whether social-emotional strengths differed by gender and ethnicity (Caucasian and Latino/a students) across the three truancy groups. Caucasian students in the low to moderate truancy groups reported higher overall social-emotional strengths than Latino/a students. Gender differences were also found in the low to moderate truancy groups in that females were less likely to report having strengths in the social-emotional domains belief-in-self and engaged living, while males were less likely to report having a strength in emotional competence. Findings demonstrate the utility of schoolwide screening measures to aid in early identification of truancy and an increased need to create truancy prevention and intervention policies that are gender-specific and culturally sensitive. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate the preliminary structural, convergent, and incremental classification validity of responses to the Subjective Academic Problems Scale (SAPS), which is a seven-item self-report behavior rating scale intended for use as a triaging tool within secondary-level school mental health screening contexts. Findings from psychometric analyses carried out with Sample 1 (N = 177) indicated that responses to the SAPS were characterized by a unidimensional measurement model and that scores derived from the scale had convergent validity with scores from several other self-reported measures of student wellbeing and mental health problems. Results from analyses conducted with Sample 2 (N = 219) confirmed the unidimensionality of responses to the SAPS measurement model and demonstrated that SAPS scores had incremental validity, when used in conjunction with scores from a self-report internalizing problems screener, for identifying students with greater levels of mental health risk. Implications for future research and practice are discussed. [ABSTRACT FROM AUTHOR]

Introduction: People with low health literacy are more likely to delay seeking care and experience adverse outcomes. While health literacy is the product of individuals’ capacities, it is also affected by the complexities of the health care system. System-level changes are needed to align health care demands better with the public’s skills and abilities. We aimed to identify the evidence base for effective strategies for creating health literate organisations. Methods: A systematic review and narrative synthesis of empirical studies was performed. Medline, Embase, PsychInfo and CINHAL databases were searched for empirical studies from OECD countries published from 2008 onwards, focusing on health literacy interventions at the organisational level. Analysis of the findings was informed by the National Academies’ five-dimensional framework for the attributes of a health literate organisation, which include: organisational commitment, accessible education and technology infrastructure, augmented workforce, embedded policies and practices, and effective bidirectional communication. Results: The title and abstract of 867 records were screened according to the selection criteria, leading to full text review of 125 articles. Seven studies were identified in the peer review literature. Adapting health literacy guidelines and tools was the most common approach to addressing organisational health literacy. Conclusion: While the use of health literacy tools proved important for raising awareness of health literacy issues within organisations, these tools were insufficient for generating the organisational changes necessary to improve organisational health literacy. [ABSTRACT FROM AUTHOR]

The process of global consultation has received little attention despite its potential for promoting international mutual understanding with marginalized communities. This article details theory, entry, implementation, and evaluation processes for global consultation research, including lessons learned from our refugee teacher intervention. The first half of the article addresses the entry process, culture-specific strengths, and challenges that can be faced in global consultation, including our experience with a lack of formal regulatory oversight of refugee education. The second half of the article details feedback collected from consultants, peer trainers, and peer trainees indicating which training content was most valuable; how some Burmese refugee teachers strive for a more studentcentered, "free" classroom for their refugee students; and, finally, the toll that intense refugee teacher consultation took on the consultants. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine and compare outcomes of two voluntary workplace health management methods: an adapted worksite self-management (WSM) approach and an intensive health monitoring (IM) approach. Research participants were randomly assigned to either the WSM group or the IM group by a computer-generated list (n = 180; 92 WSM and 88 IM). Participants completed baseline, 3 and 12-month follow-up surveys. Individuals receiving workplace WSM and IM improved in self-efficacy and nearly all health behaviors and health status variables after the intervention, compared to before the intervention. Individuals in the WSM group improved in depression symptoms at 3 and 12 months (P < 0.0001, P < 0.0001), and individuals in the IM group did not improve at either time period (P < 0.1488, P < 0.0521). Participants in the WSM group reported more improvement in physical activity and energy, health interfering less with personal life and daily activities and fewer depression symptoms at follow up, compared to participants in the IM group. This study provided additional support for worksite-based health promotion programs to promote healthy lifestyles and improve health status, and documented effectiveness of both methods, with superior performance and greater scalability for the WSM program. [ABSTRACT FROM AUTHOR]

