Increasing the Writing Capacity and Dissemination of Evaluation Findings Among US Public Health Practitioners Funded to Improve Cardiovascular Health.

CONTEXT: Contributing to the evidence base, by disseminating findings through written products such as journal articles, is a core competency for public health practitioners. Disseminating practice-based evidence that supports improving cardiovascular health is necessary for filling literature gaps, generating health policies and laws, and translating evidence-based strategies into practice. However, a gap exists in the dissemination of practice-based evidence in public health. Public health practitioners face various dissemination barriers (eg, lack of time and resources, staff turnover) which, more recently, were compounded by the COVID-19 pandemic. PROGRAM: The Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention (DHDSP) partnered with the National Network of Public Health Institutes to implement a multimodal approach to build writing capacity among recipients funded by three DHDSP cooperative agreements. This project aimed to enhance public health practitioners' capacity to translate and disseminate their evaluation findings. IMPLEMENTATION: Internal evaluation technical assistance expertise and external subject matter experts helped to implement this project and to develop tailored multimodal capacity-building activities. These activities included online peer-to-peer discussion posts, virtual writing workshops, resource documents, one-to-one writing coaching sessions, an online toolkit, and a supplemental issue in a peer-reviewed journal. EVALUATION: Findings from an informal process evaluation demonstrate positive results. Most participants were engaged and satisfied with the project's activities. Across eight workshops, participants reported increased knowledge (≥94%) and enhanced confidence in writing (≥98%). The majority of participants (83%) reported that disseminating evaluation findings improved program implementation. Notably, 30 abstracts were submitted for a journal supplement and 23 articles were submitted for consideration. DISCUSSION: This multimodal approach serves as a promising model that enhances public health practitioners' capacity to disseminate evaluation findings during times of evolving health needs.

Effect of a Workplace Weight-Loss Program for Overweight and Obese Healthcare Workers.

PURPOSE: Examining the effect of a workplace weight-loss program on weight loss, and physical, behavioral and mental well-being among overweight/obese healthcare workers. DESIGN: Quasi experimental design. SETTING: Single healthcare setting. PARTICIPANTS: Forty-one (48.0 ± 11.2 years) day-time shift healthcare employees with body mass index [BMI] >29 kg/m2. INTERVENTION: Sixteen-week program with weekly group meetings/activities and individual appointments with nutrition/health experts. MEASURES: Objective (weight, BMI, blood pressure) and self-reported measures were collected at baseline, conclusion of the intervention and 3 to 6 months post-intervention. ANALYSIS: Repeated measure analysis accounting for confounders. RESULTS: Participants had an average of 13 pounds (5.6%) weight loss (224.2 ± 6.4 vs. 211.6 ± 6.4 lbs.; P < 0.0001) upon program completion with significant decreases in BMI (37.7 ± 1.0 vs. 35.1 ± 1.0 kg/m2; P < 0.0001). Extreme obesity (BMI≥40 kg/m2) rate was reduced from 36.6% to 17.1% (P < 0.0001). There were decreases in diastolic blood pressure (76.0 ± 1.4 vs. 68.7 ± 1.5 mmHg; P = 0.001) and self-reported blood glucose (119.9 ± 4.4 vs. 105.5 ± 4.6 mg/dL; P = 0.03). Participants had improvements in weekly physical activity (25% change; P = 0.01), nutrition behavior (33% change, P < 0.0001), sleep quality (23% change, P = 0.005), and depression (72% change, P < 0.0001). Twenty-seven participants had post-intervention follow-up data. On average participants regained 8 pounds, which was less than the initial weight loss (16 lbs., N = 27). CONCLUSION: The results suggest the program may benefit healthcare employees. Further emphasis should be placed on post-intervention weight management to prevent weight regain.

Association of Home Food Availability with Prediabetes and Diabetes among Adults in the United States.

This study examined associations of home food availabilities with prediabetes and diabetes among 8929 adults (20-70 years) participating in 2007-2010 National Health and Nutrition Examination Surveys. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression. Relative to non-diabetic participants (individuals without diabetes or prediabetes), prediabetes participants were associated with lower availabilities of green vegetables (OR = 0.82; 95% CI = 0.73-0.91; p = 0.0006) and fat-free/low-fat milk (OR = 0.80, 95% CI = 0.65-0.89; p = 0.001) and higher sugary drink availability (OR = 1.24, 95% CI = 1.04-1.48; p = 0.02), adjusting for age, sex, and ethnicity (Model 1). The associations remained significant for vegetables (p = 0.005) and fat-free/low-fat milk (p = 0.02) adjusting for additional confounders (body mass index, education, Model 2). Adjusting for dietary components did not change the above results (in model 2) significantly. Participants with high healthy food availability scores had approximately 31% reduction (p = 0.003) in odds of prediabetes compared to those with low scores in Model 1. No associations were detected for diabetes except for fat-free/low-fat milk availability, for which an inverse association was observed in Model 1 (OR = 0.80, 95% CI = 0.65-0.99; p = 0.04). The results show prediabetes participants had lower availability of healthy foods and higher availability of unhealthy foods, suggesting the need to improve healthy food availability at home for this population.

Mobile Phone Text Message Intervention on Diabetes Self-Care Activities, Cardiovascular Disease Risk Awareness, and Food Choices among Type 2 Diabetes Patients.

This study examines the effects of educational text messages on diabetes self-care activities, cardiovascular disease (CVD) risk awareness, and home food availabilities related to food choices among patients with type 2 diabetes. Quasi-experimental design was used with 40 patients (58.0 ± 10.6 years) in the intervention group and 39 (55.7 ± 12.2 years) in the control group. In addition to the usual care provided for all participants, the intervention group received three educational text messages weekly for 12 weeks. Pre- and post-intervention measures were collected for both groups. Ninety-four percent of the participants receiving text messages indicated the usefulness of this program. The intervention group either maintained the same level or demonstrated small improvements in diabetes self-care activities after the intervention. Significant increases in scores of CVD risk awareness (57% increase; p = 0.04) and availabilities of fresh fruits (320% increase; p = 0.01) and fresh vegetables (250% increase; p = 0.02) in the home and weekly total (16% increase; p = 0.02) and moderate/vigorous (80% increase; p = 0.006) physical activity levels were observed for the intervention group relative to the control group. The pilot results suggest the feasibility and usefulness of the text message program for diabetes education. The study is registered with Clinical Trials.gov (NCT03039569).

Exposure to violence, neighborhood context, and health-related outcomes in low-income urban mothers.

Exposure to violence in youths has been associated with negative health outcomes, yet evidence of such in adults is limited. Additionally, it is unknown whether these negative associations persist over time and whether neighborhood characteristics affect such associations. Using longitudinal data from a sample of 2481 mostly low-income urban mothers, logistic regressions indicate that exposure to violence is associated with several poorer health outcomes after accounting for neighborhood and social factors. Also, these poorer health outcomes persisted for two years after violence exposure. This analysis underscores the need to invest in efforts to prevent and reduce exposure to violence.