23 results on '"Duncan, Dustin T."'
Search Results
2. Using GPS-defined venue-based affiliation networks among Black sexually minoritized men and transgender women to identify locations for HIV prevention interventions.
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Chen, Yen-Tyng, Shrader, Cho-Hee, Duncan, Dustin T., Rudolph, Abby E., Regan, Seann D., Kim, Byoungjun, Pagkas-Bather, Jade, Knox, Justin, Fujimoto, Kayo, and Schneider, John A.
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TRANSGENDER people , *HIV prevention , *HIV , *SEXUAL partners , *TRANS women , *PROMISCUITY , *CROWS - Abstract
HIV biomedical intervention uptake is suboptimal among Black sexually minoritized men (SMM) and transgender women (TW). Venues where people meet and interact shape HIV-related risk and prevention behaviors. We aimed to construct GPS-defined venue-based affiliation networks and identify the unique set of venues that could maximize reach of HIV biomedical interventions among Black SMM and TW. We used baseline survey and GPS data from 272 Black SMM and TW in the Neighborhoods and Networks (N2) Cohort Study in Chicago, Illinois (2018–2019). We mapped participants' GPS data to the nearest pre-identified SMM- and TW-friendly venue (n = 222) to construct affiliation networks. Network analyses were performed to identify influential venues that can yield high reach to intervention candidates. Participants were affiliated with 75.5 % of all pre-identified venues based on GPS data. Two influential venues were identified in the non-PrEP use network, which when combined, could reach 52.5 % of participants not taking PrEP. Participants that could be reached through these two influential venues reported more non-main sex partners than participants not affiliated with either venue (p = 0.049). We demonstrate a potential for GPS-defined venue-based affiliation networks to identify unique combinations of venues that could maximize the impact of HIV prevention interventions. • GPS-based affiliation networks identify optimal sets of venues for HIV prevention. • A combination of two influential venues can reach more than half of PrEP candidates. • PrEP candidates reached via influential venues reported more casual sex partners. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Sexual Orientation Disparities in Prescription Opioid Misuse Among U.S. Adults.
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Duncan, Dustin T., Zweig, Sophia, Hambrick, H. Rhodes, and Palamar, Joseph J.
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OPIOID abuse , *SEXUAL orientation , *DRUG utilization , *EPIDEMICS , *CHI-squared test , *LOGISTIC regression analysis - Abstract
Introduction: The opioid epidemic in the U.S. continues to increase in severity, and misuse of prescription opioids is of particular concern since it commonly precedes heroin use. This study examined whether sexual orientation (i.e., sexual identity and sexual attraction) is a risk factor for prescription opioid misuse and use disorder among a nationally representative sample of adults in the U.S.Methods: This study used data from adult participants (ages ≥18 years) in the 2015 National Survey on Drug Use and Health. Chi-square tests and logistic regression examined how sexual identity and sexual attraction relate to past-year and past-month prescription opioid misuse and past-year prescription opioid use disorder. Multivariable models examined associations controlling for demographic characteristics and other drug use. Gender-stratified analyses were also conducted. Data were analyzed in 2018.Results: In multivariable analyses, compared with those identifying as heterosexual, bisexual individuals were at 1.53 (95% CI=1.20, 1.97) and 1.66 (95% CI=1.14, 2.42) higher odds of reporting past-year and past-month misuse, respectively. In stratified analyses, female bisexuals remained at high risk. Regarding sexual attraction, compared with being attracted to only the opposite sex, being attracted to mostly the opposite sex (AOR=2.15, 95% CI=1.77, 2.63) or being equally attracted to both sexes (AOR=1.78, 95% CI=1.38, 2.30) were associated with higher odds for past-year opioid misuse. In stratified analyses, these associations were limited to females.Conclusions: Sexual orientation disparities in opioid misuse and use disorder among a nationally representative sample of U.S. adults was found. [ABSTRACT FROM AUTHOR]- Published
- 2019
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4. Characteristics of Adults Who Switched From Cigarette Smoking to E-cigarettes.
