Public Health Reports[JOURNAL]
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200 papers
Public Awareness and Acceptance of Wastewater Surveillance in the United States, June 2024.
Soelaeman RH, Valencia D, Horter L … +11 more , Turner H, Yadav R, Tatti KM, Nelson E, Kaur M, Amarosa D, Lyons BC, Welton M, Louis S, Losch J, Santibañez S
Public Health Rep · 2026 Jul · PMID 42402435 · Publisher ↗
OBJECTIVES: Wastewater surveillance (WWS) is a valuable public health tool for monitoring infectious diseases. Recent studies suggest its potential for monitoring opioids or other drugs. We evaluated WWS awareness and pu...
OBJECTIVES: Wastewater surveillance (WWS) is a valuable public health tool for monitoring infectious diseases. Recent studies suggest its potential for monitoring opioids or other drugs. We evaluated WWS awareness and public acceptance of WWS for respiratory and vector-borne diseases and opioids in the US population. METHODS: We conducted a nationwide cross-sectional survey in June 2024 among US adults aged ≥18 years. We used quantitative analysis (N = 2024) to assess associations between participants' awareness of and attitudes toward WWS, including how those data should be used. We performed qualitative analysis to identify themes among participants who provided comments about opioids or other illicit drugs (n = 67). RESULTS: Overall, more than half of participants expressed comfort with WWS for respiratory diseases (54.1%), mosquito-borne diseases (57.3%), and opioids or other drugs (51.1%). These percentages were significantly higher ( < .001) among people with awareness of WWS than among those who were unaware of WWS: 70.6% were comfortable with WWS for respiratory diseases and 71.6% were comfortable with WWS for mosquito-borne diseases, while slightly fewer participants were comfortable with WWS for opioids or other drugs (64.8%). Among those unaware of WWS, about half were comfortable with WWS for respiratory diseases (50.8%), mosquito-borne diseases (55.5%), or opioids or other drugs (49.2%). Qualitative analysis highlighted concerns about privacy, changes in law enforcement activity with opioid monitoring, and the possibility of negative community effects. CONCLUSIONS: Comfort with WWS activities was higher among those who were aware of WWS than among those who were not. Future efforts could focus on improving public awareness and knowledge of how wastewater data are collected and used to benefit public health.
Experiential and Structural Determinants of Communicable Disease Reporting Among Health Care Providers in Alameda County, California.
Martinson T, Khan SM, Heaton DT … +3 more , Shemsu M, Moss NJ, Trivedi KK
Public Health Rep · 2026 Jul · PMID 42389875 · Full text
Communicable disease reporting is essential for public health surveillance, yet underreporting is common. California Title 17 mandates that health care providers report >80 communicable diseases to local health departmen...
Communicable disease reporting is essential for public health surveillance, yet underreporting is common. California Title 17 mandates that health care providers report >80 communicable diseases to local health departments, according to the patient's residence. We conducted a cross-sectional survey assessing health care provider knowledge, attitudes, and practices related to reporting requirements in Alameda County, California. Of 145 health care providers surveyed from April through June 2025, 127 (87.6%) were aware of Title 17 requirements and 105 (72.4%) had submitted at least 1 report. In multivariable logistic regression analysis using Firth penalized likelihood, the following were significantly associated with higher odds of reporting communicable diseases: having an awareness of reporting requirements versus no awareness (adjusted odds ratio [AOR] = 6.91; 95% CI, 1.21-58.36), having >10 years of clinical experience versus <5 years of clinical experience (11-20 years: AOR = 11.07 [95% CI, 2.30-64.68]; >20 years: AOR = 10.89 [95% CI, 2.28-62.59]), and having training in systems of institutional reporting versus no training (AOR = 5.37; 95% CI, 1.56-22.52). Misunderstanding reporting responsibility versus accurately identifying reporting responsibility was associated with lower odds of reporting communicable diseases. Improving clinician training, clarifying reporting expectations, and expanding electronic reporting systems may strengthen public health surveillance.
A Case-Case Study of Sporadic and Outbreak-Associated Listeriosis Exposures: Initiative Food History Data, 2016-2022.
Namwase AS, Taylor EV, Conrad A … +4 more , Richardson L, Rose EB, Bruce BB, Weller DL
Public Health Rep · 2026 Jun · PMID 42377015 · Full text
OBJECTIVES: Little is known about foods associated with sporadic listeriosis, a foodborne bacterial infection. We compared self-reported foods consumed by people with sporadic versus outbreak-associated listeriosis, over...
