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Articles 4141 - 4170 of 13034
Full-Text Articles in Public Health
Using Increased Trust In Medical Researchers To Increase Minority Recruitment: The Recruit Cluster Randomized Clinical Trial, Barbara C Tilley, Arch G Mainous, Rossybelle P Amorrortu, M Diane Mckee, Daniel W Smith, Ruosha Li, Stacia M Desantis, Sally W Vernon, Gary Koch, Marvella E Ford, Vanessa Diaz, Jennifer Alvidrez
Using Increased Trust In Medical Researchers To Increase Minority Recruitment: The Recruit Cluster Randomized Clinical Trial, Barbara C Tilley, Arch G Mainous, Rossybelle P Amorrortu, M Diane Mckee, Daniel W Smith, Ruosha Li, Stacia M Desantis, Sally W Vernon, Gary Koch, Marvella E Ford, Vanessa Diaz, Jennifer Alvidrez
Faculty, Staff and Student Publications
While extensive literature exists on barriers and strategies to increase minority participation in clinical trials, progress is limited. Few strategies were evaluated in randomized trials. We studied the impact of RECRUIT, a trust-based, cluster randomized minority recruitment trial layered on top of four traditional NIH-funded parent trials (BMT CTN, CABANA, PACES, STEADY-PD III; fifty specialty sites). RECRUIT was conducted from July 2013 through April 2017. Intervention sites implemented trust-based approaches customized to individual sites, promoting relationships between physician-investigators and minority-serving physicians and their minority patients. Control sites implemented only parent trials' recruitment procedures. Adjusting for within-site clustering, we detected no …
Barriers To Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: A Systematic Review, Trisha L Amboree, Charles Darkoh
Barriers To Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: A Systematic Review, Trisha L Amboree, Charles Darkoh
Faculty, Staff and Student Publications
BACKGROUND: Human papillomavirus (HPV) is associated with poor health outcomes, including cervical cancer. Racial/ethnic minority populations experience poor health outcomes associated with HPV at higher rates. A vaccine is available to protect against HPV infections and prevent HPV-related sequelae; however, vaccination rates have remained low in the United States (U.S.) population. Thus, there is an urgent need to increase the HPV vaccination rate. Moreover, little is known about barriers to HPV vaccination in racial/ethnic minority groups. This paper highlights the most recent findings on barriers experienced by these groups.
METHODS: The PubMed database was searched on July 30, 2020, for …
The Multi-Step Approach To Covid Prevention In The Casamance Region, Saraí Hernandez Salguero
The Multi-Step Approach To Covid Prevention In The Casamance Region, Saraí Hernandez Salguero
Independent Study Project (ISP) Collection
Located in the Oussouye Department approximately 43 kilometers away from the city of Ziguinchor in the Basse Casamance region of southern Senegal is the Oussouye commune where I had the pleasure of staying for three weeks. I had learned that the inhabitants of this village were not significantly impacted by the Covid-19 virus since it became global knowledge at the start of 2020. As of March 2020, the village had only reported 69 active cases and the department saw only 8 deaths in total. I sought to figure out what could be the cause of this and through a series …
Analysis Of The Moroccan Government & Ngos Responses To Migrant Health Crisis, Jepchirchir Mutwol
Analysis Of The Moroccan Government & Ngos Responses To Migrant Health Crisis, Jepchirchir Mutwol
Independent Study Project (ISP) Collection
Healthcare access in Morocco for migrants has been a topic of growing interest. With the implementation of migration reforms in response to Morocco becoming a destination for migrants, it is important to assess the effectiveness of government policies in aiding migrant health. Additionally, assessing other political actors' influence in government policies is equally important. Through research of existing scholarship, I theorize that the biggest issue impacting migrant access to health is the illegalization of migrants. Without being a legal resident, let alone in asylum or a refugee, migrants cannot access public health services without the fear of deportation. Local and …
Disability And Healthcare Access In Morocco: Social And Cultural Influences, Christa Shipman
Disability And Healthcare Access In Morocco: Social And Cultural Influences, Christa Shipman
Independent Study Project (ISP) Collection
