Recommendations for Improving Oral Pre-exposure Prophylaxis Implementation and Social Marketing in Ugandan Fisherfolk Communities: A Qualitative Exploration.

HIV is hyperendemic among fisherfolk in Sub-Saharan Africa, especially around Lake Victoria, Uganda. We conducted cross-sectional semi-structured interviews about oral pre-exposure prophylaxis (PrEP) implementation with 35 Ugandan fisherfolk (15 women, 20 men) and 10 key stakeholders (healthcare providers, policymakers, community leaders). We used a directed content analysis approach based on implementation science and social marketing frameworks.

Health and Social Services in Puerto Rico Before and After Hurricane Maria: Predisaster Conditions, Hurricane Damage, and Themes for Recovery.

"In September 2017, Puerto Rico was struck by two major hurricanes-Irma and Maria-that intensified existing challenges in Puerto Rico's health and social services infrastructure. In the aftermath, the government of Puerto Rico created a long-term recovery plan built on an evidence-based assessment of the damage from the hurricanes and the ongoing needs across Puerto Rico. Development of the recovery plan was supported by the Federal Emergency Management Agency, other federal agencies, local stakeholders, and analysis from the Homeland Security Operational Analysis Center (HSOAC), operated by RAND Corporation under contract with the U.

Pilot Randomized Controlled Trial of an Intervention to Improve Coping with Intersectional Stigma and Medication Adherence Among HIV-Positive Latinx Sexual Minority Men.

We developed and pilot-tested an eight-session community-based cognitive behavior therapy group intervention to improve coping with intersectional stigma, address medical mistrust, and improve antiretroviral treatment adherence. Seventy-six HIV-positive Latinx sexual minority men (SMM; 38 intervention, 38 wait-list control) completed surveys at baseline, and 4- and 7-months post-baseline. Adherence was electronically monitored.

The Welcome Baby Program: An Implementation and Outcomes Evaluation.

In 2015, First 5 LA contracted with the RAND Corporation to perform an implementation and outcomes evaluation of its Welcome Baby universal home visitation program. RAND designed and executed a mixed-methods implementation and outcomes evaluation program that examined program fidelity across 12 sites in Los Angeles County, each site's community referral and resource process, staff and participant experiences with the program, factors that may influence program attrition, short-term outcomes, and the relationship between program fidelity and outcomes. Data from multiple sources were used, including interviews with staff and focus groups with participants, quantitative data from staff and participant surveys, data collected by staff and entered into an administrative database, and document review.

A Pilot Test of Game Changers, a Social Network Intervention to Empower People with HIV to be Prevention Advocates in Uganda.

We conducted a pilot randomized controlled trial of Game Changers, a 6-session group intervention that empowers people with HIV to be HIV prevention advocates in their social networks. Ninety-nine people with HIV (51 intervention, 48 wait-list control) and 58 of their social network members (alters) completed baseline and 5- and 8-month post-baseline assessments. Results indicated high acceptability, demonstrated by participants' and facilitators' positive attitudes qualitatively and favorable ratings of intervention sessions quantitatively, and high feasibility (76% attended all intervention sessions).

City of Los Angeles Neighborhood Parks: Research Findings and Policy Implications (2003-2015).

This study summarizes more than a decade of research on how well neighborhood parks in Los Angeles support physical activity. Between 2003 and 2015, researchers at the RAND Corporation studied 83 parks in the city of Los Angeles, conducting thousands of observations and fielding nearly 28,000 surveys of park users and local residents. About half of all residents said that they used their neighborhood parks, most of them routinely.

Promoting physical activity in high-poverty neighborhood parks: A cluster randomized controlled trial.

Although physical activity can help mitigate or prevent multiple chronic diseases, most people in the U.S., especially high-poverty minority groups, engage in insufficient levels of physical activity.

The Prevalence and Use of Walking Loops in Neighborhood Parks: A National Study.

Background: Previous studies indicate that the design of streets and sidewalks can influence physical activity among residents. Park features also influence park use and park-based physical activity. Although individuals can walk on streets and sidewalks, walking loops in parks offer a setting to walk in nature and to avoid interruptions from traffic.

The First National Study of Neighborhood Parks: Implications for Physical Activity.

Introduction: An extensive infrastructure of neighborhood parks supports leisure time physical activity in most U.S. cities; yet, most Americans do not meet national guidelines for physical activity.

The Paradox of Parks in Low-Income Areas: Park Use and Perceived Threats.

Concerns about safety and perceived threats have been considered responsible for lower use of parks in high poverty neighborhoods. To quantify the role of perceived threats on park use we systematically observed 48 parks and surveyed park users and household residents in low-income neighborhoods in the City of Los Angeles. Across all parks, the majority of both park users and local residents perceive parks as safe or very safe.

Effectiveness of a Free Exercise Program in a Neighborhood Park.

Background: Faculty, students, and alumni in a university-based kinesiology program developed an innovative model for health promotion practice by partnering with the local park administration in San Fernando, California to offer these exercise classes for free in a low-income, predominantly Latino neighborhood park. The classes were taught by students as practical training for academic credit.

Purpose: To evaluate the effectiveness of this pilot program in promoting moderate-to-vigorous physical activity.

Promotoras as data collectors in a large study of physical activity in parks.

