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Background: Correctional facilities are an underutilized venue for reaching young adults who have not vaccinated for human papillomavirus (HPV). The objective of this study was to identify factors that are associated with jail and local health department (LHD) interest in partnering to offer HPV vaccinations to young adults in jail., Methods: Consolidated framework for implementation research (CFIR)-guided surveys were conducted with jail administrators in Iowa, Kansas, Missouri, and Nebraska, September 2017-October 2018. Jail survey data were analyzed using chi square distribution and relative risk regression. Using data from sister surveys conducted with LHD administrators in the same counties (results previously reported), we identified characteristics of counties in which both the jail and LHD indicated interest in collaborating to offer HPV vaccinations in the jail., Results: Jail survey response was 192/347 (55.3%). Surveys with LHDs yielded 237/344 (68.9%) responses. Eleven communities were identified where both the jail and LHD expressed interest. Only "any vaccines provided in jail" predicted shared interest (RR: 5.36; CI: 2.52-11.40; p < .01). For jail administrators, offering other vaccines was 3 times (CI:1.49-6.01; p < .01) and employing a nurse 1.65 times more likely (CI: 1.20-2.28; p < .01) to predict interest in collaborating to offer HPV vaccination. Open-ended responses indicated that managing linkages and stakeholder investment were areas of emphasis where collaborations to provide vaccinations in the jails had been previously implemented., Conclusions: Interest in jail-LHD partnerships to provide HPV vaccinations in jails exists in the Midwest but will require building-out existing programs and linkages and identifying and strengthening shared values, goals, and benefits at all levels.

School nurses are often sources of health-care support for teens with sexually transmitted infections (STIs) and unintended pregnancies. However, providing prevention (e.g., condoms) and teaching technical skills (e.g., condom use) needed to reduce high-risk sexual behavior may require a change in perceptions and policies. This study used a cross-sectional study design to assess nurses' perceptions of condom availability accompanied by sex education programs among high school nurses ( n = 87) in Kansas. Results showed that school nurses in this study supported condom availability, were comfortable providing condoms, and felt condom availability was within the scope of their job but were less likely to provide condoms because of external barriers. Common barriers include administration, parents, cost, community support, and policies. School nurses, by virtue of their access to the majority of Kansas' adolescents, have the potential to provide sex education and tools such as condoms, so young people can prevent STIs and unintended pregnancies.

Purpose: The purpose of this study is to measure Facebook (FB) use as a tool for maintaining research contact with hard-to-reach women with criminal justice histories., Design/methodology/approach: Retrospective data were analyzed from a jail health intervention. Bivariate analysis compared the rates of follow-up between FB group users and non-FB group users at one post-intervention time point. Multivariate models explored predictors for FB group follow-up., Findings: Among 184 participants, 89 (48.4%) used the private research FB group. This group was more likely to complete the follow-up survey one year after enrollment compared to non-FB group users (P = 0.002). Regression analyses showed that, compared to non-FB group users, FB group users were more likely to be younger and have a history of sexually transmitted infections., Practical Implications: FB is popular among women with criminal justice histories. Use of this social media site with study participants from hard-to-reach populations may enhance study retention., Originality/value: This paper fills a gap in examining the long-term use of FB as a research strategy to maintain contain with typically hard-to-reach populations., (© Emerald Publishing Limited.)

Context: Local health departments (LHDs) play a vital role in community vaccination programs for human papillomavirus (HPV) infection, but little research has been done to assess LHD interest in cross-sectoral partnerships to vaccinate high-risk groups, specifically incarcerated persons., Objective: To describe factors associated with interest in a novel implementation strategy linking LHDs with jails in 4 Midwestern states to deliver HPV vaccine., Design: Survey based on the Consolidated Framework for Implementation Research (CFIR) model given to LHD administrators. A modified Poisson relative risk regression was used to assess the relationship between independent variables and LHD interest in implementation of a jail-based HPV vaccination program., Setting: LHDs in Kansas, Missouri, Iowa, and Nebraska., Participants: From September 2017 to April 2018, two-thirds (237/344) of invited LHD administrators from the 4 states responded to the survey., Main Outcome Measure: LHD interest in implementation of a jail-based HPV vaccination program., Results: Forty-five percent of LHDs were interested in learning more about implementing a jail-based HPV vaccination program, and 2% already offered or had plans to offer HPV vaccine in their jails. Barriers to implementation were cost (66%), inmates' short incarcerations (47%), and availability of medical staffing (43%). LHD characteristics associated with interest in implementation of a jail-based HPV vaccination program included "inner setting" CFIR variables, which capture the structural and cultural context for program implementation: 7 or more employees (odds ratio [OR] = 2.22; 95% confidence interval [CI], 1.24-3.95), perception of importance to provide HPV vaccine in jails (OR = 3.70; 95% CI, 2.00-6.84), and already providing any vaccines in jails (OR = 2.62; 95% CI, 1.18-5.80)., Conclusions: Nearly half of LHDs in the region expressed interest in partnering with local entities to meet HPV vaccination needs of high-risk groups. Research on cross-sectoral partnerships and what these collaborations look like in practice is needed for public health impact.