I stepped into the SIT Multiculturalism and Human Rights program as a pre-physical therapy student with experience working and volunteering in the disability rights arena. Striking personal encounters with Moroccans combined with these past experiences drew me to investigate how social and cultural factors influence access to healthcare for people with disabilities. I hypothesized that access to medical care is limited by social or cultural mindsets, perceptions, or beliefs for those in my target population. This subject is relevant to Morocco as a developing country and as a society with, in some cases, fixed social dynamics, while in other areas …
Los Efectos Psicosociales Que Produce El Embarazo En Las Vidas De Madres Adolescentes En Quito, Ecuador, Kaylee Howell
Los Efectos Psicosociales Que Produce El Embarazo En Las Vidas De Madres Adolescentes En Quito, Ecuador, Kaylee Howell
Independent Study Project (ISP) Collection
Research Question: What are the psychological and social effects of teen pregnancy facing teen mothers in 2021 and how do they impact their lives? Objective: The general objective is to describe the psychosocial implications produced by teen pregnancy. Background: Teen pregnancy rates of Latin America and the Caribbean are second in the world, second only to the region of Subsaharan-Africa. Within Latin America, Ecuador has the highest rates of adolescent pregnancy, surpassed only by Venezuela. Recently, the taboo surrounding reproductive health has been challenged, with the matter of abortion being brought to the supreme court. In conjunction with the matter …
Comparación Entre Las Percepciones Médicas Y Psicológicas De La Diabetes Tipo 2 Y La Tuberculosis En El Ecuador, Héctor Ortiz
Comparación Entre Las Percepciones Médicas Y Psicológicas De La Diabetes Tipo 2 Y La Tuberculosis En El Ecuador, Héctor Ortiz
Independent Study Project (ISP) Collection
Research Question: What are the differences and similarities between the perceptions of the medical and psychological management of both type 2 diabetes and tuberculosis? Objectives: The principal objective of this study is to understand the perceptions behind DM2 and TB as well as how these perceptions affect the care of these diseases. Secondary objectives are to define the epidemiological transition, describe the medical and psychological management and care of DM2 and TB, analyze how the people perceive the management and psychological care of DM2 and TB, and analyze the comparison of the perceptions of both diseases. Background: The epidemiological transition …
Assessing The Need For And Access To Migrant-Sensitive Rehabilitative Healthcare: An Analysis Of Current Swiss And German Practices, Lauren Cuppy
Independent Study Project (ISP) Collection
In recent years, the noticeable increase in migration has placed scrutiny on the migrant-sensitive services provided in healthcare settings globally. Migrants, in general, experience different health issues and worse health outcomes than non-migrants. In response to this, healthcare systems around the world have begun implementing migrant-sensitive healthcare (MSHC) systems; yet, although nearly a third of the world’s population experiences some health condition that would benefit from rehabilitation, the implementation of MSHC rehabilitation services have been critically understudied. This paper seeks to investigate the geographic and MSHC accessibility of rehabilitation in Geneva, Switzerland to fill the current gap of literature and …
Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel
Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel
Independent Study Project (ISP) Collection
Drug use, policy and outcomes differ in all countries; however, trends exist in response to these circumstances and can typically be evaluated through a pragmatic and moralistic lens. The public health, and evidence-based pragmatic approach differs from the law enforcement-centered moralistic approach, specifically in outcomes of people suffering from substance use disorder. Particularly for opioid use disorder, countries that have taken the pragmatic approach in response to opioid epidemics have had dramatic results. Two of the countries discussed include Switzerland and Portugal, with additional information on the Netherlands. In contrast, current opioid epidemics exist in certain countries who maintain a …
Spatial Disparities: The Role Of Nativity In Neighborhood Exposure To Alcohol And Tobacco Retailers, Georgiana Bostean, Luis A. Sánchez, Jason A. Douglas
Spatial Disparities: The Role Of Nativity In Neighborhood Exposure To Alcohol And Tobacco Retailers, Georgiana Bostean, Luis A. Sánchez, Jason A. Douglas
Sociology Faculty Articles and Research
Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012–2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors …
Vaccine Hesitancy Within Nevada Counties, June 2021, Kelliann Beavers, Madison Frazee-Bench, William E. Brown Jr.
