Background: While COVID-19 vaccines have significantly reduced severe infections and mortality, individuals with Alzheimer’s disease and related dementias (ADRD) remain highly at risk for long COVID, which can worsen cognitive decline and overall health. Long COVID, characterized by persistent symptoms such as fatigue, cognitive impairment (“brain fog”), and respiratory issues, presents challenges for individuals with ADRD. Understanding long COVID's impact is essential for developing targeted interventions to support aging population with ADRD.

Methods: This retrospective cohort study utilized the All of Us (AOU) Researcher Workbench to analyze electronic health records (EHR) of individuals with ADRD, identifying those with documented post-COVID symptoms. Key variables included demographics, comorbidities, cognitive function assessments, and healthcare utilization. Logistic regression and propensity score matching was applied to compare ADRD patients with and without long COVID symptoms, examining associations with disease progression, neuropsychiatric, and chronic conditions while adjusting for potential confounders.

Results: Individuals with ADRD who experienced long COVID had higher rates of persistent fatigue, worsening cognitive impairment, and increased difficulties in daily functioning compared to those without long COVID. They also exhibited a greater incidence of neuropsychiatric symptoms such as depression, anxiety, and sleep disturbances. ADRD population with pre-existing chronic conditions, including COPD, diabetes, hypertension, cardiovascular disease, kidney disease, and autoimmune disorders, faced more severe and prolonged health challenges.

Conclusion: This study highlights the long-term impact of COVID-19 on individuals with ADRD, emphasizing the importance of emergency preparedness in healthcare systems to support ADRD population during and after pandemics and improve access to essential medical services.

Background: The COVID-19 pandemic has had a profound impact on the psychological well-being of individuals, with stigma emerging as significant issues faced by COVID-19 survivors. This study aimed to explore multidimensional components of stigma faced by COVID-19 survivors in Eastern region of Nepal.

Methods: The study was conducted using qualitative research methodology in the Eastern region of Nepal. In-depth interviews were conducted with fifteen COVID-19 survivors over the phone. Thematic analysis was used to identify themes and sub-themes related to how participants experienced and negotiated multiple forms of stigma.

Results: The findings emphasize the complex and multi-layered nature of COVID-19 stigma, which includes social rejection, self-perceived stigma, discrimination from family and friends, and taunting or negative labelling from community members. Participants were forced into quarantine at hotels despite facing financial hardships, and COVID-19 survivors were removed by the police. This situation led to a loss of trust, reduced confidence, and negative effects on physical health, mental health, and overall well-being. The factors driving stigma and discrimination include a lack of knowledge and awareness about COVID-19 infection, screening, and treatment; fear of co-infection and its potential consequences; a fragile healthcare system; inadequate policies; a failure to address myths and misconceptions; and insufficient knowledge and skills to prepare for and respond to the pandemic, including dealing with stigmatization.

Conclusion: Mass education and awareness initiatives play a key role for enhancing understanding disease transmission, prevention, and control measures to address the individual, interpersonal and systemic stigma and discrimination.

The COVID-19 pandemic's long-term impacts on employee burnout and retention are serious problems that have had a big influence on healthcare systems around the globe. The causes of burnout are examined in this abstract, including growing workloads, psychological stress, and the changing landscape of healthcare delivery. It investigates the difficulties encountered by medical personnel as well as the long-term effects on their job satisfaction and mental health. The study highlights how crucial it is to address worker retention through enhanced support networks, legislative modifications, and strategic interventions in order to lower burnout and guarantee a long-lasting healthcare workforce. The presentation will include key findings and suggestions for reducing the pandemic's effects on healthcare professionals.

Background: The state of Rhode Island legalized sports betting in 2023. This study examined if the legalization of sports betting changed gambling behaviors in Rhode Island (RI) young adults.

Methods: Data from the 2022 (n=1022) and 2024 (n=1008) waves of the Rhode Island Young Adult Survey (RIYAS) was used. Participants were 18-26 years old and were residents of RI for at least part of the year. Participation in sports betting and other gambling activities (e.g., lottery tickets, scratch games) and symptoms of gambling disorder was measured in both survey waves. Logistic regression models assess the policy impacts after adjustment for age, sexual and gender status, race, ethnicity, relative social status, education, and employment.

Results: Sports betting (4.4% to 7.1%, p=0.008), and odds of sports betting after legalization was almost 3 times higher among sexual/gender minorities (OR [95%CI]) = 2.72 [1.09, 6.79]). There were no significant changes in other similar betting activities (p’s>0.05). Problem gambling (2.5% to 4.3%, p=0.032) significantly increased from 2022 to 2024 as well, with odds of screening positive for problem gambling 79% higher after legalization among all participants (OR [95%CI]) = 1.79 [1.05, 3.08]).

Conclusion: The behavioral changes that resulted from this policy change need to be analyzed to further assess strategies for harm reduction and gambling interventions to mitigate the negative impacts sports betting and gambling could bring to vulnerable individuals.

Background

Women in recovery from opioid use disorder (OUD) experience sexual and reproductive health (SRH) differences such as rates of unintended pregnancy, sexually transmitted infections, and intimate partner violence when compared to women without OUD. While in recovery, women engage with recovery healthcare clinicians (physicians, nurses, therapists, peer support, case managers), but little is known about their experiences in providing SRH to women in recovery. The purpose of our study was to understand multi-level perception of barriers and facilitators of SRH services within OUD recovery programs.

