Antonia Maria Villarruel

Community health workers (CHW) programs are effective at reducing hospitalizations, improving mental health, and supporting health‐promoting behaviors. Research suggests awareness and use of CHW services remain uneven across communities nationally. This study describes awareness, use and satisfaction with a city‐wide CHW program among racial/ethnic minority individuals in Philadelphia. Data come from a web‐based health survey conducted February–March 2024. Participants reported sociodemographic characteristics, health conditions, barriers to social resources, and awareness and use of the city's CHW program. Among 522 participants, the majority were Black (55.4%), women (70.1%), with mean age 39 years. Less than half (44.6%) were aware of the CHW program; of those, 30.5% (13.6% of whole sample) had used it. Among users, 80.3% reported being satisfied with services. In multivariate models, Asian, Hispanic/Latine, privately insured, unemployed, those without barriers to social resources, those with chronic conditions, and West Philadelphia residents had lower odds of awareness. Education, income, and anxiety symptoms were not associated with program awareness. Awareness and use of this CHW program is low to moderate among key populations in Philadelphia. Given variations in awareness, scale‐up of CHW programs should include evaluation of program reach, especially to individuals who are not employed and have chronic health conditions.

Amplifying nursing's past, present, and future contributions

Physical inactivity is a major public health priority for older Latinos with mild cognitive impairment (MCI). MCI considered a pre-dementia stage of Alzheimer’s disease (AD), increases the risk of AD and related dementias (ADRD). Evidence suggests physical activity (PA) enhances cognition indirectly by improving sleep and reducing chronic conditions like cardiovascular disease that affect neurocognitive function. Older Latinos, the fastest-growing minority group in the US., experience a disproportionate burden of cognitive disease, partly to inactivity and sleep-wake disturbances associated with obesity, diabetes, and cardiovascular risk. Latinos also faculty-level barriers to PA – including cost, neighborhood safety, and limited social support. Yet, few PA interventions are designed for older Latinos with MCI. Tiempo Juntos por Nuestra Salud (Time Together for Our Health) is a socio-ecological framework integrating education, social support, and community walking resources. As a randomized controlled trial, Tiempo Juntos will evaluate effects on moderate-intensity PA; theoretical mediators; and secondary outcomes like cognition, CV health, and sleep at 3, 6 and 12 months. 234 Spanish-speaking Latinos aged ≥55 with MCI (Montreal Cognitive assessment score 23-26) will be assigned to Tiempo Juntos or an attention control group. Participants in Tiempo Juntos will attend a 1-hour twice weekly walking session for 3 months led by a trained community health worker (CHW) followed by mobile health (mHealth) booster sessions. The control group will receive Spanish-language health education from the National Institute on Aging resources for seniors. Findings will establish groundwork for a Stage IV pragmatic trial of Tiempo Juntos serving senior Latinos nationwide.

PurposeThis paper presents the results of a holistic evaluation of VaxUpPhillyFamilies (VaxUp), a program aimed to increase pediatric COVID-19 vaccine uptake in Philadelphia, PA by connecting with parents and caregivers.MethodsTwenty-four participants were engaged in the VaxUp program. Participants completed Vaccine Information Champions (VIC) and social determinants of health (SDOH) training sessions prior to beginning the program. Each week, participants completed activities surveys to document their engagement with the program. Participants also completed midpoint and final evaluation surveys to provide feedback to the study team. Survey data were analyzed for engagement trends as well as participants’ knowledge and comfort with program content.ResultsAmbassadors found that the training sessions were useful and engaging. Conversations with the community, written information distribution, and Facebook were the most common forms of weekly ambassador engagement. Participants who completed the final evaluation survey reported more confidence in talking about the COVID-19 vaccine after program participation. All participants believed that their community viewed them as a more trusted messenger since participating. The trainings prior to the start of the program improved their communication with the community. Through this program, ambassadors were able to increase their confidence as trusted messengers both personally and when engaging with community members.ConclusionThe VaxUp program was an effective community-based initiative that addresses COVID-19 vaccine hesitancy.ImplicationsThese findings showcase that training community members to be trusted health ambassadors is essential. Engaging community members as partners in messaging health information is relevant for pediatric nurses, regardless of practice setting.

[This corrects the article DOI: 10.2196/47091.].

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Background: Web-based surveys increase access to study participation and improve opportunities to reach diverse populations. However, web-based surveys are vulnerable to data quality threats, including fraudulent entries from automated bots and duplicative submissions. Widely used proprietary tools to identify fraud offer little transparency about the methods used, effectiveness, or representativeness of resulting data sets. Robust, reproducible, and context-specific methods of accurately detecting fraudulent responses are needed to ensure integrity and maximize the value of web-based survey research. Objective: This study aims to describe a multilayered fraud detection system implemented in a large web-based survey about COVID-19 attitudes, beliefs, and behaviors; examine the agreement between this fraud detection system and a proprietary fraud detection system; and compare the resulting study samples from each of the 2 fraud detection methods. Methods: The PhillyCEAL Common Survey is a cross-sectional web-based survey that remotely enrolled residents ages 13 years and older to assess how the COVID-19 pandemic impacted individuals, neighborhoods, and communities in Philadelphia, Pennsylvania. Two fraud detection methods are described and compared: (1) a multilayer fraud detection strategy developed by the research team that combined automated validation of response data and real-time verification of study entries by study personnel and (2) the proprietary fraud detection system used by the Qualtrics (Qualtrics) survey platform. Descriptive statistics were computed for the full sample and for responses classified as valid by 2 different fraud detection methods, and classification tables were created to assess agreement between the methods. The impact of fraud detection methods on the distribution of vaccine confidence by racial or ethnic group was assessed. Results: Of 7950 completed surveys, our multilayer fraud detection system identified 3228 (40.60%) cases as valid, while the Qualtrics fraud detection system identified 4389 (55.21%) cases as valid. The 2 methods showed only “fair” or “minimal” agreement in their classifications (κ=0.25; 95% CI 0.23-0.27). The choice of fraud detection method impacted the distribution of vaccine confidence by racial or ethnic group. Conclusions: The selection of a fraud detection method can affect the study’s sample composition. The findings of this study, while not conclusive, suggest that a multilayered approach to fraud detection that includes conservative use of automated fraud detection and integration of human review of entries tailored to the study’s specific context and its participants may be warranted for future survey research.