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Poster Session F
F1 - Positive Affect, Physical Activity, and Biological Aging in Older Breast Cancer Patients
Poster Number: F1Time: 11:00 AM - 11:50 AM
Topics: Aging, Cancer
Background. Breast cancer (BC) patients are at risk for accelerated aging due to elevated levels of stress, inflammation, and metabolic demand that arise from BC and its treatments. Cellular senescence (CS), a hallmark of biological aging, has been implicated in poor clinical and quality of life outcomes in cancer patients. Individual resiliency characteristics, such as positive affect, and positive health behaviors, such as physical activity, may contribute protective effects on accelerated aging through biobehavioral processes. We aimed to examine the relationship between positive affect, physical activity, and CS, and whether positive affect and physical activity interacted in this relationship.
Methods. Older (M = 61 years of age) women (N = 45) who were recently diagnosed with Stage 0-III BC and underwent surgery but had not yet begun adjuvant treatment were enrolled in a stress management trial. At baseline, participants completed measures of physical activity (Physical Activity Scale for the Elderly) and positive affect (Affects Balance Scale) and provided blood samples. B cells were isolated from peripheral blood cells using magnetic microbeads, and cell senescence markers, p16 and p21, were quantified from B cell mRNA using qPCR.
Results. Multiple regression covarying for age, stage, surgery type, body mass index, and comorbidities revealed that greater positive affect was associated with lower levels of p21 (b = -0.06, SE = 0.02, p = .01) but not p16. Physical activity was not significantly associated with p21 or p16 (p > .05). Although physical activity was unrelated to p16 or p21, moderation models with the same covariates found the interaction between physical activity and positive affect was statistically significant for p21 (p = .01) but not p16. Simple slopes analysis revealed that for participants with higher positive affect (≥ 71), greater physical activity related to significantly lower levels of p21 (b = -0.02, SE = 0.005, p = .003), but among those with lower positive affect (< 71) physical activity was unrelated to p21 (p = .74).
Conclusions. Results suggest protective effects of positive affect on CS and that physical activity effects on CS may be limited to those with greater positive affect in older BC patients. Older BC patients may benefit from psychosocial interventions that promote positive affect in tandem with opportunities for increasing physical activity to mitigate cancer accelerated aging.
Keywords: Aging, CancerMethods. Older (M = 61 years of age) women (N = 45) who were recently diagnosed with Stage 0-III BC and underwent surgery but had not yet begun adjuvant treatment were enrolled in a stress management trial. At baseline, participants completed measures of physical activity (Physical Activity Scale for the Elderly) and positive affect (Affects Balance Scale) and provided blood samples. B cells were isolated from peripheral blood cells using magnetic microbeads, and cell senescence markers, p16 and p21, were quantified from B cell mRNA using qPCR.
Results. Multiple regression covarying for age, stage, surgery type, body mass index, and comorbidities revealed that greater positive affect was associated with lower levels of p21 (b = -0.06, SE = 0.02, p = .01) but not p16. Physical activity was not significantly associated with p21 or p16 (p > .05). Although physical activity was unrelated to p16 or p21, moderation models with the same covariates found the interaction between physical activity and positive affect was statistically significant for p21 (p = .01) but not p16. Simple slopes analysis revealed that for participants with higher positive affect (≥ 71), greater physical activity related to significantly lower levels of p21 (b = -0.02, SE = 0.005, p = .003), but among those with lower positive affect (< 71) physical activity was unrelated to p21 (p = .74).
Conclusions. Results suggest protective effects of positive affect on CS and that physical activity effects on CS may be limited to those with greater positive affect in older BC patients. Older BC patients may benefit from psychosocial interventions that promote positive affect in tandem with opportunities for increasing physical activity to mitigate cancer accelerated aging.
Authors:
Author - Jenna Hansen,
BS,
University of Miami
Co-Author - Daniela Frasca,
PhD,
University of Miami
Co-Author - Rachel Plotke,
BA,
University of Miami
Co-Author - Millan R. Kanaya, BS,
BS,
University of Miami
Co-Author - Sarah Webster,
BA,
University of Miami
Co-Author - Paula Popok,
MS,
University of Miami
Co-Author - Emily Walsh,
MS,
University of Miami
Co-Author - Molly Ream,
PhD,
University of Miami
Co-Author - Mason Kruger,
MS,
University of Miami
Co-Author - Dolores Perdomo,
PhD,
University of Miami
Co-Author - Maria Romero,
MS,
University of Miami
Co-Author - Bonnie Blomberg,
PhD,
University of Miami
Co-Author - Michael Antoni,
PhD,
University of Miami
F2 - Feeling older than one’s age predicts moving less in young but not older adults
Poster Number: F2Time: 11:00 AM - 11:50 AM
Topics: Aging, Physical Activity
Aging-focused research has linked a happier, healthier, and longer life to individuals’ beliefs and subjective experiences of aging (collectively referred to as views of aging or VOA). Findings based primarily on cross-sectional and macro-longitudinal data suggest that negative VOA serve as risk factors for worse outcomes and lower engagement in health-promoting behaviors. Although researchers have increasingly examined VOA in the context of individuals’ everyday lives using micro-longitudinal data, links between daily negative VOA and health (especially health behavior) in these contexts remain underexplored. This study takes initial steps to fill this research gap by integrating insights from different psychological perspectives and using data from an ecological momentary assessment study to examine whether individuals’ feeling subjectively older than their chronological age (assessed via self-report each morning for 14 consecutive days) negatively predicts their daily physical activity (assessed via activPAL continuously over the same timeframe). We subjected self-report, step count, and stepping time data from an adult lifespan sample of 197 adults aged 19 to 87 (mean age of 56 years) to multi-level models. Results did not show significant effects at the within-person level, suggesting that daily changes in subjective age and physical activity were not systematically related. However, they did show a significant effect at the between-person level such that, on average, people who felt older than their age also had lower step counts and fewer minutes of stepping. Based on follow-up analyses, this effect was strongest in young adults but not significant in middle-aged and older adults. It also remained significant after controlling for potential health-related confounders (stress, sadness, and pain assessed daily) and considering the potential role of other contextual factors (general beliefs about the aging process assessed once upon study enrollment). This study reflects the first investigation of daily links between VOA and device-captured measures of physical activity, providing new insights that negative VOA (in this case, feeling older than your age) puts young adults but not older groups at greater risk for an unhealthy lifestyle. Future studies focused on underlying mechanisms would enhance our understanding of how and why these effects emerge.
Keywords: Aging, Physical activityAuthors:
Co-Author - Jonathan Hakun,
Ph.D. ,
Pennsylvania State University
F3 - Geriatrics needs among older rural Veterans receiving virtual mental health services
Poster Number: F3Time: 11:00 AM - 11:50 AM
Topics: Aging, Digital Health
Background: Specialty tele-geriatric mental health (tele-GMH) consultation via regional telehealth hubs provides virtual services to rural older Veterans, their families, and referring clinicians. However, these services do not typically include geriatricians who can provide specialized care and recommend resources to meet older Veterans’ medical and functioning needs. This study describes a needs assessment conducted as a step towards integrating geriatric medicine with existing tele-GMH services.
Methods: To ascertain geriatrics needs for Veterans receiving tele-GMH services, we surveyed referring clinicians about (1) access to geriatrics-related specialty care (e.g., geriatric medicine, palliative care), and (2) local aging services for rural, older Veterans under their care (e.g., meal delivery services, home health aides, adult day centers). Twenty-five clinicians referring to tele-GMH teams responded to the survey. Need for geriatrics services were also ascertained through interviews with tele-GMH clinicians (n = 11). Survey data were summarized with percentages; rapid qualitative analyses were used to characterize needs identified during interviews.
Results: Of the referring clinicians, 14 served rural patients only and 11 served both rural and non-rural patients. Most were practicing in primary care (44%) or mental health care (32%). Referring clinicians reported lower access to geriatricians and neuropsychologists compared with access to other disciplines. Interviews with tele-GMH clinicians highlighted need for social work services, occupational therapy for home safety evaluation and falls prevention, local imaging options, palliative care, and more primary care and mental health group services. Tele-GMH clinicians reported little to no access to geriatricians for rural Veterans. With regard to local aging services, referring clinicians reported lower access to respite care and congregate meal sites compared with access to home health aides (HHAs) and meal delivery services for rural Veterans. Tele-GMH clinicians described challenges and solutions related to connecting Veterans and caregivers with HHAs and respite care.
Conclusions: Results highlight the need for specialty geriatrics services and respite or home health care for rural older Veterans. Our findings demonstrate the importance of comprehensive care for Veterans provided by GMH clinicians, geriatricians, and social workers on integrated tele-geriatrics teams.
Keywords: Aging, Tele-healthMethods: To ascertain geriatrics needs for Veterans receiving tele-GMH services, we surveyed referring clinicians about (1) access to geriatrics-related specialty care (e.g., geriatric medicine, palliative care), and (2) local aging services for rural, older Veterans under their care (e.g., meal delivery services, home health aides, adult day centers). Twenty-five clinicians referring to tele-GMH teams responded to the survey. Need for geriatrics services were also ascertained through interviews with tele-GMH clinicians (n = 11). Survey data were summarized with percentages; rapid qualitative analyses were used to characterize needs identified during interviews.
Results: Of the referring clinicians, 14 served rural patients only and 11 served both rural and non-rural patients. Most were practicing in primary care (44%) or mental health care (32%). Referring clinicians reported lower access to geriatricians and neuropsychologists compared with access to other disciplines. Interviews with tele-GMH clinicians highlighted need for social work services, occupational therapy for home safety evaluation and falls prevention, local imaging options, palliative care, and more primary care and mental health group services. Tele-GMH clinicians reported little to no access to geriatricians for rural Veterans. With regard to local aging services, referring clinicians reported lower access to respite care and congregate meal sites compared with access to home health aides (HHAs) and meal delivery services for rural Veterans. Tele-GMH clinicians described challenges and solutions related to connecting Veterans and caregivers with HHAs and respite care.
Conclusions: Results highlight the need for specialty geriatrics services and respite or home health care for rural older Veterans. Our findings demonstrate the importance of comprehensive care for Veterans provided by GMH clinicians, geriatricians, and social workers on integrated tele-geriatrics teams.
Authors:
Author - Christine E. Gould, PhD,
PhD,
VA Palo Alto
Co-Author - Chalise Carlson,
Palo Alto VA
Co-Author - Carter H. Davis,
VA Palo Alto Health Care System
Co-Author - Marisa Brodrick,
VA Palo Alto Health Care System
Co-Author - Marika B. Humber,
PhD,
VA Palo Alto Health Care System
Co-Author - Althea Lloyd,
PhD,
Department of Veterans Affairs
Co-Author - Ranak Trivedi, PhD, FSBM,
PhD, FSBM,
Stanford University/VA Palo Alto
Co-Author - Amanda Peeples,
PhD,
Department of Veterans Affairs
F5 - Financial Toxicity and Perceived Injustice: Longitudinal Associations with Symptom Changes in Cancer Patients
Poster Number: F5Time: 11:00 AM - 11:50 AM
Topics: Cancer, Mental Health
Greater perceived financial toxicity and injustice related to the cancer experience have been associated with higher levels of physical and psychological symptoms in cross-sectional studies. However, scarce longitudinal research has linked these perceptions to changes in physical and psychological symptoms to inform future interventions. This study begins to fill this gap by examining associations of financial toxicity and perceived injustice with changes in physical and psychological symptoms in solid tumor patients over a 2-month period.
Patients (N=177) with stage I-III breast, gastrointestinal, lung, or prostate cancer who reported at least mild financial toxicity were recruited from Indiana hospitals. Patients were either undergoing or had recently completed cancer treatment. Patients completed the Comprehensive Score for Financial Toxicity (COST), the Injustice Experience Questionnaire (IEQ), and PROMIS measures of pain, fatigue, sleep disturbance, anxiety, and depressive symptoms at baseline and 2 months later. The retention rate at follow-up was 94.3%. We used path analysis to examine relationships between baseline financial toxicity and perceived injustice and symptom changes, while adjusting for demographic and medical covariates.
Participants were primarily non-Hispanic White (78.5%) or Black (15.8%) and female (53.1%), with an average age of 62 years. Most participants (68.9%) had some college education, and 55% reported an annual household income of less than $51,000. Nearly half (46.9%) had stage III cancer, with diagnoses distributed fairly evenly across the cancer types. Higher financial toxicity was associated with worsening depressive symptoms (β=-0.19, p<0.01), but was not significantly correlated with changes in anxiety or physical symptoms. Greater perceived injustice was significantly associated with worsening anxiety (β=0.21, p<0.01), depressive symptoms (β=0.27, p<0.01), and sleep disturbance (β=0.13, p=0.02), and marginally associated with fatigue (β=0.09, p=0.08). Baseline symptoms were strong predictors of the same symptoms at follow-up (βs=0.44-0.65, ps<0.01).
Findings suggest that financial toxicity and perceived injustice are risk factors for depressive symptoms and that perceived injustice may also predict anxiety and physical symptom burden in patients with cancer. Further research is needed to explore the mechanisms underlying these associations to inform strategies to improve patients’ financial well-being and symptoms.
Keywords: Cancer, Longitudinal researchPatients (N=177) with stage I-III breast, gastrointestinal, lung, or prostate cancer who reported at least mild financial toxicity were recruited from Indiana hospitals. Patients were either undergoing or had recently completed cancer treatment. Patients completed the Comprehensive Score for Financial Toxicity (COST), the Injustice Experience Questionnaire (IEQ), and PROMIS measures of pain, fatigue, sleep disturbance, anxiety, and depressive symptoms at baseline and 2 months later. The retention rate at follow-up was 94.3%. We used path analysis to examine relationships between baseline financial toxicity and perceived injustice and symptom changes, while adjusting for demographic and medical covariates.
Participants were primarily non-Hispanic White (78.5%) or Black (15.8%) and female (53.1%), with an average age of 62 years. Most participants (68.9%) had some college education, and 55% reported an annual household income of less than $51,000. Nearly half (46.9%) had stage III cancer, with diagnoses distributed fairly evenly across the cancer types. Higher financial toxicity was associated with worsening depressive symptoms (β=-0.19, p<0.01), but was not significantly correlated with changes in anxiety or physical symptoms. Greater perceived injustice was significantly associated with worsening anxiety (β=0.21, p<0.01), depressive symptoms (β=0.27, p<0.01), and sleep disturbance (β=0.13, p=0.02), and marginally associated with fatigue (β=0.09, p=0.08). Baseline symptoms were strong predictors of the same symptoms at follow-up (βs=0.44-0.65, ps<0.01).
Findings suggest that financial toxicity and perceived injustice are risk factors for depressive symptoms and that perceived injustice may also predict anxiety and physical symptom burden in patients with cancer. Further research is needed to explore the mechanisms underlying these associations to inform strategies to improve patients’ financial well-being and symptoms.
Authors:
Presenter - Stella Snyder,
M.S.,
Indiana University Indianapolis
Co-Author - Shelley A. Johns, PsyD, ABPP,
PsyD, ABPP,
Indiana University School of Medicine
Co-Author - Catherine E. Mosher, PhD,
PhD,
Indiana University Indianapolis
F7 - Mental Health Screening Rates by Rural vs Urban Status in Women Veterans with a New Diagnosis of Breast Cancer
Poster Number: F7Time: 11:00 AM - 11:50 AM
Topics: Cancer, Mental Health
Background: Breast cancer (BC) is the most commonly diagnosed cancer in women veterans and up to 50% will experience symptoms of depression and/or anxiety after diagnosis, which are associated with poor prognosis, poor quality of life, and reduced survival. An increasing number of women veterans reside in rural areas, where access to behavioral health services may be limited. This study sought to evaluate disparities in mental health screening and follow-up evaluation after a new BC diagnosis by rural vs urban status.
Methods: Women veterans with a new BC diagnosis were identified between 2017 and 2021. Data for mental health screenings (PHQ-2, PHQ-9, GAD-7) were collected subsequent to an initial BC diagnosis. Rurality was defined per the USDA RUCA codes framework. Data were abstracted from several VA and non-VA datasets, including the Corporate Data Warehouse (CDW) Outpatient files, non-VA Care Medical and Pharmacy System files, VA Program Integrity Tool, and the VA Central Cancer Registry. All categorical variables were analyzed using chi-square tests and mean differences analyzed using t-tests.
Results: 14,225 women veterans with a new BC diagnosis were identified. The mean age was 63.4 years (SD 11.7). Nearly 60% (59.6%) lived in an urban setting vs 40.4% in a rural setting. In the entire cohort, only 14% had a mental health screening within 3 months of diagnosis. Urban women veterans were more likely to be screened than rural women veterans (17.4% vs 9.2%, p< 0.001). For women screened within 3 months, most screened negative regardless of rurality (75.7% urban, 76.1% rural). Of women who had a positive mental health screen, approximately one-third (34.2% urban, 31.8% rural) had additional screening. However, for those with a negative initial screen, urban veterans were more likely to have any additional screening at subsequent visits (17% urban, 10.2% rural, p= 0.001). The PHQ-2 was the most common tool used (73.8%) followed by a combination of PHQ-9 and GAD-7 (9.6%).
Conclusions: Mental health screening within 3 months of BC diagnosis is low for women veterans and there is a significant difference in screening between rural and urban veterans. It is critical to improve mental health screening in the BC population and bridge disparities in rural and urban women veterans. These efforts have implications for care in VA and non-VA settings and may impact mental health and breast cancer outcomes during the period encompassing treatment and survivorship.
Keywords: Cancer, Mental healthMethods: Women veterans with a new BC diagnosis were identified between 2017 and 2021. Data for mental health screenings (PHQ-2, PHQ-9, GAD-7) were collected subsequent to an initial BC diagnosis. Rurality was defined per the USDA RUCA codes framework. Data were abstracted from several VA and non-VA datasets, including the Corporate Data Warehouse (CDW) Outpatient files, non-VA Care Medical and Pharmacy System files, VA Program Integrity Tool, and the VA Central Cancer Registry. All categorical variables were analyzed using chi-square tests and mean differences analyzed using t-tests.
Results: 14,225 women veterans with a new BC diagnosis were identified. The mean age was 63.4 years (SD 11.7). Nearly 60% (59.6%) lived in an urban setting vs 40.4% in a rural setting. In the entire cohort, only 14% had a mental health screening within 3 months of diagnosis. Urban women veterans were more likely to be screened than rural women veterans (17.4% vs 9.2%, p< 0.001). For women screened within 3 months, most screened negative regardless of rurality (75.7% urban, 76.1% rural). Of women who had a positive mental health screen, approximately one-third (34.2% urban, 31.8% rural) had additional screening. However, for those with a negative initial screen, urban veterans were more likely to have any additional screening at subsequent visits (17% urban, 10.2% rural, p= 0.001). The PHQ-2 was the most common tool used (73.8%) followed by a combination of PHQ-9 and GAD-7 (9.6%).
Conclusions: Mental health screening within 3 months of BC diagnosis is low for women veterans and there is a significant difference in screening between rural and urban veterans. It is critical to improve mental health screening in the BC population and bridge disparities in rural and urban women veterans. These efforts have implications for care in VA and non-VA settings and may impact mental health and breast cancer outcomes during the period encompassing treatment and survivorship.
Authors:
Presenter - M. Bryant Howren,
PhD, MPH,
The University of Iowa/Iowa City VA Health Care System
Co-Author - Nicole Fleege,
MD,
The University of Iowa Hospitals & Clinics
Co-Author - Bradley Mecham,
PhD,
VA Iowa City Health Care System
Co-Author - Andrea Holcombe,
PhD,
VA Iowa City Health Care System
Co-Author - Carolyn Turvey,
PhD,
VA Iowa City Health Care System
F9 - Racial and Ethnic Disparities in Medication Adherence Between Black and Caucasian Cancer Survivors Using Oral Anticancer Medications: A Blinder-Oaxaca Decomposition Analysis
Poster Number: F9Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health of Marginalized Populations
Background
About half of cancer survivors do not adhere to prescribed oral anticancer medications (OAMs), leading to higher relapse rates, hospitalizations, and healthcare costs. Nonadherence disproportionately impacts Black cancer survivors, often due to barriers such as limited healthcare access, healthcare mistrust and health literacy challenges. However, limited research has examined adherence among Black cancer survivors using OAMs, highlighting the need to explore factors contributing to nonadherence for future interventions. This study aimed to (1) assess disparities in medication adherence among Black and Caucasian cancer survivors on OAMs, and (2) examine the extent to which these disparities may be attributed to patient demographics and psychosocial factors.
Methods
A total of 335 cancer survivors currently taking OAMs were recruited through two online panels. Participants completed a survey on medication adherence, psychosocial factors, and demographics. Medication adherence was measured with the 12-item Adherence to Refills and Medications Scale, designed to assess the extent of adherence to OAMs. Independent t-tests and multiple linear regression analyses examined differences and predictors of nonadherence between Black and White patients. A two-fold Blinder-Oaxaca decomposition analysis was used to further decompose the disparities in medication adherence identified within the regression model.
Results
Compared to Caucasian patients, Black patients had significantly lower adherence (-2.06 points, p = .04) to OAMs. The model attributed a total of 2.77 points (SE = .64) of adherence disparities to socio-demographic and psychosocial factors. Specifically, age and metropolitan residence explained 1.18 points (51.5%) and 0.18 points (7.9%) of the variance, respectively. Health literacy emerged as the most significant psychosocial factor, accounting for 1.24 points (54.2%) of the observed disparities in medication adherence.
Conclusion
Blinder-Oaxaca decomposition analysis offered a nuanced way to assess disparities in medication adherence and their contributing behavioral factors. The results indicate that younger Black cancer survivors and those who live in metropolitan areas showed lower engagement in medication use. Future interventions should adopt a multi-faceted approach to address modifiable factors, such as enhancing health literacy and providing support for OAM adherence among Black cancer survivors.
Keywords: Cancer, Health disparitiesAbout half of cancer survivors do not adhere to prescribed oral anticancer medications (OAMs), leading to higher relapse rates, hospitalizations, and healthcare costs. Nonadherence disproportionately impacts Black cancer survivors, often due to barriers such as limited healthcare access, healthcare mistrust and health literacy challenges. However, limited research has examined adherence among Black cancer survivors using OAMs, highlighting the need to explore factors contributing to nonadherence for future interventions. This study aimed to (1) assess disparities in medication adherence among Black and Caucasian cancer survivors on OAMs, and (2) examine the extent to which these disparities may be attributed to patient demographics and psychosocial factors.
Methods
A total of 335 cancer survivors currently taking OAMs were recruited through two online panels. Participants completed a survey on medication adherence, psychosocial factors, and demographics. Medication adherence was measured with the 12-item Adherence to Refills and Medications Scale, designed to assess the extent of adherence to OAMs. Independent t-tests and multiple linear regression analyses examined differences and predictors of nonadherence between Black and White patients. A two-fold Blinder-Oaxaca decomposition analysis was used to further decompose the disparities in medication adherence identified within the regression model.
Results
Compared to Caucasian patients, Black patients had significantly lower adherence (-2.06 points, p = .04) to OAMs. The model attributed a total of 2.77 points (SE = .64) of adherence disparities to socio-demographic and psychosocial factors. Specifically, age and metropolitan residence explained 1.18 points (51.5%) and 0.18 points (7.9%) of the variance, respectively. Health literacy emerged as the most significant psychosocial factor, accounting for 1.24 points (54.2%) of the observed disparities in medication adherence.
Conclusion
Blinder-Oaxaca decomposition analysis offered a nuanced way to assess disparities in medication adherence and their contributing behavioral factors. The results indicate that younger Black cancer survivors and those who live in metropolitan areas showed lower engagement in medication use. Future interventions should adopt a multi-faceted approach to address modifiable factors, such as enhancing health literacy and providing support for OAM adherence among Black cancer survivors.
Authors:
Presenter - Meng-Jung Wen,
BPharm, MS,
University of Wisconsin-Madison School of Pharmacy
Co-Author - Olayinka O. Shiyanbola,
PhD, BPharm,
University of Michigan
F10 - A Systematic Review of Interventions for Hispanic/Latinx Cancer Patients
Poster Number: F10Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health of Marginalized Populations
Background: Cancer is the leading cause of death among Hispanic/Latinx individuals, who face significant cultural, linguistic, and socioeconomic barriers to accessing care. These barriers contribute to health disparities and limit the delivery of equitable healthcare.
Tailored behavioral, psychosocial, and health interventions are needed to address these challenges, yet comprehensive reviews for this population are lacking. Objective: The aim of this study was to describe and synthesize existing behavioral, educational, psychosocial, and health services interventions tested for Hispanic/Latinx patients with cancer. Methods: The review systematically examined trials of behavioral, psychosocial, educational, and health services interventions targeted at Hispanic/Latinx populations with cancer up to January 2023. The research team conducted searches across multiple databases, including Medline ALL (Ovid), Embase (Elsevier), PsycINFO (Ovid), Scielo (Web of Science), LILACS, and the Cochrane Library (Wiley). Results: A total of 94 studies were identified, including 75 unique interventions. Among these, 28 were classified as psychotherapy-based formats. The average sample size for was 88 participants, with 19 studies including more than 100 participants. Most studies were conducted in the United States (US; 46%), followed by Brazil (20%) and Mexico (11%). Publications were predominantly in English (79%). Among US-based studies, 66% featured Hispanic/Latinx patients exclusively. Most assessed outcomes included quality of life (45%) and depression (33%). Primary intervention types were educational programs (13%) and psychosocial or psychoeducational counseling (11%). Breast cancer patients were the most frequently targeted population (51.35%). Regarding delivery methods, most interventions were provided individually (55%), followed by group settings (23%). Digital interventions constituted 8% of the studies. Conclusion: This review highlights limited: 1) interventions from Latin America (34%), 2) digital or eHealth interventions and 3) small sample sizes. Most studies were conducted in the US, underscoring the need for more international research to assess intervention effectiveness across diverse cultures. Larger, more diverse samples and greater use of digital platforms are needed to improve cancer care. Additionally, more research is needed to address challenges in implementing interventions in resource-limited settings.
Keywords: Cancer, HispanicTailored behavioral, psychosocial, and health interventions are needed to address these challenges, yet comprehensive reviews for this population are lacking. Objective: The aim of this study was to describe and synthesize existing behavioral, educational, psychosocial, and health services interventions tested for Hispanic/Latinx patients with cancer. Methods: The review systematically examined trials of behavioral, psychosocial, educational, and health services interventions targeted at Hispanic/Latinx populations with cancer up to January 2023. The research team conducted searches across multiple databases, including Medline ALL (Ovid), Embase (Elsevier), PsycINFO (Ovid), Scielo (Web of Science), LILACS, and the Cochrane Library (Wiley). Results: A total of 94 studies were identified, including 75 unique interventions. Among these, 28 were classified as psychotherapy-based formats. The average sample size for was 88 participants, with 19 studies including more than 100 participants. Most studies were conducted in the United States (US; 46%), followed by Brazil (20%) and Mexico (11%). Publications were predominantly in English (79%). Among US-based studies, 66% featured Hispanic/Latinx patients exclusively. Most assessed outcomes included quality of life (45%) and depression (33%). Primary intervention types were educational programs (13%) and psychosocial or psychoeducational counseling (11%). Breast cancer patients were the most frequently targeted population (51.35%). Regarding delivery methods, most interventions were provided individually (55%), followed by group settings (23%). Digital interventions constituted 8% of the studies. Conclusion: This review highlights limited: 1) interventions from Latin America (34%), 2) digital or eHealth interventions and 3) small sample sizes. Most studies were conducted in the US, underscoring the need for more international research to assess intervention effectiveness across diverse cultures. Larger, more diverse samples and greater use of digital platforms are needed to improve cancer care. Additionally, more research is needed to address challenges in implementing interventions in resource-limited settings.
Authors:
Presenter - Ruthmarie Hernandez-Torres, PhD,
PhD,
Memorial Sloan Kettering Cancer Center
Author - Tania Estapé,
FEFOC Fundació
Author - Xiomara Rocha-Cadman,
City of Hope
Author - Rosario Costas-Muñiz, PhD,
PhD,
Memorial Sloan Kettering Cancer Center
F11 - Dyadic Correlations of Psychosocial Health and Health Related Quality of Life Among Hispanic Prostate Cancer Survivors and Their Caregivers
Poster Number: F11Time: 11:00 AM - 11:50 AM
Topics: Cancer, Physical Activity
Background: Hispanic communities experience high burden from prostate cancer. The health of the survivor and caregiver are often interrelated, but literature on the psychosocial health of Hispanic prostate cancer survivor-caregiver dyads remain limited.
Purpose of Study: Explore the correlation between psychosocial health (anxiety, depression, social isolation) and health-related quality of life (HRQOL) of Hispanic prostate survivors and their caregivers participating in a feasibility study of Ejercicio Juntos, an adapted 12-week remotely-delivered dyadic strength training intervention.
Methods: Survivor-caregiver dyads enrolled in Ejercicio Juntos (n=14) completed Patient-Reported Outcomes Measurement Information System (PROMIS) short form measures (Anxiety 8A, Depression 8A, Social Isolation 4A) to assess psychosocial health and Functional Assessment of Cancer Therapy – General (FACT-G) to assess HRQOL (pshysical, social, emotional and functional wellbeing) at baseline. Paired t-tests and Pearson’s correlations compared self-reported psychosocial health and HRQOL between survivors and caregivers.
Results: Survivors were aged 65.3 ± 11.8 and caregivers were on average 5.8 years younger (59.5 ± 12.7 years). Caregivers were primarily female spouses/partners; all dyads were co-residing. Half of the participants preferred Spanish. Anxiety t-scores averaged 48.0 (10.6) for survivors and 47.6 (11.1) for caregivers. Depression t-scores averaged 48.7 (9.1) for survivors and 47.2 (8.8) for caregivers. Social isolation t-scores averaged 41.6 (10.2) for survivors and 40.0 (7.1) for caregivers. Survivor HRQOL averaged 83.9 (15.3) and survivor HRQOL averaged 87.1 (14.3). Anxiety, depression, social isolation, and HRQOL were not significantly different between survivors and caregivers. Depression was correlated between survivors and caregivers (r=0.53, p=0.05). Anxiety, social isolation, and HRQOL were not significantly correlated (r=0.21, p=0.49; r=0.10, p=0.74; and r=0.49, p=0.08, respectively).
Conclusion: Survivors and caregivers had similar levels of psychosocial health and HRQOL that were below population averages, with depression significantly correlated. Although the remaining within dyad correlations were not statistically significant, due in part to the small sample size, the magnitude of the coefficients for anxiety and HRQOL are still suggestive of substantial dyadic interdependence among Hispanic prostate cancer survivors and their caregivers.
Keywords: Cancer survivorship, LatinoPurpose of Study: Explore the correlation between psychosocial health (anxiety, depression, social isolation) and health-related quality of life (HRQOL) of Hispanic prostate survivors and their caregivers participating in a feasibility study of Ejercicio Juntos, an adapted 12-week remotely-delivered dyadic strength training intervention.
Methods: Survivor-caregiver dyads enrolled in Ejercicio Juntos (n=14) completed Patient-Reported Outcomes Measurement Information System (PROMIS) short form measures (Anxiety 8A, Depression 8A, Social Isolation 4A) to assess psychosocial health and Functional Assessment of Cancer Therapy – General (FACT-G) to assess HRQOL (pshysical, social, emotional and functional wellbeing) at baseline. Paired t-tests and Pearson’s correlations compared self-reported psychosocial health and HRQOL between survivors and caregivers.
Results: Survivors were aged 65.3 ± 11.8 and caregivers were on average 5.8 years younger (59.5 ± 12.7 years). Caregivers were primarily female spouses/partners; all dyads were co-residing. Half of the participants preferred Spanish. Anxiety t-scores averaged 48.0 (10.6) for survivors and 47.6 (11.1) for caregivers. Depression t-scores averaged 48.7 (9.1) for survivors and 47.2 (8.8) for caregivers. Social isolation t-scores averaged 41.6 (10.2) for survivors and 40.0 (7.1) for caregivers. Survivor HRQOL averaged 83.9 (15.3) and survivor HRQOL averaged 87.1 (14.3). Anxiety, depression, social isolation, and HRQOL were not significantly different between survivors and caregivers. Depression was correlated between survivors and caregivers (r=0.53, p=0.05). Anxiety, social isolation, and HRQOL were not significantly correlated (r=0.21, p=0.49; r=0.10, p=0.74; and r=0.49, p=0.08, respectively).
Conclusion: Survivors and caregivers had similar levels of psychosocial health and HRQOL that were below population averages, with depression significantly correlated. Although the remaining within dyad correlations were not statistically significant, due in part to the small sample size, the magnitude of the coefficients for anxiety and HRQOL are still suggestive of substantial dyadic interdependence among Hispanic prostate cancer survivors and their caregivers.
Authors:
Author - Meghan B. Skiba,
PhD, MS, MPH, RDN,
University of Arizona College of Nursing
Co-Author - Chris Segrin,
PhD,
University of Arizona
Co-Author - Terry A. Badger,
PhD, RN,
University of Arizona College of Nursing
Co-Author - Marjorie Barrera,
BS,
University of Arizona
Co-Author - Juan Contreras II,
BS,
University of Arizona
Co-Author - Bianca SantaMaria,
MPH,
University of Arizona
Co-Author - Kerri M. Winters-Stone, PhD,
PhD,
Oregon Health & Science University
F12 - Provider perceptions of implementing patient navigation for CRC screening for Black and Latina/o/e people
Poster Number: F12Time: 11:00 AM - 11:50 AM
Topics: Cancer, Dissemination and Implementation
Timely colorectal cancer (CRC) screening is the most effective way to prevent CRC or catch it early when it is easier to treat. In the US, CRC mortality rates are significantly higher for Black (vs. White) people, and Latina/o/e people are experiencing the most rapid increase of CRC incidence compared to other racial or ethnic groups. Patient navigation is an evidence-based methods of addressing barriers and facilitating timely screening by aiding in circumventing barriers to care. However, less is known about provider and administrative perspectives on implementing patient navigation at scale in primary care across a healthcare system. We conducted semi-structured interviews with Gastrointestinal (GI; n=4) and Primary Care (PCP; n=5) providers, and operational staff (n=3) in a mid-Atlantic health system to understand provider- and clinic-level challenges, preferences, and considerations for implementing a primary care CRC screening navigation program for Black and Latina/o/e patients. Participants completed a 60-minute interview on barriers/facilitators to timely CRC screening and strategies for patient navigation implementation. Interviews were recorded, transcribed, and analyzed using a pragmatic thematic analysis. Most participants identified as women (66.7%), were White (50%; 25% Black, 16.7% Asian, 8.3% declined), and physicians (50%). Interviews identified that PCPs primarily counsel patients on CRC screening options (e.g., stool vs. colonoscopy). Medical assistants were also identified as key to cueing providers to counsel patients on screening. For patients who opt for stool tests, PC providers identified gaps in follow-up for completion. Providers and operational staff identified patient education needs, specifically around colonoscopy preparation, which facilitates successful colonoscopies. Participants identified that navigators would be key for patient colonoscopy education, as well as aiding with the “logistics of a colonoscopy” (e.g., transportation, insurance). Considerations for Black and Latina/o patients focused on socioeconomic and structural barriers. Implementation strategies included notifying PC clinic administrators about navigation and involving staff such as medical assistants to facilitate navigation referrals. Our work identified opportunities to aid in delivering patient navigation in primary care. Results will be validated with patient interviews and used to tailor CRC navigation for patients in our hospital system.
Keywords: Prevention, Health disparitiesAuthors:
Author - Katarina E. AuBuchon, PhD,
PhD,
Georgetown Lombardi Comprehensive Cancer Center
Co-Author - Laura Schubel,
MedStar Health Research Institute
Co-Author - Jessica Rivera Rivera,
PhD,
MedStar Health Research Institute
Co-Author - Demetrie Garner,
MedStar Health Research Institute
Co-Author - Jennifer Tran,
MedStar Washington Hospital Center
Co-Author - Hannah Arem, PhD,
PhD,
MedStar Health Research Institute
F13 - A research protocol for a pilot, randomized controlled trial designed to examine the feasibility of a simulation-based caregiving intervention for caregivers of patients with high-grade glioma
Poster Number: F13Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Background: Family caregivers of patients with high-grade gliomas experience unique challenges often related to patients’ neurocognitive deficits and sudden performance declines. Evidence-based caregiving skill training programs to support caregivers in their caregiving role are currently lacking. The primary aim of this research protocol is to determine the feasibility of implementing a simulation-based training intervention for family caregivers of patients with high-grade gliomas using a randomized controlled trial design.
Method: Fifty patients with a high-grade glioma and their family caregivers will be randomized to the caregiving intervention or a waitlist control group. The 4-session intervention content includes two nurse-led simulation-based caregiving skills sessions and two nurse-led psychoeducation sessions offering further education and emotional support around role changes. Prior to randomization, dyads will complete self-report assessments at baseline and again 12 and 16 weeks later. Patient healthcare utilization will be extracted from the electronic medical records. Feasibility will be determined by four criteria: overall accrual, attrition, adherence, and acceptability. We will judge this trial as feasible if: 1) ≥ 50% of approached dyads consent; 2) ≥ 70% of enrolled dyads complete all assessments; and for the intervention group, 3) on average, ≥ 50% of sessions are attended; and 4) ≥ 80% of all caregivers rate the sessions as “helpful” on program evaluations. We will examine means, standard deviations (SDs), and distributions of measures for patient and caregiver psychological symptoms, caregiving-related outcomes, and patient cancer-related symptom and healthcare utilization. Using a qualitative approach, we will explore the caregiver experience with the study and with caring for an individual with a high-grade glioma to inform future research.
Results: To date, we have approached 95 dyads and enrolled 38 dyads (consent rate 40%) in this ongoing trial. We anticipate completion of enrollment in January 2025. We will present feasibility data as well as trends in outcomes including patient and caregiver psychological symptoms, caregiver caregiving self-efficacy and role adjustment, and patient cancer-related symptoms at baseline and 6-week post-intervention.
Conclusions: This trial will provide important information regarding the feasibility of delivering simulation-based skills training and if a larger efficacy trial is warranted.
Keywords: Cancer, CaregivingMethod: Fifty patients with a high-grade glioma and their family caregivers will be randomized to the caregiving intervention or a waitlist control group. The 4-session intervention content includes two nurse-led simulation-based caregiving skills sessions and two nurse-led psychoeducation sessions offering further education and emotional support around role changes. Prior to randomization, dyads will complete self-report assessments at baseline and again 12 and 16 weeks later. Patient healthcare utilization will be extracted from the electronic medical records. Feasibility will be determined by four criteria: overall accrual, attrition, adherence, and acceptability. We will judge this trial as feasible if: 1) ≥ 50% of approached dyads consent; 2) ≥ 70% of enrolled dyads complete all assessments; and for the intervention group, 3) on average, ≥ 50% of sessions are attended; and 4) ≥ 80% of all caregivers rate the sessions as “helpful” on program evaluations. We will examine means, standard deviations (SDs), and distributions of measures for patient and caregiver psychological symptoms, caregiving-related outcomes, and patient cancer-related symptom and healthcare utilization. Using a qualitative approach, we will explore the caregiver experience with the study and with caring for an individual with a high-grade glioma to inform future research.
Results: To date, we have approached 95 dyads and enrolled 38 dyads (consent rate 40%) in this ongoing trial. We anticipate completion of enrollment in January 2025. We will present feasibility data as well as trends in outcomes including patient and caregiver psychological symptoms, caregiver caregiving self-efficacy and role adjustment, and patient cancer-related symptoms at baseline and 6-week post-intervention.
Conclusions: This trial will provide important information regarding the feasibility of delivering simulation-based skills training and if a larger efficacy trial is warranted.
Authors:
Presenter - Meagan Whisenant, PhD, APRN,
PhD, APRN,
The University of Texas MD Anderson Cancer Center
Co-Author - Shiao-Pei Weathers,
MD,
The University of Texas MD Anderson Cancer Center
Co-Author - Kristin Ownby,
PhD, APRN,
Cizik School of Nursing, The University of Texas Health Science Center at Houston
Co-Author - Morgan Jones,
MA,
The University of Texas MD Anderson Cancer Center
Co-Author - Ana Garay,
BS,
The University of Texas MD Anderson Cancer Center
Co-Author - Eduardo Bruera,
MD,
The University of Texas MD Anderson Cancer Center
Co-Author - Kathrin Milbury, PhD,
PhD,
University of Texas MD Anderson Cancer Center
F14 - The role of depression in compliance with colorectal cancer screening guidelines
Poster Number: F14Time: 11:00 AM - 11:50 AM
Topics: Cancer, Mental Health
Cancer is the second leading cause of death in the United States, with a mortality rate of 184 per 100,000 in 2023. Among cancers, colorectal cancer (CRC) has a mortality rate of approximately 12.5 per 100,000, being the second leading cause of death among cancers. It is estimated that CRC will account for 8% of new cases and 9% of cancer deaths in 2024. Depression is associated with an increased risk of CRC incidence and mortality and a reduction in regular screening. Screening can increase survival because it can detect CRC at an early, less severe point. While over 70% of adults ≥45 have been screened at least once, regular screening is recommended to detect CRC in the earliest stages of its natural history. As such, it is critical to better understand what factors increase the likelihood individuals at risk will screen regularly, particularly among those individuals with depression. Utilizing a large representative national sample (n=204,530) from the 2023 Behavioral Risk Factor Surveillance System (ages≥50), we conducted a generalized linear model with a logit link function to predict the effects of a depression diagnosis (depression), and key variables associated with screening, on the likelihood of meeting screening guidelines. Further, our model included interactions between depression and the various risk factors assessed. A key interaction finding of our analysis was that African Americans (AA) with depression were 60% less likely to meet screening recommendations compared to AA participants who were not depressed and participants from other race/ethnic groups (OR=0.40, 99%CI=0.29,0.55). Collectively, these results suggest a critical need for healthcare practitioners to assess patient mental health, especially among AA patients given that they are both at higher risk of developing CRC and have a lower likelihood of screening. Further, optimal targeting of individuals at highest risk, especially when coupled with depression can reduce costs for public health campaigns, governmental organizations and non-governmental organizations.
Keywords: Cancer screening, DepressionAuthors:
Author - Ashley Becker,
International Research Institute of North Carolina
Co-Author - Samantha Bjelis,
University of Waterloo
Presenter - Daniel Rodriguez, PhD,
PhD,
La Salle University
F15 - Mixed-method pilot results of a child-focused mHealth intervention promoting sun protection
Poster Number: F15Time: 11:00 AM - 11:50 AM
Topics: Cancer, Child and Family Health
Childhood sunburns are a major risk factor for skin cancer in adulthood, and sun habits during childhood can serve as the foundation for later healthy sun behavior. However, current interventions for childhood sun protection tend to produce small effects, and most involve one-time education without the parent. The Evaluating Ultraviolet Radiation (UVR) Exposure in Kids for Adaptive Intervention (EUREKA) mobile health intervention addresses this important gap in skin cancer prevention efforts for children. EUREKA targets daily sun habits; it provides engaging and timely sun protection messages to both parent and child participants, along with an end-of-day action planning module.
In our pilot of the beta version of the EUREKA Smart Phone app, 11 parent-child dyads (children were 8-17 years old, 82% non-Hispanic White, 64% female) reporting infrequent child use of sun protection were enrolled in a 3-week study. Weeks 1 and 3 served as observation periods in which both parent and child participants were asked to complete a weekly survey along with brief self-report items about the child’s sun behavior through the app every 2 hours from 8 AM-6 PM daily. During the intervention week (Week 2), participants received just-in-time messages based on reported child sun behaviors. They also were directed to create an action plan in the app to select the sun protection behaviors they would use during an outdoor activity the next day and the strategies for enacting that plan.
During this pilot, all dyads were retained and all completed the final follow-up survey. Compared to baseline, parent reports of child behavior on a 5-point scale reflected modest improvements in most areas (e.g., for sunscreen, shade, and long-sleeve use, respectively, Ms(baseline)=1.91, 2.64, 4.09 vs. Ms(follow-up)=2.27, 3.09, 4.82). Given the small sample size, statistical tests are not reported. All participants completed exit interviews and provided feedback on potential technical improvements, benefits of the app (e.g., raised their awareness about sun protection), and recommended additional features (e.g., sunscreen reminders, alerts/information based on forecasted UV levels). Our study team is incorporating this input into the next version of the app, which we will test with a larger sample. In sum, our initial results support the feasibility and acceptability of the EUREKA intervention while also providing important input on future improvements.
Keywords: Children's health, CancerIn our pilot of the beta version of the EUREKA Smart Phone app, 11 parent-child dyads (children were 8-17 years old, 82% non-Hispanic White, 64% female) reporting infrequent child use of sun protection were enrolled in a 3-week study. Weeks 1 and 3 served as observation periods in which both parent and child participants were asked to complete a weekly survey along with brief self-report items about the child’s sun behavior through the app every 2 hours from 8 AM-6 PM daily. During the intervention week (Week 2), participants received just-in-time messages based on reported child sun behaviors. They also were directed to create an action plan in the app to select the sun protection behaviors they would use during an outdoor activity the next day and the strategies for enacting that plan.
During this pilot, all dyads were retained and all completed the final follow-up survey. Compared to baseline, parent reports of child behavior on a 5-point scale reflected modest improvements in most areas (e.g., for sunscreen, shade, and long-sleeve use, respectively, Ms(baseline)=1.91, 2.64, 4.09 vs. Ms(follow-up)=2.27, 3.09, 4.82). Given the small sample size, statistical tests are not reported. All participants completed exit interviews and provided feedback on potential technical improvements, benefits of the app (e.g., raised their awareness about sun protection), and recommended additional features (e.g., sunscreen reminders, alerts/information based on forecasted UV levels). Our study team is incorporating this input into the next version of the app, which we will test with a larger sample. In sum, our initial results support the feasibility and acceptability of the EUREKA intervention while also providing important input on future improvements.
Authors:
Author - Tammy Stump,
PhD,
University of Utah
Co-Author - Jason Wiese, PhD,
University of Utah
Co-Author - Yelena P. Wu, PhD, FSBM,
Huntsman Cancer Institute, University of Utah
Co-Author - Gabriel Bautista,
B.S.,
University of Utah
Co-Author - Kendra Nelson,
B.A.,
University of Utah
Co-Author - Sarah DeSantis,
MPH,
University of Utah
Co-Author - Kelsie Call,
University of Utah
Co-Author - Joselyn Slobodow,
University of Utah
Co-Author - Daniel Nguyen,
University of Utah
Co-Author - Lauren You,
University of Utah
F16 - Trust in different sources of cancer information by sociodemographic characteristics
Poster Number: F16Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health Communication and Policy
Background: Credibility and trustworthiness of health information sources are important considerations towards prompt and successful dissemination of health information. The fast pace of scientific advances (e.g., vaccination development and rollout during the COVID-19 pandemic) and social polarization can make implementation of health recommendations challenging and even undermine trust in science in some communities. The following analysis assesses levels of trust in different cancer information sources by key sociodemographic characteristics.
Methods: Data from 2022 Health Information National Trends Survey (n=6,252), a probability-based, nationally representative sample of non-institutionalized US adults, was analyzed to examine levels of trust in different sources of cancer information (e.g., a doctor, family or friends). Multivariable logistic regression was used to determine the association between trust in sources by age, gender, race/ethnicity, education, income and geography. Trust was dichotomized as not at all/a little (low trust) vs. some/a lot (high trust).
Results: Lower age was associated with high trust in cancer information from family and friends, charitable organizations and scientists. Compared to respondents 75 years and older, those ages 18-34 are twice as likely to trust scientists [OR= 2.10 (1.29, 3.43)] and charitable organizations [OR= 1.68 (1.23, 2.28)] for health and medical information. Low educational attainment was a prominent factor for lower odds of trusting cancer information from government health agencies [OR= 0.44 (0.25, 0.78)], charitable organizations [OR= 0.58 (0.34, 0.99)] and scientists [OR=0.38 (0.19, 0.75)], with those with less than a high school diploma reporting significantly lower odds of having trust for these entities regarding cancer information. Residing in a rural area, while increasing the odds of trusting cancer information from religious organizations [OR= 1.38 (1.01, 1.88)], decreased odds of trusting cancer information provided by scientists [OR= 0.64 (0.45, 0.90)].
Conclusion: Our analysis identified age, educational attainment and geography are meaningful factors impacting trust level across various sources of cancer information. Such noted disparities should inform the development of interventions that seek to effectively communication cancer information to the public and foster trust in evidence-based health information.
Keywords: Health communication, CancerMethods: Data from 2022 Health Information National Trends Survey (n=6,252), a probability-based, nationally representative sample of non-institutionalized US adults, was analyzed to examine levels of trust in different sources of cancer information (e.g., a doctor, family or friends). Multivariable logistic regression was used to determine the association between trust in sources by age, gender, race/ethnicity, education, income and geography. Trust was dichotomized as not at all/a little (low trust) vs. some/a lot (high trust).
Results: Lower age was associated with high trust in cancer information from family and friends, charitable organizations and scientists. Compared to respondents 75 years and older, those ages 18-34 are twice as likely to trust scientists [OR= 2.10 (1.29, 3.43)] and charitable organizations [OR= 1.68 (1.23, 2.28)] for health and medical information. Low educational attainment was a prominent factor for lower odds of trusting cancer information from government health agencies [OR= 0.44 (0.25, 0.78)], charitable organizations [OR= 0.58 (0.34, 0.99)] and scientists [OR=0.38 (0.19, 0.75)], with those with less than a high school diploma reporting significantly lower odds of having trust for these entities regarding cancer information. Residing in a rural area, while increasing the odds of trusting cancer information from religious organizations [OR= 1.38 (1.01, 1.88)], decreased odds of trusting cancer information provided by scientists [OR= 0.64 (0.45, 0.90)].
Conclusion: Our analysis identified age, educational attainment and geography are meaningful factors impacting trust level across various sources of cancer information. Such noted disparities should inform the development of interventions that seek to effectively communication cancer information to the public and foster trust in evidence-based health information.
Authors:
Co-Author - Kelly D. Blake, ScD,
ScD,
National Cancer Institute
Co-Author - Sylvia Chou,
National Cancer Institute
Co-Author - Richard P. Moser, PhD, FSBM,
PhD, FSBM,
National Cancer Institute
F6- Factors associated with research participation among current and former smokers eligible for lung cancer screening: A cross-sectional survey
Poster Number: F6Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health of Marginalized Populations
Introduction: Disparities in Lung Cancer Screening (LCS) highlight the need for research to engage high-risk individuals. We examined associations between study site, respondent characteristics, and the preferred mode of survey completion among individuals eligible for LCS.
Methods: Between February 2023 and April 2024, prospective participants were identified using electronic healthcare records from two primary care systems: Mass General Brigham (MGB) and the University of Oklahoma Health Sciences Center (OUHSC). We offered three modes of survey completion in the study, providing respondents the choice to complete the survey online, by mail, or over the phone. Eligibility criteria included being 50-80 years old, having smoked within the past 15 years, and speaking English or Spanish. We used multinomial logistic regression to estimate relative risk ratios (RRR), comparing mail and phone modes to the online mode. This study was reviewed and approved as exempt by the MGB IRB (protocol # 2021P003139), the OUHSC IRB (protocol #14825) , and the Colorado Multiple IRB (protocol #24-0128).
Results: Outreach to 2,822 individuals resulted in a sample of 315 participants. The mean age was 61.7 years (SD: 10.9). Most respondents were women (63.0%) and identified as White (63.3%). 29.8 % were Hispanic. The most common survey completion mode was mail (37.1%), followed by online (35.9%) and phone (27.0%). Characteristics associated with completion by mail were study site (RRR=6.22; respondents at OUHSC were more likely to choose mail over online compared to those at MGB, p-value < 0.01), and race (RRR = 4.76; respondents who did not identify as White were more likely to complete by mail, p-value < 0.01). For phone completion, characteristics included age (RRR = 1.06; older respondents chose phone over the online option, p-value < 0.01), language preference (RRR = 37.32; preference for completing the survey in Spanish was positively associated with choosing the phone option , p-value < 0.01), and insurance type (RRR = 20.95; military or state-insured respondents preferred the phone compared to those with employer or private insurance, p-value < 0.01).
Conclusion: We observed differences in preferences for engagement in a LCS survey based on location (study site), race, age, language, and insurance status. Survey research engagement that offers diverse communication modes, including non-digital options, may promote engagement of a heterogeneous LCS research sample.
Keywords: Cancer screening, CancerMethods: Between February 2023 and April 2024, prospective participants were identified using electronic healthcare records from two primary care systems: Mass General Brigham (MGB) and the University of Oklahoma Health Sciences Center (OUHSC). We offered three modes of survey completion in the study, providing respondents the choice to complete the survey online, by mail, or over the phone. Eligibility criteria included being 50-80 years old, having smoked within the past 15 years, and speaking English or Spanish. We used multinomial logistic regression to estimate relative risk ratios (RRR), comparing mail and phone modes to the online mode. This study was reviewed and approved as exempt by the MGB IRB (protocol # 2021P003139), the OUHSC IRB (protocol #14825) , and the Colorado Multiple IRB (protocol #24-0128).
Results: Outreach to 2,822 individuals resulted in a sample of 315 participants. The mean age was 61.7 years (SD: 10.9). Most respondents were women (63.0%) and identified as White (63.3%). 29.8 % were Hispanic. The most common survey completion mode was mail (37.1%), followed by online (35.9%) and phone (27.0%). Characteristics associated with completion by mail were study site (RRR=6.22; respondents at OUHSC were more likely to choose mail over online compared to those at MGB, p-value < 0.01), and race (RRR = 4.76; respondents who did not identify as White were more likely to complete by mail, p-value < 0.01). For phone completion, characteristics included age (RRR = 1.06; older respondents chose phone over the online option, p-value < 0.01), language preference (RRR = 37.32; preference for completing the survey in Spanish was positively associated with choosing the phone option , p-value < 0.01), and insurance type (RRR = 20.95; military or state-insured respondents preferred the phone compared to those with employer or private insurance, p-value < 0.01).
Conclusion: We observed differences in preferences for engagement in a LCS survey based on location (study site), race, age, language, and insurance status. Survey research engagement that offers diverse communication modes, including non-digital options, may promote engagement of a heterogeneous LCS research sample.
Authors:
Presenter - Catherine S. Nagawa,
PhD,
The University of Oklahoma
Co-Author - Reid S. Anctil,
BS,
Massachusetts General Hospital
Co-Author - Jordan M. Neil,
PhD,
The University of Oklahoma
Co-Author - Iván Flores,
MPH,
The University of Oklahoma
Co-Author - Natalie Durieux,
BS,
Massachusetts General Hospital
Co-Author - Rousi Shao,
PhD,
Florida State University
Co-Author - Yuchiao Chang,
PhD,
Massachusetts General Hospital
Co-Author - Elyse R. Park,
PhD, MPH, FSBM,
Massachusetts General Hospital
Co-Author - Gina R. Kruse,
MD, MPH,
University of Colorado School of Medicine
F19 - Public Perspectives on Ethical Principles to Guide Minor Consent to HIV Research: Results from a Public Deliberation in Four U.S. Cities
Poster Number: F19Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Health of Marginalized Populations
The Belmont Report names three fundamental ethical principles in research with human subjects: justice, respect for persons, and beneficence. While scientists have a shared understanding of how these principles should guide research, it is unclear whether members of the public draw on such principles when considering research ethics and policy. Minors and adults from groups and communities disproportionately affected by HIV in four US cities were gathered for a public deliberation (PD) on the acceptability of minor self-consent for enrollment in biomedical HIV prevention trials. A qualitative descriptive approach was used to describe how the deliberants’ views aligned with the Belmont principles.
Based on formal definitions from the Belmont report, all remarks from the deliberation transcripts that related to one of the principles were highlighted. One team member assigned a code to each remark summarizing its essence, and another team member verified each code. The codes assigned to each principle were categorized, and the categories were summarized to address the study aim.
Eight-eight persons aged 14 to 60 participated in the PD. The deliberants were diverse in racial and ethnic identity, gender identity, and sexual orientation. Many deliberants made remarks that were drawn from their own experiences but that also aligned with the Belmont principles. In regard to justice, 16 deliberants focused on unfair distribution of benefits (e.g., exclusion of youth fearing disclosure of their gender identity or sexual practices if parental consent was required), and 17 focused on unfair distributions of burdens (e.g., risks of participation placed primarily on LBGTQ+ youth). In regard to respect for persons, 42 deliberants focused on autonomous decision-making (e.g., youth’s right to make decisions about their bodies), and 46 focused on proper protections (e.g., ombudspersons provided to support self-consenting youth). In regard to beneficence, 12 deliberants focused on the potential benefits of the trials (e.g., HIV prevention for high-risk youth), and 51 deliberants focused on potential harms (e.g., possible side effects of prophylactic medications.). We conclude that members of the public base decisions related to research ethics in ways that are commensurate with the scientific community while also reflecting their lived experiences. The findings support our contention that PDs can provide valuable community perspectives on research regulatory practices.
Keywords: Ethical Issues, AdolescentsBased on formal definitions from the Belmont report, all remarks from the deliberation transcripts that related to one of the principles were highlighted. One team member assigned a code to each remark summarizing its essence, and another team member verified each code. The codes assigned to each principle were categorized, and the categories were summarized to address the study aim.
Eight-eight persons aged 14 to 60 participated in the PD. The deliberants were diverse in racial and ethnic identity, gender identity, and sexual orientation. Many deliberants made remarks that were drawn from their own experiences but that also aligned with the Belmont principles. In regard to justice, 16 deliberants focused on unfair distribution of benefits (e.g., exclusion of youth fearing disclosure of their gender identity or sexual practices if parental consent was required), and 17 focused on unfair distributions of burdens (e.g., risks of participation placed primarily on LBGTQ+ youth). In regard to respect for persons, 42 deliberants focused on autonomous decision-making (e.g., youth’s right to make decisions about their bodies), and 46 focused on proper protections (e.g., ombudspersons provided to support self-consenting youth). In regard to beneficence, 12 deliberants focused on the potential benefits of the trials (e.g., HIV prevention for high-risk youth), and 51 deliberants focused on potential harms (e.g., possible side effects of prophylactic medications.). We conclude that members of the public base decisions related to research ethics in ways that are commensurate with the scientific community while also reflecting their lived experiences. The findings support our contention that PDs can provide valuable community perspectives on research regulatory practices.
Authors:
Presenter - Amelia Knopf, PhD,
PhD,
Indiana University
Co-Author - Julie Maier,
PhD,
Indiana University
Co-Author - Rebecca Ryan,
PhD MPH ,
Indiana University
Co-Author - Claire Burke Draucker,
PhD,
Indiana University
F20 - What I Wish I Had Known: The Diagnosis Experiences of Young Adults with Hematological Cancers
Poster Number: F20Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Background: Cancer in adolescent and young adult (AYA) populations (ages 15-39) has been steadily increasing (Scott et al., 2020), with hematological cancers representing a significant proportion of new AYA cancer diagnoses (Huang and He, 2024). Yet, AYAs receive substantially less research focus than their older and pediatric counterparts and may have greater emotional distress. The current study aimed to elucidate the initial experiences of young adult HC cancer patients, with a focus on their reactions to receiving a diagnosis and proceeding forward with treatment.
Methods: In-depth qualitative interviews were conducted with 26 young adults (ages 20-29) diagnosed with HC, recruited from a major cancer center in the Northeast and a national young adult cancer survivor organization. Interviews were recorded, transcribed, and analyzed using thematic analysis (Braun & Clarke, 2006). The first three authors coded the data with disagreements resolved by the last author.
Results: Several common themes occurred. First, while some participants intuited that something was wrong, many attributed their early symptoms to other causes – particularly, stress – delaying medical attention. Externally visible symptoms (e.g., extreme weight loss and sizeable growths) garnered more immediate medical attention; diffuse symptoms (e.g., increased fatigue, shortness of breath) were more likely to be ignored by participants and medical professionals. Second, for many, “shock” was the first psychological reaction upon receiving a cancer diagnosis. Third, perhaps because of a “rush” to treatment, discussions with oncologists about fertility preservation were rare, as were involving the young adult in the treatment decision process. Fourth, socioeconomic status (education, parent’s occupation) was related to the swiftness of diagnosis and treatment.
Discussion: The findings point to the unique difficulties faced by young people with cancer and the need for health psychologists to better inform physicians of young patients’ initial reactions and involvement in treatment decisions.
Keywords: Cancer, Cancer survivorshipMethods: In-depth qualitative interviews were conducted with 26 young adults (ages 20-29) diagnosed with HC, recruited from a major cancer center in the Northeast and a national young adult cancer survivor organization. Interviews were recorded, transcribed, and analyzed using thematic analysis (Braun & Clarke, 2006). The first three authors coded the data with disagreements resolved by the last author.
Results: Several common themes occurred. First, while some participants intuited that something was wrong, many attributed their early symptoms to other causes – particularly, stress – delaying medical attention. Externally visible symptoms (e.g., extreme weight loss and sizeable growths) garnered more immediate medical attention; diffuse symptoms (e.g., increased fatigue, shortness of breath) were more likely to be ignored by participants and medical professionals. Second, for many, “shock” was the first psychological reaction upon receiving a cancer diagnosis. Third, perhaps because of a “rush” to treatment, discussions with oncologists about fertility preservation were rare, as were involving the young adult in the treatment decision process. Fourth, socioeconomic status (education, parent’s occupation) was related to the swiftness of diagnosis and treatment.
Discussion: The findings point to the unique difficulties faced by young people with cancer and the need for health psychologists to better inform physicians of young patients’ initial reactions and involvement in treatment decisions.
Authors:
Co-Author - Alexandria Aho,
Hunter College, City University New York, USA
Co-Author - Michelle Teitel,
Hunter College, City University New York, USA
Co-Author - Lisa Rubin,
The New School for Social Research
Co-Author - Tracey Revenson,
Hunter College & The Graduate Center, City University New York, USA
F21 - The Relationship between Financial Coping Strategies and Change in Emotional Well-Being in Cancer Patients
Poster Number: F21Time: 11:00 AM - 11:50 AM
Topics: Cancer, Social and Environmental Context and Health
Many cancer patients face financial toxicity related to treatment costs. Little research has assessed cancer patients’ strategies for coping with financial toxicity and their relation to mental health outcomes. This longitudinal study examines whether greater use of financial coping strategies predicts decline in emotional well-being in cancer patients over two months.
Patients (N=177) with stage I-III breast, gastrointestinal, lung, or prostate cancer who reported at least mild cancer-related financial toxicity were recruited from midwestern U.S. cancer centers. Patients were undergoing cancer treatment or had completed treatment within the past six months. The majority were non-Hispanic White (78.5%) and female (53.1%), with an average age of 62 years (SD=11.3). Most had attended at least some college (68.9%) and reported an annual income of less than $51,000 (55%). Patients completed study measures at baseline and two months later with a high retention rate (94.3%). Financial coping strategies were assessed with 16 dichotomous items (e.g., not filling a prescription, skipping a medical procedure or appointment, reduced spending on basics and leisure). Emotional well-being was assessed with PROMIS measures of positive affect and general life satisfaction. Multiple regression analyses were conducted to assess relationships between the number of baseline financial coping strategies and change in positive affect and life satisfaction, adjusting for demographic and medical covariates.
Patients reported using an average of 4.6 (SD=4) financial coping strategies at baseline. The most prevalent strategies included using savings (46%), reducing spending on basics (44%), and borrowing money or using credit (34%). Results indicated that greater use of financial coping strategies at baseline predicted decreased positive affect (b=-.14, p<0.05) and life satisfaction (b=-.11, p<0.05) two months later.
Results suggest that medical and lifestyle-altering strategies for coping with cancer-related costs are associated with decline in emotional well-being. Future intervention research may target financial coping strategies to improve cancer patients’ mental health.
Keywords: Cancer, Quality of lifePatients (N=177) with stage I-III breast, gastrointestinal, lung, or prostate cancer who reported at least mild cancer-related financial toxicity were recruited from midwestern U.S. cancer centers. Patients were undergoing cancer treatment or had completed treatment within the past six months. The majority were non-Hispanic White (78.5%) and female (53.1%), with an average age of 62 years (SD=11.3). Most had attended at least some college (68.9%) and reported an annual income of less than $51,000 (55%). Patients completed study measures at baseline and two months later with a high retention rate (94.3%). Financial coping strategies were assessed with 16 dichotomous items (e.g., not filling a prescription, skipping a medical procedure or appointment, reduced spending on basics and leisure). Emotional well-being was assessed with PROMIS measures of positive affect and general life satisfaction. Multiple regression analyses were conducted to assess relationships between the number of baseline financial coping strategies and change in positive affect and life satisfaction, adjusting for demographic and medical covariates.
Patients reported using an average of 4.6 (SD=4) financial coping strategies at baseline. The most prevalent strategies included using savings (46%), reducing spending on basics (44%), and borrowing money or using credit (34%). Results indicated that greater use of financial coping strategies at baseline predicted decreased positive affect (b=-.14, p<0.05) and life satisfaction (b=-.11, p<0.05) two months later.
Results suggest that medical and lifestyle-altering strategies for coping with cancer-related costs are associated with decline in emotional well-being. Future intervention research may target financial coping strategies to improve cancer patients’ mental health.
Authors:
Presenter - Marcia Burns,
M.S.,
Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA
Co-Author - Stella Snyder,
M.S.,
Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA
Co-Author - Catherine Mosher,
Ph.D.,
Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA
Co-Author - Shelley Johns,
Psy.D., ABPP,
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA; Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, USA
F22 - Trajectories of Patient-Reported Outcomes after Idecabtagene Vicleucel vs. Ciltacabtagene Autoleucel CAR T-cell Therapy among Real-World Patients with Multiple Myeloma
Poster Number: F22Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Background: CAR T-cell therapy (CAR-T) is a revolutionary treatment for multiple myeloma (MM), but real-world patient-reported outcomes (PRO) data are scarce and no studies have compared PROs between MM CAR-T regimens (idecabtagene vicleucel [ide-cel] vs ciltacabtagene autoleucel [cilta-cel]). We prospectively assessed PROs among real-world MM CAR-T recipients and compared PRO changes by regimen.
Methods: PROs were assessed at baseline (pre-CAR-T), day of CAR-T infusion (day[D]0), and D7, D14, D21, D30, D60, and D90 post-infusion. FACT-G assessed overall health-related quality of life (HRQOL) and four well-being domains (physical, social, emotional, functional). PROMIS scales assessed functioning (physical, social, cognitive) and symptoms (depression, anxiety, fatigue, sleep disturbance, pain interference, global pain). Piecewise growth curve models were used to describe PRO trajectories and to compare trajectories by CAR-T regimen controlling for age, race/ethnicity, and marital status. Sensitivity analyses further controlled for performance status, high-risk cytogenetics, extramedullary disease, bone marrow burden, and prior BCMA therapy.
Results: Participants (N=99) were mostly male (61%). Patients treated with ide-cel (n=49) vs cilta-cel (n=50) were older (M=71, SD=10 vs M=63, SD=8; p<0.001), less likely to be married (71% vs 88%; p=0.071), and had worse baseline social well-being (M=23, SD=5 vs M=24, SD=3; p=0.046) and sleep disturbance (M=51, SD=8 vs M=48, SD=9; p=0.047), though PRO differences were small. There were no other baseline PRO or clinical differences. Across treatments, most PROs worsened from baseline to D7 and improved from D7 to D90 (p-values<0.05): overall HRQOL, physical well-being, social well-being, functional well-being, physical function, social function, fatigue, and sleep disturbance. Emotional well-being improved from baseline to D7 (p=0.007) and then remained stable. Patients treated with cilta-cel vs ide-cel had larger decreases in social well-being from baseline to D7 (p=0.018) and greater increases from D7 to D90 (p=0.031). There were no other differences by CAR-T regimen. Controlling for clinical variables did not substantially change the results.
Conclusions: This was the first study to examine real-world PRO trajectories after CAR-T for MM using advanced statistical modeling. Most PROs initially worsened but improved by D90. Ide-cel and cilta-cel showed similar PRO trajectories and benefits for real-world MM patients.
Keywords: Cancer survivorship, Quality of lifeMethods: PROs were assessed at baseline (pre-CAR-T), day of CAR-T infusion (day[D]0), and D7, D14, D21, D30, D60, and D90 post-infusion. FACT-G assessed overall health-related quality of life (HRQOL) and four well-being domains (physical, social, emotional, functional). PROMIS scales assessed functioning (physical, social, cognitive) and symptoms (depression, anxiety, fatigue, sleep disturbance, pain interference, global pain). Piecewise growth curve models were used to describe PRO trajectories and to compare trajectories by CAR-T regimen controlling for age, race/ethnicity, and marital status. Sensitivity analyses further controlled for performance status, high-risk cytogenetics, extramedullary disease, bone marrow burden, and prior BCMA therapy.
Results: Participants (N=99) were mostly male (61%). Patients treated with ide-cel (n=49) vs cilta-cel (n=50) were older (M=71, SD=10 vs M=63, SD=8; p<0.001), less likely to be married (71% vs 88%; p=0.071), and had worse baseline social well-being (M=23, SD=5 vs M=24, SD=3; p=0.046) and sleep disturbance (M=51, SD=8 vs M=48, SD=9; p=0.047), though PRO differences were small. There were no other baseline PRO or clinical differences. Across treatments, most PROs worsened from baseline to D7 and improved from D7 to D90 (p-values<0.05): overall HRQOL, physical well-being, social well-being, functional well-being, physical function, social function, fatigue, and sleep disturbance. Emotional well-being improved from baseline to D7 (p=0.007) and then remained stable. Patients treated with cilta-cel vs ide-cel had larger decreases in social well-being from baseline to D7 (p=0.018) and greater increases from D7 to D90 (p=0.031). There were no other differences by CAR-T regimen. Controlling for clinical variables did not substantially change the results.
Conclusions: This was the first study to examine real-world PRO trajectories after CAR-T for MM using advanced statistical modeling. Most PROs initially worsened but improved by D90. Ide-cel and cilta-cel showed similar PRO trajectories and benefits for real-world MM patients.
Authors:
Presenter - Xiaoyin Li, PhD,
PhD,
Moffitt Cancer Center
Co-Author - Carina Ferraris,
Nova Southeastern University
Co-Author - Gabe De Avila,
Moffitt Cancer Center
Co-Author - Lisa M. Gudenkauf, PhD,
PhD,
Moffitt Cancer Center
Co-Author - Aasha I. Hoogland, PhD,
PhD,
Moffitt Cancer Center
Co-Author - Oanh Nguyen,
Moffitt Cancer Center
Co-Author - Yvelise Rodriguez,
Moffitt Cancer Center
Co-Author - Nathan Parker, PhD MPH,
PhD MPH,
Moffitt Cancer Center
Co-Author - Tiffany L. Carson, PhD, MPH, FSBM,
PhD, MPH, FSBM,
Moffitt Cancer Center
Co-Author - Christine Vinci, PhD,
PhD,
Moffitt Cancer Center
Co-Author - Rachid Baz,
Moffitt Cancer Center
Co-Author - Kenneth H. Shain,
Moffitt Cancer Center
Co-Author - Brandon Blue,
Moffitt Cancer Center
Co-Author - Ariel Grajales-Cruz,
Moffitt Cancer Center
Co-Author - Melissa Alsina,
Moffitt Cancer Center
Co-Author - Ciara Freeman,
Moffitt Cancer Center
Co-Author - Omar Castaneda Puglianini,
Moffitt Cancer Center
Co-Author - Taiga Nishihori,
Moffitt Cancer Center
Co-Author - Hien Liu,
Moffitt Cancer Center
Co-Author - Frederick Locke,
Moffitt Cancer Center
Co-Author - Heather S. Jim, PhD, FSBM,
PhD, FSBM,
Moffitt Cancer Center
Co-Author - Doris Hansen,
Moffitt Cancer Center
Co-Author - Lauren Peres,
Moffitt Cancer Center
Co-Author - Laura Oswald, PhD,
PhD,
Moffitt Cancer Center
F23 - Perspectives on Sexual Health after Cancer Treatment in a Cohort of Pelvic Cancer Survivors
Poster Number: F23Time: 11:00 AM - 11:50 AM
Topics: Cancer, Women's Health
Sexual side-effects are common after treatment for pelvic cancer. However, little is known about how pelvic cancer survivors view, conceptualize, and prioritize sexual activity and sexual pleasure after cancer treatment.
We conducted semi-structured interviews with women and gender-expansive individuals with pelvic (uterine N = 10, anal N = 3) cancer at least one-year post-radiotherapy; understudied priority populations were oversampled (i.e., racial/ethnic minorities, sexual/gender minorities, age < 40 or > 65 years). Transcripts were analyzed using thematic analysis and independently coded by two team members.
Our sample included 53% White, 20% Black, and 6.7% Asian patients, 20% Hispanic/Latino patients, four queer patients, and one transgender patient. Four themes emerged. Theme 1: Sexual activity is complex and multifaceted. Participants had broad definitions of sexual activity (e.g., masturbation, intercourse, foreplay, oral/vaginal/anal sex) and described several reasons for engaging in sexual activity (e.g., pleasure, emotional connection with partners, stress relief). Theme 2: Sex is important and decreases in desire and pleasure were distressing. Participants emphasized that sex was an important part of their life and that decreases in desire and pleasure that resulted from treatment impacted their quality of life. Theme 3: Dilators may help rediscover sexual pleasure. Some participants found that dilators were a helpful method for rediscovering their sexuality and experiencing sexual pleasure. In contrast, a few queer patients were not interested in vaginal penetration and preferred that dilators would not be presented by clinicians as a means to experience sexual pleasure. Theme 4: “You know what I mean…” (Don’t make me say it out loud!) Some participants appeared to be uncomfortable with discussing their sexual activity during the interviews.
This study highlights that decreases in sexual desire and pleasure were distressing for pelvic cancer survivors. Clinicians can address these side-effects by prioritizing sexual pleasure for pelvic cancer survivors and remembering that patients hold diverse and broad definitions of sexual activity. Though the queer patients in our sample were not interested in vaginal penetration, clinicians should not assume that patients engage in any type of sexual activity and should also present vaginal dilators as a means to conduct future pelvic exams for patients who do not practice vaginal penetration.
Keywords: Cancer survivorship, Sexual functioningWe conducted semi-structured interviews with women and gender-expansive individuals with pelvic (uterine N = 10, anal N = 3) cancer at least one-year post-radiotherapy; understudied priority populations were oversampled (i.e., racial/ethnic minorities, sexual/gender minorities, age < 40 or > 65 years). Transcripts were analyzed using thematic analysis and independently coded by two team members.
Our sample included 53% White, 20% Black, and 6.7% Asian patients, 20% Hispanic/Latino patients, four queer patients, and one transgender patient. Four themes emerged. Theme 1: Sexual activity is complex and multifaceted. Participants had broad definitions of sexual activity (e.g., masturbation, intercourse, foreplay, oral/vaginal/anal sex) and described several reasons for engaging in sexual activity (e.g., pleasure, emotional connection with partners, stress relief). Theme 2: Sex is important and decreases in desire and pleasure were distressing. Participants emphasized that sex was an important part of their life and that decreases in desire and pleasure that resulted from treatment impacted their quality of life. Theme 3: Dilators may help rediscover sexual pleasure. Some participants found that dilators were a helpful method for rediscovering their sexuality and experiencing sexual pleasure. In contrast, a few queer patients were not interested in vaginal penetration and preferred that dilators would not be presented by clinicians as a means to experience sexual pleasure. Theme 4: “You know what I mean…” (Don’t make me say it out loud!) Some participants appeared to be uncomfortable with discussing their sexual activity during the interviews.
This study highlights that decreases in sexual desire and pleasure were distressing for pelvic cancer survivors. Clinicians can address these side-effects by prioritizing sexual pleasure for pelvic cancer survivors and remembering that patients hold diverse and broad definitions of sexual activity. Though the queer patients in our sample were not interested in vaginal penetration, clinicians should not assume that patients engage in any type of sexual activity and should also present vaginal dilators as a means to conduct future pelvic exams for patients who do not practice vaginal penetration.
Authors:
Presenter - Lauren M. Carney, PhD,
PhD,
Icahn School of Medicine at Mount Sinai
Co-Author - Melanie Besculides,
DrPH,
Icahn School of Medicine at Mount Sinai
Co-Author - Ksenia Gorbenko,
PhD,
Icahn School of Medicine at Mount Sinai
Co-Author - Deborah Marshall,
MD,
Icahn School of Medicine at Mount Sinai
F24 - Methods for Precise Oncology Interventions in Nutrition and Training (OnPOINT) Trial: A Lifestyle Complexity Stratification Model for Cancer Survivors
Poster Number: F24Time: 11:00 AM - 11:50 AM
Topics: Cancer, Digital Health
Lifestyle behaviors, such as maintaining a healthy diet and engaging in regular physical activity, can reduce the risk of cancer recurrence and mitigate comorbid conditions among cancer survivors. However, individual needs for nutrition and exercise programs may vary based on medical, environmental, and psychosocial factors. To date, few studies have focused on evaluating a clinical decision-making framework that enables risk stratification to generate tailored referrals for nutrition and exercise programs, addressing the distinct needs of cancer survivors. The purpose of the OnPOINT trial is to evaluate the feasibility, acceptability, and retention of a stratified nutrition and exercise referral programs for cancer survivors, while also developing, assessing, and refining the complexity stratification model. The OnPOINT study is a two-arm randomized controlled trial that aims to enroll 300 breast, prostate, and colorectal cancer survivors who are at least six months post-treatment for their primary cancer. Eligibility criteria include: 1) age >18 years; 2) <5 servings of vegetables and fruits daily; and 3) <150 minutes of moderate-to-vigorous physical activity weekly. Eligible participants are randomized into either an 8-week virtual intervention or control arm. The 8-week virtual intervention is tailored to the unique needs of cancer survivors through a complexity stratification algorithm, which assigns participants to low, moderate, or high complexity nutrition and exercise programs. This complexity stratification algorithm integrates a range of demographic, medical, physical, environmental, and psychosocial factors, informed from clinical data obtained via EPIC electronic health records and patient-reported data from questionnaires. Enrollment commenced in September 2024. To date, 42 cancer survivors have been screened, with 6 currently enrolled in the study. The average age of those enrolled is 58 years, and the majority are non-Hispanic female breast cancer survivors. Full accrual is anticipated by Summer 2025. There is a need for nutrition and exercise programs that enable clinical providers to offer tailored referrals for cancer survivors. The OnPOINT study aims to evaluate the feasibility of implementing a complexity stratification model in clinical settings to improve nutrition and exercise referrals, with the goal of evaluating sustainable and impactful lifestyle programs for cancer survivors.
Keywords: Cancer survivorship, Health behaviorsAuthors:
Presenter - Harleen Kaur,
Ph.D.,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Paola Rossi,
MD,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - S. Grey Freylersythe,
BS,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Warda Chaudhary,
MPH,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Mary Martos,
MD,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Frank J. Penedo,
PhD, FSBM,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Jessica MacIntyre,
ARNP, NP-C, AOCNP,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Sanoj Punnen,
MD,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Carmen Calfa,
MD,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Agustin Pimentel,
MD,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Luanne Force,
MD,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
Co-Author - Hong Su An,
PhD,
University of Michigan
Chair - Tracy E. Crane,
PhD, RDN,
University of Miami, Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center
F25 - Dimensions of Masculinity Moderate the Association Between Social Support and Health-related Quality of Life in Hispanic Prostate Cancer Survivors
Poster Number: F25Time: 11:00 AM - 11:50 AM
Topics: Cancer, Social and Environmental Context and Health
Background: Prostate cancer (PC) is the 4th leading cause of cancer deaths among Hispanics in the US, who face high rates of advanced diagnoses and poor health-related quality of life (HRQoL). Although social support is linked to improved HRQoL, few studies have examined how this relationship may vary across Hispanic cultural factors, such as traditional masculinity. Thus, the current study examined whether positive and negative dimensions of traditional masculinity (i.e., caballerismo, machismo) moderated the association between social support and HRQoL in Hispanic PC survivors. Methods: Men (N=188; Mage=65.77, SD=8.0) with localized PC were assessed at baseline as part of a larger RCT examining a culturally adapted cognitive behavioral stress management intervention. Physical, emotional, and functional subscales of the Functional Assessment of Cancer Therapy-Prostate (FACT-P) assessed dimensions of HRQoL. Social support was assessed with a 12-item Interpersonal Support Evaluation List (ISEL-12). Machismo (5 items, focused on hypermasculinity, dominance, sexism, and emotional restrictiveness) and Caballerismo (3 items, focused on bravery, honor, and chivalry) were assessed using items from the MAN for Health Survey. Linear regression with moderation analyses was conducted. Results: Results indicated that greater social support was associated with better physical (β=.10, p=.04), emotional (β=.29, p<.001), and functional (β=.30, p<.001) wellbeing adjusting for covariates (i.e., age, education, years in US, cancer stage). Moderation analyses showed that traditional machismo (β=-.00, p=.99; β=.03, p=.12) and caballerismo (β=.04, p=.16; β=.02, p= .49) were not significant moderators of the associations between social support and physical and functional wellbeing, respectively; however, caballerismo (β=.08, p=.01) moderated the association between social support and emotional well-being, such that at higher levels of caballerismo, social support was associated with greater emotional well-being. Conclusions: While machismo does not significantly moderate the relationship between social support and dimensions of HRQoL, caballerismo may strengthen the association between social support and emotional well-being, with higher levels of the positive aspects of masculinity associated with better HRQoL. These findings suggest that future research should address cultural factors such as caballerismo, as they may enhance emotional well-being in Hispanic PC patients.
