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Background In 2021, the United States Preventive Services Task Force updated their recommendation, stating that individuals ages 45-49 should initiate screening for colorectal cancer. Since several screening strategies are recommended, making a shared decision involves including an individual’s preferences. Few studies have included individuals under age 50. In this study, we use a multicriteria decision analysis technique called the Analytic Hierarchy Process to explore preferences for screening strategies and evaluate whether preferences vary by age. Methods Participants evaluated a hierarchy with 3 decision alternatives (colonoscopy, fecal immunochemical test, and computed tomography colonography), 3 criteria (test effectiveness, the screening plan, and features of the test) and 7 sub-criteria. We used the linear fit method to calculate consistency ratios and the eigenvector method for group preferences. We conducted sensitivity analysis to assess whether results are robust to change and tested differences in preferences by participant variables using chi-square and analysis of variance. Results Of the 579 individuals surveyed, 556 (96%) provided complete responses to the AHP portion of the survey. Of these, 247 participants gave responses consistent enough (CR p = 0.002). These results were consistent when we restricted analysis to individuals ages 45-55 (p = 0.011). Participants rated test effectiveness as the most important criteria for making their decision (weight = 0.555). Sensitivity analysis showed our results were robust to shifts in criteria and sub-criteria weights. Conclusions We reveal potential differences in preferences for screening strategies by age that could influence the adoption of screening programs to include individuals under age 50. Researchers and practitioners should consider at-home interventions using the Analytic Hierarchy Process to assist with the formulation of preferences that are key to shared decision-making. The costs associated with different preferences for screening strategies should be explored further if limited resources must be allocated to screen individuals ages 45-49.

Adults who work in the Central Appalachian region of the United States (U.S.) are disproportionately affected by Chronic Obstructive Pulmonary Disease (COPD). While there is a socio-demographic profile of adults with COPD who are at increased risk for physical and mental distress, the risk factors that uniquely affect the health-related quality of life (HRQoL) of Central Appalachian workers with COPD are unknown. Therefore, we conducted a latent class analysis of 2016 and 2017 Behavioral Risk Factor Surveillance System data from 1326 currently employed adults with COPD living in four U.S. states (KY, NC, TN, and WV) within the Central Appalachian Region. Drawing from the social ecological model, we identified associations between theoretically informed risk indicators&mdash, comorbid health conditions, substance use and abuse, and limited access to healthcare&mdash, on three HRQoL variables, including infrequent (0&ndash, 13 days) or frequent (&ge, 14 days) physical distress, mental distress, and limited activity due to poor health over the past 30 days. Workers at high risk for comorbid conditions reported more frequent physical distress, mental distress, and activity limitations as compared to those at low risk. Workers reporting difficulty accessing healthcare were no more likely to report physical or mental distress when compared to workers with adequate access to healthcare, however, those with limited healthcare access did report more frequent activity limitation due to poor health. Interestingly, workers with COPD at high risk for substance use and abuse were no more likely to report poor HRQoL outcomes compared to those at low risk. Our findings have important implications for addressing indicators of poor health among Central Appalachian workers with COPD, especially those living with multiple comorbidities.

Lung cancer screening via low-dose computed tomography (LDCT) has been underutilized by high-risk current and former smokers since its approval in 2013. Further, lower use of other evidence-based cancer screening tests (e.g., colorectal cancer, breast cancer) has been noted among African Americans when compared with other racial and ethnic groups. Reasons for low uptake are multilayered but include the need for consideration of patients' personal values about the screening decision. The goal of the present study was to (1) identify positive and negative factors specific to lung cancer screening via LDCT and (2) develop statements to capture values about the screening test for use in a new measure of decisional values. Key informant interviews (n = 9) identified several benefits and risks of lung cancer screening that may be important to African American smokers. Based on these interviews, a pool of items with the values statements was administered to a convenience sample of 119 African Americans [aged 55-80years, current or former smokers (who quit

Background: Suicidality remains disproportionately prevalent among sexual minority youth, necessitating novel methods of understanding suicide risk in this population. Victimization and depression ...

Facebook Groups facilitate information exchange and engagement for patients with chronic conditions, including those living with Chronic Obstructive Pulmonary Disease (COPD), however, little is known about how knowledge is diffused throughout these communities. This study aimed to evaluate the content that is available on COPD-related Facebook Groups, as well as the communication (self-disclosures, social support) and engagement (agreement, emotional reaction) strategies used by members to facilitate these resources. Two researchers independently searched the &ldquo, Groups&rdquo, category using the terms &ldquo, COPD&rdquo, &ldquo, emphysema&rdquo, and &ldquo, chronic bronchitis&rdquo, Twenty-six closed (n = 23) and public (n = 3) COPD Facebook Groups were identified with 87,082 total members. The vast majority of Group members belonged to closed (n = 84,684, 97.25%) as compared to open (n = 2398, 2.75%) groups. Medications were the most commonly addressed self-management topic (n = 48, 26.7%). While overall engagement with wall posts was low, the number of &ldquo, likes&rdquo, (an indicator of agreement) was significantly greater for wall posts that demonstrated social support as compared to posts that did not (p &lt, 0.001). Findings from this study showed that COPD Facebook group members share specific disease-related experiences and request information about select self-management topics. This information can be used to improve the quality of self-management support provided to members of popular COPD Facebook groups.

