Times are displayed in (UTC-05:00) Central Time (US & Canada) Change
Poster Session B
Effects of a Dyadic Multicomponent Lifestyle Intervention in Dementia Care: Results of a Pilot Study
Poster Number: B1Time: 11:00 AM - 11:50 AM
Topics: Aging, Diet, Nutrition, and Eating Disorders
Background: Malnutrition risk is elevated amongst persons with dementia (PWD) and their care partners (CP), with evidence suggesting this risk is interdependent within dyads. However, few interventions target both members of the dyad to address the multiple factors contributing to nutrition risk. The objective of this study was to pilot test the effect on nutrition risk and functional status of “ADMIRE,” a novel multicomponent lifestyle intervention to support healthy nutrition, exercise, sleep, stress management, and social connection among dyads comprised of PWD and CP.
Methods: Guided by the Theory of Dyadic Illness Management, the ADMIRE intervention virtually delivered dyadic counseling, group exercise classes, group discussion and self-monitoring for 8 weeks to a single-arm cohort comprised of PWD and CP who resided at home (i.e. non-institutionalized). The intervention adapted two previously tested interventions: 1) A dyadic multicomponent virtual exercise intervention, “Move 2-gether”; and 2) A group-based curriculum for dyads, “DEmentia Lifestyle Intervention Program for Getting Healthy Together.” Primary outcomes of interest were change in nutrition risk as measured by the 18-item Mini Nutrition Assessment (MNA) and physical function as measured by handgrip strength. The MNA was performed by trained research dietitians at baseline and study end. Handgrip strength was averaged from 3 measures per timepoint, collected using the Jamar hand dynamometer on the dominant hand. A T-score was calculated using normative standards for age and biological sex.
Results: Seven dyads were enrolled, and all completed the intervention. Dyads were all spouses, 4/7 CP were male, 4/7 PWD were female, and PWD had moderate dementia on average. At baseline, nutrition risk was present in 4/7 PWD and 3/7 CP. Participant adherence to study activities overall was 76% for PWD and 83% for CP. PWD improved nutrition risk [MNA +2.1 ± 2.0, 95%CI (.21, 3.9), p=.03] and showed a trend for increased handgrip strength [0.55 ± 0.85, 95%CI (-.24,1.33), p=.14]. CP showed a potentially improved nutrition risk [MNA +1.2 ± 2.9, 95%CI (-1.4, 3.9), p=.31] and increased handgrip strength [0.20±0.19, 95%CI (.02, .37), p=.03].
Conclusions: Preliminary data indicate the ADMIRE intervention shows strong potential for improving nutrition risk and functional status among dyads of PWD and CP. A randomized controlled trial with an adequately powered sample is needed to confirm these effects.
Keywords: Caregiving, NutritionMethods: Guided by the Theory of Dyadic Illness Management, the ADMIRE intervention virtually delivered dyadic counseling, group exercise classes, group discussion and self-monitoring for 8 weeks to a single-arm cohort comprised of PWD and CP who resided at home (i.e. non-institutionalized). The intervention adapted two previously tested interventions: 1) A dyadic multicomponent virtual exercise intervention, “Move 2-gether”; and 2) A group-based curriculum for dyads, “DEmentia Lifestyle Intervention Program for Getting Healthy Together.” Primary outcomes of interest were change in nutrition risk as measured by the 18-item Mini Nutrition Assessment (MNA) and physical function as measured by handgrip strength. The MNA was performed by trained research dietitians at baseline and study end. Handgrip strength was averaged from 3 measures per timepoint, collected using the Jamar hand dynamometer on the dominant hand. A T-score was calculated using normative standards for age and biological sex.
Results: Seven dyads were enrolled, and all completed the intervention. Dyads were all spouses, 4/7 CP were male, 4/7 PWD were female, and PWD had moderate dementia on average. At baseline, nutrition risk was present in 4/7 PWD and 3/7 CP. Participant adherence to study activities overall was 76% for PWD and 83% for CP. PWD improved nutrition risk [MNA +2.1 ± 2.0, 95%CI (.21, 3.9), p=.03] and showed a trend for increased handgrip strength [0.55 ± 0.85, 95%CI (-.24,1.33), p=.14]. CP showed a potentially improved nutrition risk [MNA +1.2 ± 2.9, 95%CI (-1.4, 3.9), p=.31] and increased handgrip strength [0.20±0.19, 95%CI (.02, .37), p=.03].
Conclusions: Preliminary data indicate the ADMIRE intervention shows strong potential for improving nutrition risk and functional status among dyads of PWD and CP. A randomized controlled trial with an adequately powered sample is needed to confirm these effects.
Authors:
Presenter - Heather Gibbs, PhD, RD, University of Kansas Medical Center
Co-Author - Rebecca Mount, MS, RD, University of Kansas Medical Center
Co-Author - Jinxiang Hu, PhD, University of Kansas Medical Center
Co-Author - Cheryl Gibson, PhD, University of Kansas
Co-Author - Heather Keller, PhD, RD, University of Waterloo
Co-Author - Carrie McAiney, PhD, University of Waterloo
Co-Author - Laura Middleton, PhD, University of Waterloo
Co-Author - Debra Sullivan, PhD RD, University of Kansas Medical Center
Co-Author - Kristi Williams, PhD, RN, University of Kansas Medical Center
Co-Author - Lauren Ptomey, PhD, University of Kansas Medical Center
Recruitment of Black and African American Older Adults with Cognitive Decline and Their Caregivers for Informational Focus Group Interviews: Recruitment Strategies
Poster Number: B2Time: 11:00 AM - 11:50 AM
Topics: Aging, Health Disparities
Black and African American individuals experience disproportionately high levels of dementia and cognitive decline. Cognitive rehabilitation interventions can provide strategies to manage these changes, but intervention effectiveness is dependent on proper cultural sensitivity in the development, implementation, and distribution of the program. Currently, barriers exist in the delivery and recruitment of these programs, including lack of sensitivity towards unique needs for the racial and cultural considerations of the patient population and shortcomings in outreach and connection. The objective of this mixed-methods study was to inform the development of the CogCARE intervention: a program for older African American adults with mild to moderate dementia and their caregivers, which would provide strategies to manage stress levels, quality of life, and cognitive functioning. Through focus groups and recruitment, we sought to address and learn more about how to properly deliver this information to the desired population. We describe recruitment strategies and obstacles faced in gathering participant opinions and experiences with cognitive rehabilitation interventions. Over a period of six months, 58 participants were contacted, of which 20 participated in the focus group interviews, with 17 patient-participants and 3 caregivers. Recruitment strategies were varied and included flyers, community presentations, an MGB research recruitment website (Rally), and word of mouth. Presentations were held at various local community and senior centers, virtually and in person, in singular and serial manners, and for varied audience sizes (ranging from 2 to 70+ attendees). Examination of recruitment efforts demonstrated that community-engaged recruitment strategies were not only the most effective but also facilitated increased amounts of trust between patients and program staff. Participants mentioned the importance of familiarity of those delivering the program as rapport was established at these presentations through participant engagement and Q&A sessions. Results emphasize the importance of novel strategies to overcome barriers to recruitment of racially diverse populations, namely engagement in Black and African American communities. Community presentations were the most effective method of recruitment and were reflective of participant commentary during focus groups that noted how essential trust and personal connection were in reaching the target population.
Keywords: Older adults, CaregivingAuthors:
Co-Author - Yoojee Kim, Massachusetts General Hospital
Co-Author - Dumichel Harley, Massachusetts General Hospital
Co-Author - Ryan Mace, PhD, Massachusetts General Hospital/Harvard Medical School
Effectiveness of Individualized Music Listening to Reduce Agitation in Elderly Residents With Dementia: A Quality Improvement Project
Poster Number: B3Time: 11:00 AM - 11:50 AM
Topics: Aging, Implementation Science
Background
Agitation is common in dementia and worsens quality of life while burdening caregivers. Nonpharmacologic approaches are prioritized in nursing homes.
Objective
To evaluate whether individualized music listening reduces agitation among residents with dementia.
Methods
This quasi-experimental, pre–post quality improvement project was conducted in an urban Texas nursing home. Thirty-four residents received MP3 players with personalized playlists and listened daily for 15–30 minutes over three weeks. Agitation was measured using the Cohen–Mansfield Agitation Inventory (CMAI). Paired t tests assessed change.
Results
CMAI decreased from 108.7 (SD 9.5) to 91.6 (SD 8.7). Mean change −17.1, SE 2.08, 95% CI −21.3 to −12.9, t(33) = −8.21, p < .001, effect size dz = 1.41. Staff reported improved engagement and positive mood. No adverse events occurred.
Conclusions
Individualized music listening was feasible, low cost, and associated with clinically meaningful reductions in agitation. Findings support broader evaluation and implementation of person-centered music programs.
Keywords: Mental health, AgingAgitation is common in dementia and worsens quality of life while burdening caregivers. Nonpharmacologic approaches are prioritized in nursing homes.
Objective
To evaluate whether individualized music listening reduces agitation among residents with dementia.
Methods
This quasi-experimental, pre–post quality improvement project was conducted in an urban Texas nursing home. Thirty-four residents received MP3 players with personalized playlists and listened daily for 15–30 minutes over three weeks. Agitation was measured using the Cohen–Mansfield Agitation Inventory (CMAI). Paired t tests assessed change.
Results
CMAI decreased from 108.7 (SD 9.5) to 91.6 (SD 8.7). Mean change −17.1, SE 2.08, 95% CI −21.3 to −12.9, t(33) = −8.21, p < .001, effect size dz = 1.41. Staff reported improved engagement and positive mood. No adverse events occurred.
Conclusions
Individualized music listening was feasible, low cost, and associated with clinically meaningful reductions in agitation. Findings support broader evaluation and implementation of person-centered music programs.
Authors:
Presenter - Karim Ladak, BS, University of Texas at Austin, Dept of Computational Biology & Engineering
Co-Author - Rozina Ladak, DNP, FNP, South Texas Veterans Health Care Systems
A preliminary qualitative analysis of patient experiences with age-related macular degeneration (AMD) in Expressive Arts Therapy
Poster Number: B4Time: 11:00 AM - 11:50 AM
Topics: Aging, Quality of Life
Introduction: Age-related macular degeneration (AMD), characterized by the progressive loss of central vision in middle-aged and older adults, can significantly impact psychosocial well-being. This study aimed to explore the experiences of patients with AMD who participated in an Expressive Arts therapy (EXAT), particularly the changes related to their psychosocial well-being.
Methods: This qualitative study was embedded within an ongoing randomized controlled trial that evaluates the psychosocial impacts of Expressive Arts Therapy (EXAT) on patients with AMD. The EXAT involved eight weekly sessions utilizing multiple art modalities designed to address the psychosocial needs of patients with AMD, including developing flexibility. Eight participants (aged 58-79, 62.5% female), who were randomized to the EXAT group, were invited to take part in an in-depth interview at the post-intervention time-point to share their experiences. Thematic analysis was adopted to analyze the qualitative data.
Results: Four themes were identified: 1) cultivating positivity from shared experiences, 2) establishing social bonds, 3) letting go, and 4) ventilating negative emotions. The themes demonstrated that participants were buoyed by others’ experiences in coping with the challenges and limitations related to AMD. As they shared similar experiences in living with AMD, it was easier for them to build connections and support one another. Participants were inspired by arts activities that letting go can be an effective coping strategy. Participants also reported they could express their sadness and anxiety via arts-making and group sharing. Their mood mainly remained stable after EXAT as they already had their own strategies for managing emotional challenges.
Conclusion: The findings suggest that EXAT may promote psychosocial well-being in patients with AMD. Improvements in positive mood may not be palpable among participants, possibly due to the potential recruitment bias of the study, as recruited participants tended to be more proactive in facing the adversities associated with AMD. Follow-up interviews will be conducted to explore how the insights gained from EXAT can be applied and further developed in participants’ daily lives.
Keywords: Aging, Complementary MedicineMethods: This qualitative study was embedded within an ongoing randomized controlled trial that evaluates the psychosocial impacts of Expressive Arts Therapy (EXAT) on patients with AMD. The EXAT involved eight weekly sessions utilizing multiple art modalities designed to address the psychosocial needs of patients with AMD, including developing flexibility. Eight participants (aged 58-79, 62.5% female), who were randomized to the EXAT group, were invited to take part in an in-depth interview at the post-intervention time-point to share their experiences. Thematic analysis was adopted to analyze the qualitative data.
Results: Four themes were identified: 1) cultivating positivity from shared experiences, 2) establishing social bonds, 3) letting go, and 4) ventilating negative emotions. The themes demonstrated that participants were buoyed by others’ experiences in coping with the challenges and limitations related to AMD. As they shared similar experiences in living with AMD, it was easier for them to build connections and support one another. Participants were inspired by arts activities that letting go can be an effective coping strategy. Participants also reported they could express their sadness and anxiety via arts-making and group sharing. Their mood mainly remained stable after EXAT as they already had their own strategies for managing emotional challenges.
Conclusion: The findings suggest that EXAT may promote psychosocial well-being in patients with AMD. Improvements in positive mood may not be palpable among participants, possibly due to the potential recruitment bias of the study, as recruited participants tended to be more proactive in facing the adversities associated with AMD. Follow-up interviews will be conducted to explore how the insights gained from EXAT can be applied and further developed in participants’ daily lives.
Authors:
Author - Temmy L. T. LO, Centre on Behavioral Health, The University of Hong Kong
Author - Bonnie H. T. WONG, Centre on Behavioral Health, The University of Hong Kong
Author - W. C. CHAN, Department of Psychiatry, The University of Hong Kong
Author - Allen M. Y. CHEONG, School of Optometry, The Hong Kong Polytechnic University
Author - W. C. LAM, Department of Ophthalmology, The University of Hong Kong
Author - Q LI, Department of Ophthalmology, The University of Hong Kong
Author - Adrian H. Y. WAN, Centre on Behavioral Health, The University of Hong Kong
Presenter - Rainbow T. H. HO, PhD, BC-DMT, AThR, REAT, RSMT, CGP, CMA, Centre on Behavioral Health, The University of Hong Kong; Department of Social Work and Social Administration, The University of Hong Kong
Differential Associations of Education, Sex, and Lifestyle Factors with Cognitive Performance Across Data-Driven Aging Clusters
Poster Number: B5Time: 11:00 AM - 11:50 AM
Topics: Aging, Social and Environmental Context and Health
Latinos in the U.S. face a high risk for Alzheimer’s Disease and Related Dementias (ADRD) due to modifiable factors such as low education, poor sleep, inactivity, obesity, unhealthy diets, and chronic conditions. These risk factors often cluster, highlighting the importance of examining their combined effect on cognition. This study examined associations between clusters of ADRD risk factors and cognitive outcomes among Latinos. A cross-sectional study of middle-aged and older Latino adults (n=61) assessed demographics, chronic conditions, self-reported physical activity (PA), MIND diet adherence, and cognition. Key risk factors (age ≥ 65, BMI > 30, low education, poor sleep, inactivity, low MIND diet adherence, and number of chronic conditions) were dichotomized. Agglomerative clustering was used to identify data-driven risk profiles, and t-tests and linear regression analyzed within- and between-cluster differences. Cluster 1 participants were younger, fewer chronic conditions, and reported poorer behaviors (i.e., poorer sleep patterns, poorer diet and less PA compared to Cluster 2. Cluster 1 demonstrated significantly better cognitive performance than Cluster 2, with higher scores in global cognition (0.45 ± 0.52 vs. -0.38 ± 0.47, p < 0.01), working memory (0.33 ± 0.60 vs. -0.29 ± 0.54, p < 0.001), and episodic memory (0.40 ± 0.56 vs. -0.33 ± 0.50, p < 0.001). Within Cluster 1, lower education was associated with reduced global cognition (β = -0.28, p < 0.001), being male was associated with lower episodic memory (β = -0.19, p = 0.002), and higher BMI was associated with better episodic memory (β = 0.13, p = 0.034). In cluster 2, lower PA was associated with poorer global cognition (β = 0.22, p = 0.017) and episodic memory (β = 0.20, p = 0.022), while higher BMI was associated with lower episodic memory (β = -0.16, p = 0.018). Multivariate models confirmed education as the most consistent predictor of cognitive performance, while the effects of PA and BMI were prominent but not statistically significant in cluster 2. Findings suggest education was the strongest and most consistent predictor of cognitive performance among Latinos, even when other risk factors were present. As people age, physiological changes and reduced PA levels may further impact cognition. Interventions that combine educational and lifestyle strategies may support brain health and reduce ADRD risk in this population.
Keywords: Cognitive factors, Health behaviorsAuthors:
Presenter - Diana Morales, BS, University of Illinois at Urbana-Champaign
Co-Author - Christian Corral, University of Illinois Urbana Champaign
Co-Author - Jacqueline Guzman, PhD, Medical College of Wisconsin
Co-Author - Yuliana Soto, PhD, University of Illinois at Chicago
Co-Author - Edgar Munoz, University of Illinois Urbana-Champaign
Co-Author - Susan Aguiñaga, PhD, University of Illinois at Urbana-Champaign
Better Bone Health in Senior Centers: An Innovative Education Program for Behavior Change Among Older Adults
Poster Number: B6Time: 11:00 AM - 11:50 AM
Topics: Aging, Women's Health
Background
About 1 in 10 people in the US aged 50 and older have osteoporosis, a disease characterized by weakened bones and higher risk for fractures. Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis. While there is no cure, strategies to prevent bone fractures include screening, eating healthy, and getting physical activity.
Purpose
This program aims to raise awareness of osteoporosis among community-dwelling older adults and motivate them to take preventive measures toward preserving their bone health.
Methods
Five senior centers across four states (FL, MD, NY and VT) were invited to host a 90-minute educational program in which a local medical expert on bone health gave a lecture about osteoporosis followed by a peer led-interactive discussion based on the National Council on Aging’s “Better Bone Health" (BBH) Guide. The latter is a tool designed to increase participation; set goals around nutrition, physical activity, and screening; assess personal risk for fractures and falls; and document answers to doctor’s questions. Two weeks after the event, participants were sent an online / paper survey to evaluate their satisfaction, knowledge, and behaviors toward bone health.
Results
Over 290 older adults aged 50-95 years old participated in the BBH events and completed surveys. On average, 80% were satisfied with the program. Nearly half found the BBH guide with action steps very useful and said it increased their knowledge about bone health. Some of the key behavior changes participants have made or plan to make were on physical activity (52%); diet (44%); and getting a bone density screening (DXA) through their doctor (23%).
Conclusion and Recommendations
The BBH events were effective community-based interventions to improve bone health awareness among older adults. Future work should consider including on site bone density screening components to motivate older adults—especially postmenopausal women—to obtain further evaluation and diagnosis of their bone health.
Keywords: Musculoskeletal disorders, Women's healthAbout 1 in 10 people in the US aged 50 and older have osteoporosis, a disease characterized by weakened bones and higher risk for fractures. Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis. While there is no cure, strategies to prevent bone fractures include screening, eating healthy, and getting physical activity.
Purpose
This program aims to raise awareness of osteoporosis among community-dwelling older adults and motivate them to take preventive measures toward preserving their bone health.
Methods
Five senior centers across four states (FL, MD, NY and VT) were invited to host a 90-minute educational program in which a local medical expert on bone health gave a lecture about osteoporosis followed by a peer led-interactive discussion based on the National Council on Aging’s “Better Bone Health" (BBH) Guide. The latter is a tool designed to increase participation; set goals around nutrition, physical activity, and screening; assess personal risk for fractures and falls; and document answers to doctor’s questions. Two weeks after the event, participants were sent an online / paper survey to evaluate their satisfaction, knowledge, and behaviors toward bone health.
Results
Over 290 older adults aged 50-95 years old participated in the BBH events and completed surveys. On average, 80% were satisfied with the program. Nearly half found the BBH guide with action steps very useful and said it increased their knowledge about bone health. Some of the key behavior changes participants have made or plan to make were on physical activity (52%); diet (44%); and getting a bone density screening (DXA) through their doctor (23%).
Conclusion and Recommendations
The BBH events were effective community-based interventions to improve bone health awareness among older adults. Future work should consider including on site bone density screening components to motivate older adults—especially postmenopausal women—to obtain further evaluation and diagnosis of their bone health.
Authors:
Author - Dorothea Vafiadis, MS, National Council on Aging
Co-Author - Gretchen Tanbonliong, MS, MPH, RDN, MCHES, National Council on Aging
Co-Author - Kerry Glova, MPA, MSW, National Council on Aging
Gender Differences in Patient-Reported Lung Cancer Stigma following Empathic Communication Training for Clinicians
Poster Number: B7Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health Communication and Policy
BACKGROUND: Lung cancer stigma can impede care, particularly for patients with a smoking history who may experience blame or shame that undermines trust and communication with clinicians. Empathic communication—recognizing and responding to opportunities to convey understanding and support—may improve patient experiences. Empathic communication skills (ECS) training can enhance patient-reported satisfaction with communication. Little is known about whether ECS training influences stigma differently across subgroups. Gender may be important: women may show heightened moral sensitivity to stigma-related cues, while men may emphasize clinicians’ emotional attunement. This study examined (Aim 1) gender differences in perceived stigma pre- and post-ECS training, and (Aim 2) whether perceptions of clinician empathy and communication satisfaction differ by gender and relate to stigma. Exploratory analyses also considered marital status, as social support contexts may further shape stigma experiences.
METHODS: Participants were 129 patients with lung cancer (51% male; ages 42–85; 67% married) with current or former smoking history, recruited from a major cancer center in NYC (2017–2019; NCT02732834). Of these, 79 (61%) were assessed pre-ECS and 50 (39%) post-ECS. Aim 1 used a two-way ANOVA (gender × pre/post ECS) on Lung Cancer Stigma Inventory (LCSI) scores. Aim 2 used t-tests and correlations to examine gender differences in empathy (CARE) and communication satisfaction (CAHPS) and their associations with stigma. Exploratory analyses tested marital status as a moderator, examining gender × marital status effects and comparing married vs. unmarried patients within gender.
RESULTS: No significant effects of gender, pre/post status, or their interaction were observed for LCSI total or subscale scores. Married men reported higher internalized stigma than unmarried men (M=25.96 vs. 18.91, p=.031), with no differences among women. No gender differences were observed in CARE or CAHPS. Constrained disclosure was negatively associated with CAHPS (r=-.240, p=.016) and approached significance with CARE (r=-.222, p=.051).
CONCLUSIONS: Gender was not associated with stigma or empathy, but married men reported higher internalized stigma, challenging assumptions about social support. Constrained disclosure was linked to lower communication satisfaction, highlighting how withholding concerns may shape patient experiences and the importance of relational factors in care.
Keywords: Health communication, GenderMETHODS: Participants were 129 patients with lung cancer (51% male; ages 42–85; 67% married) with current or former smoking history, recruited from a major cancer center in NYC (2017–2019; NCT02732834). Of these, 79 (61%) were assessed pre-ECS and 50 (39%) post-ECS. Aim 1 used a two-way ANOVA (gender × pre/post ECS) on Lung Cancer Stigma Inventory (LCSI) scores. Aim 2 used t-tests and correlations to examine gender differences in empathy (CARE) and communication satisfaction (CAHPS) and their associations with stigma. Exploratory analyses tested marital status as a moderator, examining gender × marital status effects and comparing married vs. unmarried patients within gender.
RESULTS: No significant effects of gender, pre/post status, or their interaction were observed for LCSI total or subscale scores. Married men reported higher internalized stigma than unmarried men (M=25.96 vs. 18.91, p=.031), with no differences among women. No gender differences were observed in CARE or CAHPS. Constrained disclosure was negatively associated with CAHPS (r=-.240, p=.016) and approached significance with CARE (r=-.222, p=.051).
CONCLUSIONS: Gender was not associated with stigma or empathy, but married men reported higher internalized stigma, challenging assumptions about social support. Constrained disclosure was linked to lower communication satisfaction, highlighting how withholding concerns may shape patient experiences and the importance of relational factors in care.
Authors:
Author - Wynta Alexander, MA, Memorial Sloan Kettering Cancer Center
Co-Author - Smita Banerjee, PhD, Memorial Sloan Kettering
Co-Author - Carma Bylund, PhD, University of Florida
Co-Author - Heidi Hamann, PhD, University of Arizona
Co-Author - Noshin Haque, BA, Memorial Sloan Kettering Cancer Center
Co-Author - Aimee Moreno, BA, Memorial Sloan Kettering Cancer Center
Co-Author - Bernard J. Park, MD, Memorial Sloan Kettering Cancer Center
Co-Author - Patricia A Parker , PhD, Memorial Sloan Kettering Cancer Center
Co-Author - Maureen Rigney, LCSW, Lung Cancer Alliance
Co-Author - Elizabeth Schofield, MPH, Memorial Sloan Kettering Cancer Center
Co-Author - Megan Shen, PhD, FSBM, Fred Hutchinson Cancer Center
Co-Author - Timothy Williamson, PhD, MPH, Loyola Marymount University
Co-Author - Jamie Ostroff, PhD, FSBM, Memorial Sloan-Kettering Cancer Center
How Food Insecurity Alters Cancer Progression and Treatment Outcomes: A Scoping Review
Poster Number: B9Time: 11:00 AM - 11:50 AM
Topics: Cancer, Diet, Nutrition, and Eating Disorders
Background and Objectives: Cancer treatments are often associated with poor nutritional status and a range of late-effect health complications that can negatively impact overall health outcomes. Food insecurity, defined as limited access to sufficient nutritious foods, may exacerbate poor nutritional status and, consequently, negatively impact the health outcomes of cancer patients. This scoping review explored the physical health-related outcomes of food insecurity in individuals diagnosed with cancer, across all age groups, cancer types, and stages. The aim was to increase our understanding of how food insecurity influences these outcomes during cancer progression and treatment.
Methods: A scoping review of four electronic databases (PubMed, Scopus, CINAHL, and Embase) was conducted. Articles published between January 2014 and April 2024 examining the association between food insecurity — including direct measures of food access as well as residence in poor food environments (food deserts and/or food swamps, used as proxies for food insecurity) — and physical health-related outcomes (e.g., malnutrition, treatment complications, hospital readmission for cancer treatment, or its secondary outcomes, mortality, etc.) in patients with cancer were included.
Results: A total of 26 articles met the inclusion criteria. Key findings suggested that food insecurity and/or residing in poor food environments were significantly associated with various adverse outcomes, including increased risk of mortality, readmission to hospital, malnutrition, non-adherence to treatment, treatment complications, more advanced cancer progression, and lower survival rates.
Conclusion: Food insecurity exacerbates disparities in cancer care by contributing to adverse outcomes. Findings underscore the need for targeted interventions to address the root causes of food insecurity, including geographic and socioeconomic disparities, to improve health equity and outcomes for cancer patients.
Keywords: Cancer, NutritionMethods: A scoping review of four electronic databases (PubMed, Scopus, CINAHL, and Embase) was conducted. Articles published between January 2014 and April 2024 examining the association between food insecurity — including direct measures of food access as well as residence in poor food environments (food deserts and/or food swamps, used as proxies for food insecurity) — and physical health-related outcomes (e.g., malnutrition, treatment complications, hospital readmission for cancer treatment, or its secondary outcomes, mortality, etc.) in patients with cancer were included.
Results: A total of 26 articles met the inclusion criteria. Key findings suggested that food insecurity and/or residing in poor food environments were significantly associated with various adverse outcomes, including increased risk of mortality, readmission to hospital, malnutrition, non-adherence to treatment, treatment complications, more advanced cancer progression, and lower survival rates.
Conclusion: Food insecurity exacerbates disparities in cancer care by contributing to adverse outcomes. Findings underscore the need for targeted interventions to address the root causes of food insecurity, including geographic and socioeconomic disparities, to improve health equity and outcomes for cancer patients.
Authors:
Presenter - Mina Davari, PhD Candidate, University of South Florida
Co-Author - Sahar Heydari, PhD Student, University of South Florida
Co-Author - Acadia Buro, PhD, University of New Mexico
Chair - Marilyn Stern, PhD, University of South Florida
Preference for Self-Collected Cervical Cancer Screening in a Nationally Representative Sample of US Women
Poster Number: B10Time: 11:00 AM - 11:50 AM
Topics: Cancer, Women's Health
Background: Approximately 13,360 women will be diagnosed with cervical cancer in 2025. The 5-year relative survival rate for cervical cancer is greatest when it is detected at an early stage. One way to promote early detection is through screening. Until recently, screening for cervical cancer involved a pelvic exam in which clinicians collect vaginal samples (i.e., clinician-collected sampling). The option for self-sampling in healthcare settings is now available in which patients collect their own samples using a swab or brush. It is anticipated that at-home self-sampling will soon be another option for screening. Self-sampling can help address some of the barriers that patients face in clinician-collected sampling. Nevertheless, research on perceptions of self-sampling has been largely conducted with non-representative samples. The present research examines associations of sociodemographic, health-, and healthcare-related factors with preference for self-sampling in a nationally representative sample of US women.
Methods: We performed a cross-sectional analysis of data from the 2024 Health Information National Trends Survey. Analysis included 2,325 screening-eligible women. Weighted logistic regression examined associations of self-sampling preference with age, race/ethnicity, marital status, SES, sexual orientation, rurality, lack of transportation, having a primary care provider, insurance status, BMI, health self-efficacy, health literacy, trust in the healthcare system, perceptions of changing health recommendations, perceived quality of communication with healthcare providers, and experienced discrimination in healthcare.
Results: Overall, 20.2% of US women preferred self-sampling over clinician-collected sampling. 55.6% of women who preferred self-sampling cited multiple reasons for their preference, such as privacy and not being able to take time off work. Results from the weighted logistic regression suggested that having experienced discrimination in healthcare settings was positively associated with preference for self-sampling (OR=1.93, 95% CI=1.16-3.21, p=.01). No other associations were significant.
Conclusion: These findings suggest that 1 in 5 US women prefer self-sampling for cervical cancer screening. Providing an option to self-sample may increase cervical cancer screening among women who have concerns about privacy and taking time off work, as well as those who have experienced discrimination in healthcare settings.
Keywords: Cancer screening, Women's healthMethods: We performed a cross-sectional analysis of data from the 2024 Health Information National Trends Survey. Analysis included 2,325 screening-eligible women. Weighted logistic regression examined associations of self-sampling preference with age, race/ethnicity, marital status, SES, sexual orientation, rurality, lack of transportation, having a primary care provider, insurance status, BMI, health self-efficacy, health literacy, trust in the healthcare system, perceptions of changing health recommendations, perceived quality of communication with healthcare providers, and experienced discrimination in healthcare.
Results: Overall, 20.2% of US women preferred self-sampling over clinician-collected sampling. 55.6% of women who preferred self-sampling cited multiple reasons for their preference, such as privacy and not being able to take time off work. Results from the weighted logistic regression suggested that having experienced discrimination in healthcare settings was positively associated with preference for self-sampling (OR=1.93, 95% CI=1.16-3.21, p=.01). No other associations were significant.
Conclusion: These findings suggest that 1 in 5 US women prefer self-sampling for cervical cancer screening. Providing an option to self-sample may increase cervical cancer screening among women who have concerns about privacy and taking time off work, as well as those who have experienced discrimination in healthcare settings.
Authors:
Presenter - Jacqueline Hua, PhD, MPH, National Cancer Institute
Co-Author - Laurel Gibson, PhD, MPH, National Cancer Institute
Co-Author - William Klein, PhD, National Cancer Institute
Co-Author - Amanda Acevedo, PhD, National Cancer Institute
Youth Empowerment and Positive Youth Development Outcomes in Interventions for Adolescents and Youth Serviced by Foster Care: A Systematic Review
Poster Number: B100Time: 11:00 AM - 11:50 AM
Topics: Implementation Science , Social and Environmental Context and Health
Foster youth who lack consistent, developmentally appropriate supports often struggle to acquire the skills needed for independent living. This systematic review examines the effectiveness of empowerment-based interventions for foster youth in the United States. Following PRISMA guidelines, we conducted a comprehensive search of PubMed, PsycINFO, CINAHL, and Scopus to identify high-quality randomized controlled trials (RCTs) published between 2015 and 2025. Sixteen studies met inclusion criteria. Rayyan.ai was used to manage article screening, duplicate removal, and staged review. Studies spanned 11 U.S. states, included youth aged 9–21, featured three female-only samples, and reflected diverse racial and ethnic compositions, highlighting the broad applicability of findings. Risk of bias was assessed using the Cochrane RoB2 tool. Given that RCTs typically demonstrate greater methodological rigor than other experimental designs, this review prioritizes their findings. It also highlights studies evaluating evidence-based programs implemented in real-world contexts, thereby enhancing accessibility for youth in child welfare settings who must navigate complex service systems to meet their needs. Due to heterogeneity in study designs and outcome measures and guided by the Five Cs framework of Positive Youth Development (PYD), a narrative synthesis was conducted. Findings indicate that interventions incorporating multiple PYD components are more likely to produce robust, sustained improvements in youth outcomes. Implementing evidence-based, intentionally evaluated, and scalable empowerment prevention and intervention programs can help foster youth transition to adulthood with greater health, resilience, and societal engagement.
Keywords: Adolescents, Randomized controlled trialAuthors:
Presenter - Pamela Graham, MS, University of Memphis
Chair - Satish Kedia, PhD, MPH, MS, University of Memphis
Co-Author - Sanjaya Regmi, PhD, MPH, The University of Tennessee Knoxville College of Nursing
Co-Author - Coree Entwistle , BA, University of Memphis
Co-Author - Patrick Dillon, PhD, Kent State University
Co-Author - Alex Parkhouse, PhD, University of Memphis
Co-Author - Yong Yang, PhD, University of Memphis
Fill Bellies Not Bins: Improving vegetable liking in a school setting
Poster Number: B102Time: 11:00 AM - 11:50 AM
Topics: Implementation Science , Diet, Nutrition, and Eating Disorders
Often, children in low-resourced areas have little access to fruits and vegetables, which can affect their overall health, wellbeing, and dietary intake (Gallegos, 2021). These children rely on food school lunch programs for fruits and vegetables (FVs), making school-based intervention an ideal context. However, reports of food waste in schools demonstrate FVs as the highest contributor to school food waste (Niaki, 2017). Children's food preferences are shaped by repeated exposures to fruits and vegetables (Kähkönen, 2021). An evidence-based practice to increase liking and consumption of food items, including fruits and vegetables, is repeated exposure to the food item (Holley, Farrow, & Haycraft, 2017). Recent literature demonstrates that 6-10 exposures are most effective for liking and consumption? (Karagiannaki, 2021; Nekitsing, 2018).
This study used a hybrid type 2 implementation design to assess feasibility and effectiveness of repeated FV exposure on students’ food preference. Participants were 89 students (4th and 5th graders) from an elementary school with ~90% students qualifying for the USDA Free and Reduced Lunch Program (FRLP). Food targets (oranges, broccoli, and tomatoes) were identified by reviewing school menus and consultation with a registered dietician. Students were served each target food 8 times over 6-weeks. Students reported the extent to which they tried tastings. Regardless of whether students tasted a food target, 6 exposures (opportunities to try each food target) were operationalized as a full dose. Pre-intervention and post-intervention liking for each food target was collected (1=Don’t like it, 4=Love it).
Overall, 89 students received at least one exposure throughout the program. Of those, 47.1% of students received full doses. Students who were exposed to the full intervention demonstrated significantly more liking of the food targets pre- to post- intervention (OR 2.55, 95% CI 1.12-5.81, p = .03). The cost of the intervention was $4.78 per student, and students were highly satisfied with the intervention (91.6%).
Repeated FV is an effective and feasible school-based intervention to improve FV liking. This intervention could bridge the gap between the billions of dollars spent to serve nutritious food to students and the high degree of food waste and poor nutrition of US children.
Keywords: Diet, Children's healthThis study used a hybrid type 2 implementation design to assess feasibility and effectiveness of repeated FV exposure on students’ food preference. Participants were 89 students (4th and 5th graders) from an elementary school with ~90% students qualifying for the USDA Free and Reduced Lunch Program (FRLP). Food targets (oranges, broccoli, and tomatoes) were identified by reviewing school menus and consultation with a registered dietician. Students were served each target food 8 times over 6-weeks. Students reported the extent to which they tried tastings. Regardless of whether students tasted a food target, 6 exposures (opportunities to try each food target) were operationalized as a full dose. Pre-intervention and post-intervention liking for each food target was collected (1=Don’t like it, 4=Love it).
Overall, 89 students received at least one exposure throughout the program. Of those, 47.1% of students received full doses. Students who were exposed to the full intervention demonstrated significantly more liking of the food targets pre- to post- intervention (OR 2.55, 95% CI 1.12-5.81, p = .03). The cost of the intervention was $4.78 per student, and students were highly satisfied with the intervention (91.6%).
Repeated FV is an effective and feasible school-based intervention to improve FV liking. This intervention could bridge the gap between the billions of dollars spent to serve nutritious food to students and the high degree of food waste and poor nutrition of US children.
Authors:
Presenter - Kira Voelker, Parkview Health
Author - Avah Crane, Parkview Health
Author - Mindy Flanagan, PhD, Parkview Health
Author - Rachel Pfafman, MPH, MBA, Parkview Health
Author - Michelle Drouin, PhD, Parkview Health
Author - Dana Albright, PhD, Parkview Health
Addressing Comorbid Depression and Type 2 Diabetes Through Multilevel Integrated Care Models: A Meta-Analysis
Poster Number: B103Time: 11:00 AM - 11:50 AM
Topics: Integrated Primary Care, Diabetes
Background: One in five people with type 2 diabetes in the US experience depression, complicating self-management and increasing risk of cardiovascular and other complications. Multilevel (individual, interpersonal, organizational, societal) socioecological factors, including social support and economic stability, mediate the relationship between depression and diabetes outcomes such as hemoglobin A1c (HbA1c). Previous research emphasizes multilevel socioecological factors as key to addressing gaps in diabetes outcomes. Integrated care models that incorporate behavior change and multilevel socioecological factors offer a promising but underexplored approach to addressing comorbid depression and diabetes.
Purpose: This meta-analysis evaluates the effectiveness of integrative care with multilevel socioecological interventions on diabetes management (e.g., HbA1c control) and depression symptoms.
Data Sources and Study Selection: A systematic search was conducted in five psychosocial health databases. Participant inclusion criteria were: 1) diagnosis of diabetes via self-report or laboratory assessment (e.g., HbA1c ≥ 5.7%), 2) depressive symptoms via validated screening (e.g., PHQ-9). Study inclusion were: 1) peer-reviewed randomized control trials conducted in primary or specialty diabetes care, 2) use of integrated care with multilevel intervention.
Data Extraction and Synthesis: Three reviewers extracted demographic, clinical and psychosocial data. Ten articles (N = 13,674) met criteria. Integrated care approaches included collaborative and coordinated care, peer support, and primary care behavioral health. Multilevel interventions targeted family engagement, community group participation, care coordination, and addressing social/economic needs. Pooled analyses showed significant reductions in HbA1c (MD = -0.85, 95% CI: -1.49 to -0.21) and depression (d = -0.31, 95% CI: -0.59 to -0.04) compared to usual care.
Limitations and Conclusions: Evidence supports the use of multilevel, integrated care approaches in reducing depression and HbA1c. Our findings align with previous research, emphasizing the role of multilevel factors and integrated care interventions in closing gaps in diabetes outcomes. However, variability and insufficient comparative data on how they impact HbA1c limit conclusions. Greater standardization and alignment with multilevel health frameworks are needed to inform best practices and policy for evidence-based depression and diabetes care.
Keywords: Diabetes, DepressionPurpose: This meta-analysis evaluates the effectiveness of integrative care with multilevel socioecological interventions on diabetes management (e.g., HbA1c control) and depression symptoms.
Data Sources and Study Selection: A systematic search was conducted in five psychosocial health databases. Participant inclusion criteria were: 1) diagnosis of diabetes via self-report or laboratory assessment (e.g., HbA1c ≥ 5.7%), 2) depressive symptoms via validated screening (e.g., PHQ-9). Study inclusion were: 1) peer-reviewed randomized control trials conducted in primary or specialty diabetes care, 2) use of integrated care with multilevel intervention.
Data Extraction and Synthesis: Three reviewers extracted demographic, clinical and psychosocial data. Ten articles (N = 13,674) met criteria. Integrated care approaches included collaborative and coordinated care, peer support, and primary care behavioral health. Multilevel interventions targeted family engagement, community group participation, care coordination, and addressing social/economic needs. Pooled analyses showed significant reductions in HbA1c (MD = -0.85, 95% CI: -1.49 to -0.21) and depression (d = -0.31, 95% CI: -0.59 to -0.04) compared to usual care.
Limitations and Conclusions: Evidence supports the use of multilevel, integrated care approaches in reducing depression and HbA1c. Our findings align with previous research, emphasizing the role of multilevel factors and integrated care interventions in closing gaps in diabetes outcomes. However, variability and insufficient comparative data on how they impact HbA1c limit conclusions. Greater standardization and alignment with multilevel health frameworks are needed to inform best practices and policy for evidence-based depression and diabetes care.
Authors:
Co-Author - Jeanna Campbell, PhD, MSW, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
Co-Author - Zach Cooper, LCSW, MSW, School of Social Work, University of Georgia
Co-Author - Kylie Zarecki, BS, College of Public Health, University of Georgia
Co-Author - Leslie Johnson, PhD, MPH, MLitt, School of Medicine, Emory University
Co-Author - Gaurav Dave, MBBS, DrPH, MPH, School of Medicine, University of North Carolina at Chapel Hill
Perspectives of primary care providers on treating suicidality: barriers to Zero Suicide framework implementation
Poster Number: B104Time: 11:00 AM - 11:50 AM
Topics: Integrated Primary Care, Implementation Science
Suicide is one of the leading causes of death in the United States (U.S.) The Zero Suicide model is a healthcare system approach to suicide prevention that has been applied in mental health institutions and hospital departments in the U.S.. Primary care providers (PCP) are the frontline for identifying and managing mental health concerns, including suicidality; yet, the feasibility and acceptability of Zero Suicide has not been studied in primary care.
In this mixed methods study, we explored the perspectives and experiences of PCPs at a large, urban, academic healthcare system to understand their beliefs and practices related to suicide prevention and to discern barriers to implementing Zero Suicide. PCPs were invited to complete a survey and participate in a one-on-one semi-structured interview. The survey included questions about PCPs’ confidence treating suicidality based on the Zero Suicide Workforce Survey. The interview guide was developed based on constructs from the Consolidated Framework for Implementation Research and asked about experiences in primary care, current barriers treating patients with suicidality, and impressions on the implementation of suicide prevention tools. Surveys were analyzed with descriptive statistics and key themes from interviews were identified using rapid qualitative analysis.
19 PCPs from 9 clinics within the healthcare system participated. The majority reported having patients who attempted suicide. They prioritized behavioral healthcare and reported spending a lot of time caring for the mental health of their patients. PCPs cited lack of psychiatric resources, limited support staff, and short appointment times as challenges to managing suicidality. PCPs said that they “don’t know how to get access” to resources, and described patients being “outright declined [psychiatric] care”. PCPs wanted training available for “everyone [on the healthcare team]” and to transition their patients with a “warm handoff same day”. They found the Zero Suicide model “comprehensive” and thought it could effective in facilitating suicide prevention in primary care.
Addressing these needs could help improve the care of patients with suicidality, and contribute towards the long-term goal of becoming a Zero Suicide Institute. PCPs supported the Zero Suicide model but barriers may be difficult to address, as proposed solutions require restructuring, funding, and resources. Ensuring leadership support and stakeholder engagement will be key.
Keywords: Primary care, InterventionIn this mixed methods study, we explored the perspectives and experiences of PCPs at a large, urban, academic healthcare system to understand their beliefs and practices related to suicide prevention and to discern barriers to implementing Zero Suicide. PCPs were invited to complete a survey and participate in a one-on-one semi-structured interview. The survey included questions about PCPs’ confidence treating suicidality based on the Zero Suicide Workforce Survey. The interview guide was developed based on constructs from the Consolidated Framework for Implementation Research and asked about experiences in primary care, current barriers treating patients with suicidality, and impressions on the implementation of suicide prevention tools. Surveys were analyzed with descriptive statistics and key themes from interviews were identified using rapid qualitative analysis.
19 PCPs from 9 clinics within the healthcare system participated. The majority reported having patients who attempted suicide. They prioritized behavioral healthcare and reported spending a lot of time caring for the mental health of their patients. PCPs cited lack of psychiatric resources, limited support staff, and short appointment times as challenges to managing suicidality. PCPs said that they “don’t know how to get access” to resources, and described patients being “outright declined [psychiatric] care”. PCPs wanted training available for “everyone [on the healthcare team]” and to transition their patients with a “warm handoff same day”. They found the Zero Suicide model “comprehensive” and thought it could effective in facilitating suicide prevention in primary care.
Addressing these needs could help improve the care of patients with suicidality, and contribute towards the long-term goal of becoming a Zero Suicide Institute. PCPs supported the Zero Suicide model but barriers may be difficult to address, as proposed solutions require restructuring, funding, and resources. Ensuring leadership support and stakeholder engagement will be key.
Authors:
Author - Lauren Sun, University of Chicago Pritzker School of Medicine
Co-Author - Erin Staab, University of Chicago Pritzker School of Medicine
Co-Author - Neda Laiteerapong, University of Chicago Pritzker School of Medicine
Mental Health Stigma & Attitudes Toward Seeking Psychological Help: Assessing the roles of Self-esteem and Individualism in Immigrants
Poster Number: B105Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Health Disparities
Immigrants in the United States use mental health services at significantly lower rates than nonimmigrants. Aside from structural barriers that impact utilizing mental health care, there are also a number of individual-level barriers that prevent immigrant populations from sufficiently using the care which they need. This study assessed the impact of perceived mental health stigma on help-seeking attitudes as moderated by individualism and mediated by internalized mental health stigma and self-esteem (in serial) among immigrant college students. A path analysis of cross-sectional survey data (n = 659) was analyzed in SPSS and revealed that the association between perceived stigma and attitudes towards seeking mental health care was mediated by internalized mental illness stigma, but not self-esteem. Individualism did not moderate any paths but was independently associated with mental health seeking attitudes. A subsequent sensitivity analysis revealed that results were robust to the inclusion of key sociodemographic variables in the main moderated-mediation model. Secondarily, we observed little support for the immigrant paradox that posits intergenerational health differences of immigrant populations favoring first-generation immigrants, as there was no significant associations between generational status and all key study variables, with the exception of a significant association with internalized mental-illness stigma in first generation immigrants. If replicated, first-generation immigrants may be given special consideration as a particularly vulnerable group for mental illness stigma internalization. This study highlights the substantial burden of mental illness stigma in relation to attitudes in seeking care among immigrants in the U.S., and may illustrate the potential mechanistic relationships of mental illness stigma in this community. Future works may explore the temporal stability of these associations across time. Stigma-reduction interventions may target internalized stigma as a key determinant to health-seeking attitudes of mental health care among immigrants in the U.S. Primary care practitioners should take stigma into consideration as a critical component of patients’ attitudes when discussing mental health symptoms and potential specialist referrals.
Keywords: Health behaviors, Mental healthAuthors:
Presenter - Joseph Awad, UCLA
Co-Presenter - Namrata Poola, UCI
Co-Presenter - Alecco Walli, UCLA
Co-Presenter - Lana Bohsali, UCLA
Co-Author - Yuna Shegai, UCLA
Co-Author - Wakana Matsumoto, UCLA
Co-Author - Anjeanette Oberg, Mt San Jacinto Community College
Depressive symptoms predicting subsequent experiences of intimate partner violence among sexual minority men: mediation by substance use
Poster Number: B106Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Social and Environmental Context and Health
Background: Syndemic frameworks have been used to explain health inequities among sexual minority men (SMM), highlighting a synergistic relationship among depression, substance use, and intimate partner violence (IPV). Within this framework, IPV is typically positioned as a risk factor for adverse health outcomes, especially depression. We studied the reciprocal association, with depression and substance as potential precedents of IPV experiences among SMM.
Methods: The study used the first three waves of data (baseline, 6-month [6M], and 12-month [12M] time points) of a 2-year longitudinal study of SMM. Depressive symptoms, measured and dichotomized using PHQ-8 (cut-off: 10) at baseline and 6M, were categorized into three categories: none, intermittent (i.e., depressive symptoms at one of the waves), and chronic (i.e., depressive symptoms at both waves). Substance use was continuously measured using a modified version of question 2 of NIDA-modified ASSIST V2.0 at 6M. Any experiences of IPV victimization and perpetration were collected at baseline and 12M. Associations between depressive symptoms and each experience of IPV at 12M and mediation via substance use were examined using generalized structural equation modeling. Corresponding IPV experiences at baseline were controlled for, along with sociodemographic characteristics.
Results: Of the 424 participants, 12.5% and 15.8% reported chronic and intermittent depressive symptoms, respectively. Prevalence of any experiences of IPV at 12M was 25.5% for victimization and 17.9% for perpetration. Chronic depressive symptoms had a direct association with both any experiences of IPV victimization and perpetration, with no mediation via substance use. On the other hand, substance use fully mediated the association between intermittent depressive symptoms and IPV victimization.
Conclusion: Chronicity of depressive symptoms is an important factor to the synergistic relationship between depression and substance use in predicting IPV experiences. The findings present depressive symptoms and the maladaptive coping via substance use as potential points of intervention to address IPV within the SMM community.
Keywords: Depression, ViolenceMethods: The study used the first three waves of data (baseline, 6-month [6M], and 12-month [12M] time points) of a 2-year longitudinal study of SMM. Depressive symptoms, measured and dichotomized using PHQ-8 (cut-off: 10) at baseline and 6M, were categorized into three categories: none, intermittent (i.e., depressive symptoms at one of the waves), and chronic (i.e., depressive symptoms at both waves). Substance use was continuously measured using a modified version of question 2 of NIDA-modified ASSIST V2.0 at 6M. Any experiences of IPV victimization and perpetration were collected at baseline and 12M. Associations between depressive symptoms and each experience of IPV at 12M and mediation via substance use were examined using generalized structural equation modeling. Corresponding IPV experiences at baseline were controlled for, along with sociodemographic characteristics.
Results: Of the 424 participants, 12.5% and 15.8% reported chronic and intermittent depressive symptoms, respectively. Prevalence of any experiences of IPV at 12M was 25.5% for victimization and 17.9% for perpetration. Chronic depressive symptoms had a direct association with both any experiences of IPV victimization and perpetration, with no mediation via substance use. On the other hand, substance use fully mediated the association between intermittent depressive symptoms and IPV victimization.
Conclusion: Chronicity of depressive symptoms is an important factor to the synergistic relationship between depression and substance use in predicting IPV experiences. The findings present depressive symptoms and the maladaptive coping via substance use as potential points of intervention to address IPV within the SMM community.
Authors:
Author - Sungsub Choo, PhD, San Diego State University
Co-Author - Glenn Wagner, PhD, RAND
Co-Author - Erik Storholm, PhD, San Diego State Univeristy
Leveraging a social ecological lens to explore youth experiences and perspectives with social media, mental health, and wellbeing: results from a nationwide text message survey
Poster Number: B107Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Social and Environmental Context and Health
Background
In recent years, social media use has contributed to rising rates of anxiety, depression, and suicide rates among adolescents and young adults. In light of the reported harms, youth motivations for continuing to engage with social media are unclear. The social ecological model, which describes individual behavior as influenced by multiple layers, can be used to understand youth behavior and wellbeing. This study aimed to describe social media use among youth in the context of the social ecological model to identify opportunities for intervention.
Methods
Adolescent co-researchers in the MYHealth Research Training Program designed two qualitative surveys focused on the perceived benefits and harms of social media at each level of the social ecological model (e.g., personal, relational, community, structural). Surveys were sent via a nationwide text message poll of youth aged 14-24 in January 2024. Survey responses were analyzed by youth co-researchers and experienced qualitative researchers via inductive thematic analysis, including data familiarization, codebook creation, line-by-line coding, and theme development. Themes were aligned with the social ecological model constructs to examine participant responses across social and environmental contexts.
Results
743 participants received both surveys, and 607 responded to at least one (response rate 82%). Participants were on average 20 years old and primarily female (49.8%), White (60%), and had completed at least some college (63%). Analysis resulted in 4 themes across the social ecological levels: 1) social media as a digital mirror; 2) interpersonal connections and conflicts; 3) building community to combat isolation; 4) social media as a window on the world.
Conclusions
This study highlights the diverse effects of social media on youth wellbeing. While young people report negative experiences like self-comparison and anxiety, they also use social media to build relationships, find community, and stay informed about the world. These findings can inform future interventions to enhance youth wellbeing, such as conversations between youth and healthcare providers about social media use, creation of additional social media features to tailor content experiences, and education about harm mitigation strategies – to name a few. Further collaboration between youth, researchers, and healthcare professionals is needed to fully understand the relationship between social media use and youth wellbeing.
Keywords: Adolescents, Mental healthIn recent years, social media use has contributed to rising rates of anxiety, depression, and suicide rates among adolescents and young adults. In light of the reported harms, youth motivations for continuing to engage with social media are unclear. The social ecological model, which describes individual behavior as influenced by multiple layers, can be used to understand youth behavior and wellbeing. This study aimed to describe social media use among youth in the context of the social ecological model to identify opportunities for intervention.
Methods
Adolescent co-researchers in the MYHealth Research Training Program designed two qualitative surveys focused on the perceived benefits and harms of social media at each level of the social ecological model (e.g., personal, relational, community, structural). Surveys were sent via a nationwide text message poll of youth aged 14-24 in January 2024. Survey responses were analyzed by youth co-researchers and experienced qualitative researchers via inductive thematic analysis, including data familiarization, codebook creation, line-by-line coding, and theme development. Themes were aligned with the social ecological model constructs to examine participant responses across social and environmental contexts.
Results
743 participants received both surveys, and 607 responded to at least one (response rate 82%). Participants were on average 20 years old and primarily female (49.8%), White (60%), and had completed at least some college (63%). Analysis resulted in 4 themes across the social ecological levels: 1) social media as a digital mirror; 2) interpersonal connections and conflicts; 3) building community to combat isolation; 4) social media as a window on the world.
Conclusions
This study highlights the diverse effects of social media on youth wellbeing. While young people report negative experiences like self-comparison and anxiety, they also use social media to build relationships, find community, and stay informed about the world. These findings can inform future interventions to enhance youth wellbeing, such as conversations between youth and healthcare providers about social media use, creation of additional social media features to tailor content experiences, and education about harm mitigation strategies – to name a few. Further collaboration between youth, researchers, and healthcare professionals is needed to fully understand the relationship between social media use and youth wellbeing.
Authors:
Presenter - Samantha Chuisano, MPH, University of Michigan
Co-Author - Barbara Giambra, PhD, Cincinnati Chidren's
Co-Author - Jennifer Arroyo, University of Michigab
Co-Author - Xochitl Amaro, University of Michigan
Presenter - Nourin Chowdhury, University of Michigan
Co-Author - Juniar Lucien, University of Michigan
Co-Presenter - Melissa DeJonckheere, PhD, University of Michigan
Systematic Review of Ecological Momentary Assessment for Assessing Mental Health Among Sexual and Gender Minorities
Poster Number: B108Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Methods and Measurement
Background: Sexual and gender minority (SGM) populations face disproportionate risks of stress, depression, anxiety, and suicidal thoughts and behaviors (STBs). Ecological momentary assessment (EMA) offers a promising method for examining real-time fluctuations in psychological states within these contexts. This review aimed to (1) evaluate the feasibility and acceptability of EMA in studies involving SGM populations and (2) identify momentary predictors of mental health outcomes to inform future intervention development.
Methods: We conducted a systematic review of EMA studies focused on mental health among SGM populations. We searched five databases (PubMed, PsycINFO, Scopus, CINAHL, and the Cochrane Library) through April 2025. Eligible studies used digital EMA methods to assess psychological outcomes in predominantly SGM samples. Data extraction and quality appraisal followed the Preferred Reporting Items Meta-Analyses systematic Reviews and PRISMA and MMAT guidelines.
Results: Eleven studies met the inclusion criteria. Most used signal- or interval-contingent EMA protocols over 7–180 days. Completion rates averaged 76.1%, with higher adherence in shorter studies. EMA was effective in identifying momentary predictors of mental health outcomes. EMA captured proximal predictors of poor mental health, including negative affect, hopelessness, loneliness, discrimination, identity invalidation, and media exposure, each associated with elevated stress, depression, anxiety, or suicidal thoughts and behaviors. Protective factors such as social support, sleep quality, and affirming environments were linked to improved mental health. Three studies used predictive modeling to predict suicidal ideation and stress in advance, and two integrated EMA within just-in-time adaptive interventions (JITAIs).
Conclusions: EMA is a feasible and acceptable method for capturing real-time mental health dynamics among SGM populations, and it can inform the development of real-time interventions. However, its application remains limited. Future work should expand its scope and embed it within adaptive intervention models, such as JITAIs.
Keywords: Mental health, Minority healthMethods: We conducted a systematic review of EMA studies focused on mental health among SGM populations. We searched five databases (PubMed, PsycINFO, Scopus, CINAHL, and the Cochrane Library) through April 2025. Eligible studies used digital EMA methods to assess psychological outcomes in predominantly SGM samples. Data extraction and quality appraisal followed the Preferred Reporting Items Meta-Analyses systematic Reviews and PRISMA and MMAT guidelines.
Results: Eleven studies met the inclusion criteria. Most used signal- or interval-contingent EMA protocols over 7–180 days. Completion rates averaged 76.1%, with higher adherence in shorter studies. EMA was effective in identifying momentary predictors of mental health outcomes. EMA captured proximal predictors of poor mental health, including negative affect, hopelessness, loneliness, discrimination, identity invalidation, and media exposure, each associated with elevated stress, depression, anxiety, or suicidal thoughts and behaviors. Protective factors such as social support, sleep quality, and affirming environments were linked to improved mental health. Three studies used predictive modeling to predict suicidal ideation and stress in advance, and two integrated EMA within just-in-time adaptive interventions (JITAIs).
Conclusions: EMA is a feasible and acceptable method for capturing real-time mental health dynamics among SGM populations, and it can inform the development of real-time interventions. However, its application remains limited. Future work should expand its scope and embed it within adaptive intervention models, such as JITAIs.
Authors:
Presenter - Kamal Gautam, University of Connecticut
Co-Author - Kiran Paudel, BPH, University of Connecticut
Co-Author - Bryana Bautista, University of Connecticut
Co-Author - Antoine Khati, University of Connecticut
Co-Author - Md. Safaet Hossain Sujan, University of Connecticut
Co-Author - Ran Xu, University of Connecticut
Co-Author - Michael Copenhaver, UConn
Co-Author - Jeffrey Wickersham, Yale School of Medicine
Co-Author - Pablo K Valente, University of Connecticut
Co-Author - Crystal Park, PhD, FSBM, University of Connecticut
Co-Author - Roman Shrestha, PhD, MPH, University of Connecticut
From Barriers to Buffers: Interpersonal Coping as a Moderator Between Stressors and Mental Health in South Asian Emerging Adults
Poster Number: B109Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Social and Environmental Context and Health
Introduction: South Asian individuals represent one of the fastest-growing racial or ethnic groups in the United States, with a 109% increase since 2000, yet remain underrepresented in mental health research. South Asian individuals experience significant psychosocial stressors, such as discrimination and cultural mistrust, which contribute to elevated rates of anxious (26.4%) and depressive symptoms (25.8%). Specifically, South Asian emerging adults may face unique cultural and systemic stressors during this transitional life stage, shaping long-term psychological outcomes. Given the collectivistic nature of South Asian cultures, it is important to examine coping strategies that align with collectivistic values as protective against psychosocial stressors, thereby supporting the well-being of South Asian emerging adults. The purpose of this study was to examine the mitigating role of social support and informal help-seeking in the relations between psychosocial stressors (i.e., discrimination and cultural mistrust) and symptoms of anxiety and depression among South Asian emerging adults.
Method: The present study is an ongoing, cross-sectional online study of South Asian college student health. To date, 148 participants aged 18-30 (M = 21.7) have completed a battery of questionnaires on discrimination, mistrust, social support, help-seeking, and psychological symptoms. A series of moderation analyses assessed whether interpersonal coping mitigated the associations between psychosocial stressors and psychological symptoms.
Results: Participants were mostly women (64.5%) and 49.3% Bangladeshi, 22.4% Indian, 15.1% Pakistani, 6.6% Nepali, 2.0% Sri Lankan, 0.7% Bhutanese, and 3.9% Other. Moderation analyses revealed five significant interactions. Social support significantly moderated the associations between anxious symptoms and discrimination, ΔR² = .023, F(1, 147) = 4.14, p = .04, and depressive symptoms and cultural mistrust, ΔR² = .033, F(1, 147) = 4.83, p = .03. Similarly, informal help-seeking moderated the associations between anxious symptoms and discrimination, ΔR² = .054, F(1, 147) = 10.38, p < .01, and cultural mistrust, ΔR² = .036, F(1, 147) = 5.78, p = .02, and depressive symptoms and discrimination, ΔR² = .074, F(1, 147) = 11.60, p < .01.
Discussion: Understanding interpersonal coping strategies that may buffer the effects of psychosocial stressors on mental health may inform culturally tailored interventions for South Asian emerging adults.
Keywords: Minority health, CopingMethod: The present study is an ongoing, cross-sectional online study of South Asian college student health. To date, 148 participants aged 18-30 (M = 21.7) have completed a battery of questionnaires on discrimination, mistrust, social support, help-seeking, and psychological symptoms. A series of moderation analyses assessed whether interpersonal coping mitigated the associations between psychosocial stressors and psychological symptoms.
Results: Participants were mostly women (64.5%) and 49.3% Bangladeshi, 22.4% Indian, 15.1% Pakistani, 6.6% Nepali, 2.0% Sri Lankan, 0.7% Bhutanese, and 3.9% Other. Moderation analyses revealed five significant interactions. Social support significantly moderated the associations between anxious symptoms and discrimination, ΔR² = .023, F(1, 147) = 4.14, p = .04, and depressive symptoms and cultural mistrust, ΔR² = .033, F(1, 147) = 4.83, p = .03. Similarly, informal help-seeking moderated the associations between anxious symptoms and discrimination, ΔR² = .054, F(1, 147) = 10.38, p < .01, and cultural mistrust, ΔR² = .036, F(1, 147) = 5.78, p = .02, and depressive symptoms and discrimination, ΔR² = .074, F(1, 147) = 11.60, p < .01.
Discussion: Understanding interpersonal coping strategies that may buffer the effects of psychosocial stressors on mental health may inform culturally tailored interventions for South Asian emerging adults.
Authors:
Author - Zara Khan, M.A., The Graduate Center, City University of New York
Co-Author - Adriana Espinosa, Ph.D., City College of New York, City University of New York
Effects of Tai Chi Qigong on Psychological Distress and Health-related Quality of Life in Older Male Cancer Survivors: A 3-Arm Randomized Controlled Trial
Poster Number: B8Time: 11:00 AM - 11:50 AM
Topics: Cancer, Physical Activity
Background: Older male cancer survivors often experience psychological distress and lower health-related quality of life (HRQoL). Most non-pharmacological interventions targeting these outcomes have focused on mindfulness-based cognitive therapies or communication/group support. Tai Chi Qigong (TCQ) is a meditative movement practice combining physical postures, breathing, and mindfulness. TCQ has shown promise but remains understudied in this population.
Methods: This trial was a three-arm, randomized controlled study comparing TCQ, exercise intensity-matched (EIM) activities, and usual care (UC) among older male cancer survivors with fatigue. Participants were recruited from two cancer centers and randomized to 12 weeks of TCQ, EIM, or UC (2:2:1). Secondary outcomes included psychological distress (Brief Symptom Inventory-18) and HRQoL (Short Form Health Survey, SF-36), assessed at baseline, 6 weeks mid-point, and 1 week, 3 months, and 12 months post-intervention. Analyses followed an intent-to-treat approach, using linear mixed models with multiple imputation for missing data.
Results: Among the 113 men enrolled (mean age: 69.1 ± 7.0 years), 98 had a prostate cancer diagnosis. Average attendance rates across 24 classes were 78.4% and 76.8% for the TCQ and EIM arms. At 3 months, no statistically significant between-group differences were observed for psychological distress or HRQoL. However, at 6 weeks mid-point and 1-week post-intervention, the TCQ and EIM arms showed significant within-group improvements in global distress (BSI-global), depression, and somatization (p < .05), though not in anxiety. TCQ participants reported within-group improvements in physical well-being at 6 weeks mid-point and 1-week post-intervention (p < .05), while EIM participants showed greater within-group improvements in mental well-being at these two timepoints (p < .05).
Conclusions: Although improvements were modest and between-group differences were not statistically significant, both TCQ and EIM showed signals of benefit in psychological distress and HRQoL during and immediately after the group intervention. However, these benefits did not persist beyond the program. While findings do not support TCQ as superior to EIM or UC, the observed trends suggest its potential for improving psychological and overall well-being. Larger, adequately powered trials are warranted to identify strategies to sustain both TCQ exercise and the effects among older male cancer survivors.
Keywords: Cancer, MeditationMethods: This trial was a three-arm, randomized controlled study comparing TCQ, exercise intensity-matched (EIM) activities, and usual care (UC) among older male cancer survivors with fatigue. Participants were recruited from two cancer centers and randomized to 12 weeks of TCQ, EIM, or UC (2:2:1). Secondary outcomes included psychological distress (Brief Symptom Inventory-18) and HRQoL (Short Form Health Survey, SF-36), assessed at baseline, 6 weeks mid-point, and 1 week, 3 months, and 12 months post-intervention. Analyses followed an intent-to-treat approach, using linear mixed models with multiple imputation for missing data.
Results: Among the 113 men enrolled (mean age: 69.1 ± 7.0 years), 98 had a prostate cancer diagnosis. Average attendance rates across 24 classes were 78.4% and 76.8% for the TCQ and EIM arms. At 3 months, no statistically significant between-group differences were observed for psychological distress or HRQoL. However, at 6 weeks mid-point and 1-week post-intervention, the TCQ and EIM arms showed significant within-group improvements in global distress (BSI-global), depression, and somatization (p < .05), though not in anxiety. TCQ participants reported within-group improvements in physical well-being at 6 weeks mid-point and 1-week post-intervention (p < .05), while EIM participants showed greater within-group improvements in mental well-being at these two timepoints (p < .05).
Conclusions: Although improvements were modest and between-group differences were not statistically significant, both TCQ and EIM showed signals of benefit in psychological distress and HRQoL during and immediately after the group intervention. However, these benefits did not persist beyond the program. While findings do not support TCQ as superior to EIM or UC, the observed trends suggest its potential for improving psychological and overall well-being. Larger, adequately powered trials are warranted to identify strategies to sustain both TCQ exercise and the effects among older male cancer survivors.
Authors:
Author - Jinghua An, PhD, RN, Indiana University
Co-Author - Samuel Tundealao, MPH, Rutgers University
Co-Author - Evelyn Arana-Chicas, DrPH, Rutgers Cancer Institute of New Jersey
Co-Author - Cindy Blair, PhD, University of New Mexico
Co-Author - Yong Lin, PhD, Rutgers University
Co-Author - Shou-en Lu, PhD, Rutgers University
Co-Author - Chunxia Chen, MS, Rutgers University
Co-Author - Isaac Y Kim, PhD, Yale New Haven Hospital
Co-Author - Wadih Arap, PhD, Rutgers Cancer Institute
Co-Author - Biren Saraiya, PhD, Rutgers Cancer Institute
Co-Author - Michael Irwin, MD, University of California, Los Angeles
Co-Author - Anita Kinney, PhD, RN, FAAN, Rutgers University
Determinants and Effects of Surgical Treatment Choice for Breast Cancer: Emotion Regulation and Long-Term Psychosocial Outcomes
Poster Number: B11Time: 11:00 AM - 11:50 AM
Topics: Cancer, Decision Making
Background: Bilateral mastectomy (BMX) is an invasive surgical procedure increasingly used for patients with unilateral breast cancer (BC) despite a lack of survival benefit and heightened risk of adverse medical and psychosocial outcomes. The study sought to understand the determinants of undergoing BMX versus more conservative surgical treatment and whether psychosocial outcomes differ between the treatment groups following surgery.
Methods: Secondary analyses were conducted as part of a larger study. Baseline, 6-month, 12-month, and 18-month survey data were analyzed. Measures included the Contralateral Prophylactic Mastectomy (CPM) Survey, Overall Anxiety Severity and Impairment Scale (OASIS), Center for Epidemiology Studies-Depression Scale (CES-D), Impact of Events Scale-Revised (IES-R), Patient-Reported Outcomes Measurement Information System (PROMIS-29), Pittsburgh Sleep Quality Index (PSQI), and the Emotion Regulation Questionnaire (ERQ) Cognitive Reappraisal subscale. A logistic regression model evaluated associations between baseline factors and BMX choice. Differences in psychosocial scores were assessed between the surgical groups using linear mixed effects models to accommodate repeated measures and missing data.
Results: Women (N=137) with stages I-III unilateral BC underwent BMX (n=66) or non-BMX (n=71; including unilateral mastectomy or breast-conserving surgery). Those who chose BMX were more likely to be married or partnered (OR=3.91, 95% CI [1.70, 8.99]) and younger (OR=0.96, 95% CI [0.93, 0.99]) than women who elected non-BMX. There was no evidence that BC-worry, distress, health-related quality of life, sleep quality, or cognitive reappraisal trajectories differed between the surgical groups over the follow-up period. Women in both surgical groups reported clinically significant sleep quality impairment across all follow-up time points. The BMX group demonstrated an increase in cognitive reappraisal (re-framing a situation's meaning to alter one's emotional response) during the follow-up period (B=0.18, SE=0.08, p=.015), while the non-BMX group did not (B=0.05, SE=0.06, p=.398). Women with a high-risk hormone receptor subtype reported greater BC-worry during follow-up than those without a high-risk receptor subtype (B=0.25, SE=0.12, p=.037).
Conclusions: Findings suggest there is no psychosocial benefit to undergoing BMX among women with unilateral BC. These findings may inform decision-making among women considering BMX.
Keywords: Cancer, Decision makingMethods: Secondary analyses were conducted as part of a larger study. Baseline, 6-month, 12-month, and 18-month survey data were analyzed. Measures included the Contralateral Prophylactic Mastectomy (CPM) Survey, Overall Anxiety Severity and Impairment Scale (OASIS), Center for Epidemiology Studies-Depression Scale (CES-D), Impact of Events Scale-Revised (IES-R), Patient-Reported Outcomes Measurement Information System (PROMIS-29), Pittsburgh Sleep Quality Index (PSQI), and the Emotion Regulation Questionnaire (ERQ) Cognitive Reappraisal subscale. A logistic regression model evaluated associations between baseline factors and BMX choice. Differences in psychosocial scores were assessed between the surgical groups using linear mixed effects models to accommodate repeated measures and missing data.
Results: Women (N=137) with stages I-III unilateral BC underwent BMX (n=66) or non-BMX (n=71; including unilateral mastectomy or breast-conserving surgery). Those who chose BMX were more likely to be married or partnered (OR=3.91, 95% CI [1.70, 8.99]) and younger (OR=0.96, 95% CI [0.93, 0.99]) than women who elected non-BMX. There was no evidence that BC-worry, distress, health-related quality of life, sleep quality, or cognitive reappraisal trajectories differed between the surgical groups over the follow-up period. Women in both surgical groups reported clinically significant sleep quality impairment across all follow-up time points. The BMX group demonstrated an increase in cognitive reappraisal (re-framing a situation's meaning to alter one's emotional response) during the follow-up period (B=0.18, SE=0.08, p=.015), while the non-BMX group did not (B=0.05, SE=0.06, p=.398). Women with a high-risk hormone receptor subtype reported greater BC-worry during follow-up than those without a high-risk receptor subtype (B=0.25, SE=0.12, p=.037).
Conclusions: Findings suggest there is no psychosocial benefit to undergoing BMX among women with unilateral BC. These findings may inform decision-making among women considering BMX.
Authors:
Author - Annemarie D. Jagielo, MS, PGSP-Stanford PsyD Consortium, Palo Alto University & Stanford University School of Medicine
Co-Author - Catherine Benedict, PhD, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine
Co-Author - Matthew J. Cordova, PhD, Department of Psychology, Palo Alto University
Co-Author - Eric Neri, MS, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine
Co-Author - Bita Nouriani, MS, LMFT, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine
Co-Author - Corey Saperia, MD, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine
Co-Author - Nathan Tran, BS, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine
Co-Author - Cassidy Kinderman, BS, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine
Co-Author - David Spiegel, MD, Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine
Associations Between Perceived Structural Stigma and Anticipated Stigma
Poster Number: B110Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Health Disparities
Objective: Recent theory has highlighted the importance of perceived structural stigma (PSS), or individuals’ perceptions of stigma at the structural level. PSS may heighten anticipated stigma (i.e., expectations of experiencing stigma from others in the future), which in turn can impact behavioral health. We examined associations between PSS and anticipated stigma among a large, national sample of emerging adults. Given that sexual and gender minority (SGM) individuals may be especially vulnerable to PSS, we additionally compared SGM and non-SGM emerging adults.
Methods: This study involved three repeated assessments conducted at three month intervals among 3,296 emerging adults from the U.S. PSS was assessed with a novel 7-item self-report scale. Items explicitly referenced systemic and policy-level conditions. The scale was developed with an a priori single-factor structure (sample item: How concerned are you about laws or policies that seek to limit the rights of LGBT people?). Anticipated stigma was measured with the Intersectional Discrimination Index. Data followed a two-level structure (within-person and between-person). We fit concurrent linear mixed-effects models including fixed and random effects.
Results: Across the full sample, higher PSS was associated with greater anticipated stigma at both the within-person (B=0.12, p<.001) and between-person levels (B=0.43, p<.001). The between-person interaction with SGM status was significant (B =-0.23, p<.001), indicating that associations were stronger for SGM than non-SGM participants. The within-person interaction was weaker (B=-0.06, p=.17) and not significant. Among SGM participants, higher PSS predicted greater anticipated stigma at both the within-person and between-person levels. Among non-SGM participants, PSS was also associated with anticipated stigma at the between-person level, though the effect was weaker.
Conclusions: This study suggests that PSS and anticipated stigma are concurrently associated. The within-person and between-person effects were approximately twice as strong for SGM participants compared to non-SGM individuals. These findings underscore the importance of addressing stigma at both the individual and structural levels. By examining stigma across levels, researchers and policymakers can better understand how stigma contributes to social and health inequities and design interventions to reduce its impact.
Keywords: Public health, Health disparitiesMethods: This study involved three repeated assessments conducted at three month intervals among 3,296 emerging adults from the U.S. PSS was assessed with a novel 7-item self-report scale. Items explicitly referenced systemic and policy-level conditions. The scale was developed with an a priori single-factor structure (sample item: How concerned are you about laws or policies that seek to limit the rights of LGBT people?). Anticipated stigma was measured with the Intersectional Discrimination Index. Data followed a two-level structure (within-person and between-person). We fit concurrent linear mixed-effects models including fixed and random effects.
Results: Across the full sample, higher PSS was associated with greater anticipated stigma at both the within-person (B=0.12, p<.001) and between-person levels (B=0.43, p<.001). The between-person interaction with SGM status was significant (B =-0.23, p<.001), indicating that associations were stronger for SGM than non-SGM participants. The within-person interaction was weaker (B=-0.06, p=.17) and not significant. Among SGM participants, higher PSS predicted greater anticipated stigma at both the within-person and between-person levels. Among non-SGM participants, PSS was also associated with anticipated stigma at the between-person level, though the effect was weaker.
Conclusions: This study suggests that PSS and anticipated stigma are concurrently associated. The within-person and between-person effects were approximately twice as strong for SGM participants compared to non-SGM individuals. These findings underscore the importance of addressing stigma at both the individual and structural levels. By examining stigma across levels, researchers and policymakers can better understand how stigma contributes to social and health inequities and design interventions to reduce its impact.
Authors:
Author - Mohammad Mousavi, University of Dalaware
Co-Author - Annie Fox, School of Healthcare Leadership, MGH Institute of Health Professions, Boston, Massachusetts, USA
Co-Author - Jean-Philippe Laurenceau, PhD, University of Delaware
Co-Author - Patrick Corrigan, Illinios Institute of Technology
Co-Author - Valerie Earnshaw, PhD, University of Delaware
Dialectical Behavioral Therapy in People with Chronic Physical Illness or Disease: A Scoping Review
Poster Number: B111Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Quality of Life
Introduction:Dialectical behavioral therapy(DBT) is an evidence-based psychotherapy that balances acceptance and behavior change. DBT is effective for many mental health conditions, but its use in patients with chronic physical illness and disease is not well known. This scoping review aims to answer what has been reported about the application of DBT in patients with chronic physical illness?
Methods:We followed the Joanna Briggs Institute Manual for Evidence Synthesis guidance and the Arksey and O’Malley five-step framework. The team created a comprehensive search strategy and list of terms. Sources published through 5/2024 were included if they mentioned chronic physical illness and DBT. All sources were screened by two independent coders at the abstract, full text, and data extraction levels.
