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Little is known regarding the social network relationships that influence dissemination of evidence-based public health practices and policies. In public health, it is critical that evidence-based guidelines, such as the Centers for Disease Control and Prevention's "Best Practices for Comprehensive Tobacco Control Programs," are effectively and efficiently disseminated to intended stakeholders. To determine the organizational and network predictors of dissemination among state tobacco control programs, interviews with members of tobacco control networks across eight states were conducted between August 2009 and September 2010. Measures included partner attributes (e.g., agency type) and relationships among network members (frequency of contact, extent of collaboration, and dissemination of "Best Practices"). Exponential random graph modeling was used to examine attribute and structural predictors of collaboration and dissemination among partners in each network. Although density and centralization of dissemination ties varied across states, network analyses revealed a consistent prediction pattern across all eight states. State tobacco control dissemination networks were less dense but more centralized compared with organizational contact and collaboration networks. Tobacco control partners in each state were more likely to disseminate the "Best Practices" guidelines if they also had existing contact and collaboration relationships with one another. Evidence-based guidelines in public health need to be efficiently and broadly disseminated if we hope to translate science into practice. This study suggests that funders, advocacy groups, and public health agencies can take advantage of existing public health organizational relationships to support the communication and dissemination of evidence-based practices and policies.

The authors surveyed 1,998 Missourians to evaluate (a) awareness and (b) understanding of messages about the impact of tobacco use in Missouri, (c) belief in the accuracy of the messages, and (d) intention to vote for a tobacco tax increase on the basis of the messages. Using structural equation modeling, the relationships among these four constructs were evaluated. A comparison of smokers and nonsmokers indicated that these two groups were influenced by the messages in different ways, [chi][superscript 2](8) = 20.89, p less than 0.05, and should be modeled separately. The nonsmokers' model demonstrated significant (p less than 0.05) relationships between understanding the messages and belief in message accuracy (b = 0.41; R[superscript 2] = 0.17) and between belief in message accuracy and intention to vote in favor of the tobacco tax (b = 0.54; R[superscript 2] = 0.29). In the smokers' model, understanding the messages was not a statistically significant predictor of belief in message accuracy. However, belief in message accuracy had a significant and positive relationship with intention to vote in favor of the tax (b = 0.45; R[superscript 2] = 0.21). These findings indicate that media campaigns about tobacco use should approach smokers and nonsmokers differently. (Contains 2 tables and 2 figures.)

Context: With limited resources and increased public health challenges facing the US, the Centers for Disease Control and Prevention and others have identified partnerships between local health departments (LHDs) and nongovernmental organizations (NGOs) as critical to the public health system. LHDs utilize financial, human, and informational resources and develop partnerships with local NGOs to provide public health services. Purpose: Our study had 2 primary goals: (1) compare resources and partnerships characterizing rural, suburban, and urban LHDs, and (2) determine whether partnerships play a mediating role between LHD resources and the services LHDs provide. Methods: We conducted secondary data analysis using the National Association of County and City Health Officials 2005 Profile Study. We used chi-squared and analysis of variance (ANOVA) to examine differences between rural, suburban, and urban LHDs. We used regression-based mediation methods to test whether partnerships mediated the relationship between resources and service provision. Findings: We found significant differences between LHDs. Urban LHDs serve larger jurisdictions, have larger budgets and more staff, cultivate more partnerships with local NGOs, and provide more health services than suburban or rural LHDs. We found that partnerships were a partial mediator between resources and service provision. In playing a mediating role, partnerships reduce differences in service provision between rural, suburban, and urban LHDs. Conclusions: Partnerships mediate the relationship between resources and service provision in LHDs. LHDs could place more emphasis on cultivating relationships with local NGOs in order to increase service provision. This strategy may be especially useful for rural LHDs facing limited resources and numerous health disparities.

