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Many conservation actions must be implemented with limited data. This is especially true when planning recovery efforts for extirpated populations, such as grizzly bears (Ursus arctos) within the Bitterroot Ecosystem (BE), where strategies for reestablishing a resident population are being evaluated. Here, we applied individual-based movement models developed for a nearby grizzly bear population to predict habitat use in and near the BE, under scenarios of natural recolonization, reintroduction, and a combination. All simulations predicted that habitat use by grizzly bears would be higher in the northern half of the study area. Under the natural recolonization scenario, use was concentrated in Montana, but became more uniform across the northern BE in Idaho over time. Use was more concentrated in east-central Idaho under the reintroduction scenario. Assuming that natural recolonization continues even if bears are reintroduced, use remained widespread across the northern half of the BE and surrounding areas. Predicted habitat maps for the natural recolonization scenario aligned well with outlier and GPS collar data available for grizzly bears in the study area, with Spearman rank correlations of ≥0.93 and mean class values of ≥9.1 (where class 10 was the highest relative predicted use; each class 1-10 represented 10% of the landscape). In total, 52.4% of outlier locations and 79% of GPS collar locations were in class 10 in our predicted habitat maps for natural recolonization. Simulated grizzly bears selected habitats over a much larger landscape than the BE itself under all scenarios, including multiple-use and private lands, similar to existing populations that have expanded beyond recovery zones. This highlights the importance of recognizing and planning for the role of private lands in recovery efforts, including understanding resources needed to prevent and respond to human-grizzly bear conflict and maintain public acceptance of grizzly bears over a large landscape.

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Children and adolescents with serious emotional disturbance represent 7-12 percent of all youth in the United States. In 2017, the State of Idaho implemented the Youth Empowerment Service program, which allows youth with serious emotional disturbance who are younger than age eighteen living in households with income up to 300 percent of the federal poverty level to qualify for Medicaid and receive intensive, community-based treatment. A uniquely detailed method was used to assess the need for services: the Child and Adolescent Needs and Strengths tool, a ninety-seven-indicator instrument administered by a clinician. We used these indicators and Idaho's 2018-22 administrative Medicaid claims data to study the association between children and adolescents' clinical needs complexity and their actual Medicaid behavioral and mental health service use. Our findings show that there was a substantial proportion of youth who were underusing Medicaid behavioral and mental health care services, and there were virtually no overusers. Our findings have implications for the appropriateness of Medicaid utilization management in behavioral health care and program efforts to maintain families with youth having serious emotional disturbance in the Youth Empowerment Service program.

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Forest water reclamation is a decades-old practice of repurposing municipal reclaimed water using land application on forests to filter nutrients and increase wood production. However, long-term application may lead to nutrient saturation, leaching, and potential impairment of ground and surface water quality. We studied long-term effects of reclaimed water application on nutrient leaching potential in a four-decade time series of forest water reclamation facilities in northern Idaho. Our approach compared reclaimed water treated plots with untreated control plots at each of the forest water reclamation facilities. We measured soil nitrifier abundance and net nitrification rates and used tension lysimeters to sample soil matrix water and drain gauges to sample from a combination of matrix and preferential flow paths. We determined nutrient leaching as the product of soil water nutrient concentrations and model-estimated drainage flux. There was more than 450-fold increase in nitrifier abundance and a 1000-fold increase in net nitrification rates in treated plots compared with control plots at long-established facilities, indicating greater nitrate production with increased cumulative inputs. There were no differences in soil water ammonium, phosphate, and dissolved organic nitrogen concentrations between control and effluent treatments in tension lysimeter samples. However, concurrent with increased nitrifier abundance and net nitrification, nitrate concentration below the rooting zone was 2 to 4-fold higher and nitrate leaching was 4 to 10-fold higher in effluent treated plots, particularly at facilities that have been in operation for over two decades. Thus, net nitrification and nitrifier abundance assays are likely indicators of nitrate leaching potential. Inorganic nutrient concentrations in drain gauge samples were 2 to 11-fold higher than lysimeter samples, suggesting nutrient losses occurred predominantly through preferential flow paths. Nitrate was vulnerable to leaching during the wet season under saturated flow conditions. Although nitrogen saturation is a concern that should be mitigated at long-established facilities, these forest water reclamation facilities were able to maintain average soil water nitrate concentrations to less than 2 mg L-1, so that nitrogen and phosphorous are effectively filtered to below safe water standards.

