Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS): Study design and harmonization.

INTRODUCTION: Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS) is the first non-pharmacological multicenter randomized clinical trial (RCT) to prevent cognitive impairment in Latin America (LA). Our aim is to present the study design and discuss the strategies used for multicultural harmonization. METHODS: This 1-year RCT (working on a 1-year extension) investigates the feasibility of a multi-domain lifestyle intervention in LA and the efficacy of the intervention, primarily on cognitive function. An external harmonization process was carried out to follow the FINGER model, and an internal harmonization was performed to ensure this study was feasible and comparable across the 12 participating LA countries. RESULTS: Currently, 1549 participants have been screened, and 815 randomized. Participants are ethnically diverse (56% are Nestizo) and have high cardiovascular risk (39% have metabolic syndrome). DISCUSSION: LatAm-FINGERS overcame a significant challenge to combine the region's diversity into a multi-domain risk reduction intervention feasible across LA while preserving the original FINGER design.

Knowledge and Attitudes about Zika Virus Infection and Vaccine Intent among Medical Students in Costa Rica.

Zika virus (ZIKV) infection is a public health problem in the Americas. We assessed ZIKV knowledge, attitudes, and future ZIKV vaccine intent among medical students. In this cross-sectional study, a convenience sample of medical students in San José, Costa Rica, were surveyed to assess knowledge, attitudes, vaccine intent, and sources of information about ZIKV. Knowledge and attitude scores were calculated. Factors associated with vaccine intent were determined by bivariate analysis using a chi-square test. Of 468 participants surveyed, majority were females (299, 63.8%) and lived in urban areas (411, 87%). The participant mean knowledge score was 12.2 (SD: 3.65) out of a possible 20. Students residing in suburban or rural areas (odds ratio [OR]: 0.432; CI: 0.24-0.78), first- or second-year students (OR: 0.423; CI: 0.27-0.67), and aged < 20 years (OR: 0.586; CI: 0.36-0.97) had significantly lower knowledge scores. The participant mean attitude score was 30.2 (SD: 4.76) on a scale of 13-65, with lower numbers indicating a concern for ZIKV severity. A majority of the participants indicated they would be likely or extremely likely to receive a ZIKV vaccine (420, 89.7%) and recommend the vaccine to their patients (439, 93.8%). Vaccine intent was not influenced by demographics, total knowledge, and attitude scores. Students (388, 83%) identified the Internet as their primary source of ZIKV information. A majority of students demonstrated a positive attitude toward ZIKV and willingness to accept and recommend a vaccine. Low knowledge scores underscore the need for ZIKV education, especially in the early years of medical school. Use of the Internet should be considered in dissemination of ZIKV education.