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Background and Aims: chronic periodontitis is a slowgrowing inflammdory disease mostly evident in adults Many mental disorders such as depression are related to some physical diseases. This study was conducted with the aim of determining the indicators of chronic periodontitis in people with major depression compared to healthy people in Ilam city in 2021-2022. Materials and Methods: The type of cross-sectional study is descriptive and analytical. The statistical population included 84 patients with major depression who are hospitalized or outpatients in the psychiatric department of Mustafa Hospital. Information was collected through a researcher-made form. This form contains two parts: demographic information part (age, sex, education, place of residence, contact number, duration of illness); periodontal information section (including plaque index, pocket depth, bleeding and adhesion limit). Data were analyzed using SPSS software version 18 and t-tests, analysis of variance and Pearson's correlation. Results: In this study, 84 people including depressed patients (42people) and healthy people (42people) were investigated. The average age of the two groups was 36.11 and 32.9 years, respectively. The indices of pocket depth and buccal and palatal bleeding, clinical attachment level and plaque were significantly higher in depressed patients. Older age, female sex, and lower education were more common in people with depression, but only the level of education was statistically significant (P<0.001). BOP in depressed patients was significantly more than healthy people.(p<0.01) This plaque index was significantly higher in depressed patients with less and higher education than healthy people .(p<0.01) Conclusion: It seems, Periodontal indexes such as gingival bleeding and pocket depth were higher in patients with major depressive disorder. [ABSTRACT FROM AUTHOR]

Purpose: There is little information as to how America's broadband infrastructure might impact recent efforts to expand access to virtual care for underserved communities. Objective: To examine potential and realized access to broadband internet services within Medically Underserved Areas (MUAs) that rely on community health care service providers for primary care. Methods: This cross‐sectional study included 214,946 US Census Block Group estimates from the 2017 and 2019 American Community Survey and the corresponding Federal Communications Commission database. Changes in household broadband subscription rates and Healthy People 2020 access thresholds within MUAs were assessed. Findings: In 2019, 24,304 MUA households (31.9%) met Healthy People 2020 targets for broadband subscription rates, compared to 64.4% of non‐MUA households (n = 89,285). On average, 74.7% of MUA households had a broadband internet subscription compared to 85.2% of non‐MUA households, whereas 61.1% (n = 46,635) of MUA households had access to broadband speeds of at least 25.0 Mbps, compared to 75.6% (n = 104,696) of non‐MUA households. Within urban households, there was a 0.8 to 1.3 to 1.6 annual percentage point convergence in MUA versus non‐MUA broadband disparities between across quintiles (P <.05). Rural MUA households showed little improvement in broadband access between 2017 and 2019. Conclusions: There has been an overall convergence of broadband access disparities between MUA and non‐MUA households over time, but less improvements in access among the most rural households. Reimbursement for audio‐only telehealth visits by state Medicaid agencies would help drive down barriers to virtual health care options for populations residing in MUAs. [ABSTRACT FROM AUTHOR]

Objectives: System Dynamics (SD) is a promising decision support modeling approach for growing shared understanding of complex maternal and child health (MCH) trends. We sought to inventory published applications of SD to MCH topics and introduce the MCH workforce to these approaches through examples to support further iteration and use. Methods: We conducted a systematic search (1958–2018) for applications of SD to MCH topics and characterized identified articles, following PRISMA guidelines. Pairs of experts abstracted information on SD approach and MCH relevance. Results: We identified 101 articles describing applications of SD to MCH topics. Approach: 27 articles present qualitative diagrams, 10 introduce concept models that begin to quantify dynamics, and 67 present more fully tested/analyzed models. Purpose: The most common purposes described were to increase understanding (n = 55) and support strategic planning (n = 26). While the majority of studies (n = 53) did not involve stakeholders, 40 included what we considered to be a high level of stakeholder engagement – a strength of SD for MCH. Topics: The two Healthy People 2020 topics addressed most frequently were early and middle childhood (n = 30) and access to health services (n = 26). The most commonly addressed SDG goals were "End disease epidemics" (n = 26) and "End preventable deaths" (n = 26). Conclusions for Practice: While several excellent examples of the application of SD in MCH were found, SD is still underutilized in MCH. Because SD is particularly well-suited to studying and addressing complex challenges with stakeholders, its expanded use by the MCH workforce could inform an understanding of contemporary MCH challenges. [ABSTRACT FROM AUTHOR]

Introduction: Broadband access is a "super determinant of health." Understanding the spatial distribution and predictors of access may help target government programs and telehealth applications. Our aim was to examine broadband access across geography and sociodemographic characteristics using American Community Survey (ACS) data. Methods: We used 5‐year ACS estimates from 2014 to 2018 to evaluate broadband access across contiguous US census tracts. Rural‐Urban Commuting Area (RUCA) codes were categorized as metropolitan, micropolitan, small town, and isolated rural. We performed bivariate analyses to determine differences by RUCA categories and meeting the Healthy People 2020 (HP2020) objective (83.2% broadband access) or not. We conducted spatial statistics and spatial regression analyses to identify clusters of broadband access and sociodemographic factors associated with broadband access. Results: No RUCA grouping met the HP2020 objective; 80.6% of households had broadband access, including 82.0% of metropolitan, 73.9% of micropolitan, 70.7% of small town, and 70.0% of isolated rural households. Areas with high percentages of Black residents had lower broadband access, particularly in isolated rural tracts (54.9%). Low access was spatially clustered in the Southeast, Southwest, and northern plains. In spatial regression models, poverty and education were most strongly associated with broadband access, while the proportion of American Indian/Alaska Native population was the strongest racial/ethnic factor. Conclusions: Rural areas had less broadband access with the greatest disparities experienced among geographically isolated areas with larger Black and American Indian/Alaska Native populations, more poverty, and lower educational attainment, following well‐known social gradients in health. Resources and initiatives should target these areas of greatest need. [ABSTRACT FROM AUTHOR]

In the article, the author discusses the social determinants of health (SDH) and health disparities in the U.S. by examining the COVID-19 exposures and mortality among African Americans. Also cited are the elements of SDH like economic stability, health care, built environment, and neighborhood, how systemic racism widens SDH differences, and the underlying conditions behind the COVID-19 mortality rates like hypertension, asthma, and type 2 diabetes.

