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The prevalence of hepatitis B virus (HBV) in the homeless population is underestimated despite multiple behavioral risks. Data from a sample of 534 homeless adults from downtown Los Angeles were analyzed to examine the prevalence and predictors of HBV infection in this community. The prevalence of HBV was 7 to 10 times higher than in the US general population rate. Opiate dependence, injection and noninjection use, was an independent predictor of HBV exposure. Testing and counseling occurred at significantly lower rates for HBV than for human immunodeficiency virus. Findings emphasize the need to enhance screening and counseling in homeless communities and other populations with opiate use.An estimated 4.1 million people in the United States are infected with hepatitis C virus (HCV). see more In 2014, the Hepatitis C Community Alliance to Test and Treat (HepCCATT) collaborative was formed to address hepatitis C in Chicago. From 2014 to 2017, the HepCCATT Case Management Program case managed 181 HCV-infected people and performed on-site capacity building at a 6-site community health center (CHC) that produced codified protocols, which were translated into a telehealth program to build capacity within CHCs to deliver hepatitis C care. HepCCATT's innovative approach to addressing multilevel barriers is a potential model for increasing access to hepatitis C care and treatment.The Patient Protection and Affordable Care Act supports the integration of community health workers (CHWs) into the health care workforce, but little is known about integration and current roles of CHWs among employers in community settings. This analysis of 97 employers described the roles of CHWs in Nebraska and found significant differences between CHWs practicing in rural and urban areas in organization types employing CHWs, funding sources, and minority populations served. The findings suggest that the utility of CHWs is widely recognized among employers, but deliberate support will be needed to better define the roles of CHWs to meet the needs of the increasingly diverse demographic.Rural-dwelling, overweight/obese, limited-resource individuals and women have the lowest leisure-time physical activity rates among Americans. This community-based, single-group pre- posttest study sought to increase physical activity, step counts, and promote weight loss in 104 low-income women (84% rural). Analyses included nonparametric and repeated-measures analyses of variance to determine physical activity behaviors, step counts, and weight loss. Results show, from pre- to postintervention, participants improved self-reported step counts, physical activity goal setting and behaviors, and body weight. This study adds support that text message programs can reach a high-risk, limited-resource, predominantly rural population to promote physical activity and weight loss.An obesity preventive intervention program for preschool families, Healthy Balance, was tested in 2 sequential pilot trials. The first pilot tested the original and translated group intervention in a heterogeneous population (65 families), and the second tested the feasibility of a culturally adapted version for Latinx immigrant families (27 families). No significant study 1 intervention effects were found. However, in study 2, there were significant improvements in parent body mass index, neck circumference, and blood pressure. These studies suggest that targeting family system change and tailoring the intervention for Latinx immigrant populations is feasible and has the potential to improve obesity-related biomarkers.Adults living in rural areas are at greater risk of becoming overweight and obese due to health care disparities. A pre-/postmatched cohort design was used to evaluate a brief weight-loss counseling intervention, Ten Top Tips (10TT), in a rural primary care setting. The rank sum scores for total weight-loss behaviors and the subscales for dietary changes, self-monitoring, physical activity, and psychological coping taken before and 12 weeks after the intervention differed significantly (P = .0001). Ten Top Tips offers rural community clinics an effective weight-loss intervention.Racial minorities experience a high burden of food insecurity relative to non-Hispanic whites. Government-subsidized nutrition programs can positively impact food insecurity and nutritional risk among older adults. Yet, in New York City, where nearly 60% of people over 65 years are non-white, older minorities participate in government nutrition programs at very low rates. In this commentary, we focus on 2 programs the Child and Adult Care Food Program and Older Americans Act Nutrition Services Programs. We identify opportunities for strengthening these programs to improve their reach and engagement with diverse older adults in New York City and similarly diverse urban communities.We examined the association between perceived racial discrimination and hypertension among African Americans and whites who live in a low-income, racially integrated, urban community. Hypertension was defined as having a systolic blood pressure 140 mm Hg or more, a diastolic blood pressure 90 mm Hg or more, or taking antihypertensive medication(s). Perceived racial discrimination was based on self-reported responses of experiencing racial discrimination in various settings. Using modified Poisson multivariable regression models, we found no association between perceived racial discrimination and hypertension (prevalence ratio 0.96, 95% confidence interval 0.90-1.04). Findings suggest that social context may play a role in the relationship between perceived racial discrimination and hypertension.BACKGROUND Patient flow, from emergency department admission through to discharge, influences hospital overcrowding. We aimed to improve patient flow by increasing discharge lounge (DL) usage. LOCAL PROBLEM Patients need to receive a continuum of nursing care to encourage compliance with follow-up care after discharge from the acute care setting. METHODS Baseline data revealed inefficient use of the DL. We targeted the medical-surgical unit with the lowest DL use and trialed interventions over sequential Plan-Do-Study-Act cycles. INTERVENTIONS After surveying the nursing staff, we assessed the influence of 3 interventions on DL usage educating staff on patient eligibility, engaging a recruitment scout, and displaying a visual cue notifying staff when a patient's discharge order was written. RESULTS The unit's average DL use increased from 18% to 36%, while hospital overcrowding and discharge turnaround time decreased. CONCLUSION The DL is an effective tool to improve patient flow and decrease hospital overcrowding.