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Poster Session C
Post-Acute Care Behavioral Interventions to Improve Health-Related Quality of Life among Patients with Stroke: Hospital- vs. Home-Based Models in Taiwan
Poster Number: C1Time: 05:00 PM - 05:50 PM
Topics: Aging, Quality of Life
Background: The World Health Organization’s World Report on Ageing and Health (2015) underscored the challenges health systems face in meeting care demands from population aging. Over 30% of older adults develop disability following acute hospitalization, impairing basic activities of daily living and reducing quality of life. Post-acute care (PAC) behavioral interventions may mitigate these effects, yet little is known about whether and how hospital- vs. home-based models differ in their effects on health-related quality of life (HRQoL) among patients with stroke in the PAC phase in Taiwan.
Methods: We conducted a retrospective cohort study using medical records to examine changes in assessment scores among patients with stroke who received hospital- (N = 629) or home-based (N = 217) PAC behavioral interventions. Key health indicators included the Modified Rankin Scale (mRS), Barthel Index (BI), Instrumental Activities of Daily Living (IADL), and EuroQoL-5D (EQ-5D). We examined (1) whether hospital- and home-based PAC models differed in their effects on posttest EQ-5D scores, and (2) whether EQ-5D improvement was mediated through desired changes in mRS, BI, and IADL scores.
Results: The mean age of this cohort was 69.7 years, with 60.7% being male. Both models showed significant EQ-5D improvement. The home-based group had better EQ-5D at pretest, but this difference was non-significant at posttest. Both groups improved significantly in mRS, BI, and IADL scores, with the home-based group scoring better at both time points. However, multivariate linear autoregression controlling for pretest EQ-5D, age, and sex revealed no model differences in posttest EQ-5D. Stratified analysis showed older age predicted worse EQ-5D in both models (β = 0.086 and 0.141). Notably, in the hospital-based model, female patients (β = –0.077) and those with BI improvement (β = –0.221) reported better HRQoL at posttest, while mRS and IADL changes were not significant predictors.
Conclusions: This study demonstrated that hospital- and home-based PAC models yielded comparable HRQoL outcomes. In addition, improvement in BI, rather than IADL, mediated enhancement in EQ-5D only in the hospital-based model, suggesting that basic functional recovery may be more critical than advanced social functioning in the PAC phase. Lastly, the gender-specific benefit observed among female hospital-based patients may reflect sociocultural caregiving roles, warranting further investigation.
Keywords: Aging, Quality of lifeMethods: We conducted a retrospective cohort study using medical records to examine changes in assessment scores among patients with stroke who received hospital- (N = 629) or home-based (N = 217) PAC behavioral interventions. Key health indicators included the Modified Rankin Scale (mRS), Barthel Index (BI), Instrumental Activities of Daily Living (IADL), and EuroQoL-5D (EQ-5D). We examined (1) whether hospital- and home-based PAC models differed in their effects on posttest EQ-5D scores, and (2) whether EQ-5D improvement was mediated through desired changes in mRS, BI, and IADL scores.
Results: The mean age of this cohort was 69.7 years, with 60.7% being male. Both models showed significant EQ-5D improvement. The home-based group had better EQ-5D at pretest, but this difference was non-significant at posttest. Both groups improved significantly in mRS, BI, and IADL scores, with the home-based group scoring better at both time points. However, multivariate linear autoregression controlling for pretest EQ-5D, age, and sex revealed no model differences in posttest EQ-5D. Stratified analysis showed older age predicted worse EQ-5D in both models (β = 0.086 and 0.141). Notably, in the hospital-based model, female patients (β = –0.077) and those with BI improvement (β = –0.221) reported better HRQoL at posttest, while mRS and IADL changes were not significant predictors.
Conclusions: This study demonstrated that hospital- and home-based PAC models yielded comparable HRQoL outcomes. In addition, improvement in BI, rather than IADL, mediated enhancement in EQ-5D only in the hospital-based model, suggesting that basic functional recovery may be more critical than advanced social functioning in the PAC phase. Lastly, the gender-specific benefit observed among female hospital-based patients may reflect sociocultural caregiving roles, warranting further investigation.
Authors:
Author - Jiun-Hau Huang, SM, ScD, National Taiwan University College of Public Health, Taipei, Taiwan
Co-Author - Hsiao-Jung Lo, MPH, RN, Wei-Gong Memorial Hospital, Miaoli, Taiwan
Co-Presenter - Michelle Wang, BA, MD Candidate, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
Co-Author - Ching-Hua Chu, MD, PhD, Wei-Gong Memorial Hospital, Miaoli, Taiwan
Co-Author - Wen-Yuan Lee, MD, PhD, Wei-Gong Memorial Hospital, Miaoli, Taiwan
Reproductive and Sexual Distress in Young Adult Cancer Survivors and Their Partners: A Latent Profile Analysis
Poster Number: C10Time: 05:00 PM - 05:50 PM
Topics: Cancer, Women's Health
Background: Reproductive and sexual health (RSH) concerns are common among young adult (age 18-39 at diagnosis) breast and gynecologic cancer (BGC) survivors. Yet, although RSH concerns affect survivors’ intimate relationships and quality of life, the dyadic nature of these concerns and the distress they can engender for both members of the couple have largely been overlooked. Characterizing couples’ profiles of RSH distress may help identify those with the greatest need for support and guide development of targeted interventions.
Objectives: The objectives of the current study were to 1) identify latent profiles for dyadic RSH distress, 2) characterize these groups by demographics, reproductive/sexual health, and cancer characteristics, and 3) consider how these profiles relate to dyadic coping (partners working together to cope with stress) and communication.
Methods: We conducted Latent Profile Analysis (LPA) on a sample of 79 young adult BGC survivor-partner dyads to identify subgroups based on their shared levels of RSH distress. Primary assessments included infertility-related distress (Fertility Problem Inventory-relationship concern domain), sexual and relationship distress scale (SaRDS), dyadic coping inventory (DCI), and communication patterns questionnaire (CPQ-SF). Following profile identification, we used ANOVA, chi-square tests, and post-hoc tests to examine how these dyadic profiles differed across groups.
Results: A three-class solution provided the best fit for the data, identifying distinct groups of dyads with Low (30.37%), Moderate (43.2%), and High (26.45%) RSH distress. The profiles showed a clear gradient, with scores on all distress measures increasing from the low- to high-distress groups. Demographic and cancer-related variables did not significantly differ across these profiles. Dyads in the High Distress group reported significantly lower scores on dyadic coping and poorer communication than those in the Low and Moderate Distress groups. Dyads in the High Distress group also reported the lowest rates of current sexual activity.
Conclusion: Findings from this study of BGC dyads suggest that interpersonal processes within relationships - rather than individual or medical characteristics - are key drivers of RSH distress. Coping and communication interventions that are tailored to the distress level of the couple may be promising strategies to address RSH concerns in young adult survivor couples.
Keywords: Couple-focused, Cancer survivorshipObjectives: The objectives of the current study were to 1) identify latent profiles for dyadic RSH distress, 2) characterize these groups by demographics, reproductive/sexual health, and cancer characteristics, and 3) consider how these profiles relate to dyadic coping (partners working together to cope with stress) and communication.
Methods: We conducted Latent Profile Analysis (LPA) on a sample of 79 young adult BGC survivor-partner dyads to identify subgroups based on their shared levels of RSH distress. Primary assessments included infertility-related distress (Fertility Problem Inventory-relationship concern domain), sexual and relationship distress scale (SaRDS), dyadic coping inventory (DCI), and communication patterns questionnaire (CPQ-SF). Following profile identification, we used ANOVA, chi-square tests, and post-hoc tests to examine how these dyadic profiles differed across groups.
Results: A three-class solution provided the best fit for the data, identifying distinct groups of dyads with Low (30.37%), Moderate (43.2%), and High (26.45%) RSH distress. The profiles showed a clear gradient, with scores on all distress measures increasing from the low- to high-distress groups. Demographic and cancer-related variables did not significantly differ across these profiles. Dyads in the High Distress group reported significantly lower scores on dyadic coping and poorer communication than those in the Low and Moderate Distress groups. Dyads in the High Distress group also reported the lowest rates of current sexual activity.
Conclusion: Findings from this study of BGC dyads suggest that interpersonal processes within relationships - rather than individual or medical characteristics - are key drivers of RSH distress. Coping and communication interventions that are tailored to the distress level of the couple may be promising strategies to address RSH concerns in young adult survivor couples.
Authors:
Author - Jessica Gorman, PhD, MPH, Oregon State University
Co-Author - Soyoung Choun, PhD, Oregon State University
Co-Author - Karen Lyons, PhD, Boston College
Co-Author - S. Marie Harvey, DrPH, Oregon State University
Co-Author - Chiara Acquati, PhD, University of Houston
Co-Author - John Salsman, PhD, FSBM, Wake Forest University School of Medicine
Co-Author - Lisa Flexner, PT, DPT, FlexHealth Consulting, LLC
Co-Author - Stephanie Corey, MPH, Oregon State University
Co-Author - Geethika Koneru, MD, MPH, Oregon State University
Co-Author - Brandon Hayes-Lattin, MD, Oregon Health & Science University
Co-Author - Jennifer Reese, PhD, Fox Chase Cancer Center
Integrating Cancer Genetics into Primary Care: Preliminary Findings from the TestMiGenes Study
Poster Number: C100Time: 05:00 PM - 05:50 PM
Topics: Integrated Primary Care, Health Disparities
Purpose: Mainstream genetic testing (MGT), where primary care providers (PCPs) order genetic testing (GT) at the point of care during hereditary cancer risk assessment (HCRA), may expand access beyond referral-based models. The TestMiGenes study evaluates the implementation of MGT in federally qualified health centers (FQHCs), recognizing that starting in lower-resourced settings is essential for developing scalable approaches and reducing disparities.
Methods: TestMiGenes used a hybrid implementation-effectiveness design to compare referral-based and MGT models in FQHCs. A digital HCRA tool was administered to patients aged ≥25 during routine visits to identify eligibility per NCCN criteria. From Jan–Dec 2023, the referral model was implemented with 10 PCPs at two clinics; from Jun 2024–Jul 2025, MGT was implemented with 10 PCPs at two others. PCPs received structured genetics training and specialist support. In the referral model, eligible patients were sent to counseling before GT; in the MGT model, PCPs provided education, supported decision making, ordered GT, and disclosed results with specialist backup and referral for positive or complex findings. Primary outcomes were GT uptake and time-to-test; secondary outcomes included acceptability, feasibility, and sustainability from interviews. Quantitative analyses used chi-square and t-tests; qualitative analyses followed thematic methods.
Results: Of the 2205 patients who received HCRA, most were Black or Hispanic (92%), under 50 (53%), and female (67%). In all, 424 (19%) patients were eligible for GT, 191 from clinics using the MGT model and 233 from clinics using the referral model. GT uptake was 40% (77/191 patients) in the MGT model versus 24% (57/233 patients) in the referral model (p<0.05). Average time to GT completion was also shorter in MGT than the referral model (13 days vs. 113 days, p < 0.05). Patient and provider interviews are underway to explore acceptability, sustainability, barriers, and potential harms.
Conclusion: MGT is feasible in primary care FQHCs and improves uptake and timeliness of genetic testing. Ongoing patient and provider interviews will help explain patterns of use and inform future efforts to expand access and reduce disparities in cancer genetic services.
Keywords: Genetics, DisparitiesMethods: TestMiGenes used a hybrid implementation-effectiveness design to compare referral-based and MGT models in FQHCs. A digital HCRA tool was administered to patients aged ≥25 during routine visits to identify eligibility per NCCN criteria. From Jan–Dec 2023, the referral model was implemented with 10 PCPs at two clinics; from Jun 2024–Jul 2025, MGT was implemented with 10 PCPs at two others. PCPs received structured genetics training and specialist support. In the referral model, eligible patients were sent to counseling before GT; in the MGT model, PCPs provided education, supported decision making, ordered GT, and disclosed results with specialist backup and referral for positive or complex findings. Primary outcomes were GT uptake and time-to-test; secondary outcomes included acceptability, feasibility, and sustainability from interviews. Quantitative analyses used chi-square and t-tests; qualitative analyses followed thematic methods.
Results: Of the 2205 patients who received HCRA, most were Black or Hispanic (92%), under 50 (53%), and female (67%). In all, 424 (19%) patients were eligible for GT, 191 from clinics using the MGT model and 233 from clinics using the referral model. GT uptake was 40% (77/191 patients) in the MGT model versus 24% (57/233 patients) in the referral model (p<0.05). Average time to GT completion was also shorter in MGT than the referral model (13 days vs. 113 days, p < 0.05). Patient and provider interviews are underway to explore acceptability, sustainability, barriers, and potential harms.
Conclusion: MGT is feasible in primary care FQHCs and improves uptake and timeliness of genetic testing. Ongoing patient and provider interviews will help explain patterns of use and inform future efforts to expand access and reduce disparities in cancer genetic services.
Authors:
Co-Author - Pamela Ganschow, MD, University of Illinois at Chicago
Co-Author - Vivian Pan, MS, CGC, University of Illinois at Chicago
Co-Author - Angelina Izguerra, BPH, University of Illinois at Chicago
Co-Author - Neha Awati, MD, University of Illinois at Chicago
Co-Author - Emelia Arquilla, DO, Mile Square Health Center
Co-Author - Julie Bobitt, PhD, University of Illinois Chicago
Co-Author - Vida Henderson, PhD, PharmD, MPH, Fred Hutchinson Cancer Research Center
Co-Author - Yamile Molina, PhD, University of Illinois at Chicago
Co-Author - Garth Rauscher, PhD, University of Illinois at Chicago
Co-Author - Genesis Rios, MPH, University of Illinois at Chicago
Co-Author - Nathan Stackhouse, MD, Mile Square Health Center
Presenter - Catharine Wang, PhD, Boston University School of Public Health
Exploring patient perspectives on a new task-shared behavioral health role in Washington State
Poster Number: C101Time: 05:00 PM - 05:50 PM
Topics: Integrated Primary Care, Implementation Science
Task-sharing, in which non-specialist providers are trained to deliver psychological interventions under specialist supervision, is an emerging strategy to expand mental health services in integrated care settings in the US. In 2023, Washington State introduced a task-shared credential: the Behavioral Health Support Specialist. As the first cohort graduates, it is critical to understand patient perspectives on receiving mental health care from providers with less formal training. Such findings are relevant nationally as other states consider similar roles to expand care. We randomly sampled and recruited patients with mild or moderate depression or anxiety in the past 12 months at two primary care clinics. Mixed methods data collection consisted of semi-structured individual interviews and electronic surveys. Interview guides explored acceptability and appropriateness, as defined by Proctor et al. Interviews were audio-recorded, transcribed, and imported into Dedoose qualitative software. Two coders independently coded the interviews using a hybrid deductive-inductive coding framework in which the initial codebook was based on the interview guides and additional codes were added through open coding. They then identified key themes through discussion of codes. Survey questions were adapted from the acceptability and appropriateness sub-scales of the Mental Health Implementation Science Tools (mhIST). Quantitative data were collected via REDCap surveys; descriptive statistics were integrated with qualitative data in a joint display table. Two primary themes were identified in analysis: 1) most participants reported that receiving task-shared mental healthcare was acceptable if supervision was transparently explained at the outset; and 2) participants reported that prior experiences of task-sharing in medical services or receiving mental health services from a therapist still in training shaped their openness to task-shared mental health care. Survey responses ranged from 3 to 3.49 (range: 1-4), indicating moderate acceptability and appropriateness and convergence with qualitative data. Findings highlight the promising overall acceptability of a task-shared mental health provider to patients, and frame of reference that patients may already have from task-sharing in other settings. However, findings also underscore the need for effective communication strategies to introduce this new model to patients, which emphasize the supervision structure.
Keywords: Training, Health communicationAuthors:
Presenter - Alexandra Rose, PhD, University of Washington
Co-Author - Olga Vitruk, MPH, University of Washington
Co-Author - Brenna Renn, PhD, University of Nevada Las Vegas
Co-Author - Lydia Chwastiak, MD, MPH, University of Washington
Co-Author - William O'Connell, Ed.D, University of Washington
Co-Author - Anna Ratzliff, MD, PhD, University of Washington
Food Insecurity, Stress, and Mental Health in College Student Athletes
Poster Number: C102Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Diet, Nutrition, and Eating Disorders
BACKGROUND: Food insecurity is a growing concern on college campuses and has been linked to higher levels of stress, anxiety, and depressive symptoms. These relationships may be even more pronounced in student athletes who experience food insecurity while balancing academic and athletic demands. The purpose of this study, therefore, was to compare mental health outcomes between Division III student athletes who report food insecurity vs. food secure student athletes.
METHODS: In collaboration with the North Carolina Wesleyan University (NCWU) Sports Medicine staff, assessments of food insecurity from the World Health Organization Food Insecurity Experience Scale (FIES); mental health [Center for Epidemiological Studies Depression Scale (CES-D); Spielberger Trait Anxiety Inventory (STAI-Y2)]; and perceived stress [Perceived Stress Scale (PSS)] were conducted via an online survey. Students who responded “yes” to the question, “In the last 12 months, have you/your household cut the size of your meals or skipped meals because there wasn't enough money for food?”, were identified as potentially experiencing food insecurity. One hundred and three students with complete study data for food insecurity variables were included in the analysis. Mann-Whitney U tests were conducted to test for differences in stress and mental health outcomes between food insecure, and food secure student athletes.
RESULTS: Seventeen percent of our college student athlete sample (mean age 20.1 ± 1.6y) reported that, in the last 12 months, they/their household cut the size of their meals or skipped meals because there wasn't enough money for food. Compared to student athletes who answered “no” to this question, those identified as potentially experiencing food insecurity reported significantly higher levels of perceived stress (Z = 2.7; p = .008); depressive symptoms (Z = 2.3; p = .01); and anxious symptoms (Z = 2.8; p = .003).
CONCLUSION: Our results indicate that student athletes who reported food insecurity experienced significantly higher levels of stress, anxiety, and depressive symptoms, emphasizing the role of nutrition access as a key determinant of mental health in college student athlete populations. Considering the increased physical and mental demands placed on student athletes, these findings suggest that programs designed for student athletes should prioritize nutrition access as part of a comprehensive student athlete health promotion program.
Keywords: Mental health, Health disparitiesMETHODS: In collaboration with the North Carolina Wesleyan University (NCWU) Sports Medicine staff, assessments of food insecurity from the World Health Organization Food Insecurity Experience Scale (FIES); mental health [Center for Epidemiological Studies Depression Scale (CES-D); Spielberger Trait Anxiety Inventory (STAI-Y2)]; and perceived stress [Perceived Stress Scale (PSS)] were conducted via an online survey. Students who responded “yes” to the question, “In the last 12 months, have you/your household cut the size of your meals or skipped meals because there wasn't enough money for food?”, were identified as potentially experiencing food insecurity. One hundred and three students with complete study data for food insecurity variables were included in the analysis. Mann-Whitney U tests were conducted to test for differences in stress and mental health outcomes between food insecure, and food secure student athletes.
RESULTS: Seventeen percent of our college student athlete sample (mean age 20.1 ± 1.6y) reported that, in the last 12 months, they/their household cut the size of their meals or skipped meals because there wasn't enough money for food. Compared to student athletes who answered “no” to this question, those identified as potentially experiencing food insecurity reported significantly higher levels of perceived stress (Z = 2.7; p = .008); depressive symptoms (Z = 2.3; p = .01); and anxious symptoms (Z = 2.8; p = .003).
CONCLUSION: Our results indicate that student athletes who reported food insecurity experienced significantly higher levels of stress, anxiety, and depressive symptoms, emphasizing the role of nutrition access as a key determinant of mental health in college student athlete populations. Considering the increased physical and mental demands placed on student athletes, these findings suggest that programs designed for student athletes should prioritize nutrition access as part of a comprehensive student athlete health promotion program.
Authors:
Presenter - Madison Morrison, North Carolina Wesleyan University
Co-Author - Meredith R. Gringle, PhD. MPH, North Carolina Wesleyan University
Co-Author - Timothy Donovan, MS, LAT, ATC, North Carolina Wesleyan University
Co-Author - Carol Carson, North Carolina Wesleyan University
Co-Author - Shannon K. Crowley, PhD, North Carolina Wesleyan University
Prioritizing Black Families' Insights and Perspectives When Developing a Suicide Prevention Intervention for Black Students
Poster Number: C103Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Child and Family Health
BACKGROUND: Suicide persists as a leading cause of death among Black youth in the United States, yet few prevention programs have been developed or adapted with their perspectives in mind. Existing school-based interventions, such as the widely used Signs of Suicide (SOS) program, have demonstrated effectiveness but may not fully address the cultural and contextual realities of Black students and their families. Incorporating youth and parent perspectives is critical to ensuring relevance and impact.
METHODS: Study participants included 22 Black middle school-aged students and parents. Each participated in a semi-structured Zoom interview in which they viewed and discussed the SOS suicide prevention videos. Interviews were transcribed and analyzed using the RADaR technique to organize responses, followed by thematic analysis to identify key patterns across participants and groups. Our study assessed two guiding questions: (1) What feedback do parents and youth provide regarding the existing SOS intervention videos?; and (2) What information is most or least helpful when adapting the intervention to focus on Black students?
RESULTS (RQ1) Youth described the videos as relatable and helpful, especially the roundtable discussions and counselor advice, yet their feedback was mixed; while some affirmed the value of the scenarios, others felt the content would not encourage them to share or did not apply to their own lives. In contrast, parents consistently praised the videos’ clarity and practicality, noting that structured messages and realistic examples made them effective conversation starters and useful educational tools for supporting youth mental health. (RQ2) Youth reported that the videos increased their awareness of warning signs and reinforced the importance of seeking support from peers, teachers, and counselors. Some noted that the videos validated strategies they already knew, while a subset felt they did not learn anything new. Parents, meanwhile, emphasized that the videos would help Black youth to recognize symptoms, understand risk behaviors, and gain language for discussing mental health.
CONCLUSION: Our findings demonstrate that the SOS intervention provides a solid foundation in suicide prevention. However, adaptations that incorporate Black youth and parent perspectives may strengthen the personal applicability of the content.
Keywords: Mental health, RaceMETHODS: Study participants included 22 Black middle school-aged students and parents. Each participated in a semi-structured Zoom interview in which they viewed and discussed the SOS suicide prevention videos. Interviews were transcribed and analyzed using the RADaR technique to organize responses, followed by thematic analysis to identify key patterns across participants and groups. Our study assessed two guiding questions: (1) What feedback do parents and youth provide regarding the existing SOS intervention videos?; and (2) What information is most or least helpful when adapting the intervention to focus on Black students?
RESULTS (RQ1) Youth described the videos as relatable and helpful, especially the roundtable discussions and counselor advice, yet their feedback was mixed; while some affirmed the value of the scenarios, others felt the content would not encourage them to share or did not apply to their own lives. In contrast, parents consistently praised the videos’ clarity and practicality, noting that structured messages and realistic examples made them effective conversation starters and useful educational tools for supporting youth mental health. (RQ2) Youth reported that the videos increased their awareness of warning signs and reinforced the importance of seeking support from peers, teachers, and counselors. Some noted that the videos validated strategies they already knew, while a subset felt they did not learn anything new. Parents, meanwhile, emphasized that the videos would help Black youth to recognize symptoms, understand risk behaviors, and gain language for discussing mental health.
CONCLUSION: Our findings demonstrate that the SOS intervention provides a solid foundation in suicide prevention. However, adaptations that incorporate Black youth and parent perspectives may strengthen the personal applicability of the content.
Authors:
Co-Presenter - Kunashe Rwizi, University of Chicago
Co-Presenter - Destiny Jenkins, University of Chicago
Co-Author - Ashley Vuletíc, MPP, University of Chicago
Co-Author - Janelle Goodwill, PhD, MSW, University of Chicago
Examining Age Differences in the Association Between Mental Illness Treatment and E-Cigarette Use in US Youth and Young Adults
Poster Number: C104Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Tobacco Control and Nicotine-Related Behavior
Background: Youth and young adults in the United States face two colliding crises: mental health challenges and an epidemic of e-cigarette use. In 2024, 1 in 5 young people (aged 12-17) reported suffering from a major depressive episode in the past year and of US middle and high school students who reported current e-cigarette use, 26.3% reported daily use. While treatment for mental illness (MI) may help to reduce e-cigarette use, determining whether associations vary by age and whether there are other factors that predict e-cigarette use could help to inform tailored prevention and intervention strategies.
Methods: Data were obtained between August-December of 2023 from 4,357 respondents of the Truth Longitudinal Cohort - a nationally representative cohort of youth and young adults. Logistic regression models were used to determine whether age (15-20 vs. 21-24 years) modified the association between past-year MI treatment and current e-cigarette use by including an interaction term between age and MI treatment . Other factors in the models included sex at birth, gender identity, sexual orientation, race, perceived financial situation, and co-occurring tobacco use.
Results: Age did not significantly modify the association between past-year MI treatment and current e-cigarette use (p-value = 0.12) . Other factors associated with greater odds of current e-cigarette use, included: male sex at birth, gay/lesbian or bisexual identity, lower perceived financial situation, and use of other tobacco in the past-30 days.
Conclusion: The relationship between past-year MI treatment and current e-cigarette use appears to be consistent among youth and young adults, suggesting that a similar approach to MI treatment may be applied across these age groups in terms of e-cigarette prevention strategies. These findings underscore the importance of integrating mental health support into e-cigarette prevention efforts and considering the effects of other characteristics, such as sex at birth, sexual orientation, financial situation, and co-occurring tobacco use.
Keywords: Mental health, Tobacco useMethods: Data were obtained between August-December of 2023 from 4,357 respondents of the Truth Longitudinal Cohort - a nationally representative cohort of youth and young adults. Logistic regression models were used to determine whether age (15-20 vs. 21-24 years) modified the association between past-year MI treatment and current e-cigarette use by including an interaction term between age and MI treatment . Other factors in the models included sex at birth, gender identity, sexual orientation, race, perceived financial situation, and co-occurring tobacco use.
Results: Age did not significantly modify the association between past-year MI treatment and current e-cigarette use (p-value = 0.12) . Other factors associated with greater odds of current e-cigarette use, included: male sex at birth, gay/lesbian or bisexual identity, lower perceived financial situation, and use of other tobacco in the past-30 days.
Conclusion: The relationship between past-year MI treatment and current e-cigarette use appears to be consistent among youth and young adults, suggesting that a similar approach to MI treatment may be applied across these age groups in terms of e-cigarette prevention strategies. These findings underscore the importance of integrating mental health support into e-cigarette prevention efforts and considering the effects of other characteristics, such as sex at birth, sexual orientation, financial situation, and co-occurring tobacco use.
Authors:
Author - Rebecca Goyette, MPH, Truth Initiative
Author - Elizabeth Do, PhD, MPH, Truth Initiative
Author - Michael Liu, Truth Initiative
Author - Elizabeth Hair, PhD, Truth Initiative
Trait Mindfulness and Physical Health in College Students
Poster Number: C105Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Quality of Life
Trait mindfulness refers to a tendency to engage in present moment awareness across situations and time (Brown & Ryan, 2004). Those who are more trait mindful are less judgmental of their thoughts and more in touch with their physical and emotional well-being in the present moment. In fact, researchers have found trait mindfulness to be linked to reports of better physical health (Greeson & Chin, 2019). While these findings are valuable, most studies are cross-sectional and fail to control for relevant variables like neuroticism and perceived stress. The current study assessed the relationship between trait mindfulness and reports of physical health longitudinally, while controlling for neuroticism and stress appraisals. College students (N = 167) participated in this longitudinal study. Data was collected over a period of three months, and participants responded to a total of four surveys every three weeks. Each survey assessed the participants’ trait mindfulness, physical health symptoms, and cold symptoms. Trait mindfulness was measured using the Mindfulness Attention Awareness Scale (MAAS; Brown & Ryan, 2003). Physical health symptoms were assessed with a 12-item measure that included symptoms of fatigue, headaches, and muscle pains (Wientjes & Grossman, 1994). A cold symptoms measure assessed symptoms such as sore throat and congestion (Cohen et al., 1997). Neuroticism and stress appraisals of recent stressful experiences were also measured using validated measures. Longitudinal data analyses tested whether individuals higher in trait mindfulness at Time 1 would report fewer symptoms across time. Results confirmed consistent negative associations between trait mindfulness and both types of physical health symptoms at all time points. In other words, as participants were higher in trait mindfulness, they reported fewer physical symptoms at each subsequent time point, regardless of neuroticism or stress appraisals. These results contribute to the literature by showing that the relationship between trait mindfulness and physical health is consistent over time and continues to be meaningful even when accounting for associations with closely related variables. This study is one of the few longitudinal studies on trait mindfulness and physical health in college students. Like mindful interventions, being higher in “natural” mindfulness may be a benefit to these students who experience various stressors.
Keywords: Mindfulness, HealthAuthors:
Co-Author - Mya Hanna, Student , Grand Valley State University
Co-Author - Brian Meier , Gettysburg College
Co-Author - Daniel Frobish , Grand Valley State University
Co-Author - , Lebanon Valley College
Co-Author - Amanda Dillard, Grand Valley State University
Depression or Distress? Testing Competing Models of Mental Health and Self-Management in Type 1 Diabetes
Poster Number: C106Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Diabetes
Background: Adults with Type 1 Diabetes (T1D) experience higher rates of depressive symptoms than both the general population and those with Type 2 Diabetes. These symptoms are associated with lower self-efficacy and poorer self-management. Some theories suggest depression is more prevalent in T1D, while others attribute symptoms to diabetes-specific distress. Structural equation modeling (SEM) has not yet been used to directly compare these explanations.
Methods: A secondary SEM analysis was conducted using baseline data from 73 participants enrolled in a collaborative care trial (NCT06448429). Three models were tested to examine mediation effects on self-management behaviors: 1) the diabetes distress model, 2) the depression model, and 3) the self-efficacy model. Depression was assessed with the Patient Health Questionnaire-9, diabetes distress with the Type 1 Diabetes Distress Scale, and self-efficacy and self-management with the Self-Care of Diabetes Inventory. Individual Confirmatory Factor Analyses (CFAs) were performed for latent constructs, followed by structural models.
Results: All individual scales demonstrated good model fit (CFI≥.90, TLI ≥.90, RMSEA≤.08, SRMR≤.08). Significant mediation effects were observed in both the depression and diabetes distress models. In the depression model, depression increased diabetes distress (β= 0.80, p<0.01), which reduced self-efficacy (β= -0.33, p<0.05), and higher rates of self-efficacy increased wellness (β= 0.55, p<0.01) and self-monitoring behaviors (β= 0.71, p<0.01). Similarly, within the diabetes distress model, diabetes distress increased depressive symptoms (β= 0.82, p<0.01), leading to reductions in self-efficacy (β= -0.40, p<0.05), and increased self-efficacy led to higher rates of wellness (β= 0.80, p<0.01) and self-monitoring behaviors (β= 0.61, p<0.01). Direct effects in both models were attenuated when mediators were included. By contrast, the self-efficacy model showed limited mediation, although higher self-efficacy reduced depressive symptoms (β= -0.40, p<0.01), leading to increased diabetes distress (β= 0.81, p<0.01).
Conclusion: Findings support relationships between depression and diabetes distress, with self-efficacy emerging as a key mediator linking psychological symptoms to self-management. These results highlight the importance of targeting self-efficacy in interventions to improve health outcomes among adults with T1D.
Keywords: Diabetes, DepressionMethods: A secondary SEM analysis was conducted using baseline data from 73 participants enrolled in a collaborative care trial (NCT06448429). Three models were tested to examine mediation effects on self-management behaviors: 1) the diabetes distress model, 2) the depression model, and 3) the self-efficacy model. Depression was assessed with the Patient Health Questionnaire-9, diabetes distress with the Type 1 Diabetes Distress Scale, and self-efficacy and self-management with the Self-Care of Diabetes Inventory. Individual Confirmatory Factor Analyses (CFAs) were performed for latent constructs, followed by structural models.
Results: All individual scales demonstrated good model fit (CFI≥.90, TLI ≥.90, RMSEA≤.08, SRMR≤.08). Significant mediation effects were observed in both the depression and diabetes distress models. In the depression model, depression increased diabetes distress (β= 0.80, p<0.01), which reduced self-efficacy (β= -0.33, p<0.05), and higher rates of self-efficacy increased wellness (β= 0.55, p<0.01) and self-monitoring behaviors (β= 0.71, p<0.01). Similarly, within the diabetes distress model, diabetes distress increased depressive symptoms (β= 0.82, p<0.01), leading to reductions in self-efficacy (β= -0.40, p<0.05), and increased self-efficacy led to higher rates of wellness (β= 0.80, p<0.01) and self-monitoring behaviors (β= 0.61, p<0.01). Direct effects in both models were attenuated when mediators were included. By contrast, the self-efficacy model showed limited mediation, although higher self-efficacy reduced depressive symptoms (β= -0.40, p<0.01), leading to increased diabetes distress (β= 0.81, p<0.01).
Conclusion: Findings support relationships between depression and diabetes distress, with self-efficacy emerging as a key mediator linking psychological symptoms to self-management. These results highlight the importance of targeting self-efficacy in interventions to improve health outcomes among adults with T1D.
Authors:
Presenter - Leslie Johnson, PhD, Emory University
Co-Presenter - Zach Cooper, LCSW, University of Georgia
Coping Matters: Pathways Between Mental Illness Stigma and Depressive Symptoms among Young Adults
Poster Number: C107Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Social and Environmental Context and Health
Background: According to the stress-coping framework, coping strategies may mediate the relationships between mental illness (MI) stigma as a stressor and its consequences. Yet, it remains unclear how approach and avoidant coping strategies shape the associations between anticipated and experienced MI stigma and depressive symptoms among young adults. Moreover, prior research suggests gender differences in both experiences of MI stigma and the use of coping strategies, indicating that the pathways may differ by gender.
Purpose: To better understand the role of coping strategies in young adults’ responses to anticipated and experienced MI stigma, this study examined whether approach and avoidant coping strategies mediate associations between MI stigma and depressive symptoms among young adults, and whether these associations differ by gender.
Methods: Data from two time points were drawn from a national, longitudinal study of young adults in the United States (N = 3,578; ages 18 - 21). Path analysis with bootstrapping was used to test for mediation and multigroup analysis was used to test for gender differences.
Results: Bootstrapped analyses revealed significant indirect effects: Time 2 (T2) approach coping mediated associations between time 1 (T1) anticipated MI stigma and T2 depressive symptoms (indirect effect = 0.05, p = 0.006, 95% CI [0.02, 0.09]), and between T1 experienced MI stigma and T2 depressive symptoms (indirect effect = - 0.07, p = 0.004, 95% CI [- 0.12, -0.03]). In addition, T2 avoidant coping mediated the association between T1 experienced stigma and T2 depressive symptoms (indirect effect = 0.38, p < 0.001, 95% CI [0.19, 0.56]). The multigroup analysis indicated no gender differences (the Δχ2 comparing the constrained and unconstrained model was non-significant [Δχ2 (36) = 38.851, p = .340]), suggesting that the path model was consistent across cisgender women, cisgender men, and gender diverse groups.
Conclusion: Anticipated and experienced MI stigma are significant stressors for young adults with mental health problems and can exacerbate their depressive symptoms. Coping matters as greater use of approach coping can lead to fewer depressive symptoms while greater use of avoidant coping can lead to more depressive symptoms. Interventions that educate and support young adults in adopting effective coping strategies for MI stigma are essential.
Keywords: Coping, DepressionPurpose: To better understand the role of coping strategies in young adults’ responses to anticipated and experienced MI stigma, this study examined whether approach and avoidant coping strategies mediate associations between MI stigma and depressive symptoms among young adults, and whether these associations differ by gender.
Methods: Data from two time points were drawn from a national, longitudinal study of young adults in the United States (N = 3,578; ages 18 - 21). Path analysis with bootstrapping was used to test for mediation and multigroup analysis was used to test for gender differences.
Results: Bootstrapped analyses revealed significant indirect effects: Time 2 (T2) approach coping mediated associations between time 1 (T1) anticipated MI stigma and T2 depressive symptoms (indirect effect = 0.05, p = 0.006, 95% CI [0.02, 0.09]), and between T1 experienced MI stigma and T2 depressive symptoms (indirect effect = - 0.07, p = 0.004, 95% CI [- 0.12, -0.03]). In addition, T2 avoidant coping mediated the association between T1 experienced stigma and T2 depressive symptoms (indirect effect = 0.38, p < 0.001, 95% CI [0.19, 0.56]). The multigroup analysis indicated no gender differences (the Δχ2 comparing the constrained and unconstrained model was non-significant [Δχ2 (36) = 38.851, p = .340]), suggesting that the path model was consistent across cisgender women, cisgender men, and gender diverse groups.
Conclusion: Anticipated and experienced MI stigma are significant stressors for young adults with mental health problems and can exacerbate their depressive symptoms. Coping matters as greater use of approach coping can lead to fewer depressive symptoms while greater use of avoidant coping can lead to more depressive symptoms. Interventions that educate and support young adults in adopting effective coping strategies for MI stigma are essential.
Authors:
Presenter - Xueli Qiu, PhD, University of Delaware
Co-Author - Annie Fox, PhD, MGH Institute of Health Professions
Co-Author - Ruth Fleury-Steiner , PhD, University of Delaware
Co-Author - Jean-Philippe Laurenceau, PhD, University of Delaware
Co-Author - Patrick Corrigan, PhD, Illinois Institute of Technology
Co-Author - Valerie Earnshaw, PhD, University of Delaware
Effects of Physical Activity and Mediterranean Diet Adherence on Depressive Symptoms: A Longitudinal Mixed-Effects Analysis
Poster Number: C108Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Physical Activity
Introduction: Depression is a major concern in older adults, with consequences for quality of life, physical health, and cognition. Lifestyle strategies, such as diet and physical activity (PA), are promising targets for prevention. The Mediterranean diet benefits cardiometabolic and cognitive outcomes, but links to depression are inconsistent. PA is widely recognized as protective; however, its role within structured diet and weight loss programs remains less clear. This study examined whether Mediterranean diet adherence and PA predicted depressive symptoms over time in older adults enrolled in a dietary intervention.
Methods: We conducted a secondary analysis of a 3-arm randomized controlled trial (RCT; Tussing et al., 2017; Sanchez-Flack et al., 2021; Tussing-Humphreys et al., 2022; McLeod et al., 2025). Participants (N = 185; MedWL = 75, MedA = 73, Control = 37) completed assessments at baseline, 8 months, and 14 months. The MedWL program combined Mediterranean diet with structured PA and caloric restriction for weight loss, while MedA provided a Mediterranean diet alone. Measures included the Center for Epidemiological Studies Depression Scale (CES-D), Mediterranean diet adherence, and the GODIN PA Leisure-Time Exercise Questionnaire. Linear mixed-effects models with random intercepts for participants were used to predict depressive symptoms, adjusting for sex, race, education, and income.
Results: PA significantly predicted lower depressive symptoms (β = -0.03, p = .013). Mediterranean diet adherence was not associated with depressive symptoms over time (p = .14). Relative to the Control group, MedWL participants exhibited higher depressive symptoms, although this difference was not significant (β = 2.12, p = .07), while MedA participants did not differ (β = 0.08, p = .95).
Conclusion: PA, rather than diet adherence, was associated with reduced depressive symptoms. Notably, the MedWL arm, which combined Mediterranean diet and PA with calorie restriction, trended toward higher depressive symptoms, suggesting the burden of weight loss demands may offset PA’s benefits. The intervention context is critical. PA is protective at the individual level, but structured programs may require a gradual progression, flexible goals, and an emphasis on enjoyment to reduce distress. Future work should identify strategies that maintain PA’s mental health benefits while promoting dietary change in ways that support psychological well-being.
Keywords: Diet, DepressionMethods: We conducted a secondary analysis of a 3-arm randomized controlled trial (RCT; Tussing et al., 2017; Sanchez-Flack et al., 2021; Tussing-Humphreys et al., 2022; McLeod et al., 2025). Participants (N = 185; MedWL = 75, MedA = 73, Control = 37) completed assessments at baseline, 8 months, and 14 months. The MedWL program combined Mediterranean diet with structured PA and caloric restriction for weight loss, while MedA provided a Mediterranean diet alone. Measures included the Center for Epidemiological Studies Depression Scale (CES-D), Mediterranean diet adherence, and the GODIN PA Leisure-Time Exercise Questionnaire. Linear mixed-effects models with random intercepts for participants were used to predict depressive symptoms, adjusting for sex, race, education, and income.
Results: PA significantly predicted lower depressive symptoms (β = -0.03, p = .013). Mediterranean diet adherence was not associated with depressive symptoms over time (p = .14). Relative to the Control group, MedWL participants exhibited higher depressive symptoms, although this difference was not significant (β = 2.12, p = .07), while MedA participants did not differ (β = 0.08, p = .95).
Conclusion: PA, rather than diet adherence, was associated with reduced depressive symptoms. Notably, the MedWL arm, which combined Mediterranean diet and PA with calorie restriction, trended toward higher depressive symptoms, suggesting the burden of weight loss demands may offset PA’s benefits. The intervention context is critical. PA is protective at the individual level, but structured programs may require a gradual progression, flexible goals, and an emphasis on enjoyment to reduce distress. Future work should identify strategies that maintain PA’s mental health benefits while promoting dietary change in ways that support psychological well-being.
Authors:
Presenter - Yuliana Soto, PhD, Department of Medicine, University of Illinois at Chicago
Co-Author - Melissa Lamar, PhD, Department of Psychiatry and Behavioral Sciences, Division of Behavioral Sciences, Rush Medical College
Co-Author - Linda Schiffer, MS, Institute for Health Research and Policy, University of Illinois Chicago
Co-Author - Lara Blumstein, Institute for Health Research and Policy, University of Illinois at Chicago
Co-Author - Lisa Tussing-Humphreys, PhD, RD, MS, Institute for Health Research and Policy, University of Illinois Cancer Center, Department of Kinesiology and Nutrition, University of Illinois at Chicago
Co-Author - Marian Fitzgibbon, PhD, FSBM, Institute for Health Research and Policy, University of Illinois Cancer Center, Department of Pediatrics,University of Illinois at Chicago
Co-Presenter - Andrew McLeod, Institute for Health Research and Policy, University of Illinois Cancer Center, University of Illinois Chicago,
What do I say? How do I say it? Should I dance? TikTok as a knowledge dissemination tool for mental health
Poster Number: C109Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Health Communication and Policy
Background: With over 1.5 billion monthly active users worldwide, the social media platform TikTok offers an unparalleled opportunity to reach a vast and diverse audience, potentially making it a powerful tool for disseminating mental health information at scale. However, our understanding of how mental health researchers and organizations can effectively use the platform to promote credible mental health content is limited and evidence-based guidelines are needed.
Methods: 200 TikToks (short-form videos) from four Australian mental health organizations were sampled. Fifty-eight predictor variables, across 13 categories, were coded for each video. Variable categories included: information type, mental health topic, way content was delivered, sentiment, visual elements, video duration, multimedia integration etc. Regressions analyses were conducted to evaluate the impact of these features on 4 engagement metrics: Shares, Favorites, Likes and Views.
Results: Content features associated with greater engagement included: use of subtitles, videos filmed outdoors, longer video duration and use of more hashtags. Conversely, the use of infographics, male protagonists, lengthy captions, videos featuring challenges and those that highlighted the credentials of health experts in the videos were associated with lower engagement. While not associated with levels of engagement, TikToks from mental health organizations were found to rarely disseminate content that was clearly and explicitly evidence-based.
Conclusion: This research offers actionable strategies for researchers and organizations to guide their use of TikTok to disseminate mental health information and enhance engagement with their content. Key recommendations include enabling subtitles, increasing hashtag use and minimizing infographics. Organisations should also prioritize clearly referencing evidence-based information to improve credibility and reach and counter misinformation common on this platform.
Keywords: Mental health, Health promotionMethods: 200 TikToks (short-form videos) from four Australian mental health organizations were sampled. Fifty-eight predictor variables, across 13 categories, were coded for each video. Variable categories included: information type, mental health topic, way content was delivered, sentiment, visual elements, video duration, multimedia integration etc. Regressions analyses were conducted to evaluate the impact of these features on 4 engagement metrics: Shares, Favorites, Likes and Views.
Results: Content features associated with greater engagement included: use of subtitles, videos filmed outdoors, longer video duration and use of more hashtags. Conversely, the use of infographics, male protagonists, lengthy captions, videos featuring challenges and those that highlighted the credentials of health experts in the videos were associated with lower engagement. While not associated with levels of engagement, TikToks from mental health organizations were found to rarely disseminate content that was clearly and explicitly evidence-based.
Conclusion: This research offers actionable strategies for researchers and organizations to guide their use of TikTok to disseminate mental health information and enhance engagement with their content. Key recommendations include enabling subtitles, increasing hashtag use and minimizing infographics. Organisations should also prioritize clearly referencing evidence-based information to improve credibility and reach and counter misinformation common on this platform.
Authors:
Presenter - Louise Thornton, PhD, The University of Sydney
Co-Author - Celeste Carter, BPsych, University of Sydney
Co-Author - Erin Madden, University of Sydney
Family Communication and Cascade Testing Following Population-based BRCA1/2 Genetic Screening: Results from the BRCA Founder OutReach (BFOR) Study
Poster Number: C11Time: 05:00 PM - 05:50 PM
Topics: Cancer, Health Communication and Policy
Background: Population screening for hereditary cancer risk is an innovative cancer prevention strategy with potential to improve health among families. The BRCA Founder OutReach (BFOR) study offered population-based genetic testing (GT) for BRCA1/2 Ashkenazi Jewish founder pathogenic variants (AJPV) via digital pre-test education and engaging primary care providers (PCPs) in 4 US cities. We examined participants’ short- and long-term levels of family communication and cascade testing, and predictors of these familial impacts. Method: 4118 participants had GT with a PCP or BFOR genetics provider returning results, and completed follow-up surveys of familial impacts (sharing results with relatives, if any relatives had GT) at 12-weeks (n=2077) and 1-year (n=1659). Regression models tested how demographic (age, sex, city, has children, socioeconomic disadvantage), medical (personal and family cancer history, provider returning results), and psychological factors (perceived cancer risks, cancer-specific distress, anxiety, BRCA1/2 knowledge, GT decision satisfaction, ease of study participation) at 12-weeks were related to familial impacts at 12-weeks and 1-year. Results: Participants (3.6% AJPV+; 16.3% PCP returning results; 77.1% female; ages 25-93) shared their GT results with an average of 58.3% (73.9% AJPV+ vs 57.7% AJPV-) of their family at 12-weeks, and 61.6% (78.0% AJPV+ vs 60.9% AJPV-) at 1-year. Moreover, 17.6% (53.6% AJPV+ vs 16.3% AJPV-) and 20.1% (57.8% AJPV+ vs 18.5% AJPV-) reported any family GT at 12-weeks and 1-year, respectively. Greater family communication was related with living in Los Angeles (vs Boston, p=.01), being from a high-risk family or family with a known familial PV (vs low-risk family, p<.05), greater cancer-specific distress (p<.001), and greatest ease of participation (p<.001) in the short-term, and with older age (p=.03), AJPV+ result (p=.03), and greater cancer-specific distress (p=.04) in the long-term. Any family GT was related with AJPV+ result (p<.001), greater cancer-specific distress (p=.049), and greatest knowledge (p=.03) in the short-term, and with these factors as well as city (p=.04) and greatest GT decision satisfaction (p=.03) in the long-term. Conclusion: Population screening benefits increase if risk information and GT cascade through families. Our novel approach to extending BRCA1/2 GT led to moderate family dissemination over time, particularly in those with cancer distress and satisfactory GT experiences.
Keywords: Genetics, FamilyAuthors:
Presenter - Jada Hamilton, PhD, MPH, FSBM, Memorial Sloan Kettering Cancer Center
Co-Author - Lydia E. Pace, Brigham and Women’s Hospital; Harvard Medical School
Co-Author - Heather Symecko, University of Pennsylvania
Co-Author - Daniella Kamara, University of California Los Angeles
Co-Author - Jenny Lester, University of California Los Angeles
Co-Author - Kelsey Spielman, University of Pennsylvania
Co-Author - Kelly Morgan, Memorial Sloan Kettering Cancer Center
Co-Author - Catherine Fanjoy, Memorial Sloan Kettering Cancer Center
Co-Author - Giulia Ongaro, Memorial Sloan Kettering Cancer Center
Co-Author - Julia Gruberg, Memorial Sloan Kettering Cancer Center
Co-Author - Prince Rainier Tejada, Memorial Sloan Kettering Cancer Center
Co-Author - Anthony Braswell, University of California Los Angeles
Co-Author - Yuri Fesko, Quest Diagnostics
Co-Author - Mark E. Robson, Memorial Sloan Kettering Cancer Center
Co-Author - Katherine L. Nathanson, University of Pennsylvania
Co-Author - Nadine Tung, Beth Israel Deaconess Medical Center
Co-Author - Beth Y. Karlan, University of California Los Angeles
Co-Author - Susan M. Domchek, University of Pennsylvania
Co-Author - Judy E. Garber, Dana-Farber Cancer Institute
Co-Author - Kenneth Offit, Memorial Sloan Kettering Cancer Center
Feeling blue after scrolling for health information?: Health-related social media use and mental health in cancer patients
Poster Number: C110Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Digital Health
Background: Cancer survivorship can be an emotional journey that isolates patients from cancer-free peers and their pre-diagnosis identities. Many turn to social media (SM) to compensate for the loss of in-person connections, yet excessive SM use can intensify emotional strain. Though most patients now seek health-related information on SM, the effects of this specialized use remain unclear. While researchers recommend that providers guide patients’ SM use, we additionally examine how patient-centered communication (PCC) may interact with health-related SM use to influence patients’ mental health.
Objective: This study explores (1) the role of health-related SM and (2) PCC in cancer patients’ mental health.
Method: A sample of 1073 adult cancer survivors were selected from the nationally representative Health Information National Trends Survey (HINTS, Cycle 7; collected between March 25, 2024, and September 16, 2024). Hayes PROCESS was used in SPSS to explore relationships among study variables, including PCC, perceived isolation, health-related SM use, and mental health.
Results: Health-related SM use mediated the connection between perceived isolation and mental health, predicting poorer mental health. PCC partially moderated this relationship, showing a mitigating effect on the negative impact. The model accounted for 45% of the variance in patients’ mental health.
Discussion: Like general SM use, health-related SM engagement was associated with poorer mental health among cancer patients. However, PCC helped mitigate this impact. Through conversations, PCC provides opportunities to address cancer-related misinformation on SM and reduce feelings of isolation and effects of negative information during survivorship.
Keywords: Cancer patients, patient-provider communication, social media, mental health, isolation.
Keywords: Health communication, Cancer survivorshipObjective: This study explores (1) the role of health-related SM and (2) PCC in cancer patients’ mental health.
Method: A sample of 1073 adult cancer survivors were selected from the nationally representative Health Information National Trends Survey (HINTS, Cycle 7; collected between March 25, 2024, and September 16, 2024). Hayes PROCESS was used in SPSS to explore relationships among study variables, including PCC, perceived isolation, health-related SM use, and mental health.
Results: Health-related SM use mediated the connection between perceived isolation and mental health, predicting poorer mental health. PCC partially moderated this relationship, showing a mitigating effect on the negative impact. The model accounted for 45% of the variance in patients’ mental health.
Discussion: Like general SM use, health-related SM engagement was associated with poorer mental health among cancer patients. However, PCC helped mitigate this impact. Through conversations, PCC provides opportunities to address cancer-related misinformation on SM and reduce feelings of isolation and effects of negative information during survivorship.
Keywords: Cancer patients, patient-provider communication, social media, mental health, isolation.
Authors:
Author - Qiwei Wu, Ph.D., Texas Tech University
Co-Author - Grace Brannon, Ph.D., University of Texas at Arlington
Parental Beliefs and Support for Implementation of School-Based Adolescent Depression Screening
Poster Number: C111Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Implementation Science
Universal access to adolescent depression screening in schools can increase rates of early detection and treatment of major depression in adolescents aged 12-18. Given parental consent to screening is required, our primary objective was to assess and analyze parental knowledge, beliefs, attitudes, and concerns regarding school-based depression screening. We collected and analyzed survey data from a nationally representative sample (N = 1,207) of U.S. parents of adolescents aged 12-18 (with oversampling of African American and Hispanic parents) measuring beliefs and concerns regarding the utility, appropriateness, feasibility, and acceptability of school-based depression screening. The survey instrument was developed following a comprehensive review and synthesis of the literature on barriers and facilitators to adolescent depression screening and was pretested for validity and reliability. About 75% of parents/guardians recognized the potential health and academic benefits of screening and early detection, but most (66%) were not convinced it is necessary to screen all students. A nontrivial minority (35-45%) perceived potential undesirable effects on students as well as on school resources and quality of teaching. African American and Hispanic parents were significantly more likely to express concerns regarding the adequacy of the screening procedure, confidentiality of results, and use of results to single out or stigmatize some students. Screening-related concerns and party identification were stronger predictors of a parent’s intention to consent to screening than were perceived benefits and other parents’ support. Efforts to increase parental acceptability of school-based screening may benefit from alleviating existing concerns while reemphasizing the benefits of screening. African American and Hispanic parents can benefit from tailored information and resources to follow up on screening results with additional diagnosis and treatment, if necessary.
Keywords: Attitude(s), Mental healthAuthors:
Co-Author - Itzhak Yanovitzky, PhD, Rutgers University
Co-Author - Cynthia Blitz, PhD, Rutgers University
Examining Mental Health and Adherence to 24-Hour Movement Guidelines Among Chinese College Students
Poster Number: C112Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Physical Activity
Purpose: Research has shown that meeting the 24-hour movement guidelines (24HMG) leads to better physical health outcomes, reduces depressive and anxious feelings, and enhances overall well-being (Frederick & Wilson, 2023; Zhang & Gu, 2022). This study aimed to explore Chinese college students’ adherence to the 24HMG related to their physical activity (PA), sedentary behaviors (SB), sleep, and to examine how they impact college students’ mood disorder.
Method: Using a cross-sectional research design, 2,392 undergraduates (1014 boys; 1378 girls;135 prefer not to report; Mage = 19.44) from 25 universities in China participated in this study. They completed previously validated questionnaires assessing their PA, SB, Sleep, and mood disorder.
Results: Descriptive analyses revealed that more than 78% of participants showed mood disorder, and only 8.7 % of students adherence to the 24HMG. Among them, 31.8% of students met the physical activity guideline, 14.2% of students met the sedentary behavior guideline, and 47% met the sleep guideline. Of these students, 14.0% of the male and 5.0% of the female students met all the 24HMG, with a significant gender difference confirmed by Pearson’s chi-square test (χ² = 59.08, df = 2, p < .001). Participants in sports-related majors had a higher adherence rate to the 24HMG (16.8%) than those in non-sports-related majors (5.8%), with a significant difference confirmed by chi-square test (χ² = 75.69, df = 1, p < .001). The results of logistic regression further indicated that students who met the 24HMG combination were significantly less likely to report mood disorder compared to those who did not (OR = 0.622, 95% CI [0.426–0.908], p = .014). Additionally, meeting sleep guideline was significantly associated with a lower risk of mood disorders, with students showing lower odds of experiencing mood disorder (OR = 2.560, 95% CI [1.959–3.346], p < .001).
Conclusions: This study indicated that the 24-hour movement behaviors are important factors affecting college students’ mental health. Adherence to 24HMG can significantly reduce the mood disorder, especially meeting the sleep guideline. Conversely, lack of sufficient PA and engage in prolonged SB, and insufficient or poor-quality sleep all increase the likelihood of mood disorder in college students. Thus, increasing PA, reducing SB, and improving sleep quality may serve as effective intervention strategies for promoting college students’ mental health.
Keywords: Health behaviors, Mental healthMethod: Using a cross-sectional research design, 2,392 undergraduates (1014 boys; 1378 girls;135 prefer not to report; Mage = 19.44) from 25 universities in China participated in this study. They completed previously validated questionnaires assessing their PA, SB, Sleep, and mood disorder.
Results: Descriptive analyses revealed that more than 78% of participants showed mood disorder, and only 8.7 % of students adherence to the 24HMG. Among them, 31.8% of students met the physical activity guideline, 14.2% of students met the sedentary behavior guideline, and 47% met the sleep guideline. Of these students, 14.0% of the male and 5.0% of the female students met all the 24HMG, with a significant gender difference confirmed by Pearson’s chi-square test (χ² = 59.08, df = 2, p < .001). Participants in sports-related majors had a higher adherence rate to the 24HMG (16.8%) than those in non-sports-related majors (5.8%), with a significant difference confirmed by chi-square test (χ² = 75.69, df = 1, p < .001). The results of logistic regression further indicated that students who met the 24HMG combination were significantly less likely to report mood disorder compared to those who did not (OR = 0.622, 95% CI [0.426–0.908], p = .014). Additionally, meeting sleep guideline was significantly associated with a lower risk of mood disorders, with students showing lower odds of experiencing mood disorder (OR = 2.560, 95% CI [1.959–3.346], p < .001).
Conclusions: This study indicated that the 24-hour movement behaviors are important factors affecting college students’ mental health. Adherence to 24HMG can significantly reduce the mood disorder, especially meeting the sleep guideline. Conversely, lack of sufficient PA and engage in prolonged SB, and insufficient or poor-quality sleep all increase the likelihood of mood disorder in college students. Thus, increasing PA, reducing SB, and improving sleep quality may serve as effective intervention strategies for promoting college students’ mental health.
Authors:
Author - Yihua Yin, University of North Texas
Co-Author - Tao Zhang, PhD, University of North Texas
The Role of Warrior Identity in Buffering Post-Traumatic Stress Disorder Symptoms and Promoting Mental Health-Related Life Enrichment Among Reintegrating Veterans
Poster Number: C113Time: 05:00 PM - 05:50 PM
Topics: Military and Veterans' Health, Mental Health
Introduction: Post-traumatic stress disorder (PTSD), marked by intrusive thoughts, avoidance, hyperarousal, and negative cognitive changes, is more prevalent in veterans than non-veteran civilians. While PTSD is linked to poorer health outcomes in veterans, little is known about its impact during reintegration into civilian life. Additionally, protective factors, such as military identity (or warrior identity), may influence veterans' health. Warrior identity, a core aspect of self that shapes behavior and relationships, may buffer the negative health effects of PTSD on mental health. This study explored the relationship between PTSD, life enrichment, and whether warrior identity acts as a protective factor. Methods: US Military Veterans (N=285; M age=37.4 (SD=10); 70% Male; 75% White; 84% Non-Hispanic) transitioning/reintegrating from active duty to civilian life completed an online survey. A composite PTSD symptoms score was computed from the 5 items (yes; no) in the Primary Care PTSD Screen for DSM-5. The Enriched Life Scale (ELS) assessed mental health (i.e., My mental health is excellent) responses ranging from strongly disagree (0) - strongly agree (100). The Warrior Identity Scale (WIS) assessed the strength of military identity, ranging from disagree strongly (1) - agree strongly (4). Linear regression analysis examined the association between PTSD symptoms and ELS scores. An average WIS score was computed and tested as a moderator. Results: Approximately 86% of veterans experienced 1 or more PTSD symptoms (M=3; SD=1.8). PTSD symptoms negatively predicted mental health (B=-119.1, p<.01). PTSD symptoms and warrior identity explained 21% of the variance in mental health-related life enrichment, R²=.21, p<.01. The PTSD×WIS interaction was significant (B=34.2, p<.01), where stronger warrior identity moderated the relationship between PTSD and mental health. The PTSD×WIS interaction explained 24% of the variance (R²=.24, p<.01), which is an additional 2.8% explained variance in the model. Conclusions: Findings support our hypothesis that reintegrating veterans with fewer PTSD symptoms also have better mental health. Furthermore, a stronger warrior identity is a protective factor against PTSD symptoms and mental health. In other words, the influence of PTSD on mental health is lessened for those with a stronger warrior identity.
Keywords: Mental health, Clinical applicationsAuthors:
Author - Maurice Alsing, MPS, The Virginia Consortium Program in Clinical Psychology
Co-Author - Samantha Fitzer, PhD, Old Dominion University
Co-Author - Michelle Kelley, PhD, Old Dominion University
Co-Author - Natalie Yarish, PhD, Old Dominion University
Caring for Caregivers: How Whole Health Drives Positive Change
Poster Number: C114Time: 05:00 PM - 05:50 PM
Topics: Military and Veterans' Health, Community Engagement
Intro: Over 14 million Americans provide care to a veteran or service member. One in five adults in the United States provides care to a family member or friend. Caregivers have adverse health outcomes such as deterioration of physical health, mental health, social loneliness, and financial hardship when compared to non-caregivers. Rural caregivers are even more susceptible to the negative effects of caregiver roles. This emphasizes the need for interventions and resources aimed at improving caregiver health.
Transforming Health & Resiliency through Integration of Values-based Experiences (THRIVE) is a Department of Veterans Affairs (VA) program that was developed through the Whole Health (WH) initiative, combining traditional and complementary medicine. The intervention was adapted using human-centered design to meet the needs of rural VA caregivers. This project explores how providing a WH-based support can impact the experience of those who care for our veterans.
Methods: Caregivers participated in a 7-session virtual, WH intervention led by VA WH nurses and coaches. Participants were invited to complete an electronic survey requesting program feedback and impact on the respondent’s health and well-being. Responses (n = 772) were analyzed using thematic analysis guided by the Informal Caregiving Integrative Model (ICIM).
Results: Analysis revealed themes that highlighted the complex experience of caring for veterans. Veteran caregivers shifted perspectives by recognizing the importance of self-care and took action to reclaim their sense of self. The healing power of a community of veteran caregivers provided support and fostered resilience. Increased self-appraisal and attention to health and wellness improved the ability to provide quality care. The WH virtual intervention acted as a mediator by impacting appraisal, coping, and relationship quality leading to report of improved outcomes of the caregiver and veteran. These findings were informed by the ICIM, for evaluating caregiver intervention and how to support caregivers in the rural population.
Conclusion: Rural Veteran Caregivers report meaningful shifts in perspective, with greater emphasis on self-care and resilience through community. Taking action to support mental, physical, and emotional health ultimately strengthened their capacity to provide quality care. Findings reinforce the value of implementing interventions to improve health outcomes among rural veteran caregivers.
Keywords: Caregiving, Health outcomesTransforming Health & Resiliency through Integration of Values-based Experiences (THRIVE) is a Department of Veterans Affairs (VA) program that was developed through the Whole Health (WH) initiative, combining traditional and complementary medicine. The intervention was adapted using human-centered design to meet the needs of rural VA caregivers. This project explores how providing a WH-based support can impact the experience of those who care for our veterans.
Methods: Caregivers participated in a 7-session virtual, WH intervention led by VA WH nurses and coaches. Participants were invited to complete an electronic survey requesting program feedback and impact on the respondent’s health and well-being. Responses (n = 772) were analyzed using thematic analysis guided by the Informal Caregiving Integrative Model (ICIM).
Results: Analysis revealed themes that highlighted the complex experience of caring for veterans. Veteran caregivers shifted perspectives by recognizing the importance of self-care and took action to reclaim their sense of self. The healing power of a community of veteran caregivers provided support and fostered resilience. Increased self-appraisal and attention to health and wellness improved the ability to provide quality care. The WH virtual intervention acted as a mediator by impacting appraisal, coping, and relationship quality leading to report of improved outcomes of the caregiver and veteran. These findings were informed by the ICIM, for evaluating caregiver intervention and how to support caregivers in the rural population.
Conclusion: Rural Veteran Caregivers report meaningful shifts in perspective, with greater emphasis on self-care and resilience through community. Taking action to support mental, physical, and emotional health ultimately strengthened their capacity to provide quality care. Findings reinforce the value of implementing interventions to improve health outcomes among rural veteran caregivers.
Authors:
Author - Jolie Haun, PhD, Veterans Health Administration
Co-Author - Christopher Fowler, PhD, Veterans Health Administration
Co-Author - Meghan Kern, DPT, Veterans Health Administration
Co-Author - Julie McMahon-Grenz, OTR, Veterans Health Administration
Co-Author - Angelina Klanchar, Veterans Health Administration
Co-Author - William Lapcevic, Veterans Health Administration
Co-Author - Noel Diaz, Veterans Health Administration
Co-Author - Zachary Jones, Veterans Health Administration
Co-Author - Jenifer Arbogast, RN, Veterans Health Administration
Co-Author - Tammy Terrell, RN, Veterans Health Administration
Co-Author - Naomi Snowdy, LPN, Veterans Health Administration
Co-Author - Jacquelyn Paykel, MD, N/A
Community Health Workers Deliver Behavioral Health Components Aimed at Changing Health Behaviors in a Rural Cardiovascular Lifestyle Change Intervention
Poster Number: C115Time: 05:00 PM - 05:50 PM
Topics: Multiple Health Behavior Change , Cardiovascular Disease
Background: Cardiovascular disease (CVD) risk factors are disproportionately high in rural communities.1,2 Community health workers (CHWs) demonstrated efficacy in delivering lifestyle change interventions3-5 and behavioral health interventions6 to target modifiable risk-factors.7,8 However, there is limited research in CHWs delivering lifestyle change interventions with behavioral health (BH) components in rural communities. The present study evaluated the impact of a BH component on self-reported health behaviors within a rural cardiovascular lifestyle change intervention.
Methods: A longitudinal (2013-2023) naturalistic observational design evaluated the impact of a BH component within the Colorado Heart Healthy Screening (CHHS) program. Participants enrolled in CHHS before the integration of BH components (2013-2018) and had two visits after the introduction of the BH components (2018-2023). The study evaluated how the BH components, including assessments, referrals, and BH interventions impacted medication adherence, fat intake, fiber intake, and exercise. A three-level multi-level model examined the impact of CHW-led BH components, with individuals (level 1), nested within specific time points (level 2), nested within site of care (level 3). Covariates race/ethnicity, sex, socioeconomic status (SES), and participant readiness were included to control for confounding variables. Random intercepts were specified at the timepoint and site levels.
Results: The study included 400 participants with 1,200 visits from seven rural sites, with participants engaging in CHHS for an average of 8 years (SD±3.8 years). Medication adherence increased with older age (p = 0.05). Fat intake increased with BH components (p= 0.004), decreased with referrals (p = 0.015), and increased at certain sites (p=0.001). Fiber intake increased with referrals (p= 0.05), decreased with older age (p= 0.02), decreased in males (p= 0.04), and was variable across sites (p<0.001). Exercise increased with higher levels of readiness (p< 0.001), increased in males (p= 0.005), and was variable across sites (p=0.001).
Conclusion: The results suggest that the introduction of a BH component into CHHS was effective in changing several modifiable CVD risk factors including fat intake and fiber intake. The results are reflective of the addition of the BH components making a meaningful impact on the rural communities it serves by improving the health behaviors and well-being of the participants.
Keywords: Behavior Change, Cardiovascular diseaseMethods: A longitudinal (2013-2023) naturalistic observational design evaluated the impact of a BH component within the Colorado Heart Healthy Screening (CHHS) program. Participants enrolled in CHHS before the integration of BH components (2013-2018) and had two visits after the introduction of the BH components (2018-2023). The study evaluated how the BH components, including assessments, referrals, and BH interventions impacted medication adherence, fat intake, fiber intake, and exercise. A three-level multi-level model examined the impact of CHW-led BH components, with individuals (level 1), nested within specific time points (level 2), nested within site of care (level 3). Covariates race/ethnicity, sex, socioeconomic status (SES), and participant readiness were included to control for confounding variables. Random intercepts were specified at the timepoint and site levels.
Results: The study included 400 participants with 1,200 visits from seven rural sites, with participants engaging in CHHS for an average of 8 years (SD±3.8 years). Medication adherence increased with older age (p = 0.05). Fat intake increased with BH components (p= 0.004), decreased with referrals (p = 0.015), and increased at certain sites (p=0.001). Fiber intake increased with referrals (p= 0.05), decreased with older age (p= 0.02), decreased in males (p= 0.04), and was variable across sites (p<0.001). Exercise increased with higher levels of readiness (p< 0.001), increased in males (p= 0.005), and was variable across sites (p=0.001).
Conclusion: The results suggest that the introduction of a BH component into CHHS was effective in changing several modifiable CVD risk factors including fat intake and fiber intake. The results are reflective of the addition of the BH components making a meaningful impact on the rural communities it serves by improving the health behaviors and well-being of the participants.
Authors:
Author - Emily Bilenduke, PhD, Northwestern University
Co-Author - Stephanie Coronel-Mockler, MPH, Colorado Prevention Center Community Health
Co-Author - Nick Flattery, MPH, Colorado Prevention Center Community Health
Co-Author - Jacqueline Howard, MPH, Colorado Prevention Center Community Health
Co-Author - Bryan Contreras Zamora, MA, LPCC, University of Colorado Denver
Co-Author - Jonathan A. Shaffer, PhD, MA , University of Colorado Denver
Co-Author - Raymond O Estacio, MD, Colorado Prevention Center Community Health
Co-Author - Kristin Kilbourn, PhD MPH, University of Colorado Denver
Readiness to change health behaviors: Weekly associations with anxiety and depression
Poster Number: C116Time: 05:00 PM - 05:50 PM
Topics: Multiple Health Behavior Change , Digital Health
Background: Readiness to change unhealthy behaviors is a critical component of motivation-based interventions. Repeated measurement of readiness to change, via ecological momentary assessment (EMA), could improve understanding of how readiness to change health behaviors varies across time and identify opportunities for novel just-in-time adaptive interventions (JITAIs).
Methods: As part of a national smartphone-based intervention for anxiety and depression, participants completed twice daily EMAs for 6 months. Weekly EMAs assessed anxiety (OASIS range: 0-20), depression (ODSIS range: 0-20), and readiness to change seven health behaviors (alcohol consumption, cigarette smoking, illegal drug use/prescription misuse, unsafe sex, fruit/vegetable consumption, exercise, and weight; each with a single response scale that ranged from “1=Not at all” to “10=Extremely”). The current secondary data analyses used linear mixed-effects regressions to examine relations between weekly anxiety and depression ratings and readiness to change health behaviors.
Results: The sample (N=822) was 65% female, 38 years old (SD=12.8), 25% White, 25% Black, 25% American Indian, and 25% Hispanic/Latino. Findings indicated that, in weeks when participants were more anxious than their average, they reported significantly higher readiness to change alcohol consumption (β=0.07, 95% CI [0.04, 0.11]), cigarette smoking (β=0.05, 95% CI [0.001, 0.09]), drug use (β=0.10, 95% CI [0.03, 0.18]), fruit/vegetable consumption (β=0.04, 95% CI [0.02, 0.07]), unsafe sex (β=0.08, 95% CI [0.02, 0.13]), and weight (β=0.03, 95% CI [0.01, 0.05]). Further, compared to the average participant, participants with higher average levels of anxiety reported significantly higher readiness to change exercise (β=0.07, 95% CI [0.02, 0.11]), fruit/vegetable consumption (β=0.08, 95% CI [0.04, 0.13]), and unsafe sex (β=0.15, 95% CI [0.04, 0.27]). However, in weeks when participants were more depressed than their average, they reported significantly higher readiness to change cigarette smoking (β=0.05, 95% CI [0.01, 0.10]) and lower readiness to change exercise (β=-0.02, 95% CI [-0.04, -0.001]) and fruit/vegetable consumption (β=-0.02, 95% CI [-0.04, -0.003]).
Discussion: Findings showed that heightened anxiety may increase readiness to change unhealthy behaviors, but depression may have differential impacts on readiness. Future JITAIs may leverage this information to promote health behavior change at optimal moments.
Keywords: Health behaviors, Mental healthMethods: As part of a national smartphone-based intervention for anxiety and depression, participants completed twice daily EMAs for 6 months. Weekly EMAs assessed anxiety (OASIS range: 0-20), depression (ODSIS range: 0-20), and readiness to change seven health behaviors (alcohol consumption, cigarette smoking, illegal drug use/prescription misuse, unsafe sex, fruit/vegetable consumption, exercise, and weight; each with a single response scale that ranged from “1=Not at all” to “10=Extremely”). The current secondary data analyses used linear mixed-effects regressions to examine relations between weekly anxiety and depression ratings and readiness to change health behaviors.
Results: The sample (N=822) was 65% female, 38 years old (SD=12.8), 25% White, 25% Black, 25% American Indian, and 25% Hispanic/Latino. Findings indicated that, in weeks when participants were more anxious than their average, they reported significantly higher readiness to change alcohol consumption (β=0.07, 95% CI [0.04, 0.11]), cigarette smoking (β=0.05, 95% CI [0.001, 0.09]), drug use (β=0.10, 95% CI [0.03, 0.18]), fruit/vegetable consumption (β=0.04, 95% CI [0.02, 0.07]), unsafe sex (β=0.08, 95% CI [0.02, 0.13]), and weight (β=0.03, 95% CI [0.01, 0.05]). Further, compared to the average participant, participants with higher average levels of anxiety reported significantly higher readiness to change exercise (β=0.07, 95% CI [0.02, 0.11]), fruit/vegetable consumption (β=0.08, 95% CI [0.04, 0.13]), and unsafe sex (β=0.15, 95% CI [0.04, 0.27]). However, in weeks when participants were more depressed than their average, they reported significantly higher readiness to change cigarette smoking (β=0.05, 95% CI [0.01, 0.10]) and lower readiness to change exercise (β=-0.02, 95% CI [-0.04, -0.001]) and fruit/vegetable consumption (β=-0.02, 95% CI [-0.04, -0.003]).
Discussion: Findings showed that heightened anxiety may increase readiness to change unhealthy behaviors, but depression may have differential impacts on readiness. Future JITAIs may leverage this information to promote health behavior change at optimal moments.
Authors:
Presenter - Jeremy Langford, PhD, University of Oklahoma Health Sciences
Co-Author - Zachary Barrett, University of Oklahoma Health Sciences
Co-Author - Krista Kezbers, PhD, University of Oklahoma Health Sciences
Co-Author - Isaias Salgado, University of Oklahoma Health Sciences
Co-Author - Michael Zvolensky, PhD, University of Houston
Co-Author - Lorra Garey, PhD, University of Houston
Co-Author - Ashlea Braun, PhD, RD, University of Oklahoma Health Sciences
Co-Author - Emily Hébert, DrPH, University of Oklahoma Health Sciences
Co-Author - Michael Businelle, PhD, FSBM, University of Oklahoma Health Sciences
Adults with Functional Dyspepsia Have Heightened Sensitivity to Mechanical Pain in the Upper Abdomen
Poster Number: C117Time: 05:00 PM - 05:50 PM
Topics: Pain, Diet, Nutrition, and Eating Disorders
Introduction: Functional dyspepsia (FD) is a chronic idiopathic gastrointestinal condition characterized by meal-related upper abdominal pain, early satiety, and postprandial discomfort. A subset with FD meets criteria for avoidant/restrictive food intake disorder (ARFID). We tested differences in pain processing via quantitative sensory testing (QST) among FD without ARFID, FD+ARFID (FDAR), and healthy controls (C).
Methods: Subjects included adults (37±15 years; 80% female) from an ongoing study with FD (n=21), FDAR (n=41), and C (n=24). The QST battery measured: 1) pain pressure threshold (PPTh: first experience of pain) and tolerance (PPT: intolerable pain) by algometer at bi-lateral trapezius and the center of each abdominal quadrant, 2) central sensitization by temporal summation of pain ratings from 1st to 10th application of a sharp sensation at the non-dominant middle finger and center of each abdominal quadrant, 3) percent conditioned pain modulation, a comparison of non-dominant trapezius PPTh at baseline vs while the dominant hand is in a cold-water bath, and 4) cold pain tolerance, the maximum time subjects kept their hand in the cold water. We removed outliers using the interquartile range method and corrected for two tests per QST parameter: p<.025.
Results: Groups did not significantly differ in trapezius PPTh and PPT, central sensitization, conditioned pain modulation, or cold pain tolerance. Upper abdominal PPTh and PPT differed significantly among groups with large effect (η²=.069-.072, p=.020-.023); FDAR vs C: medium significant differences (r=.30, p=.0027-.0034), FD vs C: small trend toward significant differences (r=.19-.20, p=.034-.045), FDAR vs FD: small, non-significant differences (r=.050-.077, p=.24-.32). Lower abdominal PPTh, but not PPT, differed significantly among groups with large effect (η²=.078, p=.016); FDAR vs C: medium significant differences (r=.31, p=.0021), FD vs C and FDAR vs FD: small, non-significant differences (r=.13-.15, p=.084-.12).
Conclusion: Adults with FD have heightened sensitivity to abdominal pain, particularly in the upper abdomen, evidenced by lower PPTh and PPT by QST compared to healthy adults. Co-morbid ARFID may be associated with greater abdominal pain sensitivity, indicating a potential biomarker for prevention/intervention efforts. Further research is needed with larger samples and expanded QST batteries, including concordance with measures of gastric visceral sensitivity.
Keywords: Pain, Biobehavioral mechanismsMethods: Subjects included adults (37±15 years; 80% female) from an ongoing study with FD (n=21), FDAR (n=41), and C (n=24). The QST battery measured: 1) pain pressure threshold (PPTh: first experience of pain) and tolerance (PPT: intolerable pain) by algometer at bi-lateral trapezius and the center of each abdominal quadrant, 2) central sensitization by temporal summation of pain ratings from 1st to 10th application of a sharp sensation at the non-dominant middle finger and center of each abdominal quadrant, 3) percent conditioned pain modulation, a comparison of non-dominant trapezius PPTh at baseline vs while the dominant hand is in a cold-water bath, and 4) cold pain tolerance, the maximum time subjects kept their hand in the cold water. We removed outliers using the interquartile range method and corrected for two tests per QST parameter: p<.025.
Results: Groups did not significantly differ in trapezius PPTh and PPT, central sensitization, conditioned pain modulation, or cold pain tolerance. Upper abdominal PPTh and PPT differed significantly among groups with large effect (η²=.069-.072, p=.020-.023); FDAR vs C: medium significant differences (r=.30, p=.0027-.0034), FD vs C: small trend toward significant differences (r=.19-.20, p=.034-.045), FDAR vs FD: small, non-significant differences (r=.050-.077, p=.24-.32). Lower abdominal PPTh, but not PPT, differed significantly among groups with large effect (η²=.078, p=.016); FDAR vs C: medium significant differences (r=.31, p=.0021), FD vs C and FDAR vs FD: small, non-significant differences (r=.13-.15, p=.084-.12).
Conclusion: Adults with FD have heightened sensitivity to abdominal pain, particularly in the upper abdomen, evidenced by lower PPTh and PPT by QST compared to healthy adults. Co-morbid ARFID may be associated with greater abdominal pain sensitivity, indicating a potential biomarker for prevention/intervention efforts. Further research is needed with larger samples and expanded QST batteries, including concordance with measures of gastric visceral sensitivity.
