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Poster Session A
Olive Oil Consumption, Socioeconomic Status, and Cognition among Middle-Aged and Older Latinos
Poster Number: A1Time: 05:00 PM - 05:50 PM
Topics: Aging, Health Disparities
Introduction: Latinos in the U.S. face increased odds of cognitive impairment with age, exacerbated by inequities in socioeconomic status. Olive oil consumption is associated with cognitive health due to its Omega-3 and polyphenol content; however, usability and cognitive effects remain understudied among Latinos.
Purpose: The present study analyzed the associations among cognitive performance, olive oil consumption, and socioeconomic status in middle-aged and older Latinos.
Methods: Participants (n = 50, age = 57 ± 8.4 years, 75% female) who self-identified as Latino completed a cognitive test battery (Stroop, Trail Making, Digit Span, Digit-Symbol, Verbal Fluency, Immediate & Delayed Recall, Card Sorting, Flanker, Pattern Comparison), demographic surveys, anthropometrics, and self-reported preferred cooking oil. A within-sample z-score for global cognition was calculated. A cross-sectional regression analysis was conducted.
Results: Fifty-six percent of participants reported regular olive oil use. Adjusting for age, sex, and body mass index, olive oil was positively associated with better global cognitive performance (β = 2.28, p = 0.039). Adding education and income to the regression model nullified significance. In turn, high school educational attainment was associated with olive oil use (β = 0.53, p < 0.001).
Conclusion: Although olive oil use is positively associated with cognitive performance, socioeconomic inequities may confound effects and use among Latinos. Robust longitudinal analyses and targeted interventions are needed to promote use and analyze long-term effects across socioeconomic status groups. Specifically, increasing access to resources for low socioeconomic status groups for brain-healthy nutrition.
Keywords: Nutrition, LatinoPurpose: The present study analyzed the associations among cognitive performance, olive oil consumption, and socioeconomic status in middle-aged and older Latinos.
Methods: Participants (n = 50, age = 57 ± 8.4 years, 75% female) who self-identified as Latino completed a cognitive test battery (Stroop, Trail Making, Digit Span, Digit-Symbol, Verbal Fluency, Immediate & Delayed Recall, Card Sorting, Flanker, Pattern Comparison), demographic surveys, anthropometrics, and self-reported preferred cooking oil. A within-sample z-score for global cognition was calculated. A cross-sectional regression analysis was conducted.
Results: Fifty-six percent of participants reported regular olive oil use. Adjusting for age, sex, and body mass index, olive oil was positively associated with better global cognitive performance (β = 2.28, p = 0.039). Adding education and income to the regression model nullified significance. In turn, high school educational attainment was associated with olive oil use (β = 0.53, p < 0.001).
Conclusion: Although olive oil use is positively associated with cognitive performance, socioeconomic inequities may confound effects and use among Latinos. Robust longitudinal analyses and targeted interventions are needed to promote use and analyze long-term effects across socioeconomic status groups. Specifically, increasing access to resources for low socioeconomic status groups for brain-healthy nutrition.
Authors:
Author - Christian Corral, MS, University of Illinois Urbana-Champaign
Co-Author - Diana Morales, BS, University of Illinois at Urbana-Champaign
Co-Author - Edgar Munoz, BS, University of Illinois Urbana-Champaign
Co-Author - Susan Aguiñaga, PhD, University of Illinois at Urbana-Champaign
Moderators of a Multidomain Intervention for Cognition in Older Women with Cardiovascular Disease: The MindMoves Trial
Poster Number: A2Time: 05:00 PM - 05:50 PM
Topics: Aging, Physical Activity
Background: In the MindMoves 2x2 factorial design trial (NCT04556305), we tested separate and combined efficacies of computerized cognitive training and lifestyle physical activity interventions on cognition (episodic memory, semantic memory, working memory) and serum neurotrophic biomarkers (BDNF, VEGF, IGF-1, GDF15) in women with cardiovascular disease (CVD), a group at heightened risk for cognitive decline. Here, we evaluated whether selected baseline demographics and health factors moderate the impact of the interventions on cognition and biomarker outcomes.
Methods: Women >65 years with CVD and without baseline cognitive impairment were randomized to: (1) cognitive training (Mind); (2) lifestyle physical activity (Move); (3) combined interventions (MindMoves); or (4) usual care (control). Cognition was assessed with a battery of neuropsychological tests and biomarkers were measured in blood at baseline, 24, 48, and 72 weeks. Potential moderators were demographics (age, education) and health factors (heart failure, atrial fibrillation, diabetes, moderate pain) assessed at baseline. Separate multilevel linear growth models for each outcome and moderator were used to model temporal change as a function of main (Mind, Move) and interaction (Mind x Move) effects. Dichotomous moderators were added, with the terms of interest being the moderation of slopes for the three factorial effects.
Results: Women (N=253) were, on average, 72.4 (65–90) years old, primarily of non-Hispanic White (54%) and Black (38%) racial backgrounds, and 60% graduated college. According to the electronic health record, 12 (4.7%) were diagnosed with heart failure, 50 (19.8%) with atrial fibrillation, 55 (21.7%) with diabetes, and 70 (27.7%) reported >moderate pain at study baseline. Four significant moderated effects were found. Heart failure x Move (p=.006) for semantic memory (increase only for those with heart failure who received Move; p=.002). Heart failure x Mind x Move (p=.022) for GDF15 (decrease only for those with heart failure assigned to MindMoves, p<.001). Atrial fibrillation x Move (p=.001) for IGF-1 (decrease only for those with atrial fibrillation who received Move; p=.002). Diabetes x Mind x Move (p=.007) for working memory (increase only for those without diabetes assigned to Move, p=.007).
Conclusion: Findings were overall mixed, with beneficial moderated effects for semantic memory, GDF15, and working memory as well as negative moderated effects for IGF-1.
Keywords: Randomized controlled trial, Older adultsMethods: Women >65 years with CVD and without baseline cognitive impairment were randomized to: (1) cognitive training (Mind); (2) lifestyle physical activity (Move); (3) combined interventions (MindMoves); or (4) usual care (control). Cognition was assessed with a battery of neuropsychological tests and biomarkers were measured in blood at baseline, 24, 48, and 72 weeks. Potential moderators were demographics (age, education) and health factors (heart failure, atrial fibrillation, diabetes, moderate pain) assessed at baseline. Separate multilevel linear growth models for each outcome and moderator were used to model temporal change as a function of main (Mind, Move) and interaction (Mind x Move) effects. Dichotomous moderators were added, with the terms of interest being the moderation of slopes for the three factorial effects.
Results: Women (N=253) were, on average, 72.4 (65–90) years old, primarily of non-Hispanic White (54%) and Black (38%) racial backgrounds, and 60% graduated college. According to the electronic health record, 12 (4.7%) were diagnosed with heart failure, 50 (19.8%) with atrial fibrillation, 55 (21.7%) with diabetes, and 70 (27.7%) reported >moderate pain at study baseline. Four significant moderated effects were found. Heart failure x Move (p=.006) for semantic memory (increase only for those with heart failure who received Move; p=.002). Heart failure x Mind x Move (p=.022) for GDF15 (decrease only for those with heart failure assigned to MindMoves, p<.001). Atrial fibrillation x Move (p=.001) for IGF-1 (decrease only for those with atrial fibrillation who received Move; p=.002). Diabetes x Mind x Move (p=.007) for working memory (increase only for those without diabetes assigned to Move, p=.007).
Conclusion: Findings were overall mixed, with beneficial moderated effects for semantic memory, GDF15, and working memory as well as negative moderated effects for IGF-1.
Authors:
Author - Folarin Olanrewaju, MSN, APRN, University of Illinois Chicago
Co-Author - Michael Schoeny, Rush University College of Nursing
Co-Author - Lisa Barnes, Rush Alzheimer's Disease Center
Co-Author - Annabelle Santos Volgman, Rush University Medical Center
Co-Author - Susan J. Pressler, Indiana University
Co-Author - Zoe Arvanitakis, Rush Alzheimer's Disease Center
Co-Author - JoEllen Wilbur, Rush University College of Nursing
Author - Shannon Halloway, PHD, RN, FAAN, FAHA, University of Illinois Chicago
UNSTEADY GROUND? CHRONIC CONDITIONS AND BALANCE PERFORMANCE IN U.S. ADULTS: A COMPLEX SAMPLE ANALYSIS OF NHANES 2021-2022
Poster Number: A3Time: 05:00 PM - 05:50 PM
Topics: Aging, Cardiovascular Disease
BACKGROUND: Balance impairment is a significant public health concern affecting millions of US adults and is associated with increased fall risk, functional decline, and mortality. While research has shown that balance function declines with age, limited research has examined how specific chronic conditions may predict balance impairment independent of age. PURPOSE: To examine the association between diabetes and hypertension and balance performance as measured by the Modified Romberg Test among US adults. METHODS: This cross-sectional analysis used data from the 2021–2022 National Health and Nutrition Examination Survey (NHANES). Participants were aged 30–69 years (who completed the final two conditions of the Modified Romberg Test: standing on foam with eyes closed (Condition 4, N = 1879) and standing on foam with eyes closed while moving head (Condition 5, N = 1209). Outcomes included binary pass/fail indicators and time-to-failure (0-30 seconds). The primary predictor was a four-category diabetes-hypertension comorbidity variable (DM_HTN): neither condition, diabetes only, hypertension only, or both conditions. Covariates included age (centered), sex, race/ethnicity, and education. Complex Samples Logistic Regression and General Linear Models were used to account for NHANES sampling design, with interaction terms between DM_HTN and age included in all models. RESULTS: In adjusted logistic regression models, DM_HTN was significantly associated with increased odds of failure only in Condition 5 (F = 8.088, p = 0.003), with significant DM_HTN × age interactions in both conditions (Condition 4: F = 6.250, p = 0.007; Condition 5: F = 4.006, p = 0.032). In linear models, DM_HTN was a significant predictor for both conditions (Condition 4: F = 7.369, p = 0.004; Condition 5: F = 4.011, p = 0.032) and DM_HTN x age interaction only significant at condition 4 (F= 22.466, p <.001). CONCLUSION: This nationally representative study demonstrates that cardiometabolic comorbidity—particularly the combination of diabetes and hypertension—exerts independent effects on balance performance in US adults, with these chronic conditions serving as significant predictors of time-to-failure regardless of age in the most challenging balance condition (Condition 5). These findings support the clinical importance of chronic disease management, as the deleterious effects of such conditions may be intrinsic to the diseases themselves rather than merely an age-dependent phenomena.
Keywords: Aging, Co-morbiditiesAuthors:
Author - Revati Malani, MS, University of Illinois Urbana Champaign
Co-Author - Paige Witte, University of Illinois, Urbana Champaign
Co-Author - Shelby Keye, PhD, University of Illinois, Urbana Champaign
Recall bias affects pain and depression assessment in older adults with multimorbidity
Poster Number: A4Time: 05:00 PM - 05:50 PM
Topics: Aging, Pain
Introduction: Older adults with multimorbidity commonly receive depression and pain management through primary care settings, where symptoms are typically assessed through retrospective recall. However, recall bias for depression and pain has not been explored in older adults with multimorbidity. We examined discrepancies between prospectively measured and recalled symptoms of depression and pain among older adults with multimorbidity.
Methods: We analyzed data from a 14-day ecological momentary assessment (EMA) study of depressed older adults with multimorbidity (N = 18, age range 67 - 95). Depressive symptoms were measured through the PHQ-9, and one item from the PROMIS Pain Intensity scale was used for pain intensity. Descriptive statistics and correlational analyses examined discrepancies between retrospectively assessed depression and pain intensity symptoms over two weeks, compared to prospectively assessed EMA daily data. Baseline characteristics correlated with discrepancies were assessed, as well as the potential of recency effects.
Results: Participants had significant depressive symptoms, with 39% in the moderate-to-severe depression range. Average pain intensity over the past week was high: over half (61%) reported levels in the moderate-to-severe range. We found overreporting across most symptoms, with the largest discrepancies between prospectively recorded and recalled symptom scores for pain intensity and fatigue (d = .49). There was no association between recalled and EMA-measured items for appetite and trouble sleeping. Pain intensity at day 14 was associated with discrepancies in recalled pain (r = -.52, p = .029), and both day 14 mood and negative self-thoughts were associated with discrepancies in trouble concentrating recall (r = -.67, p = .002 and p = -.72, p < .001, respectively)—suggesting recency effects.
Conclusions: This study provides preliminary evidence of recall bias among older adults with multimorbidity, including symptom overreporting and recency effects of pain intensity and depression symptoms. While small on average, some of the discrepancies had medium effect sizes, such as for pain intensity—with a difference equivalent to 3.3 points on the 0-10 pain intensity visual analogue scale. Given the reliance on recall during healthcare encounters in busy primary care settings for this population, further research is needed to establish the magnitude of symptom recall discrepancies in larger samples.
Keywords: Multi-morbidity, AgingMethods: We analyzed data from a 14-day ecological momentary assessment (EMA) study of depressed older adults with multimorbidity (N = 18, age range 67 - 95). Depressive symptoms were measured through the PHQ-9, and one item from the PROMIS Pain Intensity scale was used for pain intensity. Descriptive statistics and correlational analyses examined discrepancies between retrospectively assessed depression and pain intensity symptoms over two weeks, compared to prospectively assessed EMA daily data. Baseline characteristics correlated with discrepancies were assessed, as well as the potential of recency effects.
Results: Participants had significant depressive symptoms, with 39% in the moderate-to-severe depression range. Average pain intensity over the past week was high: over half (61%) reported levels in the moderate-to-severe range. We found overreporting across most symptoms, with the largest discrepancies between prospectively recorded and recalled symptom scores for pain intensity and fatigue (d = .49). There was no association between recalled and EMA-measured items for appetite and trouble sleeping. Pain intensity at day 14 was associated with discrepancies in recalled pain (r = -.52, p = .029), and both day 14 mood and negative self-thoughts were associated with discrepancies in trouble concentrating recall (r = -.67, p = .002 and p = -.72, p < .001, respectively)—suggesting recency effects.
Conclusions: This study provides preliminary evidence of recall bias among older adults with multimorbidity, including symptom overreporting and recency effects of pain intensity and depression symptoms. While small on average, some of the discrepancies had medium effect sizes, such as for pain intensity—with a difference equivalent to 3.3 points on the 0-10 pain intensity visual analogue scale. Given the reliance on recall during healthcare encounters in busy primary care settings for this population, further research is needed to establish the magnitude of symptom recall discrepancies in larger samples.
Authors:
Author - Irina Mindlis, PhD, MPH, Rutgers University
Co-Author - M. Carrington Reid, MD, PhD, Weill Cornell Medicine
Co-Author - Thomas L. Rodebaugh, PhD, University of North Carolina-Chapel Hill
Cognitive Outcomes of Informal Caregivers: A Systematic Review of the Literature
Poster Number: A5Time: 05:00 PM - 05:50 PM
Topics: Aging, Social and Environmental Context and Health
Informal caregivers play a vital role in supporting individuals with health conditions such as cognitive impairment. The cognitive health of caregivers has become a focus of recent research, as the demand for caregiving continues to rise with increasing rates of dementia and other cognitive health disorders. There are competing theories about whether the act of caregiving worsens or preserves cognitive functioning for the caregiver, and what characteristics might predict these differing outcomes. Thirty-three studies met criteria for inclusion in this systematic review that synthesizes the current literature on objective and subjective measures of cognitive health of caregivers compared to non-caregivers, both cross-sectionally and longitudinally. Additionally, this review characterizes the study designs and samples included in this body of research. Results show that caregivers often perform worse than non-caregivers in tasks of executive functioning, while findings across other cognitive domains are mixed and inconsistent. Wide heterogeneity in study methods and caregiver samples was observed and described. Notably, more recent work, as well as studies using population-based controls, tended to report no differences or better cognitive performance among caregivers. Controlling for depression and health behaviors frequently accounted for differences in cognitive functioning between caregivers and non-caregivers. The findings suggest that interventions that target modifiable risk factors such as depression, health behaviors, and caregiver burden might mitigate some of the negative cognitive consequences of caregiving. Longitudinal investigations would be greatly beneficial.
Keywords: Caregiving, Cognitive factorsAuthors:
Author - Iris Yang, M.A., Southern Methodist University
Co-Author - Holly Bowen, Ph.D., Southern Methodist University
Social Needs Screening Reach and Unmet Needs Among Cancer Survivors in Urban Oncology Settings
Poster Number: A6Time: 05:00 PM - 05:50 PM
Topics: Cancer, Health Disparities
Background: Understanding patients’ social needs is a critical part of healthcare delivery as it is a strong predictor of health outcomes. Community health workers (CHWs) delivered social needs screening and community resource referral to cancer survivors at four cancer centers in a single mid-Atlantic healthcare system. We set out to evaluate social needs screening reach among cancer survivors and describe reported needs by patient characteristics.
Methods: Cancer survivors 6-12 months post-diagnosis were identified from the cancer registry and electronic health records (EHR), and few by provider referral. CHWs contacted patients by phone and screened them using an 8-item social risk factor screener embedded in the EHR covering domains of financial strain, food insecurity, transportation, utilities, employment, and housing instability. Descriptive statistics summarized screening completion, and multiple logistic regression evaluated the prevalence of social needs by patient demographics (age, sex, race, and ethnicity).
Results: From May 2022 to August 2025, the CHW program reached out to 2,208 cancer survivors; 1,644 (74%) were screened, 488 were unreachable, and 45 declined screening. Screened patients had a mean age of 64 years, 64% were female, 58% were non-Hispanic Black, 4% were Hispanic/Latino. 17% reported at least one social need, with an average of two needs per patient. The most common needs were financial strain (n=200), food insecurity (n=144), transportation (n=85), housing instability (n=85), difficulty paying utilities (n=46), and employment support (n=37). In the multiple regression, Black patients (22%; OR=8.39) and patients of other races (22%; OR = 8.31) had higher prevalence of social needs compared with White patients (3%). Hispanic patients (28%; OR=1.95) also had higher odds of reporting a social need than non-Hispanic patients (17%). Increasing age was associated with a 2.1% decrease in the odds of reporting a social need (OR=0.98). No significant differences were observed by sex.
Conclusion: In an urban oncology setting in mid-Atlantic, most patients were willing to discuss social needs over the phone with a CHW. Disparities in social needs were identified by age, race, and ethnicity. A centralized CHW-led program can support healthcare providers by identifying and addressing patients’ social needs and improving their healthcare access. Additional studies are warranted to determine the impact of CHW programs on health outcomes.
Keywords: Cancer survivorship, Risk factorsMethods: Cancer survivors 6-12 months post-diagnosis were identified from the cancer registry and electronic health records (EHR), and few by provider referral. CHWs contacted patients by phone and screened them using an 8-item social risk factor screener embedded in the EHR covering domains of financial strain, food insecurity, transportation, utilities, employment, and housing instability. Descriptive statistics summarized screening completion, and multiple logistic regression evaluated the prevalence of social needs by patient demographics (age, sex, race, and ethnicity).
Results: From May 2022 to August 2025, the CHW program reached out to 2,208 cancer survivors; 1,644 (74%) were screened, 488 were unreachable, and 45 declined screening. Screened patients had a mean age of 64 years, 64% were female, 58% were non-Hispanic Black, 4% were Hispanic/Latino. 17% reported at least one social need, with an average of two needs per patient. The most common needs were financial strain (n=200), food insecurity (n=144), transportation (n=85), housing instability (n=85), difficulty paying utilities (n=46), and employment support (n=37). In the multiple regression, Black patients (22%; OR=8.39) and patients of other races (22%; OR = 8.31) had higher prevalence of social needs compared with White patients (3%). Hispanic patients (28%; OR=1.95) also had higher odds of reporting a social need than non-Hispanic patients (17%). Increasing age was associated with a 2.1% decrease in the odds of reporting a social need (OR=0.98). No significant differences were observed by sex.
Conclusion: In an urban oncology setting in mid-Atlantic, most patients were willing to discuss social needs over the phone with a CHW. Disparities in social needs were identified by age, race, and ethnicity. A centralized CHW-led program can support healthcare providers by identifying and addressing patients’ social needs and improving their healthcare access. Additional studies are warranted to determine the impact of CHW programs on health outcomes.
Authors:
Presenter - Jessica Rivera Rivera, PhD, MPH, MedStar Health Research Institute
Co-Author - Arianna Milicia, MPH, MedStar Health Research Institute
Co-Author - Marjanna Smith, MPH, MedStar Health Research Institute
Co-Author - Laura Schubel, MPH, MedStar Health Research Institute
Co-Author - Kimberly Davis, PhD, Georgetown University
Co-Author - Mandi Pratt-Chapman, PhD, George Washington University School of Medicine and Health Services
Co-Author - Hannah Arem, PhD, MedStar Health Research Institute
Characterizing Relationships between Daily Experiences of Pain, Opioid Use, and Psychological Symptoms in Patients with Advanced Cancer Using Ecological Momentary Assessments: The Unique Role of Pain Catastrophizing Variability
Poster Number: A7Time: 05:00 PM - 05:50 PM
Topics: Cancer, Pain
Purpose
Advanced cancer pain is dynamic and multifaceted, yet little is known about factors that influence day-to-day pain. We used Ecological Momentary Assessments (EMAs) to explore within-person relationships between daily pain severity, opioid use, pain interference, and psychological symptoms striving to inform future adaptive interventions.
Methods
Participants were eligible if they were >18, undergoing treatment for advanced/metastatic cancers, reported chronic pain (>4/10), and self-reported using opioids. Once daily EMAs evaluated pain severity over the past 24 hours (least/worst/average), pain catastrophizing, opioid use, mood (negative/positive), and pain interference over 28 days. Multilevel regression models tested within-person associations, and moderating effects of variability in pain severity and catastrophizing over the 28 day period.
Results
Participants (N=26) were 54.72 (SD=13.14) years old, 61.5% female, and mostly White (76.9%). Pain severity was associated with greater the same day pain interference (all p≤0.002) and worse negative mood (βaverage=0.068, p=0.014; βworst=0.092, p=0.007). Of the three pain severity ratings, only worst pain predicted higher same-day opioid use (βworst=0.229, p<0.001), while all three pain indicators were significantly associated with lower perceived opioid efficacy. While pain variability was not a significant moderator, higher catastrophizing variability amplified the associations between pain severity and pain interference (βaverage=0.338, p=0.002; βworst=0.413, p = 0.008) as well as negative mood (βaverage=0.118, p<0.001; βworst=0.110, p<0.001; βleast=0.055, p=0.013). Similarly, higher catastrophizing variability strengthened the negative associations between pain severity and perceived opioid efficacy (βworst=−0.064, p=0.001) and positive mood (βaverage=−0.204, p<0.001; βworst=−0.123, p=0.002; βleast=−0.129, p<0.001).
Conclusions
Study findings underscore how daily pain severity shape daily pain experiences and outcomes among patients with advanced cancer. Specifically, individuals whose negative pain thoughts fluctuated more across days experienced greater pain interference, reduced perceived opioid efficacy, and more pronounced worsening of mood on days with elevated pain severity. Addressing fluctuations in pain catastrophizing via real-time, cognitive-behavioral strategies may provide personalized interventions to improve managing cancer pain and enhancing quality of life.
Keywords: Pain, CancerAdvanced cancer pain is dynamic and multifaceted, yet little is known about factors that influence day-to-day pain. We used Ecological Momentary Assessments (EMAs) to explore within-person relationships between daily pain severity, opioid use, pain interference, and psychological symptoms striving to inform future adaptive interventions.
Methods
Participants were eligible if they were >18, undergoing treatment for advanced/metastatic cancers, reported chronic pain (>4/10), and self-reported using opioids. Once daily EMAs evaluated pain severity over the past 24 hours (least/worst/average), pain catastrophizing, opioid use, mood (negative/positive), and pain interference over 28 days. Multilevel regression models tested within-person associations, and moderating effects of variability in pain severity and catastrophizing over the 28 day period.
Results
Participants (N=26) were 54.72 (SD=13.14) years old, 61.5% female, and mostly White (76.9%). Pain severity was associated with greater the same day pain interference (all p≤0.002) and worse negative mood (βaverage=0.068, p=0.014; βworst=0.092, p=0.007). Of the three pain severity ratings, only worst pain predicted higher same-day opioid use (βworst=0.229, p<0.001), while all three pain indicators were significantly associated with lower perceived opioid efficacy. While pain variability was not a significant moderator, higher catastrophizing variability amplified the associations between pain severity and pain interference (βaverage=0.338, p=0.002; βworst=0.413, p = 0.008) as well as negative mood (βaverage=0.118, p<0.001; βworst=0.110, p<0.001; βleast=0.055, p=0.013). Similarly, higher catastrophizing variability strengthened the negative associations between pain severity and perceived opioid efficacy (βworst=−0.064, p=0.001) and positive mood (βaverage=−0.204, p<0.001; βworst=−0.123, p=0.002; βleast=−0.129, p<0.001).
Conclusions
Study findings underscore how daily pain severity shape daily pain experiences and outcomes among patients with advanced cancer. Specifically, individuals whose negative pain thoughts fluctuated more across days experienced greater pain interference, reduced perceived opioid efficacy, and more pronounced worsening of mood on days with elevated pain severity. Addressing fluctuations in pain catastrophizing via real-time, cognitive-behavioral strategies may provide personalized interventions to improve managing cancer pain and enhancing quality of life.
Authors:
Author - Jian Zhao, PhD, Dana-Farber Cancer Institute
Co-Author - Meng Chen, PhD, University of Southern California
Co-Author - Kristin schreiber, MD, PhD, Brigham and Women's Hospital
Co-Author - Jenna Wilson, PhD, Brigham and Women's Hospital
Co-Author - Arvina Grahl, PhD, Spaulding Rehabilitaiton Hospital
Co-Author - Sara DeForge, MS, Dana-Farber Cancer Institute
Co-Author - Robert Edwards, PhD, Brigham and Women's Hospital
Co-Author - Matthew Allsop, PhD, University of Leeds
Co-Author - Michael Businelle, PhD, FSBM, University of Oklahoma Health Sciences Center
Co-Author - Andrea Enzinger, MD, Dana-Farber Cancer Insitute
Presenter - Desiree Azizoddin, Dana-Farber Cancer Institute
Culturally adapting the Gene Pilot electronic health decision support tool to enhance informed decision making about tumor genomic testing in Latinx cancer patients
Poster Number: A8Time: 05:00 PM - 05:50 PM
Topics: Cancer, Health Communication and Policy
Background: Tumor genomic profiling (TGP) examines mutations for precision medicine and is essential in cancer care. It also introduces complex decisions about secondary hereditary risks, which can be particularly challenging for underserved populations, including Latinx patients, due to language barriers, literacy, and cultural considerations. Targeted decision support is important for informed decisions
Objective: To culturally adapt an existing electronic decision support tool (E-DST) for Latinx cancer patients using formative research and user testing.
Methods: Mixed-methods formative research with Latinx cancer patients included focus groups (n=21), surveys (n=50), and input from community/scientific advisory boards. Gene Pilot, an E-DST developed for Black cancer patients, uses animation, voiceovers, real patient testimonial videos, and interactive values clarification section that customizes questions for doctors. Based on formative results, we culturally adapted Gene Pilot to reflect Latinx cultural values and varying literacy levels. Renamed Gene PilotLX, revisions included versions in both English and Spanish, new Latinx patient testimonials, edited videos to focus on the role of family in decision making and to address mistrust of healthcare institutions, and revising the values clarification section to better reflect the diverse experiences of Latinx cancer patients. User testing occurred with Latinx patients and members of advisory boards where they interacted with the tool and provided comments and observations. A brief survey was also administered.
Results: User testing showed high acceptability, indicating content accurately reflected important Latinx cultural values. Most believed that the patient testimonials and question list were the most useful components, and that Gene PilotLX was clear and user friendly. Of the 16 survey items (1-7 scale; 7=completely agree), 11 had mean scores over 6.0, including that the tool was easy to use (mean 6.4), easy to navigate (mean 6.8), and effective (mean 6.2). The majority also felt it was not slanted in favor of a particular TGP decision (mean 2.2).
Conclusion: The cultural adaptation of E-DST’s is critical to ensuring informed decision making and empowering patients to make decisions that are congruent with their beliefs. Gene PilotLX may improve patient trust, reduce decisional distress, and facilitate informed decision making among Latinx cancer patients.
Keywords: Decision making, e-HealthObjective: To culturally adapt an existing electronic decision support tool (E-DST) for Latinx cancer patients using formative research and user testing.
Methods: Mixed-methods formative research with Latinx cancer patients included focus groups (n=21), surveys (n=50), and input from community/scientific advisory boards. Gene Pilot, an E-DST developed for Black cancer patients, uses animation, voiceovers, real patient testimonial videos, and interactive values clarification section that customizes questions for doctors. Based on formative results, we culturally adapted Gene Pilot to reflect Latinx cultural values and varying literacy levels. Renamed Gene PilotLX, revisions included versions in both English and Spanish, new Latinx patient testimonials, edited videos to focus on the role of family in decision making and to address mistrust of healthcare institutions, and revising the values clarification section to better reflect the diverse experiences of Latinx cancer patients. User testing occurred with Latinx patients and members of advisory boards where they interacted with the tool and provided comments and observations. A brief survey was also administered.
Results: User testing showed high acceptability, indicating content accurately reflected important Latinx cultural values. Most believed that the patient testimonials and question list were the most useful components, and that Gene PilotLX was clear and user friendly. Of the 16 survey items (1-7 scale; 7=completely agree), 11 had mean scores over 6.0, including that the tool was easy to use (mean 6.4), easy to navigate (mean 6.8), and effective (mean 6.2). The majority also felt it was not slanted in favor of a particular TGP decision (mean 2.2).
Conclusion: The cultural adaptation of E-DST’s is critical to ensuring informed decision making and empowering patients to make decisions that are congruent with their beliefs. Gene PilotLX may improve patient trust, reduce decisional distress, and facilitate informed decision making among Latinx cancer patients.
Authors:
Author - Sarah Bass, PhD, MPH, FSBM, Temple University
Co-Author - Arianna Vacio, MS, Temple University
Co-Author - Tracey Revenson, PhD, FSBM, Hunter College & The Graduate Center - CUNY
Co-Author - Ana Abraido-Lanza, PhD, Columbia University
Co-Author - Katie Singley, MPH, Temple University Risk Communication Lab
Co-Author - Yana Chertock, MA, Fox Chase Cancer Center
Co-Author - Caseem Luck, M.S., Temple University College of Public Health
Co-Author - Alexandru-Mircea Rotaru, MPH, Temple University
Co-Author - Genesis Acosta Corneil, Hunter College
Co-Author - Brandon Fernandez Sedano, Hunter College
Co-Author - Javier Torres, Hunter College
Co-Author - Michael Hall, Fox Chase Cancer Center
Comparing post-test cancer genetic counseling communication and outcomes with and without pre-test counseling
Poster Number: A10Time: 05:00 PM - 05:50 PM
Topics: Cancer, Health Communication and Policy
Introduction: Effective cancer genetic counseling is critical for ensuring patients understand their genetic test results, psychologically adapt to these results, and adhere to subsequent cancer prevention recommendations. The number of people who qualify for hereditary breast and ovarian cancer (HBOC) genetic testing has outpaced the number of genetic counselors qualified to provide these services in the US. Consequently, non-genetics professionals are increasingly ordering testing, with genetic counselors meeting patients/clients only after test results are available. This research aims to characterize the content, process, and outcomes of post-test genetic counseling when it is preceded by pre-test counseling with a genetic counselor vs not.
Methods: Genetic counselors were recruited through the Rutgers Cancer Institute. HBOC patients of these counselors have been recruited to complete a set of surveys before their post-test counseling appointment (T0) and after (T1) and have their post-test counseling appointment audio recorded (recruitment ongoing). Transcripts of appointments were coded using the Roter Interaction Analysis System (RIAS). Codes will be categorized using latent class analysis to identify subgroups of communication patterns after enrollment is complete (N=100). Associations between patterns of communication in each latent class and measured patient outcomes will be assessed and compared across post-test only vs. traditional pre-test and post-test.
Results: 5 genetic counselors have enrolled, and 569 eligible patients have been sent recruitment materials through their patient portal. 74 patients have enrolled, with 38 patients having completed all parts of the study (T0 survey, audio recording, T1 survey). 33 of the complete datasets are the traditional pre-test and post-test, 5 are the post-test only model. 15 appointment recordings have been double-coded using RIAS. We hypothesize that post-test counseling that occurs without pre-test counseling will have a different pattern of communication than when preceded by pre-test counseling and that more patient-centered communication will be associated with better patient outcomes.
Discussion: Understanding how communication affects patient outcomes in post-test HBOC genetic counseling interactions is critical for developing practice and curriculum standards and designing targeted training interventions poised to increase cancer prevention and control through effective genetic counseling.
Keywords: Genetics, Health communicationMethods: Genetic counselors were recruited through the Rutgers Cancer Institute. HBOC patients of these counselors have been recruited to complete a set of surveys before their post-test counseling appointment (T0) and after (T1) and have their post-test counseling appointment audio recorded (recruitment ongoing). Transcripts of appointments were coded using the Roter Interaction Analysis System (RIAS). Codes will be categorized using latent class analysis to identify subgroups of communication patterns after enrollment is complete (N=100). Associations between patterns of communication in each latent class and measured patient outcomes will be assessed and compared across post-test only vs. traditional pre-test and post-test.
Results: 5 genetic counselors have enrolled, and 569 eligible patients have been sent recruitment materials through their patient portal. 74 patients have enrolled, with 38 patients having completed all parts of the study (T0 survey, audio recording, T1 survey). 33 of the complete datasets are the traditional pre-test and post-test, 5 are the post-test only model. 15 appointment recordings have been double-coded using RIAS. We hypothesize that post-test counseling that occurs without pre-test counseling will have a different pattern of communication than when preceded by pre-test counseling and that more patient-centered communication will be associated with better patient outcomes.
Discussion: Understanding how communication affects patient outcomes in post-test HBOC genetic counseling interactions is critical for developing practice and curriculum standards and designing targeted training interventions poised to increase cancer prevention and control through effective genetic counseling.
Authors:
Author - Liesl Broadbridge, ScM, CGC, Rutgers University
Co-Author - Paul Duberstein, PhD, Rutgers University
Co-Author - Kathryn Greene, PhD, Rutgers University
Feasibility and acceptability the Take Charge During Treatment: An Exercise Intervention during Chemotherapy for women diagnosed with breast cancer
Poster Number: A9Time: 05:00 PM - 05:50 PM
Topics: Cancer, Cardiovascular Disease
Introduction: Breast cancer (BC) is the most commonly diagnosed cancer among women in the US. Some treatments increase cardiovascular (CV) complications risks, and cardiotoxicity remains a major concern. The DECODE study investigates if the ‘Take Charge During Treatment (TCDT),’ a 16-week virtual exercise intervention can reduce systemic inflammatory load, improve endothelial function, and lower CV risk among women diagnosed with invasive, non-metastatic BC undergoing chemotherapy.
Methods: TCDT was designed to encourage participants to follow the American College of Sports Medicine’s guidelines: 150 minutes of weekly MVPA and two strength training sessions. Feasibility and acceptability were assessed quantitatively with data from eligibility, recruitment, retention, adherence, and participants satisfaction, and qualitatively using interviews with study staff to assess perceived challenges during the study.
Results: Across three participating clinical centers, 1,872 women were assessed for eligibility based on diagnosis, race, and ethnicity. Of those, 284 were fully eligible. Of those 284 women, 27% (n=76) consented to participate in the study, and 24% (n=68) were enrolled and randomized; 35 and 33 in the control and intervention groups, respectively. Recruitment and enrollment are ongoing, and data collection is still ongoing, with an attrition rate of 15% (n=8).
Interviews with study staff highlighted some challenges, including tight timelines, strict eligibility criteria, and communication gaps, which affected recruitment. Adherence was impacted by socio-economic determinants of health such as work schedules and ongoing treatment effects. Retention was hindered for control group participants who still desired physical activity. Data collection challenges included scheduling complexities and complex tests like Flow-mediated Dilation. Despite these barriers, participant satisfaction was high.
Study staff identified several opportunities for improvement, including enhanced communication, coordination, expanding eligibility criteria, considering multiple study sites, offering weekend study visits to accommodate participants with full-time jobs, streamlining scheduling processes and defining roles more clearly to improve implementation.
Conclusion: TCDT is feasible and acceptable. Challenges identified in recruitment, retention, and data collection are addressable. Our findings provide valuable insights for refining future cardio-oncology interventions.
Keywords: Cancer, Cardiovascular diseaseMethods: TCDT was designed to encourage participants to follow the American College of Sports Medicine’s guidelines: 150 minutes of weekly MVPA and two strength training sessions. Feasibility and acceptability were assessed quantitatively with data from eligibility, recruitment, retention, adherence, and participants satisfaction, and qualitatively using interviews with study staff to assess perceived challenges during the study.
Results: Across three participating clinical centers, 1,872 women were assessed for eligibility based on diagnosis, race, and ethnicity. Of those, 284 were fully eligible. Of those 284 women, 27% (n=76) consented to participate in the study, and 24% (n=68) were enrolled and randomized; 35 and 33 in the control and intervention groups, respectively. Recruitment and enrollment are ongoing, and data collection is still ongoing, with an attrition rate of 15% (n=8).
Interviews with study staff highlighted some challenges, including tight timelines, strict eligibility criteria, and communication gaps, which affected recruitment. Adherence was impacted by socio-economic determinants of health such as work schedules and ongoing treatment effects. Retention was hindered for control group participants who still desired physical activity. Data collection challenges included scheduling complexities and complex tests like Flow-mediated Dilation. Despite these barriers, participant satisfaction was high.
Study staff identified several opportunities for improvement, including enhanced communication, coordination, expanding eligibility criteria, considering multiple study sites, offering weekend study visits to accommodate participants with full-time jobs, streamlining scheduling processes and defining roles more clearly to improve implementation.
Conclusion: TCDT is feasible and acceptable. Challenges identified in recruitment, retention, and data collection are addressable. Our findings provide valuable insights for refining future cardio-oncology interventions.
Authors:
Author - Jean Bikomeye, PhD, MPH, Medical College of Wisconsin
Author - Natalia De Couto, PhD, City of Hope
Author - Kirsten Beyer, PhD, MPH, MS, Medical College of Wisconsin
Author - Andreas Beyer, PhD, FAHA, Medical College of Wisconsin
Author - Courtney Jankowski, MPH, Medical College of Wisconsin
Author - Kathryn Kern, PhD, Medical College of Wisconsin Cancer Center
Author - Sarah Golus, MS, Medical College of Wisconsin
Author - Elizabeth De León, MS, Medical College of Wisconsin Institute for Health and Humanity
Author - Laura Norwood, PhD, Medical College of Wisconsin Cardiovascular Researcher Center
Author - Allison Kriegel, PhD, FAHA, Augusta University
Author - Shane Phillips, PT, PhD, FAHA, University of Illinois Chicago
Author - Matthew Durand, PhD, Medical College of Wisconsin
Author - Michael Widlansky, MD, MPH, Medical College of Wisconsin
Author - Melinda Stolley, PhD, Medical College of Wisconsin
The Associations Between Cancer Related Distress and Pain, Fatigue, and Physical Functioning Across the Cancer Trajectory
Poster Number: A11Time: 05:00 PM - 05:50 PM
Topics: Cancer, Stress
Background: Breast cancer patients face many stressors during the cancer trajectory. Prolonged exposure to cancer-related distress can disrupt physiological functioning and threaten survivorship in cancer patients. There is limited work assessing intrapersonal changes in cancer survivors from time of diagnosis to post-treatment. This study examined associations between cancer-related distress and pain, fatigue, and physical functioning in breast cancer patients at time of diagnosis and 2 years post-treatment.
Methods: Breast cancer patients (N=124) diagnosed with stages I-IIIA cancer (Mage= 52.45, SD = 10.07) completed two study visits. Visit 1 took place pre-treatment and 4-8 weeks post-surgery (M days post-surgery = 52.07, SD = 24.83), while visit 2 occurred 2 years post-treatment. Women completed the Impact of Event Scale at both visits to assess cancer-related distress. They also completed the Breast Cancer Prevention Trial Symptom Scale to measure physical functioning, the Brief Pain Inventory to assess pain, and the Multidimensional Fatigue Symptom Inventory – Short Form to measure fatigue at both visits. Hierarchical regressions tested study hypotheses using a two-step approach. Step 1 included covariates of age, body mass index, comorbidities, cancer stage, and menopause status. Cancer-related distress was entered into Step 2, and R2 change assessed the variance explained in each symptom based on its inclusion.
Results: Cancer-related distress at visit 1 explained an additional 22% of variance in fatigue (ΔR2=.22, p<.001), 6.5% of variance in physical functioning (ΔR2=.07, p=.003), and 12.8% of variance in pain (ΔR2=.13, p<.001) above and beyond the covariates. At visit 2, cancer-related distress explained an additional 22.8% of variance in fatigue (ΔR2=.23, p<.001), 8% of variance in physical functioning (ΔR2=.08, p=.003, and 11.8% of variance in pain (ΔR2=.12, p<.001). Cancer-related distress at visit 1 did not explain a significant amount of additional variance in fatigue (ΔR2=.000, p=.973), physical functioning (ΔR2=.002, p=.560), or pain (ΔR2=.000, p=.96) at visit two while controlling for visit 1 levels of each outcome.
Conclusion: These findings highlight the impact that cancer-related distress has on physical health in cancer patients at two distinct points in the cancer trajectory. Screening for distress in breast cancer survivors may mitigate symptoms of pain, fatigue, and poor physical functioning, thus promoting longevity and wellbeing.
Keywords: Cancer, StressMethods: Breast cancer patients (N=124) diagnosed with stages I-IIIA cancer (Mage= 52.45, SD = 10.07) completed two study visits. Visit 1 took place pre-treatment and 4-8 weeks post-surgery (M days post-surgery = 52.07, SD = 24.83), while visit 2 occurred 2 years post-treatment. Women completed the Impact of Event Scale at both visits to assess cancer-related distress. They also completed the Breast Cancer Prevention Trial Symptom Scale to measure physical functioning, the Brief Pain Inventory to assess pain, and the Multidimensional Fatigue Symptom Inventory – Short Form to measure fatigue at both visits. Hierarchical regressions tested study hypotheses using a two-step approach. Step 1 included covariates of age, body mass index, comorbidities, cancer stage, and menopause status. Cancer-related distress was entered into Step 2, and R2 change assessed the variance explained in each symptom based on its inclusion.
Results: Cancer-related distress at visit 1 explained an additional 22% of variance in fatigue (ΔR2=.22, p<.001), 6.5% of variance in physical functioning (ΔR2=.07, p=.003), and 12.8% of variance in pain (ΔR2=.13, p<.001) above and beyond the covariates. At visit 2, cancer-related distress explained an additional 22.8% of variance in fatigue (ΔR2=.23, p<.001), 8% of variance in physical functioning (ΔR2=.08, p=.003, and 11.8% of variance in pain (ΔR2=.12, p<.001). Cancer-related distress at visit 1 did not explain a significant amount of additional variance in fatigue (ΔR2=.000, p=.973), physical functioning (ΔR2=.002, p=.560), or pain (ΔR2=.000, p=.96) at visit two while controlling for visit 1 levels of each outcome.
Conclusion: These findings highlight the impact that cancer-related distress has on physical health in cancer patients at two distinct points in the cancer trajectory. Screening for distress in breast cancer survivors may mitigate symptoms of pain, fatigue, and poor physical functioning, thus promoting longevity and wellbeing.
Authors:
Author - Kelsi Broich, The Ohio State University
Co-Author - Megan Renna, Ph.D., The Ohio State University
Coping, Dyadic Management, and Disease Control Among Adults with Cardiometabolic Disorders and HIV
Poster Number: A12Time: 05:00 PM - 05:50 PM
Topics: Cardiovascular Disease, HIV/AIDS
Background:
Rates of uncontrolled hypertension and diabetes are high among people living with HIV in sub-Saharan Africa, complicating comorbidity management. Understanding how couples support each other in managing diseases is essential for informing lifestyle counseling for chronic conditions. Using longitudinal data from Healthy Hearts, we investigated associations between couples’ coping, dyadic management of disease, and objective markers of disease control for hypertension, diabetes, and HIV.
Methods:
Healthy Hearts is an observational cohort study of adults living with HIV and cardiometabolic disorders (hypertension or diabetes) and their spouses in Malawi. Participants completed quarterly surveys and clinical assessments over one year. Couples’ coping was measured using Bodenmann’s Communal Coping scale. Dyadic disease management was measured using validated disease-specific tools, with behaviors categorized as medication-related (e.g., adherence to antihypertensive medications) or lifestyle-related (e.g., dietary behaviors such as salting food). Patients were asked about their own behaviors, while partners were asked about the support provided. Couple-level variables were created using both partners’ reports. Disease control cut points for blood pressure, HbA1c, and viral load were defined by clinical guidelines. Multivariable linear and logistic regression models controlling for dyadic clustering assessed predictors of dyadic management (time 3) and disease control (time 4).
Results:
Among 264 participants (mean age 52 years; 45.8% female), 96.9% were virally suppressed, but only 33.6% and 23.6% achieved hypertension and diabetes control, respectively. Communal coping was significantly associated with medication-related dyadic management (B=0.61; p=0.04), but not lifestyle-related dyadic management. Medication-related dyadic management was significantly associated with an increased odds of having controlled HIV and hypertension (AOR=1.21; p=0.04). Lifestyle-related dyadic management did not explain disease control.
Conclusions:
Communal coping within couples was positively associated with dyadic medication management. Dyadic medication management, but not lifestyle-related management, explained better disease control for HIV and hypertension. Findings suggest that counseling should leverage dyadic support to improve medication adherence while addressing gaps in lifestyle-related disease management, such as diet and exercise.
Keywords: Hypertension, HIVRates of uncontrolled hypertension and diabetes are high among people living with HIV in sub-Saharan Africa, complicating comorbidity management. Understanding how couples support each other in managing diseases is essential for informing lifestyle counseling for chronic conditions. Using longitudinal data from Healthy Hearts, we investigated associations between couples’ coping, dyadic management of disease, and objective markers of disease control for hypertension, diabetes, and HIV.
Methods:
Healthy Hearts is an observational cohort study of adults living with HIV and cardiometabolic disorders (hypertension or diabetes) and their spouses in Malawi. Participants completed quarterly surveys and clinical assessments over one year. Couples’ coping was measured using Bodenmann’s Communal Coping scale. Dyadic disease management was measured using validated disease-specific tools, with behaviors categorized as medication-related (e.g., adherence to antihypertensive medications) or lifestyle-related (e.g., dietary behaviors such as salting food). Patients were asked about their own behaviors, while partners were asked about the support provided. Couple-level variables were created using both partners’ reports. Disease control cut points for blood pressure, HbA1c, and viral load were defined by clinical guidelines. Multivariable linear and logistic regression models controlling for dyadic clustering assessed predictors of dyadic management (time 3) and disease control (time 4).
Results:
Among 264 participants (mean age 52 years; 45.8% female), 96.9% were virally suppressed, but only 33.6% and 23.6% achieved hypertension and diabetes control, respectively. Communal coping was significantly associated with medication-related dyadic management (B=0.61; p=0.04), but not lifestyle-related dyadic management. Medication-related dyadic management was significantly associated with an increased odds of having controlled HIV and hypertension (AOR=1.21; p=0.04). Lifestyle-related dyadic management did not explain disease control.
Conclusions:
Communal coping within couples was positively associated with dyadic medication management. Dyadic medication management, but not lifestyle-related management, explained better disease control for HIV and hypertension. Findings suggest that counseling should leverage dyadic support to improve medication adherence while addressing gaps in lifestyle-related disease management, such as diet and exercise.
Authors:
Presenter - Amy Conroy, Ph.D., M.P.H., University of California San Francisco
Co-Author - Hannah Leslie, Ph.D., University of California San Francisco
Co-Author - Julie Bidwell, Ph.D., University of California Davis
Co-Author - Torsten Neilands, University of California San Francisco
Co-Author - Sheri Weiser, M.D., University of California San Francisco
Co-Author - Rita Butterfield, Ph.D., University of California San Francisco
Co-Author - Nancy Mulauzi, Invest in Knowledge
Co-Author - James Mkandawire, Invest in Knowledge
Medical Trust, Financial Concerns, and Preference for an At-Home Cervical Cancer Screening Test among Hispanic/Latina women aged 21-65 in the U.S.
Poster Number: A13Time: 05:00 PM - 05:50 PM
Topics: Cancer, Women's Health
Background: In the U.S., Hispanic/Latina women face a 36% higher incidence of cervical cancer compared to non-Hispanic White women, yet report lower screening rates (69% vs. 80%). These disparities are driven by intersecting structural barriers, including financial concerns, limited access to culturally competent care, and lower trust in medical providers and systems. In May 2025, the FDA approved the first at-home cervical cancer screening kit, which has the potential to reduce barriers to screening by offering greater privacy, convenience, and autonomy. However, little is known about whether Hispanic/Latina women who face systemic barriers are more likely to prefer at-home testing compared to traditional clinic-based screening.
Purpose: To test whether higher financial concerns, lower levels of trust in doctors, and/or lower levels of trust in the healthcare system would be associated with preference for an at-home vs. clinic-based cervical cancer screening test among Hispanic/Latina women.
Method: Using a subsample (n=367; weighted n=9,456,170) of Hispanic/Latina women aged 21-65 from the 2024 Health Information National Trends Survey (HINTS 7). We conducted a multivariable logistic regression to test whether with financial concerns, trust in doctors, and trust in the healthcare system predicted preference for an at-home cervical screening test, controlling for insurance and income.
Results: Higher levels of financial concerns were associated with greater odds of preferring at-home cervical cancer screening (OR=1.63, SE=0.40, 95% CI [1.00, 2.66]), over and above insurance coverage and income. Neither trust in doctors (OR=0.66, SE=0.37, 95% CI [0.21, 2.07]) nor trust in the healthcare system (OR=0.71, SE=0.22, 95% CI [0.39, 1.31]) were associated significantly with screening preference.
Conclusions: Financial concerns emerged as a key predictor of preference for at-home cervical cancer screening among Hispanic/Latina women, underscoring the central role of affordability and access. These findings have important implications for behavioral medicine, suggesting that even promising innovations in cancer prevention may have limited impact on equity unless cost-related barriers are addressed. Future research should explore how additional barriers (e.g., stigma, immigration-related concerns, cultural norms about reproductive health) intersect with financial concerns to influence screening uptake.
Keywords: Cancer, Women's healthPurpose: To test whether higher financial concerns, lower levels of trust in doctors, and/or lower levels of trust in the healthcare system would be associated with preference for an at-home vs. clinic-based cervical cancer screening test among Hispanic/Latina women.
Method: Using a subsample (n=367; weighted n=9,456,170) of Hispanic/Latina women aged 21-65 from the 2024 Health Information National Trends Survey (HINTS 7). We conducted a multivariable logistic regression to test whether with financial concerns, trust in doctors, and trust in the healthcare system predicted preference for an at-home cervical screening test, controlling for insurance and income.
Results: Higher levels of financial concerns were associated with greater odds of preferring at-home cervical cancer screening (OR=1.63, SE=0.40, 95% CI [1.00, 2.66]), over and above insurance coverage and income. Neither trust in doctors (OR=0.66, SE=0.37, 95% CI [0.21, 2.07]) nor trust in the healthcare system (OR=0.71, SE=0.22, 95% CI [0.39, 1.31]) were associated significantly with screening preference.
Conclusions: Financial concerns emerged as a key predictor of preference for at-home cervical cancer screening among Hispanic/Latina women, underscoring the central role of affordability and access. These findings have important implications for behavioral medicine, suggesting that even promising innovations in cancer prevention may have limited impact on equity unless cost-related barriers are addressed. Future research should explore how additional barriers (e.g., stigma, immigration-related concerns, cultural norms about reproductive health) intersect with financial concerns to influence screening uptake.
Authors:
Presenter - Brandon Dona-Velazquez, Loyola Marymount University
Co-Author - , Loyola Marymount University
Co-Author - , Loyola Marymount University
Association between Social Vulnerability and Clinician Communication about Colorectal Cancer Screening Options
Poster Number: A14Time: 05:00 PM - 05:50 PM
Topics: Cancer, Health Disparities
Objective: Colorectal cancer screening is underutilized, despite its proven benefits. Clinician-led discussions of screening options are critical to support informed, patient-centered decision-making and to increase uptake. We examined how average-risk adults’ social vulnerability relates to their receipt of communication about colorectal cancer screening options from clinicians.
Methods: We analyzed data from adults aged 45-75 years who participated in the 2024 Health Information National Trends Survey (HINTS 7) and reported no history of colon or rectal cancer. We created a composite social vulnerability variable that was the sum of five survey items measured on a 5-point response scale (range: 0 to 16 points); we then trichotomized the composite variable into low (0 point), moderate (>0 to <6 points), and high levels of social vulnerability (6 to 16 points). We conducted Rao-Scott chi-square tests and logistic regression to assess the associations between social vulnerability and receipt of communication about colorectal cancer screening options. Our analyses included a final sample weight and 50 replicate weights to account for the complex survey design.
Results: Our analytical sample consisted of 3,723 participants. A small proportion (10.49%) had high social vulnerability versus moderate (27.87%) or low social vulnerability (61.64%). Most participants (64.59%) reported being told about different colorectal cancer screening options, with significant variations by sociodemographic factors. Adjusting for age, sex, race/ethnicity, and marital status, having a high versus low level of social vulnerability was significantly associated with lower odds of receiving communication about colorectal cancer screening options (adjusted odds ratio=0.64, 95% confidence interval=0.43-0.95).
Conclusion: Adults experiencing high social vulnerability were less likely to receive communication from clinicians about the availability of different colorectal cancer screening options. This communication gap may contribute to lower knowledge and uptake of colorectal cancer screening. More equitable clinician communication about different modalities should be encouraged to improve screening, particularly among those experiencing greater social vulnerability.
Keywords: Cancer screening, Health communicationMethods: We analyzed data from adults aged 45-75 years who participated in the 2024 Health Information National Trends Survey (HINTS 7) and reported no history of colon or rectal cancer. We created a composite social vulnerability variable that was the sum of five survey items measured on a 5-point response scale (range: 0 to 16 points); we then trichotomized the composite variable into low (0 point), moderate (>0 to <6 points), and high levels of social vulnerability (6 to 16 points). We conducted Rao-Scott chi-square tests and logistic regression to assess the associations between social vulnerability and receipt of communication about colorectal cancer screening options. Our analyses included a final sample weight and 50 replicate weights to account for the complex survey design.
Results: Our analytical sample consisted of 3,723 participants. A small proportion (10.49%) had high social vulnerability versus moderate (27.87%) or low social vulnerability (61.64%). Most participants (64.59%) reported being told about different colorectal cancer screening options, with significant variations by sociodemographic factors. Adjusting for age, sex, race/ethnicity, and marital status, having a high versus low level of social vulnerability was significantly associated with lower odds of receiving communication about colorectal cancer screening options (adjusted odds ratio=0.64, 95% confidence interval=0.43-0.95).
Conclusion: Adults experiencing high social vulnerability were less likely to receive communication from clinicians about the availability of different colorectal cancer screening options. This communication gap may contribute to lower knowledge and uptake of colorectal cancer screening. More equitable clinician communication about different modalities should be encouraged to improve screening, particularly among those experiencing greater social vulnerability.
Authors:
Co-Author - Wei Yi Kong, PhD, Mayo Clinic
Co-Author - Jennifer L. St. Sauver, Mayo Clinic
Co-Author - Robert M. Jacobson, MD, Mayo Clinic
Co-Author - Lila J. Finney Rutten, Mayo Clinic
“If you're lucky, it's written somewhere”: Institutional Factors Impacting Catch-up HPV Vaccination Delivery in a Collegiate Clinical Setting
Poster Number: A15Time: 05:00 PM - 05:50 PM
Topics: Cancer, Implementation Science
BACKGROUND: The HPV vaccine is a highly effective prophylaxis against HPV-related cancers and is recommended for individuals through the age of 26. The suboptimal US adolescent HPV vaccine coverage rate (61.4%) leaves nearly 39% vaccine-eligible adolescents to enter young adulthood unvaccinated. Over half of the HPV infections that develop into cancer are acquired by the age of 21. While college campuses are posited as an ideal setting to facilitate HPV vaccination among young adults, interventions to increase catch-up HPV vaccination in this setting have had varying success. An assessment was conducted to understand the institutional factors of a collegiate health services department that impact HPV vaccination delivery.
METHODS: This assessment was guided by the Consolidated Framework for Implementation Research (CFIR). Clinical personnel from a collegiate clinic were purposively recruited and provided informed consent. Fourteen (14) semi-structured interviews were conducted in Spring 2025. Rapid content analysis was used to analyze the data.
RESULTS: Several determinants were identified that impacted internal processes of delivering the HPV vaccine. Young adult patients completed an HPV screener form at intake to indicate their vaccination status and interest in receiving the vaccine during their clinical visit. The patients' electronic medical records were also reviewed to verify their vaccination status. Challenges arose when a patient was unsure of their vaccination status, and their HPV immunization history was not documented in the EMR; vaccination was either delayed until the patient could obtain records verifying their status or providers weighed the potential for vaccine re-administration, with limited formal guidance. The EMR system also presented challenges, with HPV vaccine information potentially located in two different places within the system, which slowed down procedural flow. Lastly, reminder/recall systems were not clearly established for patients and providers, which hindered the completion of the HPV vaccine series for patients.
CONCLUSION: Given the availability of the HPV vaccine and the willingness of young adults to receive vaccination, various institutional factors either facilitate or inhibit vaccination uptake. These findings present opportunities to enhance the processes involved in delivering the HPV vaccine in a collegiate setting and facilitate successful vaccination uptake.
Keywords: Cancer, Primary careMETHODS: This assessment was guided by the Consolidated Framework for Implementation Research (CFIR). Clinical personnel from a collegiate clinic were purposively recruited and provided informed consent. Fourteen (14) semi-structured interviews were conducted in Spring 2025. Rapid content analysis was used to analyze the data.
RESULTS: Several determinants were identified that impacted internal processes of delivering the HPV vaccine. Young adult patients completed an HPV screener form at intake to indicate their vaccination status and interest in receiving the vaccine during their clinical visit. The patients' electronic medical records were also reviewed to verify their vaccination status. Challenges arose when a patient was unsure of their vaccination status, and their HPV immunization history was not documented in the EMR; vaccination was either delayed until the patient could obtain records verifying their status or providers weighed the potential for vaccine re-administration, with limited formal guidance. The EMR system also presented challenges, with HPV vaccine information potentially located in two different places within the system, which slowed down procedural flow. Lastly, reminder/recall systems were not clearly established for patients and providers, which hindered the completion of the HPV vaccine series for patients.
CONCLUSION: Given the availability of the HPV vaccine and the willingness of young adults to receive vaccination, various institutional factors either facilitate or inhibit vaccination uptake. These findings present opportunities to enhance the processes involved in delivering the HPV vaccine in a collegiate setting and facilitate successful vaccination uptake.
Authors:
Presenter - Namoonga Mantina, PhD, MSPH, MBA, University of Arizona
Co-Author - Kizil Yusoof, MS, University of Arizona
Co-Author - Trisha Sindhu, University of Arizona
Co-Author - Olivia Katiku, University of Arizona
Co-Author - Priscilla Magrath, PhD, University of Arizona
Co-Author - Leila Barraza, JD, University of Arizona
Co-Author - Kelly Palmer, PhD, MHS, University of Alabama at Birmingham
Co-Author - Purnima Madhivanan, MBBS, MPH, PhD, University of Arizona
Peer coaching needs among young women at risk for hereditary cancer
Poster Number: A16Time: 05:00 PM - 05:50 PM
Topics: Cancer
Background: Young women from families carrying pathogenic BRCA1/2 variants face stressors regarding their own genetic risk and cancer risk management. These stressors can impact their quality of life and decision-making processes. Peer coaching is a promising, scalable intervention strategy for this population. However, little is known about the specific coaching needs within this population.
Method: Data are from the baseline survey of a randomized trial comparing a manualized peer coaching intervention vs. community-based peer coaching. Eligible participants (N=168) were women aged 21–30 who were genetically tested or untested first-, second- or third-degree relatives of individuals with a pathogenic BRCA1/2 variant. We examined 17 specific participant-endorsed peer coaching needs prior to the coaching intervention within four categories relevant to cancer risk management (Communication, Health, Future Planning, Wellness). Descriptive statistics and frequencies were used to describe study participants. Fisher’s exact tests and t-tests were used to assess differences in endorsement of coaching needs within each category and overall, with comparisons by tested status, age (26-30 vs. <25), partnered status, and education (>college degree vs. less than college).
Results: Participants were primarily White (86%), single (70%) and college educated (73%). Eighty-two percent had received genetic testing. There was high overall endorsement of coaching needs (M=11.8, SD=3.6), with single participants reporting greater overall need than those with partners (t=-2.24, p=.029). Older participants reported higher coaching needs related to communicating with providers (p=.015), as well as navigating insurance (p<.001) and healthcare costs (p=.02). Those with at least a college degree reported higher coaching needs related to family planning (p=.009) and navigating the healthcare system (p=.03) as compared to those without a college degree. No differences were observed by race, ethnicity or tested status.
Conclusion: Coaching needs varied based on some, but not all, participant demographics, which may be related to the developmental stages of participants and readiness to address their cancer risks medically. Future research will examine how coaching needs were addressed within the intervention and how these moderated overall intervention effects.
Keywords: Cancer, GeneticsMethod: Data are from the baseline survey of a randomized trial comparing a manualized peer coaching intervention vs. community-based peer coaching. Eligible participants (N=168) were women aged 21–30 who were genetically tested or untested first-, second- or third-degree relatives of individuals with a pathogenic BRCA1/2 variant. We examined 17 specific participant-endorsed peer coaching needs prior to the coaching intervention within four categories relevant to cancer risk management (Communication, Health, Future Planning, Wellness). Descriptive statistics and frequencies were used to describe study participants. Fisher’s exact tests and t-tests were used to assess differences in endorsement of coaching needs within each category and overall, with comparisons by tested status, age (26-30 vs. <25), partnered status, and education (>college degree vs. less than college).
Results: Participants were primarily White (86%), single (70%) and college educated (73%). Eighty-two percent had received genetic testing. There was high overall endorsement of coaching needs (M=11.8, SD=3.6), with single participants reporting greater overall need than those with partners (t=-2.24, p=.029). Older participants reported higher coaching needs related to communicating with providers (p=.015), as well as navigating insurance (p<.001) and healthcare costs (p=.02). Those with at least a college degree reported higher coaching needs related to family planning (p=.009) and navigating the healthcare system (p=.03) as compared to those without a college degree. No differences were observed by race, ethnicity or tested status.
Conclusion: Coaching needs varied based on some, but not all, participant demographics, which may be related to the developmental stages of participants and readiness to address their cancer risks medically. Future research will examine how coaching needs were addressed within the intervention and how these moderated overall intervention effects.
Authors:
Co-Author - Beth Peshkin, Georgetown University
Co-Author - Jada Hamilton, Memorial Sloan Kettering Cancer Center
Co-Author - Huma Rana, MD, Dana-Farber Cancer Center
Co-Author - Marianne Dubard Gault, MD, Swedish Cancer Institute
Co-Author - Sukh Makhnoon, UT Southwestern
Co-Author - Afton Covey, Georgetown University
Co-Author - Jacqueline Chavez Ochoa, Georgetown University
Co-Author - Nicole Schwab, Georgetown University
Co-Author - Sophia Cumbo, Georgetown University
Co-Author - Tanisha Paul, Washington University
Co-Author - Kenneth Tercyak, Georgetown University
Acceptability of an innovative salon-based HPV self-collection intervention
Poster Number: A17Time: 05:00 PM - 05:50 PM
Topics: Cancer, Community Engagement
Background: Black women in the U.S. experience cervical cancer mortality at disproportionately high rates, partly due to delayed detection resulting from lower participation in screening. These inequities are influenced by barriers such as provider bias and inadequate healthcare access. Recent FDA approval, together with growing evidence on clinical and home-based self-sampling, presents a promising avenue to expand screening reach. Yet, like other innovations, achieving equitable implementation poses challenges. To help close this gap, we seek to distribute HPV self-collection kits in community venues- hair salons. We conducted a qualitative study to guide the design of this salon-based intervention. Methods: Open ended survey questions were administered via REDCap to solicit feedback on a salon-based HPV self-collection intervention. Group Concept Mapping (GCM) was previously conducted with members of the Black Community Advisory Council of Tucson (Black CACTus) to integrate diverse perspectives in developing the intervention. GCM results were incorporated into the intervention then submitted to the Black CACTus for feedback. Results: Participants(n=10) were salon clients(n=4), stylists(n=3), and medical providers(n=3). All participants identified as Black women, with two also identifying as Latina and White. Participant ages ranged from 23-53 years old. Participants expressed strong support for the salon-based HPV self-sampling intervention, often describing it as innovative, “flexible,” “empowering,” and a “welcoming” approach to healthcare. A central theme was stylists’ vital role as trusted messengers capable of “encouraging” participation. The salon was highlighted as a “comfortable,” “safe,” and convenient space for discussing sensitive health topics, less intimidating than traditional clinical environments. Participants suggested tangible incentives to further boost engagement. Finally, feedback underscored the need for clear guidance and support, including information on whom to contact with questions, stylist responsibilities, and steps for follow-up. Conclusions: Advancing discovery in cervical cancer screening requires moving beyond clinical environments and incorporating community settings, like hair salons. Integrated perspectives from our study show strong acceptability of a salon-based HPV self-collection approach. These findings emhpasize the potential of salons to improve access to and uptake of cervical cancer screening for Black women.
Keywords: Community intervention, Women's healthAuthors:
Presenter - Kelly Palmer, PhD, MHS, University of Alabama at Birmingham
Co-Author - Kathleen Pryor, University of Arizona
Co-Author - Azaria Suero-Davis, B.S., University of Arizona
Co-Author - Jennifer Hatcher, PhD, MPH, RN, University of Arizona
Cancer screening distress in Fanconi anemia: a mixed methods study
Poster Number: A18Time: 05:00 PM - 05:50 PM
Topics: Cancer, Methods and Measurement
Background: Individuals with Fanconi anemia (FA), a rare DNA repair disorder, have significantly elevated cancer risk and cancer treatment sensitivity. Clinical recommendations include life-long multi-cancer screening, yet intensive screening may cause distress. We investigated screening-related distress among participants enrolled in the NIH FA Squamous Cell Carcinoma (FASCC) screening study.
Methods: Participants were adults with FA who participated in NIH FASCC screening visits. We used a convergent mixed methods design combining longitudinal quantitative survey data (N=30) with qualitative ethnographic data (screening visit observations (N=32) and FA community podcast transcripts (N=38)). We used multi-cycle reflexive thematic coding to analyze ethnographic data and content analysis for open-text survey data. We used descriptive statistics and Wilcoxon tests to analyze quantitative survey data, including multiple measures of physical discomfort and distress before and after screening visits.
Findings: Screening-related distress was common (92%), but at relatively low levels across all survey measures, although higher after than before screening (p=0.01). Physical discomfort was mild, with higher anticipated compared to actual discomfort (p=0.04). Participants described being accustomed to screenings, and some viewed them as anxiety-reducing. Ethnographic thematic analysis revealed a strong sense of “perceived cancer inevitability,” which prompted a “vigilant” approach to screening that participants viewed as an opportunity for “early detection.” Many described cancer screening as a “survival strategy” that was key to surpassing FA-related life expectancy and “achieving milestones” in education, careers, and family life. Participants reported a range of strategies for coping with the physical and mental burden of rigorous screening regimens, including FA community social support, positive reframing, and accurate anticipation of discomfort and care needs.
Conclusion: Cancer screening distress was common but low when quantitatively assessed using survey data; however, qualitative data suggested individuals with FA experience chronic, anticipated screening-related distress. Perceived certainty of cancer diagnosis motivated many with FA to view screening as a positive, life-extending intervention, and to adopt effective coping strategies. Integration of multiple data types enables a more nuanced and comprehensive understanding of this complex experience.
Keywords: Cancer screening, GeneticsMethods: Participants were adults with FA who participated in NIH FASCC screening visits. We used a convergent mixed methods design combining longitudinal quantitative survey data (N=30) with qualitative ethnographic data (screening visit observations (N=32) and FA community podcast transcripts (N=38)). We used multi-cycle reflexive thematic coding to analyze ethnographic data and content analysis for open-text survey data. We used descriptive statistics and Wilcoxon tests to analyze quantitative survey data, including multiple measures of physical discomfort and distress before and after screening visits.
Findings: Screening-related distress was common (92%), but at relatively low levels across all survey measures, although higher after than before screening (p=0.01). Physical discomfort was mild, with higher anticipated compared to actual discomfort (p=0.04). Participants described being accustomed to screenings, and some viewed them as anxiety-reducing. Ethnographic thematic analysis revealed a strong sense of “perceived cancer inevitability,” which prompted a “vigilant” approach to screening that participants viewed as an opportunity for “early detection.” Many described cancer screening as a “survival strategy” that was key to surpassing FA-related life expectancy and “achieving milestones” in education, careers, and family life. Participants reported a range of strategies for coping with the physical and mental burden of rigorous screening regimens, including FA community social support, positive reframing, and accurate anticipation of discomfort and care needs.
Conclusion: Cancer screening distress was common but low when quantitatively assessed using survey data; however, qualitative data suggested individuals with FA experience chronic, anticipated screening-related distress. Perceived certainty of cancer diagnosis motivated many with FA to view screening as a positive, life-extending intervention, and to adopt effective coping strategies. Integration of multiple data types enables a more nuanced and comprehensive understanding of this complex experience.
Authors:
Author - Emily Pearce, MPH, PhD, National Cancer Institute
Author - Rowan Forbes Shepherd, PhD, National Cancer Institute
Author - Camella Rising, PhD, MS, RDN, National Cancer Institute
Author - , National Cancer Institute
Author - , National Cancer Institute
Author - , National Cancer Institute
Author - Paul Han, MD, MPH, National Cancer Institute
Author - , National Cancer Institute
Author - , National Cancer Institute
Author - , National Cancer Institute
Patient Experiences with Same-Day Discharge After Pre-Pectoral Implant-Based Breast Reconstruction
Poster Number: A19Time: 05:00 PM - 05:50 PM
Topics: Cancer, Quality of Life
Advancements in breast reconstruction, such as pre-pectoral implant-based breast reconstruction (PP IBBR), are increasingly paired with same-day discharge (SDD) protocols. However, little is known about patient perspectives when these procedures are incorporated into Enhanced Recovery After Surgery initiatives. This mixed methods study examined reflections of experiences among women who underwent SDD after post-mastectomy PP IBBR. Twenty participants completed semi-structured telephone interviews that included open-ended and closed-ended questions. Quantitative data from the Surgical Satisfaction Questionnaire and SDD-specific items were summarized descriptively, while qualitative data were analyzed using content analysis. All participants reported feeling satisfied with postoperative pain control, and nearly all felt safe and satisfied with SDD. Most were satisfied with the time to return to daily and social activities, though fewer were satisfied with their return to exercise. Qualitative findings supported these results, with participants describing well-managed pain, feeling safe returning home, and appreciation for provider communication, alongside challenges including uncertainty during preparation, vulnerability in early recovery, and psychosocial difficulty adjusting to longer-term changes. Participants emphasized the importance of tailored guidance, support, and clear communication throughout the process. Overall, these perspectives suggest that SDD can be both clinically feasible and patient-centered when supported by thorough preparation, clear communication about expectations, and ongoing follow-up. These findings can help shape recovery protocols that connect surgical, psychosocial, and system-level considerations, supporting a multidisciplinary approach to postmastectomy care.
Keywords: Treatment, Health outcomesAuthors:
Author - Kiersten Pflueger, M.A., M.P.H., Stony Brook University
Co-Author - Anne Moyer, Ph.D., Stony Brook University
Co-Author - Tara Huston, M.D., Stony Brook University Medical Center
Co-Author - Devika Patel, B.S., Stony Brook University
Co-Author - Stacey Scott, Ph.D., Stony Brook University
Co-Author - Brittni Munn, P.A.-C, Stony Brook University Medical Center
Co-Author - Anastasia Bakoulis, D.O., Stony Brook University Medical Center
Anxiety and cancer-related distress impact immune and cardiometabolic trajectories across the day in breast cancer survivors
Poster Number: A20Time: 05:00 PM - 05:50 PM
Topics: Cancer
Background: Anxiety and cancer-related distress can have far-reaching psychological and biological consequences among breast cancer survivors. This study tested whether anxiety and cancer-related distress impacted immune and cardiometabolic functioning in a double-blind randomized crossover study among breast cancer survivors. We assessed their impact both on baseline biological functioning and trajectories across the day during an experimental study visit.
Method: 150 breast cancer survivors completed two 8.5-hour long study visits. During one visit, survivors received a typhoid vaccine injection and, during the other, a placebo injection. At both visits, women completed self-report measures assessing anxiety and cancer-related distress and provided blood samples to test inflammation (i.e., white blood cell count [WBC], interleukin-6 [IL-6], interleukin-18 [IL-18], and c-reactive protein [CRP]) at 6 timepoints and cardiometabolic measurements (i.e., systolic blood pressure [SBP], diastolic blood pressure [DBP], and heart rate [HR]) at 8 timepoints. Mixed linear models examined cardiometabolic and immune trajectories across the day and whether anxiety and cancer-related distress predicted these trajectories.
Results: At baseline, higher anxiety was associated with lower CRP (b = -.16, SE = .05, p = .01) and IL-6 (b = -.11, SE = .04, p = .01). Higher cancer-related distress was associated with CRP (b = .08, SE = .04, p = .03). Across the day, cancer-related distress was associated with trajectories of IL-18 (b = 7.44, SE = 3.45, p = .04) and WBC (b = -.08, SE = .04, p = .045). Systolic blood pressure (b = -3.03, SE = 1.33, p = .02), diastolic blood pressure (b = -1.50, SE = .60, p = .01), and heart rate (b = 1.15, SE = .54, p = .03) were associated with anxiety across the day. There were no significant interactions with injection type.
Conclusion: Findings highlight the differential impact that cancer-related distress and anxiety have on immune and cardiometabolic symptom trajectories among breast cancer survivors. Interventions focused on treating distress in survivors may improve immune and cardiometabolic functioning, ultimately promoting longevity and quality of life among these women.