In this article the author talks about the conditions in which people are born, grow, work, live, and age and the wider set of forces and systems shaping the conditions of daily life" also known as social determinants of health affect both a patient's risk factors for cancer and their ability to get the care they need. It mentions that the National League for Nursing (2019) offered the following suggestions for healthcare professionals.

Background: Human papillomavirus (HPV) is largely vaccine preventable. The Healthy People 2020 target goal for vaccine administration is 80%. Current United States (U. S.) rates are far lower primarily because of vaccine hesitancy and lack of provider recommendation. Objective: Implement a risk reduction initiative to increase HPV vaccine rates in females aged 12–26 in five rural counties in Maryland. Methods: A convenience sample from a rural community screened an HPV documentary movie, Questionnaire responses pre- and postscreening were surveyed for impact on vaccine readiness. Postscreening focus group comments were analyzed for common themes. Females aged 12–26 from a University Medical Group Women's Health Center located in rural Maryland were targeted. Chart review of immunization records 90 days pre- and postprovider vaccine recommendation demonstrated impact. Results: Public awareness events have the potential to impact HPV vaccine hesitancy, but this research did not achieve statistical significance. Direct provider to patient recommendations resulted in a 15% increase in HPV immunizations. Conclusions: Education of vaccine-eligible individuals should be undertaken. Implications for Nursing: Providers who recommend administration of the vaccine significantly increase immunization rates. [ABSTRACT FROM AUTHOR]

Projected estimates for lesbian, gay, bisexual, transgender, queer (LGBTQ) populations in the United States reach 4 to 8 million older adults by 2030. Healthy People 2020 created goals to improve the health, safety, and well-being of these individuals. However, not all political agendas point to resolutions favorable for this population. Provisions under the Affordable Care Act once considered status quo protections for the LGBTQ community are now threatened as law makers are rolling back health care mandates, exposing members of the LGBTQ community to potential exacerbations of prejudice, discrimination, and stigmatization previously seen as historical violations of human rights. The purpose of this article is to identify how current health care policies have created legal windows of opportunity for persons to discriminate and create juxtaposition with goals and objectives of Healthy People 2020, promoting barriers in the health care continuum for LGBTQ aging adults. [Projected estimates for lesbian, gay, bisexual, transgender, queer (LGBTQ) populations in the United States reach 4 to 8 million older adults by 2030. Healthy People 2020 created goals to improve the health, safety, and well-being of these individuals. However, not all political agendas point to resolutions favorable for this population. Provisions under the Affordable Care Act once considered status quo protections for the LGBTQ community are now threatened as law makers are rolling back health care mandates, exposing members of the LGBTQ community to potential exacerbations of prejudice, discrimination, and stigmatization previously seen as historical violations of human rights. The purpose of this article is to identify how current health care policies have created legal windows of opportunity for persons to discriminate and create juxtaposition with goals and objectives of Healthy People 2020, promoting barriers in the health care continuum for LGBTQ aging adults. [Journal of Gerontological Nursing, 46(3), 9–13.] [ABSTRACT FROM AUTHOR]

Background: Adult immunization rates are below Healthy People 2020 targets. Our objective was to evaluate the effectiveness of a multicomponent intervention to improve adult immunization rates. Methods: This prospective interventional before-and-after non-randomized study was conducted through the American Academy of Family Physicians National Research Network with 43 primary care physicians from a large multi-specialty healthcare organization (multicomponent intervention group n = 23; comparator group n = 20) in the United States. The multicomponent intervention included provider reminders, quarterly provider-level performance reports, provider education, patient visual aid materials, and standing orders on adult pneumococcal, influenza, and zoster immunizations. We assessed individual and comparative provider-level vaccination rates and missed opportunities detailing concordance with targets established by Healthy People 2020 for pneumococcal, influenza, and zoster immunizations. Results: Vaccination rates increased after 12 months in intervention and comparator groups respectively for: a). influenza from 44.4 ± 16.7 to 51.3% ± 12.9% (by 6.9 percentage points, p = 0.001) and from 35.1 ± 19.1 to 41.3% ± 14.2%, (by 6.2 percentage points, p = 0.01); b). pneumococcal vaccinations in older adults from 62.8 ± 17.6 to 81.4% ± 16.6% (by 18.6 percentage points, for p < 0.0001) and from 55.9 ± 20.0 to 72.7% ± 18.4% (by 16.7 percentage points, p < 0.0001); and c). zoster from 37.1 ± 13.4 to 41.9% ± 13.1% (by 4.8 percentage points, p < 0.0001) and from 35.0 ± 18.7 to 42.3% ± 20.9% (7.3 percentage points, p = 0.001). Pneumococcal vaccinations in adults at risk did not change from baseline in intervention group (35.7 ± 19.6 to 34.5% ± 19.0%, p = 0.3) and improved slightly in comparator group (24.3 ± 20.1 to 28.2% ± 20.0%, p = 0.003). Missed opportunities reduced after 12 months, most noticeably, for: a). for influenza from 57.7 to 48.6% (by 9.1 percentage points, p < 0.0001) and from 69.7 to 59.6% (by 10.1 percentage points, p < 0.0001); b). pneumococcal vaccinations in older adults from 18.1 to 11.5% (by 6.6 percentage points p < 0.0001) and from 24.6 to 20.4% (by 4.3 percentage points, p < 0.0001) in intervention and comparator groups respectively. Conclusions: Multicomponent interventions show promise in improving vaccination rates and reducing missed opportunities in older adults for pneumococcal and zoster vaccines and vaccination against influenza. Provider reminders remain the most effective strategy when delivered either as a component of these interventions or alone. [ABSTRACT FROM AUTHOR]

The article reports on a study that examined rural and urban progress toward national targets for rates of seven major causes of death tracked by Healthy People 2020 initiative. Highlights include the use of data from the National Vital Statistics System to assess age-adjusted death rates for the major causes of death in urban and rural areas, variation in target attainment for other causes of death by rurality and region, and a decline in diabetes-related rates in rural areas in the Northeast.