Vaccine Hesitancy Within Nevada Counties, June 2021, Kelliann Beavers, Madison Frazee-Bench, William E. Brown Jr.
Health
This fact sheet highlights estimated rates of vaccine hesitancy, vaccination rates, the index of social vulnerability, and the level of concern for 17 Nevada counties as of June, 2021. The data are reported in the U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation (ASPE) estimates.
Human-Machine Communication: Complete Volume. Volume 3. Diffusion Of Human-Machine Communication During And After The Covid-19 Pandemic
Human-Machine Communication
This is the complete volume of HMC Volume 3. Diffusion of Human-Machine Communication During and After the COVID-19 Pandemic
Article Processing Charge Waiver Policies As A Barrier To Oncology Scholarship In Low-And Lower-Middle-Income Countries, Ulysses G. Gardner Jr., Petria S. Thompson, Jason C. Burton, Caleb Stewart, Clifton D. Fuller, Michael K. Rooney, Ethan B. Ludmir
Article Processing Charge Waiver Policies As A Barrier To Oncology Scholarship In Low-And Lower-Middle-Income Countries, Ulysses G. Gardner Jr., Petria S. Thompson, Jason C. Burton, Caleb Stewart, Clifton D. Fuller, Michael K. Rooney, Ethan B. Ludmir
MEDI 9331 Scholarly Activities Clinical Years
No abstract available
Sexual Health Misinformation And Potential Interventions Among Youth On Social Media, Jahnavi Sunkara
Sexual Health Misinformation And Potential Interventions Among Youth On Social Media, Jahnavi Sunkara
The Cardinal Edge
With the rise of the internet and social media, many adolescents and young adults have turned to the internet and social media for sexual health information. However, this can be problematic because sexual health misinformation on social media utilizes a variety of techniques to quickly disseminate and retain that misinformation in users. Historically, the spread of sexual health misinformation has specifically negatively impacted adolescents and young adults regarding two sexual health topics: contraceptives and HPV vaccination. Current evidence demonstrates that a combination of corrections and inoculation would be effective against general health misinformation. However, there is a lack of research …
Hope2 Addresses Hispanic Health Inequity In Northeast, Fl: A Call To Action To Local And State Officials. A Commentary., Catherine Saenz, Judith C. Rodriguez, Manisha Salinas, Richard O. White Iii
Hope2 Addresses Hispanic Health Inequity In Northeast, Fl: A Call To Action To Local And State Officials. A Commentary., Catherine Saenz, Judith C. Rodriguez, Manisha Salinas, Richard O. White Iii
Florida Public Health Review
No abstract provided.
