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Evaluating Whether Icons and Visual Elements Help or Hinder Understanding of Key Information for Research Studies: Results From a Randomized Trial.

Informed consent forms for research are often lengthy and complex. One way to improve consent forms is to clarify the key information page required for federally funded research in the United States. We developed a visual key information page using color, plain language, bulleted text, and icons. In formative studies, the visual key information page was positively received, but some asked whether icons improve outcomes or distract from information. This study tested whether icons affect knowledge, satisfaction, or engagement with study information.

Health literacy research and practice

Maternal Heat Shock Protein as a Potential Biomarker of Adaptation to Heat Stress during Pregnancy and Its Relation to Preterm Birth.

We evaluated whether maternal HSP27 and HSP70 responded to heat stress during pregnancy and whether HSPs were associated with preterm birth in a secondary analysis of a prospective cohort with repeated biomarkers (N = 227 from MADRES). Serum HSPs were measured during early and late pregnancy using ELISA. Daily heat stress in the 30 days before HSP measurement was computed as Daily Maximum Heat Index (DMHI) and Wet Bulb Globe Temperature (WBGT). Distributed lag models identified sensitive windows of heat adaptation; logistic regression models assessed HSPs' effects on preterm birth (<37 gestational weeks, n = 18 [7.9%]). Models were adjusted for sociodemographics, study design, and heat-exposure predictors. HSP27 and HSP70 concentrations decreased over pregnancy. Higher acute DMHI exposure was associated with higher HSP27 and HSP70 during early pregnancy (1-15 days lags; strongest effect per 1-SD increase: 0.6% [95% CI: 0.001-1.2%] for HSP27 at 9 days; 8.3% [2.6-14.5%] for HSP70 at 1 day) and higher HSP27 during late pregnancy. Mothers with larger HSP70 increases over pregnancy were associated with higher preterm birth risks (OR = 5.2, [1.5, 18.6]) versus those with stable/decreasing levels. HSPs may indicate acute heat stress during pregnancy, with increased HSP70 associated with preterm birth risks.

Environmental science & technology

Effect of a Pregnancy Lifestyle Intervention Embedded Into a Home Visiting Program on Child Neurodevelopment.

Maternal obesity is associated with a higher risk of abnormal child neurodevelopment. The aim of this study was to determine the effect of a lifestyle intervention embedded into a home visiting program, Parents as Teachers (PAT), on 18-month neurodevelopment in the offspring. Pregnant women (9-15 weeks) of African American Race, 18-45 years old, first-trimester BMI 25.0-45.0 kg/m2, and socioeconomically disadvantaged (e.g., Medicaid status) were randomized to standard home visiting (PAT only) or home visiting with lifestyle weight management counseling (PAT+), which began after the baseline assessment in pregnancy and continued until 12 months postpartum. Cognitive, language, and motor development at 18 months was assessed using the Bayley III Scales of Infant Development. Neurodevelopment outcomes were compared between groups and between child sex using un-paired t-tests and ANCOVA. 200 children (105 PAT+/95 PAT only) completed the neurodevelopmental testing at 18 months. Cognitive, language, and motor composite scores did not differ between groups. Across groups, number of PAT visits was positively correlated with scores in the cognitive and language domains. Our findings suggest that a lifestyle weight management program which decreased gestational weight gain does not affect offspring neurodevelopmental outcomes at 18 months. Trial Registration: ClinicalTrials.gov identifier: NCT01768793.

Journal of nutrition and metabolism

Perceived Readiness and Ability to Socially Distance During the Early COVID-19 Epidemic in a U.S. Metropolitan Area: Implications for Local Public Health Preparedness.

Nonpharmaceutical interventions such as social distancing and face mask use were central to controlling infectious disease transmission during the early phases of the COVID-19 pandemic, particularly when vaccines and treatments were limited or unevenly available. Although public health strategies emphasized individual compliance, adherence varied widely. Empirical evidence remains limited regarding how individuals integrate influences across individual, interpersonal, and community levels when assessing their ability and readiness to socially distance. This study examined how residents evaluated, prioritized, and experienced multi-level factors shaping perceived ability and readiness to practice social distancing during the early phase of the COVID-19 epidemic.

Epidemiologia (Basel, Switzerland)

Implementing a Cash Transfer Program in Ethiopia: Adaptations, Early Implementation Outcomes, and Lessons Learned.

Survival for common and curable childhood cancers exceeds 90%-95% in high-income countries, but remains approximately 40% in sub-Saharan Africa, where treatment abandonment-largely driven by out-of-pocket costs-is common. We implemented an unconditional €200 cash transfer program in two pediatric oncology centers in Ethiopia, adapted from a successful Malawi pilot. Using the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework, we describe local context, pragmatic adaptations to the implementation strategy, and early implementation outcomes. This brief report highlights the importance of context-responsive design and systematic assessment of implementation outcomes to support fidelity, equity, sustainability, and future scale-up in low-resource settings.

Pediatric blood & cancer

Lost before forgetting: objective driving metrics track navigation deficits tied to preclinical Alzheimer's disease.

Navigation is a complex, multisensory process in which subtle changes may emerge before the onset of symptomatic Alzheimer's disease (AD). This study investigated whether navigation abilities were associated with amyloid and tau pathology in cognitively normal older adults.

Innovation in aging

Using Machine Learning to Predict Depression among Adolescents Living with HIV in Uganda.

Adolescents living with HIV (ALWHIV) face a high prevalence of depression. In Uganda, limited access to mental health services exacerbates depression, necessitating innovative solutions for early detection and intervention. Machine learning (ML) provides a promising approach for identifying adolescents at risk of depression to facilitate early intervention. This study aims to use machine learning to predict depression among ALWHIV in Uganda.

Global social welfare : research, policy & practice

Advancing Systems Thinking in Implementation Science: An Epidemiologic Perspective.

The population-level impact of public health interventions depends on their implementation in real-world settings. This is the purview of implementation science. As the field of implementation science advances, there is growing recognition that complex health challenges demand solutions that account for the dynamic systems in which interventions unfold. Epidemiologists, trained to define causal relationships and quantify population-level effects, are uniquely positioned to contribute to this effort. Yet, realizing that potential requires moving beyond traditional epidemiologic methods, which can be reductionist in nature, and embracing tools from systems thinking. This paper illustrates how integrating epidemiologic methods with principles of systems thinking can strengthen implementation science and inform implementation strategies for evidence-based interventions in complex real-world settings.

Annals of epidemiology

Is early childhood education associated with better midlife cognition, especially for children facing socioeconomic marginalization?

Education is a strong predictor of cognitive aging, but little work has evaluated the relationship between early childhood education (ECE) specifically and cognition in midlife and beyond.

PloS one

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