Background: Healthy People 2020 has made achieving health equity one of its overarching goals; another goal is increasing the number of accredited local agencies that have Community Health Improvement Plans (CHIPs). Community Health Improvement Plans are meant to serve agencies as guiding documents for multiple years. Objectives: This study investigates the prevalence with which health disparities are addressed within CHIPs and the specific health disparities targeted by these objectives. Methods: Researchers analyzed 4,094 objectives from CHIPs of 280 local Public Health Accreditation Board (PHAB)-accredited and nonaccredited public health agencies in the United States. Results: Despite the PHAB's focus on addressing health equity, not all PHAB-accredited agencies addressed health disparities (85.4% of CHIPs analyzed). However, more accredited than nonaccredited agencies (73.9%) contained at least one objective focused on health disparities. Discussion: Findings indicate that if health equity is truly a goal of national initiatives, agencies' planning documents (e.g., CHIPs) can do a better job addressing commonly ignored populations. [ABSTRACT FROM AUTHOR]

The article presents the discussion on increasing vaccination coverage levels across different vaccinations. Topics include influenza or human papillomavirus having different populations such as young children or adolescents, including many outlined in the supplement; and identification and engagement of key partners carrying out or affected by the intervention in the implementation plan.

Asthma is a prevalent and chronic disease that significantly impacts the lives of increasing numbers of children and families each year. Estimates suggest that as many as 339 million people worldwide suffer from asthma -- it is now the most common pediatric chronic disease. The burden of asthma on the child and family is high, multi-factorial, and complex. For many of these children, significant health disparities exist, worsening their health outcomes, as well as their morbidity and mortality rates. Children in the United States who are especially negatively impacted by asthma include those who come from disadvantaged backgrounds and/or are African American. Racial, ethnic, and socioeconomic factors must be considered to gain a thorough understanding of the depth and breadth of the issue. In addition, nurses practicing within the United States must understand relevant health policies that affect these children and families. Examples of such health policies include Healthy People 2020, the Affordable Care Act of 2010, Children's Health Insurance Program, the Clean Air Act, and the Public Health Law Program. Nurses are instrumental in effecting change through the use of evidence-based practice, implementation of current practice guidelines, enhancing collaboration within and across health care settings, communicating with legislators, and being involved with professional nursing organizations. [ABSTRACT FROM AUTHOR]

Each decade since 1979, the Healthy People initiative establishes the national prevention agenda and provides the foundation for disease prevention and health promotion policies and programs. Law and policy have been included in Healthy People objectives from the start, but not integrated into the overall initiative as well as possible to potentially leverage change to meet Healthy People targets and goals. This article provides background on the Healthy People initiative and its use among various stakeholder groups, describes the work of a project aiming to better integrate law and policy into this initiative, and discusses the development of Healthy People 2030 — the next iteration of health goals for the nation. Lessons from the preliminary stages of developing Healthy People by the HHS Secretary's Advisory Committee (Committee) on National Health Promotion and Disease Prevention Objectives for 2030 and a Federal Interagency Workgroup will be included. Efforts by the Committee focused on the role of law and policy as determinants of health and valuable resources around health equity are also shared. Finally, the article discusses ways that law and policy can potentially be tools to help meet Healthy People targets and to attain national health goals. [ABSTRACT FROM AUTHOR]

Breastfeeding is one of the top maternal priorities for many organizations, including the World Health Organization (WHO), The American Academy of Pediatrics (AAP), and the Center for Disease Control (CDC). Focusing on the goals of Healthy People 2020, as well as the recommendations of other organizations, this paper investigates the impacts on women's intentions to breastfeed newborns for 3 months, 6 months, and 1 year. This research used the theory of planned behavior (TPB) as a model to predict intentions for each duration of time. Body satisfaction was included as a moderating variable given research demonstrating a possible connection of body satisfaction to breastfeeding. A survey of 156 pregnant women was conducted. Results demonstrated the importance of the three TPB measures in predicting intentions. Further, significant interactions between body satisfaction and attitudes, as well as body satisfaction and subjective norms were present in predicting intentions to exclusively breastfeed one's baby from infant to 6 months of age. Theoretical implications are discussed, as well as practical implications for breastfeeding interventions and campaigns. [ABSTRACT FROM AUTHOR]

BACKGROUND: Rotavirus remains an important cause of gastroenteritis and has been associated with the hospitalization of 34 to 53 per 10 000 children <5 years of age in the United States annually from 2008 to 2012. Rotavirus vaccines are underused compared with other routine vaccines. We describe rotavirus vaccine coverage and missed opportunities for rotavirus vaccination. METHODS: The National Immunization Survey is a random-digit--dial, population-based survey including US children 19 to 35 months of age. Children fully vaccinated for rotavirus were those who received 3 doses of the pentavalent rotavirus vaccine, 2 doses of the monovalent rotavirus vaccine, or ≥3 doses of either vaccine type. Doses of the diphtheria-tetanus-acellular pertussis vaccine received from 6 weeks through 8 months and 0 days of age when the rotavirus vaccine was not received were considered missed opportunities for rotavirus vaccination according to Advisory Committee on Immunization Practices (ACIP) guidelines, and doses of the diphtheria-tetanus-acellular pertussis vaccine or measles-mumps-rubella vaccine from 6 weeks through 24 months and 0 days of age were considered missed opportunities according to World Health Organization recommendations. RESULTS: Of the 14 571 children included in the 2014 National Immunization Survey, 71% were fully vaccinated for rotavirus. Lower socioeconomic status increased the likelihood of being unvaccinated for rotavirus. Among the 14% of children who received no doses of the rotavirus vaccine, 72% had $1 ACIP-defined missed opportunities, and 83% had ≥1 World Health Organization-defined missed opportunities. Higher socioeconomic status increased the likelihood of having missed opportunities. Complete rotavirus vaccine coverage could be improved to 81% if all missed opportunities within the ACIP-recommended schedule were addressed. CONCLUSIONS: Addressing missed opportunities for rotavirus vaccination is essential to achieving the 80% rotavirus vaccine coverage target outlined by Healthy People 2020. [ABSTRACT FROM AUTHOR]

The authors explore how nurses can contextualize the United Nations 17 Sustainable Development Goals within their daily practice and create holistic plans of care for patients, families, communities, and nations. While health care often focuses on acute or chronic illness, the elements necessary for good health are far more complex than we tend to recognize. Florence Nightingale understood this complexity and wrote extensively on the myriad social and environmental factors that influence well-being. Today these factors are termed "health determinants" and undergird the United Nations 17 Sustainable Development Goals (SDGs). This article explores how nurses can contextualize the SDGs within their daily practice and create holistic plans of care for patients, families, communities, and nations. [ABSTRACT FROM AUTHOR]

