Hypertension identification via emergency responders: a randomized controlled intervention study.

OBJECTIVE: The objective was to test the effectiveness of a mail campaign that included blood pressure (BP) measurements from patients treated by emergency medical technicians (EMTs) to motivate them to (re)check their BP at a fire station. The mailing used a 2×2 research design tailoring on risk and source personalization. METHOD: In this randomized controlled trial, participants were randomized into a control group or one of four experimental groups. Participants residing in one of four fire departments in a Pacific Northwest metropolitan area were eligible if they had a systolic BP≥160 mm Hg and/or diastolic BP≥100 mm Hg when seen by EMTs during the study period (July 2007-September 2009). RESULTS: Of 7106 eligible participants, 40.7% were reached for a follow-up interview. Multivariable logistic regression analysis showed that although the absolute number of fire station BP checks was low (4%), participants who received any mailed intervention had a 3 to 5-fold increase in the odds of reporting a fire station BP check over controls. Fire station visits did not differ by type of tailored mailing. CONCLUSION: Partnering with Emergency Medical Services is an innovative way to identify high-risk community members for population health interventions.

Developing concurrency messages for the black community in Seattle, Washington.

In the United States, Blacks are disproportionately impacted by HIV/AIDS. Sexual networks and concurrent relationships have emerged as important contributors to the heterosexual transmission of HIV. To date, Africa is the only continent where an understanding of the impact of sexual concurrency has been conveyed in HIV prevention messaging. This project was developed by researchers and members of the Seattle, Washington, African American and African-Born communities, using the principles of community-based participatory research (CBPR). Interest in developing concurrency messaging came from the community and resulted in the successful submission of a community-academic partnership proposal to develop and disseminate HIV prevention messaging around concurrency. The authors describe (a) the development of concurrency messaging through the integration of collected formative data and findings from the scientific literature; (b) the process of disseminating the message in the local Black community; and (c) important factors to consider in the development of similar campaigns.

Improving low-wage, midsized employers' health promotion practices: a randomized controlled trial.

BACKGROUND: The Guide to Community Preventive Services (Community Guide) offers evidence-based intervention strategies to prevent chronic disease. The American Cancer Society (ACS) and the University of Washington Health Promotion Research Center co-developed ACS Workplace Solutions (WPS) to improve workplaces' implementation of Community Guide strategies. PURPOSE: To test the effectiveness of WPS for midsized employers in low-wage industries. DESIGN: Two-arm RCT; workplaces were randomized to receive WPS during the study (intervention group) or at the end of the study (delayed control group). SETTING/PARTICIPANTS: Forty-eight midsized employers (100-999 workers) in King County WA. INTERVENTION: WPS provides employers one-on-one consulting with an ACS interventionist via three meetings at the workplace. The interventionist recommends best practices to adopt based on the workplace's current practices, provides implementation toolkits for the best practices the employer chooses to adopt, conducts a follow-up visit at 6 months, and provides technical assistance. MAIN OUTCOME MEASURES: Employers' implementation of 16 best practices (in the categories of insurance benefits, health-related policies, programs, tracking, and health communications) at baseline (June 2007-June 2008) and 15-month follow-up (October 2008-December 2009). Data were analyzed in 2010-2011. RESULTS: Intervention employers demonstrated greater improvement from baseline than control employers in two of the five best-practice categories; implementing policies (baseline scores: 39% program, 43% control; follow-up scores: 49% program, 45% control; p=0.013) and communications (baseline scores: 42% program, 44% control; follow-up scores: 76% program, 55% control; p=0.007). Total best-practice implementation improvement did not differ between study groups (baseline scores: 32% intervention, 37% control; follow-up scores: 39% intervention, 42% control; p=0.328). CONCLUSIONS: WPS improved employers' health-related policies and communications but did not improve insurance benefits design, programs, or tracking. Many employers were unable to modify insurance benefits and reported that the time and costs of implementing best practices were major barriers. TRIAL REGISTRATION: This study is registered at clinicaltrials.gov NCT00452816.