Authors:
Author - Rebecca Karlson, BS, Massachusetts General Hospital
Co-Author - Blythe Peterson, BA, Massachusetts General Hospital
Co-Author - Abigail Dalton, BS, Massachusetts General Hospital
Co-Author - Micaela Atkins, MD, Massachusetts General Hospital
Co-Author - Kyle Staller, MD, Massachusetts General Hospital
Co-Author - Lauren Shabazian, CNP, Massachusetts General Hospital
Co-Author - Lukas Van Oudenhove, MD, PhD, University of Leuven
Co-Author - Laurie Keefer, PhD, Northwestern University Feinberg School of Medicine
Co-Author - Roberta Sclocco, PhD, Massachusetts General Hospital
Co-Author - Kendra Becker, PhD, Massachusetts General Hospital
Co-Author - Elizabeth Lawson, MD, Massachusetts General Hospital
Co-Author - Jennifer Thomas, PhD, Massachusetts General Hospital
Co-Author - Braden Kuo, MD, Massachusetts General Hospital
Co-Author - Samantha Meints, PhD, Brigham and Women's Hospital
Co-Author - Robert Edwards, PhD, Brigham and Women's Hospital
Co-Author - Helen Burton Murray, PhD, Massachusetts General Hospital/Harvard Medical School
From Distress to Disability: Depression, Anxiety, and Pain Interference in Adolescents with NF
Poster Number: C119Time: 05:00 PM - 05:50 PM
Topics: Pain, Mental Health
Neurofibromatosis (NF) is a type of genetic disorder that causes tumors to grow on the body including the brain and spinal cord. NF is associated with pain, headaches, and cognitive/learning difficulties. Among adolescents, NF affects approximately 1 in 2,000 individuals and up to 55% experience pain and 35% have chronic pain. Chronic pain disrupts well-being, social functioning, and physical abilities. Given the biopsychosocial nature of chronic pain, understanding how psychosocial factors (e.g., distress, resilience) impact functioning above and beyond pain intensity is key for enhancing the lives of adolescents with NF.
Here, we examined which risk and resilience factors impacted pain interference among adolescents with NF1 or NF2. We recruited 196 adolescents (ages 12–17) through NF-specific organizations and social media platforms across the globe. Participants completed validated assessments of anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), pain interference (Pain Interference Index), pain intensity (Numerical Rating Scale), social support (Medical Outcomes Study), mindfulness (Child and Adolescent Mindfulness Measure), and coping (Measure of Current Status).
Hierarchical regression analyses indicated that depression (β = .228, p = .003) and anxiety (β = .253, p < .001) explained significant unique variance in pain interference (R² = 59.1%) when controlling for pain intensity. When controlling for pain intensity and psychological distress, social support (β = .013, p < .823), mindfulness (β = -.047, p < .465), and adaptive coping (β = .001, p < .984) were not associated with pain interference.
Our findings emphasize the central role of psychological distress in shaping functioning and perceived interference of pain among adolescents with NF. This relationship could be reciprocally-related—chronic pain may lead to increased distress and negative biases associated with distress may amplify perceptions of pain-related interference. The fact that resilience factors were not associated with pain interference suggests that pain interference may be difficult to change and warrants further investigation. Given the pain and emotional distress associated with NF and lack of psychosocial support available, more tailored interventions are needed to enhance the lives of these adolescents and their families.
Keywords: Pain, AdolescentsHere, we examined which risk and resilience factors impacted pain interference among adolescents with NF1 or NF2. We recruited 196 adolescents (ages 12–17) through NF-specific organizations and social media platforms across the globe. Participants completed validated assessments of anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), pain interference (Pain Interference Index), pain intensity (Numerical Rating Scale), social support (Medical Outcomes Study), mindfulness (Child and Adolescent Mindfulness Measure), and coping (Measure of Current Status).
Hierarchical regression analyses indicated that depression (β = .228, p = .003) and anxiety (β = .253, p < .001) explained significant unique variance in pain interference (R² = 59.1%) when controlling for pain intensity. When controlling for pain intensity and psychological distress, social support (β = .013, p < .823), mindfulness (β = -.047, p < .465), and adaptive coping (β = .001, p < .984) were not associated with pain interference.
Our findings emphasize the central role of psychological distress in shaping functioning and perceived interference of pain among adolescents with NF. This relationship could be reciprocally-related—chronic pain may lead to increased distress and negative biases associated with distress may amplify perceptions of pain-related interference. The fact that resilience factors were not associated with pain interference suggests that pain interference may be difficult to change and warrants further investigation. Given the pain and emotional distress associated with NF and lack of psychosocial support available, more tailored interventions are needed to enhance the lives of these adolescents and their families.
Authors:
Author - Defne Yucebas, BA, Massachusetts General Hospital
Co-Author - Courtney Kilduff, BSEd, Massachusetts General Hospital
Co-Author - Ana-Maria Vranceanu, PhD, FSBM, MGH/Harvard
Co-Author - Victoria Grunberg, PhD, Massachusetts General Hospital
Top-Ranked Values among Participants in a Comprehensive Cancer Stress Management Group Program
Poster Number: C12Time: 05:00 PM - 05:50 PM
Topics: Cancer, Stress
Introduction: Recent evidence increasingly demonstrates the importance of value-based living in optimizing quality of life with cancer, including strengthened benefit from supportive cancer interventions when personal values are incorporated. However, minimal research has examined what values are commonly prioritized among individuals living with cancer distress.
Methods: Participants were enrolled in a cognitive-behavioral Cancer Stress Management Group intervention, with an integrated focus on personal values identification to promote tailored skill implementation. As part of the intervention, participants completed a Values Card Sort Activity. Using 84 cards representing unique value constructs, participants ranked their top six values.
Results: Of 133 total participants, 121 submitted values rankings. These participants were predominantly middle-aged (M=50.87, SD=11.44), married (72.7%), non-Hispanic White (90.1%) women (86%). The sample was mostly comprised of individuals with breast (56.2%), hematologic (12.4%), gynecologic (10.7%), and head and neck cancers (10.7%), with most participants exhibiting advanced disease (52.1%). Values most frequently ranked in participants’ top six were: Family (n=73, 60.3%), Health (n=59, 48.8%), Being Loved (n=33, 27.3%), Loving (n=31, 25.6%), Hope (n=30, 24.8%), Humor (n=26, 21.5%), and Friendship (n=25, 20.7%). None of the participants ranked Attractiveness, Excitement, Flexibility, Generosity, Popularity, Risk, or Tradition in their top six. When examining only first-ranked values, Family, then Health, were the most commonly endorsed. While God’s Will was not frequently reported as a first-ranked value, 9.1% of the sample ranked this value accordingly.
Discussion: These results are among the first to provide insight into values prioritized among participants in an evidence-based, group intervention for managing cancer distress. Family and Health were endorsed as a top-six value for 60.3% and 48.8% of this sample of cancer patients. Integrating these values into supportive cancer interventions could enhance patient motivation, skill use, and effectiveness, given growing evidence of value integration as a mechanism of change in such care. Future research should focus on how priority values may 1) vary among more diverse participant samples; 2) influence mechanisms that underpin improved outcomes; and 3) enhance interventions designed to reduce cancer distress.
Keywords: Cancer, StressMethods: Participants were enrolled in a cognitive-behavioral Cancer Stress Management Group intervention, with an integrated focus on personal values identification to promote tailored skill implementation. As part of the intervention, participants completed a Values Card Sort Activity. Using 84 cards representing unique value constructs, participants ranked their top six values.
Results: Of 133 total participants, 121 submitted values rankings. These participants were predominantly middle-aged (M=50.87, SD=11.44), married (72.7%), non-Hispanic White (90.1%) women (86%). The sample was mostly comprised of individuals with breast (56.2%), hematologic (12.4%), gynecologic (10.7%), and head and neck cancers (10.7%), with most participants exhibiting advanced disease (52.1%). Values most frequently ranked in participants’ top six were: Family (n=73, 60.3%), Health (n=59, 48.8%), Being Loved (n=33, 27.3%), Loving (n=31, 25.6%), Hope (n=30, 24.8%), Humor (n=26, 21.5%), and Friendship (n=25, 20.7%). None of the participants ranked Attractiveness, Excitement, Flexibility, Generosity, Popularity, Risk, or Tradition in their top six. When examining only first-ranked values, Family, then Health, were the most commonly endorsed. While God’s Will was not frequently reported as a first-ranked value, 9.1% of the sample ranked this value accordingly.
Discussion: These results are among the first to provide insight into values prioritized among participants in an evidence-based, group intervention for managing cancer distress. Family and Health were endorsed as a top-six value for 60.3% and 48.8% of this sample of cancer patients. Integrating these values into supportive cancer interventions could enhance patient motivation, skill use, and effectiveness, given growing evidence of value integration as a mechanism of change in such care. Future research should focus on how priority values may 1) vary among more diverse participant samples; 2) influence mechanisms that underpin improved outcomes; and 3) enhance interventions designed to reduce cancer distress.
Authors:
Author - Luca Hanvey, PhD, Mayo Clinic
Author - Janae Kirsch, PhD, Mayo Clinic
Author - Carrie Bronars, PhD, Mayo Clinic
Author - Sherrie Hanna, MA, Mayo Clinic
Author - Jill Snuggerud, MS, Mayo Clinic
Author - Elizabeth Kacel, PhD, Rush University Medical Center
Author - Deanna Hofschulte, CCRP, Mayo Clinic
Author - Holly Edwards, MA, Mayo Clinic
Author - Jeffrey Staab, MD, Mayo Clinic
Author - Andrea Wahner Hendrickson, MD, Mayo Clinic
Author - Katharine Price, MD, Mayo Clinic
Author - Kathryn Ruddy, MD, Mayo Clinic
Author - Shawna Ehlers, PhD, Mayo Clinic
Turning the DIAL on Physical Activity-Related Social Cognitive Theory Variables: An Interactive Voice Response (IVR)-supported Lifestyle Intervention in the Alabama Black Belt
Poster Number: C120Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Health Disparities
Grounded in Social Cognitive Theory (SCT), the Deep South IVR-supported Active Lifestyle (DIAL) intervention was developed to address physical inactivity and related chronic diseases among rural, underserved populations in the Alabama Black Belt. In a two-arm randomized controlled trial (n=245), participants from six rural Alabama counties were randomly assigned to either DIAL or waitlist control arm. DIAL intervention components (automated phone counseling, community health worker support) targeted key SCT variables (PA enjoyment, self-efficacy, outcome expectations, social support, barriers, goal setting, planning), which were assessed at baseline and 6 months (post-intervention).
The sample was comprised of mostly non-Hispanic Black women (97%), with a mean age of 59.3 years (SD=13.4) and body mass index of 36.3 kg/m2 (SD=7.9). Levels of education (60% <college degree), household income (83% <$50,000 annually) and employment (33.1% full-time) were low. At 6 months, significant between-group differences were found for PA barriers (M= 2.51, 95% CI:[0.55, 4.47], p=.012),goal setting (M= 0.60, 95% CI:[0.33, 0.88], p<.001), planning (M= 0.37, 95% CI:[0.16, 0.59], p<.001), enjoyment (M= 0.55, 95% CI:[0.25, 0.85], p<.001), self-efficacy (M= 13.82, 95% CI:[5.63, 22.01], p<.001), and social support from family/friends (M= 1.48, 95% CI:[0.52, 2.43], p=.003). While no significant between-group differences were found for outcome expectations, there were significant within-group improvements in the DIAL arm (M=0.28, 95% CI:[0.10, 0.46], p=.002), but not in the control arm.
Overall, the DIAL intervention produced significantly greater improvements in most PA-related SCT outcomes compared to a waitlist control. These results indicate that the SCT constructs were successfully targeted by DIAL intervention strategies in our target population of underactive, rural Black women with obesity. Further investigation and mediator analyses are warranted, along with re-evaluation of the existing outcome expectations measures and counseling content’s relevance/appropriateness within this target population.
Keywords: Physical activity, Health behavior changeThe sample was comprised of mostly non-Hispanic Black women (97%), with a mean age of 59.3 years (SD=13.4) and body mass index of 36.3 kg/m2 (SD=7.9). Levels of education (60% <college degree), household income (83% <$50,000 annually) and employment (33.1% full-time) were low. At 6 months, significant between-group differences were found for PA barriers (M= 2.51, 95% CI:[0.55, 4.47], p=.012),goal setting (M= 0.60, 95% CI:[0.33, 0.88], p<.001), planning (M= 0.37, 95% CI:[0.16, 0.59], p<.001), enjoyment (M= 0.55, 95% CI:[0.25, 0.85], p<.001), self-efficacy (M= 13.82, 95% CI:[5.63, 22.01], p<.001), and social support from family/friends (M= 1.48, 95% CI:[0.52, 2.43], p=.003). While no significant between-group differences were found for outcome expectations, there were significant within-group improvements in the DIAL arm (M=0.28, 95% CI:[0.10, 0.46], p=.002), but not in the control arm.
Overall, the DIAL intervention produced significantly greater improvements in most PA-related SCT outcomes compared to a waitlist control. These results indicate that the SCT constructs were successfully targeted by DIAL intervention strategies in our target population of underactive, rural Black women with obesity. Further investigation and mediator analyses are warranted, along with re-evaluation of the existing outcome expectations measures and counseling content’s relevance/appropriateness within this target population.
Authors:
Presenter - Nashira Brown, PhD, MS, University of Alabama at Birmingham
Co-Author - Walker Cole, University of Alabama at Birmingham
Co-Author - Kelsey Parrish, MS, University of Alabama at Birmingham
Co-Author - Monica Baskin, PhD, FSBM, Virginia Commonwealth University
Co-Author - Mohanraj Thirumalai, PhD, University of Alabama at Birmingham
Co-Author - Soumya Niranjan, BPharm., MS, PhD, University of Alabama at Birmingham
Co-Author - Wendy Demark-Wahnefried, PhD, RD, University of Alabama at Birmingham
Co-Author - Dori Pekmezi, PhD, FSBM, University of Alabama at Birmingham
Rural Parks and Recreation Partnerships and Programs to Promote Physical Activity: Opportunities and Challenges
Poster Number: C121Time: 05:00 PM - 05:50 PM
Topics: Physical Activity
Background: Parks and Recreation departments are key partners in improving community physical activity (PA) environments in rural areas. Multi-sectoral partnerships (e.g. churches, libraries) with rural Parks departments may expand capacity and be beneficial for PA promotion. However, whether or how rural Parks departments partner with these entities and key challenges to offering PA programs through rural Parks departments are unknown. The goal of this study was to describe rural Parks and Recreation partnerships with churches and libraries and to highlight Parks directors’ barriers and facilitators to offering PA programs.
Methods: We contacted 99 leaders of rural Parks and Recreation departments located in 12 Appalachian states by email and invited them to participate in an interview. Our semi-structured interview guide focused on understanding how Parks departments partner with churches and libraries, and perceived barriers and facilitators to offering PA programs. We used descriptive statistics (frequencies, proportions) to quantify whether Parks departments partner with churches and/or libraries and thematic analyses to describe barriers and facilitators to PA programs.
Results: Directors from 10 Parks departments in Virginia (50%) and West Virginia (50%) participated in interviews. Of these, 90% reported partnerships with churches and all reported partnerships with libraries, though very few of these supported PA programs (30% and 20%, respectively). Almost all Parks directors (90%) identified a lack of resources, namely financial, staff, and facilities, as a barrier to offering PA programs. Community interest in programs was both a key barrier and facilitator to PA programs and impacted program offerings (e.g., community interest prompted additional programs) as well as program success (e.g., lack of attendance made program unsustainable).
Conclusions: Most rural Parks directors reported existing partnerships with churches and libraries, although few of these partnerships were focused on PA programming. There is great opportunity to leverage these partnerships to support enhanced PA programs. As a lack of facilities was cited as a key barrier to PA programs by Parks directors, church/library partnerships have the potential to expand Parks access to facilities where PA programs could be held. These partnerships may also facilitate enhanced community interest in programs by expanding their reach and by making programs more broadly accessible.
Keywords: Physical activity, EnvironmentalMethods: We contacted 99 leaders of rural Parks and Recreation departments located in 12 Appalachian states by email and invited them to participate in an interview. Our semi-structured interview guide focused on understanding how Parks departments partner with churches and libraries, and perceived barriers and facilitators to offering PA programs. We used descriptive statistics (frequencies, proportions) to quantify whether Parks departments partner with churches and/or libraries and thematic analyses to describe barriers and facilitators to PA programs.
Results: Directors from 10 Parks departments in Virginia (50%) and West Virginia (50%) participated in interviews. Of these, 90% reported partnerships with churches and all reported partnerships with libraries, though very few of these supported PA programs (30% and 20%, respectively). Almost all Parks directors (90%) identified a lack of resources, namely financial, staff, and facilities, as a barrier to offering PA programs. Community interest in programs was both a key barrier and facilitator to PA programs and impacted program offerings (e.g., community interest prompted additional programs) as well as program success (e.g., lack of attendance made program unsustainable).
Conclusions: Most rural Parks directors reported existing partnerships with churches and libraries, although few of these partnerships were focused on PA programming. There is great opportunity to leverage these partnerships to support enhanced PA programs. As a lack of facilities was cited as a key barrier to PA programs by Parks directors, church/library partnerships have the potential to expand Parks access to facilities where PA programs could be held. These partnerships may also facilitate enhanced community interest in programs by expanding their reach and by making programs more broadly accessible.
Authors:
Author - Kelsey Day, PhD, MPH, University of Virginia
Co-Author - Jai Sethi, University of Virginia
Co-Author - Rebecca Krukowski, PhD, FSBM, University of Virginia
Co-Author - Jamie Zoellner, PhD, RD, University of Virginia
Exercise Enjoyment May Increase Resilience to Goal-Related Setbacks During a Gym-Based Weight Loss Challenge
Poster Number: C122Time: 05:00 PM - 05:50 PM
Topics: Physical Activity
People commonly initiate exercise programs to lose weight, but underestimate the time and effort required to achieve their goals, leading to unanticipated difficulties and setbacks. These unmet expectations may result in disengagement from exercise, having important implications for weight management and general health. Behavioral maintenance theories suggest that satisfaction with other outcomes, such as positive affective responses to exercise (e.g., enjoyment) may increase resilience to goal-related setbacks and promote behavioral adherence. To test this hypothesis, the current study recruited 182 individuals (74.3% female; Mage = 42.67) from four group fitness studios who were participating in an 8-week weight loss challenge. Participants completed weekly online surveys assessing perceived goal progress and setbacks, enjoyment of workouts attended in the prior week, affectively-charged motivation (i.e., desire, dread), and self-efficacy to exercise in the upcoming week. Objective workout attendance during the challenge was received from the fitness studios. Four multilevel models were conducted to predict (1) desire, (2) dread, (3) self-efficacy, and (4) workout attendance for the upcoming week. Predictors included prior week perceived setbacks, enjoyment of workouts, and their interaction. Findings indicated that weeks with greater perceived setbacks predicted marginally lower desire (p = .07), greater dread (p < .001), and lower self-efficacy (p < .001) for the upcoming week. Perceived setbacks were not associated with workout attendance (p = .66). In contrast, enjoyment predicted greater desire (p < .001) and lower dread (p < .001), but was not associated with self-efficacy (p = .26) or workout attendance (p = .25). Enjoyment marginally moderated the association between perceived setbacks and dread (p = .057): for those reporting higher enjoyment, dread remained low regardless of setbacks, whereas for those reporting lower enjoyment, dread increased as perceived setbacks increased. No other moderation effects were found. In summary, setbacks may have undermined motivation and self-efficacy to continue one’s exercise, but did not immediately impact behavior in this sample. In contrast, enjoyment may support motivation and help buffer the affective consequences of goal-related challenges, even if it does not directly affect behavior in the short term. Further work is needed to determine the sustainability of these effects.
Keywords: Motivation, Physical activityAuthors:
Author - Celina Furman, PhD, University of Michigan
Co-Author - Allyson Tabaczynski, PhD, University of Michigan
Co-Author - Shiyu Li, PhD, University of Michigan
Co-Author - David Conroy, PhD, University of Michigan
Pilot Study Evaluating a Strength Training Intervention Delivered via Zoom for Pre- and Perimenopausal Women
Poster Number: C123Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Women's Health
Background: Regular physical activity has been shown to attenuate the accelerated weight gain that often occurs during menopause. However, many women still gain weight during menopause despite engaging in PA for 150 minutes or more per week. Most women do not integrate strength training into their PA routine, which is problematic given strength training often results in reduced body mass. Objective: The purpose of this pilot study was to examine the feasibility and preliminary efficacy of a group-based PA and strength intervention delivered via Zoom for pre- and perimenopausal women. Methods: This pilot study randomly assigned low active pre- and perimenopausal women between the ages of 40-50 (n=39) to a 12-week PA strength intervention or a waitlist control. Participants attended two zoom sessions per week for 12 weeks. The sessions included both a 40-minute cardiovascular and strength training component and a 20-minute motivational component informed by Self-Determination Theory and Habit Formation Theory. Participants were given Apple Watch devices to monitor their PA and a digital scale that automatically transmitted data to the researchers. A focus group was conducted to obtain feedback regarding the intervention. Results: Based on the duration of the recruitment phase, adherence to the zoom sessions, retention at the follow-up, and the consumer satisfaction questionnaire, the PA strength intervention appears feasible. The intervention participants increased their PA by 21 minutes per week and the control decreased by two minutes, however, there were no differences between groups. The intervention participants reported greater increases on many of the psychosocial variables including habit formation, habit automaticity, self-efficacy, self-regulation, goal setting, PA enjoyment, PA feeling, PA revitalization, and PA tranquility. The focus group data indicated high satisfaction with the program. Participants reported that Apple watches were easy to use and participants generally adhered to wearing them. There were numerous technical difficulties with the scales that led to unusable data. Conclusions: Results indicated that the PA strength intervention delivered via zoom was feasible and participants expressed high satisfaction with several of the components. Future studies that are larger and longer in duration are needed to better understand the efficacy of the intervention.
Keywords: Physical activity, Women's healthAuthors:
Author - Beth Lewis, PhD, FSBM, University of Minnesota
Co-Author - Katie Schuver, University of Minnesota
Co-Author - Kaitlyn Swinney, PhD, University of Texas
Co-Author - Tyler Dregney, University of Minnesota
Co-Author - Jennifer Linde, PhD, FSBM, University of Minnesota
Behavior Change Techniques in Gamification-Based RCTs to Promote Physical Activity
Poster Number: C124Time: 05:00 PM - 05:50 PM
Topics: Physical Activity
Purpose and Background: To promote physical activity (PA) and wellbeing, many behavior-change interventions have been attempted. As one of the innovative strategies, gamification has gained much attention and been integrated into the most rigorous research design—randomized controlled trail (RCT)—in recently years. To inform scholars and practitioners about effective PA intervention parameters, this study aims to explore behavior change techniques (BCTs) used in gamification-based RCTS to promote PA.
Method: Using combinations of keywords including “Gamification,” “Physical Activity,” and “Randomized Controlled Trial,” we searched major databases such as ERIC and SPORTDiscus, with inclusion criteria focused on: (1) Gamification was clearly defined, (2) physical activity was objectively measured, (3) the intervention must be RCT-based, and (4) the article was published in peer-reviewed, English journals. We also used cross-referencing to maximize the retrieval of potential qualified publications. BCTs were identified in accordance with the BCT Taxonomy (v1; Michie et al., 2013).
Results: A total of 21 gamification-based RCTs were included in the present study. Guided by the Taxonomy, we identified six categories of BCT among the included studies. The BCTs inherent in the gamification design were centered on Reward and Threat (e.g., points and levels). Other most-commonly used techniques included Goal & Planning (e.g., gradual vs. immediate), Feedback & Monitoring (e.g., active vs. passive), Social Support & Comparison (e.g., leaderboard), Associations (e.g., text prompts), and self-belief (e.g., commitment pledges). Two thirds of the studies demonstrated a statistically significant intervention effect.
Discussion and Conclusion: Although more than half studies reported positive intervention effects, it is challenging to pinpoint the effectiveness of single BCTs. This is because only a few studies examined the effect of single BCTs on the promotion/maintenance of physical activity, while the majority, particularly 2-arm studies, simultaneously used two or more BCTs in the experimental group. Future research may investigate how effective these BCTs are, collectively as well as individually. Due to the limited number of gamification-based PA interventions, researchers are encouraged to replicate or redesign previous studies among varied populations.
Keywords: Physical activity, Biobehavioral mechanismsMethod: Using combinations of keywords including “Gamification,” “Physical Activity,” and “Randomized Controlled Trial,” we searched major databases such as ERIC and SPORTDiscus, with inclusion criteria focused on: (1) Gamification was clearly defined, (2) physical activity was objectively measured, (3) the intervention must be RCT-based, and (4) the article was published in peer-reviewed, English journals. We also used cross-referencing to maximize the retrieval of potential qualified publications. BCTs were identified in accordance with the BCT Taxonomy (v1; Michie et al., 2013).
Results: A total of 21 gamification-based RCTs were included in the present study. Guided by the Taxonomy, we identified six categories of BCT among the included studies. The BCTs inherent in the gamification design were centered on Reward and Threat (e.g., points and levels). Other most-commonly used techniques included Goal & Planning (e.g., gradual vs. immediate), Feedback & Monitoring (e.g., active vs. passive), Social Support & Comparison (e.g., leaderboard), Associations (e.g., text prompts), and self-belief (e.g., commitment pledges). Two thirds of the studies demonstrated a statistically significant intervention effect.
Discussion and Conclusion: Although more than half studies reported positive intervention effects, it is challenging to pinpoint the effectiveness of single BCTs. This is because only a few studies examined the effect of single BCTs on the promotion/maintenance of physical activity, while the majority, particularly 2-arm studies, simultaneously used two or more BCTs in the experimental group. Future research may investigate how effective these BCTs are, collectively as well as individually. Due to the limited number of gamification-based PA interventions, researchers are encouraged to replicate or redesign previous studies among varied populations.
Authors:
Author - Jiling Liu, Texas A&M University
Co-Author - Han Chen, Valdosta State University
Co-Author - Christine Pellegrini, PhD, FSBM, University of South Carolina
Within-subject daily associations between affective mechanisms and physical activity among physically inactive adults with overweight or obesity
Poster Number: C125Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Weight Related Health
Background: Performing physical activity (PA) regularly promotes health and reduces risk for chronic conditions, yet interventions have yielded limited public health impact especially among adults with overweight and obesity. As such, identifying mechanisms that support sustained PA in this target population remains a critical priority. Theoretical frameworks posit that affectively-charged motivations (e.g., wanting/dreading to engage in future behavior) and anticipated affect (e.g., feeling good/bad during future PA) influence decisions to initiate or maintain PA. However, much prior research has emphasized trait-level affective constructs, limiting understanding of daily, within-person processes. The purpose of the current study was to use ecological momentary assessment (EMA) to test whether morning affectively-charged motivations and anticipated affect predict same-day mean and variability in moderate-to-vigorous PA (MVPA) and light PA in physically inactive adults with overweight or obesity. Methods: This study uses data from the eMOTION study, which is an 18-week digital therapeutics intervention investigating the efficacy of targeting real-time affective mechanisms to increase PA. Affective mechanisms were measured in the morning EMA prompt with two items using 100-point visual analog scales: “How do you feel about doing PA today?” (Dread–Excited) and “How do you expect to feel during PA today?” (Miserable–Thrilled). Daily PA was assessed using continuous accelerometry via a Fitbit smartwatch. Mixed-effects location scale models were run using MixWILD software to examine associations of within- and between-person morning affectively charged motivations and anticipated affect with mean and variability in same-day PA. Results: Between- and within-persons, more positive affectively-charged motivations were associated with greater day-level MVPA and light PA (ps<.005) and day-to-day MVPA variability (ps<.001). Also between- and within-persons, more positive anticipated affect was associated with greater day-level MVPA and light PA (ps<.005), and more positive within-subjects anticipated affect was associated with more day-to-day variability in MVPA (p<.001). Discussion: Affectively-charged motivations and anticipated affect are salient predictors of MVPA volume and variability. Results support targeting day-level changes in affective mechanisms among physically inactive adults with overweight or obesity may lead to same-day improvements in PA.
Keywords: Physical activity, EmotionsAuthors:
Discussant - Tyler Mason, PhD, University of Southern California
Co-Author - Wei-Lin Wang, PhD, University of Southern California
Co-Author - Lori Hatzinger, MS, University of Southern California
Co-Author - Rachel Crosley-Lyons, MS, University of Southern California
Co-Author - Micaela Hewus, University of Southern California
Co-Author - Max Samuelson, University of Southern California
Co-Author - Delfien Van Dyck, Ghent University
Co-Author - Jimi Huh, PhD, University of Southern California
Co-Author - Genevieve Dunton, PhD, MPH, FSBM, University of Southern California
“If you put in the effort, you can achieve many things”: Exploring facilitators and barriers to increasing physical activity levels among Spanish-speaking adults
Poster Number: C126Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Health Disparities
Background: Spanish-speaking adults in the United States are less likely to meet physical activity (PA) recommendations and have higher rates of overweight/obesity compared to English-speaking adults. A critical challenge in obesity treatment is increasing the proportion of Hispanic adults who are meeting PA guidelines.
Methods: We recruited Spanish-speaking adults to participate in a 120-min virtual focus group to explore their perspectives of facilitators and barriers for increasing PA. Adults (≥18 years) were included if they had a BMI ≥25 kg/m2, were exercising <150 min/wk and spoke Spanish. The focus group was audio-recorded and transcribed verbatim. A team-based approach, consisting of 4 coders, was used to conduct a content analysis in ATLAS.ti to explore qualitative themes around facilitators and barriers to increasing PA.
Results: A total of 20 Spanish-speaking adults (age: 42.7 (range 27-71 years), BMI: 32 (range 25-46 kg/m2), 30% male, 75% Hispanic, 25% Latino) participated in a focus group (n=2 total). Qualitative categories around barriers included: 1) a strong work ethic to prioritize other life responsibilities (e.g., work, family, chores), and 2) a subsequent lack of discipline (and time) when it comes to prioritizing PA. There was an interconnectedness between many top barriers, with the commitment to work/family responsibilities, leading to lack of time, contributing to feelings of tiredness. Other barriers mentioned included being active alone, having a health condition, feelings of self-consciousness and stigma, discomfort from PA, laziness, a non-supportive physical environment, religious beliefs (around yoga), and a lack of knowledge, PA enjoyment, safety, and motivation. Qualitative categories around facilitators included: 1) having a mindset of prioritizing PA, 2) finding opportunities to move (e.g., parking further away), 3) having an instructor to teach safe movements, and 4) the importance of involving others in the PA. Other facilitators included supportive accountability, PA enjoyment, music, self-awareness of the message of “All movement counts”, information and access to free PA programs in the community, technology (at home workout videos, Instagram videos, TikTok users), and complementing PA with other tasks (reading, visualizing projects, combining it with dropping kids off).
Conclusions: Perspectives provided insights into potential challenges and opportunities for increasing PA levels among Spanish-speaking adults.
Keywords: Physical activity, Health disparitiesMethods: We recruited Spanish-speaking adults to participate in a 120-min virtual focus group to explore their perspectives of facilitators and barriers for increasing PA. Adults (≥18 years) were included if they had a BMI ≥25 kg/m2, were exercising <150 min/wk and spoke Spanish. The focus group was audio-recorded and transcribed verbatim. A team-based approach, consisting of 4 coders, was used to conduct a content analysis in ATLAS.ti to explore qualitative themes around facilitators and barriers to increasing PA.
Results: A total of 20 Spanish-speaking adults (age: 42.7 (range 27-71 years), BMI: 32 (range 25-46 kg/m2), 30% male, 75% Hispanic, 25% Latino) participated in a focus group (n=2 total). Qualitative categories around barriers included: 1) a strong work ethic to prioritize other life responsibilities (e.g., work, family, chores), and 2) a subsequent lack of discipline (and time) when it comes to prioritizing PA. There was an interconnectedness between many top barriers, with the commitment to work/family responsibilities, leading to lack of time, contributing to feelings of tiredness. Other barriers mentioned included being active alone, having a health condition, feelings of self-consciousness and stigma, discomfort from PA, laziness, a non-supportive physical environment, religious beliefs (around yoga), and a lack of knowledge, PA enjoyment, safety, and motivation. Qualitative categories around facilitators included: 1) having a mindset of prioritizing PA, 2) finding opportunities to move (e.g., parking further away), 3) having an instructor to teach safe movements, and 4) the importance of involving others in the PA. Other facilitators included supportive accountability, PA enjoyment, music, self-awareness of the message of “All movement counts”, information and access to free PA programs in the community, technology (at home workout videos, Instagram videos, TikTok users), and complementing PA with other tasks (reading, visualizing projects, combining it with dropping kids off).
Conclusions: Perspectives provided insights into potential challenges and opportunities for increasing PA levels among Spanish-speaking adults.
Authors:
Presenter - Silvia Gutierrez Raghunath, MBA, Denver Health
Co-Author - Maria Paula Reyes Ramirez, MD, University of Colorado Anschutz Medical Campus
Co-Author - Felipe Leon, MS, University of Colorado Anschutz Medical Campus
Co-Author - Alex Manis, BS, University of Tennessee Knoxville
Co-Author - Beatriz Rodriguez-Roca, PhD, University of Zaragoza
Co-Author - Javier Garcia, BS, University of Colorado Anschutz Medical Campus
Co-Author - Ryan Marker, PhD, DPT, University of Colorado Anschutz Medical Campus
Co-Author - Bethany Kwan, PhD, MSPH, FSBM, University of Colorado School of Medicine
Co-Author - Victoria Catenacci, MD, University of Colorado Anschutz Medical Campus
Co-Presenter - Danielle Ostendorf, PhD, University of Tennessee Knoxville
The Role of Trait Self-Control in Physical Activity Enjoyment and Affective Experiences Among Inactive University Students
Poster Number: C127Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Multiple Health Behavior Change
Physical activity (PA) enjoyment is a strong predictor of PA participation, making it a critical target for promoting sustained engagement among inactive university students. However, not all students experience PA positively, and many disengage when activity feels effortful or unpleasant. Trait self-control reflects an individual’s capacity to override impulses and regulate behaviour in pursuit of long-term goals, and has been consistently linked to adaptive outcomes, including greater participation in healthy lifestyle behaviours. Within a PA context, self-control may influence how individuals respond to effortful moments, shaping both in-task affective experiences and overall PA enjoyment. Yet it remains unclear whether trait self-control primarily affects in-task affective responses or post-PA enjoyment. The purpose of this study was to examine whether trait self-control predicts PA enjoyment and to explore its relationship with in-task affective responses. University students (N=81, 71% women, Mage[SD]=20.88[2.36]) completed a 15-minute self-selected treadmill walking task. Trait self-control was measured prior to PA using the Brief Self-Control Scale. Post-PA enjoyment was assessed with the Physical Activity Enjoyment Scale (PACES). In-task affective responses were recorded at 1, 5, and 10 minutes using the Feeling Scale (FS), Felt Arousal Scale (FAS), ratings of perceived exertion (RPE) scale, and a single-item enjoyment question. Trait self-control significantly predicted post-PA enjoyment (F[1,79]=11.41, p< .001, R2=.13), with higher self-control associated with greater PA enjoyment. Repeated-measures analyses revealed significant changes over time for all in-task outcomes (<.05), but no main effects of self-control, or time × self-control interactions. Mediation analyses revealed that in-task enjoyment partially mediated the relationship between trait self-control and post-PA enjoyment (B=0.22, SE=0.10, 95% CI [0.05, 0.43], p=.034) whereas FS, FAS, and RPE did not. These findings suggest that self-control also shapes post-PA enjoyment indirectly by influencing momentary perceptions of enjoyment during PA, even if it does not alter other in-task affective responses. Future research should test whether trait self-control predicts enjoyment across PA intensities, durations, and modalities. It may also be valuable to examine if interventions targeting self-control or real-time affect regulation enhance PA adherence among inactive university students.
Keywords: Physical activity, Health behaviorsAuthors:
Co-Author - Samira Sunderji, PhD Student, University of Toronto
Co-Author - Catherine Sabiston , PhD., FCAHS, University of Toronto
Adoption Barriers and Facilitators: Participant Perspectives to Guide Intervention Refinement
Poster Number: C128Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Cancer
Background. Integrating diverse stakeholder experiences is essential for designing sustainable, equitable physical activity interventions. Participant perspectives offer critical insights that shape engagement and long-term sustainability. Adoption, defined as individual-level factors influencing engagement in an intervention, is key for sustained implementation, particularly in underserved populations where alignment with participant needs is essential. The Breast cancer Resiliency through Exercise Program (B-REP) is a 12-week supervised, remotely delivered exercise intervention compared to a no-supervision control. This study qualitatively assessed participant perspectives to identify factors influencing adoption to guide intervention refinement. Methods. At post-intervention, one-to-one semi-structured online interviews (Mduration=34.5 minutes, SD=7.14) were conducted with n=4 purposively sampled participants (Mage= 54.5 years, SD=8.4; 100% Non-Hispanic Black; 50% married; 75% post-secondary education; 100% earning ≥$50,000; 50% Stage 1a; M=41.8 months since diagnosis, SD=14.9). Purposive sampling captured variation in attendance (58 to 80% of sessions) and emphasized Black participants, who enrolled at a higher rate (64.7%) compared to other racial groups combined (30.7%). Interviews were audio recorded, transcribed verbatim, and analyzed using inductive content analysis. Results. Three themes were identified. First, facilitators of program adoption (n=37 occurrences) included intervention elements, trainer influence, and personal motivators. Participants valued online session convenience in “cutting out the commute” and the trainer’s empathy, motivation, and rapport. Second, barriers (n=8) included competing priorities, such as work and caregiving responsibilities, which limited engagement. Third, future suggestions included adding nutritional guidance, increasing program frequency and duration, and using dumbbells instead of bands. Conclusion. This study highlighted key individual-level factors influencing intervention engagement. Centering the perspectives of Black women, a historically underserved population, into program design can enhance sustainability by increasing acceptability and aligning with participants’ lived experiences. Future research should examine setting-level influences, including physical environments and clinical workflows, to build a more integrated understanding of factors influencing program engagement and sustainability.
Keywords: Physical activity, CancerAuthors:
Presenter - Angela Fong, PhD, University of Michigan
Author - Isabel L. Wakefield, MA, University of Michigan
Co-Author - Oceane Streubel, University of Michigan
Co-Author - Hala I. Abbas, MS, University of Michigan
Co-Author - Mary Schmitz, PhD, MPH, FACSM, University of Pittsburgh
Co-Author - Siobhan Phillips, PhD, MPH, FSBM, Northwestern University
Co-Author - Adana Llanos, PhD, MPH, Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center and Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center
Co-Author - Sharon Manne, PhD, FSBM, Rutgers Cancer Institute
Associations between Health-Related Fitness and Academic Achievement in a National Sample of U.S. Schools
Poster Number: C129Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Child and Family Health
Background: Schools are critical for physical activity promotion. Yet, competing academic priorities limit efforts, negatively impacting student’s health and fitness. Understanding how health-related fitness relates to academics is essential for aligning health promotion with schools’ core missions. This study examined school-level associations between health-related fitness, school characteristics, and academic achievement.
Methods: We conducted an observational study from a national sample of schools in the NFL PLAY60 FitnessGram® project. Schools assessed cardiorespiratory fitness (CRF) using the PACER or 1-mile run or walk test, and body mass index (BMI) from measured height and weight. We downloaded publicly available school-level academic data (% of students performing at grade-level for math and language arts) from state department of education websites, and school characteristics data from the National Center for Education Statistics. Independent variables were the percentage of students meeting Healthy Fitness Zone (HFZ) standards for CRF and BMI, and school characteristics (e.g., school type, locale, free/reduced lunch status, and racial/ethnic composition). Dependent variables were the % of students at grade level for language arts and math. We used mixed-effects linear regression models to examine associations.
Results: There were 166 schools with CRF data (16 states) and 67 schools with BMI data (10 states). For the CRF sample, an average of 68.4% of students were eligible for free/reduced lunch; 86% of schools were elementary; and 42.8% were located in cities. Racial/ethnic composition varied across the sample. Schools with higher percentages of students in the HFZ for CRF had higher percentages of students performing at grade level in math (β=0.10, p<0.01) and language arts (β=0.13, p<0.01). We observed non-significant trends for a direct relation for BMI to math (β=0.26, p=0.48) and language arts (β=0.18, p=0.25). Economic disadvantage was inversely associated with academic outcomes, and majority Black or Hispanic schools had lower academic performance compared to majority White schools.
Conclusions: Evidence indicates school-level CRF is directly associated with academic achievement. Findings highlight disparities in academics related to economic disadvantage and race/ethnicity. Results support the need for policies/practices that prioritize student health and fitness as part of broader strategies to support academic outcomes.
Keywords: Physical activity, ChildrenMethods: We conducted an observational study from a national sample of schools in the NFL PLAY60 FitnessGram® project. Schools assessed cardiorespiratory fitness (CRF) using the PACER or 1-mile run or walk test, and body mass index (BMI) from measured height and weight. We downloaded publicly available school-level academic data (% of students performing at grade-level for math and language arts) from state department of education websites, and school characteristics data from the National Center for Education Statistics. Independent variables were the percentage of students meeting Healthy Fitness Zone (HFZ) standards for CRF and BMI, and school characteristics (e.g., school type, locale, free/reduced lunch status, and racial/ethnic composition). Dependent variables were the % of students at grade level for language arts and math. We used mixed-effects linear regression models to examine associations.
Results: There were 166 schools with CRF data (16 states) and 67 schools with BMI data (10 states). For the CRF sample, an average of 68.4% of students were eligible for free/reduced lunch; 86% of schools were elementary; and 42.8% were located in cities. Racial/ethnic composition varied across the sample. Schools with higher percentages of students in the HFZ for CRF had higher percentages of students performing at grade level in math (β=0.10, p<0.01) and language arts (β=0.13, p<0.01). We observed non-significant trends for a direct relation for BMI to math (β=0.26, p=0.48) and language arts (β=0.18, p=0.25). Economic disadvantage was inversely associated with academic outcomes, and majority Black or Hispanic schools had lower academic performance compared to majority White schools.
Conclusions: Evidence indicates school-level CRF is directly associated with academic achievement. Findings highlight disparities in academics related to economic disadvantage and race/ethnicity. Results support the need for policies/practices that prioritize student health and fitness as part of broader strategies to support academic outcomes.
Authors:
Author - Timothy Walker, The University of Texas Health Science Center at Houston
Co-Author - Andjelka Pavlovic, Kenneth H. Cooper Institute, Texas Tech University Health Sciences Center
Presenter - Derek Craig, The University of Texas Health Science Center at Houston
Co-Author - Christopher Pfledderer, UTHealth Houston School of Public Health in Austin
Co-Author - Kevin Lanza, UTHealth Houston School of Public Health in Austin
Co-Author - Kempson Onadeko, The University of Texas Health Science Center at Houston
Co-Author - Laura DeFina, Kenneth H. Cooper Institute, Texas Tech University Health Sciences Center
Improving Caregiver Dietary Behavior and Household Nutrition Through a Pediatric Cancer Lifestyle Program
Poster Number: C13Time: 05:00 PM - 05:50 PM
Topics: Cancer, Diet, Nutrition, and Eating Disorders
Background: Pediatric cancer survivors are at elevated risk for obesity and related health complications, making post-treatment dietary habits a critical focus for survivorship care. Family-centered lifestyle interventions may foster healthier eating behaviors and improve the home food environment. This study examined caregiver-reported changes in fast-food meal frequency and household availability of fruits and vegetables following participation in a healthy lifestyle program designed for pediatric cancer survivors.
Methods: Pediatric cancer survivors (n=170) enrolled in a randomized controlled trial, evaluating a family-based intervention focused on nutrition education, physical activity, and behavioral strategies for weight management, completed self-report measures at baseline and post-intervention assessing the frequency of fast-food family meals consumed in the past week and the household availability of fresh or frozen fruits and vegetables. Paired-samples t-tests were used to evaluate changes over time. The current findings reflect preliminary analyses from a larger study with ongoing data collection.
Results: Participants were predominantly female (93%), with an average caregiver age of 42.34 years (SD = 7.91). Approximately 71% identified as White, and 45% reported a household income greater than $70,000. Following the intervention, regardless of randomization condition (intervention vs. control), fast-food family meal frequency significantly declined from 2.23 (SD = 0.894) to 2.05 (SD = .699), t(168) = 3.014, p = .003, d =.230. Vegetable availability increased from 1.49 (SD = .77) to 1.64 (SD = .90), t(168) = 2.18, p = .031, d = .15. Fruit availability showed a non-significant trend (1.64 [SD = 0.94] to 1.55 [SD = .87]), t(168) = 1.39, p = .168. Moderate correlations were observed between pre- and post-intervention measures for fruits (r = .52) and vegetables (r = .45), p < .001.
Conclusion: Participation in a healthy lifestyle intervention designed for pediatric cancer survivors was associated with caregiver-reported reductions in fast-food consumption and improvements in vegetable availability within the home. These preliminary findings suggest that structured, family-centered programs may positively influence dietary behaviors and the home food environment, supporting long-term health promotion in pediatric cancer survivorship.
Keywords: Caregiving, Eating behaviorsMethods: Pediatric cancer survivors (n=170) enrolled in a randomized controlled trial, evaluating a family-based intervention focused on nutrition education, physical activity, and behavioral strategies for weight management, completed self-report measures at baseline and post-intervention assessing the frequency of fast-food family meals consumed in the past week and the household availability of fresh or frozen fruits and vegetables. Paired-samples t-tests were used to evaluate changes over time. The current findings reflect preliminary analyses from a larger study with ongoing data collection.
Results: Participants were predominantly female (93%), with an average caregiver age of 42.34 years (SD = 7.91). Approximately 71% identified as White, and 45% reported a household income greater than $70,000. Following the intervention, regardless of randomization condition (intervention vs. control), fast-food family meal frequency significantly declined from 2.23 (SD = 0.894) to 2.05 (SD = .699), t(168) = 3.014, p = .003, d =.230. Vegetable availability increased from 1.49 (SD = .77) to 1.64 (SD = .90), t(168) = 2.18, p = .031, d = .15. Fruit availability showed a non-significant trend (1.64 [SD = 0.94] to 1.55 [SD = .87]), t(168) = 1.39, p = .168. Moderate correlations were observed between pre- and post-intervention measures for fruits (r = .52) and vegetables (r = .45), p < .001.
Conclusion: Participation in a healthy lifestyle intervention designed for pediatric cancer survivors was associated with caregiver-reported reductions in fast-food consumption and improvements in vegetable availability within the home. These preliminary findings suggest that structured, family-centered programs may positively influence dietary behaviors and the home food environment, supporting long-term health promotion in pediatric cancer survivorship.
Authors:
Presenter - Jocelyn Jarvis, BS, University of South Florida
Co-Author - Sahar Heydari, University of South Florida
Co-Author - Heewon Gray, PhD, RD, University of South Florida
Co-Author - Marilyn Stern, PhD, University of South Florida
Longitudinal Measurement Invariance of the Physical Activity and Social Support Scale
Poster Number: C130Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Methods and Measurement
Background: Social support is an important predictor for increased physical activity and long-term adherence to physical activity. The Physical Activity and Social Support Scale (PASSS) is designed to measure five forms of functional social support (companionship, emotional, instrumental, informational, and validation) for physical activity. The PASSS was previously developed with exploratory factor analysis and confirmatory factor analysis, showing good psychometric properties. The objective of the proposed study was to psychometrically assess the stability and consistency of the forms of social support measured by the PASSS over time with longitudinal invariance testing.
Methods: Participants (n=611) in a 2-year, weight-loss randomized control trial, completed the PASSS along with other health questionnaires over the course of the study. Baseline, 6-months, and 24-months PASSS survey data were used to conduct multigroup confirmatory factor analyses (Model 1: all item loadings and intercepts freely estimated; Model 2: loadings constrained across time; Model 3: loadings and intercepts constrained across time) using maximum likelihood estimation. Changes in chi-square and comparative fit index (CFI) were examined across models. A lack of significant decrement in fit would indicate metric invariance (meaning factor loadings are equivalent across groups) and scalar invariance (meaning that the factor loadings and intercepts are equivalent across groups).
Results: Although the chi-square difference test was significant for the change from model 1 to model 2 (ΔX2 = 48.4; p < .001), the change in CFI (ΔCFI = .002) was negligible, suggesting metric invariance held. Similarly, although the chi- square difference test was significant for the change from model 2 to model 3 (ΔX2 = 93.8; p = .02), the change in CFI (ΔCFI = .003) was again negligible, suggesting scalar invariance held.
Conclusions: Findings show that both metric and scalar invariance held because the change in the CFI was less than .01. Although chi-square differences are reported, these are not relied on to determine invariance because of their sensitivity to sample size which has been supported by current research. Therefore, we can conclude that the forms of social support measured by the PASSS were stable and consistent over time. Furthermore, it demonstrates the PASSS’s strength in measuring social support for physical activity.
Keywords: Measurement, Social supportMethods: Participants (n=611) in a 2-year, weight-loss randomized control trial, completed the PASSS along with other health questionnaires over the course of the study. Baseline, 6-months, and 24-months PASSS survey data were used to conduct multigroup confirmatory factor analyses (Model 1: all item loadings and intercepts freely estimated; Model 2: loadings constrained across time; Model 3: loadings and intercepts constrained across time) using maximum likelihood estimation. Changes in chi-square and comparative fit index (CFI) were examined across models. A lack of significant decrement in fit would indicate metric invariance (meaning factor loadings are equivalent across groups) and scalar invariance (meaning that the factor loadings and intercepts are equivalent across groups).
Results: Although the chi-square difference test was significant for the change from model 1 to model 2 (ΔX2 = 48.4; p < .001), the change in CFI (ΔCFI = .002) was negligible, suggesting metric invariance held. Similarly, although the chi- square difference test was significant for the change from model 2 to model 3 (ΔX2 = 93.8; p = .02), the change in CFI (ΔCFI = .003) was again negligible, suggesting scalar invariance held.
Conclusions: Findings show that both metric and scalar invariance held because the change in the CFI was less than .01. Although chi-square differences are reported, these are not relied on to determine invariance because of their sensitivity to sample size which has been supported by current research. Therefore, we can conclude that the forms of social support measured by the PASSS were stable and consistent over time. Furthermore, it demonstrates the PASSS’s strength in measuring social support for physical activity.
Authors:
Author - Natalie Yarish, PhD, Old Dominion University
Co-Author - Abby Braitman, PhD, Old Dominion University
Co-Author - Shadia Mansour-Assi, MPH, Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego; Laura Rodriguez Research Institute, Family Health Centers of San Diego
Co-Author - Sonia Jain, PhD, Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego
Co-Author - David Wing, PhD, Exercise and Physical Activity Resource Center, University of California, San Diego
Co-Author - Job Godino, PhD, Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego; Laura Rodriguez Research Institute, Family Health Centers of San Diego; Exercise and Physical Activity Resource Center, University of California, San Diego
Speech and mental math on the go: Effects of activity-permissive workstations on Trier Social Stress Test performance
Poster Number: C131Time: 05:00 PM - 05:50 PM
Topics: Physical Activity
Background: Prolonged sedentary behavior raises risk for cardiovascular disease, obesity, and poor cognition. Activity-permissive workstations (APWs; e.g., treadmill and standing desks) reduce sedentary time without sacrificing productivity. Prior research shows APWs do not impair simple office tasks, but their effects on more complex performance remain unclear. The Trier Social Stress Test (TSST), a standardized paradigm involving public speaking and arithmetic, provides an ecologically valid context for assessing speech quality and cognitive performance under pressure.
Methods: In two studies, participants were randomly assigned to a sitting, standing, or treadmill workstation and completed the virtual TSST via Zoom. The test included a five-minute mock job interview, where participants were prompted to continue speaking when they paused, followed by mental arithmetic (counting backward by 13s from 1022, restarting after each error). Study 1 recruited psychology students (N=28); Study 2 recruited community members (N=69). Speech was audio-recorded, transcribed with TurboScribe, and coded for word count, silence, non-fluencies, productive word ratio, and quality ratings by two blinded raters. Arithmetic was scored by the furthest number reached and restarts.
Results: Across both studies, workstation condition did not significantly affect speech or arithmetic outcomes. In Study 2, exploratory analyses showed: males were rated lower on speech quality (p=.02) but outperformed females in arithmetic (p<.001); non-native English speakers produced more words (p=.02); participants with mental health conditions had higher productive word ratios (p=.05) and fewer non-fluencies (p=.02); higher income was linked with longer silence (p=.04) and lower speech ratings (p=.03); White participants were rated higher on speech quality than non-White peers (p=.02).
Discussion: APWs did not compromise speech or arithmetic performance even under socially evaluative stress. These findings show APWs can be used in cognitively demanding settings, such as job interviews, without detriment to verbal fluency or problem-solving. This supports broader adoption of APWs as workplace interventions that promote physical activity without undermining professional tasks. Future research should confirm these effects in larger, more diverse samples and explore intriguing subgroup differences (e.g., better speech performance among participants with mental health conditions and lower income).
Keywords: Occupational health, Physical activityMethods: In two studies, participants were randomly assigned to a sitting, standing, or treadmill workstation and completed the virtual TSST via Zoom. The test included a five-minute mock job interview, where participants were prompted to continue speaking when they paused, followed by mental arithmetic (counting backward by 13s from 1022, restarting after each error). Study 1 recruited psychology students (N=28); Study 2 recruited community members (N=69). Speech was audio-recorded, transcribed with TurboScribe, and coded for word count, silence, non-fluencies, productive word ratio, and quality ratings by two blinded raters. Arithmetic was scored by the furthest number reached and restarts.
Results: Across both studies, workstation condition did not significantly affect speech or arithmetic outcomes. In Study 2, exploratory analyses showed: males were rated lower on speech quality (p=.02) but outperformed females in arithmetic (p<.001); non-native English speakers produced more words (p=.02); participants with mental health conditions had higher productive word ratios (p=.05) and fewer non-fluencies (p=.02); higher income was linked with longer silence (p=.04) and lower speech ratings (p=.03); White participants were rated higher on speech quality than non-White peers (p=.02).
Discussion: APWs did not compromise speech or arithmetic performance even under socially evaluative stress. These findings show APWs can be used in cognitively demanding settings, such as job interviews, without detriment to verbal fluency or problem-solving. This supports broader adoption of APWs as workplace interventions that promote physical activity without undermining professional tasks. Future research should confirm these effects in larger, more diverse samples and explore intriguing subgroup differences (e.g., better speech performance among participants with mental health conditions and lower income).
Authors:
Author - Yiqing "Skylar" Yu, Colorado State University
Author - Payge Grieve, Colorado State University
Author - Daniel Graham, PhD, Colorado State University
Associations between financial toxicity and quality of life among young adult cancer survivors: the mediating roles of stress and sleep quality
Poster Number: C132Time: 05:00 PM - 05:50 PM
Topics: Quality of Life, Cancer
Purpose: Young adult (YA) cancer survivors often face substantial financial toxicity, which can impair their quality of life (QoL). Although prior research has demonstrated associations between financial toxicity and QoL among YA cancer survivors, the psychological mechanisms underlying this relationship remain unknown. Financial toxicity may contribute to elevated psychological stress, leading to disrupted sleep quality and subsequent declines in QoL. This study examined whether stress and sleep quality serially mediate the relationship between financial toxicity and QoL among YA cancer survivors.
Methods: This cross-sectional secondary analysis included 103 YA cancer survivors (ages 25–39 at diagnosis) who had recently completed treatment (within the past 6 months). Participants completed questionnaires assessing financial toxicity, perceived stress, sleep quality, and QoL. Serial multiple mediation models were estimated with full-information maximum likelihood estimation, adjusting for covariates (e.g., education level, race, and cancer type for mental QoL, education level, comorbidity, and cancer stage for physical QoL) identified from prior literature and preliminary analyses.
Results: Financial toxicity was not directly associated with mental QoL (β = 0.086, 95% CI [-0.079, 0.217]) or physical QoL (β = 0.157, 95% CI [-0.038, 0.282]), after adjusting for stress and sleep quality. However, significant indirect effects were observed. Stress mediated the relationship between financial toxicity and mental QoL (β = 0.161, 95% CI [0.054, 0.207]). Additionally, a serial mediation pathway was identified, wherein financial toxicity influenced both mental QoL (β = 0.049, 95% CI [0.008, 0.078]) and physical QoL (β = 0.057, 95% CI [0.011, 0.092]) through increased stress and subsequent poor sleep quality.
Conclusion: Findings highlight stress and sleep quality as key psychological mechanisms linking financial toxicity to both mental and physical QoL in YA cancer survivors. Specifically, stress directly impacted mental QoL, while its effect on physical QoL was mediated through sleep quality. These results underscore the importance of comprehensive interventions that directly alleviate financial burden—for example, through financial counseling or patient assistance programs—while also incorporating stress management and sleep improvement strategies to enhance QoL. Targeting these modifiable mediators may help reduce the survivorship burden among YAs with cancer.
Keywords: Cancer, Health disparitiesMethods: This cross-sectional secondary analysis included 103 YA cancer survivors (ages 25–39 at diagnosis) who had recently completed treatment (within the past 6 months). Participants completed questionnaires assessing financial toxicity, perceived stress, sleep quality, and QoL. Serial multiple mediation models were estimated with full-information maximum likelihood estimation, adjusting for covariates (e.g., education level, race, and cancer type for mental QoL, education level, comorbidity, and cancer stage for physical QoL) identified from prior literature and preliminary analyses.
Results: Financial toxicity was not directly associated with mental QoL (β = 0.086, 95% CI [-0.079, 0.217]) or physical QoL (β = 0.157, 95% CI [-0.038, 0.282]), after adjusting for stress and sleep quality. However, significant indirect effects were observed. Stress mediated the relationship between financial toxicity and mental QoL (β = 0.161, 95% CI [0.054, 0.207]). Additionally, a serial mediation pathway was identified, wherein financial toxicity influenced both mental QoL (β = 0.049, 95% CI [0.008, 0.078]) and physical QoL (β = 0.057, 95% CI [0.011, 0.092]) through increased stress and subsequent poor sleep quality.
Conclusion: Findings highlight stress and sleep quality as key psychological mechanisms linking financial toxicity to both mental and physical QoL in YA cancer survivors. Specifically, stress directly impacted mental QoL, while its effect on physical QoL was mediated through sleep quality. These results underscore the importance of comprehensive interventions that directly alleviate financial burden—for example, through financial counseling or patient assistance programs—while also incorporating stress management and sleep improvement strategies to enhance QoL. Targeting these modifiable mediators may help reduce the survivorship burden among YAs with cancer.
Authors:
Author - Haejeong An, PhD, The University of Texas MD Anderson Cancer Center
Co-Author - Kathrin Milbury, PhD, University of Texas MD Anderson Cancer Center
Co-Author - Michael Roth, MD, The University of Texas MD Anderson Cancer Center
Co-Author - Seokhun Kim, PhD, McGovern Medical School at UTHealth Houston
Author - Dalnim Cho, PhD, The University of Texas MD Anderson Cancer Center
Quality of Life and Symptom Trajectories in Post–COVID-19 Condition: A 24-Month Descriptive Analysis
Poster Number: C133Time: 05:00 PM - 05:50 PM
Topics: Quality of Life, Cardiovascular Disease
Background:
Beyond the acute phase of SARS-CoV-2 infection, many survivors report prolonged symptoms that interfere with daily functioning and adversely affect quality of life. Most studies aiming to improve understanding of post–COVID-19 condition have been cross-sectional or short-term, leaving the long-term course of symptom trajectories poorly understood. We conducted a descriptive longitudinal study to characterize symptom patterns and describe their evolution over time.
Methods:
We used data from the post-COVID cohort, a prospective community hospital–based study of adults with confirmed SARS-CoV-2 infection (> 28 days post infection) followed at initial study visit, 12 months, and 24 months. We first estimated the prevalence of reported symptoms over time, then analyzed the most common symptoms using latent class analysis (LCA) to identify subgroups with distinct profiles. Class membership was examined to characterize trajectories over time.
Results:
Among 138 participants (mean age 54 ± 15 years; 48% female), the most prevalent symptoms were fatigue (18%), memory loss (17%), musculoskeletal symptoms (17%), loss of smell/taste (12%), and shortness of breath (11%). Symptom prevalence declined over time, with the greatest reductions in the first year (any symptoms: 46% at baseline, 33% at 12 months, 28% at 24 months). LCA identified three symptom classes: Class 1 (n=12), high burden with multisystem involvement (conditional probability of symptom presence: fatigue 36%, memory loss 68%, shortness of breath 52%, musculoskeletal symptoms 63%, loss of sense of smell and taste 48%, cardio-respiratory 75%); Class 2 (n=23), fatigue-dominant (75%) with moderate memory (47%) and musculoskeletal symptoms (47%); and Class 3 (n=103), minimal symptoms. Most participants remained in Class 3 across follow-up. Recovery from Class 2 to Class 3 was more frequent than recovery from Class 1 (35% vs 25%).
Conclusions:
Two years after acute infection, post–COVID-19 condition has a lasting impact on quality of life, with fatigue and memory loss remaining common post-COVID symptoms. Most recovery occurred within the first year, suggesting a critical window for improvement. LCA identified three distinct profiles: minimal symptoms, fatigue-dominant, and multisystem burden. These findings highlight the heterogeneous long-term course of post–COVID-19 condition and the need for targeted strategies to address high-burden trajectories that may compromise quality of life.
Keywords: Quality of life, Chronic illnessBeyond the acute phase of SARS-CoV-2 infection, many survivors report prolonged symptoms that interfere with daily functioning and adversely affect quality of life. Most studies aiming to improve understanding of post–COVID-19 condition have been cross-sectional or short-term, leaving the long-term course of symptom trajectories poorly understood. We conducted a descriptive longitudinal study to characterize symptom patterns and describe their evolution over time.
Methods:
We used data from the post-COVID cohort, a prospective community hospital–based study of adults with confirmed SARS-CoV-2 infection (> 28 days post infection) followed at initial study visit, 12 months, and 24 months. We first estimated the prevalence of reported symptoms over time, then analyzed the most common symptoms using latent class analysis (LCA) to identify subgroups with distinct profiles. Class membership was examined to characterize trajectories over time.
Results:
Among 138 participants (mean age 54 ± 15 years; 48% female), the most prevalent symptoms were fatigue (18%), memory loss (17%), musculoskeletal symptoms (17%), loss of smell/taste (12%), and shortness of breath (11%). Symptom prevalence declined over time, with the greatest reductions in the first year (any symptoms: 46% at baseline, 33% at 12 months, 28% at 24 months). LCA identified three symptom classes: Class 1 (n=12), high burden with multisystem involvement (conditional probability of symptom presence: fatigue 36%, memory loss 68%, shortness of breath 52%, musculoskeletal symptoms 63%, loss of sense of smell and taste 48%, cardio-respiratory 75%); Class 2 (n=23), fatigue-dominant (75%) with moderate memory (47%) and musculoskeletal symptoms (47%); and Class 3 (n=103), minimal symptoms. Most participants remained in Class 3 across follow-up. Recovery from Class 2 to Class 3 was more frequent than recovery from Class 1 (35% vs 25%).
Conclusions:
Two years after acute infection, post–COVID-19 condition has a lasting impact on quality of life, with fatigue and memory loss remaining common post-COVID symptoms. Most recovery occurred within the first year, suggesting a critical window for improvement. LCA identified three distinct profiles: minimal symptoms, fatigue-dominant, and multisystem burden. These findings highlight the heterogeneous long-term course of post–COVID-19 condition and the need for targeted strategies to address high-burden trajectories that may compromise quality of life.
Authors:
Author - Mamadou Sy , M.D., MSPH, Department of Global and Community Health, George Mason University, Fairfax, VA, United States.
Co-Author - Ali A. Weinstein, Ph.D, Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States. Department of Global and Community Health, George Mason University, Fairfax, VA, United States.
Co-Author - Rodman Turpin, PhD, MS, Department of Global and Community Health, George Mason University, Fairfax, VA, United States.
Co-Author - Leyla de Avila, B.A, Beatty Liver and Obesity Research Program, Inova Fairfax Medical Campus, Falls Church, VA, United States.
Co-Author - Lynn H. Gerber, M.D., Beatty Liver and Obesity Research Program, Inova Fairfax Medical Campus, Falls Church, VA, United States.
Co-Author - Zobair M. Younossi , M.D., M.P.H, Beatty Liver and Obesity Research Program, Inova Fairfax Medical Campus, Falls Church, VA, United States.
How Perceived Life Chaos, Occupational, and Household Factors Are Associated with Sleep Disturbance in Firefighters
Poster Number: C134Time: 05:00 PM - 05:50 PM
Topics: Sleep
Firefighters routinely encounter unpredictable and volatile situations. However, it remains unclear whether subjective perceptions of chaos or objective occupational and household conditions are more strongly associated with sleep disruption. Identifying specific factors associated with sleep disturbance can help develop targeted sleep interventions for this population. This study investigated how perceived life chaos and objective occupational and household characteristics relate to sleep disturbance among firefighters. We hypothesized that perceived life chaos would be more strongly associated with sleep disturbance than occupational and household factors. The Sleep Assistance for Firefighters (SAFFIRE) study surveyed a sample of (N=314) Arizona firefighters on their sleep disturbance from the PROMIS Sleep Disturbance short-form (version 8b), along with questions on occupation and household. Occupational factors included rank, call volume, overtime, and years in the fire service. Household factors included marital status, presence of a bed partner, household size, annual income, and secondary employment. Perceived life chaos was measured using a modified 4-item version of the Chaos, Hubbub, and Order Scale. Backward selection was used to identify variables most strongly associated with sleep disturbance. Consistent with our hypothesis, perceived life unpredictability (B = 0.55, SE = 0.17, p = 0.002) was significantly associated with sleep disturbance. Although being never married (B = -1.72, SE = 0.91, p = 0.06) and household income (B = -0.68, SE = 0.36, p = 0.06) did not reach statistical significance, they were retained in the final model due to theoretical relevance. No other objective occupational or household factors were significant predictors. In conclusion, perceived life chaos emerged as a key contributor to sleep disturbance among firefighters, exceeding the influence of sleep-disruptive occupational and household factors. These findings suggest that sleep interventions should prioritize strategies aimed at reducing perceived uncertainty and disorganization to improve firefighter sleep health.
Keywords: Abnormal sleep, Worksite healthAuthors:
Author - Ashley Bohan, BS, The University of Arizona
Co-Author - John Sy, PhD, The University of Arizona
Co-Author - Madeleine McDonough, BS, The University of Arizona
Co-Author - Matthew Lujan, PhD, The University of Arizona
Co-Author - Erin Rael, BA, The University of Arizona
Co-Author - Dana Epstein, PhD, Arizona State University
Co-Author - Daniel Taylor, PhD, The University of Arizona
Co-Author - Matthew Buman, PhD, Arizona State University
Co-Author - Michael Grandner, PhD, The University of Arizona
Co-Author - David Glickenstein, PhD, The University of Arizona
Co-Author - Patricia Haynes, PhD, The University of Arizona
Sleep Health in Black Female Breast Cancer Survivors Participating in a Pilot Behavioral Weight Loss Intervention Study
Poster Number: C135Time: 05:00 PM - 05:50 PM
Topics: Sleep, Cancer
Sleep duration is critically important for Black American breast cancer survivors as it intersects with cancer recovery, overall health, and racial disparities in outcomes. Specifically, poor sleep disrupts hormonal regulation and metabolism, increasing risk for weight gain and obesity, which are linked to breast cancer recurrence and mortality. In this single-arm pilot study, adult breast cancer survivors with obesity (n=20) participated in a 16-session, culturally targeted, stress management-enhanced behavioral weight loss intervention adapted for cancer-relevancy. The “Survivors RESET” intervention is based on a culturally modified DPP-based lifestyle curriculum augmented with stress management strategies. Participants were Non-Hispanic Black women (mean age 57.9 years, mean BMI 37.1 kg/m²) with a history of stage 0–3 breast cancer treated with curative intent. Data collected at baseline and post-intervention were analyzed using matched-pairs t-tests. Following the intervention, participants achieved weight loss of 2.36 kg (p=.006). Baseline self-reported sleep duration averaged 7.63 (±1.59) hours on weekdays and 8.36 (±1.75) hours on weekends, with no change post-intervention. Weekly sleep duration varied between 5 and 10.5 hours, with 20% of participants classified as short sleepers (<7 hours of sleep). Self-assessed chronotype was an overall average of 3.05±1.48, which suggests a moderate to slightly late chronotype on average, with individual variation spanning from somewhat early to fairly late sleepers. The average sleep health score (SATED sleep scale) was 13.7 out of 28, indicating good sleep health and 12 participants had improved scores following the intervention period. Regarding weight loss, there was a moderate, positive correlation between baseline sleep duration and weight loss during the intervention (Pearson's r = 0.457, p = 0.045, 95% CI: 0.018 to 0.748). While sleep duration was not changed by this intervention, the majority of participants fell within the recommended range of sleep hours. Findings suggest that longer sleep duration may be associated with greater weight loss outcomes, potentially due to improved metabolic regulation or behavioral adherence. As sleep is a modifiable factor, further research with larger sample sizes is needed to explore this relationship and to better understand how sleep health influences weight loss and other outcomes relevant to cancer recurrence and quality of life.
Keywords: Cancer survivorship, Weight lossAuthors:
Author - Vivian Doerr, PhD, H. Lee Moffitt Cancer Center
Co-Author - Ashley Cooper, PhD, H. Lee Moffitt Cancer Center
Co-Author - Khaliah Fleming, EdD, MPH, H. Lee Moffitt Cancer Center
Co-Author - Sierra Pittman, H. Lee Moffitt Cancer Center
Co-Author - Jazmin Henderson, H. Lee Moffitt Cancer Center
Co-Author - Alissa Pena, H. Lee Moffitt Cancer Center
Co-Author - Heather Jim, PhD, FSBM, H. Lee Moffitt Cancer Center
Co-Author - Adana Llanos, PhD MPH, Columbia University
Co-Author - Melissa Mallory, MD FACS, H. Lee Moffitt Cancer Center
Co-Author - Lauren McCullough, PhD MSPH, Emory University
Co-Author - Dayna Johnson, PhD, Emory University
Co-Author - Tiffany Carson, PhD, MPH, FSBM, H. Lee Moffitt Cancer Center & Research Institute
Catching ZZZ’s on the Weekends: The Role of Screen Time and Caffeine Consumption on Social Jetlag
Poster Number: C136Time: 05:00 PM - 05:50 PM
Topics: Sleep, Child and Family Health
Introduction
Adolescence is marked by a change in sleep timing, notably a shift to a later chronotype. Chronotype is an individual’s natural preference for sleep and wake times based on their internal circadian rhythm. When faced with early school start times, this shift can lead to oversleeping on the weekends, known as social jetlag. Daily habits may help mitigate the severity of social jetlag, but little is known about these associations. The current study aimed to examine the relation between social jetlag and certain daily habits such as TV usage, social media usage, and caffeine consumption.
Method
A sample of adolescents (n = 47; Mage = 14.7, SDage = 1.05; 55.1% Female; 31.3% African American; 6.3% Asian; 31.2% Other; 4.2% Pacific Islander; 27% White) living in a Midwestern urban area were recruited to participate in a sleep health study. The Munich ChronoType Questionnaire (MCTQ) was administered to assess chronotype and social jetlag (i.e., the discrepancy between sleep-wake schedule on weekdays versus weekends). Using midsleep times from the MCTQ, chronotypes were characterized as early “lark” (<3:00am), late “owl” (>5:00am), or intermediate “neither” (3:00-5:00am). Sleep diaries were also completed for seven days which included self-report of TV and social media usage and caffeine consumption.
Results
The majority of adolescents endorsed an intermediate chronotype (46.9%) while the remaining were an early (18.4%) or a late chronotype (34.7%). Social jetlag was 2.6 hours on average (sd = 1.56). Over one week, adolescents watched an average of 57.8 minutes of TV (sd = 59.9), spent 114.2 minutes on social media (sd = 96.0), and consumed 1.1 caffeinated beverages (sd = 1.79). Hierarchical regressions indicated that TV usage related to social jetlag above and beyond caffeine consumption (ΔR = .154, F(41, 40) = 3.89, p = .029); however, neither caffeine consumption nor social media usage were significantly related to social jetlag.
Conclusion
Findings suggest that this sample of adolescents are intermediate chronotypes and experience a significant social jetlag. Thus, interventions can focus on reducing TV usage to help decrease social jetlag. Future analyses should explore whether the amount of screen time, with emphasis on TV usage, and/or caffeine consumption affects social jetlag differently over the course of adolescence.
Keywords: Adolescents, Abnormal sleepAdolescence is marked by a change in sleep timing, notably a shift to a later chronotype. Chronotype is an individual’s natural preference for sleep and wake times based on their internal circadian rhythm. When faced with early school start times, this shift can lead to oversleeping on the weekends, known as social jetlag. Daily habits may help mitigate the severity of social jetlag, but little is known about these associations. The current study aimed to examine the relation between social jetlag and certain daily habits such as TV usage, social media usage, and caffeine consumption.
Method
A sample of adolescents (n = 47; Mage = 14.7, SDage = 1.05; 55.1% Female; 31.3% African American; 6.3% Asian; 31.2% Other; 4.2% Pacific Islander; 27% White) living in a Midwestern urban area were recruited to participate in a sleep health study. The Munich ChronoType Questionnaire (MCTQ) was administered to assess chronotype and social jetlag (i.e., the discrepancy between sleep-wake schedule on weekdays versus weekends). Using midsleep times from the MCTQ, chronotypes were characterized as early “lark” (<3:00am), late “owl” (>5:00am), or intermediate “neither” (3:00-5:00am). Sleep diaries were also completed for seven days which included self-report of TV and social media usage and caffeine consumption.
Results
The majority of adolescents endorsed an intermediate chronotype (46.9%) while the remaining were an early (18.4%) or a late chronotype (34.7%). Social jetlag was 2.6 hours on average (sd = 1.56). Over one week, adolescents watched an average of 57.8 minutes of TV (sd = 59.9), spent 114.2 minutes on social media (sd = 96.0), and consumed 1.1 caffeinated beverages (sd = 1.79). Hierarchical regressions indicated that TV usage related to social jetlag above and beyond caffeine consumption (ΔR = .154, F(41, 40) = 3.89, p = .029); however, neither caffeine consumption nor social media usage were significantly related to social jetlag.
Conclusion
Findings suggest that this sample of adolescents are intermediate chronotypes and experience a significant social jetlag. Thus, interventions can focus on reducing TV usage to help decrease social jetlag. Future analyses should explore whether the amount of screen time, with emphasis on TV usage, and/or caffeine consumption affects social jetlag differently over the course of adolescence.
Authors:
Author - Kalika Ivaturi, Loyola University Chicago, Department of Psychology, Chicago Illinois, USA.
Co-Author - Julianna Adornetti, BA, Loyola University Chicago, Department of Psychology, Chicago Illinois, USA.
Co-Author - Stephanie Crowley, PhD, Biological Rhythms Research Laboratory, Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago Illinois, USA.
Co-Author - Amy Bohnert, PhD, Loyola University Chicago, Department of Psychology, Chicago Illinois, USA.
The Cost of Self-Reliance: Firefighters' Perspectives Toward Sleep Coaching
Poster Number: C137Time: 05:00 PM - 05:50 PM
Topics: Sleep
Sleep coaching, based on Cognitive Behavioral Therapy for Insomnia (CBTi), may be an effective intervention for sleep problems for firefighters. However, little is known about how firefighters perceive such coaching. Given that self-reliance is linked to lower intentions to seek professional help, this study examined the relationship between self-reliance, stigma towards sleep coaching, and perceptions of its effectiveness. Participants included firefighters (N = 314) from 20 Arizona fire agencies, recruited through the Sleep Assistance for Firefighters (SAFFIRE) study. They completed a survey assessing self-reliance, stigma towards sleep coaching, and its perceived effectiveness, which was adapted from the Determinants of Mental Health Treatment Seeking questionnaire. While controlling for age and years of service, multiple regression analyses were conducted to assess whether self-reliance predicted stigma and perceived effectiveness of sleep coaching. Results indicated that firefighters with more self-reliance had higher stigma towards sleep coaching (B = 0.68, SE = 0.11, p <.001, R2 = 0.12). They were also less likely to view sleep coaching as an effective intervention (B = -0.75, SE = 0.08, p <.001, R2 = 0.23). Our findings indicated that self-reliance is negatively associated with firefighters’ perceptions of sleep coaching. Addressing self-reliant tendencies by encouraging help-seeking behaviors may reduce stigma associated with sleep interventions and increase their adoption among firefighters.
Keywords: Abnormal sleep, Worksite healthAuthors:
Co-Author - Erin Rael, BA, The University of Arizona
Author - Madeleine McDonough, BS, The University of Arizona
Co-Author - John Richmond Sy, PhD, The University of Arizona
Co-Author - Ashley Bohan, BS, The University of Arizona
Co-Author - Dana Epstein, PhD, Arizona State University
Co-Author - Matthew Buman, PhD, FSBM, Arizona State University
Co-Author - Daniel Taylor, PhD, The University of Arizona
Co-Author - Michael Grandner, PhD, The University of Arizona
Co-Author - David Glickenstein, PhD, The University of Arizona
Co-Author - Patricia Haynes, PhD, The University of Arizona
Differences in Sleep Disturbance across Sleep Practice Profiles of Shiftworking Firefighters
Poster Number: C138Time: 05:00 PM - 05:50 PM
Topics: Sleep
Shiftworking firefighters experience chronic sleep disturbances, but very little is known about how they manage sleep difficulties. Therefore, the present study aimed to explore differences between sleep practices and sleep disturbance among firefighters. Shiftworking, career firefighters (N=290) from 20 different fire agencies in Arizona were administered a survey as part of the Sleep Assistance for Firefighters (SAFFIRE) study. Demographics, occupational factors, sleep practices from the Sleep Practices and Attitudes Questionnaire, and sleep disturbance from PROMIS-Sleep Disturbance short-form (version 8b) were collected. An exploratory factor analysis was used to group similar sleep practices together. Sleep practices were grouped into 1) staying in bed, 2) doing a productive activity (e.g., exercising, and doing chores), 3) doing a passive activity (e.g., listening to music, eating/drinking, and using a screened device), and 4) using alcohol and/or marijuana. A latent profile analysis classified firefighters into profiles based on shared sleep practice patterns. These were the Riser, Stay-in-Bed, and Substance-Use profiles. An ANCOVA compared mean sleep disturbance across profiles and firefighter rank while adjusting for years working nights and agency call volume. Sleep disturbance did not vary between sleep practice profiles. However, firefighter rank (F = 23.31, p <.001, ηp2 = 0.08) and its interaction with profiles (F = 3.57, p = 0.03, ηp2 = 0.03) were significantly associated with sleep disturbance. Managers with the Riser and Stay-in-Bed profiles experienced significantly less disturbance compared to managers with the Substance-Use profile and non-managerial staff regardless of sleep practice profile. Further research is needed to identify the role-specific factors contributing to sleep disturbance differences across firefighter ranks.