Objectives: Despite cancer prevention benefits associated with the human papillomavirus (HPV) vaccine, uptake in the United States is relatively low among males and females. Our objective was to use the Healthy People 2020 social determinants of health framework to determine the availability and characteristics of data on economic, educational, social, health care, and community factors affecting HPV vaccine uptake in the United States. Methods: We included the most recent data sets from 6 publicly available, US-based, federally funded surveys that contained at least 1 measure of HPV vaccination among adolescents and young adults. We searched each data set for any social determinants of health measures within the 5 domains of the framework: economic stability, education, social and community context, health and health care, and neighborhood and built environment. Results: The social determinants of health domains of education, economic stability, and health and health care appeared in all data sets. The domains of social and community context and neighborhood and built environment appeared in only 3 data sets. Even when domains were represented, we discovered gaps in the data sets, in which only limited measures of the social determinants were available. Conclusion: The addition of questions about the social determinants of health to the surveys that generate these data sets, particularly in the domains of social and community context and neighborhood and built environment, would strengthen the ability of public health researchers, policy makers, and professionals to identify associations between the social determinants of health and HPV vaccine uptake. [ABSTRACT FROM AUTHOR]

Summary Health care for victims of Puerto Rico's hurricanes in three settings highlights the impact of social determinants of health, social vulnerability, and chronic disease in disaster management. Addressing such conditions before disasters as well as food needs and health care access after disasters could mitigate disaster impact and facilitate recovery. [ABSTRACT FROM AUTHOR]

Adults age 65 or older are at increased risk for acute and chronic diseases. Patients in this group who are up to date with all CDC-recommended vaccinations can reduce morbidity and mortality. This article discusses a quality improvement project across four NP-owned primary care clinics in which all clinical staff received an educational intervention focused on best vaccination practices and Medicare billing strategies. This project yielded improved vaccination rates in the older adult patient population over a 3-month period. [ABSTRACT FROM AUTHOR]

Evidence has consistently shown that low/limited health literacy (HL) is associated with negative health consequences and higher costs for individuals and society. To generate internal data for employee training and health/wellness programming, an HL assessment of 120 university employees was conducted using the Newest Vital Sign (NVS), a valid and reliable clinical screening tool that asks individuals to interpret a nutrition label. Sociodemographic data were collected and time to administer the NVS tool was also measured. Even in this employed, well-educated sample (mean years of formal education was 16.6 years), 17% had scores indicating limited or possibly limited HL. Findings have implications for occupational training and health providers and programs. Even a well-educated workforce benefits from addressing HL challenges or situational issues with universal strategies. This project supports initiatives to assist employees better navigate, understand, and use health information and services to improve their health. [ABSTRACT FROM AUTHOR]

The article focuses on balancing infection control and frailty prevention during and after the COVID-19 pandemic will introduction of the National Center for Geriatrics and Gerontology Home Exercise Program for Older People 2020. Topics include the government has requested that people stay home to prevent spread of the infection, and the restrictions are gradually being eased considering their impact on the economy, many older people are still practicing physical distancing.

Although nurses are an invaluable component of successful health care transition, a large gap exists on methods to educate future health care professionals regarding roles and necessary transition components. The Transitional Nursing History tool introduces prelicensure students to transitional health care planning needs and the essential roles of nurses. The Transitional Nursing History tool provides experiential student learning, promotes understanding of determinants of health influences on transitional planning needs, and encourages active student engagement. Students report increased recognition of the value of transitional health care planning and actively apply the concepts in other clinical settings [ABSTRACT FROM AUTHOR]

The article informs about Guide to Community Preventive Services, commonly known as the Community Guide is an online collection of evidence-based recommendations from the Community Preventive Services Task Force (CPSTF) that identifies promising, cost-effective ways to improve community and population health. It mentions that the Community Guide covers a broad range of health topics and conditions, offering findings and recommendations for community preventive programs in health topic areas.

Many women fear the risk of developing breast cancer, and some women have increased fear because of their family history. Thankfully, the study of genetics has brought forth tools to better identify women at risk. An understanding of genetics and cancer has led to genetic testing protocols which enable at-risk women to take preventative action through medication, surgery, and intensive screenings. These protocols not only have the potential to prevent cancer but also lead to early detection. Appropriate screening for women at risk for genetic breast cancer is essential for patient care. These screenings include specific risk assessment tests, genetic counseling, and genetic testing. To provide the best possible care for patients, providers must have a basic understanding of cancer, genetics, screening tests, genetic testing, and available prevention measures. [ABSTRACT FROM AUTHOR]

The control of neglected tropical diseases (NTDs) has received huge investment in recent years, leading to large reductions in morbidity. In 2012, the World Health Organization set ambitious targets for eliminating many of these diseases as a public health problem by 2020, an aspiration that was supported by donations of treatments, intervention materials, and funding committed by a broad partnership of stakeholders in the London Declaration on NTDs. Alongside these efforts, there has been an increasing role for quantitative analysis and modeling to support the achievement of these goals through evaluation of the likely impact of interventions, the factors that could undermine these achievements, and the role of new diagnostics and treatments in reducing transmission. In this special issue, we aim to summarize those insights in an accessible way. This article acts as an introduction to the special issue, outlining key concepts in NTDs and insights from modeling as we approach 2020. [ABSTRACT FROM AUTHOR]

Background. The World Health Organization's 2020 goals for Chagas disease are (1) interrupting vector-borne intradomiciliary transmission and (2) having all infected people under care in endemic countries. Insecticide spraying has proved efficacious for reaching the first goal, but active transmission remains in several regions. For the second, treatment has mostly been restricted to recently infected patients, who comprise only a small proportion of all infected individuals. Methods. We extended our previous dynamic transmission model to simulate a domestic Chagas disease transmission cycle and examined the effects of both vector control and etiological treatment on achieving the operational criterion proposed by the Pan American Health Organization for intradomiciliary, vectorial transmission interruption (ie, <2% seroprevalence in children <5 years of age). Results. Depending on endemicity, an antivectorial intervention that decreases vector density by 90% annually would achieve the transmission interruption criterion in 2-3 years (low endemicity) to >30 years (high endemicity). When this strategy is combined with annual etiological treatment in 10% of the infected human population, the seroprevalence criterion would be achieved, respectively, in 1 and 11 years. Conclusions. Combining highly effective vector control with etiological (trypanocidal) treatment in humans would substantially reduce time to transmission interruption as well as infection incidence and prevalence. However, the success of vector control may depend on prevailing vector species. It will be crucial to improve the coverage of screening programs, the performance of diagnostic tests, the proportion of people treated, and the efficacy of trypanocidal drugs. While screening and access can be incremented as part of strengthening the health systems response, improving diagnostics performance and drug efficacy will require further research. [ABSTRACT FROM AUTHOR]