Reducing at-risk adolescents' display of risk behavior on a social networking web site: a randomized controlled pilot intervention trial.

OBJECTIVE: To determine whether an online intervention reduces references to sex and substance abuse on social networking Web sites among at-risk adolescents. DESIGN: Randomized controlled intervention trial. SETTING: www.MySpace.com. PARTICIPANTS: Self-described 18- to 20-year-olds with public MySpace profiles who met our criteria for being at risk (N = 190). Intervention Single physician e-mail. MAIN OUTCOME MEASURES: Web profiles were evaluated for references to sex and substance use and for security settings before and 3 months after the intervention. RESULTS: Of 190 subjects, 58.4% were male. At baseline, 54.2% of subjects referenced sex and 85.3% referenced substance use on their social networking site profiles. The proportion of profiles in which references decreased to 0 was 13.7% in the intervention group vs 5.3% in the control group for sex (P = .05) and 26.0% vs 22% for substance use (P = .61). The proportion of profiles set to "private" at follow-up was 10.5% in the intervention group and 7.4% in the control group (P = .45). The proportion of profiles in which any of these 3 protective changes were made was 42.1% in the intervention group and 29.5% in the control group (P = .07). CONCLUSIONS: A brief e-mail intervention using social networking sites shows promise in reducing sexual references in the online profiles of at-risk adolescents. Further study should assess how adolescents view different risk behavior disclosures to promote safe use of the Internet.

Display of health risk behaviors on MySpace by adolescents: prevalence and associations.

OBJECTIVE: To determine the prevalence of and associations among displayed risk behavior information that suggests sexual behavior, substance use, and violence in a random sample of the self-reported 18-year-old adolescents' publicly accessible MySpace Web profiles. DESIGN: Cross-sectional study using content analysis of Web profiles between July 15 and September 30, 2007. SETTING: www.MySpace.com. PARTICIPANTS: A total of 500 publicly available Web profiles of self-reported 18-year-olds in the United States. MAIN OUTCOME MEASURES: Prevalence and associations among displayed health risk behaviors, including sexual behavior, substance use, or violence, on Web profiles. RESULTS: A total of 270 (54.0%) profiles contained risk behavior information: 120 (24.0%) referenced sexual behaviors, 205 (41.0%) referenced substance use, and 72 (14.4)% referenced violence. Female adolescents were less likely to display violence references (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.15-0.6). Reporting a sexual orientation other than "straight" was associated with increased display of references to sexual behavior (OR, 4.48; 95% CI, 1.27-15.98). Displaying church or religious involvement was associated with decreased display of all outcomes (sex: OR, 0.32; 95% CI, 0.12-0.86; substance use: OR, 0.38; 95% CI, 0.19-0.79; violence: OR, 0.12; 95% CI, 0.02-0.87; any risk factor: OR, 0.36; 95% CI, 0.19-0.7). Displaying sport or hobby involvement was associated with decreased references to violence (OR, 0.27; 95% CI, 0.09-0.79) and any risk factor (OR, 0.46; 95% CI, 0.27-0.79). CONCLUSIONS: Adolescents frequently display risk behavior information on public Web sites. Further study is warranted to explore the validity of such information and the potential for using social networking Web sites for health promotion.

Conflicts of interest in translational research.

Translational research requires a team approach to scientific inquiry and product development. Translational research teams consist of basic and clinical scientists who can be members of both academic and industrial communities. The conception, pre-clinical testing, and clinical evaluation of a diagnostic or therapeutic approach demands an intense interaction between investigators with diverse backgrounds. As the barriers between industry and academia are removed, issues of potential conflict of interest become more complex. Translational researchers must become aware of the situations which constitute conflict of interest and understand how such conflicts can impact their research programs. Finally, the translational research community must participate in the dialogue ongoing in the public and private sectors and help shape the rules that will govern conflicts that arise during the evolution of their research programs.