Scale-up efforts of parenting programs have not served diverse communities well due to inadequate curricular adaptations and the lack of a culturally and linguistically competent workforce. We compared delivery of the parent–child interaction module of SafeCare© (SC-PCI) in a refugee community using two implementation approaches: standard delivery via community-based agencies and a task-shifted delivery via community members trained as community health workers (CHWs). Two hundred and six mothers received SC-PCI from trained SafeCare providers. Implementation metrics included the number enrolled and completed, service satisfaction, and in-session skill uptake. Family outcomes were collected via surveys at baseline, post-intervention, and 4-month follow-up and included parenting skill, stress, and child social-emotional development. Analyses compared differences between implementation approaches. CHWs recruited (Ns = 136 vs. 70) and completed more families (98 to 90
Unintentional pediatric firearm-related injuries constitute a public health challenge. This cross-sectional research study examines how children’s experience with firearms, parent-level supervision and training, and youth exposure to firearms is associated with youths’ knowledge about and behavior with firearms. One hundred sixty-three children aged 10–12, all with firearm exposure, and their parents participated. Self-report data from youth and parents on youth firearm experience and knowledge; family firearm use and storage; and how children were supervised and trained to use firearms served as independent variables in age- and sex-adjusted generalized linear models. Children’s knowledge about firearm safety, intended behavior in response to stories, and simulated behavior in both hunting and shooting range scenarios were outcome variables. Children who reported their families owned firearms for shooting had higher firearm safety knowledge (p = 0.01) and made safer clothing choices in simulation scenarios (OR = 2.30, p = 0.02). Family lessons about firearm safety were associated with safer clothing choices and fewer unsafe shots in simulation (p = 0.01). Children who self-reported experience hunting without adult supervision had increased time unsafe in hunting simulation (MD = 5.09, p = 0.02). Parent-reported data showed similar patterns. Additionally, per parent report, children with more firearm experience displayed greater knowledge about safety (p = 0.01) and increased safe clothing selection in simulations. Children with more firearm experience generally demonstrated more knowledge and safer simulated behavior. Youth who self-reported hunting without adult supervision took more risks in hunting simulations. Multifaceted strategies that include increased adult supervision and youth safety training could reduce unintentional youth firearms injuries.
This study examines the prevalence, characteristics, and behavioral responses associated with firearm thefts from vehicles in the United States. Data are from a national survey of firearm owners conducted by YouGov in February–March 2026 (n = 1,976). Overall, 2.7
Adolescents and young adults have high rates of exposure to the suicide thoughts and behaviors of people in their social networks and also report frequently trying to help. The current study aimed to describe the wide array of helping actions young people take and their perceptions of what was most helpful. Data came from the cross-sectional baseline data of Project Lift-Up, a national longitudinal online survey of adolescents and young adults (ages 13–22 at baseline). Participants who reported exposure to social network members’ suicide thoughts and behaviors were asked about up to 33 helping behaviors they may have tried to use. Participants’ own lived experiences of self-harm were related to greater types of helping for non-suicidal self injury and lower helping for suicide ideation. Lived experience was related to perceiving helping actions to reduce risk or to help the person regulate emotions as most helpful. While the study is limited by its focus on bystanders’ perceptions of helpfulness, the study helps paint a broader picture of the engaged helping young people are providing in their social networks and argues for more nuanced training of potential helpers for this population.