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Park, Su Hyun, Duncan, Dustin T., Shahawy, Omar El, Lee, Lily, Shearston, Jenni A., Tamura, Kosuke, Sherman, Scott E., and Weitzman, Michael
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TEENAGERS , *TOBACCO use , *ELECTRONIC cigarettes , *HEALTH of adults , *EX-smokers , *PUBLIC health - Abstract
Introduction: Because of the rapidly increasing use of electronic cigarettes (e-cigarettes), this study aimed to investigate the individual characteristics and state-level prevalence of U.S. adults who have switched to e-cigarettes from traditional cigarettes.Methods: Data from the 2012-2013 and 2013-2014 National Adult Tobacco Surveys were analyzed in 2016. Relative percent change in switching was estimated, and the state-specific prevalence of adults who switched to e-cigarettes from traditional cigarettes was calculated and mapped. Multivariate logistic regression was conducted to examine how switching varied by sociodemographic subgroups and region.Results: Overall, the number of individuals who switched from traditional cigarettes to e-cigarettes increased by approximately 100% over the 1-year interval. Significant increases were found among a number of sociodemographics and regions. Multivariate logistic regression analyses showed that young adults and those living in the South and West were more likely to switch to e-cigarettes, compared to former smokers who did not switch. Compared with current dual users, those with higher education and those who were not single were more likely to switch to e-cigarettes. The state with the highest prevalence of switching was New Mexico (7.3%), whereas Connecticut had the lowest prevalence (0.8 %) among former smokers.Conclusions: There is an increase in the progression from traditional cigarette use to e-cigarette use. Further research is warranted to determine whether this change continues and facilitates cigarette smoking cessation as a possible public health benefit and opportunity to save lives rather than constitutes a potential threat to public health. [ABSTRACT FROM AUTHOR]- Published
- 2017
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5. Perceived not actual overweight is associated with excessive school absenteeism among U.S. adolescents.
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Duncan, Dustin T., Hansen, Andrew R., Woo Baidal, Jennifer, Lyn, Rodney, Hill, Ashley, and Zhang, Jian
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Summary Background Excess body weight has been reported to be associated with excessive school absenteeism (ESA), but less is known about the association with perceived body weight. The study objective was to weigh the relative influence of perceived and measured weight status on school attendance. Methods We used the data from 3113 adolescents age 12–19 years who were interviewed as a part of the National Health and Nutrition Examination Surveys (NHANES), 2003–2008. Body weight and height were measured during the physical examination, while self-perceived body weight and the number of school days missed was assessed using questionnaires. Missing one or more days per school month (nine days per school year) was defined as, and indicative of, experiencing ESA. Results ESA was reported from 12.31 (SE = 0.89) % of adolescents. The highest prevalence occurred among healthy weight adolescents who erroneously self-perceived as overweight [21.6 (4.77) %], two times higher than adolescents with obesity who self-perceived as “just right weight” [10.3 (2.87) %]. The adjusted prevalence ratio (PR) of ESA for healthy weight adolescents who erroneously self-perceived as “overweight” was 1.91 (95%CI = 1.10–3.32) compared to healthy weight peers who correctly self-perceived as “just right” (reference group). The PRs were 0.99 (0.48–2.06) and 1.41 (0.86–2.32) respectively for adolescents with obesity who believed that their body weight was “just right” or “overweight”. No significant differences were observed between boys and girls, young (12–15 years) and older adolescents (16–19 years). Conclusions Perceived overweight rather than actual overweight is significantly associated ESA among adolescents. [ABSTRACT FROM AUTHOR]
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- 2017
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6. Quantifying spatial misclassification in exposure to noise complaints among low-income housing residents across New York City neighborhoods: a Global Positioning System (GPS) study.
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Duncan, Dustin T., Tamura, Kosuke, Regan, Seann D., Athens, Jessica, Elbel, Brian, Meline, Julie, Al-Ajlouni, Yazan A., and Chaix, Basile
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EPIDEMIOLOGICAL research , *POPULATION health , *GLOBAL Positioning System , *LOW-income housing , *COMPARATIVE studies , *GEOGRAPHIC information systems , *RESEARCH methodology , *MEDICAL cooperation , *NOISE , *POVERTY , *RESEARCH , *RESEARCH funding , *RISK assessment , *STATISTICS , *CITY dwellers , *PILOT projects , *ENVIRONMENTAL exposure , *RESIDENTIAL patterns , *EVALUATION research , *DISEASE incidence - Abstract
Purpose: To examine if there was spatial misclassification in exposure to neighborhood noise complaints among a sample of low-income housing residents in New York City, comparing home-based spatial buffers and Global Positioning System (GPS) daily path buffers.Methods: Data came from the community-based NYC Low-Income Housing, Neighborhoods and Health Study, where GPS tracking of the sample was conducted for a week (analytic n = 102). We created a GPS daily path buffer (a buffering zone drawn around GPS tracks) of 200 m and 400 m. We also used home-based buffers of 200 m and 400 m. Using these "neighborhoods" (or exposure areas), we calculated neighborhood exposure to noisy events from 311 complaints data (analytic n = 143,967). Friedman tests (to compare overall differences in neighborhood definitions) were applied.Results: There were differences in neighborhood noise complaints according to the selected neighborhood definitions (P < .05). For example, the mean neighborhood noise complaint count was 1196 per square kilometer for the 400-m home-based and 812 per square kilometer for the 400-m activity space buffer, illustrating how neighborhood definition influences the estimates of exposure to neighborhood noise complaints.Conclusions: These analyses suggest that, whenever appropriate, GPS neighborhood definitions can be used in spatial epidemiology research in spatially mobile populations to understand people's lived experience. [ABSTRACT FROM AUTHOR]- Published
- 2017
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7. Structural racism and homophobia evaluated through social media sentiment combined with activity spaces and associations with mental health among young sexual minority men.
