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Background. The U.S. Department of Health and Human Services (HHS) developed the Move Your Way campaign to help more Americans increase their physical activity. The campaign includes more than 80 English and Spanish materials that can be used to promote physical activity. HHS also developed a community-based implementation strategy for the campaign. Methods. HHS collaborated with eight community-based organizations from across the United States to pilot campaign implementation in their communities. A mixed-methods process evaluation was conducted to assess events, partnership involvement, material distribution, and social media engagement. Results. More than 168,000 people participated in 55 campaign events, initiatives, and programs hosted by lead organizations and their 175 partners. More than 37,000 campaign materials were distributed, and there were over 72 million social media impressions. Conclusion. The community-based implementation strategy was effective at reaching the intended audience and driving traffic to Move Your Way resources. The flexibility of the Move Your Way materials and messages allowed communities to incorporate the campaign into diverse physical activity–promotion strategies. Findings demonstrate that the federal government and local community organizations can successfully work together to promote physical activity. [ABSTRACT FROM AUTHOR]

Evidence-based HIV programming focused on populations at risk of HIV is critical for sustainable disease prevention. In response to the Tennessee Department of Health decision to reject federal HIV guidance, the present study examines the potential impact of Southern US states adopting policies that direct HIV prevention and testing efforts away from populations "disproportionately affected" (DA) by HIV toward populations "non-disproportionately affected" (NDA). Descriptive and projection analyses with publicly available data explored the influence of policies emphasizing NDA populations on HIV cases. Across the Southern US, DA populations (cisgender women, men who have sex with men, transgender persons, and people who inject drugs) represent the absolute majority (90%) of diagnosed HIV cases, whereas NDA populations (pregnant women, infants, first responders, and human trafficking victims) represent only a small proportion (2%) of diagnosed HIV cases. Estimated projections show avoidable HIV cases among DA populations in the Southern US alone could aggregate to over 32,000 by 2030 if prevention efforts exclusively concentrate on NDA populations, which approximates the current national annual incidence of 36,000 HIV cases. Prevention efforts aimed at DA populations compared with NDA populations could reduce new infections across the Southern US by 47% versus 1%, respectively, by 2030. Policies disregarding epidemiological data may hinder efforts to end the HIV epidemic, both regionally and nationally. [ABSTRACT FROM AUTHOR]

Background: Federal policies targeting antipsychotic use among nursing home (NH) residents may have increased reporting of diagnoses for approved uses, including schizophrenia, Tourette's syndrome, and Huntington's Disease (called "exclusionary diagnoses" because they exclude residents from the antipsychotic quality metric). We assessed changes in new exclusionary diagnoses among long‐stay NH admissions specifically with dementia following federal policies. Methods: Retrospective, quarterly, interrupted time‐series analysis (2009–2018) of new long‐stay NH residents with dementia and no exclusionary diagnoses reported before NH admission. The National Partnership and the addition of facility level antipsychotic use to the Five Star Quality Rating system were key time exposures. Outcome was quarterly facility level predicted percentage of exclusionary diagnoses within 2 years of admission stratified by NH characteristics. Results: For 264,095 long‐stay admissions, mean percentage of new exclusionary diagnoses was 2.2% before the Partnership. After the Partnership, there was an unadjusted increase in the percentage over time (slope change, 0.044, p = 0.018), but the percentage never exceeded 2.9%. The Partnership contributed to a one‐time decrease in diagnoses in NHs with an intermediate percentage of Black residents (−1.29%, p = 0.004). Before the Partnership, diagnoses were increasing among not‐for‐profit relative to for‐profit NHs (0.044; p = 0.012), but after the Partnership, the pattern reversed. For‐profit NHs saw an increase (+0.034, p = 0.002); not‐for‐profit NHs experienced a decrease (−0.014, p = 0.039). Quality Rating modifications had no significant effect. Conclusions: Exclusionary diagnosis reporting among long‐stay NH residents with dementia, the group most at risk from antipsychotics, did not increase in response to federal policies. Evaluation of reasons for the observed increase in exclusionary diagnoses among non‐dementia NH residents is warranted along with continued attention to how to incentivize the appropriate use of medications in residents with dementia that is crucial for high‐quality NH care. See related editorial by Joseph G. Ouslander in this issue. [ABSTRACT FROM AUTHOR]

Human services educators continually seek ways to make outreach programming more engaging and effective. This study evaluated an ongoing relationship education program funded by the United States Department of Health and Human Services (Administration of Children and Families) to determine the effectiveness of the Before You Tie the Knot (BYTK) premarital education program. A self-reported, quantitative, retrospective-pretest-then-post-test evaluation was utilized to assess key objectives in the sample (n = 1285). Clearly- evident effect sizes were found for perceived behavior changes in the participants' implementation of skills related to relationship quality (i.e., positive interaction, negative interaction, positive bonds, happiness/satisfaction, commitment, and not feeling trapped) covered in the training over a five-week period. Implications for how the BYTK program can facilitate change and learning in educational settings, as well as inform relationship education outreach programming, are discussed. [ABSTRACT FROM AUTHOR]