OBJECTIVES: Little is known about foods associated with sporadic listeriosis, a foodborne bacterial infection. We compared self-reported foods consumed by people with sporadic versus outbreak-associated listeriosis, overall and for certain populations. METHODS: We analyzed data on cases with ≥1 reported food exposure reported during 2016-2022 in the United States to the Initiative. We used counterfactual random forests to identify foods associated with sporadic and outbreak-associated listeriosis in certain populations (eg, pregnant women). RESULTS: Of 3413 listeriosis cases reported during 2016-2022, 83.5% (n = 2849) were sporadic. Many foods showed no differential association between sporadic and outbreak-associated illness, indicating similar associations or lack thereof with both illness types. While a subset of foods were associated with sporadic versus outbreak-associated listeriosis, these associations varied by population. For example, strawberries (odds ratio [OR] = 2.48; 95% CI, 1.11-5.52) were the only foods associated with sporadic illness among nonpregnant females aged 15 to 49 years. Among adults aged ≥65 years, 10 foods, including deli-counter sliced cheese (OR = 1.78; 95% CI, 1.28-2.47), were associated with sporadic listeriosis. CONCLUSIONS: Foods associated with sporadic listeriosis differed from foods associated with outbreak-associated illness, with differences observed across population groups and by pregnancy status. These findings highlight variation in exposure patterns and underscore the need for further attribution studies focused on sporadic illness across demographic groups, to inform population-specific prevention messaging.
Developing a Prioritization Method for Imported Infectious Diseases Using National Notifiable Surveillance Data: The Tokyo 2020 Olympic and Paralympic Games Experience.
Ikenoue C, Griffith MM, Fukusumi M … +9 more , Kanou K, Nishiki S, Arima Y, Takahashi T, Saito T, Matsui T, Shimada T, Oishi K, Sunagawa T
Public Health Rep · 2026 Jun · PMID 42377014 · Full text
An increase in imported infectious diseases that are unfamiliar to health professionals was expected during the Tokyo 2020 Olympic and Paralympic Games. The National Institute of Infectious Diseases, Japan, therefore dev...
An increase in imported infectious diseases that are unfamiliar to health professionals was expected during the Tokyo 2020 Olympic and Paralympic Games. The National Institute of Infectious Diseases, Japan, therefore developed a pragmatic quantitative methodology to prioritize imported infectious diseases with the greatest implications for medical and public health workers. This approach selected acute-onset infectious diseases recorded in the national surveillance system and defined 2 indicators: absolute caseload and the relative contribution from importations, reflecting potential workload in diagnosis and acute public health responses, and relative importation impact. We prioritized diseases exceeding predefined thresholds for both indicators. The prioritization results, based on simple calculations, identified 15 prioritized diseases and facilitated transparent nationwide public health planning. With increasing global mobility, this method can serve as a useful tool to improve preparedness for mass gatherings and routine public health planning.
Reduction in Hepatitis C Virus RNA Positivity Among Clients in an Inpatient Substance Use Treatment Program in New York City.
Weiss JJ, Riazi F, Herrera J … +1 more , Diaz Munoz D
Public Health Rep · 2026 Jun · PMID 42376802 · Full text
Abstract loading — click title to view on PubMed.
Managing Institutional Change Through Participatory Planning: Creating the College of Integrated Health Sciences at the University at Albany, State University of New York.
Appleton AA, Hardiman ER, Jurkowski JM … +2 more , Rizzo VM, Bell EM
Public Health Rep · 2026 Jun · PMID 42366803 · Full text
Many universities are navigating changes to strengthen their long-term sustainability. Although challenges and negative consequences of institutional change are often most visible, successful efforts can provide valuable...
