Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Telephone Support, Educational Material, PROVIDER/PRACTICE, Community Health Workers (CHWs)

Intervention Description: To assess whether a theory-based, community health worker–delivered intervention for household smokers will lead to reduced secondhand smoke exposure to children in Chinese families.

Intervention Results: Of the 318 families randomized, 98 (60%) of 164 intervention group and 82 (53%) of 154 of controls completed 6-month follow-up assessment. At the 6-month follow-up, 62% of intervention and 45% of comparison group households adopted complete smoking restrictions at home (P = .022); total exposure (mean number of cigarettes per week ± standard deviation) from all smokers at home in the past 7 days was significantly lower among children in the intervention (3.29 ± 9.06) than the comparison (7.41 ± 14.63) group (P = .021); and mean urine cotinine level (ng/mL) was significantly lower in the intervention (0.030 ± .065) than the comparison (0.087 ± .027) group, P < .001). Participants rating of the overall usefulness of the intervention was 4.8 + 0.8 (1 standard deviation) on the 5 point scale (1 not at all and 5 = very useful). Conclusions

Conclusion: The findings of this very first study in China showed that smoking hygiene intervention was effective in reducing children's exposure to secondhand smoke. These findings have implications for the development of primary health care–based secondhand smoke exposure reduction and family oriented smoking cessation interventions as China moves toward a smoke-free society.

Study Design: RCT

Setting: Community (households)

Population of Focus: Smoking parents or caregivers who had a child aged 5 years or younger

Data Source: Health center records and parent selfreport.

Sample Size: 318 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PROFESSIONAL_CAREGIVER, Educational Material (caregiver), Provision of Safe Sleep Item, COMMUNITY, Presentation

Intervention Description: This study assessed the feasibility, acceptability and initial outcomes of Safe Sleep Community Baby Showers for women who speak Spanish. The Safe Sleep Baby Showers use the culture and tradition of celebratory group events to connect pregnant or recently delivered women with perinatal community resources, build social support networks, and learn about the American Academy of Pediatrics (AAP) safe sleep recommendations. The baby showers include a crib demonstration facilitated by a safe sleep instructor or board member from the Kansas Infant Death and SIDS (KIDS) Network. All education and materials are in Spanish, and include a safe sleep PowerPoint presentation and a video on the ABCs of Safe Sleep (alone, back, clutter-free crib; available at KIDSKS.org). For this study, 106 pregnant or recently delivered women who spoke Spanish completed pre- and post-assessments after attending at least one of six Safe Sleep Community Baby Showers held in Sedgwick County, Kansas. Participants who complete the post-assessment received a free safety-approved portable crib and wearable blanket, as well as infant safe sleep education handouts and materials (eg, door hangers) in Spanish.

Intervention Results: Participants had a high school diploma/General Educational Diploma (GED) or less (75.3%), and were uninsured (52.1%) or had Medicaid (n = 49; 33.6%). The majority reported being very satisfied (n = 130; 89.0%) or satisfied (n = 8; 5.5%). Compared to baseline, significant increases in intentions and confidence to follow the AAP Safe Sleep Recommendations were observed following the events. The majority of participants reported intending to place their infant on the back to sleep (98.6%), use only a safe surface (crib, portable crib, bassinet; 99.3%), and only include safe items (firm mattress, fitted sheet; 93.5%) (all p < .001).

Conclusion: Study findings support both feasibility and acceptability of modifying Safe Sleep Community Baby Showers to provide culturally and linguistically appropriate education for women who speak Spanish. Initial outcomes suggest increased intentions to follow safe sleep recommendations.

Setting: Community baby showers in Sedgwick County, Kansas

Population of Focus: Pregnant women and recently delivered mothers

Intervention Components (click on component to see a list of all articles that use that intervention): PROFESSIONAL_CAREGIVER, Education/Training (caregiver), Provision of Safe Sleep Item, COMMUNITY, Presentation

Intervention Description: With the support of the Kansas Infant Death SIDS (KIDS) Network, safe sleep instructors in four rural counties (Geary, Cloud, Harvey, and Shawnee) held virtual Safe Sleep Community Baby Showers in 2020. Safe sleep, breastfeeding, and tobacco cessation/avoidance education was provided to participants regardless of education format. In-person events were interactive by nature, using presentation and demonstration, but also included video components. For virtual events, Geary and Cloud counties chose to provide educational videos and prerecorded presentations to participants (passive). Harvey and Shawnee counties held real-time interactive education over a virtual platform. Data was collected via pre- and postsurveys. Those who completed both surveys received a portable crib and wearable blanket.

Intervention Results: Based on data from 145 in-person and 74 virtual participants, virtual participants were more likely to be married (P<.001) and have private insurance (P<.001), and were less likely to report tobacco use (P<.001). Both event formats significantly increased knowledge and intentions regarding safe sleep and avoidance of secondhand smoke (all P≤.001). Breastfeeding intentions did not change. Differences were observed between in-person and virtual meetings regarding confidence in the ability to avoid secondhand smoke (in-person: 121/144, 84% vs virtual: 53/74, 72%; P=.03), intention to breastfeed ≥6 months (in-person: 79/128, 62% vs virtual: 52/66, 79%; P=.008), and confidence in the ability to breastfeed ≥6 months (in-person: 58/123, 47% vs virtual: 44/69, 64%; P=.02).

Conclusion: Although both event formats demonstrated increased knowledge/intentions to follow safe sleep recommendations, virtual events may further marginalize groups who are at high risk for poor birth outcomes. Strategies to increase technology access, recruit priority populations, and ensure disparities are not exacerbated will be critical for the implementation of future virtual events.

Setting: Four rural counties in Kansas

Population of Focus: Pregnant or postpartum women

Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, PROFESSIONAL_CAREGIVER, Education/Training (caregiver), COMMUNITY, Presentation

Intervention Description: This study assessed the impact of the two-day Kansas Infant Death and SIDS (KIDS) Network Safe Sleep Instructor (SSI) train-the-trainer program on CPS staffs' knowledge of the American Academy of Pediatrics safe sleep recommendations. Training was attended by 43 participants, 27 (63%) of whom were employed by CPS. All participants completed a 10-item pre- and post-training knowledge assessment at the beginning of the training and immediately following the training, respectively. Following training, SSIs were certified to educate parents/caregivers, childcare providers, health care providers, and other members of their communities about safe sleep practices. SSIs were tasked with providing safe sleep training to at least 10 professionals and with hosting one Safe Sleep Community Baby Shower or Crib Clinic within 9 months of certification.

Intervention Results: Following SSI certification, CPS SSIs provided more safe sleep training to professionals than other SSIs (1051 vs. 165, respectively), and both groups of SSIs were able to significantly increase the knowledge of their trainees.

Conclusion: Overall, the KIDS Network SSI training was successful. The innovative partnership with CPS allowed for provision of training to a group not historically targeted for safe sleep education.

Setting: Kansas Department of Children and Families Child Protective Services (CPS)

Population of Focus: Child Protective Services staff

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education, , PATIENT_CONSUMER

Intervention Description: This study focused on this population in a quantitative, randomized controlled trial using a low-cost, brief educational intervention, a Safety Baby Shower (SBS).

Intervention Results: Comparing self-report, safe sleep knowledge, attitudes, beliefs, and intent (KABI) to act scores across the two groups found intervention dyads to have more positive views on all four constructs than controls. Specifically, intervention dyad young mothers were significantly more likely to have positive beliefs about safe sleep and were more likely to report intent to practice infant safe sleep than control young mothers. Intervention dyad young mothers also had higher self-efficacy related to infant safety and more positive attitudes about safe sleep practices than control young mothers. Observations at a home visit conducted after delivery found no differences in the safe sleep practices by intervention status. Participant report of behaviors at the home visit also showed no differences in the use of safe position between the intervention and control groups.

Conclusion: It appears that even when young mothers gain knowledge and self-efficacy, they have difficulty implementing this knowledge. In practice, this suggests that exploring barriers prenatally with this population and offering suggestions to overcome them may be indicated.

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Television Media, Other Media, POPULATION-BASED SYSTEMS

Intervention Description: This study sought to determine whether a mass media campaign conducted in Victoria, Australia, in 2005 was effective in encouraging women across all socio-economic status (SES) groups to screen.

Intervention Results: Cervical screening increased 27% during the campaign period and was equally effective in encouraging screening across all SES groups, including low-SES women.

Conclusion: Mass media campaigns can prompt increased rates of cervical screening among all women, not just those from more advantaged areas. Combining media with additional strategies targeted at low-SES women may help lessen the underlying differences in screening rates across SES.

Study Design: QE: pretest-posttest

Setting: Victoria

Population of Focus: Women with no history of hysterectomy

Data Source: Victorian Cervical Cytology Registry

Sample Size: Approximate total (N≈1,421,390)4

Age Range: 18-69

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Policy (Community)

Intervention Description: A cross-sectional study was conducted of 4790 children aged 4-15 years recruited from 130 communities in the Healthy Communities Study. Multilevel statistical models assessed associations between school wellness policies and anthropometric (body mass index z-score [BMIz]) and nutrition measures, adjusting for child and community-level covariates.

Intervention Results: Children had lower BMI z-scores (-0.11, 95% confidence interval [CI]: -0.19, -0.03) and ate breakfast more frequently (0.14 days/week, 95% CI: 0.02-0.25) if attending a school with a wellness committee that met once or more in the past year compared to attending a school with a wellness committee that did not meet/did not exist. Children had lower added sugar (p < .0001), lower energy-dense foods (p = .0004), lower sugar intake from sugar-sweetened beverages (p = .0002), and lower dairy consumption (p = .001) if attending a school with similar or stronger implementation of the nutrition components of the school wellness policies compared to other schools in the district.

Conclusion: A more active wellness committee was associated with lower BMI z-scores in US schoolchildren. Active school engagement in wellness policy implementation appears to play a positive role in efforts to reduce childhood obesity.

Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, COMMUNITY, Community Health Services Policy

Intervention Description: The aim of this pragmatic cluster quasi-randomised controlled trial was to assess the effectiveness of implementing the Baby-friendly Initiative (BFI) in community health services.

Intervention Results: Women in the intervention group were more likely to breastfeed exclusively compared with those who received routine care: 17.9% vs. 14.1% until 6 months [cluster adjusted odds ratio (OR) = 1.33; 95% confidence interval (CI): 1.03, 1.72; P = 0.03], 41.4% vs. 35.8% until 5 months [cluster adjusted OR = 1.39; 95% CI: 1.09, 1.77; P = 0.01], and 72.1% vs. 68.2% for any breastfeeding until 6 months [cluster adjusted OR = 1.24; 95% CI: 0.99, 1.54; P = 0.06]. The intervention had no effect on breastfeeding until 12 months.

Conclusion: The Baby-friendly Initiative (BFI) in community health services increased rates of exclusive breastfeeding until 6 months.

Study Design: Pragmatic cluster quasi-experimental

Setting: 54 municipalities in six counties (Østfold,Vestfold, NordTrøndelag, Hordaland, Telemark, Finnmark)

Population of Focus: Mothers with infants ≥5 months old at the time of survey, who lived in the study area and had given birth to a singleton infant at ≥ 37 weeks GA with a birth weight ≥ 2000 gm

Data Source: Mother self-report

Sample Size: Intervention (n=1051/990)3 Control (n=981/916)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Community Events,

Intervention Description: The intervention was a flu vaccination event held in a Black church, which included health education and other preventive services such as dental, developmental, vision, hearing, and BMI screenings.

Intervention Results: The study found that the flu vaccination event held in the Black church was successful in increasing flu vaccination rates among Black children. The event also provided an opportunity to offer other preventive services to the community.

Conclusion: The study demonstrates the potential of partnering with faith-based organizations to offer preventive services to underserved communities.

Study Design: The study used a pre-post design to evaluate the impact of a flu vaccination event held in a Black church.

Setting: The study was conducted in a Black church in a low-income neighborhood in Philadelphia, Pennsylvania.

Population of Focus: The target audience was Black children aged 6 months to 18 years and their families.

Sample Size: The sample size was 100 Black children and their families.

Age Range: The age range of the children included in the study was 6 months to 18 years.

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Notification/Information Materials (Online Resources, Information Guide), CLASSROOM, Adult-led Curricular Activities/Training, Enforcement of School Rules, SCHOOL, Assembly, Reporting & Response System, Bullying Committee, Teacher/Staff Meeting, Teacher/Staff Training, School Rules, Identification and Monitoring of/Increased Supervision in Targeted Areas, POPULATION-BASED SYSTEMS, COMMUNITY, Media Campaign (Print Materials, Radio, TV)

Intervention Description: To examine the effectiveness of a widely disseminated bullying prevention program.

Intervention Results: Regression analyses controlling for baseline prevalence and school characteristics showed no overall effect on student victimization. However, when stratified by ethnicity/race, reports of relational and physical victimization decreased by 28% (RR = .72, 95% CI: .53-.98) and 37% (RR = .63, 95% CI: .42-.97), respectively, among white students relative to those in comparison schools. No similar effect was found for students of other races/ethnicities; there were no differences by gender or by grade. Students in intervention schools were more likely to perceive other students as actively intervening in bullying incidents, and 6th graders were more likely to feel sorry and want to help victims.

Conclusion: The program had some mixed positive effects varying by gender, ethnicity/race, and grade but no overall effect. Schools implementing the program, especially with a heterogeneous student body, should monitor outcomes and pay particular attention to the impact of culture, race and family influences on student behavior. Future studies of large-scale bullying prevention programs in the community must be rigorously evaluated to ensure they are effective.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Intervention (n=4959) Relational Victimization: Pretest (n=4607); Posttest (n=4480) Physical Victimization: Pretest (n=4531); Posttest (n=4419) Control (n=1559) Relational Victimization: Pretest (n=1408); Posttest (n=1456) Physical Victimization: Pretest (n=1373); Posttest (n=1448)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: This study investigates the experiences of women using a social media Facebook group for breastfeeding support and attempts to explore whether it has aided in extended breastfeeding success. In addition, it aims to explore the value of social cognitive theory (SCT) in explaining these experiences. Qualitativ, audio-recorded, semi-structured interviews were conducted from eight women who were members of a private Facebook group.

Intervention Results: A number of themes were identified from the women's experiences, with analysis uncovering the superordinate theme 'increased self-efficacy' which provided an understanding of how the group impacted women's experiences and aided them in breastfeeding success. The sub-themes of education, accessibility, online community, normalization, and extended goals provided a more detailed understanding of how self-efficacy was increased through group membership.

Conclusion: The symbiotic relationship between members of a social media group facilitates greater breastfeeding success and a longer duration of breastfeeding through the central concept of the SCT: reciprocal determinism. Therefore, it is posited that the SCT is a suitable theory of behaviour change which can potentially be used to develop interventions aiming to increase breastfeeding rates and duration.

Study Design: Qualitative study (exploratory, deductive approach)

Setting: Social media platform: Private Facebook group

Population of Focus: Women who were members of a private Facebook group

Sample Size: 8 women

Intervention Components (click on component to see a list of all articles that use that intervention): Midwifery, PROVIDER/PRACTICE, HOSPITAL, Chart Audit and Feedback, Organizational Changes, Quality Improvement, POPULATION-BASED SYSTEMS, Community — Outreach, Outreach, COMMUNITY, COMMUNITY

Intervention Description: To improve quality of care by offering more women a safe and attractive normal vaginal delivery. The target group was primarily nulliparous women at term with spontaneous onset of labor and cephalic presentation.

Intervention Results: The CS rate in nulliparous women at term with spontaneous onset of labor decreased from 10% in 2006 to 3% in 2015. During the same period the overall CS rate dropped from 20% to 11%. The prevalence of children born at the unit with umbilical cord pH <7 and Apgar score <4 at 5 min were the same over the years studied. At present, 95.2% of women delivering at our unit are satisfied with their delivery experience.

Conclusion: The CS rates have declined after implementing the nine items of organizational and cultural changes. It seems that a specific and persistent multidisciplinary activity with a focus on the Robson group 1 can reduce CS rates without increased risk of neonatal complications.

Study Design: Time trend analysis

Setting: 1 public, medium-sized tertiary level obstetric unit

Population of Focus: Nulliparous women who gave birth between January 2006 and October 2015

Data Source: Not specified

Sample Size: n=~900 (880-924) per year

Age Range: Not Specified

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Other Media, Community Events, Television Media, POPULATION-BASED SYSTEMS

Intervention Description: The project explored the potential of historically black medical schools to deliver health information to their local communities and used a community-based participatory research approach.

Intervention Results: Significant difference in Pap smear rates between Nashville (intervention) vs Chattanooga (control; 8% effect difference, p≤.01) but not between Atlanta (intervention) vs Decatur (control). Pooled results are not given.

Conclusion: This community intervention trial demonstrated modest success and are encouraging for future efforts of longer duration.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Nashville, TN; Atlanta, GA; Chattanooga, TN; and Decatur, GA

Population of Focus: Women living in predominantly black census tracts in the intervention cities

Data Source: Telephone interview

Sample Size: Baseline(n=4,053) Intervention (n=1,954); Control (n=2,099) Follow-up (n=3,914) Intervention (n=1,959); Control (n=1,955)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Presentation/Meeting/Information Session/Event, CLASSROOM, Enforcement of School Rules, SCHOOL, Bullying Committee, Assembly, Reporting & Response System, Teacher/Staff Meeting, Teacher/Staff Training, School Rules, Identification and Monitoring of/Increased Supervision in Targeted Areas, POPULATION-BASED SYSTEMS, COMMUNITY, Media Campaign (Print Materials, Radio, TV)

Intervention Description: This intervention study examined the prevalence of bullying in an urban/suburban middle school and the impact of the Olweus Bullying Prevention Program (OBPP).

Intervention Results: Statistically significant findings were found for 7th grade female students who received 1 year of the OBPP on reports of prevalence of bullying (p = .022) and exclusion by peers (p = .009). In contrast, variability in statistical findings was obtained for 8th grade females and no statistical findings were found for males. Following 1 year of the OBPP, teachers reported statistically significant improvements in their capacity to identify bullying (p = .016), talk to students who bully (p = .024), and talk with students who are bullied (p = .051). Other substantial percentile changes were also noted.

Conclusion: Findings suggest a significant positive impact of the OBPP on 7th grade females and teachers. Other grade and gender findings were inconsistent with previous literature. Recommendations for further research are provided along with implications for school health prevention programming.

Study Design: QE: time-lagged age-equivalent control group

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Intervention (n=112); Control (n=158)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): Mobile Programs, Community Events,

Intervention Description: Interprofessional, student-run vaccine outreach program (VOP) that provided free vaccination events in nontraditional community locations

Intervention Results: The VOP reached hundreds of residents who were more vulnerable to influenza infection, including patients who were under- or uninsured, lacked stable housing, and/or were unemployed. Among VOP patients, 377 (21.8%) received their first ever vaccine and 483 (27.9%) obtained the influenza vaccine rarely or every few years which indicates the VOP reached many vaccine-naïve and vaccine-inconsistent individuals. With the addition of a nurse practitioner student to VOP leadership, the 2018–2019 VOP reached the most homeless or temporarily-housed (228, 32.3%), unemployed (313, 18.5%), and disabled (60, 8.5%) patients.

Conclusion: Healthcare students serve as an eager, underutilized resource who can be leveraged to disseminate vaccines to individuals with limited access to care.

Study Design: Retrospective analysis of demographic data collected through an optional survey

Setting: Davidson County, Tennessee, USA

Population of Focus: Marginalized populations, including the uninsured, unemployed, and unhoused individuals

Sample Size: 1,803 patients who received an influenza vaccine between 2015 and 2019

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Social Media, Other Media, Mass Media, NATIONAL, COMMUNITY

Intervention Description: To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices.

Intervention Results: The average infant age (n = 1500) was 6.6 months (Standard Deviation 3.3). Most participants (74%) were female; 77% were married; 65% identified as white Non-Hispanic, 12% were black and 17% were Hispanic. 47% (n = 711) completed both surveys. We identified no differences in the odds of any of the four safe sleep practices after exposure to safe sleep recommendations in blog post format.

Conclusion: Although in-person advice has been associated with improved safe sleep practices, we did not identify changes in infant sleep practices after exposure to safe sleep advice using blog posts.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Telephone Support, COMMUNITY, Community Health Services Policy, Distribution of Promotional Items (Classroom/School), Distribution of Promotional Items (Community), Educational Material

Intervention Description: The intervention consists of three mailings and one brief coaching call delivered by 2-1-1 staff over 6 weeks. Emphasizes establishing a smoke-free home rather than smoking cessation.

Intervention Results: Overall, 40.1% reported creating a full household smoking ban. Among the nonsmoking adults reached at follow-up, days of SHS exposure in the past week decreased from 4.9 to 1.2. Among the 1148 smokers reached for follow-up, 211 people quit, an absolute reduction in smoking of 18.4% (p < .0001), with no differences by gender. Among those reached for 2-month follow-up, the proportion who reported establishing a smoke-free home was comparable to or higher than smoke-free home rates in the prior controlled research studies.

Conclusion: Among those reached for 2-month follow-up, the proportion who reported establishing a smoke-free home was comparable to or higher than smoke-free home rates in the prior controlled research studies.

Study Design: RCTs; 1st was efficacy trial, 2nd was effectiveness trial, 3rd was a generalizability trial, [4th-5th not described in article]

Setting: Telephone counseling for an educational intervention

Population of Focus: 5 2-1-1 centers chosen via competitive applications for a national grants program

Data Source: Participant reports; Tracking Tool for programs to record process of project

Sample Size: 2345 households at five 2-1-1 organizations

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education

Intervention Description: Six hundred thirteen women of Mexican origin in 3 treatment sites were randomized among 4 study arms: the full AMIGAS program with a video and a flip chart (n = 151), the AMIGAS program without the video (n = 154), the AMIGAS program without the flip chart (n = 155), and a usual care control group (n = 153). Six months after enrollment, women were surveyed and reported whether or not they had been screened.

Intervention Results: Women in any of the intervention arms were statistically significantly more likely to report being screened than those in the usual care group in both an intent-to-treat analysis and a per-protocol analysis. In the intent-to-treat analysis, 25% of women in the control group and 52% in the full AMIGAS program group reported having had Pap tests (P < .001); in the per-protocol analysis, the percentages were 29% and 62%, respectively (P < .001).

Conclusion: AMIGAS was effective in increasing Pap test screening among women of Mexican descent when used in a 1-to-1 setting. Future research should compare the 1-on-1 intervention with the group-based intervention.

Study Design: RCT: pretest-posttest

Setting: El Paso, TX; Houston, TX; and Yakima Valley, WA

Population of Focus: Mexican women with no Pap smear reported in the past 3 years

Data Source: Self-report and validated through medical records review

Sample Size: Intent-to-Treat Analysis (n=613) Intervention Group 1 (n=151); Intervention Group 2 (n=154); Intervention Group 3 (n=155); Control (n=153) Per-Protocol Analysis (n=513) Intervention Group 1 (n=128); Intervention Group 2 (n=125); Intervention Group 3 (n=127); Control (n=133)

Age Range: ≥21

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Environment Enhancements

Intervention Description: We used data from a 2009 survey (n = 424) that was designed and administered to evaluate neighborhood preferences and behavior-specific physical activity before and after residents moved. Data were grouped and stratified by pre-move physical activity levels into low-, middle-, and high-activity groups. We used Student's paired sample t test and Wilcoxon signed-rank test to compare pre- and post-move scores and used an analysis of variance to compare mean changes as a function of pre-move physical activity level.

