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Evidence regarding cancer-related fatigue (fatigue) has accumulated sufficiently such that recommendations for screening, evaluation, and/or management have been released recently by 4 leading cancer organizations. These evidence-based fatigue recommendations are available for clinicians, and some have patient versions; but barriers at the patient, clinician, and system levels hinder dissemination and implementation into practice. The underlying biologic mechanisms for this debilitating symptom have not been elucidated completely, hindering the development of mechanistically driven interventions. However, significant progress has been made toward methods for screening and comprehensively evaluating fatigue and other common symptoms using reliable and valid self-report measures. Limited data exist to support the use of any pharmacologic agent; however, several nonpharmacologic interventions have been shown to be effective in reducing fatigue in adults. Never before have evidence-based recommendations for fatigue management been disseminated by 4 premier cancer organizations (the National Comprehensive Cancer, the Oncology Nursing Society, the Canadian Partnership Against Cancer/Canadian Association of Psychosocial Oncology, and the American Society of Clinical Oncology). Clinicians may ask: Are we ready for implementation into practice? The reply: A variety of approaches to screening, evaluation, and management are ready for implementation. To reduce fatigue severity and distress and its impact on functioning, intensified collaborations and close partnerships between clinicians and researchers are needed, with an emphasis on system-wide efforts to disseminate and implement these evidence-based recommendations.

Background: The United Nations reported that in 2016 over 65 million people worldwide have forcibly left home. Over 50% are children and adolescents; a substantial number has been traumatized and displaced by war. Objective: To provide an overview of the effectiveness of psychosocial interventions in this group we conducted a narrative review and a meta-analysis of intervention studies providing data on posttraumatic stress symptoms (PTSS), depression, anxiety, grief, and general distress. Method: We searched PILOTS, MEDLINE, WoS, Embase, CENTRAL, LILACS, PsycINFO, ASSIA, CSA, and SA for studies on treatment outcomes for war-traumatized displaced children and adolescents. Between-group effect sizes (ES) and pre-post ES were reconstructed for each trial. Overall pre-post ES were calculated using a random effects model. Results: The narrative review covers 23 studies with a variety of treatments. Out of the 35 calculated between-group ES, only six were significant, all compared to untreated controls. Two of them indicated significant adverse effects on symptoms of general distress or depression. When calculating pre-post effect sizes, the positive between-group results of cognitive behavioural therapy (CBT) and interpersonal therapy (IPT) were reproduced and singular other treatments showed significant positive effects. However, the mean pre-post effects for PTSS and depression could not be interpreted due to the high heterogeneity of the included studies (PTSS: ES = 0.78; I 2  = 88.6%; depression: ES = 0.35; I 2  = 93.1%). Only the mean pre-post effect for seven active CBT treatment groups for depression (ES = 0.30, 95% CI [0.18, 0.43]) was interpretable (Q = 3.3, df = 6, p = .77). Conclusion: Given the large number of children and adolescents displaced by war there were regrettably few treatment studies available, and many of them were of low methodological quality. The effect sizes lagged behind the effects observed in traumatized minors in general, and often were small or non-significant. However, CBT and IPT showed promising results that need further replication.