Many universities are navigating changes to strengthen their long-term sustainability. Although challenges and negative consequences of institutional change are often most visible, successful efforts can provide valuable lessons. In 2024, the University at Albany launched the College of Integrated Health Sciences after a yearlong, participatory planning process. The new college integrates the university's long-standing public health programs and academic departments, 40-year partnership with the New York State Department of Health, 60-year-old School of Social Welfare, and newly developed nursing programs. A change consultant guided the planning process, and 3 working groups developed recommendations for the college's name, organizational structure, and vision, mission, and value statements. The planning process involved multiple strategies to identify student, faculty, and staff priorities and encourage active participation: 5 surveys (626 responses), 3 full-day retreats, 7 consultant-led listening sessions, and 41 working group meetings. Students, faculty, and staff (n = 168) voted on the final recommendations. Most participants reported satisfaction with the mission (75%), vision (79%), and value (85%) statements; 80% reported satisfaction (44%) or neutrality (36%) with the proposed organizational structure. Although the working groups presented 3 name options reflecting constituent priorities, voting did not reveal consensus. Deans of the public health and social work units ultimately recommended a name for the college using phrasing that resonated with the vision, mission, and value statements. The university provost and president adopted all recommendations. This case study demonstrates that effectively navigating change requires transparent, participatory planning and frequent 2-way communication, which will facilitate successful outcomes and establish a strong foundation for the institution's future.
An Urgent Need for Evidence-Based Guidance on Mercury Exposure Screening to Inform Public Health Policy, Practice, and Prevention.
Bardhi N, Rangachari P, Palumbo SD … +1 more , Spaeth KR
Public Health Rep · 2026 Jun · PMID 42334478 · Full text
OBJECTIVES: Mercury exposure is a preventable public health concern that arises from multiple environmental, dietary, and occupational exposure pathways and poses disproportionate risks to the fetus during pregnancy. How...
OBJECTIVES: Mercury exposure is a preventable public health concern that arises from multiple environmental, dietary, and occupational exposure pathways and poses disproportionate risks to the fetus during pregnancy. However, routine identification in clinical care is limited. This study aimed to generate practice-informed evidence from primary care clinicians serving populations at risk of mercury exposure to inform the development and implementation of evidence-based guidance on mercury exposure screening in primary care. METHODS: In April 2025, we conducted a qualitative study using semistructured interviews online or by telephone with 12 primary care clinicians practicing in outpatient and hospital-affiliated settings in New York City. Interviewers examined clinicians' knowledge of mercury exposure, current screening practices, perceived barriers, and recommendations for practical supports. Informed by the Knowledge-to-Action framework, we analyzed data using reflexive thematic analysis and reported in accordance with consolidated criteria for reporting qualitative research. RESULTS: Clinicians described mercury exposure as a recognized but low-priority issue in routine primary care. Screening was rare and largely reactive rather than preventive. Clinicians identified health care system-level barriers, including lack of training, lack of screening guidance, limited access to testing, health insurance restrictions, time constraints, and the absence of decision support for electronic health records. Despite these barriers, clinicians supported standardized, practical screening guidance, often referencing lead exposure screening as a useful model. They emphasized the need for simple risk-based tools, workflow integration, health care provider training, and policy support. CONCLUSIONS: Aligning public health evidence with clinical systems through evidence-based screening guidance, workflow integration, and supportive policy is essential to advance equitable mercury exposure identification and prevention in primary care.
Self-Reported Mental Health and Desired Workplace Improvements Among Working Parents, United States, 2024.
Van Buren K, Lundstrom EW, Omari A … +3 more , Marks KJ, Johnson CY, Shi DS
Public Health Rep · 2026 Jun · PMID 42334448 · Full text
OBJECTIVE: Few studies have examined the mental health burden faced by working parents. We assessed the prevalence of fair or poor self-reported mental health and identified desired workplace improvements among US workin...
OBJECTIVE: Few studies have examined the mental health burden faced by working parents. We assessed the prevalence of fair or poor self-reported mental health and identified desired workplace improvements among US working parents. METHODS: We conducted a descriptive analysis of the 2024 SummerStyles survey, a nationally representative web-based panel survey of US adults aged ≥18 years. Working parents were defined as adults employed full- or part-time with ≥1 child aged <18 years. We calculated weighted percentages and 95% CIs to characterize mental health status and workplace priorities across demographic and occupational groups. RESULTS: Among 1201 working parents, 15.3% (weighted n = 126) reported fair or poor mental health. The prevalence of self-reported fair or poor mental health was higher among women than among men (20.0% vs 11.4%), among those with lower annual household income (<$25 000: 31.6%) versus higher annual household income ($25 000-$49 999: 20.1%; $50 000-$99 999: 19.6%; >$100 000: 10.0%), among those with less versus more educational attainment (high school graduate or less: 20.2%; some college: 20.0%; ≥bachelor's degree: 10.9%), and among those with retail/stores/shopping jobs (26.8%) versus jobs in other industries (health care: 20.4%; education and tutoring: 8.0%; professional, scientific, technical, and business services: 11.4%; finance, banking, and health insurance: 10.2%). Desired workplace improvements included increased paid leave (20%), ability to work remotely/telework (20%), and flexible work schedules (19%), with differences by demographic and occupational characteristics. CONCLUSIONS: Tailored workplace policies, such as flexible scheduling and expanded leave benefits, may support the mental health of US working parents. Additional research should explore industry-specific nuances of preferred workplace flexibilities among US working parents to guide work-based interventions.