Purpose: To assess effectiveness, 1-year post-intervention, of a program delivered in jails with women to improve cervical health literacy (CHL) and up-to-date Papanicolaou (Pap) screening., Design: Pre-post design to evaluate Pap screening and CHL effects 1 year after our original randomized wait-list control study., Setting: Surveys conducted in Kansas City, 2015 to 2017 (baseline in 2014)., Participants: Adult women (n = 133)., Intervention: One-week (10-contact-hour), small-group, CHL program., Measures: Surveys to assess CHL components and up-to-date Pap screening., Analysis: χ 2 and t tests, followed by best-subsets logistic regression using sociodemographic and CHL components to fit an optimal model for up-to-date screening 1-year post-intervention., Results: 73% (133/182) women retained at 1-year. From pre-intervention, 6 of 8 CHL components improved (.01 > P > .001). Up-to-date Pap screenings increased over pre-intervention (72%-82%, P < .05). Best-subset model to predict up-to-date screening included age; public benefits; medical insurance; 5 CHL components (knowledge, benefits, barriers, seriousness, susceptibility)., Conclusion: A brief intervention to promote cervical health literacy, delivered with women during a jail detention, can lead to sustained improvements in CHL and prevention practices.

Purpose: Childhood caries disproportionately effects children who are poor, live in low-income rural and urban areas, and come from racial and ethnic minority groups. The purpose of this study was to explore the effect of public policy related to dental hygienists' level of supervision and policy uptake at the state level on the organization, delivery, and financing of school-based oral health programs (SBOHP). Methods : A multiple case study methodology was used to compare SBOHPs in the states of Missouri and Kansas. Interviews were conducted with an administrator, dental hygienist, and dentist at each Federally Qualified Health Center (FQHC) that operated a SBOHP. Mixed methods were used to conduct and analyze interviews, examine supporting documents, and to report descriptive details. Analytic categories were used to examine the various facets of the organizational structures, delivery processes, financing and billing, and operations. Results: Five themes revealing differences between two states emerged; historical development of SBOHPs, the structure of SBOHPs, staffing and professional relationships, finance and billing, and capacity of school-based oral health network. Conclusion: Dental hygienists' supervision requirements play a critical role in school-aged children's access to oral health services and the capacity of SBOHPs. The variations in the degree of practice autonomy accorded to dental hygienists under the Missouri and Kansas dental practice acts resulted in different oral health delivery models. Greater autonomy for dental hygienists is essential for realizing the promise of dental public health., (Copyright © 2019 The American Dental Hygienists’ Association.)

The primary objective of this article was to describe the development and pilot implementation of a brief jail-based cervical health promotion intervention. The intervention was guided by a preliminary study of incarcerated women's cervical health knowledge, awareness, and health literacy, as well as a social and feminist approach to intervention development. We developed and conducted a pilot implementation of the Sexual Health Empowerment Project to increase cervical health knowledge, reduce barriers related to beliefs about cervical cancer, and improve self-efficacy and confidence in navigating health systems. This article offers a framework for how empirically and theory-based interventions are developed and tailored for a jail setting. Future work should include the evaluation of the long-term effects of such a disease-specific program on health behaviors and outcomes among high-risk and vulnerable groups of women as they leave jails and enter communities., (© 2014 Society for Public Health Education.)

Drawing on cross-sectional data collected in three Kansas City jails, our objective was to describe the social, neighborhood-based context of sexual health risk prior to incarceration for 290 women. Half of the participants were clustered in Kansas City's urban core before their incarceration. Women who lived in these neighborhoods, which had the highest density of our incarcerated participants, were 3 times as likely to report a history of trading sex for money, drugs, or life necessities compared to women who lived elsewhere in the city. Living in a neighborhood that was perceived to have low social capital was also associated with sexually transmitted infection history. Gaining an understanding of these social influences in women's lives-particularly at the neighborhood level-provides key insights that will allow future interventions to change the health outcomes of women who move between disadvantaged communities and local jails.