Keywords: Cancer survivorship, CultureAuthors:
Author - Arianna E. Brito,
BS,
University of Miami
Co-Author - Sara E. Fleszar-Pavlovic,
PhD,
University of Miami
Co-Author - Patricia B. Pedreira, MS,
MS,
University of Miami
Co-Author - Patricia Moreno,
PhD,
University of Miami
Co-Author - Michael Antoni,
PhD,
University of Miami
Co-Author - Aaron Heller,
PhD,
University of Miami
Co-Author - Dolores M. Perdomo,
PhD,
University of Miami
Co-Author - Frank J. Penedo, PhD, FSBM,
PhD, FSBM,
University of Miami
F26 - Examining the psychological impact of germline genetic testing for hereditary cancer risk among individuals tested through a scalable care model with limited pre-test genetic counseling
Poster Number: F26Time: 11:00 AM - 11:50 AM
Topics: Cancer, Child and Family Health
Background: Universal approaches to germline testing for hereditary cancer risk to identify actionable mutations that otherwise would be missed using more traditional approaches (e.g., personal and family history) are increasingly being taken (Gima et al., 2024). The psychological impact (PI) of undergoing such testing without pre-test genetic counseling has been favorable (Swisher et al., 2023), however, assessments of more scalable models are limited. We examined the PI of germline testing for hereditary cancer risk syndromes on affected (those with a history of cancer) and unaffected (those without a history of cancer) individuals who receive limited pre-testing genetic counseling in scalable model and explored how PI relates to sharing results with family.
Methods: 3,385 individuals enrolled in City of Hope’s INSPIRE genomic testing study were sent a survey examining PI related to genetic test results (~two weeks following disclosure). Patients completed the 12-item Feelings About genomic Testing Results scale (FACToR; range=0-48) and were asked if they communicated test results to family. A subset of these individuals completed a follow-up survey at six months. Individuals who did not recall receiving results or did not complete at least one FACToR item were excluded from analysis.
Results: 34% of patients responded to the survey distributed two weeks following disclosure (n=846), and most did not report high PI (n=812; 96.0%). Affected patients had higher PI than unaffected patients (Mdiff=2.56, p<.001), and patients with a pathogenic result (PLP) exhibited higher PI than those receiving a variant of uncertain significance (VUS) (Mdiff=4.38, p<.001) or a negative result (Mdiff=6.54, p<.001). PLPs also exhibited decreased PI over time (Mdiff = -1.96, p = .042) while VUSs increased slightly (Mdiff =0.95, p=.006). Although there was a positive relationship between sharing germline test results with family and having a PLP status vs. not (direct effect = 1.06, p < .001), there was an indirect effect of this relationship whereby increased PI served to decrease sharing of results with family (indirect effect = −0.30, CI [–0.47, –0.16]).
Conclusion: This research demonstrates that most patients do not exhibit high PI after receiving germline testing for hereditary cancer, even with limited pre-test genetic counselling, and that efforts to mitigate PI and increase sharing results with family should focus on affected individuals and PLPs.
Keywords: Genetics, Population healthMethods: 3,385 individuals enrolled in City of Hope’s INSPIRE genomic testing study were sent a survey examining PI related to genetic test results (~two weeks following disclosure). Patients completed the 12-item Feelings About genomic Testing Results scale (FACToR; range=0-48) and were asked if they communicated test results to family. A subset of these individuals completed a follow-up survey at six months. Individuals who did not recall receiving results or did not complete at least one FACToR item were excluded from analysis.
Results: 34% of patients responded to the survey distributed two weeks following disclosure (n=846), and most did not report high PI (n=812; 96.0%). Affected patients had higher PI than unaffected patients (Mdiff=2.56, p<.001), and patients with a pathogenic result (PLP) exhibited higher PI than those receiving a variant of uncertain significance (VUS) (Mdiff=4.38, p<.001) or a negative result (Mdiff=6.54, p<.001). PLPs also exhibited decreased PI over time (Mdiff = -1.96, p = .042) while VUSs increased slightly (Mdiff =0.95, p=.006). Although there was a positive relationship between sharing germline test results with family and having a PLP status vs. not (direct effect = 1.06, p < .001), there was an indirect effect of this relationship whereby increased PI served to decrease sharing of results with family (indirect effect = −0.30, CI [–0.47, –0.16]).
Conclusion: This research demonstrates that most patients do not exhibit high PI after receiving germline testing for hereditary cancer, even with limited pre-test genetic counselling, and that efforts to mitigate PI and increase sharing results with family should focus on affected individuals and PLPs.
Authors:
Co-Author - Patrick Boyd, PhD,
PhD,
City of Hope
Co-Author - Ilana Solomon,
ScM, MA, CGC,
City of Hope
Author - Yi Xiao,
City of Hope
Author - Michael Garcia,
City of Hope
Author - Marilan Luong,
City of Hope
Author - Frances Cheung,
City of Hope
Author - Stacy Gray,
MD, AM,
City of Hope
F27 - Emotional expression during couples’ conversations about cancer: A natural language approach
Poster Number: F27Time: 11:00 AM - 11:50 AM
Topics: Cancer, Methods and Measurement
Among couples coping with cancer, research suggests that emotional expression may help improve psychosocial adjustment. However, findings are mixed, and most research relies on self-report measures of communication which may not reflect emotional expression as it occurs in conversations. The purpose of this study was to use a natural language approach to assess emotional expression during couples’ conversations about cancer and associations between emotional expression and self-reported communication and psychosocial adjustment.
Participants were 140 patients with Stage III-IV cancer (mean age=58.0; 62% female; 87% White) and their partners (mean age=58.8; 38% female; 86% White). They completed self-report measures of communication (Protective Buffering Scale), psychological adjustment (Hospital Anxiety and Depression Scale), spiritual/existential well-being (Life Completion subscale of the Quality of Life at End of Life [QUAL-E] scale), and relationship satisfaction (Couple Satisfaction Index). Couples engaged in 10-minute conversations about a cancer-related topic of their choosing. Transcriptions were analyzed using Linguistic Inquiry Word Count (LIWC) software to calculate the frequency of positive and negative emotion words used by each individual.
Correlation analyses were used to measure associations between emotion words and self-report measures. Compared to published norms, participants used fewer positive emotion words (0.81 vs. 1.44) and more negative emotion words (0.75 vs. 0.44). Among patients, there were significant negative correlations between QUAL-E Life Completion and use of words associated with anxiety (r=-0.20, p=.015) and sadness (r=-0.21, p=.014). There were no significant associations between patient or partner emotion words and measures of protective buffering, psychological distress, or relationship satisfaction.
Findings suggest that life completion - a measure of an individual's sense of meaning, peace, and the degree to which they feel cared for and able to care for others – may be a protective factor for patients with advanced cancer. The lack of associations between emotion words and self-report measures of communication and psychosocial functioning suggest that natural language use may provide unique information about emotional expression. Future research examining natural language use as it pertains to emotional expression in the context of cancer is warranted.
Keywords: Cancer, Couple-focusedParticipants were 140 patients with Stage III-IV cancer (mean age=58.0; 62% female; 87% White) and their partners (mean age=58.8; 38% female; 86% White). They completed self-report measures of communication (Protective Buffering Scale), psychological adjustment (Hospital Anxiety and Depression Scale), spiritual/existential well-being (Life Completion subscale of the Quality of Life at End of Life [QUAL-E] scale), and relationship satisfaction (Couple Satisfaction Index). Couples engaged in 10-minute conversations about a cancer-related topic of their choosing. Transcriptions were analyzed using Linguistic Inquiry Word Count (LIWC) software to calculate the frequency of positive and negative emotion words used by each individual.
Correlation analyses were used to measure associations between emotion words and self-report measures. Compared to published norms, participants used fewer positive emotion words (0.81 vs. 1.44) and more negative emotion words (0.75 vs. 0.44). Among patients, there were significant negative correlations between QUAL-E Life Completion and use of words associated with anxiety (r=-0.20, p=.015) and sadness (r=-0.21, p=.014). There were no significant associations between patient or partner emotion words and measures of protective buffering, psychological distress, or relationship satisfaction.
Findings suggest that life completion - a measure of an individual's sense of meaning, peace, and the degree to which they feel cared for and able to care for others – may be a protective factor for patients with advanced cancer. The lack of associations between emotion words and self-report measures of communication and psychosocial functioning suggest that natural language use may provide unique information about emotional expression. Future research examining natural language use as it pertains to emotional expression in the context of cancer is warranted.
Authors:
Co-Author - Karen Steinhauser,
PhD,
Duke University Medical Center
Co-Author - Karena Leo, PhD,
PhD,
Duke University Medical Center
Co-Author - Carson St. Denis,
University of North Carolina
Co-Author - Adunoluwa Z. Akinola,
University of North Carolina
F28 - Digital Storytelling as a Tool for Cancer Screening Promotion among Hispanic/Latinx Adults: Pilot Study Results
Poster Number: F28Time: 11:00 AM - 11:50 AM
Topics: Cancer, Community Engagement
Although cancer is the leading cause of death among Hispanic/Latinx individuals, many do not complete routine cancer screenings due to systemic barriers. In response to this inequitable burden of mortality, Rochester Healthy Community Partnership (RHCP) – a 20-year community and academic partnership - developed Stories for Change: La deteccíon temprana puede salvar vidas (early detection can save lives) (S4C Cancer Screening). We invited 8 Hispanic/Latinx cancer survivors or co-survivors to create 2-minute videos. The stories are heartfelt and designed to help patients make informed screening decisions. RHCP piloted S4C Cancer Screening across 3 clinical sites to evaluate acceptability and measure cancer screenings completed 7 months post intervention. We used open-ended qualitative questions to gather suggestions on how to improve the intervention and how the video influenced participants’ decision to complete screening. We recruited 51 participants overdue for cancer screening (breast = 13; cervical = 12; colorectal women = 14; colorectal men =12). The participants reported they “really liked” the digital stories (96%). After viewing, they felt more motivated to get screened (92%) and intended to be screened in the future (100%). Nearly half (45%) of participants completed their recommended cancer screening within 7 months. Among those screened, 89% reported their decision was “very much” influenced by the digital stories. Of those not screened, 26% reported lack of time and 10% each reported cost and “not recommended by provider” as barriers. Participants suggested enhancing the videos with more information on risks of late-stage diagnosis, causes, symptoms, patient experiences, and screening resources. They recommended including more stories, educating young adults, and ensuring consistent screening guidelines are reported. Those who completed screenings felt influenced by remembering cancer survivors they knew in the community, recognition of symptoms, concern for their health, and a clearer understanding of the importance of screening. Digital stories appear to be an acceptable, effective modality to encourage cancer screening among Hispanic/Latinx patients in pilot testing. However, multi-level barriers exist to completing cancer screenings. These results will guide us in improving S4C Cancer Screening, developing future studies to address these barriers, and testing whether digital stories effectively persuade viewers to complete cancer screenings.
Keywords: Cancer, Community interventionAuthors:
Presenter - Abby M. Lohr,
PhD, MPH,
Mayo Clinic
Co-Author - Jennifer L. St. Sauver,
PhD,
Mayo Clinic
Co-Author - Jamie J. O'Byrne,
MAS,
Mayo Clinic
Co-Author - Kaitlyn Smith,
Mayo Clinic
Co-Author - Katherine Diaz Vickery,
MD, MSc,
Hennepin Healthcare Research Institute
Co-Author - Valentina Hernandez,
Mountain Park Health Center
Co-Author - Lauren E. McPherson,
MD, MPH, MAT,
University of Minnesota
Co-Author - Becky R. Ford,
PhD,
Hennepin Healthcare Research Institute
Co-Author - Crystal Gonzalez,
Mountain Park Health Center
Co-Author - Silvio Kavistan,
Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute
Co-Author - Luz Molina,
Mayo Clinic
Co-Author - Miriam Goodson,
Mayo Clinic
Co-Author - Graciela Porraz Capetillo,
CHI,
Mayo Clinic
Co-Author - Davinder Singh,
MD,
Mountain Park Health Center
Co-Author - Mark L. Wieland,
MD, MPH,
Mayo Clinic
Co-Author - Irene G. Sia,
MD, MSc,
Mayo Clinic
F29 - The Physical Quality of Life of Family Caregivers of Adult Patients with Cancer: Longitudinal Effects of Caregiving Experiences in the Geriatric Care Context
Poster Number: F29Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Family caregivers of patients with cancer experience significant stress, which has substantial impact on their quality of life (QOL). Although the roles of individual and social resources in caregivers’ mental health have been well-studied, the compatible evidence in physical health and their long-term impact is lacking. Furthermore, caring for older patients may impose unique challenges. Thus, this study investigated the extent to which caregiving experiences are associated with physical QOL and the moderating effects of patient age during the first year of cancer survivorship.
Family caregivers (n=94, M age=52 years, 68% female, 50% Hispanic) of patients with colorectal cancer (M age=56 years, range=31-89 years, 76% advanced cancer) completed questionnaires assessing caregiver’s esteem, loneliness, and family support approximately four months after the patient’s diagnosis (T1). Caregivers also collected four saliva samples per day for two consecutive days at T1 and one year later (T2), from which cortisol levels at waking and bedtime, cortisol awakening response (CAR), and diurnal patterns were quantified. Caregivers’ age and gender, and patient cancer stage were covariates.
Caregivers reported high levels of esteem and family support, and low levels of loneliness. Caregivers had elevated waking and bedtime cortisol levels, and more blunted CAR and diurnal patterns, compared with those of non-caregivers. Hierarchical regression models indicated that greater loneliness was concurrently associated with lower cortisol levels at waking and at bedtime (b≤-4.94, p≤.034). Controlling for covariates and T1 cortisol values, less family support was associated with larger CAR and flatter cortisol slope at T2 (b≥1.67, p≤.021), and greater esteem was marginally associated with higher cortisol levels at waking at T2 (b=18.64, p=.073), which was the case only in caregivers of older patients.
Findings suggest that family cancer caregivers have compromised physical health and unique aspects of caregiving experience are differentially related to physical QOL by patient age across the first year of cancer survivorship. Investigating the psychosocial pathways that underly the contemporaneous roles of caregivers’ loneliness and the delayed responses of esteem and family support is warranted. Interventions tailored for caregivers’ coping resources and the geriatric care context across the cancer survivorship trajectory may help improve caregivers’ health.
Keywords: Cancer, PsychoneuroendocrinologyFamily caregivers (n=94, M age=52 years, 68% female, 50% Hispanic) of patients with colorectal cancer (M age=56 years, range=31-89 years, 76% advanced cancer) completed questionnaires assessing caregiver’s esteem, loneliness, and family support approximately four months after the patient’s diagnosis (T1). Caregivers also collected four saliva samples per day for two consecutive days at T1 and one year later (T2), from which cortisol levels at waking and bedtime, cortisol awakening response (CAR), and diurnal patterns were quantified. Caregivers’ age and gender, and patient cancer stage were covariates.
Caregivers reported high levels of esteem and family support, and low levels of loneliness. Caregivers had elevated waking and bedtime cortisol levels, and more blunted CAR and diurnal patterns, compared with those of non-caregivers. Hierarchical regression models indicated that greater loneliness was concurrently associated with lower cortisol levels at waking and at bedtime (b≤-4.94, p≤.034). Controlling for covariates and T1 cortisol values, less family support was associated with larger CAR and flatter cortisol slope at T2 (b≥1.67, p≤.021), and greater esteem was marginally associated with higher cortisol levels at waking at T2 (b=18.64, p=.073), which was the case only in caregivers of older patients.
Findings suggest that family cancer caregivers have compromised physical health and unique aspects of caregiving experience are differentially related to physical QOL by patient age across the first year of cancer survivorship. Investigating the psychosocial pathways that underly the contemporaneous roles of caregivers’ loneliness and the delayed responses of esteem and family support is warranted. Interventions tailored for caregivers’ coping resources and the geriatric care context across the cancer survivorship trajectory may help improve caregivers’ health.
Authors:
Author - Ashley Parrish,
University of Miami
Co-Author - Thomas C. Tsai,
University of Miami
Co-Author - Isabella Suarez,
University of Miami
Co-Author - Youngmee Kim,
PhD, FSBM,
University of Miami
F30 - Association of state laws regulating indoor tanning and other contextual factors with burns in a national sample of US young adults
Poster Number: F30Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health Communication and Policy
Introduction: In addition to FDA safety regulations, 46 states restrict minor indoor tanning (IT) access to prevent acute (burns from UV exposure) and chronic (skin cancer) harms. This study’s purpose was to identify state laws and other contextual factors potentially associated with burns from IT to inform state policy efforts.
Methods: We conducted an online, nationally representative survey of individuals 18-29 who indoor tanned in the last 3 years (N=1000). Respondents reported on IT as adults (18 or older) and as minors (under 18). Stringency of state laws on IT use by minors was scored, with no laws regulating minor IT = 0 and laws banning all minors under 18 from IT = 10. Generalized linear models were used to estimate the associations of policy stringency for minor use and enforcement, IT behavior, and other contextual factors with burns after IT as a minor or adult. All analyses used the sampling weights.
Results: 88% of participants reported engaging in IT in multiple facility types in the last 3 years: IT salons, gyms, beauty salons, homes, spas, and apartments. Stringency of IT laws in participants’ home states were coded as an average of 4 (weak) out of 10. 57% of participants reported burning one or more times from IT in the past 3 years, with 14% from their most recent IT session. Correlates of burns from IT when a minor were weaker age restrictions, stronger enforcement policies, more binge drinking, tanning at locales other than an IT salon, more IT sessions, shorter IT sessions, and more sunburns (ps<0.05). Correlates of burns from IT when an adult were being between 22 and 25 years old, lower perceived IT facility safety in their state, stronger enforcement policies, more IT sessions, and more sunburns (ps<0.01).
Conclusions: This is the first study to investigate the impact of the stringency and enforcement components of state IT law age restrictions on burns both for IT before and after age 18, in a representative national sample. Burns were very common in the context of weak laws in many states, yet harmful burns after IT during childhood appeared to be lower in states with stronger age restrictions. Policies to enforce weak laws or inadequate safety regulations/compliance may perpetuate IT and burns in minors or adults. Thus, increasing stringency of and compliance with state IT laws for all facility types may ultimately decrease acute harm and subsequent skin cancer rates.
Keywords: Cancer, Health policyMethods: We conducted an online, nationally representative survey of individuals 18-29 who indoor tanned in the last 3 years (N=1000). Respondents reported on IT as adults (18 or older) and as minors (under 18). Stringency of state laws on IT use by minors was scored, with no laws regulating minor IT = 0 and laws banning all minors under 18 from IT = 10. Generalized linear models were used to estimate the associations of policy stringency for minor use and enforcement, IT behavior, and other contextual factors with burns after IT as a minor or adult. All analyses used the sampling weights.
Results: 88% of participants reported engaging in IT in multiple facility types in the last 3 years: IT salons, gyms, beauty salons, homes, spas, and apartments. Stringency of IT laws in participants’ home states were coded as an average of 4 (weak) out of 10. 57% of participants reported burning one or more times from IT in the past 3 years, with 14% from their most recent IT session. Correlates of burns from IT when a minor were weaker age restrictions, stronger enforcement policies, more binge drinking, tanning at locales other than an IT salon, more IT sessions, shorter IT sessions, and more sunburns (ps<0.05). Correlates of burns from IT when an adult were being between 22 and 25 years old, lower perceived IT facility safety in their state, stronger enforcement policies, more IT sessions, and more sunburns (ps<0.01).
Conclusions: This is the first study to investigate the impact of the stringency and enforcement components of state IT law age restrictions on burns both for IT before and after age 18, in a representative national sample. Burns were very common in the context of weak laws in many states, yet harmful burns after IT during childhood appeared to be lower in states with stronger age restrictions. Policies to enforce weak laws or inadequate safety regulations/compliance may perpetuate IT and burns in minors or adults. Thus, increasing stringency of and compliance with state IT laws for all facility types may ultimately decrease acute harm and subsequent skin cancer rates.
Authors:
Presenter - David B. Buller, PhD, FSBM,
Klein Buendel, Inc.
Co-Author - Anna Mitarotondo, BA,
Rutgers Cancer Institute
Co-Author - Daniel Gundersen,
PhD,
Rutgers Institute for Nicotine and Tobacco Studies
Co-Author - Marisa Tomaino,
Rutgers Institute for Nicotine and Tobacco Studies
Co-Author - Julia Berteletti,
MSW,
Klein Buendel, Inc.
Co-Author - Carolyn J. Heckman, PhD,
Rutgers Cancer Institute
F31 - Positive Psychological Intervention to Improve Quality of Life for Women with Metastatic Breast Cancer: Feasibility, Acceptability, and Pilot Outcomes
Poster Number: F31Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Background: Quality of life (QOL) is a critical outcome for women with metastatic breast cancer (MBC). Psychological interventions for MBC tend to target end-of-life versus everyday concerns of living with MBC. Positive psychological interventions (PPIs) have the potential to improve QOL, but have not been tested among women with MBC. To fill this gap, we are conducting a single-arm pilot trial of a multimodal positive psychological intervention (PPI), enhanced with an ecological momentary intervention (EMI) for symptom management, to improve QOL for women with MBC.
Methods: We recruited women with MBC from an NCI-designated comprehensive cancer center. Participants were English-speaking, could use SMS messages and the internet, and reported clinically significant anxiety and/or depression (7+ on a 0-10 visual analog scale). Participants complete 5 weekly, 45-minute phone/video meetings, in which a study counselor introduces specific skills (e.g., gratitude, mindfulness, positive reappraisal) and encourages practicing and tracking them between sessions. Participants report physical and psychological symptoms daily via SMS messaging. Clinically elevated symptoms trigger an EMI consisting of a personalized coaching message tailored to the symptom(s) reported and the skill(s) learned that week. Primary outcomes include feasibility (recruitment/retention rates) and acceptability (Acceptability of Intervention Measure). We will also examine pre-post changes in QOL, depression, and anxiety (PROMIS short forms) using paired-samples t-tests.
Results: We approached 20 women and established contact with 15 (75%); 10 (67%) consented. Participants are 55 years old on average (range: 35-75) and identified as non-Hispanic White (50%), non-Hispanic Black (40%), or Hispanic/Latina (10%). At baseline, participants demonstrated worse QOL (physical health QOL: M=41.2; mental health QOL: M=43.1) and more depression (M=55.4) and anxiety (M=57.1) than the general population (M=50.0, SD=10). Intervention delivery is ongoing; no participants have dropped out thus far. On average, participants have completed 3 of 5 intervention sessions (range: 1-5) and responded to 88% of daily symptom assessments (range: 48-100%), triggering the EMI 17 times (range: 10-31).
Conclusions: This pilot study supports the feasibility of enrolling and retaining diverse women with MBC to this trial. Post-intervention surveys will assess intervention acceptability and impact on outcomes of interest.
Keywords: Cancer survivorship, InterventionMethods: We recruited women with MBC from an NCI-designated comprehensive cancer center. Participants were English-speaking, could use SMS messages and the internet, and reported clinically significant anxiety and/or depression (7+ on a 0-10 visual analog scale). Participants complete 5 weekly, 45-minute phone/video meetings, in which a study counselor introduces specific skills (e.g., gratitude, mindfulness, positive reappraisal) and encourages practicing and tracking them between sessions. Participants report physical and psychological symptoms daily via SMS messaging. Clinically elevated symptoms trigger an EMI consisting of a personalized coaching message tailored to the symptom(s) reported and the skill(s) learned that week. Primary outcomes include feasibility (recruitment/retention rates) and acceptability (Acceptability of Intervention Measure). We will also examine pre-post changes in QOL, depression, and anxiety (PROMIS short forms) using paired-samples t-tests.
Results: We approached 20 women and established contact with 15 (75%); 10 (67%) consented. Participants are 55 years old on average (range: 35-75) and identified as non-Hispanic White (50%), non-Hispanic Black (40%), or Hispanic/Latina (10%). At baseline, participants demonstrated worse QOL (physical health QOL: M=41.2; mental health QOL: M=43.1) and more depression (M=55.4) and anxiety (M=57.1) than the general population (M=50.0, SD=10). Intervention delivery is ongoing; no participants have dropped out thus far. On average, participants have completed 3 of 5 intervention sessions (range: 1-5) and responded to 88% of daily symptom assessments (range: 48-100%), triggering the EMI 17 times (range: 10-31).
Conclusions: This pilot study supports the feasibility of enrolling and retaining diverse women with MBC to this trial. Post-intervention surveys will assess intervention acceptability and impact on outcomes of interest.
Authors:
Presenter - Claire C. Conley,
PhD,
Georgetown Lombardi Comprehensive Cancer Center
Co-Author - Elizabeth L. Addington,
PhD,
Northwestern University Feinberg School of Medicine
Co-Author - Mikaela A. Velazquez-Sosa,
BA,
Georgetown Lombardi Comprehensive Cancer Center
Co-Author - Brenna Mossman,
PhD,
Georgetown Lombardi Comprehensive Cancer Center
Co-Author - Claudine Isaacs,
MD,
Georgetown Lombardi Comprehensive Cancer Center
Co-Author - Suzanne C. O'Neill,
PhD, FSBM,
Georgetown Lombardi Comprehensive Cancer Center
Co-Author - Judith Tedlie Moskowitz,
PhD MPH,
Northwestern University Feinberg School of Medicine
F32 - HPV Awareness and Adherence to Pap Screening and among Black Women aged 21-44: Analysis of the Health Information National Trends Survey from 2014-2022
Poster Number: F32Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health of Marginalized Populations
Background: HPV-related cancers (e.g., cervical cancer, anal cancer) are a significant health concern for women, and prevention strategies such as the HPV vaccine and early detection via regular Pap screening can significantly reduce risk and improve cancer-related health outcomes. Black women are at higher risk for HPV-related health disparities, and awareness of preventive measures like the HPV vaccine and the role of Pap smears is critical for engaging in effective care. Awareness of HPV, the HPV vaccine, and adherence to regular Pap screening are important for reducing HPV-related health disparities, but there are limited studies that evaluate trends in these outcomes over time for Black women.
Purpose: Using nationally representative samples from the Health Information National Trends Survey (HINTS) 4 Cycle 4 (2014), HINTS 5 Cycle 2 (2018), and HINTS 6 (2022), we tested whether there has been a change in self-reported adherence to Pap screening recommendations, awareness about HPV, and awareness about HPV vaccines among Black women aged 21-44.
Methods: To test our research question, we conducted three multivariate logistic regression analyses on a subsample of Black women aged 21–44 (n=309). For each regression, the predictor was survey year (2014, 2018, 2022). The outcome variables for each of the three analyses were: (1) receipt of a Pap screening within the prior 3 years, (2) HPV awareness, and (3) HPV vaccine awareness. Health insurance, age (21–29 vs. 30–44), and educational attainment were included as covariates.
Results: There was no significant differences between survey years for adherence to Pap screening (93% in 2014, 88% in 2018, 86% in 2022, ps > .291), awareness of HPV (79% in 2014, 76% in 2018, 82% in 2022, ps > .513), or awareness of HPV vaccines (77% vs 67% vs 78%, ps > .265). Of the covariates, education status significantly predicted HPV awareness (OR = 12.96, p = .001, 95% CI [1.08, 4.04]) and HPV vaccine awareness (OR = 6.18, p = .02, 95% CI [.31, 3.33]), with lower educational attainment predicting lower odds of being aware of HPV and the HPV vaccine.
Conclusions: Among Black women aged 21-44, self-reported adherence to Pap screening recommendations was high (above 85%) over the past decade and did not vary by survey year (2014, 2018, 2022). Differences in HPV awareness by education underscore the need to understand and address ecological factors that contribute to HPV-associated health disparities among Black women.
Keywords: Cancer risk perceptions, Women's healthPurpose: Using nationally representative samples from the Health Information National Trends Survey (HINTS) 4 Cycle 4 (2014), HINTS 5 Cycle 2 (2018), and HINTS 6 (2022), we tested whether there has been a change in self-reported adherence to Pap screening recommendations, awareness about HPV, and awareness about HPV vaccines among Black women aged 21-44.
Methods: To test our research question, we conducted three multivariate logistic regression analyses on a subsample of Black women aged 21–44 (n=309). For each regression, the predictor was survey year (2014, 2018, 2022). The outcome variables for each of the three analyses were: (1) receipt of a Pap screening within the prior 3 years, (2) HPV awareness, and (3) HPV vaccine awareness. Health insurance, age (21–29 vs. 30–44), and educational attainment were included as covariates.
Results: There was no significant differences between survey years for adherence to Pap screening (93% in 2014, 88% in 2018, 86% in 2022, ps > .291), awareness of HPV (79% in 2014, 76% in 2018, 82% in 2022, ps > .513), or awareness of HPV vaccines (77% vs 67% vs 78%, ps > .265). Of the covariates, education status significantly predicted HPV awareness (OR = 12.96, p = .001, 95% CI [1.08, 4.04]) and HPV vaccine awareness (OR = 6.18, p = .02, 95% CI [.31, 3.33]), with lower educational attainment predicting lower odds of being aware of HPV and the HPV vaccine.
Conclusions: Among Black women aged 21-44, self-reported adherence to Pap screening recommendations was high (above 85%) over the past decade and did not vary by survey year (2014, 2018, 2022). Differences in HPV awareness by education underscore the need to understand and address ecological factors that contribute to HPV-associated health disparities among Black women.
Authors:
Author - McKenzie Reese,
Loyola Marymount University
Co-Author - Whitney Brymwitt,
M.A.,
Loyola Marymount University
Co-Author - Timothy J. Williamson, PhD, MPH,
PhD, MPH,
Loyola Marymount University
F33 - THRIVE NOW: Results from a Survivor Co-designed Weight Loss/Wellness Pilot Program for Black Breast Cancer Survivors with Comorbid Obesity
Poster Number: F33Time: 11:00 AM - 11:50 AM
Topics: Cancer, Obesity
Black breast cancer survivors (BCS) with obesity face challenges in maintaining a healthy weight, critical for reducing cancer recurrence and improving health outcomes. Disparities in access to culturally tailored programs addressing cancer-obesity multimorbidity may contribute to poorer outcomes. This study team aimed to design, implement, and evaluate a culturally tailored weight loss/wellness program for Black BCS with obesity.
An 8-week pilot program was co-designed with five Black BCS during four design sessions. The program included weekly group sessions on nutrition, physical activity/rest, and acceptance-based psychological techniques led by a Black interventionist. Pre- and post-intervention assessments of total body weight, fat mass, skeletal muscle mass (SMM), and body fat percentage (BF%) were completed. Session engagement was examined on a 0-2 scale (0=minimal and 2=full engagement), and qualitative post-program evaluation and satisfaction ratings were also solicited.
Twelve Black BCS participated (mean age=53.7±7.4 years, BMI=41.1±11.0 kg/m²), attending 94.8±6.4% of sessions with 1.8±0.3 average engagement scores. The majority (75%) lost or maintained weight, with an average loss of 1.7% of total body weight and 3.1% fat mass. BF% reduced by 1.4% on average, and 58% of the women gained or maintained SMM. Effect sizes were medium: d=.67 (fat mass loss), d=.59 (total body weight loss), and d=.53 (BF% reduction). High satisfaction was reported, with many citing the affinity group experience and empowerment as keys to success, as denoted in quotes such as: “I feel like I was not alone and I'll never be alone” and “Finally, finally, finally something that puts women of color in the conversation and trying to offer something for us.”
The 8-week culturally tailored weight loss/wellness program was well-received and effective in promoting significant weight loss among Black BCS with obesity. These findings underscore the importance of culturally and multimorbidity-specific interventions in addressing health disparities. Future programs should explore longer treatment durations, other underserved populations, a control arm to test comparative efficacy, and the long-term impact on cancer recurrence and survival rates.
Keywords: Cancer survivorship, Weight lossAn 8-week pilot program was co-designed with five Black BCS during four design sessions. The program included weekly group sessions on nutrition, physical activity/rest, and acceptance-based psychological techniques led by a Black interventionist. Pre- and post-intervention assessments of total body weight, fat mass, skeletal muscle mass (SMM), and body fat percentage (BF%) were completed. Session engagement was examined on a 0-2 scale (0=minimal and 2=full engagement), and qualitative post-program evaluation and satisfaction ratings were also solicited.
Twelve Black BCS participated (mean age=53.7±7.4 years, BMI=41.1±11.0 kg/m²), attending 94.8±6.4% of sessions with 1.8±0.3 average engagement scores. The majority (75%) lost or maintained weight, with an average loss of 1.7% of total body weight and 3.1% fat mass. BF% reduced by 1.4% on average, and 58% of the women gained or maintained SMM. Effect sizes were medium: d=.67 (fat mass loss), d=.59 (total body weight loss), and d=.53 (BF% reduction). High satisfaction was reported, with many citing the affinity group experience and empowerment as keys to success, as denoted in quotes such as: “I feel like I was not alone and I'll never be alone” and “Finally, finally, finally something that puts women of color in the conversation and trying to offer something for us.”
The 8-week culturally tailored weight loss/wellness program was well-received and effective in promoting significant weight loss among Black BCS with obesity. These findings underscore the importance of culturally and multimorbidity-specific interventions in addressing health disparities. Future programs should explore longer treatment durations, other underserved populations, a control arm to test comparative efficacy, and the long-term impact on cancer recurrence and survival rates.
Authors:
Author - Misty Hawkins,
PhD,
Indiana University
Co-Author - Kelsey Sinclair,
MA,
Indiana University
Co-Author - Mahogany Monette,
BA,
Indiana University Indianapolis
Co-Author - Jennifer McChristian,
LCSW, DSW,
Indiana University
Co-Author - Kristen Allen-Watts, PhD, MPH,
PhD, MPH,
University of Alabama at Birmingham
Co-Author - Maresa Murray,
PhD,
Indiana University
Co-Author - Evan Jordan, Ph.D.,
Ph.D.,
Indiana Univeristy
Co-Author - Tarah Ballinger,
MD,
Simon Comprehensive Cancer Center
Co-Author - Shelley A. Johns, PsyD, ABPP,
PsyD, ABPP,
Indiana University School of Medicine
F35 - Survey Landscape Study: Sleep, Cognition, and Cancer
Poster Number: F35Time: 11:00 AM - 11:50 AM
Topics: Cancer, Sleep
Background: Both sleep and cognition are often disrupted by cancer and its treatments, reducing quality of life for cancer survivors. However, the relationship between sleep and cognition remains poorly understood, especially in the cancer context. This study aimed to identify nationally representative Federal surveys, characterize items, and explore relationships between items that assess perspectives, experiences, behaviors, conditions, and associated contextual factors related to sleep, cognition, and cancer to facilitate future research. Methods: Inclusion criteria: 1) Federal surveys with individual-level items, 2) publicly accessible data, 3) nationally representative of the US population, and 4) administered between 2013-2023. Eligible surveys were searched for sleep, cognition, and cancer related items using relevant keywords. Items were coded based on related constructs, themes, and key features. Analyses were conducted to demonstrate relationships between key constructs, themes, and contextual factors. Results: Of the 299 surveys screened, 26 met eligibility criteria. Among these, 19 surveys included a total of 160 sleep-related items, 25 featured 207 cognition-related items, and 12 surveys had 101 cancer-related items. Eleven surveys included all three domains – sleep, cognition, and cancer. Key constructs associated with cognition (e.g., memory (n=83), concentration (n=74), decision-making (n=30), confusion (n=15)), sleep (e.g., insomnia (n=40), sleep duration (n=27), tiredness (n=19), breathing issues (n=10)), and cancer (e.g., diagnosis (n=20), treatment (n=22), age of diagnosis (n=11), cancer type (n=21)) as well as contextual factors across the three domains (e.g., medical interventions (n=55), work-related issues (n=30)) were identified. To conclude this presentation, we will provide comprehensive visualizations of relationships across variables and offer examples of research questions that can be answered using the key constructs, themes, and contextual factors available through publicly accessible data from 26 surveys fielded over a ten-year period. Conclusion: This study can help researchers to leverage the substantial investments by the federal government in nationally representative surveys and advance our understanding of sleep, cognition, and contextual factors among cancer survivors and other populations.
Keywords: Health behaviors, Sleep disordersAuthors:
Co-Author - Kara L. Hall, PhD,
PhD,
National Cancer Institute
Co-Author - Todd Horowitz,
PhD,
National Cancer Institute
Co-Author - Caroline Crown,
National Cancer Institute
Co-Author - Sara Son,
National Cancer Institute
Co-Author - Christine Nguyen,
National Cancer Institute
F36 - Relationship Between Adverse Childhood Experiences (ACEs) and Cancer Risk: A Systematic Review With a Focus on American Racial and Ethnic Diverse Populations
Poster Number: F36Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health of Marginalized Populations
Adverse Childhood Experiences (ACEs) represent potentially traumatic or stressful experiences occurring in childhood and resulting from various sociocultural, political, anthropological, and cultural factors that directly impact the risk of chronic conditions, including cancer, especially among non-White Americans. However, the extent to which research on the effects of ACEs on adult cancer risk has focused on BIPOC individuals is unclear. Therefore, this systematic review aims to summarize findings on the relationship between ACEs and cancer risk among adult BIPOC. The PubMed, Embase (Elsevier), and Web of Science (Clarivate) databases were used to find peer-reviewed articles with no date limits. The selected databases focus on biomedical, health, and social sciences. The PICO was Population (Adult BIPOCs), Exposure (ACEs), Comparison (Adults with no ACEs), and Outcome (Cancer risk). The main search concepts were ACEs and cancer risk. No filters or limits were used. Search results yielded 95 articles using PubMed, 162 using Embase, and 142 using Web of Science for 399 articles. All searches were run by the end of 2023. A total of 74 duplicates were found. After removing duplicates, the number of records is 325. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines guided the article screening procedures. Studies were eligible to be included in this review if a peer-reviewed manuscript published by the end of 2023, conducted in the United States of America (US), measuring the relationship between ACEs and adulthood cancer risk, and that provides specific results or stratified results for samples of non-White American adults. Articles not focused on the relationship between ACEs and cancer risk, with no results concerning BIPOC Americans, not original research, published outside the US, or not in English, were excluded. 13 articles met the inclusion criteria. Seven studies reported increased exposure to ACEs among BIPOC. Three studies found risk factors for cancer to be predictors of the association between ACEs and cancer risk. Six studies found a graded dose-response relationship between ACEs and cancer risk among BIPOC. In contrast, one study found an inverse-graded relationship. BIPOC exposed to ACEs may be at an increased risk for cancer, highlighting the need for resilience-based interventions. Interdisciplinary and community-based approaches can help address long-term health implications.
Keywords: Cancer, Health disparitiesAuthors:
Presenter - Rolando Trejos,
MPH, CPH,
University of South Florida
Co-Author - Chighaf Bakour,
PhD, MD,
University of South Florida College of Public Health
F37 - Interest in Cancer Screening, Cancer Beliefs, and Competing Concerns of Transportation, Housing, and Food Security among Hispanic/Latina women in the United States: Insights from the 2022 Health Information National Trends Survey
Poster Number: F37Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health of Marginalized Populations
Background: Several cancer-related health disparities affect Hispanic/Latina women, including a 36% higher incidence rate of cervical cancer (compared to White women), a 30% higher mortality rate (compared to White women), and the steepest rising incidence rates of breast cancer from 2012-2021 (among any racial or ethnic group). Early detection through cervical and breast cancer screening are effective at reducing cancer incidence and mortality. However, screening rates among Hispanic/Latina women are lower compared to White women for cervical cancer (69% vs. 90%) and for breast cancer (60% vs. 65%). As such, it is important to research psychological and socioecological factors that predict interest in cancer screening among Hispanic/Latina women.
Purpose: Using the 2022 Health Information National Trends Survey (HINTS) Cycle 6, we tested whether competing concerns (e.g., lack of transportation, housing insecurity, food insecurity) and attitudes towards cancer prevention progress predicted interest in cancer screening among Hispanic/Latina women.
Methods: We conducted two separate multivariate linear regressions on subsamples of Hispanic/Latina women in the recommended age range for 1) breast cancer screening (aged 40-74; n = 208) and 2) for cervical cancer screening (aged 21-65; n = 290). In both linear models, competing concerns (a composite score of 4 items assessing transportation, housing, and food insecurity) and attitudes toward cancer prevention progress (Scale: 1-4) were entered as predictors. Interest in cancer screening was entered as the outcome (Scale: 1-4). Insurance and household income were entered as covariates.
Results: Higher competing concerns was associated significantly with higher interest in cancer screening among the breast cancer screening-eligible subsample (b=0.74, SE=0.36, p=0.45), but not the cervical cancer screening-eligible subsample (b=0.39, SE=0.32, p=.231). Beliefs in cancer prevention progress were not associated with cancer screening interest in either subsample (ps > .271).
Conclusions: Our findings surprisingly indicated that higher competing concerns were associated with higher interest in cancer screening among those eligible for breast (but not cervical) cancer screening. Whereas prior research has identified competing concerns as barriers to engaging in screening, these findings suggest that the barriers identified in past studies may be more behavioral or structural in nature (rather than attitudinal).
Keywords: Cancer screening, Women's healthPurpose: Using the 2022 Health Information National Trends Survey (HINTS) Cycle 6, we tested whether competing concerns (e.g., lack of transportation, housing insecurity, food insecurity) and attitudes towards cancer prevention progress predicted interest in cancer screening among Hispanic/Latina women.
Methods: We conducted two separate multivariate linear regressions on subsamples of Hispanic/Latina women in the recommended age range for 1) breast cancer screening (aged 40-74; n = 208) and 2) for cervical cancer screening (aged 21-65; n = 290). In both linear models, competing concerns (a composite score of 4 items assessing transportation, housing, and food insecurity) and attitudes toward cancer prevention progress (Scale: 1-4) were entered as predictors. Interest in cancer screening was entered as the outcome (Scale: 1-4). Insurance and household income were entered as covariates.
Results: Higher competing concerns was associated significantly with higher interest in cancer screening among the breast cancer screening-eligible subsample (b=0.74, SE=0.36, p=0.45), but not the cervical cancer screening-eligible subsample (b=0.39, SE=0.32, p=.231). Beliefs in cancer prevention progress were not associated with cancer screening interest in either subsample (ps > .271).
Conclusions: Our findings surprisingly indicated that higher competing concerns were associated with higher interest in cancer screening among those eligible for breast (but not cervical) cancer screening. Whereas prior research has identified competing concerns as barriers to engaging in screening, these findings suggest that the barriers identified in past studies may be more behavioral or structural in nature (rather than attitudinal).
Authors:
Author - Brandon Dona-Velazquez,
Loyola Marymount University
Co-Author - Whitney Brymwitt,
M.A.,
Loyola Marymount University
Co-Author - Timothy Williamson,
Ph.D., MPH,
Loyola Marymount University
F38 - Effects of the Mind Your BEAT physical activity intervention on psychosocial distress in rural breast cancer survivors: A mixed methods study
Poster Number: F38Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health of Marginalized Populations
Purpose: Physically inactive rural cancer survivors report elevated psychosocial distress. However, few interventions simultaneously target physical activity to reduce psychosocial distress. The Mind Your BEAT (MYB) intervention combined supervised aerobic exercise with behavior change skills and mind-body strategies (e.g., mindfulness) to reduce psychosocial distress in rural breast cancer survivors. This study used mixed methods to explore the effects of MYB on psychosocial distress in rural breast cancer survivors.
Methods: Rural breast cancer survivors (N=43) were recruited through an existing community-based exercise program and randomized to participate in the MYB intervention (n=22) or an exercise only control group (n=21). Participants completed the NCCN distress thermometer at four time points, weeks 0, 6 (mid-intervention), 12 (post-intervention), and 24 (follow-up), and a subsample of participants (N=20) completed an in-depth interview after their follow-up assessment to contextualize effects and assess program satisfaction. Repeated measures ANOVA was used to assess changes in psychosocial distress over time by group, and thematic content analysis was used to analyze interviews and identify themes.
Results: Rural breast cancer survivors (M age=66.3±10.0 years) were mostly non-Hispanic (95.1%), White (86.0%), diagnosed with stage 0 (14.3%) or I-II (66.6%) breast cancer, and roughly 5 years post-treatment (M=4.8±7.0 years). MYB participants reported statistically significant decreases in psychosocial distress from week 0 to 12 (Δ=-1.6, t=-2.1, p=.049) compared to control group participants who reported slight increases in psychosocial distress (Δ=-0.1, t=0.1, p=.949), and there was a significant time by group effect (F(3,105)=2.835, p=.042). When asked what specific aspects of the program they liked, one participant said, “[it’s] always good to connect with other people who've…gone through the same thing…And then the classes that [instructor] taught. I thought they were just very, very beneficial. And particularly about the mind and body you know working together for healing. (65yo)”
Conclusions: MYB reduced psychosocial distress among rural breast cancer survivors, and participants reported satisfaction with the program. These findings fill a critical gap on the translation of evidence-based interventions into practice in rural community settings to improve cancer survivorship and reduce cancer health disparities among rural residents.
Keywords: Cancer survivorship, StressMethods: Rural breast cancer survivors (N=43) were recruited through an existing community-based exercise program and randomized to participate in the MYB intervention (n=22) or an exercise only control group (n=21). Participants completed the NCCN distress thermometer at four time points, weeks 0, 6 (mid-intervention), 12 (post-intervention), and 24 (follow-up), and a subsample of participants (N=20) completed an in-depth interview after their follow-up assessment to contextualize effects and assess program satisfaction. Repeated measures ANOVA was used to assess changes in psychosocial distress over time by group, and thematic content analysis was used to analyze interviews and identify themes.
Results: Rural breast cancer survivors (M age=66.3±10.0 years) were mostly non-Hispanic (95.1%), White (86.0%), diagnosed with stage 0 (14.3%) or I-II (66.6%) breast cancer, and roughly 5 years post-treatment (M=4.8±7.0 years). MYB participants reported statistically significant decreases in psychosocial distress from week 0 to 12 (Δ=-1.6, t=-2.1, p=.049) compared to control group participants who reported slight increases in psychosocial distress (Δ=-0.1, t=0.1, p=.949), and there was a significant time by group effect (F(3,105)=2.835, p=.042). When asked what specific aspects of the program they liked, one participant said, “[it’s] always good to connect with other people who've…gone through the same thing…And then the classes that [instructor] taught. I thought they were just very, very beneficial. And particularly about the mind and body you know working together for healing. (65yo)”
Conclusions: MYB reduced psychosocial distress among rural breast cancer survivors, and participants reported satisfaction with the program. These findings fill a critical gap on the translation of evidence-based interventions into practice in rural community settings to improve cancer survivorship and reduce cancer health disparities among rural residents.
Authors:
Presenter - Megha Bhatia,
BA,
The University of Texas MD Anderson Cancer Center
Co-Presenter - Jenna Shi,
The University of Texas MD Anderson Cancer Center
Co-Author - Clarissa Escobar,
BS,
The University of Texas MD Anderson Cancer Center
Co-Author - Loren Bryant,
MS, MBA,
The University of Texas MD Anderson Cancer Center
Co-Author - Laura Q. Rogers, MD MPH,
MD MPH,
University of Alabama at Birmingham
Co-Author - Kathryn Schmitz,
PhD, MPH,
University of Pittsburgh Medical Center
Co-Author - Lorna H. McNeill, MPH, PhD, FSBM,
MPH, PhD, FSBM,
University of Texas MD Anderson Cancer Center
Co-Author - Scherezade K. Mama, DrPH,
DrPH,
The University of Texas MD Anderson Cancer Center
F39 - Physical activity and 10-year cardiovascular risk in family caregivers of patients diagnosed with cancer
Poster Number: F39Time: 11:00 AM - 11:50 AM
Topics: Cardiovascular Disease, Cancer
Background: Caregiving is associated with increased risk of cardiovascular disease (CVD). Physical activity is an important factor in the prevention of cardiovascular disease; however a paucity of research exists with regard to the role of physical activity and cardiovascular risk in family caregivers of those diagnosed with cancer. The aims of the study were to describe physical activity in family caregivers and examine correlates of physical activity and psychosocial and health outcomes.
Methods: The study is a secondary analysis of data from family caregivers who were enrolled as part of a Phase III trial testing a stepped collaborative care intervention for patients diagnosed with cancer. A battery of questionnaires was administered to caregivers, including measures of depressive symptoms, stress, physical activity, sleep quality, and substance use. Anthropomorphic measurements were performed and blood was collected. Cardiometabolic risk factors and the American College of Cardiology’s ASCVD calculator was used to estimate 10-year risk of CVD. For the purposes of this study, only baseline data was included. Analyses of variance, Chi-square analyses, and linear regression were performed to test the hypotheses.
Results: Of the 211 family caregivers, 69% were female and and 96% were white (mean age = 62 years, SD=12.1). No sociodemographic (e.g., age, BMI, race, income, sex) or patient related characteristics (e.g., patient quality of life, stage of cancer) predicted family caregivers’ physical activity levels. Physical activity levels were not associated with depressive symptoms, caregiver stress, sleep quality, alcohol or tobacco use. Physical activity was associated with lower levels of perceived stress (p=0.041) and 10-year risk of CVD (p=0.002). Perceived stress was also associated with higher 10-year risk of CVD (p=0.002). After adjusting for perceived stress; physical activity significantly predicted 10-year CVD risk (p=0.041). For those with low and moderate levels of physical activity their 10-year risk of CVD was 16.8% and 16% while those with vigorous levels of physical activity had a 12.4% 10-year risk of CVD.
Conclusion: Physical activity may be an important component of interventions designed to reduce CVD risk in family caregivers in the context of cancer.
Keywords: Caregiving, Cardiovascular diseaseMethods: The study is a secondary analysis of data from family caregivers who were enrolled as part of a Phase III trial testing a stepped collaborative care intervention for patients diagnosed with cancer. A battery of questionnaires was administered to caregivers, including measures of depressive symptoms, stress, physical activity, sleep quality, and substance use. Anthropomorphic measurements were performed and blood was collected. Cardiometabolic risk factors and the American College of Cardiology’s ASCVD calculator was used to estimate 10-year risk of CVD. For the purposes of this study, only baseline data was included. Analyses of variance, Chi-square analyses, and linear regression were performed to test the hypotheses.
Results: Of the 211 family caregivers, 69% were female and and 96% were white (mean age = 62 years, SD=12.1). No sociodemographic (e.g., age, BMI, race, income, sex) or patient related characteristics (e.g., patient quality of life, stage of cancer) predicted family caregivers’ physical activity levels. Physical activity levels were not associated with depressive symptoms, caregiver stress, sleep quality, alcohol or tobacco use. Physical activity was associated with lower levels of perceived stress (p=0.041) and 10-year risk of CVD (p=0.002). Perceived stress was also associated with higher 10-year risk of CVD (p=0.002). After adjusting for perceived stress; physical activity significantly predicted 10-year CVD risk (p=0.041). For those with low and moderate levels of physical activity their 10-year risk of CVD was 16.8% and 16% while those with vigorous levels of physical activity had a 12.4% 10-year risk of CVD.
Conclusion: Physical activity may be an important component of interventions designed to reduce CVD risk in family caregivers in the context of cancer.
Authors:
Author - Nikki Razavi,
University of Pittsburgh
Co-Author - Kathryn Schmitz,
PhD,
University of Pittsburgh
Co-Author - Peter Gianaros,
University of Pittsburgh
Co-Author - Vincent Reyes,
University of Pittsburgh Medical Center
Co-Author - Dan Zandberg,
University of Pittsburgh Medical Center
Co-Author - Marci Nilsen,
University of Pittsburgh
Co-Author - Guari Kiefer,
University of Pittsburgh Medical Center
Co-Author - Jonas Johnson,
University of Pittsburgh Medical Center
Co-Author - Christopher March,
University of Pittsburgh School of Medicine
Co-Author - Jason Bierenbaum,
University of Pittsburgh Medical Center
Co-Author - Nishant Tageja,
University of Pittsburgh Medical Center
Co-Author - Michael Krauze,
University of Pittsburgh Medical Center
Co-Author - Robert Vanderweele,
University of Pittsburgh Medical Center
Co-Author - Gaurav Goel,
University of Pittsburgh Medical Center
Co-Author - Gopala Ramineni,
University of Pittsburgh Medical Center
Co-Author - Michael Antoni,
University of Miami
Co-Author - Samer Tohme,
University of Pittsburgh
Co-Author - Timothy Billiar,
University of Pittsburgh
Co-Author - David Geller,
University of Pittsburgh
Presenter - Jennifer Steel,
University of Pittsburgh
F40 - Enhancing Shared Care Coordination for Complex Cancer Survivors Using Co-design to Shape a Multi-level Health System Intervention
Poster Number: F40Time: 11:00 AM - 11:50 AM
Topics: Cancer, Dissemination and Implementation
Many cancer survivors, particularly breast, endometrial, bladder, and prostate cancer survivors, with chronic cardiometabolic conditions (complex cancer survivors) are more likely to die from cardiovascular disease (CVD) than from their cancer. Health system fragmentation interferes with optimal CVD risk management during active treatment and limits shared care between primary care and oncology. Using an implementation science approach informed by co-design principles, we are developing Primary Care Connect (PC2), a health system intervention consisting of education and training, standardized communication protocols between oncology and primary care teams, nurse navigation, primary care ambassadors, and electronic health record optimization. The goal of the intervention is to support complex cancer survivors in staying connected to primary care during active cancer treatment. Guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) Framework, we are eliciting input from various stakeholders to co-design our intervention using several methods. A Scientific and Patient Advisory Board (SPAB) of national experts in survivorship care delivery and cancer survivors provides oversight and guidance. Interviews of complex cancer survivors (n=20), cancer team (n=10) and primary care providers (n=20) will inform a health ecosystem map of the current care coordination landscape and opportunities to refine the multi-level health system intervention for better fit in the clinical context. Along with quarterly SPAB meetings, Intervention Planning Groups (IPGs) of cancer and primary care clinicians will meet 6 times over the next year to tailor PC2 for health system and primary care practice environments. The SPAB participated in an experience mapping exercise to identify knowledge, psychosocial support, and actions needed to maintain continuity with primary care during active treatment. Whiteboard animation explainer videos for patients and clinicians will communicate key messages identified by the SPAB and stakeholder interviews. This intervention will be evaluated in a hybrid type 3 effectiveness-implementation trial to test effectiveness on primary care connection, chronic disease management, and patient reported outcomes, and assess implementation to inform sustainability of improved shared care delivery for complex cancer survivors.
Keywords: Cancer, Co-morbiditiesAuthors:
Presenter - Sarah J. Fadem,
PhD,
Rutgers RWJMS
Author - Jennifer R. Hemler, PhD,
PhD,
Rutgers RWJMS
Author - Shawna V. Hudson, PhD,
PhD,
Rutgers Robert Wood Johnson Medical School
Author - Jeanne Ferrante,
MD, MPH,
Rutgers RWJMS
Author - Benjamin F. Crabtree,
PhD,
Rutgers RWJMS
Author - Denalee M. O'Malley, PhD,
PhD,
Rutgers Robert Wood Johnson Medical School
F41 - Development and feasibility of an online grocery prescription program across rural and urban low resource adults.
Poster Number: F41Time: 11:00 AM - 11:50 AM
Topics: Cardiovascular Disease, Decision Making
Background
Food Is Medicine (FIM) interventions aim to reduce food insecurity and improve diet-sensitive chronic disease by providing nutrition resources integrated within healthcare. One approach is grocery prescriptions (Rx), where participants receive funds to purchase nutritious foods. Early results indicate benefits of these programs, but there is limited research on how effectiveness is influenced by contextual factors like individual purchasing choices. This study assesses the feasibility of developing an online grocery Rx program and its potential impact on low-resource adults in diverse communities.
Methods
Patients were recruited from managed care organizations (MCOs) and community clinics in Kentucky between February 1 and May 31, 2024, and screened for food insecurity using the Hunger Vital Sign™ questionnaire. Among those who screened for food insecurity, further eligibility criteria consisted of: diagnoses of hypertension or type 2 diabetes, ages 18-64, English speaking, and consent to participate. Patient health data, including systolic and diastolic BP and hemoglobin A1C, was uploaded by clinic staff or self-reported at baseline and post-intervention. Participants received a unique code to activate $200 per month for 3 months to purchase healthy foods. Eligible food items included fruits, vegetables, lean protein, and low-fat dairy. Registered dietitians selected eligible items following American Heart Association guidelines. Participants accessed a program website with cooking resources and received weekly text messages with behavioral nudges promoting healthy dietary behaviors like consuming a low-sodium diet. Participants completed a final survey evaluating changes in purchasing behaviors, health status, program satisfaction, and barriers to using the grocery Rx.
Results
On average, participants spent 26% on fruits and vegetables, 29% on lean protein, and 14% on dairy. A paired t-test comparing systolic BP pre and post-intervention indicated a significant decrease, (-1.86, p = 0.034). Although reductions in diastolic BP and HbA1c were not statistically significant, the overall trend suggests a positive impact. The program had an 87% completion rate, and participants expressed a 98.5% level of satisfaction.
Discussion
This pilot highlights the potential benefits of grocery Rx programs in managing diet-sensitive chronic disease, but further work is needed to refine effective processes and improve clinical outcomes.
Keywords: Hypertension, Built environmentFood Is Medicine (FIM) interventions aim to reduce food insecurity and improve diet-sensitive chronic disease by providing nutrition resources integrated within healthcare. One approach is grocery prescriptions (Rx), where participants receive funds to purchase nutritious foods. Early results indicate benefits of these programs, but there is limited research on how effectiveness is influenced by contextual factors like individual purchasing choices. This study assesses the feasibility of developing an online grocery Rx program and its potential impact on low-resource adults in diverse communities.
Methods
Patients were recruited from managed care organizations (MCOs) and community clinics in Kentucky between February 1 and May 31, 2024, and screened for food insecurity using the Hunger Vital Sign™ questionnaire. Among those who screened for food insecurity, further eligibility criteria consisted of: diagnoses of hypertension or type 2 diabetes, ages 18-64, English speaking, and consent to participate. Patient health data, including systolic and diastolic BP and hemoglobin A1C, was uploaded by clinic staff or self-reported at baseline and post-intervention. Participants received a unique code to activate $200 per month for 3 months to purchase healthy foods. Eligible food items included fruits, vegetables, lean protein, and low-fat dairy. Registered dietitians selected eligible items following American Heart Association guidelines. Participants accessed a program website with cooking resources and received weekly text messages with behavioral nudges promoting healthy dietary behaviors like consuming a low-sodium diet. Participants completed a final survey evaluating changes in purchasing behaviors, health status, program satisfaction, and barriers to using the grocery Rx.
Results
On average, participants spent 26% on fruits and vegetables, 29% on lean protein, and 14% on dairy. A paired t-test comparing systolic BP pre and post-intervention indicated a significant decrease, (-1.86, p = 0.034). Although reductions in diastolic BP and HbA1c were not statistically significant, the overall trend suggests a positive impact. The program had an 87% completion rate, and participants expressed a 98.5% level of satisfaction.
Discussion
This pilot highlights the potential benefits of grocery Rx programs in managing diet-sensitive chronic disease, but further work is needed to refine effective processes and improve clinical outcomes.
Authors:
Author - Lauren Batey,
MS, RDN,
University of Kentucky
Co-Author - Christa Mayfield,
University of Kentucky
Co-Author - Joshua Bush,
PhD,
University of Kentucky
Co-Author - Carlie Arlinghaus,
University of Kentucky
Co-Author - Lydia Jacobs,
University of Kentucky
Co-Author - Alison Gustafson,
PhD, MPH, RDN,
University of Kentucky
F42 - The Associations between Self-Compassion, Self-Criticism, Psychological Wellness and Cardiac Symptoms of Adults with Cardiac Conditions
Poster Number: F42Time: 11:00 AM - 11:50 AM
Topics: Cardiovascular Disease, Mental Health
Background: Psychological well-being is gaining clinical attention in cardiac rehabilitation (CR). In a clinical context, cardiac conditions have high reoccurrence rate, comorbidity and mortality, requiring continuous medical care and, thus, substantial medical resources; previous studies suggested psychological interventions could be beneficial. The concepts of self-compassion (SC) and self-criticism (SCr) are also gaining clinical attention. Studies regarding psychological wellbeing, SC and SCr among cardiac patients are limited. Preceding studies focused predominantly on the relations with physiological parameters, and that with cardiac symptom experience (CSE) remains unclear.
Objectives: To explore the relationship among SC and SCr levels, psychological well-being as reflected by stress, anxiety and depression level, and cardiac health level as reflected by CSE and medical resource utilisation, among cardiac patients.
Methods: This study adopted a cross-sectional survey study design with convenience sampling, using Self-Compassion Scale (Hong Kong Chinese Version), Depression Anxiety Stress Scale DASS-21(Chinese version), and a cardiac symptom questionnaire modified from Memorial Symptom Assessment Scale.
Results: A total of 108 cardiac patients recruited from a local public hospital were analysed. Results showed that cardiac patients with higher level of SCr were more likely to experience higher level of depressive (r = .399, p <.001), anxiety (r = .325, p <.001), and stress symptoms (r = .474, p <.001); they experienced higher level of CSE (r = .474, p <.001) and more hospital re-admissions (r = .162, p =.047). Patients with higher level of depression, anxiety and stress (DAS) visited AED more frequently. Multiple regression analysis reported that, after controlling for age and gender, DAS symptoms together with SCr showed stronger associations with CSE (F(4,103) = 13.366, p ≤ .01, Adj R2 = .316), and they were of equivalent predictive power. There were probable moderators influencing level of self-compassion.
Conclusion: Symptoms of depression, anxiety, and stress, as well as the tendency of self-criticism, are associated with the experience of cardiac symptoms. The present study's findings suggested a potential connection between psychological well-being and physical well-being among adults with cardiac issues. Psychosocial interventions targeting mitigating self-criticism may be beneficial to cardiac rehabilitation.
Keywords: Cardiovascular disease, Mental healthObjectives: To explore the relationship among SC and SCr levels, psychological well-being as reflected by stress, anxiety and depression level, and cardiac health level as reflected by CSE and medical resource utilisation, among cardiac patients.
Methods: This study adopted a cross-sectional survey study design with convenience sampling, using Self-Compassion Scale (Hong Kong Chinese Version), Depression Anxiety Stress Scale DASS-21(Chinese version), and a cardiac symptom questionnaire modified from Memorial Symptom Assessment Scale.
Results: A total of 108 cardiac patients recruited from a local public hospital were analysed. Results showed that cardiac patients with higher level of SCr were more likely to experience higher level of depressive (r = .399, p <.001), anxiety (r = .325, p <.001), and stress symptoms (r = .474, p <.001); they experienced higher level of CSE (r = .474, p <.001) and more hospital re-admissions (r = .162, p =.047). Patients with higher level of depression, anxiety and stress (DAS) visited AED more frequently. Multiple regression analysis reported that, after controlling for age and gender, DAS symptoms together with SCr showed stronger associations with CSE (F(4,103) = 13.366, p ≤ .01, Adj R2 = .316), and they were of equivalent predictive power. There were probable moderators influencing level of self-compassion.
Conclusion: Symptoms of depression, anxiety, and stress, as well as the tendency of self-criticism, are associated with the experience of cardiac symptoms. The present study's findings suggested a potential connection between psychological well-being and physical well-being among adults with cardiac issues. Psychosocial interventions targeting mitigating self-criticism may be beneficial to cardiac rehabilitation.
Authors:
Author - Joshua P.C. Ho,
Prince of Wales Hospital, Hong Kong
Co-Author - Anthony K.K. Tong, PhD.,
PhD.,
Department of Social Work and Social Administration, HKU
Co-Author - Adrian H.Y. Wan, PhD.,
PhD.,
Centre on Behavioral Health, HKU
Co-Author - Dawn W.F. Poon,
Prince of Wales Hospital, Hong Kong
F43 - The Role of Health Related Distress on Readmission and Coping after Liver Transplantation
Poster Number: F43Time: 11:00 AM - 11:50 AM
Topics: Integrated Primary Care, Mental Health
Liver transplantation (LT) is a lifesaving and life-altering intervention. In the US, approximately 10,000 patients receive LTs annually. Alcohol-related liver disease, often accompanying a co-occurring alcohol use disorder (AUD), is the primary indication for LT in the US. Management of LT requires psychological efforts to adjust to the chronic illness experience. Many patients with chronic illnesses meet criteria for adjustment disorders due to their health status and related stressors. Literature shows that LT complications are a primary reason for hospital readmissions and are an expensive readmission reason, at about $500,000 per patient. Literature demonstrates mixed results regarding the impact of mood, psychiatric, and adjustment concerns on readmission rates in solid organ transplant populations. A study in 2016 showed no association between adjustment disorders and rehospitalization for lung transplant patients. However, a study conducted in 2020 found adjustment disorders were associated with readmission rates for any medical reason. Research suggests that rehospitalization can lead to significant distress for patients and may lead to medical traumas. In fact, approximately two thirds of medical inpatients experience psychological distress. Inpatient psychology consult/liaison (CL) services play a crucial role in mitigating distress of hospitalized patients. This retrospective cohort study examined risk factors for readmission and post-operative complications in a sample of 755 LT recipients transplanted between Jan 2020 and April 2024 at a large transplant institute in the U.S. Data were collected through review of EMR. Patients who did not undergo pre-LT psychological evaluation were excluded (n=166). In the remaining sample, there was a significant association between health related DSM-5 diagnoses and readmissions within 90 days of transplant in patients with co-occurring AUD X2 (4, n=378)= 24.17, p<.001 and without AUD X2(4,n= 211)=20.91, p<.001. There was a significant association between readmissions within 90 days and inpatient psychology service consultation X2 (1, n=755)= 12.017, p<.001 regardless of pre-morbid DSM diagnoses, AUD, or other psychiatric concern. These results show the impact of health-related psychological distress as both a risk factor for readmission after LT and for continued distress during hospitalization. Results demonstrate need for psychological services in LT recipients.
Keywords: Risk factors, Organ transplantAuthors:
Presenter - Rebecca Altschuler,
Ph.D, HSP,
Tampa General Hospital Transplant Institute
Co-Author - Christine Machado Denis,
Psy.D, MSCP,
Tampa General Hospital Transplant Institute
Co-Author - Victoria Martinez,
Psy.D,
Tampa General Hospital Transplant Institute
Co-Author - Vijay Subramanian,
MD,
Tampa General Hospital Transplant Institute
Co-Author - Kiran Dhanireddy, MD,
MD,
Tampa General Hospital Transplant Institute
F44 - Optimizing Grief Interventions for Bereaved Children: A Comparative Scoping Review of Delivery Formats
Poster Number: F44Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Mental Health
Parental bereavement during childhood is associated with significant psychological challenges, including prolonged grief disorder, depression, and posttraumatic stress (Breier, 1988; Burns et al., 2020). This scoping review examines the effectiveness of grief intervention formats—individual, group, and family—for parentally bereaved children and adolescents. A systematic analysis of ten quantitative studies conducted from 2000 to 2022 revealed that intervention outcomes depend on delivery format and specific bereavement needs.
Individual interventions, particularly cognitive-behavioural therapies, effectively reduce prolonged grief symptoms, depression, PTSD, and maladaptive behaviours (Boelen et al., 2021; Hill et al., 2019). Trauma-informed approaches, such as CBT Grief-Help and Trauma and Grief Component Therapy, address grief-related distress and enhance emotional regulation, offering tailored support for diverse developmental needs (Thompson et al., 2019; Spuij et al., 2015).
Group interventions excel in fostering social and emotional support, reducing isolation, and enhancing coping strategies through peer connection (Linder et al., 2022; Siddaway et al., 2015). School-based programs and grief camps provide structured environments where children share experiences and build resilience, though variability in program structure and outcomes limits generalizability (Tillman & Prazak, 2018; McClatchey, 2020).
Family interventions, including the Family Bereavement Program, improve communication, caregiver support, and long-term adjustment (Sandler et al., 2010; de Groot et al., 2010). These approaches are especially beneficial in cases involving complex losses, such as suicide, where addressing family dynamics is critical (Kwok et al., 2005; Shapiro et al., 2014).
While these interventions demonstrate efficacy, limitations such as small sample sizes, reliance on self-reports, and inconsistent program structures persist (Currier et al., 2007; Rosner et al., 2010). Future research should focus on cultural adaptation, standardized implementation, and expanding the scope to include diverse bereavement experiences (Bergman et al., 2017). Advancing tailored, evidence-based interventions will mitigate grief-related challenges and foster resilience in bereaved children.
Keywords: Children, Parent-child transactionsIndividual interventions, particularly cognitive-behavioural therapies, effectively reduce prolonged grief symptoms, depression, PTSD, and maladaptive behaviours (Boelen et al., 2021; Hill et al., 2019). Trauma-informed approaches, such as CBT Grief-Help and Trauma and Grief Component Therapy, address grief-related distress and enhance emotional regulation, offering tailored support for diverse developmental needs (Thompson et al., 2019; Spuij et al., 2015).
Group interventions excel in fostering social and emotional support, reducing isolation, and enhancing coping strategies through peer connection (Linder et al., 2022; Siddaway et al., 2015). School-based programs and grief camps provide structured environments where children share experiences and build resilience, though variability in program structure and outcomes limits generalizability (Tillman & Prazak, 2018; McClatchey, 2020).
Family interventions, including the Family Bereavement Program, improve communication, caregiver support, and long-term adjustment (Sandler et al., 2010; de Groot et al., 2010). These approaches are especially beneficial in cases involving complex losses, such as suicide, where addressing family dynamics is critical (Kwok et al., 2005; Shapiro et al., 2014).
While these interventions demonstrate efficacy, limitations such as small sample sizes, reliance on self-reports, and inconsistent program structures persist (Currier et al., 2007; Rosner et al., 2010). Future research should focus on cultural adaptation, standardized implementation, and expanding the scope to include diverse bereavement experiences (Bergman et al., 2017). Advancing tailored, evidence-based interventions will mitigate grief-related challenges and foster resilience in bereaved children.
Authors:
Co-Author - Jamie Piercy,
PhD, R. Psych,
University of British Columbia Okanagan
F45 - Depression, Anxiety, and Sports Participation in Youth with Attention-Deficit/Hyperactivity Disorder
Poster Number: F45Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Mental Health
There is research that suggests youth who participate in organized sports report better overall mental health (Hoffmann et al., 2022). Among children with Attention-Deficit/Hyperactivity Disorder, a group that is at a heightened risk for experiencing mental health challenges (Daviss et al., 2008), participation in 3 or more sports was associated with fewer symptoms of anxiety and depression (Kiluk et al., 2009). While the existing research suggests participation in organized sports may be a protective factor against anxiety and depression in children with Attention-Deficit/Hyperactivity Disorder, the existing studies have been limited by small samples recruited from restricted geographical locations. The purpose of the current study was to evaluate if there were systematic differences in diagnoses of anxiety and depression in a nationally representative sample of youth with Attention-Deficit/Hyperactivity Disorder who did and did not participate in organized sports or sports lessons in the last 12 months. Participants were 3,764 caregivers of youth ages 6 to 17 years with a diagnosis of Attention-Deficit/Hyperactivity Disorder (68.5% boys; Mean age = 12.47 years; 72.6% White) from the 2020 National Survey of Children’s Health. Independent samples t-tests were utilized. Effect sizes were also calculated to evaluate the magnitude of the differences. Effect sizes were classified as small (.20), medium (.50), and large (.80). 1,778 youth with Attention-Deficit/Hyperactivity Disorder (47.2%) participated in organized sports or sports lessons in the last 12 months. Youth with Attention-Deficit/Hyperactivity Disorder who participated in organized sports or sports lessons in the last 12 months were significantly less likely than youth with Attention-Deficit/Hyperactivity Disorder who did not to have a diagnosis of depression by a health care provider (p = .03). The magnitude of the difference was in the large range (Cohen’s d = 5.06). There were no significant differences in the diagnosis of anxiety between youth with Attention-Deficit/Hyperactivity Disorder who participated in organized sports or sports lessons in the last 12 months and youth with Attention-Deficit/Hyperactivity Disorder who did not (p = .10). These findings highlight the importance of routine physical activity in children with Attention-Deficit/Hyperactivity Disorder and suggest participation in organized sports or sports lessons in this population may be a protective factor against depression.
Keywords: Children's health, Mental healthAuthors:
Author - Christine Limbers,
Ph.D.,
Baylor University
Co-Author - Alyssa Hartley,
B.A.,
Baylor University
Co-Author - Kaitlin Seidenberg,
B.S.,
Baylor University
Co-Author - Ian Walker,
M.S.,
Baylor University
F46 - The Mediating Role of Sleep Regularity in the Association Between Neighborhood Factors and Childhood Obesity
Poster Number: F46Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Sleep
Background: Sleep regularity (having regular daily bedtimes) is negatively associated with obesity, and our research demonstrates supportive and safe neighborhoods are positively associated with children’s sleep regularity. Little is known about whether sleep regularity mediates the well-established relationship between these neighborhood factors and obesity.
Purpose: We investigated the mediating role of sleep regularity on the association between supportive and safe neighborhoods and children’s obesity in US children aged 6-17 years.
Methods: We analyzed data from the 2021-22 National Survey of Children’s Health (n=59,038). Causal mediation (logistic regression) models were used to assess the mediating effect of sleep regularity on the association between neighborhood factors and obesity. We controlled for child’s sex, age, race/ethnicity, household poverty level, physical activity, and caregiver’s education level.
Results: In the first model (adjusting for covariates), living in unsafe neighborhoods was associated with greater likelihood of irregular bedtimes (OR= 1.82, 95% confidence interval [CI]: 1.46, 2.28). In the second model, which included living in unsafe neighborhoods and irregular bedtimes, living in unsafe neighborhoods was not significantly associated with obesity (OR=1.12 [0.89, 1.40]) while having irregular bedtime was significantly associated with obesity (OR=1.22 [1.07, 1.40]). Bootstrap CIs derived from 1,000 samples indicated that the indirect effect coefficient was significant (adjusted β coefficient = 0.02 [0.01, 0.022]). Similarly, in the first model, living in unsupportive neighborhoods was associated with greater likelihood of irregular bedtimes (OR=1.58 [1.41, 1.76]). In the second model, which included living in unsupportive neighborhoods and irregular bedtimes, both were significantly associated with obesity (OR=1.14 [1.03, 1.26] and 1.21 [1.06, 1.39], respectively). Bootstrap CIs derived from 1,000 samples indicated that the indirect effect coefficient was significant (adjusted β coefficient = 0.01 [0.007, 0.014]).
Conclusions: We find that sleep regularity was a mediator between neighborhood factors and obesity, suggesting that promoting sleep regularity may be a suitable intervention target for youth at high risk for obesity and for those living in adverse neighborhood environments. Due to the small effect sizes, however, promoting sleep regulating should be considered simultaneously with other established therapies.
Keywords: Health behaviors, ObesityPurpose: We investigated the mediating role of sleep regularity on the association between supportive and safe neighborhoods and children’s obesity in US children aged 6-17 years.
Methods: We analyzed data from the 2021-22 National Survey of Children’s Health (n=59,038). Causal mediation (logistic regression) models were used to assess the mediating effect of sleep regularity on the association between neighborhood factors and obesity. We controlled for child’s sex, age, race/ethnicity, household poverty level, physical activity, and caregiver’s education level.
Results: In the first model (adjusting for covariates), living in unsafe neighborhoods was associated with greater likelihood of irregular bedtimes (OR= 1.82, 95% confidence interval [CI]: 1.46, 2.28). In the second model, which included living in unsafe neighborhoods and irregular bedtimes, living in unsafe neighborhoods was not significantly associated with obesity (OR=1.12 [0.89, 1.40]) while having irregular bedtime was significantly associated with obesity (OR=1.22 [1.07, 1.40]). Bootstrap CIs derived from 1,000 samples indicated that the indirect effect coefficient was significant (adjusted β coefficient = 0.02 [0.01, 0.022]). Similarly, in the first model, living in unsupportive neighborhoods was associated with greater likelihood of irregular bedtimes (OR=1.58 [1.41, 1.76]). In the second model, which included living in unsupportive neighborhoods and irregular bedtimes, both were significantly associated with obesity (OR=1.14 [1.03, 1.26] and 1.21 [1.06, 1.39], respectively). Bootstrap CIs derived from 1,000 samples indicated that the indirect effect coefficient was significant (adjusted β coefficient = 0.01 [0.007, 0.014]).
Conclusions: We find that sleep regularity was a mediator between neighborhood factors and obesity, suggesting that promoting sleep regularity may be a suitable intervention target for youth at high risk for obesity and for those living in adverse neighborhood environments. Due to the small effect sizes, however, promoting sleep regulating should be considered simultaneously with other established therapies.
Authors:
Co-Author - Andrew McHill,
PhD,
Oregon Health & Science University
Co-Author - Nathan Dieckmann,
PhD,
Oregon Health & Science University
Co-Author - Carol Musil,
PhD, RN, FAAN, FGSA,
Case Western Reserve University
Co-Author - Jonathan Purnell,
MD,
Oregon Health & Science University
Co-Author - Laura Hayman,
PhD, FAAN, FAHA, FPCNA, FSBM,
University of Massachusetts Boston
F48 - Addressing Racial Inequities: A Systematic Review of Intervention Programs for African American children with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder
Poster Number: F48Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Health of Marginalized Populations
Background: African American children with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) experience significant disparities in diagnosis and treatment access. Systemic inequities, including provider bias, lack of culturally competent care, and limited healthcare access, contribute to delayed diagnoses and poorer long-term outcomes. These disparities reinforce existing health and social inequities. This systematic review examines existing interventions for African American children with ASD and ADHD and recommends equitable healthcare solutions to improve outcomes.
Methods: A systematic search of six databases, including PubMed and Scopus, identified intervention studies published between 2019 and 2024. Studies were included if they addressed healthcare disparities or implemented interventions targeting African American children with ASD or ADHD. Data was synthesized to identify recurring themes, intervention outcomes, challenges, and policy implications
Results: Seven studies met inclusion criteria, all focused on ASD. Findings highlighted the success of culturally tailored interventions in improving outcomes for African American children with ASD. Effective strategies included parent empowerment programs, reduced diagnostic wait times, and enhanced care coordination. Programs such as Spectrum of Care parent training increased advocacy skills among Black families, while Autism CARES Act-funded initiatives improved diagnostic processes nationwide. Despite these advances, no ADHD-specific interventions were identified, revealing a critical gap in addressing disparities for this population.
Conclusion: Addressing systemic inequities requires a multi-level approach emphasizing culturally responsive strategies. Key recommendations include embedding diagnostic services in primary care, expanding provider training in cultural competence, and fostering trust through community-based initiatives. While ASD interventions show promise, the absence of ADHD-focused strategies highlights an urgent need for further research and development. Without targeted interventions, disparities in ADHD diagnosis and treatment will persist, leaving African American children without the necessary support. Expanding ADHD-focused research and tailoring interventions for neurodevelopmental disorders is essential for achieving health equity for African American children.
Keywords: Children's health, Community interventionMethods: A systematic search of six databases, including PubMed and Scopus, identified intervention studies published between 2019 and 2024. Studies were included if they addressed healthcare disparities or implemented interventions targeting African American children with ASD or ADHD. Data was synthesized to identify recurring themes, intervention outcomes, challenges, and policy implications
Results: Seven studies met inclusion criteria, all focused on ASD. Findings highlighted the success of culturally tailored interventions in improving outcomes for African American children with ASD. Effective strategies included parent empowerment programs, reduced diagnostic wait times, and enhanced care coordination. Programs such as Spectrum of Care parent training increased advocacy skills among Black families, while Autism CARES Act-funded initiatives improved diagnostic processes nationwide. Despite these advances, no ADHD-specific interventions were identified, revealing a critical gap in addressing disparities for this population.
Conclusion: Addressing systemic inequities requires a multi-level approach emphasizing culturally responsive strategies. Key recommendations include embedding diagnostic services in primary care, expanding provider training in cultural competence, and fostering trust through community-based initiatives. While ASD interventions show promise, the absence of ADHD-focused strategies highlights an urgent need for further research and development. Without targeted interventions, disparities in ADHD diagnosis and treatment will persist, leaving African American children without the necessary support. Expanding ADHD-focused research and tailoring interventions for neurodevelopmental disorders is essential for achieving health equity for African American children.
Authors:
Author - Florida Uzoaru,
Ph.D,
Southeastern Louisiana University
Co-Author - Obinna Oleribe,
PhD,
California State University Dominguez Hills
Co-Author - Linda Collins,
PhD,
Southeastern Louisiana University
Co-Author - Michael Preston,
PhD,
Purdue University College of Pharmacy
Co-Author - Levi Ross, PhD, MPH, CHES,
Southeastern Louisiana University
Co-Author - Divya Chadha,
Southeastern Louisiana University
F50 - Perspectives of Black Mothers on Child Involvement in Menu Planning, Food Preparation, and Grocery Shopping
Poster Number: F50Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Diet, Nutrition, and Eating Disorders
Background: Obesity disparities in Black youth are linked to dietary behaviors that may increase their risk. Obesity prevention programs that emphasize nutrition promotion can help parents create a healthy home food environment and support child obesity prevention. This study explores Black mothers’ perspectives on child involvement in food-related tasks: menu planning, grocery shopping, and food preparation.
Methods: This secondary analysis is part of a mixed methods study (online surveys, telephone interviews) conducted with a community advisory board (CAB) of Black mothers with children aged 9-12. CAB members completed surveys about how receptive parents would be to child involvement in menu planning, grocery shopping, and food preparation, while interviews explored their reasoning for being receptive to child involvement in these food-related tasks. Interviews were digitally recorded, transcribed, and analyzed using semi-structured, hybrid thematic analysis. Two coders used codes and definitions from the codebook, met routinely to review codes, and resolved discrepancies. Emergent codes were added and defined in the codebook to address the research question comprehensively. Descriptive statistics were computed for the survey responses.
Results: The CAB (n=15) included Black/African American mothers (100%), 30-39 years old (60%), and married (53.3%). Most mothers were very receptive to child involvement in menu planning (93.3%), grocery shopping (80.0%), and food preparation (86.7%). Key reasons for high receptiveness to child involvement in food-related tasks included the importance of child involvement, reducing parent responsibility, family bonding opportunity, learning about child food preferences, child’s awareness and learning about the process, and child developing independence in food-related tasks. Reasons for low receptiveness to child involvement in food-related tasks included family’s food preferences, convenience of grocery shopping without the child, and a child’s lack of interest in food preparation.
Conclusion: Understanding Black mothers’ perspectives on child involvement in food-related tasks can provide insight on opportunities to tailor nutrition promotion strategies in child obesity prevention programs. Addressing barriers while promoting family engagement can foster healthier home food environments and reduce obesity disparities among Black children and families.
