Comparing emergency department versus high school-based recruitment for a hypertension research study with adult-youth dyads.

Dyads can be challenging to recruit for research studies, but detailed reporting on strategies employed to recruit adult-adolescent dyads is rare. We describe experiences recruiting adult-youth dyads for a hypertension education intervention comparing recruitment in an emergency department (ED) setting with a school-based community setting. We found more success in recruiting dyads through a school-based model that started with adolescent youth (19 dyads in 7 weeks with < 1 hour recruitment) compared to an ED-based model that started with adults (2 dyads in 17 weeks with 350 hours of recruitment).

Developing a Youth-Led Digital Hypertension Education Intervention for Adults With Hypertension: Qualitative Study on Refinement and Acceptability.

Background: Hypertension affects one-third of adults in the United States and is the leading risk factor for death. Underserved populations are seen disproportionately in the emergency department (ED) and tend to have worse blood pressure (BP) control. For adults, a lack of hypertension knowledge is a common barrier to hypertension control, while social support is a strong facilitator, and providing information that is culturally sensitive and relevant is especially important in this context.

Engaging youth as citizen scientists to determine health needs of New Brunswick adults.

Community health needs assessments (CHNAs) are important tools to determine community health needs, however, populations that face inequities may not be represented in existing data. The use of mixed methods becomes essential to ensure the needs of underrepresented populations are included in the assessment. We created an in-school public health course where students acted as citizen scientists to determine health needs in New Brunswick, New Jersey adults.

Evaluation of a Remote Youth Health Advocate Training Program During the COVID-19 Pandemic.

Background: Since 2016, Changing Health through Advocacy & eMPloyment In Our NeighborhoodS (CHAMPIONS) has utilized in-person programming to engage high school students from underserved Chicago communities in health advocacy education and exposure to health professional careers.

Objective: Describe outcomes after CHAMPIONS' shift from in-person to remote programming during the corona-virus disease 2019 (COVID-19) pandemic.

Methods: The Summer 2020 remote program consisted of four main activities: 1) didactic public health curriculum, 2) phone calls to COVID-19 patients, 3) COVID-19 community health projects, and 4) health professional speaker series.

Characteristics and Barriers of Emergency Department Patients Overdue for Cancer Screening.

Introduction: People without reliable access to healthcare are more likely to be diagnosed with late-stage cancer that could have been treated more effectively if diagnosed earlier. Emergency departments (ED) may be a novel place for cancer screening education for underserved patients. In this study we sought to determine patient characteristics and barriers to cancer screening for those patients who presented to a large, academic safety-net ED and were overdue for breast, cervical, and colorectal cancer screening since the coronavirus 2019 (COVID-19) pandemic.

More Accessible COVID-19 Treatment Through Monoclonal Antibody Infusion in the Emergency Department.

Introduction: Monoclonal antibody (MAB) infusion is the first treatment to manage coronavirus 2019 (COVID-19) in an outpatient setting. Yet increased risk of severe COVID-19 illness may occur from inequities in social determinants of health including access to quality healthcare. Given the safety-net nature of emergency departments (ED), a model that puts them at the center of MAB infusion may better reach underserved patients than models that require physician referral and distribute MAB at outpatient infusion centers.

Utilizing community level factors to improve prediction of out of hospital cardiac arrest outcome using machine learning.

Objectives: To evaluate the impact of community level information on the predictability of out-of-hospital cardiac arrest (OHCA) survival.

Methods: We used the Cardiac Arrest Registry to Enhance Survival (CARES) to geocode 9,595 Chicago incidents from 2014 to 2019 into community areas. Community variables including crime, healthcare, and economic factors from public data were merged with CARES.

A machine learning approach for modeling decisions in the out of hospital cardiac arrest care workflow.

Background: A growing body of research has shown that machine learning (ML) can be a useful tool to predict how different variable combinations affect out-of-hospital cardiac arrest (OHCA) survival outcomes. However, there remain significant research gaps on the utilization of ML models for decision-making and their impact on survival outcomes. The purpose of this study was to develop ML models that effectively predict hospital's practice to perform coronary angiography (CA) in adult patients after OHCA and subsequent neurologic outcomes.

Emergency Department Management of Hypertension in the Context of COVID-19.

Purpose Of Review: This review describes the relationship between COVID-19 and hypertension (HTN), and considerations for emergency medicine providers in the management of hypertensive patients during the COVID-19 pandemic.

Recent Findings: Hypertensive patients with COVID-19 have a higher risk of severe disease/complications, hospitalizations, intensive care unit (ICU) admissions, and mortality than non-hypertensive patients. Studies have also shown the importance of consideration of various demographic factors (such as older age) and socioeconomic factors that may confound these relationships.

Effect of an emergency department education and empowerment intervention on uncontrolled hypertension in a predominately minority population: The AHEAD2 randomized clinical pilot trial.

Objective: To determine whether an emergency department (ED) education and empowerment intervention coupled with early risk assessment can help improve blood pressure (BP) in a high-risk population.

Methods: A hypertension emergency department intervention aimed at decreasing disparities (AHEAD2) is a 3-arm, single-site randomized pilot trial for feasibility in an urban academic ED. A total of 150 predominantly ethnic minorities with no primary care provider and severely elevated blood pressure (BP) (≥160/100 mm Hg) were enrolled over 10 months.

Targeting of uncontrolled hypertension in the emergency department (TOUCHED): Design of a randomized controlled trial.

Background: Uncontrolled or undiagnosed hypertension (HTN) is estimated to be as high as 46% in emergency departments (EDs). Uncontrolled HTN contributes significantly to cardiovascular morbidity and disproportionately affects communities of color. EDs serve high risk populations with uncontrolled conditions that are often missed by other clinical settings and effective interventions for uncontrolled HTN in the ED are critically needed.

