OBJECTIVE: During the first year of the COVID-19 pandemic, most of the Centers for Disease Control and Prevention (CDC)'s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) funded programs (recipients) experienced significant declines in breast and cervical cancer screening volume. However, 6 recipients maintained breast and/or cervical cancer screening volume during July-December 2020 despite their states' high COVID-19 test percent positivity. We led a qualitative multi-case study to explore these recipients' actions that may have contributed to screening volume maintenance. METHODS: We conducted 22 key informant interviews with recipients, screening provider sites, and partner organizations. Interviews explored organizational and operational changes; screening barriers; actions taken to help maintain screening volume; and support for provider sites to continue screening. We documented contextual factors that may have influenced these actions, including program structures; clinic capacity; and state COVID-19 policies. RESULTS: Thematic analysis revealed crosscutting themes at the recipient, provider site, and partner levels. Recipients made changes to administrative processes to reduce burden on provider sites and delivered tailored technical assistance to support safe screening. Provider sites modified clinic protocols to increase patient safety, enhanced patient reminders for upcoming appointments, and increased patient education on the importance of timely screening during the pandemic. Partners worked with provider sites to identify and reduce patients' structural barriers to screening. CONCLUSION: Study findings provide lessons learned to inform emergency preparedness-focused planning and operations, as well as routine operations for NBCCEDP recipient programs, other cancer screening initiatives, primary care clinics, and chronic disease prevention programs.

PURPOSE: The ads from the first federally funded national tobacco education campaign, Tips From Former Smokers (Tips), considerably increased quitline calls nationwide. This study evaluates the effect of Tips on state-specific quitline calls. DESIGN: Precampaign, during-campaign, and postcampaign comparison; regression modeling. SETTING: All fifty states as well as the District of Columbia. SUBJECTS: Calls to state quitlines. INTERVENTION: Tips. MEASURES: Tips campaign exposure was measured by gross rating points (GRPs). Calls to quitline's 1-800-QUIT-NOW were assigned to markets in each state based on their area codes. ANALYSIS: Multivariate regression was used to assess the relationship between calls to state quitlines and media market-level Tips GRPs, while controlling for market and area code characteristics. RESULTS: Nationally, every 100 Tips GRPs per week at the market level was associated with an average of 45 additional quitline calls in each area code (beta = 44.65, p < .001). Tips GRPs were associated with significant increases in quitline calls in 46 states and the District of Columbia, of which 11 experienced effects significantly larger than the national average and 5 experienced significantly smaller effects. We were unable to detect statistically significant effects of GRPs on call volumes for four states. Graphically, call volumes in those states followed Tips GRPs. CONCLUSION: The Tips campaign significantly increased calls to quitlines for almost all the states. These findings underscore the effectiveness of national tobacco media campaigns for reaching state audiences.

What is already known on this topic? Quitting smoking is beneficial to health at any age, and cigarette smokers who quit before age 35 years have mortality rates similar to those of persons who never smoked. What is added by this report?During 2001-2010, the proportion of adult cigarette smokers who had made a quit attempt in the past year increased significantly in 29 states and the U.S. Virgin Islands. During 2011-2013, the proportion who had made a quit attempt increased in Hawaii and Puerto Rico and decreased in New Mexico. In 2013, the proportion who had made a quit attempt ranged from 56.2% (Kentucky) to 76.4% (Puerto Rico and Guam) with a median of 65.9%, and was generally lower in older age groups. What are the implications for public health practice? Continued implementation of effective evidence-based public health interventions can reduce the health and costs impacts of smoking-related disease and death and accelerate progress toward meeting the Healthy People 2020 target to increase to >/=80% the proportion of U.S. adult cigarette smokers who made a quit attempt in the past year. These interventions include increasing the price of tobacco products, implementing comprehensive smoke-free laws, conducting educational mass media campaigns, and providing insurance coverage for all effective cessation treatments as well as access to quitlines.

OBJECTIVES: Consumption of fruit and vegetables among children is generally below recommended levels. This evaluation addressed two questions: (1) To what extent did children's attitudes toward, familiarity with, and preferences for fruit and vegetables change during the school year? and (2) To what extent did children's consumption of fruit and vegetables change during the school year? METHODS: During the 2004-2005 school year, the Mississippi Department of Education, Child Nutrition Programs initiated a pilot program to distribute free fruit and vegetables to students (kindergarten through 12th grade) during the school day. Data were collected in 2004-2005 within a one-group pretest/posttest design using a self-report questionnaire (n=725) and 24-hour dietary recalls (n=207) with a sample of students from five schools in Mississippi. Data were analyzed in 2006-2007. RESULTS: Results showed greater familiarity with fruit and vegetables at all grade levels (p<0.05) and increased preferences for fruit among eighth- and 10th-grade students (p<0.01). Eighth-grade students also reported more positive attitudes toward eating fruit and vegetables (p<0.01), increased perceived self-efficacy to eat more fruit (p<0.01), and increased willingness to try new fruit. Finally, results showed increased consumption of fruit, but not vegetables, among eighth- and 10th-grade students (p<0.001). CONCLUSIONS: Distributing free fruit and vegetables at school may be a viable component of a more comprehensive approach for improving students' nutrition attitudes and behaviors. More program emphasis is needed on ways to promote vegetable consumption.