Objectives. To estimate state-level excess death rates during 2020 to 2023 and examine differences by region and partisan orientation. Methods. We modeled death and population counts from the Centers for Disease Control and Prevention to estimate excess death rates for the United States, 9 census divisions, and 50 states. We compared excess death rates for states with different partisan orientations, measured by the party of the seated governor and the level of partisan representation in state legislatures. Results. The United States experienced 1 277 697 excess deaths between March 2020 and July 2023. Almost 90% of these deaths were attributed to COVID-19, and 51.5% occurred after vaccines were available. The highest excess death rates first occurred in the Northeast and then shifted to the South and Mountain states. Between weeks ending June 20, 2020, through March 19, 2022, excess death rates were higher in states with Republican governors and greater Republican representation in state legislatures. Conclusions. Excess death rates during the COVID-19 pandemic varied considerably across the US states and were associated with partisan representation in state government, although the influence of confounding variables cannot be excluded. (Am J Public Health. 2024;114(9):882–891. https://doi.org/10.2105/AJPH.2024.307731) [ABSTRACT FROM AUTHOR]

With the rapidly increasing number of older people, vehicle dependence in countries like the U.S. poses many challenges for transportation planning. Vehicle dependence among most Americans has substantial environmental, safety, and equity implications, and it excludes those with limited ability to drive from participating in many everyday social activities. Also, an age-based digital divide weakens the potential role of transportation technologies and information and communication technologies in reducing travel difficulties for older people. Nevertheless, current federal policies do not sufficiently address the transportation challenges facing an aging population. This paper provides an agenda for sustainable and equitable transportation in an aging society through various modes of transportation and enhanced interagency coordination and collaboration. [ABSTRACT FROM AUTHOR]

Prior to the 2021 American Psychologist special issue "Rendered Invisible: Are Asian Americans a Model or a Marginalized Minority?" (Yip et al., 2021), only seven articles on Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations were published in the journal in 3 decades. The special issue interrogated sources of invisibility and marginalization of AANHPIs not only in the field of psychology but also in the broader national landscape. The current commentary provides a deeper dive into one of the primary drivers of AANHPI invisibility, anti-Asian biases encountered during the federal grant review process, which contributes to low funding rates and insufficient research on AANHPI communities. Despite comprising over 6% of the U.S. population, less than 1% of the National Institutes of Health's funding portfolio supports science on AANHPI populations. This qualitative study revealed thematic barriers encountered during National Institutes of Health grant reviews. A one-time survey was circulated to professional scientific networks to obtain open-ended responses regarding applicants' and reviewers' experiences proposing research with AANHPI samples, resulting in data from N = 16 respondents. Respondents were asked to indicate their role in the review process (e.g., investigator, applicant, reviewer, other) and to provide open-ended responses detailing experiences of bias. Thematic coding revealed six principal themes: (1) invalidation, (2) limited reviewer knowledge, (3) oppression Olympics, (4) White comparison groups, (5) model minority myth, and (6) homogeneity of AANHPI groups. Building off these themes, this commentary concludes with five actionable policy and institutional recommendations aimed at achieving a more inclusive national research enterprise for AANHPI investigators and communities. [ABSTRACT FROM AUTHOR]

Puerto Rico, a territory of the United States since 1898, has recently experienced an increasing frequency and intensity of natural disasters and public health emergencies. In 2022, Hurricane Fiona became the latest storm to attract media attention and cast a light on Puerto Rico's deteriorating conditions, including infrastructural failings, health care provider shortages, and high levels of chronic illness. Although recent events have been uniquely devastating, decades of inequitable US federal policy practices have fueled the persistence of health inequities in the territory. Here we demonstrate how existing health and health care inequities in Puerto Rico have been exacerbated by compounding disasters but are rooted in the differential treatment of the territory under US federal policies. Specifically, we focus on the unequal US Federal Emergency Management Agency response to disasters in the territory, the lack of parity in federal Medicaid funding for Puerto Rico, and Puerto Rico's limited political power as a territory of the United States. We also provide empirically supported policy recommendations aimed at reducing health and health care inequities in the often-forgotten US territory of Puerto Rico. (Am J Public Health. 2024;114(S6):S478–S484. https://doi.org/10.2105/AJPH.2024.307585) [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the discoverability of supporting research materials, including supporting documents, individual participant data (IPD), and associated publications, in US federally funded COVID-19 clinical study records in ClinicalTrials.gov (CTG). Methods: Study registration records were evaluated for (1) links to supporting documents, including protocols, informed consent forms, and statistical analysis plans; (2) information on how unaffiliated researchers may access IPD and, when applicable, the linking of the IPD record back to the CTG record; and (3) links to associated publications and, when applicable, the linking of the publication record back to the CTG record. Results: 206 CTG study records were included in the analysis. Few records shared supporting documents, with only 4% of records sharing all 3 document types. 27% of records indicated they intended to share IPD, with 45% of these providing sufficient information to request access to the IPD. Only 1 dataset record was located, which linked back to its corresponding CTG record. The majority of CTG records did not have links to publications (61%), and only 21% linked out to at least 1 results publication. All publication records linked back to their corresponding CTG records. Conclusion: With only 4% of records sharing all supporting document types, 12% sufficient information to access IPD, and 21% results publications, improvements can be made to the discoverability of research materials in federally funded, COVID-19 CTG records. Sharing these materials on CTG can increase their discoverability, therefore increasing the validity, transparency, and reusability of clinical research. [ABSTRACT FROM AUTHOR]

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]