There is a myth that oral contraceptive pill (OCP) use increases body weight. The objectives of this exploratory study were to examine the relationship between OCP use and perceived weight and to test whether OCP ever use moderates the relationship between measured body mass index (BMI) and perceived weight. The sample included 6,897 females aged 20 to 49 from the 2007 to 2018 National Health and Nutrition Examination Surveys (NHANES). Perceived weight was the dependent variable; OCP ever use and measured BMI were independent variables. Covariates included socioeconomic variables and perceived health. In a crude model, the odds of participants perceiving themselves as overweight relative to perceiving themselves as "just about the right weight" were 40.4% higher for each 1-unit increase in measured BMI. In an adjusted model, participants had 40.6% greater odds of having overweight self-perception compared to "right weight" with every 1-unit increase in BMI and OCP ever users had 35.9% higher odds of overweight self-perception compared to "right weight" than never users. OCP moderates the association between measured BMI and perceived weight. In stratified models, OCP users had 44.6% higher odds of overweight self-perception, while never users had 33.6% higher odds of overweight self-perception compared to "right weight" self-perception for every 1-unit BMI increase. OCP use moderates the relationship between measured BMI and perceived weight. For two women with different OCP use history and the same measured BMI, the ever OCP user has 11% higher odds of perceiving herself as overweight compared to the never user. [ABSTRACT FROM AUTHOR]

Introduction: Several evidence-informed consent practices (ECPs) have been shown to improve informed consent in clinical trials but are not routinely used. These include optimizing consent formatting, using plain language, using validated instruments to assess understanding, and involving legally authorized representatives when appropriate. We hypothesized that participants receiving an implementation science toolkit and a social media push would have increased adoption of ECPs and other outcomes. Methods: We conducted a 1-year trial with clinical research professionals in the USA (n = 1284) who have trials open to older adults or focus on Alzheimer's disease. We randomized participants to receive information on ECPs via receiving a toolkit with a social media push (intervention) or receiving an online learning module (active control). Participants completed a baseline survey and a follow-up survey after 1 year. A subset of participants was interviewed (n = 43). Results: Participants who engaged more with the toolkit were more likely to have tried to implement an ECP during the trial than participants less engaged with the toolkit or the active control group. However, there were no significant differences in the adoption of ECPs, intention to adopt, or positive attitudes. Participants reported the toolkit and social media push were satisfactory, and participating increased their awareness of ECPs. However, they reported lacking the time needed to engage with the toolkit more fully. Conclusions: Using an implementation science approach to increase the use of ECPs was only modestly successful. Data suggest that having institutional review boards recommend or require ECPs may be an effective way to increase their use. [ABSTRACT FROM AUTHOR]

BackgroundIn January 2014, the Chicago City Council scheduled a vote on local regulation of electronic cigarettes as tobacco products. One week prior to the vote, the Chicago Department of Public Health (CDPH) released a series of messages about electronic cigarettes (e-cigarettes) through its Twitter account. Shortly after the messages, or tweets, were released, the department’s Twitter account became the target of a “Twitter bomb” by Twitter users sending more than 600 tweets in one week against the proposed regulation. ObjectiveThe purpose of our study was to examine the messages and tweet patterns in the social media response to the CDPH e-cigarette campaign. MethodsWe collected all tweets mentioning the CDPH in the week between the e-cigarette campaign and the vote on the new local e-cigarette policy. We conducted a content analysis of the tweets, used descriptive statistics to examine characteristics of involved Twitter users, and used network visualization and descriptive statistics to identify Twitter users prominent in the conversation. ResultsOf the 683 tweets mentioning CDPH during the week, 609 (89.2%) were anti-policy. More than half of anti-policy tweets were about use of electronic cigarettes for cessation as a healthier alternative to combustible cigarettes (358/609, 58.8%). Just over one-third of anti-policy tweets asserted that the health department was lying or disseminating propaganda (224/609, 36.8%). Approximately 14% (96/683, 14.1%) of the tweets used an account or included elements consistent with “astroturfing”—a strategy employed to promote a false sense of consensus around an idea. Few Twitter users were from the Chicago area; Twitter users from Chicago were significantly more likely than expected to tweet in support of the policy. ConclusionsOur findings may assist public health organizations to anticipate, recognize, and respond to coordinated social media campaigns.

BackgroundOne of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice. ObjectiveSocial media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics. MethodsIn 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data. ResultsLocal health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and “tweeting” more frequently were associated with having a higher percentage of local followers. ConclusionsSocial media has the potential to reach a wide and diverse audience. Understanding audience characteristics can help public health organizations use this new tool more effectively by tailoring tweet content and dissemination strategies for their audience.