Background. Schistosomiasis remains an endemic parasitic disease affecting millions of people around the world. The World Health Organization (WHO) has set goals of controlling morbidity to be reached by 2020, along with elimination as a public health problem in certain regions by 2025. Mathematical models of parasite transmission and treatment impact have been developed to assist in controlling the morbidity caused by schistosomiasis. These models can inform and guide implementation policy for mass drug administration programs, and help design monitoring and evaluation activities. Methods. We use these models to predict whether the guidelines set by the WHO are on track for achieving their 2020 goal for the control of morbidity, specifically for Schistosoma mansoni. We examine whether programmatic adaptations; namely increases in treatment coverage and/or expansion to adult inclusion in treatment, will improve the likelihood of reaching the WHO goals. Results. We find that in low-prevalence settings, the goals are likely to be attainable under current WHO guidelines, but in moderate to high-prevalence settings, the goals are less likely to be achieved unless treatment coverage is increased and expanded to at least 85% for school-aged children and 40% for adults. Conclusions. To improve the likelihood of reaching the WHO goals, programmatic adaptations are required, particularly for moderate- to high-prevalence settings. Furthermore, improvements in adherence to treatment, potential development of candidate vaccines, and enhanced snail control and WASH (water, sanitation, and hygiene) measures will all assist in achieving the goals. [ABSTRACT FROM AUTHOR]

Background. With the 2020 target year for elimination of lymphatic filariasis (LF) approaching, there is an urgent need to assess how long mass drug administration (MDA) programs with annual ivermectin + albendazole (IA) or diethylcarbamazine + albendazole (DA) would still have to be continued, and how elimination can be accelerated. We addressed this using mathematical modeling. Methods. We used 3 structurally different mathematical models for LF transmission (EPIFIL, LYMFASIM, TRANSFIL) to simulate trends in microfilariae (mf) prevalence for a range of endemic settings, both for the current annual MDA strategy and alternative strategies, assessing the required duration to bring mf prevalence below the critical threshold of 1%. Results. Three annual MDA rounds with IA or DA and good coverage (≥65%) are sufficient to reach the threshold in settings that are currently at mf prevalence <4%, but the required duration increases with increasing mf prevalence. Switching to biannual MDA or employing triple-drug therapy (ivermectin, diethylcarbamazine, and albendazole [IDA]) could reduce program duration by about one-third. Optimization of coverage reduces the time to elimination and is particularly important for settings with a history of poorly implemented MDA (low coverage, high systematic noncompliance). Conclusions. Modeling suggests that, in several settings, current annual MDA strategies will be insufficient to achieve the 2020 LF elimination targets, and programs could consider policy adjustment to accelerate, guided by recent monitoring and evaluation data. Biannual treatment and IDA hold promise in reducing program duration, provided that coverage is good, but their efficacy remains to be confirmed by more extensive field studies. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the influence of the social determinants of health on health care seeking among young adults after they left foster care. Background: Extensive research suggests that stakeholders in foster care systems throughout the world struggle to consistently and effectively manage the health and well‐being of youth. These struggles extend beyond time in foster care as indicated by poor health and social outcomes throughout the life course. Evidence that describes how young adults address health and related social needs after leaving foster care is missing. Design: A phenomenological design, Phenomenology of Practice, was used to collect data. Content analysis was used to analyse the data, using constructs from the Healthy People 2020 SDOH Model to organise the data. Methods: Thirteen young adults who left foster care in the southwestern US were recruited using convenience sampling. Data were collected via individual interviews. Results: Young adults formerly in foster care reported using and lacking social support networks to navigate SDOH. The interrelatedness of SDOH on health outcomes after foster care is evident. Conclusions: Social support networks can help explain how young adults are both able and unable to navigate systems to address health issues. Evaluating social networks used to access care is an important aspect of assessment and intervention for these vulnerable young adults. Relevance to clinical practice: Healthcare providers facilitate healthcare access for young adults who have been in foster care through evaluation of social determinants. Assessment and care planning based on social determinants for those who have been in foster care are critical to ensure the efficacy of interventions designed to address health outcomes. Social support systems are key factors for young adults formerly in foster care to access resources, substantiating the need for ongoing assessment and development of these support systems. [ABSTRACT FROM AUTHOR]

Limited accessibility to and affordability of hearing health care (HHC) and hearing aids (HAs) are two reasons why people do not seek treatment for their hearing losses. This article is the first in a series of two and discusses affordability issues (i.e., billing models, cost-effectiveness, insurance coverage, and reimbursement) related to and provides a historical context for the Over-the-Counter Hearing Aid Act of 2017. This piece of legislation supports development of a new class of over-the-counter HAs that represents a disruptive technology that may transform the HHC industry by reducing costs specific to the device. A discussion of ethical issues and the importance of using evidence-based practice guidelines set the stage for the second article in this series, which reviews relevant research on issues pertaining to persons with mild hearing loss. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To evaluate the effectiveness of Bengal Smiles, a school‐based dental sealant programme and assess outcomes related to the U.S. Healthy People 2020 oral health objectives. Methods: A needs assessment identified high caries prevalence in Idaho children and supported the need for a school‐based dental sealant programme at a local Title 1 school. Children (n=54) ages 6‐12 were screened by dental hygiene students for suspected dental caries, sealant placement and need for referral for dental treatment. Sealant retention and sealant caries rates were computed at 12 months (n=32) using descriptive statistics. Caries rates were analysed with a t test for paired samples, while a chi‐square test was used to determine a difference in referral treatment rates before and after the intervention of administrative staff who contacted parents of children in need of dental treatment. Results: Bengal Smiles participants had a 16% decrease in suspected dental caries; however, there was no statistically significant difference in caries rates (P=.21) at baseline and 12 months. Sealant prevalence increased 370%. Sealant retention outcomes were 74% fully retained with 0% caries, 13% partially retained with 25% caries and 13% no retention with 25% caries. At 12 months, 50% of participants referred for dental treatment accessed care. The intervention of contacting parents had no statistically significant effect on increasing dental treatments (P=.75). Conclusions: School‐based sealant programmes eliminate disparities in accessing oral health care and contribute to attaining U.S. Healthy People 2020 oral health objectives. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The purpose of this paper is to review available evidence to determine the impact of the oral health‐related quality of life (OHRQL) Model for Dental Hygiene on education, research, and practice. Methods: A search was conducted in PubMed using the search terms oral health‐related quality of life, OHRQL, and dental hygiene and limited to publications between 1998 and 2016. Google Scholar was also used to identify citations for the two original OHRQL model papers to capture the literature widely read by practicing dental hygienists but not indexed in PubMed. A total of 40 publications met the predetermined search strategy. Full publications were obtained and reviewed to determine how this research is being used in education, research, and practice. Findings: The OHRQL is being utilized to a very limited degree in education, research, and practice. The literature shows how the OHRQL is actively being used in the school where the model originated in addition to a dental hygiene programme in Japan. Studies have been conducted on a variety of research instruments, including the OHRQL, designed to capture OHRQL outcomes. Japanese researchers have used the OHRQL in studies designed to determine the impact of oral healthcare delivery on patients’ oral health‐related quality of life. Conclusion: Eighteen years of the literature confirms that the OHRQL is being used minimally in education, research, and practice. Greater emphasis is needed around the collection and assessment of oral health‐related quality of life measures for providing patient‐centred care. [ABSTRACT FROM AUTHOR]