Keywords: Children's health, NutritionMethods: This secondary analysis is part of a mixed methods study (online surveys, telephone interviews) conducted with a community advisory board (CAB) of Black mothers with children aged 9-12. CAB members completed surveys about how receptive parents would be to child involvement in menu planning, grocery shopping, and food preparation, while interviews explored their reasoning for being receptive to child involvement in these food-related tasks. Interviews were digitally recorded, transcribed, and analyzed using semi-structured, hybrid thematic analysis. Two coders used codes and definitions from the codebook, met routinely to review codes, and resolved discrepancies. Emergent codes were added and defined in the codebook to address the research question comprehensively. Descriptive statistics were computed for the survey responses.
Results: The CAB (n=15) included Black/African American mothers (100%), 30-39 years old (60%), and married (53.3%). Most mothers were very receptive to child involvement in menu planning (93.3%), grocery shopping (80.0%), and food preparation (86.7%). Key reasons for high receptiveness to child involvement in food-related tasks included the importance of child involvement, reducing parent responsibility, family bonding opportunity, learning about child food preferences, child’s awareness and learning about the process, and child developing independence in food-related tasks. Reasons for low receptiveness to child involvement in food-related tasks included family’s food preferences, convenience of grocery shopping without the child, and a child’s lack of interest in food preparation.
Conclusion: Understanding Black mothers’ perspectives on child involvement in food-related tasks can provide insight on opportunities to tailor nutrition promotion strategies in child obesity prevention programs. Addressing barriers while promoting family engagement can foster healthier home food environments and reduce obesity disparities among Black children and families.
Authors:
Author - Chishinga S. Callender, BA, MS,
BA, MS,
Baylor College of Medicine-USDA/ARS Children's Nutrition Research Center
Co-Author - Matthew Ghansyam,
Baylor College of Medicine-USDA/ARS Children's Nutrition Research Center
Co-Author - Julie Miranda,
MS,
Baylor College of Medicine-USDA/ARS Children's Nutrition Research Center
Co-Author - Sophia Huang,
Baylor College of Medicine-USDA/ARS Children's Nutrition Research Center
Co-Author - Jayna Dave, PhD,
PhD,
Baylor College of Medicine - USDA/ARS Children's Nutrition Research Center
Co-Author - Maria Jibaja-Weiss,
EdD,
Baylor College of Medicine
Co-Author - Jane Richards Montealegre,
PhD,
MD Anderson Cancer Center
Co-Author - Debbe I. Thompson, PhD,
PhD,
USDA/ARS, Baylor College of Medicine
F51 - Formative Evaluation of a Lifestyle Intervention to Prevent Type 2 Diabetes in Hispanic/Latina Mothers: Evidence for a Need to Adapt
Poster Number: F51Time: 11:00 AM - 11:50 AM
Topics: Community Engagement, Diabetes
Type 2 diabetes disproportionately impacts Hispanic/Latino (H/L) communities, and efficacious lifestyle interventions to prevent type 2 diabetes have failed to engage and retain H/L participants. Integrating family members into interventions and targeting mothers specifically may improve outcomes, given the core H/L value of familism and mothers often central role in the family unit (e.g., typically doing the grocery shopping, cooking). As part of an ongoing collaboration between a local H/L-serving community organization and researchers at the University of Utah, this community-based participatory research (CBPR) project aims to culturally adapt a diabetes prevention lifestyle intervention to meet the needs of H/L mothers in Utah. As a first step, we conducted a formative evaluation of the core National Diabetes Prevention Program (DPP) curriculum in a cohort of 5 H/L mothers and their family members (N=10 total). Weekly lifestyle intervention classes were taught in Spanish by H/L-serving community health workers (CHWs). CHW-led focus groups with participants followed each class to assess barriers, facilitators, and recommendations for participating in the program. At the end of the program, CHWs completed surveys describing social determinants of health (SDOH)-based barriers to participation observed among participants as well as acceptability of the intervention. A number of methods were used to engage and retain participants, including gift cards, incentives, and offering transportation and childcare vouchers. One hundred percent of mothers (5/5) and 60% of family members (3/5) were retained through the end of the 8-week program. Thus, despite significant efforts to keep participants in the program, retention of family members was low. Barriers endorsed by CHWs included emotional, physical, social, financial, and environmental determinants. CHW ratings of the National (DPP) curriculum acceptability were moderate to low. Taken together, results highlight the urgent need to adapt the NDPP to fit H/L community needs and point to specific adaptations for a culturally-responsive program.
Keywords: Diabetes, Community interventionAuthors:
Author - Brooke E. Franklin, B.S.,
The University of Utah
Co-Author - Brynn Meulenberg,
M.S.,
The University of Utah
Co-Author - Sara Carbajal-Salisbury, B.S.,
Alliance Community Services
Co-Author - Jeannette Villalta,
University of Utah
Co-Author - Anu Asnaani, PhD,
University of Utah
Co-Author - Ana Sanchez-Birkhead,
PhD,
The University of Utah
Co-Author - Katherine J.W. Baucom,
PhD,
University of Utah
F52 - Improving ADRD Caregiver Interventions: Insights from Virtual Community Engagement Studios
Poster Number: F52Time: 11:00 AM - 11:50 AM
Topics: Community Engagement, Dissemination and Implementation
Background: Engaging community members in the co-design and refinement of interventions offers numerous benefits to behavioral researchers. Continuous community feedback enables iterative improvements that reflect real-world experiences and evolving needs. This participatory approach ensures critical factors are addressed and increases the likelihood of effective implementation and dissemination. This abstract highlights the use of community engagement studios to tailor a behavioral intervention for Alzheimer's disease and related dementias (ADRD) family caregivers. Methods: Community engagement studios were used to refine the Peer Caregiver Navigation (PCN) intervention for ADRD family caregivers. Our team collaborated with the university's Center for Community Health Partnership and Research (CCHPR) to develop agendas for two 1-hour virtual engagement studios, guided by human-centered design principles and the Consolidated Framework for Implementation Research. One studio engaged prospective PCN recipients (13 ADRD family caregivers), and the second targeted potential adopters (11 ADRD professionals). Participants were recruited through electronic flyers distributed to CCHPR’s advisory board and local Alzheimer’s caregiver support groups. Studios were conducted via Zoom, facilitated by CCHPR, and documented by 3 research team members without audio/video recording or personal identifiers. Following a brief PCN overview, participants engaged in discussions on PCN's value, components, structure, and delivery, and provided feedback on a high-fidelity participant guidebook prototype, addressing its design, layout, readability, and content. Results: Both groups affirmed the relevance and need for PCN, praising its flexibility and adaptability to caregivers' skills training and emotional support needs. The option for delivery via phone or videochat and flexible timing demonstrated high usability. Family caregivers emphasized the emotional support component and peer delivery, while the professionals favored the skills training elements and stressed the importance of proper screening and training of peers. Participants suggested adding content on grief, provider-caregiver communication, and resource navigation to the guidebook module. Conclusion: Virtual community engagement studios effectively gathered community input on intervention design. Based on participant feedback, minor adjustments will be made to enhance PCN's usability and relevance for future testing.
Keywords: Participatory research, InterventionAuthors:
Co-Author - Rachel Kendall,
Washington University in St. Louis
Co-Author - Allison Donehower,
MS, MA,
Washington University in St. Louis
Co-Author - Ryan Lindsay,
MSW, LCSW,
Washington University in St. Louis
F53 - How do people use intuition to make health decisions? A qualitative analysis
Poster Number: F53Time: 11:00 AM - 11:50 AM
Topics: Decision Making, Integrative Health and Spirituality
People often process information intuitively, which is characterized as fast, operating below conscious awareness, and driven by emotions. Little qualitative research has examined people’s lay perceptions about how they use intuition to make decisions about their health, which can provide critical insight into how relying on intuition facilitates or harms adaptive decision-making. As part of an online survey, U.S. adults (N=315; Mage=44.83; 48.3% Male; 74.6% White; 53.1% Bachelor’s degree or greater) were asked to what extent they rely on their “intuition” (M=2.71 out of 5, SD=1.14) and “gut-feeling” (M=2.64, SD=1.16) when making decisions about their health and to explain their response. Following best practices, open-ended responses were coded and analyzed by two coders using reflexive thematic analysis following a data-driven, inductive approach (Braun & Clarke, 2006). Three themes were generated that encompassed people’s understanding and use of intuition within a health decision-making context. First, intuition was described as intangible, such that intuition inherently involves a feeling or emotion, lacks certainty and concreteness, and differs from knowledge gained through sources such as medical tests. The second theme was experiential knowledge, in which people noted that intuition is influenced by their own expertise on their body and is often formed from prior experience, such as past illness. Third, intuition often functions as one tool in the toolbox such that it serves as a cue to seek medical care and is used in conjunction with other information, such as that obtained through online research. Taken together, despite intuition being “just a feeling,” many participants indicated that intuition provided valuable context, was developed through lived experiences, and was compatible with other sources of information, such as their medical provider. Participants described using intuition across the medical care seeking continuum, from noticing a symptom to determining satisfaction with one’s care, suggesting that people valued the role of intuition in making informed health decisions. These data – collected from a relatively large sample – provide rich context for understanding how people perceive the role of intuition in their health decision making. Results have implications for how researchers and health practitioners can better understand the potentially adaptive and widespread ways that people use intuition when making health decisions.
Keywords: Health beliefs, Illness behaviorAuthors:
Presenter - Abigail O'Brien,
Kent State University
Co-Presenter - Jennifer M. Taber, PhD,
PhD,
Kent State University
F54 - Young Adult`s Readiness for Advanced Care Planning: The Role of Perceived Relevance
Poster Number: F54Time: 11:00 AM - 11:50 AM
Topics: Decision Making, Multiple Health Behavior Change
Background
The benefits of advanced care planning (ACP) include improvements in end of life healthcare and reduction of stress, anxiety, and depression among family members. Despite this, most Americans, specifically young adults (18-30), have not engaged in ACP. Young adults are a particularly vulnerable population that would benefit from ACP due to recent trends (e.g., increased rates of accidental deaths, lower and/or delayed rates of marriage). Despite multiple variables having been shown to impact young adults’ readiness to complete ACP (e.g., knowledge, previous experience with death, SES), completion rates remain low. The present study examined variables that have not been previously researched in relation to readiness to complete ACP, including death anxiety, cognitive avoidance, and perceived relevancy.
Methods
Participants were recruited through an online research recruiting platform, Prolific.co. They completed the follow self-report measures: the advanced care planning engagement survey (ACPES-4), the Templer Death Anxiety Scale (TDAS), and the Cognitive Avoidance Questionnaire (CAQ), a survey about their experiences with death (e.g., having a life-threatening illness, having previous experience with ACP during a loved one`s death), and an item assessing how relevant they believe ACP is for them.
Results
Participants include 178 young adults (mean age=25.2, SD=3.26; 62.4% female; 63.5% white). Death anxiety and cognitive avoidance were not associated with readiness to complete ACP. Only an older age (r = .195, p = .009) and greater perceived relevancy (r = .422 , p < .001) were associated with a higher level of ACP completion. Variables associated with higher perceived relevancy included older age (r =.253, p < .001), being married (t(176) = 2.98 , p = .004), and having children (t (176)= -2.68, p = .008).
Discussion
Unlike previous studies completed, only age was found to be a relevant demographic factor for readiness to complete ACP, therefore older young adults were found to have more readiness for ACP. This study expands on previous research to suggest that perceived relevancy may play a significant a role in readiness for ACP for young adults. Findings from this study inform future interventions for clinicians to specifically target the relevancy of ACP for young adults during psychoeducation in order to increase the prevalence of ACP completion in young adults.
Keywords: Decision making, Health behavior changeThe benefits of advanced care planning (ACP) include improvements in end of life healthcare and reduction of stress, anxiety, and depression among family members. Despite this, most Americans, specifically young adults (18-30), have not engaged in ACP. Young adults are a particularly vulnerable population that would benefit from ACP due to recent trends (e.g., increased rates of accidental deaths, lower and/or delayed rates of marriage). Despite multiple variables having been shown to impact young adults’ readiness to complete ACP (e.g., knowledge, previous experience with death, SES), completion rates remain low. The present study examined variables that have not been previously researched in relation to readiness to complete ACP, including death anxiety, cognitive avoidance, and perceived relevancy.
Methods
Participants were recruited through an online research recruiting platform, Prolific.co. They completed the follow self-report measures: the advanced care planning engagement survey (ACPES-4), the Templer Death Anxiety Scale (TDAS), and the Cognitive Avoidance Questionnaire (CAQ), a survey about their experiences with death (e.g., having a life-threatening illness, having previous experience with ACP during a loved one`s death), and an item assessing how relevant they believe ACP is for them.
Results
Participants include 178 young adults (mean age=25.2, SD=3.26; 62.4% female; 63.5% white). Death anxiety and cognitive avoidance were not associated with readiness to complete ACP. Only an older age (r = .195, p = .009) and greater perceived relevancy (r = .422 , p < .001) were associated with a higher level of ACP completion. Variables associated with higher perceived relevancy included older age (r =.253, p < .001), being married (t(176) = 2.98 , p = .004), and having children (t (176)= -2.68, p = .008).
Discussion
Unlike previous studies completed, only age was found to be a relevant demographic factor for readiness to complete ACP, therefore older young adults were found to have more readiness for ACP. This study expands on previous research to suggest that perceived relevancy may play a significant a role in readiness for ACP for young adults. Findings from this study inform future interventions for clinicians to specifically target the relevancy of ACP for young adults during psychoeducation in order to increase the prevalence of ACP completion in young adults.
Authors:
Presenter - Caroline Wojtas,
M.A.,
La Salle Univeristy
Co-Author - Nataliya Zelikovsky, PhD,
PhD,
La Salle University
Co-Author - Caitlin A. LaGrotte, PsyD, MEd,
PsyD, MEd,
Cooper University Hospital
Co-Author - Shannon Virtue, PsyD,
PsyD,
Christiana Care Health System
F55 - Engaging Teens to Optimize an EMA and Ambulatory Cognitive Testing Protocol of Executive Functioning, Stress, and Physical Activity in Youth at Risk of T2D
Poster Number: F55Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Physical Activity
Background: Type 2 diabetes (T2D) has increased significantly among youth over the past decade, becoming a leading cause of morbidity and mortality. Prevention, therefore, is a high priority. Yet, standard lifestyle interventions show insufficient effectiveness, in part because they overlook the role of cross-cutting principles relevant to behavior change, including executive functioning (EF) and stress. Further, traditional, laboratory-based measures of these constructs do not capture their momentary dynamics nor real-world influence on behavior. This study aimed to develop and refine a novel protocol for collecting real-world data on EF, stress, and physical activity in adolescents at-risk for T2D.
Methods: An iterative design process was used to refine an ecological momentary assessment + ambulatory cognitive testing (EMA + ACT) protocol with feedback from adolescents (n=5) and research coordinators (n=4) charged with adolescent EMA protocol orientation. EMA measures were administered via smartphones using NeuroUX, an evidence-based, gamified digital platform. Semi-random assessments of EF, stress, and physical activity were completed 3 times/day over 1 week. EMA adherence was tracked, and follow-up interviews provided qualitative feedback on engagement, burden, usability, acceptability, and protocol implementation.
Results: Initial iterations of the protocol helped refine the technical aspects and content relevance of EMA prompts. Feedback from adolescents focused on modifications to reduce burden, improve clarity, and increase motivation for protocol adherence. Modifications were made to optimize engagement, including adjusting prompt frequency and survey response windows, modifying timing of reminders, and improving access to technical support. Findings revealed that real-time assessment of EF, stress, and physical activity was feasible (≥80% EMA adherence) and highly acceptable (M=4.42/5).
Conclusions: This study contributes to the development and refinement of a rigorous, user-friendly EMA + ACT protocol. Engaging end-users in the refinement process led to new insights about aspects of the protocol that supported modifications to improve engagement, reduce burden, and optimize adherence, ultimately enhancing the quality of the data that will be collected with the finalized protocol in a new study evaluating intra-individual associations and temporal dynamics among EF, stress, and physical activity in youth at-risk for T2D.
Keywords: Adolescents, TechnologyMethods: An iterative design process was used to refine an ecological momentary assessment + ambulatory cognitive testing (EMA + ACT) protocol with feedback from adolescents (n=5) and research coordinators (n=4) charged with adolescent EMA protocol orientation. EMA measures were administered via smartphones using NeuroUX, an evidence-based, gamified digital platform. Semi-random assessments of EF, stress, and physical activity were completed 3 times/day over 1 week. EMA adherence was tracked, and follow-up interviews provided qualitative feedback on engagement, burden, usability, acceptability, and protocol implementation.
Results: Initial iterations of the protocol helped refine the technical aspects and content relevance of EMA prompts. Feedback from adolescents focused on modifications to reduce burden, improve clarity, and increase motivation for protocol adherence. Modifications were made to optimize engagement, including adjusting prompt frequency and survey response windows, modifying timing of reminders, and improving access to technical support. Findings revealed that real-time assessment of EF, stress, and physical activity was feasible (≥80% EMA adherence) and highly acceptable (M=4.42/5).
Conclusions: This study contributes to the development and refinement of a rigorous, user-friendly EMA + ACT protocol. Engaging end-users in the refinement process led to new insights about aspects of the protocol that supported modifications to improve engagement, reduce burden, and optimize adherence, ultimately enhancing the quality of the data that will be collected with the finalized protocol in a new study evaluating intra-individual associations and temporal dynamics among EF, stress, and physical activity in youth at-risk for T2D.
Authors:
Co-Author - Abby Neiser,
University of Pittsburg
Co-Author - Jason Lavender,
Uniformed Services University of the Health Sciences
Co-Author - Andrea Goldschmidt, Ph.D.,
Ph.D.,
University of Pittsburg
Co-Author - Lauren Shomaker,
Colorado State University
F56 - Exploring the Use of Exercise Mode in Automatic Insulin Delivery (AID) Systems and Its Impact on Glycemic Control and Management Satisfaction among Type 1 Diabetes Patients in the U.S.
Poster Number: F56Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Physical Activity
Introduction: Managing diabetes during physical activity (PA) presents unique challenges that can significantly impact glycemic control and diabetes management. Some Automated Insulin Delivery (AID) systems have introduced additional settings that reduce insulin delivery rates and/or increase blood glucose targets to help minimize the risks of hypoglycemia and hyperglycemia associated with physical activity. This study examined how exercise modes affect diabetes management outcomes among AID users, compared to those using non-AID pumps. Methods: Between February-June 2024, 1,668 adults with Type 1 diabetes in the United States completed online surveys in which they reported their A1c levels, PA frequency, challenges related to glycemic control during and after PA, and diabetes management satisfaction. Participants included AID exercise mode users (n=776), AID non-exercise mode users (n=730), and non-AID pump users (n=162). Results were analyzed at the 95% confidence level. Results: Significantly more AID exercise mode users met the recommended 150 minutes of moderate-to-vigorous PA per week (30%) compared to those who did not use the exercise mode (17%) and non-AID pump users (19%). However, AID exercise mode users faced greater challenges with glycemic control, reporting significantly higher rates of hypoglycemia during (51%) and after (41%) physical activity, as well as more frequent hyperglycemia after exercise (15%) compared to the other groups. Diabetes management satisfaction was significantly lower for both AID exercise mode users (34%) and non-exercise mode users (34%) compared to non-AID users (54%), suggesting that exercise modes do not provide a viable solution to the general challenges AID users face with exercise. Further, more non-AID pump users had an A1c ≤7% (75%) compared to AID non-exercise mode users (74%) and AID exercise mode users (68%); however, these differences were non-significant. Conclusion: Glycemic control and satisfaction with diabetes management are weaker among AID users compared to non-AID pump users, suggesting that while AID systems, particularly with activity mode, may offer benefits in PA engagement, they introduce complexities in glycemic management that may impact user satisfaction and health outcomes. Further research is needed to optimize exercise mode features, alongside patient education on the impact of exercise on blood glucose, to reduce these challenges and improve overall diabetes management satisfaction.
Keywords: Diabetes, Physical activityAuthors:
Author - Natasha Tat,
University of Victoria
Co-Author - Sydney Chanen,
dQ&A - The Diabetes Research Company
Co-Author - Alan Beltran,
dQ&A - The Diabetes Research Company
Co-Author - Trevor Bell,
PhD,
dQ&A - The Diabetes Research Company
Co-Author - Richard Wood,
dQ&A - The Diabetes Research Company
F57 - Development and Validation of a Resilience Measure for Adults with Diabetes
Poster Number: F57Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Methods and Measurement
Introduction: Diabetes is a complex chronic disease that involves time consuming and intensive self-management, which has been shown to be associated with psychological distress. High levels of diabetes-related distress have been linked to poor glycemic outcomes. A growing body of research has demonstrated that resilience is a dispositional characteristic associated with improved psychological and glycemic outcomes among adults with diabetes. However, to date, there is no appropriate measure of diabetes-related distress for English-speaking adults with diabetes. The purpose of the present study is to develop, test, and validate a theoretically informed instrument to measure diabetes-related resilience: the Resilience Among Adults with Diabetes Scale (RADS).
Methods: A pool of 55 items was developed to reflect domains of diabetes distress and diabetes self-care behaviors. 10 experts in diabetes self-management and seven experts in resilience were recruited via the Diabetes Special Interest Group (SIG) of the Society of Behavioral Medicine (SBM) and through literature search to rate all potential items on how well they reflect diabetes distress and diabetes self-care behaviors. 255 adults with type 2 diabetes were recruited via CloudResearch to validate the measure.
Results: An exploratory factor analysis yielded a final scale of 15 items comprised of two factors: adaptability (α = .92) and determination (α = .87) with excellent internal consistency (α = .94) as well as good convergent validity (r = .39 to .42) with trait resilience. The adaptability and determination subscales demonstrated discriminant validity with measures of self-deceptive enhancement (r = .34 - .38, p < .001) but not impression management (r = 0.13, p = .061; r = 0.13, p = .047). Subscales demonstrated small to moderate correlations with diabetes self-management behaviors (r = .22 to .40). Additionally, diabetes self-efficacy was positively correlated with adaptability (r = 0.45, p < .001) and determination (r = 0.56, p < .001).
Discussion: The two-factor structure of the RADS is consistent with emerging conceptualizations of resilience that emphasize active resistance and plasticity to stressors. The RADS demonstrated largely favorable validity, with strongest associations between the RADS and trait resilience and diabetes self-efficacy. Future research is needed to determine the utility of the RADS for predicting glycemic outcomes.
Keywords: Diabetes, ResilienceMethods: A pool of 55 items was developed to reflect domains of diabetes distress and diabetes self-care behaviors. 10 experts in diabetes self-management and seven experts in resilience were recruited via the Diabetes Special Interest Group (SIG) of the Society of Behavioral Medicine (SBM) and through literature search to rate all potential items on how well they reflect diabetes distress and diabetes self-care behaviors. 255 adults with type 2 diabetes were recruited via CloudResearch to validate the measure.
Results: An exploratory factor analysis yielded a final scale of 15 items comprised of two factors: adaptability (α = .92) and determination (α = .87) with excellent internal consistency (α = .94) as well as good convergent validity (r = .39 to .42) with trait resilience. The adaptability and determination subscales demonstrated discriminant validity with measures of self-deceptive enhancement (r = .34 - .38, p < .001) but not impression management (r = 0.13, p = .061; r = 0.13, p = .047). Subscales demonstrated small to moderate correlations with diabetes self-management behaviors (r = .22 to .40). Additionally, diabetes self-efficacy was positively correlated with adaptability (r = 0.45, p < .001) and determination (r = 0.56, p < .001).
Discussion: The two-factor structure of the RADS is consistent with emerging conceptualizations of resilience that emphasize active resistance and plasticity to stressors. The RADS demonstrated largely favorable validity, with strongest associations between the RADS and trait resilience and diabetes self-efficacy. Future research is needed to determine the utility of the RADS for predicting glycemic outcomes.
Authors:
Co-Author - Aaron A. Lee, PhD,
PhD,
University of Mississippi
F58 - Does a Culturally and Linguistically Tailored Intervention Improve Diabetes-Related Outcomes in Low-Income Chinese Immigrants with Type 2 Diabetes? Preliminary Evidence from a Pilot Randomized Controlled Trial
Poster Number: F58Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Health of Marginalized Populations
Objectives: To explore the potential impact of a culturally and linguistically tailored intervention on self-efficacy and diabetes self-care activities among low-income Chinese immigrants with Type 2 Diabetes (T2D).
Methods: The current study is a secondary analysis of a 2-arm pilot Randomized Controlled Trial in 60 Chinese immigrants with T2D. Participants were randomly assigned to either the intervention group (n=30) or a wait-list control group (n=30). The intervention group received two culturally and linguistically tailored videos per week for 12 weeks via social media. These videos addressed various aspects of diabetes self-care, including diabetes basics healthy eating, physical activity, medication adherence, glucose monitoring, and behavioral techniques (e.g., goal setting and problem solving). In addition, participants in the intervention group received bi-weekly support calls from community health workers, who helped them set goals, work on problem-solving, and address social determinants of health barriers. Self-efficacy and diabetes self-care activities (general diet, specific diet, exercise, blood glucose testing, foot care, medication) were assessed at baseline, 3 months, and 6 months.
Results: Participants had a mean age of 54±12 years, with a majority being male (60%) and currently employed (58%). 70% had a high school education or less, 50% had an annual household income below $25,000, and 88% had limited English proficiency. After adjusting for age, gender, and employment status, compared to the control group, participants in the intervention group reported greater dietary adherence (P=0.006). They also reported a larger increase in self-efficacy than the control group with borderline statistical significance (P=0.056). There were no between-group differences in other outcomes at 6 months: frequency of fruits, vegetables and high-fat foods intake (P=0.452), blood glucose testing (P=0.332), foot care (P=0.887), and medication adherence (P=0.276).
Conclusions: The culturally and linguistically tailored intervention demonstrated the potential to enhance self-efficacy and diabetes self-care among low-income Chinese immigrants. A large scale adequately powered study is warranted to examine the efficacy of the intervention.
Keywords: Diabetes, Behavior ChangeMethods: The current study is a secondary analysis of a 2-arm pilot Randomized Controlled Trial in 60 Chinese immigrants with T2D. Participants were randomly assigned to either the intervention group (n=30) or a wait-list control group (n=30). The intervention group received two culturally and linguistically tailored videos per week for 12 weeks via social media. These videos addressed various aspects of diabetes self-care, including diabetes basics healthy eating, physical activity, medication adherence, glucose monitoring, and behavioral techniques (e.g., goal setting and problem solving). In addition, participants in the intervention group received bi-weekly support calls from community health workers, who helped them set goals, work on problem-solving, and address social determinants of health barriers. Self-efficacy and diabetes self-care activities (general diet, specific diet, exercise, blood glucose testing, foot care, medication) were assessed at baseline, 3 months, and 6 months.
Results: Participants had a mean age of 54±12 years, with a majority being male (60%) and currently employed (58%). 70% had a high school education or less, 50% had an annual household income below $25,000, and 88% had limited English proficiency. After adjusting for age, gender, and employment status, compared to the control group, participants in the intervention group reported greater dietary adherence (P=0.006). They also reported a larger increase in self-efficacy than the control group with borderline statistical significance (P=0.056). There were no between-group differences in other outcomes at 6 months: frequency of fruits, vegetables and high-fat foods intake (P=0.452), blood glucose testing (P=0.332), foot care (P=0.887), and medication adherence (P=0.276).
Conclusions: The culturally and linguistically tailored intervention demonstrated the potential to enhance self-efficacy and diabetes self-care among low-income Chinese immigrants. A large scale adequately powered study is warranted to examine the efficacy of the intervention.
Authors:
Author - Jiepin Cao,
PhD,
NYU Grossman School of Medicine
Co-Author - Yun Shi,
PhD,
NYU Grossman School of Medicine
Co-Author - Mary A. Sevick,
ScD, MS,
New York University School of Medicine
Co-Author - Huilin Li,
PhD,
NYU Grossman School of Medicine
Co-Author - Naumi Feldman,
DrPH,
Charles B. Wang Community Health Center, Inc.
Co-Author - Ziqiang Zhu,
MD,
Wellsure Medical Practice, New York, NY, USA
Co-Author - Audrey Chen,
NYU Grossman School of Medicine
Presenter - Lu Hu,
PhD,
New York University Grossman School of Medicine
F59 - The influence of depression, positive health behaviors, and adiposity on diabetes and health: A mediation analysis of the INDEPENDENT trial.
Poster Number: F59Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Integrated Primary Care
Background: Collaborative care models (CoCM) effectively treat depression and diabetes by supporting lifestyle change and increasing care coordination. However, existing studies examining treatment effects for CoCMs rarely examine change mechanisms. Consequently, there is limited understanding regarding the behavioral pathways that CoCMs address. In addition, trials typically examine depression as an overarching concept neglecting to analyze specific symptom profiles of depression.
Objective: Our study uses a structural equation model (SEM) to assess change mechanisms that explain how a CoCM implemented in India impacted diabetes health outcomes. We created second-order constructs of depression (anhedonia, somatic symptoms, internalizing symptoms, and restlessness) to increase the precision when analyzing intervention effects.
Research Design and Methods: This is a secondary analysis from the INtegrating DEPrEssioN and Diabetes TreatmENT Trial. Confirmatory factor analyses (CFA) examined latent variables (depression, positive health behaviors, and adiposity) cross-sectionally and longitudinally. Then, an SEM path model was used to analyze concurrent and cross-lagged regression paths.
Results: The cross-sectional and longitudinal CFA had an acceptable model fit. Depression, positive health behaviors, and adiposity mediated reductions in hemoglobin A1C; the mediating effect was demonstrated by a weakening intervention effect when mediators were included (β =-0.13, p<.05) compared to when they were excluded (β =-0.27, p<.01). Specifically, depressive symptoms were associated with reduced positive health behaviors at 6 months (β =-0.23, p<.01) and at 12 months (β =-0.22, p<.01). Positive health behaviors at 6 months were associated with reduced adiposity at 12 months (β = -0.10, p<.05). Anhedonia symptoms of depression were most responsive to the CoCM intervention whereas somatic and restless symptoms were more resistant to significant treatment effects.
Conclusions: Reductions in HbA1c may be the result of lowering depressive symptoms and increased positive health behaviors. These data reinforce the importance of addressing underlying depressive symptoms to mobilize positive health behaviors and improve diabetes health outcomes. CoCMs often utilize behavioral activation for behavioral treatments and may need to include additional modalities (e.g. acceptance and commitment therapy) to address somatic and cognitive domains of depressive symptoms.
Keywords: Diabetes, DepressionObjective: Our study uses a structural equation model (SEM) to assess change mechanisms that explain how a CoCM implemented in India impacted diabetes health outcomes. We created second-order constructs of depression (anhedonia, somatic symptoms, internalizing symptoms, and restlessness) to increase the precision when analyzing intervention effects.
Research Design and Methods: This is a secondary analysis from the INtegrating DEPrEssioN and Diabetes TreatmENT Trial. Confirmatory factor analyses (CFA) examined latent variables (depression, positive health behaviors, and adiposity) cross-sectionally and longitudinally. Then, an SEM path model was used to analyze concurrent and cross-lagged regression paths.
Results: The cross-sectional and longitudinal CFA had an acceptable model fit. Depression, positive health behaviors, and adiposity mediated reductions in hemoglobin A1C; the mediating effect was demonstrated by a weakening intervention effect when mediators were included (β =-0.13, p<.05) compared to when they were excluded (β =-0.27, p<.01). Specifically, depressive symptoms were associated with reduced positive health behaviors at 6 months (β =-0.23, p<.01) and at 12 months (β =-0.22, p<.01). Positive health behaviors at 6 months were associated with reduced adiposity at 12 months (β = -0.10, p<.05). Anhedonia symptoms of depression were most responsive to the CoCM intervention whereas somatic and restless symptoms were more resistant to significant treatment effects.
Conclusions: Reductions in HbA1c may be the result of lowering depressive symptoms and increased positive health behaviors. These data reinforce the importance of addressing underlying depressive symptoms to mobilize positive health behaviors and improve diabetes health outcomes. CoCMs often utilize behavioral activation for behavioral treatments and may need to include additional modalities (e.g. acceptance and commitment therapy) to address somatic and cognitive domains of depressive symptoms.
Authors:
Presenter - Zach Cooper, LCSW,
LCSW,
University of Georgia
Co-Author - Mohammed K Ali,
MD, MBA,
Emory University
Co-Author - Viswanathan Mohan,
MD, PhD, DSc,
Madras Diabetes Research Foundation, Dr. Mohan's Diabetes Specialties Centre
Co-Author - Lydia Chwastiak,
MD,
University of Washington
Co-Author - Leslie Johnson, PhD,
PhD,
Emory University
F60 - Experiences of Mental Illness among Adults with Type 1 Diabetes: Implications for Behavioral Interventions
Poster Number: F60Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Mental Health
Background
Individuals with type 1 diabetes (T1D) have increased rates of depression and anxiety when compared to the general population and those with type 2 diabetes. However, there is limited research investigating how adults with T1D experience mental illness and treatment seeking for mental health problems. This study aimed to examine the lived experiences of adults with T1D to determine common features of mental illness, while describing how those experiences impact mental health treatment-seeking behavior.
Methods
We utilized Giorgi and Giorgi’s six-step approach to perform a descriptive phenomenological analysis of focus group discussions (n=5) with adults with T1D: 1) collect and transcribe phenomenological data, 2) examine data to acquire a sense of the whole perspective, 3) break down the descriptions into units of meaning, 4) distill units of meaning into unified syntheses, 5) determine the structure of the phenomenon, and 6) integrate features into the essential structure of the phenomenon. This process resulted in a description of the phenomenon's meaning units that provide foundational knowledge of how living with T1D shapes experiences of mental health.
Results
Two core elements describing the experience of mental illness among adults with T1D were identified. The first element was having several co-occurring symptoms of mental illness, which was comprised of sub-units including depressive and anxiety experiences, obsessive thoughts and behaviors, sleep problems, and trauma responses. The second element was the social and environmental context in which T1D is experienced, which was comprised of several meaning units that were clustered into three primary themes (Judgement, Stress, and Burden of Living with T1D). These core elements existed at the individual, interpersonal, institutional, and societal levels. Participants indicated social (e.g. fear of clinicians not knowing how to care for them) and environmental stressors (e.g., stigma, expenses) as primary barriers to seeking mental health support.
Conclusion
Individuals with T1D have shared mental health experiences that impact their engagement with mental healthcare. Therefore, behavioral interventions should focus on integrating clinical psychological support within diabetes care settings and providing behavioral interventions in community settings. Efforts to address external stressors specific to adults with T1D may offset negative downstream impacts on their mental health.
Keywords: Diabetes, Mental healthIndividuals with type 1 diabetes (T1D) have increased rates of depression and anxiety when compared to the general population and those with type 2 diabetes. However, there is limited research investigating how adults with T1D experience mental illness and treatment seeking for mental health problems. This study aimed to examine the lived experiences of adults with T1D to determine common features of mental illness, while describing how those experiences impact mental health treatment-seeking behavior.
Methods
We utilized Giorgi and Giorgi’s six-step approach to perform a descriptive phenomenological analysis of focus group discussions (n=5) with adults with T1D: 1) collect and transcribe phenomenological data, 2) examine data to acquire a sense of the whole perspective, 3) break down the descriptions into units of meaning, 4) distill units of meaning into unified syntheses, 5) determine the structure of the phenomenon, and 6) integrate features into the essential structure of the phenomenon. This process resulted in a description of the phenomenon's meaning units that provide foundational knowledge of how living with T1D shapes experiences of mental health.
Results
Two core elements describing the experience of mental illness among adults with T1D were identified. The first element was having several co-occurring symptoms of mental illness, which was comprised of sub-units including depressive and anxiety experiences, obsessive thoughts and behaviors, sleep problems, and trauma responses. The second element was the social and environmental context in which T1D is experienced, which was comprised of several meaning units that were clustered into three primary themes (Judgement, Stress, and Burden of Living with T1D). These core elements existed at the individual, interpersonal, institutional, and societal levels. Participants indicated social (e.g. fear of clinicians not knowing how to care for them) and environmental stressors (e.g., stigma, expenses) as primary barriers to seeking mental health support.
Conclusion
Individuals with T1D have shared mental health experiences that impact their engagement with mental healthcare. Therefore, behavioral interventions should focus on integrating clinical psychological support within diabetes care settings and providing behavioral interventions in community settings. Efforts to address external stressors specific to adults with T1D may offset negative downstream impacts on their mental health.
Authors:
Presenter - Zach Cooper, LCSW,
LCSW,
University of Georgia
Co-Author - Leslie Johnson, PhD,
PhD,
Emory University
F61 - Perspectives on Blood Sugar Monitoring and Continuous Glucose Monitoring for Individuals with Type 2 Diabetes and Prediabetes
Poster Number: F61Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Digital Health
Introduction: Continuous glucose monitoring (CGM) has improved lifestyle behaviors over brief intervention periods (Ehrhardt, 2018). Currently, the standard recommendation for Type 2 diabetes (T2D) without insulin and prediabetes are lifestyle interventions, but not blood sugar monitoring (ADA 2024). To date, little is known about describing the perspectives of CGM use from individuals with T2D and prediabetes regarding blood sugar monitoring, specifically continuous glucose blood monitoring. Gaining an understanding of individuals’ perspectives around CGM use may support development and use of technology to facilitate lifestyle behaviors change to manage T2D and prediabetes.
Methods: 134 individuals with T2D who have used a CGM (n= 59) or prediabetes (n = 75) were recruited from a Midwest medical center. Participants completed online surveys about their blood sugar monitoring practices, technology utilization, desirability of technology, and barriers to technology use. Open-ended questions were coded for themes describing potential uses and barriers of CGM use.
Results: The sample was 53 years old (mean), 62% female, and 90% white. The T2D group was diagnosed with T2D for an average of 14.25 years and those with prediabetes 4.76 years. In the prediabetes group, 78% had never used a CGM. Individuals with T2D reported more importance and expressed a stronger desire to test blood glucose (BG) than individuals with prediabetes ((t(132) = 7.50, p < .001), t(99) = 2.96, p = .002 respectively). The most common barriers for the T2D sample were the costs of test strips//CGM (25%), frustration from high blood sugar readings (17%), and inconvenience (13%). The most common barriers reported in the prediabetes sample was believing their condition was under control (34%), not knowing about blood sugar testing (19%), and inconvenience (12%). Individuals with T2D and prediabetes alike reported interest in using CGMs to alter lifestyle behaviors and better understand how daily activities impact BG.
Conclusion: Although CGM use for individuals with T2D and prediabetes are not currently a standard of care, findings from this study suggest there may be opportunities to increase awareness of how BG monitoring may aid efforts to change lifestyle behaviors and better understand individualized BG patterns. Further research is needed to examine how BG monitoring practices may be applied for disease and complication prevention.
Keywords: Diabetes, TechnologiesMethods: 134 individuals with T2D who have used a CGM (n= 59) or prediabetes (n = 75) were recruited from a Midwest medical center. Participants completed online surveys about their blood sugar monitoring practices, technology utilization, desirability of technology, and barriers to technology use. Open-ended questions were coded for themes describing potential uses and barriers of CGM use.
Results: The sample was 53 years old (mean), 62% female, and 90% white. The T2D group was diagnosed with T2D for an average of 14.25 years and those with prediabetes 4.76 years. In the prediabetes group, 78% had never used a CGM. Individuals with T2D reported more importance and expressed a stronger desire to test blood glucose (BG) than individuals with prediabetes ((t(132) = 7.50, p < .001), t(99) = 2.96, p = .002 respectively). The most common barriers for the T2D sample were the costs of test strips//CGM (25%), frustration from high blood sugar readings (17%), and inconvenience (13%). The most common barriers reported in the prediabetes sample was believing their condition was under control (34%), not knowing about blood sugar testing (19%), and inconvenience (12%). Individuals with T2D and prediabetes alike reported interest in using CGMs to alter lifestyle behaviors and better understand how daily activities impact BG.
Conclusion: Although CGM use for individuals with T2D and prediabetes are not currently a standard of care, findings from this study suggest there may be opportunities to increase awareness of how BG monitoring may aid efforts to change lifestyle behaviors and better understand individualized BG patterns. Further research is needed to examine how BG monitoring practices may be applied for disease and complication prevention.
Authors:
Presenter - Dana Albright,
PhD,
Parkview Health
Co-Author - Kira Voelker,
BS, BA,
Parkview Health
Co-Author - Emily Mirro,
MBA, MS,
SynchNeuro, Inc.
Co-Author - Shauna Wagner,
NP ,
Parkview Health
Co-Author - Michelle Drouin,
PhD ,
Parkview Health
F62 - #T1D: Exploration and Characterization of Community Engagement and Support
Poster Number: F62Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Social and Environmental Context and Health
Introduction: Given the rarity of the disease, persons with Type 1 Diabetes (T1D) often lack connections with existing support networks (Wiebe, 2018). For people who are isolated, social media platforms are a conduit to organize, find support, and feel accepted (Liu, 2020). Little is known about characteristics of social media use for individuals with T1D, including the intricacies of the posts and how users participate in various groups (Gabarron, 2020). This project categorizes the living ecosystem of #T1D communities across three popular social media platforms.
Methods: One month of data from Instagram, Reddit, and Twitter were collected using #T1D and #typeonediabetes as inclusion criteria. Posts were coded using reflexive thematic analysis (Braun & Clarke, 2019) by three researchers for type of content, purpose, community building, personal reflection, and emotional valence using ratings derived from the PANAS (Watson, 1988). Each PANAS emotion was rated on a Likert scale from 1-5. Each post could represent multiple codes.
Results: The most common types of post on all platforms were personal reflection (47.94%), community building (28.68%), and advocacy (12.87%) while the least common type was paid or promotional promotion (11.98%). The top 3 purposes for posting across all platforms were sharing T1D experiences (44.40%), sharing resources (25.54%), and seeking information (13.56%), while the least common was provocative/clickbait (1.18%). Results show variation across platforms. Analysis of posts including personal reflection showed 22.69% were directly related to T1D. Community building content primarily encouraged online engagement (18.37%), and came from individual accounts (14.64%). The overall emotional tone of the #T1D community was positive with an average rating of 2.13 positive, and 1.63 negative posts and a range of emotions (happy 44.7%, sad 11.49%, angry 7.71%).
Conclusion: The #T1D community is a positive and supportive online space to share experiences, connect with others with similar lived experiences, and share information. Each platform contains unique characteristics shaped by the community itself, thus providing different types of social support to individuals with T1D. The results of this study suggest that #T1D online communities may be promoted and encouraged as a mechanism for support, with appropriate levels of trepidation.
Keywords: Diabetes, TechnologiesMethods: One month of data from Instagram, Reddit, and Twitter were collected using #T1D and #typeonediabetes as inclusion criteria. Posts were coded using reflexive thematic analysis (Braun & Clarke, 2019) by three researchers for type of content, purpose, community building, personal reflection, and emotional valence using ratings derived from the PANAS (Watson, 1988). Each PANAS emotion was rated on a Likert scale from 1-5. Each post could represent multiple codes.
Results: The most common types of post on all platforms were personal reflection (47.94%), community building (28.68%), and advocacy (12.87%) while the least common type was paid or promotional promotion (11.98%). The top 3 purposes for posting across all platforms were sharing T1D experiences (44.40%), sharing resources (25.54%), and seeking information (13.56%), while the least common was provocative/clickbait (1.18%). Results show variation across platforms. Analysis of posts including personal reflection showed 22.69% were directly related to T1D. Community building content primarily encouraged online engagement (18.37%), and came from individual accounts (14.64%). The overall emotional tone of the #T1D community was positive with an average rating of 2.13 positive, and 1.63 negative posts and a range of emotions (happy 44.7%, sad 11.49%, angry 7.71%).
Conclusion: The #T1D community is a positive and supportive online space to share experiences, connect with others with similar lived experiences, and share information. Each platform contains unique characteristics shaped by the community itself, thus providing different types of social support to individuals with T1D. The results of this study suggest that #T1D online communities may be promoted and encouraged as a mechanism for support, with appropriate levels of trepidation.
Authors:
Presenter - Kira Voelker,
BS, BA,
Parkview Health
Co-Author - Dana Albright, PhD,
PhD,
Parkview Health
Co-Author - Jessica Kichler,
PhD,
University of Windsor
Co-Author - Andy Tannous,
BS,
University of Windsor
Co-Author - Jessica Pater,
PhD,
Parkview Health
F64 - Temporal eating patterns among women in the first postpartum year: National Health and Nutrition Examination Surveys 2011-2018
Poster Number: F64Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Women's Health
Eating later into the day/overnight and extended daily ingestive periods are associated with weight gain and poorer cardiometabolic health. Due to shorter sleep duration and nighttime awakenings, postpartum women may be more likely to eat overnight and have longer daily ingestive windows, which may in turn contribute to postpartum weight retention and adverse health outcomes. To our knowledge, no published studies have characterized the timing of energy intake postpartum. The objective of this study was to characterize the timing of the daily ingestive period using interviewer administered 24-hour dietary recalls completed by women within 12 months postpartum, and to explore factors associated with the timing of the daily ingestive period. Data from the National Health and Nutrition Examination Surveys: 2011-2018 were used. Following review for exclusion criteria (those >12 months postpartum, completing <2 dietary recalls, or missing data), N=255 individuals were included in analyses. Time of first and last caloric (kcal) intake and the ingestive window (interval between first and last kcals) were averaged across 2 dietary recalls. Analyses (t-tests or ANOVA) examined whether the timing of intake differed based on recall day or participant characteristics. Participants were predominantly 20-29 years old (53%), married (59%), non-Hispanic White (39%), 7-12 months postpartum (47%), and not currently breastfeeding (60%). The average timing of first and last kcals was 7:48 and 20:31, respectively. On average, the daily ingestive period was 12.7 hours. Over half of participants completed both recalls on weekdays. The daily ingestive period (hours) was longer for those completing both recalls on weekdays (13.0±2.5) versus both on weekend days (12.6±2.2) or 1 weekday + 1 weekend day (12.3±2.6) but the difference was not significant (P=0.08). Timing of intake did not differ significantly by body mass index, weeks postpartum, breastfeeding status, marital status, education, age, race/ethnicity, or income. The ingestive window in our postpartum sample was slightly longer compared to prior studies in non-postpartum women (11.5–12.0 hours), but more research is needed to understand the magnitude of difference in the ingestive window needed to impact health outcomes. Studies are needed utilizing objective measures to more accurately characterize temporal eating patterns postpartum and how meal timing impacts weight retention and subsequent cardiometabolic disease risk.
Keywords: Diet, Weight controlAuthors:
Presenter - Camille S. Worthington, PhD RDN,
PhD RDN,
University of Alabama at Birmingham
Co-Author - Brittanny M. Polanka, PhD,
PhD,
University of Alabama at Birmingham
Co-Author - Amber W. Kinsey, PhD,
PhD,
University of Alabama at Birmingham
Co-Author - Gareth R. Dutton, PhD, FSBM,
PhD, FSBM,
University of Alabama at Birmingham
F65 - The impact of family meal environment on the relationship between adverse childhood experiences and loss of control eating in adolescents
Poster Number: F65Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Obesity
Adverse childhood experiences (ACEs) are associated with increased loss of control (LOC) eating, a key feature of binge eating that may function to regulate distress. Positive family meal environments (FMEs) may be protective against LOC eating in those with ACEs as they may provide structure and a positive atmosphere to mealtimes, which may lower risk for LOC. However, no research has examined how FMEs may impact the relationship between ACEs and LOC. The current study sought to explore how FMEs moderate the relationship between ACEs and LOC eating in adolescents. Participants were adolescents ages 12-18 (n = 65, 61.3% female) with overweight/obesity (i.e., BMI > 85th percentile) entering a 12-week lifestyle modification program. At baseline, participants answered questions about their FMEs (frequency, priority, atmosphere, and structure) and completed the Loss of Control Over Eating Scale and the Adverse Childhood Experience (ACE) Questionnaire. For the purpose of this study, we created a binary ACEs variable in which participants with no ACEs were coded as 0 and participants with one or more ACEs were coded as 1. Linear regressions were utilized to examine the relationship between the presence of ACEs and LOC eating scores. Results showed a significant relationship between the presence of ACEs and LOC eating scores (B = 14.62, p = .01), indicating that the presence of any ACEs was associated with increased LOC eating severity. We conducted a moderated regression to analyze how FMEs influenced the relationship between ACEs and LOC eating. FME frequency significantly moderated the association between ACEs and LOC eating (p = .02, F = 6.14), such that participants with ACEs who had more frequent family meals were less likely to experience LOC eating, while participants with ACEs who reported fewer family meals were more likely to experience LOC eating. No other aspects of FMEs were statistically significant moderators. Results suggest that more frequent family meals can provide a buffer against the negative effects on eating behavior associated with ACEs. These findings provide valuable insight for treatment of adolescent eating disorders and behavioral weight loss. If results are replicated, treatment could consider targeting family meal frequency for adolescents with ACEs to help reduce risk for disordered eating.
Keywords: Adolescents, Binge eatingAuthors:
Presenter - Gianna LaMena,
Drexel University
Co-Author - Jianyi Liu,
Drexel University
Co-Author - Stephanie M. Manasse, PhD,
PhD,
Drexel University
Co-Author - Caroline Martin,
Drexel University
F66 - Prevalence and correlates of eating-related concerns in young adult cancer survivors
Poster Number: F66Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Cancer
Background: Emerging research highlights eating-related concerns among young adult (YA) cancer survivors. Sociodemographic and health history correlates of disordered eating and food insecurity are not well-studied in this population. This cross-sectional study examined the prevalence and correlates of disordered eating symptoms, binge eating, and food insecurity in YA cancer survivors aged 18-39 years.
Methods: YA cancer survivors (n=173) completed the Eating Attitudes Test-26 (EAT-26; ≥ 20: eating pathology), Binge Eating Scale (BES; ≥ 17: binge eating), a 6-item US Household Food Security Survey (≥ 2: low food security), and a demographic questionnaire via REDCap. Descriptive statistics, Pearson correlations, and stepwise regression with backward elimination were conducted.
Results: Mean age was 33.7 years; 79.2% were women, and 70.5% were white. The most common cancer types were breast (20.8%), lymphoma (18.5%), and leukemia (10.4%). Mean scores were 12.92 ± 7.43 for EAT-26, 12.64 ± 8.62 for BES, and 1.15 ± 1.67 for food security. Regression analysis found that Asian/Pacific Islander race (p=0.002), Asian American race (p=0.028), surgery (p=0.004), and weight concerns (p=0.004) were positively associated with EAT-26 score. Radiation (p=0.03), immunotherapy (p=0.01), and no comorbidities (p=0.009) were inversely associated with BES score, and weight concerns (p=0.001) were positively associated with BES score. Higher income (p=0.002) and more education (p=0.018) were inversely associated with food insecurity. After adjusting for multiple comparisons, weight concerns were significantly positively associated with BES score, and low income was significantly positively associated with food insecurity.
Conclusion: Several sociodemographic and health history factors were linked to eating concerns among YA cancer survivors, with weight concerns and income remaining significant after adjusting for multiple comparisons. Findings underscore the need for tailored screening and intervention strategies to improve health outcomes and quality of life for YA cancer survivors.
Keywords: Eating behaviors, CancerMethods: YA cancer survivors (n=173) completed the Eating Attitudes Test-26 (EAT-26; ≥ 20: eating pathology), Binge Eating Scale (BES; ≥ 17: binge eating), a 6-item US Household Food Security Survey (≥ 2: low food security), and a demographic questionnaire via REDCap. Descriptive statistics, Pearson correlations, and stepwise regression with backward elimination were conducted.
Results: Mean age was 33.7 years; 79.2% were women, and 70.5% were white. The most common cancer types were breast (20.8%), lymphoma (18.5%), and leukemia (10.4%). Mean scores were 12.92 ± 7.43 for EAT-26, 12.64 ± 8.62 for BES, and 1.15 ± 1.67 for food security. Regression analysis found that Asian/Pacific Islander race (p=0.002), Asian American race (p=0.028), surgery (p=0.004), and weight concerns (p=0.004) were positively associated with EAT-26 score. Radiation (p=0.03), immunotherapy (p=0.01), and no comorbidities (p=0.009) were inversely associated with BES score, and weight concerns (p=0.001) were positively associated with BES score. Higher income (p=0.002) and more education (p=0.018) were inversely associated with food insecurity. After adjusting for multiple comparisons, weight concerns were significantly positively associated with BES score, and low income was significantly positively associated with food insecurity.
Conclusion: Several sociodemographic and health history factors were linked to eating concerns among YA cancer survivors, with weight concerns and income remaining significant after adjusting for multiple comparisons. Findings underscore the need for tailored screening and intervention strategies to improve health outcomes and quality of life for YA cancer survivors.
Authors:
Presenter - Acadia W. Buro,
PhD,
University of New Mexico
Co-Author - Nashira I. Brown,
PhD,
University of Alabama at Birmingham
Co-Author - Tiffany L. Carson,
PhD, MPH, FSBM,
H. Lee Moffitt Cancer Center & Research Institute
Co-Author - Marilyn Stern,
PhD,
University of South Florida
F67 - Overvaluation of Shape and Weight During Cognitive Behavioral Therapy for Binge-Spectrum Eating Disorders
Poster Number: F67Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Mental Health
Objective: Among those with binge-spectrum eating disorders (EDs), overvaluation of shape and weight are core factors in maintaining binge eating and compensatory behaviors as they can foster body dissatisfaction and restrictive eating, which may, in turn, drive binge eating and compensatory behaviors to “make up” for binge episodes. However, there is a lack of research exploring overvaluation of shape and weight and their associations with weekly changes in binge-spectrum ED pathology during treatment, which could help tailor interventions, prevent relapse, and improve outcomes. This study examined weekly associations between overvaluation of shape and weight during cognitive behavioral therapy for EDs (CBT-E) and frequency of binge episodes and compensatory behaviors the same and the following week.
Method: Participants included 63 adults (11.1% male) with binge eating disorder (57.14%) or full or sub-threshold bulimia nervosa (42.86%). Participants received 12 weekly sessions of CBT-E to address ED psychopathology. Prior to each session, participants completed a brief measure of overvaluation of shape and weight and reported the frequency of binge episodes and compensatory behaviors (i.e., self-induced vomiting, laxative misuse, compensatory exercise, and other extreme weight control behaviors) they experienced in the past week.
Results: Multilevel models indicated that overvaluation of shape, but not weight, was associated with higher levels of binge eating during the same week (B = 0.42, 95% CI [0.06, 0.77], p = 0.02) and the following week (B = 0.37, 95% CI [0.05, 0.69], p = 0.02). Although not significant, the same pattern was evident for overvaluation of weight for same-week binge eating (p = .072). Overvaluation of weight, but not shape, was associated with increased compensatory behaviors during the same week (B = 0.36, 95% CI [0.09 – 0.63], p < 0.01); neither overvaluation of shape or weight were associated with compensatory behaviors the next week.
Discussion: During the course of CBT-E, overvaluation of shape and weight are predictive of binge episodes and compensatory behaviors, respectively. Thus, including intervention adjuncts that target overvaluation of shape and weight may be helpful in improving treatment outcomes. Future research should also replicate this study using more granular and intensive time scales (i.e., momentarily) to better capture fluctuations of overvaluation of shape and weight and their associations with ED pathology.
Keywords: Eating behaviors, Binge eatingMethod: Participants included 63 adults (11.1% male) with binge eating disorder (57.14%) or full or sub-threshold bulimia nervosa (42.86%). Participants received 12 weekly sessions of CBT-E to address ED psychopathology. Prior to each session, participants completed a brief measure of overvaluation of shape and weight and reported the frequency of binge episodes and compensatory behaviors (i.e., self-induced vomiting, laxative misuse, compensatory exercise, and other extreme weight control behaviors) they experienced in the past week.
Results: Multilevel models indicated that overvaluation of shape, but not weight, was associated with higher levels of binge eating during the same week (B = 0.42, 95% CI [0.06, 0.77], p = 0.02) and the following week (B = 0.37, 95% CI [0.05, 0.69], p = 0.02). Although not significant, the same pattern was evident for overvaluation of weight for same-week binge eating (p = .072). Overvaluation of weight, but not shape, was associated with increased compensatory behaviors during the same week (B = 0.36, 95% CI [0.09 – 0.63], p < 0.01); neither overvaluation of shape or weight were associated with compensatory behaviors the next week.
Discussion: During the course of CBT-E, overvaluation of shape and weight are predictive of binge episodes and compensatory behaviors, respectively. Thus, including intervention adjuncts that target overvaluation of shape and weight may be helpful in improving treatment outcomes. Future research should also replicate this study using more granular and intensive time scales (i.e., momentarily) to better capture fluctuations of overvaluation of shape and weight and their associations with ED pathology.
Authors:
Author - Jannah R. Moussaoui,
B.S.,
Drexel University
Co-Author - Stephanie M. Manasse, PhD,
PhD,
Drexel University
F68 - Impact of parental eating disorder pathology on child dietary intake following experimentally manipulated food parenting
Poster Number: F68Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Child and Family Health
Parental dieting behavior and eating disorder (ED) pathology are both associated with negative child eating outcomes such as increased child use of extreme weight control behaviors. Similarly, controlling food parenting (e.g., restriction) is also associated with negative child eating outcomes. However, less is known about the relationships between parental ED pathology, food parenting, and child eating outcomes. The current study aimed to examine the impact of parental ED pathology on child dietary intake following experimentally manipulated food parenting. Participants included 76 parent-child (ages 8-11) dyads participating in a longitudinal study examining relationships between parent and child eating behaviors, food parenting, and weight status. Parents and children completed an experimentally manipulated food parenting paradigm with two conditions: 1) Restriction (i.e., parent and child were told that the child should not consume any of the study food, which was a frequently consumed food), and 2) Structured Intake (i.e., dyad was given 8 servings of the study food). Each condition lasted two weeks, with a one-week washout in between, and the order was counterbalanced. Following each condition, the child ate a test meal with 26 foods, including their study food, and 3 drinks. Parents completed the Eating Disorder Examination Questionnaire, which was used to calculate global ED pathology. Linear regression models were used to examine how baseline parent global ED pathology predicted baseline child intake (assessed as total calories, macronutrient intake, and study food calories at the test meal), separately for each food parenting condition. After Restriction, parent global ED pathology positively predicted child total calories, carbohydrates, and fat (all p < .05), with no significant relationships between parent global ED pathology and child protein intake or study food calories (all p > .12). Parent global ED pathology did not predict any of the child intake variables after Structured Intake. Taken together, the data suggest that children whose parents have higher levels of ED pathology are more negatively affected by experimentally manipulated restriction. Future work should focus on efforts to mitigate the impact of parental ED pathology on child eating outcomes.
Keywords: Eating behaviors, Parent-child transactionsAuthors:
Author - Hannah Kolpack,
BA,
University at Buffalo
Author - Jennifer Temple,
PhD,
University at Buffalo
Author - Lori Hatzinger, MS,
MS,
University of Southern California
Presenter - Katherine Balantekin,
PhD, RD,
University at Buffalo
F69 - Exploring the Relationship Between Parental Warmth and Family Food Choices in a Simulated Grocery Setting
Poster Number: F69Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Child and Family Health
Parental influence aids in shaping children's eating habits (Birch & Davison, 2001; Wood et al., 2020). In particular, parents who adopt an authoritative style—marked warmth and appropriate boundary-setting—tend to practice food-related behaviors that encourage healthy eating in their children (Blissett & Haycraft, 2008; Mellin et al., 2002). Existing studies have primarily relied on parental self-reports, and there is limited research exploring parenting style in observational settings. Thus, the aim of the present study was to explore connections between parental warmth (a common indicator of authoritative parenting) and the healthfulness of food selections in a grocery store setting. This study was a part of a larger study on parenting style with a variety of food selection tasks. For the present task, parents were observed interacting with their children in a simulated grocery aisle, where each parent-child dyad was instructed to select up to $20 worth of prepackaged foods and beverages from options including cookies/crackers, cereals, and chips/snacks, pastas, beverages, etc. In total, 145 pairs of one parent/guardian and one child (aged 5-10) participated. Food products were rated on a four-star scale, with 1 star indicating the least healthy and 4 stars the healthiest. A parental warmth composite score, consisting of warmth, parental responsiveness/involvement, and autonomy granting, was calculated by three trained coders who observed videotapes (e.g., “To what extent does the parent appear loving and warm during the interaction?”). Each coder independently rated warmth domains from 0 (not at all) to 7 (very much), and coders were highly reliable (α =.794 ). A linear regression analysis was performed, and no evidence was found to support that parental warmth predicts the healthfulness of food choices (β = 0.01, F(1, 143) = 1.75 p = 0.19). Parental warmth accounted for 1.2% of variance in the healthfulness of food choices (R²=0.01, adjusted R² = 0.005). Based on these results, it appears that parental warmth does not play a significant role in the healthfulness of parent/child food choices in a grocery store setting. Previous research has demonstrated that parenting style impacts healthy choices when in relation to limit setting (Fleary & Ettienne, 2019), so it is possible including strictness in the model would change this relationship. Future research should examine parenting style through observational methods with the inclusion of limit setting.
Keywords: Parent-child transactions, DietAuthors:
Author - Katie McMahon,
B.S.,
Colorado State University
Co-Author - Rachel Lucas-Thompson,
Ph.D.,
Colorado State University
Co-Author - Daniel Graham,
Ph.D.,
Colorado State University
F71 - An Examination of Positive Body Image and Its Association with Disordered and Intuitive Eating Throughout Pregnancy
Poster Number: F71Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Women's Health
Disordered eating during pregnancy is associated with poor maternal and fetal health outcomes, making it important to identify protective factors against maladaptive eating. Among non-pregnant samples, positive body image is associated with less disordered eating and more adaptive eating behaviors. Past research examining body image during the perinatal period has primarily focused on negative body image with little consideration of positive body image. Thus, the present study examined associations between positive body image and disordered eating behaviors (purging, restricting, and binge eating) and intuitive eating during pregnancy and tested the moderating effect of gestational weeks. Participants were 176 pregnant adults (Mage = 29.24; 77.8% White) who completed an online survey of positive body image, disordered eating, and intuitive eating. Positive body image was measured using the Body Appreciation Scale-2. Select subscales from the Eating Pathology Symptoms Inventory were used to measure disordered eating behaviors, and the Intuitive Eating Scale-II was used to measure intuitive eating behaviors. Multiple regression models examined associations between positive body image and eating behaviors, controlling for mental health, BMI, preconception positive body image, and number of pregnancy complications. Results revealed no significant associations between positive body image and any of the disordered eating behaviors (p = .517-.965). Higher positive body image was significantly associated with greater engagement in intuitive eating (p = .010), and this association was stronger for women later in pregnancy (β = .19, p = .007) vs. earlier in pregnancy (β = .17, p = .017). Gestational weeks also significantly moderated the association between positive body image and binge eating. Although the association was stronger for those earlier in pregnancy, the effect was not significant when testing the simple slopes. Taken together, findings suggest positive body image is associated with adaptive eating behaviors during pregnancy but not less disordered eating, as is commonly seen among non-pregnant women. Future studies of positive body image and associations with health behaviors across the perinatal period would offer information about whether interventions promoting positive body image (in addition to decreasing body dissatisfaction) could promote adaptive health behaviors during pregnancy.
Keywords: Eating behaviors, PregnancyAuthors:
Presenter - Cassidy M. Sandoval,
PhD,
Appalachian State University
Co-Author - Sarah J. Ehlke,
PhD,
Old Dominion University
Co-Author - Kristin E. Heron,
PhD, FSBM,
Old Dominion University
F72 - Usability of a Digital Health Application to Monitor Alcohol Use Among Rural Native American Populations
Poster Number: F72Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Health of Marginalized Populations
Background: Despite advances in digital health interventions to reduce health inequities in rural, minoritized populations, Native Americans continue to experience disproportionate behavioral health concerns and lack access to healthcare services. In addition to the lack of care, many digital health interventions for Native populations are not created with cultural relevancy or historical variables in mind, thereby decreasing the usability and effectiveness of these interventions.
Methods: Participants (n=13; Mage=40 years) completed an online survey about perceptions of culture, alcohol use, and resources in their communities. Participants also answered questions regarding the usability of a digital health application designed to monitor alcohol use.
Results: Regarding cultural perceptions and alcohol use, 84.6% of participants reported that loss of Native American culture in the US and historical trauma has contributed to problematic alcohol use in their community. The majority of participants (69.2%) also reported instances where they should have sought treatment and did not. The most common barriers to seeking treatment included 1) lack of health insurance coverage for services, 2) time constraints, 3) feelings of embarrassment, 4) lack of trust in services and/or providers, and 5) a desire to continue drinking. Regarding the usability of the digital health app, many participants indicated they would use it again in the future (46.2%) and found it easy to use (76.9%). Participants also reported that the application functions were well integrated (30.8%). Many participants reported that using the app daily (69.2%), answering questions about alcohol use (76.9%), and setting goals (61.5%) were helpful. Additionally, 53.8% reported that the app reduced their alcohol intake. Qualitative responses for improving the application included connecting people to resources in their community and the ability to review past entries to identify patterns in alcohol intake.
Conclusion: For rural Native American populations, digital health apps may offer a more usable and acceptable option for alcohol use interventions. Digital health apps can address barriers to seeking treatment, such as limited access to services and perceptions of help-seeking behaviors for this population. These results highlight the need for tailored digital health interventions that focus on addressing relevant cultural and historical factors addressing alcohol use among Native populations.
Keywords: e-Health, Minority healthMethods: Participants (n=13; Mage=40 years) completed an online survey about perceptions of culture, alcohol use, and resources in their communities. Participants also answered questions regarding the usability of a digital health application designed to monitor alcohol use.
Results: Regarding cultural perceptions and alcohol use, 84.6% of participants reported that loss of Native American culture in the US and historical trauma has contributed to problematic alcohol use in their community. The majority of participants (69.2%) also reported instances where they should have sought treatment and did not. The most common barriers to seeking treatment included 1) lack of health insurance coverage for services, 2) time constraints, 3) feelings of embarrassment, 4) lack of trust in services and/or providers, and 5) a desire to continue drinking. Regarding the usability of the digital health app, many participants indicated they would use it again in the future (46.2%) and found it easy to use (76.9%). Participants also reported that the application functions were well integrated (30.8%). Many participants reported that using the app daily (69.2%), answering questions about alcohol use (76.9%), and setting goals (61.5%) were helpful. Additionally, 53.8% reported that the app reduced their alcohol intake. Qualitative responses for improving the application included connecting people to resources in their community and the ability to review past entries to identify patterns in alcohol intake.
Conclusion: For rural Native American populations, digital health apps may offer a more usable and acceptable option for alcohol use interventions. Digital health apps can address barriers to seeking treatment, such as limited access to services and perceptions of help-seeking behaviors for this population. These results highlight the need for tailored digital health interventions that focus on addressing relevant cultural and historical factors addressing alcohol use among Native populations.
Authors:
Author - Tori Humiston,
PhD,
Massachusetts College of Pharmacy and Health Sciences
Co-Author - David L. Pennington,
PhD,
Melantha Health
F73 - Pilot test of a social media campaign on preventing cancer risk factors for emerging adults in rural communities in the American Mountain West
Poster Number: F73Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Cancer
Introduction
A social media campaign on preventing six cancer risk factors – being physical inactive, eating an unhealthy diet, using nicotine products, binging alcohol, being sunburned, and being unvaccinated for human papillomavirus (HPV) – was pilot-tested with emerging adults (EAs) aged 18-26 living in rural counties.
Methods
Using an integrated theoretical framework, social media posts were developed to counter the cancer risk factors. Posts covered simplicity, benefits, response efficacy/cost, self-efficacy/ perceived control, risk perceptions, norms, social support/relatedness, goals/values compatibility, intrinsic/extrinsic motivation, media literacy, and communication with family/friends. EAs (n=26) aged 18-26 living in rural counties in Arizona, Colorado, New Mexico, and Utah received a 4-week social media feed with 64 posts delivered in a private Facebook group. EAs completed pretest and posttest surveys, and engagement (views, reactions, comments) was recorded.
Results
Participants were 85% female and 35% Hispanic, with median age of 23. At pretest, EAs demonstrated cancer risk factors: 53% engaged in <150 minutes of moderate-to-vigorous physical activity weekly, 85% had low daily intake of fruits and vegetables, 35% used nicotine products, 58% binged alcohol, 65% were sunburned, and 38% were unvaccinated for HPV. The campaign feed received 1,060 views (mean (M)=16.6/post and 40.8/participant), 346 reactions (M=5.4/post and 13.3/participant), and 72 comments (M=1.2/post and 2.96/participant). Of the six cancer risk factors, posts on physical activity received the most views (216 views) while those on HPV and sun safety, the least (115 views each). Posts on physical activity, nicotine products, and alcohol received the most reactions (>50 reactions each) and physical activity and diet posts received the most comments (>9 comments each).
Conclusion
Social media is a popular source for health information among EAs. A multi-risk factor social media campaign has potential to engage EAs with theory-based cancer prevention messaging. The campaign will be evaluated in a randomized trial in 2025.
Keywords: Cancer, e-HealthA social media campaign on preventing six cancer risk factors – being physical inactive, eating an unhealthy diet, using nicotine products, binging alcohol, being sunburned, and being unvaccinated for human papillomavirus (HPV) – was pilot-tested with emerging adults (EAs) aged 18-26 living in rural counties.
Methods
Using an integrated theoretical framework, social media posts were developed to counter the cancer risk factors. Posts covered simplicity, benefits, response efficacy/cost, self-efficacy/ perceived control, risk perceptions, norms, social support/relatedness, goals/values compatibility, intrinsic/extrinsic motivation, media literacy, and communication with family/friends. EAs (n=26) aged 18-26 living in rural counties in Arizona, Colorado, New Mexico, and Utah received a 4-week social media feed with 64 posts delivered in a private Facebook group. EAs completed pretest and posttest surveys, and engagement (views, reactions, comments) was recorded.
Results
Participants were 85% female and 35% Hispanic, with median age of 23. At pretest, EAs demonstrated cancer risk factors: 53% engaged in <150 minutes of moderate-to-vigorous physical activity weekly, 85% had low daily intake of fruits and vegetables, 35% used nicotine products, 58% binged alcohol, 65% were sunburned, and 38% were unvaccinated for HPV. The campaign feed received 1,060 views (mean (M)=16.6/post and 40.8/participant), 346 reactions (M=5.4/post and 13.3/participant), and 72 comments (M=1.2/post and 2.96/participant). Of the six cancer risk factors, posts on physical activity received the most views (216 views) while those on HPV and sun safety, the least (115 views each). Posts on physical activity, nicotine products, and alcohol received the most reactions (>50 reactions each) and physical activity and diet posts received the most comments (>9 comments each).
Conclusion
Social media is a popular source for health information among EAs. A multi-risk factor social media campaign has potential to engage EAs with theory-based cancer prevention messaging. The campaign will be evaluated in a randomized trial in 2025.
Authors:
Presenter - David Buller,
PhD,
Klein Buendel, Inc.
Co-Author - Andrew Sussman,
PhD, MCRP,
University of New Mexico Comprehensive Cancer Center
Co-Author - Echo Warner,
PhD, MPH,
University of Utah School of Nursing
Co-Author - Alishia Kinsey,
BA,
Klein Buendel, Inc.
Co-Author - Barbara J. Walkosz,
PhD,
Klein Buendel, Inc.
Co-Author - Judith Gordon,
PhD,
University of Arizona College of Nursing
Co-Author - Gill Woodall,
PhD,
Klein Buendel, Inc.
Co-Author - Douglas Taren,
PhD,
University of Colorado School of Medicine
Co-Author - Deanna Kepka,
PhD,
University of Utah Huntsman Cancer Institute
Co-Author - Kimberly Henry,
PhD,
Colorado State University
Co-Author - Kayla Nuss, PhD,
PhD,
Klein Buendel, Inc.
Co-Author - Cindy Blair,
PhD,
University of New Mexico Health Sciences Center
Co-Author - Evelinn Borrayo,
PhD,
University of Colorado Cancer Center
Co-Author - David Wetter,
PhD,
University of Utah School of Medicine
Co-Author - Meghan Skiba,
PhD, MPH, RDN,
University of Arizona College of Nursing
Co-Author - Julia Berteletti,
MSW,
Klein Buendel, Inc.
Co-Author - Annelise Small,
BA,
Klein Buendel, Inc.
Co-Author - Dolores D. Guest,
PhD, RD,
University of New Mexico Health Sciences Center
Co-Author - John Torres,
MS,
University of New Mexico Health Sciences Center
F74 - Positive and Negative Social Media Experiences and Depression among US Adults
Poster Number: F74Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Mental Health
Introduction. Depression is associated with substantial morbidity, mortality, and increased health care costs globally. Among youth, negative experiences on social media (SM) have been associated with increased depression, and positive experiences on SM have been associated with lower depression. However, these associations have not been sufficiently explored among adults.
Methods. Participants were a national sample of 1512 U.S. adults ages 30–70 years. They were recruited via Qualtrics Sampling Services in July-August 2023, and response rate was 61.4%. Depression was assessed using the established cutoff point for the validated patient health questionnaire (PHQ-9), and positive and negative experiences on social media were self-reported. We used logistic regression controlling for relevant sociodemographic covariates to assess associations between positive and negative experiences on social media and depression as measured by the PHQ-9. Sociodemographic covariates included sex, age, race/ethnicity, educational history, employment status, and marital status.
Results. In fully-adjusted multivariable models, compared with those in the lowest quartile for negative experiences on SM, participants in the highest quartile had significantly greater odds of having depression (AOR = 2.64, 95% CI = 1.89, 3.69). Furthermore, the association between negative experiences and depression was linear (P < 0.001). However, there were no significant associations between having had positive experiences on SM and depression. For example, compared with those in the lowest quartile for positive experiences on SM, participants in the highest quartile did not have significantly greater or lesser odds of having depression (AOR = 1.13, 95% CI = 0.80, 1.61).
Conclusions. These findings are consistent with the sociological concept of negativity bias. However, it is still surprising, based on prior findings in youth, that there was no association between positive experiences and reduced depression. Given these findings, among adults it may be most useful for interventions to focus on reducing negative SM exposures.
Keywords: Mental health, Social supportMethods. Participants were a national sample of 1512 U.S. adults ages 30–70 years. They were recruited via Qualtrics Sampling Services in July-August 2023, and response rate was 61.4%. Depression was assessed using the established cutoff point for the validated patient health questionnaire (PHQ-9), and positive and negative experiences on social media were self-reported. We used logistic regression controlling for relevant sociodemographic covariates to assess associations between positive and negative experiences on social media and depression as measured by the PHQ-9. Sociodemographic covariates included sex, age, race/ethnicity, educational history, employment status, and marital status.
Results. In fully-adjusted multivariable models, compared with those in the lowest quartile for negative experiences on SM, participants in the highest quartile had significantly greater odds of having depression (AOR = 2.64, 95% CI = 1.89, 3.69). Furthermore, the association between negative experiences and depression was linear (P < 0.001). However, there were no significant associations between having had positive experiences on SM and depression. For example, compared with those in the lowest quartile for positive experiences on SM, participants in the highest quartile did not have significantly greater or lesser odds of having depression (AOR = 1.13, 95% CI = 0.80, 1.61).
Conclusions. These findings are consistent with the sociological concept of negativity bias. However, it is still surprising, based on prior findings in youth, that there was no association between positive experiences and reduced depression. Given these findings, among adults it may be most useful for interventions to focus on reducing negative SM exposures.
Authors:
Author - Brian Primack,
MD, PhD,
Oregon State University
Co-Author - Hyosin Kim,
PhD,
Oregon State University
F75 - Older adult utilization of an app for alcohol reduction
Poster Number: F75Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Aging
Background
Alcohol use among older adults is a growing concern, as data show both an increase in their alcohol consumption and an increasing size of the older adult population. Additionally, risks of alcohol use are higher among older adults. Increasing treatment options and access is vital for this population, and digital health interventions have the potential to increase access. Stand Down, an app for alcohol reduction, has shown promising results for Veterans, however, it’s efficacy and acceptability with older adults specifically is unknown.
Methods
The aim of this study was to compare app usage rates and efficacy of Stand Down between older adults (60 and older; n=35 ) and younger adults (59 and younger; n =41). Data come from an on-going randomized controlled trial focusing on the impact of peer specialists on usage and efficacy of the Stand Down app. We examined data from 76 veterans who were randomized to use Stand Down. Average drinks per day (DPD) were assessed with the Timeline Followback. Usage data were measured by the number of days a participant accessed the app. Usage data were nonnormal; nonparametric test Mann-Whitney U was used to compare means of app usage days at 20 weeks. DPD were nonnormal; Wilcoxon signed-rank test was used to assess difference at 8 weeks and at 20 weeks in DPD for the full sample. ANOVAs assessed if change in DPD significantly differed based on age group.
Results
For the overall sample, DPD decreased significantly at 8 weeks (z=-4.24, p<.001) and at 20 weeks (z=-4.96, p<.001). Change in DPD did not significantly differ between age groups at 8 weeks (F(1,72)=1.20, p=.278) (older adult M=-.64, younger adult M=-1.11) or 20 weeks (F(1,71)=1.06, p=.306) (older adult M=-1.13, younger adult M=-1.66), indicating older adults reduced their drinking similarly to younger adults. Older adults used the app on more days (M = 44.80, SD = 51.92) than younger adults (M=28.05, SD = 30.63), but this was not a statistically significant difference (z=-.303, p=.762).
Conclusions
Older adults in this sample reduced their alcohol use similarly to younger adults, with both age groups significantly reducing their average drinks per day. Both age groups also had similar app usage, indicating similar acceptability of the app. These results provide further evidence that older adults can fully engage and benefit from digital health interventions.
Keywords: Technologies, Older adultsAlcohol use among older adults is a growing concern, as data show both an increase in their alcohol consumption and an increasing size of the older adult population. Additionally, risks of alcohol use are higher among older adults. Increasing treatment options and access is vital for this population, and digital health interventions have the potential to increase access. Stand Down, an app for alcohol reduction, has shown promising results for Veterans, however, it’s efficacy and acceptability with older adults specifically is unknown.
Methods
The aim of this study was to compare app usage rates and efficacy of Stand Down between older adults (60 and older; n=35 ) and younger adults (59 and younger; n =41). Data come from an on-going randomized controlled trial focusing on the impact of peer specialists on usage and efficacy of the Stand Down app. We examined data from 76 veterans who were randomized to use Stand Down. Average drinks per day (DPD) were assessed with the Timeline Followback. Usage data were measured by the number of days a participant accessed the app. Usage data were nonnormal; nonparametric test Mann-Whitney U was used to compare means of app usage days at 20 weeks. DPD were nonnormal; Wilcoxon signed-rank test was used to assess difference at 8 weeks and at 20 weeks in DPD for the full sample. ANOVAs assessed if change in DPD significantly differed based on age group.
Results
For the overall sample, DPD decreased significantly at 8 weeks (z=-4.24, p<.001) and at 20 weeks (z=-4.96, p<.001). Change in DPD did not significantly differ between age groups at 8 weeks (F(1,72)=1.20, p=.278) (older adult M=-.64, younger adult M=-1.11) or 20 weeks (F(1,71)=1.06, p=.306) (older adult M=-1.13, younger adult M=-1.66), indicating older adults reduced their drinking similarly to younger adults. Older adults used the app on more days (M = 44.80, SD = 51.92) than younger adults (M=28.05, SD = 30.63), but this was not a statistically significant difference (z=-.303, p=.762).
Conclusions
Older adults in this sample reduced their alcohol use similarly to younger adults, with both age groups significantly reducing their average drinks per day. Both age groups also had similar app usage, indicating similar acceptability of the app. These results provide further evidence that older adults can fully engage and benefit from digital health interventions.
Authors:
Presenter - Robyn Sedotto,
Ph.D.,
VA Center for Integrated Healthcare
Co-Author - Allyson Smith,
B.S.,
VA Center for Integrated Healthcare
Co-Presenter - Abigail Masters,
PsyD,
VA Palo Alto Healthcare System
Co-Author - Kyle Possemato,
VA Center for Integrated Healthcare
Chair - Daniel Blonigen,
Ph.D.,
Center for Innovation to Implementation
F76 - Nomophobia, anxiety, and social comparison orientation: Associations with physical health symptoms among university students
Poster Number: F76Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Mental Health
Background: Nomophobia (NO MObile PHOne phoBIA) is characterized by fear or distress resulting from being without one’s mobile phone or being unable to use one’s mobile phone to connect to others, and is associated with negative mental health outcomes, particularly for up to 73% of university students. However, the overlap between nomophobia and anxiety has not been fully considered in previous work, and the utility of researching nomophobia independent of anxiety is unclear despite diagnostic criteria for existing anxiety-related conditions coinciding with nomophobia. Examining nomophobia alone can clarify its unique contributions to physical health outcomes, which have meaningful implications on students’ academic, social, and occupational functioning. The extent to which students compare themselves with others (i.e., social comparison orientation; SCO) may moderate the relation between nomophobia and health outcomes, though the role of SCO is also unclear. To address these questions, we tested the associations between nomophobia, anxiety, SCO and physical health symptoms among university students.
Methods: University students (N=310; MAge=19.4; 66% women; 34% racial/ethnic minority identity) completed an electronic survey assessing nomophobia, anxiety, SCO, and physical health symptoms using well-validated self-report measures.
Results: Nomophobia was moderately positively correlated with anxiety (r=0.42, p<0.01) and slightly positively correlated with physical health symptoms (r=0.24, p<0.01). Model comparisons revealed that a full model with nomophobia and anxiety as predictors of health symptoms did not outperform a model with anxiety alone (Bayes Factor=0.19) but outperformed a model with nomophobia alone (Bayes Factor=148587). SCO moderated the relation between nomophobia and health symptoms (F[2,258]=12.56, p<0.01): the correlation was stronger for students with higher (vs. lower) SCO.
