What is already known on this subject? African Americans are at an increased risk of both developing and dying from colorectal cancer (CRC). These disparities can be attributed in large part to deficits in the use of CRC screening among African Americans. Guided by prospect theory, available literature suggests that selectively pairing gain and loss-framed messaging with illness prevention and detection can better promote adaptive health behaviour. Specifically, loss-framed messages that emphasize the potential costs of failing to act may promote better use of illness detection behaviours, such as CRC screening. Emerging literature highlights the potential for cultural differences in the effects of gain and loss messaging on health behaviour, especially among collectivist or interdependent cultures. What does this study add? This study is the first to identify a potential and important cultural difference in the effect of message framing on cancer screening among African Americans, whereby gain-framed messaging better compelled receptivity to CRC screening. This study is also the first to show that the use of loss-framed messaging may reduce receptivity to CRC screening among African Americans by increasing perceived racism. This study demonstrates that simultaneously including a culturally targeted personal prevention message may attenuate the negative effects of loss-framed messaging on CRC screening among African Americans.

In this article we consider the process of adjustment from active street sex work to life in structured substance abuse treatment among Detroit-area women who participated in a semicoercive program administered through a drug court. We examine this transition in terms of changes in daily routines and social networks, drawing on extensive qualitative data to illuminate the ways in which women defined their own situations. Using concepts from Bourdieu and Latour as analytical aids, we analyze the role of daily routines, environments, and networks in producing the shifts in identity that those who embraced the goals of recovery demonstrated. We conclude with a discussion of how the restrictive environments and redundant situations experienced by women in treatment could be paradoxically embraced as a means to achieve expanded opportunity and enhanced individual responsibility because women effectively reassembled their social networks and identities to align with the goals of recovery.

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This paper describes the process of developing a research proposal for submission to the National Institutes of Health (NIH) in collaboration with an urban public health agency. Two university-based researchers from different social science disciplines, each with previous experience in substance abuse research, invested significant time learning about the key questions and concerns of participants in several community-based programs, including clients, administrators and professionals from the county drug court, law enforcement, and substance abuse treatment and recovery services. They then developed a proposal which integrated their own academic interests with the questions and concerns that they uncovered in their preliminary research. After the proposal was written, the researchers presented it to an audience of community partners. Following the successful funding of the study, negotiations with various partners continued throughout the data collection process. The paper concludes with some suggestions for other researchers who may wish to engage in this type of applied, collaborative, interdisciplinary research.

Transportation as a major barrier to obtaining health care is well documented in literature. It is a major contributing factor to health disparities in urban and rural areas in the United States. A lack of transportation to and from a doctor's office or other ancillary health care services worsened the medical conditions of individuals over time. The cost to society by inefficient use and distribution of health resources to promote the general wellbeing of communities is enormous. New technologies in the automobile industry have the potential to eliminate transportation as a barrier to receiving health care services regardless of a person's socioeconomic status. Automotive technologies including autonomous, driverless and semiautonomous vehicles have the potential to improve how patients get to the doctor to receive health care services more efficiently and timely. However, government, especially public health, must play a critical role at this stage of these new technologies by being at the table to provide guidance on how the new technologies should benefit population and community health.

he coronavirus disease 2019 (COVID-19) pandemic impacted the community and systems of care, adjusting the way people interact and how society functions.

This paper describes the economic changes experienced by former Detroit sex workers as they progressed through a court-supervised treatment and recovery program. Semistructured interviews were conducted with women during three phases of the program: pretreatment (n = 31), treatment (n = 24), and transitional housing/independence (n = 31). Interviews were also conducted with women who had terminated from the program (n = 8). Sources and levels of income and expenses in each phase were recorded in detail. We found that women earned and spent substantially more money when they actively engaged in street sex work. Legal income remained low after the treatment phase, with only 39 percent of women in the final phase reporting regular work. We conclude that decreased drug expenditures are not enough to offset the decrease in income that accompanies termination of sex work. Policies supporting income, employment, and education for people in transition are recommended.

OBJECTIVES/SPECIFIC AIMS: Facilitate relationships and partnership development to address the opioid crisis in Detroit and Wayne County Contribute to real-time conversations on opioid epidemic policy and practice to identify and build consensus on research questions Apply findings from each learning community session to policy briefs to better inform policymakers, providers and consumers; and advocate for institutional responsiveness METHODS/STUDY POPULATION: The study population utilizes a purposive sampling approach to intentionally organize relationships and partnership development. For example, participants registered for the December 2018 session, “Detroit/Wayne County Opioid Crisis Learning Community Series: Data Session,” include representation from school-based health clinics, community and faith-based organizations, health systems, city and county level public health, addiction/recovery organizations, law enforcement, academia and citizens. The team feels this approach ensures and builds diverse, team science perspectives and regional collaboration. The Detroit Area Mental Health Leadership Team formed in 2015 at a retreat held by the University of Michigan’s Clinical and Translational Science Initiative attended by nearly 100 community-academic partners. Mental health, stigma and suicide were identified as community priorities by participants who attended the summit. A mental health workgroup formed and later expanded its membership to strengthen diverse perspectives. The team immediately designed and administered a survey amongst its partners creating the following priorities and focus: substance abuse interventions, healthcare access, and consumer awareness of mental health issues/available resources. Since data, policy and service are common threads to design interventions, the partnership decided to facilitate dialogue and discussion from the community on special topics related to the crisis, and share the community’s recommendations on how to address them. The learning community series was designed as a bi-lingual format for sharing and expression. Deliberative democracy encourages inclusion of voices, interests and opinions often not heard or included in decision-making processes; driving the project’s purposive sampling approach. Institutional responsiveness and advocacy for adoption of the community’s recommendations will occur through strategic policy briefs summarizing each learning community session and the entire series. A dissemination plan will be utilized to encourage the policy briefs reach appropriate audiences for capacity building and institutional responsiveness. The learning community series will provide 5 sessions on data (impacting adolescents, emerging adults, and 20-mid 30 year-old adults), recovery/law enforcement, prescribing, and marijuana. The session topics arose from earlier assessment conducted by the Detroit Area Mental Health Leadership Team. RESULTS/ANTICIPATED RESULTS: A response to the opioid crisis should address community priorities identified through data, research...