In this study, amino acid functionalized poly [PHEMAPA] cryogel discs were prepared. In this respect, phenylalanine containing N-methacryloyl-(L)-phenylalanine methyl ester (MAPA) was polymerized with 2-hydroxyethyl methacrylate (HEMA) without requirement of any activation step. Laccase bound poly [Lac-PHEMAPA] cryogel discs were applied for decolorization of Reactive Blue-247 (RB-247). The ability of Lac-PHEMAPA cryogel discs on dye decolorization was found to be as 90% in 2 h and even more within 4h. The decolorization activities of 86% and 73% were observed at relatively low (4°C) and high (60°C) temperatures, respectively. The effect of dye concentration on dye decolorization and 100% decolorization activity was achieved in dye concentration between 50–300 ppm. Lac-PHEMAPA cryogel discs maintained 80% of its decolorization activity after six cycles. Consequently, the PHEMAPA cryogel discs are promising materials for immobilizing laccase. The Lac-PHEMAPA has a rapid dye decolorization in a broad range of temperature. The preparation is furthermore very stable and activity is preserved during storage. Azo dyes constitute a group of dye stuffs, which have gained great commercial interest in the textile industry. However, the excess amount of these dyes is released as effluent wastewater. Undesirable dyeing agents present in water lead to critical environmental problems and also effects on public health due to their toxic, mutagenic, and carcinogenic features [1]. Although some traditional physicochemical methods have been applied to treat wastewater by removal of colour in various steps, these techniques have many limitations such as the large quantity of chemicals consumed, incapability of fully dye removal, formation of toxic metabolites, production of a sludge, which contains also other pollutants which needs complex multistep methodologies for efficient treatment [2]. Degradation of Azo dyes involves elimination of the colour and then also to degrade the metabolites. Therefore, it is necessary to implement several techniques, because using one of them alone can not meet all requirements for effective dye decolorization and degradation of metabolites [3]. Nevertheless, decolorization of these dyes using microbial enzymes represents an eco-friendly and relatively inexpensive option over the other degradation processes. Furthermore, use of enzymes minimize the water consumption. Oxidases is a group among the enzymes, which plays an important role in the decolourization. Especially laccases have been extensively used due to their widespread availability and have been used in decolorization of several dyes. Laccase (EC 1.10.3.2) presents the polyphenol oxidases and oxygen is reduced to water with the enzymes’ catalytic activity. This enzyme has the ability of oxidizing many phenolic compounds and aromatic amines without any requirement of additives [4]. Laccase in combination with mediators constitute an effective combination when used in e.g., membrane reactors [5]. The abundance of laccase in different white-rot fungi species and production and purification of the enzyme from stable microbial sources have already been preferred in many commercial applications [6]. These properties make this enzyme unique in the textile dyeing industry. Besides, there is a growing need in the development of different approaches in dye decolorization using enzymes. In recent years, great attention has been given to immobilization processes, which provide improved reusability and stability, cost-effective system generation [7–11]. For this process, cryogels are popular polymeric materials offering a promising future with their supermacroporous structure. They are easily prepared at freezing temperature, and large pores provide some advantages such as low pressure drop, efficient diffusion property and short residence time. These characteristics of cryogels make them unique and applicable to be preferred in many fields such as medical  environmental [15–17] and biotechnological applications . Poly(2-hydroxyethyl methacrylate) [PHEMA] based support materials have the extensive potential for several applications, including enzyme immobilization because of their improved performance at a large scale of different experimental conditions . These materials can also be functionalized by novel methodologies, in this way, the hydrophilic character of PHEMA may be modified via using different monomers and ligands [22]. MAPA is a phenylalanine containing aminoacid-derived functional monomer. It is used to gain hydrophobic functionality to the support material and can interact with glycoproteins such as laccase. Therefore, the work presented herein indicates the binding mechanism of MAPA and laccase that can be attributed to the interaction between hydrophobic groups of MAPA and laccase [23]. In this study, laccase bound to cryo-polymerized support material was aimed to be used for dye decolorization - a challange that needs to be met in textile industrial scale applications. For this purpose, we have directed our attention to examine optimized conditions for ability of Lac-PHEMAPA cryogel discs. Lac-PHEMAPA cryogel discs were prepared, and efficiency in decolorization was studied. Effects of reaction time, pH value, temperature and dye concentration on decolorization efficiency of Lac-PHEMAPA cryogel discs were investigated. Besides, storage stability and reusability of Lac-PHEMAPA cryogel discs were determined. Trametes versicolor, 2,2’- azino-bis(3-ethylbenz-thiazoline-6-sulphonic acid) (ABTS), 2-hydroxyethyl methacrylate (HEMA), methylenebisacrylamide (MBAA), N,N,N’,N’-tetra-methyl-ethylenediamine (TEMED), and ammonium persulphate (APS) were obtained from Sigma-Aldrich . RB-247 was obtained from the textile industry. All other chemicals used were of analytical grade. All buffers were prepared with water processed using a reverse osmosis step with a Milli-Q system from Millipore . Laccase from 6H5CH2CH(NH2)COOCH3; 5.0 g) and sodium nitrite  were dissolved in 30 mL water containing 5% w/v potassium carbonate (K2CO3). The reaction chamber was cooled to 0 °C in an ice bath and the mixture was stirred magnetically under a nitrogen atmosphere. Then, methacryloyl chloride  was added slowly into a reaction solution. The obtained solution was stirred magnetically at 100 rpm and 24 °C for 2 h. The product was extracted with ethyl acetate and the aqueous phase was evaporated. The residue was crystallized to obtain MAPA monomer. The experimental procedure applied for the synthesis of MAPA monomer was summarized in the following as reported elsewhere [24]. (L)-phenyl alanine methyl ester  were dissolved in 5 mL of HTo determine polymerization yield, PHEMAPA cryogel discs were dried at vacuum oven and weighed. Eq.1 was used to calculate yield: Yield (%) = (mdried gel / mt) 100 (1) dried gel represents the mass of dried cryogel disc; mt represents the total mass of monomers. Here, mwet gel) were determined. Then, cryogel discs were dried at 55°C and weighted (mdried gel). Swelling degrees of PHEMAPA cryogel discs were calculated according to Eq. 2. Firstly, they were kept in water until they were completely swollen. Then, they were placed on dried paper and excess water was removed. Weights of PHEMAPA cryogel discs (mSwelling degree (S) = (mwet gel - mdriedgel ) / mdried gel(2) swollen gel). Then, water was removed from swollen cryogels by squeezing, and the weights of the squeezed cryogels (msqueezed gel) were determined. Eq. 3 was used to calculate macroporosity. To determine macroporosity, the weights of the swollen cryogels were determined (mMacroporosity (%) =(mswollen gel – msqueezed gel) /mswollen gel x 100 (3)PHEMAPA cryogel discs were characterized by FTIR  to determine the presence of phenylalanine. The samples were dried at 55 °C before analysis. Surface morphology of PHEMAPA cryogel discs was examined by SEM . Firstly, PHEMAPA cryogel discs were frozen at –20 °C and completely freeze dried in a lyophilizer . Then, the samples were coated with metallic gold, and SEM photos of them were taken in different magnifications. Binding of laccase on PHEMAPA cryogel discs was performed in a batch experimental set-up. PHEMAPA cryogel discs were equilibrated with 50 mM, pH = 6.0 phosphate buffer for 2h. Laccase solutions were prepared by dissolving laccase in 15 mL of 50 mM, pH = 6.0 phosphate buffer, and final concentrations of laccase solutions were changed between 0.1 and 1.5 mg/mL. Laccase binding experiments were performed at 25°C for 18 h. After laccase binding process, Lac-PHEMAPA cryogel discs were washed with 50 mM, pH = 6.0 phosphate buffer for three times to remove excess free enzyme molecules. Also, effect of pH value (5.0–8.0) on binding of laccase on PHEMAPA cryogel discs was investigated. Bound amount of laccase was determined according to Eq. 4 by measuring the initial and final laccase concentration spectrophotometrically at 650 nm  by Lowry method [25].Q = (Ci-Cf)V/m (4)i is the initial concentration of laccase (mg/mL), Cf is the equilibrium concentration of laccase after binding (mg/mL), V is the volume of aqueous binding solution (mL), and m is the mass of dried cryogel discs used (g).Here, Q is the amount of bound laccase on a unit mass of PHEMAPA cryogel discs (mg/g), CDye decolorization ability of Lac-PHEMAPA cryogel discs was determined with the pigment RB-247 in a batch system. RB-247 was dissolved in distilled water. The final concentration of the dye solution was 50 mg/L. Three pieces of Lac-PHEMAPA cryogel discs (21 mg) were added to the dye solution, and dye decolorization process was performed at 25 °C for 8 h. Decolorization efficiency of Lac-PHEMAPA cryogel discs was determined by measuring solutions of RB-247 (before and after decolorization) spectrophotometrically at 612 nm (Shimadzu UV-1700). The decolorization yield was calculated according to Eq. 5;Decolorization (%) = /*100 (5)Effect of pH on dye decolorization ability of Lac-PHEMAPA cryogel discs was investigated. Initial pH of the dye solution was changed between 3.0 and 8.0. Besides, the effect of temperature on dye decolorization ability of Lac-PHEMAPA cryogel discs was examined at different temperatures . On the other hand, Lac-PHEMAPA cryogel discs were stored at 4 °C for three months to examine storage stability of Lac-PHEMAPA cryogel discs. Maintaining of dye decolorization capability of Lac-PHEMAPA cryogel discs was evaluated after three months of storage. Usage of cheap and reusable enzyme bound to materials in the industry for dye decolorization processes are important. Therefore, same Lac-PHEMAPA cryogel discs were used ten times in decolorization process and decolorization efficiency of Lac-PHEMAPA cryogel discs was tested in each step. No dye desorption process was applied between decolorization steps.Materials with immobilized laccase have been applied for the treatment of textile wastewater pollutant. In literature, there have been many publications indicating applications of laccase on dye decolorization [26-30]. In most of these studies, the superiority of immobilized laccase over free laccase, and the ability of immobilized laccase on dye decolorization was reported. Apart from these studies, application of laccase in the industrial scale has been taken into consideration and for this purpose optimum conditions of dye decolorization were investigated in our study. The schematic