Conclusions: Despite attention on nomophobia as a unique risk marker, findings indicate that global anxiety may be more useful for identifying students at risk for physical health symptoms than nomophobia. Students with higher (vs. lower) SCO may be at particular risk due to their tendency to self-evaluate relative to others. Future work should determine whether these associations generalize to other populations and are causal, which would elucidate whether nomophobia can be an appropriate treatment target to manage anxiety-related and/or physical health symptoms.
Keywords: Anxiety, Mobile phoneMethods: University students (N=310; MAge=19.4; 66% women; 34% racial/ethnic minority identity) completed an electronic survey assessing nomophobia, anxiety, SCO, and physical health symptoms using well-validated self-report measures.
Results: Nomophobia was moderately positively correlated with anxiety (r=0.42, p<0.01) and slightly positively correlated with physical health symptoms (r=0.24, p<0.01). Model comparisons revealed that a full model with nomophobia and anxiety as predictors of health symptoms did not outperform a model with anxiety alone (Bayes Factor=0.19) but outperformed a model with nomophobia alone (Bayes Factor=148587). SCO moderated the relation between nomophobia and health symptoms (F[2,258]=12.56, p<0.01): the correlation was stronger for students with higher (vs. lower) SCO.
Conclusions: Despite attention on nomophobia as a unique risk marker, findings indicate that global anxiety may be more useful for identifying students at risk for physical health symptoms than nomophobia. Students with higher (vs. lower) SCO may be at particular risk due to their tendency to self-evaluate relative to others. Future work should determine whether these associations generalize to other populations and are causal, which would elucidate whether nomophobia can be an appropriate treatment target to manage anxiety-related and/or physical health symptoms.
Authors:
Author - Emmanuel Lapitan,
B.A.,
Rowan University
Co-Author - Raj Harsora,
B.S.,
Rowan University
Co-Author - Kyle Haggerty, PhD,
PhD,
Richmond VA Medical Center
Co-Author - Danielle Arigo, PhD, LP,
PhD, LP,
Rowan University
F77 - Improvements in Sleep and Mental Health After Engagement with a Digital Mental Health Platform
Poster Number: F77Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Sleep
Background:
Mental health and sleep quality have a strong bidirectional relationship. Good quality sleep can boost resilience to everyday stressors, promote workplace productivity and satisfaction, and protect one’s mental health. In contrast, exacerbated mental health concerns can impair sleep. Digital mental health solutions offering comprehensive services through both provider-led and self-guided care may simultaneously improve sleep and mental health, having greater reach.
Methods:
We examined how an employer-sponsored digital mental health platform (Modern Health) impacted perceived sleep quality. The sample included 534 newly enrolled (2021-2022) working adults (62% women, Mage=34 years, 41.5% people of color). Participants attended at least one remote therapy or coaching session, or engaged with at least one piece of self-guided digital health content. Participants completed baseline measures of sleep quality (validated single item from the PSQI) and mental health (e.g., anxiety, depression, perceived stress) before and after engaging with the platform for 3 months. Paired sample t-tests analyzed pre-post changes in these variables.
Results:
At baseline, lower sleep quality was correlated with greater depression (r=-.53), anxiety (r=-.42), and perceived stress (r=-.44, all ps<.001), and 42.5% (n=277) reported poor baseline sleep (either ‘fairly bad’ or ‘very bad’). Participants with poor baseline sleep quality (M=.90, SD=.30) reported a 40% improvement in their sleep at follow-up (M=1.26, SD=.63, p<.001). Overall, 39% (n=89) of poor baseline sleepers improved their sleep and 34% (n=78) no longer met criteria for poor sleep quality. Those with poor baseline sleep quality who showed improvement at follow-up (n=89), also showed significant reductions in anxiety (-31.3%), depression (-42.7%), and perceived stress (-22.4%), and increased wellbeing (+46.1%), distress tolerance (+8.3%), resilient coping (+4.2%), and psychological flexibility (+9.8%, all ps<.01).
Conclusion:
Results offer support that digital mental health solutions can increase sleep quality and various mental health outcomes in individuals with poor sleep. These improvements could build resilience and support valuable psychosocial benefits in the workplace, making such solutions a worthwhile consideration for employers.
Keywords: Abnormal sleep, TechnologiesMental health and sleep quality have a strong bidirectional relationship. Good quality sleep can boost resilience to everyday stressors, promote workplace productivity and satisfaction, and protect one’s mental health. In contrast, exacerbated mental health concerns can impair sleep. Digital mental health solutions offering comprehensive services through both provider-led and self-guided care may simultaneously improve sleep and mental health, having greater reach.
Methods:
We examined how an employer-sponsored digital mental health platform (Modern Health) impacted perceived sleep quality. The sample included 534 newly enrolled (2021-2022) working adults (62% women, Mage=34 years, 41.5% people of color). Participants attended at least one remote therapy or coaching session, or engaged with at least one piece of self-guided digital health content. Participants completed baseline measures of sleep quality (validated single item from the PSQI) and mental health (e.g., anxiety, depression, perceived stress) before and after engaging with the platform for 3 months. Paired sample t-tests analyzed pre-post changes in these variables.
Results:
At baseline, lower sleep quality was correlated with greater depression (r=-.53), anxiety (r=-.42), and perceived stress (r=-.44, all ps<.001), and 42.5% (n=277) reported poor baseline sleep (either ‘fairly bad’ or ‘very bad’). Participants with poor baseline sleep quality (M=.90, SD=.30) reported a 40% improvement in their sleep at follow-up (M=1.26, SD=.63, p<.001). Overall, 39% (n=89) of poor baseline sleepers improved their sleep and 34% (n=78) no longer met criteria for poor sleep quality. Those with poor baseline sleep quality who showed improvement at follow-up (n=89), also showed significant reductions in anxiety (-31.3%), depression (-42.7%), and perceived stress (-22.4%), and increased wellbeing (+46.1%), distress tolerance (+8.3%), resilient coping (+4.2%), and psychological flexibility (+9.8%, all ps<.01).
Conclusion:
Results offer support that digital mental health solutions can increase sleep quality and various mental health outcomes in individuals with poor sleep. These improvements could build resilience and support valuable psychosocial benefits in the workplace, making such solutions a worthwhile consideration for employers.
Authors:
Author - Kristen Van Swearingen,
MA,
University of North Carolina at Charlotte
Co-Author - Jessica Watrous,
PhD,
Modern Health
Co-Author - Neha Chaudhary,
PhD,
Modern Health
Co-Author - Sara Levens,
PhD,
University of North Carolina at Charlotte
Co-Author - Sara Sagui-Henson,
PhD,
Modern Health
F78 - An Anxiety Focused Mobile Application for Patients with Substance Use & Co-Occurring Anxiety Disorders: Single Arm Study Investigating Usability & Associated Changes in Anxiety and Substance Use
Poster Number: F78Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Integrative Health and Spirituality
BACKGROUND: Patients with co-occurring anxiety and substance use disorders (A-SUD) have lower rates of treatment retention and are at increased risk for unwanted returns to substance use. App-based interventions (ABIs) offer accessible care that can overcome barriers to evidence-based treatment access. Despite growth in digital interventions for SUD, few studies have examined the role of anxiety-focused ABIs for patients with A-SUD.
OBJECTIVES: The objectives of this study were: (1) assess the usability of the Unwinding Anxiety® application, an anxiety treatment-focused, public-facing mobile app, as an adjunctive treatment for A-SUD engaged in care; (2) conduct exploratory analyses of associated changes in A-SUD specific outcomes (e.g., GAD-7, Penn State Worry Questionnaire, Brief Addiction Monitor) in a single-arm trial.
METHODS: We recruited 48 AD-SUD patients engaged in care. Usability was assessed at 2 months via the Systems Usability Scale and the mHealth Satisfaction Questionnaire. Exploratory analyses (i.e., t-tests with effect sizes, McNamar’s chi-squared tests, and stepwise selection of Generalized Linear Models) investigated changes in key outcomes.
RESULTS: Of the 48 participants, 21 completed follow-up assessments (44%) considered acceptable in light of previous digital health research. Usability at 2-months was moderate via the Systems Usability Scale (M=69.5, 12.7) and high via subscales (e.g., positive experiences, negative experiences, life integration) on the mHealth Satisfaction Questionnaire. Exploratory t-tests indicated promising decreases in anxiety (d=1.4, p < 0.001), worry (d=1.07, p=0.0009) and improved emotional regulation (d=1.24, p =0.006) at follow-up. McNamar’s tests revealed reductions in craving (X2 = 4, df = 1, p = 0.04) and substance use (X2 = 4.17, df = 1, p = 0.04). Multivariate GLMs indicated unanticipated increases in the Brief Addiction Monitor SUD risk subscale, (β = 0.69, SE = 0.19, 95% CI 0.32, 1.06) and expected associations for self-regulation (β = 0.75, SE = 0.11, 95% CI 0.53, 0.96), attention control (β = 0.65, SE = 0.19, 95% CI 0.27, 1.03) and worry (β = 0.69, SE = 0.03, 95% CI -0.03, 1.42) controlling for latency, baseline scores and demographics.
CONCLUSIONS: The Unwinding Anxiety® mobile application is a promising, scalable adjunctive anxiety-focused ABI with the potential to enhance protective psychological resources and improve patients’ mental health and substance use outcomes.
Keywords: Anxiety, Substance abuseOBJECTIVES: The objectives of this study were: (1) assess the usability of the Unwinding Anxiety® application, an anxiety treatment-focused, public-facing mobile app, as an adjunctive treatment for A-SUD engaged in care; (2) conduct exploratory analyses of associated changes in A-SUD specific outcomes (e.g., GAD-7, Penn State Worry Questionnaire, Brief Addiction Monitor) in a single-arm trial.
METHODS: We recruited 48 AD-SUD patients engaged in care. Usability was assessed at 2 months via the Systems Usability Scale and the mHealth Satisfaction Questionnaire. Exploratory analyses (i.e., t-tests with effect sizes, McNamar’s chi-squared tests, and stepwise selection of Generalized Linear Models) investigated changes in key outcomes.
RESULTS: Of the 48 participants, 21 completed follow-up assessments (44%) considered acceptable in light of previous digital health research. Usability at 2-months was moderate via the Systems Usability Scale (M=69.5, 12.7) and high via subscales (e.g., positive experiences, negative experiences, life integration) on the mHealth Satisfaction Questionnaire. Exploratory t-tests indicated promising decreases in anxiety (d=1.4, p < 0.001), worry (d=1.07, p=0.0009) and improved emotional regulation (d=1.24, p =0.006) at follow-up. McNamar’s tests revealed reductions in craving (X2 = 4, df = 1, p = 0.04) and substance use (X2 = 4.17, df = 1, p = 0.04). Multivariate GLMs indicated unanticipated increases in the Brief Addiction Monitor SUD risk subscale, (β = 0.69, SE = 0.19, 95% CI 0.32, 1.06) and expected associations for self-regulation (β = 0.75, SE = 0.11, 95% CI 0.53, 0.96), attention control (β = 0.65, SE = 0.19, 95% CI 0.27, 1.03) and worry (β = 0.69, SE = 0.03, 95% CI -0.03, 1.42) controlling for latency, baseline scores and demographics.
CONCLUSIONS: The Unwinding Anxiety® mobile application is a promising, scalable adjunctive anxiety-focused ABI with the potential to enhance protective psychological resources and improve patients’ mental health and substance use outcomes.
Authors:
Author - William Nardi,
Brown University
Co-Author - Shira Dunsiger, PhD,
PhD,
Brown University, School of Public Health
Co-Author - Kate M. Guthrie, PhD, FSBM,
PhD, FSBM,
Miriam Hospital / Brown Medical School
Co-Author - Shufang Sun,
PhD,
Brown University
Co-Author - Alexandra Roy,
Brown University
Chair - Judson Brewer, MD PhD,
MD PhD,
Brown University
F79 - Early Insights from a GLP-1 Focused Care Track within a Virtual Health Program
Poster Number: F79Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Dissemination and Implementation
Background: GLP-1 medications have rapidly changed the obesity treatment landscape. However, innovative solutions could help individuals optimize the benefits of GLP-1 treatment. We evaluated interest in, engagement with, and impact of a GLP-1 focused track for individuals initiating GLP-1 treatment within the context of a virtual health program.
Methods: New and existing program members with elevated BMI (≥ 27), pre-diabetes, hypertension, and/or dyslipidemia, who were initiating a new course of GLP-1 treatment were offered the opportunity to opt in to a GLP-1 Focused Care Track. All members who opted into the GLP-1 Care Track received a 12-week curriculum tailored to GLP-1-specific concerns and access to a dedicated health coach, a dedicated clinical specialist, and an activity coach, followed by usual care. During a different enrollment period, a usual care cohort of members who met the same inclusion criteria received a standard virtual care program with a health coach but no GLP-1 specific content, no involvement from a clinical specialist (except in limited circumstances for members with hypertension), no GLP-1 focused clinical support, and no activity coach. Outcome assessment, which is ongoing, includes self-reported survey data; health/activity data collected from peripheral devices; and passively collected program engagement metrics.
Results: A total of 2,543 members met GLP-1 Care Track eligibility criteria; 1,915 (75.3%) opted into the GLP-1 Care Track and 1,079 usual care members enrolled in the standard care program. Across both groups, members were, on average, 44.5 (SD=10.3) years of age, 70.2% White, 83.0% Female, and had an average baseline BMI of 37.8 (SD=7.4). On average each week over the first five weeks of the program, members in the GLP-1 Care Track logged into the app 29.3% more times, completed 22.6% more weekly lessons, weighed in 9.9% more times, sent 54.0% more messages to their care teams, and lost 24.2% more weight compared with members in the usual care cohort (all p<0.001), who had also initiated GLP-1 treatment.
Conclusion: Preliminary findings suggest individuals are interested in GLP-1 focused virtual companion programs and that engaging with these tailored programs may support greater weight loss compared with standard virtual care programs. These programs provide health behavior focused strategies that may improve mental and physical outcomes in this rapidly growing population.
Keywords: Obesity, TechnologyMethods: New and existing program members with elevated BMI (≥ 27), pre-diabetes, hypertension, and/or dyslipidemia, who were initiating a new course of GLP-1 treatment were offered the opportunity to opt in to a GLP-1 Focused Care Track. All members who opted into the GLP-1 Care Track received a 12-week curriculum tailored to GLP-1-specific concerns and access to a dedicated health coach, a dedicated clinical specialist, and an activity coach, followed by usual care. During a different enrollment period, a usual care cohort of members who met the same inclusion criteria received a standard virtual care program with a health coach but no GLP-1 specific content, no involvement from a clinical specialist (except in limited circumstances for members with hypertension), no GLP-1 focused clinical support, and no activity coach. Outcome assessment, which is ongoing, includes self-reported survey data; health/activity data collected from peripheral devices; and passively collected program engagement metrics.
Results: A total of 2,543 members met GLP-1 Care Track eligibility criteria; 1,915 (75.3%) opted into the GLP-1 Care Track and 1,079 usual care members enrolled in the standard care program. Across both groups, members were, on average, 44.5 (SD=10.3) years of age, 70.2% White, 83.0% Female, and had an average baseline BMI of 37.8 (SD=7.4). On average each week over the first five weeks of the program, members in the GLP-1 Care Track logged into the app 29.3% more times, completed 22.6% more weekly lessons, weighed in 9.9% more times, sent 54.0% more messages to their care teams, and lost 24.2% more weight compared with members in the usual care cohort (all p<0.001), who had also initiated GLP-1 treatment.
Conclusion: Preliminary findings suggest individuals are interested in GLP-1 focused virtual companion programs and that engaging with these tailored programs may support greater weight loss compared with standard virtual care programs. These programs provide health behavior focused strategies that may improve mental and physical outcomes in this rapidly growing population.
Authors:
Author - Sean R. Zion,
PhD,
Omada Health
Presenter - Susan M. Devaraj,
PhD, MS, RD,
Omada Health
Co-Author - Sarah Linke,
PhD, MPH,
Omada Health
F81 - Designing Digital Mental Health Tools to Support the Needs of Black Adults in the United States: A Human-Centered Design Study
Poster Number: F81Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Health of Marginalized Populations
Designing Digital Mental Health Tools to Support the Needs of Black Adults in the United States: A Human-Centered Design Study
Background: Black individuals in the United States face unique mental health stressors and barriers to treatment. To understand how to support the mental health needs of this population, we recruited Black adults with experiences of depression or anxiety to share their ideas and preferences for digital mental health interventions (DMHIs), and to provide feedback on an automated text messaging program for mental health self-management, Small Steps SMS.
Methods: Participants were recruited through social media (Instagram, Facebook) and online mental health self-screeners hosted by Mental Health America, a nonprofit advocacy organization. Individuals were eligible if they identified as Black or African American, resided in the United States, had a smartphone, and had experiences of depression or anxiety. Participants (N=25) responded to prompts and engaged collaboratively in an asynchronous online discussion group and, in parallel, used the texting program for 18 days. A subset completed follow-up interviews to elaborate on their responses. Discussion group and interview transcripts were subject to thematic analysis to identify major themes related to participants' mental health needs, views of Small Steps SMS, and ideas for design of DMHIs for Black adults.
Results: Participants described that racial discrimination has a profound impact on their mental health; however, opportunities to discuss experiences were perceived to be limited. Participants anticipated and perceived judgment from non-Black and Black individuals alike when sharing their mental health experiences. They thought that DMHIs should create safe environments for mental health disclosure and processing racial discrimination without invalidation. They perceived automated text messaging to provide low-burden and non-stigmatizing mental health support but endorsed further integration of professional- and user-generated content that addresses the experiences of Black individuals, social features to connect users with shared backgrounds, and access to on-demand formal treatment resources.
Conclusions: Black adults face unique mental health challenges related to racial discrimination. DMHIs can help address these challenges by providing Black adults with a safe environment to share their experiences, as well as introducing skills for mental health self-management.
Keywords: Depression, RaceBackground: Black individuals in the United States face unique mental health stressors and barriers to treatment. To understand how to support the mental health needs of this population, we recruited Black adults with experiences of depression or anxiety to share their ideas and preferences for digital mental health interventions (DMHIs), and to provide feedback on an automated text messaging program for mental health self-management, Small Steps SMS.
Methods: Participants were recruited through social media (Instagram, Facebook) and online mental health self-screeners hosted by Mental Health America, a nonprofit advocacy organization. Individuals were eligible if they identified as Black or African American, resided in the United States, had a smartphone, and had experiences of depression or anxiety. Participants (N=25) responded to prompts and engaged collaboratively in an asynchronous online discussion group and, in parallel, used the texting program for 18 days. A subset completed follow-up interviews to elaborate on their responses. Discussion group and interview transcripts were subject to thematic analysis to identify major themes related to participants' mental health needs, views of Small Steps SMS, and ideas for design of DMHIs for Black adults.
Results: Participants described that racial discrimination has a profound impact on their mental health; however, opportunities to discuss experiences were perceived to be limited. Participants anticipated and perceived judgment from non-Black and Black individuals alike when sharing their mental health experiences. They thought that DMHIs should create safe environments for mental health disclosure and processing racial discrimination without invalidation. They perceived automated text messaging to provide low-burden and non-stigmatizing mental health support but endorsed further integration of professional- and user-generated content that addresses the experiences of Black individuals, social features to connect users with shared backgrounds, and access to on-demand formal treatment resources.
Conclusions: Black adults face unique mental health challenges related to racial discrimination. DMHIs can help address these challenges by providing Black adults with a safe environment to share their experiences, as well as introducing skills for mental health self-management.
Authors:
Presenter - Rachel Kornfield,
PhD,
Northwestern University
Co-Author - Sarah Popowski,
Northwestern University
Co-Author - Olivia Allen,
Northwestern University
Co-Author - Theresa Nguyen,
Mental Health America
Co-Author - Madhu Reddy,
PhD, MS,
Northwestern University
Co-Author - Terika McCall,
Yale University
Co-Author - Aderonke Pederson,
Harvard University
Co-Author - David Mohr,
Northwestern University
Co-Author - Jonah Meyerhoff,
Northwestern University
F82 - Clinical outcomes of a digital musculoskeletal women’s pelvic health program: an observational, longitudinal study with comparison group
Poster Number: F82Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Women's Health
Background: Chronic pelvic pain is a common yet undertreated condition that significantly impacts quality of life for women worldwide. Digital exercise therapy designed to target pelvic pain can improve symptomology while reducing time and cost-related barriers to in-person clinical care.
Methods: This longitudinal, observational study of a digital women’s pelvic health program examined pelvic pain, anxiety, and depression at 4 and 12 weeks. Intervention participants received a digital pelvic health program including exercise therapy sessions, health education, and coaching. A comparison group of nonparticipants received a series of education articles related to pelvic health. Data were collected at baseline, 4 and 12 weeks. Unadjusted and adjusted linear mixed effects models were conducted to model changes in clinical outcomes over time.
Results: A total of 797 participants (intervention: 495, nonparticipants: 302) were included in the sample. Baseline mean (SD) age was 41.5 (11.7) years and mean pain was 45.7 (18.5) out of 100. Compared to baseline, the intervention group showed significantly more pain improvement at 4 and 12 weeks versus nonparticipants after adjusting for baseline factors. The intervention group’s pain scores decreased by 44.5% at 4 weeks and 53.6% at 12 weeks. The intervention group’s adjusted pain scores decreased from 42.0 (95% CI: [39.4, 44.7]) at baseline to 23.3 (95% CI: [20.5, 26.2]) at 4 weeks to 19.5 (95% CI: [16.7, 22.4]) at 12 weeks. In contrast, nonparticipants’ pain scores decreased by 21.6% at 4 weeks and 32.7% at 12 weeks. Nonparticipants’ adjusted pain scores decreased from 42.1 (95% CI: [38.4, 45.9]) at baseline to 33.0 (95% CI: [29.2, 36.8]) at 4 weeks to 28.3 (95% CI: [24.5, 32.2]) at 12 weeks. After adjustments, the probability of the intervention group screening for moderate or severe depression was significantly lower by 11.0% at 12 weeks versus nonparticipants.
Conclusions: A digital women’s pelvic health program may help reduce short-term pelvic pain and depression symptoms.
Keywords: Women's health, PainMethods: This longitudinal, observational study of a digital women’s pelvic health program examined pelvic pain, anxiety, and depression at 4 and 12 weeks. Intervention participants received a digital pelvic health program including exercise therapy sessions, health education, and coaching. A comparison group of nonparticipants received a series of education articles related to pelvic health. Data were collected at baseline, 4 and 12 weeks. Unadjusted and adjusted linear mixed effects models were conducted to model changes in clinical outcomes over time.
Results: A total of 797 participants (intervention: 495, nonparticipants: 302) were included in the sample. Baseline mean (SD) age was 41.5 (11.7) years and mean pain was 45.7 (18.5) out of 100. Compared to baseline, the intervention group showed significantly more pain improvement at 4 and 12 weeks versus nonparticipants after adjusting for baseline factors. The intervention group’s pain scores decreased by 44.5% at 4 weeks and 53.6% at 12 weeks. The intervention group’s adjusted pain scores decreased from 42.0 (95% CI: [39.4, 44.7]) at baseline to 23.3 (95% CI: [20.5, 26.2]) at 4 weeks to 19.5 (95% CI: [16.7, 22.4]) at 12 weeks. In contrast, nonparticipants’ pain scores decreased by 21.6% at 4 weeks and 32.7% at 12 weeks. Nonparticipants’ adjusted pain scores decreased from 42.1 (95% CI: [38.4, 45.9]) at baseline to 33.0 (95% CI: [29.2, 36.8]) at 4 weeks to 28.3 (95% CI: [24.5, 32.2]) at 12 weeks. After adjustments, the probability of the intervention group screening for moderate or severe depression was significantly lower by 11.0% at 12 weeks versus nonparticipants.
Conclusions: A digital women’s pelvic health program may help reduce short-term pelvic pain and depression symptoms.
Authors:
Author - Rachel Foster,
Hinge Health
Presenter - Cynthia Castro Sweet,
Hinge Health
F83 - A Qualitative Study Examining Engagement in Mobile Health Interventions in Black College Students Who Engage in Risky Drinking
Poster Number: F83Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Substance Misuse
Black emerging adult college students (ages 18 to 25 years) experience more negative alcohol related consequences despite consuming alcohol less than their White peers (Zapolski et al., 2014), and Black college men are at particularly high risk (Zapolski et al., 2014). Mindfulness has been shown to alleviate stress, and alcohol use induced by stress (Kamboj et al., 2017), and there is a need for novel theory-driven and culturally tailored approaches to increase mindfulness uptake among higher risk groups including Black college students. This qualitative study reports themes found on ways to make mindfulness mHealth more attractive to Black emerging adult college students who engage in risky alcohol use. Black participants needed to meet criteria for binge or heavy drinking and were recruited at predominantly white institutions using flyers, mass emails, and undergraduate subject pools. Eleven Black college students aged 18 and over who endorsed binge or heavy drinking were interviewed via Zoom. Consensual qualitative research was used to analyze the data. We found eight qualitative themes: (1) Knowledge of Mindfulness, (2) Benefits of Mindfulness, (3) Barriers to Mindfulness, (4) Benefits of Mindfulness, (5) Benefits of Apps, (6) Barriers to Using App, (7) Culturally Tailored Interventions, (8) Engagement in App, and (9) Engagement in Mindfulness. These themes are being used to inform the culturally tailoring of a mindfulness mHealth application for Black college students who engage in risky alcohol use. Limitations and implications for intervention development will be discussed.
Keywords: Alcohol, Mobile phoneAuthors:
Author - Laura Marks, PhD,
PhD,
Florida State University
F84 - Implementation Determinants and Strategies of Supplemental Nutrition Assistance Program – Education (SNAP–Ed) Adoption with Healthcare Partners: A Nationwide Mixed-Methods Study
Poster Number: F84Time: 11:00 AM - 11:50 AM
Topics: Dissemination and Implementation, Diet, Nutrition, and Eating Disorders
Background: SNAP-Ed is a federal nutrition education program administered by the United States Department of Agriculture (USDA). SNAP-Ed implements evidence-based education and policy, systems, and environmental change (PSE) strategies to promote healthy living in a variety of community settings. SNAP-Ed has been increasing the implementation of programming with healthcare partners following the adoption of food insecurity and nutrition risk screenings within the healthcare system. However, barriers to effective implementation of SNAP-Ed programming with healthcare partners remain. Leveraging implementation science methods can support adoption of high-impact implementation strategies.
Methods: We used a mixed-methods explanatory sequential design to understand implementation strategies and determinants, including barriers to delivery and uptake, of SNAP-Ed programming with healthcare partners. Our nationwide survey of SNAP-Ed professionals (n=51) was followed by semi-structured virtual interviews (July 2023-June 2024) with survey respondents. The survey was used to characterize the types and the target populations of SNAP-Ed programs implemented. Interview questions were based on the Consolidated Framework for Implementation Research 2.0 which outlines determinants of implementation outcomes in five domains. We summarized survey responses descriptively, and thematically analyzed interview transcripts using a deductive/inductive hybrid approach.
Results: A sample of SNAP-Ed professionals representing all USDA regions participated in interviews (n=23). Participants most commonly partnered with outpatient clinics to deliver both education and PSE strategies. Barriers to implementation included: USDA-mandated SNAP-Ed policies around program delivery and incentives, healthcare partner staffing constraints and high turnover, and a lack of healthcare partner familiarity with SNAP-Ed. Implementation strategies that most commonly emerged in interviews were conducting educational outreach visits to familiarize clinicians with SNAP-Ed, accessing external funding to support education incentives and PSE strategies, and identifying healthcare system-based champions.
Conclusions: Implementation strategies that facilitated the adoption of SNAP-Ed seem to address many of the barriers identified and may be the key to optimizing SNAP-Ed clinical-community partnerships. Future research should compare the effectiveness of implementation strategies across healthcare settings.
Keywords: Dissemination, NutritionMethods: We used a mixed-methods explanatory sequential design to understand implementation strategies and determinants, including barriers to delivery and uptake, of SNAP-Ed programming with healthcare partners. Our nationwide survey of SNAP-Ed professionals (n=51) was followed by semi-structured virtual interviews (July 2023-June 2024) with survey respondents. The survey was used to characterize the types and the target populations of SNAP-Ed programs implemented. Interview questions were based on the Consolidated Framework for Implementation Research 2.0 which outlines determinants of implementation outcomes in five domains. We summarized survey responses descriptively, and thematically analyzed interview transcripts using a deductive/inductive hybrid approach.
Results: A sample of SNAP-Ed professionals representing all USDA regions participated in interviews (n=23). Participants most commonly partnered with outpatient clinics to deliver both education and PSE strategies. Barriers to implementation included: USDA-mandated SNAP-Ed policies around program delivery and incentives, healthcare partner staffing constraints and high turnover, and a lack of healthcare partner familiarity with SNAP-Ed. Implementation strategies that most commonly emerged in interviews were conducting educational outreach visits to familiarize clinicians with SNAP-Ed, accessing external funding to support education incentives and PSE strategies, and identifying healthcare system-based champions.
Conclusions: Implementation strategies that facilitated the adoption of SNAP-Ed seem to address many of the barriers identified and may be the key to optimizing SNAP-Ed clinical-community partnerships. Future research should compare the effectiveness of implementation strategies across healthcare settings.
Authors:
Author - Nick Hamdi,
MS, RD, LDN,
Johnson & Wales University
Co-Author - Jennifer McCaffrey,
PhD, MPH, RD,
University of Illinois at Urbana-Champaign
Co-Author - Sarah Amin,
PhD, MPH,
University of Rhode Island
F85 - Exploring the Scalability and Potential for Implementation of IDEAS for Hope, a Telehealth-Delivered Counseling Intervention for Suicide Prevention Among People Living with HIV in Kilimanjaro, Tanzania.
Poster Number: F85Time: 11:00 AM - 11:50 AM
Topics: Dissemination and Implementation, Mental Health
Background
Despite the life-saving potential of mental health interventions, their scalability and integration within healthcare systems present significant challenges, particularly in low-resource global settings. In this study, we investigated the potential to scale and integrate IDEAS for Hope, a brief telehealth counseling intervention designed to reduce suicidality and improve HIV care engagement among people living with HIV (PLWH) in Kilimanjaro, Tanzania. By examining the complex interplay of barriers and facilitators, our objective was to conduct qualitative interviews focused on identifying actionable strategies for successful national implementation.
Methods
We used purposive sampling to recruit participants from key stakeholder groups, including healthcare administrators, network and internet providers, representatives from the Ministry of Health, and community organizations. We conducted semi-structured in-depth interviews using a guide informed by the Consolidated Framework for Implementation Research (CFIR). Interviews were audio-recorded, and transcripts were coded in a team-based approach to identify barriers and facilitators to implementation of the IDEAS for Hope intervention. The CFIR – Expert Recommendations for Implementing Change (ERIC) mapping approach will be used to interpret the data and to identify targeted implementation strategies.
Results
Despite strong institutional support and emerging policy guidelines aimed at integrating mental health with HIV care, significant barriers persist. These include a shortage of trained mental health professionals, limited technological access in rural areas, the criminalization of suicide, and deeply entrenched stigma. Stakeholders recommended training peer counselors, enacting urgent policy reforms, introducing mental health programs in universities and colleges, addressing stigma, and developing inclusive technological platforms to enhance the reach and effectiveness of the intervention.
Conclusion
The IDEAS for Hope intervention is both feasible and effective in reducing suicidality and improving HIV care engagement among PLWH in Tanzania. Our research reveals that the successful implementation of mental health interventions in Tanzania requires addressing systemic, legal, cultural, and infrastructural barriers. By identifying and addressing these key challenges, the research provides a practical roadmap for implementing similar interventions in other low-resource settings.
Keywords: Research to practice translation, Mental healthDespite the life-saving potential of mental health interventions, their scalability and integration within healthcare systems present significant challenges, particularly in low-resource global settings. In this study, we investigated the potential to scale and integrate IDEAS for Hope, a brief telehealth counseling intervention designed to reduce suicidality and improve HIV care engagement among people living with HIV (PLWH) in Kilimanjaro, Tanzania. By examining the complex interplay of barriers and facilitators, our objective was to conduct qualitative interviews focused on identifying actionable strategies for successful national implementation.
Methods
We used purposive sampling to recruit participants from key stakeholder groups, including healthcare administrators, network and internet providers, representatives from the Ministry of Health, and community organizations. We conducted semi-structured in-depth interviews using a guide informed by the Consolidated Framework for Implementation Research (CFIR). Interviews were audio-recorded, and transcripts were coded in a team-based approach to identify barriers and facilitators to implementation of the IDEAS for Hope intervention. The CFIR – Expert Recommendations for Implementing Change (ERIC) mapping approach will be used to interpret the data and to identify targeted implementation strategies.
Results
Despite strong institutional support and emerging policy guidelines aimed at integrating mental health with HIV care, significant barriers persist. These include a shortage of trained mental health professionals, limited technological access in rural areas, the criminalization of suicide, and deeply entrenched stigma. Stakeholders recommended training peer counselors, enacting urgent policy reforms, introducing mental health programs in universities and colleges, addressing stigma, and developing inclusive technological platforms to enhance the reach and effectiveness of the intervention.
Conclusion
The IDEAS for Hope intervention is both feasible and effective in reducing suicidality and improving HIV care engagement among PLWH in Tanzania. Our research reveals that the successful implementation of mental health interventions in Tanzania requires addressing systemic, legal, cultural, and infrastructural barriers. By identifying and addressing these key challenges, the research provides a practical roadmap for implementing similar interventions in other low-resource settings.
Authors:
Author - Paul Ngangula,
MS,
Duke Global Health Institute
Co-Author - Louise Joel,
Kilimanjaro Christian Medical Center
Co-Author - Jackline Rwakilomba,
Kilimanjaro Christian Medical Center
Co-Author - Ryan Parker,
MS,
Duke Global Health Institute
Co-Author - Kim Madundo,
Kilimanjaro Christian Medical Center
Co-Author - Ismail Amiri,
MS,
Duke Global Health Institute
Co-Author - Brandon A. Knettel,
Ph.D.,
Duke Global Health Institute
F86 - Multi-methods assessment of technical assistance on evaluation and dissemination for community-based organizations
Poster Number: F86Time: 11:00 AM - 11:50 AM
Topics: Dissemination and Implementation, Diet, Nutrition, and Eating Disorders
Long-term sustainment of evidence-based programs is critical for improved health outcomes. However, achieving sustainability can be challenging in community-based organizations (CBOs) due to limited funding, staff, and evaluation expertise. Expanding capacity through technical assistance (TA) on robust program evaluation and dissemination practices can equip CBOs to build support receive funding, leading to improved sustainment. This study assessed the effectiveness and implementation of TA for evaluation and dissemination provided from June 2023-July 2024to food access CBOs receiving grants from UnitedHealthcare. The effectiveness of individualized monthly TA meetings were qualitatively evaluated through post-TA interviews. The interview guide, based on the National Commission for Health Education Credentialing evaluation and dissemination-related competencies and the Consolidated Framework for Implementation Research (CFIR), included questions on changes in evaluation and dissemination practices, organizational barriers and facilitators, and likelihood of program sustainment. TA implementation was evaluated through qualitative analysis by coding meeting notes according to the topics addressed: evaluation plan, evaluation measures, dissemination plan, and dissemination channels. A total of 41 individualized TA meetings were provided. Among the five interviewees, grantees mentioned that TA led to changes to evaluation practices including developing an evaluation plan, refining cost effectiveness analysis, fine-tuning surveys, and expanding data collection to include qualitative measures. There were fewer changes to dissemination practices, including expanding information in funder reports, adding one-pagers for referral partners, and creating internal quarterly reports. Interviewees expressed interest in sustaining programs, although funding was oftentimes a limiting factor. TA topics discussed included evaluation measures (n=16 mentions), evaluation planning (n=13), other content areas (n=10), dissemination planning (n=3), and dissemination strategies (n=3). Findings illustrate that TA can positively impact grantees’ practices, especially on program evaluation. Future work is needed to determine whether evaluation TA leads to long-term program sustainment. Overall, the partnership between the funder, TA providers, and grantees preliminarily shows the benefit of TA to support robust program evaluation as a benefit to both funders and CBOs.
Keywords: Effectiveness, DisseminationAuthors:
Presenter - Laura Balis, PhD,
Center for Nutrition & Health Impact
Co-Author - Shelly Palmer,
MS, RDN,
Center for Nutrition & Health Impact
Co-Author - Emily Shaw,
MPH,
Center for Nutrition & Health Impact
Co-Author - Amy Yaroch,
PhD,
Center for Nutrition & Health Impact
F87 - Using Youth Participatory Action Research to Investigate Reactions to Organ Donation Storylines on YouTube
Poster Number: F87Time: 11:00 AM - 11:50 AM
Topics: Community Engagement, Digital Health
Background: Over 100,000 people in the US are waiting for an organ transplant. While 95% of Americans support organ donation only 58% are registered donors. This gap is likely due to misconceptions—such as fears that being a donor may negatively impact care. Survey research has found that medical TV shows can influence viewer perceptions of organ donation, but research has yet to examine this in the context of TV clips being shared on social media. Because youth are presented with the choice to become organ donors when they receive a driver’s license and are heavy social media consumers, this is a vital population to engage in research about this topic. We used a youth participatory action research (YPAR) approach to analyze discussions about organ donation videos from medical dramas on YouTube.
Methods: Two high school students participating in the University of Pittsburgh’s Public Health Science Academy (PHSA) surveyed PHSA participants as to their favorite medical TV shows. The students searched YouTube with the shows mentioned in the survey alongside the term “organ donation” and identified nine organ donation YouTube videos from three medical dramas (Chicago Med, The Good Doctor, House M.D.). We extracted all comments and replies from the videos and developed a codebook using a grounded theory approach. Comments were sorted by the number of likes; the codebook was used to conduct a qualitative content analysis of the top 20 relevant comments and associated replies for each video.
Results: After three rounds of double-coding 50 comments/replies (hereafter referred to as comments) Cohen’s k>0.7 for all coding categories; the remaining were single-coded. Of 1,273 comments, 20% (n=1250) were relevant to organ donation. Of these, 24% (n=59) provided information about organ donation; sometimes this information was incorrect. Approximately 15% (n=38) indicated disapproval of the TV physician’s behavior. Other themes included personal anecdotes (10%, n=25) and questioning legality (10%, n=25) of the TV physician’s behavior.
Discussion: The use of YPAR to examine YouTube comments related to organ donation storylines on TV is feasible and may offer a unique avenue through which to understand the information that potential organ donors are exposed to in the media. Future research could use a YPAR approach to develop interventions that bridge perspectives between researchers and youth to help address the shortage of registered organ donors in the US.
Keywords: Organ transplant, Decision makingMethods: Two high school students participating in the University of Pittsburgh’s Public Health Science Academy (PHSA) surveyed PHSA participants as to their favorite medical TV shows. The students searched YouTube with the shows mentioned in the survey alongside the term “organ donation” and identified nine organ donation YouTube videos from three medical dramas (Chicago Med, The Good Doctor, House M.D.). We extracted all comments and replies from the videos and developed a codebook using a grounded theory approach. Comments were sorted by the number of likes; the codebook was used to conduct a qualitative content analysis of the top 20 relevant comments and associated replies for each video.
Results: After three rounds of double-coding 50 comments/replies (hereafter referred to as comments) Cohen’s k>0.7 for all coding categories; the remaining were single-coded. Of 1,273 comments, 20% (n=1250) were relevant to organ donation. Of these, 24% (n=59) provided information about organ donation; sometimes this information was incorrect. Approximately 15% (n=38) indicated disapproval of the TV physician’s behavior. Other themes included personal anecdotes (10%, n=25) and questioning legality (10%, n=25) of the TV physician’s behavior.
Discussion: The use of YPAR to examine YouTube comments related to organ donation storylines on TV is feasible and may offer a unique avenue through which to understand the information that potential organ donors are exposed to in the media. Future research could use a YPAR approach to develop interventions that bridge perspectives between researchers and youth to help address the shortage of registered organ donors in the US.
Authors:
Presenter - Oreoluwa Fawole,
University of Pittsburgh
Author - Tyler Feth,
Pittsburgh Science and Technical Academy
Author - Andrew Elinoff,
Pittsburgh Science and Technical Academy
Author - Kenna Campbell,
University of Pittsburgh School of Public Health
Author - Piper Narendorf,
University of Pittsburgh
Author - Amanda Lucas,
University of Pittsburgh School of Public Health
Author - Beth L Hoffman,
PhD, MPH,
University of Pittsburgh School of Public Health
F88 - Understanding Motivations for African American Participation in Genetic Research as a Catalyst for Reducing Health Disparities
Poster Number: F88Time: 11:00 AM - 11:50 AM
Topics: Decision Making, Health of Marginalized Populations
Background: Pharmacogenomics (PGX) is an area of precision medicine that examines the impact of genetics on drug response. People of African Ancestry (African Americans) continue to be underrepresented in PGX research, potentially increasing health disparities in the United States. This under-representation prevents the translation of research to individualized treatment options for African Americans. Existing research exploring African American’s attitudes toward genetic research participation mostly focuses on why they decline. Few studies have explored favorable attitudes toward participation, and most have been hypothetical. This study reports factors influencing African American’s decisions to participate in a PGX study. By understanding these factors, results from this study may inform strategies to enhance recruitment and inclusivity in PGX studies.
Methods: Interviews were conducted with African Americans who participated in a PGX study. Eligibility criteria included: 1) self-described African American, 2) 18 years or older, 3) English-speaking, 4) taking Warfarin or Clopidogrel, and 5) agreed to be interviewed. A semi-structured interview guided by the Integrative Model of Behavioral Prediction (IMBP) explicated behavioral, normative, and efficacy beliefs motivating participation decisions. All interviews were recorded, transcribed, and analyzed by two study team members using deductive thematic analysis.
Results: Participants (N=19) were on average 60 (SD=12) years old, female (n=11; 58%), and had completed some college (n=7; ~36%). Common reasons for participating included believing the study posed little harm, wanting to help advance science and address health disparities, and benefiting their community. Participants recognized other African Americans may be weary of participating, but believed their participation was important. All participants explained the decision to participate was theirs and not influenced by their community.
Conclusion: Favorable risk-benefit analyses and wanting to advance science beneficial to their community were important motivators for participation in this PGX study, and may be good targets for recruitment messaging. Interestingly, normative beliefs may not be as influential in participation decisions as posited by the IMBP. Identifying the relative influence of individual and community-level factors on participation decisions can ensure that communication and recruitment efforts represent African American values.
Keywords: Minority health, GeneticsMethods: Interviews were conducted with African Americans who participated in a PGX study. Eligibility criteria included: 1) self-described African American, 2) 18 years or older, 3) English-speaking, 4) taking Warfarin or Clopidogrel, and 5) agreed to be interviewed. A semi-structured interview guided by the Integrative Model of Behavioral Prediction (IMBP) explicated behavioral, normative, and efficacy beliefs motivating participation decisions. All interviews were recorded, transcribed, and analyzed by two study team members using deductive thematic analysis.
Results: Participants (N=19) were on average 60 (SD=12) years old, female (n=11; 58%), and had completed some college (n=7; ~36%). Common reasons for participating included believing the study posed little harm, wanting to help advance science and address health disparities, and benefiting their community. Participants recognized other African Americans may be weary of participating, but believed their participation was important. All participants explained the decision to participate was theirs and not influenced by their community.
Conclusion: Favorable risk-benefit analyses and wanting to advance science beneficial to their community were important motivators for participation in this PGX study, and may be good targets for recruitment messaging. Interestingly, normative beliefs may not be as influential in participation decisions as posited by the IMBP. Identifying the relative influence of individual and community-level factors on participation decisions can ensure that communication and recruitment efforts represent African American values.
Authors:
Presenter - Savanna Kerstiens, MA,
MA,
Northwestern University
Author - Courtney Lynam Scherr, PhD, FSBM,
PhD, FSBM,
Northwestern University
Author - Sanjana Ramesh, MPH,
MPH,
Northwestern University
Author - Hoda Fakhari,
Northwestern University
Author - Matthew Tuck,
MD, MEd, FACP,
Washington DC Veterans Affairs Medical Center
Author - Minoli Perera,
PharmD, PhD,
Northwestern University, Feinberg School of Medicine
F89 - Bridging gaps: The impact of health literacy and social support on Hispanic CKD outcomes
Poster Number: F89Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Aging
Background:
The prevalence of chronic kidney disease (CKD) continues to rise within the US Hispanic population. Limited health literacy (HL) affects a substantial portion of CKD patients, as it impedes disease self-management and health-related outcomes. Moreover, a supportive social network improves emotional adjustment to CKD, adherence to treatment regimens, and survival rates. The present study aims to assess the role of social support and HL on the mortality rates of Hispanic CKD patients, who may be particularly vulnerable to health literacy challenges, but have a stronger social network.
Methods:
The Hispanic sub-cohort of the national, multicenter, Chronic Renal Insufficiency (H-CRIC) study was utilized for analysis. Variables included: the overall support index of the Medical Outcomes Study (MOS) social support survey; Short Test of Functional Health Literacy in Adults (STOFHLA); and mortality status. Marital status was also considered.
Results:
A total of 327 individuals were enrolled in the H-CRIC study, only 224 completed all measures. Of those, 74 participants died during the study period. Cox regression models revealed HL was predictive of death (HR = .978, p<.05), and lower HL was associated with earlier mortality. Patients with HL scores 1 SD below the mean had an estimated mortality rate of 25.9% higher than average. In additional models including social support variables, unmarried status was also associated with increased risk of death (HR = .548, p<.05). Unmarried patients have an estimated mortality 47% higher than married participants. When controlling for other mortality risk factors, older age (p=<0.05), having diabetes (p= <.001), having CVD (p=<.05), and lower eGFR (p=<.05) and marital status (p < .05) were predictive of increased mortality risk, and while HL became insignificant (p= .173).
Conclusion:
Clinical implications of these findings emphasize the need for regular assessment and monitoring of HL and social support in Hispanic patients with CKD. In Hispanic populations with stronger social networks, the impact of SS may be more pronounced, potentially mitigating the negative effects of low HL. Culturally tailored interventions could bridge the gaps in literacy levels and social support within this population to improve outcomes.
Keywords: Renal/urologic disorders, HispanicThe prevalence of chronic kidney disease (CKD) continues to rise within the US Hispanic population. Limited health literacy (HL) affects a substantial portion of CKD patients, as it impedes disease self-management and health-related outcomes. Moreover, a supportive social network improves emotional adjustment to CKD, adherence to treatment regimens, and survival rates. The present study aims to assess the role of social support and HL on the mortality rates of Hispanic CKD patients, who may be particularly vulnerable to health literacy challenges, but have a stronger social network.
Methods:
The Hispanic sub-cohort of the national, multicenter, Chronic Renal Insufficiency (H-CRIC) study was utilized for analysis. Variables included: the overall support index of the Medical Outcomes Study (MOS) social support survey; Short Test of Functional Health Literacy in Adults (STOFHLA); and mortality status. Marital status was also considered.
Results:
A total of 327 individuals were enrolled in the H-CRIC study, only 224 completed all measures. Of those, 74 participants died during the study period. Cox regression models revealed HL was predictive of death (HR = .978, p<.05), and lower HL was associated with earlier mortality. Patients with HL scores 1 SD below the mean had an estimated mortality rate of 25.9% higher than average. In additional models including social support variables, unmarried status was also associated with increased risk of death (HR = .548, p<.05). Unmarried patients have an estimated mortality 47% higher than married participants. When controlling for other mortality risk factors, older age (p=<0.05), having diabetes (p= <.001), having CVD (p=<.05), and lower eGFR (p=<.05) and marital status (p < .05) were predictive of increased mortality risk, and while HL became insignificant (p= .173).
Conclusion:
Clinical implications of these findings emphasize the need for regular assessment and monitoring of HL and social support in Hispanic patients with CKD. In Hispanic populations with stronger social networks, the impact of SS may be more pronounced, potentially mitigating the negative effects of low HL. Culturally tailored interventions could bridge the gaps in literacy levels and social support within this population to improve outcomes.
Authors:
Presenter - Taylor L. Stallings, MS,
MS,
East Carolina University
Co-Author - Alan J. Christensen, PhD, FSBM,
PhD, FSBM,
East Carolina University
Co-Author - Matthew C. Whited, PhD, FSBM,
PhD, FSBM,
East Carolina University
F90 - Developing state-level policy indices to explore social safety and threats among sexual and gender minority youth across the United States
Poster Number: F90Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Health Communication and Policy
Background: Over the past decade, and especially the past few years, there has been an increase in state policies focused on sexual and gender minority (SGM) youth in the US. Discriminatory policies (e.g., school curricula exclusions, gender-affirming care bans) create social threats, while protective policies (e.g., nondiscrimination laws, conversion therapy bans) can contribute to social safety for SGM youth. To examine how policies impact the health of SGM youth, rigorous legal epidemiological methods are needed to establish and aggregate the state-level SGM policies that may be beneficial or detrimental to SGM youth’s health.
Methods: Using legal data from the Movement Advancement Project and SIECUS from 2019, we created two policy indices focused on six protective and three discriminatory policies that are likely to influence the health of SGM youth (ages 16-24). Protective policies included conversion therapy bans, gender-affirming care insurance coverage, anti-bullying and nondiscrimination policies in schools, SGM inclusion in school and sexual education curricula, and nondiscrimination policies in housing, employment, and public accommodations. Discriminatory policies included religious exemption laws, exclusion of gender-affirming care Medicaid coverage, and SGM discrimination in sexual education curricula. We assigned a +1 for each policy in effect in 2019, leading to a score of 0-6 for the protective index and 0-3 for the discriminatory index.
Results: We used maps to highlight the distribution of each policy and index. California, New Jersey, and Oregon had all six protective policies in 2019, and Texas and Arizona had all three discriminatory policies. Sixteen states had zero protective or discriminatory policies. The most common protective policy was anti-bulling and nondiscrimination policies in schools (n=30 states) and the most common discriminatory policy was religious exemption laws (n=31 states). Sexual education policies were the least common protective (n=4 states) and discriminatory (n=7 states) policies.
Conclusions: Creating state-level policy datasets for SGM youth is crucial for understanding the broader social environment. While linking individual policies to health outcomes can be complex, these indices offer a more comprehensive view of social safety and assess relations with health inequities. Continued research on the impact of SGM policies is vital for advancing public health and ensuring better outcomes for SGM youth.
Keywords: Sexual orientation, PolicyMethods: Using legal data from the Movement Advancement Project and SIECUS from 2019, we created two policy indices focused on six protective and three discriminatory policies that are likely to influence the health of SGM youth (ages 16-24). Protective policies included conversion therapy bans, gender-affirming care insurance coverage, anti-bullying and nondiscrimination policies in schools, SGM inclusion in school and sexual education curricula, and nondiscrimination policies in housing, employment, and public accommodations. Discriminatory policies included religious exemption laws, exclusion of gender-affirming care Medicaid coverage, and SGM discrimination in sexual education curricula. We assigned a +1 for each policy in effect in 2019, leading to a score of 0-6 for the protective index and 0-3 for the discriminatory index.
Results: We used maps to highlight the distribution of each policy and index. California, New Jersey, and Oregon had all six protective policies in 2019, and Texas and Arizona had all three discriminatory policies. Sixteen states had zero protective or discriminatory policies. The most common protective policy was anti-bulling and nondiscrimination policies in schools (n=30 states) and the most common discriminatory policy was religious exemption laws (n=31 states). Sexual education policies were the least common protective (n=4 states) and discriminatory (n=7 states) policies.
Conclusions: Creating state-level policy datasets for SGM youth is crucial for understanding the broader social environment. While linking individual policies to health outcomes can be complex, these indices offer a more comprehensive view of social safety and assess relations with health inequities. Continued research on the impact of SGM policies is vital for advancing public health and ensuring better outcomes for SGM youth.
Authors:
Presenter - Tamar Goldenberg,
PhD, MPH,
University of North Carolina at Greensboro
Co-Author - Azazel X. Hartley,
MPH(c),
University of North Carolina at Greensboro
Co-Author - Kristi E. Gamarel,
PhD,
University of Michigan
Co-Author - Kimberly M. Nelson,
PhD, MPH,
Boston University School of Public Health
F91 - Unfair Racial Treatment in Health Care, Health Care Utilization, and Health Status among Black, Indigenous, Women of Color
Poster Number: F91Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Women's Health
Black, Indigenous, Women of Color (BIWOC) face well-documented health disparities in the United States. However, the extent to which recent experiences of unfair racial treatment in medical settings contribute to health disparities is not well understood. The objective of this study was to examine associations of experiencing unfair racial treatment by a provider during the most recent medical encounter, with health care utilization and health status in BIWOC. We utilized multivariate logistic regression models to examine data from the Association of American Medical Colleges’ biannual Survey of Health Care Access collected between 2012 and 2019. Data were extracted for 5,549 participants who identified both as a woman and a Black, Indigenous, Person of Color to generate our BIWOC sample of interest. Among BIWOC, experiencing unfair racial treatment during their most recent health care visit in the past year was associated with higher odds of delaying health care (OR = 3.50, p < .001) and using the emergency department (ED) as their usual source of care (OR = 1.54, p < .001). Experiencing unfair racial treatment was also associated with having chronic physical conditions (OR = 1.31, p = .002), chronic depression (OR = 1.56, p < .001), and activity limitations due to both emotional (OR = 2.98, p < .001) and physical (OR = 2.47, p < .001) impairment. Recent experience of racial discrimination by a health care provider was associated with lower health care utilization and poorer health status in a national sample of BIWOC. Reducing unfair treatment in health care settings is critical for improving BIWOC health.
Keywords: Women's health, Minority groupsAuthors:
Co-Author - Joyce P. Yang, PhD,
PhD,
University of San Francisco
Co-Author - Vivian B. Hoang,
University of San Francisco, Department of Psychology
Co-Author - Sana Malik,
University of San Francisco, Department of Psychology
Co-Author - Karie Gaska,
Ross University
Co-Author - Quyen Do,
Yale University
Co-Author - Shelby Scott,
UT San Antonio
F92 - A Pilot Study Evaluating a Digital Intervention’s Impact on Gun Violence Attitudes, Aggression, and Mental Health in Young Black Males
Poster Number: F92Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Mental Health
Background: Current rates of firearm-related violence are the highest since the mid-1990s, marking a critical juncture in US public health. Young Black males (YBM), ages 15-24, represent the worst-affected group, at 24 times higher likelihood of firearm-related homicides compared to their white peers. Despite this, targeted and culturally congruent interventions addressing gun violence and associated risk factors among young Black boys and men remain insufficient.
Objective: This pilot study assessed the efficacy of video-based modules within BrotherlyACT, a culturally tailored app, to mitigate firearm injury risks and improve pre-crisis and mental health access for YBM aged 15-24 in low-resource, high-violence areas. Eligible participants were male-identifying, aged 15-24, with a SaFEty score between 1 and 5 (predicting future firearm violence). Participants engaged with seven video-based modules (~35 minutes) over four weeks, deployed via REDCap® and YouTube.
Methods: Participants completed a combined 63-item battery assessing Attitudes Towards Guns and Violence (AGVQ), Reactive-Proactive Aggression (RPQ), Psychological Distress (K10), and Depression (PHQ-8). Surveys were re-administered 4 weeks post-intervention. Outcome measures, reported as total and component subscale scores, were analyzed using paired-samples t-test and Wilcoxon non-parametric signed-rank tests.
Results: 70 YBM enrolled (Mage = 21.21 ± 3.16 years, 10% Hispanic); 26.3% had some high school education. Nearly half (48.6%) worked part-time, with 66.4% reporting an annual household income of $40,000-$59,999. Most participants (96.9%) completed the video modules in a single sitting, with 67.7% finishing within one hour. Significant reductions in attitudes towards guns and violence were observed from the pre-test (M = 29.8) to the post-test (M = 26.1), with a mean difference of 3.69 (p < .0001, d = 0.53). The AGVQ ‘Aggressive Response to Shame’ subscale showed the highest reduction (↓28%), followed by ‘Excitement Towards Guns and Violence’ (↓14.8%). Reactive aggression scores significantly decreased from 10.48 to 8.67 (p = 0.003), while proactive aggression, depression, anxiety, or overall psychological distress scores showed non-significant reductions.
Conclusions: BrotherlyACT effectively reduced negative attitudes towards guns and violence, as well as reactive aggression, among YBM, showing potential for primary prevention of firearm violence in medium to high-risk populations.
Keywords: Adolescents, ViolenceObjective: This pilot study assessed the efficacy of video-based modules within BrotherlyACT, a culturally tailored app, to mitigate firearm injury risks and improve pre-crisis and mental health access for YBM aged 15-24 in low-resource, high-violence areas. Eligible participants were male-identifying, aged 15-24, with a SaFEty score between 1 and 5 (predicting future firearm violence). Participants engaged with seven video-based modules (~35 minutes) over four weeks, deployed via REDCap® and YouTube.
Methods: Participants completed a combined 63-item battery assessing Attitudes Towards Guns and Violence (AGVQ), Reactive-Proactive Aggression (RPQ), Psychological Distress (K10), and Depression (PHQ-8). Surveys were re-administered 4 weeks post-intervention. Outcome measures, reported as total and component subscale scores, were analyzed using paired-samples t-test and Wilcoxon non-parametric signed-rank tests.
Results: 70 YBM enrolled (Mage = 21.21 ± 3.16 years, 10% Hispanic); 26.3% had some high school education. Nearly half (48.6%) worked part-time, with 66.4% reporting an annual household income of $40,000-$59,999. Most participants (96.9%) completed the video modules in a single sitting, with 67.7% finishing within one hour. Significant reductions in attitudes towards guns and violence were observed from the pre-test (M = 29.8) to the post-test (M = 26.1), with a mean difference of 3.69 (p < .0001, d = 0.53). The AGVQ ‘Aggressive Response to Shame’ subscale showed the highest reduction (↓28%), followed by ‘Excitement Towards Guns and Violence’ (↓14.8%). Reactive aggression scores significantly decreased from 10.48 to 8.67 (p = 0.003), while proactive aggression, depression, anxiety, or overall psychological distress scores showed non-significant reductions.
Conclusions: BrotherlyACT effectively reduced negative attitudes towards guns and violence, as well as reactive aggression, among YBM, showing potential for primary prevention of firearm violence in medium to high-risk populations.
Authors:
Author - Chuka Nestor Emezue, PhD, MPH, MPA, CHES,
PhD, MPH, MPA, CHES,
Rush University College of Nursing
F93 - Reflecting patients’ identities yields more engaged clinical communications overall: pilot audit correspondence experiment
Poster Number: F93Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Mental Health
Introduction: Black and Latine transgender and gender-diverse (TGD) communities endure psychiatric morbidity and prejudice. But the discriminatory mechanisms by which mental health professionals (MHPs) may deter treatment among TGD clients of color are under-examined. Leveraging MHP email and voicemail data, elicited in an audit field experiment, we isolated linguistic signatures of subtle discrimination, conditioned on clients’ disclosed racial and TGD identities.
Methods: A U.S.-representative MHP sample received simulated appointment-seeking emails, experimentally varied on disclosed TGD status, symptoms, race, ethnicity, gender. Thematic analysis surfaced “response quality” subthemes, proxying possible subtle discrimination, within MHP replies (n = 755). XGBoost decision trees identified key features. 1-step and bias-adjusted 3-step finite mixture modeling a.) detected latent response-quality classes, b.) modeled subtle discrimination by estimating MHP utterances, client race, ethnicity, and TGD disclosures as covariates of class membership. Python and Stata code is on GitHub.
Results: Five subthemes emerged: Affirm, reinforcing clients’ treatment-seeking; Agent, outsourcing replies; Fit, emphasizing MHP-client rapport (key features: “questions [or] concerns”); Justify, accounting for declining treatment (“[not] currently accepting”); Reflect, echoing client concerns (“sorry [to] hear”). A 2-class solution detected an Engaged (27%) class, emphasizing Affirm, Fit, Reflect (item-level response probability ρ = 0.23, 0.16, 0.40, respectively) and a Detached (73%) class, characterized by Agent, and Justify (ρ = 0.07, 0.06). In the 1-step model, MHP mentions of perceived clients’ TGD-specific concerns were 58% more likely to occur within Engaged-class responses. Subtheme-specific logit models revealed simulated Latina trans women more likely to receive Agent: aOR = 7.39, p = 0.02; average marginal effect (AME) = 0.10; and Justify replies: aOR = 9.32, p < 0.01; AME = 0.14, adjusting for day and week fixed effects, and disclosed symptoms.
Implications: Bridging patient-clinician perspectives in behavioral medicine begins with the initial clinical encounter. Our pilot findings suggest that MHPs’ efforts to reflect TGD clients’ TGD-specific concerns evokes linguistic signatures of empathetic and rapport-focused dialogues, broadly. Future work will leverage pretrained LLMs to examine potential vectors of subtle discrimination – and empowerment – at scale.
Keywords: Diversity, Minority healthMethods: A U.S.-representative MHP sample received simulated appointment-seeking emails, experimentally varied on disclosed TGD status, symptoms, race, ethnicity, gender. Thematic analysis surfaced “response quality” subthemes, proxying possible subtle discrimination, within MHP replies (n = 755). XGBoost decision trees identified key features. 1-step and bias-adjusted 3-step finite mixture modeling a.) detected latent response-quality classes, b.) modeled subtle discrimination by estimating MHP utterances, client race, ethnicity, and TGD disclosures as covariates of class membership. Python and Stata code is on GitHub.
Results: Five subthemes emerged: Affirm, reinforcing clients’ treatment-seeking; Agent, outsourcing replies; Fit, emphasizing MHP-client rapport (key features: “questions [or] concerns”); Justify, accounting for declining treatment (“[not] currently accepting”); Reflect, echoing client concerns (“sorry [to] hear”). A 2-class solution detected an Engaged (27%) class, emphasizing Affirm, Fit, Reflect (item-level response probability ρ = 0.23, 0.16, 0.40, respectively) and a Detached (73%) class, characterized by Agent, and Justify (ρ = 0.07, 0.06). In the 1-step model, MHP mentions of perceived clients’ TGD-specific concerns were 58% more likely to occur within Engaged-class responses. Subtheme-specific logit models revealed simulated Latina trans women more likely to receive Agent: aOR = 7.39, p = 0.02; average marginal effect (AME) = 0.10; and Justify replies: aOR = 9.32, p < 0.01; AME = 0.14, adjusting for day and week fixed effects, and disclosed symptoms.
Implications: Bridging patient-clinician perspectives in behavioral medicine begins with the initial clinical encounter. Our pilot findings suggest that MHPs’ efforts to reflect TGD clients’ TGD-specific concerns evokes linguistic signatures of empathetic and rapport-focused dialogues, broadly. Future work will leverage pretrained LLMs to examine potential vectors of subtle discrimination – and empowerment – at scale.
Authors:
Author - Simone Skeen,
School of Public Health and Tropical Medicine, Tulane University
Co-Author - Patrick Button,
PhD,
School of Liberal Arts, Tulane University
F94 - Internalized Homophobia, Discrimination, and Social Support by Gender, Race, and Ethnicity among Sexual and Gender Minority Adolescents
Poster Number: F94Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Mental Health
Introduction: Sexual and gender minority (SGM) adolescents are likely to experience higher levels of stigma, discrimination, and inadequate social support, potentially resulting in adverse mental health outcomes. These stressors can have varying effects across different groups. To enhance our understanding of the intricate relationships between these stressors and their effects on subgroups, we examined these dynamics from the perspectives of gender, race, and ethnicity to inform HIV prevention efforts.
Methods: We conducted a one-time online survey with SGM adolescents residing in Alabama, aged 14-17 years, who were assigned male sex at birth, and who self-reported having sexual interest in men. We conducted bivariate analyses stratified by gender, race, and ethnicity to examine the distribution of key variables: internalized homophobia, discrimination, and social support. With a statistical significance threshold of p < 0.05, we performed independent t-tests to compare continuous variables between groups.
Results: The study included 206 SGM adolescents; we found disparities in internalized stigma, discrimination, and social support across racial, gender, and ethnic groups. Black participants reported higher levels of internalized homophobia compared to White participants (Mean [M] = 12.07, Standard Deviation [SD] = 5.44 vs. M = 10.32, SD = 4.24; p = .023). Transgender and gender non-conforming individuals reported significantly higher discrimination than cisgender males (M = 23.46, SD = 10.99 vs. M = 16.72, SD = 12.19; p = .003). Compared to non-Hispanics, Hispanic SGM adolescents reported significantly higher internalized homophobia (M = 13.95, SD = 5.24 vs. M = 10.47, SD = 4.66; p = .001) and discrimination (M = 24.21, SD = 11.05 vs. M = 16.63, SD = 11.93; p = .004) as well as lower social support (M = 59.09, SD = 15.64 vs. M = 67.87, SD = 16.53; p = .020).
Conclusions: We found significant variations in internalized homophobia, discrimination, and social support by racial, gender, and ethnic groups. These disparities highlight the need for tailored interventions to address the lived experiences specific to racial, ethnic, and gender minority adolescents. Given that SGM adolescents are at heightened risk for adverse mental health outcomes related to discrimination and stigma, potential interventions must be implemented equitably to mitigate the negative effects of these stressors.
Keywords: Adolescents, SexualityMethods: We conducted a one-time online survey with SGM adolescents residing in Alabama, aged 14-17 years, who were assigned male sex at birth, and who self-reported having sexual interest in men. We conducted bivariate analyses stratified by gender, race, and ethnicity to examine the distribution of key variables: internalized homophobia, discrimination, and social support. With a statistical significance threshold of p < 0.05, we performed independent t-tests to compare continuous variables between groups.
Results: The study included 206 SGM adolescents; we found disparities in internalized stigma, discrimination, and social support across racial, gender, and ethnic groups. Black participants reported higher levels of internalized homophobia compared to White participants (Mean [M] = 12.07, Standard Deviation [SD] = 5.44 vs. M = 10.32, SD = 4.24; p = .023). Transgender and gender non-conforming individuals reported significantly higher discrimination than cisgender males (M = 23.46, SD = 10.99 vs. M = 16.72, SD = 12.19; p = .003). Compared to non-Hispanics, Hispanic SGM adolescents reported significantly higher internalized homophobia (M = 13.95, SD = 5.24 vs. M = 10.47, SD = 4.66; p = .001) and discrimination (M = 24.21, SD = 11.05 vs. M = 16.63, SD = 11.93; p = .004) as well as lower social support (M = 59.09, SD = 15.64 vs. M = 67.87, SD = 16.53; p = .020).
Conclusions: We found significant variations in internalized homophobia, discrimination, and social support by racial, gender, and ethnic groups. These disparities highlight the need for tailored interventions to address the lived experiences specific to racial, ethnic, and gender minority adolescents. Given that SGM adolescents are at heightened risk for adverse mental health outcomes related to discrimination and stigma, potential interventions must be implemented equitably to mitigate the negative effects of these stressors.
Authors:
Presenter - Setor K. Sorkpor,
PhD., MPH, MSN,
Florida State University
Author - Ibrahim Yigit,
PhD,
Florida State University
Author - Shauna Barnes,
APRN, MSN, FNP-BC ,
Florida State University
Author - Henna Budhwani, PhD, MPH,
Florida State University
F95 - Social support for exercise among Black women with high blood pressure: A qualitative study
Poster Number: F95Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Physical Activity
Background: Black women have one of the lowest rates of moderate-to-vigorous physical activity (MVPA) and highest rates of hypertension (HTN) of any racial or ethnic group in the US. Social support (SS) appears to be an essential component of interventions that promote getting enough MVPA for cardiovascular health benefits for Black women.
Purpose: To explore Black women’s thoughts and opinions about SS in the context of getting enough MVPA.
Methods: Qualitative methods were used to explore opinions and attitudes about SS in general, SS for MVPA, and SS for how to support self and others who want to move more, exercise or stay active. Participants were recruited with ads sent to a community organization’s network of members and were eligible if they self-identified as a Black woman, 40-64 years old with high blood pressure who has resided in the US for at least half of her life. Semi-structured telephone interviews were conducted, audio-recorded, and transcribed from Oct 2023-Mar 2024. Transcripts were analyzed using an inductive thematic approach facilitated by MAXQDA. Two researchers developed a code book that was verified by two additional researchers before thematic analysis was completed by the team.
Results: Of the 23 women who completed the interview, 43% reported a household income of < $50000, 65 % were not married, 70 % were employed full-time, and about 50% self-reported getting 150 min/week of MVPA. The mean age of the sample was 55.6 (7.45) years. Three major themes emerged from the analysis: 1) Perception and sources of SS which captured participants’ understanding of SS and their preferred sources for MVPA; 2) Motivations for and barriers to seeking SS which describes why participants view SS for MVPA as crucial for Black women with HTN and barriers such as personal, cultural, and historical factors that might hinder access; and 3) Types and strategies for utilizing SS which describes the specific types of SS participants wanted for MVPA and suggests strategies like fostering relationships and leveraging resources to help others effectively utilize SS for MVPA.
Conclusion: The findings suggest that SS can help Black women get MVPA but the action of getting support is influenced by personal, cultural and historical factors. Interventions to increase SS for MVPA should consider tailoring support to individual’s preferred sources of SS, while also addressing barriers for utilizing the SS.
Keywords: Minority health, ExercisePurpose: To explore Black women’s thoughts and opinions about SS in the context of getting enough MVPA.
Methods: Qualitative methods were used to explore opinions and attitudes about SS in general, SS for MVPA, and SS for how to support self and others who want to move more, exercise or stay active. Participants were recruited with ads sent to a community organization’s network of members and were eligible if they self-identified as a Black woman, 40-64 years old with high blood pressure who has resided in the US for at least half of her life. Semi-structured telephone interviews were conducted, audio-recorded, and transcribed from Oct 2023-Mar 2024. Transcripts were analyzed using an inductive thematic approach facilitated by MAXQDA. Two researchers developed a code book that was verified by two additional researchers before thematic analysis was completed by the team.
Results: Of the 23 women who completed the interview, 43% reported a household income of < $50000, 65 % were not married, 70 % were employed full-time, and about 50% self-reported getting 150 min/week of MVPA. The mean age of the sample was 55.6 (7.45) years. Three major themes emerged from the analysis: 1) Perception and sources of SS which captured participants’ understanding of SS and their preferred sources for MVPA; 2) Motivations for and barriers to seeking SS which describes why participants view SS for MVPA as crucial for Black women with HTN and barriers such as personal, cultural, and historical factors that might hinder access; and 3) Types and strategies for utilizing SS which describes the specific types of SS participants wanted for MVPA and suggests strategies like fostering relationships and leveraging resources to help others effectively utilize SS for MVPA.
Conclusion: The findings suggest that SS can help Black women get MVPA but the action of getting support is influenced by personal, cultural and historical factors. Interventions to increase SS for MVPA should consider tailoring support to individual’s preferred sources of SS, while also addressing barriers for utilizing the SS.
Authors:
Author - Michelle D.S. Boakye,
PhD, MPH, RN,
UMass Boston
Co-Author - Dennis Miezah,
BS, RN,
UMass Boston
Co-Author - Ashley K. Parks,
MS, FNP-BC,
UMass Boston
Co-Author - Brianna Harley,
UMass Boston
Co-Author - Laura L. Hayman, MSN, PhD, FAAN, FAHA,
MSN, PhD, FAAN, FAHA,
University of Massachusetts Boston
Presenter - Julie A. Wright,
PhD,
UMass Boston
F97 - Living environment and socio-demographic factors related to food insecurity among low income Texas college students during the COVID-19 pandemic
Poster Number: F97Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Diet, Nutrition, and Eating Disorders
Background: Low socioeconomic status is linked to food insecurity, but certain socio-demographic characteristics may be associated with greater vulnerability for food insecurity among low income populations. Little is known about socio-demographic factors that relate to food insecurity among low income college students. This study examines differences in food insecurity by gender, age, race/ethnicity, health insurance status, financial assistance status, and living situation among low income college students.
Methods: Participants were low income college students from Waves 1 and 2 of the COVID-19 Texas College Student Experiences Survey (n=738; Mage=25.9 yrs, 72% female, 36% White). Students self-reported nativity (U.S. or foreign born), gender, age (18-25, 26-44, 45+), race/ethnicity, health insurance (yes/no), living situation (on-campus, with friends, with family, other), and receipt of COVID-19 financial assistance (yes/no). Food insecurity (yes/no) was measured using the first two questions of the USDA Food Security scale which ask about financial means to support food availability and balanced meals. Logistic regressions examined relationships between socio-demographics and food insecurity. Interactions between nativity and other socio-demographic characteristics were explored, controlling for employment and marital status.
Results: Foreign born students were 2.2 times more likely to be food insecure than U.S. born (p<.01). Students aged 26-44 had 0.51 decreased odds of food insecurity compared to 18-25 year olds (p=.005). Those who identified as Latinx (p<.05), Black (p<.05), and Other races (p<.001) were ~2, ~3, and ~4 times more likely to be food insecure compared to White students, respectively. There was a trend toward significance for living situations: those living with friends off campus were 1.5 times more likely to be food insecure than those who lived with family. Gender, health insurance, and financial assistance were not associated with food insecurity. There were no significant interactions with nativity.
Discussion: Findings indicate a need for increased food security resources for low income college students who are foreign born, younger, identify as a racial/ethnic minority group, and live with friends off campus. Implementation of interventions that consider socio-demographic factors, apart from socioeconomic status, are needed to address food insecurity among low income college students.
Keywords: Low-income and minority groups, DietMethods: Participants were low income college students from Waves 1 and 2 of the COVID-19 Texas College Student Experiences Survey (n=738; Mage=25.9 yrs, 72% female, 36% White). Students self-reported nativity (U.S. or foreign born), gender, age (18-25, 26-44, 45+), race/ethnicity, health insurance (yes/no), living situation (on-campus, with friends, with family, other), and receipt of COVID-19 financial assistance (yes/no). Food insecurity (yes/no) was measured using the first two questions of the USDA Food Security scale which ask about financial means to support food availability and balanced meals. Logistic regressions examined relationships between socio-demographics and food insecurity. Interactions between nativity and other socio-demographic characteristics were explored, controlling for employment and marital status.
Results: Foreign born students were 2.2 times more likely to be food insecure than U.S. born (p<.01). Students aged 26-44 had 0.51 decreased odds of food insecurity compared to 18-25 year olds (p=.005). Those who identified as Latinx (p<.05), Black (p<.05), and Other races (p<.001) were ~2, ~3, and ~4 times more likely to be food insecure compared to White students, respectively. There was a trend toward significance for living situations: those living with friends off campus were 1.5 times more likely to be food insecure than those who lived with family. Gender, health insurance, and financial assistance were not associated with food insecurity. There were no significant interactions with nativity.
Discussion: Findings indicate a need for increased food security resources for low income college students who are foreign born, younger, identify as a racial/ethnic minority group, and live with friends off campus. Implementation of interventions that consider socio-demographic factors, apart from socioeconomic status, are needed to address food insecurity among low income college students.
Authors:
Presenter - Angela Dimaano,
Santa Clara University
Co-Author - Jill Morimoto,
Santa Clara University
Co-Author - Alice Villatoro,
Santa Clara University
Co-Author - Vanessa Errisuriz,
Santa Clara University
F98 - Gender Minority Stress as a Risk Factor for Alcohol and Cannabis Use in Rural & Urban Transgender and Nonbinary Adults
Poster Number: F98Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Substance Misuse
Aim: Transgender and nonbinary (TGNB) people face higher substance use risks than cisgender people, exacerbated by chronic gender minority stress and limited resources in rural areas. This study aimed to (1) clarify differences in alcohol and cannabis use by rurality and gender identity, (2) examine if rejection and victimization contribute to disparate alcohol/cannabis risk, moderated by rurality/urbanicity. Hypotheses included (1) alcohol/cannabis risk will be greater in rural (versus urban) and nonbinary (versus binary) participants; and (2) rejection and victimization will predict cannabis and alcohol outcomes, especially in rural participants.
Method: Cross-sectional online survey data was drawn from 151 transgender adults in a northeastern rural state (Mage=27.65±5.63 years, range=18-58; 68% rural; 40% transgender men, 31% transgender women, 29% non-binary; 3% Multiracial; 5% American Indian/Alaska Native; 5% Asian; 5% Hispanic; 31% Black; 48% White). The survey assessed participant characteristics, gender minority stress, and alcohol and cannabis use behaviors.
Results: Compared to urban participants, rural peers reported more hazardous drinking and consequences (t[148.12]=3.24, p<.001; t[43.50]=3.14, p=.002), and hazardous cannabis use (t[134.94]=2.15, p=.03; but not consequences p=.92). Substance use outcomes and gender minority stressors did not significantly differ by gender identity. Victimization experiences predicted hazardous drinking and consequences (ß=.27 SE=.28, CI[.37,1.49]; ß=.45 SE=.35, 95% CI[.50, 1.92]), and hazardous cannabis use (ß=.25, SE=.27, CI[.30,1.37]; but not consequences 95% CI [-5.69,1.87]) in the entire TGNB sample after controlling for male sex assigned at birth, age, and white race; main effects were not significantly moderated by rurality. Rejection experiences did not significantly predict any substance use behavior.
Conclusion: This study highlighted disparate alcohol/cannabis risk in rural (versus urban) TGNB adults, however victimization (but not rejection) predicted risk across both rural and urban groups. This study remedies a harmful omission of TGNB people in substance use research. Although replication is needed, preliminary findings hold implications for trauma-informed, tailored substance use interventions and policies for TGNB people.
Keywords: Substance abuse, Health disparitiesMethod: Cross-sectional online survey data was drawn from 151 transgender adults in a northeastern rural state (Mage=27.65±5.63 years, range=18-58; 68% rural; 40% transgender men, 31% transgender women, 29% non-binary; 3% Multiracial; 5% American Indian/Alaska Native; 5% Asian; 5% Hispanic; 31% Black; 48% White). The survey assessed participant characteristics, gender minority stress, and alcohol and cannabis use behaviors.
Results: Compared to urban participants, rural peers reported more hazardous drinking and consequences (t[148.12]=3.24, p<.001; t[43.50]=3.14, p=.002), and hazardous cannabis use (t[134.94]=2.15, p=.03; but not consequences p=.92). Substance use outcomes and gender minority stressors did not significantly differ by gender identity. Victimization experiences predicted hazardous drinking and consequences (ß=.27 SE=.28, CI[.37,1.49]; ß=.45 SE=.35, 95% CI[.50, 1.92]), and hazardous cannabis use (ß=.25, SE=.27, CI[.30,1.37]; but not consequences 95% CI [-5.69,1.87]) in the entire TGNB sample after controlling for male sex assigned at birth, age, and white race; main effects were not significantly moderated by rurality. Rejection experiences did not significantly predict any substance use behavior.
Conclusion: This study highlighted disparate alcohol/cannabis risk in rural (versus urban) TGNB adults, however victimization (but not rejection) predicted risk across both rural and urban groups. This study remedies a harmful omission of TGNB people in substance use research. Although replication is needed, preliminary findings hold implications for trauma-informed, tailored substance use interventions and policies for TGNB people.
Authors:
Author - Leah Cingranelli,
University of Maine
Co-Author - Krutika Rathod,
University of Maine
Co-Author - Cormac Mack,
University of Maine
Co-Author - Patricia A. Goodhines,
PhD,
University of Maine
F99 - Disadvantage in Affluence: Latiné adults’ views on government and community-based resources for supporting social, economic, and mental wellbeing in the South Bay
Poster Number: F99Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Community Engagement
Background: The South Bay is among the most affluent regions in the United States, yet Latiné communities there face vast social and economic inequalities. Government programs and community-based organizations (CBOs) are essential in addressing social needs and reducing health disparities in Latiné communities. Little is known about the accessibility and perceptions of these services among disadvantaged groups within affluent regions. This study examines the barriers and facilitators that Latinés face upon accessing both government and CBO resources for supporting social and mental wellbeing.
Methods: In-depth individual interviews were conducted with Latiné adults (18+ years old) residing in Santa Clara and San Benito Counties (n=13). Participants shared their perceptions and experiences with government and CBO resources for social and mental health needs. Interviews were ~30 minutes, conducted in English and Spanish, recorded, and transcribed. Grounded theory guided the qualitative analysis, with two independent coders reviewing and coding the interviews.
Results: Latiné adults using both government and CBO resources reported feeling more secure with CBOs than government services. Government programs were described as difficult to access due to stringent eligibility criteria and lengthy application processes. A key concern was that the federal poverty criteria are set too low, making it difficult for families in the South Bay to qualify for economic and health benefits. Concerns over legal residency status, particularly related to the public charge rule, further deterred use. However, those who accessed government services expressed satisfaction with the services received. Conversely, CBO services were described as more accessible, reliable, and diverse in offerings (e.g., clothing drives, utility payment support), though they were perceived as being limited in availability and difficult to locate.
Conclusions: Understanding the socioeconomic local context is crucial to addressing disparities in resource allocation and accessibility for Latiné communities. As illustrated by the findings, perceptions of government and CBO programs affect whether and how the social and health needs of Latiné communities are met. Enhancement of government and CBO services are vital to promoting health equity in Latiné communities, but we need to bridge the gap between these entities as well as tailor services to local contexts.
Keywords: Latino, Population healthMethods: In-depth individual interviews were conducted with Latiné adults (18+ years old) residing in Santa Clara and San Benito Counties (n=13). Participants shared their perceptions and experiences with government and CBO resources for social and mental health needs. Interviews were ~30 minutes, conducted in English and Spanish, recorded, and transcribed. Grounded theory guided the qualitative analysis, with two independent coders reviewing and coding the interviews.
Results: Latiné adults using both government and CBO resources reported feeling more secure with CBOs than government services. Government programs were described as difficult to access due to stringent eligibility criteria and lengthy application processes. A key concern was that the federal poverty criteria are set too low, making it difficult for families in the South Bay to qualify for economic and health benefits. Concerns over legal residency status, particularly related to the public charge rule, further deterred use. However, those who accessed government services expressed satisfaction with the services received. Conversely, CBO services were described as more accessible, reliable, and diverse in offerings (e.g., clothing drives, utility payment support), though they were perceived as being limited in availability and difficult to locate.