Context: The False Claims Act is the US federal government's primary tool for identifying and penalizing pharmaceutical fraud. The Department of Justice uses the False Claims Act to bring civil cases against drug manufacturers that allegedly obtain improper payment from federal programs. Methods: The authors searched the Department of Justice website for press releases published between 2006 and 2022 that announced fraud actions brought against drug companies. They then used the World Health Organization's Anatomical Therapeutic Classification index to identify the classes of prescription drugs implicated in fraud actions. Findings: During fiscal years 2006–2022, payments by six manufacturers amounted to more than 28% of total payments made as a result of federal False Claims Act actions. Nervous system and cardiovascular drugs were the classes of medications most commonly implicated in alleged fraud. Federal officials most frequently alleged that companies improperly promoted nervous system drugs and paid kickbacks to increase revenues from cardiovascular, antineoplastic and immunomodulating, and alimentary tract and metabolism drugs. Conclusions: Despite frequent pharmaceutical fraud settlements and penalties, incidence of alleged fraud among drug companies remains high. Alternative methods for preventing and deterring fraud could help safeguard our health systems and promote public health, and policy makers should ensure that effective fraud enforcement complements preventive public health regulation. [ABSTRACT FROM AUTHOR]

Unaccompanied immigrant children continue to arrive at the US–Mexico border and are at high risk for ongoing abuse, neglect, and poor mental and physical health. We are medical and legal experts in the fields of immigrant and refugee health, child abuse, and the legal rights of international refugee and migrant children. We provide an overview of US federal agencies with custody of unaccompanied immigrant children, a summary of medical care provided while in custody, and recent findings from the independent Juvenile Care Monitor Report mandating new custodial conditions for immigrant children while in federal custody. We provide recommendations to improve the health and well-being of unaccompanied immigrant children while in custody and once released to US sponsors. (Am J Public Health. 2024;114(3):340–346. https://doi.org/10.2105/AJPH.2023.307570) [ABSTRACT FROM AUTHOR]

Physical educators, including adapted physical educators, are often called upon to advocate for their students with disabilities, their physical education programs, or themselves to affect change in practice or a student's Individualized Education Program. These advocacy efforts are most effective when physical educators are knowledgeable about educational policies and legislative mandates, and how they can be applied to individual situations. This article provides key terms and reviews federal laws that impact physical education service delivery across the United States. Additionally, U.S. Department of Education policy letters and guidance documents from national organizations that support physical education and sport for students with disabilities are reviewed. Finally, the article presents common situations related to physical education along with resources stakeholders can use to address issues and advocate for physical education and extracurricular athletics for their students with disabilities. [ABSTRACT FROM AUTHOR]

The U.S. federal government strives to be a model employer of people with disabilities. Although it has been successful in recent years in increasing disability hiring, retention of this workforce remains a concern. The researchers of this mixed-methods study sought to understand the perceptions of workplace attributes by employees with disabilities in federal agencies through analysis of the Federal Employee Viewpoint Survey (FEVS) and focus groups. The study results indicate that people with disabilities, in general, have lower perceptions of workplace attributes than their peers without disabilities; however, looking at groups differentiated by disability, military experience, and sex tells a richer story. This article incorporates the voices of agency representatives and employees with disabilities to provide additional context to the survey findings. Based on the results, the authors offer practice and policy recommendations to support improved workplace experiences and retention of employees with disabilities. [ABSTRACT FROM AUTHOR]

Effective climate change resilience in local communities must center each community's unique challenges and essential role in developing climate resilience strategies. This article will discuss recent developments by the federal government that align with a community-centered approach, and how Community Health Workers can influence the outcomes. [ABSTRACT FROM AUTHOR]

Religion and spirituality (R/S) have been linked to better physical and mental health. The US government has funded several research studies that include a focus on R/S but the amount of support over the last several years appears to be declining. To better understand these funding trends for R/S and health research, we chose relevant comparisons from projects that include a focus on social support and optimism. We identified total amount of funding, change in funding patterns over time, and characteristics of funded projects from a large database of US research projects (Federal RePORTER). We reviewed 5093 projects for social support and 6030 projects for optimism before narrowing the number of eligible studies to 170 and 13, respectively. Social support projects received the largest investment of $205 million dollars. Funded awards for social support and optimism remained stable over time while R/S decreased (p = 0.01), intervention research was more characteristic and studies of African-American/Black participants were less characteristic of funded projects in social support than of R/S (ps < 0.001). Future research for R/S and health would likely benefit from continued focus on minority communities and on identifying and developing appropriate interventions to support individual and community health and well-being. [ABSTRACT FROM AUTHOR]

The measurement of sexual and gender identity in the United States has been evolving to generate more precise demographic estimates of the population and a better understanding of health and well-being. Younger cohorts of sexual- and gender-diverse adults are endorsing identities outside of the lesbian, gay, bisexual, and transgender (LGBT) labels. Current population-level surveys often include a category such as "something else" without providing further details, and doing so inadequately captures these diverse identities. In this research note, our analysis of the most recent federal data source to incorporate sexual and gender identity measures-the Household Pulse Survey-reveals that younger birth cohorts are more likely to select "something else" for their sexual identity and "none of these" for their gender identity. The observed sexual and gender identity response patterns across birth cohorts underscore the importance of developing and applying new strategies to directly measure sexual- and gender-diverse adults who identify with identities outside of those explicitly captured on surveys. The integration of sexual and gender identity measures in population-level surveys carries broader implications for civil rights and for addressing health inequities and therefore must be responsive to cohort differences in identification. [ABSTRACT FROM AUTHOR]

