Objective: To evaluate patient-reported care utilization and outcomes among young adults with juvenile idiopathic arthritis (JIA), including factors associated with complete transfer to adult rheumatology.Methods: We included young adults with JIA enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from 2015 to 2019 with age ≥ 18 years at their last clinical site visit. We used data from the CARRA Registry Long-term Follow-up program, which follows inactive CARRA Registry patients and collects patient-reported information through phone surveys. We compared the characteristics of respondents with complete and incomplete transfer to adult rheumatology care at their first Long-term Follow-up phone survey.Results: We identified 540 young adults with JIA; 187 (35%) responded to the Long-term Follow-up phone survey. The 54% of respondents with complete transfer to adult rheumatology were slightly older and reported more self-assessed disease activity, morning stiffness, and pain compared to those with incomplete transfer. Biologic use was high at both timepoints and did not differ by transfer status. Patients who completed the transfer were more likely to have private insurance and be actively pursuing postsecondary education compared to those with an incomplete transfer. Across the cohort, 65% reported problems with pain or discomfort and 45% with anxiety or depression.Conclusion: Young adult respondents with JIA in the CARRA Registry commonly report persistent medication use, but still report more problems with pain as compared to population norms. Additional work is needed to understand how best to address comorbid pain around the period of transition to adult care.

Patients diagnosed with glioblastoma multiforme (GBM) continue to face a dire prognosis. Developing accurate and efficient contouring methods is crucial, as they can significantly advance both clinical practice and research. This study evaluates the AI models developed by MRIMath© for GBM T1c and fluid attenuation inversion recovery (FLAIR) images by comparing their contours to those of three neuro-radiologists using a smart manual contouring platform. The mean overall Sørensen–Dice Similarity Coefficient metric score (DSC) for the post-contrast T1 (T1c) AI was 95%, with a 95% confidence interval (CI) of 93% to 96%, closely aligning with the radiologists’ scores. For true positive T1c images, AI segmentation achieved a mean DSC of 81% compared to radiologists’ ranging from 80% to 86%. Sensitivity and specificity for T1c AI were 91.6% and 97.5%, respectively. The FLAIR AI exhibited a mean DSC of 90% with a 95% CI interval of 87% to 92%, comparable to the radiologists’ scores. It also achieved a mean DSC of 78% for true positive FLAIR slices versus radiologists’ scores of 75% to 83% and recorded a median sensitivity and specificity of 92.1% and 96.1%, respectively. The T1C and FLAIR AI models produced mean Hausdorff distances (<5 mm), volume measurements, kappa scores, and Bland–Altman differences that align closely with those measured by radiologists. Moreover, the inter-user variability between radiologists using the smart manual contouring platform was under 5% for T1c and under 10% for FLAIR images. These results underscore the MRIMath© platform’s low inter-user variability and the high accuracy of its T1c and FLAIR AI models.

Background: The HEALing Communities Study (HCS) included health campaigns as part of a community-engaged intervention to reduce opioid-related overdose deaths in 67 highly impacted communities across Kentucky, Massachusetts, New York, and Ohio. Five campaigns were developed with community input to provide information on opioid use disorder (OUD) and overdose prevention, reduce stigma, and build demand for evidence-based practices (EBPs). An evaluation examined the recognition of campaign messages about naloxone and whether stigma and efficacy beliefs regarding OUD treatment and naloxone changed in HCS intervention communities. Methods: Data were collected through surveys offered on Facebook/Instagram to members of communities participating in the HCS intervention and wait-list control communities. Results: Participants in HCS intervention communities reported a reduction in stigma regarding OUD and increased efficacy beliefs regarding naloxone associated with recognition of campaign messages. However, this finding is cautiously interpreted as there was no clear evidence for recognition differences between the treatment/control conditions. Conclusion: Study findings indicate associations between campaign message recognition and positive outcomes. Results also highlight possible challenges concerning evaluations of social media campaigns using conventional evaluation techniques. Trial registration: ClinicalTrials.gov NCT04111939.

