Exemplar Hospital initiation trial to Enhance Treatment Engagement (EXHIT ENTRE): protocol for CTN-0098B a randomized implementation study to support hospitals in caring for patients with opioid use disorder.

BACKGROUND: Hospitalizations involving opioid use disorder (OUD) are increasing. Medications for opioid use disorder (MOUD) reduce mortality and acute care utilization. Hospitalization is a reachable moment for initiating MOUD and arranging for ongoing MOUD engagement following hospital discharge. Despite existing quality metrics for MOUD initiation and engagement, few hospitals provide hospital based opioid treatment (HBOT). This protocol describes a cluster-randomized hybrid type-2 implementation study comparing low-intensity and high-intensity implementation support strategies to help community hospitals implement HBOT. METHODS: Four state implementation hubs with expertise in initiating HBOT programs will provide implementation support to 24 community hospitals (6 hospitals/hub) interested in starting HBOT. Community hospitals will be randomized to 24-months of either a low-intensity intervention (distribution of an HBOT best-practice manual, a lecture series based on the manual, referral to publicly available resources, and on-demand technical assistance) or a high-intensity intervention (the low-intensity intervention plus funding for a hospital HBOT champion and regular practice facilitation sessions with an expert hub). The primary efficacy outcome, adapted from the National Committee on Quality Assurance, is the proportion of patients engaged in MOUD 34-days following hospital discharge. Secondary and exploratory outcomes include acute care utilization, non-fatal overdose, death, MOUD engagement at various time points, hospital length of stay, and discharges against medical advice. Primary, secondary, and exploratory outcomes will be derived from state Medicaid data. Implementation outcomes, barriers, and facilitators are assessed via longitudinal surveys, qualitative interviews, practice facilitation contact logs, and HBOT sustainability metrics. We hypothesize that the proportion of patients receiving care at hospitals randomized to the high-intensity arm will have greater MOUD engagement following hospital discharge. DISCUSSION: Initiation of MOUD during hospitalization improves MOUD engagement post hospitalization. Few studies, however, have tested different implementation strategies on HBOT uptake, outcome, and sustainability and only one to date has tested implementation of a specific type of HBOT (addiction consultation services). This cluster-randomized study comparing different intensities of HBOT implementation support will inform hospitals and policymakers in identifying effective strategies for promoting HBOT dissemination and adoption in community hospitals. TRIAL REGISTRATION: NCT04921787.

Corrigendum to "protocol for life cycle assessment modeling of US fruit and vegetable supply chains- cases of processed potato and tomato products" [Data in Brief 34 (2021) 1-24/ 106639].

[This corrects the article DOI: 10.1016/j.dib.2020.106639.].

Protocol for life cycle assessment modeling of US fruit and vegetable supply chains- cases of processed potato and tomato products.

This article elaborates on the life cycle assessment (LCA) protocol designed for formulating the life cycle inventories (LCIs) of fruit and vegetable (F&V) supply chains. As a set of case studies, it presents the LCI data of the processed vegetable products, (a) potato: chips, frozen-fries, and dehydrated flakes, and (b) tomato-pasta sauce. The data can support to undertake life cycle impact assessment (LCIA) of food commodities in a "cradle to grave" approach. An integrated F&V supply chain LCA model is constructed, which combined three components of the supply chain: farming system, post-harvest system (processing until the consumption) and bio-waste handling system. We have used numbers of crop models to calculate the crop yields, crop nutrient uptake, and irrigation water requirements, which are largely influenced by the local agro-climatic parameters of the selected crop reporting districts (CRDs) of the United States. For the farming system, LCI information, as shown in the data are averaged from the respective CRDs. LCI data for the post-harvest stages are based on available information from the relevant processing plants and the engineering estimates. The article also briefly presents the assumptions made for evaluating future crop production scenarios. Future scenarios integrate the impact of climate change on the future productivity and evaluate the effect of adaptation measures and technological advancement on the crop yield. The provided data are important to understand the characteristics of the food supply chain, and their relationships with the life cycle environmental impacts. The data can also support to formulate potential environmental mitigation and adaptation measures in the food supply chain mainly to cope with the adverse impact of climate change.

Context matters: Contrasting behavioral and residential risk factors for Lyme disease between high-incidence states in the Northeastern and Midwestern United States.

The dynamics of zoonotic vector-borne diseases are determined by a complex set of parameters including human behavior that may vary with socio-ecological contexts. Lyme disease is the most common vector-borne disease in the United States. The Northeast and upper Midwest are the regions most affected - two areas with differing levels of urbanization and differing sociocultural settings. The probability of being infected with Lyme disease is related to the risk of encounters with Ixodes scapularis ticks infected with Borrelia burgdorferi sensu lato, which reflects both the environmental tick hazard and human behaviors. Herein, we compare behavioral and peridomestic risk factors perceived to influence the risk for human-tick encounters between two high-incidence states in the Northeast (New York and New Jersey) and one high-incidence state in the Midwest (Wisconsin). We used a smartphone application, The Tick App, as a novel survey tool, during spring and summer of 2018. Adaptive human behavior was identified in the relationship between outdoor activities and the use of methods to prevent tick bites. More frequent recreational outdoor activities and gardening (a peridomestic activity) were associated with a 1.4-2.3 times increased likelihood of using personal protective measures to prevent tick bites, when accounting for demographics and previous Lyme diagnosis. Most outdoor activities were more frequently reported by participants from the Midwest (n = 697), representing an older demographic, than the Northeast (n = 396). Participants from the Northeast were less likely to report use of personal protective measures to prevent tick bites, but a larger proportion of participants from the Northeast reported application of environmental pesticides targeting ticks or mosquitoes or other insects on their property (34 % of 279 versus 22 % of 616 participants) and interventions to reduce the presence of peridomestic deer compared to participants from the Midwest (e.g. 20 % of 278 versus 7% of 615 participants reported having a deer proof fence). Participants from the Midwest were more likely to kill rodents on their property (28 % versus 13 %). These differences illustrate the need for further assessment of personal behavior and tick exposure in these two Lyme disease-endemic regions to aid in targeted public health messaging to reduce tick-borne diseases.

Prospective evaluation of a Bayesian model to predict organizational change.

This research examines a subjective Bayesian model's ability to predict organizational change outcomes and sustainability of those outcomes for project teams participating in a multi-organizational improvement collaborative.