Childhood Lead Poisoning Prevention Programs throughout the U.S. have addressed childhood lead poisoning by implementing primary and secondary prevention efforts. While many programs have helped increase screening rates, in some states children under the age of six still have not been tested for lead. This study aims to identify the barriers to childhood blood lead testing and develop a strategy to increase the number of children tested. Clark County physicians who work with children six and under were surveyed about blood lead level (BLL) testing practices, particularly, adherence to Centers for Disease Control and Prevention (CDC) guidelines, and parental compliance with orders to have their children tested to determine their blood lead levels. In addition, select in-person interviews were conducted with physicians who reported high parental compliance to identify best practices and barriers. Of the 77 physicians that provided data, 48% indicated they did not follow CDC guideline compared to 52% who follow guidelines. 18 of the 30 (or 60%) physicians reported more than 80% of parents complied with doctor recommended BLL testing. Twelve physicians identified cost, lack of insurance, and absence of symptomology as persistent barriers to lead screening. This study identified barriers to childhood lead screening including inadequate parental adherence to physician-ordered screenings and physician non-compliance with screening recommendations are two primary contributors. Addressing these issues could increase screening in children and reduce the risk of lead poisoning.

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To examine access to healthcare and health outcomes for kindergartners as they relate to insurance status and type. For the 2008, 2009, and 2010 school years, surveys were distributed to parents with a child entering kindergarten in the state of Nevada. Surveys asked parents to provide information about their child concerning their insurance status, routine medical care, medical conditions, and health behaviors. Compared to their insured peers, uninsured kindergartners were less likely to have had a check-up in the previous 12 months (p < .001; OR 6.14; 95 % CI 5.77-6.53), have a primary physician (p < .001; OR 14.32; 95 % CI 13.49-15.20), or have seen a dentist (p < .001; OR 3.93; 95 % CI 3.70-4.16), and were more likely to have a reported unmet medical need (p < .001; OR 2.60; 95 % CI 2.19-3.07). Additionally, compared to children with private insurance, those children with public insurance were less likely to have had a check-up (p < .001; OR 1.73; 95 % CI 1.59-1.89), have a primary care provider (p < .001; OR 3.87; 95 % CI 3.55-4.21), and were more likely to have unmet medical needs (p < .001; OR 2.27; 95 % CI 1.83-2.81). For children in early development-a deeply critical period-insurance status and type are predictors of important access to healthcare variables.

Social–emotional learning (SEL) programs can be considered upstream, or primary prevention, because they focus on providing students with the life skills necessary to navigate situations and relationships from which problem behaviors may arise to prevent a crisis situation. Strategies & Tools to Embrace Prevention with Upstream Programs (SEL@MS, formerly known as STEP UP) is a comprehensive SEL curriculum for middle school students aimed at promoting universal prevention strategies for healthy populations. SEL@MS enhances protective factors against negative behaviors by reinforcing multilevel approaches to strengthening community, interpersonal, and individual attributes with lesson plans that can be integrated into school curricula. This quasi-experimental pilot study was conducted over the course of two years with 59 middle school students assigned to either the intervention (n = 27) or control (n = 32) group. Analyses demonstrated significant improvements among students in the intervention group in self-regulation, responsibility, social competence, and empathy. Results of this study suggest that SEL@MS is a promising approach to enhance social and emotional protective factors that, when fostered over time, have the potential to improve overall mental health.

Background: People who identify as sexual and gender minorities (SGM) experienced disproportionate economic and mental health issues related to COVID-19 when compared to the general population. The purpose of this study was to better understand how COVID-19 has impacted the SGM community and ways to address vaccine hesitancy. Methods: Three focus groups were conducted with 21 members of the SGM community between 5 November and 10 December 2020. A thematic analysis using the reflexive approach was applied to the transcripts of the focus groups. Results: Four themes emerged: (1) Impact of COVID-19 on the Community, (2) Perceptions of Contact Tracing and Testing, (3) Perceptions of a Potential COVID-19 Vaccine, and (4) Decreasing Vaccine Hesitancy. The most relevant subthemes were that social isolation led to anxiety, stress, and fear in the SGM community during COVID-19; resilience and adaptation were positive outcomes of the pandemic; histories of medical racism contributed to hesitancy to get tested; and specific messaging from trusted messengers may be needed to encourage SGM communities to get vaccinated. These findings support other COVID-19 research on the SGM community during the start of the pandemic. Conclusions: This study provides insight into the impact of the early stages of COVID-19 on the SGM community, highlighting the unique hurdles faced by SGM individuals with regard to contact tracing and vaccine hesitancy.