Purpose: Understanding reactions to health communication campaigns is essential to designing effective messaging. Multi-year campaigns through The Helping to End Addiction Long-term ^® Initiative (HEALing) Communities Study (HCS) were implemented from April 2020 – June 2022. Responses to HCS campaign messages and statewide campaign messages were evaluated. Design: Cross-sectional, self-reported surveys of different respondents at 3 timepoints. Setting: N = 33 communities across Kentucky, Ohio, Massachusetts, and New York. Subjects: N = 2368 respondents recruited from Facebook/Instagram. Measures: Message acceptability survey items assessed attention, understandability, and visuals/text match. Message influence items assessed whether the message made the respondent want to carry naloxone, learn more about medications for opioid use disorder (MOUD), or seek help for OUD. Items were scaled from 1 (strongly disagree) to 5 (strongly agree). Analysis: All outcomes were analyzed using linear mixed models adjusted for community as a random effect. Results: Among naloxone campaigns, HCS message acceptability was higher than statewide messages (3.98, 95% CI = 3.94-4.02 vs 3.93, 95% CI = 3.89-3.97, P = 0.002). HCS message influence was also higher than those of statewide messages (3.44, 95% CI = 3.38-3.50 vs 3.40, 95% CI = 3.34-3.46, P = 0.034). Among HCS campaigns, naloxone messaging had the highest acceptability (3.96, 95% CI = 3.92-4.00), followed by MOUD stigma (3.73, 95% CI = 3.70-3.77) and MOUD awareness (3.71, 95% CI = 3.68-3.75, P < 0.001). The HCS naloxone campaign was also highest rated in terms of influence (3.47, 95% CI = 3.43-3.51, P < 0.001). Conclusion: This analysis provides insight into acceptability and potential influence of locally-tailored, opioid-related health campaign messaging. This work was performed under the HEALing Communities Study, ClinicalTrials.gov Identifier: NCT04111939, https://clinicaltrials.gov/study/NCT04111939 .

The goal was to evaluate how changes in coalition capacity and leadership were related to adoption and reach of overdose education and naloxone distribution in communities participating in the HEALing Communities Study. This was a multisite, cluster randomized waitlist-controlled trial; only analysis of Wave 1 data was performed. Longitudinal analysis of cross-sectional surveys completed by coalition members from 33 communities in 4 states based on data collected from January 2021 to June 2022. Study coalitions (n=33) received the Communities That HEAL intervention to support expansion of evidence-based practices, including overdose education and naloxone distribution, to curtail opioid-related fatalities. Coalition capacity and leadership were measured at the midpoint and end of the intervention using validated scales averaged at the community level. Community adoption and reach of overdose education and naloxone distribution were assessed as changes in the rate of community partners implementing overdose education and naloxone distribution strategies and naloxone units distributed from midpoint to the end of the intervention. Negative binomial and linear models, adjusted for baseline characteristics, were conducted in 2024. Increases in general coalition capacity, adjusted for changes in overdose education and naloxone distribution–specific coalition capacity, were significantly associated with higher rates of community partners engaged in overdose education and naloxone distribution implementation. There was a 56% increase over time in community partners engaged in overdose education and naloxone distribution implementation per unit increase in general capacity scores among coalitions receiving Communities That HEAL. Changes in coalition leadership and capacity did not significantly correlate with changes in naloxone being distributed. Strengthening general coalition capacity is vital for increasing community partner engagement to expand adoption of overdose education and naloxone distribution. Findings support ongoing investment in coalition capabilities to enhance the effectiveness of public health interventions seeking to reduce opioid-related fatalities. Efforts to strengthen general capacities of coalitions, such as data-informed decision making and collective goalsetting, may accelerate implementation and scaling of evidence-based practices such as overdose education and naloxone distribution.