In an attempt to move the field of public health from documenting health disparities to acting to rectify them, in 2001, the American Public Health Association (APHA) recognized racism as a fundamental cause of racial health disparities. Both APHA and the Council on Education for Public Health have moved to incorporate new competencies in health equity for public health professionals. As schools and programs of public health work to establish curricular offerings in race and racism, a need exists to identify approaches currently in use that can be replicated, adapted, and scaled. This systematic review sought to identify pedagogical methods and curricula that exist to support the training of US public health students in understanding racism as a structural determinant of health. We found 11 examples from peer-reviewed literature of curricula, lessons, and competencies that have been developed by public health faculty and departments since 2006. The articles discussed a range of approaches to teaching about structural racism in public health, suggesting that little consensus may exist on how to best teach this material. Furthermore, we found little rigorous evaluation of these teaching methods and curricula. The results of this review suggest future research is needed on public health pedagogy on structural racism.

CONTEXT Screening children for social determinants of health (SDOHs) has gained attention in recent years, but there is a deficit in understanding the present state of the science. OBJECTIVE To systematically review SDOH screening tools used with children, examine their psychometric properties, and evaluate how they detect early indicators of risk and inform care. DATA SOURCES Comprehensive electronic search of PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection. STUDY SELECTION Studies in which a tool that screened children for multiple SDOHs (defined according to Healthy People 2020) was developed, tested, and/or employed. DATA EXTRACTION Extraction domains included study characteristics, screening tool characteristics, SDOHs screened, and follow-up procedures. RESULTS The search returned 6274 studies. We retained 17 studies encompassing 11 screeners. Study samples were diverse with respect to biological sex and race and/or ethnicity. Screening was primarily conducted in clinical settings with a parent or caregiver being the primary informant for all screeners. Psychometric properties were assessed for only 3 screeners. The most common SDOH domains screened included the family context and economic stability. Authors of the majority of studies described referrals and/or interventions that followed screening to address identified SDOHs. LIMITATIONS Following the Healthy People 2020 SDOH definition may have excluded articles that other definitions would have captured. CONCLUSIONS The extent to which SDOH screening accurately assessed a child’s SDOHs was largely unevaluated. Authors of future research should also evaluate if referrals and interventions after the screening effectively address SDOHs and improve child well-being.

Child maltreatment is a significant public health issue in the United States. Understanding key risk factors for child maltreatment is critical to informing effective prevention. Poverty is an established risk factor for child maltreatment. However, recent research indicates that material hardship (i.e., difficulties meeting basic needs) may serve as a more direct measure of the way in which poverty affects daily life. One form of material hardship that is common among families is housing stress. Previous reviews have summarized the existing literature regarding the association of economic insecurity with child maltreatment, but no reviews have synthesized and critically evaluated the literature specific to the association of various types of housing stress with child maltreatment. We conducted a systematic search of multiple electronic databases to identify peer-reviewed studies conducted in the U.S. regarding the association of housing stress with child maltreatment. We identified 21 articles that used nine distinct measures of housing stress including homelessness or eviction, homeless or emergency shelter stays, foreclosure filing, housing instability, inadequate housing, physical housing risk, living doubled-up, housing unaffordability, and composite housing stress indicators. Overall, results from this body of literature indicate that housing stress is associated with an increased likelihood of caregiver or child self-reported maltreatment, child protective services (CPS) reports, investigated and substantiated CPS reports, out-of-home placements, and maltreatment death. Additional theory-driven research is needed to further our understanding of the contribution of specific types of housing stress to risk for specific types of maltreatment.

serves as a faculty in the Clinical Scholars program and is related to the project principal investigator (Claudia S. P. Fernandez). Claudia S. P. Fernandez is also a principal author of modules in the FastTrack Leadership Library, used in the Clinical Scholars program. The other authors report no conflicts of interest.Fellows in the Clinical Scholars program provide consent for their data to be used for educational research and program improvement purposes and all ethics guidelines of the internal review board (IRB) at the University of North Carolina at Chapel Hill were followed (IRB 16-1817).This research is based in the frame of understanding equity-centered leadership development for teams of health-care professionals working with communities to impact health disparities. Four of the authors are healthcare professionals (Claudia S. P. Fernandez [registered dietitian, nutrition therapist with 20 years of experience counseling patients with eating disorders], Cheryl C. Noble

Community health improvement processes are diverse and complex, and evaluation methods to gain generalizable knowledge across community settings are limited by available data, and the need for deep contextual knowledge. This article describes an innovative participatory approach to evaluation of a transformation initiative involving up to eighteen communities nationwide. The approach blends two qualitative research synthesis methods: participatory action synthesis and meta-ethnography and applies them to the pragmatic evaluation of a program in real-life settings. In this article, we present the justification for and details about the evaluation process. The approach presented here will be useful to both researchers and practitioners interested in evaluating community-based health and well-being initiatives and other complex interventions conducted in complex settings.