This study compared physiological data from an elite collegiate soccer player to those of his teammates over 2 seasons. The player of special interest (player A) was the winner of the MAC Hermann Trophy and was therefore considered the top player in National Collegiate Athletic Association (NCAA) division I soccer for each of the 2 seasons in which data were collected. Maximal oxygen consumption (V[Combining Dot Above]O2max) was measured during preseasons and heart rate (HR) was recorded during competitive matches. Polar Training Loads (PTL) were calculated using the Polar Team2 Pro (Polar USA) system based on time spent in HR zones. Player A had a lower V[Combining Dot Above]O2max than the team average in 2012 (56 vs. 61.5 ± 4.3 ml·kg-1·min-1) and a similar value in 2013 (54 vs. 56.9 ± 5.1 ml·kg-1·min-1). During matches, player A showed consistent significant differences from the team in percentage of time spent at 70–79% maximal heart rate (HRmax) (12.8 ± 5.5% vs. 10.1 ± 4.0%), 80–89% HRmax (54.3 ± 11.5% vs. 29.3 ± 6.8%), and 90–100% HRmax (23.1 ± 10.6% vs. 45.4 ± 8.5%). This led to a consistently lower PTL per minute accumulated by player A compared with his teammates (3.6 ± 0.4 vs. 4.4 ± 0.3), which may be beneficial over a season and may be related to his success. Thus, the ability to regulate moments of maximal exertion is useful in reducing training load and may be a characteristic of elite players, although whether our findings relate to differences in the playing style, position, or aerobic capacity of player A are unknown.

OBJECTIVE We evaluated the influence of psychosocial factors on HBV screening. METHODS Sample consisted of 1716 Vietnamese participants in our previous HBV intervention trial, recruited from 36 community-based organizations in Pennsylvania, New Jersey, and New York City between 2009 and 2014. Using the Health Belief Model and Social Cognitive Theory, we measured self-efficacy, knowledge, perceived barriers, perceived benefits, perceived severity, and risk susceptibility. Analysis of covariance was used to compare pre- and post-intervention changes of psychosocial variables. Structural equation modeling was used to explore the direct and indirect effects of the psychosocial variables on HBV screening. RESULTS Knowledge, self-efficacy, perceived benefits, and perceived barriers were directly associated with HBV screening; knowledge had the strongest effect. Perceived severity and risk susceptibility had indirect association with HBV screening through other variables. Indirect paths among the 6 psychosocial variables were also identified. CONCLUSION To promote HBV screening among Vietnamese Americans, intervention efforts should focus on increasing knowledge, self-efficacy, and perceived benefits, decreasing perceived barriers, and accounting for the dynamic cognitive processing.

This study explores the associations between teen dating violence (TDV) perpetration, victimization, sexual risk behaviors, and pregnancy among a sample of low-income, urban, and predominately African–American and Latino youth age 15 to 21 years ( N = 513). Findings suggest that youth who experienced TDV victimization were more likely to report inconsistent condom use in the past 12 months ( OR = 1.6) and pregnancy ( OR = 2.2) compared with nonvictimized youth. Youth who reported perpetrating dating violence were more likely to be female ( OR = 3.8) and to report multiple sex partners ( OR = 2.0), inconsistent condom use ( OR = 2.6), and prostitution in the past 12 months ( OR = 6.7). TDV perpetration and victimization were highly associated (χ2 = 127.00, p

Objective. To examine the gender, age, and region of residence in the anthropometric and nutritional profiles of children and adolescents aged 6–18 in Henan Province, China’s third most populous province. Design. This cross-sectional study of the China National Nutrition and Health survey (2010–2013) used a multistage cluster sampling technique. The sample included Chinese schoolchildren and adolescents aged 6 to 18 years (1,660 boys and 1,561 girls). Multiple logistic regression models were used to estimate the associations between sociodemographic correlates and overweight or obesity and stunting. Setting. Nine districts/counties in Henan Province. Participants. 3,221 subjects completed the questionnaire. Sociodemographic information was obtained. Body weight and height were measured. Results. There were statistically significant regional differences in average height and weight for boys in all age groups. Girls followed the same trends except for height when 15–18 years old. The urban-rural residence differences were found in relation to prevalence of stunting and weight status. Subjects in poor rural areas (15.43%) and ordinary rural areas (15.34%) had higher rates of stunting compared to their urban counterparts. Prevalence of overweight or obesity was highest in big city areas (15.71%) and lowest in ordinary rural areas (6.37%). Being a boy (OR = 1.69, 95% CI = 1.314–2.143), living in a big city (OR = 2.10, 95% CI = 1.431–3.073), or in a small-medium city (OR = 2.28, CI = 1.606–3.247), or being in a younger age group was associated with being overweight or obese. In addition, being a boy, living in a big city, or in a small-medium city, or being younger in age meant they were less likely to be stunted. Conclusions. A substantial dual burden of malnutrition among children and adolescents in Henan Province was revealed. The urban-rural differences in nutritional status were found. Stunting was more prevalent in rural areas than in urban. In contrast, while the rising problem of childhood and adolescent obesity still exists in the big city, we also found a great spike in obesity in small-medium cities. Evidence also indicated that boys were more likely to be overweight or obese. Our findings suggest that nutrition education, as well as environmental and policy interventions, is needed to target specific geographic regions.