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Misleading statements in a recent Obstetrics & Gynecology article require correction. No state has an abortion law that is a total ban on abortion. Every state law permits abortion when necessary to save a mother's life. Texas law does not require an "imminent" risk and allows a doctor to use his "reasonable medical judgment" to determine if an abortion is necessary to prevent a "risk" of maternal death. Similarly, Idaho allows a doctor to use his "good faith medical judgment" to determine when to intervene, without need for "immediacy".

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The purpose of this paper is to describe the implementation and outcomes of a unique traumatic brain injury (TBI) screening initiative serving the community, with a focus on underserved populations. Idaho's definition of underserved populations includes people living in rural/frontier areas, people experiencing homelessness or intimate partner violence, people with co-occurring disorders, and people with cultural and/or linguistically diverse backgrounds. The goals of screenings are to help participants gain awareness about the likelihood of having experienced a TBI, bridge the gap in TBI reporting, and provide needed support to underserved populations in a rural state. Our work represents a cross-sectional study. Beginning in 2014, TBI screenings were conducted by the Institute of Rural Health within a public health university with several internal and external partners, as well as grant funding for work. Trained interprofessional health students and/or members of the Institute of Rural Health performed TBI screenings using the Ohio State University TBI Identification Method-Interview Form. Those who screened as likely experiencing a TBI received resources for care and follow-up telephone calls. Data were collected on the number of individuals screened and their results and reported using descriptive statistics. From 2014 to 2022, a total of 1333 individuals were screened at 23 different community events across Idaho. Over 30% of screened individuals reported a history of head or neck injury, primarily due to falls and being hit by objects. The majority of identified cases of TBI were characterized by no loss of consciousness or <30 min of unconsciousness. Screenings targeting underserved populations showed higher TBI prevalence. Targeting underserved populations proved valuable in identifying TBI cases. The collaborative and interprofessional approach of this screening is unique and highlights the potential to address complex health issues effectively. These findings offer valuable insights for others implementing TBI screening programs in community settings.

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BACKGROUND: The COVID-19 pandemic disrupted how primary care patients with chronic pain received care. Our study sought to understand how long-term opioid therapy (LtOT) for chronic pain changed over the course of the pandemic overall and for different demographic subgroups. METHODS: We used data from electronic health records of 64 primary care clinics across Washington state and Idaho to identify patients who had a chronic pain diagnosis and were receiving long-term opioid therapy. We defined 10-month periods in 2019 to 2021 as prepandemic, early pandemic and late pandemic and used generalized estimating equations analysis to compare across these time periods and demographic characteristics. RESULTS: We found a proportional decrease in LtOT for chronic pain in the early months of the pandemic (OR = 0.94, P = .007) followed by an increase late pandemic (OR = 1.08, P = .002). Comparing late pandemic to prepandemic, identifying as Asian or Black, having fewer comorbidities, or living in an urban area were associated with higher likelihood of being prescribed LtOT. DISCUSSION: The use of LtOT for chronic pain in primary care has increased from before to after the COVID-19 pandemic with racial/ethnic and geographic disparities. Future research is needed to understand these disparities in LtOT and their effect on patient outcomes.

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BACKGROUND: Creating useful clinical quality measure (CQM) reports in a busy primary care practice is known to depend on the capability of the electronic health record (EHR). Two other domains may also contribute: supportive leadership to prioritize the work and commit the necessary resources, and individuals with the necessary health information technology (IT) skills to do so. Here we describe the results of an assessment of the above 3 domains and their associations with successful CQM reporting during an initiative to improve smaller primary care practices' cardiovascular disease CQMs. METHODS: The study took place within an AHRQ EvidenceNOW initiative of external support for smaller practices across Washington, Oregon and Idaho. Practice facilitators who provided this support completed an assessment of the 3 domains previously described for each of their assigned practices. Practices submitted 3 CQMs to the study team: appropriate aspirin prescribing, use of statins when indicated, blood pressure control, and tobacco screening/cessation. RESULTS: Practices with advanced EHR reporting capability were more likely to report 2 or more CQMs. Only one-third of practices were "advanced" in this domain, and this domain had the highest proportion of practices (39.1%) assessed as "basic." The presence of advanced leadership or advanced skills did not appreciably increase the proportion of practices that reported 2 or more CQMs. CONCLUSIONS: Our findings support previous reports of limited EHR reporting capabilities within smaller practices but extend these findings by demonstrating that practices with advanced capabilities in this domain are more likely to produce CQM reports.