Keywords: Abnormal sleep, Worksite healthAuthors:
Author - John Richmond T. Sy, PhD, The University of Arizona
Co-Author - Josh Barnum, The University of Arizona
Presenter - Erin Rael, The University of Arizona
Co-Author - Dana Epstein, PhD, Arizona State University
Co-Author - Michael Grandner, PhD, University of Arizona
Co-Author - Daniel J. Taylor, PhD, The University of Arizona
Co-Author - Matthew P. Buman, PhD, Arizona State University
Co-Author - David A. Glickenstein, PhD, The University of Arizona
Co-Author - Patricia L. Haynes, PhD, University of Arizona
Priority Health Challenges and Socio-Ecological Determinants among South Asian Youth in the UAE: A Mixed-Methods Community Needs Assessment
Poster Number: C139Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health, Community Engagement
South Asian migrant youths in the UAE face elevated risks for non-communicable diseases and mental health challenges yet remain underrepresented in research. We aimed to (1) identify perceived health issues, difficult health behaviours and their sociodemographic associations, and (2) explore contextual factors shaping these perceptions. A sequential mixed-methods community-needs assessment was conducted with South Asians aged 18–25 who had lived in the UAE ≥10 years. A community-based participatory approach engaged youth co-researchers. Surveys captured sociodemographic characteristics, perceived health issues, and behavioural difficulties; interviews probed contextual influences. Quantitative analyses used multivariable logistic regression; qualitative data underwent content analysis. Among 150 participants: 79.1% female, 52.7% born outside the UAE and 51.4% from upper-middle socioeconomic status. Mental health conditions (81.3%) and cardiovascular/metabolic disorders (76.0%) were the top community concerns. Stress management (6.52 ± 2.46 out of 10) and physical activity (6.07 ± 2.33 out of 10), were perceived most difficult, with family (7.29 ± 1.89 out of 10) as the strongest socio-ecological influence. Adjusted models showed that higher acculturation was associated with perceiving stress management (AOR=3.58; 95%CI:1.44–9.94) and maintaining social relationships (AOR=2.87; 1.26–7.07) as challenges; greater religiosity with perceiving sleep (AOR=1.83; 1.15–3.02) and relationships (AOR=1.84; 1.09–3.33) as difficult; higher income with perceiving substance use as salient (AOR=2.66; 1.10–6.76), while greater religiosity reduced this perception (AOR=0.53; 0.31–0.86); and female sex with highlighting other conditions like anaemia or hormonal issues (AOR=3.51; 1.18–10.88). Qualitative themes revealed how acculturation stress, stigma and trivialisation of mental health, financial constraints, and normalisation of cardiometabolic conditions limited health-seeking and behaviour change. These findings highlight the importance of culturally tailored, family-centred interventions co-designed with youth, alongside workplace initiatives addressing overwork and job insecurity. Policy action can ensure affordable access to preventive and mental health services. Future research can establish the prevalence and psychosocial drivers of these challenges, assessing generational and acculturation differences, to inform multi-level responses for South Asian migrant youths.
Keywords: Participatory research, Minority healthAuthors:
Author - Razeena Sahrin, Health Services and Systems Research, Duke-NUS Medical School
Author - Zhong Chen Tan, New York University Abu Dhabi
Author - Moumita Chowdhury, MPH, School of Global Public Health, New York University
Presenter - Sian Auer, Yale School of Public Health
Author - Suman Ansari, New York University Abu Dhabi
Author - Shahmir H. Ali, PhD, National University of Singapore
Preliminary data to inform the development of an audiovisual tool to improve patient completion of at-home FIT-DNA tests for colorectal cancer screening
Poster Number: C14Time: 05:00 PM - 05:50 PM
Topics: Cancer, Health Communication and Policy
BACKGROUND: Stool-based colorectal cancer (CRC) tests reduce barriers to screening that disproportionately impact rural regions of the US. Our team developed and tested an audiovisual tool to help patients complete the fecal immunochemical test (FIT) and found it feasible and efficacious. Nevertheless, rural clinical partners prefer FIT-DNA over FIT because it requires less clinical support to implement, but patients still struggle with accurate completion. We thus sought to identify barriers to FIT-DNA completion, and CRC screening in general, among rural Kentucky residents, to inform the development of a new audiovisual tool specific to FIT-DNA completion.
METHODS: We conducted 3 focus groups with rural Kentucky residents between 45–75 years old. We asked participants about perceptions of CRC and CRC screening modalities, including barriers to completion. We then showed them (1) our FIT-specific tool and (2) FIT-DNA instructions to determine preferences and needs, and they completed a demographic survey with questions about screening behaviors. Audio files were transcribed by a professional service, and random sections were assessed for accuracy. Coding was conducted by two members of the team and iteratively refined via regular debriefing meetings.
RESULTS: Participants (N = 18; mean age = 55.6) had at least a bachelor’s degree (88.9%), were mostly female (77.8%), and had a household income of $100,000 or more (50%). All but one previously received a provider recommendation for CRC screening, and half received a stool-based test recommendation. Ten (55.6%) were screened via colonoscopy and the other seven (38.9%) via stool-based test. They stressed two major concerns about colonoscopy—(1) the preparation and (2) transportation for the procedure—and widely preferred stool-based screening. FIT-DNA instructions were perceived as more complex than FIT, and participants stressed the need for a start-stop button on the audiovisual tool to account for this complexity.
CONCLUSION: Rural Kentucky residents emphasized well-known socioenvironmental barriers to colonoscopy and strongly endorsed at home stool-based tests, such as FIT-DNA. To address perceived complexity of FIT-DNA, we plan to simplify instructional language and include a start-stop button for the audio component in our prototype model, which we will assess and refine via focus groups in Spring 2026.
Keywords: Cancer screening, Health communicationMETHODS: We conducted 3 focus groups with rural Kentucky residents between 45–75 years old. We asked participants about perceptions of CRC and CRC screening modalities, including barriers to completion. We then showed them (1) our FIT-specific tool and (2) FIT-DNA instructions to determine preferences and needs, and they completed a demographic survey with questions about screening behaviors. Audio files were transcribed by a professional service, and random sections were assessed for accuracy. Coding was conducted by two members of the team and iteratively refined via regular debriefing meetings.
RESULTS: Participants (N = 18; mean age = 55.6) had at least a bachelor’s degree (88.9%), were mostly female (77.8%), and had a household income of $100,000 or more (50%). All but one previously received a provider recommendation for CRC screening, and half received a stool-based test recommendation. Ten (55.6%) were screened via colonoscopy and the other seven (38.9%) via stool-based test. They stressed two major concerns about colonoscopy—(1) the preparation and (2) transportation for the procedure—and widely preferred stool-based screening. FIT-DNA instructions were perceived as more complex than FIT, and participants stressed the need for a start-stop button on the audiovisual tool to account for this complexity.
CONCLUSION: Rural Kentucky residents emphasized well-known socioenvironmental barriers to colonoscopy and strongly endorsed at home stool-based tests, such as FIT-DNA. To address perceived complexity of FIT-DNA, we plan to simplify instructional language and include a start-stop button for the audio component in our prototype model, which we will assess and refine via focus groups in Spring 2026.
Authors:
Presenter - Aaron Kruse-Diehr, Augusta University School of Public Health
Co-Author - Elizabeth Holtsclaw, The Coalition Coaches
Typology of leisure and social activities and different domains of subjective health in middle-aged and older adults living in rural versus urban areas
Poster Number: C140Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health
Objective: This study aims to identify types of leisure and social activities among middle-aged and older adults, estimate their association with subjective health, and test if these relationships were equivalent between rural and urban residents.
Methods: A total of 180 rural and urban middle-aged and older adults in Taiwan were recruited for this study. Data on 15 items of leisure and social activities, as well as four domains of subjective health: self-rated health, subjective mental age, subjective physical age, and loneliness were obtained. Exploratory factor analysis, path analysis, and multi-group analysis were employed.
Results: Four types of leisure and social activities were identified: group entertainment, social gatherings, hobbies, and volunteer or religious work. Among both rural and urban middle-aged and older adults, engaging in hobbies was associated with a younger subjective mental age (β = -0.897, p = .017, and β = -0.384, p = .007, respectively), and social gatherings were associated with lower loneliness (β = -0.386, p = .004, and β = -0.259, p = .009, respectively). Furthermore, urban residents who engaged in more social gatherings tended to have a younger subjective physical age, even when considering other types of activities (β = -0.375, p = .007).
Conclusions: Engaging in social gatherings and hobbies may be beneficial for subjective health in middle-aged and older adults. However, the positive effects of leisure and social activities on health should be interpreted within the rural-urban context.
Keywords: Health, Older adultsMethods: A total of 180 rural and urban middle-aged and older adults in Taiwan were recruited for this study. Data on 15 items of leisure and social activities, as well as four domains of subjective health: self-rated health, subjective mental age, subjective physical age, and loneliness were obtained. Exploratory factor analysis, path analysis, and multi-group analysis were employed.
Results: Four types of leisure and social activities were identified: group entertainment, social gatherings, hobbies, and volunteer or religious work. Among both rural and urban middle-aged and older adults, engaging in hobbies was associated with a younger subjective mental age (β = -0.897, p = .017, and β = -0.384, p = .007, respectively), and social gatherings were associated with lower loneliness (β = -0.386, p = .004, and β = -0.259, p = .009, respectively). Furthermore, urban residents who engaged in more social gatherings tended to have a younger subjective physical age, even when considering other types of activities (β = -0.375, p = .007).
Conclusions: Engaging in social gatherings and hobbies may be beneficial for subjective health in middle-aged and older adults. However, the positive effects of leisure and social activities on health should be interpreted within the rural-urban context.
Authors:
Author - Szu-Yu Hou, National Taiwan University
Author - Ching-Ju Chiu, PhD, National Cheng Kung University
Exploring Unhealthy Weight Management Behaviors in Emerging Adult Women: A Comparative Study between South Korea and Vietnam
Poster Number: C141Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health, Weight Related Health
Unhealthy Weight Management Behaviors (UWMB) are risky practices influenced not only by individual but also by structural factors, such as appearance-related social norms. Emerging adult women in Korea are particularly vulnerable to weight control pressures via social media due to high social media engagement. At a time when Korea's aesthetic standards, disseminated through digital content, are spreading to other countries, Vietnamese women—Korea's largest multicultural group and a population influenced by Korean culture—serve as a valuable comparative group for understanding how UWMB determinants manifest in different sociocultural contexts is crucial. As a preliminary step, this exploratory cross-sectional study compares the prevalence of UWMB among emerging adult women in Korea and Vietnam.
An online survey was conducted among 431 Vietnamese women aged 19–25, and findings were compared with secondary data from 1,594 Korean women. The Korean UWMB questionnaire was translated into Vietnamese using forward–backward translation. Participants were classified as engaging in UWMB if they reported at least one harmful weight control method, including fasting, restrictive dieting, consuming meal substitutes, skipping meals, excessive smoking, taking diet pills, vomiting, and using laxatives or diuretics. Descriptive statistics, chi-square tests, and t-tests were used for analysis.
In Korea, 88.0% of participants reported engaging in at least one UWMB during the past year. The most common behavior was eating very little food (91.0%), followed by skipping meals (51.3%) and taking diet pills (38.8%). In Vietnam, a lower prevalence of 80.5% was reported, with the most frequent behaviors being skipping meals (80.7%), eating very little food (65.4%), and taking diet pills (49.6%). Extreme UWMB were reported by 29.9% of Vietnamese participants compared with 36.9% in Korea.
This study confirmed that UWMB is a pervasive lifestyle among emerging adult women in both countries. Such practices are not merely transient behaviors but carry significant implications, as lifestyle patterns established during this life stage often persist into adulthood. The findings may serve as foundational data for future research to identify differences in UWMB determinants across cultural contexts. Addressing UWMB in the global era requires not only common approaches informed by cross-cultural exchange but also culturally specific strategies tailored to each country’s context.
Keywords: Weight control, Health behaviorsAn online survey was conducted among 431 Vietnamese women aged 19–25, and findings were compared with secondary data from 1,594 Korean women. The Korean UWMB questionnaire was translated into Vietnamese using forward–backward translation. Participants were classified as engaging in UWMB if they reported at least one harmful weight control method, including fasting, restrictive dieting, consuming meal substitutes, skipping meals, excessive smoking, taking diet pills, vomiting, and using laxatives or diuretics. Descriptive statistics, chi-square tests, and t-tests were used for analysis.
In Korea, 88.0% of participants reported engaging in at least one UWMB during the past year. The most common behavior was eating very little food (91.0%), followed by skipping meals (51.3%) and taking diet pills (38.8%). In Vietnam, a lower prevalence of 80.5% was reported, with the most frequent behaviors being skipping meals (80.7%), eating very little food (65.4%), and taking diet pills (49.6%). Extreme UWMB were reported by 29.9% of Vietnamese participants compared with 36.9% in Korea.
This study confirmed that UWMB is a pervasive lifestyle among emerging adult women in both countries. Such practices are not merely transient behaviors but carry significant implications, as lifestyle patterns established during this life stage often persist into adulthood. The findings may serve as foundational data for future research to identify differences in UWMB determinants across cultural contexts. Addressing UWMB in the global era requires not only common approaches informed by cross-cultural exchange but also culturally specific strategies tailored to each country’s context.
Authors:
Author - Chaehyeon Kang, MSN, RN, College of Nursing, Yonsei University
Author - Hyeonkyeong Lee, PhD, RN, FAAN, College of Nursing, Yonsei University
Co-Author - Jisu Lee, PhD, RN, College of Nursing, Yonsei University
Co-Author - Hyemi Sun, M.Ed., RN, College of Nursing, Yonsei University
Co-Author - Sun Young Shim, PhD, RN, College of Nursing, Yonsei University
Examining the Perceived Need of Chronic Disease Prevention Programming among Clergy-in-Training
Poster Number: C142Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health, Health Communication and Policy
BACKGROUND: Many faith leaders (i.e., clergy) report a high prevalence of preventable chronic diseases, partially attributable to strenuous vocational demands impacting lifestyle behaviors (e.g., physical activity, diet). Theological schools are trusted institutions that play a vital role in equipping the next generation of clergy, among other vocations; yet current and former theological students have reported they receive little health-related education or institutional support for living a healthy lifestyle. The literature examining chronic disease prevention-related needs among theological students is sparse, particularly how health-related needs may vary between students training to be clergy and non-clergy theological students. Thus, the purpose of this study was to compare the top five overall reported chronic disease-related needs among clergy-in-training and non-clergy students from nearly 68 schools across the United States and Canada. METHODS: In 2023-2024, students (N=423) identified health needs for school program development using a modified Midsouth Congregational Health Survey index. Chi-square tests and logistic regressions were used to examine differences in the top five needs by student classification (clergy-in-training vs. non-clergy students). RESULTS: Clergy-in-training and non-clergy students were: 39.3 years old (SD=12.9), female (50% vs 71%), White (71% vs 71%), active clergy (40% vs 7%), and married (58% vs 55%), respectively. The top five needs reported by clergy-in-training and non-clergy students were: stress (67% vs 63%), anxiety or depression (65% vs 61%), nutrition (50% vs 38%), physical activity (49% vs 37%), and health services (34% vs 29%), respectively. Chi-square tests indicated differences in two needs by student classification: physical activity (p=0.02) and nutrition (p=0.01). Multivariate logistic regressions revealed clergy-in-training were more likely to report physical activity (OR:2.03, 95% CI:1.17,3.53) and nutrition (OR:1.92, 95% CI:1.11,3.30) as needs compared to non-clergy students. CONCLUSIONS: Chronic disease prevention-related needs differed across theological students, indicating clergy-in-training may desire more education on preventive strategies to handle the demands of the clergy vocation. Future research is needed to better understand the barriers and facilitators of implementing theological school-based chronic disease prevention programming for clergy-in-training."
Keywords: Health promotion, Health educationAuthors:
Author - Nathan T. West, PhD, University of Alaska Anchorage
Co-Author - Benjamin L. Webb, PhD, Southern Illinois University Edwardsville
Co-Author - Karen Webster, DMin, ACSM-EP, Healthy Seminarians - Healthy Church
Co-Author - Travis Webster, ThD, LMFT, Healthy Seminarians - Healthy Church
Co-Author - Christopher M. The, MDiv, PhD, Association of Theological Schools in the United States and Canada
Bidirectional associations between daily stress, moderate-to-vigorous physical activity, and sedentary time in young and midlife adults.
Poster Number: C143Time: 05:00 PM - 05:50 PM
Topics: Stress, Physical Activity
Daily stress exposure is a potent cardiovascular disease (CVD) risk factor that may operate, in part, through time spent in cardioprotective behaviors. Increased frequency of exposure to daily stressors (e.g., argument with a partner, pressing work deadline) has been associated with reductions in same-day moderate-to-vigorous physical activity (MVPA) and increased sedentary-time (SEDT). However, our understanding of the associations between daily stressors, MVPA and SEDT, both within and across days, in young-to-middle-aged adults remains incomplete. To address this gap, we tested the extent to which days with daily stressors were associated with less MVPA and more SEDT and, conversely, the extent to which less MVPA and more SEDT were associated with next-day daily stressor occurrence. Thirty-six young-to-middle-aged adults [29 female; 39 ± 13yrs (range:18-55yrs)] completed 14 consecutive days of (1) daily mobile app-based surveys to assess daily stress processes and (2) simultaneous wrist accelerometry to measure MVPA and SEDT (>96% compliance). Concurrent and lagged associations between daily stressor exposure (yes/no), MVPA, and SEDT were examined bidirectionally using dynamic structural equation modeling. Participants reported daily stressors (yes) on 35% of days (5 ± 4 days over the 14-day sampling timeframe). Daily MVPA was 2.49 ± 1.25 hrs and daily SEDT was 11.68 ± 2.46 hrs. At the day level, there was a negative same-day correlation between daily stressor occurrence and SEDT (r = -0.311, 95% Bayesian credible interval (CrI) [-0.605, -0.008]), but no next-day associations. There was a positive association between MVPA and next-day daily stressor occurrence (β = 0.175, 95% CrI [0.032, 0.397]), but not between daily stressor occurrence and next-day MVPA. At the person level, daily stressor occurrence was positively correlated with MVPA (r = 0.362, 95% CrI [0.074, 0.829]), but not with SEDT. Contrary to our hypotheses, these preliminary data suggest that daily stressor occurrence is associated with less same-day SEDT, while greater MVPA is associated with the occurrence of a daily stressor on the following day. These findings suggest that bidirectional daily stress-behavior associations operate differently than anticipated across temporal scales. Future research should examine the extent to which daily stressor-related behavioral activation and activity-related alterations in stress represent adaptive mechanisms with implications for future CVD risk.
Keywords: Stress, Physical activityAuthors:
Presenter - Aaron Autler, MSW, University of Delaware
Co-Author - Sun Ah Lee, PhD, The Pennsylvania State University
Co-Author - Virginia Nuckols, PhD, University of Delaware
Co-Author - Madison Evering , BS, University of Delaware
Co-Author - Freda Patterson, PhD, University of Delaware
Co-Author - David Almeida, PhD, The Pennsylvania State University
Co-Author - Jody Greaney, PhD, University of Delaware
Sequential screening for psychological distress in glaucoma clinics using AI-assisted methods
Poster Number: C144Time: 05:00 PM - 05:50 PM
Topics: Stress, Digital Health
Background: Psychological distress is common in glaucoma, with up to 30% of patients experiencing clinically significant anxiety or depression. Distress is linked to poorer adherence, worse vision-related quality-of-life, and faster disease progression. Yet distress is rarely assessed in ophthalmology clinics due to workflow, cost, and training barriers. We developed and prospectively validated an artificial intelligence (AI)-assisted sequential screening approach to detect distress while reducing burden.
Methods: We used the Duke Ophthalmic Registry (DOR), comprising >3,000 patients with primary open-angle glaucoma (POAG), to train a neural network model predicting an electronic health record (EHR)-derived phenotype of distress (“silver standard”). We then prospectively validated this model in 300 POAG patients with gold-standard outcomes from the 8-item Patient Health Questionnaire (PHQ-8). We compared three strategies against PHQ-8: (1) PHQ-2 alone (two-item screener requiring universal administration), (2) AI model alone (fully automated, EHR-based), and (3) sequential approach where the AI model was applied first and only high-risk patients completed the PHQ-2. Strategies were evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and screening burden.
Results: Distress prevalence was 17% by PHQ-8. PHQ-2 alone achieved high sensitivity (0.96) but lower specificity (0.73) and modest PPV (0.41). The AI-only model was more specific (0.80) but less sensitive (0.68), with PPV of 0.40. The sequential approach reduced PHQ-2 administration to ~25% of patients, with specificity 0.93, sensitivity 0.64, PPV 0.64, NPV 0.93, and accuracy 0.88. In practical terms, three of four patients were spared additional screening while the strategy still correctly identified most distressed patients.
Conclusions: Sequential screening using AI-assisted prediction plus targeted brief assessment represents a scalable method for integrating behavioral health into glaucoma care. Leveraging existing EHR data reduces burden while maintaining detection accuracy. Importantly, this framework aligns with broader precision behavioral medicine goals by enabling earlier identification of vulnerable patients, supporting timely referral, and improving continuity of psychosocial care in specialty settings.
This abstract was prepared with assistance from AI-based writing tools; all content was reviewed and finalized by the authors.
Keywords: Screening, StressMethods: We used the Duke Ophthalmic Registry (DOR), comprising >3,000 patients with primary open-angle glaucoma (POAG), to train a neural network model predicting an electronic health record (EHR)-derived phenotype of distress (“silver standard”). We then prospectively validated this model in 300 POAG patients with gold-standard outcomes from the 8-item Patient Health Questionnaire (PHQ-8). We compared three strategies against PHQ-8: (1) PHQ-2 alone (two-item screener requiring universal administration), (2) AI model alone (fully automated, EHR-based), and (3) sequential approach where the AI model was applied first and only high-risk patients completed the PHQ-2. Strategies were evaluated using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and screening burden.
Results: Distress prevalence was 17% by PHQ-8. PHQ-2 alone achieved high sensitivity (0.96) but lower specificity (0.73) and modest PPV (0.41). The AI-only model was more specific (0.80) but less sensitive (0.68), with PPV of 0.40. The sequential approach reduced PHQ-2 administration to ~25% of patients, with specificity 0.93, sensitivity 0.64, PPV 0.64, NPV 0.93, and accuracy 0.88. In practical terms, three of four patients were spared additional screening while the strategy still correctly identified most distressed patients.
Conclusions: Sequential screening using AI-assisted prediction plus targeted brief assessment represents a scalable method for integrating behavioral health into glaucoma care. Leveraging existing EHR data reduces burden while maintaining detection accuracy. Importantly, this framework aligns with broader precision behavioral medicine goals by enabling earlier identification of vulnerable patients, supporting timely referral, and improving continuity of psychosocial care in specialty settings.
This abstract was prepared with assistance from AI-based writing tools; all content was reviewed and finalized by the authors.
Authors:
Presenter - Samuel Berchuck, PhD, Duke University
Co-Author - Youngsoo Baek, Duke University
Co-Author - Natalie Chou, Duke University
Co-Author - Hannah Fisher, Duke University School of Medicine
Co-Author - Eun Young Choi, Kaiser Permanente, Santa Clara Homestead Medical Center
Co-Author - Kelly Muir, Duke Eye Center
Co-Author - Davina Malek, Bascom Palmer Eye Institute
Co-Author - Alessandro Jammal, Mass Eye and Ear
Co-Author - Felipe Medeiros, Bascom Palmer Eye Institute
Co-Author - Tamara Somers, PhD, Duke University
Religion, Spirituality, and Social Support in Coping with Work Stress Among African Immigrant Nurses: An Integrative Review
Poster Number: C145Time: 05:00 PM - 05:50 PM
Topics: Stress, Mental Health
Objectives: Nursing is a demanding profession, often characterized by high workloads, limited autonomy, and inadequate support. Immigrant nurses face additional stressors, including discrimination, language barriers, and acculturation challenges, which can negatively affect their mental health and contribute to burnout, ultimately impacting patient care. Despite these concerns, limited research exists on African immigrant nurses and their coping strategies for work-related stress. This integrative review explores how workplace stressors, along with religion/spirituality and social support, influence the mental health of African immigrant nurses.
Methods: A comprehensive literature review was conducted using Whittemore and Knafl's integrative review methodology across PubMed, CINAHL, Scopus, and PsycINFO, with no restrictions on publication date. The summary of the search result was presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart.
Results: From an initial pool of 540 articles, seven studies met the inclusion criteria. Four studies were conducted in the United Kingdom and included participants, primarily from Africa, Asia, and the Caribbean. Across studies, immigrant nurses reported high levels of workplace discrimination, job stress, bullying, devaluation of their skills, and unfair treatment. African immigrant nurses, in particular, reported higher stress levels than other immigrant groups. Many relied on their religious practices to manage, endure, or reframe these challenges.
Conclusions: African immigrant nurses are at a greater risk of mental health challenges compared to their White counterparts, primarily due to discriminatory behaviors and insufficient support. Addressing these issues can improve teamwork, foster a trusting environment, and enhance the mental well-being of African immigrant nurses, ultimately leading to better patient health outcomes.
Keywords: Occupational health, Religion/SpiritualityMethods: A comprehensive literature review was conducted using Whittemore and Knafl's integrative review methodology across PubMed, CINAHL, Scopus, and PsycINFO, with no restrictions on publication date. The summary of the search result was presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart.
Results: From an initial pool of 540 articles, seven studies met the inclusion criteria. Four studies were conducted in the United Kingdom and included participants, primarily from Africa, Asia, and the Caribbean. Across studies, immigrant nurses reported high levels of workplace discrimination, job stress, bullying, devaluation of their skills, and unfair treatment. African immigrant nurses, in particular, reported higher stress levels than other immigrant groups. Many relied on their religious practices to manage, endure, or reframe these challenges.
Conclusions: African immigrant nurses are at a greater risk of mental health challenges compared to their White counterparts, primarily due to discriminatory behaviors and insufficient support. Addressing these issues can improve teamwork, foster a trusting environment, and enhance the mental well-being of African immigrant nurses, ultimately leading to better patient health outcomes.
Authors:
Author - Kelly Nkengafac, BSN, University of Alabama at Birmingham
Co-Author - Julie Schexnayder, PhD, DNP, MPH, University of Alabama at Birmingham
Co-Author - Deborah Ejem, PhD, MA, University of Alabama at Birmingham
Satisfaction in SUD Care: Who feels supported?
Poster Number: C146Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, Implementation Science
Abstract
Background: Parental substance use is a common and treatable occurrence, with approximately 1 in 4 U.S. children living with at least one parent who has a substance use disorder. Although parents frequently engage in treatment, little is known about how individual characteristics, such as substance use severity and psychopathology, shape treatment satisfaction, a key indicator of engagement and recovery. Understanding parent perspectives is essential, given their dual roles as caregivers and clients.
Methods: This mixed-methods study examined whether substance use severity and psychopathology were associated with self-reported treatment satisfaction among parents accessing substance use disorder services in the Pacific Northwest. Multilevel models were estimated using survey responses from 406 parents across 23 organizations. To complement these analyses, open-ended responses from parents with lower satisfaction scores (<4) were thematically analyzed to identify unmet needs and service improvement priorities.
Results: Preliminary results indicate contrary to our hypothesis, substance use risk was not significantly associated with satisfaction ratings (β = –0.02, 95% CI [–0.12, 0.08], p = .73 ). However, higher levels of psychopathology were negatively associated with treatment satisfaction when adjusting for age and household income. This relationship held across service settings, suggesting a consistent association between psychopathology and perceived care quality (β01= -0.08, 95% C.I. [-.15, -0.01], p <0.05,). Qualitative findings contextualized these results with parents describing dissatisfaction stemming from rigid compliance policies, stigmatizing staff interactions, and lack of family-centered supports such as childcare, flexible scheduling, and housing assistance.
Conclusions: These findings highlight the importance of centering parent perspectives to inform more responsive treatment services and underscore the need for nuanced approaches to understanding experiences and satisfaction in substance use disorder treatment setting.
Keywords: Substance abuse, Co-morbidityBackground: Parental substance use is a common and treatable occurrence, with approximately 1 in 4 U.S. children living with at least one parent who has a substance use disorder. Although parents frequently engage in treatment, little is known about how individual characteristics, such as substance use severity and psychopathology, shape treatment satisfaction, a key indicator of engagement and recovery. Understanding parent perspectives is essential, given their dual roles as caregivers and clients.
Methods: This mixed-methods study examined whether substance use severity and psychopathology were associated with self-reported treatment satisfaction among parents accessing substance use disorder services in the Pacific Northwest. Multilevel models were estimated using survey responses from 406 parents across 23 organizations. To complement these analyses, open-ended responses from parents with lower satisfaction scores (<4) were thematically analyzed to identify unmet needs and service improvement priorities.
Results: Preliminary results indicate contrary to our hypothesis, substance use risk was not significantly associated with satisfaction ratings (β = –0.02, 95% CI [–0.12, 0.08], p = .73 ). However, higher levels of psychopathology were negatively associated with treatment satisfaction when adjusting for age and household income. This relationship held across service settings, suggesting a consistent association between psychopathology and perceived care quality (β01= -0.08, 95% C.I. [-.15, -0.01], p <0.05,). Qualitative findings contextualized these results with parents describing dissatisfaction stemming from rigid compliance policies, stigmatizing staff interactions, and lack of family-centered supports such as childcare, flexible scheduling, and housing assistance.
Conclusions: These findings highlight the importance of centering parent perspectives to inform more responsive treatment services and underscore the need for nuanced approaches to understanding experiences and satisfaction in substance use disorder treatment setting.
Authors:
Author - Maya Casper, MPH, University of Oregon
Co-Author - Camille Cioffi, PhD, University of Oregon
Co-Author - Leslie Leve, PhD, University of Oregon
Understanding Stress as a Modifiable Risk Factor for Poverty Related Disparities in Substance Use, a Nationally Representative, Longitudinal Study from Adolescence to Adulthood
Poster Number: C147Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, Stress
Background: The underlying mechanism driving the relationship between poverty and higher substance use rates remains unclear.1 We explore one theoretically important mediator linking poverty to substance use: stress. Poverty may be associated with increased stress levels, which may acquiesce to substance use as a maladaptive coping mechanism.
Methods: Data were from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a cohort spanning 1994-95 (Wave I) to 2016-18 (Wave V) (n= 7,873-7,902 , depending on substance). We performed generalized structural equation models to assess hypothesized serial mediation between our exposure, adolescent poverty (dichotomized as Yes/No); our 1st mediator: poverty in early adulthood (Yes/No, Wave IV); our 2nd mediator: perceived stress (continuous, using Cohen’s 4-item Perceived Stress Scale; Wave IV); and our outcome: past 30 day illicit substance use (Any/None, Wave V). Sensitivity analyses helped determine whether associations differed by type of substance. Models included survey weights and age, sex, race, education, parental education, and illicit substance use in adolescence as covariates.
Results: We found no evidence for a significant total effect between adolescent poverty, early adult poverty, perceived stress, and use of any illicit substance later in life. However, we did find a total effect between adolescent poverty and prescription painkiller use once direct and indirect pathways were considered (Adjusted Odds Ratio (AOR): 1.48; 95% Confidence Interval (95% CI): 1.09-2.00). We also found evidence for serial mediation between adolescent poverty, poverty in adulthood, stress, and any illicit substance use (AOR: 1.07, 95% CI: 1.03-1.11), such that adolescent poverty was associated with higher odds of adult poverty (AOR: 2.33, p<0.01), which was subsequently associated with higher perceived stress (β = 0.48, p<0.01), which in turn was associated with higher odds of any illicit substance use (AOR: 1.17, p<0.01). Serial mediation was also found for prescription tranquilizer (AOR: 1.14; 95% CI: 1.06-1.23), stimulant (AOR: 1.07; 95% CI: 1.00-1.14), painkiller (AOR: 1.05, 95% CI: 1.00-1.10), and sedative use (AOR: 1.10; 95% CI: 1.02- 1.19) not as prescribed, in separate models.
Conclusion: Experiencing poverty across life stages is indirectly associated with greater stress levels, and in turn, higher odds of illicit substance use later in life. Findings underscore the importance of addressing poverty to curb substance use and stress’ role as a modifiable risk factor for more proximal intervention efforts.
Keywords: Substance abuse, StressMethods: Data were from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a cohort spanning 1994-95 (Wave I) to 2016-18 (Wave V) (n= 7,873-7,902 , depending on substance). We performed generalized structural equation models to assess hypothesized serial mediation between our exposure, adolescent poverty (dichotomized as Yes/No); our 1st mediator: poverty in early adulthood (Yes/No, Wave IV); our 2nd mediator: perceived stress (continuous, using Cohen’s 4-item Perceived Stress Scale; Wave IV); and our outcome: past 30 day illicit substance use (Any/None, Wave V). Sensitivity analyses helped determine whether associations differed by type of substance. Models included survey weights and age, sex, race, education, parental education, and illicit substance use in adolescence as covariates.
Results: We found no evidence for a significant total effect between adolescent poverty, early adult poverty, perceived stress, and use of any illicit substance later in life. However, we did find a total effect between adolescent poverty and prescription painkiller use once direct and indirect pathways were considered (Adjusted Odds Ratio (AOR): 1.48; 95% Confidence Interval (95% CI): 1.09-2.00). We also found evidence for serial mediation between adolescent poverty, poverty in adulthood, stress, and any illicit substance use (AOR: 1.07, 95% CI: 1.03-1.11), such that adolescent poverty was associated with higher odds of adult poverty (AOR: 2.33, p<0.01), which was subsequently associated with higher perceived stress (β = 0.48, p<0.01), which in turn was associated with higher odds of any illicit substance use (AOR: 1.17, p<0.01). Serial mediation was also found for prescription tranquilizer (AOR: 1.14; 95% CI: 1.06-1.23), stimulant (AOR: 1.07; 95% CI: 1.00-1.14), painkiller (AOR: 1.05, 95% CI: 1.00-1.10), and sedative use (AOR: 1.10; 95% CI: 1.02- 1.19) not as prescribed, in separate models.
Conclusion: Experiencing poverty across life stages is indirectly associated with greater stress levels, and in turn, higher odds of illicit substance use later in life. Findings underscore the importance of addressing poverty to curb substance use and stress’ role as a modifiable risk factor for more proximal intervention efforts.
Authors:
Author - David C. Colston, MPH, University of North Carolina - Chapel Hill
Co-Author - Taylor W. Hargrove, PhD, University of Maryland
Co-Author - Marissa G. Hall, PhD, University of North Carolina - Chapel Hill
Co-Author - Kathryn E. Moracco, PhD, University of North Carolina - Chapel Hill
Co-Author - Chantel L. Martin, PhD, UNC Chapel Hill
Co-Author - Vivian F. Go, PhD, University of North Carolina - Chapel Hill
Single-Item Screening for Substance Use in Primary Care: An Investigation
Poster Number: C148Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, Integrated Primary Care
Efforts to promote widespread implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) have been hampered by a lack of training and available resources, including personnel and time. As a result, recently considerable attention has been paid to developing screening tools that, while brief, maintain their level of sensitivity. One such example is the recently developed NIDA single-item screen. Validation of this “instrument” has provided clinicians with another tool however concerns about sensitivity continue. As part of a large SAMHSA-funded project, universal screening featuring the NIDA single item screen was introduced into a large, urban primary care setting in late fall of 2024. In this session, we will describe the findings from this project. Through the first eight months of implementation, 7.1% of the over 3,500 primary care patients screened responded positively. Interestingly, that number does appears to fall below previously observed rates of positivity observed across a variety of primary care settings (15-25%), supporting earlier findings about sensitivity of the single item. This finding led us to examine whether we could identify descriptive factors that might be predictive of the probability of a positive screen. To address this question, age, sex, social determinants of health (SDOH), and a geo-coded deprivation index (ADI) were introduced into a multiple logistic regression. Results indicated that age in years (b= -.03, p < 0.001, OR=0.98), sex (b=-.78, p < 0.001, OR=0.46), and social determinants of health (b= 1.41,p < 0.001, OR=3.05) were significant predictors of a positive screen. Individuals were more likely to screen positive if they were younger, male, or flagged for SDOH. While the use of the NIDA single item screen did not yield the number of positive findings that a more time intensive screening process might have, the fact that a number of individuals at risk were identified and offered services should not be overlooked. Implications of these findings as they relate to widescale SBIRT implementation and the need for continued education on responding to the needs of individuals misusing substances will be considered.
Keywords: Substance abuse, ScreeningAuthors:
Author - Robert Sterling, PhD, Drexel University
Presenter - Lauren Kairys, MS, LAPC, Drexel University
Co-Author - William Leach, MS, Thomas Jefferson University
Co-Author - Anna Flattau, MD MSc MS FAAFP, Jefferson Health / Thomas Jefferson University
Co-Author - Jessica Chou, PhD, LPC, LMFT, Drexel University
Co-Author - Rikki Patton, PhD, MFT, Drexel University
Co-Author - Margaret Dickinson, MS, LAPC, Drexel University
Social Networks, Loneliness, and Connectedness in Perinatal Women with Opioid Use Disorder
Poster Number: C149Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, Social and Environmental Context and Health
Background: Perinatal women with opioid use disorder face significant challenges, including social isolation and loneliness, which can negatively impact recovery and well-being. This study aimed to assess the social network characteristics associated with loneliness and connectedness among a sample of pregnant and postpartum women in recovery.
Methods: In-depth interviews assessed perinatal women’s (i.e., egos; n=12; Mage=31.7 years±4.01) egocentric networks using a concentric circle model. Egos indicated network members (i.e., alters) at three levels: (1) core alters, (2) close social contacts, and (3) more distant yet regular contacts within personal networks, resulting in 53 alters across 12 egos. We measured participant demographics, opioid use history, and self-reported loneliness and connectedness among egos. Among alters, we assessed frequency of contact with ego, perceived support from alter to ego, consistency of support from alter to ego, and relationship to ego. Correlation analyses examined the relationships between network variables and loneliness and connectedness.
Results: Several network characteristics were identified as potentially protective against perinatal loneliness. Specifically, having daily contact with a higher number of alters (r=−0.40), more overall support from alters (r=−0.40), more consistent support from alters (r=−0.32), and the presence of mentors/sponsors (r=−0.28), significant others (r=−0.37), and healthcare providers (r=−0.34) in the network were negatively correlated with loneliness. Conversely, having a greater proportion of Level 3 alters (r=0.26) was positively correlated with loneliness. Regarding connectedness, positive correlations were found with larger networks (r=0.33), more support from alters (r=0.31), consistent support from alters (r=0.21) and having friends (r=0.35) and mentors/sponsors (r=0.39) in the network.
Conclusion: The findings suggest that network composition as well as quality and consistency of support are critical factors influencing loneliness and connectedness during this unique time. Interventions that promote consistent support, foster relationships with professionals, and increase the frequency of network contact may be effective in reducing loneliness and enhancing social connection for pregnant and postpartum women in recovery.
Keywords: Pregnancy, Social network analysisMethods: In-depth interviews assessed perinatal women’s (i.e., egos; n=12; Mage=31.7 years±4.01) egocentric networks using a concentric circle model. Egos indicated network members (i.e., alters) at three levels: (1) core alters, (2) close social contacts, and (3) more distant yet regular contacts within personal networks, resulting in 53 alters across 12 egos. We measured participant demographics, opioid use history, and self-reported loneliness and connectedness among egos. Among alters, we assessed frequency of contact with ego, perceived support from alter to ego, consistency of support from alter to ego, and relationship to ego. Correlation analyses examined the relationships between network variables and loneliness and connectedness.
Results: Several network characteristics were identified as potentially protective against perinatal loneliness. Specifically, having daily contact with a higher number of alters (r=−0.40), more overall support from alters (r=−0.40), more consistent support from alters (r=−0.32), and the presence of mentors/sponsors (r=−0.28), significant others (r=−0.37), and healthcare providers (r=−0.34) in the network were negatively correlated with loneliness. Conversely, having a greater proportion of Level 3 alters (r=0.26) was positively correlated with loneliness. Regarding connectedness, positive correlations were found with larger networks (r=0.33), more support from alters (r=0.31), consistent support from alters (r=0.21) and having friends (r=0.35) and mentors/sponsors (r=0.39) in the network.
Conclusion: The findings suggest that network composition as well as quality and consistency of support are critical factors influencing loneliness and connectedness during this unique time. Interventions that promote consistent support, foster relationships with professionals, and increase the frequency of network contact may be effective in reducing loneliness and enhancing social connection for pregnant and postpartum women in recovery.
Authors:
Presenter - Meg Patterson, Texas A&M University
Co-Author - Linnea Linde-Krieger, University of Arizona
Co-Author - Arushi Chalke, University of Arizona
Co-Author - Mariana Felix, University of Arizona
Co-Author - Alicia Allen, PhD, MPH, Arkansas Children's Research Institute
Life Stress and Cognitive Impairment in a Racially Diverse Cohort of Prostate Cancer Survivors
Poster Number: C15Time: 05:00 PM - 05:50 PM
Topics: Cancer, Stress
Background: Cognitive impairment is a common concern among prostate cancer (PC) survivors and may be influenced by psychosocial risk factors such as stress. Previous studies suggest that chronic stressors exert greater psychological and biological impact than acute, time-limited events. We examined whether acute and chronic life stress are associated with self-reported cognitive impairment in PC survivorship.
Methods: Participants were drawn from a large prospective study of diverse PC survivors designed to examine PC symptom burden and related risk factors. Self-reported cognitive impairment was defined as FACT Cog Perceived Cognitive Impairment (PCI-18) <54. Acute life events (discrete, time-limited; e.g., job loss, accident, bereavement) and chronic difficulties (persistent for at least 4 weeks; e.g., financial strain, caregiving burden, persistent health or housing problems) were assessed with the interview-based Stress and Adversity Inventory (STRAIN), summarized as cumulative frequency and severity. Paired t-tests and Fisher’s exact test were used to assess differences in sample characteristics by cognitive impairment, while univariate logistic regression with FDR correction was used to examine associations between stress and cognitive impairment. Statistical significance was defined as FDR-adjusted p-values <0.1.
Results: Overall, 80 survivors self-identified as African American (n=29), non-Hispanic White (n=32), or Hispanic (n=19); mean age was 68 years (SD=7.5) at diagnosis. Cognitive impairment was reported by 12 of 80 participants (15%). Baseline characteristics did not differ by impairment status (all p-FDR>0.1). Greater chronic stress was associated with higher odds of impairment. Compared to those without impairment, participants with cognitive impairment reported more frequent chronic life stressors (M=10.2, SD=7.0 vs. M=6.2, SD=4.2; OR=1.15, p-FDR=.050) and greater severity (M=30.9, SD=24.2 vs. M=16.4, SD=12.1; OR=1.05, p-FDR=.032). Acute life events were not associated with impairment (p-FDR>0.1).
Conclusion: Among PC survivors, both frequency and severity of cumulative chronic life stressors were associated with greater odds of cognitive impairment, whereas acute stressors were not. Findings highlight chronic stress exposure as an early indicator of cognitive impairment, and stress management interventions may help mitigate cognitive concerns in this population.
Keywords: Cognitive factors, StressMethods: Participants were drawn from a large prospective study of diverse PC survivors designed to examine PC symptom burden and related risk factors. Self-reported cognitive impairment was defined as FACT Cog Perceived Cognitive Impairment (PCI-18) <54. Acute life events (discrete, time-limited; e.g., job loss, accident, bereavement) and chronic difficulties (persistent for at least 4 weeks; e.g., financial strain, caregiving burden, persistent health or housing problems) were assessed with the interview-based Stress and Adversity Inventory (STRAIN), summarized as cumulative frequency and severity. Paired t-tests and Fisher’s exact test were used to assess differences in sample characteristics by cognitive impairment, while univariate logistic regression with FDR correction was used to examine associations between stress and cognitive impairment. Statistical significance was defined as FDR-adjusted p-values <0.1.
Results: Overall, 80 survivors self-identified as African American (n=29), non-Hispanic White (n=32), or Hispanic (n=19); mean age was 68 years (SD=7.5) at diagnosis. Cognitive impairment was reported by 12 of 80 participants (15%). Baseline characteristics did not differ by impairment status (all p-FDR>0.1). Greater chronic stress was associated with higher odds of impairment. Compared to those without impairment, participants with cognitive impairment reported more frequent chronic life stressors (M=10.2, SD=7.0 vs. M=6.2, SD=4.2; OR=1.15, p-FDR=.050) and greater severity (M=30.9, SD=24.2 vs. M=16.4, SD=12.1; OR=1.05, p-FDR=.032). Acute life events were not associated with impairment (p-FDR>0.1).
Conclusion: Among PC survivors, both frequency and severity of cumulative chronic life stressors were associated with greater odds of cognitive impairment, whereas acute stressors were not. Findings highlight chronic stress exposure as an early indicator of cognitive impairment, and stress management interventions may help mitigate cognitive concerns in this population.
Authors:
Presenter - Xiaoyin Li, PhD, Moffitt Cancer Center
Co-Author - Bihe Hu, PhD, Moffitt Cancer Center
Co-Author - KD Jacobs, PhD, Moffitt Cancer Center
Co-Author - Aasha Hoogland, PhD, Moffitt Cancer Center
Co-Author - Taylor Welniak, Moffitt Cancer Center
Co-Author - Yvelise Rodriguez, Moffitt Cancer Center
Co-Author - Crystal Bryant, Moffitt Cancer Center
Co-Author - Hannah Decosta, Moffitt Cancer Center
Co-Author - Nathaly Irizarry-Arroyo1, Moffitt Cancer Center
Co-Author - Kosj Yamoah, MD, PhD, Moffitt Cancer Center
Co-Author - Laura Oswald, PhD, Moffitt Cancer Center
Co-Author - Heather Jim, PhD, FSBM, Moffitt Cancer Center
Co-Author - Brent Small, PhD, University of North Carolina at Chapel Hill
Co-Author - Clement Gwede, PhD, MPH, RN, FSBM, H Lee Moffitt Cancer Center and Research Institute
Co-Author - Frank Penedo, PhD, FSBM, University of Miami
Co-Author - Jong Park, Moffitt Cancer Center
Co-Author - George Slavich, PhD, UCLA
Co-Author - Brian Gonzalez, PhD, FSBM, Moffitt Cancer Center
Cumulative substance use and markers of systemic inflammation: A longitudinal study of young men
Poster Number: C151Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, HIV/AIDS
Previous research on substance use and systemic inflammation has produced mixed results. Most studies have relied on small samples and one-time measures of inflammation. The effects of substance use on inflammation are especially relevant to young men living with HIV or at high risk for HIV, who exhibit higher rates of substance use and inflammation-related chronic conditions compared to the general population. The objective of this study is to investigate the cumulative effects of stimulant, cannabis, and alcohol use on systemic inflammation in this population. We hypothesize that: (1) greater cannabis use is associated with lower systemic inflammation, (2) greater stimulant use is associated with higher systemic inflammation, and (3) systemic inflammation is lower among people who exhibit low-risk alcohol use.
We used data from a longitudinal cohort study of young men living with HIV or at high risk for HIV (n=770, mean age=21.68) at three visits (baseline, one-year follow-up, and two-year follow-up). Plasma markers of inflammation were measured via electrochemiluminescence immunoassay, and substance use was assessed via urine screening (stimulants and cannabis) and self-report (alcohol). Inflammatory marker concentrations were log-transformed for analysis. We applied marginal structural models to estimate cumulative effects of substance use on inflammation, with false discovery rate correction for multiple comparisons.
Participants with detectable screens for cannabis at all visits had lower mean interleukin-6 (B=-0.25; 95% CI: -0.4, -0.11) versus those who consistently screened negative. Participants with detectable screens for stimulants at all visits had higher mean C-reactive protein (B=0.86; 95% CI: 0.35, 1.36) and interleukin-6 (B=0.62; 95% CI: 0.28, 0.96) versus those who consistently screened negative. We found no clear evidence that cumulative alcohol use was associated with inflammation.
These results suggest that greater cumulative cannabis use may be associated with lower systemic inflammation and greater cumulative stimulant use may be associated with higher systemic inflammation in this population. These findings build on previous cross-sectional studies, providing longitudinal evidence for potential anti-inflammatory effects of chronic cannabis use and pro-inflammatory effects of chronic stimulant use.
Keywords: Substance abuse, Immune functionWe used data from a longitudinal cohort study of young men living with HIV or at high risk for HIV (n=770, mean age=21.68) at three visits (baseline, one-year follow-up, and two-year follow-up). Plasma markers of inflammation were measured via electrochemiluminescence immunoassay, and substance use was assessed via urine screening (stimulants and cannabis) and self-report (alcohol). Inflammatory marker concentrations were log-transformed for analysis. We applied marginal structural models to estimate cumulative effects of substance use on inflammation, with false discovery rate correction for multiple comparisons.
Participants with detectable screens for cannabis at all visits had lower mean interleukin-6 (B=-0.25; 95% CI: -0.4, -0.11) versus those who consistently screened negative. Participants with detectable screens for stimulants at all visits had higher mean C-reactive protein (B=0.86; 95% CI: 0.35, 1.36) and interleukin-6 (B=0.62; 95% CI: 0.28, 0.96) versus those who consistently screened negative. We found no clear evidence that cumulative alcohol use was associated with inflammation.
These results suggest that greater cumulative cannabis use may be associated with lower systemic inflammation and greater cumulative stimulant use may be associated with higher systemic inflammation in this population. These findings build on previous cross-sectional studies, providing longitudinal evidence for potential anti-inflammatory effects of chronic cannabis use and pro-inflammatory effects of chronic stimulant use.
Authors:
Author - Joshua M. Schrock, MPH, PhD, Northwestern University
Co-Author - Ado Rivera, MD, PhD, Northwestern University
Co-Author - Richard T. D'Aquila, MD, Northwestern University
Co-Author - Michael Newcomb, PhD, Northwestern University
Co-Author - Brian Mustanski, PhD, Northwestern University
A Qualitative Investigation of Barriers and Facilitators to Smoking Cessation among Adults Using the Pennsylvania Quitline Text Messaging Service
Poster Number: C152Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior, Digital Health
INTRODUCTION. Cigarettes are used by over 34 million U.S. adults and cause more than 490,000 deaths annually due to smoking and smoke exposure. Quitting smoking reduces the risk of premature death and adds years to life expectancy. Quitline services are widely available and increase accessibility to quality treatment for tobacco dependence. Limited research exists on the impact of text messaging for smoking cessation among Quitline text messaging enrollees. This study investigated the facilitators and barriers to smoking cessation among Pennsylvania (PA) Quitline enrollees of the text messaging service.
METHODS. In this qualitative study, individuals 18 years or older who enrolled in PA Quitline services were invited to complete a screener from November 2023-November 2024. Demographics and variables of interest were sex, age, race/ethnicity, education, and smoking behaviors. Eligible participants were called to confirm their interest and scheduled to meet virtually for an interview. Consent was obtained and compensation was provided. Means and frequencies described participants overall. Interviews were about 1 hour, audio recorded, transcribed, and cleaned for clarity and accuracy. MAXQDA software was used for coding and after several rounds of codebook calibration, 20% of the interviews were coded independently by two members of the study team. Interrater reliability was calculated to ensure agreement (kappa=0.72) was achieved.
RESULTS. Among 357 eligible participants, 64 were selected. Participants had a mean age of 52.2 years (SD=12.6), 50.0% (n=32) were male, 54.7% (n=35) were White, 40.6% (n=23) were Black or African American, 6.3% (n=4) were Hispanic/Latino, 4.7% (n=3) were another race, and 4.7% (n=3) were mixed race.* The majority of participants 62.5% (n=40) had greater than a high school education. Additionally, 42.2% (n=27) reported they had quit smoking prior to the study. Facilitators to smoking cessation included convenience and accountability, while barriers included frequent, non-personalized text messages that mismatched smoking status.
CONCLUSION. This study investigated the facilitators and barriers to smoking cessation among PA Quitline enrollees of the text messaging service. Implications of this study suggest that while the service was helpful in motivating participants to quit smoking there are opportunities for improvement.
*Due to multiple selections allowed for race/ethnicity the combined percentages do not total 100%.
Keywords: Smoking, TreatmentMETHODS. In this qualitative study, individuals 18 years or older who enrolled in PA Quitline services were invited to complete a screener from November 2023-November 2024. Demographics and variables of interest were sex, age, race/ethnicity, education, and smoking behaviors. Eligible participants were called to confirm their interest and scheduled to meet virtually for an interview. Consent was obtained and compensation was provided. Means and frequencies described participants overall. Interviews were about 1 hour, audio recorded, transcribed, and cleaned for clarity and accuracy. MAXQDA software was used for coding and after several rounds of codebook calibration, 20% of the interviews were coded independently by two members of the study team. Interrater reliability was calculated to ensure agreement (kappa=0.72) was achieved.
RESULTS. Among 357 eligible participants, 64 were selected. Participants had a mean age of 52.2 years (SD=12.6), 50.0% (n=32) were male, 54.7% (n=35) were White, 40.6% (n=23) were Black or African American, 6.3% (n=4) were Hispanic/Latino, 4.7% (n=3) were another race, and 4.7% (n=3) were mixed race.* The majority of participants 62.5% (n=40) had greater than a high school education. Additionally, 42.2% (n=27) reported they had quit smoking prior to the study. Facilitators to smoking cessation included convenience and accountability, while barriers included frequent, non-personalized text messages that mismatched smoking status.
CONCLUSION. This study investigated the facilitators and barriers to smoking cessation among PA Quitline enrollees of the text messaging service. Implications of this study suggest that while the service was helpful in motivating participants to quit smoking there are opportunities for improvement.
*Due to multiple selections allowed for race/ethnicity the combined percentages do not total 100%.
Authors:
Author - Sophia Allen, PhD, MBA, Penn State College of Medicine
Co-Author - Victoria Francois, MPH, Penn State College of Medicine
Co-Author - Steven M. Negron-Candelario, B.S., Penn State College of Medicine
Cumulative Social Determinants of Health Exposure and Tobacco Use Among US Adults: Insights from the All of Us Research Program
Poster Number: C153Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior, Social and Environmental Context and Health
Introduction: Tobacco use in the United States (US) poses serious public health risks. Still, limited research examines factors influencing its consumption, including the cumulative effects of unfavorable social determinants of health (SDoH).
Method: Using data from the All of Us Research Program from adults aged 18+ years (version 8, n=217,968), we created a cumulative SDoH score indicator (range: 0-13) divided into approximate quintiles (Q1-Q5), with higher quintiles (e.g., Q5) indicating greater cumulative social disadvantage. This indicator was created using median cut-offs based on the following continuous factors: social cohesion, neighborhood walkability/bikeability, neighborhood disorder, neighborhood crime and safety, social support, healthcare discrimination, everyday discrimination, loneliness, perceived stress, and daily spiritual experiences; and the following binary factors: food insecurity, housing insecurity, and housing quality. We analyzed associations of this cumulative SDoH score and current use (“every day”, “some days”) of cigarettes, e-cigarettes, cigars, hookah, and smokeless tobacco (each ref: non-current users) by running multivariable logistic regressions, adjusted for sociodemographic characteristics and other substance use (i.e, alcohol, cannabis, and other drugs).
Results: The mean of the cumulative SDoH score was 5.07 (SD=2.85). The prevalence of tobacco product use was as follows: cigarettes (8.17%), e-cigarettes (4.39%), cigars (3.19%), hookah (0.74%), and smokeless tobacco (0.84%). In the models, participants in Q5 (vs. Q1) had higher odds of cigarette (OR=2.02; 95% CI: 1.90-2.15), e-cigarette (OR=1.65; 95% CI: 1.52-1.81), cigar (OR=1.39; 95% CI: 1.27-1.51), hookah (OR=1.33; 95% CI: 1.08-1.65), and smokeless tobacco (OR=1.33; 95% CI: 1.13-1.57) use. Additionally, participants in Q4 (vs. Q1) had higher odds of cigarette (OR=1.43; 95% CI: 1.35-1.53) and e-cigarette (OR=1.34; 95% CI: 1.23-1.47) use. Those in Q3 showed a similar pattern. In contrast, participants in Q2 (vs. Q1) only had higher odds of cigarette use (OR=1.09; 95% CI: 1.02-1.17).
Conclusion: Our findings suggest that greater cumulative exposure to adverse SDoH may contribute to increased tobacco use among US adults and underscore the need for equitable interventions and policies addressing adverse SDoH in populations at risk of tobacco use. Policies and interventions that address multiple social disadvantages may be more effective in mitigating tobacco use.
Keywords: Tobacco use, DisparitiesMethod: Using data from the All of Us Research Program from adults aged 18+ years (version 8, n=217,968), we created a cumulative SDoH score indicator (range: 0-13) divided into approximate quintiles (Q1-Q5), with higher quintiles (e.g., Q5) indicating greater cumulative social disadvantage. This indicator was created using median cut-offs based on the following continuous factors: social cohesion, neighborhood walkability/bikeability, neighborhood disorder, neighborhood crime and safety, social support, healthcare discrimination, everyday discrimination, loneliness, perceived stress, and daily spiritual experiences; and the following binary factors: food insecurity, housing insecurity, and housing quality. We analyzed associations of this cumulative SDoH score and current use (“every day”, “some days”) of cigarettes, e-cigarettes, cigars, hookah, and smokeless tobacco (each ref: non-current users) by running multivariable logistic regressions, adjusted for sociodemographic characteristics and other substance use (i.e, alcohol, cannabis, and other drugs).
Results: The mean of the cumulative SDoH score was 5.07 (SD=2.85). The prevalence of tobacco product use was as follows: cigarettes (8.17%), e-cigarettes (4.39%), cigars (3.19%), hookah (0.74%), and smokeless tobacco (0.84%). In the models, participants in Q5 (vs. Q1) had higher odds of cigarette (OR=2.02; 95% CI: 1.90-2.15), e-cigarette (OR=1.65; 95% CI: 1.52-1.81), cigar (OR=1.39; 95% CI: 1.27-1.51), hookah (OR=1.33; 95% CI: 1.08-1.65), and smokeless tobacco (OR=1.33; 95% CI: 1.13-1.57) use. Additionally, participants in Q4 (vs. Q1) had higher odds of cigarette (OR=1.43; 95% CI: 1.35-1.53) and e-cigarette (OR=1.34; 95% CI: 1.23-1.47) use. Those in Q3 showed a similar pattern. In contrast, participants in Q2 (vs. Q1) only had higher odds of cigarette use (OR=1.09; 95% CI: 1.02-1.17).
Conclusion: Our findings suggest that greater cumulative exposure to adverse SDoH may contribute to increased tobacco use among US adults and underscore the need for equitable interventions and policies addressing adverse SDoH in populations at risk of tobacco use. Policies and interventions that address multiple social disadvantages may be more effective in mitigating tobacco use.
Authors:
Author - Meman Diaby, MS, University of Kentucky College of Medicine
Co-Author - Osayande Agbonlahor, MD, PhD, University of Mississippi Medical Center
Co-Author - Joy L. Hart, PhD, University of Louisville
Co-Author - Delvon Mattingly, University of Kentucky College of Medicine
Short Scrolls, Big Impact: Social Media Exposure and Nicotine Pouch Use among U.S. Adults
Poster Number: C154Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior, Social and Environmental Context and Health
Background: Nicotine pouches (NPs), a rapidly emerging class of oral nicotine products, have gained traction in the U.S. market, raising concerns about their potential to expand nicotine use among vulnerable populations. While marketed as a smoke-free alternative, NPs still deliver nicotine, which is addictive and may pose health risks. Social media platforms may play a central role in shaping awareness, perceptions, and uptake of NPs, yet little is known about how exposure to NP-related content translates into use behaviors.
Method: Using Wave 7 (collected in 2022-2023) of the Population Assessment of Tobacco and Health (PATH) Study, we analyzed past 30-day NP use among adult ever NP users (N=1,496). Logistic regression models examined demographic characteristics, social media use intensity, platform type, and exposure to NP-related content on past 30-day NP use.
Results: Among the sample, 27.3% (n=408) reported NP use in the past 30 days. The population was relatively young, with 36% 18–24 years, and 31.1% were 25–34 years. Most participants were men (73.6%) and White (83.2%). The majority (82.7%) reported social media use in the past week, with more than half (53.2%) spending 1–2 hours daily on weekdays. Notably, only 3.5% reported seeing NP-related social media content in the past 7 days, but these individuals were significantly more likely to report past 30-day NP use (6.4% vs. 2.5%,p<0.001). Regression results showed women were less likely to report past 30-day NP use compared with men (OR=0.55,95%CI: 0.39–0.77). Exposure to NP-related social media content more than doubled the likelihood of NP use (OR=2.22,95%CI:1.19–4.14). Platform-specific patterns emerged: Instagram users were significantly more likely to use NPs (OR=1.45,95CI: 1.06–2.00), while Facebook (OR=0.68,95%CI:0.51–0.92) and YouTube users (OR=0.72,95%CI: 0.54–0.95) were less likely. Associations for Snapchat, TikTok, and Twitter were nonsignificant.
Conclusion: These findings underscore the influence of social media exposure and platform-specific environments in shaping nicotine pouch behaviors among adults. The heightened NP use risk associated with minimal daily social media exposure suggests that even limited engagement may be sufficient for encountering promotional content that influences use. Targeted surveillance and regulatory efforts addressing online marketing and user-generated content may be critical for reducing risks associated with this rapidly expanding nicotine product.
Keywords: Tobacco use, InternetMethod: Using Wave 7 (collected in 2022-2023) of the Population Assessment of Tobacco and Health (PATH) Study, we analyzed past 30-day NP use among adult ever NP users (N=1,496). Logistic regression models examined demographic characteristics, social media use intensity, platform type, and exposure to NP-related content on past 30-day NP use.
Results: Among the sample, 27.3% (n=408) reported NP use in the past 30 days. The population was relatively young, with 36% 18–24 years, and 31.1% were 25–34 years. Most participants were men (73.6%) and White (83.2%). The majority (82.7%) reported social media use in the past week, with more than half (53.2%) spending 1–2 hours daily on weekdays. Notably, only 3.5% reported seeing NP-related social media content in the past 7 days, but these individuals were significantly more likely to report past 30-day NP use (6.4% vs. 2.5%,p<0.001). Regression results showed women were less likely to report past 30-day NP use compared with men (OR=0.55,95%CI: 0.39–0.77). Exposure to NP-related social media content more than doubled the likelihood of NP use (OR=2.22,95%CI:1.19–4.14). Platform-specific patterns emerged: Instagram users were significantly more likely to use NPs (OR=1.45,95CI: 1.06–2.00), while Facebook (OR=0.68,95%CI:0.51–0.92) and YouTube users (OR=0.72,95%CI: 0.54–0.95) were less likely. Associations for Snapchat, TikTok, and Twitter were nonsignificant.
Conclusion: These findings underscore the influence of social media exposure and platform-specific environments in shaping nicotine pouch behaviors among adults. The heightened NP use risk associated with minimal daily social media exposure suggests that even limited engagement may be sufficient for encountering promotional content that influences use. Targeted surveillance and regulatory efforts addressing online marketing and user-generated content may be critical for reducing risks associated with this rapidly expanding nicotine product.
Authors:
Presenter - Asal Pilehvari, PhD, University of Virginia
Author - Rebecca Krukowski, PhD, FSBM, University of Virginia
Author - Melissa Little, PHD, University of Virginia
Motivation to Quit Smoking Among Sexual and/or Gender Minoritized Adults: Individual, Dyadic, and Sociodemographic Correlates in Dual-Smoking Couples
Poster Number: C155Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior, Social and Environmental Context and Health
Extant research suggests that individuals with sexual and/or gender minoritized (SGM) identities face a disproportionate cancer burden, with tobacco use as a leading cause of preventable disease and death. Yet, SGM individuals remain underrepresented in clinical research. To better address the needs of these individuals, we examined facilitators and barriers to motivation to quit smoking among SGM individuals in dual-smoking couples (DSCs), where both romantic partners smoke. Individuals in DSCs are likely to face unique challenges to cessation. In an online survey, SGM individuals with a smoking partner (N=212) reported their own motivation to quit smoking, their desire for their partner to quit, demographic information, general and smoking-specific relationship processes, and minority stress and resilience. Participants’ motivation to quit was strongly positively correlated with their desire for their partner to quit. Quit motivation was most closely tied to smoking-specific relationship processes and demographics. For instance, stronger quit motivation related to greater dyadic efficacy, smoking/cessation-specific relationship closeness, and partner support strategies—both positive (responsiveness to needs) and negative (reactance-inducing). Demographically, higher motivation was associated with older age, longer smoking history, living with a smoking partner, and identifying as monosexual (gay/lesbian). Greater religious coping and lower use of self-distraction as general coping strategies also related to stronger quit motivation. Notably, quit motivation was unrelated to SGM stigma exposure. When analyses were split by nicotine dependence, smoking-specific relationship processes remained central for the high-dependence group. For those with low dependence, demographic factors (older age, more education, longer smoking history) were more strongly tied to motivation, suggesting distinct needs based on dependence level. Overall, our findings highlight individual- and relationship-level factors that may shape quit motivation among SGMs in DSCs, informing future work aimed at improving cessation and broader health outcomes in these understudied populations. Future directions include testing associations beyond quit motivation like between smoking-specific relationship processes and SGM stigma and applying a machine learning approach to identify the most impactful predictors of cessation. AI-use disclosure: ChatGPT 5.0 assisted in writing statistical code.
Keywords: Smoking, Sexual orientationAuthors:
Presenter - Hayley Svensson, Postdoctoral Research Fellow, University of Oklahoma Health Sciences
Author - Julia McQuoid, Assistant Professor, University of Oklahoma Health Sciences
Author - Michelle vanDellen, Professor, University of Oklahoma Health Sciences
Building on Common Ground: Smoking Cessation Interventions in Hospital Settings in Low- and Middle-Income Countries. A Rapid Narrative Review
Poster Number: C156Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior, Implementation Science
Rationale: Tobacco use is a leading cause of preventable disease globally, with over 80% of smokers living in low- and middle-income countries (LMICs). Hospitalization offers a unique opportunity for smoking cessation, yet evidence for in-hospital programs in LMICs is fragmented, limiting understanding of effectiveness and implementation. This rapid narrative review aimed to synthesize evidence on hospital-based smoking cessation interventions in LMICs, examining intervention characteristics, clinical outcomes, and implementation outcomes.
Methods: We conducted a PROSPERO-registered rapid narrative review (CRD42024556458), searching MEDLINE and EMBASE up to June 2024. Of 1,624 records, 15 studies met inclusion criteria following a double-screening process. Data extraction was performed using a standardized form, with 20% double-extracted for quality assurance and the remainder extracted by one researcher and double-verified using AI-assisted tools. Implementation outcomes were categorized using Proctor's framework.
Results: Included studies (2010–2023) were from Latin America (n=9), Middle East/Africa (n=3), and Asia (n=3). Over half (n=9) were randomized controlled trials. Interventions varied in intensity, typically combining several components: counseling (n=9), follow-up (n=10), pharmacotherapy (n=2), and healthcare professional training (n=4). Most studies (n=11) reported improvements in the primary outcome (smoking abstinence, increase in knowledge, change in practice), though outcome definitions and validation methods for continued abstinence varied widely. Detailed reporting of intervention components, design rationale, and implementation outcomes was limited, reducing the potential for replication and contextual adaptation. Key implementation barriers included scalability, lack of protocols and sustainability plans; facilitators included context-relevant approaches and routine care integration.
Conclusion: Hospital-based smoking cessation interventions demonstrate potential effectiveness in LMICs. Across the included studies, common implementation challenges included scalability, adherence to a protocol, and care integration. Enhanced intervention reporting and implementation planning could improve the development of sustainable interventions. This review contributes to formative research aimed at designing an evidence-based, theory-informed smoking cessation intervention for hospital settings in Colombia.
Keywords: Health behavior change, SmokingMethods: We conducted a PROSPERO-registered rapid narrative review (CRD42024556458), searching MEDLINE and EMBASE up to June 2024. Of 1,624 records, 15 studies met inclusion criteria following a double-screening process. Data extraction was performed using a standardized form, with 20% double-extracted for quality assurance and the remainder extracted by one researcher and double-verified using AI-assisted tools. Implementation outcomes were categorized using Proctor's framework.
Results: Included studies (2010–2023) were from Latin America (n=9), Middle East/Africa (n=3), and Asia (n=3). Over half (n=9) were randomized controlled trials. Interventions varied in intensity, typically combining several components: counseling (n=9), follow-up (n=10), pharmacotherapy (n=2), and healthcare professional training (n=4). Most studies (n=11) reported improvements in the primary outcome (smoking abstinence, increase in knowledge, change in practice), though outcome definitions and validation methods for continued abstinence varied widely. Detailed reporting of intervention components, design rationale, and implementation outcomes was limited, reducing the potential for replication and contextual adaptation. Key implementation barriers included scalability, lack of protocols and sustainability plans; facilitators included context-relevant approaches and routine care integration.
Conclusion: Hospital-based smoking cessation interventions demonstrate potential effectiveness in LMICs. Across the included studies, common implementation challenges included scalability, adherence to a protocol, and care integration. Enhanced intervention reporting and implementation planning could improve the development of sustainable interventions. This review contributes to formative research aimed at designing an evidence-based, theory-informed smoking cessation intervention for hospital settings in Colombia.
Authors:
Author - Luz Angela Torres López, MD, MPH, PhD (c), Hebrew University of Jerusalem
Co-Author - Marija Milic, MD, MPH, PhD, University of Pristina/Kosobska Mitrovica
Co-Author - Yehuda Neumark, MPH, PhD, Hebrew University of Jerusalem
Co-Author - Adam J Rose, MD, Hebrew University of Jerusalem
Co-Author - Yael Bar-Zeev, MD, MPH, PhD, Hebrew University of Jerusalem
Social Comparisons and Binge Eating: Daily Associations and Differences between Sexual Minority and Heterosexual Women
Poster Number: C157Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Social and Environmental Context and Health
Background: Binge eating, or overeating with loss of control, is strongly linked to negative health outcomes and is more prevalent among women than men. Sexual minority women (SMW, who identify as lesbian, bisexual, queer) experience elevated risk for binge eating relative to heterosexual women (HW), yet these disparities are not well understood. Comparisons with others that result in negative self-evaluations (e.g., of appearance) could increase risk for binge eating; many social comparisons are positive or neutral, however, and little is known about these processes in women’s daily lives.
Methods: To address this gap, we conducted 14 days of intensive assessment with 286 women (MAge=25.4, MBMI=29.2kg/m2, 50% SMW). At the end of each day, they reported whether they experienced binge eating and/or social comparison that day (both dichotomous, yes/no). On days with comparison, they were asked about the dimension of the comparison that was most salient that day (e.g., comparison of appearance, abilities) and positive and negative affect in response to this comparison.
Results: Multilevel models showed that comparisons occurred on 38% of days and varied within-person (ICC=0.51). Comparison dimension and affective responses also varied considerably across days (ICCs 0.31-0.39), and 40% resulted in both negative and positive affect. SMW were 3.8 times more likely to experience comparison than HW (95% CI 2.33-6.02) and rated negative affect as stronger than HW (sr=0.08), though they were 55% less likely to cite appearance comparisons as most salient (CI 0.27-0.78). Binge eating was 1.5 times more likely on days with (vs. without) comparisons (CI 1.17-1.92), 1.4 times more likely on days with appearance comparisons as most salient (CI 1.01-2.01), and 1.18 times more likely for each 1-unit increase in negative affect (CI 1.003-1.40). These associations did not differ between SMW and HW.
Conclusions: Findings indicate that SMW report higher rates of social comparison in daily life and stronger negative responses than HW, which could increase their risk for binge eating. Importantly, however, SMW are less likely to experience appearance comparisons than HW; as these comparisons are strongly linked to binge eating, SMW may be protected from the highest-risk social-cognitive experiences that precipitate this behavior. There is need for ongoing investigation of the association between comparisons and binge eating risk in daily life, among both HW and SMW.
Keywords: Eating behaviors, Health disparitiesMethods: To address this gap, we conducted 14 days of intensive assessment with 286 women (MAge=25.4, MBMI=29.2kg/m2, 50% SMW). At the end of each day, they reported whether they experienced binge eating and/or social comparison that day (both dichotomous, yes/no). On days with comparison, they were asked about the dimension of the comparison that was most salient that day (e.g., comparison of appearance, abilities) and positive and negative affect in response to this comparison.
Results: Multilevel models showed that comparisons occurred on 38% of days and varied within-person (ICC=0.51). Comparison dimension and affective responses also varied considerably across days (ICCs 0.31-0.39), and 40% resulted in both negative and positive affect. SMW were 3.8 times more likely to experience comparison than HW (95% CI 2.33-6.02) and rated negative affect as stronger than HW (sr=0.08), though they were 55% less likely to cite appearance comparisons as most salient (CI 0.27-0.78). Binge eating was 1.5 times more likely on days with (vs. without) comparisons (CI 1.17-1.92), 1.4 times more likely on days with appearance comparisons as most salient (CI 1.01-2.01), and 1.18 times more likely for each 1-unit increase in negative affect (CI 1.003-1.40). These associations did not differ between SMW and HW.
Conclusions: Findings indicate that SMW report higher rates of social comparison in daily life and stronger negative responses than HW, which could increase their risk for binge eating. Importantly, however, SMW are less likely to experience appearance comparisons than HW; as these comparisons are strongly linked to binge eating, SMW may be protected from the highest-risk social-cognitive experiences that precipitate this behavior. There is need for ongoing investigation of the association between comparisons and binge eating risk in daily life, among both HW and SMW.
Authors:
Presenter - Angelica Rivera, B.A., Rowan University
Co-Author - Kaitlyn E. Ryan, B.A., Old Dominion University, Virginia Consortium Program in Clinical Psychology
Co-Author - Gabrielle M. Salvatore, PhD, Rowan University
Co-Author - Amanda L. Folk, Ph.D., Rowan University
Co-Author - Kristin Heron, PhD, FSBM, Old Dominion University, Virginia Consortium Program in Clinical Psychology
Co-Author - Danielle Arigo, PhD, LP, FSBM, Rowan University, Rowan-Virtua School of Osteopathic Medicine, Cooper Medical School of Rowan University
Parental GLP-1 Use and Family Health: Exploring Impacts on Household Food Practices, Children’s Behaviors, and Weight Communication
Poster Number: C158Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Child and Family Health
Obesity medications, particularly glucagon-like peptide-1 receptor agonists (GLP-1s), are increasingly prescribed to adults with obesity. While their individual clinical benefits are well established, little is known about how parental GLP-1 use influences the household food environment, weight-related family communication, or children’s eating and physical activity. Understanding these intergenerational dynamics is critical for integrating biomedical and behavioral approaches to obesity prevention across the lifespan. This study examined parental experiences with GLP-1 use and perceived impacts on household food practices, child eating and activity, and family communication. As part of a larger REDCap survey of adults initiating a GLP-1 in the past 6 months, this analysis included parent respondents (N=58). The survey assessed demographics, disclosure to family, household food environment, and perceived child/family impacts. Descriptive statistics summarized frequencies and distributions. Respondents were predominantly women (85%) and White (91%), mean age 44.5 years (SD=7.1). Most were married (74%), employed full time (66%), and college-educated (78%). Financial security was moderate: 43% reported enough to afford extras and 41% enough for bills with little to spare. Nearly half (47%) had one child at home, 38% had two, and 15% had three or more. Most parents (53%) were unconcerned about child weight, and 72% reported pediatricians had never raised concerns. Disclosure of GLP-1 use to children was mixed (41% not disclosed, 36% disclosed). Among those whose children knew, 47% reported children had no questions, while others expressed curiosity (27%) or asked why the parent was taking the medication (21%). More than half (59%) reported healthier household food availability, and 47% reported offering healthier foods to children, though 50% reported no change. Half (50%) became more focused on managing children’s nutrition and activity. About one-quarter (28%) observed healthier child eating behaviors, and 24% noted increases in child physical activity. Parental GLP-1 use appears to extend beyond individual health to shape household food environments and children’s behaviors. Findings highlight the potential for leveraging parental GLP-1 use as a catalyst for family-centered obesity prevention and treatment interventions.
Keywords: Weight loss, ObesityAuthors:
Author - Isa Granados, PhD, Nemours Children's Health
Co-Author - Danielle Jake-Schoffman, PhD, University of Florida
Co-Author - Karyn Governale, University of Florida College of Medicine
Co-Author - David Fedele, Ph.D., ABPP, Nemours Children's Health
Co-Author - Megan McVay, PhD, University of Florida
Binge Eating Does Not Moderate Weight Outcomes in Young Adults Participating in Weight Gain Prevention Interventions
Poster Number: C159Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Diet, Nutrition, and Eating Disorders
Background: Binge eating (BE) is associated with weight gain over time and has been shown to blunt outcomes in behavioral weight loss trials. BE may similarly negatively impact treatment outcomes in young adults at risk for obesity participating in weight gain prevention interventions, though this has not been explored. Identification of factors associated with BE in this population may also help inform treatment targets to prevent BE development in the context of a weight gain prevention program.
Methods: The 3-arm SNAP study compared a 16-week large change and a small change weight gain prevention intervention to a one-session self-guided control in young adults at risk for developing obesity (n=599; 88% female; 27% minoritized; mean [SD] age, 27.7 [4.4] years; mean [SD] BMI, 25.4 [2.6]) over 2 years. This secondary analysis follows prior analysis indicated treatment arm did not impact BE. Mixed models were used to examine whether BE, as measured by self-reported consumption of an unusually amount of food and a feeling of loss of control over the prior 6 months, 1) predicted weight change over time in all treatments and 2) moderated treatment effects on weight outcomes. Additionally, mixed models were used to analyze demographic (i.e., age, gender, race) and psychosocial factors (i.e., eating styles, motivation type, shape and weight concerns, stress, depression symptoms) associated with BE, controlling for treatment arm.
Results: BE was reported by 11.5% (n=69) of participants at baseline and 8.1% (n=40) at 24-month follow-up. Neither baseline BE nor time-varying BE predicted percentage weight change. Similarly, neither baseline BE nor time-varying BE moderated treatment effects on percentage weight change at 4 or 24 months. Between participants, individuals who were female (p=0.006), had a lower BMI (p=0.04), endorsed greater disinhibition (p<0.001), and reported greater controlled motivation (p=0.01) were more likely to endorse BE over the course of the study. Within participants, greater than average disinhibition at any timepoint was related to a higher likelihood of BE at that timepoint.
Conclusions: BE was not related to weight outcomes in the SNAP weight gain prevention interventions. Participation in weight gain prevention interventions may offer an opportunity to monitor and intervene with individuals with high levels of disinhibition and controlled motivation to potentially aid in prevention of BE while also preventing weight gain.
Keywords: Binge eating, Weight controlMethods: The 3-arm SNAP study compared a 16-week large change and a small change weight gain prevention intervention to a one-session self-guided control in young adults at risk for developing obesity (n=599; 88% female; 27% minoritized; mean [SD] age, 27.7 [4.4] years; mean [SD] BMI, 25.4 [2.6]) over 2 years. This secondary analysis follows prior analysis indicated treatment arm did not impact BE. Mixed models were used to examine whether BE, as measured by self-reported consumption of an unusually amount of food and a feeling of loss of control over the prior 6 months, 1) predicted weight change over time in all treatments and 2) moderated treatment effects on weight outcomes. Additionally, mixed models were used to analyze demographic (i.e., age, gender, race) and psychosocial factors (i.e., eating styles, motivation type, shape and weight concerns, stress, depression symptoms) associated with BE, controlling for treatment arm.
