Integrating Out-of-Pocket Costs Into Shared Decision-Making for Heart Failure With Reduced Ejection Fraction: A Stepped-Wedge Trial (POCKET-COST-HF).

Background: Guideline-directed medical therapy for heart failure (HF) with reduced ejection fraction can entail high out-of-pocket (OOP) costs, prompting concerns about financial toxicity and access. OOP costs are generally unavailable during encounters. This trial assessed the impact of providing patient-specific OOP costs to patients and clinicians.

Skeptical reactions to breast cancer screening benefits and harms: Antecedents, consequences, and implications for screening communication.

Objective: When people receive information about the benefits and harms of mammography screening, they do not always accept it at face value and instead express skepticism. The purpose of this research was to identify the psychological drivers of this skepticism. Two theory-driven hypotheses were considered: One hypothesis proposes that skeptical reactions reflect a psychological defense against information that is emotionally aversive.

Pediatric Coronavirus Disease 2019 Vaccine Experiences, Practices, and Attitudes in Rural Primary Care Clinicians.

Objective: Pediatric coronavirus disease 2019 (COVID-19) vaccination rates remain low in rural areas. A strong clinician recommendation improves vaccine uptake, but the pediatric COVID-19 vaccine recommendation practices of rural primary care clinicians have not been reported. Our objectives were to describe, among rural Colorado pediatric clinicians: 1) recommendation practices for COVID-19 vaccine compared to influenza and school-entry required vaccines, and 2) personal attitudes.

Mammography Screening Preferences Among Screening-Eligible Women in Their 40s : A National U.S. Survey.

Background: The U.S. Preventive Services Task Force (USPSTF) recently changed its recommendation for mammography screening from informed decision making to biennial screening for women aged 40 to 49 years.

Climate adaptation through crop migration requires a nexus perspective for environmental sustainability in the North China Plain.

Crop migration can moderate the impacts of global warming on crop production, but its feedback on the climate and environment remains unknown. Here we develop an integrated framework to capture the climate impacts and the feedback of adaptation behaviours with the land-water-energy-carbon nexus perspective and identify opportunities to achieve the synergies between climate adaptation and environmental sustainability. We apply the framework to assess wheat and maize migration in the North China Plain and show that adaptation through wheat migration could increase crop production by ~18.

Impact of a patient-centered tool to reduce misconceptions about coronary artery disease and its treatment: The CAD roadmap.

Objective: Health misinformation is common and can lead to harmful behaviors such as medication non-adherence. We assessed the impact of a novel patient educational tool focused on overcoming misconceptions among patients with coronary artery disease (CAD).

Methods: We developed the CAD Roadmap, an educational tool aimed at explaining the disease trajectory and overcoming common disease misconceptions (such as that statin medications are not beneficial).

Animal Lives Affected by Meat Consumption Trends in the G20 Countries.

Trends in dietary habits have far-reaching implications, but their impact on animals remains insufficiently explored, as many people continue to dissociate meat from individual animal lives. This research study quantifies the temporal development of the number of animal lives affected by meat consumption within the G20 countries between 1961 and 2020 and forecasts for 2030. Production (including slaughter) and historical and projected food balance data were analyzed to explore these trends.

Predictors of COVID-19 vaccine uptake: an online three-wave survey study of US adults.

Background: To effectively promote vaccine uptake, it is important to understand which people are most and least inclined to be vaccinated and why. In this study, we examined predictors of COVID-19 vaccine uptake and reasons for non-vaccination.

Methods: We conducted an online English-language survey study in December-2020, January-2021, and March-2021.

Game-based learning to improve diagnostic accuracy: a pilot randomized-controlled trial.

Objectives: Perform a pilot study of online game-based learning (GBL) using natural frequencies and feedback to teach diagnostic reasoning.

Methods: We conducted a multicenter randomized-controlled trial of computer-based training. We enrolled medical students, residents, practicing physicians and nurse practitioners.

