Test-to-Stay After SARS-CoV-2 Exposure: A Mitigation Strategy for Optionally Masked K-12 Schools.

Objectives: We evaluated the impact of a test-to-stay (TTS) program on within-school transmission and missed school days in optionally masked kindergarten through 12th grade schools during a period of high community severe acute respiratory syndrome coronavirus 2 transmission.

Methods: Close contacts of those with confirmed severe acute respiratory syndrome coronavirus 2 infection were eligible for enrollment in the TTS program if exposure to a nonhousehold contact occurred between November 11, 2021 and January 28, 2022. Consented participants avoided school exclusion if they remained asymptomatic and rapid antigen testing at prespecified intervals remained negative.

Test-to-Stay After Exposure to SARS-CoV-2 in K-12 Schools.

Objectives: We evaluated the safety and efficacy of a test-to-stay program for unvaccinated students and staff who experienced an unmasked, in-school exposure to someone with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Serial testing instead of quarantine was offered to asymptomatic contacts. We measured secondary and tertiary transmission rates within participating schools and in-school days preserved for participants.

Investing in Whole Person Health: Working Toward an Integration of Physical, Behavioral, and Social Health.

North Carolina is developing a unique and innovative infrastructure to support integrated physical, behavioral, and social health care. Efforts by the North Carolina Department of Health and Human Services, the Foundation for Health Leadership & Innovation, Cone Health, Atrium Health, and the One Charlotte Health Alliance advance our understanding of how to best operationalize the design and payment of integrated services. Best practices such as the collaborative care and primary care behavioral health models reduce inefficiencies and disparities by bringing together teams of primary care and behavioral health care providers.

Buying Health For North Carolinians: Addressing Nonmedical Drivers Of Health At Scale.

Since 2017 the North Carolina Department of Health and Human Services has asked how its resources could be optimized to buy health, not only health care. This has led the department to incorporate whole-person care into all of its priorities, including building a statewide infrastructure and implementing incentives to address nonmedical drivers of health-focusing on food, housing, transportation, employment, and interpersonal safety/toxic stress. This article describes four interconnected initiatives that the department has implemented or is implementing to begin integrating medical and nonmedical drivers of health.

Adverse Childhood Experiences (ACEs): An Important Element of a Comprehensive Approach to the Opioid Crisis.

Adverse childhood experiences (ACEs) are traumatic life events that are linked to more than 40 poor adult health outcomes. Up to two-thirds of drug use problems may be traced back to ACEs [1]. Investing in the resiliency of our children is an important component of a comprehensive approach to the opioid epidemic.

Dissemination and Adoption of Guidelines: The Experience of Community Care of North Carolina.

Dissemination and adoption of practice guidelines has the potential to improve the health of a population. However, these processes are complex and take place in the context of a myriad of factors that impact patient and provider behaviors. Therefore, successful strategies-like the ones utilized by Community Care of North Carolina-need to be multifaceted.

Community Care of North Carolina's approach to asthma management.

Community Care of North Carolina (CCNC) takes a comprehensive approach to asthma management. Support from CCNC helps providers follow evidence-based practice guidelines; data guide continuous quality improvement initiatives and inform the care of individual patients and populations; and care managers work with high-risk patients.

Formative development of an intervention to stop family tobacco use: the Parents and Children Talking (PACT) intervention.

Intervening with families is a promising strategy for addressing the continuing problem of adult and youth tobacco use. A four-step formative process was used to develop an innovative self-directed family-based intervention: (1) planning and strategy development through structured telephone interviews, a focus group, and a literature review; (2) development and pretesting of concepts, messages, and materials by using feedback from children and adults on prototypic materials; (3) implementing the program by mailing 6 modules to 50 families (composed of at least one adult smoker and a 9-12-year-old) with overall high levels of engagement; and (4) assessing effectiveness and making refinements by measuring the intervention effect on smoking-related communication, skills, and attitudes. Inconsistent intervention effects related to the difficulty of cessation and the influence of parental smoking suggested needed refinements.

Testing the interaction between parent-child relationship factors and parent smoking to predict youth smoking.

Purpose: To examine if parental smoking modifies the association between parent-child connectedness and parental disapproval of youth smoking with smoking behavior among minority youth.

Methods: Baseline data from an urban Seattle, Washington neighborhood-based intervention trial to reduce risk behaviors among minority males and females aged 11-15 years were used to identify 428 minority youth-parent/guardian pairs. Parental smoking status, assessed by telephone interview, and youth reports of connectedness and parental disapproval, assessed by questionnaire, were tested in Chi-squared stratified analysis and logistic regression to predict youth smoking.

Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions.

Background: Sexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community.

Smoking, exercise and dietary behaviors among mothers of elementary school-aged children in a rural North Carolina county.

Tobacco use, poor diet, and physical inactivity are risk behaviors established during childhood and influenced by parents. Improving health habits of rural families poses particular challenges because resources may be limited in number and reach. To characterize the kinds of prevention programs needed by rural families, 501 surveys were mailed to caregivers of elementary school children living in a rural North Carolina county.