Results: BE was reported by 11.5% (n=69) of participants at baseline and 8.1% (n=40) at 24-month follow-up. Neither baseline BE nor time-varying BE predicted percentage weight change. Similarly, neither baseline BE nor time-varying BE moderated treatment effects on percentage weight change at 4 or 24 months. Between participants, individuals who were female (p=0.006), had a lower BMI (p=0.04), endorsed greater disinhibition (p<0.001), and reported greater controlled motivation (p=0.01) were more likely to endorse BE over the course of the study. Within participants, greater than average disinhibition at any timepoint was related to a higher likelihood of BE at that timepoint.
Conclusions: BE was not related to weight outcomes in the SNAP weight gain prevention interventions. Participation in weight gain prevention interventions may offer an opportunity to monitor and intervene with individuals with high levels of disinhibition and controlled motivation to potentially aid in prevention of BE while also preventing weight gain.
Authors:
Author - Jacqueline Hayes, PhD, The Miriam Hospital/Brown University
Co-Author - Jennifer Warnick, PhD, Alpert Medical School of Brown University
Co-Author - Katherine Darling, PhD, The Miriam Hospital/Alpert Medical School of Brown University
Co-Author - Zihuan Cao, PhD, The Miriam Hospital/Brown University
Co-Author - Jessica LaRose, PhD, FSBM, Virginia Commonwealth University School of Public Health
Co-Author - Deborah Tate, PhD, University of North Carolina
Co-Author - Amy Gorin, PhD, University of Connecticut
Co-Author - Elissa Jelalian, PhD, The Miriam Hospital; Alpert Medical School of Brown University
Co-Author - Rena Wing, PhD, FSBM, Alpert Medical School of Brown University
Practical Problems, Psychosocial Concerns and Financial Distress in Parents with Advanced Cancer and their Spouses
Poster Number: C16Time: 05:00 PM - 05:50 PM
Topics: Cancer, Child and Family Health
Background: Patients with an incurable cancer diagnosis and their spousal caregivers parenting minor children are vulnerable to experiencing high levels of psychological distress. While illness communication has been identified as an important psychosocial need, these family may experience broader physical, practical, psychosocial, and financial problems which we hypothesize are associated with cancer-related parenting concerns and psychological symptoms.
Methods: In this cross-sectional study, patients with a stage IV solid tumor diagnosis and their spousal caregivers parenting children under the age of 18 years completed measures on cancer-related problems (NCCN problem list), financial distress (COST), cancer-related parenting concerns (PCQ) and psychological symptoms (HADS).
Results: Fifty-one patient-caregiver dyads completed the assessments. Both patients and spouses were more likely to endorse emotional problems than any other problem area (P<.0001). Compared with patients, spouses reported significantly more psychological distress (HADS, P<.01). In fact, twice as many spouses (62%) endorsed problems with depression than patients (31%) on the NCCN problem list. Physical symptoms were rated as the second most frequent problem area with both patients and spouses endorsing fatigue (64% and 56%, respectively) and sleep disturbances (58% and 56%, respectively) as frequent problems. Financial distress (COST scores and each problem area (physical, practical, spiritual, emotional and social) were significantly associated with cancer-related parenting concerns (r=.40 to r =.70) and psychological symptoms (r=.31 to r=.73). Based on multiple regression analyses including PCQ, COST, and NCCN problems list scores, only parenting concerns were uniquely associated with depressive symptoms (PCQ, patients: beta=.33, P=.05; spouses: patients: beta=.35, P<.05). When modeling anxiety symptoms, social problems were uniquely associated for patients (beta=.57, P=.0.01) and parenting concerns for caregivers (beta=.29, P=.05).
Conclusion: Although emotional problems appear to be the most pressing concern, families experience physical, practical, and financial problems. Thus, parent-focused interventions need to target a range of support needs particularly around symptom management, practical problem solving and financial navigation to mitigate psychological distress and parenting concerns.
Keywords: Cancer, CaregivingMethods: In this cross-sectional study, patients with a stage IV solid tumor diagnosis and their spousal caregivers parenting children under the age of 18 years completed measures on cancer-related problems (NCCN problem list), financial distress (COST), cancer-related parenting concerns (PCQ) and psychological symptoms (HADS).
Results: Fifty-one patient-caregiver dyads completed the assessments. Both patients and spouses were more likely to endorse emotional problems than any other problem area (P<.0001). Compared with patients, spouses reported significantly more psychological distress (HADS, P<.01). In fact, twice as many spouses (62%) endorsed problems with depression than patients (31%) on the NCCN problem list. Physical symptoms were rated as the second most frequent problem area with both patients and spouses endorsing fatigue (64% and 56%, respectively) and sleep disturbances (58% and 56%, respectively) as frequent problems. Financial distress (COST scores and each problem area (physical, practical, spiritual, emotional and social) were significantly associated with cancer-related parenting concerns (r=.40 to r =.70) and psychological symptoms (r=.31 to r=.73). Based on multiple regression analyses including PCQ, COST, and NCCN problems list scores, only parenting concerns were uniquely associated with depressive symptoms (PCQ, patients: beta=.33, P=.05; spouses: patients: beta=.35, P<.05). When modeling anxiety symptoms, social problems were uniquely associated for patients (beta=.57, P=.0.01) and parenting concerns for caregivers (beta=.29, P=.05).
Conclusion: Although emotional problems appear to be the most pressing concern, families experience physical, practical, and financial problems. Thus, parent-focused interventions need to target a range of support needs particularly around symptom management, practical problem solving and financial navigation to mitigate psychological distress and parenting concerns.
Authors:
Presenter - Morgan Jones, University of Texas MD Anderson Cancer Center
Co-Author - Katherine Voong, The University of Texas MD Anderson Cancer Center
Co-Author - Sujin Ann-Yi, PhD, Univeristy of Texas MD Anderson Cancer Center
Co-Author - Meagan Whisenant, PhD, APRN, UTHealth Cizik School of Nursing
Co-Author - Victoria Necroto, The University of MD Anderson Cancer Center
Co-Author - Kathrin Milbury, PhD, University of Texas MD Anderson Cancer Center
Development and testing of a novel, body image enhanced, multidisciplinary weight loss treatment: A randomized controlled clinical trial.
Poster Number: C160Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Multiple Health Behavior Change
Objective: Negative body image is common in adults seeking weight loss. While brief body image modules are common in multidisciplinary lifestyle interventions, they do not provide comprehensive support that targets the dialectic of body acceptance vs body change. A novel, targeted protocol to address body image in the context of the conceptual framework of body acceptance vs. body change was developed. The intervention was delivered in the context of a comprehensive, multidisciplinary lifestyle intervention for weight loss and compared to a typical weight loss treatment. Outcomes included changes in weight, body composition and body image.
Methods: A randomized controlled clinical trial compared a standard group-based lifestyle intervention (LI) to a comparable intervention enhanced with a structured, CBT-informed body image intervention (LIBI). The LIBI protocol included dialectical psychoeducation; body functionality/appreciation; cognitive restructuring; graded exposure/behavioral activation to promote body confidence; interoceptive mindfulness; media literacy; and assertiveness/values work. Participants were 58 adult (age > 18 yrs.) women with overweight/obesity (BMI > 24.9 kg/m2) randomized per-protocol (LI n=18, LIBI n=19). Participants attended pre- post- assessment visits and 12 weeks of treatment. Body image was assessed via the Body Uneasiness Test indices (GSI, PSDI) and Body Image Assessment for Obesity discrepancy scores (CBS–IBS; CBS–RBS). Body fat mass was measured via air-displacement plethysmography. Weight was recorded weekly using a calibrated scale.
Results: Per-protocol latent change score models indicated statistically significant weight loss in both LI (p < .001) and LIBI (p < .001), and significant reductions in body fat mass in LIBI (p < .001) but not LI (p = .060). For body image, PSDI decreased in both groups (LI p < .006; LIBI p < .05) while LIBI showed additional reductions in GSI (p < .01), CBS–IBS (p < .001), and CBS–RBS p < .004), consistent with broader improvements across attitudinal and perceptual dimensions. Between-group differences in weight loss and body fat mass were not significant over 12 weeks (Ps > .05).
Discussion: Findings suggest that a comprehensive, multidimensional body image intervention can be integrated into weight loss treatment to enhance body image outcomes without impeding weight reduction. This will provide important relief for this salient comorbid condition.
*Edited text with ChatGPT assistance
Keywords: Obesity, Weight lossMethods: A randomized controlled clinical trial compared a standard group-based lifestyle intervention (LI) to a comparable intervention enhanced with a structured, CBT-informed body image intervention (LIBI). The LIBI protocol included dialectical psychoeducation; body functionality/appreciation; cognitive restructuring; graded exposure/behavioral activation to promote body confidence; interoceptive mindfulness; media literacy; and assertiveness/values work. Participants were 58 adult (age > 18 yrs.) women with overweight/obesity (BMI > 24.9 kg/m2) randomized per-protocol (LI n=18, LIBI n=19). Participants attended pre- post- assessment visits and 12 weeks of treatment. Body image was assessed via the Body Uneasiness Test indices (GSI, PSDI) and Body Image Assessment for Obesity discrepancy scores (CBS–IBS; CBS–RBS). Body fat mass was measured via air-displacement plethysmography. Weight was recorded weekly using a calibrated scale.
Results: Per-protocol latent change score models indicated statistically significant weight loss in both LI (p < .001) and LIBI (p < .001), and significant reductions in body fat mass in LIBI (p < .001) but not LI (p = .060). For body image, PSDI decreased in both groups (LI p < .006; LIBI p < .05) while LIBI showed additional reductions in GSI (p < .01), CBS–IBS (p < .001), and CBS–RBS p < .004), consistent with broader improvements across attitudinal and perceptual dimensions. Between-group differences in weight loss and body fat mass were not significant over 12 weeks (Ps > .05).
Discussion: Findings suggest that a comprehensive, multidimensional body image intervention can be integrated into weight loss treatment to enhance body image outcomes without impeding weight reduction. This will provide important relief for this salient comorbid condition.
*Edited text with ChatGPT assistance
Authors:
Author - Yazmine Huizar, Ph.D., DBSM, DreamWell Psychology
Author - Martin Binks, PhD., MBA., George Mason University
Gamification Is Associated With Weight Loss in an AI Health Coaching App
Poster Number: C161Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Digital Health
Background: Obesity is a global health concern. Mobile weight loss (WL) apps provide tools to log everyday lifestyle behaviors and receive feedback. Gamification can increase adherence to a WL program; one common strategy is using streaks for repeated in‑app actions. This study examined the association between daily check‑in streaks and WL among AI health coach app users.
Methods: Users who signed up for the mobile app between February 1 and May 15, 2025 were included. Gamification was incorporated by visibly displaying each user’s current streak within the app. A streak was defined as the number of consecutive days in which users completed daily check-ins – achieved by answering a question about their well-being – with the AI coach. The longest streak achieved within the first 30 days was recorded as the main independent variable. The primary outcome was percentage WL from baseline measured on day 30 (±3 days) after enrollment. To assess associations, a regression model was adjusted for sex, age, and baseline BMI. The percentage of users who achieved ≥1% was calculated. Group differences were evaluated using Welch's t-test. P-values were adjusted by the Holm-Bonferroni method.
Results: The analysis included 23,772 users (75.0% women; aged ≥ 60 years — 19.6%). Mean baseline BMI was 32.6 (SD 6.79) kg/m2. Mean WL% was 2.30% (SD 5.11). In total, 16,583 (69.8%) users achieved ≥1% WL. Users without streaks (n = 2,295), with the longest streak of 1–14 (n = 12,724), 15–29 (n = 6,826), and 30 days (n = 1,927) lost 1.89% (SD 6.25), 2.13% (SD 5.09), 2.54% (SD 4.83), and 3.12% (SD 4.53) of their baseline weight, respectively. All between-group differences were statistically significant (P-values < 0.0001) except between the 0 and 1–14 day groups. Each additional 5-day increase in the longest streak was associated with 0.16% greater WL (per day β = 0.03193; P-value < 0.0001).
Conclusion: Streak‑based gamification of daily in‑app check‑ins on energy level and motivation was strongly associated with WL among users of a mobile AI health coach app, particularly for streaks of 15 days or more. Future studies should test streaks and other gamification features as ways to enhance tracking and improve weight loss outcomes.
Keywords: Weight loss, e-HealthMethods: Users who signed up for the mobile app between February 1 and May 15, 2025 were included. Gamification was incorporated by visibly displaying each user’s current streak within the app. A streak was defined as the number of consecutive days in which users completed daily check-ins – achieved by answering a question about their well-being – with the AI coach. The longest streak achieved within the first 30 days was recorded as the main independent variable. The primary outcome was percentage WL from baseline measured on day 30 (±3 days) after enrollment. To assess associations, a regression model was adjusted for sex, age, and baseline BMI. The percentage of users who achieved ≥1% was calculated. Group differences were evaluated using Welch's t-test. P-values were adjusted by the Holm-Bonferroni method.
Results: The analysis included 23,772 users (75.0% women; aged ≥ 60 years — 19.6%). Mean baseline BMI was 32.6 (SD 6.79) kg/m2. Mean WL% was 2.30% (SD 5.11). In total, 16,583 (69.8%) users achieved ≥1% WL. Users without streaks (n = 2,295), with the longest streak of 1–14 (n = 12,724), 15–29 (n = 6,826), and 30 days (n = 1,927) lost 1.89% (SD 6.25), 2.13% (SD 5.09), 2.54% (SD 4.83), and 3.12% (SD 4.53) of their baseline weight, respectively. All between-group differences were statistically significant (P-values < 0.0001) except between the 0 and 1–14 day groups. Each additional 5-day increase in the longest streak was associated with 0.16% greater WL (per day β = 0.03193; P-value < 0.0001).
Conclusion: Streak‑based gamification of daily in‑app check‑ins on energy level and motivation was strongly associated with WL among users of a mobile AI health coach app, particularly for streaks of 15 days or more. Future studies should test streaks and other gamification features as ways to enhance tracking and improve weight loss outcomes.
Authors:
Author - Rosemary Huntriss, MSc, MRes, Simple.Life Apps, Inc.
Co-Author - Dimitri Nikogosov, MD, Simple.Life Apps, Inc.
Co-Author - Rodion Salimgaraev, MD, Simple.Life Apps, Inc.
A GLP-1 agonist household ripple effect? Preliminary evidence and implications for behavioral science
Poster Number: C162Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Child and Family Health
One in eight Americans has used obesity management medications (OMMs), such as GLP1 agonists. Some have speculated OMMs may trigger a “ripple effect” on health behaviors within households, as seen with metabolic bariatric surgery. However, empirical evidence remains limited. This study utilized a subset of data from a larger survey study on OMMs to examine the perceived impact of OMM use on: 1) household members’ attention to their weight, eating, and exercise, 2) household members’ weight change, and 3) household food purchasing and meal patterns. English-speaking adults were recruited for the parent study in early 2025 using flyers posted in four clinic waiting rooms at a large urban health system. The analytic sample includes patients reporting current or former OMM use (n=21). Patients reported the perceived effect of their own OMM use on household eating and weight dynamics using surveys from the literature. OMM users’ ages ranged from 20 to 62 years; most identified as female (91%), Hispanic (43%), and Black (29%). Most (95%) reported a steady living arrangement (i.e., stable housing), with a mean of 2.3 additional household members other than the respondent. For Aim 1, 67% of patients with adult household members (n=12) reported their OMM use had “some” or “a lot” of impact on their adult household members’ attention to weight, eating, and exercise. Similarly, 67% of OMM users with minors in the home (n=6) reported “a little” or “some” impact on minors’ attention to these matters. For Aim 2, 42% of patients with adult household members reported that those individuals lost weight after the respondent started an OMM; no weight loss was reported for minors. For Aim 3, the majority of patients reported purchasing less snack food (81%), bread/pasta/rice/cereal (76%), and beverages (62%) after initiating an OMM, and purchasing more fruits/vegetables (71%) and poultry (42%). For meal patterns, 43% reported eating healthier meals as a family after starting an OMM; other potential changes (e.g., eating smaller meals as a family) were endorsed less frequently (all <30%). While these findings are hypothesis-generating due to the small sample size and self-report methods, results suggest potential impacts of OMM use on household health behaviors and weight, especially among adults. More research is needed to understand how OMM use may promote broader health behavior change and benefits within households, and to identify any unintended consequences of OMM use.
Keywords: Obesity, FamilyAuthors:
Presenter - Leah Schumacher, PhD, Temple University
Co-Author - Doria Wohler, Temple University
Co-Author - Elise Rodrigues, Lewis Katz School of Medicine, Temple University
Co-Author - Erin Mraz, Temple University
Co-Author - Astha Rajpal, Temple University
Co-Author - Sharon Herring, MD, MPH, Lewis Katz School of Medicine, Temple University
Co-Author - Daniel Rubin, MD, MSC, FACE, Lewis Katz School of Medicine, Temple University
Co-Author - Ajay Rao, MD, MMSc, FACP,, Lewis Katz School of Medicine, Temple University
Co-Author - Samantha Flanagan, DO, Lewis Katz School of Medicine, Temple University
Co-Author - Laura Igarabuza, MD, Lewis Katz School of Medicine, Temple University
Co-Author - Daniel Edmundowicz, MS, MD, FACP, FACC, Lewis Katz School of Medicine, Temple University
Co-Author - Resa Jones, MPH, PhD, Temple University
Co-Author - David Sarwer, PhD, Temple University
Prenatal Care Confidence Scale: A New Tool for Assessing Women’s Pregnancy-Related Self-Efficacy
Poster Number: C163Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Methods and Measurement
Background: Women’s pregnancy-related self-efficacy (PRSE), or specifically, their confidence in their ability to engage in necessary pregnancy-related health behaviors, may reduce the risk of adverse health outcomes. Most research on PRSE has focused on labor and delivery, and no psychometrically validated measures exist for self-efficacy in health behaviors during pregnancy. To address this gap, this study aims to develop the Prenatal Care Confidence Scale (PCCS) to assess women’s PRSE by: (1) identifying the factor structure of the PCCS and (2) examining its preliminary reliability and validity.
Methods: The items of the PCCS were developed by the authors using Delphi methods, and included input from experts (e.g., OBGYNs). Women aged 18–49 were recruited via ResearchMatch™ (n=1,138), the mean age was 31.11 (SD=7.05), the sample was predominantly White (81.5%), and had a bachelor or master’s degree (68.6%) (Table 1). A random split resulted in 597 participants. All participants completed demographic and health-related questionnaires, including the 6-item Kessler Distress (K6) Screen. Using SPSS, we conducted an Exploratory Factor Analysis using Promax rotation. Statistical assumptions were tested, and items were deleted iteratively. Cronbach’s alpha was calculated for the total and factor scores, and correlations with relevant measures examined convergent validity.
Results: The PCCS includes 18 items and four factors: (1) managing life, (2) physical health, (3) psychosocial health, and (4) planning (Table 2). The Kaiser-Meyer-Olkin (KMO =.89) and Bartlett’s tests of sphericity [χ (153) = 4452.81, p < .001] indicated acceptable fit for the dataset. Internal consistency was high for the total PCCS score (α =.90) and the Factors: (α = .86, .79, .78, .73, for each factor respectively). The total PCCS score (confidence) was negatively correlated with distress (K6) (r = –.43, p < .001), confidence was positively associated with more pregnancies (r =.23, p < .001), and more births (r =.22, p < .001).
Conclusions: This study indicates that the PCCS appears to have a clear four-factor structure, strong internal consistency, and preliminary convergent validity. More experience with pregnancy was associated with higher PRSE. A future Confirmatory Factor Analysis with the remaining non-overlapping sample will determine whether the four factor structure is consistent. With further refinement, the PCCS may become a valuable tool for both research and practice.
Keywords: Pregnancy, HealthMethods: The items of the PCCS were developed by the authors using Delphi methods, and included input from experts (e.g., OBGYNs). Women aged 18–49 were recruited via ResearchMatch™ (n=1,138), the mean age was 31.11 (SD=7.05), the sample was predominantly White (81.5%), and had a bachelor or master’s degree (68.6%) (Table 1). A random split resulted in 597 participants. All participants completed demographic and health-related questionnaires, including the 6-item Kessler Distress (K6) Screen. Using SPSS, we conducted an Exploratory Factor Analysis using Promax rotation. Statistical assumptions were tested, and items were deleted iteratively. Cronbach’s alpha was calculated for the total and factor scores, and correlations with relevant measures examined convergent validity.
Results: The PCCS includes 18 items and four factors: (1) managing life, (2) physical health, (3) psychosocial health, and (4) planning (Table 2). The Kaiser-Meyer-Olkin (KMO =.89) and Bartlett’s tests of sphericity [χ (153) = 4452.81, p < .001] indicated acceptable fit for the dataset. Internal consistency was high for the total PCCS score (α =.90) and the Factors: (α = .86, .79, .78, .73, for each factor respectively). The total PCCS score (confidence) was negatively correlated with distress (K6) (r = –.43, p < .001), confidence was positively associated with more pregnancies (r =.23, p < .001), and more births (r =.22, p < .001).
Conclusions: This study indicates that the PCCS appears to have a clear four-factor structure, strong internal consistency, and preliminary convergent validity. More experience with pregnancy was associated with higher PRSE. A future Confirmatory Factor Analysis with the remaining non-overlapping sample will determine whether the four factor structure is consistent. With further refinement, the PCCS may become a valuable tool for both research and practice.
Authors:
Author - Salayna Abdallah, Bachelor of Science (BS), Master of Arts (MA), Kent State University and University Hospitals
Co-Author - Nicole Fiorelli, Master of Arts, University Hospitals
Co-Author - Jennifer Levin, PhD, University Hospitals of Cleveland Medical Center/CWRU SOM
Chair - Joel Hughes, PhD, Kent State University
Barriers and facilitators to healthcare providers taking a harm reduction approach to education and counseling about perinatal cannabis use: A qualitative study
Poster Number: C164Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Substance Misuse
Background: Perinatal cannabis use (PCU), use of cannabis during pregnancy or lactation, has been associated with negative health outcomes for both parent and child. It is recommended that perinatal people abstain from PCU. However, with increased legalization, cannabis is becoming more available and lay views about safety are shifting, which is promoting more widespread use. Further, some individuals continue perinatal use despite knowledge of risks due to difficulty ceasing and/or perceived benefits of cannabis. The best evidence-based practice for these individuals is harm reduction (HR), which emphasizes success with reduction in frequency, quantity, potency, and mode of use, even in the absence of complete cessation or abstinence. HR is not currently widely adopted for PCU in the US. As part of a larger study seeking to develop a toolkit to support providers in taking an HR approach to PCU, we asked perinatal healthcare providers about barriers and facilitators to employing HR when counseling and educating patients about PCU. Methods: Perinatal healthcare providers (N=22) of varied training backgrounds (nurses, midwives, neonatologists, maternal fetal medicine and family medicine physicians) completed an in-depth semi-structured interview asking what facilitates and hinders their ability to use HR for PCU. Results were analyzed using a matrix-guided rapid analytic approach: participant responses were condensed into summary templates and transferred into a matrix, to facilitate case comparison and cull key themes. Results: Two key facilitators were: (1) working in a setting where there is a consistent approach to care across all providers (i.e., providers are confident their patients’ HR goals will be supported when being cared for by colleagues), and relatedly, (2) having a clinical culture that embraces HR (providers feel safe using this approach because others in the clinic do the same). Two primary barriers were: (1) lack of time to engage in counseling about cannabis alongside other clinical responsibilities, and (2) mandated reporting requirements related to substance use that are perceived to threaten patient – provider trust. Conclusions and Future Directions: Providers identified key facilitators and barriers of taking an HR approach to PCU. Implementation strategies included in the toolkit will be selected to capitalize on these facilitators and help providers overcome these barriers in service of promoting the use of an HR approach to PCU.
Keywords: Women's health, Substance abuseAuthors:
Presenter - Ariana Albanese, PhD, Brown University
Co-Author - E. Ruby Cramer, BA, The Warren Alpert Medical School of Brown University
Co-Author - Meghan Sharp, PhD, Rhode Island Hospital
Co-Author - Margo Katz, MA, The Rhode Island Department of Health
Co-Author - Katie Gonzalez, BA, CPRS, VNA Care New England
Co-Author - Margaret Crane, PhD, The Warren Alpert Medical School of Brown University
Co-Author - Aden Littlewood, ScB, The Warren Alpert Medical School of Brown University
Co-Author - Emily Fu, PhD, MPH, The Warren Alpert Medical School of Brown University
Co-Author - Brooke Rogers, PhD, MPH, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center
MAKING SENSE OF PCOS ON SOCIAL MEDIA: EXPLORING INFORMATION-SEEKING AND SELF MANAGEMENT STRATEGIES
Poster Number: C165Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Digital Health
Background:
Polycystic ovary syndrome (PCOS) affects up to 1 in 10 women of reproductive age and is associated with metabolic, reproductive, and psychosocial challenges. Many women turn to social media for health information and community support, yet little is known about how they interpret and integrate this content into self-management. This study explored how women with PCOS engage with and make sense of PCOS-related social media.
Methods:
Semi-structured interviews were conducted with 30 women (ages 18–40) who actively use social media to access PCOS information. Participants were recruited online and completed one-hour virtual interviews. Interviews were transcribed verbatim and analyzed using thematic analysis. Coding was guided by Sense-Making Theory to capture how participants navigated uncertainty, constructed meaning, and applied social media content to their health.
Results:
Four themes emerged:
(1) Social media as a personalized learning space: Participants curated feeds to tailor information to their needs, often supplementing clinical guidance.
(2) Critical appraisal, conflicting information, and experimentation: Women frequently encountered contradictory advice, which led them to cross-check sources, test strategies (e.g., diets, supplements), and adapt based on outcomes.
(3) Community-based meaning-making: Online communities validated experiences, normalized symptoms, and offered emotional support, particularly when medical interactions felt dismissive.
(4) Cultural identity as an interpretive lens: Racial/ethnic background shaped evaluations of advice, with some finding culturally specific content helpful, while others noted exclusionary gaps where recommendations failed to reflect their foods, practices, or experiences.
Conclusions:
Social media offered women with PCOS opportunities for personalized learning, peer validation, and cultural relevance, but also introduced challenges such as conflicting advice, exclusionary messaging, and uncertain credibility. Women navigated these tensions by critically appraising content, experimenting with strategies, and seeking reassurance from peers. Social media was a dynamic space where women actively negotiated meaning in the absence of consistent clinical guidance. Clinicians and public health professionals can support patients by acknowledging the role of social media, addressing misinformation, and guiding women toward trustworthy, inclusive resources.
Keywords: Women's health, e-HealthPolycystic ovary syndrome (PCOS) affects up to 1 in 10 women of reproductive age and is associated with metabolic, reproductive, and psychosocial challenges. Many women turn to social media for health information and community support, yet little is known about how they interpret and integrate this content into self-management. This study explored how women with PCOS engage with and make sense of PCOS-related social media.
Methods:
Semi-structured interviews were conducted with 30 women (ages 18–40) who actively use social media to access PCOS information. Participants were recruited online and completed one-hour virtual interviews. Interviews were transcribed verbatim and analyzed using thematic analysis. Coding was guided by Sense-Making Theory to capture how participants navigated uncertainty, constructed meaning, and applied social media content to their health.
Results:
Four themes emerged:
(1) Social media as a personalized learning space: Participants curated feeds to tailor information to their needs, often supplementing clinical guidance.
(2) Critical appraisal, conflicting information, and experimentation: Women frequently encountered contradictory advice, which led them to cross-check sources, test strategies (e.g., diets, supplements), and adapt based on outcomes.
(3) Community-based meaning-making: Online communities validated experiences, normalized symptoms, and offered emotional support, particularly when medical interactions felt dismissive.
(4) Cultural identity as an interpretive lens: Racial/ethnic background shaped evaluations of advice, with some finding culturally specific content helpful, while others noted exclusionary gaps where recommendations failed to reflect their foods, practices, or experiences.
Conclusions:
Social media offered women with PCOS opportunities for personalized learning, peer validation, and cultural relevance, but also introduced challenges such as conflicting advice, exclusionary messaging, and uncertain credibility. Women navigated these tensions by critically appraising content, experimenting with strategies, and seeking reassurance from peers. Social media was a dynamic space where women actively negotiated meaning in the absence of consistent clinical guidance. Clinicians and public health professionals can support patients by acknowledging the role of social media, addressing misinformation, and guiding women toward trustworthy, inclusive resources.
Authors:
Author - Halide Zeynep Aydin, PhD, George Mason University
Author - Brie Turner-McGrievy, PhD, MS, RD, FSBM, University of South Carolina
Author - Olivia White, University of South Carolina
Author - Kylie Kosofsky, University of South Carolina
Author - Anna Matson, University of South Carolina
Author - Alison Sailer, Georgia State University
Author - Emily S. Mann, PhD, University of South Carolina
Author - Minji Kim, PhD, University of South Carolina
Author - Jungmi Jun, PhD, University of South Carolina
Exploration of Mindfulness as a Protective Factor in Women’s Sexual Health
Poster Number: C166Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Mental Health
Many women who experience physical health complaints also report sexual dysfunction across a variety of domains including decreased arousal, desire and satisfaction. Although there are well-established links between disease-specific populations and sexual dysfunction, less research has focused on women who experience somatic symptoms more broadly. Similarly, mindfulness as a treatment intervention has been applied across many facets of sexual functioning, but mindfulness has been less explored in its relationship with generalized somatic complaints, and connections between specific facets of mindfulness (observing, describing, acting with awareness, nonjudging, and nonreactivity) and domains of sexual functioning (desire, arousal, lubrication, orgasm, and pain) are not well understood. The current study examined the association between these variables, and whether mindfulness moderated the association between somatic symptoms and sexual dysfunction, both overall and at domain-specific levels. Female-identifying individuals (N = 1,233; many with history of infertility, pregnancy, and/or miscarriage) residing within the United States completed online questionnaires assessing their somatic symptoms, use of mindfulness, and sexual functioning. The overall moderation model was significant, F(3, 651) = 12.75, p < .000, explaining 6% of the variance in sexual dysfunction, but mindfulness did not significantly moderate the relationship between somatic symptoms and sexual dysfunction. The domain-specific moderation models were largely unsupported with the exception that the mindful facet of awareness significantly moderated the relationship between somatic symptoms and sexual desire F(1, 853) = 18.35, p = .000, R2 = .02, such that only at high levels of mindful awareness was there a significant negative relationship between somatic symptoms and desire. The covariates of age and trying to conceive also emerged as significant predictors related to sexual desire. In addition to exploring nuances of mindfulness practice, this poster highlights the complexity of female sexual dysfunction, specifically for women who experience somatic symptom burden (e.g., fertility-related complaints and associated treatments). These women are more likely to present for treatment in medical settings, highlighting the importance of assessment and intervention in integrated care.
Keywords: Sexual functioning, MindfulnessAuthors:
Co-Author - Shana Byerley, MA, East Tennessee State University
Co-Author - Shalini Venkat, East Tennessee State University
Chair - Julia Dodd, PhD, East Tennessee State University
The Usability and Acceptability of the Guiding Lifemakers on Wellness (GLOW) Website
Poster Number: C167Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Digital Health
INTRODUCTION: Perinatal individuals face challenges related to healthy eating, mental health, and often feel overwhelmed when trying to make well-informed health decisions. The Guiding Lifemakers on Wellness (GLOW) website aimed to increase perinatal individuals' access to evidence-based information to support their health during pregnancy and postpartum.
OBJECTIVE: To assess usability and acceptability of the GLOW website, capture barriers to utilizing the program, and gain understanding of the mental processes of users interacting with the website, via cognitive walkthroughs (CW).
METHODS: During the CW participants engaged with the GLOW website by completing four tasks: (1) locate a recipe, (2) create a wellness goal, (3) locate a video, and (4) draft a brief post on the discussion board. After each task, participants answered three questions adapted from the NASA-RTLX assessing the difficulty/cognitive load of each task using a numerical scale (1-20), with lower numbers indicating easier, more successful, and less stressful tasks. Means and standard deviations are reported for each NASA-RTLX score associated with the tasks.
RESULTS: Participants (N=15) were on average 31.67 (±3.32) years old. All reported high use of laptops/smartphones (4.7 and 6.9 days/week, respectively), and high confidence in internet use (91.8/100 points). When asked to locate a recipe on the website, mean scores were 8.32 (±4.23) for mental demand, 6.07 (±5.19) for effort, and 4.93 (±4.15) for frustration level. When asked to create a wellness goal on the website, mean scores were 2.46 (±1.22) for mental demand, 2.23 (±1.76) for effort, and 1.31 (±0.82) for frustration level. When asked to locate/briefly describe an informational video on the website, mean scores were 1.87 (± 1.96) for mental demand, 1.53 (±1.09) for effort, and 1.2 (±0.40) for frustration. When asked to locate/draft a discussion board post, mean scores were 3.93 (±3.26) for mental demand, 2.67 (±2.44) for effort, and 2.07 (±1.48) for frustration level.
CONCLUSION: Participants scored locating a recipe as the most difficult. Mean scores of adapted NASA-RTLX items indicated that participants perceived completing the tasks as more mentally demanding and time intensive. Findings from this phase of the study provide key insights into logistical changes that should be considered before piloting the GLOW program, as well as provide rich data regarding the changing health-related experiences of perinatal individuals.
Keywords: Pregnancy, TechnologiesOBJECTIVE: To assess usability and acceptability of the GLOW website, capture barriers to utilizing the program, and gain understanding of the mental processes of users interacting with the website, via cognitive walkthroughs (CW).
METHODS: During the CW participants engaged with the GLOW website by completing four tasks: (1) locate a recipe, (2) create a wellness goal, (3) locate a video, and (4) draft a brief post on the discussion board. After each task, participants answered three questions adapted from the NASA-RTLX assessing the difficulty/cognitive load of each task using a numerical scale (1-20), with lower numbers indicating easier, more successful, and less stressful tasks. Means and standard deviations are reported for each NASA-RTLX score associated with the tasks.
RESULTS: Participants (N=15) were on average 31.67 (±3.32) years old. All reported high use of laptops/smartphones (4.7 and 6.9 days/week, respectively), and high confidence in internet use (91.8/100 points). When asked to locate a recipe on the website, mean scores were 8.32 (±4.23) for mental demand, 6.07 (±5.19) for effort, and 4.93 (±4.15) for frustration level. When asked to create a wellness goal on the website, mean scores were 2.46 (±1.22) for mental demand, 2.23 (±1.76) for effort, and 1.31 (±0.82) for frustration level. When asked to locate/briefly describe an informational video on the website, mean scores were 1.87 (± 1.96) for mental demand, 1.53 (±1.09) for effort, and 1.2 (±0.40) for frustration. When asked to locate/draft a discussion board post, mean scores were 3.93 (±3.26) for mental demand, 2.67 (±2.44) for effort, and 2.07 (±1.48) for frustration level.
CONCLUSION: Participants scored locating a recipe as the most difficult. Mean scores of adapted NASA-RTLX items indicated that participants perceived completing the tasks as more mentally demanding and time intensive. Findings from this phase of the study provide key insights into logistical changes that should be considered before piloting the GLOW program, as well as provide rich data regarding the changing health-related experiences of perinatal individuals.
Authors:
Author - Leigh Neptune, PhD, RDN, Wabanaki Public Health and Wellness
Co-Author - Bryn Kubinsky, BS, University of Maine
Co-Author - Jade McNamara, PhD, RDN, University of Maine
Examining health risks in college women with ADHD: A scoping review
Poster Number: C168Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Mental Health
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder marked by impulsivity, inattention, and difficulties in executive function and self-regulation. ADHD was originally thought to predominantly affect men; however, emerging research indicates similar prevalence between men and women in adulthood. Gender differences in ADHD suggest women face greater risk of psychological distress and difficulties in interpersonal relationships. Still, the impacts of these differences on women’s health remain inadequately understood. This gap is especially concerning for college women with ADHD, who may experience unique cognitive impairments and health risks in environments where substance use and sexual assault are highly prevalent. This review aims to examine these factors and underscore the need for further research on this population.
For this scoping review, we conducted a search using two databases: Psycinfo and Pubmed. Articles were included if the study aimed to examine gender, or sex, differences in university students with ADHD. Covidence, an online screening and extraction tool, was used by one author to screen one hundred and two articles. The following data was extracted from each included article: study design, method of ADHD diagnosis, aim of study, population descriptions, measures used, and results. Results were analyzed using thematic analysis.
Of the one hundred and two articles that were screened, nine met inclusion criteria. Outcomes examined in the articles included social functioning (n=6), psychological need fulfillment (n=4), health risk behaviors (n=4), and self-efficacy (n=4). Comorbidities (n=6) were found with eating disorders (n=4), stressor related disorders (n=4), and depression (n=3). Four themes emerged: Impairments in social functioning, Increased comorbidity, Impacts on cognitive health, and diagnostic considerations. Findings suggest that female college students with ADHD report higher level of health risk behaviors, poorer psychological and social functioning, and increased risk for sexual assault.
Results indicate that college women with ADHD are at increased risk compared to their peers. Current gaps in understanding the impacts of ADHD on women’s sexual, psychological, and cognitive health warrant further investigation. Moreover, the elevated presence of health risk behaviors among college women with ADHD highlights the importance of advancing research focused on this underserved population.
Keywords: Mental health, Health outcomesFor this scoping review, we conducted a search using two databases: Psycinfo and Pubmed. Articles were included if the study aimed to examine gender, or sex, differences in university students with ADHD. Covidence, an online screening and extraction tool, was used by one author to screen one hundred and two articles. The following data was extracted from each included article: study design, method of ADHD diagnosis, aim of study, population descriptions, measures used, and results. Results were analyzed using thematic analysis.
Of the one hundred and two articles that were screened, nine met inclusion criteria. Outcomes examined in the articles included social functioning (n=6), psychological need fulfillment (n=4), health risk behaviors (n=4), and self-efficacy (n=4). Comorbidities (n=6) were found with eating disorders (n=4), stressor related disorders (n=4), and depression (n=3). Four themes emerged: Impairments in social functioning, Increased comorbidity, Impacts on cognitive health, and diagnostic considerations. Findings suggest that female college students with ADHD report higher level of health risk behaviors, poorer psychological and social functioning, and increased risk for sexual assault.
Results indicate that college women with ADHD are at increased risk compared to their peers. Current gaps in understanding the impacts of ADHD on women’s sexual, psychological, and cognitive health warrant further investigation. Moreover, the elevated presence of health risk behaviors among college women with ADHD highlights the importance of advancing research focused on this underserved population.
Authors:
Co-Author - Emma Tillery, Texas A&M University
Co-Author - Sherecce Fields, PhD, Texas A&M University
A Systematic Review of Work-related and Employment Disparities Among Breast Cancer Survivors in the U.S.
Poster Number: C17Time: 05:00 PM - 05:50 PM
Topics: Cancer
Background: Up to 73% of breast cancer survivors (BCS) currently experience financial difficulties, including employment-related challenges that can disrupt financial stability, social support, and personal fulfillment. There is a need to identify risk factors and understand the nature of employment consequences among BCS in the U.S.
Objective: To synthesize evidence on the socioeconomic and racial disparities affecting employment consequences of BCS in the U.S., focusing on job loss, reduced work hours, and employment disruption, during and after treatment.
Methods: A systematic search was conducted in PubMed, CINAHL, and APA PsycINFO for studies published between 2014 and 2025. Screening was done in RAYYAN. Studies reporting employment outcomes with racial/ethnic and/or income comparisons were included. Data were extracted on study characteristics, demographics, and employment outcomes stratified by race/ethnicity and income. The Joanna Briggs Institute Critical Appraisal Tools assessed study quality.
Results: Fourteen studies, with a total of 12,475 participants, revealed significant health disparities by race/ethnicity and income. Minority survivors and those with low income experienced substantially worse outcomes related to occupational functioning and returning to work. Compared to White women, Black women faced the most severe disadvantages with higher job loss rates, reduced employment status, missed work, unpaid leave, and higher rate of diminished employment. Asian, Latina, and other minor racial/ethnic groups also had elevated risks work cessation and extended absences. Furthermore, lower income levels were associated with increasingly severe employment consequences. Women in the lowest income brackets consistently faced the highest risks of job loss and work absence compared to higher-income groups.
Conclusions: Substantial disparities exist in employment among BCS. Minority racial women, particularly Black BCS, and those with lower incomes experience significantly worse employment outcomes.
Implications: These findings highlight the need for multi-level interventions. Healthcare providers should assess employment concerns and connect vulnerable patients with vocational services. Employers need flexible policies supporting cancer survivors. Policy changes expanding leave protections and strengthening disability programs could reduce disparities. Future research should examine intervention effectiveness and mechanisms driving these inequities.
Keywords: Cancer, DisparitiesObjective: To synthesize evidence on the socioeconomic and racial disparities affecting employment consequences of BCS in the U.S., focusing on job loss, reduced work hours, and employment disruption, during and after treatment.
Methods: A systematic search was conducted in PubMed, CINAHL, and APA PsycINFO for studies published between 2014 and 2025. Screening was done in RAYYAN. Studies reporting employment outcomes with racial/ethnic and/or income comparisons were included. Data were extracted on study characteristics, demographics, and employment outcomes stratified by race/ethnicity and income. The Joanna Briggs Institute Critical Appraisal Tools assessed study quality.
Results: Fourteen studies, with a total of 12,475 participants, revealed significant health disparities by race/ethnicity and income. Minority survivors and those with low income experienced substantially worse outcomes related to occupational functioning and returning to work. Compared to White women, Black women faced the most severe disadvantages with higher job loss rates, reduced employment status, missed work, unpaid leave, and higher rate of diminished employment. Asian, Latina, and other minor racial/ethnic groups also had elevated risks work cessation and extended absences. Furthermore, lower income levels were associated with increasingly severe employment consequences. Women in the lowest income brackets consistently faced the highest risks of job loss and work absence compared to higher-income groups.
Conclusions: Substantial disparities exist in employment among BCS. Minority racial women, particularly Black BCS, and those with lower incomes experience significantly worse employment outcomes.
Implications: These findings highlight the need for multi-level interventions. Healthcare providers should assess employment concerns and connect vulnerable patients with vocational services. Employers need flexible policies supporting cancer survivors. Policy changes expanding leave protections and strengthening disability programs could reduce disparities. Future research should examine intervention effectiveness and mechanisms driving these inequities.
Authors:
Author - Anita Oppong, BSc, MSN, RM, University of Connecticut
Co-Author - Asana Musah, BSc, Diploma Midwifery, St. Michaels' Nursing and Midwifery Training College, Kumasi-Ghana
Co-Author - Evans Kyei, PhD, RN, The University of Alabama, Tuscaloosa
Co-Author - Gee Su Yang, PhD, RN, University of Connecticut
The Impact of Pain and Mental Health on Transition Readiness Among Adolescent Childhood Cancer Survivors
Poster Number: C18Time: 05:00 PM - 05:50 PM
Topics: Cancer, Pain
Background: Completion of pediatric cancer treatment marks an important milestone for childhood cancer survivors (CCS). Despite its significance, few studies have examined psychological and physical factors that may influence transition readiness, a critical element for supporting the transition of care and long-term health outcomes. This study aimed to assess the prevalence of pain, anxiety, and depression among adolescent CCS at the end of treatment and explore how these factors are associated with transition readiness.
Methods: 49 CCS (11-17 years; 63.3% Male; 75.5% White; 34.7% Leukemia/Lymphoma), 3-12 months off treatment at study enrollment, completed the Transition Readiness Inventory and PROMIS Pediatric Profile – 49. Demographic and treatment-related variables were extracted from medical records. Regression analyses were conducted to examine the moderating effects of pain experience (pain intensity, pain interference) on the association between anxiety and depression with transition readiness domains: relationships/communication with health care providers and transition-related psychosocial functioning. Models were not adjusted for covariates as no significant sociodemographic or medical covariates emerged.
Results: Among CCS, elevated levels of pain interference (T ≥ 50) were endorsed by 38.8%, anxiety (T ≥ 55) by 28.6%, and depression (T ≥ 55) by 34.7%. Anxiety was significantly associated with poorer transition-related psychosocial functioning (β = −.22, p = .023) and worse relationship/communication scores (β = −.33, p = .003) and neither were moderated by pain domains. Depression was significantly associated with poorer transition-related psychosocial functioning in the context of high pain interference (β = −.26, p = .010) and moderate (β = −.14, p = .045) and high pain intensity (β = −.33, p = .002). Depression was not associated with relationships/communication with health care providers.
Conclusions: A notable subset of adolescent CCS report elevated pain and psychological symptoms during the transition off treatment. Anxiety was associated with worse transition-specific psychosocial functioning and healthcare provider relationship/communication, while depression was linked to reduced psychosocial readiness in the context of moderate-to-high pain experience. These findings highlight the emotional complexity of this time window and the critical role of the pain experience in shaping transition readiness.
Keywords: Cancer, PainMethods: 49 CCS (11-17 years; 63.3% Male; 75.5% White; 34.7% Leukemia/Lymphoma), 3-12 months off treatment at study enrollment, completed the Transition Readiness Inventory and PROMIS Pediatric Profile – 49. Demographic and treatment-related variables were extracted from medical records. Regression analyses were conducted to examine the moderating effects of pain experience (pain intensity, pain interference) on the association between anxiety and depression with transition readiness domains: relationships/communication with health care providers and transition-related psychosocial functioning. Models were not adjusted for covariates as no significant sociodemographic or medical covariates emerged.
Results: Among CCS, elevated levels of pain interference (T ≥ 50) were endorsed by 38.8%, anxiety (T ≥ 55) by 28.6%, and depression (T ≥ 55) by 34.7%. Anxiety was significantly associated with poorer transition-related psychosocial functioning (β = −.22, p = .023) and worse relationship/communication scores (β = −.33, p = .003) and neither were moderated by pain domains. Depression was significantly associated with poorer transition-related psychosocial functioning in the context of high pain interference (β = −.26, p = .010) and moderate (β = −.14, p = .045) and high pain intensity (β = −.33, p = .002). Depression was not associated with relationships/communication with health care providers.
Conclusions: A notable subset of adolescent CCS report elevated pain and psychological symptoms during the transition off treatment. Anxiety was associated with worse transition-specific psychosocial functioning and healthcare provider relationship/communication, while depression was linked to reduced psychosocial readiness in the context of moderate-to-high pain experience. These findings highlight the emotional complexity of this time window and the critical role of the pain experience in shaping transition readiness.
Authors:
Author - Blaine Peters, BS, University of Mississippi
Co-Author - Linnea Swanson, PhD, St. Jude Children's Research Hospital
Co-Author - Nele Loecher, PhD, St. Jude Children's Research Hospital
Co-Author - Anna Jones, PhD, St. Jude Children's Research Hospital
Co-Author - Emily Browne, DNP, St. Jude Children's Research Hospital
Co-Author - Sandra Jones, DNP, St. Jude Children's Research Hospital
Co-Author - Elizabeth Barnwell, MSN, St. Jude Children's Research Hospital
Co-Author - Ryan James, PhD, St. Jude Children's Research Hospital
Co-Author - Tara Brinkman, PhD, St. Jude Children's Research Hospital
Author - Rachel Webster, PhD, St. Jude Children's Research Hospital
Adjusting to the New Normal: Tailoring Mindfulness-Based Relapse Prevention for Smoking and Alcohol in Cancer Survivors
Poster Number: C19Time: 05:00 PM - 05:50 PM
Topics: Cancer, Tobacco Control and Nicotine-Related Behavior
Background: Although most cancer patients who smoke cigarettes want to quit, most quit attempts culminate in relapse. Existing smoking cessation interventions designed for cancer patients have not demonstrated efficacy above control conditions, underscoring the need to identify factors that support successful cessation. One primary obstacle to smoking cessation is problematic alcohol use, with cancer survivors who are current smokers engaging in two-folds the odds of hazardous alcohol use than non-smoking survivors. This study gathered feedback from cancer survivors to adapt Mindfulness-based Relapse Prevention for Smoking and Alcohol use (MBRP-SA), an 8 session group-based intervention for smoking cessation and alcohol modification, to meet the unique needs of cancer survivors.
Methods: Three focus groups conducted via Zoom using a semi-structured interview guide obtained feedback on MBRP-SA from cancer survivors who reported smoking cigarettes and drinking alcohol at the time of their cancer diagnosis. Additionally, we collected data on specific cancer experiences (e.g., sleep and fatigue, self-image and identity, pain, guilt and shame, nausea). Recordings were transcribed verbatim; data were analyzed using rapid qualitative analysis methods.
Results: Participants (N=17; mean age=40.82 ±12.9 yrs; 53% female; 53% Black/African American) expressed a high level of interest in MBRP-SA and appreciated the structure, tone, and emotional relevance of the intervention. They also reported interest in content that addresses both internal experiences (e.g., cravings, stress) and external factors (e.g., social triggers, routines). The inclusion of the following topics were highly supported, given their relationship to increased smoking and drinking: sleep and fatigue, self-image and identity, pain, and guilt and shame. An additional suggested topic included addressing the “new normal” of adjusting to cancer diagnosis, highlighting how smoking and drinking are often used as coping mechanisms to regain a sense of normalcy and control in the uncertainty and loss of control caused by their diagnosis.
Conclusion: Results will inform the modification of MBRP-SA to address the unique needs of cancer survivors who smoke and use alcohol, including but not limited to adding sleep hygiene content, incorporating how to manage pain via mindfulness-based strategies, and identifying self-image and/or guilt and shame as triggers for smoking and alcohol use.
Keywords: Cancer, SmokingMethods: Three focus groups conducted via Zoom using a semi-structured interview guide obtained feedback on MBRP-SA from cancer survivors who reported smoking cigarettes and drinking alcohol at the time of their cancer diagnosis. Additionally, we collected data on specific cancer experiences (e.g., sleep and fatigue, self-image and identity, pain, guilt and shame, nausea). Recordings were transcribed verbatim; data were analyzed using rapid qualitative analysis methods.
Results: Participants (N=17; mean age=40.82 ±12.9 yrs; 53% female; 53% Black/African American) expressed a high level of interest in MBRP-SA and appreciated the structure, tone, and emotional relevance of the intervention. They also reported interest in content that addresses both internal experiences (e.g., cravings, stress) and external factors (e.g., social triggers, routines). The inclusion of the following topics were highly supported, given their relationship to increased smoking and drinking: sleep and fatigue, self-image and identity, pain, and guilt and shame. An additional suggested topic included addressing the “new normal” of adjusting to cancer diagnosis, highlighting how smoking and drinking are often used as coping mechanisms to regain a sense of normalcy and control in the uncertainty and loss of control caused by their diagnosis.
Conclusion: Results will inform the modification of MBRP-SA to address the unique needs of cancer survivors who smoke and use alcohol, including but not limited to adding sleep hygiene content, incorporating how to manage pain via mindfulness-based strategies, and identifying self-image and/or guilt and shame as triggers for smoking and alcohol use.
Authors:
Author - Ranjita Poudel, PhD, Moffitt Cancer Center
Co-Author - Skye O. Dougan, MPH, Moffitt Cancer center
Co-Author - Melinda L. Maconi, Moffitt Cancer Center
Co-Author - Madison S. Rivera, BS, BA, Moffitt Cancer Center
Co-Author - Halle Smith, BA, Moffitt Cancer Center
Co-Author - Sierra Washington, MPH, Moffitt Cancer Center
Co-Author - Marilyn Horta, PhD, Moffitt Cancer Center
Co-Author - Katie Witkiewitz, PhD, University of New Mexico
Co-Author - Vani N. Simmons, PhD, Moffitt Cancer Center
Co-Author - Christine Vinci, PhD, Moffitt Cancer Center
Age, postoperative plasma Interlukin-6, and perfusion time associated with cardiac-surgery hospitalization.
Poster Number: C2Time: 05:00 PM - 05:50 PM
Topics: Aging, Cardiovascular Disease
Objectives: Cardiac surgery is a common practice for advanced heart diseases in late age. Interleukin-6 (IL-6) is a biomarker of cardiac disease severity due to its function in myocardial gene expression. Its levels were related to myocardial injury and may play a key role in the postoperative systemic inflammatory response syndrome (SIRS) following cardiopulmonary bypass (CPB) used for open-heart surgery (OHS). IL-6 has been associated with psychiatric disorders (e.g., anxiety, depression), negative coping, and perfusion time (i.e., a key indicator of OHS complexity). This study investigated the predictive value of postoperative plasma IL-6 on hospitalization (LOH) following cardiac surgery. Methods: All patients recruited by trained research assistants (RAs) were scheduled for non-emergency, non-transplant cardiac surgery, requiring CBP (N= of 23). Two weeks prior to their scheduled operation, RAs blinded to cardiac indices and lab data conducted a face-to-face psychosocial interview at the hospital. Blood samples were collected in the morning and three days postoperatively for biomarker assays. IL-6 was measured using a sandwich enzyme immunoassay kit, Quantikine High-Sensitivity IL-6 (R&D Systems, Minneapolis MN) with no modification of the manufacturer protocol. Surgical and cardiac indices were retrieved from the National Society of Thoracic Surgeons’(STS) Adult Cardiac Database. Results: In bivariate analyses, correlated with LOH were age, more medical comorbidities, perfusion time, and postoperative IL-6. Age was also correlated with IL-6. Regression model [F(10,N=215)=8.042,p<.001,R2=.282] showed that only age, perfusion time, and postoperative IL-6 were significantly associated with LOH(p<.01). Pre-OHS IL-6 levels were highly correlated with post-OHS levels. Other stress-sensitive biomarkers (cortisol and CRP) and myocardial biomarkers (Troponin and CK-MB) have no effect on LOH. The influence of IL-6 is highly significant, even after controlling for other predictors (e.g., general health condition and perfusion time) and key STS cardiac indices. Conclusion: Expanding the previous literature, the current study reveals the association of psychopathology-related plasma levels of IL-6, age, and LOH. Our finding suggests that levels of IL-6 could mediate the influence of age and medical comorbidities on LOH. This may provide age-based mechanisms in post-OHS LOH. Behavioral health providers may take an interdisciplinary approach for aging cardiac care.
Keywords: Aging, Cardiovascular diseaseAuthors:
Author - Amy Ai, PhD, Florida State University
Co-Author - Zhe Yang, PhD candidate, Florida State University
Psychosocial and Behavioral Correlates of Eating Concerns and Food Insecurity in Adolescent and Young Adult Cancer Survivors
Poster Number: C20Time: 05:00 PM - 05:50 PM
Topics: Cancer, Social and Environmental Context and Health
Introduction: Adolescent and young adult (AYA) cancer survivors face unique psychosocial challenges that may influence eating behaviors. Additionally, food insecurity (FI) has been linked to higher risk for disordered eating, particularly binge eating. Limited research has examined these issues within this vulnerable population. This cross-sectional study examined the prevalence of eating concerns and FI, and their correlations with psychosocial and behavioral factors in AYA cancer survivors.
Methods: AYA survivors (n=111 adolescents aged 15-17 years; n=304 young adults aged 18-24 years; 52% female; 65.3% White; 11.1% Hispanic) completed the Eating Attitudes Test-26 (EAT-26, ≥20: eating pathology), Binge Eating Scale (BES, ≥ 17: binge eating), 2-item Hunger Vital Sign (≥ 1: FI), PROMIS-29 (anxiety, depression, pain interference, fatigue), Social Support and Influence Scale, and answered questions about vaping and binge drinking. Descriptive statistics and Pearson correlations were conducted.
Results: In adolescents, 9.9% reported binge eating, 4.5% exhibited eating pathology, and 17.1% experienced food insecurity. BES score was negatively correlated with social support (r=-0.441, p<0.001) and positively correlated with the eating attitudes (r=0.496, p<0.001), fatigue (r=0.442, p<0.001), depression (r=0.363, p<0.001), and pain (r=0.300, p=0.006). EAT-26 score was positively correlated with vaping (r=0.322, p=0.001), while negatively correlated with social support (r=-0.322, p=0.001). FI was negatively correlated with social support (r=-0.449, p<0.001). In young adults, 12.8% reported binge eating, 7.6% exhibited eating pathology, and 23.4% experienced FI. BES score was positively correlated with eating attitudes (r=0.384, p<0.001), anxiety (r= 0.352, p<0.001) and depression (r= 0.389, p<0.001).
Conclusion: Young adults showed higher prevalences of eating concerns and FI; however, eating concerns in adolescents exhibited stronger and more consistent associations with psychosocial and behavioral factors—particularly social support, vaping, and emotional distress—suggesting greater sensitivity to underlying emotional and behavioral dynamics. Next steps include conducting adjusted analyses to account for potential confounders, such as sociodemographic and clinical variables, to better clarify the independent contributions of each factor. Implications for practice are discussed in the context of social determinants of health.
Keywords: Cancer survivorship, Eating behaviorsMethods: AYA survivors (n=111 adolescents aged 15-17 years; n=304 young adults aged 18-24 years; 52% female; 65.3% White; 11.1% Hispanic) completed the Eating Attitudes Test-26 (EAT-26, ≥20: eating pathology), Binge Eating Scale (BES, ≥ 17: binge eating), 2-item Hunger Vital Sign (≥ 1: FI), PROMIS-29 (anxiety, depression, pain interference, fatigue), Social Support and Influence Scale, and answered questions about vaping and binge drinking. Descriptive statistics and Pearson correlations were conducted.
Results: In adolescents, 9.9% reported binge eating, 4.5% exhibited eating pathology, and 17.1% experienced food insecurity. BES score was negatively correlated with social support (r=-0.441, p<0.001) and positively correlated with the eating attitudes (r=0.496, p<0.001), fatigue (r=0.442, p<0.001), depression (r=0.363, p<0.001), and pain (r=0.300, p=0.006). EAT-26 score was positively correlated with vaping (r=0.322, p=0.001), while negatively correlated with social support (r=-0.322, p=0.001). FI was negatively correlated with social support (r=-0.449, p<0.001). In young adults, 12.8% reported binge eating, 7.6% exhibited eating pathology, and 23.4% experienced FI. BES score was positively correlated with eating attitudes (r=0.384, p<0.001), anxiety (r= 0.352, p<0.001) and depression (r= 0.389, p<0.001).
Conclusion: Young adults showed higher prevalences of eating concerns and FI; however, eating concerns in adolescents exhibited stronger and more consistent associations with psychosocial and behavioral factors—particularly social support, vaping, and emotional distress—suggesting greater sensitivity to underlying emotional and behavioral dynamics. Next steps include conducting adjusted analyses to account for potential confounders, such as sociodemographic and clinical variables, to better clarify the independent contributions of each factor. Implications for practice are discussed in the context of social determinants of health.
Authors:
Author - Ana Paula S. Rodrigues, PhD, University of South Florida
Co-Author - Acadia Buro, PhD, University of New Mexico
Co-Author - Blaine Peters, B.S., St Jude Children's Research Hospital
Co-Author - Niki Jurbergs, PhD, St. Jude Children's Research Hospital
Co-Author - Anna Jones, PhD, St. Jude Children's Research Hospital
Co-Author - Tara Brinkman, PhD, St. Jude Children's Research Hospital
Co-Author - Rachel Webster, PhD, St. Jude Children's Research Hospital
Co-Author - Marilyn Stern, PhD, University of South Florida
Breast Cancer Survivorship Outcomes by Obesity Status and Urbanicity in the United States from the Behavioral Risk Factor Surveillance System (BRFSS) Study (2019-2023)
Poster Number: C21Time: 05:00 PM - 05:50 PM
Topics: Cancer, Weight Related Health
Background. Obesity has been associated with poorer health outcomes like increased pain among breast cancer survivors (BCS). Due to their increased risk of obesity, BCS living in rural communities have an increased risk of experiencing negative cancer survivorship care outcomes. This population faces other unique challenges like limited access to medical care, lack of insurance coverage, and lower socioeconomic status. The purpose of this study was to determine differences in cancer survivorship care (CSC) outcomes among BCS of different body weight status across urban and rural communities.
Methods. Data from BCS (N= 3,767) from the 2019-2023 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed for relationships between body mass index (BMI) and urban/rural status with CSC outcomes. Outcomes included provision of treatment summary and follow-up care plans, insurance coverage, and pain. Logistic regressions analyzed the interaction of BMI and urban/rural status on CSC outcomes while accounting for demographic covariates and complex survey sample weighting.
Results. Compared to normal weight urban BCS, overweight rural BCS were nearly twice as likely to not receive a treatment summary (adjusted odds ratio = 1.90, 95% confidence interval = [1.00,3.60]). Overweight rural BCS were also likely to not receive follow-up care plans, though the significance of this finding attenuated when adjusting for covariates (unadjusted OR = 2.94 [1.12,7.75]; adjusted OR = 1.97, [0.93, 4.20]). Both urban and rural obese BCS were more likely to lack insurance coverage and this relationship persisted for rural obese BCS upon model adjustment (14.67, [3.58, 56.06]). Rural overweight and normal weight BCS were less likely to report pain compared to the normal weight urban BCS, and this relationship persisted for rural normal weight BCS after adjustment (0.44, [0.22, 0.90]]).
Conclusions. Rurality uniquely impacts CSC outcomes among BCS of different body weight statuses. Continuity of care and insurance coverage for rural BCS of higher body weight status is uniquely impacted, which can lead to less equitable care. Rural BCS may need more self-advocacy with healthcare and rural providers should be aware of inequities impacting BCS and work to connect BCS to resources to combat these inequities.
Keywords: Cancer survivorship, Health disparitiesMethods. Data from BCS (N= 3,767) from the 2019-2023 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed for relationships between body mass index (BMI) and urban/rural status with CSC outcomes. Outcomes included provision of treatment summary and follow-up care plans, insurance coverage, and pain. Logistic regressions analyzed the interaction of BMI and urban/rural status on CSC outcomes while accounting for demographic covariates and complex survey sample weighting.
Results. Compared to normal weight urban BCS, overweight rural BCS were nearly twice as likely to not receive a treatment summary (adjusted odds ratio = 1.90, 95% confidence interval = [1.00,3.60]). Overweight rural BCS were also likely to not receive follow-up care plans, though the significance of this finding attenuated when adjusting for covariates (unadjusted OR = 2.94 [1.12,7.75]; adjusted OR = 1.97, [0.93, 4.20]). Both urban and rural obese BCS were more likely to lack insurance coverage and this relationship persisted for rural obese BCS upon model adjustment (14.67, [3.58, 56.06]). Rural overweight and normal weight BCS were less likely to report pain compared to the normal weight urban BCS, and this relationship persisted for rural normal weight BCS after adjustment (0.44, [0.22, 0.90]]).
Conclusions. Rurality uniquely impacts CSC outcomes among BCS of different body weight statuses. Continuity of care and insurance coverage for rural BCS of higher body weight status is uniquely impacted, which can lead to less equitable care. Rural BCS may need more self-advocacy with healthcare and rural providers should be aware of inequities impacting BCS and work to connect BCS to resources to combat these inequities.
Authors:
Author - Kelsey Sinclair, MA, Indiana University
Co-Author - Austin Medlin, MS, Indiana University
Co-Author - Shelley Johns, PsyD, ABPP, Indiana University School of Medicine
Co-Author - Misty Hawkins, PhD, Indiana University
Emergency Department Visits Among Non-Small Cell Lung Cancer Patients: Time to Event Analyses
Poster Number: C22Time: 05:00 PM - 05:50 PM
Topics: Cancer, Mental Health
Significance. Cancer patients go to emergency departments (EDs) at higher rates than the general population. Though not unexpected, data suggest patients with more comorbidities, pain, and poorer measures of well-being visit the ED more often. If psychological variables are predictors for ED visits, as they are for the many morbidities of cancer patients, has not been explored. This study evaluates depression and cancer related stress reported by patients at diagnosis in relationship to ED usage and time to ED visits. Evaluating the complex relationship between patterns of ED use and psychological factors in this population will provide needed data regarding risk factors for ED usage as patients are receiving cancer treatment and areas of improvement in patient care and ways to reduce patient burden.
Methods. Stage IV non-small cell lung cancer (NSCLC; N=263) were accrued at diagnosis into cohort study and completed monthly/bi-monthly self-report assessments, including depressive symptoms (Patient Health Questionnaire-9; PHQ9) and cancer related stress (Impact of Events Scale; IES). ED visits (number, timing) were abstracted from electronic medical records. Demographic information was collected at baseline. The mean follow-up interval was 571 days (1.5 years). Cox Proportional Hazard regressions evaluated differences in hazard of ED visit by depression severity.
Results. Preliminary analysis using a PHQ9 cutoff (≥ 10) show patients with moderate to severe depressive symptoms had a 44% higher hazard of ED visit compared to those with no/mild symptoms (p=0.0549). Using continuous PHQ9 scores, a one-point increase in PHQ9 score was associated with a 2.9% increase in hazard of ED visit (p=0.0573). The inclusion of covariates in the model (partner status, education, and IES score) resulted in reduced hazard of ED visit and reduced statistical significance. Planned analyses (N=300+) with a follow up interval >8 years will be provided, with death included as a competing risk.
Conclusion. A novel approach examines psychological factors and time-to-event analyses to examine health care usage (ED visits) in an at risk cancer group. Thus far, data suggest psychological responses at diagnosis as potentially predicting ED utilization. Follow up analyses will test the strength of this association of depression and cancer specific stress at diagnosis as risk factors for ED usage as lung cancer patients receive first line immunotherapy and targeted treatments.
Keywords: Cancer, Mental healthMethods. Stage IV non-small cell lung cancer (NSCLC; N=263) were accrued at diagnosis into cohort study and completed monthly/bi-monthly self-report assessments, including depressive symptoms (Patient Health Questionnaire-9; PHQ9) and cancer related stress (Impact of Events Scale; IES). ED visits (number, timing) were abstracted from electronic medical records. Demographic information was collected at baseline. The mean follow-up interval was 571 days (1.5 years). Cox Proportional Hazard regressions evaluated differences in hazard of ED visit by depression severity.
Results. Preliminary analysis using a PHQ9 cutoff (≥ 10) show patients with moderate to severe depressive symptoms had a 44% higher hazard of ED visit compared to those with no/mild symptoms (p=0.0549). Using continuous PHQ9 scores, a one-point increase in PHQ9 score was associated with a 2.9% increase in hazard of ED visit (p=0.0573). The inclusion of covariates in the model (partner status, education, and IES score) resulted in reduced hazard of ED visit and reduced statistical significance. Planned analyses (N=300+) with a follow up interval >8 years will be provided, with death included as a competing risk.
Conclusion. A novel approach examines psychological factors and time-to-event analyses to examine health care usage (ED visits) in an at risk cancer group. Thus far, data suggest psychological responses at diagnosis as potentially predicting ED utilization. Follow up analyses will test the strength of this association of depression and cancer specific stress at diagnosis as risk factors for ED usage as lung cancer patients receive first line immunotherapy and targeted treatments.
Authors:
Author - Ruth Sloan, MSPH, The Ohio State University
Co-Author - Barbara Andersen, PhD, FSBM, Ohio State University
Less Is More? Lower Quit Importance Predicts Higher Anti-Tobacco Message Fatigue Among Cancer Survivors
Poster Number: C23Time: 05:00 PM - 05:50 PM
Topics: Cancer, Tobacco Control and Nicotine-Related Behavior
BACKGROUND: Message fatigue—the perception that health messages are overly repetitive, excessive, or irritating—has been identified as a barrier to tobacco prevention efforts. Yet its role in survivorship care remains poorly understood. Cancer survivors are repeatedly exposed to tobacco cessation-oriented messaging, making it important to assess how fatigue toward these messages may differ across demographic groups and its association with tobacco use status and quit importance. METHOD: We assessed message fatigue among 118 survivors completing a 3-month follow-up survey as part a larger RCT. We used the 4-item original Anti-Tobacco Message Fatigue Scale (So & Popova, 2018) adding oncology-specific items on fatigue, helpfulness (reversed), and craving. Items were assessed on a 5-point Likert scale from 1 (strong agree) to 5 (strongly disagree). The 7-item adapted scale was analyzed descriptively; associations with quit importance were examined via linear regression controlling for tobacco use status, gender, age, and race/ethnicity. RESULTS: The study sample was 38% female, mean age = 58.76 , 53% non-Hispanic Whites, 5% non-English speakers, and 53% everyday tobacco users. The adapted scale demonstrated good internal consistency (α = .78). Overall message fatigue was moderate (M = 2.94, SD = 0.76, range 1–4.86). Items most strongly endorsed were reflected perceptions of excess and repetition (e.g., “too much,” M = 3.60, SD = 1.09; “repetitive,” M = 3.50, SD = 1.09), whereas boredom, tiredness, recovery helpfulness, and craving were less strongly endorsed (means 2.35–2.88). Levels of message fatigue did not differ significantly across tobacco use status, gender, age, or race/ethnicity. Regression analyses indicated that lower quit importance was significantly associated with higher message fatigue (b = –0.18, SE = 0.06, p = .002), even after controlling for tobacco use status, gender, age, and race/ethnicity. CONCLUSION: Cancer survivors report modest but measurable fatigue toward tobacco cessation-oriented messages. The adapted 7-item scale showed good reliability and captures fatigue dimensions relevant to survivorship. Findings suggest that survivors least motivated to quit tobacco are also most likely to disengage from cessation messaging. Tailoring outreach to reduce redundancy and emphasize autonomy may preserve engagement among those at greatest risk.
Keywords: Nicotine, Cancer survivorshipAuthors:
Presenter - Natalia Van Doren, PhD, University of California, San Francisco
Author - Edgar Yu, BA, Unviersity of California, San Francisco
Author - Chigozie Onyeagoro, UC San Francisco
Author - Carmen Ma, University of California, San Francisco
Author - Zinnia Loya, University of California, San Francisco
Author - Mei-Chin Kuo, University of California, San Francisco
Author - Kylie Sloan, University of California, San Francisco
Author - Laurel Bray-Hanin, University of California, San Francisco
Author - Lisa Kroon, University of California, San Francisco
Author - Suzanne Harris, University of California, San Francisco
Author - Sonia Sharma, University of California, San Francsico
Author - Patrick Ha, University of California, San Francisco
Author - SS Yom, University of California, San Francisco
Author - Stella Bialous, University of California, San Francisco
Author - Janice Tsoh, PhD, University of California San Francisco
PAfitME-Strong (Mental Health Screening and Exercise-gaming Coaching) to Improve Mental Health among Young Adult Cancer Patients
Poster Number: C24Time: 05:00 PM - 05:50 PM
Topics: Cancer, Mental Health
Background: Over 2 million young adults (YA: 18-39 y/o) with a cancer diagnosis are living in the U.S., and most were diagnosed more than 10 years ago. However, 61% of these patients are also diagnosed with a mental health illness (e.g., depression, anxiety) within 3 years of the cancer diagnosis.
Objectives: The purpose of the study was to pilot test the effects of the PAfitME-Strong intervention on perceived stress, depressive symptoms, and anxiety symptoms when compared with a control condition among YA cancer patients.
Methods: This was a two-group design: 10 were in the intervention group and 21 were in the control group. The 12-week telehealth Strong-PAfitME comprised depressive and anxiety symptom Screening and referral navigation and health coaching that includes a personalized Physical Activity intervention with fitness-graded Motion Exercises. Perceived stress was measured by the self-reported 4-item Perceived Stress Scale (PSS). Depressive/anxiety symptoms were measured by the PROMIS emotional distress short forms, including 8 items on depression and 7 items on anxiety. Descriptive statistics and Mann-Whitney U tests were applied. Fitbits were used to measure weekly steps.
Results: In the intervention group, the mean age was 32.20 (SD=7.07) years old, and 30% were males; 40% were Whites. In the control group, the mean age was 32.05 (SD=6.25) years old, and 19.05% were males; 47.62% were White. Analyses on change scores (pre- and post-test) indicated that the intervention group improved significantly more than the control group on perceived stress (U = 91, p = 0.017, r = 0.43) and depressive symptoms (U = 77, p = 0.015, r = 0.44). Two (n=2) participants who showed moderate levels of depressive symptoms in weekly screening were successfully referred to the supportive care clinic (100%). The intervention group made more weekly steps than the control group (51,446 vs. 49,712).
Conclusions: The PAfitME-Strong intervention significantly reduced perceived stress and depressive symptoms, with moderate to large effect sizes observed in this pilot study. These findings warrant a larger randomized clinical trial to evaluate the intervention’s efficacy. The results also highlight a clinically meaningful improvement, underscoring the practical relevance of symptom reduction.
Keywords: Cancer survivorship, Mental healthObjectives: The purpose of the study was to pilot test the effects of the PAfitME-Strong intervention on perceived stress, depressive symptoms, and anxiety symptoms when compared with a control condition among YA cancer patients.
Methods: This was a two-group design: 10 were in the intervention group and 21 were in the control group. The 12-week telehealth Strong-PAfitME comprised depressive and anxiety symptom Screening and referral navigation and health coaching that includes a personalized Physical Activity intervention with fitness-graded Motion Exercises. Perceived stress was measured by the self-reported 4-item Perceived Stress Scale (PSS). Depressive/anxiety symptoms were measured by the PROMIS emotional distress short forms, including 8 items on depression and 7 items on anxiety. Descriptive statistics and Mann-Whitney U tests were applied. Fitbits were used to measure weekly steps.
Results: In the intervention group, the mean age was 32.20 (SD=7.07) years old, and 30% were males; 40% were Whites. In the control group, the mean age was 32.05 (SD=6.25) years old, and 19.05% were males; 47.62% were White. Analyses on change scores (pre- and post-test) indicated that the intervention group improved significantly more than the control group on perceived stress (U = 91, p = 0.017, r = 0.43) and depressive symptoms (U = 77, p = 0.015, r = 0.44). Two (n=2) participants who showed moderate levels of depressive symptoms in weekly screening were successfully referred to the supportive care clinic (100%). The intervention group made more weekly steps than the control group (51,446 vs. 49,712).
Conclusions: The PAfitME-Strong intervention significantly reduced perceived stress and depressive symptoms, with moderate to large effect sizes observed in this pilot study. These findings warrant a larger randomized clinical trial to evaluate the intervention’s efficacy. The results also highlight a clinically meaningful improvement, underscoring the practical relevance of symptom reduction.
Authors:
Author - Hsiao-Lan Wang, PhD, University of Alabama at Birmingham
Co-Author - Laura Szalacha, EdD, University of South Florida
Co-Author - Richard Taylor, PhD, University of Alabama at Birmingham
Co-Author - Emily Johnston, MD, University of Alabama at Birmingham
Co-Author - Rebecca Arend, MD, University of Alabama at Birmingham
Co-Author - Douglas Moellering, PhD, University of Alabama at Birmingham
Co-Author - Kelly Brown, MS, University of Alabama at Birmingham
Co-Author - Jocelyn McAlpine, MSN, University of Alabama at Birmingham
Co-Author - Terika Miller, MS, University of Alabama at Birmingham
Co-Author - Peng Li, PhD, University of Alabama at Birmingham
Co-Author - Barbara Smith, PhD, University of South Florida
Co-Author - David Vance, PhD, University of Alabama at Birmingham
Demoralization as the Key Mechanism Linking Alexithymia and Post-traumatic Growth in Chinese Breast Cancer Survivors
Poster Number: C25Time: 05:00 PM - 05:50 PM
Topics: Cancer, Women's Health
Psychosocial adjustment after a cancer diagnosis is a critical challenge. Alexithymia, a construct involving difficulty identifying and describing emotions, has traditionally been conceptualized as a stable trait but may also reflect state-like, illness-related emotional dysregulation, particularly in the context of cancer (Taylor & Bagby, 2000; Porcelli et al., 2007; Xie et al., 2024). This trait–state nuance is especially relevant in cultures that value emotional restraint, where alexithymia may represent enduring vulnerabilities and contextual adaptations (Porcelli et al., 2011). While research links alexithymia to poorer post-traumatic growth (PTG; Orejuela-Dávila et al., 2017), the mechanism explaining how it impedes growth remains unclear, particularly in non-Western settings. We hypothesized that demoralization, a state of existential distress (Clarke & Kissane, 2002), explains this link. Specifically, an inability to process emotional pain may foster hopelessness and helplessness, which directly undermines the meaning-making central to PTG.
Our study tested this model in 305 Chinese breast cancer survivors (M age = 52.0, SD = 9.77). Participants completed the Toronto Alexithymia Scale (TAS-26), Demoralization Scale—Mandarin Version (DS-MV), and Posttraumatic Growth Inventory – Chinese Version (PTGI-C). All measures were back-translated and revealed sufficient internal consistency (Cronbach’s alpha > .75).
Path analysis with bootstrapping indicated that alexithymia significantly predicted higher demoralization (β = .565, p < .001), which in turn predicted lower PTG (β = –.290, p < .001). The indirect effect of alexithymia on PTG through demoralization was significant (b = –.326, β = –.164, 95% CI [–.499, –.162], p < .001). The direct effect of alexithymia on PTG was nonsignificant (b = –.021, β = –.011, 95% CI [–.285, .248], p = .873), whereas the total effect remained significant (b = –.347, β = –.175, 95% CI [–.570, –.116], p = .002). Our findings establish demoralization as the key pathway fully explaining how alexithymia undermines cancer survivors' ability to achieve PTG. Findings highlight demoralization as a more modifiable clinical target than alexithymia, especially in contexts valuing emotional restraint. While based on cross-sectional data, alternative temporal pathways (e.g., PTG as a mediator) may also be tested in longitudinal studies to clarify the dynamic interplay among emotional processing, existential distress, and growth.
Keywords: Cancer, Cancer survivorshipOur study tested this model in 305 Chinese breast cancer survivors (M age = 52.0, SD = 9.77). Participants completed the Toronto Alexithymia Scale (TAS-26), Demoralization Scale—Mandarin Version (DS-MV), and Posttraumatic Growth Inventory – Chinese Version (PTGI-C). All measures were back-translated and revealed sufficient internal consistency (Cronbach’s alpha > .75).
Path analysis with bootstrapping indicated that alexithymia significantly predicted higher demoralization (β = .565, p < .001), which in turn predicted lower PTG (β = –.290, p < .001). The indirect effect of alexithymia on PTG through demoralization was significant (b = –.326, β = –.164, 95% CI [–.499, –.162], p < .001). The direct effect of alexithymia on PTG was nonsignificant (b = –.021, β = –.011, 95% CI [–.285, .248], p = .873), whereas the total effect remained significant (b = –.347, β = –.175, 95% CI [–.570, –.116], p = .002). Our findings establish demoralization as the key pathway fully explaining how alexithymia undermines cancer survivors' ability to achieve PTG. Findings highlight demoralization as a more modifiable clinical target than alexithymia, especially in contexts valuing emotional restraint. While based on cross-sectional data, alternative temporal pathways (e.g., PTG as a mediator) may also be tested in longitudinal studies to clarify the dynamic interplay among emotional processing, existential distress, and growth.