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Duncan, Dustin T., Cook, Stephanie H., Wood, Erica P., Regan, Seann D., Chaix, Basile, Tian, Yijun, and Chunara, Rumi
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COMPETENCY assessment (Law) , *RACISM , *WELL-being , *GLOBAL Positioning System , *SEXUAL orientation , *PSYCHOLOGY of men , *SOCIAL media , *HOMOPHOBIA , *POPULATION geography , *REGRESSION analysis , *RACE , *SEXUAL minorities , *DESCRIPTIVE statistics , *SECONDARY analysis , *PSYCHOSOCIAL factors - Abstract
Research suggests that structural racism and homophobia are associated with mental well-being. However, structural discrimination measures which are relevant to lived experiences and that evade self-report biases are needed. Social media and global-positioning systems (GPS) offer opportunity to measure place-based negative racial sentiment linked to relevant locations via precise geo-coding of activity spaces. This is vital for young sexual minority men (YSMM) of color who may experience both racial and sexual minority discrimination and subsequently poorer mental well-being. P18 Neighborhood Study (n = 147) data were used. Measures of place-based negative racial and sexual-orientation sentiment were created using geo-located social media as a proxy for racial climate via socially-meaningfully-defined places. Exposure to place-based negative sentiment was computed as an average of discrimination by places frequented using activity space measures per person. Outcomes were number of days of reported poor mental health in last 30 days. Zero-inflated Poisson regression analyses were used to assess influence of and type of relationship between place-based negative racial or sexual-orientation sentiment exposure and mental well-being, including the moderating effect of race/ethnicity. We found evidence for a non-linear relationship between place-based negative racial sentiment and mental well-being among our racially and ethnically diverse sample of YSMM (p <.05), and significant differences in the relationship for different race/ethnicity groups (p <.05). The most pronounced differences were detected between Black and White non-Hispanic vs. Hispanic sexual minority men. At two standard deviations above the overall mean of negative racial sentiment exposure based on activity spaces, Black and White YSMM reported significantly more poor mental health days in comparison to Hispanic YSMM. Effects of discrimination can vary by race/ethnicity and discrimination type. Experiencing place-based negative racial sentiment may have implications for mental well-being among YSMM regardless of race/ethnicity, which should be explored in future research including with larger samples sizes. • We study structural discrimination via place-based race/sexual-orientation climate. • Geo-located social media sentiment was a proxy for structural racism and homophobia. • Linking social media and activity spaces created negative climate exposure measures. • Negative racial climate exposure and mental health were related non-linearly. • Significant differences by race/ethnicity groups motivates larger sample studies. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Association Between Electronic Cigarette Marketing Near Schools and E-cigarette Use Among Youth.
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Giovenco, Daniel P., Casseus, Myriam, Duncan, Dustin T., Coups, Elliot J., Lewis, M. Jane, and Delnevo, Cristine D.
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Purpose Electronic cigarettes (e-cigarettes) are now the most popular tobacco product among youth. Little is known about the relationship between exposure to e-cigarette marketing at the point-of-sale and youth e-cigarette use. Methods Research staff collected data on e-cigarette availability and promotion in tobacco retailers within a half-mile of 41 schools participating in the 2014 New Jersey Youth Tobacco Survey. These data were linked with participant responses from the New Jersey Youth Tobacco Survey (n = 3,909) and log-Poisson regression models estimated adjusted prevalence ratios for ever and past-month e-cigarette use. Results Nearly a quarter of high school students in New Jersey have tried e-cigarettes (24.1%) and 12.1% were past-month users. Prevalence was highest among males, non-Hispanic whites, and students who have used other tobacco products. After controlling for covariates and the clustered nature of the data, e-cigarette retailer density around schools was positively associated with ever and past-month use of e-cigarettes ( p < .05). E-cigarette advertising volume significantly increased the probability of being a past-month e-cigarette user (adjusted prevalence ratio: 1.03, p = .031). Conclusions This study suggests that the point-of-sale environment around schools may contribute to e-cigarette use among youth. Policy efforts to restrict tobacco promotion at the point-of-sale may play a role in reducing the use of e-cigarettes. [ABSTRACT FROM AUTHOR]
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- 2016
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9. Proximity to Fast-Food Outlets and Supermarkets as Predictors of Fast-Food Dining Frequency.