Background: The co-occurring use of tobacco and marijuana among young adults is an important behavioral phenomenon within the field of substance use. Studying tobacco and marijuana use together among young adults can provide important insight into patterns of initiation and continuation. Objectives: The primary goal of this study was to examine characteristics associated with co-use among young adults and to discover the ways experiences of co-users can help contextualize trends in co-use. Methods: This study employed a sequential explanatory mixed methods design. Quantitative analyses used 12 years of nationally representative National Health and Nutrition Examination Survey (NHANES) data (2005-2016) to assess the characteristics and experiences of young adult (21-30) co-users. Results from analyses of NHANES, prior literature, and theoretical constructs were used to develop a guide for 20 in-depth, semi-structured interviews with young adult co-users living in the state of Maryland. Interviews were analyzed using thematic analysis. Quantitative results and qualitative findings were integrated. The original NHANES analysis occurred during October and November 2017, interviews took place during December 2017 and January 2018, and all mixed methods integration was conducted in 2018. Results: Tobacco and marijuana co-users have unique characteristics and experiences compared to single product users; the experiences of co-users can offer unique insights on co-use. Meta-inferences emerged from integration. Conclusions/importance: Co-users conceptualize tobacco and marijuana differently and hold different risk perceptions for each substance. Co-users may be at risk for polytobacco product use. These findings highlight the profound influence these two substances have on young adult co-users' experiences and behaviors.

Objective Despite advancements in cancer treatment, racial disparities in breast cancer survival persist, with African American women experiencing lower survival rates and poorer quality of life than non-Hispanic White women. Using a social cognitive model of restorative well-being as a framework, this qualitative study sought: (a) to examine strength- and culture-related factors associated with African American female breast cancer survivors' cancer coping and post-treatment experiences and (b) to make recommendations for culturally sensitive intervention. Methods Eight focus groups occurred with a total of 40 local African American breast cancer survivors. Focus groups were audiotaped and transcribed verbatim. Framework analyses were used to identify themes. NVivo qualitative analysis software-managed data. Results Two major themes emerged from the focus group discussions: (a) God enables breast cancer survivorship and works every day in our lives and (b) the healthiest thing about us is that we are strong African American women. Recommendations for intervention planning and implementation were made towards intervention structure, content development and language framing in a local context. Conclusion Findings suggest a need for community-based participatory survivorship interventions that are culturally and spiritually consonant and peer-based. Such interventions may respond to the cancer-related and personal needs of the target population.

Supplemental digital content is available in the text., Background Hospital investments in care coordination services and innovative delivery models represent an important source for improving care efficiency and population health. Objective The aim of this study was to explore variation of hospital-initiated care coordination services and participation in Accountable Care Organizations (ACOs) by community characteristics within an organizational theory framework. Methods Our main data sets included the 2015 American Hospital Association Annual Survey, Survey of Care Systems and Payment, American Community Survey, and Area Health Resource File. Two main outcomes were (a) hospital-reported initiation of care coordination practices (such as chronic disease management, post-hospital discharge continuity of care, and predictive analytics) and (b) participation in ACO models. State fixed-effects models were used to test the association between the adoption of care coordination practices and hospital characteristics, community-level sociodemographic characteristics, and health policies. Results Hospitals with large bed size, located in urban areas, and/or with high volume of operations were more likely to adopt care coordination practices and participate in the ACO models. Hospitals serving communities with high uninsurance rates and/or poverty rates were significantly less likely to provide care coordination practices. More stringent Community Benefit Laws (CBLs) were positively associated with the implementation of care coordination practices suggesting strong normative impacts of CBLs. Conclusion Greater hospital-initiated care coordination practices and innovative ACO models were available in well-resourced areas. Policymakers may consider increasing resources for care coordination practices in rural, underserved, and high-poverty–high-uninsured areas to ensure that vulnerable populations can benefit from these services.

Chronic obstructive pulmonary disease (COPD) is a respiratory disease that often goes undiagnosed, particularly in its early stages.To examine sociodemographic, general health, and COPD specific factors, including severity of lung obstruction, that are associated with healthcare provider-diagnosed COPD among U.S. adults.NHANES cross-sectional data collected from 2007-2012 on adults aged 40-79 years (n=10,219) were analyzed. The primary outcome was self-reported COPD diagnosis with predictive factors analyzed via chi-square and logistic regression analyses.During 2007-2012, 5.2% of US adults aged 40-79 reported being diagnosed with COPD. Among those diagnosed, 50.8% reported fair or poor health, 47.1% were currently smoking cigarettes, 49.1% were taking prescription respiratory medication, 36.4% had moderate or worse lung obstruction, and nearly 90% had one or more respiratory symptoms. Logistic regression revealed positive associations between receiving a COPD diagnosis and the following: being white (AOR: 3.08, 95% CI: 1.82-5.20); being aged 60-79 years (AOR: 1.65, 95% CI: 1.07-2.53); reporting fair/poor health (AOR: 2.91, CI: 1.55-5.46); having 4-9 (AOR: 3.5, CI: 1.3-9.4) or 10 or more healthcare visits in prior year (AOR: 5.06, CI: 1.62-15.77); being a former (AOR: 1.75, CI: 1.2-2.5) or current smoker (AOR: 1.70, CI: 1.17-2.48); having more severe lung obstruction (AOR: 4.90, CI: 3.28-7.32); having 3 or more respiratory symptoms (AOR: 22.07, CI: 12.03-40.49).Multiple factors are associated with self-reported COPD diagnosis with number of reported respiratory symptoms having the strongest association. After controlling for other factors, having mild lung obstruction was not associated with being diagnosed.