presentation of the overall methodology and dye decolorization process is briefly illustrated in Figure 1.Textile wastewater shows markedly fluctuating pH and temperature values [31]. In addition to these parameters, initial dye concentration and reaction time have significant effects on dye decolorization [32]. By this reason, our paper focuses on examining the efficiency of Lac-PHEMAPA cryogel discs on dye decolorization with confirming their properties on enzyme stability and reusability of Lac-PHEMAPA cryogel discs. H2O/gpolymer) values for PHEMAPA cryogel discs. Furthermore, macroporosity of the PHEMAPA cryogel discs was found as 76.7% and gelation yield was obtained as 89%. Thus, monomers HEMA and MAPA were mostly polymerized to get the whole structure of the PHEMAPA cryogel. SEM images of PHEMAPA cryogel discs are given in Figure 2. Unique characteristics of cryogels can be clearly seen on SEM images of the PHEMAPA cryogel discs. Bulk structure of the PHEMAPA cryogel discs was characterized with interconnected large pores. Some swelling properties of PHEMA and PHEMAPA cryogel discs are also given in Table 1. Macroporous structure of PHEMAPA cryogel discs provided the high swelling ratio (987%) and high swelling degree  (6)eq is the equilibrium concentration of laccase (mg/mL), b is the Langmuir constant (g/mmol) and Qmax is the binding capacity of PHEMAPA cryogel discs. Freundlich isotherm was defined in Eq.7Here, Q is the amount of bound laccase on PHEMAPA cryogel discs(mg/g), CQe = KfCe1/n (7)2 value for Langmuir adsorption isotherm is higher than the R2 value for Freundlich isotherm. Thus, our system fits Langmuir isotherm and laccase molecules were placed on PHEMAPA cryogel discs as a single layer. The obtained results indicated that there was no steric hindrance when laccase molecules interacted with special binding sites on PHEMAPA cryogel discs. Furthermore, equal energy binding, homogeneous interaction sites and no lateral interaction which are related to Langmuir adsorption are valid for our affinity binding system.Langmuir and Freundlich adsorption isotherms were given in Table 2. According to the results, RFirst- and second-order kinetic models were applied to the experimental data for determining mechanisms controlling adsorption process like mass transfer and chemical reaction [37]. The pseudo first order kinetic of Lagergren is the most widely used equation for the adsorption of solute from a liquid solution, and it is defined in Eq. 8.log[qeq / (qeq – qt)] = (k1t) / 2.303 (8)eq is the experimental amount of laccase bound at equilibrium (mg/g), qt is the amount of laccase bound at time t (mg/g) and k1 is the rate constant.Here, qThe pseudo second order kinetic model is defined in Eq. 9.(t/qt) =(1 / k2qeq2) +(1/ qeq) t (9)2 is the rate constant of the pseudo-second-order adsorption (g mg–1min–1). If the pseudo-second-order kinetics is applicable, the plot of t/q versus t should be linear.Here, kPseudo-first and -second order kinetic models for binding of laccase on PHEMAPA cryogel discs are summarized in Table 3. When the results were evaluated, the correlation coefficient was higher for pseudo second order kinetics. Therefore, the affinity system in this study could be explained by pseudo-second order kinetics. The binding of laccase on PHEMAPA cryogel discs did not affect diffusion limitations. Macropores inside PHEMAPA cryogel structure prevented from flow resistance. As a result, specific interactions between laccase and phenylalanine controlled kinetic behaviour. In other words, binding of laccase on PHEMAPA cryogel discs was chemically controlled and was performed without diffusion limitations.Effect of reaction time on dye decolorization efficiency of Lac-PHEMAPA cryogel discs was given in Figure 5. As can be clearly seen from the figure, the ability of Lac-PHEMAPA cryogel discs on dye decolorization was found to be as 90% in 2 h. It was observed that Lac-PHEMAPA cryogel discs were capable to decolorize the dye RB-247 with 100% efficiency in 4 h. Furthermore, PHEMAPA cryogel discs and Lac-PHEMAPA cryogel discs were compared in terms of dye decolorization capabilities in the same conditions as stated above. Obtained results are given in Figure 5. According to the figure, it is clear that Lac-PHEMAPA cryogel discs were able to decolorize RB-247 with a high percentage , whereas PHEMAPA cryogel discs were capable of absorbing 24% of RB-247 dye. Therefore, obtained decolorization efficiency of Lac-PHEMAPA cryogel discs on RB-247 can be attributed to biodegradation ability of cryogel discs.Effect of pH on dye decolorization of Lac-PHEMAPA cryogel discs was investigated and obtained results are shown in Figure 6. As clearly seen in the figure, Lac-PHEMAPA cryogel discs showed maximum dye decolorization activity  at the range of pH = 4–6. Also, dye decolorization activity decreased dramatically below pH 4.0 and above pH = 6.0, only 11% decolorization rate was observed at pH = 8. Different pH values have effect on dye decolorization efficiency. Therefore, pH adaptability of Lac-PHEMAPA cryogel discs in a wide range of pH values provides an opportunity for treatment of dye contaminated effluents. . Seven different temperatures  were tested to determine the effect of temperature on dye decolorization and obtained results were presented in Figure 7. It can be seen that Lac-PHEMAPA cryogel discs showed 86% decolorization activity even at 4 °C. Also, dye decolorization efficiency of 100% was observed between 10–30 °C. Lac-PHEMAPA cryogel discs had the ability of 73% dye decolorization activity at relatively high temperature (60 °C). Temperature is a critical parameter for enzyme stability. Effect of temperature on dye decolorization of Lac-PHEMAPA cryogel discs was investigatedTo determine storage life of immobilized enzymes, Lac-PHEMAPA cryogel discs were stored at +4 °C for three months. After three months, Lac-PHEMAPA cryogel discs showed close to 100% decolorization efficiency. Reusability of Lac-PHEMAPA cryogel discs were tested for their decolorization efficiency, and obtained results are shown in Figure 8. Lac-PHEMAPA cryogel discs maintained 80% and 60% of its decolorization activity after six cycles and ten cycles, respectively. It is noteworthy to say that, the reusability experiments were performed without any dye desorption process between each dye decolorization cycle. There have been several studies in the literature aiming decolorization of textile dyes using different kinds of physical and chemical methods [38–40]. Even though these methods find a great range of availability and applicability for the decolorization of wastes contaminated with dye, optional assays relied on biotechnological methodologies has received great interest. Laccase immobilized on matrices have taken place as one of the most widely used materials for this purpose . It is noteworthy saying that immobilization of laccase enhances decolorization efficiency and cost-effectively provide sustainable approach with the advantages of reusability and long-term storage stability. Usually, up to recent days, polymeric support materials consisting of polyacrylamide and alginate were frequently preferred for enzyme immobilization. However, porous materials have been introduced as effective matrices for immobilization of enzymes with low cost and high mechanical stability. Trametes modesta immobilized on γ-aluminum oxide pellets were applicable for the decolorization of anthrachinonic dyes  and azo dyes, Indigo Carmine, and the triphenyl- methane dye Crystal Violet [45].Decolorization ability of laccase on the decolorization of textile dyes has been reported in many types of research. One of these studies showed that laccase from .In a previous study, laccase immobilized poly-g-PLA/ODA-MMT nanocomposite was prepared for the decolorization of Reactive Red 3. Effects of different experimental conditions  were determined for optimizing the decolorization process. Decolorization efficiency of laccase (0.05 mg/mL laccase concentration) immobilized poly-g-PLA/ODA-MMT nanocomposites was found as 65% in pH = 5.0 at 20 ºC for 90 min [46]Tramates versicolor immobilized on porous glass beads and their efficiency on dye decolorization were investigated. Anthraquinone (Reactive blue 19 and Dispersed blue 3), indigoid (Acid blue 74) dyes and azo dyes (Acid red 27 and Reactive black 5) were decolorized. The results from this study indicated that different decolorization rates were obtained for mentioned dyes defined as 40.6% for acid red 27, 12.0% for reactive black 5, 74.0% for acid blue 74, 78.0% for dispersed blue, 77.0 for reactive blue 19 [42].In another study, laccase from A previous research reported that ZnO nanowires into macroporous SiO2 formed composite material used for laccase immobilization. The dye decolorization ability of resultant support material was examined. As a result of this study, 93% and 82% decolorization rates were reported for Remazol brilliant blue B, and acid blue 25, respectively. In accordance with the results of our study, laccase immobilized composite indicated enhanced thermal stability and pH adaptability. In addition, laccase immobilization leads to maintained 42% decolorization ability after ten cycles [47].In a previous study, sol-gel synthesis of biopolymer-silica hybrids was preferred as matrices for laccase immobilization. They reported 84% Malachite green degradation ability for 72 h [26].In another study, laccase trapped beads consisting of alginate/gelatin blend with polyethylene glycol was used for dye decolorization. Glutaraldehyde activated materials have enhanced decolorization ability. Reactive Red B-3BF (50 mg/L) was decolorized down to 50% after ten cycles [48].Trametes hirsuta decolorize effectively triarylmethane, indigoid, anthraquinonic and azo dyes [49]. Another study showed that immobilized laccase more than 70% of retained its activity after 5 months storage at +4 °C [44]. In a previous study in literature, laccase immobilized on Poly(MMA-co-GMA) cyogel showed maximum activity at pH = 4 and immobilized laccase activity decrease dramatically above and below pH = 4 [50]. Another study showed that Trametes versicolor crude laccase showed maximum activity at pH = 4.5 [51]. Lentinus polychrous crude laccase showed maximum Acid Blue 80 decolorization activity around pH = 5 [52]. In this study, immobilized laccase showed maximum dye decolorization activity at pH = 4, 5, 6 and decolorization rate achieved above 70%. Purified laccase from Textile dyes are chosen for the cloths since the pigment is very robust and will be resistant to bleaching and degradation. The surplus dyes that are released from industries are, therefore, a challenge. Use of high concentrations of immobilized enzymes is one approach; another approach might be to combine, for example, laccase with nanoparticles of titanium, which will become an efficient partner to the laccase when exposed to UV-light, since titanium creates activated oxygen that is a potent reagent for degrading aromatic structures [52–55]. In order not to destroy the enzymes by oxidation from the activated oxygen from the titanium, one would need to use sequential treatment of the dyes in order to degrade the dye molecules and also to degrade the metabolites formed.Dye effluents lead to important environmental problems. Therefore, coping with these effluents is of great concern and