Mental Health Screening Before and After the 2020 COVID-19 Closures of US College Campuses: A Cross-Sectional Comparison Using Natural Language Processing.
Aluri J, Lewis S, Witmer AM … +6 more , Aguirre C, Howland Z, King L, Han S, Dredze M, Wilcox HC
Public Health Rep · 2026 Jun · PMID 42334438 · Full text
OBJECTIVES: Mental health screening platforms can be used to identify students in mental distress and can connect students to mental health services during disruptive events such as campus closures. We examined college s...
OBJECTIVES: Mental health screening platforms can be used to identify students in mental distress and can connect students to mental health services during disruptive events such as campus closures. We examined college students' utilization of a mental health screening platform in the year before and after COVID-19-related campus closures. METHODS: We analyzed 12 239 students across 31 US institutions who used the Interactive Screening Platform (ISP) in the 1 year before and after the COVID-19-related campus closure on March 15, 2020. We analyzed 3 outcomes: the monthly number of participants at each college, the proportion of participants who entered a dialogue with a mental health counselor, and the proportion of participants who sought a referral through the platform. To determine whether students sought a referral to mental health services, we used natural language processing methods to analyze messages between students and counselors. We used 2-sample tests to test for differences in means and χ tests to determine differences in proportions, with < .05 indicating significance. RESULTS: We found no significant differences in the mean number of participants before and after March 15, 2020 (14.4 vs 16.0 participants per month, respectively), the proportion of participants who participated in a dialogue with a counselor (22.9% [1327 of 5806] vs 23.3% [1501 of 6433]), or the proportion of participants who sought a referral (11.2% [649 of 5806] vs 10.9% [698 of 6433]). CONCLUSIONS: Student use of the ISP was sustained after the COVID-19-related campus closures, suggesting that the ISP can continue to engage with students during disruptions to campus life. The ISP is a tool that campus leaders can consider using during future disruptive events.
Change in Volume of Contacts to the National Call Center for Homeless Veterans After the US Supreme Court Ruling on .
Montgomery AE, Pandit K, DeRussy AJ … +2 more , Richman JS, Tsai J
Public Health Rep · 2026 Jun · PMID 42334429 · Full text
OBJECTIVES: Homelessness is an important public health issue, and the number of individuals experiencing unsheltered homelessness has increased since 2020. On June 28, 2024, the US Supreme Court issued a 6-to-3 decision...
OBJECTIVES: Homelessness is an important public health issue, and the number of individuals experiencing unsheltered homelessness has increased since 2020. On June 28, 2024, the US Supreme Court issued a 6-to-3 decision in , which broadened the authority of local governments to prohibit public camping. The National Call Center for Homeless Veterans (NCCHV) offers a 24/7 virtual option for veterans to access services to address housing instability. The objective of this study was to assess whether expanded local enforcement authority affected inflow and characteristics of individuals contacting NCCHV after the decision. METHODS: We used data from 418 814 contacts to NCCHV from January 1, 2023, through December 31, 2024. We conducted 3 types of analyses: (1) bivariate analysis comparing changes in contact characteristics using Wald χ tests, (2) direct comparisons of average weekly call volume using paired tests, and (3) an interrupted time-series analysis using an autoregressive linear regression model. RESULTS: While we did not observe seasonal variations in call volume, we found a significant increase in average weekly NCCHV call volume between the pre- and post- periods, from 3926.6 to 4394.8 calls (mean [95% CI] change in average weekly call volume: 468.2 [216.8-719.6; = .005). CONCLUSIONS: This study provides an indication of the association between the decision and an increase in help-seeking behavior (potentially representing increased needs) among veterans experiencing housing instability. Future work should assess on-the-ground changes in the needs of individuals experiencing housing instability and responses offered by providers of homeless services.
