Prior to the Covid-19 pandemic, there were high rates of food and housing insecurity and unmet childcare, clothing, and physical and mental health needs among community college students. There was a growing body of evidence linking these unmet needs to adverse educational outcomes. In response, many community colleges had started to develop basic needs initiatives directed at addressing these unmet essential needs to make college feasible. The Covid-19 pandemic created enormous economic and logistical challenges for all sectors, including community colleges. The purpose of this study was to explore changes in community college student basic needs services and programs. An online survey of administrators at Texas community colleges designated as Hispanic-Serving Institutions was administered in late fall 2020. Administrators were asked about 19 basic needs initiative areas. The results indicate an overall decrease in the number of basic needs initiative programs and services at the community colleges during the pandemic. While specific service provision areas, such as food, childcare, clothing, and training, had the greatest decline, programming directed at financial assistance, mental health referrals, student employment, and on-campus physical health services increased.

Religious affiliation and attendance have been shown to affect various facets of mental health, including the willingness to seek mental health assistance; however, little is known about how theological beliefs influence people’s assessments of religious and secular mental health assistance options. Prior research using theological conservatism (beliefs about scripture, sin, and salvation) has conceptualized this perspective as being a schema in which the dimensions operate in tandem. Nonetheless, given the personalized nature of mental health, this study has conceptualized this perspective as three interrelated, but distinctly different dimensions of a religious belief system. Using data from the NORC General Social Survey’s (GSS) 2006 and 2018 waves (N = 2563), this study enlists a fruitful but underutilized approach to gauging perceptions of mental health assistance through the use of situational vignettes that prompt survey respondent appraisals of different sets of circumstances and various possible solutions. This study finds some support for the hypothesis that predicted theological conservatism would be associated with a more favorable view of religious support for mental health as opposed to secular sources of assistance; there was also considerable support for the hypothesis that the salvation dimension of this worldview would exhibit an influence apart from the scripture and sin dimensions. This investigation sheds light on an understudied facet of religion in relation to receptivity toward distinctive forms of mental health treatment and highlights potential directions for future research.

Introduction: Developing and implementing trauma clinical guidance is integral to providing quality care to all trauma patients while maintaining a minimum standard of treatment. A mixed-methods novel consensus-building approach was used to identify the current barriers to developing and implementing trauma clinical guidance and highlight the priority areas for change to better support end users. Methods: As part of year 1 of the Design for Implementation: The Future of Trauma Clinical Guidance and Research Conference Series, preconference participant surveys and hybrid, professionally facilitated, structured dialogue were used to define the ideal future state of trauma clinical guidance development and dissemination. Novel to this context, in-person and virtual “user stories”, a form of structured focus group, were generated, and a “minimum viable product” (MVP), a form of brokered dialogue, was developed. Descriptive statistics and thematic analysis were used to evaluate preconference survey and “user story” results. Results: 72 in-person and up to 35 virtual attendees participated. The majority (92%) of in-person attendees and nearly half (48%) of virtual attendees completed the preconference survey. Participants identified barriers along the continuum of clinical guidance development, dissemination, and adoption. Areas for improvement centered around the creation, storage, and use of guidance. Across the survey and user stories, participants expressed the need for clinical guidance that is comprehensive, evidence-based, coordinated, and easily accessible by all clinicians both domestically and abroad. The MVP targeted the risks and objectives to improved guidance. A prominent theme throughout this consensus-building assessment was the imperative for collaboration between professional societies for clinical guidance development and dissemination. Discussion: Trauma clinical guidance must be current, consolidated, and coordinated with patient-centered outcomes prioritized. Next steps include turning the MVP produced into a prototype and refining it to inform a national redesign of trauma clinical guidance. Level of evidence: Level III.