Engaging fathers perinatally improves infant outcomes and parent well-being, yet few strategies share evidence with fathers. We explored the feasibility, acceptability, and preliminary efficacy of text4FATHER—a texting intervention designed to improve fathers’ infant care beliefs, self-efficacy, behaviors, and partner support from mid-pregnancy to 2 months post-birth. In this exploratory pilot randomized controlled trial, 97 adult expectant fathers with less than a college degree were randomized to receive text4FATHER or not. Self-reported outcomes by fathers and mothers were assessed at baseline (mid-pregnancy) and 2 months post-birth. We analyzed intent-to-treat effects using random coefficient regression models. We found recruiting expectant fathers feasible; of eligible father-mother dyads, 123/163 consented (recruitment feasibility = 68
Government research-practice partnerships (GRPPs) can bridge the gap between empirical research and policy implementation. However, it remains unclear precisely how state-level governmental agencies navigate evidence-based policymaking. The ongoing collaboration between the Arizona Department of Education and the research team at Arizona State University began as a need for an annual evaluation of the School Safety Program, which aims to improve school safety by providing funding and training to school resource officers and school mental health professionals throughout the state. Unique to this relationship is the structure of the power dynamics between the university and the state. Specifically, this partnership inverts the typical arrangement in which the research team traditionally controls funding, deadlines, and data access. This partnership exemplifies how GRPPs can bridge research and policy by integrating collaborative evaluation frameworks and co-created logic models that serve as boundary objects, facilitating shared language, trust, and sustained engagement across organizational boundaries. The manuscript details operational challenges, including navigating divergent institutional timelines, complex data governance, and dissemination demands, while highlighting mutual capacity-building that enhances both research rigor and policy relevance. Perspectives from both government and academic partners underscore the bidirectional benefits of the partnership, while the GRPP faces opportunities and tensions in responding to legislative audits and expanding its role beyond evaluation to support program implementation and policy adaptation. This case study advances theoretical and practical knowledge on sustaining mature, equitable GRPPs that promote evidence-based policymaking, continuous program improvement, and knowledge mobilization in complex governmental contexts.
Artificial intelligence (AI) has had an unprecedented impact on several aspects of the human condition and is increasingly being incorporated into research endeavors. AI and related research methods hold great promise for the prevention science field. This special issue, "Transforming Prevention Science: Advances and Applications of Artificial Intelligence and Related Methods," features several examples of the application of, and technical development in, AI and other research methods and technologies. The current paper introduces this special issue, which was launched through an open call issued in August 2024. The goal of the special issue was to bring together original empirical, methodological, and conceptual papers on the use of AI and machine learning in prevention research and practice. The papers are organized into four cross-cutting themes: (a) use of AI for prevention-relevant risk stratification across universal, selective, and indicated prevention; (b) use of AI to improve prevention services, programs, and intervention delivery; (c) use of AI as a research methodology and tool; and (d) frameworks, ethics, equity, and infrastructure for responsible AI use in prevention science. Equity, community engagement, and methodological transparency cut across all four themes. This introductory paper closes with a discussion of cross-cutting methodological and measurement considerations and priorities for the field, including the implications of large language models for prevention research conducted during and after the issue's submission window.
Preventive services are intended to be provided without cost-sharing under the Affordable Care Act (ACA), yet many patients still incur out-of-pocket (OOP) costs during routine annual checkups where such services are typically delivered. This study examines the prevalence and predictors of OOP payments among insured adults and assesses how both perceived affordability and awareness of ACA preventive care provisions relate to financial experiences and future preventive care intentions. Using original survey data from a statewide sample of 912 insured adults in Pennsylvania who had received an annual checkup within the past 10 years, we found that 23.5
