Increasing support for the prevention of adverse childhood experiences and substance use: Implementation of narrative change strategies in local health departments.

Adverse childhood experiences (ACEs) are potentially traumatic but preventable experiences that occur before the ages of 18, including child abuse, witnessing violence, and parental substance use. ACEs have been linked with increased risk for substance use, along with a variety of other negative health outcomes. However, there is limited evidence of community-level strategies that link ACEs and substance to increase awareness of prevention efforts. This article reports on a $2.9 million program to promote health equity and inform narratives for the prevention of ACEs and substance use within three Midwestern communities. Program partners sought to create new transformational narratives that linked ACEs and substance use, while underscoring the importance of addressing social determinants of health (SDOH) that lead to disparities in ACEs and substance use. A mixed-methods evaluation design included document review, in-depth interviews with program staff (N = 8) and community liaisons (N = 2), and site reports from program staff (N = 8) and their community partners (N = 17). Analyses showed that successful implementation efforts had early leadership buy-in and support, set clear and manageable expectations at the outset of implementation, and developed strong relationships with organizations that engage in health equity work. Training and technical assistance were critical to helping community partners build trust, recognize each other's perspectives, broaden and reframe their world view, and better understand narrative efforts for the primary prevention of ACEs and substance use.

Best Practices for Financial Sustainability of Healthy Food Service Guidelines in Hospital Cafeterias.

In February and March 2017 we examined barriers and facilitators to financial sustainability of healthy food service guidelines and synthesized best practices for financial sustainability in retail operations. We conducted qualitative, in-depth interviews with 8 hospital food service directors to learn more about barriers and facilitators to financial sustainability of healthy food service guidelines in retail food service operations. Analysts organized themes around headers in the interview guide and also made note of emerging themes not in the original guide. They used the code occurrence and co-occurrence features in Dedoose version 7.0.23 (SocioCultural Research Consultants) independently to analyze patterns across the interviews and to pull illustrative quotes for analysis. Two overarching themes emerged, related to 1) the demand for and sales of healthy foods and beverages, and 2) the production and supply of healthy foods and beverages. Our study provides insights into how hospital food service directors can maximize revenue and remain financially viable while selling healthier options in on-site dining facilities.

Lessons from the 2006 Louisiana health and population survey.

The 2005 hurricane season caused extensive damage and induced a mass migration of approximately 1.1 million people from southern Louisiana in the United States. Current and accurate estimates of population size and demographics and an assessment of the critical needs for public services were required to guide recovery efforts. Since forecasts using pre-hurricane data may produce inaccurate estimates of the post-hurricane population, a household survey in 18 hurricane-affected parishes was conducted to provide timely and credible information on the size of these populations, their demographics and their condition. This paper describes the methods used, the challenges encountered, and the key factors for successful implementation. This post-disaster survey was unique because it identified the needs of the people in the affected parishes and quantified the number of people with these needs. Consequently, this survey established new population and health indicator baselines that otherwise would have not been available to guide the relief and recovery efforts in southern Louisiana.

Use of computer modeling for emergency preparedness functions by local and state health officials: a needs assessment.

The authors, collaborating from several public health institutes, present the methodology, results, and lessons learned from a multistate needs assessment of local and state public health and safety officials regarding their familiarity and use of formal computer modeling for preparedness activities. The study was undertaken to provide information to the newly formed Preparedness Modeling Unit within the Centers for Disease Control and Prevention. The focus was on the use of sophisticated mathematical models associated with three public health threats: pandemic influenza, radiologic release, and severe heat waves. The use of computer modeling and scenario-based analyses can be used to better frame problems and opportunities, integrate data sources, expect outcomes, and improve multistakeholder decision making. The results of the eight state needs assessment demonstrated that preparedness officials are familiar with models and would use computer modeling as a tool, along with other tools and general experiences, depending upon the perceived quality and validity of the model and the assumptions, as well as the applicability, of the model to their particular setting and population. More needs to be done to improve awareness and dissemination of available models and share best practices in both knowledge and use of models. Use of preparedness modeling would enhance the planning for vulnerable and at-risk populations, all-hazard emergencies and infectious disease containment strategies, as well as for response functions including evacuation, sheltering, quarantine, and distribution of medications and supplies.