User Characteristics of a Low-Acuity Emergency Department Alternative for Low-Income Patients.

Introduction: Emergency department (ED) use for healthcare that can be treated elsewhere is costly to the healthcare system. However, convenience settings such as urgent care centers (UCC) are generally inaccessible to low-income patients. Housing an UCC within a federally qualified health center (FQHC UCC) provides an accessible convenience setting for low-income patients.

Community Targeting of Uncontrolled Hypertension: Results of a Hypertension Screening and Education Intervention in Community Churches Serving Predominantly Racial/Ethnic Minority Populations.

Uncontrolled hypertension is the primary risk factor for the development of cardiovascular complications and particularly burdens racial/ethnic minority populations. To determine the effectiveness of a community hypertension screening, education, and empowerment intervention on blood pressure (BP) improvement. .

Engaging Youth Through Digital Badges to Promote Health in Underserved Communities.

The CHAMPIONS NETWork program trains Chicago high school students as health advocates while preparing them to become future health professionals. We added digital badging to the curriculum in its third year of programming (2018). This article describes methods and student feedback about digital badging, allowing others to implement similar technology-driven opportunities to engage youth and promote healthy living.

Barriers and Facilitators to Hypertension Control Following Participation in a Church-Based Hypertension Intervention Study.

Purpose: Hypertension is the primary risk factor for development of cardiovascular complications. Community-initiated interventions have proven effective in reducing cardiovascular disease risk among individuals who might otherwise face barriers to care. The purposes of this study were to gain feedback on a church-based hypertension intervention study and assess barriers and facilitators to hypertension control after participation in the study.

Evaluation of an Enhanced Peer Mentoring Program on Scholarly Productivity and Promotion in Academic Emergency Medicine: A Five-Year Review.

Objective: To design, implement, and evaluate the effectiveness of an enhanced peer mentoring program (EPMP) for faculty in emergency medicine aimed at overcoming traditional mentoring challenges.

Methods: Full time faculty (Clinical Instructor, Assistant, and Associate levels) were placed into peer groups (based upon their primary academic roles) led by senior faculty advisors at the Professor level. Peer groups met at least quarterly from 2012 to 2017.

Empowering Chicago's Youths as the Next Generation of Health Advocates.

The CHAMPIONS NETWork summer program trains high school students to become health advocates in underserved Chicago, Illinois, communities. It provides a more innovative approach to traditional pipeline programs through the added responsibility of active health promotion. To determine whether student empowerment changed during the program, participants completed pre- and postassessments on health knowledge and self-efficacy.

The CHAMPIONS NETWork: Training Chicago High School Students as Health Advocates to Improve Health Equity.

In Chicago, major disparities exist across ethnic groups, income levels, and education levels for common chronic conditions and access to care. Concurrently, many of Chicago's youth are unemployed, and the number of minorities pursuing health professions is low. In an effort to eliminate this health equity gap, the University of Illinois at Chicago convened a community-university-hospital partnership to implement the CHAMPIONS NETWork (Community Health And eMPowerment through Integration Of Neighborhood-specific Strategies using a Novel Education & Technology-leveraged Workforce).

A hypertension emergency department intervention aimed at decreasing disparities: Design of a randomized clinical trial.

Effective interventions to identify and treat uncontrolled hypertension (HTN), particularly in underrepresented populations that use the emergency department (ED) for primary care, are critically needed. Uncontrolled HTN contributes significantly to cardiovascular morbidity and mortality and is more frequently encountered among patients presenting to the ED as compared to the primary care setting. EDs serve as the point of entry into the health care system for high-risk patient populations, including minority and low-income patients.

Patient and System Factors Related to Missed Opportunities for Screening in an Electronic Medical Record-driven, Opt-out HIV Screening Program in the Emergency Department.

Objective: Emergency departments (EDs) have implemented HIV screening using a variety of strategies. This study investigates how specific patient and health system factors in the ED impact who is and is not screened in a combined targeted and nontargeted, electronic medical record (EMR)-driven, opt-out, HIV screening program.

Methods: This was a retrospective, cross-sectional study of ED visits where patients were determined eligible for HIV screening by an EMR algorithm between November 18, 2014, and July 15, 2015.

Assessment of Nurse Perspectives on an Emergency Department-Based Routine Opt-Out HIV Screening Program.

Routine opt-out HIV screening is recommended for everyone between 13 and 64 years of age. An urban, academic emergency department implemented a nurse-driven routine opt-out HIV screening program. The aim of our study was to assess program uptake and opportunities to improve the program from the perspectives of emergency nurses.

Harnessing the Power of the Electronic Medical Record to Facilitate an Opt-Out HIV Screening Program in an Urban Academic Emergency Department.

Emergency Departments (EDs) are important settings for routine HIV screening because they are safety nets for populations with limited access to primary care and high risk for HIV infection. However, EDs rarely perform routine HIV screening due to logistical barriers. An electronic medical record (EMR)-driven routine opt-out HIV screening program was implemented in an urban academic ED and led to rapid scale-up of screening volume and detection of unknown HIV infection.

A pilot randomized trial teaching mindfulness-based stress reduction to traumatized youth in foster care.

This article presents a pilot project implementing a mindfulness-based stress reduction program among traumatized youth in foster and kinship care over 10 weeks. Forty-two youth participated in this randomized controlled trial that used a mixed-methods (quantitative, qualitative, and physiologic) evaluation. Youth self-report measuring mental health problems, mindfulness, and stress were lower than anticipated, and the relatively short time-frame to teach these skills to traumatized youth may not have been sufficient to capture significant changes in stress as measured by electrocardiograms.