Frailty, a state of heightened vulnerability to stressors, is prevalent in older adults and imposes substantial health and economic burdens. While socioeconomic deprivation (measured by the Townsend Deprivation Index, TDI) is linked to adverse health outcomes, its specific associative relationship with frailty and the putative mediating roles of chronic inflammation, metabolic dysregulation, and mental health remain unclear. In this cross-sectional study of 264,475 middle-aged and older UK Biobank participants, frailty was assessed using the Fried phenotype criteria. Multinomial logistic regression examined TDI-frailty associations, and multiple mediation analyses (pathways: deprivation → mediators → frailty) evaluated effects of inflammatory (CRP), metabolic (vitamin D), and mental health markers, adjusted for sociodemographic, behavioral, and health-related covariates. Higher TDI scores were significantly associated with increased odds of pre-frail (OR = 1.060, P < 0.001) and frail (OR = 1.182, P < 0.001) status, with a stronger male association (OR = 4.680, P < 0.001) and dose-dependent gradient across quartiles. Collectively, mediators explained 10
Research-practice partnerships (RPPs) can be an effective strategy for bridging disconnects among research, policy, and practice, as they present unique opportunities for rigorous research that produces clear, actionable findings that can directly inform the work of governmental agencies on high-priority topics. This paper describes two interconnected randomized controlled trials conducted by a decade-long RPP between researchers at New York University (NYU) and New York City Public Schools (NYCPS) policy leaders in the Division of Early Childhood Education (DECE), starting at the launch of New York City's universal pre-K system. This RPP navigated opportunities and challenges for conducting rigorous research to evaluate professional learning (PL) for pre-K teachers assigned to "Explore," a math-focused PL approach (Study 1) or "Create," an arts-focused PL approach (Study 2). In each study, we examined impacts on classroom practice and quality (using observation data collected by NYCPS) and children's school readiness (using direct assessment data collected by NYU), relative to content-agnostic PL serving as a business-as-usual control. Results indicated that Explore did not have significant impacts (relative to control), likely because of low levels of implementation. In contrast, Create had several significant and substantively meaningful positive impacts (relative to control) on teacher practice, quality, and children's learning. Overall, our findings suggest that PL implemented by a large district at scale can have positive impacts when the PL model is robust, when PL has clear targets or focus, and when participation in PL is sufficient. We discuss how findings generated by our RPP have informed DECE's work, as well as challenges encountered conducting the research and utilizing findings, particularly during a mayoral transition. The study was pre-registered with Open Science Framework in July 2023.
To examine the sexual networks of PrEP-eligible Latino men to assess how homophily and dyadic characteristics and behaviors relate to PrEP communication among sexual partners. From February 2022 to August 2023, we used tailored methodologies to engage and recruit PrEP-eligible Latino men in South Florida. A three-wave Respondent Driven Sampling strategy (RDS) was used to recruit first and second order friends, completing networks of up to 13 individuals. A two-level logistic regression model was used to assess individual and dyadic level variables in relation to PrEP outcomes of interest. Four hundred eighty-eight participants (egos) reported 1065 sexual partners (alters), primarily perceived as Latino and casual partners. Emotional closeness was associated with increased odds of PrEP-related conversations and PrEP status disclosure, at the ego and alter level. Consistent condom use was associated with decreased odds of PrEP conversations. At the alter level, odds of PrEP status disclosure were lower when consistent condom use and main partner status were reported by the ego. Among PrEP-eligible Latino men, PrEP communication and disclosure of PrEP use are related to the dyadic characteristics and behaviors between sexual partners. Discussing PrEP with sexual partners may influence individual awareness and willingness to use PrEP. In the development of future HIV prevention programs for Latino men, prevention strategies must integrate the unique differences in sexual partnership characteristics and behaviors.
Objective:To compare smoking prevalence, smoking intensity, quit attempts, and quit ratio across four glycemic groups among US adults. Methods:We analyzed National Health and Nutrition Examination Survey data collected in the United States from 2011 through 2023 among adults aged 20 years or older. Glycemic status was classified as no diabetes, prediabetes, controlled diabetes, or uncontrolled diabetes. Survey-weighted analyses estimated smoking outcomes and adjusted associations using models adjusted for demographic, socioeconomic, behavioral, and clinical factors. Results:Among 29,096 adults, current smoking prevalence was 17.45%, 19.63%, 14.30%, and 19.83% across the four groups, respectively (P < 0.01). Smoking intensity differed across groups (P<0.01). Quit attempt prevalence did not differ significantly (P = 0.06), whereas quit ratio differed (56.36%, 57.20%, 71.28%, and 59.69%; P < 0.01). In fully adjusted models, prediabetes (adjusted odds ratio [aOR]: 1.31; 95% confidence interval [CI]: 1.10, 1.57) and uncontrolled diabetes (aOR: 1.37; 95% CI: 1.02, 1.83) were associated with higher odds of current smoking. Prediabetes was associated with a lower quit ratio among ever smokers (aOR: 0.80; 95% CI: 0.66, 0.98). Conclusions:Smoking burden remained substantial among adults with prediabetes and uncontrolled diabetes, supporting targeted cessation interventions across the glycemic spectrum and informing future public health planning.