What Predicts How Safe People Feel In Their Neighborhoods And Does It Depend On Functional Status?, Alfredo J. Velasquez, Jason A. Douglas, Fangqi Guo, Jennifer W. Robinette
What Predicts How Safe People Feel In Their Neighborhoods And Does It Depend On Functional Status?, Alfredo J. Velasquez, Jason A. Douglas, Fangqi Guo, Jennifer W. Robinette
Health Sciences and Kinesiology Faculty Articles
Feeling unsafe in one's neighborhood is related to poor health. Features of the neighborhood environment have been suggested to inform perceptions of neighborhood safety. Yet, the relative contribution of these features (e.g., uneven sidewalks, crime, perceived neighborhood physical disorder) on perceived neighborhood safety, particularly among people with disabilities who may view themselves as more vulnerable, is not well understood. We examined whether sidewalk quality assessed by third party raters, county-level crime rates, and perceived neighborhood disorder would relate to neighborhood safety concerns, and whether functional limitations would exacerbate these links. Using data from the 2012/2014 waves of the Health and …
4-H Student Nutrition Advisory Councils Support Positive Youth Development And Health Outcomes Among Underserved Populations, Shannon Klisch, Katherine E. Soule
4-H Student Nutrition Advisory Councils Support Positive Youth Development And Health Outcomes Among Underserved Populations, Shannon Klisch, Katherine E. Soule
Journal of Extension
4-H SNAC Clubs engage youth in low-income schools with majority Latinx enrollment in leadership activities to increase schoolwide health and wellness. 4-H SNAC Clubs aim to develop youth health leaders, establish youth-adult partnerships, and increase access to 4-H in Latinx communities. Outcomes related to healthful living and positive youth development were assessed using the Teen Teacher Retrospective Survey (n=59) across five 4-H SNAC Clubs. Results show positive outcomes related to self-reported health behaviors for students and their families and leadership development. 4-H SNAC Clubs can increase access to 4-H among Latinx youth and support healthier communities through the Supplemental Nutrition …
Post Pandemic Aquatics: Professionals On Deck, Susan J. Grosse
Post Pandemic Aquatics: Professionals On Deck, Susan J. Grosse
International Journal of Aquatic Research and Education
As aquatic programs re-open and/or expand as COVID restrictions lift, avoiding virus transmission is a top health and safety concern. This article presents options for safe social distancing for professionals and participants during teaching of swim lessons, coaching sessions, and aquatic exercise classes. Emphasis is on practical, session-to-session issues. Suggestions are applicable to all ages of participants in aquatic programs. Focus is on information for aquatic professionals providing direct participant service. Guidelines for program management are also included.
Do Water Safety Lessons Improve Water Safety Knowledge?, Michael J. Tipton, Joseph Muller, Cristian Abelairas Gomez, Jo Corbett
Do Water Safety Lessons Improve Water Safety Knowledge?, Michael J. Tipton, Joseph Muller, Cristian Abelairas Gomez, Jo Corbett
International Journal of Aquatic Research and Education
A person, usually a child or young adult, dies by drowning every 90 seconds around the planet. Most drowning prevention initiatives do not assess the efficacy of the intervention. In this study, thirteen- to fourteen-year-olds had their level of water safety knowledge (covering cold shock, rips and tides) assessed before, just after, and 3-6 months after one, 25-minute water safety lesson on these topics. We evaluated the knowledge gained and retained on water safety “awareness” (i.e., knowledge of risks) and “confidence” in terms of knowing what to do in an emergency. The results demonstrated that the lesson significantly increased water …
Engaging Rural High School Youth In E-Cigarette Prevention And Advocacy, Melinda J. Ickes, Olivia Zidzik, Nathan L. Vanderford
Engaging Rural High School Youth In E-Cigarette Prevention And Advocacy, Melinda J. Ickes, Olivia Zidzik, Nathan L. Vanderford
Journal of Interprofessional Practice and Collaboration
Introduction: Recent national data reinforce over 3.6 million young people across the United States are currently using e-cigarettes, but little research exists on prevention and/or youth engagement strategies.
Purpose: Pilot a peer led e-cigarette prevention and advocacy training and determine attitudes and self-efficacy among participating rural high school leaders post-training.