Keywords: Cancer survivorship, EmotionsMethod: 150 breast cancer survivors completed two 8.5-hour long study visits. During one visit, survivors received a typhoid vaccine injection and, during the other, a placebo injection. At both visits, women completed self-report measures assessing anxiety and cancer-related distress and provided blood samples to test inflammation (i.e., white blood cell count [WBC], interleukin-6 [IL-6], interleukin-18 [IL-18], and c-reactive protein [CRP]) at 6 timepoints and cardiometabolic measurements (i.e., systolic blood pressure [SBP], diastolic blood pressure [DBP], and heart rate [HR]) at 8 timepoints. Mixed linear models examined cardiometabolic and immune trajectories across the day and whether anxiety and cancer-related distress predicted these trajectories.
Results: At baseline, higher anxiety was associated with lower CRP (b = -.16, SE = .05, p = .01) and IL-6 (b = -.11, SE = .04, p = .01). Higher cancer-related distress was associated with CRP (b = .08, SE = .04, p = .03). Across the day, cancer-related distress was associated with trajectories of IL-18 (b = 7.44, SE = 3.45, p = .04) and WBC (b = -.08, SE = .04, p = .045). Systolic blood pressure (b = -3.03, SE = 1.33, p = .02), diastolic blood pressure (b = -1.50, SE = .60, p = .01), and heart rate (b = 1.15, SE = .54, p = .03) were associated with anxiety across the day. There were no significant interactions with injection type.
Conclusion: Findings highlight the differential impact that cancer-related distress and anxiety have on immune and cardiometabolic symptom trajectories among breast cancer survivors. Interventions focused on treating distress in survivors may improve immune and cardiometabolic functioning, ultimately promoting longevity and quality of life among these women.
Authors:
Author - Megan Renna, Ph.D., The Ohio State University
Co-Author - Kelsi Broich, The Ohio State University
The Associations between Health Information Sources and Surgical Decision-Making among Women with Early-Stage Breast Cancer
Poster Number: A21Time: 05:00 PM - 05:50 PM
Topics: Cancer, Decision Making
Breast cancer is the second most common cancer among women in the United States. Due to advances in early detection, most women are diagnosed with early-stage disease, where surgery – either mastectomy or breast-conserving surgery (BCS) – is the primary treatment. Because both options are viable, the decision is preference sensitive and may be influenced by external information sources. Research suggests women, particularly younger women, are increasingly turning to online sources of health information to inform their surgical treatment decisions. A 2025 study found that online discussions about mastectomy on Reddit, a popular social media forum, have become increasingly positive over the past decade, suggesting that perceptions of surgical treatment may shift over time. In addition, the increasingly wide variety of media platforms, and the number of people who use them, could result in different information being shared on different media sources. As such, this study examined the associations between sources of health information and surgical treatment decision among women with early-stage cancer. Women (N = 182) who were diagnosed with early-stage breast cancer (Mage = 45.36; SD = 8.73, 77% White) completed an online survey assessing the sources of health information they used to inform their surgical treatment decision, along with demographic and clinical characteristics. Binary logistic regression analyses were conducted to predict surgical choice (BCS vs. mastectomy), controlling for clinical factors. Results indicated that women who utilized social media were more likely to undergo a mastectomy (OR = 2.51, p = .02). The utilization of information from healthcare providers, the internet, and friends and family were not significant predictors. Age at diagnosis, stage of disease, and genetic test results were also non-significant covariates. Findings suggest social media use may be associated with increased likelihood of mastectomy among women with early-stage breast cancer. This study highlights the need for further research to clarify whether and how social media influences surgical decision-making. Understanding the role of health information sources in decision-making can inform patient-provider communication and support shared decision making. Future research could examine whether the use of specific health information sources is associated with subsequent treatment-related regret.
Keywords: Cancer survivorship, Decision makingAuthors:
Author - Caroline Salafia, PhD, Memorial Sloan Kettering Cancer Center
Co-Author - Keith Bellizzi, PhD, MPH, FSBM, University of Connecticut
Co-Author - Elizabeth Hintz, PhD, University of Connecticut
Co-Author - Jolaade Kalinowski, Ed.D, MA, The University of Connecticut
Co-Author - Timothy Moore, PhD, University of Connecticut
Opinions on the Effect of Alcohol on Cancer Risk Among U.S. Adults
Poster Number: A22Time: 05:00 PM - 05:50 PM
Topics: Cancer, Health Communication and Policy
Purpose: Research has found associations between alcohol consumption and an increased risk for certain cancers, yet many U.S. adults do not recognize alcohol use as a cancer risk factor. The aim of this study was to determine correlates of opinions about the effect of alcohol on cancer risk among U.S. adults.
Methods: A cross-sectional analysis of the Health Information National Trends Survey data collected from March to September 2024 (HINTS 7). The primary outcome was worded as, “In your opinion, how does drinking alcohol affect the risk of getting cancer?” Response options were: decreases risk, no effect on the risk, increases risk, and don’t know. Model 1 compared decreases risk and no effect to increases risk. Model 2 compared don't know responses to increases risk. Univariable and multivariable associations between opinions on the effect of alcohol on cancer risk with possible correlates including: demographic characteristics, internet use, social media use, alcohol use, smoking, trust in scientists, and political viewpoints. After excluding individuals with missing data for the main outcome and other study variables, the final sample size was 5,466. Odds ratios and 95% confidence intervals are reported.
Results: Of the 5,466 participants, 39.8% reported that alcohol increases risk of cancer, 9.5% reported that alcohol decreases risk of cancer or has no effect, and 50.7% reported don’t know. In Model 1, odds of decreases risk/no effect were greater in individuals who reported any alcohol use in the past 30 days. Odds of decreases risk/no effect were lower in female (vs. male), Asian (vs. White), those with “a lot” of trust in information about cancer from scientists (vs. some, a little, and not at all), or had ever looked for cancer information from any source (vs. not). In Model 2, odds of don’t know were higher in older age groups (vs. 18-34 year-olds) or had identified as Black/African American (vs. White). Odds of don’t know were lower in Asian (vs. White), college graduates (vs. not), those with “a lot” of trust in scientists for cancer information (vs. some, a little, and not at all), looked for cancer information from any source (vs. not), watched a health-related video on social media (vs. never), or had liberal political viewpoints (vs. moderate).
Conclusion: Findings from the present study may inform targeted and tailored communications to improve awareness about alcohol consumption and increased risk of developing cancer.
Keywords: Cancer, AlcoholMethods: A cross-sectional analysis of the Health Information National Trends Survey data collected from March to September 2024 (HINTS 7). The primary outcome was worded as, “In your opinion, how does drinking alcohol affect the risk of getting cancer?” Response options were: decreases risk, no effect on the risk, increases risk, and don’t know. Model 1 compared decreases risk and no effect to increases risk. Model 2 compared don't know responses to increases risk. Univariable and multivariable associations between opinions on the effect of alcohol on cancer risk with possible correlates including: demographic characteristics, internet use, social media use, alcohol use, smoking, trust in scientists, and political viewpoints. After excluding individuals with missing data for the main outcome and other study variables, the final sample size was 5,466. Odds ratios and 95% confidence intervals are reported.
Results: Of the 5,466 participants, 39.8% reported that alcohol increases risk of cancer, 9.5% reported that alcohol decreases risk of cancer or has no effect, and 50.7% reported don’t know. In Model 1, odds of decreases risk/no effect were greater in individuals who reported any alcohol use in the past 30 days. Odds of decreases risk/no effect were lower in female (vs. male), Asian (vs. White), those with “a lot” of trust in information about cancer from scientists (vs. some, a little, and not at all), or had ever looked for cancer information from any source (vs. not). In Model 2, odds of don’t know were higher in older age groups (vs. 18-34 year-olds) or had identified as Black/African American (vs. White). Odds of don’t know were lower in Asian (vs. White), college graduates (vs. not), those with “a lot” of trust in scientists for cancer information (vs. some, a little, and not at all), looked for cancer information from any source (vs. not), watched a health-related video on social media (vs. never), or had liberal political viewpoints (vs. moderate).
Conclusion: Findings from the present study may inform targeted and tailored communications to improve awareness about alcohol consumption and increased risk of developing cancer.
Authors:
Author - Navreet Singh, MPH, Wayne State University
Co-Author - Nancy Buderer, MS, Nancy Buderer Consulting, LLC
Co-Author - Aisha Langford, Wayne State University
Disparities in Colorectal Cancer Screening by Nativity, Citizenship, and Screening Modality: The Role of Social Vulnerability and Frailty
Poster Number: A23Time: 05:00 PM - 05:50 PM
Topics: Cancer, Aging
Background: Limited information exists on the association of colorectal cancer (CRC) screening modalities, frailty and social vulnerability (SVI) among immigrant populations in the U.S. We examined CRC screening disparities by nativity, citizenship and assessed the role of SVI and frailty on CRC preventative health service utilization.
Methods: We identified 57,168 adults aged ≥45 from the 2019, 2021, 2023 National Health Interview Survey, including 8,520 foreign born and 2,405 non-citizens. CRC screening status was categorized as invasive, non-invasive, or neither. A modified frailty scale (fatigue, resistance, ambulation, multimorbidity, low BMI) and social vulnerability index (socioeconomic status, household characteristics, racial/ethnic minority status, access to care) was constructed. Fixed-effect multivariable and multinomial logistic regression examined associations with adjusted odds ratio (OR) between modality, frailty and SVI across full sample and immigrants.
Results: Overall, 28.7% of adults had never been screened for CRC. Screening uptake and invasive modality use were significantly lower among foreign-born individuals and non-citizens. Non-citizens were less likely to receive any CRC screening (OR 0.48, 95% CI: 0.41, 0.55) and had even lower odds of invasive screening (OR: 0.44, 95% CI: 0.25, 0.78) compared to citizens. Foreign-born immigrants with high SVI had lower odds of invasive (OR: 0.58, 95% CI: 0.42, 0.80) screening compared to U.S. born counterparts. U.S. residence <5 years, Hispanic, Asian ethnicity and age 45-55 years consistently showed lower screening odds. Unexpectedly, frailty was associated with increased odds of screening in the full sample, but this association was not observed among subgroups.
Conclusion: We used nationally representative data and found evidence that invasive CRC screening is independently associated with immigration status, high social vulnerability and duration of U.S. residence. Strategies should be implemented to address the disparities and educate immigrant communities and ensure proper access to preventative care.
Keywords: Colorectal cancer screening; Older Adult; Immigrant health; Citizenship; Screening modality; Social vulnerability; Frailty; Health disparities
Keywords: Cancer screening, Older adultsMethods: We identified 57,168 adults aged ≥45 from the 2019, 2021, 2023 National Health Interview Survey, including 8,520 foreign born and 2,405 non-citizens. CRC screening status was categorized as invasive, non-invasive, or neither. A modified frailty scale (fatigue, resistance, ambulation, multimorbidity, low BMI) and social vulnerability index (socioeconomic status, household characteristics, racial/ethnic minority status, access to care) was constructed. Fixed-effect multivariable and multinomial logistic regression examined associations with adjusted odds ratio (OR) between modality, frailty and SVI across full sample and immigrants.
Results: Overall, 28.7% of adults had never been screened for CRC. Screening uptake and invasive modality use were significantly lower among foreign-born individuals and non-citizens. Non-citizens were less likely to receive any CRC screening (OR 0.48, 95% CI: 0.41, 0.55) and had even lower odds of invasive screening (OR: 0.44, 95% CI: 0.25, 0.78) compared to citizens. Foreign-born immigrants with high SVI had lower odds of invasive (OR: 0.58, 95% CI: 0.42, 0.80) screening compared to U.S. born counterparts. U.S. residence <5 years, Hispanic, Asian ethnicity and age 45-55 years consistently showed lower screening odds. Unexpectedly, frailty was associated with increased odds of screening in the full sample, but this association was not observed among subgroups.
Conclusion: We used nationally representative data and found evidence that invasive CRC screening is independently associated with immigration status, high social vulnerability and duration of U.S. residence. Strategies should be implemented to address the disparities and educate immigrant communities and ensure proper access to preventative care.
Keywords: Colorectal cancer screening; Older Adult; Immigrant health; Citizenship; Screening modality; Social vulnerability; Frailty; Health disparities
Authors:
Presenter - Quazi Minhaz Tabassum, MPH, University of North Carolina at Charlotte
Rethinking Depression Diagnosis in Ovarian Cancer: The Role of Somatic Symptoms
Poster Number: A24Time: 05:00 PM - 05:50 PM
Topics: Cancer, Mental Health
Objective: A recent meta-analysis reported that ovarian cancer patients have more than a threefold increase in risk of being diagnosed with depression compared to the general population. However, the role of disease-related processes in contributing to depressive symptoms—particularly at diagnosis and during treatment—remains unclear. The objective of this study was to examine the contribution of somatic depressive symptoms to the assessment of depressive symptom severity in patients with ovarian cancer, both at diagnosis and one-year later, compared to a healthy control group.
Methods: 428 ovarian cancer patients completed psychosocial assessments at 1-2 weeks prior to surgical intervention or initiation of neoadjuvant chemotherapy (T1) and at a 1-year (T3) follow-up visit. A comparison sample from the Midlife in the United States (MIDUS) study was included. Item factor analysis was used to examine the functioning of somatic items in a common depression symptom index in both samples.
Results: Somatic items demonstrated differential functioning between groups. Specifically, ovarian cancer patients were more likely to endorse somatic symptoms at lower levels of depression as compared to healthy aging adults; they additionally required a lower level of depression to endorse somatic items as compared to non-somatic items. These differences between cancer patients and healthy aging adults were no longer present at one-year post-diagnosis.
Conclusions: These findings support the conclusion that somatic symptoms may disproportionately inflate depression scores among ovarian cancer patients at diagnosis, potentially leading to misclassification or overestimation of depression severity. This highlights the need for refined measurement approaches that account for the somatic burden of cancer in assessing depression during active disease.
Keywords: Cancer survivorship, Mental healthMethods: 428 ovarian cancer patients completed psychosocial assessments at 1-2 weeks prior to surgical intervention or initiation of neoadjuvant chemotherapy (T1) and at a 1-year (T3) follow-up visit. A comparison sample from the Midlife in the United States (MIDUS) study was included. Item factor analysis was used to examine the functioning of somatic items in a common depression symptom index in both samples.
Results: Somatic items demonstrated differential functioning between groups. Specifically, ovarian cancer patients were more likely to endorse somatic symptoms at lower levels of depression as compared to healthy aging adults; they additionally required a lower level of depression to endorse somatic items as compared to non-somatic items. These differences between cancer patients and healthy aging adults were no longer present at one-year post-diagnosis.
Conclusions: These findings support the conclusion that somatic symptoms may disproportionately inflate depression scores among ovarian cancer patients at diagnosis, potentially leading to misclassification or overestimation of depression severity. This highlights the need for refined measurement approaches that account for the somatic burden of cancer in assessing depression during active disease.
Authors:
Author - Rachel Telles, M.A., University of Iowa
Co-Author - Premal Thaker, M.D., Washington University School of Medicine
Co-Author - Michael Goodheart, M.D., University of Iowa Hospitals and Clinics
Co-Author - Frank Penedo, Ph.D., University of Miami Sylvester Comprehensive Cancer Center
Co-Author - Anil Sood, MD, UT MD Anderson Cancer Center
Co-Author - Susan Lutgendorf, PhD, University of Iowa
Characteristics Associated with Quality of Life, Anxiety, and Depressive Symptoms among Caregivers of Patients with Advanced Lung Cancer
Poster Number: A25Time: 05:00 PM - 05:50 PM
Topics: Cancer, Quality of Life
Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Patients with advanced non-small cell lung cancer (ANSCLC) experience high symptom burden and poor quality of life (QOL), for which caregivers provide essential support. Caregivers of patients with ANSCLC are at risk for poor psychosocial outcomes, such as anxiety and depression. Prior studies characterizing caregivers primarily consist of small, homogenous samples outside of the United States. Here, we sought to identify characteristics associated with QOL, anxiety, and depressive symptoms among caregivers of patients with ANSCLC participating in a large, multi-site trial in the United States.
Methods: Across 22 sites, caregivers (N=548) of patients recently (<12 weeks) diagnosed with ANSCLC enrolled in a clinical trial between 6/2018 and 5/2023. Caregivers reported demographic information (age, race, ethnicity, cohabitation with patient, relationship to patient) and completed baseline measures of depression and anxiety symptoms (HADS; Hospital Anxiety and Depression Scale; elevated subscale scores >7), QOL (Caregiver Oncology Quality of Life Questionnaire), and prognostic understanding (Prognosis and Treatment Perception Questionnaire). We used linear regression to independently test the associations of demographic information and prognostic understanding with QOL, anxiety, and depressive symptoms.
Results: Caregivers were on average 57.4 years old (SD=14.0); the majority were White (86.3%), women (68.6%), the patients’ spouse (63.9%), and living with the patient (75.0%). Approximately half (54.1%) reported clinically elevated anxiety, and 24.6% reported elevated depressive symptoms. Caregivers who were younger (B=-0.06, SE=0.01, p<.001), White (B=1.07, SE=0.53, p=.045), and women (B=1.12, SE=0.39, p<.01) reported greater anxiety symptoms. Younger caregivers (B=-0.03, SE=0.01, p=.02) and those living with the patient (B=-1.17, SE=0.37, p<.01) reported greater depressive symptoms. Younger age was associated with lower QOL (B=0.22, SE=0.04, p<.001). Caregivers who reported that the patient’s cancer was not curable reported greater anxiety symptoms (B=0.90, SE=0.46, p=.049).
Conclusions: Caregivers’ demographic characteristics and prognostic understanding were associated with psychosocial outcomes, with younger caregivers at greatest risk of low mood and poor QOL. These data may inform efforts to identify caregivers who would benefit from additional supportive care services.
Keywords: Caregiving, CancerMethods: Across 22 sites, caregivers (N=548) of patients recently (<12 weeks) diagnosed with ANSCLC enrolled in a clinical trial between 6/2018 and 5/2023. Caregivers reported demographic information (age, race, ethnicity, cohabitation with patient, relationship to patient) and completed baseline measures of depression and anxiety symptoms (HADS; Hospital Anxiety and Depression Scale; elevated subscale scores >7), QOL (Caregiver Oncology Quality of Life Questionnaire), and prognostic understanding (Prognosis and Treatment Perception Questionnaire). We used linear regression to independently test the associations of demographic information and prognostic understanding with QOL, anxiety, and depressive symptoms.
Results: Caregivers were on average 57.4 years old (SD=14.0); the majority were White (86.3%), women (68.6%), the patients’ spouse (63.9%), and living with the patient (75.0%). Approximately half (54.1%) reported clinically elevated anxiety, and 24.6% reported elevated depressive symptoms. Caregivers who were younger (B=-0.06, SE=0.01, p<.001), White (B=1.07, SE=0.53, p=.045), and women (B=1.12, SE=0.39, p<.01) reported greater anxiety symptoms. Younger caregivers (B=-0.03, SE=0.01, p=.02) and those living with the patient (B=-1.17, SE=0.37, p<.01) reported greater depressive symptoms. Younger age was associated with lower QOL (B=0.22, SE=0.04, p<.001). Caregivers who reported that the patient’s cancer was not curable reported greater anxiety symptoms (B=0.90, SE=0.46, p=.049).
Conclusions: Caregivers’ demographic characteristics and prognostic understanding were associated with psychosocial outcomes, with younger caregivers at greatest risk of low mood and poor QOL. These data may inform efforts to identify caregivers who would benefit from additional supportive care services.
Authors:
Author - Emily Walsh, PhD, Massachusetts General Hospital/Harvard Medical School
Co-Author - Jenipher Silva, BS, Massachusetts General Hospital
Co-Author - Isabel Torio, BS, Massachusetts General Hospital
Co-Author - Phalaen Chang, BA, Massachusetts General Hospital
Co-Author - Ethan Markel, BA, Massachusetts General Hospital
Co-Author - Joseph Greer, PhD, Massachusetts General Hospital/Harvard Medical School
Co-Author - Jennifer Temel, MD, Massachusetts General Hospital/Harvard Medical School
Co-Author - Jamie Jacobs, PhD, Massachusetts General Hospital/Harvard Medical School
Risk of Recurrence: The Impact of Socioeconomic Status and Sleep on Inflammation in Breast and Colorectal Cancer Survivors
Poster Number: A26Time: 05:00 PM - 05:50 PM
Topics: Cancer, Sleep
Background: Cancer patients and survivors of a low socioeconomic status (SES) are at greater risk of experiencing a cancer recurrence compared to their higher SES counterparts (Gordon et al., 1992; Srougi et al., 2011). Individuals of a low SES also show increased inflammation associated with cancer development (Fraga et al., 2015; Muscatell et al., 2018). Up to 75% of cancer patients and survivors experience poor sleep, further fueling inflammation (Irwin et al., 2015, Otte et al., 2014). This study explored associations between SES (income, educational attainment) and inflammation (CRP, LBP, sCD14, and the ratio of LBP to sCD14) and whether sleep moderates these relationships in a sample of breast and colorectal cancer survivors.
Methods: Breast and colorectal cancer patients (N = 297) completed 3 study visits; a pre-treatment visit and two follow-up visits (6-and 18-months post-treatment). At all visits, patients provided a self-report of their income along with fasting blood samples to assess levels of CRP, LBP, and sCD14. Information on their highest level of education obtained was collected at visit 1. At visits 2 and 3, they completed the Pittsburgh Sleep Quality Index.
Results: Linear mixed models controlled for cancer type, cancer stage, treatment type, physical comorbidities, body mass index, age, biological sex, alcohol use, and menopausal status. Income was significantly associated with CRP (F = 4.484, p = .012) and the ratio of LBP to sCD14 (F = 5.383, p = .005), with the lowest income group ($0-$24,999) having lower levels of these markers compared to the mid-level income group ($25,000-$74,999). Education and sleep significantly interacted to predict CRP (F = 3.371, p = .037). Pairwise comparisons indicated poor sleep quality led to higher CRP for individuals with a high school diploma or less compared to the those with some college or a college degree (Mdiff = -.582, SE = .286, p = .043). Sleep did not moderate any other associations between SES and inflammation (ps = .307 - .953).
Conclusion: Low SES may not always equate to elevated inflammation in cancer survivors. Interactions between sociodemographic factors, health resources, life stressors, and health behaviors might be most influential. If research continues to find higher CRP among survivors with a high school diploma or less who report low sleep quality, medical providers should administer sleep screenings to these survivors to help identify and intervene on sleep concerns.
Keywords: Cancer, Abnormal sleepMethods: Breast and colorectal cancer patients (N = 297) completed 3 study visits; a pre-treatment visit and two follow-up visits (6-and 18-months post-treatment). At all visits, patients provided a self-report of their income along with fasting blood samples to assess levels of CRP, LBP, and sCD14. Information on their highest level of education obtained was collected at visit 1. At visits 2 and 3, they completed the Pittsburgh Sleep Quality Index.
Results: Linear mixed models controlled for cancer type, cancer stage, treatment type, physical comorbidities, body mass index, age, biological sex, alcohol use, and menopausal status. Income was significantly associated with CRP (F = 4.484, p = .012) and the ratio of LBP to sCD14 (F = 5.383, p = .005), with the lowest income group ($0-$24,999) having lower levels of these markers compared to the mid-level income group ($25,000-$74,999). Education and sleep significantly interacted to predict CRP (F = 3.371, p = .037). Pairwise comparisons indicated poor sleep quality led to higher CRP for individuals with a high school diploma or less compared to the those with some college or a college degree (Mdiff = -.582, SE = .286, p = .043). Sleep did not moderate any other associations between SES and inflammation (ps = .307 - .953).
Conclusion: Low SES may not always equate to elevated inflammation in cancer survivors. Interactions between sociodemographic factors, health resources, life stressors, and health behaviors might be most influential. If research continues to find higher CRP among survivors with a high school diploma or less who report low sleep quality, medical providers should administer sleep screenings to these survivors to help identify and intervene on sleep concerns.
Authors:
Presenter - Faith Wilbourne, M.A., Ohio State University
Co-Author - Megan Renna, Ph.D., Ohio State University
Examining the effectiveness of a data coaching process to increase child physical activity, perceived motor competence, and staff physical activity promoting practices: A randomized controlled trial
Poster Number: A27Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Implementation Science
Background:
Recent studies established a direct link between a child’s competence in fundamental motor skills (i.e. motor competence, MC) and their participation in PA. Interventions that target MC have resulted in increased daily PA. Targeting out of school time (OST) offers advantages over school-based interventions since they offer more flexibility and time while also reaching under-served populations. However, OST programs often fail to incorporate MC, despite the potential positive impacts on locomotor and object control skills in children. Equipping OST leaders with foundational knowledge in MC development and child PA behavior is a promising strategy for improving MC and PA in youth. The study will build the foundation for a sustainable OST training program and evaluate potential for broader dissemination. Over a one-year period, we will test our data coaching system intervention named OST-Coach. The aims are to a) determine the impact OST-Coach has on evidence-based PA behavior and MC and b) identify factors that influence the effectiveness of the OST-Coach intervention. Successful completion of this study will provide preliminary evidence to support the utilization of OST-Coach in OST-related programs.
Methods:
Data collection is currently ongoing. OST program leaders receiving OST-Coach will participate in an iterative quality improvement and feedback process following a modified version of the Plan-Do-Study Act method (IDPR Cycle). The IDPR cycle will take program leaders through four specific steps to improve child PA and MC: Investigate (e.g., what are the current PA levels of children in the program?), design (e.g., how can child PA be increased?), practice (e.g., integration of evidence-based strategies to increase PA), and reflect (e.g., did the integration of new practices increase child PA?). We will conduct a randomized controlled trial with four OST sites (N=200 total participants across sites) with random assignment at the site level. Two sites will randomly receive the OST-Coach intervention (N=100 intervention; N=100 control). Sites that received the intervention will be evaluated to measure implementation outcomes (e.g., adoption of evidence-based practices) and child PA and MC.
Implications:
The development of our systematic, collaborative implementation approach could be replicated across OST programs nationally.
Keywords: Physical activity, Children's healthRecent studies established a direct link between a child’s competence in fundamental motor skills (i.e. motor competence, MC) and their participation in PA. Interventions that target MC have resulted in increased daily PA. Targeting out of school time (OST) offers advantages over school-based interventions since they offer more flexibility and time while also reaching under-served populations. However, OST programs often fail to incorporate MC, despite the potential positive impacts on locomotor and object control skills in children. Equipping OST leaders with foundational knowledge in MC development and child PA behavior is a promising strategy for improving MC and PA in youth. The study will build the foundation for a sustainable OST training program and evaluate potential for broader dissemination. Over a one-year period, we will test our data coaching system intervention named OST-Coach. The aims are to a) determine the impact OST-Coach has on evidence-based PA behavior and MC and b) identify factors that influence the effectiveness of the OST-Coach intervention. Successful completion of this study will provide preliminary evidence to support the utilization of OST-Coach in OST-related programs.
Methods:
Data collection is currently ongoing. OST program leaders receiving OST-Coach will participate in an iterative quality improvement and feedback process following a modified version of the Plan-Do-Study Act method (IDPR Cycle). The IDPR cycle will take program leaders through four specific steps to improve child PA and MC: Investigate (e.g., what are the current PA levels of children in the program?), design (e.g., how can child PA be increased?), practice (e.g., integration of evidence-based strategies to increase PA), and reflect (e.g., did the integration of new practices increase child PA?). We will conduct a randomized controlled trial with four OST sites (N=200 total participants across sites) with random assignment at the site level. Two sites will randomly receive the OST-Coach intervention (N=100 intervention; N=100 control). Sites that received the intervention will be evaluated to measure implementation outcomes (e.g., adoption of evidence-based practices) and child PA and MC.
Implications:
The development of our systematic, collaborative implementation approach could be replicated across OST programs nationally.
Authors:
Co-Author - Sarah Arraiga, Kansas State University
Co-Author - Katie Schwartzkopf, Kansas State University
Co-Author - Denver Brown, PhD, Kansas State University
Co-Author - Emily Mailey, PhD, Kansas State University
Sex Differences in the Links Between SOL, WASO, and Cardiovascular Outcomes
Poster Number: A29Time: 05:00 PM - 05:50 PM
Topics: Cardiovascular Disease, Sleep
Background
Sleep disturbances such as sleep onset latency (SOL), waking after sleep onset (WASO), and nightmares are associated with autonomic stress, thereby increasing cardiovascular disease (CVD) risk. Few studies, however, have examined whether these effects extend to cortisol dysregulation, are independent of body mass index (BMI), or differ by sex. The present study tested whether sleep disturbances predict cardiovascular and hypertension risk.
Methods
Participants were 1,253 adults from the Midlife in the United States (MIDUS) Project. The Mage = 54.7 years and the project is 56.8% female. Predictors included sleep trouble symptoms (SOL + WASO), nightmare frequency (PSQI 5h), perceived stress (PSS), and log-transformed baseline cortisol. Outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), resting pulse, and hypertension risk (SBP ≥ 130 or DBP ≥ 80). Covariates were age, sex, and BMI. Multiple linear regressions tested continuous outcomes, and a logistic regression modeled hypertension odds. Sex-stratified regressions examined gender differences.
Results
Linear models showed that BMI and age were the most consistent predictors of blood pressure wherein higher BMI predicted both SBP (β = .20, p < .001) and DBP (β = .07, p = .017), while older age predicted higher SBP (β = .28, p < .001) but lower DBP (β = -.13, p < .001). Crosstabs indicated that women reported more frequent sleep trouble symptoms and nightmares than men, whereas men had higher hypertension prevalence. In regression models, women had significantly lower SBP and DBP than men (β = −.07, p = .011) but higher resting pulse (β = .10, p < .001). Sleep trouble symptoms significantly predicted higher resting pulse (β = .06, p = .044), along with BMI (β = .17, p < .001). Logistic regression showed that SOL and WASO symptoms were associated with 19% greater odds of hypertension (OR = 1.19, 95% CI [1.03, 1.38], p = .016). Sex-stratified models revealed stronger prediction for women (R² = .16) than men (R² = .07). Nightmares, perceived stress, and cortisol were also nonsignificant predictors.
Conclusions
Sleep disturbance symptoms were linked to elevated pulse and greater hypertension risk, beyond established factors. Findings highlight the importance of targeting sleep disturbance as a modifiable risk factor for CVD. These preliminary findings emphasize the need for further research on women’s cardiovascular health.
Keywords: Women's health, Sleep disordersSleep disturbances such as sleep onset latency (SOL), waking after sleep onset (WASO), and nightmares are associated with autonomic stress, thereby increasing cardiovascular disease (CVD) risk. Few studies, however, have examined whether these effects extend to cortisol dysregulation, are independent of body mass index (BMI), or differ by sex. The present study tested whether sleep disturbances predict cardiovascular and hypertension risk.
Methods
Participants were 1,253 adults from the Midlife in the United States (MIDUS) Project. The Mage = 54.7 years and the project is 56.8% female. Predictors included sleep trouble symptoms (SOL + WASO), nightmare frequency (PSQI 5h), perceived stress (PSS), and log-transformed baseline cortisol. Outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), resting pulse, and hypertension risk (SBP ≥ 130 or DBP ≥ 80). Covariates were age, sex, and BMI. Multiple linear regressions tested continuous outcomes, and a logistic regression modeled hypertension odds. Sex-stratified regressions examined gender differences.
Results
Linear models showed that BMI and age were the most consistent predictors of blood pressure wherein higher BMI predicted both SBP (β = .20, p < .001) and DBP (β = .07, p = .017), while older age predicted higher SBP (β = .28, p < .001) but lower DBP (β = -.13, p < .001). Crosstabs indicated that women reported more frequent sleep trouble symptoms and nightmares than men, whereas men had higher hypertension prevalence. In regression models, women had significantly lower SBP and DBP than men (β = −.07, p = .011) but higher resting pulse (β = .10, p < .001). Sleep trouble symptoms significantly predicted higher resting pulse (β = .06, p = .044), along with BMI (β = .17, p < .001). Logistic regression showed that SOL and WASO symptoms were associated with 19% greater odds of hypertension (OR = 1.19, 95% CI [1.03, 1.38], p = .016). Sex-stratified models revealed stronger prediction for women (R² = .16) than men (R² = .07). Nightmares, perceived stress, and cortisol were also nonsignificant predictors.
Conclusions
Sleep disturbance symptoms were linked to elevated pulse and greater hypertension risk, beyond established factors. Findings highlight the importance of targeting sleep disturbance as a modifiable risk factor for CVD. These preliminary findings emphasize the need for further research on women’s cardiovascular health.
Authors:
Author - Elijah Nichols, BS, University of Kansas
Co-Author - Anna Quesada, BA, University of Kansas
Co-Author - Nancy Hamilton, PhD, University of Kansas
Creating and optimizing a Spanish-Language version of the Clinical Opiate Withdrawal Scale (COWS): La Escala Clínica de Síndrome Abstinencia de Opiáceos (ECAO)
Poster Number: A30Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, Methods and Measurement
Background: The Clinical Opiate Withdrawal Scale (COWS) is a commonly used tool to systematically assess the severity of patients experiencing withdrawal from opioids in a clinical or medical setting. Even though the COWS has been used for decades, there exists no official or published Spanish-language version. Hispanic and Latino communities, the most common Spanish-speaking communities, face persistent disparities accessing culturally and linguistically appropriate care. More than half of Hispanic individuals prefer Spanish-speaking physicians, highlighting the importance of linguistically appropriate tools in fostering trust and accurate communication. To date and to our knowledge, no other comparable assessments exist that could be used in place of a Spanish-language version of the COWS. Purpose: The current study created and evaluated a Spanish-language version of the COWS for free use among clinical and medical providers. The aims were 1) translate the COWS into the ECAO; 2) ensure accurate and appropriate translation by gathering attitudes and feedback about the ECAO. Methods: The translation of the COWS into the ECAO occurred using members of the research team who were fluent Spanish speakers. Standard forward/backward translation methods were used. Next, attitudes and feedback were assessed from healthcare workers using a unique online-only design that asked participants to compare the ECAO to the COWS. In addition to questionnaires, a “fake” patient video was created to standardized assessments of accuracy. Specifically, the ECAO’s acceptability, appropriateness, feasibility, understandability, actionability, accuracy, and cultural competency were measured. Results: The final sample size was N=107 (Mage = 40.00 years; woman=58.88%; White=71.64%; Hispanic/Latino=12.26%; master’s degree = 42.06%) healthcare workers. There were no differences between the COWS (M=19.13; SD=6.14; range 5-31) and ECAO (M=19.39; SD=5.43; range 4-29) sum scores (t(71.66)=-0,19, p=.85). Participants rated the ECAO high on all attitude measures, with relative areas of improvement being visual aids and instructions. Conclusions: Overall, participants were favorable toward the ECAO as a measure for opioid withdrawal. It is highly recommended that practitioners begin to use this, which we will make freely available following the peer-review process.
Keywords: Opioids, AssessmentAuthors:
Co-Author - Seth Jones, BS, University of Richmond
Co-Author - Melanie Hernandez, University of Richmond
Co-Author - America Lerma, University of Richmond
Co-Author - Samantha Nava, BS, University of Richmond
Co-Author - Karina Vazquez, PhD, University of Richmond
Adolescents’ perceived difficulty in accessing sexual and reproductive health services before, during, and after the COVID-19 pandemic
Poster Number: A31Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Social and Environmental Context and Health
Background: Little is known about how the COVID-19 pandemic influenced adolescent access to sexual and reproductive healthcare products and services, and whether any challenges abated as COVID-19 became endemic.
Methods: Data are from the QuaranTeen Health Study, an online longitudinal study of adolescents aged 13-17 (N=1,803) recruited in 2023-2024. We assessed perceived difficulty in accessing sexual and reproductive healthcare products and services (i.e., birth control/contraception, human immunodeficiency virus (HIV) and other sexually transmitted infection (STI) testing, condoms, and appointments with healthcare providers [HCP]) before the pandemic, during the acute phase of the pandemic, and in the past 2 months. Perceptions before and during the pandemic were assessed at baseline. Perceptions of the past 2 months were assessed at baseline and 2-month follow-up. Participants responded on a 5-point Likert scale from ‘strongly disagree’ to ‘strongly agree’ that they had access difficulty. Participants who responded that they ‘somewhat’ or ‘strongly’ agreed were considered to have perceived difficulty accessing products and services. We evaluated the prevalence of perceived difficulty for the cohort overall, and stratified by ever having engaged in oral, penile-vaginal, and/or penile-anal sex.
Results: The percentage of adolescents reporting difficulty before the pandemic was 17% for HCP appointment, 25% for HIV/STI testing, 30% for birth control, and 29% for condoms. Perceived difficulty accessing all services was higher during (versus before), the pandemic: 42% for HCP appointment, 38% for HIV/STI tests, and 37% for both birth control and condoms. After the pandemic, the prevalence of perceived difficulty accessing birth control and HIV/STI tests persisted (38% and 37%, respectively). The perceived difficulty of getting condoms or an HCP appointment decreased (30% and 31%, respectively) but remained higher than pre-pandemic levels. In stratified analyses, sexually experienced participants universally reported more difficulty than inexperienced youth accessing products and services across all time periods.
Discussion: The COVID-19 pandemic increased perceived difficulty in accessing sexual and reproductive health products and services, and these perceived difficulties may be persisting. There is a critical need to improve adolescents’ ability, and their awareness of their ability, to access these essential products and services.
Keywords: Adolescents, Public healthMethods: Data are from the QuaranTeen Health Study, an online longitudinal study of adolescents aged 13-17 (N=1,803) recruited in 2023-2024. We assessed perceived difficulty in accessing sexual and reproductive healthcare products and services (i.e., birth control/contraception, human immunodeficiency virus (HIV) and other sexually transmitted infection (STI) testing, condoms, and appointments with healthcare providers [HCP]) before the pandemic, during the acute phase of the pandemic, and in the past 2 months. Perceptions before and during the pandemic were assessed at baseline. Perceptions of the past 2 months were assessed at baseline and 2-month follow-up. Participants responded on a 5-point Likert scale from ‘strongly disagree’ to ‘strongly agree’ that they had access difficulty. Participants who responded that they ‘somewhat’ or ‘strongly’ agreed were considered to have perceived difficulty accessing products and services. We evaluated the prevalence of perceived difficulty for the cohort overall, and stratified by ever having engaged in oral, penile-vaginal, and/or penile-anal sex.
Results: The percentage of adolescents reporting difficulty before the pandemic was 17% for HCP appointment, 25% for HIV/STI testing, 30% for birth control, and 29% for condoms. Perceived difficulty accessing all services was higher during (versus before), the pandemic: 42% for HCP appointment, 38% for HIV/STI tests, and 37% for both birth control and condoms. After the pandemic, the prevalence of perceived difficulty accessing birth control and HIV/STI tests persisted (38% and 37%, respectively). The perceived difficulty of getting condoms or an HCP appointment decreased (30% and 31%, respectively) but remained higher than pre-pandemic levels. In stratified analyses, sexually experienced participants universally reported more difficulty than inexperienced youth accessing products and services across all time periods.
Discussion: The COVID-19 pandemic increased perceived difficulty in accessing sexual and reproductive health products and services, and these perceived difficulties may be persisting. There is a critical need to improve adolescents’ ability, and their awareness of their ability, to access these essential products and services.
Authors:
Co-Author - Julia Bond, PhD, MPH, Boston University School of Public Health
Co-Author - Shira Dunsiger, PhD, Brown University, School of Public Health
Co-Author - Jacquelin Sauer, MPH, Boston University School of Public Health
Co-Author - Lynsie Ranker, PhD, MPH, Boston University School of Public Health
Co-Author - Michele Ybarra, PhD, Center for Innovative Public Health Research
Presenter - Kimberly Nelson, PhD, MPH, Boston University School of Public Health
Father engagement in their children’s health care
Poster Number: A32Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health
Introduction: In 2016, the American Academy of Pediatrics published a policy statement providing guidance to pediatricians to support the role of fathers in children’s health. Among children with chronic illness, the benefits of father involvement in children’s healthcare have been observed (i.e., improved adherence). Yet, outside of an illness context, there is limited evidence examining fathers’ engagement in children’s healthcare and whether such engagement is associated with positive outcomes for children. Therefore, this study describes fathers’ engagement in children’s healthcare and examines associations between father engagement in children’s healthcare and children’s preventive health behaviors, measured by flu vaccination status, among a non-clinical sample. Methods: Participants included 898 fathers from Fathers and Families, a multi-year cohort of fathers with children ages 1-6 established in 2021. Engagement, measured in 2023-24, was operationalized as (1) attendance at pediatric visits in the past year (0, 25, 50, 75, 100%) and (2) current responsibility in child healthcare (i.e., staying home with child when sick) relative to coparents' responsibility. Logistic regression models were fit to examine associations between engagement and child flu vaccination, adjusting for father race/ethnicity, child age, and recruitment site. The constructs representing engagement in children’s healthcare were used in separate models, given collinearity (r = .63). Inverse probability weighting addressed selection bias due to attrition. Results: Fathers were predominantly White (68%) with postgraduate degrees (49%). Forty percent attended >75% of pediatric visits; 15% never attended a visit. In 50% of households, fathers reported they and their coparent shared equal responsibility for their child’s healthcare; in 10%, fathers were primarily responsible. Compared to children with fathers who did not attend pediatric visits, having a father who attended 25-50% of visits (odds ratio [OR] = 2.50, 95% confidence interval [CI]: 1.70-3.69) or >75% of visits (OR = 2.64, CI: 1.77-3.92) was associated with higher odds of receiving the flu vaccination. Greater father responsibility was also associated with vaccination. Discussion: Findings highlight the critical role of fathers in children’s health. To support preventive healthcare, pediatric providers must engage fathers and integrate them into pediatric systems, systems that have historically relied on mothers.
Keywords: Children's health, PreventionAuthors:
Presenter - Natalie Grafft, PhD, Boston College
Co-Author - Brian Lo, PhD, MPH, RD, University of Guelph
Co-Author - Katherine Bauer, PhD, University of Michigan
Co-Author - Jess Haines, PhD, University of Guelph
Co-Author - Kirsten Davison, PhD, Boston College
Mothers’ experiences of dyadic Expressive Arts-Based Intervention with their children with intellectual disabilities: A preliminary qualitative study
Poster Number: A33Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Quality of Life
Introduction: Mothers of children with intellectual disabilities (ID) tend to face heightened psychological distress due to demanding caregiving responsibilities and communication challenges with their children. These challenges can strain the mother-child relationship and worsen maternal well-being. Given that Expressive Arts-based Intervention (EXAT) emphasized playfulness and nonverbal communication, it was introduced to these dyads to foster dyadic communication and psychosocial well-being. This study examined mothers’ experiences of participating in a dyadic EXAT with their children.
Methods: This qualitative study was a side study of a randomized controlled trial in assessing the impacts of EXAT in enhancing the psychosocial well-being of mothers and their children with ID. Some mothers, who were randomized into the 8-week EXAT group, were invited to participate in an in-depth interview at the post-intervention time point to explore their experiences and perceived changes. The EXAT consisted of eight weekly sessions, which adopted multiple art forms to promote psychosocial outcomes and relationships of the dyads. Thematic analysis was employed to analyze the qualitative data.
Results: Seven mothers, aged 36-47, were interviewed. Four themes emerged from the analysis: (1) parent-child relationships, (2) self-care, (3) social support, and (4) parenting. Mothers expressed that EXAT strengthened their relationships with their children by providing quality time during the sessions, allowing them to jointly engage in arts-making and play activities. They realized the importance of self-care regardless of their heavy workload as a mother. They also experienced social support and encouragement through interactions with the therapists and other mothers. Group sharing further allowed the mothers to gain skills and insights into parenting.
Conclusion: The qualitative findings illustrate the potential of EXAT in enhancing mothers’ psychosocial well-being, particularly fostering parent-child communication and understanding. More interviews will be conducted to further explore the effects of EXAT on this population. Mothers will also be invited to participate in follow-up interviews to explore whether the insights gained from EXAT continue to benefit them or if they encounter new challenges.
Keywords: Complementary Medicine, ChildrenMethods: This qualitative study was a side study of a randomized controlled trial in assessing the impacts of EXAT in enhancing the psychosocial well-being of mothers and their children with ID. Some mothers, who were randomized into the 8-week EXAT group, were invited to participate in an in-depth interview at the post-intervention time point to explore their experiences and perceived changes. The EXAT consisted of eight weekly sessions, which adopted multiple art forms to promote psychosocial outcomes and relationships of the dyads. Thematic analysis was employed to analyze the qualitative data.
Results: Seven mothers, aged 36-47, were interviewed. Four themes emerged from the analysis: (1) parent-child relationships, (2) self-care, (3) social support, and (4) parenting. Mothers expressed that EXAT strengthened their relationships with their children by providing quality time during the sessions, allowing them to jointly engage in arts-making and play activities. They realized the importance of self-care regardless of their heavy workload as a mother. They also experienced social support and encouragement through interactions with the therapists and other mothers. Group sharing further allowed the mothers to gain skills and insights into parenting.
Conclusion: The qualitative findings illustrate the potential of EXAT in enhancing mothers’ psychosocial well-being, particularly fostering parent-child communication and understanding. More interviews will be conducted to further explore the effects of EXAT on this population. Mothers will also be invited to participate in follow-up interviews to explore whether the insights gained from EXAT continue to benefit them or if they encounter new challenges.
Authors:
Author - Bonnie H. T. WONG, Centre on Behavioral Health, The University of Hong Kong
Author - Temmy L. T. LO, Centre on Behavioral Health, The University of Hong Kong
Author - Herman H. M. LO, Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
Author - Adrian H. Y. WAN, Centre on Behavioral Health, The University of Hong Kong
Author - Phyllis K. S. WONG, Department of Social Work, The Chinese University of Hong Kong
Presenter - Rainbow T. H. HO, PhD, BC-DMT, AThR, REAT, RSMT, CGP, CMA, Centre on Behavioral Health, The University of Hong Kong; Department of Social Work and Social Administration, The University of Hong Kong
A Dyadic Approach to Understanding Anxiety and Overall Health in Pediatric Oncology: Insights from an Actor-Partner Interdependence Model
Poster Number: A34Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Cancer
Background: Child and caregiver anxiety contribute to child overall health during cancer treatment. However, extant studies rely on either caregiver proxy-reports or child self-reports, and none have simultaneously examined caregiver and child reports.
Aims: This cross-sectional study dyadically examined caregiver and child anxiety and child overall health perceptions in pediatric cancer.
Methods: Children and caregivers (n=76 dyads; n=152 total) were recruited from two Midwestern children’s hospitals. Dyads reported the child’s overall health via PROMIS Global Health 7 proxy- and self-report scales, and their own anxiety via the PROMIS Anxiety 8a scale. We examined associations in demographic information, medical characteristics, and focal variables via descriptive statistics, Pearson and point-biserial correlations, and a one-way ANOVA. An Actor-Partner Interdependence Model (APIM) evaluated dyadic associations between child and caregiver self-reports of anxiety and child self- and caregiver proxy-reports of child overall health.
Results: Among 76 child (88.2% White, 34.2% Female) and caregiver (92.1% White, 69.7% Female) dyads, children (M=46.64, SD=9.09) and caregivers (M=39.33, SD=8.97) reported below average child overall health. Caregivers reported above average anxiety levels (M=55.18, SD=8.37), and children reported below average anxiety levels (M=46.31, SD=10.05). APIM analyses revealed significant actor effects: higher levels of self-reported anxiety were associated with lower levels of child and caregiver proxy-reports of overall health within person (b = -0.29, p < .001). Marginally significant partner effects revealed greater anxiety was associated with lower partner reports of child overall health (b = -0.14, p = .051). Lower child-reported overall health was also associated with having a male caregiver (b = -4.69, p = .02) and being older (b = -1.05, p <.001). Greater caregiver education (b = 2.62, p = .02) and relapsed disease (b = 0.83, p = .04) were significantly associated with higher caregiver self-reported anxiety, and female caregivers had higher anxiety than male caregivers (b = -0.76, p = .09).
Conclusions: Our findings underscore supporting the family system within pediatric cancer, and suggest mitigating caregiver anxiety may promote children’s overall health. Interventions are needed for child–caregiver dyads to support mental and overall health during cancer treatment, with tailored support for mothers and adolescents.
Keywords: Parent-child transactions, CancerAims: This cross-sectional study dyadically examined caregiver and child anxiety and child overall health perceptions in pediatric cancer.
Methods: Children and caregivers (n=76 dyads; n=152 total) were recruited from two Midwestern children’s hospitals. Dyads reported the child’s overall health via PROMIS Global Health 7 proxy- and self-report scales, and their own anxiety via the PROMIS Anxiety 8a scale. We examined associations in demographic information, medical characteristics, and focal variables via descriptive statistics, Pearson and point-biserial correlations, and a one-way ANOVA. An Actor-Partner Interdependence Model (APIM) evaluated dyadic associations between child and caregiver self-reports of anxiety and child self- and caregiver proxy-reports of child overall health.
Results: Among 76 child (88.2% White, 34.2% Female) and caregiver (92.1% White, 69.7% Female) dyads, children (M=46.64, SD=9.09) and caregivers (M=39.33, SD=8.97) reported below average child overall health. Caregivers reported above average anxiety levels (M=55.18, SD=8.37), and children reported below average anxiety levels (M=46.31, SD=10.05). APIM analyses revealed significant actor effects: higher levels of self-reported anxiety were associated with lower levels of child and caregiver proxy-reports of overall health within person (b = -0.29, p < .001). Marginally significant partner effects revealed greater anxiety was associated with lower partner reports of child overall health (b = -0.14, p = .051). Lower child-reported overall health was also associated with having a male caregiver (b = -4.69, p = .02) and being older (b = -1.05, p <.001). Greater caregiver education (b = 2.62, p = .02) and relapsed disease (b = 0.83, p = .04) were significantly associated with higher caregiver self-reported anxiety, and female caregivers had higher anxiety than male caregivers (b = -0.76, p = .09).
Conclusions: Our findings underscore supporting the family system within pediatric cancer, and suggest mitigating caregiver anxiety may promote children’s overall health. Interventions are needed for child–caregiver dyads to support mental and overall health during cancer treatment, with tailored support for mothers and adolescents.
Authors:
Presenter - Anna Olsavsky, PhD, The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Madeline Peek, Nationwide Children's Hospital
Co-Author - Kathleen Montgomery, PhD, RN, PCNS-BC, University of Wisconsin - Madison, School of Nursing
Co-Author - Micah Skeens, PhD, APRN, FAAN, CPNP-PC, Abigail Wexner Research Institute at Nationwide Children's Hospital
Perceived Safety of School Routes: A Geographic Comparison of Parent and Administrator Perceptions in North Macedonia
Poster Number: A35Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Methods and Measurement
Background:
Perceptions of home-to-school route safety are an important factor influencing children’s use of active transport. The purpose of this study was to examine concordance between school administrator and parent perceptions of home-to-school route safety, in both urban and rural areas, throughout North Macedonia.
Methods:
Data for this study were drawn from the World Health Organization’s European Childhood Obesity Surveillance Initiative (COSI)—5th round. As part of COSI, school administrators (n=111) and parents (n=2442) rated home-to-school route safety for active transport (e.g., walking) on a 10-point Likert-type scale (1=extremely safe; 10=extremely unsafe). Mean safety ratings from both groups were calculated across urban and rural settings within Macedonian public health regions (Bitola, Kochani, Kumanovo, Ohrid, Prilep, Shtip, Skopje, Strumica, Tetovo, and Veles). Means were then ranked from 1 (safest) to 10 (least safe). Spearman’s rank correlation coefficients (rho) were used to assess bivariate associations between school administrator and parent safety rankings overall and location (urban versus rural).
Results:
Overall, less than 30% of parents indicated their home-to-school route as “extremely safe.”
School and parent assessments of home-to-school route safety showed no significant correlation in either rural (rho=0.128; p=0.72) or urban (rho=0.406; p=0.24) areas. Despite this lack of association, both groups identified rural areas of Shtip and Tetovo as having the safest routes. Rural areas within the capital region of Skopje were rated the least safe by school representatives (10 of 10), whereas parents’ ratings were at the midpoint (5 of 10). Similar to rural findings, school administrators and parents generally differed in their safety assessments of urban areas. However, they converged in ranking Veles as the safest and Kumanovo as the least safe urban setting.
Discussion:
School administrators and parents provided inconsistent ratings of school-to-home route safety. Although the underlying reasons for these differences are unclear, it is plausible that school administrators were less familiar with local routes than parents, particularly if they reside outside the school’s immediate community. Future research should explore factors underlying these discrepancies to better understand how community context and school administrative and parental perspectives influence assessments of school-to-home route safety.
Keywords: Assessment, Physical environmentPerceptions of home-to-school route safety are an important factor influencing children’s use of active transport. The purpose of this study was to examine concordance between school administrator and parent perceptions of home-to-school route safety, in both urban and rural areas, throughout North Macedonia.
Methods:
Data for this study were drawn from the World Health Organization’s European Childhood Obesity Surveillance Initiative (COSI)—5th round. As part of COSI, school administrators (n=111) and parents (n=2442) rated home-to-school route safety for active transport (e.g., walking) on a 10-point Likert-type scale (1=extremely safe; 10=extremely unsafe). Mean safety ratings from both groups were calculated across urban and rural settings within Macedonian public health regions (Bitola, Kochani, Kumanovo, Ohrid, Prilep, Shtip, Skopje, Strumica, Tetovo, and Veles). Means were then ranked from 1 (safest) to 10 (least safe). Spearman’s rank correlation coefficients (rho) were used to assess bivariate associations between school administrator and parent safety rankings overall and location (urban versus rural).
Results:
Overall, less than 30% of parents indicated their home-to-school route as “extremely safe.”
School and parent assessments of home-to-school route safety showed no significant correlation in either rural (rho=0.128; p=0.72) or urban (rho=0.406; p=0.24) areas. Despite this lack of association, both groups identified rural areas of Shtip and Tetovo as having the safest routes. Rural areas within the capital region of Skopje were rated the least safe by school representatives (10 of 10), whereas parents’ ratings were at the midpoint (5 of 10). Similar to rural findings, school administrators and parents generally differed in their safety assessments of urban areas. However, they converged in ranking Veles as the safest and Kumanovo as the least safe urban setting.
Discussion:
School administrators and parents provided inconsistent ratings of school-to-home route safety. Although the underlying reasons for these differences are unclear, it is plausible that school administrators were less familiar with local routes than parents, particularly if they reside outside the school’s immediate community. Future research should explore factors underlying these discrepancies to better understand how community context and school administrative and parental perspectives influence assessments of school-to-home route safety.
Authors:
Co-Presenter - Lorraine Wallace, PhD, The Ohio State University
Co-Presenter - Aleksandra Aleksandra Stamenova , MD, Saints Cyril and Methodius University--Faculty of Medicine
Co-Author - Igor Spiroski , MD, PhD, Saints Cyril and Methodius University--Institute of Public Health
Barriers to Medication Adherence an Associations with SDOH among Children Receiving Hematopoietic Stem Cell Transplant
Poster Number: A36Time: 05:00 PM - 05:50 PM
Topics: Child and Family Health, Social and Environmental Context and Health
Hematopoietic stem cell transplant (HCT) requires intense self-managed medication regimens post-discharge. Nonadherence to medication is common among children and linked to poor outcomes. Understanding barriers to medication adherence and associations with social determinants of health (SDOH) could identify potential targets for intervention. Thus, we aimed to describe barriers to adherence post-HCT discharge and explore potential barrier predictors.
Caregivers of children aged 0-21 years were enrolled at HCT discharge and reported demographic information used to calculate SDOH variables: Child Opportunity Index (COI) and national Area Deprivation Index (ADI). Caregivers completed the Barrier Scale (BS; 18 barriers) at enrollment and exit 11 weeks later. Correlations, t-tests, and chi square/fisher’s exact tests were used to evaluate associations between SDOH and barriers. The sample of children (n=49) was primarily White (n=35, 71%), male (n=27, 55%), and 8.74 years old (SD=6.75). Most caregivers had at least a college education (n=25, 51%), an income over $50,001 (n=22, 44%), moderate COI (M=2.9, SD=1.3), and moderate-to-high ADI (M=64.1, SD=22.5). Barriers at enrollment (M=3.79, SD=2.21) were significantly higher than exit (M=2.06, SD=1.74; t(43)=5.04, p<.001). Top barriers at enrollment and exit were “hates medication taste” (enrollment: n=30, 64%; exit: n=15, 33%), “forgets medications” (enrollment: n=20, 43%; exit: n=10, 22%), and “not want to take medications” (enrollment: n=20, 43%; exit: n=9, 20%). At exit, “hates medication taste” was endorsed more often among caregivers with lower income (t(39)=2.69, p=.003) and lower education (t(42)=2.49, p=.012), and “forgets medication” was endorsed more by caregivers of children receiving an autologous transplant (χ(1)=9.12, p=.01). At both enrollment and exit, “not want to take medications” was endorsed more often with caregivers of younger children (t(45)=2.98, p=.003; t(43)=2.09, p=.002). At exit, a higher number of total barriers were significantly correlated with lower COI (r(45)=-.30, p=.048) and higher ADI (r(45)=.39, p=.01).
Overall, caregiver-reported barriers to adherence declined from discharge to 11 weeks post-HCT. Families from areas with lower child-opportunity and higher deprivation exhibited more barriers at 11 weeks. These findings suggest intervention post-discharge is needed to address potential barriers to adherence, and families from vulnerable areas may require long-term support.
Keywords: Children's health, Health disparitiesCaregivers of children aged 0-21 years were enrolled at HCT discharge and reported demographic information used to calculate SDOH variables: Child Opportunity Index (COI) and national Area Deprivation Index (ADI). Caregivers completed the Barrier Scale (BS; 18 barriers) at enrollment and exit 11 weeks later. Correlations, t-tests, and chi square/fisher’s exact tests were used to evaluate associations between SDOH and barriers. The sample of children (n=49) was primarily White (n=35, 71%), male (n=27, 55%), and 8.74 years old (SD=6.75). Most caregivers had at least a college education (n=25, 51%), an income over $50,001 (n=22, 44%), moderate COI (M=2.9, SD=1.3), and moderate-to-high ADI (M=64.1, SD=22.5). Barriers at enrollment (M=3.79, SD=2.21) were significantly higher than exit (M=2.06, SD=1.74; t(43)=5.04, p<.001). Top barriers at enrollment and exit were “hates medication taste” (enrollment: n=30, 64%; exit: n=15, 33%), “forgets medications” (enrollment: n=20, 43%; exit: n=10, 22%), and “not want to take medications” (enrollment: n=20, 43%; exit: n=9, 20%). At exit, “hates medication taste” was endorsed more often among caregivers with lower income (t(39)=2.69, p=.003) and lower education (t(42)=2.49, p=.012), and “forgets medication” was endorsed more by caregivers of children receiving an autologous transplant (χ(1)=9.12, p=.01). At both enrollment and exit, “not want to take medications” was endorsed more often with caregivers of younger children (t(45)=2.98, p=.003; t(43)=2.09, p=.002). At exit, a higher number of total barriers were significantly correlated with lower COI (r(45)=-.30, p=.048) and higher ADI (r(45)=.39, p=.01).
Overall, caregiver-reported barriers to adherence declined from discharge to 11 weeks post-HCT. Families from areas with lower child-opportunity and higher deprivation exhibited more barriers at 11 weeks. These findings suggest intervention post-discharge is needed to address potential barriers to adherence, and families from vulnerable areas may require long-term support.
Authors:
Author - Lydia Wisne, BS, The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Anna Olsavsky, PhD, The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Madeline Peek, BA, The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Cynthia Gerhardt, PhD, The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Ahna Pai, PhD, The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Micah Skeens, PhD, APRN, FAAN, CPNP-PC, The Abigail Wexner Research Institute at Nationwide Children's Hospital
Beyond “Hard to Reach”: Centering Black Women’s Participation in Health Research
Poster Number: A37Time: 05:00 PM - 05:50 PM
Topics: Community Engagement, Health Disparities
Introduction: Historical and ongoing structural inequities along with the underrepresentation of African American (AA) women with visible roles in research, likely contribute to their persistent mistrust towards research. Consequently, less than 3% of AA women participate in clinical studies, which threatens the applicability of research findings among this population. This study assessed recruitment strategies targeted for middle-aged AA women involved in an 8-week community-gardening intervention focused on increasing physical activity and improving psychological health.
Methods: Recruitment took place through word of mouth, university e-week announcements, and Black Faculty and Professionals Alliance Newsletter announcements as well as social media. Community engagement occurred through face-to-face interaction at a church, university community events, Juneteenth community events, and farmer’s markets. Flyers were also distributed at a community music event and mall, libraries, and barbershops and beauty salons. Active recruitment occurred over a span of 3-months; however, rapport building with community partners started 1-year prior to the study.
Results: Recruitment through word of mouth (13.5%), online (5.4%), Juneteenth events (5.4%), music festival (5.4%), and church (2.7%) resulted in a total of 37 interested, 19 of which were eligible to participate. Twelve of the 19 (63%) eligible women enrolled in the study.
Conclusions: Word of mouth and face-to-face recruitment methods were most successful in recruiting AA women in Champaign, Illinois which is a rural, predominately white community. Online recruitment, including social media and university platforms, proved to be less successful in enrolling participants, so future researchers should consider in-person recruitment methods to recruit and enroll AA women. Though word of mouth recruitment is not considered a structured method, our findings align with the literature in that it may be one of the best recruitment strategies for AA women. Researchers should devote time to establishing relationships with community partners and participate in community events to build trust and encourage the dissemination of study information.
Keywords: Participatory research, Health disparitiesMethods: Recruitment took place through word of mouth, university e-week announcements, and Black Faculty and Professionals Alliance Newsletter announcements as well as social media. Community engagement occurred through face-to-face interaction at a church, university community events, Juneteenth community events, and farmer’s markets. Flyers were also distributed at a community music event and mall, libraries, and barbershops and beauty salons. Active recruitment occurred over a span of 3-months; however, rapport building with community partners started 1-year prior to the study.
Results: Recruitment through word of mouth (13.5%), online (5.4%), Juneteenth events (5.4%), music festival (5.4%), and church (2.7%) resulted in a total of 37 interested, 19 of which were eligible to participate. Twelve of the 19 (63%) eligible women enrolled in the study.
Conclusions: Word of mouth and face-to-face recruitment methods were most successful in recruiting AA women in Champaign, Illinois which is a rural, predominately white community. Online recruitment, including social media and university platforms, proved to be less successful in enrolling participants, so future researchers should consider in-person recruitment methods to recruit and enroll AA women. Though word of mouth recruitment is not considered a structured method, our findings align with the literature in that it may be one of the best recruitment strategies for AA women. Researchers should devote time to establishing relationships with community partners and participate in community events to build trust and encourage the dissemination of study information.
Authors:
Author - , National Cancer Institute
Co-Author - Vanesu Jakachira, BS, University of Illinois Urbana-Champaign
Co-Author - , University of Illinois Urbana-Champaign
Structural determinants of the academia-promotora partnership when addressing mental health disparities among Hispanic/Latines: A qualitative study
Poster Number: A38Time: 05:00 PM - 05:50 PM
Topics: Community Engagement, Mental Health
Background: The use of the promotora or community health worker (CHW) model among academic research groups, non-governmental organizations, and state-level public health agencies has emerged as a strategy to address mental health disparities among Hispanics and Latines. However, when these programs are examined, most researchers focus on assessing their impact on community participants and promotoras, disregarding systemic elements of these interventions, such as academic institutions and policies, that also have an impact on the interventions and the mental wellbeing of participants.
Objectives: The purpose of this study is to understand, from the perspective of scholars, structural determinants that impact academia-promotora partnerships to address mental health disparities among the Hispanic/Latine community in the U.S.
Participants: A convenience sample of 12 scholars (research groups’ PIs, Co-PIs, graduate students, and staff) who have experience working with promotores to address mental health disparities among Hispanics and Latines.
Methods: This study uses qualitative methods to explore academic research groups’ experiences, feelings, perceptions, and interactions using the promotora model to address Hispanic/Latine mental health disparities. Semi-structured interviews were conducted. We used thematic analysis to examine and identify patterns in the participants’ responses.
Results: We identified four major recurrent topics regarding structural determinants that impact the implementation of the academia-promotora partnership: (1) tension between collaboration and dependency in the partnership, (2) uneven academic engagement and power dynamics, (3) methodological challenges, and (4) scarce funding.
Discussion: (1) The predominance of the efficacy-before-effectiveness paradigm in academia and the U.S. healthcare system has made the grant funding stream for these programs unsteady, creating an uneven relationship of dependency between academia and promotores. (2) The need to improve and increase the training of scholars on CBPR methods. (3) The expansion of the Medicare Physician Fee Schedule to reimburse the work of promotores is a sign in the right direction if maintained and expanded. Scholars have different degrees of knowledge regarding how this will be implemented. (4) The paradigm shift toward implementation science has been key to promoting the importance of the promotora model to implement community programs.
Keywords: Community intervention, HispanicObjectives: The purpose of this study is to understand, from the perspective of scholars, structural determinants that impact academia-promotora partnerships to address mental health disparities among the Hispanic/Latine community in the U.S.
Participants: A convenience sample of 12 scholars (research groups’ PIs, Co-PIs, graduate students, and staff) who have experience working with promotores to address mental health disparities among Hispanics and Latines.
Methods: This study uses qualitative methods to explore academic research groups’ experiences, feelings, perceptions, and interactions using the promotora model to address Hispanic/Latine mental health disparities. Semi-structured interviews were conducted. We used thematic analysis to examine and identify patterns in the participants’ responses.
Results: We identified four major recurrent topics regarding structural determinants that impact the implementation of the academia-promotora partnership: (1) tension between collaboration and dependency in the partnership, (2) uneven academic engagement and power dynamics, (3) methodological challenges, and (4) scarce funding.
Discussion: (1) The predominance of the efficacy-before-effectiveness paradigm in academia and the U.S. healthcare system has made the grant funding stream for these programs unsteady, creating an uneven relationship of dependency between academia and promotores. (2) The need to improve and increase the training of scholars on CBPR methods. (3) The expansion of the Medicare Physician Fee Schedule to reimburse the work of promotores is a sign in the right direction if maintained and expanded. Scholars have different degrees of knowledge regarding how this will be implemented. (4) The paradigm shift toward implementation science has been key to promoting the importance of the promotora model to implement community programs.
Authors:
Author - Edward Chauca, PhD, MA., University of Massachusetts, Amherst
Co-Author - Lizbeth Becerra, MPH, University of Southern California
Leveraging a Community Engaged Focus Group for Diabetes Management in Primary Care to Identify Community Needs and Increase Physician Trust
Poster Number: A39Time: 05:00 PM - 05:50 PM
Topics: Community Engagement, Integrated Primary Care
Background: Rates of nonadherence for patients with diabetes and chronic conditions continue to rise with greater rates in more marginalized communities. The community engaged research framework allows researchers to partner with community members for the development of interventions that are culturally informed and ready to implement. The purpose of the study was to hold a focus group to identify what community members and medicine residents see as the greatest needs and factors influencing the health and diabetes management in the community to help inform an annual health fair. We also aimed to determine if the focus group experience improved physician trust.
Methods: Participants included 10 resident internal medicine physicians and 9 community members. Participants identified three most important factors in a healthy community, three greatest health problems, and completed the physician trust scale prior to the focus group. Following the focus group, participants identified barriers to improving diabetes management, the physician trust scale, and changes in perceptions.
Results: 58% of participants identified access to health care as a top factor important in a healthy community, 37% of participants identified low crime and good jobs/healthy economy as a top factor, and 26% identified a good place to raise children. 74% of patients identified heart disease as the most concerning health problem in their community, 68% diabetes, and 53% hypertension. There was a significant increase in physician trust in the full sample ( t[17] = -1.96, p < 0.001) and when looking at only the community participants (t[8] = -2.67, p < 0.001). Following the focus group the most identified barriers to improving diabetes in the community were: lack of awareness (78%), trust in healthcare providers (78%), racial disparities (63.2%). 100% of participants agreed that the discussion addressed barriers in diabetes and health and 95% agreed that they felt more empowered to improve community health.
Discussion: Including resident trainees in community-engaged focus groups allows for a unique opportunity to better understand the needs of the population for which they provide care. The community-engaged focus group was a successful intervention in identifying community needs and increasing physician trust. This information was used to inform the development of an annual health fair for our division and health system partners, which was well attended.
Keywords: Community intervention, DiabetesMethods: Participants included 10 resident internal medicine physicians and 9 community members. Participants identified three most important factors in a healthy community, three greatest health problems, and completed the physician trust scale prior to the focus group. Following the focus group, participants identified barriers to improving diabetes management, the physician trust scale, and changes in perceptions.
Results: 58% of participants identified access to health care as a top factor important in a healthy community, 37% of participants identified low crime and good jobs/healthy economy as a top factor, and 26% identified a good place to raise children. 74% of patients identified heart disease as the most concerning health problem in their community, 68% diabetes, and 53% hypertension. There was a significant increase in physician trust in the full sample ( t[17] = -1.96, p < 0.001) and when looking at only the community participants (t[8] = -2.67, p < 0.001). Following the focus group the most identified barriers to improving diabetes in the community were: lack of awareness (78%), trust in healthcare providers (78%), racial disparities (63.2%). 100% of participants agreed that the discussion addressed barriers in diabetes and health and 95% agreed that they felt more empowered to improve community health.
Discussion: Including resident trainees in community-engaged focus groups allows for a unique opportunity to better understand the needs of the population for which they provide care. The community-engaged focus group was a successful intervention in identifying community needs and increasing physician trust. This information was used to inform the development of an annual health fair for our division and health system partners, which was well attended.
Authors:
Author - Erin Tobin, PhD, Henry Ford Health
Co-Author - Aayush Mittal, MD, Henry Ford Health
Co-Author - Jamie Abad, MD, Henry Ford Health
Co-Author - Rachel Bond, PhD, Henry Ford Health
Co-Author - Vanessa Robinson, MD, Henry Ford Health
Co-Author - Kevin Whitlow, MD, Henry Ford Health
Co-Author - Jasmine Omar, MD, Henry Ford Health
Listening to West Haven: A Community Health Needs Assessment to Guide Clinic Development
Poster Number: A40Time: 05:00 PM - 05:50 PM
Topics: Community Engagement, Social and Environmental Context and Health
Health needs assessments (HNAs) are essential tools for identifying community health priorities, guiding resource allocation, and informing the development of responsive, equity-oriented health interventions. In under-resourced areas, HNAs can be particularly powerful in shaping initiatives that bridge service gaps and strengthen local infrastructure. West Haven, Connecticut—an urban-suburban community with over 55,000 residents—faces persistent disparities in access to preventive care, transportation, mental health services, and culturally responsive resources. To guide the potential development of a university-affiliated community clinic, we conducted a community health needs assessment in collaboration with the West Haven Health Department. The Social Ecological Model (SEM) informed our multi-level analysis of health challenges and opportunities.
Our mixed-methods approach included 15 key informant interviews with healthcare professionals, educators, and community leaders; 150 anonymous surveys from West Haven residents gathered through community events and tabling efforts; and windshield surveys conducted across neighborhoods to assess physical and environmental conditions affecting health. This triangulated strategy aimed to capture both institutional and lived experiences of healthcare access in the region.
Thematic analysis of the qualitative data revealed pressing needs across SEM levels. At the individual level, respondents cited limited health literacy, financial strain, and competing life demands. Interpersonally, mistrust in healthcare systems and lack of culturally competent providers were recurrent themes. Organizational concerns included fragmented care, difficulty navigating Medicaid, and a lack of visible local providers. Community-level barriers centered around transportation, food insecurity, and limited access to preventive services. Policy-level issues included insufficient after-hours care and lack of funding for integrated services. Windshield surveys confirmed geographic inequities in neighborhood health assets and walkability.
Our findings underscore a strong desire for a trusted, community-based clinic offering bilingual services, wellness education, interprofessional training opportunities, and holistic care. This project highlights the critical role of HNAs in co-creating sustainable health solutions that reflect local voices and community-defined priorities.
Keywords: Public health, Community interventionOur mixed-methods approach included 15 key informant interviews with healthcare professionals, educators, and community leaders; 150 anonymous surveys from West Haven residents gathered through community events and tabling efforts; and windshield surveys conducted across neighborhoods to assess physical and environmental conditions affecting health. This triangulated strategy aimed to capture both institutional and lived experiences of healthcare access in the region.
Thematic analysis of the qualitative data revealed pressing needs across SEM levels. At the individual level, respondents cited limited health literacy, financial strain, and competing life demands. Interpersonally, mistrust in healthcare systems and lack of culturally competent providers were recurrent themes. Organizational concerns included fragmented care, difficulty navigating Medicaid, and a lack of visible local providers. Community-level barriers centered around transportation, food insecurity, and limited access to preventive services. Policy-level issues included insufficient after-hours care and lack of funding for integrated services. Windshield surveys confirmed geographic inequities in neighborhood health assets and walkability.
Our findings underscore a strong desire for a trusted, community-based clinic offering bilingual services, wellness education, interprofessional training opportunities, and holistic care. This project highlights the critical role of HNAs in co-creating sustainable health solutions that reflect local voices and community-defined priorities.
Authors:
Presenter - Alvin Tran, ScD, MPH, University of New Haven
Co-Author - Quinn Duclos, PhD, MS, CHES, University of New Haven
IDEA: Development of the First Decisional Support Tool for Black American Potential Living Kidney Donors Contemplating APOL1 Genetic Testing
Poster Number: A41Time: 05:00 PM - 05:50 PM
Topics: Decision Making, Health Disparities
Background: APOL1-associated kidney disease disproportionately affects people of African ancestry, necessitating appropriate genetic testing (GT) for Black American (BA) potential living kidney donors. This study describes the development of Informed Decisions About APOL1 (IDEA), a culturally tailored decisional support tool for APOL1 GT in living kidney donation.
Methods: IDEA was developed in three phases. Phase I involved designing a wireframe based on results from focus groups, surveys, and expert input covering key topics. Phase II included prototype development with NuRelm, an app development company. In Phase III, trained standardized healthcare providers guided BA participants through four rounds of simulated consultations using the app; participants completed pre- and post-simulation surveys and focus groups after each round to solicit feedback on the app, from which iterative refinements were subsequently made.
Results: 30 BA participants engaged in four rounds of simulations. 60% were male (n=18), with an average age of 56.2 years (SD= 11.6). Post-encounter survey results indicated that 93.3% (n=28) of participants rated the app as either good, very good, or excellent, while 90% (n=27) found the app easy to use. All respondents reported that the app would be useful for individuals contemplating APOL1 GT. 93.3% of participants felt that they had enough information to make a decision about GT after completing the simulated consultation, and 90% reported that they would have opted to undergo GT. Main participant suggestions for improving the app included enhancing the aesthetics with brighter colors, streamlining the risks and benefits section, and adding more information and resources on inherited risk and live kidney donation. Refinements were made to the app following each round of simulations based on participant feedback.
Conclusion: IDEA is a novel tool to support informed decision-making for BA potential living kidney donors. The final phase will gather transplant professional feedback via a Delphi process.