Results:The database search yielded 7,599 results; 5,070 abstracts were screened, 121 articles underwent full-text review, and data was extracted from 61 sources. Source types included 11 randomized controlled trials, 13 case series/reports, 8 non-randomized experimental studies, 6 theses/dissertations, 5 mixed method studies, 4 books, 2 abstracts, 1 cohort study, 1 qualitative study, and 10 "other". Studies were conducted in the US(N=33), Europe(9), Iran(8), and Australia(3). Illness/disease types included overweight/obesity(N=15), neurology/neurosurgery(10), chronic pain(10), generic(6), gastrointestinal disorders(6), infectious diseases(4), oncology(3), cardiovascular disease(2), endocrine disorders(2), renal disease(1), surgery(1), and obstetrics/gynecology(1). Most sources described use of DBT as a clinical or research intervention(N=53). The majority of DBT interventions involved skills training(N=50). Skills training domains inclusion varied(emotion regulation(42); mindfulness(40); distress tolerance(39); interpersonal effectiveness(28)). A range of validated self-report measures were used to assess outcome domains (e.g., psychosocial, behavioral, medical/clinical).
Discussion:DBT has been applied in chronic physical illness populations with notable variation in DBT intervention structure, delivery, outcome domains and measures. Given the transdiagnostic nature of DBT and high mental health comorbidity in these patients, it is a promising intervention to target multiple mechanisms(e.g., behavioral, biological, appraisal). Rigorous clinical trials to assess the impact of DBT on health outcomes in patients with chronic physical illness are warranted.
Keywords: Multiple chronic conditions, Behavior ChangeMethods:We followed the Joanna Briggs Institute Manual for Evidence Synthesis guidance and the Arksey and O’Malley five-step framework. The team created a comprehensive search strategy and list of terms. Sources published through 5/2024 were included if they mentioned chronic physical illness and DBT. All sources were screened by two independent coders at the abstract, full text, and data extraction levels.
Results:The database search yielded 7,599 results; 5,070 abstracts were screened, 121 articles underwent full-text review, and data was extracted from 61 sources. Source types included 11 randomized controlled trials, 13 case series/reports, 8 non-randomized experimental studies, 6 theses/dissertations, 5 mixed method studies, 4 books, 2 abstracts, 1 cohort study, 1 qualitative study, and 10 "other". Studies were conducted in the US(N=33), Europe(9), Iran(8), and Australia(3). Illness/disease types included overweight/obesity(N=15), neurology/neurosurgery(10), chronic pain(10), generic(6), gastrointestinal disorders(6), infectious diseases(4), oncology(3), cardiovascular disease(2), endocrine disorders(2), renal disease(1), surgery(1), and obstetrics/gynecology(1). Most sources described use of DBT as a clinical or research intervention(N=53). The majority of DBT interventions involved skills training(N=50). Skills training domains inclusion varied(emotion regulation(42); mindfulness(40); distress tolerance(39); interpersonal effectiveness(28)). A range of validated self-report measures were used to assess outcome domains (e.g., psychosocial, behavioral, medical/clinical).
Discussion:DBT has been applied in chronic physical illness populations with notable variation in DBT intervention structure, delivery, outcome domains and measures. Given the transdiagnostic nature of DBT and high mental health comorbidity in these patients, it is a promising intervention to target multiple mechanisms(e.g., behavioral, biological, appraisal). Rigorous clinical trials to assess the impact of DBT on health outcomes in patients with chronic physical illness are warranted.
Authors:
Author - Riley Psenka, BS, Medical University of South Carolina
Co-Author - Grace Amaden, BA, Duke University Medical Center, Philadelphia College of Osteopathic Medicine
Co-Author - Brendan Li, BS, Duke University Medical Center, University of South Florida Morsani College of Medicine
Co-Author - Natalie Chou, BA, Duke University Medical Center
Co-Author - Kathryn Moody, BS, Medical University of South Carolina
Co-Author - Andrada Neacsiu, PhD, Duke University Medical Center
Co-Author - Tamara Somers, PhD, Duke University Medical Center
Co-Author - Kelly Hyland, PhD, Medical University of South Carolina, Duke University Medical Center
Exploring the direct and indirect associations of screen use and sleep with depressive symptoms in college students
Poster Number: B112Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Sleep
Inadequate sleep is highly prevalent among U.S. young adults. Through emerging independence and life transitions, sleep is usually compromised for other activities such as academic work or social gatherings. Such unhealthy sleep patterns may be linked to other negative physical and mental health outcomes, such as greater depression. Excessive screen use, which is prevalent among young adults, is associated with both worse sleep and greater depression. To date, few studies have examined the relationship between screen use and sleep jointly with depression, especially among young adults. In this study, we examine the direct and indirect associations of screen use with sleep and depressive symptoms. We hypothesize that longer screen use is associated with greater depressive symptoms both directly and indirectly via worse sleep.
Survey data from a large, multi-campus public university in the Northeastern region of the U.S. were analyzed (n=4017, 64% female, 72% White, age=20±1.4). Participants reported average daily and pre-sleep (2 hours before bedtime) screen use time, as well as sleep timing on school days and non-school days. Overall sleep quality and the frequency of having trouble sleeping were also assessed. Sleep durations for school days and non-school days were calculated based on the self-reported sleep-wake timing. Depressive symptoms were assessed using the standard CES-D-10 scale. All analyses were performed using R, and confidence intervals for direct and indirect effects were estimated using 10000 bias-corrected bootstrapped samples.
Results suggested that longer daily screen use was associated with greater depressive symptoms, with significant indirect associations through numerous features of sleep (later school day sleep time [B = 0.04 [0.02, 0.06]]; later non-school day sleep time [B = 0.02 [0.01, 0.04]] and wake time [B = 0.02 [0.01, 0.03]]; shorter school day sleep duration [B = 0.03 [0.01, 0.04]]; worse sleep quality [B =0.08 [0.04, 0.12]]; and greater sleep trouble [B =0.07 [0.02, 0.11]]). Results were similar for pre-sleep screen use.
As both screen use and sleep are modifiable behaviors and are both linked with depressive symptoms, they should be considered together as behavior change targets for depression prevention or intervention. Future studies should explore the associations among different types of screen use behaviors, sleep, and depression in a longitudinal setting.
Keywords: Depression, Health behaviorsSurvey data from a large, multi-campus public university in the Northeastern region of the U.S. were analyzed (n=4017, 64% female, 72% White, age=20±1.4). Participants reported average daily and pre-sleep (2 hours before bedtime) screen use time, as well as sleep timing on school days and non-school days. Overall sleep quality and the frequency of having trouble sleeping were also assessed. Sleep durations for school days and non-school days were calculated based on the self-reported sleep-wake timing. Depressive symptoms were assessed using the standard CES-D-10 scale. All analyses were performed using R, and confidence intervals for direct and indirect effects were estimated using 10000 bias-corrected bootstrapped samples.
Results suggested that longer daily screen use was associated with greater depressive symptoms, with significant indirect associations through numerous features of sleep (later school day sleep time [B = 0.04 [0.02, 0.06]]; later non-school day sleep time [B = 0.02 [0.01, 0.04]] and wake time [B = 0.02 [0.01, 0.03]]; shorter school day sleep duration [B = 0.03 [0.01, 0.04]]; worse sleep quality [B =0.08 [0.04, 0.12]]; and greater sleep trouble [B =0.07 [0.02, 0.11]]). Results were similar for pre-sleep screen use.
As both screen use and sleep are modifiable behaviors and are both linked with depressive symptoms, they should be considered together as behavior change targets for depression prevention or intervention. Future studies should explore the associations among different types of screen use behaviors, sleep, and depression in a longitudinal setting.
Authors:
Author - Yuqi Shen, M.H.S, The Pennsylvania State Univeristy
Co-Author - Stephanie Lanza, Ph.D., The Pennsylvania State University
Co-Author - Anne-Marie Chang, Ph.D., The Pennsylvania State University
Associations of Cannabis Use, Depression and Mental Health Services among U.S. Young Adults Aged 20–35: Data from the National Health and Nutrition Examination Survey 2011–2016
Poster Number: B113Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Substance Misuse
Background: Cannabis legalization and accessibility have increased across the U.S., but the relationship between cannabis use, depression, and treatment utilization among young adults remains unclear. This study examined associations between cannabis use, depressive symptoms, and mental health service use among U.S. young adults aged 20–35.
Methods: Data were drawn from 13,210 participants in the 2011–2016 National Health and Nutrition Examination Survey. Cannabis use was categorized as nonusers, nonregular users (not past-month users or never regular users), and regular users (≥once/month for >1 year). Outcomes included depressive symptoms (PHQ-9), past-month antidepressant use (prescription records), and past-year visits with mental health professionals (MHPs). Weighted logistic regression models estimated associations between cannabis use and outcomes, adjusting for age, sex, race/ethnicity, marital status, education, and insurance.
Results: Depressive symptoms were reported by 8.2% of nonusers, 13.4% of nonregular users, and 14.4% of regular users. Compared with nonusers, both nonregular (OR=1.74, 95% CI: 1.01–3.00) and regular (OR=1.89, 95% CI: 1.12–3.19) users had higher odds of depression. Nonregular users were more likely to use antidepressants (AOR=1.59, 95% CI: 1.03–2.45), while regular users were not significantly different (AOR=1.25, 95% CI: 0.72–2.18). Regular users initially showed higher odds of visiting MHPs (OR=1.91, 95% CI: 1.18–3.09), but this association was attenuated after adjustment.
Conclusion: Cannabis use—particularly regular use—is associated with elevated depressive symptoms among young adults. However, its relationship with treatment utilization is complex, suggesting that cannabis may be used to self-manage depression but does not consistently translate to greater engagement with mental health care. These findings highlight the importance of clarifying motivations for cannabis use and barriers to treatment access in order to inform interventions for young adults navigating both substance use and mental health challenges.
Keywords: Substance abuse, Mental healthMethods: Data were drawn from 13,210 participants in the 2011–2016 National Health and Nutrition Examination Survey. Cannabis use was categorized as nonusers, nonregular users (not past-month users or never regular users), and regular users (≥once/month for >1 year). Outcomes included depressive symptoms (PHQ-9), past-month antidepressant use (prescription records), and past-year visits with mental health professionals (MHPs). Weighted logistic regression models estimated associations between cannabis use and outcomes, adjusting for age, sex, race/ethnicity, marital status, education, and insurance.
Results: Depressive symptoms were reported by 8.2% of nonusers, 13.4% of nonregular users, and 14.4% of regular users. Compared with nonusers, both nonregular (OR=1.74, 95% CI: 1.01–3.00) and regular (OR=1.89, 95% CI: 1.12–3.19) users had higher odds of depression. Nonregular users were more likely to use antidepressants (AOR=1.59, 95% CI: 1.03–2.45), while regular users were not significantly different (AOR=1.25, 95% CI: 0.72–2.18). Regular users initially showed higher odds of visiting MHPs (OR=1.91, 95% CI: 1.18–3.09), but this association was attenuated after adjustment.
Conclusion: Cannabis use—particularly regular use—is associated with elevated depressive symptoms among young adults. However, its relationship with treatment utilization is complex, suggesting that cannabis may be used to self-manage depression but does not consistently translate to greater engagement with mental health care. These findings highlight the importance of clarifying motivations for cannabis use and barriers to treatment access in order to inform interventions for young adults navigating both substance use and mental health challenges.
Authors:
Author - Olivia X. Shen, University of Illinois Chicago
Co-Author - Qiping Fan, PhD, Clemson University
Co-Author - Loretta Hsueh, PhD, University of Illinois at Chicago
The Association of Having a Primary Care Provider with Visiting a Mental Health Professional: Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018
Poster Number: B114Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Integrated Primary Care
Background: Primary care providers (PCPs) commonly provide mental health care (MHC) for patients with psychological distress, but challenges such as PCP burnout and a lack of mental health specialization highlight the need to connect patients to mental health providers (MHPs). Research suggests a tight link between PCPs and MHPs, as PCPs routinely screen for mental health concerns and make referrals to MHC; additionally, PCPs typically have long-term trusting relationships with their patients, which may facilitate patients’ willingness to follow up with MHC recommendations. The link between having a PCP and visiting with an MHP has not yet been tested. Our objective was to examine the association of having a PCP with visiting an MHP in the past year among a nationally representative sample.
Methods: Data came from the 2011-2018 National Health and Nutrition Examination Survey. Respondents were coded as seeing an MHP within the past year (yes/no) from the question, “During the past 12 months, have you seen or talked to a mental health professional such as a psychologist, psychiatrist, psychiatric nurse or clinical social worker about your health?” Having a PCP was derived from two questions regarding whether the respondent had a routine place of care, and if so, the type of place. Respondents who answered, “Doctor’s office or HMO,” “Hospital outpatient department,” and “Clinic or health center” were coded as having a PCP; “Hospital emergency room” and “Doesn’t go to one place most often” were coded as not having a PCP. Logistic regressions examined the association of having a PCP with a past-year visit to an MHP controlling for demographics and insurance status.
Results: Of n=20,169 respondents (mage= 49.5 years, SDage=17.7, 51.6% female) in this sample, n=1,800 (8.9%) reported a past-year visit with an MHP, and n=15,753 (78.1%) reported having a PCP. In fully-adjusted models, having a PCP was significantly associated with increased odds (OR= 1.74, 95% CI: 1.42, 2.13, p<.001) of a past-year visit with an MHP.
Conclusion: In this nationally representative sample of adults, those who had a PCP were more likely to have visited an MHP in the past year. Prior literature suggests potential explanations for this association, such as PCPs administering screeners (e.g., PHQ-9) and offering referrals to MHPs. Future studies are needed to explore the specific barriers that patients face in accessing mental health care after being referred by a PCP.
Keywords: Mental health, Primary careMethods: Data came from the 2011-2018 National Health and Nutrition Examination Survey. Respondents were coded as seeing an MHP within the past year (yes/no) from the question, “During the past 12 months, have you seen or talked to a mental health professional such as a psychologist, psychiatrist, psychiatric nurse or clinical social worker about your health?” Having a PCP was derived from two questions regarding whether the respondent had a routine place of care, and if so, the type of place. Respondents who answered, “Doctor’s office or HMO,” “Hospital outpatient department,” and “Clinic or health center” were coded as having a PCP; “Hospital emergency room” and “Doesn’t go to one place most often” were coded as not having a PCP. Logistic regressions examined the association of having a PCP with a past-year visit to an MHP controlling for demographics and insurance status.
Results: Of n=20,169 respondents (mage= 49.5 years, SDage=17.7, 51.6% female) in this sample, n=1,800 (8.9%) reported a past-year visit with an MHP, and n=15,753 (78.1%) reported having a PCP. In fully-adjusted models, having a PCP was significantly associated with increased odds (OR= 1.74, 95% CI: 1.42, 2.13, p<.001) of a past-year visit with an MHP.
Conclusion: In this nationally representative sample of adults, those who had a PCP were more likely to have visited an MHP in the past year. Prior literature suggests potential explanations for this association, such as PCPs administering screeners (e.g., PHQ-9) and offering referrals to MHPs. Future studies are needed to explore the specific barriers that patients face in accessing mental health care after being referred by a PCP.
Authors:
Author - Viviana Uribe, University of Illinois at Chicago
Co-Author - Loretta Hsueh, PhD, University of Illinois at Chicago
Latiné Adults in Silicon Valley Prioritize Root Social Stressors to Address Mental Health Struggles
Poster Number: B115Time: 11:00 AM - 11:50 AM
Topics: Mental Health, Stress
Background: Silicon Valley in California is renowned for its booming tech industry and immense wealth. Yet, it represents a contradiction of affluence and extreme inequality. Latiné residents in the region experience profound social and economic disadvantages that may negatively affect stress and mental health. The current study examines (a) the social and economic stressors impacting the mental health of Latiné adults and (b) the strategies they seek or recommend to address these challenges and promote wellbeing.
Methods: In-depth, semi-structured individual interviews were conducted with Latiné adults (18+ years old) residing in Santa Clara County (n=20). Interviews were ~60 minutes, conducted in English or Spanish, audio-recorded, and transcribed verbatim. Thematic analysis guided the qualitative analysis, with three independent coders reviewing and coding the interviews.
Results: Participants described economic instability (e.g., housing), lack of opportunities for social mobility (e.g., education access), community deprivation (e.g., cultural erasure, gentrification), environmental conditions (e.g., climate change), limits to healthcare access (e.g., poor quality healthcare), and interpersonal conflicts (e.g., familial demands) as primary causes to mental health for Latiné adults. Biological causes of mental illness were not discussed. In response to mental health concerns, participants described seeking or recommending services directly targeting the root causes to stress. Although specialty mental health services (e.g., therapist) were touted as important, participants emphasized economic and social safety-nets to promoting mental wellbeing, including housing support services (e.g., rental stipends), food pantries, basic need essentials services (e.g., utility support), government-sponsored social safety-net programs (e.g., SNAP), and community-based social and child-specific programming as essential.
Conclusion: Mental health and help-seeking, as understood by Latiné adults, are shaped by social and economic context. There is value in using traditional mental health services to improve mental wellbeing. Yet, Latiné adults in Silicon Valley prioritized services that directly targeted the root stressors impacting mental health. In a time when safety-nets are being dismantled at the federal level, there is a need to strengthen these services at community/regional levels if we are to properly address mental health.
Keywords: Mental health, Minority healthMethods: In-depth, semi-structured individual interviews were conducted with Latiné adults (18+ years old) residing in Santa Clara County (n=20). Interviews were ~60 minutes, conducted in English or Spanish, audio-recorded, and transcribed verbatim. Thematic analysis guided the qualitative analysis, with three independent coders reviewing and coding the interviews.
Results: Participants described economic instability (e.g., housing), lack of opportunities for social mobility (e.g., education access), community deprivation (e.g., cultural erasure, gentrification), environmental conditions (e.g., climate change), limits to healthcare access (e.g., poor quality healthcare), and interpersonal conflicts (e.g., familial demands) as primary causes to mental health for Latiné adults. Biological causes of mental illness were not discussed. In response to mental health concerns, participants described seeking or recommending services directly targeting the root causes to stress. Although specialty mental health services (e.g., therapist) were touted as important, participants emphasized economic and social safety-nets to promoting mental wellbeing, including housing support services (e.g., rental stipends), food pantries, basic need essentials services (e.g., utility support), government-sponsored social safety-net programs (e.g., SNAP), and community-based social and child-specific programming as essential.
Conclusion: Mental health and help-seeking, as understood by Latiné adults, are shaped by social and economic context. There is value in using traditional mental health services to improve mental wellbeing. Yet, Latiné adults in Silicon Valley prioritized services that directly targeted the root stressors impacting mental health. In a time when safety-nets are being dismantled at the federal level, there is a need to strengthen these services at community/regional levels if we are to properly address mental health.
Authors:
Presenter - Alice Villatoro, PhD, Santa Clara University
Co-Author - Bianca Duarte, B.S., Santa Clara University
Co-Author - Veronica Miranda, PhD, Santa Clara University
Lessons learned from the adaptation of the daily inventory of stressful events for SMS delivery
Poster Number: B116Time: 11:00 AM - 11:50 AM
Topics: Methods and Measurement, Stress
Introduction
Daily stressors lead to an increased risk of poor health outcomes such as heart disease, stroke, and mental illness. The Daily Inventory of Stressful Events (DISE) is a widely used measure of daily stressors and recommended by the Science of Behavior Change website. The DISE's popularity is based on its wide use, demonstrated validity in diverse samples, and the detailed information it provides researchers. However, DISE involves conducting one-on-one interviews with participants over several days and thus may present a high burden to both participants and researchers. Accordingly, many researchers have opted to simplify the measure by substituting the interview with a battery of survey questions.
Methods
The current study aims to examine an adaptation of DISE delivered via mobile phone text messages. The adaptation was developed for a feasibility study addressing dementia caregiver stress and self-care and arose with the goal of reducing participant and researcher burden while still providing high-quality information about the variability in daily stressors experienced by participants. As such, we examine variability of responses, patterns of completion, valid response rates, and survey drop out to determine if the adaptation was feasible and what ways it could potentially be improved for use in future studies.
Results
Overall, we found high completion rates (87%) and normally distributed response patterns, suggesting overall feasibility. However, we did identify two question types (single choice with multiple options and time related) that had higher frequencies of invalid responses. Further, we found that invalid responses preceded higher rates of survey drop out. Additionally, we observed decreased participation over time, suggesting potential survey fatigue.
Conclusion
The text message delivery of the DISE provided useful information concerning the daily stressors of participants in our study. Yet, the quality of the data collected was hindered by several design choices made in the transition from interview to text message. We provide recommendations for enhancing the utility of mobile phone text message delivery of both DISE and other measures and highlight the need for additional validity work on such adaptations.
Keywords: Measurement, StressDaily stressors lead to an increased risk of poor health outcomes such as heart disease, stroke, and mental illness. The Daily Inventory of Stressful Events (DISE) is a widely used measure of daily stressors and recommended by the Science of Behavior Change website. The DISE's popularity is based on its wide use, demonstrated validity in diverse samples, and the detailed information it provides researchers. However, DISE involves conducting one-on-one interviews with participants over several days and thus may present a high burden to both participants and researchers. Accordingly, many researchers have opted to simplify the measure by substituting the interview with a battery of survey questions.
Methods
The current study aims to examine an adaptation of DISE delivered via mobile phone text messages. The adaptation was developed for a feasibility study addressing dementia caregiver stress and self-care and arose with the goal of reducing participant and researcher burden while still providing high-quality information about the variability in daily stressors experienced by participants. As such, we examine variability of responses, patterns of completion, valid response rates, and survey drop out to determine if the adaptation was feasible and what ways it could potentially be improved for use in future studies.
Results
Overall, we found high completion rates (87%) and normally distributed response patterns, suggesting overall feasibility. However, we did identify two question types (single choice with multiple options and time related) that had higher frequencies of invalid responses. Further, we found that invalid responses preceded higher rates of survey drop out. Additionally, we observed decreased participation over time, suggesting potential survey fatigue.
Conclusion
The text message delivery of the DISE provided useful information concerning the daily stressors of participants in our study. Yet, the quality of the data collected was hindered by several design choices made in the transition from interview to text message. We provide recommendations for enhancing the utility of mobile phone text message delivery of both DISE and other measures and highlight the need for additional validity work on such adaptations.
Authors:
Author - Nathan P Helsabeck, PhD, The Ohio State University College of Nursing
Author - Emily Hales, MPH, The Ohio State University College of Nursing
Author - Ana Carolina Wong, BSN, BA, RN, The Ohio State University College of Nursing
Author - Kathy Wright, PhD, RN, APRN-CNS, PMHCNS-BC, FNAP, FGSA, FAAN, The Ohio State University
Qualitative End-user Feedback informs Design of Novel Dyadic SMART
Poster Number: B117Time: 11:00 AM - 11:50 AM
Topics: Methods and Measurement, Diabetes
Introduction. Reciprocal peer support, where two participants in self-care support programs are matched as peer partners, has demonstrated benefits for type 2 diabetes (T2D). Optimizing adaptive interventions using study designs such as sequential multiple assignment randomized trials (SMARTs) necessitates randomizing to a condition more than once during a study. This presents unique challenges for peer interventions (e.g., subsequent randomizations may break up peer partners), which have been understudied. We sought to understand the best way to facilitate peer matching during a dyadic SMART.
Methods. Participants (N=8) experienced an abbreviated 3-week peer support intervention including an initial call with a coach and their peer partner as well as daily text messages about self-care and peer support with conversation prompts for the peer relationship (“icebreakers”). After, they provided feedback on text messaging content and completed an interview regarding their experiences and attitudes towards changing peer partners. Interviews were transcribed and analyzed using rapid qualitative analysis.
Results. The sample was 55.1 years old (SD=11.9); 50% male; 50% non-Hispanic white, 38% non-Hispanic Black, and 13% missing; 50% married and average duration of T2D was 12.6 years (SD=7.5). Participants liked working with their peer, reminders from text messages, and found icebreakers helpful. Participants were happy with who they were matched with and said their relationships focused on accountability and support. Regarding changing peer partners, more participants wanted to stay with their peer (n=5) than wanted to change (n=2) or were ambivalent (n=1), several noting their answer was influenced by the high quality of their current match. Participants discussed how a new peer could bring a new perspective, and it would be beneficial to keep meeting new people. However, they also were concerned about losing a good connection too soon and disrupting progress as well as wanted the opportunity to continue to grow with their current peer.
Discussion. Feedback from participants was largely positive. They developed strong peer relationships in 3 weeks which will require careful consideration as changing peer partners may impact retention and intervention engagement. Results informed intervention design regarding timing of randomizations to facilitate matching and decision rules regarding re-matching peers at the intervention midpoint.
Keywords: Methods, DiabetesMethods. Participants (N=8) experienced an abbreviated 3-week peer support intervention including an initial call with a coach and their peer partner as well as daily text messages about self-care and peer support with conversation prompts for the peer relationship (“icebreakers”). After, they provided feedback on text messaging content and completed an interview regarding their experiences and attitudes towards changing peer partners. Interviews were transcribed and analyzed using rapid qualitative analysis.
Results. The sample was 55.1 years old (SD=11.9); 50% male; 50% non-Hispanic white, 38% non-Hispanic Black, and 13% missing; 50% married and average duration of T2D was 12.6 years (SD=7.5). Participants liked working with their peer, reminders from text messages, and found icebreakers helpful. Participants were happy with who they were matched with and said their relationships focused on accountability and support. Regarding changing peer partners, more participants wanted to stay with their peer (n=5) than wanted to change (n=2) or were ambivalent (n=1), several noting their answer was influenced by the high quality of their current match. Participants discussed how a new peer could bring a new perspective, and it would be beneficial to keep meeting new people. However, they also were concerned about losing a good connection too soon and disrupting progress as well as wanted the opportunity to continue to grow with their current peer.
Discussion. Feedback from participants was largely positive. They developed strong peer relationships in 3 weeks which will require careful consideration as changing peer partners may impact retention and intervention engagement. Results informed intervention design regarding timing of randomizations to facilitate matching and decision rules regarding re-matching peers at the intervention midpoint.
Authors:
Author - McKenzie K. Roddy, PhD, Vanderbilt University Medical Center
Co-Author - Sara Haji, MS, Vanderbilt University Medical Center
Co-Author - Angela F. Pfammatter, PhD, University of Tennessee, Knoxville
Co-Author - Robert Greevy Jr., PhD, Vanderbilt University Medical Center
Co-Author - Lindsay Mayberry, PhD, FSBM, Vanderbilt University Medical Center
Great Power Competition: Variable Ratio-Based Technology Use Competes with Health Behaviors among U.S. Service Members
Poster Number: B118Time: 11:00 AM - 11:50 AM
Topics: Military and Veterans' Health, Digital Health
Introduction: The DoD’s interest in health behaviors stems from mitigating risks to occupational performance. Research in civilian populations has proposed that technology use that capitalizes on variable ratio (VR) reinforcement (e.g., social media, video games, and streaming services) is an under-recognized health behavior that may moderate health outcomes in dietary habits, BMI, sleep, and social engagement. The current study has two aims: 1) describe the prevalence and use patterns of VR technologies among service members (SMs), and 2) determine the correlation of these technologies with health behaviors, hypothesizing a negative association with health behaviors, regardless of technology type.
Methods: This study surveys SMs on their technology use and other health behaviors. Data analysis was derived from 95 respondents at a rural, northwestern United States military base. The population was primarily White (74%) males (71%) and aged 18-27 years old (56%). Descriptive statistics and pairwise correlation coefficients were used to explore the linear association between variables.
Findings: The estimated prevalence of weekly streaming service use was 87%, 85% for social media, 58% for video games, and 38% for mobile video games (MVGs). The highest reported weekly hours of use were for social media (28 hrs), followed by video games (23 hrs), streaming services (18 hrs), and MVGs (12 hrs). Social media use (r = .36, p < .01) and MVGs (r = .58, p < .01) were associated with more minutes of movement each hour after work. MVGs were associated with less overall sleep quality (r = .40, p < .05), better ratings of overall quality of social interactions (r = .50, p < .05), and yet also with less quality social interactions with people geographically close to the respondent (r = .50, p < .05).
Discussion: Reported technology use and health behaviors reveal nuanced results that do not mirror other populations. The use duration suggested that technology use is competing with other health behaviors. Yet, data from respondents showed mixed impact of social media and MVGs on health outcomes, and no significance among the other digital health behaviors. Sample size and single-site data collection limit generalizability. These exploratory findings justify a need for deeper research among SMs. Better understanding of digital health behaviors will help develop targeted interventions to optimize the benefits of technology while mitigating negative impacts on health.
Keywords: Technology, Health behaviorsMethods: This study surveys SMs on their technology use and other health behaviors. Data analysis was derived from 95 respondents at a rural, northwestern United States military base. The population was primarily White (74%) males (71%) and aged 18-27 years old (56%). Descriptive statistics and pairwise correlation coefficients were used to explore the linear association between variables.
Findings: The estimated prevalence of weekly streaming service use was 87%, 85% for social media, 58% for video games, and 38% for mobile video games (MVGs). The highest reported weekly hours of use were for social media (28 hrs), followed by video games (23 hrs), streaming services (18 hrs), and MVGs (12 hrs). Social media use (r = .36, p < .01) and MVGs (r = .58, p < .01) were associated with more minutes of movement each hour after work. MVGs were associated with less overall sleep quality (r = .40, p < .05), better ratings of overall quality of social interactions (r = .50, p < .05), and yet also with less quality social interactions with people geographically close to the respondent (r = .50, p < .05).
Discussion: Reported technology use and health behaviors reveal nuanced results that do not mirror other populations. The use duration suggested that technology use is competing with other health behaviors. Yet, data from respondents showed mixed impact of social media and MVGs on health outcomes, and no significance among the other digital health behaviors. Sample size and single-site data collection limit generalizability. These exploratory findings justify a need for deeper research among SMs. Better understanding of digital health behaviors will help develop targeted interventions to optimize the benefits of technology while mitigating negative impacts on health.
Authors:
Author - Thomas Holland, PsyD, United States Air Force
Co-Author - Chase Aycock, PsyD, United States Air Force
Co-Author - Brandon Smith, PhD, United States Air Force
Co-Author - Joseph Galluzzo, PhD, United States Air Force
Impact of Interpersonal Trauma Exposure and Unhealthy Alcohol Use on Women Veteran’s Social Support Access and Alcohol Use Treatment Interest
Poster Number: B119Time: 11:00 AM - 11:50 AM
Topics: Military and Veterans' Health, Substance Misuse
Women veterans report higher exposure to interpersonal trauma events compared to the general population and male veterans. These trauma experiences are linked to detrimental physical and mental health, and psychosocial outcomes, particularly unhealthy alcohol use. Negative reinforcement models suggest women veterans drink to cope with trauma-related distress. Drinking increases revictimization risk due to impaired judgment and lowered inhibitions. While alcohol use is prevalent among women veterans, they are less likely to seek alcohol use treatment compared to their male counterparts. Barriers to treatment, such as diminished social support, are not well understood. Positive social support is vital for recovery. This study aimed to understand the relationship between social support, alcohol-related interpersonal factors, and treatment interests among women veterans with unhealthy alcohol use and trauma history. Participants (N = 118) were women veterans enrolled in primary care at a VA Medical Center with indicators of unhealthy alcohol use. They completed an online survey with measures on alcohol use, trauma exposure, and likelihood of engaging in alcohol treatment. Participants were divided into two groups: those with interpersonal trauma (n = 49) and those with no trauma or non-interpersonal trauma (n = 69). Independent sample t-tests to compare the two groups, as well as linear regressions focused on the interpersonal trauma group were conducted. The interpersonal trauma group reported significantly lower social support (t(109) = -2.32, p = .01) and higher social and total consequences (t(72) = 3.35, p < .001; t(81) = 4.05, p < .001) from drinking without significant differences in alcohol consumption (t(116) = -0.19, p > .05). This group also showed greater readiness to engage in alcohol treatment (t(87) = 2.90, p < .01) and a higher likelihood of attending with the goal to improve relationships (t(106) = 2.20, p = .02). However, an inverse relationship was found between social support and the treatment barrier of negative support (β = -0.26, p < .05), indicating women in the interpersonal trauma group with less social support may worry more about further support deterioration through treatment. Future research should explore ways to mitigate fears of support loss and increase social connections to foster treatment engagement.
Keywords: Alcohol, TraumaAuthors:
Presenter - Rachael Shaw Riniolo, PhD, VA Center for Integrated Healthcare
Co-Author - Katherine Buckheit, PhD, VA Center for Integrated Healthcare
Co-Author - Robyn Sedotto, PhD, VA Center for Integrated Healthcare
Co-Author - Kyle Possemato, PhD, VA Center for Integrated Healthcare
Adapting Evidence-Based Self-Management Interventions for Brain Cancer Survivors: A Strengths-Based, Skills-Building Approach
Poster Number: B12Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Background: With advances in treatment, people are living longer with brain cancer. However, brain cancer survivors face persistent physical, cognitive, and psychosocial challenges that impact quality of life. There are no evidence-based quality of life interventions tailored to the unique needs of this population. Building on successful self-management programs for chronic conditions such as stroke and diabetes, we aimed to develop an adapted intervention for brain cancer survivors.
Methods: We engaged an expert design panel comprising people living with brain cancer, clinicians, researchers, and other brain cancer community partners to guide adaptation of existing interventions. In parallel, we conducted 8 virtual focus groups (n=61) with diverse brain cancer survivors to elicit perspectives on intervention content and delivery. Focus group transcripts were analyzed using content analysis, guided by the Framework for Reporting Adaptations and Modifications-Enhanced.
Results: The expert panel emphasized the importance of strengths-based approaches, group discussion over didactics, and attention to brain cancer-specific needs across phases of the journey from diagnosis to survivorship. Focus groups recommended topics on problem-solving, stress management skills, mental health care (including stigma and social isolation; symptom & tumor education; and strategies for information management and navigating health care. Program format suggestions included opportunities to build community, delivery flexibility and support for mobility and/or cognitive impairments, 6-8 weekly virtual sessions. The final adapted intervention comprises eight biweekly sessions over 16 weeks. Each session includes 60 minutes of structured content and 30 minutes of unstructured community-building. Topics include: (1) Orientation and Glioma Basics, (2) Problem Solving Skills, (3) Stress and Coping Skills, (4) Navigating the Healthcare System, (5) Social Support and Interpersonal Skills, (6) Healthy Lifestyles, (7) Memory and Cognition, and (8) Planning for the Future.
Conclusion: This co-designed, strengths-based self-management support intervention addresses the mental and behavioral health needs of brain cancer survivors and is grounded in survivor input and evidence-based practices. Future work will pilot test the intervention to assess feasibility, acceptability, and preliminary outcomes.
This abstract outline was developed using Microsoft CoPilot based on the study protocol.
Keywords: Cancer survivorship, Quality of lifeMethods: We engaged an expert design panel comprising people living with brain cancer, clinicians, researchers, and other brain cancer community partners to guide adaptation of existing interventions. In parallel, we conducted 8 virtual focus groups (n=61) with diverse brain cancer survivors to elicit perspectives on intervention content and delivery. Focus group transcripts were analyzed using content analysis, guided by the Framework for Reporting Adaptations and Modifications-Enhanced.
Results: The expert panel emphasized the importance of strengths-based approaches, group discussion over didactics, and attention to brain cancer-specific needs across phases of the journey from diagnosis to survivorship. Focus groups recommended topics on problem-solving, stress management skills, mental health care (including stigma and social isolation; symptom & tumor education; and strategies for information management and navigating health care. Program format suggestions included opportunities to build community, delivery flexibility and support for mobility and/or cognitive impairments, 6-8 weekly virtual sessions. The final adapted intervention comprises eight biweekly sessions over 16 weeks. Each session includes 60 minutes of structured content and 30 minutes of unstructured community-building. Topics include: (1) Orientation and Glioma Basics, (2) Problem Solving Skills, (3) Stress and Coping Skills, (4) Navigating the Healthcare System, (5) Social Support and Interpersonal Skills, (6) Healthy Lifestyles, (7) Memory and Cognition, and (8) Planning for the Future.
Conclusion: This co-designed, strengths-based self-management support intervention addresses the mental and behavioral health needs of brain cancer survivors and is grounded in survivor input and evidence-based practices. Future work will pilot test the intervention to assess feasibility, acceptability, and preliminary outcomes.
This abstract outline was developed using Microsoft CoPilot based on the study protocol.
Authors:
Author - Bethany Kwan, PhD, University of Colorado School of Medicine
Co-Author - Juliana Barnard, MA, University of Colorado School of Medicine
Co-Author - Carly Ritger, MS, University of Colorado School of Medicine
Co-Author - Lindsay Lennox, MA, University of Colorado School of Medicine
Co-Author - Daniel Myers, University of Colorado School of Medicine
Co-Author - Heather Smyth, PhD, University of Colorado School of Medicine
Co-Author - Wendy Gehring, University of Colorado School of Medicine
Co-Author - Shelby West, University of Colorado School of Medicine
Co-Author - Clara Adeniyi, Case Western Reserve University
Co-Author - Juliana Santos, University of Colorado School of Medicine
Co-Author - Molly McVoy, MD, Case Western Reserve University
A Focus Group Study Exploring Mindfulness and Healthy Behaviors among Black Women
Poster Number: B120Time: 11:00 AM - 11:50 AM
Topics: Multiple Health Behavior Change , Women's Health
Black women are disproportionately impacted by chronic diseases such as heart disease and diabetes, making interventions to promote healthy behaviors (i.e., physical activity, sleep, and nutrition) that reduce disease risk critically important. While mindfulness shows promise for reducing stress and promoting healthy behaviors, formative research is needed to inform culturally-tailored interventions. This study employed focus group interviews to elicit participants’ perceptions of these healthy behaviors and mindfulness as a tool to help inform a mindfulness-based lifestyle behavior intervention designed specifically for Black women. Five focus groups were conducted; transcribed interviews were coded with a combined inductive and deductive approach informed by an integration of Intersectionality Theory and the Minority Stress Theory. Three team members coded the transcripts, with discrepancies resolved by discussions until consensus was reached. A senior team member occasionally joined coding sessions to ensure that codes were being consistently applied. A total of 37 participants completed the interviews (Mean age = 53.8 years; 89% self-identified as Black or African American). Participants tended to distinguish between what is healthy compared to what is feasible within their lifestyle (or healthy-ish), and much of the dissonance between aspirational and realized health was attributed to stressors. While many of these stressors were generalized (e.g., occupation-related stress), others were more directly connected to lived experiences with a minoritized identity (e.g., experiences specific to Black Americans). With respect to incorporating mindfulness techniques to manage that stress, participants reported a range of responses from no interest at all to already having integrated mindfulness-based strategies (e.g., meditation and deep breathing). Recommendations for a mindfulness-based intervention specific to this population included representation of women of color, consideration for time limitations due to conflicting demands, opportunities to connect with other Black women in the program, and having human interaction. In conclusion, while there are many barriers to healthy behaviors for Black women, there is evidence that mindfulness-based strategies can support these women by both reducing stress and facilitating a healthier lifestyle.
Keywords: Mindfulness, Health behaviorsAuthors:
Presenter - Belinda O'Hagan, Brown University School of Public Health
Author - Sugandha Gupta-Louis, Ferkauf Graduate School of Psychology
Co-Author - Michael Onu, Brown University School of Public Health
Co-Author - Tayla Von Ash, ScD, MPH, Brown University School of Public Health
Co-Author - Patricia Riscia, Brown University School of Public Health
Exploring the association between cancer screening adherence status, perceived cancer risk, and physical activity: A 28-day ecological momentary assessment study
Poster Number: B121Time: 11:00 AM - 11:50 AM
Topics: Multiple Health Behavior Change , Physical Activity
Background: Regular physical activity (PA) and adherence to cancer screening guidelines are key strategies to reduce one’s cancer risk. While cancer screenings are often considered “teachable moments” to also promote healthier behaviors, some researchers caution that adherence may also produce a “health certificate effect,” in which individuals feel falsely reassured and reduce PA. This study examined associations between cancer screening adherence and PA levels and patterns, assessed via retrospective surveys and ecological momentary assessment (EMA), and tested whether perceived cancer risk moderated these relationships.
Method: Data came from a 28-day nationwide EMA study. At baseline, participants reported cancer history, screening adherence, cancer risk perceptions, and average daily minutes of moderate-to-vigorous PA (MVPA). EMA responses were used to derive MVPA indices (mean, intercept, slope, quadratic term, and volatility). Analyses of covariance tested differences in retrospective and EMA-based MVPA across adherence groups, and moderated regressions examined whether cancer risk perceptions influenced these relationships.
Results: Participants (N = 397) were predominantly White, non-Hispanic, and had completed at least 12 years of education. Fully adherent participants (i.e., up to date with all eligible screenings) showed greater day-to-day fluctuations in MVPA compared to those who were partially adherent (i.e., up to date with one or more but not all eligible screenings). Perceived susceptibility moderated the relationship between screening adherence and EMA-assessed MVPA. When perceived susceptibility was low, fully adherent participants reported lower first-day and average MVPA than non-adherent participants, and lower average MVPA than partially adherent participants. At higher levels of susceptibility, fully adherent participants reported higher MVPA overall.
Conclusion: The current study observed different activity profiles across adherence groups and supported a health certificate effect. As more studies integrate PA interventions into cancer screening contexts, these findings highlight the importance of assessing adherence to all eligible screenings rather than individual ones, considering perceived susceptibility in intervention design, and leveraging EMA methods to capture nuanced, real-time PA levels and patterns.
Keywords: Physical activity, Cancer screeningMethod: Data came from a 28-day nationwide EMA study. At baseline, participants reported cancer history, screening adherence, cancer risk perceptions, and average daily minutes of moderate-to-vigorous PA (MVPA). EMA responses were used to derive MVPA indices (mean, intercept, slope, quadratic term, and volatility). Analyses of covariance tested differences in retrospective and EMA-based MVPA across adherence groups, and moderated regressions examined whether cancer risk perceptions influenced these relationships.
Results: Participants (N = 397) were predominantly White, non-Hispanic, and had completed at least 12 years of education. Fully adherent participants (i.e., up to date with all eligible screenings) showed greater day-to-day fluctuations in MVPA compared to those who were partially adherent (i.e., up to date with one or more but not all eligible screenings). Perceived susceptibility moderated the relationship between screening adherence and EMA-assessed MVPA. When perceived susceptibility was low, fully adherent participants reported lower first-day and average MVPA than non-adherent participants, and lower average MVPA than partially adherent participants. At higher levels of susceptibility, fully adherent participants reported higher MVPA overall.
Conclusion: The current study observed different activity profiles across adherence groups and supported a health certificate effect. As more studies integrate PA interventions into cancer screening contexts, these findings highlight the importance of assessing adherence to all eligible screenings rather than individual ones, considering perceived susceptibility in intervention design, and leveraging EMA methods to capture nuanced, real-time PA levels and patterns.
Authors:
Presenter - Bingjing Mao, Louisiana State University Health Sciences Center New Orleans
Co-Author - Jordan Neil, PhD, OUHSC
Co-Author - Sixia Chen, University of Oklahoma Health Sciences Center
Co-Author - Emily Hébert, DrPH, University of Oklahoma Health Sciences Center
Co-Author - Michael Businelle, PhD, FSBM, University of Oklahoma Health Sciences Center
Feasibility and Preliminary Efficacy of a 12-Week Primary-Care Based Behavioral Counseling Intervention Among Adults with Cardiovascular Disease Risk Factors
Poster Number: B122Time: 11:00 AM - 11:50 AM
Topics: Multiple Health Behavior Change , Cardiovascular Disease
Background: Physical activity (PA) and dietary counseling are recommended for adults with cardiovascular disease (CVD) risk factors. However, these programs are seldom implemented in primary care where patients receive CVD treatments.
Purpose: To evaluate the feasibility and preliminary efficacy of a 12-week primary care-based behavioral counseling intervention (BCI) for adults at risk for CVD.
Methods: Patients were recruited through a novel clinical screening and referral workflow implemented in six local Family Medicine clinics to participate in a phase IIa ‘proof of concept’ single-arm pre-post study. Participants received a theory-based (Multi-Process Action Control) 12-week, remotely delivered BCI that included health education, health coaching, and a wearable activity/sleep monitor. Changes in psychosocial constructs (e.g., behavioral regulation skills, habits), behavioral outcomes (PA, diet, sleep), and health outcomes (cardiometabolic and self-reported) were assessed with paired t-tests, and Cohen’s d effect sizes were calculated.
Results: Ninety-seven participants (mean age = 50.6 years, 64% female) completed the BCI. Moderate-large improvements were observed for behavioral regulation skills, health habits, and health identity psychosocial constructs (d = 0.75-1.03). Muscle-strengthening exercise, daily kilocalories, whole fruit and total protein intake, and sleep efficiency, quality, and disturbances improved to a small-moderate degree (d = 0.23-0.64). Small-moderate improvements in diastolic blood pressure, bodyweight, total fat mass, depressive symptoms, fatigue, general health, and quality of life were also observed (d = 0.25-0.53). While no significant changes in device-based PA were observed in the overall sample, small-moderate improvements in daily steps, vigorous-intensity PA, and moderate-vigorous PA were observed for participants not meeting aerobic PA guidelines at baseline (d = 0.25-0.53). Participants with lower baseline steps and dietary quality saw greater improvements. Intervention retention (85%) and adherence (e.g., 98% of coaching sessions attended) was high.
Conclusion: These results support the feasibility and preliminary efficacy of a 12-week primary care-based BCI to change targeted psychosocial mechanisms of action, and specific health behaviors and outcomes—particularly in patients with less favorable health behaviors at baseline. A randomized controlled trial is warranted to confirm these findings.
Keywords: Health behavior change, Primary carePurpose: To evaluate the feasibility and preliminary efficacy of a 12-week primary care-based behavioral counseling intervention (BCI) for adults at risk for CVD.
Methods: Patients were recruited through a novel clinical screening and referral workflow implemented in six local Family Medicine clinics to participate in a phase IIa ‘proof of concept’ single-arm pre-post study. Participants received a theory-based (Multi-Process Action Control) 12-week, remotely delivered BCI that included health education, health coaching, and a wearable activity/sleep monitor. Changes in psychosocial constructs (e.g., behavioral regulation skills, habits), behavioral outcomes (PA, diet, sleep), and health outcomes (cardiometabolic and self-reported) were assessed with paired t-tests, and Cohen’s d effect sizes were calculated.
Results: Ninety-seven participants (mean age = 50.6 years, 64% female) completed the BCI. Moderate-large improvements were observed for behavioral regulation skills, health habits, and health identity psychosocial constructs (d = 0.75-1.03). Muscle-strengthening exercise, daily kilocalories, whole fruit and total protein intake, and sleep efficiency, quality, and disturbances improved to a small-moderate degree (d = 0.23-0.64). Small-moderate improvements in diastolic blood pressure, bodyweight, total fat mass, depressive symptoms, fatigue, general health, and quality of life were also observed (d = 0.25-0.53). While no significant changes in device-based PA were observed in the overall sample, small-moderate improvements in daily steps, vigorous-intensity PA, and moderate-vigorous PA were observed for participants not meeting aerobic PA guidelines at baseline (d = 0.25-0.53). Participants with lower baseline steps and dietary quality saw greater improvements. Intervention retention (85%) and adherence (e.g., 98% of coaching sessions attended) was high.
Conclusion: These results support the feasibility and preliminary efficacy of a 12-week primary care-based BCI to change targeted psychosocial mechanisms of action, and specific health behaviors and outcomes—particularly in patients with less favorable health behaviors at baseline. A randomized controlled trial is warranted to confirm these findings.
Authors:
Author - Jenna Springer, M.S. Health and Human Physiology, Department of Health, Sport, and Human Physiology, University of Iowa
Co-Author - Garrett Steinbrink, M.S. Kinesiology, Department of Health, Sport, and Human Physiology, University of Iowa
Co-Author - Lauren Tetmeyer, M.S. Health and Human Physiology, Department of Health, Sport, and Human Physiology, University of Iowa
Co-Author - Katherine Mellen, Ph.D., R.D., Department of Health, Sport, and Human Physiology, University of Iowa
Co-Author - Britt Marcussen, M.D., Department of Family Medicine, University of Iowa Healthcare
Co-Author - Dale Bond, Ph.D., Center for Obesity Research, Innovation and Education, Digestive Health Institute Hartford Hospital/HealthCare
Co-Author - Yin Wu, Ph.D., Center for Obesity Research, Innovation and Education, Digestive Health Institute Hartford Hospital/HealthCare
Co-Author - Lucas Carr, Ph.D., Department of Health, Sport, and Human Physiology, University of Iowa
Developing and Evaluating a Culturally Appropriate Non-Opioid Pain Coping Skills Training Intervention for Spanish-Speaking Hispanic/Latine Cancer Survivors: A Mixed-Methods Study
Poster Number: B123Time: 11:00 AM - 11:50 AM
Topics: Pain, Community Engagement
Background. Hispanic/Latine (H/L) populations experience disparities in cancer-related care and inadequate access to pain treatments, contributing to medication misuse, emotional distress, and diminished quality of life. Language and cultural barriers further limit access and adherence to pain management services. While our web-based painTRAINER® has proven effective for pain management in NIH-funded trials, it previously was available only in English. Methods. Following community-engaged processes with H/L organizations, community advisory boards, and bilingual health experts, we adapted and translated painTRAINER to create PainTRAINER en Español, which includes 8 weekly pain coping skills training modules (45 min each) led by a virtual coach. We conducted a mixed-methods feasibility study among H/L cancer survivors with persistent pain. Primary outcomes: feasibility (≥70% completed 6/8 modules) and acceptability (≥70% satisfied/very satisfied). Semi-structured interviews (N=30) underwent comprehensive thematic analysis. Results. Quantitative: Thirty participants (97% female, 57% breast cancer survivors) enrolled over a 3 month period. Of 29 who started, 25 (86.2%; 95% CI: 68.3-96.1%) completed ≥6 modules, exceeding the feasibility threshold. All 25 rating acceptability (100%; 95% CI: 86.3-100%) were satisfied/very satisfied. Qualitative: Six themes emerged: severe pain disrupting family roles and daily functioning; cultural alignment with H/L family values and spiritual beliefs; meaningful transformations including significant pain reduction, renewed life purpose, and enhanced family relationships; program flexibility and accessibility features; emotional healing journeys often described as spiritual "rebirth"; and strong advocacy for program expansion to other Spanish speaking and pain populations. Participants progressed from experiencing uncontrolled pain and hopelessness to sustained skill practice, growing confidence, enhanced quality of life, and greater family harmony. Conclusions. PainTRAINER en Español demonstrated excellent feasibility and acceptability while influencing outcomes beyond pain reduction to include renewed purpose, improved family relationships, and desire to help others. The successful cultural adaptation integrated evidence-based pain management techniques with H/L cultural values and linguistic appropriateness. These findings support broader testing of culturally-responsive digital health interventions for cancer survivors.
Keywords: Pain, Health disparitiesAuthors:
Presenter - Megan Bennett, MS, MS, PhD, Department of Health and Exercise Science, Wake Forest University
Co-Author - Mariana Rodriguez-Pardy, MPH, Wake Forest NCORP Research Base
Co-Author - Anna Snavely, PhD, Department of Biostatistics and Data Science, Wake Forest University School of Medicine Wake Forest NCORP Research Base
Co-Author - Katherine Ramos, PhD, Psychiatry and Behavioral Sciences, Duke University School of Medicine
Co-Author - Alexandra Coffield, BS, Wake Forest School of Medicine
Co-Author - Nicole Nunez, BS, Wake Forest School of Medicine
Co-Author - Zachary Ward, BS, Wake Forest School of Medicine
Co-Author - Victoria McGuirt, BS, Department of Health and Exercise Science, Wake Forest University
Co-Author - Tonya Henighan, MPH, Wake Forest NCORP Research Base
Co-Author - Christine Rini, PhD, FSBM, Northwestern University Feinberg School of Medicine
Co-Author - Francis Keefe, PhD, Psychiatry and Behavioral Sciences, Duke University School of Medicine
Co-Author - Glenn Lesser, MD, Wake Forest School of Medicine; 6Department of Cancer Medicine, Wake Forest University School of Medicine
Co-Author - Mark Brown, MA, Department of Biostatistics and Data Science, Wake Forest University School of Medicine Wake Forest NCORP Research Base
Co-Author - Kathryn Weaver, PhD MPH, Wake Forest University School of Medicine
Co-Author - Karen Craver, MHA, Wake Forest NCORP Research Base
Co-Author - Donald Penzien, PhD, FSBM, FAHS, Wake Forest School of Medicine
Illness Burden of Multiple Chronic Overlapping Pain Conditions in Patients with Urologic Chronic Pelvic Pain Syndrome (UCPPS)
Poster Number: B124Time: 11:00 AM - 11:50 AM
Topics: Pain, Quality of Life
Background and Aims. Urologic chronic pelvic pain syndrome (UCPPS), a constellation of painful urological conditions including interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, is characterized by pain in the pelvic region or genitalia often accompanied by urinary frequency or urgency. Comorbidities often include a cluster of pain disorders called chronic overlapping pain conditions (COPC) caused by dysregulated or amplified pain processing within the CNS. Little is known about the toll specific COPCs impose on UCPPS symptoms, physical and mental function and well being (quality of life, QOL), fatigue, or distress (i.e., illness profile). Method. We collected baseline data from 152 UCPPS patients (M age 43 yrs, 83% Female) enrolled in an NIH clinical trial. Testing battery assessed UCPPS symptoms, presence and severity of COPCs, QOL, fatigue, and distress. Results. UCPPS patients reported an average of 1.9 (SD=1.7) COPCs the most common of which were migraine (N = 57) and chronic low back pain (n = 54, cLBP). Number of additional COPCs was more strongly associated with worse physical functioning due to physical health (SF12 PCS; r = -.48, p < .05) problems than to mental health (SF MCS r = - .13, SF-12, p > .05) problems. Of 36 possible COPC dyads, the 10 most frequent pairs included a combination of migraine (5 dyads), cLBP (4 dyads) tension headache (3 dyads), IBS or TMD (2 dyads). COPC dyads with migraine were associated with a worse illness profile including more intense overall painful symptoms (McGill-Total) and fatigue (PROMIS), QOL impairment (SF-12 PCS), and pain interference (PROMIS). In general, the presence of COPCs was less strongly and consistently associated, if at all, with worse mental health status (BSI-GSI, SF-12 MCS, CSQ catastrophizing) or worse UCPPS symptoms (i.e. pelvic pain, urinary symptoms) as measured by the GUPI or ICSI (all ps >.05). In 57% of comparisons, illness burden of having multiple COPCs was worse than having a single COPC comorbidity. Conclusions. Data suggest that COPCs increase patient burden of UCPPS with the greatest impact involving specific disease combinations including cLBP, migraine and tension headache, TMD, and IBS. Comorbidity burden is greatest for QOL impairment due to physical functioning and limitations from physical - but not mental health - problems, fatigue, and overall intensity of pain symptoms. Acknowledgement. NIH/DK grant 096606.
Keywords: Multiple chronic conditions, PainAuthors:
Author - Jeffrey Lackner, Psy.D., University at Buffalo Department of Medicine
Co-Author - Chang–Xing Ma, Ph.D., University at Buffalo Department of Biostatistics and Public Health
Co-Author - Gregory Gudleski, Ph.D., University at Buffalo Department of Medicine
Co-Author - Christopher Radziwon, Ph.D., University at Buffalo Department of Medicine
Co-Author - Sonia Sharma, DDS, PhD, University at Buffalo Department of Medicine
Co-Author - Teresa Danforth, M.D., University at Buffalo Department of Urology
Co-Author - Andrew Rogers, Ph.D., University at Buffalo Department of Medicine
Co-Author - Kaila Dietel, B.A., University at Buffalo Department of Medicine
Co-Author - Tova Ablove, M.D., University at Buffalo Department of Obstetrics and Gynecology
Subtypes of Chronic Pain Patients – Proposing a Three-Group Model
Poster Number: B125Time: 11:00 AM - 11:50 AM
Topics: Pain
Introduction: Pain has been shown to have a drastic negative impact on psychological wellbeing, and chronic pain patients are at heightened risk for comorbid mental illnesses, including depression and substance use. Despite its negative health outcomes, chronic pain and tailored interventions to reduce it remain understudied. Specifically, there is a gap in scientific knowledge about how patients at different levels of physical and psychological pain severity may respond to treatment, which may account for findings of varied mental health and substance use risk within the population.
Methods: Archival data accessed via Mendeley included a sample of 99 adults experiencing chronic or recurrent pain and their responses to the McGill Pain Questionnaire (MPQ), a survey including categorical responses about lifestyle, pain, and history. A Principal Components Analysis (PCA) was conducted and interpreted with an explanation by Julius, an AI-powered data analyst, followed by a K-means Clustering method to identify and confirm the number of clusters that best fit the data.
Results: The PCA showed an underlying structure among variables, as proposed, explaining 84% of variance. The exploratory class analysis indicated that a three-group model best fits the data, and groups were labelled by response themes. The “low risk” group (65% of the sample) was characterized by measures of overall health, with few psychological or sleep problems. The “medically complex” group (18%) featured high ratings of pain and medication use. Finally, the “psychosocially distressed group” (17%) demonstrated high levels of stress, sleep disturbance, and alcohol use.
Discussion: The results identified three distinct subgroups of chronic pain patients, characterized by their varying levels of overall health, health behaviors, and stress. Study limitations include relying on self-reported scores for the questionnaire data and the use of cross-sectional data to draw conclusions, rather than longitudinal and causal relationships among variables. Future studies would benefit from the inclusion of additional variables that impact treatment success, including somatic perception and trauma history, as well as the use of a longitudinal design to better understand the trajectory of recovery, quality of life, and disability status. Understanding the subtypes of chronic pain will allow for treatment and outcome improvements for these patients in the future.
Keywords: Pain, ChronicMethods: Archival data accessed via Mendeley included a sample of 99 adults experiencing chronic or recurrent pain and their responses to the McGill Pain Questionnaire (MPQ), a survey including categorical responses about lifestyle, pain, and history. A Principal Components Analysis (PCA) was conducted and interpreted with an explanation by Julius, an AI-powered data analyst, followed by a K-means Clustering method to identify and confirm the number of clusters that best fit the data.
Results: The PCA showed an underlying structure among variables, as proposed, explaining 84% of variance. The exploratory class analysis indicated that a three-group model best fits the data, and groups were labelled by response themes. The “low risk” group (65% of the sample) was characterized by measures of overall health, with few psychological or sleep problems. The “medically complex” group (18%) featured high ratings of pain and medication use. Finally, the “psychosocially distressed group” (17%) demonstrated high levels of stress, sleep disturbance, and alcohol use.
Discussion: The results identified three distinct subgroups of chronic pain patients, characterized by their varying levels of overall health, health behaviors, and stress. Study limitations include relying on self-reported scores for the questionnaire data and the use of cross-sectional data to draw conclusions, rather than longitudinal and causal relationships among variables. Future studies would benefit from the inclusion of additional variables that impact treatment success, including somatic perception and trauma history, as well as the use of a longitudinal design to better understand the trajectory of recovery, quality of life, and disability status. Understanding the subtypes of chronic pain will allow for treatment and outcome improvements for these patients in the future.
Authors:
Author - Shana Smolen, Touro University
Co-Author - Sharon Cohen, Touro University
Co-Author - Gianna Puccio, Touro University
Co-Author - Aida Aminpour, Touro University
Co-Author - Kerry Cannity, Ph.D., Touro University
The Shadow of the Morning: A Within-Person Mediation Analysis of Morning Stress Anticipation, Positive Incidental Affect, and Objectively-Measured Daily Sitting Time
Poster Number: B126Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Mental Health
Background: Daily sedentary behavior is a significant health risk. While morning anticipation is known to shape daily behavior, the underlying mechanisms are unclear. This study tested the within-person hypothesis that morning stress anticipation increases same-day sitting time by reducing daily positive incidental affect (PIA). Methods: A purposive sample of 152 adults (female = 67.1%, age = 18-59, M = 24.97) completed a 7-day ecological momentary assessment (EMA) protocol. Participants wore activPAL4™ micro accelerometers to objectively measure total daily sitting time. Participants completed smartphone-based surveys upon waking and at three quasi-random times during the day. The morning survey measured stress anticipation, and the three quasi-random time surveys assessed current PIA using a 5-item measure (happy, enjoyable, satisfied, relaxed and energetic) on a 5-point Likert scale. Multilevel models were used to conduct a within-person mediation analysis. The primary model tested the indirect effect of person-mean centered morning stress anticipation (rescaled to 10-point units) on sitting time via person-mean centered PIA. Models controlled for demographic, health status, and other potential confounders. Results: A significant indirect effect was found (ACME: β = 1.97, 95% CI [0.47, 3.62]). On days when stress anticipation was 10 points higher than usual, participants experienced significantly lower PIA (Path a: β = –0.08, p < .001). Lower PIA, in turn, was associated with significantly more sitting time (Path b: β = –24.64, p = .010). The direct effect of a 10-point increase in stress anticipation on sitting time remained significant (ADE: β = 8.27, p = .003). The mediation accounted for 19.22% of the total effect. A robustness check using negative incidental affect as the mediator was not significant. Conclusion: Positive incidental affect is an important pathway through which morning stress anticipation leads to increased sitting behavior. Thus, interventions aiming to reduce sitting time could target managing morning stress anticipation and fostering daily positive affective experiences. For instance, encouraging the formulation of specific plans for activity in the morning could be an effective strategy for just-in-time adaptive interventions (JITAI). Such approaches could aim to translate positive motivational states into concrete active behaviors, potentially buffering against the effects of anticipated stress throughout the day.
Keywords: Physical activity, Mental healthAuthors:
Presenter - William Feung, Taipei American School
Co-Author - Shang-Ti Chen, National Dong Hwa University
Co-Author - Chih-Hsiang Yang, University of South Carolina
Effects of school-based physical activity interventions on physical activity, cardiovascular fitness, and body composition: a meta-analysis of randomized controlled trials
Poster Number: B127Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Multiple Health Behavior Change
Background and Objectives: Low physical activity (PA) in youth is a common health concern and often persists into adulthood. Because most children and adolescents attend P–12 schools, schools are a practical place to promote PA. Earlier meta-analyses of school-based PA interventions have generated mixed results from randomized controlled trials (RCTs) and evidence from more recent trials has not been synthesized. It is also unclear whether factors such as age and intervention length affect outcomes. This research synthesis used a multi-level meta-analysis and meta-regression to examine the effects of school-based PA interventions on objectively measured PA, cardiovascular fitness, and body composition, and to test whether age and intervention duration moderate these effects.
Methods: We comprehensively searched 30 databases in August 2025. Studies were eligible for inclusion if they were RCTs with at least two assessment points separated by the intervention, and if the outcomes included objectively measured PA, cardiovascular fitness, or body composition (i.e. body mass index [BMI]). Eligible interventions had to be conducted in P-12 schools. Studies were excluded if they used non-RCT designs, relied on self-reported PA measures, did not include a PA component, or were not conducted in schools. Multi-level random-effects meta-regression models were used as the primary data analysis approach.
Results: The final dataset included 22 studies conducted across 12 countries, with a total of 10,317 participants (55% female; mean age = 10.7 years, SD = 2.1; age range: 6.2–14 years). The pooled effect of school-based PA interventions on PA was small and non-significant (Hedges’ g = 0.08, 95% CI [−0.01, 0.16], p = .09). Neither participant age (β = 0.00, p = .95) nor intervention duration (β = −0.01, p = .84) moderated the intervention effects on PA. Similarly, no intervention effects were observed for cardiovascular fitness (Hedges’ g = 0.04, 95% CI [−0.13, 0.21], p = .66) or BMI (Hedges’ g = 0.10, 95% CI [−0.15, 0.35], p = .45).
Conclusion: School-based PA interventions showed small, non-significant effects on PA across different ages and intervention durations. Similarly, non-significant effects were found for cardiovascular fitness and BMI. These findings suggest that promoting PA in school settings remains a significant challenge. Future research and practice should continue to test and refine more effective school-based strategies to improve youth health.
Keywords: Physical activity, Behavior ChangeMethods: We comprehensively searched 30 databases in August 2025. Studies were eligible for inclusion if they were RCTs with at least two assessment points separated by the intervention, and if the outcomes included objectively measured PA, cardiovascular fitness, or body composition (i.e. body mass index [BMI]). Eligible interventions had to be conducted in P-12 schools. Studies were excluded if they used non-RCT designs, relied on self-reported PA measures, did not include a PA component, or were not conducted in schools. Multi-level random-effects meta-regression models were used as the primary data analysis approach.
Results: The final dataset included 22 studies conducted across 12 countries, with a total of 10,317 participants (55% female; mean age = 10.7 years, SD = 2.1; age range: 6.2–14 years). The pooled effect of school-based PA interventions on PA was small and non-significant (Hedges’ g = 0.08, 95% CI [−0.01, 0.16], p = .09). Neither participant age (β = 0.00, p = .95) nor intervention duration (β = −0.01, p = .84) moderated the intervention effects on PA. Similarly, no intervention effects were observed for cardiovascular fitness (Hedges’ g = 0.04, 95% CI [−0.13, 0.21], p = .66) or BMI (Hedges’ g = 0.10, 95% CI [−0.15, 0.35], p = .45).
Conclusion: School-based PA interventions showed small, non-significant effects on PA across different ages and intervention durations. Similarly, non-significant effects were found for cardiovascular fitness and BMI. These findings suggest that promoting PA in school settings remains a significant challenge. Future research and practice should continue to test and refine more effective school-based strategies to improve youth health.
Authors:
Author - Han Chen, Ph.D., Valdosta State University
Presenter - Han Chen, Ph.D., Valdosta State University
Co-Presenter - Jiling Liu, Ph.D., Texas A&M University
Co-Presenter - Senlin Chen, Ph.D., Louisiana State University
Feel better yet? Only active individuals report enhanced positive activated affect on days they engage in more moderate-to-vigorous physical activity.
Poster Number: B128Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Mental Health
Engaging in more MVPA than usual is associated with higher positive affect and, reciprocally, higher positive affect is associated with more MVPA. However, this association is not consistent across studies. Effects may differ based on a person's typical activity level, with consistently active people showing attenuated affective responses to MVPA. This study used data from a 21-day study to examine whether typical activity level moderated the daily within-person associations between affect and MVPA. Participants were 21-44-year-old adults who were overweight/obese. They wore an activPAL monitor for 21 days to assess daily steps and MVPA minutes and completed morning and evening surveys about four types of affect: positive-activated (e.g., lively, happy), positive-deactivated (e.g., calm, relaxed), negative-activated (e.g., tense, angry), and negative-deactivated (e.g., sad, lonely) on a 0-4 Likert scale. Using days 1-7 participants were categorized as active (≥10,000 steps/day) or inactive (<10,000 steps/day). Using days 8-21, multilevel models (MLMs) examined activity level moderating the within-person effect of MVPA on evening affect. Two-part MLMs examined activity level moderating the within-person effect of morning affect on the odds and time spent in MVPA. All models controlled for between-person effects, sex, and weekends, with separate models for each type of affect. Participants (N=86, Mage=30.3±6.5, 59% female,74% White) averaged 15.7±1.5 minutes of MVPA/day and 25 (29.4%) were categorized as active. There were no main effects of MVPA on evening affect or morning affect on MVPA, but being active moderated the bidirectional within-person associations. Engaging in more MVPA than usual was associated with enhanced evening positive-activated affect among active people (bsimple=0.01, se=0.00,p=.02) but not inactive people (bsimple=-0.00, se=0.00, p=.18). Being active was associated with higher odds of engaging in MVPA (odds ratio=2.94, 95% confidence interval: 1.33, 6.49) compared to being inactive, but only when morning positive-activated affect was low. There were no other significant moderation effects. This study provides evidence that the reciprocal, within-person associations between affect and MVPA are limited to active individuals and to positive activated forms of affect. This suggests that inactive people may not experience the affect-enhancing benefits of MVPA, which has implications for lifestyle interventions and public health messaging.
Keywords: Physical activity, EmotionsAuthors:
Presenter - Jimikaye Courtney, Ph.D., University of North Carolina at Chapel Hill
Co-Author - Stone Norris, MA, University of North Carolina at Chapel Hill
Co-Author - Paschal Sheeran, PhD, FSBM, The University of North Carolina at Chapel Hill
Co-Author - Claudio Battaglini, PhD, University of North Carolina at Chapel Hill
Symptoms as Correlates of Sedentary Behavior in Adults with Multiple Sclerosis
Poster Number: B129Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Multiple Health Behavior Change
Background
Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease of the central nervous system that manifests with cognitive and physical dysfunction, fatigue, anxiety, depression, poor quality of life, and various comorbid conditions. Additionally, people with MS are more sedentary than those without MS, averaging approximately 8 hours of sitting per day.
Objective
We examined walking ability, fatigue, health-related quality of life, anxiety, depression, cognitive, and physical function as correlates of self-reported sedentary behavior in adults with MS.
Methods
The sample included 519 adults with MS who completed online surveys assessing demographics, clinical characteristics (e.g., MS type, patient-determined disease steps [PDDS]), sedentary behavior (Marshall Sitting Questionnaire; [MSQ]), walking impairment (Multiple Sclerosis Walking Scale [MSQS-12]), fatigue (Fatigue Severity Scale [FSS]), anxiety and depressive symptoms (Hospital Anxiety [HADS-A] and Depression [HADS-D] Scale [HADS-D]), along with physical and mental components of health related quality of life (Short Form Health Survey -12 [SF-12 PCS] and [SF-12 MCS]). Participants further completed Zoom-based assessments of verbal learning and memory (California Verbal Learning Test II [CVLT-II]), cognitive processing speed (Symbol Digit Modalities Test [SDMT]), and lower leg function (30-second Sit-to-Stand [30-STS]). Statistical analyses included bivariate correlations and a multivariable linear regression that identified correlates of sedentary behavior in MS.
Results
The bivariate analysis indicated MSQ scores were statistically associated with FSS (r = .080, p<.05), SF-12 MCS (r = -.102, p<.05), and CVLT-II (r = -.090, p<.05). The multivariate regression demonstrated that SF-12 MCS scores (b =-.102, p<.05) entered the model in Step 1, and CVLT-II entered the model in Step 2 (b =-.089, p>.05).
Conclusion
We identified FSS, SF-12 MCS, and CVLT-II as correlates of sedentary behavior in adults with MS. SF-12 MCS was the strongest predictor of sedentary time.
Keywords: Behavior Change, Physical activityMultiple sclerosis (MS) is an immune-mediated neurodegenerative disease of the central nervous system that manifests with cognitive and physical dysfunction, fatigue, anxiety, depression, poor quality of life, and various comorbid conditions. Additionally, people with MS are more sedentary than those without MS, averaging approximately 8 hours of sitting per day.
Objective
We examined walking ability, fatigue, health-related quality of life, anxiety, depression, cognitive, and physical function as correlates of self-reported sedentary behavior in adults with MS.
Methods
The sample included 519 adults with MS who completed online surveys assessing demographics, clinical characteristics (e.g., MS type, patient-determined disease steps [PDDS]), sedentary behavior (Marshall Sitting Questionnaire; [MSQ]), walking impairment (Multiple Sclerosis Walking Scale [MSQS-12]), fatigue (Fatigue Severity Scale [FSS]), anxiety and depressive symptoms (Hospital Anxiety [HADS-A] and Depression [HADS-D] Scale [HADS-D]), along with physical and mental components of health related quality of life (Short Form Health Survey -12 [SF-12 PCS] and [SF-12 MCS]). Participants further completed Zoom-based assessments of verbal learning and memory (California Verbal Learning Test II [CVLT-II]), cognitive processing speed (Symbol Digit Modalities Test [SDMT]), and lower leg function (30-second Sit-to-Stand [30-STS]). Statistical analyses included bivariate correlations and a multivariable linear regression that identified correlates of sedentary behavior in MS.
Results
The bivariate analysis indicated MSQ scores were statistically associated with FSS (r = .080, p<.05), SF-12 MCS (r = -.102, p<.05), and CVLT-II (r = -.090, p<.05). The multivariate regression demonstrated that SF-12 MCS scores (b =-.102, p<.05) entered the model in Step 1, and CVLT-II entered the model in Step 2 (b =-.089, p>.05).
Conclusion
We identified FSS, SF-12 MCS, and CVLT-II as correlates of sedentary behavior in adults with MS. SF-12 MCS was the strongest predictor of sedentary time.
Authors:
Author - Sydney DeJonge-Bolton, MS, University of Illinois Chicago
Co-Author - Le Thao Trinh Huynh, PhD, University of Illinois at Chicago
Co-Author - Victoria Flores, PhD, University of La Verne
Co-Author - Robert Motl, PhD, University of Illinois Chicago
Who Do Rural Communities Trust? The Role of Information Sources in Human Papillomavirus Vaccination Uptake in Rural Indiana
Poster Number: B13Time: 11:00 AM - 11:50 AM
Topics: Cancer, Health Disparities
Background: Indiana is among the top seven states with the highest cervical cancer mortality rates. Yet, Human papillomavirus (HPV) vaccine uptake among Indiana adults ages 19-26 remains low at 40.2%. Of Indiana’s 92 counties, 42 are rural, where residents have limited access to healthcare. They are more exposed to alternative information sources, making them vulnerable to misinformation and may contribute to lower HPV vaccine uptake. Understanding how trust in information sources relates to vaccine uptake is important, especially in rural areas. Objective: Examined the association between trust in commonly used information sources and HPV vaccine uptake in rural Indiana.
Methods: From May 2024 to March 2025, participants were recruited at two rural clinics operated by nurse practitioners affiliated with a university’s School of Nursing in Northern Indiana. We invited participants in clinic waiting areas to complete a survey. We analyzed adults aged 18-45, consistent with HPV vaccine eligibility. Participants reported whether they had ever received the HPV vaccine and their level of trust in HPV information from each source using 4-Likert scale, including healthcare providers (HCPs), professional organizations, brochures, libraries, family, friends, and Internet. Trust level was recoded as a binary variable for analysis purposes. Logistic regression assessed associations between trust and vaccine uptake, adjusting for confounders.
Results: Participants’ age mean was 32.3 years (SD=7.69); 84.7% were female, 43.2% were married, and 39.1% had received the HPV vaccine. The most trusted sources were HCPs (81.1%), professional organizations (65.5%), and brochures (45.9%). Those who trusted HPV vaccine information from HCPs (aOR=10.76, 95%CI=1.20-96.37) and libraries (aOR=3.67, 95%CI=1.01-13.26) had significantly higher odds of receiving HPV vaccine. Other sources were not statistically significant.
Conclusion and Implications:
Those who trusted HCPs and libraries were more likely to be HPV-vaccinated, suggesting that rural residents rely on established and community-based sources for vaccination decisions. In contrast, digital and informal sources had low impact. To improve uptake in rural areas, interventions should enhance provider-patient communication, utilize local channels like community libraries as vaccine information hubs, and expand roles for accessible HCPs, including community paramedics to deliver tailored vaccine education and services.
Keywords: Cancer, information seekingMethods: From May 2024 to March 2025, participants were recruited at two rural clinics operated by nurse practitioners affiliated with a university’s School of Nursing in Northern Indiana. We invited participants in clinic waiting areas to complete a survey. We analyzed adults aged 18-45, consistent with HPV vaccine eligibility. Participants reported whether they had ever received the HPV vaccine and their level of trust in HPV information from each source using 4-Likert scale, including healthcare providers (HCPs), professional organizations, brochures, libraries, family, friends, and Internet. Trust level was recoded as a binary variable for analysis purposes. Logistic regression assessed associations between trust and vaccine uptake, adjusting for confounders.
Results: Participants’ age mean was 32.3 years (SD=7.69); 84.7% were female, 43.2% were married, and 39.1% had received the HPV vaccine. The most trusted sources were HCPs (81.1%), professional organizations (65.5%), and brochures (45.9%). Those who trusted HPV vaccine information from HCPs (aOR=10.76, 95%CI=1.20-96.37) and libraries (aOR=3.67, 95%CI=1.01-13.26) had significantly higher odds of receiving HPV vaccine. Other sources were not statistically significant.
Conclusion and Implications:
Those who trusted HCPs and libraries were more likely to be HPV-vaccinated, suggesting that rural residents rely on established and community-based sources for vaccination decisions. In contrast, digital and informal sources had low impact. To improve uptake in rural areas, interventions should enhance provider-patient communication, utilize local channels like community libraries as vaccine information hubs, and expand roles for accessible HCPs, including community paramedics to deliver tailored vaccine education and services.
Authors:
Presenter - Alfu Laily, Purdue University
Co-Author - Soojung Jo, Purdue University
Predictors of Physical Activity among Youth with Functional Abdominal Pain: An Idiographic Evaluation of Intensive Longitudinal Data
Poster Number: B130Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Pain
Background: Functional abdominal pain is a debilitating chronic condition that can interfere with engagement in physical activity (PA) and quality of life among youth. Despite clinical recommendations encouraging PA engagement, the majority of youth with functional abdominal pain do not meet current PA guidelines. A lack of PA engagement is likely influenced by the interplay of biopsychosocial factors, including pain symptoms, fatigue, sleep, and social support. Identifying which of these indicators significantly predict daily PA patterns is an important step toward developing interventions that promote health behavior change.
Purpose: The present study used ecological momentary assessment (EMA) and activity monitors to evaluate the predictive roles of fatigue, pain, sleep, and social support on both individual- and group-level PA variability in youth with functional abdominal pain. These factors were examined in real time and evaluated on their capacity to predict PA 30 minutes following survey completion.