Background: Asian Americans have the highest incidence and mortality rates of hepatocellular carcinoma among all U.S. racial/ethnic groups. Inadequate hepatitis B (HBV) monitoring and treatment contribute to poorer outcomes and increased healthcare costs. We conducted a Patient Navigator-led Intervention (PNMI) through a randomized controlled trial to improve monitoring and treatment adherence among Asian Americans with chronic HBV infection. Methods: From 2015 to 2017, we enrolled 532 eligible Asian American adults living with chronic HBV (CHB) in greater Philadelphia area, New Jersey, and New York City. They were non-compliant with HBV follow up care, and randomly assigned to either intervention or control group. Generalized linear mixed-effects models (GLMM) were used to estimate the odds ratio (OR) for the rates of doctor’s visit for CHB and having ALT test. Results: Our findings indicated that intervention group had higher rate of doctors’ visits than that of control group at both 6-month (77.22% v. 45.75%) and 12 months assessments (90.73% v. 60.61%). More intervention group participants received ALT test than control group did at 6-month (52.90% v. 25.10% at 6 months) and 12-month (75.40% v. 46.75%). Results of the GLMM showed that those in the intervention group were more likely than those in the control group to have doctor’s visit and ALT test at 6- and 12-month follow-ups. Conclusions: The findings from this culturally and linguistically appropriate PNMI intervention demonstrated strong effects on adherence to hepatitis B virus (HBV) follow-up care among non-adherent Asian American patients living with chronic HBV infection. These findings suggest opportunities for implementation the evidence-based best practice that could lead to reducing disparities in chronic liver disease and liver cancer among high-risk, underserved populations. Citation Format: Grace X. Ma, Lin Zhu, Shumenghui Zhai, Yin Tan, Xiaoli Ma, Olorunseun O. Ogunwobi, Michelle Naidoo, Tsunyou Ting, Min Qi Wang. Improving monitoring and treatment adherence among underserved Asian Americans with chronic hepatitis B through a patient navigator-led intervention [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PR02.

Objective The study was conducted to evaluate the stability of commercial coated lipase (CT-LIP) in vitro. Methods The capsules were tested under different conditions with a range of temperature, pH, dry heat treatment and steaming treatment, simulated gastric fluid (SGF) and simulated intestinal fluid (SIF) in this work, respectively. Free lipase (uncoated lipase, UC-LIP) was the control group. Lipase relative activities measured in various treatments were used as a reference frame to characterize the stability. Results The lipase activities were decreased with increasing temperatures (p

More than half of persons living with HIV (PLWH) do not enter into or remain in continuous HIV medical care. Disclosure of HIV serostatus to social contacts may play an important role in successful engagement of PLWH with medical care. The effect of disclosure on medical care engagement was examined in a sample of African American PLWH (n = 262) recruited from community-based organizations as part of a peer community health worker initiative. At baseline assessment, many of the PLWH (46 %) reported they had not disclosed their serostatus to others. Engagement in medical care was assessed 45 and 90 days after enrollment. Participants who disclosed their HIV status were subsequently more likely to engage in HIV medical care (78 %) than persons who did not disclose their status (66 %), an effect that was confirmed in multiple logistic regression. The findings highlight disclosure as an important predictor of engagement in HIV medical care for PLWH.

The present study examined the relationship between religious capital and depressive symptoms and the moderating role of the Big Five personality constructs in a national sample of African American adults. Data were collected from a national probability sample of 803 African American men and women using a telephone survey including measures of the Big Five personality traits, religious capital, and depressive symptomology. Most interestingly, there was evidence for Personality × Religious Capital interactions on depressive symptomology. Higher religious capital was related to lower depressive symptomology among persons with low conscientiousness or low openness to experience. However, religious capital was less related to depressive symptoms among those with high conscientiousness or high openness. This study reinforces the importance of examining the moderating effects of personality and perceived religious capital in understanding mental health outcomes. This information can be of use to practitioners in designing culturally appropriate interventions, including the use of capital from faith-based organizations.

Background: HPV vaccination is recommended for female and male adolescents in the U.S. to prevent HPV-related cancer, yet the uptake remains suboptimal nationwide. Compared with other racial/ethnic groups, Asian American adolescents have the lowest HPV vaccination rates. Successful HPV vaccine depends heavily on parents' attitudes, perceptions, and willingness to have their adolescents vaccinated. Objective: This pilot study aimed to examine the intervention effect on the primary outcome of a provider-based, culturally tailored, multilevel intervention to promote HPV vaccination. Method: A total of 180 parents (110 for intervention group and 70 for control group) with 290 adolescents aged 11 to 18 (170 for intervention group, 120 for control group) were recruited from primary care community health centers in Philadelphia and NYC from 2015 to 2017. Specifically, we compared the uptake of first shot of HPV vaccination at the 6-month post-intervention assessment and completion rate of three shots. Results: The uptake of at least 1 shot of HPV vaccine was significantly higher among the intervention group (76.36%) than the control (10.00%). The difference between intervention and control group remained statistically significant (odds ratio = .38.47, 95% 13.99 - 105.80) even when we controlled for demographics and health-related covariates, lending support to the significant and strong effects of our intervention on vaccination uptake. Conclusion: Our finding indicates that provider-based, culturally tailored, multilevel intervention showed promising effect of HPV vaccination uptake among Asian American adolescents. Greater effort and measures are needed for broader implementation of such intervention. Future research is also necessary to explore the application to ethnic minority populations to prevent cancer and reduce health disparities. Acknowledgement: This project was supported by National Outreach Network (NON) - Community Health Educator (CHE) supplement grant funded by Center for Reduce Cancer Health Disparities (CRCHD)-National Cancer Institute (NCI) (Grant Number: U54CA153513; PI: Grace X. Ma, PhD). The authors wish to thank clinical collaborator Chinatown Medical Services (CMS) and their staff for their support and collaboration. Citation Format: Grace X. Ma, Shumenghui Zhai, Lin Zhu, Philip Siu, Yin Tan, Sarah Lai, Ivette Astudillo, Safa S. Ibrahim, Ming-Chin Yeh, Min Qi Wang. Promising effects of a culturally tailored multilevel pilot intervention to increase HPV vaccination uptake among Asian American female and male adolescents [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A029.

