Leadership Characteristics of Extension Agents Facilitating a Healthy Communities, Civic-Engagement Randomized Trial in Rural Towns.

Leadership styles and skills are associated with group dynamics, creativity, and project implementation in community change initiatives; specifically, collaborative leadership skills can lead to a greater likelihood of effective, sustainable improvement in the health of communities. This study sought to examine the leadership styles and skills of Extension Agents engaged in leading a community policy, system, and environmental change initiative. Our aim was to describe how collaborative the leadership style of these leaders was and how high they scored in collaborative leadership skills.

Heterogeneity in Health Outcomes in the Strong Hearts, Healthy Communities-2.0 Multilevel Intervention in a Community-Randomized Trial: An Exploratory Study of Moderators.

Background/objectives: Multilevel interventions have demonstrated efficacy in improving obesity and other related health outcomes. However, heterogeneity in individual responses indicates the need to identify the factors associated with responses and non-responses to multilevel interventions. The objective of this report is to identify the potential sources of heterogeneity through the exploration of the moderation effects of participant characteristics (sociodemographic and baseline physical/mental health) in the Strong Hearts, Healthy Communities-2.

Process evaluation findings from Strong Hearts, Healthy Communities 2.0: a cardiovascular disease prevention intervention for rural women.

Background: Strong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cardiovascular disease prevention program that was effective in improving physical activity and nutrition behaviors and clinical outcomes among women in 11 rural New York, USA towns.

Multilevel Interventions Targeting Obesity: State of the Science and Future Directions.

A seminal report, released in 2001 by the Institute of Medicine, spurred research on the design, implementation, and evaluation of multilevel interventions targeting obesity and related behaviors. By addressing social and environmental factors that support positive health behavior change, interventions that include multiple levels of influence (e.g.

Improvements in dietary intake, behaviors, and psychosocial measures in a community-randomized cardiovascular disease risk reduction intervention: Strong Hearts, Healthy Communities 2.0.

Background: Cardiovascular disease (CVD) prevalence has disproportionately risen among midlife and older female adults of rural communities, partly due to poor diet and diet-related behaviors and psychosocial factors that impede healthy eating.

Objectives: This study aimed to evaluate the impact of Strong Hearts Healthy Communities 2.0 (SHHC-2.

Lessons learned from principal investigators on recruitment for community-based health behavior studies during the COVID-19 pandemic.

Little is known about pandemic-related impacts on participant recruitment into community-based health studies during the COVID-19 pandemic. The aim of this report was to summarize lessons learned from principal investigators (PIs) of NIH-funded community-based health behavior studies that were scheduled to recruit during the COVID-19 pandemic. We report on findings from three open-ended questions that were part of a 50-question online survey conducted from December 2022 - January 2023, completed by 52 PIs.

Recruiting experiences of NIH-funded principal investigators for community-based health behavior interventions during the COVID-19 pandemic.

Successful recruitment into randomized trials and interventions is essential to advance scientific knowledge to improve health. This rapid assessment study explored how the COVID-19 pandemic affected participant recruitment overall, identified how it exacerbated existing challenges to recruit hard-to-reach populations, and described how NIH-funded Principal Investigators (PIs) responded to COVID-era recruitment challenges. A cross-sectional survey of NIH-funded PIs conducting interventions and trials related to health behaviors was conducted in 2022.

Changes in physical activity outcomes in the Strong Hearts, Healthy Communities (SHHC-2.0) community-based randomized trial.

Background: Physical inactivity is a risk factor for numerous adverse health conditions and outcomes, including all-cause mortality. Aging rural women are at particular risk for physical inactivity based on environmental, sociocultural, and psychosocial factors. This study reports on changes in physical activity and associated factors from a multicomponent community-engaged intervention trial.

Improvements and Maintenance of Clinical and Functional Measures Among Rural Women: Strong Hearts, Healthy Communities-2. 0 Cluster Randomized Trial.

Background: Cardiovascular disease is the leading cause of death in the United States; however, women and rural residents face notable health disparities compared with male and urban counterparts. Community-engaged programs hold promise to help address disparities through health behavior change and maintenance, the latter of which is critical to achieving clinical improvements and public health impact.

Methods: A cluster-randomized controlled trial of Strong Hearts, Healthy Communities-2.

A Rapid Assessment Procedure to Develop A Non-Communicable Disease Prevention Pilot Health Communications Project Using E- and M-Health Communications in Pohnpei State, Federated States of Micronesia.

Pohnpei State of the Federated States of Micronesia, located in the Northwestern Pacific Ocean, has limited health research infrastructure; chronic non-communicable diseases (NCD) such as diabetes, heart disease, and cancer are a concern. Over 73% of Pohnpei's population is overweight or obese. E- and m- (mobile) health interventions are becoming more popular in low and middle income countries.

An Assessment of E-health Resources and Readiness in the Republic of the Marshall Islands: Implications for Non-communicable Disease Intervention Development.

The prevalence of non-communicable diseases (NCDs) is rapidly increasing in low and middle income countries (LMIC). The Republic of the Marshall Islands is an island country in the Pacific located near the equator and has the third highest prevalence of diabetes in the world, high rates of complications, and early mortality with limited or no resources for tertiary care of these complications. Given the limited resources of the country, there is a need for strategies which emphasize NCD prevention.

Evaluating the implementation of cervical cancer screening programs in low-resource settings globally: a systematized review.

Purpose: Cervical cancer disproportionately burdens low-resource populations where access to quality screening services is limited. A greater understanding of sustainable approaches to implement cervical cancer screening services is needed.

Methods: We conducted a systematized literature review of evaluations from cervical cancer screening programs implemented in resource-limited settings globally that included a formal evaluation and intention of program sustainment over time.