Intervention Results: After moving, the high-activity group continued to be significantly more active than the middle- and low-activity groups (P < .001). However, we saw the biggest increase in pre- to post-move total physical activity in the low-activity group (mean increase, 176.3 min/wk) compared with the middle- (mean increase, 69.5 min/wk) and high-activity groups (mean decrease, 67.9 min/wk). All 3 groups had significant increases in walking inside the neighborhood for recreation. The preferred neighborhood features with the most significant pre- to post-move change scores were those associated with greater walkability.

Conclusion: This study supports the role the environment plays in physical activity. These data suggest that moving to an activity-friendly neighborhood can positively affect physical activity levels, particularly among residents who had previously been least active.

Setting: Community

Population of Focus: Children and addults

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education,

Intervention Description: A case study shows us how group prenatal care may be one viable vehicle through which to affect this change. Group prenatal care is one of the few interventions shown to improve pregnancy outcomes for black women.

Intervention Results: The intervention increased the likelihood of diagnosing the unmet mental health needs, but the available mental health referral network for uninsured and underinsured patients in St. Louis was inadequate. Therefore, the collaborative identified a mental health referral network to care for pa- tients whose mental health needs excee- ded the ability of obstetrical clinicians to address in the group space

Conclusion: The underlying mechanism through which group prenatal care works may be through increased quantity and quality of patient and practitioner time together and communication. We hypothesize that this, in turn, fosters greater opportunity for cross-cultural exposure and decreases clinician implicit bias, explicit bias, and racism, thus increasing the likelihood that practitioners advocate for systems-level changes that directly benefit patients and improve perinatal outcomes.

Study Design: Qualitative

Setting: Community-based

Population of Focus: Predominantly low-income, black women

Sample Size: Unknown

Age Range: Not disclosed

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Community-Based Group Education, Patient Navigation,

Intervention Description: In 2014, the University of Illinois Health and Health Sciences System initiated the Coordinated Healthcare for Complex Kids (CHECK) program. This comprehensive care coordination demonstration project aimed to provide services for children and young adults with chronic health conditions in Chicago insured by Medicaid. CHECK adopted a holistic approach, addressing social determinants of health, caregiver wellness, mental health, and chronic disease management. The program targeted individuals with diagnoses such as asthma, diabetes, sickle cell disease, seizure disorder, or prematurity, spanning from birth to age 25. Participants were enrolled in the traditional, fee-for-service state Medicaid program or a Medicaid managed care organization (MCO) in Illinois. CHECK offered various services, including care coordination by community health workers (CHWs), mental health services by professionals, and disease-specific health education. CHWs assessed individual and family needs, analyzing health care utilization patterns in the year before enrollment. The program operated from May 1, 2014, to April 30, 2017, with data collection conducted in May 2018, covering the 12 months before and after randomization. For further details, refer to Table 4: Intervention Descriptions in the Evidence Review.

Intervention Results: In this analysis of the Chicago-based CHECK program (a large care-coordination initiative for low-income children and youth with chronic health conditions), overall Medicaid expenditures and utilization decreased considerably during the first year of the CHECK program for both CHECK participants and the usual care group. Notably, expenditures did not increase among CHECK participants, which has been noted in other care coordination programs. The rate of inpatient and ED utilization decreased for both groups. The mean (SD) inpatient utilization before enrollment in CHECK was 63.0 (344.4) per 1000 PYs for the intervention group and 69.3 (370.9) per 1000 PYs for the usual care group, which decreased to 43.5 (297.2) per 1000 PYs and 47.8 (304.9) per 1000 PYs, respectively, after the intervention.

Conclusion: Medicaid expenditures and utilization patterns decreased similarly among participants who were enrolled in the CHECK program and those in the UC group. Among children and young adults with asthma and those considered medium and high risk, a comprehensive care coordination program indicated that it could decrease ED utilization.

Study Design: RCT

Setting: Community (Coordinated Healthcare for Complex Kids (CHECK) program; Illinois Medicaid)

Population of Focus: Children with chronic diseases

Sample Size: The study involved a total of 6,245 children and young adults, with 3,119 individuals in the control group and 3,126 individuals in the intervention group.

Age Range: The study included children younger than 1 year old and youth older than 18 years. The mean age of the participants was 11.3 years.

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Hospital Policies, POPULATION-BASED SYSTEMS, COMMUNITY, Community Health Services Policy, Provider Training/Education

Intervention Description: To assess the effectiveness of the Baby Friendly Community Initiative (BFCI) on exclusive breast feeding at 6 months.

Intervention Results: The crude rates of exclusive breast feeding at discharge, 3 and 6 months, and of any breast feeding at 6 and 12 months increased at each round of data collection after baseline in the early and late intervention groups. At the end of the project, 10% of infants were exclusively breast fed at 6 months and 38% were continuing to breast feed at 12 months. However, the comparison by adjusted rates and logistic regression failed to show statistically significant differences between groups and rounds of data collection in the intention-to-treat analysis, as well as when compliance with the intervention and training coverage was taken into account.

Conclusion: The study failed to demonstrate an effect of the BFCI on the rates of breast feeding. This may be due, among other factors, to the time needed to observe an effect on breast feeding following this complex intervention.

Study Design: QE: pretest-posttest time-lagged nonequivalent control group

Setting: 18 Local Health Authorities (LHAs) in 9 regions of Italy

Population of Focus: Women living in the area covered by LHA, with infants > 2000g, who spoke Italian, English, French, or Spanish (or who had a relative who spoke these languages), and without a postpartum condition that required admission to the NICU

Data Source: Mother self-report

Sample Size: Early Intervention Group5 • Enrolled (n=2846) • 12-month follow-up (n=2474) Late Intervention Group • Enrolled (n=2248) • 12-month follow-up (n=1931)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: The support offered to mothers after hospital discharge can be decisive in maintaining exclusive breastfeeding during the first 6 months post-partum. The objective of this study was to assess the impact on the duration of exclusive breastfeeding of a participatory intervention using an online social network--Facebook. A randomized clinical trial was performed involving 251 mother–child pairings in a university hospital in the Northeast of Brazil, 123 of which assigned to the intervention group and 128 to the control group. After hospital discharge, the intervention group was followed through a closed group of an online social network, where weekly posters were published on topics related to breastfeeding and an active communication was established with the mothers. The groups were interviewed monthly over the phone until the child reached 6 months of age.

Intervention Results: The exclusive breastfeeding frequencies were higher in the intervention group in all follow-up months, reaching 33.3% in the sixth month versus 8.3% in the control group. The median exclusive breastfeeding duration was 149 days (95% CI [129.6, 168.4]) in the intervention group and 86 days (95% CI [64.9, 107.1]) in the control group (P < 0.0001). The proportional risk of early interruption of exclusive breastfeeding was 0.38 (95% CI [0.28, 0.51], P < 0.0001).

Conclusion: This intervention had a positive impact on the duration and frequency of exclusive breastfeeding.

Study Design: Single-blind, RCT

Setting: Social media platform: Facebook

Population of Focus: Mother-child pairings assisted in the maternity ward of a Baby-Friendly Hospital who used Facebook

Sample Size: 251 mother-child pairings

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Other Education, Telephone Support, Technology-Based Support, COMMUNITY, Individual Supports,

Intervention Description: Pregnancy mobile apps are becoming increasingly popular, with parents-to-be seeking information related to their pregnancy and their baby through mobile technology. This increase raises the need for prenatal apps with evidence-based content that is personalized and reliable. The primary objective of this study is to assess whether the use of a health system–sponsored mobile app—Circle by Providence—aimed at providing personalized and reliable health information on pregnancy, postpartum recovery, and infant care is associated with improved health outcomes and increased healthy behaviors and knowledge among users.

Intervention Results: A total of 567 participants were enrolled in the study—167 in the app user group and 400 in the nonuser group. We found statistically significant differences between the two groups for certain behavior outcomes: subjects who used the app had 75% greater odds of breastfeeding beyond 6 months postpartum (P=.012), were less likely to miss prenatal appointments (P=.046), and were 50% more likely to exercise 3 or more times a week during pregnancy (P=.04). There were no differences in nutritional measures, including whether they took prenatal vitamins, ate 5 fruits or vegetables a day, or drank caffeine. We found no differences in many of the infant care outcomes; however, there was an increase in awareness of “purple crying.” Finally, there were no significant differences in measured clinical health outcomes, including cesarean births, length of hospital stays (in minutes), low birth weight infants, preterm births, small-for-gestational-age births, large-for-gestational-age births, and neonatal intensive care unit stays.

Conclusion: The use of the Circle app, which provides access to personalized and evidence-based health information, was associated with an increase in certain healthy behaviors and health knowledge, although there was no impact on clinical health outcomes. More research is needed to determine the impact of mobile prenatal apps on healthy pregnancies, clinical health outcomes, and infant care.

Study Design: Observational study using surveys and electronic medical records

Setting: Providence St. Joseph Health's Consumer Innovation Team launched app in Portland, Oregon and greater Seattle, Washington areas/Online

Population of Focus: Women with four or more prenatal encounters at one of the seven selected clinics that gave birth to a live infant at a Providence hospital in the past 4-6 months

Sample Size: 567 women (167 in the app user group and 400 in the comparison nonuser group)

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, PATIENT_CONSUMER, Community Events, COMMUNITY, Nurse/Nurse Practitioner, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: The study aimed to evaluate the effectiveness of a cervical cancer prevention education program for rural Korean immigrant women. A total of 46 Korean immigrant women who had not been screened in the past three years participated. The experimental group participated in the intervention program once a week for four weeks and completed a post-program survey in week 12.

Intervention Results: The experimental group participated in the intervention program once a week for four weeks and completed a post-program survey in week 12. Compared to the control group, significant increases were detected in level of knowledge of cervical cancer prevention (p = .001), behavioral attitude toward cervical cancer prevention (p = .029) and behavioral intention regarding cervical cancer prevention (p = .005) in the experimental group. Pap screening rate of the experimental group was significantly increased (p = .029), but the rate of change in the selection of primary care providers was not significant.

Conclusion: The results suggest the need for a multilevel approach to address cultural and systemic barriers to Korean immigrant women in promotion of cervical cancer prevention behavior.

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Multicomponent School-Based Program, COMMUNITY, Policy (Community)

Intervention Description: Schools signal health priorities through policies. School districts prioritize health and, accordingly, their school health environments through policies that engage parents/guardians, campus educators, staff, and community leaders in the development process. Using a repeated cross-sectional study design, we compare the presence and strength of policies related to four topics—physical activity, nutrition, mental health, and bullying—described in elementary school Campus Improvement Plans (CIPs; also called school improvement plans) within Texas, across four Texas Public Health Regions (PHRs), and between 2016 and 2020. CIPs were collected using a multi-stage probability-based survey approach, scored using an adapted WellSAT tool, and analyzed to determine associations between PHR or year and health topic.

Intervention Results: Across 170 CIPs, bullying was the most frequently addressed topic, followed by mental health, physical activity, and nutrition. On average, schools addressed 2.7 ± 1.3 topics within their CIP; 38.2% of schools addressed all four, 26.5% addressed three, 12.4% addressed two, 15.3% addressed one, and 7.6% addressed none. CIPs in the same district had high levels of clustering (ICCs = 0.28–0.55). The mostly rural Panhandle PHR included the fewest topics in their CIPs and used the weakest policy language.

Conclusion: Between 2016 and 2020, there was a decrease in the proportion of CIPs that addressed nutrition; the strength of language for mental health and bullying also decreased. Regional and time trends reveal opportunities for more robust school health policy interventions.

Study Design: Repeated cross-sectional study

Setting: Elementary Schools in Texas across Texas Public Health Regions

Population of Focus: Elementary aged children, Grades K-5, attending participating schools with Campus Improvement Plans

Sample Size: 170 Campus Improvement Plans/Elementary schools

Age Range: Children ages 5-11 years

Intervention Components (click on component to see a list of all articles that use that intervention): Policy (Community), Food Programs

Intervention Description: Over 2011-2013, the SEBTC demonstrations were evaluated by using a random assignment design. Households were randomly assigned a monthly $60-per-child benefit, a monthly $30-per-child benefit, or no benefit, depending on the study year.

Intervention Results: SEBTC reduced the prevalence of very low food security among children by one-third. It also had positive impacts on 6 of the 8 child nutrition outcomes measured (amounts of fruits and vegetables; whole grains; dairy foods; and added sugars).

Conclusion: SEBTC is a promising model to improve food security and the dietary quality of low-income school-aged children in the summer months.

Study Design: Random assignment design

Setting: Community-based

Population of Focus: Households with school-aged children

Sample Size: 52000

Age Range: n/a

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Community Health Workers (CHWs), Outreach (Provider), PATIENT/CONSUMER, Motivational Interviewing, Telephone Support, Home Visits

Intervention Description: To evaluate the effectiveness of a lay delivered intervention to reduce Latino children’s exposure to environmental tobacco smoke (ETS). The a priori hypothesis was that children living in households that were in the intervention group would have lower exposure over time than measurement only controls.

Intervention Results: There were no significant condition-by-time interactions. Significant or near significant time main effects were seen for children’s hair cotinine and parent’s report of exposure.

Conclusion: Applying a lay promotora model to deliver the behavioural problem solving intervention unfortunately was not effective. A likely explanation relates to the difficulty of delivering a relatively complex intervention by lay women untrained in behaviour change theory and research methods.

Study Design: Two group, randomized control trial

Setting: Community (home)

Population of Focus: Latino children

Data Source: Recruited from community organizations and venues such as Head Start Programs and cultural fairs

Sample Size: 143 Latino parents of children aged 1 to 9 who reported smoking at least 6 cigarettes a week

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Supports, Social Media

Intervention Description: In the United States, there are lower rates of breastfeeding among African American mothers, particularly those who are younger women. Recent epidemiological studies have shown a strong association of more aggressive types of breast cancer (estrogen receptor negative) among African American women, with a higher risk in African American women who did not breastfeed their children. This study aims to describe the process evaluation of recruitment and educational strategies to engage pregnant African American participants for a pilot study designed to determine whether social media messaging about breast cancer risk reduction through breastfeeding may positively influence breastfeeding rates.

Intervention Results: More than 3000 text messages were sent and received through WIC e-blasts and keyword responses from flyers. A total of 472 women were recruited through WIC e-blast, and 161 responded to flyers and contacts through the local health care network, community-based organizations, Facebook, and friend referrals. A total of 633 women were assessed for eligibility to participate in the study. A total of 288 pregnant African American women were enrolled, consented, and completed presurvey assessments (102.8% of the goal), and 22 participants attended focus groups or interviews reporting on their experiences with Facebook and the educational messages.

Conclusion: This process evaluation suggests that using electronic, smartphone apps with social media holds promise for both recruitment and conduct of health education intervention studies for pregnant African American women. Providing messaging and resources through social media to reinforce and educate women about breastfeeding and potentially provide lactation support is intriguing. Convenience (for researchers and participants) is an attribute of social media for this demographic of women and worthy of further research as an educational tool.

Study Design: Process evaluation

Setting: Social media platform: Facebook

Population of Focus: Pregnant African American women recruited through WIC

Sample Size: 472 women

Intervention Components (click on component to see a list of all articles that use that intervention): Media Campaign (Print Materials, Public Address System, Social Media), Distribution of Promotional Items (Community),

Intervention Description: The first intervention involved an FASD informational poster affixed to a pregnancy test dispenser, while the second intervention involved an FASD informational poster alone. Both interventions were posted in women's restrooms at establishments serving alcohol in eight study communities in Alaska and the Yukon Territory.

Intervention Results: The study found that both intervention groups showed improvement in knowledge of FASD, with the dispenser group scoring higher than the poster group on the FASD Health Belief questions at both baseline and follow-up. Additionally, alcohol consumption among pregnant women was lower at follow-up than at baseline, and a smaller proportion of pregnant participants reported drinking alcohol within the past 30 days at follow-up, indicating that the interventions may have influenced pregnant participants to stop drinking. The study also reported generally positive comments from patrons and no requests from establishments to remove the messages prior to the end of the study

Conclusion: Both interventions were posted in women's restrooms at establishments serving alcohol in eight study communities in Alaska and the Yukon Territory.

Study Design: Formative Evaluation

Setting: Alaska & Yukon regions

Population of Focus: women of childbearing age, particularly those who consume alcohol and may be pregnant or become pregnant

Sample Size: 2132

Age Range: 21-40

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Peer Counselor, Assessment (PATIENT_CONSUMER), Professional Support, HEALTH_CARE_PROVIDER_PRACTICE, Other (Provider Practice), COMMUNITY, Social Supports, Individual Supports,

Intervention Description: In 2014, the New York State WIC program launched the You Can Do it (YCDI) initiative in 12 WIC clinics. This multicomponent intevention, which was originally developed by the Vermont WIC program, was designed to improve participants' knowledge, attitudes, confidence, and social support to breastfeed exclusively through a screening and tailored counseling protocol combined with peer counselor and professional support spanning the prenatal and early postpartum periods. This multicomponent intervention paired with a yearlong learning community in the 12 clinics.

Intervention Results: Prevalence of exclusive BF at 7 and 30 days was significantly higher among BAPT women compared with non-BAPT or baseline cohorts. Non-Hispanic black and Hispanic women in the BAPT cohort achieved significantly higher exclusive BF rates at 30 and 60 days compared with those in non-BAPT and baseline cohorts.

Conclusion: The initiative seems to be effective at increasing exclusive BF, particularly among non-Hispanic black and Hispanic women in the New York State WIC program.

Study Design: Quasi-experimental study

Setting: 12 WIC clinics in New York State

Population of Focus: Prenatal women enrolled in WIC during the first trimester of pregnancy who intended to breastfeed or were undecided

Sample Size: Baseline cohort of 688 mother-infant dyads and two intervention cohorts: Breastfeeding Attrition Prediction Tool (BAPT) (n=362 monther-infant dyads) and non-BAPT (n=347 mother-infant dyads); 12 WIC clinics; 47 WIC staff members

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education, Community Health Workers (CHWs), Outreach (caregiver),

Intervention Description: The study describes a community-specific and culturally coherent approach to youth mental health services, emphasizing culturally relevant adjustments in the delivery of youth mental wellness services and related community wellness initiatives, with a focus on connections to culture and traditional skills, and strengthening support systems to improve access to mainstream mental healthcare when needed.

Intervention Results: The study highlights the adaptation of the ACCESS Open Minds framework to Inuit paradigms in Ulukhaktok and its potential as a sustainable prototype for delivering youth mental health services in Indigenous communities.

Conclusion: The conclusion emphasizes the need for easier access to specialized mental health services when needed in Indigenous communities.

Study Design: Community-specific and culturally coherent approach to youth mental health services

Setting: Ulukhaktok, Northwest Territories, Canada

Population of Focus: Indigenous youth in the Ulukhaktok community

Sample Size: Not explicitly mentioned in the provided abstract

Age Range: Age range: Primarily focused on youth under the age of 25, with a specific emphasis on adolescents

Intervention Components (click on component to see a list of all articles that use that intervention): Other Person-to-Person Education, Television Media, COMMUNITY, PATIENT/CONSUMER, Other Media, POPULATION-BASED SYSTEMS

Intervention Description: To test the effectiveness of a community intervention program to promote breast and cervical cancer screening.

Intervention Results: There were higher Pap smear completion rates for women under 40 years of age in the intervention community.

Conclusion: Although it is important to address the cultural needs of all Mexican American women, it is also important to understand the tangible environmental barriers faced by the older women.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Predominantly Mexican American neighborhoods in San Antonio and Houston, TX

Population of Focus: Mexican American women

Data Source: Self-report through personal interviews

Sample Size: Baseline (n=1,776) Intervention (n=882); Control (n=894) First Panel Follow-up (n=296) Intervention (n=153); Control (n=143) Second Panel Follow-up (n=145) Intervention (n=70); Control (n=75)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, Other Media, COMMUNITY, POPULATION-BASED SYSTEMS

Intervention Description: Evaluate the effect of an educational intervention on four domains of health care utilization and cervical cancer prevention and screening in a Hispanic population.

Intervention Results: Educational interventions designed to meet the needs identified by the sample group led to an increase in HPV awareness throughout the entire population surveyed and an increase in health care service utilization and HPV vaccine acceptance for women living in the US for <5 years.

Conclusion: These tools should be promoted to reduce the cervical cancer burden on vulnerable populations.

Study Design: QE: pretest-posttest

Setting: Boston, MA

Population of Focus: Hispanic women in the Boston area

Data Source: Written survey in English or Spanish

Sample Size: Baseline (n=318) Follow-up (n=295)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Policy (Community)

Intervention Description: Wellness policies were evaluated using the validated Wellness School Assessment Tool (WellSAT). Concurrently, schools completed the validated Alliance for a Healthier Generation’s Healthy Schools Program (HSP) self-assessment to evaluate physical activity practices. Overall, 13 of 20 physical activity measures from WellSAT and 12 of 13 physical activity measures from HSP were aligned to match policy with practice.

Intervention Results: Most policy items scored 0 or 1, indicating either ‘no mention in the policy’ or ‘containing weak or vague language’. Corresponding HSP results indicated that school physical activity practices are ‘not in place’ or ‘under development’. A strong, positive, correlation (r = 0.92, P < 0.001) indicated that a significant relationship exists between policy and implementation.

Conclusion: Results indicate that most districts currently have weak policies regarding physical activity, limiting the potential to positively influence school-based physical activity.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Lactation Consultant, Provision of Breastfeeding Item, Group Education, Incentives, Professional Support, COMMUNITY, Individual Supports,

Intervention Description: The Canada Prenatal Nutrition Program (CPNP) aims to improve birth outcomes and promote and support breastfeeding among vulnerable women. Using charitable donations, the Parkdale Parents' Primary Prevention Project (5Ps) CPNP provides postnatal lactation support to its clients in addition to standard prenatal services (group education workshops, individualized support from public health nurses and dieticians, community referrals, snacks, two public transit tokens, grocery store gift card, self-serve food bank, and childcare). This lactation support program was designed and implemented by 5Ps CPNP staff and includes three components: 1) gift package of breastfeeding and infant care supplies; 2) IBCLC visits within 48 h of referral; and 3) double electric breast pump.

Intervention Results: Ninety-one percent of participants were born outside of Canada; 55% had incomes below the Low-Income Cut-Off; and 55% reported food insecurity. All participants initiated breastfeeding, 84% continued for 6 months and 16% exclusively breastfed for 6 months. Among breastfed infants, ≥76% received vitamin D supplementation. Approximately 50% of infants were introduced to solids before 6 months. Only high school education or less and food insecurity were associated with lower breastfeeding rates. Overall, 75% of participants received at least one visit with a lactation consultant and 95% of these received a breast pump.