The sexual health of people with mental illness is commonly overlooked, neglected or inadequately addressed in mental health care, despite evidence showing that people with severe mental illness are more vulnerable to sexually transmitted infections (including HIV), sexual side-effects, and sexual dysfunction than the general population. This article reports a study that investigated sexual health screening in five community mental health clinics within a large a regional health service in Victoria, Australia. The aim of the study was to examine the extent to which sexual health screening is currently undertaken on newly admitted case-managed consumers, and to identify the types of screening undertaken. An exploratory design using retrospective file audit was used in the study. A total of 186 medical records met the study inclusion criteria. The study found that less than 40% of consumers were provided with sexual health screening during their first 12 weeks of case management. The study also found that sexual side-effects, issues of fertility, sexual self-esteem, safe sexual practices, and sexual dysfunction were rarely screened for. Poor sexual health screening has implications for the safety and quality of mental health care and requires targeted research to improve understandings and approaches to care. [ABSTRACT FROM AUTHOR]

This study reports the systematic development of a population-based health screening package for all Thai people under the universal health coverage (UHC). To determine major disease areas and health problems for which health screening could mitigate health burden, a consultation process was conducted in a systematic, participatory, and evidence-based manner that involved 41 stakeholders in a half-day workshop. Twelve diseases/health problems were identified during the discussion. Subsequently, health technology assessments, including systematic review and meta-analysis of health benefits as well as economic evaluations and budget impact analyses of corresponding population-based screening interventions, were completed. The results led to advice against elements of current clinical practice, such as annual chest X-rays and particular blood tests (e.g. kidney function test), and indicated that the introduction of certain new population-based health screening programs, such as for chronic hepatitis B, would provide substantial health and economic benefits to the Thais. The final results were presented to a wide group of stakeholders, including decision-makers at the Ministry of Public Health and the public health insurance schemes, to verify and validate the findings and policy recommendations. The package has been endorsed by the Thai UHC Benefit Package Committee for implementation in fiscal year 2016. [ABSTRACT FROM AUTHOR]

Breast and cervical cancers continue to contribute to high cancer mortality rates in American Indian/Alaska Native women; culturally appropriate interventions are needed to influence screening behaviors and to reduce delays in obtaining care. In a pilot feasibility study designed to influence Pacific Northwest American Indian/Alaska Native women’s health screening knowledge and behaviors (breast and cervical), we employed a community-based participatory research approach. Data from interviews with study participants, those involved in implementation of the study and observations were included in the analysis. Study questions focused on training of staff, recruitment of participants, and implementation of the protocol and data management. The complexities of translational, transcultural research and the importance of reporting pilot feasibility studies to the advancement of transcultural research are highlighted in the findings of this research effort. [ABSTRACT FROM AUTHOR]

Universal screening is increasingly becoming part of prevention and early intervention best practice in schools. Although the number of schools engaging in universal screening has increased over the past decade, emotional and behavioral problems are often their primary focus. Problem-focused screening, however, does not address positive contributions to mental health and is useful for only a small percentage of students. Conversely, the information obtained when assessing for strengths is relevant for all students. The inclusion of a strength-based approach in school-based universal mental health screening serves to broaden educators' understanding of mental health and can inform reactive and proactive interventions that address problems and enhance strengths. This article discusses the knowledge and skills needed to implement universal complete mental health screening, that is, screening that assesses for students' strengths and problems. A detailed description of complete mental health screening is provided, followed by a step-by-step implementation guide with specific considerations for practitioners who wish to engage in complete mental health screening as part of comprehensive efforts to promote the well-being of all students. Finally, the process of complete mental health screening is illustrated with a case example. [ABSTRACT FROM AUTHOR]