Methods: A sample of 74 youth (ages 8–17; 73% female) participated over the course of the 14-day study. Participants completed EMAs four times daily, reporting current fatigue, pain severity, and perceived social support. Objective measures of PA and total sleep time were collected continuously using wrist-worn accelerometers. Two-level time-series models were evaluated within-person and between-person effects of fatigue, pain, social support, and sleep on PA variability.
Results: Analyses revealed a significant effect of between-person fatigue while controlling for within-person effects. Specifically, as fatigue increased relative to the rest of the sample, PA engagement patterns were observed to be less variable (β = -0.56, 95% CI = -1.128, -0.023). In contrast, reports of pain, social support, and total sleep time were not significant predictors of PA.
Conclusions: Findings highlight the role of fatigue in affecting daily PA engagement among youth with functional abdominal pain. Compared to pain severity, social support, or sleep duration, fatigue levels represented the most salient predictor of PA patterns. Thus, fatigue represents a key risk factor for sedentary behavior and failure to meet PA recommendations. Importantly, additional work is needed to determine if these findings have value when replicated at the day level or on longer timescales that might mirror intervention periods.
Keywords: Physical activity, Health behaviorsPurpose: The present study used ecological momentary assessment (EMA) and activity monitors to evaluate the predictive roles of fatigue, pain, sleep, and social support on both individual- and group-level PA variability in youth with functional abdominal pain. These factors were examined in real time and evaluated on their capacity to predict PA 30 minutes following survey completion.
Methods: A sample of 74 youth (ages 8–17; 73% female) participated over the course of the 14-day study. Participants completed EMAs four times daily, reporting current fatigue, pain severity, and perceived social support. Objective measures of PA and total sleep time were collected continuously using wrist-worn accelerometers. Two-level time-series models were evaluated within-person and between-person effects of fatigue, pain, social support, and sleep on PA variability.
Results: Analyses revealed a significant effect of between-person fatigue while controlling for within-person effects. Specifically, as fatigue increased relative to the rest of the sample, PA engagement patterns were observed to be less variable (β = -0.56, 95% CI = -1.128, -0.023). In contrast, reports of pain, social support, and total sleep time were not significant predictors of PA.
Conclusions: Findings highlight the role of fatigue in affecting daily PA engagement among youth with functional abdominal pain. Compared to pain severity, social support, or sleep duration, fatigue levels represented the most salient predictor of PA patterns. Thus, fatigue represents a key risk factor for sedentary behavior and failure to meet PA recommendations. Importantly, additional work is needed to determine if these findings have value when replicated at the day level or on longer timescales that might mirror intervention periods.
Authors:
Author - Peter Fantozzi, MA, University of Kansas
Co-Author - Calissa Leslie-Miller, MS, University of Kansas
Co-Author - Christopher Cushing, PhD, University of Kansas
Co-Author - Jennifer Schurman, PhD, Children’s Mercy Kansas City, University of Missouri-Kansas City School of Medicine
Exercise Self Efficacy, Perceived Exertion and Affective Responses to Exergaming and Treadmill Walking in Physically Inactive vs. Physically Active Women
Poster Number: B131Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Women's Health
BACKGROUND: Despite strong evidence that regular physical activity (PA) is protective against adverse health outcomes, only ~20% of U.S. adult women are meeting CDC minimum PA recommendations (recs) for health [150 min of moderate to vigorous intensity PA (MVPA)/week]. Research suggests that MVPA may elicit negative affective responses, especially in inactive individuals, which may, in part, explain low rates of PA in women. The purpose of this study was to investigate rate of perceived exertion (RPE) and affective PA responses during a treadmill vs. a virtual reality (VR) exergaming bout, in inactive vs. physically active women.
METHODS: Healthy women (n = 19; mean age 31.3 +/- 11.9 y) completed an enrollment session which included the PA Readiness Questionnaire, Self-Efficacy for Exercise (SEE) questionnaire, International PA Questionnaire (IPAQ), anthropometrics, resting hemodynamics, and two 13-minute exercise sessions on different days (a VR exergaming bout and a treadmill bout). Both bouts included a 3-min warm up and 10-min MVPA phase. Maximum rate of perceived exertion (RPE), post-exercise state anxiety, and exercise affective responses were assessed for each bout.
RESULTS: Compared to those meeting MVPA recs, those not meeting MVPA recs had lower SEE scores (37.8 vs. 54.8; t = -2.2, p = .04), and higher RPE during the treadmill bout was associated with greater perceived difficulty (r = 0.47, p =0.10; trend). This relationship was not evidenced in the VR bout in inactive women. Additionally, higher RPE during the VR bout was significantly associated with a reduced anxious response (r = -0.67, p = .02), and lower post-exercise state anxiety (r = -0.58, p = .05). These relationships were not evidenced in the treadmill bout in the less active women, nor were they evidenced (for either exercise bout) in those meeting MVPA rec.’s.
CONCLUSIONS: Despite reporting lower exercise self-efficacy than active women, higher RPE during VR exergaming was associated with more positive affective responses in less active participants, which was not seen in the treadmill bout, nor in physically active participants. Additionally, higher RPE was associated with greater perceived difficulty during the treadmill bout, but not the VR bout, in less active women. These findings suggest that VR exergaming may elicit positive affective responses to exercise, even at higher intensities, in less active women, which may help to increase MVPA adherence in this population.
Keywords: Physical activity, Health promotionMETHODS: Healthy women (n = 19; mean age 31.3 +/- 11.9 y) completed an enrollment session which included the PA Readiness Questionnaire, Self-Efficacy for Exercise (SEE) questionnaire, International PA Questionnaire (IPAQ), anthropometrics, resting hemodynamics, and two 13-minute exercise sessions on different days (a VR exergaming bout and a treadmill bout). Both bouts included a 3-min warm up and 10-min MVPA phase. Maximum rate of perceived exertion (RPE), post-exercise state anxiety, and exercise affective responses were assessed for each bout.
RESULTS: Compared to those meeting MVPA recs, those not meeting MVPA recs had lower SEE scores (37.8 vs. 54.8; t = -2.2, p = .04), and higher RPE during the treadmill bout was associated with greater perceived difficulty (r = 0.47, p =0.10; trend). This relationship was not evidenced in the VR bout in inactive women. Additionally, higher RPE during the VR bout was significantly associated with a reduced anxious response (r = -0.67, p = .02), and lower post-exercise state anxiety (r = -0.58, p = .05). These relationships were not evidenced in the treadmill bout in the less active women, nor were they evidenced (for either exercise bout) in those meeting MVPA rec.’s.
CONCLUSIONS: Despite reporting lower exercise self-efficacy than active women, higher RPE during VR exergaming was associated with more positive affective responses in less active participants, which was not seen in the treadmill bout, nor in physically active participants. Additionally, higher RPE was associated with greater perceived difficulty during the treadmill bout, but not the VR bout, in less active women. These findings suggest that VR exergaming may elicit positive affective responses to exercise, even at higher intensities, in less active women, which may help to increase MVPA adherence in this population.
Authors:
Co-Presenter - Maxima Iglesias, North Carolina Wesleyan University
Co-Presenter - Brooke Wiggins, North Carolina Wesleyan University
Co-Author - Ayra Sundbom, Ed.D., North Carolina Wesleyan University
Co-Author - Emily Foraker, North Carolina Wesleyan University
Co-Author - Meredith R. Gringle, PhD, MPH, North Carolina Wesleyan University
Co-Author - Meir Magal, PhD, North Carolina Wesleyan University
Co-Author - Shannon K. Crowley, PhD, North Carolina Wesleyan University
Refining a College Student-Led Implementation Strategy Using Implementation Mapping in a Rural School
Poster Number: B132Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Implementation Science
Many physical activity (PA) interventions have been designed, yet few are scaled up or sustained. Additional refinement of implementation strategies may improve adoption, implementation, and maintenance of PA interventions. One such intervention is Hoosier Sport, a sport-based program partnering with middle schools to increase youth PA engagement. The objective of the present study was to (1) retrospectively use an implementation mapping approach to identify determinants, compile methods of change, and evaluate outcomes and (2) to synthesize results of implementation mapping within the context of a pilot study of the Hoosier Sport implementation strategy. We conducted a retrospective study of Hoosier Sport using implementation mapping to iteratively develop a comprehensive implementation strategy. Implementation mapping occurred with a campus-community team composed of researchers, college students, and community partners. A pilot study of Hoosier Sport served as the input and exemplified retrospective use of implementation mapping in context. The process identified key strengths (e.g., high fidelity and program interest) and weaknesses (e.g., reproducibility of evaluation and training materials, limited theoretical rationale), and used them to pinpoint opportunities for refinement (e.g., integration of positive youth development into sport lessons, connecting theoretical constructs to performance objectives). Our findings demonstrate a pragmatic example of the utility of implementation mapping, while also contributing to the literature by providing a unique assessment of past research combined with future implementation planning.
Keywords: Physical activity, ChildrenAuthors:
Co-Author - McKenna Major, Indiana University School of Medicine
Co-Author - Julianna King, Indiana University School of Public Health-Bloomington
Co-Author - Skyler Taaffe, Indiana University School of Public Health-Bloomington
Co-Author - Luke Troyer, Indiana University School of Public Health-Bloomington
Co-Author - Derek Craig, UTHealth Houston School of Public Health
Co-Author - Richard Holden, PhD, Indiana University School of Public Health-Bloomington
Co-Author - Vanessa Kercher, PhD, Indiana University School of Public Health-Bloomington
Presenter - Kyle Kercher, Indiana University School of Public Health-Bloomington
Temporal variation in Obesity and Physical Activity trends among High School Students in Illinois, evidence from The Youth Risk Behavior Surveillance System (2007 – 2023).
Poster Number: B133Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Health Disparities
Introduction: As physical activity (PA) and obesity trends evolve among high school students, examining differences by sex, age, and race/ethnicity is essential to inform public health strategies. This study analyzes temporal trends in PA and obesity among Illinois high school students, with a focus on subgroup variations.
Methods: This study used the 2007–2023 Illinois Youth Risk Behavior Surveillance System (YRBSS) dataset. Students were classified as physically active (≥60 min PA on ≥5 days/week) and obese (BMI ≥30 kg/m²). Temporal trends were analyzed using Prais-Winsten regression with autocorrelation, with a p-value <0.05 indicating increasing or decreasing trends, and a p-value ≥0.05 indicating stability. All analyses were conducted in R.
Results: The prevalence of PA and obesity from 2007 to 2023 was: 2007(37.66%, 10.04%), 2009(38.22%, 10.50%), 2011(42.96%, 9.58%), 2013(43.63%, 9.72%), 2015(44.03%, 10.56%), 2017(42.84%, 12.54%), 2019(43.53%, 12.49%), 2021(44.09%, 11.53%), 2023(42.35%, 11.93%). Overall, PA [0.006(95%CI: 0.004,0.009)] and obesity [0.004(95% CI: 0.002,0.005); p < 0.0001] showed slight upward trends. Similar patterns were seen in males [Obesity:0.004(0.002,0.005); PA:0.005(95% CI: 0.001,0.009)], females [Obesity: 0.004(95% CI:0.002,0.006); PA:0.007(95%CI:0.004,0.010)], and students >14 years [Obesity: 0.004(95%CI: 0.002,0.006); PA: 0.007(95%CI: 0.004,0.010)]. In contrast, students ≤14 years showed stable obesity [0.003(95%CI: -0.0005,0.007)] and PA [0.001(95%CI: -0.006,0.009)] trends. By race/ethnicity, obesity increased among Black students [0.008(95%CI: 0.004,0.012)] and other races [0.006(95%CI: 0.003,0.009)], while it remained stable in White [-0.002(95%CI: -0.007,0.0025)] and Hispanic students [0.001(95%CI: -0.001,0.003)]. PA increased among White [0.012(95%CI:0.008,0.016)] and Hispanic students [0.005(95% CI: 0.003,0.009)], while remaining stable in Black students [0.004 (95% CI: -0.001,0.010)] and other races [0.005(95% CI: -0.003,0.013)].
Conclusion: PA and obesity rose slightly from 2007–2023, increasing among students >14 but remaining stable in those ≤14. Obesity rose in Black and other groups but was stable in White and Hispanic students. PA increased in White and Hispanic students but not in Black and other groups. These patterns underscore age- and race-specific differences, highlighting the need for targeted interventions.
Keywords: Obesity, Physical activityMethods: This study used the 2007–2023 Illinois Youth Risk Behavior Surveillance System (YRBSS) dataset. Students were classified as physically active (≥60 min PA on ≥5 days/week) and obese (BMI ≥30 kg/m²). Temporal trends were analyzed using Prais-Winsten regression with autocorrelation, with a p-value <0.05 indicating increasing or decreasing trends, and a p-value ≥0.05 indicating stability. All analyses were conducted in R.
Results: The prevalence of PA and obesity from 2007 to 2023 was: 2007(37.66%, 10.04%), 2009(38.22%, 10.50%), 2011(42.96%, 9.58%), 2013(43.63%, 9.72%), 2015(44.03%, 10.56%), 2017(42.84%, 12.54%), 2019(43.53%, 12.49%), 2021(44.09%, 11.53%), 2023(42.35%, 11.93%). Overall, PA [0.006(95%CI: 0.004,0.009)] and obesity [0.004(95% CI: 0.002,0.005); p < 0.0001] showed slight upward trends. Similar patterns were seen in males [Obesity:0.004(0.002,0.005); PA:0.005(95% CI: 0.001,0.009)], females [Obesity: 0.004(95% CI:0.002,0.006); PA:0.007(95%CI:0.004,0.010)], and students >14 years [Obesity: 0.004(95%CI: 0.002,0.006); PA: 0.007(95%CI: 0.004,0.010)]. In contrast, students ≤14 years showed stable obesity [0.003(95%CI: -0.0005,0.007)] and PA [0.001(95%CI: -0.006,0.009)] trends. By race/ethnicity, obesity increased among Black students [0.008(95%CI: 0.004,0.012)] and other races [0.006(95%CI: 0.003,0.009)], while it remained stable in White [-0.002(95%CI: -0.007,0.0025)] and Hispanic students [0.001(95%CI: -0.001,0.003)]. PA increased among White [0.012(95%CI:0.008,0.016)] and Hispanic students [0.005(95% CI: 0.003,0.009)], while remaining stable in Black students [0.004 (95% CI: -0.001,0.010)] and other races [0.005(95% CI: -0.003,0.013)].
Conclusion: PA and obesity rose slightly from 2007–2023, increasing among students >14 but remaining stable in those ≤14. Obesity rose in Black and other groups but was stable in White and Hispanic students. PA increased in White and Hispanic students but not in Black and other groups. These patterns underscore age- and race-specific differences, highlighting the need for targeted interventions.
Authors:
Presenter - Godsway Edem Kpene, Department of Health and Kinesiology, University of Illinois Urbana – Champaign, USA
Co-Author - Esther Fewu, Department of Science, Jasikan College of Education, Ghana
Co-Author - Sandra Darfour-Oduro, Department of Public Health Studies, Elon University. Elon, NC. USA
Co-Author - Ramat Sarbah, Department of Health and Kinesiology, University of Illinois Urbana – Champaign, USA
Co-Author - Rafael Miranda Tassitano, Department of Health and Kinesiology, University of Illinois Urbana – Champaign, USA
Co-Author - Cecilia Marinho Tenorio, Department of Health and Kinesiology, University of Illinois Urbana – Champaign, USA
Effectiveness of Participatory Physical Activity Interventions on Mental Health in Adults: A Systematic Review and Meta-Analysis
Poster Number: B134Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Mental Health
Mental disorders are the leading cause of years lived with disability worldwide. Physical activity (PA) can be an effective preventative measure and can also complement pharmacological approaches in reducing mental health symptoms. Participatory research, which involves collaboration with individuals directly affected by the issue, centers local perspectives and may yield more relevant, impactful interventions. This review evaluated the effects of PA interventions developed using participatory methods on adult mental health. Findings were categorized using the Lubans et al. (2016) framework into three mental health determinants: cognitive function, well-being (e.g., self-esteem, quality of life), and ill-being (e.g., anxiety, depression). We also examined whether the number of participatory stages (two or fewer vs. three or more) influences these outcomes, classified using the Freire et al. (2022) framework (ideating, creating, refining, implementing, evaluating, sharing). Searches on Web of Science, PubMed, and EBSCO using predetermined keywords and inclusion and exclusion criteria were conducted to identify eligible studies per PRISMA guidelines. Sixteen studies were included in the review. Findings were extracted and analyzed using semi-quantitative synthesis and meta-analysis. The systematic review revealed positive effects for cognitive function, stress, and fatigue (100% of findings); happiness/mood and loneliness (75%); and global self-esteem (60%). However, broader mental health outcomes showed mixed results, with 54% of positive findings for overall mental health, 46% for well-being, and 57% for ill-being. Meta-analysis confirmed small yet statistically significant effects for overall mental health (effect size = 0.30, 95% CI [0.08, 0.53]) and well-being (0.28, 95% CI [0.09, 0.47]). Both the review and meta-analysis indicated that interventions incorporating three or more participatory stages were more effective than those with fewer stages, showing 77% versus 36% positive findings and effect sizes of 0.66 versus 0.12, respectively. Findings suggest participatory PA interventions can improve adult mental health, with greater benefits when multiple engagement stages are incorporated. Future practice should prioritize multi-stage participatory approaches to optimize PA intervention effectiveness in mental health contexts.
Note: AI-assisted language editing was used.
Keywords: Exercise, Mental healthNote: AI-assisted language editing was used.
Authors:
Author - Yahan Liang, Old Dominion University
Co-Author - Xihe Zhu, Old Dominion University
Co-Author - Ji-Hye Yang, Old Dominion University
An Experimental Test of Remembered Affect on Affective Associations for Physical Activity
Poster Number: B135Time: 11:00 AM - 11:50 AM
Topics: Physical Activity
Traditional approaches to increase physical activity (PA) often emphasize cognitive factors (e.g., attitudes), yet growing evidence suggests affective processes may be stronger predictors of PA intentions and subsequent PA. Affective associations with PA, feelings automatically connected to memories experienced during PA, have been associated with health behavior In lab-based tasks and correlational work, but less work has focused on affective associations relative to controlled affective constructs like affective attitudes and anticipated affect. We extend the literature by experimentally testing whether recalling positive in-task affect after PA enhances affective associations with PA, and subsequent PA intentions in a natural, non-lab setting. We also examined the indirect effect of remembered affect on PA intentions and behavior via affective associations and explored the effect of the intervention on anticipated affect and affective attitudes. Using an ecological remembered affect intervention, adults who reported typical PA less than 150 minutes/week (N = 76; mean age = 36.97; 59.3% female; 54.2% non-Hispanic White) completed a 30-minute PA session in a location of their choosing and were randomly assigned to one of two post-PA conditions to complete on their phones: (1) recalling positive affect during PA (experimental) or (2) reporting objective activity details (control). Affective associations, anticipated affect (i.e. regret and pride), affective attitudes, PA intentions, and PA behavior were assessed at baseline and one-week post PA session. We used 2 (condition) x 2 (time) ANOVAs to test change over time by condition. A condition X time effect occurred for positive affective associations (F(1,74) = 4.03, p = .048) such that those in the remembered affect condition experienced an increase overtime but those in the control condition did not. No interaction effects were observed for anticipated affect, affective attitudes, intentions, or PA behavior (all p > .34). Additionally, change in affective associations did not mediate the relationship between condition and change in PA intentions or behavior at follow-up. A brief remembered affect task may strengthen positive affective associations for PA but may be insufficient alone to increase intentions or behavior. Combining remembered affect with complementary strategies may more effectively promote sustained PA engagement.
Keywords: Physical activity, EmotionsAuthors:
Co-Author - Robin Rubey, M.S., Washington State University
Presenter - Emma Therkildsen, Washington State University
Co-Author - Renee Magnan, PhD, FSBM, Washington State University Vancouver
Effects of a one-time acceptance-based workshop on perceived exertion and affect during exercise: The Preparing Individuals for Physical (PIP) Activity Study
Poster Number: B136Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Weight Related Health
Individuals with higher body weight and internalized weight bias (IWB) are at risk for insufficient physical activity (PA). They report greater perceived exertion and negative affect as heart rate (HR) rises during PA, which may interfere with sustained PA engagement. Acceptance-based interventions (ACT) have empirical support and aim to increase awareness and tolerance of uncomfortable experiences in the service of long-term health goals. This pilot trial examined whether an ACT intervention could modify the relationship between HR and perceived exertion or affect during moderate-intensity PA in individuals with higher body weight, varying IWB levels, and insufficient PA.
Adults with a BMI of 25-40 who reported <60 min of moderate-intensity PA/week over the past 6 months, and who had high or low IWB (high: ≥4.87 and low: <3.0 on the modified weight bias internalization scale) were randomly assigned to a 90-min ACT workshop or psychoeducation control (CON) prior to 30 min of treadmill walking at 65-75% of age-predicted maximal HR. HR was measured every minute, while perceived exertion (RPE) and affect (Feeling Scale) were assessed every 5 min. Linear mixed-effects models examined the effects of within-person centered HR, treatment, and their interaction on RPE and affect. Since IWB groups were not balanced or large enough to evaluate treatment interactions, IWB was included as a covariate.
Thirty adults (91% female; 63% non-Hispanic White; 48±9.87 yrs; BMI 33±3.82 kg/m2; 78% high IWB) completed the study. During exercise HR increased by 11.83±5.88 bpm and did not differ by group. The interaction between HR and treatment was significant for RPE (β=3.0, p=.003). In ACT, increases in HR predicted higher RPE scores (β=0.22, p<.01), but this association was not significant in CON (β=0.05, p=.92). The interaction for affect was also significant (β=2.2, p=.031). In CON, increased HR was marginally associated with lower affect (β=-0.05, p=.09), whereas in ACT, HR was not significantly related to affect (β=0.01, p=.53).
These results align with ACT’s goals of bringing awareness to physiological exercise-related experiences (e.g., aligning RPE with HR) and supporting tolerance of exercise-induced discomfort (affect). Findings suggest ACT can favorably modify the relationship between HR and perceived exertion or affect. Confirming these effects in a fully powered trial and investigating how they translate into everyday PA engagement is an important next step.
Keywords: Physical activity, Biobehavioral mechanismsAdults with a BMI of 25-40 who reported <60 min of moderate-intensity PA/week over the past 6 months, and who had high or low IWB (high: ≥4.87 and low: <3.0 on the modified weight bias internalization scale) were randomly assigned to a 90-min ACT workshop or psychoeducation control (CON) prior to 30 min of treadmill walking at 65-75% of age-predicted maximal HR. HR was measured every minute, while perceived exertion (RPE) and affect (Feeling Scale) were assessed every 5 min. Linear mixed-effects models examined the effects of within-person centered HR, treatment, and their interaction on RPE and affect. Since IWB groups were not balanced or large enough to evaluate treatment interactions, IWB was included as a covariate.
Thirty adults (91% female; 63% non-Hispanic White; 48±9.87 yrs; BMI 33±3.82 kg/m2; 78% high IWB) completed the study. During exercise HR increased by 11.83±5.88 bpm and did not differ by group. The interaction between HR and treatment was significant for RPE (β=3.0, p=.003). In ACT, increases in HR predicted higher RPE scores (β=0.22, p<.01), but this association was not significant in CON (β=0.05, p=.92). The interaction for affect was also significant (β=2.2, p=.031). In CON, increased HR was marginally associated with lower affect (β=-0.05, p=.09), whereas in ACT, HR was not significantly related to affect (β=0.01, p=.53).
These results align with ACT’s goals of bringing awareness to physiological exercise-related experiences (e.g., aligning RPE with HR) and supporting tolerance of exercise-induced discomfort (affect). Findings suggest ACT can favorably modify the relationship between HR and perceived exertion or affect. Confirming these effects in a fully powered trial and investigating how they translate into everyday PA engagement is an important next step.
Authors:
Presenter - KayLoni Olson, PhD, Alpert Medical School, Brown University and The Miriam Hospital, Weight Control and Diabetes Research Center
Co-Author - Zihuan Cao, PhD, The Miriam Hospital, Weight Control and Diabetes Research Center
Co-Author - Jessica Unick, PhD, Alpert Medical School, Brown University and The Miriam Hospital, Weight Control and Diabetes Research Center
Co-Author - Kathryn Demos, PhD, Alpert Medical School, Brown University and The Miriam Hospital, Weight Control and Diabetes Research Center
Co-Author - Dale Bond, PhD, Hartford HealthCare, Obesity Research Center
Co-Author - Jason Lillis, PhD, Alpert Medical School, Brown University and The Miriam Hospital, Weight Control and Diabetes Research Center
Co-Author - Rena Wing, PhD, FSBM, Alpert Medical School, Brown University and The Miriam Hospital, Weight Control and Diabetes Research Center
Co-Author - Stephanie Goldstein, PhD, Alpert Medical School, Brown University and The Miriam Hospital, Weight Control and Diabetes Research Center
From Evidence to Practice: Co-Creation and Evaluation of a School-Based Physical Activity Policy in a Low-Income Brazilian City
Poster Number: B137Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Implementation Science
Background: Despite global endorsements and evidence-based strategies, physical inactivity persists among youth, with significant disparities in the Global South. Schools are key settings for PA promotion, yet translating evidence-based strategies into practice faces challenges such as limited resources, context-specific barriers, and lack of policy institutionalization. Aim: To co-create and evaluate system-level barriers and facilitators as perceived by stakeholders regarding a school-based PA policy for the public elementary school system in Arapiraca, Brazil, a low-income city (HDI = 0.64). Methods: A mixed-methods, co-creation approach was used to develop the school-based PA policy. A two-round Delphi process with a scientific committee (n=5) and a steering committee (n=13), including professionals from multiple local system sectors (education, health, and urban planning), integrated global and local guidelines, institutional documents, and stakeholder input into a policy template. Following consultation, an online survey assessed school stakeholders’ perceived barriers and facilitators related to policy importance, adoption, and implementation. Quantitative survey data were analyzed using descriptive statistics, including frequencies and percentages, to evaluate ratings for each policy item. Results: The final policy includes two chapters, four sections, and 15 items covering Physical Education, PA during school hours, professional development, and Monitoring & Evaluation. Three sections were removed due to local feasibility constraints (before/after school programs, staff engagement, and family/community engagement). Survey responses (n=91; 34% response rate) indicated ≥80% of policy items were rated as important, adoptable, and implementable, with highest support for licensed PE teachers, extended PE time, and professional development. Conclusion: The study demonstrates that a participatory, context-specific approach can produce a feasible, evidence-informed school-based PA policy in a low-income Brazilian city. The process enhances stakeholder buy-in and demonstrates potential for scalability and sustainability. Integrating evidence-based guidance with local stakeholder input advances understanding of contextual influences on behavior and offers a replicable framework for sustainable health promotion.
Keywords: Physical activity, PolicyAuthors:
Author - Rafael Tassitano, University of Illinois Urbana-Champaign
Co-Author - Luís Carlos Silva, University of Pernambuco
Co-Author - Maria Cecilia Tenorio, University of Illinois Urbana-Champaign
Effects of activity-permissive workstations on stress responses: A randomized controlled trial
Poster Number: B138Time: 11:00 AM - 11:50 AM
Topics: Physical Activity, Stress
Background: Prolonged sedentary behavior is a pervasive public health concern linked to elevated cardiometabolic risk and poorer mental health. Activity-permissive workstations (APWs), such as treadmill desks, offer a scalable strategy to replace sedentary time with light-intensity physical activity during work hours. Although APWs reduce sedentary time and increase energy expenditure, their effects on acute stress responses, a critical determinant of health and productivity, remain underexplored. This randomized controlled trial is among the first to evaluate both physiological and psychological stress reactivity and recovery during active workstation use.
Methods: Adult participants (N=157) were randomized to a sitting, standing, or treadmill workstation and further assigned to either the Trier Social Stress Test (TSST) or a control task (nature documentary). Psychological (perceived stress, mood) and physiological (heart rate, blood pressure, salivary cortisol) responses were assessed across baseline, stressor, and recovery phases and analyzed using multilevel splines. Workload, enjoyment, comfort, concentration, and safety were measured post-session and analyzed with ANOVA.
Results: Treadmill participants walked for 85 minutes (Mspeed=1.26 mph). They reported significantly better mood after 20 minutes at the workstation, before the stressor, compared to sitting (p=.01). Importantly, although treadmill users were walking and experiencing the stressor simultaneously, this did not exacerbate physiological or psychological reactivity or impede recovery. As expected, the TSST increased perceived workload (p=.02), but workload was not perceived differently across workstations. Treadmill users reported greater enjoyment vs. sitting (p=.02) and greater comfort vs. standing (p=.002), with no differences in concentration or perceived safety.
Discussion: Treadmill desks reduced sedentary time and increased energy expenditure without elevating stress reactivity or hindering recovery. These findings indicate that APWs can be integrated into workplace routines without impairing employees’ ability to manage acute stressors. The combination of health benefits and high acceptability underscores their promise as a practical workplace intervention. Scaling APWs within organizational health promotion strategies could help reduce long-term risks of prolonged sitting while supporting employee resilience and productivity.
Keywords: Physical activity, StressMethods: Adult participants (N=157) were randomized to a sitting, standing, or treadmill workstation and further assigned to either the Trier Social Stress Test (TSST) or a control task (nature documentary). Psychological (perceived stress, mood) and physiological (heart rate, blood pressure, salivary cortisol) responses were assessed across baseline, stressor, and recovery phases and analyzed using multilevel splines. Workload, enjoyment, comfort, concentration, and safety were measured post-session and analyzed with ANOVA.
Results: Treadmill participants walked for 85 minutes (Mspeed=1.26 mph). They reported significantly better mood after 20 minutes at the workstation, before the stressor, compared to sitting (p=.01). Importantly, although treadmill users were walking and experiencing the stressor simultaneously, this did not exacerbate physiological or psychological reactivity or impede recovery. As expected, the TSST increased perceived workload (p=.02), but workload was not perceived differently across workstations. Treadmill users reported greater enjoyment vs. sitting (p=.02) and greater comfort vs. standing (p=.002), with no differences in concentration or perceived safety.
Discussion: Treadmill desks reduced sedentary time and increased energy expenditure without elevating stress reactivity or hindering recovery. These findings indicate that APWs can be integrated into workplace routines without impairing employees’ ability to manage acute stressors. The combination of health benefits and high acceptability underscores their promise as a practical workplace intervention. Scaling APWs within organizational health promotion strategies could help reduce long-term risks of prolonged sitting while supporting employee resilience and productivity.
Authors:
Presenter - Yiqing "Skylar" Yu, Colorado State University
Co-Author - Daniel Graham, PhD, Colorado State University
Examining Disordered Eating Behaviors as Mediators Between PTSD and Health Outcomes
Poster Number: B139Time: 11:00 AM - 11:50 AM
Topics: Quality of Life, Diet, Nutrition, and Eating Disorders
Eating disorders (EDs) and posttraumatic stress disorder (PTSD) are highly comorbid disorders that have both been independently associated with poor long-term health outcomes (Kärkkäinen et al., 2018; Pacella et al., 2013). This study sought to examine the mediating effects of disordered eating (DE) behaviors on the association between PTSD severity and a range of health outcomes. Using seven mediation models in a trauma-exposed undergraduate sample (n= 693), we examined whether three domains of DE (cognitive restraint, uncontrolled eating, and emotional eating) mediated the effect of PTSD symptoms on physical functioning, physical role limitations, emotional role limitations, mental health, social functioning, bodily pain, and general health. Results revealed significant indirect effects of PTSD via DE behaviors in only a subset of health outcome domains. Specifically, significant mediators for the association between PTSD severity and health outcomes consisted of emotional eating for emotional role limitations (95% CI= [-.0899, -.0224]), mental health (95% CI= [-.0858, -.0242]) and general health (95% CI= [-.0820, -.0163]), and binge eating for bodily pain (95% CI= [.0816, -.0126]). Cognitive restraint did not significantly mediate the association between PTSD and any of the physical health domains. These findings highlight the importance of understanding the dynamic relationship between DE and health behaviors when developing targeted screening and intervention efforts, specifically relating to overeating behaviors. These findings also support the need to assess motivations driving overeating behaviors, given binge eating and emotional eating were associated with different health outcomes.
Keywords: Health outcomes, TraumaAuthors:
Author - Taylor Kliebhan, M.S., Old Dominion University
Co-Author - Lauren Smith, B.S., Old Dominion University
Co-Author - Selah Ball, B.S., College of William & Mary
Co-Author - Sage Hawn, Ph.D., Old Dominion University
Leveraging Peer Connection: Virtual Adaptation of Fear of Cancer Recurrence Therapy for Young Adults with Hematological Malignancies
Poster Number: B14Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Purpose: Hematologic malignancies (HM) are among the most prevalent cancers in young adulthood, and fear of cancer recurrence (FCR) is a top unmet need in this population. Tailored interventions for young adults (YAs) with cancer are scarce, despite nearly 1 in 2 reporting a desire for group and online supports. Fear of Cancer Recurrence Therapy (FORT), a cognitive-existential group intervention, has been shown to reduce FCR in survivors of breast and gynecological cancer. The present study aimed to adapt FORT for YAs with HM and for virtual delivery.
Method: Two patient advisory boards (PABs) were formed: one with YAs with lymphoma (n=6, 50% females, age range=20-37) and one with YAs with leukemia (n=5, 40% females, age range=25-37). Each PAB engaged in four virtual meetings to provide feedback on FORT content, language, functionality, and delivery. Thematic analysis was used to analyze transcripts. Modifications suggested by the PABs were reviewed by FORT content and developmental context experts to guide the adaptation.
Results: Both groups found FORT to be relevant and helpful in addressing FCR. YAs emphasized the value of its group format for fostering peer support and shared understanding. Virtual delivery was endorsed for improved accessibility. YAs provided targeted feedback to tailor the intervention, such as integrating values tied to aspects of identity, adding content on hope and meaning, softening language in cognitive restructuring, and enhancing opportunities for interaction in a virtual setting. Notably, the lymphoma and leukemia PABs described largely overlapping experiences of FCR and of the intervention. Diagnosis-specific experiences primarily involved triggers of FCR, and in some cases, treatment intensity.
Conclusion: Centering the perspectives of patients with lived experience, this study highlights the applicability and value of FORT in addressing FCR among YAs with HM. By combining the benefits of group support and online format, FORT-YA shows significant potential for applicability to other YA cancer populations. Future steps include conducting a feasibility trial in YAs with HM.
Keywords: Cancer survivorship, CopingMethod: Two patient advisory boards (PABs) were formed: one with YAs with lymphoma (n=6, 50% females, age range=20-37) and one with YAs with leukemia (n=5, 40% females, age range=25-37). Each PAB engaged in four virtual meetings to provide feedback on FORT content, language, functionality, and delivery. Thematic analysis was used to analyze transcripts. Modifications suggested by the PABs were reviewed by FORT content and developmental context experts to guide the adaptation.
Results: Both groups found FORT to be relevant and helpful in addressing FCR. YAs emphasized the value of its group format for fostering peer support and shared understanding. Virtual delivery was endorsed for improved accessibility. YAs provided targeted feedback to tailor the intervention, such as integrating values tied to aspects of identity, adding content on hope and meaning, softening language in cognitive restructuring, and enhancing opportunities for interaction in a virtual setting. Notably, the lymphoma and leukemia PABs described largely overlapping experiences of FCR and of the intervention. Diagnosis-specific experiences primarily involved triggers of FCR, and in some cases, treatment intensity.
Conclusion: Centering the perspectives of patients with lived experience, this study highlights the applicability and value of FORT in addressing FCR among YAs with HM. By combining the benefits of group support and online format, FORT-YA shows significant potential for applicability to other YA cancer populations. Future steps include conducting a feasibility trial in YAs with HM.
Authors:
Presenter - Sharlane Lau, HBSc, The Graduate Center, City University of New York
Co-Author - Megha Manoj, HBSc, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
Co-Author - Norma D'Agostino, PhD, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
Co-Author - Pamela Mosher, MD, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
Co-Author - Marlie Smith, RN, MN, Princess Margaret Cancer Centre, University Health Network
Co-Author - Jennifer Jones, PhD, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
Co-Author - Vishal Kukreti, MD, Department of Medical Oncology & Hematology, Princess Margaret Cancer Centre, University Health Network
Co-Author - Rinat Nissim, PhD, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
Co-Author - Christine Maheu, RN, PhD, Ingram School of Nursing, McGill University
Co-Author - Sophie Lebel, PhD, Department of Psychology, University of Ottawa
Co-Author - Aliza Panjwani, PhD, Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network
Perceptions of disease severity, medication adherence, and health-related quality of life as root cause predictors of hospital emergency department readmission.
Poster Number: B140Time: 11:00 AM - 11:50 AM
Topics: Quality of Life, Multiple Health Behavior Change
Background: The 30-day period between hospital discharge and primary care hand-off presents a gap in care when illness perceptions regarding chronic disease and treatment may be inaccurate resulting in sub-optimal self-management behavior. Sub-optimal self-management behavior may result in hospital readmissions and poorer health-related quality of life (HRQOL). The hypothesis providing a healthcare technician in a navigator role to provide assistance using talking points about medication adherence and red flag symptoms awareness results in reduction in 30-day all cause readmissions was tested.
Methods: Hospitalized adults (n=204) with type 2 diabetes and no currently assigned primary care physician were recruited for a transitional care intervention and surveyed regarding their illness perceptions and self-management behavior during the week prior to admission and surveyed 30 days after hospital discharge to identify the root causes of readmission. Participants were administered the following surveys: Brief Illness Perception Questionnaire, the Morisky Medication Adherence, Summary of Diabetes Self-care Behaviors, SF-8 HRQL, and the CTM-3 for satisfaction with transitions.
Results: The sample consisted of 70% Black race, 20% Hispanic, with an average age of 45 years, and annual income below $20,000. Those scoring high on disease threat (p=.01), low scores on mental function of health-related quality of life (p=.04), sub-optimal medication adherence due to side effects (β=-.42, p=.002) following hospital discharge were more likely to be readmitted. Social determinants of health factors associated with readmission included lower socioeconomic status (.04)
Conclusion: Healthcare technician level providers can serve as navigators and impact 30-day transitional care between hospital discharge and primary care provider access in a meaningful way that prevents readmission by improving medication adherence and health-related quality of life in a very low income racial and ethnic minority population.
Keywords: Quality of life, Chronic illnessMethods: Hospitalized adults (n=204) with type 2 diabetes and no currently assigned primary care physician were recruited for a transitional care intervention and surveyed regarding their illness perceptions and self-management behavior during the week prior to admission and surveyed 30 days after hospital discharge to identify the root causes of readmission. Participants were administered the following surveys: Brief Illness Perception Questionnaire, the Morisky Medication Adherence, Summary of Diabetes Self-care Behaviors, SF-8 HRQL, and the CTM-3 for satisfaction with transitions.
Results: The sample consisted of 70% Black race, 20% Hispanic, with an average age of 45 years, and annual income below $20,000. Those scoring high on disease threat (p=.01), low scores on mental function of health-related quality of life (p=.04), sub-optimal medication adherence due to side effects (β=-.42, p=.002) following hospital discharge were more likely to be readmitted. Social determinants of health factors associated with readmission included lower socioeconomic status (.04)
Conclusion: Healthcare technician level providers can serve as navigators and impact 30-day transitional care between hospital discharge and primary care provider access in a meaningful way that prevents readmission by improving medication adherence and health-related quality of life in a very low income racial and ethnic minority population.
Authors:
Author - Melissa Scollan-Koliopoulos, EDD, Sacred Heart University
Sleep Duration and Sleep Quality and their Associations with Depression and Anxiety Symptoms in Jamaican Adults: The Mediating Role of Psychological Stress
Poster Number: B141Time: 11:00 AM - 11:50 AM
Topics: Sleep, Mental Health
Over 20% of Jamaican adults report significant sleep disturbances, and one in every seven experience symptoms of depression (DS) and anxiety (AS). Short sleep duration (SD; less than 7 hours) and poor sleep quality (SQ) may be associated with increased psychological stress (SS), which in turn may contribute to DS and AS. Despite these concerns, research examining the associations among SD, SQ, SS, DS, and AS within the Jamaican population remains limited. This cross-sectional study was part of a larger study and explored associations among SD, SQ, DS, AS, SS, and socio-demographic variables in a convenience sample of Jamaican adults. Most participants (n = 506; Mage = 32.65 years) were female (59%), employed (70%), had college education (70%), not married (76%), not currently a student (75%), and of lower or lower-middle socioeconomic status (73%). Participants completed self-report measures of SD (M = 6.26 hours; SD = 1.36), SQ (M = 5.65; SD = 2.01), DS, AS, SS, and socio-demographic variables. DS (M = 9.16; SD = 9.41), AS (M = 6.36; SD = 7.03), and SS (M = 7.38; SD = 5.91) were below the approximate respective clinically relevant thresholds (i.e., normal or mild). Participants who reported SD of less than seven hours per night had increased odds of reporting clinically relevant (i.e., not normal or mild) DS (OR = 3.42, 95% CI [1.94, 6.02], p < .001) and SS (OR = 2.07, 95% CI [1.26, 3.39], p = .004). Participants who reported SQ of less than seven had increased odds of reporting clinically relevant DS (OR = 2.69, 95% CI [1.46, 4.95], p = .001) and SS (OR = 2.18, 95% CI [1.25, 3.80], p = .006). SD and SQ were not associated with significant odds of reporting clinically relevant AS. Structural equation models indicated that SD had a significant indirect effect on DS (β = –.046, CI 95% [–.090, –.002]) and AS (β = –.043, CI 95% [–.084, –.001]) through SS. SQ had a significant indirect effect on DS (β = –.091, CI 95% [–.142, –.041]) and AS through SS (β = –.089, CI 95% [–.139, –.039]). SS may be a psychological mechanism (i.e., mediator) through which SD and SQ affect DS and AS. Jamaicans with lower SD and poorer SQ may be more susceptible to elevated SS, which is in turn associated with heightened DS and AS. To improve mental health outcomes in this population, health behavior interventions should incorporate components that address both inadequate SD and poor SQ, as these may be key targets for reducing SS and, subsequently, DS and AS.
Keywords: Health behaviors, Mental healthAuthors:
Author - Andre Bateman, PhD, The University of the West Indies at Mona
Co-Author - Alexi-Jade Lyew, The University of the West Indies at Mona
Co-Author - Makayla Ramlochan, The University of the West Indies at Mona
Co-Author - Akosua Gyimah, MS, The University of the West Indies at Mona
Co-Author - Robyn Brown, MS, The University of the West Indies at Mona
Co-Author - Onicka Williams, The University of the West Indies at Mona
Co-Author - Chelsi Ricketts, PhD, University of Toronto, Toronto
Evening Circadian Preference as a Risk Factor for Sleep Problems and Sleep-Related Cannabis Expectancies in College Students
Poster Number: B142Time: 11:00 AM - 11:50 AM
Topics: Sleep, Substance Misuse
Introduction: Evening circadian preference is a well-established risk factor for emerging adult sleep problems and substance use. Insomnia symptoms affect around 30% of US adults, with elevated rates in college students due to developmental and environmental risks. College sleep problems may lead to self-medication with substances like cannabis, triggering a feed-forward risk process maintained by sleep-related cannabis expectancies (SRCE). The role of sleep aid use behaviors in the development of related expectancies remains unknown, especially among vulnerable groups with evening chronotypes. This study aimed to clarify the role of evening circadian preference in sleep problems, substance use, and SCRE, hypothesizing (a) greater concurrent, short-term sleep and substance risk, and (b) stronger short-term prospective associations of cannabis sleep aid use with SCRE.
Methods: One-month prospective online survey data was drawn from college students in Northern New England at Time 1 (T1; N=332, Mage=19.04±1.39 [range=18-25], 47% male, 83% non-Hispanic white) and Time 2 (T2; n=151, Minterval=33.48±6.94 days). Surveys assessed T1 circadian preference and T1-T2 sleep health, substance use, and SRCE.
Results: Compared to Morning-Intermediate chronotypes(n=238, 72%), Evening types (n=84, 25%) demonstrated more severe T1-T2 cognitive pre-sleep arousal, insomnia symptoms, insomnia diurnal impact, and T1 positive SRCE (ts=2.21-4.75, ps<.03), but not T2 positive SCRE, T1-T2 negative SRCE or substance use risk (ps>.05). Circadian preference moderated associations of T1 past-year cannabis sleep aid frequency (M=1.80±3.09; 31%) with T2 negative SRCE (b=0.02. SE=0.01, p=.005, 95%CI [0.01,0.03]; but not positive SCRE, (p=.84), after controlling for age, sex, T1 cannabis frequency, and T1 SRCE in available prospective data (R2=.43). Conditional effects revealed a significant negative association in participants with lower/later circadian preference (b=-0.08. SE=0.04, p=.03, 95%CI [-0.15,-0.01]), but not among those at moderate/earlier levels (ps=.22-.44).
Conclusion: Results highlight evening circadian preference as a risk factor for concurrent, short-term sleep problems, and less protective negative SRCE following cannabis sleep aid use. Continued multidisciplinary research integrating behavioral sleep medicine, addiction, and implementation science perspectives is needed to guide intervention development, embedding behavioral evidence into college healthcare.
Keywords: Risk factors, Substance abuseMethods: One-month prospective online survey data was drawn from college students in Northern New England at Time 1 (T1; N=332, Mage=19.04±1.39 [range=18-25], 47% male, 83% non-Hispanic white) and Time 2 (T2; n=151, Minterval=33.48±6.94 days). Surveys assessed T1 circadian preference and T1-T2 sleep health, substance use, and SRCE.
Results: Compared to Morning-Intermediate chronotypes(n=238, 72%), Evening types (n=84, 25%) demonstrated more severe T1-T2 cognitive pre-sleep arousal, insomnia symptoms, insomnia diurnal impact, and T1 positive SRCE (ts=2.21-4.75, ps<.03), but not T2 positive SCRE, T1-T2 negative SRCE or substance use risk (ps>.05). Circadian preference moderated associations of T1 past-year cannabis sleep aid frequency (M=1.80±3.09; 31%) with T2 negative SRCE (b=0.02. SE=0.01, p=.005, 95%CI [0.01,0.03]; but not positive SCRE, (p=.84), after controlling for age, sex, T1 cannabis frequency, and T1 SRCE in available prospective data (R2=.43). Conditional effects revealed a significant negative association in participants with lower/later circadian preference (b=-0.08. SE=0.04, p=.03, 95%CI [-0.15,-0.01]), but not among those at moderate/earlier levels (ps=.22-.44).
Conclusion: Results highlight evening circadian preference as a risk factor for concurrent, short-term sleep problems, and less protective negative SRCE following cannabis sleep aid use. Continued multidisciplinary research integrating behavioral sleep medicine, addiction, and implementation science perspectives is needed to guide intervention development, embedding behavioral evidence into college healthcare.
Authors:
Author - Sabrina Muzac, University of Maine
Co-Author - Krutika Rathod, University of Maine
Co-Author - Lisa LaRowe, Ph.D., Massachusetts General Hospital
Co-Author - Patricia Goodhines, PhD, University of Maine
Associations of Sedentary Activity with Negative Affect and Sleep Problems in College Students
Poster Number: B143Time: 11:00 AM - 11:50 AM
Topics: Sleep, Physical Activity
Aim: College students are a critical risk group for both depression/anxiety symptoms and sleep problems. Sedentary behavior is increasingly recognized as a public health risk factor; however, knowledge of its relationship to college students' behavioral health and functional impairment remains limited. This study examined college students’ activity levels, affective symptoms, and sleep problems, hypothesizing that greater sedentary time would be associated with affective distress and sleep-related complaints.
Method: Cross-sectional data was drawn from 332 college students (Mage=19.04±1.39, range=18–25; 47% male; 83% White) as part of a larger prospective study at a four-year university in the northeastern U.S. Online surveys assessed sedentary behavior and physical activity, general health, depression/anxiety symptoms, sleep problems and diurnal impact.
Results: On average, participants reported 6.21±3.25 hours/day of sedentary activity, 1.97±2.13 hours/day walking, 1.77±1.47 hours/day moderate exercise, and 1.92±1.14 hours/day vigorous exercise. The sample also endorsed average subclinical depression/anxiety symptoms (M=1.09±0.91) and insomnia symptoms (M=8.03±5.86). Sedentary activity specifically was correlated with depression/anxiety symptoms, somatic and cognitive pre-sleep arousal, insomnia symptoms, and diurnal impact (rs=.15-.18, ps<.01), but not general health (p>.05). Regressions using available data (N=322-323) controlling for age and male sex showed sedentary activity was associated with greater depression/anxiety symptoms (β=0.16, b=1.56, SE=0.65, p<.002). Sleep models additionally controlling for depression/anxiety symptoms revealed that sedentary activity was associated with diurnal impact (β=0.08, b=0.13, SE=.07, p<.04), but not for pre-sleep arousal, sleep rating, or insomnia symptom severity (ps>.05).
Conclusions: Sedentary behavior is a potential risk factor for affective and diurnal functioning in college students. While sedentary activity was not related to sleep problems after controlling for depression/anxiety, associations with sleep-related functional impairment remained robust. Future prospective research integrating multidisciplinary perspectives from exercise science and behavioral sleep medicine may clarify directional pathways and affective mechanisms. Preliminary findings suggest that tailored interventions targeting both physical activity and emotional distress can promote sustainable sleep health and functioning.
Keywords: Physical activity, Risk factorsMethod: Cross-sectional data was drawn from 332 college students (Mage=19.04±1.39, range=18–25; 47% male; 83% White) as part of a larger prospective study at a four-year university in the northeastern U.S. Online surveys assessed sedentary behavior and physical activity, general health, depression/anxiety symptoms, sleep problems and diurnal impact.
Results: On average, participants reported 6.21±3.25 hours/day of sedentary activity, 1.97±2.13 hours/day walking, 1.77±1.47 hours/day moderate exercise, and 1.92±1.14 hours/day vigorous exercise. The sample also endorsed average subclinical depression/anxiety symptoms (M=1.09±0.91) and insomnia symptoms (M=8.03±5.86). Sedentary activity specifically was correlated with depression/anxiety symptoms, somatic and cognitive pre-sleep arousal, insomnia symptoms, and diurnal impact (rs=.15-.18, ps<.01), but not general health (p>.05). Regressions using available data (N=322-323) controlling for age and male sex showed sedentary activity was associated with greater depression/anxiety symptoms (β=0.16, b=1.56, SE=0.65, p<.002). Sleep models additionally controlling for depression/anxiety symptoms revealed that sedentary activity was associated with diurnal impact (β=0.08, b=0.13, SE=.07, p<.04), but not for pre-sleep arousal, sleep rating, or insomnia symptom severity (ps>.05).
Conclusions: Sedentary behavior is a potential risk factor for affective and diurnal functioning in college students. While sedentary activity was not related to sleep problems after controlling for depression/anxiety, associations with sleep-related functional impairment remained robust. Future prospective research integrating multidisciplinary perspectives from exercise science and behavioral sleep medicine may clarify directional pathways and affective mechanisms. Preliminary findings suggest that tailored interventions targeting both physical activity and emotional distress can promote sustainable sleep health and functioning.
Authors:
Co-Author - Patricia Goodhines, PhD, University of Maine
Insomnia Symptoms and Pain: Cross-Sectional and Longitudinal Associations Over 10 Years in Middle-Aged and Older Adults
Poster Number: B144Time: 11:00 AM - 11:50 AM
Topics: Sleep, Pain
Introduction: : Insomnia symptoms and pain are highly comorbid conditions that increase with age, but most studies to date have been cross-sectional. Key gaps remain in understanding whether insomnia symptoms predict future pain outcomes across different ages, particularly for pain tolerance—a clinically important but understudied dimension of pain experience. Although age-related changes in sleep architecture and pain perception suggest that the sleep–pain relationship may vary across the lifespan, this has rarely been systematically tested. This 10-year longitudinal study addressed these gaps by examining (1) cross-sectional and longitudinal associations between insomnia symptoms and both pain presence and pain tolerance, and (2) whether these associations varied across a wide age range (30–84 years) in a large, nationally representative sample. Methods: Data were drawn from Waves 2 (2004-2006) and 3 (2013-2014) of the Midlife in the United States (MIDUS) study. The analytic sample included 2,603 middle-aged and older adults (56.2% female; M age = 55.11 years). Insomnia symptoms were assessed with four validated items. Outcomes were chronic pain presence(yes/no) and low tolerance for pain (higher scores = lower tolerance). Logistic regression was used to test the associations between sleep and chronic pain, and linear regression was used to test the associations between sleep and low tolerance for pain. Covariates included gender, race, and education. Age (as a continuous variable) was included as a covariate for the first research question and examined as a moderator for the second research question. Results: Cross-sectionally, higher insomnia symptoms were associated with greater odds of chronic pain (OR=1.64, 95% CI=1.48–1.81) and with lower tolerance for pain (β=.04, SE=.021, p=.04). Longitudinally, insomnia symptoms at Wave 2 were associated with greater odds of chronic pain (OR=1.37, 95% CI=1.23–1.52) and lower tolerance for pain (β=.05, SE=.02, p=.01) at Wave 3, controlling for baseline pain. Age did not moderate these associations. Conclusions: This study provides robust 10-year longitudinal evidence that insomnia symptoms predict both pain presence and reduced pain tolerance across the entire adult lifespan. Findings indicate that insomnia symptoms may be a modifiable risk factor for adverse pain outcomes at any adult age, highlighting the broad potential for sleep interventions to reduce pain burden and improve pain tolerance.
Keywords: Pain, AgingAuthors:
Presenter - Eunjin Tracy, PhD, University of Missouri
Co-Author - Shinye Kim, Ph.D., University of Wisconsin-Madison
Co-Author - Pei-shu Chao , M.A., University of Missouri
Co-Author - Eunjung Kim, M.S., University of Missouri
Co-Author - Jichan Kim, Ph.D. , Liberty University
The Impact of Internalized Stigma of Mental Illness on College Students’ Health
Poster Number: B145Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Mental Health
INTRODUCTION Internalized stigma of mental illness predicts lowered self-esteem, increased psychiatric symptoms, and other negative outcomes, and even mild internalized stigma has negative psychological impact (Drapalski et al., 2023). Some research indicates that it may also harm physical health (Pearl et al., 2017; Brown & Batty, 2021). Most research in this area has occurred within the context of serious mental illness or chronic physical conditions, leaving undergraduates understudied despite their increasing high rates of symptoms of mental illness (Lipson et al., 2022). Understanding the role of internalized stigma in the mental and physical health of undergraduates could reveal stigma as an important target for campus outreach or suggest that internalized stigma has lessened health effects in this population. Students high in internalized stigma may be particularly vulnerable to negative health outcomes if they also have difficulty disclosing distress to others, leading to reduced social support and help-seeking. This study aimed to investigate whether internalized stigma impacts the mental and physical health of undergraduate students, and whether this impact is heightened for students with high disclosure distress.
METHOD College students (n=670) completed surveys assessing internalized stigma of mental illness (Internalized Stigma of Mental Illness; Ritsher et al., 2004), distress around self-disclosure (Disclosure Distress Index; Kahn & Hessling, 2001), and global health (PROMIS Global Health, Hays et al., 2004).
RESULTS Linear regressions demonstrated that internalized stigma significantly predicted worse physical health, b = -.07, p = .002, and distress disclosure did not moderate this relationship, b = -.0002, p = .82. Internalized stigma similarly predicted worse mental health, b = -.09, p < .001, and the interaction of internalized stigma and distress disclosure trended towards significance in predicting mental health, b = -.001, p = .059.
DISCUSSION Our results suggest that internalized stigma of mental illness negatively affects college students’ mental and physical health. These findings are concerning given stigma’s association with reduced help-seeking along with many students’ limited experience navigating the healthcare system independently. While distress around disclosure does not appear to impact the relationship between internalized stigma and physical health, it may buffer the relationship between stigma and mental health.
Keywords: Mental health, Health outcomesMETHOD College students (n=670) completed surveys assessing internalized stigma of mental illness (Internalized Stigma of Mental Illness; Ritsher et al., 2004), distress around self-disclosure (Disclosure Distress Index; Kahn & Hessling, 2001), and global health (PROMIS Global Health, Hays et al., 2004).
RESULTS Linear regressions demonstrated that internalized stigma significantly predicted worse physical health, b = -.07, p = .002, and distress disclosure did not moderate this relationship, b = -.0002, p = .82. Internalized stigma similarly predicted worse mental health, b = -.09, p < .001, and the interaction of internalized stigma and distress disclosure trended towards significance in predicting mental health, b = -.001, p = .059.
DISCUSSION Our results suggest that internalized stigma of mental illness negatively affects college students’ mental and physical health. These findings are concerning given stigma’s association with reduced help-seeking along with many students’ limited experience navigating the healthcare system independently. While distress around disclosure does not appear to impact the relationship between internalized stigma and physical health, it may buffer the relationship between stigma and mental health.
Authors:
Presenter - Anna Grace Kelly, M.A., George Mason University
Co-Presenter - Griffin Perry, George Mason University
Co-Author - Natasha Tonge, PhD, George Mason University
Weight Stigma, Internalized Weight Bias, and Physical Activity: Examining Behaviors, Motivations, and Gender Dynamics
Poster Number: B146Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Physical Activity
Weight stigma is a well-documented social determinant that negatively impacts physical and mental health. Internalized weight bias (IWB) and experienced weight stigma (EWS) have been linked to maladaptive health behaviors, including physical inactivity and exercise avoidance; however, few studies have examined how such forms of stigma relate to various types of physical activity (PA), extrinsic exercise motivations, and social contextual experiences. This study investigated the influence of IWB and EWS on PA behaviors, motivations, and weight-related exercise avoidance (WREA), with attention to the moderating role of gender. Social contextual factors (e.g., PA types, social media use, interpersonal experiences, and PA locations) were also qualitatively examined for a broader understanding of how stigma operates in PA settings.
A nationally representative U.S. sample (N = 435) across ages 18+, gender, race, ethnicity, education, income, and BMI was recruited. Participants completed a cross-sectional online survey assessing demographics, IWB, EWS, PA frequency, WREA, extrinsic exercise motivations, and open-ended free responses about contextual factors. Qualitative data were thematically coded, and mixed-method analyses included regressions, ANCOVAs, MANCOVAs, chi-square tests, and moderation analyses in SPSS.
Results indicated that IWB consistently predicted lower PA frequency, greater WREA, and greater extrinsic motivations for weight management and appearance (p’s < .01). EWS significantly predicted WREA and social recognition motive (p’s < .01). Social contextual analyses revealed that no reported PA participation (F(4, 420) = 4.09, p = 0.003, partial η² = 0.037) or no reported PA locations experienced higher EWS (F(4, 420) = 1.58, p = 0.178, partial η² = 0.015), suggesting disengagement from structured PA may reflect perceived stigma. Women reported higher IWB, WREA, weight management motive, and social media use during PA, while men reported more public PA locations and social recognition motive. A gender × EWS interaction (F(1,422) = 5.26, p = 0.022, ΔR2=0.01) showed that appearance motive was marginally more strongly associated with EWS in women (b = 1.19, p = .062).
Findings highlight how IWB and EWS shape PA behaviors and motivations, underscoring the need for stigma-informed and supportive PA environments, while future longitudinal and mixed-method research should examine adherence and strategies to reduce such stigma across diverse populations.
Keywords: Physical activity, Social ecologyA nationally representative U.S. sample (N = 435) across ages 18+, gender, race, ethnicity, education, income, and BMI was recruited. Participants completed a cross-sectional online survey assessing demographics, IWB, EWS, PA frequency, WREA, extrinsic exercise motivations, and open-ended free responses about contextual factors. Qualitative data were thematically coded, and mixed-method analyses included regressions, ANCOVAs, MANCOVAs, chi-square tests, and moderation analyses in SPSS.
Results indicated that IWB consistently predicted lower PA frequency, greater WREA, and greater extrinsic motivations for weight management and appearance (p’s < .01). EWS significantly predicted WREA and social recognition motive (p’s < .01). Social contextual analyses revealed that no reported PA participation (F(4, 420) = 4.09, p = 0.003, partial η² = 0.037) or no reported PA locations experienced higher EWS (F(4, 420) = 1.58, p = 0.178, partial η² = 0.015), suggesting disengagement from structured PA may reflect perceived stigma. Women reported higher IWB, WREA, weight management motive, and social media use during PA, while men reported more public PA locations and social recognition motive. A gender × EWS interaction (F(1,422) = 5.26, p = 0.022, ΔR2=0.01) showed that appearance motive was marginally more strongly associated with EWS in women (b = 1.19, p = .062).
Findings highlight how IWB and EWS shape PA behaviors and motivations, underscoring the need for stigma-informed and supportive PA environments, while future longitudinal and mixed-method research should examine adherence and strategies to reduce such stigma across diverse populations.
Authors:
Presenter - Lydia Mansour, M.A., East Carolina University
Co-Author - Robert Carels, PhD MBA ABPP, FSBM, East Carolina University
Reimagining Resilience: A Mixed-Methods Approach to Examining Resilience
Poster Number: B147Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Methods and Measurement
Background.
Resilience, defined broadly as the ability to “bounce back” from adversity and continue with life, has been highlighted as a potential explanation for why Black women experience positive outcomes (e.g., career success) despite the adversity that they face. However, the utility of a high resilience score (i.e., being more resilience) has been shown in prior research to be context dependent and not always positive. Additionally, there is no singular measurement of resilience in the literature, making it difficult to understand how resilience influences the outcomes of Black women.
Purpose.
Using a mixed-method approach, the goal of this research is to explore two related research questions. 1.) How do Black women define and engage with the concept of resilience? 2.) How does reframing the measurement of resilience, and the creation of a new scale that measures resilience for Black women, influence the outcomes that resilience is able to predict?
Method.
Research question 1 was tested using qualitative interviews from 24 Black women. The study aimed to learn more about how Black women think about resilience and what role resilience plays in their daily lives. Interviews lasted 60 minutes on average. Sample interview questions include “In your opinion, what does it mean to be resilient?” and “What strategies do you use to recover from significant life challenges?”
Based on the findings from our qualitative data analysis, a new scale for resilience in Black women will be created that captures two subscale of resilience: resilience as an experience, and resilience as an expectation, the latter of which has been largely overlooked in the current resilience scales. Research question 2 will be tested using linear regression to compare this newly created resilience scale to the Connor-Davison Resilience Scale, John Henryism Active Coping, and the Brief Cope Scale and independently test how well these resilience scales predict perceived stress, physical activity, and depression.
Anticipated Results.
We expect to find that the two subscales of the Resilience in Black Women scale (i.e., resilience as an experience and resilience as an expectation) will be positive correlated with each other, and with the other resilience scales. We suspect that resilience as an experience with be negatively correlated with the outcome measures and that resilience as an expectation will be positively correlated with the outcome measures.
Keywords: Resilience, Health outcomesResilience, defined broadly as the ability to “bounce back” from adversity and continue with life, has been highlighted as a potential explanation for why Black women experience positive outcomes (e.g., career success) despite the adversity that they face. However, the utility of a high resilience score (i.e., being more resilience) has been shown in prior research to be context dependent and not always positive. Additionally, there is no singular measurement of resilience in the literature, making it difficult to understand how resilience influences the outcomes of Black women.
Purpose.
Using a mixed-method approach, the goal of this research is to explore two related research questions. 1.) How do Black women define and engage with the concept of resilience? 2.) How does reframing the measurement of resilience, and the creation of a new scale that measures resilience for Black women, influence the outcomes that resilience is able to predict?
Method.
Research question 1 was tested using qualitative interviews from 24 Black women. The study aimed to learn more about how Black women think about resilience and what role resilience plays in their daily lives. Interviews lasted 60 minutes on average. Sample interview questions include “In your opinion, what does it mean to be resilient?” and “What strategies do you use to recover from significant life challenges?”
Based on the findings from our qualitative data analysis, a new scale for resilience in Black women will be created that captures two subscale of resilience: resilience as an experience, and resilience as an expectation, the latter of which has been largely overlooked in the current resilience scales. Research question 2 will be tested using linear regression to compare this newly created resilience scale to the Connor-Davison Resilience Scale, John Henryism Active Coping, and the Brief Cope Scale and independently test how well these resilience scales predict perceived stress, physical activity, and depression.
Anticipated Results.
We expect to find that the two subscales of the Resilience in Black Women scale (i.e., resilience as an experience and resilience as an expectation) will be positive correlated with each other, and with the other resilience scales. We suspect that resilience as an experience with be negatively correlated with the outcome measures and that resilience as an expectation will be positively correlated with the outcome measures.
Authors:
Presenter - Jasmine Perry, M.A., University of Connecticut
Building a Community-Driven Model of Disability Using Concept Mapping in Appalachian Kentucky
Poster Number: B148Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Quality of Life
Background: People with disabilities experience physical, social, psychological, and financial inequities often exacerbated by living in underserved rural communities, such as Appalachian Kentucky. In addition to high rates of poverty and poor health outcomes, Appalachian Kentucky has almost twice the U.S. rate of disability (22.9% compared with 12.7% nationally). This study aims to develop and verify a shared cultural model of disability describing the range of barriers, facilitators, and opportunities for intervention to improve quality of life and long-term health for people living with disabilities in Appalachia.
Methods: From April to September 2025, we recruited 47 participants, including people with disabilities (n=26), family caregivers (n=25), and health and human service providers and other professionals (n=31), some with multiple roles. Using concept mapping, a participatory mixed method, we conducted a series of activities, including (1) brainstorming, (2) sorting, and (3) rating factors that impact living with disability. We used multidimensional scaling and hierarchical cluster analysis to generate concept maps and conducted bivariate rating comparisons. We presented the resulting maps to participants in guided group discussions to co-develop an actionable model of barriers, facilitators, and intervention opportunities.
Results: Participants listed 96 factors that impact living with disability in Appalachian Kentucky, which grouped into 11 thematic areas related to healthcare, caregiving, perceptions of the region, education and awareness, jobs and income, and social relationships. We identified high correlation across participant groups. Based on initial results from sorting and rating, elements related to healthcare (e.g., medication availability, accommodations in clinics, accessing local providers) were seen as important and feasible for change, while elements related to income, caregiving, and resource availability were seen as less feasible targets. Guided group discussions will further explicate results and identify specific intervention opportunities.
Conclusion: Our novel application of concept mapping involving this population produced a community-driven cultural model of disability incorporating local barriers and facilitators. Overall, the participant-validated model constructed will serve as a platform to guide future intervention development to improve quality of life and long-term health for Appalachians with disabilities.
Keywords: Disability, Health disparitiesMethods: From April to September 2025, we recruited 47 participants, including people with disabilities (n=26), family caregivers (n=25), and health and human service providers and other professionals (n=31), some with multiple roles. Using concept mapping, a participatory mixed method, we conducted a series of activities, including (1) brainstorming, (2) sorting, and (3) rating factors that impact living with disability. We used multidimensional scaling and hierarchical cluster analysis to generate concept maps and conducted bivariate rating comparisons. We presented the resulting maps to participants in guided group discussions to co-develop an actionable model of barriers, facilitators, and intervention opportunities.
Results: Participants listed 96 factors that impact living with disability in Appalachian Kentucky, which grouped into 11 thematic areas related to healthcare, caregiving, perceptions of the region, education and awareness, jobs and income, and social relationships. We identified high correlation across participant groups. Based on initial results from sorting and rating, elements related to healthcare (e.g., medication availability, accommodations in clinics, accessing local providers) were seen as important and feasible for change, while elements related to income, caregiving, and resource availability were seen as less feasible targets. Guided group discussions will further explicate results and identify specific intervention opportunities.
Conclusion: Our novel application of concept mapping involving this population produced a community-driven cultural model of disability incorporating local barriers and facilitators. Overall, the participant-validated model constructed will serve as a platform to guide future intervention development to improve quality of life and long-term health for Appalachians with disabilities.
Authors:
Co-Author - Michelle Roberts, MS, MA, University of Kentucky
Co-Author - Nancy Schoenberg, PhD, University of Kentucky
Co-Author - Erin Koch, PhD, University of Kentucky
Co-Author - Anastasia Todd, PhD, University of Kentucky
Co-Author - Ann Kingsolver, PhD, University of Kentucky
Co-Author - Jessica Thompson, PhD, MEd, The Pennsylvania State University
Examining associations between church-level social factors and health behaviors among a sample of United Methodist Clergy: A secondary data analysis
Poster Number: B149Time: 11:00 AM - 11:50 AM
Topics: Social and Environmental Context and Health, Health Communication and Policy
Background: Many of the nearly quarter-million US clergy have reported a high prevalence of poor physical and mental health outcomes (obesity, metabolic syndrome, depression). Clergy have qualitatively reported multi-level vocational demands and barriers impacting health behavior engagement (days off, physical activity, diet). Recent literature has shown how church-level social factors (health policies/messaging, clergy support) can positively influence the health behaviors of their congregants; yet few studies have examined the connection between these church-level initiatives and the clergyperson’s own health. Thus, this preliminary study reports associations between church-level social factors and clergy health behaviors. Methods: This study was a secondary cross-sectional analysis of active, church-appointed United Methodist North Carolina clergy who participated in the 2023 Statewide Clergy Health Survey (N=676). Linear and modified Poisson regressions were used to examine associations between social-related factors (congregational support and demands; relationships with church staff) and clergy health behaviors (physical activity, sleep, Sabbath [i.e., intentional day of rest], days off, vacation). Results: Clergy were on average: 53.1 (SD=13.3) years of age, white (83%), male (62%), and serving churches with an average weekly attendance of 131 members and visitors (SD=183.7). No statistically significant associations were found between social-related factors and physical activity or sleep. Every one unit increase in congregational support (i.e., love and care) was associated with 1.4 more vacation days taken by clergy in the past year (coef=1.37, 95% CI=0.34-2.41). For every one unit increase in congregational demands, clergy were 1.3 times more likely to not regularly take a day off each week (RR=1.28, 95% CI=1.12-1.46). Every one unit increase in satisfaction with relations with other clergy and church staff was associated with 0.4 more intentional days of rest kept by clergy in the past four weeks (coef=0.35, 95% CI=0.12-0.59). Conclusions: Findings provide preliminary evidence on how the church environment, particularly social-related factors, might impact clergy health behavior engagement, especially related to taking time away from work. Future research should continue to explore how addressing both individual behavior and church-level social factors may assist in chronic disease prevention efforts among clergy.
Keywords: Social support, Health behaviorsAuthors:
Author - Nathan T. West, PhD, University of Alaska Anchorage
Co-Author - Jia Yao, MA, Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University
Co-Author - Brook E. Harmon, PhD, RD, FAND, Department of Nutrition and Healthcare Management, Appalachian State University
Co-Author - Todd W. Ferguson, PhD, Religion and Public Life Center, Rice University
Co-Author - Rae Jean Proeschold-Bell, PhD, Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University
Illness perceptions as predictors of posttraumatic stress in cancer: A longitudinal study
Poster Number: B15Time: 11:00 AM - 11:50 AM
Topics: Cancer
Background. Cancer-associated trauma can precipitate symptoms of posttraumatic stress, requiring adjustments which are dependent on illness perceptions.
Aims. This study examined the association between two key dimensions of illness perceptions – perceived control and perceived consequences – measured at baseline, and symptoms of posttraumatic stress (PTSS) assessed over a 12-month period among cancer survivors.
Methods. Data were drawn from the Yale UConn Cancer Resilience (YUCAN) study, which included 569 cancer survivors (Mage = 59.2, SD = 11.48) diagnosed with breast (58.3%), colorectal (10.2%), or prostate (31.5%) cancer. Participants completed surveys at baseline (T1), 6 months (T2) and 12 months (T3). Multiple linear regression models were used to determine if perceived control and perceived consequences at T1 were associated with PTSS at T2, and T3, adjusting for age, gender, marital status, and education.
Results. Greater perceived control at T1 was positively associated with lower PTSS at T2 (β = -0.01, p < .05) and T3 (β = -0.02, p < .001). Higher levels of perceived consequences at T1 were positively associated with higher PTSS at T2 (β = 0.03, p < .001) and T3 (β = 0.03, p < .001). Older age was also significantly associated with lower PTSS across both time points (T2-T3).
Conclusions. Findings suggest that illness perceptions—specifically beliefs about control and consequences—play a significant role in both short- and long-term psychological adjustment among adult cancer survivors. Targeting maladaptive illness perceptions may enhance psychological interventions designed to alleviate the burden of posttraumatic stress symptoms following cancer diagnosis and treatment.
Keywords: Cancer survivorship, StressAims. This study examined the association between two key dimensions of illness perceptions – perceived control and perceived consequences – measured at baseline, and symptoms of posttraumatic stress (PTSS) assessed over a 12-month period among cancer survivors.
Methods. Data were drawn from the Yale UConn Cancer Resilience (YUCAN) study, which included 569 cancer survivors (Mage = 59.2, SD = 11.48) diagnosed with breast (58.3%), colorectal (10.2%), or prostate (31.5%) cancer. Participants completed surveys at baseline (T1), 6 months (T2) and 12 months (T3). Multiple linear regression models were used to determine if perceived control and perceived consequences at T1 were associated with PTSS at T2, and T3, adjusting for age, gender, marital status, and education.
Results. Greater perceived control at T1 was positively associated with lower PTSS at T2 (β = -0.01, p < .05) and T3 (β = -0.02, p < .001). Higher levels of perceived consequences at T1 were positively associated with higher PTSS at T2 (β = 0.03, p < .001) and T3 (β = 0.03, p < .001). Older age was also significantly associated with lower PTSS across both time points (T2-T3).
Conclusions. Findings suggest that illness perceptions—specifically beliefs about control and consequences—play a significant role in both short- and long-term psychological adjustment among adult cancer survivors. Targeting maladaptive illness perceptions may enhance psychological interventions designed to alleviate the burden of posttraumatic stress symptoms following cancer diagnosis and treatment.
Authors:
Presenter - Chizobam Nweke, MD, MA, University of Connecticut
Co-Author - Candidus Nwakasi, Ph.D, MSPH, University of Connecticut
Co-Author - Caroline Salafia, PhD, Memorial Sloan Kettering Cancer Center
Co-Author - Keith Bellizzi, PhD, MPH, FSBM, University of Connecticut
Co-Author - Crystal Park, PhD, FSBM, University of Connecticut
Application of the Theory of Planned Behavior to understand the implementation of opioid education and naloxone distribution programs on college campuses
Poster Number: B150Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Implementation Science
Background: The U.S. opioid overdose epidemic’s reach is expanding. Opioid overdose education & naloxone training/distribution (OEND) programs are key in a multipronged public health response. College campus infrastructure could support national implementation of such programs for young adults with broad reach in their communities. This important setting is underutilized, and critical gaps remain in understanding campus OEND program implementation.
Method: Based on our qualitative work developing Columbia University’s OEND program, we prioritized implementation in student groups at potentially high risk for opioid use or those well-positioned to disseminate opioid-related resources or administer naloxone (e.g. Greek life, Resident Assistants). We surveyed participants 2 weeks after program implementation (9/2019-9/2020, n=404 students) to assess key predictors of behavioral intention (intent/lack of intent). Measures were informed by the Theory of Planned Behavior (e.g. Brief Opioid Overdose Knowledge, Opioid Overdose Attitudes Scales).
Results: Student participants had high intent to carry (79.2%) & administer (95.3%) naloxone. Knowledge about opioids & opioid overdose risk/response was unrelated to intent to carry (p=.40) but was related to intent to administer (p=.029, OR=1.28, CI=1.03,1.59). Attitudes about naloxone distribution & policies were related to intent to carry (p=.001, OR=2.57, CI=1.49,4.46) & administer (p<.001, OR=5.28, CI=2.35,11.86). Self-efficacy to distribute naloxone to those who might benefit from it & train peers on its administration was related to intent to carry (p<.001, OR=2.24, CI=1.52,3.30) & administer (p<.001, OR=6.20, CI=2.85,13.48). Self-efficacy to administer naloxone was related to intent to carry (p=.015, OR=1.08, CI=1.02,1.15) & administer (p<.001, OR=1.27, CI=1.11,1.44). Intent to keep naloxone at home, administer naloxone & educate/train peers on its administration was related to intent to carry (p<.001, OR=4.04, CI=2.48,6.60). Intent to keep naloxone at home, carry naloxone in the community & educate/train peers on its administration was related to intent to administer (p<.001, OR=8.35, CI=3.44,20.27).
Conclusion: This is the first theory-informed analysis of predictors of intent to carry/administer naloxone among undergraduate college students engaged in an OEND program, advancing understanding of what influences their decision to intervene in an overdose situation and implementation of campus OEND programs.
Keywords: Opioids, TheoryMethod: Based on our qualitative work developing Columbia University’s OEND program, we prioritized implementation in student groups at potentially high risk for opioid use or those well-positioned to disseminate opioid-related resources or administer naloxone (e.g. Greek life, Resident Assistants). We surveyed participants 2 weeks after program implementation (9/2019-9/2020, n=404 students) to assess key predictors of behavioral intention (intent/lack of intent). Measures were informed by the Theory of Planned Behavior (e.g. Brief Opioid Overdose Knowledge, Opioid Overdose Attitudes Scales).
