American journal of preventive medicine
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The 2-1-1 helpline is a social services innovation that has spread rapidly throughout the U.S. Policy diffusion theory suggests that policymakers seek to reduce uncertainty by anticipating the effects of a proposed innovation through tools such as cost-benefit analyses. Few policy diffusion studies have examined use of information, such as cost-benefit analyses, in the diffusion process. The purpose of this study is to examine how cost-benefit analyses were used during the rapid diffusion of 2-1-1 across states. The paper also describes components of 2-1-1 cost-benefit analyses. ⋯ The diffusion of 2-1-1 helplines in the U.S. has been influenced by interjurisdictional exchange of cost-benefit analyses, in both the creation of original analyses and/or the referencing of previous work.
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Hurricanes Katrina and Rita struck the Gulf Coast forcing unprecedented mass evacuation and devastation. Texas 2-1-1 is a disaster communication hub between callers with unmet needs and community services at disaster sites and evacuation destinations. ⋯ New disaster management strategies and policies are needed for evacuation destinations to support extended evacuation and temporary or permanent relocation. Planning and monitoring disaster resources for unmet needs over time and location could be targeted effectively using real-time 2-1-1 call patterns. Smaller evacuation communities were more vulnerable, exhausting their limited resources more quickly. Emergency managers should devise systems to more quickly authorize vouchers and reimbursements. As 2-1-1s expand and coordinate disaster roles nationwide, opportunities exist for analysis of unmet disaster needs to improve disaster management and enhance community resiliency.
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Randomized Controlled Trial Multicenter Study
Aid-assisted decision making and colorectal cancer screening: a randomized controlled trial.
Shared decision making (SDM) is a widely recommended yet unproven strategy for increasing colorectal cancer (CRC) screening uptake. Previous trials of decision aids to increase SDM and CRC screening uptake have yielded mixed results. ⋯ Decision aid-assisted SDM has a modest impact on CRC screening uptake. A decision aid plus personalized risk assessment tool is no more effective than a decision aid alone.