Background Community health workers (CHWs) are lay individuals who are trained to serve as liaisons between members of their communities and healthcare providers and services. Methods A systematic review was conducted to synthesize evidence from all prospective controlled studies on effectiveness of CHW programs in improving screening mammography rates. Studies reported in English and conducted in the United States were included if they: (1) evaluated a CHW intervention designed to increase screening mammography rates in women 40 years of age or older without a history of breast cancer; (2) were a randomized controlled trial (RCT), case-controlled study, or quasi-experimental study; and (3) evaluated a CHW intervention outside of a hospital setting. Results Participation in a CHW intervention was associated with a statistically significant increase in receipt of screening mammography [Risk Ratio (RR):1.06 (favoring intervention); 95% Confidence Interval (CI:1.02, 1.11),p=0.003]. The effect remained when pooled data from only RCTs were included in meta-analysis (RR:1.07,95% CI:1.03,1.12,p=0.0005), but was not present using pooled data from only quasi-experimental studies (RR:1.03,95% CI:0.89,1.18,p=0.71). In RCTs, participants recruited from medical settings (RR:1.41,95% CI:1.09,1.82,p=0.008), programs conducted in urban settings (RR:1.23,95% CI:1.09,1.39,p=0.001), and programs where CHWs were matched to intervention participants on race or ethnicity (RR:1.58, 95%CI:1.29,1.93,p=0.0001) demonstrated stronger effects on increasing mammography screening rates. Conclusions CHW interventions are effective for increasing screening mammography in certain settings and populations. Impact CHW interventions are especially associated with improvements in rate of screening mammography in medical settings, urban settings, and in participants who are racially or ethnically concordant with the CHW.

The ongoing pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), necessitates strategies to identify prophylactic and therapeutic drug candidates for rapid clinical deployment. Here, we describe a screening pipeline for the discovery of efficacious SARS-CoV-2 inhibitors. We screen a best-in-class drug repurposing library, ReFRAME, against two high-throughput, high-content imaging infection assays: one using HeLa cells expressing SARS-CoV-2 receptor ACE2 and the other using lung epithelial Calu-3 cells. From nearly 12,000 compounds, we identify 49 (in HeLa-ACE2) and 41 (in Calu-3) compounds capable of selectively inhibiting SARS-CoV-2 replication. Notably, most screen hits are cell-line specific, likely due to different virus entry mechanisms or host cell-specific sensitivities to modulators. Among these promising hits, the antivirals nelfinavir and the parent of prodrug MK-4482 possess desirable in vitro activity, pharmacokinetic and human safety profiles, and both reduce SARS-CoV-2 replication in an orthogonal human differentiated primary cell model. Furthermore, MK-4482 effectively blocks SARS-CoV-2 infection in a hamster model. Overall, we identify direct-acting antivirals as the most promising compounds for drug repurposing, additional compounds that may have value in combination therapies, and tool compounds for identification of viral host cell targets.

Learning collaboratives are increasingly used as mechanisms to support and hasten the diffusion and implementation of innovation, clinical evidence, and effective models of care. Factors contributing to the collaboratives' success or failure are poorly understood. The Agency for Healthcare Research and Quality (AHRQ) has sponsored collaboratives for nearly two decades to support improvements in health care quality and value by accelerating the diffusion and implementation of innovation. We examined AHRQ's experience with these collaboratives to characterize their attributes, identify factors that might contribute to their success or failure, and assess the challenges they encountered. Building on the literature and insights from AHRQ's experience, we propose a taxonomy that can offer guidance to decision makers and funders about the factors they should consider in developing collaboratives and planning their evaluation, as well as to researchers who seek to conduct research that will ultimately help decision makers make better investments in diffusing innovation and evidence.

Latinas have higher cervical cancer age-adjusted incidence and mortality rates, and present with more advanced disease compared to non-Latino whites. This study used a cross-sectional mixed methods survey design, exploring knowledge, attitudes, and beliefs regarding the human papillomavirus (HPV), the HPV vaccine, and cervical cancer screening with four groups of women (Mexican, Honduran, Puerto-Rican, Anglo American; n=80) attending low-income health clinics along with one group of Latina health care workers (n=17). Data analyses included univariate frequency distributions and one-way ANOVA tests for quantitative data, thematic and content analysis of qualitative data, and cultural consensus analysis using the covariance method to compare groups. Results indicate overall cultural consensus for the five subgroups for both the agree/disagree questions and rankings on cervical cancer risk factors. However, differences were found between Latina women compared to Anglo American patients and health care clinic workers around birth control practices as possible causal factors for cervical cancer. Other findings suggested greater awareness of HPV and the HPV vaccine among Anglo American and Puerto Rican women compared to Mexican and Honduran women. Mexican and Honduran women were less likely to be aware of HPV and the HPV vaccine, and more likely to be uninsured and without a regular health care provider. Results point to the need to assess knowledge, attitudes, and beliefs in specific subgroups experiencing cervical cancer disparities to identify target areas for health education. Study findings will be used to inform the development and pilot testing of health education curriculum modules for cervical cancer prevention.While cervical cancer screening using the Papanicolaou (Pap) smear has resulted in dramatic reductions in cervical cancer incidence and mortality for women in the United States, its benefits have not been equitably distributed through all sociodemographic groups, based on age, socioeconomic and insured/uninsured status, and cultural and racial/ethnic categories (Downs et al. 2008;McDougall et al. 2007;Newmann and Garner 2005; Watson et al. 2008 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript such remarkable success, a disproportionate incidence and mortality burden continues to be shouldered by Latinas, including the rural and migrant populations (Howe et al. 2006). Numerous factors have been cited to explain these cancer disparities, including unequal access to health care, lower screening rates, lower adherence to follow-up recommendations, a lack of regular health care provider, lower health literacy, low levels of acculturation, income inequality, immigration status, lower education, cultural beliefs, and additional structural factors (Coronado et al. 2004;Freeman and Wingrove 2005; Hiatt et. al. 2001;Howell et al. 2009;Jacobs et al. 2005;Ramirez et al. 2005;Zambrana et al. 1999). In order to understand cultural factors that might explain cervical cancer disparit...