Conclusions: Understanding the socioeconomic local context is crucial to addressing disparities in resource allocation and accessibility for Latiné communities. As illustrated by the findings, perceptions of government and CBO programs affect whether and how the social and health needs of Latiné communities are met. Enhancement of government and CBO services are vital to promoting health equity in Latiné communities, but we need to bridge the gap between these entities as well as tailor services to local contexts.
Authors:
Presenter - Roberto Javier Mercado López,
Santa Clara University
Co-Author - Tatiana Londoño,
PhD, MSW,
University of California, Los Angeles
Co-Author - Alice Villatoro,
PhD,
Santa Clara University
F100 - “Train the algorithm early”: Strategies for navigating social media and protecting mental health among transgender and nonbinary young adults
Poster Number: F100Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Mental Health
Background: Transgender and nonbinary (TNB) young adults face substantial mental health inequities, which may be exacerbated by exposure to cissexism, misogyny, and other social stressors on social media. However, social media can also be a vital source of information and community support for TNB young adults. In this qualitative analysis, we sought to better understand the resources and curation strategies TNB young adults use to protect their mental health and wellbeing online.
Methods: 29 TNB young adults (aged 19-25 years) living across the United States completed in-depth interviews on their social media use as part of a larger study exploring the impacts of social media on substance use and disordered eating behaviors. Participants had diverse gender identities (59% nonbinary, 24% men, 17% women) and racial/ethnic backgrounds (28% White, 24% Asian/Asian American, 24% multiracial, 17% Black/African American, 7% Hispanic/Latine). Participant responses to questions on strategies for protecting mental health on social media (e.g., “What are some of the ways you ‘curate’ or protect yourself in your social media environment to make it work best for you?”) were extracted and analyzed using rapid content analysis. Codes were developed inductively through iterative analysis of participant responses and organized into themes by the research team, with input from a community advisory board.
Results: Participants described using a variety of strategies for navigating their social media environments, which were grouped into three key themes: 1. Activating critical social media literacy (e.g., building awareness of algorithms, profit motives, sponsored content); 2. Optimizing use of built-in app functions and features (e.g., content filters, block features, time limits); and 3. Building resilience and community support (e.g., ignoring hateful content, following TNB role models, engaging in self-affirmation). Participants described these strategies as helping buffer against harmful content, or even as allowing them to cultivate joyful and affirming social media spaces.
Conclusions: TNB young adults in this study employed diverse social media curation strategies that bridged individual skill-building with collective resilience and community-building. Public health and policy interventions to promote healthier social media spaces for TNB young adults should build upon these strategies to ensure such interventions are grounded in existing community strengths.
Keywords: Technologies, Minority healthMethods: 29 TNB young adults (aged 19-25 years) living across the United States completed in-depth interviews on their social media use as part of a larger study exploring the impacts of social media on substance use and disordered eating behaviors. Participants had diverse gender identities (59% nonbinary, 24% men, 17% women) and racial/ethnic backgrounds (28% White, 24% Asian/Asian American, 24% multiracial, 17% Black/African American, 7% Hispanic/Latine). Participant responses to questions on strategies for protecting mental health on social media (e.g., “What are some of the ways you ‘curate’ or protect yourself in your social media environment to make it work best for you?”) were extracted and analyzed using rapid content analysis. Codes were developed inductively through iterative analysis of participant responses and organized into themes by the research team, with input from a community advisory board.
Results: Participants described using a variety of strategies for navigating their social media environments, which were grouped into three key themes: 1. Activating critical social media literacy (e.g., building awareness of algorithms, profit motives, sponsored content); 2. Optimizing use of built-in app functions and features (e.g., content filters, block features, time limits); and 3. Building resilience and community support (e.g., ignoring hateful content, following TNB role models, engaging in self-affirmation). Participants described these strategies as helping buffer against harmful content, or even as allowing them to cultivate joyful and affirming social media spaces.
Conclusions: TNB young adults in this study employed diverse social media curation strategies that bridged individual skill-building with collective resilience and community-building. Public health and policy interventions to promote healthier social media spaces for TNB young adults should build upon these strategies to ensure such interventions are grounded in existing community strengths.
Authors:
Co-Author - Sangeeta Subedi,
MS,
Boston University
Co-Author - Schuyler Bailar,
Boston University
Co-Author - S. Bryn Austin, ScD,
Boston Children's Hospital
Co-Author - Kimberly M. Nelson, PhD, MPH,
Boston University School of Public Health
Co-Author - Allegra R. Gordon,
ScD, MPH,
Boston University
F101 - “An environment of fear wherever I go”: Perspectives of transgender individuals in the face of anti-transgender legislation
Poster Number: F101Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Stress
Background: Transgender and gender diverse (TGD) individuals have faced increasing levels of systemic oppression as they have faced more than 1,200 proposed bills seeking to limit the rights of TGD individuals since 2023. These legislative efforts have succeeded in more than half of the states in the USA, suggesting a growing antipathy towards TGD individuals. It is vital to examine the impacts of such legislation on a population that already faces health disparities to gain a greater understanding of the role that systemic discrimination may play in TGD individuals’ lives.
Methods: As a part of a larger study, a sample of adult TGD participants (N = 349) were recruited through an online participant recruitment platform and asked free-response questions assessing impacts of anti-transgender legislation on their lives, as well as questions examining demographic information. Qualitative data were analyzed using an inductive code development process founded in principles of thematic analysis.
Results: The thematic framework developed from participant responses included four primary themes: (1) Profound Psychological Distress, (2) Proximal and Distal Impacts of Legislation, (3) Mobility and Agency, and (4) Experiences of Privilege. Profound Psychological Distress included discussions of increased anxiety, depression, and suicidality. Proximal and Distal Impacts of Legislation incorporated experiences and concerns related to the participants and members of the TGD community more broadly, as well as fears about an increasingly hostile sociopolitical landscape. Mobility and Agency included both those who were and were not able to flee hostile home states, while Experiences of Privilege included perceptions from those who live in “safe” states, who experience passing privilege, and those who experience a form of “survivor’s guilt.”
Conclusion: Anti-transgender legislation, regardless of the direct impact on an individual, reflects an existential threat to the broader TGD community. The results presented highlight the profound psychological impact of this legislation on TGD individuals while serving to contextualize the experiences of those most injured by these legislative initiatives. These results further highlight the important role that systems of legislation and discrimination plays in the well-being of minoritized populations, demonstrating the importance of considering these systems when developing research and interventions to improve behavioral health.
Keywords: Environmental, Minority healthMethods: As a part of a larger study, a sample of adult TGD participants (N = 349) were recruited through an online participant recruitment platform and asked free-response questions assessing impacts of anti-transgender legislation on their lives, as well as questions examining demographic information. Qualitative data were analyzed using an inductive code development process founded in principles of thematic analysis.
Results: The thematic framework developed from participant responses included four primary themes: (1) Profound Psychological Distress, (2) Proximal and Distal Impacts of Legislation, (3) Mobility and Agency, and (4) Experiences of Privilege. Profound Psychological Distress included discussions of increased anxiety, depression, and suicidality. Proximal and Distal Impacts of Legislation incorporated experiences and concerns related to the participants and members of the TGD community more broadly, as well as fears about an increasingly hostile sociopolitical landscape. Mobility and Agency included both those who were and were not able to flee hostile home states, while Experiences of Privilege included perceptions from those who live in “safe” states, who experience passing privilege, and those who experience a form of “survivor’s guilt.”
Conclusion: Anti-transgender legislation, regardless of the direct impact on an individual, reflects an existential threat to the broader TGD community. The results presented highlight the profound psychological impact of this legislation on TGD individuals while serving to contextualize the experiences of those most injured by these legislative initiatives. These results further highlight the important role that systems of legislation and discrimination plays in the well-being of minoritized populations, demonstrating the importance of considering these systems when developing research and interventions to improve behavioral health.
Authors:
Co-Author - Conor Duffy,
Virginia Commonwealth University
Co-Author - Steph L. Cull, M.S. Psychology,
M.S. Psychology,
Virginia Commonwealth University
Co-Author - Jackline A. Otieno,
Virginia Commonwealth University
Co-Author - Gabrielle M. Cardinale-McGinnis, B.S. Psychology,
B.S. Psychology,
Virginia Commonwealth University
Co-Author - Dex Schult,
Virginia Commonwealth University
Co-Author - Foster Mardigan,
Virginia Commonwealth University
Co-Author - Regina Easter,
Virginia Commonwealth University
Co-Author - Eric G. Benotsch, PhD,
PhD,
Virginia Commonwealth University
F102 - Improving Latina women wellness screenings intentions using a telenovela video-drama intervention.
Poster Number: F102Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Health of Marginalized Populations
Background: Latina women are significantly less likely to utilize cancer screenings than Non-Hispanic White women (American Cancer Society, 2021). Early parental encouragement may increase the likelihood of screening utilization as research has emphasized the role of mothers in communicating the importance of female health screenings (Moore de Peralta et al., 2017). Moreover, telenovelas, which utilize technology and story-telling, can be used as culturally congruent media for presenting health messages to Latino audiences as an intervention strategy to initiate change (Crist et al., 2015). Yet, no empirical studies have developed and tested the efficacy of a video-drama based on traditional Latina/o values to increase intentions of women wellness screenings among Latina women.
Objective: This study tested the efficacy of a brief telenovela video-drama intervention to increase intentions of utilizing women wellness screenings among adult Latina Women. We hypothesize that viewing the short-length scripted telenovela video-drama will increase participants intentions and positive attitudes to utilize women wellness cancer screenings as well as increase perceived behavioral control and willingness to discuss women wellness screenings with family members.
Methods: Based on themes from interviews with Latina women, a scripted telenovela was developed and implemented as an online survey. Latina-identifying adult women (N = 68; M age = 37.41, SD = 11.80) were asked about attitudes, intentions, and familial communication about women wellness screenings prior to and after viewing the 15-minute video telenovela intervention.
Results: Over 57% of participants report having had a screening in the last year. Most participants (65%) retrospectively reported a lack of parental communication regarding women wellness screenings. Perceiving the telenovela to encourage screenings (M = 4.70, SD = 1.09) significantly predicted intentions to receive a screening (B = 0.41, SE = 0.19, p = .03) and intentions to make an appointment (B = 0.61, SE = 0.18, p =.001) in the next year.
Conclusions: Culturally-driven interventions delivered through telenovela-dramas appear to encourage health behavioral change. Specifically, this intervention produced immediate changes in intentions to utilize cancer screenings among Latina women, which are important predictors of future behavioral engagement.
Keywords: Cancer screening, LatinoObjective: This study tested the efficacy of a brief telenovela video-drama intervention to increase intentions of utilizing women wellness screenings among adult Latina Women. We hypothesize that viewing the short-length scripted telenovela video-drama will increase participants intentions and positive attitudes to utilize women wellness cancer screenings as well as increase perceived behavioral control and willingness to discuss women wellness screenings with family members.
Methods: Based on themes from interviews with Latina women, a scripted telenovela was developed and implemented as an online survey. Latina-identifying adult women (N = 68; M age = 37.41, SD = 11.80) were asked about attitudes, intentions, and familial communication about women wellness screenings prior to and after viewing the 15-minute video telenovela intervention.
Results: Over 57% of participants report having had a screening in the last year. Most participants (65%) retrospectively reported a lack of parental communication regarding women wellness screenings. Perceiving the telenovela to encourage screenings (M = 4.70, SD = 1.09) significantly predicted intentions to receive a screening (B = 0.41, SE = 0.19, p = .03) and intentions to make an appointment (B = 0.61, SE = 0.18, p =.001) in the next year.
Conclusions: Culturally-driven interventions delivered through telenovela-dramas appear to encourage health behavioral change. Specifically, this intervention produced immediate changes in intentions to utilize cancer screenings among Latina women, which are important predictors of future behavioral engagement.
Authors:
Author - Patricia Cabral,
Occidental College
F103 - Predictors of never testing for HIV among men who have sex with men in Nepal
Poster Number: F103Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Health of Marginalized Populations
Introduction: Men who have sex with men (MSM) are disproportionately affected by HIV. Existing structural barriers to HIV prevention efforts in Nepal increase vulnerability to HIV acquisition and transmission among MSM, undermining the HIV response. Therefore, this study aimed to measure and determine factors associated with never testing for HIV among MSM in Nepal and inform future public health interventions addressing low testing rates in the country.
Methods: We conducted the first population-based HIV bio-behavioral surveillance study of MSM using the respondent-driven sampling (RDS) method. We computed estimates for never testing HIV and conducted bivariate and multivariate analyses to explore the correlation between participant characteristics and never testing HIV.
Result: Among 250 participants, more than half of the participants, 54.1 (95% CI; 47.8-60.3) were less than 25 years old, and 50.9% (95% CI; 44.6-57.1) identified themselves as bisexual. More than half of the participants never tested for HIV in their lifetime (52.5%), and only 11.7% of them tested for HIV in the last 12 months. MSM who never engaged in transactional sex (aOR:0.3; 95% CI: 0.1-0.8), had no access to daily internet (aOR: 5.8; 95% CI: 1.6-21.2), without a prior diagnosis of sexually transmitted infection (aOR: 8.5; 95% CI: 2.9-25.5), never heard of HIV self-testing (aOR:6.8; 95% CI: 2.9-16.2), and were unaware that someone taking PrEP (aOR:45.6; 95% CI: 10.7-194.1) had higher odds of never being tested for HIV. Conversely, MSM who were single (aOR:0.3; 95% CI: 0.1-0.8) had lower odds of never testing for HIV.
Conclusion: More than half of the participants were never tested for HIV. To achieve the 95-95-95 goal, it is imperative to reach out to people who engaged in transactional sex, have been diagnosed with STIs, and were unaware of an HIV self-testing kit. Integrating digital health intervention in the existing HIV prevention programs could help key populations access HIV testing and strengthen recent HIV prevention programs.
Keywords: HIV, Minority healthMethods: We conducted the first population-based HIV bio-behavioral surveillance study of MSM using the respondent-driven sampling (RDS) method. We computed estimates for never testing HIV and conducted bivariate and multivariate analyses to explore the correlation between participant characteristics and never testing HIV.
Result: Among 250 participants, more than half of the participants, 54.1 (95% CI; 47.8-60.3) were less than 25 years old, and 50.9% (95% CI; 44.6-57.1) identified themselves as bisexual. More than half of the participants never tested for HIV in their lifetime (52.5%), and only 11.7% of them tested for HIV in the last 12 months. MSM who never engaged in transactional sex (aOR:0.3; 95% CI: 0.1-0.8), had no access to daily internet (aOR: 5.8; 95% CI: 1.6-21.2), without a prior diagnosis of sexually transmitted infection (aOR: 8.5; 95% CI: 2.9-25.5), never heard of HIV self-testing (aOR:6.8; 95% CI: 2.9-16.2), and were unaware that someone taking PrEP (aOR:45.6; 95% CI: 10.7-194.1) had higher odds of never being tested for HIV. Conversely, MSM who were single (aOR:0.3; 95% CI: 0.1-0.8) had lower odds of never testing for HIV.
Conclusion: More than half of the participants were never tested for HIV. To achieve the 95-95-95 goal, it is imperative to reach out to people who engaged in transactional sex, have been diagnosed with STIs, and were unaware of an HIV self-testing kit. Integrating digital health intervention in the existing HIV prevention programs could help key populations access HIV testing and strengthen recent HIV prevention programs.
Authors:
Presenter - Kamal Gautam,
MPH,
University of Connecticut
Co-Author - Kiran Paudel, BPH,
BPH,
University of Connecticut
Co-Author - Anjila Pandey,
BPH,
Tribhuvan University, Nepal
Co-Author - Prashamsa Bhandari,
MPH,
Tribhuvan University, Nepal
Co-Author - Manisha Dhakal,
Blue Diamond Society, Nepal
Co-Author - Md. Safaet Hossain Sujan,
University of Connecticut
Co-Author - Jefferey A Wickersham,
PhD,
Yale School of Medicine
Co-Author - Roman Shrestha, PhD, MPH,
PhD, MPH,
University of Connecticut
F104 - Applying the Necessity-Concerns Framework to Determine the Effect of a Cognitive Intervention on HIV Treatment Adherence and Outcomes in Jos, Nigeria
Poster Number: F104Time: 11:00 AM - 11:50 AM
Topics: Decision Making, Multiple Health Behavior Change
Background: Medication nonadherence occurs in people living with the Human Immunodeficiency Virus (PLWH), usually leading to negative outcomes. Educational adherence interventions for PLWH can improve their treatment adherence. However, little is known about the effect of these interventions designed from psychological health models on treatment adherence. The Necessity-Concerns Framework (NCF) explains how adherence is influenced by the patient’s belief in their personal need for the treatment (Necessity beliefs) and any concerns about their medicines, using the Belief-about-Medicines Questionnaire. This study determined the effect of an educational intervention designed from the NCF on HIV treatment adherence in Jos, Nigeria.
Methods: The study was conducted in Jos University Teaching Hospital and Plateau State Specialist Hospital. After obtaining ethical approval, data were collected from 351 adult (>18 years) PLWH receiving antiretrovirals (ARVs) for six months or longer. They were recruited into control and intervention groups as they came to the health facilities. Data were collected at baseline and at least 6-month follow-up. The Standard Morisky Scale was used to measure adherence. The control group received routine adherence counselling, while the intervention group, in addition, received an educational intervention involving reinforced medication education and adherence counseling (MEAC) based on the NCF. T-tests and repeated measures ANOVA were done to determine the effect of the intervention on treatment adherence.
Results: Most of the respondents were females (77.5%), within the age range of 35-54 years (68.7%), with secondary level of education (39.6%). The medication adherence rate was the same pre- and post-intervention in the control group (74.3%) but increased from 71.0% pre- to 82.4% post-intervention in the intervention group, although this difference was not statistically significant (p=0.06). A significant (p<0.01) increase in mean necessity-beliefs about ARVs and Necessity-Concerns Differential (NCD) was observed in the intervention group compared to the control group post-intervention. This suggests that the educational intervention increased PLWHs’ necessity beliefs about ARVs.
Conclusion: Adherence interventions that support patients’ treatment beliefs and medication adherence should be designed based on psychological health models and implemented to improve treatment outcomes.
Keywords: HIV, ComplianceMethods: The study was conducted in Jos University Teaching Hospital and Plateau State Specialist Hospital. After obtaining ethical approval, data were collected from 351 adult (>18 years) PLWH receiving antiretrovirals (ARVs) for six months or longer. They were recruited into control and intervention groups as they came to the health facilities. Data were collected at baseline and at least 6-month follow-up. The Standard Morisky Scale was used to measure adherence. The control group received routine adherence counselling, while the intervention group, in addition, received an educational intervention involving reinforced medication education and adherence counseling (MEAC) based on the NCF. T-tests and repeated measures ANOVA were done to determine the effect of the intervention on treatment adherence.
Results: Most of the respondents were females (77.5%), within the age range of 35-54 years (68.7%), with secondary level of education (39.6%). The medication adherence rate was the same pre- and post-intervention in the control group (74.3%) but increased from 71.0% pre- to 82.4% post-intervention in the intervention group, although this difference was not statistically significant (p=0.06). A significant (p<0.01) increase in mean necessity-beliefs about ARVs and Necessity-Concerns Differential (NCD) was observed in the intervention group compared to the control group post-intervention. This suggests that the educational intervention increased PLWHs’ necessity beliefs about ARVs.
Conclusion: Adherence interventions that support patients’ treatment beliefs and medication adherence should be designed based on psychological health models and implemented to improve treatment outcomes.
Authors:
Presenter - Comfort Nanbam Sariem,
PhD,
University of Jos, Jos, Nigeria
Author - Jonah Musa,
PhD,
University of Jos, Jos, Nigeria
Author - Tolulope Afolaranmi,
MBBS,
University of Jos, Jos, Nigeria
Author - Halima Sule,
MBBS,
University of Jos, Jos, Nigeria
Author - Jonathan Bulus,
MBBS,
Plateau State Specialist Hospital, Jos, Jos Nigeria
Author - John Aguiyi,
PhD,
Univeristy of Jos, Jos, Nigeria
Author - Atine Sagay,
MBBS, MSc,
Univeristy of Jos, Jos, Nigeria
Co-Author - Zoe Moon,
University College London
Co-Author - Rob Horne,
University College London
F105 - Feasibility, acceptability, appropriateness, and usability of a limited interaction mHealth intervention to support HIV PrEP uptake among young sexual minoritized men 17-24 years old
Poster Number: F105Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Digital Health
Background: Young gay, bisexual, queer, and other sexual minoritized men (YSMM) are disproportionately affected by HIV. We sought to develop a limited interaction, person-centered and theory-based mHealth intervention to support sexual wellbeing, HIV testing, and HIV pre-exposure prophylaxis (PrEP) uptake tailored to YSMM 17-24 years old with reported sexual behavior indicating potential benefit of PrEP.
Methods: “OnPOINT” was iteratively developed in partnership with a youth advisory board. Multimodal intervention content was acquired online, factually verified, and theoretically categorized to support HIV testing and PrEP uptake according to information-motivation-behavioral skills model constructs. Participants were randomized to one of two attention-matched versions of OnPOINT: (1) an information-only control, and (2) a theory-based experimental version. Both versions had an embedded PrEP resource locator and participants were mailed a free HIV self-testing kit. OnPOINT provided a daily prevention tip to participants over 30 days, with culturally-tailored SMS messages daily to support engagement with OnPOINT. Recruitment via social media and men-for-men networking apps was launched and completed in mid-2024; screening and enrollment procedures occurred online using evidence-based methods of fraud detection. Follow-up surveys will complete Fall 2024; data remains masked. Upon completion of the active-phase of intervention activities at 1-month follow-up, participants were surveyed using validated measures assessing acceptability (=0.93), appropriateness (=0.91), system usability (=0.85; scale range:10-100), and PrEP uptake.
Results: Of 207 HIV-negative/status-unknown YSMM not on PrEP who screened eligible, 57% enrolled (n=118; Mage=21.5; 92.4% cisgender; 66.1% Black, Latino, or multiracial/another). At 1-month follow-up, participants (n=98; 83% retention) reported moderate acceptability (M=3.78; range:1-5), moderate appropriateness (M=3.90; range:1-5), and above average system usability (M=76.45) of OnPOINT. PrEP uptake was reported by 9.3% of HIV-negative participants at 1-month follow-up.
Conclusions: OnPOINT shows promise to support HIV prevention. Our procedures indicate feasibility to recruit and enroll YSMM who could benefit from PrEP with limited participant interaction. OnPOINT had adequate acceptability, appropriateness, and system usability as tested. Outcomes by trial arm will be presented at the conference when the trial is unmasked.
Keywords: Randomized controlled trial, e-HealthMethods: “OnPOINT” was iteratively developed in partnership with a youth advisory board. Multimodal intervention content was acquired online, factually verified, and theoretically categorized to support HIV testing and PrEP uptake according to information-motivation-behavioral skills model constructs. Participants were randomized to one of two attention-matched versions of OnPOINT: (1) an information-only control, and (2) a theory-based experimental version. Both versions had an embedded PrEP resource locator and participants were mailed a free HIV self-testing kit. OnPOINT provided a daily prevention tip to participants over 30 days, with culturally-tailored SMS messages daily to support engagement with OnPOINT. Recruitment via social media and men-for-men networking apps was launched and completed in mid-2024; screening and enrollment procedures occurred online using evidence-based methods of fraud detection. Follow-up surveys will complete Fall 2024; data remains masked. Upon completion of the active-phase of intervention activities at 1-month follow-up, participants were surveyed using validated measures assessing acceptability (=0.93), appropriateness (=0.91), system usability (=0.85; scale range:10-100), and PrEP uptake.
Results: Of 207 HIV-negative/status-unknown YSMM not on PrEP who screened eligible, 57% enrolled (n=118; Mage=21.5; 92.4% cisgender; 66.1% Black, Latino, or multiracial/another). At 1-month follow-up, participants (n=98; 83% retention) reported moderate acceptability (M=3.78; range:1-5), moderate appropriateness (M=3.90; range:1-5), and above average system usability (M=76.45) of OnPOINT. PrEP uptake was reported by 9.3% of HIV-negative participants at 1-month follow-up.
Conclusions: OnPOINT shows promise to support HIV prevention. Our procedures indicate feasibility to recruit and enroll YSMM who could benefit from PrEP with limited participant interaction. OnPOINT had adequate acceptability, appropriateness, and system usability as tested. Outcomes by trial arm will be presented at the conference when the trial is unmasked.
Authors:
Presenter - Steven John,
PhD, MPH,
Medical College of Wisconsin
Co-Author - Andrew O'Neil,
MPH,
Medical College of Wisconsin
Co-Author - Keith Horvath,
PhD,
San Diego State University
F106 - Implementation and Evaluation of Adherence Coaching: An extension of P3, an mHealth app for PrEP Adherence Among Young Racially Diverse Men and Transgender Women who have Sex with Men
Poster Number: F106Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Digital Health
Background. P3 (Prepared, Protected, emPowered) is an app that utilizes social networking and gaming to improve PrEP adherence among young men who have sex with men and transgender women (YMSM/YTW). Technology-based tools may improve patient adherence when integrated with education or counseling. We developed P3+, an extension of P3, to include adherence coaching; engaging participants in client-centered strengths-based discussions about sexual health and PrEP and assisting individuals in identifying barriers and developing tailored strategies to support PrEP adherence. Purpose. We describe the adaptation and implementation of adherence coaching and explore perceptions of the intervention. Methods. We first conducted a 30-day field test to adapt Integrated Next Step Counseling (iNSC) for delivery via text format. Next, we recruited YMSM/YTW from Houston, Tampa, Philadelphia, Chicago, Boston, and New York City (Bronx) to participate in a three-arm randomized controlled trial (SOC, P3, P3+). Eighty-one participants received the P3+ intervention for 3 months. Participants were offered up to 8 adherence coaching sessions during the intervention. We then conducted a survey and qualitative interviews (n=14) at 3-months. Results. We found that the iNSC techniques based on verbal communication (e.g., providing affirmations) were easily translated to text format and accepted by participants, whereas reflective listening statements (e.g., paraphrasing) were not well received by participants as they caused delays in the responses from coaches. Also, we found that quick responses from coaches were essential for active engagement. In the RCT, participants attended on average, 3 coaching sessions. Approximately 91% of participants (n=61/67) trusted the information they received from their coach, and ~71.6% believed their coach helped them solve any PrEP-related problems. A thematic analysis found adherence coaching was generally acceptable and engaging. Themes across interviews related to the benefits of coaches (e.g., resourceful), preferences for engagement (e.g., call vs. text), coach rapport (e.g., personable), and coaching topics (e.g., PrEP experiences, sexual health). A few participants reported not needing adherence coaching due to having access to similar resources. Conclusions. Adherence coaching delivered via in-app texting based on iNSC was feasible and acceptable and should be explored further as a companion to digital health interventions.
Keywords: HIV, TechnologyAuthors:
Presenter - Brittany L. Lane, PhD,
PhD,
Florida State University, College of Nursing, Center of Population Sciences for Health Equity
Co-Author - Crissi Rainer,
MS,
Florida State University, College of Nursing, Institute on Digital Health and Innovation
Co-Author - Kathryn Muessig,
PhD,
Florida State University, College of Nursing, Institute on Digital Health and Innovation
Co-Author - Casey Xavier Hall,
PhD, MPH,
Florida State University, College of Nursing, Center of Population Sciences for Health Equity
Co-Author - Lisa Hightow-Weidman, MD, MPH,
Florida State University, College of Nursing, Institute on Digital Health and Innovation
F107 - Alcohol use and misuse and the care continuum for HIV pre-exposure prophylaxis: a scoping review of research and interventions
Poster Number: F107Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Substance Misuse
Background: Pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV among individuals at high risk, however, its effectiveness is contingent on sufficient engagement across the PrEP care continuum, which includes awareness, willingness, uptake, adherence, and continuation. Alcohol use and misuse have been shown to affect different steps in the PrEP care continuum, but evidence remains mixed. Building on a previous scoping review (2021) on this subject, we synthesized the available evidence on alcohol’s impact on the PrEP care continuum and identified interventions for PrEP users who use alcohol.
Methods: Using PRISMA-ScR guidelines, we searched MEDLINE and Web of Science for studies published after March 31, 2020. Articles addressing (1) alcohol use, alcohol misuse, or alcohol use disorder and (2) one or more steps in the PrEP care continuum were included. We also included studies that evaluated the effectiveness of interventions for alcohol use among PrEP users. Data on study characteristics, populations, and outcomes were extracted and qualitatively synthesized.
Results: 48 studies were included. For PrEP awareness, evidence was mixed: 4 studies found positive associations, 3 reported negative associations, and 1 found no association. Among the 13 studies that focused on willingness to use PrEP, the effects of alcohol were split among positive, neutral, and negative associations. Among 11 PrEP uptake studies, most reported neutral effects, while some showed positive associations that are possibly due to heightened HIV risk awareness among alcohol users. For adherence, alcohol misuse was negatively associated in 10 studies, with fewer reporting positive or no effects. Continuation studies revealed mostly neutral findings, though there was an even split of positive and negative studies. 6 studies evaluated four interventions (e.g., motivational interviewing, digital feedback tools) to address alcohol use among PrEP users. While some interventions led to reductions in alcohol use or misuse, not one study significantly improved PrEP adherence or persistence.
Conclusions: Alcohol use and misuse influence the PrEP care continuum in complex ways, with varying associations depending on context and population. Although targeted interventions show potential, they remain underexplored. Future research should focus on improving PrEP care among individuals who face behavioral risk factors
Keywords: HIV, AlcoholismMethods: Using PRISMA-ScR guidelines, we searched MEDLINE and Web of Science for studies published after March 31, 2020. Articles addressing (1) alcohol use, alcohol misuse, or alcohol use disorder and (2) one or more steps in the PrEP care continuum were included. We also included studies that evaluated the effectiveness of interventions for alcohol use among PrEP users. Data on study characteristics, populations, and outcomes were extracted and qualitatively synthesized.
Results: 48 studies were included. For PrEP awareness, evidence was mixed: 4 studies found positive associations, 3 reported negative associations, and 1 found no association. Among the 13 studies that focused on willingness to use PrEP, the effects of alcohol were split among positive, neutral, and negative associations. Among 11 PrEP uptake studies, most reported neutral effects, while some showed positive associations that are possibly due to heightened HIV risk awareness among alcohol users. For adherence, alcohol misuse was negatively associated in 10 studies, with fewer reporting positive or no effects. Continuation studies revealed mostly neutral findings, though there was an even split of positive and negative studies. 6 studies evaluated four interventions (e.g., motivational interviewing, digital feedback tools) to address alcohol use among PrEP users. While some interventions led to reductions in alcohol use or misuse, not one study significantly improved PrEP adherence or persistence.
Conclusions: Alcohol use and misuse influence the PrEP care continuum in complex ways, with varying associations depending on context and population. Although targeted interventions show potential, they remain underexplored. Future research should focus on improving PrEP care among individuals who face behavioral risk factors
Authors:
Co-Author - Anton L.V. Avanceña,
The University of Texas at Austin
Co-Author - Rana Zalmai,
The University of Texas at Austin
Co-Author - Godwin Okoye,
The University of Texas at Austin
F108 - Development of a Stigma Intervention for Batswana Women Living with HIV and Serious Mental Illness
Poster Number: F108Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Mental Health
BACKGROUND: Women with serious mental illness (SMI) show elevated prevalence of HIV in sub-Saharan Africa. Women living with HIV and SMI (WLHSMI) are particularly vulnerable to medication nonadherence and decompensation. A prior peer and clinician co-led stigma intervention for pregnant HIV+ women in Botswana reduced stigma and depressive symptoms. The current study seeks to reduce intersectional stigma in WLHSMI, thus improving HIV viral load, treatment adherence, and mental health outcomes. This presentation outlines the collaborative process of developing the intervention. METHODS: The team included Botswana and US-based psychologists, psychiatrists, students, and HIV researchers. Semi-structured interviews with 6 WLHSMI were conducted, translated, and coded. Themes of around Respected Womanhood and Experienced Stigma informed revisions to an 8-session manual from an evidence-based anti-stigma manual. The team worked virtually for 16 months, recruiting mental health nurses and peer WLHSMI as co-leaders from a psychiatric hospital in Botswana. RESULTS: The intervention was piloted in June 2024 in Botswana by US and local team members. 7 clinicians and 12 WLHSMI were trained; 5 clinicians and 6 peers were selected co-leaders (understood content, actively participated, spoke/listened appropriately during small group work, willing to lead in training; peers only: shared lived experiences). Changes were made from local feedback, e.g., handouts revised for low literacy, sessions were opened and closed with prayer led by group member. Written feedback was collected via evaluation form (79% response rate). Verbal feedback was also included. Women reported good group cohesion, planning to use information, and highlighted graduation ceremony. Modules that were noted to have limited engagement were modified/dropped. The first intervention cohort is underway, with updates to be included in the final presentation. DISCUSSION: Through partnership with Batswana hospitals and universities, our study successfully developed a program to address intersectional stigma in WLHSMI. Cultural adaptation and input from local collaborators were crucial at each stage. Using interview and training feedback, we added vignettes of experienced stigma and stories of overcoming stigma and achieving Respected Womanhood to model cognitive reframing and behavioral adaptations. Final revisions will be made based on outcomes and scalability recommendations by public health partners.
Keywords: HIV, Mental healthAuthors:
Author - Valerie Jackson,
University of Central Florida
Co-Author - Hlanganiso Roy,
PhD,
University of Botswana
Author - Philip Opondo,
MD,
University of Botswana
Co-Author - Ari Ho-Foster,
MSc ,
University of Botswana
Co-Author - Karen Choe,
EdM,
New York University
Co-Author - Chris Kang,
MA,
New York University
Co-Author - Joee Zucker,
MA,
Palo Alto University
Co-Author - Lawrence Yang,
PhD,
New York University
F109 - From Brain to Body: The Effects of A Mindfulness Intervention on Neural Threat Reactivity And Inflammatory Gene Expression
Poster Number: F109Time: 11:00 AM - 11:50 AM
Topics: Integrative Health and Spirituality, Mental Health
Mindfulness interventions have demonstrated beneficial effects on both mental and physical health, but the neuroimmune mechanisms through which they confer these benefits remain unclear. Mindful awareness redirects attention toward the present moment, which may reduce threat-related neural activity and downstream inflammation in response to stress. Social-evaluative threat, where the self is negatively judged by others, is a stressor with potent inflammatory consequences. As part of a randomized controlled trial (NCT05304052), the current study tested whether a mindfulness intervention reduced neural reactivity to social-evaluative threat and reduced downstream pro-inflammatory signaling. Healthy young adults were randomly assigned to a waitlist control group (n = 23) or a 6-week mindfulness intervention (Mindful Awareness Practices; n = 26) that has been shown to reduce stress and inflammation. Before and after the intervention, we collected blood samples and BOLD neuroimaging data during a social-evaluative threat task (revised Montreal Imaging Stress Task; MIST), focusing on activity in three threat-related neural regions: the bilateral amygdala, the dorsal anterior cingulate cortex (dACC), and the bilateral anterior insula (AI). Leukocyte genome-wide RNA profiles were analyzed using promoter-based bioinformatic analyses to infer NF-κB transcription factor activity, a canonical pro-inflammatory signaling pathway. Relative to waitlist control, mindfulness led to reductions in amygdala activity (p=.03), dACC activity (p=.07), and AI activity (p=.04) in response to the MIST from pre- to post-intervention. Mindfulness also resulted in reductions in NF-κB activity (p=.01) pre- to post-intervention compared to the control condition. Further, the effect of mindfulness on NF-κB activity was no longer significant when changes in neural threat reactivity were included in the model (p=.80), suggesting that reduced responsiveness to threat in these structures may account for the impact of the mindfulness intervention on downstream inflammation. Overall, results indicate that mindfulness reduces neural reactivity to social-evaluative threat, which may contribute to beneficial changes in stress-inflammatory biology.
Keywords: Resilience, PsychoneuroimmunologyAuthors:
Co-Author - Robin Blades,
University of California, Los Angeles, Department of Psychology
Co-Author - Naomi Eisenberger,
University of California, Los Angeles, Department of Psychology
Co-Author - Steve W. Cole, PhD,
PhD,
University of California, Los Angeles, Cousins Center for Psychoneuroimmunology
Co-Author - Chloe Boyle,
University of California, Los Angeles, Cousins Center for Psychoneuroimmunology
Co-Author - Tyrus Korecki,
University of California, Los Angeles, Department of Psychology
Co-Author - Julienne Bower,
University of California, Los Angeles, Department of Psychology
F110 - Buffers of Death Anxiety in a Nationwide Probability Sample: The Role of Distress Tolerance, Afterlife Beliefs, and Spiritual/Religious Peace
Poster Number: F110Time: 11:00 AM - 11:50 AM
Topics: Integrative Health and Spirituality, Mental Health
Background: Death anxiety, or an individual’s fear of their own death, is highly prevalent in older adults as well as in individuals with chronic diseases such as HIV/AIDs and cancer. Heightened death anxiety is associated with depression, anxiety, fear of recurrence and fear of progression in cancer patients, and is a transdiagnostic factor underlying psychopathology more broadly. However, few studies have explored factors that may buffer against death anxiety, particularly with regards to positive psychological variables such as distress tolerance and religious/spiritual variables such as afterlife beliefs. Therefore, the aim of this study is to explore these potential buffers of death anxiety.
Methods: The study sample included participants (n = 2,396, mean age = 50.9, SD = 19.1) from the nationwide Landmark Spirituality and Health Survey. Death anxiety was assessed via four items including questions like "I do not feel prepared to face my own death" and "Thinking about death makes me feel uneasy.” Predictors were spiritual and religious measures and positive psychological measures. Covariates included sociodemographic variables and generalized anxiety.
Results: Hierarchical linear regression was used to analyze buffers of death anxiety. Model 1 tested sociodemographic control variables and included age, sex, race/ethnicity, and education. Model 2 added spiritual and religious variables: afterlife beliefs, identity centrality of faith, and spiritual/religious peace. Model 3 added positive psychological correlates including distress tolerance, optimism, and meaning in life. Lastly, model 4 added generalized anxiety. In the full model (model 4), lower death anxiety was associated with stronger afterlife beliefs (beta = -.054, t = -2.457, p = .014), higher spiritual/religious peace (beta = -.118, t = -3.151, p = .002), higher distress tolerance (beta = -.350, t = -13.378, p < .001), and lower general anxiety (beta = .058, t = 2.805, p = .005). Additionally, in a stepwise regression analysis, distress tolerance explained the most variance in death anxiety (14.5%), followed by spiritual/religious peace (2.4%), age (1.5%), and afterlife beliefs (0.4%).
Discussion: Results indicate that distress tolerance, spiritual/religious peace, and afterlife beliefs may serve as potential buffers against death anxiety. Future research should explore these effects longitudinally to understand causal mechanisms that can inform the development of interventions.
Keywords: Spirituality, BeliefsMethods: The study sample included participants (n = 2,396, mean age = 50.9, SD = 19.1) from the nationwide Landmark Spirituality and Health Survey. Death anxiety was assessed via four items including questions like "I do not feel prepared to face my own death" and "Thinking about death makes me feel uneasy.” Predictors were spiritual and religious measures and positive psychological measures. Covariates included sociodemographic variables and generalized anxiety.
Results: Hierarchical linear regression was used to analyze buffers of death anxiety. Model 1 tested sociodemographic control variables and included age, sex, race/ethnicity, and education. Model 2 added spiritual and religious variables: afterlife beliefs, identity centrality of faith, and spiritual/religious peace. Model 3 added positive psychological correlates including distress tolerance, optimism, and meaning in life. Lastly, model 4 added generalized anxiety. In the full model (model 4), lower death anxiety was associated with stronger afterlife beliefs (beta = -.054, t = -2.457, p = .014), higher spiritual/religious peace (beta = -.118, t = -3.151, p = .002), higher distress tolerance (beta = -.350, t = -13.378, p < .001), and lower general anxiety (beta = .058, t = 2.805, p = .005). Additionally, in a stepwise regression analysis, distress tolerance explained the most variance in death anxiety (14.5%), followed by spiritual/religious peace (2.4%), age (1.5%), and afterlife beliefs (0.4%).
Discussion: Results indicate that distress tolerance, spiritual/religious peace, and afterlife beliefs may serve as potential buffers against death anxiety. Future research should explore these effects longitudinally to understand causal mechanisms that can inform the development of interventions.
Authors:
Author - Gina Scorpiniti, MA,
MA,
University of Miami
Co-Author - Gail Ironson, PhD, MD, FSBM,
PhD, MD, FSBM,
University of Miami
F111 - Breaking Barriers, Building Trust: The Role of Context in Supporting Black College Men’s Mental Health
Poster Number: F111Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Social and Environmental Context and Health
Background: Emerging adult Black men in college experience unique stressors—academic pressures, racial discrimination, and societal expectations of masculinity—which contribute to depressive symptoms, poor academic performance, and an increased risk of dropping out. Despite the availability of mental health services, many do not seek formal help, further limiting their ability to manage stress and maintain academic success.
Purpose: This study explored the social and contextual factors influencing help-seeking behaviors among Black college men, offering insights into barriers and facilitators that can inform targeted interventions.
Methods: A qualitative design guided by the Social Ecological Model was employed. Five focus groups were conducted with 20 Black men aged 18 to 25 at an urban public university in the southeastern U.S. Participants discussed their experiences and perspectives on mental health and help-seeking. Data were analyzed to identify themes related to coping strategies, help-seeking motivations, barriers and facilitators, and societal views on vulnerability.
Results: Four organizing themes emerged: (1) Coping strategies, including substance use and social isolation, employed until participants reached a “boiling point” or breakdown; (2) Help-seeking motivations, influenced by personal crises or academic pressures; (3) Barriers and facilitators to help-seeking, highlighting the social construction of masculinity as a barrier and trust as a key facilitator; and (4) Societal views on vulnerability, which reinforced stigma around seeking formal help. Participants expressed a preference for informal support networks, including peers and female family members, over campus mental health services, citing cultural disconnection and lack of representation as concerns.
Conclusions: This study underscores the importance of context—specifically, how cultural and societal norms shape help-seeking behaviors among Black college men—offering lessons learned for developing culturally responsive interventions. Key recommendations include fostering trust through peer-led and trusted-family-led support programs and integrating cultural competence training into campus counseling services and advertisements. These findings highlight the need for campus-wide conversations around mental health and help-seeking, offering a roadmap to bridge the gap between Black college men’s lived experiences and the development of effective, accessible mental health care.
Keywords: Depression, Health behaviorsPurpose: This study explored the social and contextual factors influencing help-seeking behaviors among Black college men, offering insights into barriers and facilitators that can inform targeted interventions.
Methods: A qualitative design guided by the Social Ecological Model was employed. Five focus groups were conducted with 20 Black men aged 18 to 25 at an urban public university in the southeastern U.S. Participants discussed their experiences and perspectives on mental health and help-seeking. Data were analyzed to identify themes related to coping strategies, help-seeking motivations, barriers and facilitators, and societal views on vulnerability.
Results: Four organizing themes emerged: (1) Coping strategies, including substance use and social isolation, employed until participants reached a “boiling point” or breakdown; (2) Help-seeking motivations, influenced by personal crises or academic pressures; (3) Barriers and facilitators to help-seeking, highlighting the social construction of masculinity as a barrier and trust as a key facilitator; and (4) Societal views on vulnerability, which reinforced stigma around seeking formal help. Participants expressed a preference for informal support networks, including peers and female family members, over campus mental health services, citing cultural disconnection and lack of representation as concerns.
Conclusions: This study underscores the importance of context—specifically, how cultural and societal norms shape help-seeking behaviors among Black college men—offering lessons learned for developing culturally responsive interventions. Key recommendations include fostering trust through peer-led and trusted-family-led support programs and integrating cultural competence training into campus counseling services and advertisements. These findings highlight the need for campus-wide conversations around mental health and help-seeking, offering a roadmap to bridge the gap between Black college men’s lived experiences and the development of effective, accessible mental health care.
Authors:
Presenter - Kofoworola D.A. Williams,
PhD, MPH,
Drexel University
Co-Author - Sharyn A. Dougherty,
PhD, MPH,
Virginia Commonwealth University
Co-Author - Shawn Utsey,
PhD,
Virginia Commonwealth University
Co-Author - Jessica G. LaRose,
PhD,
Virginia Commonwealth University
Co-Author - Amy Adkins,
PhD,
Virginia Commonwealth University
Co-Author - Jeanine Guidry-Drost,
PhD,
Tilburg University
Co-Author - Spit for Science Working Group,
Virginia Commonwealth University
Co-Author - Kellie E. Carlyle,
PhD, MPH, MEd,
Virginia Commonwealth University
F112 - Characterizing geriatric mental telehealth services and patients served by the Veterans Health Administration’s regional telehealth providers
Poster Number: F112Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Digital Health
Background: Geriatric mental health (GMH) is an understaffed specialty within the Veterans Health Administration (VHA) where approximately half of Veterans served are aged 65 years or older. Through telehealth, non-local GMH providers can serve older Veterans and reduce patient stress related to travel. We aimed to characterize the GMH telehealth services received by older Veterans using electronic health record (EHR) data.
Methods: EHR data were extracted for the period of October 2021 to September 2023 from the Corporate Data Warehouse (a VHA national enterprise data system comprised of clinical and administrative data) for 4 regional telehealth GMH teams staffed by geriatric psychiatrists, pharmacists, geropsychologists, and neuropsychologists. Variables extracted included Veteran demographics, diagnoses (ICD-10 codes), services delivered at encounter, i.e. Clinical Procedural Terminology (CPT) codes, and visit modality. Data were summarized using descriptive statistics.
Results: 9,853 encounters were completed with 2,396 Veterans by 17 GMH providers across the 2-year period. Most patients were male (95.5%) with a mean age of 75.5 (SD = 8.3) years. Over half resided in urban areas (55.7%); 42.1% resided in either rural or highly rural areas. The majority were white (85.3%), and not Hispanic or Latino (82.2%). Video to home was the most frequent modality (46.8%) followed by video to clinic (27.5%), and phone (21%). Geriatric psychiatrists used all three modalities at comparable rates (39.7% video to home, 28.5% video to clinic, and 23.8% phone), geropsychologists and pharmacists used video to home most often (63.4%, 48.9%, respectively), and neuropsychologists mostly utilized video to clinic (81.3%). Medication management (65.8%) and psychotherapy (32.4%) were the most provided services. High complexity of Veteran needs was indicated by co-occurrence of dementia and mental health diagnoses (depression, PTSD, anxiety) and frequent use of the interactive complexity CPT code alongside medical or psychotherapy services.
Conclusions: GMH providers provided high rates of video telehealth services to patients with complex cognitive and mental health needs compared to audio-only services. The variations in telehealth modality across disciplines may signify differences in providers’ roles. Future directions will examine whether rural and non-rural Veterans differ in their utilization of telehealth services by provider type, modality, and type of service.
Keywords: Aging, Tele-healthMethods: EHR data were extracted for the period of October 2021 to September 2023 from the Corporate Data Warehouse (a VHA national enterprise data system comprised of clinical and administrative data) for 4 regional telehealth GMH teams staffed by geriatric psychiatrists, pharmacists, geropsychologists, and neuropsychologists. Variables extracted included Veteran demographics, diagnoses (ICD-10 codes), services delivered at encounter, i.e. Clinical Procedural Terminology (CPT) codes, and visit modality. Data were summarized using descriptive statistics.
Results: 9,853 encounters were completed with 2,396 Veterans by 17 GMH providers across the 2-year period. Most patients were male (95.5%) with a mean age of 75.5 (SD = 8.3) years. Over half resided in urban areas (55.7%); 42.1% resided in either rural or highly rural areas. The majority were white (85.3%), and not Hispanic or Latino (82.2%). Video to home was the most frequent modality (46.8%) followed by video to clinic (27.5%), and phone (21%). Geriatric psychiatrists used all three modalities at comparable rates (39.7% video to home, 28.5% video to clinic, and 23.8% phone), geropsychologists and pharmacists used video to home most often (63.4%, 48.9%, respectively), and neuropsychologists mostly utilized video to clinic (81.3%). Medication management (65.8%) and psychotherapy (32.4%) were the most provided services. High complexity of Veteran needs was indicated by co-occurrence of dementia and mental health diagnoses (depression, PTSD, anxiety) and frequent use of the interactive complexity CPT code alongside medical or psychotherapy services.
Conclusions: GMH providers provided high rates of video telehealth services to patients with complex cognitive and mental health needs compared to audio-only services. The variations in telehealth modality across disciplines may signify differences in providers’ roles. Future directions will examine whether rural and non-rural Veterans differ in their utilization of telehealth services by provider type, modality, and type of service.
Authors:
Author - Chalise Carlson,
VA Palo Alto Health Care System, GRECC
Co-Author - Shilpa Hampole,
MA,
Dissemination and Training Division, Nation Center for PTSD, VA Palo Alto Health Care System
Co-Author - Zachary Burningham,
PhD,
VA Salt Lake City Medical Center, Health Services Research and Development Informatics, Decision-Enhancement, and Analytic Science (IDEAS) Center of Innovation, Salt Lake City, Utah, USA
Co-Author - Marika B. Humber,
PhD,
VA Palo Alto Health Care System, GRECC
Co-Author - Marisa Brodrick,
VA Palo Alto Health Care System, GRECC
Co-Author - Susan Schultz,
MD,
Department of Veterans Affairs
Co-Author - Christine E. Gould, PhD,
PhD,
VA Palo Alto
F114 - Group Cognitive Behavioral Therapy for Functional Neurological Disorder
Poster Number: F114Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Quality of Life
Introduction: Functional Neurological Disorder (FND) describes clinical syndromes of alterations in motor, sensory, or cognitive functioning that are inconsistent with other neurological conditions and are not explained by other medical or psychiatric conditions. FND is a common cause of disability and distress increasingly seen in neurological practices, representing up to 10% of all new neurological consultations. With the demand for FND-specific care outpacing the availability of specialized providers, scalable interventions such as group tele-psychotherapy may address gaps in care delivery.
Methods: For this study of telehealth group psychotherapy for patients with FND, 16 adult participants were recruited from the waitlist of a neurology clinic’s embedded psychology service. Patients were randomly assigned to immediate intervention (Group 1) or an 8-week waitlist control before intervention (Group 2). Participants provided information on their FND illness experience and treatment, quality of life, psychological well-being, and functional symptoms. Relationships between diagnostic experiences, well-being, and therapy engagement were investigated.
Results: Average time from symptom onset to therapy initiation was 10.2 years (range: 1.3–30.4 years), with an average delay of 9.6 years to receiving an FND diagnosis (range: 1 week–30.2 years). Longer delays between symptom onset and start of psychotherapy were associated with increased anxiety (r=.68, p=.05) and depression (r=.67, p=.05), worsened emotional well-being (r=-.65, p=.05), more physical pain (r=-.63, p=.05), and worse overall health (r=-.65, p=.05) at baseline. Experiences of stigmatization and discrimination related to FND were related to worsened emotional well-being (r=-.65, p=.05). Further, higher baseline somatization (r=-.69, p=.01) and psychiatric comorbidities (r=-.61, p=.05) were associated with reduced therapy attendance.
Conclusions: Findings underscore the need to reduce diagnostic delays and improve access to timely FND care. Delays in FND diagnosis and treatment exacerbate psychological distress and physical symptoms, highlighting the importance of early intervention. Experiences of stigmatization and discrimination related to FND were independently associated with poorer emotional well-being, emphasizing the need for sensitive diagnostic communication and psychoeducation. Telehealth group psychotherapy offers a scalable and accessible option for addressing these challenges.
Keywords: Tele-health, CBTMethods: For this study of telehealth group psychotherapy for patients with FND, 16 adult participants were recruited from the waitlist of a neurology clinic’s embedded psychology service. Patients were randomly assigned to immediate intervention (Group 1) or an 8-week waitlist control before intervention (Group 2). Participants provided information on their FND illness experience and treatment, quality of life, psychological well-being, and functional symptoms. Relationships between diagnostic experiences, well-being, and therapy engagement were investigated.
Results: Average time from symptom onset to therapy initiation was 10.2 years (range: 1.3–30.4 years), with an average delay of 9.6 years to receiving an FND diagnosis (range: 1 week–30.2 years). Longer delays between symptom onset and start of psychotherapy were associated with increased anxiety (r=.68, p=.05) and depression (r=.67, p=.05), worsened emotional well-being (r=-.65, p=.05), more physical pain (r=-.63, p=.05), and worse overall health (r=-.65, p=.05) at baseline. Experiences of stigmatization and discrimination related to FND were related to worsened emotional well-being (r=-.65, p=.05). Further, higher baseline somatization (r=-.69, p=.01) and psychiatric comorbidities (r=-.61, p=.05) were associated with reduced therapy attendance.
Conclusions: Findings underscore the need to reduce diagnostic delays and improve access to timely FND care. Delays in FND diagnosis and treatment exacerbate psychological distress and physical symptoms, highlighting the importance of early intervention. Experiences of stigmatization and discrimination related to FND were independently associated with poorer emotional well-being, emphasizing the need for sensitive diagnostic communication and psychoeducation. Telehealth group psychotherapy offers a scalable and accessible option for addressing these challenges.
Authors:
Co-Author - Matthew Kridel,
PhD,
Wellstar MCG Health
Co-Author - J. Hunter Chavis,
BS,
Augusta University Department of Psychological Sciences
F115 - Wellness centers address high-achieving students’ mental and physical health
Poster Number: F115Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Cardiovascular Disease
In recent years, the educational landscape witnessed a significant increase in the prevalence of behavioral health challenges among high-achieving students. Factors including academic pressures, societal expectations, and the complexities of modern adolescence have contributed to this surge. One intervention that has gained traction is the establishment of school-based wellness centers, which aim to provide a holistic approach to student well-being by integrating mental and physical health services directly within the school environment. This longitudinal study employing a convergent parallel mixed-methods design investigated the efficacy of school-based wellness centers in addressing mental and physical health challenges and improving academic outcomes in high-achieving secondary schools. A cluster-randomized controlled trial was conducted across six high-performing schools (n=3312 students) over three years. Qualitative data were collected through in-depth semi-structured interviews and focus groups with school administrators, counselors, and students pre- and post-intervention. Thematic analysis and open coding was employed. Findings underscored the wellness center’s crucial role in offering timely interventions, promoting mental and physical health awareness, and cultivating a culture of well-being. Challenges included integrating the center into the school's daily routine and ensuring consistent student engagement. Quantitative data were collected through validated mental health assessments and academic performance metrics. Multilevel modeling revealed that students in schools with wellness centers showed significant reductions in depression (β=-0.42, 95% CI [-0.55, -0.29], p<0.01) and anxiety symptoms (β=-0.38, 95% CI [-0.51, -0.25], p<0.01) compared to control schools. Additionally, students in the wellness center schools demonstrated a 16% increase in physical activity levels, as measured by accelerometer data, over the course of the study period (p<0.01). Academic performance, measured by standardized test scores, improved significantly in intervention schools (Cohen's d=0.31, p<0.05). This study provides a context-rich understanding of the multifaceted impacts of school-based wellness centers within high-achieving school settings. Insights gleaned underscore the imperative for educational stakeholders to prioritize and invest in such interventions, given their potential to reshape the wellness experience at the school systems level.
Keywords: Prevention, Behavior ChangeAuthors:
Co-Presenter - Rick Yang,
Harvard College
Co-Presenter - Alina Yang,
Scarsdale High School
F117 - Suicide Deaths Within 12 Months After Positive Risk Screening During Healthcare Encounters
Poster Number: F117Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Social and Environmental Context and Health
Background: Suicide is a significant public health concern in the US. The Joint Commission requires suicide risk screening in psychiatric settings and for patients with behavioral complaints in non-psychiatric settings, but suicide decedents often have healthcare encounters for non-psychiatric concerns before death. A large hospital system implemented a universal suicide risk screening program to improve detection across all healthcare settings, regardless of presenting complaint.
Methods: Suicide risk screening, demographic, and clinical data were extracted from the electronic health record to examine trends in risk identification over a 10-year period: five years prior to screening implementation (Pre) and five years after (Post). A modified Levenshtein ratio and seven sequential matching steps were used to link patients with a death within twelve months after positive index event using state mortality data. Patients with a positive encounter in the Pre era were not included in Post era. Encounters were further analyzed by presenting complaint.
Results: In the Pre era (N = 13,385), the average suicide death rate within 365 days of a positive index event was 2,189.7, with 33.6% of deaths linked to non-behavioral health after an index encounter at a rate of 1,183.2 suicides. In the Post era (N = 47,077), the average rate was 2,042.3, with 67% of suicide deaths linked to non-behavioral healthcare after an index encounter, at a rate of 118.8 suicides. Over 68% of all positive index events occurred in the emergency department in both eras. In the Post era, rates of suicide deaths per 100 000 person-years after a positive index event in the ED that presented for non-behavioral healthcare were 131.9. Inpatient healthcare accounted for less than 9% of all positive index events in the Post era yet yielded the highest rates of suicide (non-behavioral health = 257.8; behavioral health = 304.4) compared to all other settings.
Conclusions: This is the first large study to compare patterns between pre- versus post-universal screening eras which links healthcare encounters in the 12 months subsequent to an index encounter with state mortality data. Across the study period, the average rate of suicide death among non-behavioral health encounters was 242.5, underscoring the importance of optimizing risk identification to improve prevention. Understanding the variability of utilization and risk across clinical contexts may help guide these prevention efforts.
Keywords: Risk, Health behaviorsMethods: Suicide risk screening, demographic, and clinical data were extracted from the electronic health record to examine trends in risk identification over a 10-year period: five years prior to screening implementation (Pre) and five years after (Post). A modified Levenshtein ratio and seven sequential matching steps were used to link patients with a death within twelve months after positive index event using state mortality data. Patients with a positive encounter in the Pre era were not included in Post era. Encounters were further analyzed by presenting complaint.
Results: In the Pre era (N = 13,385), the average suicide death rate within 365 days of a positive index event was 2,189.7, with 33.6% of deaths linked to non-behavioral health after an index encounter at a rate of 1,183.2 suicides. In the Post era (N = 47,077), the average rate was 2,042.3, with 67% of suicide deaths linked to non-behavioral healthcare after an index encounter, at a rate of 118.8 suicides. Over 68% of all positive index events occurred in the emergency department in both eras. In the Post era, rates of suicide deaths per 100 000 person-years after a positive index event in the ED that presented for non-behavioral healthcare were 131.9. Inpatient healthcare accounted for less than 9% of all positive index events in the Post era yet yielded the highest rates of suicide (non-behavioral health = 257.8; behavioral health = 304.4) compared to all other settings.
Conclusions: This is the first large study to compare patterns between pre- versus post-universal screening eras which links healthcare encounters in the 12 months subsequent to an index encounter with state mortality data. Across the study period, the average rate of suicide death among non-behavioral health encounters was 242.5, underscoring the importance of optimizing risk identification to improve prevention. Understanding the variability of utilization and risk across clinical contexts may help guide these prevention efforts.
Authors:
Author - Julia Livingstone,
MA,
UT Southwestern Medical Center
Co-Author - Olivia Hudgens,
BA,
UT Southwestern Medical Center
Co-Author - Alex Treacher,
PhD,
Parkland Center for Clinical Innovations
Co-Author - Jacqueline Naeem,
MD,
Parkland Center for Clinical Innovations
Co-Author - Sidra Goldman-Mellor,
PhD, MPH,
UC Merced
Co-Author - Michael Schoenbaum,
PhD,
National Institutes of Health (NIH/NIMH)
Co-Author - Kimberly Roaten,
PhD,
UT Southwestern Medical Center, Parkland Health and Hospital System
F119 - Exploring the Scalability and Potential for Implementation of IDEAS for Hope, a Telehealth-Delivered Counseling Intervention for Suicide Prevention Among People Living with HIV in Kilimanjaro, Tanzania.
Poster Number: F119Time: 11:00 AM - 11:50 AM
Topics: Mental Health, HIV/AIDS
Background
Despite the life-saving potential of mental health interventions, their scalability and integration within healthcare systems present significant challenges, particularly in low-resource global settings. In this study, we investigated the potential to scale and integrate IDEAS for Hope, a brief telehealth counseling intervention designed to reduce suicidality and improve HIV care engagement among people living with HIV (PLWH) in Kilimanjaro, Tanzania. By examining the complex interplay of barriers and facilitators, our objective was to conduct qualitative interviews focused on identifying actionable strategies for successful national implementation.
Methods
We used purposive sampling to recruit participants from key stakeholder groups, including healthcare administrators, network and internet providers, representatives from the Ministry of Health, and community organizations. We conducted semi-structured in-depth interviews using a guide informed by the Consolidated Framework for Implementation Research (CFIR). Interviews were audio-recorded, and transcripts were coded in a team-based approach to identify barriers and facilitators to implementation of the IDEAS for Hope intervention. The CFIR – Expert Recommendations for Implementing Change (ERIC) mapping approach will be used to interpret the data and to identify targeted implementation strategies.
Results
Despite strong institutional support and emerging policy guidelines aimed at integrating mental health with HIV care, significant barriers persist. These include a shortage of trained mental health professionals, limited technological access in rural areas, the criminalization of suicide, and deeply entrenched stigma. Stakeholders recommended training peer counselors, enacting policy reforms to better support mental health integration, introducing mental health programs or concentrations in universities and colleges, addressing stigma, utilizing multiple communication channels, and developing inclusive technological platforms to enhance the reach and effectiveness of the intervention.
Conclusion
Our research reveals that the successful implementation of mental health interventions in Tanzania requires addressing systemic, legal, cultural, and infrastructural barriers. By identifying and addressing these key challenges, the research provides a practical roadmap for implementing similar interventions in other low-resource settings.
Keywords: Research to practice translation, Mental healthDespite the life-saving potential of mental health interventions, their scalability and integration within healthcare systems present significant challenges, particularly in low-resource global settings. In this study, we investigated the potential to scale and integrate IDEAS for Hope, a brief telehealth counseling intervention designed to reduce suicidality and improve HIV care engagement among people living with HIV (PLWH) in Kilimanjaro, Tanzania. By examining the complex interplay of barriers and facilitators, our objective was to conduct qualitative interviews focused on identifying actionable strategies for successful national implementation.
Methods
We used purposive sampling to recruit participants from key stakeholder groups, including healthcare administrators, network and internet providers, representatives from the Ministry of Health, and community organizations. We conducted semi-structured in-depth interviews using a guide informed by the Consolidated Framework for Implementation Research (CFIR). Interviews were audio-recorded, and transcripts were coded in a team-based approach to identify barriers and facilitators to implementation of the IDEAS for Hope intervention. The CFIR – Expert Recommendations for Implementing Change (ERIC) mapping approach will be used to interpret the data and to identify targeted implementation strategies.
Results
Despite strong institutional support and emerging policy guidelines aimed at integrating mental health with HIV care, significant barriers persist. These include a shortage of trained mental health professionals, limited technological access in rural areas, the criminalization of suicide, and deeply entrenched stigma. Stakeholders recommended training peer counselors, enacting policy reforms to better support mental health integration, introducing mental health programs or concentrations in universities and colleges, addressing stigma, utilizing multiple communication channels, and developing inclusive technological platforms to enhance the reach and effectiveness of the intervention.
Conclusion
Our research reveals that the successful implementation of mental health interventions in Tanzania requires addressing systemic, legal, cultural, and infrastructural barriers. By identifying and addressing these key challenges, the research provides a practical roadmap for implementing similar interventions in other low-resource settings.
Authors:
Author - Paul Ngangula,
Duke Global Health Institute
Co-Author - Louise Joel,
Kilimanjaro Christian Medical Centre
Co-Author - Jackline Rwakilomba,
Kilimanjaro Christian Medical Centre
Co-Author - Ryan Parker,
Duke Global Health Institute
Co-Author - Kim Madundo,
Kilimanjaro Christian Medical University
Co-Author - Ismail Amiri,
Duke Global Health Institute
Co-Author - Brandon A. Knettel, Ph.D.,
Ph.D.,
Duke Global Health Institute
F120 - The Impact of a Creative Narrative Behavioral Health Intervention for SGM Emerging Adults of Color
Poster Number: F120Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Mental Health
Introduction: Critical Narrative Interventions (CNI) are an evidence-based intervention strategy that elicits self-reflection and encourages behavior change. However, CNIs have not been examined as a strategy to address the mental health of sexual and gender minority (SGM) communities of color, who are often disproportionately affected by depression, anxiety, and suicide risk. In this pilot study, we assessed the feasibility and acceptability of CNIs to address the mental health of emerging adult SGM of color.
Methods: SGM emerging adults of color (N=15; M=20.70 years; SD=1.8) were randomized to one of two CNI strategies: a) a photo-novella condition (i.e., photographs) or b) a digital storytelling condition (i.e., videos). Participants had 30 days to create a narrative illustrating how they have felt seen or unseen as SGM persons of color. Participants reported on the feasibility, acceptability, and appropriateness of their assigned CNI via surveys. We also assessed the CNI’s effect on mental health treatment attitudes (α = .81), depression symptoms (α = .75), anxiety symptoms (α = .85), psychological well-being (α = .89), and self-esteem (α = .81) by examining the changes from baseline and 30-day follow-up surveys using paired sample t-tests.
Results: Participants self-identified as Asian/Asian American (50%), Black/African American (25%), Multiracial (15%), and Hispanic Black (5%) and Gay, Lesbian, Bisexual, Queer, Asexual and Cisgender, Genderqueer, Non-binary, and Transgender. CNIs were acceptable (M=17.26; SD = 3.15), appropriate (M=17.47; SD = 2.39), and feasible (M=16.60; SD = 2.46). Overall, participants reported decreases in depression (M=12.80(3.47) to M=10.53(4.44); p = .01), anxiety (M=10.87(4.27) to M=9.13(3.85); p=.03) and increased psychological well-being (M=40.27(8.24) to M=42.07(6.44); p=.04), and attitudes towards mental health treatment (M=51.33(12.87) to M=54.67(9.97); p=.03) from pre- to post-CNI. There were no significant changes in self-esteem. No differences by CNI assignment were observed.
Discussion: CNIs are feasible for SGM communities of color and have promise in impacting mental health outcomes. Findings have implications for the development and scalability of narratives as stand-alone independent strategies or as components that can be incorporated into mHealth interventions.
Keywords: Minority health, InterventionMethods: SGM emerging adults of color (N=15; M=20.70 years; SD=1.8) were randomized to one of two CNI strategies: a) a photo-novella condition (i.e., photographs) or b) a digital storytelling condition (i.e., videos). Participants had 30 days to create a narrative illustrating how they have felt seen or unseen as SGM persons of color. Participants reported on the feasibility, acceptability, and appropriateness of their assigned CNI via surveys. We also assessed the CNI’s effect on mental health treatment attitudes (α = .81), depression symptoms (α = .75), anxiety symptoms (α = .85), psychological well-being (α = .89), and self-esteem (α = .81) by examining the changes from baseline and 30-day follow-up surveys using paired sample t-tests.
Results: Participants self-identified as Asian/Asian American (50%), Black/African American (25%), Multiracial (15%), and Hispanic Black (5%) and Gay, Lesbian, Bisexual, Queer, Asexual and Cisgender, Genderqueer, Non-binary, and Transgender. CNIs were acceptable (M=17.26; SD = 3.15), appropriate (M=17.47; SD = 2.39), and feasible (M=16.60; SD = 2.46). Overall, participants reported decreases in depression (M=12.80(3.47) to M=10.53(4.44); p = .01), anxiety (M=10.87(4.27) to M=9.13(3.85); p=.03) and increased psychological well-being (M=40.27(8.24) to M=42.07(6.44); p=.04), and attitudes towards mental health treatment (M=51.33(12.87) to M=54.67(9.97); p=.03) from pre- to post-CNI. There were no significant changes in self-esteem. No differences by CNI assignment were observed.
Discussion: CNIs are feasible for SGM communities of color and have promise in impacting mental health outcomes. Findings have implications for the development and scalability of narratives as stand-alone independent strategies or as components that can be incorporated into mHealth interventions.
Authors:
Author - Jennifer Tran,
PhD,
University of Pennsylvania
Co-Author - Jessica Webster,
MSc,
University of Pennsylvania
Co-Author - Tyler Burgese,
MA,
University of Pennsylvania
Co-Author - Jose Bauermeister,
PhD, MPH,
University of Pennsylvania
F121 - Race-Based Discrimination, Internalized Racism, and Anticipatory Stigma among Male Couples: A Comparative Study of White, Racial/Ethnic Minority, and Interracial Dyads
Poster Number: F121Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Stress
Background: Interracial male couples experience greater minority stress than same-race male couples and heterosexual dyads. Although research has explored interracial and same-race relationships in the context of minority stress theory, no study has integrated both race/ethnicity and same-sex couple dynamics in this topic. We examined differences in experiences of race-based discrimination, internalized racism, and anticipatory stigma among individuals within similar or mixed racial/ethnic relationships.
Methods: Baseline data were drawn from the Empowering Relationships and Opportunities for Safety project. A sample of 391 sexual minority men (SMM) in romantic relationships (Mage=32.1 years; 63.7% racial/ethnic minority) reported experiences of race-based discrimination, internalized racism, and anticipatory stigma. A MANOVA model examined differences in these outcomes across the following groups: a) Latinx SMM with a Latinx partner, b) White SMM with a White SMM partner, c) Black SMM with a Black partner, d) Asian SMM with an Asian partner, e) White SMM with a partner of color, and f) SMM of color with a White partner.
Results: There were significant differences in SMM’s experiences with racism and stigma across dyad groups. Compared to White couples, SMM of color with a partner of color experienced significantly higher levels of internalized racism and forms of race-based discrimination. There was also significant heterogeneity in internalized racism and anticipatory stigma across SMM of color with a partner of color. Additionally, experiences of racism and stigma were consistently higher among SMM of color with a White partner, compared to White SMM with a partner of color.
Implications: Our findings highlight the importance of considering lived experiences of racial and ethnic identity and male couple dynamics when designing relationship-based interventions. Future interventions should acknowledge within-group differences across male couples of color, raise awareness of intersectional stress, and facilitate discussions around lived experience for interracial couples.
Keywords: Minority health, RaceMethods: Baseline data were drawn from the Empowering Relationships and Opportunities for Safety project. A sample of 391 sexual minority men (SMM) in romantic relationships (Mage=32.1 years; 63.7% racial/ethnic minority) reported experiences of race-based discrimination, internalized racism, and anticipatory stigma. A MANOVA model examined differences in these outcomes across the following groups: a) Latinx SMM with a Latinx partner, b) White SMM with a White SMM partner, c) Black SMM with a Black partner, d) Asian SMM with an Asian partner, e) White SMM with a partner of color, and f) SMM of color with a White partner.
Results: There were significant differences in SMM’s experiences with racism and stigma across dyad groups. Compared to White couples, SMM of color with a partner of color experienced significantly higher levels of internalized racism and forms of race-based discrimination. There was also significant heterogeneity in internalized racism and anticipatory stigma across SMM of color with a partner of color. Additionally, experiences of racism and stigma were consistently higher among SMM of color with a White partner, compared to White SMM with a partner of color.
Implications: Our findings highlight the importance of considering lived experiences of racial and ethnic identity and male couple dynamics when designing relationship-based interventions. Future interventions should acknowledge within-group differences across male couples of color, raise awareness of intersectional stress, and facilitate discussions around lived experience for interracial couples.
Authors:
Author - Junye Ma, MA,
MS,
SDSU-UC San Diego Joint Doctoral Program in Clinical Psychology
Co-Author - Glenn Wagner, PhD,
RAND
Co-Author - Daniel Siconolfi,
Ph.D., MPH,
RAND
Co-Author - Carrie L. Nacht,
MPH,
San Diego State University
Co-Author - Erik Storholm,
Ph.D.,
San Diego State Univeristy
F122 - An Investigation of Team Safety among Sexual and Gender Minority College Athletes
Poster Number: F122Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Physical Activity
Introduction: Efforts to promote welcoming environments for sexual and gender minority (SGM) college athletes tend to focus on reducing discrimination and acts of violence against them. Preventing discrimination may be necessary, but insufficient to promote team safety for SGM college athletes. Guided by a community advisory board comprised of former and current SGM college athletes, the present study explored whether psychological safety, belongingness, and SGM student-athlete climate contributed to team safety, and examined the impact of team safety on SGM athletes’ well-being. We hypothesized that SGM college athletes with greater perceived team safety would report greater well-being.
Method: Participants included 131 SGM college athletes (33.6% gender minority, 99.2% sexual minority, 61.1% racial/ethnic minority) who completed an online questionnaire. Exploratory factor analysis was conducted to examine the ways in which belongingness, psychological safety, and SGM student-athlete climate contributed to the construct of team safety. We also tested a structural equation model to examine the extent to which the factor scores that constituted team safety were associated with well-being.
Results: The exploratory factor analysis results suggest that components of psychological safety, belongingness, and SGM student-athlete climate contributed to two factors to create the construct of team safety, namely inclusive behaviors and absence of social exclusion. The inclusive behaviors factor accounted for 76.28% of the variance, while the absence of social exclusion factor accounted for 4.1% of the variance. For the structural equation model results, the measurement model demonstrated good fit (CFI = .98, TLI = .98, RMSEA = .06, SRMR = .02). Greater perception of team safety was significantly associated with greater well-being (b = .87, p < .001).
Discussion: Results may provide guidance for making university-organized athletics and sports a safe and inclusive environment for SGM college athletes. Findings from our study suggest that facilitating team safety for SGM college athletes requires the absence of social exclusion and the promotion of inclusive behaviors, which can be established through anti-discrimination policies and institutional programming to promote inclusion.
Keywords: Sexual orientation, Minority healthMethod: Participants included 131 SGM college athletes (33.6% gender minority, 99.2% sexual minority, 61.1% racial/ethnic minority) who completed an online questionnaire. Exploratory factor analysis was conducted to examine the ways in which belongingness, psychological safety, and SGM student-athlete climate contributed to the construct of team safety. We also tested a structural equation model to examine the extent to which the factor scores that constituted team safety were associated with well-being.
Results: The exploratory factor analysis results suggest that components of psychological safety, belongingness, and SGM student-athlete climate contributed to two factors to create the construct of team safety, namely inclusive behaviors and absence of social exclusion. The inclusive behaviors factor accounted for 76.28% of the variance, while the absence of social exclusion factor accounted for 4.1% of the variance. For the structural equation model results, the measurement model demonstrated good fit (CFI = .98, TLI = .98, RMSEA = .06, SRMR = .02). Greater perception of team safety was significantly associated with greater well-being (b = .87, p < .001).
Discussion: Results may provide guidance for making university-organized athletics and sports a safe and inclusive environment for SGM college athletes. Findings from our study suggest that facilitating team safety for SGM college athletes requires the absence of social exclusion and the promotion of inclusive behaviors, which can be established through anti-discrimination policies and institutional programming to promote inclusion.
Authors:
Co-Author - Kristin L. Schneider, PhD,
PhD,
Rosalind Franklin University of Medicine & Science
F123 - Assessing feasibility, appropriateness, and acceptability of digital patient journaling for qualitative data collection in cancer research
Poster Number: F123Time: 11:00 AM - 11:50 AM
Topics: Methods and Measurement, Cancer
Digital methods for qualitative data collection in cancer research remain underutilized, despite their ability to increase patient access to participation, support inductive inquiry, and produce innovative findings. Our objective is to develop a feasible, appealing, and user-friendly digital approach qualitative research participation. In this study we assessed feasibility, appropriateness, and acceptability of using digital patient journaling (DPJ) for collecting qualitative data.
Thirty patients who completed treatment for breast cancer (N=15) or head and neck cancer (N=15) were asked to participate in weekly DPJ for a total of four weeks. Participants were asked each week to respond to a prompt or free write. Feasibility was assessed by rates of recruitment, journal entry completion, and retention, as well as patient-reported feasibility via exit survey using a validated measure. Patient-reported appropriateness, acceptability, and usability were assessed through exit surveys using validated measures. Semi-structured interviews were conducted with a subset of participants (N=10) to further understand perspectives about quality, barriers, facilitators, and recommendations. Thematic analysis was used to examine qualitative data and descriptive statistics were computed for quantitative data.
Patients averaged 56.8 years old, and most were White (53.3%) and non-Hispanic (66.7%). One third (33.3%) were college graduates. Recruitment rate (73%) and journal completion rate (75%) indicate feasibility, while retention rate (60%), indicates need for enhanced support for retention. However, patient-reported data (Likert scale, 1=strongly disagree, 5=strongly agree) indicates high feasibility (mean=4.4), appropriateness (mean=4.29), and acceptability (mean=4.29). Patients found DPJ easy to use (mean=4.39) and felt others would learn to use DPJ very quickly (mean=4.06). During interviews, patients reported high receptivity to DPJ, high ease of use, and DPJ may have therapeutic benefit. Patients indicated DPJ had potential to enhance understandings of patient experiences for researchers, providers, family members, and other patients. Recommendations included ability to edit, distribute, and personalize journal entries.
Findings underscore DPJ as a mostly feasible, appropriate, and appealing method of qualitative data collection with potential to offer insights into patient experiences, as well as therapeutic benefit, enhanced social support, and improved care.
Keywords: Research methods, CancerThirty patients who completed treatment for breast cancer (N=15) or head and neck cancer (N=15) were asked to participate in weekly DPJ for a total of four weeks. Participants were asked each week to respond to a prompt or free write. Feasibility was assessed by rates of recruitment, journal entry completion, and retention, as well as patient-reported feasibility via exit survey using a validated measure. Patient-reported appropriateness, acceptability, and usability were assessed through exit surveys using validated measures. Semi-structured interviews were conducted with a subset of participants (N=10) to further understand perspectives about quality, barriers, facilitators, and recommendations. Thematic analysis was used to examine qualitative data and descriptive statistics were computed for quantitative data.
Patients averaged 56.8 years old, and most were White (53.3%) and non-Hispanic (66.7%). One third (33.3%) were college graduates. Recruitment rate (73%) and journal completion rate (75%) indicate feasibility, while retention rate (60%), indicates need for enhanced support for retention. However, patient-reported data (Likert scale, 1=strongly disagree, 5=strongly agree) indicates high feasibility (mean=4.4), appropriateness (mean=4.29), and acceptability (mean=4.29). Patients found DPJ easy to use (mean=4.39) and felt others would learn to use DPJ very quickly (mean=4.06). During interviews, patients reported high receptivity to DPJ, high ease of use, and DPJ may have therapeutic benefit. Patients indicated DPJ had potential to enhance understandings of patient experiences for researchers, providers, family members, and other patients. Recommendations included ability to edit, distribute, and personalize journal entries.
Findings underscore DPJ as a mostly feasible, appropriate, and appealing method of qualitative data collection with potential to offer insights into patient experiences, as well as therapeutic benefit, enhanced social support, and improved care.
Authors:
Co-Author - Rebecca Blackwell,
PhD,
Moffitt Cancer Center
Co-Author - Melinda Maconi,
PhD,
Moffitt Cancer Center
Co-Author - Melanie Buhlmann,
Moffitt Cancer Center
Co-Author - Taylor Welniak,
Moffitt Cancer Center
Co-Author - Kimberley Lee, MD, MHS,
MD, MHS,
Moffitt Cancer Center
Co-Author - Kedar Kirtane,
MD,
Moffitt Cancer Center
Co-Author - Brian D. Gonzalez, PhD,
PhD,
Moffitt Cancer Center
F124 - Suicide risk acuity patterns across healthcare settings: Context is key
Poster Number: F124Time: 11:00 AM - 11:50 AM
Topics: Methods and Measurement, Mental Health
Background: Suicide risk detection across healthcare settings is an essential component of prevention. Many healthcare systems focus on risk identification only among patients seeking behavioral healthcare, consistent with The Joint Commission (TJC) requirements. However, most individuals who die by suicide have contact with non-behavioral health clinicians just prior to death. More information is needed about the distribution of risk acuity across healthcare contexts from primary care to emergency departments (ED) and across all presenting complaints.
Methods: Data were analyzed from >3 million encounters during a 5-year period following implementation of a universal suicide screening program in a hospital system. Suicide risk acuity was determined based on clinical data and on responses to validated screening measures, the Ask-Suicide Screening Questions and the Columbia-Suicide Severity Rating Scale, screener version:
No Risk: negative screening.
Historical Risk: only positive on screening items related to past behavior .
Moderate Risk: only positive responses on non-acute screening items .
High Risk: positive response on items endorsing current plan/intern AND/OR suicide behavior ICD codes in the encounter .
All data were extracted from the electronic health record. A dichotomous variable was created to categorize encounters based on whether screening was required according to TJC requirements (yes/no). Frequencies and percentages were calculated.
Results: 3,008,835 encounters were analyzed across all clinical settings. The majority were completed in the ED and outpatient clinics, 34.2% and 57.4%, respectively. In the ED, 94.2% (970,002) did not meet mandatory TJC screening criteria, but 2.1% (20,335) of these encounters were positive for current suicide risk. In outpatient clinics, 98.3% (1,698,253) did not meet TJC criteria, but of those encounters .7% (12,404) were positive for current risk.
Conclusions: Only .4% of the total encounters in which screening was not required were classified as high risk, suggesting a minimal increase in resource requirements with expanded screening. More importantly, these data confirm suicide risk is present during encounters for non-behavioral healthcare issues and highlight an important opportunity for expanded identification and prevention. Additionally, the results provide important information that can be used by other systems to estimate the resources that might be required with expanded screening.
Keywords: Prevention, ScreeningMethods: Data were analyzed from >3 million encounters during a 5-year period following implementation of a universal suicide screening program in a hospital system. Suicide risk acuity was determined based on clinical data and on responses to validated screening measures, the Ask-Suicide Screening Questions and the Columbia-Suicide Severity Rating Scale, screener version:
No Risk: negative screening.
Historical Risk: only positive on screening items related to past behavior .
Moderate Risk: only positive responses on non-acute screening items .
High Risk: positive response on items endorsing current plan/intern AND/OR suicide behavior ICD codes in the encounter .
