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Background: U.S. Hispanic/Latino construction workers constitute a large and historically underserved group in terms of smoking cessation services. Using formative research, we developed a worksite smoking cessation intervention tailored to the life/work circumstances of these workers. Aims: This study aims to examine the feasibility, acceptability, and potential efficacy of the developed intervention "Enhanced Care" (EC; one group behavioral counseling session provided around the food truck + fax referral to tobacco quitline [QL] + 8-week nicotine replacement treatment [NRT]) compared with "Standard Care" (SC; fax referral to tobacco QL + 8-week NRT) in a pilot, two-arm, cluster randomized controlled trial. Method: In collaboration with construction site safety managers, a sample of 17 construction sites (EC: nine sites/65 smokers; SC: eight sites/69 smokers) was enrolled. Participants received two follow-ups at 3 and 6 months after enrollment. Feasibility outcomes were enrollment rate, adherence to treatment, and 6-month retention rates. The primary efficacy outcome was 6 months prolonged abstinence verified by expired carbon monoxide <10 ppm. Results: Enrollment rate was high (85.9%). Six-month follow-up rates were acceptable (EC = 76.9%, SC = 66.6%). Adherence to treatment was better in the EC group (received worksite intervention: EC = 93.8%, SC = 88.4%; contacted by QL: EC = 49.2%, SC = 40.6%). Abstinence rates were 27.7% for the EC and 20.3% for the SC (p = 0.315). Discussion: The developed intervention was feasible and acceptable, and it substantially improved abstinence among Hispanic/Latino workers. The involvement of safety managers was essential to the implementation of the intervention. Training safety managers to deliver the intervention has great potential to implement a sustainable smoking cessation service in the construction sector.

Background: Smoking prevalence among Hispanic/Latino construction workers in the United States is very high (31%). Aims: To investigate tobacco use profiles in these minority workers and explore their management's views about implementing sustainable worksite smoking cessation services. Methods: Analysis of baseline data from a smoking cessation trial among Hispanic/Latino construction workers (n = 134; adult men =18 years), and semistructured, 45-minute interviews with 24 key personnel at six construction companies in south Florida were conducted. Interviews were recorded, transcribed, and analyzed thematically. Results: Overall, 43.3% of workers were Cuban, and 81.3% had low acculturation level. Nicotine dependence levels were "high" in 61.8% of workers. Half of the workers had a successful quit attempt but only 9.9% received advice from a physician to quit smoking, 16.7% used medication to quit, and 79.2% did not receive assistance. Participants in the interviews stated that nothing was provided to help smokers quit smoking and considered distributing self-help materials with free medications as the most appropriate service. Challenges to integrating the service were time restriction and cost. Recommendations for implementing the service were local/state government mandate. Discussion: Tailoring tobacco treatment to Hispanic/Latino construction workers' job circumstances and culture is essential to support their cessation efforts. Integrating worksite tobacco treatment services into other available health promotion programs (e.g., safety) and enforcing smoke-free legislation in the construction sector can facilitate its adoption. Conclusion: Involving key stakeholders and mandating the service by the State and local government are necessary to integrate sustainable worksite smoking cessation services in the construction sector.

The fear factor among women who have been previously pursued, the reasons it affects some and not others are analyzed.

Background: Intimate partner violence (IPV) is a largely undetected occurrence in the United States reported by 36-50% of women in their lifetime and associated with extensive physical and psychological implications. Currently, conflicting recommendations exist regarding screening practices with the United States Preventative Services Task Force (USPSTF) and the World Health Organization (WHO) advocating for and against universal screening, respectively. With research suggesting that women are seldom asked about IPV during clinic visits, further information is needed regarding current screening practices.Objectives: To identify current IPV screening approaches in the primary care setting and factors that may impact screening completion.Methods: We retrospectively examined patients presenting for annual examinations at four university-associated primary care clinics in southeast Florida (n = 400). Patient demographics, screener demographics, screening completion, and screening results were collected from the medical record. Results were compared to depression and anxiety screenings due to comparable prevalence and screening recommendations. Pearson chi square and Fisher exact tests were utilized to compare screening rates by demographic characteristics.Results: IPV screening occurred at a much lower frequency (8.5%) compared to screenings for anxiety (37.3%) and depression (71.3%). Among documented IPV screenings, 64.7% of encounters resulted in patient refusal to be screened. Screening rates were found to be marginally impacted by patient ethnicity (P = 0.052).Conclusions: Findings of both low screening rates and low screening success raise significant concerns for the shortcomings of advocating for universal IPV screening. Therefore, additional studies are necessary to identify covert barriers to screening completion before universal inquiry is advised. [ABSTRACT FROM AUTHOR]

Introduction: Over 2.6 million Hispanic/Latino construction workers (CWs) live in the US; 91% of South Florida CWs are Hispanic/Latino. CWs have higher smoking and lower cessation rates than other workers. Limited access to cessation services, worksite turnover, and lack of interventions tailored to culture/occupation hinder cessation. Partnering with worksite food trucks to deliver unique cessation interventions may improve these efforts. Aims: To explore a novel cessation approach, assess worker/worksite acceptability, and seek input into intervention development. Methods: In 2016, we conducted five semi-structured focus groups with 37 smoking Hispanic/Latino CWs. Constant comparative analysis was used to examine a priori themes regarding smoking behaviours, cessation treatments, intervention delivery, cultural adaptation, and quit interest. Results: CWs reported tremendous job stress. Most smoking occurred during the workday and most CWs did not use nicotine replacement therapy with past quit attempts. Most CWs were open to a worksite face-to-face group cessation intervention before work (many underutilize breaks and feel pressure to keep working). CWs felt it unnecessary to tailor the intervention to Hispanics/Latinos indicating smokers are the same regardless of race/ethnicity. Conclusions: Findings demonstrate the need to consider work environments, job demands/stress, and worker preferences when developing accessible and acceptable cessation interventions. [ABSTRACT FROM AUTHOR]

The increasing number and older age of women Veterans receiving care at Veterans Health Administration (VHA) requires health-care providers to adjust to their changing patient population. We explored women Veterans' self-reported knowledge of menopause, current/preferred sources of menopausal health information, and perceptions/barriers regarding treatment of menopausal symptoms. Three focus groups were conducted at two South Florida VHA facilities in 2014, which included 30 women Veterans (aged 45-60 years) who visited VHA primary care clinics at least once in the past year. Participants reported using various sources to obtain general and menopausal health information, particularly family, friends, and the internet. Some women also had discussions with their health-care providers, but believed not all VHA providers were knowledgeable about menopause. Most preferred older female providers, thinking they were better informed about menopausal issues. Women favored complementary/alternative therapies and were against using hormone therapy (HT) for symptom relief, although they felt they were insufficiently informed about HT. Menopausal-age women are the fastest growing group at VHA. To provide better care and enhance their experiences, the VHA must educate all primary care providers about menopausal care and strive to address women Veterans' menopausal concerns and preferences. [ABSTRACT FROM AUTHOR]