Physical health screenings were conducted by researchers and peer wellness specialists for adults attending publicly-funded community mental health programs. A total of 457 adults with serious mental illnesses attended health fairs in 4 U.S. states and were screened for 8 common medical co-morbidities and health risk factors. Also assessed were self-reported health competencies, medical conditions, and health service utilization. Compared to non-institutionalized U.S. adults, markedly higher proportions screened positive for obesity (60%), hypertension (32%), diabetes (14%), smoking (44%), nicotine dependence (62%), alcohol abuse (17%), drug abuse (11%), and coronary heart disease (10%). A lower proportion screened positive for hyperlipidemia (7%). Multivariable random regression analysis found significant pre- to post-screening increases in participants’ self-rated abilities for health practices, competence for health maintenance, and health locus of control. Screening identified 82 instances of undiagnosed diabetes, hypertension or hyperlipidemia, and 76 instances where these disorders were treated but uncontrolled. These results are discussed in the context of how this global public health approach holds promise for furthering the goal of integrating health and mental health care. [ABSTRACT FROM AUTHOR]

Developing mental health care capacity in postearthquake Haiti is hampered by the lack of assessments that include culturally bound idioms Haitians use when discussing emotional distress. The current paper describes a novel emic-etic approach to developing a depression screening for Partners in Health/Zanmi Lasante. In Study 1 Haitian key informants were asked to classify symptoms and describe categories within a pool of symptoms of common mental disorders. Study 2 tested the symptom set that best approximated depression in a sample of depressed and not depressed Haitians in order to select items for the screening tool. The resulting 13-item instrument produced scores with high internal reliability that were sensitive to culturally informed diagnoses, and interpretations with construct and concurrent validity (vis-à-vis functional impairment). Discussion focuses on the appropriate use of this tool and integrating emic perspectives into developing psychological assessments globally. The screening tool is provided as an Appendix. [ABSTRACT FROM PUBLISHER]

This study assesses the ability of a brief screening form, the Behavioral and Emotional Screening System–Student Form (BESS-SF), to predict scores on the much longer form from which it was derived: the Behavior Assessment System for Children–Second Edition Self-Report of Personality–Child Form (BASC-2-SRP-C). The present study replicates a former study included in the BESS manual with an entirely new sample. Participants included 252 students from a large, urban, Southwestern U.S. city school district in the third through fifth grades. The sample’s ethnic majority was Hispanic (81.7%). Results revealed high specificity and negative predictive values between the screener and omnibus form, suggesting a child who identifies as not “at-risk” on the BESS-SF will likely identify as not “at-risk” on the BASC-2-SRP-C domains. These results effectively replicate the previous findings with a new sample of largely Hispanic (Latino/a) students from a large urban school district. [ABSTRACT FROM AUTHOR]

Introduction: People with learning disabilities experience higher rates of injury compared to the general population, but little is known about the circumstances and perceived impact of these injuries on people with learning disabilities themselves. Method: Content analysis was conducted from interviews with 113 adults with learning disabilities who had at least one injury in a 12-month period. Qualitative interviews were conducted with ten adults with learning disabilities (and their carers where appropriate) who had experienced serious or frequent injury or frequent falls with or without injury in a 12-month period. Findings: The most commonly reported contributory factors for injuries and/or falls were related to physical health status (for example, epilepsy) and the environment (for example, walking/banging into furniture or stairs/steps). In terms of perceived impact, the development of fear of walking outdoors unsupported or fear of crossing a road were highlighted. The non-use and misuse of assistive technology was also highlighted as a concern. Conclusion: These findings demonstrate that occupational therapists have a key role to play in tailoring injury and fall prevention strategies and interventions for people with learning disabilities. In particular, environmental assessment and monitored use of assistive technology is important. [ABSTRACT FROM AUTHOR]

On average 60 per cent of men and 75 per cent of women visit their GP annually for a consultation. This makes GP practices an ideal setting for chlamydia screening but staff often feel that offering screening to young people could cause offence or anxiety. However, chlamydia has a high infection rate and is asymptomatic; therefore it is vital that people are screened to increase the diagnostic rate. This article explores barriers that prevent GP staff offering such screening and the views of young people about whether they feel offers of screening are appropriate. [ABSTRACT FROM AUTHOR]