All data were extracted from the electronic health record. A dichotomous variable was created to categorize encounters based on whether screening was required according to TJC requirements (yes/no). Frequencies and percentages were calculated.
Results: 3,008,835 encounters were analyzed across all clinical settings. The majority were completed in the ED and outpatient clinics, 34.2% and 57.4%, respectively. In the ED, 94.2% (970,002) did not meet mandatory TJC screening criteria, but 2.1% (20,335) of these encounters were positive for current suicide risk. In outpatient clinics, 98.3% (1,698,253) did not meet TJC criteria, but of those encounters .7% (12,404) were positive for current risk.
Conclusions: Only .4% of the total encounters in which screening was not required were classified as high risk, suggesting a minimal increase in resource requirements with expanded screening. More importantly, these data confirm suicide risk is present during encounters for non-behavioral healthcare issues and highlight an important opportunity for expanded identification and prevention. Additionally, the results provide important information that can be used by other systems to estimate the resources that might be required with expanded screening.
Authors:
Author - Olivia Hudgens,
UT Southwestern Medical Center
Co-Author - Julia Livingstone,
M.A.,
UT Southwestern Medical Center
Co-Author - Alex Treacher,
Ph.D.,
Parkland Center for Clinical Innovation (PCCI)
Co-Author - Jacqueline Naeem,
M.D.,
Parkland Center for Clinical Innovation (PCCI)
Co-Author - Sidra Goldman-Mellor,
Ph.D., M.P.H,
UC Merced
Co-Author - Michael Schoenbaum,
Ph.D.,
National Institutes of Health (NIH/NIMH)
Co-Author - Kimberly Roaten,
Ph.D.,
UT Southwestern Medical Center, Parkland Health and Hospital System
F125 - The relationship of perceived stress management skills and inflammation in breast cancer patients following primary surgery
Poster Number: F125Time: 11:00 AM - 11:50 AM
Topics: Cancer, Stress
Background: Inflammation in breast cancer (BC) patients has been associated with increased risk of recurrence and negative impacts on quality of life. Perceived stress management skills (PSMS) efficacy has been associated with inflammation, however, the relationship between the subtypes of PSMS efficacy and inflammation after surgery is unclear. Therefore, this study used a quantitative modeling analysis to examine the relationship between subscales of PSMS efficacy and inflammation after surgery. We hypothesized that all subscales of PSMSs are associated with decreased inflammation after BC surgery.
Methods: Participants included BC patients stage III or below (n = 240; M age = 50.34) who had surgery for primary breast cancer in the past 8 weeks and had not begun adjuvant radiation or chemotherapy. PSMSs were measured by the Measure of Current Status-Part A (MOCS) subscales (relaxation, awareness of tension, assertiveness, cognitive coping skills). An inflammation latent construct was measured by log transformations of serum Interleukin-1, Interleukin-6, and Tumor necrosis factor (TNF) values. Missing data on inflammatory markers was estimated using maximum likelihood estimation. Structural equation modeling assessed the association of PSMSs and inflammation while controlling for weeks since surgery, age, and income.
Results: The final model met criteria for sufficient fit (CFI =.939, RMSEA =.046, SRMR = .053). A direct path was observed from cognitive coping skills to inflammation (β = -.37, p =.006). Relaxation, awareness of tension, and assertiveness were not significantly associated with inflammation (p >.05). In addition, age had a trending relationship with inflammation (β = .22, p =.090). Weeks since surgery and income were not associated with inflammation (p >.05).
Conclusions: Although, relaxation, awareness of tension, and assertiveness did not appear to be associated with inflammation, the primary finding from the current study suggests that higher cognitive coping efficacy is associated with lower levels of inflammation. Cognitive coping strategies may be implemented in targeted interventional studies to improve immune function in BC patients after surgery. Future research may investigate the mechanisms by which cognitive coping strategies promote less inflammation and how these coping strategies and inflammation are associated with long term clinical outcomes (i.e., recurrence and mortality) in BC patients post-surgical treatment.
Keywords: Cancer, StressMethods: Participants included BC patients stage III or below (n = 240; M age = 50.34) who had surgery for primary breast cancer in the past 8 weeks and had not begun adjuvant radiation or chemotherapy. PSMSs were measured by the Measure of Current Status-Part A (MOCS) subscales (relaxation, awareness of tension, assertiveness, cognitive coping skills). An inflammation latent construct was measured by log transformations of serum Interleukin-1, Interleukin-6, and Tumor necrosis factor (TNF) values. Missing data on inflammatory markers was estimated using maximum likelihood estimation. Structural equation modeling assessed the association of PSMSs and inflammation while controlling for weeks since surgery, age, and income.
Results: The final model met criteria for sufficient fit (CFI =.939, RMSEA =.046, SRMR = .053). A direct path was observed from cognitive coping skills to inflammation (β = -.37, p =.006). Relaxation, awareness of tension, and assertiveness were not significantly associated with inflammation (p >.05). In addition, age had a trending relationship with inflammation (β = .22, p =.090). Weeks since surgery and income were not associated with inflammation (p >.05).
Conclusions: Although, relaxation, awareness of tension, and assertiveness did not appear to be associated with inflammation, the primary finding from the current study suggests that higher cognitive coping efficacy is associated with lower levels of inflammation. Cognitive coping strategies may be implemented in targeted interventional studies to improve immune function in BC patients after surgery. Future research may investigate the mechanisms by which cognitive coping strategies promote less inflammation and how these coping strategies and inflammation are associated with long term clinical outcomes (i.e., recurrence and mortality) in BC patients post-surgical treatment.
Authors:
Presenter - Ania Murillo,
B.S.,
University of Miami Miller School of Medicine
Co-Author - Mason Krueger,
M.S.,
Department of Psychology, University of Miami
Co-Author - Michael Antoni,
PhD,
Department of Psychology, University of Miami
F126 - Development and validation of a theoretically informed instrument to measure the antecedents of microbreaking intentions for procedural healthcare workers
Poster Number: F126Time: 11:00 AM - 11:50 AM
Topics: Methods and Measurement, Pain
Background: Procedural healthcare workers experience a high prevalence of work-related musculoskeletal disorders (WMSD) due to prolonged, repetitive, and non-neutral positioning associated with their work. The prevention of WMSD in this population is imperative given its association with reduced quality of life, burnout, decreased productivity, early retirement, and adverse patient outcomes. Microbreaking is a promising individual-level strategy to minimize risk factors associated with WMSD; however, few workers have reported incorporating microbreaks into their routines. A theory-based instrument measuring the psychosocial determinants and intentions of microbreaking would facilitate the development and evaluation of microbreaking interventions to promote the safety and well-being of procedural healthcare workers.
Objective: The study aimed to develop and validate a theoretically informed instrument to measure the antecedents of microbreaking intentions (I-MAMI) for procedural healthcare workers.
Methods: The instrument and its items were developed according to the standard methodology as set forth by DeVellis et al, (2022). Six subscales were established based on the theoretical framework of the Integrated Behavioral Model. Face validity of the preliminary instrument was established by way of expert triangulation. Nine professionals with expertise in health behavior and ergonomics then engaged in a Delphi process to establish content validity.
Results: Face validity was established through multiple iterations of triangulation with three subject matter experts who assessed the clarity and relevance of the scale items systematically, leading to revisions that enhanced each subscale's alignment with the intended construct. Delphi participants reached a majority consensus in 2 rounds. The final average scale content validity index (S-CVI) for the subscales of experiential attitude, instrumental attitude, injunctive norm, descriptive norm, perceived control, and self-efficacy were 0.82, 0.93, 0.96, 0.93, 0.96 and 0.90, respectively.
Conclusions: The I-MAMI demonstrates good face and content validity. Further testing for construct validity and internal consistency is needed. This instrument may help inform and evaluate interventions to promote individual level microbreaking behavior of workers in a healthcare setting.
Keywords: Beliefs, Health behaviorsObjective: The study aimed to develop and validate a theoretically informed instrument to measure the antecedents of microbreaking intentions (I-MAMI) for procedural healthcare workers.
Methods: The instrument and its items were developed according to the standard methodology as set forth by DeVellis et al, (2022). Six subscales were established based on the theoretical framework of the Integrated Behavioral Model. Face validity of the preliminary instrument was established by way of expert triangulation. Nine professionals with expertise in health behavior and ergonomics then engaged in a Delphi process to establish content validity.
Results: Face validity was established through multiple iterations of triangulation with three subject matter experts who assessed the clarity and relevance of the scale items systematically, leading to revisions that enhanced each subscale's alignment with the intended construct. Delphi participants reached a majority consensus in 2 rounds. The final average scale content validity index (S-CVI) for the subscales of experiential attitude, instrumental attitude, injunctive norm, descriptive norm, perceived control, and self-efficacy were 0.82, 0.93, 0.96, 0.93, 0.96 and 0.90, respectively.
Conclusions: The I-MAMI demonstrates good face and content validity. Further testing for construct validity and internal consistency is needed. This instrument may help inform and evaluate interventions to promote individual level microbreaking behavior of workers in a healthcare setting.
Authors:
Presenter - Robin Riddle,
DPT,
University of Alabama at Birmingham
Co-Author - Gregory Pavela,
PhD,
University of Alabama at Birmingham
Co-Author - Don Lein,
PhD, PT,
University of Alabama at Birmingham
Co-Author - Teneasha Washington,
PhD,
University of Alabama at Birmingham
Co-Author - Kevin Fontaine,
PhD,
University of Alabama at Birmingham
F127 - A GPT-4o-assisted, human-in-the-loop solution for intercoder reliability: guide for behavioral scientists
Poster Number: F127Time: 11:00 AM - 11:50 AM
Topics: Methods and Measurement, Mental Health
Inter-coder reliability (ICR), often measured via Cohen’s κ, is a hallmark of rigor and trustworthiness in qualitative inquiry. In practice, ICR, even while embracing labor-intensive in-person deliberation and triangulation, can be difficult to attain, rate-limiting the throughput of qualitative investigation. Bridging the strengths and perspectives of AI and human knowledge representations, we demonstrate a novel GPT-4o-assisted technique to achieve substantial–almost perfect ICR transparently, and reproducibly. These techniques will be valuable to theoretically grounded behavioral science, which examines both abstract psychological constructs and observable behaviors. In our parent study, two analysts independently applied attribute (age <30, disability, etc.), and pattern (financial, aspirational, and ideological stressors) codes to Reddit data in 80- and 150-post cycles. ICR on the latter codes, describing imperiled personal ambition, and internalized psycho-political conflict, proved elusive: Cohen’s κ ≤ 0.20, Cycles 1–3. Recent empirics demonstrate that ICR incorporating “zero-shot” classification (requiring no additional training data) with post-GPT-4 commercial large language models (LLMs) can match human coding fidelity. We used the OpenAI Python API library to initialize a GPT-4o-enabled “AI coder.” Specifically, we engineered modular prompts, combining a.) firm role assignments, precisely tasking GPT-4o; b.) structured code definitions matching our human coding schema; c.) clarifications on proper coding application, determined via prior in-person code triangulation; d.) a formatting ruleset, ensuring standardized human-interpretable outputs, and e.) justifications for coding decisions, instantiating chain-of-thought-reasoning essential to human-LLM alignment. We prompted GPT-4o to code only those texts on which human coders disagreed on initial coding applications. Akin to a negotiated agreement procedure, each analyst independently reassessed their initially applied codes in light of GPT-4o’s coding decisions and justifications. These independently revised codings attained Cohen’s κ > 0.90. GPT-4o pays equal attention to every word and sentence, undeterred by fatigue or distraction, while eschewing overly interpretive coding applications that may weaken transparency and consistency. We provide Python 3.9 replication scripts and open materials to reproduce our approach in an integrated Open Science Framework-GitHub repository.
Keywords: Methodological issues, TechnologyF128 - Impact of a Multicomponent Food is Medicine Intervention on Physical and Mental Health Outcomes for Patients With and Without Food Insecurity
Poster Number: F128Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Diet, Nutrition, and Eating Disorders
Background: Food insecurity – the lack of consistent access to sufficient quantity and quality of health-promoting foods – contributes to the development and progression of diet-sensitive chronic diseases, such as obesity, cardiovascular disease, and type 2 diabetes. Food is Medicine (FIM) interventions, characterized by the integration of nutrition programs in the healthcare setting, may serve as a promising strategy for addressing food insecurity and diet-sensitive chronic diseases. However, current policies limit access of FIM to patients with diet-sensitive chronic disease, such as diabetes and heart disease regardless of food security status. It is possible that FIM may benefit patients with food insecurity regardless of chronic disease status.
Objective: To explore the impact of Recipe4Health (R4H), a multicomponent FIM intervention, on physical and mental health outcomes in participants with and without food insecurity (n=336).
Methods: Participants with diet-sensitive chronic conditions and/or food insecurity were referred to R4H, which included 16 weekly produce deliveries and behavioral intervention sessions. Food security status was assessed using the USDA 6-item Adult Food Security Screener Survey. Outcomes included vegetable/fruit (V/F) intake, physical activity (PA) and mental health. Within and between group pre-post changes by food security status were assessed using repeated measures linear mixed effects models, adjusting for baseline values.
Results: A majority of participants identified as food insecure (62%). Participants with food insecurity experienced significant pre/post increases in daily servings of V/F (0.38 ± 0.15; p=0.01) and minutes of moderate-to-vigorous PA per week (28.94 ± 9.84; p<0.01), as well as improvements in loneliness, anxiety, and depressive symptoms (p<0.01 for all). Those who were food secure did not experience significant pre/post increases in V/F (p=0.09) nor PA (p=0.06). Food secure participants did experience significant pre/post improvements in loneliness, anxiety, and depressive symptoms (p<0.01 for all). Between-group differences by food security status were observed only for anxiety, where participants with food security experienced significantly less anxious symptoms compared to those with food insecurity (-1.24 [-2.33, -0.14]; p=0.03).
Conclusion: Policymakers may consider expanding access of FIM to those with food insecurity regardless of their chronic disease status.
Keywords: Diet, Health behavior changeObjective: To explore the impact of Recipe4Health (R4H), a multicomponent FIM intervention, on physical and mental health outcomes in participants with and without food insecurity (n=336).
Methods: Participants with diet-sensitive chronic conditions and/or food insecurity were referred to R4H, which included 16 weekly produce deliveries and behavioral intervention sessions. Food security status was assessed using the USDA 6-item Adult Food Security Screener Survey. Outcomes included vegetable/fruit (V/F) intake, physical activity (PA) and mental health. Within and between group pre-post changes by food security status were assessed using repeated measures linear mixed effects models, adjusting for baseline values.
Results: A majority of participants identified as food insecure (62%). Participants with food insecurity experienced significant pre/post increases in daily servings of V/F (0.38 ± 0.15; p=0.01) and minutes of moderate-to-vigorous PA per week (28.94 ± 9.84; p<0.01), as well as improvements in loneliness, anxiety, and depressive symptoms (p<0.01 for all). Those who were food secure did not experience significant pre/post increases in V/F (p=0.09) nor PA (p=0.06). Food secure participants did experience significant pre/post improvements in loneliness, anxiety, and depressive symptoms (p<0.01 for all). Between-group differences by food security status were observed only for anxiety, where participants with food security experienced significantly less anxious symptoms compared to those with food insecurity (-1.24 [-2.33, -0.14]; p=0.03).
Conclusion: Policymakers may consider expanding access of FIM to those with food insecurity regardless of their chronic disease status.
Authors:
Co-Author - June Tester,
MD,
University of California, San Francisco
Co-Author - Lan Xiao,
PhD,
Stanford University School of Medicine
Co-Author - Benjamin Emmert-Aronson,
PhD,
Open Source Wellness
Co-Author - Elizabeth Markle,
PhD,
Open Source Wellness
Co-Author - Steven Chen,
MD,
Alameda Health Services
Co-Author - Lisa Goldman Rosas, PhD, MPH, FSBM,
PhD, MPH, FSBM,
Stanford University School of Medicine
F129 - Collaborating with community partners to adapt a diabetes prevention program to be culturally relevant for Latino persons with acquired brain injury
Poster Number: F129Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Multiple Health Behavior Change
Background: Latino persons with acquired brain injury (ABI) have higher rates of overweight and obesity, prediabetes, and diabetes compared to Non-Hispanic White persons. However, there is no evidence-based weight loss program that is culturally applicable and available in Spanish for Latino persons with ABI. Using community-based participatory approaches and the ADAPT process framework, we adapted the evidence-based, CDC-recognized Diabetes Prevention Program Group Lifestyle Balance for Traumatic Brain Injury (GLB-TBI) and Cerebral Vascular Accident (CVA) to be culturally and linguistically relevant for Latino persons (GLB-ABI Latino).
Methods: We conducted multiple focus groups with community partners (n=17) to establish the need for adaptation, identify Latino-cultural barriers and facilitators to intervention implementation and uptake of the GLB-TBI/CVA, and identify specific adaptations to enhance adoption of the intervention among Latino persons. Community partners included former program participants, care partners, dietitians, coach interventionists, physicians, and external researchers and most identified as Latino/a (n=12). Internal researchers reviewed the curricula, incorporated feedback, and iteratively vetted adaptations with community partners.
Results: Community partners provided Latino cultural input for curricula adaptations and study conduct considerations. Themes to tailor the curricula included: including family throughout intervention delivery to improve diet and physical activity uptake, social cues typical within Latino households, budget-friendly Latino recipes, culturally-tailored instructional cooking sessions, basic needs intake assessments at the start of the program specific for food access, local resource lists for food access, and cultural competency/humility training for health coaches.
Discussion: Collaboration with our community partners provided invaluable insight into cultural and linguistically appropriate adaptations that best serve Latino persons. We will continue to work with community partners during the next phases of the project: translating the adapted curricula into Spanish and piloting the intervention with Latino persons (n=12 English-speaking, n=12 Spanish-speaking) to measure feasibility, weight loss and secondary outcomes (lipids, glucose, patient reported outcomes). After piloting, the curricula will be made publicly available as a tool to implement at scale at CDC-accredited sites nationally.
Keywords: Latino, Health behavior changeMethods: We conducted multiple focus groups with community partners (n=17) to establish the need for adaptation, identify Latino-cultural barriers and facilitators to intervention implementation and uptake of the GLB-TBI/CVA, and identify specific adaptations to enhance adoption of the intervention among Latino persons. Community partners included former program participants, care partners, dietitians, coach interventionists, physicians, and external researchers and most identified as Latino/a (n=12). Internal researchers reviewed the curricula, incorporated feedback, and iteratively vetted adaptations with community partners.
Results: Community partners provided Latino cultural input for curricula adaptations and study conduct considerations. Themes to tailor the curricula included: including family throughout intervention delivery to improve diet and physical activity uptake, social cues typical within Latino households, budget-friendly Latino recipes, culturally-tailored instructional cooking sessions, basic needs intake assessments at the start of the program specific for food access, local resource lists for food access, and cultural competency/humility training for health coaches.
Discussion: Collaboration with our community partners provided invaluable insight into cultural and linguistically appropriate adaptations that best serve Latino persons. We will continue to work with community partners during the next phases of the project: translating the adapted curricula into Spanish and piloting the intervention with Latino persons (n=12 English-speaking, n=12 Spanish-speaking) to measure feasibility, weight loss and secondary outcomes (lipids, glucose, patient reported outcomes). After piloting, the curricula will be made publicly available as a tool to implement at scale at CDC-accredited sites nationally.
Authors:
Presenter - Librada Callender, PhD,
PhD,
Baylor Scott & White Research Institute
Co-Author - Alexandria Suhalka,
MPH,
Baylor Scott & White Research Institute
Co-Author - Christa Ochoa,
MPH,
Baylor Scott & White Research Institute
Co-Author - Alvaro Carrera,
BS,
Baylor Scott & White Research Institute
Co-Presenter - Enrico Quilico, Phd,
PhD,
Baylor Scott & White Research Institute
Co-Author - Simon Driver, PhD,
PhD,
Baylor Scott & White Research Institute
F130 - Relations between Food Insecurity and Overweight/Obesity Classifications among College Students who Self-Report as Food Insecure
Poster Number: F130Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Obesity
Background and Objectives: Food insecurity is a public health concern, and college students have recently been recognized as an at-risk population. While current literature notes a relation between food insecurity and obesity, few studies have examined the association as a function of severity of food insecurity, especially among college students. The aim of this study was to examine relations between the body mass index (BMI) classifications (underweight/normal vs. overweight/obesity) and food insecurity levels (low food security: reduced food quality vs. very low food security: severely reduced food intake) among college students.
Methods: A secondary data analysis was performed using data from a cross-sectional study which was conducted during the Fall of 2022 at a large urban southeastern research university. A total of 588 self-identified racially and ethnically diverse food-insecure undergraduate college students aged ≥ 18 years (mean age = 21.05 ± 4.06) completed an online survey. The Chi-Square test was used to assess the prevalence of overweight/obesity among food security levels. Binary logistic regression was used to assess whether food insecurity levels were associated with overweight/obesity.
Results: The majority (62%) of students were in households with very low food security. Findings showed statistically significant differences in BMI classifications between low and very low food-secure college students (p<0.001). Very low food security level was found to significantly predict being overweight/obese significantly compared with low food security before and after adjusting the model for covariates. (Crude Model: OR=1.822; 95% CI, 1.285-2.583, p-value<0.001 and Adjusted Model: OR=1.737; 95% CI, 1.198-2.518, p-value=0.004).
Conclusion: Undergraduate college students in very low food-secure households may be more likely to be overweight/obese than their peers in low food-secure households. Implications for intervention strategies are considered.
Keywords: Obesity, NutritionMethods: A secondary data analysis was performed using data from a cross-sectional study which was conducted during the Fall of 2022 at a large urban southeastern research university. A total of 588 self-identified racially and ethnically diverse food-insecure undergraduate college students aged ≥ 18 years (mean age = 21.05 ± 4.06) completed an online survey. The Chi-Square test was used to assess the prevalence of overweight/obesity among food security levels. Binary logistic regression was used to assess whether food insecurity levels were associated with overweight/obesity.
Results: The majority (62%) of students were in households with very low food security. Findings showed statistically significant differences in BMI classifications between low and very low food-secure college students (p<0.001). Very low food security level was found to significantly predict being overweight/obese significantly compared with low food security before and after adjusting the model for covariates. (Crude Model: OR=1.822; 95% CI, 1.285-2.583, p-value<0.001 and Adjusted Model: OR=1.737; 95% CI, 1.198-2.518, p-value=0.004).
Conclusion: Undergraduate college students in very low food-secure households may be more likely to be overweight/obese than their peers in low food-secure households. Implications for intervention strategies are considered.
Authors:
Presenter - Mina Davari,
PhD student,
College of Behavioral and Community Sciences, University of South Florida, USA.
Co-Author - Nashira Brown,
PhD,
Department of Health Behavior, University of Alabama at Birmingham, USA.
Co-Author - David Himmelgreen,
PhD,
Department of Anthropology, University of South Florida, USA.
Co-Author - Amber Dumford,
PhD,
College of Education, University of South Florida, USA.
Co-Author - Kyaien Connor,
PhD,
School of Social Work, University of Pittsburgh, USA.
Chair - Marilyn Stern, PhD,
PhD,
College of Behavioral and Community Sciences, University of South Florida, USA & Department of Health Outcomes and Behavior, Moffitt Cancer Center, USA.
Chair - Rita DeBate,
PhD,
College of Public Health, University of South Florida, USA.
F131 - Sociodemographic reporting and representativeness in obesity-related clinical trials
Poster Number: F131Time: 11:00 AM - 11:50 AM
Topics: Health of Marginalized Populations , Methods and Measurement
Federal policies mandate the inclusion of historically marginalized groups in clinical research studies. Yet, certain groups, such as racial and ethnic minoritized groups and older adults, tend to be underrepresented. A few studies suggest this pattern may hold true for clinical trials focused on obesity, although past work has been limited by focusing largely on just one type of intervention (behavioral treatment) and lack of assessment of representativeness using objective benchmarks. This study used clinicaltrials.gov—an online database of studies managed by the National Library of Medicine—to comprehensively assess sociodemographic reporting and participant representativeness in obesity-related clinical trials. Sex, race, ethnicity, and age data were collected for interventional studies completed in the US with results from 01/01/2012-10/13/2023. Search terms were obesity, overweight, adiposity, weight loss, and body mass index. The frequency of reporting of each characteristic was assessed. The percentage of trial participants who were female, 65 or older, and of each racial and ethnicity identity was also computed and compared to both census data and disease-specific estimates (to account for disproportionate impact of obesity in some groups). The search yielded 847 study records, 450 of which were retained. Most studies focused on behavioral interventions (35%), medications (30%), or more than one type of intervention (17%). Sex was nearly always reported (99% studies); older age (35%), race (75%), and ethnicity (56%) were reported less often, although race and ethnicity reporting increased over time (p’s<.001). Three patterns were observed for representativeness: (1) females were overrepresented in all trial types; (2) individuals identifying as Black/African American tended to be slightly overrepresented, even when adjusting for disproportionate obesity impact; and (3) representation of older adults and individuals from other racial or ethnic minoritized groups differed by trial type, with these individuals generally equitably represented in behavioral trials and underrepresented in other trial types (e.g., medications, devices). These findings suggest progress has been made in some aspects of demographic reporting and inclusion in obesity-related trials, although gaps remain. Since lack of representation may limit generalizability and, ultimately, compromise patient care, continued efforts are needed to increase reporting and representativeness.
Keywords: Diversity, Weight controlAuthors:
Presenter - Leah Schumacher,
PhD,
Temple University
Co-Author - Joseph Chibueze,
Lewis Katz School of Medicine, Temple University
Co-Author - Francesca Knudsen,
Utah State University
Co-Author - Siddhartha Kalala,
Brown University
Co-Author - Astha Rajpal,
Temple University
Co-Author - Ksenia Power,
PhD,
Temple University
Co-Author - Julie Silver,
MD,
Wake Forest University School of Medicine
Co-Author - Helen Burton-Murray,
PhD,
Harvard Medical School
F132 - Social context matters: Postpartum Black women’s perspectives on social supports needs for diet and physical activity changes
Poster Number: F132Time: 11:00 AM - 11:50 AM
Topics: Obesity, Women's Health
Background: Social support for healthy eating and physical activity has been linked to better adherence and greater self-efficacy for weight loss. Yet, behavioral weight loss interventions for postpartum Black women often neglect the role of social support on improving adherence to weight loss-related behaviors. This study explores postpartum Black women's social support needs to eat healthy foods and be physically active.
Methods: We conducted semi-structured interviews with postpartum Black women (n=8) with overweight or obesity (body mass index (BMI) between 25.0 - 45.0 kg/m2) based on BMI calculated from self-reported weight and height. We recruited women to share their social support needs related to diet and physical activity and their thoughts on an online weight loss intervention specifically for Black mothers. In an online Webex interview, participants were asked to discuss 1) the types of support that would be important for consuming a healthy diet and engaging in physical activity, 2) who should provide this support, and 3) the kinds of messages that would make them feel supported. We conducted a thematic analysis of responses related to social support. Interviews were transcribed by a third party and independently coded by three investigators (kappa=0.87) using Dedoose (v.9.2.12).
Results: Participants were on an average 33.6 (SD = 3.2) years old with a mean BMI of 32.4 kg/m2 (SD=7.0); 83% had one child. Support from 1)family and friends in preparing nutritious meals and 2) guidance on the nutritional content of foods to facilitate healthier dietary choices, emerged as key themes in social support for healthy eating. Major themes for social support to engage in physical activity included 1) receiving childcare support from friends and family, 2) having an exercise partner for accountability and 3) learning exercise skills from a team of experts. Messages that acknowledged and appreciated participants' efforts in practicing healthy behaviors, while also motivating them for weight loss, emerged as key themes for participants feeling most supported.
Conclusion: Future research should examine whether explicitly providing instrumental, informational, and emotional support or guiding women to mobilize their social networks to provide such support can improve the efficacy of lifestyle interventions for weight, diet, and physical activity changes among postpartum Black women with overweight or obesity.
Keywords: Health disparities, InterventionsMethods: We conducted semi-structured interviews with postpartum Black women (n=8) with overweight or obesity (body mass index (BMI) between 25.0 - 45.0 kg/m2) based on BMI calculated from self-reported weight and height. We recruited women to share their social support needs related to diet and physical activity and their thoughts on an online weight loss intervention specifically for Black mothers. In an online Webex interview, participants were asked to discuss 1) the types of support that would be important for consuming a healthy diet and engaging in physical activity, 2) who should provide this support, and 3) the kinds of messages that would make them feel supported. We conducted a thematic analysis of responses related to social support. Interviews were transcribed by a third party and independently coded by three investigators (kappa=0.87) using Dedoose (v.9.2.12).
Results: Participants were on an average 33.6 (SD = 3.2) years old with a mean BMI of 32.4 kg/m2 (SD=7.0); 83% had one child. Support from 1)family and friends in preparing nutritious meals and 2) guidance on the nutritional content of foods to facilitate healthier dietary choices, emerged as key themes in social support for healthy eating. Major themes for social support to engage in physical activity included 1) receiving childcare support from friends and family, 2) having an exercise partner for accountability and 3) learning exercise skills from a team of experts. Messages that acknowledged and appreciated participants' efforts in practicing healthy behaviors, while also motivating them for weight loss, emerged as key themes for participants feeling most supported.
Conclusion: Future research should examine whether explicitly providing instrumental, informational, and emotional support or guiding women to mobilize their social networks to provide such support can improve the efficacy of lifestyle interventions for weight, diet, and physical activity changes among postpartum Black women with overweight or obesity.
Authors:
Presenter - Snehaa Ray,
MS,
University of Connecticut
Co-Author - Christie Idiong,
MS,
University of Connecticut
Co-Author - Richard Bannor,
MPH,
University of Connecticut
Co-Author - Kim Gans, PhD,
PhD,
University of Connecticut and Brown University
Co-Author - Sherry L. Pagoto, PhD, FSBM,
PhD, FSBM,
University of Connecticut
Co-Author - Molly E. Waring, PhD, FSBM,
PhD, FSBM,
University of Connecticut
Co-Author - Ock K. Chun, PhD,
PhD,
University of Connecticut
Co-Author - Loneke Blackman Carr, PhD, RD,
PhD, RD,
University of Connecticut
F133 - Food decision-making improves after a behavioral weight loss intervention
Poster Number: F133Time: 11:00 AM - 11:50 AM
Topics: Obesity, Diet, Nutrition, and Eating Disorders
Background: A previous study by Demos and colleagues (2017) found that participation in a behavioral weight loss intervention (BWLI) increased individuals’ self-control in selecting healthier, less tasty foods (type 1 self-control), yet did not reduce selection of unhealthy, tastier foods (type 2 self-control) on a food choice task. Less is known about how implicit attitudes about food may influence individuals’ food choices (e.g., if having stronger associations between unhealthy foods and positive emotions might impair type 2 self-control).
Methods: We aimed to replicate and extend the study by Demos et al. (2017) by exploring associations between self-control and implicit biases towards foods in 74 adults with overweight/obesity (mean ± SD, age = 50.7 ± 10.4 years, BMI = 31.2 ± 4.5 kg/m2, 86.5% White, 68.9% Female) who completed self-report questionnaires and behavioral tasks (a food choice task and a food Implicit Association Test [IAT]) before and after a 12-week Internet-based BWL treatment. Generalized Linear Mixed Models (GLMM) explored whether there were pre-post changes in self-control (both type 1 and type 2). Linear regression models examined the associations between health and taste ratings with food choice at baseline and post-treatment, and explored whether self-control and implicit attitudes towards food (at both baseline and post-treatment) were associated with greater weight loss post-treatment.
Results: GLMM models showed increased log-odds of exerting both type 1 (p=.019) and type 2 self-control (p<.001) after completion of the BWLI. Regression models showed a preference for tastier foods at baseline (p<.001). At post-treatment, participants took into account both the health and taste rating of a food when making a choice (ps<.001). Interestingly, regression models showed greater execution of type 2 self-control and higher IAT scores (stronger association of healthy foods being “good”) at baseline predicted less weight loss post-treatment (ps<.001). Conversely, greater type 2 self-control and higher IAT scores at post-treatment were associated with greater weight loss, and greater engagement in type 1 self-control was associated with less weight loss (ps<.001).
Conclusion: Results show that participants improved in both forms of self-control following a BWLI. Future research should investigate strategies to enhance self-control related to avoidance of unhealthy foods and address implicit biases towards food choices within a BWLI.
Keywords: Obesity, Health behaviorsMethods: We aimed to replicate and extend the study by Demos et al. (2017) by exploring associations between self-control and implicit biases towards foods in 74 adults with overweight/obesity (mean ± SD, age = 50.7 ± 10.4 years, BMI = 31.2 ± 4.5 kg/m2, 86.5% White, 68.9% Female) who completed self-report questionnaires and behavioral tasks (a food choice task and a food Implicit Association Test [IAT]) before and after a 12-week Internet-based BWL treatment. Generalized Linear Mixed Models (GLMM) explored whether there were pre-post changes in self-control (both type 1 and type 2). Linear regression models examined the associations between health and taste ratings with food choice at baseline and post-treatment, and explored whether self-control and implicit attitudes towards food (at both baseline and post-treatment) were associated with greater weight loss post-treatment.
Results: GLMM models showed increased log-odds of exerting both type 1 (p=.019) and type 2 self-control (p<.001) after completion of the BWLI. Regression models showed a preference for tastier foods at baseline (p<.001). At post-treatment, participants took into account both the health and taste rating of a food when making a choice (ps<.001). Interestingly, regression models showed greater execution of type 2 self-control and higher IAT scores (stronger association of healthy foods being “good”) at baseline predicted less weight loss post-treatment (ps<.001). Conversely, greater type 2 self-control and higher IAT scores at post-treatment were associated with greater weight loss, and greater engagement in type 1 self-control was associated with less weight loss (ps<.001).
Conclusion: Results show that participants improved in both forms of self-control following a BWLI. Future research should investigate strategies to enhance self-control related to avoidance of unhealthy foods and address implicit biases towards food choices within a BWLI.
Authors:
Author - Kate E. Worwag,
M.S.,
University of Florida
Co-Author - Taylor N. Swanson,
M.S.,
University of Florida
Co-Author - Kelsey L. Barrett,
M.S.,
University of Florida
Co-Author - Armaan Ram Shetty,
B.S.,
University of Florida
Co-Author - Kelsey M. Arroyo,
M.S.,
University of Florida
Co-Author - Meena Shankar,
MS, RDN, CCRC,
University of Florida
Co-Author - Kathryn M. Ross,
PhD, MPH, FSBM,
University of Florida
F134 - A pilot randomized controlled trial targeting positive affect during exercise to increase physical activity after metabolic and bariatric surgery
Poster Number: F134Time: 11:00 AM - 11:50 AM
Topics: Obesity, Physical Activity
Physical activity is critical to enhance weight loss maintenance and prevent disease for individuals undergoing metabolic and bariatric surgery (MBS), but less than 15% of adults meet moderate-vigorous physical activity (MVPA) recommendations post-MBS. Positive affect during exercise is shown to predict future activity. However, psychological barriers to physical activity, such as low self-efficacy, weight stigma, psychiatric conditions and fear of injury, are common post-MBS. Low positive affect around physical activity could interfere with physical activity habit building and maintenance.
The Gaining Optimism After Weight Loss Surgery (GOALS) intervention was designed to increase physical activity post-MBS by targeting positive affect during activity via positive psychological and behavior change approaches. GOALS was developed following the ORBIT model and tested in a pilot RCT (phase IIb). It includes 10 weekly phone calls, a written manual, and Fitbits. This study assessed intervention feasibility, acceptability, and preliminary efficacy compared to a physical activity education/Fitbit control. Assessments were conducted at baseline, post-intervention, and 24 weeks.
We recruited adults 6-12 months post-MBS at Massachusetts General Hospital who self-reported less than 200 minutes/week of MVPA. The 58 participants were M 44 years old, 88% women, and 68% non-Hispanic white. Baseline actigraph-measured MVPA was 110 mins/week (SD=86). Feasibility, measured as session completion, was high: participants completed 9.6/10 sessions on average (SD=1.5). Acceptability, measured as ease and utility ratings of each session topic on a 0-10 scale, was also high: scores ranged from 8.5 to 9.0/10. Compared to control, MVPA increased by 4.6 mins/week (95% CI: -37.1, 46.3, effect size (ES)=0.1) post-intervention and 29.5 mins/week (95% CI: -5.5, 64.6, ES=0.3) at 24 weeks. Self-efficacy for exercise and barriers to being active improved with medium-to-large ES at both follow-up points. Effects on steps, BMI, and general psychological well-being (e.g., depression, positive affect) were minimal.
In conclusion, GOALS was feasible, acceptable, and led to medium-to-large effect size improvements in physical activity attitudes. Effects on physical activity and psychological well-being were inconsistent. Future work should adapt the intervention to connect attitudes around exercise to actual behavior change, and test it in a fully powered efficacy trial.
Keywords: Physical activity, ObesityThe Gaining Optimism After Weight Loss Surgery (GOALS) intervention was designed to increase physical activity post-MBS by targeting positive affect during activity via positive psychological and behavior change approaches. GOALS was developed following the ORBIT model and tested in a pilot RCT (phase IIb). It includes 10 weekly phone calls, a written manual, and Fitbits. This study assessed intervention feasibility, acceptability, and preliminary efficacy compared to a physical activity education/Fitbit control. Assessments were conducted at baseline, post-intervention, and 24 weeks.
We recruited adults 6-12 months post-MBS at Massachusetts General Hospital who self-reported less than 200 minutes/week of MVPA. The 58 participants were M 44 years old, 88% women, and 68% non-Hispanic white. Baseline actigraph-measured MVPA was 110 mins/week (SD=86). Feasibility, measured as session completion, was high: participants completed 9.6/10 sessions on average (SD=1.5). Acceptability, measured as ease and utility ratings of each session topic on a 0-10 scale, was also high: scores ranged from 8.5 to 9.0/10. Compared to control, MVPA increased by 4.6 mins/week (95% CI: -37.1, 46.3, effect size (ES)=0.1) post-intervention and 29.5 mins/week (95% CI: -5.5, 64.6, ES=0.3) at 24 weeks. Self-efficacy for exercise and barriers to being active improved with medium-to-large ES at both follow-up points. Effects on steps, BMI, and general psychological well-being (e.g., depression, positive affect) were minimal.
In conclusion, GOALS was feasible, acceptable, and led to medium-to-large effect size improvements in physical activity attitudes. Effects on physical activity and psychological well-being were inconsistent. Future work should adapt the intervention to connect attitudes around exercise to actual behavior change, and test it in a fully powered efficacy trial.
Authors:
Co-Author - Emily H. Feig,
PhD,
Massachusetts General Hospital
Co-Author - Crystal Castillo,
BA,
Massachusetts General Hospital
Co-Author - Sai Rachakonda,
BA,
Massachusetts General Hospital
Co-Author - Nikita Acharya,
MA,
Massachusetts General Hospital
Co-Author - Anne Thorndike,
MD, MPH,
Massachusetts General Hospital
Co-Author - Christina Psaros,
PhD,
Massachusetts General Hospital
Co-Author - Noreen Reilly-Harrington,
PhD,
Massachusetts General Hospital
Co-Author - Jeff Huffman,
MD,
Massachusetts General Hospital
F136 - Understanding the Impact of Chronotype on Behavioral Weight Loss Interventions
Poster Number: F136Time: 11:00 AM - 11:50 AM
Topics: Obesity, Sleep
Background: Given associations between evening chronotype (i.e., a preference for later sleep/wake times) and greater body mass index (BMI), there is growing interest in how chronotype may influence the effectiveness of behavioral weight loss interventions in adults with overweight or obesity.
Methods: This systematic scoping review aimed to summarize the literature regarding how chronotype affects changes in weight and weight-related behaviors (i.e., diet, physical activity) during behavioral weight management programs. Searches were performed in PubMed, Embase, and PsychINFO in December 2023. Data extraction included: publication year, study design, measures for assessing chronotype and anthropometrics, intervention phase (initial vs. maintenance), duration, approach (e.g., tailored to chronotype), and weight loss outcomes.
Results: Eight studies were published between 2017 and 2023, and most (n = 5) employed non-randomized experimental or quasi-experimental designs. Chronotype was assessed through self-report and BMI was the most common anthropometric measure. Duration of initial interventions varied from 31 days to 3 months. Two studies of interventions that did not adjust for chronotype (e.g., did not tailor meal timing based on chronotype) found that individuals with evening chronotypes experienced less weight loss outcomes compared to morning chronotypes; another found no significant differences in weight change. Three interventions adjusted for chronotype (i.e., a non-randomized study [n = 91], a quasi-experimental study [n = 32], and a randomized controlled trial [RCT; n = 209]), demonstrated no significant differences in weight loss by chronotype, with both groups achieving similar weight loss outcomes. The RCT also evaluated one-year weight loss maintenance and found that the chronotype-adjusted intervention led to better weight loss maintenance compared to the conventional intervention control for both morning and evening chronotypes.
Conclusions: Results demonstrated that individuals with evening chronotypes may experience poorer weight loss outcomes during behavioral interventions compared to morning chronotypes unless interventions are adjusted to chronotype; however, the limited number of studies and substantial methodological variation indicate that further research is needed to validate the effectiveness of chronotype-adjusted interventions.
Keywords: Obesity, Sleep disordersMethods: This systematic scoping review aimed to summarize the literature regarding how chronotype affects changes in weight and weight-related behaviors (i.e., diet, physical activity) during behavioral weight management programs. Searches were performed in PubMed, Embase, and PsychINFO in December 2023. Data extraction included: publication year, study design, measures for assessing chronotype and anthropometrics, intervention phase (initial vs. maintenance), duration, approach (e.g., tailored to chronotype), and weight loss outcomes.
Results: Eight studies were published between 2017 and 2023, and most (n = 5) employed non-randomized experimental or quasi-experimental designs. Chronotype was assessed through self-report and BMI was the most common anthropometric measure. Duration of initial interventions varied from 31 days to 3 months. Two studies of interventions that did not adjust for chronotype (e.g., did not tailor meal timing based on chronotype) found that individuals with evening chronotypes experienced less weight loss outcomes compared to morning chronotypes; another found no significant differences in weight change. Three interventions adjusted for chronotype (i.e., a non-randomized study [n = 91], a quasi-experimental study [n = 32], and a randomized controlled trial [RCT; n = 209]), demonstrated no significant differences in weight loss by chronotype, with both groups achieving similar weight loss outcomes. The RCT also evaluated one-year weight loss maintenance and found that the chronotype-adjusted intervention led to better weight loss maintenance compared to the conventional intervention control for both morning and evening chronotypes.
Conclusions: Results demonstrated that individuals with evening chronotypes may experience poorer weight loss outcomes during behavioral interventions compared to morning chronotypes unless interventions are adjusted to chronotype; however, the limited number of studies and substantial methodological variation indicate that further research is needed to validate the effectiveness of chronotype-adjusted interventions.
Authors:
Presenter - Taylor N. Swanson, MS,
University of Florida
Co-Author - Kelsey M. Arroyo, MS,
University of Florida
Co-Presenter - Kelsey L. Barrett,
MS,
University of Florida
Co-Presenter - Armaan Ram Shetty,
BS,
University of Florida
Co-Presenter - Kate E. Worwag,
MS,
University of Florida
Co-Presenter - Meena Shankar, MS, RDN, CCRC,
MS, RDN, CCRC,
University of Florida
Co-Presenter - Kathryn M. Ross, PhD, MPH, FSBM,
PhD, MPH, FSBM,
University of Florida
F137 - Quality of Life and Care Considerations in Macromastia: A Systematic Review
Poster Number: F137Time: 11:00 AM - 11:50 AM
Topics: Pain, Quality of Life
Background:
Macromastia, or excessive breast enlargement, is a major cause of shoulder, neck, and back pain. It also impacts overall health, leading to chronic pain and worsened mental health. Despite over 90% of patients experiencing symptom relief from breast reduction surgery, insurance companies often deny coverage based on outdated criteria. This review examines how macromastia affects quality of life, focusing on physical consequences like chronic pain and musculoskeletal issues, as well as psychological impacts such as body image concerns and mental health disorders. It also addresses barriers to care, such as insurance coverage challenges and access disparities, with the goal of guiding healthcare providers toward more comprehensive and equitable care.
Methods:
A comprehensive literature search was conducted in PubMed, targeting publications from March 2014 to March 2024. Keywords included "macromastia," "reduction mammaplasty," "breast reduction," "screening," "assessment," "chronic pain," "quality of life," "treatment outcome," and "satisfaction." Studies were included if they focused on breast reduction for macromastia and were published in English. Articles that didn't meet these criteria were excluded. Selected studies were evaluated for risk of bias based on study design, sample size, and potential conflicts of interest.
Results: Our search yielded 883 articles, of which 86 met our criteria and were included in the analysis. We categorized the data into chronic pain, adolescents, outcomes/screenings, insurance/cost, and mental health. The literature strongly supports reduction mammoplasty for treating symptomatic macromastia, noting its association with declines in mental health, back and neck pain, headaches, and physical limitations. However, insurance coverage for this procedure is inconsistent, often leaving patients without coverage despite its cost-effectiveness compared to other symptom management methods.
Discussion:
Symptomatic macromastia can be debilitating, affecting both physical health (pain, posture, and mobility) and mental well-being in adolescents and adults. Although reduction mammoplasty offers high satisfaction and relief, its use is limited by insurance restrictions, disproportionately affecting those who cannot afford the procedure. This contributes to the healthcare disparities faced by lower socioeconomic status patients. These findings aim to inform clinical recommendations for the care and management of macromastia.
Keywords: Pain, Quality of lifeMacromastia, or excessive breast enlargement, is a major cause of shoulder, neck, and back pain. It also impacts overall health, leading to chronic pain and worsened mental health. Despite over 90% of patients experiencing symptom relief from breast reduction surgery, insurance companies often deny coverage based on outdated criteria. This review examines how macromastia affects quality of life, focusing on physical consequences like chronic pain and musculoskeletal issues, as well as psychological impacts such as body image concerns and mental health disorders. It also addresses barriers to care, such as insurance coverage challenges and access disparities, with the goal of guiding healthcare providers toward more comprehensive and equitable care.
Methods:
A comprehensive literature search was conducted in PubMed, targeting publications from March 2014 to March 2024. Keywords included "macromastia," "reduction mammaplasty," "breast reduction," "screening," "assessment," "chronic pain," "quality of life," "treatment outcome," and "satisfaction." Studies were included if they focused on breast reduction for macromastia and were published in English. Articles that didn't meet these criteria were excluded. Selected studies were evaluated for risk of bias based on study design, sample size, and potential conflicts of interest.
Results: Our search yielded 883 articles, of which 86 met our criteria and were included in the analysis. We categorized the data into chronic pain, adolescents, outcomes/screenings, insurance/cost, and mental health. The literature strongly supports reduction mammoplasty for treating symptomatic macromastia, noting its association with declines in mental health, back and neck pain, headaches, and physical limitations. However, insurance coverage for this procedure is inconsistent, often leaving patients without coverage despite its cost-effectiveness compared to other symptom management methods.
Discussion:
Symptomatic macromastia can be debilitating, affecting both physical health (pain, posture, and mobility) and mental well-being in adolescents and adults. Although reduction mammoplasty offers high satisfaction and relief, its use is limited by insurance restrictions, disproportionately affecting those who cannot afford the procedure. This contributes to the healthcare disparities faced by lower socioeconomic status patients. These findings aim to inform clinical recommendations for the care and management of macromastia.
Authors:
Presenter - Lanah Almatroud,
Michigan State University College of Human Medicine
Author - Zeinab Mhanna,
Michigan State University College of Human Medicine
Author - Gabby Young,
Michigan State University College of Human Medicine
Author - Natoshia R. Cunningham, Ph.D,
Michigan State University
F138 - The Relationship Between Arrest History and Pain Measures on Patients with Sickle Cell Disease Living in Jamaica
Poster Number: F138Time: 11:00 AM - 11:50 AM
Topics: Pain, Health of Marginalized Populations
Chronic disease is often associated with impairments in biological, psychological, and social functioning with a primary symptom related to chronic pain. Sickle cell disease (SCD) is an inherited blood disorder that is distinguished by sickle-shaped red blood cells due to abnormal hemoglobin, which results in vaso-occlusions (i.e., blockages in blood vessels). In countries other than the US, the severity of one’s chronic pain can often be associated with illicit activities for pain control and management. In this study, 133 individuals living with SCD in Jamaica were assessed during a routine hematological check-up for the impact of pain on their livelihood, significant others’ response to their expression of pain, and pain associated with engaging in daily activities (West Haven-Yale Multidimensional Pain Inventory [WHYMPI]). Independent-Samples Mann-Whitney U tests were conducted to evaluate the correlation between eight factors on the WHYMPI and whether individuals had ever been arrested. The only significant correlation occurred between negative comments from significant others about one’s communication of pain and individuals that had ever been arrested, p = .003. This result supports extant literature on the impact of chronic pain on patient’s livelihood. While these data have been analyzed using different metrics demonstrating that interpersonal support is a strong predictor of reduced pain and suffering in individuals with SCD, this result delineates the importance of interpersonal communication that aims to ameliorate one’s pain without negating their pain experience.
Keywords: Pain, Health disparitiesAuthors:
Author - Jenny L. Norris,
BA,
North Carolina Central University
Co-Author - Cara L. Green,
BS,
North Carolina Central University
Co-Author - John J. Sollers IV,
Thomas More University
Co-Author - Luca Mattassini,
Thomas More University
Co-Author - Malibongwe Mkosi,
Thomas More University
Co-Author - Brett P. Reid,
BS,
North Carolina Central University
Co-Author - Mary Wood,
MA,
Duke University Medical Center
Co-Author - Camela S. Barker,
PhD,
Fielding University
Co-Author - Beyonnshea N. Lucas,
BS,
North Carolina Central University
Co-Author - Ervin D. Whitley,
BS,
North Carolina Central University
Co-Author - Ashyia N. Williams,
BS,
North Carolina Central University
Co-Author - Suquey-Amparo Castillo-Lopez,
BS,
North Carolina Central University
Co-Author - Sadeja Goodman,
BS,
North Carolina Central University
Co-Author - Christopher L. Edwards, PhD,
North Carolina Central University
Co-Author - John J. Sollers III, PhD,
PhD,
North Carolina Central University
F139 - Feasibility of a mind-body and walking program for chronic pain: A multisite randomized controlled trial
Poster Number: F139Time: 11:00 AM - 11:50 AM
Topics: Pain, Physical Activity
Background: Increasing multimodal physical function in chronic pain is challenging. Despite IMMPACT guidelines, no pain trials capture physical function comprehensively (i.e., via self-report, performance-based, and objective/step-count-based measures), and most have limited racial/ethnic diversity. This study tested the feasibility and preliminary effects of a mind-body walking program (GetActive-Fitbit) and an active comparator (Healthy Living with Pain; HLP) on multimodal physical function, emotional function, pain, and putative mechanistic targets across 3 geographically diverse academic medical centers (Massachusetts General Hospital, Duke University, and Rush University).
Methods: 92 sedentary adults with chronic pain were randomized to GetActive-Fitbit vs. HLP. Primary outcomes were feasibility of recruitment, treatment arms, and assessments, participant retention, racial/ethnic diversity, treatment expectancy, credibility, satisfaction, and clinician fidelity. We also measured multimodal physical function (WHODAS-2, 6-min walk test, Actigraph-measured step-count), emotional function (PROMIS anxiety and depression), pain (PEG-3), and putative mechanisms (pain-catastrophizing, kinesiophobia, adaptive coping and mindfulness).
Results: Both interventions met the benchmarks for feasibility of treatment, credibility, fidelity, assessment, and retention. Benchmarks for expectancy and satisfaction were met in GetActive-Fitbit but not HLP. The diversity benchmark was met. The recruitment benchmark was not met (71% of eligible participants recruited).
GetActive-Fitbit was associated with significant improvements in multimodal physical function including step-count (95% CI=672.72,1529.37,P<.001,d=0.78), 6-min walk test (CI=34.33,62.87, P<.001,d=1.04) and WHODAS (CI=-0.54,-0.30,P<.001,d=1.14), as well as in pain (CI=-2.05,-0.52,P=.002,d=0.52), but not emotional function. Coping-related putative mechanisms such as pain catastrophizing (CI=-10.60,-5.63,P<.001,d=0.99), kinesiophobia (CI=6.98,-2.64,P<.001,d=0.67),adaptive coping (CI=0.02,0.35,P=.027,d=0.34) and mindfulness (CI=0.457,3.18,P=.01,d=0.41) also improved.
HLP participants improved only in pain (CI=-1.41,-0.12, P=.02,d=0.37) and 6-min walk test (CI=26.75,54.38,P<.001,d=0.94).
Conclusions and Relevance: GetActive-Fitbit is feasible and shows promise in improving multimodal physical function and putative mechanistic targets, to be tested in a future efficacy trial.
Keywords: Pain, Physical activityMethods: 92 sedentary adults with chronic pain were randomized to GetActive-Fitbit vs. HLP. Primary outcomes were feasibility of recruitment, treatment arms, and assessments, participant retention, racial/ethnic diversity, treatment expectancy, credibility, satisfaction, and clinician fidelity. We also measured multimodal physical function (WHODAS-2, 6-min walk test, Actigraph-measured step-count), emotional function (PROMIS anxiety and depression), pain (PEG-3), and putative mechanisms (pain-catastrophizing, kinesiophobia, adaptive coping and mindfulness).
Results: Both interventions met the benchmarks for feasibility of treatment, credibility, fidelity, assessment, and retention. Benchmarks for expectancy and satisfaction were met in GetActive-Fitbit but not HLP. The diversity benchmark was met. The recruitment benchmark was not met (71% of eligible participants recruited).
GetActive-Fitbit was associated with significant improvements in multimodal physical function including step-count (95% CI=672.72,1529.37,P<.001,d=0.78), 6-min walk test (CI=34.33,62.87, P<.001,d=1.04) and WHODAS (CI=-0.54,-0.30,P<.001,d=1.14), as well as in pain (CI=-2.05,-0.52,P=.002,d=0.52), but not emotional function. Coping-related putative mechanisms such as pain catastrophizing (CI=-10.60,-5.63,P<.001,d=0.99), kinesiophobia (CI=6.98,-2.64,P<.001,d=0.67),adaptive coping (CI=0.02,0.35,P=.027,d=0.34) and mindfulness (CI=0.457,3.18,P=.01,d=0.41) also improved.
HLP participants improved only in pain (CI=-1.41,-0.12, P=.02,d=0.37) and 6-min walk test (CI=26.75,54.38,P<.001,d=0.94).
Conclusions and Relevance: GetActive-Fitbit is feasible and shows promise in improving multimodal physical function and putative mechanistic targets, to be tested in a future efficacy trial.
Authors:
Co-Author - Julia Hooker,
PhD,
Massachusetts General Hospital
Co-Author - Katherine McDermott, PhD,
PhD,
Massachusetts General Hospital
Co-Author - Danielle La Camera,
Massachusetts General Hospital
Co-Author - Julie R. Brewer,
Massachusetts General Hospital
Co-Author - Claire Szapary,
Massachusetts General Hospital
Co-Author - Tamara J. Somers, PhD,
PhD,
Duke University
Co-Author - John Burns,
PhD,
Rush University
Co-Author - Francis Keefe,
PhD,
Duke University
Co-Author - Sarah Kelleher,
PhD,
Duke University
Co-Author - Hannah M. Fisher,
Duke University School of Medicine
Co-Presenter - Rebecca Jedi,
PhD,
Rush University
Co-Author - Ronald Kulich,
PhD,
Massachusetts General Hospital
Co-Author - Robert Parker,
ScD,
Massachusetts General Hospital
Co-Author - Ana-Maria Vranceanu, PhD, FSBM,
PhD, FSBM,
MGH/Harvard
F140 - MoodMover: Development and usability testing of an mHealth physical activity intervention for depression
Poster Number: F140Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Mental Health
Background:
Physical activity (PA) is recognized as a modifiable lifestyle factor for managing depression. An app-based intervention to promote PA among individuals with depression may be a viable alternative or adjunct to conventional treatments offering increased accessibility.
Objective:
This study aimed to describe the early stages of development and usability testing of a 9-week app-based intervention, MoodMover, specifically designed to promote PA for people with depression.
Methods:
Development of MoodMover followed the initial stages of the Integrate, Design, Assess, and Share (IDEAS) framework. The development process included: (1) identifying intervention needs and planning; (2) intervention development; and (3) usability testing and refinement. Usability testing employed a mixed-methods formative approach via virtual semi-structured interviews involving goal-oriented tasks and administration of the mHealth App Usability Questionnaire (MAUQ).
Results:
Drawing on formative research, a multidisciplinary research team developed the intervention, guided by the Multi-Process Action Control framework. Nine participants engaged in the usability testing with the MoodMover prototypes receiving an average MAUQ score of 5.79 (SD = 1.04), indicating good to high usability. Necessary modifications were made based on end-users’ feedback.
Conclusions:
The development of MoodMover, the first theoretically informed app-based PA intervention for individuals with depression, may provide another evidence-based treatment option which has wide reach. The comprehensive usability testing indicated interest in the app and strong perceptions of usability enabling a user-centered approach to refine the app to better align with end-users’ preferences and needs. Testing the feasibility and preliminary efficacy of the refined MoodMover is now recommended.
Keywords: Physical activity, DepressionPhysical activity (PA) is recognized as a modifiable lifestyle factor for managing depression. An app-based intervention to promote PA among individuals with depression may be a viable alternative or adjunct to conventional treatments offering increased accessibility.
Objective:
This study aimed to describe the early stages of development and usability testing of a 9-week app-based intervention, MoodMover, specifically designed to promote PA for people with depression.
Methods:
Development of MoodMover followed the initial stages of the Integrate, Design, Assess, and Share (IDEAS) framework. The development process included: (1) identifying intervention needs and planning; (2) intervention development; and (3) usability testing and refinement. Usability testing employed a mixed-methods formative approach via virtual semi-structured interviews involving goal-oriented tasks and administration of the mHealth App Usability Questionnaire (MAUQ).
Results:
Drawing on formative research, a multidisciplinary research team developed the intervention, guided by the Multi-Process Action Control framework. Nine participants engaged in the usability testing with the MoodMover prototypes receiving an average MAUQ score of 5.79 (SD = 1.04), indicating good to high usability. Necessary modifications were made based on end-users’ feedback.
Conclusions:
The development of MoodMover, the first theoretically informed app-based PA intervention for individuals with depression, may provide another evidence-based treatment option which has wide reach. The comprehensive usability testing indicated interest in the app and strong perceptions of usability enabling a user-centered approach to refine the app to better align with end-users’ preferences and needs. Testing the feasibility and preliminary efficacy of the refined MoodMover is now recommended.
Authors:
Author - Yiling Tang,
University of British Columbia
Co-Author - Madelaine Gierc,
University of British Columbia
Co-Author - Henry La,
University of Victoria
Co-Author - Juehee Kim,
University of British Columbia
Co-Author - Sam Liu,
University of Victoria
Co-Author - Raymond W Lam,
University of British Columbia
Co-Author - Eli Puterman,
University of British Columbia
Co-Author - Guy Faulkner,
University of British Columbia
F141 - Do descriptive and injunctive norms for proximal reference groups better predict daily step counts: a cross-sectional study among Chinese graduate students
Poster Number: F141Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Social and Environmental Context and Health
Introduction: Social norms have been widely regarded as important determinants of health-related behaviors. Many theories proposed that socially proximal referents are more influential compared to distal referents. Till now, it remains unclear whether descriptive and injunctive norms for proximal reference groups better predict daily step counts. The present study aimed to study how different reference groups influence the associations between social norms and daily step counts.
Methods: 354 Chinese graduate students completed a cross-sectional study. Descriptive norms and injunctive norms for typical graduate students on campus and typical same-sex graduate students on campus were measured using online survey, and their step counts in the past 7 days were recorded by Werun, a fitness plugin documenting steps taken by users every day. Univariate regression analysis was first performed to study the associations between demographic characteristics and daily step counts. Hierarchical regression analysis was performed to test whether social norms for proximal reference group, i.e. typical same-sex graduate students on campus, was better when predicting daily step counts. Data analysis was performed by STATA/SE 15.1.
Results: Univariate regression analysis revealed that age and year of graduate study were associated with daily step counts. Hierarchical regression analysis showed that both descriptive norms(β=0.45, p<0.001) and injunctive norms(β=0.27, p<0.001) for typical graduate students on campus were significantly associated with daily step counts among Chinese graduate students after adjusting for significant demographic characteristics. However, adding social norms for typical same-sex graduate students on campus into the models did not significantly change the R square regardless of the types of social norms. Social norms for typical same-sex graduate students on campus did not significantly predict daily step counts after adjusting for significant demographic characteristics and social norms for typical graduate students on campus.
Conclusions: The present study examined the influence of reference groups on associations between social norms and daily step counts. This study suggests that social norms for typical same-sex students do not provide additional benefits when predicting daily step counts. Findings of this study may inform design of social norm interventions regarding how to choose an appropriate reference group.
Keywords: Physical activity, BeliefsMethods: 354 Chinese graduate students completed a cross-sectional study. Descriptive norms and injunctive norms for typical graduate students on campus and typical same-sex graduate students on campus were measured using online survey, and their step counts in the past 7 days were recorded by Werun, a fitness plugin documenting steps taken by users every day. Univariate regression analysis was first performed to study the associations between demographic characteristics and daily step counts. Hierarchical regression analysis was performed to test whether social norms for proximal reference group, i.e. typical same-sex graduate students on campus, was better when predicting daily step counts. Data analysis was performed by STATA/SE 15.1.
Results: Univariate regression analysis revealed that age and year of graduate study were associated with daily step counts. Hierarchical regression analysis showed that both descriptive norms(β=0.45, p<0.001) and injunctive norms(β=0.27, p<0.001) for typical graduate students on campus were significantly associated with daily step counts among Chinese graduate students after adjusting for significant demographic characteristics. However, adding social norms for typical same-sex graduate students on campus into the models did not significantly change the R square regardless of the types of social norms. Social norms for typical same-sex graduate students on campus did not significantly predict daily step counts after adjusting for significant demographic characteristics and social norms for typical graduate students on campus.
Conclusions: The present study examined the influence of reference groups on associations between social norms and daily step counts. This study suggests that social norms for typical same-sex students do not provide additional benefits when predicting daily step counts. Findings of this study may inform design of social norm interventions regarding how to choose an appropriate reference group.
Authors:
Co-Author - Xinchen Ye,
Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
Co-Author - yuhan hu,
Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
Co-Author - siwen huang,
Vanke School of Public Health, Tsinghua University, Beijing, China
Co-Author - Qingyu Li,
Vanke School of Public Health, Tsinghua University, Beijing, China
Co-Author - Sitong Luo,
Vanke School of Public Health, Tsinghua University, Beijing, China
Co-Author - Phoenix K. H. Mo,
Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
F142 - Differences in regular aerobic exercise among people with migraine not explained by migraine symptoms, beliefs, or psychological features
Poster Number: F142Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Pain
Background: It is unclear why people with migraine are less physically active than the general population. Migraine symptoms may interfere with physical activity participation as such activity exacerbates them. Alternatively the fear-avoidance model posits people with migraine may fear, and thus avoid, activities associated with pain (e.g. physical activity) even during pain-free periods. The present study evaluated differences in migraine symptoms, disability, migraine-related beliefs and psychological features in people with migraine who did and did not regularly participate in aerobic exercise.
Method: This is a secondary cross-sectional analysis of baseline data from a 3-month longitudinal observational daily diary study. Adults with episodic migraine (N=62) completed validated surveys evaluating migraine characteristics, disability (Migraine Disability Assessment and Migraine Specific Quality of Life 2.1), migraine-related beliefs (Headache Management Self-Efficacy, Locus of Control) and psychological features (PROMIS-Anxiety and -Sleep Disturbance). Patients self-reported if they regularly exercised. A “yes” indicated the number of days in a typical week patients regularly exercised (i.e. 1-2 days, 3-5 or 6-7). Two-tailed t-tests evaluated differences in these measures between patients with migraine who regularly exercise and those who do not.
Results: Participants were primarily White (68.9%) Non-Hispanic (83.6%) women (84.4%) who averaged 8 headache days/month (SD=2.9). 36 (58.1%) participants reported regular aerobic exercise and 26 (41.9%) did not. Of the 36 participants that exercised, 8 (22.2%) exercised 1-2 days/week, 24 (66.7%) exercised 3-5 days/week and 4 (11.1%) exercised 6-7 days/week. There were no significant differences in headache attack intensity, headache frequency, and migraine-related disability and quality of life (ps > .05) between migraine patients who exercise compared to those who do not. No significant differences in headache management self-efficacy, locus of control, worry and rumination, and sleep disturbance were found between groups (ps > .05).
Conclusions: The current study found no support for a relationship between migraine symptoms, migraine-related beliefs, psychological features and regular participation in aerobic exercise. More research is needed to determine alternative explanations for variation of exercise rates among people with migraine with a goal of reducing barriers to exercise in this population.
Keywords: Headache, ExerciseMethod: This is a secondary cross-sectional analysis of baseline data from a 3-month longitudinal observational daily diary study. Adults with episodic migraine (N=62) completed validated surveys evaluating migraine characteristics, disability (Migraine Disability Assessment and Migraine Specific Quality of Life 2.1), migraine-related beliefs (Headache Management Self-Efficacy, Locus of Control) and psychological features (PROMIS-Anxiety and -Sleep Disturbance). Patients self-reported if they regularly exercised. A “yes” indicated the number of days in a typical week patients regularly exercised (i.e. 1-2 days, 3-5 or 6-7). Two-tailed t-tests evaluated differences in these measures between patients with migraine who regularly exercise and those who do not.
Results: Participants were primarily White (68.9%) Non-Hispanic (83.6%) women (84.4%) who averaged 8 headache days/month (SD=2.9). 36 (58.1%) participants reported regular aerobic exercise and 26 (41.9%) did not. Of the 36 participants that exercised, 8 (22.2%) exercised 1-2 days/week, 24 (66.7%) exercised 3-5 days/week and 4 (11.1%) exercised 6-7 days/week. There were no significant differences in headache attack intensity, headache frequency, and migraine-related disability and quality of life (ps > .05) between migraine patients who exercise compared to those who do not. No significant differences in headache management self-efficacy, locus of control, worry and rumination, and sleep disturbance were found between groups (ps > .05).
Conclusions: The current study found no support for a relationship between migraine symptoms, migraine-related beliefs, psychological features and regular participation in aerobic exercise. More research is needed to determine alternative explanations for variation of exercise rates among people with migraine with a goal of reducing barriers to exercise in this population.
Authors:
Presenter - Rebecca E. Klapper,
EdM, CMPC,
Ferkauf Graduate School of Psychology, Yeshiva University
Co-Author - Elizabeth K. Seng, PhD, FSBM,
PhD, FSBM,
Yeshiva University
F143 - Lifestyle physical activity and fatigue in persons newly diagnosed with multiple sclerosis: A cross-sectional study
Poster Number: F143Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Multiple Health Behavior Change
Background: Fatigue is a prevalent and debilitating symptom of multiple sclerosis (MS), even in the early stages of the disease. To date, the
association between physical activity (PA) and fatigue has not been examined in people newly diagnosed with MS (PNDwMS), yet this could
inform fatigue management and behavioral intervention in early MS.
Purpose: This study examined the association between device‐measured PA outcomes and symptomatic fatigue in PNDwMS.
Materials and methods: Participants diagnosed with MS within the past two years (n=49) wore a hip‐based ActiGraph model GT3X+
accelerometer for 7 days to measure PA levels, including time spent in light PA (LPA) and moderate‐to‐vigorous PA (MVPA), sedentary time (ST),
and daily step count. Participants further completed the Fatigue Severity Scale (FSS). We used Pearson and Spearman’s correlations to examine
the bivariate relationships between PA outcomes and FSS scores. We then performed stepwise multiple linear regression analysis of FSS scores
on PA outcomes, controlling for disability status assessed by the Paent Determined Disease Steps (PDDS).
Results: There were significant bivariate correlations between LPA (r=–0.42), daily step count (r=–0.35), and ST (r=0.33) with FSS scores in the
study sample. The stepwise multiple linear regression analysis indicated that FSS scores were associated with LPA (β=–0.42, R2=0.18) when LPA,
ST, and daily step count were entered into the model. After controlling for PDDS as a covariate (R2=0.35), the association between FSS and LPA
was attenuated but was still statistically significant (β=–0.34). There were no significant associations between fatigue and other PA outcomes (i.e.,
ST and step count).
Conclusions: Our results indicated that LPA was significantly associated with perceived fatigue severity in PNDwMS, even after controlling for
disability status. The finding highlights the opportunity for developing behavioral interventions targeting LPA for managing fatigue in PNDwMS.
Keywords: Physical activity, Fatigueassociation between physical activity (PA) and fatigue has not been examined in people newly diagnosed with MS (PNDwMS), yet this could
inform fatigue management and behavioral intervention in early MS.
Purpose: This study examined the association between device‐measured PA outcomes and symptomatic fatigue in PNDwMS.
Materials and methods: Participants diagnosed with MS within the past two years (n=49) wore a hip‐based ActiGraph model GT3X+
accelerometer for 7 days to measure PA levels, including time spent in light PA (LPA) and moderate‐to‐vigorous PA (MVPA), sedentary time (ST),
and daily step count. Participants further completed the Fatigue Severity Scale (FSS). We used Pearson and Spearman’s correlations to examine
the bivariate relationships between PA outcomes and FSS scores. We then performed stepwise multiple linear regression analysis of FSS scores
on PA outcomes, controlling for disability status assessed by the Paent Determined Disease Steps (PDDS).
Results: There were significant bivariate correlations between LPA (r=–0.42), daily step count (r=–0.35), and ST (r=0.33) with FSS scores in the
study sample. The stepwise multiple linear regression analysis indicated that FSS scores were associated with LPA (β=–0.42, R2=0.18) when LPA,
ST, and daily step count were entered into the model. After controlling for PDDS as a covariate (R2=0.35), the association between FSS and LPA
was attenuated but was still statistically significant (β=–0.34). There were no significant associations between fatigue and other PA outcomes (i.e.,
ST and step count).
Conclusions: Our results indicated that LPA was significantly associated with perceived fatigue severity in PNDwMS, even after controlling for
disability status. The finding highlights the opportunity for developing behavioral interventions targeting LPA for managing fatigue in PNDwMS.
Authors:
Author - Le Thao Trinh Huynh, PhD, MPH,
University of Illinois at Chicago
Co-Author - Peixuan Zheng,
PhD,
University of Illinois Chicago
Co-Author - Brenda Jeng,
PhD,
University of Illinois Chicago
Co-Author - Robert W. Motl, PhD, FSBM, FNAK,
University of Illinois Chicago
F144 - A Systematic Review of Postpartum Physical Activity Intervention Mediators
Poster Number: F144Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Women's Health
Background. Regular physical activity (PA) is associated with many health and wellness benefits; however, up to 94% of postpartum individuals do not meet PA guidelines. Understanding mediators of postpartum PA behaviour change interventions is essential to increase PA participation following childbirth. The purpose of this pre-registered review was to identify putative mediators of postpartum PA interventions.
Methods. Six databases were searched for primary or grey literature from database inception until December, 2023. Intervention studies of any publication date or language were included if they contained 1) individuals up to 12-months postpartum, 2) a PA, muscle strengthening exercise, or pelvic floor muscle training intervention, 3) a no exercise or different exercise intervention comparator, 4) a report on PA behaviour change, and 5) a report on change in a putative psychological or environmental mediator outcome that could be classified with the Theoretical Domains Framework (TDF). We categorized results by mediation path, mediator TDF domain, and PA outcome and then calculated a summary median Pearson r and interquartile range (IQR) for each path.
Results. Twenty-eight articles (3,328 participants) were eligible and summary effects for Paths AB, A, B, and C were calculated from two, nineteen, two, and 18 unique studies respectively. For the mediation Path AB, we found very small effects from the following domains: beliefs about capabilities (r = .08; IQR: .04, .11), beliefs about consequences (r = .02; IQR: .01, .02), environmental context and resources (r = .01; IQR: .01, .01), and social influences (r = .08; IQR: .07, .10). For Path A (i.e., the association between the PA intervention and putative mediator), in addition to the domains identified in Path AB, we observed effects in the domains of behavioural regulation (r = .25; IQR: .22, .31), knowledge (r = .09; IQR: -.14, .32), and emotions (r = -.06; IQR: -.17, .03). We found a small total effect (Path C; r = .12; IQR: .03, .28) of postpartum PA interventions on PA.
Conclusion. Future postpartum PA interventions should consider integrating components that address outcomes under the domains of beliefs about capabilities, beliefs about consequences, environmental context and resources, and social influences. Further research is needed that tests mediating variables of postpartum PA interventions, particularly those that promote non-conscious processes of habit and identity.
Keywords: Physical activity, Health behavior changeMethods. Six databases were searched for primary or grey literature from database inception until December, 2023. Intervention studies of any publication date or language were included if they contained 1) individuals up to 12-months postpartum, 2) a PA, muscle strengthening exercise, or pelvic floor muscle training intervention, 3) a no exercise or different exercise intervention comparator, 4) a report on PA behaviour change, and 5) a report on change in a putative psychological or environmental mediator outcome that could be classified with the Theoretical Domains Framework (TDF). We categorized results by mediation path, mediator TDF domain, and PA outcome and then calculated a summary median Pearson r and interquartile range (IQR) for each path.
Results. Twenty-eight articles (3,328 participants) were eligible and summary effects for Paths AB, A, B, and C were calculated from two, nineteen, two, and 18 unique studies respectively. For the mediation Path AB, we found very small effects from the following domains: beliefs about capabilities (r = .08; IQR: .04, .11), beliefs about consequences (r = .02; IQR: .01, .02), environmental context and resources (r = .01; IQR: .01, .01), and social influences (r = .08; IQR: .07, .10). For Path A (i.e., the association between the PA intervention and putative mediator), in addition to the domains identified in Path AB, we observed effects in the domains of behavioural regulation (r = .25; IQR: .22, .31), knowledge (r = .09; IQR: -.14, .32), and emotions (r = -.06; IQR: -.17, .03). We found a small total effect (Path C; r = .12; IQR: .03, .28) of postpartum PA interventions on PA.
Conclusion. Future postpartum PA interventions should consider integrating components that address outcomes under the domains of beliefs about capabilities, beliefs about consequences, environmental context and resources, and social influences. Further research is needed that tests mediating variables of postpartum PA interventions, particularly those that promote non-conscious processes of habit and identity.
Authors:
Presenter - Heather Hollman,
DC, MRSc,
University of Victoria
Co-Author - Sophie Tran,
DC, MSc,
University of British Columbia
Co-Author - Margie H. Davenport,
PhD,
University of Alberta
Co-Author - Sam Liu,
PhD,
University of Victoria
Co-Author - Wuyou Sui,
PhD,
University of Western Ontario
Co-Author - Aleah Ross,
MSc,
University of Victoria
Co-Author - Erla Hjartar,
BSc,
University of Iceland
Co-Author - Ryan E. Rhodes,
PhD, FSBM,
University of Victoria
F146 - Challenges and Insights: Children's Experiences with Waist-Worn Accelerometers in a Digital Physical Activity Intervention
Poster Number: F146Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Physical Activity
Introduction
Accelerometers are now ubiquitous in physical activity research. Device acceptability and protocol are critical to rigorous measurement and are a particular concern with children. However, few studies report pragmatic, qualitative information to improve accelerometer wear protocols. This qualitative study reports child and parent experiences of the ActiGraph WGT3X-BT accelerometer, as used in the ACTIWEB-PA trial.
Methods
The ACTIWEB-PA pilot randomized controlled trial tested a physical activity intervention in 41 children aged 8-11 years. Children wore the ActiGraph on their right hip for 7 days at baseline and again at 12 weeks. Interviews with children and parents were conducted at 12 weeks and transcribed. Dedoose software was used to code and identify key themes regarding device comfort, usability, and suggestions for improvement.
Results
Thirty-four child-parent pairs completed the interview (83% of sample). Children were 9.35±0.98 years old; 52.9% were female, and among parents, 85.3% were mothers. While children generally found the device unobtrusive, several reported discomfort, particularly related to waist placement. Common issues included the device riding up during physical activity and the belt slipping during the day, causing irritation and itchiness. As one child noted, "It got in the way when I was running; it kept going up and down." Parents also faced challenges in ensuring their children wore the device consistently. Despite these difficulties, many children enjoyed the social aspect of wearing the device, often viewing it as a "badge of participation" in a research study, with one child sharing, “I liked showing it off at school.” However, some parents observed that children’s initial enthusiasm waned over time. Suggestions for improvement included offering the belt in a variety of colors, integrating the device with smartphone apps for easier wear-time logging, redesigning the belt for greater comfort and security, and considering a wrist-worn version.
Conclusions
The accelerometer was generally well-tolerated by children, but discomfort related to waist placement and belt design was common. These issues, along with declining engagement, suggest improvements to hip-worn accelerometer comfort and usability are overdue. A more secure, comfortable belt or attachment system, as well as fun customization options, could enhance user experience, sustain engagement, and improve data completeness in future studies with children.
Keywords: Physical activity, ChildrenAccelerometers are now ubiquitous in physical activity research. Device acceptability and protocol are critical to rigorous measurement and are a particular concern with children. However, few studies report pragmatic, qualitative information to improve accelerometer wear protocols. This qualitative study reports child and parent experiences of the ActiGraph WGT3X-BT accelerometer, as used in the ACTIWEB-PA trial.
Methods
The ACTIWEB-PA pilot randomized controlled trial tested a physical activity intervention in 41 children aged 8-11 years. Children wore the ActiGraph on their right hip for 7 days at baseline and again at 12 weeks. Interviews with children and parents were conducted at 12 weeks and transcribed. Dedoose software was used to code and identify key themes regarding device comfort, usability, and suggestions for improvement.
Results
Thirty-four child-parent pairs completed the interview (83% of sample). Children were 9.35±0.98 years old; 52.9% were female, and among parents, 85.3% were mothers. While children generally found the device unobtrusive, several reported discomfort, particularly related to waist placement. Common issues included the device riding up during physical activity and the belt slipping during the day, causing irritation and itchiness. As one child noted, "It got in the way when I was running; it kept going up and down." Parents also faced challenges in ensuring their children wore the device consistently. Despite these difficulties, many children enjoyed the social aspect of wearing the device, often viewing it as a "badge of participation" in a research study, with one child sharing, “I liked showing it off at school.” However, some parents observed that children’s initial enthusiasm waned over time. Suggestions for improvement included offering the belt in a variety of colors, integrating the device with smartphone apps for easier wear-time logging, redesigning the belt for greater comfort and security, and considering a wrist-worn version.
Conclusions
The accelerometer was generally well-tolerated by children, but discomfort related to waist placement and belt design was common. These issues, along with declining engagement, suggest improvements to hip-worn accelerometer comfort and usability are overdue. A more secure, comfortable belt or attachment system, as well as fun customization options, could enhance user experience, sustain engagement, and improve data completeness in future studies with children.
Authors:
Presenter - Somya Rastogi,
PhD,
University of Wisconsin-Madison
Co-Author - Lisa Cadmus-Bertram, PhD,
PhD,
University of Wisconsin - Madison
Co-Author - Luis Columna,
PhD,
University of Wisconsin-Madison
Co-Author - Kelli Koltyn,
PhD,
University of Wisconsin-Madison
Co-Author - Ronald Gangnon,
PhD,
University of Wisconsin-Madison
Co-Author - Paul Peppard,
PhD,
University of Wisconsin-Madison
Co-Author - Kristen Malecki,
PhD,
University of Illinois
F147 - Formative Test of a Digital Therapeutics Intervention to Enhance Affective Response During Physical Activity: Compliance, Engagement, and Adherence
Poster Number: F147Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Physical Activity
Digital therapeutics allows for scalable real-world intervention and assessment of health behaviors on a broad scale and at a lower cost. However, technological complexities and burden may dampen participant compliance, engagement, and adherence─posing challenges for the evaluation of intervention efficacy and effectiveness. This formative study assessed compliance, engagement, and adherence components, and their correlations to each other, to a digital therapeutics intervention (eMOTION Study) that aimed to enhance affective response (i.e., how people feel) during physical activity. Sedentary adults (N=37, ages 25-75, 51% female) participated in a 14-day physical activity intervention consisting of daily physical activity goals and self-regulated planning sessions delivered through smartphone notifications. Variables of compliance to measurement procedures (e.g., smartwatch wear time, ecological momentary assessment [EMA] response rates), engagement with intervention components (e.g., completion of daily goal/planning sessions), and adherence to intervention targets (e.g., completing planned physical activity sessions) were assessed. Partial correlations, controlling for age and body mass index (BMI), evaluated associations within and between compliance, engagement, and adherence variables at the person-level. On average, participants wore the smartwatch 22.3 (SD: 2.6) hours per day, averaging 64% (Range: 0.0-98.3%) of all EMA prompts answered. An average of 74% (range: 0-100%) of scheduled daily physical activity goals and self-regulated planning sessions were completed. Of the days that physical activity was planned, an average of 75% (range: 0-100%) were completed. After controlling for age and BMI, significant person-level correlations were found among all variables within compliance to measurement procedures, engagement with intervention components, and adherence to intervention targets (ps<.05). No significance were found comparing variables between compliance to measurement procedures, engagement with intervention components, and adherence to intervention targets (ps≥.05). A formative test of a digital therapeutic PA intervention showed that levels of participant compliance, engagement, and adherence were acceptable and unrelated to each other. These findings help to limit concerns that the quantity of evaluation data will be lower for individuals who are less engaged or less adherent to a digital therapeutics intervention.