Conclusion: This study provides initial evidence that postnatal lactation support can be delivered within a CPNP site, with high uptake by clients. While all participants initiated breastfeeding and 84% continued for 6 months, adherence to the recommended 6 months of exclusive breastfeeding was low. Further research is needed to better understand the barriers to exclusive breastfeeding and how to support this practice among vulnerable women.

Study Design: Evaluation data

Setting: A Canada Prenatal Nutrition Program site in Toronto

Population of Focus: Pregnant women in the catchment area

Sample Size: 199 women

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): Policy (Community), Social Supports, Family-Based Interventions, Housing Programs

Intervention Description: Rapid Rehousing Program

Intervention Results: Participants expressed feelings of insecurity in emergency shelters due to lack of privacy, theft, unsanitary conditions, and safety concerns. Families noted improvements in children's behavior and academic performance after moving into their own homes. Participants reported feeling safer and more secure once they had their own space and autonomy. Families expressed a sense of security and belonging after being housed, leading to improved relationships with family and friends and a sense of hope for the future.

Conclusion: The study highlighted the importance of the Rapid Rehousing Program in improving the security and well-being of families experiencing homelessness. Moving from emergency shelters to their own homes provided a sense of security, autonomy, and hope for the future. Recommendations included providing clear expectations about housing subsidies, offering financial education, and enhancing case management to support long-term housing security for families

Setting: Salt Lake City, UT

Population of Focus: policymakers, social service providers, researchers

Sample Size: n=31

Age Range: average age 37.5 yrs of age

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, HOSPITAL, Quality Improvement, Policy/Guideline (Hospital), Crib Card, Sleep Environment Modification, Promotional Event, POPULATION-BASED SYSTEMS, COMMUNITY, Social Media, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Visual Display (Community)

Intervention Description: To improve sleep environment safety for inpatient infants.

Intervention Results: The proportion of infant cribs without loose objects in them increased (32-72%, p = .025), and safe sleep positioning remained stable (82% vs. 95%, p = .183).

Conclusion: Staff education, swaddle sleep sacks, and bedside storage containers were associated with improved sleep safety among pediatric inpatients at our institution and may help at other institutions.

Study Design: QE: pretest-posttest

Setting: University of Iowa Children’s Hospital

Population of Focus: Infants less than 1 year of age developmentally ready for a crib and asleep

Data Source: Crib audit/infant observation

Sample Size: Baseline (n=22) Follow-up 1 (not reported) Follow-up 2 (n=37) Follow-up 3 (n=18)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Enabling Services, Educational Material, Community-Based Group Education, Designated Clinic/Extended Hours, PROVIDER/PRACTICE

Intervention Description: This paper summarizes impacts of a breast and cervical cancer screening intervention spearheaded by a Native Hawaiian community.

Intervention Results: Women in intervention community significantly more likely to be compliant with Pap smear guidelines than women in control community (X2=5.73. p=.02)

Conclusion: Positive changes in screening activities among women aware of the intervention support the importance of information diffusion by community consumers. Diffusion may occur beyond the boundaries of the community as defined.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Oahu, HI

Population of Focus: Native Hawaiian women

Data Source: Telephone survey

Sample Size: Total (N=1,260) Analysis (n=678) Intervention (n=318); Control (n=360)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Other Education, Telephone Support, Technology-Based Support, COMMUNITY, Individual Supports

Intervention Description: We assessed whether increased use of breastfeeding smartphone applications (apps) impacts breastfeeding rates for low-income women. Women were randomized to one of two novel apps: control app containing digital breastfeeding handouts and BreastFeeding Friend (BFF), an interactive app containing on-demand breastfeeding educational and video content. The BFF app was a novel smartphone app designed based on a cross-sectional breastfeeding survey and feeback from focus group of postpartum, low-income African American women. Specifically, a multidisciplinary team of lactation consultants, perinatologists, and neonatologists designed the BFF app. The educational content included interactive advice on overcoming breastfeeding challenges, educational content on breastfeeding benefits, normal infant behavior and maternal postpartum physiology, strategies to optimize breastfeeding and pumping at work or school, hyperlinks to on-demand videos with tips and troubleshooting for successful latching, common breastfeeding positions, and using and cleaning a breast pump, as well as links to resources. All participants were given a complimentary Android smartphone with assigned breastfeeding app preloaded by a telecom provider.

Intervention Results: In the RCT, BFF and control app median uses were 15 (interquartile range [IQR] 4–24) and 9 (IQR 5–19) (p = 0.1), respectively. Breastfeeding initiation did not differ with app usage (84.1% in highest quartile versus 78.2% for lowest quartile; p = 0.5). Rates of sustained and exclusive breastfeeding through 6 months were similar between groups. Among both groups, smartphone apps were the most preferred breastfeeding resource at 6 weeks. Low quartile users also preferred alternative online breastfeeding resources: >50% of all users preferred technology-based breastfeeding resources.

Conclusion: Increased usage of breastfeeding apps did not improve breastfeeding rates among low-income women. However, technology-based resources were the most preferred breastfeeding resource after hospital discharge, indicating ongoing development of technology-based interventions has potential to increase breastfeeding in this high-needs population. clinicaltrials.gov (NCT03167073).

Study Design: Secondary analysis of an RCT

Setting: Prenatal clinic serving women with Medicaid or no health insurance at an academic medical center/Online

Population of Focus: Pregnant women at approximately 36 weeks' gestation recruited during routine obstetric appointments

Sample Size: 169 women

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Individual Supports

Intervention Description: A secondary analysis of data from 76 girls (mean ± SD, 10.5 ± 1.0 years) was conducted. Players were classified as high self-determined motivation (HSDM) or low self-determined motivation (LSDM) and randomised to trained (intervention) or untrained (control) coaches. Training included 2 workshops on strategies for activity-promoting practices. Girls were exposed to environmental contexts (practices and games) led by a trained/untrained coach (depending on arm) and one without coaches (free time) daily. Girls wore accelerometers each day. Using mixed random-effects models, the influence of motivation, context and training on %MVPA was analysed.

Intervention Results: Trained coaches' practices were associated with the greatest %MVPA with no difference between HSDM and LSDM players (38.28 ± 1.77%; 37.64 ± 1.80%; p = 0.66). HSDM players had significantly greater %MVPA versus LSDM players during untrained coaches' practices (23.58 ± 1.77%; 20.51 ± 1.78%; p = 0.03). During games with trained coaches, HSDM players had greater %MVPA compared to LSDM players (23.79 ± 1.76%; 18.56 ± 1.74%; p < 0.001). No between-group difference in %MVPA during free time was found (12.85 ± 0.82%; 13.39 ± 0.84%; p = 0.64).

Conclusion: The impact of individual differences in self-determined motivation on %MVPA during practices was attenuated when coaches were trained to implement activity-promoting practices.

Study Design: 2-arm parallel-group RCT

Setting: 5-day basketball youth sports camp

Population of Focus: Adolescent girls

Data Source: Accelerometer

Sample Size: 76 girls

Age Range: Ages 9-12

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Environment Enhancements

Intervention Description: Effective population-based approaches implemented in communities can help increase physical activity among all Americans. Evidence suggests that built environment interventions offer one such approach. These interventions aim to create or modify community environmental characteristics to make physical activity easier or more accessible for all people in the places where they live. In 2016, the Community Preventive Services Task Force released a recommendation for built environment approaches to increase physical activity. This recommendation is based on a systematic review of 90 studies (search period, 1980-June 2014) conducted using methods outlined by the Guide to Community Preventive Services.

Intervention Results: The Community Preventive Services Task Force found sufficient evidence of effectiveness to recommend combined built environment strategies. Specifically, these strategies combine interventions to improve pedestrian or bicycle transportation systems with interventions to improve land use and environmental design. Components of transportation systems can include street pattern design and connectivity, pedestrian infrastructure, bicycle infrastructure, and public transit infrastructure and access. Components of land use and environmental design can include mixed land use, increased residential density, proximity to community or neighborhood destinations, and parks and recreational facility access.

Conclusion: Implementing this Community Preventive Services Task Force recommendation in communities across the United States can help promote healthy and active living, increase physical activity, and ultimately improve cardiovascular health.

Setting: Community

Population of Focus: Children and addults

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Community-Based Group Education, Other Person-to-Person Education, Patient Navigation

Intervention Description: We conducted a cluster-randomized trial at 23 ethnic churches in the Baltimore, Maryland–Washington, DC, metropolitan area between 2010 and 2014. Trained CHWs enrolled 560 women. The intervention group received an individually tailored cancer-screening brochure followed by CHW-led health literacy training and monthly telephone counseling with navigation assistance. Study outcomes included receipt of an age-appropriate cancer screening test, health literacy, cancer knowledge, and perceptions about cancer screening at 6 months.

Intervention Results: The odds of having received a mammogram were 18.5 (95% confidence interval [CI] = 9.2, 37.4) times higher in the intervention than in the control group, adjusting for covariates. The odds of receiving a Papanicolaou test were 13.3 (95% CI = 7.9, 22.3) times higher; the odds of receiving both tests were 17.4 (95% CI = 7.5, 40.3) times higher. Intervention effects also included increases in health literacy and positive perceptions about cancer screening.

Conclusion: A health literacy–focused CHW intervention successfully promoted cancer-screening behaviors and related cognitive and attitudinal outcomes in Korean American women.

Setting: 23 ethnic churches in the Baltimore,MD-Washington, DC area

Population of Focus: Korean American women who had not had a pap test in 24 months and who could read and write Korean or English

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, Motivational Interviewing/Counseling, Feedback,

Intervention Description: Contraception consultation combined with in-person brief interventions and motivational interviewing with support from community participants

Intervention Results: The study has shown preliminary success in changing behaviors and impacting how the community views the prevention of alcohol-exposed pregnancies. The CHOICES intervention was found to be acceptable and welcomed by the tribal community, indicating its potential for implementation with other interested populations. The program has demonstrated success in reducing the risk for alcohol-exposed pregnancies among participants, with the majority showing a reduction in risk through behavior changes such as increased use of birth control, reduced alcohol consumption, or a combination of both.

Conclusion: By incorporating community input and making appropriate modifications to the intervention materials, the program has been successful in addressing the issue of alcohol-exposed pregnancies within the American Indian community. The study highlights the importance of community-based participatory research (CBPR) in developing and implementing effective prevention programs. The researchers suggest that future implementation efforts can benefit from the methods and results discussed in the study to sustain and expand this important alcohol-exposed pregnancy prevention program. Overall, the study underscores the significance of primary prevention efforts, such as increasing the utilization of birth control, in reducing the risk of alcohol-exposed pregnancies, particularly among at-risk populations like American Indians

Study Design: The study design involves the modification and implementation of an existing alcohol-exposed pregnancy prevention program, Project CHOICES, to fit the needs and norms of the American Indian community, specifically the Oglala Sioux Tribe.

Setting: Oglala Sioux Tribe community,

Population of Focus: Non-pregnant American Indian women, particularly within the Oglala Sioux Tribe community

Sample Size: Not specified

Age Range: Reproductive age

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, Motivational Interviewing/Counseling, Feedback,

Intervention Description: The intervention included MI counseling techniques, such as reflective listening and open questioning, to encourage participants to decrease binge drinking and/or increase birth control use to reduce the risk of alcohol-exposed pregnancies. The interventionists provided either two or four CHOICES sessions, held approximately 1-2 weeks apart, depending on the site's preference. Participants were given gift card incentives for participating in the intervention sessions and completing follow-up data collection. Additionally, referrals to local health care providers for birth control were provided, and participants were encouraged to make appointments to discuss their birth control options

Intervention Results: The results of the study showed a significant decrease in the risk of alcohol-exposed pregnancies (AEP) among American Indian women enrolled in the program

Conclusion: Even with minor changes to make the CHOICES intervention culturally and linguistically appropriate and the potential threats to program validity those changes entail, we found a significant impact in reducing AEP risk. This highlights the capacity for the CHOICES intervention to be implemented in a wide variety of settings and populations

Study Design: Pre-post intervention design

Setting: Three sites, two located on a reservation and a third that serves American Indian women in an urban setting

Population of Focus: Non-pregnant American Indian women at-risk for alcohol-exposed pregnancies due to binge drinking and being at-risk for unintended pregnancy

Sample Size: 193 women

Age Range: 18-46

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Other Education, Telephone Support, Peer Counselor, Lactation Consultant, Technology-Based Support, COMMUNITY, Individual Supports,

Intervention Description: LATCH -- Lactation Advice thru Texting Can Help is a pilot, web-based texting intervention designed to improve breastfeeding rates among mothers receiving WIC. The two-way texting intervention provided both evidence-based breastfeeding education through automated texts adn a mode for mothers to freely exchange texts with breastfeeding peer counselor (PC). In addition to providing breastfeeding education, the automated texts were personalized by addressing the mother by name and signed by the PC. These automatic personalized texts were sent out regularly both prenatally and in the immediate post-partum period to increase peer counselor points of contact with mom via text. The web-based texting platform allowed all text messages to be recorded, and thus, the on-site lactation consultants and WIC supervisors were able to monitor and supervise all text-based communication regularly.

Intervention Results: Primary outcomes included early post-partum (PP) contact and exclusive breastfeeding (EBF) rates at 2 weeks PP. Feasibility outcomes included text messaging engagement and mother's satisfaction with texting platform. Fifty-eight women were enrolled, 52 of whom were available for intention-to-treat analysis (n = 30 texting, n = 22 control). Contact between mothers and PCs within 48 hr of delivery was greater in the texting group (86.6% vs. 27.3%, p < .001). EBF rates at 2 weeks PP among participants in the texting intervention was 50% versus 31.8% in the control arm (p = .197). Intervention group mothers tended to be more likely to meet their breastfeeding goals (p = .06).

Conclusion: Participants were highly satisfied with the Lactation Advice thru Texting Can Help intervention, and findings suggest that it may improve early post-delivery contact and increase EBF rates among mothers enrolled in WIC who receive PC. A large, multicentre trial is feasible and warranted.

Study Design: Pilot RCT

Setting: WIC breastfeeding programs at a hospital-based primary care center and a federally qualified community health center/Cell phone

Population of Focus: Pregnant women at 18-30 weeks gestation from local WIC breastfeeding peer counselor programs

Sample Size: 52 women (30 texting and 22 control)

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): Professional Support, Community Birth Centers

Intervention Description: The intervention described in the document pertains to the culturally-centered care model implemented at Roots Community Birth Center. This model focuses on addressing racial disparities in birth outcomes by providing culturally-centered and relationship-centered care to pregnant individuals.

Intervention Results: Overall, the document suggests that culturally-centered care models have the potential to improve equity in childbirth outcomes and reduce disparities in birth outcomes among different racial and ethnic groups. However, the financial challenges faced by birth centers like Roots Community Birth Center highlight the need for policy and payment innovations to support the implementation of such models in maternity care

Conclusion: Roots Community Birth Center is one model of care that grew out of a desire to address persistent racial inequities in childbirth, using a systems-level approach. Such a model may serve as an instructive example for innovation in other clinical areas where health inequities are prevalent.

Study Design: Qualitative

Setting: Community-based

Population of Focus: African American women

Sample Size: 284 families

Age Range: Not disclosed

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Media Campaign (Print Materials, Radio, TV), STATE, Campaign, Policy/Guideline (State), Mass Media

Intervention Description: This study examined the impact of antismoking activities targeting the general population and an advertising campaign targeting smoking during pregnancy on the prevalence of smoking during pregnancy in New South Wales (NSW), Australia.

Intervention Results: Prevalence of smoking during pregnancy decreased from 2003 to 2011 overall (0.39% per month), and for all strata examined. For pregnancies overall, none of the evaluated initiatives was associated with a change in the trend of smoking during pregnancy. Significant changes associated with increased tobacco tax and the extension of the smoking ban (in combination with graphic warnings) were found in some strata.

Conclusion: The declining prevalence of smoking during pregnancy between 2003 and 2011, while encouraging, does not appear to be directly related to general population antismoking activities or a pregnancy-specific campaign undertaken in this period.

Study Design: Quasi experimental cross sectional

Setting: Statewide and community: national antismoking campaigns

Population of Focus: Health records of all pregnancies resulting in a live birth between 2003 to 2011 in one state (New South Wales)

Data Source: Health records for all pregnancies resulting in birth in New South Wales

Sample Size: 800,619 pregnancies among 534,513 women in New South Wales

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Green Spaces/Parks

Intervention Description: There is a paucity of studies, especially among diverse populations, demonstrating the effects of policy and environmental interventions to increase regular physical activity. The Grow Healthy Together Chattanooga project provided the opportunity to assess the impact of physical activity policy and environmental interventions on the physical activity among predominately African American children living in the inner city. Using the System for Observing Physical Activity and Recreation in Communities (SOPARC), the authors examined the physical activity of children along urban pedestrian/bike routes/trails and recreational park areas within the boundaries of the Grow Healthy Together Chattanooga communities. SOPARC data were collected at baseline (fall 2010/spring 2011) and repeated (spring 2014) in each community.

Intervention Results: The SOPARC assessments yielded a total of 692 child/youth observations in 2010 and 806 observations in 2014. Children/youth observed in 2014 were greater than 2 times the odds of engaging in moderate/vigorous physical activity compared with their 2010 counterparts (odds ratio = 2.75, 95% confidence interval, 1.43-5.32).

Conclusion: The present findings support the hypothesis that policy and environmental interventions can contribute to increased physical activity levels among children/youth over ∼3-year period. These results provide evidence that improved access to "urban" pedestrian/bicycle routes/trails appears to translate into increased opportunities for physical activity among inner city children/youth.

Study Design: Quasi-experimental design

Setting: Community-based

Population of Focus: Children and youth living in south and east Chattanooga neighborhoods

Data Source: Observational data, focus group data

Sample Size: 1,929 youth

Age Range: Ages 6-18

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education, Prenatal Care Access,

Intervention Description: We linked birth certificates and Medicaid claims for women receiving group prenatal care in 18 healthcare practices and applied preferential-within cluster propensity score methods to identify a comparison group, accounting for the nested data structure by practice. We examined five standardized, claims-based outcomes: postpartum visit attendance; contraception within 3 days; and any contraception, long-acting reversible contraception (LARC), and permanent contraception within eight weeks. We assessed outcomes using logistic regression for two treatment levels: (1) any group attendance compared to no group attendance and (2) attendance at five or more group sessions to at least five prenatal care visits, including crossovers attending fewer than five group sessions (minimum threshold analysis).

Intervention Results: Women attending at least five group sessions had higher rates of postpartum visit attendance (71.5% vs. 67.5%, p < .05). Women with any group attendance (N = 2834) were more likely than women with individual care only (N = 13,088) to receive contraception within 3 days (19.8% vs. 16.9%, p < .001) and to receive a LARC within eight weeks' postpartum (18.0% vs. 15.2%, p < .001). At both treatment levels, group participants were less likely to elect permanent contraception (5.9% vs. 7.8%, p < 0.001). Women meeting the five-visit group threshold were not more likely to initiate contraception or LARCs within 8 weeks' postpartum.

Conclusion: Participation in at least five group compared to five individual prenatal care visits is associated with greater rates of postpartum visit attendance. Additional engagement and education in group prenatal care may influence postpartum visit attendance.

Study Design: Retrospective cohort

Setting: 18 healthcare practices serving Medicaid-enrolled women, South Carolina

Sample Size: 15922 Medicaid enrolled women (2834 women received CenteringPregnancy, 13088 received individual prenatal care)

Age Range: 14-44

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Community-Based Group Education, Group Education, Telephone Support, Educational Material, CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), PARENT/FAMILY, Presentation/Meeting/Information Session/Event, Notification/Information Materials (Online Resources, Information Guide)

Intervention Description: The objective of this trial was to test if parents’ participation in an intervention based on an empowerment ideology and participatory experiences decreased the number of cigarettes smoked in homes.

Intervention Results: The median number of cigarettes smoked in the home daily decreased from 18 to 4 in the total sample (both groups about equally), however no statistically significant difference was detected between groups at 6 months follow-up.

Conclusion: Participation in the study, independent of group, may have resulted in parents decreasing the number of cigarettes smoked in the home. Valuable lessons were learned about recruiting and working with this group of parents, all of whom faced the challenges of tobacco and almost half of whom lived in poverty

Study Design: RCT

Setting: Community (home)

Population of Focus: Families connected with public health nursing offices, family resource centers, daycare centers, and kindergartens in Prince Edward Island, with at least one cigarette smoked daily in the home, children up to 5 years of age residing there, and one parent (smoker or not) willing to participate

Data Source: Data were collected in two intervieweradministered questionnaires competed in participants’ homes at baseline and 6-months follow-up.

Sample Size: 60 families

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Group Education, Access, Community-Based Group Education, Sleep Environment Modification

Intervention Description: To investigate, by using qualitative methods, beliefs among African-American and American Indian families about infant safe sleep practices, barriers to acceptance of prevention recommendations, and more effective messaging strategies.

Intervention Results: Themes included reasons for and influences on sleep decisions, and concerns about safe sleep recommendations. Parental sleep decisions seemed to be driven by perceptions of what would make their infant most comfortable and safe, and what would be most convenient. Parents were aware of safe sleep recommendations but unaware of the rationale. Because they generally did not believe that their infants were at risk for a sleep-related death, day-to-day decisions seemed to focus on what was most effective in getting their infant to sleep. There appeared to be no distinctions in opinions among African-American and American Indian families. African-American and American Indian families seemed to have similar concerns about infant comfort and safety, and their perceptions about what would be most effective in achieving these goals appeared to be important influences on their sleep practices.

Conclusion: Adherence with safe sleep recommendations may be enhanced if health care providers and educational materials discussed rationale underlying recommendations and addressed common parental concerns. It may be beneficial to target educational interventions towards fathers, as they may be untapped sources in implementing safe sleep practices.

Study Design: N/A

Setting: Focus Groups

Data Source: Mother and supporters participating in focus groups

Sample Size: 73 participants

Age Range: Mean age for the participants was 24.9 years for the mothers and 30.7 years for the supporters, and mean age for the children was 5.6 months for both groups.

Intervention Components (click on component to see a list of all articles that use that intervention): POPULATION-BASED SYSTEMS, COMMUNITY, Other (Communities)

Intervention Description: To determine whether integrating influence strategies (reciprocation, consistency, consensus, feeling liked, authority, and scarcity) throughout Chickasaw Nation Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics (1) changed participants' perception of the WIC experience and (2) affected breastfeeding initiation rates.

Intervention Results: The demonstration project resulted in 5 improved influence measures (P < .02), aligning with the influence principle of "feeling liked." The model had a small effect (φ = 0.10) in distinguishing breastfeeding initiation; women in the influence model were 1.5 times more likely (95% CI, 1.19-1.86; P < .05) to initiate breastfeeding compared with women in the traditional model, controlling for parity, mother's age, and race.

Conclusion: Consistent with Social Cognitive Theory, changing the WIC environment by integrating influence principles may positively affect women's infant feeding decisions and behaviors, specifically breastfeeding initiation rates.

Study Design: QE: non-equivalent control group

Setting: 4 WIC clinics in Chickasaw Nation, OK

Population of Focus: Parents and caregivers who were pregnant or had a child ≤ 3 years old

Data Source: Mother self-report

Sample Size: Intervention (n=846) Control (n=807)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Group Education, COMMUNITY, Other (Communities), POPULATION-BASED SYSTEMS

Intervention Description: To assess the clinical effectiveness and cost effectiveness of a policy to provide breastfeeding groups for pregnant and breastfeeding women.