troublesome because of the complexity of dye contaminants. The techniques developed for this aim are cost effective and sophisticated. Consequently, easy to prepare and cheap decolorization techniques have gained attention to manage dye effluents. In this study, the ability of laccase bound to (PHEMAPA) cryogel discs was indicated for dye decolorization using a model dye, Reactive Blue 247. MAPA was preferred to eliminate the activation process for enzyme binding and cryogel discs known as novel polymeric systems were used because of their unique structural features and advantageous dynamics. After using a model substrate (ABTS) for determining laccase activity of laccase bound (PHEMAPA) cryogel discs, the experimental conditions were optimized in order to determine the best performance of immobilized laccase on (PHEMAPA) cryogel discs in dye decolorization. When the facility of these cryogels was taken into consideration, it could be suggested that these materials are promising tools for enzyme binding along with dye decolorization by the advantage of excellent enzyme activity in a broad range of temperature and stability preserved during storage.This paper deals with small pieces of cryogels into which laccase has been immobilized. It is obvious that the combination of the cryogel with the big pores, and the enzyme functions well regarding degrading of surplus dyes in wastewater from textile industry.It should be mentioned that cryogels can be prepared in many different shapes. Monoliths and big discs could be created as filters for passing wastewater through. The pores are big enough to allow microorganisms to pass through the cryogel. What is fascinating is also the fact that there is very little backpressure when passing liquid through a cryogel. Furthermore, when treating wastewater with mixing, the cryogel can be protected from attrition by producing the gel within a plastic “housing” [53] . This latter prolongs the lifespan for the cryogels. These factors open up possibilities for scaling up treatment of industrial waters.


The Support at Home pilot program provided financial support for home care services by middle-income adults with disabilities in San Francisco to support aging in place. This presentation reports the results of the mixed-methods evaluation of the program, which incorporated administrative records, surveys of clients and comparison group members, surveys of informal caregivers of clients, surveys of the care providers hired by clients, and focus groups with clients and with informal caregivers. Outcome measures included the Older People’s Quality of Life Questionnaire, Patient Health Questionnaire-2, an adapted Burden Scale for Family Caregivers, and self-reported falls, emergency department visits, and hospitalizations. Analyses included pre-post chi-squared and t-test comparisons and comparisons of changes between the client and comparison groups. Multivariate regression analyses were conducted to control for demographic differences between the groups. An economic analysis was conducted to learn whether changes in costs associated with medical appointments, emergency department visits, and hospitalizations were greater than the costs of the program, including both voucher and administrative costs. Results indicated statistically significant positive changes in personal stress and financial stress, but not in the composite quality of life score. There also were statistically significant reductions in attendance at medical appointments, falls, emergency department visits, and hospitalizations. The focus group data supported the findings regarding personal and financial stress, and also indicated that clients and their caregivers perceived positive quality of life benefits. The economic analysis indicated substantial cost savings from the program due to reduced use of medical services.


The purpose of our study was to understand the capacity of Silver Sneakers, a federally funded and community-based exercise program, to serve older adults (aged ≥65 years) in our mixed rural/urban catchment area of central Pennsylvania. We identified 139 registered Silver Sneakers program locations; of these, 18 were closed because of the COVID-19 pandemic. We used questionnaires to interview Silver Sneakers program staff by telephone . Most programs were offered by private gyms (52%). Fewer programs were in rural counties than in urban counties. Most facilities reported that membership was equally mixed by gender, and member retention strategies included program perks and promotion of Silver Sneakers as a Medicare benefit. Most (89%) programs were able to continue classes during the pandemic, in part by adapting to video platforms. Overall, Silver Sneakers programs offer a sustainable option to facilitate access to exercise programs and reduce barriers to physical activity among older adults in our catchment area. Silver Sneakers is an exercise program widely available in the US and free to many with Medicare benefits. Little data exist about availability of programs in rural or urban communities or specific data about which classes are available, especially in mixed rural/urban regions.Our study provides a comprehensive assessment of Silver Sneakers programs accessible to older adults (aged ≥65 years) in the mixed rural/urban catchment area of the Penn State Cancer Institute.The results of this study will provide contextual data for similar mixed urban and rural regions looking to leverage this health care resource, especially for areas serving traditionally underserved regions with high numbers of older adults.The purpose of our study was to understand the capacity of Silver Sneakers, a community-based and free-to-most exercise program, to serve older adults (aged ≥65 years) in our mixed rural/urban catchment area of the Penn State Cancer Institute in central Pennsylvania. Although regular exercise reduces disease risk and promotes healthy aging –3, many We performed an observational study, with data collection and analysis occurring between August 2019 and January 2021. First, we identified all registered Silver Sneakers program locations in our 28-county catchment area. Second, we conducted a one-time telephone questionnaire with Silver Sneakers program staff.To identify all registered Silver Sneakers program locations in our catchment area, we manually matched geographic information system data (based on zip codes) with locations on the Silver Sneakers website in the 28-county catchment area by using their web-based locator tool . By usinNext, a study team member (R.M.) called each Silver Sneakers facility and invited a program staff member to participate in a 20-minute telephone questionnaire. If they agreed to participate, an interview consisting of 21 multiple-choice questions was then administered to assess member and program characteristics, training of staff, and program marketing. For open-ended responses , the interviewer requested the participant to elaborate.Quantitative and qualitative responses to the telephone questionnaire were manually captured by the interviewer and recorded in a secured program database. Quantitative data were cleaned and summarized using descriptive statistics. Responses to each question were reported as the number and percentage per total available responses for each question, and characterized by geographic area type . Qualitative data  were used to complement or clarify responses on the questionnaire regarding program characteristics and other details.The Silver Sneakers study protocol was reviewed by the Institutional Review Board at the Pennsylvania State University College of Medicine and deemed exempt from full board review.In 27 of 28 counties, 139 programs were identified. The mean number of Silver Sneakers locations was 4.96 per county (range: 0–18). Berks, Lancaster, Dauphin, and York counties reported the highest program densities, between 14 and 18 locations per county. These urban counties encompass or border the larger metropolitan areas of Harrisburg and Philadelphia, Pennsylvania, and Baltimore, Maryland .Most programs were offered by private gyms (72 [52%]) . Others were offered by YMCA (41), community centers (18), residential care (4), and senior centers (4). Fewer Silver Sneakers programs were found in counties designated as rural  when comEighteen gyms closed during the COVID-19 pandemic, leaving a sample of 121 participating facilities. Of the 121 facilities, 80 agreed to participate in the questionnaire. Among the response categories provided, most facilities (69%) reported membership was equally mixed by gender, and 94% reported that their members ranged from 65 to 80 years old. Program staff said that many members exercised several times per week with friends or family. Additionally, 35% reported that social opportunities were a primary reason that participants remained active in Silver Sneakers. Membership retention strategies included program perks (64%) and promotion of Silver Sneakers as a Medicare benefit (11.3%). Classic class  was the most popular class (83.8%). Most (89%) of the facilities reported that they were still able to offer Silver Sneakers during the pandemic, with 60% reporting that they were able to adapt the program format to video platforms to conduct classes.Silver Sneakers programs provide a sustainable option to facilitate access to exercise programs and increase physical activity among older adults nationwide. To the best of our knowledge, this is the first evaluation study to provide a comprehensive assessment of Silver Sneakers programs accessible to older adults in the Penn State Cancer Institute catchment area, or others in the central Pennsylvania region.Our assessment highlighted an opportunity to maximize the use of memberships by expanding programs within rural communities in our area. Fewer programs and a higher proportion of older adults were present in rural compared with urban areas, which generally have more economic output. Consideration of programs and infrastructures in areas where older adults reside may be beneficial, particularly in areas that have high populations of older adults but few or no programs available.Our results also suggested that offering program perks that promoted social gatherings seemed more relevant to older adults compared with other strategies. Older adults were mostly characterized as sociable, indicating that the environment fostered friendships and maintained their interest.The main limitations of our study were its cross-sectional nature and the timing of the COVID-19 pandemic during our data collection period. Despite these limitations, our questionnaire had a high response rate (66%). Silver Sneakers continued in 89% of the facilities, which speaks to its high adaptability to change. Common barriers related to access, cost, technology, and transportation were exacerbated for older adults during the pandemic but highlighted opportunities to improve with online technology, which suggests that it may play an integral role in future exercise instruction ,14.Providing access to programs such as Silver Sneakers is a step toward helping older adults meet recommended exercise guidelines. Our study provides contextual and relevant data for mixed rural/urban regions looking to leverage this health care resource, especially for areas serving traditionally underserved regions with high numbers of older adults.