Food insecurity (FI) has short‐ and long‐term effects on maternal and child health, with persistent inequities within under‐resourced communities of colour (e.g., Hispanic and Non‐Hispanic Black). Interventions to mitigate maternal–child FI must engage the voices of under‐resourced communities of colour to improve implementation and tackle socio‐ecological drivers of inequities, leading to positive maternal–child outcomes. This exploratory sequential mixed‐methods study aimed to co‐create implementation strategies to tailor a culturally sensitive intervention to address FI during the first 1000 days of life in under‐resourced communities of colour in Las Vegas. A Community Advisory Board (CAB) engaged in a two‐step participatory process. First, through the concept mapping, hierarchical cluster analysis organized 125 strategies into seven thematic areas: policy and advocacy, access to food and resources, built environment, education across systems, social and peer support, cultural congruency and trust, and wellness and mental health. Second, through consensus‐building, strategies were combined by similarity (n = 94) and excluded if unrelated to health and nutrition (n = 9). The CAB reached a consensus on 22 strategies classified across three socio‐ecological levels. Examples of strategies at the community level (n = 16) included increasing utilization of federal nutrition assistance programmes; at the service level (n = 4), integrating FI screenings and referral coordination systems across services; and at the individual level (n = 2), providing mentorship, education, and support for families and moms. The co‐creation of a culturally sensitive intervention to reduce inequities in maternal‐child FI during the first 1000 days of life requires multi‐level strategies across three socio‐ecological levels in under‐resourced communities of colour in Las Vegas. Community members were engaged in a participatory and consensus‐building process that generated strategies to develop a multi‐leveled intervention across the community, service, and individual socioecological levels to address maternal–child food insecurity within the first 1000 days of life in Las Vegas, Nevada. Key messages Implementation co‐creation can increase interventions' feasibility, acceptability, and ownership, ultimately reducing structural barriers and inequities. Using a concept mapping activity, the community advisory board (CAB) identified seven thematic areas for addressing maternal‐child food insecurity: policy and advocacy, access to food and resources, built environment, education across systems, social and peer support, cultural congruency and trust, and wellness and mental health. Using a consensus‐building process, the CAB reached a consensus on 22 strategies across three socio‐ecological levels. Examples of strategies at the community level (n = 16) included the reach and utilization of federal nutrition assistance programmes; at the service level (n = 4), integrating FI screenings and referral and coordination systems across services; and at the individual level (n = 2), developing groups that provide support for moms. The co‐creation of a culturally sensitive intervention to address maternal‐child food insecurity during the first 1000 days requires multi‐level strategies across three socio‐ecological levels.

Background Colorectal cancer (CRC) is the third leading cause of cancer deaths in the United States for men and women combined but is preventable with timely screening. Evidence‐based interventions (EBIs) provide promising opportunities to increase screening. There are few descriptive examples of the processes used to assess and implement EBIs to increase CRC screening. Project Description The Colorectal Cancer Prevention Network (CCPN) in South Carolina facilitated an intensive quality improvement technical assistance project aimed to increase CRC screening in 25 primary care clinics. In this paper we provide a detailed description of the process used to implement EBIs, report on the changes in CRC screening rates, and examine the impact of the interventions across clinics with different attributes (such as clinic size and rurality). Methods We used Chi‐square to explore changes in screening rates from baseline to years two and three of clinic implementation. We used Difference‐in‐Differences analysis to assess changes in screening rates from baseline to third year for clinics with different attributes. Results and Conclusions Across all clinics, the CRC screening increased from 45% to 51% (p < 0.05) from baseline to third year of participation. Sixteen of out 25 clinics saw an increase in screening rates for their second year, and 14 out of 25 saw an increase in their third year. Clinics with smaller patient populations, rural clinics, clinics with fewer uninsured patients, and clinics with lower baseline rates saw greater percentage point improvements. Clinics onboarded in the second year saw the lowest gains. We conclude that a structured tailored approach to the selection of EBIs can have positive effects on CRC screening rates, but positive change may vary depending on clinic attributes.

Conservationists have long sought to reduce consumer demand for products from overexploited wildlife species. Health practitioners have also begun calling for reductions in the wildlife trade to reduce pandemic risk. Most wildlife‐focused demand reduction campaigns have lacked rigorous evaluations and thus their impacts remain unknown. There is thus an urgent need to review the evidence from beyond conservation science to inform future demand‐reduction efforts. We searched for systematic reviews of interventions that aimed to reduce consumer demand for products that are harmful (e.g., cigarettes and illicit drugs). In total, 41 systematic reviews were assessed, and their data extracted. Mass‐media campaigns and incentive programs were, on average, ineffective. While advertising bans, social marketing, and location bans were promising, there was insufficient robust evidence to draw firm conclusions. In contrast, the evidence for the effectiveness of norm appeals and risk warnings was stronger, with some caveats.

Inadequate housing threatens family stability in communities across the United States. This study reviews emerging evidence on housing interventions in the context of scale-up for the child welfare system. In child welfare, scale-up refers to the extent to which fully implemented interventions sustainably alleviate family separations associated with housing instability. It incorporates multiple aspects beyond traditional measures of effectiveness including costs, potential reach, local capacities for implementation, and fit within broader social services. The framework further encompasses everyday circumstances faced by service providers, program administrators, and policymakers who allocate resources under conditions of scarcity and uncertainty. The review of current housing interventions reveals a number of systemic constraints for scale-up in child welfare. Reliance on rental assistance programs limits capacity to address demand, while current practices that target the most vulnerable families may inadvertently diminish effectiveness of the intervention and increase overall demand. Alternative approaches that focus on homelessness prevention and early intervention must be tested in conjunction with community initiatives to increase accessibility of affordable housing. By examining system performance over time, the scalability framework provides an opportunity for more efficient coordination of housing services within and outside of the child welfare system.