Methods: The study incorporated a one-group, post-test design. Participants were recruited from an existing student leadership program (N = 16) which provides advanced cancer education and training to high school students who are from Appalachian Kentucky who participated in an e-cigarette prevention and empowerment training in December 2019. Data …
Real-Time Geospatial Analysis Identifies Gaps In Covid-19 Vaccination In A Minority Population, Cici Bauer, Kehe Zhang, Miryoung Lee, Michelle Jones, Arturo Rodriguez, Isela De La Cerda, Belinda Reininger, Susan P Fisher-Hoch, Joseph B Mccormick
Real-Time Geospatial Analysis Identifies Gaps In Covid-19 Vaccination In A Minority Population, Cici Bauer, Kehe Zhang, Miryoung Lee, Michelle Jones, Arturo Rodriguez, Isela De La Cerda, Belinda Reininger, Susan P Fisher-Hoch, Joseph B Mccormick
Faculty, Staff and Student Publications
COVID-19 vaccination is being rapidly rolled out in the US and many other countries, and it is crucial to provide fast and accurate assessment of vaccination coverage and vaccination gaps to make strategic adjustments promoting vaccine coverage. We reported the effective use of real-time geospatial analysis to identify barriers and gaps in COVID-19 vaccination in a minority population living in South Texas on the US-Mexico Border, to inform vaccination campaign strategies. We developed 4 rank-based approaches to evaluate the vaccination gap at the census tract level, which considered both population vulnerability and vaccination priority and eligibility. We identified areas with …
The Association Of Parent-Child Communication With Internet Addiction In Left-Behind Children In China: A Cross-Sectional Study, Jingjing Cai, Yun Wang, Feng Wang, Jingjing Lu, Lu Li, Xudong Zhou
The Association Of Parent-Child Communication With Internet Addiction In Left-Behind Children In China: A Cross-Sectional Study, Jingjing Cai, Yun Wang, Feng Wang, Jingjing Lu, Lu Li, Xudong Zhou
Pharmacy Faculty Articles and Research
Objective: Internet addiction has emerged as a growing concern worldwide. This study aimed to compare the prevalence of Internet addiction between left-behind children (LBC) and non-left-behind children (non-LBC), and explore the role of paternal and maternal parent-child communication on LBC.
Methods: We conducted a cross-sectional survey in rural areas in Anhui, China. The complete data were available from 699 LBC and 740 non-LBC. Multivariable logistic regression was used to examine 1) whether LBC were more likely to develop Internet addiction, and 2) the association between parent-child communication and Internet addiction among LBC.
Results: LBC had a higher likelihood to report …
Challenges In Conducting Online Videoconferencing Qualitative Interviews With Adolescents On Sensitive Topics, Salima Moez Meherali, Samantha Louie-Poon
Challenges In Conducting Online Videoconferencing Qualitative Interviews With Adolescents On Sensitive Topics, Salima Moez Meherali, Samantha Louie-Poon
The Qualitative Report
In the wake of COVID-19, researchers are seeking innovative data-collection methods. Computer-mediated communication platforms have played a pivotal role among these pursuits. However, conducting online interviews present challenges to both researchers and participants. Online data-collection forces researchers to give up control over the study environment due to the varying location participants partake in interviews. Consequently, researchers can no longer fully guarantee the confidentiality and privacy of the researcher-participant conversations. Participants may face difficulties if being asked to disclose private information in the presence of family members. These challenges are heightened when conducting online interviews with adolescents on sensitive topics. Thus, …
Paternal Parenting Stress During Middle Childhood: The Impact Of Covid-19, Vanessa Newell, Kathryn E. Cherry, Emily D. Gerstein
Paternal Parenting Stress During Middle Childhood: The Impact Of Covid-19, Vanessa Newell, Kathryn E. Cherry, Emily D. Gerstein
Undergraduate Research Symposium
Background: Parenting stress is the unpleasant psychological reaction to the demands of parenthood, including perceptions of competence at and knowledge of the day-to-day and long-term tasks of parenting (Deater-Deckard 2006). While most research has examined mothers, father parenting stress is also critical to children’s development, predicting increased problem behaviors (Cabrera & Mitchell 2009) and poorer cognitive skills (Harwood, 2017). The COVID-19 pandemic may increase parental stress in multiple ways, as parents are at home more with their children while fulfilling occupational and personal responsibilities. Parents have reported increased stress due to job loss, school closures, and other stressors (van Tilburg …
Cost-Effectiveness Analysis Comparing Integrated And Malaria-Only Social And Behavior Change Programming In Nigeria: Initial Costing Data, Avenir Health
Sexual and Reproductive Health, Rights, and Choices
Breakthrough RESEARCH is conducting an effectiveness evaluation of social and behavior change (SBC) programming implemented by Breakthrough ACTION in Nigeria, comparing an integrated SBC program in Kebbi and Sokoto states with a malaria-only SBC program in Zamfara state. Using these results on impact, a cost-effectiveness analysis will determine which approach is more cost-effective in achieving improvements in health. This report presents estimated costs for the initial stage of the project, from April 2018 through December 2019, in the three northern states where the study is being conducted.