Aims: This article discusses the rationale for measuring national well-being, and examines the use of subjectively oriented well-being measures in the context of public policy. Recent years have witnessed growing attention towards the concept and measurement of well-being, both within academic disciplines, intergovernmental organizations such as the World Health Organization (WHO) as well as in many governments across Europe, including the Nordic countries. Economic indicators have commonly been regarded as proxies of societal progress of nations, but indicators of well-being have increasingly been applied in order to complement or replace these measures. Methods: Well-being indicators of the WHO “Health 2020” framework are critically examined with particular attention given to the subjective aspects of well-being. Literature discussing the rationale for subjective indicators is reviewed. As a background, central theoretical and measurement perspectives on well-being are outlined, including hedonic, eudaimonic and objective list approaches. Results: The WHO refers to well-being in definitions of health and mental health, but has primarily reported on disease. The “Health 2020” framework marked a shift in this concern. One of the main targets of “Health 2020” concerns well-being, involving six core indicators. Only one indicator refers to well-being as subjective experience. Literature supports more extensive use of subjective indicators in combination with objective measures. Conclusions: Although consensus on definitions and instruments is lacking, subjective and objective measures of national well-being may jointly contribute to a more comprehensive understanding of societal progress, as well as a broader conception of health. Further research is required, particularly with regard to eudaimonic indicators. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this study was to assess perceptions of pharmacy educators on the priorities and roles of pharmacists in meeting the Healthy People 2020 objectives. STUDY DESIGN: Cross-sectional, qualitative online national survey. METHODS: A comprehensive literature review identified documented roles and responsibilities of pharmacists in addressing the 42 topic areas in Healthy People 2020. From this, a 14-item survey was developed to identify priorities of categories to improve the health of the nation and importance of the pharmacist role to achieve the objectives. The survey was sent electronically to the members of the Public Health Special Interest Group of the American Association of Colleges of Pharmacy in May and June 2014. RESULTS: Participants identified the following Healthy People 2020 categories as most important in improving the health of the nation: chronic diseases, health care services, lifestyle, prevention/well-being, and environmental factors. They identified the following Healthy People 2020 categories as possessing the most important roles for pharmacists in working to improve the health of the nation: chronic diseases, health care services, lifestyle, prevention/well-being, and infectious disease. CONCLUSIONS: There exists great congruence between top categories of importance and those that the pharmacist can impact to improve the health of the nation. The results of this study can guide efforts to educate and activate pharmacists as interprofessional team members improving health locally and globally. [ABSTRACT FROM AUTHOR]

In our nation of rapidly growing diversity and increasing cross-cultural interactions, cultural competence has been recognized as critical for reducing health disparities and improving access to high-quality health care. However, more than a decade of experience in establishing, developing, and implementing cultural immersion programs for nursing students in the United States and in developing countries has convinced this scholar that although cultural competence is of critical importance, many other factors need to be examined and kept in mind as we continue to take on the monumental challenge of eliminating health disparities. This article presents the background and context of current efforts to eliminate health disparities and points out some other key considerations that will be vital in achieving the desired outcome. [ABSTRACT FROM AUTHOR]

This article describes a replicable model of health literacy that promotes positive youth development. Now in its fifth year of implementation and run by Advance African Development, Inc., it is an integrated year-long, in-class, student-centered, technology-driven, and service-learning youth empowerment program. Forty-minute sessions are offered once a week to create health literate K-12 public school students able to use the Internet to obtain and understand health information, and to practice informed decision-making about their health. Data collected were qualitative and included student service learning projects to solve community health issues. Community engagement exposed students to problem-solving, collaborative and transformational leadership, and advocacy skills. Prior to the program, less than half of the students had heard of MedlinePlus, and those who had heard of it rarely could describe its purpose. Approximately 500 students and 10 teachers participated, and over 40 sessions were provided from August 2015 to June 2016. [ABSTRACT FROM PUBLISHER]

Objectives: One strategy to increase the uptake of human papillomavirus (HPV) vaccine among adolescents is through the use of pharmacists. Our objectives were to (1) use a publicly available database to describe the statutory and regulatory authority of pharmacists to administer the HPV vaccine in the United States and (2) discuss how the current status of laws may influence achievement of the Healthy People 2020 goal of 80% HPV vaccination rate for teenagers aged 13-15. Methods: Using information from the Centers for Disease Control and Prevention’s (CDC’s) Public Health Law Program database, we identified state laws in effect as of January 1, 2016, giving pharmacists authority to administer vaccines. We used a standardized analysis algorithm to determine whether states’ laws (1) authorized pharmacists to administer HPV vaccine, (2) required third-party authorization for pharmacist administration, and (3) restricted HPV vaccine administration by pharmacists to certain patient age groups. Results: Of 50 states and the District of Columbia, 40 had laws expressly granting pharmacists authority to administer HPV vaccine to patients, but only 22 had laws that authorized pharmacists to vaccinate preadolescents aged 11 or 12 (ie, the CDC-recommended age group). Pharmacists were granted prescriptive authority by 5 states, and they were given authority pursuant to general (non–patient-specific) third-party authorization (eg, a licensed health care provider) by 32 states or patient-specific third-party authorization by 3 states. Conclusions: Most states permitted pharmacists to administer HPV vaccines only to boys and girls older than 11 or 12, which may hinder achievement of the Healthy People 2020 goal for HPV vaccination. Efforts should be made to strengthen the role of pharmacists in addressing this public health issue. [ABSTRACT FROM AUTHOR]

The article discusess use of family nursing practice, research and education for analyzing social determinants in health in the U.S. Topics discussed include improving health outcomes of individuals; use of public health planning, implementation, and evaluation for improving the same; and role of the family for the same.