Authors:
Co-Author - L. Brooke Short, Bowling Green State University
Co-Author - William O'Brien, Bowling Green State University
Exploring Cancer-Related Cognitive Impairment Research Through the Lens of Cognitive Intra-Individual Variability: A Systematic Review
Poster Number: C26Time: 05:00 PM - 05:50 PM
Topics: Cancer, Aging
Exploring Cancer-Related Cognitive Impairment Research Through the Lens of Cognitive Intra-Individual Variability: A Systematic Review
Chunhong Xiao, David E. Vance, Rebecca Billings, Hathaichanok Phaowiriya, Ritu Aneja, Victor A. Del Bene, Nusrat Jahan, Susan McCammon, Elizabeth E. Brown, Ellen M. Lavoie Smith, Richard Taylor, Diane Von Ah, Hsiao-Lan Wang
Cancer-related cognitive impairment (CRCI) across various cancer types remains a troublesome symptom. CRCI was frequently defined by standard normative measures that use mean-based or tally-based summations. Cognitive Intra-Individual Variability (IIV) refers to the measurement of fluctuations in one’s cognitive performance across cognitive tests and cognitive domains (i.e., dispersion) or within a cognitive test across trials (i.e., inconsistency). The purpose of this systematic review was to describe the utility of cognitive IIV that has been studied in CRCI across cancer types. A search for all original research articles related to cognitive IIV across cancer types was conducted with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach using detailed search terms and strategies in MEDLINE (via PubMed), Embase, and Scopus databases. Initially, 1,625 articles were retrieved, unfortunately only five articles met the criteria for this systematic review; this shows that cognitive IIV is being underutilized in CRCI literature. We observed that across the CRCI literature, cognitive IIV was underutilized (only 5 studies used it and all were in breast cancer survivors (BCS)). Yet, from these few studies, the following patterns emerged: 1) BCS performed similarly to controls but displayed greater cognitive IIV when cognitive tests became more difficult; 2) cognitive IIV differences increased later during chemotherapy; and 3) cognitive IIV did not explain subjective cognitive problems. This systematic review revealed the use of cognitive IIV is underutilized in CRCI research. Suggestions for possible insights and caveats of its use in CRCI research are posited.
Keywords: Cognitive factors, Chronic illnessChunhong Xiao, David E. Vance, Rebecca Billings, Hathaichanok Phaowiriya, Ritu Aneja, Victor A. Del Bene, Nusrat Jahan, Susan McCammon, Elizabeth E. Brown, Ellen M. Lavoie Smith, Richard Taylor, Diane Von Ah, Hsiao-Lan Wang
Cancer-related cognitive impairment (CRCI) across various cancer types remains a troublesome symptom. CRCI was frequently defined by standard normative measures that use mean-based or tally-based summations. Cognitive Intra-Individual Variability (IIV) refers to the measurement of fluctuations in one’s cognitive performance across cognitive tests and cognitive domains (i.e., dispersion) or within a cognitive test across trials (i.e., inconsistency). The purpose of this systematic review was to describe the utility of cognitive IIV that has been studied in CRCI across cancer types. A search for all original research articles related to cognitive IIV across cancer types was conducted with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach using detailed search terms and strategies in MEDLINE (via PubMed), Embase, and Scopus databases. Initially, 1,625 articles were retrieved, unfortunately only five articles met the criteria for this systematic review; this shows that cognitive IIV is being underutilized in CRCI literature. We observed that across the CRCI literature, cognitive IIV was underutilized (only 5 studies used it and all were in breast cancer survivors (BCS)). Yet, from these few studies, the following patterns emerged: 1) BCS performed similarly to controls but displayed greater cognitive IIV when cognitive tests became more difficult; 2) cognitive IIV differences increased later during chemotherapy; and 3) cognitive IIV did not explain subjective cognitive problems. This systematic review revealed the use of cognitive IIV is underutilized in CRCI research. Suggestions for possible insights and caveats of its use in CRCI research are posited.
Authors:
Author - Chunhong Xiao, PhD, RN, The University of Tennessee at Knoxville
Co-Author - David E. Vance, PhD, MGS, FAAN , School of Nursing, University of Alabama at Birmingham, Birmingham,
Co-Author - Rebecca Billings, MLIS, University of Alabama at Birmingham, Birmingham,
Co-Author - Hathaichanok Phaowiriya , PhD Student , School of Nursing, University of Alabama at Birmingham,
Co-Author - Ritu Aneja, PhD , University of Alabama at Birmingham, Birmingham
Co-Author - Victor A. Del Bene, PhD, University of Alabama at Birmingham,
Co-Author - Nusrat Jahan, MD, University of Alabama at Birmingham
Chair - Susan McCammon, MD, University of Alabama at Birmingham
Co-Author - Ellen M. Lavoie Smith, PhD, MSN, RN, AOCN, FAAN , , University of Alabama at Birmingham
Co-Author - Richard Taylor, PhD, DNP, CRNP, University of Alabama at Birmingham
Co-Author - Diane Von Ah, PhD, RN , the Ohio State University
Co-Author - Hsiao-Lan Wang, PhD, RN, CMSRN, ACMSN, EP-C, FAAN , University of Alabama at Birmingham
Evaluating an evidence-based family history screening program adapted to increase reach and uptake of screening for BRCA-associated cancers in rural public health clinics
Poster Number: C27Time: 05:00 PM - 05:50 PM
Topics: Cancer, Women's Health
OBJECTIVE: To adapt and implement Georgia’s statewide BRCA-associated family cancer history (FH) screening program to increase FH screening rates among diverse patient populations in rural public health clinics.
METHODS: From June 2024–January 2025, we conducted a multilevel adaptation of Georgia Center for Oncology Research and Education’s statewide FH screening program for BRCA-associated cancers to enhance sustainability and expand reach. A stakeholder committee of cancer control leaders, public health champions, and patients identified gaps and opportunities through interviews, focus groups, and study team synthesis, then developed and ranked adaptation strategies. In February 2025, we launched a multi-site clustered randomized controlled trial in six clinics in Georgia’s Southwest Public Health District to test the adapted program. Preliminary screening data were collected between February–June 2025, supplemented with county-level data. Mixed-effects logistic regression was used to assess FH screening uptake between trial arms.
RESULTS: Fifteen adaptations were prioritized across individual (n=2), provider (n=1), clinic (n=7), organization (n=3), and community (n=2) levels. Most focused on implementation and scale-up (n=10), followed by contextual modifications (n=4) and communication content (n=1). Key adaptations included expanded outreach (e.g., posters, phone scripts, social media), streamlined workflows (e.g., simplified data entry, automated referrals), and integration of theory-based, risk-stratified communication materials. Among 2287 women aged ≥25 years seen across study clinics, 329 completed screening: 235 of 1350 in the intervention arm (17.4%) and 94 of 937 in the standard care arm (10.0%). Women in the intervention arm had 65% higher odds of completing FH screening compared to standard care (p=0.028) in the multivariable mixed-effect model. Race, poverty, and insurance status did not significantly influence screening once the intervention was introduced, though higher county income was positively associated with uptake (p<0.001).
CONCLUSIONS: Strong partnerships between public health agencies, community organizations, and academic institutions were essential for successful adaptation. Preliminary results indicate promising potential of an adapted screening program for improving access to cancer genetic risk assessment in rural areas. Ongoing trial evaluation will provide further data into program impact and sustainability.
Keywords: Cancer screening, GeneticsMETHODS: From June 2024–January 2025, we conducted a multilevel adaptation of Georgia Center for Oncology Research and Education’s statewide FH screening program for BRCA-associated cancers to enhance sustainability and expand reach. A stakeholder committee of cancer control leaders, public health champions, and patients identified gaps and opportunities through interviews, focus groups, and study team synthesis, then developed and ranked adaptation strategies. In February 2025, we launched a multi-site clustered randomized controlled trial in six clinics in Georgia’s Southwest Public Health District to test the adapted program. Preliminary screening data were collected between February–June 2025, supplemented with county-level data. Mixed-effects logistic regression was used to assess FH screening uptake between trial arms.
RESULTS: Fifteen adaptations were prioritized across individual (n=2), provider (n=1), clinic (n=7), organization (n=3), and community (n=2) levels. Most focused on implementation and scale-up (n=10), followed by contextual modifications (n=4) and communication content (n=1). Key adaptations included expanded outreach (e.g., posters, phone scripts, social media), streamlined workflows (e.g., simplified data entry, automated referrals), and integration of theory-based, risk-stratified communication materials. Among 2287 women aged ≥25 years seen across study clinics, 329 completed screening: 235 of 1350 in the intervention arm (17.4%) and 94 of 937 in the standard care arm (10.0%). Women in the intervention arm had 65% higher odds of completing FH screening compared to standard care (p=0.028) in the multivariable mixed-effect model. Race, poverty, and insurance status did not significantly influence screening once the intervention was introduced, though higher county income was positively associated with uptake (p<0.001).
CONCLUSIONS: Strong partnerships between public health agencies, community organizations, and academic institutions were essential for successful adaptation. Preliminary results indicate promising potential of an adapted screening program for improving access to cancer genetic risk assessment in rural areas. Ongoing trial evaluation will provide further data into program impact and sustainability.
Authors:
Co-Author - Angela Zhang, MPH, Emory University Rollins School of Public Health
Co-Author - Angelo Marra, MPH, Emory University Rollins School of Public Health
Co-Author - Yuan Liu, PhD, MS, Emory University Rollins School of Public Health
Co-Author - Cam Escoffery, PhD, MPH, Rollins School of Public Health
Co-Author - Cindy Snyder, DNP, ACGN, FNP-C, CBCN, Georgia Center for Oncology Research and Education
Co-Author - Cynthia Walters, RN, Georgia Department of Public Health
Co-Author - Shacoria Anderson, MPH, Emory University
Co-Author - Dayanna Ramirez Leon, MPH, Emory University
Co-Author - Sheryl Gabram, MD, MBA, FACS, Emory University
Co-Author - Denise Ballard, MEd, Emory University
Co-Author - Yue Guan, PhD, ScM, CGC, Emory University
Rates of Depression and Mental Healthcare Utilization Pre- and Post-COVID-19: A Nationally Representative Sample Among Those with and without Coronary Heart Disease
Poster Number: C28Time: 05:00 PM - 05:50 PM
Topics: Cardiovascular Disease, Mental Health
Depression is strongly linked to coronary heart disease (CHD). Despite evidence-based treatments for depression, such as antidepressants and talk therapy, patients underutilize these services. The COVID-19 pandemic impacted cardiovascular outcomes, increased depression rates, and changed access to mental health care. We explored differences in depression levels between patients with and without CHD, rates of mental healthcare service use, and changes in depression and mental healthcare service utilization before and after the pandemic.
A repeated cross-sectional design analyzed the 2019 (pre-COVID) and 2022 (post-COVID) National Health Interview Survey (NHIS) datasets. Self-reported CHD diagnosis defined individuals with and without CHD. Depression was assessed using the 8-item Patient Health Questionnaire (PHQ-8). Self-reported mental healthcare utilization was defined as either prescription antidepressant use, talk therapy use, or both.
The study included 34,870 individuals, of whom 54.2% were female, with a mean age of 60.44 years, and primarily Non-Hispanic White (68.9%). Within this sample, 7.3% reported a diagnosis of CHD. Those diagnosed with CHD had higher PHQ-8 scores (M = 3.94, SD = .080, 99% CI = [3.73, 4.15]) compared to those without a CHD diagnosis (M = 2.27, SD = .022, 99% CI = [2.21, 2.33]), F(7, 32522) = 397.84, p < .001. Having a CHD diagnosis tripled the odds of having PHQ-8 scores in the moderate to severe depression range, OR = 3.506, 99% CI [1.657, 7.418]. However, the presence of a CHD diagnosis did not influence mental healthcare service utilization, OR = 1.542, 99% CI [.724, 3.285]. Furthermore, PHQ-8 scores were not significantly higher in 2022 (4.106, SD = .114, 99% CI = [3.735, 4.476]) than in 2019 (3.919, SD = .136, 99% CI = [3.570, 4.269]), F(3, 2427) = .892, p = .345. Year was not a significant predictor of mental healthcare utilization among individuals with CHD, OR = 1.114, 99% CI [.704, 1.762].
Early detection and treatment of depression can enhance cardiovascular and mental health management. Individuals with CHD had higher depression scores and a greater proportion in the clinically elevated range. No differences in depression or mental healthcare use were observed pre- and post-COVID-19 among people reporting CHD. Routine depression screening remains vital for CHD patients. Future studies should explore barriers to mental healthcare access so that those with CHD can better address their physical and mental health.
Keywords: Cardiovascular disease, DepressionA repeated cross-sectional design analyzed the 2019 (pre-COVID) and 2022 (post-COVID) National Health Interview Survey (NHIS) datasets. Self-reported CHD diagnosis defined individuals with and without CHD. Depression was assessed using the 8-item Patient Health Questionnaire (PHQ-8). Self-reported mental healthcare utilization was defined as either prescription antidepressant use, talk therapy use, or both.
The study included 34,870 individuals, of whom 54.2% were female, with a mean age of 60.44 years, and primarily Non-Hispanic White (68.9%). Within this sample, 7.3% reported a diagnosis of CHD. Those diagnosed with CHD had higher PHQ-8 scores (M = 3.94, SD = .080, 99% CI = [3.73, 4.15]) compared to those without a CHD diagnosis (M = 2.27, SD = .022, 99% CI = [2.21, 2.33]), F(7, 32522) = 397.84, p < .001. Having a CHD diagnosis tripled the odds of having PHQ-8 scores in the moderate to severe depression range, OR = 3.506, 99% CI [1.657, 7.418]. However, the presence of a CHD diagnosis did not influence mental healthcare service utilization, OR = 1.542, 99% CI [.724, 3.285]. Furthermore, PHQ-8 scores were not significantly higher in 2022 (4.106, SD = .114, 99% CI = [3.735, 4.476]) than in 2019 (3.919, SD = .136, 99% CI = [3.570, 4.269]), F(3, 2427) = .892, p = .345. Year was not a significant predictor of mental healthcare utilization among individuals with CHD, OR = 1.114, 99% CI [.704, 1.762].
Early detection and treatment of depression can enhance cardiovascular and mental health management. Individuals with CHD had higher depression scores and a greater proportion in the clinically elevated range. No differences in depression or mental healthcare use were observed pre- and post-COVID-19 among people reporting CHD. Routine depression screening remains vital for CHD patients. Future studies should explore barriers to mental healthcare access so that those with CHD can better address their physical and mental health.
Authors:
Author - Lyubov Gavrilova, M.A., Kent State University
Co-Author - Yasmine Eshera, M.A., Kent State University
Co-Author - Mellisa Watson, M.A., Kent State University
Co-Author - Joel Hughes, Ph.D., Kent State University
Weight Status and Global and Disease-Related Stress Among Adolescents with Congenital Heart Disease
Poster Number: C29Time: 05:00 PM - 05:50 PM
Topics: Cardiovascular Disease, Stress
Adolescents with congenital heart disease (CHD) are at higher risk for future cardiovascular complications, which are exacerbated by overweight/obesity and increased stress. This study (1) determined the relationship between weight status and stress among adolescents with CHD and (2) determined the relationship between weight status and stress according to gender and childhood opportunity.
Adolescents aged 12-18 with CHD (N=98) completed the Perceived Stress Scale-10 and the Responses to Stress Questionnaire adapted for CHD-related stressors. Weight status was defined by the adolescents’ Body Mass Index percentile as recorded at the clinical encounter closest to the date they completed the survey and categorized as overweight/obese or healthy weight according to Centers for Disease Control guidelines. The Childhood Opportunity Index determined the quality of participants’ neighborhood resources and was categorized as either very low to low opportunities (“lower opportunity”) or moderate to very high opportunities (“higher opportunity”). Age and gender were self-reported, and neighborhood income was estimated from census tracts. Stress was regressed on weight status, controlling for age and neighborhood income. Over one-third of participants (36%) were overweight/obese. Among all participants, global stress was approximately four points higher among participants with overweight/obesity compared to those with healthy weight (b=3.71, p=.044). Disease-related stress was similar across weight status (b=2.27, p=.177). Among male participants, global stress was nearly five points higher for those with overweight/obesity compared to those with healthy weight (b=4.92, p=.026). Among female participants, global stress was not associated with weight status (b=1.67, p=.263). Among participants with lower opportunity, global stress was around nine points higher for those with overweight/obesity compared to those with healthy weight (b=8.92, p=.030). Among participants with higher opportunity, global stress was not associated with weight status (b=2.66, p=.198). Future research should use longitudinal methods to understand the direction of the relationship between stress and weight status. Adolescents with CHD classified as obese/overweight, especially those with lower opportunity and those that are male, may benefit from additional screening during clinic visits to identify increased stress and facilitate referral to stress reduction resources.
Keywords: Cardiovascular disease, StressAdolescents aged 12-18 with CHD (N=98) completed the Perceived Stress Scale-10 and the Responses to Stress Questionnaire adapted for CHD-related stressors. Weight status was defined by the adolescents’ Body Mass Index percentile as recorded at the clinical encounter closest to the date they completed the survey and categorized as overweight/obese or healthy weight according to Centers for Disease Control guidelines. The Childhood Opportunity Index determined the quality of participants’ neighborhood resources and was categorized as either very low to low opportunities (“lower opportunity”) or moderate to very high opportunities (“higher opportunity”). Age and gender were self-reported, and neighborhood income was estimated from census tracts. Stress was regressed on weight status, controlling for age and neighborhood income. Over one-third of participants (36%) were overweight/obese. Among all participants, global stress was approximately four points higher among participants with overweight/obesity compared to those with healthy weight (b=3.71, p=.044). Disease-related stress was similar across weight status (b=2.27, p=.177). Among male participants, global stress was nearly five points higher for those with overweight/obesity compared to those with healthy weight (b=4.92, p=.026). Among female participants, global stress was not associated with weight status (b=1.67, p=.263). Among participants with lower opportunity, global stress was around nine points higher for those with overweight/obesity compared to those with healthy weight (b=8.92, p=.030). Among participants with higher opportunity, global stress was not associated with weight status (b=2.66, p=.198). Future research should use longitudinal methods to understand the direction of the relationship between stress and weight status. Adolescents with CHD classified as obese/overweight, especially those with lower opportunity and those that are male, may benefit from additional screening during clinic visits to identify increased stress and facilitate referral to stress reduction resources.
Authors:
Author - Amelia Greiner, BA, Nationwide Children's Hospital
Co-Author - Jamie Jackson, PhD, Nationwide Children's Hospital
Co-Author - Amy Ferketich, PhD, MA, 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 - Emma Jensen, BA, Nationwide Children's Hospital
Co-Author - Clifford Cua, MD, Nationwide Children's Hospital
Co-Author - Kristen Fox, PhD, Nationwide Children's Hospital
Brain Health Factors in Middle Adulthood, by Ethnicity
Poster Number: C3Time: 05:00 PM - 05:50 PM
Topics: Aging, Health Disparities
Background: Alzheimer’s disease and related dementias (ADRD) disproportionately impact Latinos in the US. It is now estimated that up to 50% of cases of ADRD could be delayed or prevented with modifiable health behaviors and lifestyle factors. Indeed, existing disparities in ADRD among Latino adults have been largely attributed to a higher prevalence of cardiovascular risk factors for ADRD, including obesity, hyperlipidemia, hypertension, and diabetes. One proposed mechanism underlying these disparities is access to and availability of appropriate healthcare, as well as health self-management (SM) skills and health literacy (HL) for effectively managing chronic conditions and navigating healthcare systems. The aim of this study was to explore differences in health literacy and self-management skills, as well as established modifiable risk factors for ADRD in Latinos and non-Latino Whites in a diverse middle-aged cohort.
Methods: Survey data from an ongoing cohort study, the MidCog study, were used. Chi-square analyses examined associations between ethnicity with SM skills, HL, and known risk factors for ADRD (i.e., diabetes, obesity, hypertension, hyperlipidemia, hearing or vision impairment, alcohol use, smoking, depression, social isolation). HL was assessed using the Newest Vital Sign (NVS), and SM skills were assessed using the Comprehensive Health Activities Scale (CHAS).
Results: Rates of low/limited HL were more than three times higher among Latinos compared to non-Latino White participants (37.9% vs. 11.1%, p<0.001), and SM skills were also significantly lower among Latinos (CHAS score: M=67.6 (SD=19.9) vs. 80.8 (14.4), p<0.001). Latino adults additionally reported 3-fold higher rates of diabetes (19.3% vs. 6.1%) as well as higher rates of obesity (50.9% vs. 29.0%) compared to non-Latino White adults (p<0.001). Latino adults reported lower rates of hazardous alcohol use compared to non-Latino Whites (29.1% vs. 42.1%, p=0.004). No significant differences were found for other modifiable risk factors for ADRD.
Conclusion: Our data support extant literature that highlights disparities in cardiovascular risk factors for ADRD as well as HL and SM skills among Latinos versus non-Latino Whites. Promoting health literacy during midlife could improve self-management skills, imparting healthier lifestyle and more routine and effective healthcare use, reducing risk of later life ADRD. This may ultimately help to ameliorate existing brain health disparities.
Keywords: Aging, DisparitiesMethods: Survey data from an ongoing cohort study, the MidCog study, were used. Chi-square analyses examined associations between ethnicity with SM skills, HL, and known risk factors for ADRD (i.e., diabetes, obesity, hypertension, hyperlipidemia, hearing or vision impairment, alcohol use, smoking, depression, social isolation). HL was assessed using the Newest Vital Sign (NVS), and SM skills were assessed using the Comprehensive Health Activities Scale (CHAS).
Results: Rates of low/limited HL were more than three times higher among Latinos compared to non-Latino White participants (37.9% vs. 11.1%, p<0.001), and SM skills were also significantly lower among Latinos (CHAS score: M=67.6 (SD=19.9) vs. 80.8 (14.4), p<0.001). Latino adults additionally reported 3-fold higher rates of diabetes (19.3% vs. 6.1%) as well as higher rates of obesity (50.9% vs. 29.0%) compared to non-Latino White adults (p<0.001). Latino adults reported lower rates of hazardous alcohol use compared to non-Latino Whites (29.1% vs. 42.1%, p=0.004). No significant differences were found for other modifiable risk factors for ADRD.
Conclusion: Our data support extant literature that highlights disparities in cardiovascular risk factors for ADRD as well as HL and SM skills among Latinos versus non-Latino Whites. Promoting health literacy during midlife could improve self-management skills, imparting healthier lifestyle and more routine and effective healthcare use, reducing risk of later life ADRD. This may ultimately help to ameliorate existing brain health disparities.
Authors:
Author - Sophia Light, PhD, The University of Chicago
Co-Author - Fangyu Yeh, Northwestern University Feinberg School of Medicine
Co-Author - Morgan Bonham, Northwestern University Feinberg School of Medicine
Co-Author - Stacy Bailey, Northwestern University Feinberg School of Medicine
Co-Author - Lauren Opsasnick Rogers, Northwestern University Feinberg School of Medicine
Co-Author - Michael Wolf, MA MPH PhD, Northwestern University Feinberg School of Medicine
Social Ties and Mental Health After Spontaneous Coronary Artery Dissection: Insights from a Multi-Center Study
Poster Number: C30Time: 05:00 PM - 05:50 PM
Topics: Cardiovascular Disease, Mental Health
Background: Social relationships are important for both psychological well-being and cardiovascular outcomes. Spontaneous coronary artery dissection (SCAD), an increasingly recognized cause of acute coronary syndrome, is associated with high psychological distress, but social functioning in this population is rarely assessed. This study aimed to describe social relationships among patients with SCAD and their association with mental health.
Methods: Patients diagnosed with SCAD within the past 3 years were recruited from 6 hospitals across Canada. Participants completed questionnaires assessing sociodemographics and validated measures, including the General Functioning subscale of the Family Assessment Device (GF-6), the ENRICHD Social Support Instrument (ESSI), the Three-Item Loneliness Scale (LS-3), the Dyadic Adjustment Scale (DAS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Associations between sociodemographics, social functioning, and mental health were examined using Pearson correlations. Significant sociodemographic correlates (age, sex, time since diagnosis) were included as covariates in regressions examining the effect of social functioning on mental health.
Results: The study included 326 participants (93% female; mean age=53.3±11.1 years; 85% White; 74% married/partnered). Mean scores were 10.1±3.7 for family functioning (GF-6), 27.9±5.7 for perceived social support (ESSI), 4.6±1.8 for loneliness (LS-3), 6.3±5.5 for depressive symptoms (PHQ-9), and 5.1±5.1 for generalized anxiety (GAD-7). Among partnered participants, mean DAS score was 114.7±21.1. In multiple regression models, higher depressive symptoms were associated with lower perceived support (β=-.18, p=.009) and greater loneliness (β=.24, p<.001). Greater generalized anxiety was also associated with loneliness (β=.29, p<.001). Among partnered participants, relationship quality was not significantly associated with mental health outcomes in multiple models.
Conclusion: About 20-30% of patients with SCAD experience some challenges in social functioning, particularly loneliness. Similarly, of partnered patients, 18% report relationship distress. These social functioning rates are comparable to those previously reported in other cardiac populations. Poor social functioning was strongly associated with symptoms of depression and anxiety, underscoring the need to integrate social variables into the assessment and care of patients with SCAD.
Keywords: Cardiovascular disease, Social supportMethods: Patients diagnosed with SCAD within the past 3 years were recruited from 6 hospitals across Canada. Participants completed questionnaires assessing sociodemographics and validated measures, including the General Functioning subscale of the Family Assessment Device (GF-6), the ENRICHD Social Support Instrument (ESSI), the Three-Item Loneliness Scale (LS-3), the Dyadic Adjustment Scale (DAS), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). Associations between sociodemographics, social functioning, and mental health were examined using Pearson correlations. Significant sociodemographic correlates (age, sex, time since diagnosis) were included as covariates in regressions examining the effect of social functioning on mental health.
Results: The study included 326 participants (93% female; mean age=53.3±11.1 years; 85% White; 74% married/partnered). Mean scores were 10.1±3.7 for family functioning (GF-6), 27.9±5.7 for perceived social support (ESSI), 4.6±1.8 for loneliness (LS-3), 6.3±5.5 for depressive symptoms (PHQ-9), and 5.1±5.1 for generalized anxiety (GAD-7). Among partnered participants, mean DAS score was 114.7±21.1. In multiple regression models, higher depressive symptoms were associated with lower perceived support (β=-.18, p=.009) and greater loneliness (β=.24, p<.001). Greater generalized anxiety was also associated with loneliness (β=.29, p<.001). Among partnered participants, relationship quality was not significantly associated with mental health outcomes in multiple models.
Conclusion: About 20-30% of patients with SCAD experience some challenges in social functioning, particularly loneliness. Similarly, of partnered patients, 18% report relationship distress. These social functioning rates are comparable to those previously reported in other cardiac populations. Poor social functioning was strongly associated with symptoms of depression and anxiety, underscoring the need to integrate social variables into the assessment and care of patients with SCAD.
Authors:
Presenter - Lisa-Marie Maukel, PhD, University of Ottawa Heart Institute
Co-Author - Karen Bouchard, PhD, University of Ottawa Heart Institute
Co-Author - Thais Coutinho, MD, FRCPC, Mayo Clinic
Co-Author - Sharon Mulvagh, MD, Dalhousie University
Co-Author - Mina Madan, MD, MHS, University of Toronto
Co-Author - Christine Pacheco, MD, Université de Montréal
Co-Author - Jacqueline Saw, MD, University of British Columbia
Co-Author - Jennifer Reed, PhD, University of Ottawa Heart Institute
Co-Author - Shuangbo Liu, MD, University of Manitoba
Co-Author - Louise Sun, MD, University of Ottawa Heart Institute
Co-Author - Amélie Paquin, MD, PhD, Laval University
Co-Author - Heather Tulloch, PhD, C. Psych, University of Ottawa Heart Institute
Early self-management practices and self-efficacy among participants in a healthy lifestyle program for people with traumatic brain injury
Poster Number: C31Time: 05:00 PM - 05:50 PM
Topics: Cardiovascular Disease, Multiple Health Behavior Change
Background: Individuals with traumatic brain injury (TBI) are at increased risk for obesity and other cardiometabolic diseases. The evidence-based Diabetes Prevention Program Group Lifestyle Balance for TBI (GLB-TBI) has been shown to significantly reduce weight and metabolic risk factors through enhanced self-management. However, little is known about the adoption of self-management strategies during the core phase (e.g., first 12 of 22 sessions) of the program. Understanding patterns of attendance, self-monitoring, and self-efficacy during the core phase may inform strategies to improve adherence and outcomes across the 12-month program.
Methods: Participants (n=43) enrolled in a telehealth delivered GLB-TBI intervention, meeting weekly for the first 12 weeks of the 12-month program. The GLB-TBI promotes losing weight (5-7% of starting weight) and increasing physical activity by tracking dietary intake and physical activity and self-weighing weighing weekly. Attendance, weekly dietary and physical activity tracking, and weigh-ins were tallied and summarized by demographic characteristics. Health-related self-efficacy was measured using the Self-Rated Abilities for Health Practices (SRAHP) Scale.
Results: Engagement in the intervention was high, with a median of 12 (IQR: 11,12) sessions attended, 9 (IQR: 6, 10) weeks of diet tracking, and 21 (IQR: 11, 45) weigh-ins over the first 12 weeks. Participants also had relatively high levels of self-efficacy (median score of 93 out of 112, IQR: 79, 99). Patterns of attendance and diet/physical activity tracking appear similar among demographic groups (i.e., sex, ethnicity, race, marital status, employment status), but weigh-ins trend higher among those identifying as Hispanic (28 vs. 19), not married (24 vs. 18), and not employed (24 vs. 17).
Discussion: Patterns of self-management may differ subtly among demographic groups and the relationship with weight-loss will be explored at the conclusion of the trial. The higher than recommended number of weigh-ins per week also warrants further exploration. Future analyses may be able to shed light on strategies to improve adherence and untangle how long-term weight-loss is related to early self-management behaviors and self-efficacy.
Keywords: Disability, Behavior ChangeMethods: Participants (n=43) enrolled in a telehealth delivered GLB-TBI intervention, meeting weekly for the first 12 weeks of the 12-month program. The GLB-TBI promotes losing weight (5-7% of starting weight) and increasing physical activity by tracking dietary intake and physical activity and self-weighing weighing weekly. Attendance, weekly dietary and physical activity tracking, and weigh-ins were tallied and summarized by demographic characteristics. Health-related self-efficacy was measured using the Self-Rated Abilities for Health Practices (SRAHP) Scale.
Results: Engagement in the intervention was high, with a median of 12 (IQR: 11,12) sessions attended, 9 (IQR: 6, 10) weeks of diet tracking, and 21 (IQR: 11, 45) weigh-ins over the first 12 weeks. Participants also had relatively high levels of self-efficacy (median score of 93 out of 112, IQR: 79, 99). Patterns of attendance and diet/physical activity tracking appear similar among demographic groups (i.e., sex, ethnicity, race, marital status, employment status), but weigh-ins trend higher among those identifying as Hispanic (28 vs. 19), not married (24 vs. 18), and not employed (24 vs. 17).
Discussion: Patterns of self-management may differ subtly among demographic groups and the relationship with weight-loss will be explored at the conclusion of the trial. The higher than recommended number of weigh-ins per week also warrants further exploration. Future analyses may be able to shed light on strategies to improve adherence and untangle how long-term weight-loss is related to early self-management behaviors and self-efficacy.
Authors:
Co-Presenter - Christa Ochoa, MPH, Baylor Scott & White Research Institute
Co-Presenter - Kamiah Moss, PhD, Baylor Scott & White Research Institute
Co-Author - Taylor Gilliland, MS, CCRC, Baylor Scott & White Research Institute
Co-Author - Librada Callender, PhD, MPH, Baylor Scott & White Research Institute
Co-Author - Evan McShan, PhD, Baylor Scott & White Research Institute
Co-Author - Simon Driver, PhD, Mass General Brigham Spaulding Rehabilitation
Associations Between Social and Structural Determinants and Dietary Outcomes Among Perinatal Women Living In New Hampshire
Poster Number: C32Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Diet, Nutrition, and Eating Disorders
Background
Dietary intake during the perinatal period may influence health outcomes of both mother and child. While previous research has explored food insecurity and maternal diet quality, there are limited studies examining the relationship between social and structural determinants of health (experiences with discrimination, food security status, WIC participation, and area of residence) with diet quality in perinatal populations.
Objective
To examine the associations between experiences with discrimination, food security status, WIC participation, and area of residence with diet quality among perinatal women living in New Hampshire.
Methods
Participants completed a sociodemographic questionnaire, the short Healthy Eating Index (sHEI), the Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire and the USDA 6-item Food Security Module. Mann-Whitney U and Kruskal-Wallis tests were conducted for all continuous variables after a Shapiro-Wilk’s test confirmed that the data was not normally distributed (p<0.05). Fisher’s exact tests assessed associations between categorical variables. Significance was assessed at p < 0.05.
Results
Participants (n=51) were majority postpartum 3 years (84%), married (84%), and non-Hispanic White (73%). Nearly all respondents reported “no” to experiencing any form of discrimination during healthcare visits (97%), 60% reported never personally experiencing discrimination while 86% agreed that racial/ethnic discrimination against non-white groups happens often/sometimes. Forty percent reported residing in suburban areas, 32% reported residing in rural areas, and 28% reported residing in urban/metro areas. The median total sHEI score was 53.5 (IQR = 11.4) out of 100 total possible points. There were no significant differences in total sHEI scores by food security status, or area of residence. Compared to participants who reported high food security status, intake of fruits and vegetables was significantly lower for participants who reported marginal, low, and very low food security (p < 0.05). Urban and rural residents had higher sHEI subcomponent dairy scores than suburban residents (p.adj = 0.02).
Conclusion
Diet quality in this perinatal population was suboptimal. Food security status and area residence may negatively influence intake of certain critical food groups. Trends in subgroup differences may suggest potential disparities.
Keywords: Maternal Nutrition, Perinatal, Food Security, Diet Quality
Keywords: Nutrition, DietDietary intake during the perinatal period may influence health outcomes of both mother and child. While previous research has explored food insecurity and maternal diet quality, there are limited studies examining the relationship between social and structural determinants of health (experiences with discrimination, food security status, WIC participation, and area of residence) with diet quality in perinatal populations.
Objective
To examine the associations between experiences with discrimination, food security status, WIC participation, and area of residence with diet quality among perinatal women living in New Hampshire.
Methods
Participants completed a sociodemographic questionnaire, the short Healthy Eating Index (sHEI), the Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire and the USDA 6-item Food Security Module. Mann-Whitney U and Kruskal-Wallis tests were conducted for all continuous variables after a Shapiro-Wilk’s test confirmed that the data was not normally distributed (p<0.05). Fisher’s exact tests assessed associations between categorical variables. Significance was assessed at p < 0.05.
Results
Participants (n=51) were majority postpartum 3 years (84%), married (84%), and non-Hispanic White (73%). Nearly all respondents reported “no” to experiencing any form of discrimination during healthcare visits (97%), 60% reported never personally experiencing discrimination while 86% agreed that racial/ethnic discrimination against non-white groups happens often/sometimes. Forty percent reported residing in suburban areas, 32% reported residing in rural areas, and 28% reported residing in urban/metro areas. The median total sHEI score was 53.5 (IQR = 11.4) out of 100 total possible points. There were no significant differences in total sHEI scores by food security status, or area of residence. Compared to participants who reported high food security status, intake of fruits and vegetables was significantly lower for participants who reported marginal, low, and very low food security (p < 0.05). Urban and rural residents had higher sHEI subcomponent dairy scores than suburban residents (p.adj = 0.02).
Conclusion
Diet quality in this perinatal population was suboptimal. Food security status and area residence may negatively influence intake of certain critical food groups. Trends in subgroup differences may suggest potential disparities.
Keywords: Maternal Nutrition, Perinatal, Food Security, Diet Quality
Authors:
Author - Selina Awinbisa Agandaa, MS, University of New Hampshire
Co-Author - Noereem Z. Mena, University of New Hampshire
Co-Author - Maria Carlota Dao, PhD, University of New Hampshire
Co-Author - Sherman Bigornia, PhD, University of New Hampshire
The Moderation Effect of Parent Water Competency on Parental Perceptions of Toddler Drowning Risk after Self-Rescue Water Training
Poster Number: C33Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Child and Family Health
Pediatric drowning is a preventable health threat. Water competency (WC) is an effective strategy to reduce drowning risk, as are parent supervision and safeguarding. Parent WC includes maintaining supervision and risk awareness even as their child’s WC improves. Parents tend to overestimate child WC, especially after children receive WC lessons. If parents perceive their child has more WC, they may reduce engagement and supervision. The current study examined changes in parental perceptions of drowning risk following toddler WC training, and the moderating role of parent WC on those changes. We hypothesized parental risk perceptions would decrease after training, with higher parent WC buffering changes. As part of a larger study, 50 toddlers (86% White and non-Hispanic, 58% female) aged 12-23 months (M=1.45, SD=0.27) were recruited from three cities in the United States. Assessments occurred at baseline and after 20 ten-minute child WC training sessions over 4 weeks. At each assessment, parental perceptions of toddler drowning risks were collected; parents reported family demographics and parent WC at baseline. A moderation analysis was performed using PROCESS SPSS macro with baseline parental risk perceptions as the predictor, follow-up parental risk perceptions as the outcome, age, gender, and research site as covariates, and parent WC as the moderator. The moderation model was significant R2=0.30, F(6,42)=2.98, p=0.02. Baseline parental risk perceptions (b=-0.95, t=-2.04, p<0.001) and parent WC (b=-0.80, t=-2.65, p=0.01) significantly predicted follow-up parental risk perceptions. The interaction was significant (b=0.24, t=2.66, p=0.01), indicating parent WC moderates change in parental risk perceptions. Simple slope analyses revealed that at moderate to high parent WC, parents were more likely to perceive increased toddler drowning risk at follow-up than at low WC. Findings reveal a potential misperception among parents regarding their toddler’s water safety. Parental risk perceptions decreased at follow-up, suggesting parents may overestimate the protective value of training. Notably, only parents with moderate to high WC maintained or increased their risk perceptions after child WC training. These findings highlight the need for multifaceted family-centered drowning prevention efforts that include parent-specific training to enhance WC, engagement, supervision, safeguarding, and risk awareness, as well as teaching WC to children.
Keywords: Risk perception, PreventionAuthors:
Author - Julia M. W. Hall, BS, MPH, University of Alabama at Birmingham
Co-Author - Casie Morgan, PHD, Medical University of South Carolina
Co-Author - David C. Schwebel, PHD, University of Iowa
Evaluating Maternal Attributions of Infant Intentionality in the PREPP Trial
Poster Number: C34Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Integrated Primary Care
Background: Practical Resources for Effective Postpartum Parenting (PREPP) is a preventive intervention initiated during pregnancy and delivered adjunctively with obstetric care that integrates psychoeducation, mindfulness coaching, and caregiving skill training. Prior randomized control trials demonstrate that PREPP reduces infant fuss/cry behavior and maternal depressive symptoms, though the intervention’s underlying mechanisms and effects on maternal perceptions of infants have not been examined. Especially relevant due to their association with heightened risk for disruptions in caregiving are maternal infant attributions (IA), which identify maladaptive, unrealistic parental beliefs about infants’ intentions (e.g., purposeful diaper soiling, behavior intended to seek praise). This study examined whether PREPP reduces total IA and whether reductions in infant fuss/cry behavior are mediated by changes in IA. We hypothesized that PREPP would reduce infant fuss/cry behavior through reductions in maternal IA.Methods: From 2018-2023, 175 pregnant individuals were randomized to PREPP or Enhanced Treatment as Usual (ETAU). A subsample (n=141) with Infant Intentionality Questionnaire (IIQ) data at 6 and 16 weeks postpartum was analyzed. Additional measures included demographics and parent-reported infant fuss/cry behavior at 16 weeks postpartum. Analyses included t-tests, Fisher’s exact tests, linear regression, and mediation using structural equation modeling (SEM). Maternal age was negatively, and Medicaid insurance status positively, associated with IIQ scores; both were included as covariates. Results: Participants were 42.6% White and 57.4% Hispanic/Latina; mean gestational age was 38.9 weeks. Mean maternal age was 30.7 years. PREPP was associated with lower total maternal IA at 6 weeks postpartum (p<0.05) and showed a trend toward lower IA at 16 weeks postpartum (p=0.062). Indirect effects of IA at 6 and 16 weeks on infant fuss/cry behavior were nonsignificant. Conclusions: PREPP reduces maternal attributions of infant intentionality at 6 weeks postpartum with trends toward continued reductions at 16 weeks. Although IA did not mediate intervention effects on infant fuss/cry behavior, reductions in maladaptive parental attributions of infant intentionality may represent a clinically meaningful outcome given their documented links to developmental risk. Limitations include COVID-19-related attrition and limited statistical power to detect indirect effects.
Keywords: Caregiving, InterventionAuthors:
Co-Presenter - Katerina Millner, B.A., Perinatal Pathways Lab, Columbia University Medical Center
Co-Presenter - Amaya Smole, B.A., Columbia University Vagelos College of Physicians and Surgeons
Co-Author - Elizabeth Werner, Ph.D., Departments of Obstetrics & Gynecology and Psychiatry, Columbia University Medical Center
Co-Author - Catherine Monk, Ph.D., Departments of Obstetrics & Gynecology and Psychiatry, Columbia University Medical Center
Co-Author - Zheshu Jiang, M.S., Perinatal Pathways Lab, Columbia University Medical Center
Children’s Active School Transportation Behavior and Its Implications for Community Safety in North Macedonia
Poster Number: C35Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Community Engagement
Background:
Active transportation to school (ATS) is recognized as a cost-effective way for children to achieve recommended daily physical activity levels and promote overall health. This study examined ATS practices among second-grade students in North Macedonia (MKD), with particular attention to predictors of children’s behaviors, including parental perceptions of home-to-school (HS) route safety.
Methods:
This nationally representative cross-sectional study was conducted as part of the World Health Organization’s (WHO) European Childhood Obesity Surveillance Initiative—6th round with 2nd grade students (n=2266) from 111 primary schools and their parents/caregivers in MKD. Children’s ATS behaviors, parental perceptions of HS route safety, and child and family sociodemographic characteristics were assessed using a validated self-reported questionnaire. Perceptions of HS route safety was measured on a 10-point Likert-type scale and categorized as very safe (1-3), safe (4-7) and very unsafe (8-10). A multiple logistic regression model estimated adjusted odds ratios (aORs) and accompanying 95% confidence intervals (CIs).
Results:
More than half of students aged 7–8 years (61.3%) engaged in ATS, aligning with 59.3% of parents/caregivers perceiving the HS route as safe or very safe. After adjusting for covariates, significant differences in ATS likelihood emerged. No differences were observed between boys and girls. However, eight-year-olds were more likely than seven-year-olds to use ATS (aOR=1.35, 95% CI:1.13–1.62). Students whose primary language was not Macedonian had higher odds of ATS (aOR=1.26, 95% CI:1.01–1.56), as did children from families with low perceived wealth (aOR=1.40, 95% CI:1.22–1.60). Parental perceptions of HS route safety were strongly associated with ATS: children were more likely to use ATS if parents rated the HS as very safe (aOR=3.41, 95% CI:2.69–4.34) or safe (aOR=1.25, 95% CI:1.02–1.53). Finally, children residing in rural areas were more likely to engage in ATS than those in urban areas (aOR=1.32, 95% CI:1.19–1.48).
Discussion:
These findings demonstrate that AST is relatively common among young children in MKD, yet strongly influenced by age, family socioeconomic background, language, and geographic context. Parental perceptions of HS safety emerged as a particularly powerful determinant. Interventions that enhance HS safety could meaningfully support greater uptake of ATS and contribute to healthier, more active youth.
Keywords: Health behaviors, Physical activityActive transportation to school (ATS) is recognized as a cost-effective way for children to achieve recommended daily physical activity levels and promote overall health. This study examined ATS practices among second-grade students in North Macedonia (MKD), with particular attention to predictors of children’s behaviors, including parental perceptions of home-to-school (HS) route safety.
Methods:
This nationally representative cross-sectional study was conducted as part of the World Health Organization’s (WHO) European Childhood Obesity Surveillance Initiative—6th round with 2nd grade students (n=2266) from 111 primary schools and their parents/caregivers in MKD. Children’s ATS behaviors, parental perceptions of HS route safety, and child and family sociodemographic characteristics were assessed using a validated self-reported questionnaire. Perceptions of HS route safety was measured on a 10-point Likert-type scale and categorized as very safe (1-3), safe (4-7) and very unsafe (8-10). A multiple logistic regression model estimated adjusted odds ratios (aORs) and accompanying 95% confidence intervals (CIs).
Results:
More than half of students aged 7–8 years (61.3%) engaged in ATS, aligning with 59.3% of parents/caregivers perceiving the HS route as safe or very safe. After adjusting for covariates, significant differences in ATS likelihood emerged. No differences were observed between boys and girls. However, eight-year-olds were more likely than seven-year-olds to use ATS (aOR=1.35, 95% CI:1.13–1.62). Students whose primary language was not Macedonian had higher odds of ATS (aOR=1.26, 95% CI:1.01–1.56), as did children from families with low perceived wealth (aOR=1.40, 95% CI:1.22–1.60). Parental perceptions of HS route safety were strongly associated with ATS: children were more likely to use ATS if parents rated the HS as very safe (aOR=3.41, 95% CI:2.69–4.34) or safe (aOR=1.25, 95% CI:1.02–1.53). Finally, children residing in rural areas were more likely to engage in ATS than those in urban areas (aOR=1.32, 95% CI:1.19–1.48).
Discussion:
These findings demonstrate that AST is relatively common among young children in MKD, yet strongly influenced by age, family socioeconomic background, language, and geographic context. Parental perceptions of HS safety emerged as a particularly powerful determinant. Interventions that enhance HS safety could meaningfully support greater uptake of ATS and contribute to healthier, more active youth.
Authors:
Presenter - Aleksandra Stamenova, MD, University Ss.Cyril and Methodius in Skopje, Faculty of Medicine-Skopje
Author - Lorraine Wallace, PhD, The Ohio State University, Collage of Medicine, Columbus, Ohio
Author - Igor Spiroski, MD, PhD, MPH , University Ss.Cyril and Methodius in Skopje, Faculty of Medicine-Skopje; Institute of Public Health of the Republic of North Macedonia
Co-designing a virtual, self-directed cardiovascular health promotion intervention with adolescents: A qualitative analysis of adolescent perspectives
Poster Number: C36Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Cardiovascular Disease
Background: Pediatric guidelines recommend intensive behavioral interventions to reduce cardiovascular disease (CVD) risk, but demand far exceeds availability, and existing programs are poorly tailored for youth. Virtual, self-guided interventions may address scalability, yet little is known about adolescent responses to such material in the context of cardiovascular health (CVH) behaviors. This qualitative study explored adolescents’ perspectives on a novel virtual CVH Promotion Program (CPP) adapted from the Diabetes Prevention Program (DPP), addressing the modality, pacing and source of content delivery, and specific intervention design to optimize skills-based learning.
Methods: We recruited diverse adolescents aged 12-17 years with BMI≥85th percentile for age and sex with at least one CVD risk factor (hypertension, dyslipidemia or prediabetes/type 2 diabetes mellitus). Participants completed 1:1, virtual “design sessions” with self-guided stimuli (e.g., videos, prompts, case studies) adapted from the DPP, followed by semi-structured interviews on concept comprehension, presentation and engagement. Sessions were recorded, transcribed, and analyzed using a rapid analysis approach.
Results: Twelve adolescents completed sessions (42% female gender, mean age 14 years, 33% White, 33% Hispanic, 33% Black/African American). Rapid qualitative analysis revealed four themes: 1) Contrary to our expectations, adolescents prefer variety over a consistent mode of material delivery (i.e., mix of video, audio and text over only videos) for longitudinal CVH interventions. Teens were tolerant of more dated visual materials for greater diversity of content. 2) For standard behavioral health content that is familiar to most teens, they prioritized learning application from peer and cartoon examples rather than reiteration of material from experts in the field. 3) Adolescents approach interventions seeking strategies for direct application to their lives, desiring specific examples and alternatives in the context of real-world scenarios. 4) Teens were more willing to share their responses and progress with a coach rather than peers.
Conclusions: Diverse adolescents are accepting of a virtual, self-guided CVH intervention supplemented with a health coach rather than peer interaction. To optimize engagement, interventions should include a variety of content modalities with peers modeling examples, enabling adolescents to learn skills directly relevant to their lives.
Keywords: Adolescents, Behavior ChangeMethods: We recruited diverse adolescents aged 12-17 years with BMI≥85th percentile for age and sex with at least one CVD risk factor (hypertension, dyslipidemia or prediabetes/type 2 diabetes mellitus). Participants completed 1:1, virtual “design sessions” with self-guided stimuli (e.g., videos, prompts, case studies) adapted from the DPP, followed by semi-structured interviews on concept comprehension, presentation and engagement. Sessions were recorded, transcribed, and analyzed using a rapid analysis approach.
Results: Twelve adolescents completed sessions (42% female gender, mean age 14 years, 33% White, 33% Hispanic, 33% Black/African American). Rapid qualitative analysis revealed four themes: 1) Contrary to our expectations, adolescents prefer variety over a consistent mode of material delivery (i.e., mix of video, audio and text over only videos) for longitudinal CVH interventions. Teens were tolerant of more dated visual materials for greater diversity of content. 2) For standard behavioral health content that is familiar to most teens, they prioritized learning application from peer and cartoon examples rather than reiteration of material from experts in the field. 3) Adolescents approach interventions seeking strategies for direct application to their lives, desiring specific examples and alternatives in the context of real-world scenarios. 4) Teens were more willing to share their responses and progress with a coach rather than peers.
Conclusions: Diverse adolescents are accepting of a virtual, self-guided CVH intervention supplemented with a health coach rather than peer interaction. To optimize engagement, interventions should include a variety of content modalities with peers modeling examples, enabling adolescents to learn skills directly relevant to their lives.
Authors:
Presenter - Qihan Yu, Northwestern University Feinberg School of Medicine
Co-Author - Angela Pfammatter, PhD, FAHA, FSBM, University of Tennessee, Knoxville
Co-Author - Sarah Kennedy, PhD, Department of Psychiatry, University of Colorado Anschutz Medical Campus
Co-Author - Leo Castillo, MA, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Zecilly Guzman, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Sideeq Ibrahim, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - MicKayla Jones, MPH, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Jehad Alharbi, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Erianna Burrel, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Simrun Varshney, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
Co-Author - Diana Madden, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Kathryn Kaplan, MPH, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Nia Heard-Garris, MD, MBA, MSc, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Norrina Allen, PhD, MPH, FAHA, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
Co-Author - Lauren Bonner, PhD, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
Co-Author - Lisa Kuhns, PhD, MPH, Ann & Robert H. Lurie Children’s Hospital of Chicago
Co-Author - Amanda Marma, MD, MS, Ann & Robert H. Lurie Children’s Hospital of Chicago
The Association between Parenting Styles and Added Sugar Intake in Preschool-Aged Children
Poster Number: C37Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Diet, Nutrition, and Eating Disorders
Background: Parenting style has been related to child weight status in early childhood, but the underlying mechanisms are not well-understood. This study aimed to examine whether parenting styles would be associated with added sugar intake in preschool-aged children.
Methods: Eighty children aged 3-5 years, each with one parent, were recruited from northern New England, US. Parents completed the Parenting Styles and Dimensions Questionnaire and reported their child’s dietary intake using the Dietary Screener Questionnaire at baseline and six-month follow-up. Bivariate analyses were conducted to compare child dietary outcomes by parental education and household income. Linear mixed-effects models were used to evaluate the associations between parenting styles (permissive, authoritative) and dietary outcomes (total added sugar, sugar from sugar-sweetened beverages [SSBs]), adjusting for child age, sex, estimated daily energy intake, parental education, and visit timepoint (baseline vs. six-month follow-up). Effect modification by child appetitive traits (measured with the Child Eating Behavior Questionnaire) was additionally explored.
Results: Higher parental education was associated with lower child intake of total added sugar and of added sugar from SSBs (p-values < 0.01). Permissive parenting style was positively associated with child total added sugar intake (standardized beta coefficient β_s= 0.29, 95% CI: 0.10, 0.48) and added sugar from SSBs. (β_s= 0.29, 95% CI: 0.07, 0.51). No associations were found for authoritative style. There was no evidence for effect modification or mediation by child appetitive traits.
Conclusions: Permissive parenting may increase childhood obesity risk through promoting excess added sugar consumption in young children.
Keywords: Nutrition, Children's healthMethods: Eighty children aged 3-5 years, each with one parent, were recruited from northern New England, US. Parents completed the Parenting Styles and Dimensions Questionnaire and reported their child’s dietary intake using the Dietary Screener Questionnaire at baseline and six-month follow-up. Bivariate analyses were conducted to compare child dietary outcomes by parental education and household income. Linear mixed-effects models were used to evaluate the associations between parenting styles (permissive, authoritative) and dietary outcomes (total added sugar, sugar from sugar-sweetened beverages [SSBs]), adjusting for child age, sex, estimated daily energy intake, parental education, and visit timepoint (baseline vs. six-month follow-up). Effect modification by child appetitive traits (measured with the Child Eating Behavior Questionnaire) was additionally explored.
Results: Higher parental education was associated with lower child intake of total added sugar and of added sugar from SSBs (p-values < 0.01). Permissive parenting style was positively associated with child total added sugar intake (standardized beta coefficient β_s= 0.29, 95% CI: 0.10, 0.48) and added sugar from SSBs. (β_s= 0.29, 95% CI: 0.07, 0.51). No associations were found for authoritative style. There was no evidence for effect modification or mediation by child appetitive traits.
Conclusions: Permissive parenting may increase childhood obesity risk through promoting excess added sugar consumption in young children.
Authors:
Author - Zhuoya Zhang, Dartmouth College
Co-Author - Delaina Carlson, University of Connecticut
Co-Author - Diane Gilbert-Diamond, PhD, Dartmouth College
Co-Author - Jennifer Emond, PhD, Dartmouth College
Pilot Trial of a Heat Acclimatization Schedule to Support Children’s Outdoor Play During Extreme Heat
Poster Number: C38Time: 05:00 PM - 05:50 PM
Topics: Climate Change and Health, Physical Activity
Introduction: Extreme heat limits children’s outdoor physical activity (PA) during summertime. Adult trials suggest heat acclimatization schedules can build heat tolerance, but schedules have not been tested with children. This study tested a child-adapted heat acclimatization schedule to assess the impact on thermal sensation and frequency of outdoor visits.
Methods: Children (n=31) ages 7–12 from 21 families in Austin, TX, were block randomized to a heat acclimatization intervention (n=15) or a normal activity schedule (n=16) during July 1st to August 15th 2025, where the average daily temperature was 96°F. The intervention consisted of 10 continuous days of outdoor PA (e.g., active games, free play, walking, jogging, tag), beginning at 45 minutes of low-to-moderate PA and progressing to 60 minutes of moderate-to-vigorous PA. Participants completed 4–7 days of surveys, both pre- and post-intervention, to assess time outdoors (yes/no for morning, afternoon, and evening periods) and thermal sensation (-3=cold to 3=hot) using the American Society of Heating, Refrigeration, and Air-Conditioning Engineers scale. We analyzed the changes pre- and post-intervention, via fully adjusted logistic regression for time outdoors and linear regression for thermal sensation.
Results: From the 358 surveys (about 11 surveys per child), thermal sensation did not vary statistically among the groups or parts of the day in the pre-intervention period. The intervention group had 2.6 times higher odds of afternoon outdoor visits when temperatures peaked (OR=2.57; 95% CI: 0.78–8.45) compared to the control group, with lower odds of morning (OR=0.53; 0.15–1.91) and evening visits (OR=0.36; 0.10–1.37). The intervention group reported a 0.6-unit lower morning thermal sensation (MD=-0.59; 95% CI: -1.41, 0.23) relative to the control group, with little change in sensation during the afternoon or evening.
Conclusion: Preliminary behavioral signals—including increased afternoon outdoor visits and reduced morning thermal sensation—suggest that acclimatization may support children’s safe outdoor activity during extreme heat. These findings highlight important pathways for behavioral adaptation and provide a foundation for sufficiently powered trials.
AI: GitHub Copilot was used as an assistive tool during code development. All code and analyses were reviewed and validated by the authors.
Keywords: Children's health, Physical activityMethods: Children (n=31) ages 7–12 from 21 families in Austin, TX, were block randomized to a heat acclimatization intervention (n=15) or a normal activity schedule (n=16) during July 1st to August 15th 2025, where the average daily temperature was 96°F. The intervention consisted of 10 continuous days of outdoor PA (e.g., active games, free play, walking, jogging, tag), beginning at 45 minutes of low-to-moderate PA and progressing to 60 minutes of moderate-to-vigorous PA. Participants completed 4–7 days of surveys, both pre- and post-intervention, to assess time outdoors (yes/no for morning, afternoon, and evening periods) and thermal sensation (-3=cold to 3=hot) using the American Society of Heating, Refrigeration, and Air-Conditioning Engineers scale. We analyzed the changes pre- and post-intervention, via fully adjusted logistic regression for time outdoors and linear regression for thermal sensation.
Results: From the 358 surveys (about 11 surveys per child), thermal sensation did not vary statistically among the groups or parts of the day in the pre-intervention period. The intervention group had 2.6 times higher odds of afternoon outdoor visits when temperatures peaked (OR=2.57; 95% CI: 0.78–8.45) compared to the control group, with lower odds of morning (OR=0.53; 0.15–1.91) and evening visits (OR=0.36; 0.10–1.37). The intervention group reported a 0.6-unit lower morning thermal sensation (MD=-0.59; 95% CI: -1.41, 0.23) relative to the control group, with little change in sensation during the afternoon or evening.
Conclusion: Preliminary behavioral signals—including increased afternoon outdoor visits and reduced morning thermal sensation—suggest that acclimatization may support children’s safe outdoor activity during extreme heat. These findings highlight important pathways for behavioral adaptation and provide a foundation for sufficiently powered trials.
AI: GitHub Copilot was used as an assistive tool during code development. All code and analyses were reviewed and validated by the authors.
Authors:
Presenter - Tyson Murray, MS, The University of Texas Health Science Center at Houston, Austin, Texas
Author - Samuel Williams, DO, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
Author - Alefiyah Malbari, MD, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
Author - Kevin Lanza, PhD, The University of Texas Health Science Center at Houston, Austin, Texas
A 60-Minute Play-Rich Climate Education Workshop Improves Youth Climate Literacy, Environmental Efficacy, and Pro-environmental Behavior Intentions
Poster Number: C39Time: 05:00 PM - 05:50 PM
Topics: Climate Change and Health, Multiple Health Behavior Change
Climate change education (CCE) often relies on cognitive instruction that fails to engage youth in ways that feel relevant, hopeful, or actionable (Nepraš et al., 2022). While longer, immersive forms of experiential, play-based learning are known to foster meaningful engagement with complex topics (Behrendt & Franklin, 2014), the promise of ultra-short interventions remains largely unexplored. This study evaluated a 60-minute play-rich climate–food systems workshop grounded in the Holistic Outdoor Play-rich Education (HOPE) framework, a new model that integrates distinct modalities of play and guided learning to activate cognitive, creative, and social-emotional processes that deepen youth engagement with complex environmental issues.
The workshop was delivered to 73 migrant youth (grades 6–12) across nine groups. Activities included curiosity-driven mini-lessons linking food waste and climate impacts, collaborative footprint-sorting games, and mindful tasting of climate-resilient foods. High-school–aged counselors facilitated all sessions. A mixed-method evaluation assessed pre–post changes in climate–food knowledge, pro-environmental behavior intentions, self- and collective environmental efficacy, nature connection, and affective wellbeing, with observations and counselor focus groups providing qualitative insights into engagement and emotional responses.
Youth showed significant improvements in climate–food knowledge (p = .013, d = .30), pro-environmental behavior intentions (p < .001, d = .71) and self-environmental efficacy (p = .005, d = .34). Small positive trends were observed for nature connection and positive affect. Qualitative data highlighted strong peer engagement, laughter, and collaborative problem-solving during play-based activities. Participants expressed increased optimism and reduced climate worry, often noting feeling “more able to help” and “less anxious” after session.
Findings demonstrate that even a single 60-minute play-rich session can meaningfully influence youth’s climate-related efficacy, behavioral intentions, and emotional wellbeing. Grounding abstract climate concepts in food—a familiar, sensory-rich domain—enhanced relevance, supported emotional regulation, and fostered hope. This work suggests that brief, intentionally designed interventions can complement longer CCE efforts and offers a scalable model for behaviorally informed, youth-centered climate programming across school, camp, and community settings.
Keywords: Resilience, InterventionThe workshop was delivered to 73 migrant youth (grades 6–12) across nine groups. Activities included curiosity-driven mini-lessons linking food waste and climate impacts, collaborative footprint-sorting games, and mindful tasting of climate-resilient foods. High-school–aged counselors facilitated all sessions. A mixed-method evaluation assessed pre–post changes in climate–food knowledge, pro-environmental behavior intentions, self- and collective environmental efficacy, nature connection, and affective wellbeing, with observations and counselor focus groups providing qualitative insights into engagement and emotional responses.
Youth showed significant improvements in climate–food knowledge (p = .013, d = .30), pro-environmental behavior intentions (p < .001, d = .71) and self-environmental efficacy (p = .005, d = .34). Small positive trends were observed for nature connection and positive affect. Qualitative data highlighted strong peer engagement, laughter, and collaborative problem-solving during play-based activities. Participants expressed increased optimism and reduced climate worry, often noting feeling “more able to help” and “less anxious” after session.
Findings demonstrate that even a single 60-minute play-rich session can meaningfully influence youth’s climate-related efficacy, behavioral intentions, and emotional wellbeing. Grounding abstract climate concepts in food—a familiar, sensory-rich domain—enhanced relevance, supported emotional regulation, and fostered hope. This work suggests that brief, intentionally designed interventions can complement longer CCE efforts and offers a scalable model for behaviorally informed, youth-centered climate programming across school, camp, and community settings.
Authors:
Presenter - Xiangyou Shen, PhD, Oregon State University
Co-Author - Siew Sun Wong, PhD, Oregon State University
Co-Author - Lydia Gorrell, Oregon State University
Co-Author - Anna Hough, Oregon State University
Co-Author - LeeAnn Mikkelson, Oregon State University
Co-Author - Samuel Chan , Oregon State University
“Forging a Community of Care”: A culturally Adapted Behavioral Intervention for Latino Dementia Caregivers
Poster Number: C4Time: 05:00 PM - 05:50 PM
Topics: Aging, Community Engagement
Background: Latino family dementia caregivers provide more time-intensive and greater levels of care and report more depression and less family support than other racial/ethnic groups. While several psychoeducational interventions for dementia caregivers exist, few have been adapted or developed specifically for Latino dementia caregivers. This gap underscores the critical need for culturally adapted programs that focus on Latino caregivers’ unique caregiving needs. To address this, we collaborated with a Community Advisory Board (CAB) to culturally adapt Tele-Savvy, a caregiver mastery program, for Latino dementia caregivers. Methods: Guided by the Cultural Adaptation Behavioral Health Stage Model and informed by principles of community-engaged research, we established a CAB consisting of 9 Latino community members, including dementia caregivers, to co-develop the culturally adapted program. During Stage 1 of the adaptation model, “Information Gathering”, each of the 10 meetings with the CAB focused on discussions to improve the cultural relevance and contextual fit of the program with Latinos, including: how intervention content was presented; appropriateness of examples; and what was missing in the program to support the needs of Latino caregivers. We utilized the Framework for Reporting Adaptations and Modifications – Enhanced to document the adaptation process. Results: The culturally adapted intervention was rebranded as Forging a Community of Care. The content was conceptualized utilizing the ecological model to emphasize the diverse systems that caregivers interact with (person with dementia, family, community, and healthcare system). Other adaptations included the culturally appropriate translation of and language in materials; prioritizing engagement with the family in caregiving; contextualizing dementia within Latino culture; and including content to address conversations with loved ones about living wills, legal and health power of attorney, and in-home and long-term care. Conclusions: The collaborative work with the Latino CAB ensures the development of a culturally attuned intervention to improve Latino ADRD caregivers’ sense of competence and confidence in dealing with the behavioral and psychological symptoms of dementia. This work will inform future research to test the feasibility, acceptability, and preliminary efficacy of the adapted program.
Keywords: Caregiving, LatinoAuthors:
Presenter - Maria Quiñones-Cordero, PhD, University of Rochester School of Nursing
Co-Author - Kenneth Hepburn, PhD, Emory University
Co-Author - Silvia Sorensen, PhD, University of Rochester
Changes in Physical Activity Timing and Intensity Under Extreme Heat Conditions
Poster Number: C40Time: 05:00 PM - 05:50 PM
Topics: Climate Change and Health, Physical Activity
Background: Climate change is driving an increase in the frequency, severity, and duration of extreme heat events, which have well-established negative impacts on human health. Previous research has focused on a multitude of risk factors that make individuals vulnerable to negative health outcomes due to extreme heat. However, few studies have investigated what behavioral changes regarding physical activity occur within the context of an intervention.
Methods: Using data from the WalkIT Arizona study, we investigate how daily exercise timing differs based on extreme heat conditions and intervention strategies. Healthy, insufficiently active adults (N = 512) were instructed to wear an accelerometer for one year. This physical activity intervention occurred in Maricopa County, a location characterized by prolonged extreme heat events. For every participant, each day of active intervention was extracted at the minute-level, yielding 128,374 total observation days over all participants. Functional principal component analysis (fPCA) was applied to identify dominant patterns in daily physical activity (PA) timing and intensity. This analysis generates a set of archetypical components, ordered by their contribution to overall daily activity patterns, and each day has a score for each component. Linear mixed effects models were fit to the data to examine differences in fPCA component scores according to extreme vs. non-extreme heat days.
Results: Scores for component 1 were significantly lower on extreme heat days than on non-extreme heat days (β = 535.6, p < .001), which indicates PA later in the day and reduced intensity. Component 2 contrasts early morning versus late evening PA. For this component, scores were significantly lower on extreme heat days compared to non-heat days, emphasizing low morning and high evening PA (β = −194.81, p < .001).
Discussion: Findings from both components demonstrate a significant effect of heat on both exercise timing and intensity within the context of a physical activity intervention, indicating a need to further investigate participants’ PA changes while environmental stressors are present. During extreme heat days, participant activity shifts to later in the day and to a lower intensity. These findings can be used to better inform future interventions by tailoring methods of encouraging physical activity based on participants’ environmental context.
Keywords: Physical activity, EnvironmentMethods: Using data from the WalkIT Arizona study, we investigate how daily exercise timing differs based on extreme heat conditions and intervention strategies. Healthy, insufficiently active adults (N = 512) were instructed to wear an accelerometer for one year. This physical activity intervention occurred in Maricopa County, a location characterized by prolonged extreme heat events. For every participant, each day of active intervention was extracted at the minute-level, yielding 128,374 total observation days over all participants. Functional principal component analysis (fPCA) was applied to identify dominant patterns in daily physical activity (PA) timing and intensity. This analysis generates a set of archetypical components, ordered by their contribution to overall daily activity patterns, and each day has a score for each component. Linear mixed effects models were fit to the data to examine differences in fPCA component scores according to extreme vs. non-extreme heat days.
Results: Scores for component 1 were significantly lower on extreme heat days than on non-extreme heat days (β = 535.6, p < .001), which indicates PA later in the day and reduced intensity. Component 2 contrasts early morning versus late evening PA. For this component, scores were significantly lower on extreme heat days compared to non-heat days, emphasizing low morning and high evening PA (β = −194.81, p < .001).
Discussion: Findings from both components demonstrate a significant effect of heat on both exercise timing and intensity within the context of a physical activity intervention, indicating a need to further investigate participants’ PA changes while environmental stressors are present. During extreme heat days, participant activity shifts to later in the day and to a lower intensity. These findings can be used to better inform future interventions by tailoring methods of encouraging physical activity based on participants’ environmental context.
Authors:
Author - Analisa Vavoso, Chapman University
Co-Author - Vincent Berardi, PhD, Chapman University
Co-Author - Marc Adams, PhD, MPH, Arizona State University
A Qualitative Study of Undergraduate Student Knowledge, Beliefs, and Influences of HPV Vaccination
Poster Number: C41Time: 05:00 PM - 05:50 PM
Topics: Community Engagement, Multiple Health Behavior Change
Introduction
College students, at high risk of contracting human papillomavirus (HPV), report some of the lowest HPV vaccination rates in the U.S. Despite this disparity, current HPV vaccination initiatives frequently prioritize early vaccine initiation, rather than “catch up” populations such as college students. Often having access to insurance, healthcare services, and HPV vaccination, college populations are an ideal target for intervention. This qualitative study sought to determine undergraduate knowledge, beliefs, and influencing factors, particularly in the post-COVID-19 landscape, related to HPV and HPV vaccination to inform development of targeted interventions.
Methods
We recruited 19 undergraduate students currently enrolled at the research institution to participate in one of three focus groups in April 2025. A semi-formal interview guide was used to explore students’ knowledge, beliefs, and influencing factors surrounding HPV and HPV vaccination, as well as perceived risk, perceived importance, gender differences, cues to action, and independence in health decision making. Focus groups were audio recorded, transcribed, and analyzed using inductive thematic analysis to identify qualitative themes.
Results
Of the 19 participants, most were female (n=14, 73.7%) and White (n=10, 52.6%). Median age was 20.0 years (range of 18-24 years). Students frequently demonstrated low knowledge around HPV and HPV vaccine, while simultaneously expressing a desire for greater education for themselves and their peers. Perceived risk from HPV was low, despite an understanding of the prevalence of HPV. Many students emphasized the importance of conducting personal research before trusting or taking action on health messaging, including messaging from healthcare providers.
Discussion
Findings indicate low HPV and HPV vaccine knowledge as well as low perceived risk, providing potential rationale for low vaccination rates in this population. Students’ desire for more information underscores the importance of college populations as a key audience for intervention. Their increased preference for doing their own research on health-related matters appears associated with recent events related to politics, media, and concerns about trustworthy sources. Given their desire for education and concerns regarding accuracy, targeted interventions are greatly needed to provide college populations with evidence-based health information specific to HPV and vaccination.
Keywords: Health beliefs, Cancer risk perceptionsCollege students, at high risk of contracting human papillomavirus (HPV), report some of the lowest HPV vaccination rates in the U.S. Despite this disparity, current HPV vaccination initiatives frequently prioritize early vaccine initiation, rather than “catch up” populations such as college students. Often having access to insurance, healthcare services, and HPV vaccination, college populations are an ideal target for intervention. This qualitative study sought to determine undergraduate knowledge, beliefs, and influencing factors, particularly in the post-COVID-19 landscape, related to HPV and HPV vaccination to inform development of targeted interventions.
Methods
We recruited 19 undergraduate students currently enrolled at the research institution to participate in one of three focus groups in April 2025. A semi-formal interview guide was used to explore students’ knowledge, beliefs, and influencing factors surrounding HPV and HPV vaccination, as well as perceived risk, perceived importance, gender differences, cues to action, and independence in health decision making. Focus groups were audio recorded, transcribed, and analyzed using inductive thematic analysis to identify qualitative themes.
Results
Of the 19 participants, most were female (n=14, 73.7%) and White (n=10, 52.6%). Median age was 20.0 years (range of 18-24 years). Students frequently demonstrated low knowledge around HPV and HPV vaccine, while simultaneously expressing a desire for greater education for themselves and their peers. Perceived risk from HPV was low, despite an understanding of the prevalence of HPV. Many students emphasized the importance of conducting personal research before trusting or taking action on health messaging, including messaging from healthcare providers.
Discussion
Findings indicate low HPV and HPV vaccine knowledge as well as low perceived risk, providing potential rationale for low vaccination rates in this population. Students’ desire for more information underscores the importance of college populations as a key audience for intervention. Their increased preference for doing their own research on health-related matters appears associated with recent events related to politics, media, and concerns about trustworthy sources. Given their desire for education and concerns regarding accuracy, targeted interventions are greatly needed to provide college populations with evidence-based health information specific to HPV and vaccination.
Authors:
Co-Author - Alyssa Lee, MPH, University of South Alabama
Co-Author - Sydney Cosby, University of Alabama Birmingham
Co-Author - Maura Hawkins, University of South Alabama
Co-Author - Casey Daniel, PhD, MPH, University of South Alabama College of Medicine, Family Medicine
Key Informants’ Perceptions of Barriers and Interventions for HPV Vaccine Uptake Among College Students
Poster Number: C42Time: 05:00 PM - 05:50 PM
Topics: Community Engagement, Decision Making
Background: Human papillomavirus (HPV) is the most common sexually transmitted infection and
plays a role in numerous cancers. HPV vaccination coverage among college students remains low despite recommendations for widespread immunization. Understanding the perspectives of university stakeholders can inform more effective strategies to promote vaccine uptake. This study aimed to explore knowledge, barriers, and facilitators related to HPV vaccination, as well as recommendations for intervention design, through key informant interviews affiliated with a Northeastern US university.
Method: Semi-structured interviews were conducted with key informants affiliated with student health, education, and outreach services at the university. Participants were asked about their roles, perceptions of HPV-related education, and insights on vaccine access, student concerns, and potential intervention strategies. Interviews were recorded, transcribed, and thematically analyzed using a codebook developed through an iterative process.
Results: Three major themes emerged from the data including health literacy, gatekeepers, and intervention design. While they believed some students were informed about HPV, many lacked fundamental knowledge, particularly regarding the vaccine’s purpose and availability. Health literacy gaps were attributed to inadequate sex education, sociocultural norms, and limited student engagement with health services. Informants emphasized student demand for clear, accessible information on vaccine benefits, risks, disease prevention, and the logistics of vaccination. Key informants mentioned cost, understanding of insurance coverage, SES, trust in the medical system, access to transportation, level of sexual activity, growing autonomy, and exposure to peer-led health discussions as influences on vaccination perceptions. Effective strategies were thought to include peer-led outreach, tabling events, interactive activities, and incentives.
Discussion: Findings highlight the need for multi-modal, student-centered interventions that improve health literacy and address structural and cultural barriers to vaccination. Peer education, incentives, and interactive outreach events were recommended as promising approaches. Efforts should also include clearer communication about cost, access points, and the public health importance of HPV vaccination. Addressing mixed perceptions of the student health center may also improve engagement and vaccine uptake.
Keywords: STDs, Preventionplays a role in numerous cancers. HPV vaccination coverage among college students remains low despite recommendations for widespread immunization. Understanding the perspectives of university stakeholders can inform more effective strategies to promote vaccine uptake. This study aimed to explore knowledge, barriers, and facilitators related to HPV vaccination, as well as recommendations for intervention design, through key informant interviews affiliated with a Northeastern US university.
Method: Semi-structured interviews were conducted with key informants affiliated with student health, education, and outreach services at the university. Participants were asked about their roles, perceptions of HPV-related education, and insights on vaccine access, student concerns, and potential intervention strategies. Interviews were recorded, transcribed, and thematically analyzed using a codebook developed through an iterative process.
Results: Three major themes emerged from the data including health literacy, gatekeepers, and intervention design. While they believed some students were informed about HPV, many lacked fundamental knowledge, particularly regarding the vaccine’s purpose and availability. Health literacy gaps were attributed to inadequate sex education, sociocultural norms, and limited student engagement with health services. Informants emphasized student demand for clear, accessible information on vaccine benefits, risks, disease prevention, and the logistics of vaccination. Key informants mentioned cost, understanding of insurance coverage, SES, trust in the medical system, access to transportation, level of sexual activity, growing autonomy, and exposure to peer-led health discussions as influences on vaccination perceptions. Effective strategies were thought to include peer-led outreach, tabling events, interactive activities, and incentives.
Discussion: Findings highlight the need for multi-modal, student-centered interventions that improve health literacy and address structural and cultural barriers to vaccination. Peer education, incentives, and interactive outreach events were recommended as promising approaches. Efforts should also include clearer communication about cost, access points, and the public health importance of HPV vaccination. Addressing mixed perceptions of the student health center may also improve engagement and vaccine uptake.
Authors:
Author - K. Olivia Mock, MA, Stony Brook University
Co-Author - Rose Martillotti, MA, Stony Brook University
Co-Author - Sana Malik, DrPH, MSW, MPH, Stony Brook University
Co-Author - Giuseppina Caravella, MPH, MS, CHES, Stony Brook University
Co-Author - Xicheng Zhou, MSW, Stony Brook University
Co-Author - Matthew Mbamelu, LMSW, Stony Brook University
Co-Author - Kathleen H. Scarbrough, MD, MPH, Stony Brook Medicine
Community-Informed Digital Advertisements Outperform Study Team-Designed Advertisements in Clinical Trial Recruitment
Poster Number: C43Time: 05:00 PM - 05:50 PM
Topics: Community Engagement, Cardiovascular Disease
Background
Clinical trials often fail to meet enrollment goals. Community engagement in advertisement (ad) design can enhance the relevance and appeal of recruitment materials. However, few studies have evaluated if ads designed with community input enhance trial interest and enrollment compared to study team-designed ads.
Methods
Within Access Nourish (NCT06743191), a feasibility trial enrolling adults with hypertension living in low access census tracts (enrollment goal: n=67), we evaluated three Meta (Facebook/Instagram) ads during study recruitment: (1) a community-informed ad, which was developed in collaboration with a group of community advisors for population health research, (2) a community-designed ad, developed entirely by a member of the community advisory group using provided study information, and (3) a study team-designed ad. The ads ran for 7 days. We compared ad performance using link click-through rate (CTR), defined as the percentage of users who clicked the ad’s embedded link to the study’s eligibility screener out of the total number of ad impressions. We also assessed the number and proportion of people who completed the screener, met eligibility criteria, and enrolled in the study.
Results
The community-informed ad had the highest link CTR (4.6%), compared to the research team ad (3.3%) and community-designed ad (3.0%). Of the 156 respondents from Meta who completed the study screener, 81 (51.9%) came from the community-informed ad, 41 (26.3%) from the community-designed ad, and 34 (21.8%) from the research team ad. Of those eligible (103), the highest proportion (47.6%, n=49) were from the community-informed ad, followed by 36 (35.0%) from the community-designed ad, and 18 (17.5%) from the study team ad. Among respondents (31% White, 25% Black, 31% Hispanic, and 50% women) who consented to participate (n=16), most (eight) were from the community-informed ad, followed by the community-designed ad (five) and the study team ad (three). Half of the 10 participants who subsequently enrolled were from the community-informed ad, while the remaining were split between the community-designed (two) and study team ads (three).
Conclusion
Community-informed ads may result in increased study engagement and conversion at multiple recruitment stages, suggesting a promising strategy for improving equity in clinical trial participation. Future research is needed with larger, more diverse study populations to assess the scalability of this approach.
Keywords: Community intervention, Population healthClinical trials often fail to meet enrollment goals. Community engagement in advertisement (ad) design can enhance the relevance and appeal of recruitment materials. However, few studies have evaluated if ads designed with community input enhance trial interest and enrollment compared to study team-designed ads.