Results: Student participants had high intent to carry (79.2%) & administer (95.3%) naloxone. Knowledge about opioids & opioid overdose risk/response was unrelated to intent to carry (p=.40) but was related to intent to administer (p=.029, OR=1.28, CI=1.03,1.59). Attitudes about naloxone distribution & policies were related to intent to carry (p=.001, OR=2.57, CI=1.49,4.46) & administer (p<.001, OR=5.28, CI=2.35,11.86). Self-efficacy to distribute naloxone to those who might benefit from it & train peers on its administration was related to intent to carry (p<.001, OR=2.24, CI=1.52,3.30) & administer (p<.001, OR=6.20, CI=2.85,13.48). Self-efficacy to administer naloxone was related to intent to carry (p=.015, OR=1.08, CI=1.02,1.15) & administer (p<.001, OR=1.27, CI=1.11,1.44). Intent to keep naloxone at home, administer naloxone & educate/train peers on its administration was related to intent to carry (p<.001, OR=4.04, CI=2.48,6.60). Intent to keep naloxone at home, carry naloxone in the community & educate/train peers on its administration was related to intent to administer (p<.001, OR=8.35, CI=3.44,20.27).
Conclusion: This is the first theory-informed analysis of predictors of intent to carry/administer naloxone among undergraduate college students engaged in an OEND program, advancing understanding of what influences their decision to intervene in an overdose situation and implementation of campus OEND programs.
Authors:
Presenter - Savannah P. Alexander, MPH, Columbia University Mailman School of Public Health
Co-Author - Carrigan Parish, PhD, DDS, Columbia University Mailman School of Public Health
Co-Author - Victoria Mello, MPH, Columbia University Mailman School of Public Health
Co-Author - Margaret Pereyra, DrPH, Columbia University Mailman School of Public Health
Co-Author - Melanie Bernitz, MD, MPH, Columbia Health & Columbia University Vagelos College of Physicians and Surgeons
Co-Author - Michael McNeil, EdD, CHES, FACHA, Columbia Health & Columbia University Mailman School of Public Health
Co-Author - Lisa Rosen-Metsch, PhD, Columbia University Mailman School of Public Health
Co-Author - Kevin Graves, MS, LMFT, Kevin Graves Marriage and Family Therapist Inc.
Co-Author - Rachel Shelton, ScD, MPH, Columbia Mailman School of Public Health
Substance Use and Depression Among U.S. Adolescents (2021–2023): Exploring Demographic and Geographic Differences
Poster Number: B151Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Tobacco Control and Nicotine-Related Behavior
Background
Adolescent substance use causes significant risks to one's physical, mental, and social health, and demographic variations may indicate that populations are more vulnerable. To identify inequalities based on sex, race/ethnicity, and county type, this study presents updated national-level evidence on alcohol, cannabis, opioid, tobacco, and inhalant use patterns among adolescents in the United States. This study also examines the association of past-year major depressive episodes with substance use.
Methods
We used pooled data from the National Survey on Drug Use and Health (NSDUH) cycles 2021–2023 for this study. Questions regarding past year tobacco, alcohol, marijuana, opioid, and inhalant use, and major depressive episode were our outcomes. Weighted logistic regression analyses were conducted in R.
Results
Among 34,284 U.S. adolescents surveyed (2021–2023), past-year prevalence was 17.4% for alcohol, 11.8% for marijuana, 14.0% for opioids, 5.2% for tobacco, 2.4% for inhalants, and 18.6% for major depressive episodes. Females had higher odds of alcohol (OR = 1.39, p < .001), marijuana (OR = 1.37, p < .001), opioid (OR = 1.23, p < .001), and inhalant use (OR = 1.17, p < .05), and were more likely to report depression (OR = 3.47, p < .001). Nonmetropolitan adolescents had greater odds of opioid (OR = 1.25, p < .001) and tobacco use (OR = 1.38, p < .001). Racial/ethnic disparities were evident: Non-Hispanic White adolescents had the highest marijuana (11.2%), tobacco (7.8%), and inhalant use (2.4%). Asian adolescents reported the lowest use (marijuana: 3.9%, tobacco: 2.1%) and depression (9.7%). Compared to White youth, Black adolescents had lower odds of marijuana (OR = 0.55, p < .001), tobacco (OR = 0.49, p < .001), and depression (OR = 0.56, p < .001). Asian adolescents also had lower odds of marijuana (OR = 0.32, p < .001), tobacco (OR = 0.36, p < .001), and depression (OR = 0.47, p < .001). Hispanic adolescents had similar odds for marijuana and tobacco but lower odds of depression (OR = 0.87, p = .002).
Conclusion
Significant demographic disparities exist in adolescent substance use and major depressive episodes. These findings highlight the need for prevention and intervention approaches that address both depression and substance use, tailored to specific demographic risk profiles.
Keywords: Substance abuse, DepressionAdolescent substance use causes significant risks to one's physical, mental, and social health, and demographic variations may indicate that populations are more vulnerable. To identify inequalities based on sex, race/ethnicity, and county type, this study presents updated national-level evidence on alcohol, cannabis, opioid, tobacco, and inhalant use patterns among adolescents in the United States. This study also examines the association of past-year major depressive episodes with substance use.
Methods
We used pooled data from the National Survey on Drug Use and Health (NSDUH) cycles 2021–2023 for this study. Questions regarding past year tobacco, alcohol, marijuana, opioid, and inhalant use, and major depressive episode were our outcomes. Weighted logistic regression analyses were conducted in R.
Results
Among 34,284 U.S. adolescents surveyed (2021–2023), past-year prevalence was 17.4% for alcohol, 11.8% for marijuana, 14.0% for opioids, 5.2% for tobacco, 2.4% for inhalants, and 18.6% for major depressive episodes. Females had higher odds of alcohol (OR = 1.39, p < .001), marijuana (OR = 1.37, p < .001), opioid (OR = 1.23, p < .001), and inhalant use (OR = 1.17, p < .05), and were more likely to report depression (OR = 3.47, p < .001). Nonmetropolitan adolescents had greater odds of opioid (OR = 1.25, p < .001) and tobacco use (OR = 1.38, p < .001). Racial/ethnic disparities were evident: Non-Hispanic White adolescents had the highest marijuana (11.2%), tobacco (7.8%), and inhalant use (2.4%). Asian adolescents reported the lowest use (marijuana: 3.9%, tobacco: 2.1%) and depression (9.7%). Compared to White youth, Black adolescents had lower odds of marijuana (OR = 0.55, p < .001), tobacco (OR = 0.49, p < .001), and depression (OR = 0.56, p < .001). Asian adolescents also had lower odds of marijuana (OR = 0.32, p < .001), tobacco (OR = 0.36, p < .001), and depression (OR = 0.47, p < .001). Hispanic adolescents had similar odds for marijuana and tobacco but lower odds of depression (OR = 0.87, p = .002).
Conclusion
Significant demographic disparities exist in adolescent substance use and major depressive episodes. These findings highlight the need for prevention and intervention approaches that address both depression and substance use, tailored to specific demographic risk profiles.
Authors:
Presenter - Aminul I. Apu, MS, Department of Public Health, School of Applied Sciences, The University of Mississippi, University, MS 38677, USA
Co-Author - R. Andrew Yockey, PhD, Department of Public Health, School of Applied Sciences, The University of Mississippi, University, MS 38677, USA
Tailoring a Patient Engagement Framework for Substance Use Disorder Research
Poster Number: B152Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Community Engagement
Patient engagement holds promise for advancing discovery and innovation in research across the substance use disorder (SUD) treatment cascade. Despite increasing recognition of the importance of engaging patients in SUD research, as well as the National Institute on Drug Abuse’s commitment to patient engagement, we have limited understanding of best practices for patient engagement in the SUD field. Patient engagement frameworks are tools that help stakeholders support, evaluate, improve, and report on patient involvement in research. Yet, patient engagement frameworks that are tailored to the unique needs of patients and communities impacted by SUD are nascent. Our goal was to tailor the Assessing Community Engagement (ACE) Conceptual Model, a popular patient engagement framework developed by the National Academy of Medicine, for SUD research. The ACE Conceptual Model includes core principles of community engagement (e.g., trust, culturally-centered, co-equal) and domains of impact of engaged research (e.g., strengthened partnerships and alliances, expanded knowledge, improved health, thriving communities). Notably, the Model is designed to be adaptable; its developers recommended that communities review and refine the Model as needed to support their unique needs. We recruited n=25 participants engaged in active substance use and n=25 participants in recovery from SUD for the current study. We used concept mapping, a community-based participatory and mixed-methods approach, to identify key elements of SUD patient engaged research. Participants identified risks and benefits of engaging in research, and described ways that they want to be treated by researchers. Results were integrated into the ACE Conceptual Model. Several unique core principles of engagement for SUD-related research were identified, including: respect, transparency, fair compensation, and minimizing triggers related to trauma and/or substance use. Several unique domains of impact of SUD-related research were additionally modified or added, including: expanded knowledge of SUD, societal change and stigma reduction, improved treatment and recovery for people with SUD, and a sense of purpose for participants. Discussion will focus on future directions for evaluating the tailored patient engagement framework and strategies for applying the framework within SUD research.
Keywords: Substance abuse, Participatory researchAuthors:
Presenter - Valerie Earnshaw, PhD, University of Delaware
Co-Author - Kayla Zawislak, LCSW, CADC, Addiction Policy Forum
Co-Author - Akilah Dulin, PhD, Tulane University
Co-Author - Jessica Hulsey, Addiction Policy Forum
Comorbid Physical and Psychological Symptoms as a Risk Factor for Persistent Substance Use among US Adolescents
Poster Number: B153Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Mental Health
Introduction: While most US adolescents who experiment with substance use (SU) do not progress to persistent use, nearly 2 million youths aged 12-17 years (7.8%) developed a SU disorder (SUD) in 2024. Multiple risk factors have been associated with developing a SUD including early SU initiation prior to age 14 years. Our recent work found that youth with comorbid physical and psychological symptoms (PPS) are at two times greater risk for early SU initiation, suggesting they may be at particular risk for transitioning to persistent SU and SUD.
Methods: We used longitudinal data from the Adolescent Brain and Cognitive Development Study to determine whether US youth with more severe and worsening PPS trajectories were at greater risk for persistent SU across early adolescence (ages 9/10 to 13/14 years; n=8,311). Youth who reported SU at baseline (ages 9/10) were excluded. PPS trajectories were established based on parental reports on the Child Behavior Checklist of physical (e.g., pain, other somatic) and psychological (e.g., anxiety, depression) symptoms. Every 6 months, youth reported SU since the previous assessment (any use including a sip/puff vs. none). Due to low prevalence, alcohol, tobacco, cannabis, and other drugs were combined into a single annual SU measure (yes/no). The outcome of SU over time was categorized as: no use, one year of use, and persistent use (≥2 years). Multinomial regression was used to examine the association between PPS and persistent SU, adjusting for sex, race and ethnicity.
Results: Regarding PPS symptoms, 28% of youths were classified as asymptomatic, 39% as low/stable symptoms, 25.3% as moderate/persistent symptoms, and 7.9% as severe/worsening symptoms. Approximately 9.8% of youth reported any SU during the study and 1.7% had persistent use. Prevalence of persistent SU varied by PPS group: 3.1% in the severe/worsening group, 2.0% in the moderate/persistent group, 1.6% in the low/stable group, and 1.1% in the asymptomatic group. Adjusting for sex, race and ethnicity, youth in the severe/worsening and moderate/persistent PPS groups were significantly more likely to report persistent SU compared to the asymptomatic group (AOR 2.85 [1.57, 5.21] and 1.77 [1.06, 2.93], respectively).
Conclusion: The association between youths’ comorbid symptomology and persistent SU during early adolescence suggests a need to screen for and better manage physical and psychological symptoms to mitigate the risk for SU progression.
Keywords: Adolescents, Substance abuseMethods: We used longitudinal data from the Adolescent Brain and Cognitive Development Study to determine whether US youth with more severe and worsening PPS trajectories were at greater risk for persistent SU across early adolescence (ages 9/10 to 13/14 years; n=8,311). Youth who reported SU at baseline (ages 9/10) were excluded. PPS trajectories were established based on parental reports on the Child Behavior Checklist of physical (e.g., pain, other somatic) and psychological (e.g., anxiety, depression) symptoms. Every 6 months, youth reported SU since the previous assessment (any use including a sip/puff vs. none). Due to low prevalence, alcohol, tobacco, cannabis, and other drugs were combined into a single annual SU measure (yes/no). The outcome of SU over time was categorized as: no use, one year of use, and persistent use (≥2 years). Multinomial regression was used to examine the association between PPS and persistent SU, adjusting for sex, race and ethnicity.
Results: Regarding PPS symptoms, 28% of youths were classified as asymptomatic, 39% as low/stable symptoms, 25.3% as moderate/persistent symptoms, and 7.9% as severe/worsening symptoms. Approximately 9.8% of youth reported any SU during the study and 1.7% had persistent use. Prevalence of persistent SU varied by PPS group: 3.1% in the severe/worsening group, 2.0% in the moderate/persistent group, 1.6% in the low/stable group, and 1.1% in the asymptomatic group. Adjusting for sex, race and ethnicity, youth in the severe/worsening and moderate/persistent PPS groups were significantly more likely to report persistent SU compared to the asymptomatic group (AOR 2.85 [1.57, 5.21] and 1.77 [1.06, 2.93], respectively).
Conclusion: The association between youths’ comorbid symptomology and persistent SU during early adolescence suggests a need to screen for and better manage physical and psychological symptoms to mitigate the risk for SU progression.
Authors:
Presenter - Rebecca Evans-Polce, PhD, University of Michigan
Co-Author - Sara Evans-Lacko, PhD, London School of Economics
Co-Author - Sean Esteban McCabe, MSW, PhD, University of Michigan
Co-Author - Terri Voepel-Lewis, PhD, RN, University of Michigan
FIRST INTRODUCER, UNDERLYING REASONS AND CONTRIBUTING FACTORS ASSOCIATED WITH SUBSTANCE USE AMONG ADOLESCENTS IN LAGOS STATE, NIGERIA.
Poster Number: B154Time: 11:00 AM - 11:50 AM
Topics: Substance Misuse, Mental Health
Background: Adolescent substance use is an urgent global health challenge, often initiated during secondary school years and associated with mental and lifelong health risks. In sub-Saharan Africa, and especially in Nigeria’s megacity Lagos, rapid urbanization, peer dynamics, and socio-economic disparities create a unique environment for adolescent substance use. Yet limited research has examined three critical dimensions of adolescent substance use: the first introducer, the underlying reasons for initiation, and the associated risk and protective factors.
Methods: A descriptive cross-sectional survey was conducted among 800 secondary school students in Lagos State. Data were collected using a modified World Health Organization Student Drug-Use Questionnaire. Descriptive statistics profiled prevalence and patterns of use, while chi-square tests (p<0.05) identified socio-demographic associations using Epi Info version 7.
Results: Participants’ mean age was 15.3 years (SD = 1.5); 52.5% were male and 70.0% identified as Christian. Lifetime prevalence of substance use was 13.9%, with a mean initiation age of 12.9 years (range 7–19). Friends were the predominant introducers (67.6%), followed by family members (14.4%). Motivations included curiosity (54.1%), coping with pain (53.1%), boredom (29.7%), joy-seeking (21.6%), and youthful exuberance (18.0%). Situational use before exams (4.5%), sports (2.7%), and at parties (33.3%) was also reported. Increased substance use was significantly associated with older age (p<0.001), male gender (p<0.001), larger family size (p<0.001), non- christian religion (p<0.001), and lower maternal education (p<0.001). Protective factors included higher maternal education and Christian affiliation. Smoking (47.7%) and oral ingestion (46.8%) were the main methods of use.
Conclusions: Adolescent substance use in Lagos is shaped by peer introductions, curiosity, social pressures, and coping needs. Demographic and familial factors heighten vulnerability while maternal education and religiosity act as protective buffers.
Implications for Behavioral Medicine: Findings highlight the urgent need for multi-level, culturally tailored interventions. Peer-led prevention, school-based programs, maternal education, and faith-based initiatives can reduce initiation and strengthen resilience. While rooted in Lagos, these insights are transferable to other African urban centers and globally, where adolescent substance use follows similar patterns.
Keywords: Substance abuse, Health policyMethods: A descriptive cross-sectional survey was conducted among 800 secondary school students in Lagos State. Data were collected using a modified World Health Organization Student Drug-Use Questionnaire. Descriptive statistics profiled prevalence and patterns of use, while chi-square tests (p<0.05) identified socio-demographic associations using Epi Info version 7.
Results: Participants’ mean age was 15.3 years (SD = 1.5); 52.5% were male and 70.0% identified as Christian. Lifetime prevalence of substance use was 13.9%, with a mean initiation age of 12.9 years (range 7–19). Friends were the predominant introducers (67.6%), followed by family members (14.4%). Motivations included curiosity (54.1%), coping with pain (53.1%), boredom (29.7%), joy-seeking (21.6%), and youthful exuberance (18.0%). Situational use before exams (4.5%), sports (2.7%), and at parties (33.3%) was also reported. Increased substance use was significantly associated with older age (p<0.001), male gender (p<0.001), larger family size (p<0.001), non- christian religion (p<0.001), and lower maternal education (p<0.001). Protective factors included higher maternal education and Christian affiliation. Smoking (47.7%) and oral ingestion (46.8%) were the main methods of use.
Conclusions: Adolescent substance use in Lagos is shaped by peer introductions, curiosity, social pressures, and coping needs. Demographic and familial factors heighten vulnerability while maternal education and religiosity act as protective buffers.
Implications for Behavioral Medicine: Findings highlight the urgent need for multi-level, culturally tailored interventions. Peer-led prevention, school-based programs, maternal education, and faith-based initiatives can reduce initiation and strengthen resilience. While rooted in Lagos, these insights are transferable to other African urban centers and globally, where adolescent substance use follows similar patterns.
Authors:
Presenter - Tolulope Kolawole, DVM, MSPH, MBA, FRSPH, School of Public Health, Virginia Commonwealth University, Virginia, United States.
Cigarillo Use Prevention Messaging Themes: Qualitative Feedback from Black Young Adults
Poster Number: B155Time: 11:00 AM - 11:50 AM
Topics: Tobacco Control and Nicotine-Related Behavior, Health Disparities
Background: Cigarillo use can cause cancer and heart and lung diseases. U.S. Black young adults have a high prevalence of use, with beliefs about anticipated outcome expectancies (OE) linked to use behaviors. However, little is known about how effective OE messaging themes may be in prevention messaging. Thus, we qualitatively examined how contextualizing cigarillo use health harms with OE themes may affect message effectiveness among Black young adults.
Methods: In May-December 2024, 52 Black 18-30-year-olds susceptible to or had experimented with cigarillos completed a within-subjects, eye-tracking task with prevention messages and a qualitative interview to provide their feedback on message saliency and liking/disliking message content for OE themes. Messages described cigarillo use health risks (i.e., long-term, short-term, social, and nicotine addiction) contextualized to four OE themes: 1) smoking/sensory experience, 2) relaxation and pleasure from use, 3) social admirability, and 4) cigarillo use misaligning with personal authenticity/values. Four messages per theme included text and imagery. Two coders conducted qualitative analysis within and across OE themes.
Results: Most participants felt messages resonated with them overall, with a few participants per theme expressing that certain themes were less salient to them. The social admirability theme (e.g., cigarillo use leaves an unpleasant odor that others notice) received the most positive feedback for theme saliency, followed in turn by smoking/sensory experience (e.g., while cigarillos may taste good, you can lose ability to taste), relaxation/pleasure (e.g., cigarillo smoking being more “tense” than “relaxing” due to increased blood pressure), and misalignment with authenticity/values (e.g., framing heart disease as “breaking the soul”). Also, while participants generally liked all message content across themes, more participants expressed dislike toward the message content for misalignment with authenticity/values compared to the others, with this theme eliciting the most mixed reactions.
Conclusion: Our findings suggest that contextualizing cigarillo use health harms with relevant outcome expectancies can potentially be effective among Black young adults. Messages that highlight social admirability and sensory experiences may be especially promising, though there is a need to use various message themes to enhance overall message saliency and effectiveness among Black young adults.
Keywords: Tobacco control, Health beliefsMethods: In May-December 2024, 52 Black 18-30-year-olds susceptible to or had experimented with cigarillos completed a within-subjects, eye-tracking task with prevention messages and a qualitative interview to provide their feedback on message saliency and liking/disliking message content for OE themes. Messages described cigarillo use health risks (i.e., long-term, short-term, social, and nicotine addiction) contextualized to four OE themes: 1) smoking/sensory experience, 2) relaxation and pleasure from use, 3) social admirability, and 4) cigarillo use misaligning with personal authenticity/values. Four messages per theme included text and imagery. Two coders conducted qualitative analysis within and across OE themes.
Results: Most participants felt messages resonated with them overall, with a few participants per theme expressing that certain themes were less salient to them. The social admirability theme (e.g., cigarillo use leaves an unpleasant odor that others notice) received the most positive feedback for theme saliency, followed in turn by smoking/sensory experience (e.g., while cigarillos may taste good, you can lose ability to taste), relaxation/pleasure (e.g., cigarillo smoking being more “tense” than “relaxing” due to increased blood pressure), and misalignment with authenticity/values (e.g., framing heart disease as “breaking the soul”). Also, while participants generally liked all message content across themes, more participants expressed dislike toward the message content for misalignment with authenticity/values compared to the others, with this theme eliciting the most mixed reactions.
Conclusion: Our findings suggest that contextualizing cigarillo use health harms with relevant outcome expectancies can potentially be effective among Black young adults. Messages that highlight social admirability and sensory experiences may be especially promising, though there is a need to use various message themes to enhance overall message saliency and effectiveness among Black young adults.
Authors:
Presenter - Henri Brignol, BS, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
Co-Author - , MBBS, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
Co-Author - , MPH, Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
Co-Author - Mignonne Guy, PhD, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University
Co-Author - , DrPH, Department of Health Behavior, Society, and Policy, Rutgers School of Public Health and Rutgers Institute for Nicotine & Tobacco Studies, Rutgers University
Co-Author - Kelvin Choi, PhD, MPH, Division of Intramural Research, National Institute on Minority Health and Health Disparities
Co-Author - , PhD, MA, Jeb E. Brooks School of Public Policy and Department of Communication, Cornell University
Co-Author - Lilianna Phan, PhD, MPH, MS, Department of Community Health and Prevention, Dornsife School of Public Health & Division of Graduate Nursing, College of Nursing and Health Professions, Drexel University
Awareness of a National Tobacco Cessation and Prevention Campaign and Stages of Quitting Electronic Cigarettes: Findings from the Truth® Campaign (September 2024 to May 2025)
Poster Number: B156Time: 11:00 AM - 11:50 AM
Topics: Tobacco Control and Nicotine-Related Behavior
Background. This study examines associations between awareness of a national tobacco cessation and prevention campaign and stages of quitting e-cigarettes.
Methods. Data were obtained from a repeated, cross-sectional online survey of youth and young adults (aged 15-24 years), collected from September 2024 to May 2025. Multinomial regression models were used to determine associations between level of campaign awareness (no awareness, low awareness, high awareness) of the truth® campaign and stages of quitting (precontemplation, contemplation, and preparation/action/maintenance, based on expressed quit intentions) among e-cigarette users, adjusted for the effects of age, sex assigned at birth, race, mother’s education level, sexual orientation, current use of other tobacco products, and time interval (September-November 2024, December 2024-February 2025, and March 2025-May 2025).
Results. Campaign awareness levels remained steady during the observation period (~60%). Compared to those with no campaign awareness, those with low and high campaign awareness were more likely to be in contemplation (OR=1.78 and OR=2.63) and preparation/action/maintenance (OR=1.63 and OR=2.77) stages, respectively. Older age, female gender, Non-Hispanic Black identity, and later time interval were associated with further quit stage, while bisexual identity was associated with earlier quit stage.
Conclusion. Higher levels of campaign awareness were associated with further stages of quitting. Results suggest that campaign messages are resonating with youth and young adults who use e-cigarettes and may be encouraging them to quit.
Keywords: Tobacco use, AdolescentsMethods. Data were obtained from a repeated, cross-sectional online survey of youth and young adults (aged 15-24 years), collected from September 2024 to May 2025. Multinomial regression models were used to determine associations between level of campaign awareness (no awareness, low awareness, high awareness) of the truth® campaign and stages of quitting (precontemplation, contemplation, and preparation/action/maintenance, based on expressed quit intentions) among e-cigarette users, adjusted for the effects of age, sex assigned at birth, race, mother’s education level, sexual orientation, current use of other tobacco products, and time interval (September-November 2024, December 2024-February 2025, and March 2025-May 2025).
Results. Campaign awareness levels remained steady during the observation period (~60%). Compared to those with no campaign awareness, those with low and high campaign awareness were more likely to be in contemplation (OR=1.78 and OR=2.63) and preparation/action/maintenance (OR=1.63 and OR=2.77) stages, respectively. Older age, female gender, Non-Hispanic Black identity, and later time interval were associated with further quit stage, while bisexual identity was associated with earlier quit stage.
Conclusion. Higher levels of campaign awareness were associated with further stages of quitting. Results suggest that campaign messages are resonating with youth and young adults who use e-cigarettes and may be encouraging them to quit.
Authors:
Co-Author - Elizabeth Do, PhD, MPH, Truth Initiative
Co-Author - Shiyang (Michael) Liu, MS, Truth Initiative
Co-Author - Joslynn Watkins, MPH, Truth Initiative
Co-Author - Jessica Rath, PhD, Truth Initiative
Co-Author - Elizabeth Hair, PhD, Truth Initiative
The Effect of Pictorial Health Warning Labels Placed on the ENDS Device on Young Adult Smokers’ Subjective Experiences: A Crossover Study
Poster Number: B157Time: 11:00 AM - 11:50 AM
Topics: Tobacco Control and Nicotine-Related Behavior, Health Communication and Policy
Significance: In recent years, Electronic Nicotine Delivery Systems (ENDS) have become the leading tobacco product among young people in the U.S, many of whom are unaware of their addictive and harmful potential. This is further exacerbated by ENDS marketing which aids misperception of these products as safe alternatives to cigarettes. Current trends reveal that majority of young users have no history of smoking, making these products a source of potential net harm, rather than harm reduction. Therefore, there is a need to convey scientifically accurate information about ENDS content and health effects. Health Warning Labels (HWLs) represent an effective strategy to communicate tobacco-related risks. This study aims to assess the impact of 4 evidence-based ENDS-specific pictorial HWLs, placed on the device, on users’ subjective experiences.
Methods: A total of 55 current healthy ENDS users aged 21–35 years, completed two 60-minute ad libitum vaping sessions with their preferred flavor (tobacco/menthol) and nicotine concentration (3% or 5%) of ENDS in a within-subject crossover design (no-HWL vs. HWL) after a 12-hour abstinence. We compared the mean change in subjective measures pre- and post-smoking between the two HWL conditions.
Results: Study participants were aged 24 years, on average. High-dependent users reported lower satisfaction [p=0.070] and a significant reduction in craving [p=0.007], enjoyment [p=0.004] and psychological reward in terms of lower calmness [p<0.001] post HWL-session compared to post no-HWL session. Moreover, they reported an increase in nausea as well as decreased product appeal in the HWL condition for puff liking [p=0.005] and puff satisfaction [p=0.018] compared to no-HWL condition. Finally, all participants reported significantly reduced motivation to use the same product if it were the only one available in the market.
Conclusion: Our findings indicate that placing pictorial HWLs directly on ENDS devices significantly diminishes use experience and product appeal. This evidence from a sensitive crossover study supports expanding regulatory efforts beyond the current FDA-mandated HWLs, to require device-based pictorial warnings that communicate broader health risks, to curb ENDS initiation and use among the US youth.
Keywords: Tobacco control, Health communicationMethods: A total of 55 current healthy ENDS users aged 21–35 years, completed two 60-minute ad libitum vaping sessions with their preferred flavor (tobacco/menthol) and nicotine concentration (3% or 5%) of ENDS in a within-subject crossover design (no-HWL vs. HWL) after a 12-hour abstinence. We compared the mean change in subjective measures pre- and post-smoking between the two HWL conditions.
Results: Study participants were aged 24 years, on average. High-dependent users reported lower satisfaction [p=0.070] and a significant reduction in craving [p=0.007], enjoyment [p=0.004] and psychological reward in terms of lower calmness [p<0.001] post HWL-session compared to post no-HWL session. Moreover, they reported an increase in nausea as well as decreased product appeal in the HWL condition for puff liking [p=0.005] and puff satisfaction [p=0.018] compared to no-HWL condition. Finally, all participants reported significantly reduced motivation to use the same product if it were the only one available in the market.
Conclusion: Our findings indicate that placing pictorial HWLs directly on ENDS devices significantly diminishes use experience and product appeal. This evidence from a sensitive crossover study supports expanding regulatory efforts beyond the current FDA-mandated HWLs, to require device-based pictorial warnings that communicate broader health risks, to curb ENDS initiation and use among the US youth.
Authors:
Presenter - Sharika Ferdous, BSc, MPH, Florida International University
Co-Author - Sreshtha Chowdhury, MPH, Florida International University
Co-Author - Simanta Roy, MPH, Florida International University
Co-Author - Tarana Ferdous, Florida International University
Co-Author - Taghrid Asfar, University of Miami
Co-Author - Zoran Bursac, Florida International University
Co-Author - Wasim Maziak, Florida International University
Changes in perceived self and use of tobacco, nicotine, and cannabis: Exploratory analyses
Poster Number: B158Time: 11:00 AM - 11:50 AM
Topics: Tobacco Control and Nicotine-Related Behavior, Health Disparities
Introduction: Fluidity in the perceived self with respect to sexual orientation (SO) and gender identity (GI) has been associated with engagement in various health-related behaviors. For example, emerging published data indicates that self-reported changes in SO, particularly shifts from heterosexual identities, are associated with a higher use of nicotine and tobacco use. The current study explored the association between the changes in both SO and GI and use of nicotine, tobacco, and marijuana/cannabis.
Methods: Participants were between 18 and 45 years old and completed at least 2 waves of the Rutgers Omnibus Study (N=5,525) on MTurk. SO and/or GI status was stratified within each SO and GI subgroup as follows: Started heterosexual/cisgender and maintained (Group 1) or changed (Group 2); Started SGM and maintained (Group 3) or changed (Group 4). Outcome variables included ever and past 30-day use of the following in the most recently completed wave: cigarettes, e-cigarettes, cigars, smokeless tobacco, nicotine pouches, and marijuana/cannabis. Multivariable logistic regression analyses were conducted, adjusting for age and sex at birth.
Results: Overall, regardless of baseline status, individuals who reported a change in their SO and/or GI status were more likely to report ever and/or past 30-day nicotine and tobacco use in their most recently completed wave. Specifically, those who reported changes in their SO (combined Groups 2 [n=101] and 4 [n=121]), as compared to those who maintained (combined Groups 1 [n=4,342] and 3 [n=905]), had significantly greater odds of reporting ever use of e-cigarettes (aOR=1.48) and past 30-day use of cigarettes, e-cigarettes, cigars, smokeless tobacco, and nicotine pouches (aORs=1.74-2.92). Those who reported changes in their GI (combined Groups 2 [n=41] and 4 [n=51]), versus those who maintained (combined Groups 1 [n=5,304] and 3 [n=106]), had significantly greater odds of reporting ever use of smokeless tobacco (aOR=1.94) and past 30-day use of cigarettes, e-cigarettes, cigars, and smokeless tobacco (aORs=1.66-2.94). No significant findings were observed for marijuana/cannabis use.
Discussion: These exploratory analyses suggest disproportionate nicotine and tobacco use among those who report changes in SO and GI, regardless of their initially reported identities. Caution is warranted when interpreting the results related to the use of smokeless tobacco and nicotine pouches, and GI, due to the small sample size.
Keywords: Minority health, Tobacco useMethods: Participants were between 18 and 45 years old and completed at least 2 waves of the Rutgers Omnibus Study (N=5,525) on MTurk. SO and/or GI status was stratified within each SO and GI subgroup as follows: Started heterosexual/cisgender and maintained (Group 1) or changed (Group 2); Started SGM and maintained (Group 3) or changed (Group 4). Outcome variables included ever and past 30-day use of the following in the most recently completed wave: cigarettes, e-cigarettes, cigars, smokeless tobacco, nicotine pouches, and marijuana/cannabis. Multivariable logistic regression analyses were conducted, adjusting for age and sex at birth.
Results: Overall, regardless of baseline status, individuals who reported a change in their SO and/or GI status were more likely to report ever and/or past 30-day nicotine and tobacco use in their most recently completed wave. Specifically, those who reported changes in their SO (combined Groups 2 [n=101] and 4 [n=121]), as compared to those who maintained (combined Groups 1 [n=4,342] and 3 [n=905]), had significantly greater odds of reporting ever use of e-cigarettes (aOR=1.48) and past 30-day use of cigarettes, e-cigarettes, cigars, smokeless tobacco, and nicotine pouches (aORs=1.74-2.92). Those who reported changes in their GI (combined Groups 2 [n=41] and 4 [n=51]), versus those who maintained (combined Groups 1 [n=5,304] and 3 [n=106]), had significantly greater odds of reporting ever use of smokeless tobacco (aOR=1.94) and past 30-day use of cigarettes, e-cigarettes, cigars, and smokeless tobacco (aORs=1.66-2.94). No significant findings were observed for marijuana/cannabis use.
Discussion: These exploratory analyses suggest disproportionate nicotine and tobacco use among those who report changes in SO and GI, regardless of their initially reported identities. Caution is warranted when interpreting the results related to the use of smokeless tobacco and nicotine pouches, and GI, due to the small sample size.
Authors:
Presenter - Min-Jeong Yang, PhD, Institute for Nicotine and Tobacco Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
Co-Author - Marisa Tomaino, BA, Institute for Nicotine and Tobacco Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
Co-Author - Ollie Ganz, DrPH, Institute for Nicotine and Tobacco Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
Co-Author - Matthew B. Schabath, PhD, Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
Co-Author - Cristine Delnevo, PhD, MPH, Institute for Nicotine and Tobacco Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
Co-Author - Michelle T. Bover Manderski, PhD, MPH, Institute for Nicotine and Tobacco Studies, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
An examination of African immigrants with obesity: weight, lifestyle factors, and body image following immigration
Poster Number: B159Time: 11:00 AM - 11:50 AM
Topics: Weight Related Health , Diet, Nutrition, and Eating Disorders
African immigrants in the US are highly affected by obesity and obesity-related health conditions possibly due to exposure to the obesinogenic food environment and sedentary lifestyle in the US. Research on African immigrants weight, body image, and lifestyle factors after migration is needed to inform their lifestyle interevntion needs. We conducted a survey of 70 African immigrants with overweight or obesity (mean age 40.69 (SD=10.26), BMI 31.41kg/m2 (SD=3.95), and 67.14% female) who had lived in Africa for at least 18 years before migrating and lived in the US for at least 3 years. About 84.29% reported gaining over 5 pounds since migration, with an average weight gain of 29.68 lbs (SD=28.9) [Median=20; IQR = 15 – 32]. Participants weight percentile adjusted for age and sex post-migration was 11.17 (SD=17.66) points higher than pre-migration [Median=7; IQR=0 to 18] (P<0.0001). The majority of participants (58.57%) reported dietary changes after migration of which the most common were fast food intake and reduction in fruit and vegetable consumption. The most common barrier to healthy diet was feeling that fruit and vegetables in the US do not taste as good as they did in Africa. Just over half of the participants (58.57%) met the national guidelines for physical activity and the most common barrier to physical activity was…. About 87.14% of participants desired leaner body types than they currently have and 75.71% expressed interest in participating in lifestyle interventions designed for African immigrants. Post-migration weight gain is common among African immigrants with overweight or obesity, and their diets appear to become less healthy. Future studies should design lifestyle interventions tailored for this population, considering their unique barriers to healthy diet and physical activity.
Keywords: Diet, Physical activityAuthors:
Author - Richard Bannor, PhD, MPH, University of Connecticut
Co-Author - Sherry Pagoto, PhD, University of Connecticut
Co-Author - Christie Idiong, University of Connecticut
Co-Author - Jared Goetz, University of Connecticut
Co-Author - Jolaade Kalinowski, University of Connecticut
Co-Author - Roman Shrestha, University of Connecticut
Co-Author - Ran Xu, PhD, University of Connecticut
Examining Differences in Meaning in Life and Logistical Stress in Younger and Older Adult Spousal Cancer Caregivers
Poster Number: B16Time: 11:00 AM - 11:50 AM
Topics: Cancer, Stress
Background: The experience of caregiving is often associated with a renewed sense of meaning and purpose. Little is known about the differences in existential beliefs between younger and older cancer caregivers. This study examined the relationships between meaning and psychosocial factors specifically among younger (YACC, ages 18-39) and older (OACC, ages 40-81) spousal cancer caregivers.
Methods: A national online survey recruited 177 spousal cancer caregivers (YACC: n=71, OACC: n=106) who completed measures of meaning in life, anxiety, depression, social support, quality of life, resilience, and logistical caregiving stress (e.g., managing medication schedules, chores). Bivariate correlations were conducted to assess relationships between presence of meaning and search for meaning with psychosocial factors. Independent sample t-tests were used to compare the mean scores of YACC and OACC for all variables.
Results: On average, YACC reported less presence of meaning (t(175)=-2.9, p<.01) and greater search for meaning (t(175)=4.6, p<.001) than OACC. For both groups, greater presence of meaning was positively correlated with social support and resilience. Among OACC, presence of meaning was also associated with higher quality of life (r=.5, p<.001) and lower anxiety (r=-.4, p<.001) and depression (r=-.6, p<.001). Search for meaning was positively associated with anxiety for both groups (OACC: r=.2, p<.05; YACC: r=.3, p<.01), and depression for YACC (r=.3, p<.01). Generally, YACC reported higher anxiety (t(175)=7.3, p<.001) and higher depression (t(175)=8.9, p<.001) than OACC. Both age groups reported similar mean scores for resilience, and emotional and instrumental support. More logistical stress was associated with lower presence of meaning (r=-.1, p<.05) and higher search for meaning (r=.4, p<.001). YACC reported significantly higher stress associated with all nine logistical tasks compared to OACC.
Conclusions: Despite similar levels of social support, younger spousal cancer caregivers experience lower meaning in life and greater distress compared to older counterparts, alongside increased logistical caregiving stress. These differences highlight the importance of tailored interventions and support groups for younger caregivers, focusing on enhancing meaning and implementing stress-reduction strategies.
Keywords: Cancer, CaregivingMethods: A national online survey recruited 177 spousal cancer caregivers (YACC: n=71, OACC: n=106) who completed measures of meaning in life, anxiety, depression, social support, quality of life, resilience, and logistical caregiving stress (e.g., managing medication schedules, chores). Bivariate correlations were conducted to assess relationships between presence of meaning and search for meaning with psychosocial factors. Independent sample t-tests were used to compare the mean scores of YACC and OACC for all variables.
Results: On average, YACC reported less presence of meaning (t(175)=-2.9, p<.01) and greater search for meaning (t(175)=4.6, p<.001) than OACC. For both groups, greater presence of meaning was positively correlated with social support and resilience. Among OACC, presence of meaning was also associated with higher quality of life (r=.5, p<.001) and lower anxiety (r=-.4, p<.001) and depression (r=-.6, p<.001). Search for meaning was positively associated with anxiety for both groups (OACC: r=.2, p<.05; YACC: r=.3, p<.01), and depression for YACC (r=.3, p<.01). Generally, YACC reported higher anxiety (t(175)=7.3, p<.001) and higher depression (t(175)=8.9, p<.001) than OACC. Both age groups reported similar mean scores for resilience, and emotional and instrumental support. More logistical stress was associated with lower presence of meaning (r=-.1, p<.05) and higher search for meaning (r=.4, p<.001). YACC reported significantly higher stress associated with all nine logistical tasks compared to OACC.
Conclusions: Despite similar levels of social support, younger spousal cancer caregivers experience lower meaning in life and greater distress compared to older counterparts, alongside increased logistical caregiving stress. These differences highlight the importance of tailored interventions and support groups for younger caregivers, focusing on enhancing meaning and implementing stress-reduction strategies.
Authors:
Author - Cate Pappano, University of Colorado Denver
Co-Author - Bryan Contreras Zamora, University of Colorado Denver
Co-Author - Tamar Parmet, University of Colorado Denver
Co-Author - Austin Mallard, University of Colorado Denver
Co-Author - David Bradford, BA, University of Colorado Denver
Co-Author - Kristin Kilbourn, PhD MPH, University of Colorado Denver
The Momentary Impact of Glucose on Inhibitory Control Following Roux-en-Y Gastric Bypass
Poster Number: B160Time: 11:00 AM - 11:50 AM
Topics: Weight Related Health , Decision Making
While cognitive function generally improves following metabolic and bariatric surgery (MBS), momentary lapses in executive functioning may partially explain why some patients struggle with adhering to postsurgical recommendations. Poor glucose control has been linked to deficits in executive functioning among individuals with diabetes, including research gained from naturalistic data collection methods such as ecological momentary assessment (EMA) and continuous glucose monitoring (CGM). Despite evidence that momentary glucose dysregulation remains a concern following MBS, its direct relationship with executive functioning has yet to be explored. This study utilized a novel combination of CGM and EMA to determine whether glucose functioning impacted performance on a momentary task of inhibitory control among patients who were one-year post-Roux-en-Y gastric bypass surgery. Forty-four adults (Mean age = 43.52 years, 84.1% female, 95.5% White) wore a CGM and completed six Stop Signal Task (SST) tests per day for 10 days on a computer tablet. Four indices of glucose functioning (mean, variability, % time in hypo- and hyper-glycemia) were calculated from CGM data obtained during the three hours prior to a given SST in EMA. After controlling for the effects of eating and time-of-day, multilevel models revealed that higher average glucose and greater time spent in hyperglycemia (when compared to the participant’s own baseline levels) predicted slower SST reaction time scores (ꞵ=3.8, p=.032 and ꞵ=3.6, p=.034, respectively) at the end of the three-hour window. Effects for glucose variability and time spent in hypoglycemia were not significant (p=.203 and p=.821, respectively). When taken together, these results demonstrate that high levels of glucose, particularly in the hyperglycemic range, lead to moments of poorer inhibitory control. At minimum, findings emphasize the importance of close monitoring and potential intervention of glucose control in the postsurgical period. Further, these results suggest that patients may have difficulty inhibiting impulses for maladaptive behaviors when their glucose levels are very high, highlighting an important area for future research.
Keywords: Weight loss, Cognitive factorsAuthors:
Presenter - Gail Kerver, PhD, Sanford Research, Center for Biobehavioral Research
Co-Author - Scott Engel, PhD, Sanford Research, Center for Biobehavioral Research
Co-Author - Glen Forester, PhD, Sanford Research, Center for Biobehavioral Research
Co-Author - John Gunstad, PhD, Kent State University
Co-Author - David Sarwer, PhD, Temple University
Co-Author - Kristine Steffen, PharmD, PhD, North Dakota State University
Weight self-stigma moderates prospective association between social comparison orientation and weight outcomes in a support-focused behavioral weight loss program
Poster Number: B161Time: 11:00 AM - 11:50 AM
Topics: Weight Related Health
Introduction: In group-based weight loss programs, social comparison can promote healthy competition, but feelings of shame or stigma may undermine potential benefits. In this study, we investigated whether internalized weight stigma moderates the association between social comparison and weight loss outcomes. We hypothesized that the association between baseline social comparison orientation and weight loss would depend on participants’ weight self-stigma. Specifically, we expected that among those with high self-stigma, upward comparison would predict less weight loss and downward comparison would predict greater weight loss.
Methods: Participants (N = 321; Mage = 53.39) with overweight or obesity received 12-months of remotely delivered group-based behavioral weight loss treatment. The first 3 months involved weekly group sessions (~15 participants per group) and prompted regular text messaging between participants. Participants were instructed to self-weigh daily using a digital scale during assessment periods (0, 3, 6, 12 months). At baseline, tendency to compare with others was assessed using the Iowa-Netherlands Comparison Orientation Measure (INCOM) and weight self-stigma was measured via the Weight Self-Stigma Questionnaire (WSSQ). Multiple linear regression examined moderation effects, controlling for BMI.
Results: At 3 months, participants lost an average of 5.28% from baseline (SD = 3.22%). Main effects of upward social comparison orientation (B = -0.003, β = -0.09, t(312) = -1.38, p = .17) and weight self-stigma (B = 0.004, β = 0.12, t(312) = 1.86, p = .07) were not significant. The overall model explained 2% of the variance in 3-month weight loss (R2 = .02). However, the interaction between upward comparison and self-stigma predicted 3-month weight loss (B = -0.003, β = -0.13, t(312) = -2.10, p = .04). Among participants with high weight self-stigma, greater upward comparison was associated with less weight loss (B = -0.003, β = -0.18, t(312) = -2.10, p = .04). No significant effects were found at 6 or 12 months, nor for downward or general comparison.
Conclusions: During periods of frequent group contact, weight self-stigma may hinder weight loss among individuals with a tendency toward upward social comparison. This finding highlights the importance of addressing stigma and attending to social comparisons in group-based weight loss interventions.
Keywords: Weight loss, Social supportMethods: Participants (N = 321; Mage = 53.39) with overweight or obesity received 12-months of remotely delivered group-based behavioral weight loss treatment. The first 3 months involved weekly group sessions (~15 participants per group) and prompted regular text messaging between participants. Participants were instructed to self-weigh daily using a digital scale during assessment periods (0, 3, 6, 12 months). At baseline, tendency to compare with others was assessed using the Iowa-Netherlands Comparison Orientation Measure (INCOM) and weight self-stigma was measured via the Weight Self-Stigma Questionnaire (WSSQ). Multiple linear regression examined moderation effects, controlling for BMI.
Results: At 3 months, participants lost an average of 5.28% from baseline (SD = 3.22%). Main effects of upward social comparison orientation (B = -0.003, β = -0.09, t(312) = -1.38, p = .17) and weight self-stigma (B = 0.004, β = 0.12, t(312) = 1.86, p = .07) were not significant. The overall model explained 2% of the variance in 3-month weight loss (R2 = .02). However, the interaction between upward comparison and self-stigma predicted 3-month weight loss (B = -0.003, β = -0.13, t(312) = -2.10, p = .04). Among participants with high weight self-stigma, greater upward comparison was associated with less weight loss (B = -0.003, β = -0.18, t(312) = -2.10, p = .04). No significant effects were found at 6 or 12 months, nor for downward or general comparison.
Conclusions: During periods of frequent group contact, weight self-stigma may hinder weight loss among individuals with a tendency toward upward social comparison. This finding highlights the importance of addressing stigma and attending to social comparisons in group-based weight loss interventions.
Authors:
Author - Nicole Miller, BA, Drexel University
Co-Author - Charlotte Hagerman, PhD, Drexel University; Oregan Research Institute
Co-Author - Danielle Arigo, PhD, LP, FSBM, Rowan University
Co-Author - Gabrielle Salvatore, PhD, Rowan University
Co-Author - Meghan Butryn, PhD, Drexel University
Predictors of Body Image Concerns and Psychosocial Health in Adolescents
Poster Number: B162Time: 11:00 AM - 11:50 AM
Topics: Weight Related Health , Mental Health
BACKGROUND: It is important to identify avenues that may be efficacious in mitigating body image concerns among adolescents with obesity to reduce psychosocial distress and engagement in unhealthy weight control behaviors. Thus, the purpose of this study was to determine whether bully victimization, objective weight status, parental concern about weight, and doctor concern about weight predicts adolescent concern about weight.
METHODS: We conducted a cross-sectional study of children and adolescents from the combined 2022-2023 National Survey of Children’s Health. For our primary analysis, adjusted multinomial logistic regression models examined associations between adolescent concern about body image and weight status, bully victimization, parental concern for weight, and doctor addressed weight. Secondarily, we examined associations between adolescent’s concern for their body image and psychosocial outcomes.
RESULTS: A total of 41,470 adolescents aged 10-17 years (13.8 ± 2.3 years; 51.2% male) were included in our analyses. Adolescents who were victims of bullying were 2.09 times more likely [95% CI (1.99, 2.09)] and 2.78 times more likely [95% CI (2.51, 3.08)] to be somewhat and very concerned about their body image, respectively. Adolescents whose parents reported concern for their high body weight were 7.62 [95% CI (7.03, 8.26)] and 18.25 [95% CI (16.22, 20.53)] times more likely to be somewhat and very concerned about their body image, respectively. Adolescents whose doctors reported concern about their high weight were 6.08 [95% CI (5.63, 6.58)] and 13.74 [95% CI (12.25, 15.40)] times more likely to be somewhat and very concerned about their body image, respectively. Lastly, adolescent concern for body image was associated with greater psychosocial distress.
CONCLUSION: Adolescent concern for body image is associated with engagement in unhealthy weight control behaviors (previous findings) and greater psychosocial distress. Our findings suggest that bullying and concerns about weight addressed by both parents and physicians predict greater body image concern. Thus, addressing how parents and physicians address weight concerns and bully mitigation may reduce adolescent body image concerns and concomitant psychosocial and health behavior concerns.
Keywords: Obesity, Mental healthMETHODS: We conducted a cross-sectional study of children and adolescents from the combined 2022-2023 National Survey of Children’s Health. For our primary analysis, adjusted multinomial logistic regression models examined associations between adolescent concern about body image and weight status, bully victimization, parental concern for weight, and doctor addressed weight. Secondarily, we examined associations between adolescent’s concern for their body image and psychosocial outcomes.
RESULTS: A total of 41,470 adolescents aged 10-17 years (13.8 ± 2.3 years; 51.2% male) were included in our analyses. Adolescents who were victims of bullying were 2.09 times more likely [95% CI (1.99, 2.09)] and 2.78 times more likely [95% CI (2.51, 3.08)] to be somewhat and very concerned about their body image, respectively. Adolescents whose parents reported concern for their high body weight were 7.62 [95% CI (7.03, 8.26)] and 18.25 [95% CI (16.22, 20.53)] times more likely to be somewhat and very concerned about their body image, respectively. Adolescents whose doctors reported concern about their high weight were 6.08 [95% CI (5.63, 6.58)] and 13.74 [95% CI (12.25, 15.40)] times more likely to be somewhat and very concerned about their body image, respectively. Lastly, adolescent concern for body image was associated with greater psychosocial distress.
CONCLUSION: Adolescent concern for body image is associated with engagement in unhealthy weight control behaviors (previous findings) and greater psychosocial distress. Our findings suggest that bullying and concerns about weight addressed by both parents and physicians predict greater body image concern. Thus, addressing how parents and physicians address weight concerns and bully mitigation may reduce adolescent body image concerns and concomitant psychosocial and health behavior concerns.
Authors:
Author - Kristie Rupp, Southern Connecticut State University
Co-Author - Stephanie McCoy, PhD, MPH, University of Southern Mississippi
Sedentary Behavior and Youth Obesity: An Intersectional Analysis of Moderation by Social Determinants and Active Living Environments
Poster Number: B163Time: 11:00 AM - 11:50 AM
Topics: Weight Related Health , Health Disparities
Introduction: Youth sedentary time has been linked to higher obesity risk, and this association may vary by social determinants of health (SDOH) related to individual-level factors (e.g., education) and active living environments (e.g., neighborhood safety). This study evaluated whether the association between meeting screen-time recommendations and overweight/obesity (OWOB) prevalence varies across intersectional SDOH.
Methods: We analyzed 2022–2023 National Survey of Children’s Health (NSCH) data (ages 6–17). The outcome was OWOB (yes/no) from BMI-for-age. The exposure was SB adherence (yes/no) based on the ≤2h/day recommendation for recreational screen time. We used an intersectionality approach to capture different combinations (i.e., strata) of SDOH. Strata were defined by cross-classifying caregiver-reported sex (boy/girl), race/ethnicity (non-Hispanic [NH] White, NH Black, NH Asian, Hispanic, Other), household education (college degree, <college), neighborhood safety (safe/unsafe), sidewalks/walking paths (yes/no), and park/playground availability (yes/no), for 159 total intersectional SDOH strata. We fit logistic multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) models to estimate stratum-specific predicted probabilities of OWOB by SB adherence and assess effect modification across intersectional SDOH.
Results: Among 62,895 children and adolescents (48% female), the predicted prevalence of OWOB was 30.7% (SB=No) and 27.2% (SB=Yes), and overall risk difference between SB groups was -3.5 percentages. SB was uniformly protective across all SDOH strata (risk differences median= -3.80, range= -5.04 to -2.38). The risk ranks for OWOB prevalence across strata were highly stable between levels of SB (91.2% of strata shifted by ≤2 ranks), indicating minimal effect modification. The lowest predicted OWOB prevalence was for NH Asian girls in more-educated families and safe neighborhoods with sidewalks and parks (SB No=17.0%, SB Yes=14.6%). The highest was for NH boys in less-educated families and unsafe neighborhoods without sidewalks and parks (SB No=58.3%, SB Yes=54.1%).
Conclusions: SB adherence was consistently protective across intersectional SDOH groups and thus appears to benefit all youth. Given that OWOB prevalence varied more across SDOH than by SB adherence, there is a need for more interventions focused on youth who experience SDOH.
Keywords: Health disparities, ObesityMethods: We analyzed 2022–2023 National Survey of Children’s Health (NSCH) data (ages 6–17). The outcome was OWOB (yes/no) from BMI-for-age. The exposure was SB adherence (yes/no) based on the ≤2h/day recommendation for recreational screen time. We used an intersectionality approach to capture different combinations (i.e., strata) of SDOH. Strata were defined by cross-classifying caregiver-reported sex (boy/girl), race/ethnicity (non-Hispanic [NH] White, NH Black, NH Asian, Hispanic, Other), household education (college degree, <college), neighborhood safety (safe/unsafe), sidewalks/walking paths (yes/no), and park/playground availability (yes/no), for 159 total intersectional SDOH strata. We fit logistic multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) models to estimate stratum-specific predicted probabilities of OWOB by SB adherence and assess effect modification across intersectional SDOH.
Results: Among 62,895 children and adolescents (48% female), the predicted prevalence of OWOB was 30.7% (SB=No) and 27.2% (SB=Yes), and overall risk difference between SB groups was -3.5 percentages. SB was uniformly protective across all SDOH strata (risk differences median= -3.80, range= -5.04 to -2.38). The risk ranks for OWOB prevalence across strata were highly stable between levels of SB (91.2% of strata shifted by ≤2 ranks), indicating minimal effect modification. The lowest predicted OWOB prevalence was for NH Asian girls in more-educated families and safe neighborhoods with sidewalks and parks (SB No=17.0%, SB Yes=14.6%). The highest was for NH boys in less-educated families and unsafe neighborhoods without sidewalks and parks (SB No=58.3%, SB Yes=54.1%).
Conclusions: SB adherence was consistently protective across intersectional SDOH groups and thus appears to benefit all youth. Given that OWOB prevalence varied more across SDOH than by SB adherence, there is a need for more interventions focused on youth who experience SDOH.
Authors:
Presenter - Suryeon Ryu, Children's Mercy Kansas City
Co-Author - Jordan Carlson, Children's Mercy Kansas City
Intervention Training Competency and Satisfaction Contrasting Hospital and Community Nurse Outcomes: Preparation Phase of EPIS
Poster Number: B164Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Implementation Science
Background: In sub-Saharan Africa, maternal and neonatal mortality remain public health priorities. Medical Information Service via Telephone (MIST), an evidence-based 24/7 provider-to-provider support system from the United States, was adapted for mobile phones (mMIST) for testing in Cameroon. Training outcomes are critical to implementation success, yet few studies contrast experiences between hospital-based and community-based nurse trainees to inform future scientific endeavors.
Objective: To evaluate training satisfaction, competency perceptions, and differences between hospital and community-based nurses in a pilot phase prior to the full-scale implementation of the mMIST intervention in northwest Cameroon.
Study Design: In the multi-methods pilot (03/2022–02/2023), we trained 106 providers: 14 expert physicians, 16 hospital-based nurse responders, and 76 community-based providers, typically nurses, midwives, and lay providers. Training included evidence-based checklists, live simulation, and a train-the-trainer model. Satisfaction and perceived competency were assessed using an 8-item post-training survey (Likert scale and open response). Comparative analyses examined outcomes between hospital and community-based nurses.
Results: Overall training satisfaction was high, with ~87% of trainees reporting satisfaction, and about 98% reporting mMIST training improved clinical care delivery. Notably, hospital-based nurses reported greater confidence in using World Health Organization (WHO)-aligned checklists compared to community-based nurses. Differences emerged in post-training assessment of perceptions of ease of system use (61% community vs. 93% hospital), confidence in ability to use the system (78% community vs. 93% hospital), and sufficient equipment needed to use the system (31% community vs. 87% hospital). Community-based nurses highlighted challenges with intermittent network connectivity and limited in-person mentorship post-training.
Conclusion: While training for mMIST was acceptable and feasible across provider levels, differential perceptions between hospital and community-based nurses highlight implementation concerns obscured when evaluating data in aggregate. Addressing post-training support and structural limitations for community-based nurses can strengthen uptake and improve ongoing fidelity and sustainment. Findings highlight the importance of tailoring training for health workforce development to enhance care delivery.
Keywords: Pregnancy, TrainingObjective: To evaluate training satisfaction, competency perceptions, and differences between hospital and community-based nurses in a pilot phase prior to the full-scale implementation of the mMIST intervention in northwest Cameroon.
Study Design: In the multi-methods pilot (03/2022–02/2023), we trained 106 providers: 14 expert physicians, 16 hospital-based nurse responders, and 76 community-based providers, typically nurses, midwives, and lay providers. Training included evidence-based checklists, live simulation, and a train-the-trainer model. Satisfaction and perceived competency were assessed using an 8-item post-training survey (Likert scale and open response). Comparative analyses examined outcomes between hospital and community-based nurses.
Results: Overall training satisfaction was high, with ~87% of trainees reporting satisfaction, and about 98% reporting mMIST training improved clinical care delivery. Notably, hospital-based nurses reported greater confidence in using World Health Organization (WHO)-aligned checklists compared to community-based nurses. Differences emerged in post-training assessment of perceptions of ease of system use (61% community vs. 93% hospital), confidence in ability to use the system (78% community vs. 93% hospital), and sufficient equipment needed to use the system (31% community vs. 87% hospital). Community-based nurses highlighted challenges with intermittent network connectivity and limited in-person mentorship post-training.
Conclusion: While training for mMIST was acceptable and feasible across provider levels, differential perceptions between hospital and community-based nurses highlight implementation concerns obscured when evaluating data in aggregate. Addressing post-training support and structural limitations for community-based nurses can strengthen uptake and improve ongoing fidelity and sustainment. Findings highlight the importance of tailoring training for health workforce development to enhance care delivery.
Authors:
Author - Henna Budhwani, PhD, MPH, FSBM, Florida State University College of Nursing
Co-Author - Lily B Cooper, MPH, Florida State University College of Nursing
Co-Author - Gregory Halle-Ekane, MD, University of Buea Department of Obstetrics and Gynecology
Co-Author - Eric Wallace, MD, University of Alabama at Birmingham Heersink School of Medicine
Co-Author - Victoria R Jauk, MPH, MSN, University of Alabama at Birmingham Heersink School of Medicine
Co-Author - Jeff M Szychowski, PhD, University of Alabama at Birmingham School of Public Health
Co-Author - Waldemar A Carlo, MD, University of Alabama at Birmingham Heersink School of Medicine
Co-Author - Mary Glory Ngong, Cameroon Baptist Convention Health Services
Co-Author - Rahel Mbah Kyeng, MPH, Cameroon Baptist Convention Health Services
Co-Author - Hanne Harbison, MHSPH, MSN, WHNP-BC, Florida State University College of Nursing
Co-Author - Pius M Tih, PhD, MPH, Cameroon Baptist Convention Health Services
Co-Author - Alan TN Tita, MD, PhD, University of Alabama at Birmingham Heersink School of Medicine
Co-Author - Comfort Enah, PhD, University of Massachusetts Lowell School of Nursing
Overestimating Emotions for Reproductive Outcomes: Testing the Impact Bias in Patients having In-Vitro Fertilization
Poster Number: B165Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Decision Making
According to affective forecasting theory, when people consider possible outcomes of the future, they tend to overestimate the intensity and duration of their emotions (Wilson & Gilbert, 2003). Researchers have argued this impact bias likely exists for medical decisions, but there have been few direct tests. In this study, we examined if fertility patients had an impact bias for outcomes of In-Vitro Fertilization (IVF) treatment. Specifically, we tested if patients overestimated their emotions (happy, sad) and quality of life (QoL) for successful or unsuccessful outcomes of the procedure. METHODS: Fertility patients (N = 50; M age = 32.3; 94% White) from a single private fertility clinic in the Midwest, who were planning their first IVF treatment, were invited to participate in a longitudinal survey study in which they were assessed before and after having IVF. Prior to having treatment, patients completed a survey in which they were asked to anticipate their future emotions and QoL if a) IVF treatment succeeded and they got pregnant, and b) if IVF treatment failed and they did not get pregnant. The order of the questions was counterbalanced. Approximately 4 months later, patients had completed IVF and learned the outcome. Within 7-10 days of this appointment, patients completed a second survey in which they reported their present emotions and QoL. RESULTS: Findings revealed an impact bias such that patients overestimated their emotions and QoL for either outcome. For example, relative to their present emotions, pregnant women had overestimated their happiness, t(27) = 3.58, p = .001, dz = .69, and positive QoL, t(27) = 5.84, p < .001, dz = 1.12; Non-pregnant women overestimated their sadness, t(21) = 4.91, p < .001, dz = 1.07 (but QoL was not significantly different). Findings additionally showed that patients who had experienced IVF success were sadder than they anticipated while those who had experienced IVF failure were happier than they anticipated. CONCLUSIONS: These findings are the first to demonstrate an impact bias for IVF treatment outcomes, and they offer insight into this complex, highly emotional medical decision. By increasing awareness of these emotional errors, physicians can encourage patients to have more realistic expectations for IVF and its outcomes, and this may ultimately enhance informed decision making about the treatment. Future studies should replicate these findings with a larger sample of fertility patients.
Keywords: Emotions, Women's healthAuthors:
Presenter - Amanda Dillard, Phd, Grand Valley State University
Co-Author - Michael Wolfe, Phd, Grand Valley State University
Co-Author - Todd Williams, Phd, Grand Valley State University
Co-Author - Mili Thakur, MD, Fertility Center
Mapping the Landscape of Maternal Health Innovations in the United States: A Systematic Scoping Review of Implementation Approaches, Equity Integration, and Scaling Factors.
Poster Number: B166Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Child and Family Health
Background: The United States faces a persistent maternal health crisis with high mortality rates and significant racial disparities. Diverse innovations spanning digital health, community-based care, quality improvement, and social determinants interventions have emerged, but comprehensive synthesis of their implementation characteristics remains limited.
Objective: To systematically identify and analyze maternal health innovations implemented across the United States between 2021-2025, examining their design, implementation approaches, equity considerations, and scalability using the RE-AIM framework.
Methods: We conducted a scoping review following Arksey and O'Malley's framework. Comprehensive searches were performed across PubMed, CINAHL, PsycINFO, and grey literature sources between May-July 2025. Eligible studies included maternal health innovations targeting pregnant, birthing, or postpartum individuals. Three reviewers independently screened studies and extracted data on innovation characteristics, implementation factors, outcomes, and equity considerations. Quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis employed the RE-AIM framework.
Results: Fifteen studies met inclusion criteria, encompassing six innovation categories: Digital Health/Telehealth (27%), Clinical Quality Improvement (13%), Community Workforce Development (13%), Social Determinants interventions (13%), Policy/Payment Reform (20%), and Communication/Mental Health Access (13%). Geographic distribution included national (20%), multi-state (27%), and state-specific (53%) implementations. All innovations incorporated explicit equity considerations, predominantly targeting Medicaid recipients, racial/ethnic minorities, and safety-net populations. Seven innovations (47%) achieved scaled implementation beyond pilot stages. Technology-enabled interventions demonstrated high implementation fidelity, while sustainability was strongest for policy institutionalization and cost-effective health system models.
Conclusions: This review reveals a diverse landscape of maternal health innovations with exceptional equity integration. RE-AIM analysis identified critical scaling factors including organizational infrastructure, policy support, sustainable funding, and demonstrated effectiveness. Findings suggest meaningful progress in innovative service delivery while highlighting the importance of implementation science frameworks for optimizing scale-up and sustainability.
Keywords: Pregnancy, Women's healthObjective: To systematically identify and analyze maternal health innovations implemented across the United States between 2021-2025, examining their design, implementation approaches, equity considerations, and scalability using the RE-AIM framework.
Methods: We conducted a scoping review following Arksey and O'Malley's framework. Comprehensive searches were performed across PubMed, CINAHL, PsycINFO, and grey literature sources between May-July 2025. Eligible studies included maternal health innovations targeting pregnant, birthing, or postpartum individuals. Three reviewers independently screened studies and extracted data on innovation characteristics, implementation factors, outcomes, and equity considerations. Quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis employed the RE-AIM framework.
Results: Fifteen studies met inclusion criteria, encompassing six innovation categories: Digital Health/Telehealth (27%), Clinical Quality Improvement (13%), Community Workforce Development (13%), Social Determinants interventions (13%), Policy/Payment Reform (20%), and Communication/Mental Health Access (13%). Geographic distribution included national (20%), multi-state (27%), and state-specific (53%) implementations. All innovations incorporated explicit equity considerations, predominantly targeting Medicaid recipients, racial/ethnic minorities, and safety-net populations. Seven innovations (47%) achieved scaled implementation beyond pilot stages. Technology-enabled interventions demonstrated high implementation fidelity, while sustainability was strongest for policy institutionalization and cost-effective health system models.
Conclusions: This review reveals a diverse landscape of maternal health innovations with exceptional equity integration. RE-AIM analysis identified critical scaling factors including organizational infrastructure, policy support, sustainable funding, and demonstrated effectiveness. Findings suggest meaningful progress in innovative service delivery while highlighting the importance of implementation science frameworks for optimizing scale-up and sustainability.
Authors:
Author - Grace Kyei, BSN RN, University of Massachusetts Boston
Co-Author - Esther Nana Kwaning, MSN BSN RN, University of Massachusetts Boston
Co-Author - Evans Kyei, PhD MSc. RN, The University of Alabama
Social Comparison Target Selections as Health Information Preferences among Women in Midlife with Elevated Risk for Cardiovascular Disease
Poster Number: B167Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Digital Health
Background: Insufficient physical activity (PA) has numerous negative health consequences, particularly among women in midlife (ages 40-65) with risk factors for cardiovascular disease. Health information preferences and processing styles vary between individuals and influence PA, but whether and how these vary for the same person across contexts is unknown. Specifically, contextual factors predicting social comparison (i.e., self-evaluation relative to others to obtain self-relevant information) are not well understood, and may uniquely explain the link between PA-related social comparison and daily variation in PA.
Methods: We examined once-daily social comparison target selections as indicators of health information preferences and assessed potential predictors of selections and responses. Using a web app designed to increase PA for women in midlife with elevated CVD risk, participants (N=88; MAge=51.6; MBMI=31.9; 66.7% White) selected and viewed a peer profile each morning for 7 days. They self-reported their responses to these target profiles on the web app and wore PA monitors to capture their behavior.
Results: Two-level multilevel models showed considerable daily variability in women’s social comparison target selections, as well as in their responses and PA behavior (ICCs<0.63). On days women reported higher satisfaction with their steps from the previous day than was typical for them, they were less likely to select a downward target (i.e., a peer who engaged in less PA than they did; ORs<0.78; 95% CI 0.637, 0.954) and were more likely to select no preference for type of peer profile (ORs>1.25; 95% CI 1.052, 1.488; ps<0.03). Daily PA satisfaction did not predict affective response (immediately after viewing the comparison target; srs<0.01, ps>0.80).
Conclusions: Findings indicate meaningful daily fluctuations in social comparison target selection among women in midlife with elevated risk for cardiovascular disease. Contextual factors predicted these variations, underscoring the dynamic nature of health information preferences. As such, real-time assessment of information preferences is critical and is likely to have direct implications for digital health interventions. Tailoring content to momentary experiences may enhance personalization and intervention effectiveness. Future work should refine dynamic measures and examine how these changing preferences are linked to PA behavior.
Keywords: Physical activity, information seekingMethods: We examined once-daily social comparison target selections as indicators of health information preferences and assessed potential predictors of selections and responses. Using a web app designed to increase PA for women in midlife with elevated CVD risk, participants (N=88; MAge=51.6; MBMI=31.9; 66.7% White) selected and viewed a peer profile each morning for 7 days. They self-reported their responses to these target profiles on the web app and wore PA monitors to capture their behavior.
Results: Two-level multilevel models showed considerable daily variability in women’s social comparison target selections, as well as in their responses and PA behavior (ICCs<0.63). On days women reported higher satisfaction with their steps from the previous day than was typical for them, they were less likely to select a downward target (i.e., a peer who engaged in less PA than they did; ORs<0.78; 95% CI 0.637, 0.954) and were more likely to select no preference for type of peer profile (ORs>1.25; 95% CI 1.052, 1.488; ps<0.03). Daily PA satisfaction did not predict affective response (immediately after viewing the comparison target; srs<0.01, ps>0.80).
Conclusions: Findings indicate meaningful daily fluctuations in social comparison target selection among women in midlife with elevated risk for cardiovascular disease. Contextual factors predicted these variations, underscoring the dynamic nature of health information preferences. As such, real-time assessment of information preferences is critical and is likely to have direct implications for digital health interventions. Tailoring content to momentary experiences may enhance personalization and intervention effectiveness. Future work should refine dynamic measures and examine how these changing preferences are linked to PA behavior.
Authors:
Author - Emmanuel Lapitan, MA, Rowan University
Co-Author - Andrea F Lobo, PhD, Rowan University
Co-Author - Danielle Arigo, PhD, LP, FSBM, Rowan University
The Impact of Sleep Quality on High Blood Pressure Among Pregnant Women: A Systematic Review
Poster Number: B168Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Sleep
Introduction: Pregnancy is a vulnerable time marked by many physical and emotional challenges. During pregnancy, women face added stressors and may deal with mental and emotional hardships. Pregnant women also experience worsened health outcomes and may develop conditions during pregnancy that affect long-term health outcomes for both the mother and child. Cardiovascular disease (CVD) is the leading cause of death globally and is estimated to account for over 17 million deaths annually. During pregnancy, many women develop high blood pressure which often leads to cardiovascular disease later in life. These complications of pregnancy are important and should be prioritized as a point of public health importance. Sleep habits and increased blood pressure are highly correlated however, few studies have explored pregnant women as the population of interest in relation to sleep and the intersection with high blood pressure. Additionally, much of the existing literature has examined the relationship cardiovascular disease and obstructive sleep apnea but have not examined other sleep habits. The purpose of this systematic review is to examine the impact of sleep habits on blood pressure among pregnant women.
Methods: To examine this relationship, a systematic review was conducted with literature from January 2014 to May 2024. Initially, 404 articles were screened, twelve studies were left to be reviewed and used for data analysis to compare findings. Studies were reviewed by 2 reviewers and excluded if participants were not adults, having multiple birth pregnancies, if studies did not look at both sleep and CVD.
Results: Across the twelve studies, results showed similar findings; specifically, that poor sleep increases the risk of hypertension among pregnant women. Future studies might consider exploring other aspects of cardiovascular health as well as use consistent measures across studies in order to draw larger and more complex comparisons across studies or explore this topic as a meta-analysis.
Conclusions: The findings of this research can help guide future interventions or programs tailored to educate pregnant women on the importance of working with this population to improve their heart health and sleep quality. Future studies might consider exploring other aspects of cardiovascular health as well as use consistent measures across studies in order to draw larger and more complex comparisons across studies or explore this topic as a meta-analysis.
Keywords: Pregnancy, Women's healthMethods: To examine this relationship, a systematic review was conducted with literature from January 2014 to May 2024. Initially, 404 articles were screened, twelve studies were left to be reviewed and used for data analysis to compare findings. Studies were reviewed by 2 reviewers and excluded if participants were not adults, having multiple birth pregnancies, if studies did not look at both sleep and CVD.
Results: Across the twelve studies, results showed similar findings; specifically, that poor sleep increases the risk of hypertension among pregnant women. Future studies might consider exploring other aspects of cardiovascular health as well as use consistent measures across studies in order to draw larger and more complex comparisons across studies or explore this topic as a meta-analysis.
Conclusions: The findings of this research can help guide future interventions or programs tailored to educate pregnant women on the importance of working with this population to improve their heart health and sleep quality. Future studies might consider exploring other aspects of cardiovascular health as well as use consistent measures across studies in order to draw larger and more complex comparisons across studies or explore this topic as a meta-analysis.
Authors:
Co-Author - Elena Lynn, University of Delaware
Co-Author - Yendelela Cuffee, PhD, MPH, University of Delaware
"My body is working so hard to keep my baby alive, I thank it, and I love it": A Qualitative Investigation of a Brief Mindful Self-Compassion Intervention during Pregnancy
Poster Number: B169Time: 11:00 AM - 11:50 AM
Topics: Women's Health, Integrative Health and Spirituality
Introduction: The perinatal period is a critical time for body image, self-compassion (SC), and internalized weight bias. Improving the delivery of interventions aimed at addressing these constructs during pregnancy could improve emotional and physical health for expectant people.
Methods: Participants (n=60; age=28.68 ± 4.78 years; black/African American=32;53.3%) completed a 1-week intervention, which consisted of one of the following meditations once per day: 1) compassionate body scan (days 1-2), 2) affectionate breathing (days 3-4), and 3) loving-kindness meditation (days 5-7). To inform the development of future interventions, qualitative data was gathered via open-ended survey methods that examined women’s experiences of the brief SC meditation intervention, including its impact on body image, emotional health, and accessibility. Two independent coders performed thematic analysis to identify key themes related to the intervention’s effects and barriers to participation.
Results: Seven themes emerged: 1) Enhancement of SC and Emotional Wellbeing, 2) Shifts in Body Image and Acceptance, 3) Heightened Mind-Body Connection, 4) Positive Impact on Pregnancy and Postpartum Experience, 5) Hindrances/Barriers to Practicing SC Meditation, 6) Need for Broader Accessibility and Specific Content, and 7) Enhanced Community.
Conclusions: Participants noted enhanced psychological growth and reduced feelings of anxiety during the brief meditation intervention. They experienced heightened awareness of bodily sensations and physical changes and noted improved acceptance of their changing body. Participants endorsed mindful SC as a useful tool during pregnancy, for labor, and during postpartum recovery. Many expressed a desire for more pregnancy-specific meditations and broader accessibility of materials. Several participants hoped to continue using the meditations and believed in their potential to foster community and societal benefits. Barriers included time constraints, fatigue, distractions, lack of reminders, and feelings of overwhelm. Future research should focus on developing tailored meditations for pregnancy and addressing barriers to improve intervention delivery and broaden dissemination efforts. Overall, SC meditation was favorably viewed, and participants noted many benefits to this brief intervention.
Keywords: Women's health, MeditationMethods: Participants (n=60; age=28.68 ± 4.78 years; black/African American=32;53.3%) completed a 1-week intervention, which consisted of one of the following meditations once per day: 1) compassionate body scan (days 1-2), 2) affectionate breathing (days 3-4), and 3) loving-kindness meditation (days 5-7). To inform the development of future interventions, qualitative data was gathered via open-ended survey methods that examined women’s experiences of the brief SC meditation intervention, including its impact on body image, emotional health, and accessibility. Two independent coders performed thematic analysis to identify key themes related to the intervention’s effects and barriers to participation.
Results: Seven themes emerged: 1) Enhancement of SC and Emotional Wellbeing, 2) Shifts in Body Image and Acceptance, 3) Heightened Mind-Body Connection, 4) Positive Impact on Pregnancy and Postpartum Experience, 5) Hindrances/Barriers to Practicing SC Meditation, 6) Need for Broader Accessibility and Specific Content, and 7) Enhanced Community.
Conclusions: Participants noted enhanced psychological growth and reduced feelings of anxiety during the brief meditation intervention. They experienced heightened awareness of bodily sensations and physical changes and noted improved acceptance of their changing body. Participants endorsed mindful SC as a useful tool during pregnancy, for labor, and during postpartum recovery. Many expressed a desire for more pregnancy-specific meditations and broader accessibility of materials. Several participants hoped to continue using the meditations and believed in their potential to foster community and societal benefits. Barriers included time constraints, fatigue, distractions, lack of reminders, and feelings of overwhelm. Future research should focus on developing tailored meditations for pregnancy and addressing barriers to improve intervention delivery and broaden dissemination efforts. Overall, SC meditation was favorably viewed, and participants noted many benefits to this brief intervention.
