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The article outlines key concepts of a series of webinars as a guide for local governments in the U.S. and U.S. territories that want to engage community and faith-based organizations (CFBOs) in the Zika response. The ten step approach for engaging CFBOs to deliver Zika health messages include assembling a community engagement and health communication team, connecting with CFBOs that can help reach communities, and anticipating and identifying information needs.

The article talks about seven prevention priorities of scientist officers for the Commissioned Corps of the U.S. Public Health Service (USPHS). It comments on the National Prevention Strategy (NPS) federal agenda promoting tobacco-free living, preventing excessive alcohol use and drug abuse, and healthy food habits. It talks about the NPS priority on encouraging active living and living injury- and violence-free. It talks about sexual and reproductive health, and emotional and mental well-being.

Background: Over half of malaria cases reported in the USA occur among people travelling to visit friends and relatives (VFRs), predominantly to West Africa. Few studies have queried VFR travellers directly on barriers to seeking pre-travel care. We aim to describe the knowledge, attitudes and practices of VFRs travelling to malaria-endemic countries from the USA. With these findings, we aim to design interventions to encourage preventive behaviours before and during travel.Methods: Sixteen focus groups were held in two US metropolitan areas with West African immigrant populations: Minneapolis-St. Paul, MN, and New York City, NY. A total of 172 people from 13 African countries participated. Focus group discussions were audio-recorded and transcribed, and modified grounded theory analysis was performed. Participants reviewed themes to verify intent of statements.Results: Participants described the high cost of provider visits and chemoprophylaxis, challenges in advocating for themselves in healthcare settings and concerns about offending or inconveniencing hosts as barriers to malaria prevention. Cultural barriers to accessing pre-travel care included competing priorities when trip planning, such as purchasing gifts for family, travel logistics and safety concerns. When participants sought pre-travel care, most consulted their primary care provider. Participants expressed low confidence in US providers' knowledge and training about malaria and other tropical diseases.Conclusion: Barriers to pre-travel care for VFR travellers are multifaceted and extend beyond their perception of disease risk. Only some barriers previously reported in anecdotal and qualitative literature were supported in our findings. Future interventions should be aimed at barriers identified by individual communities and involve primary and travel specialist healthcare providers. Additional work is needed to address systems-level barriers to accessing care and establishing community-based programs to support West African VFR traveller health. [ABSTRACT FROM AUTHOR]

Objective: To describe medical tourism among a subset of US residents; identify possible indicators for medical tourism., Methods: The US Centers for Disease Control and Prevention collaborated with 11 states and territories to ask 6 questions about medical tourism, using the Behavioral Risk Factor Surveillance System. Data collected from January 1, 2016, through December 31, 2016, included whether respondents traveled internationally for preplanned care, travel reasons and destinations, procedures received, and occurrence and treatment of complications. A descriptive analysis of demographics, socioeconomic status and health access variables was performed, and a regression model with a log-link function and Poisson distribution was used to estimate prevalence ratios (PR) for medical tourism., Results: Of 93,492 respondents, 517 (0.55%) traveled internationally during the previous year for care. Mexico was the most common destination (41% of trips). Dentistry accounted for 55% of treatments. Complications from care received abroad were reported by 5% of medical tourists; 67% sought care upon returning to the United States. The prevalence of medical tourism was 1.32% (95% CI, 1.00-1.64). The prevalence of medical tourism was higher in Hispanics and non-whites (PR, 3.97; 95% CI, 2.48-6.32) and higher among those without current health insurance (PR, 2.70; 95% CI, 1.69-4.34)., Conclusions: This is the largest collection of population-based surveillance data describing medical tourism among US residents from multiple states and territories. Understanding the demographic and socioeconomic factors associated with medical tourism can inform evidence-based recommendations for travelers and clinicians who may advise or care for these individuals before, during, or after travel.

During 2013, the Maryland Department of Health and Mental Hygiene in Baltimore, MD, USA, received report of 2 Maryland residents whose surgical sites were infected with rapidly growing mycobacteria after cosmetic procedures at a clinic (clinic A) in the Dominican Republic. A multistate investigation was initiated; a probable case was defined as a surgical site infection unresponsive to therapy in a patient who had undergone cosmetic surgery in the Dominican Republic. We identified 21 case-patients in 6 states who had surgery in 1 of 5 Dominican Republic clinics; 13 (62%) had surgery at clinic A. Isolates from 12 (92%) of those patients were culture-positive for Mycobacterium abscessus complex. Of 9 clinic A case-patients with available data, all required therapeutic surgical intervention, 8 (92%) were hospitalized, and 7 (78%) required ≥3 months of antibacterial drug therapy. Healthcare providers should consider infection with rapidly growing mycobacteria in patients who have surgical site infections unresponsive to standard treatment.

In August 2013, the Maryland Department of Health and Mental Hygiene (MDHMH) was notified of two persons with rapidly growing nontuberculous mycobacterial (RG-NTM) surgical-site infections. Both patients had undergone surgical procedures as medical tourists at the same private surgical clinic (clinic A) in the Dominican Republic the previous month. Within 7 days of returning to the United States, both sought care for symptoms that included surgical wound abscesses, clear fluid drainage, pain, and fever. Initial antibiotic therapy was ineffective. Material collected from both patients' wounds grew Mycobacterium abscessus exhibiting a high degree of antibiotic resistance characteristic of this organism.

Objective: Unintentional injury in the home is a leading cause of death for toddlers. The majority of injuries occur at home; parents play a significant role in injury prevention. Health-related behavior change theory suggests that behavior change is only possible if individuals (a) recognize the problem, and (b) believe they are vulnerable. This study examined these characteristics among novice parents of toddlers by investigating how well parents recognize hazards in the home and whether they believe their toddlers are vulnerable to those hazards., Methods: Three types of participants were recruited: novice parents of toddlers ages 12-36 months, daycare employees, and pediatric healthcare workers. All participants were examined three rooms simulating a typical toddler's bedroom, a living room, and a bathroom. Participants marked any hazards they recognized with stickers. Parents completed the hazard identification task twice, once identifying hazards for all toddlers and another time identifying hazards for their child., Results: Participants identified less than half the hazards present in the simulated rooms; parents identified more hazards than comparison groups. Parents identified significantly fewer hazards for their own child than they identified for other children., Discussion: Although parents identified more hazards than the professionals, they failed to identify a large portion of hazards and they perceived their own children to have less vulnerability than toddlers more broadly. Results indicate that education about toddler's vulnerability to injury in the home, as well as instructing parents about what situations are hazardous, might be considered during development of toddler home injury prevention programs.