Publications

Environmental sustainability, an essential outcome for implementation scientists to improve health

Translating evidence of humans’ harmful impact on the environment into changes is challenging. Implementation science can facilitate a shift from a reactive to proactive approach in tackling environmental sustainability. This article aims to help implementation and environmental scientists incorporate concepts from the other field into their research.

Frontiers in Health Services

Real-World Adoption of Adjuvant Therapies for Resected Stage IB-III Non-Small-Cell Lung Cancer.

Background: Recent clinical trials support adjuvant treatment with novel immunotherapy and targeted therapy agents for selected non-small-cell lung cancer (NSCLC) after resection. The "real-world" implementation of these treatments, however, remains unknown. This study evaluated trends in the uptake of adjuvant chemotherapy, immunotherapy, and targeted therapy for patients with resected NSCLC. Methods: Patients with resected stage IB-III NSCLC within the Veterans Health Administration (2017-2023) were included. Use of adjuvant chemotherapy, immunotherapy, and/or targeted therapy was evaluated over the study period. Factors associated with adjuvant therapy use were identified using multivariable-adjusted logistic regression. Results: Of the 1980 patients included, 846 (42.7%) underwent adjuvant therapy. There was a modest but not statistically significant increase in adjuvant therapy use from 37.1% in 2017 to 45.9% in 2023. Use of adjuvant chemotherapy alone declined from 36.6% to 23.5%, while use of adjuvant immunotherapy (0.5% to 21.2%) and targeted therapy (0% to 1.2%) increased. Factors associated with adjuvant therapy use included younger age, fewer comorbidities, and higher tumor stage. Conclusions: Despite the increased use of adjuvant immunotherapy and targeted therapy for resected stage IB-III NSCLC, overall adjuvant therapy uptake remains low. Further efforts will be necessary to better incorporate these novel treatments into routine clinical practice.

Cancers

Diaphragm-based carbon monoxide electrolyzers for multicarbon production under alkaline conditions

Transforming waste carbon into valuable fuels and chemicals is a key step toward sustainable manufacturing. One approach is the electrochemical conversion of carbon monoxide (CO) into energy-rich multicarbon compounds. Here we show that diaphragms offer a feasible pathway for CO electrolysis, helping reduce system costs and enhance compatibility with renewable energy inputs.

Nature Communications

The Importance of Health Equity Scholarship in Uncertain Times.

JAMA health forum

The 10-year anniversary of the dissemination and implementation models in health interactive webtool: History, refinement, use, and guidance.

Theories, models, and frameworks (TMFs) are essential tools in dissemination and implementation (D&I) research, yet selecting and applying the most appropriate TMF is routinely a challenge, particularly for those new to the field. To address this need, we developed the Dissemination and Implementation Models in Health webtool (www.dissemination-implementation.org) a free, interactive, and evolving online resource designed to support the thoughtful use of D&I TMFs across all phases of research and practice - from planning through assessment. Created through a multi-institutional collaboration and refined using human-centered design, the webtool includes features such as logic model development, D&I TMF selection and comparison, guidance on combining and adapting models, strategies for application, and linkages to measurement tools. Since its initial release in 2014, the webtool has expanded to include over 110 D&I TMFs and new thematic content areas, including a section dedicated to health equity. It can be used in D&I trainings, proposal development, consultations, and academic coursework. Usage analytics and community feedback reflect ongoing relevance, utility, and evolving needs. The webtool continues to address a significant gap in D&I infrastructure by guiding users in selecting and operationalizing D&I TMFs, ultimately supporting more rigorous, context-sensitive translational research and practice.

Journal of clinical and translational science

NutriConnect: Enhancing health and food security through sustainable solutions and partnerships: Design and protocol of a pragmatic comparative effectiveness trial.

Food insecurity and poor dietary intake contribute to health disparities, particularly among socioeconomically disadvantaged populations. Produce prescription programs aim to improve access to fruits and vegetables (F&V) for those with diet-sensitive conditions, but comparative effectiveness data are limited.

Contemporary clinical trials

The Purpose and Value of Editorial Content at JAMA Health Forum.

JAMA health forum

Identifying Predictors of Problematic Substance Use Among Youth Living with HIV in Uganda: A Machine Learning Approach.

Substance use among youth is a significant public health issue, particularly in low resource settings in Sub-Saharan Africa (SSA), where it contributes to HIV transmission and poor engagement in HIV care. This study employs machine learning (ML) techniques to develop models for predicting problematic substance use (PSU) among youth living with HIV (YLHIV) in Uganda, aiming to identify important multilevel risk factors and compare predictive performance of ML algorithms. Utilizing a cross-sectional dataset of 200 YLHIV aged 18-24 in Uganda, we trained and evaluated six predictive models, through 10-fold cross validation. Model performance was assessed using area under receiver operating characteristic curve (AUROC), and precision recall curve (AUPRC). Subsequent feature importance analysis revealed key predictors of PSU. The random forest model achieved the best discriminative performance with an AUROC of 0.78 (0.01) and AUPRC of 0.75 (0.02). Key predictors of PSU spanned individual, interpersonal, and community dimensions including depression, sexual risk-taking behaviors, monthly income, adverse childhood experiences, family involvement in selling alcohol, friends enabling access to alcohol, exposure to community educational campaigns against alcohol, household size, and knowledge of alcohol effects on HIV treatment. Our findings highlight ML's potential in predicting PSU among YLHIV and provide insights to guide targeted interventions and support policy formulations mitigating PSU effects on HIV management.

AIDS and behavior

Public Attitudes Toward Mental Health Treatment Policy

National policy has vacillated over time in its focus on involuntary and community-based interventions. The findings of this cross-sectional study indicate that the public largely supports policies that expand voluntary, community-based services, a position shared by members of all political parties. In comparison, the public is less supportive of involuntary policies.

JAMA Network Open