First responders face extreme workplace stressors that can increase symptoms of distress. While mindfulness-based interventions are well-established for stress management, their time-intensive formats may pose barriers for those with long shifts and unpredictable schedules. Smartphone-delivered mindfulness interventions offer a flexible alternative. This study used a micro-randomized controlled trial design to test the effectiveness of two smartphone-delivered mindfulness interventions in reducing momentary stress and stress reactivity to a self-reported stressor. The two interventions included: (1) a text message reminder to engage in a mindfulness practice (brief message) and (2) a prompt to complete an app-based guided mindfulness practice (MYAPT.MIND). Participants were 75 first responders (M = 38.9, SD = 6.8) who completed ecological momentary assessments twice a day (EMA 1 and EMA 2) and received 1 of 3 conditions daily (i.e., no-intervention, brief message, or MYAPT.MIND) between EMA 1 and EMA 2 for 30 days. Multilevel modeling was used to estimate the proximal effects of the daily intervention assignments and to test whether the interventions dampened the impact of stressor exposures on momentary stress at EMA 2. Results indicated no direct effect of interventions on momentary stress. However, participants who were assigned to MYAPT.MIND reported smaller increases in momentary stress following a stressor exposure than for the brief message or control groups. These findings highlight the potential of app-based mindfulness interventions as a “just-in-time” tool for acute stress management.
Background: Somalia has introduced a new Community Health Strategy to strengthen primary health care (PHC) and improve health system resilience. The strategy addresses persistent gaps in service delivery, limited access to essential health services in rural and underserved communities, and inadequate capacity to respond to public health emergencies. Methods: This correspondence presents a descriptive policy analysis of Somalia's newly launched Community Health Strategy using national policy documents and relevant peer-reviewed literature to assess its priorities and implications for community-based health service delivery. Results: The strategy prioritizes expansion of community health worker programs, integration of preventive and promotive services, strengthened referral pathways between communities and primary health facilities, improved workforce capacity, enhanced supervision, and stronger coordination among government and implementing partners. It also emphasizes preparedness for disease outbreaks and other public health emergencies to improve health system resilience. Conclusions: Somalia's Community Health Strategy represents an important step toward strengthening primary health care and building a more resilient health system. Effective implementation could improve equitable access to essential services, enhance community-level disease prevention and response, and accelerate progress toward universal health coverage.
Research on the etiology of nonsuicidal self-injury (NSSI) has been largely deficit-focused, with emotion dysregulation frequently underscored as a common predictor of NSSI. Meanwhile, strengths-based models have been less frequently employed. This cross-sectional study explored the direct and indirect (through emotion regulation difficulties) potentially protective effects of strengths-based psychological variables (i.e., mindfulness, self-compassion, optimism, and resilience) on the likelihood of reporting past-year NSSI in a cross-national sample of university students (N = 861) residing in Belgium (n = 320), Canada (n = 136), and Australia (n = 406). The fit of the logistic mediation model did not differ when country was included, suggesting that the model was broadly applicable across all three contexts. Greater mindfulness, self-compassion, optimism, and resilience were all indirectly associated with a lower likelihood of reporting past-year NSSI through better emotion regulation. Notably, greater self-compassion and optimism were also directly associated with a lower likelihood of reporting past-year NSSI. Findings lend preliminary cross-national support for the possible protective roles of strengths-based psychological variables in relation to NSSI and for the mediating role of emotion regulation in these relations. Results also underscore the distinct contributions of self-compassion and optimism in relation to past-year NSSI, independent of those explained by emotion regulation, shedding light on a strengths-based etiological model that extends beyond emotion regulation difficulties.