A globally networked hybrid approach to public health capacity training for maternal health professionals in low and middle income countries.

Background: MundoComm is a current NIH-funded project for sustainable public health capacity building in community engagement and technological advances aimed at improving maternal health issues. Two to four teams are selected annually, each consisting of three healthcare professionals and one technical person from specific low and middle income countries (LMICs) including Costa Rica, Dominican Republic, Honduras, and other LMICs. MundoComm is a course with three parts: in-person workshops, online modules, and mentored community engagement development.

Does Usage of an eHealth Intervention Reduce the Risk of Excessive Gestational Weight Gain? Secondary Analysis From a Randomized Controlled Trial.

Background: Excessive gestational weight gain (GWG) contributes to the development of obesity in mother and child. Internet-based interventions have the potential for delivering innovative and interactive options for prevention of excessive GWG to large numbers of people.

Objective: The objective of this study was to create a novel measure of Internet-based intervention usage patterns and examine whether usage of an Internet-based intervention is associated with reduced risk of excessive GWG.

Participation in Genetic Research: Amazon's Mechanical Turk Workforce in the United States and India.

Background: Genomic research has innumerable benefits. However, if people are unwilling to participate in genomic research, application of knowledge will be limited. This study examined the likelihood of respondents from a high- and a low- to middle-income country to participate in genetic research.

Development and Implementation of Culturally Tailored Offline Mobile Health Surveys.

Background: In low and middle income countries (LMICs), and other areas with low resources and unreliable access to the Internet, understanding the emerging best practices for the implementation of new mobile health (mHealth) technologies is needed for efficient and secure data management and for informing public health researchers. Innovations in mHealth technology can improve on previous methods, and dissemination of project development details and lessons learned during implementation are needed to provide lessons learned to stakeholders in both the United States and LMIC settings.

Objective: The aims of this paper are to share implementation strategies and lessons learned from the development and implementation stages of two survey research projects using offline mobile technology, and to inform and prepare public health researchers and practitioners to implement new mobile technologies in survey research projects in LMICs.

Sociocultural variation in attitudes toward use of genetic information and participation in genetic research by race in the United States: implications for precision medicine.

Background: "Precision medicine" (PM) requires researchers to identify actionable genetic risks and for clinicians to interpret genetic testing results to patients. Whether PM will equally benefit all populations or exacerbate existing disparities is uncertain.

Methods: We ascertained attitudes toward genetic testing and genetic research by race in the United States using the online Amazon mTurk US workforce (n = 403 White; n = 56 African American (AA)).

Developing the Evidence Base to Inform Best Practice: A Scoping Study of Breast and Cervical Cancer Reviews in Low- and Middle-Income Countries.

Background: Breast and cervical cancers have emerged as major global health challenges and disproportionately lead to excess morbidity and mortality in low- and middle-income countries (LMICs) when compared to high-income countries. The objective of this paper was to highlight key findings, recommendations, and gaps in research and practice identified through a scoping study of recent reviews in breast and cervical cancer in LMICs.

Methods: We conducted a scoping study based on the six-stage framework of Arskey and O'Malley.

Rural middle school nutrition and physical activity environments and the change in body mass index during adolescence.

Background: For rural adolescents, schools are among the few places where environmental interventions can promote health outside of the home. The goal of this study was to assess the nutrition and physical activity (N&PA) environments of schools attended by a birth cohort and examine the association with change in body mass index (BMI) from sixth to eighth grade.

Methods: Using data from adolescents of a rural New York State birth cohort (N = 281), we used linear mixed models to identify N&PA environments associated with change in BMI.

Breastfeeding duration and weight gain trajectory in infancy.

Background And Objectives: Short breastfeeding duration may exacerbate accelerated early growth, which is linked to higher obesity risk in later life. This study tested the hypothesis that infants at higher risk for obesity were more likely to be members of a rising weight-for-length (WFL) z score trajectory if breastfed for shorter durations.

Methods: This prospective, observational study recruited women from an obstetric patient population in rural central New York.

How an online intervention to prevent excessive gestational weight gain is used and by whom: a randomized controlled process evaluation.

Background: Online interventions have emerged as a popular strategy to promote healthy behaviors. Currently, there is little agreement about how to capture online intervention engagement. It is also uncertain who engages with weight-related online interventions and how engagement differs by demographic and weight characteristics.

Changes in family income status and the development of overweight and obesity from 2 to 15 years: a longitudinal study.

Background: An emerging body of research suggests the trajectory of a family's income affects children's health and development more profoundly than the often-measured income at a single time point. The purpose of this study was to examine the associations between changes in family income status, early-life risk factors, and body mass index (BMI) z-score trajectory from age 2 to 15 years.

Methods: This longitudinal study employed a birth cohort (n = 595) located in a rural region of New York State.

The healthy start partnership: an approach to obesity prevention in young families.

This article investigates the impact of community-based interventions developed by the Healthy Start Partnership (HSP) to promote healthy body weights in families. Intercept surveys were conducted to monitor community exposure. A nonconcurrent, no treatment control design was used to assess population-level weight outcomes.

Associations Between Mothers' and Their Children's Weights at 4 Years of Age.

OBJECTIVES: To examine the importance of maternal weight characteristics as predictors of overweight (BMI ≥85th percentile and <95th percentile) and obesity (BMI ≥ 95th percentile) in offspring at age 4 years. METHODS: Chi-square and logistic regression analyses were conducted on a sample of 321 mother/child pairs from an earlier observational cohort study on mothers' postpartum weight retention. RESULTS: Maternal early pregnancy BMI and infant birth weight were each positively and significantly (p <0.