Methods
Within Access Nourish (NCT06743191), a feasibility trial enrolling adults with hypertension living in low access census tracts (enrollment goal: n=67), we evaluated three Meta (Facebook/Instagram) ads during study recruitment: (1) a community-informed ad, which was developed in collaboration with a group of community advisors for population health research, (2) a community-designed ad, developed entirely by a member of the community advisory group using provided study information, and (3) a study team-designed ad. The ads ran for 7 days. We compared ad performance using link click-through rate (CTR), defined as the percentage of users who clicked the ad’s embedded link to the study’s eligibility screener out of the total number of ad impressions. We also assessed the number and proportion of people who completed the screener, met eligibility criteria, and enrolled in the study.
Results
The community-informed ad had the highest link CTR (4.6%), compared to the research team ad (3.3%) and community-designed ad (3.0%). Of the 156 respondents from Meta who completed the study screener, 81 (51.9%) came from the community-informed ad, 41 (26.3%) from the community-designed ad, and 34 (21.8%) from the research team ad. Of those eligible (103), the highest proportion (47.6%, n=49) were from the community-informed ad, followed by 36 (35.0%) from the community-designed ad, and 18 (17.5%) from the study team ad. Among respondents (31% White, 25% Black, 31% Hispanic, and 50% women) who consented to participate (n=16), most (eight) were from the community-informed ad, followed by the community-designed ad (five) and the study team ad (three). Half of the 10 participants who subsequently enrolled were from the community-informed ad, while the remaining were split between the community-designed (two) and study team ads (three).
Conclusion
Community-informed ads may result in increased study engagement and conversion at multiple recruitment stages, suggesting a promising strategy for improving equity in clinical trial participation. Future research is needed with larger, more diverse study populations to assess the scalability of this approach.
Authors:
Author - Azuka Ngige, MBBS, MPH, Johns Hopkins University School of Medicine
Co-Author - Timothy Plante, MD, MHS, University of Vermont
Co-Author - Ashauna Lee, Johns Hopkins University School of Public Health
Co-Author - Joyline Chepkorir, BS, MS, PhD, Johns Hopkins University School of Nursing
Co-Author - Philip Okonkwo, Johns Hopkins University School of Nursing
Co-Author - Stephen Juraschek, MD, PhD, Beth Israel Deaconess Medical Center
Co-Author - Erin Michos, MD, MHS, Johns Hopkins University School of Medicine
Co-Author - Cheryl Himmelfarb, PhD, RN, Johns Hopkins University School of Nursing
Co-Author - Hailey Miller, PhD, RN, Johns Hopkins University School of Nursing
Women’s reactions to the United States Preventive Services Task Force 2024 mammography guideline: A Focus Group Study
Poster Number: C44Time: 05:00 PM - 05:50 PM
Topics: Decision Making, Cancer
Background: From 2009 to 2024, the United States Preventive Services Task Force (USPSTF) recommended that women aged 40-49 make an informed choice about when to begin having mammograms. In 2024, the USPSTF updated its guideline, recommending that all women start biennial screening at age 40. Because the new guideline de-emphasizes informed choice, we conducted focus groups to evaluate whether women still want to be informed about both the benefits and harms of breast cancer screening (BCS).
Methods: Participants were women ages 39-49 who had been previously enrolled in an ongoing longitudinal study where they were exposed to a decision aid conveying information about the prior USPSTF guideline and BCS harms and benefits. They were invited to participate in a follow-up focus group after completing a survey that communicated the new USPSTF guideline and the rationale for the change. Focus group questions probed women’s thoughts and feelings about being informed about both BCS harms and benefits considering the new guidelines. Purposive sampling was used to obtain a sample diverse in race, educational attainment, and prior screening preferences. A rapid coding framework was used to analyze the data and articulate themes.
Results: Eight focus groups were conducted with 4-6 people in each (N=39). 41% identified as Black (51% white), 51% had less than a college degree, and 76% had indicated a preference to screen at their current age (vs. waiting until older). Three key themes emerged: 1) Receiving information about the harms of BCS had little to no negative effect on participants; 2) Participants emphasized the importance of being educated about both BCS benefits and harms and that information should not be withheld; 3) Participants were strongly opposed to the idea of screening as a performance metric for clinicians, instead insisting screening is a personal choice.
Discussion: Even though the USPSTF no longer emphasizes informed choice in its 2024 BCS guideline, these women still wanted to be informed about both BCS harms and benefits and perceived little or no harm in being educated. Withholding information, and implementing targets for screening uptake, were viewed as unacceptable. These women believed they should be empowered to make their own screening decisions and did not want to feel coerced into screening.
Keywords: Screening, CancerMethods: Participants were women ages 39-49 who had been previously enrolled in an ongoing longitudinal study where they were exposed to a decision aid conveying information about the prior USPSTF guideline and BCS harms and benefits. They were invited to participate in a follow-up focus group after completing a survey that communicated the new USPSTF guideline and the rationale for the change. Focus group questions probed women’s thoughts and feelings about being informed about both BCS harms and benefits considering the new guidelines. Purposive sampling was used to obtain a sample diverse in race, educational attainment, and prior screening preferences. A rapid coding framework was used to analyze the data and articulate themes.
Results: Eight focus groups were conducted with 4-6 people in each (N=39). 41% identified as Black (51% white), 51% had less than a college degree, and 76% had indicated a preference to screen at their current age (vs. waiting until older). Three key themes emerged: 1) Receiving information about the harms of BCS had little to no negative effect on participants; 2) Participants emphasized the importance of being educated about both BCS benefits and harms and that information should not be withheld; 3) Participants were strongly opposed to the idea of screening as a performance metric for clinicians, instead insisting screening is a personal choice.
Discussion: Even though the USPSTF no longer emphasizes informed choice in its 2024 BCS guideline, these women still wanted to be informed about both BCS harms and benefits and perceived little or no harm in being educated. Withholding information, and implementing targets for screening uptake, were viewed as unacceptable. These women believed they should be empowered to make their own screening decisions and did not want to feel coerced into screening.
Authors:
Author - Tamar Parmet, MSW, University of Colorado Denver
Co-Author - Brad Morse, PhD, University of Colorado Anschutz Medical Campus
Co-Author - Grant Yoder, MEd, University of Colorado Anschutz Medical Campus
Co-Author - Damilola Jolaoso, University of Colorado Anschutz Medical Campus
Co-Author - Marilyn Schapira, MD, University of Pennsylvania
Co-Author - Carmen Lewis, MD, University of Colorado Anschutz Medical Campus
Co-Author - Kirsten McCaffery, PhD, University of Sydney
Co-Author - Jolyn Hersch, PhD, University of Sydney
Co-Author - Joseph Cappella, PhD, University of Pennsylvania
Co-Author - Channing Tate, PhD, University of Colorado Anschutz Medical Campus
Co-Author - Kelly Arnett, MD, University of Colorado Anschutz Medical Campus
Co-Author - Laura Scherer, PhD, University of Colorado, Anschutz Medical Campus
Risk-concordant information seeking behavior following receipt of personalized breast cancer risk estimates: The role of risk skepticism
Poster Number: C45Time: 05:00 PM - 05:50 PM
Topics: Decision Making, Health Communication and Policy
Background: Seeking health information helps people understand how to promote health, detect disease, and identify treatment options. We examined: 1) whether women who received personalized breast cancer risk estimates engaged in risk-concordant information seeking, and 2) whether such behavior was moderated by skepticism of the estimate provided.
Methods: We recruited 781 Black women aged 39-74 from the Dynata Internet panel. They completed a survey that included the Gail model personalized breast cancer risk assessment. Participants were informed that they were at lower-than-average, about average, or higher-than-average risk. Risk-concordant information seeking was defined as choosing to view breast cancer screening information that was consistent with this risk category (e.g., a participant at average risk choosing to view risk information intended for women at average risk). Risk skepticism was determined by asking participants to indicate whether they thought they were at higher, average, or lower risk, regardless of what they were told. Underestimators believed their actual risk category was lower than the calculated risk; overestimators believed their actual risk category was higher than the calculated risk.
Results: 48% of women sought risk-concordant information. Of those who sought discordant information, 36% chose low-risk information, 28% chose high-risk information, and 36% chose average-risk information. Additionally, 69% of women disagreed with the Gail model risk category information. Of those who disagreed, most (74%) were underestimators. There was an interaction between risk category and skepticism, p=0.01. Investigation of the interaction revealed that there was one group who was particularly less likely to engage in risk-concordant information seeking: women who were informed they were at lower-than-average risk, but who thought that their risk was actually higher-than-average (i.e., they were overestimators), OR=0.15, p=0.02.
Conclusion: Women who disagreed with results from the Gail model indicating they were at lower-than-average risk tended to seek information for women at average or above-average risk. Women who were who were told that their risk was average or above average did not show the converse results, suggesting different underlying motivations for people who believe their risk is higher or lower than the Gail model estimate.
Keywords: Cancer risk perceptions, information seekingMethods: We recruited 781 Black women aged 39-74 from the Dynata Internet panel. They completed a survey that included the Gail model personalized breast cancer risk assessment. Participants were informed that they were at lower-than-average, about average, or higher-than-average risk. Risk-concordant information seeking was defined as choosing to view breast cancer screening information that was consistent with this risk category (e.g., a participant at average risk choosing to view risk information intended for women at average risk). Risk skepticism was determined by asking participants to indicate whether they thought they were at higher, average, or lower risk, regardless of what they were told. Underestimators believed their actual risk category was lower than the calculated risk; overestimators believed their actual risk category was higher than the calculated risk.
Results: 48% of women sought risk-concordant information. Of those who sought discordant information, 36% chose low-risk information, 28% chose high-risk information, and 36% chose average-risk information. Additionally, 69% of women disagreed with the Gail model risk category information. Of those who disagreed, most (74%) were underestimators. There was an interaction between risk category and skepticism, p=0.01. Investigation of the interaction revealed that there was one group who was particularly less likely to engage in risk-concordant information seeking: women who were informed they were at lower-than-average risk, but who thought that their risk was actually higher-than-average (i.e., they were overestimators), OR=0.15, p=0.02.
Conclusion: Women who disagreed with results from the Gail model indicating they were at lower-than-average risk tended to seek information for women at average or above-average risk. Women who were who were told that their risk was average or above average did not show the converse results, suggesting different underlying motivations for people who believe their risk is higher or lower than the Gail model estimate.
Authors:
Presenter - Erika Waters, PhD, MPH, FSBM, Washington University School of Medicine
Co-Author - Ashley Housten, OTD, MSCI, Washington University School of Medicine
Co-Author - Channing Tate, PhD, MPH, University of Colorado Anschutz
Co-Author - Guannan Shen, University of Colorado
Co-Author - Carmen Lewis, University of Colorado
Co-Author - Jennifer Taber, PhD, Kent State University
Co-Author - Heather Smyth, University of Colorado
Co-Author - Laura Scherer, University of Colorado, Anschutz Medical Campus
Psychometric Properties of Ecological Momentary Assessment of Psychosocial Functioning in Adults with Type 1 Diabetes
Poster Number: C46Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Methods and Measurement
Ecological momentary assessment (EMA) is a promising methodology for examining the contextual impact of psychosocial functioning on chronic disease management in individuals with type 1 diabetes (T1D). Little is known regarding psychometric properties of EMA of psychosocial functioning in adult participants with T1D. Fifty-one participants with T1D completed a 14-day EMA assessment of symptoms of depression, anxiety, diabetes-related distress, and fear of hypoglycemia. Multilevel linear models were used to evaluate the association of EMA psychosocial questions with standard psychosocial measures. Feasibility was demonstrated via high response rates across the 14-day EMA response period (three times daily). All four EMA measures (depression, anxiety, diabetes distress, and fear of hypoglycemia) showed meaningful (i.e.,>=25%) within-person variability (from 28.7% in diabetes distress to 46.5% in fear of hypoglycemia). All measures exceeded between-person reliability of 0.8 within 1 to 3 days. None of the measures demonstrated significant diurnal patterns. Convergent validity was established via significant correlations between all aggregate EMA measures with corresponding gold standard surveys. Overall, findings support the psychometric properties (feasibility, reliability, and validity) of EMA psychosocial measures in an adult cohort with T1D. This is the first study to date to examine psychometric properties of EMA psychosocial measures examining depression, anxiety, diabetes-related distress, and fear of hypoglycemia simultaneously in an adult population with T1D.
Keywords: Diabetes, MethodologyAuthors:
Author - Hayley Centola, PhD, University of Michigan
Co-Author - Melissa Plegue, MA, University of Michigan
Co-Author - Dana Albright, PhD, Parkview Health
Co-Author - Kara Mizokami-Stout, MD, University of Michigan, Veteran Affairs Ann Arbor Healthcare System
Co-Author - Lynn Ang, MD, University of Michigan
Co-Author - Jennifer Iyengar, MD, University of Michigan
Co-Author - Emily Hirschfeld, BA, University of Michigan
Author - Anna Kratz, PhD, University of Michigan
Co-Author - Evan Reynolds, PhD, Michigan State University
Co-Author - Brian Callaghan, MD, University of Michigan
Co-Author - Rodica Pop-Busui, MD, PhD, University of Michigan, Oregon Health & Science University
Author - Joyce Lee, MD, MPH, University of Michigan
When Everything is Stressful: Multiple Barriers to Diabetes Self-Management in Rural Black Communities
Poster Number: C47Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Health Disparities
Background: Multiple psychosocial stressors—including depression, perceived stress, relationship strain, parental stress, diabetes-specific distress, discrimination, and financial burden—significantly impact diabetes self-management among rural African Americans. However, few studies have comprehensively examined these multifaceted relationships, particularly in rural settings where diabetes education and support programs are limited. This pilot study examined the relationships between multiple psychosocial stressors and diabetes self-management behaviors in rural African Americans (N=36).
Methods: We investigated associations between psychosocial stressors and diabetes self-management behaviors among rural African American adults (mean age=64.53 years, SD=9.17). Participants completed validated measures assessing diabetes self-care activities, depression, perceived stress, relationship strain, parental stress, diabetes-specific distress, everyday discrimination, and financial burden. The study employed correlational and thematic analyses to examine relationships between stressors and self-management behaviors.
Results: Analysis revealed suboptimal self-management across key behaviors: healthy eating (M=2.61 days, SD=1.47), physical activity (M=2.25 days, SD=2.70), glucose monitoring (M=3.91 days, SD=3.50), and foot care (M=4.11 days, SD=1.33). Financial stress showed a significant negative correlation with diabetes self-care (r=-0.628, p<0.05). Strong positive associations emerged between emotional burden and perceived stress (r=0.804, p<0.01), and between financial stress and discrimination (r=0.508, p<0.05). Perceived stress strongly correlated with both diabetes distress (r=0.64, p<0.001) and emotional burden (r=0.67, p<0.001). Qualitative analysis identified emotional and financial stressors as primary barriers to effective self-management.
Conclusions: These findings highlight the complex interplay between multiple psychosocial stressors and diabetes self-management in rural African Americans. Results emphasize the need for comprehensive, stress-informed diabetes education programs that address financial strain, depression, discrimination, and relationship stressors. Future interventions should integrate psychosocial support with evidence-based diabetes education to address both clinical and multifaceted psychosocial barriers in this underserved community.
Keywords: Chronic illness, Self ManagementMethods: We investigated associations between psychosocial stressors and diabetes self-management behaviors among rural African American adults (mean age=64.53 years, SD=9.17). Participants completed validated measures assessing diabetes self-care activities, depression, perceived stress, relationship strain, parental stress, diabetes-specific distress, everyday discrimination, and financial burden. The study employed correlational and thematic analyses to examine relationships between stressors and self-management behaviors.
Results: Analysis revealed suboptimal self-management across key behaviors: healthy eating (M=2.61 days, SD=1.47), physical activity (M=2.25 days, SD=2.70), glucose monitoring (M=3.91 days, SD=3.50), and foot care (M=4.11 days, SD=1.33). Financial stress showed a significant negative correlation with diabetes self-care (r=-0.628, p<0.05). Strong positive associations emerged between emotional burden and perceived stress (r=0.804, p<0.01), and between financial stress and discrimination (r=0.508, p<0.05). Perceived stress strongly correlated with both diabetes distress (r=0.64, p<0.001) and emotional burden (r=0.67, p<0.001). Qualitative analysis identified emotional and financial stressors as primary barriers to effective self-management.
Conclusions: These findings highlight the complex interplay between multiple psychosocial stressors and diabetes self-management in rural African Americans. Results emphasize the need for comprehensive, stress-informed diabetes education programs that address financial strain, depression, discrimination, and relationship stressors. Future interventions should integrate psychosocial support with evidence-based diabetes education to address both clinical and multifaceted psychosocial barriers in this underserved community.
Authors:
Author - Idethia Harvey, University of Missouri
Helpful and harmful family and friend involvement associated with diabetes self-management and well-being among emerging adults with type 1 diabetes
Poster Number: C48Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Child and Family Health
Type 1 diabetes (T1D) daily management occurs in social contexts and is affected by helpful and harmful social support, but few measures assess both. We previously designed and validated the Family and Friend Involvement in Adults’ Diabetes (FIAD) measure in type 2 diabetes to query frequencies of helpful and harmful behaviors from family/friends over the past month. We adapted the FIAD items for T1D and evaluated its psychometric properties and associations with diabetes management and well-being.
Emerging adults (age 18-24) enrolled in a randomized clinical trial completed at baseline an HbA1c test, the adapted FIAD, and measures of social support (emotional and autonomy support), self-management (self-care, self-efficacy), and well-being (diabetes distress, global well-being). We confirmed the two-factor FIAD structure (confirmatory factor analysis [CFA] with fit indices) and assessed internal consistency reliability (Cronbach’s α). We used Spearman’s ρ to evaluate construct validity with other social support measures. Both scales were examined in the same regression models with robust standard errors for each outcome to examine criterion validity.
Among N=254 emerging adults with T1D [mean (SD) age 21.1 (2.2) years; 29% male, 53% non-Hispanic White, 28% Hispanic, 65% insulin pump; HbA1c 8.0% (1.6)] the 16-item FIAD has two factors correlated at 0.45. The CFA indicated the model fit the data well [CFI = .948, RMSEA = .058 (95% CI .045, .072), SRMR = .051]. Helpful (α=0.87) and harmful (α=0.78) scores range 1 to 5, means 2.9 (0.9) and 1.9 (0.8). Helpful was positively associated with emotional (ρ=0.51) and autonomy support (ρ=0.50) and harmful was negatively associated with autonomy support (ρ=-0.22). Helpful and harmful were each associated with self-care, self-efficacy, diabetes distress (reversed), and global well-being with small to medium effects (helpful βs 0.20 to 0.38; harmful βs -0.28 to -0.36), but not with HbA1c. All reported associations had p values <.01.
The adapted FIAD is a reliable and valid measure of helpful and harmful family/friend involvement among emerging adults with T1D. Helpful and harmful aspects were each associated with self-reported diabetes outcomes – in opposite directions – when included in the same regression models, indicating both aspects are independently associated with outcomes. The FIAD advances social support assessment for emerging adults with T1D.
Keywords: Family, Social supportEmerging adults (age 18-24) enrolled in a randomized clinical trial completed at baseline an HbA1c test, the adapted FIAD, and measures of social support (emotional and autonomy support), self-management (self-care, self-efficacy), and well-being (diabetes distress, global well-being). We confirmed the two-factor FIAD structure (confirmatory factor analysis [CFA] with fit indices) and assessed internal consistency reliability (Cronbach’s α). We used Spearman’s ρ to evaluate construct validity with other social support measures. Both scales were examined in the same regression models with robust standard errors for each outcome to examine criterion validity.
Among N=254 emerging adults with T1D [mean (SD) age 21.1 (2.2) years; 29% male, 53% non-Hispanic White, 28% Hispanic, 65% insulin pump; HbA1c 8.0% (1.6)] the 16-item FIAD has two factors correlated at 0.45. The CFA indicated the model fit the data well [CFI = .948, RMSEA = .058 (95% CI .045, .072), SRMR = .051]. Helpful (α=0.87) and harmful (α=0.78) scores range 1 to 5, means 2.9 (0.9) and 1.9 (0.8). Helpful was positively associated with emotional (ρ=0.51) and autonomy support (ρ=0.50) and harmful was negatively associated with autonomy support (ρ=-0.22). Helpful and harmful were each associated with self-care, self-efficacy, diabetes distress (reversed), and global well-being with small to medium effects (helpful βs 0.20 to 0.38; harmful βs -0.28 to -0.36), but not with HbA1c. All reported associations had p values <.01.
The adapted FIAD is a reliable and valid measure of helpful and harmful family/friend involvement among emerging adults with T1D. Helpful and harmful aspects were each associated with self-reported diabetes outcomes – in opposite directions – when included in the same regression models, indicating both aspects are independently associated with outcomes. The FIAD advances social support assessment for emerging adults with T1D.
Authors:
Presenter - Lindsay Mayberry, PhD, FSBM, Vanderbilt University Medical Center
Co-Author - Deborah Wiebe, PhD, MPH, University of California, Merced
Co-Author - Robert Greevy, PhD, Vanderbilt University Medical Center
Co-Author - Cynthia Berg, PhD, FSBM, University of Utah
Recollections of family stigma, illness threat, and anxiety during insulin initiation
Poster Number: C49Time: 05:00 PM - 05:50 PM
Topics: Diabetes
Purpose: For those with a multigenerational legacy of diabetes, stigma perceptions include one’s own personal stigma of diabetes and/or insulin use and recollections of the family members’ perceived stigma and disclosure. We assessed the degree of recollections people initially starting insulin treatment hold regarding a family member’s experiences with insulin use, stigma, and disclosure regarding insulin. In addition, we explored the effect of family stigma recollections on anxiety regarding the diabetes diagnosis during initiation of insulin treatment within the context of a multigenerational legacy of diabetes.
Methods: A convenience sample of adults (n=92) from three Northeastern Coastal Metropolitan hospitals in the United States, new to insulin use were recruited during their hospital stay. All participants had a self-reported family history of diabetes. Perceptions of family stigma and disclosure, internalized stigma, and anxiety were measured.
Results: Recollections of Family insulin stigma and disclosure and the quality and quantity of memories of insulin use (vivid, frequent, and intrusive) predict one’s own personal perception of stigma of diabetes (F=7.78, df 2, p=0.001). In this model, family stigma of insulin uniquely explained the variance in one’s own perceptions of stigma (B=0.35 p=0.02).
One’s own personal internalized stigma of diabetes predicts social disclosure of diabetes (F=63.05, p=<.001) with family recollections (B= -.53, p=<.001) and personal stigma (B=.94, p=<.001) contributing unique variance. Individuals who recalled a family context of insulin stigma, and had frequent, vivid, or intrusive memories of insulin use by family members and had their own personal degree of perceived diabetes stigma, were also more likely to report anxiety due to diabetes specifically ( F=3.85, P=0.012, family stigma B= -0.288 , p=0.022 ; personal stigma B=3.24, p=.00002).
Conclusion: The more someone recalled the stigma of family diabetes and insulin and reported high levels of internalized stigma, the more likely they were to disclose and talk about diabetes themselves. When people are being initiated onto insulin treatment, recollections of a family member’s experience are relevant and may even contribute to stigma, influence disclosure behavior, and contribute to anxiety. Anxiety is known to influence self-management and coping with diabetes.
Keywords: Diabetes, Social stressMethods: A convenience sample of adults (n=92) from three Northeastern Coastal Metropolitan hospitals in the United States, new to insulin use were recruited during their hospital stay. All participants had a self-reported family history of diabetes. Perceptions of family stigma and disclosure, internalized stigma, and anxiety were measured.
Results: Recollections of Family insulin stigma and disclosure and the quality and quantity of memories of insulin use (vivid, frequent, and intrusive) predict one’s own personal perception of stigma of diabetes (F=7.78, df 2, p=0.001). In this model, family stigma of insulin uniquely explained the variance in one’s own perceptions of stigma (B=0.35 p=0.02).
One’s own personal internalized stigma of diabetes predicts social disclosure of diabetes (F=63.05, p=<.001) with family recollections (B= -.53, p=<.001) and personal stigma (B=.94, p=<.001) contributing unique variance. Individuals who recalled a family context of insulin stigma, and had frequent, vivid, or intrusive memories of insulin use by family members and had their own personal degree of perceived diabetes stigma, were also more likely to report anxiety due to diabetes specifically ( F=3.85, P=0.012, family stigma B= -0.288 , p=0.022 ; personal stigma B=3.24, p=.00002).
Conclusion: The more someone recalled the stigma of family diabetes and insulin and reported high levels of internalized stigma, the more likely they were to disclose and talk about diabetes themselves. When people are being initiated onto insulin treatment, recollections of a family member’s experience are relevant and may even contribute to stigma, influence disclosure behavior, and contribute to anxiety. Anxiety is known to influence self-management and coping with diabetes.
Authors:
Author - Melissa Scollan-Koliopoulos, EDD, Sacred Heart University
Connected and Confident: Advancing Health Through Digital Literacy for Older Adults
Poster Number: C5Time: 05:00 PM - 05:50 PM
Topics: Aging, Digital Health
Daily in the USA, 12,000 baby boomers turn 65. Research shows that older adults with digital skills are more likely to access reliable health information, use telehealth, and manage medications and chronic conditions effectively. Digital literacy reduces social isolation by enabling participation in online social networks, classes, and support groups, which is linked to better mental health and lower risk of cognitive decline. Digitally engaged older adults are also better equipped to recognize misinformation, advocate for their care, and connect with community resources.
A public/private partnership (Jan 2023–Sept 2024) was funded by the California Dept. of Aging Access to Technology grant; administered by the San Mateo County Dept. of Aging and Adult Services; designed and implemented by Community Tech Network, a nonprofit creating multi-lingual digital literacy content and capacity through a train-the-trainer model, and conducted by community-based organizations (CBOs) serving older adults in San Mateo County.
38 staff/volunteers from 6 CBOs received DigitalLift training. 1,070+ learners aged 65+ received 7,700+ hours of training via in-person and virtual group classes/workshops and 1:1 support in 7 languages (English, Spanish, Mandarin, Cantonese, Russian, Tagalog, Japanese). 508 older adults received a tablet and 72 were enrolled in the Federal Affordable Connectivity Program for broadband access. Participants were primarily Asian (432, 39%), Latino (222, 20%) and Caucasian (202, 18%). Post-training surveys showed participants felt confident using technology (95%); able to navigate the internet safely (95%); access health information (85%) and government services (72%); more connected (84%); and able to join classes or community activities (74%).
A CBO in the partnership expanded training using AARP’s Older Adults Technology Services program. Between Jan–Aug 2025, 159 older adults received 1:1 tech support and 64 joined classes/workshops. While data is too limited for statistical significance, self-reported surveys from multi-session participants (N=37) showed pre/post improvements: comfortable using a device 49%vs78%; connected to the world 68%vs83%; confident connecting with friends/family online 62%vs92%; able to find resources 51%vs81%; less alone 65%vs79%; and confident staying safe and recognizing scams 51%vs81%.
These results demonstrate the impactful role of digital literacy in promoting older adults’ health, independence, and connection.
Keywords: Aging, TechnologyA public/private partnership (Jan 2023–Sept 2024) was funded by the California Dept. of Aging Access to Technology grant; administered by the San Mateo County Dept. of Aging and Adult Services; designed and implemented by Community Tech Network, a nonprofit creating multi-lingual digital literacy content and capacity through a train-the-trainer model, and conducted by community-based organizations (CBOs) serving older adults in San Mateo County.
38 staff/volunteers from 6 CBOs received DigitalLift training. 1,070+ learners aged 65+ received 7,700+ hours of training via in-person and virtual group classes/workshops and 1:1 support in 7 languages (English, Spanish, Mandarin, Cantonese, Russian, Tagalog, Japanese). 508 older adults received a tablet and 72 were enrolled in the Federal Affordable Connectivity Program for broadband access. Participants were primarily Asian (432, 39%), Latino (222, 20%) and Caucasian (202, 18%). Post-training surveys showed participants felt confident using technology (95%); able to navigate the internet safely (95%); access health information (85%) and government services (72%); more connected (84%); and able to join classes or community activities (74%).
A CBO in the partnership expanded training using AARP’s Older Adults Technology Services program. Between Jan–Aug 2025, 159 older adults received 1:1 tech support and 64 joined classes/workshops. While data is too limited for statistical significance, self-reported surveys from multi-session participants (N=37) showed pre/post improvements: comfortable using a device 49%vs78%; connected to the world 68%vs83%; confident connecting with friends/family online 62%vs92%; able to find resources 51%vs81%; less alone 65%vs79%; and confident staying safe and recognizing scams 51%vs81%.
These results demonstrate the impactful role of digital literacy in promoting older adults’ health, independence, and connection.
Authors:
Author - Winter Sandra, PhD, MHA, Senior Coastsiders
Master Trainer and Facilitator Insights on Structured Guidance for Delivering Culturally Adapted Diabetes Self-Management Education
Poster Number: C50Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Implementation Science
Background
Black adults in the US face a disproportionately higher diabetes complications, with nearly twice the mortality rate compared to White adults. Systemic and individual barriers such as limited access to culturally appropriate programs, mistrust, and health literacy challenges, partly drive these differences in health outcomes. Diabetes Self-Management Education (DSME) programs, when culturally adapted, can address these barriers and improve outcomes. Despite evidence of the benefits of adaptation, structured guidance for training facilitators to deliver culturally adapted DSME with fidelity while allowing flexibility is lacking.
Methods
This qualitative study explored the perspectives of master trainers and group facilitators on (1) existing DSME training, (2) elements to consider for training in delivery, fidelity and cultural adaptation, and (3) components for a structured guide for delivering culturally adapted DSME. We conducted semi-structured key informant interviews with master trainers who had extensive experience in facilitator instruction and Black facilitators with previously completed DSME training. The interview informed structured guidance for culturally adapted DSME. We conducted qualitative content analysis with triangulation and audit trails to ensure rigor.
Findings
Three master trainers and two facilitators reported strengths and limitations with the current DSME facilitator training. The training’s structured and scripted format helped facilitator’s confidence through practice teaching and scenario-based learning, yet it restricted flexibility for tailoring. Virtual training delivery improved accessibility but limited personal connection. Key insights for guide development included earlier distribution of training materials, engaging master trainers, and enhanced cultural integration, including personal storytelling, and use of local languages. One master trainer noted the rewarding aspect of witnessing facilitators’ enthusiasm for helping others. Master trainers also emphasized that sharing personal motivations and lived experiences was key to fostering engagement and preparedness for delivering culturally adapted DSME.
Conclusions
Providing structured guidance that distinguishes essential DSME elements that must be delivered with fidelity and those that can be adapted to local culture can better prepare facilitators, improve cultural relevance, and support the long-term sustainability of DSME in Black communities.
Keywords: Disparities, Self ManagementBlack adults in the US face a disproportionately higher diabetes complications, with nearly twice the mortality rate compared to White adults. Systemic and individual barriers such as limited access to culturally appropriate programs, mistrust, and health literacy challenges, partly drive these differences in health outcomes. Diabetes Self-Management Education (DSME) programs, when culturally adapted, can address these barriers and improve outcomes. Despite evidence of the benefits of adaptation, structured guidance for training facilitators to deliver culturally adapted DSME with fidelity while allowing flexibility is lacking.
Methods
This qualitative study explored the perspectives of master trainers and group facilitators on (1) existing DSME training, (2) elements to consider for training in delivery, fidelity and cultural adaptation, and (3) components for a structured guide for delivering culturally adapted DSME. We conducted semi-structured key informant interviews with master trainers who had extensive experience in facilitator instruction and Black facilitators with previously completed DSME training. The interview informed structured guidance for culturally adapted DSME. We conducted qualitative content analysis with triangulation and audit trails to ensure rigor.
Findings
Three master trainers and two facilitators reported strengths and limitations with the current DSME facilitator training. The training’s structured and scripted format helped facilitator’s confidence through practice teaching and scenario-based learning, yet it restricted flexibility for tailoring. Virtual training delivery improved accessibility but limited personal connection. Key insights for guide development included earlier distribution of training materials, engaging master trainers, and enhanced cultural integration, including personal storytelling, and use of local languages. One master trainer noted the rewarding aspect of witnessing facilitators’ enthusiasm for helping others. Master trainers also emphasized that sharing personal motivations and lived experiences was key to fostering engagement and preparedness for delivering culturally adapted DSME.
Conclusions
Providing structured guidance that distinguishes essential DSME elements that must be delivered with fidelity and those that can be adapted to local culture can better prepare facilitators, improve cultural relevance, and support the long-term sustainability of DSME in Black communities.
Authors:
Presenter - Olubukola Tikare, MSc, BPharm, University of Michigan
Co-Author - Tina Kansariwala, BS, University of Wisconsin-Madison
Co-Author - Martha Maurer, PhD MSSW, University of Wisconsin-Madison
Co-Presenter - Olayinka Shiyanbola, PhD BPharm, University of Michigan Ann Arbor
From diagnosis to action: applying the ORBIT (Obesity-Related Behavioral Intervention Trials) model to design a patient app for diabetes prevention in an urban primary care setting
Poster Number: C51Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Digital Health
Background: Effective options exist to prevent type 2 diabetes, yet referral and uptake in primary care remain low, particularly for racial/ethnic minorities and people with low income who face structural barriers to lifestyle change. Health information technology (HIT), when designed for dissemination and sustainability, can bridge these gaps by delivering timely information, decision support, and navigation outside the visit. Few HIT or mobile health apps are designed for these populations or address their specific needs. We used the ORBIT framework for early behavioral intervention development to guide customer discovery for a brief, scalable, patient-facing app.
Methods: Semi-structured customer discovery interviews were conducted with 24 adult, English-speaking, primary care patients with electronic health record–documented prediabetes at an urban academic health system serving predominantly minority, under-resourced communities. All had a primary care visit within the past two years. Rapid qualitative analysis was applied by three raters: a case-by-domain matrix was created, three interviews were double-coded to establish agreement, remaining interviews were independently coded, and themes were summarized. Designing-for-dissemination and sustainability principles translated findings into app requirements. Behavioral foundations included the Theory of Planned Behavior, Self-Persuasion Theory, Behavioral Economics, and a guided locus-of-control reframe. Prior provider interviews informed the guide and interpretation. Activities correspond to ORBIT Phase Ia (Define).
Results: Among the 24 participants, the mean (SD) age was 58.8 (11.6) years, and 88% were women. Half identified as African American/Black (50%) and 42% as Hispanic/Latino. More than half (54%) had completed postsecondary education, while 38% had a high school education or less. Six themes described what patients need to act: Understanding the Diagnosis; Making Informed Treatment Decisions; Integrating Lifestyle Changes into Daily Life; Finding Motivation; Staying on Track with Lifestyle Change; and Navigating Prediabetes in the Context of Health and Financial Realities.
Conclusions: Patients want clear information, respectful partnership, and small, self-chosen steps that fit real life. ORBIT-guided discovery in at-risk, underserved communities produced design targets for a patient-facing mHealth app and a blueprint for Phase Ib refinement, usability testing, and a feasibility trial.
Keywords: Health behavior change, InterventionMethods: Semi-structured customer discovery interviews were conducted with 24 adult, English-speaking, primary care patients with electronic health record–documented prediabetes at an urban academic health system serving predominantly minority, under-resourced communities. All had a primary care visit within the past two years. Rapid qualitative analysis was applied by three raters: a case-by-domain matrix was created, three interviews were double-coded to establish agreement, remaining interviews were independently coded, and themes were summarized. Designing-for-dissemination and sustainability principles translated findings into app requirements. Behavioral foundations included the Theory of Planned Behavior, Self-Persuasion Theory, Behavioral Economics, and a guided locus-of-control reframe. Prior provider interviews informed the guide and interpretation. Activities correspond to ORBIT Phase Ia (Define).
Results: Among the 24 participants, the mean (SD) age was 58.8 (11.6) years, and 88% were women. Half identified as African American/Black (50%) and 42% as Hispanic/Latino. More than half (54%) had completed postsecondary education, while 38% had a high school education or less. Six themes described what patients need to act: Understanding the Diagnosis; Making Informed Treatment Decisions; Integrating Lifestyle Changes into Daily Life; Finding Motivation; Staying on Track with Lifestyle Change; and Navigating Prediabetes in the Context of Health and Financial Realities.
Conclusions: Patients want clear information, respectful partnership, and small, self-chosen steps that fit real life. ORBIT-guided discovery in at-risk, underserved communities produced design targets for a patient-facing mHealth app and a blueprint for Phase Ib refinement, usability testing, and a feasibility trial.
Authors:
Author - Cara Stephenson-Hunter, PhD, Albert Einstein College of Medicine
Co-Author - Katherine Florian, Albert Einstein College of Medicine
Co-Author - Cara Stephenson-Hunter, Albert Einstein College of Medicine
Co-Author - Linda Gallo, PhD, FSBM, San Diego State University
Mechanisms of Maladaptive Eating Behavior among Individuals with Obesity and Pain: Exploring Rumination
Poster Number: C52Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Pain
Upwards of 40% of adults in the United States (US) are classified as obese, highlighting obesity as an ongoing public health crisis. Pain affects 33-40% of individuals with obesity, contributing to increased distress and substantial additional burden, taxing coping resources. Individuals with obesity often manage distress through maladaptive eating behaviors, yet variability remains in how and why individuals with obesity and pain engage in these behaviors. Explicating transdiagnostic factors that contribute to individual differences in eating behavior provides necessary clinical precision for personalized intervention targets. One such mechanism that is relevant to both obesity and pain is rumination, an aspect of repetitive negative thinking that is focused on past negative thoughts or problems and can influence behavioral responses and may contribute to exacerbated pain and more maladaptive eating behaviors. However, the role of rumination in terms of eating behavior among adults with obesity and pain is unexplored. The present study examined the mechanistic role of rumination and its facets (e.g., brooding, reflection) on emotional, external, and restrained eating behaviors among individuals with comorbid obesity and general pain as indicated by pain grade >= 1. Participants were 137 adults with comorbid obesity and pain (Mage = 31.96 years, SD = 10.82, age range 18-75 years; 62.0% female). Results indicated that greater levels of rumination were statistically significantly associated with greater emotional and external eating. Regarding the specific sub-facets of rumination, greater ruminative brooding was statistically significantly associated with greater emotional and external eating. These findings provide empirical evidence indicating that rumination generally, and specifically ruminative brooding, a passive comparison of one’s reality with an unattained standard, may be an important target for behavioral weight management interventions. Treatments that target these mechanistic processes, such as cognitive behavior therapy, can be specifically tailored to reduce rumination to ultimately impact eating behavior outcomes. These findings highlight a novel opportunity to improve outcomes for maladaptive eating in individuals with comorbid obesity and pain.
Keywords: Obesity, PainAuthors:
Presenter - Lindsay Bevers, B.S., Division of Behavioral Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA
Co-Author - Andrew Rogers, Ph.D., Division of Behavioral Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA; Department of Pediatric Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
Co-Author - Michael Zvolensky, Ph.D., Department of Psychology, University of Houston, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Co-Author - Brooke Redmond, Ph.D., Department of Psychology, University of Houston, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA
Nonnutritive Sweeteners Association with Obesity Management: An Analysis of Acceptable Daily Intake and Body Mass Index
Poster Number: C53Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Weight Related Health
Obesity is a growing public health concern as data shows 33% of US adults are overweight, 35% are obese, and over 6% are extremely obese. Nonnutritive sweeteners (NNS), such as aspartame, acesulfame potassium (AceK), sucralose, and saccharin, are often used to lower the caloric intake of common foods and beverages while still being able to enjoy them, making them a popular choice for individuals attempting to lose or manage their weight. Research shows that consuming different NNS may also have different effects on body weight, however no study has evaluated multiple NNS on weight status, at the same time. Additionally, studies generally only report overall consumption levels of NNS, and not consumption levels relative to known safety standards. The safe limits for NNS are established by the Food and Drug Administration in the form of an acceptable daily intake (ADI), which are determined by evaluating toxicological studies on animals to find the highest dose of an NNS that causes no adverse effect, then multiplying it by a safety factor to account for variability between humans and animals. Therefore, the purpose of this study was the evaluate differences in AceK, aspartame, saccharin, and sucralose consumption and ADI levels between normal weight and overweight/obese young adults. College students were asked to self-report their height and weight in pounds and inches, and were categorized based on BMI to either a normal weight or overweight/obese group. AceK, aspartame, saccharin, and sucralose consumption were evaluated using a previously validated food frequency questionnaire. Independent t-tests evaluated group differences of NNS consumption and ADIs scores between groups. Compared to students in the normal weight group, students in the overweight/obese group on average consumed significantly more AceK (p≤0.001; d=0.47), aspartame (p<0.004; d=0.38), saccharin (p≤0.001; d=0.57), and sucralose (p≤0.001; d=0.51), and had a significantly greater ADI scores for AceK (p<0.008; d=0.36), saccharin (p≤0.001; d=0.45), and sucralose (p<0.017; d=0.33). Only one obese student exceeded an ADI which was for sucralose. Further research is needed to observe the unique effects risks of overconsumption of each NNS. Understanding the risks for each sweetener could support more specific guidelines around consumption of each sweetener, helping consumers make more informed decisions around their food choices.
Keywords: Nutrition, ObesityAuthors:
Presenter - Paul Branscum, PhD, RD, FAAHB, FSBM, Miami University
Co-Author - Emelin Conboy, Miami University
Co-Author - Benjamin Miller, BS, Miami University
Parents’ reactions to a social media marketing campaign promoting Universal School Meals among elementary-aged US children: A content analysis
Poster Number: C54Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Child and Family Health
Background: US state Universal School Meal (USM) programs have been shown to improve food security and diet quality, yet many children do not participate in them. To inform strategies to increase participation, this study analyzed parents’ reactions to a social media marketing campaign designed to motivate parents to encourage children to eat more school meals.
Methods: In 2025, content analysis was used to characterize parents’ comments on Facebook posts from a social media marketing campaign promoting the benefits of USM for elementary-aged children. The campaign was conducted during a 2024 randomized controlled trial in 8 states offering USM and covered 5 topics: convenience, healthfulness, academic benefits, saving money, and social benefits of school meals. Comments were double-coded with inductively-developed codes. Frequencies and proportions were calculated to evaluate parents’ acceptance/rejection of the campaign messages, stratified by campaign topic. Emergent themes were identified among parents’ comments to characterize their perceptions of the benefits of school meals and barriers to children's participation. Frequencies and proportions of comments mentioning these themes were calculated, stratified by acceptance/rejection of the campaign.
Results: A total of 419 parents were randomized to receive the campaign, of which 96 commented on campaign posts. Posts received 378 total comments: 34% indicated acceptance of the campaign, 29% indicated rejection, 22% indicated acceptance and rejection (agreed with some aspects of the campaign messages but not others), and 14% were unclear (did not clearly indicate acceptance or rejection). Comments that indicated acceptance largely focused on gratitude for the money-saving, convenience, and social benefits of school meals. Comments indicating rejection discussed beliefs that school meals were unhealthy and of poor quality, with some questioning the posts’ credibility.
Conclusions: Parents’ reactions to a social media marketing campaign promoting USM programs indicate that many parents are grateful for the convenience and cost-saving benefits of USM programs, but report barriers to their children’s participation. Future social media marketing campaigns may wish to focus on these benefits and include references and statistics to boost credibility of claims. Structural changes to school meals may also be needed, such as improving the healthfulness and quality of school meals.
Keywords: Nutrition, ChildrenMethods: In 2025, content analysis was used to characterize parents’ comments on Facebook posts from a social media marketing campaign promoting the benefits of USM for elementary-aged children. The campaign was conducted during a 2024 randomized controlled trial in 8 states offering USM and covered 5 topics: convenience, healthfulness, academic benefits, saving money, and social benefits of school meals. Comments were double-coded with inductively-developed codes. Frequencies and proportions were calculated to evaluate parents’ acceptance/rejection of the campaign messages, stratified by campaign topic. Emergent themes were identified among parents’ comments to characterize their perceptions of the benefits of school meals and barriers to children's participation. Frequencies and proportions of comments mentioning these themes were calculated, stratified by acceptance/rejection of the campaign.
Results: A total of 419 parents were randomized to receive the campaign, of which 96 commented on campaign posts. Posts received 378 total comments: 34% indicated acceptance of the campaign, 29% indicated rejection, 22% indicated acceptance and rejection (agreed with some aspects of the campaign messages but not others), and 14% were unclear (did not clearly indicate acceptance or rejection). Comments that indicated acceptance largely focused on gratitude for the money-saving, convenience, and social benefits of school meals. Comments indicating rejection discussed beliefs that school meals were unhealthy and of poor quality, with some questioning the posts’ credibility.
Conclusions: Parents’ reactions to a social media marketing campaign promoting USM programs indicate that many parents are grateful for the convenience and cost-saving benefits of USM programs, but report barriers to their children’s participation. Future social media marketing campaigns may wish to focus on these benefits and include references and statistics to boost credibility of claims. Structural changes to school meals may also be needed, such as improving the healthfulness and quality of school meals.
Authors:
Presenter - Carolyn Chelius, MS, University of North Carolina at Chapel Hill
Co-Author - Amanda Zeitlin, MPH, Stanford University
Co-Author - Christina Hecht, PhD, Nutrition Policy Institute, University of California Agriculture and Natural Resources
Co-Author - Anisha I. Patel, MD, MSPH, MSHS, Stanford University
Co-Author - Kenneth Hecht, JD, Nutrition Policy Institute, University of California Agriculture and Natural Resources
Co-Author - Andrea Pedroza-Tobias, PhD, Stanford University
Co-Author - Anna Grummon, PhD, Stanford University
Self-Compassion and Health Behaviors: Associations with Physical Activity, Exercise Avoidance, and Food Purchasing
Poster Number: C55Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Physical Activity
Background: Self-compassion is the practice of responding to one’s own suffering, setbacks, or perceived shortcomings with kindness, understanding, and acceptance rather than self-criticism. By cultivating mindful awareness and recognizing one’s shared humanity, self-compassion represents an important determinant of psychological well-being and overall health. Although prior research links self-compassion to healthier eating and physical activity, little is known about its associations with exercise avoidance or food purchasing behaviors, or whether these associations differ by gender and sexual minority status.
Methods: A national sample of adults (N = 435) was recruited via a Qualtrics research panel to reflect U.S. distributions of age, gender, race, ethnicity, education, income, and BMI. Participants completed measures of self-compassion, physical activity (PA), exercise avoidance, and food purchasing behaviors. Hierarchical regression analyses examined associations between self-compassion and health behaviors, adjusting for age and BMI. Moderation analyses explored whether gender or sexual minority status influenced these relationships.
Results: Higher self-compassion was associated with greater engagement in PA (β = 0.25, p < 0.001; ΔR² = 0.05), lower exercise avoidance (β = –0.43, p < 0.001; ΔR² = 0.16), and healthier food purchasing behaviors (β = 0.22, p < 0.001; ΔR² = 0.05). These associations remained significant after controlling for covariates. Neither gender nor sexual minority status significantly altered these relationships.
Conclusion: Self-compassion consistently predicts healthier lifestyle behaviors, including increased PA, reduced exercise avoidance, and healthier food purchasing. These findings highlight self-compassion as a promising target for behavioral health interventions and suggest that integrating self-compassion skills training into public health and healthcare practice may support sustainable improvements in lifestyle behaviors.
Keywords: Physical activity, Health behaviorsMethods: A national sample of adults (N = 435) was recruited via a Qualtrics research panel to reflect U.S. distributions of age, gender, race, ethnicity, education, income, and BMI. Participants completed measures of self-compassion, physical activity (PA), exercise avoidance, and food purchasing behaviors. Hierarchical regression analyses examined associations between self-compassion and health behaviors, adjusting for age and BMI. Moderation analyses explored whether gender or sexual minority status influenced these relationships.
Results: Higher self-compassion was associated with greater engagement in PA (β = 0.25, p < 0.001; ΔR² = 0.05), lower exercise avoidance (β = –0.43, p < 0.001; ΔR² = 0.16), and healthier food purchasing behaviors (β = 0.22, p < 0.001; ΔR² = 0.05). These associations remained significant after controlling for covariates. Neither gender nor sexual minority status significantly altered these relationships.
Conclusion: Self-compassion consistently predicts healthier lifestyle behaviors, including increased PA, reduced exercise avoidance, and healthier food purchasing. These findings highlight self-compassion as a promising target for behavioral health interventions and suggest that integrating self-compassion skills training into public health and healthcare practice may support sustainable improvements in lifestyle behaviors.
Authors:
Author - Katie DeRouen, East Carolina University
Co-Author - Lydia Mansour, East Carolina University
Co-Author - Abigail Metzler, BA, East Carolina University
Co-Author - Katrina Escobar, East Carolina University
Co-Author - Robert Carels, PhD MBA ABPP, FSBM, East Carolina University
Concurrent and Prospective Associations Between Prenatal Loss of Control Eating and Cardiovascular Health During Pregnancy: A Replication and Extension of Prior Findings
Poster Number: C56Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Women's Health
In a prior cross-sectional study of early pregnancy data from a community sample with pre-pregnancy body mass index (BMI)≥25 (N=124), we found loss of control eating (LOC; feeling unable to stop eating and/or control the type/amount of food eaten) related to poorer cardiovascular health (CVH; i.e., composite of 5/8 Life’s Essential 8 [LE8] metrics). This secondary analysis aimed to: 1) Replicate and extend cross-sectional findings using the full LE8; 2) test longitudinal associations; 3) explore differences in results when using a proposed version of LE8 that accounts for pregnancy-related CVH implications (e.g., weight gain, gestational diabetes).
In early (n=273) and late (n=179) pregnancy (M[SD]weeks’ gestation=13.6[2.7] and 36.6[1.3], respectively), participants completed assessments of CVH metrics: self-reports of diet, physical activity, nicotine use, sleep; measures of BMI, blood pressure; blood draws to obtain blood glucose, lipids. LOC, assessed in early pregnancy via the Eating Disorder Examination-Questionnaire, was dichotomized (0=absent; 1=present). We scored CVH metrics using the original and pregnancy-adapted LE8 to create composite CVH scores (range=0-100; higher=better). Linear and binary logistic regression models tested if early pregnancy LOC related to composite CVH score and odds of having more (1) or less (0) ideal scores for each CVH metric in early and late pregnancy. All models adjusted for LOC propensity score, age, gestational age, ethnicity, racial identity, income, and education; longitudinal models also adjusted for randomization status and early pregnancy CVH.
LOC was not significantly associated with CVH composite (b=-0.64, t(261)=-0.50, p=.62; b=2.12, t(157)=1.85, p=.07) nor individual CVH metric (ps>.05) scores in early or late pregnancy. Results remained nonsignificant and continued to demonstrate unreliable patterns when using pregnancy-adapted CVH scores, which were highly correlated with those based on original LE8 scoring algorithms (rs≥.96, p<.01).
This study did not observe any associations between LOC and CVH in pregnancy, contrasting previous findings. Although the sample, methods, and analytic procedures closely mirrored those of our prior study, a few key differences may have contributed to discrepant results. Future research should clarify prenatal CVH among non- vs. treatment-seeking populations, implications of interview vs. questionnaire prenatal LOC measures, and utility of the pregnancy-adapted LE8.
Keywords: Binge eating, Health outcomesIn early (n=273) and late (n=179) pregnancy (M[SD]weeks’ gestation=13.6[2.7] and 36.6[1.3], respectively), participants completed assessments of CVH metrics: self-reports of diet, physical activity, nicotine use, sleep; measures of BMI, blood pressure; blood draws to obtain blood glucose, lipids. LOC, assessed in early pregnancy via the Eating Disorder Examination-Questionnaire, was dichotomized (0=absent; 1=present). We scored CVH metrics using the original and pregnancy-adapted LE8 to create composite CVH scores (range=0-100; higher=better). Linear and binary logistic regression models tested if early pregnancy LOC related to composite CVH score and odds of having more (1) or less (0) ideal scores for each CVH metric in early and late pregnancy. All models adjusted for LOC propensity score, age, gestational age, ethnicity, racial identity, income, and education; longitudinal models also adjusted for randomization status and early pregnancy CVH.
LOC was not significantly associated with CVH composite (b=-0.64, t(261)=-0.50, p=.62; b=2.12, t(157)=1.85, p=.07) nor individual CVH metric (ps>.05) scores in early or late pregnancy. Results remained nonsignificant and continued to demonstrate unreliable patterns when using pregnancy-adapted CVH scores, which were highly correlated with those based on original LE8 scoring algorithms (rs≥.96, p<.01).
This study did not observe any associations between LOC and CVH in pregnancy, contrasting previous findings. Although the sample, methods, and analytic procedures closely mirrored those of our prior study, a few key differences may have contributed to discrepant results. Future research should clarify prenatal CVH among non- vs. treatment-seeking populations, implications of interview vs. questionnaire prenatal LOC measures, and utility of the pregnancy-adapted LE8.
Authors:
Presenter - Riley Jouppi, M.S., University of Pittsburgh
Co-Author - Shannon Donofry, PhD, RAND
Co-Author - Christine Call, PhD, University of Pittsburgh
Co-Author - Rachel Conlon, PhD, University of Pittsburgh School of Medicine
Co-Author - Michele Levine, PhD, University of Pittsburgh Medical Center
Qualitative Insights from Project Empower-ED: Piloting an Online, Single-Session Intervention for Caregivers of Youth Hospitalized for Anorexia Nervosa
Poster Number: C57Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Mental Health
Background: Anorexia nervosa (AN) is among the deadliest psychiatric illnesses and hospitalizations for medical consequences of AN are rising. Although AN affects youth at similar rates across sociodemographic groups, access to evidence-based care remains profoundly inequitable: adolescents from minoritized backgrounds and those with public insurance are the least likely to receive recommended treatment. Family-Based Treatment (FBT) is an effective outpatient intervention for adolescent AN, but it is rarely accessible to Medicaid-insured families and seldom adapted for inpatient medical settings where parental involvement is critical. To address these gaps, we adapted a self-guided web-based single-session intervention (SSI) originally designed to reduce parental accommodation of children’s anxiety, tailoring it for AN, to be delivered in a hospital serving a high proportion of minoritized and Medicaid-insured families. The adapted program, Project Empower-ED, was designed to strengthen parents’ self-efficacy in managing their child’s AN and reduce parental accommodation of restrictive eating behaviors, core mechanisms of FBT. This pilot study examined the feasibility and acceptability of Project Empower-ED among caregivers of youth hospitalized for AN-related medical stabilization.
Methods: Caregivers (N = 25) at a large, urban pediatric hospital completed Project Empower-ED in English (n=20) or Spanish (n=5) during their child’s hospitalization prior to discharge. Feasibility was assessed by enrollment and completion, and acceptability by qualitative feedback analyzed with inductive content analysis.
Results: Of the 27 eligible caregivers, all enrolled and 25 completed the SSI, supporting high feasibility. Caregivers reported the SSI 1) normalized distress and increased sense of confidence (e.g., greater understanding of the disorder and feeling more prepared for difficult mealtimes), 2) provided concrete strategies to reduce accommodation behaviors, and 3) was practical and accessible in its digital, bilingual format. Feedback included adding more real-world examples and offering the intervention earlier in treatment.
Conclusions: Initial findings support that the delivery of a brief, FBT-informed, web-based SSI during inpatient medical stabilization is feasible and acceptable for caregivers across sociodemographic backgrounds. Project Empower-ED may help bridge gaps in access to evidence-based caregiver support during a critical stage of treatment.
Keywords: Intervention, AdolescentsMethods: Caregivers (N = 25) at a large, urban pediatric hospital completed Project Empower-ED in English (n=20) or Spanish (n=5) during their child’s hospitalization prior to discharge. Feasibility was assessed by enrollment and completion, and acceptability by qualitative feedback analyzed with inductive content analysis.
Results: Of the 27 eligible caregivers, all enrolled and 25 completed the SSI, supporting high feasibility. Caregivers reported the SSI 1) normalized distress and increased sense of confidence (e.g., greater understanding of the disorder and feeling more prepared for difficult mealtimes), 2) provided concrete strategies to reduce accommodation behaviors, and 3) was practical and accessible in its digital, bilingual format. Feedback included adding more real-world examples and offering the intervention earlier in treatment.
Conclusions: Initial findings support that the delivery of a brief, FBT-informed, web-based SSI during inpatient medical stabilization is feasible and acceptable for caregivers across sociodemographic backgrounds. Project Empower-ED may help bridge gaps in access to evidence-based caregiver support during a critical stage of treatment.
Authors:
Presenter - Ariela Kaiser, PhD, Ann & Robert H. Lurie Children's Hospital of Chicago; Northwestern University Feinberg School of Medicine
Co-Presenter - Arielle Smith, BA, Northwestern University Feinberg School of Medicine
Co-Author - Lauren Swift, PhD, Ann & Robert H. Lurie Children's Hospital of Chicago; Northwestern University Feinberg School of Medicine
Co-Author - Jenna Sung, PhD, Boston University
Co-Author - Jocelyn Lebow, PhD, Mayo Clinic
Co-Author - Jessica Schleider, PhD, Northwestern University
Dietary Acculturation and Perceived Academic Stress Among International Students at a U.S. University
Poster Number: C58Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Stress
Background:
International students face unique stressors when adapting to new academic and cultural environments. Dietary acculturation, which refers to the process of adopting the dietary practices of the host country, has been linked to adverse health outcomes in this population. However, its impact on academic stress remains largely unexplored.
Aim:
To examine the relationship between dietary acculturation and academic stress among international students.
Methods:
We conducted a cross-sectional survey of 117 international students at a large public university in the Southeastern U.S. Participants reported socio-demographics, frequency of preparing and eating their native diet, influence of U.S. diet on cooking and purchasing patterns, and perceived dietary shift. Academic stress was measured using items from the Perception of Academic Stress scale and dichotomized as extreme vs. mild stress. Associations were assessed using bivariate tests and logistic regression, adjusting for age, gender, race, region, length of stay in the U.S., academic college, class standing, and number of dependents.
Results:
Participants were primarily aged 25–34 years (51.3%), Asian (76.1%), and from South Asia (70.7%). Nearly one-third (29.9%) reported extreme stress. In bivariate analyses, only perceived dietary shift was significantly associated with stress (p=0.013). Logistic regression revealed that students who reported not sure about shifting away from their native diet had significantly higher odds of extreme stress compared to those who reported no dietary shift (OR = 5.44, 95% CI: 1.70–17.47; adjusted OR = 23.03, 95% CI: 2.45–216.20). Students who ate their native diet at moderate frequency (6–15 times/week) also had increased odds of extreme stress (adjusted OR = 37.85, 95% CI: 2.63–545.23). Native diet preparation frequency was not significantly associated with stress after adjustment.
Conclusions:
Findings suggest that uncertainty about dietary identity and moderate consumption of the native diet may be linked to higher academic stress among international students. Culturally responsive campus food policies and support programs may help ease dietary adaptation and reduce stress. Further research with larger, more representative samples is needed to clarify the mechanisms linking dietary acculturation to academic well-being.
Keywords: Acculturation, StressInternational students face unique stressors when adapting to new academic and cultural environments. Dietary acculturation, which refers to the process of adopting the dietary practices of the host country, has been linked to adverse health outcomes in this population. However, its impact on academic stress remains largely unexplored.
Aim:
To examine the relationship between dietary acculturation and academic stress among international students.
Methods:
We conducted a cross-sectional survey of 117 international students at a large public university in the Southeastern U.S. Participants reported socio-demographics, frequency of preparing and eating their native diet, influence of U.S. diet on cooking and purchasing patterns, and perceived dietary shift. Academic stress was measured using items from the Perception of Academic Stress scale and dichotomized as extreme vs. mild stress. Associations were assessed using bivariate tests and logistic regression, adjusting for age, gender, race, region, length of stay in the U.S., academic college, class standing, and number of dependents.
Results:
Participants were primarily aged 25–34 years (51.3%), Asian (76.1%), and from South Asia (70.7%). Nearly one-third (29.9%) reported extreme stress. In bivariate analyses, only perceived dietary shift was significantly associated with stress (p=0.013). Logistic regression revealed that students who reported not sure about shifting away from their native diet had significantly higher odds of extreme stress compared to those who reported no dietary shift (OR = 5.44, 95% CI: 1.70–17.47; adjusted OR = 23.03, 95% CI: 2.45–216.20). Students who ate their native diet at moderate frequency (6–15 times/week) also had increased odds of extreme stress (adjusted OR = 37.85, 95% CI: 2.63–545.23). Native diet preparation frequency was not significantly associated with stress after adjustment.
Conclusions:
Findings suggest that uncertainty about dietary identity and moderate consumption of the native diet may be linked to higher academic stress among international students. Culturally responsive campus food policies and support programs may help ease dietary adaptation and reduce stress. Further research with larger, more representative samples is needed to clarify the mechanisms linking dietary acculturation to academic well-being.
Authors:
Presenter - Chidimma Okoli, MPH, UNC Charlotte
Co-Author - Quazi Minhaz Tabassum, MPH, University of North Carolina at Charlotte
Co-Author - Jessica Miller, M.S., University of North Carolina at Charlotte
Mapping Food Security Efforts in the Omaha Metro: A Landscape Analysis to Advance Behavioral Medicine Innovation
Poster Number: C59Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Social and Environmental Context and Health
The objective of this landscape analysis of community-based programs in the Omaha Metro (3-county area) was to understand the needs of populations experiencing food insecurity, identify gaps in service, and propose solutions that ultimately inform improved food and nutrition security using a behavioral medicine lens. This collaborative work included identifying opportunities to create a pipeline of service and data collection to conduct proactive, upstream work. As part of this analysis, we conducted a series of key informant interviews (N=40) with local organizations working to address food security and related social determinants of health (e.g., emergency food, government agencies, advocacy organizations, educational institutions, healthcare organizations). Guided by the Consolidated Framework for Implementation Research (CFIR), we asked interviewees about a range of CFIR domains including innovation, inner setting, outer setting (policies and laws), and implementation processes (reflecting and evaluating) with respect to their programming. Interviews were 45-60 minutes long, audio recorded, and transcribed verbatim. Using a content analysis approach, team members coded transcripts to identify emergent themes. Key themes that emerged included: Program delivery and adaptation (e.g., program operations, barriers, tailoring strategies); Partnerships and community connections (e.g., collaborations, gaps); Resources and constraints (e.g., funding, staffing, transportation); Cultural alignment (e.g., serving diverse communities); Evaluation and data gaps (e.g., current data collection, challenges); and Future priorities and systemic needs (e.g., sustainability, upstream issues, policy advocacy). These findings highlight both the complexity and potential for innovation in addressing food and nutrition security through a behavioral medicine lens. By uncovering systemic barriers, adaptive strategies, and opportunities for upstream interventions, this landscape analysis provides a foundation for designing integrated, evidence-informed approaches that link food and nutrition security with health outcomes. These insights point to novel pathways for cross-sector collaboration, data-driven decision-making, and behavioral strategies (e.g., culturally relevant food access, medically tailored meals, community-clinical linkages) that can advance sustainable solutions among populations with low income.
Keywords: Low-income, NutritionAuthors:
Author - Courtney Parks, PhD, Center for Nutrition & Health Impact
Author - Hollyanne Fricke, MPH, Center for Nutrition & Health Impact
Author - Christina Ballu, MPH, Center for Nutrition & Health Impact
Author - Whitney Clausen, MPH, Center for Nutrition & Health Impact
Author - Carolina Morales, MS, RDN, Center for Nutrition & Health Impact
Author - Amy Yaroch, PhD, Center for Nutrition & Health Impact
Psychosocial and financial unmet needs for young adult cancer caregivers living in geographically disparate areas
Poster Number: C6Time: 05:00 PM - 05:50 PM
Topics: Cancer, Health Disparities
Background: We explored whether young adult cancer caregivers (YACC) who live in resource constrained communities (rural, healthcare professional shortage areas (HPSA), or persistent poverty) face greater psychosocial and unmet financial needs than their counterparts.
Methods: We conducted an online survey of N=99 YACC across the United States in 2025 to explore geographic disparities in psychosocial and financial unmet needs. Bivariate statistics were applied to summarize sociodemographics, psychosocial outcomes (depression, stress), financial impact of caregiving (score of 0-100, lower score indicates greater impact), caregiver burden index (range 0-20 higher scores indicate more burden) and geographic disparate areas using Zip codes to estimate rurality, and primary and mental HPSAs, county to estimate areas of persistent poverty.
Results: YACC were primarily female (69%), heterosexual (74%), white (69%), married/living as married (56%), and without a college degree (72%). Most were caregiving to a parent (41%), friend (21%), or grandparent (20%) for 0-2 years (45%) or 3-5 years (32%), primarily for patients with lung (30%) or breast (18%) cancer. While relatively few YACC lived in a primary care HPSA, 45% lived in a mental HPSA, and 41% lived in an area of persistent poverty; 41% were rural. YACC in geographically disparate areas suffer from moderate to extreme depression (73%), moderate to high stress (88%), moderate caregiver burden (mean: 9.8, range 0-20) and moderate financial impact of caregiving (mean: 62.3, SD: 19.3). Geographic disparities persisted across different measures; that there were no differences in psychosocial or financial outcomes between individuals living in rural or urban areas.
Conclusions: This study sought to establish the influence of geographic disparities on YACC’s unmet needs to inform the design of a multilevel intervention. Our findings underscore the complex interplay of rurality, emotional labor, financial strain, and identity transformation in YACC.
Keywords: Cancer, CaregivingMethods: We conducted an online survey of N=99 YACC across the United States in 2025 to explore geographic disparities in psychosocial and financial unmet needs. Bivariate statistics were applied to summarize sociodemographics, psychosocial outcomes (depression, stress), financial impact of caregiving (score of 0-100, lower score indicates greater impact), caregiver burden index (range 0-20 higher scores indicate more burden) and geographic disparate areas using Zip codes to estimate rurality, and primary and mental HPSAs, county to estimate areas of persistent poverty.
Results: YACC were primarily female (69%), heterosexual (74%), white (69%), married/living as married (56%), and without a college degree (72%). Most were caregiving to a parent (41%), friend (21%), or grandparent (20%) for 0-2 years (45%) or 3-5 years (32%), primarily for patients with lung (30%) or breast (18%) cancer. While relatively few YACC lived in a primary care HPSA, 45% lived in a mental HPSA, and 41% lived in an area of persistent poverty; 41% were rural. YACC in geographically disparate areas suffer from moderate to extreme depression (73%), moderate to high stress (88%), moderate caregiver burden (mean: 9.8, range 0-20) and moderate financial impact of caregiving (mean: 62.3, SD: 19.3). Geographic disparities persisted across different measures; that there were no differences in psychosocial or financial outcomes between individuals living in rural or urban areas.
Conclusions: This study sought to establish the influence of geographic disparities on YACC’s unmet needs to inform the design of a multilevel intervention. Our findings underscore the complex interplay of rurality, emotional labor, financial strain, and identity transformation in YACC.
Authors:
Author - Katharine Adelstein, PhD, APRN, University of Louisville School of Nursing
Author - Cindy A Turner, MPH, University of Utah/Huntsman Cancer Institute
Author - Katie Rogers, MS, Huntsman Cancer Institute, Cancer Control and Population Sciences Dept, University of Utah
Author - Mary Killela, PhD, RN, Huntsman Cancer Institute, Cancer Control and Population Sciences Dept, University of Utah; College of Nursing, University of Utah
Author - Anne Kirchhoff, PhD, MPH, Huntsman Cancer Institute, Cancer Control and Population Sciences Dept, University of Utah; Department of Pediatrics, School of Medicine, University of Utah
Author - Echo Warner, PhD, MPH, Huntsman Cancer Institute, Cancer Control and Population Sciences Dept, University of Utah; College of Nursing, University of Utah
What’s On Your Kid’s Plate Study: Assessing the Impact of the Eat Well, Be Well Program on Fruit and Vegetable Intake Among SNAP Households
Poster Number: C61Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders
Background: SNAP (Supplemental Nutrition Assistance Program) provides essential but insufficient support to improve food/nutrition security and increase fruit and vegetable (FV) intake among lower-income households with children. Incentive programs that reduce the cost of FVs have shown promise among adults, yet limited evidence exists on their impact on children’s diet. Rhode Island’s statewide Eat Well, Be Well (EWBW) program, launched in January 2024, provides $0.50 in SNAP benefits for every $1.00 spent on fresh FVs, at select stores, directly linked to EBT. The What’s On Your Kid’s Plate study evaluates the program’s effect on child FV intake frequency.
Methods: Eligible participants were SNAP-enrolled guardians of children aged 1–8 years in Rhode Island (RI) (intervention) or Connecticut (CT) (comparison). Recruitment occurred via community partners, WIC text blasts, and local events. Of 1,367 adults screened, 711 met eligibility criteria, passed quality checks, and completed the child survey (May–September 2023); 460 completed follow-up measures 6–8 months after EWBW launched. Surveys assessed guardian FV intake (via food frequency questionnaire) and child FV frequency (five items from the National Survey of Children’s Health). Linear mixed models with random intercepts estimated change in FV frequency, with state, time, and their interaction as fixed effects.
Results: Most guardians were female (98%), U.S.-born (81%), and participating in WIC (93%). In CT, the proportion of children eating fruit 1–3 times/day declined from 69% to 61%; in RI, from 59% to 56%; for vegetables, CT saw a slight decrease from 43% to 41%, while RI remained stable at 40%, however, none of these changes were statistically significant. Fruit consumption was consistently more frequent than vegetable consumption. Guardian FV intake and child FV frequency were positively correlated at both timepoints (⍴=0.27, p<0.05). Change in child FV frequency did not differ between states (b=0.145, p-interaction=0.32).
Discussion: Parental FV intake was associated with higher child FV frequency, though no change was observed in child intake frequency following EWBW. The trend toward maintained intake of vegetables in RI, relative to declines in CT, suggests potential protective effects. Continued follow-up will clarify impacts, inform refinements, and strengthen evidence guiding nutrition incentive policy.
Keywords: Diet, PolicyMethods: Eligible participants were SNAP-enrolled guardians of children aged 1–8 years in Rhode Island (RI) (intervention) or Connecticut (CT) (comparison). Recruitment occurred via community partners, WIC text blasts, and local events. Of 1,367 adults screened, 711 met eligibility criteria, passed quality checks, and completed the child survey (May–September 2023); 460 completed follow-up measures 6–8 months after EWBW launched. Surveys assessed guardian FV intake (via food frequency questionnaire) and child FV frequency (five items from the National Survey of Children’s Health). Linear mixed models with random intercepts estimated change in FV frequency, with state, time, and their interaction as fixed effects.
Results: Most guardians were female (98%), U.S.-born (81%), and participating in WIC (93%). In CT, the proportion of children eating fruit 1–3 times/day declined from 69% to 61%; in RI, from 59% to 56%; for vegetables, CT saw a slight decrease from 43% to 41%, while RI remained stable at 40%, however, none of these changes were statistically significant. Fruit consumption was consistently more frequent than vegetable consumption. Guardian FV intake and child FV frequency were positively correlated at both timepoints (⍴=0.27, p<0.05). Change in child FV frequency did not differ between states (b=0.145, p-interaction=0.32).
Discussion: Parental FV intake was associated with higher child FV frequency, though no change was observed in child intake frequency following EWBW. The trend toward maintained intake of vegetables in RI, relative to declines in CT, suggests potential protective effects. Continued follow-up will clarify impacts, inform refinements, and strengthen evidence guiding nutrition incentive policy.
Authors:
Author - Alison Tovar, PhD, MPH, Brown University
Co-Author - Emily Elenio, Brown University School of Public Health Department of Behavioral and Social Sciences
Co-Author - Vanessa Oddo, PhD, University of Illinois Chicago
Co-Author - Julien Leider, University of Illinois Chicago
Co-Author - Lisa Powell, PhD, University of Illinois Chicago
Presenter - Maya Vadiveloo, PhD, University of Rhode Island
Initiating the eBATTLE Obesity Project: User-Centered Design of a Digital Intervention to Support Healthy Lifestyle and Weight Management in Adolescents with Obesity
Poster Number: C62Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Multiple Health Behavior Change
Background: Digital health interventions have the potential to promote healthy lifestyle and behavior change to facilitate weight loss and maintenance in adolescents with obesity. There is however limited knowledge regarding which design features, behavior change techniques (BCTs) and persuasive system design (PSDs) principles that can be most useful.
Aim: In preparation for the eBATTLE obesity trial, the study aimed to explore the needs and wishes of adolescents with obesity in terms of a digital health intervention, and to identify design features, BCTs and PSDs that can enhance healthy lifestyles and behavior change to support weight management.
Method: In total, 15 semi-structured interviews and 6 co-design workshops with key stakeholders explored supportive design features, followed by iterative testing of prototypes, design and development sprints. Key stakeholders (N=67) included in this iterative design and development process included: adolescents with obesity (n=23), next of kin (n=9), healthcare providers (n=24), service designer (n=1) and eHealth experts (e.g., designers, software developers, content developers, scientists) (n=10).
Results: Identified design features, co-creation and user testing with the stakeholders resulted in the development of an evidence-informed app-based intervention for weight management called Habition©™. Findings show how innovative approaches can be applied to integrate BCTs and PSDs into digital design aiming to support adolescents’ needs for health behavior change.
Conclusion: Early and ongoing involvement of adolescents and other key stakeholders is a necessity to develop engaging, motivating, useful and user-centered digital health interventions.
Keywords: Obesity, AdolescentsAim: In preparation for the eBATTLE obesity trial, the study aimed to explore the needs and wishes of adolescents with obesity in terms of a digital health intervention, and to identify design features, BCTs and PSDs that can enhance healthy lifestyles and behavior change to support weight management.
Method: In total, 15 semi-structured interviews and 6 co-design workshops with key stakeholders explored supportive design features, followed by iterative testing of prototypes, design and development sprints. Key stakeholders (N=67) included in this iterative design and development process included: adolescents with obesity (n=23), next of kin (n=9), healthcare providers (n=24), service designer (n=1) and eHealth experts (e.g., designers, software developers, content developers, scientists) (n=10).
Results: Identified design features, co-creation and user testing with the stakeholders resulted in the development of an evidence-informed app-based intervention for weight management called Habition©™. Findings show how innovative approaches can be applied to integrate BCTs and PSDs into digital design aiming to support adolescents’ needs for health behavior change.
Conclusion: Early and ongoing involvement of adolescents and other key stakeholders is a necessity to develop engaging, motivating, useful and user-centered digital health interventions.
Authors:
Author - Rikke Aune Asbjørnsen, PhD, Oslo University Hospital / Vestfold Hospital Trust
Co-Author - Jøran Hjelmesæth, MD PhD, Vestfold Hospital TRust
Co-Author - Marianne Ollivier, MSc, Oslo University Hospital
Co-Author - Line Kristin Johnson, PhD, Vestfold Hospital Trust
Co-Author - Jens Hertel, PhD, Vestfold Hospital Trust
Co-Author - Lise Solberg Nes, LP PhD, FSBM, Oslo University Hospital / University of Oslo
Understanding eHealth Literacy – A Scoping Review
Poster Number: C63Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Health Communication and Policy
The expansion of eHealth and AI technologies has transformed how individuals engage in accessing and using health information. This shift holds promise for improving health outcomes globally, yet reliance on online resources also presents challenges in identifying credible information and using eHealth tools effectively. The ability to effectively engage with these technologies, commonly known as eHealth literacy, is a critical determinant of their effectiveness. However, foundational definitions and measurements of eHealth literacy remain anchored in outdated frameworks that do not capture the complexity of today’s technologies, or the behavioral and structural barriers users encounter.
This scoping review mapped the evolution of eHealth literacy definitions and measurement approaches over the past two decades. Drawing from 113 peer-reviewed articles (from 11,621 initial articles) across six databases (PubMed, Embase, PsycINFO, Medline, Engineering Village, and Cochrane), we identified five integrated domains: Knowledge; Skills (Cognitive, Technical, Critical, Social, and Applied); Perceived Competence; Context (Personal and Systems); and Purpose that were consistent across studies.
Findings revealed a growing convergence between eHealth, behavioral science, and systems thinking. Recent research increasingly embedded constructs such as self-efficacy, motivation, privacy, and trust, while recognizing the decisive role of contextual and technological environments in shaping digital behaviors and decision-making. Yet, gaps persist in existing measurement tools’ ability to capture users’ real competencies and evolving needs, dimensions essential for understanding eHealth literacy.
We argue for a shift from viewing eHealth literacy as a static set of functional skills to embracing it as a dynamic, adaptive construct that evolves with technology. Positioning eHealth literacy in this way will help guide the design of future digital health interventions that are innovative, adaptable, and person-centered. Therefore, this work provides a roadmap for researchers, practitioners, and policymakers to accelerate the development of next-generation eHealth systems that advance discovery, foster individual empowerment, and enable sustainable innovation.
Keywords: e-Health, Health communicationThis scoping review mapped the evolution of eHealth literacy definitions and measurement approaches over the past two decades. Drawing from 113 peer-reviewed articles (from 11,621 initial articles) across six databases (PubMed, Embase, PsycINFO, Medline, Engineering Village, and Cochrane), we identified five integrated domains: Knowledge; Skills (Cognitive, Technical, Critical, Social, and Applied); Perceived Competence; Context (Personal and Systems); and Purpose that were consistent across studies.
Findings revealed a growing convergence between eHealth, behavioral science, and systems thinking. Recent research increasingly embedded constructs such as self-efficacy, motivation, privacy, and trust, while recognizing the decisive role of contextual and technological environments in shaping digital behaviors and decision-making. Yet, gaps persist in existing measurement tools’ ability to capture users’ real competencies and evolving needs, dimensions essential for understanding eHealth literacy.
We argue for a shift from viewing eHealth literacy as a static set of functional skills to embracing it as a dynamic, adaptive construct that evolves with technology. Positioning eHealth literacy in this way will help guide the design of future digital health interventions that are innovative, adaptable, and person-centered. Therefore, this work provides a roadmap for researchers, practitioners, and policymakers to accelerate the development of next-generation eHealth systems that advance discovery, foster individual empowerment, and enable sustainable innovation.
Authors:
Presenter - Simon L. Bacon, BSc. MSc. PhD, Concordia University, Montreal, Canada; Montreal Behavioural Medicine Centre
Co-Author - Comfort Sanuade, B.Physio, MSc., Concordia University, Montreal, Canada; Montreal Behavioural Medicine Centre
Co-Author - Laurence Paquet, BSc. MSc., Montreal Behavioural Medicine Centre
Co-Author - Patrice Ngangue, MD, MSc. PhD, Montreal Behavioural Medicine Centre
Determinants of Telehealth Utilization among U.S. Adults with Cardiometabolic Disease: Insights from the Health Information National Trends Survey
Poster Number: C64Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Cardiovascular Disease
Background: Telehealth visits are increasingly used to support chronic disease management, yet inequities in access may exacerbate disparities among adults with cardiometabolic conditions. Andersen’s Behavioral Model of Health Services Use provides a framework to examine how predisposing, enabling, and need factors shape telehealth use.
Objective: To identify predictors of telehealth visits among U.S. adults with cardiometabolic conditions (hypertension, diabetes, or heart conditions) using Andersen’s Behavioral Model.