Objectives. To model the hypothetical impact of preventing excessive gestational weight gain on midlife obesity and compare the estimated reduction with the US Healthy People 2020 goal of a 10% reduction of obesity prevalence in adults. Methods. We analyzed 3917 women with 1 to 3 pregnancies in the prospective US National Longitudinal Survey of Youth, from 1979 to 2012. We compared the estimated obesity prevalence between 2 scenarios: gestational weight gain as reported and under the scenario of a hypothetical intervention that all women with excessive gestational weight gain instead gained as recommended by the Institute of Medicine (2009). Results. A hypothetical intervention was associated with a significantly reduced estimated prevalence of obesity for first (3.3 percentage points; 95% confidence interval [CI] = 1.0, 5.6) and second (3.0 percentage points; 95% CI = 0.7, 5.2) births, and twice as high in Black as in White mothers, but not significant in Hispanics. The population attributable fraction was 10.7% (95% CI = 3.3%, 18.1%) in first and 9.3% (95% CI = 2.2%, 16.5%) in second births. Conclusions. Development of effective weight-management interventions for childbearing women could lead to meaningful reductions in long-term obesity. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death in Hispanic Americans. Social and physical determinants of health unique to this community must be understood before interventions can be designed and implemented. This article describes a CVD risk assessment conducted in a primarily Mexican American community, using Healthy People 2020 as a model. Social (language, culture, awareness of CVD, and socio-economic status) and physical (presence and use of recreation areas, presence of grocery stores, public transportation, and environmental pollution) determinants of health as well as access to health services were assessed. Fifteen community leaders were interviewed using guided interviews. Database searches and direct observations were conducted. Using these methods provided comprehensive assessment of social and physical determinants of health, and access issues that were unique to the community studied. Findings demonstrated greater awareness of diabetes than CVD as a health problem, with little knowledge of CVD risk factors. Lack of access to health services (lack of insurance, lack of a medical home) and presence of cultural and socioeconomic barriers such as language, unemployment, low income, and lack of insurance were identified. The physical determinants such as environment presented fewer barriers, with adequate access to fruits and vegetables, transportation, and parks. Results revealed target areas for intervention. [ABSTRACT FROM AUTHOR]

The article presents an independent mid-course review conducted by the National Vaccine Advisory Committee (NVAC) to evaluate the progress on the goals of the National Vaccine Plan and develop recommendations for the U.S. Assistant Secretary for Health (ASH). Topics discussed include priority opportunity areas for advancing U.S. vaccine and immunization efforts, health and economic benefits of immunization, and recommended actions for future updates to the National Vaccine Plan.

Background: An acceptable and affordable food basket (FB) is necessary to meet not only physical (healthy) needs but also the non-physical needs of individuals and communities. Methods: FBs were developed based on the Cypriot national food-based dietary guidelines for six types of household: single woman (±40 years), single man (±40 years), a couple (±40 years) without children, single woman (±40 years) with two children (10-year- old boy and 14-year-old girl), single man (±40 years) with two children and a couple (±40 years) with two children. Non-physical needs (kitchen equipment, physical activity and other related functions of food) were added to the baskets. The cost, acceptability and feasibility of FB were examined through the focus group discussions. Affordability was defined as the cost of the each basket as a percentage of household income (Guaranteed Minimum Income [GMI]). Results: The budget for healthy food has the highest proportion in the total food budget (83-89%) compared with the other components. The part of the budget required for other functions of food is small compared with that of healthy food and ranged between 4.7 and 6.7% of the total monthly budget. For low-income families, the proportion of income that needs to be spent on the FB for physical needs and FB for physical and non-physical needs ranged from around 39 to 72% and 47 to 81%, respectively. Conclusions: The FB fulfilling physical and non-physical needs is not affordable among the low-income families (mainly with children) receiving the GMI scheme in Cyprus. [ABSTRACT FROM AUTHOR]

Background Simultaneous administration of all age-appropriate doses of vaccines is an effective strategy for raising vaccination coverage. Vaccination coverage for ≥4 dose of DTaP (diphtheria, tetanus toxoids, and acellular pertussis vaccine) among children 19–35 months in the United States has not reached the Healthy People 2020 target of 90%. Risk factors for missed opportunities for simultaneous administration of the fourth dose of DTaP have not been investigated. Methods A missed opportunity for simultaneous administration of the fourth dose of DTaP is defined as the failure to administer an age-eligible fourth dose of DTaP, and during the same age-eligible period for the fourth dose of DTaP other recommended and age-appropriate doses of vaccines are given to children. This study used 2001–2014 National Immunization Survey data to describe the trend in missed opportunities for simultaneous administration of the fourth dose of DTaP from 2001 through 2014, assess the prevalence of children who missed opportunities for simultaneous administration of the fourth dose of DTaP by selected factors, and recognize significant risk factors for missed opportunities for simultaneous administration of the fourth dose of DTaP. Results From 2001 to 2014, the prevalence of missed opportunities for simultaneous administration of the fourth dose of DTaP among children 19–35 months in the United States ranged from 5.7% to 9.0%; across 13 factors considered, the prevalence of missed opportunities varied from 3.3% to 22.9%. Children who were late in receiving the first to third dose of DTaP had significantly higher prevalence of missed opportunities for simultaneous administration of the fourth dose of DTaP than children who received these doses on-time, with adjusted prevalence ratios for late vs. on-time of 1.7, 1.6, and 3.2, and all P-value < 0.01. Conclusions Improving on-time vaccination of the third dose of DTaP could substantially reduce missed opportunities for simultaneous administration of the fourth dose of DTaP. [ABSTRACT FROM AUTHOR]