ObjectivesThe overall purposes of this first US national pilot study were to (1) test the feasibility of online administration of the Bioethical Issues in Biostatistical Consulting (BIBC) Questionnaire to a random sample of American Statistical Association (ASA) members; (2) determine the prevalence and relative severity of a broad array of bioethical violations requests that are presented to biostatisticians by investigators seeking biostatistical consultations; and (3) establish the sample size needed for a full-size phase II study.DesignA descriptive survey as approved and endorsed by the ASA.ParticipantsAdministered to a randomly drawn sample of 112 professional biostatisticians who were ASA members.Primary and secondary outcome measuresThe 18 bioethical violations were first ranked by perceived severity scores, then categorised into three perceived severity subcategories in order to identify seven ‘top tier concern violations’ and seven ‘second tier concern violations’.ResultsMethodologically, this phase I pilot study demonstrated that the BIBC Questionnaire, as administered online to a random sample of ASA members, served to identify bioethical violations that occurred during biostatistical consultations, and provided data needed to establish the sample size needed for a full-scale phase II study. The No. 1 top tier concern was ‘remove or alter some data records in order to better support the research hypothesis’. The No. 2 top tier concern was ‘interpret the statistical findings based on expectation, not based on actual results’. In total, 14 of the 18 BIBC Questionnaire items, as judged by a combination of ‘severity of violation’ and ‘frequency of occurrence over past 5 years’, were rated by biostatisticians as ‘top tier’ or ‘second tier’ bioethical concerns.ConclusionThis pilot study gives clear evidence that researchers make requests of their biostatistical consultants that are not only rated as severe violations, but further that these requests occur quite frequently.

BACKGROUND: Faith-based organizations (FBOs) are important venues for health promotion, particularly in medically underserved communities. These organizations vary considerably in their structural capacities, which may be linked to variability in implementation success for health promotion initiatives. Lacking an existing validated assessment of organizational capacity specific to FBOs, an initial prototype assessment was developed. METHODS: The FBO-CI (Faith-Based Organization Capacity Inventory) assesses three structural areas of capacity: Staffing and Space, Health Promotion Experience, and External Collaboration. The multidisciplinary team, including FBO leaders, co-developed the initial instrument. The initial reliability from a convenience sample of 34 African American churches including descriptions of FBOs representing three capacity levels is reported. RESULTS: The FBO-CI demonstrated feasibility of administration using an in-person interview format, and the three subscales had acceptable internal reliability (α ~.70). Most churches had an established health ministry (n = 23) and had conducted activities across an average of seven health areas in the previous two years. CONCLUSIONS: This initial FBO-CI prototype is promising, and future work should consider validation with a larger sample of churches and domain expansion based on the conceptual model. The FBO-CI has a number of potential uses for researchers, FBO leaders, and practitioners working with FBOs in health promotion initiatives.

Seven out of every 10 deaths in the United States can be attributed to chronic disease,1 with an estimated 75% of U.S. health care dollars spent on treating chronic conditions.2 Worldwide, chronic ...

Health promotion interventions in African American communities are frequently delivered in church settings. The Men's Prostate Awareness Church Training (M-PACT) intervention aimed to increase informed decision making for prostate cancer screening among African American men through their churches. Given the significant proportion and role of women in African American churches, the M-PACT study examined whether including women in the intervention approach would have an effect on study outcomes compared with a men-only approach. The current analysis discusses the men's participation rates in the M-PACT intervention, which consisted of a series of 4 bimonthly men's health workshops in 18 African American churches. Data suggest that once enrolled, retention rates for men ranged from 62 to 69 % over the workshop series. Among the men who were encouraged to invite women in their lives (e.g., wife/partner, sister, daughter, friend) to the workshops with them, less than half did so (46 %), suggesting under-implementation of this "health partner" approach. Finally, men's participation in the mixed-sex workshops were half the rate as compared to the men-only workshops. We describe recruitment techniques, lessons learned, and possible reasons for the observed study group differences in participation, in order to inform future interventions to reach men of color with health information.

Introduction This study investigated the relationship between four suspected risk factors—affective dysregulation, conduct problems, depressive symptoms, and psychological distress—and incident nonmedical prescription analgesic (NPA) use among college students. Methods The sample was derived from 929 college students from a large, mid-Atlantic university who completed the third annual College Life Study assessment (Y 3 ) and were NPA use naive at baseline (Y 1 ). A series of logistic regression analyses were conducted to evaluate the predictors of incident NPA use by Y 3 . Separate models were developed to evaluate the association between the suspected risk factors and (a) NPA use relative to non-use of other drugs, including nonmedical use of other drug classes, (b) NPA use relative to other drug use, and (c) other drug use relative to non-use. All models included gender, parental education level, and race/ethnicity. Results Affective dysregulation was significantly associated with becoming an incident NPA user relative to both drug users without NPA use as well as non-users, after statistically controlling for demographic characteristics and other factors. Conduct problems in early childhood were positively related to both incident NPA use and other drug use without NPA use relative to non-users, after statistically controlling for demographic characteristics and other factors. Depressive symptoms were associated with NPA incidence at the bivariate level only. Conclusions These findings extend previous research suggesting that NPA use might be related to deficits in regulating negative emotional states, and highlight possible markers for screening and intervention to prevent NPA use.