Breakthrough Research—Social And Behavior Change Costing Community Of Practice Series Brief #3: Capturing The Start-Up Costs Associated With Social And Behavior Change Interventions, Breakthrough Research
Breakthrough Research—Social And Behavior Change Costing Community Of Practice Series Brief #3: Capturing The Start-Up Costs Associated With Social And Behavior Change Interventions, Breakthrough Research
Sexual and Reproductive Health, Rights, and Choices
A successful social and behavior change (SBC) intervention requires the investment of time and resources in the intervention’s start-up phase, which is defined as the time from the project initiation until the project begins broad implementation. When conducting a costing study of an SBC intervention, it is useful to capture these initial costs separately and allocate them appropriately over the life of the intervention. By examining start-up costs separately, the post-start-up implementation costs can be forecasted more accurately for future budgeting purposes and for determining the appropriate costs for scaling-up interventions. This is the third in a series of briefs …
Food-As-Medicine: An Everyday Strategy Of Health, Rachel Rebecca Bogan
Food-As-Medicine: An Everyday Strategy Of Health, Rachel Rebecca Bogan
Dissertations, Theses, and Capstone Projects
Using food-as-medicine, a valuable strategy of health, as its focus, this dissertation examines why and how New Yorkers use food to negotiate their health. I argue that while using food medicinally is a common health practice, food-as-medicine operates unequally among different groups of New Yorkers. I attribute this inequity, in part, to how those in power, including public health experts, biomedical doctors, and the food industry, operationalize food-as-medicine as a health remedy and to a neoliberal, healthist context that ties people’s morally “correct” uses of food-as-medicine to their abilities to access “good” citizenship and optimal health.
I chose to write …
Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph
Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph
Mental Health / Substance Use Disorders
Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.
The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …
Precision Public Health Campaign: Delivering Persuasive Messages To Relevant Segments Through Targeted Advertisements On Social Media, Jisun An, Haewoon Kwak, Hanya M. Qureshi, Ingmar Weber
Precision Public Health Campaign: Delivering Persuasive Messages To Relevant Segments Through Targeted Advertisements On Social Media, Jisun An, Haewoon Kwak, Hanya M. Qureshi, Ingmar Weber
Research Collection School Of Computing and Information Systems
Although established marketing techniques have been applied to design more effective health campaigns, more often than not, the same message is broadcasted to large populations, irrespective of unique characteristics. As individual digital device use has increased, so have individual digital footprints, creating potential opportunities for targeted digital health interventions. We propose a novel precision public health campaign framework to structure and standardize the process of designing and delivering tailored health messages to target particular population segments using social media–targeted advertising tools. Our framework consists of five stages: defining a campaign goal, priority audience, and evaluation metrics; splitting the target audience …
The 2021 Ipr Future Of Communications In Asia Report, Tina Mccorkindale, Sarah Crawshaw, Su Lin Yeo, Stephen Thomas, Alexis B. Fitzsimmons, Pang, A.
The 2021 Ipr Future Of Communications In Asia Report, Tina Mccorkindale, Sarah Crawshaw, Su Lin Yeo, Stephen Thomas, Alexis B. Fitzsimmons, Pang, A.
Research Collection Lee Kong Chian School Of Business
The communication function within Asian-headquartered organizations is undergoing significant growth and changes that will be pivotal for its future success, according to a new Institute for Public Relations (IPR) research report. The “IPR Future of Communications in Asia” research report investigates key changes that will impact the future of the communications function. The analysis is based on interviews with 30 senior communications executives based in Asia in a variety of industries from 2019 to 2020, and three focus groups with nearly 20 senior communication leaders in late 2020.