Keywords: e-Health, Physical activityAuthors:
Presenter - Lori Hatzinger, MS,
MS,
University of Southern California
Co-Author - Rachel Crosley-Lyons, MS,
MS,
University of Southern California
Co-Author - Micaela Hewus,
University of Southern California
Co-Author - Wei-Lin Wang, PhD,
PhD,
University of Southern California
Co-Author - Jimi Huh, PhD,
PhD,
University of Southern California
Co-Author - Delfien Van Dyck,
PhD,
Ghent University
Co-Author - Genevieve F. Dunton, PhD, MPH, FSBM,
PhD, MPH, FSBM,
University of Southern California
F148 - PHYSICAL ACTIVITY KNOWLEDGE AMONG U.S. COMMUNITY HEALTH WORKERS
Poster Number: F148Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Health of Marginalized Populations
The knowledge and awareness of physical activity (PA) guidelines (e.g., 150 minutes of moderate-to-vigorous PA per week) is limited among adults in the United States. Community health workers (CHWs) are frontline public health workers and members of the community they serve. Their roles include health education, promotion and advocacy, mostly focused on tackling health inequities. CHWs may be important collaborators to promote PA among underserved populations. However, little is known about the knowledge of this population towards PA. We conducted a nationwide survey to explore the current knowledge of PA among U.S. CHWs. We administered the questionnaire on knowledge and awareness of the PA guidelines from the Office of Disease Prevention and Health Promotion to CHWs across the country. Among 108 surveyed CHWs (Mage=42 SD=9.7, 86% Female, 47.2% White), 77.6% reported that they have recommended PA to their clients; however, only 38% reported any familiarity with the U.S. PA guidelines. This is reflected through their overall score (Moverall score=3.18, SD=1.5), which ranges from 0-7 correct answers; thereby suggesting low knowledge of PA, largely driven by the lack of awareness on specific dosage recommendations: only 19.4% selected the correct answer for the recommended weekly dose of moderate PA, 8.4% for vigorous PA, and 24.3% for muscle strengthening. The majority of CHWs had a good understanding of PA (>50% of the respondents selected the correct answer for what is moderate PA/vigorous PA, as well as the correct example for each). Chi-Square tests show no statistically significant difference in PA knowledge between demographic groups, but those who reported having familiarity with PA guidelines were more likely to correctly respond to what the dosage of moderate PA is (X2(1, N=108), 6.35, p=0.012). These findings provide an insight on the current knowledge of PA among CHWs. It suggests a gap in knowledge and awareness of PA guidelines and recommendations among CHWs. Future research may consider increasing education on PA among CHWs and examine how increase in education may translate to increase in PA among the communities they serve.
Keywords: Physical activity, Health promotionAuthors:
Author - Ana Selzer,
MS,
University of Illinois at Urbana-Champaign
Co-Author - Andiara Schwingel,
PhD,
University of Illinois Urbana Champaign
Co-Author - Pedro Hallal,
PhD,
University of Illinois Urbana Champaign
Co-Author - Tracey Smith,
DNP, PHCNS-BC, MS,
Illinois Public Health Association
Co-Author - Susan Aguiñaga, PhD,
PhD,
University of Illinois at Urbana-Champaign
F150 - Modeling the influence of psychological distress and mental well-being on trajectories of physical activity behavior: A growth curve analysis of Apple Watch data
Poster Number: F150Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Mental Health
Background: While mental health is known to influence physical activity (PA) behavior, much of the existing research relies on aggregated measurement periods, overlooking the day-to-day variability of PA. Examining how mental health influences PA trajectories is essential for capturing a more nuanced understanding of this complex relationship. This study explored how indicators of mental health influence daily PA behavior among college students over a four-week study period.
Methods: This prospective observational study included 298 college students (Mage = 20 years; 75% female) who wore an Apple Watch daily and provided access to four weeks of PA (i.e., “active minutes”) data. Participants completed a baseline survey to assess psychological distress (Kessler Psychological Distress Scale) and mental wellbeing (Warwick-Edinburgh Mental Well-Being Scale), which were used to classify individuals into groups based on mild-to-severe vs. low psychological distress and high vs. low mental wellbeing. Growth curve models were computed to examine how mental health status influenced trajectories of day-to-day PA behavior, controlling for sex.
Results: Findings revealed that individuals reporting mild-to-severe psychological distress engaged in significantly fewer daily PA minutes on average compared to those reporting low distress (β = -10.46, SE = 2.58, p < 0.001), and experienced a greater decrease in daily PA over time (β = -0.15, SE = 0.08, p = 0.045). Conversely, individuals reporting low mental wellbeing engaged in significantly fewer daily PA minutes on average than those reporting high wellbeing (β = -8.65, SE = 3.49, p = 0.014), but no differences were observed over time (β = 0.14, SE = 0.10, p = 0.184).
Conclusion: These results highlight that psychological distress and mental wellbeing play an influential role in day-to-day PA levels in college students, with distress appearing to have a more pronounced influence on PA trajectories. Periods of heightened mental health risk may be crucial opportunities for intervention to prevent significant drops in PA.
Keywords: Physical activity, Mental healthMethods: This prospective observational study included 298 college students (Mage = 20 years; 75% female) who wore an Apple Watch daily and provided access to four weeks of PA (i.e., “active minutes”) data. Participants completed a baseline survey to assess psychological distress (Kessler Psychological Distress Scale) and mental wellbeing (Warwick-Edinburgh Mental Well-Being Scale), which were used to classify individuals into groups based on mild-to-severe vs. low psychological distress and high vs. low mental wellbeing. Growth curve models were computed to examine how mental health status influenced trajectories of day-to-day PA behavior, controlling for sex.
Results: Findings revealed that individuals reporting mild-to-severe psychological distress engaged in significantly fewer daily PA minutes on average compared to those reporting low distress (β = -10.46, SE = 2.58, p < 0.001), and experienced a greater decrease in daily PA over time (β = -0.15, SE = 0.08, p = 0.045). Conversely, individuals reporting low mental wellbeing engaged in significantly fewer daily PA minutes on average than those reporting high wellbeing (β = -8.65, SE = 3.49, p = 0.014), but no differences were observed over time (β = 0.14, SE = 0.10, p = 0.184).
Conclusion: These results highlight that psychological distress and mental wellbeing play an influential role in day-to-day PA levels in college students, with distress appearing to have a more pronounced influence on PA trajectories. Periods of heightened mental health risk may be crucial opportunities for intervention to prevent significant drops in PA.
Authors:
Presenter - Claire I. Groves, MA,
MA,
The University of Texas at San Antonio
Co-Author - Denver Brown, PhD,
PhD,
Kansas State University
F151 - Differences in Mental Health Outcomes by Commuting Modes among US College Students
Poster Number: F151Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Mental Health
Sufficient physical activity (PA) participation can promote positive mental health; however, college students often do not meet PA guidelines (aerobic & muscle-strengthening) and may report higher rates of depressive and perceived stress symptoms. Active travel (e.g., walk, bike, etc.) to and from campus may be a practical approach to promoting PA and reducing mental distress symptoms.
PURPOSE: To examine the independent association between commuting modes and depressive and perceived stress symptoms among US college students.
METHODS: Data were collected from a volunteer sample of students from a large, Northeastern university (2018–2024) using an online survey. Participants self-reported their demographics (e.g., race, gender, sexual orientation) and number of trips/week to and from campus using various commuting modes (e.g., walk, bike, non-motorized, car, bus). The Center for Epidemiological Studies–Depression–7 (CESD; 0-21 score) and the Perceived Stress Scale-10 (PSS; 0-40 score) assessed mental distress. Travel mode trips to/from were summed and served as the independent variable (0-14 trips/week). 95% confidence intervals (CI) not including zero were considered statistically significant.
RESULTS: Participants (n=6781; 69.0% non-Hispanic White; 60.0% women; 86.1%
heterosexual; aged 20±1 years) reported scores of MCESD=6.39±4.26 and MPSS=17.15±7.17. Average total trips were MWalk=7.84±5.78, MBike=0.68±2.35, MNon-motorized=0.21±1.29, MCar=2.37±3.97, and MBus=2.28±3.70. Total walking trips (F(6, 3527)=28.84, β=-0.039, 95% CI [-0.069, -0.008]), non-motorized trips (F(6, 3172)=26.93, β=0.229 [0.092, 0.366]), and bus trips (F(6, 3378)=28.09, β=0.042 [0.004, 0.079]) were associated with CESD scores. Total walking trips (F(6, 3265)=20.64, β=-0.058 [-0.112, -0.004]), bike trips (F(6, 3013)=18.22, β=-0.143 [-0.253, -0.032]), and non-motorized trips (F(6, 2951)=18.71, β=0.429, [0.192, 0.666]) were associated with PSS scores.
CONCLUSION: Mental distress among college students may be alleviated through the promotion of commuting via walking rather than non-motorized modes (i.e., skateboard). Universities should assess walkability and bikeability on campus and surrounding residential areas to promote mental well-being via active commutes.
Keywords: Physical activity, DepressionPURPOSE: To examine the independent association between commuting modes and depressive and perceived stress symptoms among US college students.
METHODS: Data were collected from a volunteer sample of students from a large, Northeastern university (2018–2024) using an online survey. Participants self-reported their demographics (e.g., race, gender, sexual orientation) and number of trips/week to and from campus using various commuting modes (e.g., walk, bike, non-motorized, car, bus). The Center for Epidemiological Studies–Depression–7 (CESD; 0-21 score) and the Perceived Stress Scale-10 (PSS; 0-40 score) assessed mental distress. Travel mode trips to/from were summed and served as the independent variable (0-14 trips/week). 95% confidence intervals (CI) not including zero were considered statistically significant.
RESULTS: Participants (n=6781; 69.0% non-Hispanic White; 60.0% women; 86.1%
heterosexual; aged 20±1 years) reported scores of MCESD=6.39±4.26 and MPSS=17.15±7.17. Average total trips were MWalk=7.84±5.78, MBike=0.68±2.35, MNon-motorized=0.21±1.29, MCar=2.37±3.97, and MBus=2.28±3.70. Total walking trips (F(6, 3527)=28.84, β=-0.039, 95% CI [-0.069, -0.008]), non-motorized trips (F(6, 3172)=26.93, β=0.229 [0.092, 0.366]), and bus trips (F(6, 3378)=28.09, β=0.042 [0.004, 0.079]) were associated with CESD scores. Total walking trips (F(6, 3265)=20.64, β=-0.058 [-0.112, -0.004]), bike trips (F(6, 3013)=18.22, β=-0.143 [-0.253, -0.032]), and non-motorized trips (F(6, 2951)=18.71, β=0.429, [0.192, 0.666]) were associated with PSS scores.
CONCLUSION: Mental distress among college students may be alleviated through the promotion of commuting via walking rather than non-motorized modes (i.e., skateboard). Universities should assess walkability and bikeability on campus and surrounding residential areas to promote mental well-being via active commutes.
Authors:
Author - Keegan T. Peterson, MPH,
Penn State University
Co-Author - Caellum Impelluso,
MS,
Penn State University
Co-Author - Melissa Bopp,
PhD,
Penn State University
F152 - Physical activity engagement by domain among shift workers: NHANES 2017-2020
Poster Number: F152Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Social and Environmental Context and Health
Purpose: To examine associations of shift work with physical activity (PA) engagement across domains of occupation, transportation, and leisure activity, and to assess whether these associations differed by nativity and socioeconomic status (SES) among US adults.
Methods: Data came from 4,456 adults (44.1±14.5 years; 32.5% non-Hispanic White; 48% female; 69.9% US-born) in the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020. Shift work was self-reported based on work schedule over the past 3 months and operationalized as: a traditional daytime schedule (9am-5pm), regular shift work (i.e., evenings/nights or early mornings), rotating shift work (i.e., irregular shift work), with a traditional schedule as the referent. Moderate and vigorous PA minutes/week by the domains of occupation, transportation, and leisure activity were self-reported along with sedentary behavior. Nativity was defined as being born in or outside of the US, and SES as household poverty-income ratio. Multivariable linear regression was used to measure associations between key study variables.
Results: 2,745 adults (61.6%) were shift workers, with 1,173 (26.3%) working regular shifts and 1,572 (35.3%) working rotating shifts. Compared to traditional daytime schedules, both regular shift (β: 122.4±36.5, p=0.003) and rotating shift schedules (β: 68.5±23.4, p=0.007) were associated with greater weekly vigorous occupational PA. Similarly, both shift types (regular shift, β: 238.8±31.5, p<0.001; rotating shift, β: 167.4±44.9, p=0.001) were associated with higher moderate occupational PA. A regular shift work schedule was also associated with a higher transportation PA (β: 28.8±9.7, p=0.006). Rotating shift work on the other hand was associated with greater vigorous (β: 20.9±6.3, p=0.003) and moderate (β: 23.5±6.3, p=0.001) leisure PA compared with a traditional schedule. A rotating shift work schedule was associated with less time spent in sedentary behavior (β: -52.3±14.4, p=0.001). Nativity moderated the association between shift work (dichotomous variable) and moderate occupational PA (p=0.001), whereas SES moderated the association between shift work and sedentary behavior (p=0.007).
Conclusions: While regular and rotating shift work was associated with greater levels of PA across domains, rotating shift work specifically, was associated with health-enhancing leisure PA. Future studies should investigate the role of shift timing and occupation on PA engagement.
Keywords: Population health, Physical activityMethods: Data came from 4,456 adults (44.1±14.5 years; 32.5% non-Hispanic White; 48% female; 69.9% US-born) in the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020. Shift work was self-reported based on work schedule over the past 3 months and operationalized as: a traditional daytime schedule (9am-5pm), regular shift work (i.e., evenings/nights or early mornings), rotating shift work (i.e., irregular shift work), with a traditional schedule as the referent. Moderate and vigorous PA minutes/week by the domains of occupation, transportation, and leisure activity were self-reported along with sedentary behavior. Nativity was defined as being born in or outside of the US, and SES as household poverty-income ratio. Multivariable linear regression was used to measure associations between key study variables.
Results: 2,745 adults (61.6%) were shift workers, with 1,173 (26.3%) working regular shifts and 1,572 (35.3%) working rotating shifts. Compared to traditional daytime schedules, both regular shift (β: 122.4±36.5, p=0.003) and rotating shift schedules (β: 68.5±23.4, p=0.007) were associated with greater weekly vigorous occupational PA. Similarly, both shift types (regular shift, β: 238.8±31.5, p<0.001; rotating shift, β: 167.4±44.9, p=0.001) were associated with higher moderate occupational PA. A regular shift work schedule was also associated with a higher transportation PA (β: 28.8±9.7, p=0.006). Rotating shift work on the other hand was associated with greater vigorous (β: 20.9±6.3, p=0.003) and moderate (β: 23.5±6.3, p=0.001) leisure PA compared with a traditional schedule. A rotating shift work schedule was associated with less time spent in sedentary behavior (β: -52.3±14.4, p=0.001). Nativity moderated the association between shift work (dichotomous variable) and moderate occupational PA (p=0.001), whereas SES moderated the association between shift work and sedentary behavior (p=0.007).
Conclusions: While regular and rotating shift work was associated with greater levels of PA across domains, rotating shift work specifically, was associated with health-enhancing leisure PA. Future studies should investigate the role of shift timing and occupation on PA engagement.
Authors:
Author - Tiwaloluwa Ajibewa,
PhD,
Northwestern University Feinberg School of Medicine
Co-Author - Brittanny M. Polanka, PhD,
PhD,
University of Alabama at Birmingham
Co-Author - Tyler Quinn,
PhD,
West Virginia University School of Public Health
Co-Author - Loretta Hsueh, PhD,
PhD,
University of Illinois at Chicago
F153 - Lived Experiences and Informed Behavior Change in the Women Exercising: Active, and Learning Together for Health (WEALTH) Trial
Poster Number: F153Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Women's Health
Before menopause, women experience physical activity (PA) declines that coincide with adverse health risks. PA engagement is a gendered phenomenon with differences in women’s and men’s exercise preferences and behaviors. For example, dance fitness programs are dominated by female participants and are one of the top preferred forms of group exercise modalities among women. To identify effective strategies for promoting PA and health among premenopausal women, this study explores general experiential characteristics women embody while participating in a group-based dance fitness workplace intervention.
Two focus groups (n=11) were conducted with premenopausal women (mean age: 39.75 years 6.06) enrolled in a 6-week group-based dance fitness feasibility trial that met for 30 minutes twice per week. The focus group guide was tailored to extrapolate aspects of the intervention delivery that influenced participants’ attitudes, behaviors, and experiences related to their exercise engagement while participating in the intervention. A narrative inquiry using critical events and thematic analyses was used to identify these characteristics and their relationship with the intervention.
There were lived experiences women brought with them into the intervention that informed their experience, namely a desire for exercise consistency and a historically negative relationship with exercise. These lived experiences, in tandem with subjective and objective intervention design factors, influenced their personal experience in the intervention. Women consistently reported that this program was fun and brought feelings of social connectedness/acceptance and comfort, positively impacting their experiences. Their participation in the intervention led to the reporting of changes in actual behavior, health, and perceptions of exercise, which positively influenced their intention to continue being physically active post-intervention.
All women will experience menopause and its detrimental health effects. This intervention provided a first step to understanding intervention strategies and lived experiences that may be useful to improve the protective PA behaviors and health of women before menopause occurs. PA programs that provide 30-minute durations of fun, group-based, women-only modalities may grant the consistency with exercise women report a desire to have in their lives.
Keywords: Physical activity, Health behavior changeTwo focus groups (n=11) were conducted with premenopausal women (mean age: 39.75 years 6.06) enrolled in a 6-week group-based dance fitness feasibility trial that met for 30 minutes twice per week. The focus group guide was tailored to extrapolate aspects of the intervention delivery that influenced participants’ attitudes, behaviors, and experiences related to their exercise engagement while participating in the intervention. A narrative inquiry using critical events and thematic analyses was used to identify these characteristics and their relationship with the intervention.
There were lived experiences women brought with them into the intervention that informed their experience, namely a desire for exercise consistency and a historically negative relationship with exercise. These lived experiences, in tandem with subjective and objective intervention design factors, influenced their personal experience in the intervention. Women consistently reported that this program was fun and brought feelings of social connectedness/acceptance and comfort, positively impacting their experiences. Their participation in the intervention led to the reporting of changes in actual behavior, health, and perceptions of exercise, which positively influenced their intention to continue being physically active post-intervention.
All women will experience menopause and its detrimental health effects. This intervention provided a first step to understanding intervention strategies and lived experiences that may be useful to improve the protective PA behaviors and health of women before menopause occurs. PA programs that provide 30-minute durations of fun, group-based, women-only modalities may grant the consistency with exercise women report a desire to have in their lives.
Authors:
Author - Jaclyn Hadfield,
PhD,
LSU
Co-Author - Ryan Hulteen,
OhD,
LSU
Co-Author - Heather Allaway,
PhD,
LSU
F154 - The impact of psychological inflexibility on the relationship between anxiety and sleep: A preliminary study
Poster Number: F154Time: 11:00 AM - 11:50 AM
Topics: Sleep, Mental Health
Background: The relationship between anxiety and sleep is well-established. Psychological inflexibility describes a style of behavior guided by “rigid” psychological reactions instead of personal values and has been associated with anxiety and anxiety disorders. This could contribute to the anxiety-sleep relationship; people high in psychological inflexibility may be more sensitive to, fearful of, and/or reactive to poor sleep and its perceived effects. This worry can exacerbate sleep difficulties through catastrophic thinking about one’s sleep. The current study aimed to determine whether psychological inflexibility moderated the relationship between anxiety and sleep among early college students, a group at high risk for poor sleep.
Methods: Cross-sectional data on various psychosocial measures were collected from college students attending a large state university located in the Southeastern U.S. Participants’ responses on the Acceptance and Action Questionnaire–Version 2 (AAQ-2), Generalized Anxiety Disorder–7 (GAD-7), and the Insomnia Severity Index (ISI) were analyzed using the PROCESS macro.
Results: Participants (N = 3,167; mean age = 18.67 years, SD = 1.79) reported, on average, moderate anxiety on the GAD-7 (M = 12.39, SD = 5.18); clinical insomnia on the ISI (M = 14.68, SD = 5.63); and a mean AAQ-2 score of 20.12 (SD = 9.83), with higher scores indicating more psychological inflexibility and scores above 25 indicating potential impact on overall well-being. Psychological inflexibility (b = 0.150, SE = 0.022, t = 6.70, p < 0.001) and anxiety (b = 0.591, SE = 0.044, t = 13.543, p < 0.001) both independently predicted sleep. Psychological inflexibility moderated the relationship between anxiety and sleep (b = -0.004, SE = 0.001, t = -2.986, p < 0.001), though this effect was small (ΔR2 = 0.002). It was also in the opposite direction as hypothesized; as psychological inflexibility decreased, the relationship between anxiety and sleep strengthened.
Conclusion: Results from this large cross-sectional study suggest psychological inflexibility may not be an appropriate treatment target for improving sleep in early college students. It moderates the relationship between anxiety and sleep opposite the expected direction, and the effect size is small. Given the strong association between anxiety and sleep dysfunction, it is vital to identify intervenable mechanisms. Following these factors among college students over time could yield different results.
Keywords: Sleep disorders, AnxietyMethods: Cross-sectional data on various psychosocial measures were collected from college students attending a large state university located in the Southeastern U.S. Participants’ responses on the Acceptance and Action Questionnaire–Version 2 (AAQ-2), Generalized Anxiety Disorder–7 (GAD-7), and the Insomnia Severity Index (ISI) were analyzed using the PROCESS macro.
Results: Participants (N = 3,167; mean age = 18.67 years, SD = 1.79) reported, on average, moderate anxiety on the GAD-7 (M = 12.39, SD = 5.18); clinical insomnia on the ISI (M = 14.68, SD = 5.63); and a mean AAQ-2 score of 20.12 (SD = 9.83), with higher scores indicating more psychological inflexibility and scores above 25 indicating potential impact on overall well-being. Psychological inflexibility (b = 0.150, SE = 0.022, t = 6.70, p < 0.001) and anxiety (b = 0.591, SE = 0.044, t = 13.543, p < 0.001) both independently predicted sleep. Psychological inflexibility moderated the relationship between anxiety and sleep (b = -0.004, SE = 0.001, t = -2.986, p < 0.001), though this effect was small (ΔR2 = 0.002). It was also in the opposite direction as hypothesized; as psychological inflexibility decreased, the relationship between anxiety and sleep strengthened.
Conclusion: Results from this large cross-sectional study suggest psychological inflexibility may not be an appropriate treatment target for improving sleep in early college students. It moderates the relationship between anxiety and sleep opposite the expected direction, and the effect size is small. Given the strong association between anxiety and sleep dysfunction, it is vital to identify intervenable mechanisms. Following these factors among college students over time could yield different results.
Authors:
Author - Rose Skelly,
MA,
East Carolina University
Co-Author - Kallie R.S. Maloney,
MA,
East Carolina University
Co-Author - Taylor L. Stallings, MS,
MS,
East Carolina University
Co-Author - Riley G. Craig,
BS,
East Carolina University
Co-Author - Matthew C. Whited, PhD, FSBM,
PhD, FSBM,
East Carolina University
F155 - Sleep promotion strategies in childcare settings: A systematic review
Poster Number: F155Time: 11:00 AM - 11:50 AM
Topics: Sleep, Child and Family Health
Although nighttime sleep promoting strategies within the home setting are well documented, less is known about daytime sleep promotion within childcare settings. This represents a significant gap in the literature given that most under age 5 receive childcare and depend on daytime sleep to meet their sleep needs. The current systematic review aims to summarize findings of prior studies assessing sleep promotion strategies used in childcare settings.
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. A search was conducted by a health sciences librarian in PubMed, PsycINFO, and CINAHL. Medical Subject Headings (MeSH) and search terms were used to identify articles mentioning “sleep” and “childcare”. Screening at both the title/abstract and full text levels were independently screened by two reviewers with discrepancies resolved by a senior reviewer. Methods reported in included studies were critically assessed using the “Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies” developed by the National Heart, Lung, and Blood Institute (NHLBI).
Only seven studies met the inclusion criteria. All studies were published between 1996 and 2018 and in one of four countries: Australia (n=3), United States (n=2), Japan (n=1), and Malaysia (n=1). Five studies examined the effects of mandatory naps. Researchers found that mandatory naps led to higher incidence and frequency of napping, shorter nighttime sleep duration, longer sleep over 24 hours on weekdays, and delayed bedtime. Two studies examined the effects of music and massage on nap latency; both found that introducing music and massage reduced nap latency. All studies were considered “fair”, ranging from 6-9 points, as per the NLBI assessment criteria.
Additional research with more rigorous methodology is needed to examine effective sleep promotion strategies in childcare beyond simply mandating sleep (e.g., best practices for providers with regard to environment setting and assisting children in falling asleep). Future studies should consider using objective measures of sleep.
Keywords: Children, Children's healthWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. A search was conducted by a health sciences librarian in PubMed, PsycINFO, and CINAHL. Medical Subject Headings (MeSH) and search terms were used to identify articles mentioning “sleep” and “childcare”. Screening at both the title/abstract and full text levels were independently screened by two reviewers with discrepancies resolved by a senior reviewer. Methods reported in included studies were critically assessed using the “Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies” developed by the National Heart, Lung, and Blood Institute (NHLBI).
Only seven studies met the inclusion criteria. All studies were published between 1996 and 2018 and in one of four countries: Australia (n=3), United States (n=2), Japan (n=1), and Malaysia (n=1). Five studies examined the effects of mandatory naps. Researchers found that mandatory naps led to higher incidence and frequency of napping, shorter nighttime sleep duration, longer sleep over 24 hours on weekdays, and delayed bedtime. Two studies examined the effects of music and massage on nap latency; both found that introducing music and massage reduced nap latency. All studies were considered “fair”, ranging from 6-9 points, as per the NLBI assessment criteria.
Additional research with more rigorous methodology is needed to examine effective sleep promotion strategies in childcare beyond simply mandating sleep (e.g., best practices for providers with regard to environment setting and assisting children in falling asleep). Future studies should consider using objective measures of sleep.
Authors:
Author - Belinda O'Hagan,
Brown University
Co-Author - Tayla Von Ash, ScD, MPH,
ScD, MPH,
Brown University School of Public Health
F156 - Individual and Dyadic Associations of Self-regulation with Sleep Health in Patients with Cancer and their Sleep-partner Caregivers
Poster Number: F156Time: 11:00 AM - 11:50 AM
Topics: Sleep, Cancer
Patients with cancer and their partner caregivers often experience sleep disturbances, which have been attributed to their elevated levels of distress. Individual differences in reflexive and deliberative self-regulation (e.g., impulsive vs. purposeful responses to stress, respectively) have been uniquely associated with one’s own and partner’s health. Less known is the extent to which such self-regulation patterns differentially relate to one’s own and partner’s sleep health in the cancer patient-caregiver dyadic context.
Patients newly diagnosed with colorectal cancer and their sleep-partner caregivers (N=147 dyads, M age=56.3 years, 31% female patients, 61% Hispanic) completed measures of impulsivity and benefit finding (reflexive and deliberative self-regulation, respectively). Patients and caregivers also wore actigraphy watches for 14 consecutive days, from which intradaily variation (IV: 0-2, higher=more variation), interdaily stability (IS: 0-1, higher=more stability), and sleep regularity index (SRI: 0-100%, higher=more regularity) were derived. Each person’s age, body mass index, resting mean arterial pressure, and patient’s gender and cancer stage were included as covariates.
Both patients and caregivers endorsed low levels of impulsivity and moderate to high levels of benefit finding. Compared to caregivers, patients showed significantly higher IV, lower IS, and lower SRI (p<.01). Actor-partner interdependence model indicated that for both patients and caregivers, one’s higher impulsivity was associated with one’s own lower IV (b=-.03, p=.014) and higher IS (b=.02, p=.011). One’s higher benefit finding was marginally associated with one’s higher IV (b=.03, p=.052). Additionally, one’s higher impulsivity was associated with partner’s higher IV (b=.04, p=.004), lower IS (b=-.02, p=.047), and lower SRI (b=-1.79, p=.027).
Findings revealed that higher impulsivity was related to less sleep fragmentation and variability individually, but less consolidated and stable rest-activity patterns dyadically. Further investigations of such differential findings are warranted, including examining the associations of impulsivity with self-reported sleep fragmentation and quality, as well as the potential roles of dyadic behaviors (e.g., verbal and nonverbal exchanges) in sleep health. Sleep interventions for cancer populations may need to consider not only individual stress regulation tendencies but also their roles in partners’ sleep health.
Keywords: Abnormal sleep, Couple-focusedPatients newly diagnosed with colorectal cancer and their sleep-partner caregivers (N=147 dyads, M age=56.3 years, 31% female patients, 61% Hispanic) completed measures of impulsivity and benefit finding (reflexive and deliberative self-regulation, respectively). Patients and caregivers also wore actigraphy watches for 14 consecutive days, from which intradaily variation (IV: 0-2, higher=more variation), interdaily stability (IS: 0-1, higher=more stability), and sleep regularity index (SRI: 0-100%, higher=more regularity) were derived. Each person’s age, body mass index, resting mean arterial pressure, and patient’s gender and cancer stage were included as covariates.
Both patients and caregivers endorsed low levels of impulsivity and moderate to high levels of benefit finding. Compared to caregivers, patients showed significantly higher IV, lower IS, and lower SRI (p<.01). Actor-partner interdependence model indicated that for both patients and caregivers, one’s higher impulsivity was associated with one’s own lower IV (b=-.03, p=.014) and higher IS (b=.02, p=.011). One’s higher benefit finding was marginally associated with one’s higher IV (b=.03, p=.052). Additionally, one’s higher impulsivity was associated with partner’s higher IV (b=.04, p=.004), lower IS (b=-.02, p=.047), and lower SRI (b=-1.79, p=.027).
Findings revealed that higher impulsivity was related to less sleep fragmentation and variability individually, but less consolidated and stable rest-activity patterns dyadically. Further investigations of such differential findings are warranted, including examining the associations of impulsivity with self-reported sleep fragmentation and quality, as well as the potential roles of dyadic behaviors (e.g., verbal and nonverbal exchanges) in sleep health. Sleep interventions for cancer populations may need to consider not only individual stress regulation tendencies but also their roles in partners’ sleep health.
Authors:
Presenter - Thomas C. Tsai,
University of Miami
Co-Author - Jamie Zeitzer,
PhD,
Stanford University
Co-Author - Youngmee Kim, PhD, FSBM,
PhD, FSBM,
University of Miami
F157 - Improving the inpatient environment for sleep in children undergoing stem cell transplant
Poster Number: F157Time: 11:00 AM - 11:50 AM
Topics: Sleep, Cancer
Background: Pediatric stem cell transplant (SCT) patients are often hospitalized for extended durations. We have demonstrated that children undergoing transplant at our hospital are exposed to disruptive noise in the overnight period consistently during their hospitalization. These disruptions worsen their nighttime sleep quality and reduce sleep duration, ultimately resulting in poorer health outcomes. Nursing staff identified key environmental issues that exacerbate the problem, including loud cabinets outside of patient rooms, and insufficient patient room door gasketing.
Objective: To determine if environmental modifications (soft-close cabinet hinges and quiet door latch mechanism) could decrease noise levels for pediatric SCT patients.
Methods: Objective meters continuously tracked noise levels at one-minute intervals during Baseline and Post-Environmental Modification (1-month each). We assessed the frequency that levels exceeded thresholds known to be associated with night wakings (>80 dB or sound level changes [SLCs] between measurements >17.5 dB) during the overnight period (8pm-8am). Wilcoxon ranked sum tests determined whether noise levels differed between Baseline and Post-Environmental Modification.
Results: At Baseline, the noise range was 52.6-99.1 dB, compared with 52.5-91.0 dB at Post-Environmental Modification. The mean nightly sound level decreased at Post-Environmental Modification (55.9 dB vs. 57.0 dB at Baseline; p<.001), as did the mean number of noise readings exceeding 80 dB (0.5x/night vs. 6.7x/night at Baseline; p<.001) and the mean number of SLCs (2.5x/night vs. 21.9x/night at Baseline, p<.001).
Conclusions: Pediatric SCT patients are routinely exposed to noise levels that disrupt their sleep at night. Simple hospital unit modifications have the potential to meaningfully reduce the environmental challenges that are known to affect their sleep. Hospital administrators should evaluate inpatient rooms to identify potential areas that can be remediated in order to improve patient sleep and health.
Keywords: Children's health, Physical environmentObjective: To determine if environmental modifications (soft-close cabinet hinges and quiet door latch mechanism) could decrease noise levels for pediatric SCT patients.
Methods: Objective meters continuously tracked noise levels at one-minute intervals during Baseline and Post-Environmental Modification (1-month each). We assessed the frequency that levels exceeded thresholds known to be associated with night wakings (>80 dB or sound level changes [SLCs] between measurements >17.5 dB) during the overnight period (8pm-8am). Wilcoxon ranked sum tests determined whether noise levels differed between Baseline and Post-Environmental Modification.
Results: At Baseline, the noise range was 52.6-99.1 dB, compared with 52.5-91.0 dB at Post-Environmental Modification. The mean nightly sound level decreased at Post-Environmental Modification (55.9 dB vs. 57.0 dB at Baseline; p<.001), as did the mean number of noise readings exceeding 80 dB (0.5x/night vs. 6.7x/night at Baseline; p<.001) and the mean number of SLCs (2.5x/night vs. 21.9x/night at Baseline, p<.001).
Conclusions: Pediatric SCT patients are routinely exposed to noise levels that disrupt their sleep at night. Simple hospital unit modifications have the potential to meaningfully reduce the environmental challenges that are known to affect their sleep. Hospital administrators should evaluate inpatient rooms to identify potential areas that can be remediated in order to improve patient sleep and health.
Authors:
Co-Author - Andrea Fidler, PhD, MPH,
PhD, MPH,
Children's Hospital of Philadelphia
Co-Author - Robyn Blacken,
BSN, RN, CPHON, BMTCN,
Boston Children's Hospital
Co-Author - Rose G. Mintor,
DNP, RN, NI-BC, CPN, EBP-C,
Boston Children's Hospital
Co-Author - Sarah Tarquini,
PhD,
Boston Children's Hospital
Co-Author - Leslie E. Lehmann,
MD,
Dana-Farber Cancer Institute
F158 - Socio-Ecological Influences on Early-Stage Non-Small Cell Lung Cancer Treatment Disparities
Poster Number: F158Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Cancer
Purpose: There are racial/ethnic disparities in receipt of guideline concordant cancer treatment. Thus, we aimed to explore patient-reported socio-ecological influences that may drive early-stage non small cell lung cancer (NSCLC) treatment disparities.
Methods: We conducted semi-structured in-depth interviews asking patients about treatment received and treatment experiences. A total of 28 patients were recruited from the LA SEER Registry who were: 1) newly diagnosed with early-stage NSCLC within 6-12 months at the time of ascertainment, and 2) not actively undergoing treatment. Patients were recruited from mailings and phone call follow-up. Interviews (about 60 min.) were recorded, transcribed using a text-to-speech service, and edited for accuracy. Grounded in the socio-ecological framework, participant responses were content-coded using a constant comparison method. Two co-authors independently coded the transcripts and then met to refine the codebook. The data was subsequently organized and analyzed into major themes using Dedoose.
Results: The average age of our cohort was 70 years old. Of patients interviewed, 46% Non-Hispanic White, 29% Hispanic, 18% Non-Hispanic Black, and 7% Non-Hispanic Asian. 64% of our patients were female and 34% of our patients were male. 25 interviews were conducted in English and 3 interviews were conducted in Spanish. We found three main spheres of socio-ecological influence that drive differences in patient treatment: personal, interpersonal, and organizational factors. At the individual-level of influence, treatment is often based on the alignment with patients’ personal preferences and health goals and their personal knowledge and health literacy in understanding the various treatment modalities. We found that interpersonal factors between patients and providers influence treatment decisions through confidence or trust in providers and communication. The provider specialty and patient referral pathway also impact the potential treatment modalities that are presented to patients and insurance related issues may influence treatment delays.
Conclusion: Multiple levels of influence drive treatment decisions for early-stage NSCLC treatment, particularly the personal-, interpersonal- and organizational-factors. The findings illustrate the need to conduct a quantitative study to determine whether these factors are associated with patient receipt of guideline concordant cancer treatment.
Keywords: Cancer, Decision makingMethods: We conducted semi-structured in-depth interviews asking patients about treatment received and treatment experiences. A total of 28 patients were recruited from the LA SEER Registry who were: 1) newly diagnosed with early-stage NSCLC within 6-12 months at the time of ascertainment, and 2) not actively undergoing treatment. Patients were recruited from mailings and phone call follow-up. Interviews (about 60 min.) were recorded, transcribed using a text-to-speech service, and edited for accuracy. Grounded in the socio-ecological framework, participant responses were content-coded using a constant comparison method. Two co-authors independently coded the transcripts and then met to refine the codebook. The data was subsequently organized and analyzed into major themes using Dedoose.
Results: The average age of our cohort was 70 years old. Of patients interviewed, 46% Non-Hispanic White, 29% Hispanic, 18% Non-Hispanic Black, and 7% Non-Hispanic Asian. 64% of our patients were female and 34% of our patients were male. 25 interviews were conducted in English and 3 interviews were conducted in Spanish. We found three main spheres of socio-ecological influence that drive differences in patient treatment: personal, interpersonal, and organizational factors. At the individual-level of influence, treatment is often based on the alignment with patients’ personal preferences and health goals and their personal knowledge and health literacy in understanding the various treatment modalities. We found that interpersonal factors between patients and providers influence treatment decisions through confidence or trust in providers and communication. The provider specialty and patient referral pathway also impact the potential treatment modalities that are presented to patients and insurance related issues may influence treatment delays.
Conclusion: Multiple levels of influence drive treatment decisions for early-stage NSCLC treatment, particularly the personal-, interpersonal- and organizational-factors. The findings illustrate the need to conduct a quantitative study to determine whether these factors are associated with patient receipt of guideline concordant cancer treatment.
Authors:
Co-Author - Lauren Scampavia,
M.S.,
Keck School of Medicine of USC
Co-Author - Jennifer Ferrin,
B.S.,
Keck School of Medicine of USC
Discussant - Angel Arizpe,
MPH PhDc,
Keck School of Medicine of USC
Chair - Albert Farias,
PhD,
Keck School of Medicine of USC
F159 - Barriers and Facilitators of a Healthy Diet in Antioquia, Colombia: Insights from Focus Groups Using the Theoretical Domains Framework
Poster Number: F159Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Diet, Nutrition, and Eating Disorders
Objective: To use the Theoretical Domains Framework (TDF) to map barriers and facilitators of a healthy diet in a Colombian population (Province of Antioquia). Methods: 148 Adults (18+ years old: 73.6% women) participated in 16 focus groups across 8 of the 9 subregions of Antioquia. An inductive thematic analysis was conducted, with the TDF used for higher-order categories. Results: Regarding social influences, eating is a deeply rooted family tradition, with individuals often consuming foods common in their childhood homes. Home-cooked meals are strongly linked to a healthy diet, and women are typically the primary cooks and food providers. When a family member has a medical condition, the eating habits of the entire family often change to support that individual. Social influences are substantial, as participants strive to eat healthily but may indulge when sweet treats are offered. For environmental context and resources, participants noted that fruits and vegetables are generally accessible, and in rural areas, it is often possible to grow one’s own food, with vegetables being predominant. However, despite the availability of healthy foods, financial constraints often limit access, leading some to rely on what they can grow or afford. Regarding skills, participants recognized a variety of cooking methods, including steaming, frying, and stewing; as for behavioral regulation, they emphasized the importance of moderating fried food consumption, as most typical foods are fried. They also highlighted the need to reduce sweet treat intake. For knowledge, a healthy diet is understood to include fruits and vegetables, should be balanced, and avoid frying foods. Participants believe that a healthy diet helps prevent various diseases but stressed the importance of considering individual characteristics when choosing the best foods. The timing of meals is also recognized as important, though beliefs vary. Conclusion: Based on these findings, programs promoting healthy eating in Colombia should emphasize the importance of healthy meals as a way to care for loved ones. These programs should equip individuals with skills to manage social pressure and reinforce healthy eating as a preventive measure against chronic diseases. Lastly, it is crucial that these programs provide affordable and accessible food options to ensure widespread adoption of healthier eating practices.
Keywords: Health behavior change, Low-incomeAuthors:
Co-Author - Carolina Úsuga,
MsC,
Universidad EAFIT
Co-Author - Jesús Alexander Palau,
MsC,
Universidad EAFIT
Co-Author - Isabela Cano,
Universidad EAFIT
Co-Author - Carla Maldonado,
Universidad EAFIT
Co-Author - Camila Duque,
Universidad EAFIT
Co-Author - María del Pilar Guevara,
Universidad EAFIT
Co-Author - Elizabeth Rendón,
PhD,
Universidad EAFIT
Co-Author - Kim Lavoie,
PhD,
UQAM
Co-Author - Simon Bacon,
PhD,
Concordia University
Co-Author - Mariantonia Lemos, PhD,
Universidad EAFIT
F160 - Physical Activity in Colombia: Using the Theoretical Domains Framework to Explore Challenges and Enablers
Poster Number: F160Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Physical Activity
Objective: Given the importance that physical activity has on the development and progression of most chronic disease, the objective of this study was: to use the Theoretical Domains Framework (TDF) to identify the factors that hinder and those that facilitate physical activity among the residents of Antioquia, a province in Colombia. Method: 16 focus groups were conducted in adults (over 18 years old) from Antioquia, Colombia. A total of 148 participants, of whom 73.6% were women, participated. An inductive thematic analysis was carried out, with the TDF serving as the overarching categorization method. Results: Regarding beliefs about consequences, participants acknowledged numerous benefits of physical activity. They reported that engaging in physical activity helped to maintain good health, enhance emotional and mental well-being, and contribute to stress reduction, relaxation, and enjoyment. They also emphasized the social aspect of physical activity (social influences), highlighting its role in facilitating interactions with others. For environmental context and resources, participants pointed out the availability of various free physical activity programs, specifically emphasizing aerobic dance programs and the presence of outdoor gyms accessible to the general public. They also recognized the vital role of local public and private institutions in offering these programs and making them accessible to the community. Finally, regarding knowledge, participants identified behaviors such as walking, jogging, stretching, and cycling as forms of physical activity and highlighted that it helped prevent diseases, particularly cardiovascular diseases. Conclusion: In order to promote physical activity in Colombian population, programs should build upon the public and private initiatives that are already in place and highlight the social component of the activities. Also, it is important that these programs emphasize and reinforce the benefits of physical activity on mental health and the prevention of cardiovascular diseases. Finally, programs should point out that small daily decisions can increase physical activity levels.
Keywords: Behavior Change, Low-incomeAuthors:
Co-Author - Ana Maria Peralta,
MsC,
EAFIT University
Co-Author - Jesús Alexander Palau,
MsC,
Universidad EAFIT
Co-Author - Maria del Pilar Guevara,
Universidad EAFIT
Co-Author - Camila Duque,
Universidad EAFIT
Co-Author - Carla Maldonado,
Universidad EAFIT
Co-Author - Isabela Cano,
Universidad EAFIT
Co-Author - Elizabeth Rendon,
PhD,
Universidad EAFIT
Co-Author - Kim Lavoie,
PhD,
UQAM
Co-Author - Simon Bacon,
PhD,
Concordia University
Co-Author - Mariantonia Lemos, PhD,
Universidad EAFIT
F161 - A Prescription for Diverse Healthcare Workforce – Anti-racism Recruitment Practices in the Field of Pharmacy
Poster Number: F161Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Education, Training, and Career Development
The diversity of the healthcare workforce is a social determinant of health. A diverse workforce reflecting communities served is crucial for improving patient health outcomes. Based on multiple process observations, our clinic's Midwest Pharmacy EID (Equity, Inclusion, Diversity) Council identified systemic disadvantages for racial/ethnic minority representation in the workforce and proposed specific practices for improving equity in recruitment. This project aims to identify stakeholder perspectives on the proposed recruitment practices and assess key determinants and resource needs for sustainable adoption.
Fifteen focus groups were conducted with five groups of pharmacy recruitment stakeholders (N=34) including pharmacist and technician managers, a human resources partner, and staff pharmacists. Participants reviewed the proposed practices, shared perceptions, and identified implementation barriers and facilitators. A two-step rapid analysis approach identified salient themes.
Participants showed strong interest in adopting proposed practices but identified implementation challenges. Outreach efforts are limited by weak connections with local organizations, financial and travel constraints, and bureaucracy. Job posting and screening processes face communication issues, a lack of diverse candidates, and no standardized EID criteria for candidate screening. Pre-interview preparation is inconsistent, with calls for more accessible resources and regular training. Maintaining diversity in interview panels is challenging and overburdens minoritized employees. Interview structure and content face issues balancing consistency and adaptability while EID assessments are limited by inadequate rubrics and hesitancy in asking sensitive questions. Variations in scoring rubrics raise concerns about bias, and debriefing sessions struggle with addressing bias and difficulties in avoiding groupthink.
Strategies to improve recruitment equity include building partnerships with colleges and offering internships to develop a talent pipeline. Networking through professional association events and sponsorships and active social media presence can expand visibility and candidate reach. Streamlining processes should focus on organizational coordination and standardizing evaluation criteria. Finally, diverse interview panels with EID-trained interviewers and structured, standardized scoring can reduce bias, while candidate feedback ensures a continually improving process.
Keywords: Policy, EnvironmentalFifteen focus groups were conducted with five groups of pharmacy recruitment stakeholders (N=34) including pharmacist and technician managers, a human resources partner, and staff pharmacists. Participants reviewed the proposed practices, shared perceptions, and identified implementation barriers and facilitators. A two-step rapid analysis approach identified salient themes.
Participants showed strong interest in adopting proposed practices but identified implementation challenges. Outreach efforts are limited by weak connections with local organizations, financial and travel constraints, and bureaucracy. Job posting and screening processes face communication issues, a lack of diverse candidates, and no standardized EID criteria for candidate screening. Pre-interview preparation is inconsistent, with calls for more accessible resources and regular training. Maintaining diversity in interview panels is challenging and overburdens minoritized employees. Interview structure and content face issues balancing consistency and adaptability while EID assessments are limited by inadequate rubrics and hesitancy in asking sensitive questions. Variations in scoring rubrics raise concerns about bias, and debriefing sessions struggle with addressing bias and difficulties in avoiding groupthink.
Strategies to improve recruitment equity include building partnerships with colleges and offering internships to develop a talent pipeline. Networking through professional association events and sponsorships and active social media presence can expand visibility and candidate reach. Streamlining processes should focus on organizational coordination and standardizing evaluation criteria. Finally, diverse interview panels with EID-trained interviewers and structured, standardized scoring can reduce bias, while candidate feedback ensures a continually improving process.
Authors:
Co-Presenter - Xuan Zhu,
PhD,
Mayo Clinic
Co-Presenter - Assata S. Kokayi,
PhD,
Kern Center for the Science of Health Care Delivery, Mayo Clinic
Co-Author - Eddy E. Ogbuji,
PhD,
Mayo Clinic
Co-Author - Caitlin S. Brown,
Pharm.D., R.PH, BCCCP,
Mayo Clinic
Co-Author - Lydia L. Patel,
Pharm.D., R.PH, BCPS,
Mayo Clinic
Co-Author - Gladys B. Asiedu, PhD,
PhD,
Mayo Clinic
F162 - Exploring Trends in Dietary Factors and Gut Microbiome among Breast Cancer Survivors in the Midwestern United States
Poster Number: F162Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Cancer
Background: Geographic region impacts cancer incidence and gut microbiome. While five servings of fruit and vegetables and 30g of fiber per day are recommended by the American Institute of Cancer Research, most diets fail to meet this cancer prevention and microbiome diversity promoting goal. A high incidence of breast cancer in the Midwestern U.S. necessitates exploring dietary factors and gut microbiome in this region.
Objective: To explore trends and associations between dietary factors and gut microbiota in Midwestern post-treatment, breast cancer survivors randomized to a digital coaching intervention or waitlist-control.
Methods: Analysis to date includes 38 of 45 Midwestern females receiving six months of digital health coaching (goal setting, tracking, and support in physical health, nutrition, and exercise via email, phone, and text) or waitlist-control, completing the Diet History Questionnaire III, and providing stool samples at baseline and six months. Fiber and fiber-rich foods, Healthy Eating Index-2015 (HEI), glycemic load, and gut microbiome at order level were analyzed using 16S sequencing. Mann-Whitney and Wilcoxon tests were used to compare groups at baseline and six-months.
Results: Subjects were mostly White (n=37, 97.4%). Mean age was 53.2 years (SD = 13.2). More participants were post-menopausal (n=24, 63.2%) and on endocrine therapy (n=30, 78.9%). Over six months, no significant changes were observed in diet or glycemic load in the overall group, meeting 61% of recommended fiber intake and 53% of fruit/vegetable intake. The average HEI remained stable for the entire group, (baseline: 64.8 [10.1]; 6-month: 64.2 [9.6]). Most microbiota at the order level remained stable; however, Bacillales significantly decreased in the intervention and increased in the control group (p = .014). Premenopausal women had significantly higher levels of Bifidobacteriales (p = .049), while postmenopausal had higher levels of Enterobacteriales (p = .045). HER2 positive had higher levels of Betaproteobacteriales (p = .044); progesterone positive had lower levels of Verrucomicrobiales (p = .008).
Conclusion: No changes were observed in dietary factors over six months, which may limit the ability to detect dietary effects on microbiota. Further investigation is needed to understand the intervention’s impact on diet, microbiome, and potential contributing factors of menopausal and breast cancer receptor status within the context of Midwestern survivors.
Keywords: Behavior Change, Cancer survivorshipObjective: To explore trends and associations between dietary factors and gut microbiota in Midwestern post-treatment, breast cancer survivors randomized to a digital coaching intervention or waitlist-control.
Methods: Analysis to date includes 38 of 45 Midwestern females receiving six months of digital health coaching (goal setting, tracking, and support in physical health, nutrition, and exercise via email, phone, and text) or waitlist-control, completing the Diet History Questionnaire III, and providing stool samples at baseline and six months. Fiber and fiber-rich foods, Healthy Eating Index-2015 (HEI), glycemic load, and gut microbiome at order level were analyzed using 16S sequencing. Mann-Whitney and Wilcoxon tests were used to compare groups at baseline and six-months.
Results: Subjects were mostly White (n=37, 97.4%). Mean age was 53.2 years (SD = 13.2). More participants were post-menopausal (n=24, 63.2%) and on endocrine therapy (n=30, 78.9%). Over six months, no significant changes were observed in diet or glycemic load in the overall group, meeting 61% of recommended fiber intake and 53% of fruit/vegetable intake. The average HEI remained stable for the entire group, (baseline: 64.8 [10.1]; 6-month: 64.2 [9.6]). Most microbiota at the order level remained stable; however, Bacillales significantly decreased in the intervention and increased in the control group (p = .014). Premenopausal women had significantly higher levels of Bifidobacteriales (p = .049), while postmenopausal had higher levels of Enterobacteriales (p = .045). HER2 positive had higher levels of Betaproteobacteriales (p = .044); progesterone positive had lower levels of Verrucomicrobiales (p = .008).
Conclusion: No changes were observed in dietary factors over six months, which may limit the ability to detect dietary effects on microbiota. Further investigation is needed to understand the intervention’s impact on diet, microbiome, and potential contributing factors of menopausal and breast cancer receptor status within the context of Midwestern survivors.
Authors:
Presenter - Robin Lally,
PhD, RN, MS, BA, AOCN, FAAN,
University of Nebraska Medical Center
Co-Author - Mariah Jackson,
PhD, MMN, RDN, LMNT,
University of Nebraska Medical Center
Co-Author - Rebecca Johnson Beller, PhD, BSN, RN,
PhD, BSN, RN,
University of Nebraska Medical Center
Co-Author - Rachael Schmidt,
APRN, DNP, FNP-C, AOCNP,
University of Nebraska Medical Center
Co-Author - Gisele Tlusty, PhD, MSN, RN,
PhD, MSN, RN,
MD Anderson Cancer Center
Co-Author - Kevin Kupzyk,
PhD,
University of Nebraska Medical Center
Co-Author - Leorey Saligan,
PhD, RN, CRNP, FAAN,
National Institutes of Health
Co-Author - Kelly Brassil,
PhD, RN,
Pack Health, A Quest Diagnostics Company
Co-Author - Marilyn Hammer,
PhD, DC, RN, FAAN,
Dana Farber Cancer Institute
F163 - Understanding the Smoking Cessation Needs of Cancer Survivors with Socioeconomic Disadvantage
Poster Number: F163Time: 11:00 AM - 11:50 AM
Topics: Cancer, Tobacco Control and Nicotine-Related Behavior
Quitting smoking is one of the most impactful behavior changes that can be made to improve health and quality of life at any age. Unfortunately, disparities in smoking cessation outcomes persist, particularly for groups with socioeconomic disadvantage who continue to experience a high burden from smoking and its negative health effects while also facing unique barriers to quitting. Cancer survivors with low income have an increased risk of financial toxicity, and are faced with the added burden of medical debt for cancer-related care. This study aimed to identify the unique smoking cessation needs of low-income cancer survivors, in order to determine potential avenues of addressing barriers.
We conducted in-depth qualitative interviews with cancer survivors with food insecurity who continue to smoke after cancer diagnosis. A national sample of participants were recruited through online and physical advertisements. A semi-structured interview guide was used to understand key areas, such as past and current smoking behaviors and interest in cessation, experiences with cancer and subsequent treatments, and financial situation. The interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s reflexive thematic analysis.
In this sample of cancer survivors (N=40, 50% female, M age 41.9 (SD=10.8), 60% Black/African American, 32% with lung cancer), many participants were interested in quitting smoking, yet several challenges and barriers were identified. This included stressful life events, lack of a support system, and lack of reliable access to healthcare, particularly for those in rural areas. Many participants had attempted to quit on their own without the use of evidence-based cessation methods, largely due to lack of knowledge or interest, lack of money, or fear of drug interactions with their cancer treatments. Additionally, healthcare teams largely prioritized cancer treatment above smoking cessation, resulting in participants receiving little to no advice or resources for quitting.
Findings from this study highlight the importance of tailored smoking cessation interventions for cancer survivors within the healthcare system that goes beyond advising to quit smoking. Therefore, more targeted research and appropriate programming are needed to prioritize smoking cessation among low-income cancer survivors and improve quality of life for all patients.
Keywords: Cancer survivorship, SmokingWe conducted in-depth qualitative interviews with cancer survivors with food insecurity who continue to smoke after cancer diagnosis. A national sample of participants were recruited through online and physical advertisements. A semi-structured interview guide was used to understand key areas, such as past and current smoking behaviors and interest in cessation, experiences with cancer and subsequent treatments, and financial situation. The interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s reflexive thematic analysis.
In this sample of cancer survivors (N=40, 50% female, M age 41.9 (SD=10.8), 60% Black/African American, 32% with lung cancer), many participants were interested in quitting smoking, yet several challenges and barriers were identified. This included stressful life events, lack of a support system, and lack of reliable access to healthcare, particularly for those in rural areas. Many participants had attempted to quit on their own without the use of evidence-based cessation methods, largely due to lack of knowledge or interest, lack of money, or fear of drug interactions with their cancer treatments. Additionally, healthcare teams largely prioritized cancer treatment above smoking cessation, resulting in participants receiving little to no advice or resources for quitting.
Findings from this study highlight the importance of tailored smoking cessation interventions for cancer survivors within the healthcare system that goes beyond advising to quit smoking. Therefore, more targeted research and appropriate programming are needed to prioritize smoking cessation among low-income cancer survivors and improve quality of life for all patients.
Authors:
Presenter - Madeline Castele,
Case Western Reserve University
Co-Author - Kareena Shah,
Case Western Reserve University
Co-Author - Avianna M. Thompson,
Case Western Reserve University
Co-Author - Jin Kim-Mozeleski,
Case Western Reserve University
F164 - Home Environment Factors are Related to Parent and Child Diet, Activity and Body Size
Poster Number: F164Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Obesity
The disproportionate prevalence of obesity among Hispanic/Latino populations in the U.S. is a major public health concern. Socioecological models point to the importance of environmental influences on obesity-related health behaviors and outcomes. Both social and physical elements of the home environment have been shown to impact energy balance behaviors and weight within families. The current analyses explored whether availability of physical activity equipment, fruits, and vegetables in the home as well as parental role modeling for activity and eating behaviors were associated with activity levels, dietary intake and weight among parents and children.
Baseline data from a larger intervention study with 415 Hispanic/Latino families were derived from self-report surveys and measured body size. Pearson correlations indicated that physical activity home environment was positively related to moderate-to-vigorous physical activity (MVPA; p=.034) among adults and negatively related to percent body fat among children (p=.008). Fruit availability in the home was positively correlated with adult fruit (p=.010), vegetable (p=.003) and sugary beverage (p=.024) intake and child sugary beverage intake (p=.010). Parental role modeling was significantly associated with adult MVPA (p<.001), walking (p=.003), frequency of fruit (p<.001) and vegetable (p<.001) intake, body mass index (BMI; p=.047; inversely) and waist circumference (p=.027; inversely) as well as children’s frequency of eating breakfast (p=.014), fruits (p<.001), vegetables (p<.001), and BMI z-score (p=.022; inversely).
Given multiple associations with parental role modeling, social aspects of the environment may be needed to extend the reach of the physical environment. Further exploration of frequency and intensity of role modeling are warranted. The finding that increased fruit availability was related to higher sugary beverage consumption may indicate a tendency toward preferences for sweets. Perhaps sugary beverages are used as rewards for eating fruit, which, if limited, may allow for balanced intake and not be deleterious to health. Findings indicate that both physical and social home environment factors may be potential targets for obesity prevention and intervention among Latino families.
Keywords: Obesity, EnvironmentBaseline data from a larger intervention study with 415 Hispanic/Latino families were derived from self-report surveys and measured body size. Pearson correlations indicated that physical activity home environment was positively related to moderate-to-vigorous physical activity (MVPA; p=.034) among adults and negatively related to percent body fat among children (p=.008). Fruit availability in the home was positively correlated with adult fruit (p=.010), vegetable (p=.003) and sugary beverage (p=.024) intake and child sugary beverage intake (p=.010). Parental role modeling was significantly associated with adult MVPA (p<.001), walking (p=.003), frequency of fruit (p<.001) and vegetable (p<.001) intake, body mass index (BMI; p=.047; inversely) and waist circumference (p=.027; inversely) as well as children’s frequency of eating breakfast (p=.014), fruits (p<.001), vegetables (p<.001), and BMI z-score (p=.022; inversely).
Given multiple associations with parental role modeling, social aspects of the environment may be needed to extend the reach of the physical environment. Further exploration of frequency and intensity of role modeling are warranted. The finding that increased fruit availability was related to higher sugary beverage consumption may indicate a tendency toward preferences for sweets. Perhaps sugary beverages are used as rewards for eating fruit, which, if limited, may allow for balanced intake and not be deleterious to health. Findings indicate that both physical and social home environment factors may be potential targets for obesity prevention and intervention among Latino families.
Authors:
Author - Selena Nguyen-Rodriguez,
California State University, Long Beach
Co-Author - Gail Frank,
California State University, Long Beach
Co-Author - Natalia Gatdula, MPH,
California State University Long Beach
Co-Author - Melawhy L. Garcia, MPH, PhD,
California State University Long Beach
F165 - Health Behavior Across the Political Spectrum: A Meta-Analytic Approach
Poster Number: F165Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Substance Misuse
Individuals’ political orientation, represented on a continuum ranging from liberal to conservative, is associated with various health outcomes. This association may be partially attributable to variability in health behavior participation and research indicates conceptually consistent trends in health behavior participation for conservatives and liberals, although substantive variability has been observed in effect sizes. The current research aimed to synthesize research studies reporting associations between political orientation and health behavior using meta-analysis. Studies reporting political orientation-health behavior associations were identified in a systematic database search. Multi-level meta-analysis revealed small, non-zero negative averaged correlations between conservatism and substance use (r = -.186, 95% CI [-.322, -.050]), and between conservatism and COVID-19 prevention behaviors (r = -.171, 95% CI [-.237, -.105]), and a small, non-zero positive relationship between conservatism and dietary behaviors (i.e., meat consumption; r = .153, 95% CI [.101, .205]). However, the correlation for non-COVID-19 vaccination behaviors was no different from zero (r = -0.046, 95% CI [-.178, .086]). Further, we investigated several moderators of the political orientation-health behavior relationship including political orientation measure type, population type, publication status and country of origin. Moderator analyses revealed larger effect sizes in studies employing a right-wing authoritarianism measure and conservative measures relative to those adopting political self-placement measures for substance use and dietary behaviors. Analyses indicated larger political orientation-health behavior effect sizes in general population samples relative to student samples for substance use and COVID-19 prevention. Findings are consistent with theory and prior research indicating that endorsement of conservative beliefs is associated with less substance use, lower participation in COVID-19 prevention behaviors and more meat consumption. The current study is the first to synthesize the relationship between political orientation and these four groups of health behaviors. These findings have value because they contribute to emerging evidence indicating political orientation as a salient correlate of health behavior.
Keywords: Health behaviors, Eating behaviorsAuthors:
Co-Author - Zoe Griffith, MA,
MA,
University of California, Merced
Co-Author - Martin S. Hagger, PhD, FSBM,
PhD, FSBM,
University of California, Merced
F166 - Increasing water availability and accessibility in family childcare homes to improve young children’s water intake: Results from the “Drink Well/Bebe Bien” Study
Poster Number: F166Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Social and Environmental Context and Health
Purpose: To report the results of the Drink Well study, which aimed to increase water availability, accessibility and children’s water consumption in family childcare homes (FCCH), which care for over two million U.S. children.
Methods: 67 FCCH providers (FCCPs) from under-resourced communities in RI, MA and CT (63% Latina) completed baseline surveys that determined practices and barriers/strategies to improving water availability/accessibility. Then an intervention package was delivered to FCCH, including water filters, self-serve water stations, pitchers, child water bottles and educational materials for FCCPs, children and parents. Post-surveys were conducted 2-3 months later. Pre-post changes in FCCPs’ attitudes, barriers and practices re. water access/availability, and use/acceptability of intervention strategies were assessed. FCCPs also completed post-intervention qualitative interviews.
Results: 61 FCCP completed the post survey (91%). The intervention package was well utilized and liked. The percentage of FCCHs with self-serve water easily available indoors increased from 41.5% to 71.7%, and outdoors from 44.6% to 75%. Always providing water at snack-time increased from 62.0% to 76.7%; always providing water at meals increased from 83.3% to 88.3%. Prompting children to drink water at least 5 times daily increased from 29.2% to 58.3%. At posttest, 60% of FCCPs reported that children's access to water increased a lot; 61.7% reported that child water intake increased a lot; and 43% reported their own water consumption increased a lot because of the intervention. Only 25% of FCCPs reported that having parental support for child water intake increased a lot. When asked how much the intervention helped them to serve more water to children, and get children to drink more water, 88.3% and 85% of FCCPs, respectively reported “very much”. Qualitative survey and interview data supported the quantitative results. Final statistical analyses/testing and qualitative data analysis will be completed before March 2024.
Conclusions: Drink Well/Bebe Bien was feasible and acceptable to FCCPs and shows promise in increasing water accessibility and children’s intake in FCCHs. These results indicate the importance of training and support to promote drinking water for FCCPs and the need to involve parents in order to also influence children’s intake in the home setting. A larger scale RCT that will measure children’s actual pre-post water consumption is warranted.
Keywords: Children's health, NutritionMethods: 67 FCCH providers (FCCPs) from under-resourced communities in RI, MA and CT (63% Latina) completed baseline surveys that determined practices and barriers/strategies to improving water availability/accessibility. Then an intervention package was delivered to FCCH, including water filters, self-serve water stations, pitchers, child water bottles and educational materials for FCCPs, children and parents. Post-surveys were conducted 2-3 months later. Pre-post changes in FCCPs’ attitudes, barriers and practices re. water access/availability, and use/acceptability of intervention strategies were assessed. FCCPs also completed post-intervention qualitative interviews.
Results: 61 FCCP completed the post survey (91%). The intervention package was well utilized and liked. The percentage of FCCHs with self-serve water easily available indoors increased from 41.5% to 71.7%, and outdoors from 44.6% to 75%. Always providing water at snack-time increased from 62.0% to 76.7%; always providing water at meals increased from 83.3% to 88.3%. Prompting children to drink water at least 5 times daily increased from 29.2% to 58.3%. At posttest, 60% of FCCPs reported that children's access to water increased a lot; 61.7% reported that child water intake increased a lot; and 43% reported their own water consumption increased a lot because of the intervention. Only 25% of FCCPs reported that having parental support for child water intake increased a lot. When asked how much the intervention helped them to serve more water to children, and get children to drink more water, 88.3% and 85% of FCCPs, respectively reported “very much”. Qualitative survey and interview data supported the quantitative results. Final statistical analyses/testing and qualitative data analysis will be completed before March 2024.
Conclusions: Drink Well/Bebe Bien was feasible and acceptable to FCCPs and shows promise in increasing water accessibility and children’s intake in FCCHs. These results indicate the importance of training and support to promote drinking water for FCCPs and the need to involve parents in order to also influence children’s intake in the home setting. A larger scale RCT that will measure children’s actual pre-post water consumption is warranted.
Authors:
Presenter - Kim M. Gans,
PhD, MPH,
University of Connecticut and Brown University
Co-Author - Vanessa Esquivel,
University of Connecticut
Co-Author - Sarah Warykas,
University of Connecticut
Co-Author - Alison Tovar, PhD, MPH,
PhD, MPH,
Brown University
Co-Author - Patricia Risica,
PhD, RD,
Brown University
F167 - Youth GPS: Lessons learned from the Development of a Substance Use Screening and Education Intervention at a Youth Sexual Health Clinic
Poster Number: F167Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Multiple Health Behavior Change
Adolescents and young adults (AYA) are at higher risk for HIV/STI transmission when compared to the general population. This is exacerbated by alcohol use and other substance use. Youth GPS is an ongoing intervention seeking to reduce risky substance use and sexual behavior among AYA and has been optimized for use in an urban HIV/STI testing youth clinic. The intervention consists of an electronic screening, brief intervention, and referral to treatment. Participants are screened for current substance use and risky sexual behaviors using a screening tool from the Substance Abuse and Mental Health Administration (SAMHSA). The brief intervention consists of a motivational interviewing session with a peer navigator. During these sessions, the navigator and participant discuss current substance use, general health, sexual health impacts, and patient-led goal setting for behavioral changes related to substance use. If patients request a referral to treatment, the peer navigator facilitates connection with a community resource. Additional screenings are completed at 30 and 90 days to identify any behavioral changes. The intervention is currently focused on sexual, racial, and/or ethnic minority AYA aged 18-24 years old, as these groups face the highest risk for HIV/STI transmission among youth. Analysis of intervention data from the first three years of use showed a reduction in alcohol use, vaping, and marijuana use, as well as a reduction in sexual partners and unprotected sex. Initially only open to men of color who have sex with men, the intervention underwent several revisions to allow for fewer barriers to participation for clinic patients with risky substance use. The study team continues to improve the intervention based on informal patient feedback, review with other researchers, patient acceptability and feasibility data, input from the clinic’s youth advisory board, and focus groups. Based on this feedback, the study team has worked to make a more streamlined, engaging intervention. Youth have consistently given positive feedback related to the non-judgmental peer-based discussions and have requested more discussion with peer navigators at 30 and 90 days. Next steps include incorporating more qualitative data collection as a means of creating a fuller understanding of behavior changes post-intervention, and implementing the new, streamlined version of the intervention.
Keywords: Adolescents, Substance abuseAuthors:
Co-Author - Ana Gutierrez,
MSPH,
University of South Florida
Co-Author - Celia Miller,
University of South Florida
Co-Author - Lisa Sanders,
MD,
University of South Florida
Co-Author - Sayre Wilson,
PhD,
Northeastern University
Co-Author - Robert Leeman,
PhD,
Northeastern University
Co-Author - Carina Rodriguez,
MD,
University of South Florida
Co-Author - Andy Catalan Lim,
MPH,
San Diego State University
F168 - Testing the Biopsychosocial Minority Stress Framework among Sexual Minority Men with HIV who Use Methamphetamine in San Francisco
Poster Number: F168Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, HIV/AIDS
Background: Sexual minority men (SMM) in the US are disparately impacted by intertwining epidemics of HIV and methamphetamine (METH) use relative to heterosexual men. The Biopsychosocial Minority Stress Framework posits that minority stress (i.e., stigma-related stress) causes such disparities by impacting SMM’s psychological health, health behavior, and biological health. This study examined associations between minority stress, METH use, antiretroviral therapy (ART) adherence, and HIV viral load among SMM with HIV receiving contingency management (CM) for METH use.
Methods: SMM with HIV who use METH in San Francisco, CA (N = 110; 57.3% racial/ethnic minority) were randomized to receive a positive-affect intervention adjunct to 3 months of CM or CM alone. An autoregressive cross-lagged structural equation model estimated associations between minority stress, METH use, ART adherence, and HIV viral load, controlling for randomization status, over two 3-month lags. Minority stress and METH use frequency at baseline were continuous; dichotomous variables were METH use during CM (any vs no use), baseline and 3-month ART adherence (< 90% vs ≥ 90%), baseline and 6-month HIV viral load (< 200 vs ≥ 200 copies/ml), and randomization status. Multigroup analysis examined moderation by racial/ethnic minority status.
Results: Differences were observed for non-Hispanic White versus racial/ethnic minority participants in the probability of METH use during CM predicted by minority stress (0.027 vs –0.028, p = .001), suboptimal ART adherence (0.349 vs –0.322, p < .001), and METH use frequency (–0.069 vs 0.074, p < .001) at baseline. Randomization status independently predicted lower probability of METH use during CM (–0.223, p = .014) and unsuppressed HIV viral load at 6 months (–0.274, p = .003) across groups; no other variables independently predicted HIV viral load at 6 months.
Conclusions: In this sample of SMM with HIV receiving CM for METH use, associations between baseline variables and METH use during CM differed by race/ethnicity. Among non-Hispanic White participants, greater minority stress and suboptimal ART adherence at baseline predicted higher probability of METH use during CM while more frequent METH use at baseline predicted lower probability of METH use during CM. Among racial/ethnic minority participants, effects of comparable size but opposite direction were observed for each association. Racial/ethnic differences in coping may explain these findings.
Keywords: Sexual orientation, Social stressMethods: SMM with HIV who use METH in San Francisco, CA (N = 110; 57.3% racial/ethnic minority) were randomized to receive a positive-affect intervention adjunct to 3 months of CM or CM alone. An autoregressive cross-lagged structural equation model estimated associations between minority stress, METH use, ART adherence, and HIV viral load, controlling for randomization status, over two 3-month lags. Minority stress and METH use frequency at baseline were continuous; dichotomous variables were METH use during CM (any vs no use), baseline and 3-month ART adherence (< 90% vs ≥ 90%), baseline and 6-month HIV viral load (< 200 vs ≥ 200 copies/ml), and randomization status. Multigroup analysis examined moderation by racial/ethnic minority status.
Results: Differences were observed for non-Hispanic White versus racial/ethnic minority participants in the probability of METH use during CM predicted by minority stress (0.027 vs –0.028, p = .001), suboptimal ART adherence (0.349 vs –0.322, p < .001), and METH use frequency (–0.069 vs 0.074, p < .001) at baseline. Randomization status independently predicted lower probability of METH use during CM (–0.223, p = .014) and unsuppressed HIV viral load at 6 months (–0.274, p = .003) across groups; no other variables independently predicted HIV viral load at 6 months.
Conclusions: In this sample of SMM with HIV receiving CM for METH use, associations between baseline variables and METH use during CM differed by race/ethnicity. Among non-Hispanic White participants, greater minority stress and suboptimal ART adherence at baseline predicted higher probability of METH use during CM while more frequent METH use at baseline predicted lower probability of METH use during CM. Among racial/ethnic minority participants, effects of comparable size but opposite direction were observed for each association. Racial/ethnic differences in coping may explain these findings.
Authors:
Author - Michael Miller-Perusse,
MS,
SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology
Co-Author - Adam W. Carrico,
PhD,
Robert Stempel College of Public Health & Social Work, Florida International University
Co-Author - Jonathan Helm,
PhD,
San Diego State University Department of Psychology
Co-Author - Annesa Flentje,
PhD,
University of California, San Francisco Department of Community Health Systems
Co-Author - Laramie R. Smith,
PhD,
University of California, San Diego School of Medicine
Co-Author - Keith J. Horvath,
PhD,
San Diego State University Department of Psychology
F169 - Bridging Gaps in Medication-Assisted Treatment Access and Health Literacy in Correctional Facilities: A Case Study from the St. Louis County Jail
Poster Number: F169Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Social and Environmental Context and Health
Medication-Assisted Treatment (MAT) has become a critical tool in managing opioid dependency and supporting recovery. However, despite its effectiveness, access to MAT in correctional settings remains challenging due to logistical and systemic barriers. This project details the implementation of a MAT program at the St. Louis County Jail, focusing on innovative solutions to expand healthcare access, streamline Medicaid enrollment, and promote health literacy among incarcerated individuals.
To address the gap in healthcare accessibility, a volunteer-based system was established, recruiting students from various St. Louis universities, including undergraduate, law, and medical students. This collaborative approach facilitated Medicaid enrollment for over 500 inmates, providing them with essential healthcare coverage and access to MAT services during and after incarceration. Leveraging a digitized and simplified enrollment process, this program significantly reduced administrative hurdles, ensuring that inmates could seamlessly access critical treatment resources upon release. The success of this enrollment model demonstrates how a data-driven, volunteer-supported approach can bridge the gap in healthcare access within correctional facilities, offering a template for similar initiatives.
In addition to Medicaid enrollment, the project addressed a key health literacy need within the jail environment: reliable information on drug safety. Incarcerated individuals face heightened risks associated with counterfeit drugs and unregulated substances, making drug safety education vital. To mitigate this risk, health literacy materials were developed and disseminated through tablets provided to inmates across all jail levels, reaching approximately 1,200 individuals. These materials warned of the dangers of counterfeit drugs and provided inmates with practical knowledge to identify and avoid hazardous substances, both within the facility and upon reentry into the community.
This case study highlights the effectiveness of combining MAT access with health literacy in a correctional setting, demonstrating that public health interventions can have a profound impact on incarcerated populations. The successes and insights gained from this project offer a replicable model for correctional facilities nationwide, underscoring the role of accessible treatment and education in advancing public health within marginalized populations.
Keywords: Substance abuse, Evidence basedTo address the gap in healthcare accessibility, a volunteer-based system was established, recruiting students from various St. Louis universities, including undergraduate, law, and medical students. This collaborative approach facilitated Medicaid enrollment for over 500 inmates, providing them with essential healthcare coverage and access to MAT services during and after incarceration. Leveraging a digitized and simplified enrollment process, this program significantly reduced administrative hurdles, ensuring that inmates could seamlessly access critical treatment resources upon release. The success of this enrollment model demonstrates how a data-driven, volunteer-supported approach can bridge the gap in healthcare access within correctional facilities, offering a template for similar initiatives.
In addition to Medicaid enrollment, the project addressed a key health literacy need within the jail environment: reliable information on drug safety. Incarcerated individuals face heightened risks associated with counterfeit drugs and unregulated substances, making drug safety education vital. To mitigate this risk, health literacy materials were developed and disseminated through tablets provided to inmates across all jail levels, reaching approximately 1,200 individuals. These materials warned of the dangers of counterfeit drugs and provided inmates with practical knowledge to identify and avoid hazardous substances, both within the facility and upon reentry into the community.
This case study highlights the effectiveness of combining MAT access with health literacy in a correctional setting, demonstrating that public health interventions can have a profound impact on incarcerated populations. The successes and insights gained from this project offer a replicable model for correctional facilities nationwide, underscoring the role of accessible treatment and education in advancing public health within marginalized populations.
Authors:
Co-Author - Guatham Sudhakar,
St Louis County Department of Public Health
Co-Presenter - Paula Oldeg,
MD,
St Louis County Department of Public Health
Co-Presenter - Ernest McDonnell,
MA,
St Louis County Department of Public Health
F170 - Distinct Response Trajectories in Multisystemic Therapy: A Latent Class Growth Analysis
Poster Number: F170Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Child and Family Health
Multisystemic Therapy (MST) is a family—and community-based intervention that treats severe behavioral issues. Although MST is a well-established treatment with proven efficacy, current research examining its effects tend to focus on average treatment effects or single-group trajectories of change, which limits understanding of individual differences in treatment outcomes. Latent Class Growth Analysis (LCGA) advances this research by identifying distinct response patterns. This study sought to identify and validate distinct classes of MST response trajectories.
The study involved secondary data analyses of 185 adolescents (Mage =15.35, SD=1.28;65.4% Male) recruited from two MST provider centers in the Denver metropolitan area for a transportability study. Parent-reported externalizing behavior was collected across four time points. LCGA identified distinct response patterns, using maximum likelihood estimation for missing data. Treatment response patterns were validated using concurrent adolescent-reported substance use.
A four-class solution showed significant improvement over three classes (VLMR=19.92, p=.006; BLRT=21.19, p<.001) with clear separation (entropy=0.851). Classes included: (1) “High-Increasing”(3.5%) showing highest initial levels and significant increase (intercept=83.66, slope=1.54, p=.027);(2)“Low-Declining” (27.6%) with lowest initial levels and steepest decline (intercept=50.08, slope=-3.29, p<.001);(3) “Moderate-Declining”(45.9%) showing moderate initial levels and consistent decline (intercept=63.97, slope=-2.54, p<.001); and (4) “High-Declining” (23.2%) with elevated initial levels and moderate decline (intercept=75.42, slope=-1.97, p<.001). Kruskal-Wallis tests validated class differences in substance use at all time points (Time 1: H(3)=15.404, p=.002; Time 2:H(3)=11.890, p=.008; Time 3:H(3)=11.623, p=.009; Time 4:H(3)=15.924, p=.001), with moderate effect sizes. Post-hoc analyses showed Class 1 had the highest drug use, Class 4 had moderate-to-high levels, and Classes 2 and 3 had lower, stable patterns.
This study advances MST treatment outcome research by identifying four distinct response trajectories, which showed concurrent validity with teen reports of illegal substance use. While most youth improved, the High-Increasing class suggests standard MST may not serve all youth adequately. These findings provide a foundation for developing targeted intervention strategies and early identification of youth at risk for poor response.
Keywords: Substance abuse, AdolescentsThe study involved secondary data analyses of 185 adolescents (Mage =15.35, SD=1.28;65.4% Male) recruited from two MST provider centers in the Denver metropolitan area for a transportability study. Parent-reported externalizing behavior was collected across four time points. LCGA identified distinct response patterns, using maximum likelihood estimation for missing data. Treatment response patterns were validated using concurrent adolescent-reported substance use.
A four-class solution showed significant improvement over three classes (VLMR=19.92, p=.006; BLRT=21.19, p<.001) with clear separation (entropy=0.851). Classes included: (1) “High-Increasing”(3.5%) showing highest initial levels and significant increase (intercept=83.66, slope=1.54, p=.027);(2)“Low-Declining” (27.6%) with lowest initial levels and steepest decline (intercept=50.08, slope=-3.29, p<.001);(3) “Moderate-Declining”(45.9%) showing moderate initial levels and consistent decline (intercept=63.97, slope=-2.54, p<.001); and (4) “High-Declining” (23.2%) with elevated initial levels and moderate decline (intercept=75.42, slope=-1.97, p<.001). Kruskal-Wallis tests validated class differences in substance use at all time points (Time 1: H(3)=15.404, p=.002; Time 2:H(3)=11.890, p=.008; Time 3:H(3)=11.623, p=.009; Time 4:H(3)=15.924, p=.001), with moderate effect sizes. Post-hoc analyses showed Class 1 had the highest drug use, Class 4 had moderate-to-high levels, and Classes 2 and 3 had lower, stable patterns.
This study advances MST treatment outcome research by identifying four distinct response trajectories, which showed concurrent validity with teen reports of illegal substance use. While most youth improved, the High-Increasing class suggests standard MST may not serve all youth adequately. These findings provide a foundation for developing targeted intervention strategies and early identification of youth at risk for poor response.
Authors:
Author - Precious Mathis,
Baylor University
Co-Author - Fodie Koita,
Baylor University
Co-Author - Soleil St. Laurent,
Baylor University
Co-Author - Shawn Latendresse,
Ph.D.,
Baylor University
Co-Author - Mary Lauren Benton,
Ph.D.,
Baylor University
Co-Author - Phillippe Cunningham,
Ph.D.,
Department of Psychiatry and Behavioral Sciences, Division of Global and Community Health, Family Services Research Center, Medical University of South Carolina,
Co-Author - Stacy Ryan-Pettes,
Ph.D.,
Baylor University
F172 - Negative Affective Context and Smoking Cue Reactivity Among Primary E-Cigarette Users: Main Effects but no Interaction for Provocation of Craving
Poster Number: F172Time: 11:00 AM - 11:50 AM
Topics: Tobacco Control and Nicotine-Related Behavior, Stress
Identifying cues capable of inducing craving to vape (nicotine) among e-cigarette users is important in informing treatments for nicotine cessation. Both proximal (e.g., holding an e-cigarette or lighter), distal (e.g., images of smoking environments), and the combination of proximal and distal nicotine-related cues have been found to effectively elicit urges for nicotine. Furthermore, as compared to static images or imaginal strategies, virtual reality (VR) environments have the ability to integrate a wide variety of proximal and distal cues through detailed and enhanced exposure scenes. Yet, little is known about how negative affective context influences cue-induced reactivity. In this study, we examined both the additive and potential interactive effects of vaping-cue provocation in the context of negative or neutral affect. We conducted a fully-within subject examination of the factorial combination of these internal (negative affect induction or not) and external (proximal or distal e-cigarette cues) cues. A total of 50 daily e-cigarette users participated in the study. We hypothesized that both proximal and distal cues — provided respectively by in vivo exposure to users’ preferred e-cigarette device and an immersive 360-degree video of a social environment involving nicotine use presented through a VR headset— would result in heightened urges to vape (nicotine). We also hypothesized that a negative affect induction would induce greater urge to vape compared to participants’ natural affect state. Lastly, we hypothesized an interaction between affective and vaping cues, with individuals showing the highest reactivity to vaping cues following negative affect induction. We found that internal and external cue exposure had additive but not interactive effects on urge to vape. Results also supported our hypothesis that affect induction procedures increase the urge to vape. Finally, we found that both proximal (emphasizing in vivo vaping cues) and distal (emphasizing VR headset-based cues for nicotine use) greater reported urge to vape. These results contribute to the literature by revealing the efficacy of cue presentation via VR headset on cravings in e-cigarette users, as well as showing that negative affect induction has additive but not interactive effects on urge to vape.
