This study assesses the effectiveness of a strategy for obtaining active written parental consent for the outcome evaluation of an alcohol, tobacco, and other drug (ATOD) abuse prevention program. A local school-based strategy that was implemented in 16 middle schools in ten rural and suburban school districts is presented. Using a multiple case study approach and an adequacy of performance analysis, it was found that seven of the ten districts achieved a minimum consent rate goal set at 70% (ranged from 53% to 85%, average rate of 72%). Only two districts achieved a desired consent rate of 80%. Interviews with a key contact person in each school district provided profile information that distinguished districts that were successful in implementing an active parental consent strategy from those that were not successful. A cost effectiveness analysis showed that this local school-based strategy for obtaining parental consent for program evaluation was more cost effective than in previous studies. However, more than 20% of the data collection costs involved obtaining active written consent. Methodological and practical implications are discussed.

Book design by Patricia Yalden and other staff members at Brookhaven National Laboratory. Cover design by Kanako Yamamoto of Affordable Creative Services, Inc.Front cover: Scanning tunneling microscope image of an ammonia synthesis catalyst that is made of ruthenium particles about 10 nanometers in diameter. This nanoparticle catalyst is 10 times more active than commercial iron-based catalysts (courtesy of Zhen Song and Jan Hrbek, Brookhaven National Laboratory).Back cover: Detailed atomic structure of silicon nanoparticles simulated by state-of-the-art, highly accurate quantum techniques (courtesy of Giulia Galli, Lawrence Livermore National Laboratory). Copyright informationThis document is a work of the U.S. Government and is in the public domain. Subject to stipulations below, it may be distributed and copied, with acknowledgment to the National Nanotechnology Coordination Office (NNCO) and the U.S. Department of Energy. Copyrights to portions of this report (including graphics) contributed by workshop participants and others are reserved by original copyright holders or their assignees, and are used here under the Government's license and by permission. Requests to use any images must be made to the provider identified in the image credits, or to the NNCO if no provider is identified. AcknowledgmentsThanks are extended to the principal authors listed on the title page of this report (reverse side of this page). In addition, the report's authors wish to thank all the participants at the March 16-18, 2004 workshop held in Arlington, VA, particularly the workshop cochairs, Ellen Williams of the University of Maryland and Robert Hwang of Brookhaven National Laboratory. The presentations and discussions at that workshop provided the foundation for this report.Credit is due to staff members in the Department of Energy's Office of Basic Energy Sciences and in the National Nanotechnology Coordination Office who assisted in organizing the workshop and in editing the final report:Christie Ashton, Department of Energy's Office of Basic Energy Sciences Sam Gill, NNCO Stephen Gould, NNCO Geoffrey Holdridge, NNCO Philip Lippel, NNCO Special thanks are due to Robert Hwang and other staff members at Brookhaven National Laboratory who prepared, edited, and printed the first edition of the manuscript, and to Geoffrey Holdridge, Philip Lippel, Cate Alexander, and other staff members at the National Nanotechnology Coordination Office and WTEC, Inc. who contributed to editing, production, and distribution of this second edition.Finally, thanks to all the members of the National Science and Technology Council's Subcommittee on Nanoscale Science, Engineering, and Technology, who cosponsored the workshop with the Department of Energy and who reviewed the draft report before its publication.This workshop was sponsored by the U.S. Department of Energy and, through the National Nanotechnology Coordination Office, the other member agencies of the Nanoscale Science, Engineering, and Technology (NSET) Subcommittee, Committee on Techn...

Background: The rate of inappropriate antibiotic prescribing for acute respiratory tract infections (ARTIs) is 45% among urgent care centers across the United States. To contribute to the US National Action Plan for Combating Antibiotic-Resistant Bacteria, which aims to decrease rates of inappropriate prescribing, we implemented 2 behavioral nudges using the evidence-based MITIGATE tool kit from urgent-care settings, at 3 high-volume, rural, urgent-care centers. Methods: An interrupted time series (ITS) analysis was conducted comparing a preintervention phase during the 2017–2018 influenza season (October through March) to the intervention phase during the 2018–2019 influenza season. We compared the rate of inappropriate or non–guideline-concordant antibiotic prescribing for ARTIs across 3 urgent-care locations. The 2 intervention behavioral nudges were (1) staff and patient education and (2) peer comparison. Provider education included presentations at staff meetings and grand rounds, and patient education print materials were distributed to the 3 locations coupled with news media and social media. We utilized the CDC “Be Antibiotics Aware” campaign materials, with our hospital’s logo added, and posted them in patient rooms and waiting areas. For the peer comparison behavioral intervention, providers were sent individual feedback e-mails with their prescribing data during the intervention period and a blinded ranking e-mail in which they were ranked in comparison to their peers. In the blinded ranking email, providers were placed into categories of “low prescribers,” those with a ≤23% inappropriate antibiotic prescribing rate based on the US National Action Plan for Combating Antibiotic-Resistance Bacteria 2020 goal, or “high prescribers,” those with a rate greater than the national average (45%) of inappropriate antibiotic prescribing for ARTI. Results: Our results show that fewer inappropriate antibiotic prescriptions were written during the intervention period (58.8%) than during the preintervention period (73.0%), resulting in a 14.5% absolute decrease in rates of inappropriate prescribing among urgent-care locations over a 6-month period (Fig. 1). The largest percentage decline in rates was seen in the month of April (−35.8%) when compared to April of the previous year. The ITS analysis revealed that the rate of inappropriate prescribing was statistically significantly different during the preintervention period compared to the intervention period (95% CI, −4.59 to −0.59; P = .0142). Conclusions: Using interventions outlined in the MITIGATE tool kit, we were able to reduce inappropriate antibiotic prescribing for ARTI in 3 rural, urgent-care locations.Funding: NoneDisclosures: Larissa May repo, Speaking honoraria-Cepheid Research grants-Roche Consultant-BioRad Advisory Board-Qvella Consultant-Nabriva

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