Background Use of technology is increasing in health promotion and has continued growth potential in intervention research. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this paper reports on the adoption, reach, and implementation of Project HEAL (Health through Early Awareness and Learning)—a community-based implementation trial of a cancer educational intervention in 14 African American churches. We compare adoption, reach, and implementation at the organizational and participant level for churches in which lay peer community health advisors (CHAs) were trained using traditional classroom didactic methods compared with a new online system. Methods Fifteen churches were randomized to one of two study groups in which two CHAs per church were trained through either classroom (“Traditional”; n = 16 CHAs in 8 churches) or web-based (“Technology”; n = 14 CHAs in 7 churches) training methods. Once trained and certified, all CHAs conducted a series of three group educational workshops in their churches on cancer early detection (breast, prostate, and colorectal). Adoption, reach, and implementation were assessed using multiple data sources including church-level data, participant engagement in the workshops, and study staff observations of CHA performance. Results The project had a 41% overall adoption rate at the church level. In terms of reach, a total of 375 participants enrolled in Project HEAL—226 participants in the Traditional group (43% reach) and 149 in the Technology group (21% reach; p .05). Conclusions Overall, the Project HEAL intervention had reasonable adoption, though reach could have been better. Implementation was strong across both study groups, suggesting the promise of using web-based methods to disseminate and implement evidence-based interventions in faith-based settings and other areas where community health educators work to eliminate health disparities.

OBJECTIVE We examined modifiable facilitation strategies (exposures) during high school that are associated with motiva- tion for minority youth pursuit of health science. METHODS A sample (N = 116) of minority (73% African-American/Black, 21% Hispanic/Latino) 12th graders from 6 high schools in a lower socioeconomic area bordering Washington, DC completed a self-administered survey. Path modeling was used to examine whether: (1) exposures: high school science courses, extra-curricular science activities, personal health experiences, and adult encouragement predict Theory of Planned Behavior (TPB) constructs including attitude, subjective norm, and perceived behavioral control, and (2) TPB constructs predict the outcome of intent to pursue college health science. RESULTS The path model indicated that adult encouragement was associated with attitude (p < .01), subjective norm (p < .01), and perceived behavioral control (p < .01); and personal health experiences were associated with attitude (p < .01). Attitude and subjective norm were associated with intent (p < .01). CONCLUSION Motivating minority high schoolers from low socioeconomic areas through adult encouragement and personal health experiences to value health scientists and to perceive that others support their pursuit of health science may be pathways for facilitating their intention to pursue college health science.

Researchers have expressed growing interest in factors that may explain the relationship between religious involvement and health-related outcomes. Faith-based organizations are a significant institution in African American communities, both serving religious/spiritual needs and providing an important source of social capital. These communities often suffer a disproportionate burden of health conditions as well. The present study examined the role of social capital (social support, interconnectedness, and community participation) in the relationship between religious involvement (beliefs and behaviours) and physical and emotional functioning and depressive symptoms, among a national probability sample of African Americans (N=803). Participants completed telephone interviews. We used structural equation modelling to test hypotheses based on the theoretical model. Results indicate that interconnectedness played a modest mediational role in the relationship between religious behaviours/participation and depressive symptoms. Interconnectedness was predictive of fewer depressive symptoms and marginally with better emotional functioning. Findings highlight the importance of trust in and commitment to one’s community for health and have implications for community-based health promotion initiatives. Copyright © 2014 John Wiley & Sons, Ltd.

Health care providers' use of recommended communication techniques can increase patients' adherence to prevention and treatment regimens and improve patient health outcomes. The authors conducted a survey of Maryland dentists to determine the number and type of communication techniques they use on a routine basis.The authors mailed a 30-item questionnaire to a random sample of 1,393 general practice dentists and all 169 members of the Maryland chapter of the American Academy of Pediatric Dentistry. The overall response rate was 38.4 percent. Analysis included descriptive statistics, analysis of variance and ordinary least squares regression analysis to examine the association of dentists' characteristics with the number of communication techniques used. They set the significance level at P.05.General dentists reported routinely using a mean of 7.9 of the 18 communication techniques and 3.6 of the seven basic techniques, whereas pediatric dentists reported using a mean of 8.4 and 3.8 of those techniques, respectively. General dentists who had taken a communication course outside of dental school were more likely than those who had not to use the 18 techniques (P.01) but not the seven basic techniques (P.05). Pediatric dentists who had taken a communication course outside of dental school were more likely than those who had not to use the 18 techniques (P.05) and the seven basic techniques (P.01).The number of communication techniques that dentists used routinely varied across the 18 techniques and was low for most techniques. Practical Implications. Professional education is needed both in dental school curricula and continuing education courses to increase use of recommended communication techniques. Specifically, dentists and their team members should consider taking communication skills courses and conducting an overall evaluation of their practices for user friendliness.

Inappropriate analysis and reporting of biomedical research remain a problem despite advances in statistical methods and efforts to educate researchers.To determine the frequency and severity of requests biostatisticians receive from researchers for inappropriate analysis and reporting of data during statistical consultations.Online survey.United States.A randomly drawn sample of 522 American Statistical Association members self-identifying as consulting biostatisticians.The Bioethical Issues in Biostatistical Consulting Questionnaire soliciting reports about the frequency and perceived severity of specific requests for inappropriate analysis and reporting.Of 522 consulting biostatisticians contacted, 390 provided sufficient responses: a completion rate of 74.7%. The 4 most frequently reported inappropriate requests rated as "most severe" by at least 20% of the respondents were, in order of frequency, removing or altering some data records to better support the research hypothesis; interpreting the statistical findings on the basis of expectation, not actual results; not reporting the presence of key missing data that might bias the results; and ignoring violations of assumptions that would change results from positive to negative. These requests were reported most often by younger biostatisticians.The survey provides information on the reported frequency of inappropriate requests but not on how such requests were handled or whether the requests reflected researchers' maleficence or inadequate knowledge about statistical and research methods. In addition, other inappropriate requests may have been made that were not prespecified in the survey.This survey suggests that researchers frequently make inappropriate requests of their biostatistical consultants regarding the analysis and reporting of their data. Understanding the reasons for these requests and how they are handled requires further study.U.S. Department of Health and Human Services.