In 1987, the United States federal government began funding homelessness services. In the decades that followed, it mandated their systemization based on "best practices." Divergence from these practice modalities jeopardized federal support. In Emerson County, the rural county discussed here, this initiative encountered resistance to its narrow de!nition of eligible clients, certain best practices, and the terms of acceptable systemization. Dissenters preferred broader eligibility and were committed to a long-term transitional housing model that required clients to participate in services that helped them become "housing ready." Most dissenters were evangelical Protestant agencies that emphasized the power of Christian "transformation," which transitional housing was well-suited to support. This model ran counter to the federal best practice of "rapid rehousing," which made services optional and dispensed with transitional housing. This paper analyzes how local system builders, committed to inclusion and communitarian governance, consistently improvised cooperation to accommodate both federal rules and dissenting practices. Social workers seeking to make effective organizational connections in homelessness services might consider strategies of communitarianism, a respect for the limits of strategic accommodation, and the utilization of individuals with a "foot in both worlds" who can communicate effectively across difference. [ABSTRACT FROM AUTHOR]

This study examines the goals of medical aid-in-dying (MAID) legislation introduced to the US Congress from 1994–2020 using a policy mapping analysis approach. Using congress.gov, we identified 98 bills, 23 bills were analyzed in this study. Most of the bills aimed to restrict the use of federal funds, to regulate the drugs commonly used for MAID, to prohibit the development of policies or practices supporting MAID, and to regulate practitioners' roles in MAID. In practice, these bills would limit patient access to MAID by restricting drugs, funds, health care services, legal assistance, policy, and research. These findings suggest there lacks congressional support for MAID, even though polls of the public are divided yet favorable. Policymakers who support MAID should consider affirmative policies that 1) prevent MAID policies from discriminating against vulnerable groups, 2) support funding to study the use of MAID, and 3) build avenues to allow all qualified people to access MAID in places where it is legal. [ABSTRACT FROM AUTHOR]

To help achieve the initial goal of providing universal COVID-19 vaccine access to approximately 258 million adults in 62 US jurisdictions, the federal government launched the Federal Retail Pharmacy Program (FRPP) on February 11, 2021. We describe FRPP's collaboration among the federal government, US jurisdictions, federal entity partners, and 21 national chain and independent pharmacy networks to provide large-scale access to COVID-19 vaccines, particularly in communities disproportionately affected by COVID-19 (eg, people aged ≥65 years, people from racial and ethnic minority groups). FRPP initially provided 10 000 vaccination sites for people to access COVID-19 vaccines, which was increased to >35 000 vaccination sites by May 2021 and sustained through January 31, 2022. From February 11, 2021, through January 31, 2022, FRPP vaccination sites received 293 million doses and administered 219 million doses, representing 45% of all COVID-19 immunizations provided nationwide (38% of all first doses, 72% of all booster doses). This unprecedented public–private partnership allowed the federal government to rapidly adapt and scale up an equitable vaccination program to reach adults, later expanding access to vaccine-eligible children, during the COVID-19 pandemic. As the largest federal COVID-19 vaccination program, FRPP exemplifies how public–private partnerships can expand access to immunizations during a public health emergency. Pharmacies can help meet critical national public health goals by serving as convenient access points for sustained health services. Lessons learned from this effort—including the importance of strong coordination and communication, efficient reporting systems and data quality, and increasing access to and demand for vaccine, among others—may help improve future immunization programs and support health system resiliency, emphasizing community-level access and health equity during public health emergencies. [ABSTRACT FROM AUTHOR]

The article discusses the double bind trapped between the risk of criminal conviction for ending a pregnancy that is not perilous enough to qualify for the medical exceptions to state abortion bans and the risk of civil liability for not ending a pregnancy that is too dangerous. Topics include historical precedent for a modified version of the double bind, representative medical exceptions from state bans on providing abortion, and the problem with enumeration.

The federal government executed thirteen individuals in the last seven months of the Trump administration. While American media discourse in 2020 was focused largely on other events such as the COVID-19 pandemic and the presidential election, the news media nevertheless served as a key source of information about the executions to the American public. This study examines accounts of the executions from online news sources in order to identify the ways in which news outlets that lean to opposing ends of the political spectrum framed the executions. A thematic content analysis shows that the executions were discussed in the context of major events of the time, including the presidential election, the pandemic, and demonstrations calling for racial justice. News sources that lean to the political left tended to frame the executions as a political move by President Trump, who was backed by a conservative Supreme Court while neglecting more pressing issues like managing the pandemic. Right-leaning sources were more likely to frame the executions as overdue justice that had been unnecessarily delayed by frivolous lawsuits and baseless claims of racial injustice. Implications for public support and the future of capital punishment are discussed. [ABSTRACT FROM AUTHOR]

An editorial is presented on the upcoming national referendum in Australia on the Indigenous Voice to Parliament, focusing on the Uluru Statement from the Heart, the co-design process of The Voice, and the steps taken to implement constitutional reform. It reports that the Uluru Statement calls for constitutional recognition and outlines principles for the Indigenous Voice, and it emphasizes the historical injustices faced by First Nations Peoples and the impending constitutional amendment.

BACKGROUND: It is estimated that approximately 90% of children in foster care have experienced a traumatic event, with nearly half reporting exposure to 4 or more types of traumatic events. Educators must remain alert to indicators suggesting a history of trauma and understand the difficulties foster youth may face regulating their emotions and behavior while in school. METHODS: A framework for foster youth trauma in the public education system identifies the interplay between macro‐level forces, such as federal and state policy, and school and teacher micro‐level forces. RESULTS: The framework highlights the inadequacy of educators in identifying the manifestations of trauma, specifically in foster youth, and how the current implemented policy leads to misinterpretation of the outward behavioral displays of trauma as other behavioral issues. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Federal and state policies, school districts, teacher and principal practices, teacher and school administrator preparation programs must incorporate knowledge about trauma pervasiveness and the consequences of trauma on foster youth attitude and behavior in the classroom. CONCLUSION: The framework guides change efforts toward improving school climate and culture through preparing school professionals to meet the diverse needs of foster youth and tackling those policies and behaviors that exclude foster youth from schooling. [ABSTRACT FROM AUTHOR]

An introduction to articles in the issue is presented on topics including laws targeting marginalized populations, positive development in the study of laws' relationship to public health, and enactment of laws aimed at reducing the consumption of sugary beverages.

