Until recently, few children with chronic illnesses such as sickle cell disease (SCD) lived past late adolescence. Substantial reductions in mortality mean a growing number of adolescents with SCD reach adulthood. Consensus among researchers and health care providers (HCP) from multiple disciplines is that critical attention to and more empirical research on the transition from pediatric to adult care is needed. We address the following questions: (1) How do pediatric and adult providers demonstrate involvement in transition? (2) What is expected of adolescents when they move to adult care? and (3) Do providers think there is a need for a systematic transition program? A cross-sectional, multi-format survey research study utilizing open-ended and forced-choice questions was conducted to compare responses between pediatric and adult providers from multiple disciplines. Data were collected from 227 HCP in three waves. Significant bivariate results (p < 0.05) reflected differing opinions regarding transition expectations and program need, especially among female providers, those practicing in urban areas, and providers who treat both adolescent and adult clients in comparison with their counterparts. Discussion includes implications for program development, social service and public health practice, and future research.

Introduction/Objectives: Pre-exposure prophylaxis (PrEP) use in the southern United States is low despite its effectiveness in preventing HIV acquisition and high regional HIV prevalence. Our objectives were to assess PrEP knowledge, attitudes, and prescribing practices among Tennessee primary care providers. Methods: We developed an anonymous cross-sectional electronic survey from March to November 2019. Survey development was guided by the Capability, Opportunity, Motivation, and Behavior framework and refined through piloting and interviews. Participants included members of professional society and health center listservs licensed to practice in Tennessee. Respondents were excluded if they did not complete the question regarding PrEP prescription in the previous year or were not in a position to prescribe PrEP (e.g., hospital medicine). Metrics included PrEP prescription in the preceding year, PrEP knowledge scores (range 0-8), provider attitudes about PrEP, and provider and practice characteristics. Knowledge scores and categorical variables were compared across PrEP prescriber status with Wilcoxon rank-sum and Fisher’s exact tests, respectively. Results: Of 147 survey responses, 99 were included and 43 (43%) reported PrEP prescription in the preceding year. Compared with non-prescribers: prescribers had higher median PrEP knowledge scores (7.3 vs 5.6, P < .01), a higher proportion had self-reported patient PrEP inquiries (95% vs 21%, P < .01), and a higher proportion had self-reported good or excellent ability to take a sexual history (83% vs 58%, P = .01) and comfort taking a sexual history (92% vs 63%, P < .01) from men who have sex with men, a subgroup with high HIV risk. Most respondents felt obligated to provide PrEP (65%), and felt all primary care providers should provide PrEP (63%). Conclusion: PrEP provision is significantly associated with PrEP knowledge, patient PrEP inquiries, and provider sexual history taking ability and comfort. Future research should evaluate temporal relationships between these associations and PrEP prescription as potential routes to increase PrEP provision.

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Objectives: Tennessee was 1 of 8 states that received funding from the Care and Prevention in the United States Demonstration Project, which aimed to reduce HIV-related morbidity and mortality among racial/ethnic and sexual minority populations. The objective of this study was to describe implementation of a social network strategy (SNS) program, which leverages personal connections in social networks, to reach people with undiagnosed HIV infection for HIV testing. We targeted young black men who have sex with men (MSM) at 3 agencies in Memphis and Nashville, Tennessee, during 2013-2016. Methods: Specialists at the 3 agencies identified MSM with and without diagnosed HIV infection (ie, recruiters) who could recruit members from their social networks for HIV testing (ie, network associates). Both recruiters and network associates received OraQuick rapid and confirmatory HIV tests. We used w 2 and Fisher exact tests to assess differences in demographic characteristics, HIV testing, and care engagement status by agency. Results: Of 1752 people who were tested for HIV in the SNS program, 158 (9.0%) tested positive; of these, 80 (50.6%) were newly diagnosed with HIV. Forty-seven of the 78 (60.3%) people who were previously diagnosed with HIV were not in care in the previous 12 months; of these, 27 (57.4%) were reengaged in medical care. Of 80 people newly diagnosed with HIV, 44 (55.0%) were linked to care. Conclusions: The SNS program ascertained HIV status among a high-risk population in a heavily burdened region. Further program evaluation is needed to understand how to improve linkage to care among people with newly diagnosed HIV.

Aim:This study was to establish a baseline level of knowledge, attitude, and practice (KAP) of oral health promotion (OHP) among oral health providers in Kingdom of Saudi Arabia. The study also described and evaluated the factors that facilitate or limit the practice of OHP and examined the relationship between the level of knowledge and attitude that practitioners have of OHP and their OHP practice. Materials and methods:A cross-sectional questionnaire included demographic questions and questions on the KAP of oral health promotion. Out of 365 questionnaires that were disseminated, 106 questionnaires were fully completed. Crosstabulation was conducted to establish factors associated with KAP scores. Logistic regression analysis was conducted to determine the factors that were associated with the practice of OHP. Results:The baseline level of oral health providers' knowledge and attitude toward OHP was fair. Only a few providers have integrated OHP into their practice. Age of participants was significantly associated with knowledge of OHP among the providers. Also, there was a significant difference in mean attitude scores toward OHP by education level. The practice of OHP was significantly related to education level and facility type.Conclusion: Further research focusing on different cities or geographical regions in the KSA is needed to validate this finding. Also, the finding supports the need for continuous training in OHP to ensure that health providers understand and apply OHP practices in their work. Clinical significance:Due to the scarcity of data that measure OHP among oral health providers in the KSA, proper education and training programs by governmental authorities are difficult to implement. This study will provide baseline measures for future investigations for academicians and practitioners, alike.

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Purpose This study assessed whether perinatal factors were associated with breast cancer among Hispanics, a group with fairly low incidence rates of breast cancer. Methods Data was used from a case-control study of breast cancer among Hispanics age 30 to 79 conducted between 2003 and 2008 on the Texas-Mexico border. In-person interviews were completed with 188 incident breast cancer cases ascertained through surgeons and oncologists, and 974 controls (with respective response rates of 97% and 78%). Results Relative to birth weight 2,500–3,999 grams, there was no elevation in breast cancer risk for birth weight of ≥4,000 grams (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.47–1.21). Conclusions The results tended to differ slightly from previous studies of this topic perhaps owing to the different hormonal milieu among Hispanics relative to Caucasians, African Americans and Asians in whom all previous studies of this topic have been conducted. Confirmation of these findings in larger studies may assist in determining how hormonal mechanisms responsible for breast cancer differ by ethnicity.

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