Researchers propose social support as one of the factors that may explain the positive relationship often observed between religious involvement and health outcomes. African-Americans are a population that tends to have higher than average levels of religious involvement and are also disproportionately impacted by most health conditions. The present study sought to determine whether social support mediates the role of religious involvement in physical and emotional functioning and depressive symptoms, among a national probability sample of African-Americans (N = 803). Study participants completed telephone interviews. We used structural equation modelling to test hypotheses based on the theoretical model. Findings suggest evidence for a mediating role of belonging and tangible support in the association between religious behaviours and physical functioning as well as depression. There was no mediational role played by appraisal support, or for emotional functioning. Implications for faith-based health pro...

This article describes the development of a spiritually based intervention to increase informed decision making for prostate cancer screening through African American churches. The intervention used spiritually themed health messages, incorporated women as supportive health partners, and included a health information technology component. The Men's Prostate Awareness Church Training Project followed a community-based participatory research process to develop educational materials, and training for 40 community health advisors to implement the 4-part prostate health workshop series that will be implemented in 20 churches. Implications are discussed for designing culturally relevant interventions to reduce prostate cancer disparities impacting African American men.

The study was designed to evaluate the effects of probiotics (Bacillus subtilis) to enhance immunity, antioxidation, digestive enzymes activity and hematological profile of Shaoxing duck. A population of 200 laying ducks (160 days old) was divided into two groups each further divided in five replications. The control (G1) were fed on basal diet and (G2) with B. subtilis 1×108 cfu/kg in addition of basal diet for thirty five days. The results showed that, ducks were treated with probiotics (B. subtilis), their serum IL-2 increased and IL-10 decreased (P

Communication practices of dental care providers are especially important to provider-patient and provider-caregiver communication because most patients report that they obtain oral health information from their dentist. The purpose of this study was to determine the perceptions of English-speaking Maryland adults who had a child 6 years and younger in the home about the communication practices of their dentists and staff. Five questions from the Consumer Assessment of Healthcare Providers and Systems survey were included in a random digit dial telephone survey administered in March and April 2010. A total of 803 surveys were completed with adults 18-65 years of age who had a child in their home 6 years of age and younger. Land and cell phones were used. The analysis included frequencies, percentages, chi-square tests, and multivariate logistic regression. The response rate was 24%. Overall, those with higher levels of education and women were more likely to respond favorably about the communication practices of their dentist and staff. Respondents whose child was insured with Medicaid/State Children's Health Insurance Program (SCHIP) were less likely to respond favorably. Medicaid/SCHIP recipients are the individuals with the greatest dental disease and in need of preventive information and regimens for themselves and for their children. Spending time with patients and providing them with accurate information in a manner that patients feel respected and listened to contributes to the patient's ability to understand and act upon this information. Thus, these communication practices are pivotal to increasing oral health literacy and decreasing dental disparities.

This study provides 10-year trend data on the psychosocial correlates of physical dating violence victimization (PDV) among male participants ( N = 7,949 in 2009) in the national Youth Risk Behavior Surveys from 1999–2009. Unadjusted odds ratios (OR) and 95% confidence intervals (CI) were examined followed by multivariate logistic regression analyses, which included all significant independent variables from the univariate analyses. Adjusted OR and 95% CI assessed the significance of the relationships. PDV was significantly and consistently associated with feelings of sadness or hopelessness, repeated engagement in physical fighting, current and multiple sex partners, and lack of condom use. A less consistent but noteworthy pattern was found for PDV and gun carrying and cocaine use among adolescent males. PDV is an important public health issue for adolescent males, not just females. There appears to be a set of stable correlates of dating violence victimization among high school males in the United States.

African American faith communities are an important source of social capital. The present study adapted a theory-based social capital instrument to result in religious (e.g., from organized worship) and spiritual (e.g., from relationship with higher power) capital measures. Data from a national sample of 803 African Americans suggest the instruments have high internal reliability and are distinct from general religiosity. Measurement models confirmed factor structures. Religious capital was positively associated with self-rated health status. Religious and spiritual capital were negatively associated with depressive symptoms, but these associations largely became nonsignificant in multivariate models that controlled for demographic characteristics. An exception is for spiritual capital in the form of community participation, which retained a negative association with depressive symptoms. These instruments may have applied value for health promotion research and practice in African American communities.

OBJECTIVE: To examine the relationship of driver dispositions with traffic safety behaviors and beliefs. METHODS: A random digit-dial telephone survey was conducted of 796 licensed drivers. RESULTS: Binary and multivariate logistic regression analyses compared hurried and nonhurried drivers and found that hurried drivers were more likely to admit to a variety of risky behaviors. They were also less likely to believe they would be ticketed for speeding and to report wearing their seat belt than were nonhurried drivers. CONCLUSIONS: More research is needed into identifying the underlying motivational factors of hurried drivers and what countermeasures will be most effective for them. Language: en

This research examines the interaction effect of message framing (gain vs. loss) and perceived susceptibility (i.e., perceived likelihood that one’s child is at risk of contracting HPV) on African American parents’ intentions to vaccinate their children against HPV. Results of an experiment (N = 193), in which parents were exposed to either a gain-framed or loss-framed message about HPV vaccination, revealed a significant interaction between message framing and perceived susceptibility when parents were required to pay for the vaccine. The specific pattern of interaction suggested that parents who perceived their children to be at high risk of contracting HPV were more persuaded by the gain-framed message, whereas those who believed their children to be at low risk of contracting HPV were more persuaded by the loss-framed message. Implications of the findings for HPV vaccination messaging are discussed.

