To explore the attitude towards COVID-19 vaccination among healthcare workers in the US, we surveyed three groups of individuals (essential non-healthcare workers, general healthcare workers, and correctional healthcare workers). We found surprisingly high portions of healthcare workers with COVID-19 vaccine hesitancy/resistance, with 23% of correctional healthcare workers and 17% general healthcare workers (as compared to 12%) refusing to be vaccinated against COVID-19. Multivariate regression models suggest that current season flu vaccination (aOR = 3.34), relying on employer for COVID-19 information (aOR = 3.69), and living in the Midwest (aOR = 5.04) to be strongly associated with COVID-19 vaccine acceptance among essential workers and general healthcare workers. Current season flu vaccination (aOR = 7.52) is also strongly associated with COVID-19 vaccine acceptance among correctional healthcare workers. Potential mechanisms of vaccine hesitancy/resistance among healthcare workers involves low health literacy and employer mistrust. Our findings are highly relevant as we try to reach COVID-19 vaccination goals in the US.

Colorectal cancer is the third most common cancer in the United States. Established risk factors include older age, unhealthy lifestyle (high consumptions of red/preserved meat, low consumptions of fruit and vegetables, smoking, high alcohol consumption, and lack of physical activities), personal and family medical histories and low socioeconomic status (low insurance coverage, education and income). Asian American subgroups vary significantly in terms of culture, socioeconomic status, and health behaviors, yet most registries and researches aggregate all Asian Americans as one group. In this review, we summarized and compared colorectal cancer incidence among different Asian American subgroups, and to explore the reasons behind the heterogeneity. Based on limited literatures, we found that Japanese Americans have the highest colorectal cancer incidence among all Asian Americans. The incidence is decreasing among most Asian American subgroups except for Korean Americans. Such heterogeneity is influenced by lifestyle factors related to the country of origin and the United States, as well as colorectal cancer screening.

Introduction: The US South is the epicenter of the epidemic of mass incarceration. Prisons have experienced substantial challenges in preventing COVID-19. Incarcerated individuals and prison staff are at a high risk for infection due to minimal available preventive measures. Prisons are not closed systems and many staff come from communities in close proximity to the facility. Characteristics of the communities immediately surrounding prisons are an overlooked but critical factor to better understand the role prisons play in pandemics. Methods: We used facility-level COVID-19 data from the COVID Prison Project to identify the number of unique outbreaks between May 2019 and May 2020. We used a county-level composite indicator of economic distress (DCI score) to identify the environment surrounding each prison (2015–2019). We modeled the number of outbreaks to DCI scores using negative binomial regression, adjusting for race/ethnicity (African American and Latino/Hispanic), age (65 and older), and rurality level. Results: Our sample included 570 prisons in 368 counties across 13 Southern states. We found that score was positively and significantly associated with prison COVID-19 outbreaks (aRR, 1.012; p < 0.0001), and rurality was potentially a stronger surrogate measure of economic distress (aRR, 1.35; p, 0.02). Economic stability is a key precursor to physical health. Poorer communities have been disproportionately impacted by the pandemic, and we found that prisons located in these communities were more susceptible to recurring outbreaks. Prison-based disease prevention interventions should consider the impact that the outside world has on the health of incarcerated individuals.

Probation has received relatively little research attention. In this exploratory two-study inquiry, we first analyzed quantitative data to identify factors driving probation revocation in Pulaski County, Arkansas, among 10,260 individuals (mostly male and African American) between 2015 and 2019 (Study 1). We found individuals with felony histories were significantly more likely to be revoked (aOR 17.2 for one or two convictions; aOR 25.1 for three or more convictions). Other predictors include lower education, younger age at first sentence, unemployment, and substance use. In Study 2, we conducted 20 in-depth qualitative interviews with 12 key stakeholders and 8 individuals with probation experience. We found that client financial instability, substance use and mental health disorders, stakeholder risk avoidance, officer caseload, and lack of accessible resources/services contributed to probation revocation. We conclude with recommendations for changes to probation policy and practice, including officer training, alternatives to incarceration, service expansion, and community engagement.

BackgroundApproximately 13 million (4.7%) people in the United States have latent TB infection (LTBI). Persons born prior to 1951 have disproportionately higher LTBI prevalence, and frequently experience delays in TB diagnosis and TB deaths. Nevertheless, this birth-cohort was overlooked in the 2016 US Preventive Service Task Force (USPSTF) recommendation for LTBI screening. The aims of this project are to (1) determine the LTBI prevalence in this birth-cohort, (2) assess TB complications prevented by LTBI screening in this birth-cohort, and (3) raise TB awareness among providers and the community.MethodsWe propose to: (1) Develop educational pamphlets for the physicians and community. (2) Screen 10,000 members of the target birth-cohort during their routine clinical visits for 1 year, using T-SPOT.TB. County health officers, the partners of Arkansas Department of Health, will enroll physicians in their jurisdictions to participate in TB screening. LTBI prevalence in the birth cohort will be determined, and TB complications will be compared among cohort TB cases that were screened to those not previously screened. (3) Incorporate LTBI and birth-cohort status in patient medical forms.ResultsIn our preliminary study, for the period 2009–2014, 142 of 326 TB cases (43.6% of all US-born TB cases) were reported from the target birth-cohort; 72.6% of the cases had unique genotype strains.ConclusionIf the LTBI prevalence in this birth cohort exceeds 8–10%, we recommend a nation-wide screening program for this birth-cohort. Even without treatment, we believe that screening and noting diagnosis of LTBI in the patient record will impact delayed diagnosis and mortality.Disclosures All authors: No reported disclosures.