In the 2018 fleet-based program, there were statistical differences between the SLs and SELs of fleets that participated with varying degrees of cooperation. Significant reductions in SL and SEL relied on cooperation of 25% or more in slowing vessel speed. This analysis highlights how slowing vessel speed to 10 knots or less is an effective method in reducing underwater noise emitted from commercial ships.Commercial shipping is the dominant source of low-frequency noise in the ocean. It has been shown that the noise radiated by an individual vessel depends upon the vessel’s speed. This study quantified the reduction in source levels (SLs) and sound exposure levels (SELs) for ships participating in two variations of a vessel speed reduction (VSR) program. SLs and SELs of individual ships participating in the program between 2014 and 2017 were statistically lower than non-participating ships ( In regions exposed to ship noise, ambient sound levels have risen over the past several decades due to increases in the number, gross tonnage, and horsepower of commercial vessels4. In addition to these parameters, vessel underwater radiated noise levels and vessel speed are positively correlated, suggesting noise pollution may be mitigated by reducing vessel speed8.Low-frequency noise (5–400 Hz) in the ocean is dominated by commercial shipping9. Enrollment was made available to companies operating container ships or vehicle carriers within the VSR zone, which extends approximately from Point Conception southeast to the Long Beach Harbor. Enrolled vessels were requested to reduce their speeds to a target speed to receive a financial reward. Vessels that participated in the VSR program from 2014 through 2017 received financial incentives of up to $2,500 per one-way transit and positive public press10. In 2018, the financial rewards ranged approximately from $1000 to $35,000 per company based on level of cooperation11. In addition to its original goals of reducing the risk of ship strikes on endangered whales and decreasing air pollution emissions, the VSR program also recognizes the opportunity to address underwater noise pollution in the Santa Barbara Channel (SBC). For example, acute and chronic noise pollution generated from commercial shipping has been documented to impact marine mammals, fish, and invertebrates in the form of acoustic communication masking, behavioral alterations, increased physiological stress, and reduced reproductive success13. Because of this, the potential for reducing noise pollution from commercial shipping by reducing vessel speed may allow the VSR program to address an even more comprehensive conservation initiative than originally anticipated.In 2014, the Channel Islands National Marine Sanctuary (CINMS) partnered with the Santa Barbara County Air Pollution Control District, Ventura County Air Pollution Control District, National Marine Sanctuary Foundation, and the Environmental Defense Center to implement a voluntary, incentive-based vessel speed reduction (VSR) initiative known as the Protecting Blue Whales and Blue Skies Program (hereafter VSR program)14. The Port of Los Angeles, in particular, is the busiest seaport in the United States, in terms of vessel traffic flow, and plays an essential role in the economic stability of California15. In addition to the economic importance of the SBC, measured by transported commerce, it is also a highly productive region that has led to a diversity and richness in zooplankton, fish, squid, and marine mammals18. The SBC is also an important summer foraging area for endangered baleen whale populations, as they aggregate in cold upwelling regions to feed primarily on krill21. Because of the ecologically important habitats in the SBC, noise pollution from commercial vessel traffic is a continuing management concern.The SBC is an ideal region for the study of underwater noise pollution due to its position as a basin shielded from deep ocean noise by the presence of the Channel Islands and its proximity to the San Pedro Bay Port Complex , which results in an abundance of low-frequency ambient noise that is directly correlated with commercial vessel traffic Fig. 14. The PIn this study, we evaluated the efficacy of a VSR program in the SBC for reducing underwater radiated noise of participating vessels. By using long-term acoustic records from the SBC, we compared ship source levels (SLs) and sound exposure levels (SELs) in relation to Automatic Identification System (AIS) speed over ground (SOG) values measured at the closest point of approach to the recording site. SLs are estimated with a surface-reflection compensated spherical spreading propagation model and compared between VSR participants at different SOGs and levels of cooperation. The analysis allows for a comprehensive acoustic analysis of two variations of the incentive-based VSR program (transit-by-transit and fleet-based). Both of the approaches showed a reduction in SL and SEL estimates for participating vessels compared to non-compliant vessels when fleets slowed at least 25% of their transits in the VSR zone.From 2014 through 2018, paired AIS and acoustic recordings were extracted for 9297 vessel transits, including all types of vessels travelling through the SBC. The three vessel types under investigation in this study constituted 6738 of the extracted transits (72.5% of the AIS tracked vessels). Of these, 3778 vessel transits from 1299 unique vessels passed the 1 h isolation, no hydrophone cable strumming, and environmental conditions requirements for analysis inclusion. The transits were made up of 2677 container ships, 485 vehicle carriers, and 616 bulkers.−1  was 7.3 ± 1.9 m s2 and average SL was 194.2 ± 6.6 dB re 1 μPa2 @ 1 m. SL estimates were highest for the container ships and lowest for the bulkers.Broadband 5–1000 Hz) RL (received level), SL, and SEL estimates from 3778 recorded transits of the three ship types studied are shown in Table 000 Hz RL2s. Average duration of 15 dB above background sound levels for all ship types transiting at different speeds was 727 s. Duration was specific to each ship transit and was dependent on speed and CPA. The average duration of transits with speeds less than 5.1 m s−1 (10 knots) was 676.2 s, while the average duration of transits with speeds greater than 9.3 m s−1 (18 knots) was 791.4 s. The duration of the faster transits was longer than the slower transits because of increased RL with increased speed, causing the RL to remain above the threshold for longer.Broadband SEL allows for an estimate of total acoustic energy radiated into a region taking into account the transit duration. Including all ship types, the average broadband SEL was 158.1 ± 6.0 dB re 1 μPa−1 . Bulkers had the highest slope between SOG and SL , while vehicle carriers had the lowest slope  , which was smaller than the slope of SOG and SL. Bulkers had the highest slope between SOG and SEL, although it was smaller than the SOG versus SL relationship  were associated with ships that participated in the transit-by-transit VSR program. The association was determined by matching the VSR program-supplied transit time and International Maritime Organization (IMO) identification number of the rewarded transits with the transits in the AIS and acoustic data. The 152 transits represented 47 unique vessels. The rewarded group consisted of 43 transits and the remaining 109 transits were recorded from the control group. Container ships represented 98.0% of the participating vessel transits, and vehicle carriers represented 2.0% of the participating vessel transits. Container ships represented 42 out of the 43 transits in the rewarded group, while 1 transit was a vehicle carrier. The control group consisted of 107 container ship transits and 2 vehicle carrier transits from 1 unique vehicle carrier.−1 faster than the average speed over ground of the rewarded group. The average SL of the control group was 5.2 dB higher than the average SL of the rewarded group  are shown in Fig. The average speed over ground of the control group was 2.5 m sup Table . There wup Table . There wIn 2018, of the 1169 vessel transits that were recorded with paired acoustic and AIS data, 555 were from vessels participating in the fleet-based VSR program, of which 254 occurred when the program was active and 301 occurred when the program was inactive. Fleets were binned in award tiers based on percentage of cooperation. The participating vessel transits consisted of 50 recorded from fleets in the sapphire award tier, 113 from the gold award tier, 180 from the silver award tier, 177 from the bronze award tier, and 35 from the non-compliant tier  between the control and rewarded groups for SOG, broadband SL, and SEL. The average reduction in SOG, SL, and SEL between control and rewarded groups was 2.5 m s−1 (4.8 knots), 5.2 dB, and 4.7 dB, respectively.In the transit-by-transit VSR program, there was a significant difference (−1). While the fleet-based VSR program was active, broadband SL and SEL estimates from the sapphire, gold, and silver award tiers were significantly different from the non-compliant tier Table . The gre−1).While the program was inactive, there were no statistical differences in broadband SLs between any of the award and non-compliant tiers. SOGs from the sapphire and gold award tiers were significantly different from the non-compliant tier. The greatest difference in SOG while the program was inactive was between the sapphire award tier and non-compliant tier , and a statistical difference in SOG and SEL within the silver award tier  while the program was active versus inactive. The SOG, SL, and SEL within the sapphire and bronze award tiers, and non-compliant tier were not significantly different while the program was active versus inactive.There was a statistical difference in SOG, SL, and SEL within the gold award tier  within award tiers and between award tiers while the program was active versus inactive are displayed.All of the statistical results for the 2018 fleet-based approach are shown in the matrix in Table 5. The average SL for a ship transiting at 10.5 m s−1 (20.4 knots) in this study was 201.2 dB re 1 uPa2 @ 1 m, which is within 1 dB of the SL estimate for a ship transiting at the same speed at Site B in Gassmann et al. (2017). Our SL estimates are higher than SLs from other vessel noise studies at Site B because our SL estimates included a TL model which corrected for surface reflections that occur at sites with low inclination angles (Lloyd’s mirror) between ship near-surface sources and the seafloor-mounted acoustic recorder22. An approximate compensation to compare broadband source levels from 10 to 1000 Hz at Site B in McKenna et al. (2012) to Lloyd’s mirror corrected broadband levels from 5 to 1000 Hz can be derived by adding 20 to 27 dB5. Adding 20 dB to the average broadband SL estimates of containerships in McKenna et al. (2012) traveling on average at 10.85 m s−1 is 205.5 dB re 1 uPa2 @ 1 m, which is within 2–3 dB of the SL estimates of container ships traveling at the same speed in this study. When comparing overlapping frequencies, surface-reflection corrected mean SL spectra from vessels transiting on average at 5.4 m s−1 in this study were within 0–8 dB of the mean SL spectra calculated from a full-wave propagation loss model from vessels transiting at 5.8 m s−1 in Haro Strait, British Columbia6. Our SL spectra across frequencies was on average 3 dB higher than the SL estimates from Haro Strait, which may be due in part to the difference in depth at which the recording device was deployed6. The SL spectra from container and cargo ships estimated in St. Lawrence Seaway with a full-wave propagation loss model were within 5–9 dB of the SL spectra of container ships travelling at similar