ABSTRACTSurgical site infections (SSIs) contribute to negative outcomes for patients and health care organizations. Compliance with clinical practice guidelines likely can help prevent SSIs. An interdisciplinary team at a regional referral center in Michigan sought to reduce SSIs by improving compliance with the facility's preoperative antibiotic selection, dosing, timing, and redosing protocol. The interventions for the quality improvement project included adding the preprocedural antibiotics and doses to the master OR schedule; holding an education session for all preoperative nurses, intraoperative nurses, and anesthesia professionals; and posting a reference guide in the preoperative and intraoperative areas. Compliance with the facility's protocol for antibiotic selection, dosing, and timing significantly improved. However, SSI rates and compliance with redosing recommendations did not change significantly. The team decided to add the antibiotic order information to the master OR schedule permanently. The team plans to consider providing education sessions on administering preprocedural antibiotics outside the OR.

Information on how school-based programs is implemented and sustained during crises is limited. In this study, we assessed the impact of the COVID-19 pandemic on the implementation of a HIV prevention intervention in The Bahamas. Data were collected from 139 Grade 6 teachers in 2021–2022. Teachers attended virtual training and received implementation monitoring from coordinators. On average, teachers taught 26.4 (SD = 9.2) of the 35 core activities, and 7.4 (SD = 2.4) out of 9 sessions. More than half (58.3%) of teachers completed 28 or more core activities; 69.1% covered eight or all nine sessions, which is equivalent to 80% of the HIV intervention curriculum. Almost half of the teachers (43%) reported that the pandemic negatively impacted their ability to teach the program; 72% of teachers maintained that the program remained “very important” during times of crisis. Greater self-efficacy and supports increased implementation fidelity.

Social-emotional competence is a critical factor to target with universal preventive interventions that are conducted in schools because the construct (a) associates with social, behavioral, and academic outcomes that are important for healthy development; (b) predicts important life outcomes in adulthood; (c) can be improved with feasible and cost-effective interventions; and (d) plays a critical role in the behavior change process. This article reviews this research and what is known about effective intervention approaches. Based on that, an intervention model is proposed for how schools should enhance the social and emotional learning of students in order to promote resilience. Suggestions are also offered for how to support implementation of this intervention model at scale.

Background Sustainability of evidence-based interventions (EBI) remains a challenge for public health community-based institutions. The conceptual definition of sustainment is not universally agreed upon by researchers and practitioners, and strategies utilized to facilitate sustainment of EBI are not consistently reported in published literature. Given these limitations in the field, a systematic review was conducted to summarize the existing evidence supporting discrete sustainment strategies for public health EBIs and facilitating and hindering factors of sustainment. Methods We searched PsychINFO, Embase, ProQuest, PubMed, and Google Scholar. The initial search was run in March 2017 and an update was done in March 2019. Study eligibility criteria included (a) public health evidence-based interventions, (b) conducted in the community or community-based settings, and (c) reported outcomes related to EBI sustainment. Details characterizing the study setting, design, target population, and type of EBI sustained were extracted. Results A total of 26 articles published from 2004 to 2019 were eligible for data extraction. Overall, the importance of sustainability was acknowledged across all of the studies. However, only seven studies presented a conceptual definition of sustainment explicitly within the text. Six of the included studies reported specific sustainment strategies that were used to facilitate the sustainment of EBI. Only three of the studies reported their activities related to sustainment by referencing a sustainment framework. Multiple facilitators (i.e., adaptation/alignment, funding) and barriers (i.e., limited funding, limited resources) were identified as influencing EBI sustainment. The majority ( n  = 20) of the studies were conducted in high-income countries. Studies from low-income countries were mostly naturalistic. All of the studies from low-income countries reported lack of funding as a hindrance to sustainment. Implication for dissemination and implementation research Literature focused on sustainment of public health EBIs should present an explicit definition of the concept. Better reporting of the framework utilized, steps followed, and adaptations made to sustain the intervention might contribute to standardizing and developing the concept. Moreover, encouraging longitudinal dissemination and implementation (D&I) research especially in low-income countries might help strengthen D&I research capacity in public health settings.