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Athens, Jessica K., Duncan, Dustin T., and Elbel, Brian
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CONVENIENCE foods , *ECOLOGY , *FOOD habits , *FORECASTING , *METROPOLITAN areas , *REGRESSION analysis , *SHOPPING , *SURVEYS , *TELEPHONES , *CROSS-sectional method , *MEDICAL coding , *DESCRIPTIVE statistics - Abstract
Background This study used cross-sectional data to test the independent relationship of proximity to chain fast-food outlets and proximity to full-service supermarkets on the frequency of mealtime dining at fast-food outlets in two major urban areas, using three approaches to define access . Interactions between presence of a supermarket and presence of fast-food outlets as predictors of fast-food dining were also tested. Methods Residential intersections for respondents in point-of-purchase and random-digit-dial telephone surveys of adults in Philadelphia, PA, and Baltimore, MD, were geocoded. The count of fast-food outlets and supermarkets within quarter-mile, half-mile, and 1-mile street network buffers around each respondent’s intersection was calculated, as well as distance to the nearest fast-food outlet and supermarket. These variables were regressed on weekly fast-food dining frequency to determine whether proximity to fast food and supermarkets had independent and joint effects on fast-food dining. Results The effect of access to supermarkets and chain fast-food outlets varied by study population. Among telephone survey respondents, supermarket access was the only significant predictor of fast-food dining frequency. Point-of-purchase respondents were generally unaffected by proximity to either supermarkets or fast-food outlets. However, ≥1 fast-food outlet within a 1-mile buffer was an independent predictor of consuming more fast-food meals among point-of-purchase respondents. At the quarter-mile distance, ≥1 supermarket was predictive of fewer fast-food meals. Conclusions Supermarket access was associated with less fast-food dining among telephone respondents, whereas access to fast-food outlets were associated with more fast-food visits among survey respondents identified at point-of-purchase. This study adds to the existing literature on geographic determinants of fast-food dining behavior among urban adults in the general population and those who regularly consume fast food. [ABSTRACT FROM AUTHOR]
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- 2016
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10. Census tract correlates of vape shop locations in New Jersey.
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Giovenco, Daniel P., Duncan, Dustin T., Coups, Elliot J., Lewis, M. Jane, and Delnevo, Cristine D.
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INTERNET stores , *ELECTRONIC cigarettes , *SOCIAL norms - Abstract
Introduction: Vape shops are opening across the USA, but little is known about the types of neighborhoods where they are located. This study explores community-level predictors of vape shop locations in New Jersey, USA.Methods: Vape shops were identified in July 2015 using a validated systematic online search protocol and geocoded using Google Earth Pro. Multivariable logistic regression identified demographic and other predictors of vape shop presence at the census tract level.Results: Tobacco outlet density was consistently associated with higher odds of vape shop presence after adjusting for covariates (p<0.05). However, factors traditionally associated with tobacco retail were negatively associated with vapor outlets. Census tracts with a higher proportion of non-Hispanic black residents had significantly lower odds of having a vape shop (?=-0.03, p<0.001).Discussion: Vape shops are commonly located in census tracts where tobacco retail is high, but where fewer racial minorities live. The retail environment may communicate social norms regarding vaping and ultimately influence use behaviors of community residents. [ABSTRACT FROM AUTHOR]- Published
- 2016
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11. Proposing the observational–implementation hybrid approach: designing observational research for rapid translation.
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Knox, Justin, Schwartz, Sheree, Duncan, Dustin T., Curran, Geoff, Schneider, John, Stephenson, Rob, Wilson, Patrick, Nash, Denis, Sullivan, Patrick, and Geng, Elvin
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RESEARCH personnel , *SCIENTIFIC observation , *EXPERIMENTAL design , *ACQUISITION of data , *EPIDEMIOLOGISTS , *PIPELINE inspection - Abstract
We propose the observational–implementation hybrid approach—the incorporation of implementation science methods and measures into observational studies to collect information that would allow researchers to anticipate, estimate, or infer the effects of interventions and implementation strategies. Essentially, we propose that researchers collect implementation data early in the research pipeline, in situations where they might not typically be thinking about implementation science. We describe three broad contextual scenarios through which the observational–implementation hybrid approach would most productively be applied. The first application is for observational cohorts that individually enroll participants—either for existing (to which implementation concepts could be added) or for newly planned studies. The second application is with routinely collected program data, at either the individual or aggregate levels. The third application is to the collection of data from study participants enrolled in an observational cohort study who are also involved in interventions linked to that study (e.g., collecting data about their experiences with those interventions). Examples of relevant implementation data that could be collected as part of observational studies include factors relevant to transportability, participant preferences, and participant/provider perspectives regarding interventions and implementation strategies. The observational–implementation hybrid model provides a practical approach to make the research pipeline more efficient and to decrease the time from observational research to health impact. If this approach is widely adopted, observational and implementation science studies will become more integrated; this will likely lead to new collaborations, will encourage the expansion of epidemiological training, and, we hope, will push both epidemiologists and implementation scientists to increase the public health impact of their work. [ABSTRACT FROM AUTHOR]
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- 2023
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12. The role of neighborhood characteristics in racial/ethnic disparities in type 2 diabetes: Results from the Boston Area Community Health (BACH) Survey.
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Piccolo, Rebecca S., Duncan, Dustin T., Pearce, Neil, and McKinlay, John B.