Purpose: Determine availability of emergency contraception (EC) at rural and urban pharmacies in Kansas., Methods: A sample of 201 Kansas pharmacies was selected using a random integer generator. We measured ability to dispense EC within 24 hours and whether it was in stock at the time of the survey call. We examined EC availability based on geographic differences and pharmacy type., Findings: Of the sample, 186 pharmacists agreed to be interviewed. Of these, 19% (n = 36) were unable to provide EC within 24 hours. There were essentially no differences in availability of EC between rural (75% could dispense in 24 hours) and urban pharmacies (85% could dispense in 24 hours) (P= .105). Corporate pharmacies were more likely to be able to provide EC within 24 hours compared to independent pharmacies (OR = 3.79, CI 1.71-8.43). Thirty-one percent (n = 57) of pharmacists did not carry EC at the time of the survey call. With this sample, urban pharmacies were more than twice as likely to report carrying EC compared to rural pharmacies (OR = 2.47, CI 1.31-4.68), and corporate pharmacies were also more likely to report carrying EC compared to independent pharmacies (OR = 7.77, CI 3.72-16.21)., Conclusions: In a sample of Kansas pharmacies, there were no differences between rural and urban pharmacies in 24-hour EC availability; however, there were differences in those who stocked EC at the time of the survey call. Corporate pharmacies were more likely to dispense EC within 24 hours and have it in stock compared to independent pharmacies, suggesting differences in availability of EC., (© 2012 National Rural Health Association.)

Objective: To identify clearer, learner-preferred, educational approaches for aspects of cervical cancer education found to be difficult to understand for low-literacy, Mexican, immigrant women., Setting: Kansas City, Kansas; Garden City, Kansas; San Antonio, Texas., Participants: Forty-five Mexican immigrant women in the United States for 5 years or less, ninth grade education or less, and predominantly Spanish speaking., Methods: Interviews were conducted to evaluate preference and best comprehension among options for specific cervical cancer educational elements, including reproductive system terminology, the purpose of Pap tests and meaning of results, Human Papilloma Virus (HPV), and illustrations of anatomy and Pap procedure., Results: We identified terminology, translation, content, and illustrations preferred by participants and areas of inadequate existing knowledge needed for comprehension of concepts being taught. Analogies, illustrations, and introduction of medical terms in conjunction with equivalent common Spanish terms were effective ways of building bridges from existing knowledge to new knowledge. Participants desired detailed information and shared new information with others, Conclusion: We learned the importance of assessing patients' existing body knowledge. The detail desired by participants challenged common simplification approaches to teaching low-literacy learners. Participant willingness to share information challenged ideas of cultural taboo. Results provide evidence for more effective delivery of women's health education and call for further research on best approaches to teaching low-literacy learners., (© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.)

In this exploratory study the authors investigated characteristics, including reported experiences of violence, related to incarcerated women's self-report of cervical cancer screening and cancer history and treatment. During a four month period in 2010, 204 women in Kansas City jails were surveyed. Multiple logistic regression models were used to examine the relations of socio-demographic and community characteristics and history of violence among the women to their cervical cancer screening, diagnosis, and treatment histories. Forty percent of the women in the current sample reported abnormal Pap histories, though only 6% of all Pap smears done in the U.S. are abnormal. Women who reported abuse histories in this study were found to be more likely to report having ever had an abnormal Pap smear (for physical abuse Odds Ratio [OR] = 6.05; CI 2.36, 15.54 and for past year intimate partner violence OR = 2.41; CI 1.09, 5.31). Participants who did not fear neighborhood violence were less likely to report an abnormal Pap history (OR = 0.57; CI 0.34, 0.96) and more likely to visit a family doctor for their Pap screenings (OR = 1.91; CI 1.01, 3.60). Women who perceived greater neighborhood violence had increased odds of reporting that they received Pap screenings in a hospital setting (OR = 1.47; CI 1.08, 2.00). Frequency of Pap screening did not differ in women who did and did not have fear of neighborhood violence. This study highlights the heightened cervical cancer risk experienced by women with criminal justice histories and suggests that violence at several levels has implications for cervical cancer prevention for these women.