Journal of urban health : bulletin of the New York Academy of Medicine
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Randomized Controlled Trial
Shelter Bans Among People Experiencing Homelessness: an Exploratory Study of Predictors in Two Large Canadian Datasets.
Emergency shelters are a core component of homeless service systems that address immediate basic needs. Service bans, which refer to temporary or permanent disallowances from a program or organization, are an underresearched phenomenon that can leave people experiencing homelessness without needed supports. This exploratory study examined the factors associated with shelter bans among people experiencing homelessness using secondary data from two Canadian studies: (1) a multisite randomized controlled trial of Housing First (At Home/Chez Soi Demonstration Project) and (2) a cross-sectional survey of youth experiencing homelessness across Canada (2019 Without a Home-National Youth Homelessness Survey). ⋯ Overall, the findings suggest that victimization and criminalization during homelessness may increase the risk of shelter loss from bans and further exclusion. The observed regional differences also highlight the potential limits of individual-level predictors. Further research is needed on shelter ban outcomes, as well as how capacity limits and organizational policies affect banning decisions.
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African American (AA) women experience much greater mortality due to breast cancer (BC) than non-Latino Whites (NLW). Clinical patient navigation is an evidence-based strategy used by healthcare institutions to improve AA women's breast cancer outcomes. While empirical research has demonstrated the potential effect of navigation interventions for individuals, the population-level impact of navigation on screening, diagnostic completion, and stage at diagnosis has not been assessed. ⋯ In the control setting, the mean population-level screening mammography rate was 46.3% (95% CI: 46.2%, 46.4%), the diagnostic completion rate was 80.2% (95% CI: 79.9%, 80.5%), and the mean early cancer diagnosis rate was 65.9% (95% CI: 65.1%, 66.7%). Simulation results suggest that network navigation may lead up to a 13% increase in screening completion rate, 7.8% increase in diagnostic resolution rate, and a 4.9% increase in early-stage diagnoses at the population-level. Results suggest that systems science methods can be useful in the adoption of clinical and network navigation policies to reduce breast cancer disparities.
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The USA was built on legalized racism that started with enslavement and continues in the form of structural racial discrimination. This discrimination is difficult to measure because its many manifestations are hard to observe and dynamic. A useful tool would measure across settings, institutions, time periods in a person's life and the country's history. ⋯ Leading researchers and policy makers have called for improved measures of structural racism and discrimination and specifically for a lifecourse approach to measurement. This study is a step in that direction. CLASSIFICATION: Social Sciences.
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The purpose of the present study is to investigate mental well-being among youth after witnessing police stops. A national, urban-born sample of youth in the USA from the most recent wave (2014-2017) of the Fragile Families and Child Wellbeing Study (FFCWS) was employed, with a focus on youth who had not been directly stopped by police (N = 2506). We used t-tests and multivariable ordinary least squares (OLS) regression to estimate direct associations, product-term analysis to test for effect modification by gender and race/ethnicity, and the Karlson-Holm-Breen (KHB) method to assess for mediation by experiences of emotional distress during a stop. ⋯ Findings hold regardless of gender, yet vary somewhat by race and ethnicity, with youth of color reporting less anxiety than their White counterparts after witnessing an intrusive stop, but reporting greater reductions in happiness. Collectively, our findings suggest that witnessing police stops may contribute to inequities in youth mental well-being. A public health approach that combines prevention and treatment strategies may mitigate the harms of police exposure and reduce disparities in youth well-being.
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The COVID-19 pandemic prompted the early release of thousands of incarcerated individuals, including those with histories of intimate partner violence (IPV) perpetration. Survivor advocates stress the importance of adequate supports for decarcerated individuals during re-entry, and notification and supports for their partners or ex-partners if there is a history of IPV. This survey assessed IPV survivors' expectations of and experiences with decarceration in the state of Michigan. ⋯ By contrast, out of 72 survivors with still-incarcerated (ex-)partners, the same percentage - 64.3% - expected harmful behavior from their partner if released. Decarceration efforts may distinguish between individuals who are likely to harm versus help (ex-)partners upon release. Nonetheless, survivors reported several unmet needs, indicating the need for better re-integration services for decarcerated individuals and their families.