Introduction: Trauma clinical guidance (guidelines, protocols, algorithms, etc) has been shown to improve patient outcomes; however, it is only used in about half of the patients to whom it applies. Guidance implementation is affected by intrinsic factors (eg, guidance format) as well as extrinsic factors (eg, the clinical environment). Recommendations and frameworks have been created to aid in the development of implementable guidance. We hypothesize that existing trauma clinical guidance lacks elements important for implementation. Methods: The Framework for Guideline Implementability by Gagliardi, which consists of 22 elements arranged into eight domains, was used to evaluate trauma clinical guidance. A sample of 20 pieces of guidance, crafted by 11 professional organizations, were reviewed. Data were extracted to identify the presence or absence of each implementability element. Results: All guidance provided a clear objective and 85% allowed for individualized application of recommendations based on clinical scenario. Approximately half of the guidance included formatting elements, such as graphic aids, to enhance usability, and 50% incorporated formal evidence grading. Patient-friendly tools accompanied 10% of guidance, and few discussed implementation strategies (25%) or quality metrics (30%) to evaluate guidance implementation. Discussion: Clinical guidance exists on a spectrum, from narrative (eg, written documents) to executable tools (eg, automated decision support based on patient context). While integration of computable guidance into clinical workflows may be the ultimate goal in high-resource settings, there are other more feasible and even cost-free modifications developers may integrate into new guidance to improve implementation across settings. Conclusion: Utilization of trauma clinical guidance is crucial for improving healthcare quality. To achieve this, guidance developers might leverage the elements in the new TRAUMA (Transparency, Robust inclusivity, Adaptability, Usability, Measurability, Accessibility) framework that enhance implementability. Future research is needed to validate this theoretical new framework’s impact on clinical implementation and patient outcomes. Level of evidence: IV.

Traumatic injury is the leading cause of death for individuals aged 1–45 in the USA. Variations in patient management based on geographic locations, community resources, and provider characteristics contribute to disparities in patient outcomes. It is estimated that 20,000 Americans lives could be saved yearly if all trauma centers performed as well as the highest-performing center, which is achievable, in part, through the reduction of inappropriate practice variation. Trauma clinical guidance currently lacks standardization, is redundant, and remains difficult to access and implement at the bedside. To explore and address these issues, the Design for Implementation: The Future of Trauma Research and Clinical Guidance (DFI) Conference Series was developed. This conference series and complementary research aims to redesign the development, dissemination, and implementation of trauma clinical guidance with a focus on more effective and equitable systems. To do so, key community partners were convened to present clinical guidance best practices, including digital integration, resource stratification, and patient-centeredness. Conference attendees, which included partners from various provider groups, patients, dissemination and implementation scientists, public health experts, government agencies, and software developers, worked together to create a “minimum viable product” which specified key objectives for an ideal future state of trauma clinical guidance, as well as the “risk”, “audience”, and “key performance indicators”. The next conference in the series will take place in February 2025, with a focus on translating the conceptualized priorities into tangible solutions. This paper serves to share the events from the 2024 conference proceedings.

On August 2–3, 2023, the Summit on the Advancement of Focused Equity Research in Trauma (SAFER-Trauma) was convened in Chicago, Illinois, USA. Thought leaders comprised of over 50 in-person and over 80 virtual attendees, including trauma surgeons, nurses, trauma program managers, researchers, and survivors convened at the American College of Surgeons headquarters in Chicago to take stock of existing disparities in injury care and research and consider innovative solutions to address them. To achieve these goals, the first day of the conference focused on the Current State of Trauma Research and Disparities, and the second day focused on A Unified Response to Address Disparities in Trauma Research. Video recordings of all presentations are freely available on the conference website (https://www.nattrauma.org/safer-trauma-new/). SAFER-Trauma was designed by the Coalition for National Trauma Research’s Equity, Diversity and Inclusion Committee, chaired by Vanessa Ho, MD, PhD, MPH, FACS, and was made possible by a conference grant funded through the Agency for Healthcare Research and Quality (1-R13-HS029444). This article, along with the entire series of articles from the conference, constitutes the conference proceedings which include major topic areas, outline the current literature, and provide a roadmap to drive progress toward equity in trauma research.