Keywords: Genetics, Organ transplantMethods: IDEA was developed in three phases. Phase I involved designing a wireframe based on results from focus groups, surveys, and expert input covering key topics. Phase II included prototype development with NuRelm, an app development company. In Phase III, trained standardized healthcare providers guided BA participants through four rounds of simulated consultations using the app; participants completed pre- and post-simulation surveys and focus groups after each round to solicit feedback on the app, from which iterative refinements were subsequently made.
Results: 30 BA participants engaged in four rounds of simulations. 60% were male (n=18), with an average age of 56.2 years (SD= 11.6). Post-encounter survey results indicated that 93.3% (n=28) of participants rated the app as either good, very good, or excellent, while 90% (n=27) found the app easy to use. All respondents reported that the app would be useful for individuals contemplating APOL1 GT. 93.3% of participants felt that they had enough information to make a decision about GT after completing the simulated consultation, and 90% reported that they would have opted to undergo GT. Main participant suggestions for improving the app included enhancing the aesthetics with brighter colors, streamlining the risks and benefits section, and adding more information and resources on inherited risk and live kidney donation. Refinements were made to the app following each round of simulations based on participant feedback.
Conclusion: IDEA is a novel tool to support informed decision-making for BA potential living kidney donors. The final phase will gather transplant professional feedback via a Delphi process.
Authors:
Author - Heather Gardiner, PhD, MPH, Buffalo University
Co-Author - Jessica Barker, MPH, Temple University
Co-Author - Dena Werner, PhD, Buffalo University
Co-Author - Ilene Hollin, PhD, MPH, Temple University
Co-Author - Sarah Bass, PhD, MPH, Termple University
Author - Laura Siminoff, PhD, MPH, Temple University
Co-Author - Ryan Blunt, MPH, Temple University
Co-Author - Melody Slashinski, PhD, MPH, Temple University
Co-Author - Xiangling Wang, MD, PhD, Cleveland Clinic
Co-Author - Avrum Gillespie, MD, Temple University Hospital
Co-Author - Marina Weis-Haggerty, NuRelm
Co-Author - Nermeen Nokali, NuRelm
Co-Author - Sam Shaaban, NuRelm
Co-Author - Ryan Lind, Temple University
Co-Author - Jon Rentler, Temple University
Co-Author - Elizabeth Kachur, PhD, Temple University
Utilizing Empirical Ethics to Conceptualize Religion-Based Vaccine Hesitancy in the United States
Poster Number: A42Time: 05:00 PM - 05:50 PM
Topics: Decision Making, Integrative Health and Spirituality
Religion’s impact on public healthcare decisions is largely understudied. Considering religion as a significant determinant to vaccine hesitancy in the U.S. is both timely and innovative. Religious and scientific commitments may interact and influence vaccine hesitancy among religious individuals and groups. Vaccine hesitancy among pre-health students is under-researched but important, given that they are still developing their opinions and philosophies regarding how and if to integrate religion (be it their own religion, their future patients’ religion, or religious influences in general) into their future clinical practice. This project investigates religion-based vaccine hesitancy among Christian and Jewish community leaders and pre-health students in the Phoenix, Arizona metropolitan area to unpack how religious frameworks, morals, values, and perceptions of science underpin the willingness acceptance vs. hesitancy among religious individuals and groups. Three case studies of vaccines are used explore vaccine hesitancy: 1) the HPV vaccine, which is controversial among religious communities due to its connections to sexual behavior; 2) the COVID-19 vaccine, which can be controversial for religious individuals due to its connections to DNA as a God-designed basic material of life; and 3) the seasonal influenza vaccine, which is largely noncontroversial among religious groups and will be used as neutral comparison. Utilizing a mixed methods approach including empirical ethics and qualitative methods, as well as being informed by local religious leaders, will allow us to better conceptualize and understand the relationships between religion, science, and health. We anticipate this work will produce preliminary findings that can inform future research focused on how religion impacts the future healthcare workforce's vaccine hesitancy and trust in public health.
Keywords: Population health, Health beliefsAuthors:
Author - Rachel Gur-Arie, Arizona State University
Co-Presenter - Rodolfo Quijada, Arizona State University
Co-Presenter - Emily Brown, Arizona State University
Association of Social Isolation with Receipt of American Diabetes Association Guideline-Recommended Care Among Older U.S. Adults with Diabetes: NHANES 2011–2018
Poster Number: A44Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Aging
BACKGROUND: The American Diabetes Association’s (ADA) Standards of Care in Diabetes recommends regular foot and eye exams, hemoglobin A1c (HbA1c) checks, and cholesterol testing to support optimal diabetes management. However, older adults (65+ years) with type 2 diabetes may be less likely to receive these services, in part due to higher rates of social isolation, defined as the objective state of having infrequent or no social contact. Socially isolated adults may lack the motivation, tangible support (e.g., transportation), or external accountability needed to follow through with clinical recommendations. This study seeks to examine the association of social isolation and receiving guideline-recommended care among a nationally representative sample of older adults with diabetes.
METHODS: Data came from 958 respondents aged 65+ years with diabetes from the National Health and Nutritional Examination Survey 2011-2018. Social isolation was operationalized using a 4-point index based on single marital status, living alone, and two indicators of social engagement difficulty. Receipt of ADA guideline-recommended diabetes care was defined as meeting all five criteria in the past year: having a diabetes provider seen at least once, HbA1c testing, foot and eye exams, and cholesterol testing. Logistic regression models tested the association of social isolation with the receipt of care, controlling for demographics, BMI, HbA1c, depression, and health insurance.
RESULTS: Respondents had a mean age of 72.5 (SD=0.23); 47% were female. Only 4.9% were socially isolated, and 43.7% had received guideline-recommended care. Social isolation was not associated with receiving guideline-recommended care in fully-adjusted models (p=.20). Of covariates, only those living at or below the poverty line were less likely to receive care (OR=0.52, p=.02) compared to those living above the poverty line.
CONCLUSIONS: Social isolation was not associated with receipt of ADA-recommended care. Our stricter and objective definition of social isolation may have led to an underestimation of social isolation’s true prevalence among older adults with diabetes. Nevertheless, socioeconomic factors, rather than social isolation alone, may play a larger role in care receipt. Given the elevated risk of social isolation among older adults and its broader health impacts, future research should examine its role in other aspects of diabetes management, such as self-care behaviors.
Keywords: Diabetes, Social supportMETHODS: Data came from 958 respondents aged 65+ years with diabetes from the National Health and Nutritional Examination Survey 2011-2018. Social isolation was operationalized using a 4-point index based on single marital status, living alone, and two indicators of social engagement difficulty. Receipt of ADA guideline-recommended diabetes care was defined as meeting all five criteria in the past year: having a diabetes provider seen at least once, HbA1c testing, foot and eye exams, and cholesterol testing. Logistic regression models tested the association of social isolation with the receipt of care, controlling for demographics, BMI, HbA1c, depression, and health insurance.
RESULTS: Respondents had a mean age of 72.5 (SD=0.23); 47% were female. Only 4.9% were socially isolated, and 43.7% had received guideline-recommended care. Social isolation was not associated with receiving guideline-recommended care in fully-adjusted models (p=.20). Of covariates, only those living at or below the poverty line were less likely to receive care (OR=0.52, p=.02) compared to those living above the poverty line.
CONCLUSIONS: Social isolation was not associated with receipt of ADA-recommended care. Our stricter and objective definition of social isolation may have led to an underestimation of social isolation’s true prevalence among older adults with diabetes. Nevertheless, socioeconomic factors, rather than social isolation alone, may play a larger role in care receipt. Given the elevated risk of social isolation among older adults and its broader health impacts, future research should examine its role in other aspects of diabetes management, such as self-care behaviors.
Authors:
Presenter - Asher Hong, BS, University of Illinois at Chicago
Co-Author - Clare Wongwai, BA, University of Illinois at Chicago
Co-Author - Esther Yoon, PhD MPH MS, Northwestern University Feinberg School of Medicine
Co-Author - Loretta Hsueh, PhD, University of Illinois at Chicago
Associations of Race, Specific Asian Origin Grouping, and English Proficiency with Receiving a Diabetes Care Plan Among Adults with Type 2 Diabetes: Data from the California Health Interview Survey
Poster Number: A45Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Health Disparities
Background: Asian Americans are at elevated risk for poor diabetes outcomes, with substantial heterogeneity in disease burden across origin subgroups. Limited English proficiency (LEP) may further exacerbate disparities. Diabetes care plans are crucial drivers of a person’s ability to engage in diabetes self-management, yet Asian Americans may have reduced access to care plans.
Objective: To examine the association of race and ethnicity, and LEP with receiving a diabetes care plan, and to explore whether LEP status differentially impacts the association of race and ethnicity and the receipt of a diabetes care plan.
Methods: Data were from 25,642 respondents with self-reported diabetes from the 2013-2022 California Health Interview Survey. Multivariable logistic regressions estimated the association of race and ethnicity and LEP with receipt of a diabetes care plan, first using the aggregate Asian American grouping and then disaggregating by seven specific Asian origin groupings. Stratified analysis within LEP status examined whether associations of Asian origin grouping and the receipt of a diabetes care plan are modified by LEP status.
Results: About one in five of all respondents had LEP (22.0%), and most respondents had received a diabetes care plan (82.7%). Only Chinese respondents and respondents with LEP had lower odds of receiving a diabetes care plan (OR=0.27, 95% CI: 0.19-0.40 and OR=0.73, 95% CI: 0.59-0.89, respectively). Among those without LEP, Chinese respondents had 64% lower odds of receiving a plan (95% CI: 0.21-0.63) than Hispanic/Latino respondents. Among those with LEP, both Chinese and Korean respondents remained at 77% (95% CI: 0.08-0.64) and 79% (95% CI: 0.06-0.76) lower odds of receiving a plan compared.
Conclusion: In this sample of adults with diabetes in California, most had received a diabetes care plan from their provider, but Asian respondents were less likely to receive a plan than non-Hispanic White respondents. Disaggregation by specific Asian origin groups reveals that Chinese respondents were less likely to have received a care plan compared to White respondents, but no significant differences were observed for any other Asian origin group. LEP status was also associated with a lower likelihood of receiving a care plan across all models, although the impact of LEP on receiving a diabetes care plan differed by specific Asian origin group.
Keywords: Ethnic differences, Health promotionObjective: To examine the association of race and ethnicity, and LEP with receiving a diabetes care plan, and to explore whether LEP status differentially impacts the association of race and ethnicity and the receipt of a diabetes care plan.
Methods: Data were from 25,642 respondents with self-reported diabetes from the 2013-2022 California Health Interview Survey. Multivariable logistic regressions estimated the association of race and ethnicity and LEP with receipt of a diabetes care plan, first using the aggregate Asian American grouping and then disaggregating by seven specific Asian origin groupings. Stratified analysis within LEP status examined whether associations of Asian origin grouping and the receipt of a diabetes care plan are modified by LEP status.
Results: About one in five of all respondents had LEP (22.0%), and most respondents had received a diabetes care plan (82.7%). Only Chinese respondents and respondents with LEP had lower odds of receiving a diabetes care plan (OR=0.27, 95% CI: 0.19-0.40 and OR=0.73, 95% CI: 0.59-0.89, respectively). Among those without LEP, Chinese respondents had 64% lower odds of receiving a plan (95% CI: 0.21-0.63) than Hispanic/Latino respondents. Among those with LEP, both Chinese and Korean respondents remained at 77% (95% CI: 0.08-0.64) and 79% (95% CI: 0.06-0.76) lower odds of receiving a plan compared.
Conclusion: In this sample of adults with diabetes in California, most had received a diabetes care plan from their provider, but Asian respondents were less likely to receive a plan than non-Hispanic White respondents. Disaggregation by specific Asian origin groups reveals that Chinese respondents were less likely to have received a care plan compared to White respondents, but no significant differences were observed for any other Asian origin group. LEP status was also associated with a lower likelihood of receiving a care plan across all models, although the impact of LEP on receiving a diabetes care plan differed by specific Asian origin group.
Authors:
Presenter - Loretta Hsueh, PhD, University of Illinois Chicago
Co-Author - Layna Lu, BA, Northwestern University
Co-Author - Milkie Vu, PhD, MA, Northwestern University
Co-Author - Meng-Han Tsai, PhD, Augusta University
The Role of Diabetes Awareness on Preventive Health Behavior Changes among Menopausal Women: A 4-year Longitudinal Study
Poster Number: A46Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Women's Health
Objective: This study investigates the longitudinal impact of type 2 diabetes (T2D) awareness on preventive health behaviors (i.e., moderate-to-vigorous physical activity [MVPA], alcohol consumption, smoking) among menopausal women.
Methods: Using data from the Health and Retirement Study between 2008 and 2014, naturally menopausal women aged 45+ years were categorized into three groups based on combined self-reported diagnosis and HbA1c levels: 1) Diagnosed T2D - participants reporting a clinical diabetes diagnosis; 2) Undiagnosed T2D - individuals without a reported diagnosis but with HbA1c levels indicating hyperglycemia (≥5.7%); and 3) Normoglycemic - participants with no diagnosis and HbA1c below the threshold (<5.7%). Preventive health behaviors, including MVPA, alcohol consumption, and smoking, were assessed. Linear mixed models (LMM) adjusted for sociodemographic variables and evaluated longitudinal associations between diabetes awareness status and these behaviors.
Results: Compared to individuals diagnosed with T2D, HbA1c levels significantly decreased in both undiagnosed T2D (-0.77 %p, p<.001) and normoglycemic individuals (-1.05 %p, p<.001) over the four-year follow-up period. However, the adjusted difference in HbA1c between undiagnosed T2D and normoglycemic groups widened over four years, driven by larger declines among the normoglycemic group (baseline 0.49%p; follow-up: 0.77%p). MVPA increased in both undiagnosed T2D (1.63 points, p=.006) and normoglycemic women (1.93 points, p<.001), relative to the diagnosed T2D group. Despite anticipated reductions in alcohol consumption and smoking, no significant changes were observed over time after adjustment (alcohol consumption: β=-0.05, p=.553; smoking: β=-0.93, p=.095), and no significant interactions were found between time and group (all p>.05).
Conclusion: Adjusted LMM analyses showed HbA1c declined in the undiagnosed T2D and normoglycemic group relative to the diagnosed T2D group, yet the gap widened undiagnosed T2D and normoglycemic group, indicating persistent HbA1c among the undiagnosed T2D women. The higher MVPA levels observed in both undiagnosed T2D and normoglycemic women compared to diagnosed T2D women may reflect that diagnosis alone may be insufficient to promote optimal preventive behaviors like MVPA. Also, this study suggests the need for enhanced clinical education strategies that effectively reduce alcohol consumption and smoking in disease management for all menopausal women.
Keywords: Diabetes, Health behavior changeMethods: Using data from the Health and Retirement Study between 2008 and 2014, naturally menopausal women aged 45+ years were categorized into three groups based on combined self-reported diagnosis and HbA1c levels: 1) Diagnosed T2D - participants reporting a clinical diabetes diagnosis; 2) Undiagnosed T2D - individuals without a reported diagnosis but with HbA1c levels indicating hyperglycemia (≥5.7%); and 3) Normoglycemic - participants with no diagnosis and HbA1c below the threshold (<5.7%). Preventive health behaviors, including MVPA, alcohol consumption, and smoking, were assessed. Linear mixed models (LMM) adjusted for sociodemographic variables and evaluated longitudinal associations between diabetes awareness status and these behaviors.
Results: Compared to individuals diagnosed with T2D, HbA1c levels significantly decreased in both undiagnosed T2D (-0.77 %p, p<.001) and normoglycemic individuals (-1.05 %p, p<.001) over the four-year follow-up period. However, the adjusted difference in HbA1c between undiagnosed T2D and normoglycemic groups widened over four years, driven by larger declines among the normoglycemic group (baseline 0.49%p; follow-up: 0.77%p). MVPA increased in both undiagnosed T2D (1.63 points, p=.006) and normoglycemic women (1.93 points, p<.001), relative to the diagnosed T2D group. Despite anticipated reductions in alcohol consumption and smoking, no significant changes were observed over time after adjustment (alcohol consumption: β=-0.05, p=.553; smoking: β=-0.93, p=.095), and no significant interactions were found between time and group (all p>.05).
Conclusion: Adjusted LMM analyses showed HbA1c declined in the undiagnosed T2D and normoglycemic group relative to the diagnosed T2D group, yet the gap widened undiagnosed T2D and normoglycemic group, indicating persistent HbA1c among the undiagnosed T2D women. The higher MVPA levels observed in both undiagnosed T2D and normoglycemic women compared to diagnosed T2D women may reflect that diagnosis alone may be insufficient to promote optimal preventive behaviors like MVPA. Also, this study suggests the need for enhanced clinical education strategies that effectively reduce alcohol consumption and smoking in disease management for all menopausal women.
Authors:
Presenter - Jeong-Hui Park, PhD, Texas A&M University
Author - Matthew Lee Smith, PhD, Indiana University
Author - Ledric D. Sherman, PhD, Texas A&M University
Author - Taehyun Roh, PhD, Texas A&M University
Author - Tyler Prochnow, PhD, Texas A&M University
Understanding stigma among adolescents with type 2 diabetes melliitus: A conceptual analysis for contemporary care
Poster Number: A47Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Mental Health
Introduction: Stigma refers to a socially devalued attribute that leads to marginalization and discrimination. Among adolescents with type 2 diabetes mellitus (T2DM), stigma can be particularly harmful due to their unique developmental stage, peer influence, and widespread misconceptions about the condition. However, stigma remains poorly defined and inadequately understood among this population. This concept analysis used Walker and Avant’s concept analysis method to provide conceptual clarity of stigma in adolescents with T2DM, identifying its defining attributes, antecedents, and consequences.
Methods: A comprehensive database search was conducted in PubMed, CINAHL, EMBASE, Scopus, and Web of Science from inception to August 2025. Also, the reference lists of included articles were reviewed to identify additional eligible studies. A total of 17 articles met the inclusion criteria and were synthesized using thematic and integrative approach.
Results: Stigma in adolescents with T2DM has four key antecedents which include diagnosis of T2DM, a sense of "otherness" (feeling different or isolated from peers due to their diagnosis), misconception and lack of awareness, and insulin stereotyping. Five defining attributes were organized into two categories: enacted (external) stigma which is experienced through negative labeling and external blame, or self-stigma (internalized) which is expressed through feelings of shame and embarrassment, self-blame and resignation, and concealment of the disease. Five major consequences emerged from the analysis which are poor diabetes management and outcomes, fear of judgment, peer rejection, and social isolation, emotional and psychological distress, risky health behaviors and avoidance, and bullying and family verbal abuse.
Conclusion: This concept analysis T2DM sets foundations for further investigations and targeted interventions. Future studies should aim at developing a validated tool that quantifies the effects of stigma and inform targeted interventions in adolescents with T2DM.
Keywords: Mental health, AdolescentsMethods: A comprehensive database search was conducted in PubMed, CINAHL, EMBASE, Scopus, and Web of Science from inception to August 2025. Also, the reference lists of included articles were reviewed to identify additional eligible studies. A total of 17 articles met the inclusion criteria and were synthesized using thematic and integrative approach.
Results: Stigma in adolescents with T2DM has four key antecedents which include diagnosis of T2DM, a sense of "otherness" (feeling different or isolated from peers due to their diagnosis), misconception and lack of awareness, and insulin stereotyping. Five defining attributes were organized into two categories: enacted (external) stigma which is experienced through negative labeling and external blame, or self-stigma (internalized) which is expressed through feelings of shame and embarrassment, self-blame and resignation, and concealment of the disease. Five major consequences emerged from the analysis which are poor diabetes management and outcomes, fear of judgment, peer rejection, and social isolation, emotional and psychological distress, risky health behaviors and avoidance, and bullying and family verbal abuse.
Conclusion: This concept analysis T2DM sets foundations for further investigations and targeted interventions. Future studies should aim at developing a validated tool that quantifies the effects of stigma and inform targeted interventions in adolescents with T2DM.
Authors:
Author - Eric Peprah Osei, University of Illinois Chicago
Co-Author - Martyn-Nemeth, PhD, RN, FAHA, FPCN, FAAN, University of Illinois Chicago
Spatio-Temporal Impact of Crime on the Prevalence of Diabetes across US Counties from 2012 to 2020
Poster Number: A48Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Social and Environmental Context and Health
Background: Despite the long-term impact of crime on diabetes observed in the US, no study to date has investigated how macro-level processes, such as county-level crime rates, were geographically and temporally associated with diabetes prevalence. This study aimed to test the hypothesis that higher levels of crime rates would be related to higher prevalence of diabetes across US counties over time.
Methods: County-level diabetes prevalence data came from the 2012-2020 CDC United States Diabetes Surveillance System (n=3,195 counties). County-level crime rates (counts of violent crime per 100,000 persons at each county) were obtained from County Health Rankings & Roadmaps, 2012-2020, which was expressed in 1-standard deviation increase (1-SD) and quartiles (lowest [referent], low-medium, medium-high, and high). Spatio-temporal Gaussian mixed-effects models with random intercepts for county and year and a Matérn spatial correlation (R package spaMM, function fitme) were used to estimate temporal and local relationships between county-level crime rates and diabetes prevalence over time, adjusting for percentages of a specific racial and/or ethnic group (White, Black, Hispanic, Asian, and American Indian and Alaska Native), and percentages of inactive, limited healthy food, and poverty.
Results: The averaged prevalence of county-level diabetes across counties, 2012-2020, was 8.53 for standardized and 8.04 for quartile exposure variables. The mean crime rate was 257 (SD=205). Random-effects standard deviations were stable across models: county=1.04–1.37, year=0.18–0.21. After covariate adjustments, a 1-SD increase in county-level crime rates was related to higher diabetes prevalence (β=0.14, p<.001). Compared to low crime rates, low-medium, medium-high, and high crime rates were associated with a 0.09%, 0.18%, and 0.28% higher prevalence of diabetes, respectively.
Conclusions: Individuals residing in neighborhoods with greater violent crime could increase the risk of diabetes across US counties from 2012 to 2020. These findings highlight the importance of addressing neighborhood safety as a potential social determinant of health and reducing local crime. Local and state efforts aimed at reducing violent crime, enhancing community safety, promoting supportive physical activity-friendly environments, and having better access to healthy food environments may help ease diabetes risk and reduce disparities in diabetes for the US population.
Keywords: Diabetes, EnvironmentalMethods: County-level diabetes prevalence data came from the 2012-2020 CDC United States Diabetes Surveillance System (n=3,195 counties). County-level crime rates (counts of violent crime per 100,000 persons at each county) were obtained from County Health Rankings & Roadmaps, 2012-2020, which was expressed in 1-standard deviation increase (1-SD) and quartiles (lowest [referent], low-medium, medium-high, and high). Spatio-temporal Gaussian mixed-effects models with random intercepts for county and year and a Matérn spatial correlation (R package spaMM, function fitme) were used to estimate temporal and local relationships between county-level crime rates and diabetes prevalence over time, adjusting for percentages of a specific racial and/or ethnic group (White, Black, Hispanic, Asian, and American Indian and Alaska Native), and percentages of inactive, limited healthy food, and poverty.
Results: The averaged prevalence of county-level diabetes across counties, 2012-2020, was 8.53 for standardized and 8.04 for quartile exposure variables. The mean crime rate was 257 (SD=205). Random-effects standard deviations were stable across models: county=1.04–1.37, year=0.18–0.21. After covariate adjustments, a 1-SD increase in county-level crime rates was related to higher diabetes prevalence (β=0.14, p<.001). Compared to low crime rates, low-medium, medium-high, and high crime rates were associated with a 0.09%, 0.18%, and 0.28% higher prevalence of diabetes, respectively.
Conclusions: Individuals residing in neighborhoods with greater violent crime could increase the risk of diabetes across US counties from 2012 to 2020. These findings highlight the importance of addressing neighborhood safety as a potential social determinant of health and reducing local crime. Local and state efforts aimed at reducing violent crime, enhancing community safety, promoting supportive physical activity-friendly environments, and having better access to healthy food environments may help ease diabetes risk and reduce disparities in diabetes for the US population.
Authors:
Co-Author - , PhD, Georgia State University
Co-Author - , MPH, National Institute on Minority Health and Health Disparities, National Institutes of Health
Co-Author - , PhD, NYU Grossman School of Medicine
Co-Author - , PhD, Emory University
Exploring online health information seeking behavior among individuals with diabetes: A scoping review
Poster Number: A49Time: 05:00 PM - 05:50 PM
Topics: Diabetes, Digital Health
Background
With the global burden of diabetes on the rise, effective self-management remains essential for optimal diabetes control. This depends heavily on patients’ ability to access and use relevant health information. While the internet has become a preferred source, a comprehensive overview of online health information seeking (OHIS) behavior among individuals with diabetes is lacking. This review maps current evidence, identifies gaps, and informs future studies.
Objectives
To explore the OHIS behavior among individuals with diabetes by addressing: (1) the online sources they use, (2) the types of health information they seek, and (3) the factors that influence their OHIS behavior.
Methods
Following the PRISMA-ScR guidelines and guided by the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) tool, we systematically searched PubMed and Scopus for empirical studies published in English from inception to April 2025. Two reviewers independently screened titles and abstracts, resolving any discrepancies through discussion and, when needed, consultation with a third reviewer. Data were qualitatively synthesized in line with the research questions.
Results
Of the 1,072 articles screened, 46 studies met the inclusion criteria. Eight main online sources were identified, with social media and forums being the most frequent, followed by general internet searches and search engines. Patients primarily sought information on self-management strategies, general diabetes knowledge, and treatment options. Factors influencing OHIS behavior emerged across four levels: individual (e.g., sociodemographic characteristics, health status, psychological factors, knowledge and skills), interpersonal (e.g., social support, relationships with healthcare providers), organizational (e.g., quality of care, healthcare utilization), and environmental (e.g., internet access, characteristics of information sources).
Conclusions
Individuals with diabetes actively use the internet to address substantial information needs, with their behavior shaped by various personal and contextual factors. Enhancing eHealth literacy is key to helping patients navigate online resources effectively. Healthcare professionals should discuss patients’ online findings, recommend credible sources, and leverage social networks in care. With the emergence of large language model-based chatbots, future research should explore their role in supporting OHIS in diabetes management.
Keywords: Diabetes, Health behaviorsWith the global burden of diabetes on the rise, effective self-management remains essential for optimal diabetes control. This depends heavily on patients’ ability to access and use relevant health information. While the internet has become a preferred source, a comprehensive overview of online health information seeking (OHIS) behavior among individuals with diabetes is lacking. This review maps current evidence, identifies gaps, and informs future studies.
Objectives
To explore the OHIS behavior among individuals with diabetes by addressing: (1) the online sources they use, (2) the types of health information they seek, and (3) the factors that influence their OHIS behavior.
Methods
Following the PRISMA-ScR guidelines and guided by the SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type) tool, we systematically searched PubMed and Scopus for empirical studies published in English from inception to April 2025. Two reviewers independently screened titles and abstracts, resolving any discrepancies through discussion and, when needed, consultation with a third reviewer. Data were qualitatively synthesized in line with the research questions.
Results
Of the 1,072 articles screened, 46 studies met the inclusion criteria. Eight main online sources were identified, with social media and forums being the most frequent, followed by general internet searches and search engines. Patients primarily sought information on self-management strategies, general diabetes knowledge, and treatment options. Factors influencing OHIS behavior emerged across four levels: individual (e.g., sociodemographic characteristics, health status, psychological factors, knowledge and skills), interpersonal (e.g., social support, relationships with healthcare providers), organizational (e.g., quality of care, healthcare utilization), and environmental (e.g., internet access, characteristics of information sources).
Conclusions
Individuals with diabetes actively use the internet to address substantial information needs, with their behavior shaped by various personal and contextual factors. Enhancing eHealth literacy is key to helping patients navigate online resources effectively. Healthcare professionals should discuss patients’ online findings, recommend credible sources, and leverage social networks in care. With the emergence of large language model-based chatbots, future research should explore their role in supporting OHIS in diabetes management.
Authors:
Author - Pin-Heng Tiao, PharmD, National Taiwan University
Author - Hsun-Yu Chan, National Taiwan Normal University
Author - Yen-Ming Huang, National Taiwan University
Trends in Physical Activity and Dietary Habits Among Illinois High School Students: Insights from the Youth Risk Behavior Surveillance System (2007-2021)
Poster Number: A50Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Health Disparities
Introduction and Objective: Physical inactivity and poor dietary habits among adolescents are great public health concerns, contributing to an increased risk of chronic disease. Understanding the trends of dietary habits associated with physical activity (PA) is crucial for shaping effective public health interventions. This study analyzes trends in PA and dietary habits among high school students in Illinois.
Methods:Data were drawn from (YRBSS) for Illinois high school students spanning 2007–2021. Key variables included self-reported PA frequency and dietary habits, including fruit, fruit juice, green salad, potatoes, carrots, other vegetables, and soda. T-tests, ANOVA, and linear regression assessed differences by sex, age, and race/ethnicity, and associations between diet and PA.Temporal trends were evaluated using the Prais-Winsten Method.
Results: The average number of PA days increased from 4.45 ± 2.49 in 2007-4.82 ± 2.44; p<0.05 in 2021,with males reporting higher levels than females. Fruit intake showed an overall decline (β –0.008; 95% CI: –0.012 to –0.005; p < 0.0001)despite increases among females, Hispanics, and adolescents >14 years. In2015, fruit consumers reported +1.60 PA days compared with non-consumers. Green salad intake decreased from 57.8% in 2007, 48.6% in 2021(p < 0.0001), particularly among adolescents >14 years, paralleled by lower PA. Fruit juice intake declined (β –0.0025; 95% CI: –0.004 to –0.001; p < 0.0001),but consumers reported +1 PA day in 2015; declines were sharper among females, adolescents >14 years, and Other ethnicity, followed by White, Hispanic, and Black groups. Carrot intake rose from 42.95% - 45.80%, with PA association strengthening (r = 0.474 → 0.842), and other vegetable intake increased from 77.74% -81.01%, with stronger PA association (r = 0.626 → 1.215). Potato intake decreased from 63.83% → 59.24% alongside a weakened PA association (r = 0.613 → 0.539).While the trends of not taking soda increased across the years from18.64% → 31.48%,with its association with PA decreased (r = –0.086 → –0.092).
Conclusion: PA and dietary habits shifted from 2007–2021, with PA higher in males and adolescents ≤14. Fruit, salad, juice, and potato intake declined, while carrot and vegetable intake increased. Soda intake decreased but weakened in its link to PA, whereas fruits and vegetables stayed positively associated. Targeted efforts are needed across sex, age and race to promote healthy eating and active lifestyles
Keywords: Adolescents, Health disparitiesMethods:Data were drawn from (YRBSS) for Illinois high school students spanning 2007–2021. Key variables included self-reported PA frequency and dietary habits, including fruit, fruit juice, green salad, potatoes, carrots, other vegetables, and soda. T-tests, ANOVA, and linear regression assessed differences by sex, age, and race/ethnicity, and associations between diet and PA.Temporal trends were evaluated using the Prais-Winsten Method.
Results: The average number of PA days increased from 4.45 ± 2.49 in 2007-4.82 ± 2.44; p<0.05 in 2021,with males reporting higher levels than females. Fruit intake showed an overall decline (β –0.008; 95% CI: –0.012 to –0.005; p < 0.0001)despite increases among females, Hispanics, and adolescents >14 years. In2015, fruit consumers reported +1.60 PA days compared with non-consumers. Green salad intake decreased from 57.8% in 2007, 48.6% in 2021(p < 0.0001), particularly among adolescents >14 years, paralleled by lower PA. Fruit juice intake declined (β –0.0025; 95% CI: –0.004 to –0.001; p < 0.0001),but consumers reported +1 PA day in 2015; declines were sharper among females, adolescents >14 years, and Other ethnicity, followed by White, Hispanic, and Black groups. Carrot intake rose from 42.95% - 45.80%, with PA association strengthening (r = 0.474 → 0.842), and other vegetable intake increased from 77.74% -81.01%, with stronger PA association (r = 0.626 → 1.215). Potato intake decreased from 63.83% → 59.24% alongside a weakened PA association (r = 0.613 → 0.539).While the trends of not taking soda increased across the years from18.64% → 31.48%,with its association with PA decreased (r = –0.086 → –0.092).
Conclusion: PA and dietary habits shifted from 2007–2021, with PA higher in males and adolescents ≤14. Fruit, salad, juice, and potato intake declined, while carrot and vegetable intake increased. Soda intake decreased but weakened in its link to PA, whereas fruits and vegetables stayed positively associated. Targeted efforts are needed across sex, age and race to promote healthy eating and active lifestyles
Authors:
Author - Ramat Sarbah, University of Illinois Urbana-Champaign
Co-Author - Ramatu Sarbah, University of Illinois Urbana-Champaign
Co-Author - Rafael Miranda Tassitano, University of Illinois Urbana-Champaign
Co-Author - Thayna Ramos Flores, University of Illinois Urbana-Champaign
Co-Author - Maria Cecilia M.Tenorio, University of Illinois Urbana-Champaign
Associations between Food Insecurity and Disordered Eating Behaviors: Analysis of the 2022–2023 National Survey of Children’s Health (NSCH)
Poster Number: A51Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Child and Family Health
Background & Objective: Food insecurity—defined as the inability to access sufficient nutritious food—remains a pressing issue for U.S. children and adolescents and may have consequences beyond nutrition. Although food insecurity has been linked to psychosocial outcomes such as depression and anxiety in adults, its association with disordered eating behaviors in younger populations remains underexplored. Childhood and adolescence are critical developmental periods when stress and instability can significantly impact behavioral health. This study examines associations between food insecurity and eight domains of disordered eating behavior among U.S. children and adolescents.
Methods: Secondary data from the 2022–2023 National Survey of Children’s Health (NSCH), a nationally representative cross-sectional survey, were analyzed. The analytic sample included 68,000 children and adolescents aged 6–17. Binary logistic regression models assessed associations between food insecurity and various domains of disordered eating behavior—binge eating, skipping meals, low interest in food, picky eating, purging, diet pill use, overexercising, and fear of eating—while adjusting for covariates. Rao–Scott chi-square tests compared the weighted prevalence of each outcome by food security status.
Results: The sample consisted of 66.6% children and adolescents who were food secure, 33.1% with mild-to-moderate insecurity, and 0.8% with severe insecurity. Bivariate analyses revealed significant associations between food insecurity and binge eating, meal skipping, low interest in food, picky eating, diet pill use, and fear of eating (all p < .001), while no differences were observed for overexercising. In regression models adjusting for covariates, mild-to-moderate insecurity was associated with greater odds of binge eating, meal skipping, low interest in food, picky eating, diet pill use, and fear of eating (all p < .0001). Severe insecurity was associated with meal skipping (p = 0.0006) and low interest in food (p = 0.0029). No associations were observed for overexercising.
Conclusion: Food insecurity was consistently associated with multiple disordered eating behaviors in U.S. children and adolescents, particularly restrictive and avoidant patterns. Findings underscore the need to address household food access as part of pediatric behavioral health and eating disorder prevention.
Keywords: Binge eating, Eating behaviorsMethods: Secondary data from the 2022–2023 National Survey of Children’s Health (NSCH), a nationally representative cross-sectional survey, were analyzed. The analytic sample included 68,000 children and adolescents aged 6–17. Binary logistic regression models assessed associations between food insecurity and various domains of disordered eating behavior—binge eating, skipping meals, low interest in food, picky eating, purging, diet pill use, overexercising, and fear of eating—while adjusting for covariates. Rao–Scott chi-square tests compared the weighted prevalence of each outcome by food security status.
Results: The sample consisted of 66.6% children and adolescents who were food secure, 33.1% with mild-to-moderate insecurity, and 0.8% with severe insecurity. Bivariate analyses revealed significant associations between food insecurity and binge eating, meal skipping, low interest in food, picky eating, diet pill use, and fear of eating (all p < .001), while no differences were observed for overexercising. In regression models adjusting for covariates, mild-to-moderate insecurity was associated with greater odds of binge eating, meal skipping, low interest in food, picky eating, diet pill use, and fear of eating (all p < .0001). Severe insecurity was associated with meal skipping (p = 0.0006) and low interest in food (p = 0.0029). No associations were observed for overexercising.
Conclusion: Food insecurity was consistently associated with multiple disordered eating behaviors in U.S. children and adolescents, particularly restrictive and avoidant patterns. Findings underscore the need to address household food access as part of pediatric behavioral health and eating disorder prevention.
Authors:
Presenter - Mina Davari, PhD Candidate, University of South Florida
Chair - Marilyn Stern, Professor , University of South Florida
How does reverse recess relate to student diet quality, energy intake, and food waste? A plate waste investigation.
Poster Number: A52Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Health Communication and Policy
Background: Modifications to the school environment, such as moving recess before lunch (“reverse recess”), may be a cost-effective method to improve student nutrition and reduce food waste. Yet, investigations using objective assessments within large, diverse samples are needed. The current study is a secondary analysis of a school-based plate waste investigation that examined the association between reverse recess and diet quality, energy intake, and plate waste in a large, sociodemographically diverse sample.
Methods: Ten elementary schools (M enrollment=678; 66% racial/ethnic minority; 60% Title I; 54% National School Lunch participation rate) participated in a cross-sectional plate waste assessment. Across schools, xx% of grades had recess before lunch (“reverse recess”). Validated digital imagery methods were applied to calculate diet quality (Healthy Eating Index [HEI-2015]), energy intake (kilocalories [kcals]), and plate waste (% grams wasted) for each meal component. Hierarchal mixed models evaluated group differences in outcomes. Group-by-grade interactions were evaluated within grade levels.
Results: A total of 2,524 trays were evaluated (1,656 reverse recess). Reverse recess was not related to overall diet quality (HEI total score) or energy intake (total kcal). Reverse recess was associated with higher HEI scores for Total Fruit (2.7+2.2, p<.0001) and Whole Fruit (3.0+2.3, p=.001) and lower HEI scores for Total Vegetables (1.6+1.9, p<.0001). Similarly, reverse recess was associated with greater fruit energy (30+32 kcals, p<.0001) and lower vegetable energy consumption (15+33 kcals, p<.0001). Students with reverse recess wasted more vegetables (52% grams wasted) compared to students with recess after lunch (45% grams wasted, p=.0009). Group-by-grade interactions were identified for several HEI (Total Fruit, Total Protein Foods, Fatty Acids, Refined Grains, Added Sugars) and energy intake variables (total energy, vegetables, snacks), with no clear patterns observed.
Conclusions: Reverse recess was not associated with overall diet quality or energy intake. Students with reverse recess had greater fruit intake, lower vegetable intake, and greater vegetable waste compared to recess after lunch. Additional strategies are needed to improve vegetable intake and reduce vegetable waste. Prospective research designs, with repeated plate waste assessments, are necessary to confirm our findings and inform school nutrition policy.
Keywords: Diet, ChildrenMethods: Ten elementary schools (M enrollment=678; 66% racial/ethnic minority; 60% Title I; 54% National School Lunch participation rate) participated in a cross-sectional plate waste assessment. Across schools, xx% of grades had recess before lunch (“reverse recess”). Validated digital imagery methods were applied to calculate diet quality (Healthy Eating Index [HEI-2015]), energy intake (kilocalories [kcals]), and plate waste (% grams wasted) for each meal component. Hierarchal mixed models evaluated group differences in outcomes. Group-by-grade interactions were evaluated within grade levels.
Results: A total of 2,524 trays were evaluated (1,656 reverse recess). Reverse recess was not related to overall diet quality (HEI total score) or energy intake (total kcal). Reverse recess was associated with higher HEI scores for Total Fruit (2.7+2.2, p<.0001) and Whole Fruit (3.0+2.3, p=.001) and lower HEI scores for Total Vegetables (1.6+1.9, p<.0001). Similarly, reverse recess was associated with greater fruit energy (30+32 kcals, p<.0001) and lower vegetable energy consumption (15+33 kcals, p<.0001). Students with reverse recess wasted more vegetables (52% grams wasted) compared to students with recess after lunch (45% grams wasted, p=.0009). Group-by-grade interactions were identified for several HEI (Total Fruit, Total Protein Foods, Fatty Acids, Refined Grains, Added Sugars) and energy intake variables (total energy, vegetables, snacks), with no clear patterns observed.
Conclusions: Reverse recess was not associated with overall diet quality or energy intake. Students with reverse recess had greater fruit intake, lower vegetable intake, and greater vegetable waste compared to recess after lunch. Additional strategies are needed to improve vegetable intake and reduce vegetable waste. Prospective research designs, with repeated plate waste assessments, are necessary to confirm our findings and inform school nutrition policy.
Authors:
Author - Katlyn Garr, Virginia Commonwealth University
Co-Author - Laura Thornton, University of North Carolina at Chapel Hill
Co-Author - Hollie Raynor, University of Tennessee
Co-Author - , Virginia Commonwealth University
Examining Momentary Associations Between Alcohol Use and Weight-motivated Exercise Intentions Among Binge-drinking Undergraduates
Poster Number: A53Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Digital Health
Among U.S. college students, drinking has been cross-sectionally linked to weight-motivated exercise (e.g., compensatory exercise to offset calories from alcohol). Yet the momentary pathway between them, which helps establish temporal precedence, remains unexamined. Momentary methods can also help examine explanatory variables, e.g., if drinking leads to negative affect (NA), which in turn predicts weight-motivated exercise. We hypothesized that drinking would predict stronger subsequent weight-motivated exercise intentions, and that this relationship can be explained by increased NA after drinking.
We recruited 10 undergraduates reporting at least one BD episode (women >=4, men >=5 drinks in one night/day) in the past two weeks. Over 2 weeks, students completed 5 ecological momentary assessment (EMA) surveys per day, reporting intention and motivations to exercise, alcohol consumption since the previous prompt, and current NA (i.e., shame and sadness on 1-5 scales). When participants intended to exercise, they selected motivations to do so; endorsements of five weight-focused motivations (e.g., “to compensate for calories I have eaten,” “to change my physical shape or weight”) were summed to create a continuous variable.
Using multilevel models, we tested whether: (1) drinking predicted weight-motivated exercise intentions, (2) drinking predicted NA, and (3) NA predicted weight-motivated exercise intentions. Drinking significantly predicted higher next-prompt weight-motivated exercise intentions (b=.114, SE=.033, p<.001) and marginally predicted increases in NA (shame: b=.27, p=.095; sadness: b=.28, p=.061). However, NA did not reliably predict weight-motivated exercise (shame: b=-.013, p=.144; sadness: b=-.013, p=.114).
This momentary methodology corroborates previous findings by supporting a link between drinking and weight/shape-motivated exercise, but goes beyond the literature by establishing a temporal link between the two, providing some evidence that drinking may increase the likelihood of subsequent ED cognitions. Although NA did not explain this link in our pilot sample, larger studies are needed to more robustly test mediation. Interventions for ED risk in undergraduates should recognize drinking as an intervention target, as drinking may be a potential momentary trigger for ED cognitions.
Keywords: Alcohol, ExerciseWe recruited 10 undergraduates reporting at least one BD episode (women >=4, men >=5 drinks in one night/day) in the past two weeks. Over 2 weeks, students completed 5 ecological momentary assessment (EMA) surveys per day, reporting intention and motivations to exercise, alcohol consumption since the previous prompt, and current NA (i.e., shame and sadness on 1-5 scales). When participants intended to exercise, they selected motivations to do so; endorsements of five weight-focused motivations (e.g., “to compensate for calories I have eaten,” “to change my physical shape or weight”) were summed to create a continuous variable.
Using multilevel models, we tested whether: (1) drinking predicted weight-motivated exercise intentions, (2) drinking predicted NA, and (3) NA predicted weight-motivated exercise intentions. Drinking significantly predicted higher next-prompt weight-motivated exercise intentions (b=.114, SE=.033, p<.001) and marginally predicted increases in NA (shame: b=.27, p=.095; sadness: b=.28, p=.061). However, NA did not reliably predict weight-motivated exercise (shame: b=-.013, p=.144; sadness: b=-.013, p=.114).
This momentary methodology corroborates previous findings by supporting a link between drinking and weight/shape-motivated exercise, but goes beyond the literature by establishing a temporal link between the two, providing some evidence that drinking may increase the likelihood of subsequent ED cognitions. Although NA did not explain this link in our pilot sample, larger studies are needed to more robustly test mediation. Interventions for ED risk in undergraduates should recognize drinking as an intervention target, as drinking may be a potential momentary trigger for ED cognitions.
Authors:
Author - Ashley Kim, Williams College
Co-Author - Rebecca Crochiere, Ph.D., Williams College
Cue-exposure treatment for overeating and obesity: a systematized review
Poster Number: A54Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders
Overweight and obesity are heterogeneous and complex diseases. Many individuals do not respond or maintain results from traditional behavioral weight loss programs, and many cannot tolerate pharmacological treatments due to adverse side effects, necessitating the evaluation of alternative behavioral treatment approaches. Cue-exposure treatment has demonstrated success in treating anxiety disorders, substance use disorders, and binge eating, but has yet to be systematically evaluated for the treatment of overweight, obesity, or overeating. The current study is a systematized review that synthesized and evaluated the evidence for cue-exposure treatment for reducing overeating and anthropometric outcomes among individuals with overweight or obesity (PROSPERO registration #CRD42025618871). Studies were identified from electronic database searches and reference lists, using multiple search terms relating to cue-exposure treatment, overeating, overweight, and obesity, which resulted in 15 eligible studies. The search yielded both randomized trials (N = 13) and quasi-experimental studies (N = 2). Studies were primarily conducted among adults (N = 11), while a smaller number were conducted with children (N = 2) and adolescents (N = 2). Most studies employed in vivo exposure techniques (N = 11), although virtual reality-based approaches were also used in several studies (N = 4). Study results generally supported cue-exposure treatment in reducing overeating but results were mixed for anthropometric outcomes. Conclusions were limited by risk of bias, small samples, limited long term follow-up data, and the inability to attribute outcomes to the effects of exposures in multifaceted treatment programs. While results show initial promise, this review highlights the need for higher quality randomized trials with larger samples and longer follow-ups to make conclusive recommendations about the effectiveness of cue-exposure treatment for reducing overeating and anthropometric outcomes among individuals with overweight or obesity.
Keywords: Obesity, Eating behaviorsAuthors:
Co-Author - Ellen Pasquale, MS, University of California, San Diego
Co-Author - Allison Boyar, BS, University of California, San Diego
Co-Author - Kerri Boutelle, PhD, University of California San Diego
A scoping review of eating disorder symptoms and mental health during the postpartum period: Predictors, course, and consequences for mothers and infants
Poster Number: A55Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Women's Health
Objective. Eating disorders (EDs) are most prevalent in women of reproductive age and. During the postpartum period, women with a history of ED are at high risk for remission. Yet research on ED symptoms and their impacts on infant feeding and maternal mental health is limited. This scoping review aims to provide an overview of the current research on postpartum ED symptoms and their effects on mothers and their babies as well as postpartum screening and treatment strategies.
Methods. This review included all available English-language literature published between 2000 and January 2025. Collecting, charting, and reviewing the included material were done using the JBI Scoping Review Methodology. The search strategy included PubMed, SCOPUS, and APA PsychInfo electronic databases.
Results. A total of 43 articles were included and analyzed from 332 identified citations. Ten of the 12 studies that used scales to assess ED symptoms used the EDE-Q scale. Among studies that compared across groups with a history of specific ED diagnoses and non-ED groups, all found that bulimia nervosa was associated with elevated risk for postpartum internalizing symptoms and individuals with anorexia nervosa diagnosis had an elevated risk for postpartum internalizing symptoms in all studies except one. Several longitudinal studies found an increase in ED symptoms after childbirth, particularly among women with a lifetime history of ED. Findings on differences in breastfeeding initiation or duration during the first year were mixed. There is some evidence that maternal ED symptoms affect aspects of the maternal-infant feeding relationship.
Discussion. This review provides novel insights into ED symptoms, effects, and care in the postpartum period. This topic deserves attention because postpartum women are at high risk for remission and women without a previously diagnosed ED are at risk for developing a new ED. Postpartum ED symptoms uniquely predict worse maternal mental health symptoms and are associated with a more difficult infant feeding relationship. Despite the public health significance of this problem, research on screening and treatment needs during this time is limited, and no specialized screening tools exist. Few articles examined differences among women with differing language, race/ethnicity, or socio-economic status. Future focus on this period offers an opportunity to tailor ED care and potentially improve maternal and infant health trajectories.
Keywords: Eating behaviors, Women's healthMethods. This review included all available English-language literature published between 2000 and January 2025. Collecting, charting, and reviewing the included material were done using the JBI Scoping Review Methodology. The search strategy included PubMed, SCOPUS, and APA PsychInfo electronic databases.
Results. A total of 43 articles were included and analyzed from 332 identified citations. Ten of the 12 studies that used scales to assess ED symptoms used the EDE-Q scale. Among studies that compared across groups with a history of specific ED diagnoses and non-ED groups, all found that bulimia nervosa was associated with elevated risk for postpartum internalizing symptoms and individuals with anorexia nervosa diagnosis had an elevated risk for postpartum internalizing symptoms in all studies except one. Several longitudinal studies found an increase in ED symptoms after childbirth, particularly among women with a lifetime history of ED. Findings on differences in breastfeeding initiation or duration during the first year were mixed. There is some evidence that maternal ED symptoms affect aspects of the maternal-infant feeding relationship.
Discussion. This review provides novel insights into ED symptoms, effects, and care in the postpartum period. This topic deserves attention because postpartum women are at high risk for remission and women without a previously diagnosed ED are at risk for developing a new ED. Postpartum ED symptoms uniquely predict worse maternal mental health symptoms and are associated with a more difficult infant feeding relationship. Despite the public health significance of this problem, research on screening and treatment needs during this time is limited, and no specialized screening tools exist. Few articles examined differences among women with differing language, race/ethnicity, or socio-economic status. Future focus on this period offers an opportunity to tailor ED care and potentially improve maternal and infant health trajectories.
Authors:
Author - Marina Pearsall, MPH, RDN, RTI International
Co-Author - Wan-Chen Lin, University of North Carolina at Chapel Hill
Co-Author - Nisha Gottfredson O'Shea, PhD, University of North Carolina at Chapel Hill
Effects of internally regulated eating on body composition: a systematic review and meta-analysis of randomized controlled trials
Poster Number: A56Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Weight Related Health
Background/Objectives: Traditional weight management strategies often rely on dietary modifications and regular exercise with/without behavior or medication therapy. However, these approaches are difficult to sustain and may negatively impact long-term well-being. Internally regulated eating may be a promising alternative, as it emphasizes responding to internal hunger and fullness cues, although evidence on its effectiveness for improving body composition remains inconclusive. This meta-analysis of randomized controlled trials (RCTs) aimed to clarify the effects of internally regulated eating on body composition in adults.
Methods: PubMed, Scopus, PsycINFO, and Web of Science were searched for RCTs published up to January 22, 2025. Studies were included if they involved adults, implemented an internally regulated eating intervention (e.g., intuitive and/or mindful eating), and reported effects in body weight, body mass index (BMI), waist circumference (WC), fat mass, body image concerns, food cravings, anxiety, and depression. Random-effects analyses were conducted to assess mean differences (MD) or standardized MD (SMD), with 95% confidence intervals (95% CIs). The evidence certainty was examined using Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Results: Overall, 18 RCTs comprising 1,465 adults (89% women; mean age, 43 years) were included. Internally regulated eating had no significant effects on weight, BMI and WC. However, a small significant effect in fat mass was observed (MD: -0.02 kg, 95%CI: -0.03, -0.01; GRADE=low). Internally regulated eating also significantly reduced body image concerns (SMD: -0.89, 95%CI: -1.40, -0.37; GRADE=low) and food cravings (SMD: -1.49, 95%CI: -2.62, -0.36; GRADE=very low) but had no significant effects on anxiety and depression. Except for sex and control type, which indicated small significant reduction in BMI among women (MD: -0.43 kg/m2, 95%CI: -0.72, -0.14) and among studies with no treatment control group (MD: -0.48 kg/m2, 95%CI: -0.74, -0.22), the findings remained similar across subgroups.
Conclusions: This review revealed that internally regulated eating may not be an effective standalone strategy for improving body composition in adults. While a small reduction in fat mass was observed, the evidence certainty was low. Further, high-quality RCTs are needed to clarify the long-term impact of internally regulated eating on body composition.
Keywords: Eating behaviors, ObesityMethods: PubMed, Scopus, PsycINFO, and Web of Science were searched for RCTs published up to January 22, 2025. Studies were included if they involved adults, implemented an internally regulated eating intervention (e.g., intuitive and/or mindful eating), and reported effects in body weight, body mass index (BMI), waist circumference (WC), fat mass, body image concerns, food cravings, anxiety, and depression. Random-effects analyses were conducted to assess mean differences (MD) or standardized MD (SMD), with 95% confidence intervals (95% CIs). The evidence certainty was examined using Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Results: Overall, 18 RCTs comprising 1,465 adults (89% women; mean age, 43 years) were included. Internally regulated eating had no significant effects on weight, BMI and WC. However, a small significant effect in fat mass was observed (MD: -0.02 kg, 95%CI: -0.03, -0.01; GRADE=low). Internally regulated eating also significantly reduced body image concerns (SMD: -0.89, 95%CI: -1.40, -0.37; GRADE=low) and food cravings (SMD: -1.49, 95%CI: -2.62, -0.36; GRADE=very low) but had no significant effects on anxiety and depression. Except for sex and control type, which indicated small significant reduction in BMI among women (MD: -0.43 kg/m2, 95%CI: -0.72, -0.14) and among studies with no treatment control group (MD: -0.48 kg/m2, 95%CI: -0.74, -0.22), the findings remained similar across subgroups.
Conclusions: This review revealed that internally regulated eating may not be an effective standalone strategy for improving body composition in adults. While a small reduction in fat mass was observed, the evidence certainty was low. Further, high-quality RCTs are needed to clarify the long-term impact of internally regulated eating on body composition.
Authors:
Presenter - Sheida Zeraattalabmotlagh, University of Houston
Co-Author - Tracey Ledoux, PhD RD, University of Houston
Trends in Beverage Consumption among Texas School-aged Children and Adolescents
Poster Number: A57Time: 05:00 PM - 05:50 PM
Topics: Diet, Nutrition, and Eating Disorders, Child and Family Health
Background: Consumption of sugar-sweetened beverages is associated with adverse health outcomes, such as increased risk of overweight and obesity among children and adolescents. This study aims to examine the prevalence and trends of beverage consumption among school-aged children and adolescents in Texas from 2000 to 2023.
Methods: Beverage consumption data were collected from 4th, 8th, and 11th graders across 6 waves (2000-2002, 2004-2005, 2009-2011, 2015-2016, 2019-2020, 2021-2023) of the Texas School Physical Activity and Nutrition (Texas SPAN) survey between 2000-2023. Students self-reported times/day that yogurt/yogurt drinks, 100% juice, fruit-flavored drinks, milk (including plain and flavored), soda (including regular and diet), water, tea/coffee (with added sugar or no sugar), and energy drinks were consumed. Water and tea/coffee were first available in 2009-2011 for the 8th and 11th grades and in 2013-2015 for the 4th grade. The energy drink was first available in 2019-2020. Each beverage consumption was dichotomized into 0 vs. 1+ times/day. Weighted logistic regression models were conducted to assess the trends in beverage consumption prevalence over time with wave as a continuous independent variable, adjusting for sex, ethnicity, and community type (urban vs. rural). Bonferroni correction was used to set the significance value at p<0.006 for 8 beverage categories with complete data for each wave.
Results: Significant downward trends in 100% juice, fruit-flavored drinks, milk, and soda consumption across grades were found (p<0.006). A significant upward trend was found in yogurt/yogurt drinks among 4th graders (p=0.0013). The prevalence of yogurt/yogurt drinks consumption among 4th graders significantly increased from 20.6% in 2000-2002 to 29.1% in 2021-2023. About one-third of the students consumed tea/coffee in 2021-2023 (4th: 31.8%, 8th: 35.4%, 11th: 36.3%). In 2021-2023, 17.2% of 4th graders, 14.3% of 8th graders, and 15.3% of 11th graders reported consuming energy drinks 1+ times/day. No significant changes were seen in water, tea/coffee, and energy drink consumption over time.
Conclusions: Overall, 100% juice, fruit-flavored drinks, milk, and soda consumption decreased at all three grade levels. While decreases in sugary beverages are a promising trend and mirror similar data at the national level, interventions tailored to increase milk intake and decrease caffeinated and energy drinks are warranted.
Keywords: Children, DietMethods: Beverage consumption data were collected from 4th, 8th, and 11th graders across 6 waves (2000-2002, 2004-2005, 2009-2011, 2015-2016, 2019-2020, 2021-2023) of the Texas School Physical Activity and Nutrition (Texas SPAN) survey between 2000-2023. Students self-reported times/day that yogurt/yogurt drinks, 100% juice, fruit-flavored drinks, milk (including plain and flavored), soda (including regular and diet), water, tea/coffee (with added sugar or no sugar), and energy drinks were consumed. Water and tea/coffee were first available in 2009-2011 for the 8th and 11th grades and in 2013-2015 for the 4th grade. The energy drink was first available in 2019-2020. Each beverage consumption was dichotomized into 0 vs. 1+ times/day. Weighted logistic regression models were conducted to assess the trends in beverage consumption prevalence over time with wave as a continuous independent variable, adjusting for sex, ethnicity, and community type (urban vs. rural). Bonferroni correction was used to set the significance value at p<0.006 for 8 beverage categories with complete data for each wave.
Results: Significant downward trends in 100% juice, fruit-flavored drinks, milk, and soda consumption across grades were found (p<0.006). A significant upward trend was found in yogurt/yogurt drinks among 4th graders (p=0.0013). The prevalence of yogurt/yogurt drinks consumption among 4th graders significantly increased from 20.6% in 2000-2002 to 29.1% in 2021-2023. About one-third of the students consumed tea/coffee in 2021-2023 (4th: 31.8%, 8th: 35.4%, 11th: 36.3%). In 2021-2023, 17.2% of 4th graders, 14.3% of 8th graders, and 15.3% of 11th graders reported consuming energy drinks 1+ times/day. No significant changes were seen in water, tea/coffee, and energy drink consumption over time.
Conclusions: Overall, 100% juice, fruit-flavored drinks, milk, and soda consumption decreased at all three grade levels. While decreases in sugary beverages are a promising trend and mirror similar data at the national level, interventions tailored to increase milk intake and decrease caffeinated and energy drinks are warranted.
Authors:
Author - Yuzi Zhang, The University of Texas Health Science Center at Houston
Co-Author - Christopher Pfledderer, The University of Texas Health Science Center at Houston
Co-Author - Raja Malkani, The University of Texas Health Science Center at Houston
Co-Author - Carolyn Smith, The University of Texas Health Science Center at Houston
Co-Author - Emma Mullane, The University of Texas Health Science Center at Houston
Co-Author - Nalini Ranjit, The University of Texas Health Science Center at Houston
Co-Author - Deanna Hoelscher, PhD, The University of Texas Health Science Center at Houston
The Family Health Van: What does "Meeting People Where they are" Look Like for Type 2 Diabetes Screening and Education?
Poster Number: A59Time: 05:00 PM - 05:50 PM
Topics: Community Engagement, Diabetes
The Family Health Van (FHV) is a mobile health initiative designed to improve awareness, screening, and prevention of Type 2 Diabetes (T2DM) among newcomer populations in Hamilton, Ontario. Using the RE-AIM Framework, this research project was implemented in Hamilton neighbourhoods with higher newcomer densities, engaging adults and children through “meeting them where they are” in community spaces such as libraries, parks, recreation centres, schools, and cultural events. Participants completed a pre and post knowledge exchange questionnaire, interactive activities, and risk screening to assess understanding of T2DM. A total of 51 participants (48 adults and 3 children) were recruited, all identifying as newcomers. Before reviewing the educational toolkit, participants demonstrated varying knowledge of T2DM, often recognizing lifestyle factors but lacking understanding of biological mechanisms or screening processes. After engaging with the toolkit, both adults and children showed stronger knowledge of insulin function, risk factors, and prevention strategies, and expressed greater confidence in managing their health. The FHV’s community-based, culturally tailored approach has effectively increased T2DM awareness and prevention knowledge while fostering trust and accessibility. Continued adaptation and iteration of the toolkits and community partnership development are key to sustaining long-term impact and addressing barriers including language, stigma, and healthcare access.
Keywords: Diabetes, Health promotionAuthors:
Presenter - Sujane Kandasamy, MSc., PhD, McMaster University
Author - Yusra Naqvi, McMaster University
Author - Maduo Pathmaraj, McMaster University
Author - Matthew Kwan, PhD, Brock University
Feasibility and acceptability of a Patient-Centered Heart Failure Self-care Intervention Integrating Commercial mHealth Apps and Devices with Individually Tailored Text Messages
Poster Number: A60Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Cardiovascular Disease
Background: Despite the rapid growth of mobile health (mHealth) technologies for cardiovascular disease such as heart failure (HF), a key translational gap remains. Most commercial mHealth apps lack empirical testing, while investigator-developed apps rarely progress beyond pilot studies to efficacy trials or commercialization. To address this gap, we developed and pilot tested iCardia4HF, a patient-centered self-care intervention that integrates commercial mHealth apps and devices with individually tailored text messages (TMs).
Objective: To describe the development of iCardia4HF and highlight findings from evaluating its feasibility and acceptability in patients with HF.
Methods: The intervention design included: (1) review of commercial apps and devices supporting HF self-care, (2) development of a theory-based TM program targeting modifiable behavioral factors, and (3) creation of a tailoring algorithm for individualized TM delivery. Pilot testing involved a two-arm randomized controlled trial and exit interviews at 12 weeks using the Technology Acceptance Model to assess perceived usefulness, ease-of-use, satisfaction, and intention to continue. Items were scored on a 5-point Likert-scale (1=strongly disagree, 5=strongly agree).
Results: Three commercial mHealth apps and devices were selected: (1) HF Health Storylines app; (2) Withings app, Body Cardio scale, and blood pressure cuff (BP-801); and (3) Fitbit app and Charge 3 tracker. Each targeted distinct behaviors and altogether provided patients with an integrated suite of HF self-care tools. Using 5 validated instruments assessing HF health beliefs, self-care, and knowledge, we developed >300 TM and an algorithm for TM tailoring. Exit interviews with intervention participants (n=46, mean age 55±11 years, 50% female, 85% Black) showed high acceptance of the intervention, with more than 80% positively rating perceived usefulness, ease-of-use, satisfaction, and intention to continue (scores ≥4). Participants described the intervention as helpful, motivating, and easy to use, highlighting the value of reminders, self-monitoring tools, and TMs. A few patients noted occasional inconveniences with the BP cuff (e.g. Bluetooth issues).
Conclusion: Integrating commercially available mHealth apps and devices with tailored TM is a feasible and acceptable patient-centered strategy to promote HF self-care. An efficacy trial funded by NHLBI is currently underway to evaluate the clinical impact of iCardia4HF.
Keywords: Cardiovascular disease, Self ManagementObjective: To describe the development of iCardia4HF and highlight findings from evaluating its feasibility and acceptability in patients with HF.
Methods: The intervention design included: (1) review of commercial apps and devices supporting HF self-care, (2) development of a theory-based TM program targeting modifiable behavioral factors, and (3) creation of a tailoring algorithm for individualized TM delivery. Pilot testing involved a two-arm randomized controlled trial and exit interviews at 12 weeks using the Technology Acceptance Model to assess perceived usefulness, ease-of-use, satisfaction, and intention to continue. Items were scored on a 5-point Likert-scale (1=strongly disagree, 5=strongly agree).
Results: Three commercial mHealth apps and devices were selected: (1) HF Health Storylines app; (2) Withings app, Body Cardio scale, and blood pressure cuff (BP-801); and (3) Fitbit app and Charge 3 tracker. Each targeted distinct behaviors and altogether provided patients with an integrated suite of HF self-care tools. Using 5 validated instruments assessing HF health beliefs, self-care, and knowledge, we developed >300 TM and an algorithm for TM tailoring. Exit interviews with intervention participants (n=46, mean age 55±11 years, 50% female, 85% Black) showed high acceptance of the intervention, with more than 80% positively rating perceived usefulness, ease-of-use, satisfaction, and intention to continue (scores ≥4). Participants described the intervention as helpful, motivating, and easy to use, highlighting the value of reminders, self-monitoring tools, and TMs. A few patients noted occasional inconveniences with the BP cuff (e.g. Bluetooth issues).
Conclusion: Integrating commercially available mHealth apps and devices with tailored TM is a feasible and acceptable patient-centered strategy to promote HF self-care. An efficacy trial funded by NHLBI is currently underway to evaluate the clinical impact of iCardia4HF.
Authors:
Presenter - Spyros Kitsiou, University of Illinois Chicago
Co-Author - Susan Pressler, PhD, RN, Indiana University
Co-Author - Ben Gerber, MD, MPH, University of Massachusetts Chan Medical School
Co-Author - Todd Ruppar, PhD, RN, Loyola University, Chicago
Co-Author - Susan Buchholz, PhD, RN, Michigan State University
Co-Author - Mayank Kansal, MD, University of Illinois Chicago
Health at Home: The Iterative Development AI-generated Cancer Screening Outreach Materials
Poster Number: A61Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Community Engagement
Background: Social drivers of health (SDoH), such as socioeconomic status, significantly influence cancer morbidity and mortality in underserved communities. Residents of the New York City Housing Authority (NYCHA), a public housing system for low-income individuals, are more likely to be impacted by SDoH, making interventions to address SDoH crucial. While Artificial Intelligence (AI) is more commonly used to enhance workplace training and marketing, its application in cancer outreach and engagement remains limited. AI-generated content may offer a novel way to engage underserved populations with preventive health messages.
Parent Project: Health at Home (HaH) is a community-based research study that brings integrated cancer screenings to NYCHA developments. The program offers same-day and off-site appointments for NYCHA residents, increasing access to breast, cervical, colorectal, lung, and prostate cancer screenings.
Methods: Four introductory videos were created using a consistent script developed by the research team: three were AI-generated (Google Veo 3, Colossyan, InVideo) using script prompts, and one featured a physician presenter recorded via Zoom. After video generation, two feedback sessions were held with members of the Tisch Cancer Institute’s Community Outreach and Engagement program (N=6) and the Community Advisory Board (N=23). Participants shared impressions of each video, offering feedback on strengths, weaknesses, and suggestions for improvement. Transcripts were thematically coded into three categories: 1) positive feedback, 2) negative feedback, and 3) recommended changes. Coding was used to identify patterns in viewer perception.
Results: Thematic analysis of the first session revealed two key patterns: preference for the physician-led video, linked to trustworthiness and visual appeal, and negative feedback on the Colossyan video for unnatural delivery and lack of representative visuals. Revisions included adding an AI disclosure and diversifying actors to reflect the community. In the second session, the Google Veo 3 video was viewed as most relatable due to NYC visuals, while the physician-led video was associated with perceived inauthenticity and a weaker audience connection.
Conclusion: This study highlights that AI-generated videos can support cancer outreach, but trust, relatability, and diverse representation are critical. Future efforts should combine human and AI elements with continued community-informed evaluation.
Keywords: Cancer screening, Health communicationParent Project: Health at Home (HaH) is a community-based research study that brings integrated cancer screenings to NYCHA developments. The program offers same-day and off-site appointments for NYCHA residents, increasing access to breast, cervical, colorectal, lung, and prostate cancer screenings.
Methods: Four introductory videos were created using a consistent script developed by the research team: three were AI-generated (Google Veo 3, Colossyan, InVideo) using script prompts, and one featured a physician presenter recorded via Zoom. After video generation, two feedback sessions were held with members of the Tisch Cancer Institute’s Community Outreach and Engagement program (N=6) and the Community Advisory Board (N=23). Participants shared impressions of each video, offering feedback on strengths, weaknesses, and suggestions for improvement. Transcripts were thematically coded into three categories: 1) positive feedback, 2) negative feedback, and 3) recommended changes. Coding was used to identify patterns in viewer perception.
Results: Thematic analysis of the first session revealed two key patterns: preference for the physician-led video, linked to trustworthiness and visual appeal, and negative feedback on the Colossyan video for unnatural delivery and lack of representative visuals. Revisions included adding an AI disclosure and diversifying actors to reflect the community. In the second session, the Google Veo 3 video was viewed as most relatable due to NYC visuals, while the physician-led video was associated with perceived inauthenticity and a weaker audience connection.
Conclusion: This study highlights that AI-generated videos can support cancer outreach, but trust, relatability, and diverse representation are critical. Future efforts should combine human and AI elements with continued community-informed evaluation.
Authors:
Co-Author - Samiha Alam, B.A., The City University of New York at Hunter College
Co-Author - Sophia Karam, The City University of New York at Hunter College
Co-Author - Sarah Miller, Psy.D, The Icahn School of Medicine at Mount Sinai
Co-Author - Jamilia Sly, PhD, The Icahn School of Medicine at Mount Sinai
A Virtual Assistant for Screening Social Needs in Caregivers of Children with Cancer
Poster Number: A62Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Cancer
Social needs (e.g., access to food, transportation, or financial support) can impact the ability of children and their families to cope with pediatric cancer. Screening for social needs is crucial to identify children and families at risk, provide necessary resources, and reduce health disparities. Virtual assistants (VA; chatbot) have the potential to leverage artificial intelligence to screen for social needs and offer local resources, contributing to a holistic approach to cancer care. We aimed to explore the usability and acceptability of a social needs VA prototype through user-testing and thematic content analysis with caregivers of children with cancer.
Eligible caregivers had children aged 0-17, within one year of a cancer diagnosis, and actively receiving treatment. Caregivers were ≥18 and spoke English. They reported demographic characteristics, interacted with the VA, and then completed a semi-structured interview assessing user experience and feedback on features. Upon study completion, they completed the System Usability Scale (SUS; Scale: 0-100), a caregiver satisfaction survey, and selected reaction cards.
Forty caregivers (82.5% Female, n=33; 87.5% White, n=35; M=39.60 years old, SD=11.35) of children with cancer (62.5% Male, n=25; M=8.90 years old, SD=5.54) were recruited. Feedback revealed 3 major themes: 1. VA acceptability through simple, effective design (e.g., ease of use, helpfulness); 2. caregiver preferences for optimal VA usefulness (e.g., timing of intervention, module preference); 3. applicability of VA resources to caregivers' real-time needs (e.g., accessibility, applicability). Negative feedback included a non-technology preference when communicating social needs (n=10, 25%). The SUS score (M=82.6; SD=14.01) was above average (>68). The caregiver satisfaction survey responses endorsed that the VA was “good to use” (n=35, 85.4%) and that it “motivated me to stay engaged while completing the screening and finding community resources” (n=37, 90.2%). The most common reaction card endorsements were positive: “Accessible” (n=24, 82.9%), “Easy to use” (n=34, 82.9), “Useful” (n=32, 78%), and “Valuable” (n=28, 68.3%).
Caregivers considered the VA usable and acceptable, with positive feedback on its features. Caregivers’ feedback showed high applicability, ease of use, and helpfulness. Overall acceptance of the VA suggests it has high potential to support families in managing social needs during pediatric cancer treatment.
Keywords: e-Health, CancerEligible caregivers had children aged 0-17, within one year of a cancer diagnosis, and actively receiving treatment. Caregivers were ≥18 and spoke English. They reported demographic characteristics, interacted with the VA, and then completed a semi-structured interview assessing user experience and feedback on features. Upon study completion, they completed the System Usability Scale (SUS; Scale: 0-100), a caregiver satisfaction survey, and selected reaction cards.
Forty caregivers (82.5% Female, n=33; 87.5% White, n=35; M=39.60 years old, SD=11.35) of children with cancer (62.5% Male, n=25; M=8.90 years old, SD=5.54) were recruited. Feedback revealed 3 major themes: 1. VA acceptability through simple, effective design (e.g., ease of use, helpfulness); 2. caregiver preferences for optimal VA usefulness (e.g., timing of intervention, module preference); 3. applicability of VA resources to caregivers' real-time needs (e.g., accessibility, applicability). Negative feedback included a non-technology preference when communicating social needs (n=10, 25%). The SUS score (M=82.6; SD=14.01) was above average (>68). The caregiver satisfaction survey responses endorsed that the VA was “good to use” (n=35, 85.4%) and that it “motivated me to stay engaged while completing the screening and finding community resources” (n=37, 90.2%). The most common reaction card endorsements were positive: “Accessible” (n=24, 82.9%), “Easy to use” (n=34, 82.9), “Useful” (n=32, 78%), and “Valuable” (n=28, 68.3%).
Caregivers considered the VA usable and acceptable, with positive feedback on its features. Caregivers’ feedback showed high applicability, ease of use, and helpfulness. Overall acceptance of the VA suggests it has high potential to support families in managing social needs during pediatric cancer treatment.
Authors:
Author - Adelaide Booze, B.A., Nationwide Childrens Hospital
Author - Lydia Wisne, B.S., Nationwide Children's Hospital
Author - Anna Olsavsky, PhD, Nationwide Childrens Hospital
Author - Daniel Jackson, B.S, Ohio State University
Author - Emre Sezgin, BBA, MSc, PhD, Nationwide Children's Hospital
Author - Micah Skeens, PhD APRN FAAN, Nationwide Childrens Research Institue
Acceptability, Appropriateness, Feasibility, and Preliminary Effect of an AI-Generated Social Media-Based Sex-Related Alcohol Expectancies Challenge Intervention (ACE): A Mixed Methods Pilot Study
Poster Number: A63Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Multiple Health Behavior Change
Background: Both research and theory suggest that people’s perceptions about alcohol’s effects, termed alcohol expectancies (AE), are directly associated with condomless sex and can moderate and mediate the effect of alcohol consumption on risky sexual behaviors. Such evidence indicates that interventions which specifically challenge sex-related AE might be useful to promote safe sex in alcohol-involved situation. Moreover, current research supports using artificial intelligence (AI)-facilitated and social media platforms to increase the cost-effectiveness and acceptability of intervention among young adults. This pilot study tested the acceptability, appropriateness, feasibility, and preliminary effect of a research-scripted, AI-facilitated alcohol expectancy challenge video intervention (ACE) among college men.
Methods: This study used a convergent parallel mixed methods design and randomized a small number of heterosexual college men (N=41) to receive ACE intervention, disseminated via Instagram Reels, or a control. Quantitative data were collected on the acceptability, appropriateness, and feasibility of the intervention. Preliminary effect of the intervention on condomless sex intention was measured using a hypothetical sexual scenario. Individual semi-structured interviews (n=2) were conducted to collect qualitative data on the acceptability, appropriateness, and feasibility of the intervention.