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BLACK people , *COMMUNITIES , *HISPANIC Americans , *TYPE 2 diabetes , *RACE , *STATISTICAL sampling , *SELF-evaluation , *SURVEYS , *WHITE people , *LOGISTIC regression analysis , *DESCRIPTIVE statistics - Abstract
Racial/ethnic disparities in the prevalence of type 2 diabetes mellitus (T2DM) are well documented and until recently, research has focused almost exclusively on individual-based determinants as potential contributors to these disparities (health behaviors, biological/genetic factors, and individual-level socio-demographics). Research on the role of neighborhood characteristics in relation to racial/ethnic disparities in T2DM is very limited. Therefore, the aim of this research is to identify and estimate the contribution of specific aspects of neighborhoods that may be associated with racial/ethnic disparities in T2DM. Data from the Boston Area Community Health III Survey (N = 2764) was used in this study, which is a community-based random-sample survey of adults in Boston, Massachusetts from three racial/ethnic groups (Black, Hispanic, and White). We applied two-level random intercepts logistic regression to assess the associations between race/ethnicity, neighborhood characteristics (census tract socioeconomic status, racial composition, property and violent crime, open space, geographic proximity to grocery stores, convenience stores, and fast food, and neighborhood disorder) and prevalent T2DM (fasting glucose > 125 mg/dL, HbA1c ≥ 6.5%, or self-report of a T2DM diagnosis). Black and Hispanic participants had 2.89 times and 1.48 times the odds of T2DM as White participants, respectively. Multilevel models indicated a significant between-neighborhood variance estimate of 0.943, providing evidence of neighborhood variation. Individual demographics (race/ethnicity, age and gender) explained 22.3% of the neighborhood variability in T2DM. The addition of neighborhood-level variables to the model had very little effect on the magnitude of the racial/ethnic disparities and on the between-neighborhood variability. For example, census tract poverty explained less than 1% and 6% of the excess odds of T2DM among Blacks and Hispanics and only 1.8% of the neighborhood variance in T2DM. While the findings of this study overall suggest that neighborhood factors are not a major contributor to racial/ethnic disparities in T2DM, further research is needed including data from other geographic locations. [ABSTRACT FROM AUTHOR]
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- 2015
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13. Neighborhood-level LGBT hate crimes and current illicit drug use among sexual minority youth.
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Duncan, Dustin T., Hatzenbuehler, Mark L., and Johnson, Renee M.
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HEALTH of LGBTQ+ people , *HATE crime prevention , *DRUGS of abuse , *SEXUAL minority youth , *COMPARATIVE studies , *HETEROSEXUALITY , *MARIJUANA abuse - Abstract
Abstract: Objective: To investigate whether past-30 day illicit drug use among sexual minority youth was more common in neighborhoods with a greater prevalence of hate crimes targeting lesbian, gay, bisexual, and transgender (LGBT, or sexual minority) individuals. Methods: We used a population-based survey of public school youth in Boston, Massachusetts, consisting of 1292 9th–12th grade students from the 2008 Boston Youth Survey Geospatial Dataset (sexual minority n =108). Data on LGBT hate crimes involving assaults or assaults and battery between 2005 and 2008 were obtained from the Boston Police Department and linked to youths’ residential address. Youth reported past-30 day use of marijuana and other illicit drugs. Wilcoxon–Mann–Whitney tests and corresponding p-values were computed to assess differences in substance use by neighborhood-level LGBT assault hate crime rate among sexual minority youth (n =103). Results: The LGBT assault hate crime rate in the neighborhoods of sexual minority youth who reported current marijuana use was 23.7 per 100,000, compared to 12.9 per 100,000 for sexual minority youth who reported no marijuana use (p =0.04). No associations between LGBT assault hate crimes and marijuana use among heterosexual youth (p >0.05) or between sexual minority marijuana use and overall neighborhood-level violent and property crimes (p >0.05) were detected, providing evidence for result specificity. Conclusions: We found a significantly greater prevalence of marijuana use among sexual minority youth in neighborhoods with a higher prevalence of LGBT assault hate crimes. These results suggest that neighborhood context (i.e., LGBT hate crimes) may contribute to sexual orientation disparities in marijuana use. [Copyright &y& Elsevier]
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- 2014
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14. The built environment and depressive symptoms among urban youth: A spatial regression study.
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Duncan, Dustin T., Piras, Gianfranco, Dunn, Erin C., Johnson, Renee M., Melly, Steven J., and Molnar, Beth E.
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Highlights: [•] Significant positive spatial autocorrelation was found in depressive symptoms. [•] Significant positive spatial autocorrelation was found in the built environment. [•] Spatial regression models were necessary and improved model fit. [•] The built environment can have depressogenic effects among youth. [•] Overall, the built environment minimally influenced youth depressive symptoms. [Copyright &y& Elsevier]
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- 2013
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15. Accessibility of HIV Services in Philadelphia: Location-Allocation Analysis.