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BACKGROUND: Land uses such as crop production, livestock grazing, mining, and urban development have contributed to degradation of drylands worldwide. Loss of big sagebrush (Artemisia tridentata) on disturbed drylands across the western U.S. has prompted massive efforts to re-establish this foundational species. There has been growing interest in avoiding the severe limitations experienced by plants at the seed and seedling stages by instead establishing plants from containerized greenhouse seedlings ("tubelings"). In some settings, a potential alternative approach is to transplant larger locally-collected plants ("wildlings"). We compared the establishment of mountain big sagebrush (A. tridentata ssp. vaseyana) from tubelings vs. wildlings in southeastern Idaho. A mix of native and non-native grass and forb species was drill-seeded in a pasture previously dominated by the introduced forage grass, smooth brome (Bromus inermis). We then established 80 m x 80 m treatment plots and planted sagebrush tubelings (n = 12 plots, 1200 plants) and wildlings (n = 12 plots, 1200 plants). We also established seeded plots (n = 12) and untreated control plots (n = 6) for long-term comparison. We tracked project expenses in order to calculate costs of using tubelings vs. wildlings as modified by probability of success. RESULTS: There was high (79%) tubeling and low (10%) wildling mortality within the first year. Three years post-planting, chance of survival for wildlings was significantly higher than that of tubelings (85% and 14% respectively). Despite high up-front costs of planting wildlings, high survival rates resulted in their being < 50% of the cost of tubelings on a per-surviving plant basis. Additionally, by the third year post-planting 34% of surviving tubelings and 95% of surviving wildlings showed evidence of reproduction (presence / absence of flowering stems), and the two types of plantings recruited new plants via seed (3.7 and 2.4 plants, respectively, per surviving tubeling/wildling). CONCLUSIONS: Our results indicate that larger plants with more developed root systems (wildlings) may be a promising avenue for increasing early establishment rates of sagebrush plants in restoration settings. Our results also illustrate the potential for tubelings and wildlings to improve restoration outcomes by "nucleating" the landscape via recruitment of new plants during ideal climate conditions.

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Exotic annual grass invasion is a widespread threat to the integrity of sagebrush ecosystems in Western North America. Although many predictors of annual grass prevalence and native perennial vegetation have been identified, there remains substantial uncertainty about how regional-scale and local-scale predictors interact to determine vegetation heterogeneity, and how associations between vegetation and cattle grazing vary with environmental context. Here, we conducted a regionally extensive, one-season field survey across burned and unburned, grazed, public lands in Oregon and Idaho, with plots stratified by aspect and distance to water within pastures to capture variation in environmental context and grazing intensity. We analyzed regional-scale and local-scale patterns of annual grass, perennial grass, and shrub cover, and examined to what extent plot-level variation was contingent on pasture-level predictions of site favorability. Annual grasses were widespread at burned and unburned sites alike, contrary to assumptions of annual grasses depending on fire, and more common at lower elevations and higher temperatures regionally, as well as on warmer slopes locally. Pasture-level grazing pressure interacted with temperature such that annual grass cover was associated positively with grazing pressure at higher temperatures but associated negatively with grazing pressure at lower temperatures. This suggests that pasture-level temperature and grazing relationships with annual grass abundance are complex and context dependent, although the causality of this relationship deserves further examination. At the plot-level within pastures, annual grass cover did not vary with grazing metrics, but perennial cover did; perennial grasses, for example, had lower cover closer to water sources, but higher cover at higher dung counts within a pasture, suggesting contrasting interpretations of these two grazing proxies. Importantly for predictions of ecosystem response to temperature change, we found that pasture-level and plot-level favorability interacted: perennial grasses had a higher plot-level cover on cooler slopes, and this difference across topography was starkest in pastures that were less favorable for perennial grasses regionally. Understanding the mechanisms behind cross-scale interactions and contingent responses of vegetation to grazing in these increasingly invaded ecosystems will be critical to land management in a changing world.

