Heterogeneity in Health Outcomes in the Strong Hearts, Healthy Communities-2.0 Multilevel Intervention in a Community-Randomized Trial: An Exploratory Study of Moderators.

Background/objectives: Multilevel interventions have demonstrated efficacy in improving obesity and other related health outcomes. However, heterogeneity in individual responses indicates the need to identify the factors associated with responses and non-responses to multilevel interventions. The objective of this report is to identify the potential sources of heterogeneity through the exploration of the moderation effects of participant characteristics (sociodemographic and baseline physical/mental health) in the Strong Hearts, Healthy Communities-2.

Identifying and Removing Fraudulent Attempts to Enroll in a Human Health Improvement Intervention Trial in Rural Communities.

Using the internet to recruit participants into research trials is effective but can attract high numbers of fraudulent attempts, particularly via social media. We drew upon the previous literature to rigorously identify and remove fraudulent attempts when recruiting rural residents into a community-based health improvement intervention trial. Our objectives herein were to describe our dynamic process for identifying fraudulent attempts, quantify the fraudulent attempts identified by each action, and make recommendations for minimizing fraudulent responses.

Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women.

Background: Strong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns.

Multilevel Interventions Targeting Obesity: State of the Science and Future Directions.

A seminal report, released in 2001 by the Institute of Medicine, spurred research on the design, implementation, and evaluation of multilevel interventions targeting obesity and related behaviors. By addressing social and environmental factors that support positive health behavior change, interventions that include multiple levels of influence (e.g.

Comparison of percutaneous decannulation and open surgical repair for large-bore arterial access sites of extracorporeal membrane oxygenation.

Introduction: Following weaning of peripheral venoarterial extracorporeal membrane oxygenation (ECMO) support, removal of cannulas and repair of large-bore arterial sites is traditionally by open surgical repair (OSR). The use of a percutaneous vascular closure device (VCD) offers a minimally invasive alternative to OSR with potential for reduced operative complications, reduced hospital length of stay and in-hospital mortality.

Methods: A systematic review of Medline and Embase databases was conducted for studies comparing VCD-assisted decannulation with OSR following decannulation of peripheral ECMO.

Improvements in dietary intake, behaviors, and psychosocial measures in a community-randomized cardiovascular disease risk reduction intervention: Strong Hearts, Healthy Communities 2.0.

Background: Cardiovascular disease (CVD) prevalence has disproportionately risen among midlife and older female adults of rural communities, partly due to poor diet and diet-related behaviors and psychosocial factors that impede healthy eating.

Objectives: This study aimed to evaluate the impact of Strong Hearts Healthy Communities 2.0 (SHHC-2.

Lessons learned from principal investigators on recruitment for community-based health behavior studies during the COVID-19 pandemic.

Little is known about pandemic-related impacts on participant recruitment into community-based health studies during the COVID-19 pandemic. The aim of this report was to summarize lessons learned from principal investigators (PIs) of NIH-funded community-based health behavior studies that were scheduled to recruit during the COVID-19 pandemic. We report on findings from three open-ended questions that were part of a 50-question online survey conducted from December 2022 - January 2023, completed by 52 PIs.

Recruiting experiences of NIH-funded principal investigators for community-based health behavior interventions during the COVID-19 pandemic.

Successful recruitment into randomized trials and interventions is essential to advance scientific knowledge to improve health. This rapid assessment study explored how the COVID-19 pandemic affected participant recruitment overall, identified how it exacerbated existing challenges to recruit hard-to-reach populations, and described how NIH-funded Principal Investigators (PIs) responded to COVID-era recruitment challenges. A cross-sectional survey of NIH-funded PIs conducting interventions and trials related to health behaviors was conducted in 2022.

Integrating Civic Engagement Into a Lifestyle Intervention for Rural Women - A Mixed Methods Process Evaluation.

Purpose: The present study aimed to evaluate the implementation of a civic engagement curriculum (HEART Club) designed to catalyze positive environmental change in rural communities.

Design: The HEART Club curriculum was integrated into a six-month community-based health behavior intervention to reduce cardiovascular disease risk.

Setting: Participants were recruited from eight rural towns in Montana and New York.

Minimally invasive surgical resection of a large primary pulmonary hydatid cyst: a thoracoscopic approach.

Pulmonary hydatid disease is a rare parasitic disease in Australia with few reported cases. The mainstay of treatment in pulmonary hydatid disease is surgical resection followed by medical treatment with benzimidazoles to reduce the risk of recurrence. We present a case of successful resection of a large primary pulmonary hydatid cyst via minimally invasive video-assisted thoracoscopic surgery approach in a 65-year-old gentleman with incidental hepatopulmonary hydatid disease.

COVID-19 Related Protocol Considerations and Modifications within a Rural, Community-Engaged Health Promotion Randomized Trial.

Rural communities are at higher risk for physical inactivity, poor dietary behaviors, and related chronic diseases and obesity. These disparities are largely driven by built environment, socioeconomic, and social factors. A community-based cluster randomized controlled trial of an intervention, the Change Club, aims to address some of these disparities via civic engagement for built environment change.

Changes in physical activity outcomes in the Strong Hearts, Healthy Communities (SHHC-2.0) community-based randomized trial.

Background: Physical inactivity is a risk factor for numerous adverse health conditions and outcomes, including all-cause mortality. Aging rural women are at particular risk for physical inactivity based on environmental, sociocultural, and psychosocial factors. This study reports on changes in physical activity and associated factors from a multicomponent community-engaged intervention trial.