The purpose of this study was to identify the barriers and benefits to human papillomavirus (HPV) vaccination in a low-income, Latina farmworker population in central Florida. This study reports on formative qualitative research conducted on perceptions of benefits, barriers, costs, place, and promotion related to the HPV vaccine from surveys and interviews with a sample of 46 low-income, Latina farm workers and 19 health care workers serving this population. It was found that Latina farmworkers hold many misperceptions about the HPV vaccine and the potential links between HPV infection and cervical cancer. In addition, it was observed that HPV vaccination intention was inversely related to concerns about adolescent sexual behavior and low perceived risk of infection but might be positively influenced by belief in illness prevention and physician recommendation. These findings add to the growing research on HPV vaccine acceptability among Latina subgroups to inform intervention development, marketing materials, education, and policy.

Objective: to know the medicinal plants used in self-care by people with cancer in palliative care. Method: this is a qualitative study, of the exploratory and descriptive type. The research was conducted in Pelotas, Rio Grande do Sul, in the participants' homes. Data collection was conducted between June and September 2018. The study participants were people with cancer in palliative care followed-up by the Program of Interdisciplinary Home Hospitalization, in use of medicinal plants. They totaled 20 participants, with 14 having the presence of the caregiver during the interview; she occasionally encouraged them to answer the questions. Results: it was identified that people with cancer in palliative care already used medicinal plants before the illness and continued using them in a search for therapeutic action, both for reducing symptoms caused by late-stage of the disease and for curing cancer. The knowledge of medicinal plants, most of the times, was passed from generation to generation or by friends and, generally, the use of plants is not informed to the health care professionals. Conclusion: the research produced a recovery of the popular knowledge of the species used in palliative care by people with cancer, promoting the comprehension of their habits regarding the use of the plants. Accordingly, the expansion of pharmacological studies related to the plants used for the treatment of signs and symptoms of cancer is essential.

Buscou-se conhecer as plantas medicinais utilizadas para gripes e resfriados por agricultores da região Sul do Rio Grande do Sul e compará-las com evidências científicas. Estudo descritivo realizado com 12 moradores agricultores da Ilha dos Marinheiros, no município de Rio Grande, Rio Grande do Sul, Brasil. Utilizou-se a análise descritiva, comparando os resultados com a literatura científica. Foram citadas 13 plantas utilizadas para gripes e resfriados: Achyrocline satureioides, Allium sativum, Cinnamomum zeylanicum, Citrus limon, Citrus reticulata, Citrus sinensis, Gochnatia polymorpha, Illicium verum, Mentha piperita, Mikania sp., Ocimum selloi, Origanum majorana e Verbena sp. Os resultados mostraram que o conhecimento popular vai ao encontro das evidências científicas para a maioria das indicações, visto que 84,6% das plantas citadas estão condizentes com a literatura. Desta maneira, enfatiza-se a riqueza do saber popular, a necessidade de sua valorização e constante aproximação dos profissionais de saúde a este saber, integrado ao científico.

Identificar as plantas medicinais utilizadas na saúde da criança, por famílias de agricultores de base ecológica da Região Sul do Rio Grande do Sul, Brasil. A pesquisa é de abordagem qualitativa, exploratória e descritiva, sendo os dados coletados de janeiro a maio de 2009. Os sujeitos foram de oito famílias de agricultores, residentes nos municípios de Pelotas, Morro Redondo, Canguçu e Arroio do Padre. Foram citadas seis plantas (Chrysanthemun cinerariifolium, Foeniculum vulgare, Acca sellowiana, Citrus sp., Origanun sp., Sambucus spp.), sendo que apenas para uma (Foeniculum vulgare) encontramos estudos farmacológicos comprovando o que os sujeitos da pesquisa referiram. É de extrema importância que o profissional enfermeiro tenha conhecimento a respeito das plantas medicinais para transmitir informações pertinentes sobre a forma de preparo, dosagens e indicações relacionados às plantas utilizadas na saúde da criança.