Wastewater Monitoring: Improving Public Awareness and Understanding in the United States, May 2024.

Objectives: Although wastewater monitoring for virus detection has increased in communities worldwide, public awareness, understanding, questions, and concerns about wastewater monitoring are largely unknown. We assessed awareness, knowledge, and support for wastewater monitoring for detection of viruses and bacteria among US residents and elicited questions and concerns from residents about its use.

Methods: We conducted a survey among a racially and ethnically diverse sample of residents in Colorado, Maryland, Missouri, Nebraska, and Texas to assess awareness, knowledge, and support of wastewater monitoring.

Comparing acceptance of smoking cessation and smoke-free home intervention offers and associated factors among people with low income in the USA: baseline results of a randomised controlled trial.

Introduction: State tobacco quitlines are the most commonly available smoking cessation programmes; however, they have low reach and typically only enrol people who are ready to quit in the next 30 days. Expanding quitline services may increase the total number of people engaged in tobacco control efforts and the number who eventually quit. In this randomised controlled trial, we offered both arms a tobacco quitline intervention.

Helping low-income smokers quit: findings from a randomized controlled trial comparing specialized quitline services with and without social needs navigation.

Background: Quitting smoking is especially challenging for low-income smokers due to high stress, high smoking prevalence around them, and limited support for quitting. This study aimed to determine whether any of three interventions designed specifically for low-income smokers would be more effective than standard tobacco quitline services: a specialized quitline, the specialized quitline with social needs navigation, or the standard quitline with social needs navigation.

Methods: Using a randomized 2 × 2 factorial design, low-income daily cigarette smokers (n = 1944) in Missouri, USA who called a helpline seeking assistance with food, rent or other social needs were assigned to receive alone (n = 485), (n = 484), alone (n = 485), or  +  (n = 490).

Appeal of Tobacco Quitline Services Among Low-Income Smokers.

Introduction: State tobacco quitlines are delivering cessation assistance through an increasingly diverse range of channels. However, offerings vary from state to state, many smokers are unaware of what is available, and it is not yet clear how much demand exists for different types of assistance. In particular, the demand for online and digital cessation interventions among low-income smokers, who bear a disproportionate burden of tobacco-related disease, is not well understood.

Transportation and other social needs as markers of mental health conditions.

Objective: The study sought to determine whether reporting a history of depression, anxiety, PTSD, bipolar disorder, drug or alcohol use disorder, ADHD, schizophrenia, or current depressive symptoms was associated with requesting help for any of 12 social needs.

Methods: A community-based sample of 1,944 low-income adult smokers in Missouri who had called a telephone helpline for social needs were recruited between June 1, 2017 and November 15, 2020. Helpline data on callers' requests for assistance with utilities, housing, food, household goods, healthcare, transportation, adult care, financial assistance, employment, legal assistance, personal safety and childcare were merged with self-reported mental health data collected in a subsequent phone survey with the same callers.

Leveling the Playing Field: Mailing Pharmacotherapy to Medicaid Members Who Smoke.

Introduction: Smoking rates differ by insurance type; rates are often double for Medicaid and uninsured compared with that for Medicare or privately insured. State-funded tobacco quitlines' provision of free nicotine replacement therapy varies. In some states, Medicaid beneficiaries must obtain nicotine replacement therapy from a physician, whereas others get nicotine replacement therapy mailed to them.

Examining Psychosocial Correlates of a Home Smoking Ban Among Low-income Smokers: Analysis of Social Support, Unmet Social Needs, Perceived Stress, and Depressive Symptoms.

Home smoking bans reduce exposure to second-hand smoke. Understanding how psychosocial factors are related to having a home smoking ban may lead to better interventions for populations less likely to have home smoking bans, including low-income smokers. In this study, we used baseline data from 1,944 participants in a randomized trial of low-income smokers in Missouri to explore psychosocial correlates of a total home smoking ban.

Low housing quality, unmet social needs, stress and depression among low-income smokers.

Smokers are at greater risk of multiple health conditions that are exacerbated by environmental hazards associated with low housing quality. However, little is known about the prevalence of low housing quality among low-income smokers. Using correlations and logistic regression, we examined associations among eight housing quality indicators - pests, water leaks, mold, lead paint, and working smoke detectors, appliances, heating, and air conditioning - and between housing quality and social needs, depressive symptoms, perceived stress, sleep problems, and self-rated health in a community-based sample of 786 low-income smokers from 6 states.

Correlates of smoking discarded cigarettes in a sample of low-income adults.