Early care and education (ECE), or the care young children receive before entering formal schooling, can take multiple forms and is delivered in different settings, such as a center, church, or public school. Federal and state governments regularly fund ECE programs and policies through the Child Care and Development Block Grant Act (CCDBG). Many families, however, face significant challenges in access, cost, and quality of ECE programs, and ECE professionals report substantial challenges in the workplace (e.g., inadequate training) and beyond (e.g., low wages). Policies addressing issues related to ECE were proposed in 2021, but stalled on the U.S. federal policy agenda. In this study, we examine the ECE content of local television news coverage both for its representations of and for its potential influences on ECE policy agendas. We use data from local stations affiliated with the major networks (ABC, NBC, CBS, and FOX) in media markets across the U.S., airing before and during the pandemic. We analyze elements of coverage that could affect public recognition of ECE-related issues, including how problems were framed (e.g., news coverage highlighting scandals or adverse events at ECE facilities) and solutions identified (e.g., public policy). We find that during 2018 and 2019, more coverage highlighted scandalous activity than public policy. The reverse was true, however, during the early period of the pandemic (from mid-March through June of 2020). Researchers and health professionals were seldom included in stories in either sample, and very few stories offered context about the benefits of ECE for health and well-being. These coverage patterns have implications for the public's understanding of ECE policy and the perceived need for reform. Policymakers, advocates, and researchers looking to advance support for ECE should consider ways to use local television news to present health and policy-relevant information to broad segments of the public. Highlights: Local tv news coverage related to early care and education (ECE) inconsistently highlighted policy, a potential solution to issues of access, affordability, and quality faced by individuals and families. In 2018 and 2019, local tv news coverage of ECE frequently highlighted scandalous and adverse events occurring near or with staff from ECE facilities. Such coverage – focused on the individual problems associated with ECE - may lead viewers to question the safety and legitimacy of childcare offerings in their community and limit perceptions of systemic issues. During the first stage of the COVID-19 pandemic – March through June of 2020 – local tv news coverage of ECE frequently highlighted the policy response to COVID-19 and related provisions for early care and education. Researchers and advocates working to advance ECE-related policy should consider the opportunity to partner with local tv news to build awareness of the need for policy reform. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To estimate neighborhood income differences between the locations of 340B-covered entities and their contract pharmacies (CPs) and examine whether these differences vary between hospitals and grantees. STUDY DESIGN: Cross-sectional study. METHODS: Using Health Resources and Services Administration 340B Office of Pharmacy Affairs Information System and zip code tabulation area (ZCTA)--level US Census Bureau databases, we created a unique data set that contains covered entities' characteristics, CP use, and ZCTA-level median household income in 2019 for more than 90,000 pairs of covered entities and CPs. We computed income differences between each pair and for a subset of pairs in which the pharmacy is within 100 miles of the covered entity for both hospitals and federal grantees. RESULTS: On average, median income in the pharmacy's ZCTA is about 35% higher than in the covered entity's ZCTA, with little difference between hospitals (36%) and grantees (33%). Roughly 72% of arrangements cover less than 100 miles; in that subset, income is about 27% higher for pharmacy ZCTAs, with little difference between hospitals (28%) and grantees (25%). In more than 50% of arrangements, the median income in the pharmacy's ZCTA is more than 20% higher than in the covered entity's ZCTA. CONCLUSIONS: CPs serve at least 2 purposes: They can increase low-income patients' access to medicines directly when a CP is closer to where a covered entity's patients live, and they can increase profits for covered entities (some of which are potentially passed on to patients) and CPs. We find that in 2019, both hospitals and grantees used CPs to generate income but generally they do not appear to contract with pharmacies located in neighborhoods where low-income patients are likeliest to live. Prior research findings have suggested that hospitals and grantees behave differently from each other with respect to CP use, but results of our analysis suggest the opposite. [ABSTRACT FROM AUTHOR]

Objectives. To understand the practices, attitudes, and beliefs of type 1 diabetes (T1D) providers towards school-based diabetes care (SBDC), including counseling families and communicating with schools, and explore the barriers and facilitators which affect their support of SBDC. Research Design and Methods. We conducted a national survey of pediatric T1D providers about their perceived support of SBDC, including family counseling and school communication. We used descriptive statistics to analyze results and explored differences by practice size (<500, 500–999, and ≥1000 patients) and environment (academic vs nonacademic). Results. A total of 149 providers completed the survey. Nearly, all (95%) indicated SBDC was very important. Though most (63%) reported counseling families about SBDC multiple times per year, few (19%) spoke with school staff routinely, reporting that was a shared responsibility among different providers. Close to 90% agreed school feedback on T1D management plans would be helpful, yet only 31% routinely requested this input. Moderate to extremely significant barriers to SBDC communication included internal factors, such as staff resources (67%) and time (82%), and external factors, such as school nurse education needs (62%) and differing school district policies (70%). Individuals from large or academic practices reported more barriers in their knowledge of SBDC, including federal/state laws. Desired facilitators for SBDC included a designated school liaison (84%), electronic transmission for school forms (90%), and accessible school staff education (95%). Conclusions. Though providers universally agree that SBDC is important, there are multilevel internal (practice) and external (policy) barriers to facilitating a bidirectional relationship between schools and health teams. [ABSTRACT FROM AUTHOR]