Objective: This study examined the prevalence and correlates of co-occurring obesity and diabetes among community mental health program members.Methods: Medical screenings of 457 adults with serious mental illnesses were conducted by researchers and peer wellness specialists in four U.S. states. Body mass index was measured directly. Diabetes was assessed via glycosylated hemoglobin and interview self-report. Multivariable logistic regression analysis examined associations with known predictors.Results: In the sample, 59% were obese, 25% had diabetes, and 19% had both conditions. When gender, diagnosis, and site were controlled, co-occurring diabetes and obesity was almost three times as likely among African Americans (OR=2.93) as among participants from other racial groups and half as likely among smokers as among nonsmokers (OR=.58). Older persons and those with poorer self-rated physical health also were more likely to have these co-occurring conditions.Conclusions: Results support the need for culturally competent treatment and for smoking cessation options with sensitivity to the potential for weight gain. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the extent of surveillance for breast cancer for post-menopausal women with learning disabilities living in residential care.Methodology: The primary carers of 129 post-menopausal women with learning disabilities living in three residential care settings were surveyed using a newly developed questionnaire. The response rate was 69.7 per cent.Results: The findings revealed that 85.6 per cent of the sample received invitations to attend mammography breast screening, with an attendance rate of 93.5 per cent. However 16 per cent were unable to complete the procedure owing to difficulties such as fear, discomfort, distress and an inability to co-operate. Of the women surveyed 26.7 per cent received a manual breast examination. However 24 per cent of the entire sample did not receive any breast surveillance.Conclusions: Even though a substantial proportion of the women received breast screening, almost a quarter received no screening, owing to difficulties experienced during the procedure, not receiving an invitation to attend for screening or a failure to carry out manual breast examinations. [ABSTRACT FROM AUTHOR]

In a recent colon cancer risk study, genetic assessment and colonoscopy were offered to virtually all of the adult Ashkenazi Jews in an urban community. The present study was designed to examine factors influencing participation and response in the initial study and to suggest strategies for improving participation in future health promotion programs. The study comprised a random sample of three groups of individuals who had been targeted for participation in the previous study: those who had (a) agreed to participate (n = 234); (b) declined participation (n = 179); and (c) failed to respond to a mailed recruitment package (n = 128). All participants completed a brief telephone survey. Key multivariate predictors of both response and participation were individuals' perceptions of the drawbacks of participating in colon cancer screening research and the degree of decisional conflict they experienced. Response was further predicted by the influence of spouses, family history of colon cancer, past knowledge of genetic testing for colon cancer, and education level. Participation was predicted by awareness that the study was supported by the Ashkenazi Jewish community, past experience with genetic testing, individuals' perceptions of the benefits of participating, and whether or not they had children. The degree to which individuals understand the purpose and nature of genetic screening research, along with their levels of decisional conflict and other psychosocial factors, may influence the likelihood of their participation in such research. Results of this study suggest a number of possible strategies for improving participation and response rates in disease prevention and detection studies. [ABSTRACT FROM AUTHOR]

Understanding the state-level processes that can shape the operations of health and welfare programs is of particular importance today. This article describes the process by which the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program was implemented in the Commonwealth of Pennsylvania. The case study highlights the factors that facilitated and hindered the transformation of this federal policy into a local program. Implications for children's health programming are identified. [ABSTRACT FROM AUTHOR]

The first objective of this article is to summarize literature on selected variables that can influence parents' efforts to enhance their parenting skills, including participation in prevention-oriented education and skills-training programs. The second objective is to report the results of a survey of rural parents with preadolescents (N=203) on prevention-relevant parenting beliefs and past parenting enhancement efforts, such as parent education program attendance. Descriptive analyses of these variables and their relationships to socioeconomic status and family composition are reported. Results regarding prevention-relevant parenting beliefs indicate relatively low levels of perceived susceptibility to adolescent problem behaviors and high levels of perceived parent efficacy in preventing adolescent problems. High levels of past parenting enhancement efforts also were reported. Little evidence of gender differences on the parenting belief and enhancement variables was found, but education, income, and family structure and composition variables were significantly associated with several key parenting belief and enhancement variables. [ABSTRACT FROM AUTHOR]

The article presents abstracts on psychology of psychological assessment topics which include assessment of animal stress and comfort, evolution of the Rorschach in Japan, and evaluation of social and sensorimotor skills for employment.