Integrating Cost into Shared Decision-Making for Heart Failure with Reduced Ejection Fraction (POCKET-COST-HF): A Trial Providing Out-of-Pocket Costs for Heart Failure Medications during Clinical Encounters.

Background: Evidence-based medical therapy for heart failure with reduced ejection fraction (HFrEF) often entails substantial out-of-pocket costs that can vary appreciably between patients. This has raised concerns regarding financial toxicity, equity, and adherence to medical therapy. In spite of these concerns, cost discussions in the HFrEF population appear to be rare, partly because out-of-pocket costs are generally unavailable during clinical encounters.

Elevating Home Health Aide Input in Co-Creation of COVID-19 Vaccine Messaging.

Home health aides (HHAs) care for patients highly vulnerable to COVID-19 and are disproportionately women from minority communities that have been adversely impacted by COVID-19. Yet, direct care workers are less likely to be vaccinated against COVID-19 compared to others. As the pandemic evolves, interest in vaccination may decrease suggesting the need for relevant vaccine messaging to HHAs.

Biodiversity Impact Assessment Considering Land Use Intensities and Fragmentation.

Land use is a major threat to terrestrial biodiversity. Life cycle assessment is a tool that can assess such threats and thereby support environmental decision-making. Within the Global Guidance for Life Cycle Impact Assessment (GLAM) project, the Life Cycle Initiative hosted by UN Environment aims to create a life cycle impact assessment method across multiple impact categories, including land use impacts on ecosystem quality represented by regional and global species richness.

Multi-Institutional Analysis of Cancer Patient Exposure, Perceptions, and Trust in Information Sources Regarding Complementary and Alternative Medicine.

Purpose: Complementary and alternative medicine (CAM) use during cancer treatment is controversial. We aim to evaluate contemporary CAM use, patient perceptions and attitudes, and trust in various sources of information regarding CAM.

Methods: A multi-institutional questionnaire was distributed to patients receiving cancer treatment.

Assessing and Understanding Reactance, Self-Exemption, Disbelief, Source Derogation and Information Conflict in Reaction to Overdiagnosis in Mammography Screening: Scale Development and Preliminary Validation.

Purpose: Overdiagnosis is a concept central to making informed breast cancer screening decisions, and yet some people may react to overdiagnosis with doubt and skepticism. The present research assessed 4 related reactions to overdiagnosis: reactance, self-exemption, disbelief, and source derogation (REDS). The degree to which the concept of overdiagnosis conflicts with participants' prior beliefs and health messages (information conflict) was also assessed as a potential antecedent of REDS.

Impact of prior COVID-19 infection on perceptions about the benefit and safety of COVID-19 vaccines.

In this online survey of 1,733 US adults in December 2021, respondents believed COVID-19 vaccines are less beneficial and less safe for someone who had already had COVID-19. Those who experienced COVID-19 after being vaccinated believed that the vaccines are less beneficial and less safe than those who had not. Findings highlight the need to better communicate evolving evidence of COVID-19 vaccine benefit and safety and to tailor communications to peoples' COVID-19 history and vaccination status.

Telehealth Use During the COVID-19 Pandemic Among Veterans and Nonveterans: Web-Based Survey Study.

Background: In the first year of the COVID-19 pandemic, studies reported delays in health care usage due to safety concerns. Delays in care may result in increased morbidity and mortality from otherwise treatable conditions. Telehealth provides a safe alternative for patients to receive care when other circumstances make in-person care unavailable or unsafe, but information on patient experiences is limited.

Development of a Naturalness Preference Scale.

Objective: Naturalness preference can influence important health decisions. However, the literature lacks a reliable way to measure individual differences in naturalness preferences. We fill this gap by designing and validating a scale to measure individual differences in naturalness preference.

Effects of Nitrogen Emissions on Fish Species Richness across the World's Freshwater Ecoregions.

The increasing application of synthetic fertilizer has tripled nitrogen (N) inputs over the 20th century. N enrichment decreases water quality and threatens aquatic species such as fish through eutrophication and toxicity. However, the impacts of N on freshwater ecosystems are typically neglected in life cycle assessment (LCA).