Youth Well-Being in the Digital Age: An Ongoing Priority for Public Health.
Young E, Rasberry CN, Wilkins NJ … +4 more , Mpofu JJ, Ashley C, Haridopolos S, Underwood JM
Public Health Rep · 2026 Jun · PMID 42318792 · Full text
Abstract loading — click title to view on PubMed.
Variation by Race and Ethnicity in the Population Attributable Fractions Associated With Key Tuberculosis Risk Factors in the United States.
Ahmed MM, Manjoo-Docrat R, Robsky KO … +6 more , Cilloni L, Beeler Asay GR, Kammerer JS, Marks SM, Dowdy D, Shrestha S
Public Health Rep · 2026 Jun · PMID 42289777 · Full text
OBJECTIVE: Although the overall incidence of tuberculosis (TB) in the United States has declined in the last 2 decades, the incidence among racial and ethnic minority populations remains elevated. The objective of this s...
OBJECTIVE: Although the overall incidence of tuberculosis (TB) in the United States has declined in the last 2 decades, the incidence among racial and ethnic minority populations remains elevated. The objective of this study was to estimate the contributions of 4 risk factors to the incidence of TB, stratified by race and ethnicity and recent transmission in the United States. METHODS: We estimated the population attributable fractions (PAFs) of TB and TB attributed to recent transmission (RT-TB) associated with HIV, diabetes, current incarceration, and past-year experience of homelessness in the United States during 2011-2015 and 2016-2019, stratified by race and ethnicity. RESULTS: The 4 risk factors contributed modestly to TB and RT-TB in the overall US population. During 2016-2019, the estimated PAFs for HIV were 5.0% of all TB cases (6.0% among RT-TB), 6.7% (6.0% among RT-TB) for diabetes, 2.8% (3.9% among RT-TB) for incarceration, and 4.1% (11.3% among RT-TB) for homelessness but varied substantially by race and ethnicity. Diabetes-associated PAFs for RT-TB were >10% among Asian, Hispanic, and Native Hawaiian or Other Pacific Islander populations but 0% among other populations. By contrast, PAFs for RT-TB associated with homelessness were <2% among Asian and Native Hawaiian or Other Pacific Islander populations but >10% among Hispanic, Black, American Indian or Alaska Native, and White populations. CONCLUSIONS: Efforts to reduce TB disparities in the United States should consider race and ethnicity and associated context.
From Research to Impact: Assessing a Decade of CDC's Public Health Science by Topic Area, 2014-2023.
Ortega J, Dunkley VE, Knuth M … +6 more , Kim C, Meites E, Yoo BB, Wainwright K, Zhu BP, Reynolds MG
Public Health Rep · 2026 Jun · PMID 42274309 · Full text
OBJECTIVES: To provide a sound foundation for public health policy and practice, scientific work must address priority topics and reach appropriate audiences. This analysis provides an evaluation of a large public health...
OBJECTIVES: To provide a sound foundation for public health policy and practice, scientific work must address priority topics and reach appropriate audiences. This analysis provides an evaluation of a large public health scientific publication portfolio. We explored the relevance and impact of a decade of Centers for Disease Control and Prevention (CDC)-authored publications. METHODS: We used Science Clips, a CDC library database, to identify 34 104 scientific publications published from 2014 through 2023 with ≥1 CDC-affiliated author. To identify public health topics, we applied a large language modeling framework using BERTopic to publication titles and abstracts. We obtained bibliometric indicator data from Altmetric, Dimensions, and BMJ Impact Analytics. We assessed the percentage of publications with online attention, academic citations, and policy citations; the median Altmetric Attention Score; and the median number of academic citations by topic area. RESULTS: Of CDC-authored publications published during 2014-2020, 94.6% were cited by academic articles and 52.4% were cited in clinical guidance or policy. Of those published during 2014-2023, 83.8% garnered online attention. Publications clustered into 46 public health topics. Fungal infections had the highest median number of academic citations (36.5 per publication), mining safety and health had the highest proportion of articles with policy citations (92.5%), and substance abuse or opioids received the highest median Altmetric Attention Score (14.0). More than one-quarter of topics ranked in the top 5 for ≥1 of the 3 indicators. CONCLUSIONS: CDC-authored scientific publications in this collection addressed an array of public health topics and demonstrated resonance in academic and policy arenas and with the public. Evaluating publication portfolios can strengthen science, policy, and communications partnerships.