Results: ACE was considered acceptable (M=4.27; SD = 0.87; range: 2.25-5), appropriate (M=4.6, SD =0.6, range: 3-5), and feasible (M=4.32, SD=0.82, range:2.25-5) among college men. It had small to medium effect in reducing condomless sex intention (d=0.58), a small effect in reducing sex-related AE regarding disinhibition (d=0.22), and a small effect in increasing sex-related AE regarding women’s vulnerability (d=-0.22). Qualitative evidence highlighted areas of improvement, such as adding more scientific evidence to support content presented in the intervention, making the intervention more engaging, and incorporating more effective psychoeducation approach (e.g., cognitive restructuring) in future interventions.
Conclusions: This study provided preliminary evidence supporting the use of an AI-facilitated video intervention, disseminated via social media, to reduce condomless sex intention among college men. Evidence can be used to improve future intervention to be tested in future larger efficacy trial.
Keywords: Behavior Change, AlcoholMethods: This study used a convergent parallel mixed methods design and randomized a small number of heterosexual college men (N=41) to receive ACE intervention, disseminated via Instagram Reels, or a control. Quantitative data were collected on the acceptability, appropriateness, and feasibility of the intervention. Preliminary effect of the intervention on condomless sex intention was measured using a hypothetical sexual scenario. Individual semi-structured interviews (n=2) were conducted to collect qualitative data on the acceptability, appropriateness, and feasibility of the intervention.
Results: ACE was considered acceptable (M=4.27; SD = 0.87; range: 2.25-5), appropriate (M=4.6, SD =0.6, range: 3-5), and feasible (M=4.32, SD=0.82, range:2.25-5) among college men. It had small to medium effect in reducing condomless sex intention (d=0.58), a small effect in reducing sex-related AE regarding disinhibition (d=0.22), and a small effect in increasing sex-related AE regarding women’s vulnerability (d=-0.22). Qualitative evidence highlighted areas of improvement, such as adding more scientific evidence to support content presented in the intervention, making the intervention more engaging, and incorporating more effective psychoeducation approach (e.g., cognitive restructuring) in future interventions.
Conclusions: This study provided preliminary evidence supporting the use of an AI-facilitated video intervention, disseminated via social media, to reduce condomless sex intention among college men. Evidence can be used to improve future intervention to be tested in future larger efficacy trial.
Authors:
Author - Weiqi Chen, University of Wisconsin - Madison
Co-Author - , Arizona State University
Co-Author - Angela Chia-chen Chen, Michigan State University
Co-Author - , Arizona State University
Digital Health Tools to Enhance Pediatric Self-Management: A Scoping Review
Poster Number: A64Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Child and Family Health
Background: Digital health tools can be used to improve access to self-management in pediatric populations. This scoping review aims to 1) outline the literature on available technologies targeting pediatric self-management and 2) propose future research directions to advance this literature. Method: PsychINFO, PubMed, and Google Scholar were searched using the terms: (“electronic monitoring”) OR (“remote monitoring”) OR (“wearables”) OR (“digital health”) AND pediatrics. Results: A total of 433 articles were identified and 26 duplicates removed; 340 were excluded based on abstract/title review; 29 were excluded based on full text review (24 removed for including an adult population, 3 removed for not being empirical, and 2 removed for exclusive focus on parent data). Thirty-eight studies were included in the final review. Populations varied, with most studies in asthma (N = 11) and diabetes (N = 6). Other populations included arthritis, cystic fibrosis, COVID-19, cardiology, migraine, obesity, sleep, sickle cell disease, surgery, among others. A total of 2879 participants were enrolled across studies. The mean age of participants was 10.95 years. On average, 48.40% of participants were female and 48.13% were white. Twenty-two studies included a broad age range (e.g., early childhood through adolescence), while 1 included early childhood, 7 included school-age youth, and 4 included adolescents and/or young adults. Five studies did not identify ages of participants but stated children and/or adolescents were included. Digital tools used included apps (N = 3), phone or text-messaging (N = 3), external connected devices (N = 10), and wearables (N = 18) . Twelve articles were identified as feasibility or validation trials; 5 were identified as randomized-controlled trials. The poster will also describe the effectiveness of the digital tools used. Conclusions: Digital health tools are increasingly being used to enhance pediatric self-management in various populations, with some more commonly studied (asthma, diabetes). These tools can be used to enhance patient outcomes and access to care. Future research should involve 1) evaluating these tools in other pediatric populations, 2) examination of provider use and implementation of digital tools in clinical care, as no studies focused on medical providers use of tools, and 3) use of rapid testing and evaluation methods and trial methodologies that expedite scientific knowledge generation.
Keywords: Children's health, TechnologiesAuthors:
Co-Author - Kevin Hommel, Ph.D., Cincinnati Children's Hospital Medical Center
Networks in Skin Cancer-Related TikTok Videos: Hashtags Co-occurrence Strategies to Uncover Latent Communities and Pockets of Conversation
Poster Number: A65Time: 05:00 PM - 05:50 PM
Topics: Digital Health
Background. Due to its strong association with beauty and its high prevalence among youth and young adults, skin cancer has become a widely discussed topic on social media, particularly on TikTok, which has a predominantly young user base. Yet, limited work in this area has been conducted, including an analysis of hashtags and their diffusion on the platform.
Objectives. To identify key hashtag communities discussing skin cancer on TikTok.
Methods. We used the hashtag #skincancer to collect relevant N=1,233 relevant TikTok videos. From these videos, we extracted N=2,645 unique hashtags and constructed an adjacency matrix based on hashtag co-occurrence. We then applied the Louvain algorithm to build a hashtag co-occurrence network designed to detect communities within it.
Results. We identified 6 key co-occurrence communities. The largest community (152 hashtags, 38.87%) emphasized health education and skin cancer awareness, particularly regarding sun exposure prevention. Other prominent communities focused on spiritual faith (17.39%), other cancer types (15.86%), skincare and esthetics (12.53%), health technologies (8.44%), and melanoma and manicure (6.91%). Promotional hashtags such as #foryourpages, #duet, #tiktokpartner, and #viral were found across these communities, along with tags related to brands, products, therapies, technologies, doctors, and companies.
Conclusion. Hashtag co-occurrence networks reveal distinct content communities discussing skin cancer on TikTok. These findings suggest that content creators use hashtags to align with specific topics and as a tool to promote and disseminate content more broadly. Our insights hold implications for digital public health interventions, suggesting that insights into hashtag networks may offer more targeted intervention strategies.
Keywords: Informatics, Health communicationObjectives. To identify key hashtag communities discussing skin cancer on TikTok.
Methods. We used the hashtag #skincancer to collect relevant N=1,233 relevant TikTok videos. From these videos, we extracted N=2,645 unique hashtags and constructed an adjacency matrix based on hashtag co-occurrence. We then applied the Louvain algorithm to build a hashtag co-occurrence network designed to detect communities within it.
Results. We identified 6 key co-occurrence communities. The largest community (152 hashtags, 38.87%) emphasized health education and skin cancer awareness, particularly regarding sun exposure prevention. Other prominent communities focused on spiritual faith (17.39%), other cancer types (15.86%), skincare and esthetics (12.53%), health technologies (8.44%), and melanoma and manicure (6.91%). Promotional hashtags such as #foryourpages, #duet, #tiktokpartner, and #viral were found across these communities, along with tags related to brands, products, therapies, technologies, doctors, and companies.
Conclusion. Hashtag co-occurrence networks reveal distinct content communities discussing skin cancer on TikTok. These findings suggest that content creators use hashtags to align with specific topics and as a tool to promote and disseminate content more broadly. Our insights hold implications for digital public health interventions, suggesting that insights into hashtag networks may offer more targeted intervention strategies.
Authors:
Author - Xue-Jing Liu, Indiana University School of Public Health
Co-Author - Danny Valdez, PhD, Indiana University School of Public Health
Co-Author - Eric Walsh-Buhi, PhD, Indiana University School of Public Health
Assessing the Validity of Videoconferencing to Measure Physical Function in People with Chronic Kidney Disease
Poster Number: A66Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Aging
Background: Functional status is associated with adverse outcomes in people with chronic kidney disease (CKD). Although validated physical function assessments like handgrip strength (HGS), timed up and go (TUG), and gait speed (GS) exist, their implementation in routine CKD care is limited. Videoconferencing has been implemented to assess physical function in other chronic disease populations, but not yet in patients with CKD. We investigate the validity of videoconferencing to assess physical function in people living with CKD compared to the gold standard in-person assessments.
Methods: Adults with any stage of CKD who were evaluated at nephrology clinics were recruited at an academic teaching health system. Physical function was assessed simultaneously by two in-person assessors and one remote assessor via Zoom videoconferencing using HGS, TUG, and GS tests at two visits, approximately 4-6 weeks apart. HGS was measured with a Jamar dynamometer (kg); TUG and GS were timed with a stopwatch (s, m/s). In-person rater scores were averaged into a composite score. Mixed-effect models were used to calculate intraclass correlation coefficients (ICC) to estimate absolute and consistency agreement. The visit number and type of assessor were modeled as fixed effects, and the participant was modeled as a random effect. If heteroscedasticity was detected in models, Bland-Altman plots were employed to visualize the differences in agreement. Analyses were performed in STATA v18.0.
Results: Remote and in-person HGS and TUG results showed high levels of absolute and consistency agreement, with ICCs ≥ 0.9. The absolute and consistency agreements of GS were slightly lower with ICC = 0.68 (95% CI: 0.48, 0.84) and ICC = 0.77 (95% CI: 0.59, 0.88), respectively. Heteroscedasticity was observed in GS models. Bland-Altman plots showed that the in-person GS test was scored, on average, 0.11 m/s (95% CI: 0.07, 0.15) faster than the remote test.
Conclusion: Compared to in-person assessments, remotely assessed HGS and TUG were highly valid, whereas remote GS was moderately to highly valid. Future studies should determine how to improve the accuracy of remote GS assessment. Nonetheless, the implementation of videoconferencing offers a feasible approach for more routine detection of functional decline in people with CKD.
Keywords: Tele-health, Chronic illnessMethods: Adults with any stage of CKD who were evaluated at nephrology clinics were recruited at an academic teaching health system. Physical function was assessed simultaneously by two in-person assessors and one remote assessor via Zoom videoconferencing using HGS, TUG, and GS tests at two visits, approximately 4-6 weeks apart. HGS was measured with a Jamar dynamometer (kg); TUG and GS were timed with a stopwatch (s, m/s). In-person rater scores were averaged into a composite score. Mixed-effect models were used to calculate intraclass correlation coefficients (ICC) to estimate absolute and consistency agreement. The visit number and type of assessor were modeled as fixed effects, and the participant was modeled as a random effect. If heteroscedasticity was detected in models, Bland-Altman plots were employed to visualize the differences in agreement. Analyses were performed in STATA v18.0.
Results: Remote and in-person HGS and TUG results showed high levels of absolute and consistency agreement, with ICCs ≥ 0.9. The absolute and consistency agreements of GS were slightly lower with ICC = 0.68 (95% CI: 0.48, 0.84) and ICC = 0.77 (95% CI: 0.59, 0.88), respectively. Heteroscedasticity was observed in GS models. Bland-Altman plots showed that the in-person GS test was scored, on average, 0.11 m/s (95% CI: 0.07, 0.15) faster than the remote test.
Conclusion: Compared to in-person assessments, remotely assessed HGS and TUG were highly valid, whereas remote GS was moderately to highly valid. Future studies should determine how to improve the accuracy of remote GS assessment. Nonetheless, the implementation of videoconferencing offers a feasible approach for more routine detection of functional decline in people with CKD.
Authors:
Author - Jack Markillie, University of Pennsylvania
Co-Author - Sarah Cohen, BS, University of Pennsylvania
Co-Author - Sanya Tinikar, University of Pennsylvania
Co-Author - Sarah Schrauben, University of Pennsylvania
Design and evaluation of virtual reality-based experiences illustrating genomic influences on eating
Poster Number: A67Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Diet, Nutrition, and Eating Disorders
Virtual reality (VR) offers a novel approach to overcoming barriers of traditional dietary health education and behavior change interventions by leveraging flexible, immersive experiences. This study evaluates a pilot VR intervention designed to teach the concept of gene-environment interaction (GxE) and its influence on eating behavior. Additional goals include encouraging dietary behavior change in line with individuals' dietary predispositions and reducing negative attitudes toward reward-based eating (RBE) behaviors and individuals with higher body weight.
The Behavioral Framework of Immersive Technologies, which outlines how VR features can address specific psychological barriers to behavior change, was used to map intervention design features to intervention goals. The VR intervention comprised four sections: an introduction, a scenario depicting high RBE genetic predisposition, a scenario depicting low RBE genetic predisposition, and a scenario illustrating high RBE genetic predisposition with environmental modifications. Participants embodied an avatar named AJ, experiencing genomic influences on eating behavior and health outcomes over time through interactive tasks and simulated scenarios.
Ten participants completed the VR intervention using a think-aloud procedure, followed by a short questionnaire and a semi-structured interview. Qualitative feedback indicated that participants found the VR intervention to be an engaging, informative way to learn about GxE concepts. Participants demonstrated a general understanding of GxE, although their focus varied between genetic and environmental influences. Many reported feeling empathetic toward AJ, especially when experiencing weight gain and changes in health outcomes over time. The experience motivated some participants to consider their own health behaviors and envision making healthier food choices.
Overall, the VR intervention successfully conveyed GxE educational content and facilitated empathy and behavior change motivation among a subset of the sample. The immersive nature of VR, combined with interactive and embodied experiences, shows promise for enhancing patient education and supporting health behavior change. Feedback from the current evaluation aligns with and better elucidates themes consistent with the formative framework. Such work helps to shape emerging best practices for constructing immersive, VR-based health education and behavior change interventions.
Keywords: Health education, GeneticsThe Behavioral Framework of Immersive Technologies, which outlines how VR features can address specific psychological barriers to behavior change, was used to map intervention design features to intervention goals. The VR intervention comprised four sections: an introduction, a scenario depicting high RBE genetic predisposition, a scenario depicting low RBE genetic predisposition, and a scenario illustrating high RBE genetic predisposition with environmental modifications. Participants embodied an avatar named AJ, experiencing genomic influences on eating behavior and health outcomes over time through interactive tasks and simulated scenarios.
Ten participants completed the VR intervention using a think-aloud procedure, followed by a short questionnaire and a semi-structured interview. Qualitative feedback indicated that participants found the VR intervention to be an engaging, informative way to learn about GxE concepts. Participants demonstrated a general understanding of GxE, although their focus varied between genetic and environmental influences. Many reported feeling empathetic toward AJ, especially when experiencing weight gain and changes in health outcomes over time. The experience motivated some participants to consider their own health behaviors and envision making healthier food choices.
Overall, the VR intervention successfully conveyed GxE educational content and facilitated empathy and behavior change motivation among a subset of the sample. The immersive nature of VR, combined with interactive and embodied experiences, shows promise for enhancing patient education and supporting health behavior change. Feedback from the current evaluation aligns with and better elucidates themes consistent with the formative framework. Such work helps to shape emerging best practices for constructing immersive, VR-based health education and behavior change interventions.
Authors:
Presenter - Susan Persky, PhD, FSBM, National Human Genome Research Institute
Co-Author - Megan Jiao, National Human Genome Research Institute
Co-Author - Junhan Chen, National Human Genome Research Institute
Co-Author - Crystal Peterson, National Human Genome Research Institute
Pilot Study of a Digital Light-Touch Preventive Strategy with Biometric Monitoring for College Student Behavioral Health
Poster Number: A68Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Physical Activity
This pilot study evaluated the feasibility and acceptability of a digital light-touch prevention intervention (dLTPI) paired with biometric monitoring to promote well-being among first-year college students. The dLTPI was a single-session, 20-minute mobile intervention in which participants selected a target domain (physical activity, sleep, or emotional health) and completed targeted behaviors to support that goal over four weeks. The dLPTI included elements of motivational interviewing, goal setting, and advice from peers and experts. Behaviors were tracked via mobile self-report and continuous monitoring with an Oura Ring. Outcomes included biweekly surveys of depression and substance use, wearable data, and a post-intervention evaluation.
A total of 110 students (63% Female; Mean age = 18.55, SD = 0.61) enrolled in a single-arm pilot feasibility trial. Engagement was strong: all completed the intervention, 62% logged activities on >10 days, and 44% logged >20 days. Most (81%) adhered to their chosen activities. Perceived usefulness differed significantly across components (χ²(5) = 60.70, p < .001), with addressing barriers (83%), incentives (69%), and flexibility (65%) rated most valuable, while wearable integration was least endorsed (6%).
Oura data suggested that all participants had a significant reduction in sedentary behavior (b = −2.49, p < .001) and fewer nightly wake episodes (b = −0.031, p = .0034). Psychological outcomes were stable across the study period, with low baseline depression (M = 7.77, SD = 6.12) and anxiety (M = 7.15, SD = 6.18) and no significant increase or decrease in symptoms (ps > .05). Importantly, participants endorsed high levels of perceived health improvement (M = 6.80, 95% CI: 6.37–7.24, p < .001), would recommend the intervention (M = 6.43, 95% CI: 5.99–6.87, p < .001), and reported improved funcational improvement (M = 5.66, 95% CI: 5.23–6.08, p = .003).
Taken together, the findings demonstrate that dLTPIs are both feasible and well-received among college students. Preliminary evidence suggests this low-dose approach has beneficial effects on engagement, sedentary behavior, and sleep, without increasing psychological distress. These results underscore the potential of light-touch digital prevention strategies for promoting well-being during the transition to college, and they provide a foundation for future refinement and large-scale implementation.
Keywords: e-Health, TechnologiesA total of 110 students (63% Female; Mean age = 18.55, SD = 0.61) enrolled in a single-arm pilot feasibility trial. Engagement was strong: all completed the intervention, 62% logged activities on >10 days, and 44% logged >20 days. Most (81%) adhered to their chosen activities. Perceived usefulness differed significantly across components (χ²(5) = 60.70, p < .001), with addressing barriers (83%), incentives (69%), and flexibility (65%) rated most valuable, while wearable integration was least endorsed (6%).
Oura data suggested that all participants had a significant reduction in sedentary behavior (b = −2.49, p < .001) and fewer nightly wake episodes (b = −0.031, p = .0034). Psychological outcomes were stable across the study period, with low baseline depression (M = 7.77, SD = 6.12) and anxiety (M = 7.15, SD = 6.18) and no significant increase or decrease in symptoms (ps > .05). Importantly, participants endorsed high levels of perceived health improvement (M = 6.80, 95% CI: 6.37–7.24, p < .001), would recommend the intervention (M = 6.43, 95% CI: 5.99–6.87, p < .001), and reported improved funcational improvement (M = 5.66, 95% CI: 5.23–6.08, p = .003).
Taken together, the findings demonstrate that dLTPIs are both feasible and well-received among college students. Preliminary evidence suggests this low-dose approach has beneficial effects on engagement, sedentary behavior, and sleep, without increasing psychological distress. These results underscore the potential of light-touch digital prevention strategies for promoting well-being during the transition to college, and they provide a foundation for future refinement and large-scale implementation.
Authors:
Co-Presenter - Johanna Hidalgo, MA, University of Vermont
Author - Jennifer Ha, University of Vermont
Author - Natalie Noble, University of Vermont
Author - Julia Kim, University of Vermont
Author - Christopher Danforth, University of Vermont
Co-Presenter - Matthew Price, University of Vermont
Social Media Engagement and Willingness to Engage in Telehealth Services among Depressed Young Men with Limited Healthcare Utilization
Poster Number: A69Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Mental Health
Background: Young adults use social media at historically high rates, yet paradoxically report greater social isolation compared to non-users. Men are less likely than women to seek both physical and psychological healthcare, but prior research suggests their willingness increases when they perceive other men engaging in care. This dynamic—rooted in social learning theory—may also operate within social media environments. Importantly, young men who are actively engaged in health-related social media may be especially receptive to telehealth services, as technology-mediated care could carry less stigma than in-person visits. It is therefore critical to examine whether depressed young men who are not currently receiving care, but who engage socially online, demonstrate greater willingness to participate in telehealth services
Purpose: To examine whether greater social media engagement is associated with higher willingness to use telehealth services among young men (aged 18–40) in the U.S. reporting clinically significant depressive symptoms (i.e., PHQ-4 scores above 3).
Method: We analyzed data from the 2024 Health Information National Trends Survey (HINTS) Cycle 7, using a subsample of young men with elevated depressive symptoms (n=31; weighted n=2,430,086). A multivariable linear regression tested whether health-related social media engagement (“how often did you interact with people who have similar health or medical issues on social media or online forums?”; 1-5 scale) predicted willingness to use telehealth in the future (“how willing are you to do a telehealth visit in the future if one is offered to you?” 1-4 scale), controlling for insurance status and race/ethnicity.
Results: Social media engagement was not significantly associated with willingness to use telehealth services (b = –0.36, p = .079, 95% CI [–.76, .04]). Neither insurance status nor race/ethnicity were significantly associated with willingness to use telehealth (all p > .05).
Conclusion: Willingness to engage in telehealth did not differ by level of social media engagement among young men with depressive symptoms. This suggests that factors beyond online engagement (e.g., stigma, masculine norms) may better account for variability in telehealth interest. Future research should evaluate these explanatory variables to inform strategies that promote telehealth as an accessible approach to addressing high levels of depression within this population.
Keywords: Tele-health, DepressionPurpose: To examine whether greater social media engagement is associated with higher willingness to use telehealth services among young men (aged 18–40) in the U.S. reporting clinically significant depressive symptoms (i.e., PHQ-4 scores above 3).
Method: We analyzed data from the 2024 Health Information National Trends Survey (HINTS) Cycle 7, using a subsample of young men with elevated depressive symptoms (n=31; weighted n=2,430,086). A multivariable linear regression tested whether health-related social media engagement (“how often did you interact with people who have similar health or medical issues on social media or online forums?”; 1-5 scale) predicted willingness to use telehealth in the future (“how willing are you to do a telehealth visit in the future if one is offered to you?” 1-4 scale), controlling for insurance status and race/ethnicity.
Results: Social media engagement was not significantly associated with willingness to use telehealth services (b = –0.36, p = .079, 95% CI [–.76, .04]). Neither insurance status nor race/ethnicity were significantly associated with willingness to use telehealth (all p > .05).
Conclusion: Willingness to engage in telehealth did not differ by level of social media engagement among young men with depressive symptoms. This suggests that factors beyond online engagement (e.g., stigma, masculine norms) may better account for variability in telehealth interest. Future research should evaluate these explanatory variables to inform strategies that promote telehealth as an accessible approach to addressing high levels of depression within this population.
Authors:
Presenter - Raul Rivera III, Loyola Marymount University
Co-Author - , Loyola Marymount University
Co-Author - , Loyola Marymount University
Informing Youth Physical Activity Interventions through Quantifying Dog-Facilitated Physical Activity
Poster Number: A70Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Child and Family Health
Background: Two-thirds of youth in the United States do not meet the National Physical Activity (PA) Guidelines, underscoring the need for the development of novel, feasible, high-reach interventions. Dog-facilitated PA (i.e., dog walking, active play) may enhance enjoyment, motivation, and social support, which are all key behavioral determinants of youth PA. Dog-facilitated PA also represents a high-reach opportunity, given that half of households in the United States own dogs. Prior to intervention development, objective data on the quantity and quality of youth dog-facilitated PA, and identification of predictors, are needed to determine how the child-dog relationship can be leveraged to promote PA. Purpose: The purposes of this study were to 1) determine the quantity and intensity of objectively-measured dog-facilitated PA in dog-owning youth, 2) compare accelerometry and parent-report measurement methods, and 3) evaluate whether the strength of the child-dog bond, sex of the child, yard size and/or dog size were associated with dog-facilitated PA. Methods: 23 children (mean age = 8.5 ± 1.4 years) and their dogs wore paired Bluetooth-enabled accelerometers (ActiGraph GT3X-BT) for 7 days to detect PA and proximity. Parents completed daily logs of child dog-facilitated activity. Minutes and intensity of PA performed in proximity to the dog were quantified and compared to parent reports. Results: Children engaged in an average of 16.6 ± 10.9 daily minutes of moderate-to-vigorous PA (MVPA) in proximity to their dog, which was 22% of average total daily MVPA. Parents underreported dog-facilitated MVPA by 11.7 minutes (p = .008) compared to device data. No significant associations were found between dog-facilitated MVPA and the child-dog bond, sex of the child, yard size, or dog size. Conclusions: Nearly one-quarter of children’s daily MVPA occurred with their dog, suggesting considerable intervention potential. Importantly, this study demonstrated that Bluetooth-enabled accelerometry is a feasible method for quantifying dog-facilitated PA in youth. These findings highlight how objective, scalable measurement can inform the design and evaluation of interventions leveraging the child-dog relationship to promote PA through structured (dog walking) and unstructured (active play) activities. This study provides preliminary data to inform development of scalable, human-animal interaction based PA interventions for children.
Keywords: Physical activity, ChildrenAuthors:
Author - Colleen Sands, PhD, Franklin Pierce University
Co-Author - Sarah Burkart, MPH, PhD, University of South Carolina
Co-Author - Megan Mueller, PhD, Tufts University
Co-Author - Katie Potter, PhD, University of Massachusetts Amherst
Digital Skills training facilitates telemedicine primary care appointments in older adults with diabetes
Poster Number: A71Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Aging
Background: Regular primary care visits for type 2 diabetes (T2D) can improve management. Much of routine medical care for T2D can be delivered by telemedicine. Numerous studies have found diabetes care delivered via telemedicine can lead to improved outcomes. Besides safety and convenience, telemedicine may allow for more frequent contact with healthcare providers. Older adults, especially those of low-income or belonging to underserved communities, who often have higher rates of T2D, have less access to and familiarity with digital technology. Older adults often want greater support for using new technology. The impact of digital skills training for older adults is uncertain.
Methods: We recruited primary care patients attending an in-person appointment at a Midwestern urban clinic serving a low-income population. Participants were age 50-70, had T2D, owned an internet-capable device, and had never had a telemedicine appointment. Participants received hands-on training from a digital skills educator, including setting up and logging into MyChart (Epic patient portal). Participants were encouraged to schedule a virtual diabetes management appointment within 6 months of enrollment. Semi-structured interviews were completed by participants who completed both the training and an appointment, as well as those who did not complete an appointment and/or training.
Results: 65 participants (mean age = 60.89 years, 70.8% female, 96.9% African American, 53.8% Medicaid/Medicare) were enrolled from November 2023-May 2025. 25 received telemedicine training and 18 completed a telemedicine appointment (18/25, 72%). Of the 39 participants who did not receive training (29 lost to follow up), 5 completed a telemedicine appointment (5/39, 12.8%). All interviewees who received training (n=12) found it helpful. Participants found telemedicine to be convenient and of comparable quality to in-person care. Participants often said they would use telemedicine (medication check-ins) as supplemental to in-person care (emergencies, yearly physicals).
Discussion: Older adults are more likely to successfully complete a telemedicine appointment after they have completed digital skills training. Integration of training into regular clinical practice may decrease no-show rates, especially among highly vulnerable populations, facilitating timely follow-up and potentially enhancing diabetes outcomes.
Keywords: Aging, Tele-healthMethods: We recruited primary care patients attending an in-person appointment at a Midwestern urban clinic serving a low-income population. Participants were age 50-70, had T2D, owned an internet-capable device, and had never had a telemedicine appointment. Participants received hands-on training from a digital skills educator, including setting up and logging into MyChart (Epic patient portal). Participants were encouraged to schedule a virtual diabetes management appointment within 6 months of enrollment. Semi-structured interviews were completed by participants who completed both the training and an appointment, as well as those who did not complete an appointment and/or training.
Results: 65 participants (mean age = 60.89 years, 70.8% female, 96.9% African American, 53.8% Medicaid/Medicare) were enrolled from November 2023-May 2025. 25 received telemedicine training and 18 completed a telemedicine appointment (18/25, 72%). Of the 39 participants who did not receive training (29 lost to follow up), 5 completed a telemedicine appointment (5/39, 12.8%). All interviewees who received training (n=12) found it helpful. Participants found telemedicine to be convenient and of comparable quality to in-person care. Participants often said they would use telemedicine (medication check-ins) as supplemental to in-person care (emergencies, yearly physicals).
Discussion: Older adults are more likely to successfully complete a telemedicine appointment after they have completed digital skills training. Integration of training into regular clinical practice may decrease no-show rates, especially among highly vulnerable populations, facilitating timely follow-up and potentially enhancing diabetes outcomes.
Authors:
Co-Author - Kelsey Ufholz, PhD, Case Western Reserve University
Co-Author - Goutham Rao, MD, Case Western Reserve University and University Hospitals
Co-Author - Danielle Robinson, BA, University Hospitals
Co-Author - Isaac Alexander, BA, University Hospitals
Co-Author - David Imre, MPH, University Hospitals
Co-Author - Olivia Perotti, BA, University Hospitals
Co-Author - Bridget Haas, PhD, Case Western Reserve University
Exploring Empowerment and Behaviour Change through Personal Health Records: A Developmental Mixed Methods Evaluation
Poster Number: A72Time: 05:00 PM - 05:50 PM
Topics: Digital Health
Background
Digital personal health records (PHRs) are more than repositories of information; they can trigger changes in how people manage their health. Access can first lead to enablement, where individuals gain knowledge and skills. Enablement can then foster empowerment, reflected in greater confidence and control. Empowerment may support involvement, as people take initiative in self-care, and engagement, as they participate more actively in collaborative care with providers. This study examined MyHealthNB, a province-wide PHR in New Brunswick, Canada, to explore these pathways and quantify their impacts.
Methods
We employed an exploratory sequential mixed methods design embedded within a developmental evaluation approach. This flexible approach allowed continuous adaptation of methods as the PHR and stakeholder priorities evolved. The evaluation was conducted in partnership with industry (PHR designers), government (PHR implementers), and community organizations. Phase 1 involved 32 qualitative interviews exploring user experiences across enablement, empowerment, involvement, and engagement domains. Insights informed Phase 2, a cross-sectional survey of 885 users measuring 21 outcomes within these domains. Targeted recruitment strategies ensured representation of groups often excluded, including newcomers, older adults, people with disability, and those living in rural regions. Analyses included descriptive statistics, t-tests, mediation analysis, and multivariable regression.
Results
Interviews revealed a progression from access (enablement), to confidence and control (empowerment), to behavioural changes in self-care (involvement) and shared decision-making (engagement). Survey findings confirmed positive impacts across all 21 outcomes (p < .05). Mediation analysis identified empowerment as the central pathway linking enablement to greater involvement and engagement. Stronger impacts were predicted by platform satisfaction, family doctor access, provider support, digital literacy, and frequency of use.
Conclusions
This developmental evaluation shows how mixed methods research can adapt to evolving interventions and stakeholder needs. By clarifying and quantifying how PHRs influence enablement, empowerment, involvement, and engagement, the study advances understanding of how PHR access can drive behaviour change. Findings highlight the need to embed PHRs within supportive care relationships and prioritize user-friendly design to maximize impact.
Keywords: Technologies, Behavior ChangeDigital personal health records (PHRs) are more than repositories of information; they can trigger changes in how people manage their health. Access can first lead to enablement, where individuals gain knowledge and skills. Enablement can then foster empowerment, reflected in greater confidence and control. Empowerment may support involvement, as people take initiative in self-care, and engagement, as they participate more actively in collaborative care with providers. This study examined MyHealthNB, a province-wide PHR in New Brunswick, Canada, to explore these pathways and quantify their impacts.
Methods
We employed an exploratory sequential mixed methods design embedded within a developmental evaluation approach. This flexible approach allowed continuous adaptation of methods as the PHR and stakeholder priorities evolved. The evaluation was conducted in partnership with industry (PHR designers), government (PHR implementers), and community organizations. Phase 1 involved 32 qualitative interviews exploring user experiences across enablement, empowerment, involvement, and engagement domains. Insights informed Phase 2, a cross-sectional survey of 885 users measuring 21 outcomes within these domains. Targeted recruitment strategies ensured representation of groups often excluded, including newcomers, older adults, people with disability, and those living in rural regions. Analyses included descriptive statistics, t-tests, mediation analysis, and multivariable regression.
Results
Interviews revealed a progression from access (enablement), to confidence and control (empowerment), to behavioural changes in self-care (involvement) and shared decision-making (engagement). Survey findings confirmed positive impacts across all 21 outcomes (p < .05). Mediation analysis identified empowerment as the central pathway linking enablement to greater involvement and engagement. Stronger impacts were predicted by platform satisfaction, family doctor access, provider support, digital literacy, and frequency of use.
Conclusions
This developmental evaluation shows how mixed methods research can adapt to evolving interventions and stakeholder needs. By clarifying and quantifying how PHRs influence enablement, empowerment, involvement, and engagement, the study advances understanding of how PHR access can drive behaviour change. Findings highlight the need to embed PHRs within supportive care relationships and prioritize user-friendly design to maximize impact.
Authors:
Author - Paula Voorheis, PhD, University of Wisconsin
Co-Author - Stephan Dombrowski, PhD, University of New Brunswick
Co-Author - Frances Bruno, RN, MSc, University of Toronto
Co-Author - Carolyn Steele Gray, PhD, University of Toronto
Experimental Designs with Repeated Randomizations for Optimizing Adaptive Interventions: Guidelines and Practical Considerations
Poster Number: A73Time: 05:00 PM - 05:50 PM
Topics: Digital Health, Methods and Measurement
Background. In adaptive interventions, dynamic information about individuals is used to determine whether and how to intervene. Depending on the nature of the intervention (e.g., human-delivered vs. digitally delivered), adaptations may need to occur slowly or rapidly (after a month vs. daily). The optimization of adaptive interventions has been powered by two experimental designs, both employing sequential randomizations but on different timescales: the sequential multiple assignment randomized trial (SMART) on a slow timescale for standard adaptive interventions and the micro-randomized trial (MRT) on a fast timescale for just-in-time adaptive interventions. Purpose. This paper intends to help investigators, who have research questions about the delivery and adaptation of intervention options at more than one time point, select and plan a trial design with the right form of sequential randomizations, on the appropriate timescale. Methods. This is a conceptual paper discussing considerations related to designing sequential randomizations. Results. We clarify the differences and similarities between the SMART and the MRT, outline the types of questions that can be answered by the two experimental designs, and provide guidelines for selecting and planning the appropriate form of trial design based on the questions that need answers. Conclusions. When designing a trial with sequential randomizations, it is essential to consider the need for sequential randomizations, the appropriate timescale for randomizations, whether to impose restrictions on randomizations, whether to randomize upfront or sequentially, the timing for measuring the primary outcome, and sample size planning.
Keywords: Intervention, MethodologyAuthors:
Author - Shiyu Zhang, PhD, University of Michigan
Author - John Dziak, PhD, Institute for Health Research and Policy, University of Illinois Chicago
Co-Author - , PhD, University of Michigan
Author - Inbal Nahum-Shani, PhD, University of Michigan
Public support for US prison nutrition standards: An experimental study with US adults
Poster Number: A74Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Diet, Nutrition, and Eating Disorders
Background: US prison meals are not required to follow consistent nutrition standards, putting people who have experienced incarceration at risk for chronic disease. Advocates have expressed support for a policy to mandate US prisons follow nutrition standards; however, public support for such a policy—and factors that may influence support—remain unknown. This study examined whether different rationales for mandating prison nutrition standards influence support and how support varies by demographic characteristics.
Methods: In 2025, we recruited a convenience sample of 1,201 US adults ages ≥ 18 years. In an online between-subjects experiment, participants were randomized to view 1 of 4 study conditions: a control where they saw no rationale for a policy mandating nutrition standards in US prisons or 1 of 3 rationales (cost-saving, right-to-health, and recidivism-reducing). Participants reported their level of policy support using a response scale ranging from “strongly oppose” (coded as 1) to “strongly support” (5). Associations between policy rationale and public support, and between participant demographic characteristics and policy support were measured using logistic regression, using a binary outcome of support vs. oppose/neutral.
Results: The majority of participants (79%) supported mandating prison nutrition standards. Participants who viewed the cost-saving rationale were more likely to support the policy than those who viewed no rationale (average differential effect, ADE = .09, p = .01). Participants who viewed the right-to-health and recidivism-reducing rationales were not more likely to support the policy than participants who viewed no rationale (ps > .05). Black participants (ADE = .06, p = .03) and Latino participants (ADE = .09, p = .01) were more likely to support the policy than White participants and participants with a graduate degree (ADE = .08, p = .02) were more likely to support the policy than participants with less than a college degree.
Conclusions: Support for a policy to mandate nutrition standards in US prisons was high among a convenience sample of US adults, indicating potential political interest in such a policy. Advocates may benefit from framing the policy as cost-saving and leveraging the higher support among particular US sub-populations (Black, Latino, and highly-educated adults).
Keywords: Nutrition, PrisonMethods: In 2025, we recruited a convenience sample of 1,201 US adults ages ≥ 18 years. In an online between-subjects experiment, participants were randomized to view 1 of 4 study conditions: a control where they saw no rationale for a policy mandating nutrition standards in US prisons or 1 of 3 rationales (cost-saving, right-to-health, and recidivism-reducing). Participants reported their level of policy support using a response scale ranging from “strongly oppose” (coded as 1) to “strongly support” (5). Associations between policy rationale and public support, and between participant demographic characteristics and policy support were measured using logistic regression, using a binary outcome of support vs. oppose/neutral.
Results: The majority of participants (79%) supported mandating prison nutrition standards. Participants who viewed the cost-saving rationale were more likely to support the policy than those who viewed no rationale (average differential effect, ADE = .09, p = .01). Participants who viewed the right-to-health and recidivism-reducing rationales were not more likely to support the policy than participants who viewed no rationale (ps > .05). Black participants (ADE = .06, p = .03) and Latino participants (ADE = .09, p = .01) were more likely to support the policy than White participants and participants with a graduate degree (ADE = .08, p = .02) were more likely to support the policy than participants with less than a college degree.
Conclusions: Support for a policy to mandate nutrition standards in US prisons was high among a convenience sample of US adults, indicating potential political interest in such a policy. Advocates may benefit from framing the policy as cost-saving and leveraging the higher support among particular US sub-populations (Black, Latino, and highly-educated adults).
Authors:
Presenter - Carolyn Chelius, MS, University of North Carolina at Chapel Hill
Co-Author - Shu Wen Ng, PhD, University of North Carolina at Chapel Hill
Co-Author - Anna Grummon, PhD, Stanford University
Co-Author - Marissa Hall, PhD, University of North Carolina at Chapel Hill
Influence of Verified vs. Unverified Health Sources on Parental Vaccine Decisions
Poster Number: A75Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Decision Making
The credibility of health-related information sources may influence parental decisions regarding childhood vaccinations. This study examined whether the type of health information source used by parents was associated with their child's vaccination uptake. Health information source type was categorized as a verified source (healthcare providers, scientific journals) or unverified source (family/friends, social media, opinion blogs). A sample of 887 parents (55% male; mean age=36.42 years; standard deviation (SD)=12.29) completed an anonymous online survey. Participants reported demographic characteristics, primary health information sources, and whether their child received 12 child vaccines, including included Varicella (chickenpox), COVID-19, DTaP, Hib, Hepatitis A, Hepatitis B, Influenza, MMR, MCV4, Pneumococcal conjugate (pneumonia), IPV, and Rotavirus. Independent samples t-tests and chi-square tests were conducted to compare demographic characteristics (age, household size, number of children, sex, ethnicity, education, household income, sexual orientation, and political affiliation) between verified and unverified information source groups. Separate multivariable logistic regression models were conducted for each vaccine with a significant unadjusted group difference, estimating adjusted odds ratios (aORs), 95% confidence intervals (CIs), and p-values. Results showed verified source users were more likely to identify as Hispanic/Latino, report higher household incomes, and identify as a Democrat (p-values<.001). Verified information users were also more likely to have a bachelor's degree (p=.002) and to identify as heterosexual (p=.001). Compared to unverified source users, verified source users had significantly higher odds of vaccinating their child across most vaccines including DTaP, Hib, Hepatitis A, Hepatitis B, Influenza, MMR, MCV4, pneumonia, IPV, and Rotavirus (all p<0.01). Verified source users also reported significantly higher overall vaccination rates (p<0.001). No significant differences were found for the chickenpox (Varicella) or COVID-19 vaccines. Results underscore the importance of health information credibility in promoting vaccine adherence. Efforts to enhance both access to and understanding of trusted health information may promote greater childhood vaccination uptake.
Keywords: Health communication, Children's healthAuthors:
Author - Karly Geller, PhD, Miami University
Author - Skyler Montaine-O’Brien, Ohio State University
Author - Paul Branscum, Miami University
Author - Brandy Reeves-Doyle, Miami University
Hope on the Horizon: Hope as a possible mechanism of positive-framed nicotine warnings on discouragement to use nicotine products
Poster Number: A76Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Tobacco Control and Nicotine-Related Behavior
Framing of health messages - whether emphasizing benefits of taking action (gain-frame) or risks of not taking action (loss-frame) - may be a factor in motivating health behavior change. There are mixed results regarding the effectiveness of gain- versus loss-framed health communications to motivate behavior change. Research indicates that the effectiveness of loss-framed messages to motivate behavior is due in part to the negative emotional responses they elicit (e.g., worry). However, less is understood about how gain-framed messages may motivate health behavior change. One potential mechanism may be hope, a feeling of optimism experienced while considering future outcomes. The current study examined two future-oriented affective responses elicited from gain- and loss-framed nicotine warnings (i.e. worry and hope) and how these affective responses may, in turn, discourage use. In an online 2x2 between-subjects experiment, 287 young adults between the ages of 18 and 25 (mean age = 22.73 years; 50.5% female; 50.5% Non-Hispanic White) were randomly assigned to evaluate images of four gain or loss framed nicotine warnings on e-cigarette or nicotine pouch products on hope, worry, and discouragement to use elicited from the warnings. Using multilevel models, gain- versus loss-framed warnings elicited significantly greater feelings of hope (est=.72, p=.001). No other significant mean differences emerged for frame, product type, nor any frame x product type interactions. However, a multilevel mediation revealed an indirect effect of message frame on discouragement to use via hope elicited from the warnings (indirect b = -.15, CI: -.28,-.05). Such that more hope elicited from the positive-framed warnings was, in turn, associated with more discouragement to use. These findings provide preliminary evidence of a possible mechanism for how gain-framed warnings for nicotine products may discourage use, and may be particularly useful to consider for policies communicating about nicotine to young adults who may experience reactance to loss-framed messages.
Keywords: Nicotine, Health communicationAuthors:
Presenter - Caleb Selzler, B.S., Washington State University Vancouver
Co-Author - Renee Magnan, PhD, FSBM, Washington State University Vancouver
Hope tempered by caution: A mixed methods investigation of public beliefs about using epigenetic therapies in clinical care
Poster Number: A77Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Health Disparities
Background: Emerging epigenetic therapies leverage changes in gene expression without altering the underlying DNA sequence, potentially providing innovative and personalized approaches to prevent, detect, or treat serious health conditions (e.g., cancer). We investigated public beliefs about using epigenetic therapies in clinical care and about implementing protective policies.
Methods: We conducted 27 virtual focus groups (N=153) and an online survey (N=1431) with U.S. adults. Recruitment was stratified by race, ethnicity (Hispanic and non-Hispanic white, Black, Asian, and Indigenous), and education (vo-tech/some college or less vs. associate’s degree or more). Qualitative data were analyzed using thematic analysis. Survey data were analyzed using frequencies. Survey item response scales were 1 (least positive) – 5 (most positive).
Results: There was convergence between the qualitative and survey data. The theme Novel Therapeutics included comments about developing novel pharmaceuticals, including those that “remove the [epigenetic] flags” that lead to disease. Risk-Stratified Prevention included discussion of identifying people at high disease risk and guiding risk-reducing action, such as “early detection, especially for cancer.” Over 60% of survey participants gave positive ratings of 4 or 5 to questions about using epigenetics to improve medical treatments and fixing human health problems and diseases, and 61% favored (4 or 5) policies to facilitate living a healthy lifestyle. The theme Ethical, Legal, and Social Implications included discussion of the likely high cost of epigenetic therapies, lack of coverage by insurance companies, and exacerbating health disparities: “those who can pay a premium will get extremely individualized healthcare that will help them so much…but the regular folk will have a disadvantage.” Over 70% of survey participants expressed concerns (1 or 2) about affordability of epigenetic-based therapies, and 65% supported (4 or 5) policies to limit their cost. Concerns about discrimination also arose, “…[epigenetics] may keep them from treating you properly [the physician] may make a judgment on it…,” but only 17% of survey participants felt that discrimination would increase.
Conclusion: Participants from two demographically diverse samples identified potential benefits of epigenetic therapies to address clinical care needs but also expressed concerns about misuse, identifying areas for implementing protective policies.
Keywords: Genetics, BeliefsMethods: We conducted 27 virtual focus groups (N=153) and an online survey (N=1431) with U.S. adults. Recruitment was stratified by race, ethnicity (Hispanic and non-Hispanic white, Black, Asian, and Indigenous), and education (vo-tech/some college or less vs. associate’s degree or more). Qualitative data were analyzed using thematic analysis. Survey data were analyzed using frequencies. Survey item response scales were 1 (least positive) – 5 (most positive).
Results: There was convergence between the qualitative and survey data. The theme Novel Therapeutics included comments about developing novel pharmaceuticals, including those that “remove the [epigenetic] flags” that lead to disease. Risk-Stratified Prevention included discussion of identifying people at high disease risk and guiding risk-reducing action, such as “early detection, especially for cancer.” Over 60% of survey participants gave positive ratings of 4 or 5 to questions about using epigenetics to improve medical treatments and fixing human health problems and diseases, and 61% favored (4 or 5) policies to facilitate living a healthy lifestyle. The theme Ethical, Legal, and Social Implications included discussion of the likely high cost of epigenetic therapies, lack of coverage by insurance companies, and exacerbating health disparities: “those who can pay a premium will get extremely individualized healthcare that will help them so much…but the regular folk will have a disadvantage.” Over 70% of survey participants expressed concerns (1 or 2) about affordability of epigenetic-based therapies, and 65% supported (4 or 5) policies to limit their cost. Concerns about discrimination also arose, “…[epigenetics] may keep them from treating you properly [the physician] may make a judgment on it…,” but only 17% of survey participants felt that discrimination would increase.
Conclusion: Participants from two demographically diverse samples identified potential benefits of epigenetic therapies to address clinical care needs but also expressed concerns about misuse, identifying areas for implementing protective policies.
Authors:
Presenter - Erika Waters, PhD, MPH, FSBM, Washington University School of Medicine
Co-Author - Julia Maki, PhD, Washington University in St Louis
Co-Author - Jada Hamilton, PhD, MPH, FSBM, Memorial Sloan Kettering Cancer Center
Co-Author - Erin Linnenbringer, Washington University School of Medicine
Author - Jessica Mozersky, Washington University in St. Louis
Co-Author - Nicole Ackermann, Washington University School of Medicine
Co-Author - Aantaki Raisa, Washington University in St. Louis
Co-Author - Caitlin Yuen, Washington University in St. Louis
Co-Author - Bryce Puesta Takenaka, Yale University
Co-Author - George Souroullas, Washington University in St. Louis
Co-Author - Chelsey Carter, Yale University
IMPROVING PARENT UNDERSTANDING AND SATISFACTION THROUGH STANDARDIZED PATIENT EDUCATION MATERIALS IN PEDIATRIC OUTPATIENT PSYCHIATRY
Poster Number: A78Time: 05:00 PM - 05:50 PM
Topics: Health Communication and Policy, Mental Health
Parents of children and adolescents often leave psychiatric visits with unanswered questions about new diagnoses, medications, or treatment plans, which can increase anxiety, reduce adherence, and pose safety risks. Although family-centered care is a cornerstone of psychiatric nursing, education practices in outpatient psychiatry are inconsistent. Evidence shows that structured, evidence-based handouts improve comprehension, support health literacy, and enhance caregiver satisfaction (Attkisson & Zwick, 1982; Wiegmann et al., 2024). This quality improvement project uses the Plan-Do-Study-Act framework to implement standardized educational handouts and an electronic health record (EHR) documentation phrase (.phrase) in a pediatric outpatient psychiatry clinic serving youth ages 6–18. Providers will receive brief training to deliver handouts (adapted from an evidence-based resource) during visits involving a new psychiatric diagnosis or new medication initiation, with the .phrase used to document education consistently. Data collection includes manual chart audits and EHR reviews of 75–100 qualifying visits during an eight-week implementation, compared with retrospective audits of 82 baseline visits. Parent satisfaction will be measured with a parent-adapted Client Satisfaction Questionnaire (CSQ-8); 35 baseline surveys have been collected, with 75–100 expected post-implementation. Projected outcomes include increased documentation of education in charts, at least 85% distribution of handouts at eligible visits, and at least 85% of parents reporting high satisfaction (mean CSQ-8 score ≥4.0/5.0). By embedding standardized, evidence-based handouts into EHR workflow, this initiative represents an innovative, low-burden strategy to improve communication, enhance caregiver understanding, and support treatment adherence. The project objectives are to describe the impact of standardized education on satisfaction and documentation, identify strategies for embedding handouts and EHR tools into workflow, and discuss implications for nurse-led innovations that advance family-centered behavioral health care.
Keywords: Education, Evidence basedAuthors:
Author - Allison Weaver, PMHNP-BC, DNP(c), Georgia Southern University
Invited and Accepted: Who takes part in clinical trials?
Poster Number: A79Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Community Engagement
Enrolling diverse participants in clinical trials is crucial for research. Unfortunately, many trials fail to achieve overall recruitment and diverse representation. Two key points of recruitment are 1) invitation to join the trial and 2) the participant's acceptance of the trial invitation. This analysis evaluates who is invited and who accepts engagement in clinical trials in a self-selected sample.
Data come from an online study evaluating preferences for clinical trial designs. Respondents viewed a brief educational video describing the basic features of clinical trials and were asked if 1) they had ever been asked to join a clinical trial, and if so, 2) whether they participated. Respondents were recruited through an online survey platform that includes high-quality survey respondents who regularly engage in online surveys and research. Variables analyzed included self-reported demographics (age, gender, education, race, and ethnicity), the presence or absence of chronic diseases, the Research Attitudes Questionnaire scores, and the Discrimination in Medicine Scale.
Respondents (N = 568) were 56.2±17.8 (mean ± SD) years of age, 66.6% women, 68.7% non-Hispanic White, and 46.5% with a college degree. 21.7% had ever been invited to participate in a clinical trial, and 63.5% of those took part (n = 73; 12.9% of the full sample). Compared to those never invited to a trial, those who were invited were more likely to be men (OR = 1.75, 95% CI [1.16, 2.63] and to have a chronic disease (OR = 1.68, 95% CI [1.13, 2.51]. There were no significant differences by age, race/ethnicity, education, or reported experiences with discrimination, nor were there any significant interactions between the predictors tested and chronic disease status. Among those invited, no differences were observed in terms of age, gender, race/ethnicity, education, chronic disease status, or experiences of discrimination between participants and non-participants. Respondents who had participated in clinical trials held more positive views of research than those who had not participated (OR = 1.15, 95% CI [1.06, 1.26].
In this self-selected sample, men were more likely to be invited to clinical trials. No demographic variables were associated with participation, suggesting a high degree of willingness to join clinical trials when invited. The association between positive research attitudes and trial participation requires further exploration to establish the direction of causality.
Keywords: Research methods, DiversityData come from an online study evaluating preferences for clinical trial designs. Respondents viewed a brief educational video describing the basic features of clinical trials and were asked if 1) they had ever been asked to join a clinical trial, and if so, 2) whether they participated. Respondents were recruited through an online survey platform that includes high-quality survey respondents who regularly engage in online surveys and research. Variables analyzed included self-reported demographics (age, gender, education, race, and ethnicity), the presence or absence of chronic diseases, the Research Attitudes Questionnaire scores, and the Discrimination in Medicine Scale.
Respondents (N = 568) were 56.2±17.8 (mean ± SD) years of age, 66.6% women, 68.7% non-Hispanic White, and 46.5% with a college degree. 21.7% had ever been invited to participate in a clinical trial, and 63.5% of those took part (n = 73; 12.9% of the full sample). Compared to those never invited to a trial, those who were invited were more likely to be men (OR = 1.75, 95% CI [1.16, 2.63] and to have a chronic disease (OR = 1.68, 95% CI [1.13, 2.51]. There were no significant differences by age, race/ethnicity, education, or reported experiences with discrimination, nor were there any significant interactions between the predictors tested and chronic disease status. Among those invited, no differences were observed in terms of age, gender, race/ethnicity, education, chronic disease status, or experiences of discrimination between participants and non-participants. Respondents who had participated in clinical trials held more positive views of research than those who had not participated (OR = 1.15, 95% CI [1.06, 1.26].
In this self-selected sample, men were more likely to be invited to clinical trials. No demographic variables were associated with participation, suggesting a high degree of willingness to join clinical trials when invited. The association between positive research attitudes and trial participation requires further exploration to establish the direction of causality.
Authors:
Presenter - Melissa Crane, PhD, Rush University Medical Center
Co-Author - Chen Yeh, MS, Rush University Medical Center
Co-Author - Paul Glover, BA, Rush University Medical Center
Co-Author - Sumihiro Suzuki, PhD, Rush University Medical Center
Co-Author - Bradley Appelhans, PhD, FSBM, Rush University Medical Center
Racial, Ethnic, and Sex Differences in Agreement between Self-reported Social Risks and Need for Support
Poster Number: A80Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Methods and Measurement
Health systems increasingly screen patients for social risks; however, agreement between self-reported social risks and need for support (“social needs”), and variation in risk-need agreement by race, ethnicity, and sex, are not well understood. We assessed agreement between self-reported social risks and need for support and compared risk-need concordance across demographic groups in a diverse national sample of patients.
Methods: A stratified sample of Veterans Health Administration primary care patients was surveyed on social risks and need for support in 12 domains (e.g., food, housing) in the past 6 months. We examined risk-need sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and concordance, calculating age-adjusted relative risk ratios (aRRR) of discordance across race-ethnicity-sex groups.
Results: Of the 38,759 invited, 7,095 (18.3%) responded and 6,596 complete cases (17.0%) were analyzed. Weighted participants represented 937,003 patients (4.1% Black females [BF], 19.4% Black males [BM],1.6% Hispanic females [HF], 11.3% Hispanic males [HM], 5.3% White females [WF], 58.4% White males [WM]). Across domains, risk-need sensitivity ranged from 42% (housing) to 99% (loneliness) (median sensitivity=79%), and specificity ranged from 68% (loneliness) to 98% (childcare) (median specificity=88%). PPV ranged from 27% (housing) to 69% (legal issues) (median PPV=47%), and NPV ranged from 93% (housing) to 99% (childcare and loneliness) (median NPV=97%). Compared to WM, likelihood of need-without-risk discordance was significantly higher for loneliness (aRRRs: 14.02, WF; 10.87, HF; 8.08, HM; 5.63, BF; 3.73, BM); paying for basics (3.95, BM; 2.55, BF); housing (2.67, BM; 2.33, HF; 2.19, HM); legal issues (2.41, BF; 1.98, HM); adult caregiving (2.13, BM; 1.71, HM); food (2.84, BM); internet (2.64, HF); and transportation (2.36, BM). Likelihood of need-without-risk discordance was lower for work (0.039, BF) and legal issues (0.41, WF). Compared to WM, likelihood of risk-without-need discordance was higher for transportation (2.37, HF) and education and (1.69, HM) and lower for loneliness (0.73, BM) and legal issues (0.36, HM).
Conclusions: Social risk questions often over-identify patients without need for support and under-identify those who desire support for needs, particularly in certain demographic groups. Improved survey methods are essential to accurately detect social needs in diverse populations.
Keywords: Risk, Health disparitiesMethods: A stratified sample of Veterans Health Administration primary care patients was surveyed on social risks and need for support in 12 domains (e.g., food, housing) in the past 6 months. We examined risk-need sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and concordance, calculating age-adjusted relative risk ratios (aRRR) of discordance across race-ethnicity-sex groups.
Results: Of the 38,759 invited, 7,095 (18.3%) responded and 6,596 complete cases (17.0%) were analyzed. Weighted participants represented 937,003 patients (4.1% Black females [BF], 19.4% Black males [BM],1.6% Hispanic females [HF], 11.3% Hispanic males [HM], 5.3% White females [WF], 58.4% White males [WM]). Across domains, risk-need sensitivity ranged from 42% (housing) to 99% (loneliness) (median sensitivity=79%), and specificity ranged from 68% (loneliness) to 98% (childcare) (median specificity=88%). PPV ranged from 27% (housing) to 69% (legal issues) (median PPV=47%), and NPV ranged from 93% (housing) to 99% (childcare and loneliness) (median NPV=97%). Compared to WM, likelihood of need-without-risk discordance was significantly higher for loneliness (aRRRs: 14.02, WF; 10.87, HF; 8.08, HM; 5.63, BF; 3.73, BM); paying for basics (3.95, BM; 2.55, BF); housing (2.67, BM; 2.33, HF; 2.19, HM); legal issues (2.41, BF; 1.98, HM); adult caregiving (2.13, BM; 1.71, HM); food (2.84, BM); internet (2.64, HF); and transportation (2.36, BM). Likelihood of need-without-risk discordance was lower for work (0.039, BF) and legal issues (0.41, WF). Compared to WM, likelihood of risk-without-need discordance was higher for transportation (2.37, HF) and education and (1.69, HM) and lower for loneliness (0.73, BM) and legal issues (0.36, HM).
Conclusions: Social risk questions often over-identify patients without need for support and under-identify those who desire support for needs, particularly in certain demographic groups. Improved survey methods are essential to accurately detect social needs in diverse populations.
Authors:
Presenter - Leslie Hausmann, PhD, FSBM, University of Pittsburgh
Co-Author - Lauren Russell, MPH, MPP, Veterans Health Administration
Co-Author - David Frank, MPH, Veterans Affairs Pittsburgh Healthcare System
Co-Author - Soumik Purkayastha, MS, PhD, University of Pittsburgh School of Public Health
Co-Author - Jennifer McCoy, MA, Veterans Affairs Pittsburgh Healthcare System
Co-Author - Sarah Leder, MSW, Veterans Health Administration
Co-Author - Joshua Gordon, MD, PhD, Veterans Affairs Pittsburgh Healthcare System
Co-Author - Gregory Procario, MS, Veterans Affairs Pittsburgh Healthcare System
Co-Author - Shane Lamba, MPH, Veterans Health Administration
Motivational and Psychological Predictors of Asthma Medication Adherence in Urban Emerging Adults
Poster Number: A81Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Mental Health
Background:
Urban emerging adults with asthma often struggle with low adherence to controller medications, contributing to poor symptom control and increased health risks. While adherence is a key self-management behavior, individual-level contributors such as motivation and psychological distress are not well understood in this population. This study applied a behavioral framework to examine predictors of adherence among Black/African American emerging adults with uncontrolled asthma.
Purpose:
To evaluate the role of psychological distress, self-efficacy, motivation, asthma knowledge, and substance use in predicting adherence to asthma controller medications using multiple assessment methods.
Methods:
Participants (N = 152; ages 18 to 29) with physician-diagnosed persistent asthma and suboptimal self-reported adherence were recruited from an urban university medical system and surrounding community settings. Measures included validated assessments of asthma knowledge, psychological distress, self-efficacy, motivation, and substance use. Adherence was captured using three approaches: a four-week adherence behavior checklist, 30-day recall via visual analog scale, and seven-day daily reporting via SMS. Structural equation modeling tested a theoretically informed model examining direct and indirect effects on medication adherence.
Results:
Motivation was the strongest direct predictor of medication adherence across all measures. Self-efficacy predicted motivation, and psychological distress was negatively associated with both self-efficacy and motivation. Asthma knowledge was associated with self-efficacy but did not directly predict adherence. The revised model showed good fit (CFI = .965, RMSEA = .048), and mediation analyses revealed that motivation mediated the relationship between self-efficacy and adherence (z = 2.87, p = .004).
Conclusions:
Motivation and self-efficacy are key modifiable targets for improving adherence to asthma medication in emerging adults. Psychological distress also appears to be an important barrier. One limitation was the operationalization of motivation as the sum of importance and confidence, which may overlap with self-efficacy. This conceptual overlap highlights the need for more refined and theoretically distinct measurement of motivation in behavioral interventions tailored to emerging adults.
Keywords: Asthma, Health outcomesUrban emerging adults with asthma often struggle with low adherence to controller medications, contributing to poor symptom control and increased health risks. While adherence is a key self-management behavior, individual-level contributors such as motivation and psychological distress are not well understood in this population. This study applied a behavioral framework to examine predictors of adherence among Black/African American emerging adults with uncontrolled asthma.
Purpose:
To evaluate the role of psychological distress, self-efficacy, motivation, asthma knowledge, and substance use in predicting adherence to asthma controller medications using multiple assessment methods.
Methods:
Participants (N = 152; ages 18 to 29) with physician-diagnosed persistent asthma and suboptimal self-reported adherence were recruited from an urban university medical system and surrounding community settings. Measures included validated assessments of asthma knowledge, psychological distress, self-efficacy, motivation, and substance use. Adherence was captured using three approaches: a four-week adherence behavior checklist, 30-day recall via visual analog scale, and seven-day daily reporting via SMS. Structural equation modeling tested a theoretically informed model examining direct and indirect effects on medication adherence.
Results:
Motivation was the strongest direct predictor of medication adherence across all measures. Self-efficacy predicted motivation, and psychological distress was negatively associated with both self-efficacy and motivation. Asthma knowledge was associated with self-efficacy but did not directly predict adherence. The revised model showed good fit (CFI = .965, RMSEA = .048), and mediation analyses revealed that motivation mediated the relationship between self-efficacy and adherence (z = 2.87, p = .004).
Conclusions:
Motivation and self-efficacy are key modifiable targets for improving adherence to asthma medication in emerging adults. Psychological distress also appears to be an important barrier. One limitation was the operationalization of motivation as the sum of importance and confidence, which may overlap with self-efficacy. This conceptual overlap highlights the need for more refined and theoretically distinct measurement of motivation in behavioral interventions tailored to emerging adults.
Authors:
Author - Karen MacDonell, PhD, Florida State University
Author - Amy Hall, PhD, MSN, Florida State University/ Wayne State University
Author - Jean-Marie Bruzzese, PhD, Columbia University
Author - Bo Wang, PhD, University of Massachusetts
Psychosocial Factors and Metabolic Syndrome in Asian American Subgroups: A Cross-Sectional Analysis
Poster Number: A82Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Weight Related Health
Introduction: Asian subgroups, often homogenized in previous research despite distinct cultural backgrounds, may experience different psychosocial influences on metabolic syndrome (MetS). This study aims to address this gap by exploring how psychosocial factors affect MetS prevalence differently among Asian subgroups.
Methods: This study included participants (n = 5792, mean age = 51.6, 58.7% women) from the NIH All of Us Research Platform controlled tier v8. Metabolic syndrome was defined using The National Cholesterol Education Program Adult Treatment Panel III criteria and the most recent participant data was assessed. In the sample, the overall prevalence of MetS was 25.6% (n = 1480). Asian participants were grouped into the categories of Chinese (n = 1652), Filipino (n = 879), Indian (n = 1388), Japanese (n = 377), Korean (n = 372), Vietnamese (n = 601), Pakistani (n = 123), or Other Asian (n = 400). Psychosocial factors were measured using validated scales for discrimination, stress, social support, loneliness, and food insecurity. Regression models estimated associations between each psychosocial factor and MetS prevalence, and interactions tested subgroup differences.
Results: Associations between psychosocial factors and MetS varied by Asian subgroup. Material hardship and discrimination were consistently harmful: food insecurity in Chinese and everyday discrimination in Chinese, Korean, and Vietnamese participants. Among Koreans, social support was protective (PR = 0.57, p = 0.0007, 95% CI [0.41, 0.79]), and loneliness was associated with increased MetS risk (PR = 1.72, p = 0.035, 95% CI [1.04, 2.84]), suggesting a strong role for social ties in this subgroup. Global tests indicated modest heterogeneity across Asian subgroups (p = 0.078).
Conclusion: The findings from this study suggest that psychosocial stressors such as food insecurity and discrimination are important determinants of metabolic syndrome in Asian Americans, with certain subgroups facing heightened vulnerability to specific domains. Although overall heterogeneity was modest, the subgroup patterns highlight the importance of disaggregating Asian Americans and tailoring culturally informed strategies to reduce cardiometabolic health disparities.
Disclosure: Use of artificial intelligence (ChatGPT, OpenAI) was limited to code development and did not contribute to content generation or interpretation.
Keywords: Ethnic differences, Risk factorsMethods: This study included participants (n = 5792, mean age = 51.6, 58.7% women) from the NIH All of Us Research Platform controlled tier v8. Metabolic syndrome was defined using The National Cholesterol Education Program Adult Treatment Panel III criteria and the most recent participant data was assessed. In the sample, the overall prevalence of MetS was 25.6% (n = 1480). Asian participants were grouped into the categories of Chinese (n = 1652), Filipino (n = 879), Indian (n = 1388), Japanese (n = 377), Korean (n = 372), Vietnamese (n = 601), Pakistani (n = 123), or Other Asian (n = 400). Psychosocial factors were measured using validated scales for discrimination, stress, social support, loneliness, and food insecurity. Regression models estimated associations between each psychosocial factor and MetS prevalence, and interactions tested subgroup differences.
Results: Associations between psychosocial factors and MetS varied by Asian subgroup. Material hardship and discrimination were consistently harmful: food insecurity in Chinese and everyday discrimination in Chinese, Korean, and Vietnamese participants. Among Koreans, social support was protective (PR = 0.57, p = 0.0007, 95% CI [0.41, 0.79]), and loneliness was associated with increased MetS risk (PR = 1.72, p = 0.035, 95% CI [1.04, 2.84]), suggesting a strong role for social ties in this subgroup. Global tests indicated modest heterogeneity across Asian subgroups (p = 0.078).
Conclusion: The findings from this study suggest that psychosocial stressors such as food insecurity and discrimination are important determinants of metabolic syndrome in Asian Americans, with certain subgroups facing heightened vulnerability to specific domains. Although overall heterogeneity was modest, the subgroup patterns highlight the importance of disaggregating Asian Americans and tailoring culturally informed strategies to reduce cardiometabolic health disparities.
Disclosure: Use of artificial intelligence (ChatGPT, OpenAI) was limited to code development and did not contribute to content generation or interpretation.
Authors:
Presenter - Qianxia Jiang, PhD, University of Central Florida
Co-Author - Dev Patel, University of Central Florida
Voices of Black Men: Community-Informed Definitions and Determinants of Health-Related Quality of Life
Poster Number: A83Time: 05:00 PM - 05:50 PM
Topics: Health Disparities
Black men in the United States have among the lowest life expectancy and health-related quality of life (HRQoL) compared to any other racial/ethnic-gender group. HRQoL is a multidimensional indicator of health strongly associated with premature mortality. Because of this association, it has been the target of national and international public health campaigns. Prevailing models of HRQoL recognize that attempts to improve this powerful indicator of health should be population-specific; that is, efforts should recognize the unique contextual factors impacting HRQoL among the priority population. Yet despite their low HRQoL, little is known about the contextual factors that impact this indicator of health among Black men. Such an understanding can be used to inform health promotion programs that can ultimately improve HRQoL and life expectancy among Black men.
The current qualitative study aims to understand how Black men define HRQoL and the factors associated with HRQoL. A focus group protocol using an ecological approach was developed in conjunction with a community advisory board to understand individual, social, and community factors impacting HRQoL among Black men. The focus group protocol was also pilot tested before implementation. Data were collected across seven focus groups with 56 participants identifying as Black men. The mean age was 45.28 years.
Thematic analysis was used to identify common themes. Three main themes emerged: (1) a holistic conceptualization of HRQoL that includes mental, physical, social, and spiritual functioning, (2) a state of HRQoL centered predominantly on mental health concerns, and (3) specific multilevel determinants of HRQoL (e.g., hypertension, motivation, peers, and access to resources).
These results have important implications for those designing and implementing programming to improve HRQoL among Black men. The results suggest that: (1) efforts to promote HRQoL among Black men should intentionally address mental health, in addition to spiritual, physical, and social health, and (2) recognize the unique multilevel determinants impacting HRQoL. Recognizing how Black men define HRQoL is crucial to achieving health equity and ensuring that health promotion efforts are culturally tailored to ensure alignment and successful health-related change among Black men.
Keywords: Disparities, Minority groupsThe current qualitative study aims to understand how Black men define HRQoL and the factors associated with HRQoL. A focus group protocol using an ecological approach was developed in conjunction with a community advisory board to understand individual, social, and community factors impacting HRQoL among Black men. The focus group protocol was also pilot tested before implementation. Data were collected across seven focus groups with 56 participants identifying as Black men. The mean age was 45.28 years.
Thematic analysis was used to identify common themes. Three main themes emerged: (1) a holistic conceptualization of HRQoL that includes mental, physical, social, and spiritual functioning, (2) a state of HRQoL centered predominantly on mental health concerns, and (3) specific multilevel determinants of HRQoL (e.g., hypertension, motivation, peers, and access to resources).
These results have important implications for those designing and implementing programming to improve HRQoL among Black men. The results suggest that: (1) efforts to promote HRQoL among Black men should intentionally address mental health, in addition to spiritual, physical, and social health, and (2) recognize the unique multilevel determinants impacting HRQoL. Recognizing how Black men define HRQoL is crucial to achieving health equity and ensuring that health promotion efforts are culturally tailored to ensure alignment and successful health-related change among Black men.
Authors:
Presenter - Kalyn Prothro, University of South Carolina
Co-Author - Guillermo Wippold, PhD, University of South Carolina
Co-Author - Derek Griffith, PhD, Georgetown University
Co-Author - Dawn Wilson, PhD, FSBM, University of South Carolina
Co-Author - Nicole Zarrett, PhD, FSBM, University of South Carolina
Co-Author - Demetrius Abshire, PhD, RN, University of South Carolina
Co-Author - Terry Woods, Main Attraction Barbershop
Mass Incarceration and Alzheimer’s Disease and Related Dementia Mortality: The Disproportionate Impact on Black Americans
Poster Number: A84Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Social and Environmental Context and Health
Significance: Alzheimer’s Disease and related dementias (ADRD) mortality rates have increased in the United States (US) since 2000 with rates among non-Hispanic (nH) Blacks appearing lower than among nH Whites, however the change in mortality rate has increased 303% for Blacks compared to 191% for Whites. Social factors that disproportionality impact Black populations across the lifespan have been shown to increase risk for cognitive decline and ADRD, disproportionate penalization through racialized targeting by the criminal justice system is one such stressor. This study evaluates racial differences in the relationship between lagged incarceration rates and ADRD mortality at the county level.
Methods: Two-way fixed effect Poisson regression models were used to examine whether historical exposure to high prison incarceration rates corresponds with elevated risk of ADRD mortality among Black adult populations, relative to White adults, across all US counties, in a longitudinal manner from 2005 to 2018. Concurrent as well as 5-, 10-, and 15- year lagged incarceration rates were formulated as exposures. County level ADRD mortality rate, by race (Black and White) for those over 65 years of age for a given year was the outcome of interest. The analytic dataset comprised a total of 34,194 county-years by race (Black, White) and sex (male, female), spanning 14 years and 1401 urban counties (~43% of all counties) in the US.
Results: As supported by previous studies, this analysis found ADRD mortality IRRs to be 1.52 for women relative to men, and 0.76 for Blacks relative to Whites. However, relative to Whites, the incidence rate ratio (IRR) of ADRD mortality among Blacks increases significantly by 1.01 (p<0.001) per 100 unit (prison population divided by population) increase in prison incarceration rate at lag 15 years, but not at other exposure lags.
Conclusion: These findings are supported by evidence that many of the impacts of mass incarceration on individuals and communities are also risk factors (or associated with risk factors) for cognitive decline as well as ADRD. They also serve as a measurable example of racially disparate health outcomes as they relate to social factors for not just the individual but the community as whole. While these findings may be unsurprising, their consideration as our society ages is imperative if we wish to pursue a more equitable to health in the US.
Keywords: Alzheimer's disease, RaceMethods: Two-way fixed effect Poisson regression models were used to examine whether historical exposure to high prison incarceration rates corresponds with elevated risk of ADRD mortality among Black adult populations, relative to White adults, across all US counties, in a longitudinal manner from 2005 to 2018. Concurrent as well as 5-, 10-, and 15- year lagged incarceration rates were formulated as exposures. County level ADRD mortality rate, by race (Black and White) for those over 65 years of age for a given year was the outcome of interest. The analytic dataset comprised a total of 34,194 county-years by race (Black, White) and sex (male, female), spanning 14 years and 1401 urban counties (~43% of all counties) in the US.
Results: As supported by previous studies, this analysis found ADRD mortality IRRs to be 1.52 for women relative to men, and 0.76 for Blacks relative to Whites. However, relative to Whites, the incidence rate ratio (IRR) of ADRD mortality among Blacks increases significantly by 1.01 (p<0.001) per 100 unit (prison population divided by population) increase in prison incarceration rate at lag 15 years, but not at other exposure lags.
Conclusion: These findings are supported by evidence that many of the impacts of mass incarceration on individuals and communities are also risk factors (or associated with risk factors) for cognitive decline as well as ADRD. They also serve as a measurable example of racially disparate health outcomes as they relate to social factors for not just the individual but the community as whole. While these findings may be unsurprising, their consideration as our society ages is imperative if we wish to pursue a more equitable to health in the US.
Authors:
Author - Ruth Sloan, MSPH, The Ohio State University
Co-Author - Parvati Singh, PhD, The Ohio State University
Mortality Risk in Hispanic Chronic Kidney Disease Patients: The Interplay of Depression, Diabetes, and Cardiovascular Disease
Poster Number: A85Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Cardiovascular Disease
Background:
Chronic kidney disease (CKD) is increasing among the U.S. Hispanic population, who also experience higher rates of diabetes and cardiovascular disease (CVD). Depression is common among CKD patients and has been consistently associated with poorer health outcomes. It is known that the cooccurrence of metabolic and cardiovascular comorbidities may have adverse effects on survival. The present study aims to assess the role of depression, diabetes, and CVD on mortality risk of Hispanic CKD patients, who may be vulnerable to the impact of physical and mental health comorbidities.
Methods:
The Hispanic sub-cohort of the national, multicenter, Chronic Renal Insufficiency Cohort (H-CRIC) study was utilized for analysis. Variables included: Beck Depression Inventory (BDI) scores, presence of diabetes and CVD, age, sex, and all-cause mortality. Cox proportion regression was used to examine associations between these factors and mortality, including main effects, and moderating effects (depression x diabetes x CVD), and covariates.
