Despite the critical need for well-designed clinical trials on the effect of ECs on cessation and cigarette reduction, the majority of studies have been observational or noncomparative intervention designs. Only three RCTs studying ECs as a cessation or reduction intervention have been published, and none were conducted in the United States. The current study adds knowledge to current literature on the feasibility of using ECs to aid smoking reduction among young smokers in US urban populations.

Background: Approaches that move beyond individuals and target couples may be an effective strategy for reducing sexual and reproductive health (SRH) disparities among adolescents and young adults (AYA). However, few researchers have attempted to recruit couples due to feasibility and methodological issues. This study aims to enhance implementation and methodological approaches to successfully engage heterosexual Black and Latino adolescent and young adult (AYA) couples in sexual reproductive health (SRH) research. Methods: We developed a four-step approach to systematically engage AYA couples in a qualitative study examining factors that influence uptake of combination HIV prevention methods: 1) understanding barriers and facilitators to engaging AYA couples, (2) identifying AYAs living in geographic areas of HIV vulnerability, (3) recruiting and screening AYA couples, and (4) scheduling and completion of the interview session. Results: Black and Latino youth aged 16 to 24 and their opposite sex romantic were recruited in the South Bronx, New York from September 2017-May 2018. Three hundred and seventy-two men and women completed screening procedures to determine eligibility for the index participant; 125 were eligible and enrolled into the study. Forty-nine nominated partners (NPs) participated in screening procedures and enrolled into the study. A total of 49 couples enrolled into the study; 23 couples completed study activities. Conclusions: Developing a systematic recruitment plan aided in successfully engaging Black and Latino heterosexual youth. Nevertheless, barriers to study enrollment remained including locating eligible IPs and screening of the NP. Targeting both young men and women was an effective recruitment strategy. Moreover, dyadic strategies that allow for simultaneous interaction with both couple members may be a beneficial strategy to couples' study enrollment and completion of study activities.

IntroductionOur team conducted a cluster randomized controlled trial (DUET) that compared the effectiveness of three theory-driven, implementation strategies on dental provider adherence to tobacco dependence treatment guidelines (TDT). In this paper we describe the process of adapting the implementation strategies to the local context of participating dental public health clinics in New York City.MethodsEighteen dental clinics were randomized to one of three study arms testing several implementation strategies: Current Best Practices (CBP) (i.e. staff training, clinical reminder system and Quitline referral system); CBP + Performance Feedback (PF) (i.e. feedback reports on provider delivery of TDT); and CBP + PF + Pay-for-Performance (i.e. financial incentives for provision of TDT). Through an iterative process, we used Stirman's modification framework to classify, code and analyze modifications made to the implementation strategies.ResultsWe identified examples of six of Stirman's twelve content modification categories and two of the four context modification categories. Content modifications were classified as: tailoring, tweaking or refining (49.8%), adding elements (14.1%), departing from the intervention (9.3%), loosening structure (4.4%), lengthening and extending (4.4%) and substituting elements (4.4%). Context modifications were classified as those related to personnel (7.9%) and to the format/channel (8.8%) of the intervention delivery. Common factors associated with adaptations that arose during the intervention included staff changes, time constraints, changes in leadership preferences and functional limitations of to the Electronic Dental Record.ConclusionsThis study offers guidance on how to capture intervention adaptation in the context of a multi-level intervention aimed at implementing sustainable changes to optimize TDT in varying public health dental settings.

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ment rate of 90%) and B (drugs at reimbursement rate of 50%) were observed. RESULTS: In 2010, total expenditure for all prescription drugs was €36.5 million. In 2011, total expenditure for all prescription drugs was €43.2 million. Thus, there was a cost / consumption increase of 18.23% across the board. Cardiovascular therapeutic area carried most of the burden in 2010 and 2011 with the above average increase of 26.46% amounting to 31.44% of total consumption in 2011 CONCLUSIONS: Moderate increase in cost / consumption from 2010 to 2011 predominantly accounts for disease management medicines. OBJECTIVES:To define the factors which affect the price of single pill combinations of antihypertensive including angiotensin receptor blockers (ARB) in Turkey and to estimate the price of amlodipine / valsartan 10/320 mg combination (28 package). METHODS: ARBs in single pill combination (SPC) with calcium channel blocker (CCB) or diuretics were evaluated. The prices of the only reimbursed combinations were abstracted from the price list of the Turkish Ministry of Health. ARB type, dose increment regarding minimum available dose of ARB, CCB and diuretics in the market, being original drug and package size were analyzed as predictor in a regression model to estimate the price of the combination. RESULTS: In Turkey, 113 SPCs which include candesartan or eprosartan or irbesartan or losartan or olmesartan or telmisartan or valsartan as ARB, and hydrochlorothiazide as diuretic or amlodipine as CCB are currently reimbursed. The regression model showed that ARB type, dose increment in ARB and amlodipine and package size can be used to predict combination price (Bϭ0.89, 4.01, 12.61 and 0.87 respectively; PϽ0.0001 for all). Being original drug or dose increment in HCTZ have no significant effect on price (Bϭ-0.028, Pϭ0.312; BϽ0.001, Pϭ989, respectively). The model explains 92% of variance in drug price. The price of the amlodipine / valsartan 10/320 mg (28 package) is estimated to be 55.91 TL (24.59 Euro) (95% CI 52.46 -59.12 TL) by using the formula. CONCLUSIONS: The formula can be used for estimating the price of the new SPC, when ARB type, ARB and amlodipine -if used in combination-, package size are known. Interestingly neither adding HCTZ nor being original drug affect price of the antihypertensive SPCs in Turkey.