Methods: We analyzed nationally representative data from HINTS 7 (2023–2024) among adults with self-reported hypertension, diabetes, or heart conditions (N=3,198; weighted N=96,908,084). The outcome was a self-reported telehealth visit in the past 12 months. Three nested survey-weighted logistic regression models were estimated: Model 1 included predisposing factors (age, sex, urban/rural residence); Model 2 added enabling factors (education, income, digital literacy, insurance, marital status, and electronic messaging with providers); and Model 3 added need factors (self-rated health, and self-health management confidence). Wald tests evaluated incremental contributions of each block.
Results: Among adults with cardiometabolic conditions (mean age 58.6 years; 54% male; 72% White; 83% urban; 71% ≥some college), 38% reported a telehealth visit. Predisposing factors were not significantly associated with telehealth use. In Model 2, enabling factors improved model fit (F(7,189) =8.21, p=<0.001); digital literacy (OR=1.08; 95% CI=1.02–1.15) and electronic messaging with providers (OR=2.39; 95% CI=1.74–3.30) were significant enablers of telehealth use. Model 3 showed that adding need factors did not significantly improve model fit (F(6,190) =1.55, p=0.16). However, controlling for all other variables in models 1 to 3, higher self-management confidence was inversely associated with telehealth use: very confident (OR=0.38; 95% CI=0.16–0.93) and completely confident (OR=0.29; 95% CI=0.12–0.73).
Conclusion: Telehealth use among adults with cardiometabolic conditions was driven primarily by enabling factors, especially digital literacy and provider communication, while predisposing factors were not predictive. Greater self-management confidence, a need factor, was inversely associated with telehealth use. Interventions that strengthen digital literacy and provider–patient communication may help reduce disparities in telehealth utilization.
Keywords: Cardiovascular disease, Health disparitiesObjective: To identify predictors of telehealth visits among U.S. adults with cardiometabolic conditions (hypertension, diabetes, or heart conditions) using Andersen’s Behavioral Model.
Methods: We analyzed nationally representative data from HINTS 7 (2023–2024) among adults with self-reported hypertension, diabetes, or heart conditions (N=3,198; weighted N=96,908,084). The outcome was a self-reported telehealth visit in the past 12 months. Three nested survey-weighted logistic regression models were estimated: Model 1 included predisposing factors (age, sex, urban/rural residence); Model 2 added enabling factors (education, income, digital literacy, insurance, marital status, and electronic messaging with providers); and Model 3 added need factors (self-rated health, and self-health management confidence). Wald tests evaluated incremental contributions of each block.
Results: Among adults with cardiometabolic conditions (mean age 58.6 years; 54% male; 72% White; 83% urban; 71% ≥some college), 38% reported a telehealth visit. Predisposing factors were not significantly associated with telehealth use. In Model 2, enabling factors improved model fit (F(7,189) =8.21, p=<0.001); digital literacy (OR=1.08; 95% CI=1.02–1.15) and electronic messaging with providers (OR=2.39; 95% CI=1.74–3.30) were significant enablers of telehealth use. Model 3 showed that adding need factors did not significantly improve model fit (F(6,190) =1.55, p=0.16). However, controlling for all other variables in models 1 to 3, higher self-management confidence was inversely associated with telehealth use: very confident (OR=0.38; 95% CI=0.16–0.93) and completely confident (OR=0.29; 95% CI=0.12–0.73).
Conclusion: Telehealth use among adults with cardiometabolic conditions was driven primarily by enabling factors, especially digital literacy and provider communication, while predisposing factors were not predictive. Greater self-management confidence, a need factor, was inversely associated with telehealth use. Interventions that strengthen digital literacy and provider–patient communication may help reduce disparities in telehealth utilization.
Authors:
Author - Joyline Chepkorir, PhD, MSc, RN, Johns Hopkins University
Co-Author - Doris Osei-Afriyie, PhD, MPH, University of Chicago
Co-Author - Hailey Miller, PhD, RN, Johns Hopkins University
Co-Author - Oluwabunmi Ogungbe, PhD, MPH, RN, Johns Hopkins University School of Nursing
Co-Author - Erin Michos, MD, Johns Hopkins School of Medicine
Co-Author - Zaib Hussain, MBBS, MPH, Johns Hopkins School of Medicine
Co-Author - Binu Koirala, PhD, MGS, BSN, RN, Johns Hopkins University School of Nursing
Co-Author - Richard Bannor, University of Connecticut
Co-Author - Brenda Owusu, DNP, APRN, ANP-BC, FNP-BC, University of Miami
Co-Author - Tiwaloluwa Ajibewa, Northwestern University Feinberg School of Medicine
Co-Author - Eyitayo Owolabi, PhD, Arizona State University
Co-Author - Nana Adomako, PharmD, PhD, Johns Hopkins University School of Nursing
Co-Author - Azuka Ngige, Johns Hopkins University School of Medicine
Co-Author - Ashauna Work, Johns Hopkins Bloomberg School of Public Health
Co-Author - Cheryl Himmelfarb, PhD, MSN, BS, RN, Johns Hopkins University School of Nursing
COVID-19 Antigen Rapid Test: A Bilingual Intervention to Increase Self-Efficacy and Intentions
Poster Number: C65Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Health Communication and Policy
Introduction: The at-home rapid antigen testing is an essential screening tool for reducing COVID-19 spread, but common challenges such as cost, accessibility, and limited language translations, hinder its proper use. Hispanic communities in U.S./Mexico border regions are especially impacted due to high numbers of Spanish speaking individuals. This study examined whether a culturally tailored digital health intervention could improve confidence and intentions to conduct COVID-19 self-tests among adults in El Paso, Texas. Methods: One hundred fifty-two adults (M = 48.5 years, SD = 14.9; 80.3% women; 95.4% Hispanic) participated in the study. More than three-quarters (77.6%) reported speaking Spanish, and two-thirds (67.0%) reported annual incomes of below $35,000. Participants were randomized to receive either the standard iHealth® test instructions (control condition) or the culturally tailored digital health intervention (treatment condition). Results: Independent samples t-tests revealed that participants who received the culturally tailored digital health intervention reported significantly greater ease in completing the test (M = 3.88 vs. 3.38, p = .029) and stronger intentions to self-test if symptomatic (M = 4.21 vs. 3.80, p = .035) or exposed to COVID-19 (M = 4.30 vs. 3.84, p = .016) in comparison to the participants who received the standard iHealth® test instructions. Conclusion: Culturally and language appropriate self-testing instructions, especially those combining multiple dissemination formats, may enhance the usability of at-home testing. Such strategies could strengthen infectious disease prevention efforts in language diverse communities and reduce barriers to equitable participation in public health practices.
Keywords: Culture, ScreeningAuthors:
Presenter - Michelle Gil, MPH, University of Texas at El Paso
Author - Uchenna Gbugu, PharmD, University of Texas at El Paso
Author - Elida Herrera, B.S., University of Texas at El Paso
Author - Alyssa A. Martinez, MPH, University of Texas at El Paso
Author - Gabriel Frietze, PhD, University of Texas at El Paso
Proximal Effects of Momentary Hunger and Craving Assessments and Dietary Prompts on Glucose Excursions in Adults at High Risk for Type 2 Diabetes
Poster Number: C66Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Diabetes
Introduction: Postprandial glucose excursions (deviations from baseline glucose levels, usually >1 SD above the person-specific mean) are contributors to cardiometabolic disease in adults at risk for type 2 diabetes. Just-in-time adaptive interventions (JITAIs) delivered via smartphones offer promising strategies to mitigate such fluctuations by targeting real-time eating behaviors. This micro-randomized trial tested the proximal effects of smartphone-based dietary prompts on glucose excursions in adults at risk for type 2 diabetes.
Methods: Adults (n=33; BMI ≥ 25; ADA risk score >=5) wore continuous glucose monitors and received up to seven randomized prompts daily for 4 weeks. At each decision point, participants were randomized (1:1:1) to: (1) Control (no prompt), (2) EMA-only (prompt assessing hunger/cravings), or (3) EMA + Diet (EMA followed by a dietary prompt related to meal composition, timing, or quantity). The primary outcome was the number of glucose excursions in the 60 minutes post-prompt. Mixed-effects Poisson regression models with random intercepts were used to estimate incidence rate ratios (IRRs), with post-hoc contrasts for pairwise comparisons.
Results: EMA-only prompts significantly reduced glucose excursions in the 60 minutes following prompt delivery compared to the control condition, with a 14% reduction in excursions (IRR= 0.86, p < .001). EMA + Dietary prompts produced a smaller, non-significant 6% reduction versus control (IRR = 0.94, p = .066). Post-hoc contrasts indicated that EMA-only was significantly more effective than EMA + Diet prompts (p = .0315). While all intervention conditions trended toward improved outcomes relative to the Control, EMA-only prompts yielded the most robust proximal benefit. EMA-only prompts were not intended as an intervention, but as self-assessments of hunger/cravings that may have influenced participants' subsequent behavior.
Conclusion: These findings highlight the effectiveness of EMA-only prompts as brief, low-burden nudges that drive short-term physiological improvements in glucose regulation. The lack of added benefit from dietary prompts may reflect factors like complexity, timing, or the relevance of the prompt to the participant's state. Future JITAIs should test intervention burden, timing, and relevance to optimize study approach and metabolic outcomes. This study provides support for minimal, well-timed EMA strategies as a feature of digital health interventions for glycemic control.
Keywords: Diabetes, Health behaviorsMethods: Adults (n=33; BMI ≥ 25; ADA risk score >=5) wore continuous glucose monitors and received up to seven randomized prompts daily for 4 weeks. At each decision point, participants were randomized (1:1:1) to: (1) Control (no prompt), (2) EMA-only (prompt assessing hunger/cravings), or (3) EMA + Diet (EMA followed by a dietary prompt related to meal composition, timing, or quantity). The primary outcome was the number of glucose excursions in the 60 minutes post-prompt. Mixed-effects Poisson regression models with random intercepts were used to estimate incidence rate ratios (IRRs), with post-hoc contrasts for pairwise comparisons.
Results: EMA-only prompts significantly reduced glucose excursions in the 60 minutes following prompt delivery compared to the control condition, with a 14% reduction in excursions (IRR= 0.86, p < .001). EMA + Dietary prompts produced a smaller, non-significant 6% reduction versus control (IRR = 0.94, p = .066). Post-hoc contrasts indicated that EMA-only was significantly more effective than EMA + Diet prompts (p = .0315). While all intervention conditions trended toward improved outcomes relative to the Control, EMA-only prompts yielded the most robust proximal benefit. EMA-only prompts were not intended as an intervention, but as self-assessments of hunger/cravings that may have influenced participants' subsequent behavior.
Conclusion: These findings highlight the effectiveness of EMA-only prompts as brief, low-burden nudges that drive short-term physiological improvements in glucose regulation. The lack of added benefit from dietary prompts may reflect factors like complexity, timing, or the relevance of the prompt to the participant's state. Future JITAIs should test intervention burden, timing, and relevance to optimize study approach and metabolic outcomes. This study provides support for minimal, well-timed EMA strategies as a feature of digital health interventions for glycemic control.
Authors:
Author - Phrashiah Githinji, PhD, University of Utah
Co-Author - Anita On, University of Texas at Arlington
Co-Author - Paul Estabrooks, PhD, University of Utah
Co-Author - Chad Rethorst, PhD, Texas A&M AgriLife Research
Latent profiles of smartwatch-derived modifiable lifestyle behaviors and their association with cognition in older adults without dementia
Poster Number: C67Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Aging
Objective: With the rise of passive monitoring, continuous metrics from low-cost, commercially available smartwatches can inform risk for cognitive impairment/decline in older adults. Prior research links low step count, low heart rate variability (HRV), and high intraindividual variability (IIV) in sleep duration with poorer cognition; however, how participants cluster into groups with distinct digital phenotypes remains unclear. This study used both person-centered and variable-centered approaches to examine how smartwatch-derived HRV, IIV sleep duration, and step count relate to cognition.
Methods: Fifty-one community-dwelling older adults (MAge = 68.6 ± 6.86; 27.4% Black/African American race; 59% women; MEducation = 16.3 ± 2.4; 80.3% cognitively unimpaired, 19.6% with mild cognitive impairment [MCI]) completed baseline cognitive testing to yield a global cognitive composite. Participants also completed four weeks of near-continuous monitoring (~23 hrs/day) using a Garmin Vivosmart 4. HRV was calculated as daily sedentary standard deviation of N-N intervals (SDNN), daily step count from accelerometer-based arm swing, and IIV sleep duration as the intraindividual standard deviation across days. Smartwatch metrics were z-scored and entered into a latent profile analysis (LPA) to identify groups with similar smartwatch profiles. Profile membership was then entered into a linear regression predicting cognition, controlling for age, sex, and estimated IQ. In a separate model, cognition was regressed on all smartwatch metrics.
Results: Based on model fit statistics, two latent profiles emerged. Class 2 (n=39) represented participants with healthier behaviors across domains—they slept longer (6.88 vs. 5.82 hrs), walked more (~6,236 vs. 3,800 steps/day), and had higher HRV (47.9 vs. 37.5 ms). Class membership significantly predicted cognition (b = 0.43, p = .022), with Class 2 performing better, even after excluding MCI participants. In the separate analysis of all smartwatch metrics, only step count significantly predicted cognition (b = 0.20, p = .025).
Conclusions: Clustering participants based on objective health behaviors from smartwatch data reveals meaningful digital phenotypes linked to cognitive function in aging. Step count emerged as the strongest individual predictor of cognition, highlighting the potential of simple, passive metrics to identify early cognitive decline.
Keywords: Aging, Health behaviorsMethods: Fifty-one community-dwelling older adults (MAge = 68.6 ± 6.86; 27.4% Black/African American race; 59% women; MEducation = 16.3 ± 2.4; 80.3% cognitively unimpaired, 19.6% with mild cognitive impairment [MCI]) completed baseline cognitive testing to yield a global cognitive composite. Participants also completed four weeks of near-continuous monitoring (~23 hrs/day) using a Garmin Vivosmart 4. HRV was calculated as daily sedentary standard deviation of N-N intervals (SDNN), daily step count from accelerometer-based arm swing, and IIV sleep duration as the intraindividual standard deviation across days. Smartwatch metrics were z-scored and entered into a latent profile analysis (LPA) to identify groups with similar smartwatch profiles. Profile membership was then entered into a linear regression predicting cognition, controlling for age, sex, and estimated IQ. In a separate model, cognition was regressed on all smartwatch metrics.
Results: Based on model fit statistics, two latent profiles emerged. Class 2 (n=39) represented participants with healthier behaviors across domains—they slept longer (6.88 vs. 5.82 hrs), walked more (~6,236 vs. 3,800 steps/day), and had higher HRV (47.9 vs. 37.5 ms). Class membership significantly predicted cognition (b = 0.43, p = .022), with Class 2 performing better, even after excluding MCI participants. In the separate analysis of all smartwatch metrics, only step count significantly predicted cognition (b = 0.20, p = .025).
Conclusions: Clustering participants based on objective health behaviors from smartwatch data reveals meaningful digital phenotypes linked to cognitive function in aging. Step count emerged as the strongest individual predictor of cognition, highlighting the potential of simple, passive metrics to identify early cognitive decline.
Authors:
Author - Sophia Holmqvist, M.A., Temple University, Philadelphia, PA, USA
Co-Author - Stephanie Simone, Ph.D., Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, USA
Co-Author - Marina Kaplan, B.A., Temple University, Philadelphia, PA, USA
Co-Author - Riya Chaturvedi, B.A., Penn Frontotemporal Degeneration Center, Philadelphia, PA, USA
Co-Author - Tania Giovannetti, Ph.D., Temple University, Philadelphia, PA, USA
What Patients Say: Feasibility and Acceptability of a Digital Health Tool on Clinical Trials as Part of Routine Oncology Care
Poster Number: C68Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Cancer
Purpose: The mychoiceTM Implementation study aims to evaluate the 1) feasibility of delivering a digital, evidence-based clinical trial preparatory tool designed to promote discussion about clinical trials to all new medical oncology patients and 2) acceptability of this dissemination approach to patients.
Methods : The study involves three sources of data: the website analytics via Pantheon, the feedback survey embedded in the site, and survey data from the IRB approved implementation study. mychoiceTM prompts patients to navigate through 4 sections including basic information about clinical trials, patient testimonials, questions to ask their provider, and resources, with the option to complete the brief feedback survey. Lab staff contacted patients by phone to offer the opportunity to enroll in implementation study, which includes post view (after viewing mychoiceTM), 1-month, and 4-month surveys, a 2-month interview, and a 6-month chart review.
Results : Between February 2024 and June 2025, 6,040 patients received a link to the tool, and Pantheon website analytics suggest a rough estimate of 16,509 views during that period. 192 patients completed the feedback survey. 67% of survey respondents agreed that mychoiceTM helped them better understand that clinical trials might be a treatment option to consider if offered, and 70% agreed that the mychoiceTM tool helped them identify questions they want to ask their doctor about clinical trials. 71 participants completed the post view survey and 63 completed the one-month follow-up survey as part of the implementation study. 73% of respondents were white, 21% were black, 4% were more than one race, 1% were Asian, and 3% were of Hispanic/Latino ethnicity. Participants generally leaned toward participating in a clinical trial (μ = 7.76, SD = 2.83) on an 11-point strongly agree/strongly disagree scale adapted from the Ottawa Decision Support Framework. Participants reported feeling adequately prepared to make a decision using mychoiceTM (Preparation for Decision Making PrepDM μ = 71.9, SD = 17.5). There were no statistically significant differences in PrepDM scores by race or ethnicity.
Conclusion: Delivering digital health tools via EMR driven data directly to patients is both feasible and acceptable. These results suggest the value of this tool for decision making and promise of increasing patient intent to participate. Additional analyses will focus on impact on clinical trial participation.
Keywords: Cancer, Decision makingMethods : The study involves three sources of data: the website analytics via Pantheon, the feedback survey embedded in the site, and survey data from the IRB approved implementation study. mychoiceTM prompts patients to navigate through 4 sections including basic information about clinical trials, patient testimonials, questions to ask their provider, and resources, with the option to complete the brief feedback survey. Lab staff contacted patients by phone to offer the opportunity to enroll in implementation study, which includes post view (after viewing mychoiceTM), 1-month, and 4-month surveys, a 2-month interview, and a 6-month chart review.
Results : Between February 2024 and June 2025, 6,040 patients received a link to the tool, and Pantheon website analytics suggest a rough estimate of 16,509 views during that period. 192 patients completed the feedback survey. 67% of survey respondents agreed that mychoiceTM helped them better understand that clinical trials might be a treatment option to consider if offered, and 70% agreed that the mychoiceTM tool helped them identify questions they want to ask their doctor about clinical trials. 71 participants completed the post view survey and 63 completed the one-month follow-up survey as part of the implementation study. 73% of respondents were white, 21% were black, 4% were more than one race, 1% were Asian, and 3% were of Hispanic/Latino ethnicity. Participants generally leaned toward participating in a clinical trial (μ = 7.76, SD = 2.83) on an 11-point strongly agree/strongly disagree scale adapted from the Ottawa Decision Support Framework. Participants reported feeling adequately prepared to make a decision using mychoiceTM (Preparation for Decision Making PrepDM μ = 71.9, SD = 17.5). There were no statistically significant differences in PrepDM scores by race or ethnicity.
Conclusion: Delivering digital health tools via EMR driven data directly to patients is both feasible and acceptable. These results suggest the value of this tool for decision making and promise of increasing patient intent to participate. Additional analyses will focus on impact on clinical trial participation.
Authors:
Author - Kelsey Lachow, MPH, Fox Chase Cancer Center
Author - Nicole Harrington, MPH, Fox Chase Cancer Center
Author - Madeline Albert, MA, Fox Chase Cancer Center
Author - Zoe Landau, MPH, Fox Chase Cancer Center
Author - Cassidy Kenny, MBA, Fox Chase Cancer Center
Author - Sarah Bass, PhD, MPH, FSBM, Temple University
Author - Martin Edelman, MD, Fox Chase Cancer Center
Author - Linda Fleisher, PhD, MPH, FSBM, Fox Chase Cancer Center
Correlates of Online Health Information–Seeking Skills among U.S. Adults: Findings from the 2024 Health Information National Trends Survey (HINTS 7)
Poster Number: C69Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Decision Making
Purpose: Online health information–seeking skills are important because much of today’s health information is accessed on the internet, and these skills can help people make informed decisions and manage their health. The objective of this study was to identify correlates of U.S. adults who strongly agreed they had the skills to find health information online.
Methods: We conducted a secondary, cross-sectional analysis of data from the National Cancer Institute’s 2024 Health Information National Trends Survey (HINTS 7; N = 7,278). Data were collected March through September 2024 from U.S. adults via two modes: paper and web-based surveys. The primary outcome was assessed with the item: “How much do you agree or disagree: I have the skills to find the health information I need on the internet.” Responses were dichotomized as strongly agree versus all other responses combined (somewhat agree, somewhat disagree, and strongly disagree). Correlates included sociodemographic characteristics, frequency of internet use, use of digital devices, health/wellness app use, history of medical conditions, confidence in completing medical forms, confidence in taking care of one’s own health, and social media use. After excluding individuals with missing data on any study variable, the analytic sample included 5,745 respondents. Univariable and multivariable logistic regression models were estimated in SAS v9.4. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) are reported.
Results: Overall, 54% of respondents strongly agreed that they have the skills to find needed health information on the internet. In the multivariable logistic regression model, lower odds of strongly agreed were associated with older age (per 1-year increase: OR = 0.97, 95% CI: 0.96, 0.98). Higher odds of strongly agreed were associated with being a college graduate (OR = 1.44, 95% CI: 1.15, 1.81), using the internet more than once per day (OR = 3.51, 95% CI: 2.29, 5.37), tablet use (OR = 1.43, 95% CI: 1.16, 1.76), health/wellness app use (OR = 1.44, 95% CI: 1.14, 1.84), being very confident in filling out medical forms (OR = 3.38, 95% CI: 2.58, 4.44), and being completely confident in one’s ability to take care of their own health (OR = 2.25, 95% CI: 1.69, 3.00).
Conclusion: Our findings emphasize the need to close age- and education-related gaps in online health information–seeking skills and may inform interventions to improve both digital and health literacy among U.S. adults.
Keywords: Decision making, Health communicationMethods: We conducted a secondary, cross-sectional analysis of data from the National Cancer Institute’s 2024 Health Information National Trends Survey (HINTS 7; N = 7,278). Data were collected March through September 2024 from U.S. adults via two modes: paper and web-based surveys. The primary outcome was assessed with the item: “How much do you agree or disagree: I have the skills to find the health information I need on the internet.” Responses were dichotomized as strongly agree versus all other responses combined (somewhat agree, somewhat disagree, and strongly disagree). Correlates included sociodemographic characteristics, frequency of internet use, use of digital devices, health/wellness app use, history of medical conditions, confidence in completing medical forms, confidence in taking care of one’s own health, and social media use. After excluding individuals with missing data on any study variable, the analytic sample included 5,745 respondents. Univariable and multivariable logistic regression models were estimated in SAS v9.4. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) are reported.
Results: Overall, 54% of respondents strongly agreed that they have the skills to find needed health information on the internet. In the multivariable logistic regression model, lower odds of strongly agreed were associated with older age (per 1-year increase: OR = 0.97, 95% CI: 0.96, 0.98). Higher odds of strongly agreed were associated with being a college graduate (OR = 1.44, 95% CI: 1.15, 1.81), using the internet more than once per day (OR = 3.51, 95% CI: 2.29, 5.37), tablet use (OR = 1.43, 95% CI: 1.16, 1.76), health/wellness app use (OR = 1.44, 95% CI: 1.14, 1.84), being very confident in filling out medical forms (OR = 3.38, 95% CI: 2.58, 4.44), and being completely confident in one’s ability to take care of their own health (OR = 2.25, 95% CI: 1.69, 3.00).
Conclusion: Our findings emphasize the need to close age- and education-related gaps in online health information–seeking skills and may inform interventions to improve both digital and health literacy among U.S. adults.
Authors:
Author - Aisha Langford, PhD, MPH, FSBM, Wayne State University
Co-Author - Navreet Singh, MPH, Wayne State University
Co-Author - Nancy Buderer, MS, Nancy Buderer Consulting, LLC
Examining the acceptability of utilizing a continuous glucose monitoring system to manage steroid-induced hyperglycemia during chemotherapy in patients with breast cancer
Poster Number: C7Time: 05:00 PM - 05:50 PM
Topics: Cancer, Diabetes
Background
Over 60% of women diagnosed with node-positive breast cancer will receive chemotherapy and glucocorticoids. Use of glucocorticoids during chemotherapy has been found to cause hyperglycemia, which is associated with a range of negative outcomes including increased toxicity, longer hospital stays, chemo-resistance, cancer recurrence, and progression. Resources for identifying, monitoring, and managing hyperglycemia during chemotherapy are lacking. This study aims to examine the acceptability of using continuous glucose monitors (CGMs) among breast cancer patients receiving chemotherapy with glucocorticoids.
Methods
Participants included breast cancer patients undergoing a chemotherapy regimen that included glucocorticoids. A purposive sampling approach was used to obtain representation from patients in the following groups: low-risk (HgbA1c<5.7%, BMI<30), at-risk (HgbA1c 5.7-6.4 and/or BMI>30), and with diabetes (HgbA1c>6.5%). Participants wore a CGM for 8 weeks during chemotherapy. At baseline and 8-weeks, participants completed the Stanford Efficacy Scale (SES) and the Treatment Acceptability Questionnaire (TAQ). Participants were also invited to complete a brief qualitative exit interview.
Results
The sample (N=20) was 60% White and 15% Black, with the majority (90%) identifying as non-Hispanic. Most participants (75%) were married or partnered. For all 3 groups, confidence in how to manage blood sugar increased from pre- to post-CGM, with change scores on the 30-point SES ranging from 5-7-point increases for each group. Results from the TAQ showed that participants found the CGM easy to use and understand. Patients reported feeling motivated to continue managing blood sugar and to maintain diet/exercise. Scores on TAQ items assessing negative impacts from the CGM (e.g., frustration with CGM error/alarms, impact on sleep quality) were low (M=1.32 on 0-4 scale), indicating minimal patient burden caused by wearing a CGM.
Discussion
These preliminary results suggest that the use of a CGM device is acceptable to patients with breast cancer undergoing chemotherapy with glucocorticoids. The positive impacts and minimal burden of CGM use, regardless of diabetes status, implies that this tool could easily be added to routine care for this population. The data obtained from the present study will be used to inform the development of a multi-level intervention for managing blood glucose levels during chemotherapy.
Keywords: Cancer, DiabetesOver 60% of women diagnosed with node-positive breast cancer will receive chemotherapy and glucocorticoids. Use of glucocorticoids during chemotherapy has been found to cause hyperglycemia, which is associated with a range of negative outcomes including increased toxicity, longer hospital stays, chemo-resistance, cancer recurrence, and progression. Resources for identifying, monitoring, and managing hyperglycemia during chemotherapy are lacking. This study aims to examine the acceptability of using continuous glucose monitors (CGMs) among breast cancer patients receiving chemotherapy with glucocorticoids.
Methods
Participants included breast cancer patients undergoing a chemotherapy regimen that included glucocorticoids. A purposive sampling approach was used to obtain representation from patients in the following groups: low-risk (HgbA1c<5.7%, BMI<30), at-risk (HgbA1c 5.7-6.4 and/or BMI>30), and with diabetes (HgbA1c>6.5%). Participants wore a CGM for 8 weeks during chemotherapy. At baseline and 8-weeks, participants completed the Stanford Efficacy Scale (SES) and the Treatment Acceptability Questionnaire (TAQ). Participants were also invited to complete a brief qualitative exit interview.
Results
The sample (N=20) was 60% White and 15% Black, with the majority (90%) identifying as non-Hispanic. Most participants (75%) were married or partnered. For all 3 groups, confidence in how to manage blood sugar increased from pre- to post-CGM, with change scores on the 30-point SES ranging from 5-7-point increases for each group. Results from the TAQ showed that participants found the CGM easy to use and understand. Patients reported feeling motivated to continue managing blood sugar and to maintain diet/exercise. Scores on TAQ items assessing negative impacts from the CGM (e.g., frustration with CGM error/alarms, impact on sleep quality) were low (M=1.32 on 0-4 scale), indicating minimal patient burden caused by wearing a CGM.
Discussion
These preliminary results suggest that the use of a CGM device is acceptable to patients with breast cancer undergoing chemotherapy with glucocorticoids. The positive impacts and minimal burden of CGM use, regardless of diabetes status, implies that this tool could easily be added to routine care for this population. The data obtained from the present study will be used to inform the development of a multi-level intervention for managing blood glucose levels during chemotherapy.
Authors:
Presenter - Nicole Arrato, PhD, Duke University School of Medicine
Co-Author - Smrithi Divakaran, MBBS, MSPH, Duke University School of Medicine
Co-Author - Daniel Youssef, BS, Duke University School of Medicine
Co-Author - Michael Willis, BA, Duke University School of Medicine
Co-Presenter - Breanna Barrett, BA, Duke University
Co-Presenter - Anika Dhuler, Duke University
Co-Presenter - Kate Lee, Duke University
Co-Presenter - Florine Lijesen, Duke University
Co-Presenter - Ananya Pinnamaneni, Duke University
Co-Presenter - Phuong Ngu, Duke University
Co-Presenter - Cody Powell, Duke University
Co-Presenter - Daliya Rizvi, Duke University
Co-Author - Gretchen Kimmick, MD, MS, Duke University School of Medicine
Co-Author - Rebecca Shelby, PhD, Duke University School of Medicine
Co-Author - Afreen Shariff, MD, MBBS, Duke University School of Medicine
User Perspectives on Humanlikeness in AI-Enhanced Digital Mental Health Interventions
Poster Number: C70Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Mental Health
Background
Mental health conditions like depression are common and undertreated in the US. Digital mental health interventions (DMHIs) can overcome barriers to care, but often face low uptake and engagement. Generative AI, trained on large datasets of human writing, now enables responsive, natural-language interactions that may enhance user experience by mimicking aspects of human communication. Yet little is known about how users perceive such applications, particularly the desirability and perceived risks of humanlikeness in AI chatbots, and views on whether such tools could, or should, substitute human support.
Methods
Participants were recruited through ResearchMatch and paid ads on Facebook/Instagram. Eligible individuals resided in the U.S., owned a smartphone, and reported experiences of depression. Participants (N=28) engaged in asynchronous online discussions. Transcripts were thematically analyzed to identify participants’ mental health needs, experiences with generative AI, and design ideas for AI-enhanced DMHIs.
Results
Participants described that humanlike qualities such as acknowledgement, linguistic authenticity, varied personality and tone, and voice features enhanced perceived support, rapport, and engagement. At the same time, participants appreciated AI’s constant availability. Because participants reserved social judgement as exclusive to humans, they felt more comfortable disclosing information to AI. Alongside these benefits, participants also stressed limits of humanlike design. Many were divided on whether AI can or should attempt to replicate empathy, noting that such attempts often felt scripted or robotic. Importantly, participants viewed AI as inappropriate for serious mental health conditions or crises, where human expertise and judgment were deemed essential for safety.
Conclusion
Participants wanted AI to emulate select humanlike qualities, while preserving non-humanlike strengths that promote comfort in disclosure. As AI was seen as unable to replicate human empathy or judgment, participants expressed limited trust in AI’s usefulness for crises, stressing the importance of referral and human oversight. Overall, while humanlikeness was viewed as enhancing DMHIs, these tools were nonetheless viewed as a potentially valuable complement to, but not replacement for, human care and connection. These insights can inform the design of AI-enhanced DMHIs that meet user needs.
Keywords: Technology, Mental healthMental health conditions like depression are common and undertreated in the US. Digital mental health interventions (DMHIs) can overcome barriers to care, but often face low uptake and engagement. Generative AI, trained on large datasets of human writing, now enables responsive, natural-language interactions that may enhance user experience by mimicking aspects of human communication. Yet little is known about how users perceive such applications, particularly the desirability and perceived risks of humanlikeness in AI chatbots, and views on whether such tools could, or should, substitute human support.
Methods
Participants were recruited through ResearchMatch and paid ads on Facebook/Instagram. Eligible individuals resided in the U.S., owned a smartphone, and reported experiences of depression. Participants (N=28) engaged in asynchronous online discussions. Transcripts were thematically analyzed to identify participants’ mental health needs, experiences with generative AI, and design ideas for AI-enhanced DMHIs.
Results
Participants described that humanlike qualities such as acknowledgement, linguistic authenticity, varied personality and tone, and voice features enhanced perceived support, rapport, and engagement. At the same time, participants appreciated AI’s constant availability. Because participants reserved social judgement as exclusive to humans, they felt more comfortable disclosing information to AI. Alongside these benefits, participants also stressed limits of humanlike design. Many were divided on whether AI can or should attempt to replicate empathy, noting that such attempts often felt scripted or robotic. Importantly, participants viewed AI as inappropriate for serious mental health conditions or crises, where human expertise and judgment were deemed essential for safety.
Conclusion
Participants wanted AI to emulate select humanlike qualities, while preserving non-humanlike strengths that promote comfort in disclosure. As AI was seen as unable to replicate human empathy or judgment, participants expressed limited trust in AI’s usefulness for crises, stressing the importance of referral and human oversight. Overall, while humanlikeness was viewed as enhancing DMHIs, these tools were nonetheless viewed as a potentially valuable complement to, but not replacement for, human care and connection. These insights can inform the design of AI-enhanced DMHIs that meet user needs.
Authors:
Presenter - Claire Moon, Northwestern University
Co-Author - Sarah Popowski, Northwestern University
Co-Author - Jack Svoboda, Northwestern University
Co-Author - Jonah Meyerhoff, PhD, Northwestern University
Co-Author - David Mohr, PhD, Northwestern University
Co-Author - Rachel Kornfield, PhD, Northwestern University
Reaching Older Adults in the Digital Era: A Systematic Review of Recruitment Strategies for Virtual Interventions
Poster Number: C71Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Aging
Background: Addressing the health and aging needs of a growing older adult population requires innovative approaches, with virtual interventions offering convenient access to healthcare, education, and social engagement. Yet, many groups—particularly racial and ethnic minorities—remain underrepresented in digital health research. This study presents a systematic review of recruitment strategies used in virtual-based interventions targeting older adults.
Methods: This systematic review included studies that: (1) used virtual interventions with audio and visual components, (2) enrolled participants aged 65 or older, (3) were published in English or with translation, (4) were published in 2010 or later, and (5) reported recruitment methods. Articles were retrieved from EMBASE, Google Scholar, PubMed, BMC Geriatrics, The Gerontologist, Journal of the American Geriatrics Society, and Nature Aging. We extracted data on age, gender, sample size, racial/ethnic distribution, and recruitment strategies.
Results: Of the 101 studies reviewed, 29 (28.7%) enrolled more than 100 participants. Nearly all (98/101; 97%) included both male and female participants, and only 14 (13.9%) included individuals aged 80 and older. 40 out of 101 (39.6%) studies provided race/ethnic distribution, though just seven studies produced data that closely reflected state-level demographics or offered balanced racial/ethnic representation. 51 studies (50.5%) used more than one approach to recruitment, yet only one study disclosed the financial costs associated with participant recruitment.
Conclusion: This systematic review highlights that there is no one-size-fits-all approach to recruiting older adults into virtual interventions; multiple strategies are often employed to meet study goals. By including a broader range of recruitment methods, participant health backgrounds, and study designs than prior reviews, our work offers a more comprehensive understanding of what facilitates—and hinders—engagement in digital health research. However, gaps in reporting—particularly around race, ethnicity, and recruitment costs—limit insights into equity and scalability. Future studies should prioritize consistent demographic reporting and cost transparency, while also considering supports such as internet access or alternative delivery formats to promote equitable participation among older adults.
Keywords: Aging, TechnologyMethods: This systematic review included studies that: (1) used virtual interventions with audio and visual components, (2) enrolled participants aged 65 or older, (3) were published in English or with translation, (4) were published in 2010 or later, and (5) reported recruitment methods. Articles were retrieved from EMBASE, Google Scholar, PubMed, BMC Geriatrics, The Gerontologist, Journal of the American Geriatrics Society, and Nature Aging. We extracted data on age, gender, sample size, racial/ethnic distribution, and recruitment strategies.
Results: Of the 101 studies reviewed, 29 (28.7%) enrolled more than 100 participants. Nearly all (98/101; 97%) included both male and female participants, and only 14 (13.9%) included individuals aged 80 and older. 40 out of 101 (39.6%) studies provided race/ethnic distribution, though just seven studies produced data that closely reflected state-level demographics or offered balanced racial/ethnic representation. 51 studies (50.5%) used more than one approach to recruitment, yet only one study disclosed the financial costs associated with participant recruitment.
Conclusion: This systematic review highlights that there is no one-size-fits-all approach to recruiting older adults into virtual interventions; multiple strategies are often employed to meet study goals. By including a broader range of recruitment methods, participant health backgrounds, and study designs than prior reviews, our work offers a more comprehensive understanding of what facilitates—and hinders—engagement in digital health research. However, gaps in reporting—particularly around race, ethnicity, and recruitment costs—limit insights into equity and scalability. Future studies should prioritize consistent demographic reporting and cost transparency, while also considering supports such as internet access or alternative delivery formats to promote equitable participation among older adults.
Authors:
Presenter - Ginikachi Olelewe, M.S., Touro College of Osteopathic Medicine, New York, NY, USA
Co-Author - Suyee Winn, M.D., Cedars Sinai Medical Center, Los Angeles, California, USA
Co-Author - Nadia Hyunh, Cedars Sinai Medical Center, Los Angeles, California, USA
Co-Author - Tara Ostad, M.D., Cedars Sinai Medical Center, Los Angeles, California, USA
Co-Author - Celina Shirazipour, PhD, Cedars Sinai Medical Center, Los Angeles, California, USA
Co-Author - Allison Mays, M.D., Cedars Sinai Medical Center, Los Angeles, California, USA
Identifying Screening-Level Predictors of Enrollment in a Mobile Mindfulness RCT Using Headspace: A Bayesian Model-Averaged Logistic Regression Approach
Poster Number: C72Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Integrative Health and Spirituality
Background: Mindfulness meditation is a useful tool with documented effects on various health-related outcomes. Despite the promise of mindfulness meditation, research has identified that some people do not participate in the traditional in-person interventions. Mobile versions, such as those that are app-based, are proposed to solve some of the issues associated with in-person formats, but it remains unclear whether there are differences in enrollers of app-based meditation. Use of app-based meditation is rapidly growing, and identifying if differences exist in enrollment is important to understanding the generalizability of effects and revealing if there are groups being underserved. Purpose: This study uses screening data from a randomized-waitlist controlled trial testing the app-based mindfulness intervention Headspace to examine predictors of study enrollment. Method: After excluding five participants with missing responses, 262 participants (age M = 37.5 years, SD = 11.1; 74.4% non-male) completed a screening survey to assess eligibility and demographic and motivational characteristics. This included the following five factors: age, gender, prior sitting meditation practice in the last six months, and willingness to be randomized into either the meditation or waitlist group. A Bayesian model-averaged logistic regression was performed using JASP to examine predictors of study enrollment. Specifically, a set of 32 candidate models, specified from combinations of the five predictors, were evaluated and averaged. Results: In total, 140 participants enrolled in the study. The best fitting model included only one predictor, willingness to be randomized to the meditation group. Models including this predictor were supported 16 times more than models excluding it. Participants willing to be randomized to the meditation group were 4.5 times more likely to enroll than those who were not. Discussion: Even with limited data a motivational characteristic emerged as a predictor of study enrollment. Findings may suggest that providing psychoeducation on the value of being in a mindfulness meditation treatment group is important to increase willingness to enroll. This may be especially important among groups who are less informed on the practice. Examining factors driving willingness and considering whether it is possible to increase willingness of potential participants who may benefit from enrolling in the intervention is an important avenue for future work.
Keywords: Mobile phone, Mindfulness-Based Stress ReductionAuthors:
Author - Mercedes Peña, BA, University of California, Merced
Author - Ihnwhi Heo, M.Sc., University of California, Merced
Author - Sarah Depaoli, PhD, University of California, Merced
Author - Matthew Zawadzki, PhD, University of California, Merced
Movement over Virtual Reality (MoVR): Exploring the acceptability of adopting virtual reality to promote physical activity among Latina/o adults with cardiometabolic risk factors
Poster Number: C73Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Physical Activity
Background: Physical inactivity is a significant public health concern contributing to chronic diseases. Furthermore, Latino/a adults have the higher rates of physical inactivity compared to other racial/ethnic groups in the U.S. There is growing adoption of virtual reality (VR) therapeutic tools to improve health outcomes, yet few studies focus VR use to promote physical activity (PA) in the Latina/o community. This study explores the acceptability of using a Latin dance-inspired VR intervention to promote PA among Latina/o adults with cardiometabolic risk factors in Los Angeles.
Methods: Eligible participants self-identified as Latino/a, spoke English or Spanish, and self-reported a diagnosis of prediabetes or scored “high-risk” for developing prediabetes on the CDC’s widely available “Do I Have Prediabetes” screening tool. We partnered with promotores (community health workers) to recruit participants in under-resourced Los Angeles communities. Participants received a VR orientation, engaged in a facilitated 30-minute VR dance activity, and participated in a 45-minute focus group. Focus groups were conducted based on the preferred language (English or Spanish) and participant age (18-29, 30-49, 50-70 years old). Focus group questions were based on the Theoretical Framework of Acceptability domains: 1) affective attitude 2) burden 3) ethicality 4) intervention coherence 5) opportunity costs 6) perceived effectiveness and 7) self-efficacy. We utilized an inductive coding approach and thematic analysis to synthesize themes and subthemes related to VR use for physical activity.
Results: We conducted eleven focus groups (n=66). Most participants were foreign born (83.3%), female (74.2%), preferred Spanish (63.6%), and identified as Mexican (53%). Salient themes related to VR acceptability included digital equity (financial barriers, digital literacy), language access, cultural connection, stress relief, and mitigating structural barriers. Older adults had overwhelmingly positive opinions about VR compared to younger adults who expressed reluctance about its usefulness.
Conclusion: VR was widely well received and has the potential to promote PA in the Latino/a community given, especially among older adults and potential to mitigate structural barriers. However, digital equity and inclusive programming must be addressed to effectively reach all communities. These insights will guide the development of an inclusive culturally tailored VR dance intervention.
Keywords: Latino, TechnologiesMethods: Eligible participants self-identified as Latino/a, spoke English or Spanish, and self-reported a diagnosis of prediabetes or scored “high-risk” for developing prediabetes on the CDC’s widely available “Do I Have Prediabetes” screening tool. We partnered with promotores (community health workers) to recruit participants in under-resourced Los Angeles communities. Participants received a VR orientation, engaged in a facilitated 30-minute VR dance activity, and participated in a 45-minute focus group. Focus groups were conducted based on the preferred language (English or Spanish) and participant age (18-29, 30-49, 50-70 years old). Focus group questions were based on the Theoretical Framework of Acceptability domains: 1) affective attitude 2) burden 3) ethicality 4) intervention coherence 5) opportunity costs 6) perceived effectiveness and 7) self-efficacy. We utilized an inductive coding approach and thematic analysis to synthesize themes and subthemes related to VR use for physical activity.
Results: We conducted eleven focus groups (n=66). Most participants were foreign born (83.3%), female (74.2%), preferred Spanish (63.6%), and identified as Mexican (53%). Salient themes related to VR acceptability included digital equity (financial barriers, digital literacy), language access, cultural connection, stress relief, and mitigating structural barriers. Older adults had overwhelmingly positive opinions about VR compared to younger adults who expressed reluctance about its usefulness.
Conclusion: VR was widely well received and has the potential to promote PA in the Latino/a community given, especially among older adults and potential to mitigate structural barriers. However, digital equity and inclusive programming must be addressed to effectively reach all communities. These insights will guide the development of an inclusive culturally tailored VR dance intervention.
Authors:
Author - Yelba Castellon-Lopez, MD, MS, Cedars-Sinai Medical Center
Presenter - Gael Perez, Cedars-Sinai Medical Center
Co-Author - Leslie Aguilar-Hernandez, Cedars-Sinai Medical Center
Co-Author - Desiree Acosta, MPH, David Geffen School of Medicine at UCLA
Co-Author - Iris Guzman-Ruiz, PhD, MPH, Cedars-Sinai Medical Center
Co-Author - Michael Fine, Cedars-Sinai Medical Center
Co-Author - Paulina Monteon-Garcia, MPH, Cedars-Sinai Medical Center
Co-Author - Liana Gutierrez, Cedars-Sinai Medical Center
Co-Author - Jailene Cruz, Cedars-Sinai Medical Center
Co-Author - Vanessa Torres, PhD, MPH, Cedars-Sinai Medical Center
Co-Author - O. Kenrik Duru, MD, MS, David Geffen School of Medicine at UCLA
Aligning Confidence and Competence: Applying Self-Efficacy to Evaluate Large Language Models in Healthcare Communication
Poster Number: C74Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Methods and Measurement
Large Language Models (LLMs) are increasingly integrated into health communication and behavioral interventions. However, little is known about whether LLMs can evaluate their own performance or anticipate difficulties. Applying a self-efficacy framework to LLMs offers a novel perspective (beyond generic task and benchmark comparisons) for assessing how these systems might reliably support healthcare communication and decisions.
This study adapts the General Self-Efficacy Scale (GSES) as an evaluation framework to examine whether LLMs demonstrate meaningful “self-efficacy.” We compared model self-ratings against their objective task accuracy (based on human evaluations) across three cognitive task categories (computational, social, and medical tasks). Four publicly available LLMs (GPT-5, Claude 4, Gemini 2.5, Grok 4) were tested. After completing each task, models self-rated using GSES. Task accuracy was compared to human-annotated responses. Differences in self-efficacy ratings across models were analyzed using pairwise Kruskal-Wallis tests.
LLMs demonstrated relatively consistent accuracy within models across different task types, but their self-efficacy ratings varied significantly. Across tasks, Grok 4 exhibited the highest self-efficacy score (GSES=31/40), while Gemini 2.5 was the lowest (GSES=18/40). Notably, LLMs that expressed higher self-efficacy did not necessarily achieve higher objective task performance compared to more modestly self-rated models. Significant differences in self-efficacy were observed (e.g., Computational: H(3)=8.40, p=.038)). Variation in ratings was pronounced for items assessing nuanced constructs (e.g., adaptability and problem-solving under stress). We also observed a distinctive perception of self-efficacy by LLMs which indicated that LLMs could be as susceptible to overconfidence, leading to incorrect responses.
LLMs, like humans, may demonstrate varying degrees of calibration between confidence and performance. Overconfident yet inaccurate models may pose risks in behavioral health communication and decision support, whereas better-calibrated models could enhance trust and adoption. Embedding behavioral science constructs, such as self-efficacy, into AI evaluation provides a novel and hybrid framework for assessing readiness of LLMs in behavioral medicine and lays critical groundwork for future assessments aligning with human and machine cognition.
Keywords: Technology, MeasurementThis study adapts the General Self-Efficacy Scale (GSES) as an evaluation framework to examine whether LLMs demonstrate meaningful “self-efficacy.” We compared model self-ratings against their objective task accuracy (based on human evaluations) across three cognitive task categories (computational, social, and medical tasks). Four publicly available LLMs (GPT-5, Claude 4, Gemini 2.5, Grok 4) were tested. After completing each task, models self-rated using GSES. Task accuracy was compared to human-annotated responses. Differences in self-efficacy ratings across models were analyzed using pairwise Kruskal-Wallis tests.
LLMs demonstrated relatively consistent accuracy within models across different task types, but their self-efficacy ratings varied significantly. Across tasks, Grok 4 exhibited the highest self-efficacy score (GSES=31/40), while Gemini 2.5 was the lowest (GSES=18/40). Notably, LLMs that expressed higher self-efficacy did not necessarily achieve higher objective task performance compared to more modestly self-rated models. Significant differences in self-efficacy were observed (e.g., Computational: H(3)=8.40, p=.038)). Variation in ratings was pronounced for items assessing nuanced constructs (e.g., adaptability and problem-solving under stress). We also observed a distinctive perception of self-efficacy by LLMs which indicated that LLMs could be as susceptible to overconfidence, leading to incorrect responses.
LLMs, like humans, may demonstrate varying degrees of calibration between confidence and performance. Overconfident yet inaccurate models may pose risks in behavioral health communication and decision support, whereas better-calibrated models could enhance trust and adoption. Embedding behavioral science constructs, such as self-efficacy, into AI evaluation provides a novel and hybrid framework for assessing readiness of LLMs in behavioral medicine and lays critical groundwork for future assessments aligning with human and machine cognition.
Authors:
Presenter - Daniel I. Jackson, BSc., Nationwide Children's Hospital
Co-Author - Emma Jensen, B.A., Nationwide Children's Hospital
Co-Author - Syed-Amad Hussain, BSE, Nationwide Children's Hospital
Co-Author - Emre Sezgin, BBA, MSc, PhD, Nationwide Children's Hospital
Willingness to do a Telehealth Visit if Offered in U.S. Adults
Poster Number: C75Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Integrated Primary Care
Purpose: Telehealth visits with health care providers can offer flexibility and convenience to patients while also reducing potential transportation barriers. However, not all patients are willing to do a telehealth visit. The purpose of the present study was to evaluate possible predictors of U.S. adults being very willing to do a telehealth visit if offered one.
Methods: Secondary analysis of cross-sectional data from the 2024 Health Information National Trends Survey (HINTS 7) completed by U.S. adults. Surveys were done on paper or on the web. Participants were asked, “How willing are you to do a telehealth visit in the future if one is offered to you?” We compared “very willing” vs. all other responses (somewhat willing, somewhat unwilling, and very unwilling). Using logistic regression models, univariable and multivariable associations were assessed between very willing to do a telehealth visit and demographic characteristics, various medical conditions, frequency of internet use, perceived search skills to find needed health information on the internet, confidence in filling out medical forms, frustration with learning to use new technology, lack of reliable transportation, and type of work hours (none, part-time, or full-time). After excluding participants with missing data for any study variable, the analytical sample size was 5,782. Odds ratios and 95% confidence intervals are reported.
Results: In this sample, 39% were very willing to do a telehealth visit if offered one. In the multivariable model, higher odds of being very willing to do a telehealth visit were found in those who were 35-49 years old (vs. 18-34), a college graduate (vs. not), very confident in filling out medical forms (vs. somewhat, a little, or not at all), agreed to having search skills to find needed health information on the internet (vs. disagreed), a history of anxiety or depression (vs. not), or a history of chronic lung disease (vs. not). In contrast, participants who agreed that learning how to use new technology is frustrating (vs. disagreed) had lower odds of being very willing to do a telehealth visit.
Conclusion: Making telehealth visits user-friendly and easy to navigate may increase patients’ willingness to participate, especially among those who find learning new technology frustrating. In addition, patients with a history of anxiety, depression, or chronic lung disease may prefer and benefit from expanded telehealth opportunities.
Keywords: Tele-health, Public healthMethods: Secondary analysis of cross-sectional data from the 2024 Health Information National Trends Survey (HINTS 7) completed by U.S. adults. Surveys were done on paper or on the web. Participants were asked, “How willing are you to do a telehealth visit in the future if one is offered to you?” We compared “very willing” vs. all other responses (somewhat willing, somewhat unwilling, and very unwilling). Using logistic regression models, univariable and multivariable associations were assessed between very willing to do a telehealth visit and demographic characteristics, various medical conditions, frequency of internet use, perceived search skills to find needed health information on the internet, confidence in filling out medical forms, frustration with learning to use new technology, lack of reliable transportation, and type of work hours (none, part-time, or full-time). After excluding participants with missing data for any study variable, the analytical sample size was 5,782. Odds ratios and 95% confidence intervals are reported.
Results: In this sample, 39% were very willing to do a telehealth visit if offered one. In the multivariable model, higher odds of being very willing to do a telehealth visit were found in those who were 35-49 years old (vs. 18-34), a college graduate (vs. not), very confident in filling out medical forms (vs. somewhat, a little, or not at all), agreed to having search skills to find needed health information on the internet (vs. disagreed), a history of anxiety or depression (vs. not), or a history of chronic lung disease (vs. not). In contrast, participants who agreed that learning how to use new technology is frustrating (vs. disagreed) had lower odds of being very willing to do a telehealth visit.
Conclusion: Making telehealth visits user-friendly and easy to navigate may increase patients’ willingness to participate, especially among those who find learning new technology frustrating. In addition, patients with a history of anxiety, depression, or chronic lung disease may prefer and benefit from expanded telehealth opportunities.
Authors:
Author - Navreet Singh, MPH, Wayne State University
Co-Author - Aisha Langford, Wayne State University
Co-Author - Nancy Buderer, MS, Nancy Buderer Consulting, LLC
A Machine Learning Based Predictive Model for Identifying Extreme Weight Management Behaviors (EWMB) in Emerging Adult Women
Poster Number: C76Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Weight Related Health
Background: Extreme weight management behaviors (EWMB)—including diet pill use, self-induced vomiting, laxative use, and diuretic use for weight control—are early signs of eating disorders. These behaviors are linked to serious physical and psychological harm. EWMB is rising globally and has become more prevalent in societies shaped by sociocultural ideals that favor thinness and by media-driven appearance pressure. Correcting the risky lifestyle choice of EWMB is central to preventive health, highlighting the growing importance of predicting their determinants and intervening proactively. This study aimed to develop and evaluate a machine learning (ML) model to predict high-risk EWMB groups among emerging adult women.
Methods: We conducted a secondary analysis of data from a national cross-sectional survey (n=1,594). From 62 candidate variables, 29 were selected through t-tests, Chi-square tests, recursive feature elimination (RFE), and theoretical relevance. Six algorithms were compared: Random Forest, Gradient Boosting, XGBoost, Elastic Net, SVM, and Shallow Neural Network. Label noise filtering and 5-fold cross-validation enhanced robustness. Data imbalance was addressed using SMOTE variants, and hyperparameters were optimized via grid search. Performance was evaluated with AUROC, AUPRC, accuracy, precision, recall, specificity, F1-score, and NPV. Model interpretability was assessed using SHAP(SHapley Additive exPlanations).
Results: EWMB prevalence was 36.97%, including 34.2% for diet drug use, 5.6% for self-induced vomiting, 1.4% for laxative use, and 1.6% for diuretic use. Random Forest (no resampling) showed best performance (AUROC = 0.718, F1 = 0.623, Recall = 0.818). Key predictors included weight-related self-stigma, BMI, thin-ideal internalization, appearance-related pressure from significant others, and perceived body shape (overweight).
Conclusion: These findings suggest EWMB risk arises not only from physiological indicators like BMI but also from complex psychological and socio-cultural influences. The ML model developed in this study demonstrates the potential for early identification of high-risk individuals. This predictive approach may inform future interventions and serve as a foundation for personalized digital health tools targeting EWMB.
Keywords: Weight control, Health behaviorsMethods: We conducted a secondary analysis of data from a national cross-sectional survey (n=1,594). From 62 candidate variables, 29 were selected through t-tests, Chi-square tests, recursive feature elimination (RFE), and theoretical relevance. Six algorithms were compared: Random Forest, Gradient Boosting, XGBoost, Elastic Net, SVM, and Shallow Neural Network. Label noise filtering and 5-fold cross-validation enhanced robustness. Data imbalance was addressed using SMOTE variants, and hyperparameters were optimized via grid search. Performance was evaluated with AUROC, AUPRC, accuracy, precision, recall, specificity, F1-score, and NPV. Model interpretability was assessed using SHAP(SHapley Additive exPlanations).
Results: EWMB prevalence was 36.97%, including 34.2% for diet drug use, 5.6% for self-induced vomiting, 1.4% for laxative use, and 1.6% for diuretic use. Random Forest (no resampling) showed best performance (AUROC = 0.718, F1 = 0.623, Recall = 0.818). Key predictors included weight-related self-stigma, BMI, thin-ideal internalization, appearance-related pressure from significant others, and perceived body shape (overweight).
Conclusion: These findings suggest EWMB risk arises not only from physiological indicators like BMI but also from complex psychological and socio-cultural influences. The ML model developed in this study demonstrates the potential for early identification of high-risk individuals. This predictive approach may inform future interventions and serve as a foundation for personalized digital health tools targeting EWMB.
Authors:
Author - Hyemi Sun, M.Ed, RN, College of Nursing, Yonsei University
Presenter - Hyeonkyeong Lee, PhD, RN, FAAN, College of Nursing, Yonsei University
Co-Author - Jisu Lee, PhD, RN, College of Nursing, Yonsei University
Co-Author - Chaehyeon Kang, MSN, RN, College of Nursing, Yonsei University
Social Media and Food Content: A Qualitative Exploration of Black/African American Young Adult Women's Experiences
Poster Number: C77Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Diet, Nutrition, and Eating Disorders
Background: Young adult (ages 18-25) Black/African American women often view social media content that can help or hinder their initiation and maintenance of health-promoting behaviors, including healthy eating. However, no previous research to our knowledge has explored how they view food content on social media and how it influences their food choices.
Objective: The aims of the current study were to (1) explore young Black/African American women’s perspectives on and experiences with food-related content on social media, (2) understand influences on young Black/African American women’s choices to cook meals and recipes they encounter on social media, and (3) gather feedback on potential future intervention strategies to promote healthy eating.
Methods: Black/African American young adult women participated in semi-structured interviews via Zoom. Interviews explored their use of food content on social media, perspectives on example social media food posts, opinion of social media food influencers including racial and cultural inclusivity, and gathered their feedback on future intervention strategies. Interviews were recorded, transcribed verbatim, and analyzed for emerging themes using conventional content analysis.
Results: Participants (N=14) had a mean age of 22.4 years and BMI of 28.5 kg/m2. Many participants (57.1%) reported seeing food content on their social media feeds several times a day, mostly on TikTok (81.8%), Instagram (63.6%), and YouTube (45.5%). Several themes were developed including Lifestyle Considerations; Inspiration/Variety; and Cultural Influences. Participants shared that social media is a helpful source of food inspiration and a tool for meal planning when meal ideas are easily adaptable around lifestyle factors and taste preferences. They also found content is most useful when it is educational, trustworthy, and culturally diverse. Additionally, many participants were skeptical about social media influencers making health claims and disliked posts promoting diet culture and advertisements. Participants felt the proposed intervention strategies would be valuable and provided suggestions for preferred features.
Conclusions: Social media has potential as a tool to influence food choices, and the creation of a personalized social-media-based intervention to promote healthful eating was appealing to participants. Results will inform a future intervention design tailored to Black/African American young adult women’s preferences.
Keywords: Diet, Minority healthObjective: The aims of the current study were to (1) explore young Black/African American women’s perspectives on and experiences with food-related content on social media, (2) understand influences on young Black/African American women’s choices to cook meals and recipes they encounter on social media, and (3) gather feedback on potential future intervention strategies to promote healthy eating.
Methods: Black/African American young adult women participated in semi-structured interviews via Zoom. Interviews explored their use of food content on social media, perspectives on example social media food posts, opinion of social media food influencers including racial and cultural inclusivity, and gathered their feedback on future intervention strategies. Interviews were recorded, transcribed verbatim, and analyzed for emerging themes using conventional content analysis.
Results: Participants (N=14) had a mean age of 22.4 years and BMI of 28.5 kg/m2. Many participants (57.1%) reported seeing food content on their social media feeds several times a day, mostly on TikTok (81.8%), Instagram (63.6%), and YouTube (45.5%). Several themes were developed including Lifestyle Considerations; Inspiration/Variety; and Cultural Influences. Participants shared that social media is a helpful source of food inspiration and a tool for meal planning when meal ideas are easily adaptable around lifestyle factors and taste preferences. They also found content is most useful when it is educational, trustworthy, and culturally diverse. Additionally, many participants were skeptical about social media influencers making health claims and disliked posts promoting diet culture and advertisements. Participants felt the proposed intervention strategies would be valuable and provided suggestions for preferred features.
Conclusions: Social media has potential as a tool to influence food choices, and the creation of a personalized social-media-based intervention to promote healthful eating was appealing to participants. Results will inform a future intervention design tailored to Black/African American young adult women’s preferences.
Authors:
Author - Francesca Wilkins, MS, University of Florida
Co-Author - Megan McVay, PhD, University of Florida
Co-Author - Danielle Jake-Schoffman, PhD, University of Florida
#BoostYourShot: Addressing Vaccine Hesitancy in Philadelphia through a community-engaged social marketing campaign
Poster Number: C78Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Community Engagement
Background: Vaccine hesitancy remains a significant barrier to achieving public health goals, particularly among communities with high levels of mistrust. Building on preliminary research that identified key factors influencing COVID-19 booster vaccine hesitancy, our study developed and piloted the community-engaged “Boost Your Shot” social marketing campaign to increase uptake in the 19134 zip code in Philadelphia, which has low rates of booster uptake and is primarily minority and low income.
Methods: Formative work included qualitative interviews (n=30) and surveys (n=119) with adults in the area who had received the initial COVID-19 vaccines but not been boosted. A six- month multi-layered campaign in English and Spanish was then co-created and implemented with community partners (e.g. community development organizations, FQHCs). Occurring from February through July, 2024, the campaign included participating in local events, working with community health workers, distributing campaign materials via traditional and community partner communication channels, and utilizing traditional and social media. To evaluate the campaign's impact, we recruited a cohort (n=77) of adults who had not previously been boosted and surveyed them three times.
Results: The campaign reached over 5000 households through face-to-face education and material distribution and 130,000 people through media channels. We attended 33 community events, distributing materials in English and Spanish. 36% of the evaluation cohort reported getting a booster during the campaign, twice the city average. For those who did not get boosted, a statistically significant increase in intent to get boosted was found at end of the campaign (p=.04). There was also significant change in how participants characterized themselves, moving from “I will never be boosted” to “I will get boosted” (p=.02). Significant changes in attitudes about getting vaccinated were also observed and believed susceptibility to getting COVID-19 in the future was significantly increased (p=.006). Most agreed that the campaign made them more aware of why they should get boosted and that it is important.
Conclusions: This study demonstrates the impact of a community-engaged, targeted social marketing campaign to reduce vaccine hesitancy and increase COVID-19 booster uptake. Engaging communities is key to establishing trust and ensuring messaging is tailored to a population’s specific needs.
Keywords: Health communication, Community interventionMethods: Formative work included qualitative interviews (n=30) and surveys (n=119) with adults in the area who had received the initial COVID-19 vaccines but not been boosted. A six- month multi-layered campaign in English and Spanish was then co-created and implemented with community partners (e.g. community development organizations, FQHCs). Occurring from February through July, 2024, the campaign included participating in local events, working with community health workers, distributing campaign materials via traditional and community partner communication channels, and utilizing traditional and social media. To evaluate the campaign's impact, we recruited a cohort (n=77) of adults who had not previously been boosted and surveyed them three times.
Results: The campaign reached over 5000 households through face-to-face education and material distribution and 130,000 people through media channels. We attended 33 community events, distributing materials in English and Spanish. 36% of the evaluation cohort reported getting a booster during the campaign, twice the city average. For those who did not get boosted, a statistically significant increase in intent to get boosted was found at end of the campaign (p=.04). There was also significant change in how participants characterized themselves, moving from “I will never be boosted” to “I will get boosted” (p=.02). Significant changes in attitudes about getting vaccinated were also observed and believed susceptibility to getting COVID-19 in the future was significantly increased (p=.006). Most agreed that the campaign made them more aware of why they should get boosted and that it is important.
Conclusions: This study demonstrates the impact of a community-engaged, targeted social marketing campaign to reduce vaccine hesitancy and increase COVID-19 booster uptake. Engaging communities is key to establishing trust and ensuring messaging is tailored to a population’s specific needs.
Authors:
Author - Sarah Bass, PhD, MPH, FSBM, Temple University
Co-Author - Katie Singley, MPH, Temple University Risk Communication Lab
Co-Author - Caseem Luck, M.S., Temple University College of Public Health
Co-Author - Gwen Collier-Jefferson, New Kensington Community Development Corporation
Co-Author - Stasia Monteiro, HACE Community Development Corporation
Co-Author - Jingwei Wu, PhD, Temple University
Co-Author - Arianna Vacio, MS, Temple University
Co-Author - Lolade Kola-Adewuyi, Temple University
Co-Author - Alexandru-Mircea Rotaru, MPH, Temple University
Co-Author - Kirsten Paulus, PhD, MPH, Temple University
Co-Author - Omari Coker, Temple University
Co-Author - Molly Piacentini, Temple University
Co-Author - Yuki Inuzuka, Temple University
Co-Author - Zachary Dean, Temple University
Co-Author - Heather Gardiner, PhD, MPH, Temple University
When Patients Know More: The Burden of Patient Advocacy on Healthcare
Poster Number: C79Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Health Disparities
As Internet access expands, seeking online health information is a commonplace practice. This may allow patients to have a better understanding of their medical conditions and options than do their providers, creating a burden on patients to educate their providers to access proper care. We have termed this phenomenon the “burden of patient advocacy.” While patients’ negative experiences with providers may be shaped by discrimination or bias, our focus is on situations where negative interactions occur primarily due to provider knowledge gaps rather than discriminatory behavior. Thus, we examine here whether the frequency of and/or emotional responses to this experience are associated with healthcare outcomes, and whether such associations occur independent of related constructs such as healthcare discrimination. Participants were adults with a chronic health condition (N = 202; Mage = 42 (13.5); 48% female). Participants completed a survey that included the Burden of Patient Advocacy Scale (including Frequency and Emotionality subscales), Discrimination in Medical Settings and healthcare outcomes. Participants also completed an open-ended question describing a time in which they felt they needed to educate their healthcare provider about their health condition. Regression analyses were conducted predicting healthcare outcomes from Frequency and Emotionality in Step 1 and adding in relevant covariates in Step 2. Regression analyses indicated that the Emotionality of having to educate health care providers, but not the Frequency, was associated with worse perception of treatment outcomes (-0.26, p < .001), willingness to seek care from the same healthcare provider (-0.41, p < .0001) or for the same health condition (-0.40, p < .0001), and greater desire to seek a new healthcare provider (0.36, p < .0001), even when controlling for health care discrimination and sociodemographic factors. Additional analyses revealed that high-arousal emotional responses (e.g., anger, frustration) predicted health outcomes, whereas low-arousal emotions (e.g., feeling dismissed, hopeless) did not. Understanding this phenomenon is crucial for chronic health patients, as it might represent a unique barrier to seeking continuing care that has been previously unexplored.
Keywords: Health communication, Chronic illnessAuthors:
Presenter - Charlie Coward, University of California, Merced
Co-Presenter - Jennifer Howell, University of California, Merced
Co-Presenter - Deborah Wiebe, University of California, Merced
Longitudinal Changes in Parental Reasons for HPV Vaccine Declination and Predictors of Secondary Acceptance
Poster Number: C8Time: 05:00 PM - 05:50 PM
Topics: Cancer, Decision Making
Introduction. Parental declination of human papillomavirus (HPV) vaccination is higher than for other recommended vaccines, resulting in low coverage and missed opportunities for cancer prevention. We sought to characterize how parents’ reasons for HPV vaccine declination changed over time and correlated with secondary acceptance (vaccination after declination).
Methods. Between February 2022 and October 2024, we recruited 211 parents who declined HPV vaccination for their 11–17-year-old child in Pennsylvania. Parents enrolled in a 12-month longitudinal survey, completing 5 surveys at 3-month intervals. Surveys assessed reasons for declining HPV vaccine (thirteen reasons were aggregated into six categories), provider vaccine communication practices, opinion of providers, and secondary acceptance. We used logistic regression to assess correlates of secondary acceptance.
Results. At baseline, the main reasons for declining HPV vaccine related to vaccine safety/side effects (39%), knowledge/attitudes (18%), inconsistent provider recommendation (15%), child not being sexually active (13%), personal autonomy (8%), and child characteristics (7%). Throughout the study, reasons for vaccine declination decreased in each category except personal autonomy, which remained stable. The largest decreases were in safety/side effect (baseline=39%, 12 months=28%) and inconsistent provider recommendation (baseline=15%, 12 months=5%). Overall, 27% of parents reported secondary acceptance of HPV vaccination within 12 months. In multivariable analysis, parents who reported more than one concern at baseline (OR=0.37, 95% CI:0.14, 0.95), self-reported same or higher level of knowledge about HPV vaccination as their child’s provider (OR=0.35, 95% CI:0.11, 0.95), and had a child aged 12-17 years (OR=0.24, 95% CI:0.09, 0.58) had lower odds of secondary acceptance. Conversely, parents whose children had received all other recommended vaccines had six times the odds (OR=5.95, 95% CI:2.33, 16.40) of secondary acceptance.
Conclusion. This longitudinal research provides a nuanced understanding of HPV vaccine declination as dynamic rather than fixed decisions, suggesting that continued communication and engagement with parents may yield significant increases in HPV vaccine uptake through secondary acceptance.
Keywords: Prevention, Primary careMethods. Between February 2022 and October 2024, we recruited 211 parents who declined HPV vaccination for their 11–17-year-old child in Pennsylvania. Parents enrolled in a 12-month longitudinal survey, completing 5 surveys at 3-month intervals. Surveys assessed reasons for declining HPV vaccine (thirteen reasons were aggregated into six categories), provider vaccine communication practices, opinion of providers, and secondary acceptance. We used logistic regression to assess correlates of secondary acceptance.
Results. At baseline, the main reasons for declining HPV vaccine related to vaccine safety/side effects (39%), knowledge/attitudes (18%), inconsistent provider recommendation (15%), child not being sexually active (13%), personal autonomy (8%), and child characteristics (7%). Throughout the study, reasons for vaccine declination decreased in each category except personal autonomy, which remained stable. The largest decreases were in safety/side effect (baseline=39%, 12 months=28%) and inconsistent provider recommendation (baseline=15%, 12 months=5%). Overall, 27% of parents reported secondary acceptance of HPV vaccination within 12 months. In multivariable analysis, parents who reported more than one concern at baseline (OR=0.37, 95% CI:0.14, 0.95), self-reported same or higher level of knowledge about HPV vaccination as their child’s provider (OR=0.35, 95% CI:0.11, 0.95), and had a child aged 12-17 years (OR=0.24, 95% CI:0.09, 0.58) had lower odds of secondary acceptance. Conversely, parents whose children had received all other recommended vaccines had six times the odds (OR=5.95, 95% CI:2.33, 16.40) of secondary acceptance.
Conclusion. This longitudinal research provides a nuanced understanding of HPV vaccine declination as dynamic rather than fixed decisions, suggesting that continued communication and engagement with parents may yield significant increases in HPV vaccine uptake through secondary acceptance.
Authors:
Author - William Calo, PhD, JD, MPH, Penn State College of Medicine
Presenter - Alexander Caine , MPH, Penn State College of Medicine
Co-Author - Chelsea Bufalini, MPH, Penn State College of Medicine
Co-Author - Parth Shah, PhD, PharmD, Fred Hutch Cancer Center
Co-Author - Ben Fogel, MD, Penn State College of Medicine
Co-Author - Mack Ruffin , MD, Penn State College of Medicine
Co-Author - Jen Kraschnewski, MD, Penn State College of Medicine
Co-Author - Bernice Hausman, PhD, Penn State College of Medicine
Co-Author - Jennifer Moss, PhD, Penn State College of Medicine
Co-Author - Joel Segel, PhD, Penn State University
Co-Author - Erika Christiansen, MPH, Penn State College of Medicine
Addressing Skepticism of Personalized Cancer Risk Information among Black Women
Poster Number: C80Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Cancer
Purpose: Breast cancer risk models can provide women with breast cancer risk information tailored to their individual risk factors, but women often react to these estimates with skepticism. Black women are disproportionately affected by breast cancer and their reactions to personalized cancer risk information are understudied. We examined Black women’s skepticism of risk estimates generated using the Gail model breast cancer risk calculator.
Methods: Black women aged 39-74 were recruited for an online survey (April-May 2025). Participants completed the Gail model, were presented with their personal 10-year risk, and informed if their risk was lower, higher, or about the same as women in the general population. They were then asked what they thought their personal risk was and their responses were categorized as: 1) over-estimator: believing their actual risk was higher than the estimate, 2) under-estimator: believing their actual risk was lower, and 3) acceptor: believing their actual risk was the same. Participants completed measures of emotional responding, whether their estimate conflicted with healthcare distrust, past health information, and sociodemographic factors (e.g., health literacy, education). Multinomial logistic regression models determined how different psychological and sociodemographic factors predicted risk skepticism using acceptors as the reference category.
Results: 694 participants were included in analyses (mean age: 55.8 years). Both over- (18%) and under-estimators (51%) were more likely than acceptors (31%) to express healthcare distrust, feel their risk estimate conflicted with past health information, desire a different risk estimate, and express less relief in their risk estimate (all p<0.01). Over-estimators (but not under-estimators) were more likely than acceptors to have a family history of breast cancer, express anxiety and anger toward their risk estimate, and have lower health literacy (all p<.01). Under-estimators (but not over-estimators) were less likely than acceptors to have a regular doctor (p<.05).
Conclusions: Many Black women were skeptical of their personalized breast cancer risk. Several putative mechanisms may explain this skepticism, including healthcare distrust, emotional responses to the estimate, feeling the estimate conflicted with other health information, and having a family history of breast cancer. Interventions are needed to support Black women's personalized risk-based screening decisions.
Keywords: Cancer risk perceptions, Cancer screeningMethods: Black women aged 39-74 were recruited for an online survey (April-May 2025). Participants completed the Gail model, were presented with their personal 10-year risk, and informed if their risk was lower, higher, or about the same as women in the general population. They were then asked what they thought their personal risk was and their responses were categorized as: 1) over-estimator: believing their actual risk was higher than the estimate, 2) under-estimator: believing their actual risk was lower, and 3) acceptor: believing their actual risk was the same. Participants completed measures of emotional responding, whether their estimate conflicted with healthcare distrust, past health information, and sociodemographic factors (e.g., health literacy, education). Multinomial logistic regression models determined how different psychological and sociodemographic factors predicted risk skepticism using acceptors as the reference category.
Results: 694 participants were included in analyses (mean age: 55.8 years). Both over- (18%) and under-estimators (51%) were more likely than acceptors (31%) to express healthcare distrust, feel their risk estimate conflicted with past health information, desire a different risk estimate, and express less relief in their risk estimate (all p<0.01). Over-estimators (but not under-estimators) were more likely than acceptors to have a family history of breast cancer, express anxiety and anger toward their risk estimate, and have lower health literacy (all p<.01). Under-estimators (but not over-estimators) were less likely than acceptors to have a regular doctor (p<.05).
Conclusions: Many Black women were skeptical of their personalized breast cancer risk. Several putative mechanisms may explain this skepticism, including healthcare distrust, emotional responses to the estimate, feeling the estimate conflicted with other health information, and having a family history of breast cancer. Interventions are needed to support Black women's personalized risk-based screening decisions.
Authors:
Co-Presenter - Ashley Housten, OTD, MSCI, Washington University School of Medicine
Co-Presenter - Channing Tate, PhD, MPH, University of Colorado Anschutz
Co-Author - Erika Waters, PhD, MPH, FSBM, Washington University School of Medicine
Co-Author - Jennifer Taber, PhD, Kent State University
Co-Author - Carmin Lewis, MD, MPH, University of Colorado School of Medicine
Co-Author - Heather Smyth, PhD, Colorado School of Public Health
Co-Author - Guannan Shen, MS, University of Colorado School of Medicine
Co-Author - Laura Scherer, PhD, University of Colorado, Anschutz Medical Campus
A Policy Index Examining Policies to Combat Vaccination Hesitancy Across Varying Socioeconomic, Racial, and Geographic Communities
Poster Number: C81Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Health Disparities
Mobile Integrated Health-Community paramedicine (MIH-CP) is a novel approach to reducing the geographic and sociodemographic vaccination disparities. Traditional paramedics provide emergency care and transport to hospitals. As physician extenders, community paramedics have an expanded role that includes clinical follow-up to established care plans and wraparound services that address the social determinants of health. However, policies regulating their administration and scope of work are inconsistent. We created a comprehensive policy index of the 50 states in the U.S. examining MIH-CP policies, rules, and regulations regarding administration/quality assurance, funding, and workforce development/education. Overall, very few states explicitly codified policies for MIH-CP administration and when they did, the policies tended to be vague. For example, Delaware designed an MIH-CP administration policy but the wording of the policy only, “Acknowledges the importance of Mobile Integrated Health and Community Paramedicine and encourages stakeholders to collaborate and support its expansion” without funding, authority, or accountability specifications. Education requirements varied, with most states not formally enacting policies to standardize education for MIH-CPs. However, some states have explicit requirements, including Arkansas, which requires MIH-CPs fulfill all of the requirements of EMTs, as well as completing a community paramedic training program from an accredited college or university approved by the department of health and a minimum number of hours of classroom training. Funding for MIH-CP programs generally relies on a patchwork of grant funding, rather than formal appropriation of funds from state or local governments, potentially limiting program longevity and hindering expansion of services. Analysis of this policy index demonstrates the inconsistent nature with which MIH-CP programs are regulated. Future research will provide insight as to the implementation and administration of MIH-CP programs and examine whether more robust programs are associated with reduced vaccination disparities within each state.
Keywords: Policy, Public healthAuthors:
Presenter - Monica Kasting, PhD, Purdue University
Co-Author - Megan Davish, Purdue University
Co-Author - Bukola Usidame, Purdue University
Co-Author - Gregory Zimet, PhD, Indiana University
Co-Author - Laura Schwab Reese, Purdue University
Insights into young women’s social media sharing behaviors: Recommendations for public health campaigns
Poster Number: C82Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Women's Health
Background: Public health messages must compete for people’s attention on social media, and engagement is crucial for messages to reach desired audiences and achieve intended effects. Young women’s rationale for sharing content on social media remains under-researched. Understanding these motivations is essential for informing the design of public health campaigns that incentivize sharing and align with young women’s content preferences. Therefore, we assessed young women’s self-reported social media sharing behaviors (one form of engagement) and the characteristics of the content they reported sharing.
Methods: Using social media and local advertising, we recruited women aged 18-25 across five states to participate in virtual focus groups. Focus groups asked participants to reflect on social media content they engage with and describe the purpose of their social media sharing behaviors. We transcribed focus group recordings, inductively coded transcripts, and analyzed data thematically. The analysis focused on the types of content participants did or did not share and the motivations driving their sharing engagement.
Results: Participants (n=41) across 7 focus groups described message features that would motivate or disincentivize sharing on social media. Participants expressed that they would share content that was relatable, in their preferred format (i.e., videos, posts, etc.), and/or was consistent with current trends. Negative emotional tone, unappealing aesthetics, and inauthentic depictions of young women were content features that disincentivized sharing. The primary motivations for sharing were to make someone laugh and to disseminate new information. Soliciting opinions, helpful content, and alternatives for behaviors drove social media sharing to a lesser extent.