Intervention Results: The number of breastfeeding groups increased from 10 to 27 in intervention localities, where 1310 women attended, and remained at 10 groups in control localities. No significant differences in breastfeeding outcomes were found.

Conclusion: A policy for providing breastfeeding groups in relatively deprived areas of Scotland did not improve breastfeeding rates at 6-8 weeks. The costs of running groups would be similar to the costs of visiting women at home.

Study Design: Pragmatic cluster RCT

Setting: 14 clusters of general practices

Population of Focus: Clusters of general practices that collected breastfeeding data through the Child Health Surveillance Program of the National Health Service Scotland from Oct 2002 forward

Data Source: Child Health Surveillance Programme

Sample Size: Intervention (n=7) Control (n=7) N=Clusters

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Television Media, POPULATION-BASED SYSTEMS

Intervention Description: Evaluate the impact of a Coronation Street story line, in which one of the characters died from cervical cancer, on the National Health Service (NHS) Cervical Screening Programme.

Intervention Results: 21.3% increase in number of Pap smears during study period in 2001 than same time period in 2000 (95% CI: 21.0%-21.6%)

Conclusion: We have demonstrated a large impact of a soap opera story line on the cervical screening programme although the benefit to health is not clear. Further research will determine the long-term effect of the story.

Study Design: QE: pretest-posttest

Setting: Lancashire and Greater Manchester zones of the North West Region of the National Health Service

Population of Focus: Women whose previous Pap smear was normal and who were on routine recall during the intervention period

Data Source: Health Authority cervical screening databases

Sample Size: Total (N=320,128)5 N= Pap smears

Age Range: ≥25

Intervention Components (click on component to see a list of all articles that use that intervention): Multicomponent Approach, Funding Support, Community Health Workers (CHWs),

Intervention Description: This multi-component intervention included patient education about health conditions (hypertension, gestational diabetes, and depression), important health behaviors (nutrition and exercise), and common postpartum symptoms; taught self-management skills; enhanced social support; and connected patients with community resources and health care services, including transportation needs. The intervention also addressed specific psychosocial needs of enrollees. A payment reform component included a cost-sharing arrangement between the health care system and the Medicaid payer to cover costs related to employing a social worker and community health worker, and financial incentives for completed postpartum visits.

Intervention Results: Compared with women in the control group, program participants had higher rates of postpartum visits in the HEDIS-defined time period (66.9% vs 56.0%; P < .001) and higher rates of all postpartum outpatient or gynecologic care up to 90 days after delivery (90.2% vs 83.4%; P= .002). Similarly, program participants were more likely to be enrolled with the Medicaid plan than mothers in the matched comparison group at six months after delivery (79.1% [400/506] vs 73.3% [742/1012]; P= .015) and at one year after delivery (71.0% [359/506] vs 66.3% [671/1012]; P= .067), although this was not statistically significant at one year after delivery.

Conclusion: This novel partnership between a health care system and a Medicaid payer increased postpartum visits among high-risk, low-income mothers. The follow-up rate was higher for visits that occurred within 90 days after delivery, a period consistent with current recommendations for postpartum care from the American College of Obstetricians and Gynecologists. This is one of few initiatives that have integrated health care systems, payers, physicians, and social workers to address access to care and social determinants of health for underserved women.

Study Design: Propensity scoring of Medicaid claims data from 2014 to 2017 was used to compare timely postpartum visits for mothers enrolled in the intervention program versus a similar group of mothers enrolled in the same Medicaid plan who gave birth in 2015 and 2016.

Setting: Mount Sinai Hospital, a large tertiary hospital in New York City

Population of Focus: Women insured by Healthfirst who delivered between April 2015 and October 16 who spoke Spanish or English and had at least 1 of the following: gestational diabetes, hypertension, positive screen for depression, late registration for prenatal care (> 20 weeks), or residence in neighborhoods considered at high risk for diabetes or hypertension.

Sample Size: 506

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Community-Based Group Education, Patient Navigation

Intervention Description: Assess the effectiveness of a culturally customized program (Esperanza y Vida [Hope and Life]) in increasing breast and cervical cancer screening among Latinas, and to examine how screening rates related to changes in cancer knowledge, differences in ethnic origins, and geographic location.

Intervention Results: Screening rates were significantly higher for the intervention versus the control group for clinical breast examination (CBE; 48% vs. 31%; adjusted odds ratio [aOR], 2.2; 95% confidence interval [CI], 1.1-4.2), breast self-examination (45% vs. 27%; aOR, 2.3; 95% CI, 1.1-5.0), and Pap testing (51% vs. 30%; aOR, 3.9; 95% CI, 1.1-14.1), but not for mammography (67% vs. 58%; aOR, 0.7; 95% CI, 0.1-3.6).

Conclusion: Esperanza y Vida has the potential to reduce health disparities in breast and cervical cancer morbidity and mortality rates through increasing cancer screening and thereby increasing early detection.

Study Design: Cluster RCT

Setting: Arkansas and New York City, NY

Population of Focus: Latina women

Data Source: Telephone survey

Sample Size: Baseline (n=487) Intervention (n=308); Control (n=179) Follow-up (n=238)

Age Range: Mean: 39.3

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, , COMMUNITY

Intervention Description: To assess the association between the change in statewide smoke-free laws and the rate of preterm or low birth weight delivery hospitalizations.

Intervention Results: Non-Hispanic black mothers had a higher rate of preterm or low birth weight delivery hospitalization than other racial/ethnic groups. Overall, there was no association between the change in smoke-free laws and preterm or low birth weight delivery rate. Among non-Hispanic black mothers, the change in statewide smoke-free laws was associated with a 0.9-1.9 percentage point (P < .05) reduction in preterm or low birth weight delivery rate beginning in the third year after the laws took effect. There was no association among non-Hispanic white mothers. A decline in the black-white disparity of 0.6-1.6 percentage points (P < .05) in preterm or low birth weight delivery rates was associated with the change in state smoke-free laws.

Conclusion: The change in state smoke-free laws was associated with a reduction in racial/ethnic disparities in preterm or low birth weight delivery hospitalizations in selected US states.

Intervention Components (click on component to see a list of all articles that use that intervention): Social Media, Notification/Information Materials (Online Resources, Information Guide), , PARENT_FAMILY, COMMUNITY

Intervention Description: We compared the impact of safe sleep or breastfeeding mHealth messaging on bedsharing and breastfeeding at 2 to 5 months.

Intervention Results: Overall, exposure to breastfeeding versus safe sleep messaging was not associated with a difference in any breastfeeding at 2 to 5 months (69.3% vs 65.5%, respectively; adjusted odds ratio [aOR] = 1.33 [95% confidence interval, 0.91, 1.94]). Women with shorter planned duration of breastfeeding who received breastfeeding messaging had increased odds of breastfeeding at 2 to 5 months (50% vs 31%; aOR 3.13 [95% CI, 1.47, 6.65]). Mothers who received safe sleep messaging had lower rates of bedsharing overall when compared to breastfeeding messaging (24.8% vs 35.2%; aOR = 0.58 [95% CI, 0.44, 0.78]).

Conclusion: In this large multi-ethnic US sample, receipt of safe sleep mHealth messaging was associated with lower rates of bedsharing without negatively impacting breastfeeding rates. Future research should focus on continued development of interventions to improve adherence to both safe sleep and breastfeeding recommendations.

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Support/Counseling/Remediation, Community Events,

Intervention Description: The intervention described in the study was designed to promote youth thriving and included additional training for mentors and group and dyadic activities for mentors and youth to participate in together. This mentoring program was unique in its focus on promoting youth thriving and its inclusion of additional training and activities for mentors and youth.

Intervention Results: The results of the study showed that program staff characteristics and approaches, such as work engagement, adherence to program guidelines, and supervisor-rated staff competence, predicted more favorable mentoring relationship quality. By contrast, a nondirective approach to supporting mentors predicted lower relationship quality.

Conclusion: The conclusion of the study was that further investigation of program staff influences on mentoring relationship development could be fruitful and ultimately provide a basis for enhancing program effectiveness.

Study Design: The study design was a randomized comparative effectiveness trial of an intervention intended to enhance youth outcomes in CBM programs operated by 10 agencies affiliated with Big Brothers Big Sisters of America.

Setting: community-based youth mentoring programs, specifically the Big Brothers Big Sisters program

Population of Focus: mentor-youth pairs in the Big Brothers Big Sisters program, as well as program staff who support the development of these relationships.

Sample Size: 450 mentor-youth pairs supported by 76 program staff across 10 agencies.

Age Range: child adolescent

Intervention Components (click on component to see a list of all articles that use that intervention): Community-Based Group Education,

Intervention Description: This study was an analysis of focus group data generated as part of a larger project focused on community involvement in Black maternal health. English speaking pregnant or recently postpartum women age 18 or older who receive services from BIH were recruited to participated in the focus group analyzed in this study. All facilitators of the focus group were Black women in order to facilitate candid conversation about racism in prenatal care.

Intervention Results: The need for mental health care was common thread underlying all conversations about prenatal health improve- ments desired by our focus groups. Participants expressed the centrality of mental health access during our discussion of other themes (e.g.: ease of access, inclusion of partners, special classes for teen moms) by discussing them in terms of their relationship to mental health. Our participants’ clear expression of the centrality of mental health care to their prenatal health guided our decision to focus on mental health as a necessary pillar of any group prenatal care intervention designed to mitigate perinatal healthcare disparities in this paper. Three themes related to mental health integration into group pre- natal care emerged from thematic analysis of the transcripts. Participants expressed insufficient access and advocacy, and provider distrust

Conclusion: Evidence exists supporting group prenatal care as a tool for mitigation of perinatal health disparities among Black women. There is also a large body of data describing the disproportionate burden of mental health needs among Black women. The rich data we present here from Black women on their desire for the integration of these two needs fits well into the parallel conversation occurring in the literature. To our knowledge, this is the first study investigating desires of Black women regarding group prenatal care designed specifically for them. They expressed a strong desire for more access to mental health care providers who are racially conscious and aware of white supremacy, and nuanced opinions on the role of racial concordance in health equity.

Study Design: Qualitative

Setting: Community-based

Population of Focus: Black birthing people

Sample Size: 11

Age Range: 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Policy (Community)

Intervention Description: The Healthy, Hunger-Free Kids Act of 2010 strengthened nutrition standards for meals and beverages provided through the National School Lunch, Breakfast, and Smart Snacks Programs, affecting fifty million children daily at 99,000 schools. The legislation's impact on childhood obesity is unknown. We tested whether the legislation was associated with reductions in child obesity risk over time using an interrupted time series design for 2003-18 among 173,013 youth in the National Survey of Children's Health.

Intervention Results: We found no significant association between the legislation and childhood obesity trends overall. For children in poverty, however, the risk of obesity declined substantially each year after the act's implementation, translating to a 47 percent reduction in obesity prevalence in 2018 from what would have been expected without the legislation.

Conclusion: These results suggest that the Healthy, Hunger-Free Kids Act's science-based nutritional standards should be maintained to support healthy growth, especially among children living in poverty.

Intervention Components (click on component to see a list of all articles that use that intervention): Access, , COMMUNITY

Intervention Description: Functional referral system including pre referral care, access to emergency transport and ensuring continuity of care between facilities is critical for improved newborn health outcome.

Intervention Results: Ambulance was used as a means of transportation in 308 (88.5%) neonates. While no ambulance had an incubator only 7 (2.0%) neonates were kept on a Kangaroo Mother Care position. Monitoring enroute was done to only 94 (27%) of the transferred neonates with 169 (54.9%) of health care professionals escorting the neonates lacking training on essential newborn care. On arrival, 115 (33%) were hypothermic, 74 (21.3%) hypoxic, 30 (8.6%) with poor perfusion and 49 (14.1%) hypoglycemic. Hypothermic neonates had an increased chance of dying compared to those who were normothermic (OR = 2.09, 95% CI (1.05–4.20), p = 0.037). The chance of dying among those presenting with hypoxia was almost three times (OR = 2.88, 95%CI (1.44–5.74), p = 0.003) while those with poor perfusion was almost five times (OR = 4.76, 95%CI (1.80–12.58), p = 0.002). Additionally, neonates who had hyperglycemia (RBG > 8.3mmol/l) on arrival had a higher probability of dying compared to those who were euglycemic [(OR = 3.10, 95% CI (1.19–8.09) p = 0.021]. Overall mortality was 22.4% within 48 hours of admission and risk of dying increased as the presence of poor clinical status added on.

Conclusion: Effective referral network is needed for improved neonatal health outcomes. Pre referral supportive care, training of health care professionals, transportation with improved monitoring, clear communication protocol and referral documentation should be invested and effectively utilized.

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Community Health Workers (CHWs), PATIENT/CONSUMER, Home Visits, Educational Material, Other Person-to-Person Education, Peer Counselor, Motivational Interviewing, CAREGIVER, Home Visit (caregiver), Education/Training (caregiver), Educational Material (caregiver), Motivational Interviewing/Counseling

Intervention Description: We assessed the effectiveness of a community health worker intervention focused on reducing exposure to indoor asthma triggers.

Intervention Results: The high-intensity group improved significantly more than the low-intensity group in its pediatric asthma caregiver quality-of-life score (P=.005) and asthma-related urgent health services use (P=.026). Asthma symptom days declined more in the high-intensity group, although the across-group difference did not reach statistical significance (P= .138). Participant actions to reduce triggers generally increased in the high-intensity group. The projected 4-year net savings per participant among the high-intensity group relative to the low-intensity group were $189–$721.

Conclusion: Community health workers reduced asthma symptom days and urgent health services use while improving caregiver quality-of-life score. Improvement was greater with a higher-intensity intervention.

Study Design: RCT

Setting: Community (home)

Population of Focus: Families in low-income households with children with asthma

Data Source: In-home interviewing, dust sample and standardized home inspection

Sample Size: 274 randomized participants

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Environment Enhancements

Intervention Description: Active People, Healthy NationSM is an initiative led by the US Centers for Disease Control and Prevention to improve the health of 27 million Americans by 2027 by increasing their level of physical activity.1 An earlier commentary provided the rationale and an overall description of Active People, Healthy NationSM.2 A core goal of this initiative is to galvanize action across communities, government and nongovernmental organizations, and institutions to use a set of proven strategies to increase physical activity (Figure 1). Every Active People, Healthy NationSM strategy can be designed to support equitable and inclusive access to opportunities for physical activity for all people, regardless of age, race, education, socioeconomic position, disability status, sexual orientation, or geographic location.

Intervention Results: The Community Guide has 4 types of findings: recommend against, insufficient evidence, recommend with sufficient evidence, and recommend with strong evidence. Seven strategies recommended as having sufficient or strong evidence of effectiveness by the Community Guide are described next: Activity-Friendly Routes to Everyday Destinations, Access to Places for Physical Activity, School and Youth Programs, Community-Wide Campaigns, Social Support, Individual Supports, and Prompts to Encourage Physical Activity

Conclusion: As illustrated on the signpost in Figure 1, health equity is the foundation of the Active People, Healthy NationSM initiative. Although inequities in physical activity levels persist across population groups, the strategies in Figure 1 can be adapted to address these inequities through changes in programs, policies, systems, and the environment. Some strategies can be used to improve physical activity levels among individuals, whereas others focus on community-wide changes. Communities can also add and combine strategies depending on their resources, needs, and context. Using these proven strategies, Active People, Healthy NationSM is galvanizing action across communities, governmental and nongovernmental organizations, and institutions to increase physical activity levels across the United States. The launch of this initiative marks the beginning of a journey to improve the health of 27 million Americans by 2027 through increases in physical activity.

Setting: Community

Population of Focus: Children and addults

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Professional Support, HEALTH_CARE_PROVIDER_PRACTICE, Baby Friendly Hospital Initiative, COMMUNITY, Individual Supports,

Intervention Description: The Westside Healthy Start Program (WHS), located in Chicago, Illinois, developed an ongoing multilevel approach to breastfeeding promotion. Key elements of the WHS breastfeeding model include individual education and counseling from pregnancy to 6 months postpartum and partnership with a local safety-net hospital to implement the Baby Friendly Hospital Initiative and provide lactation support to delivering patients. All WHS participants receive general breastfeeding education from case managers throughout pregnancy (such as information about breastfeeding benefits) and one face-to-face visit from a BFC in the third trimester for more personalized and comprehensive support. WHS collaborates with the largest delivering hospital in the service area, a safety-net provider, to improve the breastfeeding environment and systems of care.

Intervention Results: In the year our model was implemented, 44.6% (49/110) of prenatal WHS participants reported that they planned to breastfeed, and 67.0% (183/273) of delivered partici- pants initiated. Among participants reaching 6 months postpartum, 10.5% (9/86) were breastfeeding. WHS also had 2667 encounters with women delivering at our partner hospital during breastfeeding rounds, with 65.1% of contacts initiating. Community data was not available to assess the efficacy of our model at the local level. However, WHS participants fared better than all delivering patients at our partner hospital, where 65.0% initiated in 2015.

Conclusion: Healthy Start programs are a promising vehicle to improve breastfeeding initiation at the individual and community level. Additional evaluation is necessary to understand barriers to duration and services needed for this population.

Study Design: Evaluation data

Setting: Westside Healthy Start program located in Chicago, IL

Population of Focus: Low-income, African-American women who are pregnant

Sample Size: 652 women

Age Range: Women <17 to 45 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Enabling Services, Individual Supports, Community Health Workers (CHWs),

Intervention Description: conducted a cross-sectional cohort study, measuring 3 domains of obstetric racism as defined for, by, and with Black birthing people: humanity (violation of safety and accountability, autonomy, communication and information exchange, and empathy); kinship (denial or disruption of community and familial bonds that support Black birthing people); and racism in the form of anti-Black racism and misogynoir (weaponization of societal stereotypes and scripts in service provision that reproduce gendered anti-Black racism in the hospital).

Intervention Results: Analyses were based on 806 Black birthing people, 720 (89.3%) of whom had at least 1 CSP present throughout their labor, birth, and immediate postpartum care. The presence of CSPs was associated with fewer acts of obstetric racism across all 3 domains, with statistically significant reductions in scores in the CSP group of one-third to two-third SD units relative to the no-CSP group.

Conclusion: findings suggest that CSPs may be an effective way to reduce obstetric racism as part of quality improvement initiatives, emphasizing the need for democratizing the birthing experience and birth space, and incorporating community members as a way to promote the safety of Black birthing people in hospital settings.

Study Design: Crossectional Cohort Study

Setting: Clinical

Population of Focus: Black birthing people

Sample Size: 806

Age Range: 24-36

Intervention Components (click on component to see a list of all articles that use that intervention): Policy (Community), Food Programs

Intervention Description: The intervention in this study was the increase in Supplemental Nutrition Assistance Program (SNAP) benefit levels resulting from the re-evaluation of the Thrifty Food Plan (TFP). The TFP serves as the basis for determining SNAP benefit allotments, and in 2021, there was a 21% monthly benefit increase for SNAP participants due to the updated TFP. This increase in SNAP benefits was a critical and permanent change implemented by the USDA amidst the COVID-19 pandemic.

Intervention Results: Prior to the policy change, SNAP participants had significantly worse food insecurity, lower diet quality scores, and higher perceived stress and anxiety/ depression when compared to non-participants (all Ps < 0.05). After adjustment for differences in sociodemographic characteristics, there were no significant effects of the TFP re-evaluation on food insecurity, diet quality, and mental health outcomes among SNAP participants relative to non-participants (all Ps > 0.05). Qualitative responses suggested that rising food prices and growing inflation potentially negated the benefits of the policy change; however, most SNAP participants described the added benefits as helpful in purchasing additional food supplies and offsetting other household costs during this period.

Conclusion: The TFP benefit increase may have helped to prevent inflation-related disparities in food insecurity and health outcomes from widening among SNAP participants and non-participants. Further research is needed to determine the long-term impacts of this policy change.

Study Design: Longitudinal and web-based

Setting: Community-based

Population of Focus: US adults with incomes at or below 65,000

Sample Size: 1776

Age Range: 18-60

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Community-Based Group Education, PATIENT/CONSUMER

Intervention Description: This study examined the feasibility and efficacy of Salud Es Vida – a promotora-led, Spanish-language educational group session on cervical cancer screening (Pap tests), self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds.

Intervention Results: While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores.

Conclusion: The group intervention approach was associated with increased cervical cancer knowledge, but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: 4 rural counties in Southeast GA

Population of Focus: Hispanic/Latino immigrant women ages 21-65 who had not had a Pap test in 2 years or more

Data Source: Written survey; cervical cancer screening questions were derived from the Health Information National Trends Survey

Sample Size: Baseline (n=176) Intervention (n=86); Control (n=90) Follow-up/Analysis (n=90) Intervention (n=38); Control (n=52)

Age Range: 21-65

Intervention Components (click on component to see a list of all articles that use that intervention): Policy (Community), Social Supports, Housing Supports

Intervention Description: tested relationships between three domains of housing - quality, stability, and affordability – with three types of child maltreatment – psychological abuse, physical abuse, and neglect

Intervention Results: Housing affordability was associated with reduced psychological and physical abuse (β = −1.10, p < 0.05 and β = −0.66, p < 0.05 respectively), but not with neglect. Neither housing quality nor stability had any significant association with any maltreatment type. The only significant predictor of neglect was maternal depression.

Conclusion: Housing affordability in particular may protect against maltreatment, but other domains of housing insecurity appear to have little to no effect controlling for other household factors. Findings highlight the need for increased affordable housing supply, as well as mental health supports for families cost-burdened by meeting basic needs.

Study Design: longitudinal survey

Setting: 20 U.S. Cities

Population of Focus: policy makers, social workers, public health, medical staff

Sample Size: N=1804

Age Range: Mothers with children aged 5 and 9

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: Alongside increasing social media use worldwide, there is an expanding research focus on how social media use affects health behaviours, decisions and perceptions. The objective of this study was to systematically determine if and how breastfeeding is promoted and supported on the popular social media platform Instagram, which currently has over 700 million active users worldwide. To assess how Instagram is used to depict and portray breastfeeding, and how users share perspectives and information about this topic, we analysed 4,089 images and 8,331 corresponding comments posted with popular breastfeeding-related hashtags (#breastfeeding, #breastmilk, #breastisbest, and #normalizebreastfeeding).

Intervention Results: We found that Instagram is being mobilized by users to publicly display and share diverse breastfeeding-related content and to create supportive networks that allow new mothers to share experiences, build confidence, and address challenges related to breastfeeding. Discussions were overwhelmingly positive and often highly personal, with virtually no antagonistic content. Very little educational content was found, contrasted by frequent depiction and discussion of commercial products.

Conclusion: Instagram is currently used by breastfeeding mothers to create supportive networks and could potentially offer new avenues and opportunities to "normalize," protect, promote, and support breastfeeding more broadly across its large and diverse global online community.