Trends in Pediatric Opioid Ingestion and Associated Factors in Washington State, 2014-2023.
Nchinda NN, Leonard J, Sirotzki A … +2 more , Firth M, Fishman PA
Public Health Rep · 2026 Jun · PMID 42267705 · Full text
OBJECTIVES: Opioid intoxication among children is a growing public health concern given the increased prevalence of high-potency synthetic opioids in the United States. This study evaluated trends in pediatric opioid ing...
OBJECTIVES: Opioid intoxication among children is a growing public health concern given the increased prevalence of high-potency synthetic opioids in the United States. This study evaluated trends in pediatric opioid ingestions and associated demographic factors in Washington State. METHODS: We conducted a retrospective data review of Washington Poison Center nontherapeutic pediatric opioid exposures reported from January 2014 through December 2023 among children and adolescents aged 0 to 17 years. We assessed trends based on opioid type and demographic factors. We performed logistic regression analysis and calculated odds ratios (ORs) and 95% CIs. RESULTS: A total of 2873 pediatric opioid ingestions were reported; the mean (range) age was 7.4 (0.1-17.0) years, with a slight female predominance (52%). During the 10-year study period, we found a significant increase in fentanyl ingestion (9700%), a 59% decrease in hydrocodone ingestion, and a 56% decrease in oxycodone ingestion. Fentanyl ingestion (OR = 4.25; 95% CI, 2.88-6.22), adolescent age (OR = 2.00; 95% CI, 1.48-2.70), and a high-level neighborhood socioeconomic disadvantage (OR = 1.91; 95% CI, 1.36-2.73) had increased odds of a major effect (life threatening). We found 9 reported associated deaths. CONCLUSIONS: Recent trends of pediatric opioid ingestion in Washington State indicate a disproportionate increase in fentanyl ingestion and life-threatening effects associated with socioeconomically disadvantaged neighborhoods. Further studies and policy are needed to improve surveillance and prevention of pediatric opioid ingestions.
A US Public Health Service Commissioned Corps Response to a Syphilis Outbreak in Tribal Communities in South Dakota and North Dakota, 2025.
Gonzales KA, O'Connell MC, Taylor MM … +5 more , Chen TH, Broghammer T, VanderMay M, Peltier C, Holt NF
Public Health Rep · 2026 Jun · PMID 42260993 · Full text
From January 5 through April 4, 2025, and July 14 through October 10, 2025, the US Public Health Service Commissioned Corps conducted the largest reported deployment in response to a syphilis outbreak in US history. Duri...
From January 5 through April 4, 2025, and July 14 through October 10, 2025, the US Public Health Service Commissioned Corps conducted the largest reported deployment in response to a syphilis outbreak in US history. During two 90-day periods, 67 US Public Health Service officers were deployed in 30-day rotations across 9 Tribal areas within the Indian Health Service Great Plains Area and 3 urban centers in South Dakota and North Dakota to support ongoing outbreak activities. Overall, the deployment identified 139 people newly diagnosed with syphilis through screening 2913 people. By 30 days after deployments for the syphilis outbreak response, 126 (90.6%) people with newly diagnosed syphilis had started treatment. This case study highlights the effective coordination among the Indian Health Service, the US Public Health Service Commissioned Corps, state health departments, Tribal health agencies, the Great Plains Tribal Leaders Health Board, and other partners. Prioritized activities of the response included contact tracing, health care provider education, community-based screening events, and field-based administration of treatment. We describe the roles of culturally sensitive public health practice, interagency collaboration, and rapid clinical response in responding to sexually transmitted infection outbreaks. Experience gained in South Dakota and North Dakota may provide insightful direction for future large-scale infectious disease campaigns.
Public Health Perspectives on the Cost and Value of Certification for Disease Intervention Professionals.
Goldberg DG, Reiss AL, Gimm G
Public Health Rep · 2026 Jun · PMID 42257247 · Full text
OBJECTIVES: Enhancing the disease intervention (DI) workforce through professional certification has been a national goal for several decades. The objectives of this qualitative study were to (1) understand facilitators...