Conclusion: Findings demonstrate that young women have a variety of incentives motivating sharing on social media, which may not align with the content of some public health campaigns. Public health campaigns can address this misalignment by integrating the target audience’s perspectives into the message design process. Employing strategic communication strategies can drive organic content promotion and shape campaign design. For example, public health campaigns can highlight the novelty of information with message features (i.e., format, aesthetics) to encourage sharing and achieve wider reach of campaign messages.
Keywords: Health communication, InternetMethods: Using social media and local advertising, we recruited women aged 18-25 across five states to participate in virtual focus groups. Focus groups asked participants to reflect on social media content they engage with and describe the purpose of their social media sharing behaviors. We transcribed focus group recordings, inductively coded transcripts, and analyzed data thematically. The analysis focused on the types of content participants did or did not share and the motivations driving their sharing engagement.
Results: Participants (n=41) across 7 focus groups described message features that would motivate or disincentivize sharing on social media. Participants expressed that they would share content that was relatable, in their preferred format (i.e., videos, posts, etc.), and/or was consistent with current trends. Negative emotional tone, unappealing aesthetics, and inauthentic depictions of young women were content features that disincentivized sharing. The primary motivations for sharing were to make someone laugh and to disseminate new information. Soliciting opinions, helpful content, and alternatives for behaviors drove social media sharing to a lesser extent.
Conclusion: Findings demonstrate that young women have a variety of incentives motivating sharing on social media, which may not align with the content of some public health campaigns. Public health campaigns can address this misalignment by integrating the target audience’s perspectives into the message design process. Employing strategic communication strategies can drive organic content promotion and shape campaign design. For example, public health campaigns can highlight the novelty of information with message features (i.e., format, aesthetics) to encourage sharing and achieve wider reach of campaign messages.
Authors:
Co-Presenter - Anne O'Regan, BA, Northwestern University
Co-Presenter - Alina Majid, MPH, Northwestern University
Co-Author - Courtney Scherr, PhD, FSBM, Northwestern University
Co-Author - Kerstin Kalke, MA, PhD, Northwestern University
Co-Author - Savanna Kerstiens, MA, Northwestern University
Co-Author - Prudence Kunyanga, MS, Michigan State University
Co-Author - Carrie Stehman, MA, University of Wisconsin – Madison
Co-Author - Karolin Wadie, MPH, Rutgers University
Co-Author - Elsa Alvarado, BA, The Ohio State University
Co-Author - Lauren Long, MA, The Ohio State University
Co-Author - Kelly Hirko, PhD, MPH, Michigan State University
Co-Author - Noelle LoConte, MD, University of Wisconsin – Madison
Co-Author - Andrea Villanti, PhD, MPH, Rutgers University
Co-Author - Darren Mays, PhD, MPH, The Ohio State University
Warning label messages about the cancer risk associated with alcohol: Effects of causal language
Poster Number: C83Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Decision Making
Background: Alcohol is a known carcinogen of at least seven types of cancer. A need exists for raising public awareness of this fact, but there is a lack of consensus on the appropriate language that will accomplish this goal. Highlighting causal certainty (e.g., alcohol consumption causes cancer, vs. alcohol consumption is may cause cancer) is one method, but it is not fully understood how such differences affect perceptions of certainty about the alcohol-cancer relationship.
Objective: To investigate the effects of causal language in warning messages about alcohol and cancer risk.
Methods: In an online factorial experiment conducted in 2023, 799 US adults were randomly assigned to view one of eight messages employing different combinations of causal verbs (e.g., “causes”) and modal verbs (e.g., “may”) to describe the alcohol-cancer relationship. Analyses compared the effects of causal language on perceptions of causal certainty, alcohol-related cancer risk, message credibility, message reactance, and alcohol consumption intentions.
Results: Causal language did not affect perceived causal certainty, perceived cancer risk, or alcohol consumption intentions, but decreased perceived message credibility and increased reactance. Modal language decreased perceived causal certainty and cancer risk, increased perceived credibility of messages containing “causes,” and decreased reactance to all messages.
Conclusions: Causal language in alcohol warning messages has complex, countervailing effects: higher-certainty causal verbs do not increase risk perceptions but increase negative reactance, whereas high-uncertainty modal verbs decrease risk perceptions but also reactance. These results suggest causal language may pose potential tradeoffs for risk communication efforts, raising the need for caution and more research to understand its effects.
Keywords: Cancer risk perceptions, Health communicationObjective: To investigate the effects of causal language in warning messages about alcohol and cancer risk.
Methods: In an online factorial experiment conducted in 2023, 799 US adults were randomly assigned to view one of eight messages employing different combinations of causal verbs (e.g., “causes”) and modal verbs (e.g., “may”) to describe the alcohol-cancer relationship. Analyses compared the effects of causal language on perceptions of causal certainty, alcohol-related cancer risk, message credibility, message reactance, and alcohol consumption intentions.
Results: Causal language did not affect perceived causal certainty, perceived cancer risk, or alcohol consumption intentions, but decreased perceived message credibility and increased reactance. Modal language decreased perceived causal certainty and cancer risk, increased perceived credibility of messages containing “causes,” and decreased reactance to all messages.
Conclusions: Causal language in alcohol warning messages has complex, countervailing effects: higher-certainty causal verbs do not increase risk perceptions but increase negative reactance, whereas high-uncertainty modal verbs decrease risk perceptions but also reactance. These results suggest causal language may pose potential tradeoffs for risk communication efforts, raising the need for caution and more research to understand its effects.
Authors:
Presenter - Jackelyn Payne, PhD, MPH, National Cancer Institute
Co-Author - Jacob Rohde, PhD, MPH, University of Connecticut
Co-Author - Carlos Garrido, PhD, MS, MPH, National Institute on Minority Health and Health Disparities
Co-Author - Emma Jesch, PhD, MPH, National Cancer Institute
Co-Author - William Klein, PhD, National Cancer Institute
Co-Author - David Berrigan, PhD MPH, NCI
Co-Author - Richard Moser, PhD, National Cancer Institute
Co-Author - Paul Han, MD, MA, MPH, National Cancer Institute
Integrating AI into the Co-Design Process to Develop Social Media Messages about Alcohol and Cancer Risk: Opportunities and Limitations
Poster Number: C84Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Cancer
Background: Co-design is a recommended approach for developing relevant and engaging social media messages to promote behavior change, particularly for young adults. Due to time and resource constraints, co-design often results in the creation of low-fidelity artifacts (e.g., sketches, storyboards) that are adopted to produce high-fidelity interventions. Advances in generative AI may be a promising tool to help develop high-fidelity artifacts during the co-design process. We synthesize our experience and participant responses to the use of generative AI in the co-design of social media images to increase awareness among young adult women of the link between alcohol and breast cancer.
Methods: Women 18-25 years were recruited to participate in focus groups through social media and local ads in five states with among the highest prevalence of past-month alcohol consumption. Between May and July 2024, seven co-design focus groups (n=41) occurred over Zoom. Focus groups lasted on average 53 minutes, were transcribed, and three team members inductively coded transcripts and analyzed the data using thematic analysis.
Results: Participants' responses to AI-generated images acknowledged that AI was an imperfect tool. Sometimes, AI exceeded their expectations by producing more impactful images than they had imagined. Sometimes, AI missed the intent, as when the images seemed to promote rather than discourage alcohol consumption. As a research team, we found that generating prompts required significant trial and error, and that images lacked racial, ethnic, and body diversity. At the time, the technology was limited to static imagery, and participants desired dynamic content. Despite these limitations, we produced, on average, 25 images per focus group, making generative AI an efficient tool for receiving feedback in a short amount of time.
Conclusion: Some of the discussions were prompted by a mismatch (good or bad) between participants' intentions and the AI-generated content. It is unlikely that these would have occurred using traditional co-design practices. The use of generative AI in co-design to create high-fidelity prototypes in real-time can aid the research process by rapidly producing higher-fidelity images and generating a wider range of feedback compared to standard co-design practices. More research is needed to determine if this is beneficial to the overall co-design process. Note: Grammarly was used to edit and refine this abstract.
Keywords: Health communication, MethodologyMethods: Women 18-25 years were recruited to participate in focus groups through social media and local ads in five states with among the highest prevalence of past-month alcohol consumption. Between May and July 2024, seven co-design focus groups (n=41) occurred over Zoom. Focus groups lasted on average 53 minutes, were transcribed, and three team members inductively coded transcripts and analyzed the data using thematic analysis.
Results: Participants' responses to AI-generated images acknowledged that AI was an imperfect tool. Sometimes, AI exceeded their expectations by producing more impactful images than they had imagined. Sometimes, AI missed the intent, as when the images seemed to promote rather than discourage alcohol consumption. As a research team, we found that generating prompts required significant trial and error, and that images lacked racial, ethnic, and body diversity. At the time, the technology was limited to static imagery, and participants desired dynamic content. Despite these limitations, we produced, on average, 25 images per focus group, making generative AI an efficient tool for receiving feedback in a short amount of time.
Conclusion: Some of the discussions were prompted by a mismatch (good or bad) between participants' intentions and the AI-generated content. It is unlikely that these would have occurred using traditional co-design practices. The use of generative AI in co-design to create high-fidelity prototypes in real-time can aid the research process by rapidly producing higher-fidelity images and generating a wider range of feedback compared to standard co-design practices. More research is needed to determine if this is beneficial to the overall co-design process. Note: Grammarly was used to edit and refine this abstract.
Authors:
Presenter - Courtney Scherr, PhD, Northwestern University
Co-Author - Kerstin Hundal, PhD, Northwestern University
Co-Author - Hoda Fakhari, 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
Higher Rates of Lung Cancer Screening Discussions in 2024 than 2022: Medical and Behavioral Predictors of Patient-Clinician Conversations
Poster Number: C85Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Cancer
Background: Lung cancer screening with low-dose CT (LDCT) reduces mortality and has been recommended by the USPSTF since 2013. The 2021 guidelines expanded eligibility to adults aged 50-80 with ≥20 pack-years who currently smoke or quit within 15 years. Cancer screening was disrupted during the COVID-19 pandemic, and fewer adults reported discussing lung cancer screening with clinicians in 2022 than before 2020. It is unclear whether discussions have rebounded post-pandemic or now potentially exceed pre-2020 levels, given expanded eligibility.
Purpose: We tested the pre-registered hypothesis that a higher proportion of screening-eligible adults in 2024 (vs. 2022) would report discussing lung cancer screening and examined whether medical and behavioral factors predicted these discussions.
Method: We analyzed a subsample (n = 2,147; weighted n = 68,227,775) of adults from HINTS 2022 and 2024 who were aged 50-80, reported current or former smoking, and did not have lung cancer. Multivariate logistic regression examined survey year (2024 vs. 2022) as a predictor of patient-clinician discussions (yes/no). We also evaluated whether smoking, chronic lung conditions, insurance, and family history predicted screening discussions, controlling for age, sex, race, education, income, and sexual orientation.
Results: Reported lung cancer screening discussions were significantly higher in 2024 (15.8%) than in 2022 (9.9%), OR = 1.83, p = .011, 95% CI [1.15, 2.91]. Participants who reported current (vs. former) smoking were 4.95 times more likely to discuss lung cancer screening (p < .001, 95% CI [2.61, 8.40]). Those with insurance coverage were 7.31 times more likely (p = .001, 95% CI [2.18, 24.44] and those with >1 chronic lung condition were 2.76 times more likely (p = .001, 95% CI [1.54, 4.93]). Family history was not associated with screening discussions (p = .964).
Conclusions: Lung cancer screening discussions were higher in 2024 than in 2022, suggesting a rebound in preventive care services post-COVID and possibly increased clinician awareness of the revised guidelines. Outreach is needed to increase discussions among adults who are uninsured, formerly smoked, or have no chronic lung conditions to ensure equitable access to lung screening among those eligible. Future research should explore strategies to increase patient-clinician discussions and evaluate whether the content and quality of these discussions promotes patient engagement and screening uptake.
Keywords: Screening, CancerPurpose: We tested the pre-registered hypothesis that a higher proportion of screening-eligible adults in 2024 (vs. 2022) would report discussing lung cancer screening and examined whether medical and behavioral factors predicted these discussions.
Method: We analyzed a subsample (n = 2,147; weighted n = 68,227,775) of adults from HINTS 2022 and 2024 who were aged 50-80, reported current or former smoking, and did not have lung cancer. Multivariate logistic regression examined survey year (2024 vs. 2022) as a predictor of patient-clinician discussions (yes/no). We also evaluated whether smoking, chronic lung conditions, insurance, and family history predicted screening discussions, controlling for age, sex, race, education, income, and sexual orientation.
Results: Reported lung cancer screening discussions were significantly higher in 2024 (15.8%) than in 2022 (9.9%), OR = 1.83, p = .011, 95% CI [1.15, 2.91]. Participants who reported current (vs. former) smoking were 4.95 times more likely to discuss lung cancer screening (p < .001, 95% CI [2.61, 8.40]). Those with insurance coverage were 7.31 times more likely (p = .001, 95% CI [2.18, 24.44] and those with >1 chronic lung condition were 2.76 times more likely (p = .001, 95% CI [1.54, 4.93]). Family history was not associated with screening discussions (p = .964).
Conclusions: Lung cancer screening discussions were higher in 2024 than in 2022, suggesting a rebound in preventive care services post-COVID and possibly increased clinician awareness of the revised guidelines. Outreach is needed to increase discussions among adults who are uninsured, formerly smoked, or have no chronic lung conditions to ensure equitable access to lung screening among those eligible. Future research should explore strategies to increase patient-clinician discussions and evaluate whether the content and quality of these discussions promotes patient engagement and screening uptake.
Authors:
Co-Author - Timothy Williamson, PhD, MPH, Loyola Marymount University
Co-Author - Whitney Brymwitt, BA, MA, Loyola Marymount University
Exploring Discrimination in Transgender and Gender Nonbinary (TGNB) Individuals with Disabilities: A Narrative Review
Poster Number: C86Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Mental Health
Objective: Discrimination is a well-documented driver of health inequities, yet the unique forms it takes for transgender and gender nonbinary (TGNB) individuals with disabilities remain largely understudied. We conducted a narrative review that ynthesizes and critiques the limited empirical research at this intersection.
Method: Systematic searches of Academic Search Complete, APA PsycInfo, PubMed, SocIndex, and Web of Science identified 10 peer-reviewed empirical studies meeting inclusion criteria (peer-reviewed, empirical research with full text availability in English) . Studies varied in methodology, sample composition, and operationalization of disability.
Results: Discrimination was documented across healthcare, education, social services, and community contexts, manifesting as stigma, microaggressions, overt harassment, ableism, cisgenderism, and heterosexism. Neurodevelopmental disabilities, particularly autism spectrum disorder, were most frequently represented. Intersectional patterns emerged, with TGNB individuals with disabilities facing compounded exclusion, heightened vulnerability to violence, and systemic barriers to care not typically experienced by those with only one marginalized identity.
Conclusion: Discrimination toward TGNB people with disabilities is pervasive, multifaceted, and uniquely shaped by intersecting systems of cisgenderism and ableism. Yet empirical work remains sparse, often constrained by small samples, inconsistent disability definitions, and lack of longitudinal designs. Future research should adopt intersectional, community-engaged, and mixed-methods approaches to illuminate these experiences and inform culturally responsive policies and interventions. This review underscores the urgent need to center TGNB people with disabilities in discrimination and health disparities research.
Keywords: Disparities, Minority groupsMethod: Systematic searches of Academic Search Complete, APA PsycInfo, PubMed, SocIndex, and Web of Science identified 10 peer-reviewed empirical studies meeting inclusion criteria (peer-reviewed, empirical research with full text availability in English) . Studies varied in methodology, sample composition, and operationalization of disability.
Results: Discrimination was documented across healthcare, education, social services, and community contexts, manifesting as stigma, microaggressions, overt harassment, ableism, cisgenderism, and heterosexism. Neurodevelopmental disabilities, particularly autism spectrum disorder, were most frequently represented. Intersectional patterns emerged, with TGNB individuals with disabilities facing compounded exclusion, heightened vulnerability to violence, and systemic barriers to care not typically experienced by those with only one marginalized identity.
Conclusion: Discrimination toward TGNB people with disabilities is pervasive, multifaceted, and uniquely shaped by intersecting systems of cisgenderism and ableism. Yet empirical work remains sparse, often constrained by small samples, inconsistent disability definitions, and lack of longitudinal designs. Future research should adopt intersectional, community-engaged, and mixed-methods approaches to illuminate these experiences and inform culturally responsive policies and interventions. This review underscores the urgent need to center TGNB people with disabilities in discrimination and health disparities research.
Authors:
Author - Steph Cull, M.S., Virginia Commonwealth University
Co-Author - Eric Benotsch, PhD, Virginia Commonwealth University
Co-Author - Paige Nurkin, Virginia Commonwealth University
Co-Author - Foster Mardigian, Virginia Commonwealth University
Co-Author - Jackie Otieno, Virginia Commonwealth University
Co-Author - Regina Easter, Virginia Commonwealth University
Exploring Predictors of Depressive Symptom Improvement in Hispanic Adults with Epilepsy After a Culturally Tailored Telehealth Intervention: Implications for Health Equity
Poster Number: C87Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Mental Health
Introduction: People with epilepsy have significantly higher depressive symptoms compared to the general population. Depression in this population is associated with lower quality of life, higher seizure frequency, greater perceived stigma and a lack of social support. Reports show a higher depression prevalence and limited access to treatment resources among Hispanic adults with epilepsy vs. non-Hispanic whites. To address this need we adapted Project UPLIFT, a telehealth depression self-management program developed for adults with epilepsy, for the Hispanic population. Our trial found greater depression remission at 6 months in UPLIFT vs. usual care (UC). The goal of this analysis is to identify predictors of improvement in depressive symptoms among Hispanic adults with epilepsy who participated in UPLIFT.
Methods: English and Spanish-speaking Hispanic adults with epilepsy and elevated depressive symptoms (n=72) were enrolled from three epilepsy clinics in New York City. Participants completed the PHQ9, demographic and medical history surveys and were randomized to UPLIFT or UC. We used linear regression analysis to identify predictors of 6-month change in PHQ9 scores in the UPLIFT arm. Hypothesized predictors were age, gender, language of intervention delivery, recruitment clinic, income, seizures in the past month, and session completion. Covariates were baseline PHQ9, antidepressant medication use, and intervention cohort.
Results: UPLIFT participants (n=36) were 47±11 years old and 72% were female. Most chose to participate in Spanish (67%). Independent predictors of greater 6-month PHQ9 reduction were male gender (B=3.635, p=0.037) and recruitment clinic (B=-5.048, p=0.039; participants from Bellevue Hospital and Lutheran Family Health Center improved more than those from the NYU Comprehensive Epilepsy Center).
Conclusion: We found that age and social determinants such as language and income did not predict treatment response, suggesting broad relevance of UPLIFT for Hispanic adults with epilepsy. Greater improvements in depressive symptoms were seen among men and patients from epilepsy clinics that primarily serve uninsured and minority populations. These findings suggest that tailored behavioral interventions may support health equity by addressing the need for mental health resources for diverse individuals with epilepsy. Future research with Hispanic communities beyond New York City is key to understanding generalizability of these results.
Keywords: Diversity, EpilepsyMethods: English and Spanish-speaking Hispanic adults with epilepsy and elevated depressive symptoms (n=72) were enrolled from three epilepsy clinics in New York City. Participants completed the PHQ9, demographic and medical history surveys and were randomized to UPLIFT or UC. We used linear regression analysis to identify predictors of 6-month change in PHQ9 scores in the UPLIFT arm. Hypothesized predictors were age, gender, language of intervention delivery, recruitment clinic, income, seizures in the past month, and session completion. Covariates were baseline PHQ9, antidepressant medication use, and intervention cohort.
Results: UPLIFT participants (n=36) were 47±11 years old and 72% were female. Most chose to participate in Spanish (67%). Independent predictors of greater 6-month PHQ9 reduction were male gender (B=3.635, p=0.037) and recruitment clinic (B=-5.048, p=0.039; participants from Bellevue Hospital and Lutheran Family Health Center improved more than those from the NYU Comprehensive Epilepsy Center).
Conclusion: We found that age and social determinants such as language and income did not predict treatment response, suggesting broad relevance of UPLIFT for Hispanic adults with epilepsy. Greater improvements in depressive symptoms were seen among men and patients from epilepsy clinics that primarily serve uninsured and minority populations. These findings suggest that tailored behavioral interventions may support health equity by addressing the need for mental health resources for diverse individuals with epilepsy. Future research with Hispanic communities beyond New York City is key to understanding generalizability of these results.
Authors:
Author - Stefany De Brito, BS, NYU Grossman School of Medicine
Co-Author - Leydi Payano, MS, NYU Grossman School of Medicine
Co-Author - Jacqueline Montesdeoca, MPH, NYU Grossman School of Medicine
Co-Author - Laura Diaz, MPH, NYU Grossman School of Medicine
Co-Author - Amy Jongeling, MD PhD, NYU Grossman School of Medicine
Co-Author - Blanca Vazquez, MD, NYU Grossman School of Medicine
Co-Author - Daniel Friedman, MD, MSc, NYU Grossman School of Medicine
Co-Author - Orrin Devinsky, MD, NYU Grossman School of Medicine
Co-Author - Tanya Spruill, PhD, NYU Grossman School of Medicine
Feasibility and baseline characteristics of the on-going Integrated Activity and Nutrition Study among underserved school-aged children
Poster Number: C89Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Diet, Nutrition, and Eating Disorders
Background: Summer poses increased obesity risks and potential learning loss for children affected by poverty, largely due to limited access to structured nutrition and physical activity (PA) programs. Lutein, a plant-derived antioxidant found in green leafy vegetables, has been associated with enhanced cognitive function across age groups. However, no randomized controlled trials have evaluated summer interventions combining PA with lutein-rich foods in underserved children. This study describes the protocol of the ongoing Integrated Child Activity and Nutrition (ICAN) study and provides a descriptive analysis of the current participants.
Methods: This waitlist randomized controlled trial enrolled children aged 6-11 years from households eligible for Supplemental Nutrition Assistance Program (SNAP) for an eight-week summer intervention (June-August 2025) at an elementary school in Bloomington, IL. The program ran every weekday (8:30 AM to 3:30 PM) and included approximately two hours of academic lessons, two hours of nutrition education, and two and one-half hours of structured PA. Daily snacks provided at least 6mg lutein per day through whole-food recipes such as egg spinach quiche, green smoothies, and egg bites. Skin and macular carotenoids (i.e. macular pigment optical density or MPOD) were assessed using the Veggie Meter® and heterochromatic flicker photometry, respectively. Cardiorespiratory fitness was assessed using the Progressive Aerobic Cardiovascular Endurance Run (PACER) test. Height and weight were measured and used to calculate Body Mass Index percentile. Whole-body adiposity was measured using bioelectrical impedance analysis. Control participants will receive the program in the subsequent summer.
Results: The sample consisted of 33 participants (intervention n=27, control n=6) at baseline, with a retention rate of ~82%. Participants (55% male; 8.70±1.48 years) had mean Veggie Meter scores of 238.9±47.3, MPOD of 0.54±0.36, raw PACER scores of 12.5±5.32 laps, and whole-body adiposity of 22.1±12.11%. Nearly half (48%) of the sample had healthy weight, 26% obesity, 16% overweight, and 10% underweight.
Conclusion: This study demonstrates intervention feasibility and is among the few examining skin carotenoid status in children affected by poverty, showing levels higher than previous findings in this population. Findings from this study will be incorporated into the ongoing examination of the intervention effectiveness over three years.
Keywords: Community intervention, Low-incomeMethods: This waitlist randomized controlled trial enrolled children aged 6-11 years from households eligible for Supplemental Nutrition Assistance Program (SNAP) for an eight-week summer intervention (June-August 2025) at an elementary school in Bloomington, IL. The program ran every weekday (8:30 AM to 3:30 PM) and included approximately two hours of academic lessons, two hours of nutrition education, and two and one-half hours of structured PA. Daily snacks provided at least 6mg lutein per day through whole-food recipes such as egg spinach quiche, green smoothies, and egg bites. Skin and macular carotenoids (i.e. macular pigment optical density or MPOD) were assessed using the Veggie Meter® and heterochromatic flicker photometry, respectively. Cardiorespiratory fitness was assessed using the Progressive Aerobic Cardiovascular Endurance Run (PACER) test. Height and weight were measured and used to calculate Body Mass Index percentile. Whole-body adiposity was measured using bioelectrical impedance analysis. Control participants will receive the program in the subsequent summer.
Results: The sample consisted of 33 participants (intervention n=27, control n=6) at baseline, with a retention rate of ~82%. Participants (55% male; 8.70±1.48 years) had mean Veggie Meter scores of 238.9±47.3, MPOD of 0.54±0.36, raw PACER scores of 12.5±5.32 laps, and whole-body adiposity of 22.1±12.11%. Nearly half (48%) of the sample had healthy weight, 26% obesity, 16% overweight, and 10% underweight.
Conclusion: This study demonstrates intervention feasibility and is among the few examining skin carotenoid status in children affected by poverty, showing levels higher than previous findings in this population. Findings from this study will be incorporated into the ongoing examination of the intervention effectiveness over three years.
Authors:
Presenter - Ruyu Liu, PhD, RD, University of Illinois, Urbana-Champaign
Co-Author - Christopher J. Kinder, PhD, University of Illinois, Urbana-Champaign
Co-Author - Emma McCabe, BS, University of Illinois, Urbana-Champaign
Co-Author - Shelby Keye Cerna, PhD, University of Illinois, Urbana-Champaign
Co-Author - Emily Jones, PhD, Illinois State University
Co-Author - Jessica Aren Madson, PhD, RD, University of Illinois, Urbana-Champaign
Co-Author - Krystal Hodge, PhD, MPH, University of Illinois, Urbana-Champaign
Co-Author - Kevin Andrew Richards, PhD, University of Illinois, Urbana-Champaign
Co-Author - Naiman Khan, PhD, RD, University of Illinois, Urbana-Champaign
Potential mechanisms of CBT for cancer distress (CBT-C): Skill self-efficacy and patient-ranked skill components
Poster Number: C9Time: 05:00 PM - 05:50 PM
Topics: Cancer, Stress
While Cognitive-Behavioral Therapy for cancer distress (CBT-C) has been reported as feasible, acceptable, and clinically effective within a real-world practice setting, potential mechanisms of effectiveness are poorly understood. After completing 5 sessions of CBT-C (10 hour dose), 128 patients were asked to rank 24 components of CBT-C via card sort with the “most useful or helpful” component ranked as #1 (response rate=77%, n=98). They were also asked to complete pre- and post-intervention questionnaires, including the Measure of Current Status A&B (MOCS-A&B, response rate=87%, n=111). The sample is characterized by mixed cancer type, mean age 51.2 yrs, 75% partnered, 90% non-Hispanic white, 86% female, and 16.5 year of education. Patients’ top 10 ranked components were cognitive reappraisal (6.40 mean rank), coping skills training (6.92), recognizing unhelpful thought patterns (7.05), diaphragmatic breathing (7.19), personal values card sort (8.16), understanding the CBT framework (8.76), guided imagery (10.03), recognizing symptoms of stress (10.24), problem-solving (11.96), and progressive muscle relaxation (12.16). CBT-C specific skill self-efficacy ratings yielded large effect sizes for Relaxation (d, 1.07) and Coping Confidence (d, 1.07), and medium effect sizes for Awareness of Tension (d, 0.75) and Assertiveness (0.65). Non-specific therapeutic effect sub-scales yielded medium (Bonding, d 0.56), small (Normalization, d 0.42), and non-significant effects (Feeling Cared For, Downward Comparison). In conclusion, we found alignment between most useful patient-reported tools and measures of skill self-efficacy, with the strongest evidence supporting the significance of training in Cognitive Reappraisal, Coping Skills, Recognizing Unhelpful Thought Patterns, Relaxation Skills, and integration of a Personal Values Card Sort (an Acceptance and Commitment Therapy component) to bolster relevance of and motivation for skill practice. Effects not specific to CBT-C included Bonding and Normalization suggesting the beneficial impact of group-delivery and education on cancer distress as a Normal, Expected, Signficant, and Treatable (NEST) experience among people diagnosed with cancer.
Keywords: Cancer, Evidence basedAuthors:
Presenter - Shawna Ehlers, PhD, Mayo Clinic
Co-Author - Janae Kirsch, PhD, Mayo Clinic
Co-Author - Elizabeth Kacel, PhD, Rush University
Co-Author - Luca Hanvey, PhD, Mayo Clinic
Co-Author - Carrie Bronars, PhD, Mayo Clinic
Co-Author - Sherrie Hanna, MA, Mayo Clinic
Co-Author - Jill Snuggerud, MS, Mayo Clinic
Co-Author - Deanna Hofschulte, CCRP, Mayo Clinic
Co-Author - Holly Edwards, MA, Mayo Clinic
Co-Author - Jeffrey Staab, MD, Mayo Clinic
Co-Author - Katharine Price, MD, Mayo Clinic
Co-Author - Andrea Wahner Hendrickson, MD, Mayo Clinic
Co-Author - Kathryn Ruddy, MD, MPH, Mayo Clinic
Assessing Hazardous Drinking and its Demographic Correlates among U.S. Black Young Adults
Poster Number: C90Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Substance Misuse
Background: Alcohol and tobacco use are leading preventable causes of cancer and heart and lung diseases. Also, while national data have found that Black young adults have lower alcohol use prevalence throughout adulthood than other groups, Black individuals experience greater burden of alcohol-related health harms. Few studies have used the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) Scale, a validated screening tool to assess hazardous drinking associated with alcohol-related health harms, among Black young adults susceptible to tobacco use. We assessed alcohol use and demographic correlates to hazardous drinking among Black young adults susceptible to cigarillo smoking.
Methods: We used baseline data from a trial testing cigarillo smoking prevention messaging for Black 18-30-year-olds in April-July 2025. This analysis includes those aged ≥21-years-old (n=183). Participants reported their age (coded as continuous), biological sex (coded as male, female), education (≤ high school, some college/GED, ≥ college degree), employment (coded as employed, unemployed), annual household income (coded as <$75,000, ≥ $75,000), and sexual orientation (coded as heterosexual, gay). Using AUDIT-C, participants reported their frequency (coded as never, ≤monthly, >monthly), intensity (coded as 1-2 drinks, ≥3 drinks on a typical drinking day), and binge drinking (≥6 drinks/occasion; coded as no, yes). We then determined hazardous drinking (coded as yes, no), with scores of ≥4 for men and ≥3 for women. We used descriptive statistics to assess alcohol use behaviors and a multivariable binary logistic regression to examine demographic associations with hazardous drinking.
Results: One-third drank ≤monthly (31.7%) or >monthly (29.5%). About 75.0% drank 1-2 drinks, whereas 25.1% drank 3-10 drinks on a typical day of drinking. About 35.0% binge drank and 29.5% engaged in hazardous drinking. Black young adult males (adjusted odds ratio [AOR]=2.63, 95% confidence intervals [CI]= 1.23, 5.62) and those with some college/GED (vs. (≤ high school; AOR=2.17, 95% CI= 1.04, 4.50) were more likely to drink hazardously.
Discussion: A notable proportion of Black young adults susceptible to cigarillo smoking may also be engaging in harmful alcohol use. Future studies should assess the potential connection between cigar smoking susceptibility and alcohol use for public health strategies and potentially maximize the impact of multiple behavior prevention interventions.
Keywords: Alcohol, PreventionMethods: We used baseline data from a trial testing cigarillo smoking prevention messaging for Black 18-30-year-olds in April-July 2025. This analysis includes those aged ≥21-years-old (n=183). Participants reported their age (coded as continuous), biological sex (coded as male, female), education (≤ high school, some college/GED, ≥ college degree), employment (coded as employed, unemployed), annual household income (coded as <$75,000, ≥ $75,000), and sexual orientation (coded as heterosexual, gay). Using AUDIT-C, participants reported their frequency (coded as never, ≤monthly, >monthly), intensity (coded as 1-2 drinks, ≥3 drinks on a typical drinking day), and binge drinking (≥6 drinks/occasion; coded as no, yes). We then determined hazardous drinking (coded as yes, no), with scores of ≥4 for men and ≥3 for women. We used descriptive statistics to assess alcohol use behaviors and a multivariable binary logistic regression to examine demographic associations with hazardous drinking.
Results: One-third drank ≤monthly (31.7%) or >monthly (29.5%). About 75.0% drank 1-2 drinks, whereas 25.1% drank 3-10 drinks on a typical day of drinking. About 35.0% binge drank and 29.5% engaged in hazardous drinking. Black young adult males (adjusted odds ratio [AOR]=2.63, 95% confidence intervals [CI]= 1.23, 5.62) and those with some college/GED (vs. (≤ high school; AOR=2.17, 95% CI= 1.04, 4.50) were more likely to drink hazardously.
Discussion: A notable proportion of Black young adults susceptible to cigarillo smoking may also be engaging in harmful alcohol use. Future studies should assess the potential connection between cigar smoking susceptibility and alcohol use for public health strategies and potentially maximize the impact of multiple behavior prevention interventions.
Authors:
Presenter - Rebeka Moges, California Polytechnic State University
Co-Author - Lem Phan, MPH, Drexel University
Co-Author - Henri Brignol, BS, Drexel University
Co-Author - Mignonne Guy, PhD, Virginia Commonwealth University
Co-Author - Kymberle Sterling, DrPH, Rutgers University
Co-Author - Jeff Niederdeppe, PhD, MA, Cornell University
Co-Author - Kelvin Choi, PhD, MPH, National Institute on Minority Health and Health Disparities
Co-Author - Lilianna Phan, PhD, MPH, MS, Drexel University
Community Perspectives on Factors Influencing Participation in a Digital Health Trial to Promote HPV Vaccination in the U.S. Vietnamese Population
Poster Number: C91Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Digital Health
Background: The U.S. Vietnamese community experience HPV-related cancer disparities. Despite the increasing adoption of digital health to promote HPV vaccination, U.S. Vietnamese are underrepresented in these studies. We examined community partners’ perspectives on factors impacting U.S. Vietnamese parents’ enrollment in and engagement with digital health interventions for adolescent HPV vaccination to inform culturally relevant strategies and advance equity in cancer prevention.
Methods: This formative work was done to prepare for Project HERO (HPV Education & Resources for the U.S. Vietnamese Population), a factorial trial using digital health to improve HPV vaccination. In 2024, we conducted interviews with Vietnamese parents of adolescents, healthcare providers, and community leaders (n=34). Interviews focused on barriers to, facilitators of, and opportunities to improve community members’ participation in HPV vaccination-related digital health research. We used an inductive thematic analysis approach with four qualitative coders.
Results: Participants valued digital health for its accessibility and wide reach, particularly for those with busy schedules or limited care access. Digital platforms were seen as effective for delivering health knowledge, with videos most preferred, followed by phone calls and text messages. Identified barriers included little familiarity with digital health, difficulty navigating digital tools, language barriers, and fear of scams. Participants also discussed family and cultural dynamics: Receptiveness to digital health is influenced by immigration generations. Many Vietnamese parents relied on their children for health information and decision-making. While Vietnamese parents feel a strong responsibility for their children’s health, preventive care is not prioritized. Actionable strategies to strengthen recruitment and engagement included partnering with trusted community organizations, using popular Facebook groups, providing bilingual materials and culturally concordant staff, designing for those with low digital health literacy, offering financial incentives, appealing to protecting family health, and emphasizing that information offered by the digital health program is endorsed by medical experts.
Discussion: Our findings highlight several strategies that can improve U.S. Vietnamese community members’ participation and engagement in an HPV vaccination-related digital health technologies and research studies.
Keywords: Cancer, Minority healthMethods: This formative work was done to prepare for Project HERO (HPV Education & Resources for the U.S. Vietnamese Population), a factorial trial using digital health to improve HPV vaccination. In 2024, we conducted interviews with Vietnamese parents of adolescents, healthcare providers, and community leaders (n=34). Interviews focused on barriers to, facilitators of, and opportunities to improve community members’ participation in HPV vaccination-related digital health research. We used an inductive thematic analysis approach with four qualitative coders.
Results: Participants valued digital health for its accessibility and wide reach, particularly for those with busy schedules or limited care access. Digital platforms were seen as effective for delivering health knowledge, with videos most preferred, followed by phone calls and text messages. Identified barriers included little familiarity with digital health, difficulty navigating digital tools, language barriers, and fear of scams. Participants also discussed family and cultural dynamics: Receptiveness to digital health is influenced by immigration generations. Many Vietnamese parents relied on their children for health information and decision-making. While Vietnamese parents feel a strong responsibility for their children’s health, preventive care is not prioritized. Actionable strategies to strengthen recruitment and engagement included partnering with trusted community organizations, using popular Facebook groups, providing bilingual materials and culturally concordant staff, designing for those with low digital health literacy, offering financial incentives, appealing to protecting family health, and emphasizing that information offered by the digital health program is endorsed by medical experts.
Discussion: Our findings highlight several strategies that can improve U.S. Vietnamese community members’ participation and engagement in an HPV vaccination-related digital health technologies and research studies.
Authors:
Co-Author - Huyen-Anh Giang, BA, The University of Chicago
Co-Author - Valerie Espinoza, Northwestern University
Co-Author - David Tran, BS, Northwestern University
Co-Author - Ninh Nguyen, BS, Northwestern University
Co-Author - Chau Tran, Northwestern University
Co-Author - Lilian Bui, MD, MPH, Northwestern University
Co-Author - Linh P. Schiffer, Depauw University
Co-Author - Phuong Do, Northwestern University
Co-Author - Eric Adjei Boakye, PhD, MA, Saint Louis University
Co-Author - Heather Brandt, PhD, St. Jude Children's Research Hospital
Co-Author - Jasmin Tiro, PhD, MPH, University of Chicago
Co-Author - Rachel Kornfield, PhD, Northwestern University
Co-Author - Juned Siddique, DrPH, Northwestern University
Co-Author - Ella Berry, BA, Chinese Mutual Aid Association
Co-Author - Sa Tran, Chinese Mutual Aid Association
Co-Author - Emma Macdonald, BA, Chinese Mutual Aid Association
Co-Author - Quoc Tommy Dang, DO, Swedish Medical Group
Co-Author - Anh Quynh Nguyen, MD, The University of Chicago
Co-Author - Namratha Kandula, MD, MPH, Northwestern University
Author - Milkie Vu, PhD, MA, Northwestern University
Micro-costing analysis of a limited interaction mHealth intervention to support HIV PrEP uptake among young sexual minoritized men 17-24 years old
Poster Number: C92Time: 05:00 PM - 05:50 PM
Topics: HIV/AIDS, Implementation Science
Background: Young gay, bisexual, queer, and other sexual minoritized men (YSMM) are disproportionately affected by HIV in the U.S. “OnPOINT” is as limited interaction, person-centered and theory-based mHealth intervention to support sexual wellbeing, HIV testing, and HIV pre-exposure prophylaxis (PrEP) uptake tailored to YSMM 17-24 years old with reported sexual behavior indicating potential benefit of PrEP. We previously found OnPOINT supported increases in self-efficacy and reductions in attitudinal barriers towards HIV self-testing, as well as increases in PrEP uptake. As such, we sought to conduct a costing analysis to support future implementation considerations of OnPOINT.
Methods: In 2024, HIV-negative/status-unknown YSMM not on PrEP (n=118; mean age=21.5; 92.4% cisgender; 66.1% Black, Latino, or multiracial/another) were recruited from social media and men-for-men networking apps to participate in OnPOINT. OnPOINT had an embedded PrEP resource locator and participants were mailed a free HIV self-testing kit; n=2 reported a reactive test result. OnPOINT provided a daily prevention tip to participants over 30 days, with culturally-tailored SMS messages daily to support engagement with OnPOINT. Established micro-costing procedures were used to consider implementation, intervention, and downstream costs as directly measured by the research team. Costs associated with site development and maintenance, online advertising, personnel and effort administering OnPOINT, and HIV self-testing kits with supplies and shipping were used with participant tracking and survey data to determine the following costing metrics: cost per participant enrolled (i.e., reach), cost per HIV test conducted, cost per reactive HIV test result, and incremental cost per PrEP start.
Results: The cost per participant enrolled in OnPOINT was $556. Cost per HIV test completed was $617, and cost per reactive test result was $3,277. The incremental cost per PrEP start was $3,740.
Conclusions: HIV self-testing is considered cost-effective compared to standard, clinic-based testing when policymakers are willing to pay $12,201 (2024 inflation-adjusted USD) for each additional HIV diagnosis identified, indicating OnPOINT was a cost-effective approach to expanding HIV testing while supporting PrEP uptake in tandem among YSMM without a reactive test result.
Keywords: HIV, e-HealthMethods: In 2024, HIV-negative/status-unknown YSMM not on PrEP (n=118; mean age=21.5; 92.4% cisgender; 66.1% Black, Latino, or multiracial/another) were recruited from social media and men-for-men networking apps to participate in OnPOINT. OnPOINT had an embedded PrEP resource locator and participants were mailed a free HIV self-testing kit; n=2 reported a reactive test result. OnPOINT provided a daily prevention tip to participants over 30 days, with culturally-tailored SMS messages daily to support engagement with OnPOINT. Established micro-costing procedures were used to consider implementation, intervention, and downstream costs as directly measured by the research team. Costs associated with site development and maintenance, online advertising, personnel and effort administering OnPOINT, and HIV self-testing kits with supplies and shipping were used with participant tracking and survey data to determine the following costing metrics: cost per participant enrolled (i.e., reach), cost per HIV test conducted, cost per reactive HIV test result, and incremental cost per PrEP start.
Results: The cost per participant enrolled in OnPOINT was $556. Cost per HIV test completed was $617, and cost per reactive test result was $3,277. The incremental cost per PrEP start was $3,740.
Conclusions: HIV self-testing is considered cost-effective compared to standard, clinic-based testing when policymakers are willing to pay $12,201 (2024 inflation-adjusted USD) for each additional HIV diagnosis identified, indicating OnPOINT was a cost-effective approach to expanding HIV testing while supporting PrEP uptake in tandem among YSMM without a reactive test result.
Authors:
Presenter - Steven John, PhD, MPH, University of Minnesota
Co-Author - Andrew O'Neil, MPH, Medical College of Wisconsin
HIV-Related Shame and Alcohol Use Among Men Who Have Sex with Men: The Mediating Role of Posttraumatic Stress Symptoms Related to Being Recently Diagnosed with HIV
Poster Number: C93Time: 05:00 PM - 05:50 PM
Topics: HIV/AIDS, Substance Misuse
Men who have sex with men (MSM) have high rates of alcohol use and are disproportionately affected by HIV. Among individuals living with HIV, alcohol use is associated with reduced antiretroviral therapy adherence and poor treatment outcomes. Although shame has been shown to be associated with alcohol use, no studies have examined the relationship between shame specific to HIV and alcohol use among MSM. Additionally, few studies have examined the psychological mechanisms that underlie the relationship between shame and alcohol use. A potential mechanism could be posttraumatic stress symptoms, which have been associated with both shame and alcohol use. The present study aimed to examine whether posttraumatic stress symptoms related to being recently diagnosed with HIV would mediate the relationship between HIV-related shame and alcohol use among MSM recently diagnosed with HIV. We hypothesized that greater HIV-related shame would be associated with more posttraumatic stress symptoms, which in turn would be associated with greater alcohol use when controlling for age and education. Data came from the baseline assessment of a randomized controlled efficacy trial of a health enhancement and risk reduction intervention targeting MSM recently diagnosed with HIV. Participants (N = 195) were recruited from two community HIV clinics in New York City and completed an audio computer-assisted self-interview. We found that HIV-related shame was positively associated with posttraumatic stress symptoms (b = 1.077, SE = .069, 95% CI = [.941, 1.213]), posttraumatic stress symptoms were positively associated with alcohol use (b = .132, SE = .037, 95% CI = [.060, .204]), and HIV-related shame was positively associated with alcohol use (b = .107, SE = .036, 95% CI = [.036, .178]). When controlling for posttraumatic stress symptoms, HIV-related shame and alcohol use were no longer associated (b = -.035, SE = .053, 95% CI = [-.139, .069]). Furthermore, we found that posttraumatic stress symptoms mediated the relationship between HIV-related shame and alcohol use (indirect effect = .142, SE = .049, 95% CI = [.049, .242]). These findings suggest that posttraumatic stress symptoms related to being recently diagnosed with HIV are a potential intervention target to disrupt the pathway between HIV-related shame and alcohol use, thereby improving health outcomes among MSM recently diagnosed with HIV.
Keywords: HIV, AlcoholAuthors:
Author - Karissa Tran, MA, University of California, Los Angeles
Co-Author - Eric Cortez, MS, MA, University of California, Los Angeles
Co-Author - Manuel Ramirez, MA, University of California, Los Angeles
Co-Author - Nathan Hansen, PhD, University of Georgia
Presenter - Patrick Wilson, PhD, University of California, Los Angeles
PrEP Stigma Experiences Among Primary Care Clients at a Large Health System
Poster Number: C94Time: 05:00 PM - 05:50 PM
Topics: HIV/AIDS, Health Disparities
Introduction: Stigma is a known barrier to PrEP initiation globally. However, stigma as an entity is often difficult to address in meaningful ways. The purpose of this analysis was to examine discrete components of stigma and variation in the way stigma may manifest based on demographic characteristics and PrEP knowledge.
Methods: A cross-sectional survey was conducted with primary care patients (N=273) at a large health system in the midwestern United States. Participating primary care patients were primarily Black (57.9%) or White (25.2%), heterosexual (68.3%), and women (44.6%). 40.6% of the sample had been diagnosed with a sexually transmitted infection in the past year. Regression models were used to examine the association of race/ethnicity, gender, identifying as LGBTQ+, and PrEP knowledge with PrEP stigma. Stigma was measured via three scales measuring intrapersonal stigma (e.g., I would feel ashamed to tell other people that I was taking PrEP), interpersonal stigma (e.g., My sexual partner(s) would approve of me taking PrEP), and PrEP attitudes (e.g., There are easier ways to keep from getting HIV than taking PrEP).
Results: Race/ethnicity (β=.143, SE=.163, p=.031), identifying as LGBTQ+ (β=.201, SE=.171, p=.004), and PrEP knowledge (β=-.134, SE=.066, p=.044) emerged as a significant predictors of intrapersonal PrEP stigma. Identifying as LGBTQ+ (β=-.194, SE=.176, p=.006) and PrEP knowledge (β=-.155, SE=.068, p=.022) were significantly associated with reduced interpersonal PrEP stigma.
Conclusions: While knowledge alone is not sufficient for behavior change, PrEP knowledge was universally associated with reduced concerns of interpersonal and intrapersonal PrEP stigma. Universally increasing PrEP knowledge may positively impact PrEP-related stigma. Specific stigma reduction activities may be needed among people not identifying as LGBTQ+. Similarly, intrapersonal stigma reduction activities may be warranted for those identifying as Black or Latinx.
Keywords: HIV, Health disparitiesMethods: A cross-sectional survey was conducted with primary care patients (N=273) at a large health system in the midwestern United States. Participating primary care patients were primarily Black (57.9%) or White (25.2%), heterosexual (68.3%), and women (44.6%). 40.6% of the sample had been diagnosed with a sexually transmitted infection in the past year. Regression models were used to examine the association of race/ethnicity, gender, identifying as LGBTQ+, and PrEP knowledge with PrEP stigma. Stigma was measured via three scales measuring intrapersonal stigma (e.g., I would feel ashamed to tell other people that I was taking PrEP), interpersonal stigma (e.g., My sexual partner(s) would approve of me taking PrEP), and PrEP attitudes (e.g., There are easier ways to keep from getting HIV than taking PrEP).
Results: Race/ethnicity (β=.143, SE=.163, p=.031), identifying as LGBTQ+ (β=.201, SE=.171, p=.004), and PrEP knowledge (β=-.134, SE=.066, p=.044) emerged as a significant predictors of intrapersonal PrEP stigma. Identifying as LGBTQ+ (β=-.194, SE=.176, p=.006) and PrEP knowledge (β=-.155, SE=.068, p=.022) were significantly associated with reduced interpersonal PrEP stigma.
Conclusions: While knowledge alone is not sufficient for behavior change, PrEP knowledge was universally associated with reduced concerns of interpersonal and intrapersonal PrEP stigma. Universally increasing PrEP knowledge may positively impact PrEP-related stigma. Specific stigma reduction activities may be needed among people not identifying as LGBTQ+. Similarly, intrapersonal stigma reduction activities may be warranted for those identifying as Black or Latinx.
Authors:
Author - DeAnne Turner, PhD, MPH, University of South Florida
Co-Author - McKenzie Berezin , PhD, New York University
Co-Author - Sean Manogue, Henry Ford Health
Co-Author - Jeremy Toney , Henry Ford Health
Co-Author - Elizabeth Lockhart , PhD MPH, Henry Ford Health
From HIV Self-Test to PrEP: A Mixed Methods Study on Peer Navigation and PrEP Linkage Among MSM in Philadelphia
Poster Number: C95Time: 05:00 PM - 05:50 PM
Topics: HIV/AIDS
Background: Linkage to PrEP is critical to maximize the benefits of HIV self-testing (HIVST), an increasingly available modality that can expand test uptake among priority populations. However, PrEP uptake remains low after HIVST, particularly among men who have sex with men (MSM), who account for the majority of new HIV diagnoses in the US. Coupling HIVST with peer navigation may improve PrEP uptake among MSM reluctant to engage in care. We explored how peers could facilitate PrEP linkage among MSM self-testers.
Methods: We conducted a sequential mixed-methods study among MSM who had completed an HIV self-test through the Philadelphia Department of Public Health. To be eligible, MSM had to report being ≥17 years and no prior HIV diagnosis. Participants completed a baseline survey that evaluated preferences for a PrEP linkage navigator using Likert scales and a 30-day follow-up survey to determine if they had linked to care. We then purposively sampled MSM who had and had not seen a provider after self-testing, for semi-structured interviews. Interviews explored HIV prevention experiences and navigator preferences and were analyzed using thematic analysis.
Results: Between October 2022 and March 2024, a total of 84 MSM were enrolled in the study. The median age was 28, 31% were Black, and 23% were Latinx. In quantitative data, the most important characteristics of a linkage navigator were having formal medical training (mean 3.85, SD 1.35), similar sexual orientation (mean 3.23, SD 1.51), and prior experience with PrEP (mean 3.19, SD 1.51). We interviewed a total of 21 MSM, 12 of whom had seen a provider after self-testing. Three qualitative themes emerged in interviews: (1) Knowledge: navigators should understand medical topics, healthcare systems, insurance navigation, and sexual health literacy while addressing PrEP misconceptions; (2) Communication: non-judgmental, culturally sensitive, easily accessible navigators available via text/phone were important; (3) and LGBTQ competence: understanding LGBTQ identities, and discrimination experiences was valued over shared lived experience. Low perceived risk was common among those who did not link to care.
Conclusions: Peer navigators can support PrEP linkage after HIVST by leveraging medical knowledge, effective communication skills, and LGBTQ cultural competence. Participants highly valued sexual health literacy. These insights can inform interventions to improve PrEP uptake after HIVST.
Keywords: HIV, PreventionMethods: We conducted a sequential mixed-methods study among MSM who had completed an HIV self-test through the Philadelphia Department of Public Health. To be eligible, MSM had to report being ≥17 years and no prior HIV diagnosis. Participants completed a baseline survey that evaluated preferences for a PrEP linkage navigator using Likert scales and a 30-day follow-up survey to determine if they had linked to care. We then purposively sampled MSM who had and had not seen a provider after self-testing, for semi-structured interviews. Interviews explored HIV prevention experiences and navigator preferences and were analyzed using thematic analysis.
Results: Between October 2022 and March 2024, a total of 84 MSM were enrolled in the study. The median age was 28, 31% were Black, and 23% were Latinx. In quantitative data, the most important characteristics of a linkage navigator were having formal medical training (mean 3.85, SD 1.35), similar sexual orientation (mean 3.23, SD 1.51), and prior experience with PrEP (mean 3.19, SD 1.51). We interviewed a total of 21 MSM, 12 of whom had seen a provider after self-testing. Three qualitative themes emerged in interviews: (1) Knowledge: navigators should understand medical topics, healthcare systems, insurance navigation, and sexual health literacy while addressing PrEP misconceptions; (2) Communication: non-judgmental, culturally sensitive, easily accessible navigators available via text/phone were important; (3) and LGBTQ competence: understanding LGBTQ identities, and discrimination experiences was valued over shared lived experience. Low perceived risk was common among those who did not link to care.
Conclusions: Peer navigators can support PrEP linkage after HIVST by leveraging medical knowledge, effective communication skills, and LGBTQ cultural competence. Participants highly valued sexual health literacy. These insights can inform interventions to improve PrEP uptake after HIVST.
Authors:
Author - Aiyana Williams, BS, University of Pennsylvania
Co-Author - Danny Bracy, MPH, University of Pennsylvania, Perelman School of Medicine
Co-Author - AnnaMarie Otor, BS, University of Pennsylvania, Perelman School of Medicine
Co-Author - Kathleen Brady, MD, Philadelphia Department of Public Health & Perelman School of Medicine at the University of Pennsylvania
Co-Author - Cedric Bien-Gund, MD, MSCE, Perelman School of Medicine at the University of Pennsylvania
Barriers, Facilitators, and Coping Strategies to the Implementation of Health Behavior Interventions for Cancer Prevention in HIV-Positive African Communities: A Scoping Review
Poster Number: C96Time: 05:00 PM - 05:50 PM
Topics: Implementation Science , Multiple Health Behavior Change
Background: People living with HIV (PLHIV) in African countries face elevated cancer risk due to HIV-related factors and lifestyle challenges, including poor weight management (WM), low physical activity (PA), and unhealthy diets. While interventions target these behaviors, little is known about their implementation. This scoping review examined barriers, facilitators, and coping strategies affecting implementation of interventions promoting WM, PA, and healthy eating (HE) among PLHIV in Africa.
Methods: We searched PubMed, Scopus, CINAHL, PsycINFO, and Cochrane Library for studies (2000–2024). Eligible studies included HIV-positive adults in Africa and used randomized or quasi-experimental designs targeting WM, PA, or diet. Barriers and facilitators were categorized using the Socio-Ecological Model (SEM) as Author-Reported (explicitly identified) or Reviewer-Inferred (derived from engagement, dropout, or other implementation details).
Results: We identified 21 studies: 12 PA, six nutrition education, and three combined PA and nutrition, mostly from South Africa and Nigeria. Only two explicitly reported barriers/facilitators, including individual-level (knowledge, self-efficacy), organizational-level (tailored, theory-driven programs, peer/staff support), and community-level barriers (poverty, limited food access, unsafe spaces). In other studies, factors were reviewer-inferred. Individual facilitators included self-efficacy, empowerment, and motivation, while barriers included complex health needs, low literacy, and weak self-monitoring. Interpersonal facilitators included peer/staff support, with inconsistent support as a barrier. Organizational facilitators were culturally tailored, theory-driven interventions with clinic integration, structured follow-up, and incentives; barriers included resource-intensity and logistics. Community facilitators included food access, while barriers included poverty, unsafe spaces, and COVID-19 disruptions. Policy barriers were economic constraints and limited funding. No coping strategies were reported or inferred.
Conclusion: A key gap remains in systematically reporting barriers and facilitators across SEM levels—especially community and policy—and how they are addressed, underscoring the need to integrate implementation perspectives to design effective, sustainable interventions in African countries.
Keywords: Research to practice translation, Behavior ChangeMethods: We searched PubMed, Scopus, CINAHL, PsycINFO, and Cochrane Library for studies (2000–2024). Eligible studies included HIV-positive adults in Africa and used randomized or quasi-experimental designs targeting WM, PA, or diet. Barriers and facilitators were categorized using the Socio-Ecological Model (SEM) as Author-Reported (explicitly identified) or Reviewer-Inferred (derived from engagement, dropout, or other implementation details).
Results: We identified 21 studies: 12 PA, six nutrition education, and three combined PA and nutrition, mostly from South Africa and Nigeria. Only two explicitly reported barriers/facilitators, including individual-level (knowledge, self-efficacy), organizational-level (tailored, theory-driven programs, peer/staff support), and community-level barriers (poverty, limited food access, unsafe spaces). In other studies, factors were reviewer-inferred. Individual facilitators included self-efficacy, empowerment, and motivation, while barriers included complex health needs, low literacy, and weak self-monitoring. Interpersonal facilitators included peer/staff support, with inconsistent support as a barrier. Organizational facilitators were culturally tailored, theory-driven interventions with clinic integration, structured follow-up, and incentives; barriers included resource-intensity and logistics. Community facilitators included food access, while barriers included poverty, unsafe spaces, and COVID-19 disruptions. Policy barriers were economic constraints and limited funding. No coping strategies were reported or inferred.
Conclusion: A key gap remains in systematically reporting barriers and facilitators across SEM levels—especially community and policy—and how they are addressed, underscoring the need to integrate implementation perspectives to design effective, sustainable interventions in African countries.
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 - Marilyn Stern, PhD, University of South Florida
Co-Author - Clement Gwede, PhD, MPH, RN, FSBM, H Lee Moffitt Cancer Center and Research Institute
Making SNAP access snappy: Insights from a qualitative study of California college students
Poster Number: C97Time: 05:00 PM - 05:50 PM
Topics: Implementation Science , Health Communication and Policy
Background: Food insecurity remains a problem for college students, with estimates above 40%. While the Supplemental Nutrition Assistance Program (SNAP) could reduce food insecurity, college student participation remains low due to complex application processes and confusing student-specific eligibility rules. In California, efforts have been made to streamline the student access through policy changes and campus support, however, challenges persist. This mixed-methods study aimed to better understand the student SNAP application process among University of California (UC) undergraduate and graduate students from the student perspective.
Sample: UC undergraduate and graduate students who had applied for SNAP were identified through campus Basic Needs Centers and invited to participate in a mixed-methods study. A total of 30 undergraduate and 28 graduate students (n=58) participated.
Methods: Before focus group discussions, participants completed a brief survey assessing demographics and food security status. We conducted 12 focus groups (6 among undergraduates and graduates separately) across 6 UC campuses between July and October 2024. Transcripts were coded separately by two coders and codes were managed, using Atlas.ti software.
Results: Most participants were cisgender woman (74%), Latino (35%) and Asian (38%), first-generation college students (59%). More than half were food insecure (64%) and receiving SNAP benefits (60%). We identified the following four central themes among graduate and undergraduate students: (1) applying for CalFresh is easier with campus Basic Needs CalFresh support and online tools can help improve the process, (2) SNAP benefits support students’ overall wellbeing, (3) students learned about SNAP from family, peers, and campus networks, and (4) unreliable county communication placed burden on students and delayed potential access to SNAP.
Conclusion: These findings support the effectiveness of campus-based SNAP assistance for college students, demonstrate that SNAP access is beneficial, and reveal ways to improve county-level processes to ensure timely access to benefits. Continued investment in campus Basic Needs programs is essential for increasing SNAP enrollment among students in need of assistance. Lastly, these insights aim to inform policy changes that better connect eligible students to the food assistance required to thrive in higher education.
Keywords: Policy, NutritionSample: UC undergraduate and graduate students who had applied for SNAP were identified through campus Basic Needs Centers and invited to participate in a mixed-methods study. A total of 30 undergraduate and 28 graduate students (n=58) participated.
Methods: Before focus group discussions, participants completed a brief survey assessing demographics and food security status. We conducted 12 focus groups (6 among undergraduates and graduates separately) across 6 UC campuses between July and October 2024. Transcripts were coded separately by two coders and codes were managed, using Atlas.ti software.
Results: Most participants were cisgender woman (74%), Latino (35%) and Asian (38%), first-generation college students (59%). More than half were food insecure (64%) and receiving SNAP benefits (60%). We identified the following four central themes among graduate and undergraduate students: (1) applying for CalFresh is easier with campus Basic Needs CalFresh support and online tools can help improve the process, (2) SNAP benefits support students’ overall wellbeing, (3) students learned about SNAP from family, peers, and campus networks, and (4) unreliable county communication placed burden on students and delayed potential access to SNAP.
Conclusion: These findings support the effectiveness of campus-based SNAP assistance for college students, demonstrate that SNAP access is beneficial, and reveal ways to improve county-level processes to ensure timely access to benefits. Continued investment in campus Basic Needs programs is essential for increasing SNAP enrollment among students in need of assistance. Lastly, these insights aim to inform policy changes that better connect eligible students to the food assistance required to thrive in higher education.
Authors:
Presenter - Suzanna Martinez, PhD, MS, University of California, San Francisco
Co-Author - Sonali Singh, University of California, San Francisco
Co-Author - Nicole Liu, MPH, UC Berkeley
Co-Author - Swetha Thiagarajan, MPH, UC Berkeley
Adaptation of the Theoretical Domains Framework to Measure Psychosocial Constructs Related to Implementing Play Streets
Poster Number: C98Time: 05:00 PM - 05:50 PM
Topics: Implementation Science , Methods and Measurement
Purpose: The Theoretical Domains Framework (TDF) integrates 33 behavior change theories into 14 domains to measure psychosocial constructs affecting behavior (e.g., attitudes, self-efficacy), including implementation behaviors in organizational/clinical settings. Still, adaptation is needed for community settings. This project describes the process of assessing the applicability of, and modifying, the TDF to measure delivery of Play Streets – a community-based intervention involving the temporary closure of streets or activation of public areas to create safe, accessible opportunities for youth and families to engage in active play.
Methods: We conducted a literature review to create an initial pool of 151 items and modified wording to focus on planning and delivery (i.e., doing) of Play Streets. Then, we refined wording to ensure construct alignment and clarity. Next, we sent the scale to experts –four individuals with experience implementing Play Streets and four established, community-based, implementation science researchers– to review clarity, content, and face and construct validity. Feedback was compiled and reviewed alongside TDF definitions to finalize items. Notes on key decisions were recorded.
Results: Following expert review, the domains of social/professional role and identity, optimism and memory, attention, and decision processes were deemed less applicable to implementing Play Streets and excluded, 10 TDF domains remained: knowledge, skills, beliefs about capabilities, beliefs about consequences, reinforcement, intention, behavioral regulation, goals, environmental context and resources, and social influences. Content experts identified four key points. 1) Not all questions applied to both youth and adult implementers, (e.g., having resources to implement). (2) Not all items seemed distinct for planning and doing (e.g., better aligned with both phases). (3) Response options did not match item wording, and some items lacked clarity, prompting revisions. (4) Not all items aligned with domain definitions, resulting in renaming one domain (i.e., “goals” retitled “personal prioritization”) and splitting another into two (i.e., environmental “resources” and “context”).
Conclusion: Adapting existing implementation science measures for community-based programs requires careful thought about the process and contextual implications. Following this review, the TDF measure is ready for feasibility and validity testing with Play Streets implementers.
Keywords: Methods, Community interventionMethods: We conducted a literature review to create an initial pool of 151 items and modified wording to focus on planning and delivery (i.e., doing) of Play Streets. Then, we refined wording to ensure construct alignment and clarity. Next, we sent the scale to experts –four individuals with experience implementing Play Streets and four established, community-based, implementation science researchers– to review clarity, content, and face and construct validity. Feedback was compiled and reviewed alongside TDF definitions to finalize items. Notes on key decisions were recorded.
Results: Following expert review, the domains of social/professional role and identity, optimism and memory, attention, and decision processes were deemed less applicable to implementing Play Streets and excluded, 10 TDF domains remained: knowledge, skills, beliefs about capabilities, beliefs about consequences, reinforcement, intention, behavioral regulation, goals, environmental context and resources, and social influences. Content experts identified four key points. 1) Not all questions applied to both youth and adult implementers, (e.g., having resources to implement). (2) Not all items seemed distinct for planning and doing (e.g., better aligned with both phases). (3) Response options did not match item wording, and some items lacked clarity, prompting revisions. (4) Not all items aligned with domain definitions, resulting in renaming one domain (i.e., “goals” retitled “personal prioritization”) and splitting another into two (i.e., environmental “resources” and “context”).
Conclusion: Adapting existing implementation science measures for community-based programs requires careful thought about the process and contextual implications. Following this review, the TDF measure is ready for feasibility and validity testing with Play Streets implementers.
Authors:
Presenter - Jacqueline Vigil, MPH, CHES, Baylor University
Co-Author - Jacob Szeszulski, PhD, Texas A&M AgriLife Research
Co-Author - Cassandra Beattie, PhD, Texas A&M Agrilife Research
Co-Author - Kendra Marstall, MPH, CHES, Texas A&M AgriLife Research
Co-Presenter - M. Renée Umstattd Meyer, PhD, MCHES, Baylor University
Who is talking about the potential harms of alcohol? Results from two waves of a nationally representative survey
Poster Number: C99Time: 05:00 PM - 05:50 PM
Topics: Implementation Science , Cancer
Background: Alcohol is a risk factor for several negative health outcomes. Healthcare providers have an important role in educating patients about the health effects of alcohol, especially among patients with chronic diseases. A provider’s recommendation is one of the strongest predictors of behavior change, however, the frequency of provider discussions about alcohol needs to be increased. Understanding the characteristics of people who report having a provider initiate a discussion about alcohol can inform patient-provider interventions.
Methods: Two waves of the nationally representative, Health Information National Trends Survey (HINTS) were used to explore correlates of a provider-initiated discussion of the harms of alcohol among adults who had seen a provider in the last year using weighted multivariable logistic regression modeling. Data were collected in 2019 and 2022, and each wave was analyzed separately. Health information (history of cancer, diabetes, high blood pressure, heart disease, or depression, BMI), health behaviors (current drinking, current smoking, current e-cigarette use), and demographics were included as potential correlates. A unified model adjusting for correlates identified as relevant after backwards elimination in either wave was estimated in each wave, providing wave-specific adjusted odds ratios and confidence intervals. The unified model included current drinking, history of diabetes, high blood pressure, heart disease, depression, BMI, age, race, ethnicity, and gender.
Results: In 2019, drinking status, race, ethnicity, and gender were associated with a provider discussion, with identifying as a race other than White being the strongest correlate (aOR: 2.29, 95% CI: 1.50-3.49). In 2022, drinking status, high blood pressure, age, and ethnicity were associated with a provider discussion, with drinking status being the strongest correlate. Specifically, adults reporting heavy drinking had more than 2 times the odds of reporting a provider discussion compared to those who did not drink (aOR: 2.09, 95% CI: 1.35, 3.23).
Discussion: Across two waves of nationally representative data, few correlates of a provider discussion of the harms of alcohol were consistent (drinking status and ethnicity only). Chronic diseases known to be associated with alcohol use were not strong correlates of a discussion, indicating the potential need for clinical interventions targeting improved discussion among these specific groups.
Keywords: Alcohol, Clinical applicationsMethods: Two waves of the nationally representative, Health Information National Trends Survey (HINTS) were used to explore correlates of a provider-initiated discussion of the harms of alcohol among adults who had seen a provider in the last year using weighted multivariable logistic regression modeling. Data were collected in 2019 and 2022, and each wave was analyzed separately. Health information (history of cancer, diabetes, high blood pressure, heart disease, or depression, BMI), health behaviors (current drinking, current smoking, current e-cigarette use), and demographics were included as potential correlates. A unified model adjusting for correlates identified as relevant after backwards elimination in either wave was estimated in each wave, providing wave-specific adjusted odds ratios and confidence intervals. The unified model included current drinking, history of diabetes, high blood pressure, heart disease, depression, BMI, age, race, ethnicity, and gender.
Results: In 2019, drinking status, race, ethnicity, and gender were associated with a provider discussion, with identifying as a race other than White being the strongest correlate (aOR: 2.29, 95% CI: 1.50-3.49). In 2022, drinking status, high blood pressure, age, and ethnicity were associated with a provider discussion, with drinking status being the strongest correlate. Specifically, adults reporting heavy drinking had more than 2 times the odds of reporting a provider discussion compared to those who did not drink (aOR: 2.09, 95% CI: 1.35, 3.23).
Discussion: Across two waves of nationally representative data, few correlates of a provider discussion of the harms of alcohol were consistent (drinking status and ethnicity only). Chronic diseases known to be associated with alcohol use were not strong correlates of a discussion, indicating the potential need for clinical interventions targeting improved discussion among these specific groups.
Authors:
Presenter - Kara Wiseman, MPH, PhD, University of Virginia
Co-Author - J. Wes Kinchen, MPH, University of Virginia
Co-Author - Deepika Suresh, MD, University of Virginia
Co-Author - Neha Rajpal, MD, University of Virginia
Co-Author - Christopher Wheldon, PhD, Temple University College of Public Health
Co-Author - Neeral Shah, MD, University of Virginia
The Impact of Pelvic and Sexual Pain on Romantic Partnerships: A Systematic Review
Poster Number: C118Time: 05:00 PM - 05:50 PM
Topics: Pain
Background: Chronic pelvic pain (CPP) is a disabling condition that affects approximately 15% of women in the United States and contributes to substantial psychological distress, sexual dysfunction, and interpersonal challenges. Although CPP is known to influence intimate relationships, little research has synthesized how partner communication, perceived partner responsiveness (PPR), and attachment dynamics shape relational and sexual well-being among affected couples. This systematic review examined (1) how PPR influences communication, sexual function, and relationship satisfaction, and (2) how attachment styles manifest within couples coping with CPP-related sexual pain.
Methods: A systematic search of PubMed, PsycINFO, and Medline identified peer-reviewed studies published within the past 15 years. Eligible studies included adult participants with at least one CPP condition and assessed romantic or sexual partnerships. Twelve studies met inclusion criteria: eight cross-sectional, two qualitative, and two dyadic daily diary designs.
Results: Most samples consisted of women aged 18–45 diagnosed with provoked vestibulodynia, endometriosis, or vulvar pain; few studies reported race/ethnicity, and none focused on male CPP. Across studies, facilitative and positive PPR—such as validation, emotional support, or collaborative problem-solving—consistently predicted greater sexual satisfaction and relationship quality, though associations with pain severity were inconsistent. Avoidant and anxious attachment styles were common among both patients and partners and were linked to lower sexual function, reduced intimacy, and greater relational distress.
Conclusions: Interventions that enhance disclosure, promote secure attachment, and cultivate supportive partner responses may improve relational and sexual well-being—even when pain symptoms persist. Significant gaps remain regarding diverse populations, male CPP, and longitudinal change. Future research should prioritize inclusive sampling and develop couple-based behavioral interventions targeting relational functioning in the context of CPP.
Keywords: Pain, Sexual functioningMethods: A systematic search of PubMed, PsycINFO, and Medline identified peer-reviewed studies published within the past 15 years. Eligible studies included adult participants with at least one CPP condition and assessed romantic or sexual partnerships. Twelve studies met inclusion criteria: eight cross-sectional, two qualitative, and two dyadic daily diary designs.
Results: Most samples consisted of women aged 18–45 diagnosed with provoked vestibulodynia, endometriosis, or vulvar pain; few studies reported race/ethnicity, and none focused on male CPP. Across studies, facilitative and positive PPR—such as validation, emotional support, or collaborative problem-solving—consistently predicted greater sexual satisfaction and relationship quality, though associations with pain severity were inconsistent. Avoidant and anxious attachment styles were common among both patients and partners and were linked to lower sexual function, reduced intimacy, and greater relational distress.
Conclusions: Interventions that enhance disclosure, promote secure attachment, and cultivate supportive partner responses may improve relational and sexual well-being—even when pain symptoms persist. Significant gaps remain regarding diverse populations, male CPP, and longitudinal change. Future research should prioritize inclusive sampling and develop couple-based behavioral interventions targeting relational functioning in the context of CPP.
Authors:
Presenter - Gabrielle Hettie, MS, University of Connecticut
Examining Artificial Intelligence Chatbots’ Responses in Providing Human Papillomavirus Vaccine Information for Young Adults: Qualitative Content Analysis
Poster Number: C88Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Cancer
Background: The growing use of artificial intelligence (AI) chatbots for seeking health-related information is concerning, as they were not originally developed for delivering medical guidance. The quality of chatbots’ responses relies heavily on their training data and is often compromised in medical contexts due to their lack of specific training data in medical literature. Objectives: This study examined AI chatbots responses to human papillomavirus (HPV)-related questions by analyzing structure, linguistic features, information accuracy and currency, and vaccination stance.
Methods: We conducted a qualitative content analysis to examine four selected AI chatbots (ChatGPT-4, Claude 3.7-Sonnet, DeepSeek-V3, and Docus [General AI Doctor]) responses to HPV vaccine questions. These questions, simulated by young adults, were adapted from items on the Vaccine Conspiracy Beliefs Scale and Google Trends. The selection criteria for AI chatbots included popularity, accessibility, countries of origin, response update methods, and intended use. We used a deductive approach to develop initial code groups, then an inductive approach to generate codes. We also assessed readability using the Flesch-Kincaid Grade Level and Reading Ease Score.
Results: All AI chatbots cited evidence-based sources from reputable health organizations. We found no fabricated information or inaccuracies in numerical data. For complex questions, all AI chatbots appropriately deferred to healthcare professionals’ suggestions. All chatbots maintained a neutral or pro-vaccine stance, corresponding with the scientific consensus. The mean response lengths varied (word count; ChatGPT: 436.4, Claude: 188.0, DeepSeek: 510.0, Docus: 159.4), as did readability (Flesch-Kincaid Grade-Level; ChatGPT: 10.7, Claude: 13.2, DeepSeek:11.3, Docus:12.2). ChatGPT and Claude offered personalized responses, while DeepSeek and Docus lacked this. Occasionally, some responses included broken or irrelevant links and medical jargon.
Conclusion: Amidst an online environment saturated with misinformation, AI chatbots have the potential to serve as alternative sources of accurate HPV-related information to conventional online platforms (websites, social media), though improvements in readability, personalization, and link accuracy are still needed.
Keywords: Cancer, Health communicationMethods: We conducted a qualitative content analysis to examine four selected AI chatbots (ChatGPT-4, Claude 3.7-Sonnet, DeepSeek-V3, and Docus [General AI Doctor]) responses to HPV vaccine questions. These questions, simulated by young adults, were adapted from items on the Vaccine Conspiracy Beliefs Scale and Google Trends. The selection criteria for AI chatbots included popularity, accessibility, countries of origin, response update methods, and intended use. We used a deductive approach to develop initial code groups, then an inductive approach to generate codes. We also assessed readability using the Flesch-Kincaid Grade Level and Reading Ease Score.
Results: All AI chatbots cited evidence-based sources from reputable health organizations. We found no fabricated information or inaccuracies in numerical data. For complex questions, all AI chatbots appropriately deferred to healthcare professionals’ suggestions. All chatbots maintained a neutral or pro-vaccine stance, corresponding with the scientific consensus. The mean response lengths varied (word count; ChatGPT: 436.4, Claude: 188.0, DeepSeek: 510.0, Docus: 159.4), as did readability (Flesch-Kincaid Grade-Level; ChatGPT: 10.7, Claude: 13.2, DeepSeek:11.3, Docus:12.2). ChatGPT and Claude offered personalized responses, while DeepSeek and Docus lacked this. Occasionally, some responses included broken or irrelevant links and medical jargon.
Conclusion: Amidst an online environment saturated with misinformation, AI chatbots have the potential to serve as alternative sources of accurate HPV-related information to conventional online platforms (websites, social media), though improvements in readability, personalization, and link accuracy are still needed.
Authors:
Presenter - Alfu Laily, Purdue University
Co-Author - Laura Schwab-Reese, Purdue University
Co-Author - Megan Davish, Purdue University
Co-Author - Emily Cahue, Purdue University
Co-Author - Kathryn LaRoche, Purdue University
Co-Author - Natalia Rodriguez, Purdue University
Co-Author - Robert Duncan, Colorado State University
Co-Author - Randolph Hubach, Purdue University
Co-Author - Monica Kasting, Purdue University
Examining Emotion Dysregulation in Pregnancy as a Predictor of Postpartum Disordered Eating Attitudes and Behaviors in U.S. Military Active-Duty Service Women
Poster Number: C60Time: 05:00 PM - 05:50 PM
Topics: Military and Veterans' Health, Diet, Nutrition, and Eating Disorders
The postpartum period is a vulnerable time for elevated eating disorder symptoms. However, limited research has examined prospective risk factors for disordered eating attitudes and behaviors during the postpartum period. Emotion dysregulation throughout pregnancy is a robust predictor of postpartum psychological outcomes, and thus may be a relevant predictor of disordered eating attitudes and behaviors. Therefore, the aim of this study was to evaluate the prospective associations of emotion dysregulation during pregnancy with postpartum disordered eating attitudes and behaviors in U.S. military active-duty Service women – a population at particularly high-risk for eating disorder symptoms. Pregnant Service women (N=178; Mage=29.58 years) were recruited between 12- and 27-weeks gestation (second trimester) for a longitudinal, observational study. Participants completed surveys assessing emotion regulation difficulties and disordered eating attitudes and behaviors (dietary restraint, eating concerns, dissatisfaction with weight/shape, and emotional eating) at baseline (second trimester) and postpartum between 6- to 18-weeks after delivery. A series of linear regression models examined prospective associations of second trimester emotion dysregulation with each postpartum disordered eating attitude and behavior variable; analyses adjusted for relevant demographic and health variables, as well as baseline levels of the specified outcome variable, and were corrected for multiple comparisons. Results indicated emotion dysregulation during pregnancy significantly predicted greater disordered eating attitude and behavior outcomes during the postpartum period. Specifically, higher emotion dysregulation scores during pregnancy predicted higher postpartum dietary restraint (β=0.35, p=.002), eating concerns (β=0.40, p<.001), dissatisfaction with weight/shape (β=0.20, p=.04), and emotional eating (β=7.23, p<.001). Overall, findings indicate that greater difficulties with emotion regulation during the second trimester are associated with risk for higher postpartum disordered eating symptoms. Pregnancy is a period of significant physical, neurobiological, and psychological changes that are associated with and may exacerbate difficulties responding to and modulating one’s emotions. As such, therapeutic approaches for improving adaptive emotion regulation skills during pregnancy may have utility in reducing risk for postpartum disordered eating attitudes and behaviors.
Keywords: Women's health, Eating behaviorsAuthors:
Author - Mary Quattlebaum, PhD, Military Cardiovascular Outcomes Research (MiCOR) Program
Co-Author - Zoe Sinkford, B.A., Military Cardiovascular Outcomes Research (MiCOR) Program
Co-Author - Autumn Mains, MSN, RN, Military Cardiovascular Outcomes Research (MiCOR) Program
Co-Author - Stephanie Rioux, BSN, RN, Military Cardiovascular Outcomes Research (MiCOR) Program
Co-Author - Victoria Thomas, B.A., Uniformed Services University
Co-Author - Mark Haigney, M.D, Military Cardiovascular Outcomes Research (MiCOR) Program
Co-Author - David Klein, M.D., David Grant Medical Center
Co-Author - Marian Tanofsky-Kraff, Ph.D., Uniformed Services University
Co-Author - Jason Lavender, PhD, Military Cardiovascular Outcomes Research (MiCOR) Program
Co-Author - Katherine Thompson, PhD, Military Cardiovascular Outcomes Research (MiCOR) Program
Poster Session C
Description
Date: 4/23/2026
Start: 5:00 PM
End: 5:50 PM
Location: Salon D