Background and aims Quitting smoking is the most potent way to reduce the health risks associated with smoking cigarettes, and public health objectives in the United States include dramatic increases in the proportion of smokers making a serious quit attempt each year. The US Centers for Disease Control and Prevention (CDC) has, since 2000, set as its Healthy People 2020 objective to encourage 80% of smokers to make a serious quit attempt per year. This study assessed the trend in quit attempts from 2009 to 2014. Design We examined the percentage of US smokers making a serious quit attempt each year from 2009 to 2014 from the repeating cross-sectional National Health Interview Survey (NHIS). Setting United States. Participants The number of qualifying respondents per year ranged from 5748 in 2010 to 7219 in 2012, with a total of 40 362 respondents included in the analysis. Measurements Respondents were deemed to have made a serious quit attempt if they were either current smokers who reported that they stopped smoking for more than 1 day in the past 12 months because they were trying to quit smoking, or reported being former smokers (smoked 100+ cigarettes life-time, but now not smoking) who quit in the past year. Findings Analyses of trends from 2009 to 2014 showed an overall linear increase in quit attempts [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.01-1.04, P = 0.0075], but also a quadratic trend (OR = 1.01, 95% CI = 1.00-1.02, P = 0.0189). Conclusions The proportion of US smokers making a serious quit attempt has increased since 2009, due to an upward trend since 2011. The 2014 serious quit attempt rate was 55.0%. These rates are still below the Healthy People 2020 objective of 80% of smokers making a serious quit attempt per year. [ABSTRACT FROM AUTHOR]

Purpose Influenza vaccination rates among healthcare providers (HCPs) in long-term care facilities (LTCFs) are commonly below the Healthy People 2020 goal of 90%. This study was conducted to develop and evaluate an intervention program designed to increase influenza uptake among HCPs in LTCFs. Methods This study was conducted in four Midwestern LTCFs. Baseline interviews, surveys, and administrative data analysis were performed following the 2013–2014 influenza season. Interventions implemented during the 2014–2015 season were based on the health belief and ecological models and included goal-setting worksheets, policy development, educational programs, kick-off events, incentives, a vaccination tracking roster, and facility-wide communication about vaccine uptake among HCPs. Outcomes were evaluated in 2015. Results At baseline, 50% of 726 nursing staff employed during the 2013–2014 influenza season had documented receipt of influenza vaccine (Site A: 34%; Site B: 5%; Site C: 75%; Site D: 62%), and 31% of 347 survey respondents reported absenteeism due to respiratory illness. At follow-up, 85% of HCPs had documented receipt of influenza vaccine (p < 0.01) and 19% of 323 survey respondents reported absenteeism due to respiratory illness (p < 0.01). Vaccination rates among respondents’ family members increased from 31% at baseline to 44% post-intervention (p < 0.01). Reasons for declining vaccination did not change following exposure to educational programs, but HCPs were more likely to recommend vaccination to others after program implementation. Conclusions Vaccination rates among long-term care HCPs and their family members increased significantly and HCP absenteeism decreased after the implementation of multifaceted interventions based on an ecological model. The findings suggest that major increases in HCP vaccination can be achieved in LTCFs. More research is needed to evaluate the impact of increased HCP vaccination on the health and productivity of LTCF employees, their family members, and residents. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify barriers to and facilitators of human papillomavirus (HPV) vaccination in children aged 9-17 years across Texas. A literature review informed the development of a web-based survey designed for people whose work involves HPV vaccination in settings serving pediatric patients. The survey was used to examine current HPV vaccine recommendation practices among healthcare providers, barriers to HPV vaccination, reasons for parent/caregiver vaccine refusal, staff and family education practices, utilization of reminder and recall systems and status of vaccine administration (payment, ordering and stocking). 1132 responses were received representing healthcare providers, administrative and managerial staff. Respondents identified perceived barriers to HPV vaccination as parental beliefs about lack of necessity of vaccination prior to sexual debut, parental concerns regarding safety and/or side effects, parental perceptions that their child is at low risk for HPV-related disease, and parental lack of knowledge that the vaccine is a series of three shots. Of responding healthcare providers, 94 % (n = 582) reported they recommend the vaccine for 9-12 year olds; however, same-day acceptance of the vaccine is low with only 5 % (n = 31) of providers reporting the HPV vaccine is 'always' accepted the same day the recommendation is made. Healthcare providers and multidisciplinary care teams in pediatric care settings must work to identify gaps between recommendation and uptake to maximize clinical opportunities. Training in methods to communicate an effective HPV recommendation and patient education tailored to address identified barriers may be helpful to reduce missed opportunities and increase on-time HPV vaccinations. [ABSTRACT FROM AUTHOR]

HPV vaccine series completion rates among adolescent Hispanic females and males (~39 and 21 %, respectively) are far below the Healthy People 80 % coverage goal. Completion of the 3-dose vaccine series is critical to reducing the incidence of HPV-associated cancers. This formative study applies social marketing theory to assess the needs and preferences of Hispanic mothers in order to guide the development of interventions to increase HPV vaccine completion. We conducted 51 in-depth interviews with Hispanic mothers of adolescents to identify the key concepts of social marketing theory (i.e., the four P's: product, price, place and promotion). Results suggest that a desire complete the vaccine series, vaccine reminders and preventing illnesses and protecting their children against illnesses and HPV all influence vaccination (product). The majority of Completed mothers did not experience barriers that prevented vaccine series completion and Initiated mothers perceived a lack of health insurance and the cost of the vaccine as potential barriers. Informational barriers were prevalent across both market segments (price). Clinics are important locations for deciding to complete the vaccine series (place). They are the preferred sources to obtain information about the HPV vaccine thus making them ideal locations to deliver intervention messages, followed by television, the child's school and brochures (promotion). Increasing HPV vaccine coverage among Hispanic adolescents will reduce the rates of HPV-associated cancers and the cervical cancer health disparity among Hispanic women. This research can inform the development of an intervention to increase HPV vaccine series completion in this population. [ABSTRACT FROM AUTHOR]

Healthy People 2020 (HP2020) aims to improve population health outcomes through several objectives, including health communication and health information technology. We used 7 administrations of the Health Information National Trends Survey to examine HP2020 goals toward access to the Internet through broadband and mobile devices (N = 34080). We conducted descriptive analyses and obtained predicted marginals, also known as model-adjusted risks, to estimate the association between demographic characteristics and use of mobile devices. The HP2020 target (7.7% of the US population) for accessing the Internet through a cellular network was surpassed in 2014 (59.7%), but the HP2020 target (83.2%) for broadband access fell short (63.8%). Sex and age were associated with accessing the Internet through a cellular network throughout the years (Wald Ftest, P<.05). The increase in the percentage of people accessing the Internet through mobile devices presents an opportunity for technology-based health interventions that should be explored. [ABSTRACT FROM AUTHOR]