Introduction: Colorectal cancer (CRC) is the third most-diagnosed cancer among men and women in the US. This study aimed to evaluate the influence of an interactive inflatable colon exhibit on CRC knowledge and screening intent among men attending state fairs in 2 midwestern states.
Methods: At the 2023 state fairs in 2 midwestern states, eligible participants (men aged 18-75 y who could speak and read English and resided in 1 of the 2 states) completed a presurvey, an unguided tour of the inflatable Super Colon, and a postsurvey. Primary outcomes were changes in knowledge (actual and perceived) and CRC screening intent from presurvey to postsurvey. We used χ2 tests to examine differences in survey results between the 2 sites and the association between demographic characteristics and behaviors (knowledge and intentions) before entering the Super Colon exhibit. We used the McNemar test to examine differences in presurvey to postsurvey distributions.
Results: The study sample (N = 940) comprised 572 men at site A (60.8%) and 368 men at site B (39.2%). Except for 1 question, baseline CRC knowledge was relatively high. Greater perceived knowledge was inversely associated with greater actual knowledge. After touring the Super Colon, participants improved their actual knowledge of CRC prevention and self-perceived CRC knowledge. Most participants (95.4%) agreed that the Super Colon was effective for teaching people about CRC.
Conclusion: These findings emphasize the role of community-based educational initiatives in encouraging CRC screening uptake and increasing research participation among men and affirm that the inflatable colon is as an effective educational tool for increasing CRC knowledge and encouraging early-detection screening behavior among men.
Introduction: During the COVID-19 pandemic, Supplemental Nutrition Assistance Program (SNAP) emergency allotments and emergency rent assistance provided support to low-income households. Rent burden, a form of housing insecurity, can severely limit household resources, which, in turn, affects health equity. We explored whether these policy interventions equitably supported households that were or were not experiencing rent burden.
Methods: We used data from the US Household Pulse Survey (June 2022-May 2023) to examine whether associations between emergency support policies and indicators of food and housing security differed according to household rent burden status. We modeled each outcome (food sufficiency or being current on rent) as a function of policy exposure (SNAP emergency allotments or emergency rent assistance), rent burden, and their interaction. We included demographic characteristics, state of residence, and survey cycle as covariates. We modeled each outcome and policy exposure combination separately.
Results: Receiving emergency allotments (72.4% vs 67.2% for SNAP participants in states with and without emergency allotments, respectively) and emergency rent assistance (64.5% vs 57.6% for households that received and were waitlisted/denied assistance, respectively) were associated with greater food sufficiency. The relationship between emergency allotments and food sufficiency was stronger in rent-burdened households; however, emergency rent assistance supported food sufficiency to a greater extent in non-rent-burdened households. Emergency rent assistance supported households in being current on rent (78.7% vs 56.4% for households that received and were waitlisted/denied assistance, respectively) and supported being current on rent to a greater extent in non-rent-burdened households than in rent-burdened households.
Conclusion: The relationship between emergency support policies and food or housing security differed according to whether households were experiencing rent burden. Associations were sometimes stronger in less economically constrained conditions. These results indicate an opportunity to better design policies to support low-income households, address food and housing security, and ultimately decrease the prevalence of chronic disease.
The objective of this study was to examine the state-level association between household energy insecurity and diabetes prevalence in 2020. We obtained 1) state-level data on household energy characteristics from the 2020 Residential Energy Consumption Survey and 2) diagnosed diabetes prevalence from the US Diabetes Surveillance System. We found states with a higher percentage of household energy insecurity had greater diabetes prevalence compared with states with lower percentages of energy insecurity. Interventions related to energy assistance may help reduce household energy insecurity, mitigate the risk of diabetes-related complications, and alleviate some of the burden of diabetes management during extreme temperatures.
This commentary explores the critical roles of health equity and ethical considerations in the deployment of artificial intelligence (AI) in public health and medicine. As AI increasingly permeates these fields, it promises substantial benefits but also poses risks that could exacerbate existing disparities and ethical challenges. This commentary delves into the current integration of AI technologies, underscores the importance of ethical social responsibility, and discusses the implications for practice and policy. Recommendations are provided to ensure AI advancements are leveraged responsibly, promoting equitable health outcomes and adhering to rigorous ethical standards across all populations.
A toolkit, developed by a multidisciplinary team of national and statewide professionals, was promoted among school nurses in Michigan to support use of the standards of care for asthma in schools. We evaluated the effectiveness of the toolkit to assist school nurses in providing support for students with asthma. We used a multimethod approach to assess use of the toolkit, changes in nursing practices as a result of using the toolkit, and challenges encountered when implementing the standards for asthma care. During a 12-month period, from July 2022 through June 2023, increases in time on web page and monthly page views aligned with efforts to promote toolkit use. School nurses reported using the toolkit and implementing practice changes pertaining to training and education, ensuring proper use of and access to asthma medications, and advocating for self-carry of asthma medications. Challenges to implementing the standards of asthma care were time, parental engagement, institutional support, and identifying students with asthma. We found that our promotional efforts prompted school nurses to access the toolkit, which helped school nurses to effectuate practice changes to improve support for students with asthma in schools.
Introduction: Poorly controlled diabetes is a principal cause of end stage renal disease (ESRD), generating an estimated 44% of new cases. Diabetes self-management education and support (DSMES) has been documented to reduce adverse outcomes such as ESRD. Helping patients better manage their condition could ultimately reduce ESRD prevalence.
Methods: We compared the county-level availability of DSMES and dialysis as of November 2022 sorted by the estimated prevalence of diabetes among residents aged 18 years or older. The locations of DSMES programs and ESRD dialysis facilities were obtained from 2 professional organizations and the Centers for Medicare & Medicade Services. Estimated diabetes prevalence was obtained from the Centers for Disease Control and Prevention's PLACES data set. Counties were considered to have high diabetes prevalence if they fell into the top quartile for diabetes prevalence in 2019 (≥14.4% of adults). Analyses were conducted in 2023.
Results: DSMES was available in 41.0% of counties but in only 20.7% of counties with high diabetes prevalence versus 47.9% of low prevalence counties. Dialysis facilities were present in 59.2% of all counties, in 52.8% of all high diabetes prevalence counties, and in 61.4% of other counties. DSMES availability was linked to the presence of a hospital in the county, with only 6.3% of counties without a hospital offering the service.
Implications: DSMES could play a role in reducing the prevalence of ESRD. Public health professionals need to be aware of the differing levels of local availability of this service and work to develop partnerships to provide DSMES in high-prevalence areas not currently served.