Results:
A total of 327 individuals were enrolled in the H-CRIC study, with a Mean age of 56.6 ± 11.17 years, and 38% were female. During the study period, 137 participants died. Cox regression models indicated that higher depressive symptoms were associated with a 3.1% higher risk of mortality per a one-point increase on the BDI (HR = 1.031, p <.001). Diabetes increased mortality risk by 131% (HR = 2.313, p <.001) and CVD increased risk by 126% (HR = 2.262, p =.002). Age was also a significant predictor with a 3.7% higher risk of death per year (HR = 1.037 per year, p <.001). Female sex was protective, associated with a 37% lower risk compared to male counterparts (HR = 0.0632, p = .014). Notably, diabetes and CVD moderated the effect of depression on mortality (HR = 0.968, p = .036), indicating that the relative impact of depression on mortality was attenuated, but still significant, due to the presence of these comorbid medical conditions.
Conclusion:
These findings highlight the need for integrated management of physical conditions (e.g., diabetes and CVD), but also depressive symptoms in Hispanic CKD patients. Integrated care, including mental health screening and tailored interventions addressing both physical and psychological health, may help improve survival rates and overall outcomes for patients managing complex medical conditions.
Keywords: Depression, Chronic illnessChronic kidney disease (CKD) is increasing among the U.S. Hispanic population, who also experience higher rates of diabetes and cardiovascular disease (CVD). Depression is common among CKD patients and has been consistently associated with poorer health outcomes. It is known that the cooccurrence of metabolic and cardiovascular comorbidities may have adverse effects on survival. The present study aims to assess the role of depression, diabetes, and CVD on mortality risk of Hispanic CKD patients, who may be vulnerable to the impact of physical and mental health comorbidities.
Methods:
The Hispanic sub-cohort of the national, multicenter, Chronic Renal Insufficiency Cohort (H-CRIC) study was utilized for analysis. Variables included: Beck Depression Inventory (BDI) scores, presence of diabetes and CVD, age, sex, and all-cause mortality. Cox proportion regression was used to examine associations between these factors and mortality, including main effects, and moderating effects (depression x diabetes x CVD), and covariates.
Results:
A total of 327 individuals were enrolled in the H-CRIC study, with a Mean age of 56.6 ± 11.17 years, and 38% were female. During the study period, 137 participants died. Cox regression models indicated that higher depressive symptoms were associated with a 3.1% higher risk of mortality per a one-point increase on the BDI (HR = 1.031, p <.001). Diabetes increased mortality risk by 131% (HR = 2.313, p <.001) and CVD increased risk by 126% (HR = 2.262, p =.002). Age was also a significant predictor with a 3.7% higher risk of death per year (HR = 1.037 per year, p <.001). Female sex was protective, associated with a 37% lower risk compared to male counterparts (HR = 0.0632, p = .014). Notably, diabetes and CVD moderated the effect of depression on mortality (HR = 0.968, p = .036), indicating that the relative impact of depression on mortality was attenuated, but still significant, due to the presence of these comorbid medical conditions.
Conclusion:
These findings highlight the need for integrated management of physical conditions (e.g., diabetes and CVD), but also depressive symptoms in Hispanic CKD patients. Integrated care, including mental health screening and tailored interventions addressing both physical and psychological health, may help improve survival rates and overall outcomes for patients managing complex medical conditions.
Authors:
Author - Taylor Stallings, MS, East Carolina University
Co-Author - Rose Skelly, East Carolina University
Co-Author - Riley Craig, East Carolina University
Co-Author - Matthew Whited, PhD, FSBM, East Carolina University
Co-Author - Alan Christensen, PhD, FSBM, East Carolina University
Race and weight loss outcomes: exploring the potential mediating role of the home food environment during a behavioral weight loss intervention
Poster Number: A86Time: 05:00 PM - 05:50 PM
Topics: Health Disparities , Weight Related Health
Background: Research has consistently demonstrated Black adults lose less weight than white adults in behavioral weight loss (BWL) interventions. Certain BWL programs target the obesogenic home food environment to facilitate weight loss. This raises the possibility that BWL programs are less effective at targeting the home food environment in Black versus white participants, which could explain disparities in weight loss outcomes by race. The present study aimed to explore the potential mediating effect of the home food environment (measured by the Home Food Inventory; HFI) on the relation between race and weight loss outcomes during a BWL intervention. We hypothesized that changes in HFI would mediate the relation between race and percent weight change. Method: Adults (n=283) with overweight or obesity were enrolled in a 12-month BWL intervention. Participants completed the HFI at baseline (T1), mid-treatment (6-months; T2), and end-of-treatment (12-months; T3). HFI Obesogenic scores and percent weight change were calculated at each time point, and linear regression models were used to test study aims. Results: Pathway A of the mediation model showed white participants reduced their HFI scores more so than did Black participants from T1 to T2 (b= -2.15, SE= 0.93, p= 0.022). For Pathway B, changes in HFI were not significantly associated with percent weight change at any time point. For Pathway C, Black participants experienced less percent weight change from T1 to T3 (b=-4.98, SE=0.96, p=<0.001) and T2 to T3 (b=-0.99, SE=0.50, p= 0.049) than did white participants. Discussion: Our results support previous findings that white participants experience a greater reduction in weight compared to Black participants during BWL interventions throughout treatment and particularly from baseline to mid-treatment. Although changes in the home food environment did not predict weight change significantly, this study was the first to demonstrate BWL programs produce less positive change in the home food environment among Black versus white participants, which is clinically meaningful. Black participants may face unique barriers to a healthier home food environment (e.g., access to healthier foods or cultural preferences). Gold-standard BWL interventions could consider tailoring the delivery of content to help Black participants overcome these barriers.
Note: AI was used to help generate code for this project.
Keywords: Race, Weight lossNote: AI was used to help generate code for this project.
Authors:
Co-Author - Mayor Watts, Williams College
Co-Author - Rebecca Crochiere, Ph.D., Williams College
From Conversations to Support: How Barbershops Promote Health Among Black Men
Poster Number: A87Time: 05:00 PM - 05:50 PM
Topics: Health Disparities
Background: Black men experience high rates of adverse health and among the lowest life expectancy of any racial/ethnic-gender group in the U.S. Although recent reviews have identified a dearth of health promotion programming designed and implemented specifically for Black men, these reviews have highlighted the potential of barbershop-based programming. Barbershops are a culturally institution for many Black men in the U.S and have evolved into safe places to have difficult conversations (e.g., about health) with peers. One review found 13 largely successful barbershop-based health promotion programs for Black men. While the success of these barbershop-based programs underscores the importance of contextually-relevant, community-based programming for Black men, most manuscripts have focused on outcomes as opposed to the processes by which outcomes are achieved.
Purpose: The purpose of the present study was to understand: (1) peer-derived sources of health-related support at the barbershop and (2) the role of the barbershop in promoting health among Black men.
Methods: Focus group questions were developed with a community advisory board (CAB) and pilot tested among a group of Black male barbers. Focus groups (k = 7) were then conducted at barbershops that serve predominantly Black male clientele. The focus groups were analyzed by two independent coders using a codebook that was inductively and deductively developed . Themes were then developed based on the codes and confirmed with the CAB.
Results: Three themes emerged: (1) dynamic and candid exchange of health-related support at the barbershop (i.e., how Black men communicate about health at the barbershop; e.g., role modeling, passive testimonials); (2) tailored forms of health-related and judgment free communication that provide encouragement and increase motivation (i.e., what is communicated when health is discussed at the barbershop; e.g., tailored information, judgment-free advice); and (3) characteristics of a supportive environment at the barbershop that facilitate health-related communication (e.g., social support, positive environment).
Conclusions: The findings have implications for those interested in designing and implementing barbershop-based health promotion efforts for Black men. Incorporating the findings into such efforts may align the effort with the preferences of Black men and can lead to more successful barbershop-based efforts.
Keywords: Health communication, Health promotionPurpose: The purpose of the present study was to understand: (1) peer-derived sources of health-related support at the barbershop and (2) the role of the barbershop in promoting health among Black men.
Methods: Focus group questions were developed with a community advisory board (CAB) and pilot tested among a group of Black male barbers. Focus groups (k = 7) were then conducted at barbershops that serve predominantly Black male clientele. The focus groups were analyzed by two independent coders using a codebook that was inductively and deductively developed . Themes were then developed based on the codes and confirmed with the CAB.
Results: Three themes emerged: (1) dynamic and candid exchange of health-related support at the barbershop (i.e., how Black men communicate about health at the barbershop; e.g., role modeling, passive testimonials); (2) tailored forms of health-related and judgment free communication that provide encouragement and increase motivation (i.e., what is communicated when health is discussed at the barbershop; e.g., tailored information, judgment-free advice); and (3) characteristics of a supportive environment at the barbershop that facilitate health-related communication (e.g., social support, positive environment).
Conclusions: The findings have implications for those interested in designing and implementing barbershop-based health promotion efforts for Black men. Incorporating the findings into such efforts may align the effort with the preferences of Black men and can lead to more successful barbershop-based efforts.
Authors:
Presenter - Guillermo Wippold, PhD, University of South Carolina
Co-Author - Demetrius Abshire, PhD, University of South Carolina
Co-Author - Dawn K Wilson, PhD, University of South Carolina
Co-Author - Terry Woods, Main Attraction Barbershop
Co-Author - Nicole Zarrett, PhD, FSBM, University of South Carolina
Co-Author - Derek Griffith, PhD, University of Pennsylvania
Discrimination, Sleep, Mindfulness, and Depressive Symptoms: A Moderated Mediation Analysis in People Living with HIV in Thailand
Poster Number: A88Time: 05:00 PM - 05:50 PM
Topics: HIV/AIDS, Mental Health
Thailand remains to be one of the countries with the highest HIV prevalence rate in the Asian-Pacific region. A high proportion of People Living with HIV (PLHIV) with depression report a higher prevalence of sleep disturbances. Addressing Thai PLHIV’s mental health is critically important, as depressive symptoms have been linked to quality of life, medication adherence, and substance use. Interestingly, there’s been growing evidence that points to the benefits of mindfulness on sleep quality and mental health. This study’s aim was to quantitatively assess the moderating role of mindfulness and the mediating role of sleep in the association between discrimination and depressive symptoms within PLHIV in Thailand. This analysis used cross-sectional data of (N = 310) Thai PLHIV, and a moderated-mediation path analysis was conducted in SPSS. Results of the study indicated that discrimination and sleep disturbances significantly predicted greater depressive symptoms, and sleep disturbances partially mediated the association between discrimination and depressive symptoms, as hypothesized. The model predicting depressive symptoms was significant and explained a little less than half of the variance in the outcome. This analysis further supports sleep disturbances as another pathway in which discrimination impacts the mental health of PLHIV in Thailand. Managing sleep disturbances as a key modifiable factor to alleviate the impact of discrimination on the mental health of PLHIV may be a unique opportunity for intervention, particularly using non-pharmacological means. Concurrently, this work points to the necessity of providing regular assessments of sleep health in routine care, in accordance with established recommendations on sleep disturbance management in PLHIV. Brief patient-education in care settings is particularly pertinent to further support PLHIV’s behavioral sleep habits. Though we did not find evidence of moderation by mindfulness in this sample, the negative association of mindfulness at the bivariate level is consistent with previous works that point to mindfulness as a potential factor in improving sleep and mental health. Still, this study emphasizes the relationship between sleep disturbances and depressive symptoms and may inform targeted interventions in this predominantly Buddhist community that address the substantial burden of discrimination on the mental and behavioral health of Thai PLHIV.
Keywords: HIV, DepressionAuthors:
Presenter - Joseph Awad, UCLA
Co-Author - Chengshi Shiu, MSW, PhD, National Taiwan University
Co-Author - Wei-Ti Chen, RN, CNM, PhD, FAAN, University of California, Los Angeles
Patterns of Methamphetamine Use and Treatment Experiences Among People with HIV in San Diego, CA: A Rapid Qualitative Analysis
Poster Number: A89Time: 05:00 PM - 05:50 PM
Topics: HIV/AIDS, Substance Misuse
Background: Methamphetamine (meth) use is associated with poorer HIV care engagement, worse mental health outcomes, and increased HIV risk behaviors. Understanding how meth use begins and evolves, as well as identifying treatment approaches perceived as helpful, is critical for developing and/or increasing the reach of substance use interventions that address the unique needs of people with HIV (PWH). This study aimed to qualitatively examine meth use trajectories of PWH, substance use treatment histories, and perceptions of treatment helpfulness.
Methods: We recruited 15 adult PWH from an academic medical center HIV clinic who endorsed moderate or high risk meth involvement scores per the W.H.O. ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). Semi-structured interviews were conducted in 2021-24. Interview transcripts were summarized using a standardized summary template and analyzed by four team members following a rapid qualitative analysis approach.
Results: Most participants initiated meth use in late adolescence or early adulthood and were often introduced to meth use through sexual partners or friends. Use typically escalated to weekly or daily use, punctuated by months- to years-long periods of sobriety. Meth use was largely sexualized, described as enhancing pleasure or arousal, while others used to cope with stress. Co-use with ketamine and/or GHB occurred mainly in sexualized settings. All participants had engaged in non-pharmacologic substance use treatment (e.g., residential, individual or group therapy, 12-step, peer support), and many reported experience with pharmacologic treatments, which were described as partially effective in reducing meth cravings or use. Whereas some PWH valued the social connection and education provided by treatment programs, others felt unsupported in their harm-reduction goals. Self-directed strategies to reduce meth use included distraction and sexual abstinence.
Conclusion: Meth use in PWH frequently began in young adulthood, was sexualized, and involved patterns of escalating use with intermittent periods of sobriety. Participants engaged with a wide range of pharmacologic and non-pharmacologic treatments, though perceived helpfulness varied, and harm-reduction goals were sometimes misaligned with abstinence-oriented models. Findings highlight the need for tailored, multi-modal interventions that address sexualized context of meth use and varied treatment goals of PWH who use meth.
Keywords: Substance abuse, HIVMethods: We recruited 15 adult PWH from an academic medical center HIV clinic who endorsed moderate or high risk meth involvement scores per the W.H.O. ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). Semi-structured interviews were conducted in 2021-24. Interview transcripts were summarized using a standardized summary template and analyzed by four team members following a rapid qualitative analysis approach.
Results: Most participants initiated meth use in late adolescence or early adulthood and were often introduced to meth use through sexual partners or friends. Use typically escalated to weekly or daily use, punctuated by months- to years-long periods of sobriety. Meth use was largely sexualized, described as enhancing pleasure or arousal, while others used to cope with stress. Co-use with ketamine and/or GHB occurred mainly in sexualized settings. All participants had engaged in non-pharmacologic substance use treatment (e.g., residential, individual or group therapy, 12-step, peer support), and many reported experience with pharmacologic treatments, which were described as partially effective in reducing meth cravings or use. Whereas some PWH valued the social connection and education provided by treatment programs, others felt unsupported in their harm-reduction goals. Self-directed strategies to reduce meth use included distraction and sexual abstinence.
Conclusion: Meth use in PWH frequently began in young adulthood, was sexualized, and involved patterns of escalating use with intermittent periods of sobriety. Participants engaged with a wide range of pharmacologic and non-pharmacologic treatments, though perceived helpfulness varied, and harm-reduction goals were sometimes misaligned with abstinence-oriented models. Findings highlight the need for tailored, multi-modal interventions that address sexualized context of meth use and varied treatment goals of PWH who use meth.
Authors:
Presenter - Maximo Prescott, MS, MPH, San Diego State University / UC San Diego Joint Doctoral Program in Clinical Psychology
Co-Author - Victoria Chentsova, MS, San Diego State University / UC San Diego Joint Doctoral Program in Clinical Psychology
Co-Author - Jorge Delgado, BA, University of California, San Diego
Co-Author - David Moore, PhD, University of California, San Diego
Co-Author - David Grelotti, MD, University of California, San Diego
Co-Author - Jessica Montoya, PhD, University of California, San Diego
Correlates of HIV and STI Knowledge: Findings from the Alabama Youth Survey on HIV Prevention
Poster Number: A90Time: 05:00 PM - 05:50 PM
Topics: HIV/AIDS, Health Disparities
Background: Minorities adolescents experience high rates of discrimination that may predispose them to adverse health behaviors, such as condomless sex and substance use that heighten risk of HIV and sexually transmitted infections (STI). Risk is greatest for minority males who reside in the southern United States due to high prevalence of HIV/STIs in their communities and reduced access to inclusive sexual health education. Understanding HIV and STI knowledge in this population is critical to inform intervention development designed to reduce HIV and STI rates.
Objective: To explore the association of psychosocial characteristics with HIV and STI knowledge level.
Methods: 206 male adolescents with sexual interest in males residing in Alabama were recruited online and in-person from the Magic City Acceptance Academy and community center. HIV and STI knowledge were measured using the HIV Knowledge Questionnaire and the STI Knowledge Scale, respectively. Other scales utilized were the Revised Internalized Homophobia Scale, the Everyday Discrimination Scale, the Patient Health Questionnaire-8, the Medical Outcomes Study Social Support Survey, and Generalized Self-Efficacy Scale. Multivariable linear regression models were built for each outcome, HIV and STI knowledge, separately adjusting for age, race, and ethnicity.
Results: The mean age was 16 (range 14-17 years); the majority of respondents identified as White (n=127) and Non-Hispanic (n=167). HIV knowledge, scored on a range of 0-18, was moderate (mean [M]=10.22, SD=3.68). STI knowledge, scored on a range of 0-27, was low (M=10.22, SD=5.28). Univariate analyses showed internalized homophobia (β=-.20, p=.014), social support (β=.18, p=.028), and self-efficacy (β=.20, p=.016) were significant associates of HIV knowledge while social support alone was a significant associate of STI knowledge (β=.17, p=.039). In multivariable analyses, only internalized homophobia remained significantly associated with HIV knowledge (β=-.18, p=.039), and no factors were significantly associated with STI knowledge.
Conclusions: Findings suggest interventions aimed at improving sexual health outcomes among southern sexual minority male adolescents should concurrently address internalized homophobia and HIV knowledge to maximize public health impact. Further research examining STI knowledge is warranted given the documented low STI knowledge and the inability to identify any significant correlates of STI knowledge.
Keywords: HIV, STDsObjective: To explore the association of psychosocial characteristics with HIV and STI knowledge level.
Methods: 206 male adolescents with sexual interest in males residing in Alabama were recruited online and in-person from the Magic City Acceptance Academy and community center. HIV and STI knowledge were measured using the HIV Knowledge Questionnaire and the STI Knowledge Scale, respectively. Other scales utilized were the Revised Internalized Homophobia Scale, the Everyday Discrimination Scale, the Patient Health Questionnaire-8, the Medical Outcomes Study Social Support Survey, and Generalized Self-Efficacy Scale. Multivariable linear regression models were built for each outcome, HIV and STI knowledge, separately adjusting for age, race, and ethnicity.
Results: The mean age was 16 (range 14-17 years); the majority of respondents identified as White (n=127) and Non-Hispanic (n=167). HIV knowledge, scored on a range of 0-18, was moderate (mean [M]=10.22, SD=3.68). STI knowledge, scored on a range of 0-27, was low (M=10.22, SD=5.28). Univariate analyses showed internalized homophobia (β=-.20, p=.014), social support (β=.18, p=.028), and self-efficacy (β=.20, p=.016) were significant associates of HIV knowledge while social support alone was a significant associate of STI knowledge (β=.17, p=.039). In multivariable analyses, only internalized homophobia remained significantly associated with HIV knowledge (β=-.18, p=.039), and no factors were significantly associated with STI knowledge.
Conclusions: Findings suggest interventions aimed at improving sexual health outcomes among southern sexual minority male adolescents should concurrently address internalized homophobia and HIV knowledge to maximize public health impact. Further research examining STI knowledge is warranted given the documented low STI knowledge and the inability to identify any significant correlates of STI knowledge.
Authors:
Presenter - Brittany Shelton, DrPH, University of Tennessee Knoxville
Author - Aokun Chen, PhD, University of Florida
Author - Danielle Trotter, University of Tennessee Knoxville
Author - Artur Quieroz, PhD, Florida State University
Author - Henna Budhwani, PhD, MPH, FSBM, Florida State University
Acceptability, feasibility, and user experiences of a geofenceable adaptive-coping JITAI for people with HIV
Poster Number: A91Time: 05:00 PM - 05:50 PM
Topics: HIV/AIDS, Digital Health
People with HIV (PWH) often endure comorbid mental health challenges, disproportionately rooted in violent trauma, with maladaptive coping (e.g. hazardous alcohol use) undermining treatment adherence. Momentary stressors can be both intra-individual and environmental: typically place-based. Evidence-based interventions such as Living in the Face of Trauma (LIFT) impart adaptive coping skills, but lack scalability, context awareness, and real-time accessibility. We piloted NOLA Gem, adapting LIFT into a just-in-time adaptive intervention (JITAI) featuring daily diary inputs, personalizable geofencing of stressful or traumatogenic spaces, and stress endorsement– or geofence-triggered “push” adaptive coping skills tools. User-guided “pull” psychoeducation sessions were available on demand. PWH with trauma histories (Mage = 54.2; 73.3% Black, 56.7% male; 63.3% <$20K household income) were quasi-randomized into treatment (NOLA Gem, n = 22), or control (daily diaries exclusively, n = 8) for a 21-day timespan; mixed methods acceptability and usability data were captured at offboarding. Paradata determined feasibility. All procedures were IRB approved and preregistered. Stata SE/18.0 and Python 3.13 commits are on GitHub. Acceptability was high: 100% of NOLA Gem users considered the app “very” or “somewhat” successful at addressing daily stressors, 91% endorsed increased calm and emotional wellbeing, 50% were “extremely likely” (Net Promoter Score = 10/10) to recommend the app to friends. Overall, an average 28 (of 42 possible) daily diaries was completed; 23.7% elicited an adaptive coping recommendation (80.9% considered “very” or “somewhat” relevant to users’ daily stressors). Most frequent were Calming Breathwork: 46 (19.7%), and Mindfulness Meditation: 31 (21.5%). These skills were most frequently completed: n = 46, 12.68% of all completed skills and n = 41, 20.0%, respectively. In human- and Gemma 3 LLM–analyzed interviews, participants described enhanced stress management and self-insight, often intuiting the JITAI model. The daily diaries’ length and timing, and occasional glitches, were consistently voiced frustrations. These results offer a promising acceptability and feasibility profile for NOLA Gem, with well-honed “push” decision rules deterring habituation, and skills completion rates in excess of recommendation rates indicating valuable user-initiated “pull” engagement. Pruning daily diary items and determining efficacy are clear future directions.
Keywords: Mobile phone, StressAuthors:
Presenter - Simone Skeen, Warren Alpert Medical School, Brown University
Co-Author - Stephanie Tokarz, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University
Co-Author - Rayna Gasik, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University
Co-Author - Ethan Smith, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University
Co-Author - Katherine Theall, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University
Co-Author - Gretchen Clum, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University
From Concept to Clinic: Adapting a Communication Intervention for Cervical Cancer Screening Among Women Living with HIV in Ghana
Poster Number: A92Time: 05:00 PM - 05:50 PM
Topics: Implementation Science , Cancer
Background: Cervical cancer (CC) is a major cause of morbidity and mortality among women living with HIV (WLHIV) in Ghana, yet screening rates remain low despite strong evidence of its effectiveness in reducing disease burden. Innovative approaches are needed to address these gaps. This study examined an evidence-based communication intervention (EBCI) integrating the 3R model—Reframing (emphasizing benefits), Reprioritizing (highlighting urgency), and Reforming (shifting norms)—with HPV self-sampling to promote screening uptake. We applied a cultural adaptation process to refine the EBCI and assess its characteristics and adoption potential among WLHIV and healthcare providers (HCPs) at a teaching hospital in Ghana.
Methods: Using a two-phase exploratory sequential mixed methods design, Phase 1 recruited WLHIV (n=14) and HCPs (n=11) via face-to-face invitations. Through the Nominal Group Technique, participants reviewed the self-sampling process and 3R messages, discussed cultural adaptations, and ranked preferred components. Phase 2 pilot-tested the refined EBCI with WLHIV (n=30) and HCPs (n=15), who completed surveys on feasibility, acceptability, appropriateness, and adoptability, followed by interviews. Quantitative data were analyzed descriptively (SPSS) and qualitative data thematically (NVivo).
Results: In the adaptation phase, 97% of participants identified hospitals as the most trusted and preferred location to receive HPV self-sampling kits, 56% recommended bilingual delivery of health messages to increase accessibility, and 81% endorsed social media platforms as the primary channel for disseminating intervention-related information. In the pilot phase, participants rated the EBCI highly across all implementation outcomes: acceptability (88.9%), feasibility (93.3%), adoptability (84.4%), and appropriateness (95.6%). Qualitative interviews revealed that the intervention was perceived as easy to use, provided reassurance during the screening process, and helped reduce stigma associated with cervical cancer and HIV.
Conclusion: A culturally adapted EBCI combining the 3R model with HPV self-sampling is feasible, acceptable, and potentially adoptable within Ghana’s hospital settings. Emphasizing trusted distribution sites, multilingual communication, and social media outreach may enhance engagement and screening uptake among WLHIV. Findings inform strategies to scale CC screening in high-risk populations across sub-Saharan Africa
Keywords: Cancer, Cancer screeningMethods: Using a two-phase exploratory sequential mixed methods design, Phase 1 recruited WLHIV (n=14) and HCPs (n=11) via face-to-face invitations. Through the Nominal Group Technique, participants reviewed the self-sampling process and 3R messages, discussed cultural adaptations, and ranked preferred components. Phase 2 pilot-tested the refined EBCI with WLHIV (n=30) and HCPs (n=15), who completed surveys on feasibility, acceptability, appropriateness, and adoptability, followed by interviews. Quantitative data were analyzed descriptively (SPSS) and qualitative data thematically (NVivo).
Results: In the adaptation phase, 97% of participants identified hospitals as the most trusted and preferred location to receive HPV self-sampling kits, 56% recommended bilingual delivery of health messages to increase accessibility, and 81% endorsed social media platforms as the primary channel for disseminating intervention-related information. In the pilot phase, participants rated the EBCI highly across all implementation outcomes: acceptability (88.9%), feasibility (93.3%), adoptability (84.4%), and appropriateness (95.6%). Qualitative interviews revealed that the intervention was perceived as easy to use, provided reassurance during the screening process, and helped reduce stigma associated with cervical cancer and HIV.
Conclusion: A culturally adapted EBCI combining the 3R model with HPV self-sampling is feasible, acceptable, and potentially adoptable within Ghana’s hospital settings. Emphasizing trusted distribution sites, multilingual communication, and social media outreach may enhance engagement and screening uptake among WLHIV. Findings inform strategies to scale CC screening in high-risk populations across sub-Saharan Africa
Authors:
Presenter - Matt Asare, Baylor University
Co-Author - Dorcas Obiri-Yeboah, University of Cape Coast
Co-Author - Patrick Kafui-Akakpo, University of Cape Coast
Co-Author - Sebastian Ken-Amoah, University of Cape
Co-Author - Nancy Innocentia Ebu, University of Cape Coast
Evaluating the Impact of Tailored Strategies on a Produce Prescription Program’s Implementation Outcomes
Poster Number: A93Time: 05:00 PM - 05:50 PM
Topics: Implementation Science , Diet, Nutrition, and Eating Disorders
Background: “Food is Medicine” programs can improve food insecurity and diet-related health outcomes. Produce prescription programs, a type of Food is Medicine program, entail healthcare providers “prescribing” free or reduced-cost vegetables to eligible patients. Previous studies identified multi-level barriers to implementing Food is Medicine programs. However, there is scant research examining how implementation strategies can improve Food is Medicine implementation outcomes. This study aims to assess changes in implementation outcomes following the introduction of tailored implementation strategies.
Methods: “VeggieRx” is an annual, 6-month produce prescription program in Rhode Island. Primary care providers in one hospital system referred eligible patients to Southside Community Land Trust (SCLT), a non-profit organization, which coordinated biweekly produce deliveries to patients’ homes. This single-arm pilot study measured implementation outcomes (i.e., adoption, implementation (fidelity)) before and after strategies were applied for the 2023 VeggieRx season. Strategies included improving the referral system and SCLT workflow. Adoption was measured as the number of physician referrals to VeggieRx. Implementation was measured by the number of individuals and households receiving produce deliveries. Patient acceptability was measured via text message after each delivery. Patient food security was also assessed. Descriptive statistics were calculated for all outcomes.
Results: VeggieRx referrals increased from 38 households in 2022 to 60 in 2023, following the introduction of the implementation strategies. The number of households receiving vegetables increased by 53.7% from 2022 to 2023, and the number of individuals receiving vegetables increased from 114 to 181. Participants used most to all of the vegetables in each delivery (Median=88.6% of weekly responses, IQR=78.4%,95.5%). Most participants already knew how to use the vegetables (Median=72.1% of responses, IQR=59.0%,75.6%) or by using the recipes included with the delivery (Median=27.0%, IQR=23.9%,39.5%). Food security increased from 18.2% of participants at baseline to 36.6% at follow-up.
Conclusion: This study demonstrates the value of tailored implementation strategies and their potential to expand the impact of future produce prescription programs.
Keywords: Research to practice translation, Health disparitiesMethods: “VeggieRx” is an annual, 6-month produce prescription program in Rhode Island. Primary care providers in one hospital system referred eligible patients to Southside Community Land Trust (SCLT), a non-profit organization, which coordinated biweekly produce deliveries to patients’ homes. This single-arm pilot study measured implementation outcomes (i.e., adoption, implementation (fidelity)) before and after strategies were applied for the 2023 VeggieRx season. Strategies included improving the referral system and SCLT workflow. Adoption was measured as the number of physician referrals to VeggieRx. Implementation was measured by the number of individuals and households receiving produce deliveries. Patient acceptability was measured via text message after each delivery. Patient food security was also assessed. Descriptive statistics were calculated for all outcomes.
Results: VeggieRx referrals increased from 38 households in 2022 to 60 in 2023, following the introduction of the implementation strategies. The number of households receiving vegetables increased by 53.7% from 2022 to 2023, and the number of individuals receiving vegetables increased from 114 to 181. Participants used most to all of the vegetables in each delivery (Median=88.6% of weekly responses, IQR=78.4%,95.5%). Most participants already knew how to use the vegetables (Median=72.1% of responses, IQR=59.0%,75.6%) or by using the recipes included with the delivery (Median=27.0%, IQR=23.9%,39.5%). Food security increased from 18.2% of participants at baseline to 36.6% at follow-up.
Conclusion: This study demonstrates the value of tailored implementation strategies and their potential to expand the impact of future produce prescription programs.
Authors:
Presenter - Emily Fu, PhD, MPH, The Warren Alpert Medical School of Brown University
Co-Author - Alison Tovar, PhD, MPH, Brown University School of Public Health
Co-Author - Nadia Tsado, MPH, Brown University School of Public Health
Co-Author - Linda Guzman, PhD, The Warren Alpert Medical School of Brown University
Co-Author - Ariana Albanese, The Warren Alpert Medical School of Brown University
Co-Author - Brady Dunklee, Care New England Healthcare System
Co-Author - Kelli Scott, PhD, Northwestern University Feinberg School of Medicine
Co-Author - Hannah Frank, The Warren Alpert Medical School of Brown University
Enhancing actionability of federal and state health data dashboards for supporting evidence-based health policies and practices
Poster Number: A94Time: 05:00 PM - 05:50 PM
Topics: Implementation Science , Digital Health
Dashboards can be cost-effective tools for brokering timely, relevant, and credible research evidence to a wide range of health decision-makers if they are actionable (i.e., usable, useful, and decision support-oriented). A cluster probability sample of current U.S. federal and state public health dashboards (N=210) was analyzed for actionability. The theory-grounded coding instrument was developed and validated iteratively with inputs from the literature and an expert convening and then fine-tuned via intercoder reliability tests. Dashboards sampled were accessed multiple times over a year (July 2024-July 2025) to ensure they are active and unchanged. Access to about 30% of federal dashboards has been suspended to comply with recent executive orders, specifically dashboards visualizing COVID-19, HIV/AIDS, and health inequities-related data, and some were altered to restrict data analyses by sex and race/ethnicity categories. About one-third of all state dashboards rely on third-party platforms for designing and hosting dashboards, raising legitimate concerns regarding accessibility and sustainability. Federal dashboards (n=58) scored higher than state dashboards (n=152) on most indicators of usability (accessibility, ease of navigation, interactivity, data visualization, and technical support) but were comparable in usefulness (data customization, interpretation, and analysis affordances). Still, both federal and state dashboards primarily utilize population-level epidemiological and health services data, but not also other types of relevant data (e.g., behavioral and public opinion data) or data that support mapping and monitoring of available community assets, which limits their usefulness. Data used in dashboards is primarily drawn from general and patient populations, although state dashboards are more likely to incorporate local data to enhance relevance and actionability. Data specific to underserved or vulnerable populations other than children are rarely used, further perpetuating potential bias due to data absenteeism. Information regarding the identity of dashboard creator or funding source is missing from 80% of dashboards, potentially undermining user trust. Actionability of public health dashboards can be significantly improved if they adhere to a common set of design and implementation standards. Additional research and investments are needed to advance the design, implementation, and adaptation of these tools for greater impact.
Keywords: Informatics, Decision makingAuthors:
Co-Author - Itzhak Yanovitzky, PhD, Rutgers University
Co-Author - Gretchen Stahlman, PhD, Florida State University
Co-Author - Charles Senteio, PhD, LMSW, MBA, Rutgers University
Recruiting dyads to inform a partner-based behavioral hypertension intervention in primary care: “Heart Care Pairs”
Poster Number: A95Time: 05:00 PM - 05:50 PM
Topics: Integrated Primary Care, Cardiovascular Disease
BACKGROUND: Nearly half of adults in the US are living with hypertension (HTN), and the majority of those do not have their HTN under control. HTN diagnosis and treatment often occur in primary care. Interventions include lifestyle modifications (e.g., diet and physical activity changes) and blood pressure lowering medications. The present study aimed to assess the feasibility of recruiting dyads from primary care and describe the behavioral health and social support needs of patients with HTN and their potential care partners.
METHODS: Participants were recruited from primary care practices in Birmingham, AL. Patients were eligible if they were adults, diagnosed with HTN, and willing to invite someone to accompany them to a study visit. Visits included quantitative surveys and semi-structured qualitative interviews with the 1) patient, 2) partner, and 3) dyad. Data were combined in a convergent parallel mixed methods design to describe the health and social support needs of dyads and to inform the adaptation of the Heart Care Pairs Intervention for future pilot testing.
RESULTS: Thirty-five dyads completed the study, meeting the recruitment goal in six months. The average age of the patient group was 50.5 (SD: 11.9, range: 26-73) and the partner group was 45.7 (SD: 18.7, range: 19-85); 69% of the patients and 66% of the partners were women; 74% in both groups were Black/African American. Dyad types varied including, in relation to the patient: spouses (34%), adult children (23%), neighbors/friends (20%), elder parents (11%), siblings (6%), an aunt and an ex-spouse. Half (51%) of the partner group reported they also took medications for HTN. In qualitative interviews participants recalled receiving medications for HTN and far less, if any, time on lifestyle modifications. Participants expressed greatest need for dietary guidance and stress management. Many shared past passive involvement in their partners’ medical visits and were willing to actively receive education and communication tools if offered as part of their primary care.
CONCLUSIONS: A variety of dyads can be recruited from primary care to inform interventions involving lifestyle modifications with social support. Team-based care including behavioral health consultants can help offload demands on primary care providers to meet patients’ needs for lifestyle behavior change. Actively involving a care partner in medical visits could help bolster the effectiveness of heart health recommendations.
Keywords: Primary care, HypertensionMETHODS: Participants were recruited from primary care practices in Birmingham, AL. Patients were eligible if they were adults, diagnosed with HTN, and willing to invite someone to accompany them to a study visit. Visits included quantitative surveys and semi-structured qualitative interviews with the 1) patient, 2) partner, and 3) dyad. Data were combined in a convergent parallel mixed methods design to describe the health and social support needs of dyads and to inform the adaptation of the Heart Care Pairs Intervention for future pilot testing.
RESULTS: Thirty-five dyads completed the study, meeting the recruitment goal in six months. The average age of the patient group was 50.5 (SD: 11.9, range: 26-73) and the partner group was 45.7 (SD: 18.7, range: 19-85); 69% of the patients and 66% of the partners were women; 74% in both groups were Black/African American. Dyad types varied including, in relation to the patient: spouses (34%), adult children (23%), neighbors/friends (20%), elder parents (11%), siblings (6%), an aunt and an ex-spouse. Half (51%) of the partner group reported they also took medications for HTN. In qualitative interviews participants recalled receiving medications for HTN and far less, if any, time on lifestyle modifications. Participants expressed greatest need for dietary guidance and stress management. Many shared past passive involvement in their partners’ medical visits and were willing to actively receive education and communication tools if offered as part of their primary care.
CONCLUSIONS: A variety of dyads can be recruited from primary care to inform interventions involving lifestyle modifications with social support. Team-based care including behavioral health consultants can help offload demands on primary care providers to meet patients’ needs for lifestyle behavior change. Actively involving a care partner in medical visits could help bolster the effectiveness of heart health recommendations.
Authors:
Presenter - Kaylee Crockett, PhD, University of Alabama at Birmingham
Co-Author - Mari Katundu, MSc, University of Alabama at Birmingham
Co-Author - Tejossy John, MPH, University of Alabama at Birmingham
Correlates of Always Receiving Help from Primary Care Offices in Coordinating Care: Findings from the 2024 Health Information National Trends Survey
Poster Number: A96Time: 05:00 PM - 05:50 PM
Topics: Integrated Primary Care, Cardiovascular Disease
Purpose: Primary care provider (PCP) offices play a key role in coordinating care among multiple providers and services, particularly for patients with complex health needs. In the present study, we evaluated potential correlates of participants reporting that they “always” received the help they needed from their PCP office to manage care across providers and services.
Methods: We conducted a cross-sectional, secondary analysis of the National Cancer Institute’s 2024 Health Information National Trends Survey (HINTS 7; N= 7278). Data were collected March-September 2024 via two modes: paper and web-based survey. The primary outcome was: “In the past 12 months, how often did you get the help you needed from your primary care provider’s office to manage your care among different providers and services?” Responses were dichotomized as “always” vs. not always (usually, sometimes, or never combined). Candidate correlates included sociodemographic characteristics (age, sex, race/ethnicity); history of diabetes, hypertension, heart condition, chronic lung disease, depression/anxiety, or cancer; confidence completing medical forms (proxy for health literacy); confidence managing one’s health; patient portal use and encouragement; frequency of health care visits; online health information–seeking skills; and patient-centered communication (PCC) scores. Complete-case analysis yielded an analytic sample of 4,067 (1,771 always; 2,296 not always). Univariable and multivariable logistic regression models were estimated in SAS 9.4; adjusted odds ratios (ORs) and 95% confidence intervals (CIs) are reported.
Results: Overall, 44% reported “always” receiving help from their PCP office to manage care. In the multivariable logistic regression model, greater odds of “always” were observed for participants with a heart condition (OR=2.063, 95% CI: 1.319–3.226), those who were “very” confident completing medical forms (OR=1.462, 95% CI: 1.019–2.097), and for higher PCC scores (per 1-point increase: OR=1.046, 95% CI: 1.039–1.054).
Conclusion: Perceiving that PCP offices “always” help manage care was associated with having a heart condition, greater confidence completing medical forms, and stronger PCC. Interventions that enhance PCC and health literacy may improve the consistency of primary care support for coordination across providers and services.
Keywords: Cardiovascular disease, Health communicationMethods: We conducted a cross-sectional, secondary analysis of the National Cancer Institute’s 2024 Health Information National Trends Survey (HINTS 7; N= 7278). Data were collected March-September 2024 via two modes: paper and web-based survey. The primary outcome was: “In the past 12 months, how often did you get the help you needed from your primary care provider’s office to manage your care among different providers and services?” Responses were dichotomized as “always” vs. not always (usually, sometimes, or never combined). Candidate correlates included sociodemographic characteristics (age, sex, race/ethnicity); history of diabetes, hypertension, heart condition, chronic lung disease, depression/anxiety, or cancer; confidence completing medical forms (proxy for health literacy); confidence managing one’s health; patient portal use and encouragement; frequency of health care visits; online health information–seeking skills; and patient-centered communication (PCC) scores. Complete-case analysis yielded an analytic sample of 4,067 (1,771 always; 2,296 not always). Univariable and multivariable logistic regression models were estimated in SAS 9.4; adjusted odds ratios (ORs) and 95% confidence intervals (CIs) are reported.
Results: Overall, 44% reported “always” receiving help from their PCP office to manage care. In the multivariable logistic regression model, greater odds of “always” were observed for participants with a heart condition (OR=2.063, 95% CI: 1.319–3.226), those who were “very” confident completing medical forms (OR=1.462, 95% CI: 1.019–2.097), and for higher PCC scores (per 1-point increase: OR=1.046, 95% CI: 1.039–1.054).
Conclusion: Perceiving that PCP offices “always” help manage care was associated with having a heart condition, greater confidence completing medical forms, and stronger PCC. Interventions that enhance PCC and health literacy may improve the consistency of primary care support for coordination across providers and services.
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
Co-Author - Megan Dekker, MD, Henry Ford Health
Co-Author - Joseph Miller, MD, Henry Ford Health
Primary Care Provider Perspectives on Managing Cancer Survivors with Multiple Chronic Conditions
Poster Number: A97Time: 05:00 PM - 05:50 PM
Topics: Integrated Primary Care, Decision Making
Background: Cancer survivors with multiple chronic conditions (MCCs) face complex health needs. Primary care providers (PCPs) are central to long-term survivorship management; yet, little is known about their practices, perspectives, and needs for managing this population.
Purpose: The objective of this study was to characterize PCP experiences, including differences in care approaches, perceived challenges, and resource needs, in managing cancer survivors with MCCs.
Methods: We conducted a short (<10 min) online survey of PCPs associated with an academic medical cancer center in Summer 2025. The survey assessed PCP confidence in managing cancer survivors with MCCs, their care approach with this population, and perceived barriers and resource gaps. Descriptive statistics summarized quantitative responses; open-text responses were analyzed thematically.
Results: Twenty-three PCPs with varied clinical experience completed the survey (82% completion rate). Commonly encountered comorbidities included depression (20%), hypertension (18%), and type 2 diabetes (16%). Hematologic (14%), brain (13%), pancreatic (12%), and head and neck (12%) cancer histories pose the greatest management challenges for MCC survivors. Commonly perceived factors that impact the health of survivors with MCCs included low socioeconomic status (65%), limited social support (78%), and limited access to healthcare (83%). Most PCPs (87%) reported modifying care for cancer survivors with MCCs. Common strategies included (1) enhanced surveillance, (2) engagement with oncology team, (3) increased focus on psychosocial health, and (4) shifting structure of follow-up visits. Reported gaps and challenges to providing care for this population included (1) limited knowledge of medical needs of cancer survivors (e.g., late effects, tailored screening), (2) lack of access to necessary social and clinical supportive resources for patients, (3) difficulties with care coordination with oncology team and services, and (4) shortness of medical appointments.
Conclusions: PCPs adapt care for cancer survivors with MCCs but face knowledge, resource, and care coordination barriers. Addressing these gaps through survivorship-specific training, improved access to supportive services, and streamlined oncology-primary care communication could enhance care quality. These findings will inform the design of interventions to strengthen PCP capacity in survivorship care.
Keywords: Primary care, ChronicPurpose: The objective of this study was to characterize PCP experiences, including differences in care approaches, perceived challenges, and resource needs, in managing cancer survivors with MCCs.
Methods: We conducted a short (<10 min) online survey of PCPs associated with an academic medical cancer center in Summer 2025. The survey assessed PCP confidence in managing cancer survivors with MCCs, their care approach with this population, and perceived barriers and resource gaps. Descriptive statistics summarized quantitative responses; open-text responses were analyzed thematically.
Results: Twenty-three PCPs with varied clinical experience completed the survey (82% completion rate). Commonly encountered comorbidities included depression (20%), hypertension (18%), and type 2 diabetes (16%). Hematologic (14%), brain (13%), pancreatic (12%), and head and neck (12%) cancer histories pose the greatest management challenges for MCC survivors. Commonly perceived factors that impact the health of survivors with MCCs included low socioeconomic status (65%), limited social support (78%), and limited access to healthcare (83%). Most PCPs (87%) reported modifying care for cancer survivors with MCCs. Common strategies included (1) enhanced surveillance, (2) engagement with oncology team, (3) increased focus on psychosocial health, and (4) shifting structure of follow-up visits. Reported gaps and challenges to providing care for this population included (1) limited knowledge of medical needs of cancer survivors (e.g., late effects, tailored screening), (2) lack of access to necessary social and clinical supportive resources for patients, (3) difficulties with care coordination with oncology team and services, and (4) shortness of medical appointments.
Conclusions: PCPs adapt care for cancer survivors with MCCs but face knowledge, resource, and care coordination barriers. Addressing these gaps through survivorship-specific training, improved access to supportive services, and streamlined oncology-primary care communication could enhance care quality. These findings will inform the design of interventions to strengthen PCP capacity in survivorship care.
Authors:
Presenter - Wen You, PhD, University of Virginia
Author - Naveen Abedin, University of Virginia
Author - Nicholas Kidd, University of Virginia
Author - Jundong Li, Associate Professor, University of Virginia
Author - Kathleen Porter, University of Virginia
Geospatial Analysis of Yoga Studios and Cardiometabolic Conditions: Evaluating Accessibility of a Recommended Wellness Practice
Poster Number: A98Time: 05:00 PM - 05:50 PM
Topics: Integrative Health and Spirituality, Health Disparities
Background: Yoga is increasingly recognized as an effective strategy for preventing and managing chronic conditions such as obesity, hypertension, and diabetes. However, little is known about how access to yoga varies geographically or whether yoga studio availability aligns with population health needs. Understanding these spatial patterns is essential, as yoga can serve as a low-cost intervention for cardiometabolic health and stress management. This study examined the distribution of yoga studios across Massachusetts and whether density correlates with county-level indicators of chronic disease burden and social determinants of health (SDOH).
Methods: We conducted a geospatial analysis using ArcGIS Pro 3.5.2 to map studio locations from the Google Maps Platform. County-level data on chronic disease prevalence (obesity, hypertension, diabetes) and SDOH (education, income, commuting time, food insecurity) were sourced from public databases. Bivariate choropleth mapping and Spearman correlations identified spatial patterns and associations between studio density and SDOH.
Results: Studio density varied across Massachusetts, ranging from 0.02 to 0.28 per 1,000 residents. Counties with higher studio density had higher educational attainment (≥470 per 1,000 college-educated) and fewer residents with long commutes (~20 vs. 52 per 1,000 population). Significant negative correlations were found between density and commuting time (ρ = –0.691, FDR p = 0.038) and road network density (ρ = –0.684, FDR p = 0.041). No significant correlations were observed between density and chronic disease prevalence.
Conclusion: This study found that yoga studio density in Massachusetts does not align with areas of greatest chronic disease burden. Instead, studios were concentrated in counties with higher educational attainment, lower food insecurity, and more favorable commuting patterns. Counties with high obesity, diabetes, and hypertension often had fewer studios and greater socioeconomic challenges. These patterns suggest that access to yoga may be shaped more by structural and economic conditions than by community health needs. Addressing these mismatches will be essential to ensuring that yoga and other integrative health approaches are accessible to the populations who stand to benefit most. Future research should test whether finer geographic analyses and qualitative studies can clarify how spatial access influences yoga participation among people with chronic disease.
Keywords: Disease, Health disparitiesMethods: We conducted a geospatial analysis using ArcGIS Pro 3.5.2 to map studio locations from the Google Maps Platform. County-level data on chronic disease prevalence (obesity, hypertension, diabetes) and SDOH (education, income, commuting time, food insecurity) were sourced from public databases. Bivariate choropleth mapping and Spearman correlations identified spatial patterns and associations between studio density and SDOH.
Results: Studio density varied across Massachusetts, ranging from 0.02 to 0.28 per 1,000 residents. Counties with higher studio density had higher educational attainment (≥470 per 1,000 college-educated) and fewer residents with long commutes (~20 vs. 52 per 1,000 population). Significant negative correlations were found between density and commuting time (ρ = –0.691, FDR p = 0.038) and road network density (ρ = –0.684, FDR p = 0.041). No significant correlations were observed between density and chronic disease prevalence.
Conclusion: This study found that yoga studio density in Massachusetts does not align with areas of greatest chronic disease burden. Instead, studios were concentrated in counties with higher educational attainment, lower food insecurity, and more favorable commuting patterns. Counties with high obesity, diabetes, and hypertension often had fewer studios and greater socioeconomic challenges. These patterns suggest that access to yoga may be shaped more by structural and economic conditions than by community health needs. Addressing these mismatches will be essential to ensuring that yoga and other integrative health approaches are accessible to the populations who stand to benefit most. Future research should test whether finer geographic analyses and qualitative studies can clarify how spatial access influences yoga participation among people with chronic disease.
Authors:
Author - Ethan Ouimet, MS, RDN, LDN, Northeastern University
Co-Author - Shayna Basu, Northeastern University
Co-Author - Angeles Tepper, PhD, Wayne State University
Co-Author - Neha Gothe, PhD, Northeastern University
Expressive arts versus mindful yoga for individuals with mild-to-moderate Parkinson’s Disease: A non-inferiority randomized controlled trial
Poster Number: A99Time: 05:00 PM - 05:50 PM
Topics: Integrative Health and Spirituality, Stress
Mind-body interventions, such as expressive arts therapy (EXAT) and mindful yoga (MY), may enhance wellbeing in individuals with Parkinson’s disease (PD). However, their comparative effectiveness remains uncertain.
This non-inferiority randomized controlled trial (RCT) evaluates whether EXAT is non-inferior to MY in improving motor and psychosocial outcomes for individuals with mild-to-moderate PD.
A single-blind, two-arm RCT was conducted in Hong Kong from January 2024 to July 2025. A total of 145 participants (mean [SD] age, 66.5 [7.9] years; 73 [50.3%] male) diagnosed with mild-to-moderate PD were randomized to either an EXAT (n=77) or MY (n=68) intervention.
Participants received either EXAT (encompassing dance, movement, drawing, and music) or MY, delivered over 6 weeks with 1.5 hours for each week.
The primary outcome was perceived stress. Secondary outcomes included quality of life (PDQ-8, WHOQOL-BREF), self-efficacy, self-compassion, motor function, social support, and physical activity.
Using intention-to-treat principles, linear mixed-effects regression models revealed no significant between-group differences in perceived stress at any timepoint, with no group × time interaction. Secondary outcomes showed no significant changes over time or between groups. Social support significantly improved in the MY group at 6-month follow-up (mean difference [MD], 0.37 [95% CI, 0.02 to 0.71]; P = 0.037) and marginally in the EXAT group (MD, 0.28 [95% CI, -0.04 to 0.60]; P = 0.09). Physical activity increased significantly post-intervention in the EXAT group (MD, 0.36 [95% CI, 0.03 to 0.70]; P = 0.03) and marginally in the MY group (MD, 0.36 [95% CI, 0.02 to 0.74]; P = 0.066), with no between-group differences.
EXAT showed equal beneficial to mindful yoga in supporting psychosocial wellbeing in individuals with mild-to-moderate PD, indicating its potential as an equally effective intervention. The significant improvement in social support in the mindful yoga group at follow-up suggests its mindfulness focus may foster stronger interpersonal connections, while the EXAT group may has a potential trend toward enhanced social engagement through creative expression. Future research should adopt the Multiphase Optimization Strategy to investigate and optimize the interaction effects of the active components of the two interventions, as well as explore long-term effects and underlying mechanisms to better understand their therapeutic potential.
Keywords: Complementary Medicine, Randomized controlled trialThis non-inferiority randomized controlled trial (RCT) evaluates whether EXAT is non-inferior to MY in improving motor and psychosocial outcomes for individuals with mild-to-moderate PD.
A single-blind, two-arm RCT was conducted in Hong Kong from January 2024 to July 2025. A total of 145 participants (mean [SD] age, 66.5 [7.9] years; 73 [50.3%] male) diagnosed with mild-to-moderate PD were randomized to either an EXAT (n=77) or MY (n=68) intervention.
Participants received either EXAT (encompassing dance, movement, drawing, and music) or MY, delivered over 6 weeks with 1.5 hours for each week.
The primary outcome was perceived stress. Secondary outcomes included quality of life (PDQ-8, WHOQOL-BREF), self-efficacy, self-compassion, motor function, social support, and physical activity.
Using intention-to-treat principles, linear mixed-effects regression models revealed no significant between-group differences in perceived stress at any timepoint, with no group × time interaction. Secondary outcomes showed no significant changes over time or between groups. Social support significantly improved in the MY group at 6-month follow-up (mean difference [MD], 0.37 [95% CI, 0.02 to 0.71]; P = 0.037) and marginally in the EXAT group (MD, 0.28 [95% CI, -0.04 to 0.60]; P = 0.09). Physical activity increased significantly post-intervention in the EXAT group (MD, 0.36 [95% CI, 0.03 to 0.70]; P = 0.03) and marginally in the MY group (MD, 0.36 [95% CI, 0.02 to 0.74]; P = 0.066), with no between-group differences.
EXAT showed equal beneficial to mindful yoga in supporting psychosocial wellbeing in individuals with mild-to-moderate PD, indicating its potential as an equally effective intervention. The significant improvement in social support in the mindful yoga group at follow-up suggests its mindfulness focus may foster stronger interpersonal connections, while the EXAT group may has a potential trend toward enhanced social engagement through creative expression. Future research should adopt the Multiphase Optimization Strategy to investigate and optimize the interaction effects of the active components of the two interventions, as well as explore long-term effects and underlying mechanisms to better understand their therapeutic potential.
Authors:
Presenter - Rainbow Ho, PhD, CBH, HKU
Co-Presenter - Jojo Yan Yan Kwok, BN(Hons), MPH, PhD, The University of Hong Kong
Co-Author - Qi Wang, The University of Hong Kong
Co-Author - Hiu Ying FUNG, PhD, The University of Hong Kong
Co-Author - Charis Ann LAI, The University of Hong Kong
Co-Author - Sunny Yu Yee CHENG, The University of Hong Kong
Co-Author - Emily Wing Tung SZETO, The University of Hong Kong
Goal disturbance and emotional symptoms in patients with cancer
Poster Number: A100Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Cancer
Background. Cancer is a major stressor leading to a wide range of emotions. Some emotions are adaptive, in the sense that they help patients cope with cancer. Emotions can also be maladaptive, if they are disproportionately severe or persistent and interfere with functioning. To distinguish between adaptive and maladaptive emotions, we integrated theories on goal disturbance and mental disorders and derived two hypotheses.
Objective. To test the hypotheses that (1) goal disturbance and emotional symptoms are reciprocally and positively associated to each other; and (2) the association between goal disturbance and emotional symptoms is stronger in patients with maladaptive emotions as compared to patients with adaptive emotions.
Methods. Patients (n=132) filled out Ecological Momentary Assessments 5 times per day for 14 consecutive days in which emotional symptoms and activities related to life goals were documented. The importance of life goals in six domains were assessed with an interview (work/study, disease-related health, lifestyle health, social activities, religious, spiritual and intellectual activities, and leisure). Patients were grouped as having adaptive or maladaptive emotions based on a reference standard (a psychiatric diagnostic assessment, or the subjective need for professional mental healthcare). Linear mixed models were built in R, with either goal disturbance or negative emotional symptoms as dependent variable.
Results. Goal disturbance for social activities and leisure activities were significantly and positively associated with emotional symptoms. Goal disturbance for disease-related health activities was significantly and negatively associated with emotional symptoms; no significant association was found for other activities. With negative emotions as outcome variable, evidence was obtained that goal disturbance was more strongly associated with emotional symptoms in patients with maladaptive emotions than patients with adaptive emotions.
Conclusion. For social activities and leisure activities, these findings support the existence of reciprocal effects of goal disturbance and emotional symptoms, and of the effect of goal disturbance on the development of maladaptive emotions in patients with cancer.
Keywords: Cancer, Mental healthObjective. To test the hypotheses that (1) goal disturbance and emotional symptoms are reciprocally and positively associated to each other; and (2) the association between goal disturbance and emotional symptoms is stronger in patients with maladaptive emotions as compared to patients with adaptive emotions.
Methods. Patients (n=132) filled out Ecological Momentary Assessments 5 times per day for 14 consecutive days in which emotional symptoms and activities related to life goals were documented. The importance of life goals in six domains were assessed with an interview (work/study, disease-related health, lifestyle health, social activities, religious, spiritual and intellectual activities, and leisure). Patients were grouped as having adaptive or maladaptive emotions based on a reference standard (a psychiatric diagnostic assessment, or the subjective need for professional mental healthcare). Linear mixed models were built in R, with either goal disturbance or negative emotional symptoms as dependent variable.
Results. Goal disturbance for social activities and leisure activities were significantly and positively associated with emotional symptoms. Goal disturbance for disease-related health activities was significantly and negatively associated with emotional symptoms; no significant association was found for other activities. With negative emotions as outcome variable, evidence was obtained that goal disturbance was more strongly associated with emotional symptoms in patients with maladaptive emotions than patients with adaptive emotions.
Conclusion. For social activities and leisure activities, these findings support the existence of reciprocal effects of goal disturbance and emotional symptoms, and of the effect of goal disturbance on the development of maladaptive emotions in patients with cancer.
Authors:
Author - Joost Dekker, PhD, FSBM, Amsterdam University Medical Center (location VUmc)
Behavioral Pathways to Firearm Risk: The Role of Psychological Distress in Aggression and Attitudes Among Vulnerable Youth
Poster Number: A101Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Child and Family Health
Background: Firearm violence is a leading cause of death among U.S. youth, with Black adolescents experiencing homicide rates up to 18 times higher than their White peers. Youth attitudes toward guns and violence are shaped by behavioral and psychosocial factors, including aggression, mental health, and trauma exposure, but few studies examine how these factors interact. Psychological distress may play a key moderating role in how aggression manifests in pro-firearm beliefs, particularly among youth facing chronic adversity. Understanding these behavioral pathways is essential for informing trauma-informed, equity-focused prevention strategies.
Objective: To assess whether psychological distress moderates the relationship between two aggression subtypes: proactive (goal-driven) and reactive (impulsive), and attitudes toward guns and violence among high-risk youth.
Methods: Baseline data were drawn from a pilot digital intervention targeting firearm and substance use prevention (N = 70). Participants (ages 16–25) were recruited from clinical and community settings. Measures included the Attitudes Toward Guns and Violence Questionnaire (AGVQ™), Proactive and Reactive Aggression Questionnaire, PHQ-8 (depressive symptoms), and past-year violence exposure. Linear regression and moderation analyses tested whether psychological distress influenced the aggression–attitude link. Analyses were conducted using JASP and Python (Google Colab).
Results: AGVQ scores were strongly correlated with proactive aggression (r = .80), reactive aggression (r = .70), psychological distress (r = .69), depression (r = .69), and past-year violence exposure (r = .67), all p < .001. In regression models, only proactive aggression significantly predicted AGVQ scores (β = 1.19, p < .001). Psychological distress was not an independent predictor (p = .176) but modestly attenuated the reactive aggression–AGVQ link (β = -0.054, p = .084).
Conclusions: Proactive aggression was the strongest predictor of pro-firearm attitudes, regardless of psychological distress. These findings underscore the importance of addressing cognitive-behavioral aggression patterns alongside trauma and distress in youth violence prevention. Behavioral medicine approaches should tailor interventions to aggression subtype and embed emotional regulation strategies to reduce firearm risk among structurally marginalized youth.
Keywords: Violence, AdolescentsObjective: To assess whether psychological distress moderates the relationship between two aggression subtypes: proactive (goal-driven) and reactive (impulsive), and attitudes toward guns and violence among high-risk youth.
Methods: Baseline data were drawn from a pilot digital intervention targeting firearm and substance use prevention (N = 70). Participants (ages 16–25) were recruited from clinical and community settings. Measures included the Attitudes Toward Guns and Violence Questionnaire (AGVQ™), Proactive and Reactive Aggression Questionnaire, PHQ-8 (depressive symptoms), and past-year violence exposure. Linear regression and moderation analyses tested whether psychological distress influenced the aggression–attitude link. Analyses were conducted using JASP and Python (Google Colab).
Results: AGVQ scores were strongly correlated with proactive aggression (r = .80), reactive aggression (r = .70), psychological distress (r = .69), depression (r = .69), and past-year violence exposure (r = .67), all p < .001. In regression models, only proactive aggression significantly predicted AGVQ scores (β = 1.19, p < .001). Psychological distress was not an independent predictor (p = .176) but modestly attenuated the reactive aggression–AGVQ link (β = -0.054, p = .084).
Conclusions: Proactive aggression was the strongest predictor of pro-firearm attitudes, regardless of psychological distress. These findings underscore the importance of addressing cognitive-behavioral aggression patterns alongside trauma and distress in youth violence prevention. Behavioral medicine approaches should tailor interventions to aggression subtype and embed emotional regulation strategies to reduce firearm risk among structurally marginalized youth.
Authors:
Presenter - Chuka Emezue, PhD, MPH, MPA, CHES, Rush University College of Nursing
Feasibility and Acceptability of Smartphone-Based Ecological Momentary Assessment for Monitoring Suicidal Ideation Among Gay, Bisexual, and Other Men Who Have Sex with Men in Nepal
Poster Number: A102Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Methods and Measurement
Background
Suicide is a major cause of death in low- and middle-income countries (LMICs). Gay, bisexual, and other men who have sex with men (GBMSM) face disproportionate risks due to stigma and exclusion. Ecological momentary assessment (EMA) is increasingly being used to capture real-time fluctuations in suicidal ideation, but no studies have examined its feasibility or acceptability in LMICs, including Nepal.
Methods
Between May and July 2024, we enrolled 50 GBMSM with a history of suicidal ideation or moderate to severe depressive symptoms in Nepal. Participants completed three smartphone-based daily EMAs over a 30-day period. Feasibility was assessed through recruitment, retention, and EMA prompt compliance, whereas acceptability was evaluated through exit surveys and interviews.
Findings
Of the 55 individuals screened, 50 were enrolled, and all completed the baseline survey. Forty-eight participants (96%) responded to at least one EMA, completing 2,943 of the 4,500 surveys prompted (65.4%). EMA prompt compliance was similar across time points (66.9% morning, 64.5% afternoon, 64.8% evening) and did not differ between those who reported and those who did not report suicidal ideation (median 74% vs. 72%). In the adjusted linear regression models, prior suicide planning (β: -19·9, 95% CI: -36·2 to -3·7), chemsex engagement (β: -30·1, 95% CI: -50·4 to -9·7), and identity disclosure (β: -23·0, 95% CI: -45·8 to -1·3) were associated with lower compliance. Acceptability ratings were high (mean 4.0-4.4 across domains), with qualitative themes emphasizing ease of use, self-reflection, and perceived support, but concerns about repetitive suicide questions and privacy.
Conclusion
Smartphone-based EMA is feasible and acceptable for monitoring suicidal ideation among GBMSM in Nepal and may inform scalable digital suicide prevention interventions in similar LMIC settings.
Keywords: Mental health, MeasurementSuicide is a major cause of death in low- and middle-income countries (LMICs). Gay, bisexual, and other men who have sex with men (GBMSM) face disproportionate risks due to stigma and exclusion. Ecological momentary assessment (EMA) is increasingly being used to capture real-time fluctuations in suicidal ideation, but no studies have examined its feasibility or acceptability in LMICs, including Nepal.
Methods
Between May and July 2024, we enrolled 50 GBMSM with a history of suicidal ideation or moderate to severe depressive symptoms in Nepal. Participants completed three smartphone-based daily EMAs over a 30-day period. Feasibility was assessed through recruitment, retention, and EMA prompt compliance, whereas acceptability was evaluated through exit surveys and interviews.
Findings
Of the 55 individuals screened, 50 were enrolled, and all completed the baseline survey. Forty-eight participants (96%) responded to at least one EMA, completing 2,943 of the 4,500 surveys prompted (65.4%). EMA prompt compliance was similar across time points (66.9% morning, 64.5% afternoon, 64.8% evening) and did not differ between those who reported and those who did not report suicidal ideation (median 74% vs. 72%). In the adjusted linear regression models, prior suicide planning (β: -19·9, 95% CI: -36·2 to -3·7), chemsex engagement (β: -30·1, 95% CI: -50·4 to -9·7), and identity disclosure (β: -23·0, 95% CI: -45·8 to -1·3) were associated with lower compliance. Acceptability ratings were high (mean 4.0-4.4 across domains), with qualitative themes emphasizing ease of use, self-reflection, and perceived support, but concerns about repetitive suicide questions and privacy.
Conclusion
Smartphone-based EMA is feasible and acceptable for monitoring suicidal ideation among GBMSM in Nepal and may inform scalable digital suicide prevention interventions in similar LMIC settings.
Authors:
Presenter - Kamal Gautam, University of Connecticut
Co-Author - Kiran Paudel, BPH, University of Connecticut
Co-Author - Jeffrey Wickersham, Yale School of Medicine
Co-Author - Sandesh Bhusal, University of Connecticut
Co-Author - Md. Safaet Hossain Sujan, University of Connecticut
Co-Author - Antoine Khati, University of Connecticut
Co-Author - Prashu Ram Chaudhari, Blue Diamond Society, Nepal
Co-Author - Navin Devkota, National Academy of Health Sciences, Kathmandu, Nepal
Co-Author - Ran Xu, Uconn
Co-Author - Michael Copenhaver, UConn
Co-Author - Omkar Dhungel, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
Co-Author - Pablo K Valente, University of Connecticut
Co-Author - Roman Shrestha, PhD, MPH, University of Connecticut
Investigation of factors influencing mental health service referral and use among Chinese American populations using community-engaged implementation science
Poster Number: A103Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Community Engagement
Background: Asian Americans often experience a need for mental health treatments yet underutilize mental health services (MHS). Community-based MHS can play a key role in addressing this disparity. The Pui Tak Center (PTC), a community-based organization with strong relationships with local churches, serves recent immigrants and Chinese Americans in Chicagoland and implemented a reduced-cost program offering in-language MHS. Our community-academic partnership sought to characterize barriers to and facilitators of MHS referral and utilization among community members.
Methods: PTC staff members (n=11) from various programs and leaders (n=15) from 2 affiliated church organizations were recruited. In-depth, semi-structured interviews explored perceived barriers, facilitators, and opportunities regarding referral and utilization of MHS among community members. Data were analyzed using an inductive-deductive hybrid thematic approach. The Exploration, Preparation, Implementation Sustainment (EPIS) framework was used to organize findings.
Findings: Barriers to MHS referral and use within the EPIS outer context included community members’ low awareness of and stigma against mental health issues and treatments, low perceived priority of MHS, and high perceived cost of MHS. Facilitators within the inner context included collaboration between PTC and church affiliates (referral of clients from churches/social services programs to MHS, MHS fee subsidy agreements) and established trust between referring individuals (e.g., service providers, pastors) and community members. Innovation-related facilitators of referral included multilingual services and faith-based, culturally concordant MHS. Opportunities to increase MHS use among community members within the outer context included enhanced education and mental health awareness.
Discussion: Our theory-driven characterization of barriers, facilitators, and opportunities to MHS referral and use serve to inform implementation practices of MHS programs in PTC and similar settings. Identified opportunities of increasing community education and mental health awareness may help address barriers salient to the Chinatown community, such as the stigmatization of MHS and difficulties accessing/prioritizing it. These findings can support the effective implementation of community-embedded MHS, which aim to address the multi-factorial challenges to mental health equity among Chinese American populations.
Keywords: Mental health, Community interventionMethods: PTC staff members (n=11) from various programs and leaders (n=15) from 2 affiliated church organizations were recruited. In-depth, semi-structured interviews explored perceived barriers, facilitators, and opportunities regarding referral and utilization of MHS among community members. Data were analyzed using an inductive-deductive hybrid thematic approach. The Exploration, Preparation, Implementation Sustainment (EPIS) framework was used to organize findings.
Findings: Barriers to MHS referral and use within the EPIS outer context included community members’ low awareness of and stigma against mental health issues and treatments, low perceived priority of MHS, and high perceived cost of MHS. Facilitators within the inner context included collaboration between PTC and church affiliates (referral of clients from churches/social services programs to MHS, MHS fee subsidy agreements) and established trust between referring individuals (e.g., service providers, pastors) and community members. Innovation-related facilitators of referral included multilingual services and faith-based, culturally concordant MHS. Opportunities to increase MHS use among community members within the outer context included enhanced education and mental health awareness.
Discussion: Our theory-driven characterization of barriers, facilitators, and opportunities to MHS referral and use serve to inform implementation practices of MHS programs in PTC and similar settings. Identified opportunities of increasing community education and mental health awareness may help address barriers salient to the Chinatown community, such as the stigmatization of MHS and difficulties accessing/prioritizing it. These findings can support the effective implementation of community-embedded MHS, which aim to address the multi-factorial challenges to mental health equity among Chinese American populations.
Authors:
Presenter - Maya Lee, MA, University of Illinois Chicago
Co-Author - Layna Lu, Northwestern University Feinberg School of Medicine
Co-Author - Jane Mann, Pui Tak Center
Co-Author - David Wu, Pui Tak Center
Co-Author - Marym Zaheeruddin, Northwestern University
Co-Author - Si Hyun Park, University of Chicago
Co-Author - Kiarri Kershaw, PhD, Northwestern University Feinberg School of Medicine
Co-Author - Loretta Hsueh, PhD, University of Illinois at Chicago
Co-Author - Milkie Vu, PhD, MA, Northwestern University Feinberg School of Medicine
Racism, Psychosocial Resources, and Mental Health among Foreign-Born Chinese Immigrants in the U.S.: A Latent Class Analysis
Poster Number: A104Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Health Disparities
Background: Mental health disparities are often overlooked in minoritized groups, including foreign-born Chinese immigrants. Racism is a critical risk factor for poor mental health. Meanwhile, psychosocial resources, such as social support and coping strategies, play a significant role in fostering resilience against the harmful effects of racism.
Aims: This study aims to 1) identify distinct patterns of racism exposure and psychosocial resources among foreign-born Chinese immigrants and 2) examine these patterns in relation to depression and anxiety symptoms.
Methods: We analyzed data from an online survey with 458 foreign-born Chinese immigrants. Measures included racism (perceived racial discrimination, racism experienced, and racism heard) and psychosocial resources (social support, problem-focused, emotion-focused, and avoidant coping). Latent class analysis was used to identify distinct patterns of racism exposure and psychosocial resources. Binomial logistic regressions were used to examine associations between class membership and depression and anxiety, adjusting for sociodemographic, immigration-related, and acculturation-related factors.
Results: Among 458 participants (M age = 34, SD = 10.4), most were female (70%), married/partnered (63%), and had lived in the U.S. for an average of 9 years. Over half had a bachelor’s degree or higher (60%), were employed (53%), and reported household incomes ≤ $40,000 (48%). About two-thirds were U.S. citizens or permanent residents. Over one-third (36%) were at risk for depression, and 29% were at risk for anxiety. Four latent classes were identified: Class 1, “High Racism Exposure, Low Psychosocial Resources—Predominantly Negative Coping”; Class 2, “High Racism Exposure, Low Psychosocial Resources—No Negative Coping”; Class 3, “Low Racism Exposure, High Psychosocial Resources”; and Class 4, “Low Racism Exposure, Low Psychosocial Resources.” Participants in Classes 1 and 2 were at greater risk for depression and anxiety compared to Class 3.
Conclusion: The study revealed significant heterogeneity among foreign-born Chinese immigrants regarding their experiences of racism and access to psychosocial resources, leading to distinct mental health outcomes. Tailoring interventions to meet the specific needs of different subgroups while building psychosocial resources can more effectively support this population in managing the psychological impacts of racism.
Keywords: Mental health, Minority healthAims: This study aims to 1) identify distinct patterns of racism exposure and psychosocial resources among foreign-born Chinese immigrants and 2) examine these patterns in relation to depression and anxiety symptoms.
Methods: We analyzed data from an online survey with 458 foreign-born Chinese immigrants. Measures included racism (perceived racial discrimination, racism experienced, and racism heard) and psychosocial resources (social support, problem-focused, emotion-focused, and avoidant coping). Latent class analysis was used to identify distinct patterns of racism exposure and psychosocial resources. Binomial logistic regressions were used to examine associations between class membership and depression and anxiety, adjusting for sociodemographic, immigration-related, and acculturation-related factors.
Results: Among 458 participants (M age = 34, SD = 10.4), most were female (70%), married/partnered (63%), and had lived in the U.S. for an average of 9 years. Over half had a bachelor’s degree or higher (60%), were employed (53%), and reported household incomes ≤ $40,000 (48%). About two-thirds were U.S. citizens or permanent residents. Over one-third (36%) were at risk for depression, and 29% were at risk for anxiety. Four latent classes were identified: Class 1, “High Racism Exposure, Low Psychosocial Resources—Predominantly Negative Coping”; Class 2, “High Racism Exposure, Low Psychosocial Resources—No Negative Coping”; Class 3, “Low Racism Exposure, High Psychosocial Resources”; and Class 4, “Low Racism Exposure, Low Psychosocial Resources.” Participants in Classes 1 and 2 were at greater risk for depression and anxiety compared to Class 3.
Conclusion: The study revealed significant heterogeneity among foreign-born Chinese immigrants regarding their experiences of racism and access to psychosocial resources, leading to distinct mental health outcomes. Tailoring interventions to meet the specific needs of different subgroups while building psychosocial resources can more effectively support this population in managing the psychological impacts of racism.
Authors:
Presenter - Yang Li, PhD, RN, University of Texas at Austin School of Nursing
Co-Author - Pranavi Garlapati, University of Miami Miller School of Medicine
Co-Author - Milkie Vu, PhD, MA, Northwestern University
Latent Profiles of Proximal Minority Stress among Sexual Minority Men in the U.S.: The Role of Relationship Interaction Patterns in Mental Health Care Engagement
Poster Number: A105Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Health Disparities
Background: Exposure to minority stress is linked to adverse mental health outcomes among sexual minority men (SMM). For those in same-sex relationships, prior exposure to minority stress may influence the dynamics within their relationship, which in turn affects health behaviors. Yet, little is known about distinct minority stress profiles and their associations with mental health service use. Further, the role of relationship interaction patterns in moderating these associations remains understudied, which was the focus of this study.
Methods: Data were drawn from the baseline survey of a longitudinal cohort study on intimate partner violence and sexual health among adult SMM in the U.S. Latent profile analysis identified proximal minority stress profiles using participants’ levels of internalized homophobia, internalized racism, and anticipated stigma. Logistic regressions tested associations between minority stress profiles and mental health care engagement, with demand-withdrawal interactions (i.e., one partner pressures or demands, while the other withdraws) as a moderator, controlling for age, race/ethnicity, and education.