speeds in this study23, with our SL spectra across frequencies approximately 6 dB lower. Our surface-reflection corrected SL estimates from vessels transiting at 18 knots were within 0–10 dB from SL estimates from a single vessel transiting at 18 knots computed via Bayesian marginalization techniques24. Differences may be due to the high SL levels at prominent frequency tonals for the single ship spectra compared to our SL spectra averaged over multiple transits. The discrepancies between SL estimates measured at different locations, depths, and with varying propagation loss models is an ongoing issue and should continue to be investigated, in order to establish a method that enables comparison across sites and effective management plans for mitigating SLs. Because the transits in this study were recorded from the same site and the SL estimates were computed using the same transmission loss model, the measured change during the program active months is a reliable reduction.The broadband (5–1000 Hz) SL estimates in this study are consistent with the broadband SL estimate in Gassmann et al. (2017)25. Across all vessels, our relationship of 2.0 dB s m−1 (1.0 dB/knot) is within 0.2 dB s m−1 from the relationship found in Viers et al. (2016) and within 0.1 dB/knot from the relationship found in ships greater than 250 m in length in Simard et al. (2016)23. The relationship between SOG and SL for containerships in McKenna et al. (2013) was 1.1 dB/knot, which is within 0.1 dB/knot of the relationship for containerships in this study8. The relationship between SOG and SEL in this study had a smaller positive slope than the relationship between SOG and SL. As noted in McKenna et al. (2013), this is likely due to differences in the duration a vessel is transiting in the region8. Although the SEL slope is slightly less than the SL slope, we found that slower transits decreased the duration of time that the RL was above the 15 dB background sound level threshold in the majority of the vessel transits under investigation. The increased SL with increased speed may allow for some vessel sounds to travel farther distances and therefore be received above the threshold for longer durations.Our results show a positive relationship between SOG and SL, similar to past studies8. While our study incorporates a specific harmonic mean sound speed value in the transmission loss model for every month, there may be additional variability in underwater propagation that changes with season. For instance, there may be a decrease in radiated noise during the fall due to warm surface waters, creating downward refraction. In spring, the sound speed profile is closer to homogeneous, because of increases in storms creating a deeper mixed layer allowing the modified-Lloyd’s mirror model to be a better fit for spring environments, as sound travels in a straighter path than during the fall.Seasonal differences in radiated noise may also be contributing to differences in SL values. McKenna et al. (2013) identified that “month” was an important covariate in predicting SL estimates28. Slow speeds observed from the fleets in the sapphire award tier while the Protecting Blue Whales and Blue Skies program was inactive may be due to fleets' involvement in these additional speed reduction programs throughout the year.The Protecting Blue Whale and Blue Skies incentive-based VSR program was put into effect in the SBC in an effort to principally reduce air pollution impacts on local human populations and mitigate ship strikes on endangered whale species. At the inception of the program, reducing underwater noise from commercial shipping was regarded as a potential third conservation benefit of slowing large vessels. The added benefit of reducing underwater noise pollution from commercial shipping is quantified in this study. The transit-by-transit VSR approach (2014–2017) decreased SL estimates by over 5 dB and SEL estimates by over 4 dB for rewarded transits. The fleet-based approach (2018) allowed for significant reduction in SL and SEL estimates for ships that slowed 25% or more of their transits in the VSR zone , when compared to non-compliant vessel transits. However, there was no statistical difference in SL or SEL between the bronze award tier and non-compliant tier, highlighting the limited reduction in noise levels for fleets not slowing down compared to the higher cooperating fleets. There was no significant difference between SOG or SL between the sapphire and gold award tiers, which may be due to the small sample size of the sapphire award tier. Additionally, the SOG of the sapphire and gold award tiers were significantly slower than the lesser cooperating fleets while the program was inactive, and there was no significant reduction in SOG within the sapphire award tier while the program was active versus inactive. This suggests that there may be fundamental differences between tiers that were not related to the Protecting Blue Whales and Blue Skies program. Additional voluntary speed reduction efforts exist in the Santa Barbara Channel seasonally and year-round, including voluntary VSR requests from NOAA—which run from May through November each year, the year-round Green Flag incentive program established by the Port of Long Beach, and the Vessel Speed Reduction Program established by the Port of Los Angeles6. The Enhancing Cetacean Habitat and Observation (ECHO) program’s average control speed was faster  on average than the control speed in this study . This allowed for an SOG reduction of 4.0 m s−1 (7.7 knots) during the ECHO program, compared to the Protecting Blue Whale and Blue Sky VSR program SOG reduction of 2.5 m s−1. Because of this, the ECHO program had a larger reduction in SL (11.17 dB for container ships) between the control and participating groups compared to the SL reduction found in this study. Similarly to this study, the ECHO program found the largest reduction in noise below 100 Hz, and the smallest reductions in the intermediate frequency range6. This is most likely attributed to the reduction in noise brought about by cavitation, which is most prominent in frequencies below 100 Hz.A vessel speed reduction program initiated in British Columbia also identified slowing vessel speed as an effective method to reduce source levels of commercial vessels14. Taking into account the average duration of approximately 12 min that a ship transit was 15 dB above background sound levels in this study, there would need to be at least 10 ships slowing down to half of their speed to result in a 0.7 dB reduction in daily average ambient noise levels. In order to maximize the reduction in daily average ambient noise levels, regulating the speed of vessels in the VSR zone, or fleets as a whole, may be necessary given the low cooperation with the incentive-based VSR program.An additional single ship transit in the Santa Barbara Channel can increase ambient noise levels averaged over a day by 1 dB27. Employing regulations for mandatory speed restrictions of 10 knots, as is done in the Seasonal Management Areas along the U.S. East Coast, would ensure that efforts to reduce the threat of lethal ship strikes, air pollution, and ocean noise are undertaken by all fleets in the region. Third-party certification and labeling programs such as Organic, Fair Trade, Rainforest Alliance, and Green Marine have promoted social and environmental sustainability, with appropriate private and public recognition30. Involving the VSR program and more commercial shipping fleets into certification programs like Green Marine may be an effective approach to further reduce speeds and improve voluntary cooperation or enhance government regulations. Additionally, the International Maritime Organization has identified quieting technologies, such as specific propeller and hull designs, as a potential method to reduce underwater noise. Retrofitting vessels in the commercial shipping industry may allow for a method to reduce noise on an international scale33.There are likely many reasons why certain fleets showed lower cooperation rates or would be less inclined to slow their speeds during the VSR program months; for example, scheduling, cost, competition, mechanics, weather and other issues along their overall routes. The incentive-based VSR program includes public recognition, which shows promise for the importance of positive public relations and its role in commercial shipping fleets’ willingness to participate in VSR programsMitigating underwater noise generated from commercial shipping has the potential to reduce acoustic, physiological, and behavioral impacts that have been identified in marine mammals, fish, and invertebrates, allowing for an ecosystem-based approach to management. Effort into the investigation of biological responses to decreases in noise levels brought about by VSR programs is vital to ensure that measured SL and SEL reductions are adequate in reducing ship noise impacts on endangered whales and other marine organisms. Because the commercial shipping industry is a complex, intermodal system that operates under suites of constraints and externalities, an investigation into the various processes and stakeholders affected by the VSR program, including consumers, may aid in discovering how to permanently build conservation into commercial shipping.−1, from a moored Acoustic Doppler Current Profiler (ADCP) in the Santa Barbara Channel34. Additional information, such as ship length, was obtained from Lloyd’s Register of Ships35. The detailed vessel type was identified with the Marine Traffic online database36. Ship types were categorized into three groups: container ships (including reefers), bulkers , and vehicle carriers (including roll-on roll-offs). Tankers were not targeted for speed reduction in the SBC in the Protecting Blue Whales and Blue Skies incentive program from 2014 through 2018, and therefore were not included in this study.Locations of all ships, including ships that were not participating in the VSR program, transiting in the SBC were tracked by an AIS receiver located on Santa Ynez Peak that is maintained by the Santa Barbara Wireless Foundation Fig. . AIS mes8. To assess the ANSI/ASA (2009) environmental condition requirements for underwater measurements of ship sounds, wind speed from the National Oceanic and Atmospheric Administration (NOAA) buoy (station 46053) near the acoustic recorder were checked and any transits that were associated with wind speeds greater than 10.28 m s−1 were discarded, as higher wind speed can increase ambient noise levels38.Vessels transits were eliminated if another vessel transit occurred within the monitoring area within 1 h to ensure that each ship transit was acoustically isolated39  have been maintained at a long-term acoustic monitoring station (Site B) in the SBC  at ~ 580 m depth, 3 km off of the northbound shipping lane from 2007 to presentThe underwater radiated source level (SL) from an individual vessel was estimated from the received sound pressure level (RL) by accounting for the frequency-dependent transmission loss (TL) at the distance from the source to the receiver at the closest point of approach (CPA),37 (Eq. 2). The frequency-dependent hydrophone calibration was then applied to the PSDs to achieve RL in dB re 1 μPa2. To compute broadband RL values, hydrophone calibration-corrected RL levels in 1 Hz bins were converted to linear sound power spectra densities and summed across the 5–1000 Hz band, which is the approximate band for which ships are the principal source of noise within the SBC. The broadband RL values were then re-converted into dB re 1 μPa2.Received levels for each vessel transit were averaged over the data window period that equaled the time it took the ship to travel its length, as defined