Keywords: Nicotine, MoodAuthors:
Author - Laura J. Long,
PhD,
Boston University, Department of Psychological and Brain Sciences
Co-Author - Matthew J. Samora,
MA,
Boston University, Department of Psychological and Brain Sciences
Co-Author - Tess Indriolo,
BA,
Boston University, Department of Psychological and Brain Sciences
Co-Author - Yanjia Geng,
BA,
Boston University, Department of Psychological and Brain Sciences
Co-Author - Emilie G. Huber,
Boston University, Department of Psychological and Brain Sciences
Co-Author - Santiago Papini,
PhD,
Department of Psychology, University of Hawaii
Co-Author - Jasper A. J. Smits,
PhD,
Department of Psychology, University of Texas at Austin
Co-Author - Michael W. Otto,
PhD,
Boston University, Department of Psychological and Brain Sciences
F173 - Co-developing recommendations for smoking cessation behavioural support for adults with spinal cord injury: A theory-based and partnered approach
Poster Number: F173Time: 11:00 AM - 11:50 AM
Topics: Tobacco Control and Nicotine-Related Behavior, Community Engagement
Introduction: People living with a spinal cord injury (SCI) report higher cigarette smoking rates compared to those without SCI. There remain inequities in access to smoking cessation services, specifically tailored for people with SCI. This study used a systematic, partnered and consensus approach to co-develop theory- and evidence-based recommendations for behavioural support for adults with a SCI. Methods: Guided by pragmatism and the ORBIT model, an established 10-step knowledge translation approach and the AGREE II instrument and reporting guidelines were applied to co-develop the smoking cessation recommendations. An integrated knowledge translation partnership was established with a provincial non-profit SCI organization. This partnership aimed to co-create smoking cessation supports that can be delivered through their Peer Health Coach Program. In addition to the partnership, a multidisciplinary panel of 12 researchers and research users was created to review data sources and establish consensus on recommendations. Data sources were synthesized using the Behaviour Change Intervention Ontology and included studies on cigarette smoking and cessation behaviour of persons with SCI, a scoping review of smoking cessation interventions for persons with physical disabilities, community feedback on intervention preferences, Canadian guidelines and best practices for smoking cessation, and guidelines for health behaviour change for persons with SCI. During two in-person meetings (2.5 days), the partnership and panel deliberated and established consensus on mechanisms of action, behaviour change techniques, delivery considerations, and recommendations for providing smoking cessation behavioural support that can be implemented and delivered by peer health coaches. Results: The panel established 100% consensus on the recommendations which are structured in four sections: 1) introduction, 2) how to have a conversation, 3) what to say during a conversation, and 4) glossary. These recommendations include 17 behavior change techniques corresponding to 13 mechanisms of action. Survey responses indicated that the panel members found the recommendations document clear, unambiguous, and useful. Conclusion: The co-developed and theory-based intervention recommendations provides a tailored smoking cessation resource for persons with SCI and peer health coaches that aims to reduce tobacco use disparities and improve the health and quality of life of people with SCI.
Keywords: Tobacco use, Behavior ChangeAuthors:
Author - Kelsey Wuerstl,
PhD,
University of British Columbia
Co-Author - Christopher McBride,
PhD,
Spinal Cord Injury British Columbia
Co-Author - Kathleen A. Martin Ginis, PhD,
University of British Columbia
Co-Author - Guy Faulkner,
PhD,
University of British Columbia
Co-Author - Mary Jung,
PhD,
University of British Columbia
Co-Author - Joan Bottorff,
PhD,
University of British Columbia
Co-Author - Neil Eves,
PhD,
University of British Columbia
Co-Author - Peter Selby,
MD,
Centre for Addiction and Mental Health, Toronto, Ontario
Co-Author - Laura Struik,
PhD,
University of British Columbia
Co-Author - Teri Thorson,
Spinal Cord Injury British Columbia
Co-Author - Christopher West,
PhD,
University of British Columbia
Co-Author - Rhonda Willms,
MD,
University of British Columbia
Co-Author - Alanna Shwed,
MSc,
The University of British Columbia Okanagan
Co-Author - Parres Elizabeth Gwen Holliday,
BSc,
The University of British Columbia Okanagan
Co-Author - Heather Gainforth,
PhD,
University of British Columbia
F174 - Smoking Behavior Across Levels of Educational Attainment Among Cardiac Event Patients Who Smoke
Poster Number: F174Time: 11:00 AM - 11:50 AM
Topics: Tobacco Control and Nicotine-Related Behavior, Cardiovascular Disease
Background: Greater educational attainment is associated with lower smoking prevalence. This relationship holds across age, gender, and occupation. In contrast, little is known about how smoking behavior differs among smokers of different levels of educational attainment.
Purpose: The objective was to understand how smoking and smoking-related behaviors may differ among smokers across levels of educational attainment.
Methods: Data were collected as part of the baseline assessment in the Post-Acute Coronary Event Smoking (PACES) trial. Participants were recruited from inpatient units in the Minneapolis, MN area, smoked ≥ 1 cigarette a day, were 18-75 years old, and were diagnosed with acute coronary syndrome. Baseline assessments collected information on participants' demographics, including educational attainment, and smoking behaviors, including cigarettes per day, time to first cigarette in the morning, use of other tobacco products, smoking inside the home, and other smokers in the home. Educational attainment was modeled as: 1) 8th grade or less, 2) grades 9-11, 3) high school graduate/GED, 4) technical school/associates degree/some college but did not graduate, 5) college graduate, and 6) graduate degree.
Results: A total of 227 participants (67.8% male) enrolled in PACES; 58.6% identified as non-Hispanic White and 41.4% identified as a racial or ethnic minority. Mean age of participants was 54.8 (SD = 9.1) years. Educational attainment was significantly correlated with time to first cigarette in the morning (rho = -.18; p = .006), but not cigarettes per day. Mann-Whitney U tests indicated significantly lower educational attainment among those who smoke inside their home (p = .008) and those who live with another smoker (p = .026). No significant differences were observed in educational attainment among those who used only cigarettes vs. used cigarettes and another form of tobacco.
Conclusions: Results suggest those with lower educational attainment engage in smoking behaviors that may make it more difficult to quit. These smoking behaviors likely interact (e.g., it is easier to smoke upon waking if one smokes inside their home; it is harder to implement and maintain a household smoking ban if multiple smokers live in the home). These results can inform the development of tailored cessation and harm reduction strategies for those with lower educational attainment.
Keywords: Tobacco use, Cardiovascular diseasePurpose: The objective was to understand how smoking and smoking-related behaviors may differ among smokers across levels of educational attainment.
Methods: Data were collected as part of the baseline assessment in the Post-Acute Coronary Event Smoking (PACES) trial. Participants were recruited from inpatient units in the Minneapolis, MN area, smoked ≥ 1 cigarette a day, were 18-75 years old, and were diagnosed with acute coronary syndrome. Baseline assessments collected information on participants' demographics, including educational attainment, and smoking behaviors, including cigarettes per day, time to first cigarette in the morning, use of other tobacco products, smoking inside the home, and other smokers in the home. Educational attainment was modeled as: 1) 8th grade or less, 2) grades 9-11, 3) high school graduate/GED, 4) technical school/associates degree/some college but did not graduate, 5) college graduate, and 6) graduate degree.
Results: A total of 227 participants (67.8% male) enrolled in PACES; 58.6% identified as non-Hispanic White and 41.4% identified as a racial or ethnic minority. Mean age of participants was 54.8 (SD = 9.1) years. Educational attainment was significantly correlated with time to first cigarette in the morning (rho = -.18; p = .006), but not cigarettes per day. Mann-Whitney U tests indicated significantly lower educational attainment among those who smoke inside their home (p = .008) and those who live with another smoker (p = .026). No significant differences were observed in educational attainment among those who used only cigarettes vs. used cigarettes and another form of tobacco.
Conclusions: Results suggest those with lower educational attainment engage in smoking behaviors that may make it more difficult to quit. These smoking behaviors likely interact (e.g., it is easier to smoke upon waking if one smokes inside their home; it is harder to implement and maintain a household smoking ban if multiple smokers live in the home). These results can inform the development of tailored cessation and harm reduction strategies for those with lower educational attainment.
Authors:
Presenter - Rosa Gerdts,
BA,
Hennepin Healthcare Research Institute
Co-Author - Melissa Adkins-Hempel,
BA, CTTS,
Hennepin Healthcare Research Institute
Co-Author - Pearl Fang,
BS,
Hennepin Healthcare Research Institute
Co-Author - Oscar Oranday Perez,
Hennepin Healthcare Research Institute
Co-Author - Sarah Cameron,
MS, CTTS, NBC-HWC,
Hennepin Healthcare Research Institute
Co-Author - Christopher Breault,
BS,
Brown University
Co-Author - Shira I. Dunsiger,
PhD,
Brown University
Co-Author - Susan A. Everson-Rose,
PhD, MPH,
University of Minnesota
Co-Author - Sandra J. Japuntich,
PhD,
Hennepin Healthcare, University of Minnesota Medical School
Co-Author - Andrew M. Busch,
PhD,
Hennepin Healthcare, University of Minnesota Medical School
F175 - Prevalence and correlates of uncontrolled vaping
Poster Number: F175Time: 11:00 AM - 11:50 AM
Topics: Tobacco Control and Nicotine-Related Behavior, Tobacco Control and Nicotine-Related Behavior
Background. Some people who use e-cigarettes vape more than they want, which we call uncontrolled vaping. We sought to characterize the prevalence and correlates of uncontrolled vaping and reasons for limiting vaping.
Methods. Participants were a nationally representative online sample of 1,002 US adults who currently used e-cigarettes. In November 2022, participants completed an online survey about uncontrolled vaping (perceptions and consequences) and reasons they limited their use. Analyses used weighted and adjusted logistic regression.
Results. Nearly one-third (29%) of participants reported uncontrolled vaping perceptions at least sometimes, but only 4% reported uncontrolled vaping consequences at least sometimes. Participants who vaped higher concentrations of nicotine, daily, and first thing in the morning reported higher uncontrolled vaping perceptions (all p<.05). Participants who vaped higher concentrations of nicotine, were dual users, or were people of color reported more uncontrolled vaping consequences (all p<.05). Those with higher uncontrolled vaping perceptions and consequences were more likely to endorse limiting their vaping for reasons that include the cost, reducing cravings of quitting smoking, dependence, and other people wanting them to limit their vaping.
Conclusions. Uncontrolled vaping is relatively common, with close to one-third of people who vape experiencing this phenomenon. Our findings highlight the complex interplay of factors contributing to uncontrolled vaping and underscore the need for targeted interventions and regulations to address this issue among diverse vape users.
Keywords: Nicotine, Public healthMethods. Participants were a nationally representative online sample of 1,002 US adults who currently used e-cigarettes. In November 2022, participants completed an online survey about uncontrolled vaping (perceptions and consequences) and reasons they limited their use. Analyses used weighted and adjusted logistic regression.
Results. Nearly one-third (29%) of participants reported uncontrolled vaping perceptions at least sometimes, but only 4% reported uncontrolled vaping consequences at least sometimes. Participants who vaped higher concentrations of nicotine, daily, and first thing in the morning reported higher uncontrolled vaping perceptions (all p<.05). Participants who vaped higher concentrations of nicotine, were dual users, or were people of color reported more uncontrolled vaping consequences (all p<.05). Those with higher uncontrolled vaping perceptions and consequences were more likely to endorse limiting their vaping for reasons that include the cost, reducing cravings of quitting smoking, dependence, and other people wanting them to limit their vaping.
Conclusions. Uncontrolled vaping is relatively common, with close to one-third of people who vape experiencing this phenomenon. Our findings highlight the complex interplay of factors contributing to uncontrolled vaping and underscore the need for targeted interventions and regulations to address this issue among diverse vape users.
Authors:
Presenter - Shayna Farris,
University of North Carolina at Chapel Hill
Co-Author - Tara Licciardello Queen,
PhD,
University of North Carolina at Chapel Hill
Co-Author - Mayank Sakhuja,
PhD,
University of North Carolina at Chapel Hill
Co-Author - Mohammad Ebrahimi Kalan,
PhD,
University of Maryland at College Park
Co-Author - Marissa G. Hall,
PhD,
University of North Carolina at Chapel Hill
Co-Author - Paschal Sheeran,
PhD,
University of North Carolina at Chapel Hill
Co-Author - Kurt M. Ribisl,
PhD,
University of North Carolina at Chapel Hill
Co-Author - Jennifer Mendel Sheldon,
MPH,
University of North Carolina at Chapel Hill
Co-Author - Noel T. Brewer,
PhD,
University of North Carolina at Chapel Hill
F176 - I Bet I Can Quit: NIH SBIR-funded Randomized Trial of a Gamified Smoking Cessation App with a Deposit Contract
Poster Number: F176Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Tobacco Control and Nicotine-Related Behavior
Significance: Contingency management (CM), which uses financial incentives to motivate behavior change, is among the most effective non-pharmacological treatments for cigarette smoking cessation in academic research settings. Two promising strategies for facilitating real-world application of CM are delivering it via smartphone apps and funding the incentives via deposit contracts, in which participants pay a deposit of their own money up front that they can only recoup by quitting smoking. Methods: We conducted a randomized trial of a smoking cessation app that was structured as a 28-day “game” with a $30 deposit (their “bet”). All “players” were provided with a Bluetooth-enabled breath carbon monoxide (CO) monitor, included with their $30 deposit. Players were instructed to quit by day 2. All players who abstained from smoking between day 3-28, verified by daily breath testing with up to 2 lapse days allowed, were declared “winners.” Winners split the total sum of deposits equally, such that their $30 deposit was refunded plus they received extra profit from the forfeited deposits of players who did not submit the required breath tests. U.S. adults (N = 245, Mage = 44.9) who smoked at least 5 cigarettes per day (M = 13.5) were recruited nationwide (47 states) in 14 cohorts (M = 18 participants, range 4-34). Each cohort was randomized to play the “Group” or “Individual” version of the game. The Group version included the deposit contract, a social feed where players could communicate with each other and a host who provided smoking cessation education, and a game board that displayed players’ progress. The Individual version only included the deposit contract (no social feed or game board). Participants completed follow-up assessments at 1 (i.e., post-game), 2, 3, and 6 months after the game start date. Results: The win rate was not significantly different in the Group (43.1%) vs. Individual (37.5%) version (p=.59 in model adjusting for clustering and covariates). However, a longitudinal model comparing self-reported 7-day point prevalence abstinence showed significant differences at 1 month favoring the Group version (OR=1.86, 95% CI: 1.04-3.24) and trends in the same direction at 2, 3, and 6 months (ORs=1.20-1.59). Conclusion: Incorporating social interaction and education enhanced the short-term effects of a deposit contract for smoking cessation delivered via an app. These findings will guide future app development and commercialization efforts.
Keywords: Smoking, Tobacco useAuthors:
Presenter - Erika Litvin Bloom,
PhD,
WayBetter
Co-Author - Joseph Waring,
MPH,
WayBetter
Co-Author - Sandra Japuntich,
Ph.D.,
Hennepin Healthcare/University of Minnesota Medical School
Co-Author - Jesse Dallery,
PhD,
University of Florida
Co-Author - Tricia Leahey,
PhD,
University of Connecticut
Co-Author - Shira Dunsiger,
PhD,
Brown University, School of Public Health
Co-Author - Jamie Rosen,
WayBetter
F177 - Evaluation of a Tailored Interview Guide for Adults Who Smoke and Attempt to Quit with Text Messaging
Poster Number: F177Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Tobacco Control and Nicotine-Related Behavior
Significance. Cigarette smoking causes more than 480,000 deaths annually. The U.S. Food and Drug Administration announced a proposed product standard to ban menthol cigarettes. This ban may cause an increase in the utilization of Quitlines (QL); however few studies have been conducted among Black adults who use QL services to ask about the challenges experienced during a quit attempt. To develop and refine a semi-structured interview guide for adult smokers who want to quit, we evaluated questions with Pennsylvania (PA) QL enrollees. Methods. In this qualitative and mixed methods study, individuals who enrolled in PA QL services were invited to complete a screener. Eligible participants were called to confirm their interest and scheduled to meet via Zoom for an interview. Consent was obtained and compensation was provided. The interview guide is being used in a larger study of 64 participants. It included a script for the interviewer with consent to record the conversation (audio only), and questions divided into six categories: 1) past quit attempts, 2) perspectives on use of the PA QL and the text messaging service, 3) use of technology, 4) interactions with health care provider, 5) experiences with other addictive substances, and 6) suggestions for improvement of the PA QL text messaging service. The study was reviewed and approved by our Institutional Review Board. Results. The guide was tested with 10 participants who were primarily Black adults (80%), identified as female (70%), completed some college (40%), and had a mean age of 50 years (SD: 15.8, range 20-65). While some participants needed assistance with connecting to the researcher via Zoom, once connected they were willing to share challenges with quitting. After assessing the format of the guide, we made changes to ask participants quantitative questions about smoking behaviors first and subsequently asked more in-depth (open-ended) questions. Conclusion. Few studies have developed and tested an interview guide to collect the challenges and responses of adults who smoke and want to quit. This study has implications for the design of smoking cessation interventions and demonstrated the feasibility to reach Black adults. Future research should consider recruitment strategies to include Black male adults who smoke.
Keywords: Tobacco use, e-HealthAuthors:
Presenter - Sophia I. Allen,
PhD, MBA,
Penn State College of Medicine
Co-Presenter - Victoria Francois,
MPH,
Penn State College of Medicine
Co-Presenter - Shubekshya Upadhyay,
MPH,
Penn State University
Co-Presenter - Abena Duah,
MHA,
Penn State College of Medicine
F178 - Comparison of HPV and PAP tests for Cervical Cancer Screening Differences by Urban-Rural Residency
Poster Number: F178Time: 11:00 AM - 11:50 AM
Topics: Cancer, Women's Health
Background
The use of the Human Papillomavirus (HPV) test in cervical cancer screening expanded and influenced the 2018 Cervical Cancer Screening (CCS) guidelines and altered how providers interpret and use HPV and Pap tests. Social and environmental factors also play a role in screening practices. This study aimed to examine how urban-rural geographic designations impact the administration of cervical cancer screening tests.
Methods
This retrospective observational study analyzes differences in Pap and HPV tests used across four geographic areas: large cities, metropolitan areas, medium to small towns, and rural regions. Using 2019 and 2021 National Health Interview Survey (NHIS) data, which captures health outcomes, healthcare use, and behaviors, we examined cervical cancer screening (CCS). The NHIS, conducted by the CDC's National Center for Health Statistics, included questions about Pap and HPV tests and whether women were informed of their screening type. Chi-square tests were used to assess geographic differences, and odds ratios will explore associations by region and year.
Results
The sample included women aged 25-65 years. In 2019, 81.8% overall reported receiving a Pap test, with large cities at 81.3%, metropolitan areas at 83.4%, medium to small towns at 81.5%, and rural regions at 81.1% (p=0.04). HPV test rates showed greater variation, with 32.1% overall with large cities at 36.2%, metropolitan areas at 34.4%, medium to small towns at 30.3%, and rural regions at 26.4% (p<0.001). In 2021, Pap test rates were similar across regions at 81.1% overall (p=0.004), while HPV test rates remained varied, with large cities at 40.1%, metropolitan areas at 36.5%, medium to small towns at 32.7%, and rural regions at 30.2% (p<0.001). Only 53.0% of women were informed about the type of test, with the lowest rate in rural regions at 50.5%; large cities at 52.6%, metropolitan areas at 54.3%, and medium to small towns at 53.4% (p<0.001).
Conclusions
Slight geographic differences in Pap test rates were found for 2019, with significant differences in 2021. HPV test use was much lower overall, especially in rural regions. Fewer women in rural regions were informed about the type of test they received. These findings highlight regional disparities in cervical cancer screening, guiding targeted interventions to improve screening consistency and enhance early detection efforts nationwide.
Keywords: Cancer screening, Public healthThe use of the Human Papillomavirus (HPV) test in cervical cancer screening expanded and influenced the 2018 Cervical Cancer Screening (CCS) guidelines and altered how providers interpret and use HPV and Pap tests. Social and environmental factors also play a role in screening practices. This study aimed to examine how urban-rural geographic designations impact the administration of cervical cancer screening tests.
Methods
This retrospective observational study analyzes differences in Pap and HPV tests used across four geographic areas: large cities, metropolitan areas, medium to small towns, and rural regions. Using 2019 and 2021 National Health Interview Survey (NHIS) data, which captures health outcomes, healthcare use, and behaviors, we examined cervical cancer screening (CCS). The NHIS, conducted by the CDC's National Center for Health Statistics, included questions about Pap and HPV tests and whether women were informed of their screening type. Chi-square tests were used to assess geographic differences, and odds ratios will explore associations by region and year.
Results
The sample included women aged 25-65 years. In 2019, 81.8% overall reported receiving a Pap test, with large cities at 81.3%, metropolitan areas at 83.4%, medium to small towns at 81.5%, and rural regions at 81.1% (p=0.04). HPV test rates showed greater variation, with 32.1% overall with large cities at 36.2%, metropolitan areas at 34.4%, medium to small towns at 30.3%, and rural regions at 26.4% (p<0.001). In 2021, Pap test rates were similar across regions at 81.1% overall (p=0.004), while HPV test rates remained varied, with large cities at 40.1%, metropolitan areas at 36.5%, medium to small towns at 32.7%, and rural regions at 30.2% (p<0.001). Only 53.0% of women were informed about the type of test, with the lowest rate in rural regions at 50.5%; large cities at 52.6%, metropolitan areas at 54.3%, and medium to small towns at 53.4% (p<0.001).
Conclusions
Slight geographic differences in Pap test rates were found for 2019, with significant differences in 2021. HPV test use was much lower overall, especially in rural regions. Fewer women in rural regions were informed about the type of test they received. These findings highlight regional disparities in cervical cancer screening, guiding targeted interventions to improve screening consistency and enhance early detection efforts nationwide.
Authors:
Co-Presenter - Tylar Dickson,
Michigan State University College of Human Medicine
Co-Presenter - Lanah Almatroud,
Michigan State University College of Human Medicine
Author - Sabrina Ford, PhD,
Michigan State University
F179 - M-O-M-S™ on the Bayou: Planning an Intervention for Post-disaster Mental Health in Pregnancy for Rural Louisiana - Caregiver and Childbearing Women’s Perspectives
Poster Number: F179Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Mental Health
Background: Low-income childbearing women living in rural underserved communities hit by disaster are challenged to find mental health support. The purpose of this project was to determine community need and implementation strategies for delivering the prenatal psychoeducational intervention, Mentors Offering Maternal Support™ (M-O-M-S™) post-disaster, using the EPIS (Exploration, Preparation, Implementation, Sustainment) framework.
Methods: A qualitative study was conducted using guided interviews with stakeholders hit by Hurricane Ida (2021) in rural Louisiana, including 22 perinatal/community care providers and 20 women who were pregnant or postpartum at the time of the disaster. Braun & Clarke’s (2022) reflective thematic analysis methods were used to determine common themes among stakeholders.
Results: Maternal health caregivers described mental health needs of women through the themes: (1) Caring for women vulnerable before the disaster, (2) Disaster affects everybody’s mental health, (3) Modifying care – being proactive, (4) Absolute need of the M-O-M-S™ Intervention. Women’s perspectives of their mental health needs emerged in themes, (1) Surviving disruptions in motherhood, (2) Need emotional support! (3) Find a way to persevere, (4) M-O-M-S™: Someone to go through this with me.
Implications: This study provided the groundwork for initial implementation and evaluation of a project aimed to improve maternal mental health.
Keywords: Health disparities, Mental healthMethods: A qualitative study was conducted using guided interviews with stakeholders hit by Hurricane Ida (2021) in rural Louisiana, including 22 perinatal/community care providers and 20 women who were pregnant or postpartum at the time of the disaster. Braun & Clarke’s (2022) reflective thematic analysis methods were used to determine common themes among stakeholders.
Results: Maternal health caregivers described mental health needs of women through the themes: (1) Caring for women vulnerable before the disaster, (2) Disaster affects everybody’s mental health, (3) Modifying care – being proactive, (4) Absolute need of the M-O-M-S™ Intervention. Women’s perspectives of their mental health needs emerged in themes, (1) Surviving disruptions in motherhood, (2) Need emotional support! (3) Find a way to persevere, (4) M-O-M-S™: Someone to go through this with me.
Implications: This study provided the groundwork for initial implementation and evaluation of a project aimed to improve maternal mental health.
Authors:
Presenter - Gloria Giarrtano,
PhD, APRN, CNS, FAAN,
Louisiana State University Health- New Orleans, School of Nursing
Co-Author - Emily Harville,
PhD,
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine
Co-Author - Michelle Patterson,
MSN, RN,
Nichols State University
Co-Author - Bianca Northland,
M.D.,
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine
Co-Author - Kirsten Dorans,
PhD,
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine
Co-Author - Sherri Longo,
MD,
Ochsner Health System
Co-Author - Karen Weis,
PhD, RNC-OB, FAAN,
University of Kansas Medical Center
Co-Author - Mary Schultheis,
Cresent City Family Services
F180 - Associations between Prenatal Endocrine Profiles, Parity, and Prenatal Episodic Verbal Memory
Poster Number: F180Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Child and Family Health
Pregnancy is a transformative period, marked by an array of significant hormonal, physical, social, and cognitive changes that prepare women for motherhood. While hormonal fluctuations are believed to drive cognitive changes during pregnancy, such as changes in memory, this relationship remains underexplored in humans. Moreover, parity, the number of previous births, could modulate these changes, yet this has been largely overlooked in existing research despite robust evidence from non-human animal studies indicating cumulative effects of pregnancy on cognitive performance. Thus, this study investigates the role of prenatal estradiol and oxytocin on episodic memory during pregnancy and examines how parity is related to prenatal episodic memory changes and endocrine profiles. We prospectively followed 244 pregnant women across three prenatal time-points (MGestation age : T1 = 16 weeks, T2 = 26 weeks, T3 = 35 weeks), assessing episodic memory using the Verbal Memory Test from the Wechsler Memory Scale-III and salivary estradiol and oxytocin levels. Analyses were adjusted for maternal age, years of education, and fetal sex, selected based on traditional third-variable criteria. Adjusted multilevel modeling revealed that higher concentrations of estradiol at 25 weeks gestation were significantly associated with poorer verbal memory performance at 25 weeks gestation. Additionally, parity did not moderate these effects and instead was found to be an independent predictor of episodic memory, with a larger number of previous births predicting poorer memory performance. Higher parity was also significantly associated with lower prenatal oxytocin levels, although no significant associations were found between oxytocin and episodic memory. This study highlights the potential influence of prenatal hormones, particularly estradiol, on episodic memory during pregnancy and suggests that prior reproductive experience may also play a role in these prenatal episodic memory changes and prenatal endocrine profiles.
Keywords: Pregnancy, Biobehavioral mechanismsAuthors:
Presenter - Jessica Marino,
B.A.,
University of California, Merced
Co-Author - Jennifer Hahn-Holbrook,
PhD,
University of California, Merced
Co-Author - Laura Glynn, PhD,
PhD,
Chapman University
F182 - Bridging the Gap in Lactation Support through State Medicaid Coverage and Policy Reform
Poster Number: F182Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Health of Marginalized Populations
Background: Access to comprehensive lactation support services is essential for promoting successful breastfeeding practices, which have significant health benefits for both mothers and infants. Despite these benefits, disparities in lactation support persist, particularly among low-income populations reliant on Medicaid. Currently, many state Medicaid programs do not reimburse outpatient visits with International Board-Certified Lactation Consultants (IBCLCs) or other healthcare providers for breastfeeding support. This lack of coverage creates a critical gap in access for marginalized and low-income communities, which often intersect with communities of color.
Objective: To understand the current landscape of stat-level Medicaid policies on outpatient lactation consultation and other breastfeeding services, identify gaps in access, and provide recommendations for expanding coverage in states without such provisions.
Methods: A comprehensive search of Medicaid State Plan Amendments (SPAs) was conducted to identify state-level policies on Medicaid coverage for outpatient lactation consultants and other breastfeeding services. This search resulted in a total of nineteen SPAs from January 2012 to December 2024, which were included for further analysis.
Results: Fourteen states have amended their state Medicaid plans to include provisions for lactation coverage and/or reimbursement (CO, CT, DE, GA, IL, NE, NH, NJ, NM, NY, OH, OR, TN, VT), with nineteen approved amendment proposals, some of which apply to the same states (NH, NY, OH). Ten SPAs explicitly recognize IBCLCs as billable provider types (CO, DE, IL, NH, NJ, NY, OH, OR, TN, VT), while five SPAs extend this designation to other lactation support providers (CO, DE, GA, NM, TN). Five states have session limits for lactation support (DE, GA, NE, NJ, OR), and two states restrict coverage to sessions conducted during the postpartum period, with exceptions allowed for medical necessity (NE, OR). Additionally, three states (CO, CT, NH) provide reimbursement for hospital-grade breast pumps or other breastfeeding-related supplies.
Conclusion: Policy recommendations include: (i) Implementing separate reimbursement through Medicaid for IBCLC services, (ii) Securing state funding to meet federal matching requirements, and (iii) Developing and submitting a state plan amendment (SPA) through state Medicaid programs.
Keywords: Health policy, Low-income groupsObjective: To understand the current landscape of stat-level Medicaid policies on outpatient lactation consultation and other breastfeeding services, identify gaps in access, and provide recommendations for expanding coverage in states without such provisions.
Methods: A comprehensive search of Medicaid State Plan Amendments (SPAs) was conducted to identify state-level policies on Medicaid coverage for outpatient lactation consultants and other breastfeeding services. This search resulted in a total of nineteen SPAs from January 2012 to December 2024, which were included for further analysis.
Results: Fourteen states have amended their state Medicaid plans to include provisions for lactation coverage and/or reimbursement (CO, CT, DE, GA, IL, NE, NH, NJ, NM, NY, OH, OR, TN, VT), with nineteen approved amendment proposals, some of which apply to the same states (NH, NY, OH). Ten SPAs explicitly recognize IBCLCs as billable provider types (CO, DE, IL, NH, NJ, NY, OH, OR, TN, VT), while five SPAs extend this designation to other lactation support providers (CO, DE, GA, NM, TN). Five states have session limits for lactation support (DE, GA, NE, NJ, OR), and two states restrict coverage to sessions conducted during the postpartum period, with exceptions allowed for medical necessity (NE, OR). Additionally, three states (CO, CT, NH) provide reimbursement for hospital-grade breast pumps or other breastfeeding-related supplies.
Conclusion: Policy recommendations include: (i) Implementing separate reimbursement through Medicaid for IBCLC services, (ii) Securing state funding to meet federal matching requirements, and (iii) Developing and submitting a state plan amendment (SPA) through state Medicaid programs.
Authors:
Presenter - Rizwana Biviji, PhD, MS,
College of Health Solutions, Arizona State University, Phoenix, AZ, USA
Co-Author - Jiya Mutyala,
Phoenix Country Day School, Phoenix, AZ, USA
Co-Author - Haniyah Syed,
BS,
Arizona College of Osteopathic Medicine, Midwestern University, Phoenix, AZ, USA
Co-Author - Lakisa Muhammad,
CPM, LM, LCCE,
Arizona Birthworkers of Color, Phoenix, AZ, USA
Co-Author - Jennie Bever,
PhD, IBCLC,
4th Trimester Arizona, Tempe, AZ, USA
F183 - The Inclusion of Menstrual Cycle Self-Monitoring in Physical Activity Interventions for Women: A Feasibility Study
Poster Number: F183Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Digital Health
Physical activity (PA) engagement may be impacted by menstrual cycle (MC) symptoms, though it is unclear how much and under what circumstances. Currently, this association has been primarily examined from a physiological perspective (i.e., graded exercise testing), with less focus on how psychological or perceptual factors may be associated with daily MC experiences (e.g., mood changes, motivation). Understanding the role of MC experiences in women’s motivation for and engagement in PA in daily life would help inform the design of digital PA interventions and support tools for menstruating women. In the present 2-part study, we explored the preferences and needs of insufficiently active, menstruating women in a post-Roe cultural context as they relate to using digital applications for PA promotion. Part 1 (N = 20; Mage= 26.60 years, MBMI= 27.80 kg/m2) consisted of a 30-minute semi-structured interview to explore perspectives and lived experiences of MC and PA patterns, within and across days. Participants were then invited to complete Part 2 which included 7 days of objective PA assessment (captured by Fitbit), menstrual health self-monitoring, and an exit interview (N = 14; Mage=26.79age, MBMI=27.83). Qualitative data from Parts 1 and 2 were analyzed using thematic analysis. We identified 7 major themes in women’s interview responses: (1) menstruation and everyday life experiences, (2) attitudes towards menstruation, (3) preferences for connecting and communicating about menstrual health, (4) empowered decision making, (5) key features of menstrual cycle self-monitoring tools, (6) Fitbit’s suitability for menstrual cycle self-monitoring needs, and (7) participant reaction to intensive 7-day tracking of menstrual health and PA patterns. Findings suggest that women perceive their daily experiences, including PA engagement, to be influenced by a variety of factors related to their MC (e.g., physical, psychological, emotional). The Fitbit device and application were found to be easily usable and acceptable, though participants expressed a continued need for greater personalization and more opportunities for social support. As participants responded positively to current methods, and suggested willingness to engage in longer intensive assessment procedures, a critical next step is to establish temporal associations between MC symptoms and device-assessed PA behavior, to more effectively develop PA interventions for women that can reach them in daily life.
Keywords: Women's health, Physical activityAuthors:
Author - Gabreille Salvatore,
Rowan University
Author - Angelica Rivera,
Rowan University
Author - Ninelle Edenne, BA,
BA,
Rowan University
Author - Danielle Arigo, PhD, LP,
PhD, LP,
Rowan University
F184 - Exploring Gender-Based Attitudes Toward Perinatal Depression: Implications for Treatment and Support
Poster Number: F184Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Mental Health
Background: Perinatal depression (PND) is one of the most common complications occurring during and after pregnancy. Although it affects roughly 24% of mothers and 10% of male partners, many individuals remain undiagnosed and untreated. Stigmatizing attitudes and lack of knowledge regarding PND can reduce conversations between partners about PND and ultimately impact treatment-seeking. It is, therefore, critical to identify factors that could influence symptom identification and treatment seeking. This study explores gender differences in attitudes toward PND, highlighting potential implications for health education and clinical interventions.
Method: Participants (N=179; 50.8% female; 49.2% male) completed an online questionnaire. PND-related knowledge, attitudes, and beliefs were assessed using the Attitudes About Postpartum Depression Scale and an adapted version of the Mental Health Literacy Scale. Data was summarized using descriptive statistics and comparison tests (t-tests, chi-square tests) were computed to examine differences in PND-related attitudes between male and female respondents.
Results: Gender comparisons revealed numerous significant differences in PND-related attitudes and beliefs. Female participants perceived PND as being more common (t[177]=-2.05, p<.05) and serious (t[173.52]=2.54, p<.05) than male participants. Male participants reported more negative attitudes about PND overall compared to females ( t[172.7]=4.16, p<0.001). Males also held more potentially harmful beliefs about the causes and treatment needs for PND. For instance, male participants were more likely to attribute PND to a lack of preparedness for parenthood (t[166.49]=2.88, p<.01) or certain personality traits (t[169.37]=2.25,p<.05) and were also more likely to believe that PND would go away with time (t[173.24]=3.23, p<0.001) and individuals should be able to cope with their symptoms without needing treatment (t[166.81]=3.82, p< 0.001).
Conclusion: Males were more likely to underestimate the severity of PND, exhibit a false understanding of disease causes, and have unfavorable perceptions of treatment. These misperceptions can adversely impact support and treatment seeking throughout pregnancy, leading women to cope with the condition on their own, further impacting their mental well-being. Public health campaigns and clinical education interventions are needed to stop the perpetuation of PND-related stigmas.
Keywords: Women's health, Mental healthMethod: Participants (N=179; 50.8% female; 49.2% male) completed an online questionnaire. PND-related knowledge, attitudes, and beliefs were assessed using the Attitudes About Postpartum Depression Scale and an adapted version of the Mental Health Literacy Scale. Data was summarized using descriptive statistics and comparison tests (t-tests, chi-square tests) were computed to examine differences in PND-related attitudes between male and female respondents.
Results: Gender comparisons revealed numerous significant differences in PND-related attitudes and beliefs. Female participants perceived PND as being more common (t[177]=-2.05, p<.05) and serious (t[173.52]=2.54, p<.05) than male participants. Male participants reported more negative attitudes about PND overall compared to females ( t[172.7]=4.16, p<0.001). Males also held more potentially harmful beliefs about the causes and treatment needs for PND. For instance, male participants were more likely to attribute PND to a lack of preparedness for parenthood (t[166.49]=2.88, p<.01) or certain personality traits (t[169.37]=2.25,p<.05) and were also more likely to believe that PND would go away with time (t[173.24]=3.23, p<0.001) and individuals should be able to cope with their symptoms without needing treatment (t[166.81]=3.82, p< 0.001).
Conclusion: Males were more likely to underestimate the severity of PND, exhibit a false understanding of disease causes, and have unfavorable perceptions of treatment. These misperceptions can adversely impact support and treatment seeking throughout pregnancy, leading women to cope with the condition on their own, further impacting their mental well-being. Public health campaigns and clinical education interventions are needed to stop the perpetuation of PND-related stigmas.
Authors:
Co-Author - Emily Leslie,
San Diego State University
Co-Author - Nadia Hemmat,
MPH,
San Diego State University
Co-Author - Emily Schmied, PhD,
PhD,
San Diego State University
F185 - Associations between positive affect and grief symptoms in spousal bereavement
Poster Number: F185Time: 11:00 AM - 11:50 AM
Topics: Quality of Life, Mental Health
Objectives: Spousal bereavement is associated with detrimental mental and physical health outcomes. Positive affect is a protective factor associated with improved health; however, few studies have examined its impact in the context of spousal bereavement. This study examined the association between positive affect and grief symptoms (grief rumination, complicated grief, depression, and quality of life) among adult populations experiencing spousal bereavement.
Methods: The sample consisted of 40 bereaved spouses (60.0% female, 66.4 years old [SD = 10.9], mean days since loss 60 days [SD=24.6]) who participated in the REST to Overcome loss and Reduce Risk (RESTore) Plus study. Grief symptoms were measured using the Inventory of Complicated Grief (ICG), Utrecht Grief Rumination Scale (UGRS). Depressive symptoms and quality of life were measured using the Center for Epidemiologic Studies Depression Scale (CES-D), and 36-Item Short Form Survey (SF-36), respectively. Positive affect was assessed using the Positive and Negative Affect Schedule (PANAS). Linear regression was used to examine the associations between positive affect, grief symptoms, depressive symptoms, and quality of life (Physical functioning, energy and fatigue, emotional wellbeing, and social functioning).
Results: Mean values on positive affect, grief symptoms, grief rumination, and depressive symptoms were 29.7 (7.6), 25.2 (10.6), 35.7 (10.1), 19.1 (10.1). Subscales on the SF-36 included physical functioning (86.1 [15.4]), energy and fatigue (47.1 [20.0]), emotional well-being (61.9 [17.6]), and social functioning (67.5 [24.0]). There was a significant association between positive affect and grief symptoms (B=-0.75, 95% CI=-1.14 to -0.36), grief rumination (B=-0.63; 95% CI=-1.02 to -0.24), depressive symptoms (B=-0.92; 95 CI=-1.24 to -0.60), energy and fatigue (B=2.01; CI=1.44 to 2.57), emotional wellbeing (B=1.80; CI=1.31 to 2.28), social functioning (B=1.97; CI=1.15 to 2.78). All reported B values were unstandardized. These associations remained significant after controlling for age, sex, race, education, and days since loss.
Conclusion: Positive affect is associated with grief, depressive symptoms and quality of life among bereaved spouses, suggesting a protective effect. Future interventional studies should examine the enhancement of positive affect through psychological interventions and its effects on physical and mental health outcomes.
Keywords: Quality of life, EmotionsMethods: The sample consisted of 40 bereaved spouses (60.0% female, 66.4 years old [SD = 10.9], mean days since loss 60 days [SD=24.6]) who participated in the REST to Overcome loss and Reduce Risk (RESTore) Plus study. Grief symptoms were measured using the Inventory of Complicated Grief (ICG), Utrecht Grief Rumination Scale (UGRS). Depressive symptoms and quality of life were measured using the Center for Epidemiologic Studies Depression Scale (CES-D), and 36-Item Short Form Survey (SF-36), respectively. Positive affect was assessed using the Positive and Negative Affect Schedule (PANAS). Linear regression was used to examine the associations between positive affect, grief symptoms, depressive symptoms, and quality of life (Physical functioning, energy and fatigue, emotional wellbeing, and social functioning).
Results: Mean values on positive affect, grief symptoms, grief rumination, and depressive symptoms were 29.7 (7.6), 25.2 (10.6), 35.7 (10.1), 19.1 (10.1). Subscales on the SF-36 included physical functioning (86.1 [15.4]), energy and fatigue (47.1 [20.0]), emotional well-being (61.9 [17.6]), and social functioning (67.5 [24.0]). There was a significant association between positive affect and grief symptoms (B=-0.75, 95% CI=-1.14 to -0.36), grief rumination (B=-0.63; 95% CI=-1.02 to -0.24), depressive symptoms (B=-0.92; 95 CI=-1.24 to -0.60), energy and fatigue (B=2.01; CI=1.44 to 2.57), emotional wellbeing (B=1.80; CI=1.31 to 2.28), social functioning (B=1.97; CI=1.15 to 2.78). All reported B values were unstandardized. These associations remained significant after controlling for age, sex, race, education, and days since loss.
Conclusion: Positive affect is associated with grief, depressive symptoms and quality of life among bereaved spouses, suggesting a protective effect. Future interventional studies should examine the enhancement of positive affect through psychological interventions and its effects on physical and mental health outcomes.
Authors:
Co-Author - Christopher Fagundes,
Ph.D.,
Department of Psychological Sciences, Rice Social Sciences, Rice University, Houston, TX
Co-Author - Mercedes Carnethon,
Ph.D.,
(2) Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
Co-Author - Judith Moskowitz,
Ph.D., MPH,
(3) Department of Medical Social Sciences, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL
Co-Author - Diana A. Chirinos, PhD,
PhD,
Northwestern University
F187 - Resilience is an Independent Predictor of Psychosocial Wellness Above and Beyond Disability and Symptom Burden in Multiple Sclerosis
Poster Number: F187Time: 11:00 AM - 11:50 AM
Topics: Quality of Life, Multiple Health Behavior Change
Existing literature has demonstrated that resilience predicts positive well-being in people with multiple sclerosis (MS), above and beyond the effects of disability and symptoms such as pain, fatigue, and depressed mood. To add to this growing body of literature, we analyzed data from a large nationwide survey to examine the association between resilience and psychosocial wellness variables—satisfaction with life, meaning and purpose, and satisfaction with social roles and activities—while controlling for disability and common MS-related symptoms. Survey data was collected from N=1260 adults with MS across the United States through Qualtrics. The data includes survey measures of the primary predictor of interest, resilience (Connor-Davidson Resilience Scale), and covariates—pain (Patient Reported Outcomes Measurement Information System [PROMIS] Pain Intensity 3a), fatigue (Fatigue Severity Scale), disability level (Patient Determined Disease Steps [PDDS]), depressive symptoms (PROMIS Depression 4a), and bladder symptoms (Bladder Control Scale). Psychosocial wellness outcomes of interest included measures of life satisfaction (PROMIS Satisfaction with Life), meaning and purpose (PROMIS Meaning and Purpose 8a), and social wellness (PROMIS Satisfaction with Social Roles and Activities 8a). Most respondents were White (83.7%; 9.6% Black, 3.9% Multiracial) and cisgender women (83.2%), and 5.6% were Hispanic or Latine (92.9%). There was wide variability in both age (mean=50.89, range=21-83) and disability level (range of PDDS scores=0-8). In linear regression models adjusting for disability level, pain, fatigue, depressive symptoms, and bladder symptoms, resilience was significantly associated with meaning and purpose (b=0.36, p<0.001), life satisfaction (b=0.29, p<0.001), and social wellness (b=0.27, p<0.001). These findings provide evidence that resilience predicts social and emotional wellness above and beyond the effects of disability level and highly prevalent symptoms in MS. This analysis further broadens the scope of existing research by replicating prior findings in a large MS sample, and by expanding to include newly considered and greatly impactful MS-related symptoms, such as bladder control. Future efforts may focus on behavioral interventions aimed at increasing resilience, thereby helping people with MS maintain wellness despite experiencing MS symptoms.
Keywords: Resilience, Quality of lifeAuthors:
Author - Josiah Goga,
BS,
Michigan Medicine
Co-Author - Evan Smith,
PhD,
Michigan Medicine
Co-Author - Kevin Alschuler,
PhD,
University of Washington
Co-Author - Kathy Zackowski,
PhD,
National Multiple Sclerosis Society
Co-Author - Jade Treder,
BS,
Michigan Medicine
Co-Author - Dawn Ehde,
PhD,
University of Washington Medicine
Co-Author - Anna Kratz,
PhD,
Michigan Medicine
F188 - The association between ego network characteristics and metabolic dysfunction-associated steatosis liver disease among Mexican immigrant adults along the Southern Arizona United States/Mexico border
Poster Number: F188Time: 11:00 AM - 11:50 AM
Topics: Obesity, Cancer
Background and Aims: In the Southern Arizona border region, estimates indicate that the overall prevalence of MASLD (metabolic dysfunction-associated steatosis liver disease), an emerging risk factor for liver cancer, among Mexican-origin adults is nearly 40%. Despite data linking social networks to the promotion and maintenance of healthy lifestyle behaviors, research on social networks influence on MASLD risk is limited. The purpose of this study was to determine whether egocentric social network characteristics are associated with Mexican-origin adults’ risk for MASLD. Methods: Egocentric social network data were collected from a community-based sample of 195 Mexican immigrant adults (women=137; men=58) residing in the Southern Arizona U.S./Mexico border region. Hepatic steatosis was assessed via FibroScan® using continuous attenuation parameter (CAP) values measured in decibels per meter (dB/m). MASLD was identified as having a CAP score of ≥288 dB/m. Analyses characterized network structure and determined the relationship between egocentric network structure and MASLD. Results: Participants’ egocentric networks had an average size of four alters. Seventy-seven (39%) participants were identified with MASLD. Neither participants’ network size nor proportion of kin in participants’ network was associated with MASLD status. However, number of women in participants’ network was statistically associated with MASLD status. Specifically, having more females in one’s network is associated with lower odds of having MASLD (b=-0.40, SE=0.18, p<0.05). Conclusion: Our findings elucidate the interpersonal processes, specifically the number of women in an individual’s network, that could be leveraged to promote adherence to lifestyle modifications, the recommended primary line of treatment for individuals with MASLD, particularly among high-risk underrepresented populations. The results of this study have significant implications for public health interventions for high-risk Mexican immigrant populations.
Keywords: Latino, DiseaseAuthors:
Presenter - Adriana Maldonado,
The University of Arizona
Author - Diego Leal,
University of Arizona
Author - Edgar A. Villavicencio, MPH,
MPH,
The University of Arizona
Author - Estefania Ochoa Mora,
University of Arizona
Author - Naim Alkhouri,
Arizona Liver Health
Author - David O. Garcia, PhD,
PhD,
University of Arizona
F189 - The moderating role of mindfulness in the association between anxiety and internalized stigma among substance users
Poster Number: F189Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Substance Misuse
Substance use is a prevalent and growing problem across the United States; recent estimates suggest that 17.3% of individuals report having a substance use disorder (Substance Abuse and Mental Health Services Administration, 2023). Among substance users, internalized stigma of substance use is prevalent and associated with a lack of seeking treatment and poorer recovery outcomes (Rao et al., 2009). Internalized stigma of substance use is also associated with poor mental health, including higher levels of anxiety symptoms (Vogel et al., 2013). Increasing levels of mindfulness may potentially buffer the association between the internalized stigma of substance use and anxiety (Van Dam et al., 2014). The current study examines the potential mediating role of mindfulness on the association between anxiety symptoms and the internalized stigma of substance use among 125 substance users.
Individuals who had reported seeking treatment for a substance use disorder (n=125) were recruited to participate in an online survey. Participants reported on demographics and measures including the Generalized Anxiety Disorder Scale (GAD-7 Spitzer et al., 2006), the Internalized Stigma of Substance Abuse Scale (ISSA; Luoma et al., 2007), and the Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2008). Using the process macro in SPSS 29.0, we assessed the moderating role of the FFMQ in the association between the PSS-10 and the ISSA.
Results indicate that scores from the GAD-7 are positively associated with scores from the ISSA (B=.69, p =.012), and scores from the FFMQ are negatively associated with scores from the ISSA (B=-.38, p =.022). The interaction between the GAS-7 and the FFMQ is also significant, indicating a significant interaction effect present (B=.05, p =.045). The model explains 20.5% of the variance in internalized stigma of substance use in the current sample.
Although the interaction effect was not in the expected direction, results indicate that individuals with higher levels of mindfulness have less internalized stigma of substance abuse for all levels of anxiety. However, as anxiety symptoms increase, mindfulness has less of an effect on the internalized stigma of substance abuse. Results highlight the importance of mindfulness, particularly among individuals with lower levels of anxiety, as mindfulness may not be as protective for individuals experiencing high levels of anxiety. Future directions and implications will be discussed.
Keywords: Anxiety, Substance abuseIndividuals who had reported seeking treatment for a substance use disorder (n=125) were recruited to participate in an online survey. Participants reported on demographics and measures including the Generalized Anxiety Disorder Scale (GAD-7 Spitzer et al., 2006), the Internalized Stigma of Substance Abuse Scale (ISSA; Luoma et al., 2007), and the Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2008). Using the process macro in SPSS 29.0, we assessed the moderating role of the FFMQ in the association between the PSS-10 and the ISSA.
Results indicate that scores from the GAD-7 are positively associated with scores from the ISSA (B=.69, p =.012), and scores from the FFMQ are negatively associated with scores from the ISSA (B=-.38, p =.022). The interaction between the GAS-7 and the FFMQ is also significant, indicating a significant interaction effect present (B=.05, p =.045). The model explains 20.5% of the variance in internalized stigma of substance use in the current sample.
Although the interaction effect was not in the expected direction, results indicate that individuals with higher levels of mindfulness have less internalized stigma of substance abuse for all levels of anxiety. However, as anxiety symptoms increase, mindfulness has less of an effect on the internalized stigma of substance abuse. Results highlight the importance of mindfulness, particularly among individuals with lower levels of anxiety, as mindfulness may not be as protective for individuals experiencing high levels of anxiety. Future directions and implications will be discussed.
Authors:
Author - Amanda Sather,
University of Connecticut
Author - Carissa D'Aniello Heyda,
Ph.D.,
Fairfield University
Author - Rachel Tambling,
Ph.D.,
University of Connecticut
Author - Beth Russell,
Ph.D.,
University of Connecticut
Author - Nathaniel Stekler,
University of Connecticut
F190 - The effects of acute resistance exercise on state anxiety in adults: A systematic review with meta-analysis
Poster Number: F190Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Physical Activity
Introduction: Anxiety is a prevalent mental health concern with associated health, economic, and social burden. Frontline treatments can help manage anxiety but are not effective for all, nor are they intended for acute symptom management. Meta-analytic evidence supports the use of resistance exercise (RE) training for anxiety, but the acute effects of a single RE bout on potentially distressing, transiently elevated state anxiety remain unclear.
Purpose: To quantify the overall effect of acute RE vs control on state anxiety in adults across a single session and to synthesize existing literature.
Methods: Randomized controlled studies measuring state anxiety with a validated state anxiety measure before and after (at multiple post-session timepoints) a single RE session were included. ProQuest, PsycInfo, PubMed, PubMed Central, Web of Science Core Collection, and ScienceDirect were used to locate studies published between 2000 and 2023. Random-effects models with time as a moderator were created to quantify overall acute state anxiety effects between (RE vs control) and within conditions. Participant characteristics and study design variables were extracted for systematic review.
Results: Nine studies were included in the systematic review (416 participants), of which six contained sufficient data for the meta-analysis (226 participants). Reductions in state anxiety were non-significantly greater (i.e., lower) for RE compared to control conditions (Standardized Mean Difference [SMD]=-0.11; 95% Confidence Interval [CI]: -0.46, 0.24, p=0.42), and significantly moderated by time (F2,28=15.42, p< 0.001). Within condition, state anxiety was significantly reduced for RE (SMD=-0.34; 95% CI: -0.68, -0.01, p=0.045) and control (SMD=-0.22; 95% CI: -0.43, 0.01, p=0.04). Most studies included healthy participants (7/9 studies), reported RE intensity (range: 50-85% 1RM; 7/9 studies), and reported RE setting (in labs or gyms; 5/9 studies), while few reported participants’ RE training age (one with no RE history, and one with a mean of 1.6 years), and details of familiarization with RE prior to testing (2/9 studies).
Discussion: Resistance exercise had small-to-moderate anxiolytic effects in relatively healthy adults which varied across time and appears to be present for up to three hours post-RE. Although these results are promising, the lack of research within anxious samples prevents generalizing the present results to people with anxiety, warranting future research.
Keywords: Anxiety, ExercisePurpose: To quantify the overall effect of acute RE vs control on state anxiety in adults across a single session and to synthesize existing literature.
Methods: Randomized controlled studies measuring state anxiety with a validated state anxiety measure before and after (at multiple post-session timepoints) a single RE session were included. ProQuest, PsycInfo, PubMed, PubMed Central, Web of Science Core Collection, and ScienceDirect were used to locate studies published between 2000 and 2023. Random-effects models with time as a moderator were created to quantify overall acute state anxiety effects between (RE vs control) and within conditions. Participant characteristics and study design variables were extracted for systematic review.
Results: Nine studies were included in the systematic review (416 participants), of which six contained sufficient data for the meta-analysis (226 participants). Reductions in state anxiety were non-significantly greater (i.e., lower) for RE compared to control conditions (Standardized Mean Difference [SMD]=-0.11; 95% Confidence Interval [CI]: -0.46, 0.24, p=0.42), and significantly moderated by time (F2,28=15.42, p< 0.001). Within condition, state anxiety was significantly reduced for RE (SMD=-0.34; 95% CI: -0.68, -0.01, p=0.045) and control (SMD=-0.22; 95% CI: -0.43, 0.01, p=0.04). Most studies included healthy participants (7/9 studies), reported RE intensity (range: 50-85% 1RM; 7/9 studies), and reported RE setting (in labs or gyms; 5/9 studies), while few reported participants’ RE training age (one with no RE history, and one with a mean of 1.6 years), and details of familiarization with RE prior to testing (2/9 studies).
Discussion: Resistance exercise had small-to-moderate anxiolytic effects in relatively healthy adults which varied across time and appears to be present for up to three hours post-RE. Although these results are promising, the lack of research within anxious samples prevents generalizing the present results to people with anxiety, warranting future research.
Authors:
Author - Seana Smith,
University of Wisconsin-Madison
Co-Author - John Gidley,
University of Wisconsin-Madison
Co-Author - Arunadee Fernando,
Iowa State University
Co-Author - Darragh O'Sullivan,
University of Limerick
Co-Author - Jacob Meyer,
University of Wisconsin-Madison
F191 - "Once you know better, you should do better.” Public interpretations of epigenetic educational materials
Poster Number: F191Time: 11:00 AM - 11:50 AM
Topics: Health Communication and Policy, Decision Making
Background: Epigenetics, the study of gene regulation through chemical alteration of DNA, is a rapidly evolving field with important clinical and public health implications. However, there is little awareness or understanding of the topic in the general public, as well as limited scientific knowledge about how to communicate about epigenetics with the public.
Objective: To investigate how people understand and interpret epigenetics information, including how these interpretations shape potentially stigmatizing or otherwise-harmful beliefs.
Methods: We conducted 27 virtual focus groups (N=153) stratified by education (≥ bachelor’s degree; ≤ some college experience) and race/ethnicity (Asian; Black or African American; Hispanic; Indigenous; white). Participants who identified as more than one race or ethnicity self-selected which group to join. An educational video explaining epigenetics was presented, followed by a discussion to elicit participant reactions. Two independent coders analyzed the transcribed data using standard thematic analysis and validation techniques.
Results: Deductive codes related to understanding of, and reaction to epigenetics revealed areas of significant confusion. Participants reacted with a mix of interest, overwhelm, and skepticism. Inductive codes were identified including individual responsibility for, and control over, one’s health and the health of one’s future lineage. Many participants expressed the idea that ‘once you know better, you should do better,’ and highlighted how the potential for inheritance of epigenetic tags created an additional layer of responsibility towards future generations. Although inconsistent, there was some recognition that fulfilling this obligation might be challenging due to external factors, especially for populations that have been socially marginalized, and could become a source of stress or stigma.
Conclusions: Unfamiliarity with epigenetics paired with the considerable complexity of the topic presents a substantial challenge for communicating it to a broad audience. Our data suggest that particular care is required to explain epigenetics in a way that will be accessible and will not be misunderstood or confer undue burden. Furthermore, caution is needed in walking the fine line between empowering individuals with information relevant for their health, and over-emphasizing personal responsibility when many epigenetic-relevant factors (e.g., air pollution) may be beyond individual control.
Keywords: Genetics, Health communicationObjective: To investigate how people understand and interpret epigenetics information, including how these interpretations shape potentially stigmatizing or otherwise-harmful beliefs.
Methods: We conducted 27 virtual focus groups (N=153) stratified by education (≥ bachelor’s degree; ≤ some college experience) and race/ethnicity (Asian; Black or African American; Hispanic; Indigenous; white). Participants who identified as more than one race or ethnicity self-selected which group to join. An educational video explaining epigenetics was presented, followed by a discussion to elicit participant reactions. Two independent coders analyzed the transcribed data using standard thematic analysis and validation techniques.
Results: Deductive codes related to understanding of, and reaction to epigenetics revealed areas of significant confusion. Participants reacted with a mix of interest, overwhelm, and skepticism. Inductive codes were identified including individual responsibility for, and control over, one’s health and the health of one’s future lineage. Many participants expressed the idea that ‘once you know better, you should do better,’ and highlighted how the potential for inheritance of epigenetic tags created an additional layer of responsibility towards future generations. Although inconsistent, there was some recognition that fulfilling this obligation might be challenging due to external factors, especially for populations that have been socially marginalized, and could become a source of stress or stigma.
Conclusions: Unfamiliarity with epigenetics paired with the considerable complexity of the topic presents a substantial challenge for communicating it to a broad audience. Our data suggest that particular care is required to explain epigenetics in a way that will be accessible and will not be misunderstood or confer undue burden. Furthermore, caution is needed in walking the fine line between empowering individuals with information relevant for their health, and over-emphasizing personal responsibility when many epigenetic-relevant factors (e.g., air pollution) may be beyond individual control.
Authors:
Author - Julia Maki, PhD,
PhD,
Washington University in St. Louis
Co-Author - Aantaki Raisa,
PhD,
Washington University in St. Louis
Co-Author - Clarissa Gaona Romero,
BA,
Washington University in St. Louis
Co-Author - Caitlin Yuen,
Washington University in St. Louis
Co-Author - Christina Panzer,
BA,
Yale University
Co-Author - Jada G. Hamilton, PhD, MPH,
Memorial Sloan Kettering Cancer Center
Co-Author - Erin Linnenbringer,
MS, PhD,
Washington University in St. Louis
Co-Author - Jessica Mozersky,
PhD,
Washington University in St. Louis
Co-Author - Erika A. Waters, PhD, MPH, FSBM,
Washington University in St. Louis
F192 - Implementation of the World’s First Healthy Checkout Policy: Process, Barriers, and Facilitators
Poster Number: F192Time: 11:00 AM - 11:50 AM
Topics: Health Communication and Policy, Social and Environmental Context and Health
Introduction: Berkeley, CA implemented the world’s first Healthy Checkout Ordinance in 2021, stipulating that sweetened beverages and foods high in sodium or sugar cannot be placed in grocery store checkout areas. Evaluation of the ordinance has found relatively high store compliance postimplementation. In this study, we aim to characterize the implementation process as well as implementation barriers and facilitators of this pivotal public health policy.
Methods: We conducted observations of meetings relevant to the ordinance held by a City of Berkeley Commission, the Berkeley City Council, and a Berkeley City Council subcommittee. We examined correspondences between Berkeley city staff overseeing policy enforcement and representatives from a local community-based organization involved in policy advocacy and implementation. We also reviewed a Berkeley City Audit Report and memos between city officials. Finally, we conducted semi-structured in-depth interviews with 11 retailers implementing the Healthy Checkout Ordinance.
Results:The first step in implementation—policy communication with retailers—was conducted by youth representatives of a community-based organization. Representatives provided information packets and visited Berkeley retailers subject to the ordinance to offer technical assistance. Efforts from this organization were funded by City Council based on recommendations from the City of Berkeley Commission established by Berkeley’s soda tax ordinance. Thus, facilitators of implementation included city-funded outreach to stores and buy-in from a city commission invested in the policy. A barrier to implementation was the delay of store inspections by one year due to limited city staff capacity. Despite this barrier, only 14% of stores were significantly out of compliance after inspections, reportedly due to confusion around the definition of the checkout area, a need for additional technical assistance, and in one case, retailer resistance. The majority of retailers (82%) reported that the ordinance was easy to implement but also shared that barriers to implementation included a lack of communication from the city beyond initial efforts when the policy was passed.
Conclusions: The world’s first Healthy Checkout Ordinance shows promise for improving retail food environments, in part due to initial store outreach and a dedicated subcommittee. Though, for optimal implementation, additional and ongoing technical assistance and enforcement are needed.
Keywords: Policy, NutritionMethods: We conducted observations of meetings relevant to the ordinance held by a City of Berkeley Commission, the Berkeley City Council, and a Berkeley City Council subcommittee. We examined correspondences between Berkeley city staff overseeing policy enforcement and representatives from a local community-based organization involved in policy advocacy and implementation. We also reviewed a Berkeley City Audit Report and memos between city officials. Finally, we conducted semi-structured in-depth interviews with 11 retailers implementing the Healthy Checkout Ordinance.
Results:The first step in implementation—policy communication with retailers—was conducted by youth representatives of a community-based organization. Representatives provided information packets and visited Berkeley retailers subject to the ordinance to offer technical assistance. Efforts from this organization were funded by City Council based on recommendations from the City of Berkeley Commission established by Berkeley’s soda tax ordinance. Thus, facilitators of implementation included city-funded outreach to stores and buy-in from a city commission invested in the policy. A barrier to implementation was the delay of store inspections by one year due to limited city staff capacity. Despite this barrier, only 14% of stores were significantly out of compliance after inspections, reportedly due to confusion around the definition of the checkout area, a need for additional technical assistance, and in one case, retailer resistance. The majority of retailers (82%) reported that the ordinance was easy to implement but also shared that barriers to implementation included a lack of communication from the city beyond initial efforts when the policy was passed.
Conclusions: The world’s first Healthy Checkout Ordinance shows promise for improving retail food environments, in part due to initial store outreach and a dedicated subcommittee. Though, for optimal implementation, additional and ongoing technical assistance and enforcement are needed.
Authors:
Presenter - Alexandria Reimold,
PhD,
University of California, Davis
Co-Author - Ethan Wolf,
MPH,
University of California, Davis
Co-Author - Noelle Chin,
University of California, Davis; University of California, Berkeley
Co-Author - Anna H Grummon,
Stanford University School of Medicine
Co-Author - Natalie Riva-Smith,
Harvard TH Chan School of Public Health
Co-Author - James Krieger,
University of Washington School of Public Health; Healthy Food America
Co-Author - Jennifer Falbe,
ScD, MPH,
UC Davis
F195 - Associations of Adolescents’ Food Preparation and Cooking Frequencies with Parental Restriction and Autonomy Support
Poster Number: F195Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Child and Family Health
Adolescence is marked by a global shift toward greater eating autonomy, but little is known how this autonomy is developed or in what ways eating autonomy may be associated with dietary intake. Previous research has shown adolescent intake is influenced by parental restriction, modeling, and the home-food environment more generally. It is likely that teens’ food preparation and cooking behaviors are important antecedents to their intake and ultimately overall diet quality. However, more research is needed to understand adolescents’ engagement in independent food preparation and cooking behaviors.
US adolescents (n=185) aged 12–17 years, were recruited through parent-directed Facebook ads for an online study to validate a new measure evaluating the construct of adolescent eating autonomy (including 7 cooking items). They also completed the Child Feeing Questionnaire (parental restriction, 7-items) and a survey of parental autonomy support in adolescents’ food choices (12-items). In this secondary data analysis, we used ANOVAs to test whether adolescents’ cooking engagement varies based on level of parental restriction and autonomy support. We hypothesized that high parental restriction and low parental autonomy support would be independently associated with lower adolescent food preparation and cooking. We also hypothesized that older age would be associated with more frequent cooking.
We found that high perceived parental restriction was associated with 40-50% lower frequency of teens’ preparation of snacks and use of various cooking methods [F range (1, 183) = 5.7-9.3 (all p <0.02)]. Similarly, low perceived parental autonomy support was associated with substantially lower frequency of all food preparation and cooking behaviors [F range (1, 182) = 6.4-15.9 (all p <0.01)] other than making dinner (p>0.05). Contrary to our hypothesis we found lower instances of breakfast, lunch, and snack preparation for older adolescents compared younger [F range (1, 182) = 4.1-7.8 (all p <0.04)].
This work begins to uncover elements of adolescents’ autonomous food preparation and cooking behaviors and their relationships to parental factors that may be inhibiting critical aspects of adolescent eating behavior development. Future work will examine mechanisms of adolescent eating autonomy development as well as investigate associations between food preparation behaviors, healthfulness of dietary intake, and broader health outcomes.
Keywords: Eating behaviors, AdolescentsUS adolescents (n=185) aged 12–17 years, were recruited through parent-directed Facebook ads for an online study to validate a new measure evaluating the construct of adolescent eating autonomy (including 7 cooking items). They also completed the Child Feeing Questionnaire (parental restriction, 7-items) and a survey of parental autonomy support in adolescents’ food choices (12-items). In this secondary data analysis, we used ANOVAs to test whether adolescents’ cooking engagement varies based on level of parental restriction and autonomy support. We hypothesized that high parental restriction and low parental autonomy support would be independently associated with lower adolescent food preparation and cooking. We also hypothesized that older age would be associated with more frequent cooking.
We found that high perceived parental restriction was associated with 40-50% lower frequency of teens’ preparation of snacks and use of various cooking methods [F range (1, 183) = 5.7-9.3 (all p <0.02)]. Similarly, low perceived parental autonomy support was associated with substantially lower frequency of all food preparation and cooking behaviors [F range (1, 182) = 6.4-15.9 (all p <0.01)] other than making dinner (p>0.05). Contrary to our hypothesis we found lower instances of breakfast, lunch, and snack preparation for older adolescents compared younger [F range (1, 182) = 4.1-7.8 (all p <0.04)].
This work begins to uncover elements of adolescents’ autonomous food preparation and cooking behaviors and their relationships to parental factors that may be inhibiting critical aspects of adolescent eating behavior development. Future work will examine mechanisms of adolescent eating autonomy development as well as investigate associations between food preparation behaviors, healthfulness of dietary intake, and broader health outcomes.
Authors:
Presenter - Amanda Ziegler,
University at Buffalo
Co-Author - Lori Hatzinger, MS,
MS,
University of Southern California
Co-Author - Jennifer L Temple,
University at Buffalo
F196 - Examining Dyadic Interdependence of Social Support and Health Behaviors in Black Breast Cancer Patients and Their Informal Caregivers
Poster Number: F196Time: 11:00 AM - 11:50 AM
Topics: Cancer, Social and Environmental Context and Health
Purpose: We examined whether Black women with breast cancer and their informal caregivers demonstrated interdependence in perceived social support and health behaviors.
Methods: Patients and caregivers completed phone surveys: T1, < 8 weeks of the patient’s initial cancer visit; T2, 2 months later; T3, 4 months later). Actor Partner Interdependence Models analyzed interdependence of perceived social support (Medical Outcomes Study Social Support Survey [MOS-SSS]) and health behaviors (a composite measure based on days of exercise/week, serving of fruits and vegetables/day, and smoking status). We hypothesized that patients and caregivers would demonstrate prospective interdependence (i.e., that one person’s measures at one timepoint would predict the other person’s measures at the next).
Results: 210 participants provided baseline data. All patients and 93% of caregivers identified as Black/African American. All patients and 70% of caregivers self-described as female. 65% of patients reported not living with their caregiver. Mean patient age was 58.5 (SD = 10.9); mean caregiver age was 49.9 (SD = 14.2). Mean baseline MOS-SSS scores were 82.4 (SD = 17.1) for patients and 82.9 (SD = 19.2) for caregivers.
Dyad members’ general levels of perceived social support were correlated (i.e., random intercepts for patient and caregiver MOS-SSS scores were correlated, r = .22, p = .03). Change in caregivers’ social support demonstrated significant variance (p = .02); some caregivers’ support decreased whereas others’ increased. There was a significant association between overall patient and caregiver health behavior scores (patient and caregiver random intercepts were correlated, r = .35, p = .01). Patients showed significant variance in change in health behaviors over time (p <.01); some demonstrated improving health behaviors whereas others demonstrated worsening health behaviors. There was no prospective dyadic interdependence for either social support or health behaviors.
Discussion: Our hypothesis—that dyads would demonstrate prospective interdependence in social support and health behaviors—was not supported. We did, however, find significant correlations in overall levels of social support as well as scores on the composite health behavior variable. Patients with low support or poor health behaviors may also have caregivers with low support or poor health behaviors. Screening patients and caregivers could identify pairs who may benefit from interventions.
Keywords: Cancer, CaregivingMethods: Patients and caregivers completed phone surveys: T1, < 8 weeks of the patient’s initial cancer visit; T2, 2 months later; T3, 4 months later). Actor Partner Interdependence Models analyzed interdependence of perceived social support (Medical Outcomes Study Social Support Survey [MOS-SSS]) and health behaviors (a composite measure based on days of exercise/week, serving of fruits and vegetables/day, and smoking status). We hypothesized that patients and caregivers would demonstrate prospective interdependence (i.e., that one person’s measures at one timepoint would predict the other person’s measures at the next).
Results: 210 participants provided baseline data. All patients and 93% of caregivers identified as Black/African American. All patients and 70% of caregivers self-described as female. 65% of patients reported not living with their caregiver. Mean patient age was 58.5 (SD = 10.9); mean caregiver age was 49.9 (SD = 14.2). Mean baseline MOS-SSS scores were 82.4 (SD = 17.1) for patients and 82.9 (SD = 19.2) for caregivers.
Dyad members’ general levels of perceived social support were correlated (i.e., random intercepts for patient and caregiver MOS-SSS scores were correlated, r = .22, p = .03). Change in caregivers’ social support demonstrated significant variance (p = .02); some caregivers’ support decreased whereas others’ increased. There was a significant association between overall patient and caregiver health behavior scores (patient and caregiver random intercepts were correlated, r = .35, p = .01). Patients showed significant variance in change in health behaviors over time (p <.01); some demonstrated improving health behaviors whereas others demonstrated worsening health behaviors. There was no prospective dyadic interdependence for either social support or health behaviors.
Discussion: Our hypothesis—that dyads would demonstrate prospective interdependence in social support and health behaviors—was not supported. We did, however, find significant correlations in overall levels of social support as well as scores on the composite health behavior variable. Patients with low support or poor health behaviors may also have caregivers with low support or poor health behaviors. Screening patients and caregivers could identify pairs who may benefit from interventions.
Authors:
Presenter - Tess Thompson, PhD, MPH,
PhD, MPH,
UNC-Chapel Hill
Author - Thomas Rodebaugh,
PhD,
University of North Carolina at Chapel Hill
Author - Katherine Glover-Collins,
MD,
Washington University School of Medicine
Author - Julie Margenthaler,
MD,
Washington University School of Medicine
Author - Graham Colditz,
MD, DrPH,
Washington University School of Medicine
F197 - Validation of the Functional Assessment of Cancer Therapy – Immune Checkpoint Modulator Symptom Index (FACT-ICM SI-17) to Facilitate Implementation for Research and Clinical Care
Poster Number: F197Time: 11:00 AM - 11:50 AM
Topics: Cancer, Methods and Measurement
Background: Immune checkpoint modulators (ICM) have revolutionized treatment for various cancer types. However, ICMs have unique mechanistic immune-related adverse events (irAEs) that are distinct from those seen with other systemic anti-neoplastic agents. The goal of the current study was to select and validate a smaller set of items from the FACT-ICM item bank to assess the most common, distressing, and diagnostically useful symptomatic irAEs to facilitate implementation for research and clinical care.
Method: We generated items assessing symptomatic irAEs through a multi-step process of 1) literature review and iterative expert input and 2) qualitative interviews of patients, caregivers, and clinicians regarding irAEs and quality of life (QOL) secondary to receipt of an ICM. We then administered an initial set of items across five longitudinal or cross-sectional studies. We used a Delphi method to select a final set of items and evaluated its validity, reliability, minimally important differences (MIDs), and sensitivity to change.
Results: Qualitative interviews were conducted with 14 patients, 7 caregivers, and 6 clinicians. Findings informed an initial set of 46 symptomatic irAEs, which we administered to 501 patients treated with an ICM (N=501, 52% female, mean age = 64), diagnosed with non-small cell lung cancer (n=342), head and neck cancer (n=72), melanoma (n=46), or renal cell carcinoma (n=43), and recruited from an international lung cancer registry or a comprehensive cancer center. A final set of the most common, distressing, and diagnostically useful symptomatic irAEs was selected, validated, and mapped to FACIT items. This produced the 17-item FACT-ICM Symptom Index (FACT-ICM SI-17). We calculated reliability (α=0.86), construct validity (CFI=0.93), convergent validity with FACT-G, EORTC QLQ-C30, and EQ-5D measures of physical QOL (r=0.69–0.73), discriminant validity with emotional and social QOL (r=0.03–0.65), and criterion validity (i.e., patients reporting better ECOG performance status also reported fewer concerns). We confirmed that response option anchors adequately captured MIDs and were sensitive to change.
Conclusions: The FACT-ICM SI-17 demonstrates construct, convergent, and divergent validity and reliability, minimally important difference, and sensitivity to change. This brief, validated version of the FACT-ICM is optimized and ready for use in research and clinical care.
Keywords: Cancer survivorship, MeasurementMethod: We generated items assessing symptomatic irAEs through a multi-step process of 1) literature review and iterative expert input and 2) qualitative interviews of patients, caregivers, and clinicians regarding irAEs and quality of life (QOL) secondary to receipt of an ICM. We then administered an initial set of items across five longitudinal or cross-sectional studies. We used a Delphi method to select a final set of items and evaluated its validity, reliability, minimally important differences (MIDs), and sensitivity to change.
Results: Qualitative interviews were conducted with 14 patients, 7 caregivers, and 6 clinicians. Findings informed an initial set of 46 symptomatic irAEs, which we administered to 501 patients treated with an ICM (N=501, 52% female, mean age = 64), diagnosed with non-small cell lung cancer (n=342), head and neck cancer (n=72), melanoma (n=46), or renal cell carcinoma (n=43), and recruited from an international lung cancer registry or a comprehensive cancer center. A final set of the most common, distressing, and diagnostically useful symptomatic irAEs was selected, validated, and mapped to FACIT items. This produced the 17-item FACT-ICM Symptom Index (FACT-ICM SI-17). We calculated reliability (α=0.86), construct validity (CFI=0.93), convergent validity with FACT-G, EORTC QLQ-C30, and EQ-5D measures of physical QOL (r=0.69–0.73), discriminant validity with emotional and social QOL (r=0.03–0.65), and criterion validity (i.e., patients reporting better ECOG performance status also reported fewer concerns). We confirmed that response option anchors adequately captured MIDs and were sensitive to change.
Conclusions: The FACT-ICM SI-17 demonstrates construct, convergent, and divergent validity and reliability, minimally important difference, and sensitivity to change. This brief, validated version of the FACT-ICM is optimized and ready for use in research and clinical care.
Authors:
Presenter - Lisa M. Gudenkauf,
PhD, MPH,
Moffitt Cancer Center
Co-Author - Danielle B. Tometich,
PhD,
University of South Florida
Co-Author - Aasha I. Hoogland,
PhD,
Moffitt Cancer Center
Co-Author - Kedar Kirtane,
MD,
Moffitt Cancer Center
Co-Author - Brent J. Small,
PhD,
University of North Carolina at Chapel Hill
Co-Author - Anna Barata,
PhD,
Mass General Cancer Center
Co-Author - Brian D. Gonzalez,
PhD,
Moffitt Cancer Center
Co-Author - Christine Chung,
MD,
Moffitt Cancer Center
Co-Author - Nikhil Khushalani,
MD,
Moffitt Cancer Center
Co-Author - David Cella,
PhD,
Northwestern University Feinberg School of Medicine
Co-Author - Kimberly A. Webster,
MA,
Northwestern University Feinberg School of Medicine
Co-Author - Adam P. Dicker,
MD,
Thomas Jefferson University
Co-Author - Heather S.L. Jim,
PhD,
Moffitt Cancer Center
F198 - Health Care Time Disparities Among Older Adults with Cancer in the U.S.: Evidence from the Health and Retirement Study (2012 to 2018)
Poster Number: F198Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health of Marginalized Populations
Background: The growing burden of healthcare needs among older adults diagnosed with cancer in the United States necessitates a deeper understanding of how this population engages with the healthcare system. Time spent receiving healthcare can be a critical indicator of access to care and patient burden which can result in disparities within this group. This study explores factors associated with the heterogeneity observed in time spent receiving healthcare.
Method: We used data from the 2012 to 2018 Health and Retirement Study, a nationally representative longitudinal survey of older U.S. adults. The survey asks “Yesterday, did you do health-related activities other than walking or exercising (e.g., visiting a doctor, taking medications, doing treatments)?” and records the duration in minutes and hours. The time variable is defined as binary, with 1 indicating more than an hour spent on healthcare and 0 indicating an hour or less. Logistic regression was conducted to examine the predictors of time spent on receiving healthcare among individuals diagnosed with cancer.
Results: Of 24,907 respondents, 4,178 (17%) were identified as cancer survivors. This subgroup had an average age of 70.6 years, with 55.6% female and 15.6% Black. Most had no income (74.5%), and 52.8% had only high school diploma. Most of the sample had Medicare alone (27.2%) or combined with other insurance (35.8%). Results revealed that males had a 6% higher chance of spending over an hour on receiving care compared to females (OR=1.06, p<0.01). Patients with no income faced significantly higher odds of spending more than an hour on receiving care compared to those with annual earning $100K or more (OR=4.09, p<0.01). Black patients were 20% more likely to spend over an hour receiving care than White patients (OR=1.20, p<0.001). Patients with dual Medicare/Medicaid coverage had substantially higher odds of spending more than an hour on receiving care (OR=2.46, p<0.01).
Conclusion: Findings showed certain demographic and socioeconomic factors, particularly being Black or having dual eligibility, significantly increase the likelihood of cancer patients spending more time receiving care—groups already known to experience lower quality of care. These findings underscore the need for further research to better understand the mechanisms underlying the differences in the time spent receiving healthcare as well as the relation between the quality and amount of care patients receive.
Keywords: Cancer survivorship, DisparitiesMethod: We used data from the 2012 to 2018 Health and Retirement Study, a nationally representative longitudinal survey of older U.S. adults. The survey asks “Yesterday, did you do health-related activities other than walking or exercising (e.g., visiting a doctor, taking medications, doing treatments)?” and records the duration in minutes and hours. The time variable is defined as binary, with 1 indicating more than an hour spent on healthcare and 0 indicating an hour or less. Logistic regression was conducted to examine the predictors of time spent on receiving healthcare among individuals diagnosed with cancer.
Results: Of 24,907 respondents, 4,178 (17%) were identified as cancer survivors. This subgroup had an average age of 70.6 years, with 55.6% female and 15.6% Black. Most had no income (74.5%), and 52.8% had only high school diploma. Most of the sample had Medicare alone (27.2%) or combined with other insurance (35.8%). Results revealed that males had a 6% higher chance of spending over an hour on receiving care compared to females (OR=1.06, p<0.01). Patients with no income faced significantly higher odds of spending more than an hour on receiving care compared to those with annual earning $100K or more (OR=4.09, p<0.01). Black patients were 20% more likely to spend over an hour receiving care than White patients (OR=1.20, p<0.001). Patients with dual Medicare/Medicaid coverage had substantially higher odds of spending more than an hour on receiving care (OR=2.46, p<0.01).
Conclusion: Findings showed certain demographic and socioeconomic factors, particularly being Black or having dual eligibility, significantly increase the likelihood of cancer patients spending more time receiving care—groups already known to experience lower quality of care. These findings underscore the need for further research to better understand the mechanisms underlying the differences in the time spent receiving healthcare as well as the relation between the quality and amount of care patients receive.
Authors:
Presenter - Asal Pilehvari, PhD,
PhD,
University of Virginia
Co-Author - Anthony Asuncion,
BA,
UNiversity of Virginia
Co-Author - Nao Hagiwara,
PhD,
University of Virginia
Co-Author - Wen You, PhD,
PhD,
University of Virginia
Co-Author - KAthleen porter,
PhD,
University of Virginia
Poster Session F
Description
Date: 3/29/2025
Start: 11:00 AM
End: 11:50 AM
Location: Grand Ballroom A-B