Introduction: Unconventional smoking behaviors such as smoking used or discarded cigarettes may increase the risk of nicotine dependence and exposure to toxins. To better understand low-income smokers who smoke discarded cigarettes and to inform effective tobacco cessation strategies, the current study examined potential correlates not considered in prior studies.

Methods: This secondary analysis examined baseline data from 1936 low-income smokers participating in a randomized cessation trial.

Intention to vaccinate children for COVID-19: A segmentation analysis among Medicaid parents in Florida.

COVID-19 vaccines have been granted emergency use authorization for children ages 5 years and older. To understand how racially and ethnically diverse parents of young children enrolled in Medicaid feel about a prospective COVID-19 vaccine for their children, we administered an online survey that included both close-ended and open-ended items to a statewide sample in Florida (n = 1951). We used quantitative responses to conduct a statistical audience segmentation analysis that identified five distinct sub-groups that varied widely in the likelihood that they would get a COVID-19 vaccine for their child.

Re-examining phone counseling for smoking cessation: Does the evidence apply to low-SES smokers?

Introduction: A 2019 Cochrane review concluded telephone counseling is an effective intervention for smoking cessation. However, the review did not assess the role of socioeconomic status (SES) indicators on the effectiveness of telephone counseling.

Methods: We reviewed 65 U.

Helpline Calls Associated With Preventable Emergency Department Utilization.

Introduction: Unmet social needs are linked with greater healthcare utilization, but most studies lack timely and granular data on these needs. The 2-1-1 helpline is a telephone helpline focused on social needs. The objective of the study is to determine whether the number of 2-1-1 requests per 1,000 people is associated with preventable emergency department visits and compare the strength of the association with another commonly used predictor, Area Deprivation Index.

Comparing two approaches to remote biochemical verification of self-reported cessation in very low-income smokers.

Little is known about the acceptability and use of remote biochemical verification of self-reported cessation among low-income and racially diverse smokers. We compared responses to an in-person carbon monoxide breath test and in-home urine cotinine test among 270 adults who reported 7-day continuous abstinence at 6-month follow-up in a community-based randomized cessation trial. Half of participants (50%) reported annual household income below $10,000, one in four (28%) had not completed high school, and 69% were Black or African American.

Expressed and unexpressed social needs in low-income adults in the U.S.

Many healthcare organisations are now routinely screening patients for social needs such as food and housing. It is largely unknown whether the needs they identify would have been expressed by the patient in the absence of screening. To better understand expressed and unexpressed social needs, we administered a social needs screener to 1,397 low-income adults who called a 2-1-1 helpline in Missouri seeking assistance with social needs between June 2017 and October 2019.

Addressing Social Needs in Health Care Settings: Evidence, Challenges, and Opportunities for Public Health.

There has been an explosion of interest in addressing social needs in health care settings. Some efforts, such as screening patients for social needs and connecting them to needed social services, are already in widespread practice. These and other major investments from the health care sector hint at the potential for new multisector collaborations to address social determinants of health and individual social needs.

Client Perspectives on Health Coaching: Insight for Improved Program Design.

In this paper, we examine client perspectives of health coaching programs and differences by insurance type. We used descriptive coding and directed content analysis to analyze semi-structured qualitative in-person interviews that assessed preferred health coach qualifications and experience, desirable attributes for coaches, and interest in having a coach. We recruited participants (N = 140 adults: 61 commercial insurance, 79 Medicaid) without consideration of prior health coaching experience.

How Do Social Needs Cluster Among Low-Income Individuals?

Social needs screening in health care settings reveals that many low-income individuals have multiple unmet social needs at the same time. Having multiple simultaneous social needs greatly increases the odds of experiencing adverse health outcomes. To better understand how and which social needs cluster in these cases, the authors examined data from 14,749 low-income adults who completed a social needs assessment in one of 4 separate studies conducted between 2008 and 2019 in the United States.

Assessing The Capacity Of Local Social Services Agencies To Respond To Referrals From Health Care Providers.

Health care providers are increasingly screening low-income patients for social needs and making referrals to social services agencies to assist in resolving them. A major assumption of this approach is that local social services providers have the capacity and resources to help. To explore this assumption, we examined 711,613 requests related to fifty different social needs received from callers to 211 helplines in seven states during 2018.

Specialized tobacco quitline and basic needs navigation interventions to increase cessation among low income smokers: Study protocol for a randomized controlled trial.

Smoking in the United States follows a clear socioeconomic gradient: low-income Americans smoke more and quit less than those with more education and income. Evidence-based interventions like tobacco quitlines are designed to make effective cessation services available on a population basis to all smokers. However, these interventions do not address many of the unique challenges faced by low-income smokers, including unmet basic needs like food, housing, personal safety and money for necessities that often supersede health needs.