Results: Out of the 500 SMM (Mage = 32.7 years; 70% SMM of color), 66% reported engaging in mental health care in the past 6 months, and 74% received mental medications in the past 6 months. Model fit indices (AIC, BIC, entropy, log-likelihood, class size) supported a 3-class solution: Class 1 (Low minority stress; 69.8% of the sample), Class 2 (High minority stress – Internalized Homophobia; 18.8%), and Class 3 (High minority stress – Internalized Homophobia and Racism; 11.4%). Compared to Class 1, SMM in Class 3 had significantly lower odds of mental health care engagement (OR = 0.36, p = .001) and psychiatric medication prescription (OR = 0.37, p = .004). There was a significant interaction between minority stress profiles and demand-withdrawal dynamic: In Class 3, higher demand-withdrawal interaction was associated with increased odds of receiving a mental health prescription, compared to Class 1.
Conclusions: Our findings elucidated the negative associations between minority stress profiles and mental health care engagement, with demand-withdrawal interactions exacerbating this association. These results highlight the need for interventions that simultaneously address both individual-level minority stress processes and couple-level interaction patterns to promote utilization of mental health services.
Keywords: Mental health, Minority groupsMethods: Data were drawn from the baseline survey of a longitudinal cohort study on intimate partner violence and sexual health among adult SMM in the U.S. Latent profile analysis identified proximal minority stress profiles using participants’ levels of internalized homophobia, internalized racism, and anticipated stigma. Logistic regressions tested associations between minority stress profiles and mental health care engagement, with demand-withdrawal interactions (i.e., one partner pressures or demands, while the other withdraws) as a moderator, controlling for age, race/ethnicity, and education.
Results: Out of the 500 SMM (Mage = 32.7 years; 70% SMM of color), 66% reported engaging in mental health care in the past 6 months, and 74% received mental medications in the past 6 months. Model fit indices (AIC, BIC, entropy, log-likelihood, class size) supported a 3-class solution: Class 1 (Low minority stress; 69.8% of the sample), Class 2 (High minority stress – Internalized Homophobia; 18.8%), and Class 3 (High minority stress – Internalized Homophobia and Racism; 11.4%). Compared to Class 1, SMM in Class 3 had significantly lower odds of mental health care engagement (OR = 0.36, p = .001) and psychiatric medication prescription (OR = 0.37, p = .004). There was a significant interaction between minority stress profiles and demand-withdrawal dynamic: In Class 3, higher demand-withdrawal interaction was associated with increased odds of receiving a mental health prescription, compared to Class 1.
Conclusions: Our findings elucidated the negative associations between minority stress profiles and mental health care engagement, with demand-withdrawal interactions exacerbating this association. These results highlight the need for interventions that simultaneously address both individual-level minority stress processes and couple-level interaction patterns to promote utilization of mental health services.
Authors:
Presenter - Junye Ma, SDSU-UC San Diego Joint Doctoral Program in Clinical Psychology
Co-Author - Sungsub Billy Choo, Ph.D., San Diego State University
Co-Author - Glenn Wagner, RAND
Co-Author - Erik Storholm, Ph.D., San Diego State Univeristy
Psycholytic Ketamine: A Gentle Gateway to Healing - Real-World Outcomes from 72,000 Patients
Poster Number: A106Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Digital Health
Joyous Public Benefit Corporation has treated over 72,000 patients with anxiety, depression, and PTSD using a novel low-dose ketamine protocol that represents a paradigm shift from traditional psychedelic approaches. In this presentation, we will share comprehensive outcomes from our chart review (currently in submission for publication) examining the safety and efficacy of psycholytic ketamine dosing.
Our approach—utilizing 10-120mg buccal ketamine taken daily for an average of 5 months—demonstrates clinical outcomes that surpass any known pharmaceutical treatment for anxiety and depression, with effect sizes exceeding 2.0 for moderate-to-severe cases. The "go low and go slow" philosophy maintains patient orientation and stability while facilitating profound therapeutic change, making it accessible for home-based treatment and integration with psychotherapy.
Key findings include:
* 68% response rates and 48% remission rates for depression by week 18
* 67% response rates and 51% remission rates for anxiety by week 18
* Exceptionally favorable safety profile with minimal adverse events
* High treatment retention when cost barriers are removed
* Preliminary evidence of sustained benefits post-treatment
Unlike psychedelic protocols requiring clinical supervision, psycholytic dosing creates a calm, oriented state where patients experience being "bigger than their bodies"—reducing overwhelming nervous system responses while maintaining full cognitive capacity. This approach bridges the gap between traditional therapy and psychedelic medicine, offering expansion without existential disruption.
We will also present our emerging "Joyous for Therapists" program, demonstrating how psycholytic states enhance therapeutic work, allowing patients to process previously inaccessible material while building sustainable mental health habits.
This talk offers practical insights for clinicians seeking evidence-based, accessible alternatives to high-dose psychedelic protocols, with profound implications for the future of mental health treatment.
Keywords: Anxiety, DepressionOur approach—utilizing 10-120mg buccal ketamine taken daily for an average of 5 months—demonstrates clinical outcomes that surpass any known pharmaceutical treatment for anxiety and depression, with effect sizes exceeding 2.0 for moderate-to-severe cases. The "go low and go slow" philosophy maintains patient orientation and stability while facilitating profound therapeutic change, making it accessible for home-based treatment and integration with psychotherapy.
Key findings include:
* 68% response rates and 48% remission rates for depression by week 18
* 67% response rates and 51% remission rates for anxiety by week 18
* Exceptionally favorable safety profile with minimal adverse events
* High treatment retention when cost barriers are removed
* Preliminary evidence of sustained benefits post-treatment
Unlike psychedelic protocols requiring clinical supervision, psycholytic dosing creates a calm, oriented state where patients experience being "bigger than their bodies"—reducing overwhelming nervous system responses while maintaining full cognitive capacity. This approach bridges the gap between traditional therapy and psychedelic medicine, offering expansion without existential disruption.
We will also present our emerging "Joyous for Therapists" program, demonstrating how psycholytic states enhance therapeutic work, allowing patients to process previously inaccessible material while building sustainable mental health habits.
This talk offers practical insights for clinicians seeking evidence-based, accessible alternatives to high-dose psychedelic protocols, with profound implications for the future of mental health treatment.
Authors:
Author - Sharon Niv, Joyous PBC
Author - , U Alberta
Author - , Joyous PBC
Author - , U Alberta
Desire to Change and NSSI Severity: Examining the Relationship Between Motivation and Self-Injury Frequency, Urges, and Thoughts
Poster Number: A107Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Health Disparities
Non-suicidal self-injury (NSSI) is a significant mental health concern, characterized by deliberate harm to one’s body without suicidal intent. Research indicates that approximately 13% of young adults in the U.S. engage in NSSI at some point in their lives. Given these concerns, understanding the factors that influence motivation for change is critical for developing effective interventions and reducing the burden of NSSI. Therefore, we explored how NSSI frequency, thoughts, and perceived impairment relate to the desire to change.
We analyzed data from 6,643 individuals (median age 17.89) who reported a lifetime history of NSSI after completing a mental health screener. Using linear regressions, we examined how motivation to change—assessed via agreement with statements like “I want to stop my self-injury”—related to NSSI frequency, urges, and thoughts. We hypothesized that individuals with lower motivation would engage in NSSI more frequently, whereas those with higher motivation would exhibit lower frequencies of NSSI.
Results indicated that individuals who expressed a greater desire to change their NSSI behavior engaged in self-injury on fewer days in the past month (β = -1.40, p < .001), experienced fewer urges to self-injure (β = -0.23, p < .001), and had fewer NSSI-related thoughts (β = -0.26, p < .001). Similarly, individuals who expressed a strong desire to stop self-injury—rather than just reduce it—engaged in self-injury less frequently (β = -1.48, p < .001), experienced fewer urges (β = -0.24, p < .001), and had fewer self-injurious thoughts (β = -0.27, p < .001). Finally, those who reported greater difficulty in stopping self-injury engaged in more frequent NSSI behaviors (β = 0.67, p < .001), experienced stronger urges (β = 0.12, p < .001), and had more persistent self-injury-related thoughts (β = 0.06, p < .001). Therefore, these findings suggest that lower motivation to change is associated with more frequent NSSI and stronger, more persistent urges and thoughts related to self-injury. In contrast, individuals who reported a desire to change their behavior engaged in NSSI less frequently in the past month compared to those without such desires.
This highlights the importance of motivation enhancement interventions that emphasize the negative impact of self-injury, especially for individuals who may not perceive their NSSI as problematic.
Keywords: Clinical applications, Mental healthWe analyzed data from 6,643 individuals (median age 17.89) who reported a lifetime history of NSSI after completing a mental health screener. Using linear regressions, we examined how motivation to change—assessed via agreement with statements like “I want to stop my self-injury”—related to NSSI frequency, urges, and thoughts. We hypothesized that individuals with lower motivation would engage in NSSI more frequently, whereas those with higher motivation would exhibit lower frequencies of NSSI.
Results indicated that individuals who expressed a greater desire to change their NSSI behavior engaged in self-injury on fewer days in the past month (β = -1.40, p < .001), experienced fewer urges to self-injure (β = -0.23, p < .001), and had fewer NSSI-related thoughts (β = -0.26, p < .001). Similarly, individuals who expressed a strong desire to stop self-injury—rather than just reduce it—engaged in self-injury less frequently (β = -1.48, p < .001), experienced fewer urges (β = -0.24, p < .001), and had fewer self-injurious thoughts (β = -0.27, p < .001). Finally, those who reported greater difficulty in stopping self-injury engaged in more frequent NSSI behaviors (β = 0.67, p < .001), experienced stronger urges (β = 0.12, p < .001), and had more persistent self-injury-related thoughts (β = 0.06, p < .001). Therefore, these findings suggest that lower motivation to change is associated with more frequent NSSI and stronger, more persistent urges and thoughts related to self-injury. In contrast, individuals who reported a desire to change their behavior engaged in NSSI less frequently in the past month compared to those without such desires.
This highlights the importance of motivation enhancement interventions that emphasize the negative impact of self-injury, especially for individuals who may not perceive their NSSI as problematic.
Authors:
Presenter - Israel Ramirez, BA, Northwestern University
Co-Author - Theresa Nguyen, MSW, Mental Health America
Co-Author - Kaylee Kruzan, MSW, PhD, Northwestern University
The association between everyday discrimination and adolescents' mental health: The role of coping approaches
Poster Number: A108Time: 05:00 PM - 05:50 PM
Topics: Mental Health, Quality of Life
Background: Everyday discrimination, daily microaggressions and unfair treatment by people due to factors such as race and gender, has been linked to poor mental health among adolescents. Given that early life mental health issues can undermine school performance, future orientation, and increase risk for later life psychopathology, identifying protective factors that can facilitate health adaptation during this critical period of development is a priority. To fill this gap, we investigated the association between everyday discrimination and depression, anxiety, non-suicidal self-injury (NSSI) and suicidal ideation (SI) and whether specific coping strategies (e.g., avoidant, problem- or emotion-focused) moderated this association among a diverse group of adolescents.
Methods: Data are baseline surveys of high school students (N=2,360) enrolled in a school-based study assessing health and developmental outcomes. GLMs tested the hypothesized association between everyday discrimination, and youths’ depression, anxiety, NSSI and SI and whether coping strategies moderated these relationships adjusting for age, sex, ethnicity, poverty status, and state.
Results: Half of the sample was female (52%), 31% identified as non-Hispanic White, followed by African American (29%), Hispanic (24%), Multiracial (9%), and Asian (7%). One-third of students (34%) experienced moderate to severe anxiety, half (51%) reported moderate to severe depressive symptoms, 17% engaged in NSSI, and 19% seriously considered suicide. Three out of four adolescents (78%) experienced some form of everyday discrimination. Everyday discrimination scores were associated with higher odds of moderate to severe anxiety (AOR = 1.15, 95%CI[1.10, 1.20]) or depression (AOR = 1.18, 95% CI[1.13, 1.23]), NSSI (AOR = 1.12, 95%CI[1.06, 1.18]), and SI (AOR = 1.08, 95%CI[1.03, 1.14]). In contrast to avoidant and emotion-focused coping strategies, problem-focused coping strategies were inversely associated with all four mental health indicators. Notably, avoidant and emotion-focused coping approaches exacerbated the negative effect of everyday discrimination for anxiety and depression (ps < 0.05).
Conclusion: Although policy and structural changes are needed, it is vital to create and deliver programs that help adolescents develop adaptive coping strategies rather than coping approaches that amplify the negative effects of discrimination.
Keywords: Adolescents, CopingMethods: Data are baseline surveys of high school students (N=2,360) enrolled in a school-based study assessing health and developmental outcomes. GLMs tested the hypothesized association between everyday discrimination, and youths’ depression, anxiety, NSSI and SI and whether coping strategies moderated these relationships adjusting for age, sex, ethnicity, poverty status, and state.
Results: Half of the sample was female (52%), 31% identified as non-Hispanic White, followed by African American (29%), Hispanic (24%), Multiracial (9%), and Asian (7%). One-third of students (34%) experienced moderate to severe anxiety, half (51%) reported moderate to severe depressive symptoms, 17% engaged in NSSI, and 19% seriously considered suicide. Three out of four adolescents (78%) experienced some form of everyday discrimination. Everyday discrimination scores were associated with higher odds of moderate to severe anxiety (AOR = 1.15, 95%CI[1.10, 1.20]) or depression (AOR = 1.18, 95% CI[1.13, 1.23]), NSSI (AOR = 1.12, 95%CI[1.06, 1.18]), and SI (AOR = 1.08, 95%CI[1.03, 1.14]). In contrast to avoidant and emotion-focused coping strategies, problem-focused coping strategies were inversely associated with all four mental health indicators. Notably, avoidant and emotion-focused coping approaches exacerbated the negative effect of everyday discrimination for anxiety and depression (ps < 0.05).
Conclusion: Although policy and structural changes are needed, it is vital to create and deliver programs that help adolescents develop adaptive coping strategies rather than coping approaches that amplify the negative effects of discrimination.
Authors:
Author - Jocelyn Gutierrez, MPHc, California State University, Northridge
Co-Author - Rasmey Gomez, MPHc, California State University, Northridge
Co-Author - Christopher Rogers, PhD, MPH, California State University, Northridge
Co-Author - Myriam Forster, PhD, MPH, California State University, Northridge
Developing and validating self-report measures of health professional students’ self-efficacy, behavioral intention, and outcome expectancy in addressing medication non-adherence
Poster Number: A109Time: 05:00 PM - 05:50 PM
Topics: Methods and Measurement, Multiple Health Behavior Change
Introduction
Medication nonadherence is a critical public health issue, contributing to substantial costs and preventable deaths. Healthcare professionals (HCPs) can play a key role in supporting adherence. However, research indicates that HCPs may struggle to identify and address nonadherence, perhaps in part because curricula surrounding this issue are largely unstandardized. Further, no validated tools exist to assess HCP students’ confidence and readiness to address patient nonadherence. In light of this gap, we developed and examined the psychometric properties of self-report measures of HCP students’ self-efficacy (SE), behavioral intention (BI), and outcome expectancy (OE) regarding clinical discussions related to nonadherence. We hypothesized that these measures would demonstrate acceptable validity and reliability.
Methods
Medical students (n = 409) completed our study-developed self-report surveys assessing SE, BI, and OE regarding identifying and addressing medication nonadherence. Each scale contained 14 items and was developed based on a model of constructs predictive of health professional behavior (Godin et al., 2008). Participants also completed a validated measure of SE of clinical communication skills among healthcare providers (SE-12) and an honest responding tendencies questionnaire. Measures’ psychometrics were examined via exploratory factor analysis (EFA) and correlations to assess divergent and convergent validity.
Results
EFAs revealed a one-factor solution as the optimal structure for each measure, accounting for 39% of the variance for SE, 49% for BI, and 42% for OE. Primary loadings were acceptable for each item on the measures (λs = .42-.78) and internal consistency was strong across measures (Cronbach’s αs = .89-.93). Bivariate correlations among SE, BI, and OE ranged from r = .38 - .56 (ps < .001), reflecting expected effect sizes for distinct but related constructs. Aligned with divergent validity, correlations between the unrelated honest responding questionnaire and SE (r = .11, p = .04), BI (r = .02, p > .05), and OE (r = .05, p > .05) were small. Further, SE-12 was positively associated with the nonadherence SE scale (r = .411, p < .001), OE (r = .218, p < .001) and BI (r = .218, p < .001).
Discussion
Findings provide preliminary evidence for the reliability and validity of the measures. Possible future uses include assessment and improvement of HCP training surrounding nonadherence.
Keywords: Methods, MeasurementMedication nonadherence is a critical public health issue, contributing to substantial costs and preventable deaths. Healthcare professionals (HCPs) can play a key role in supporting adherence. However, research indicates that HCPs may struggle to identify and address nonadherence, perhaps in part because curricula surrounding this issue are largely unstandardized. Further, no validated tools exist to assess HCP students’ confidence and readiness to address patient nonadherence. In light of this gap, we developed and examined the psychometric properties of self-report measures of HCP students’ self-efficacy (SE), behavioral intention (BI), and outcome expectancy (OE) regarding clinical discussions related to nonadherence. We hypothesized that these measures would demonstrate acceptable validity and reliability.
Methods
Medical students (n = 409) completed our study-developed self-report surveys assessing SE, BI, and OE regarding identifying and addressing medication nonadherence. Each scale contained 14 items and was developed based on a model of constructs predictive of health professional behavior (Godin et al., 2008). Participants also completed a validated measure of SE of clinical communication skills among healthcare providers (SE-12) and an honest responding tendencies questionnaire. Measures’ psychometrics were examined via exploratory factor analysis (EFA) and correlations to assess divergent and convergent validity.
Results
EFAs revealed a one-factor solution as the optimal structure for each measure, accounting for 39% of the variance for SE, 49% for BI, and 42% for OE. Primary loadings were acceptable for each item on the measures (λs = .42-.78) and internal consistency was strong across measures (Cronbach’s αs = .89-.93). Bivariate correlations among SE, BI, and OE ranged from r = .38 - .56 (ps < .001), reflecting expected effect sizes for distinct but related constructs. Aligned with divergent validity, correlations between the unrelated honest responding questionnaire and SE (r = .11, p = .04), BI (r = .02, p > .05), and OE (r = .05, p > .05) were small. Further, SE-12 was positively associated with the nonadherence SE scale (r = .411, p < .001), OE (r = .218, p < .001) and BI (r = .218, p < .001).
Discussion
Findings provide preliminary evidence for the reliability and validity of the measures. Possible future uses include assessment and improvement of HCP training surrounding nonadherence.
Authors:
Presenter - Emma Gaydos, BA, Rosalind Franklin University of Medicine and Science
Co-Author - Meghan Howe, MS, Rosalind Franklin University of Medicine and Science
Co-Author - Sophia Rintell, MS, Rosalind Franklin University of Medicine and Science
Co-Author - Petula Walsh-Grant, BA, Rosalind Franklin University of Medicine and Science
Co-Author - Rachel Neff Greenley, PhD, Rosalind Franklin University of Medicine & Science
Creating and Specifying a Comprehensive Measure of Support for Science
Poster Number: A110Time: 05:00 PM - 05:50 PM
Topics: Methods and Measurement, Health Communication and Policy
Science as an important United States institution is increasingly under attack on a national scale, including major funding cuts to the National Institutes of Health and CDC, as well as the rescission of research funds from many universities. Established scientific findings and views, including those on the safety of vaccines or the necessity of medical research at all, are being misrepresented and dismissed nationwide under anti-scientific leaders. However, this mistrust does not necessarily translate to how individuals perceive science overall nor whether they may support scientific endeavors. Within this concerning environment, it is important to have a full understanding of what support for science means.
While several measures of support for science exist, they each focus on different aspects of the construct, ranging from science comprehension and numeracy to attitudes towards science/scientists to norms for science and trust in scientists. Yet there are few efforts to comprehensively measure this phenomenon in a psychometrically robust and conceptually diverse way. We aimed to bring these aspects together into one comprehensive measure, recognising that psychology as a field has a surplus of measures but a dearth of robust assessments of them.
We conducted an exploratory factor analysis using an online sample of U.S. adults (N = 203, 51% female, 76% white) collected in September 2023. Participants responded to 48 items (each measured on a scale of 1-5) divided among six subscales presented in randomized order. Appropriate items were reverse-coded so all items were scored in the positive direction. Across 9744 observations we concluded a seven-factor model using an unweighted least squares estimation of Pearson product-moment correlations and an oblimin rotation was the best fitting model (RMSD = 0.036, hyperplane count = 228, high factor indeterminacy). This solution, which reduced the total number of items to 29, resulted in six subscales and one standalone item, including factors for science comprehension (6 items), trust in science and scientists (4 items), positive attitudes toward scientific research (4 items), numeracy (6 items), social norms for supporting science (4 items), and support for science funding (5 items). The standalone item related to decreased confidence in scientists when they change their mind. The comprehensiveness and psychometric rigor of this new measure suggests it may be useful in future research.
Keywords: Measurement, Health communicationWhile several measures of support for science exist, they each focus on different aspects of the construct, ranging from science comprehension and numeracy to attitudes towards science/scientists to norms for science and trust in scientists. Yet there are few efforts to comprehensively measure this phenomenon in a psychometrically robust and conceptually diverse way. We aimed to bring these aspects together into one comprehensive measure, recognising that psychology as a field has a surplus of measures but a dearth of robust assessments of them.
We conducted an exploratory factor analysis using an online sample of U.S. adults (N = 203, 51% female, 76% white) collected in September 2023. Participants responded to 48 items (each measured on a scale of 1-5) divided among six subscales presented in randomized order. Appropriate items were reverse-coded so all items were scored in the positive direction. Across 9744 observations we concluded a seven-factor model using an unweighted least squares estimation of Pearson product-moment correlations and an oblimin rotation was the best fitting model (RMSD = 0.036, hyperplane count = 228, high factor indeterminacy). This solution, which reduced the total number of items to 29, resulted in six subscales and one standalone item, including factors for science comprehension (6 items), trust in science and scientists (4 items), positive attitudes toward scientific research (4 items), numeracy (6 items), social norms for supporting science (4 items), and support for science funding (5 items). The standalone item related to decreased confidence in scientists when they change their mind. The comprehensiveness and psychometric rigor of this new measure suggests it may be useful in future research.
Authors:
Co-Author - Maya Rogers, University of Minnesota
Co-Author - Traci Mann, University of Minnesota
Examining Mental Health, Relationship Functioning, and Caregiver Burden in Veteran-Caregiver Dyads: An Actor-Partner Interdependence Model Approach
Poster Number: A111Time: 05:00 PM - 05:50 PM
Topics: Military and Veterans' Health, Social and Environmental Context and Health
Background: Post-9/11 Veterans with traumatic brain injury, post-traumatic epilepsy, and other complex health conditions often receive support from family caregivers. This support promotes Veterans’ quality of life, but high caregiver burden has also been associated with worse mental health and relationship quality among caregivers. To date, most research has focused on either Veterans or caregivers, without fully implementing dyadic perspectives. This research examined how Veterans and caregivers influence each other’s health and relationships, and whether caregiver burden mediates this dynamic.
Methods: The study included 100 Veteran-caregiver dyads (88% spouse/partner dyads) in which the Veteran had post-traumatic epilepsy (n=24), non-traumatic epilepsy (n=15), traumatic brain injury without epilepsy (n=44), or none of these conditions (n=15). Veterans and caregivers completed self-report surveys assessing mental health (Veterans RAND 12-Item Health Survey); relationship functioning (Dyadic Relationship Scale: dyadic strain, positive dyadic interaction), and aspects of caregiver burden (loss of self, Zarit Caregiver Burden Scale, positive aspects of caregiving). Data were analyzed using mediated Actor-Partner Interdependence Models (APIMeM) to assess individual and dyadic associations among mental health and relationship functioning, with separate estimates for Veterans and caregivers.
Results: Our APIMeM analyses suggested that loss of self, caregiver burden, and positive aspects of caregiving each mediated the association between caregiver mental health and the caregiver’s and Veteran’s relationship functioning. Worse caregiver mental health was associated with greater caregiver burden, which in turn was associated with more dyadic strain for both the caregiver (R2=0.46) and Veteran (R2=0.31). The same pattern was observed when loss of self since becoming a caregiver served as the mediator (caregiver strain: R2=0.40; Veteran strain: R2=0.32). Likewise, better caregiver mental health was associated with perceiving more positive aspects of caregiving, which was associated with more positive dyadic interactions for both the caregiver (R2=0.49) and Veteran (R2=0.20).
Conclusion: These data suggest that improving caregiver mental health may affect how caregivers appraise the positive and negative aspects of caregiving, which can affect relationship functioning for both dyad members and in turn support Veterans’ and caregivers’ self-care and well-being.
Keywords: Caregiving, Quality of lifeMethods: The study included 100 Veteran-caregiver dyads (88% spouse/partner dyads) in which the Veteran had post-traumatic epilepsy (n=24), non-traumatic epilepsy (n=15), traumatic brain injury without epilepsy (n=44), or none of these conditions (n=15). Veterans and caregivers completed self-report surveys assessing mental health (Veterans RAND 12-Item Health Survey); relationship functioning (Dyadic Relationship Scale: dyadic strain, positive dyadic interaction), and aspects of caregiver burden (loss of self, Zarit Caregiver Burden Scale, positive aspects of caregiving). Data were analyzed using mediated Actor-Partner Interdependence Models (APIMeM) to assess individual and dyadic associations among mental health and relationship functioning, with separate estimates for Veterans and caregivers.
Results: Our APIMeM analyses suggested that loss of self, caregiver burden, and positive aspects of caregiving each mediated the association between caregiver mental health and the caregiver’s and Veteran’s relationship functioning. Worse caregiver mental health was associated with greater caregiver burden, which in turn was associated with more dyadic strain for both the caregiver (R2=0.46) and Veteran (R2=0.31). The same pattern was observed when loss of self since becoming a caregiver served as the mediator (caregiver strain: R2=0.40; Veteran strain: R2=0.32). Likewise, better caregiver mental health was associated with perceiving more positive aspects of caregiving, which was associated with more positive dyadic interactions for both the caregiver (R2=0.49) and Veteran (R2=0.20).
Conclusion: These data suggest that improving caregiver mental health may affect how caregivers appraise the positive and negative aspects of caregiving, which can affect relationship functioning for both dyad members and in turn support Veterans’ and caregivers’ self-care and well-being.
Authors:
Presenter - Alisa Bedrov, Ph.D., University of Utah
Co-Author - Robert T. George, M.S., University of Utah
Co-Author - Mohammed Alshanbari, DrPH, University of Utah
Co-Author - Roxana E. Delgado, Ph.D., University of Texas Health Science Center at San Antonio
Co-Author - Erin Bouldin, Ph.D., University of Utah
Co-Author - Mary Jo Pugh, Ph.D., RN, University of Utah
Healthcare provider behaviors aligned with the Common-Sense Model of Self-Regulation promote concordance, trust, and treatment adherence among military Veterans living with persistent physical symptoms
Poster Number: A112Time: 05:00 PM - 05:50 PM
Topics: Military and Veterans' Health, Health Communication and Policy
Persistent physical symptoms (PPS) are prevalent and remain difficult to treat across healthcare settings. A goal of PPS research is to elucidate healthcare provider behaviors that foster improved experiences with PPS care and treatment adherence. The Common-Sense Model of Self-Regulation (CSM) posits that providers can foster better healthcare experiences and outcomes by engaging in behaviors that promote a shared understanding of patients’ illness. This prospective study examined associations between patients’ report of CSM-consistent provider behaviors and their reported concordance with their providers, trust in their providers, and treatment adherence over time across two treatment settings (primary vs. tertiary care). Participants included 230 US military Veterans who met the Kansas criteria for Gulf War Illness, a form of PPS common among Veterans who served in the first Persian Gulf War. 117 Veterans were seen in primary care only, and 113 Veterans were seen at a tertiary care center specializing in post-deployment health. Linear mixed models assessed associations between CSM behaviors and each outcome (concordance, trust, adherence) separately. A multigroup path model tested if concordance and/or trust mediated the relationship between CSM behaviors and adherence differentially across treatment setting. Indirect effects were considered significant when the bootstrapped 95% CI was not inclusive of 0. This analysis plan was pre-registered on the Open Science Framework. CSM behaviors demonstrated significant positive associations to concordance (t(299)=12.28, p<0.0001), trust (t(151)=4.65, p<0.0001), and adherence (t(279)=2.25, p=0.0254) across time; these associations did not differ based on treatment setting. Trust significantly mediated the relationship between CSM behaviors and adherence among Veterans seen in primary care only, and concordance significantly mediated the relationship between CSM behaviors and adherence among Veterans seen in tertiary care. These findings support the notion that healthcare provider behaviors that promote a shared understanding of patients’ illness are influential in the context of PPS care, leading to improved concordance with providers, trust in providers, and adherence to care recommendations. Further, the findings suggest both trust and concordance may be mechanisms through which CSM behaviors promote greater adherence to PPS treatment recommendations, which often require complex health behavior changes.
Keywords: Chronic illness, MeditationAuthors:
Author - Laura Lesnewich, PhD, War Related Illness and Injury Study Center, VA New Jersey Health Care System
Co-Author - Rachel Boska, PhD, War Related Illness and Injury Study Center, VA New Jersey Health Care System
Co-Author - Anthony Pawlak, PhD, Rutgers, The State University of New Jersey
Co-Author - L. Alison Phillips, PhD, FSBM, Iowa State University
Co-Author - Katharine Bloeser, War Related Illness and Injury Study Center, VA New Jersey Health Care System
Co-Author - Peter Bayley, PhD, War Related Illness and Injury Study Center, VA Palo Alto Health Care System
Co-Author - Helena Chandler, PhD, War Related Illness and Injury Study Center, VA New Jersey Health Care System
Co-Author - Justeen Hyde, PhD, Center for Healthcare Organization and Implementation Research, VA Bedford Health Care System
Co-Author - Matthew Reinhard, PsyD, War Related Illness and Injury Study Center, Washington DC VA Medical Center
Co-Author - Rachel Stewart, PhD, War Related Illness and Injury Study Center, Washington DC VA Medical Center
Co-Author - Drew Helmer, MD, MS, Center for Innovations in Quality, Effectiveness & Safety, Michael E. DeBakey VA Medical Center
Co-Author - Lisa McAndrew, PhD, War Related Illness and Injury Study Center, VA New Jersey Health Care System
Developing Active Pro-Environmental Campaign Messaging: Variations in Beliefs by Physical Activity and Pro-Environmental Behavior Participation
Poster Number: A113Time: 05:00 PM - 05:50 PM
Topics: Multiple Health Behavior Change , Physical Activity
Plastic litter poses a growing threat to both human and environmental health in the United States and globally. Litter pickup during outdoor activities is an understudied form of active pro-environmental behavior (active PEB), as it combines health-enhancing physical activity (PA) with sustainability efforts. Existing studies of co-occurring lifestyle behaviors are limited to behaviors within a similar domain (e.g., smoking and alcohol use or exercise and diet). However, efforts to change multiple behaviors can span across domains. This presentation reports two sequential studies: 1) associations between elicited beliefs about this type of active PEB and individuals’ current engagement in PA, litter cleanup, and active PEB, and 2) how current behavior levels modify the associations between these beliefs and future active PEB intentions. The Theory of Planned Behavior (TPB) was used to guide coding of elicited beliefs. However, TPB does not explicitly address how prior engagement in one behavior may shape intentions for another. The Compensatory Carry-Over Action Model complements TPB by highlighting how one behavior can facilitate another through shared goals or psychological resources, offering a valuable lens for cross-domain behavior change. Two Qualtrics panel surveys were conducted using samples of coastal counties that were demographically similar to US coastal residents. In the elicitation study, participants with higher engagement in PA, litter cleanup, and active PEB reported more advantage-framed beliefs, while disadvantage-framed beliefs did not differ. Belief patterns also varied across PA, PEB, and active PEB for reporting of beliefs organized by TPB constructs. Additionally, current behavior levels modified the associations between belief themes and future active PEB intentions. Beliefs emphasizing physical health benefits and pro-environmental outcomes were among the most promising themes for messaging and were consistently associated with stronger active PEB intentions across most groups. However, there was greater variation in associations for mental health consequences, social connection, and task efficiency. These findings suggest that gain-framed messages may promote goal facilitation of the multiple behavior change of combining outdoor activities with litter cleanup. Overall, these findings inform novel persuasive message strategies to address the growing health and environmental threats posed by marine debris.
Keywords: Beliefs, Physical activityAuthors:
Author - Jennifer Gay, PhD, University of Georgia
Co-Author - Jiaying Liu, PhD, University of California, Santa Barbara
Co-Author - Yidi Wang, University of California, Santa Barbara
Maintaining a healthy lifestyle: A qualitative study
Poster Number: A114Time: 05:00 PM - 05:50 PM
Topics: Multiple Health Behavior Change , Weight Related Health
Purpose: A “healthy lifestyle” includes a high-quality diet, regulated by hunger and satiety cues, and sufficient physical activity. Although the obesogenic environment makes a healthy lifestyle challenging, many succeed. Understanding the experience of maintaining a healthy lifestyle may reveal ways to better assist those who are not successful in this goal. This study used a qualitative approach to explore shared experiences of the “healthy lifestyle” phenomenon.
Methods: College students from an urban university were eligible if they had a high-quality diet, engaged in >/=150 minutes of moderate to vigorous physical activity (MVPA) each week, and relied on internal cues to determine when and how much to eat as determined by web-based screeners including the Start the Conversation Diet Quality Screener (STC), the International Physical Activity Questionnaire (IPAQ), and the Reliance on Hunger and Satiety subscale of the Intuitive Eating Scale-2 (RHS). Cutoff scores for the STC (9.66) and RHS (20.36) were selected because they represented the 66th %ile in our previous research of 974 college students. IPAQ scores indicated those who met MVPA criteria. College students who met all three criteria were invited to participate in one-time semi-structured virtual interviews to discuss their lifestyle. The interviewers (n=2) had experience and training in conducting semi-structured interviews for qualitative research. The interview guide was developed based on a review of the literature and pilot tested among volunteer college students. Interviews were recorded, transcribed verbatim, and uploaded to Atlas ti (Berlin, Germany) for coding. Trained coders used the thematic analysis (Braun & Clarke, 2006) method within a phenomenological epistemology to code the data.
Results: The sample (n=30) consisted of mostly young adults (Mage=21, SD=2.5; 67% female) who identified with several racial/ethnic groups (33% white, 17% Black, 40% Hispanic, 20% Asian). All participants reported a healthy lifestyle includes 1) learning about health, 2) relying on others for support and guidance, 3) managing internal and external resources and opportunities to achieve health goals, and 4) using physical and emotional signals as a guide.
Conclusions: Results suggest that maintaining a healthy lifestyle involves intentional effort while respecting physical and emotional preferences and needs. Future studies should test these associations using quantitative methods.
Keywords: Health behaviors, Health promotionMethods: College students from an urban university were eligible if they had a high-quality diet, engaged in >/=150 minutes of moderate to vigorous physical activity (MVPA) each week, and relied on internal cues to determine when and how much to eat as determined by web-based screeners including the Start the Conversation Diet Quality Screener (STC), the International Physical Activity Questionnaire (IPAQ), and the Reliance on Hunger and Satiety subscale of the Intuitive Eating Scale-2 (RHS). Cutoff scores for the STC (9.66) and RHS (20.36) were selected because they represented the 66th %ile in our previous research of 974 college students. IPAQ scores indicated those who met MVPA criteria. College students who met all three criteria were invited to participate in one-time semi-structured virtual interviews to discuss their lifestyle. The interviewers (n=2) had experience and training in conducting semi-structured interviews for qualitative research. The interview guide was developed based on a review of the literature and pilot tested among volunteer college students. Interviews were recorded, transcribed verbatim, and uploaded to Atlas ti (Berlin, Germany) for coding. Trained coders used the thematic analysis (Braun & Clarke, 2006) method within a phenomenological epistemology to code the data.
Results: The sample (n=30) consisted of mostly young adults (Mage=21, SD=2.5; 67% female) who identified with several racial/ethnic groups (33% white, 17% Black, 40% Hispanic, 20% Asian). All participants reported a healthy lifestyle includes 1) learning about health, 2) relying on others for support and guidance, 3) managing internal and external resources and opportunities to achieve health goals, and 4) using physical and emotional signals as a guide.
Conclusions: Results suggest that maintaining a healthy lifestyle involves intentional effort while respecting physical and emotional preferences and needs. Future studies should test these associations using quantitative methods.
Authors:
Author - Tracey Ledoux, PhD RD, University of Houston
Co-Author - Sarah Sibouyeh, BS, University of Houston
Co-Author - Lili Arney, University of Houston
Exploring Models for Delivery of the Digital Pain Self-Management Program EPIO
Poster Number: A115Time: 05:00 PM - 05:50 PM
Topics: Pain, Digital Health
Background
The digital pain self-management intervention EPIO was designed, developed, feasibility and efficacy tested to improve access to psychosocial support for people living with chronic pain. Studies have shown significant psychological benefits from use of EPIO in terms of reduced depression, anxiety and pain catastrophizing, and improved quality of life. Adherence has however surfaced as a major challenge to the effect of digital health interventions and determining how to best deliver such interventions is now vital.
Objective
To explore 3-month digital intervention adherence (i.e., use/program completion) of EPIO when delivered in either a simple blended care model or through the more common app download only access.
Methods
Participants living with pain for ≥3 months received either access to the EPIO program in 1) A simple blended care model (n=125; i.e., EPIO combined with one face-to-face introduction session and two follow-up phone calls) or through 2) Digital download only (n=73; i.e., no individual introduction or follow-up). Data related to system use (e.g., progress and frequency of use) were encrypted and collected through a secure server. The EPIO program contains nine cognitive-behavioral modules with aspects of acceptance and commitment therapy. Participants completing 6-9 modules were defined as program completers.
Results
Participants were median 50 years old (range 20-81), primarily female (83%), with a variety of pain conditions. Individual days of program use were median 21 (range 1-85 days) for the blended care group, and 8 (range 1-74) for the digital download only group, p<.001. Maximum module completion was median 6 (range 0-9) modules for the blended care group, and 2 (range 0-9) for the download only group, p<.001. Differences in program completion were even more pronounced, with 52% program completion in the simple blended care group versus 15% in the digital download only group, p<.001.
Conclusions
Digital health interventions have the potential to improve access to evidence-based treatment and support. Even the most promising interventions will fail to be of benefit if not used, however. This study shows how the most conventional app access form of download only may engender significantly less use of an established self-management intervention compared to delivery through a simple blended care model. Some form of in-person contact might hence be required for use and intended effect of digital health programs.
Keywords: Pain, e-HealthThe digital pain self-management intervention EPIO was designed, developed, feasibility and efficacy tested to improve access to psychosocial support for people living with chronic pain. Studies have shown significant psychological benefits from use of EPIO in terms of reduced depression, anxiety and pain catastrophizing, and improved quality of life. Adherence has however surfaced as a major challenge to the effect of digital health interventions and determining how to best deliver such interventions is now vital.
Objective
To explore 3-month digital intervention adherence (i.e., use/program completion) of EPIO when delivered in either a simple blended care model or through the more common app download only access.
Methods
Participants living with pain for ≥3 months received either access to the EPIO program in 1) A simple blended care model (n=125; i.e., EPIO combined with one face-to-face introduction session and two follow-up phone calls) or through 2) Digital download only (n=73; i.e., no individual introduction or follow-up). Data related to system use (e.g., progress and frequency of use) were encrypted and collected through a secure server. The EPIO program contains nine cognitive-behavioral modules with aspects of acceptance and commitment therapy. Participants completing 6-9 modules were defined as program completers.
Results
Participants were median 50 years old (range 20-81), primarily female (83%), with a variety of pain conditions. Individual days of program use were median 21 (range 1-85 days) for the blended care group, and 8 (range 1-74) for the digital download only group, p<.001. Maximum module completion was median 6 (range 0-9) modules for the blended care group, and 2 (range 0-9) for the download only group, p<.001. Differences in program completion were even more pronounced, with 52% program completion in the simple blended care group versus 15% in the digital download only group, p<.001.
Conclusions
Digital health interventions have the potential to improve access to evidence-based treatment and support. Even the most promising interventions will fail to be of benefit if not used, however. This study shows how the most conventional app access form of download only may engender significantly less use of an established self-management intervention compared to delivery through a simple blended care model. Some form of in-person contact might hence be required for use and intended effect of digital health programs.
Authors:
Author - Elin Børøsund, PhD, Oslo University Hospital, Oslo, Norway/University of South-East Norway, Drammen, Norway
Co-Author - Milada Hagen, PhD, Oslo Metropolitan University, Oslo, Norway
Co-Author - Cecilie Varsi, RN PhD, University of South-East Norway, Drammen, Norway/Oslo University Hospital, Oslo, Norway
Co-Author - Hilde Eide, RN PhD, University of South-Eastern Norway, Drammen, Norway
Co-Author - Lori Waxenberg, PhD, University of Florida, Gainesville, FL
Co-Author - Karen Weiss, PhD, Mayo Clinic, Rochester, MN
Co-Author - Eleshia Morrison, PhD, Mayo Clinic, Rochester, MN
Co-Author - Hanne Stavenes Støle, MS, Oslo University Hospital/Norwegian Institute of Public Health, Oslo, Norway
Co-Author - Ólöf Birna Kristjánsdóttir, PhD, Oslo University Hospital, Oslo, Norway
Co-Author - Elin Bolle Strand Strand, LP PhD, Oslo University Hospital/VID Specialized University, Oslo, Norway
Co-Author - Rikke Asbjørnsen, MSc, Oslo University Hospital, Oslo, Norway / Vestfold Hospital Trust, Tønsberg, Norway
Co-Author - Audun Stubhaug, MD PhD, Oslo University Hospital/University of Oslo, Oslo, Norway
Co-Author - Karlein MG Schreurs, PhD, University of Twente, Enschede, Netherlands
Co-Author - Lise Solberg Nes, Oslo University Hospital / University of Oslo, Oslo, Norway / Mayo Clinic, Rochester, MN
Evaluation of a Curriculum on Safe Pain Management for Older Adults
Poster Number: A116Time: 05:00 PM - 05:50 PM
Topics: Pain, Aging
Purpose:
This study aims to determine the efficacy of a six-week curriculum in promoting knowledge, attitudes, and behaviors related to wellness and safe pain management among community-dwelling older adults.
Methods:
This quasi-experimental study involved 100 participants aged >50 years who were assigned to one of eight cohorts. Individual cohorts ran for a 12-week period. Cohorts were staggered in a semi-crossover model, where each cohort began as its own control group, and then transitioned into the experimental activities. Participants received a standard of care brochure during the control period (weeks 1-6). During weeks 7-12, participants joined a 6-week workshop, facilitated by individuals trained in the pain management curriculum. Outcome measures for contemplation and behavior change; quality of life and experience with pain; and opinions, perceptions, and stigma were administered on 5-point Likert scale based on the Transtheoretical Model at baseline and at the end of weeks 6, 12, and 18 (post-workshop). Descriptive statistics and paired T-tests were used to characterize participants and the intervention effects, respectively.
Results:
Majority of the participants were White (63%) and Black (28%) women between the ages of 60 to 79. Preliminary findings on behavior contemplation and change from the first 6 cohorts that completed the study are described here: On a scale of 1 to 5 where “3” and above indicated that the knowledge or behavior is being implemented, participants were likely to connect with a pharmacist to discuss over-the-counter drugs and other medications for pain relief post-intervention (mean 3.05, p<0.05). They were significantly likely to try physical therapy as strategies for pain management. Of all alternative medical practices evaluated, meditation had the most significant increase in trial or adoption for pain management. There was a statistically significant increase in participants’ self-reported efficacy in their overall pain management that persisted through the follow up period (30% post-control; 63% post-intervention; and 75% post-follow up).
Conclusion:
Preliminary results have demonstrated the curriculum has demonstrated efficacy in improving wellness and pain relief among community-dwelling older adults. It has potential to be replicated in a variety of settings, with special recruitment efforts recommended to target more older adult male participants and others from more diverse racial and ethnic backgrounds.
Keywords: Pain, Older adultsThis study aims to determine the efficacy of a six-week curriculum in promoting knowledge, attitudes, and behaviors related to wellness and safe pain management among community-dwelling older adults.
Methods:
This quasi-experimental study involved 100 participants aged >50 years who were assigned to one of eight cohorts. Individual cohorts ran for a 12-week period. Cohorts were staggered in a semi-crossover model, where each cohort began as its own control group, and then transitioned into the experimental activities. Participants received a standard of care brochure during the control period (weeks 1-6). During weeks 7-12, participants joined a 6-week workshop, facilitated by individuals trained in the pain management curriculum. Outcome measures for contemplation and behavior change; quality of life and experience with pain; and opinions, perceptions, and stigma were administered on 5-point Likert scale based on the Transtheoretical Model at baseline and at the end of weeks 6, 12, and 18 (post-workshop). Descriptive statistics and paired T-tests were used to characterize participants and the intervention effects, respectively.
Results:
Majority of the participants were White (63%) and Black (28%) women between the ages of 60 to 79. Preliminary findings on behavior contemplation and change from the first 6 cohorts that completed the study are described here: On a scale of 1 to 5 where “3” and above indicated that the knowledge or behavior is being implemented, participants were likely to connect with a pharmacist to discuss over-the-counter drugs and other medications for pain relief post-intervention (mean 3.05, p<0.05). They were significantly likely to try physical therapy as strategies for pain management. Of all alternative medical practices evaluated, meditation had the most significant increase in trial or adoption for pain management. There was a statistically significant increase in participants’ self-reported efficacy in their overall pain management that persisted through the follow up period (30% post-control; 63% post-intervention; and 75% post-follow up).
Conclusion:
Preliminary results have demonstrated the curriculum has demonstrated efficacy in improving wellness and pain relief among community-dwelling older adults. It has potential to be replicated in a variety of settings, with special recruitment efforts recommended to target more older adult male participants and others from more diverse racial and ethnic backgrounds.
Authors:
Author - , TRX Solutions, LLC
Co-Author - , TRX Solutions, LLC
Co-Author - , TRX Solutions,LLC
Presenter - , National Council on Aging
Co-Presenter - Gretchen Tanbonliong, National Council on Aging
Co-Presenter - Jennifer Weber, MS, RDN, Weber-Moore Consulting, LLC
Impact of Tailored Mindfulness-Based Stress Reduction Interventions for Chronic Pain Management in Safety-Net Settings: A Systematic Review
Poster Number: A117Time: 05:00 PM - 05:50 PM
Topics: Pain, Integrative Health and Spirituality
Background: Chronic pain affects millions of U.S. adults and disproportionately impacts those with lower versus higher socioeconomic status. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) interventions can be effective at helping patients manage chronic pain. Thus, there is a need to evaluate the impact of tailored MBSR and MBCT interventions in safety-net settings where lower income populations receive medical care.
Objective: This systematic review (1) evaluates whether different levels of tailoring and/or adaptation in MBSR and MBCT interventions improves pain outcomes (e.g., pain impact, pain severity, pain catastrophizing, pain intensity, pain interference, average pain) for adults with chronic pain receiving care in safety-net settings, such as Federally-Qualified Health Centers (FQHCs) or Community Health Centers (CHCs), and (2) describes intervention adaptations made to address the unique demographic, socioeconomic, and cultural characteristics of patients.
Methods: Electronic databases were searched for experimental studies that tested the efficacy of MBSR or MBCT as adjunctive or monotherapy targeting adult patients with chronic pain receiving care in safety-net settings. Four reviewers conducted screening, data extraction, and quality assessment following PRISMA guidelines.
Results: The search yielded 1,161 articles, of which four met inclusion criteria (N = 278 total patients). All four studies tested adapted MBSR programs and no studies that used MBCT qualified for inclusion. Intervention ranged from nine to 21 weeks in duration, three studies used nonrandomized controlled designs, and one employed a randomized controlled trial design. Three studies reported significant reductions in most pain outcomes. Studies with cultural, linguistic, and technology-based adaptations produced large effect sizes for pain interference (range d = -1.67 to -0.95) and pain intensity (d = -0.79). Quality assessment revealed global ratings from weak to moderate quality.
Conclusions: Findings suggest that adaptation type and implementation approach (e.g., using a stand-alone eHealth approach) may influence intervention efficacy more than the number of adaptations made. Future research requires improved methodology quality and clearer descriptions of the mindfulness-based approaches used to better determine the efficacy of these interventions in safety-net populations.
Keywords: Mindfulness-Based Stress Reduction, Low-incomeObjective: This systematic review (1) evaluates whether different levels of tailoring and/or adaptation in MBSR and MBCT interventions improves pain outcomes (e.g., pain impact, pain severity, pain catastrophizing, pain intensity, pain interference, average pain) for adults with chronic pain receiving care in safety-net settings, such as Federally-Qualified Health Centers (FQHCs) or Community Health Centers (CHCs), and (2) describes intervention adaptations made to address the unique demographic, socioeconomic, and cultural characteristics of patients.
Methods: Electronic databases were searched for experimental studies that tested the efficacy of MBSR or MBCT as adjunctive or monotherapy targeting adult patients with chronic pain receiving care in safety-net settings. Four reviewers conducted screening, data extraction, and quality assessment following PRISMA guidelines.
Results: The search yielded 1,161 articles, of which four met inclusion criteria (N = 278 total patients). All four studies tested adapted MBSR programs and no studies that used MBCT qualified for inclusion. Intervention ranged from nine to 21 weeks in duration, three studies used nonrandomized controlled designs, and one employed a randomized controlled trial design. Three studies reported significant reductions in most pain outcomes. Studies with cultural, linguistic, and technology-based adaptations produced large effect sizes for pain interference (range d = -1.67 to -0.95) and pain intensity (d = -0.79). Quality assessment revealed global ratings from weak to moderate quality.
Conclusions: Findings suggest that adaptation type and implementation approach (e.g., using a stand-alone eHealth approach) may influence intervention efficacy more than the number of adaptations made. Future research requires improved methodology quality and clearer descriptions of the mindfulness-based approaches used to better determine the efficacy of these interventions in safety-net populations.
Authors:
Presenter - Tania Valdez, MPH, San Diego State University
Co-Author - Zahid Lopez, PhD, San Diego State University
Co-Author - Perla Rocha, BA, San Diego State University
Co-Author - Gloria Toba, MPH, San Ysidro Health
Co-Author - Anthony Zepeda, BA, San Diego State University
Co-Author - Taylor Clark, PhD, San Diego Veterans Affairs Healthcare System
Co-Author - Linda Gallo, PhD, San Diego State University
Co-Author - Noe Crespo, PhD, MPH, MS, San Diego State University
Exploring Sedentary Behaviour as a Risk Factor for Mental Health Outcomes in a Sample of Jamaican Younger Adults
Poster Number: A118Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Mental Health
Over 14% of Jamaican adults report clinically relevant symptoms of depression (DS) while population prevalence of anxiety symptoms (AS) is increasing. Sedentary behaviour is a risk factor for adverse mental health outcomes, though its mechanism of association is less clear. Globally, public health guidelines for the maximum hours of ST per day supporting optimal mental health are unclear. This is the first known study assessing sitting time (ST; a form of sedentary behavior) and its associations with mental health outcomes in Jamaican adults. This self-report, cross-sectional study explored associations among ST, DS, AS, psychological stress (SS), controlling for socio-demographic variables, in a convenience sample of Jamaican younger adults (N = 377; M = 26.77; SD = 6.23). Most participants were female (59.7%), employed (62.4%), college educated (74.3%), not married (86.1%), and low-socioeconomic status (70.9%). Mean participant ST was 6.67 hours per day (SD = 3.94) with 57.0% reporting ST of ≥ 6 hours per day (ST-6). On average DS (M = 10.24; SD = 3.69), AS (M = 7.13; SD = 7.40), and SS (M = 7.91; SD = 6.09) were normal/mild (i.e., not clinically relevant). Binary coded (BC) mental health outcomes (i.e., 0 = normal/mild, 1 = moderate/severe), indicated BC-DS (68.3%), BC-AS (62.3%), and BC-SS (63.9%) were mostly normal/mild. Only SS (r = 0.150, p = .006) and BC-SS (ρ = .154, p = .003) were significantly correlated with ST and ST-6 respectively. Logistic regression indicated that ST ≥ 6 hours per day was associated with increased odds (i.e., by 88%) of reporting clinically relevant SS (OR = 1.88, 95% CI [1.15, 3.07], p = .012). ST-6 was not associated with clinically relevant DS or AS. Structural equation modeling indicated that ST had significant indirect effects on DS (β = .076, CI 95% [.027, .126]) and AS (β = .074, CI 95% [.025, .122]) through SS. Higher ST, specifically ≥ 6 hours per day, was associated with clinically relevant SS, and increased DS and AS through SS. Therefore, ST of < 6 hours per day may support optimal mental health outcomes and SS may be a psychological mechanism through which lower ST is associated with improved mental health symptoms. ST appears to be a risk factor for (i.e., correlate and/or determinant of) mental health outcomes in Jamaican younger adults. Health behaviour interventions targeting improved mental health symptoms in this population should account for sedentary behaviour to optimize effectiveness.
Keywords: Mental health, Health behaviorsAuthors:
Author - Andre Bateman, PhD, The University of the West Indies at Mona
Co-Author - Nikisha Harris, MS, The University of the West Indies at Mona
Co-Author - Akosua Gyimah, MS, The University of the West Indies at Mona
Co-Author - Robyn Brown, MS, The University of the West Indies at Mona
Co-Author - Onicka Williams, The University of the West Indies at Mona
Co-Author - Chelsi Ricketts, PhD, University of Toronto, Toronto
Leveraging Generative AI to Adapt Feasibility Study Content for a Theory-Based Physical Activity Randomized Controlled Trial
Poster Number: A119Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Digital Health
Background
Adapting content from a feasibility trial into a randomized controlled trial (RCT) often requires careful refinement to ensure scalability, theoretical fidelity and contextual relevance. Generative AI may accelerate this process, but its application to theory-based behavior change interventions is underexplored.
Purpose
To explore how generative AI can support the adaptation of a feasibility trial (Cox and Rhodes, 2023) into a Multi-Process Action Control (M-PAC)–based RCT promoting physical activity among inactive adults transitioning to retirement.
Methods
Fifty-two prompts were developed using the Behavior Change Technique Ontology (BCIO), specifying individual behavior change techniques (BCTs) with their definitions and unique identifiers. Prompts specified the lesson(s) within the 10-lesson intervention, aligned with the M-PAC constructs (reflective, regulatory, reflexive processes), the target population, and the mode of delivery (multi-platform eHealth/mHealth). Prompts were entered into ChatGPT (GPT-4o; OpenAI, June 2025), Gemini (2.5 Pro; Google, June 2025), Grok 3 (xAI, 2025), and Copilot (GPT-4; OpenAI/Microsoft, June 2025). Across platforms, 208 outputs were generated, collated, and iteratively reviewed by a subset of the research team to assess alignment with BCTs, theoretical fidelity, and contextual appropriateness. Outputs were then synthesized into 10 finalized lesson plans for the RCT.
Results
All platforms produced usable content, though relevance and alignment with the retirement transition context varied, and all required considerable human revision. A key limitation was a tendency to generate very similar responses for distinct BCT prompts, with limited differentiation across techniques. Outputs were often generic, requiring adaptation to maintain fidelity with the M-PAC framework and population needs. ChatGPT, Gemini, and Grok 3 generally produced longer responses, while Copilot generated shorter, more concise responses.
Conclusions
Generative AI can accelerate idea generation and support adaptation of theory-based intervention content, but human-in-the-loop oversight is essential to ensure contextual relevance and theoretical fidelity. Systematic integration of AI may offer a scalable, innovative approach to reduce researcher burden, enhance efficiency, and support translation of feasibility trials into RCTs, advancing methodological approaches in theory-based intervention development.
Keywords: Theory, Physical activityAdapting content from a feasibility trial into a randomized controlled trial (RCT) often requires careful refinement to ensure scalability, theoretical fidelity and contextual relevance. Generative AI may accelerate this process, but its application to theory-based behavior change interventions is underexplored.
Purpose
To explore how generative AI can support the adaptation of a feasibility trial (Cox and Rhodes, 2023) into a Multi-Process Action Control (M-PAC)–based RCT promoting physical activity among inactive adults transitioning to retirement.
Methods
Fifty-two prompts were developed using the Behavior Change Technique Ontology (BCIO), specifying individual behavior change techniques (BCTs) with their definitions and unique identifiers. Prompts specified the lesson(s) within the 10-lesson intervention, aligned with the M-PAC constructs (reflective, regulatory, reflexive processes), the target population, and the mode of delivery (multi-platform eHealth/mHealth). Prompts were entered into ChatGPT (GPT-4o; OpenAI, June 2025), Gemini (2.5 Pro; Google, June 2025), Grok 3 (xAI, 2025), and Copilot (GPT-4; OpenAI/Microsoft, June 2025). Across platforms, 208 outputs were generated, collated, and iteratively reviewed by a subset of the research team to assess alignment with BCTs, theoretical fidelity, and contextual appropriateness. Outputs were then synthesized into 10 finalized lesson plans for the RCT.
Results
All platforms produced usable content, though relevance and alignment with the retirement transition context varied, and all required considerable human revision. A key limitation was a tendency to generate very similar responses for distinct BCT prompts, with limited differentiation across techniques. Outputs were often generic, requiring adaptation to maintain fidelity with the M-PAC framework and population needs. ChatGPT, Gemini, and Grok 3 generally produced longer responses, while Copilot generated shorter, more concise responses.
Conclusions
Generative AI can accelerate idea generation and support adaptation of theory-based intervention content, but human-in-the-loop oversight is essential to ensure contextual relevance and theoretical fidelity. Systematic integration of AI may offer a scalable, innovative approach to reduce researcher burden, enhance efficiency, and support translation of feasibility trials into RCTs, advancing methodological approaches in theory-based intervention development.
Authors:
Author - Carol Brennan, PhD, University of Victoria
Co-Author - Rachel Mallinson, University of Victoria
Co-Author - Ryan Rhodes, PhD, FSBM, University of Victoria
Temporal Associations Between Waking Movement Behaviors and Dimensions of Negative Affect in Hispanic College Students with Obesity: A Network Analysis Using Compositional Data
Poster Number: A120Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Mental Health
Waking movement behaviors – sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) – have been linked to negative affect (NA). Yet, most studies examine these behaviors in isolation, neglecting their interdependent nature. Studies also often use single items or composite scores to assess NA, overlooking heterogeneity in symptom presentation. These limitations reduce the utility of findings to effectively guide intervention design. This intensive longitudinal study used network analysis to examine real-time associations between movement behaviors and dimensions of NA in a sample of Hispanic college students with obesity. Participants (N = 36; Mage = 20 ± 2 years; 64% female) completed five ecological momentary assessments (EMAs) daily and wore accelerometers for six days. EMA prompts assessed four NA dimensions on a 1 (not at all) to 5 (extremely) scale: nervous/anxious, sad/depressed, stressed, and frustrated/angry. Accelerometer data from the 60-min window surrounding each EMA prompt (30 min before/after) were processed to estimate time spent in SB, LPA, and MVPA, expressed as isometric log-ratio coordinates to preserve their compositional structure. Multilevel vector autoregressive models were estimated to examine temporal (t-1 lag) and contemporaneous (same moment) associations between each movement behavior and NA. On average, participants’ 60-min movement compositions consisted of 76.1% SB, 12.3% LPA, and 11.6% MVPA. SB predicted greater subsequent sadness/depression (r = 0.107, 95% CI: 0.001, 0.212). A bidirectional association was found for LPA with stress: LPA predicted lower future stress (r = -0.157, 95% CI: -0.275, -0.04), while stress predicated more future LPA (r = 0.19, 95% CI: 0.031, 0.35). LPA also predicted lower future nervousness/anxiousness (r = -0.131, 95% CI: -0.255, -0.006) and LPA (r = -0.158, 95% CI: -0.277, -0.038). Finally, MVPA predicted greater future stress (r = 0.124, 95% CI: 0.01, 0.239). Contemporaneous associations between movement behaviors and each NA dimension were non-significant. This study enhances our understanding of how movement behaviors and NA interact as a complex and dynamic system. Findings suggest that targeting specific behaviors may lead to more effective interventions aimed at distinct dimensions of NA. Moving forward, idiographic approaches could further refine personalization strategies, tailoring them to individuals' unique symptom presentations.
Keywords: Physical activity, Mental healthAuthors:
Presenter - Denver Brown, PhD, Kansas State University
Co-Author - Carah Holesovsky, MS, Kansas State University
Co-Author - Chih-Hsiang Yang, PhD, University of South Carolina
Co-Author - Abhishek Aggarwal, PhD, Brown University
Co-Author - Alan Meca, PhD, University of Texas at San Antonio
Co-Author - Itamar Lerner, PhD, University of Texas at San Antonio
Co-Author - Michael Vitevitch, PhD, University of Kansas
Co-Author - Kelsie Forbush, PhD, University of Kansas
Summer youth employment program for preventing unhealthy shifts in movement behaviors among adolescents during summer vacation: A proof-of-concept study
Poster Number: A121Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Child and Family Health
Purpose: During summer, adolescents show an unhealthy shift in their movement behaviors (reduced physical activity, increased sedentary time, irregular sleep). The Structured Days Hypothesis attributes these changes to the absence of a structured day (pre-planned, routinized, and adult-supervised environments). Summer Youth Employment Programs (SYEPs) may provide a structured summer program for adolescents by anchoring daily routines around a consistent work schedule that may promote healthy activity behaviors. This proof-of-concept study evaluated the initial signal of whether SYEP participation helps adolescents maintain or promote healthier activity behaviors.
Method: This small-scale single-group pre-posttest study (Phase 2a) design is guided by the Obesity-Related Behavioral Intervention Trials (ORBIT) model, which presents a systematic process of translating basic science findings into behavioral interventions. Adolescents (n=15, 16.5 years, 80% female, 80% Hispanic/Latino) from one public high school worked at a summer day camp as junior counselors up to 24 h/week for six weeks (Mon–Thu, 8:30 AM–3:30 PM, 1 h lunch). Fridays were reserved for professional development and social activities. Activity behaviors were assessed via wrist-worn ActiGraph GT3X at baseline (end of school year) and post (final SYEP week), processed in GGIR. Per the ORBIT model, the initial signal, not statistical significance, was evaluated. Therefore, outcomes were presented descriptively as means and standard deviations.
Results: One participant returned the accelerometer at post without data and was excluded from analyses. Over the summer, adolescents’ sedentary time decreased by 43.1 min/day (SD = 64.6), while moderate to vigorous physical activity (MVPA) increased by 8.8 min/day (SD = 15.9). Sleep duration decreased by 40.3 min/day (SD = 71.2); however, sleep onset (10:11 PM) and offset (8:20 AM) remained similar to baseline (10:15 PM and 8:13 AM).
Conclusion: Pre-post changes in MVPA and sedentary behavior were in desirable directions. Sleep findings were mixed, with decreased duration but stable sleep timing. Aligned with the ORBIT model, this proof-of-concept study provides initial signal that SYEP may serve as a structured program to prevent unhealthy shifts in adolescents’ movement behaviors over the summer, warranting evaluation in a larger-scale pilot randomized controlled trial (Phase 2b).
Keywords: Adolescents, Physical activityMethod: This small-scale single-group pre-posttest study (Phase 2a) design is guided by the Obesity-Related Behavioral Intervention Trials (ORBIT) model, which presents a systematic process of translating basic science findings into behavioral interventions. Adolescents (n=15, 16.5 years, 80% female, 80% Hispanic/Latino) from one public high school worked at a summer day camp as junior counselors up to 24 h/week for six weeks (Mon–Thu, 8:30 AM–3:30 PM, 1 h lunch). Fridays were reserved for professional development and social activities. Activity behaviors were assessed via wrist-worn ActiGraph GT3X at baseline (end of school year) and post (final SYEP week), processed in GGIR. Per the ORBIT model, the initial signal, not statistical significance, was evaluated. Therefore, outcomes were presented descriptively as means and standard deviations.
Results: One participant returned the accelerometer at post without data and was excluded from analyses. Over the summer, adolescents’ sedentary time decreased by 43.1 min/day (SD = 64.6), while moderate to vigorous physical activity (MVPA) increased by 8.8 min/day (SD = 15.9). Sleep duration decreased by 40.3 min/day (SD = 71.2); however, sleep onset (10:11 PM) and offset (8:20 AM) remained similar to baseline (10:15 PM and 8:13 AM).
Conclusion: Pre-post changes in MVPA and sedentary behavior were in desirable directions. Sleep findings were mixed, with decreased duration but stable sleep timing. Aligned with the ORBIT model, this proof-of-concept study provides initial signal that SYEP may serve as a structured program to prevent unhealthy shifts in adolescents’ movement behaviors over the summer, warranting evaluation in a larger-scale pilot randomized controlled trial (Phase 2b).
Authors:
Presenter - Aliye Cepni, PhD, University of Houston
Author - Tracey Ledoux, PhD RD, University of Houston
Author - Robert Glenn Weaver, PhD, University of South Carolina
Author - Craig Johnston, PhD, University of Houston
Morning Leisure Anticipation and Planned Activity Type Differentially Predict Daily Physical Activity: An Ecological Momentary Assessment Study
Poster Number: A122Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Decision Making
Background: Promoting daily physical activity is a public health priority, yet the real-time psychological drivers influencing activity levels, particularly among adults, remain unclear. This study examined how two potential drivers, morning anticipated leisure pleasure (ALP) and planned leisure activity type, are associated with daily physical activity, both independently and interactively. Methods: A purposive sample of 160 adults completed a 7-day ecological momentary assessment (EMA) protocol (response rate = 87.4%). Participants wore activPAL4™ micro accelerometers to objectively measure total daily energy expenditure (MET·h). Morning surveys assessed ALP for the day's leisure activity with a 4-item scale, the day’s planned leisure type (active, passive, or other/none), and previous-night sleep quality. Current activity was assessed via participants' personal smartphone with one item, triggered by three semi-random prompts per day. We analyzed 885 daily records using two-level linear mixed-effects models, controlling for demographics, health status, and other potential confounders including sleep quality and accelerometer wear time. Results: At the within-person level, a 1-SD increase in morning ALP (day-level deviation from person mean) was associated with an additional energy expenditure of 0.38 MET·h on the same day (β = 0.38, p < .001). While the main effects of planned activity type on MET·h were not significant, morning-reported plans were linked to leisure behavior frequencies reported via EMA throughout the day. Planning an active day predicted higher active leisure frequency (β = 0.09, p < .001), whereas planning a passive day predicted higher passive leisure frequency (β = 0.08, p < .01). Critically, the ALP–MET·h association was stronger on days when active leisure compared to days without such plans (simple slopes = 1.01 vs. 0.39, p < .001), suggesting that having an active plan amplifies the translation into actual movement behavior. Conclusion: Morning affective expectations and planned leisure contexts are independently and interactively associated with adults’ daily physical activity. Encouraging the formulation of specific active leisure plans in the morning, particularly when pleasant anticipation to leisure is high, may be an effective strategy for just-in-time adaptive interventions aiming to translate motivational states into concrete active behavior.
Keywords: Physical activity, Decision makingAuthors:
Presenter - Shang-Ti Chen, National Dong Hwa University
Co-Author - Chih-Hsiang Yang, University of South Carolina
Co-Author - Po-Wen Ku, National Chung Hsing University
Exercise intervention preferences, barriers, and facilitators in adults with epilepsy: A cross-sectional survey
Poster Number: A123Time: 05:00 PM - 05:50 PM
Topics: Physical Activity
INTRODUCTION: Epilepsy is a common neurological disorder that can affect quality of life and daily activities. While exercise may benefit adults with epilepsy, limited research has examined how to design interventions that meet the needs and preferences of this population.
PURPOSE: To explore exercise preferences, barriers, and facilitators to participating in an exercise intervention among adults with epilepsy.
METHODS: A cross-sectional survey developed by the research team was administered online between January 15 to February 28, 2025, to adults (≥ 18 years) in the United States with a self-reported epilepsy diagnosis. Participants (n=25) provided demographic information, epilepsy characteristics, current physical activity, and preferences for intervention delivery mode, duration, frequency, intensity, modality, and location, as well as perceived safety, barriers, and facilitators. All response choices were select a single-item or all that apply and were summarized using descriptive statistics.
RESULTS: Participants were primarily aged 25-35 years (36%), female (60%), White (84%), and employed full-time (52%); most had generalized epilepsy (36%), were diagnosed for >10 years (56%), were taking seizure medication (80%), and had not experienced a seizure in over two years (42%). Forty percent (n=10) expressed interest in an exercise intervention. Delivery preferences were split between in-person and virtual formats (40%). The most frequent preferences were 26-52 week duration (40%), 3 or 5 days/week (30%), moderate (60%) or vigorous (70%) intensity, 45-60 minute sessions (50%), and gym-based locations (70%). Running and free weightlifting were the most preferred exercise modalities. A majority (68%) of participants felt safe exercising alone or with others. Reported barriers and facilitators varied, with common barriers including fear of injury, health problems, and time constraints. Frequent facilitators included flexible scheduling (60%), clear health benefits (56%), ability to exercise at their own pace (40%), and support from friends and family (40%).
CONCLUSION: Preferences, barriers, and facilitators identified in this study can inform the design of exercise interventions for adults with epilepsy that are likely to bolster attendance and acceptability and could facilitate future studies on the effects of exercise on epilepsy. Larger, more diverse samples are needed to determine whether these findings are consistent across adults with epilepsy.
Keywords: Epilepsy, Physical activityPURPOSE: To explore exercise preferences, barriers, and facilitators to participating in an exercise intervention among adults with epilepsy.
METHODS: A cross-sectional survey developed by the research team was administered online between January 15 to February 28, 2025, to adults (≥ 18 years) in the United States with a self-reported epilepsy diagnosis. Participants (n=25) provided demographic information, epilepsy characteristics, current physical activity, and preferences for intervention delivery mode, duration, frequency, intensity, modality, and location, as well as perceived safety, barriers, and facilitators. All response choices were select a single-item or all that apply and were summarized using descriptive statistics.
RESULTS: Participants were primarily aged 25-35 years (36%), female (60%), White (84%), and employed full-time (52%); most had generalized epilepsy (36%), were diagnosed for >10 years (56%), were taking seizure medication (80%), and had not experienced a seizure in over two years (42%). Forty percent (n=10) expressed interest in an exercise intervention. Delivery preferences were split between in-person and virtual formats (40%). The most frequent preferences were 26-52 week duration (40%), 3 or 5 days/week (30%), moderate (60%) or vigorous (70%) intensity, 45-60 minute sessions (50%), and gym-based locations (70%). Running and free weightlifting were the most preferred exercise modalities. A majority (68%) of participants felt safe exercising alone or with others. Reported barriers and facilitators varied, with common barriers including fear of injury, health problems, and time constraints. Frequent facilitators included flexible scheduling (60%), clear health benefits (56%), ability to exercise at their own pace (40%), and support from friends and family (40%).
CONCLUSION: Preferences, barriers, and facilitators identified in this study can inform the design of exercise interventions for adults with epilepsy that are likely to bolster attendance and acceptability and could facilitate future studies on the effects of exercise on epilepsy. Larger, more diverse samples are needed to determine whether these findings are consistent across adults with epilepsy.
Authors:
Author - Sydney Churchill, PhD, University of North Carolina at Chapel Hill
Co-Author - Jeni Lansing, PhD, University of Wisconsin Madison
Co-Author - Elizabeth Stegemoller, PhD, Iowa State University
Co-Author - Jacob Meyer, PhD, FSBM, University of Wisconsin Madison
Results of a pilot randomized controlled trial of a COM-B-based physical activity behavior change intervention in people newly diagnosed with multiple sclerosis
Poster Number: A124Time: 05:00 PM - 05:50 PM
Topics: Physical Activity
Background: Physical activity (PA) is strongly recommended for people newly diagnosed with multiple sclerosis (PNDwMS), yet PNDwMS are physically inactive and might require unique interventions for promoting behavior change.
Purpose: This pilot randomized controlled trial (RCT) examined the efficacy of a behavioral intervention based on the Capability-Opportunity-Motivation-Behavior (COM-B) model and delivered through online coaching and newsletters for promoting PA in PNDwMS.
Methods: We undertook an unblinded, parallel-group, RCT involving 50 PNDwMS (disease duration ≤ 2 years) who were randomly assigned to either the PA intervention (n = 25) or the waitlist control (n = 25) conditions. The intervention was delivered over 16 weeks by a researcher uninvolved in randomization. Data were collected at baseline and post-intervention. Primary outcomes were device-measured (steps/day, light PA [LPA], moderate-to-vigorous PA [MVPA]) and self-reported (Godin Leisure-Time Exercise Questionnaire [GLTEQ] and International Physical Activity Questionnaire [IPAQ]) PA. Secondary outcomes included fatigue (Fatigue Severity Scale [FSS]), depression and anxiety (Hospital Anxiety and Depression Scale [HADS-D and HADS-A), and health-related quality of life (HRQOL) (Multiple Sclerosis Impact Scale [MSIS-29] and Short Form Health Status Survey [SF-12]). Data were analyzed (intent-to-treat) using 2(condition) × 2(time) mixed-effects ANOVA.
Results: There were statistically significant group-by-time interactions on device-measured (MVPA) and self-reported (IPAQ) PA (p .05) as well as depression (HADS-D) and mental HRQOL (SF-12 mental contribution score) (p < .05). There were significant improvements in minutes/day of MVPA (11.2 minutes/day, 95% CI: 8.8, 13.7, d = 0.2), IPAQ scores (11.4 units, 95% CI: 10.4, 12.3, d = 0.3), HADS-D score (1.4 units, 95% CI: 1.3, 1.5, d = 0.3), and SF-12 MCS (5.6 units, 95% CI: 5.1, 6.1, d = 0.3) in the PA intervention condition between baseline and post-intervention, but not in the WLC condition.
Conclusion: The findings provided evidence for the efficacy of the COM-B-based behavioral intervention for increasing PA and improving mental health outcomes in PNDwMS.
Keywords: Randomized controlled trial, Health behavior changePurpose: This pilot randomized controlled trial (RCT) examined the efficacy of a behavioral intervention based on the Capability-Opportunity-Motivation-Behavior (COM-B) model and delivered through online coaching and newsletters for promoting PA in PNDwMS.