Authors:
Presenter - Natalie Papini, PhD, Northern Arizona University
Co-Author - Nikole Squires, MS, CHES, ATC, Northern Arizona University
Co-Author - Lea Cambranes, MsC, Northern Arizona University
Co-Author - Rachel Negovan, Northern Arizona University
Co-Author - Aleeyah Sutton, BS, Northern Arizona University
Co-Author - Julia Gardner, MPH, Northern Arizona University
Co-Author - Rizwana Biviji, PhD, MS, Arizona State University
Co-Author - Nanette Lopez, PhD, RDN, Northern Arizona University
A case-control study of physical activity and postoperative delirium in surgical oncology
Poster Number: B17Time: 11:00 AM - 11:50 AM
Topics: Cancer, Physical Activity
More than 20% of cancer survivors experience postoperative delirium (POD) following tumor resection. POD is associated with increased risk of cognitive and functional decline and shortened survival. Cognitive and functional fortification from preoperative physical activity (PA) may help reduce POD risk among cancer survivors. We conducted a case-control study to compare preoperative PA and sitting time (ST) based POD status among cancer survivors who underwent tumor resection at Moffitt Cancer Center (MCC). POD cases [identified based on positive Confusion Assessment Method (CAM) tests] and controls (negative CAM tests) were identified using MCC operative reports from a 7-month period spanning 2024-2025. Controls were frequency-matched to cases in a 2:1 ratio based on procedure type, sex, and age (± 5 years). PA (days in a typical week engaging in ≥10 minutes of walking, moderate PA, and vigorous PA) and ST (typical hours per weekday) were self-reported in an electronic questionnaire at initial MCC presentation. Additional self- or clinician-reported demographic, behavioral, and clinical data were collected via retrospective chart review. Differences in PA and ST between POD cases and controls were evaluated using ANCOVA and multivariable logistic regression. The final study sample included 48 POD cases (age 64.4 ± 11.5, 47.9% female) and 96 controls (age 65.0 ± 11.4, 44.8% female). The most common procedure types were gastrointestinal and genitourinary tumor resection (29.2% and 18.8%, respectively). There were no statistically significant differences in demographic, clinical, or behavioral characteristics between groups (all p > 0.05). Marriage or living with a partner was associated with higher PA and lower ST (p < 0.01) and, though not statistically significant, was more frequent among cases than controls (75.0% vs. 60.4%, p = 0.07). Adjusting for marital status, cases reported less walking, moderate PA, vigorous PA, and total PA and more ST than controls, but mean differences were not significant (all p > 0.05). Cases had significantly lower odds of engaging in any PA ≥ 7 times per week than controls (aOR = 0.47, 95% CI 0.23-0.97). Conversely, cases had significantly higher odds of sitting ≥ 8 hours per day than controls (aOR = 2.35, 95% CI 1.13-4.89). Increasing PA and reducing ST may be important targets for behavioral interventions to reduce POD risk among cancer survivors undergoing tumor resection.
Keywords: Cancer, Physical activityAuthors:
Presenter - Ashlyn Brushwood, BS, Nova Southeastern University Dr. Kiran C Patel College of Allopathic Medicine
Co-Author - Jeffrey Huang, MD, Moffitt Cancer Center
Co-Author - Nathan Parker, PhD MPH, Moffitt Cancer Center
A User-Centered Design Approach to Optimize Medical Regimen Self-Management by Patients and Family Caregivers After Hematopoietic Cell Transplantation (HCT)
Poster Number: B18Time: 11:00 AM - 11:50 AM
Topics: Cancer, Implementation Science
Background
Allogeneic HCT is a life-altering treatment for patients with hematologic disease. Recipients must have family caregivers to assist them with care post-hospital discharge. Given data showing that nonadherence is common, evidence-based interventions are urgently needed to help patients and their family caregivers manage the challenges of the post-HCT medical regimen together. We created a novel 4-session dyadic problem-solving therapy (DPST), involving both the patient and family caregiver and targeting adherence to the multicomponent medical regimen, all delivered via video conference. To optimize DPST and increase its feasibility, acceptability, efficacy, and eventual dissemination, we implemented a user-centered design approach in intervention development and testing.
Method
We initially adapted our DPST from traditional PST for application to dyads and medical adherence. It then went through 3 stages of iterative, user-centered processes. Stage 1 consisted of focus group input from patients, family caregivers, and HCT health care professionals. Participants gave feedback on DPST content and procedures. Stage 2 consisted of piloting the refined DPST intervention with dyads and seeking feedback on content and procedures. In Stage 3, we are evaluating the resulting 4-session DPST intervention in a single-site randomized controlled trial for acceptability, feasibility, and potential efficacy. Primary outcomes are adherence to the medical regimen and patient and caregiver perceived task self-efficacy.
Results
For Stage 1 focus groups, we conducted 3 patient groups (n=12), 3 family caregiver groups (n=12), and 3 health care professional groups (n=14). All types of groups supported the dyadic approach and focus on adherence, and suggested procedural changes (e.g., flexible session timing and scheduling). Stage 2 (n=3 dyads) incorporated recommended changes, and dyads received the modified intervention and suggested further changes (e.g., simplified content wording; a streamlined approach for easier adoption). Stage 3 is underway, with comparison of the finalized DPST intervention to an attention-control study arm.
Conclusion
User-centered design strategies generated novel feedback, leading to important intervention revisions. An iterative approach to intervention development allowed for direct involvement of stakeholders at sequential stages of work, yielding the potential for greater acceptability and potential utility of the intervention.
Keywords: Cancer, InterventionAllogeneic HCT is a life-altering treatment for patients with hematologic disease. Recipients must have family caregivers to assist them with care post-hospital discharge. Given data showing that nonadherence is common, evidence-based interventions are urgently needed to help patients and their family caregivers manage the challenges of the post-HCT medical regimen together. We created a novel 4-session dyadic problem-solving therapy (DPST), involving both the patient and family caregiver and targeting adherence to the multicomponent medical regimen, all delivered via video conference. To optimize DPST and increase its feasibility, acceptability, efficacy, and eventual dissemination, we implemented a user-centered design approach in intervention development and testing.
Method
We initially adapted our DPST from traditional PST for application to dyads and medical adherence. It then went through 3 stages of iterative, user-centered processes. Stage 1 consisted of focus group input from patients, family caregivers, and HCT health care professionals. Participants gave feedback on DPST content and procedures. Stage 2 consisted of piloting the refined DPST intervention with dyads and seeking feedback on content and procedures. In Stage 3, we are evaluating the resulting 4-session DPST intervention in a single-site randomized controlled trial for acceptability, feasibility, and potential efficacy. Primary outcomes are adherence to the medical regimen and patient and caregiver perceived task self-efficacy.
Results
For Stage 1 focus groups, we conducted 3 patient groups (n=12), 3 family caregiver groups (n=12), and 3 health care professional groups (n=14). All types of groups supported the dyadic approach and focus on adherence, and suggested procedural changes (e.g., flexible session timing and scheduling). Stage 2 (n=3 dyads) incorporated recommended changes, and dyads received the modified intervention and suggested further changes (e.g., simplified content wording; a streamlined approach for easier adoption). Stage 3 is underway, with comparison of the finalized DPST intervention to an attention-control study arm.
Conclusion
User-centered design strategies generated novel feedback, leading to important intervention revisions. An iterative approach to intervention development allowed for direct involvement of stakeholders at sequential stages of work, yielding the potential for greater acceptability and potential utility of the intervention.
Authors:
Presenter - Donna M. Posluszny, PhD, University of Pittsburgh and UPMC Hillman Cancer Center
Co-Author - Dana H. Bovbjerg, PhD, University of Pittsburgh and UPMC Hillman Cancer Center
Co-Author - Arthur M. Nezu, PhD, Drexel University
Co-Author - Karen L. Syrjala, PhD, University of Washington and Fred Hutchinson Cancer Center
Co-Author - Lindsay M. Sabik, PhD, University of Pittsburgh and UPMC Hillman Cancer Center
Co-Author - Susan M. Sereika, PhD, University of Pittsburgh and UPMC Hillman Cancer Center
Co-Author - Mouzer Agha, MD, University of Pittsburgh and UPMC Hillman Cancer Center
Co-Author - Mary Amanda Dew, PhD, University of Pittsburgh
Understanding Experienced Barriers to Lung Cancer Screening among Latinos Following a Text Message-Based Intervention
Poster Number: B19Time: 11:00 AM - 11:50 AM
Topics: Cancer, Digital Health
Introduction
Rates among lung cancer screening among Latinos remain low. While prior studies have documented perceived barriers to screening, such as fear of outcomes and cost, little is known about the actual barriers experienced by Latinos who participate in interventions promoting lung cancer screening. This study aimed to assess the barriers encountered by participants in a text messaging intervention designed to promote the uptake of lung cancer screening among Latinos.
Methods
We conducted a qualitative content analysis (conventional and inductive) of responses to the open-ended question, ‘What prevented you from getting screened for lung cancer with low-dose CT scan?”. This item was part of the 12-week follow-up survey in A Todo Pulmón, a single-arm pilot text messaging intervention to promote lung cancer screening among Latino participants eligible for but not yet engaged in screening. For this analysis, we included those who received the intervention but had not undergone screening at follow-up (N=26). Participants submitted open-text responses in English or Spanish through REDCap. Two bilingual (English/Spanish) coders independently developed and iteratively refined inductive codes. Coding was conducted without qualitative analysis software. Coders met to discuss and resolve discrepancies through consensus. Spanish responses were translated to English for reporting.
Results
Participants reported six major barriers to lung cancer screening: (1) busy schedules and lack of time (“my job sometimes gives me 10 minutes of break, sometimes I’ve left after 5pm and the places are already closed”; (2) caregiving responsibilities (“I’ve been taking care of my mother, who’s sick”; (3) concerns about cost and insurance (“I didn’t know insurance covered it every year”; (4) difficulty managing multiple appointments (“I also don’t like going out for so many medical appointments”); (5) lack of knowledge of screenings being annual (“Screened a couple of years ago, didn't know it was annual”); and (6) fear of screening procedures and outcomes (“I needed time because I’m fearful of MRI exams, get anxiety”).
Discussion
Latinos who did not undergo lung cancer screening during the intervention reported barriers such as limited time, competing caregiving responsibilities, and challenges managing multiple medical appointments. Future interventions should address these factors to facilitate timely screening uptake among Latino populations.
Keywords: Cancer screening, LatinoRates among lung cancer screening among Latinos remain low. While prior studies have documented perceived barriers to screening, such as fear of outcomes and cost, little is known about the actual barriers experienced by Latinos who participate in interventions promoting lung cancer screening. This study aimed to assess the barriers encountered by participants in a text messaging intervention designed to promote the uptake of lung cancer screening among Latinos.
Methods
We conducted a qualitative content analysis (conventional and inductive) of responses to the open-ended question, ‘What prevented you from getting screened for lung cancer with low-dose CT scan?”. This item was part of the 12-week follow-up survey in A Todo Pulmón, a single-arm pilot text messaging intervention to promote lung cancer screening among Latino participants eligible for but not yet engaged in screening. For this analysis, we included those who received the intervention but had not undergone screening at follow-up (N=26). Participants submitted open-text responses in English or Spanish through REDCap. Two bilingual (English/Spanish) coders independently developed and iteratively refined inductive codes. Coding was conducted without qualitative analysis software. Coders met to discuss and resolve discrepancies through consensus. Spanish responses were translated to English for reporting.
Results
Participants reported six major barriers to lung cancer screening: (1) busy schedules and lack of time (“my job sometimes gives me 10 minutes of break, sometimes I’ve left after 5pm and the places are already closed”; (2) caregiving responsibilities (“I’ve been taking care of my mother, who’s sick”; (3) concerns about cost and insurance (“I didn’t know insurance covered it every year”; (4) difficulty managing multiple appointments (“I also don’t like going out for so many medical appointments”); (5) lack of knowledge of screenings being annual (“Screened a couple of years ago, didn't know it was annual”); and (6) fear of screening procedures and outcomes (“I needed time because I’m fearful of MRI exams, get anxiety”).
Discussion
Latinos who did not undergo lung cancer screening during the intervention reported barriers such as limited time, competing caregiving responsibilities, and challenges managing multiple medical appointments. Future interventions should address these factors to facilitate timely screening uptake among Latino populations.
Authors:
Author - Jeffrey Ramos Santiago, PhD, University of Rochester Medical Center
Co-Author - Rafael Orfin, University of Rochester Medical Center
Co-Author - Mary Jo Evans, University of Rochester Medical Center
Co-Author - Maria Delgado Sutton, Cancer Support Community at Gilda's Club
Co-Author - Francisca Barria Lopez, University of Rochester Medical Center
Co-Author - Gabriella Alvarez, University of Rochester Medical Center
Co-Author - Scott McIntosh, Ph.D., University of Rochester Medical Center
Co-Author - Dongmei Li, Ph.D., University of Rochester Medical Center
Co-Author - Alejandra Hurtado-de-Mendoza, Ph.D., Georgetown Lombardi Comprehensive Cancer Center
Co-Author - Lisa Carter-Bawa, Ph.D., Hackensack Meridian Health
Co-Author - Patricia Rivera, MD, University of Rochester Medical Center
Co-Author - Ana Paula Cupertino, Ph.D., University of Rochester Medical Center
Co-Author - Francisco Cartujano-Barrera, MD, University of Rochester Medical Center
Health behaviors in neuro-oncology caregivers: Change due to care role and caregiver burden
Poster Number: B20Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Background: Family members and friends often take on critical caregiving responsibilities for cancer patients. Caregiver burden and distress can be substantial, especially for those caring for patients with poor prognosis, rapidly progressive disease, like brain cancer. There is a dearth of literature, however, on whether and how the caregiving role can impact caregivers’ health behaviors.
Objective: Our goal is to: 1) identify self-reported health behavior changes due to the caregiving role in a neuro-oncology caregiving sample and 2) explore the association of health behavior change with caregiver burden and distress.
Methods: Baseline data from a supportive intervention for neuro-oncology caregivers were analyzed. Prior to randomization, caregivers completed a survey that included: demographic questionnaires, health behaviors and whether caregiving affected these behaviors, the 12-item Zarit Burden Index, the 8-item Patient Health Questionnaire (depression), and the 7-item Generalized Anxiety Disorder scale. Descriptive statistics were calculated for all variables. A stepwise logistic regression was conducted to determine the relationship of burden, depression, and anxiety to health behavior change due to caregiving.
Results: Caregivers (N=116) were 71% female, 12% racial/ethnic minority, averaged 57.6 years old (SD=14.7), and 81% patients’ spouses. 67% of patients had Grade 4 tumors. Caregivers most commonly reported sleeping 5-7 hours/night (46%), engaging in exercise 0 days/week (43%), eating out 1-2 meals/week (57%), drinking 0 alcoholic beverages/week (49%), drinking 1-7 caffeinated beverages/week (41%), and no tobacco use (95%). Caregivers most commonly reported impacts to their sleep (71%), exercise (58%), and meals not prepared at home (56%). Controlling for demographic factors, change in sleep, meals, exercise, and alcohol consumption were positively associated with burden (p<.05), but no statistically significant associations were identified for anxiety or depression.
Discussion: Neuro-oncology caregivers report that their role impacts their health behaviors, especially sleep, exercise, and diet. Moreover, these changes are significantly associated with self-reported caregiver burden. This suggests that as burden increases, caregivers may be sacrificing key health-promoting behaviors. More research is needed to explore mechanisms around this effect and develop interventions to support caregiver health behavior maintenance.
Keywords: Caregiving, Health behaviorsObjective: Our goal is to: 1) identify self-reported health behavior changes due to the caregiving role in a neuro-oncology caregiving sample and 2) explore the association of health behavior change with caregiver burden and distress.
Methods: Baseline data from a supportive intervention for neuro-oncology caregivers were analyzed. Prior to randomization, caregivers completed a survey that included: demographic questionnaires, health behaviors and whether caregiving affected these behaviors, the 12-item Zarit Burden Index, the 8-item Patient Health Questionnaire (depression), and the 7-item Generalized Anxiety Disorder scale. Descriptive statistics were calculated for all variables. A stepwise logistic regression was conducted to determine the relationship of burden, depression, and anxiety to health behavior change due to caregiving.
Results: Caregivers (N=116) were 71% female, 12% racial/ethnic minority, averaged 57.6 years old (SD=14.7), and 81% patients’ spouses. 67% of patients had Grade 4 tumors. Caregivers most commonly reported sleeping 5-7 hours/night (46%), engaging in exercise 0 days/week (43%), eating out 1-2 meals/week (57%), drinking 0 alcoholic beverages/week (49%), drinking 1-7 caffeinated beverages/week (41%), and no tobacco use (95%). Caregivers most commonly reported impacts to their sleep (71%), exercise (58%), and meals not prepared at home (56%). Controlling for demographic factors, change in sleep, meals, exercise, and alcohol consumption were positively associated with burden (p<.05), but no statistically significant associations were identified for anxiety or depression.
Discussion: Neuro-oncology caregivers report that their role impacts their health behaviors, especially sleep, exercise, and diet. Moreover, these changes are significantly associated with self-reported caregiver burden. This suggests that as burden increases, caregivers may be sacrificing key health-promoting behaviors. More research is needed to explore mechanisms around this effect and develop interventions to support caregiver health behavior maintenance.
Authors:
Author - Maija Reblin, PhD, FSBM, University of Vermont
Co-Author - Deanna Witte, MSMS, H. Lee Moffitt Cancer Center and Research Institute
Co-Author - Kelcie Willis, M.S., Massachusetts General Hospital
Co-Author - Kristen Wells, PhD MPH, San Diego State University
Co-Author - Alissa Thomas, MD, University of Vermont Cancer Center
Co-Author - Margaret Byrne, PhD, H. Lee Moffitt Cancer Center and Research Institute
Feasibility of a community-based mindful self-compassion intervention for adults and family caregivers of individuals with high genetic cancer risk
Poster Number: B21Time: 11:00 AM - 11:50 AM
Topics: Cancer, Integrative Health and Spirituality
Background. Li-Fraumeni syndrome (LFS) is a hereditary syndrome that poses high psychosocial burdens due to whole-body cancer risks from birth, lifelong cancer screening, few prevention options, and increased early mortality risk. Currently, there is a lack of supportive care interventions to address psychosocial burdens among diagnosed individuals and their families. Practicing mindful self-compassion (MSC) may develop inner resources to cope with difficult LFS-related experiences through mindfulness, self-kindness, and a sense of common humanity. We used a mixed-methods approach to examine the feasibility, acceptability, and appropriateness of a community-based MSC intervention for adults with LFS and their family caregivers. Methods. We involved LFS patient/community advocates at all research phases. Participants were adult attendees of the 2024 Living LFS family camp and diagnosed with LFS or a non-LFS family caregiver. The intervention consisted of a group-based, 60-minute MSC skills training. Feasibility was measured by attendance rate (goal: ≥70% of 40 slots). We assessed acceptability and appropriateness via post-training debriefing, an online survey (2 wks post camp) and focus groups (6 wks post camp). Survey items measured training satisfaction, relevance, and usefulness on 6-point Likert scales. We calculated descriptive statistics and thematically analyzed qualitative data. Results. The feasibility goal was met; 31 participants (16 with LFS, 15 caregivers) completed the training. Of these, 24 completed the survey and 8 participated in a focus group. On average, participants were very satisfied (M=5.67, SD=0.64) and agreed the training was relevant (M=5.17, SD=1.23) and would assist with LFS challenges (M=5.36, SD=0.90). Several reported the training helped them realize the need for self-kindness and thought MSC would be an effective tool to reduce distress. Many described feeling soothed and supported during the training. Anticipated challenges to practicing MSC in daily life included forgetting (how) to use it and the complexity of coping with emotions like guilt and grief. Most wanted additional opportunities for community practice. Conclusion. Findings suggest a community-based MSC intervention is a feasible way to introduce and foster MSC among families affected by LFS. Results will inform development of an adapted 8-week MSC program (Neff & Germer, 2013), a next step toward advancing targeted supportive care resources for LFS populations.
Keywords: Mindfulness, Community interventionAuthors:
Presenter - Camella Rising, PhD, MS, RDN, National Cancer Institute
Co-Author - Amelia Coffaro, BA, C-IAYT, Ascension Columbia St. Mary's Cancer Center, University of Wisconsin at Milwaukee
Co-Author - Catherine Wilsnack, PhD, MSW, LMSW, National Cancer Institute
Co-Author - Rowan Forbes Shepherd, PhD, National Cancer Institute
Co-Author - Andi Last, Living LFS, Inc.
Co-Author - Payal P. Khincha, MBBS, MSHS, National Cancer Institute
Ambiguity aversion in clinical trials evaluating multicancer detection (MCD) tests
Poster Number: B22Time: 11:00 AM - 11:50 AM
Topics: Cancer, Decision Making
Background: Early cancer detection through screening saves lives. Multicancer detection (MCD) tests may be efficacious and require evidence from conventional randomized control trials (RCT). These trials, however, require large sample sizes, long follow-up periods, and the willingness of subjects to not receive the treatment as part of the control group. Alternative trials designs may help with recruitment. This study compared four control variations for a hypothetical MCD trial to test if certain configurations led to preference toward or bias against participating.
Method: U.S. adults aged 45-70 (N=1,576) viewed a flyer for a hypothetical MCD RCT. Participants were randomized to one of four control group descriptions: 1) conventional (no MCD testing); 2) testing with unknown results; 3) testing with unknowable results (due to disclosure safeguards); and 4) testing with unknowable, time-delayed results (due to testing banked blood samples at the end of the trial). Primary outcomes were study interest (5-point scale) and intentions to participate (binary yes/no). ANOVAs and chi-square tests examined main effects; linear regression models examined perceived study benefit and trust in study researchers (both 5-point scales) as potential mediating factors driving indirect effects.
Results: Interest was higher in the conventional control (M=3.73) than all other conditions (all ps<.05); interest was similar for the unknown (M=3.42), unknowable (M=3.36), and time-delayed (M=3.45) conditions. Intentions to participate was similar across all conditions (range 14-21%). Both perceived study benefit and trust in study researchers negatively mediated study main effects. For example, perceived study benefit fully mediated the effects of the unknown vs. conventional control group (indirect effect: b=-.05, p<.01; total effect: b=-.09, p<.01) on study interest.
Conclusion: Alternative RCT designs induce less interest in participation (as well as lower perceived study benefit and trust) than a conventional RCT design. This finding may be attributable to ambiguity aversion—a bias against options with unknown risks; however, efforts to mitigate this bias by reassuring participants about the unknowability of the test results were not effective, which may suggest that people’s bias may be driven by other factors that deserve further investigation.
Keywords: Cancer, Randomized controlled trialMethod: U.S. adults aged 45-70 (N=1,576) viewed a flyer for a hypothetical MCD RCT. Participants were randomized to one of four control group descriptions: 1) conventional (no MCD testing); 2) testing with unknown results; 3) testing with unknowable results (due to disclosure safeguards); and 4) testing with unknowable, time-delayed results (due to testing banked blood samples at the end of the trial). Primary outcomes were study interest (5-point scale) and intentions to participate (binary yes/no). ANOVAs and chi-square tests examined main effects; linear regression models examined perceived study benefit and trust in study researchers (both 5-point scales) as potential mediating factors driving indirect effects.
Results: Interest was higher in the conventional control (M=3.73) than all other conditions (all ps<.05); interest was similar for the unknown (M=3.42), unknowable (M=3.36), and time-delayed (M=3.45) conditions. Intentions to participate was similar across all conditions (range 14-21%). Both perceived study benefit and trust in study researchers negatively mediated study main effects. For example, perceived study benefit fully mediated the effects of the unknown vs. conventional control group (indirect effect: b=-.05, p<.01; total effect: b=-.09, p<.01) on study interest.
Conclusion: Alternative RCT designs induce less interest in participation (as well as lower perceived study benefit and trust) than a conventional RCT design. This finding may be attributable to ambiguity aversion—a bias against options with unknown risks; however, efforts to mitigate this bias by reassuring participants about the unknowability of the test results were not effective, which may suggest that people’s bias may be driven by other factors that deserve further investigation.
Authors:
Co-Author - Jacob Rohde, PhD, MPH, University of Connecticut
Co-Author - Jackelyn Payne, PhD, MPH, National Cancer Institute
Co-Author - Richard Moser, PhD, FSBM, National Cancer Institute
Co-Author - Paul Han, MD, MPH, National Cancer Institute
Evaluating the role of fatigue in adherence, feasibility, and acceptability of a mHealth physical activity intervention for breast cancer survivors
Poster Number: B23Time: 11:00 AM - 11:50 AM
Topics: Cancer, Physical Activity
Background: Cancer-related fatigue (CRF) is a common, persistent consequence of breast cancer that reduces quality of life. Physical activity (PA) is the first-line approach for CRF management. Mobile health (mHealth) interventions offer scalable methods to promote PA among breast cancer survivors (BCS), yet existing interventions are not tailored for BCS with CRF. Little is known about whether CRF influences intervention feasibility, acceptability, and adherence, factors that may affect efficacy. Understanding these relationships is necessary for designing effective interventions for BCS with CRF. This study uses data from Fit2Thrive, a remote mHealth PA intervention for BCS that used the Multiphase Optimization Strategy methodology, to examine whether baseline CRF moderates Fit2Thrive feasibility, acceptability, and adherence outcomes. Methods: Inactive BCS (n=269; Mage=52.5; SD=9.9) received a core intervention (Fitbit + Fit2Thrive smartphone app) and were randomized to “on” or “off” levels of five components: support calls, deluxe app, online gym, buddy, and text messages for 12-weeks followed by a 12-week maintenance period. Baseline CRF was measured using the Patient-Reported Outcomes Measurement Information System fatigue short form and dichotomized to indicate clinically elevated fatigue (T > 55; 52% elevated, 48% within normal limits). Feasibility was measured by accrual, retention, and PA goal adherence rates; acceptability was measured via post-program evaluations administered at week 12. The moderating effect of CRF on feasibility and acceptability outcomes was tested using logistic regression models for dichotomized outcomes (high v. low retention, Fitbit adherence, PA goal attainment, acceptability) and Poisson regression for continuous Fit2Thrive app usage. Results: Baseline CRF did not significantly moderate 12-week feasibility, acceptability, or adherence outcomes. There were no significant interactions between CRF status and effects of any individual intervention component on these outcomes. Conclusions: mHealth PA interventions designed for the general BCS population may be equally feasible and acceptable for those with clinically elevated CRF, supporting their potential to promote PA adoption among this high-need group. Further research should assess whether interventions are equally efficacious in increasing PA for BCS with CRF and explore strategies to tailor mHealth approaches to their unique needs.
Keywords: Fatigue, Cancer survivorshipAuthors:
Author - Payton Solk, MS, Northwestern University Feinberg School of Medicine
Co-Author - Jing Song, MS, Northwestern University Feinberg School of Medicine
Co-Author - Juned Siddique, DrPH, Northwestern University Feinberg School of Medicine
Co-Author - David Cella, PhD, Northwestern University Feinberg School of Med
Co-Author - Sofia Garcia, PhD, Northwestern University Feinberg School of Medicine
Co-Author - Bonnie Spring, PhD, ABPP, FSBM, Florida State University College of Medicine
Co-Author - Frank Penedo, PhD, University of Miami Sylvester Comprehensive Cancer Center
Co-Author - Kerry Courneya, PhD, University of Alberta
Co-Author - Ronald Ackerman, MD, Northwestern University
Co-Author - Siobhan Phillips, PhD, MPH, Northwestern University Feinberg School of Medicine
Effectiveness of an online Meaning-Centered Psychotherapy in Chinese caregivers of advanced cancer: A pilot randomized controlled trial
Poster Number: B24Time: 11:00 AM - 11:50 AM
Topics: Cancer, Mental Health
Background
Chinese caregivers of advanced cancer patients experience profound existential distress and death anxiety while navigating Confucian obligations to sustain hope and maintain familial harmony. This distress compounds health risks and predicts adverse bereavement outcomes. To address cultural gaps in supportive care, we adapted U.S.-based Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C) for Chinese contexts. The study aimed to assess the feasibility, acceptability, and preliminary effects of culturally adapted MCP-C among Chinese caregivers of patients with advanced cancer, compared with enhanced usual care.
Method
A mixed-method pilot two-arm randomized controlled trial was conducted with 46 participants assigned to either seven sessions of MCP-C group (n=23) or enhanced usual care group (n=23), which included mental health resources and targeted referrals. Assessments were conducted at baseline, immediately (T1), and three months post-intervention (T2) using self-reported questionnaires and semi-structured interviews.
Results
MCP-C was feasible and satisfactory in terms of attendance, adherence, credibility, safety, and treatment fidelity. Compared with enhanced usual care, participants in MCP-C experienced a significant reduction in depression (T1 effect size [ES]: -3.78, p=0.001; T2 ES: -3.14, p=0.03) and anxiety (T1 ES: -3.41, p=0.03; T2 ES: -5.46, p=0.001) at T1 and T2. Additionally, they demonstrated improvement in meaning scale (ES: 2.65, p=0.02) at T1. Qualitative analysis revealed three key themes: (1) reconciling personal and familial values, (2) finding purpose through caregiving, and (3) enhanced family connectedness.
Conclusion
The seven sessions of MCP-C were feasible, well-received, and demonstrated preliminary effectiveness in reducing psychological distress and enhancing sense of meaning among Chinese cancer caregivers. These findings provide early evidence for culturally adapted existential interventions in Confucian contexts and support a full-scale trial to rigorously evaluate MCP-C’s effectiveness in this population.
Keywords: Caregiving, Randomized controlled trialChinese caregivers of advanced cancer patients experience profound existential distress and death anxiety while navigating Confucian obligations to sustain hope and maintain familial harmony. This distress compounds health risks and predicts adverse bereavement outcomes. To address cultural gaps in supportive care, we adapted U.S.-based Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C) for Chinese contexts. The study aimed to assess the feasibility, acceptability, and preliminary effects of culturally adapted MCP-C among Chinese caregivers of patients with advanced cancer, compared with enhanced usual care.
Method
A mixed-method pilot two-arm randomized controlled trial was conducted with 46 participants assigned to either seven sessions of MCP-C group (n=23) or enhanced usual care group (n=23), which included mental health resources and targeted referrals. Assessments were conducted at baseline, immediately (T1), and three months post-intervention (T2) using self-reported questionnaires and semi-structured interviews.
Results
MCP-C was feasible and satisfactory in terms of attendance, adherence, credibility, safety, and treatment fidelity. Compared with enhanced usual care, participants in MCP-C experienced a significant reduction in depression (T1 effect size [ES]: -3.78, p=0.001; T2 ES: -3.14, p=0.03) and anxiety (T1 ES: -3.41, p=0.03; T2 ES: -5.46, p=0.001) at T1 and T2. Additionally, they demonstrated improvement in meaning scale (ES: 2.65, p=0.02) at T1. Qualitative analysis revealed three key themes: (1) reconciling personal and familial values, (2) finding purpose through caregiving, and (3) enhanced family connectedness.
Conclusion
The seven sessions of MCP-C were feasible, well-received, and demonstrated preliminary effectiveness in reducing psychological distress and enhancing sense of meaning among Chinese cancer caregivers. These findings provide early evidence for culturally adapted existential interventions in Confucian contexts and support a full-scale trial to rigorously evaluate MCP-C’s effectiveness in this population.
Authors:
Presenter - Naomi Takemura, RN, BN, PhD, The Hong Kong Polytechnic University
Co-Author - Arthur Cheuk-Man Li, HCPC(UK), HKPS(HK), BSc, MSSc, Psy.D., The University of Hong Kong
Co-Author - Janelle Yorke, RN, PhD, The Hong Kong Polytechnic University
Co-Author - Allison Applebaum, PhD, Icahn School of Medicine at Mount Sinai
Implementation and Preliminary Outcomes of the Caregivers-Patient Support for Coping with Advanced Cancer (CASA) Intervention
Poster Number: B25Time: 11:00 AM - 11:50 AM
Topics: Cancer, Implementation Science
Advanced cancer profoundly impacts the psychosocial well-being of patients and their caregivers, particularly in Latino/Hispanic cultural contexts where family support and spirituality play a central role. Despite the central importance of family and spiritual well-being, these dimensions are rarely addressed in clinical care, highlighting the need for culturally sensitive interventions tailored to Latino/Hispanic populations. Adapted as a culturally responsive intervention, the CASA intervention aims to enhance communication and spiritual well-being among patients and caregivers coping with advanced cancer. The aim of this study was to describe the implementation and preliminary outcomes of the CASA intervention in a Puerto Rican sample. In this study, we recruited 52 participants, of whom 11 dyads (n = 22) received the CASA intervention, delivered by clinical psychology doctoral students under the supervision of a clinical psychologist. Participants included patients coping with cancer and their caregivers, with a mean age of 57 years, and the majority were female. We assessed outcomes using pre- and post-measures (FACIT, PHQ-8, GAD-7, Distress Thermometer, and FACT-G) and analyzed them using the Wilcoxon signed-rank test. Preliminary findings of the dyads who completed the intervention (n=18) indicated significant improvements in spiritual well-being (Z = −2.618, p = 0.009, adjusted α = 0.025, r = 0.44) and quality of life (Z = −2.957, p = 0.003, adjusted α = 0.01, r = 0.51), as well as significant reductions in symptoms of depression (Z = −2.764, p = 0.006, adjusted α = 0.0125, r = 0.46), anxiety (Z = −2.667, p = 0.008, adjusted α= 0.0166, r = 0.44), and emotional distress (Z = −2.195, p = 0.028, adjusted α = 0.05, r = 0.38). These findings also demonstrated the feasibility of delivering CASA through supervised doctoral students, highlighting its potential for integration in training and clinical settings. Overall, results suggest that CASA may be a promising and acceptable intervention. However, further research with a larger sample is needed to confirm its efficacy and clinical impact on cancer care, particularly within Latino/Hispanic populations.
Keywords: Cancer, Social supportAuthors:
Author - Stephanie Torres-Marrero, BA, Ponce Health Sciences University
Co-Author - Ninoshka Rivera, MS, Ponce Health Sciences University
Co-Author - Denise Cortés-Cortés, BA, Ponce Health Science University
Co-Presenter - Sabrina Pérez-De Santiago, BA, Ponce Health Science University
Co-Author - Alondra De Lahongrais-Lamboy, Ponce Health Science University
Co-Author - Carled Argüelles-Berrios, MS, Ponce Health Science University
Co-Author - Lianel Rosario-Ramos, MS, Ponce Health Science University
Co-Author - Normarie Torres-Blasco, PhD, Ponce Health Science University
Addressing the Nutrition Needs of Cancer Survivors with Nutrition Insecurity: A Pilot Study
Poster Number: B26Time: 11:00 AM - 11:50 AM
Topics: Cancer, Diet, Nutrition, and Eating Disorders
Background: Interventions to address nutrition security are needed to improve quality of life and clinical outcomes for cancer survivors.
Methods: We conducted a single arm proof-of-concept study at the University of California, San Francisco to determine the acceptability and feasibility of a 4-week intervention to increase nutrition security among cancer survivors. The study was conducted among adults who had completed therapy, were able to speak and read English, had access to the Internet, and either reported nutrition insecurity based on the USDA Food Security Scale and/or belonged to a NIH-designated vulnerable population. After completing baseline surveys, participants received vouchers for use on Instacart (“Fresh Funds”), weekly calls, and educational materials. Use of the funds was restricted to foods and beverages consistent with the American Cancer Society nutrition guidelines. After completing the intervention, participants completed follow-up surveys to assess the feasibility, acceptability, and appropriateness of the intervention (AIM, IAM, FIM; range: 1-5, higher scores indicate more feasible, acceptable, appropriate) and were invited to an exit interview.
Results: 40 cancer survivors were enrolled between February-April 2025. Mean age was 55 years (range: 46-78); 83% were female; 33% were Hispanic or Latino, 28% were Non-Hispanic (NH) Asian, 23% NH White, 10% NH Other or multiple races, and 8% NH Black. More than eight cancer types were represented; the most common were colorectal (38%) and breast (33%). 55% had low nutrition security. Follow-up at 4 weeks was 98% complete. The intervention was deemed highly acceptable, appropriate, and feasible; mean (standard deviation, SD) scores on the AIM, IAM, and FIM were 4.4, 4.5, and 4.5 (all SD 0.8). 98% of codes provided to participants were activated during the study. Most orders using the funds included fruits and vegetables (66%); the next most common categories included were nuts and seeds (8% of orders) and water (8% of orders). In exit interviews, participants reported an overall positive experience, described the amount of funds as adequate, and provided suggestions to improve the intervention, such as including recipes.
Conclusion: An innovative nutrition security intervention using vouchers for online grocery shopping was feasible, acceptable, and appropriate. This intervention is a promising approach to improve access to healthy foods among cancer survivors.
Keywords: Nutrition, Cancer survivorshipMethods: We conducted a single arm proof-of-concept study at the University of California, San Francisco to determine the acceptability and feasibility of a 4-week intervention to increase nutrition security among cancer survivors. The study was conducted among adults who had completed therapy, were able to speak and read English, had access to the Internet, and either reported nutrition insecurity based on the USDA Food Security Scale and/or belonged to a NIH-designated vulnerable population. After completing baseline surveys, participants received vouchers for use on Instacart (“Fresh Funds”), weekly calls, and educational materials. Use of the funds was restricted to foods and beverages consistent with the American Cancer Society nutrition guidelines. After completing the intervention, participants completed follow-up surveys to assess the feasibility, acceptability, and appropriateness of the intervention (AIM, IAM, FIM; range: 1-5, higher scores indicate more feasible, acceptable, appropriate) and were invited to an exit interview.
Results: 40 cancer survivors were enrolled between February-April 2025. Mean age was 55 years (range: 46-78); 83% were female; 33% were Hispanic or Latino, 28% were Non-Hispanic (NH) Asian, 23% NH White, 10% NH Other or multiple races, and 8% NH Black. More than eight cancer types were represented; the most common were colorectal (38%) and breast (33%). 55% had low nutrition security. Follow-up at 4 weeks was 98% complete. The intervention was deemed highly acceptable, appropriate, and feasible; mean (standard deviation, SD) scores on the AIM, IAM, and FIM were 4.4, 4.5, and 4.5 (all SD 0.8). 98% of codes provided to participants were activated during the study. Most orders using the funds included fruits and vegetables (66%); the next most common categories included were nuts and seeds (8% of orders) and water (8% of orders). In exit interviews, participants reported an overall positive experience, described the amount of funds as adequate, and provided suggestions to improve the intervention, such as including recipes.
Conclusion: An innovative nutrition security intervention using vouchers for online grocery shopping was feasible, acceptable, and appropriate. This intervention is a promising approach to improve access to healthy foods among cancer survivors.
Authors:
Co-Author - Sabino Maldonado-Torres, MD, University of California, San Francisco
Co-Author - Irina Tolstykh, MS, University of California, San Francisco
Co-Author - Banaz Shwan, University of California, San Francisco
Co-Author - Bryan Khuong Le, University of California, San Francisco
Co-Author - F. Alethea Marti, Stanford University
Co-Author - Rebecca Grey, MPH, MSW, LCSW, Stanford University
Co-Author - Wei-ting Chen, PhD, Stanford University
Co-Author - Lisa Goldman Rosas, PhD, MPH, FSBM, Stanford University
Co-Author - Sorbarikor Piawah, MD MPH, University of California, San Francisco
Presenter - Erin L. Van Blarigan, ScD, University of California, San Francisco
Promoting Sun Safety in Underserved Communities: A Behavioral Trial Among Rural Youth
Poster Number: B27Time: 11:00 AM - 11:50 AM
Topics: Cancer, Child and Family Health
Background
Skin cancer incidence and mortality rates are higher in rural versus urban areas. Rural youth are at increased risk due to greater sun exposure, limited use of sun protection, and limited access to sun safety resources. Few evidence-based skin cancer prevention programs are designed for rural populations. The RAYS (Rural Adult and Youth Sun Protection study) intervention is a community-based program delivered through youth sport, a natural gathering place in rural communities. This analysis of the ongoing trial examines the feasibility of recruiting leagues, coaches, and parents and describes baseline sun protection habits among youth players.
Methods
Over 2 years, RAYS enrolled coaches and parents from little league baseball teams (ages 3-7). Leagues were randomized to RAYS (skin cancer prevention education and sun safety supplies: sunscreen, sunglasses, shade tents, ultraviolet protection sleeves) or a comparator focused on general injury prevention. Assessments occurred at baseline (season start), post-intervention (season end), and one year post-baseline. The analysis summarizes parent-reported child sun safety behaviors at baseline.
Results
In the first 2 years, 11 baseball leagues from rural counties in Utah and West Virginia were invited; 6 enrolled and 5 declined (e.g., due to staffing changes, time constraints). Of 94 invited coaches, 63% (n=59) enrolled and 97% (n=57) were retained post-treatment. Of 634 invited parents, 22% (n=137) enrolled; 76% (n=104) were retained. At baseline, children inconsistently practiced sun safety (5-point Likert scale: 1=Never, 5=Always). Composite scores indicated children “Sometimes” (M=2.96, SD=0.47) engaged in any sun protection when outdoors. Behaviors such as wearing sunglasses, hats, sleeves, seeking shade, and sunscreen reapplication averaged “Sometimes” (M=3.05, SD=0.31). Sunscreen was “Often” (M=3.65, SD=0.97) used, whereas long pants and avoiding peak UV hours were “Rarely” (M=2.39, SD=0.14) practiced.
Discussion
Skin cancer disproportionately affects rural and underserved communities. High retention in RAYS reinforces the feasibility of innovative, community-based interventions to address this population’s unique needs. Engagement may have been improved by local leaders, such as coaches, suggesting that leveraging trusted community figures could support sustained enrollment. Future efforts are needed to strengthen parent enrollment and address inconsistencies in sun protection behaviors.
Keywords: Cancer, Children's healthSkin cancer incidence and mortality rates are higher in rural versus urban areas. Rural youth are at increased risk due to greater sun exposure, limited use of sun protection, and limited access to sun safety resources. Few evidence-based skin cancer prevention programs are designed for rural populations. The RAYS (Rural Adult and Youth Sun Protection study) intervention is a community-based program delivered through youth sport, a natural gathering place in rural communities. This analysis of the ongoing trial examines the feasibility of recruiting leagues, coaches, and parents and describes baseline sun protection habits among youth players.
Methods
Over 2 years, RAYS enrolled coaches and parents from little league baseball teams (ages 3-7). Leagues were randomized to RAYS (skin cancer prevention education and sun safety supplies: sunscreen, sunglasses, shade tents, ultraviolet protection sleeves) or a comparator focused on general injury prevention. Assessments occurred at baseline (season start), post-intervention (season end), and one year post-baseline. The analysis summarizes parent-reported child sun safety behaviors at baseline.
Results
In the first 2 years, 11 baseball leagues from rural counties in Utah and West Virginia were invited; 6 enrolled and 5 declined (e.g., due to staffing changes, time constraints). Of 94 invited coaches, 63% (n=59) enrolled and 97% (n=57) were retained post-treatment. Of 634 invited parents, 22% (n=137) enrolled; 76% (n=104) were retained. At baseline, children inconsistently practiced sun safety (5-point Likert scale: 1=Never, 5=Always). Composite scores indicated children “Sometimes” (M=2.96, SD=0.47) engaged in any sun protection when outdoors. Behaviors such as wearing sunglasses, hats, sleeves, seeking shade, and sunscreen reapplication averaged “Sometimes” (M=3.05, SD=0.31). Sunscreen was “Often” (M=3.65, SD=0.97) used, whereas long pants and avoiding peak UV hours were “Rarely” (M=2.39, SD=0.14) practiced.
Discussion
Skin cancer disproportionately affects rural and underserved communities. High retention in RAYS reinforces the feasibility of innovative, community-based interventions to address this population’s unique needs. Engagement may have been improved by local leaders, such as coaches, suggesting that leveraging trusted community figures could support sustained enrollment. Future efforts are needed to strengthen parent enrollment and address inconsistencies in sun protection behaviors.
Authors:
Author - Kate Welch, BS, Huntsman Cancer Institute
Co-Author - Juliana Moyano, BA, Huntsman Cancer Institute
Co-Author - Dannell Boatman, EdD, West Virginia University and Lombardi Cancer Center
Co-Author - Jonathan Chipman, PhD, Huntsman Cancer Institute
Co-Author - Douglas Grossman, MD, PhD, Huntsman Cancer Institute
Co-Author - David Dzewaltowski, PhD, University of Nebraska Medical Center
Co-Author - Trang VoPham, PhD, Huntsman Cancer Institute
Co-Author - Kenneth Tercyak, PhD, FSBM, Georgetown University
Co-Author - Yelena Wu, PhD, FSBM, Huntsman Cancer Institute, University of Utah
“You should just be focused on surviving”: A qualitative study of sexual late effects among young adult survivors of childhood cancer
Poster Number: B28Time: 11:00 AM - 11:50 AM
Topics: Cancer, Quality of Life
Background. Despite survival rates of childhood cancer surpassing 90%, very little research is dedicated to assessing sexual late effects from the cancer experience. Sexual self-concept – that is, the variables that combine to create one’s sexual identity, such as social supports, body image, and sexual functioning – is particularly overshadowed in many survivorship clinics, where the goal is focused on long-term remission rather than quality of life. While survival is the “main goal” of treatment, data are beginning to demonstrate significant sexual and romantic late effects that affect quality of life.
Methods. Semi-structured interviews were conducted to assess and describe sexual self-concept among young adult survivors of childhood cancer. The research team oversampled participants who identified as sexual and/or gender minorities in a concerted effort to identify needs specific to this population. Transcribed interviews were coded by a team of researchers to prepare for thematic analysis. Fifteen codes explicitly described the impact of the cancer experience on participants’ lives. The resulting excerpts were reviewed for themes within this sample.
Results. Our sample consisted of 48 young adult survivors of childhood cancer (ages 18-39) who were predominantly assigned female at birth (75.0%), identified as women (64.6%), White (77.1%), and single (64.6%). Sexual orientation, religion, and education level were incredibly diverse among the sample, with no explicit majority. There were several themes that emerged regarding sexual self-concept post-cancer, including sexual “repulsion” that survivors identified as stemming from past oncology treatment; a sense of being “damaged” by childhood cancer that would impact their ability to engage in future partnership; partner discomfort with scars from surgery; using past romantic and sexual relationships as a form of social support during cancer treatment; and conditional acceptance of sexual late effects, as the “main goal” of treatment was survival.
Conclusion. While sexual education is already variable throughout the US, our data identify that childhood cancer survivors would benefit from tailored, oncology-focused sexual adjustment interventions. Both individual and couples’ interventions could decrease the prevalence of sexual late effects; increase partnership and potential fertility rates among childhood cancer survivors; and increase the focus of survival on quality of life.
Keywords: Cancer survivorship, Sexual behaviorMethods. Semi-structured interviews were conducted to assess and describe sexual self-concept among young adult survivors of childhood cancer. The research team oversampled participants who identified as sexual and/or gender minorities in a concerted effort to identify needs specific to this population. Transcribed interviews were coded by a team of researchers to prepare for thematic analysis. Fifteen codes explicitly described the impact of the cancer experience on participants’ lives. The resulting excerpts were reviewed for themes within this sample.
Results. Our sample consisted of 48 young adult survivors of childhood cancer (ages 18-39) who were predominantly assigned female at birth (75.0%), identified as women (64.6%), White (77.1%), and single (64.6%). Sexual orientation, religion, and education level were incredibly diverse among the sample, with no explicit majority. There were several themes that emerged regarding sexual self-concept post-cancer, including sexual “repulsion” that survivors identified as stemming from past oncology treatment; a sense of being “damaged” by childhood cancer that would impact their ability to engage in future partnership; partner discomfort with scars from surgery; using past romantic and sexual relationships as a form of social support during cancer treatment; and conditional acceptance of sexual late effects, as the “main goal” of treatment was survival.
Conclusion. While sexual education is already variable throughout the US, our data identify that childhood cancer survivors would benefit from tailored, oncology-focused sexual adjustment interventions. Both individual and couples’ interventions could decrease the prevalence of sexual late effects; increase partnership and potential fertility rates among childhood cancer survivors; and increase the focus of survival on quality of life.
Authors:
Author - Megan Wirtz, MA, The Graduate Center, City University of New York
Co-Author - Jennifer Ford, PhD, FSBM, Hunter College, City University of New York
Integrating Physical Activity into Cancer Survivorship Settings: Perspectives from Prostate Cancer Support Groups
Poster Number: B29Time: 11:00 AM - 11:50 AM
Topics: Cancer, Physical Activity
Objective
Physical activity is associated with reduced mortality risk and improved quality of life among cancer survivors. However, many prostate cancer survivors do not meet minimum physical activity recommendations. This research aimed to understand prostate cancer support group member reported perspectives and considerations for implementing a physical activity intervention in a cancer support group setting.
Methods
Researchers conducted four semi-structured focus groups with prostate cancer support group members in western NY and central and eastern NC. Focus groups were recorded, transcribed verbatim, and qualitatively coded independently by at least two research team members using template analysis. The finalized list of codes were reviewed collectively by the research team and organized into themes and subthemes through consensus. Member checking was performed with study participants to ensure credible findings.
Results
Participants were 25 members at various points in the cancer care continuum representing three different prostate cancer support groups. Participant responses led to the identification of themes including individual- and group-level barriers to physical activity (e.g., lack of personal motivation and insufficient space for the group to engage in physical activity), individual and group-level facilitators to physical activity (e.g., tracking personal progress and existing support group members willing to champion the intervention in the group), leverageable support group resources to promote physical activity (e.g., strong sense of community and social support), recommendations for intervention content (e.g., suggestions about specific types of physical activity to promote), and considerations for intervention delivery (e.g., perspectives surrounding the characteristics of an appropriate interventionist).
Conclusions
Prostate cancer support groups represent a promising setting to implement interventions promoting physical activity among survivors of prostate cancer. Interventions that address the individual and group-level barriers to engagement in physical activity, leverage possible individual- and group-level facilitators of physical activity, and are responsive to the community-presented considerations for intervention content and delivery may be especially effective in promoting physical activity among survivors in prostate cancer support group settings.
Keywords: Cancer, Physical activityPhysical activity is associated with reduced mortality risk and improved quality of life among cancer survivors. However, many prostate cancer survivors do not meet minimum physical activity recommendations. This research aimed to understand prostate cancer support group member reported perspectives and considerations for implementing a physical activity intervention in a cancer support group setting.
Methods
Researchers conducted four semi-structured focus groups with prostate cancer support group members in western NY and central and eastern NC. Focus groups were recorded, transcribed verbatim, and qualitatively coded independently by at least two research team members using template analysis. The finalized list of codes were reviewed collectively by the research team and organized into themes and subthemes through consensus. Member checking was performed with study participants to ensure credible findings.
Results
Participants were 25 members at various points in the cancer care continuum representing three different prostate cancer support groups. Participant responses led to the identification of themes including individual- and group-level barriers to physical activity (e.g., lack of personal motivation and insufficient space for the group to engage in physical activity), individual and group-level facilitators to physical activity (e.g., tracking personal progress and existing support group members willing to champion the intervention in the group), leverageable support group resources to promote physical activity (e.g., strong sense of community and social support), recommendations for intervention content (e.g., suggestions about specific types of physical activity to promote), and considerations for intervention delivery (e.g., perspectives surrounding the characteristics of an appropriate interventionist).
Conclusions
Prostate cancer support groups represent a promising setting to implement interventions promoting physical activity among survivors of prostate cancer. Interventions that address the individual and group-level barriers to engagement in physical activity, leverage possible individual- and group-level facilitators of physical activity, and are responsive to the community-presented considerations for intervention content and delivery may be especially effective in promoting physical activity among survivors in prostate cancer support group settings.
Authors:
Author - Nathaniel Woodard, PhD, MPH, University at Buffalo
Co-Author - Nathalie Lopez, University at Buffalo
Co-Author - Tara-Ann Perreault, MPH, University at Buffalo
Testing the Interdependence of Perceived Threat and Self-reported Diet Quality between Prostate Cancer Survivors and Their Partners
Poster Number: B30Time: 11:00 AM - 11:50 AM
Topics: Cancer, Diet, Nutrition, and Eating Disorders
Background: A healthy diet leads to improved outcomes for prostate cancer (PCa) survivors. Survivors’ diets are affected by their perceived health threat from PCa. Additionally, survivors and their partners (e.g., spouses) affect each other’s perceived threat and diets. However, little is known about how these mutual effects evolve over time, and how neighborhood context moderates these effects. This study examined 1) the longitudinal relations of perceived threat and diets within and between PCa survivors and partners and 2) the moderating effects of neighborhood socioeconomic context.
Methods: This study analyzed the secondary data from the control group of a psychosocial intervention for PCa survivors and partners. Data were collected at four timepoints: baseline (T1), 4 months (T2), 8 months (T3), and 12 months after baseline (T4). Perceived threat and diet were measured via self-reported surveys. Neighborhood context was assessed as the Area Deprivation Index (ADI), which was measured by 19 socioeconomic indicators.
Structural Equation Modeling was used to examine main and interaction effect models; the Actor-Partner Interdependence Model (a dyadic analysis model) was applied to build these models. Main effect models examined longitudinal relationships of perceived threat and diet within and between survivors and partners across consecutive timepoints (T1-T2, T2-T3, T3-T4); Interaction effect models examined the moderating effects of ADI.
Results: Mutual effects were observed. For survivors, greater perceived threat at T2 and T3 predicted greater partners’ threat at T3 (p=.011) and T4 (p=.029). Similarly, healthier survivor diets at T1 and T3 predicted healthier partner diets at T2 (p=.024) and T4 (p=.039). In contrast, greater partners’ threat and healthier partner diets at T2 predicted greater survivor threat and healthier survivor diets at T3 (ps<.01).
Neighborhood context moderated these effects. In high ADI areas, between T3 and T4, survivors’ threat more strongly predicted partners’ threat (p=.003); conversely, the effect of partners’ diets on survivors’ diets was weaker (p=.048).
Conclusions: PCa survivors and partners can improve each other's perceived threat and diets over time; these mutual effects varied in highly deprived neighborhoods. To optimally improve PCa survivors’ diets and health, their perceived PCa threat, their partners’ perceived threat and diets, and neighborhood context should be considered.
Keywords: Diet, Cognitive factorsMethods: This study analyzed the secondary data from the control group of a psychosocial intervention for PCa survivors and partners. Data were collected at four timepoints: baseline (T1), 4 months (T2), 8 months (T3), and 12 months after baseline (T4). Perceived threat and diet were measured via self-reported surveys. Neighborhood context was assessed as the Area Deprivation Index (ADI), which was measured by 19 socioeconomic indicators.
Structural Equation Modeling was used to examine main and interaction effect models; the Actor-Partner Interdependence Model (a dyadic analysis model) was applied to build these models. Main effect models examined longitudinal relationships of perceived threat and diet within and between survivors and partners across consecutive timepoints (T1-T2, T2-T3, T3-T4); Interaction effect models examined the moderating effects of ADI.
Results: Mutual effects were observed. For survivors, greater perceived threat at T2 and T3 predicted greater partners’ threat at T3 (p=.011) and T4 (p=.029). Similarly, healthier survivor diets at T1 and T3 predicted healthier partner diets at T2 (p=.024) and T4 (p=.039). In contrast, greater partners’ threat and healthier partner diets at T2 predicted greater survivor threat and healthier survivor diets at T3 (ps<.01).
Neighborhood context moderated these effects. In high ADI areas, between T3 and T4, survivors’ threat more strongly predicted partners’ threat (p=.003); conversely, the effect of partners’ diets on survivors’ diets was weaker (p=.048).
Conclusions: PCa survivors and partners can improve each other's perceived threat and diets over time; these mutual effects varied in highly deprived neighborhoods. To optimally improve PCa survivors’ diets and health, their perceived PCa threat, their partners’ perceived threat and diets, and neighborhood context should be considered.
Authors:
Presenter - Jingle Xu, MSN, MHS, University of North Carolina at Chapel Hill - School of Nursing
Co-Author - Baiming Zou, PhD, Department of Biostatistics, University of North Carolina at Chapel Hill
Co-Author - Lixin Song, PhD, RN, FAAN, UTHSCSA
Co-Author - Jennifer Leeman, DrPH, University of North Carolina at Chapel Hill
Co-Author - Hung-Jui Tan, MD, MSHPM, School of Medicine, Department of Urology, University of North Carolina at Chapel Hill
Co-Author - Rachel Hirschey, PhD, The University of North Carolina, Chapel Hill
Analysis of the NHLBI Behavioral and Social Science Clinical Trial Portfolio from FY2012 to FY2024
Poster Number: B31Time: 11:00 AM - 11:50 AM
Topics: Cardiovascular Disease
Background: The National Heart, Lung, and Blood Institute (NHLBI) has a pivotal role in advancing behavioral and social science (BSS) clinical research. This portfolio analysis characterized the number of awarded NHLBI BSS clinical trials (CT), types of grant mechanisms, early-stage investigator (ESI) status, and scientific topic areas during the fiscal years (FY) 2012 through 2024. Additionally, we compared mechanistic vs. non-mechanistic BSS CTs and publication productivity.
Methods: The analysis included NHLBI extramural CT Type 1 (new) and Type 2 (renewal) awards. CT status was identified via an NIH system CT flag. The Research, Condition, and Disease Categorization (RCDC) system was used to identify the BSS research portfolio as well as to categorize scientific areas within the portfolio.
Results: NHLBI supported a total of 650 BSS CT awards from FY 2012-2024 (range 12 to 75 per year; 35% of NHLBI CT portfolio). Thirty-five percent of R01 BSS CTs were awarded to ESIs. Of the RCDC categories of interest to the NHLBI mission, the most prevalent category for BSS CTs was Prevention (69%), followed by Nutrition (27%), Obesity, Physical Activity, and Social Determinants of Health (24% each). Major health conditions identified within the portfolio included cardiovascular diseases, weight loss, chronic diseases, heart failure, sleep apnea, and asthma. The number of awarded BSS CT applications revealed a shift in predominant grant mechanisms, primarily as a result of a downturn in Rs from 60% of the portfolio during 2012-2016 to 41% from 2017-2024. Further, a majority (79%) of 2017-2024 awards were non-mechanistic CT awards. Awarded BSS CTs grants yielded ~9 publications (median of 4) per award, and a mean relative citation ratio of 2.37.
Summary: NHLBI BSS CT awards are instrumental for supporting advances in BSS research. This analysis provides an overview of the scientific landscape for researchers to examine the science of behavior change strategies needed to promote heart, lung, blood, and sleep health.
Keywords: Cardiovascular disease, Research methodsMethods: The analysis included NHLBI extramural CT Type 1 (new) and Type 2 (renewal) awards. CT status was identified via an NIH system CT flag. The Research, Condition, and Disease Categorization (RCDC) system was used to identify the BSS research portfolio as well as to categorize scientific areas within the portfolio.
Results: NHLBI supported a total of 650 BSS CT awards from FY 2012-2024 (range 12 to 75 per year; 35% of NHLBI CT portfolio). Thirty-five percent of R01 BSS CTs were awarded to ESIs. Of the RCDC categories of interest to the NHLBI mission, the most prevalent category for BSS CTs was Prevention (69%), followed by Nutrition (27%), Obesity, Physical Activity, and Social Determinants of Health (24% each). Major health conditions identified within the portfolio included cardiovascular diseases, weight loss, chronic diseases, heart failure, sleep apnea, and asthma. The number of awarded BSS CT applications revealed a shift in predominant grant mechanisms, primarily as a result of a downturn in Rs from 60% of the portfolio during 2012-2016 to 41% from 2017-2024. Further, a majority (79%) of 2017-2024 awards were non-mechanistic CT awards. Awarded BSS CTs grants yielded ~9 publications (median of 4) per award, and a mean relative citation ratio of 2.37.
Summary: NHLBI BSS CT awards are instrumental for supporting advances in BSS research. This analysis provides an overview of the scientific landscape for researchers to examine the science of behavior change strategies needed to promote heart, lung, blood, and sleep health.
Authors:
Author - , PhD, National Institutes of Health; National Heart, Lung, and Blood Institute
Co-Author - , MS, National Institutes of Health; National Heart, Lung, and Blood Institute
Co-Author - Rebecca Campo, National Institutes of Health; National Heart, Lung, and Blood Institute
Co-Author - Charlotte Pratt, National Institutes of Health
Associations Between Sleep Health and Marijuana Susceptibility in Adolescents with Congenital Heart Disease
Poster Number: B32Time: 11:00 AM - 11:50 AM
Topics: Cardiovascular Disease, Tobacco Control and Nicotine-Related Behavior
Poor sleep health and marijuana use have been linked to cardiovascular complications. No research has explored the relationship between these health risk behaviors among cardiovascular at-risk adolescents with congenital heart disease (CHD).
This study aims to 1) determine the association between sleep health (i.e., sleep quality/hygiene) and susceptibility to future or continued marijuana use and 2) identify unique associations between sleep health and marijuana susceptibility adjusting for sociodemographic/clinical characteristics.
Adolescents with CHD (N=98) completed self-report measures of sleep quality (Pittsburgh Sleep Quality Index), sleep hygiene (Adolescent Sleep Health Scale-Revised), and susceptibility to future or continued marijuana use. Sociodemographic (age, gender, estimated neighborhood income)/clinical (CHD severity, perceived stress [Perceived Stress Scale-10]) characteristics were obtained through self-report measures or medical record review. Logistic regression analyses examined the relationship between sleep health and marijuana susceptibility.
Susceptibility to marijuana was common (40.2%). Participants reporting better sleep hygiene had decreased odds of marijuana susceptibility (OR=0.35, 95% CI [0.16, 0.75], p=.007). Similarly, poorer sleep quality was associated with increased odds of marijuana susceptibility (OR=1.21, 95% CI [1.05, 1.40], p=.011). These associations remained after adjusting for sociodemographic characteristics and CHD severity (sleep hygiene: OR=.40, 95% CI [0.17, 0.96], p=.041; sleep quality: OR=1.22, 95% CI [1.03, 1.44], p=.021). However, when perceived stress was added to the models, sleep health was no longer significantly related to marijuana susceptibility (sleep hygiene: OR=1.08, 95% CI [0.37, 3.15], p=.889; sleep quality: OR=1.07, 95% CI [0.89, 1.29], p=.444). Rather, greater perceived stress was associated with increased odds of susceptibility to marijuana use (sleep hygiene model: OR=1.14, 95% CI [1.05, 1.25], p=.002; sleep quality model: OR=1.14, 95% CI [1.05, 1.24], p=.001).
Adolescents with CHD that have poor sleep health demonstrate elevated odds of susceptibility to marijuana, with perceived stress potentially playing a role in this association. Provided that these health risks may co-occur, cardiovascular risk reduction interventions for this population may benefit from targeting both poor sleep and marijuana susceptibility, which is prevalent, and including stress management components.
Keywords: Adolescents, Cardiovascular diseaseThis study aims to 1) determine the association between sleep health (i.e., sleep quality/hygiene) and susceptibility to future or continued marijuana use and 2) identify unique associations between sleep health and marijuana susceptibility adjusting for sociodemographic/clinical characteristics.
Adolescents with CHD (N=98) completed self-report measures of sleep quality (Pittsburgh Sleep Quality Index), sleep hygiene (Adolescent Sleep Health Scale-Revised), and susceptibility to future or continued marijuana use. Sociodemographic (age, gender, estimated neighborhood income)/clinical (CHD severity, perceived stress [Perceived Stress Scale-10]) characteristics were obtained through self-report measures or medical record review. Logistic regression analyses examined the relationship between sleep health and marijuana susceptibility.
Susceptibility to marijuana was common (40.2%). Participants reporting better sleep hygiene had decreased odds of marijuana susceptibility (OR=0.35, 95% CI [0.16, 0.75], p=.007). Similarly, poorer sleep quality was associated with increased odds of marijuana susceptibility (OR=1.21, 95% CI [1.05, 1.40], p=.011). These associations remained after adjusting for sociodemographic characteristics and CHD severity (sleep hygiene: OR=.40, 95% CI [0.17, 0.96], p=.041; sleep quality: OR=1.22, 95% CI [1.03, 1.44], p=.021). However, when perceived stress was added to the models, sleep health was no longer significantly related to marijuana susceptibility (sleep hygiene: OR=1.08, 95% CI [0.37, 3.15], p=.889; sleep quality: OR=1.07, 95% CI [0.89, 1.29], p=.444). Rather, greater perceived stress was associated with increased odds of susceptibility to marijuana use (sleep hygiene model: OR=1.14, 95% CI [1.05, 1.25], p=.002; sleep quality model: OR=1.14, 95% CI [1.05, 1.24], p=.001).
Adolescents with CHD that have poor sleep health demonstrate elevated odds of susceptibility to marijuana, with perceived stress potentially playing a role in this association. Provided that these health risks may co-occur, cardiovascular risk reduction interventions for this population may benefit from targeting both poor sleep and marijuana susceptibility, which is prevalent, and including stress management components.
Authors:
Author - Emma Jensen, BA, Nationwide Children's Hospital
Co-Author - Jamie Jackson, Nationwide Children's Hospital
Co-Author - Amy Ferketich, OSU School of Public Health
Co-Author - Joseph Rausch, PhD, Nationwide Children's Hospital
Co-Author - Vidu Garg, MD, Nationwide Children's Hospital
Co-Author - Judith Groner, MD, Nationwide Children's Hospital
Co-Author - Amelia Greiner, BA, Nationwide Children's Hospital
Co-Author - Clifford Cua, MD, Nationwide Children's Hospital
Co-Author - Kristen Fox, PhD, Nationwide Children's Hospital
EFFECTS OF THE BUILT FAMILY LIFESTYLE PROGRAM ON PARENTING PRACTICES & FAMILY COMMUNICATION IN THE HOME ENVIRONMENT
Poster Number: B33Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Physical Activity
Introduction: The Be Unstoppable in Life (BUILT) Family Lifestyle Program was developed for families of children with ADHD in partnership with Chicago Park District (CPD). The BUILT curriculum provides families with health focused challenges to complete together at home. These challenges provide opportunities for parents and children to build their relationships and bring greater structure in routine to their homes.
Purpose: This analysis tested the effects of BUILT on parenting practices and family communication. Methods: A total of 44 children (M=¬8.57 yrs., SD=1.66; 46% female) and 26 parents (M=39.56 yrs., SD=7.65, 86% female) participated in the program from 08/2022 to 05/2024.
Participants were enrolled in CPD programming across 6 parks. Families participated in either an 8-week online version consisting of 21 home challenges or a 6-week in-person version with 13 challenges. Families received access to brief educational videos, activity trackers, and health coaching by UIC students and CPD staff. A subset of parents (N=15) completed the Parent and Family Adjustment Scales (PAFAS) and he Family Problem Solving Communication (FPSC) scale pre-post. PAFAS assesses changes in parenting practices and adjustment in the evaluation of parenting interventions. The parenting practices score is the composite of four subscales: consistency, coercion, positive encouragement, and parent-child relationship. The adjustment score is based on 3 subscales: parent adjustment, family relationships, and parental teamwork. The FPSC Scale assesses how effectively families deal with stressful situations by measuring how much communication is inflammatory versus supportive. Changes from baseline to posttest were assessed with paired sample t-tests and Cohen’s d effect sizes.
Results: Overall, small-moderate improvements were observed in parenting practices pre-post (Mchange=1.0, SDchange=2.78, t=1.39, p=.185, Cohen’s d = .36). This effect was stronger in the in-person implementation (Mchange=1.50, SD = 2.43, t=1.513, p=.144, Cohen’s d = .618) than the on-line implementation (Mchange=.67, SDchange=3.08, t=.649, p=.535, Cohen’s d = .216). No changes were observed in family adjustment or parent-child communication (all Cohen’s d < .10, all p-values > .50). Conclusion: BUILT in-person programming demonstrates some potential to improve parenting practices, influencing on communication and adjustment outcomes would require substantive changes to the curriculum.
Keywords: Children's health, Health behavior changePurpose: This analysis tested the effects of BUILT on parenting practices and family communication. Methods: A total of 44 children (M=¬8.57 yrs., SD=1.66; 46% female) and 26 parents (M=39.56 yrs., SD=7.65, 86% female) participated in the program from 08/2022 to 05/2024.
Participants were enrolled in CPD programming across 6 parks. Families participated in either an 8-week online version consisting of 21 home challenges or a 6-week in-person version with 13 challenges. Families received access to brief educational videos, activity trackers, and health coaching by UIC students and CPD staff. A subset of parents (N=15) completed the Parent and Family Adjustment Scales (PAFAS) and he Family Problem Solving Communication (FPSC) scale pre-post. PAFAS assesses changes in parenting practices and adjustment in the evaluation of parenting interventions. The parenting practices score is the composite of four subscales: consistency, coercion, positive encouragement, and parent-child relationship. The adjustment score is based on 3 subscales: parent adjustment, family relationships, and parental teamwork. The FPSC Scale assesses how effectively families deal with stressful situations by measuring how much communication is inflammatory versus supportive. Changes from baseline to posttest were assessed with paired sample t-tests and Cohen’s d effect sizes.
Results: Overall, small-moderate improvements were observed in parenting practices pre-post (Mchange=1.0, SDchange=2.78, t=1.39, p=.185, Cohen’s d = .36). This effect was stronger in the in-person implementation (Mchange=1.50, SD = 2.43, t=1.513, p=.144, Cohen’s d = .618) than the on-line implementation (Mchange=.67, SDchange=3.08, t=.649, p=.535, Cohen’s d = .216). No changes were observed in family adjustment or parent-child communication (all Cohen’s d < .10, all p-values > .50). Conclusion: BUILT in-person programming demonstrates some potential to improve parenting practices, influencing on communication and adjustment outcomes would require substantive changes to the curriculum.
Authors:
Author - Amanda Vukits, MS, MPH, University of Illinois Chicago
Co-Author - Timber Terrell, MS, University of Illinois Chicago
Co-Author - Yuliana Soto, PhD, University of Illinois at Chicago
Co-Author - Jared Ramer, MS, PhD, University of Illinois at Chicago
Co-Author - Jake Leese, JD, University of Illinois Chicago
Co-Author - Eduardo Bustamante, PhD, University of Illinois Chicago
Breastfeeding Reimagined: An Augmented Reality App Pilot Intervention for people using a breast pump to express breastmilk
Poster Number: B34Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Digital Health
Breastfeeding is recommended for feeding for the first 6 months of a baby’s life to maintain optimal benefits for the baby and mother. Feeding directly at the breast is not always feasible due to life events such as the mother being a student, military deployment, incarcerated, work deployment, or baby being in the neonatal intensive care unit. Breast milk expression (hand, breast pump) is necessary to maintain a healthy milk supply for people who need to be away from their baby during feeding times. The purpose of this intervention was to determine the effects of an app (tablet, augmented reality) on breast milk expression (grams, ml). This research was conducted in Los Angeles, California from October 2023-December 2024. People who were using a breast pump to express breast milk were assigned to the intervention and control groups. Study sessions happened at one of the university lactation spaces or at the participants’ home which included using a hospital grade, hands-free, wireless, electronic double breast pump. Each group had three sessions (enrollment, session 1, and session 2). The Augmenting Milk Output Realities (AMOR) app was a customized experience that consisted of personal photos (baby only, baby with participant, baby with family members) provided by the participant. For the control group, the Augmenting Milk Output Realities (AMOR) app was shown on a tablet during breast pump sessions 1 and 2. For the intervention group, the AMOR app was shown on a tablet during breast pump session 1 and on an augmented reality (AR) headset device during breast pump session 2. At the end of sessions 1 and 2, breast milk expressed in a bottle was weighed (g) on a food scale and volume (ml) was observed. The control group started at a higher baseline breastmilk expression amount compared to the intervention group. The volume and weight of breastmilk for session 1 by right and left side were consistently higher in the control group. The volume of the right side for session 2 was highest in the intervention group. The volume of the left side and weight of the right and left sides were higher in the control group. The volume and weight of the expressed breastmilk increased for both the right and left side from session 1 to session 2 for the intervention group. AR shows that it could be a promising way to maintain healthy milk supply via expressed breastmilk. More research is needed to demonstrate how AR could be effective in consecutive breast pump sessions.
Keywords: Women's health, TechnologyAuthors:
Co-Author - Poojitha Gidugu, California State University Northridge
Co-Author - Niralee Bhanushali, California State University, Northridge
Co-Author - Kacie Blackman, PhD, California State University Northridge
Identifying sources of hope and hopelessness among Black families in Chicago
Poster Number: B35Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Mental Health
Background: The existing research on Black youth mental health in Chicago has largely centered on the effects of violence exposure. While this body of work is important, it leaves less explored the broader factors that contribute to resilience and vulnerability. Hope and hopelessness are critical constructs that shape mental health trajectories, yet little is known about how Black youth and their families define and experience these states in their everyday lives.
Methods: To address this gap, the present study explores the following research question: (1) What promotes feelings of hope and hopelessness among Black youth and their parents in Chicago? Our study analyzed qualitative responses collected from 22 Black adolescents and their parents, each of whom participated in a semi-structured interview conducted via Zoom. These questions about hope and hopelessness were part of a more comprehensive interview guide designed to better understand the experiences and perspectives of Black families. Interviews were coded using Dedoose software. Thematic analysis techniques were used to identify patterns within and across youth and parent responses.
Results: Black adolescent respondents shared that their experiences of hope are grounded in immediate, tangible supports and achievements, while hopelessness is tied to macro-level crises and personal struggles. For example, some students identified disparities in education and neighborhood violence as experiences that made them feel hopeless, while others explained how their faith informed and fueled their sense of hope in the midst of difficult times. Among Black parents, hope is framed around meaning, impact, faith, and children’s resilience, while hopelessness is tied to systemic injustice and economic precarity. Black parents often spoke about finding hope in the lives of their children and in found great meaning and purpose in their roles as parents and providers.
Conclusion: Taken together, these findings highlight the importance of addressing both personal supports and systemic barriers when developing interventions that aim to cultivate hope and reduce hopelessness among Black youth and families.
Keywords: Race, AdolescentsMethods: To address this gap, the present study explores the following research question: (1) What promotes feelings of hope and hopelessness among Black youth and their parents in Chicago? Our study analyzed qualitative responses collected from 22 Black adolescents and their parents, each of whom participated in a semi-structured interview conducted via Zoom. These questions about hope and hopelessness were part of a more comprehensive interview guide designed to better understand the experiences and perspectives of Black families. Interviews were coded using Dedoose software. Thematic analysis techniques were used to identify patterns within and across youth and parent responses.
Results: Black adolescent respondents shared that their experiences of hope are grounded in immediate, tangible supports and achievements, while hopelessness is tied to macro-level crises and personal struggles. For example, some students identified disparities in education and neighborhood violence as experiences that made them feel hopeless, while others explained how their faith informed and fueled their sense of hope in the midst of difficult times. Among Black parents, hope is framed around meaning, impact, faith, and children’s resilience, while hopelessness is tied to systemic injustice and economic precarity. Black parents often spoke about finding hope in the lives of their children and in found great meaning and purpose in their roles as parents and providers.
Conclusion: Taken together, these findings highlight the importance of addressing both personal supports and systemic barriers when developing interventions that aim to cultivate hope and reduce hopelessness among Black youth and families.
Authors:
Co-Presenter - Destiny Jenkins, University of Chicago
Co-Presenter - Dayhana Joseph, University of Chicago
Co-Author - Ashley Vuletíc, MPP, University of Chicago
Co-Author - Janelle Goodwill, PhD, MSW, University of Chicago
School Readiness in Young Children with Spina Bifida
Poster Number: B36Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health
Importance: While it is well-documented that school-aged children with spina bifida (SB) are at risk for cognitive and learning challenges, limited research has examined the emergence of these difficulties in early childhood. Given the importance of early intervention, it is crucial to enhance understanding of school readiness - one of five vital signs for pediatric health that focuses on the physical, psychosocial, cognitive, and academic skills conducive to learning.
Objective: This study examined school readiness in young children (ages 3-7 years old) with SB, as well as demographic and medical correlates to guide future intervention development.
Methods/Design: As part of an ongoing study, 24 children with SB (58% female, Mage = 5.01) and their caregivers were recruited from a Midwestern hospital to complete a comprehensive school readiness assessment. Children received a performance-based assessment of academic, cognitive, and fine motor skills, whereas caregivers completed online surveys assessing social, emotional, and behavioral concerns. Frequency counts were calculated for the number of children with clinically elevated school readiness concerns. Spearman correlations and independent samples t-tests were used to examine associations between school readiness and demographic and medical variables.
Results: On the performance-based assessment, most children scored at least one standard deviation below the age-normed mean for fine motor dexterity (Right Hand = 75%, Left = 75%, Both = 83%). A sizeable subset of children scored below average for spatial (62%), and global (62%), verbal (36%), nonverbal (36%), cognitive domains, and foundational pre-academic skills (21%). Almost all caregivers (92%) expressed clinically elevated concerns for their child’s social, emotional, and/or behavioral functioning. Over half (56.5%) reported elevated concerns regarding their child’s adaptive and motor skills and more than 30% endorsed elevated concerns regarding physical symptoms, defiance/aggressive behavior, anxiety, mood and affect, and emotional lability. Shunt presence, postnatal repair, and lower income were all associated with reduced school readiness (p<.05).
Conclusions & Relevance to Care: Findings document difficulties across multiple school readiness domains at higher rates than the general population. Results highlight the importance of early developmental screening to provide targeted and individually tailored support to young children with SB.
Keywords: Children's health, Health outcomesObjective: This study examined school readiness in young children (ages 3-7 years old) with SB, as well as demographic and medical correlates to guide future intervention development.
Methods/Design: As part of an ongoing study, 24 children with SB (58% female, Mage = 5.01) and their caregivers were recruited from a Midwestern hospital to complete a comprehensive school readiness assessment. Children received a performance-based assessment of academic, cognitive, and fine motor skills, whereas caregivers completed online surveys assessing social, emotional, and behavioral concerns. Frequency counts were calculated for the number of children with clinically elevated school readiness concerns. Spearman correlations and independent samples t-tests were used to examine associations between school readiness and demographic and medical variables.