Persons with disabilities (PWDs) are disproportionately unemployed, underpaid, and underemployed despite their desire and capacity to work. The U.S. federal/state vocational rehabilitation (VR) program, under the supervision of the Rehabilitation Services Administration (RSA), is charged with providing services to assist eligible PWDs (VR consumers) in achieving employment. Despite research showing that VR consumers closed to self-employment (vs. non-self-employment closures) have better outcomes, self-employment is often considered as a last resort. Moreover, some evidence suggests self-employment (like non-self-employment) outcomes are associated with VR consumers' gender and racial/ethnic identity. The objective of this study was to determine trends of case closures in self-employment among PWDs within the VR program from 2011–2013 to 2017–2019 and to examine the effects of gender and race/ethnicity on self-employment outcomes. Variables of interest were obtained from RSA's Case Service Report (RSA-911) data set for 2011, 2012, 2013, 2017, 2018, and 2019. Data were recoded and analyzed. The number of closures in self-employment declined significantly. Weekly earnings in self-employment increased. Time from application to closure in self-employment decreased. Differences in VR self-employment outcomes by race/ethnicity and gender were noted. Efforts should be made to increase competency in self-employment of VR counselors and promote self-employment within the VR program. [ABSTRACT FROM AUTHOR]

The present study concerned the database, Case Closeout Memoranda, established by the National Science Foundation (NSF) of the United States. In the study, the current authors retrieved 3,064 reported cases of suspected noncompliance in research between 1989 to 2019. We then analyzed the classification of misbehaviors and subsequent actions; the authors also investigated the evolution of the violations and actions over the three decades. The preliminary results include the following: the closed cases over the years can be categorized into 31 types of misbehaviors and 5 types of subsequent actions; the total number of closed cases increased significantly after 2004 and reached a peak in the same year; among the closed cases, verbatim plagiarism accounts for the most significant reported breach, followed by grant frauds; in terms of subsequent actions, individuals with fewer breaches were often warned about questionable research practices, and a major portion of those with more severe issues performed administrative actions, followed by monetary recovery and being defined as research misconduct. Finally, the authors proposed establishing a national case database of noncompliance in research in Taiwan to promote retrospective studies and categorization research further. In addition, the authors hoped that Taiwanese local government ministries and research institutions can consider the suggestions in the article to uphold accountability, transparency, and social responsibility. (Article content in Chinese with English extended abstract)

Intimate partner violence is a preventable public health problem affecting more than 12 million people in the United States annually. The immense burden of victimization is most often borne by women. Nearly one in two female homicide victims are killed by current or former partners (more than 50% of which involve firearms). Firearm-related morbidity and mortality are concentrated where firearm ownership is most prevalent and firearm laws are least restrictive, indicating the potential for law to serve as an intervention. Understanding intricacies within laws and how they vary is critical to studying their influence on health. This study is the first to use the scientific legal mapping technique of policy surveillance to create legal data by systematically collecting and coding laws that authorize or require courts to prohibit offenders subject to domestic violence restraining orders (DVROs) and temporary restraining orders (TROs) from purchasing and possessing firearms ("firearm prohibitor" laws). These data measure key provisions of federal and state laws from 1991 to 2016, including whether the law includes a firearm prohibition, who qualifies as an intimate partner, notice and hearing requirements, whether the prohibition occurs automatically or through judicial discretion, and if the law permits or requires the relinquishment or removal of firearms. The federal law, enacted in 1994 (and reauthorized in 2022), only protects qualifying victims that obtain final DVROs. States can mirror or go beyond federal measures. From 1991 to 2016, 38 states enacted a firearm prohibitor law through DVROs (37 states), TROs (20 states), or both (19 states). Today, survivors suffer from a sluggish and fragmented legal system leading to the unequal protection of victims based on where they happen to live. This research provides an in-depth descriptive analysis of this complex and nuanced legal system, recommendations to spur policy reform, and longitudinal data for future research. [ABSTRACT FROM AUTHOR]

Public health agencies' ability to protect health in the wake of COVID-19 largely depends on public trust. In February 2022 we conducted a first-of-its-kind nationally representative survey of 4,208 US adults to learn the public's reported reasons for trust in federal, state, and local public health agencies. Among respondents who expressed a "great deal" of trust, that trust was not related primarily to agencies' ability to control the spread of COVID-19 but, rather, to beliefs that those agencies made clear, science-based recommendations and provided protective resources. Scientific expertise was a more commonly reported reason for "a great deal" of trust at the federal level, whereas perceptions of hard work, compassionate policy, and direct services were emphasized more at the state and local levels. Although trust in public health agencies was not especially high, few respondents indicated that they had no trust. Lower trust was related primarily to respondents' beliefs that health recommendations were politically influenced and inconsistent. The least trusting respondents also endorsed concerns about private-sector influence and excessive restrictions and had low trust in government overall. Our findings suggest the need to support a robust federal, state, and local public health communications infrastructure; ensure agencies' authority to make science-based recommendations; and develop strategies for engaging different segments of the public. [ABSTRACT FROM AUTHOR]

Many clinicians, including those who work in government, experience potential clashes between their professional responsibilities and personal interests that can create conflicts of interest (COIs). Some clinicians might assert that their personal stakes do not influence their professional actions, but data suggest otherwise. This commentary on a case suggests that COIs must be acknowledged with sincerity and managed such that they are eliminated or, at least, credibly mitigated. Moreover, policies and procedures that guide responses to clinicians' COIs must be in place before clinicians assume roles in government. Without external accountability and respect for the limits of selfregulation, clinicians' capacity to reliably promote the public interest without bias could be compromised. [ABSTRACT FROM AUTHOR]