Methods

We used a qualitative descriptive study design and purposively recruited healthcare providers (age 18 or older and English speaking) who serve women in recovery from OUD. We conducted one-on-one audio recorded telephone interviews which were professionally transcribed, verified, and analyzed following thematic analysis.

Results

Among the N=34 participants in the study, there were therapists (n=13, 38%), leaders/managers (n=5, 15%), physicians (n=5, 15%), registered nurses (n=4, 12%), peer support specialists (n=3, 9%), nurse practitioners (n=2, 6%), and case managers/social workers (n=2, 6%). We identified two overarching themes and (sub themes): Barriers (Training Needs, Stigma and Feelings of Shame, and Siloed Nature of Healthcare) and Facilitators (Community of Shared Experiences and Envisioning Ideal SRH Programming).

Conclusions

Healthcare providers in OUD recovery spaces recognized the important need for improved SRH for women in recovery, however systemic barriers and training gaps are barriers to the provision of care. Existing shared recovery spaces and multi-disciplinary considerations of SRH programming may help to address health differences.

Background: Black people living with HIV often face a healthcare system that overlooks, mistreats, or devalues them. Racism, stigma, and neglect aren’t just occasional issues—they are daily barriers. This study looks at how individuals push back against those injustices, drawing on personal strength, community, and self-advocacy to survive and thrive.

Methods: We conducted in-depth interviews with Black individuals living with HIV to hear directly from them about their experiences. Through careful analysis of their stories, we identified common themes around how they cope with discrimination and navigate broken systems.

Results: Participants shared their mistreatment experience at healthcare settings, including being dismissed by doctors, overlooked by case managers, and made to feel judged or unseen in healthcare spaces. Despite these harms, many found ways to stand up for themselves—challenging unfair treatment, relying on trusted friends and community networks, and drawing strength from spirituality and cultural identity. Participants mentioned multiple coping strategies, ranging from spiritual practice and self-advocacy to community engagement and social connection.

Discussion: While these stories highlight the harms caused by systemic bias, they also reveal the remarkable resilience of Black individuals living with HIV. These findings underscore the urgent need for structural transformation in healthcare. Moving beyond cultural competence, institutions must commit to equity-driven efforts for groups impacted by HIV.

Background

Studies of health-related interventions often include organizational partners during planning phases to help ensure the feasibility of measuring individual-level outcomes. However, beginning a study with such partners in place reduces or removes the ability to examine whether organizations’ interest in participating is generalizable. Relatedly, few studies offer detailed strategies or workflows for organizational recruitment methods. Yet, understanding organizational recruitment at a granular level is critical for reproducible research. As part of a national US study, we designed a methodology and web app to partially automate and systematize the organizational recruitment process.

Methods

As part of a nationwide randomized controlled trial, we developed a web app using PHP and Javascript/HTML (with a MySQL database) to assist with recruitment of 180 randomly selected first responder agencies. Subsequently, we created multiple email and voicemail templates to standardize recurrent agency interactions.

Results

Through development and iterations of the web app and templates, study recruitment efforts have become increasingly streamlined. For example, the addition of a ‘filter by timezone’ option helps our team account for time variations when contacting agencies. The introduction of automated reminder emails (linked to ‘last correspondence date’) and recruitment communication templates has improved our capacity to monitor agency recruitment progress and ensure consistency in follow-up.

Conclusion

The implementation of this technology-supported workflow will enable granular quantitative reporting on organizational recruitment (e.g., average number of contact attempts of each type); we believe that this approach has the potential to be widely adapted and adopted for health-related organizational research recruitment efforts.

Background:
The shortage of skilled healthcare workers (HCWs) in sub-Saharan Africa limits access to high-quality family planning (FP) services. Subcutaneous depot medroxyprogesterone acetate self-injection (DMPA-SC SI) offers a promising solution, empowering women and reducing provider workload. However, provider capacity gaps hinder uptake. In Plateau State, Nigeria, the Ministry of Health integrated supportive supervision (ISS) and mentoring into the health system to strengthen HCW skills in counseling and initiating DMPA-SC SI.

Intervention:
The program used two approaches: (1) ISS, with monthly facility visits using national FP checklists, and (2) ISS plus on-the-job mentoring by trained providers. Both were embedded in routine systems to enhance sustainability and scalability.

Methods:
A quasi-experimental study was conducted from April to August 2024 across three LGAs: Jos North (control), Jos South (ISS only), and Bassa (ISS + mentoring). Seventy-seven FP providers from 70 facilities participated. Pre- and post-intervention assessments used a 3-point rating scale to score counseling and initiation skills. Descriptive and inferential statistics assessed performance changes.

Results:
Bassa (ISS + mentoring) showed significant improvements: median counseling scores rose from 5 to 22.5 (p < 0.001); mean initiation scores reached 25.2 (p < 0.001). ISS alone also improved outcomes but to a lesser extent.

Conclusions:
ISS and mentoring significantly enhance provider skills in DMPA-SC SI service delivery. Embedding these strategies in existing systems offers a scalable, cost-effective model to expand contraceptive access and advance universal health coverage in resource-limited settings.