There is a large literature on promotores' involvement in health promotion and a smaller literature on their roles in data collection, most often among predominantly Latino populations. But the extent to which promotores can be successful as the primary data collectors across racially/ethnically and socioeconomically diverse neighborhoods is less well documented. In a study of physical activity in 50 urban neighborhood parks, we found that a team of Spanish/English bilingual promotoras (female promotores) successfully implemented a direct observation protocol in all participant neighborhoods and achieved high interrater reliability (.

How much neighborhood parks contribute to local residents' physical activity in the City of Los Angeles: a meta-analysis.

Objective: To quantify the contribution of neighborhood parks to population-level, moderate-to-vigorous physical activity (MVPA).

Method: We studied park use in 83 neighborhood parks in Los Angeles between 2003 and 2014 using systematic observation and surveys of park users and local residents. We observed park use at least 3-4 times per day over 4-7 clement days.

Impact of park renovations on park use and park-based physical activity.

Background: Given the concerns about low rates of physical activity among low-income minority youth, many community-based organizations are investing in the creation or renovation of public parks to encourage youth to become more physically active. To what degree park renovations accomplish this goal is not known.

Methods: We used the System for Observing Play and Recreation in Communities (SOPARC) to measure park users and their physical activity levels before and after 2 parks were renovated.

Involving community stakeholders to increase park use and physical activity.

Objective: The aim of this study is to describe implementation of a randomized controlled trial of community-based participatory research (CBPR) approaches to increase park use and physical activity across 33 diverse neighborhoods in Los Angeles.

Methods: Fifty parks were randomly assigned based on park size, facilities and programs, and neighborhood socio-demographic characteristics to: park director (PD, 17 parks); PD and park advisory board of interested community members (PD+PAB, 16 parks); and no-intervention control (17 parks) arms. Between 2007 and 2012, PDs and PABs from the 33 intervention parks participated in community engagement, baseline assessment, marketing training, intervention design and implementation, and follow-up assessment.

Partnerships for parks and physical activity.

Purpose: Given the need for comprehensive and multidisciplinary active living interventions, this article describes an innovative partnership for park design and evaluation.

Design: The Trust for Public Land partnered with the RAND Corporation and the San Francisco Department of Public Health to generate context-sensitive active park design, establish evaluation methods, and build the framework for future collaboration.

Setting: These partners worked together from 2009 to 2012 to design, renovate, and study parks in San Francisco, California.

The potential for pocket parks to increase physical activity.

Purpose: To assess the use of new pocket parks in low-income neighborhoods.

Design: The design of the study was a quasi-experimental post-test only comparison.

Setting: Los Angeles, California, was the setting for the study.

Physical activity in parks: A randomized controlled trial using community engagement.

Background: Physical inactivity is an important health risk factor that could be addressed at the community level.

Purpose: The goal of the study was to determine whether using a community-based participatory approach with park directors and park advisory boards (PABs) could increase physical activity in local parks. Whether involving PABs would be more effective than working with park directors alone was also tested.

CMS Innovation Center Health Care Innovation Awards: Evaluation Plan.

The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children's Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g.

Neighborhood poverty, park use, and park-based physical activity in a Southern California city.

A rich literature indicates that individuals of lower socio-economic status engage in less leisure time physical activity than individuals of higher socio-economic status. However, the source of the difference is believed to be, in part, due to differential access to resources that support physical activity. However, it has not been shown as to whether equal access to parks can mitigate differences in leisure time physical activity.

Exploring park director roles in promoting community physical activity.

Background: Parks provide numerous opportunities for physical activity (PA). Previous studies have evaluated parks' physical features, but few have assessed how park staff influence PA.

Methods: We conducted semistructured interviews with 49 park directors, focusing on perceptions of their role, park programs, marketing and outreach, external collaborations, and PA promotion.

Impact and cost-effectiveness of family Fitness Zones: a natural experiment in urban public parks.

We evaluated the impact of outdoor exercise equipment (FZ, Fitness Zones) in 12 parks serving diverse populations. We used the System for Observing Play and Recreation in Communities (SOPARC) to assess use and estimate energy expenditure prior to and twice after FZ installation. Park use increased more in FZ parks than in 10 control parks that did not get equipment, but the difference was not statistically significant.

Effects of park improvements on park use and physical activity: policy and programming implications.

Background: Many assume that improving the quality and the perceived safety of facilities in parks and recreation centers is critical to attracting more users and increasing population physical activity. There are few studies in which these assumptions have been tested.

Purpose: This study aims to assess the impact of park improvements on park use and physical activity.

Parks and physical activity: why are some parks used more than others?

Objective: To assess how park characteristics and demographic factors are associated with park use.

Methods: We studied a diverse sample of parks in a Southern California metropolitan area in 2006-2008 representing a variety of racial and ethnic communities of different socioeconomic strata. We surveyed 51 park directors, 4257 park users and local residents, and observed 30 parks.

The British river of the future: how climate change and human activity might affect two contrasting river ecosystems in England.

The possible effects of changing climate on a southern and a north-eastern English river (the Thames and the Yorkshire Ouse, respectively) were examined in relation to water and ecological quality throughout the food web. The CLASSIC hydrological model, driven by output from the Hadley Centre climate model (HadCM3), based on IPCC low and high CO(2) emission scenarios for 2080 were used as the basis for the analysis. Compared to current conditions, the CLASSIC model predicted lower flows for both rivers, in all seasons except winter.