OBJECTIVES: Enhancing the disease intervention (DI) workforce through professional certification has been a national goal for several decades. The objectives of this qualitative study were to (1) understand facilitators and barriers to obtaining Certified in Disease Intervention (CDI) certification and (2) identify potential strategies to improve access to certification. METHODS: We used a grounded theory approach to accomplish these objectives and develop a conceptual framework of the major factors that influence DI specialist decisions to obtain professional certification. We conducted 9 virtual listening sessions in 2026 with 9 representatives from health departments across the United States. We used constant comparative analysis to collect data and perform data analysis. RESULTS: We organized key themes into a conceptual framework to explain influences on certification at 3 levels: societal/systems, organizational, and individual. At the societal/systems level, the major influences were availability of government funding to support certification, the overall movement to professionalize the DI workforce, and current political priorities. Funding, workload, local population needs, and the organizational structure and staffing model influenced the ability of organizations to support certification. At the individual level, the main influences were ability to pay, perceived value and benefit of CDI certification, and time to study and take the certification examination. CONCLUSIONS: CDI certification was viewed as a positive step toward enhancing the DI workforce by offering standardization, development of skills, and opportunities for career growth. The financial barrier of employees paying the full cost of CDI certification should be considered by employers and certification organizations. Cost subsidization and support are necessary to improve CDI certification uptake and sustain CDI recertification.
The Integral Role of Dentists During Disasters: Restoring Function, Nutrition, and Dignity.
Rizek J, Vos J
Public Health Rep · 2026 Jun · PMID 42251490 · Full text
OBJECTIVES: Dentistry is often portrayed in disaster literature as ancillary (forensics, logistics), while its clinical role in restoring oral function, preventing malnutrition, and supporting psychosocial recovery is un...
OBJECTIVES: Dentistry is often portrayed in disaster literature as ancillary (forensics, logistics), while its clinical role in restoring oral function, preventing malnutrition, and supporting psychosocial recovery is underemphasized. The objective of this research was to highlight the role of dentists in disaster response. METHODS: This conceptual analysis synthesized published accounts, policy statements, and field examples to reframe dental contributions in disaster settings as essential components of survival and recovery. It examined oral/maxillofacial trauma care, infection control, links between oral health and nutrition, and dignity-restoring prosthodontic interventions. RESULTS: Dentists provided interventions that stabilized airways, reduced infection risk, controlled pain, restored chewing and speech, and supported nutritional rehabilitation, outcomes that materially affect survival and recovery. Despite these contributions, dental professionals are rarely integrated into disaster health systems and emergency medical teams (EMTs). CONCLUSION: Incorporating dental capabilities into disaster frameworks (EMTs, US National Disaster Medical System), predeployment training, mobile dental assets, and nutrition-oral health integration can improve functional recovery and dignity for disaster survivors. Research and policy development are needed to quantify the effect of dental interventions on health outcomes and to standardize deployment pathways.
Evaluating the Impact of the Federal Tobacco 21 Legislation on Adolescent E-Cigarette Use and Risk Perceptions.
Geletko KW, Mills J, Dix N … +3 more , Bomma M, Price A, Harman J
Public Health Rep · 2026 Jun · PMID 42244307 · Full text
OBJECTIVES: The rise in popularity of electronic cigarettes (e-cigarettes) among adolescents in the United States during the past decade is concerning because of the device's novelty and potential long-term health effect...
OBJECTIVES: The rise in popularity of electronic cigarettes (e-cigarettes) among adolescents in the United States during the past decade is concerning because of the device's novelty and potential long-term health effects. In response, a federal Tobacco 21 (T21) law was enacted in 2019 to raise the minimum age for purchasing tobacco products and e-cigarettes from 18 to 21 years. We examined changes in adolescent e-cigarette use after implementation of T21 during a period of broader federal tobacco control activity. METHODS: We analyzed data from the 2019 and 2020 National Youth Tobacco Survey (NYTS) to assess changes in e-cigarette use among middle and high school students aged 9 to 19 years (most aged 13-17 y) following implementation of the federal T21 law. Weighted logistic regression models examined associations between policy implementation and current e-cigarette use, controlling for demographic characteristics and perceived harm and addictiveness. RESULTS: The prevalence of current e‑cigarette use declined from 16% (95% CI, 15%-18%) in 2019 to 11% (95% CI, 10%-13%) in 2020. After implementation of the federal T21 law in December 2019, adolescents were significantly less likely to use e‑cigarettes, with a 24% reduction in the odds of current use (odds ratio = 0.76; 95% CI, 0.64-0.91; = .003). CONCLUSIONS: Federal legislation such as increasing the minimum age for purchasing tobacco and nicotine products may be an effective strategy in reducing and preventing e-cigarette use among adolescents. Future research should assess the sustainability of the effects of T21 legislation over time and examine how federal policies interact with other public health interventions to influence adolescent e-cigarette use.