Results: On the performance-based assessment, most children scored at least one standard deviation below the age-normed mean for fine motor dexterity (Right Hand = 75%, Left = 75%, Both = 83%). A sizeable subset of children scored below average for spatial (62%), and global (62%), verbal (36%), nonverbal (36%), cognitive domains, and foundational pre-academic skills (21%). Almost all caregivers (92%) expressed clinically elevated concerns for their child’s social, emotional, and/or behavioral functioning. Over half (56.5%) reported elevated concerns regarding their child’s adaptive and motor skills and more than 30% endorsed elevated concerns regarding physical symptoms, defiance/aggressive behavior, anxiety, mood and affect, and emotional lability. Shunt presence, postnatal repair, and lower income were all associated with reduced school readiness (p<.05).
Conclusions & Relevance to Care: Findings document difficulties across multiple school readiness domains at higher rates than the general population. Results highlight the importance of early developmental screening to provide targeted and individually tailored support to young children with SB.
Authors:
Author - Blake Hardin, B.A., Nationwide Children's Hospital
Co-Author - Morgan Sachleben, B.S., Nationwide Children's Hospital
Co-Author - Madeline Marsh, B.S., Nationwide Children's Hospital
Co-Author - Camille Wilson, PhD, Nationwide Children's Hospital
Co-Author - Katherine Steingass, PhD, Nationwide Children's Hospital
Co-Author - Cynthia Gerhardt, PhD, Nationwide Children's Hospital
Co-Author - Hudson Taylor, PhD, Nationwide Children's Hospital
Co-Author - Adrien Winning, PhD, Nationwide Children's Hospital
Medication Adherence Following Electronic Monitoring Device Initiation: Insights to Optimize Run-In Periods in Clinical Trials
Poster Number: B37Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Cancer
Background: Electronic adherence monitoring devices (EAMDs), pill boxes or pill bottles that record date- and time-stamps of device actuations are a preferred and common strategy for assessing medication adherence. Historically, experts have hypothesized that adherence increases as a result of EAMD use and recommended that adherence-promotion trials using EAMDs include a run-in period to washout reactivity to EAMD implementation. Data on the presence and duration of reactivity to EAMD use, however, is mixed and largely derived from adults with HIV, leaving minimal guidance for researchers working with other populations. The purpose of this study is to evaluate patterns of adherence in the first four weeks of EAMD use in a sample of adolescents and young adults (AYAs) with cancer to provide insights to inform run-in selection.
Methods: This study includes a secondary analysis of data collected as part of a pilot feasibility trial of an adherence-promotion intervention for AYAs with cancer. During the 4-week run-in period, AYAs were asked to use an eCAPTM EAMD for medication administration. Weekly adherence was defined as the percentage of prescribed doses taken (range = 0-100%) and summarized as week-specific means. Two mixed-effects regression models with a random intercept for participant and robust standard errors clustered by participant were fit to evaluate changes in adherence over time. Time was modeled as linear in the first model (Weeks 1–4 coded 1–4) and categorical in the second (Weeks 2–4 contrasted with Week 1).
Results: The dataset included 166 weeks of data from 46 AYAs. Weekly adherence was stable across Weeks 1-3 (M = 88%, 87%, 88%) and lower in Week 4 (73%). Variability was stable across Weeks 1-3 (SD = 20%, 22%, 21%), but higher in Week 4 (SD = 33%). In the first mixed-effects model, time (weeks) was associated with a significant decrease in adherence (b = 3.47, 95% CI: −6.39, −0.54; p = .02). In the second mixed-effects model, Weeks 2-3 did not differ significantly from Week 1, but Week 4 was 13% lower than Week 1 (95% CI: -23.93, -2.57, p = .02).
Conclusions: Data suggest that AYAs with cancer demonstrate reactivity to EAMDs for at least 3 weeks, highlighting the importance of including run-in periods in adherence-promotion trials. While attenuation began to emerge at Week 4, data collected over a longer study period and with a larger sample are needed to determine the optimal run-in period for AYAs with cancer.
Keywords: Self Management, AdolescentsMethods: This study includes a secondary analysis of data collected as part of a pilot feasibility trial of an adherence-promotion intervention for AYAs with cancer. During the 4-week run-in period, AYAs were asked to use an eCAPTM EAMD for medication administration. Weekly adherence was defined as the percentage of prescribed doses taken (range = 0-100%) and summarized as week-specific means. Two mixed-effects regression models with a random intercept for participant and robust standard errors clustered by participant were fit to evaluate changes in adherence over time. Time was modeled as linear in the first model (Weeks 1–4 coded 1–4) and categorical in the second (Weeks 2–4 contrasted with Week 1).
Results: The dataset included 166 weeks of data from 46 AYAs. Weekly adherence was stable across Weeks 1-3 (M = 88%, 87%, 88%) and lower in Week 4 (73%). Variability was stable across Weeks 1-3 (SD = 20%, 22%, 21%), but higher in Week 4 (SD = 33%). In the first mixed-effects model, time (weeks) was associated with a significant decrease in adherence (b = 3.47, 95% CI: −6.39, −0.54; p = .02). In the second mixed-effects model, Weeks 2-3 did not differ significantly from Week 1, but Week 4 was 13% lower than Week 1 (95% CI: -23.93, -2.57, p = .02).
Conclusions: Data suggest that AYAs with cancer demonstrate reactivity to EAMDs for at least 3 weeks, highlighting the importance of including run-in periods in adherence-promotion trials. While attenuation began to emerge at Week 4, data collected over a longer study period and with a larger sample are needed to determine the optimal run-in period for AYAs with cancer.
Authors:
Co-Author - Constance Mara, Cincinnati Children's Hospital Medical Center
Co-Author - Tyler Ketterl, MD, MS, Seattle Children's Hospital
Co-Author - Rachel Tillery Webster, PhD, St Jude Children's Research Hospital
Co-Author - Robin Norris, MD, MS, MPH, Cincinnati Children's Hospital Medical Center
Contributing Factors to Diabetes-Specific Family Conflict in Caregivers of Youth with Type 1 Diabetes
Poster Number: B38Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Diabetes
Objective: Managing type 1 diabetes (T1D) requires a demanding daily routine, including glucose monitoring, insulin administration, carbohydrate counting, and physical activity. Although consistent engagement in these tasks is essential for optimal glycemic control, research shows that youth with T1D and their caregivers often experience high levels of stress and conflict. Diabetes-specific family conflict has been linked to reduced parental involvement in T1D care and suboptimal glycemic outcomes. While interventions targeting family conflict exist, few studies have explored individual and family-level factors contributing to diabetes-specific family conflict, which could tailor interventions further. This study examined whether child-level characteristics (e.g., age, sex), diabetes-specific variables (e.g., T1D duration, HbA1c, time in range), and caregiver psychosocial factors (e.g., diabetes distress, anxiety) are associated with diabetes-specific family conflict.
Methods: Caregivers of youth (aged 8-18 years) with T1D completed the Parent Problem Areas in Diabetes (PAID-PR) scale to measure diabetes distress, the Diabetes Family Conflict Scale - Revised (DFCS-R) to assess diabetes-specific family conflict, and the State-Trait Anxiety Inventory to measure anxiety via an online measure. Child-level and diabetes-specific data were extracted from medical records. Youth provided 14 days of glucose data from their personal continuous glucose monitor (CGM).
Results: The sample included 123 caregivers, primarily mothers (89%), with a mean age of 41.76±6.52 years. Youth were 49% female, with a mean age of 13.4±2.6 years, a mean T1D duration of 3.97±3.14 years, and a mean HbA1c of 7.8±1.4%. CGM data showed that youth spent 26% of the time in the target glucose range (70–180 mg/dL), 2% in the hypoglycemic range (<70 mg/dL), and 72% in the hyperglycemic range (>180 mg/dL). In multivariable regression analysis, less time in range (β=-0.29, p<.01) and higher parent diabetes distress (β=0.47, p<.01) significantly predicted higher levels of parent-reported diabetes-specific family conflict (F(6,108)=13.68, p<.01, R²=0.43).
Conclusions: These findings suggest that interventions aimed at reducing family conflict should consider strategies that support caregivers' emotional health and promote improved glycemic outcomes in youth. Tailoring interventions to address these interrelated factors may enhance family functioning and diabetes management in pediatric T1D care.
Keywords: Family, DiabetesMethods: Caregivers of youth (aged 8-18 years) with T1D completed the Parent Problem Areas in Diabetes (PAID-PR) scale to measure diabetes distress, the Diabetes Family Conflict Scale - Revised (DFCS-R) to assess diabetes-specific family conflict, and the State-Trait Anxiety Inventory to measure anxiety via an online measure. Child-level and diabetes-specific data were extracted from medical records. Youth provided 14 days of glucose data from their personal continuous glucose monitor (CGM).
Results: The sample included 123 caregivers, primarily mothers (89%), with a mean age of 41.76±6.52 years. Youth were 49% female, with a mean age of 13.4±2.6 years, a mean T1D duration of 3.97±3.14 years, and a mean HbA1c of 7.8±1.4%. CGM data showed that youth spent 26% of the time in the target glucose range (70–180 mg/dL), 2% in the hypoglycemic range (<70 mg/dL), and 72% in the hyperglycemic range (>180 mg/dL). In multivariable regression analysis, less time in range (β=-0.29, p<.01) and higher parent diabetes distress (β=0.47, p<.01) significantly predicted higher levels of parent-reported diabetes-specific family conflict (F(6,108)=13.68, p<.01, R²=0.43).
Conclusions: These findings suggest that interventions aimed at reducing family conflict should consider strategies that support caregivers' emotional health and promote improved glycemic outcomes in youth. Tailoring interventions to address these interrelated factors may enhance family functioning and diabetes management in pediatric T1D care.
Authors:
Author - Alexandra Monzon, PhD, Nemours Children's Health
Author - Susana Patton, PhD, ABPP, CDCES, Nemours Children's Health
The Co-developing SHELTER (Safe, Healthy Environments and Local Transformation for Equity and Resilience) Project
Poster Number: B40Time: 11:00 AM - 11:50 AM
Topics: Child and Family Health, Community Engagement
In June 2025, 105,373 people were experiencing homelessness in New York City (NYC) shelters. Children make up ~1/3 of the shelter population; nearly half are aged 0-5. Children under age five (under-5s) experiencing homelessness are vulnerable, as the first five years of life constitute a vital period for child development and lifelong wellbeing. Moreover, these under-5s face an elevated risk of adverse childhood experiences, chronic health conditions, and repeated episodes of homelessness. Data concerning these under-5s in the United States is scarce, leading to notable evidence gaps and challenges in accurately assessing their needs. In high-income countries, few studies have focused exclusively on this marginalized group or used mixed methods with peer-led, inclusive research involving people with lived experience to examine pertinent public health issues.
Co-developing SHELTER (Safe, Healthy Environments and Local Transformation for Equity and Resilience), employing community-based participatory research, was co-developed with families who have under-5s and lived experience of homelessness in NYC shelters. The aim is to determine what barriers exist in the physical and social environments to optimize health and wellbeing among under-5s living in NYC shelters. This project offers a key chance to monitor children who have left shelters and are often missed by services. Our study, using a sequential mixed-methods design, addresses evidence gaps by conducting a community health needs assessment. For the quantitative survey, we are collecting data on socio-demographics, housing history, physical and social environments, child health, and parental mental health. Preliminary quantitative data guided the structure of our qualitative, semi-structured interviews. Participant recruitment commenced in May 2025, and all data collection concluded in November 2025.
The overall objective is to enhance data (quality and quantity) for this vulnerable population, to improve their quality of care. Ultimately, we will share the results and co-develop a translational intervention of their choice (e.g., policy recommendations, information toolkits). The intervention outcome will be to target and mitigate one or more of the identified barriers in this formative mixed-methods research. The multiphase optimization strategy (MOST) Preparation Phase will systematically guide the co-development of intervention components, aiming to improve implementability from the outset.
Keywords: Participatory research, Community interventionCo-developing SHELTER (Safe, Healthy Environments and Local Transformation for Equity and Resilience), employing community-based participatory research, was co-developed with families who have under-5s and lived experience of homelessness in NYC shelters. The aim is to determine what barriers exist in the physical and social environments to optimize health and wellbeing among under-5s living in NYC shelters. This project offers a key chance to monitor children who have left shelters and are often missed by services. Our study, using a sequential mixed-methods design, addresses evidence gaps by conducting a community health needs assessment. For the quantitative survey, we are collecting data on socio-demographics, housing history, physical and social environments, child health, and parental mental health. Preliminary quantitative data guided the structure of our qualitative, semi-structured interviews. Participant recruitment commenced in May 2025, and all data collection concluded in November 2025.
The overall objective is to enhance data (quality and quantity) for this vulnerable population, to improve their quality of care. Ultimately, we will share the results and co-develop a translational intervention of their choice (e.g., policy recommendations, information toolkits). The intervention outcome will be to target and mitigate one or more of the identified barriers in this formative mixed-methods research. The multiphase optimization strategy (MOST) Preparation Phase will systematically guide the co-development of intervention components, aiming to improve implementability from the outset.
Authors:
Presenter - Diana Margot Rosenthal, PhD, MSc, MPA, New York University
Co-Author - Kate Guastaferro, PhD, MPH, New York University
Co-Author - Jasia Kubik, BA, New York University
Co-Author - Melody Goodman, PhD, MS, New York University
Evaluating the Taste of Culture In-Service Training: Community Educators’ readiness to address Health Literacy, Nutrition Label use, Dietary Behavior, and Hypertension Risk Reduction
Poster Number: B41Time: 11:00 AM - 11:50 AM
Topics: Community Engagement, Cardiovascular Disease
Background: Dietary intake and lifestyle behaviors are key modifiable risk factors related health outcomes including hypertension. Hypertension affects 45% of U.S adults, with Black adults (54%), and adults 60 years and older (75%) experiencing higher rates. Most U.S. adults consume 3400 mg of sodium each day despite recommendations to limit sodium intake to less than 2300 mg per day. Dietary changes may be challenging to implement due to cultural and social contexts. Training community educators to deliver tailored classes can reduce diet-related disparities and build community belonging. Method: Community educators (N=15) completed a 2-day, 12-hour, in-person training on how to deliver a 4-lesson curriculum, Taste of Cultures (ToC). ToC teaches kitchen skills, how to cook with herbs and spices, and uses recipes (at or below 10% daily value for sodium) from featured cultures (e.g. African, Caribbean). Community educators learned how to implement the program, collect blood pressure, Veggie Meter scores and administer the Newest Vital Sign (NVS) health literacy assessment tool. A post training evaluation assessed community educators’ confidence, preparedness, and acceptability of the training as well as feedback on if they could feasibly administer the NVS during ToC classes. Outcomes were assessed using a 5-point Likert scale (e.g. 5=high preparedness) and four open-ended questions, (e.g., Why do participants avoid blood pressure screening at classes?). Responses were analyzed for perceived readiness to implement ToC and challenges with health screenings. The study was IRB reviewed as exempt.
Results: Educators ages ranged from 33 to 58 years (M = 43.64 years), were mostly female (86.7%), White (80%), and reported high confidence to deliver ToC. Confidence was high for teaching about Nutrition Facts label (M = 4.67, SD = 1.05), cooking with herbs/spices (M = 4.47, SD = 1.06) and blood pressure control (M = 4.36, SD = 1.15). Confidence was lowest for administering the NVS (M = 3.40, SD = 1.18). Educators thought community learners would complete the blood pressure screenings (M = 3.73, SD = 0.80) and would reduce sodium intake after ToC (M = 3.87, SD = 0.35) Training was effective at increasing knowledge of curriculum delivery (M = 4.80, SD = 0.41). Conclusion: The training improved community educator’s confidence and preparedness to deliver ToC to community learners; future work should strengthen the health literacy tool training to enhance implementation
Keywords: Blood pressure, Community interventionResults: Educators ages ranged from 33 to 58 years (M = 43.64 years), were mostly female (86.7%), White (80%), and reported high confidence to deliver ToC. Confidence was high for teaching about Nutrition Facts label (M = 4.67, SD = 1.05), cooking with herbs/spices (M = 4.47, SD = 1.06) and blood pressure control (M = 4.36, SD = 1.15). Confidence was lowest for administering the NVS (M = 3.40, SD = 1.18). Educators thought community learners would complete the blood pressure screenings (M = 3.73, SD = 0.80) and would reduce sodium intake after ToC (M = 3.87, SD = 0.35) Training was effective at increasing knowledge of curriculum delivery (M = 4.80, SD = 0.41). Conclusion: The training improved community educator’s confidence and preparedness to deliver ToC to community learners; future work should strengthen the health literacy tool training to enhance implementation
Authors:
Author - Isabella Alobele, Msc, University of Florida
Co-Author - Lori Johnson, University of Florida
Co-Author - Hillary Macmicheal, University of Florida
Co-Author - Jeanette Andrade, Ph.D., R.D.N., L.D.N., F.A.N.D., University of Florida
Co-Author - Xiaoya Zhang, Ph.D, University of Florida
Co-Author - Melissa Vilaro, MPH, PhD, University of Florida
Insights from the SHARE Research Program: Approaches, Success and Lessons Learned in Recruitment and Retention of Emerging Adults with HIV in Florida
Poster Number: B42Time: 11:00 AM - 11:50 AM
Topics: Community Engagement, HIV/AIDS
The SHARE Program is a NIH-funded program grant focused on the self-management of HIV and alcohol use among emerging adults with HIV in Florida (age 18-29). The program consists of three research support cores and three research projects. Individuals from the target population who had at least 1 alcoholic drink within 30 days of screening were eligible to enroll in either of the, then, two active studies (i.e., Define or Engage). Define was a longitudinal cohort study that aimed to identify developmentally and culturally relevant intervention targets to improve self-management of HIV and alcohol use among our target population using survey methodology at baseline and 9-month follow-up. Engage was a one-month study aimed at engaging participants in wearing a wrist biosensor to detect alcohol use and report alcohol use through daily ecological momentary assessments. Concurrently, a micro-randomized trial was conducted aimed at developing an mHealth app for self-management of alcohol use. Planned recruitment targets for Define (n=175) and Engage (n=160) were addressed utilizing both clinic and community partnerships and digital recruitment efforts state-wide, with a total of n=105 and n=66 participants recruited and consented into Define and Engage, respectively. Retention was relatively poor and varied considerably between projects, with Define having n=38 (21.7%) participants complete study activities and Engage having n=22 (33%). Our online recruitment efforts (n=133, 78%) were more effective than our clinic partnerships. For Define, n=25 (65.7%) were recruited via online efforts and for Engage, n=18 (81.8%). We observed regional differences in engagement across both studies, with n=48 (31%) of enrolled participants residing in the Central East and n=46 (29%) in the Southeast regions of Florida. Further, n=18 (30%) of participants who completed study activities resided in the Central East and n=19 (31%) in the Southeast regions. We recruited a racially and ethnically diverse sample. Of those who completed study activities, n=19 (31%) were black males, n=17 (28%) were white males, and n=22 (36%) were Hispanic. Additional details will be provided in the final poster presentation, including highlights of successes and lessons learned. Overall, valuable insights have been gleaned from the recruitment and retention data that informed the SHARE Program’s ongoing clinical trial, Sustain.
Keywords: HIV, AlcoholAuthors:
Author - Sara Green, MSW, Florida State University
Co-Author - Kayla Hicks, MPH, Florida State University
Co-Author - Karen MacDonell, PhD, Florida State University
Co-Author - Sharry Solis, MPH, Florida State University
Co-Author - Jonathan Morgan, Florida State University
Co-Author - Sylvie Naar, PhD, FSBM, Florida State University College of Medicine
Co-Author - Scott Pickett, PhD, Florida State University
College Students’ Responses to HPV Vaccine Educational Materials: A Focus Group Study
Poster Number: B43Time: 11:00 AM - 11:50 AM
Topics: Community Engagement, Decision Making
Background: Human papillomavirus (HPV) is the most common sexually transmitted infection and
plays a significant role in numerous cancers as well as non-cancerous genital warts and genital dysplasia. HPV
vaccination rates remain low among college-aged populations despite the vaccine’s effectiveness in preventing
these cancers. In order to inform future educational interventions targeting this demographic, this study
explored student impressions of various HPV vaccine educational materials, which will allow for developing
evidence-based, appealing messaging formats for future dissemination and evaluation.
Method: Virtual focus groups were conducted with undergraduate students at a Northeastern U.S. university.
Each session began with open-ended questions on HPV and vaccination awareness, followed by a
presentation of educational materials including Instagram reels, infographic carousels, posters, QR-code flyers,
and vaccine checklists. Participants responded to session polls and discussed each material’s clarity, visual
appeal, delivery method, and perceived effectiveness in promoting HPV vaccination. Sessions were recorded,
transcribed, and thematically analyzed using a structured codebook.
Results: Thematic analysis of focus group transcripts revealed three overarching themes including HPV and
Vaccine Associations, Effective and Ineffective Messaging, and Intervention Design Preferences. Within these
themes, subthemes included awareness of HPV as a sexually transmitted infection and cancer-causing virus;
perceptions of message clarity, visual appeal, modality, and specificity; and preferences for delivery strategies
such as peer-led outreach, social media dissemination, incentives, and integration into campus life. The
themes reflect a range of considerations that influence how students interpret and engage with HPV vaccine
information.
Discussion: Student feedback highlights the need for culturally tailored peer-led digital outreach to improve
HPV vaccine awareness and uptake. Interventions should prioritize concise, visually appealing messaging that
emphasizes cancer prevention and leverages social media and peer influence. These findings will guide the
development of targeted health communication strategies for diverse college populations.
Keywords: STDs, Preventionplays a significant role in numerous cancers as well as non-cancerous genital warts and genital dysplasia. HPV
vaccination rates remain low among college-aged populations despite the vaccine’s effectiveness in preventing
these cancers. In order to inform future educational interventions targeting this demographic, this study
explored student impressions of various HPV vaccine educational materials, which will allow for developing
evidence-based, appealing messaging formats for future dissemination and evaluation.
Method: Virtual focus groups were conducted with undergraduate students at a Northeastern U.S. university.
Each session began with open-ended questions on HPV and vaccination awareness, followed by a
presentation of educational materials including Instagram reels, infographic carousels, posters, QR-code flyers,
and vaccine checklists. Participants responded to session polls and discussed each material’s clarity, visual
appeal, delivery method, and perceived effectiveness in promoting HPV vaccination. Sessions were recorded,
transcribed, and thematically analyzed using a structured codebook.
Results: Thematic analysis of focus group transcripts revealed three overarching themes including HPV and
Vaccine Associations, Effective and Ineffective Messaging, and Intervention Design Preferences. Within these
themes, subthemes included awareness of HPV as a sexually transmitted infection and cancer-causing virus;
perceptions of message clarity, visual appeal, modality, and specificity; and preferences for delivery strategies
such as peer-led outreach, social media dissemination, incentives, and integration into campus life. The
themes reflect a range of considerations that influence how students interpret and engage with HPV vaccine
information.
Discussion: Student feedback highlights the need for culturally tailored peer-led digital outreach to improve
HPV vaccine awareness and uptake. Interventions should prioritize concise, visually appealing messaging that
emphasizes cancer prevention and leverages social media and peer influence. These findings will guide the
development of targeted health communication strategies for diverse college populations.
Authors:
Presenter - Rose Martillotti, MA, Stony Brook University
Co-Author - K. Olivia Mock, MA, Stony Brook University
Co-Author - Sana Malik, DrPH, MSW, MPH, Stony Brook University
Co-Author - Giuseppina Caravella, MPH, MS, CHES, Stony Brook Medicine
Co-Author - Annalea Trask, Stony Brook Medicine
Co-Author - Devika Patel, Stony Brook University
Co-Author - Melanie M. Kim, Stony Brook Medicine
Co-Author - Afshan Rubab, Stony Brook University
Co-Author - Kathleen Scarbrough, MD, MPH, Stony Brook Medicine
Equity-Driven Engagement with Cancer Survivors and At-Risk Communities: Best Practices and Lessons Learned
Poster Number: B44Time: 11:00 AM - 11:50 AM
Topics: Community Engagement, Cancer
Background: Cancer survivors and communities at risk continue to face inequities across the cancer control continuum. Racial and ethnic minority groups, rural residents, and socioeconomically disadvantaged populations often experience barriers such as limited access to care, transportation difficulties, cultural and language differences, and financial hardship. Effective engagement strategies are critical to addressing these disparities and advancing health equity.
Objective: This work synthesizes evidence and experiential insights to identify best practices for engaging cancer survivors and at-risk communities, with an emphasis on culturally responsive and equity- driven approaches.
Methods: A targeted review of the literature was combined with experiential knowledge from community outreach and survivorship engagement efforts. Attention was given to studies addressing biopsychosocial and economic disparities, including racial/ethnic inequities, rural and geographic barriers, and the unique challenges faced by low-income survivors.
Results: Several best practices emerged as central to effective engagement. Multidisciplinary and diverse teams integrate clinical, research, and community perspectives to ensure relevance. Community advisory boards provide survivors with a formal voice, strengthening trust and guiding priorities. Culturally sensitive materials and approaches improve accessibility and participation. Outreach activities, both in-person and online, expand reach and flexibility. Partnerships with community-based organizations and community health workers, particularly bilingual staff, bridge cultural gaps and improve navigation. Finally, peer support groups and survivor-led navigation models foster empowerment, reduce stigma, and enhance trust. Together, these strategies address barriers of mistrust, access, and socioeconomic burden while positioning survivors as partners in care.
Conclusions: Equity-driven community engagement requires authentic listening and consistent presence to build trust. Engagement itself is a form of empowerment, ensuring that every individual voice is valued, even when it comes from a single survivor. Relationships formed through this process strengthen resilience and create lasting support systems. By embedding these principles into survivorship care, programs can move beyond outreach toward true partnership, advancing equity for diverse and underserved populations
Keywords: Cancer survivorship, Health behaviorsObjective: This work synthesizes evidence and experiential insights to identify best practices for engaging cancer survivors and at-risk communities, with an emphasis on culturally responsive and equity- driven approaches.
Methods: A targeted review of the literature was combined with experiential knowledge from community outreach and survivorship engagement efforts. Attention was given to studies addressing biopsychosocial and economic disparities, including racial/ethnic inequities, rural and geographic barriers, and the unique challenges faced by low-income survivors.
Results: Several best practices emerged as central to effective engagement. Multidisciplinary and diverse teams integrate clinical, research, and community perspectives to ensure relevance. Community advisory boards provide survivors with a formal voice, strengthening trust and guiding priorities. Culturally sensitive materials and approaches improve accessibility and participation. Outreach activities, both in-person and online, expand reach and flexibility. Partnerships with community-based organizations and community health workers, particularly bilingual staff, bridge cultural gaps and improve navigation. Finally, peer support groups and survivor-led navigation models foster empowerment, reduce stigma, and enhance trust. Together, these strategies address barriers of mistrust, access, and socioeconomic burden while positioning survivors as partners in care.
Conclusions: Equity-driven community engagement requires authentic listening and consistent presence to build trust. Engagement itself is a form of empowerment, ensuring that every individual voice is valued, even when it comes from a single survivor. Relationships formed through this process strengthen resilience and create lasting support systems. By embedding these principles into survivorship care, programs can move beyond outreach toward true partnership, advancing equity for diverse and underserved populations
Authors:
Author - Memnun Seven, PhD, RN, University of Massachusetts
Effects of Affective States on Colorectal Cancer Screening Health Message Persuasion Depend on Whether People Avoid Cancer Information
Poster Number: B45Time: 11:00 AM - 11:50 AM
Topics: Decision Making, Cancer
Background: People frequently defensively avoid information about threatening health conditions. A primary reason is to avoid negative emotions. We tested whether, consistent with a mood-as-a-resource hypothesis, inducing positive mood (versus negative or neutral mood) would decrease colorectal cancer (CRC) information avoidance among people who avoid cancer information.
Methods: First, we successfully identified video clips that induced positive, neutral, or negative mood in individuals who either do or do not tend to avoid CRC information (N=265). Next, a new set of participants who were non-adherent to CRC screening guidelines (N=337; 48% avoiders) were assigned to view one of the affect induction videos followed by either a CRC screening promotion video or an attentional control video. We assessed intentions to talk to a doctor about being screened, intentions to be screened for CRC and willingness to view a CRC personal risk calculator.
Results: Participants shown the CRC video had stronger intentions to talk to a doctor about getting screened than those shown the attention control video (M=2.31 vs. 1.88, F(1, 328)=17.19, p<.001), stronger intentions to be screened (M=2.30 vs. 1.92, F(1, 328)=13.08, p<.001), and were more willing to view the personal risk calculator (34.4% vs. 19.2%, AOR=2.17, 95% CI=1.31, 3.60, p=.003). There were no main effects of affect induction on any of the outcome variables (ps>.40). Avoidance interacted with affect induction to predict screening intentions, although not in a way consistent with the mood-as-a-resource hypothesis. Whereas avoiders’ screening intentions tended to be stronger after the neutral affect induction than after either the positive or negative affect induction, the pattern was the opposite for non-avoiders (ps>.023).
Discussion: The study yielded the surprising overall pattern that avoiders’ intentions were strongest after a neutral affect induction, and non-avoiders’ intentions were weakest after a neutral affect induction. Findings highlight the importance of targeting health communication based on psychological characteristics such as defensive information avoidance. Messages targeting people who avoid health information might be more effective if they do not employ emotional appeals—including fear appeals that evoke high negative affect or gain framing if it evokes high arousal positive affect.
Keywords: Health communication, EmotionsMethods: First, we successfully identified video clips that induced positive, neutral, or negative mood in individuals who either do or do not tend to avoid CRC information (N=265). Next, a new set of participants who were non-adherent to CRC screening guidelines (N=337; 48% avoiders) were assigned to view one of the affect induction videos followed by either a CRC screening promotion video or an attentional control video. We assessed intentions to talk to a doctor about being screened, intentions to be screened for CRC and willingness to view a CRC personal risk calculator.
Results: Participants shown the CRC video had stronger intentions to talk to a doctor about getting screened than those shown the attention control video (M=2.31 vs. 1.88, F(1, 328)=17.19, p<.001), stronger intentions to be screened (M=2.30 vs. 1.92, F(1, 328)=13.08, p<.001), and were more willing to view the personal risk calculator (34.4% vs. 19.2%, AOR=2.17, 95% CI=1.31, 3.60, p=.003). There were no main effects of affect induction on any of the outcome variables (ps>.40). Avoidance interacted with affect induction to predict screening intentions, although not in a way consistent with the mood-as-a-resource hypothesis. Whereas avoiders’ screening intentions tended to be stronger after the neutral affect induction than after either the positive or negative affect induction, the pattern was the opposite for non-avoiders (ps>.023).
Discussion: The study yielded the surprising overall pattern that avoiders’ intentions were strongest after a neutral affect induction, and non-avoiders’ intentions were weakest after a neutral affect induction. Findings highlight the importance of targeting health communication based on psychological characteristics such as defensive information avoidance. Messages targeting people who avoid health information might be more effective if they do not employ emotional appeals—including fear appeals that evoke high negative affect or gain framing if it evokes high arousal positive affect.
Authors:
Presenter - Heather Orom, PhD, University at Buffalo
Co-Author - Natasha Allard, MBA, University at Buffalo School of Public Health and Health Professions
Co-Author - Erika Waters, PhD, MPH, FSBM, Washington University School of Medicine
Co-Author - Marc Kiviniemi, PhD, MBA, CPH, FSBM, University of Kentucky
Co-Author - Amy McQueen, PhD, FSBM, Washington University, School of Medicine
Co-Author - Jennifer Hay, PhD, FSBM, Memorial Sloan Kettering Cancer Center
The Causal Effect of Defensiveness on Emotions and Behavioral Intentions
Poster Number: B46Time: 11:00 AM - 11:50 AM
Topics: Decision Making, Cancer
Background: Defensive strategies are reactions to threatening health information aimed at controlling negative emotions elicited by the threat. Defensive reactions may take the form of mental disengagement (distraction) or downplaying the personal relevance of the information (reappraisal). Correlational evidence indicates that defensiveness is associated with lower health behavior engagement. However, causal evidence concerning the relationships among defensiveness, emotions, and behavior is lacking. The present work aimed to fill this gap by experimentally manipulating defensive responses to health information about the negative consequences of alcohol consumption. We hypothesized that participants who engaged in defensiveness in the form of distraction or reappraisal would report lower negative emotions (relative to a control condition), and that lower negative emotions would be associated with lower intentions to drink less.
Methods: U.S. adult participants were recruited online through Prolific (N = 415, 97% women, 75% White, Mage = 43 years old, average weekly alcohol consumption = 9.52 drinks). Drawing on methodology used in research on emotion regulation, participants were randomly assigned to 1 of 3 conditions in which they engaged in a defensive strategy (distraction or reappraisal) or did not engage in defensiveness (control condition) while watching a video describing health consequences of alcohol consumption. Then, participants reported negative emotions and intentions to reduce their alcohol consumption.
Results: Consistent with hypotheses, a mediation analysis indicated that participants who engaged in defensiveness (either distraction or reappraisal) reported lower fear/anxiety after exposure to the health message compared to participants in the control condition. Lower fear/anxiety was subsequently associated with lower alcohol reduction intentions (direct effect: (B = .08, 95% CI [-0.07, 0.23]); indirect effect: (B = -0.08. 95% CI [-0.13, -0.03]).
Discussion: Results provide causal support that defensive strategies function to reduce fear/anxiety but lower one’s motivation to engage in behavior change. Findings support theoretical models and correlational findings concerning the role of emotion in defensive responses to threatening health information. Future research may test interventions that help people regulate their emotions in response to threatening health messages without reducing motivation to engage in healthy behaviors.
Keywords: Alcohol, Decision makingMethods: U.S. adult participants were recruited online through Prolific (N = 415, 97% women, 75% White, Mage = 43 years old, average weekly alcohol consumption = 9.52 drinks). Drawing on methodology used in research on emotion regulation, participants were randomly assigned to 1 of 3 conditions in which they engaged in a defensive strategy (distraction or reappraisal) or did not engage in defensiveness (control condition) while watching a video describing health consequences of alcohol consumption. Then, participants reported negative emotions and intentions to reduce their alcohol consumption.
Results: Consistent with hypotheses, a mediation analysis indicated that participants who engaged in defensiveness (either distraction or reappraisal) reported lower fear/anxiety after exposure to the health message compared to participants in the control condition. Lower fear/anxiety was subsequently associated with lower alcohol reduction intentions (direct effect: (B = .08, 95% CI [-0.07, 0.23]); indirect effect: (B = -0.08. 95% CI [-0.13, -0.03]).
Discussion: Results provide causal support that defensive strategies function to reduce fear/anxiety but lower one’s motivation to engage in behavior change. Findings support theoretical models and correlational findings concerning the role of emotion in defensive responses to threatening health information. Future research may test interventions that help people regulate their emotions in response to threatening health messages without reducing motivation to engage in healthy behaviors.
Authors:
Author - Jennifer Taber, PhD, Kent State University
Co-Author - Abigail O'Brien, PhD, Kent State University
Well-Being in Diabetes: Testing a Positive Psychology Intervention
Poster Number: B47Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Digital Health
Background: Positive emotion has protective health benefits and is associated with lower HbA1c and lower risk of mortality in those with Diabetes Mellitus (DM), independent of negative emotion. FERN is a positive psychological intervention (PPI) based on the Positive Pathways to Health theoretical model that posits PPIs can provide stress buffering effects such as adaptive coping strategies and strengthened social relationships which predict better physiological functioning and adherence to health behaviors.
Methods: In a single-arm trial of FERN (NPR Resilience Challenge), 3630 participants completed baseline measures and at least one follow-up. Within this sample, n=207 self-reported that they had diabetes (74% ciswoman; 83% White; mean age=59.4, SD=13.0). Baseline, T2 and T3 surveys were completed approximately 8 and 12 weeks later measuring PROMIS positive affect, anxiety, depression, sleep disturbance, social isolation, meaning & purpose, self-efficacy, and life satisfaction. Mixed effects models and moderation analysis were used to understand the association between diabetes status on post-intervention well-being.
Results: Participants with diabetes (n=207) did not differ significantly from the rest of the sample on any of the well-being variables at baseline (all p’s>.05): positive affect (M=40.4, SD=7.4), anxiety (M=61.4, SD=5.8), depression (M=55.9, SD=6.1), sleep disturbance (M=54.6, SD =7.6), social isolation (M=52.7, SD=7.2), meaning & purpose (M=43.8, SD=9.8), self-efficacy (M=43.9, SD=8.4), and life satisfaction (M=46.3, SD=9.1). The subset with diabetes improved statistically significantly (p<.001) on every PROMIS measure from T1 to T2 and significant effects were maintained at T3. Additionally, all participants, including those with DM, improved from baseline moderate anxiety (M=61.8) by at least 3 T-score points, which is considered a clinically meaningful change at T2(β1= -3.79, 95% CI -3.98 – -3.59, p<.001) and T3 (β2= -4.3, 95% CI -4.55 – -4.14, p<.001). Similar meaningful improvements were found for depression, sleep disturbance, and social isolation, all exceeding 3 T-score points at T2 and T3. Diabetes status did not moderate the effect of the intervention on outcomes, showing that FERN was just as effective in participants with diabetes as those without DM.
Conclusion: A positive psychology intervention was associated with increases in positive emotion and well-being equally for those with and without diabetes.
Keywords: Resilience, DiabetesMethods: In a single-arm trial of FERN (NPR Resilience Challenge), 3630 participants completed baseline measures and at least one follow-up. Within this sample, n=207 self-reported that they had diabetes (74% ciswoman; 83% White; mean age=59.4, SD=13.0). Baseline, T2 and T3 surveys were completed approximately 8 and 12 weeks later measuring PROMIS positive affect, anxiety, depression, sleep disturbance, social isolation, meaning & purpose, self-efficacy, and life satisfaction. Mixed effects models and moderation analysis were used to understand the association between diabetes status on post-intervention well-being.
Results: Participants with diabetes (n=207) did not differ significantly from the rest of the sample on any of the well-being variables at baseline (all p’s>.05): positive affect (M=40.4, SD=7.4), anxiety (M=61.4, SD=5.8), depression (M=55.9, SD=6.1), sleep disturbance (M=54.6, SD =7.6), social isolation (M=52.7, SD=7.2), meaning & purpose (M=43.8, SD=9.8), self-efficacy (M=43.9, SD=8.4), and life satisfaction (M=46.3, SD=9.1). The subset with diabetes improved statistically significantly (p<.001) on every PROMIS measure from T1 to T2 and significant effects were maintained at T3. Additionally, all participants, including those with DM, improved from baseline moderate anxiety (M=61.8) by at least 3 T-score points, which is considered a clinically meaningful change at T2(β1= -3.79, 95% CI -3.98 – -3.59, p<.001) and T3 (β2= -4.3, 95% CI -4.55 – -4.14, p<.001). Similar meaningful improvements were found for depression, sleep disturbance, and social isolation, all exceeding 3 T-score points at T2 and T3. Diabetes status did not moderate the effect of the intervention on outcomes, showing that FERN was just as effective in participants with diabetes as those without DM.
Conclusion: A positive psychology intervention was associated with increases in positive emotion and well-being equally for those with and without diabetes.
Authors:
Presenter - Chelsea Brown, MT-BC, Northwestern University Feinberg School of Medicine
Co-Author - Karen M. Llave, PhD, Northwestern University Feinberg School of Medicine
Co-Author - Elizabeth Addington, PhD, Northwestern University Feinberg School of Medicine
Co-Author - Judith Moskowitz, PhD MPH, Northwestern University Feinberg School of Medicine
From Glucose Dynamics to Cognitive Outcomes: A Scoping Review of Continuous Glucose Monitoring in Diabetes
Poster Number: B48Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Digital Health
Diabetes is associated with accelerated cognitive decline and emerging evidence suggests that glycemic variability, beyond mean glucose, may contribute to this process. Continuous glucose monitoring (CGM) provides real-time, high-resolution data on glucose dynamics and offers an opportunity to clarify links with cognitive outcomes. However, existing studies are heterogeneous in design and measures, limiting synthesis and a clear understanding of the evidence. To address this gap, we conducted a scoping review, following the Arksey and O’Malley framework, to map how CGM has been applied in cognitive research among adults with diabetes.
Comprehensive searches (PubMed, CINAHL, Cochrane, EMBASE, PsycINFO) identified 21 eligible studies. Publications ranged from 2010 to 2025, with two-thirds published since 2022. All were observational, with one pre-/post-intervention. Designs included cross-sectional (n=8), prospective longitudinal (n=3), and repeated-measures using ecological momentary assessment (n=4). Sample sizes ranged from 20 to 594; most targeted older adults with type 2 diabetes (n=15), while six focused on type 1 diabetes. About half of the U.S.-based studies were conducted in predominantly White populations (60-100%). CGM wear periods ranged from 2 to 70 days, most commonly 1–2 weeks, using devices such as FreeStyle Libre or Dexcom. Adherence to CGM was consistently high (>89%), underscoring the feasibility of its use in cognitive research. Most commonly reported metrics included time below range (n=16), time above range (n=13), and time in range (n=12). Cognitive outcomes were assessed across diverse domains. Executive function was most frequent (71%), followed by processing speed (52%), attention (48%), and memory (48%). Three studies assessed perceived cognitive function. Only six studies used longitudinal or repeated cognitive assessments, limiting insight into how daily glucose fluctuations relate to acute cognitive changes over time.
This review underscores the feasibility and growing use of CGM in cognitive research, while pointing to substantial heterogeneity across study designs, metrics, and cognitive domains. To advance the field, future studies should standardize CGM measures, expand inclusion of racially and ethnically diverse populations, and prioritize longitudinal designs that capture dynamic glucose–cognition relationships, ultimately informing strategies to preserve cognitive health in diabetes.
Keywords: Diabetes, Cognitive factorsComprehensive searches (PubMed, CINAHL, Cochrane, EMBASE, PsycINFO) identified 21 eligible studies. Publications ranged from 2010 to 2025, with two-thirds published since 2022. All were observational, with one pre-/post-intervention. Designs included cross-sectional (n=8), prospective longitudinal (n=3), and repeated-measures using ecological momentary assessment (n=4). Sample sizes ranged from 20 to 594; most targeted older adults with type 2 diabetes (n=15), while six focused on type 1 diabetes. About half of the U.S.-based studies were conducted in predominantly White populations (60-100%). CGM wear periods ranged from 2 to 70 days, most commonly 1–2 weeks, using devices such as FreeStyle Libre or Dexcom. Adherence to CGM was consistently high (>89%), underscoring the feasibility of its use in cognitive research. Most commonly reported metrics included time below range (n=16), time above range (n=13), and time in range (n=12). Cognitive outcomes were assessed across diverse domains. Executive function was most frequent (71%), followed by processing speed (52%), attention (48%), and memory (48%). Three studies assessed perceived cognitive function. Only six studies used longitudinal or repeated cognitive assessments, limiting insight into how daily glucose fluctuations relate to acute cognitive changes over time.
This review underscores the feasibility and growing use of CGM in cognitive research, while pointing to substantial heterogeneity across study designs, metrics, and cognitive domains. To advance the field, future studies should standardize CGM measures, expand inclusion of racially and ethnically diverse populations, and prioritize longitudinal designs that capture dynamic glucose–cognition relationships, ultimately informing strategies to preserve cognitive health in diabetes.
Authors:
Author - Jeeyeon Kim, University of Michigan
Co-Author - Jayeong Kim, MSN, RN, Seoul National University
Co-Author - Heather Cuevas, PhD, APRN, ACNS-BC, FCNS, FAAN, University of Texas at Austin
Barriers and Facilitators to Implementing Peer Support Interventions for Medication Adherence in African American Populations with Type 2 Diabetes in Rural U.S. Communities: An Integrative Review
Poster Number: B49Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Diabetes
Background: African American populations in rural U.S. communities experience disproportionate rates of type 2 diabetes, compounded by limited healthcare access, financial constraints, cultural stigma, and systemic mistrust of providers. Peer support interventions show promise for improving medication adherence and diabetes outcomes, yet evidence on their implementation in rural African American contexts remains scattered.
Objective: This integrative review synthesized evidence on barriers and facilitators to implementing peer support interventions for medication adherence among African Americans with type 2 diabetes in rural or underserved settings.
Methods: Following PRISMA guidelines, we searched PubMed, CINAHL, and PsycINFO for peer-reviewed studies published between 2000 and 2024. Ten eligible studies were identified, including randomized controlled trials, pilot interventions, mixed-methods studies, and qualitative research. Extracted data focused on intervention design, sociocultural dynamics, peer leader roles, and reported outcomes.
Results: Barriers included transportation challenges, financial limitations, cultural stigma surrounding diabetes, language and literacy barriers, and mistrust of healthcare systems. Facilitators encompassed strong community engagement, culturally tailored education, integration with faith-based and community networks, and trust-building through race-congruent peer leaders. Peer support models enhanced medication adherence, self-efficacy, psychosocial well-being, and glycemic control. However, sustainability and scalability were hindered by limited funding and infrastructure.
Conclusions: This integrative review demonstrates that peer support interventions offer a promising strategy to improve medication adherence and diabetes outcomes among rural African American populations. Addressing structural barriers, leveraging culturally relevant community networks, and ensuring sustainable funding are essential for long-term effectiveness. Importantly, current evidence is limited for Black immigrant populations, underscoring the need for future research to adapt and scale culturally tailored peer support interventions to this underrepresented group.
Keywords: Diabetes, DiabetesObjective: This integrative review synthesized evidence on barriers and facilitators to implementing peer support interventions for medication adherence among African Americans with type 2 diabetes in rural or underserved settings.
Methods: Following PRISMA guidelines, we searched PubMed, CINAHL, and PsycINFO for peer-reviewed studies published between 2000 and 2024. Ten eligible studies were identified, including randomized controlled trials, pilot interventions, mixed-methods studies, and qualitative research. Extracted data focused on intervention design, sociocultural dynamics, peer leader roles, and reported outcomes.
Results: Barriers included transportation challenges, financial limitations, cultural stigma surrounding diabetes, language and literacy barriers, and mistrust of healthcare systems. Facilitators encompassed strong community engagement, culturally tailored education, integration with faith-based and community networks, and trust-building through race-congruent peer leaders. Peer support models enhanced medication adherence, self-efficacy, psychosocial well-being, and glycemic control. However, sustainability and scalability were hindered by limited funding and infrastructure.
Conclusions: This integrative review demonstrates that peer support interventions offer a promising strategy to improve medication adherence and diabetes outcomes among rural African American populations. Addressing structural barriers, leveraging culturally relevant community networks, and ensuring sustainable funding are essential for long-term effectiveness. Importantly, current evidence is limited for Black immigrant populations, underscoring the need for future research to adapt and scale culturally tailored peer support interventions to this underrepresented group.
Authors:
Author - Esther Nana Kwaning, MSN BSN, University of Massachusetts Boston
Co-Author - Grace Kyei, BSN, University of Massachusetts BOston
Co-Author - Evans Kyei, PhD MSc., The University of Alabama
Acceptability of a multi-component mobile behavioral intervention to reduce hypoglycemia in adults with type 1 diabetes
Poster Number: B50Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Digital Health
Hypoglycemia is an acute, common, and potentially life-threatening condition for people with type 1 diabetes (T1D). The ability to detect and respond to hypoglycemia episodes is impacted by the recurrence of hypoglycemia and maladaptive beliefs that hinder self-care. Behavioral interventions that enhance hypoglycemia symptom detection and address unhelpful beliefs may reduce barriers to self-management, but access remains severely limited.
HypoPals is a mobile behavioral intervention designed to improve hypoglycemic self-management in adults with T1D. The intervention had two components: hypoglycemia symptom detection training and hypoglycemia psychoeducation. We conducted a 52-week pilot study with 18-70-year-olds with T1D to assess intervention acceptability. Using a mixed methods approach, participants completed a questionnaire on intervention acceptability immediately after program completion, and a subset participated in semi-structured interviews to gain insights into their experiences with the intervention. Both the questionnaire and interviews were aligned with constructs from the Theoretical Framework of Acceptability. Descriptive analyses were performed on questionnaire data. Thematic analysis of interview transcripts was conducted to identify themes related to intervention acceptability.
All participants completed the intervention, and twenty were interviewed. Most (96%) found the content to be acceptable, and 88% found the intervention to be helpful. In interviews, participants indicated that trust, consistent timing and format of delivery (i.e., text messages), and content readability positively impacted their engagement with the intervention. Additionally, participants reported that HypoPals facilitated reflection about hypoglycemic events, offering an opportunity to refresh knowledge and learn new tips to manage hypoglycemia even after years living with T1D. However, participants expressed that some aspects of HypoPals, such as the delayed timing of the symptom detection training after a hypoglycemic event, hindered their engagement.
The findings for the HypoPals intervention pilot study demonstrated its acceptability, establishing the feasibility of using digital behavioral interventions to address facets of established barriers to T1D hypoglycemia self-management. Our study emphasizes the potential of using mobile health technology as a vehicle to deliver complex behavioral interventions to address hypoglycemia among people with T1D.
Keywords: Diabetes, InterventionHypoPals is a mobile behavioral intervention designed to improve hypoglycemic self-management in adults with T1D. The intervention had two components: hypoglycemia symptom detection training and hypoglycemia psychoeducation. We conducted a 52-week pilot study with 18-70-year-olds with T1D to assess intervention acceptability. Using a mixed methods approach, participants completed a questionnaire on intervention acceptability immediately after program completion, and a subset participated in semi-structured interviews to gain insights into their experiences with the intervention. Both the questionnaire and interviews were aligned with constructs from the Theoretical Framework of Acceptability. Descriptive analyses were performed on questionnaire data. Thematic analysis of interview transcripts was conducted to identify themes related to intervention acceptability.
All participants completed the intervention, and twenty were interviewed. Most (96%) found the content to be acceptable, and 88% found the intervention to be helpful. In interviews, participants indicated that trust, consistent timing and format of delivery (i.e., text messages), and content readability positively impacted their engagement with the intervention. Additionally, participants reported that HypoPals facilitated reflection about hypoglycemic events, offering an opportunity to refresh knowledge and learn new tips to manage hypoglycemia even after years living with T1D. However, participants expressed that some aspects of HypoPals, such as the delayed timing of the symptom detection training after a hypoglycemic event, hindered their engagement.
The findings for the HypoPals intervention pilot study demonstrated its acceptability, establishing the feasibility of using digital behavioral interventions to address facets of established barriers to T1D hypoglycemia self-management. Our study emphasizes the potential of using mobile health technology as a vehicle to deliver complex behavioral interventions to address hypoglycemia among people with T1D.
Authors:
Presenter - Juniar Lucien, MS, University of Michigan - Ann Arbor
Co-Author - Annika Agni, BS, University of Michigan - Ann Arbor
Co-Author - Yu Kuei Lin, MD, University of Michigan - Ann Arbor
Co-Author - Melissa DeJonckheere, PhD, University of Michigan - Ann Arbor
Examining the Moderating Role of Emotion Regulation on the Relationship between PTSD and Obesity Among Adults with Type 2 Diabetes
Poster Number: B51Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Mental Health
Introduction: Obesity increases risk and severity of type 2 diabetes and its associated complications. PTSD has been associated with greater incidence of type 2 diabetes and obesity. Patients with type 2 diabetes who experience emotional dysregulation have poorer self-management behaviors (i.e., diet and exercise) that can contribute to obesity. Less understood is how emotion dysregulation is associated with risk of obesity among patients with type 2 diabetes and PTSD symptoms. The present study aims to examine the relationship between PTSD and body mass index (BMI) and examine emotion dysregulation moderators of this relationship.
Methods: Adults with type 2 diabetes (N = 363; age: M = 58.9, SD = 14.1) completed an online study. Participants were primarily female (64.5%) and White (79.3%). BMI (kg/m²; M = 37.8, SD = 10.6) was in the obese range. PTSD symptoms were measured using the Primary Care PTSD Screen for DSM-5, with higher scores indicating greater symptom endorsement. The Difficulties in Emotion Regulation Scale (DERS) short form includes subscales of nonacceptance of emotional responses, difficulties engaging in goal-directed behavior, impulse control difficulties, limited access to emotion regulation strategies, and lack of emotional clarity. Greater scores indicate greater emotion dysregulation. Regression analyses examined emotion dysregulation domains as potential moderators of the relationship between PTSD and BMI after adjusting for age and sex.
Results: No main effects of PTSD symptoms (ps > .077) or DERS subscales (ps > .535) emerged. Significant interactions between PTSD symptoms and emotion dysregulation domains of nonacceptance of emotional responses (B = .178, p = .042) and limited access to emotion regulation strategies (B = .121, p = .026) were found. PTSD symptoms were more strongly associated with greater BMI among individuals with high levels of non-acceptance of emotional responses and limited access to emotion regulation strategies. There were no significant conditional effects for either interaction.
Conclusions: Among adults with type 2 diabetes, PTSD symptoms are associated with higher BMI among individuals who have greater emotion dysregulation. Providers should consider early assessment of PTSD among those with type 2 diabetes to promote healthy emotional responses that may mitigate harmful disease self-management behaviors that contribute to obesity.
Keywords: Diabetes, EmotionsMethods: Adults with type 2 diabetes (N = 363; age: M = 58.9, SD = 14.1) completed an online study. Participants were primarily female (64.5%) and White (79.3%). BMI (kg/m²; M = 37.8, SD = 10.6) was in the obese range. PTSD symptoms were measured using the Primary Care PTSD Screen for DSM-5, with higher scores indicating greater symptom endorsement. The Difficulties in Emotion Regulation Scale (DERS) short form includes subscales of nonacceptance of emotional responses, difficulties engaging in goal-directed behavior, impulse control difficulties, limited access to emotion regulation strategies, and lack of emotional clarity. Greater scores indicate greater emotion dysregulation. Regression analyses examined emotion dysregulation domains as potential moderators of the relationship between PTSD and BMI after adjusting for age and sex.
Results: No main effects of PTSD symptoms (ps > .077) or DERS subscales (ps > .535) emerged. Significant interactions between PTSD symptoms and emotion dysregulation domains of nonacceptance of emotional responses (B = .178, p = .042) and limited access to emotion regulation strategies (B = .121, p = .026) were found. PTSD symptoms were more strongly associated with greater BMI among individuals with high levels of non-acceptance of emotional responses and limited access to emotion regulation strategies. There were no significant conditional effects for either interaction.
Conclusions: Among adults with type 2 diabetes, PTSD symptoms are associated with higher BMI among individuals who have greater emotion dysregulation. Providers should consider early assessment of PTSD among those with type 2 diabetes to promote healthy emotional responses that may mitigate harmful disease self-management behaviors that contribute to obesity.
Authors:
Presenter - Rhea Mundle, B.S., University of Mississippi
Co-Author - Negin Ghaffari, B.A., University of Mississippi
Co-Author - Aaron Lee, PhD, University of Mississippi
Assessing The Influence of Social Networks on Health Behaviors of Older Adults Living with Type 2 Diabetes
Poster Number: B52Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Social and Environmental Context and Health
Introduction
With the rising burden of type 2 diabetes (T2DM) among older adults, both social support and social networks should be included in diabetes management discussions and shared decision-making to promote optimal clinical outcomes. Despite the impact of social support and social network on self-care adherence, the mechanism by which they influence T2DM self-care is unclear. This study assessed social networks of older adults before, during, and after a diabetes intervention and how changes in their social networks affected self-care management and T2DM-related health outcomes.
Methods
Adults (≥55 years) who had a diagnosis of T2DM were recruited from two clinics affiliated with an academic medical center as well as from community organizations. Participants were recruited via approved study flyers and snow balling. Participants completed questions focused on their social network, the connection between the ego and each alter and Medical Outcomes Study Social Support Survey at three different time points—baseline, 6 months post-baseline, and 12 months post-baseline. Descriptives and linear regression analysis are reported.
Results
A total of 58 participants completed the study with mean age of 64 years. The majority were female, more than half were Non-Hispanic White, and more than half had Medicare insurance. About one third (34%) of participants provided three trusted alter names with an average of 1.8 (1.00) trusted alter names. On average, participants’ amount of contact with each alter was 6.00 (2.65) and participants rely on their social network for health advice. We found no significant association between network size, trusted alters present in the network, support score, frequency, and value of information with change in HbA1c. An increase in the number of trusted alters was marginally significantly associated with a decrease in HbA1c levels (p-value = 0.06).
Discussion
Rural older adults with T2DM identified trusted social networks who provide them with health advice. Social networks are vital for this population and their self-care behaviors and clinical outcomes.
Keywords: Health behaviors, Social network analysisWith the rising burden of type 2 diabetes (T2DM) among older adults, both social support and social networks should be included in diabetes management discussions and shared decision-making to promote optimal clinical outcomes. Despite the impact of social support and social network on self-care adherence, the mechanism by which they influence T2DM self-care is unclear. This study assessed social networks of older adults before, during, and after a diabetes intervention and how changes in their social networks affected self-care management and T2DM-related health outcomes.
Methods
Adults (≥55 years) who had a diagnosis of T2DM were recruited from two clinics affiliated with an academic medical center as well as from community organizations. Participants were recruited via approved study flyers and snow balling. Participants completed questions focused on their social network, the connection between the ego and each alter and Medical Outcomes Study Social Support Survey at three different time points—baseline, 6 months post-baseline, and 12 months post-baseline. Descriptives and linear regression analysis are reported.
Results
A total of 58 participants completed the study with mean age of 64 years. The majority were female, more than half were Non-Hispanic White, and more than half had Medicare insurance. About one third (34%) of participants provided three trusted alter names with an average of 1.8 (1.00) trusted alter names. On average, participants’ amount of contact with each alter was 6.00 (2.65) and participants rely on their social network for health advice. We found no significant association between network size, trusted alters present in the network, support score, frequency, and value of information with change in HbA1c. An increase in the number of trusted alters was marginally significantly associated with a decrease in HbA1c levels (p-value = 0.06).
Discussion
Rural older adults with T2DM identified trusted social networks who provide them with health advice. Social networks are vital for this population and their self-care behaviors and clinical outcomes.
Authors:
Presenter - Brittany Smalls, PhD, MHSA, MSHPsy, University of Texas Medical Branch
Co-Author - Suraksha Khanal, University of Texas Medical Branch
Co-Author - Adebola Adegboyega, PhD, RN, University of Kentucky
Co-Author - Courtney Ortz, PhD, University of Texas Medical Branch (UTMB) Health
Co-Author - Anna Smith, PhD, University of Kentucky
Integrating Diverse Perspectives to Develop a Salon-based Prediabetes Risk Screening and Prevention Program Referral Intervention
Poster Number: B53Time: 11:00 AM - 11:50 AM
Topics: Diabetes, Community Engagement
Background: Prediabetes is estimated to affect more than 97 million US adults. Alarmingly, over 90% of people with prediabetes are unaware of their risk status. Further, public awareness of evidence-based lifestyle interventions remains low. Community-based strategies are needed to promote prediabetes risk screening and prevention program awareness. To this end, we conducted a community-based participatory study using Group Concept Mapping (GCM) to gather diverse perspectives to develop a salon-based prediabetes risk screening and prevention program referral intervention. Methods: We conducted GCM with members of the Black Community Advisory Council of Tucson (Black CACTus) using the GroupWisdom and REDCap online platforms. The GCM steps are: 1) Brainstorming statements in response to a prompt, 2) Sorting statements thematically into categories, 3) Rating statements on importance and feasibility, 4) Reviewing the cluster map, and 5) Reviewing a draft intervention. Results: The 12 participating Black CACTus members included, primary healthcare providers (n=2), female-identifying stylists (n=4), Black women salon clients (n=4), and diabetes prevention program providers (n=2). All identified as Black women, with two also identifying as Latina and White. A total of 45 statements resulted from brainstorming. From the sorting data, a seven-cluster map was generated with a stress factor of 0.2712. The clusters were labeled: 1) Peer Support, Information and Processing, 2) Health Awareness and Education, 3) Stylists, 4) Informed Stylists, 5) Building Trust through Personalized Approach in Hair Salons, 6) Environment, and 7) Logistics. Clusters 3, “Stylists,” had the highest average rating for importance. The cluster rated the most feasible was Cluster 6, “Environment.” When importance and feasibility were considered together, cluster 1 was the lowest rated. Conclusions: Integrating the diverse perspectives of vested community partners facilitates tailoring of interventions for community settings. Our results are strengthened by the GCM mixed-methods approach and consensus of the Black CACTus on the importance and feasibility of leveraging and regarding the stylists and salon environment. The findings of this study advance the development of an innovative salon-based prediabetes risk screening and prevention program referral intervention.
Keywords: Participatory research, ScreeningAuthors:
Presenter - Kelly Palmer, PhD, MHS, University of Alabama at Birmingham
Co-Author - Niko Verdecias, DrPH, MPH, Arizona State University
Co-Author - Kathleen Pryor, University of Arizona
Co-Author - Azaria Suero-Davis, BS, University of Arizona
Co-Author - Raymond Yurika, MSc, University of Arizona
Co-Author - Abby Lohr, PhD, MPH, Mayo Clinic
Associations Between Perinatal Exposures and ARFID Dimensions in Adults: A Secondary Analysis of the ARFID-GEN Study
Poster Number: B54Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Women's Health
Background: Perinatal exposures (e.g., preterm birth) may influence the risk of developing eating disorders. However, the role of perinatal exposures in the development of avoidant/restrictive food intake disorder (ARFID) remains understudied. We examined whether mean scores of each ARFID dimension (picky eating/sensory-based avoidance, low appetite/lack of interest, fear/concern) differed based on the presence of perinatal exposures in adults with ARFID.
Methods: N=2,619 adults with ARFID, from the ARFID Genes and Environment Study, reported demographic information, ARFID symptoms (using the Nine Item ARFID Screen [NIAS] and the Pica, ARFID, and Rumination Disorder Interview ARFID Questionnaire [PARDI-AR-Q]), and details about their own gestation and birth via the Pregnancy History Questionnaire. We applied generalized linear models with relevant covariates to evaluate associations among perinatal exposures (preterm birth, maternal smoking, c-section, breech birth, birth defect(s), birth weight, neonatal intensive care unit admission, and type of feeding) with each NIAS and PARDI-AR-Q dimension. False discovery rate (q-value) was used to correct for multiple comparisons. Effect sizes (Cohen’s d) were calculated.
Results: Participants whose birthing parent smoked while pregnant had higher scores on NIAS picky eating (B=0.60, q=.012, d=0.13) and PARDI-AR-Q lack of interest (B=0.20, q=.039, d=0.07) than those whose parent did not smoke. Participants born with birth defect(s) scored higher on PARDI-AR-Q sensory-based avoidance (B=0.52, q=.012, d=0.33) than those without birth defect(s). Type of feeding was significantly associated with NIAS picky eating (omnibus q=.012): those who were only bottle-fed had significantly higher scores than those who were both breast- and bottle-fed (B=0.60, Tukey-adjusted p = .0005, d=0.13). No other significant associations were observed.
Conclusion: Perinatal exposures were related to picky eating/sensory-based avoidance and lack of interest but not fear about aversive consequences of eating in a sample of people with ARFID. Picky eating/sensory-based avoidance and lack of interest have been linked to neurodevelopmental processes, which may also be impacted by perinatal exposures—which may help explain these associations. However, effect sizes were small. Longitudinal and case-control studies are needed to better understand the role of perinatal exposures in the development of ARFID.
AI helped write code for data analysis
Keywords: Eating behaviors, PregnancyMethods: N=2,619 adults with ARFID, from the ARFID Genes and Environment Study, reported demographic information, ARFID symptoms (using the Nine Item ARFID Screen [NIAS] and the Pica, ARFID, and Rumination Disorder Interview ARFID Questionnaire [PARDI-AR-Q]), and details about their own gestation and birth via the Pregnancy History Questionnaire. We applied generalized linear models with relevant covariates to evaluate associations among perinatal exposures (preterm birth, maternal smoking, c-section, breech birth, birth defect(s), birth weight, neonatal intensive care unit admission, and type of feeding) with each NIAS and PARDI-AR-Q dimension. False discovery rate (q-value) was used to correct for multiple comparisons. Effect sizes (Cohen’s d) were calculated.
Results: Participants whose birthing parent smoked while pregnant had higher scores on NIAS picky eating (B=0.60, q=.012, d=0.13) and PARDI-AR-Q lack of interest (B=0.20, q=.039, d=0.07) than those whose parent did not smoke. Participants born with birth defect(s) scored higher on PARDI-AR-Q sensory-based avoidance (B=0.52, q=.012, d=0.33) than those without birth defect(s). Type of feeding was significantly associated with NIAS picky eating (omnibus q=.012): those who were only bottle-fed had significantly higher scores than those who were both breast- and bottle-fed (B=0.60, Tukey-adjusted p = .0005, d=0.13). No other significant associations were observed.
Conclusion: Perinatal exposures were related to picky eating/sensory-based avoidance and lack of interest but not fear about aversive consequences of eating in a sample of people with ARFID. Picky eating/sensory-based avoidance and lack of interest have been linked to neurodevelopmental processes, which may also be impacted by perinatal exposures—which may help explain these associations. However, effect sizes were small. Longitudinal and case-control studies are needed to better understand the role of perinatal exposures in the development of ARFID.
AI helped write code for data analysis
Authors:
Presenter - Emily Woodworth, University at Albany, State University of New York
Co-Author - Laura Thornton, PhD, University of North Carolina at Chapel Hill
Co-Author - Lisa Dinkler, PhD, Karolinska Institutet
Co-Author - Nadia Micali, PhD, University College London; Mental Health Services of the Capital Region of Denmark
Co-Author - Jerry Guintivano, PhD, University of North Carolina at Chapel Hill
Co-Author - Jessica Johnson, MPH, University of North Carolina at Chapel Hill
Co-Author - Cynthia Bulik, PhD, University of North Carolina at Chapel Hill; Karolinska Institutet
Co-Author - Emily Pisetsky, PhD, University of North Carolina at Chapel Hill
Understanding How Pakistani Audiences Respond to Healthy Diet Content on YouTube: A Comparative Sentiment and Thematic Analysis of Urdu and English Comments
Poster Number: B55Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Digital Health
Unhealthy diets are a major contributor to Pakistan’s rising burden of noncommunicable diseases, while digital platforms are increasingly shaping how people seek nutrition advice. YouTube has become a widely used source of dietary guidance, yet little is known about how Pakistani audiences perceive this content. This study examined both the sentiment and substance of viewer engagement with healthy diet videos. A systematic search strategy identified ten YouTube videos oriented to Pakistani audiences on healthy diets with high audience engagement. All comments (n = 4,728) were scraped and analyzed using a mixed-methods design. English-language comments (n = 4,224) were classified with the VADER lexicon, while Urdu-language comments (n = 478) were fewer in number and therefore examined directly through qualitative thematic analysis. Sentiment distributions showed 48.8% neutral, 46.2% positive, and 8.8% negative among English comments, compared with 36.2% negative, 34.3% neutral, and 29.5% positive among Urdu comments. A Chi-square test confirmed a significant difference between the two groups (χ² = 313.23, p < 0.001).Qualitative insights revealed that in Urdu comments, negative responses frequently raised concerns about the high cost of ingredients, questioned the quality of dietary advice, and doubted the creators’ expertise. Positive responses, in contrast, were oriented toward appreciation and interest in additional healthy diet topics. Among English-language comments, negative responses mainly criticized the dietary advice and questioned its feasibility in the Pakistani context, while positive comments conveyed acknowledgment and encouragement. Taken together, the findings indicate that both Urdu- and English-language audiences expressed a mix of positive and critical perspectives, but with different emphases. These differences may reflect variations in linguistic accessibility, cultural framing, and socioeconomic context, shaping how healthy diet content is received. More broadly, the study underscores the need to consider how YouTube and similar platforms are influencing dietary behaviors in Pakistan, and calls for follow-up research to better understand these dynamics and their public health implications.
Keywords: Diet, Health promotionAuthors:
Author - Ahmad Umar, University Institute of Public Health, The University of Lahore
Author - Priyanshi Sharma, Stanford University
Presenter - Sian Auer, Yale University School of Public Health
Author - Shahmir H. Ali, National University of Singapore
Long-term efficacy of sharing digital self-monitoring in a behavioral weight loss program
Poster Number: B56Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Digital Health
Introduction: Digital self-monitoring tools are widely used by adults attempting lifestyle modification, but little is known about the impact of sharing these data with others. Data sharing could promote behavior change through supportive accountability, yet may also lead to unintended effects, such as heightened self-consciousness or shame. This study examined whether the efficacy of a behavioral weight loss program could be improved if participants’ digital self-monitoring data were shared with other parties.
Methods: Participants (N = 322) enrolled in a 24-month behavioral weight loss program that included group sessions, individual coaching calls, and text messages from coaches and program peers. All participants were instructed to engage in daily self-monitoring of weight, physical activity, and dietary intake. Using a 2x2x2 factorial design, participants were randomized to data sharing with their coach (ON vs OFF), data sharing with fellow group members (ON vs OFF), and data sharing with a selected friend or family member outside of the program (ON vs OFF). Longitudinal changes in weight and secondary outcomes were analyzed at 3, 6, 12, and 24 months using multilevel models with missing data imputed. Time-by-condition interactions were examined to see the effect of each factor on the pattern of change in weight and other outcomes.
Results: Weight loss significantly differed over time in Coach Share ON vs OFF (p = .004), with 24-month weight loss averaging 9.0% in Coach Share ON vs 6.6% in Coach Share OFF. A greater increase in participant perception of coach knowledge was also observed in Coach Share ON vs OFF (p = .04). Weight change over time did not significantly differ for Group Share ON vs OFF (p = 0.69) or Friend/Family Share ON vs OFF (p = 0.56). Change over time in treatment satisfaction did not differ significantly between any Share ON vs OFF conditions.
Conclusions: Providing coaches with access to participants’ digital self-monitoring data enhanced long-term weight loss compared to delivery of the behavioral program without such access. Similar benefits were not observed when data were shared with peers or friends/family outside the program. These findings suggest that treatment providers may be the more effective partners for data sharing, and that alternative approaches may be needed to improve the efficacy of peer or friend/family data are sharing.
Keywords: Weight loss, e-HealthMethods: Participants (N = 322) enrolled in a 24-month behavioral weight loss program that included group sessions, individual coaching calls, and text messages from coaches and program peers. All participants were instructed to engage in daily self-monitoring of weight, physical activity, and dietary intake. Using a 2x2x2 factorial design, participants were randomized to data sharing with their coach (ON vs OFF), data sharing with fellow group members (ON vs OFF), and data sharing with a selected friend or family member outside of the program (ON vs OFF). Longitudinal changes in weight and secondary outcomes were analyzed at 3, 6, 12, and 24 months using multilevel models with missing data imputed. Time-by-condition interactions were examined to see the effect of each factor on the pattern of change in weight and other outcomes.
Results: Weight loss significantly differed over time in Coach Share ON vs OFF (p = .004), with 24-month weight loss averaging 9.0% in Coach Share ON vs 6.6% in Coach Share OFF. A greater increase in participant perception of coach knowledge was also observed in Coach Share ON vs OFF (p = .04). Weight change over time did not significantly differ for Group Share ON vs OFF (p = 0.69) or Friend/Family Share ON vs OFF (p = 0.56). Change over time in treatment satisfaction did not differ significantly between any Share ON vs OFF conditions.
Conclusions: Providing coaches with access to participants’ digital self-monitoring data enhanced long-term weight loss compared to delivery of the behavioral program without such access. Similar benefits were not observed when data were shared with peers or friends/family outside the program. These findings suggest that treatment providers may be the more effective partners for data sharing, and that alternative approaches may be needed to improve the efficacy of peer or friend/family data are sharing.
Authors:
Presenter - Meghan Butryn, Drexel University
Co-Author - Anna Upman, Drexel University
Co-Author - Nicole Miller, Drexel University
Co-Author - Charlotte Hagerman, Oregon Research Institute
Co-Author - Evan Forman, Drexel University
Co-Author - Danielle Arigo, PhD, LP, FSBM, Rowan University
Co-Author - Fengqing Zhang, Drexel University
Co-Author - Erica LaFata, Oregon Research Institute
Co-Author - Brandy-Joe Milliron, PhD, Drexel University
Co-Author - Bonnie Spring, PhD, ABPP, FSBM, Florida State University College of Medicine
Examining the Home Food Environment of Children: Implications for School-Based Nutrition Initiatives
Poster Number: B57Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Implementation Science
Children in the United States consistently fall short of meeting recommended daily servings of fruits and vegetables (FV), a pattern linked to obesity, cardiovascular disease, cancers, and adverse cognitive, emotional, and behavioral outcomes (Paquin, 2021; Nemours Children’s Health, 2024; USDA, 2020) Many students, particularly those from impoverished households, rely on school nutrition programs to supplement home nutrition.
As part of a larger food-based intervention study, we examined the home food environment using food journals, which were developed by incorporating elements of 24-hour dietary recall and Photo Voice. Students were prompted to draw pictures of and write everything they ate from the time they left school the day before to the time they arrived at school the day of the assessment. Food journals were completed at three timepoints (pre, during, and post intervention), for three days at each timepoint, totaling nine journals each. Additionally, students completed a liking survey to determine how much each student liked or disliked 10 fruits and 10 vegetables.
According to the food journals, completed by 87 students, consumption of FV was rare at home. Of the 465 usable journals, 353 (75.9%) did not contain a fruit or vegetable, 57 (12.2%) only contained a fruit, 47 (10.1%) only contained a vegetable, and only 8 (1.7%) contained both a fruit and a vegetable. On average, students liked 6.68 fruits and 4.39 vegetables. Independent samples t-tests revealed that students who consumed at least one vegetable at home (M=5.25, SD=2.29) liked significantly more types of vegetables compared to students who did not consume any vegetables at home (M=3.92, SD=(2.41), t(55)=2.33, p=.023. No significant effect was found for fruits, likely due to their broader acceptability.
Results demonstrate that children in this study rely heavily on school lunch programs for access to fruits and vegetables. Additionally, while our results show that consumption of vegetables at home was related to overall vegetable liking, a variety of socioeconomic barriers exist, requiring more systemic interventions for nutrition. Therefore, optimizing FV intake inside of school is essential. Future work should continue to build strategies for maximizing the impact of school nutrition programs to reduce health disparities in chronic illness and cognitive performance for youth.
Keywords: Nutrition, ChildrenAs part of a larger food-based intervention study, we examined the home food environment using food journals, which were developed by incorporating elements of 24-hour dietary recall and Photo Voice. Students were prompted to draw pictures of and write everything they ate from the time they left school the day before to the time they arrived at school the day of the assessment. Food journals were completed at three timepoints (pre, during, and post intervention), for three days at each timepoint, totaling nine journals each. Additionally, students completed a liking survey to determine how much each student liked or disliked 10 fruits and 10 vegetables.
According to the food journals, completed by 87 students, consumption of FV was rare at home. Of the 465 usable journals, 353 (75.9%) did not contain a fruit or vegetable, 57 (12.2%) only contained a fruit, 47 (10.1%) only contained a vegetable, and only 8 (1.7%) contained both a fruit and a vegetable. On average, students liked 6.68 fruits and 4.39 vegetables. Independent samples t-tests revealed that students who consumed at least one vegetable at home (M=5.25, SD=2.29) liked significantly more types of vegetables compared to students who did not consume any vegetables at home (M=3.92, SD=(2.41), t(55)=2.33, p=.023. No significant effect was found for fruits, likely due to their broader acceptability.
Results demonstrate that children in this study rely heavily on school lunch programs for access to fruits and vegetables. Additionally, while our results show that consumption of vegetables at home was related to overall vegetable liking, a variety of socioeconomic barriers exist, requiring more systemic interventions for nutrition. Therefore, optimizing FV intake inside of school is essential. Future work should continue to build strategies for maximizing the impact of school nutrition programs to reduce health disparities in chronic illness and cognitive performance for youth.
Authors:
Author - Avah Crane, Parkview Health
Co-Author - Kira Voelker, BS, BA, Parkview Health
Co-Author - Mindy Flanagan, PhD, Parkview Health
Co-Author - Michelle Druin, PhD, Parkview Health
Co-Author - Dana Albright, PhD, Parkview Health
Food for Thought: Exploring Documentation of Disordered Eating Discussions in Veteran Women’s Mental Health Care
Poster Number: B58Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Military and Veterans' Health
Women veterans exhibit alarming prevalence rates of eating disorders (EDs; Bartlett & Mitchell, 2015). Aspects of military service may be risk factors associated with developing EDs (Masheb et al., 2019). Though effective ED treatments exist (Kaidesoja et al., 2023), patient factors (Innes et al., 2017) and systemic gaps in clinical practice (Daugelat et al., 2023) are potential barriers to treatment seeking and engagement. High rates of mental health (MH) care utilization have previously been documented among women veterans with ED symptoms (Krupp et al., 2023), while rates of ED-specific treatment engagement appear low (Mitchell et al., 2022). Understanding the prevalence and context of whether and how ED symptoms are discussed in routine MH services may illuminate potential gaps in care. A retrospective medical record review was conducted among veterans who reported probable ED symptoms on a research survey (parent survey N = 197; Buchholz et al., 2018). Disordered eating symptoms were assessed using the Eating Disorders Examination Questionnaire (EDE-Q; Fairburn & Bèglin, 2008). Out of 64 respondents who reported probable ED symptoms, 28 evidenced codable MH encounters. A total of 222 MH encounter notes were reviewed and coded for presence and context of discussions of eating behaviors. Documentation of discussions regarding eating behavior most frequently appeared in relation to routine, non-specific questionnaires (n = 20 notes), medical conditions (n = 10 notes), and weight management (n = 10 notes), with infrequent reference to EDs in remission (n = 2 notes) or in relation to other MH conditions (n = 2 notes). Despite high rates of MH engagement, conversations focused on eating behaviors appear to be limited in routine MH encounters. Findings suggest the possibility that patient nondisclosure and a lack of structured screening may lead to missed opportunities to identify and address ED symptoms. Selective screening paradigms for individuals exhibiting ED risk factors may help close this symptom-treatment gap and align well with current ED research and treatment initiatives within the Veterans Health Administration. Implications for provider education will be discussed.