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Webster, Jessica L., Thorpe, Lorna E., Duncan, Dustin T., and Goldstein, Neal D.
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DIAGNOSIS of HIV infections , *HIV infection epidemiology , *HIV prevention , *INTELLECT , *TRAVEL , *CONTINUUM of care - Abstract
Introduction: As the first step in the HIV care continuum, timely diagnosis is central to reducing transmission of the virus and ending the HIV epidemic. Studies have shown that distance from a testing site is essential for ease of access to services and educational material. This study shows how location-allocation analysis can be used to improve allocation of HIV testing services utilizing existing publicly available data from 2015 to 2019 on HIV prevalence, testing site location, and factors related to HIV in Philadelphia, Pennsylvania.Methods: The ArcGIS Location-Allocation analytic tool was used to calculate locations for HIV testing sites using a method that minimizes the distance between demand-point locations and service facilities. ZIP code level demand was initially specified on the basis of the percentage of late HIV diagnoses and in a sensitivity analysis on the basis of a composite of multiple factors. Travel time and distance from demand to facilities determined the facility location allocation. This analysis was conducted from 2021 to 2022.Results: Compared with the 37 facilities located in 20 (43%) Philadelphia ZIP codes, the model proposed reallocating testing facilities to 37 (79%) ZIP codes using percent late diagnoses to define demand. On average, this would reduce distance to the facilities by 65% and travel time to the facilities by 56%. Results using the sensitivity analysis were similar.Conclusions: A wider distribution of HIV testing services across the city of Philadelphia may reduce distance and travel time to facilities, improve accessibility of testing, and in turn increase the percentage of people with knowledge of their status. [ABSTRACT FROM AUTHOR]- Published
- 2022
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16. Neighborhood social cohesion, religious participation and sexual risk behaviors among cisgender black sexual minority men in the southern United States.
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Duncan, Dustin T., Ransome, Yusuf, Park, Su Hyun, Jackson, Skyler D., Kawachi, Ichiro, Branas, Charles C., Knox, Justin, Al-Ajlouni, Yazan A., Mountcastle, Hayden, Miles, Caleb H., and Hickson, DeMarc A.
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RISK-taking behavior , *PSYCHOLOGY of Black people , *CONFIDENCE intervals , *MULTIVARIATE analysis , *MEN , *REGRESSION analysis , *SEXUAL minorities , *ALCOHOL drinking , *DESCRIPTIVE statistics , *ODDS ratio , *RELIGION , *UNSAFE sex - Abstract
Few studies have examined associations between neighborhood social cohesion and sexual risk behaviors among gay, bisexual, and other sexual minority men (SMM), and none have among Black SMM in the southern U.S. The purpose of the current study is to examine associations between neighborhood social cohesion and sexual risk behaviors among Black SMM in the southern U.S., a population heavily impacted by HIV. We also examined whether these relationships are modified by religious participation for Black SMM in the southern U.S. Data was obtained from the MARI Study, a sample of Black SMM ages 18–66 years, recruited from the Jackson, MS and Atlanta, GA metropolitan areas (n = 354). Neighborhood social cohesion was assessed with a validated 5-item scale. We conducted multivariable regression analyses to examine the association between neighborhood social cohesion with each of the sexual risk behaviors (e.g., condomless sex and drug use before or during sex), controlling for key confounders. We then performed moderation analysis by religious participation (religious attendance and private religiosity). Compared to Black SMM with higher perceived neighborhood social cohesion, Black SMM with lower neighborhood social cohesion had increased odds of alcohol use before or during sex (aPR = 1.56; 95% CI = 1.16–2.11) and condomless anal sex with casual partners (aPR = 1.55; 1.03–2.32). However, the magnitude of these associations varied by religious attendance and private religiosity. Black SMM with low religious service attendance had higher risk of alcohol use in the context of sex when perceived neighborhood social cohesion was low; those with high private religiosity had elevated alcohol use in the context of sex when perceived neighborhood social cohesion was low. Interventions that target connectedness among neighborhood members through community education or mobilization efforts, including the involvement of religious organizations, should be considered for HIV prevention focused on alcohol and condomless sex among Black SMM. • Neighborhood social cohesion was associated with sexual risk behaviors. • The magnitude of these associations varied by religious participation. • Further research is needed to investigate mechanisms in associations. [ABSTRACT FROM AUTHOR]
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- 2021
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17. Assessment of spatial mobility among young men who have sex with men within and across high HIV prevalence neighborhoods in New York city: The P18 neighborhood study.