Methods: We undertook an unblinded, parallel-group, RCT involving 50 PNDwMS (disease duration ≤ 2 years) who were randomly assigned to either the PA intervention (n = 25) or the waitlist control (n = 25) conditions. The intervention was delivered over 16 weeks by a researcher uninvolved in randomization. Data were collected at baseline and post-intervention. Primary outcomes were device-measured (steps/day, light PA [LPA], moderate-to-vigorous PA [MVPA]) and self-reported (Godin Leisure-Time Exercise Questionnaire [GLTEQ] and International Physical Activity Questionnaire [IPAQ]) PA. Secondary outcomes included fatigue (Fatigue Severity Scale [FSS]), depression and anxiety (Hospital Anxiety and Depression Scale [HADS-D and HADS-A), and health-related quality of life (HRQOL) (Multiple Sclerosis Impact Scale [MSIS-29] and Short Form Health Status Survey [SF-12]). Data were analyzed (intent-to-treat) using 2(condition) × 2(time) mixed-effects ANOVA.
Results: There were statistically significant group-by-time interactions on device-measured (MVPA) and self-reported (IPAQ) PA (p .05) as well as depression (HADS-D) and mental HRQOL (SF-12 mental contribution score) (p < .05). There were significant improvements in minutes/day of MVPA (11.2 minutes/day, 95% CI: 8.8, 13.7, d = 0.2), IPAQ scores (11.4 units, 95% CI: 10.4, 12.3, d = 0.3), HADS-D score (1.4 units, 95% CI: 1.3, 1.5, d = 0.3), and SF-12 MCS (5.6 units, 95% CI: 5.1, 6.1, d = 0.3) in the PA intervention condition between baseline and post-intervention, but not in the WLC condition.
Conclusion: The findings provided evidence for the efficacy of the COM-B-based behavioral intervention for increasing PA and improving mental health outcomes in PNDwMS.
Authors:
Author - Le Thao Trinh Huynh, University of Illinois at Chicago
Co-Author - Robert Motl, PhD, University of Illinois at Chicago
Screen Time, Physical Activity, and Anxiety in Youth: An ABCD Secondary Data Analysis
Poster Number: A125Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Child and Family Health
Background/Objective: Most adolescents exceed 2 hours of daily screen use, a level that continues to rise annually. Excessive screen time has been linked to a multitude of morbidities increasing cardiovascular disease, depression, and obesity. This engagement may come at the expense of other behaviors such as physical activity and sports – activities known to counter several health morbidities. Despite these established risks, little is known about the sport-related factors that moderate these relationships. This study conducts a secondary analysis using data from the Adolescent Brain Cognitive Development (ABCD) Study to assess the relationship between physical activity, screen time, and anxiety, alongside the role of sport enjoyment, sport participation, and demographic factors. We hypothesize that greater screen time will be associated with higher anxiety levels and lower levels of physical activity, with sport-related factors moderating these relationships.
Methods: The sample included cross-sectional data from children aged 9-10 who were participants in the ABCD Data Release 6.0. The ABCD Study is the largest longitudinal study of adolescent brain development in the United States. Anxiety was measured by the generalized anxiety disorder (GAD-7) and social anxiety disorder (SAD) scores from the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADs). Screen time was measured by the Screen Time Questionnaire (STQ), sport participation via the Sports Activities Involvement Questionnaire (SAIQ), and sport enjoyment via a single parent-report item at screening. Linear regression models will test associations, adjusting for demographic covariates (e.g., race, sex, and ethnicity), with sport-related factors as moderators.
Results: Analyses are ongoing. We expect these relationships to be particularly pronounced among children from rural environments and lower socioeconomic backgrounds, where limited access to sports opportunities may make screen time a primary leisure activity. Exploratory analyses will examine how sex, ethnicity, and urbanicity may influence patterns of screen time use and its relationship with physical activity and sport. Findings will inform tailored sport and physical activity interventions to reduce anxiety and address screen time across diverse youth populations.
Keywords: Physical activity, Children's healthMethods: The sample included cross-sectional data from children aged 9-10 who were participants in the ABCD Data Release 6.0. The ABCD Study is the largest longitudinal study of adolescent brain development in the United States. Anxiety was measured by the generalized anxiety disorder (GAD-7) and social anxiety disorder (SAD) scores from the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADs). Screen time was measured by the Screen Time Questionnaire (STQ), sport participation via the Sports Activities Involvement Questionnaire (SAIQ), and sport enjoyment via a single parent-report item at screening. Linear regression models will test associations, adjusting for demographic covariates (e.g., race, sex, and ethnicity), with sport-related factors as moderators.
Results: Analyses are ongoing. We expect these relationships to be particularly pronounced among children from rural environments and lower socioeconomic backgrounds, where limited access to sports opportunities may make screen time a primary leisure activity. Exploratory analyses will examine how sex, ethnicity, and urbanicity may influence patterns of screen time use and its relationship with physical activity and sport. Findings will inform tailored sport and physical activity interventions to reduce anxiety and address screen time across diverse youth populations.
Authors:
Presenter - Julianna King, Indiana University - Bloomington
Co-Author - Pranav Kapoor, Indiana University - Bloomington
Co-Author - Vanessa Martinez Kercher, Indiana University - Bloomington
Co-Author - Kyle Kercher, Indiana University - Bloomington
Co-Author - Bailey Ortyl, Indiana University - Bloomington
Applying Body Neutrality Principles to Physical Activity Promotion: A Pilot Test of the Body Neutrality Playbook
Poster Number: A126Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Women's Health
Background
Body image concerns and weight stigma can undermine motivation for physical activity (PA), particularly among women not meeting moderate to vigorous physical activity (MVPA )recommendations. The Body Neutrality Playbook is a six-week, self-guided workbook grounded in body neutrality principles, designed to promote sustainable PA by fostering autonomous motivation, self-compassion, and body appreciation while reducing harmful appearance-based cognitions.
Purpose
This pilot study examined preliminary effects of the Body Neutrality Playbook on PA behavior, Self-Determination Theory (SDT) motivation, and body image–related constructs in women insufficiently active at baseline.
Methods
Twenty adult women (mean age 37.6 ± 12.3 years, baseline MVPA <150 min/week) completed the Body Neutrality Playbook over six weeks. Measures were collected at baseline and post-intervention, including self-reported weekly minutes of MVPA, PA intention and planning, SDT-based motivation (intrinsic, integrated, identified, introjected, external, amotivation), basic psychological needs satisfaction (competence, autonomy, relatedness), body functionality appreciation, body compassion (body kindness, motivated action, common humanity), internalized weight bias, and physical appearance comparison. Analyses examined mean change scores and Cohen's d effect sizes to assess preliminary impact.
Results
Post-intervention, participants demonstrated meaningful increases in MVPA minutes per week, PA intention and planning. SDT outcomes showed increased competence, autonomy, integrated regulation and intrinsic motivation, and decreased introjected regulation. Body image–related outcomes indicated increased body appreciation, decreased physical appearance comparison, and improvements in two of three body compassion subscales (body kindness and motivated action). Effect sizes for these changes were in the small-to-large range, suggesting practical significance despite the small sample.
Conclusions
Preliminary findings suggest the Body Neutrality Playbook may promote autonomous PA motivation and positive body image while reducing appearance-based self-comparisons among women who are insufficiently active. The combination of body neutrality principles and SDT-informed behavior change strategies may address both psychological and behavioral barriers to PA. Future research with larger, more diverse samples and a controlled design is warranted to evaluate efficacy and mechanisms of change.
Keywords: Physical activity, MotivationBody image concerns and weight stigma can undermine motivation for physical activity (PA), particularly among women not meeting moderate to vigorous physical activity (MVPA )recommendations. The Body Neutrality Playbook is a six-week, self-guided workbook grounded in body neutrality principles, designed to promote sustainable PA by fostering autonomous motivation, self-compassion, and body appreciation while reducing harmful appearance-based cognitions.
Purpose
This pilot study examined preliminary effects of the Body Neutrality Playbook on PA behavior, Self-Determination Theory (SDT) motivation, and body image–related constructs in women insufficiently active at baseline.
Methods
Twenty adult women (mean age 37.6 ± 12.3 years, baseline MVPA <150 min/week) completed the Body Neutrality Playbook over six weeks. Measures were collected at baseline and post-intervention, including self-reported weekly minutes of MVPA, PA intention and planning, SDT-based motivation (intrinsic, integrated, identified, introjected, external, amotivation), basic psychological needs satisfaction (competence, autonomy, relatedness), body functionality appreciation, body compassion (body kindness, motivated action, common humanity), internalized weight bias, and physical appearance comparison. Analyses examined mean change scores and Cohen's d effect sizes to assess preliminary impact.
Results
Post-intervention, participants demonstrated meaningful increases in MVPA minutes per week, PA intention and planning. SDT outcomes showed increased competence, autonomy, integrated regulation and intrinsic motivation, and decreased introjected regulation. Body image–related outcomes indicated increased body appreciation, decreased physical appearance comparison, and improvements in two of three body compassion subscales (body kindness and motivated action). Effect sizes for these changes were in the small-to-large range, suggesting practical significance despite the small sample.
Conclusions
Preliminary findings suggest the Body Neutrality Playbook may promote autonomous PA motivation and positive body image while reducing appearance-based self-comparisons among women who are insufficiently active. The combination of body neutrality principles and SDT-informed behavior change strategies may address both psychological and behavioral barriers to PA. Future research with larger, more diverse samples and a controlled design is warranted to evaluate efficacy and mechanisms of change.
Authors:
Author - Kayla Nuss, PhD, Klein Buendel
Co-Author - Amanda Brice, BS, MPH, Klein Buendel LLC
Co-Author - Sierra Held, BS, Klein Buendel
Co-Author - Taylor Sullivan, Klein Buendel
Co-Author - Noah Chirico, MPH, Klein Buendel
Co-Author - Anne Poirier, Shaping Perspectives
Gratitude and Well-Being in Athletes: A Systematic Scoping Review
Poster Number: A127Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Mental Health
Gratitude, which can be considered both an affective trait and a positive emotional state, is the recognition and appreciation of the goodness in one’s life, either from someone or something. Over the past few decades, interest in examining gratitude has grown dramatically, and its relations with health and well-being in the general population have been extensively documented. Some research has examined the psychological benefits of gratitude in populations with specific challenges, such as athletes. Given athletes’ reports of exhaustion, feelings of overwhelm, anxiety, and sleep difficulties specific to high-performance settings, it is important to determine how the established relationship between gratitude and psychological health applies for athletes. To date, the evidence on how gratitude (trait or state) and gratitude interventions relate to athletes’ mental health and subjective well-being has yet to be systematically reviewed, the aim of the present systematic review.
In accordance to PRISMA guidelines, a total of 669 records were retrieved across three databases (PubMed, PsycInfo, and SPORTDiscus) and 48 records were accessed for eligibility through full-text review. 24 studies (22 articles) were included in the final review. Across the 24 studies, higher trait and state gratitude were consistently associated with increased life satisfaction (n=7), positive affect (n=1), self-esteem (n=3), resilience (n=2), and overall well-being (n=2). Eleven studies found that gratitude was associated with lower levels of athlete burnout. Three studies included gratitude interventions. Specific sport-domain gratitude measured in 6 out of the 24 studies showed that high school and collegiate athletes with higher sport-domain gratitude reported relationships with greater sport-specific psychological aspects such as increased coach-athlete relationships, sport/team satisfaction, and decreased athlete burnout. This review highlights the emerging role of gratitude as a potential protective and enhancing factor in athlete mental health and well-being. While no studies included direct performance metrics (e.g., wins/losses, rankings, record), the findings underscore the importance of using positive psychological constructs like gratitude to foster psychological well-being that is necessary for enjoyment and sustained engagement in physical activity.
Keywords: Physical activity, Mental healthIn accordance to PRISMA guidelines, a total of 669 records were retrieved across three databases (PubMed, PsycInfo, and SPORTDiscus) and 48 records were accessed for eligibility through full-text review. 24 studies (22 articles) were included in the final review. Across the 24 studies, higher trait and state gratitude were consistently associated with increased life satisfaction (n=7), positive affect (n=1), self-esteem (n=3), resilience (n=2), and overall well-being (n=2). Eleven studies found that gratitude was associated with lower levels of athlete burnout. Three studies included gratitude interventions. Specific sport-domain gratitude measured in 6 out of the 24 studies showed that high school and collegiate athletes with higher sport-domain gratitude reported relationships with greater sport-specific psychological aspects such as increased coach-athlete relationships, sport/team satisfaction, and decreased athlete burnout. This review highlights the emerging role of gratitude as a potential protective and enhancing factor in athlete mental health and well-being. While no studies included direct performance metrics (e.g., wins/losses, rankings, record), the findings underscore the importance of using positive psychological constructs like gratitude to foster psychological well-being that is necessary for enjoyment and sustained engagement in physical activity.
Authors:
Author - Erika Osherow, M.Ed., M.A., University of Connecticut
Co-Author - Crystal Park, PhD, FSBM, University of Connecticut
Making interventions more effective: Examining changes in theoretical constructs during a peer delivered physical activity intervention for breast cancer survivors
Poster Number: A128Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Cancer
Background. Less is known about changes in theoretical constructs during the intervention phase of physical activity (PA) programs. Examining these data can be highly informative in making theory-based interventions more effective before post-intervention assessments and follow ups. We examined longitudinal changes in self-efficacy, self-regulation and affect (Social-Cognitive Theory constructs) during a 12-week theory-based PA program (webMFT) for cancer survivors. We examined changes in these constructs as predictors of active minutes (measured by Fitbit®) over 12w and intervention adherence (receipt of 12 weekly peer coaching calls).
Methods. 10 peer coaches delivered webMFT to breast cancer survivors (n=30 randomized to webMFT at baseline, mean age=58.1 [SD=8.55], 1.40 years post-diagnosis [SD=0.5], 80% Stage 0-1 cancer, 80% White) for 12w. webMFT participants received a FitBit® tracker, weekly synchronization reminders, and weekly PA coaching calls tailored to PA data from the FitBit®. At baseline, 4w, 8w and 12w, they completed standardized questionnaires assessing self-efficacy for PA (Multidimensional Self-Efficacy for Exercise: total score; task, coping and scheduling self-efficacy), self-regulation skills (PA Self-Regulation Scale) and affective response to PA (Feeling Scale) We used mixed effects regression models to examine changes in constructs and participant outcomes (active minutes/week and intervention call adherence).
Results. webMFT participants increased PA from baseline (mean=150.83 active min/week, SD=136.56) to 12w (mean=174.43 active min/week, SD=120.98). Increases in total self-efficacy over time was positively associated with PA over 12w (b=5.25, SE=2.07, p=.01). There were no significant associations between changes in self-regulation skills, task or coping self-efficacy with changes in PA. However, increases in scheduling self-efficacy was positively associated with increased PA over 12w (b=.60, SE=.20, p=.01). Change towards positive affect during PA was positively associated with active min/week over 12w (b=1.12, SE=.08, p=.01). We found significant positive associations between increases in total self-efficacy, self-regulation skills and affect with call adherence over 12w.
Conclusions. Peer coaches should focus on improving participants’ self-efficacy (specifically, for finding time for PA) and positive affect during PA not only to increase their PA but also to boost their adherence to intervention calls.
Keywords: Cancer survivorship, Physical activityMethods. 10 peer coaches delivered webMFT to breast cancer survivors (n=30 randomized to webMFT at baseline, mean age=58.1 [SD=8.55], 1.40 years post-diagnosis [SD=0.5], 80% Stage 0-1 cancer, 80% White) for 12w. webMFT participants received a FitBit® tracker, weekly synchronization reminders, and weekly PA coaching calls tailored to PA data from the FitBit®. At baseline, 4w, 8w and 12w, they completed standardized questionnaires assessing self-efficacy for PA (Multidimensional Self-Efficacy for Exercise: total score; task, coping and scheduling self-efficacy), self-regulation skills (PA Self-Regulation Scale) and affective response to PA (Feeling Scale) We used mixed effects regression models to examine changes in constructs and participant outcomes (active minutes/week and intervention call adherence).
Results. webMFT participants increased PA from baseline (mean=150.83 active min/week, SD=136.56) to 12w (mean=174.43 active min/week, SD=120.98). Increases in total self-efficacy over time was positively associated with PA over 12w (b=5.25, SE=2.07, p=.01). There were no significant associations between changes in self-regulation skills, task or coping self-efficacy with changes in PA. However, increases in scheduling self-efficacy was positively associated with increased PA over 12w (b=.60, SE=.20, p=.01). Change towards positive affect during PA was positively associated with active min/week over 12w (b=1.12, SE=.08, p=.01). We found significant positive associations between increases in total self-efficacy, self-regulation skills and affect with call adherence over 12w.
Conclusions. Peer coaches should focus on improving participants’ self-efficacy (specifically, for finding time for PA) and positive affect during PA not only to increase their PA but also to boost their adherence to intervention calls.
Authors:
Presenter - Bernardine Pinto, PhD, FSBM, University of South Carolina
Co-Author - Madison Kindred, PhD, Augusta University
Co-Author - Shira Dunsiger, PhD, Brown University, School of Public Health
Co-Author - Victoria DeScenza, PhD, University of Connecticut
Capability – Opportunity – Motivation – Behavior (COM-B) Model Correlates of Physical Activity in People with Multiple Sclerosis and Analogue Generalized Anxiety Disorder
Poster Number: A129Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Mental Health
Background: Generalized anxiety disorder (GAD) is prevalent, burdensome, and poorly treated among people with multiple sclerosis (MS). Physical activity may be a promising lifestyle approach for treating GAD in people with MS, and a foundational step in development of high-quality behavioral interventions for targeting physical activity involves examination of established theoretical constructs as correlates of this health behavior.
Purpose: This study examined the constructs within the Capability-Motivation-Opportunity-Behavior (COM-B) model for explaining current and long-term physical activity behavior in people with MS who had analogue GAD.
Methods: Participants (N=320) were prescreened for analogue GAD based on scores of ≥8 on the Generalized Anxiety Disorder-7 item questionnaire and then completed online REDCap surveys regarding demographic and clinical characteristics, anxiety symptoms, depressive symptoms, physical activity [Godin Leisure Time Exercise Questionnaire (GLTEQ), Physical Activity Staging Questionnaire (PASQ)], and COM-B constructs. Participants were categorized into current physical activity groups based on the GLTEQ scores, and long-term physical activity groups based on the PASQ scores. Multivariate Analysis of Variance (MANOVA) and Discriminant Function Analysis (DFA) identified COM-B constructs that differentiated physical activity groups.
Results: MANOVA indicated that all COM-B constructs were significantly different among the current (Wilk’s λ = .54, F(44, 590) = 4.83, p <.001) and the long-term physical activity groups (Wilks’ λ = .55, F(44, 590) = 4.68, p <.001). DFA identified Action Control, Intention, Coping Planning, Action Self-efficacy, Maintenance Self-efficacy, Action Planning, and Recovery Self-efficacy as primary differentiating variables of current physical activity groups. DFA identified Action Control, Maintenance Self-efficacy, Action Self-efficacy, Recovery Self-efficacy, Intention, Coping Planning, Goal Setting, and Action Planning as primary differentiating variables of long-term physical activity groups in persons with MS and analogue GAD.
Conclusions: Our results identified factors within the Capability and Motivation domains of the COM-B model as primary correlates of current and long-term physical activity in people with MS who have analogue GAD. Such results may guide the development of physical activity behavioral interventions for increasing this health behavior and treating GAD in people with MS.
Keywords: Physical activity, Health behavior changePurpose: This study examined the constructs within the Capability-Motivation-Opportunity-Behavior (COM-B) model for explaining current and long-term physical activity behavior in people with MS who had analogue GAD.
Methods: Participants (N=320) were prescreened for analogue GAD based on scores of ≥8 on the Generalized Anxiety Disorder-7 item questionnaire and then completed online REDCap surveys regarding demographic and clinical characteristics, anxiety symptoms, depressive symptoms, physical activity [Godin Leisure Time Exercise Questionnaire (GLTEQ), Physical Activity Staging Questionnaire (PASQ)], and COM-B constructs. Participants were categorized into current physical activity groups based on the GLTEQ scores, and long-term physical activity groups based on the PASQ scores. Multivariate Analysis of Variance (MANOVA) and Discriminant Function Analysis (DFA) identified COM-B constructs that differentiated physical activity groups.
Results: MANOVA indicated that all COM-B constructs were significantly different among the current (Wilk’s λ = .54, F(44, 590) = 4.83, p <.001) and the long-term physical activity groups (Wilks’ λ = .55, F(44, 590) = 4.68, p <.001). DFA identified Action Control, Intention, Coping Planning, Action Self-efficacy, Maintenance Self-efficacy, Action Planning, and Recovery Self-efficacy as primary differentiating variables of current physical activity groups. DFA identified Action Control, Maintenance Self-efficacy, Action Self-efficacy, Recovery Self-efficacy, Intention, Coping Planning, Goal Setting, and Action Planning as primary differentiating variables of long-term physical activity groups in persons with MS and analogue GAD.
Conclusions: Our results identified factors within the Capability and Motivation domains of the COM-B model as primary correlates of current and long-term physical activity in people with MS who have analogue GAD. Such results may guide the development of physical activity behavioral interventions for increasing this health behavior and treating GAD in people with MS.
Authors:
Presenter - Petra Šilić, University of Illinois Chicago
Co-Author - Ariel Kidwell-Chandler, University of Illinois Chicago
Co-Author - Trinh Huynh, PhD, University of Illinois Chicago
Co-Author - Robert Motl, PhD, University of Illinois Chicago
The Importance of the Superwoman Schema for Understanding Physical Activity Among African American Women
Poster Number: A130Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Health Disparities
The Superwoman Schema (SWS) provides a critical cultural framework for understanding the different ways African American women respond to stress, lived experiences, and unfair treatment. While past studies have evaluated the impact of the SWS on mental health, less research has evaluated physical health and has been limited by self-reports. Drawing from a multi-theoretical framework, this study examined the extent to which the SWS adds to our understanding of objectively-measured physical activity (PA) among African American women, alongside other psycho-social constructs. Baseline data from 245 African American women with overweight or obesity (MBMI=36.85±7.23; Mage=52.44±13.14) who participated in the ongoing ‘Together Everyone Achieves More Physical Activity’ randomized controlled trial were included. Participants completed a baseline survey, including the SWS - obligation to help others sub-scale and measures of self-efficacy for PA, self-determined motivation for PA, and social support for PA from family. Participants also wore an ActiGraph accelerometer for 7-days to assess average daily minutes of light PA and moderate to vigorous PA. Mixed modeling with adjustments for covariates (e.g., age, marital status, education, BMI) revealed that SWS – obligation to help others (B = 4.81, p < .05), self-efficacy (B = -5.77, p < .01) and autonomous motivation (B = 8.72, p < .01) were significantly associated with light PA. However, only autonomous motivation was associated with moderate to vigorous PA (B = .28, p < .01). There were no significant effects for social support from family. While past research has generally found that the SWS – obligation to help others is related to worse health outcomes, the present study is among the first to use an objective measure of PA, differentiate between PA intensities, and demonstrate that this aspect of the SWS may relate to greater daily light PA. Furthermore, the present study demonstrates that the SWS – obligation to help others relates to daily light PA, even when accounting for other robust psycho-social predictors, which has not been evaluated in past research. Thus, this study highlights the importance of integrating cultural constructs, such as the SWS, alongside theory-based psycho-social constructs, for enhanced understanding of PA engagement among African American women.
Keywords: Physical activity, CultureAuthors:
Presenter - Allison Sweeney, PhD, University of South Carolina
Co-Author - Lisa Brockington, MSN, BSN, University of South Carolina
Co-Author - Timothy Simmons, BA, University of Maryland
Co-Author - Dawn Wilson, PhD, University of South Carolina
Co-Author - Pamela Martin, PhD, University of South Carolina
Co-Author - Nicole Zarrett, PhD, University of South Carolina
Youth sports practices as a setting for physical activity promotion among mothers: results from a single-arm open pilot trial
Poster Number: A131Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Women's Health
Introduction: Youth sports have been examined as a setting for health promotion interventions for children, but not parents. We pilot tested a physical activity (PA) promotion intervention delivered to mothers during their children’s sports practices.
Methods: We partnered with a youth football and cheerleading organization to conduct a 6-week single-arm open pilot trial of an intervention consisting of group PA sessions during practice. Feasibility was determined based on whether enrollment, retention, and assessment targets were met. Acceptability was determined based on participant engagement and satisfaction. Preliminary efficacy was determined based on whether participants experienced increases in moderate to vigorous PA (MVPA) or PA self-efficacy at 3- and 6-weeks relative to baseline.
Results: We met recruitment (n=26) and retention (85%) targets, but only collected follow-up data from 12 participants. Twelve out of 18 planned intervention sessions were offered due to practice cancellations; participant attendance ranged from 0 to 12 sessions. Participant satisfaction was high, and significant increases in MVPA and PA self-efficacy were observed.
Conclusions: This study demonstrated the feasibility, acceptability, and preliminary efficacy of a PA promotion intervention delivered to mothers during youth sports practices. Youth sports practices may provide a promising opportunity for delivering health promotion interventions to parents.
Keywords: Physical activity, Women's healthMethods: We partnered with a youth football and cheerleading organization to conduct a 6-week single-arm open pilot trial of an intervention consisting of group PA sessions during practice. Feasibility was determined based on whether enrollment, retention, and assessment targets were met. Acceptability was determined based on participant engagement and satisfaction. Preliminary efficacy was determined based on whether participants experienced increases in moderate to vigorous PA (MVPA) or PA self-efficacy at 3- and 6-weeks relative to baseline.
Results: We met recruitment (n=26) and retention (85%) targets, but only collected follow-up data from 12 participants. Twelve out of 18 planned intervention sessions were offered due to practice cancellations; participant attendance ranged from 0 to 12 sessions. Participant satisfaction was high, and significant increases in MVPA and PA self-efficacy were observed.
Conclusions: This study demonstrated the feasibility, acceptability, and preliminary efficacy of a PA promotion intervention delivered to mothers during youth sports practices. Youth sports practices may provide a promising opportunity for delivering health promotion interventions to parents.
Authors:
Co-Author - Belinda O'Hagan, Brown University
Presenter - Tayla Von Ash, ScD, MPH, Brown University School of Public Health
Co-Author - Shira Dunsiger, PhD, Brown University, School of Public Health
Co-Author - Bess Marcus, PhD, FSBM, Brown University
Feasibility and Acceptability of Completing Office Tasks on a Treadmill Desk: A Qualitative Study
Poster Number: A132Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Social and Environmental Context and Health
Background: Sedentary behavior has become a growing concern due to its health risks. Innovative interventions such as activity-permissive workstations (APWs; e.g., treadmill desks) offer a potential solution to reduce prolonged sitting while maintaining productivity. However, the practicality and user experience of these workstations are not yet fully understood. This study assessed the feasibility and acceptability of treadmill desks in a lab environment to inform scalable public health strategies that reduce sedentary behavior in daily work.
Methods: College students in Colorado (n = 48) completed a lab session that involved performing office tasks (e.g., reading, writing, virtual meeting) on a treadmill desk, followed by a semi-structured interview. All interviews were audiotaped and transcribed using Teams software manually checked for accuracy and coded in Atlas.ti 9. Using deductive thematic analysis, two coders achieved high inter-rater reliability (Krippendorff’s α = 0.87) and discrepancies were resolved with a third coder.
Results: Four themes emerged capturing participants’ experience on the treadmill desk: 1) Lifestyle and Perceptions of APWs: participants acknowledged their sedentary habits and saw APWs as a way for adding movement and supporting a healthier routine; 2) Bodily Sensations: some participants did not experience changes in bodily sensations from using the treadmill desk, while others reported feelings of fatigue or, conversely, increased energy after using the treadmill desk; 3) Cognitive Performance and Emotional Responses: attention and productivity were generally maintained, and some participants, particularly those with ADHD and who tend to fidget while sitting, reported increased focus on the treadmill desk; and 4) Factors Influencing Treadmill Desk Usage: preference of treadmill desks was shaped by individual lifestyle patterns, health status or awareness, task compatibility, availability and accessibility.
Discussion: Treadmill desks were perceived as a feasible and acceptable workstation option, particularly as a complement to traditional desks. These findings highlight the potential for treadmill desks to reduce sedentary time, while supporting healthier and potentially more attentive work practices. Importantly, this study provides early evidence to inform public health strategies aimed at integrating movement into everyday work settings, contributing to long-term efforts to combat the health risks of sedentary behavior.
Keywords: Exercise, Public healthMethods: College students in Colorado (n = 48) completed a lab session that involved performing office tasks (e.g., reading, writing, virtual meeting) on a treadmill desk, followed by a semi-structured interview. All interviews were audiotaped and transcribed using Teams software manually checked for accuracy and coded in Atlas.ti 9. Using deductive thematic analysis, two coders achieved high inter-rater reliability (Krippendorff’s α = 0.87) and discrepancies were resolved with a third coder.
Results: Four themes emerged capturing participants’ experience on the treadmill desk: 1) Lifestyle and Perceptions of APWs: participants acknowledged their sedentary habits and saw APWs as a way for adding movement and supporting a healthier routine; 2) Bodily Sensations: some participants did not experience changes in bodily sensations from using the treadmill desk, while others reported feelings of fatigue or, conversely, increased energy after using the treadmill desk; 3) Cognitive Performance and Emotional Responses: attention and productivity were generally maintained, and some participants, particularly those with ADHD and who tend to fidget while sitting, reported increased focus on the treadmill desk; and 4) Factors Influencing Treadmill Desk Usage: preference of treadmill desks was shaped by individual lifestyle patterns, health status or awareness, task compatibility, availability and accessibility.
Discussion: Treadmill desks were perceived as a feasible and acceptable workstation option, particularly as a complement to traditional desks. These findings highlight the potential for treadmill desks to reduce sedentary time, while supporting healthier and potentially more attentive work practices. Importantly, this study provides early evidence to inform public health strategies aimed at integrating movement into everyday work settings, contributing to long-term efforts to combat the health risks of sedentary behavior.
Authors:
Author - Chang Nie, Colorado State University
Author - Hailey Graham, Birkbeck Business School, Birkbeck, University of London
Author - Yiqing "Skylar" Yu, Colorado State University
Author - Katie McMahon, M.S., Colorado State University
Author - Daniel Graham, PhD, Colorado State University
The role of distress and resilience factors in the relationship between internalized health-related stigma and mental health symptoms
Poster Number: A133Time: 05:00 PM - 05:50 PM
Topics: Quality of Life, Social and Environmental Context and Health
Internalized stigma has frequently been observed among people with chronic health conditions and is recognized as a distressing process that can harm emotional health. The previous research into disease-specific internalized stigma has tailored insights for specific health conditions; however, the siloed nature of these efforts within one condition at a time has impeded the development of a nimbler framework of how the transdiagnostic concept of stigma impacts emotional health. Building a transdiagnostic stigma framework provides a foundation for future intervention studies to explore resilience-focused treatments that preserve emotional health. Such interventions could be disseminated across treatment centers requiring less need for nuanced training or conditional formatting of treatment.
Internalized health stigma has been tied to increased levels of psychological distress (e.g., shame), which is a known contributor to adverse mental health symptoms. On the other hand, resilience factors (e.g., self-esteem) may buffer against the harms of this stigma. The present research aimed to build this understanding by asking if shame positively mediates the relationship between stigma and mental health symptoms, and if these overall relationships negatively moderated by higher self-esteem? This was answered through a preregistered secondary analysis of a cross-sectional dataset of 300 adults who reported having at least one type of stigmatized chronic health condition (cancer, chronic pain, HIV, obesity, skin diseases, diabetes). These participants completed a survey of validated measures assessing internalized health stigma, shame, self-esteem, and mental illness symptoms.
A moderated mediation analysis found that greater internalized health-related stigma was associated with heightened symptoms of depression, anxiety, and social anxiety. These relationships were positively mediated by higher levels of internalized shame and higher self-esteem negatively moderated the pathway from shame to social anxiety. These findings highlight the relationship between internalized health stigma, shame, and mental illness symptoms for people with chronic health conditions. The results also emphasize the role of increased self-esteem in strengthening the resilience of individuals with chronic health conditions by potentially buffering against social anxiety. Future research can further these findings through therapeutic interventions to address shame and social anxiety.
Keywords: Resilience, Multiple chronic conditionsInternalized health stigma has been tied to increased levels of psychological distress (e.g., shame), which is a known contributor to adverse mental health symptoms. On the other hand, resilience factors (e.g., self-esteem) may buffer against the harms of this stigma. The present research aimed to build this understanding by asking if shame positively mediates the relationship between stigma and mental health symptoms, and if these overall relationships negatively moderated by higher self-esteem? This was answered through a preregistered secondary analysis of a cross-sectional dataset of 300 adults who reported having at least one type of stigmatized chronic health condition (cancer, chronic pain, HIV, obesity, skin diseases, diabetes). These participants completed a survey of validated measures assessing internalized health stigma, shame, self-esteem, and mental illness symptoms.
A moderated mediation analysis found that greater internalized health-related stigma was associated with heightened symptoms of depression, anxiety, and social anxiety. These relationships were positively mediated by higher levels of internalized shame and higher self-esteem negatively moderated the pathway from shame to social anxiety. These findings highlight the relationship between internalized health stigma, shame, and mental illness symptoms for people with chronic health conditions. The results also emphasize the role of increased self-esteem in strengthening the resilience of individuals with chronic health conditions by potentially buffering against social anxiety. Future research can further these findings through therapeutic interventions to address shame and social anxiety.
Authors:
Author - Elijah Mudryk, M.A., University of Florida
Author - Rebecca Pearl, Ph.D. , University of Florida
Quality of Life Trajectories in Children Undergoing Hematopoietic Stem Cell Transplantation
Poster Number: A134Time: 05:00 PM - 05:50 PM
Topics: Quality of Life, Child and Family Health
Introduction:
Children receiving hematopoietic stem cell transplant (HCT) face intense outpatient regimens, life-threatening complications (e.g., graft-versus-host disease (GVHD)), and restrictions negatively impacting quality of life (QOL). Research has shown QOL may improve 4-6 months post-HCT. However, little is known about QOL in the acute phase post-HCT (first 100 days). We explored longitudinal patterns and medical (i.e., readmissions, GVHD) factors moderating QOL post-HCT.
Methods:
Caregivers of children 0-21 years old were enrolled at discharge and followed for 11 weeks. At weeks 3, 6, and 9, caregivers completed the Pediatric Quality of Life Inventory (PedsQL; scale: 0-100). At enrollment, caregivers reported child demographics, and medical charts were reviewed for readmissions and GVHD status. Descriptive statistics, correlations, and repeated measures ANOVAs were examined.
Results:
The sample of children (n=50) was primarily White (70%), non-Hispanic/Latino (86%), male (54%), and an average age of 8.35 years (SD=6.77). Thirty two percent developed GVHD (n=16), and 40% were readmitted (n=20). On average, QOL was 73.79 (SD=16.15) at week 3, 74.72 (SD=18.07) at week 6, and 75.46 (SD=19.18) at week 9. Readmissions were correlated with lower QOL (week 3: r(35)=-.41, p=.02; week 6: r(37)=-.39, p=.02; week 9: r(39)=-.50, p=.001). Mean QOL scores improved over time, F(2, 52) = 3.06, p=.06, η²p=.11, indicating a medium to large effect. GVHD was a significant moderator, F(2, 50)=3.48, p=.04, η²p=.12, such that QOL decreased for those with GVHD and increased for those without GVHD.
Discussion:
We found improvements over 9 weeks following discharge post-HCT, suggesting child QOL may improve faster than expected. Children with GVHD had worsening QOL, which aligns with cross-sectional research in long-term survivors. Children who avoided readmission had better QOL. Additional research is needed to explore factors associated with QOL in the acute phase post pediatric HCT. Clinicians should proactively address QOL factors for children who develop GVHD and are readmitted.
Keywords: Quality of life, Longitudinal researchChildren receiving hematopoietic stem cell transplant (HCT) face intense outpatient regimens, life-threatening complications (e.g., graft-versus-host disease (GVHD)), and restrictions negatively impacting quality of life (QOL). Research has shown QOL may improve 4-6 months post-HCT. However, little is known about QOL in the acute phase post-HCT (first 100 days). We explored longitudinal patterns and medical (i.e., readmissions, GVHD) factors moderating QOL post-HCT.
Methods:
Caregivers of children 0-21 years old were enrolled at discharge and followed for 11 weeks. At weeks 3, 6, and 9, caregivers completed the Pediatric Quality of Life Inventory (PedsQL; scale: 0-100). At enrollment, caregivers reported child demographics, and medical charts were reviewed for readmissions and GVHD status. Descriptive statistics, correlations, and repeated measures ANOVAs were examined.
Results:
The sample of children (n=50) was primarily White (70%), non-Hispanic/Latino (86%), male (54%), and an average age of 8.35 years (SD=6.77). Thirty two percent developed GVHD (n=16), and 40% were readmitted (n=20). On average, QOL was 73.79 (SD=16.15) at week 3, 74.72 (SD=18.07) at week 6, and 75.46 (SD=19.18) at week 9. Readmissions were correlated with lower QOL (week 3: r(35)=-.41, p=.02; week 6: r(37)=-.39, p=.02; week 9: r(39)=-.50, p=.001). Mean QOL scores improved over time, F(2, 52) = 3.06, p=.06, η²p=.11, indicating a medium to large effect. GVHD was a significant moderator, F(2, 50)=3.48, p=.04, η²p=.12, such that QOL decreased for those with GVHD and increased for those without GVHD.
Discussion:
We found improvements over 9 weeks following discharge post-HCT, suggesting child QOL may improve faster than expected. Children with GVHD had worsening QOL, which aligns with cross-sectional research in long-term survivors. Children who avoided readmission had better QOL. Additional research is needed to explore factors associated with QOL in the acute phase post pediatric HCT. Clinicians should proactively address QOL factors for children who develop GVHD and are readmitted.
Authors:
Author - Madeline Peek, B.A., The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Anna Olsavsky, PhD, The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Lydia Wisne, B.S., The Abigail Wexner Research Institute at Nationwide Children's Hospital
Co-Author - Ahna Pai, PhD, FSBM, The Abigail Wexner Research Institute at Nationwide Children's Hospital & The Ohio State University
Co-Author - Cynthia Gerhardt, PhD, The Abigail Wexner Research Institute at Nationwide Children's Hospital & The Ohio State University
Co-Author - Micah Skeens, PhD APRN FAAN, The Abigail Wexner Research Institute at Nationwide Children's Hospital & The Ohio State University
Using Fitbits for Extending Sleep Duration among Adults with Short Sleep Duration: Retention, Adherence, and User Experiences
Poster Number: A135Time: 05:00 PM - 05:50 PM
Topics: Sleep
Study Objectives: Consumer sleep trackers (CSTs) are increasingly common in the population and can provide insights into sleep behaviors for behavioral interventions. This study aimed to describe the implementation, adherence, and participant perceptions of CSTs among two behavioral sleep extension studies.
Methods: Both studies employed randomized controlled trial designs. Participants were provided with Fitbit devices and engaged in structured coaching sessions via Zoom or phone, supplemented with sleep education materials. Adherence was measured by the number of days with sleep data recorded during the intervention periods (8 weeks for study 1, 12 weeks for study 2). Participant feedback was collected through end-of-study surveys and open-ended questions to assess usability, satisfaction, and perceived impact.
Results: Participants were randomized to either the intervention or control group; here we present the outcomes for the intervention group-study 1 enrolled 60 participants and study 2 enrolled 73 participants. Adherence was 89% and 86% and study retention was 100% and 86%, respectively. Participants reported increased awareness of sleep patterns and found the CST helpful for motivation and goal tracking. However, technical issues, discomfort, and emotional responses to sleep data were noted as barriers.
Conclusions: Fitbit devices, when paired with personalized coaching and support, can effectively be used to promote participant engagement in sleep behavior change studies. Continued research is essential to refine wearable technology interventions to maximize their impact on health behavior modification.
Keywords: Technology, Sleep disordersMethods: Both studies employed randomized controlled trial designs. Participants were provided with Fitbit devices and engaged in structured coaching sessions via Zoom or phone, supplemented with sleep education materials. Adherence was measured by the number of days with sleep data recorded during the intervention periods (8 weeks for study 1, 12 weeks for study 2). Participant feedback was collected through end-of-study surveys and open-ended questions to assess usability, satisfaction, and perceived impact.
Results: Participants were randomized to either the intervention or control group; here we present the outcomes for the intervention group-study 1 enrolled 60 participants and study 2 enrolled 73 participants. Adherence was 89% and 86% and study retention was 100% and 86%, respectively. Participants reported increased awareness of sleep patterns and found the CST helpful for motivation and goal tracking. However, technical issues, discomfort, and emotional responses to sleep data were noted as barriers.
Conclusions: Fitbit devices, when paired with personalized coaching and support, can effectively be used to promote participant engagement in sleep behavior change studies. Continued research is essential to refine wearable technology interventions to maximize their impact on health behavior modification.
Authors:
Author - Eliza Taylor, University of Utah
Author - Mary Takgbajouah, DePaul University
Author - Jennifer Duffecy, PhD, FSBM, University of Illinois at Chicago
Author - Minsun Park, PhD, University of Illinois at Chicago
Author - Sirimon Reutrakul, MD, University of Illinois at Chicago
Author - Pamela Martyn-Nemeth, PhD, University of Illinois at Chicago
Rooted & rested: Ethnic social affiliation and family support are associated with better sleep outcomes for Latine adults
Poster Number: A136Time: 05:00 PM - 05:50 PM
Topics: Sleep, Social and Environmental Context and Health
Background: Latine individuals in the U.S. report higher rates of short sleep duration and sleep disturbances compared to the non-Hispanic white population (Concha et al., 2021; Whinnery et al., 2014). Ethnic identity and familism have been correlated with positive health outcomes, mitigating the adverse effects of acculturation stress and discrimination (McHale et al., 2011; Mossakowski et al., 2003). However, little is known about the associations between these cultural factors and sleep in the Latine population. This study aims to explore the direct effects of ethnic identity on sleep in a sample of Latine adults, including whether familism moderated these associations. We hypothesized higher levels of ethnic identity and social affiliation with those who share one’s ethnic identity will be associated with longer sleep duration, higher sleep efficiency, and lower sleep fragmentation, while comfort with mainstream American culture will be associated with poorer sleep. We also hypothesize that family support will moderate these relationships, such that high family support will strengthen the association between ethnic identity and sleep and weaken the association between mainstream culture comfort and poor sleep. Methods: Data were collected from a sample of 2,159 adults (48% female, 100% Hispanic/Latino) as part of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Participants completed the Scale of Ethnic Experiences - Short Form (ethnic identity) and Sabogal’s 14-item scale (familism). Sleep outcomes were measured using actigraphy. Results: Ethnic social affiliation was slightly positively associated with sleep duration (r(2159) = .070, p < .05), comfort with mainstream culture was negatively associated with sleep efficiency (r(2159) = -.179, p < .001) and positively associated with sleep fragmentation index (r(2159) = .173, p < .001). Family support and ethnic identity were not associated with sleep outcomes. However, family support moderated the association between ethnic social affiliation and sleep duration in Latine adults (ΔR² = .003, p = .016), suggesting that the positive association between ethnic social affiliation with others who share one’s ethnic identity and sleep duration is stronger for those with higher family support. Conclusion: These findings demonstrate the importance of incorporating cultural values such as familism and ethnic identity in sleep interventions for Latine populations.
Keywords: Culture, Sleep disordersAuthors:
Presenter - Tetyana Krutsik, BA, DePaul University
Co-Author - Alexis Friesen, BA, DePaul University
Co-Author - Joanna Buscemi, PhD, DePaul University
Chronic Diseases, Sleep Duration, and Cognition among Middle-Aged and Older Latinos
Poster Number: A137Time: 05:00 PM - 05:50 PM
Topics: Sleep, Aging
Introduction: Latinos are at a higher risk of cognitive decline, in which chronic diseases (CD) and sleep play a contributing role. However, research examining the effect of differences in CD and sleep on cognition is limited. Therefore, we seek to examine differences in cognitive function across sleep duration and presence of CD among middle-aged and older Latinos.
Methods: Participants reported their sleep duration and were classified into the short (<7 hours) or intermediate (7-8 hours) sleep group These were further divided into two groups: no CD or CD (if they had one or more of the following: diabetes, heart failure, high blood pressure, high cholesterol, kidney disease). All participants completed a series of cognitive tests that measured global cognition (Mini Mental State Examination), executive functioning (Stroop, Trail Making Tests, and Symbol Digit Modalities), and episodic memory (Immediate and Delay Recall). Composite z-scores were calculated for executive function and episodic memory. Descriptives and independent t-tests were conducted and effect sizes were calculated.
Results: Fifty -nine middle-aged and older Latinos (MAge=58±8 years, 76% female) participated in the study. Independent sample t-tests revealed that within the short sleep group (NNo CD = 17, NCD= 17), participants with CD had significantly lower global cognition (MNo CD= 28.71±1.05, MCD= 27.35±2.06; t(23.75)= -2.41, p = .024, Cohen’s d= -.83) and executive function (MNo CD= 1.64±2.38, MCD= -.80±3.63; t(32)= -2.32, p = .027, Cohen’s d= -.80). Additionally, t-tests revealed that within the intermediate sleep group (NNo CD = 10, NCD= 15), participants with CD had a significantly lower performance in episodic memory (MNo CD= .47±1.66, MCD= -1.09±1.72; t(22)= -2.21, p = .038, Cohen’s d= -.92) when compared to participants without CD.
Conclusion: Latinos with CD in the short sleep group exhibited poorer cognitive performance on executive function and global cognition compared to those without CD. Furthermore, Latinos with CD in the intermediate sleep group demonstrated poorer performance on episodic memory compared to those with no CD. Future interventions may consider targeting both sleep and chronic conditions to reduce the risk of cognitive decline among this population.
Keywords: Latino, DiseaseMethods: Participants reported their sleep duration and were classified into the short (<7 hours) or intermediate (7-8 hours) sleep group These were further divided into two groups: no CD or CD (if they had one or more of the following: diabetes, heart failure, high blood pressure, high cholesterol, kidney disease). All participants completed a series of cognitive tests that measured global cognition (Mini Mental State Examination), executive functioning (Stroop, Trail Making Tests, and Symbol Digit Modalities), and episodic memory (Immediate and Delay Recall). Composite z-scores were calculated for executive function and episodic memory. Descriptives and independent t-tests were conducted and effect sizes were calculated.
Results: Fifty -nine middle-aged and older Latinos (MAge=58±8 years, 76% female) participated in the study. Independent sample t-tests revealed that within the short sleep group (NNo CD = 17, NCD= 17), participants with CD had significantly lower global cognition (MNo CD= 28.71±1.05, MCD= 27.35±2.06; t(23.75)= -2.41, p = .024, Cohen’s d= -.83) and executive function (MNo CD= 1.64±2.38, MCD= -.80±3.63; t(32)= -2.32, p = .027, Cohen’s d= -.80). Additionally, t-tests revealed that within the intermediate sleep group (NNo CD = 10, NCD= 15), participants with CD had a significantly lower performance in episodic memory (MNo CD= .47±1.66, MCD= -1.09±1.72; t(22)= -2.21, p = .038, Cohen’s d= -.92) when compared to participants without CD.
Conclusion: Latinos with CD in the short sleep group exhibited poorer cognitive performance on executive function and global cognition compared to those without CD. Furthermore, Latinos with CD in the intermediate sleep group demonstrated poorer performance on episodic memory compared to those with no CD. Future interventions may consider targeting both sleep and chronic conditions to reduce the risk of cognitive decline among this population.
Authors:
Co-Author - Edgar Munoz, University of Illinois Urbana-Champaign
Co-Author - Diana Morales, BS, University of Illinois at Urbana-Champaign
Co-Author - Christian Corral, University of Illinois Urbana-Champaign
Co-Author - Susan Aguiñaga, PhD, University of Illinois at Urbana-Champaign
Longitudinal Associations Between Infant Parenting and Toddler Sleep: Exploring the Moderating Role of Infant Regulation
Poster Number: A138Time: 05:00 PM - 05:50 PM
Topics: Sleep, Child and Family Health
Sleep in early life has lasting health effects, with caregivers playing a central role in its development. A consistent bedtime routine and parents’ bedtime emotional availability are associated with longer sleep duration during both infancy and toddlerhood. Less is known about the longer-term longitudinal associations between infant parenting and toddler sleep. The current study evaluated parenting routine, nurturance, and anxiety at infant age seven months as predictors of child sleep duration and sleep problems at ages 18-24 months. Participants were 66 first-time parents (M age = 30.8 years, 60.9% White, 97% mothers) who participated in an online intervention study, with infant sleep or care content implemented from infant age two to four months and follow-up surveys at ages seven and 18-24 months. Ordinary least squares regressions assessed associations between aspects of parenting and sleep and moderation by infant regulation at seven months, adjusting for study group, infant feeding mode, and sleep at baseline. Exploratory analyses examined whether findings were consistent while adjusting for parent race, ethnicity, household income, food insecurity, and toddler age.
Tests of associations between aspects of infant parenting and toddler sleep were non-significant (p>.17). The interaction between infant parenting routine and infant regulation in the prediction of toddler sleep duration was significant (p<.01, η²ₚ=.13, 95% CI [.01, .28]). At low levels of infant regulation, lower levels of routine predicted shorter sleep, while higher levels of routine predicted longer sleep (β=.89; p=.02). At regulation levels at or above the mean, the relationship was not significant (p>.13). This moderation remained significant when adjusting for parent race, ethnicity, income, food insecurity, and toddler age. Lower income and identifying as Black also significantly predicted shorter sleep duration. Of the aspects of infant parenting examined, only routine predicted sleep outcomes into toddlerhood, with this relationship influenced by infants’ ability to regulate. Infants lower on regulation may benefit the most from routines, though future research should examine whether results replicate in larger samples and among fathers. Further exploration of infant factors and parent-infant interactions are warranted to better understand implications of these relationships for early life sleep given its established links with cognitive, emotional, and behavioral development.
Keywords: Caregiving, Parent-child transactionsTests of associations between aspects of infant parenting and toddler sleep were non-significant (p>.17). The interaction between infant parenting routine and infant regulation in the prediction of toddler sleep duration was significant (p<.01, η²ₚ=.13, 95% CI [.01, .28]). At low levels of infant regulation, lower levels of routine predicted shorter sleep, while higher levels of routine predicted longer sleep (β=.89; p=.02). At regulation levels at or above the mean, the relationship was not significant (p>.13). This moderation remained significant when adjusting for parent race, ethnicity, income, food insecurity, and toddler age. Lower income and identifying as Black also significantly predicted shorter sleep duration. Of the aspects of infant parenting examined, only routine predicted sleep outcomes into toddlerhood, with this relationship influenced by infants’ ability to regulate. Infants lower on regulation may benefit the most from routines, though future research should examine whether results replicate in larger samples and among fathers. Further exploration of infant factors and parent-infant interactions are warranted to better understand implications of these relationships for early life sleep given its established links with cognitive, emotional, and behavioral development.
Authors:
Presenter - Mars Scharf, BA, University at Buffalo
Author - Julie Bowker, PhD, University at Buffalo
Author - Stephanie Anzman-Frasca, PhD, University at Buffalo
The Role of Financial Strain in the Association between Household Dysfunction and Adolescent Disciplinary Events and Arrest
Poster Number: A139Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health, Health Disparities
Background: Household dysfunction [(HHD) e.g., parent/caregiver alcohol or drug misuse, mental illness, suicide, divorce, intimate partner violence, or incarceration)] are a class of adverse childhood experiences that predict negative health outcomes over the life course. There is considerable evidence that adolescents with a history of early adversity are at greater risk of problem behaviors (e.g., prematurely leaving school, substance use, interpersonal violence) that make them vulnerable for disciplinary action at school, school dropout and criminal justice involvement. However, little research with divers school based samples has explored the role of financial insecurity in the relationship between HHD and adolescent delinquency (e.g., disorderly conduct, truancy, running away, weapons carrying, vandalism, shoplifting) or arrest.
Methods: Data are baseline survey of diverse high school students (N=1,564) enrolled in a school-based study assessing health and developmental outcomes. GLMs tested the association between HHD and delinquent behaviors and arrest and whether financial insecurity moderated this association, adjusting for age, sex, ethnicity, poverty status, and state.
Results: Half of the sample was female (51%), 29% identified as non-Hispanic White, followed by African American (24%), Hispanic (21%), Multiracial (19%), and Asian (8%). More than one in three students (36%) had 1-2 HHD, and 10% had 3 or more. Over one in seven (14%) students reported disciplinary events for at least one delinquent behavior, and 5% reported being arrested. For every additional HHD stressor was associated with an increased risk ratio of having a disciplinary event at school (RRR: 1.43, 95% CI: 1.27, 1.61) or being arrested (RRR: 1.57, 95% CI: 1.33, 1.86). Importantly, financial insecurity moderated this association; youth with a history of HHD and experiencing financial insecurity had significantly relative risk of being arrested than youth with a history of HHD but who reported more financially stable backgrounds (p=0.02).
Conclusion: These findings underscore the need for intervention efforts that address both trauma and economic hardship in order to prevent or reduce delinquency and justice system involvement among vulnerable youth.
Keywords: Adolescents, Public healthMethods: Data are baseline survey of diverse high school students (N=1,564) enrolled in a school-based study assessing health and developmental outcomes. GLMs tested the association between HHD and delinquent behaviors and arrest and whether financial insecurity moderated this association, adjusting for age, sex, ethnicity, poverty status, and state.
Results: Half of the sample was female (51%), 29% identified as non-Hispanic White, followed by African American (24%), Hispanic (21%), Multiracial (19%), and Asian (8%). More than one in three students (36%) had 1-2 HHD, and 10% had 3 or more. Over one in seven (14%) students reported disciplinary events for at least one delinquent behavior, and 5% reported being arrested. For every additional HHD stressor was associated with an increased risk ratio of having a disciplinary event at school (RRR: 1.43, 95% CI: 1.27, 1.61) or being arrested (RRR: 1.57, 95% CI: 1.33, 1.86). Importantly, financial insecurity moderated this association; youth with a history of HHD and experiencing financial insecurity had significantly relative risk of being arrested than youth with a history of HHD but who reported more financially stable backgrounds (p=0.02).
Conclusion: These findings underscore the need for intervention efforts that address both trauma and economic hardship in order to prevent or reduce delinquency and justice system involvement among vulnerable youth.
Authors:
Author - Rasmey Gomez, MPHc, California State University, Northridge
Co-Author - Mikaela Rojas, MPH , Project Share
Co-Author - Christopher Rogers, PhD, MPH;, California State University, Northridge
Co-Author - Timothy Grigsby, PhD, School of Public Health University of Nevada, Las Vegas
Co-Author - Myriam Forster, PhD, MPH, California State University, Northridge
Preparing to implement a pharmacy technician-led health related social needs program in a comprehensive medication therapy management clinic
Poster Number: A140Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health, Implementation Science
Background: There is growing recognition that addressing patients’ unmet health related social needs (HRSNs) should be integrated into healthcare delivery. HRSN screening most often occurs in hospitals. However, implementation should extend to pharmacy settings given their accessibility and trust built through frequent interactions between patients and pharmacy staff. Despite its promise, patients’ receptivity to HRSN screening and receiving support for unmet needs in a pharmacy setting remain unclear. This pilot study assessed patients’ comfort with HRSN screening and interest in receiving support for unmet HRSNs at a comprehensive medication therapy management (CMTM) clinic.
Methods: Screening questions about food insecurity, housing instability, transportation barriers, and paying utility bills were administered to patients of a CMTM clinic to identify unmet HRSNs. Patients then rated their comfort with screening questions on a scale from 1 (not comfortable) to 5 (comfortable). Patients were also asked if they would be interested in receiving assistance when needs arise as part of routine care at the CMTM clinic. Descriptive statistics were used to summarize responses.
Results: The patients in this sample (n=64) were on average 59 years old and enrolled in Medicare (62.5%) or Medicaid (34.4%). Most patients reported food insecurity, with 79.7% worrying about running out of food and 81.3% lacking money to buy more food in the past year. Some patients also experienced transportation barriers (37.5%), housing instability (31.3%), and difficulty paying utilities (15.0%). Patients rated being comfortable with screening questions about housing (mean: 4.31 SD: 1.17), transportation (mean 4.27, SD: 1.21), and food (mean 4.11, SD: 1.18), but were slightly less comfortable when asked about utilities (mean: 3.9, SD: 0.85). Nearly all patients (93.8%) expressed interest in receiving assistance with unmet needs as part of their care at the CMTM clinic.
Conclusion: Patients at the CMTM clinic reported high levels of unmet HRSNs and expressed both comfort with screening questions and interest in receiving support as part of their routine care. Ongoing research will assess the level of support patients require following referrals.
Keywords: Social support, SocioeconomicMethods: Screening questions about food insecurity, housing instability, transportation barriers, and paying utility bills were administered to patients of a CMTM clinic to identify unmet HRSNs. Patients then rated their comfort with screening questions on a scale from 1 (not comfortable) to 5 (comfortable). Patients were also asked if they would be interested in receiving assistance when needs arise as part of routine care at the CMTM clinic. Descriptive statistics were used to summarize responses.
Results: The patients in this sample (n=64) were on average 59 years old and enrolled in Medicare (62.5%) or Medicaid (34.4%). Most patients reported food insecurity, with 79.7% worrying about running out of food and 81.3% lacking money to buy more food in the past year. Some patients also experienced transportation barriers (37.5%), housing instability (31.3%), and difficulty paying utilities (15.0%). Patients rated being comfortable with screening questions about housing (mean: 4.31 SD: 1.17), transportation (mean 4.27, SD: 1.21), and food (mean 4.11, SD: 1.18), but were slightly less comfortable when asked about utilities (mean: 3.9, SD: 0.85). Nearly all patients (93.8%) expressed interest in receiving assistance with unmet needs as part of their care at the CMTM clinic.
Conclusion: Patients at the CMTM clinic reported high levels of unmet HRSNs and expressed both comfort with screening questions and interest in receiving support as part of their routine care. Ongoing research will assess the level of support patients require following referrals.
Authors:
Presenter - Angela Kong, PhD, MPH, RDN, University of Illinois at Chicago
Co-Author - Jessica Tilton , PharmD, University of Illinois Chicago
Co-Author - Bianca Stachnik, University of Illinois Chicago
Co-Author - Centrella Dunbar, CPhT, University of Illinois Chicago
Co-Author - Gabriela Tesarski, University of Illinois Chicago
Co-Author - Chuxian Tang , PharmD, MPH, University of Illinois Chicago
How does Optimism Relate to Social Support to Impact Physical Symptoms in College Students During COVID-19?
Poster Number: A141Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health, Quality of Life
The severity of physical symptoms may be influenced by an individual’s level of optimism. Optimism could play a key role by enabling a person to approach the future with a positive outlook, potentially enhancing self-care and mental well-being. The objective of this study was to examine the relationship between optimism and physical symptoms among college students, with social support as a moderator. Data were collected from 292 students during the height of the COVID-19 pandemic through a virtual questionnaire assessing social support and optimism in May 2020, followed by a questionnaire in November 2020 assessing the severity of 33 physical symptoms (e.g. stomach pain, headaches, constipation). Linear regressions were conducted to analyze the main effects of and interactions between optimism and social support in predicting physical symptoms. The results indicated that students with higher levels of optimism reported less severe physical symptoms (b = -0.694, p = 0.016). However, social support was found to not be a significant moderator of the association between optimism and symptoms (p < 0.05). While social support did not significantly strengthen the link between optimism and physical symptoms, the study emphasizes the association between optimism and reduced severity of physical symptoms. This highlights the importance of fostering optimism in college students to mitigate the impact of physical symptoms.
Keywords: Health outcomes, Social supportAuthors:
Author - Adelaide Kuehner, Chapman University
Co-Author - Brooke Jenkins, Chapman University
Maintenance Effects on Moderate to Vigorous Physical Activity: a 48-Week, Multi-site Electronic Health Record-Integrated Physical Activity Promotion Intervention in Breast & Endometrial Cancer Survivors
Poster Number: A142Time: 05:00 PM - 05:50 PM
Topics: Physical Activity, Cancer
Most breast and endometrial cancer survivors are inactive, despite the benefits of moderate to vigorous physical activity (MVPA). Existing MVPA interventions improve short-term (<6 months) MVPA, but few assess long-term maintenance. MyActivity tested a stepped-care approach to incorporate MVPA into cancer care in a singly randomized trial. All participants received the minimal intervention [study website + Fitbit integrated into the electronic health record with weekly feedback via the patient portal] and non-responders (met <80% of MVPA goal for prior 4 weeks) were randomized to online gym or coaching augmentation strategies during the initial 24-week intervention. At 24-weeks, overall MVPA increased, responders increased MVPA more compared to non-responders and to non-responders allocated to online gym (GYM)(p<0.05). There were no differences in MVPA for non-responders randomized to coaching calls (COACH) versus GYM at 24-weeks. The purpose of these analyses is to determine effects of MyActivity on MVPA at 48-weeks. Inactive survivors [n=323; Mage=57.4 (SD=11.0); 73.7% breast; 25.4% endometrial] received the minimal intervention. MVPA adherence was assessed at 4, 8, 12, 16 and 20 weeks; non-responders (n=116) at each timepoint were randomized for the remainder of the 24-week intervention to GYM or bi-weekly COACH. Responders continued with the minimal intervention. During weeks 24 to 48, the minimal intervention continued but augmentation strategies ended. Mixed effects models examined each intervention condition’s effect on daily average accelerometer-assessed MVPA from baseline (T1) to 48-weeks (T3) accounting for post-intervention (24-week; T2) changes. Overall, MVPA remained significantly elevated above T1 values at T3 (M∆=2.5 min/day; 95%CI [0.73,4.34]; p=0.01), but the change magnitude was attenuated from T2 (M∆=5.6 min/day; 95%CI[3.8,7.4];p<0.001). Differences for responders v. non-responders, overall, and for non-responders in GYM or COACH were no longer significant at T3. Finally, MVPA change did not significantly differ for non-responders randomized to COACH v. GYM (Mdiff=-3.1;95%CI [-8.8,2.62]; p=0.29) similar to T2. MyActivity may be a scalable strategy to promote and maintain MVPA among cancer survivors. Future work should explore how to implement MyActivity into cancer care for other cancer populations, test other augmentation strategies and explore ways to enhance MVPA maintenance.
Keywords: Physical activity, Cancer survivorshipAuthors:
Author - Julia Pincever, MA, Northwestern University Feinberg School of Medicine
Co-Author - Payton Solk, MS, Northwestern University Feinberg School of Medicine
Co-Author - Jing Song, MS, Northwestern University Feinberg School of Medicine
Co-Author - Hannah Freeman, BA, Northwestern University Feinberg School of Medicine;
Co-Author - Megan Agnew, PhD, MPH, University of Wisconsin-Madison
Co-Author - Christian Schmidt, PhD, University of Wisconsin-Madison
Co-Author - Shirlene Wang, PhD, Northwestern University Feinberg School of Medicine
Co-Author - Kristina Hasanaj, PhD, Northwestern University Feinberg School of Medicine
Co-Author - Julia Frey, BS, Northwestern University Feinberg School of Medicine
Co-Author - Fiona Webb, BA, Northwestern University Feinberg School of Medicine
Co-Author - Lauren Wang, BS, Northwestern University Feinberg School of Medicine
Co-Author - Emma Barber, MD, Northwestern University Feinberg School of Medicine
Co-Author - Mary Sesto, PT, PhD, University of Wisconsin-Madison
Co-Author - William Gradishar, MD, Northwestern University Feinberg School of Medicine
Co-Author - Amye Tevaarwerk, MD, Mayo Clinic Cancer Center
Co-Author - Bonnie Spring, PhD, ABPP, FSBM, Florida State University College of Medicine
Co-Author - Ryan Spencer, MD, MS, FACOG, University of Wisconsin- Madison
Co-Author - Ron Gangnon, PhD, University of Wisconsin- Madison
Co-Author - Inbal Nahum-Shani, PhD, University of Michigan
Co-Author - Lisa Cadmus-Bertram, PhD, University of Wisconsin - Madison
Co-Author - Kristen A. Pickett, PhD, University of Wisconsin - Madison
Co-Author - Siobhan Phillips, PhD, MPH, Northwestern University Feinberg School of Medicine
The NIH Pathways to Prevention (P2P) Program: Examining Contextual Factors to Advance Behavioral Science and Improve Health
Poster Number: A143Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health, Methods and Measurement
Introduction:
Behavioral science plays a central role in disease prevention and health promotion. Preventive interventions, implemented across the socio-ecological model, are often designed to impact behavior and improve health outcomes. The National Institutes of Health (NIH), Office of Disease Prevention (ODP) leads the Pathways to Prevention (P2P) program, which commissions systematic evidence reviews and convenes workshops to examine prevention topics of broad public health importance. The purpose of this study was to 1) identify recent P2P workshops that included behavioral science concepts, interventions, and recommendations, and to 2) highlight how behavioral scientists can utilize the P2P program to move the field of prevention forward.
Methods:
Investigators analyzed materials (i.e., systematic evidence reviews, independent panel reports, federal partner meeting reports) derived from all P2P workshops conducted within the past six years. A thematic analysis was conducted to identify patterns and generate insights regarding the application of behavioral science approaches across a range of disease prevention and health promotion topics examined by the P2P program.
Results:
Since 2019, five P2P workshops have included behavioral science experts, interventions, findings, and recommendations. These workshops focused on a variety of topics including postpartum health, nutrition, physical activity, telehealth, and the uptake of preventive clinical services. These workshops also examined contextual factors, including upstream social determinants of health, and their impact on downstream health behaviors and outcomes. Commonly identified methodologic evidence gaps included the need to: standardize definitions, interventions, and reporting measures; design and fund sufficiently large, longer-term studies; and promote the broader inclusion of investigators and participants from diverse backgrounds across all phases of research. Recommendations consistently highlighted the need to ensure rigorous design and testing of behavioral health interventions to develop effective, adaptable, and sustainable health solutions.
Conclusion:
The P2P program is a useful resource for behavioral researchers in designing robust intervention studies that improve health. This analysis highlights the need for continued attention to study design, outcomes, reporting, and dissemination to maximize the implementation of behavioral interventions.
Keywords: Prevention, MethodologyBehavioral science plays a central role in disease prevention and health promotion. Preventive interventions, implemented across the socio-ecological model, are often designed to impact behavior and improve health outcomes. The National Institutes of Health (NIH), Office of Disease Prevention (ODP) leads the Pathways to Prevention (P2P) program, which commissions systematic evidence reviews and convenes workshops to examine prevention topics of broad public health importance. The purpose of this study was to 1) identify recent P2P workshops that included behavioral science concepts, interventions, and recommendations, and to 2) highlight how behavioral scientists can utilize the P2P program to move the field of prevention forward.
Methods:
Investigators analyzed materials (i.e., systematic evidence reviews, independent panel reports, federal partner meeting reports) derived from all P2P workshops conducted within the past six years. A thematic analysis was conducted to identify patterns and generate insights regarding the application of behavioral science approaches across a range of disease prevention and health promotion topics examined by the P2P program.
Results:
Since 2019, five P2P workshops have included behavioral science experts, interventions, findings, and recommendations. These workshops focused on a variety of topics including postpartum health, nutrition, physical activity, telehealth, and the uptake of preventive clinical services. These workshops also examined contextual factors, including upstream social determinants of health, and their impact on downstream health behaviors and outcomes. Commonly identified methodologic evidence gaps included the need to: standardize definitions, interventions, and reporting measures; design and fund sufficiently large, longer-term studies; and promote the broader inclusion of investigators and participants from diverse backgrounds across all phases of research. Recommendations consistently highlighted the need to ensure rigorous design and testing of behavioral health interventions to develop effective, adaptable, and sustainable health solutions.
Conclusion:
The P2P program is a useful resource for behavioral researchers in designing robust intervention studies that improve health. This analysis highlights the need for continued attention to study design, outcomes, reporting, and dissemination to maximize the implementation of behavioral interventions.
Authors:
Co-Author - Elizabeth Neilson, PhD, MPH, MSN, National Institutes of Health
Co-Author - Bob McNellis, MPH, PA , National Institutes of Health
Co-Author - Keisha Shropshire, MPH, National Institutes of Health
Co-Author - Kate Winseck, MSW, National Institutes of Health
Co-Author - Elizabeth Vogt, MPH, National Institutes of Health
Social Network Structure and Psychological Distress in a Sober Active Community
Poster Number: A145Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health, Substance Misuse
Introduction: Addiction is a complex, pervasive condition affecting physical, social, and mental health. Social support and robust social networks are crucial to the recovery process. This study examines the association between social networks and psychological distress among members of The Phoenix, a sober active community that integrates group-based exercise, such as CrossFit, into addiction recovery.
Methods: Using Social Network Analysis (SNA), we analyzed relationships in two Phoenix CrossFit networks in Denver, Colorado (N=35) and Wichita, Kansas (N=42). Participants in each location were asked to indicate anyone in their CrossFit network they felt went above and beyond to support their recovery. Linear Network Autocorrelation Models (LNAMs) were used to evaluate how network position and connections relate to psychological distress. Exponential Random Graph Models (ERGMs) were used to explore factors explaining the presence of supportive ties between network members. Study procedures and measures, including the Kessler Psychological Distress Scale (K6), were approved by the Institutional Review Board.
Results: The findings indicate that network centrality, such as being identified as a common source of support (in-degree), was associated with lower psychological distress. Conversely, peripheral network positions correlated with higher psychological distress in both networks. Additionally, individuals experiencing higher psychological distress tended to seek more supportive connections, while those with lower distress were more frequently nominated as supportive figures.
Conclusion: Our results highlight the significant potential of community-based recovery resources like The Phoenix to foster social networks that promote mental well-being. These findings suggest that supportive and central roles within recovery communities can mitigate psychological distress and encourage healthier social dynamics, which are essential for long-term recovery.
Keywords: Social network analysis, Substance abuseMethods: Using Social Network Analysis (SNA), we analyzed relationships in two Phoenix CrossFit networks in Denver, Colorado (N=35) and Wichita, Kansas (N=42). Participants in each location were asked to indicate anyone in their CrossFit network they felt went above and beyond to support their recovery. Linear Network Autocorrelation Models (LNAMs) were used to evaluate how network position and connections relate to psychological distress. Exponential Random Graph Models (ERGMs) were used to explore factors explaining the presence of supportive ties between network members. Study procedures and measures, including the Kessler Psychological Distress Scale (K6), were approved by the Institutional Review Board.
Results: The findings indicate that network centrality, such as being identified as a common source of support (in-degree), was associated with lower psychological distress. Conversely, peripheral network positions correlated with higher psychological distress in both networks. Additionally, individuals experiencing higher psychological distress tended to seek more supportive connections, while those with lower distress were more frequently nominated as supportive figures.
Conclusion: Our results highlight the significant potential of community-based recovery resources like The Phoenix to foster social networks that promote mental well-being. These findings suggest that supportive and central roles within recovery communities can mitigate psychological distress and encourage healthier social dynamics, which are essential for long-term recovery.
Authors:
Author - Yunlin Zhou, MS, Texas A&M University
Author - Anjorin Adeyemi, PhD, MS, Texas A&M University
Author - Shuai Ma, MS, Texas A&M University
Author - Linlin Luo, PhD, Texas A&M University
Author - Allison Francis, PhD, MS, Texas A&M University
Author - Zhenning Kang, MS, Texas A&M University
Author - Tyler Prochnow, PhD, MS, Texas A&M University
Author - Katie Heinrich, PhD, The Phoenix
Work and health meaning-making among precariously employed gay, bisexual, and queer immigrant and refugee men in Toronto
Poster Number: A146Time: 05:00 PM - 05:50 PM
Topics: Social and Environmental Context and Health
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people experience mental health and trauma outcomes as a result of systemic exclusion from the labor market in Canada, with less known about intersectional labor precarity for LGBTQ+ immigrants. How populations experiencing intersectional precarity appraise work and health challenges is unknown. Drawing from 13 interviews in 2021 and utilizing Park’s meaning making model as a framework, this qualitative study focuses on gay, bisexual, and queer immigrant and refugee men experiencing precarious employment in Toronto, Canada to ask the following question: how do participants make meaning of their work and health experiences? Participants were primarily highly educated and arrived in Canada on refugee status or immigrated to live without persecution of their sexual orientation and/or gender identity. Through reflexive thematic analysis, we identified two meanings made from work and health experiences: ambivalence towards the presumed superiority of the standard employment relationship and valuing the possibility of leveraging precarious work. Implications of our findings include the risk of meaning making loops without situational change or intervention and the opportunity for collaboration between health and labor professionals working with hard-to-reach populations.
Keywords: Socioeconomic, StressAuthors:
Author - Amy Xu, MSW, Ohio State University
Author - David Kinitz, The Ohio State University
Author - Basak Yanar, PhD, Institute for Work and Health
Author - Sonja Senthanar, PhD, University of Northern British Columbia
Author - Yvonne Su, PhD, York University
Author - Roya Haghiri-Vijeh, PhD, York University
Sociodemographic Differences in Health Service Utilization among Heavy Drinkers During the COVID-19 Pandemic
Poster Number: A147Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, Mental Health
Purpose
Heavy alcohol use increases health risks and healthcare needs, and there was increased alcohol use among adults during the COVID-19 pandemic. The National Institute on Alcohol Abuse and Alcoholism defines heavy drinking as consuming five or more drinks on any day for men and four or more for women. This study explored past 12-month mental health and telehealth service use among U.S. adults reporting heavy alcohol use during the COVID-19 pandemic, focusing on key sociodemographic differences by age, sex, race/ethnicity, education, income, and insurance status.
Methods
Data were sourced from the 2021–2023 National Health and Nutrition Examination Survey (NHANES), a nationally representative dataset, including n=2,353 adults reporting heavy alcohol use in the past 12 months. A complex sampling methodology was used to ensure generalizability of study findings. Descriptive statistics were performed to examine the demographic characteristics of the target population, and multiple logistic regression analyses assessed the association between sociodemographic characteristics and health service utilization, controlling for general health status. Statistical significance was determined based on 95% confidence intervals (CIs) that did not include 1. All analyses were conducted using SAS v. 9.4.
Results
About 17% of the sample used mental health services and approximately 31% used telehealth services in the past 12 months. Males were significantly less likely than females to use mental health (OR=0.6; CI:0.4–0.8) and telehealth (OR=0.5; CI: 0.4–0.7) services. Non-Hispanic (NH) Asian (OR=0.3; CI: 0.2–0.7) and NH Black (OR=0.6; CI: 0.4–0.9) adults had significantly lower odds of mental health service use compared to NH Whites. Young (OR=6.6; CI: 3.4–13.0) and middle-aged (OR=3.5; CI: 1.9–6.4) adults were significantly more likely than older adults to utilize mental health services. Low-income earners (OR=1.8; CI: 1.3–2.5) showed significantly greater use of mental health services, while college graduates and insured individuals had significantly higher odds of using both services.