in ANSI/ASA (2009)37 Eq. . Receive40. A combination of the Lloyd’s mirror model and a spherical spreading model was used to account for the surface induced, source depth-dependent increase in TL seen with decreases in frequency41. The modified Lloyd’s mirror model utilizes the Lloyd’s mirror model from 5 Hz up to the frequency at which the Lloyd’s mirror TL and the spherical spreading model intersect. From the frequency of intersection to 1000 Hz, a spherical spreading model is used5. The intersection point between models depended on the source depth (see Effective Source Depth section) during a specific ship transit and ranged from 46 to 701 Hz.To account for surface reflection interference (Lloyd’s mirror) that may reduce sound measurements at recording sites at much greater horizontal distances than the water depth, such as at Site B, we used a modified Lloyd’s mirror TL model, which was demonstrated to reproduce the sound levels received from ships transiting near their CPA in the northbound shipping lane42. Harmonic mean sound speed was calculated by dividing the total depth by the sum of the time it takes the sound to pass through each layer of constant sound speed. Depth, temperature, and salinity were measured near Site B  on CalCOFI line 81.8 and station 46.9 four times per year and multiple times per year by the California Underwater Glider Network on line 8043. Between these two data sources, 30 sound speed profiles were measured from 2014 through 2018. Of the 49 months with paired acoustic and AIS data in this study, there were 30 months with corresponding sound speed profiles. For months that did not have a sound speed profile measurement, the sound speed profile measurement with the closest date was used.Harmonic mean sound speed required for the TL model was calculated with data from the California Cooperative Oceanic Fisheries Investigations  and California Underwater Glider Network44. Constructive and destructive interference from surface reflections depends on the depth and frequency of the acoustic source, requiring that propeller dimensions and draft be determined for use with the modified Lloyd’s mirror model.Propeller diameter and draft are directly related to acoustic source depth, as cavitation occurs near the tip of the rotating propellers44. Source depths ranged from 0.3 to 11.1 m with an average of 3.7 m ± 1.4 m.Propeller diameters were modeled from a subset of 35 propeller measurements from the 2020 World’s Merchant Fleet utilizing the relationship between the propeller diameter and the ship length Fig. . The dep37.Source levels were estimated by adding the modified Lloyd’s mirror TL to the RL over the data window period. Broadband SLs were measured by summing across the 5–1000 Hz frequency band. Source level spectra were measured from 5 to 1000 Hz, and displayed in 1 Hz bins and 1/3 octave bands in compliance with ANSI/ASA (2009)The relationship of SL versus vessel speed was determined by calculating the slope (regression coefficient) of the least-squares linear-fit, minimizing the sum of the squares of the deviations of the data from the model. The relationship was measured for each ship type.2) at various ranges of interest (ROI), and integrating over the duration of the transit:14. ROIs for each transit ranged from the depth of the hydrophone to the distance the ship travelled over the duration T, before and after CPA. Estimated RLs were calculated for each 1 min interval over the duration of the passage.The sound exposure level (SEL) was estimated as if each ship were transiting directly over the HARP by subtracting the frequency dependent TL from SL to estimate RL (in units of μPa−1 (12 knots) or less in 2014 and 2016 and 5.14 m s−1 (10 knots) or less in 2017 to present when transiting through the designated VSR zone. The target speeds were chosen because they have been shown to maximize reduction in ship strike risk, along with the added benefit of reduced air emissions46. The VSR program was active during the summer and fall (July 1 through November 15). During the winter and spring (November 16 through June 30) the VSR program was inactive, which served as control months to measure baseline noise measurements from the participating vessels.The VSR program requested that enrolled vessels reduce speeds to a target of 6.17 m sIn 2014, 2016, and 2017 the VSR program utilized a transit-by-transit approach for vessel enrollment. With this approach, enrolled companies signed up individual vessels and selected transits at the beginning of the program season to receive financial rewards and positive public relations for traveling at the reduced target speeds in the VSR zone.In 2018, the VSR program changed to a fleet-based approach to incentivize slow speeds across all transits taking place in the VSR zone. In the fleet approach, container ship and vehicle carrier companies that cooperated in the program were rewarded based on the percentage of nautical miles that all vessels in their fleets traveled at 10 knots or less during the 2018 program season in the VSR zone. Companies with fleets that demonstrated higher percentages of cooperating transit miles were awarded with financial rewards and positive press. The award scale adopted by the VSR program in these years was based on percentage of cooperation .−1 or higher prior to program enrollment. By doing this, the transit-by-transit VSR program was able to ensure that it was incentivizing companies that were voluntarily slowing transit speeds from previous years. The fleet-based VSR approach did not require a minimum historical average SOG qualifier for vessel enrollment in order to enroll all transits of involved fleets under operation by the participating companies. A total of 18.7% of the transits extracted with paired AIS and acoustic data, that met all required criteria for analysis, were associated with ships that participated in the VSR programs.Across all years of the program, historical AIS data was obtained from the United States Coast Guard, processed by the National Marine Fisheries Service, and provided to the VSR program administrators to monitor enrolled vessel speeds. In years that utilized a transit-by-transit approach, historical AIS data were analyzed to ensure the transits enrolled in the VSR program had an average speed of 6.17 m sRewarded (transit-by-transit approach)Control (transit-by-transit approach)Program active (fleet-based approach)Program inactive (fleet-based approach)Transits of participating vessels in the Santa Barbara Channel from 2014 through 2018 were categorized into 4 different groups:The effects of the incentive-based VSR program were calculated for the transit-by-transit approach and the fleet-based approach separately. The effect of the transit-by-transit approach was calculated by comparing the rewarded group to the control group. A t-test was used to determine if the SL measurements of the two groups were equal or not equal. The null hypothesis for the t-test is that the SL measurements of the control group and the rewarded group were equal.p-values were adjusted with the Benjamini and Hochberg (1995) method to control for false discoveries with multiple comparisons47.A Kruskal–Wallis test was conducted to determine the effect of the fleet-based approach by comparing the fleet award tiers to one another, and comparing each fleet award tier to itself while the program was active versus inactive. The null hypothesis of the Kruskal–Wallis test is that mean ranks of the SLs between award tiers and within award tiers while the program was active versus inactive are the same. A Dunn’s test of multiple comparisons was conducted to establish any significant differences within and between specific tiers.


Nicotiana benthamiana resistance to Phytophthora infestans. However, the functions of StMKK1 in potato immunity are unknown. To investigate the roles of StMKK1 in potato resistance to different pathogens, such as the potato late-blight pathogen P. infestans, the bacterial wilt pathogen Ralstonia solanacearum, and the gray-mold fungal pathogen Botrytis cinerea, we generated StMKK1 transgenic lines and investigated the response of potato transformants to destructive oomycete, bacterial, and fungal pathogens. The results showed that overexpression and silencing of StMKK1 do not alter plant growth and development. Interestingly, we found that StMKK1 negatively regulated potato resistance to the hemibiotrophic/biotrophic pathogens P. infestans and R. solanacearum, while it positively regulated potato resistance to the necrotrophic pathogen B. cinerea. Further investigation showed that overexpression of StMKK1 suppressed potato pathogen-associated molecular pattern (PAMP)-triggered immunity (PTI) and salicylic acid (SA)-related responses, while silencing of StMKK1 enhanced PTI and SA-related immune responses. Taken together, our results showed that StMKK1 plays dual roles in potato defense against different plant pathogens via negative regulation of PTI and SA-related signaling pathways.Mitogen-activated protein kinase (MAPK) cascades play important roles in plant immunity. Previously, we reported that the potato StMKK1 protein negatively regulates  Phytophthora infestans, Ralstonia solanacearum, and Botrytis cinerea. P. infestans, a hemibiotrophic pathogenic oomycete1, is the causal agent of potato late blight, which results in global costs of more than 6 billion dollars per year2. The biotrophic bacterial pathogen R. solanacearum causes one of the most notorious diseases of potato, known as potato bacterial wilt3. Potato gray mold is a common disease and is caused by the necrotrophic fungal pathogen B. cinerea4. These diseases lead to billions of dollars of potato production losses annually and pose serious threats to food security.Potato, the world’s third most important food crop (FAOSTAT 2013), is threatened by a group of major pathogens, 5. The first layer relies on pattern-recognition receptors (PRRs), which can percept pathogen-associated molecular patterns (PAMPs). The perception of PAMPs triggers a series of defense responses called PAMP-triggered immunity (PTI)6. The second layer is mediated by plant-resistance (R) proteins that can detect cognate pathogen effectors and subsequently activate a robust immune response called effector-triggered immunity (ETI)7.To combat pathogens, plants have evolved two-layered plant immune systems9. MAPK cascades generally contain three kinase components, MAP kinase kinase kinase (MAPKKKs), MAP kinase kinase (MAPKKs), and MAPKs10. It has been shown that the activation of both PRR proteins and R proteins can induce MAPK cascades, which play central roles in signaling defense responses13. For example, MEKK1−MKK4/MKK5−MPK3/MPK6, which can be activated by the bacterial PAMP flg22, could induce WRKY transcription factor gene expression and positively regulate plant defense against bacterial and fungal pathogens15. In addition, another well-demonstrated MAPK cascade in Arabidopsis, consisting of MKK1/MKK2 and MPK4, negatively regulates plant immunity by regulating the expression of PR genes and the accumulation of H2O216. In addition, AtMKK3, which can enhance the expression of PR genes, was shown to play a role in the defense against Pseudomonas syringae pv. tomato DC300017.The mitogen-activated protein kinase (MAPK) cascade is an important pathway that transduces extracellular stimuli into intracellular responsesGhMKK1 decreases N. benthamiana resistance to R. solanacearum18, while ZmMKK1 positively regulates N. tabacum resistance to Pseudomonas solanacearum19. Although the role of several MKK proteins in plant immunity has already been studied in Arabidopsis, their role in the potato response to different classes of pathogens is still unknown. Several MKK proteins were reported