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Elaeophorosis, infection by the filarial worm Elaeophora schneideri, is a parasitic disease of wild ungulates in North America; however, our understanding of the relevance of E. schneideri to moose (Alces alces) morbidity and mortality is incomplete. Between March 2020 and July 2022, necropsy and histopathology were performed on 61 Shiras moose (Alces alces shirasi) in Idaho, US. Among the 41 adults (greater than 1 yr old), 21 moose were from northern Idaho, and 20 were from southeastern Idaho. Elaeophorosis was diagnosed in 24% (10 of 41). All 10 infected moose were from southeastern Idaho; none of the 21 moose from northern Idaho were infected. No juvenile moose (nine from northern and 11 from southeastern Idaho) were infected. Microfilariae were detected histologically in 9 of 10 infected moose, most consistently in brain tissue associated with lesions indicative of ischemic injury to the neuroparenchyma attributed to occlusion of arterioles and capillaries by microfilariae or fibrin thrombi, including edema, necrosis, and glial nodules. Microfilariae found in other tissues of the head, including the eye, tongue, and pinnae of some animals, as well as in lung, heart, liver, and kidney, typically were associated with inflammation. Three of the 10 infected moose had cropped ears attributed to elaeophorosis, and four exhibited abnormal behavior, which may have been due to neuropathology associated with E. schneideri microfilariae in the brain.

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As part of our interest in the volatile phytoconstituents of aromatic plants of the Great Basin, we have obtained essential oils of Ambrosia acanthicarpa (three samples), Artemisia ludoviciana (12 samples), and Gutierrezia sarothrae (six samples) from the Owyhee Mountains of southwestern Idaho. Gas chromatographic analyses (GC-MS, GC-FID, and chiral GC-MS) were carried out on each essential oil sample. The essential oils of A. acanthicarpa were dominated by monoterpene hydrocarbons, including α-pinene (36.7-45.1%), myrcene (21.6-25.5%), and ß-phellandrene (4.9-7.0%). Monoterpene hydrocarbons also dominated the essential oils of G. sarothrae, with ß-pinene (0.5-18.4%), α-phellandrene (2.2-11.8%), limonene (1.4-25.4%), and (Z)-ß-ocimene (18.8-39.4%) as major components. The essential oils of A. ludoviciana showed wide variation in composition, but the relatively abundant compounds were camphor (0.1-61.9%, average 14.1%), 1,8-cineole (0.1-50.8%, average 11.1%), (E)-nerolidol (0.0-41.0%, average 6.8%), and artemisia ketone (0.0-46.1%, average 5.1%). This is the first report on the essential oil composition of A. acanthicarpa and the first report on the enantiomeric distribution in an Ambrosia species. The essential oil compositions of A. ludoviciana and G. sarothrae showed wide variation in composition in this study and compared with previous studies, likely due to subspecies variation.

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BACKGROUND: A shortage of healthcare providers, particularly in primary care and mental health, exists in the predominately rural state of Idaho. There are also barriers to retaining healthcare providers to work in rural and remote communities. Limited research using U.S. samples has explored factors that may affect the retention of healthcare providers in rural areas. Additionally, due to differences between communities, it is important to conduct community-level investigations to better understand how these factors may affect retention in rural areas. Therefore, the purpose of this study was to explore factors affecting healthcare provider retention in a rural community in Northern Idaho. METHODS: A modified version of the Nursing Community Apgar Questionnaire (NCAQ) was completed by 30 healthcare providers in a rural and frontier community in Northern Idaho to assess factors influencing healthcare provider retention. Factors were classified into classes including geographic, economic, scope of practice, medical support, and facility and community support classes. Retention factors were assessed on their perceived importance to retention as well as whether they were perceived as an advantage or challenge to retention based on Likert scales. A "Community Apgar" score was also created by combining the importance and advantage/challenge factors. RESULTS: Overall, items in the medical support group had the highest importance of any other class and included factors such as nursing workforce. Additionally, the facility and community support class, which included factors such as televideo support, was rated the highest advantage class and had the highest Apgar score, indicating it contained the factor that healthcare providers identified as the most important advantage (i.e., medical reference resources). CONCLUSION: Our study identified multiple factors that healthcare providers deemed as important advantages or disadvantages to retaining healthcare providers in rural areas. Overall, facility and community support factors were found to have the highest advantage in the retention of rural providers. Rural healthcare organizations looking to increase healthcare provider retention should target retention efforts towards these factors. Additional research should also be conducted on other rural samples across the U.S. to make comparisons of findings.

