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Background Drug overdose deaths, including those involving prescription opioids and heroin, have more than quadrupled in the United States since 1999 [1]. Synthetic opioids, particularly illicitly manufactured fentanyl (IMF), have driven the largest increase in overdose deaths from 2014 to 2017 [2,3]. In 2015, both the DEA and the CDC issued nationwide alerts identifying illicitly manufactured fentanyl as a threat to public health and safety. In 2017, Florida heroin deaths had increased by 72% from 2014 (549 to 944) and fentanyl deaths had increased over

Background: Evidence has continued to emerge that Long-acting reversible contraception (LARC) is highly effective in preventing unintended pregnancies and induced abortions, but utilization of LARC remains low among US women, particularly among minority and low income women. Aims: We designed this study to develop insights into factors that can better inform urban, predominantly African American women’s decisions to use LARC.Methods: We conducted focus group interviews with women, in conjunction with a community-based organization providing programs for underserved women, in an urban southeastern U.S city with sites in predominantly African American neighborhoods. Results: Key insights from the focus group results for healthcare providers include: the importance of framing discussions with patients within the context of the patients’ goals; the need to acknowledge and respect the support systems that women rely on for child birthing and childcare; recognition of the clinician’s role as a trusted and respected source of information; and the need to understand and be prepared to address much of the inaccurate and misleading information that can interfere with the patients’ optimal choices for contraception. Discussion: A critical component for applying Implementation Science theory to increase utilization of evidence based practices such as LARC requires understanding women’s perspectives of the factors influencing their decisions to use LARC. Conclusion: This study provides important insights into: 1) the potential barriers inherent in minority women’s concerns about LARC, and 2) how these insights can inform implementation strategies such as patient centered counseling and education to overcome those barriers.

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Background and Purpose: The Joint Commission mandates that certified Primary Stroke Centers provide patient education addressing stroke warning signs, use of 911 for access to emergent care, personal risk factors, medications prescribed, and follow-up after discharge. The patient’s retention of this information is imperative for reducing secondary stroke occurrence and morbidity. This study evaluated the Acute Ischemic Stroke (AIS) patient’s ability to retain the stroke education information provided near the time of hospital discharge. Methods: A prospective hospital-based cohort study was comprised of AIS patients who were admitted to the stroke unit at an urban core hospital located in Jacksonville, Florida. Diagnosis of AIS was confirmed by a Neurologist and by a CT or MRI. All participants received Joint Commission mandated stroke education administered by a nurse during their hospitalization. The patient education included verbal instructions with the use of illustrative handouts. Stroke education retention was evaluated near the time of hospital discharge using a five-question survey. The level of health literacy was assessed by the Short Version-Test of Functional Health Literacy in Adults (S-TOFLHA). Results: Of 189 consecutive patients screened between October 2009 and June 2010, 100 (53%) consented to participate. Seventy patients were excluded due to severe cognitive impairment, and 18 eligible patients refused to participate. The average age was 60 years old, 57% were male, 56% African American, 43% resided within the urban core, and 75% earned less than $25,000 per year. A total of 59% of patients had low to marginal health literacy. Retention of stroke knowledge was lacking even with standard stroke post education; 12% could name all 5 warning signs, 43% knew their personal risk factors, 85% knew to call 911 for warning signs of stroke, 76% knew their medications prescribed for stroke prevention, and 53% knew their type of stroke. Conclusion: Current methods of educating hospitalized AIS patients may not adequately prepare the hospitalized stroke survivor with basic knowledge on stroke prevention. Alternative methods of education will need to be developed for AIS patients in urban core hospitals. By using the Patient-Centered Care model and principles of adult learning, this study has the potential to lead to changes in educational interventions, nursing practices, and communication.