Time to Progress Through the Latent Tuberculosis Infection Care Cascade in Primary Care.
Wu AZ, Aiona K, Murrill M … +3 more , Narita M, Skarbinski J, Winglee K
Public Health Rep · 2026 Jun · PMID 42244306 · Full text
OBJECTIVES: Although treatment of latent tuberculosis infection (LTBI) is highly effective for preventing tuberculosis disease, diagnosis requires several steps. A care cascade is a helpful framework for identifying the...
OBJECTIVES: Although treatment of latent tuberculosis infection (LTBI) is highly effective for preventing tuberculosis disease, diagnosis requires several steps. A care cascade is a helpful framework for identifying the clinical events necessary for successful LTBI treatment, yet the timing of progression through these events is poorly characterized. We calculated the timing of an LTBI care cascade and assessed whether timing was associated with increased cascade progression. METHODS: We conducted an observational study through the Tuberculosis Epidemiologic Studies Consortium using electronic health records to calculate the timing of steps in the LTBI care cascade in the United States from 2020 through 2022 (N = 693 254 patients). Using receiver operating characteristic curves, we identified optimal maximum times (OMTs) associated with cascade progression, and we calculated risk ratios to compare outcomes between patients who advanced above and below OMTs. RESULTS: The median (IQR) time from most recent test order to test result was 3 (1-4) days; from most recent test order to imaging order, 7 (4-18) days; from imaging order to treatment prescription, 17 (6-40) days; from treatment prescription to treatment start, 0 (0-1) days; from treatment start to treatment completion, 116 (103-120) days; and for the entire cascade, 150 (133-189) days. Risk ratios for cascade progression ranged from 1.10 to 2.81, demonstrating that patients completing steps below the OMTs showed marginally higher likelihoods of progression through the care cascade. CONCLUSIONS: These findings highlight the importance of sustained follow-up and caution against early classification of patients as lost to care, supporting public health strategies for health systems, programs, health care providers, and care navigators that emphasize long-term engagement to maximize the preventive effect of LTBI treatment.
A Qualitative Evaluation of Community Colleges as a Pathway to the Certified in Disease Intervention Credential.
Gale KS, Dailey-Provost J, Bateman M … +3 more , Hilman J, Shoaf K, Gren LH
Public Health Rep · 2026 Jun · PMID 42244305 · Full text
OBJECTIVE: Community colleges can offer short-term training due to their flexible scheduling, affordable tuition, and capacity to integrate certification opportunities within programs tailored to regional workforce needs...
OBJECTIVE: Community colleges can offer short-term training due to their flexible scheduling, affordable tuition, and capacity to integrate certification opportunities within programs tailored to regional workforce needs. We identified existing assets and readiness to develop a Certified in Disease Intervention credential at community colleges to expand the disease intervention (DI) workforce. METHODS: From fall 2024 through spring 2025, 2 community colleges in the western United States participated in mapping a DI professional job task analysis (JTA) using course syllabi (n = 12) and assignments to identify curricular gaps. DI employer listening sessions (n = 13) provided additional input on job skills. We conducted listening sessions with 4 college faculty, 3 staff, and 14 students to evaluate the feasibility of DI training and identify student support strategies. The research team evaluated educational frameworks to develop an approach for community colleges to assess readiness for implementing DI professional training. RESULTS: Community college courses mapped to the JTA more commonly for knowledge (range, 21.3%-72.3%) than for skills (range, 0%-66.0%). Feasibility to implement DI training at the community college level was viewed favorably by employers, faculty, staff, and students. Students identified needs for additional social supports, particularly for students from underrepresented populations. Steps for community colleges interested in providing curriculum to support DI certification included (1) mapping existing or proposed curriculum, (2) identifying curricular gaps and building opportunities for demonstrating JTA skills, and (3) evaluating the feasibility of adding new programming. CONCLUSION: DI professional training can likely be implemented successfully at community colleges. With modest adjustments to current courses, community colleges can document competencies that may enhance preparation for national DI certification.
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