to play a role in SA-related immune signaling20. For example, tomato SlMKK2 and SlMKK4 were shown to be involved in both JA- and SA-signaling pathways21. Constitutively active AtMKK2-EE was shown to reduce SA levels upon P. syringae infection22.MKKs play dual roles in plant defense against different pathogens. For example, overexpression of P. infestans RXLR effector. Overexpression of StMKK1 in N. benthamiana promotes plant susceptibility to P. infestans, indicating that StMKK1 negatively regulates plant immunity to the late-blight pathogen. However, the functions of StMKK1 in potato to P. infestans and other pathogens remain unknown. In this study, to dissect the role of StMKK1 in potato resistance to different plant pathogens, we constructed StMKK1 transgenic potato and investigated the response of potato transformants to oomycete, fungal, and bacterial pathogens.Previously, we showed that the potato StMKK1 protein is a host target of the Arabidopsis encodes ten MKK genes, and AtMKK1 and AtMKK2 are very similar to each other23. To determine whether StMKK1 is redundant in potato, we identified all MKK proteins in potato, tomato, and N. benthamiana and performed a phylogenetic analysis with Arabidopsis MKKs  in the activation loop . The expression levels of StMKK1 were significantly upregulated in the different overexpression (OE) transgenic plants and downregulated in the RNAi transgenic plants, as determined by qRT-PCR 24, showed no morphologically distinct phenotypes compared to the wild-type plant Desiree , lesion development was photographed, and lesion diameters were measured25. The results showed that StMKK1 OE lines developed larger lesions  bursts and immune-related gene expression, which in some cases, leads to plant cell death that is unfavorable for biotrophic pathogens, as they require a biotrophic environment for disease development. However, necrotrophic plant pathogens use plant cell death responses to kill the host cell for proliferation29; thus, plants express an opposite response to these pathogens. Second, different plant hormones respond differently to biotrophic/hemibiotrophic or necrotrophic pathogens. For example, SA positively regulates a large portion of the plant immune response to biotrophic and hemibiotrophic plant pathogens31, while it negatively regulates plant immunity to necrotrophic pathogens32.Many genes are reported to play dual roles in plant immunity; on the one hand, these genes contribute to plant susceptibility to biotrophic pathogens, and on the other hand, they promote plant resistance to necrotrophic pathogensStMKK1 OE-1/3/5 and RNAi-8/10/12 lines. The transgenic plants were infiltrated with flg22, and PTI-related gene expression and ROS bursts were detected. As shown in Fig. 4StFRK1 and StWRKY7 was reduced and the flg22-triggered ROS burst was suppressed in StMKK1 OE-1/3/5 plants. However, the RNAi-8/10/12 lines showed enhanced expression of PTI-related genes and induction of an ROS burst -related disease resistance33. To reveal the role of potato StMKK1 in the SA-related defense response, we analyzed the effect of StMKK1 on SA-responsive gene expression. StMKK1 was transiently expressed in N. benthamiana leaves for 2 days before harvest to assess SA-responsive gene expression. The results showed that the expression of NbPR1, NbPR2, NbPR5, and NbICS1 was significantly repressed in StMKK1-expressing leaves compared with that in the GFP-GUS control  ethanesulfonic acid (MES), 10 mM MgCl2, and 200 mM acetosyringone, pH 5.6) to an OD600 of 0.3 and kept at room temperature for 1 h before infiltration into N. benthamiana leaves.GFP-StMKK1 and StMKK1-pART27-RNAi plasmids were constructed as described previously24. Agrobacterium tumefaciens-harboring pART27-StMKK1 was transformed into potato cv Desiree by stem segment transformation as described previously40. The rooted transformants grown on MS medium supplemented with vitamins, 100 mg/L kanamycin, and 30 g/L sucrose were transferred to a new MS medium without kanamycin at 23 °C with a 16/8 h day/night cycle. Three weeks later, the transformants were transferred to plastic pots containing potting soil in a climate chamber at 25 °C with a 16/8 h day/night cycle. For both overexpression and RNAi constructs, more than five independent transformants were obtained and confirmed by PCR with the forward primer of the 35S promoter and the gene-specific reverse primer of StMKK1  plates at 18 °C in the dark for approximately 2 weeks before zoospores were collected. 14-3-GFP is a GFP-expressing transformant of P. infestans H30P02 and was shown to reach a 100% infection efficiency on Desiree in a previous study25. P. parasitica was grown on 5% carrot juice agar (CA) plates at 23 °C in the dark for 4−5 days, and the zoospores were prepared as described previously41. Botrytis cinerea strain B05.10 was grown on potato dextrose agar (PDA) plates in the dark at 23 °C for 3−4 days before spores were collected. The R. solanacearum strain GMI1000 was grown in liquid LB medium overnight at 28 °C in a shaker.N. benthamiana plants were grown in a climate chamber with a 16/8 h day/night cycle at 25 °C. Four- to five-week-old N. benthamiana plants and 5-week-old potato plants were used for infection assays. Zoospores from P. infestans isolate 14-3-GFP were collected as described previously26. Detached leaf assays were performed by inoculating 10-μL zoospore suspensions containing 1000 zoospores onto one potato leaflet. The inoculated leaves were kept in moisture in the dark at 18 °C and the lesion diameters were measured at 4 dai. For B. cinerea inoculation, the spore suspension was prepared as described previously42, and for each leaf, a 2-μL spore suspension that contained approximately 2000 spores was used. The inoculated leaves were kept at room temperature, and at 2 dai, the lesion diameters were measured. For R. solanacearum infection, R. solanacearum overnight cultures were collected and washed two times before dilution with distilled tap water to an OD600 of 0.1. Two-week-old potato plants were inoculated with R. solanacearum suspensions using the method described previously43. Wilting symptoms were observed at 5 dai, and the number of bacteria in the aerial parts of the infected plants (cfu/fresh weight) was counted as described previously43. For Phytophthora parasitica infection, the GFP-tagged strain Pp1121 was used. P. parasitica was cultured, and infection assays were performed as described previously41, and the lesion diameters were measured at 3 dai.Potato and 26 using the appropriate primer pairs shown in Supplemental Table StMKK1 expression levels in different transgenic lines were quantified using the 2ΔΔCt method, and the potato gene Actin was used for normalization. Additionally, the expression of the N. benthamiana gene Actin was used for normalization.Total RNA was isolated from transgenic potato lines using TRIzol reagent (Invitrogen). First-stranded cDNAs were synthesized, and qRT-PCR was performed as described44. To analyze the transcript level of StMKK1 under SA treatment, SA was dissolved in ethanol, and 10 mM SA solution was sprayed onto 2-month-old potato leaves. Leaves were harvested at 1, 3, 6, 12, and 24 h after SA spraying for RNA extraction.The 10 µM flg22-treated leaves were subsequently used for ROS production analysis as described previously26. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was performed to detect the proteins. Antibody  was used according to descriptions given in the manual.Samples expressing GFP-StMKK1 and GFP-GUS were extracted using lysis buffer as described previouslyAccession numbers of StMKK1 are as follows: Sotub12g010200.1.1. NbMKK1/2: Niben101Scf02790g03012.1, Niben101Scf13387g00027.1, Niben101Scf10103g03014.1, Niben101Scf00611g07010.1.Supplemental information revised


This study assessed the feasibility and acceptability of the Healthy Outcomes through Peer Educators (HOPE) training program designed to train African American (AA) grandmothers to serve as peer educators for other AA grandmothers who are at risk for diabetes. The newly trained peer educators will provide the needed encouragement and positive reinforcement essential for successful sustainable health behaviors to grandmothers enrolled in a subsequent Diabetes Prevention Program.Thirty AA women between the ages of 49–72 were enrolled in the pre-post single group study. The participants were required to attend a 2-h Diabetes Prevention Program session every week for 16 weeks. The sessions covered the role of the peer educator and encouraged participants to increase their physical activity and consume more servings of fruits and vegetables daily. We noted the number of participants who successfully completed the training and solicited their perspective regarding the strengths of the program and suggestions to improve the program. The Wilcoxon Signed Ranks Test was performed to evaluate changes in body weight, self-reported physical activity, and fruit and vegetable intake from baseline to week 16.p < 0.05. Fruit and vegetable intake increased significantly  at week 16 compared to week one,  Z = 4.46, p < 0.05. Participants were more physically active at week 16  compared to week 1,  Z = 4.62, p < 0.05.Ninety three percent (n = 28) of enrollees completed the training program. All (n = 28) the peer educator trainees indicated that they would recommend the program to a friend and 93% (n = 26) reported that the program met their needs. The participants (n = 28) felt that the training prepared them to offer support to other grandmothers in their community. A Wilcoxon Signed Ranks Test revealed that participants body weights were significantly lower after completion of the 16 week training program  compared to baseline , Z = − 4.43, The peer educator training component of HOPE was found to be feasible and acceptable as evidenced by our successful recruitment and retention of participants. Participation in the peer educator training program also resulted in improvement in health behaviors. Almost one third of African American (AA) grandmothers living with grandchildren serve as primary caregivers compared to 9% of the general population . AfricanThe incidence of obesity, depression, and diabetes is high among AA grandmother caregivers . The psyIt is likely that 80% of AA grandmother caregivers are overweight or obese, many whom care for a grandchild who is also overweight or obese , 12. TheMost AA grandmothers serve as the primary caregiver for their grandchild, often receiving little or no support from other family members . TherefoThe Diabetes Prevention Program (DPP)  is an evOur peer support intervention is based on the Social Learning Theory (SLT) that assumes that people are shaped by their environment and learn by observing others , 28. AccGrandmothers enrolled in DPP will increase knowledge, practice new skills, and increase self-efficacy as a result of receiving ongoing peer support Fig. . In a prThe first step toward the delivery of DPP + HOPE is to train AA grandmothers to serve as peer educators for other grandmothers within their community. This paper provides the outcomes of this study which assessed the feasibility of the novel peer educator training component of HOPE.This pre-post single group study tested the feasibility and acceptability of the 16-week peer educator training component of the HOPE intervention. The study was approved by the University Social Sciences Human Subjects Protection Committee and participants provided written informed consent prior to any study procedure.2); (2) no previous diagnosis of diabetes; 3) and a glycosylated hemoglobin A1C between 5.7 and 6.4% [Any woman who self-identified as African American was eligible to participate in the training program if she was 40 years of age or older and identified as the primary caregiver of one or more grandchildren ages 2 through 18 years. A primary caregiver was defined as “one who provides instrumental and expressive care to a grandchild living in the same household daily for an indefinite period.”  