Study Design: Qualitative study

Setting: Social media platform: Instgram

Population of Focus: Active Instagram users who shared perspectives and information about breastfeeding with popular breastfeeding-related hashtags

Sample Size: 4,089 images and 8,331 corresponding comments

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Other Education, Telephone Support, Peer Counselor, Technology-Based Support, COMMUNITY, Individual Supports,

Intervention Description: The LATCH study was a multisite study designed to test the effectiveness of a 2-way text messaging intervention encouraging exclusive breastfeeding among women enrolled in WIC, combining in-person prenatal and postpartum breastfeeding education and support (breastfeeding peer counseling) with mobile health technology (text messaging). Four WIC BFPC sites in Connecticut participated in the study. The effectiveness of BFPCs was clearly established in the literature; thus, the text messaging intervention was designed to faciliate the BFPCs' work, not replace it.

Intervention Results: Lactation Advice Through Texting Can Help had a significant impact on early contact between participants and BFPCs (odds ratio = 2.93; 95% confidence interval, 1.35–6.37) but did not have a significant impact on EBF (odds ratio = 1.26; 95% confidence interval, 0.54–2.66).

Conclusion: Lactation Advice Through Texting Can Help has the potential to facilitate the work of BFPCs by shortening the time-to-first-contact with clients after giving birth. Research is needed to identify the level of breastfeeding support staff coverage that WIC clinics must have to meet the demand for services created by Lactation Advice Through Texting Can Help.

Study Design: Multisite, single-blind RCT

Setting: WIC breastfeeding peer counselor program/Cell phone

Population of Focus: Low-income women participating in the WIC BFPC program

Sample Size: 174 women

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): Access, Care Coordination, HEALTH_CARE_PROVIDER_PRACTICE, COMMUNITY, Collaboration with Local Agencies (Health Care Provider/Practice)

Intervention Description: N/A

Intervention Results: Although most US adolescents had a usual source of care (91%), only about one-half (51%) had access to a PCMH. Disparities in the prevalence of PCMHs were seen by race/ethnicity, poverty, and having special health care needs. There were lower adjusted odds in having a PCMH for Hispanic (aOR, 0.56; 95% CI, 0.45-0.68) and black adolescents (aOR, 0.55; 95% CI, 0.46-0.66) compared with white adolescents. Those living below 4 times the poverty level had lower adjusted odds of PCMH access. Adolescents with 3-5 special health care needs had lower adjusted odds (aOR, 0.43; 95% CI, 0.35-0.52) of having a PCMH compared with adolescents without any special health care needs. Other than receiving family centered care, every component of PCMH was slightly lower in 2011-2012 compared with 2007.

Conclusion: PCMH access was lower among minorities, those living in poverty, and those with multiple special health care needs. These disparities in PCMH access among these typically underserved groups call for further study and interventions that would make PCMHs more accessible to all adolescents.

Study Design: Data on adolescents ages 12-17 years (n = 34 601) from the 2011-2012 National Survey of Children's Health were used in this cross-sectional study to determine what proportion had access to a PCMH. Multivariable logistic regression was used to calculate the odds of having a PCMH, adjusting for sociodemographic characteristics and special health care needs. Comparisons were made to distribution of PCMH in 2007.

Setting: NSCH survey; United States

Population of Focus: Adolescents

Sample Size: 34601

Age Range: 12/17/2024

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Multicomponent School-Based Program, COMMUNITY, Policy (Community)

Intervention Description: Schools are critical for developing students' health through didactic health education adn encouraging healthy habits. School health stakeholders recognize the interconnected nature of academic success and school wellness components (i.e., physical and mental health, the school environment, families, and community involvement). Driving this integrated perspective is the Whole School, Whole Community (WSCC) model, a comprehensive framework for school wellness. It is essential to establish the current baseline levels of strength and comprehensiveness of WSCC-aligned policies. Fifty-four Connecticut public school districts' policies were evaluated using the WellSAT WSCC, a new measure of how well district-level policies address topic areas within each domain of the WSCC model. The comprehensiveness and strength of each district's policies were calculated and then averaged across districts to assess areas of strength and need.

Intervention Results: Districts' policies were most comprehensive in the domains of Social and Emotional Climate; Behavioral Supports (Counseling, Psychological, and Social Services); and Family Engagement. Policies were strongest for Safe Environment (Physical Environment); Behavioral Supports; and Health Services.

Conclusion: School district policy coverage of the WSCC model within Connecticut varies by domain and is often fragmented. Comprehensive and coordinated policies modeled from WSCC domains are needed to better support safe, healthy, and supportive school environments.

Study Design: Policy evaluation

Setting: Connecticut Public School Districts

Population of Focus: Policies in public school districts

Sample Size: 54 school districts (30 randomly selected and 24 with administrative reviews in the 2019-2020 school year)

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Presentation/meeting/information Session (Classroom), SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Outreach

Intervention Description: An investigation of whether and to what extent a peer-led model is able to counteract mechanisms underlying bullying in peer groups, seeking clarification of divergence in reported results on the efficacy of peer-led models.

Intervention Results: Two studies were carried out in Italy within a project tackling bullying and cyberbullying in secondary schools. In the first study (n= 386), concerning the first phase of the project, a significant decrease was found only for cyberbullying, most of all for male peer educators. For the second study (n= 375) the model was improved and significant effects were found for several participating groups (peer educators and the experimental classes), who exhibited a decrease in bullying, victimization, and cybervictimization.

Conclusion: Results suggest that peer educators can act as agents of change in the broader context.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Study 1: Intervention 1 (n=126); Intervention 2 (n=63); Control (n=47) Study 2: Intervention (n=231); Control (n=144)

Age Range: 14-20

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Green Spaces/Parks

Intervention Description: A Play Streets-style intervention was defined as the closing down of a street or parking lot to traffic to provide the public with a safe, open space to actively play and/or be physically active that was accessible at no cost, was designed primarily for youth (children and/or adolescents), and may have organized events and environmental supports such as marked play areas, loose equipment, and games.

Intervention Results: School-aged children with complete data (n = 353) wore pedometers for an average of 92.97 min (SD = 60.12) and accrued a mean of 42.08 steps/min (SD = 17.27), with no significant differences between boys (μ = 43.82, SD = 15.76) and girls (μ = 40.66, SD = 18.34). iSOPARC observations revealed no significant differences in child activity by sex; however, male teens were more active than female teens. Most adults were sedentary during Play Streets according to pedometer and iSOPARC data. Children in diverse rural communities are physically active at Play Streets.

Conclusion: Play Streets are a promising intervention for promoting active play among children that lack safe opportunities to be active.

Study Design: Cross-sectional design without a comparison group

Setting: Diverse low-income rural communities

Population of Focus: School-aged children in elementary-to-middle school

Data Source: Student self-report, systematic observation, and pedometer data

Sample Size: 370 children

Age Range: Ages 3-15

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Community-Based Group Education

Intervention Description: Between the pretest and posttest surveys, women in the intervention group participated in the educational program over three weekly educational sessions. The intervention group churches served as the education sites, with women participating in the educational sessions at the churches from which they were recruited. Each educational session lasted approximately two hours. Women participating in the educational sessions received a token payment of $5 for each session they attended. To implement the cervical cancer education program, we constituted 20 groups with 8 to 14 women per group. Women in the control group received the cervical cancer education booklets after the posttest surveys.

Intervention Results: Overall, there was a significant intervention effect, with intervention compared with control group women twice (adjusted odds ratio = 2.0, 95% confidence interval = 1.3–3.2, p<.01) as likely to self-report Pap smear use at the posttest.

Conclusion: The findings support the efficacy of the multifaceted, theory-guided, culturally tailored community-based participatory cervical cancer education program for Samoan women in effecting positive changes in Pap smear use and cervical cancer-related knowledge and attitudes.

Study Design: Cluster RCT

Setting: Twenty-six Samoan-speaking churches on the main island of Tutulia in the American Samoa

Population of Focus: Samoan women a with no selfreported Pap smear in the past 2 years, no history of cervical cancer or hysterectomy, and plans to stay in the Territory throughout the study period

Data Source: Personal interviews

Sample Size: Total (N=416) Analysis (n=398) Intervention (n=201); Control (n=197)

Age Range: ≥20

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Television Media, Other Media, POPULATION-BASED SYSTEMS

Intervention Description: The mass media has been shown to be effective at improving participation in cervical screening. A 2007 television advertising campaign to promote cervical screening in New South Wales (NSW) was examined.

Intervention Results: Significant increase in mean number of screens per week in intervention period than same period in previous year (17% difference, t-value=3.84)

Conclusion: Despite the ecological nature of this study, the mass media campaign appears to have been successful in increasing screening in unscreened and underscreened women in NSW.

Study Design: QE: pretest-posttest design

Setting: New South Wales

Population of Focus: Women in New South Wales

Data Source: New South Wales Pap Test Register

Sample Size: Approximate total (N≈27,100) 2006 (n=12,284) 2007 (n=14,816) N=mean Pap smears per week

Age Range: 20-69

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: The importance of support to breastfeeding success is well established, as are the difficulties many mothers face in accessing the support they need. With the majority of UK mothers now accessing social media for support, Breastfeeding Support Facebook (BSF) groups have increased exponentially. BSF groups vary in type (local or national/international) and in moderation—overseen by breastfeeding mothers and by midwives or trained lactation specialists. Some groups aimed at supporting mothers in a specific geographical area also have associated face-to-face groups, facilitated as either professional or peer support. Little is currently known about these specific local groups, their prevalence, impact or value to mothers. This paper examines mothers' experiences of using local BSF groups and why they value them as part of a larger study exploring the impact of midwife moderation on these groups. An online survey consisting of open and closed questions was completed by 2028 mothers.

Intervention Results: Findings identified that local BSF groups are widely used and highly valued for their connection with local face-to-face services and other mothers. They offer access to expertise and shared experience in a format mothers find convenient and timely, improving confidence and self-efficacy. Local BSF groups enable the formation of support networks and development of breastfeeding knowledge that mothers credit with increased well-being, motivation and breastfeeding duration. As such, they have the potential to add value to local face-to-face services and improve breastfeeding experiences and knowledge in communities.

Conclusion: The findings have important implications to support the development of integrated online interventions to improve public health.

Study Design: Qualitative study

Setting: Social media platform: Breastfeeding Support Facebook groups

Population of Focus: Mothers in the UK using local Breastfeeding Support Facebook groups

Sample Size: 2028 mothers

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, Enabling Services, Other Media, COMMUNITY, POPULATION-BASED SYSTEMS

Intervention Description: A 48-month community intervention was conducted to improve breast and cervical cancer (BCC) screening among Korean American (KA) women in Alameda County (AL), California. KA women in Santa Clara (SC) County, California served as a comparison group.

Intervention Results: After adjusting for all covariates, no significant difference in Pap smear rates between intervention and comparison counties.

Conclusion: Although our overall intervention did not appear to enhance screening practices at the community-level, attendance at a women's health workshop appears to have increased cervical cancer screening.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Alameda County and Santa Clara County, CA

Population of Focus: Korean American women

Data Source: Telephone survey

Sample Size: Total (N=2,176) Baseline (n=1,093); Follow-up (n=1,083) Analysis (participated in baseline or follow-up) (n=1,902) Baseline (n=818) Intervention (n=404); Control (n=414) Follow-up (n=1,084) Intervention (n=418); Control (n=458)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: To date, most breastfeeding research on social media only focuses on content analysis, and there remains limited knowledge about the social networks of online communities (who interacts with whom), influencers in the breastfeeding space and the diffusion of evidence-based knowledge. This study, grounded in social network theory, aims to better understand the breastfeeding communication landscape on Twitter including determining the presence of a breastfeeding network, communities and key influencers. Further, we characterize influencer interactions, roles and the content being shared.

Intervention Results: The study revealed an overall breastfeeding social network of 3,798 unique individuals (users) and 3,972 tweets with commonly used hashtags (e.g., #breastfeeding and #normalizebreastfeeding). Around one third of users (n = 1,324, 34%) exchanged pornographic content (PC) that sexualized breastfeeding. The non-PC network (n = 2,474 users) formed 144 unique communities, and content flowing within the network was disproportionately influenced by 59 key influencers. However, these influencers had mostly inward-oriented interaction (% composition, E-I index: 47% professionals, -0.18; 41% interested citizens, -0.67; 12% companies, -0.18), limiting opportunities for evidence-based dissemination to the lay public.

Conclusion: Although more tweets about peer-reviewed research findings were sent compared with tweets about nonevidence-based lay recommendations, our findings suggest that it is the lay public who often communicated findings, which may be overcome through a targeted social network-based intervention.

Study Design: Outcome evaluation

Setting: Social media platform: Twitter

Population of Focus: Influencers in the breastfeeding space on Twitter

Sample Size: 3,798 unique individuals (users), 3,962 tweets

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: As recently highlighted by the National Academy of Sciences, there is a need for the scientific community (SC) to diffuse its findings to the public more effectively online, as means to counteract the spread of misinformation. In response to this call, we gathered data from Twitter for one month from major breastfeeding hashtags resulting in an interconnected social network (n = 3,798 users). We then identified 59 influencers who disproportionately influenced information flow using social network analysis. These influencers were from the SC (e.g. academics, researchers, health care practitioners), as well as interested citizens (IC) and companies. We then conducted an ego-network analysis of influencer networks, developed ego maps, and compared diffusion metrics across the SC, IC and company influencers. We also qualitatively analyzed their tweets (n = 711) to understand the type of information being diffused.

Intervention Results: Content analysis of tweets suggest IC are more active than the SC in diffusing evidence-based breastfeeding knowledge, with 35% of their tweets around recent research findings compared to only 12% by the SC. Nonetheless, in terms of outreach to the general public, the two-step networks of SC influences were more heterogenous than ICs (55.7 ± 5.07, 50.9 ± 12.0, respectively, P<0.001).

Conclusion: Collectively, these findings suggest SC influencers may possess latent potential to diffuse research and evidence- based practices. However, the research suggests specific ways to enhance diffusion.

Study Design: Outcome evaluation

Setting: Social media platform: Twitter

Population of Focus: Influencers from the scientific community using major breastfeeding hashtags on Twitter for a month

Sample Size: 59 influencers, 711 tweets

Intervention Components (click on component to see a list of all articles that use that intervention): Access, Community Health Workers (CHWs), Mobile Programs

Intervention Description: The authors created extending Maternal Care After Pregnancy (eMCAP), a community-based program, to address health care disparities and enhance access to care for the 12 months after birth. The team also evaluated the ability of Z codes (ICD-10 codes for social determinants of health) to identify patients with health-related social needs. The program is a multidisciplinary effort of nurses, nurse home visitors, physicians, advanced practice providers (APRNs [advanced practice registered nurses]), community health workers (CHWs), social services, behavioral health teams, and pharmacists working within a specially designed electronic health registry linked to existing electronic medical records and an obstetric quality database.

Intervention Results: The eMCAP program demonstrated improvement in attendance and quality of postpartum care for women living in underserved areas with chronic hypertenion (CHTN) and diabetes mellitus (DM). Compared to matched controls who were provided standard referrals, follow-up postpartum attendance for eMCAP women with CHTN was significantly better at 2 weeks and 1, 3, 6, 9, and 12 months (all p < 0.001). Similarly, eMCAP women with DM had significantly better follow-up at 2 weeks (p = 0.04), 1 month (p = 0.002), and 3 months (p = 0.049), resulting in HbA1c values for DM being significantly lower (p < 0.05) throughout the postpartum period.

Conclusion: The postpartum period represents a critical opportunity to understand and improve short- and long-term health with various platforms suggested to combat this crisis, but the roles of access to care, community-based support, and electronic health management systems remain unknown. We offer our experiences from eMCAP as an opportunity for further study in other health care settings. The findings of improved health care outcomes are key measures important to improving maternal morbidity and mortality across the United States.

Study Design: Observational study

Setting: Parkland health system in Dallas

Population of Focus: Predominantly Black and Hispanic women

Sample Size: 1,479 enrolled women

Age Range: Reproductive age

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education, Patient Navigation, Enabling Services, PROVIDER/PRACTICE, Provider Reminder/Recall Systems, Provider Education, Designated Clinic/Extended Hours, Female Provider, COMMUNITY, Television Media, Other Media, POPULATION-BASED SYSTEMS

Intervention Description: Development and implementation of a multifaceted intervention using community-based participatory research (CBPR) methodology and evaluated with a quasi-experimental controlled design with cross-sectional pre-intervention (2000) and post-intervention (2004) telephone surveys. Data were analyzed in 2005.

Intervention Results: Significantly greater odds of Pap smear for women in intervention county than in control county (OR=2.02, 95% CI: 1.37-2.99)

Conclusion: A multifaceted community-based participatory research (CBPR) intervention was associated with increased Pap test receipt among Vietnamese-American women in one community.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Santa Clara County, CA and Harris County, TX

Population of Focus: Vietnamese women living in either county

Data Source: Computer-assisted telephone interviewing system

Sample Size: Baseline(n=1,566) Intervention (n=798); Control (n=768) Follow-up (n=2,009) Intervention (n=1,004); Control (n=1,005)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Other (Communities), Social Supports

Intervention Description: The Children's Healthy Living (CHL) Program focuses on prevention of childhood obesity in the Pacific region, which is known to track into obesity and type 2 diabetes in adulthood. The CHL trial used a social ecological framework of health and wellness designed to act on multiple levels and in multiple components within behavioral, physical, social, cultural, economic, and policy environments to reduce the prevalence of overweight and obesity among children in multiple USAP communities, ultimately reducing it by 3.9% during a 2-year period. The CHL intervention was develped by a consortium of collborators at land grant colleges in the USAP region. The trial used a common template of 19 activities that were selected to address target behaviors. The intervention activities were grouped into 4 functions (or strategies): environmental change, organizational policy change, social marketing, and training that addressed the interersonal (training role of models, parents, and teachers), community (increasing access to healthy foods and environments for safe play), and organizational and policy (strengthening preschool wellness policies) levels of the social ecological model.

Intervention Results: Among the 9840 children included in the analysis (4866 girls [49.5%] and 4974 boys [50.5%]; 6334 [64.4%] aged 2-5 years), the intervention group showed significant improvements compared with the control group from times 1 to 3 in prevalence of overweight plus obesity (d = −12.60% [95% CI, −20.92% to −4.28%]), waist circumference (d = −1.64 [95% CI, −2.87 to −0.41] cm), and acanthosis nigricans prevalence (d = −3.55% [95% CI, −6.17% to −0.92%]). Significant improvements were also observed from times 2 to 3 in prevalence of overweight plus obesity (d = −8.73% [95% CI, −15.86% to −1.60%]) but not in waist circumference (d = −0.81 [95% CI, −1.85 to 0.23] cm).

Conclusion: This randomized clinical trial found that the outcomes of the Children’s Healthy Living intervention were maintained and enhanced 6 years after the intervention among young children in the US-affiliated Pacific region. The prevalence of overweight, obesity, and acanthosis nigricans was further reduced in communities, suggesting that multilevel multicomponent interventions may help reduce child overweight and obesity in this region.

Study Design: Randomized clinical trial

Setting: Communities in 5 jurisdictions (Hawaii, Alaska, Commonwealth of the Northern Mariana Islands, American Samoa, and Guam) of the US-affiliated Pacific Region

Population of Focus: Children aged 2-8 yrs of age in the 27 selected communities

Sample Size: 9,840 children

Age Range: Children ages 2-8 years

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education

Intervention Description: The current study is a randomized trial of a promotora-led educational intervention focused on cervical cancer in a local Hispanic community.

Intervention Results: Follow-up data revealed significant improvements in all outcome measures.

Conclusion: The observed association between cervical cancer knowledge and Pap smear receipt underscores the importance of educating vulnerable populations about the diseases that disproportionately affect them.

Study Design: RCT: pretest-posttest

Setting: South Philadelphia, PA

Population of Focus: Hispanic women

Data Source: In-person interview administered in Spanish by the promotoras

Sample Size: Total (N=120) Intervention (n=60); Wait-List Control (n=60) Analysis (n=70) Intervention (n=34); Wait-List Control (n=36)

Age Range: 18-65

Intervention Components (click on component to see a list of all articles that use that intervention): Designated Clinic/Extended Hours, Community Health Services Policy, Public Insurance (Health Care Provider/Practice),

Intervention Description: The intervention described in the study involved granting free access to daytime and out-of-hours general practice services for all children aged younger than 6 years in the Republic of Ireland. This policy change allowed additional children to have free visits to both daytime and out-of-hours care settings, leading to a significant increase in healthcare service utilization among this age group

Intervention Results: In the year after granting of free general practice care for children younger than 6 years, 9.4% more children attended the daytime services and 20.1% more children were seen in the out-of-hours services. Annual number of visits by patients increased by 28.7% for daytime services and by 25.7% for outof-hours services, translating to 6,682 more visits overall. Average visitation rate for children this age increased from 2.77 visits per year to 3.25 visits per year for daytime services, but changed little for out-of-hours services, from 1.52 visits per year to 1.59 visits per year.

Conclusion: Offering free childhood general practice services led to a dramatic increase in visits. This increase has implications for future health care service planning in mixed public and privately funded systems.

Study Design: The study design was a retrospective analysis of electronic health record data before and after the implementation of a policy change.

Setting: Republic of Ireland, specifically in 8 daytime general practice services and their local out-of-hours service called NorthDoc.

Population of Focus: Healthcare providers, policymakers, and researchers interested in healthcare utilization and access to care for children.

Sample Size: The study used anonymized retrospective visit data from general practice electronic health record systems for all 440,000 children aged younger than 6 years in the Republic of Ireland.

Age Range: The age range of the study population was children under 6 years old.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Community-Based Group Education, COMMUNITY, Other Media

Intervention Description: The objective of this study was to determine the feasibility and effectiveness of translating films, and whether the use of narrative is an effective vehicle for producing changes in knowledge, attitudes, and behaviors regarding cervical cancer compared with a nonnarrative film. A randomized controlled telephone trial surveyed the effectiveness of two films our team produced among a sample of 300 monolingual Spanish-speaking women, ages 25 to 45, who were of Mexican origin. Participants were recruited using random digit dialing (RDD) procedures from 2013 to 2014 in Los Angeles County and were randomly selected to view either a narrative or nonnarrative film. Data were collected by phone at baseline, 2 weeks, and 6 months after viewing. On average, participants arrived in the USA 25 years ago. The majority reported having less than high school education and limited English proficiency.

Intervention Results: Compared with their nonnarrative counterparts, women who received the cervical cancer–related information in the narrative film showed a significantly greater increase in new knowledge (p = 0.01) and in supportive attitudes about Pap tests expense (p = 0.05). Importantly, at 6 months, although not statistically significant, women who viewed the narrative film were also more likely to have had or scheduled a Pap test (62% vs 42%).

Conclusion: Narratives are a useful and underutilized tool to communicate information about cancer prevention. These findings have important implications for the delivery of health education among Spanish-speaking, low-literacy immigrant women, and for the reduction of cancer-related disparities.

Setting: Los Angeles county, CA

Population of Focus: monolingual Spanish-speaking women, ages 25 to 45, who were of Mexican origin.