Keywords: Eating behaviors, Women's healthAuthors:
Author - Bethany Crawford, PhD, VA Center for Integrated Healthcare
Author - Paul King, PhD, VA Center for Integrated Healthcare
Author - Meghan B. Krupp, PhD, VA Western New York Healthcare System
Author - Laura Buchholz, PhD, VA Center for Integrated Healthcare
Author - Reza N. Sahlan, MSc, University at Buffalo
Momentary Predictors of Weight-Motivated Exercise Among Female Collegiate Athletes
Poster Number: B59Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Physical Activity
Background: Female collegiate athletes are at-risk for eating disorders (EDs); yet, detection of risk is challenging because sport participation often requires frequent and intense exercise, a behavior that also can be used to control one’s weight in EDs. Assessing if weight-based factors underlie motivation for exercise and reasons for satisfaction with exercise in this population may elucidate ED risk, because exercising for weight-motivated reasons has been linked to increased ED cognitions and behaviors. Further, identifying predictors of weight-focused exercise, such as fear of weight gain, could inform interventions. This study is the first to investigate in this population: 1) whether momentary fear of weight gain, body satisfaction, and appearance satisfaction prospectively predict weight-motivated exercise and weight-based reasons for satisfaction with exercise; and 2) whether weight-motivated exercise prospectively predicts weight-based satisfaction with exercise. Method: Female collegiate athletes (n=45) completed a 2-week ecological momentary assessment (EMA; brief smartphone-delivered surveys) protocol, comprising 6 daily surveys measuring study variables. Results: Participants endorsed weight-based reasons for exercise motivation and satisfaction 20.3% and 19.8% of the time, respectively. Multilevel models tested prospective relations. At the trend level, fear of weight gain was associated with 16% increased odds of subsequent weight-motivated exercise (OR = 1.16, SE = 0.10, p = .08) and 21% increased odds of satisfaction with exercise for weight-based reasons (OR = 1.21, SE = 0.12, p = .06). Additionally, body satisfaction was associated with 18% reduced odds of subsequent weight-motivated exercise at the trend-level (OR = 0.82, SE = 0.09, p = 0.08). Finally, engaging in weight-motivated exercise was associated with a 7-fold increase in odds of subsequent satisfaction with exercise for weight-based reasons (OR = 7.29, SE = 3.28, p < .001). Discussion: Findings suggest fear of weight gain may be a momentary risk factor for weight-focused exercise, whereas body satisfaction may be a protective factor, highlighting potential targets for momentary interventions like just-in-time adaptive interventions (JITAIs). Results also demonstrated weight-motivated exercise predicted increased odds of weight-based satisfaction with exercise, implying these weight-focused cognitions are persistent across time. Note: AI helped generate code for this project.
Keywords: Exercise, Women's healthAuthors:
Presenter - Rebecca Crochiere, Williams College
Co-Author - Ava Simunovic, Williams College
Co-Author - Euna Lee, Williams College
Co-Author - Ashley Kim, Williams College
Co-Author - Elizabeth Lampe, Geisel School of Medicine, Dartmouth College
Co-Author - Stephanie Manasse, PhD, Nemours Children's Health
Co-Author - Fengqing Zhang, PhD, Drexel University
Associations of Cyberbullying with Disordered Eating Behaviors, Intuitive Eating, and Orthorexic Eating Behaviors among College Students
Poster Number: B60Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Mental Health
Background: Cyberbullying is a psychosocial stressor that may adversely impact health. However, how cyberbullying relates to maladaptive eating behaviors (e.g., disordered eating [DE], orthorexic eating [OE]) and adaptive eating (e.g., intuitive eating [IE]) remains unclear.
Purpose: To examine associations between cyberbullying and DE, IE, and OE among college students.
Methods: A cross-sectional study was conducted among college students (N=1,621; 2022-2023, Mage=20.4±3.2). Independent variable was self-reported cyberbullying exposure (e.g., someone posted mean or hurtful comments about me online). Dependent variables included DE (e.g., overeating, binge eating), IE (e.g., I trust my body to determine how much to eat), and OE (e.g., willingness to spend more money for healthier food), all self-reported. Modified Poisson regressions examined associations between cyberbullying with DE and OE, while liner regressions examined associations with IE, adjusting for age, sex, race/ethnicity, parental education, and BMI.
Results: Although the effect sizes varied by the type of cyberbullying and eating behaviors, cyberbullying was generally associated with a higher prevalence of most DE (except binge eating; PR range=1.19-1.61), OE (PR range=1.22-1.27), and lower IE scores (β range=-2.26 to -8.39) after adjustments. Cumulative associations were observed across most DE, IE, and OE (p for trend ≤.02).
Conclusion: History of cyberbullying was associated with greater DE and OE and lower IE. These findings highlight the importance of addressing cyberbullying to prevent maladaptive eating behaviors and promote adaptive eating in college students. Longitudinal studies are needed to explore potential mediators, such as psychosocial stress and coping mechanisms, to inform targeted interventions.
Keywords: Binge eating, Mental healthPurpose: To examine associations between cyberbullying and DE, IE, and OE among college students.
Methods: A cross-sectional study was conducted among college students (N=1,621; 2022-2023, Mage=20.4±3.2). Independent variable was self-reported cyberbullying exposure (e.g., someone posted mean or hurtful comments about me online). Dependent variables included DE (e.g., overeating, binge eating), IE (e.g., I trust my body to determine how much to eat), and OE (e.g., willingness to spend more money for healthier food), all self-reported. Modified Poisson regressions examined associations between cyberbullying with DE and OE, while liner regressions examined associations with IE, adjusting for age, sex, race/ethnicity, parental education, and BMI.
Results: Although the effect sizes varied by the type of cyberbullying and eating behaviors, cyberbullying was generally associated with a higher prevalence of most DE (except binge eating; PR range=1.19-1.61), OE (PR range=1.22-1.27), and lower IE scores (β range=-2.26 to -8.39) after adjustments. Cumulative associations were observed across most DE, IE, and OE (p for trend ≤.02).
Conclusion: History of cyberbullying was associated with greater DE and OE and lower IE. These findings highlight the importance of addressing cyberbullying to prevent maladaptive eating behaviors and promote adaptive eating in college students. Longitudinal studies are needed to explore potential mediators, such as psychosocial stress and coping mechanisms, to inform targeted interventions.
Authors:
Presenter - Cynthia Yoon, PhD, Pusan National University
Co-Presenter - Anna Trabulsi, BS, University of Houston
Co-Presenter - Soo Jin Lee, PhD, Pusan National University
Co-Presenter - HaeMi Jun, BS, Pusan National University
Co-Presenter - Craig Johnston, PhD, University of Houston
Can Intuitive Eating Work at Work? A Qualitative Exploration of Workplace Wellness Programs
Poster Number: B61Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Implementation Science
Workplace wellness programs have historically emphasized weight-loss outcomes, yet evidence for their long-term effectiveness is limited. Research shows these programs can also lead to adverse effects, including weight regain, heightened workplace stigma, stress, and binge-eating behaviors. Intuitive eating (IE), which promotes awareness of hunger and satiety cues alongside gentle nutrition, has emerged as a promising weight-inclusive alternative. Early workplace-based IE interventions have demonstrated improvements in dietary quality, reductions in disordered eating, and decreased internalization of weight stigma.
To identify factors promoting and limiting the adoption of IE programs at work, 16 semi-structured interviews were conducted via Microsoft Teams with corporate nutrition experts (n=9) and workplace wellness managers (n=7) during the fall of 2024. Participants were recruited through purposive maximum variation and snowball sampling, and interviews continued until data saturation was reached. Transcripts were coded using both deductive and inductive approaches in Atlas.ti and analyzed using thematic analysis.
Two major themes with 12 subthemes emerged, reflecting direct and indirect influences on IE implementation. Direct facilitators included positive attitudes from nutrition experts, recognition of the harms of weight-loss initiatives, and flexible implementation strategies. Direct barriers included limited IE knowledge and training, cultural resistance shaped by dominant diet norms, stigma within the IE community, and organizational focus on perceived cost savings. Indirect barriers (not related to IE programs) included concerns about productivity culture, superficial or unsustainable wellness program outcomes, and reliance on weak or absent evaluation methods. Indirect facilitators included a broader shift toward holistic wellness and mental health. Additional opportunities for promoting IE programs included framing IE as a mental health benefit to gain organizational buy-in and offering group-based or hybrid program formats.
Findings suggest that while some organizations have adopted IE programs, broader uptake faces multi-level barriers. Nutrition experts largely advocate for IE approaches, whereas wellness managers tend to hold more weight-centric views and have less familiarity with IE. These perspectives highlight both the challenges and opportunities for advancing IE as a sustainable component of workplace wellness.
Keywords: Eating behaviors, Worksite healthTo identify factors promoting and limiting the adoption of IE programs at work, 16 semi-structured interviews were conducted via Microsoft Teams with corporate nutrition experts (n=9) and workplace wellness managers (n=7) during the fall of 2024. Participants were recruited through purposive maximum variation and snowball sampling, and interviews continued until data saturation was reached. Transcripts were coded using both deductive and inductive approaches in Atlas.ti and analyzed using thematic analysis.
Two major themes with 12 subthemes emerged, reflecting direct and indirect influences on IE implementation. Direct facilitators included positive attitudes from nutrition experts, recognition of the harms of weight-loss initiatives, and flexible implementation strategies. Direct barriers included limited IE knowledge and training, cultural resistance shaped by dominant diet norms, stigma within the IE community, and organizational focus on perceived cost savings. Indirect barriers (not related to IE programs) included concerns about productivity culture, superficial or unsustainable wellness program outcomes, and reliance on weak or absent evaluation methods. Indirect facilitators included a broader shift toward holistic wellness and mental health. Additional opportunities for promoting IE programs included framing IE as a mental health benefit to gain organizational buy-in and offering group-based or hybrid program formats.
Findings suggest that while some organizations have adopted IE programs, broader uptake faces multi-level barriers. Nutrition experts largely advocate for IE approaches, whereas wellness managers tend to hold more weight-centric views and have less familiarity with IE. These perspectives highlight both the challenges and opportunities for advancing IE as a sustainable component of workplace wellness.
Authors:
Author - Katie McMahon, M.S., Colorado State University
Co-Author - Shelly Palmer, M.S., Colorado State University
Co-Author - Sarah Stotz, Ph.D., Colorado State University
Co-Author - Dan Graham, Ph.D., Colorado State University
Initial Validation of the State-Dietary Restriction Scale among Adults with Eating Disorder Pathology
Poster Number: B62Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Digital Health
Dietary restriction (DR) is a prevalent and debilitating eating disorder (ED) behavior that is associated with high risk of morbidity and mortality. Despite these adverse health impacts, no research has developed a measure of DR that is designed for administration at the state-level (e.g., momentary, daily), such as via ecological momentary assessment (EMA) or daily diaries. This is notable, as state-level measures overcome limitations of cross-sectional research (e.g., retrospective recall bias) and provide insight into vital “when” questions (e.g., “When people report worse negative affect, do they also report greater DR at those times or later that day/the next day”). To address this research gap, the present study aimed to develop and provide an initial validation of the State-Dietary Restriction Scale (SDRS) in two samples (S) of adults with ED pathology. In S1, participants (N=174; Mage= 21.1, SD=3.8) completed 1 survey per day on mobile devices for a 14-day daily diary period. In S2, participants (N =150; Mage = 21.0, SD = 4.1) completed 4 surveys per day on mobile devices for a 10-day EMA period. Multilevel confirmatory and structural equation models were used to examine the construct, convergent, discriminant, and criterion validity of the SDRS. In S1 and S2, the SDRS had excellent fit as a unidimensional measure, supporting construct validity. Convergent validity was established with measures of mental health in the expected directions, and levels of significance and magnitude. For example, at times when participants reported greater DR than usual, they reported greater body dissatisfaction, negative affect, emotion dysregulation, and purging behaviors (e.g., self-induced vomiting) at those times. Discriminant validity was confirmed at the state-level via non-significant associations between DR and different intuitive eating behaviors (e.g., eating foods for health reasons). Also, supporting criterion validity, at times when (S2) and on days when (S1) participants reported greater DR than usual, they reported greater disinhibited ED behaviors (e.g., binge eating) later that day (S2) and the next day (S1), respectively. Collectively, these findings provide initial support for the SDRS as a measure of DR that is designed for state-level research. The SDRS can provide vital insight into: (1) the temporality of dynamic associations between factors that can promote and follow DR in everyday life; (2) novel targets for ED treatments.
Keywords: Eating behaviors, e-HealthAuthors:
Author - Kelly Romano, Ph.D., University of Minnesota
Co-Author - Carol Peterson, PhD, University of Minnesota
The Benefit of Daily and “Real-Time” Logging of Dietary Intake for Weight Loss
Poster Number: B63Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Weight Related Health
Background: Behavioral weight management programs encourage participants to self-monitor dietary intake daily, preferably throughout the day as eating/drinking occurs. Despite theoretical support for the importance of self-monitoring intake throughout the day, there has been little research on within-day patterns of self-monitoring and how these patterns may be associated with weight loss.
Methods: We examined within-day patterns of self-monitoring and associations with weight loss in 449 adults with obesity (mean±SD age = 49.4±11.4 years, BMI = 35.7±4.0 kg/m2, 83.5% female, 23.4% Black or African American, 9.8% Hispanic) who enrolled in a 16-week behavioral weight loss program. Participants were asked to self-monitor dietary intake daily (preferably throughout the day) using the FatSecret smartphone app. Weight was measured at baseline and the end of intervention using BodyTrace e-scales. Each day was coded as one of five patterns (no logging, backlogging on a later day, logging once a day, logging in real time, or pre-logging in advance of the day), and k-means clustering was used to categorize participants by these self-monitoring patterns. Differences in weight change between clusters were investigated via ANOVA (continuous percent change) and chi-square (whether participants achieved clinically-meaningful weight losses of ≥5% from baseline) tests.
Results: K-means clustering identified four discrete patterns of dietary self-monitoring, corresponding to tendencies toward Minimal Logging (n=101), Backlogging (n=124), Daily Logging (n=59), and Real-Time Logging (n=165). There was not a significant difference in weight loss between the Real-Time Logging (M±SD; 9.1±4.1%) and Daily Logging (7.7±4.7%) groups, p=.219; however, both groups lost more weight than the Backlogging (5.7±4.1%) and Minimal Logging (2.1±3.4%) groups, ps<.001. Moreover, 88.5% of Real-Time Logging participants achieved clinically-meaningful weight losses, compared to 71.2% of Daily Logging, 55.6% of Backlogging, and 19.8% of Minimal Logging, all between-group ps < .05.
Conclusion: Results provide empirical evidence supporting recommendations for daily (and, ideally, throughout the day) self-monitoring of dietary intake for weight loss. Future studies should investigate strategies to increase adherence to daily self-monitoring of dietary intake, such as use of technological supports and less burdensome self-monitoring tools.
Keywords: Weight loss, ObesityMethods: We examined within-day patterns of self-monitoring and associations with weight loss in 449 adults with obesity (mean±SD age = 49.4±11.4 years, BMI = 35.7±4.0 kg/m2, 83.5% female, 23.4% Black or African American, 9.8% Hispanic) who enrolled in a 16-week behavioral weight loss program. Participants were asked to self-monitor dietary intake daily (preferably throughout the day) using the FatSecret smartphone app. Weight was measured at baseline and the end of intervention using BodyTrace e-scales. Each day was coded as one of five patterns (no logging, backlogging on a later day, logging once a day, logging in real time, or pre-logging in advance of the day), and k-means clustering was used to categorize participants by these self-monitoring patterns. Differences in weight change between clusters were investigated via ANOVA (continuous percent change) and chi-square (whether participants achieved clinically-meaningful weight losses of ≥5% from baseline) tests.
Results: K-means clustering identified four discrete patterns of dietary self-monitoring, corresponding to tendencies toward Minimal Logging (n=101), Backlogging (n=124), Daily Logging (n=59), and Real-Time Logging (n=165). There was not a significant difference in weight loss between the Real-Time Logging (M±SD; 9.1±4.1%) and Daily Logging (7.7±4.7%) groups, p=.219; however, both groups lost more weight than the Backlogging (5.7±4.1%) and Minimal Logging (2.1±3.4%) groups, ps<.001. Moreover, 88.5% of Real-Time Logging participants achieved clinically-meaningful weight losses, compared to 71.2% of Daily Logging, 55.6% of Backlogging, and 19.8% of Minimal Logging, all between-group ps < .05.
Conclusion: Results provide empirical evidence supporting recommendations for daily (and, ideally, throughout the day) self-monitoring of dietary intake for weight loss. Future studies should investigate strategies to increase adherence to daily self-monitoring of dietary intake, such as use of technological supports and less burdensome self-monitoring tools.
Authors:
Presenter - Kathryn Ross, Ph.D. M.P.H. FSBM FTOS, Advocate Aurora Research Institute
Co-Author - Andrea Brockmann, Ph.D., University of Florida
Co-Author - Meena Shankar, M.S., RDN, CCRC, University of Florida
Co-Author - Jaime Ruiz, Ph.D., University of Florida
Co-Author - Yu-Peng Chen, M.S., University of Florida
Co-Author - Lisa Anthony, Ph.D., University of Florida
Co-Author - Michael Perri, Ph.D., University of Florida
Theory-Guided Smoothie Intervention Improves Outcomes in Rural Adolescents with Low Skin Carotenoid Levels
Poster Number: B64Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Social and Environmental Context and Health
Background
A diet rich in fruits is crucial during adolescence. Despite this, most adolescents fail to meet the recommended intake of fruits, especially in rural areas. Schools are uniquely positioned to influence dietary behaviors, providing an opportunity to improve fruit consumption. Interventions grounded in behavioral theories, such as Social Cognitive Theory (SCT) and Choice Architecture, are proven effective in promoting sustained behavior change through intrinsic and extrinsic motivators.
Purpose
This study evaluated an eight-week, school-based educational smoothie taste-test intervention guided by SCT and Choice Architecture-based strategies to improve fruit intake, as measured objectively by skin carotenoid levels (SCL).
Methods
Participants included 101 students (n=64 intervention, n=37 control) from 5 rural middle schools. Two schools received the intervention, three were controls. Using the Veggie Meter®, SCL were measured on two back to back days pre-post intervention, then averaged. SCLs range from 0-800, with higher scores indicating a diet higher in carotenoids. A two-way repeated measures analysis of variance assessed between-group SCL from pre-post intervention. Linear regression assessed whether baseline SCL predicted post-intervention improvements. Students were grouped into quartiles by baseline SCL, and repeated measures analysis of covariance compared changes between intervention and control groups among students in the lowest quartile. Statistical significance was set at a p<0.05.
Results
There were no significant differences between school designation in SCL from pre- to post-intervention: F(1, 99)=1.00, p=.319. In intervention schools, baseline SCL significantly predicted change: F(1,62)=32.183, p<.001, R^2=.34, B=-0.585, but no association was observed in controls. Among students in the lowest quartile (SCL<108), intervention participants showed significantly greater improvement than control participants (85.7+/-51.3 vs. 78.0+/-32.4, p=.007).
Discussion
The intervention provided an added benefit for students with the lowest baseline SCL, suggesting a protective effect for those most vulnerable. Findings support the feasibility of theory-driven, school-based smoothie interventions to improve fruit consumption in rural adolescents. Integrating choice architecture tactics with SCT may enhance student engagement, offering a scalable model to improve fruit intake and strengthen nutrition security in rural adolescents.
Keywords: Adolescents, Behavior ChangeA diet rich in fruits is crucial during adolescence. Despite this, most adolescents fail to meet the recommended intake of fruits, especially in rural areas. Schools are uniquely positioned to influence dietary behaviors, providing an opportunity to improve fruit consumption. Interventions grounded in behavioral theories, such as Social Cognitive Theory (SCT) and Choice Architecture, are proven effective in promoting sustained behavior change through intrinsic and extrinsic motivators.
Purpose
This study evaluated an eight-week, school-based educational smoothie taste-test intervention guided by SCT and Choice Architecture-based strategies to improve fruit intake, as measured objectively by skin carotenoid levels (SCL).
Methods
Participants included 101 students (n=64 intervention, n=37 control) from 5 rural middle schools. Two schools received the intervention, three were controls. Using the Veggie Meter®, SCL were measured on two back to back days pre-post intervention, then averaged. SCLs range from 0-800, with higher scores indicating a diet higher in carotenoids. A two-way repeated measures analysis of variance assessed between-group SCL from pre-post intervention. Linear regression assessed whether baseline SCL predicted post-intervention improvements. Students were grouped into quartiles by baseline SCL, and repeated measures analysis of covariance compared changes between intervention and control groups among students in the lowest quartile. Statistical significance was set at a p<0.05.
Results
There were no significant differences between school designation in SCL from pre- to post-intervention: F(1, 99)=1.00, p=.319. In intervention schools, baseline SCL significantly predicted change: F(1,62)=32.183, p<.001, R^2=.34, B=-0.585, but no association was observed in controls. Among students in the lowest quartile (SCL<108), intervention participants showed significantly greater improvement than control participants (85.7+/-51.3 vs. 78.0+/-32.4, p=.007).
Discussion
The intervention provided an added benefit for students with the lowest baseline SCL, suggesting a protective effect for those most vulnerable. Findings support the feasibility of theory-driven, school-based smoothie interventions to improve fruit consumption in rural adolescents. Integrating choice architecture tactics with SCT may enhance student engagement, offering a scalable model to improve fruit intake and strengthen nutrition security in rural adolescents.
Authors:
Author - Amelia Sullivan, MS, RDN, University of Maine
Co-Author - Bryn Kubinsky, BS, Unversity of Maine
Co-Author - Emma Watras, MS, RDN, LD, University of Maine
Co-Author - Jade McNamara, PhD, RDN, Unversity of Maine
Understanding Interest in Nutrient-Dense Meal Kits: Behavioral and Environmental Factors Among Undergraduates with Poor Diet Quality
Poster Number: B65Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Social and Environmental Context and Health
Background: College students often experience poor diet quality (DQ) due to behavioral and environmental barriers. Poor dietary habits during this life stage can contribute to chronic disease risk later in life. Thoughtfully designed, no-cost meal kits may support healthier DQ by offering nutrient-dense ingredients and simple recipes that reduce effort, skill, and financial resources.
Purpose: Examine behavioral and environmental factors that predict interest in meal kits among college students.
Methods: A cross-sectional convenience sample of undergraduates completed an online survey assessing health behaviors. Items included: DQ using the Short Healthy Eating Index, ultra-processed food consumption (UPFC) reported as servings/day, weekly cooking frequency, and food security status (FSS) using the 10-item USDA Household Food Security Module. A Pearson correlation examined directionality of relationship among variables. A linear regression determined predictors of meal kit interest. Significance was set at p<.05.
Results: Participants (N=477) were on average 20.2 (±2.0) years old, primarily White (90.0%), female (65.3%), and evenly distributed across grade levels. Overall, DQ was low (47.7±10.0). Almost one-third of respondents (27%, n=135) indicated interest in receiving a meal kit, and 24% (n = 117) were neutral/not sure. Approximately 44% (n=219) of students agreed or strongly agreed that meal kits would improve their DQ. Higher interest in meal kits was associated with lower DQ (r=.11, p=.023), higher UPFC (r=-.10, p=.002), and infrequent cooking (r=.14, p=.009). FSS was not associated with meal kit interest (r=-.07, p =.105). Lower UPFC was associated with lower DQ (r=-.37, p<.001) and infrequent cooking (r=-.18, p<.001). The overall regression model was significant, F(5,295)=2.708, p=.021, R2=.028. Cooking infrequently was the only significant predictor of meal kit interest (ß=.13, p=.026).
Conclusions: Interest in meal kits among college students was associated with lower DQ, higher UPFC, and less frequent cooking, suggesting meal kits may appeal most to those who cook less frequently and have room for dietary improvement. Providing nutritious, free meal kits may reduce barriers to healthy eating and introduce students to new, health-promoting foods, leading to healthier eating behaviors and chronic disease prevention. Future research should explore how meal kits can be integrated on campuses to improve DQ and reduce barriers to healthy eating.
Keywords: Nutrition, Community interventionPurpose: Examine behavioral and environmental factors that predict interest in meal kits among college students.
Methods: A cross-sectional convenience sample of undergraduates completed an online survey assessing health behaviors. Items included: DQ using the Short Healthy Eating Index, ultra-processed food consumption (UPFC) reported as servings/day, weekly cooking frequency, and food security status (FSS) using the 10-item USDA Household Food Security Module. A Pearson correlation examined directionality of relationship among variables. A linear regression determined predictors of meal kit interest. Significance was set at p<.05.
Results: Participants (N=477) were on average 20.2 (±2.0) years old, primarily White (90.0%), female (65.3%), and evenly distributed across grade levels. Overall, DQ was low (47.7±10.0). Almost one-third of respondents (27%, n=135) indicated interest in receiving a meal kit, and 24% (n = 117) were neutral/not sure. Approximately 44% (n=219) of students agreed or strongly agreed that meal kits would improve their DQ. Higher interest in meal kits was associated with lower DQ (r=.11, p=.023), higher UPFC (r=-.10, p=.002), and infrequent cooking (r=.14, p=.009). FSS was not associated with meal kit interest (r=-.07, p =.105). Lower UPFC was associated with lower DQ (r=-.37, p<.001) and infrequent cooking (r=-.18, p<.001). The overall regression model was significant, F(5,295)=2.708, p=.021, R2=.028. Cooking infrequently was the only significant predictor of meal kit interest (ß=.13, p=.026).
Conclusions: Interest in meal kits among college students was associated with lower DQ, higher UPFC, and less frequent cooking, suggesting meal kits may appeal most to those who cook less frequently and have room for dietary improvement. Providing nutritious, free meal kits may reduce barriers to healthy eating and introduce students to new, health-promoting foods, leading to healthier eating behaviors and chronic disease prevention. Future research should explore how meal kits can be integrated on campuses to improve DQ and reduce barriers to healthy eating.
Authors:
Author - Emma Watras, MS, RDN, LD, University of Maine
Co-Author - Amelia Sullivan, MS, RDN, University of Maine
Co-Presenter - Bryn Kubinsky, BS, University of Maine
Co-Author - Jade McNamara, PhD, RDN, University of Maine
SELF-COMPASSION IS ASSOCIATED WITH DISORDERED EATING SYMPTOMOLOGY, BUT FAILED TO MODERATE ASSOCIATIONS BETWEENATHLETIC-IDEAL INTERNALIZATION AND DISORDERED EATING SYMPTOMOLOGY AMONG U.S. STUDENT-ATHLETES
Poster Number: B66Time: 11:00 AM - 11:50 AM
Topics: Diet, Nutrition, and Eating Disorders, Weight Related Health
Background. Collegiate athletes face academic and athletic performance pressures that increase their risk for disordered eating (Byrne & McLean, 2001; Epli Koc, 2016; Magnus et al, 2009). Estimates suggest 7% to 47% of student-athletes experience disordered eating (Labossière & Thibault, 2020); however, these estimates are likely lower than reality because athletes tend to underreport eating disorder symptoms due to the misperception that food restriction and excessive exercise enhance performance (Bratland-Sanda & Sundgot-Borgen, 2013). Sport-related pressures, like internalization of sociocultural attitudes about the importance of an athletic physique (known as athletic-ideal internalization), may contribute to disordered eating as athletes engage in extreme eating behaviors to achieve the optimal physical attributes and build for their sport (Bell et al., 2016). Thus, it is important to examine factors that may protect student-athletes against the development of disordered eating in the context of athletic-ideal internalization. Methods. This study explored self-compassion as a moderator of the relation between athletic-ideal internalization and disordered eating in student-athletes. Data were collected from undergraduate student-athletes at midwestern universities using an online survey (n=220) between October 2024 and April 2025. Participants reported their demographics, information related to their experience as a student-athletes, and study measures. Results. Athletes’ self-compassion was negatively associated with body dissatisfaction (r= -0.30, p<.01) binge eating (r= -0.25, p<.01), cognitive restraint (r= -0.21, p<.01), excessive exercise (r= -0.20, p< .01), restrictive eating (r= -0.15 p<.05), and athletic-ideal internalization (r= -0.15 p<.05). However, self-compassion did not significantly moderate the association between athletic-ideal internalization and disordered eating symptomology. Conclusions. Collegiate athletes who reported higher self-compassion also reported lower disordered eating and lower athletic-ideal internalization, but self-compassion did not impact associations between internalization and disordered eating. Future interventions should examine whether cultivating self-compassion can buffer the effects of athlete-specific risk factors for disordered eating.
Keywords: Eating behaviors, Attitude(s)Authors:
Author - Caitlyn Zon, M.S., Illinois Institute of Technology
Co-Author - Arlen Moller, PhD, Illinois Institute of Technology
Co-Author - Alissa Haedt-Matt, PhD, Rosalind Franklin
Social Comparison via Physical Activity Leaderboards: Perceptions, Preferences, and Implications for Physical Activity Promotion among Insufficiently Active Adults
Poster Number: B67Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Physical Activity
Background: Opportunities for social comparison (self-evaluation relative to others) are often used as behavior change techniques to promote physical activity (PA). These opportunities are common in digital health tools via leaderboards that rank a users’ PA behavior against that of others. Highly active people tend to respond positively to these opportunities; however, evidence shows mixed responses to leaderboards, and how they function among insufficiently active adults (i.e., to increase PA) is unclear. This study was designed to explore how these adults perceive and process information from PA leaderboards, as an application of social comparison in health behavior promotion.
Methods: Insufficiently active adults (N=21; MAge=36 years; MBMI=30.5 kg/m2; 67% women; 62% underrepresented group) participated in a 1-hour semi-structured interview. Participants described their overarching perceptions of social comparison; their perceptions of and responses to PA leaderboards; and their feedback on a new PA leaderboard interface. Interviews were independently coded by 2 trained researchers and we used reflexive thematic analysis with member checking to generate and refine themes.
Results: We generated 5 themes related to social comparison and leaderboards in the context of PA: 1) a shift in attitudes toward social comparison during the interview (from negative to neutral or mixed); 2) responses to comparison were dependent on person-level traits (stable across time and situations) and situational factors (which can vary for the same person); 3) even without context, a leaderboard image prompted (mild) emotional responses; 4) openness to PA leaderboards as helpful for motivating PA, and; 5) a broader desire for ways to connect with others around PA.
Conclusions: Insufficiently active adults recognize social comparison as a common experience and can describe their perceptions and responses, which depend on person- and context-level factors. Observed emotional responses underscore the ubiquity of comparison processes and how people draw on these experiences to form their views of its utility. Although comparison was initially described as negative, leaderboards were perceived as positive, with interest in interaction with the other leaderboard users. Thus, insufficiently active adults are receptive to leaderboards as a helpful tool to support PA promotion, though their effects on PA motivation and behavior require rigorous testing in daily life.
Keywords: Social stress, Health behavior changeMethods: Insufficiently active adults (N=21; MAge=36 years; MBMI=30.5 kg/m2; 67% women; 62% underrepresented group) participated in a 1-hour semi-structured interview. Participants described their overarching perceptions of social comparison; their perceptions of and responses to PA leaderboards; and their feedback on a new PA leaderboard interface. Interviews were independently coded by 2 trained researchers and we used reflexive thematic analysis with member checking to generate and refine themes.
Results: We generated 5 themes related to social comparison and leaderboards in the context of PA: 1) a shift in attitudes toward social comparison during the interview (from negative to neutral or mixed); 2) responses to comparison were dependent on person-level traits (stable across time and situations) and situational factors (which can vary for the same person); 3) even without context, a leaderboard image prompted (mild) emotional responses; 4) openness to PA leaderboards as helpful for motivating PA, and; 5) a broader desire for ways to connect with others around PA.
Conclusions: Insufficiently active adults recognize social comparison as a common experience and can describe their perceptions and responses, which depend on person- and context-level factors. Observed emotional responses underscore the ubiquity of comparison processes and how people draw on these experiences to form their views of its utility. Although comparison was initially described as negative, leaderboards were perceived as positive, with interest in interaction with the other leaderboard users. Thus, insufficiently active adults are receptive to leaderboards as a helpful tool to support PA promotion, though their effects on PA motivation and behavior require rigorous testing in daily life.
Authors:
Presenter - Raj Harsora, B.S., Rowan University
Co-Author - Emmanuel Lapitan, M.A., Rowan University
Co-Author - Ninelle Edenne, BA, Rowan University
Co-Author - Angelica R. Rivera, B.A., Rowan University
Co-Author - Giada Benasi, PhD, Rowan University
Co-Author - Gabrielle Salvatore, PhD, Rowan University
Co-Author - Andrea F. Lobo, Ph.D., Rowan University
Co-Author - Danielle Arigo, PhD, LP, FSBM, Rowan University
Participant responses to AI generated images in a technology-based intervention designed to encourage protection against overdose
Poster Number: B68Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Substance Misuse
Our team creates technology-based interventions to encourage positive health behaviors among people who use drugs (PWUD). Over multiple studies, we developed the Participatory Education and Research into Lived Experience (PEARLE) methodology which, among other formative steps, entails showing storyboards to members of a target population and conducting interviews to explore what types of messaging will be effective, and who should deliver these messages onscreen.
In July of 2025 as part of a project to develop an intervention encouraging participants to protect themselves and others from overdose, we created a series of images using ChatGPT and Gemini AI tools. One set of images depicted men and women of different ages and races. Another set showed both photo-realistic and cartoon looking images of drugs (a pile of powder next to a straw and a lighter), and a “safer crack smoking kit”.
In August we showed very basic storyboards featuring draft messages matched with the AI images to a convenience sample of New York City adults (n=18) who reported using illicit substances within the past 30 days. Three interviewers who had experience working with PWUD conducted semi-structured interviews examining participants’ response to the images and the messaging.
Participants frequently attributed complicated backstories to each AI image, describing who was openly using drugs, who was in recovery, and who might be using drugs in secret. Participants also overwhelmingly said they preferred photo-realistic images of drugs and harm reduction supplies (e.g. an intranasal naloxone dispenser) to cartoon looking illustrations because the serious nature of substance use and overdose warranted “real” images. When shown the different sets of AI generated images and asked which would be the best to deliver messages about protection against overdose, participants almost universally chose images of two middle aged White males, both off which had been created in response to a prompt of “former drug user in New York”.
Although not originally intended as a study of participant response to AI created images, our work suggests numerous lines of inquiry. Particularly interesting questions include why participants so frequently assigned detailed behavioral histories to computer generated images, and why so many participants selected images created in response to a prompt for a former drug user in New York as the best person to deliver messaging.
Keywords: Technology, Substance abuseIn July of 2025 as part of a project to develop an intervention encouraging participants to protect themselves and others from overdose, we created a series of images using ChatGPT and Gemini AI tools. One set of images depicted men and women of different ages and races. Another set showed both photo-realistic and cartoon looking images of drugs (a pile of powder next to a straw and a lighter), and a “safer crack smoking kit”.
In August we showed very basic storyboards featuring draft messages matched with the AI images to a convenience sample of New York City adults (n=18) who reported using illicit substances within the past 30 days. Three interviewers who had experience working with PWUD conducted semi-structured interviews examining participants’ response to the images and the messaging.
Participants frequently attributed complicated backstories to each AI image, describing who was openly using drugs, who was in recovery, and who might be using drugs in secret. Participants also overwhelmingly said they preferred photo-realistic images of drugs and harm reduction supplies (e.g. an intranasal naloxone dispenser) to cartoon looking illustrations because the serious nature of substance use and overdose warranted “real” images. When shown the different sets of AI generated images and asked which would be the best to deliver messages about protection against overdose, participants almost universally chose images of two middle aged White males, both off which had been created in response to a prompt of “former drug user in New York”.
Although not originally intended as a study of participant response to AI created images, our work suggests numerous lines of inquiry. Particularly interesting questions include why participants so frequently assigned detailed behavioral histories to computer generated images, and why so many participants selected images created in response to a prompt for a former drug user in New York as the best person to deliver messaging.
Authors:
Presenter - Ian Aronson, Ph.D., NDRI-USA
Author - Robert Quiles, NDRI-USA
Author - Anthony Cramer, NDRI-USA
Author - Olivia Marcus, Ph.D., NDRI-USA
Author - Alex S. Bennett, Ph.D., NYU
Education and Language as Barriers to Telehealth Utilization: Evidence of the Digital Divide in the United States, 2022
Poster Number: B69Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Health Disparities
Abstract
Background
Telehealth has become a vital component of healthcare delivery in the United States, especially following the COVID-19 pandemic. However, disparities in digital access persist. The digital divide—defined by differences in digital literacy, access, and communication ability—may limit telehealth adoption among marginalized populations. This study examines how two key indicators of the digital divide—educational attainment and English language proficiency—affect telehealth utilization.
Objectives
To evaluate whether lower levels of education and limited English proficiency are associated with decreased telehealth use among U.S. adults.
Methods
This study used 2022 data from the Medical Expenditure Panel Survey (MEPS), integrating the full-year consolidated file and office-based visit file. Adults aged 18 and older were included. Telehealth utilization was measured as a binary variable indicating whether a respondent had a telehealth visit. Multivariable logistic regression was used to assess the relationship between telehealth use and two main predictors: education level and self-reported English proficiency. Models adjusted for age, sex, race/ethnicity, insurance coverage, marital status, region, and poverty status. Final results are based on a fully adjusted model including both predictors. Analyses accounted for MEPS's complex survey design using weights and robust standard errors.
Results
Individuals with less than a high school education had significantly lower odds of using telehealth compared to those with a college degree (OR = 0.58, 95% CI: 0.45–0.76). Respondents who reported speaking English “not well” had 58% lower odds of telehealth use compared to those who spoke “very well” (OR = 0.42, 95% CI: 0.30–0.59).
Conclusions
Educational attainment and English proficiency are key barriers to telehealth utilization in the U.S. These findings underscore the importance of addressing the digital divide through targeted outreach, language access services, and digital literacy efforts to ensure equitable virtual care access for all populations.
Keywords: Tele-health, DisparitiesBackground
Telehealth has become a vital component of healthcare delivery in the United States, especially following the COVID-19 pandemic. However, disparities in digital access persist. The digital divide—defined by differences in digital literacy, access, and communication ability—may limit telehealth adoption among marginalized populations. This study examines how two key indicators of the digital divide—educational attainment and English language proficiency—affect telehealth utilization.
Objectives
To evaluate whether lower levels of education and limited English proficiency are associated with decreased telehealth use among U.S. adults.
Methods
This study used 2022 data from the Medical Expenditure Panel Survey (MEPS), integrating the full-year consolidated file and office-based visit file. Adults aged 18 and older were included. Telehealth utilization was measured as a binary variable indicating whether a respondent had a telehealth visit. Multivariable logistic regression was used to assess the relationship between telehealth use and two main predictors: education level and self-reported English proficiency. Models adjusted for age, sex, race/ethnicity, insurance coverage, marital status, region, and poverty status. Final results are based on a fully adjusted model including both predictors. Analyses accounted for MEPS's complex survey design using weights and robust standard errors.
Results
Individuals with less than a high school education had significantly lower odds of using telehealth compared to those with a college degree (OR = 0.58, 95% CI: 0.45–0.76). Respondents who reported speaking English “not well” had 58% lower odds of telehealth use compared to those who spoke “very well” (OR = 0.42, 95% CI: 0.30–0.59).
Conclusions
Educational attainment and English proficiency are key barriers to telehealth utilization in the U.S. These findings underscore the importance of addressing the digital divide through targeted outreach, language access services, and digital literacy efforts to ensure equitable virtual care access for all populations.
Authors:
Author - Memuna Aslam, Oregon State University
Co-designing STARRS personalized feedback visualizations with expectant parents: Preparation phase research to inform a just-in-time adaptive intervention for emotion regulation
Poster Number: B70Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Mental Health
Stress during the transition to parenthood significantly impacts parental and infant outcomes, yet there are few interventions to support emotion regulation (ER) that are easily accessible in the daily lives of expectant parents. Mobile health (mHealth) interventions have the potential to offer accessible, real-time support to help individuals build important ER skills for managing stress. Yet, sustained user engagement remains a critical challenge. Personalized feedback visualizations are one promising strategy for increasing engagement in app-based ER skill activities. The broaden-and-build theory and empirical research suggest positive emotions such as enjoyment and interest promote open thinking, exploration, and skill-building, thereby increasing motivation to engage in current and future tasks. Thus, we hypothesized that positive emotions elicited by viewing personalized feedback visualizations can increase future engagement in ER skill activities. The present study involved a quantitative survey and semi-structured interview with first-time expectant parents (N=31) with the purpose of co-designing features of personalized feedback visualizations. On average participants reported that app-based visualizations of their personal data were useful (M=3.5, SD=0.9) and enjoyable (M=3.7, SD=0.8). Further, they indicated interest in additional tools to manage emotions and stress (M=4.2, SD=0.7), including reminders to check in on their emotions and stress (M=3.4, SD=1.0). When presented with several feedback visualization options, the most highly rated included (1) which ER skills most reduced stress (M=4.5, SD=0.6), (2) changes in physiological stress before and after using an app-based ER skill activity (M=4.4, SD=0.7), and (3) prevalence of common stressors (M=4.4, SD=0.7). In contrast, participants were least interested in visualizations that pertained to number and types of app-based ER skill activities completed in the app (M=3.2, SD=1.2). We also asked participants describe their own ideas for visualizations which included themes pertaining to length of time in stressful states, how sleep affects stress, and fluctuations in mood. Insights from this co-design study will inform refinements to a suite of personalized feedback visualizations and lay the groundwork for subsequent research geared toward constructing a just-in-time adaptive intervention for improving ER during the transition to parenthood.
Keywords: Participatory research, TechnologyAuthors:
Presenter - Lizbeth Benson, PhD, University of Michigan
Co-Author - Irene Tung, PhD, California State University, Dominguez Hills
Co-Author - Tiffany Sudijono, University of Michigan
Co-Author - Amanda Kubitz, University of Michigan
Co-Author - Paloma Vega Martinez, California State University Dominguez Hills
Co-Author - Vanessa Pedroza, California State University Dominguez Hills
Co-Author - Jennifer Baker, BA, California State University Dominguez Hills
Co-Author - Arianna Peredia, California State University Dominguez Hills
Co-Author - Xuhai 'Orson' Xu, PhD, Columbia University
Technology-Assisted Mindfulness-Based Interventions to Reduce Loneliness in Underserved Communities
Poster Number: B71Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Mental Health
Loneliness is an urgent public health challenge in the United States, with significant effects on mental and physical health while deepening inequalities. An estimated 37.4% of adults report moderate to severe loneliness. Research consistently links loneliness to mental health conditions and physical illnesses, such as increased risk of cardiovascular diseases and premature mortality. Furthermore, widespread loneliness also strains families, communities, and healthcare systems. This study examined the effectiveness of two technology-assisted mindfulness-based stress reduction (MBSR) interventions—one delivered via smartphone app and the other via videoconferencing—in reducing loneliness among underserved communities. A three-arm randomized controlled trial was conducted with adults in Western New York. Participants were randomly assigned to one of three groups: an 8-week mobile app-based MBSR program, an 8-week videoconference (Zoom) MBSR program, or a control group. Loneliness and social disconnection were assessed at five time points (baseline through 3-month follow-up). Analysis used latent growth modeling in Mplus Version 8.4. The sample included 250 participants (mean age = 44.85 years; 83.6% female; 70.8% Black). No significant baseline differences were observed across groups. Results showed that loneliness decreased more steeply over time in both the Zoom and app groups compared to the control group (by -4.180, p = .002, 95% CI = [-6.855, -1.548] and by -3.943, p = .002, 95% CI = [-6.468, -1.417], respectively). Notably, the app group continued to show progressive improvement in loneliness over time, whereas the Zoom group demonstrated significant improvement immediately after the intervention, but the effect plateaued between one and three months. We did not observe improvement in social disconnectedness from pre- to post-intervention in either group; however, the app group showed a significantly faster decline in social disconnectedness over time than the control group. These findings indicate that both app- and videoconference-based MBSR interventions can effectively reduce loneliness among underserved adults. The results underscore the potential of digital platforms as practical modalities for delivering mindfulness-based support. Importantly, technology-assisted interventions provide scalable, cost-effective solutions while expanding access to evidence-based care and overcoming barriers such as geography, transportation, and provider shortages.
Keywords: Mindfulness, e-HealthAuthors:
Presenter - Yu-Ping Chang, PhD, University at Buffalo
Author - Weijun Wang, PhD, University at Buffalo, The State University of New York
VISION-ACT: A mobile health (mHealth) behavioral intervention for distress in glaucoma patients
Poster Number: B72Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Stress
INTRODUCTION
Glaucoma patients often experience psychosocial distress, negatively impacting disease outcomes and accelerating progression. Behavioral interventions for distress in glaucoma are sparse and when available often require a provider. To increase coping skills for distressed glaucoma patients, we used a scalable delivery mechanism of a mobile health (mHealth) framework to deliver a behavioral intervention based on Acceptance and Commitment Therapy (ACT), called VISION-ACT. This details its iterative development and preliminary feasibility and acceptability.
METHODS
We interviewed 20 primary open-angle glaucoma (POAG) patients from Duke in four iterative phases of semi-structured interviews, during which the mHealth framework was refined based on emerging themes and feedback. Interviews were recorded, transcribed, and rapidly analyzed to directly inform VISION-ACT app development. We then recruited POAG patients (age≥18 years) who had a visual field within the past year at the Duke Eye Center, have been prescribed pressure lowering eye drop medication, and endorsed at least mild distress (Patient Health Questionnaire-4≥3) to participate in the refined 6-week mobile app based behavioral intervention, VISION-ACT. Patients completed self-report assessments including the Hospital Anxiety and Depression Scale (HADS) at baseline (A1), post treatment (A2), and 1-month follow-up (A3).
RESULTS
Patient interview feedback provided valuable insights for refining our ACT-based mHealth intervention and findings set the stage for the pilot study to test the VISION-ACT mobile app and assess initial feasibility, acceptability, and preliminary efficacy to reduce distress in POAG patients. Our pilot patients (N=17) are 47% male, 53% White, 29% Black, with a mean baseline HADS of 11.5 (4.1) and age of 64.9 (8.4) years. Preliminary findings suggest VISION-ACT is feasible (accrual=17 in 5 months, 91% retention at A2), acceptable (average Client Satisfaction Questionnaire>3.1/4), and 88% reported use of skills or ideas from the intervention at A2.
DISCUSSION
VISION-ACT demonstrates strong initial feasibility and acceptability. These findings support the potential of this scalable mHealth behavioral intervention to address psychosocial needs in glaucoma patients. Future work will test the VISION-ACT protocol in a fully powered efficacy trial.
*This abstract was prepared with assistance from AI-based writing tools; all content was reviewed and finalized by the authors.*
Keywords: Stress, e-HealthGlaucoma patients often experience psychosocial distress, negatively impacting disease outcomes and accelerating progression. Behavioral interventions for distress in glaucoma are sparse and when available often require a provider. To increase coping skills for distressed glaucoma patients, we used a scalable delivery mechanism of a mobile health (mHealth) framework to deliver a behavioral intervention based on Acceptance and Commitment Therapy (ACT), called VISION-ACT. This details its iterative development and preliminary feasibility and acceptability.
METHODS
We interviewed 20 primary open-angle glaucoma (POAG) patients from Duke in four iterative phases of semi-structured interviews, during which the mHealth framework was refined based on emerging themes and feedback. Interviews were recorded, transcribed, and rapidly analyzed to directly inform VISION-ACT app development. We then recruited POAG patients (age≥18 years) who had a visual field within the past year at the Duke Eye Center, have been prescribed pressure lowering eye drop medication, and endorsed at least mild distress (Patient Health Questionnaire-4≥3) to participate in the refined 6-week mobile app based behavioral intervention, VISION-ACT. Patients completed self-report assessments including the Hospital Anxiety and Depression Scale (HADS) at baseline (A1), post treatment (A2), and 1-month follow-up (A3).
RESULTS
Patient interview feedback provided valuable insights for refining our ACT-based mHealth intervention and findings set the stage for the pilot study to test the VISION-ACT mobile app and assess initial feasibility, acceptability, and preliminary efficacy to reduce distress in POAG patients. Our pilot patients (N=17) are 47% male, 53% White, 29% Black, with a mean baseline HADS of 11.5 (4.1) and age of 64.9 (8.4) years. Preliminary findings suggest VISION-ACT is feasible (accrual=17 in 5 months, 91% retention at A2), acceptable (average Client Satisfaction Questionnaire>3.1/4), and 88% reported use of skills or ideas from the intervention at A2.
DISCUSSION
VISION-ACT demonstrates strong initial feasibility and acceptability. These findings support the potential of this scalable mHealth behavioral intervention to address psychosocial needs in glaucoma patients. Future work will test the VISION-ACT protocol in a fully powered efficacy trial.
*This abstract was prepared with assistance from AI-based writing tools; all content was reviewed and finalized by the authors.*
Authors:
Presenter - Natalie Chou, BA, Duke University School of Medicine
Co-Author - Hannah Fisher, PhD, Duke University School of Medicine
Co-Author - Laura Fish, PhD, Duke University Medical Center
Co-Author - Margaret Falkovic, MSW, Duke University Medical Center
Co-Author - Heather Parnell, MSW, Duke University Medical Center
Co-Author - Christina Makarushka, MPH, Duke University Medical Center
Co-Author - Felipe Medeiros, MD, University of Miami Miller School of Medicine
Co-Author - Kelly Muir, MD, Duke University School of Medicine
Co-Author - Tamara Somers, PhD, Duke University School of Medicine
Co-Author - Samuel Berchuck, PhD, Duke University School of Medicine
Exploring Social Motivational Mechanisms in Virtual Physical Activity Interventions for Children and Adolescents: A Scoping Review
Poster Number: B73Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Physical Activity
Background:
Virtual physical activity (PA) interventions, such as e-health/m-health apps and online fitness programs, have burgeoned in recent years as a promising approach for increasing youth PA. While many PA interventions focus on changing individual-level mechanisms, the role of social motivational contextual features remains underexplored (Benavides et al., 2021; Benítez-Andrades et al., 2020; Ridgers et al., 2021). Therefore, the purpose of this scoping review is to explore how virtual PA interventions use social motivational strategies to improve or enhance PA participation among children and adolescents in school-based and community settings. Given the growing interest in leveraging technology for health and PA promotion, we examined the current state of research on social motivational components such as peer and family interaction, support, and belongingness within virtual PA programs.
Methods:
Following PRISMA-ScR guidelines, we systematically searched APA PsycINFO, ProQuest, PubMed, and SPORTDiscus for peer-reviewed articles published between January 2010 and March 2024. Eligible studies (1) included youth aged 6–18, (2) used virtual or digital PA delivery (e.g., apps, online PE), (3) integrated at least one social motivational component (e.g., social comparison, peer interaction, team challenges, social norm messaging), and (4) were implemented in school or community settings. Of the 318 records initially identified, seven studies met the inclusion criteria.
Results:
Virtual PA interventions that incorporated peer interaction, group goals, class competitions, or family-based support demonstrated short-term benefits for motivation, social connectedness, and PA involvement. These benefits were observed across both children and adolescents, with students often reporting greater ownership, accountability, and enjoyment when social features were emphasized. However, most programs were brief, focused on engagement rather than long-term behavior change, and rarely tailored their design to meet the developmental needs across childhood and adolescence.
Conclusion:
Although virtual PA programs with social features show promise for improving short-term outcomes, there is a need for developmentally tailored virtual interventions that promote sustained, real-world PA. Future research should integrate adaptive features aligned with cognitive, social, and emotional development, thereby sustaining engagement beyond the novelty effect.
Keywords: e-Health, Physical activityVirtual physical activity (PA) interventions, such as e-health/m-health apps and online fitness programs, have burgeoned in recent years as a promising approach for increasing youth PA. While many PA interventions focus on changing individual-level mechanisms, the role of social motivational contextual features remains underexplored (Benavides et al., 2021; Benítez-Andrades et al., 2020; Ridgers et al., 2021). Therefore, the purpose of this scoping review is to explore how virtual PA interventions use social motivational strategies to improve or enhance PA participation among children and adolescents in school-based and community settings. Given the growing interest in leveraging technology for health and PA promotion, we examined the current state of research on social motivational components such as peer and family interaction, support, and belongingness within virtual PA programs.
Methods:
Following PRISMA-ScR guidelines, we systematically searched APA PsycINFO, ProQuest, PubMed, and SPORTDiscus for peer-reviewed articles published between January 2010 and March 2024. Eligible studies (1) included youth aged 6–18, (2) used virtual or digital PA delivery (e.g., apps, online PE), (3) integrated at least one social motivational component (e.g., social comparison, peer interaction, team challenges, social norm messaging), and (4) were implemented in school or community settings. Of the 318 records initially identified, seven studies met the inclusion criteria.
Results:
Virtual PA interventions that incorporated peer interaction, group goals, class competitions, or family-based support demonstrated short-term benefits for motivation, social connectedness, and PA involvement. These benefits were observed across both children and adolescents, with students often reporting greater ownership, accountability, and enjoyment when social features were emphasized. However, most programs were brief, focused on engagement rather than long-term behavior change, and rarely tailored their design to meet the developmental needs across childhood and adolescence.
Conclusion:
Although virtual PA programs with social features show promise for improving short-term outcomes, there is a need for developmentally tailored virtual interventions that promote sustained, real-world PA. Future research should integrate adaptive features aligned with cognitive, social, and emotional development, thereby sustaining engagement beyond the novelty effect.
Authors:
Author - Katherine Gann, University of Arkansas
Author - Anqi Deng, PhD, University of South Carolina
Author - Nicole Zarrett, PhD, FSBM, University of South Carolina
Understanding Factors Influencing Compliance, Engagement, and Adherence to a 4-Month Digital Therapeutics Physical Activity Intervention
Poster Number: B74Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Physical Activity
Digital therapeutics allow for the implementation of scalable real-world health behavior interventions. However, participants’ compliance, engagement, and adherence over time may fluctuate and wane, contributing to an intervention’s effectiveness. The current study examined time-invariant and time-varying factors influencing participants’ compliance, engagement, and adherence to a 4-month digital therapeutic intervention aimed to enhance affective response (i.e., how people feel) during physical activity (PA) among inactive adults. Digital intervention strategies included Sunday scheduling and daily PA goals/planning sessions through smartphone notifications. Outcomes (i.e., affective response) were assessed through Ecological Momentary Assessment (EMA) and smartwatch accelerometry. Passively-collected metrics assessed compliance to assessment procedures (e.g., smartwatch wear time, EMA response rates), engagement with digital intervention strategies (e.g., completion of daily goal/planning sessions), and adherence to behavioral intervention components (e.g., achieving their daily goal, completing intended PA sessions from the Sunday scheduling). Multilevel models examined the effects of time-varying temporal (day of week) and psychological factors (momentary affect, stress), and time-invariant demographics (sex, race, ethnicity) on compliance, engagement, and adherence. Interactions between time-in-study and variables of interest were also tested. To date, 76 adults (ages 19-85, 63% female) have completed the study. Females were more likely to complete morning (OR=1.14, p=.03) and evening (OR=1.24, p=.002) goal sessions, and intended PA sessions (OR=1.21, p=.01) but were less likely to meet their PA goal (OR=0.69, p=.003). Time-varying factors showed lower odds of completing intended PA on Monday-Thursday (vs. Sunday) (ORs=.78-.62, ps=.04-<.001), and greater odds of completing intended PA when participants felt greater levels of stress (OR=1.01, p<.001) and greater negative affect (OR=3.38, p<.001) that morning. Significant interactions were found between time-in-study and many variables of interest, indicating changing patterns of compliance, engagement, and adherence over time. Findings display the dynamic nature of compliance, engagement, and adherence from a 4-month real-world digital therapeutic intervention. These findings help identify factors that can inform intervention design and implementation to improve overall intervention effectiveness.
Keywords: Physical activity, e-HealthAuthors:
Author - Lori Hatzinger, MS, University of Southern California
Co-Author - Max Samuelson, University of Southern California
Co-Author - Micaela Hewus, University of Southern California
Co-Author - Wei-Lin Wang, PhD, University of Southern California
Co-Author - Jimi Huh, PhD, University of Southern California
Co-Author - Deflien Van Dyck, PhD, Ghent University
Co-Author - Genevieve Dunton, PhD, MPH, FSBM, University of Southern California
A Mobile Health (mHealth) Intervention to Support Pain Self-Management and Quality of Life Among Cancer Survivors: Protocol for a Pilot Study
Poster Number: B75Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Pain
Background: Cancer survivors commonly experience post-treatment pain, with over half reporting it and up to 38% experiencing moderate to severe levels. While opioids are widely used, concerns about misuse and side effects underscore the need for accessible, non-opioid alternatives. Evidence supports cognitive behavioral and mindfulness-based strategies for pain self-management. Mobile health (mHealth) apps offer scalable, cost-effective delivery. This study aims to provide comprehensive methodological details to ensure replicability and to evaluate an mHealth intervention designed to support pain self-management and improve quality of life among cancer survivors.
Methods: A curated set of 60 pre-tested messages targeting pain, opioid education, mental health, and symptom severity was implemented in the PiLR Health™ mHealth app for a 1-week, single-arm pilot intervention. Up to 20 eligible participants (≥18 years old, cancer survivors within 3 years of diagnosis, experiencing pain) will complete a baseline survey, ecological momentary assessments (EMAs; sent at a randomly selected time between 8–11 AM and 5–8 PM), e-diary entries, and a post-intervention survey. A randomly selected message will be sent at a randomly selected time between 8 and 11 AM daily, followed by brief ratings of message effectiveness. Participants can earn up to $116 for completing all activities: $30 each for baseline and follow-up surveys, and up to $56 for EMAs. As a pilot, analysis will focus on feasibility (≥80% retention and EMA completion), acceptability (Post-Study System Usability Questionnaire mean score ≥3.5), and preliminary efficacy (pre-post changes in pain severity and quality of life scores). Engagement metrics (e.g., time spent on the app) will be analyzed, and qualitative data from e-diaries will be examined using sentiment and linguistic analysis.
Results and Next Steps: The app is currently in internal testing. Recruitment will begin in October 2025 using electronic health record screening, paid social media ads, and community outreach. Data collection is expected to conclude by December 2025. The protocol and results will be presented at the meeting, if invited. Findings will provide benchmarks and preliminary evidence of feasibility and acceptability for a future waitlist-controlled, biomarker-informed trial. The pilot will also inform design refinements and implementation strategies for a larger trial targeting underserved cancer survivors experiencing pain.
Keywords: Cancer, InterventionsMethods: A curated set of 60 pre-tested messages targeting pain, opioid education, mental health, and symptom severity was implemented in the PiLR Health™ mHealth app for a 1-week, single-arm pilot intervention. Up to 20 eligible participants (≥18 years old, cancer survivors within 3 years of diagnosis, experiencing pain) will complete a baseline survey, ecological momentary assessments (EMAs; sent at a randomly selected time between 8–11 AM and 5–8 PM), e-diary entries, and a post-intervention survey. A randomly selected message will be sent at a randomly selected time between 8 and 11 AM daily, followed by brief ratings of message effectiveness. Participants can earn up to $116 for completing all activities: $30 each for baseline and follow-up surveys, and up to $56 for EMAs. As a pilot, analysis will focus on feasibility (≥80% retention and EMA completion), acceptability (Post-Study System Usability Questionnaire mean score ≥3.5), and preliminary efficacy (pre-post changes in pain severity and quality of life scores). Engagement metrics (e.g., time spent on the app) will be analyzed, and qualitative data from e-diaries will be examined using sentiment and linguistic analysis.
Results and Next Steps: The app is currently in internal testing. Recruitment will begin in October 2025 using electronic health record screening, paid social media ads, and community outreach. Data collection is expected to conclude by December 2025. The protocol and results will be presented at the meeting, if invited. Findings will provide benchmarks and preliminary evidence of feasibility and acceptability for a future waitlist-controlled, biomarker-informed trial. The pilot will also inform design refinements and implementation strategies for a larger trial targeting underserved cancer survivors experiencing pain.
Authors:
Presenter - Sunny Jung Kim, PhD, Virginia Commonwealth University
Co-Author - Farnese Murielle Edimo Motto, MSPH, CHES, Virginia Commonwealth University School of Public Health
Co-Author - Emily Edwards, MPH, Virginia Commonwealth University
Co-Author - Oxana Palesh, PhD, MPH, Virginia Commonwealth University
Co-Author - Susan Hong, MD, Virginia Commonwealth University
Co-Author - Vanessa Sheppard, PhD, Virginia Commonwealth University
Augmented Reality for the Prevention and Treatment of Substance Use Disorders: A Scoping Review
Poster Number: B76Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Tobacco Control and Nicotine-Related Behavior
Background: Augmented Reality (AR) is a rapidly developing technology that overlays 3D digital images into the real world, typically through smartphones or other video-enabled devices. AR-based interventions can facilitate health behavior change, such as preventing and treating substance use disorders (SUD). However, no existing review has addressed the current state of AR research in SUD, including its effectiveness or avenues for future investigation.
Methods: To address this gap, a comprehensive literature review was conducted on studies that utilize AR for the prevention or treatment of SUD following PRISMA guidelines for scoping reviews. The literature search was conducted across 5 databases, including grey literature. Data related to the purpose of the study, type of substance, type of AR stimuli, AR modality, location of AR delivery, duration and frequency of the intervention, suggested timing of intervention delivery, and outcomes (e.g., usability, feasibility, and SUD-related outcomes) were extracted and narratively summarized.
Results: A total of 1657 records were identified, and 12 studies were included. Studies were categorized broadly into education/prevention (n=6) and treatment (n=6), and most addressed nicotine dependence (n=10; 5 from a single research group). AR stimuli, including smoking-related images (e.g., cigarettes, lighters), human organs (e.g., lungs), and public health warnings, were delivered via smartphones or projectors in either laboratory or real-world settings. AR sessions varied in duration (i.e., 30 secs to 50 mins) and frequency (i.e., 1 session once to 2-5 sessions/day for 7 days). Treatment-focused studies delivered cue exposure therapy and warning messages. Similarly, educational studies demonstrated the impact of substance use on human organs. Half of the studies (n=6) assessed and demonstrated strong evidence of feasibility and acceptability. Although pilot studies (n=9) showed promise regarding SUD-related outcomes (i.e., decreased cue reactivity, abstinence), larger trials are needed to establish the efficacy of AR in this domain.
Conclusion: Findings indicate AR-based interventions are evolving in the SUD field, with most focusing on preventing and treating nicotine dependence. To address research gaps, future work can extend to other substances (e.g., alcohol), include more diverse populations, refine methodological approaches (e.g., gamification), and conduct large-scale trials to determine efficacy.
Keywords: e-Health, Tobacco useMethods: To address this gap, a comprehensive literature review was conducted on studies that utilize AR for the prevention or treatment of SUD following PRISMA guidelines for scoping reviews. The literature search was conducted across 5 databases, including grey literature. Data related to the purpose of the study, type of substance, type of AR stimuli, AR modality, location of AR delivery, duration and frequency of the intervention, suggested timing of intervention delivery, and outcomes (e.g., usability, feasibility, and SUD-related outcomes) were extracted and narratively summarized.
Results: A total of 1657 records were identified, and 12 studies were included. Studies were categorized broadly into education/prevention (n=6) and treatment (n=6), and most addressed nicotine dependence (n=10; 5 from a single research group). AR stimuli, including smoking-related images (e.g., cigarettes, lighters), human organs (e.g., lungs), and public health warnings, were delivered via smartphones or projectors in either laboratory or real-world settings. AR sessions varied in duration (i.e., 30 secs to 50 mins) and frequency (i.e., 1 session once to 2-5 sessions/day for 7 days). Treatment-focused studies delivered cue exposure therapy and warning messages. Similarly, educational studies demonstrated the impact of substance use on human organs. Half of the studies (n=6) assessed and demonstrated strong evidence of feasibility and acceptability. Although pilot studies (n=9) showed promise regarding SUD-related outcomes (i.e., decreased cue reactivity, abstinence), larger trials are needed to establish the efficacy of AR in this domain.
Conclusion: Findings indicate AR-based interventions are evolving in the SUD field, with most focusing on preventing and treating nicotine dependence. To address research gaps, future work can extend to other substances (e.g., alcohol), include more diverse populations, refine methodological approaches (e.g., gamification), and conduct large-scale trials to determine efficacy.
Authors:
Author - Ranjita Poudel, PhD, Moffitt Cancer Center
Co-Author - Madison S. Rivera, BS, BA, Moffitt Cancer Center
Co-Author - Mary Katherine Haver, Moffitt Cancer Center
Co-Author - Marilyn Horta, PhD, Moffitt Cancer Center
Co-Author - Skye O. Dougan, MPH, Moffitt Cancer Center
Co-Author - Helen Yates, MPH, Moffitt Cancer Center
Co-Author - Karen O. Brandon, PhD, Moffitt Cancer Center
Co-Author - Thomas H. Brandon, PhD, Moffitt Cancer Center
Co-Author - Christine Vinci, PhD, Moffitt Cancer Center
Designing for Implementation: Developing a Digital Opioid Safety Intervention for Pharmacy Settings
Poster Number: B77Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Substance Misuse
Pharmacists are ideally positioned to offer opioid safety interventions due to high accessibility and medication expertise. Barriers to integrate opioid safety interventions into pharmacy practice include limited time and perceived inability to change setting workflows. A digital opioid safety tool provides patients privacy and convenience without increasing pharmacist workloads. Objective: To design a digital pharmacy-based opioid safety intervention with a focus on implementation.
Using the consolidated framework for implementation research and an exploratory sequential mixed methods study design, we conducted semi-structured qualitative interviews (n=30) with patients using opioid prescriptions for chronic/acute pain and clinical/community pharmacists. Interviews explored patient and pharmacist needs regarding intervention content, format, and implementation barriers and facilitators. We used deductive and inductive content analysis followed by narrative analysis. Qualitative findings informed prototype design including content, patient narratives, tailoring language, and formatting. We conducted in-depth user testing interviews (n=4) with patients and pharmacists and evaluated preliminary user engagement, feasibility, and acceptability of the prototype through quantitative patient and pharmacist surveys (n=30).
Patient interviews indicated significant gaps in opioid safety knowledge and beliefs that increased risks of future overdose. Patients preferred the convenience of app-based opioid safety content, to website. Pharmacists called for de-stigmatizing and increasing naloxone dispensing rates. Participants emphasized the need for patient-centered language, audio and video content, and balanced messaging between preventing opioid harms and effective pain management. These data informed the digital prototype of the opioid medication safety app (OpiSafe) that covers pain management, safe opioid use, medication storage and disposal, and naloxone use, with personal stories (product of narrative analysis) in each section. We also identified potential implementation strategies for integrating OpiSafe within pharmacy practice. User testing interviews and pilot testing surveys elicited positive feedback, high feasibility and acceptability, and suggestions for increasing interactivity and customizability as a pain management and opioid safety app. Future research will include refinement of OpiSafe based on end-user feedback and a larger effectiveness study.
Keywords: Opioids, Knowledge integrationUsing the consolidated framework for implementation research and an exploratory sequential mixed methods study design, we conducted semi-structured qualitative interviews (n=30) with patients using opioid prescriptions for chronic/acute pain and clinical/community pharmacists. Interviews explored patient and pharmacist needs regarding intervention content, format, and implementation barriers and facilitators. We used deductive and inductive content analysis followed by narrative analysis. Qualitative findings informed prototype design including content, patient narratives, tailoring language, and formatting. We conducted in-depth user testing interviews (n=4) with patients and pharmacists and evaluated preliminary user engagement, feasibility, and acceptability of the prototype through quantitative patient and pharmacist surveys (n=30).
Patient interviews indicated significant gaps in opioid safety knowledge and beliefs that increased risks of future overdose. Patients preferred the convenience of app-based opioid safety content, to website. Pharmacists called for de-stigmatizing and increasing naloxone dispensing rates. Participants emphasized the need for patient-centered language, audio and video content, and balanced messaging between preventing opioid harms and effective pain management. These data informed the digital prototype of the opioid medication safety app (OpiSafe) that covers pain management, safe opioid use, medication storage and disposal, and naloxone use, with personal stories (product of narrative analysis) in each section. We also identified potential implementation strategies for integrating OpiSafe within pharmacy practice. User testing interviews and pilot testing surveys elicited positive feedback, high feasibility and acceptability, and suggestions for increasing interactivity and customizability as a pain management and opioid safety app. Future research will include refinement of OpiSafe based on end-user feedback and a larger effectiveness study.
Authors:
Presenter - Deepika Rao, PhD, MS, BPharm, College of Pharmacy, University of Texas at Austin
Co-Author - Lisa Marsch, PhD, Geisel School of Medicine, Center for Technology and Behavioral Health, Dartmouth College
Co-Author - Sarah Lord, Ph.D., Geisel School of Medicine, Center for Technology and Behavioral Health, Dartmouth College
Mobile health intervention for emerging adults with regular cannabis use: A pilot micro-randomized trial
Poster Number: B78Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Substance Misuse
Background
We report results of the MiWaves mobile health (mHealth) intervention—a just-in-time adaptive intervention (JITAI) powered by Artificial Intelligence (AI) to reduce cannabis use and associated consequences among emerging adults (EAs). The JITAI employed a reinforcement learning algorithm (RL)—an AI approach that continually interacts with the participant in real-time to learn to make decisions to maximize proximal benefits.
Methods
A micro-randomized trial (MRT) randomized EAs (ages 18-25; n=122; regularly used cannabis and were motivated to change their use), twice daily (AM/PM) to receive either a mHealth intervention message or no message. At each decision point, a RL algorithm adjusted the probability of delivering a message using prior data to maximize proximal engagement. Over 30 days, participants were prompted to complete twice daily surveys and assessments post-intervention and 2 months post-enrollment. Primary outcomes include feasibility and acceptability of MiWaves among EAs; exploratory outcomes evaluated the effects of the intervention on cannabis use and the impact of message delivery on proximal cannabis use and engagement.
Results
Regarding feasibility, 89.1% (122/137) of participants who were eligible, verified, and consented downloaded the MiWaves app. Participants completed 5,642 (77.1%) of the total 7,320 twice-daily self-monitoring surveys. Regarding acceptability, most participants (80.4%) rated the MiWaves messages and notifications at least a “3” (somewhat or greater on a 5-point Likert scale) for care, support, warmth, and respect. Exploratory analyses on cannabis use from baseline to 1-month or 2-month assessments show reductions in past-month cannabis use days (1M: mean difference = 2.1 days, 95% CI: 0.9, 3.4; 2M: mean difference = 3.3 days, 95% CI: 1.6, 5.0). In exploratory MRT analyses, there was no evidence that delivering (vs. not delivering) an intervention message impacted proximal cannabis use (b= 0.008, 95% CI: -0.003, 0.020). However, when evaluating proximal mHealth engagement (a range of 0 to 3) between the current and next micro-randomization, delivering (vs. not delivering) an intervention message increased engagement (b= 0.044, 95% CI: 0.018, 0.070).
Conclusion
We have developed an innovative, acceptable, and feasible AI-powered mHealth intervention to reduce cannabis use among EAs. This intervention is a pivotal first step for the next generation of personalized digital interventions for substance use.
Keywords: e-Health, Substance abuseWe report results of the MiWaves mobile health (mHealth) intervention—a just-in-time adaptive intervention (JITAI) powered by Artificial Intelligence (AI) to reduce cannabis use and associated consequences among emerging adults (EAs). The JITAI employed a reinforcement learning algorithm (RL)—an AI approach that continually interacts with the participant in real-time to learn to make decisions to maximize proximal benefits.
Methods
A micro-randomized trial (MRT) randomized EAs (ages 18-25; n=122; regularly used cannabis and were motivated to change their use), twice daily (AM/PM) to receive either a mHealth intervention message or no message. At each decision point, a RL algorithm adjusted the probability of delivering a message using prior data to maximize proximal engagement. Over 30 days, participants were prompted to complete twice daily surveys and assessments post-intervention and 2 months post-enrollment. Primary outcomes include feasibility and acceptability of MiWaves among EAs; exploratory outcomes evaluated the effects of the intervention on cannabis use and the impact of message delivery on proximal cannabis use and engagement.
Results
Regarding feasibility, 89.1% (122/137) of participants who were eligible, verified, and consented downloaded the MiWaves app. Participants completed 5,642 (77.1%) of the total 7,320 twice-daily self-monitoring surveys. Regarding acceptability, most participants (80.4%) rated the MiWaves messages and notifications at least a “3” (somewhat or greater on a 5-point Likert scale) for care, support, warmth, and respect. Exploratory analyses on cannabis use from baseline to 1-month or 2-month assessments show reductions in past-month cannabis use days (1M: mean difference = 2.1 days, 95% CI: 0.9, 3.4; 2M: mean difference = 3.3 days, 95% CI: 1.6, 5.0). In exploratory MRT analyses, there was no evidence that delivering (vs. not delivering) an intervention message impacted proximal cannabis use (b= 0.008, 95% CI: -0.003, 0.020). However, when evaluating proximal mHealth engagement (a range of 0 to 3) between the current and next micro-randomization, delivering (vs. not delivering) an intervention message increased engagement (b= 0.044, 95% CI: 0.018, 0.070).
Conclusion
We have developed an innovative, acceptable, and feasible AI-powered mHealth intervention to reduce cannabis use among EAs. This intervention is a pivotal first step for the next generation of personalized digital interventions for substance use.
Authors:
Author - Devin Tomlinson, University of Michigan
Author - Maureen Walton, University of Michigan
Author - Inbal Nahum-Shani, University of Michigan
Author - Maya Campbell, University of Michigan
Author - Autumn Rae Florimbio, PhD, University of Michigan
Author - Susobhan Ghosh, Harvard University
Author - Yongyi Guo, Harvard University
Author - Pei-Yao Hung, University of Michigan
Author - Mark Newman, University of Michigan
Author - Jeremy Lin, University of California, Irvine
Author - Tianchen Qian, PhD, University of California, Irvine
Author - John Dziak, University of Michigan
Author - Huijie Pan, Harvard University
Author - Kelly Zhang, Harvard University
Author - Lauren Zimmermann, University of Michigan
Author - Erin Bonar, University of Michigan
Author - Susan Murphy, Harvard University
Author - Lara Coughlin, University of Michigan
Optimising a digitally delivered behavioural weight loss programme: a factorial cluster randomised controlled trial
Poster Number: B79Time: 11:00 AM - 11:50 AM
Topics: Digital Health, Weight Related Health
Digitally-delivered weight loss programmes can provide a convenient, potentially cheaper, and scalable treatment option for people who may need to lose weight. However, outcomes are often inferior to in-person interventions in the long-term.
A total of 1,335 adults enrolling in a commercial weight management programme were randomised to one of 16 experimental conditions. The 4 components tested were an introductory video call with a health coach, drop-in webchat sessions with the health coach, goal-setting statements, and food diary review plus feedback. Participants received the core weight loss programme along with 0-4 of the additional components. The primary outcome was weight change at 16 weeks. Secondary outcomes, measured at 4, 16, and 24 weeks, included cancellation of subscription and programme engagement, defined as the number of interactions with the app’s main functions. Fidelity and acceptability were assessed using component adherence data and self-report questionnaires. Selection of components for the enhanced programme was based on whether they produced at least a minimal improvement in weight loss defined as ≥0.75 kg either alone or in combination with other components at 16 weeks.
Weight data were available for 52% of participants at 4 weeks, 26% at 16 weeks, and 20% at 24 weeks. The health coach intro video call lead to a significant positive effect on weight loss at 24 weeks, resulting in an average additional loss of 1 kg compared to those who did not receive the call. The food diary review and feedback component had significant adverse effects on weight loss at both 16 and 24 weeks and were associated with lower engagement. Engagement tended to be lower in conditions that included multiple components, particularly when the food diary was present. Although no component or combination met the pre-defined optimisation objective of ≥ 0.75 kg additional weight loss at 16 weeks, the findings offer insight to inform future intervention development by identifying components that may be further refined and tested in subsequent studies.
The findings suggest that brief, early human contact could meaningfully enhance the effectiveness of digital interventions, while effortful components that lack adequate support may reduce engagement or increase dropout. The results reinforce the importance of delivering low-burden, well-timed support, while highlighting an ongoing challenge of sustaining engagement even in the medium term.
Keywords: Weight loss, Weight controlA total of 1,335 adults enrolling in a commercial weight management programme were randomised to one of 16 experimental conditions. The 4 components tested were an introductory video call with a health coach, drop-in webchat sessions with the health coach, goal-setting statements, and food diary review plus feedback. Participants received the core weight loss programme along with 0-4 of the additional components. The primary outcome was weight change at 16 weeks. Secondary outcomes, measured at 4, 16, and 24 weeks, included cancellation of subscription and programme engagement, defined as the number of interactions with the app’s main functions. Fidelity and acceptability were assessed using component adherence data and self-report questionnaires. Selection of components for the enhanced programme was based on whether they produced at least a minimal improvement in weight loss defined as ≥0.75 kg either alone or in combination with other components at 16 weeks.