In the 1920s and '30s, the U.S. federal government produced many educational films about national parks and national forests. These films were widely shown in nontheatrical venues such as schools, as well as in commercial movie theaters as shorts before the main feature film. Neglected for decades, these films are of interest now, in the age of global warming, for the way they represent ideas about nature and conservation from a century ago. Significantly, as much as these films depict natural scenery, they also focus on cars, roads, and roadbuilding. This essay focuses on three government films depicting mountains in the interwar years, the first era of roadbuilding in the national parks and forests. These films reveal the state's role in promoting fossil capitalism and settler colonialism, constructing what was then a new and contradictory idea of 'wilderness' in modernity. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic spurred some regulators in the USA to require occupational health and safety programs to prevent COVID-19 transmission in workplaces. The objective of this study was to describe such state and federal regulations enacted between January 2020 and January 2022. Regulations, including emergency temporary standards (ETS) and permanent standards, were identified through a search of Nexis Uni and Bloomberg Law and review of US OSHA websites and the Federal Register. Full texts were reviewed for regulatory scope, hazard and exposure definitions, determination of exposure or risk levels, and control strategies. Four state (California, Michigan, Virginia, and Oregon) and two federal regulations were identified. All regulations described respiratory aerosols as the primary source of SARS-CoV-2 and recognized person-to-person transmission by droplet, airborne, and contact routes. Only the US OSHA ETS for healthcare explicitly stated that inhalation of respiratory particles was the most likely method of COVID-19 transmission. The Virginia, Michigan, and Oregon regulations described different categories of risk defined by exposure frequency and duration or specific workplace activities. California described exposure as places and times when employees come into contact or congregate with other people. The US OSHA ETS for healthcare described exposure as involving close contact with suspected or confirmed COVID-19 patients. While all of the state regulations required strategies from across the hierarchy, only the Virginia regulations specifically incorporated the hierarchy of controls. Only the California and Virginia regulations explicitly linked control strategies to the transmission route, while Virginia demarcated control strategies by risk level. Oregon linked risk level to occupancy levels and physical distancing requirements and referred to the use of a layered approach for transmission control. The US OSHA ETS for healthcare defined droplet and airborne precautions but made no mention of the hierarchy of controls or risk levels. Respirators were discussed in most of the regulations. The first Michigan regulation explicitly required respirators appropriate to exposure risk. The California regulations noted that respirators protect the wearer while face coverings protect people around the wearer. These regulations offer insights for a permanent US OSHA infectious disease regulation, such as the need to consider a range of transmission modes including near- and far-range aerosol inhalation, endemic and novel pathogens, workplaces beyond healthcare settings, factors that contribute to exposure and risk, the hierarchy of controls, the role of vaccination, and the importance of written exposure assessment and infection prevention plans. [ABSTRACT FROM AUTHOR]

The purpose of this exploratory study was to develop a preliminary understanding of the influence of state-level contextual factors predictive of employment outcomes for the U.S. State/Federal Vocational Rehabilitation System (State VR) participants with traumatic brain injury (TBI). Participants were 5,213 individuals with TBI with Individualized Plans for Employment closed during federal Fiscal Year 2016. A four-step hierarchical logistic regression model (5.6% explained variance) containing five demographic, three state-level economic, six state TBI service climate, and nine State VR service variable expenditures correctly classified 57.0% of cases as attaining or not attaining an employment outcome at closure. Significant predictors associated with an employment closure were (a) education, veteran status, and presence of a secondary area of disability impairment; (b) state-level per-capita income; (c) State VR specialized acquired brain injury (ABI)/TBI service and state TBI Implementation Partnership grant funding; and (d) State VR service expenditures on diagnosis and treatment, occupational or vocational training, on-the-job training, job readiness training, transportation, maintenance support, and benefits counseling. The practice, policy, and research implications of these findings are presented. [ABSTRACT FROM AUTHOR]

The article focuses on President James Buchanan's nominated chief justice of Utah Territory Delana R. Eckels, focusing particularly on his views regarding polygamy, Mormonism, Mormon leader Brigham Young, and the party platform of the Democratic Party regarding the Mormons. Topics explored include his role in the Utah War, public sentiment regarding the Mormon Church and its founder Joseph Smith, issues of freedom of religion and "local sovereignty," and issues of state and federal oversight related to slavery and the domestic sphere.

The article examines food insecurity among college students, focusing on the prevalence of nontraditional students who struggle to afford adequate food. It discusses the distinction between food insecurity and hunger, the eligibility criteria for the Supplemental Nutrition Assistance Program (SNAP), and findings from a Government Accountability Office (GAO) report revealing that many eligible food-insecure students do not receive necessary benefits.