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Other Education, Telephone Support, Technology-Based Support, COMMUNITY, Individual Supports

Intervention Description: To test the effects of weekly SMS for improving infant feeding practices and infant weight. SMS were sent automatically using a web-based SMS messaging platform from the time the participant enrolled in the study until the end (4 months later). Participants were randomized to receive SMS about infant's general health issues (control) or SMS for improving feeding practices (intervention) for 4 months. Intervention SMS were created with a focus on reinforcing WIC messages on breastfeeding, preventing overfeeding, delaying introduction of solid foods, and delaying and reducing baby juice comsumption. A total of 18 messages (1 per week for 4 months) were sent. All messages were written at a grade 5 level in Spanish for PR or English for HI.

Intervention Results: A total of 170 participants completed the study (n = 86 control and n = 84 intervention). Baseline characteristics were similar between groups. At the end, exclusive breastfeeding rates were similar between groups (67.4% control and 59.1% intervention). Introduction of other foods and beverages, addition of foods to the bottle, placing infants to sleep with milk bottles, caregiver's method and response to feeding infants and distractions while feeding infants were similar between groups. Also, weight status or rate of weight gain was similar between groups.

Conclusion: There were no significant improvements in feeding practices or in weight with the intervention. The timeline of the messages in relation to the targeted behavior may have affected the effectiveness of the intervention. Earlier dissemination of messages, higher level of intensity, longer intervention, additional contacts and inclusion of other caregivers may be needed to achieve the desired effects.

Study Design: Multisite RCT

Setting: WIC programs in Puerto Rico and Hawaii/Cell phone

Population of Focus: Caregivers of infants 0-2 months old participating in the WIC program

Sample Size: 170 participants (86 control and 84 intervention)

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Presentation/meeting/information Session (Classroom), Peer-led Curricular Activities/Training, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Presentation

Intervention Description: The NoTrap! (Noncadiamointrappola!) program is a school-based intervention, which utilizes a peer-led approach to prevent and combat both traditional bullying and cyberbullying. The aim of the present study was to evaluate the efficacy of the third Edition of the program in accordance with the recent criteria for evidence-based interventions.

Intervention Results: Towards this aim, two quasi-experimental trials involving adolescents (age M = 14.91, SD = .98) attending their first year at different high schools were conducted. In Trial 1 (control group, n = 171; experimental group, n = 451), latent growth curve models for data from pre-, middle- and post-tests showed that intervention significantly predicted change over time in all the target variables (victimization, bullying, cybervictimization, and cyberbullying). Specifically, target variables were stable for the control group but decreased significantly over time for the experimental group. Long-term effects at the follow up 6 months later were also found. In Trial 2 (control group, n = 227; experimental group, n = 234), the moderating effect of gender was examined and there was a reported decrease in bullying and cyberbullying over time (pre- and post-test) in the experimental group but not the control group, and this decrease was similar for boys and girls.

Conclusion: The significant improvement in target variables in trials of the third edition, compared to the non-significant improvements found for the first and second editions, suggests that the new/modified components may have improved the efficacy of the program.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=375) Intervention (n=231); Control (n=144)

Age Range: 14-18

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Peer-led Mentoring/Support Counseling, CLASSROOM, Presentation/meeting/information Session (Classroom), SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Event, Presentation

Intervention Description: The aim of the present study is to describe and evaluate an ongoing peer-led model against bullying and cyberbullying carried out with Italian adolescents.

Intervention Results: Results showed a significant decrease in the experimental group as compared to the control group for all the variables except for cyberbullying. Besides, in the experimental group we found a significant increase in adaptive coping strategies like problem solving and a significant decrease in maladaptive coping strategies like avoidance: these changes mediate the changes in the behavioural variables. In particular, the decrease in avoidance predicts the decrease in victimization and cybervictimization for peer educators and for the other students in the experimental classes whereas the increase in problem solving predicts the decrease in cyberbullying only in the peer educators group.

Conclusion: Results are discussed following recent reviews on evidence based efficacy of peer led models.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Italy

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Trial 1: Intervention (n=451); Control (n=171) Trial 2: Intervention (n=234); Control (n=227)

Age Range: Mean: ~16.23

Intervention Components (click on component to see a list of all articles that use that intervention): Social Supports, Policy (Community), Housing Supports

Intervention Description: Through a series of logistic regressions and generalized estimating equations, we tested the temporal associations of emergency/transitional housing and child protection involvement as well as how both experiences affected school attendance and mobility.

Intervention Results: Experiences of emergency or transitional housing often proceeded or occurred concurrently with child protection involvement and increased the likelihood of child protection services. Emergency or transitional housing and child protection involvement posed risks for lower school attendance and greater school mobility.

Conclusion: A multisystem approach to assist families across social services may be important for stabilizing children's housing and bolstering their success at school. A two-generation approach focused on residential and school stability and enhancing family resources could boost adaptive success of family members across contexts.

Study Design: logistic regression

Setting: Hennepin and Ramsey County of Minnesota

Sample Size: 3278 children (ages 4 to 15) whose families used emergency or transitional housing; comparison group of 2613 children who did not use emergency or transitional housing.

Age Range: children aged 4-15 yrs old

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Workers (CHWs), Home Visits,

Intervention Description: The Baby Love program, administered by the Social Work Division of the University of Rochester Strong Memorial Hospital, pairs licensed, master’s-prepared social workers with community health workers (CHWs) to address barriers to health for high-risk pregnant and parenting women and infants as part of an interdisciplinary, perinatal health care team. The program serves participants by (1) increasing linkage with health and community support services, (2) educating participants on perinatal- and parenting-related topics along with stress-reduction strategies, and (3) providing support and advocacy for participants. The CHW serves as the primary Baby Love service provider, completing regular home visits and forming supportive relationships throughout the course of a women’s pregnancy and for one year postpartum. To facilitate integrated care, all interventions are documented in the participant’s medical record.CHWs are trained based on the Family Development Credential Program, a strengths-based approach of partnership between the family and CHW that is focused on achieving identified service goals.

Intervention Results: During the study period, Baby Love participants had fewer adverse outcomes than did nonparticipants, including lower rates of preterm birth. Neonatal intensive care unit (NICU) admission rates were 16% among participants compared with 21% among nonparticipants. The odds of NICU admission, preterm birth, and low birth weight were all lower among Baby Love participants than nonparticipants, whereas the odds of attending a postpartum visit within 60 days and attending at least four well-child visits within six months after births were higher.

Conclusion: The societal imperative to improve perinatal outcomes continues to pose a public health challenge. Well-structured CHW-supported home-visiting programs are a promising tool to more fully address the needs of a broader population of diverse and socioeconomically disadvantaged pregnant women. The Baby Love program’s effectiveness at improving perinatal outcomes and addressing social determinants of health from its integrated placement within the health delivery system positions this program as a valuable contributor to a fully integrated care delivery system

Study Design: Retrospective cohort study

Setting: Social Work Division of the University of Rochester Strong Memorial Hospital

Population of Focus: At-risk pregnant women

Sample Size: 353 enrolled with Baby Love;102 in comparison group

Age Range: Childbearing age

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Community Health Workers (CHWs),

Intervention Description: The Coordination of Healthcare for Complex Kids (CHECK) program is a healthcare innovation project designed as a quality improvement project to provide comprehensive care coordination in children insured by Illinois Medicaid with chronic disease. The CHECK model consisted of community health workers (CHWs) supported by pediatricians, subspecialists, behavioral health providers, and legal experts. All were focused on helping families navigate the complex healthcare system. This design provides an opportunity to investigate the effectiveness of CHWs integrated with the healthcare system (29–32).

Intervention Results: Children engaged in CHECK were more likely to be female (p=.046) and to identify as Black and/or Hispanic/Latino than enrolled-only children. School absence was not different between the groups. Average total cost for engaged children was 21.3% more than enrolled-only children the first year (p=.027) but did not differ by the second year (p=.948). At baseline, 68.1% of the cohort had at least one ED visit 12 months prior to CHECK, this reduced to 49.5% post-1 and 41.9% post-2. Engaged children were 21% more likely to visit an ED (p=.010) and 40% more likely to have a controller.

Conclusion: CHECK program receipt was associated with improved healthcare utilization and controller prescriptions. School attendance did not change. The CHECK model offers potential pathways to support low-income children with asthma.

Study Design: The study design is a retrospective analysis of the Coordination of Healthcare for Complex Kids (CHECK) program, which ran from December 1, 2014, through August 31, 2017. The study used healthcare utilization claims data from Illinois Medicaid to evaluate the impact of the CHECK program on school absence, healthcare utilization, asthma prescriptions, and cost in low-income school-aged children with asthma. The study also assessed whether the amount of community health worker (CHW) services received was associated with changes in outcomes.

Setting: The study was conducted in Chicagoland, which includes vulnerable communities in Chicago, Illinois. The CHECK program was housed at the University of Illinois at Chicago

Population of Focus: he target audience for the study includes healthcare professionals, policymakers, researchers, and organizations involved in pediatric asthma care coordination, health disparities, and health equity initiatives. The study's findings and lessons learned are relevant to those interested in improving pediatric asthma outcomes and addressing health disparities in vulnerable populations.

Sample Size: The sample size of the study included a total of 2,668 children with asthma who were enrolled in the CHECK program. Among them, 1,701 children were classified as having a medium baseline risk, and 185 children had a high baseline risk. The sample size reflects a diverse cohort of varying severity and control of asthma, including children with other chronic conditions.

Age Range: The study included patients who were 0-25 years old and insured by Illinois Medicaid. However, for this analysis, the CHECK cohort was limited to school-aged children (K-12) attending Chicago Public Schools

Intervention Components (click on component to see a list of all articles that use that intervention): Collaboration with Local Agencies (Health Care Provider/Practice), Community Health Workers (CHWs), Patient-Centered Medical Home,

Intervention Description: The intervention involved comparing outcomes for youth in crisis who received a crisis evaluation in a primary care behavioral health (PCBH) setting to those presenting to the emergency department at the main hospital campus.

Intervention Results: The results indicated that youth evaluated in the PCBH setting were more likely to receive a psychiatric admission, had a shorter latency to the next behavioral health appointment, and had higher rates of completing at least one visit in the year following the evaluation.

Conclusion: Opportunities for future research on cost-effectiveness of care and continuous improvement aligned with quadruple aim outcomes are discussed. Overall, this study is among few others investigating the potential for pediatric integrated care models to contribute to youth suicide prevention and the study demonstrated promising increases in access and engagement with timely behavioral health care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Study Design: The study utilized a retrospective cohort study design.

Setting: Large, predominantly rural health system, comparing outcomes for youth who received a crisis evaluation in a primary care behavioral health (PCBH) setting to those presenting to the emergency department at the main hospital campus.

Population of Focus: The target audience includes healthcare providers, policymakers, and researchers interested in pediatric integrated care and youth mental health services.

Sample Size: The study compared outcomes for 171 youth who received a crisis evaluation in a PCBH setting to 171 youth presenting to the emergency department.

Age Range: The study focused on adolescents and young adults, as it discussed crisis evaluations for individuals aged 10–24 who were at risk for suicide

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Community Events,

Intervention Description: The purpose of this study was to develop and implement a community-based program aiming for smoking, alcohol, and substance use prevention based on multiple disciplinary literacy strategies. A one-group pretest-and-posttest comparison design was used to test the feasibility of the new substance use prevention program. Thirty-two adolescents, most from families with minority and low-socioeconomic status backgrounds, participated. The group met for a 1-hour session once a week for 10 weeks. The program was implemented in a suburban setting in a southeastern state in the United States.

Intervention Results: The results of the study indicated that the community-based youth substance use prevention program using disciplinary literacy strategies was well-received by the participants, with high levels of satisfaction reported. Significant positive changes were observed in participants' knowledge, skills, assets related to substance use, intention not to smoke, perception of the unhealthiness of tobacco, perceived benefits of remaining tobacco-free, and attitudes toward smoking.

Conclusion: The study found that the community-based youth substance use prevention program was effective in improving participants' knowledge, skills, assets related to substance use, intention not to smoke, perception of the unhealthiness of tobacco, perceived benefits of remaining tobacco-free, and attitudes toward smoking.

Study Design: Pre/post intervention design

Setting: Suburban community in a southeastern USA state

Population of Focus: Practitioners of community-based youth substance prevention programs

Sample Size: 32 adolescents

Age Range: No age range given, only that "adolescents" were study participants

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Incentives, Educational Material, Peer Counselor, Motivational Interviewing, Pharmacotherapy (Nicotine), Other Person-to-Person Education, Group Education, Community-Based Group Education

Intervention Description: To assess the feasibility and acceptability of implementing a culturally tailored, intensive smoking cessation program, including contingency-based financial rewards (CBFR), for pregnant Aboriginal women.

Intervention Results: Twenty-two of 38 eligible women (58%) enrolled in the program, with 19 (86% remaining at the end of their pregnancy. The program was highly acceptable to both women and providers. Feasibility issues included challenges providing twice-weekly visits for 3 weeks and running fortnightly support groups. Of the 19 women who completed the program, 15 (79%) reported a quit attempt lasting >=24 hours, and 8 (42%) were CO-confirmed as not smoking in late pregnancy. The rewards were perceived to help motivate women, but the key to successful quitting was considered to be the intensive support provided.

Conclusion: 'Stop Smoking in its Tracks' was acceptable and is likely to be feasible to implement with some modifications. The program should be tested in a larger study.

Study Design: Single group pre-post test

Setting: Aboriginal Maternal and Infant Health Services clinics

Population of Focus: Pregnant aboriginal women seeking prenatal care at health services sites who were smoking and older than 16 years and less than 20 weeks gestation who were local residents

Data Source: Self-reported smoking levels, breath CO

Sample Size: 38, 19 completed the program

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Policy (Community), School-Based Family Intervention, Social Supports,

Intervention Description: Schools often struggle to build partnerships with homeless and highly mobile (HHM) families. These families are not homogeneous; they live in and engage with schools from diverse residential contexts. Using Epstein’s theory and framework and drawing from 132 interviews with HHM parents, school personnel, and community stakeholders in an urban district,

Intervention Results: results suggest that (a) interviewees had divergent experiences with family, school, and community partnerships; (b) some school actors were better positioned to engage HHM families than others; and (c) the diverse residential context of HHM families molded partnership building in unique ways.

Conclusion: Although partnerships were not always shaped by the residential context, in a number of ways, living in shelter, doubling up, or residing in housing first molded the opportunities to engage in their children’s education (Table 2). In this section, findings are connected to the literature and tied back to Epstein’s concept of “family-like schools” and “school-like families.” I also suggest some theoretical implications and recommendations for practice and policy

Setting: urban school distric

Sample Size: 132 parents

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: Social media crosses socioeconomic and geographic lines and can inform and empower people, increase communication speed, and mobilize partnerships. Through the dissemination of standardized messages and graphics, social media can be optimized for the delivery of evidence-based nutrition information. In 2014, the USDA launched a mobile-responsive Web site to assist WIC staff in engaging participants and community partners. Resources included posters, brochures, videos, widgets, graphics, and BF peer counseling training. Recognizing the opportunity for spreading messages via social media, the Web site was enhanced with the addition of a social media toolkit for World Breastfeeding Week/National Breastfeeding Month (August, 2016). The goal of the project was to create sample graphics and messages based on the campaign that could be used by WIC agencies and partners to reach participants, eligible participants, and the public. Messages were developed using content from the Loving Support campaign materials and Loving Support Peer Counseling Training. Agencies were encouraged to link to the Loving Support Web site and use the hashtag #WICLovingSupport in their posts. Agencies could also customize the messages and graphics as needed to promote their own activities and events. The toolkit included Facebook covers and posts, Twitter headers and posts, a Twibbon, an Instagram post, and an e-card. A guide to using the toolkit with sample messages was created as well. The Figure shows sample images and messages.

Intervention Results: The toolkit was launched on July 12, 2016 and received 4,319 page views by the end of August. Overall there were 9,432 downloads of all Loving Support materials and 29,745 page views to the Loving Support Web site. This was a 50% increase in page views and a 17% increase in downloads over the previous month, before the launch of the toolkit. Use of the toolkit continued since August with 1,507 page views between August, 2016 and February, 2017. The number of users for that same period was 5,007 (new and returning users). There were 2,342 downloads of social media graphics, with Facebook covers and posts, the e-card, and Instagram posts as the most downloaded items. The Twibbon campaign had 36 supporters. A TweetReach snapshot report from August 2 to August 6 (during World Breastfeeding Week) showed that the hashtag #WICLovingSupport had 60 tweets from 40 contributors, 287,820 accounts reached (the number of people who likely saw content), and 362,607 impressions (the number of times people likely reached).

Conclusion: Translating policy and guidance into action-oriented messages that WIC agencies can easily use and disseminate can increase the exposure of evidence-based nutrition messages. Although it is a relatively low-cost communication strategy, social media involves a high cost in time and attention needed to maintain an active presence.8 By providing a ready-to-go social media toolkit, the Food and Nutrition Service was able to offer consistent messaging, but it also reduced WIC staff workload and reached many people with information about BF promotion and support.

Study Design: Program evaluation

Setting: Social media platforms: Facebook, Twitter, and Instagram

Population of Focus: WIC staff

Sample Size: 5,007 new and returning users

Intervention Components (click on component to see a list of all articles that use that intervention): Access, Adult-led Support/Counseling/Remediation, Community Events, YOUTH, COMMUNITY

Intervention Description: In October 2013, Johns Hopkins Medicine clinicians established the Center for Salud/Health and Opportunities for Latinos (Centro SOL) to better address the health needs of Baltimore's growing Latino community. Centro SOL's mission focuses on four core activities: clinical services; advocacy and community engagement efforts; pipeline/education opportunities; and research consultations. Progress is measured through a scorecard reviewed annually by Centro SOL leadership.

Intervention Results: Centro SOL's program has expanded health care access for undocumented immigrants, patient safety and quality of service/care programs for patients with limited English proficiency, and pipeline opportunities for Latino youth. In 2017, 2,763 uninsured patients received primary or specialty care and 290 people received group therapy to address stress-related conditions. In addition, 49 Latino students (ranging from high school to postgraduate students) received mentorship at Centro SOL.

Conclusion: In the next five years, Centro SOL plans to expand the pipeline for Latinos interested in health professions fields and to further improve access to health services for Latino families through both advocacy efforts and enhanced clinical services.

Study Design: Program evaluation

Setting: Centro SOL established by Johns Hopkins Medicine to address the healthcare needs of the emeging Latino settlement in Baltimore, Maryland

Population of Focus: Latino immigrant community in Baltimore, Maryland

Sample Size: 2,763 uninsured patients from different age groups, including children and adults, received primary or specialty care; 49 Latino high school and postgraduate students aged 15-20 received mentorship and provided feedback

Age Range: Children and adolescents 0-20 years of age

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Green Spaces/Parks

Intervention Description: Play Streets is a place-based intervention that is typically organized by local governments or community organizations and involves temporarily closing streets to create safe places and free opportunities for physical activity. In this descriptive study we examined 162 of Chicago's PlayStreets, held in the summer of 2018, to assess the volume and type of physical activity among youth participants and the variety of services provided to residents. We analyzed implementation data and forms completed after PlayStreets, and we conducted systematic observations at a purposeful sample of PlayStreets.

Intervention Results: We found that PlayStreets provides opportunities for youth physical activity in areas where opportunities do not otherwise always exist. PlayStreets also provides an avenue for residents to access community resources. This research on Chicago's experience with PlayStreets showed how one city is temporarily turning streets into places for youth physical activity to advance health equity.

Conclusion: Local policies that facilitate temporarily closing streets and that provide resources to support opportunities for physical activity and access to community resources can advance health equity in cities nationwide.

Study Design: Descriptive study

Setting: Urban play areas/ Community-based

Population of Focus: Children and adolescents

Data Source: iSOPARC observations

Sample Size: 1,741 youth

Age Range: Ages 6-17

Intervention Components (click on component to see a list of all articles that use that intervention): Environment Enhancements, COMMUNITY

Intervention Description: Play Streets is a place-based intervention that is typically organized by local governments or community organizations and involves temporarily closing streets to create safe places and free opportunities for physical activity. In this descriptive study we examined 162 of Chicago's PlayStreets, held in the summer of 2018, to assess the volume and type of physical activity among youth participants and the variety of services provided to residents.

Intervention Results: We found that PlayStreets provides opportunities for youth physical activity in areas where opportunities do not otherwise always exist. PlayStreets also provides an avenue for residents to access community resources. This research on Chicago's experience with PlayStreets showed how one city is temporarily turning streets into places for youth physical activity to advance health equity.

Conclusion: Local policies that facilitate temporarily closing streets and that provide resources to support opportunities for physical activity and access to community resources can advance health equity in cities nationwide.

Intervention Components (click on component to see a list of all articles that use that intervention): Medicaid, Access, Continuity of Care (Caseload), Community Health Centers

Intervention Description: N/A

Intervention Results: We found the probability of unmet need for medical and dental care to be lower among HRSA HC patients than individuals whose usual source of care were not HRSA HCs.

Conclusion: HRSA HC patients have lower probabilities of unmet need for medical and dental care. This is likely because HRSA HCs provide accessible, affordable, and comprehensive primary care services. Expanding capacity of these organizations will help reduce unmet need and its consequences.

Study Design: We used logistic regression models to compare the predicted probabilities of unmet need for uninsured and Medicaid individuals whose usual source of care is HRSA HCs versus clinics in general or private physicians.

Setting: Nationally representative survey of low income, adult patients who identified HRSA HCs as their usual source of care

Population of Focus: HRSA HC patients

Sample Size: ?

Age Range: 18+

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, Quality Improvement, Screening Tool Implementation,

Intervention Description: The intervention involved universal screening for postpartum depression (PPD) using the Edinburgh Postnatal Depression Scale (EPDS) at multiple obstetric and pediatric practices in Houston, Texas. The EPDS is a 10-item self-report questionnaire that screens for symptoms of PPD. The intervention also included facilitating referrals for evaluation and treatment for women who screened positive for PPD. The study reports that the intervention was designed to increase access to perinatal mental health services. The intervention described in the study aligns with a discernable strategy of universal screening for PPD and facilitating referrals for evaluation and treatment. The study reports that the intervention was based on the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) guidelines for perinatal mental health.

Intervention Results: The study reports that a total of 102,906 screens for postpartum depression (PPD) were completed between May 2014 and July 2018. Of those, 6.3% screened positive for PPD. The obstetric practices completed 18,919 screens, and the pediatric practices completed 83,987 screens. The study also reports that 2,222 referrals were made, with 1,702 (76.6%) completed appointments. The remaining pediatric practices had 4,608 positive screens resulting in 1,390 (30.2%) referrals and 278 (20.0%) completed appointments. The study does not report on the women who received mental health care outside the TCH system.

Conclusion: This project demonstrated that with planning, systems review and trained staff, PPD screening can be integrated into obstetric and pediatric practices and high screening and referral rates can be achieved.

Study Design: The study design/type is a quality improvement project. The project was designed to increase access to perinatal mental health services through universal screening for postpartum depression (PPD) and facilitating referrals for evaluation and treatment, at a multi-site, integrated system of pediatric and obstetric practices in Houston, Texas. The study reports on the results of the project, including the number of screens completed, positive screens identified, referrals made, and appointments completed.