Weight data were available for 52% of participants at 4 weeks, 26% at 16 weeks, and 20% at 24 weeks. The health coach intro video call lead to a significant positive effect on weight loss at 24 weeks, resulting in an average additional loss of 1 kg compared to those who did not receive the call. The food diary review and feedback component had significant adverse effects on weight loss at both 16 and 24 weeks and were associated with lower engagement. Engagement tended to be lower in conditions that included multiple components, particularly when the food diary was present. Although no component or combination met the pre-defined optimisation objective of ≥ 0.75 kg additional weight loss at 16 weeks, the findings offer insight to inform future intervention development by identifying components that may be further refined and tested in subsequent studies.
The findings suggest that brief, early human contact could meaningfully enhance the effectiveness of digital interventions, while effortful components that lack adequate support may reduce engagement or increase dropout. The results reinforce the importance of delivering low-burden, well-timed support, while highlighting an ongoing challenge of sustaining engagement even in the medium term.
Authors:
Author - Gina Wren, University of Oxford
Co-Author - Dimitrios A Koutoukidis, University of Oxford
Co-Author - , University of Oxford
Co-Author - , Second Nature
Co-Author - , Second Nature
Co-Author - , Second Nature
Co-Author - , Second Nature
Co-Author - , University of Oxford
Co-Author - , University of Oxford
Co-Author - , University of Oxford
From Screen to Search: Examining Public Awareness of Freedom House Ambulance Service After Viewing The Pitt
Poster Number: B80Time: 11:00 AM - 11:50 AM
Topics: Health Communication and Policy, Community Engagement
Background: Previous research has found that fictional medical TV programs can influence viewers’ seeking of real-world health information. On February 20th 2025, the 8th episode of the medical drama The Pitt featured a character who was a member of Freedom House ambulance service, a group of Black men from Pittsburgh who pioneered pre-hospital emergency care; few have heard about Freedom House due to systemic racism eliminating its story from mainstream culture. This study aimed to use social media data to examine public awareness of Freedom House following The Pitt storyline.
Methods: We used Google search trends for the terms “freedom house” and “freedom house ambulance” for a one-month time frame, from two weeks before February 20th to two weeks after. Simultaneously, we searched the subreddit r/ThePittTVShow for “Freedom House” and retrieved the resulting posts and comments using the RStudio package RedditExtractoR. Two trained research assistants independently coded the posts/comments (n=1,788) for relevance and the presence or absence of specific content using a systematically developed codebook (Cohen's κ =0.66-1.00).
Results: Google searches more than doubled in the 24 hours following the airing of the episode and were still elevated two weeks after the episode aired. Approximately 8% (n=138) of the posts/comments were relevant to the Freedom House storyline. The most frequent content category was emotional engagement (36%, n=49; e.g. “I loved the mention of Freedom House!...Its incredibly sad the amount of racism and discrimination these men faced”). Consistent with the Google search trends results, 18% (n=25) of posts mentioned not knowing about Freedom House before watching the episode and 9% (n= 12) mentioned searching online for more information about Freedom House because of viewing the episode (e.g. “Just finished a deep internet dive on the organization. They are all so amazing).
Conclusion: Google search trends combined with comments on Reddit provide evidence that viewers may have been motivated to search and learn more about Freedom House ambulance service from The Pitt. To the best of our knowledge, this is the first study to combine these methods, offering support for the use of social media data to augment Google search trends results. Our results also lend support to integrating public health messaging into fictional medical programs to educate the public and accelerate the dissemination of timely public health knowledge.
Keywords: Health communication, Health educationMethods: We used Google search trends for the terms “freedom house” and “freedom house ambulance” for a one-month time frame, from two weeks before February 20th to two weeks after. Simultaneously, we searched the subreddit r/ThePittTVShow for “Freedom House” and retrieved the resulting posts and comments using the RStudio package RedditExtractoR. Two trained research assistants independently coded the posts/comments (n=1,788) for relevance and the presence or absence of specific content using a systematically developed codebook (Cohen's κ =0.66-1.00).
Results: Google searches more than doubled in the 24 hours following the airing of the episode and were still elevated two weeks after the episode aired. Approximately 8% (n=138) of the posts/comments were relevant to the Freedom House storyline. The most frequent content category was emotional engagement (36%, n=49; e.g. “I loved the mention of Freedom House!...Its incredibly sad the amount of racism and discrimination these men faced”). Consistent with the Google search trends results, 18% (n=25) of posts mentioned not knowing about Freedom House before watching the episode and 9% (n= 12) mentioned searching online for more information about Freedom House because of viewing the episode (e.g. “Just finished a deep internet dive on the organization. They are all so amazing).
Conclusion: Google search trends combined with comments on Reddit provide evidence that viewers may have been motivated to search and learn more about Freedom House ambulance service from The Pitt. To the best of our knowledge, this is the first study to combine these methods, offering support for the use of social media data to augment Google search trends results. Our results also lend support to integrating public health messaging into fictional medical programs to educate the public and accelerate the dissemination of timely public health knowledge.
Authors:
Presenter - Ore Fawole, University of Pittsburgh
Author - Kate Leshniosky, University of Pittsburgh School of Public Health
Author - Tiffany Lee, University of Pittsburgh School of Public Health
Author - Tommy Manning, University of Pittsburgh School of Public Health
Author - Beth Hoffman, PhD, MPH, University of Pittsburgh School of Public Health
Evolution of Cancer Discussions on Reddit (2008–2024): Natural Language Processing Insights and Public Health Implications
Poster Number: B81Time: 11:00 AM - 11:50 AM
Topics: Health Communication and Policy, Cancer
Background. Cancer is one of the leading causes of death worldwide and is frequently discussed online in various contexts. Social media platforms, particularly Reddit, offer open forums where individuals share experiences, seek advice, and contribute to health-related conversations. However, the role and function of social media as a cancer resource is understudied, particularly from an applied data science perspective.
Objectives. This study aims to examine how public discussions about cancer have evolved on Reddit between 2008 and 2024.
Method. We used Reddit PRAW to scrape N=622,498 posts from N=53,546 unique users, including 48,017 submissions and 574,481 comments. We used descriptive statistics to track posts over time. Then, we applied BERTopic, a topic modeling technique that combines transformer-based embeddings with clustering, to analyze posts from the subreddit r/cancer.
Results. The volume of cancer-related discussions steadily increased on Reddit between 2008 and 2024, with slight declines during the COVID-19 pandemic (2020–2021). We also identified 150 distinct topics. The most prevalent topics included colorectal cancer, hair loss, insurance-related challenges, emotional and psychological reflections, and chemotherapy. Topics such as caregiver support, COVID-19 concerns, and online communities showed the greatest fluctuations, indicating periods of heightened public interest.
Conclusion. Cancer-related discussions on Reddit reflect widespread concern over financial, physical, and emotional challenges during the cancer journey. The fluctuation during the pandemic highlighted the urgent need for both offline and online support systems for cancer survivors. Future work will consider this highly relevant Reddit content as training data for further machine-learning model building.
Keywords: Health behaviors, Informatics Objectives. This study aims to examine how public discussions about cancer have evolved on Reddit between 2008 and 2024.
Method. We used Reddit PRAW to scrape N=622,498 posts from N=53,546 unique users, including 48,017 submissions and 574,481 comments. We used descriptive statistics to track posts over time. Then, we applied BERTopic, a topic modeling technique that combines transformer-based embeddings with clustering, to analyze posts from the subreddit r/cancer.
Results. The volume of cancer-related discussions steadily increased on Reddit between 2008 and 2024, with slight declines during the COVID-19 pandemic (2020–2021). We also identified 150 distinct topics. The most prevalent topics included colorectal cancer, hair loss, insurance-related challenges, emotional and psychological reflections, and chemotherapy. Topics such as caregiver support, COVID-19 concerns, and online communities showed the greatest fluctuations, indicating periods of heightened public interest.
Conclusion. Cancer-related discussions on Reddit reflect widespread concern over financial, physical, and emotional challenges during the cancer journey. The fluctuation during the pandemic highlighted the urgent need for both offline and online support systems for cancer survivors. Future work will consider this highly relevant Reddit content as training data for further machine-learning model building.
Authors:
Author - Xue-Jing Liu, MPH, Department of Applied Health Science, Indiana University School of Public Health-Bloomington
Co-Author - Danny Valdez, PhD, Indiana University School of Public Health
Chair - Eric Walsh-Buhi, PhD, Department of Applied Health Science, Indiana University School of Public Health-Bloomington
Communication Strategies to Reduce the Nocebo Effect: A Scoping Review
Poster Number: B82Time: 11:00 AM - 11:50 AM
Topics: Health Communication and Policy, Social and Environmental Context and Health
Background: The nocebo effect refers to adverse outcomes driven by negative expectations rather than pharmacological mechanisms and may be unintentionally elicited through routine treatment communication. Although several communication strategies have been proposed to mitigate nocebo effects, empirical evidence remains scattered and has not yet been systematically mapped. This scoping review aimed to identify, categorize, and summarize communication strategies that have been empirically examined to reduce nocebo-related outcomes.
Methods: Following PRISMA-ScR guidelines, we searched PubMed, Scopus, and PsycInfo from inception to June 14, 2025. Studies using experimental designs that deliberately manipulated treatment-related communication to assess nocebo-related outcomes were included. Data were charted on study characteristics, communication strategies, outcomes, and effectiveness. Strategies were categorized based on shared core characteristics and theoretical mechanisms.
Results: Thirty-eight studies were included, identifying nine distinct communication strategies. These were grouped into five overarching categories: framing of treatment information (attribute, message, and contextual framing), nocebo education, interaction style (empathetic communication, personalization, reassuring wording), choice over treatment, and nondisclosure. Nocebo education was the most frequently studied strategy and showed generally consistent effects on global side-effect expectations and related cognitive outcomes, particularly in recent online studies. Framing-based strategies yielded mixed effects but were largely non-harmful across settings. Interaction-style strategies demonstrated beneficial effects in selected contexts, although evidence remains limited. Choice over treatment showed mixed effects across studies, whereas nondisclosure consistently reduced reported side effects in clinical populations, highlighting ethical tensions in nocebo reduction.
Conclusion: Overall, a growing body of empirical research suggests that communication strategies can mitigate nocebo effects, but effectiveness varies by strategy, outcome, and context. Future research should prioritize clinically relevant outcomes, patient populations, and ethically acceptable approaches to translating these strategies into routine care.
Keywords: Health communication, Decision makingMethods: Following PRISMA-ScR guidelines, we searched PubMed, Scopus, and PsycInfo from inception to June 14, 2025. Studies using experimental designs that deliberately manipulated treatment-related communication to assess nocebo-related outcomes were included. Data were charted on study characteristics, communication strategies, outcomes, and effectiveness. Strategies were categorized based on shared core characteristics and theoretical mechanisms.
Results: Thirty-eight studies were included, identifying nine distinct communication strategies. These were grouped into five overarching categories: framing of treatment information (attribute, message, and contextual framing), nocebo education, interaction style (empathetic communication, personalization, reassuring wording), choice over treatment, and nondisclosure. Nocebo education was the most frequently studied strategy and showed generally consistent effects on global side-effect expectations and related cognitive outcomes, particularly in recent online studies. Framing-based strategies yielded mixed effects but were largely non-harmful across settings. Interaction-style strategies demonstrated beneficial effects in selected contexts, although evidence remains limited. Choice over treatment showed mixed effects across studies, whereas nondisclosure consistently reduced reported side effects in clinical populations, highlighting ethical tensions in nocebo reduction.
Conclusion: Overall, a growing body of empirical research suggests that communication strategies can mitigate nocebo effects, but effectiveness varies by strategy, outcome, and context. Future research should prioritize clinically relevant outcomes, patient populations, and ethically acceptable approaches to translating these strategies into routine care.
Authors:
Author - Sheng-Kang Peng, National Taiwan University
Co-Author - Pin-Heng Tiao, PharmD, National Taiwan University
Co-Author - Yen-Ming Huang, PhD, National Taiwan University
Young Adult Women's Perceptions of Co-Designed AI-generated Alcohol and Breast Cancer Risk Message Imagery
Poster Number: B83Time: 11:00 AM - 11:50 AM
Topics: Health Communication and Policy, Cancer
Background: Awareness of the association between alcohol and cancer risk is low among young adult women, at a time when alcohol consumption is relatively high, and the impacts of alcohol on breast cancer risk are also pronounced. We report on participants’ discussions of alcohol and breast cancer risk messages generated during co-design sessions, where we used generative artificial intelligence (AI) to create high-fidelity prototypes.
Methods: Using social media and local ads in five states with among the highest prevalence of past-month alcohol consumption, we recruited women aged 18-25 years to participate in co-design focus groups. Between May and July 2024, seven focus groups (n=41) lasting an average of 53 minutes each occurred via Zoom. Recordings were transcribed, inductively coded by three team members, and analyzed using thematic analysis.
Results: Participants’ discussions of the AI-generated images emphasized the importance of relevance and relatability. Participants noted aspects of the AI-generated images that were not relatable or relevant, including elements such as the type of drinks, colors, patterns, fabrics, and the overall aesthetic of the message. Participants noted the link between alcohol and cancer was unclear in some images. They acknowledged the dichotomy between their current experiences and future selves and discussed combining some AI-generated images to illustrate a temporal or contextual shift, for instance, by juxtaposing images of college-age women drinking with images of the women surrounding a friend undergoing breast cancer treatment. They also suggested that AI-generated images depicting other consequences of drinking, like being hungover or not having a good time, may be effective, particularly if paired with images of a fun social alternative like having coffee or tea. Participants determined that some images they suggested, for instance, bar scenes and using pink or pink ribbons, once generated, seemed to promote alcohol consumption.
Conclusion: Using generative AI to co-create high-fidelity images linking alcohol and breast cancer resulted in rich reflections about message content and format preferences. Discussions and attitudes that emerged during the discussions highlighted that theories, such as construal level theory and emotional flow, can be strategically applied when developing campaign messages about the negative effects of alcohol consumption. Note: Grammarly AI was used in the editing of this abstract.
Keywords: Health communication, Cancer risk perceptionsMethods: Using social media and local ads in five states with among the highest prevalence of past-month alcohol consumption, we recruited women aged 18-25 years to participate in co-design focus groups. Between May and July 2024, seven focus groups (n=41) lasting an average of 53 minutes each occurred via Zoom. Recordings were transcribed, inductively coded by three team members, and analyzed using thematic analysis.
Results: Participants’ discussions of the AI-generated images emphasized the importance of relevance and relatability. Participants noted aspects of the AI-generated images that were not relatable or relevant, including elements such as the type of drinks, colors, patterns, fabrics, and the overall aesthetic of the message. Participants noted the link between alcohol and cancer was unclear in some images. They acknowledged the dichotomy between their current experiences and future selves and discussed combining some AI-generated images to illustrate a temporal or contextual shift, for instance, by juxtaposing images of college-age women drinking with images of the women surrounding a friend undergoing breast cancer treatment. They also suggested that AI-generated images depicting other consequences of drinking, like being hungover or not having a good time, may be effective, particularly if paired with images of a fun social alternative like having coffee or tea. Participants determined that some images they suggested, for instance, bar scenes and using pink or pink ribbons, once generated, seemed to promote alcohol consumption.
Conclusion: Using generative AI to co-create high-fidelity images linking alcohol and breast cancer resulted in rich reflections about message content and format preferences. Discussions and attitudes that emerged during the discussions highlighted that theories, such as construal level theory and emotional flow, can be strategically applied when developing campaign messages about the negative effects of alcohol consumption. Note: Grammarly AI was used in the editing of this abstract.
Authors:
Presenter - Courtney Scherr, PhD, Northwestern University
Co-Author - Kerstin Hundal, MA, Northwestern University
Co-Author - Hoda Fakhari, PhD, Northwestern University
Co-Author - Savanna Kerstiens, MA, Northwestern University
Co-Author - Lauren Long, Ohio State University
Co-Author - Elsa Alvarado, Ohio State University
Co-Author - Kelly Hirko, PhD, Michigan State University
Co-Author - Noelle LoConte, MD, University of Wisconsin
Co-Author - Andrea Villanti, PhD, Rutgers University
Co-Author - Darren Mays, PhD, MPH, Ohio State University
Improving EHR Documentation to Advance Tobacco Treatment and Lung Cancer Screening: A Qualitative Study Integrating Scientific Perspectives in a FQHC
Poster Number: B84Time: 11:00 AM - 11:50 AM
Topics: Health Disparities , Cancer
Significance
Accurate tobacco-use documentation in Electronic Health Records (EHRs) is vital for evidence-based treatment and timely lung cancer screening (LCS) referrals. In Federally Qualified Health Centers (FQHCs) inaccurate tobacco-use data undermines identifying patients for tobacco interventions and timely screenings. While research highlights systemic tobacco-use documentation issues, few studies examine these challenges in safety-net settings or propose corrective actions. We conducted a study in a large FQHC to identify specific causes of inaccuracy.
Methods
From July 2023 and January 2025, we collected data as part of a mixed methods clinical trial implementing EMPACT-Us, a multicomponent tobacco cessation service suite, at Family Health Centers of San Diego. We conducted semi-structured interviews (n=62) with Primary Care Providers (PCPs), Medical Assistants (MAs) and Health Educators (HEs) to assess the feasibility and acceptability of EMPACT-Us. Data were analyzed using a deductive-inductive approach. We also observed MAs (n=64) during routine patient screenings, focusing on tobacco-use questions to document workflow and identify challenges.
Results
Interviews revealed persistent contributors to inaccurate EHR tobacco-use documentation. We developed five sub-codes under the theme of ‘inaccurate information’ capturing patterns of documentation errors at intake, uncorrected known errors, patient-driven misreporting, narrative workarounds, and EHR design limitations. Location-specific errors included language and cultural barriers, need for interpreters, and information lost in translation. Observations revealed variability in MA-patients engagement, often shaped by demanding clinical flow. Staff sometimes rushed through screenings, skipped questions, inappropriately modified the screening script, or missed chances to clarify vague responses and support relapsed patients. Improving documentation accuracy will require workflow redesign, targeted training, culturally and linguistically tailored screening, enhanced Clinical Decision Support (CDS) tools (?), and clear accountability.
Conclusion
These findings reinforce prior research showing that EHR tobacco-use fields are often unreliable and poorly integrated into clinical workflows. By identifying distinct error types and contextual contributors, this study highlights opportunities to improve documentation, strengthen CDS for LCS, and advance equitable, high-quality care for all patients.
Keywords: Tobacco use, Health disparitiesAccurate tobacco-use documentation in Electronic Health Records (EHRs) is vital for evidence-based treatment and timely lung cancer screening (LCS) referrals. In Federally Qualified Health Centers (FQHCs) inaccurate tobacco-use data undermines identifying patients for tobacco interventions and timely screenings. While research highlights systemic tobacco-use documentation issues, few studies examine these challenges in safety-net settings or propose corrective actions. We conducted a study in a large FQHC to identify specific causes of inaccuracy.
Methods
From July 2023 and January 2025, we collected data as part of a mixed methods clinical trial implementing EMPACT-Us, a multicomponent tobacco cessation service suite, at Family Health Centers of San Diego. We conducted semi-structured interviews (n=62) with Primary Care Providers (PCPs), Medical Assistants (MAs) and Health Educators (HEs) to assess the feasibility and acceptability of EMPACT-Us. Data were analyzed using a deductive-inductive approach. We also observed MAs (n=64) during routine patient screenings, focusing on tobacco-use questions to document workflow and identify challenges.
Results
Interviews revealed persistent contributors to inaccurate EHR tobacco-use documentation. We developed five sub-codes under the theme of ‘inaccurate information’ capturing patterns of documentation errors at intake, uncorrected known errors, patient-driven misreporting, narrative workarounds, and EHR design limitations. Location-specific errors included language and cultural barriers, need for interpreters, and information lost in translation. Observations revealed variability in MA-patients engagement, often shaped by demanding clinical flow. Staff sometimes rushed through screenings, skipped questions, inappropriately modified the screening script, or missed chances to clarify vague responses and support relapsed patients. Improving documentation accuracy will require workflow redesign, targeted training, culturally and linguistically tailored screening, enhanced Clinical Decision Support (CDS) tools (?), and clear accountability.
Conclusion
These findings reinforce prior research showing that EHR tobacco-use fields are often unreliable and poorly integrated into clinical workflows. By identifying distinct error types and contextual contributors, this study highlights opportunities to improve documentation, strengthen CDS for LCS, and advance equitable, high-quality care for all patients.
Authors:
Author - Paloma Mohn, Family Health Centers of San Diego
Author - Brittany Olivera, MPH, UC San Diego
Co-Author - Kimberly Brouwer, PhD, University of California, San Diego
Co-Author - Gabriela Ramirez, Family Health Centers of San Diego
Co-Author - Karim Ghobrial-Sedky, MD, MSc: Psychiatry, Family Health Centers of San Diego
Co-Author - Job Godino, PhD, University of California, San Diego
Co-Author - Naomi Romero Alvarez, Family Health Centers of San Diego
Co-Author - Nichelle Brown, MPH, University of California, San Diego
Co-Author - Mark Myers, PhD, University of California, San Diego
Co-Author - Charles Bart Smoot, M.D., Family Health Centers of San Diego
Co-Author - David Strong, PhD, PhD, Herbert Wertheim School of Public Health, University of California, San Diego
Prevalence of social needs among Black cancer survivors and impact of community health worker delivered support on needs
Poster Number: B85Time: 11:00 AM - 11:50 AM
Topics: Health Disparities , Cancer
Medical care is estimated to account for 10-20% of health outcomes, while other factors, such as social determinants of health, may account for as much as 80-90% of these outcomes; Black cancer patients often have worse outcomes than cancer survivors of other races. We set out to determine the impact of Community Health Worker (CHW) support on Black cancer survivors’ health-related social needs (HRSN).
Cancer survivors who identified as Black/African American from five cancer centers in the Washington, DC were invited to participate in a six-month CHW-supported intervention. An 8-item social risk factor screener was administered at baseline, three, and six-months to track changes in HRSN. Participation in the intervention was not dependent on identifying a HRSN. CHWs reached out to patients by phone weekly if any needs remained unresolved, or monthly to assess for any new needs and to offer social support or health promotion resources.
A total of 1553 Black cancer survivors were screened for HRSN from June 2022-August 2025. Among all those screened, the baseline prevalence of HRSN was 530/1553 (34.1%) and 469/1553 (30.2%) enrolled in the study. Among those who enrolled and completed the 6-month intervention by 8/22/2025 (n=350), the baseline prevalence of HRSN was 49.7% (n=174). The most common baseline needs at baseline were financial strain (n=97), food insecurity (n=93), transportation (n=45), housing insecurity (n=43), and mental health (n=35). At 3 months, 28.6% (n=100) still reported a HRSN, which dropped to 24.6% (n=86) at 6 months. At 3 months, the most common HRSN were financial strain (n=57), food insecurity (n=40), housing insecurity (n=24), and mental health (n=20); these numbers changed only slightly at six months (n=58, 38, 22, 14, respectively).
While overall prevalence of HRSN went down over time, some needs, like housing insecurity and financial strain, proved more difficult to resolve due to limited resources. Also, survivors may benefit the most from getting support in the first 3 months, suggesting that the frequency or type of CHW support for HRSN could decrease after 3 months. After enrollment completion in December 2025 we will further be able to explore changes in HRSN and impact of the CHW intervention on quality of life and social support.
Keywords: Cancer survivorship, Health disparitiesCancer survivors who identified as Black/African American from five cancer centers in the Washington, DC were invited to participate in a six-month CHW-supported intervention. An 8-item social risk factor screener was administered at baseline, three, and six-months to track changes in HRSN. Participation in the intervention was not dependent on identifying a HRSN. CHWs reached out to patients by phone weekly if any needs remained unresolved, or monthly to assess for any new needs and to offer social support or health promotion resources.
A total of 1553 Black cancer survivors were screened for HRSN from June 2022-August 2025. Among all those screened, the baseline prevalence of HRSN was 530/1553 (34.1%) and 469/1553 (30.2%) enrolled in the study. Among those who enrolled and completed the 6-month intervention by 8/22/2025 (n=350), the baseline prevalence of HRSN was 49.7% (n=174). The most common baseline needs at baseline were financial strain (n=97), food insecurity (n=93), transportation (n=45), housing insecurity (n=43), and mental health (n=35). At 3 months, 28.6% (n=100) still reported a HRSN, which dropped to 24.6% (n=86) at 6 months. At 3 months, the most common HRSN were financial strain (n=57), food insecurity (n=40), housing insecurity (n=24), and mental health (n=20); these numbers changed only slightly at six months (n=58, 38, 22, 14, respectively).
While overall prevalence of HRSN went down over time, some needs, like housing insecurity and financial strain, proved more difficult to resolve due to limited resources. Also, survivors may benefit the most from getting support in the first 3 months, suggesting that the frequency or type of CHW support for HRSN could decrease after 3 months. After enrollment completion in December 2025 we will further be able to explore changes in HRSN and impact of the CHW intervention on quality of life and social support.
Authors:
Presenter - Hannah Arem, PhD, MedStar Health Research Institute
Co-Author - Jessica Rivera Rivera, PhD, MedStar Health Research Institute
Co-Author - Dana Rosenberg, George Washington University
Co-Author - Oluwabukola Oluwole, MedStar Health Research Institute
Co-Author - Claudia Campos, George Washington University
Co-Author - Arianna Milicia, MedStar Health Research Institute
Co-Author - Marjanna Smith, MPH, MedStar Health Research Institute
Co-Author - Katie Adams, MS, MedStar Health Research Institute
Co-Author - Kimberly Davis, Georgetown University
Co-Author - Mandi Pratt-Chapman, MA, PhD, The George Washington University Cancer Institute
Barriers to Care: How Gender Minority Stress Shapes Trans and Gender Diverse Healthcare Decisions
Poster Number: B87Time: 11:00 AM - 11:50 AM
Topics: Health Disparities , Integrated Primary Care
Aim: Healthcare avoidance and delay is well-documented among trans and gender diverse (TGD) adults, despite high rates of adverse health outcomes. Although emerging evidence links discrimination to delayed healthcare, specific domains of gender minority stress informing these decisions remain unclear, precluding targeted intervention. This study characterized a subgroup of TGD adults reporting past-year healthcare delay due to fear of discrimination and explored how multiple domains of gender minority stress relate to this behavior.Method: Cross-sectional online survey data was drawn from 151 transgender adults in a northeastern state (Mage=27.65±5.63 years, range=18-58; 40% men, 31% women, 29% non-binary; 48% White, 31% Black, 5% American Indian/Alaska Native, 5% Asian, 5% Hispanic, 3% Multiracial). The survey assessed participant characteristics, gender minority stress, and past-year healthcare delay due to fear of discrimination. Results: TGD adults who delayed healthcare in the past year (n=81;54%) were more likely to identify as BIPOC (versus white; χ2=14.21, p<.001) and reported significantly more frequent distal (victimization, rejection, non‐affirmation, discrimination experiences; ts=5.13-6.65, ps<.001) and proximal (expectations of rejection, concealment of gender identity, internalized transphobia; ts=2.89-9.42, ps<.001) gender minority stress, compared to those who did not delay care (n=70;46%); groups did not differ by age or anxiety symptoms (ps=.15-.19). In the full sample, a logistic regression model revealed that victimization (β=.45,SE=.21,OR=1.57), non‐affirmation (β=.12,SE=.06,OR=1.13), and expectations of rejection (β=.17,SE=.04,OR=1.19) were significantly associated with delaying healthcare—above and beyond rejection, discrimination, concealment, and internalized transphobia—after controlling for race and anxiety symptoms.Conclusion: Although TGD adults who delayed healthcare due to fear of discrimination endorsed greater gender minority stress generally, specific domains of victimization, non-affirmation, and expectations of rejection were most strongly related to healthcare delay. Greater representation of BIPOC TGD adults amongst those who delayed healthcare likely reflects intersecting minority stressors, warranting continued explication with racially diverse TGD samples. Findings may guide integration of behavioral medicine into TGD healthcare through interventions that enhance self-advocacy and improve access and care provision.
Keywords: Minority health, Health disparitiesAuthors:
Author - Leah Cingranelli, M.A., University of Maine
Co-Author - Krutika Rathod, M.A., University of Maine
Co-Author - Patricia Goodhines, PhD, University of Maine
Navigating food insecurity with Community Cultural Wealth; a qualitative study examining a Guaranteed Income intervention
Poster Number: B88Time: 11:00 AM - 11:50 AM
Topics: Health Disparities , Diet, Nutrition, and Eating Disorders
Background: Food insecurity (FI) - limited or uncertain access to adequate food - is associated with chronic disease and disproportionately affects Black households. Black Emerging Adults (BEA, aged 18-24) are at risk for FI due to financial instability. Although previous research identified FI coping strategies among college-students, none used a strengths-based framework. Yosso’s Community Cultural Wealth model can elucidate how BEA apply multiple dimensions of cultural capital (e.g., Social, Resistant) to circumvent FI and inform future interventions. Guaranteed Income (GI) interventions report reductions in food insecurity, but none focused on this population. This phenomenological qualitative study examined how BEA use Cultural Wealth to navigate FI in the presence and absence of GI.
Methods: A sub-sample of BEA (aged 18-24) were recruited from among participants of a larger 2-year, randomized waitlist-controlled GI trial of BEA from low-income census tracts in Oakland and San Francisco. FI, as indicated by the validated Hunger-Vital Sign assessment on quarterly surveys, was used to identify two groups of interview participants, before GI-group (n=13) and during GI-group (n=12). Participants were recruited using criterion sampling and balanced by gender, city, and food security. Independent coders used thematic analysis to identify Cultural Wealth domains and their interaction with GI.
Results: Collective agency was an overarching theme, as BEA leveraged their social networks to obtain food. BEA used familial and social capital through meal sharing, bargaining, and informal/formal food assistance to navigate FI, irrespective of study arm. Novel strategies unidentified in previous literature, included generational family recipes (low cost/filling) and food bartering with peers. Some BEA applied transformative-resistant capital through nutrition education, community gardening, and advocacy to support community food justice. GI enabled BEA to buy more healthy food and meet youth-determined needs (e.g., bills, clothes). With GI, BEA invested in familial/social capital by financially contributing to household expenses and sharing food with peers.
Conclusion: BEA built collective agency with their social networks to navigate FI. GI strengthened BEA’s familial/social capital to reduce FI for themselves and their community. Future FI interventions can implement strategies that align with Cultural Wealth to produce sustainable solutions to FI.
Keywords: Socioeconomic, Minority healthMethods: A sub-sample of BEA (aged 18-24) were recruited from among participants of a larger 2-year, randomized waitlist-controlled GI trial of BEA from low-income census tracts in Oakland and San Francisco. FI, as indicated by the validated Hunger-Vital Sign assessment on quarterly surveys, was used to identify two groups of interview participants, before GI-group (n=13) and during GI-group (n=12). Participants were recruited using criterion sampling and balanced by gender, city, and food security. Independent coders used thematic analysis to identify Cultural Wealth domains and their interaction with GI.
Results: Collective agency was an overarching theme, as BEA leveraged their social networks to obtain food. BEA used familial and social capital through meal sharing, bargaining, and informal/formal food assistance to navigate FI, irrespective of study arm. Novel strategies unidentified in previous literature, included generational family recipes (low cost/filling) and food bartering with peers. Some BEA applied transformative-resistant capital through nutrition education, community gardening, and advocacy to support community food justice. GI enabled BEA to buy more healthy food and meet youth-determined needs (e.g., bills, clothes). With GI, BEA invested in familial/social capital by financially contributing to household expenses and sharing food with peers.
Conclusion: BEA built collective agency with their social networks to navigate FI. GI strengthened BEA’s familial/social capital to reduce FI for themselves and their community. Future FI interventions can implement strategies that align with Cultural Wealth to produce sustainable solutions to FI.
Authors:
Presenter - Roddrick Dugger, Ph.D., M.P.H, Oregon Health & Sciences University/ University of California San Francisco
Co-Author - Jasmin Parker-Brown, M.P.H., University of South Carolina
Co-Author - Angela Odoms-Young, PhD, University of Illinois At Chicago
Co-Author - Emily Arnold, PhD, University of California San Francisco
Co-Author - Michelle Nakphong, Ph.D., University of California San Francisco
Co-Author - Holly Nishimura, Ph.D., University of California San Francisco
Co-Author - Darius Bright, University of California San Francisco
Co-Author - Aisha Siddiqui, University of California San Francisco
Co-Author - Margaret Libby, University of California San Francisco
Co-Author - Marguerita Lightfoot, PhD, Oregon Health and Sciences University
Co-Author - Sheri Lippman, Ph.D., University of California San Francisco
Experiences of Stigma and Discrimination Among Transgender and Non-Binary Adults: A Qualitative Focus Group Study
Poster Number: B89Time: 11:00 AM - 11:50 AM
Topics: Health Disparities , Social and Environmental Context and Health
Background: Transgender and non-binary (TNB) individuals experience significant health disparities linked to stigma and discrimination. However, the underlying mechanisms by which multidimensional stigma results in adverse health outcomes for TNB populations are relatively underexplored. Understanding these experiences is essential for developing effective behavioral programs and policies to improve health outcomes for TNB individuals. Methods: We conducted two semi-structured focus groups with TNB adults in South Carolina in 2025 (N=9). Participants were recruited through community organizations, flyers, and snowball sampling. Eligibility criteria included age 18+, South Carolina residence, and transgender or non-binary identity. Focus groups included an activity where participants mapped consequences of stigma experiences. Discussions were audio-recorded, transcribed verbatim, and analyzed using thematic analysis by three independent coders. Results: Preliminary findings reveal pervasive stigma across multiple domains. Healthcare barriers included denial of gender-affirming care, insurance refusal, non-inclusive intake forms, and staff who refused to accommodate participants’ gender identity, resulting in care avoidance. Family experiences were characterized by persistent misgendering and questioning of gender identity. Participants described experiencing transphobia within LGBTQ+ spaces, reporting rejection by some gay community members and discrimination from other transgender individuals. Intersectional experiences emerged with some participants navigating racialized gender norms, religious traditions, and "passing" pressures. Participants connected these stigma experiences to delayed care-seeking, suicidal ideation, and suppression of authentic self-expression. Supportive intimate relations emerged as a key support in navigating fraught healthcare environments. Conclusions: TNB individuals face compounding stigma from families, healthcare systems, and paradoxically, within LGBTQ+ communities. These findings underscore the need for comprehensive cultural competency training for healthcare providers emphasizing inclusion, respectful communication and pronoun use, and policy shifts to improve insurance coverage for gender-affirming care. Healthcare avoidance among TNB individuals represents a rational response to anticipated discrimination rather than an individual-level barrier.
Keywords: Gender, Health disparitiesAuthors:
Author - Rochelle Altman, EdD, PhD in progress, College of Charleston
Co-Author - Priyanka Dubey, PhD, MSW, Boise State University
Co-Author - OJ Holmes, College of Charleston
Co-Author - Emily Womack, College of Charleston
Co-Author - Shaon Lahiri, PhD, MPH, College of Charleston
Exploration of the Superwoman Schema and Behavioral Antecedents of Cardiovascular Disease among Black Women Living with Systemic Lupus Erythematosus
Poster Number: B90Time: 11:00 AM - 11:50 AM
Topics: Health Disparities , Cardiovascular Disease
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease affecting multiple organ systems. Black women bear a disproportionate burden of SLE inequities in prevalence, quality of life and cardiovascular health. Socio-behavioral mechanisms underlying these inequities are poorly understood. The Superwoman Schema (SWS) captures how Black women may interpret the world rooted in their sociocultural context. Understanding how SWS shapes living with SLE is critical for intervention development.
Methods: We analyzed data collected from 2015-2019 through the Georgians Organized Against Lupus cohort. This sample is limited to Black women (n=584). Primary measures included Giscombé 35-item SWS questionnaire (G-SWS-Q), Brief-Coping Orientation to Problems Experienced Inventory (adaptive coping, maladaptive coping, and substance use), Self-efficacy to Manage Symptoms (SEMS), Self-Efficacy to Manage Medications (SEMM) and cardiovascular disease (CVD) hospitalization after 2019 (ICD codes). After scale validation, we applied structural equation modeling to test predictive relationships (SWS-->Coping-->Self-Efficacy-->CVD Hospitalization).
Results: Mean age and years living with SLE were 48.3 (SD: 13.3) and 15.7 (10.0) years. Direct effects between SWS and coping behaviors were significant, with maladaptive coping having the largest effect estimate (β=0.521, p<0.001). Direct effects between two coping behaviors and both self-efficacy constructs were significant (SEMS/Adaptive: β=0.194, p<0.001; SEMS/Maladaptive: β=-0.406, p<0.00; SEMM/Adaptive: β=0.146, p<0.001; SEMM/Maladaptive: β =-0.397, p<0.001). Adaptive coping was negatively related to CVD hospitalization (β = -0.182, p=0.03). Mediation analyses showed partial mediation between SWS and both SEMM and SEMS through coping constructs with the greatest effect size in the maladaptive coping pathway (SEMM: β =-0.207, p<0.001; SEMS: β =-0.211, p<0.001). There was partial mediation between SWS and CVD-hospitalization through adaptive coping (β =-0.043, p=0.05).
Conclusions: Our findings suggest that SWS is associated with self-efficacy and adaptive and maladaptive coping behaviors. CVD hospitalization was negatively associated with adaptive coping. Findings highlight potentially health-promoting and health-damaging pathways associated with SWS and underscore the importance of interventions that strengthen health-promoting coping in SLE.
Keywords: Chronic, CultureMethods: We analyzed data collected from 2015-2019 through the Georgians Organized Against Lupus cohort. This sample is limited to Black women (n=584). Primary measures included Giscombé 35-item SWS questionnaire (G-SWS-Q), Brief-Coping Orientation to Problems Experienced Inventory (adaptive coping, maladaptive coping, and substance use), Self-efficacy to Manage Symptoms (SEMS), Self-Efficacy to Manage Medications (SEMM) and cardiovascular disease (CVD) hospitalization after 2019 (ICD codes). After scale validation, we applied structural equation modeling to test predictive relationships (SWS-->Coping-->Self-Efficacy-->CVD Hospitalization).
Results: Mean age and years living with SLE were 48.3 (SD: 13.3) and 15.7 (10.0) years. Direct effects between SWS and coping behaviors were significant, with maladaptive coping having the largest effect estimate (β=0.521, p<0.001). Direct effects between two coping behaviors and both self-efficacy constructs were significant (SEMS/Adaptive: β=0.194, p<0.001; SEMS/Maladaptive: β=-0.406, p<0.00; SEMM/Adaptive: β=0.146, p<0.001; SEMM/Maladaptive: β =-0.397, p<0.001). Adaptive coping was negatively related to CVD hospitalization (β = -0.182, p=0.03). Mediation analyses showed partial mediation between SWS and both SEMM and SEMS through coping constructs with the greatest effect size in the maladaptive coping pathway (SEMM: β =-0.207, p<0.001; SEMS: β =-0.211, p<0.001). There was partial mediation between SWS and CVD-hospitalization through adaptive coping (β =-0.043, p=0.05).
Conclusions: Our findings suggest that SWS is associated with self-efficacy and adaptive and maladaptive coping behaviors. CVD hospitalization was negatively associated with adaptive coping. Findings highlight potentially health-promoting and health-damaging pathways associated with SWS and underscore the importance of interventions that strengthen health-promoting coping in SLE.
Authors:
Presenter - Jerik Leung, Rollins School of Public Health, Emory University
Author - Regine Haardoerfer, PhD, Rollins School of Public Health, Emory University
Author - Charmayne Dunlop-Thomas, MS, MPH, Emory University School of Medicine
Author - Tené Lewis, PhD, Emory University
Author - Cam Escoffery, PhD, MPH, Rollins School of Public Health
Author - S. Sam Lim, MD, MPH, Emory University School of Medicine
Associations of Subjective and Objective Social Status with Mental Health and Sleep in Emerging and Older Adults
Poster Number: B91Time: 11:00 AM - 11:50 AM
Topics: Health Disparities , Sleep
Background: Subjective social status (SSS) reflects perceptions of one’s social standing in terms of wealth, education, and occupational prestige, and is an emerging transdiagnostic risk factor that may improve understanding of health disparities. This study investigated whether SSS uniquely predicts mental health (depression and anxiety) and subjective sleep health (duration, quality, insomnia symptoms) in socioeconomically-diverse samples of emerging adults (S1) and older adults (S2). It was hypothesized that SSS would account for unique variance in both samples, over and above objective SES proxies.
Method: Cross-sectional survey data was collected on SSS and diverse health behaviors. S1 was comprised of 328 college students (Mage=19.03±1.39, range=18-25; 53% female; 83% white; 28% first-generation, 33% employed) and S2 was comprised of 123 older adults (Mage=70.71±6.45, range=50-90; 74% female; 98% white; 29% economically insecure, 32% ≤ high school education) recruited in northern New England.
Results: SSS was associated with SES proxies negatively in S1 (first-generation and working status; ds=.26-.30) and positively in S2 (annual income and years of education; ds=.65-.80). Greater SSS was associated with less frequent depression and anxiety symptoms (ds=.32-.47), poorer sleep quality (ds=.41), and longer sleep duration (weekday only, S1; d=.24-.61) in both samples, and insomnia symptom severity in S1 (d=.32). Hierarchical regression analyses adjusting for age and sex found that lower SSS was related to more frequent depression symptoms (S1: β=-.12, 95%CI -0.26, -0.01; S2: β=-.20, 95%CI -2.77, -0.12) and shorter sleep durations (S1, weekday only: β=.15, 95%CI 0.03, 0.22; S2: β=.23, 95%CI 0.02, 0.31) in both studies, over and above respective SES proxies. In S1, low SSS was associated with more frequent anxiety symptoms (β=-.12, 95%CI -0.27, -0.02) and worse sleep quality (β=-.17, 95%CI -0.32, -0.07). After adjusting for age, sex, and SES proxies, SSS was not related to insomnia symptom severity in either study.
Conclusions: Lower SSS predicted more frequent mental health concerns and worse sleep across diverse emerging and older adults, beyond objective SES. Findings highlight SSS as a unique target for reducing behavioral health inequities across the adult lifespan. Continued multidisciplinary research may further integrate perspectives between research and practice through the development of tailored interventions and evidence-based health policy.
Keywords: Socioeconomic, DisparitiesMethod: Cross-sectional survey data was collected on SSS and diverse health behaviors. S1 was comprised of 328 college students (Mage=19.03±1.39, range=18-25; 53% female; 83% white; 28% first-generation, 33% employed) and S2 was comprised of 123 older adults (Mage=70.71±6.45, range=50-90; 74% female; 98% white; 29% economically insecure, 32% ≤ high school education) recruited in northern New England.
Results: SSS was associated with SES proxies negatively in S1 (first-generation and working status; ds=.26-.30) and positively in S2 (annual income and years of education; ds=.65-.80). Greater SSS was associated with less frequent depression and anxiety symptoms (ds=.32-.47), poorer sleep quality (ds=.41), and longer sleep duration (weekday only, S1; d=.24-.61) in both samples, and insomnia symptom severity in S1 (d=.32). Hierarchical regression analyses adjusting for age and sex found that lower SSS was related to more frequent depression symptoms (S1: β=-.12, 95%CI -0.26, -0.01; S2: β=-.20, 95%CI -2.77, -0.12) and shorter sleep durations (S1, weekday only: β=.15, 95%CI 0.03, 0.22; S2: β=.23, 95%CI 0.02, 0.31) in both studies, over and above respective SES proxies. In S1, low SSS was associated with more frequent anxiety symptoms (β=-.12, 95%CI -0.27, -0.02) and worse sleep quality (β=-.17, 95%CI -0.32, -0.07). After adjusting for age, sex, and SES proxies, SSS was not related to insomnia symptom severity in either study.
Conclusions: Lower SSS predicted more frequent mental health concerns and worse sleep across diverse emerging and older adults, beyond objective SES. Findings highlight SSS as a unique target for reducing behavioral health inequities across the adult lifespan. Continued multidisciplinary research may further integrate perspectives between research and practice through the development of tailored interventions and evidence-based health policy.
Authors:
Presenter - Krutika Rathod, M.A, University of Maine
Co-Author - Morgan Tallman, M.A, University of Maine
Co-Author - Holly Timblin, University of Maine
Co-Author - Rebecca MacAulay, PhD, University of Maine
Co-Author - Patricia Goodhines, PhD, University of Maine
Feasibility and Acceptability of Kindness Interventions in Asian American Cancer Patients and Caregivers
Poster Number: B92Time: 11:00 AM - 11:50 AM
Topics: Health Disparities , Cancer
Background: After cancer diagnosis, patients from collectivist cultures (e.g., Asian Americans [AAs]) may view themselves as a burden on family member caregivers due to changes in physical function and social roles/responsibilities, which may lead to lower psychological health. In healthy individuals, positive activity interventions (PAIs), such as acts of kindness, have been shown to increase feelings of autonomy, competence, and connectedness, which are associated with psychological well-being. The purpose of this study was to qualitatively assess the feasibility and acceptability of 2 novel PAIs, household and outside contribution, for AA cancer patients and caregivers. Method: Forty AA cancer patient dyads ≤1 year of diagnosis were randomized to 1 of 3 groups: 1) household contribution (e.g., cook for caregiver); 2) outside contribution (e.g., donate food); or 3) control (keep track of daily activities). Patients engaged in the PAI or control activity once per week for 4 weeks; at study end, participants who volunteered were randomly selected to participate in a semi-structured exit interview. Interviews were transcribed and thematic analysis was employed: 2 coders independently coded meaningful units line-by-line, codes were discussed and refined iteratively until >85% consensus was reached, and meanings were extracted from the codes to form themes and sub-themes. Results: Eight participants [75% female, mean age = 60.8(SD = 10.3)] were interviewed (Household Patient: n = 1; Household Caregiver: n = 2; Outside Patient: n = 2; Outside Caregiver: n = 1; Control Patient: n = 1; Control Caregiver: n =1). Three major themes emerged: 1) participation motivators and barriers, 2) PAI acceptability and feasibility, and 3) suggestions for future randomized controlled trials (RCTs). AAs enrolled in the study to contribute to AA research and to help others and hesitated to enroll due to cancer-related stigma and language barriers. Caregivers in the household contribution group expressed appreciation of the patient’s efforts (acceptable). Patients in the outside contribution group found the PAI to be beneficial (acceptable) but mixed feelings about feasibility of the PAI. Participants suggested future RCTs tailor the household contribution study activities to cancer stage and sub-culture and refine the reporting methods and resources provided for the outside contribution condition. Conclusion: These findings inform refinement of the PAIs for future RCTs.
Keywords: Cancer, InterventionAuthors:
Presenter - Lilian Shin-Cho, PhD, Fox Chase Cancer Center
Co-Author - Jiahui Yu, BS, Fox Chase Cancer Center
Author - Meagan Whisenant, PhD, APRN, UTHealth Houston Cizik School of Nursing
Author - Carlos Barcenas, MD, University of Texas MD Anderson Cancer Center
Author - Lorenzo Cohen, PhD, MD Anderson Cancer Center
Author - Qian Lu, PhD, FSBM, MD Anderson Cancer Center
Extreme Community PrEP Stigma as a Potential Deterrent to PrEP Use among Black and Hispanic Men Who Have Sex with Men in the Deep South
Poster Number: B93Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Social and Environmental Context and Health
Introduction: HIV pre-exposure prophylaxis (PrEP) is nearly 100% effective at preventing HIV. Black and Hispanic men who have sex with men (BHMSM) in the Deep South have the highest HIV incidence yet the lowest PrEP use in the United States. PrEP stigma (i.e., negative social judgments against individuals who use PrEP) may deter PrEP use. However, most PrEP stigma research focuses on the perception of PrEP users as sexually promiscuous and may overlook other negative beliefs that may deter uptake.
Methods: To address this knowledge gap, we conducted a secondary analysis of an online survey of BHMSM in the Deep South not living with HIV. We used multinomial logistic regression models to test associations between the validated Community PrEP-Related Stigma Scale and PrEP use (never, former, or current), controlling for covariates. We also tested for associations between this scale’s four subscales (sexual behavior, poor judgment and substance use, extreme perceptions, and positive perceptions) and PrEP use. We calculated Cronbach’s alphas to assess internal consistency.
Results: Our analytical sample (n=281) had a mean age of 35.0 years old (SD: 10.4) and was 46.6% Non-Hispanic Black and 53.4% Hispanic. Cronbach’s alphas indicated good internal consistency for the full scale (α=0.89) and acceptable to good internal consistency for three of the four subscales (α=0.73-0.89). The positive perceptions subscale had questionable internal consistency (α=0.68). We found no evidence of an association between the overall Community PrEP-Related Stigma Scale and the likelihood of never (versus current) PrEP use. We also found null results for three of the four subscales; however, a 1-point increase in the extreme perceptions subscale (i.e., views that community members believe PrEP users are living with HIV, bad people, or hiding something) was associated with a 16.5% higher relative risk of never using PrEP versus current PrEP use (p=.019). We also found no evidence of a relationship between the Community PrEP-Related Stigma Scale nor its subscales and the likelihood of former (versus current) PrEP use.
Conclusions: Community perceptions that PrEP users are living with HIV or are deceitful may deter PrEP use among BHMSM in the Deep South and may be more prohibitive than the perception that PrEP users are promiscuous. PrEP campaigns that include messages depicting PrEP users as honest and open may contribute to increased uptake of PrEP.
Keywords: HIV, AIDSMethods: To address this knowledge gap, we conducted a secondary analysis of an online survey of BHMSM in the Deep South not living with HIV. We used multinomial logistic regression models to test associations between the validated Community PrEP-Related Stigma Scale and PrEP use (never, former, or current), controlling for covariates. We also tested for associations between this scale’s four subscales (sexual behavior, poor judgment and substance use, extreme perceptions, and positive perceptions) and PrEP use. We calculated Cronbach’s alphas to assess internal consistency.
Results: Our analytical sample (n=281) had a mean age of 35.0 years old (SD: 10.4) and was 46.6% Non-Hispanic Black and 53.4% Hispanic. Cronbach’s alphas indicated good internal consistency for the full scale (α=0.89) and acceptable to good internal consistency for three of the four subscales (α=0.73-0.89). The positive perceptions subscale had questionable internal consistency (α=0.68). We found no evidence of an association between the overall Community PrEP-Related Stigma Scale and the likelihood of never (versus current) PrEP use. We also found null results for three of the four subscales; however, a 1-point increase in the extreme perceptions subscale (i.e., views that community members believe PrEP users are living with HIV, bad people, or hiding something) was associated with a 16.5% higher relative risk of never using PrEP versus current PrEP use (p=.019). We also found no evidence of a relationship between the Community PrEP-Related Stigma Scale nor its subscales and the likelihood of former (versus current) PrEP use.
Conclusions: Community perceptions that PrEP users are living with HIV or are deceitful may deter PrEP use among BHMSM in the Deep South and may be more prohibitive than the perception that PrEP users are promiscuous. PrEP campaigns that include messages depicting PrEP users as honest and open may contribute to increased uptake of PrEP.
Authors:
Presenter - John Guigayoma, Northwestern University
Author - Dennis Li, Northwestern University Feinberg School of Medicine
Author - DeMarc Hickson, Us Helping Us, People Into Living, Inc.
Author - Mariano Kanamori, University of Miami Miller School of Medicine
Author - Tyler Wray, Brown University School of Public Health
Health Behavior Interventions for Cancer Prevention in HIV-Positive African Communities: A Scoping Review
Poster Number: B94Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Multiple Health Behavior Change
Background: People living with HIV (PLHIV) in African countries face increased cancer risk due to HIV-related factors and lifestyle challenges. Key contributors include poor weight management, low physical activity, and unhealthy diets, highlighting the need to evaluate interventions targeting these behaviors. Despite evidence that lifestyle changes reduce cancer risk, interventions among PLHIV in African communities remain underexplored. This scoping review examined interventions promoting weight management, physical activity, and healthier diets among PLHIV in Africa and summarized their characteristics and outcomes.
Methods: We searched PubMed, Scopus, CINAHL, PsycINFO, and Cochrane Library for studies published 2000–2024. Eligible studies included HIV-positive adults in Africa and used randomized or quasi-experimental designs targeting weight management (WM), physical activity (PA), or healthy eating (HE).
Results: We identified 21 studies: 12 PA alone, six nutrition education, and three combined PA and nutrition. Sample sizes ranged 26–128, except one study (3,200). Mean age was 36–48 years, mostly female. Studies were conducted in eight African countries, primarily South Africa. PA interventions involved supervised aerobic or resistance training, three times weekly for 30–90 minutes over 6 weeks–6 months. Nutrition education used flyers, group sessions, or cooking demonstrations (1–12 sessions, up to 12 months). Combined interventions provided guideline-based education in 15–60 minute sessions, with follow-up up to 32 months. PA consistently improved VO₂peak, maximal strength, and 6-minute walk test performance, with smaller changes in body composition. Combined interventions improved HE but had mixed effects on body composition. Nutrition education enhanced HE and nutrition knowledge, with inconsistent effects on BMI and anthropometry. Few studies reported behavioral frameworks, including Social Cognitive Theory and Health Belief Model.
Conclusions: PA interventions were more structured and intensive, yielding stronger gains in fitness, strength, and body composition. Nutrition education and combined approaches produced modest dietary improvements and mixed anthropometric outcomes. Evidence is heterogeneous, frameworks underused, and long-term effects unclear. Future interventions should be culturally tailored, theory-informed, and designed for sustained impact.
Keywords: HIV, Health promotionMethods: We searched PubMed, Scopus, CINAHL, PsycINFO, and Cochrane Library for studies published 2000–2024. Eligible studies included HIV-positive adults in Africa and used randomized or quasi-experimental designs targeting weight management (WM), physical activity (PA), or healthy eating (HE).
Results: We identified 21 studies: 12 PA alone, six nutrition education, and three combined PA and nutrition. Sample sizes ranged 26–128, except one study (3,200). Mean age was 36–48 years, mostly female. Studies were conducted in eight African countries, primarily South Africa. PA interventions involved supervised aerobic or resistance training, three times weekly for 30–90 minutes over 6 weeks–6 months. Nutrition education used flyers, group sessions, or cooking demonstrations (1–12 sessions, up to 12 months). Combined interventions provided guideline-based education in 15–60 minute sessions, with follow-up up to 32 months. PA consistently improved VO₂peak, maximal strength, and 6-minute walk test performance, with smaller changes in body composition. Combined interventions improved HE but had mixed effects on body composition. Nutrition education enhanced HE and nutrition knowledge, with inconsistent effects on BMI and anthropometry. Few studies reported behavioral frameworks, including Social Cognitive Theory and Health Belief Model.
Conclusions: PA interventions were more structured and intensive, yielding stronger gains in fitness, strength, and body composition. Nutrition education and combined approaches produced modest dietary improvements and mixed anthropometric outcomes. Evidence is heterogeneous, frameworks underused, and long-term effects unclear. Future interventions should be culturally tailored, theory-informed, and designed for sustained impact.
Authors:
Author - Sahar Heydari, PhD, University of South Florida
Co-Author - Ana Paula Rodrigues, PhD, University of South Florida
Co-Author - Jocelyn Jarvis, BS, University of South Florida
Co-Author - Clement Gwede, PhD, MPH, RN, FSBM, H Lee Moffitt Cancer Center and Research Institute
Co-Author - Marilyn Stern, PhD, University of South Florida
HIV Pre-Exposure Prophylaxis Among People Experiencing Homelessness in the United States: A Scoping Review
Poster Number: B95Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Health Disparities
Background
People experiencing homelessness (PEH) in the U.S. are disproportionately affected by HIV due to intersecting structural, social, and behavioral vulnerabilities. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention strategy, yet uptake and sustained use among PEH remain low. Examining the current evidence base is critical to identify barriers, facilitators, and opportunities for tailoring PrEP implementation to this population.
Method
We conducted a scoping review of peer-reviewed literature. Eligible studies included those that examined awareness, acceptability, access, or adherence to PrEP among PEH. Data were extracted on study characteristics and key findings, and synthesized to identify emergent themes on individual, interpersonal, and structural levels.
Results
35 studies met the criteria, most of which were quantitative (n=22), followed by qualitative (n=10) and mixed methods (n=3). Across studies, PrEP awareness among PEH was generally low, though interest increased substantially once PrEP was explained. Structural vulnerability—including poverty, lack of insurance, and criminalization—emerged as a central barrier to PrEP care engagement. Multilevel stigma related to homelessness, substance use, and mental illness further undermined PrEP engagement by discouraging healthcare utilization, reinforcing medical mistrust, and compounding marginalization within service systems. Additional barriers included competing survival priorities, fragmented care, difficulties with safe medication storage. Facilitators included integration of PrEP into low-threshold, community-based settings (e.g., mobile clinics), peer navigation, and supportive services such as transportation and mental health care. Several studies highlighted the promise of long-acting injectable PrEP in addressing adherence and storage challenges.
Conclusion
Despite elevated HIV risk, PEH remain underserved in PrEP implementation. Evidence underscores that structural vulnerability and multilevel stigma are central drivers of low awareness, access, and adherence, and must be directly addressed in intervention design. Tailored, multi-level strategies embedded within trusted, low-barrier service settings, alongside broader structural responses such as housing support and policy reform, are needed to achieve meaningful impact. Future research should rigorously evaluate the effectiveness of integrated service models and long-acting PrEP in overcoming these barriers.
Keywords: HIV, SocioeconomicPeople experiencing homelessness (PEH) in the U.S. are disproportionately affected by HIV due to intersecting structural, social, and behavioral vulnerabilities. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention strategy, yet uptake and sustained use among PEH remain low. Examining the current evidence base is critical to identify barriers, facilitators, and opportunities for tailoring PrEP implementation to this population.
Method
We conducted a scoping review of peer-reviewed literature. Eligible studies included those that examined awareness, acceptability, access, or adherence to PrEP among PEH. Data were extracted on study characteristics and key findings, and synthesized to identify emergent themes on individual, interpersonal, and structural levels.
Results
35 studies met the criteria, most of which were quantitative (n=22), followed by qualitative (n=10) and mixed methods (n=3). Across studies, PrEP awareness among PEH was generally low, though interest increased substantially once PrEP was explained. Structural vulnerability—including poverty, lack of insurance, and criminalization—emerged as a central barrier to PrEP care engagement. Multilevel stigma related to homelessness, substance use, and mental illness further undermined PrEP engagement by discouraging healthcare utilization, reinforcing medical mistrust, and compounding marginalization within service systems. Additional barriers included competing survival priorities, fragmented care, difficulties with safe medication storage. Facilitators included integration of PrEP into low-threshold, community-based settings (e.g., mobile clinics), peer navigation, and supportive services such as transportation and mental health care. Several studies highlighted the promise of long-acting injectable PrEP in addressing adherence and storage challenges.
Conclusion
Despite elevated HIV risk, PEH remain underserved in PrEP implementation. Evidence underscores that structural vulnerability and multilevel stigma are central drivers of low awareness, access, and adherence, and must be directly addressed in intervention design. Tailored, multi-level strategies embedded within trusted, low-barrier service settings, alongside broader structural responses such as housing support and policy reform, are needed to achieve meaningful impact. Future research should rigorously evaluate the effectiveness of integrated service models and long-acting PrEP in overcoming these barriers.
Authors:
Co-Presenter - Alexandra Dziura, University of Connecticut
Co-Presenter - Cheng Ren, PhD, University of Albany
Misconception, stigma, and limited access: anal cancer prevention barriers among adults with HIV
Poster Number: B96Time: 11:00 AM - 11:50 AM
Topics: HIV/AIDS, Cancer
People with HIV (PWH) are living longer and are at increased risk of chronic conditions, like cancer. Recent guidelines recommend anal cancer early detection and screening for high-risk groups, mainly PWH. This qualitative study explored anal cancer perceptions among PWH to inform future interventions. We recruited PWH over 35 years old from clinics and community organizations in high HIV burden counties across New Jersey. We conducted individual interviews and recordings were professionally transcribed then thematically analyzed. This analysis focused on how lived experiences with HIV (e.g., diagnosis, stigma, support) influenced anal cancer risk perceptions and screening behaviors. The sample included 26 PWH. Just over half of participants identified as men (57%), and most were gay or bisexual (61%). Majority (69%) was African American/Black and/or Hispanic (15%). Mean age was 56 years. Mean time since HIV diagnosis was 25 years. Participants noted that HIV stigma experiences were less prevalent compared to when they were first diagnosed but still problematic, which many attributed to changing social norms. However, HIV stigma experiences and social isolation influenced their perceived stigma of anal cancer. Some drew parallels with the social stigma associated with HIV testing to anal cancer screening. Although a few spoke highly about HIV programs providing comprehensive information and support, cancer education was notably missing. Most were not aware that HIV increased cancer risk. Low perceived risk of anal cancer was common and shaped by anal sex misconceptions and stigma. Some (26%) had been offered and accepted anal screening from their trusted providers; one declined screening due to discomfort with the procedure. Three participants were treated for anal pre-cancer or cancer. Although they were highly engaged in HIV care, the remaining (69%) had not received recommendations to screen. At the end of the interviews, many indicated high willingness to screen, and were interested in sharing screening information through HIV support groups and social networks. Our findings highlighted multiple similarities between HIV and anal cancer stigmas, which negatively influenced perceived need for screening. Non-stigmatizing screening education materials that emphasize cancer prevention benefits are needed to increase awareness and promote uptake of anal cancer screening among PWH. Increasing provider recommendations and access to services remain priorities.
Keywords: Cancer screening, HIVAuthors:
Co-Author - Rachel Wagner, MA, Rutgers Cancer Institute
Co-Author - Kristen Krause, PhD, MPH, Rutgers University School of Public Health
Co-Author - Azana Sall, BA, Rutgers University School of Public Health
Co-Author - Ann Bagchi, PhD, DNP, FNP-C, APN, Rutgers University School of Business
Presenter - Racquel Kelly Kohler, PhD, MSPH, Rutgers Cancer Institute of New Jersey
Delivering web-based parent training program usage data in real-time: the iterative development of an administrative dashboard
Poster Number: B97Time: 11:00 AM - 11:50 AM
Topics: Implementation Science , Digital Health
Introduction
Online parent training (PT) programs help strengthen parent-child relationships by providing parents with practical knowledge and evidence-based strategies for managing child behavior. In a hybrid PT model, facilitators engage with parents while parents complete online modules. Administrative dashboards offer an integrated platform for program staff (i.e., administrators, facilitators, researchers) to track parent progress and activity in online PT modules in real time.
Methods
We iteratively developed and tested an administrative data delivery dashboard of the online ezParent PT program. Using a single-group design with administrators and facilitators who deliver ezParent, participants (N=15) spent 30 minutes reviewing the ezDashboard and completed a survey about their experience. The survey included the validated 10-item System Usability Scale (SUS) and open-ended questions focusing on navigation ease and overall usefulness of the ezDashboard. Following the usability testing, we made additional refinements (i.e., added exportable reports) to the dashboard. Based on feedback from an Expert Advisory Board (EAB) made of experts in community programming and PT delivery, we also created a new metric, the Engagement Index, to measure and summarize parent participation within modules to provide facilitators with insights into how parents use the program. The EAB reviewed the revised dashboard and completed the SUS survey. Final refinements have been completed.
Results
In the initial usability testing, participants indicated high usability of the ezDashboard with a total mean SUS score of 83.5 (SD 16.3). Most participants (n=13, 87%) rated the overall user-friendliness of the ezDashboard as good (n=3, 20%), excellent (n=9, 60%), or best imaginable (n=1, 7%). Open-ended questions showed the ezDashboard is or would be useful to monitor parent progress and trends in engagement (n=8, 53%). To facilitate that, we created the Engagement Index (0-100% per module) to assist facilitators’ understanding of how parents interact with ezParent. After revisions, the EAB rated the ezDashboard as 83.6 (SD11.4).
Conclusions
Results from iterative testing indicate that the ezDashboard is easy to use and provides functional information to those delivering ezParent. In 2026, the ezDashboard will be used in a randomized controlled trial testing hybrid delivery of ezParent. The usefulness of the Engagement Index as a more robust measure of program use will be assessed.
Keywords: e-Health, Parent-child transactionsOnline parent training (PT) programs help strengthen parent-child relationships by providing parents with practical knowledge and evidence-based strategies for managing child behavior. In a hybrid PT model, facilitators engage with parents while parents complete online modules. Administrative dashboards offer an integrated platform for program staff (i.e., administrators, facilitators, researchers) to track parent progress and activity in online PT modules in real time.
Methods
We iteratively developed and tested an administrative data delivery dashboard of the online ezParent PT program. Using a single-group design with administrators and facilitators who deliver ezParent, participants (N=15) spent 30 minutes reviewing the ezDashboard and completed a survey about their experience. The survey included the validated 10-item System Usability Scale (SUS) and open-ended questions focusing on navigation ease and overall usefulness of the ezDashboard. Following the usability testing, we made additional refinements (i.e., added exportable reports) to the dashboard. Based on feedback from an Expert Advisory Board (EAB) made of experts in community programming and PT delivery, we also created a new metric, the Engagement Index, to measure and summarize parent participation within modules to provide facilitators with insights into how parents use the program. The EAB reviewed the revised dashboard and completed the SUS survey. Final refinements have been completed.
Results
In the initial usability testing, participants indicated high usability of the ezDashboard with a total mean SUS score of 83.5 (SD 16.3). Most participants (n=13, 87%) rated the overall user-friendliness of the ezDashboard as good (n=3, 20%), excellent (n=9, 60%), or best imaginable (n=1, 7%). Open-ended questions showed the ezDashboard is or would be useful to monitor parent progress and trends in engagement (n=8, 53%). To facilitate that, we created the Engagement Index (0-100% per module) to assist facilitators’ understanding of how parents interact with ezParent. After revisions, the EAB rated the ezDashboard as 83.6 (SD11.4).
Conclusions
Results from iterative testing indicate that the ezDashboard is easy to use and provides functional information to those delivering ezParent. In 2026, the ezDashboard will be used in a randomized controlled trial testing hybrid delivery of ezParent. The usefulness of the Engagement Index as a more robust measure of program use will be assessed.
Authors:
Author - Julia Berteletti, MSW, Klein Buendel, Inc.
Co-Author - Susie Breitenstein, PhD, RN, FAAN, The Ohio State University College of Nursing
Co-Author - Nathan Helsabeck, PhD, The Ohio State University College of Nursing
Co-Author - Kayla Herbell, PhD, RN, The Ohio State University College of Nursing
Co-Author - Charlie Barger, BA, Klein Buendel, Inc.
Co-Author - Alishia Kinsey, BS, Klein Buendel, Inc.
Implementation Monitoring of a Worksite Walking Challenge, 50K4Life: Pilot Results and Benchmarking for the Future
Poster Number: B98Time: 11:00 AM - 11:50 AM
Topics: Implementation Science , Physical Activity
Monitoring the completeness and consistency of intervention implementation is imperative for interpreting program outcomes particularly in complex behavior change trials. 50K4Life is a Sequential Multiple Assignment Randomized Trial (SMART) to increase walking among Texas school district employees. In this SMART there are two phases with two intervention conditions per phase; Phase 1 includes school-based walking challenges with and without text messaging, while in Phase 2, schools that were non-responsive (the school site did not meet the walking challenge goal) in Phase 1 receive individually-adapted health coaching or environmental changes led by school walking champions. We report on the development of the implementation monitoring plan and its application during a pilot, including use of the Consolidated Framework for Implementation Research (CFIR) inner and implementation process domains. The Inner Domain, defined as within-school, was not supportive of walking at baseline with few opportunities for employee walking or other physical activity across the pilot schools (n=4). For the Implementation Monitoring domain, the 50K4Life pilot had 28.6% reach (n=98), defined as the % of participants with less than 7,000 steps/day. Nearly twice as many walking challenge notifications were implemented (191.5%) and 95.2% of the text messages were sent as planned. Additional unscheduled notifications were due primarily to pre-challenge instructions, troubleshooting, and post-challenge rewards. In Phase 2, an average of 4.67 individually-adapted health coaching sessions were held with 6 participants (of 6 planned sessions with 38 participants, m=18.5 minutes). Environmental changes were assigned to 2 schools with 1 school planning walking groups and working toward improved campus walkability. Fidelity was varied for Phase 2 primarily due to low participation as well as changes in implementation staff and a lack of time for staff training. Following CFIR recommendations, the project’s community advisory board assisted with refining intervention content and the implementation plan. We will discuss how these results are informing the delivery and implementation monitoring of the full trial and be used to define thresholds for implementation of complex interventions, aiding in benchmark setting for other implementation programs.
Keywords: Effectiveness, InterventionsAuthors:
Author - Jennifer Gay, PhD, University of Georgia
Co-Author - Erin Finley, PhD MPH, UT Health San Antonio/South Texas Veterans Health Care System
Co-Author - Jada Moss, MPH, University of Georgia
Co-Author - Susan Buchholz, PhD, RN, Michigan State University
Co-Author - Deborah Parra-Medina, PhD, University of Colorado Anschutz Medical Campus
Co-Author - Jennifer Salinas, PhD, University of Texas at El Paso
Implementation determinants and strategies for a community-based healthy eating and active living intervention for women of reproductive age
Poster Number: B99Time: 11:00 AM - 11:50 AM
Topics: Implementation Science , Multiple Health Behavior Change
Background: To achieve public health impact, evidence-based intervention (EBIs) must be implemented with sufficient reach, adoption, and sustainment -- requiring tailored implementation strategies -- particularly in non-clinical, community-based settings. This study identifies and describes implementation determinants and potential strategies for the Healthy Eating and Active Living Taught at Home (HEALTH) EBI. HEALTH aims to improve weight outcomes among mothers and is embedded in the community-based Parents as Teachers (PAT) home visiting model.
Methods: We conducted semi-structured interviews with PAT supervisors and providers who conduct home visits participating in the HEALTH Dissemination and Implementation study. The Consolidated Framework for Implementation Research (CFIR) and adapted Shengelia et al Access framework informed interview guides and deductive analysis.
Results: Eight supervisors and 14 providers completed interviews. Determinants identified across CFIR domains (Outer setting: local conditions, partnerships; Inner setting: communication, compatibility, access to knowledge; Implementor: capability, motivation; Innovation: design, adaptability) cut across implementation outcomes of provider choice to use HEALTH with moms, amount of HEALTH delivered, and perceived acceptability and benefit of HEALTH. Providers were hesitant to offer HEALTH to moms with significant social needs and reported HEALTH was not a priority during home visits when stressors existed. However, providers and supervisors felt HEALTH was needed and would benefit the communities they served. Communication with other providers, supervision, and training supported providers’ capability to deliver HEALTH. Providers cited their own weight/health behaviors as either causing discomfort in adopting and delivering HEALTH or as motivation for delivering HEALTH. The ability to adapt HEALTH to fit mom’s needs/preferences and compatibility of HEALTH with PAT workflow facilitated use of HEALTH and perceived benefits for moms. Provider relationships and engagement with moms supported acceptability and perceived benefit.
Discussion: Determinants across CFIR influenced HEALTH adoption, use, and perceived acceptability and benefit. Community-based EBIs may benefit from strategies targeting social needs (e.g., building partner relationships). Strategies such as facilitating peer learning and promoting adaptability may help providers outside healthcare deliver health-focused EBIs.
Keywords: Obesity, Health behavior changeMethods: We conducted semi-structured interviews with PAT supervisors and providers who conduct home visits participating in the HEALTH Dissemination and Implementation study. The Consolidated Framework for Implementation Research (CFIR) and adapted Shengelia et al Access framework informed interview guides and deductive analysis.
Results: Eight supervisors and 14 providers completed interviews. Determinants identified across CFIR domains (Outer setting: local conditions, partnerships; Inner setting: communication, compatibility, access to knowledge; Implementor: capability, motivation; Innovation: design, adaptability) cut across implementation outcomes of provider choice to use HEALTH with moms, amount of HEALTH delivered, and perceived acceptability and benefit of HEALTH. Providers were hesitant to offer HEALTH to moms with significant social needs and reported HEALTH was not a priority during home visits when stressors existed. However, providers and supervisors felt HEALTH was needed and would benefit the communities they served. Communication with other providers, supervision, and training supported providers’ capability to deliver HEALTH. Providers cited their own weight/health behaviors as either causing discomfort in adopting and delivering HEALTH or as motivation for delivering HEALTH. The ability to adapt HEALTH to fit mom’s needs/preferences and compatibility of HEALTH with PAT workflow facilitated use of HEALTH and perceived benefits for moms. Provider relationships and engagement with moms supported acceptability and perceived benefit.
Discussion: Determinants across CFIR influenced HEALTH adoption, use, and perceived acceptability and benefit. Community-based EBIs may benefit from strategies targeting social needs (e.g., building partner relationships). Strategies such as facilitating peer learning and promoting adaptability may help providers outside healthcare deliver health-focused EBIs.
Authors:
Author - Amanda Gilbert, PhD, LCSW, Washington University in St. Louis School of Public Health
Co-Author - Callie Walsh-Bailey, PhD, MPH, Feinberg School of Medicine, Northwestern University
Co-Author - Shaquille Christmas, MPH, Washington University in St. Louis School of Public Health
Co-Author - Debra Haire-Joshu, PhD, RN, MSN, MS, Washington University in St. Louis School of Public Health
Co-Author - Allison Kemner, MPH, Parents as Teachers
Co-Author - Rachel Tabak, PhD, Washington University in St. Louis School of Public Health
Examining Associations Between Behavioral Automaticity and Weight Management Hope in Adults with Current or Former Obesity
Poster Number: B39Time: 11:00 AM - 11:50 AM
Topics: Weight Related Health , Methods and Measurement
Introduction: Habit formation is an increasingly targeted mechanism for supporting sustainable behavior change in obesity treatment, as behaviors with high automaticity are more resilient against fatigue, lapses in motivation, and stress. Although research has examined cognitive-motivational correlates of automaticity, hope theory constructs remain unexplored. Hope, in both dispositional and domain-specific forms, reflects self-beliefs about abilities to generate pathways to goals (pathways thought) and sustain effort over time (agentic thought), each theoretically relevant to habit formation. This study is the first to examine associations between behavioral automaticity and both dispositional hope and weight management hope.
Methods: As part of a larger initiative to validate the Weight Management Hope Scale (WMHS), this study analyzed cross-sectional survey data from 385 U.S. adults with current or former obesity pursuing weight loss or maintenance. Participants completed the WMHS, Dispositional Hope Scale, and the Self-Report Behavioral Automaticity Index for five health behaviors: daily aerobic activity, portion control, vegetable consumption, fruit consumption, and lean protein consumption. Pearson correlations tested relationships between hope constructs and automaticity. Hierarchical regressions examined whether WMHS accounted for unique variance in automaticity beyond dispositional hope.
Results: Automaticity for all five behaviors was significantly associated with weight management hope (r=.25–.37, p<.001) and dispositional hope (r=.21–.32, p<.001). Steiger’s Z tests revealed weight management agentic thought showed stronger associations with automaticity than weight management pathways thought for vegetable consumption, portion control, and aerobic activity (z=2.14–3.33, p<.05). Weight management hope explained additional variance in automaticity across all five behaviors (ΔR2=.01–.07, p<.05), with dispositional hope becoming non-significant in the final models for four of five behaviors.
Conclusion: The findings of this study provide preliminary evidence that both dispositional hope and weight management hope may be relevant to habit formation processes. Future research using longitudinal and experimental methods will be needed to understand the mechanistic relationships between these constructs, including whether hope serves as an antecedent, consequence, or co-developing factor during habit formation.
Keywords: Weight control, Health behavior changeMethods: As part of a larger initiative to validate the Weight Management Hope Scale (WMHS), this study analyzed cross-sectional survey data from 385 U.S. adults with current or former obesity pursuing weight loss or maintenance. Participants completed the WMHS, Dispositional Hope Scale, and the Self-Report Behavioral Automaticity Index for five health behaviors: daily aerobic activity, portion control, vegetable consumption, fruit consumption, and lean protein consumption. Pearson correlations tested relationships between hope constructs and automaticity. Hierarchical regressions examined whether WMHS accounted for unique variance in automaticity beyond dispositional hope.
Results: Automaticity for all five behaviors was significantly associated with weight management hope (r=.25–.37, p<.001) and dispositional hope (r=.21–.32, p<.001). Steiger’s Z tests revealed weight management agentic thought showed stronger associations with automaticity than weight management pathways thought for vegetable consumption, portion control, and aerobic activity (z=2.14–3.33, p<.05). Weight management hope explained additional variance in automaticity across all five behaviors (ΔR2=.01–.07, p<.05), with dispositional hope becoming non-significant in the final models for four of five behaviors.
Conclusion: The findings of this study provide preliminary evidence that both dispositional hope and weight management hope may be relevant to habit formation processes. Future research using longitudinal and experimental methods will be needed to understand the mechanistic relationships between these constructs, including whether hope serves as an antecedent, consequence, or co-developing factor during habit formation.
Authors:
Author - Casey Hughes, DrPH, MA, Bloomberg School of Public Health, Johns Hopkins University
Co-Author - Rajiv Rimal, PhD MA, Bloomberg School of Public Health, Johns Hopkins University
Co-Author - Kenneth Feder, PhD, Bloomberg School of Public Health, Johns Hopkins University
Co-Author - Carol Underwood, PhD MA, Bloomberg School of Public Health, Johns Hopkins University
Poster Session B
Description
Date: 4/23/2026
Start: 11:00 AM
End: 11:50 AM
Location: Salon D