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National pharmacy associations have increasingly explored regulation according to a "standard of care." In such a model, pharmacists can provide a wide range of clinical services aligned with their education and training. Based on Idaho's experience implementing this model, there are five critical steps states must take to enact a standard of care: 1) Adopt a broad definition of "practice of pharmacy;" 2) Allow elasticity for practice innovation over time; 3) Decide which limited instances still necessitate prescriptive regulation; 4) Eliminate all unnecessary regulations; and 5) Strengthen accountability for deviations from the standard of care. States wishing to adopt a standard of care approach can follow this five-step process to enhance patient care and mitigate the lag that is otherwise constant between laws and practice.

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INTRODUCTION: Alignment of National Breast and Cervical Cancer Early Detection Program (NBCCEDP) clinical services with the spatial distribution of breast and cervical cancer burden is essential to maximizing programmatic impact and addressing cancer disparities. This study identified spatial clustering of breast and cervical cancer burden scores and assessed whether and to what extent NBCCEDP clinical services were associated with clusters for the 5-year period, 2015-2019. METHODS: We examined burden scores for spatial clustering using Local Indicators of Spatial Association (LISA) tests in GeoDA. We then used t-tests to compare the NBCCEDP 5-year average percentage of eligible women served clinical breast and cervical cancer services between hotspot (high burden) and coolspot clusters. RESULTS: There was statistically significant spatial clustering in the pattern of breast and cervical cancer burden scores across counties, with hotspot clusters mostly observed in the Southern region, Idaho and Nevada. For both breast and cervical cancer, higher percentages of eligible women received breast and cervical cancer clinical services in coolspot clusters compared to hotspot clusters during each year from 2015-2019. CONCLUSION: NBCCEDP clinical services can help reduce breast and cervical cancer burden. Yet, during 2015-2019, increased service delivery was not aligned with the spatial distribution of counties with greater breast and cervical cancer burdens. NBCCEDP recipients may improve their impact on breast and cervical cancer burden by prioritizing and consistently increasing service delivery in cancer burden hotspot clusters if they have not already maximized their resources in these areas.

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INTRODUCTION: The Environmental Protection Agency (EPA)'s Worker Protection Standards is the primary set of legislation aimed at protecting farmworkers from occupational pesticide exposure in the United States. Previous studies suggest that worker adoption of Pesticide Protective Behaviors (PPBs) promoted by WPS is associated with lower urinary pesticide concentrations. However, adoption of PPBs is often outside of the control of individual farmworkers and dependent on workplace factors such as employer provisioning of Personal Protective Equipment (PPE) and access to trainings/resources. METHODS: We conducted a mixed-method study including urinary pesticide biomonitoring, surveys, and interviews with 62 Latinx farmworkers in southwestern Idaho from April to July 2022. We integrated findings across the various data sources to identify emergent themes relating to farmworkers' perceptions of workplace compliance with WPS and potential implications for their pesticide risk perceptions, protective behaviors, and urinary pesticide concentrations. RESULTS: Participants reported some indications of poor workplace compliance with WPS regulations, notably inconsistent access to clean handwashing stations and notification of pesticide applications. Some farmworkers, particularly pesticide applicators, viewed herbicides to be categorically safer than other classes of pesticides such as insecticides; these perceptions appeared to influence protective behaviors, such as the relatively low use of PPE while applying herbicides. These findings are underscored by the higher concentrations of biomarkers of herbicides, but not insecticides, among pesticide applicators compared with non-applicators (e.g. median 2,4-D concentrations = 1.40 µg/L among applicators and 0.69 µg/L among non-applicators). Participants further reported concerns regarding the inadequacy of pesticide safety training, pesticide drift, and the lack of communication regarding pesticide applications on and near fields where they are working. DISCUSSION: Participants' perceptions that herbicides are categorically safer than other pesticide classes is in direct conflict with WPS training, raising concerns about discrepancies between WPS instruction and other on-the-job training, as well as the inadequate provisioning of PPE during the application of certain pesticides. Our findings also suggest that current WPS regulations may not sufficiently address farmworkers' concerns, particularly in regard to pesticide drift.