Setting: The study was conducted in an integrated multi-site pediatric and obstetric setting, which includes three hospitals and a Pavilion for Women (PFW) that provides inpatient and outpatient services in obstetric and gynecologic care. The Women’s Place—Center for Reproductive Psychiatry (The Women’s Place) is also located within the PFW and is dedicated to the treatment of women’s mental health

Population of Focus: The target audience for the study is healthcare providers, particularly those working in obstetric and pediatric practices, who are interested in implementing routine screening and referrals for perinatal mood disorders. The study provides a successful model for increasing access to perinatal mental health services in an integrated multi-site setting.

Sample Size: The sample size for the study is not explicitly stated in the given texts. However, the study reports that a total of 102,906 screens for postpartum depression were completed between May 2014 and July 2018, and 6487 (6.3%) of those screens were positive. The study also involved multiple obstetric and pediatric practices in Houston, Texas.

Age Range: The age group is not explicitly stated in the given texts. However, the study involved perinatal mental health services, which typically refers to the period during pregnancy and up to one year postpartum. The study also involved pediatric practices that screened women at the 2 week and 2, 4, and 6-month well-baby visit. Therefore, it can be inferred that the study focused on women who were pregnant or had recently given birth, as well as their infants.

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Individual Supports

Intervention Description: To investigate the impact of a health educational program for children composed of 5 days of camp and a 12-week follow up on the physical activity level, sedentary behaviour, anthropometric data and food intake in overweight and obese children.

Intervention Results: After the follow up, 25% of the children became active (>1500 and <3000 Metabolic Equivalent of Tasks per week). In contrast, the number of sedentary children (<600 Metabolic Equivalent of Tasks per week) decreased by 15% and insufficiently active (600-1500 Metabolic Equivalent of Tasks per week) increased by 15%. The physical activity level of leisure time increased significantly throughout weekdays (26.0%) and weekends (14.1%) after the follow up compared to before the camp. Sedentary behaviour showed a significant reduction of 177.14 and 41.43 minutes on weekdays and weekends, respectively. Before the camp, the consumption of sugar and sweets was out of control (100% inadequate), and after the intervention, 58.4% started to consume these foods in a balanced way.

Conclusion: The Health Educational Program for Children (5-day camp and the 12 weeks of follow up) contributed to an increase in the physical activity level and a reduction in the sedentary behaviour and anthropometric measures in overweight and obese children.

Study Design: Cohort study

Setting: Participants in summer camp for overweight and obese children in Brazil

Population of Focus: Overweight or obese children participating in summer camp who did not have physical problems that limited their participation

Data Source: Anthropometric, questionnaires (physical activity and eating habits)

Sample Size: 20 children

Age Range: Ages 9-11

Intervention Components (click on component to see a list of all articles that use that intervention): Policy (Community),

Intervention Description: The study focused on evaluating the association between the presence and strength of local smoke-free ordinances and cigarette and smokeless tobacco use among high school students in Kentucky. The researchers examined the impact of smoke-free laws on youth tobacco use, particularly focusing on the differences in tobacco use prevalence based on the strength of these laws and the urban/rural location of the students.

Intervention Results: Students in counties with a comprehensive smoke-free law were 23% less likely to smoke cigarettes and 16% less likely to use smokeless, compared to those in counties without a law. Students in counties with moderate/weak laws did not differ in likelihood of use for either product, compared to those in counties without a law. Students in urban counties were 14% less likely to smoke, but there was no difference in likelihood of smokeless use by urban/rural location.

Conclusion: Comprehensive smoke-free laws are associated with a lower likelihood of youth cigarette and smokeless use. Rural youth may be at increased risk of cigarette smoking relative to youth in urban areas.

Study Design: Longitudinal cohort design

Setting: Kentucky

Population of Focus: Organizations and advocates for smoke-free policies, public health professionals, policymakers, adolescent health workers

Sample Size: 353502 10th and 12th grade students

Age Range: ages 15-18

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Individual Supports

Intervention Description: Preliminary evidence suggests acceptance-based behavioral treatments (ABTs) may increase PA; however, this approach has not been tested in adolescents. This was a nonrandomized experimental pilot study that examined feasibility, acceptability, and treatment outcomes of a school-based, acceptance-based behavioral intervention for PA. Adolescents (n = 20) with low activity received a PA tracking device and were allocated to device use only or device use plus 10-weeks of ABT. PA, cardiovascular fitness, and physiological outcomes were measured pre- and postintervention.

Intervention Results: The intervention was found to be feasible and acceptable. PA, cardiovascular fitness, and physiological outcomes improved over time in the intervention group, but not in the comparison condition.

Conclusion: This study demonstrated feasibility, acceptability, and preliminary treatment efficacy based on effect sizes for an acceptance-based behavioral intervention to increase PA in adolescents.

Study Design: Non-randomized experimental pilot study

Setting: Middle schools

Population of Focus: 7th grade (mid-adolescent students)

Data Source: Fitbit

Sample Size: 20 students

Age Range: Age 12

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Workers (CHWs), Educational Material, Training, Screening in Nontraditional Settings

Intervention Description: The intervention described in the article to increase postpartum depression (PPD) screening is the implementation of a community health worker (CHW) program . The CHWs were trained to assist providers with PPD screening and behavioral health referrals by addressing patient barriers to care. The CHWs also provided education to patients and families about PPD and the importance of screening. The CHWs were available to assist patients during their well-child visits and provided follow-up phone calls to patients who screened positive for PPD.

Intervention Results: The study found that the implementation of a community health worker (CHW) program was effective in increasing postpartum depression (PPD) screening rates in a pediatric patient-centered medical home (PCMH) that primarily serves a Latinx immigrant population. The study found that the overall screening rate increased from 45% to 66% after the implementation of the CHW program . The study also found that the rate of patients referred after positive screenings increased from 9% to 22% following project implementation . The study concludes that CHWs can assist providers with PPD screening and behavioral health referrals by addressing patient barriers to care and that future studies focusing on the referral process for PPD treatment and resources for minority populations are needed to assess the impact of screening on maternal and infant clinical outcomes

Conclusion: Postpartum depression is a serious problem that affects many new mothers and often goes unrecognized, with even higher prevalence among minority populations, specifically immigrant mothers. Pediatric providers caring for infants and mothers must prioritize screening for PPD to improve diagnostic rates and ensure effective referrals and treatment protocols are in place. This project demonstrates how CHWs can assist providers with PPD screening and behavioral health referrals by addressing patient barriers to care. Future studies focusing on the referral process for PPD treatment and resources for minority populations, are needed to assess the impact of screening on maternal and infant clinical outcomes.

Study Design: The study design is a pre- and post-intervention study . The study evaluated the effectiveness of implementing a community health worker (CHW) intervention to improve postpartum depression (PPD) screening and referral rates in two South Carolina patient-centered medical homes that primarily provide care to low-income Latinx populations . The study collected pre- and post-implementation data by reviewing current procedural terminology (CPT) billing codes and examining patient charts

Setting: Pediatric clinic that serves a diverse population of patients, including Latinx and immigrant mothers two South Carolina patient-centered medical homes that primarily provide care to low-income Latinx populations

Population of Focus: However, it is likely that the target audience includes healthcare providers, policymakers, and researchers who are interested in improving postpartum depression screening and referral rates in diverse populations, particularly Latinx and immigrant mothers. The study provides insights into the effectiveness of utilizing community health workers (CHWs) to improve PPD screening and referral rates in low-income Latinx populations

Sample Size: he sample size for the study is 552 patients . This sample size was used to evaluate the effectiveness of the interventions implemented in two South Carolina patient-centered medical homes that primarily provide care to low-income Latinx populations

Age Range: The study does not focus on a specific age group. However, the sample population includes newborns and children up to 6 months of age who were seen at 1 month and 6-month well-child visit

Intervention Components (click on component to see a list of all articles that use that intervention): PARENT_FAMILY, Training (Parent/Family), Electronic PA, Family-Based Interventions, Media Campaign (Print Materials, Radio, TV), COMMUNITY

Intervention Description: Social media is an important communication tool during times of crisis because of its vast reach. Understanding the effectiveness of sharing public health guidance and promoting school children's physical activity during the COVID-19 pandemic can inform dissemination best practices. We classified 418 posts from parent/community members of a school-based physical activity Facebook group by content type, and used concurrent mixed methods to examine (1) differences in dissemination effectiveness (reactions, shares, and comments) between two pandemic phases and (2) themes and sentiments of comments. Phase I included school closures through the release of national school re-entry guidelines (March 1, 2020 – May 15, 2020) and Phase II extended through the school year start (May 16, 2020 – August 1, 2020).

Intervention Results: Policy and guidance posts prompted more comments while feel-good stories produced more reactions compared to other content types. Members reacted more during Phase II, which mainly consisted of policy and guidance (86%). Four major themes of information and resources, personal disclosures, questions and concerns, and support for educators emerged.

Conclusion: Sharing public health guidance for schoolchildren on social media was an effective strategy to disseminate information when in-person discourse was limited. Creating social media spaces where discussion is encouraged can provide social and emotional support for parents/community members.

Study Design: Concurrent Mixed Methods

Setting: Social media (public Facebook group in a large metropolitan area in the southwest US)

Population of Focus: Parents of school-aged children

Sample Size: 418 posts to a public Facebook group with approximately 1,500 members

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Workers (CHWs), Prenatal Care Access, Care Coordination,

Intervention Description: The intervention being evaluated in the study is the Health Start Program (HSP) in Arizona. The HSP is a community health worker (CHW) home visiting perinatal support program. CHWs are required to complete 12 hours of continuing education per year . The HSP aims to provide support to at-risk, racially and ethnically diverse, rural, and urban mothers and children in Arizona. The program focuses on improving maternal and child health outcomes by providing various forms of support, including prenatal care, newborn health, and child health up to 5 years of age. The program involves home visits and aims to address the significant challenges and barriers to obtaining healthcare services faced by under-resourced women in Arizona. The specific details of the intervention activities and content are not explicitly outlined in the study protocol

Intervention Results: It primarily focuses on the evaluation protocol, data sources, outcome measures, and the methodology used for assessing maternal and child health outcomes using administrative data.

Conclusion: The study aims to meet the federal Home Visiting Evidence of Effectiveness (HomVEE) standard for evidence-based effectiveness. The study will use a matched comparison group design that meets the published standard for HomVEE's moderate rating. The study will evaluate the impact of the HSP on multiple maternal, infant, and child health outcomes using a combination of four data source

Study Design: The study design is a retrospective, propensity score-matched observational study. The study uses a matched comparison group design that meets the published standard for Home Visiting Evidence of Effectiveness (HomVEE) moderate rating. The study aims to evaluate the impact of the Health Start Program (HSP) on multiple maternal, infant, and child health outcomes. The study uses a combination of four data sources: the HSP database, Vital Records Birth Data, Hospital Discharge Data, and Arizona State Immunization Information System. The study employs propensity score matching (PSM) to create a synthetic comparison group to observe the "counterfactual" to HSP participation, that is, what would have happened in the absence of the program. The study will compare outcomes between HSP mothers and those matched to them by the propensity score

Setting: The setting for this study is the state of Arizona in the United States. Arizona is the sixth largest state in the US, with a population of 6.8 million people. The state is unique in its racial and ethnic diversity, with a higher proportion of Latino and American Indian residents compared to the national average. Additionally, nearly a quarter of the population lives in rural areas, where poverty rates are almost double that of the national poverty rate. The Health Start Program (HSP) is a statewide program that employs community health workers (CHWs) in 14 distinct Arizona counties to engage at-risk, low-income mothers and improve maternal and child outcomes .

Population of Focus: The target audience for the Health Start Program (HSP) in Arizona includes at-risk, low-income, and racially and ethnically diverse pregnant women and their families. The program aims to engage this specific demographic to improve maternal and child outcomes by providing support, education, and advocacy through the use of community health workers (CHWs) who reflect the ethnic, cultural, and socioeconomic characteristics of the communities they serve. The HSP is designed to address the needs of under-resourced women and families who may face significant challenges and barriers to obtaining healthcare services, particularly prenatal care

Sample Size: However, the protocol does mention that the analytic population is of sufficient size to detect meaningful program effects from low-frequency events, including preterm births, low and very low birth weights, maternal morbidity, and differences in immunization and hospitalization rates over a relatively long period. The study also notes that lack of statistical power is not a significant issue for this project, despite the respective sizes of the intervention and comparison populations

Age Range: The study focuses on maternal and child health outcomes within the context of the Health Start Program (HSP) in Arizona. While the specific age range of the children included in the study is not explicitly mentioned, the outcomes evaluated are related to prenatal care, newborn health, and child health up to 5 years of age. Therefore, the study likely encompasses maternal and child health outcomes from prenatal care initiation through early childhood, covering a broad age range from prenatal to early childhood stages

Intervention Components (click on component to see a list of all articles that use that intervention): Environment Enhancements, Family Leave, Workplace Policies, State Laws, COMMUNITY

Intervention Description: To reduce the burden of chronic disease, the Centers for Disease Control and Prevention (CDC) funded the Orange County Partnerships to Improve Health (OC-PICH) project in Orange County, California

Intervention Results: The outdoor exercise equipment (OEE) was installed along a walking path in Edison Park (Anaheim) and grouped within a single area (a "fitness zone") in Garden Grove Park. In both parks, there were significantly greater odds of high-intensity physical activity overall after the installation-19% higher odds in Anaheim, and 23% higher odds in Garden Grove. However, the fitness zone area in Garden Grove had substantially higher odds of increased physical activity post-intervention (OR = 5.29, CI: 3.76-7.44, p < 0.001).

Conclusion: While the increases in physical activity levels are consistent with past studies that link OEE to higher levels of physical activity among park users, our findings also suggest that the location and placement of equipment within a park may be an important factor to consider when improving park amenities for physical activity.

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement, Community Health Workers (CHWs), EMR Reminder,

Intervention Description: The intervention aimed at optimizing community-based referrals in primary care using Quality Improvement (QI) methodology. The intervention involved several components, including: Dedicating space for Community Health Workers (CHWs) near providers. Creating electronic CHW schedules and warm handoff blocks, Improving communication with providers using email and huddle reminders, Posting informative signs in exam rooms, Co-locating services with medical providers, Creating scheduled warm handoff blocks. Improving leadership involvement and communication with providers. These interventions align with a discernible strategy of optimizing workflows to increase warm handoffs with CHWs, with a focus on co-locating services, creating scheduled warm handoff blocks, and improving leadership involvement and communication with providers. The article presents a study that analyzes a multicomponent intervention aimed at optimizing community-based referrals in primary care using QI methodology. The intervention involved multiple strategies and components to improve the warm handoff rate between families with unmet social needs and CHWs, demonstrating a comprehensive approach to addressing social determinants of health in a primary care setting

Intervention Results: The CHW warm handoff rate increased two-fold from a monthly median of 11% to 24% in the intervention period. The number of social needs screenings completed and CHW referrals increased during the intervention period. Of all patients screened in the intervention period, 8.4% were referred to a CHW, significantly higher than the referral rate in the baseline period. Of all referrals made in the intervention period, 22% had a warm handoff, also significantly higher than the warm handoff rate in the baseline period. The Ages and Stages Questionnaire Third Edition (ASQ-3) screening rate at the 12-month well-baby visit showed an increase from a baseline median rate of 83% to 92% in the intervention period . These results indicate the effectiveness of the QI intervention in increasing the CHW warm handoff rate and improving the social needs screening and referral process in the primary care setting.

Conclusion: The results illustrate that QI methods can be used to optimize workflows to increase warm handoffs with CHWs. This is important as health centers work to improve their social needs screening and referral programs.

Study Design: The study design used in the article is a Quality Improvement (QI) methodology. The authors used the Model for Improvement as the QI framework to increase Community Health Worker (CHW) warm handoffs. They conducted several Plan, Do, Study, Act (PDSA) cycles, which is a key quality improvement model used for rapid change testing and process improvement. The study analyzed the impact of the intervention on process measures, outcome measures, and balancing measures

Setting: The study was conducted at an academic-affiliated federally qualified health center (FQHC) located in the South Bronx, New York. The FQHC has been established since 1967 and is located in congressional district 15, which is the poorest in the nation . The study was conducted in a single site, which may limit the generalizability of the findings to other healthcare settings. However, the study provides insights into the effectiveness of quality improvement methods in optimizing community-based referrals and warm handoffs in a primary care setting.

Population of Focus: The target audience for this study includes healthcare professionals, particularly those involved in primary care and community health settings. This may encompass physicians, nurses, community health workers, social workers, and other healthcare providers who are interested in improving the identification and referral of patients with unmet social needs. Additionally, individuals and organizations involved in quality improvement initiatives within healthcare settings may also find the study relevant. The findings and methodologies presented in the article are likely to be of interest to those seeking to optimize community-based referrals and warm handoffs in primary care using quality improvement methodology.

Sample Size: The article does not explicitly mention the sample size in terms of the number of patients involved in the study. However, it does provide specific data points related to the number of patients screened for social needs in both the baseline and intervention periods, as well as the number of CHW referrals placed. These data points indicate the scale of the study, but the exact sample size in terms of the number of patients is not explicitly stated.

Age Range: The article does not specify a specific age range for the patients involved in the study. However, it does mention that the screening was conducted most often by a parent or guardian prior to the medical exam at new patient visits and annual well-child visits from birth through age 21 . Therefore, it can be inferred that the study involved patients from birth through age 21.

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation, PARENT/FAMILY, CLASSROOM, Adult-led Curricular Activities/Training, Enforcement of School Rules, Notification/Information Materials (Online Resources, Information Guide), SCHOOL, Bullying Committee, Reporting & Response System, Teacher/Staff Training, School Rules, POPULATION-BASED SYSTEMS, COMMUNITY, Media Campaign (Print Materials, Radio, TV), Presentation

Intervention Description: The goal of this large population-based initiative was to reduce bullying by producing a quantifiable change in school climate using an established program and standardized measurement tool.

Intervention Results: After 1 to 2 years of program implementation, across cohorts, there were reductions in student self-reports of bullying others, and improvements in student perceptions of adults' responsiveness, and students' attitudes about bullying.

Conclusion: This initiative reaffirms the efficacy of the OBPP, emphasizes the importance of an identified coalition, and highlights several positive outcomes. It is recommended that the OBPP be implemented through the establishment of community partnerships and coalitions as consistent with the public health model.

Study Design: QE: pretest-posttest age-equivalent cohort

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: HALT! Schools Cohort 1: Middle school (n=0); High school (n=999) Cohort 2: Middle school (n=12972); High school (n=7436) PA CARES Schools: Middle school (n=9899); High School (n=6048)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Material, Other Education, Telephone Support, Partner-Level Intervention, Technology-Based Support, COMMUNITY, Social Supports, Individual Supports,

Intervention Description: Social support for breastfeeding, in particular the support of an infant's father, has been identified as a crucial element for successful breastfeeding. Mobile health (mHealth) interventions employing digital technologies provide a rapidly evolving means of engaging fathers and providing them with information and support to address their needs related to both breastfeeding and transitioning to fatherhood. The Parent Infant Feeding Initiative (PIFI) was a 4-arm, randomized controlled trial conducted in Perth, Australia. The objective of this study was to determine the effectiveness of various father-focused breastfeeding interventions in terms of key infant feeding outcomes. The primary outcomes were duration of exclusive and any breastfeeding. The trial arms included a control group and 3 interventions, consisting of a face-to-face father-focused antenatal breastfeeding class facilitated by a male peer facilitator; Milk Man, a breastfeeding smartphone app designed specifically for fathers; and a combination of both interventions.

Intervention Results: A total of 1426 couples were recruited from public (443/1426, 31.1%) and private (983/1426, 68.9%) hospitals. Of these, 76.6% (1092/1426) of fathers completed the baseline questionnaire, 58.6% (836/1426) completed the 6-week follow-up questionnaire, and 49.2% (702/1426) completed the 26-week follow-up questionnaire. The average age of fathers who completed the baseline questionnaire was 33.6 (SD 5.2) years; the majority were born in Australia (76.4%) and had attended university (61.8%). There were no significant differences between the control and any of the intervention groups in any of the infant feeding outcomes or level of breastfeeding self-efficacy and postpartum partner support reported by mothers.

Conclusion: This study did not demonstrate that any intervention was superior to another or that any intervention was inferior to the standard care delivered in routine antenatal classes. Further studies are needed to test the effectiveness of these interventions in more socioeconomically diverse populations that are likely to benefit most from additional partner supports.

Study Design: RCT

Setting: Antenatal breastfeeding class/Online

Population of Focus: Couples from public and private hospitals in Perth, Australia

Sample Size: 1426 couples

Age Range: Adults 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Social Supports

Intervention Description: Year 8 girls nominated other girls in their year who are likely to be influential (e.g. who they look up to, are good listeners); the 18% most nominated were invited to be peer supporters (PSs). PSs attended 2 consecutive days of training (plus a top-up day 5 weeks later) outside the school site, led by pairs of PS trainers, to increase their knowledge about PA and their capabilities and confidence to promote PA in their friendship group.

Intervention Results: Six schools were recruited: four PLAN-A (n = 269) and two control (n = 158). In total, 94.7% of Year 8 girls participated. A total of 55 (17–24% of Year 8 girls) PSs were trained (attendance rate 91–100%). Five girls were trained as PS trainers. Questionnaire data provision exceeded 92% at all time points. Accelerometer return rates were > 85% and wear-time criteria were met by 83%, 71% and 62% of participants at T0, T1 and T2, respectively. Mean weekday MVPA did not differ between intervention arms at T1 (1.1 minutes, 95% CI –4.3 to 6.5 minutes) but did at T2 (6.1 minutes, 95% CI 1.4 to 10.8 minutes), favouring PLAN-A. The mean cost of intervention delivery was £2685 per school or £37 per Year 8 girl. Process evaluation identified good fidelity, engagement and enjoyment of the PS training and peer-support strategies. PSs needed more guidance on how to start conversations.

Conclusion: Informal peer-led intervention approaches, such as PLAN-A, hold promise as a means of promoting PA to adolescent girls.

Study Design: RCT

Setting: 6 secondary schools

Population of Focus: Girls aged 12-13

Data Source: Accelerometer and questionnaire; PS training attendance; minutes of moderate to vigorous PA (MVPA)

Sample Size: 269 experimental and158 control

Age Range: Ages 12-13

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Social Supports

Intervention Description: A two-arm cluster randomised controlled feasibility study was conducted in six English secondary schools (4 intervention & 2 control). Year 8 (age 12-13) girls were eligible and randomisation was at school-level. The intervention involved training Year 8 girls (out of school for two consecutive days, plus one top-up day 5 weeks later), who were identified by their peers as influential, to provide informal support to their friends to increase their physical activity. Feasibility of the intervention and the research was examined, including: recruitment, training attendance and data provision rates, evidence of promise of the intervention to affect weekday moderate-to-vigorous physical activity (MVPA), intervention cost and estimation of the sample size for a definitive trial. Accelerometer and questionnaire data were collected at the beginning of Year 8 (Time 0), the end of Year 8 (10-weeks after peer-supporter training) and the beginning of Year 9 (Time 2).