In additand 6.4% . The graThe grandmother must be willing to be weighed at the time of enrollment in the study and the end of the study period as well as attend weekly DPP training sessions as able. Grandmothers were excluded if they were pregnant or had diseases that would limit their life span or restrict their ability to participate in the study.We recruited 30 women from two community centers located in ethnically diverse neighborhoods in Wisconsin. The staff at each community center was asked to identify 15 women whom they felt would be a good peer educator for the HOPE peer educator training. In addition to meeting the inclusion criteria listed above for grandmothers, desirable characteristics and attributes of a peer educator included being actively engaged in community-based activities, being willing and available to be trained and participate in the subsequent DPP + HOPE intervention, have good interpersonal skills, possess similarities to the target participants, be respected in the community, have the ability to motivate others, have good listening skills, have basic problem-solving skills, live in the community being served, and be willing to help the community.The grandmothers were required to participate in a 32-h DPP training program. The training program’s schedule is flexible. The training program can be offered in its entirety on 4 consecutive days for trainees who prefer a concentrated experience or spread out over a 2-to-16-week period. The HOPE training program was offered 2 h a week over 16 weeks to accommodate the participants schedules.The sessions which were led by a diabetes care and education specialist, promoted healthy eating, increased physical activity, modest weight loss (5%), and reduction in hemoglobin A1C. The sessions also covered the role of the peer educator which included empathic listening and helping participants develop health goals for themselves and family members. These training sessions were guided by the DPP training manual and a peer support training manual and toolkit that focused on supportive, non-judgmental communication, goal setting, motivational interviewing, and providing social and emotional support. The grandmothers were also required to complete human participant research ethics (IRB) training.We assessed the feasibility of the training program by noting the number of participants recruited and retained in the program. We also conducted open-ended interviews during the last week of the program to learn about each participant’s experience during the training sessions. The 30-min interview was led by a study team member who did not participate in the training sessions to encourage honest feedback. Based on our previous work , we askeA digital electronic scale  was used to measure the body weight of each participant. Each grandmother’s weight was obtained while the woman was in a standing position, shoeless, and wearing light clothing. Physical activity and dietary behavior were assessed at the time of enrollment and the completion of the 16 week training period using two validated surveys: the International Physical Activity Questionnaire (IPAQ)  and the Hemoglobin A1c was evaluated at baseline to determine eligibility to participate in the study  and the The authors read the transcripts from each interview thoroughly to obtain an understanding of the data. Analysis of the interview transcripts used a conventional content analysis approach , where eBecause the data was slightly skewed, the Wilcoxon Sign Rank Test was used to assess changes in body weight, physical activity and fruit and vegetable intake from baseline to week 16. All analyses were conducted using SAS .Participants were, on average, 52.4 ± 9.5 years old (49–72 years) and all reported annual family incomes less than 200% of the 2019 federal poverty level. The participants reported having a total of 42 grandchildren  living with them. Of these children, 60% were boys.Thirty women were recruited to participate in the training program. Ninety-three percent (n = 28) successfully completed the training. One woman relocated to another state during week 3 and another left the program during week 2 due to an employment opportunity.The average weekly participation rate varied between 96 and 82% which leveled off at after week four of the study.All study participants (n = 28) were available to evaluate the program at the end of the 16 week study period. Participants unanimously agreed that they would recommend the program to a friend and most  reported that the program met their needs. All the participants reported that they really enjoyed interacting with their neighbors during the peer educator training sessions and felt that the training prepared them to offer support to other grandmothers in their community.A significant theme that emerged from the exit interviews was that participants enjoyed the training sessions because they were able to connect with neighbors and offer support, strength, and hope to their peers, which allowed for personal growth, wellness, and a sense of belonging within the community. One peer educator trainee stated the following “When I moved to Wisconsin, I felt lonely because I didn’t know anybody. I watched a kid being picked on by other boys, but I did not know who to call for help. I knew a lot of my neighbors in Chicago, Illinois so I could call them if I saw their kid in trouble.” Several grandmothers suggested that we include the children in some of the sessions, particularly the cooking and nutrition classes. One grandmother stated “I want to learn how to cook green vegetables like asparagus and Brussels sprouts. I think I overcook vegetables and I add too much salt to give them taste. I know they are full of vitamins but they cost so much and don’t really fill you up.” p < 0.05. Fruit and vegetable intake increased significantly  at week 16 compared to week one,  Z = 4.46, p < 0.05. Participants were more physically active at week 16  compared to week 1,  Z = 4.62, p < 0.05  compared to baseline , Z = − 4.43, In addition to positive measured health outcomes, participants reported an increase in family time through walks, active play, reading with their grandchildren and preparing and eating meals as a family. Participants frequently mentioned that their grandchild became a ‘change agent’ by refocusing them on healthy behaviors and practices. At one site, the peer educator trainees led a petition to remove the soda vending machines from the local community center, improving their built environment and ultimately advancing community health.This article describes a peer educator training program designed to provide grandmothers with the skills to help other grandmothers in their community in making and sustaining healthy lifestyle choices. These newly trained peer educators will be paired with peers enrolled in a subsequent structured educational intervention, DPP + HOPE to improve problematic health behaviors related to diet and exercise in grandmother caregivers. These peer educators will lead group activities during the DPP sessions and support their peers in making and sustaining healthy lifestyle choices. Peer educators will also provide one on one phone support during the week to their assigned peers to reinforce DPP session topics and encourage participants to maintain health goals. During these phone calls, participants can discuss any barriers they face when attempting to meet their goals, and collectively problem solve ways of addressing the barriers. All the participants expressed confidence and enthusiasm about providing support to other grandmother caregivers in their community.The peer educator training component of HOPE was found to be feasible and acceptable as evidenced by our successful recruitment and retention of 93% of participants (n = 28) who successfully completed the study. The peer educator trainees enjoyed interacting with their neighbors and reported increasing their physical activity and consumption of fruits and vegetables because of their participation in the program. Weight gain among the participants was attenuated during their enrollment in the training program with 89% (n = 25) of participants experiencing weight loss Table .Peer support has been found to improve health behaviors and disease management when incorporated into an educational program –26. Our There are several limitations to this study. First, the study findings cannot be generalized to all AA women because of the small sample size, sample selection, and low statistical power. However, this small sample is acceptable since this was a feasibility study. A larger study is needed to more rigorously determine intervention efficacy and the generalizability of the results; We plan to conduct a randomized controlled trial comparing the intervention efficacy of DPP + HOPE with an active comparator, DPP alone.It is important to note that self-report of physical activity and fruit and vegetable intake possibly introduced social desirability and recall bias and compromised the validity of the findings. For future studies, a research associate who does not interact with the participants will administer the survey to each participant individually, so participants are not pressured to impress the research staff or peers. We will ask participants to maintain food diaries, so they have a record of their food intake. Fitbit watches will be provided for all participants (peer educators and participants) so a record of steps walked per day is maintained.The peer coach training for HOPE was approximately 40 h in total. The community advisory committee and study participants from a previous study recommended that the peer training be limited to 2 h per week to give the participants adequate time to learn the material. The training program can be translated to other communities and the trainings sessions can be shortened or lengthened based on the educational background and availability of the participants.The strengths of this study which include our intent to assess the feasibility of recruiting and retaining high-risk grandmother caregivers in the training program outweigh the limitations noted above.The HOPE training program was designed to be sustainable at a community or neighborhood level by being responsive to each community’s unique physical and social environment. Peers can be matched based on culture, language, age, and sex. Churches, civic groups, and community centers can partner with health care organizations and academic partners to train neighborhood volunteers with a DPP based curriculum at little to no cost. This project promoted strong social and community ties among community members strengthening social capital and providing participants with the confidence to advocate for healthier food choices at their local community center. The success of the HOPE training and the community’s excitement to enlarge the project by augmenting an existing DPP program with HOPE reinforces its potential for other communities.Incorporating community-based peer support in educational programs may promote strong social and community ties among community members. By sharing their own lived experiences, peer educator grandmothers can help other caregivers in their community develop their own health goals, create strategies for self-empowerment and take steps toward serving as positive role models for their grandchildren. This work may provide a model for effectively facilitating behavior change and reducing the risk of obesity, diabetes, and other chronic diseases.