Adolescents’ internalizing and externalizing behaviors are among the most prevalent mental health challenges worldwide, yet the factors associated with these behaviors remain under-explored in many contexts, including Ethiopia. Father involvement is an important but often overlooked correlate of adolescent social competence and behavioral outcomes. This study examines the associations between father involvement and adolescents’ internalizing and externalizing behaviors, focusing on the potential mediating role of adolescent social competence and the moderating role of peer pressure in these relationships. Data were collected from 516 adolescents (mean age = 14.77 ± 0.71; 52.52
The Research Methods Resources (RMR) section of the National Institutes of Health (NIH) website provides information on design, analysis, and sample size for designs used in NIH-supported clinical trials including randomized controlled trials, individually randomized group-treatment trials, parallel group- or cluster-randomized trials, group- or cluster-stepped wedge trials, and group regression discontinuity designs. The material provided for each design includes background information, links to webinars and training opportunities, a list of frequently asked questions and answers, the relevant CONSORT or TREND statement, key references for the designs and for state of the practice reviews, methods for sample size and power, and common errors. Sample size calculators are readily available for randomized controlled trials, but not for the other four designs; as a result, the RMR website provides a sample size calculator for each, set up as a tutorial in 8–9 steps. Each step includes text and references that can be explored if the user is new to the calculator or left largely hidden if the user is familiar with the calculator. Each sample size calculator provides worked examples for variations for the design including those based on a simple difference vs a net difference, or on a cross-sectional design vs a cohort design. The worked examples are available for download as an.pdf document and present the formulae used for the calculations. The calculators can be used to estimate sample size requirements for a new trial or to confirm a calculation made by others. The sample size calculators are illustrated with three examples.
Objectives: In 2025, Florida officials announced plans to end vaccine mandates, including school-based vaccine requirements. This study assessed whether Florida parents/caregivers reported changes in pediatric vaccination intentions related to the state's announcement and identified correlates of reported changes.Methods: We conducted an online survey with 519 Florida parents/caregivers of school-aged children in December 2025. Eligibility criteria included being aged 18 or older, having at least one school-aged child, residing in Florida, and speaking English. Measures included sociodemographic characteristics, political affiliation, vaccine hesitancy, and self-reported changes in vaccination intention following the policy announcement. Descriptive statistics and multivariate regression models examined correlates of vaccine hesitancy and vaccination intention change.Results: Overall, 42% of participants reported being more likely to vaccinate children following the announcement, 38% reported no change, and 20% reported being less likely. Vaccine hesitancy was the only variable independently associated with reported intention change. Hesitant respondents were more likely than non-hesitant respondents to report decreased vaccination intentions (44% vs 13%) and less likely to report increased intentions (16% vs 50%).Conclusions: Findings suggest vaccine hesitancy shapes responses to vaccine policy change. Such policies may reinforce existing vaccination attitudes, resulting in divergent vaccination intentions among caregivers with differing levels of hesitancy.
Background Primary care providers are well-positioned to educate patients about alcohol-related health risks, such as breast cancer, but little is known about their awareness of the alcohol-breast cancer (ABC) link or their counseling practices. This study aimed to assess the level of awareness of alcohol as a breast cancer risk factor among providers; to assess the prevalence of provider counseling discussions with their patients about the alcohol-breast cancer link; and identify predictors of level of awareness and counseling discussion about the alcohol-breast cancer link. Methods We conducted a cross-sectional survey of primary care providers in Alabama between September and December 2023. A 3-min online questionnaire assessed provider knowledge of the ABC link, counseling practices, and perceived barriers to patient education. Descriptive statistics, bivariate analyses, and logistic regression were used to identify predictors of awareness and counseling behavior. Results Among 123 respondents, only 19.5% reported counseling patients about the ABC link. Awareness was significantly higher among counseling providers (95.8%) compared to non-counseling providers (41.7%, p < 0.001). Older age and female gender were associated with greater awareness (OR = 1.08 per year, p = 0.001; OR = 5.26 for females, p = 0.003). Counseling was more likely among providers who were female (OR = 5.26, p = 0.041), did not engage in binge drinking (OR = 12.5, p = 0.045), and had higher patient loads (OR = 1.02 per patient, p = 0.019). The most cited barrier to counseling was lack of awareness (49.4%), while increased provider education was the most frequently proposed solution (45.3%). Conclusions Despite the critical role of providers in preventive health, most providers do not counsel patients about the ABC link. Awareness is a key driver of counseling but not sufficient on its own. Targeted educational interventions are needed to enhance provider engagement in alcohol-related cancer prevention.