There are more than 200 sovereign states on the globe, and they all have unique characteristics. On the globe, no two states are the same. The idea of territoriality, which divides states into federal and unitary states, is one of the most significant characteristics that set them apart. One of the most powerful nations in the world, the United States of America continues to work hard to protect all that is important to its citizens while maintaining strong democratic principles. American history includes the creation of a federal system. Due to these factors, America is fascinating and challenging to comprehend and evaluate. The link between the core and the periphery is quite unclear. This article’s goal is to argue these ambiguous policies by bringing them to light. The federal and state powers are specifically listed in the United States Constitution. However, certain ambiguities make it hard to determine where the boundary between federal and state authorities resides. The topic of discussion in this essay is this troubling predicament. In the framework of the paper’s theme, the Supreme Court of America’s expertise, and its authority in the process of the separation of powers will be examined. Here, it should be highlighted that everything is up to interpretation, which will rely on the Supreme Court judge. A conclusion will be offered based on the work’s argument, outlining the author’s perspective. [ABSTRACT FROM AUTHOR]

Data accumulation efforts are pushing the study of policy innovation diffusion in new directions. This replication study uses one such effort, the State Policy Innovation and Diffusion database, to interrogate the claim that policy attributes like salience and complexity condition the speed of innovation adoption. The study finds that policy complexity does push the effect of policy salience in a negative direction. However, it also finds substantial heterogeneity in these conditional effects across State Policy Innovation and Diffusion's major constituent datasets. In addition, while not completely answering questions about convenience sampling bias, the study shows that the fundamental results do not change with one re-weighting of the results to capture a hypothetical distribution of the population of state policy innovations. The article concludes with future directions for the study of both policy diffusion within American federalism and cross-national diffusion. [ABSTRACT FROM AUTHOR]

In July 2021, a sweeping Executive Order committed the entire U.S. federal government to reining in big business. Dozens of proposed bills at the state level similarly target big business for stricter regulatory treatment. But unlike in past decades, today's calls to break up and intensely regulate big business do not hinge on harms to consumers qua consumers. Instead, today's anti-bigness sentiment rests to a large extent on the claim that big is bad because it is ungovernable. Giant corporations with market power treat legal requirements as mere recommendations, and routinely engage in behavior that harms our civil liberties and degrades the environment as long as it maximizes their own bottom line, or so the argument goes. But the "big is ungovernable" claim as currently construed is underdeveloped. In fact, many theoretical and empirical analyses suggest that big means better governability. If "big is ungovernable" is popular not because of the merits but strictly because of a strong anti-bigness sentiment, we could end up with bad policies negating economies of scale. This Article provides a comprehensive assessment of how size and market power create governance problems, and a blueprint for how to ameliorate these problems. Super-big corporations have (1) power to shape the regulatory framework that governs them, and (2) a fragmentation of knowledge within them that makes it harder to detect and stop transgressions of the framework. These features dilute not just the expected legal sanction, but also moral constraints and the prospect of market discipline for misbehaving. For example, super-big corporations can leverage their market power to force their customers, workers, and suppliers to sign class action waivers and gag clauses, thereby diluting both legal and reputational sanctions for misbehaving. And the fragmentation of knowledge within super-big corporations makes it harder for law enforcers to detect culpability. and easier for individuals working within these corporations to behave badly without feeling guilty about it. Recognizing the limitations of laws, markets, and morals to govern big business has concrete policy implications. At a general level the analysis here can provide an intellectual structure for rethinking criteria for breaking up or downsizing firms according to governability. At a more specific level, this Article questions the desirability of oft-made proposals such as increasing the severity of sanctions. Solutions to bigness-control problems instead must directly address the power problem, such as by making class action waivers unenforceable, and the information problem, such as by recalibrating corporate law's director oversight duties. [ABSTRACT FROM AUTHOR]

There has been increasing national attention to the issue of racial disparities in pregnancy-related deaths. Federal legislation can support approaches at multiple levels of intervention to improve maternal health. As part of the CDC Policy Academy, a team of CDC staff completed a policy analysis to determine the approaches addressed in federal legislation to reduce racial disparities in pregnancy-related deaths. We analyzed federal maternal mortality legislation introduced January 2017 through December 2021. Common approaches addressed by the legislation were categorized into themes and reviewed for their alignment with approaches identified in clinical and public health literature to reduce pregnancy-related deaths, with an emphasis on social determinants of health (SDOH) approaches and reducing racial disparities. Thirty-seven unduplicated bills addressed pregnancy-related deaths, including 27 House or Senate bills that were introduced but not passed, 6 resolutions highlighting the maternal health crisis, 2 bills that passed the House only, and 2 bills enacted into law (Preventing Maternal Deaths Act of 2018 and Protecting Moms Who Served Act). The most common themes mentioned in federal legislation were improving maternal health care, addressing health inequities and SDOH, enhancing data, and promoting women's health. Legislation focused on health inequities and SDOH emphasized implicit bias training and improving SDOH, including racism and other social factors. The reviewed federal legislation reflected common clinical and public health approaches to prevent pregnancy-related deaths, including a significant focus on reducing bias and improving SDOH to address racial disparities. [ABSTRACT FROM AUTHOR]

Many information technology (IT) projects in the U.S. federal government have been plagued with failures and overruns in recent years, wasting a large amount of tax revenues and undermining the public's confidence in the government's ability to manage such resources and deliver on its commitments. What affects the performance of IT projects in the federal government? We find that prior literature on IT project management from the private sector setting is inadequate to answer this question. In addition, to the best of our knowledge, information systems (IS) research thus far has not considered how the decision-making authority of an IT unit influences IT project performance at the organizational level. We leverage several unique characteristics of the public sector, vis-à-vis for-profit firms, in developing our theory and hypothesis. Utilizing official datasets on IT projects and human resource records, we find that the more IT managerial officials and supervisors a federal bureau has, the lower time overruns it experiences in its IT projects. Interestingly, this relationship is weakened when the bureau has a larger number of ongoing IT projects. Our findings offer new theoretical insights for the IT project management literature and provide meaningful policy insights into government IT management. [ABSTRACT FROM AUTHOR]