The Covid-19 pandemic has complicated efforts to address the US’s opioid crisis with a comprehensive, multi-part federal effort that combines primary medical care, essential support services, outreach to persons who misuse substances, patient engagement, and access to medications for opioid use disorder (OUD). This webinar will focus on how the pandemic is impacting efforts to address the opioid crisis. The panelists will also discuss some of the recommendations of the ASPPH Task Force on Public Health Approaches to the Opioid Crisis and how the pandemic might impact the panel’s recommendations, including its recommendation that a multi-site, multi-institutional collaborative evaluation structure be created that can leverage the strengths of different universities and agencies toward an effective, coordinated approach.

Discuss recommendations of the ASPPH Task Force on Public Health Initiatives to Address the Opioid Crisis. Learn from members of the academic public health community other/alternative public health initiatives to address the crisis.

The opioid crisis has accounted for 770 000 deaths in the United States over the past 20 years, a number approximately equal to the first 20 years of the AIDS epidemic.1 A substantial portion of these deaths were the direct result of overprescription of opioids, and many others were caused by former prescription opioid users migrating to less expensive and easier to obtain heroin and synthetic opioids, such as fentanyl and its analogues. The opioid crisis has contributed to the decline in US overall life expectancy for 3 consecutive years; the first 3 year-on-year decline in US life expectancy since the 1918 flu pandemic.

Parents acquire information about human papillomavirus (HPV) vaccines online and encounter vaccine-critical content, especially on social media, which may depress vaccine uptake. Secondary analysis in a randomized trial of a Facebook-delivered adolescent health campaign targeting mothers with posts on HPV vaccination was undertaken with the aims of (a) determining whether the pre-post-change occurred in self-reports of the mothers on HPV vaccination of their adolescent daughters; (b) describing the comments and reactions to vaccine posts; (c) exploring the relationship of campaign engagement of the mothers assessed by their comments and reactions to posts to change in the self-reports of the mothers of HPV vaccination. Mothers of daughters aged 14-17 were recruited from 34 states of the US ( = 869). A social media campaign was delivered in two Facebook private groups that differed in that 16% of posts in one were focused on indoor tanning (IT) and 16% in the other, on prescription drug misuse, assigned by randomization. In both groups, posts promoted HPV vaccination ( = 38 posts; no randomization) and vaccination for other disease (e.g., influenza, = 49). HPV and other vaccination posts covered the need for a vaccine, the number of adolescents vaccinated, how vaccines are decreasing the infection rates, and stories of positive benefits of being vaccinated or harms from not vaccinating. Guided by social cognitive theory and diffusion of innovations theory, posts were intended to increase knowledge, perceived risk, response efficacy (i.e., a relative advantage over not vaccinated daughters), and norms for vaccination. Some vaccination posts linked to stories to capitalize on identification effects in narratives, as explained in transportation theory. All mothers received the posts on vaccination (i.e., there was no randomization). Mothers completed surveys at baseline and 12- and 18-month follow-up to assess HPV vaccine uptake by self-report measures. Reactions (such as sad, angry) and comments to each HPV-related post were counted and coded. Initiation of HPV vaccination (1 dose) was reported by 63.4% of mothers at baseline, 71.3% at 12-month posttest (pre/post < 0.001), and 73.3% at 18-month posttest (pre/post < 0.001). Completion of HPV vaccination (two or three doses) was conveyed by 50.2% of mothers at baseline, 62.5% at 12-month posttest (pre/post < 0.001), and 65.9% at 18-month posttest (pre/post < 0.001). For posts on HPV vaccines, 8.1% of mothers reacted ( = 162 total), and 68.4% of posts received a reaction (63.2% like; 13.2% love, 7.9% sad). In addition, 7.6% of mothers commented ( = 122; 51 unfavorable, 68 favorable, 1 neutral), and 50.0% of these posts received a comment. There were no differences in pre-post change in vaccine status by the count of reactions or comments to HPV vaccine posts (Ps > 0.05). Baseline vaccination was associated with the valence of comments to HPV vaccine posts (7.2% of mothers whose daughters had completed the HPV series at baseline made a favorable comment but 7.6% of mothers whose daughters were unvaccinated made an unfavorable comment). Effective strategies are needed in social media to promote HPV vaccines and counter misinformation about and resistance to them. Mothers whose daughters complete the HPV vaccine course might be recruited as influencers on HPV vaccines, as they may be predisposed to talk favorably about the vaccine. Comments from mothers who have not been vaccinated should be monitored to ensure that they do not spread vaccine-critical misinformation. Study limitations included lack of randomization and control group, relatively small number of messages on HPV vaccines, long measurement intervals, inability to measure views of vaccination posts, reduced generalizability related to ethnicity and social media use, and use of self-reported vaccine status. www.clinicaltrials.gov, identifier NCT02835807.

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Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. A meta-evaluation was completed of studies evaluating a specific household water treatment method, the biosand water filter. Results from the meta-evaluation illustrate that biosand water filters improve drinking water quality and reduce diarrheal disease. However, there is no generally agreed upon field method for determining biosand water filter effectiveness that is useable in low-resource communities. A pilot study was conducted of potential field use indicators, including the Colilert coliform Presence/ Absence test, hydrogen sulfide, alkalinity, hardness, pH, and fluorescently-labeled latex microspheres. The study included both laboratory and field testing. The Colilert Presence/ Absence test had the highest correlation to the United States Environmental Protection Agency standard method (IDEXX Quanti-trays), but more data is needed before making a recommendation. This study adds to understanding about evaluation of biosand water filters and provides preliminary data to address the need for a field use indicator for biosand water filters.

In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration–funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an academic health department (AHD) involving the East Tennessee State University College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessment and community-centered practice. Similarly, the COPH recognized the need to expand evidence-based practice implementation and evaluation opportunities for public health students. Personnel from the SCRHD, LIFEPATH, and the COPH developed a formal AHD agreement during the summer of 2012 and launched the program the subsequent fall semester. One aspect of the COPH/SCRHD/LIFEPATH model that addresses financial barriers experienced by other AHDs is the competitive awarding of the coordinator position to a doctor of public health student from the COPH, demonstrating investment in the model by the college. The doctor of public health student gains leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. The SCRHD benefits from the formal academic background of graduate-level interns dedicated to working in the community. This AHD framework offers an opportunity for doctoral-level students to develop practical leadership skills in a health department while enhancing the capacity of the SCRHD and the COPH to serve their community and stakeholders.

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Frequently, educational approaches are considered as a dichotomy – liberal versus professional. However, perpetuating this dichotomy may not best serve students or the workforce. We are at the forefront of an educational movement and it is critical that we think intentionally about who we are training our students to be and how do we best do it. Baccalaureate public health education is occurring in a range of locations including community colleges, traditional liberal arts schools, and schools of public health. Faculty and staff have a diverse range of training and experience in educational frameworks, In addition, this educational movement is occurring at a time when the disciplinary boundaries of public health are expanding and becoming less defined.