Conclusion
Significant sociodemographic differences exist in health service utilization among adults with heavy alcohol use during the pandemic. These findings underscore the need to enhance access and reduce barriers to mental health and telehealth services during public health emergencies, particularly for males, racial minorities, those with lower education, and the uninsured.
Keywords: Alcoholism, Substance abuseHeavy alcohol use increases health risks and healthcare needs, and there was increased alcohol use among adults during the COVID-19 pandemic. The National Institute on Alcohol Abuse and Alcoholism defines heavy drinking as consuming five or more drinks on any day for men and four or more for women. This study explored past 12-month mental health and telehealth service use among U.S. adults reporting heavy alcohol use during the COVID-19 pandemic, focusing on key sociodemographic differences by age, sex, race/ethnicity, education, income, and insurance status.
Methods
Data were sourced from the 2021–2023 National Health and Nutrition Examination Survey (NHANES), a nationally representative dataset, including n=2,353 adults reporting heavy alcohol use in the past 12 months. A complex sampling methodology was used to ensure generalizability of study findings. Descriptive statistics were performed to examine the demographic characteristics of the target population, and multiple logistic regression analyses assessed the association between sociodemographic characteristics and health service utilization, controlling for general health status. Statistical significance was determined based on 95% confidence intervals (CIs) that did not include 1. All analyses were conducted using SAS v. 9.4.
Results
About 17% of the sample used mental health services and approximately 31% used telehealth services in the past 12 months. Males were significantly less likely than females to use mental health (OR=0.6; CI:0.4–0.8) and telehealth (OR=0.5; CI: 0.4–0.7) services. Non-Hispanic (NH) Asian (OR=0.3; CI: 0.2–0.7) and NH Black (OR=0.6; CI: 0.4–0.9) adults had significantly lower odds of mental health service use compared to NH Whites. Young (OR=6.6; CI: 3.4–13.0) and middle-aged (OR=3.5; CI: 1.9–6.4) adults were significantly more likely than older adults to utilize mental health services. Low-income earners (OR=1.8; CI: 1.3–2.5) showed significantly greater use of mental health services, while college graduates and insured individuals had significantly higher odds of using both services.
Conclusion
Significant sociodemographic differences exist in health service utilization among adults with heavy alcohol use during the pandemic. These findings underscore the need to enhance access and reduce barriers to mental health and telehealth services during public health emergencies, particularly for males, racial minorities, those with lower education, and the uninsured.
Authors:
Presenter - Precious Patrick Edet, MD, DrPH, MPH, University of Mississippi
Co-Author - Hannah Allen, PhD, University of Mississippi
More Than a Risk Factor: Understanding Alcohol Use After Cancer Diagnosis
Poster Number: A148Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, Cancer
Background. Alcohol consumption is the third leading preventable cause of cancer worldwide. As such, existing research has focused on alcohol use and cancer risk, with minimal attention on drinking after cancer diagnosis. Examining drinking patterns post-diagnosis is critical to inform effective patient care and improve health outcomes. Lung cancer (LC) patients are a generally understudied group, and alcohol use among them is especially overlooked. This study aims to understand alcohol use in LC patients by identifying those engaging in elevated levels of drinking following diagnosis.
Methods. Patients with stage IV non-small cell lung cancer (NSCLC; N=317) were accrued at diagnosis and completed self-report measures bimonthly thereafter. Drinking status (categorized into “no drinking”, “moderate drinking”, and “hazardous drinking”) was determined using self-reported frequency and quantity of alcohol use. Predictors consisted of patient demographics, physical symptoms (20-item composite scale), smoking status, and psychological factors (depression [Patient Health Questionnaire-9], anxiety [Generalized Anxiety Disorder-7], and cancer-related stress [Impacts of Events Scale]).
Results. Multinomial logistic regression was used to explore characteristics associated with baseline drinking. Relative Risk Ratios (RR) were calculated, with “no drinking” as the reference group. Drinking was associated with: 1) Sex: males were over 2 times as likely to drink hazardously as females (RR: 2.52, p <.05); 2) Education: patients with more than a high school education were more likely drink hazardously than those with less education (RR: 5.38, p <.01); 3) Cancer-related stress: higher stress was linked to greater likelihood of hazardous drinking (RR: 1.04, p <.05); and 4) Smoking: compared to current smokers, former smokers were 58% less likely to drink hazardously (p <.01) and never smokers were 93% less likely to drink hazardously (p <.01). Repeated measures data will be included in the final analyses exploring changes in drinking patterns up to 24 months after.
Conclusion. This is the first study examining characteristics associated with drinking among NSCLC patients at diagnosis. Results suggest notable patient factors may be linked to hazardous use. Longitudinal data will provide insight into how and for whom drinking patterns progress post-diagnosis. Further research on alcohol use after LC diagnosis is needed to improve outcomes for individuals with NSCLC.
Keywords: Alcohol, CancerMethods. Patients with stage IV non-small cell lung cancer (NSCLC; N=317) were accrued at diagnosis and completed self-report measures bimonthly thereafter. Drinking status (categorized into “no drinking”, “moderate drinking”, and “hazardous drinking”) was determined using self-reported frequency and quantity of alcohol use. Predictors consisted of patient demographics, physical symptoms (20-item composite scale), smoking status, and psychological factors (depression [Patient Health Questionnaire-9], anxiety [Generalized Anxiety Disorder-7], and cancer-related stress [Impacts of Events Scale]).
Results. Multinomial logistic regression was used to explore characteristics associated with baseline drinking. Relative Risk Ratios (RR) were calculated, with “no drinking” as the reference group. Drinking was associated with: 1) Sex: males were over 2 times as likely to drink hazardously as females (RR: 2.52, p <.05); 2) Education: patients with more than a high school education were more likely drink hazardously than those with less education (RR: 5.38, p <.01); 3) Cancer-related stress: higher stress was linked to greater likelihood of hazardous drinking (RR: 1.04, p <.05); and 4) Smoking: compared to current smokers, former smokers were 58% less likely to drink hazardously (p <.01) and never smokers were 93% less likely to drink hazardously (p <.01). Repeated measures data will be included in the final analyses exploring changes in drinking patterns up to 24 months after.
Conclusion. This is the first study examining characteristics associated with drinking among NSCLC patients at diagnosis. Results suggest notable patient factors may be linked to hazardous use. Longitudinal data will provide insight into how and for whom drinking patterns progress post-diagnosis. Further research on alcohol use after LC diagnosis is needed to improve outcomes for individuals with NSCLC.
Authors:
Author - Sara Ellis, Ohio State University
Co-Author - Peter Shields, MD, Ohio State University
Co-Author - Barbara Andersen, PhD, FSBM, Ohio State University
Investigating individual-level and contextual predictors of substance use stigma among college students
Poster Number: A149Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse
Introduction: Stigma toward people with substance use disorder (SUD) is a known barrier to effective treatment and is associated with negative health outcomes. While much is known about stigma in the general public, stigma among young adults, a population that has experienced sharp increases in drug overdose death rates, is understudied. As such, we examined factors that predict stigma among college students.
Methods: Data for the current study came from a survey of 332 undergraduate students administered during the 2024/2025 academic year. Path analysis was employed to incorporate multiple predictor and outcome variables simultaneously. A number of individual-level and contextual predictors (i.e., gender, age, empathy, exposure to drug use, exposure to drug messaging on social media, peer and parent disapproval of substance use, familiarity with people with SUD, personal substance use) were used to predict stigma measures (i.e., desire for social distance, negative affect toward people with SUD, stigmatization of people with SUD). Robust maximum likelihood estimation was used to handle missing data and to account for non-normal or skewed distributions.
Results: The model predicted a significant amount of variance in desire for social distance (r2 = .23, p < .001), negative affect (r2 = .08, p = .031), and stigmatization of substance users (r2 = .18, p < .001). For social distance, women and participants not familiar with people with SUD reported greater desires for social distance compared to males and those who knew someone with SUD. For negative affect, identifying as a woman and higher levels of past-month alcohol use resulted in higher levels of negative affect, whereas more empathy was associated with lower levels of negative affect. For stigmatization of people with SUD, people who reported more exposure to drug messaging on social media, more past-month marijuana use, and more empathy reported less stigmatization toward people with SUD.
Conclusions: Findings highlight a need to use a targeted approach to reduce stigma toward people with SUD on college campuses, one that builds support among young adults for people in recovery. Campus programming should incorporate messaging that decreases desire for social distance from people with SUD and works to change negative affect experienced when people encounter those with SUD. Findings will be discussed within the context of early intervention, treatment, and mutual support on college campuses.
Keywords: Substance abuse, Attitude(s)Methods: Data for the current study came from a survey of 332 undergraduate students administered during the 2024/2025 academic year. Path analysis was employed to incorporate multiple predictor and outcome variables simultaneously. A number of individual-level and contextual predictors (i.e., gender, age, empathy, exposure to drug use, exposure to drug messaging on social media, peer and parent disapproval of substance use, familiarity with people with SUD, personal substance use) were used to predict stigma measures (i.e., desire for social distance, negative affect toward people with SUD, stigmatization of people with SUD). Robust maximum likelihood estimation was used to handle missing data and to account for non-normal or skewed distributions.
Results: The model predicted a significant amount of variance in desire for social distance (r2 = .23, p < .001), negative affect (r2 = .08, p = .031), and stigmatization of substance users (r2 = .18, p < .001). For social distance, women and participants not familiar with people with SUD reported greater desires for social distance compared to males and those who knew someone with SUD. For negative affect, identifying as a woman and higher levels of past-month alcohol use resulted in higher levels of negative affect, whereas more empathy was associated with lower levels of negative affect. For stigmatization of people with SUD, people who reported more exposure to drug messaging on social media, more past-month marijuana use, and more empathy reported less stigmatization toward people with SUD.
Conclusions: Findings highlight a need to use a targeted approach to reduce stigma toward people with SUD on college campuses, one that builds support among young adults for people in recovery. Campus programming should incorporate messaging that decreases desire for social distance from people with SUD and works to change negative affect experienced when people encounter those with SUD. Findings will be discussed within the context of early intervention, treatment, and mutual support on college campuses.
Authors:
Presenter - Övgü Kaynak, PhD, Penn State Harrisburg
Co-Author - Christopher Whipple, PhD, Penn State Harrisburg
Alcohol consequences and food addiction symptoms over time in a diverse sample of emerging adults with histories of heavy drinking
Poster Number: A150Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse, Diet, Nutrition, and Eating Disorders
Research has noted similarities between disordered overeating and substance use, resulting in the conceptualization of food addiction (FA). FA and excessive alcohol use often co-occur, and there is overlap in the brain regions and systems that are implicated during consumption of highly palatable foods and alcohol. However, little research has explored the longitudinal associations between these two behaviors in emerging adulthood (18-29). The current study aimed to examine temporal associations between FA symptoms and alcohol consequences across 3 time points spanning 16 months. Data were collected from 595 emerging adults (mean age 22.64, 57.6% female, 45.2% White, 40.2% Black). Latent growth curve modeling was used to examine trajectories of FA symptoms and alcohol consequences across time points, and random intercept cross-lagged panel models were used to explore temporal associations between the two constructs. Results showed that both outcomes decreased significantly across time points. There were significant, positive between-person effects between FA symptom count and alcohol consequences (est. = 0.366, SE = 0.10, p < 0.001), suggesting that participants who report higher YFAS symptom counts across time points also report higher YAACQ scores. At time point 2, there were significant, positive contemporaneous within person-effects between deviations in FA symptom count and alcohol consequences, suggesting that at time point 2, within person increases in one outcome predicted within person increases in the other (est. = 0.306, SE = 0.15, p = 0.036). Contemporaneous effects at time points 1 and 3 were nonsignificant. All cross-lagged paths were nonsignificant, suggesting that within person deviations in one outcome at one time point did not predict within person deviations in the other outcome at the next time point. Results add to the body of literature demonstrating that FA and alcohol use co-occur. Results also suggest that targeting both constructs simultaneously may be important, given that within person changes in one construct largely did not impact within person changes in the other. Further, early emerging adulthood may be an important time for intervention, as symptoms decreased across time. Future research should examine these constructs across a longer timeline to explore the trajectories of FA symptoms and alcohol consequences into later emerging adulthood and the early stages of adulthood.
Keywords: Alcohol, Eating behaviorsAuthors:
Presenter - Mary Takgbajouah, MA, DePaul University
Author - Kyla Belisario, MA, McMaster University
Author - Ashley Dennhardt, PhD, The University of Memphis
Author - James MacKillop, PhD, McMaster University
Author - James Murphy, PhD, The University of Memphis
Author - Joanna Buscemi, PhD, DePaul University
Trends in United States Methamphetamine Mortality by Census Division, 2005-2023
Poster Number: A151Time: 05:00 PM - 05:50 PM
Topics: Substance Misuse
Objectives: Methamphetamine use and co-involvement with other drugs is a public health crisis needing to be addressed. This study examined temporal trends in methamphetamine-related mortality across the nine US Census Divisions from 2005 to 2023 within the context of the evolving “fourth wave” of the overdose crisis.
Methods: Data were obtained from the CDC WONDER multiple causes of death database to identify methamphetamine-involved poisoning deaths among US residents aged 15–74. Mortality rates were calculated per 100,000 population and stratified by Census Division. Joinpoint regression was applied to estimate annual percent change and identify statistically significant inflection points.
Results: Methamphetamine-related deaths increased nationwide over the study period. The highest cumulative burden occurred in the Pacific, South Atlantic, and Mountain divisions, while New England and Middle Atlantic recorded the lowest rates though both rose sharply in recent years. Several regions showed marked surges: East North Central increased 68.0% annually from 2013–2017; East South Central grew 48.6% annually from 2013–2021. Pacific Division rates accelerated 34.7% annually from 2018–2021 before stabilizing. Mountain and West South Central displayed steady long-term growth, and early declines in parts of the Midwest reversed after 2010. By 2023, mortality rates were highest in the Pacific, East South Central, and Mountain divisions.
Conclusions: Methamphetamine mortality has escalated nationally but varies considerably by region in timing and scale. Recent plateaus in select areas may reflect early intervention efforts; however, persistently high rates highlight the need for regionally tailored harm reduction, treatment, and prevention strategies.
Keywords: Substance abuse, Risk factorsMethods: Data were obtained from the CDC WONDER multiple causes of death database to identify methamphetamine-involved poisoning deaths among US residents aged 15–74. Mortality rates were calculated per 100,000 population and stratified by Census Division. Joinpoint regression was applied to estimate annual percent change and identify statistically significant inflection points.
Results: Methamphetamine-related deaths increased nationwide over the study period. The highest cumulative burden occurred in the Pacific, South Atlantic, and Mountain divisions, while New England and Middle Atlantic recorded the lowest rates though both rose sharply in recent years. Several regions showed marked surges: East North Central increased 68.0% annually from 2013–2017; East South Central grew 48.6% annually from 2013–2021. Pacific Division rates accelerated 34.7% annually from 2018–2021 before stabilizing. Mountain and West South Central displayed steady long-term growth, and early declines in parts of the Midwest reversed after 2010. By 2023, mortality rates were highest in the Pacific, East South Central, and Mountain divisions.
Conclusions: Methamphetamine mortality has escalated nationally but varies considerably by region in timing and scale. Recent plateaus in select areas may reflect early intervention efforts; however, persistently high rates highlight the need for regionally tailored harm reduction, treatment, and prevention strategies.
Authors:
Presenter - Robert Yockey, PhD, University of Mississippi
Co-Author - Rachel Hoopsick, PhD, MS, MPH, MCHES, University of Illinois Urbana Champaign
Co-Author - Tonazzina Sauda, University of Illinois Urbana Champaign
Co-Author - Tyler Lee, University of Illinois Urbana Champaign
Co-Author - Amy Ni, University of Illinois at Urbana-Champaign
Co-Author - Amber Amis, University of Mississippi
Co-Author - Elise Devier, University of Mississippi
Associations between Attitudes Towards Support through Quitting Resources and Stages of Quitting
Poster Number: A152Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior
Background. This study examines associations between attitudes towards quitting resources and stages of quitting.
Methods. Data were obtained from a repeated, cross-sectional online survey of youth and young adults (aged 15-24 years), collected from September 2024 to May 2025. Multinomial regression models were used to determine associations between agreement with attitudes towards cessation resources (“Quitting with support is a more effective way to quit nicotine than quitting without support” and “There is a free quitting nicotine program available that has been experienced by millions”) and stages of quitting (precontemplation, contemplation, and preparation/action/maintenance, based on expressed quit intentions). Models adjusted for the effects of age, sex assigned at birth, race, mother’s education level, sexual orientation, current use of other tobacco products, and time interval (September-November 2024, December 2024-February 2025, and March 2025-May 2025).
Results. Agreement with “There is a free quitting nicotine program available that has been experienced by millions” (RRR=1.36 and 1.36) and “Quitting with support is a more effective way to quit nicotine than quitting without support” (RRR=1.24 and 1.31) was associated with increased likelihood of being in contemplation and preparation/action stages, compared to the precontemplation stage, respectively. Older age, female gender, Non-Hispanic Black identity, Hispanic/Latino identity, and later time intervals were associated with further quit stage, while bisexual identity was associated with earlier quit stage.
Conclusion. Agreement with attitudes supporting the use of quitting resources were associated with further stages of quitting. Results suggest that messaging regarding quitting with support is resonating with youth and young adults who use e-cigarettes and may be encouraging them to quit.
Keywords: Cessation, AdolescentsMethods. Data were obtained from a repeated, cross-sectional online survey of youth and young adults (aged 15-24 years), collected from September 2024 to May 2025. Multinomial regression models were used to determine associations between agreement with attitudes towards cessation resources (“Quitting with support is a more effective way to quit nicotine than quitting without support” and “There is a free quitting nicotine program available that has been experienced by millions”) and stages of quitting (precontemplation, contemplation, and preparation/action/maintenance, based on expressed quit intentions). Models adjusted for the effects of age, sex assigned at birth, race, mother’s education level, sexual orientation, current use of other tobacco products, and time interval (September-November 2024, December 2024-February 2025, and March 2025-May 2025).
Results. Agreement with “There is a free quitting nicotine program available that has been experienced by millions” (RRR=1.36 and 1.36) and “Quitting with support is a more effective way to quit nicotine than quitting without support” (RRR=1.24 and 1.31) was associated with increased likelihood of being in contemplation and preparation/action stages, compared to the precontemplation stage, respectively. Older age, female gender, Non-Hispanic Black identity, Hispanic/Latino identity, and later time intervals were associated with further quit stage, while bisexual identity was associated with earlier quit stage.
Conclusion. Agreement with attitudes supporting the use of quitting resources were associated with further stages of quitting. Results suggest that messaging regarding quitting with support is resonating with youth and young adults who use e-cigarettes and may be encouraging them to quit.
Authors:
Presenter - Elizabeth Do, PhD, MPH, Truth Initiative
Co-Author - Kristiann Koris, MPP, Truth Initiative
Co-Author - Shiyang (Michael) Liu, MS, Truth Initiative
Co-Author - Elizabeth Hair, PhD, Truth Initiative
Policy Windows and Political Will: A Five-State Comparative Analysis of Tobacco Control Policy in the United States.
Poster Number: A153Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior, Substance Misuse
Background: State-level tobacco control policies vary dramatically across the United States, creating disparities in public health protections and outcomes. Understanding these variations is critical for developing effective tobacco control strategies, particularly given rising youth e-cigarette use rates.
Purpose: To compare tobacco control policies across five U.S. states using integrated theoretical frameworks and examine how policy structure and political dynamics influence adoption and effectiveness.
Methods: We conducted a comparative case study of California, New York, Massachusetts, Alabama, and Florida, selected to represent diverse tobacco control environments. Using the Health Policy Triangle and Kingdon's Multiple Streams Framework, we systematically analyzed smoke-free laws, flavored tobacco regulations, taxation structures, retail licensing, and e-cigarette policies through legal documents, policy reports, and prevalence data from 2022.
Results: California and Massachusetts demonstrated comprehensive regulatory frameworks with aligned political will, strong actor coalitions, and local government innovation, corresponding to the lowest tobacco use rates (9.7% and 10.4% adult smoking, respectively). Alabama exhibited policy stagnation due to stream misalignment and weak institutional capacity, showing the highest adult smoking rate (15.6%). Florida's preemption laws blocked local innovation despite moderate state-level protections. New York showed strong policies with implementation inconsistencies. Youth e-cigarette use ranged from 5.6% (California) to 17.5% (Alabama).
Conclusions: Policy effectiveness depends on comprehensive design, implementation capacity, political alignment, and local empowerment. Removing preemption barriers and leveraging policy windows are essential for advancing tobacco control. The integrated theoretical approach provides valuable insights for behavioral health interventions across diverse political contexts.
Keywords: Smoking, Health policyPurpose: To compare tobacco control policies across five U.S. states using integrated theoretical frameworks and examine how policy structure and political dynamics influence adoption and effectiveness.
Methods: We conducted a comparative case study of California, New York, Massachusetts, Alabama, and Florida, selected to represent diverse tobacco control environments. Using the Health Policy Triangle and Kingdon's Multiple Streams Framework, we systematically analyzed smoke-free laws, flavored tobacco regulations, taxation structures, retail licensing, and e-cigarette policies through legal documents, policy reports, and prevalence data from 2022.
Results: California and Massachusetts demonstrated comprehensive regulatory frameworks with aligned political will, strong actor coalitions, and local government innovation, corresponding to the lowest tobacco use rates (9.7% and 10.4% adult smoking, respectively). Alabama exhibited policy stagnation due to stream misalignment and weak institutional capacity, showing the highest adult smoking rate (15.6%). Florida's preemption laws blocked local innovation despite moderate state-level protections. New York showed strong policies with implementation inconsistencies. Youth e-cigarette use ranged from 5.6% (California) to 17.5% (Alabama).
Conclusions: Policy effectiveness depends on comprehensive design, implementation capacity, political alignment, and local empowerment. Removing preemption barriers and leveraging policy windows are essential for advancing tobacco control. The integrated theoretical approach provides valuable insights for behavioral health interventions across diverse political contexts.
Authors:
Author - Evans Kyei, PhD MSc. RN, The University of Alabama, Capstone College of Nursing
Co-Author - Mercy Mumba, PhD RN FAAN, The University of Alabama Capstone College of Nursing
Longitudinal Outcomes from an Interdisciplinary Inpatient Traumatic Brain Injury (TBI) Rehabilitation Program for Service Members and Veterans: The Role of Tobacco use
Poster Number: A154Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior, Military and Veterans' Health
Objective: We sought to examine the association between tobacco use and trajectories of TBI-related outcomes in an interdisciplinary inpatient traumatic brain injury (TBI) rehabilitation program for service members and veterans (SM/Vs) with history of mild to moderate injury.
Methods: SM/Vs with mild to moderate traumatic brain injury (TBI) participated in a Veterans Affairs inpatient TBI rehabilitation program known as the Intensive Evaluation and Treatment Program (IETP) between July 1, 2022, and May 30, 2024. The program provided participants with in-depth clinical assessments, interdisciplinary care, referrals, and case management targeting TBI and commonly co-occurring conditions. Core elements of IETP included detailed musculoskeletal, neurological, and behavioral assessments, creation of personalized treatment plans, collaboration within an interdisciplinary care team, and structured discharge planning. At baseline and program discharge, participants completed the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist for DSM-5 (PCL-5). Electronic health records were abstracted to obtain information on age, service length, and tobacco use. To assess the relationship between initial self-reported tobacco use and changes over time in NSI and PCL-5 scores, we used two mixed-effects linear models, adjusting for participant age and duration of military service.
Results: Participants had an average inpatient stay of 41.50 days (SD = 19.94). SM/Vs were 41.64 years old (SD = 5.57) and had an average length of military service of 18.02 years (SD = 3.25). Tobacco use significantly interacted with time (i.e., baseline, discharge) on PCL-5 scores (b = 5.58, SE = 2.75, p = 0.04), suggesting that tobacco use was associated with attenuated symptom improvement compared to those with no tobacco use. The interaction between tobacco use and time was not significant in the NSI model (b = 0.92, SE = 2.23, p = 0.68); however, the main effect of time was statistically significant (b = -13.84, SE = 1.01, p < 0.001), suggesting that patients experienced decreased neurobehavioral symptoms as a result of participation.
Conclusion: Interdisciplinary inpatient rehabilitation programs for SM/Vs with mild to moderate TBI should account for tobacco use as a potential mediator of posttraumatic stress disorder (PTSD) outcomes in future investigations, and may benefit from integrating targeted tobacco cessation interventions to optimize symptom improvement.
Keywords: Tobacco use, RehabilitationMethods: SM/Vs with mild to moderate traumatic brain injury (TBI) participated in a Veterans Affairs inpatient TBI rehabilitation program known as the Intensive Evaluation and Treatment Program (IETP) between July 1, 2022, and May 30, 2024. The program provided participants with in-depth clinical assessments, interdisciplinary care, referrals, and case management targeting TBI and commonly co-occurring conditions. Core elements of IETP included detailed musculoskeletal, neurological, and behavioral assessments, creation of personalized treatment plans, collaboration within an interdisciplinary care team, and structured discharge planning. At baseline and program discharge, participants completed the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist for DSM-5 (PCL-5). Electronic health records were abstracted to obtain information on age, service length, and tobacco use. To assess the relationship between initial self-reported tobacco use and changes over time in NSI and PCL-5 scores, we used two mixed-effects linear models, adjusting for participant age and duration of military service.
Results: Participants had an average inpatient stay of 41.50 days (SD = 19.94). SM/Vs were 41.64 years old (SD = 5.57) and had an average length of military service of 18.02 years (SD = 3.25). Tobacco use significantly interacted with time (i.e., baseline, discharge) on PCL-5 scores (b = 5.58, SE = 2.75, p = 0.04), suggesting that tobacco use was associated with attenuated symptom improvement compared to those with no tobacco use. The interaction between tobacco use and time was not significant in the NSI model (b = 0.92, SE = 2.23, p = 0.68); however, the main effect of time was statistically significant (b = -13.84, SE = 1.01, p < 0.001), suggesting that patients experienced decreased neurobehavioral symptoms as a result of participation.
Conclusion: Interdisciplinary inpatient rehabilitation programs for SM/Vs with mild to moderate TBI should account for tobacco use as a potential mediator of posttraumatic stress disorder (PTSD) outcomes in future investigations, and may benefit from integrating targeted tobacco cessation interventions to optimize symptom improvement.
Authors:
Co-Presenter - Justin McDaniel, PhD, Southern Illinois University, Carbondale
Co-Author - Julie McMahon-Grenz, MS, OTR/L, James A Haley Veterans Hospital
Co-Author - Tali Schneider, PhD, James A Haley Veterans Hospital
Co-Author - Risa Nakase-Richardson, PhD, James A Haley Veterans Hospital
Co-Author - Mary Jo Pugh, PhD, University of Utah
Presenter - Jolie Haun, EdS, PhD, James A Haley Veterans Hospital
More Favorable Prototypes are Associated with Smoking and Vaping Willingness in Emerging Adult College Students: Applying the Prototype Willingness Model to Nicotine Use
Poster Number: A155Time: 05:00 PM - 05:50 PM
Topics: Tobacco Control and Nicotine-Related Behavior, Social and Environmental Context and Health
Both smoking and vaping have detrimental health effects. Emerging adults have particularly high prevalence rates (Patrick, Miech, Johnston, & O’Malley, 2024), with over a quarter of undergraduate students having engaged in nicotine use (American College Health Association, 2024). The Prototype Willingness Model provides a framework for understanding how social reactivity leads to health risk behavior via prototypes, images of a typical user, and behavioral willingness, an openness to behavior in social circumstances. In the present study, we apply the Prototype Willingness Model to compare smoker and vaper prototype favorability and smoking and vaping willingness and examine the relationship of smoking and vaping prototypes on smoking and vaping willingness among emerging adults.
A convenience sample of 239 college students (M age= 20.0, SD = 1.25, range 18-24; 84.1% female; 58% white; 84.4% domestic students; past year use 32.2% e-cigarettes, 20.5% cigarettes) participated in an anonymous online survey on their smoking and vaping prototype favorability as well as their willingness to engage in both behaviors.
Vaping prototypes were more favorable than smoking prototypes (p < .001) and vaping willingness was higher than smoking willingness (p = .007). Of all demographic variables, only past use was associated with future use willingness (ps ≤ .014); thus, past use was included as a control variable in logistic regressions. E-cigarette prototype favorability significantly increased odds of high vaping willingness by 1.57, 95% C.I. (1.195, 2.571). Similarly, smoking prototype favorability significantly increased odds of high smoking willingness by 1.52, 95% C.I. (1.026, 2.252). For all analyses, functional results persisted when excluding participants who failed an attention check (19.5%).
These results simultaneously tie together and expand upon the current research on smoking, vaping, and the Prototype Willingness Model to establish a more comprehensive understanding of emerging adults’ social cognitions regarding smoking and vaping. The present study was cross-sectional; future studies could use longitudinal design to further explore both smoking and vaping prototype development (e.g., media exposure and early childhood experiences) and behavioral prediction. Together, this research could better inform intervention strategies and college health resources focused on addressing prototypes and using them to discourage use and reduce nicotine addiction.
Keywords: Nicotine, SmokingA convenience sample of 239 college students (M age= 20.0, SD = 1.25, range 18-24; 84.1% female; 58% white; 84.4% domestic students; past year use 32.2% e-cigarettes, 20.5% cigarettes) participated in an anonymous online survey on their smoking and vaping prototype favorability as well as their willingness to engage in both behaviors.
Vaping prototypes were more favorable than smoking prototypes (p < .001) and vaping willingness was higher than smoking willingness (p = .007). Of all demographic variables, only past use was associated with future use willingness (ps ≤ .014); thus, past use was included as a control variable in logistic regressions. E-cigarette prototype favorability significantly increased odds of high vaping willingness by 1.57, 95% C.I. (1.195, 2.571). Similarly, smoking prototype favorability significantly increased odds of high smoking willingness by 1.52, 95% C.I. (1.026, 2.252). For all analyses, functional results persisted when excluding participants who failed an attention check (19.5%).
These results simultaneously tie together and expand upon the current research on smoking, vaping, and the Prototype Willingness Model to establish a more comprehensive understanding of emerging adults’ social cognitions regarding smoking and vaping. The present study was cross-sectional; future studies could use longitudinal design to further explore both smoking and vaping prototype development (e.g., media exposure and early childhood experiences) and behavioral prediction. Together, this research could better inform intervention strategies and college health resources focused on addressing prototypes and using them to discourage use and reduce nicotine addiction.
Authors:
Author - Sasha Weisman, Bryn Mawr College
Co-Author - Laurel Peterson, PhD, Bryn Mawr College
Co-Author - Reggie Jones, LCSW, MSS, MLSP , Bryn Mawr College
Inclusion of African immigrants in lifestyle interventions for Black adults in the US: a systematic review
Poster Number: A156Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Cardiovascular Disease
The African immigrant population in the US is growing rapidly and is disproportionately affected by obesity. Their exposure to African cultures prior to migration heavily influences their diet and physical activity behaviors, underscoring the need for culturally-tailored lifestyle interventions. Lifestyle interventions have been culturally-tailored for Black adults in the US, but it is unclear whether theoretical frameworks and associated cultural tailoring are relevant to African immigrants. This systematic review examined the representation of African immigrants in lifestyle interventions that target Black adults in the US, the theoretical models underpinning these interventions, and the type of cultural tailoring that was performed. We conducted our literature search in CINAHL Plus, Cochrane Library, Medline, PsycInfo, and PubMed from January 2013 to June 2024. We examined lifestyle intervention trials targeting Black/African American adults with weight loss as an outcome. Our search resulted in 2,099 articles, of which 39 were eligible. None of the studies explicitly indicated that they included African immigrants in their sample. About 61.5% of the articles indicated that their intervention was underpinned by theoretical model(s), and the most common model was social cognitive theory. About 43.6% of trials did not include cultural tailoring of their intervention content. Lifestyle interventions that are tailored for African immigrants are needed due to their exposure to African cultures. Future lifestyle interventions targeting Black/African American populations should measure immigration status and address the needs of both immigrant and non-immigrant Black Americans.
Keywords: Health disparities, Health behavior changeAuthors:
Author - Richard Bannor, PhD, MPH, University of Connecticut
Co-Author - Christie Idiong, MSc, University of Connecticut
Co-Author - Summaya Abdul Razak, MSc, University of Connecticut
Co-Author - Jessica Foy, University of Connecticut
Co-Author - Jared Goetz, University of Connecticut
Co-Author - Ran Xu, PhD, University of Connecticut
Co-Author - Jolaade Kalinowski, University of Connecticut
Co-Author - Roman Shrestha, University of Connecticut
Co-Author - Sherry Pagoto, PhD, University of Connecticut
Effect of Behavioral Weight Management Interventions on Symptoms of Binge-Eating Disorder and Bulimia Nervosa: A Systematic Review & Meta-Analysis
Poster Number: A157Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Diet, Nutrition, and Eating Disorders
Many individuals with obesity meet criteria for an eating disorder such as binge-eating disorder (BED) or bulimia nervosa (BN). However, it is unclear whether behavioral weight management (BWM) interventions such as behavioral weight loss (BWL), which encourage intentional dietary restriction, are safe for individuals diagnosed with these disorders. As such, the purpose of this systematic review and meta-analysis was to evaluate the impact of BWM interventions on eating disorder symptoms among individuals diagnosed with BED or BN. Electronic database searches yielded 22 experimental groups across 11 trials that met inclusion criteria (890 participants). All 11 trials reported that on average, baseline eating disorder symptoms decreased after BWM interventions at both post-treatment and follow-up. Random-effects meta-analyses revealed no significant difference between BWM interventions and comparison groups in post-treatment eating disorder symptom change (Hedges’ g = 0.04, 95% CI [-0.20, 0.29]), however heterogeneity for this analysis was high and statistically significant (I2 = 68.01%, p < .001). Heterogeneity was no longer significant (I2 = 0%, p = 0.51) after the addition of moderator variables (group vs. individual treatment, active vs. control comparator, use of BWL vs. another BWM intervention, percent female, mean age) to the analysis. Two of these moderator terms were statistically significant, including use of an active vs. control comparator condition (b = 0.63, p = .03) and use of BWL vs. another BWM intervention (b = 0.35, p = .03). Further examination of these significant interactions revealed that post-treatment decreases in eating disorder symptoms were greater among BWM interventions when they were compared with no-treatment control (vs. active) comparator groups, and when BWM interventions other than BWL were used. These findings, though limited by the small number of trials, heterogeneity in study design, and sparse long-term outcome data, suggest that behavioral weight management interventions do not increase eating disorder symptoms even among individuals diagnosed with full-threshold BED or BN.
Keywords: Weight control, Binge eatingAuthors:
Presenter - Michael Berry, PhD, VA Connecticut Healthcare System
Author - Craig Gunderson, MD, Yale School of Medicine
Author - Samer Ein Alshaeba, MD, Yale School of Medicine
Author - Melissa Funaro, MS, Yale School of Medicine
Author - Jürgen Holleck, MD, Yale School of Medicine
Author - Elizabeth Marhoffer, MD, Yale School of Medicine
Author - Robin Masheb, PhD, VA Connecticut Healthcare System/Yale School of Medicine
Changes in height and weight as determinants of child zBMI changes for children 6-12 years of age: A mega-analysis
Poster Number: A158Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Diet, Nutrition, and Eating Disorders
zBMI changes for children in weight control programs are a function of weight change in the context of height changes. Both height and weight velocities increase throughout childhood into adolescence. Understanding how growth and weight change together is essential for setting appropriate goals in pediatric weight management across different stages of development. Using mega-analysis techniques, we examined zBMI change at 2-year follow-up for 482 children who received Family-based Behavioral Treatment (FBT), categorized into 6-9 and 10-12 age groups. Multiple regression assessed whether age, sex, height and weight changes and their interactions predicted zBMI change. Estimated zBMI change for children with large height or weight changes were based on ± 1 SD from the mean change.
Individual participant data for the mega-analysis were extracted from 11 Randomized Controlled Trials studying FBT. Main outcomes included height, weight and zBMI change at 24 months for 6-12 year-old children with obesity in families with parents with obesity. Results showed a significant age x growth x weight change interaction, with no differences by sex. The average zBMI changes at 2 years were -.38 and -.29 for 6-9 or 10-12 year-old children, both of which are greater than the -.25 change associated with reduced risk of cardiometabolic disease. Large height gains were associated with zBMI reductions of -.56 and -.49 for 6-9 or 10-12 year-old children, while those with large weight losses had zBMI changes of -.85 and -.71. zBMI changes for those with a combination of large height gains and large weight losses were -.98 and -.91 for the 6-9 and 10-12 year-old children, respectively. Larger height gains were associated with significantly greater zBMI reductions, larger weight reduction was associated with greater zBMI reductions than those with greater height changes, and the combination of greater growth and greater weight loss was associated with greater zBMI change than weight loss alone for both age groups.
These findings show that growth plays a role in reducing zBMI for 6-12 year-old children, with a greater effect for 6-9 year-old than 10-12 year-old children. Accounting for age-related growth patterns when setting weight loss goals may help better predict achievable zBMI changes and support more developmentally tailored treatment planning.
Keywords: Weight control, ChildrenIndividual participant data for the mega-analysis were extracted from 11 Randomized Controlled Trials studying FBT. Main outcomes included height, weight and zBMI change at 24 months for 6-12 year-old children with obesity in families with parents with obesity. Results showed a significant age x growth x weight change interaction, with no differences by sex. The average zBMI changes at 2 years were -.38 and -.29 for 6-9 or 10-12 year-old children, both of which are greater than the -.25 change associated with reduced risk of cardiometabolic disease. Large height gains were associated with zBMI reductions of -.56 and -.49 for 6-9 or 10-12 year-old children, while those with large weight losses had zBMI changes of -.85 and -.71. zBMI changes for those with a combination of large height gains and large weight losses were -.98 and -.91 for the 6-9 and 10-12 year-old children, respectively. Larger height gains were associated with significantly greater zBMI reductions, larger weight reduction was associated with greater zBMI reductions than those with greater height changes, and the combination of greater growth and greater weight loss was associated with greater zBMI change than weight loss alone for both age groups.
These findings show that growth plays a role in reducing zBMI for 6-12 year-old children, with a greater effect for 6-9 year-old than 10-12 year-old children. Accounting for age-related growth patterns when setting weight loss goals may help better predict achievable zBMI changes and support more developmentally tailored treatment planning.
Authors:
Author - Leonard Epstein, PhD, FSBM, Jacobs School of Medicine and Biomedical Sciences, University At Buffalo
Co-Author - Nicholas Neuwald, PhD, Jacobs School of Medicine and Biomedical Sciences
Co-Author - Rocco Paluch, MA, Jacobs School of Medicine and Biomedical Sciences, university at Buffalo
Co-Author - Teresa Quattrin, MD, Jacobs School of Medicine and Biomedical Sciences
Weight Discrimination: A Barrier to Cancer Screening for Women
Poster Number: A159Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Cancer
Background: High body mass index (BMI) is associated with lower rates of routine breast and cervical cancer screening, although this association is observed more consistently in White women than in Black women. One factor that may contribute to avoidance or delay of cancer screening among people with high BMI is anticipation of weight discrimination. Patients who have experienced weight discrimination may be hesitant to participate in cancer screening due to concerns about being judged or mistreated by health care providers or experiencing shame during screening procedures.
Purpose: To examine the association between weight discrimination and receipt of up to date (UTD) cervical and breast cancer screening.
Methods: A demographically diverse sample of US women (39% Black/African American; 29% Latina; 32% sexual minority) with representation across the BMI spectrum was recruited from an online panel to examine rates of cervical cancer screening (N=961; aged 25-64 years) and breast cancer screening (N=461; aged 40-64 years) following US Preventive Services Task Force guidelines. Logistic regression assessed the association between previous experiences with weight discrimination and UTD cervical and breast cancer screening in Black and non-Black participants, adjusting for BMI and demographic characteristics.
Results: Rates of UTD cervical cancer screening were similar among Black (62.3%) and non-Black women (60.7%); however, a higher proportion of Black (59.3%) than non-Black women (47.0%) had received a mammogram within the past two years. Among non-Black women, more frequent exposure to weight discrimination was associated with lower odds of being UTD for both cervical cancer screening, AOR=0.79, 95% CI=0.64, 0.98, and breast cancer screening, AOR=0.60, 95% CI=0.42, 0.85. Weight discrimination was unassociated with either form of cancer screening among Black women.
Conclusions: Previous experiences with interpersonal weight discrimination may deter some women from seeking routine screening for breast and cervical cancer. Strategies for mitigating the harmful consequences of weight-related discrimination in health care settings are needed.
Keywords: Cancer screening, ObesityPurpose: To examine the association between weight discrimination and receipt of up to date (UTD) cervical and breast cancer screening.
Methods: A demographically diverse sample of US women (39% Black/African American; 29% Latina; 32% sexual minority) with representation across the BMI spectrum was recruited from an online panel to examine rates of cervical cancer screening (N=961; aged 25-64 years) and breast cancer screening (N=461; aged 40-64 years) following US Preventive Services Task Force guidelines. Logistic regression assessed the association between previous experiences with weight discrimination and UTD cervical and breast cancer screening in Black and non-Black participants, adjusting for BMI and demographic characteristics.
Results: Rates of UTD cervical cancer screening were similar among Black (62.3%) and non-Black women (60.7%); however, a higher proportion of Black (59.3%) than non-Black women (47.0%) had received a mammogram within the past two years. Among non-Black women, more frequent exposure to weight discrimination was associated with lower odds of being UTD for both cervical cancer screening, AOR=0.79, 95% CI=0.64, 0.98, and breast cancer screening, AOR=0.60, 95% CI=0.42, 0.85. Weight discrimination was unassociated with either form of cancer screening among Black women.
Conclusions: Previous experiences with interpersonal weight discrimination may deter some women from seeking routine screening for breast and cervical cancer. Strategies for mitigating the harmful consequences of weight-related discrimination in health care settings are needed.
Authors:
Presenter - Mary Gerend, PhD, Florida State University College of Medicine
Co-Author - Lucille Wilkinson , Florida State University College of Medicine
Co-Author - Chandler Pendleton, MS, Florida State University College of Medicine
Co-Author - Angelina Sutin, PhD, Florida State University College of Medicine
Co-Author - Janet Shepherd, MD, University of Colorado School of Medicine
A culturally tailored, social media-based DPP paired with a fresh produce distribution program shows promise in improving healthy eating and reducing SDOH barriers among low-income communities in NYC.
Poster Number: A160Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Diabetes
Objective:
To evaluate the efficacy of a culturally tailored, social media–based diabetes preventive program (DPP) paired with a fresh produce distribution program among low-income Chinese immigrants at elevated risk for diabetes.
Methods:
A randomized controlled trial was conducted with 150 Chinese immigrants (mean age 50.0 years [SD = 12.6], 83% female, and 69% with annual household income below USD $55,000) recruited from multiple community settings in NYC. Participants were randomized 1:1 into the intervention or control group (n = 75 per group). The control group received usual care, while the intervention group received culturally tailored, in-language DPP videos (2-3 videos per week for 12 weeks), biweekly bilingual support calls to address social determinants of health (SDOH)-related barriers, and a 10-week distribution of fresh produce. Outcomes included changes in weight (primary) and self-efficacy, dietary intake, physical activity, food insecurity, and digital literacy (secondary), assessed at baseline, 3 months, and 6 months. Group differences over time were analyzed using linear mixed models.
Results:
At 3 months, the intervention group showed statistically significant improvements compared with the control group in dietary intake (-0.100, 95% CI: -1.62 to -0.38, Padj = .005), household food insecurity (-0.922, 95% CI: -1.52 to -0.33, Padj = .007), SDOH barriers (-1.061, 95% CI: -1.75 to -0.37, Padj = .008), and digital literacy (2.539, 95% CI: 0.58 to 4.50, Padj = .034). At 6 months, the intervention group also demonstrated significant improvements in self-efficacy (10.732, 95% CI: 2.08 to 19.38, Padj = .046) and SDOH barriers (-0.957, 95% CI: -1.65 to -0.27, Padj = .020). No statistically significant differences were observed in other outcomes, including weight changes, between groups.
Conclusions:
The culturally tailored, social media-based DPP paired with a fresh produce distribution program showed promising improvements in dietary intake and SDOH barriers.
Keywords: Weight control, DiabetesTo evaluate the efficacy of a culturally tailored, social media–based diabetes preventive program (DPP) paired with a fresh produce distribution program among low-income Chinese immigrants at elevated risk for diabetes.
Methods:
A randomized controlled trial was conducted with 150 Chinese immigrants (mean age 50.0 years [SD = 12.6], 83% female, and 69% with annual household income below USD $55,000) recruited from multiple community settings in NYC. Participants were randomized 1:1 into the intervention or control group (n = 75 per group). The control group received usual care, while the intervention group received culturally tailored, in-language DPP videos (2-3 videos per week for 12 weeks), biweekly bilingual support calls to address social determinants of health (SDOH)-related barriers, and a 10-week distribution of fresh produce. Outcomes included changes in weight (primary) and self-efficacy, dietary intake, physical activity, food insecurity, and digital literacy (secondary), assessed at baseline, 3 months, and 6 months. Group differences over time were analyzed using linear mixed models.
Results:
At 3 months, the intervention group showed statistically significant improvements compared with the control group in dietary intake (-0.100, 95% CI: -1.62 to -0.38, Padj = .005), household food insecurity (-0.922, 95% CI: -1.52 to -0.33, Padj = .007), SDOH barriers (-1.061, 95% CI: -1.75 to -0.37, Padj = .008), and digital literacy (2.539, 95% CI: 0.58 to 4.50, Padj = .034). At 6 months, the intervention group also demonstrated significant improvements in self-efficacy (10.732, 95% CI: 2.08 to 19.38, Padj = .046) and SDOH barriers (-0.957, 95% CI: -1.65 to -0.27, Padj = .020). No statistically significant differences were observed in other outcomes, including weight changes, between groups.
Conclusions:
The culturally tailored, social media-based DPP paired with a fresh produce distribution program showed promising improvements in dietary intake and SDOH barriers.
Authors:
Author - Jing Liu, New York University Grossman School of Medicine
Author - Yanan Zhao, PhD, New York University Grossman School of Medicine
Author - Huilin Li, PhD, New York University Grossman School of Medicine
Author - Lu Hu, PhD, New York University Grossman School of Medicine
Brief Mindful Self-Compassion Meditation Intervention during Pregnancy Significantly Improved Weight Bias Internalization
Poster Number: A161Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Women's Health
Introduction: Body image during pregnancy (BIPS), self-compassion (SC), and internalized weight bias in pregnancy (WBIS-P) are all censorious constructs that warrant intervention throughout the perinatal period, which could improve the emotional and physical health of expectant people.
Methods: Participants (n=60, 53.3% Black, age=28.68 ± 4.78 years) completed three meditations: 1) compassionate body scan, 2) affectionate breathing, and 3) loving-kindness meditation (one meditation daily) over a 1-week period. Assessments occurred at baseline, post-intervention, and 1-month post-baseline. We expected increased SC and body image and reduced WBIS-P over time.
Results: All variables exhibited acceptable normality (p’s > .05). Mauchly’s test of sphericity was non-significant for SC and WBIS-P, but significant for BIPS. Thus, Greenhouse-Geisser was used to correct for sphericity for BIPS. Repeated-measures ANOVAs were used to evaluate changes in SC, BIPS, and WBIS-P over three time points. SC significantly increased across time, F(2, 96) = 7.66, p < .001, η² = .138. Pairwise comparisons with Bonferroni correction indicated significant increases from Time 1 to Time 2 (p = .025), and from Time 1 to Time 3 ( p = .003). However, when covariates (age, parity, trimester, meditation experience) were added, the time effect on SC was no longer significant, F(2, 82) = 0.05, p = .956. BIPS scores decreased significantly over time, F(1.65, 59.43) = 14.88, p < .001, η² = .287. Significant reductions were observed from Time 1 to Time 2 (p = .001), and Time 3 ( p < .001). While the main effect of time was no longer significant with covariates included, a significant covariate, meditation experience, emerged, F(2, 58) = 3.70, p = .031, η² = .113. Any meditation experience was associated with greater declines in body image concerns over time compared to those with none, F(1, 29) = 5.60, p = .025. WBIS-P also significantly decreased over time, F(2, 90)= 32.91, p < .001, η² = .422. Reductions were observed from Time 1 to Time 2 ( p = <.001), and Time 3 ( p < .001). The main effect of time remained significant after accounting for covariates F(2, 76) = 4.66, p = .012, η² = .109.
Conclusions: Findings suggest a brief intervention can significantly improve weight bias internalization in pregnancy. Future research should focus on exploring more effective interventions to reduce weight bias and techniques to strengthen SC during pregnancy.
Keywords: Intervention, MeditationMethods: Participants (n=60, 53.3% Black, age=28.68 ± 4.78 years) completed three meditations: 1) compassionate body scan, 2) affectionate breathing, and 3) loving-kindness meditation (one meditation daily) over a 1-week period. Assessments occurred at baseline, post-intervention, and 1-month post-baseline. We expected increased SC and body image and reduced WBIS-P over time.
Results: All variables exhibited acceptable normality (p’s > .05). Mauchly’s test of sphericity was non-significant for SC and WBIS-P, but significant for BIPS. Thus, Greenhouse-Geisser was used to correct for sphericity for BIPS. Repeated-measures ANOVAs were used to evaluate changes in SC, BIPS, and WBIS-P over three time points. SC significantly increased across time, F(2, 96) = 7.66, p < .001, η² = .138. Pairwise comparisons with Bonferroni correction indicated significant increases from Time 1 to Time 2 (p = .025), and from Time 1 to Time 3 ( p = .003). However, when covariates (age, parity, trimester, meditation experience) were added, the time effect on SC was no longer significant, F(2, 82) = 0.05, p = .956. BIPS scores decreased significantly over time, F(1.65, 59.43) = 14.88, p < .001, η² = .287. Significant reductions were observed from Time 1 to Time 2 (p = .001), and Time 3 ( p < .001). While the main effect of time was no longer significant with covariates included, a significant covariate, meditation experience, emerged, F(2, 58) = 3.70, p = .031, η² = .113. Any meditation experience was associated with greater declines in body image concerns over time compared to those with none, F(1, 29) = 5.60, p = .025. WBIS-P also significantly decreased over time, F(2, 90)= 32.91, p < .001, η² = .422. Reductions were observed from Time 1 to Time 2 ( p = <.001), and Time 3 ( p < .001). The main effect of time remained significant after accounting for covariates F(2, 76) = 4.66, p = .012, η² = .109.
Conclusions: Findings suggest a brief intervention can significantly improve weight bias internalization in pregnancy. Future research should focus on exploring more effective interventions to reduce weight bias and techniques to strengthen SC during pregnancy.
Authors:
Presenter - Natalie Papini, PhD, Northern Arizona University
Co-Author - Nanette Lopez, PhD, RDN, Northern Arizona University
Co-Author - Erin McLear , Arizona State University
Co-Author - Rachel Negovan, Northern Arizona University
Co-Author - Aleeyah Sutton, B.S., Northern Arizona University
Co-Author - Nikole Squires, MS, CHES, ATC, Northern Arizona University
Co-Author - Lea Cambranes, MSc, Northern Arizona University
Co-Author - Julia Gardner, MPH, Northern Arizona University
Co-Author - Taniya Nagpal, PhD, University of Alberta
Co-Author - Rizwana Biviji, PhD, MS, Arizona State University
Social Perceptions of GLP-1–assisted Weight Loss in Black and White Women with Obesity
Poster Number: A162Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Women's Health
Perceptions of individuals who use GLP-1 agonists for weight loss are often unfavorable due to beliefs that the medications are “cheating” compared to lifestyle methods emphasizing willpower and effort. Additionally, intersectionality theory suggests that because Black women with obesity hold three marginalized social identities (Black, woman, obesity), whereas White women hold two, negative attitudes may be stronger toward Black women who lose weight with a GLP-1 compared to White women.
This experimental study used a 2x2 design to test how exposure to different weight loss methods affected stigma toward a Black or White target woman with obesity. A sample of 402 women with overweight or obesity who self-identified as Black or White (Mage = 39.8) were randomly assigned to read about a Black or White woman named Evette who lost 15% of her total body weight with either diet/exercise or a GLP-1. Participants answered questions measuring fat phobia, dislike, desire for social distance, and blame toward Evette, as well as beliefs that she took a shortcut to lose weight.
Stigma toward Evette was higher when she lost weight with a GLP-1 (fat phobia: M = 2.75; dislike: M = 1.62) vs. diet/exercise (fat phobia: M = 1.92; dislike: M = 1.40; ps < .001). Contrary to hypotheses, Evette was perceived more negatively when she was depicted as White (fat phobia: M = 2.46; dislike: M = 1.51; social distance: M = 2.04) vs. Black (fat phobia: M = 2.21; dislike: M = 1.29; social distance: M = 1.50; ps < .001). Further, moderated mediation analyses found that losing weight with a GLP-1 vs. diet/exercise led to higher fat phobia, dislike, desire for social distance, and blame via stronger shortcut beliefs, and this effect was more pronounced when Evette was portrayed as White.
While literature is mixed, results align with studies showing that White women face higher social penalties for having obesity compared to Black women. Strict body size ideals promoted by Western cultures may fuel perceptions that White women should rely on “gold standard” methods like diet and exercise. Our findings underscore that, in the era of novel obesity medications, such expectations can translate into harsher judgments toward White women who pursue GLP-1-assisted weight loss. Yet, addressing stigma toward medical obesity treatments remains critical for Black women as well, who bear a disproportionate burden of negative obesity-related health outcomes.
Keywords: Obesity, Weight lossThis experimental study used a 2x2 design to test how exposure to different weight loss methods affected stigma toward a Black or White target woman with obesity. A sample of 402 women with overweight or obesity who self-identified as Black or White (Mage = 39.8) were randomly assigned to read about a Black or White woman named Evette who lost 15% of her total body weight with either diet/exercise or a GLP-1. Participants answered questions measuring fat phobia, dislike, desire for social distance, and blame toward Evette, as well as beliefs that she took a shortcut to lose weight.
Stigma toward Evette was higher when she lost weight with a GLP-1 (fat phobia: M = 2.75; dislike: M = 1.62) vs. diet/exercise (fat phobia: M = 1.92; dislike: M = 1.40; ps < .001). Contrary to hypotheses, Evette was perceived more negatively when she was depicted as White (fat phobia: M = 2.46; dislike: M = 1.51; social distance: M = 2.04) vs. Black (fat phobia: M = 2.21; dislike: M = 1.29; social distance: M = 1.50; ps < .001). Further, moderated mediation analyses found that losing weight with a GLP-1 vs. diet/exercise led to higher fat phobia, dislike, desire for social distance, and blame via stronger shortcut beliefs, and this effect was more pronounced when Evette was portrayed as White.
While literature is mixed, results align with studies showing that White women face higher social penalties for having obesity compared to Black women. Strict body size ideals promoted by Western cultures may fuel perceptions that White women should rely on “gold standard” methods like diet and exercise. Our findings underscore that, in the era of novel obesity medications, such expectations can translate into harsher judgments toward White women who pursue GLP-1-assisted weight loss. Yet, addressing stigma toward medical obesity treatments remains critical for Black women as well, who bear a disproportionate burden of negative obesity-related health outcomes.
Authors:
Presenter - Stacy Post, PhD, Georgetown University
Co-Author - Michelle Stock, PhD, The George Washington University
Co-Author - Susan Persky, PhD, FSBM, National Human Genome Research Institute
Understanding the roles of sleep duration, caloric intake, and physical activity in long-term weight loss maintenance
Poster Number: A163Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Sleep
Background: Sleep duration has been linked to greater body weight, but little is known about whether sleep duration is proximally associated with weight-related behaviors (i.e., dietary intake and physical activity) during weight loss maintenance.
Methods: This secondary analysis examined whether prior-night sleep duration was associated with dietary intake and physical activity, and whether average sleep duration was associated with long-term weight change. Participants were 254 adults with obesity (baseline M ± SD age = 50.6 ± 11.3 years, BMI = 35.6 ± 4.4 kg/m2, 81.9% women, 70.1% non-Hispanic White) who had lost ≥5% of baseline weight during a 16-week behavioral weight loss program and then randomized to one of two 20-month maintenance interventions. During the maintenance phase, participants self-reported prior-night sleep duration via a single-item questionnaire administered weekly (on a randomly selected day between Monday and Saturday) through a study smartphone app. Daily caloric intake and physical activity were self-monitored via smartphone app; weight was assessed using e-scales.
Results: Average (M ± SD) sleep duration was 6.84 ± 0.87 hours and participants regained 1.71 ± 7.13 kg (+1.90 ± 7.64%) from their weight at the end of the initial weight loss program during the maintenance phase. Multilevel models showed sleep duration was not significantly associated with next-day caloric intake or physical activity, ps > .05; however, there was significant variability across participants in the strength and direction of these relationships, ps < .01, with small subsets (ns ≤ 10) showing significantly positive or negative associations. Over the course of the maintenance trial, average sleep duration was not significantly associated with weight change, ps > .05.
Conclusions: Sleep duration showed no consistent association with next-day caloric intake, physical activity, or long-term weight change at the group level; however, individual differences suggest that sleep may play a more influential role for some. Results highlight the importance of considering individual-level differences, day-to-day variability, and contextual factors when examining associations between sleep and weight-related behaviors. Future studies should utilize comprehensive, objective, 24-hour measures of sleep and activity, assess subgroup variability, and examine demographic patterns that may differentiate individuals most influenced by sleep in the context of weight maintenance.
Keywords: Weight loss, ObesityMethods: This secondary analysis examined whether prior-night sleep duration was associated with dietary intake and physical activity, and whether average sleep duration was associated with long-term weight change. Participants were 254 adults with obesity (baseline M ± SD age = 50.6 ± 11.3 years, BMI = 35.6 ± 4.4 kg/m2, 81.9% women, 70.1% non-Hispanic White) who had lost ≥5% of baseline weight during a 16-week behavioral weight loss program and then randomized to one of two 20-month maintenance interventions. During the maintenance phase, participants self-reported prior-night sleep duration via a single-item questionnaire administered weekly (on a randomly selected day between Monday and Saturday) through a study smartphone app. Daily caloric intake and physical activity were self-monitored via smartphone app; weight was assessed using e-scales.
Results: Average (M ± SD) sleep duration was 6.84 ± 0.87 hours and participants regained 1.71 ± 7.13 kg (+1.90 ± 7.64%) from their weight at the end of the initial weight loss program during the maintenance phase. Multilevel models showed sleep duration was not significantly associated with next-day caloric intake or physical activity, ps > .05; however, there was significant variability across participants in the strength and direction of these relationships, ps < .01, with small subsets (ns ≤ 10) showing significantly positive or negative associations. Over the course of the maintenance trial, average sleep duration was not significantly associated with weight change, ps > .05.
Conclusions: Sleep duration showed no consistent association with next-day caloric intake, physical activity, or long-term weight change at the group level; however, individual differences suggest that sleep may play a more influential role for some. Results highlight the importance of considering individual-level differences, day-to-day variability, and contextual factors when examining associations between sleep and weight-related behaviors. Future studies should utilize comprehensive, objective, 24-hour measures of sleep and activity, assess subgroup variability, and examine demographic patterns that may differentiate individuals most influenced by sleep in the context of weight maintenance.
Authors:
Author - Taylor Swanson, MS, University of Florida
Co-Author - Kate Worwag, MS, University of Florida
Co-Author - Kelsey Barrett, BS, University of Florida
Co-Author - Armaan Shetty, University of Florida
Co-Author - Meena Shankar, MS, RDN, CCRC, University of Florida
Co-Author - Jaime Ruiz, PhD, University of Florida
Co-Author - Kathryn Ross, PhD, MPH, FSBM, Advocate Aurora Research Institute
Weight loss medication stigma: “shortcut beliefs” among users of GLP-1s
Poster Number: A164Time: 05:00 PM - 05:50 PM
Topics: Weight Related Health , Diet, Nutrition, and Eating Disorders
People with obesity commonly experience stigma based on their body size, and as use of Glucagon-Like Peptide 1 Agonists (GLP-1s) for weight loss become more common, there is recognition that they may also experience stigma for using GLP-1s. Medication-related stigma can express itself in medication shortcut beliefs, the belief that someone is “taking an easy way out” or is “cheating” on losing weight. Currently, little is known about the experience of medication shortcut beliefs among users of GLP-1s. Thus, this study aimed to investigate associations between medication shortcut beliefs and weight-related variables. A cross-sectional survey study was conducted with a national US sample of n=203 individuals who started using a GLP-1 in the prior 6 months. Participants completed two Medication Shortcut Belief scales adapted from prior studies: (1) internal shortcut beliefs, the participants’ beliefs about themselves taking a shortcut with medication use, and (2) external shortcut beliefs, their perception of other’s beliefs that medication is a shortcut. Participants also completed the Weight Bias Internalization scale, the DOSE-nonadherence scale, an item on extent of negative comments from friends/family about weight loss medication, and an item on the interest to receive support to manage negative perceptions of medication use. Regression analyzes were conducted, with ChatGPT contributing to code generation. The sample was predominantly women (83.3%) with a mean BMI 35.5±7.6 kg/m2 and age 50.6±12.6. Endorsement of internal shortcut beliefs was low to moderate (mean 2.3, scale 1-7) and external shortcut beliefs were moderate to high (mean 4.6, scale 1-7). Negative comments from friends/family were uncommon (3.7, scale 1- 4, 4 = no negative comments). Internalized shortcut beliefs were not significantly associated with number of past weight loss attempts or presence of weight-related comorbidities but were positively associated with lower medication adherence (p=.014). External shortcut beliefs were related to greater interest in receiving support to manage negative perceptions of medication use from others (p=.002). Post-hoc analyses showed that external shortcut beliefs and receiving negative comments from friends/family were related to internalized general weight stigma. These findings suggest that addressing weight loss medication shortcut beliefs might assist with medication adherence. Further research is needed to investigate causal relationships.
Keywords: Obesity, Weight lossAuthors:
Author - Selina Willfort, MSc, MA, University of Florida
Co-Author - Danielle Jake-Schoffman, PhD, University of Florida
Co-Author - Andreas Schwerdtfeger, PhD, University of Graz
Co-Author - Megan McVay, PhD, University of Florida
Differences in determinants of performing the 5Ds of bystander intervention to prevent sexual violence on college campuses: A Reasoned Action Approach
Poster Number: A165Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Community Engagement
Sexual violence is a widespread and deeply ingrained problem that affects people of all ages, genders, and socioeconomic backgrounds. Bystander interventions (BI) are the gold standard for sexual violence prevention by the government and public health agencies and is defined as someone who isn’t directly involved stepping in to change the outcome of a potentially risky situation. While some studies have been done to understand what motivates, enables, and compels college students to engage in BI on college campuses, a problem in BI research is that BI is typically evaluated as a ‘behavioral category’. That is, it represents a collection of behaviors that have a common goal. With regards to BI, five behaviors are commonly taught be an effective bystander which are known as the “5 Ds”: distract, delegate, document, delay, and direct. The purpose of this study was to evaluate individual determinants of each of the 5 D's of BI to prevent sexual assault on a college campus, to identify significant behavioral and environmental determinants that can serve as a foundation for future targeted BI interventions. The theoretical underpinnings of the Reasoned Action Approach (RAA) were used for this study. College students across the country were recruited and randomized to one of five surveys, specific to one of the 5D's (150 to each group; 750 total). RAA variables (intentions, attitudes, perceived norms, and perceived behavioral control (PBC)) were measured for each of the 5D's. Linear regression analyses were used to evaluate determinants of intentions via the RAA variables. Perceived norms significantly predicted all of the BI strategies (all p's<0.001), except for 'direct', and along with perceived norms, attitudes significantly predicted the delay (p<0.001) and distract (p<0.045) strategies. PBC was the only significant predictor (p<0.001) for the direct strategy. Results showed that normative influences were the strongest among the BI strategies to prevent sexual assault among college students, except for direct strategies. This is likely because direct strategies involve directly getting involved in the situation (e.g. speaking up, acting out), and require more skills overall self-confidence, compared to passive strategies such as strategies that are supportive in nature (document, or delegate) but do not directly break up potentially harmful or risky situations.
Keywords: Sexual abuse, ViolenceAuthors:
Presenter - Paul Branscum, PhD, RD, FAAHB, FSBM, Miami University
Co-Author - Romana Ferdous, Miami University
Co-Author - Christine Hackman, PhD CHES, California Polytechnic State University-San Luis O
Preliminary Test of an Embodiment Model in Women Veterans: The Interplay of Physical and Emotional Well-Being
Poster Number: A166Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Military and Veterans' Health
Research has shown steep age-related declines in physical activity among women Veterans (Washington et al., 2016), placing them at risk for negative health outcomes. Though causal factors have not been established, studies suggest that numerous physiological, cognitive, affective, and social factors may play a contributory role in shifting activity levels (e.g., chronic pain, changing appraisals of the role of physical activity in one’s life, or mental health conditions such as depression or eating pathology). The embodied-self model (Cook-Cottone, 2020), a biopsychosocial model of attunement, may help to explain the interactions of these factors. This study conducted a preliminary test of physiological, cognitive, and affective factors included within the embodied-self model. Study measures were selected to map onto this triad of constructs, with the Body Appreciation Scale-2 (Tylka & Wood-Barcalow, 2015) as the indicator of embodiment. Data were obtained from a survey of 209 women Veterans. Respondents were on average 49.5 years old (SD = 10.9) and predominantly White (62.7%), non-Hispanic (85.6%), married (41.6%) Army Veterans (49.3%). The majority self-reported current service-connected disabilities (71.8%), and a sizeable proportion self-reported prior mental health history (54.5% depression, 36.8% anxiety, 33.5% PTSD). Structural equation models with three endogenous variables (physiological, cognitive, affective) were built to test the embodied-self model. Observed factor loadings guided revisions to successive models. The final structural model yielded good fit per established indices (Hu & Bentler, 1999; CFI = 0.967, RMSEA = 0.052, SRMR = 0.072). The physiological (ß = .213, p = 0.004) and affective factors (ß = -.630, p < 0.001) were statistically significantly associated with embodiment, whereas the cognitive factor was not (ß = .087, p = 0.120). Findings support the influence of physiological (e.g., pain) and affective factors (e.g., depression, anxiety, eating disorder symptoms) on embodiment in predictable ways: for instance, less pain is associated with positive embodiment, and higher mental health symptoms are associated with lower embodiment. Further evaluation of the embodied-self model is warranted.
Keywords: Women's health, Biobehavioral mechanismsAuthors:
Author - Bethany A.H. Crawford, PhD, VA Center for Integrated Healthcare
Author - Paul King, PhD, VA Center for Integrated Healthcare
Author - Wendy Guyker, PhD, VA Center for Integrated Healthcare
Author - Jacob Scharer, Ph.D., Center for Integrated Healthcare
Author - Abigail Ramon, PhD, VA Center for Integrated Healthcare
Author - Catherine Cook-Cottone, PhD, University at Buffalo
Author - Carrie Pengelly, MS, Veterans Administration
Assessing Diagnostic Delay Experiences Among Endometriosis Patients in the U.S.: The Development of a Semi-Structured Interview Guide
Poster Number: A167Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Women's Health
Background: Endometriosis impacts nearly 6 million women in the U.S. and causes symptoms such as chronic pelvic pain and infertility. On average, it takes 7 to 10 years to diagnose this disease. However, there are limited qualitative studies that investigate why endometriosis patients in the U.S. experience delayed diagnosis times.
Aim: The purpose of this pilot study was to develop and assess a semi-structured interview guide to explore the barriers that contribute to a delayed endometriosis diagnosis in patients.
Methods: In this online qualitative study, endometriosis patients were recruited from the Central Pennsylvania Endometriosis Support Network in July 2025. Eligible participants currently lived in the U.S., were 18 years old or older, could read and write in English, and had endometriosis confirmed through laparoscopy. Consent was obtained, all interviews were audio-recorded, and compensation was provided. The interview guide included a script for the interviewer, and the questions were divided into six categories: 1) opening questions, 2) endometriosis history, 3) treatment, 4) diagnosis, 5) closing questions, and 6) evaluation questions. Participants were also asked to bring an object to the interview that resembled their experience with endometriosis. The study was reviewed and met the criteria for exemption by the Penn State Institutional Review Board.
Results: Overall, 10 participants completed the study. Interviews averaged 40 minutes. Participants had a mean age of 35 years (SD=5.78, range 24-44), all lived in Pennsylvania, and mostly received their diagnosis in the last 5 years. Thematic analysis was used to code and categorize transcripts. The themes suggested that more questions should be included to ask about provider-patient interactions, sociocultural factors, and health system challenges.
Discussion/Conclusion: Few studies have developed and tested an interview guide to examine the challenges that contribute to a delayed endometriosis diagnosis in patients. This study has implications for the design of endometriosis interventions and has the potential to add to the growing body of literature on qualitative endometriosis studies. Future research should consider recruitment strategies to include women from historically marginalized backgrounds with endometriosis.
Keywords: Women's health, OB-GYN disordersAim: The purpose of this pilot study was to develop and assess a semi-structured interview guide to explore the barriers that contribute to a delayed endometriosis diagnosis in patients.
Methods: In this online qualitative study, endometriosis patients were recruited from the Central Pennsylvania Endometriosis Support Network in July 2025. Eligible participants currently lived in the U.S., were 18 years old or older, could read and write in English, and had endometriosis confirmed through laparoscopy. Consent was obtained, all interviews were audio-recorded, and compensation was provided. The interview guide included a script for the interviewer, and the questions were divided into six categories: 1) opening questions, 2) endometriosis history, 3) treatment, 4) diagnosis, 5) closing questions, and 6) evaluation questions. Participants were also asked to bring an object to the interview that resembled their experience with endometriosis. The study was reviewed and met the criteria for exemption by the Penn State Institutional Review Board.
Results: Overall, 10 participants completed the study. Interviews averaged 40 minutes. Participants had a mean age of 35 years (SD=5.78, range 24-44), all lived in Pennsylvania, and mostly received their diagnosis in the last 5 years. Thematic analysis was used to code and categorize transcripts. The themes suggested that more questions should be included to ask about provider-patient interactions, sociocultural factors, and health system challenges.
Discussion/Conclusion: Few studies have developed and tested an interview guide to examine the challenges that contribute to a delayed endometriosis diagnosis in patients. This study has implications for the design of endometriosis interventions and has the potential to add to the growing body of literature on qualitative endometriosis studies. Future research should consider recruitment strategies to include women from historically marginalized backgrounds with endometriosis.
Authors:
Author - Victoria Francois, Penn State College of Medicine
Co-Author - Sophia Allen, PhD, MBA, Penn State College of Medicine
Surveillance of Gestational Diabetes and Postpartum Screening: Integrating Scientific Perspectives to Close Data Gaps and Accelerate Maternal Health Impact
Poster Number: A168Time: 05:00 PM - 05:50 PM
Topics: Women's Health, Health Communication and Policy
Background
Gestational diabetes mellitus (GDM) is increasing in the United States, driven by higher maternal age and body mass index. Women with GDM face a ten-fold lifetime risk of type 2 diabetes (T2D). Postpartum diabetes screening is critical to identify undiagnosed T2D and prevent progression, yet fewer than 30% of eligible women are screened in many settings. Current national surveillance systems are fragmented and rely on self-report or isolated clinical settings. There is an urgent need to identify gaps and opportunities for integrating diverse scientific perspectives into public health surveillance of postpartum care, with the goal of strengthening health services and enhancing behavioral interventions for this population.
Methods
We conducted a structured environmental scan of U.S. data sources capturing GDM and postpartum diabetes screening variables. For each identified source, we assessed scope, representativeness, integration potential, and capacity to inform cross-disciplinary interventions.
Results
Eight sources were identified: National Vital Statistics System, Pregnancy Risk Assessment Monitoring System (PRAMS), National Health and Nutrition Examination Survey (NHANES), National Ambulatory Medical Care Survey, Nationwide Readmissions Databases, Behavioral Risk Factor Surveillance System, hospital and health insurance electronic health records (EHRs), and data from individual practices and specialty centers. All sources captured GDM, but only PRAMS, NHANES, EHRs, and select practice-level data included postpartum diabetes screening. Limitations of these data sources included small sample sizes, removal of key questions, lack of temporal linkage, absence of screening variables, and restricted access. Care fragmentation, amplified by insurance churn and non-interoperable systems, hinder longitudinal monitoring.
Conclusions
Postpartum diabetes screening remains under-monitored due to disconnected data and research silos. Integrating epidemiologic, behavioral, health systems, and policy perspectives—through standardized measures, linked datasets, and digital health innovations—can accelerate discovery and produce sustainable improvements in postpartum care.
Keywords: Public health, Informatics Gestational diabetes mellitus (GDM) is increasing in the United States, driven by higher maternal age and body mass index. Women with GDM face a ten-fold lifetime risk of type 2 diabetes (T2D). Postpartum diabetes screening is critical to identify undiagnosed T2D and prevent progression, yet fewer than 30% of eligible women are screened in many settings. Current national surveillance systems are fragmented and rely on self-report or isolated clinical settings. There is an urgent need to identify gaps and opportunities for integrating diverse scientific perspectives into public health surveillance of postpartum care, with the goal of strengthening health services and enhancing behavioral interventions for this population.
Methods
We conducted a structured environmental scan of U.S. data sources capturing GDM and postpartum diabetes screening variables. For each identified source, we assessed scope, representativeness, integration potential, and capacity to inform cross-disciplinary interventions.
Results
Eight sources were identified: National Vital Statistics System, Pregnancy Risk Assessment Monitoring System (PRAMS), National Health and Nutrition Examination Survey (NHANES), National Ambulatory Medical Care Survey, Nationwide Readmissions Databases, Behavioral Risk Factor Surveillance System, hospital and health insurance electronic health records (EHRs), and data from individual practices and specialty centers. All sources captured GDM, but only PRAMS, NHANES, EHRs, and select practice-level data included postpartum diabetes screening. Limitations of these data sources included small sample sizes, removal of key questions, lack of temporal linkage, absence of screening variables, and restricted access. Care fragmentation, amplified by insurance churn and non-interoperable systems, hinder longitudinal monitoring.
Conclusions
Postpartum diabetes screening remains under-monitored due to disconnected data and research silos. Integrating epidemiologic, behavioral, health systems, and policy perspectives—through standardized measures, linked datasets, and digital health innovations—can accelerate discovery and produce sustainable improvements in postpartum care.
Authors:
Co-Author - Kara Suvada, MPH, Emory University
Co-Author - Rosette Chakkalakal, MD, MHS, Emory University
Presenter - Leslie Johnson, PhD, MPH, MLitt, Emory University
Poster Session A
Description
Date: 4/22/2026
Start: 5:00 PM
End: 5:50 PM
Location: Salon D