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BACKGROUND: Internationally 18% of youth are obese. Fitness testing can be used to establish fitness surveillance, which can inform policy and targeted interventions aimed at addressing obesity. The purpose of this study was to estimate the prevalence of overweight, obesity, and low fitness in Idaho school-aged youth through a pilot study. METHODS: A convenience sample of 13 teachers from 11 north Idaho rural schools collected FitnessGram fitness data: body composition (body mass index [BMI]), aerobic capacity (Progressive Aerobic Cardiovascular Endurance Run [PACER] test), muscular endurance (curl up), strength (pushup), and flexibility (sit and reach). RESULTS: A total of 761 students (aged 9-18 years) from grades 3&5, 7, and 9 to 12 participated in the study. Approximately 24% of 3&5 and 22% of 7th, and 12% of 9 to 12th-grade students were categorized as Needs Improvement/Health Risk by FitnessGram standards for BMI. Similarly, approximately 25% of 3&5, and 22% of 7 and 9 to 12th-grade students were considered Needs Improvement/Health Risk for PACER. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Results from fitness testing can provide school and public health representatives with a "needs assessment" of student health that can be used to help develop policies and practices to improve student health and wellbeing. CONCLUSIONS: This study provides a model for statewide annual fitness testing surveillance and reporting within K-12 public school physical education classrooms.

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ABSTRACT: We compared mpox vaccination access between urban and rural residents who received ≥1 JYNNEOS dose using immunization data in Idaho and New Mexico. Rural residents traveled 5 times farther and 3 times longer than urban residents to receive mpox vaccination. Increasing mpox vaccine availability to health care facilities might increase uptake.

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Methyl bromide (MeBr) is a sterilizing fumigant used to control quarantine pests that is restricted due to its detrimental atmospheric effects. The degradation of injected MeBr produces crop-available Br- . Up to five applications of MeBr were used in southeastern Idaho fields to combat the pale cyst nematode (Globodera pallida). Data regarding the uptake and partitioning of Br- in crops following MeBr application in the region were unavailable. Research determined background concentrations of Br- in alfalfa (Medicago sativa L.), barley (Hordeum vulgare L.), corn (Zea mays L.), potato (Solanum tuberosum L.), and wheat (Triticum aestivum L.) compared to MeBr-treated fields. Background Br- concentrations ranged from nondetectable (ND) to 33.0 mg Br- kg-1 ; vegetative tissue concentrations were greater than reproductive, except corn where there was no difference. Nearly all crops grown in MeBr-treated fields had greater Br- concentrations than background. Background-baled-alfalfa tissue Br- concentration was 33.0 mg kg-1 compared to 117.8 mg Br- kg-1 from a MeBr-treated field. Br- concentration in green alfalfa decreased from 79.8 to 36.5 mg Br- kg-1 at the final cutting in a MeBr-treated field, where time after application decreased crop Br- concentrations. Small grains had low Br- concentrations in reproductive tissue (1.7 mg Br- kg-1 ) compared to vegetative tissue (106.5 mg Br- kg-1 ). Corn stover concentration (12.7 mg Br- kg-1 ) was low relative to small-grain straw, but corn ear (5.8 mg Br- kg-1 ) was greater than small-grain reproductive tissue in the MeBr-treated field. Crop selection following MeBr applications should consider the likelihood of elevated Br- concentration for the plant fractions intended end use.

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During the COVID-19 pandemic, public health authorities have encouraged the use of face masks to minimize transmission within the community. To assess mask wear during a COVID-19 surge and guide public health response efforts, including public messaging on mask recommendations, we compared observed mask use in the largest city in each of Idaho's 2 most populous counties, both without a current mask mandate. We recorded mask usage by every third person exiting stores of 5 retail chains in Boise and Nampa during November 8-December 5, 2021. Observations were conducted during three time periods (morning, afternoon, and evening) on weekday and weekend days. A multivariable model with city, retail chain, and city-chain interaction was used to assess mask wear differences by city for each chain. Of 3021 observed persons, 22.0% wore masks. In Boise, 31.3% (430/1376) of observed persons wore masks; in Nampa, 14.3% (236/1645) wore masks. Among all persons wearing masks, > 94% wore masks correctly; cloth and surgical masks were most common. By retail chain, observed individuals at Boise locations were 2.3-5.7 times as likely to wear masks than persons at respective Nampa locations. This study provided a rapid, nonconfrontational assessment of public use of mitigation measures in 2 Idaho cities during a COVID-19 surge.

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