Intervention Results: Four hundred twenty-seven girls were recruited (95% recruitment rate). 55 girls consented to be a peer-supporter and 53 peer-supporters were trained (97% of those invited). Accelerometer return rates exceeded 85% at each time point and wear time criteria was met by 83%, 71% and 62% participants at Time 0, 1 and 2 respectively. Questionnaire data were provided by >91% of participants at each time point. Complete-case adjusted linear regression analysis showed evidence of a 6.09 minute (95% CI = 1.43, 10.76) between-arms difference in weekday MVPA at Time 2 in favour of the intervention arm. On average PLAN-A cost £2685 per school to deliver (£37 per Year 8 girl). There were no adverse events. A trial involving 20 schools would be adequately powered to detect a between-arms difference in weekday MVPA of at least six minutes.

Conclusion: The PLAN-A intervention adopts a novel peer-led approach, is feasible, and shows evidence of promise to positively affect girls' physical activity levels. A definitive trial is warranted.

Study Design: Two-arm cluster RCT

Setting: Six secondary schools

Population of Focus: Secondary school girls

Data Source: Accelerometer; questionnaire

Sample Size: 427 girls

Age Range: Ages 12-13

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Access

Intervention Description: All grade 5 students in (London, Ontario, Canada) were invited to participate in the [ACT-i-Pass] program (G5AP) in May 2014. A total of 643 children completed surveys, that included Physical Activity Questionnaire for Children (PAQ-C), at baseline (October 2014) and 6-month follow-up (April 2015). Difference in the means t-test compared PAQ-C scores between baseline and follow-up for the sample and subgroups. Multiple regression analysis tested associations between change in PAQ-C scores and intrapersonal-, interpersonal-, and physical environment-level variables.

Intervention Results: PA increased significantly from baseline to 6-month follow-up. Girls, visible minorities, immigrants, and children with low parental support experienced significant increases in PA. Regression found girls benefitted from the G5AP significantly more than boys, and lower parental support is related to increases in PA.

Conclusion: The findings indicate that collaboratively developed, community-based interventions can significantly increase children's PA levels, particularly among subgroups with traditionally lower PA. The pre-post evaluation of this community-based intervention provides useful evidence for developing policies and programs aimed at making population-level improvements in children's PA levels.

Study Design: Pre-post evaluation

Setting: Grade 5 students in London, Ontario, Canada

Population of Focus: All grade 5 students in the city

Data Source: PA Questionnaire for Children (PAQ-C)

Sample Size: 643 students

Age Range: Mean age 9.8 (SD = 0.57)

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Prompts

Intervention Description: In 2000, the Guide to Community Preventive Services (Community Guide) completed a systematic review of the effectiveness of various approaches to increasing physical activity including informational, behavioral and social, and environmental and policy approaches. Among these approaches was the use of signs placed by elevators and escalators to encourage stair use. This approach was found to be effective based on sufficient evidence. Over the past 5 years the body of evidence of this intervention has increased substantially, warranting an updated review. This update was conducted on 16 peer-reviewed studies (including the six studies in the previous systematic review), which met specified quality criteria and included evaluation outcomes of interest.

Intervention Results: No Results

Conclusion: These studies evaluated two interventions: point-of-decision prompts to increase stair use and enhancements to stairs or stairwells (e.g., painting walls, laying carpet, adding artwork, playing music) when combined with point-of-decision prompts to increase stair use. This latter intervention was not included in the original systematic review. According to the Community Guide rules of evidence, there is strong evidence that point-of-decision prompts are effective in increasing the use of stairs. There is insufficient evidence, due to an inadequate number of studies, to determine whether or not enhancements to stairs or stairwells are an effective addition to point-of-decision prompts.

Setting: Community

Population of Focus: Children and adults

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM, Peer-led Curricular Activities/Training, SCHOOL, Assembly, Media Campaign (Print Materials, Public Address System, Social Media), POPULATION-BASED SYSTEMS, COMMUNITY, Training, Event, Media Campaign (Print Materials, Radio, TV), Distribution of Promotional Items (Classroom/School), Distribution of Promotional Items (Community)

Intervention Description: In a community randomized controlled trial, intervention middle school students from small towns were exposed to a community and school-based anti-violence intervention ("Resolve It, Solve It").

Intervention Results: Students in the intervention group reported a significantly higher rate of decline in verbal victimization compared to control students. The difference was only significant among males. For physical victimization, the decline in the intervention group compared to the control group was in the expected direction but did not reach statistical significance (p=0.069). This near significant difference was accounted for by males.

Conclusion: These results suggest that a media and reinforcing community intervention led by older peers can alter rates of growth for some measures of violence and associated factors among small-town youth. Further research is indicated to determine how different campaign messages influence students by sex.

Study Design: Cluster RCT: pretest-posttest

Setting: US

Population of Focus: Not specified

Data Source: Not specified

Sample Size: Total (n=1492) Intervention (n=712); Control (n=780)

Age Range: NR

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Patient Navigation, Enabling Services, COMMUNITY, Community Events, POPULATION-BASED SYSTEMS, Home Visits

Intervention Description: A group-randomized controlled trial to evaluate a cervical cancer screening intervention program targeting Seattle’s Cambodian refugee community.

Intervention Results: The proportion of women in the intervention group reporting recent cervical cancer screening increased from 44% at baseline to 61% at follow-up (+17%). The corresponding proportions among the control group were 51 and 62% (+11%). These temporal increases were statistically significant in both the intervention (P < 0.001) and control (P = 0.027) groups.

Conclusion: This study was unable to document an increase in Pap testing use specifically in the neighborhood-based outreach intervention group; rather, we found an increase in both intervention and control groups. A general awareness of the project among women and their health care providers as well as other ongoing cervical cancer screening promotional efforts may all have contributed to increases in Pap testing rates.

Study Design: Cluster RCT

Setting: Seattle, Washington

Population of Focus: Cambodian women

Data Source: Self-report through personal interviews and verified through medical record review

Sample Size: Total (N=370) Analysis (n=289) Intervention (n=144); Control (n=145)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY

Intervention Description: At-risk adolescents have been defined as youth who are or might be in physical, mental, or emotional danger. An Urban Forest Health Intervention Program (UFHIP) was formed at a center for at-risk adolescents in Israel, in order to promote physical activity and reduce risky behavior. From 2015 to 2016, at-risk youth were nonrandomly selected to participate in the UFHIP. Questionnaires were administered to both intervention and control groups before and after the intervention. Univariate and multivariable analyses evaluated the intervention's effect.

Intervention Results: The study participants (n = 53) showed 0.81 more sessions per week of 60 min of physical activity than did the control group (n = 23; p = 0.003). Among the intervention group, smoking frequency reduced from a mean of 2.60 (SD = 1.30) to 1.72 (SD = 1.08), whereas that in the control group increased from 3.17 (1.03) to 3.39 (1.03). In both groups, there was a reduction in alcohol consumption, with a greater change among intervention participants: -1.08 (SD = 1.30), compared with -0.09 (SD = 1.79) in the control group.

Conclusion: Findings indicate that the environmental intervention was efficacious in increasing physical activity and reducing risky behaviors among youth. The effectiveness of this intervention among larger samples is warranted in future prospective studies.

Study Design: Quasi experimental non-randomized control

Setting: Youth advancement center for at-risk youth in Karmiel, Israel

Population of Focus: At risk adolescents

Data Source: Questionnaires

Sample Size: 76 adolescents (53 intervention, 2 control)

Age Range: Ages 15-17

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Other Person-to-Person Education, Enabling Services, Other Media, Community Events, COMMUNITY, POPULATION-BASED SYSTEMS

Intervention Description: In a randomized controlled trial of 20 communities, the study examined whether a comprehensive intervention influenced cancer screening behaviors and lifestyle practices in rural communities in Eastern Washington State. Cross-sectional surveys at baseline and post-intervention included interviews with a random sample of approximately 100 households per community. The interview included questions on ever use and recent use of Pap test, mammogram, and fecal occult blood test (FOBT) and sigmoidoscopy/colonoscopy, fruit and vegetable consumption and smoking practices.

Intervention Results: The study found few significant changes in use of screening services for cervical (Pap test), breast (mammogram) or colorectal cancer (fecal occult blood test (FOBT) or sigmoidoscopy/colonoscopy) between intervention and control communities. Results showed no significant differences in fruit and vegetable consumption nor in smoking prevalence between the two groups. We found more awareness of and participation in intervention activities in the treatment communities than the control communities.

Conclusion: Our null findings might be attributable to the low dose of the intervention, a cohort effect, or contamination of the effect in non-intervention communities. Further research to identify effective strategies to improve cancer prevention lifestyle behaviors and screening practices are needed.

Study Design: Cluster RCT

Setting: Twenty communities in the Lower Yakima Valley of WA

Population of Focus: Women

Data Source: Self-report through personal interviews

Sample Size: Total (N=1,962) Analysis (n=1,851) Intervention (n=894); Control (n=957)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): Prenatal Care Access, Access, Community Health Centers

Intervention Description: The study did not involve an intervention. Instead, it focused on analyzing the operational efficiency, patient composition, and regional context of U.S. health centers and their associations with access to early prenatal care and low birth weight. The study utilized data from multiple sources to examine the quality of prenatal care and birth outcomes of patients served at Community Health Centers (CHCs) operating in the United States in 2015. The research involved analyzing existing data to understand the relationships between sociodemographic composition of CHCs and the efficiency of health centers, as well as how CHC demographics and efficiency are associated with the numbers of patients served and patient health outcomes relating to pregnancy and childbirth

Intervention Results: The study found that there were significant differences in the association between latent classes and access to prenatal care in the first trimester. CHCs in Class 2, characterized by patients who are Older Rural Whites, had the highest rate of access to prenatal care in the first trimester. Compared to other classes, CHCs in Class 2 had more prenatal patients who received early prenatal care. The study also found that greater efficiency at health centers was associated with lower rates of low birth weight (LBW), even controlling for the sociodemographic composition of CHC patients and regional context. However, greater efficiency was not associated with improved access to early prenatal healthcare. The study noted several limitations, including that their measure of prenatal care only captured the timing of initiation of care and did not capture other dimensions of prenatal care quality. Additionally, the study was unable to identify and separate what share of the labor and financial inputs to their DEA model were being used specifically for pregnancy-related services.

Conclusion: The study concluded that Community Health Centers (CHCs) play a crucial role in providing prenatal care, particularly in rural areas where access to obstetric services is declining. The findings highlighted the importance of CHCs in addressing the unique challenges of providing prenatal and perinatal health care in rural communities. The study also emphasized the persistent racial inequalities in prenatal care and birth outcomes, with CHCs serving predominantly white patients having the highest rates of early access to prenatal care and the lowest rates of low birth weight (LBW) births. Conversely, CHCs serving a larger share of Black and Hispanic patients had significantly lower rates of early access to prenatal care and higher rates of LBW births. The study suggested that patient and regional sociodemographic factors had a stronger association with lower or higher rates of LBW at health centers than either patient access to early prenatal care or the relative efficiency of the centers. Additionally, the study highlighted the need for future research to examine how patient characteristics within particular regional settings of healthcare are associated with patient engagement in care and health outcomes.

Study Design: The study design was a cross-sectional analysis of data from the Uniform Data System (UDS) of the Health Resources and Services Administration (HRSA) for the year 2015. The study used a combination of latent class analysis (LCA), data envelopment analysis (DEA), and generalized linear models with a fractional response to analyze the associations between operational efficiency, patient composition, regional context of U.S. health centers, and access to early prenatal care and low birth weight. The study aimed to identify and classify diversity among health centers in terms of their patient populations and regional contexts and to understand how these factors are associated with the degree of access to early prenatal care for patients and the health outcomes of prenatal patients and their babies.

Setting: The setting of this study is the United States, specifically community health centers (CHCs) that provide primary care services to underserved populations. The study used data from the Uniform Data System (UDS) of the Health Resources and Services Administration (HRSA) to analyze the associations between operational efficiency, patient composition, regional context of U.S. health centers, and access to early prenatal care and low birth weight.

Population of Focus: The target audience for this study includes researchers, policymakers, and practitioners interested in improving maternal and child health through the community health center (CHC) system in the United States. Additionally, stakeholders involved in healthcare delivery, public health, and health disparities may also find the findings of this study relevant to their work.

Sample Size: The initial sample size for this study was 1,331 community health centers (CHCs) funded by the Community Health Center (CHC) Program. However, 79 health centers were excluded, resulting in a final sample of 1,252 CHCs for the latent class analysis (LCA). For the data envelopment analysis (DEA) model, an additional 187 CHCs were excluded, reducing the sample to 1,065. Finally, 24 CHCs were excluded from the sample for analyses predicting the proportion of births born at low birth weight (LBW), resulting in a final sample of 1,041 CHCs for LBW analyses.

Age Range: The study did not have a specific target age group. Instead, the study focused on perinatal health outcomes, which includes health outcomes related to pregnancy and childbirth. The study analyzed data on patient demographics, health outcomes, quality of care indicators, costs, and revenues for all 1,375 federally-qualified health centers (FQHCs) in the United States. The study also used regional zip code tabulation area (ZCTA)-level data from the US Census American Community Survey (ACS; 2010–2014) and Behavioral Risk Factor Surveillance System (BRFSS; 2009–2012) to obtain regional data associated with each CHC's service area.

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, COMMUNITY

Intervention Description: We examined associations between implementation of a federal smoke-free housing rule by the New York City Housing Authority (NYCHA) and pediatric Medicaid claims for asthma, lower respiratory tract infections, and upper respiratory tract infections in the early post-policy intervention period.

Intervention Results: In New York City, introduction of a smoke-free policy was not associated with lower rates of Medicaid claims for any outcomes in the early postpolicy period. Exposure to the smoke-free policy was associated with slightly higher than expected rates of outpatient upper respiratory tract infection claims (incidence rate ratio = 1.05, 95% confidence interval: 1.01, 1.08), a result most pronounced among children aged 3-6 years.

Conclusion: Ongoing monitoring is essential to understanding long-term health impacts of smoke-free housing policies.

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, , COMMUNITY, Media Campaign (Print Materials, Radio, TV)

Intervention Description: In this study, our aim was to establish whether the TiRO campaign was followed by a decrease in hospital admissions for childhood asthma and other respiratory conditions related to second-hand smoke exposure across Scotland.

Intervention Results: After TiRO in 2014, we identified a decrease relative to the underlying trend in the slope of admissions for asthma (-0·48% [-0·85 to -0·12], p=0·0096) in younger children (age <5 years), but not in older children (age 5-15 years). Asthma admissions did not change after TiRO among children 0-15 years of age when data were analysed according to area deprivation quintile. Following the 2006 legislation, independent of TiRO, asthma admissions decreased in both younger children (-0·36% [-0·67 to -0·05], p=0·021) and older children (-0·68% [-1·00 to -0·36], p<0·0001), and in children from the most deprived (SIMD 1; -0·49% [-0·87 to -0·11], p=0·011) and intermediate deprived (SIMD 3; -0·70% [-1·17 to -0·23], p=0·0043) area quintiles, but not in those from the least deprived (SIMD 5) area quintile.

Conclusion: Our findings suggest that smoke-free home interventions could be an important tool to reduce asthma admissions in young children, and that smoke-free public space legislation might improve child health for many years, especially in the most deprived communities.

Intervention Components (click on component to see a list of all articles that use that intervention): Professional Support, Community Birth Centers

Intervention Description: This article describes a departure from traditional White supremacist research models that privilege quantitative outcomes to the exclusion of iterative processes, lived experiences, and consciousness-raising. A community organizing approach to birth center development led by Black women and rooted in equity values of safety, love, trust, and justice is outlined.

Intervention Results: Birth Detroit is a Black-led, community-informed model that includes integration of evidence-based approaches to improving health outcomes and that embraces community midwifery prenatal care and a strategic trajectory to open a birth center in the city of Detroit.

Conclusion: Birth Detroit demonstrates the operationalization of a Black feminist standpoint, lifts up the power of communities to lead in their own care, and offers a blueprint for action to improve inequities and maternal-infant health in Black communities.

Study Design: Qualitative

Setting: Community-based

Population of Focus: African American women

Sample Size: 391

Age Range: Not disclosed

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Peer Counselor, Motivational Interviewing, Educational Material, Other Person-to-Person Education, Community-Based Group Education, Group Education, Incentives

Intervention Description: Given serious consequences of maternal smoking, we aimed to develop and test a multicomponent behavioral intervention to enhance smoking cessation during pregnancy.

Intervention Results: The estimated smoking cessation rate was 70.0% (21/30) at the second week of the intervention, and 63.3% (19/30) at the conclusion of the 8-week intervention assuming the dropouts as smoking. In interrupted time series analysis, the mean daily number of cigarettes smoked among quitters decreased by 6.52, 5.34, and 4.67 among early, delayed, and late intervention groups, respectively. Quitters' mean urine cotinine level maintained stably high before the intervention but decreased rapidly to the nonsmoking range once the intervention was initiated. Most participants (85.7%) reported meeting or exceeding expectations, and 100% would recommend the program to others.

Conclusion: This pilot multicomponent intervention was feasible and acceptable to most participants, resulting in a high smoking cessation rate among pregnant smokers who were unlikely to quit spontaneously.

Study Design: Cohort-Multiple-baseline intervention pilot studymultiple interrupted time series approach

Setting: Community-based prenatal clinics

Population of Focus: English speaking pregnant women who are current smokers without alcohol or drug dependency or mental health disorders

Data Source: Urine cotinine, self-report calendar of cigarette use

Sample Size: 30

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, Community-Based Group Education, Telephone Support

Intervention Description: To evaluate the effect of two forms of postnatal social support for disadvantaged inner city mothers on maternal and child health outcomes.

Intervention Results: At 12 and 18 months, there was little impact for either intervention on the main outcomes: child injury (SHV: relative risk 0.99; 95% confidence intervals 0.68 to 1.45, CGS: 0.91; 0.61 to1.36), maternal smoking (SHV: 0.86; 0.62 to 1.19, CGS: 0.97; 0.72 to 1.33) or maternal depression (SHV: 0.86; 0.62 to1.19, CGS: 0.93; 0.69 to 1.27). SHV women had different patterns of health service use (with fewer taking their children to the GP) and had less anxious experiences of motherhood than control women. User satisfaction with the SHV intervention was high. Uptake of the CGS intervention was low: 19%, compared with 94% for the SHV intervention.

Conclusion: There was no evidence of impact on the primary outcomes of either intervention among this culturally diverse population. The SHV intervention was associated with improvement in some of the secondary outcomes.

Study Design: RCT with two intervention groups

Setting: Community (Well-child visit)

Population of Focus: Women from culturally diverse background with infants in two disadvantaged boroughs of London, UK

Data Source: Questionnaires at baseline, 12 and 18 month follow-ups.

Sample Size: 731 mothers with 183 allocated to support health visitor intervention, 184 to community group services intervention, and 364 to control group

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT_CONSUMER, Educational Materials, Other Education, Technology-Based Support, COMMUNITY, Social Media, Social Supports,

Intervention Description: Many women do not have adequate and consistent social support to help them deal with breastfeeding difficulties at home after childbirth. Millennial women (those born between 1980 and 1999) have a significant presence online, making internet-based sources of breastfeeding support a potentially far-reaching, cost-effective, and convenient innovation. Social media platforms (e.g., Facebook, YouTube, Twitter, LinkedIn, Pinterest, GooglePlus+, Tumblr, and Instagram) are internet-based applications that enable the creation and exchange of user-generated content that may provide an avenue of social support. Social media breastfeeding support groups (SMBSGs) provide a cost-efficient, immediate approach to gaining social support and education from vast populations with various sociodemographics. Using 17 SMBSGs, the study team explored the variables that lead to sustained, exclusive breastfeeding to 6 months for breastfeeding millennial women who follow SMBSGs.

Intervention Results: Using structural equation modeling, I examined relationships among personal factors; competing situational demands; social support; and confidence in, knowledge of, attitude toward, and sustainability of breastfeeding. Age, education, and competing work and family demands were all predictive of social support. Breastfeeding social support had a direct effect on participants’ breastfeeding confidence, knowledge, and attitudes (F = 4.96, R2 = .07, p < .002). Furthermore, within SMBSGs, exclusive breastfeeding to 6 months was reported to be three times (66%) greater than the U.S. national average (22%).

Conclusion: Interventions aimed at providing women with resources to gain breastfeeding social support, such as SMBSGs, may be vehicles to improve women’s confidence, knowledge, and attitudes and, therefore, increase the potential for exclusive breastfeeding to 6 months.

Study Design: Repeated measures, longitudinal, mixed-methods

Setting: Online social media support groups across 21 countries

Population of Focus: Convenience sample of exclusively breastfeeding millenial women who followed at least one of 17 social media breastfeeding support groups

Sample Size: 241 women

Age Range: Women 18 years and older

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Community-Based Group Education

Intervention Description: A community intervention program was launched in 1996 to improve breast and cervical cancer screening among Korean American women in Alameda County, California.

Intervention Results: No significant differences in Pap smear rates between the intervention and comparison counties

Conclusion: After 18 months, interim program assessment revealed that mammograms improved, but Pap smears, breast self-examinations, and clinical breast examinations did not change significantly. However, results were similar for the control county probably because the program was not implemented fully. Several strategies for improving program implementation are discussed including recommendations for researchers planning community intervention projects.

Study Design: QE: pretest-posttest non-equivalent control group

Setting: Alameda County and Santa Clara County, CA

Population of Focus: Korean American women

Data Source: Telephone survey

Sample Size: Baseline (n=818) Intervention (n=404); Control (n=414)

Age Range: ≥18

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Educational Material, Other Education, Provision of Breastfeeding Item, PROVIDER/PRACTICE, Hospital Policies, Other (Provider Practice), POPULATION-BASED SYSTEMS, COMMUNITY, Other (Communities), Provider Training/Education

Intervention Description: A breastfeeding promotion program conducted on the Navajo reservation.

Intervention Results: Based on medical records review of feeding practices of all the infants born the year before (n = 988) and the year after (n = 870) the intervention, the program was extremely successful.

Conclusion: This combination of techniques, including qualitative and quantitative research into local definitions of the problem, collaboration with local institutions and individuals, reinforcement of traditional understandings about infant feeding, and institutional change in the health care system, is an effective way of facilitating behavioral change.

Study Design: QE: pretest-posttest

Setting: Shiprock, NM

Population of Focus: All mothers with infants born at the Shiprock hospital

Data Source: Medical record review

Sample Size: Preintervention (n=988) Postintervention (n=870)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Environment Enhancements, COMMUNITY

Intervention Description: This study investigated the effectiveness of providing physical activity (PA) equipment as an environmental intervention on middle school students' PA levels and stakeholders' perceptions of the effectiveness of equipment provisions during school lunch recess.

Intervention Results: The overall percentage of moderate to vigorous PA levels was increased in both schools (ranging from 8.0% to 24.0%). In school 2, there was a significant difference in seventh- and eighth-grade students' moderate to vigorous PA levels from the baseline. Three major themes were identified: (1) unmotivated, (2) unequipped, and (3) unquestionable changes (with students becoming more active).

Conclusion: Environmental supports (access, equipment, and supervision) significantly and positively influenced middle school students' lunchtime PA levels.