Spiritual and religious capital are forms of the broader construct of social capital. The present study, using probability-based sampling methods, surveyed a national sample of African American adults to examine the relative contributions of spiritual and religious capital to their physical and emotional functioning. Analyses were conducted to determine if these constructs made a unique contribution above and beyond general social capital. African American men and women (N = 803) were interviewed by telephone. Hierarchical linear regressions revealed that, across the full sample, although social capital was a positive predictor of physical and emotional functioning (p

The study was conducted to evaluate the effects of probiotic supplementation (Bacillus subtilis) in diet on performance, blood properties and microflora of Shaoxing duck. A population of 200 laying ducks (160 days old) was divided into two groups each having five replications. The control (T0) were fed on basal diet while T1 with Bacillus subtilis 1 x 10 CFU/kg in addition to basal diet for thirty five days. The results 8 showed that for T1 group, the egg laying rate increased (3.79%) significantly, while a decrease of about 12.60%, 23.52% and 40.14% was observed in egg triglyceride, total cholesterol and malondialdehyde, respectively. However, the blood glucose content and alkaline phosphatase activity increased by 15.13% and 53.41%, significantly. Moreover, there was a decrease of blood cholesterol, uric acid and ammonia in T1 by 28.86%, 22.39% and 62.5%, respectively. As compared to T0, T1 showed a significant increased in the amount of caecal microflora, i.e. general aerobic bacteria (18.68%) and Lactobacillus (9.92%). In conclusion, supplementation of Bacillus subtilis in diets had significant effects on some aspects of egg composition, biochemical properties of blood and few microflora of Shaoxing ducks.

This report explores the level of detailed knowledge about the Tuskegee Syphilis Study (TSS) among 848 Blacks and Whites in three U.S. cities across an array of demographic variables. The Tuskegee Legacy Project (TLP) Questionnaire was used, which was designed to explore the willingness of minorities to participate in biomedical studies. A component of the TLP Questionnaire, the TSS Facts & Myths Quiz, consisting of seven yes/no factual questions, was used to establish respondents’ level of detailed knowledge on the TSS. Both Blacks and Whites had similar very low mean quiz score on the 7-point scale, with Blacks’ scores being slightly higher than Whites (1.2 vs. 0.9, p = .003). When analyzing the level of knowledge between racial groups by various demographic variables, several patterns emerged: (a) higher education levels were associated with higher levels of detailed knowledge and (b) for both Blacks and Whites, 30 to 59 years old knew the most about TSS compared with younger and older adult age groups. The findings show that much of the information that circulates in the Black and White communities about the TSS is false, often minimizing or understating the most egregious injustices that occurred. Health promotion and educational implications of these findings are offered and conclude that the findings should be used as a catalyst to explore local realities and sentiments regarding participation in biomedical research within the research philosophy and framework of community-based participatory research.

Purpose: The purpose of this study was to determine whether a belief in the AIDS origin conspiracy theory is related to likelihood or fear of participation in research studies. Methods: The Tuskegee Legacy Project Questionnaire was administered via random-digit-dialed telephone interview to black, white, and Hispanic participants in 4 cities in 1999 and 2000 (n = 1,133) and in 3 cities in 2003 (n = 1,162). Results: In 1999, 27.8% of blacks, 23.6% of Hispanics, and 8% of whites (P ≤ .001) reported that it was “very or somewhat likely” that AIDS is “the result of a government plan to intentionally kill a certain group of people by genocide.” In 2003, 34.1% of blacks, 21.9% of Hispanics, and 8.4% of whites (P ≤ .001) reported the same. Conclusions: Whereas blacks and Hispanics were more than 3 times more likely than whites to believe in this AIDS origin conspiracy theory, holding this belief was not associated with a decreased likelihood of participation in, or increased fear of participation in, bio...

Objective Informatics applications have the potential to improve participation in clinical trials, but their design must be based on user-centered research. This research used a fully counterbalanced experimental design to investigate the effect of changes made to the original version of a website, [http://BreastCancerTrials.org/][1], and confirm that the revised version addressed and reinforced patients' needs and expectations. Design Participants included women who had received a breast cancer diagnosis within the last 5 years (N=77). They were randomized into two groups: one group used and reviewed the original version first followed by the redesigned version, and the other group used and reviewed them in reverse order. Measurements The study used both quantitative and qualitative measures. During use, participants' click paths and general reactions were observed. After use, participants were asked to answer survey items and open-ended questions to indicate their reactions and which version they preferred and met their needs and expectations better. Results Overall, the revised version of the site was preferred and perceived to be clearer, easier to navigate, more trustworthy and credible, and more private and safe overall. However, users who viewed the original version last had similar attitudes toward both versions. Conclusion By applying research findings to the redesign of a website for clinical trial searching, it was possible to re-engineer the interface to better support patients' decisions to participate in clinical trials. The mechanisms of action in this case appeared to revolve around creating an environment that supported a sense of personal control and decisional autonomy. [1]: http://breastcancertrials.org/