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Duncan, Dustin T., Regan, Seann D., Park, Su Hyun, Goedel, William C., Kim, Byoungjun, Barton, Staci C., Halkitis, Perry N., and Chaix, Basile
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• Most studies investigating the role of neighborhoods in HIV-related outcomes among men who have sex with men (MSM) exclusively focus on the residential environment. • Spatial mobility was documented with both self-reported survey data and objective GPS data, which provided uncorrelated information. • Almost two-thirds (62.9%) of participants' GPS points were recorded in NYC ZIP code tabulation areas within the highest quartile of HIV prevalence. • Compared to males, it was found that transfemale, genderqueer, and other MSM spent a much higher fraction of their non-home GPS time in high HIV prevalence areas. The purpose of this study was to examine and quantify spatial mobility among HIV-negative young men who have sex with men (YMSM) within and across high prevalence HIV neighborhoods in New York City (NYC). We completed an analysis with global positioning system (GPS) and survey data to quantify spatial mobility for participants enrolled in the P18 Neighborhood Study (analytic n = 211; 83.4%). Spatial mobility was documented with self-reported survey data and objective GPS data, which was uncorrelated. Nearly one-quarter of participants (26.1%) said that they consider the neighborhood in which they currently live to differ from the neighborhood in which they had sex most frequently. In addition, 62.9% of participants' GPS points were recorded in NYC ZIP Code Tabulation Areas within the highest quartile of HIV prevalence. Future studies of YMSM populations should be conducted to examine how environments beyond the residential neighborhood can influence sexual health, which may guide HIV prevention services. [ABSTRACT FROM AUTHOR]
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- 2020
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18. Multivariate spatiotemporal modeling of drug- and alcohol-poisoning deaths in New York City, 2009–2014.
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Ransome, Yusuf, Subramanian, S.V., Duncan, Dustin T., Vlahov, Daivid, and Warren, Joshua
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Drug- and alcohol-poisoning deaths remain current public health problems. Studies to date have typically focused on individual-level predictors of drug overdose deaths, and there remains a limited understanding of the spatiotemporal patterns and predictors of the joint outcomes. We use a hierarchical Bayesian spatiotemporal multivariate Poisson regression model on data from (N = 167) ZIP-codes between 2009 and 2014 in New York City to examine the spatiotemporal patterns of the joint occurrence of drug (opioids) and alcohol-poisoning deaths, and the covariates associated with each outcome. Results indicate that rates of both outcomes were highly positively correlated across ZIP-codes (cross-correlation: 0.57, 95% credible interval (CrI): 0.29, 0.77). ZIP-codes with a higher prevalence of heavy drinking had higher alcohol-poisoning deaths (relative risk (RR):1.63, 95% CrI: 1.26, 2.05) and drug-poisoning deaths (RR: 1.29, 95% CrI: 1.03, 1.59). These spatial patterns may guide public health planners to target specific areas to address these co-occurring epidemics. [ABSTRACT FROM AUTHOR]
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- 2020
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19. Spatial accessibility of pre-exposure prophylaxis (PrEP): different measure choices and the implications for detecting shortage areas and examining its association with social determinants of health.
- Author
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Luan, Hui, Li, Guangquan, Duncan, Dustin T., Sullivan, Patrick S., and Ransome, Yusuf
- Subjects
- *
PRE-exposure prophylaxis , *SOCIAL determinants of health , *SUPPLY & demand , *SCARCITY , *ZIP codes - Abstract
We examine how various pre-exposure prophylaxis (PrEP) accessibility measures impact the detection of PrEP shortage areas and the relation of shortage areas to social determinants of health (SDOH). Using ZIP Code Tabulation Areas (ZCTAs) in New York City as a case study, we compared 25 measures of spatial PrEP accessibility across four categories, including density, proximity, two-step floating catchment area (2SFCA), and Gaussian 2SFCA (G2SFCA). Bayesian spatial regression models were used to examine how PrEP accessibility is associated with SDOH. Using density to measure PrEP accessibility for small areas such as ZCTAs poses challenges to statistical modeling because the measured accessibility values are highly skewed with excess zeros, leading to the necessity of using complex models such as the two-part mixture model. When G2SFCA measures are used, which account for distance decay effects and the competition from the PrEP demand side, findings on PrEP shortage area detection and the association between PrEP accessibility and SDOH were more consistent and less sensitive to spatial scales (i.e., varying from 10- to 30-minute driving). This research adds to the nascent research on PrEP accessibility measurement and sheds light on selecting an appropriate measure to assess spatial disparities in PrEP accessibility and its associations with SDOH. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
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20. What's Your Walk Score((R))?: Web-Based Neighborhood Walkability Assessment for Health Promotion and Disease Prevention.
- Author
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Duncan, Dustin T
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- 2013
- Full Text
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21. Neighborhood-level social processes and substantiated cases of child maltreatment.
- Author
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Molnar, Beth E., Goerge, Robert M., Gilsanz, Paola, Hill, Andrea, Subramanian, S.V., Holton, John K., Duncan, Dustin T., Beatriz, Elizabeth D., and Beardslee, William R.