Improvements and Maintenance of Clinical and Functional Measures Among Rural Women: Strong Hearts, Healthy Communities-2. 0 Cluster Randomized Trial.

Background: Cardiovascular disease is the leading cause of death in the United States; however, women and rural residents face notable health disparities compared with male and urban counterparts. Community-engaged programs hold promise to help address disparities through health behavior change and maintenance, the latter of which is critical to achieving clinical improvements and public health impact.

Methods: A cluster-randomized controlled trial of Strong Hearts, Healthy Communities-2.

Does lung cancer screening with low-dose computerized tomography improve survival?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'Does lung cancer screening with low-dose computerised tomography (LDCT) improve survival?' More than 963 papers were found, of which 8 randomized control trials and 1 meta-analysis represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated.

Physical activity and healthy eating behavior changes among rural women: an exploratory mediation analysis of a randomized multilevel intervention trial.

Rural women experience disproportionately higher levels of obesity in comparison to their non-rural counterparts. The present exploratory mediation analysis sought to identify mechanisms that might have contributed to rural women's physical activity and diet changes after participating in a 6-month multilevel community-randomized trial: Strong Hearts, Healthy Communities (SHHC). SHHC was conducted in 16 rural towns in Montana and New York, between 2015 and 2016; 194 overweight, sedentary midlife, and older women (mean age 59; 26.

Feasibility of a yoga intervention to decrease pain in older women: a randomized controlled pilot study.

Background: A significant proportion of older women suffer from chronic pain, which can decrease quality of life. The objective of this pilot randomized study was to evaluate the feasibility of a flow-restorative yoga intervention designed to decrease pain and related outcomes among women aged 60 or older.

Methods: Flow-restorative yoga classes were held twice weekly for 1 hour and led by a certified yoga instructor.

Ripple Effects of a Community-Based Randomized Trial for Rural Women: Strong Hearts, Healthy Communities.

Objective: This study aimed to examine (1) whether the Strong Hearts, Healthy Communities intervention (SHHC) improved social network members' (SNMs') weight, exercise, and diet and (2) whether SNMs' weight and behavioral changes were modified by their relationship closeness and/or spatial closeness with trial participants.

Methods: Eight towns received the SHHC intervention, which focused on building individual healthy behaviors and creating supportive social and built environments for exercise and healthy eating. Eight towns received an education-only control intervention.

The Strong Hearts, Healthy Communities Program 2.0: An RCT Examining Effects on Simple 7.

Introduction: Rural women have higher rates of cardiovascular disease than their nonrural counterparts, partially because of their social and environmental contexts. The study objective is to test a refined version of the multilevel Strong Hearts, Healthy Communities intervention, which used extensive process and outcome evaluation data from the original randomized trial to optimize effectiveness as measured by improved Simple 7 score, a composite measure of cardiovascular disease risk.

Study Design: The intervention was implemented in a 6-month, delayed intervention, community-randomized trial; control participants received the program following 24-week outcome assessment.

Web-Based Dissemination of a Civic Engagement Curriculum to Promote Healthy Eating and Active Living in Rural Towns: The eHEART Study.

Civic engagement interventions aimed at improving food and physical activity environments hold promise in addressing rural health disparities, but ensuring feasible and sustained dissemination remains a challenge. The present study aimed to evaluate the feasibility of a civic engagement curriculum adapted for online dissemination (Healthy Eating and Activity in Rural Towns (eHEART)). The eHEART curriculum and website were developed based on feedback from local health educators and community members.

Serum carotenoids are strongly associated with dermal carotenoids but not self-reported fruit and vegetable intake among overweight and obese women.

Background: Accurate assessment of fruit and vegetable intake (FVI) is essential for public health nutrition research and surveillance. Blood carotenoid concentrations are robust biomarkers of FVI, but collecting blood samples typically is not feasible in population-based studies. Understanding how well non-invasive measures compare to blood estimates is important for advancing surveillance and evaluation.

Changes in diet and physical activity resulting from the Strong Hearts, Healthy Communities randomized cardiovascular disease risk reduction multilevel intervention trial.

Background: Women living in rural areas face unique challenges in achieving a heart-healthy lifestyle that are related to multiple levels of the social-ecological framework. The purpose of this study was to evaluate changes in diet and physical activity, which are secondary outcomes of a community-based, multilevel cardiovascular disease risk reduction intervention designed for women in rural communities.

Methods: Strong Hearts, Healthy Communities was a six-month, community-randomized trial conducted in 16 rural towns in Montana and New York, USA.

Associations between frequency of food shopping at different food sources and fruit and vegetable intake among rural residents in upstate New York, USA.

Objective: To examine the frequency of shopping at different food sources and the associations between shopping at different food sources and fruit and vegetable (FV) intake among upstate New York rural residents.

Design: Cross-sectional study. Descriptive statistics and linear mixed models were used.

Strong Hearts for New York: A multilevel community-based randomized cardiovascular disease risk reduction intervention for rural women.

Background: Rural midlife and older women have high rates of cardiovascular disease (CVD) risk factors and lower access to healthy living resources. The Strong Hearts, Healthy Communities (SHHC) intervention, tailored to the needs of rural women, demonstrated effectiveness on many outcomes. The purpose of the Strong Hearts for New York (SHNY) study is to evaluate the efficacy of an enhanced version of the curriculum (SHHC-2.