- Subjects
- *
NEIGHBORHOODS , *SOCIAL processes , *CHILD abuse , *PUBLIC health , *SOCIOECONOMICS , *PHYSICAL abuse - Abstract
Child maltreatment is a preventable public health problem. Research has demonstrated that neighborhood structural factors (e.g. poverty, crime) can influence the proportion of a neighborhood's children who are victims of maltreatment. A newer strategy is the identification of potentially modifiable social processes at the neighborhood level that can also influence maltreatment. Toward this end, this study examines neighborhood-level data (maltreatment cases substantiated by Illinois’ child protection agency, 1995–2005, social processes measured by the Project on Human Development in Chicago Neighborhoods, U.S. Census data, proportions of neighborhoods on public assistance, and crime data) that were linked across clusters of contiguous, relatively homogenous Chicago, IL census tracts with respect to racial/ethnic and socioeconomic composition. Our analysis—an ecological-level, repeated cross-sectional design utilizing random-intercept logit models—with a sensitivity analysis using spatial models to control for spatial autocorrelation—revealed consistent associations between neighborhood social processes and maltreatment. Neighborhoods higher in collective efficacy, intergenerational closure, and social networks, and lower in disorder had lower proportions of neglect, physical abuse, and sexual abuse substantiated cases, controlling for differences in structural factors. Higher collective efficacy and social network size also predicted a lower proportion of substance-exposed infants. This research indicates that strategies to mobilize neighborhood-level protective factors may decrease child maltreatment more effectively than individual and family-focused efforts alone. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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22. COVID-19 testing, case, and death rates and spatial socio-demographics in New York City: An ecological analysis as of June 2020.
- Author
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Kim, Byoungjun, Rundle, Andrew G., Goodwin, Alicia T.Singham, Morrison, Christopher N., Branas, Charles C., El-Sadr, Wafaa, and Duncan, Dustin T.
- Subjects
- *
COVID-19 testing , *DEATH rate , *COVID-19 , *BUILT environment , *ZIP codes - Abstract
We assessed the geographic variation in socio-demographics, mobility, and built environmental factors in relation to COVID-19 testing, case, and death rates in New York City (NYC). COVID-19 rates (as of June 10, 2020), relevant socio-demographic information, and built environment characteristics were aggregated by ZIP Code Tabulation Area (ZCTA). Spatially adjusted multivariable regression models were fitted to account for spatial autocorrelation. The results show that different sets of neighborhood characteristics were independently associated with COVID-19 testing, case, and death rates. For example, the proportions of Blacks and Hispanics in a ZCTA were positively associated with COVID-19 case rate. Contrary to the conventional hypothesis, neighborhoods with low-density housing experienced higher COVID-19 case rates. In addition, demographic changes (e.g. out-migration) during the pandemic may bias the estimates of COVID-19 rates. Future research should further investigate these neighborhood-level factors and their interactions over time to better understand the mechanisms by which they affect COVID-19. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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23. Associations of spatial mobility with sexual risk behaviors among young men who have sex with men in New York City: A global positioning system (GPS) study.
- Author
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Kim, Byoungjun, Regan, Seann D., Callander, Denton, Goedel, William C., Chaix, Basile, and Duncan, Dustin T.
- Subjects
- *
HIV infection risk factors , *CONDOMS , *GLOBAL Positioning System , *SCIENTIFIC observation , *POPULATION geography , *RISK assessment , *RISK-taking behavior , *HUMAN sexuality , *ANAL sex , *SOCIOECONOMIC factors , *BODY movement , *MEN who have sex with men , *SEXUAL partners - Abstract
Spatial contexts and spatial mobility are important factors of the HIV epidemic and sexually transmitted infections. Using global positioning system (GPS) devices, we examined the associations of objectively measured spatial mobility with sexual risk behaviors among gay, bisexual and other men who have sex with men (MSM) in New York City. This observational study included a subgroup of 253 HIV-negative MSM from the Project 18 Cohort Study, who participated in the GPS monitoring sub-study. Spatial mobility was measured as (1) distance traveled and (2) activity space size defined as daily path area during 2-week of GPS tracking. We examined the associations of these measures with numbers of male sexual partners and condomless anal intercourse (CAI) acts during last six months using quasi-Poisson models, adjusting for socio-demographics. Results demonstrated that spatial mobility was positively associated with sexual risk behaviors, for example, with CAI (incidence rate ratio [IRR] = 1.01 for a 10 km increase in distance traveled and IRR = 1.04 for a 1 km2 increase in 50 m-buffer activity space size). Our findings may enhance the understanding of spatial contexts of HIV risk. Future studies should be conducted to examine the mechanisms for the associations between spatial mobility behaviors with sexual risk behaviors as well as the influence of neighborhood characteristics in various neighborhood contexts, which may guide the place-based HIV prevention services. • GPS-based spatial mobility was positively associated with sexual risk behaviors. • Findings confirm the spatial contexts of HIV risks in urban environments. • Future studies may guide the place-based HIV prevention services. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
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