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Lower colorectal cancer screening rates among African Americans contribute to higher colorectal cancer incidence and mortality. We tested the effects of a racially-targeted messaging intervention that used favorable behavioral norm information to increase uptake of at-home Fecal Immunochemical Test (FIT) Kits. We expected stronger intervention effects among African Americans with stronger racial identity. Eligible African Americans were randomized to one of four intervention conditions: injunctive norm message, descriptive norm message, both messages, neither message. The norm-based messages were delivered via an animated video health message. Background variables, constructs defined by the theory of planned behavior, racial identity, screening modality preferences, and uptake and return of FIT Kits were assessed. Of 205 participants, 111(54%) requested FIT Kits. Contrary to hypotheses, multigroup path analyses indicated stronger effects of targeted messages among African Americans with weaker racial identity. Findings highlight the importance of within-race heterogeneity in the receptivity to racially-targeted health messages., Author(s): Mark Manning [sup.1] [sup.2] [sup.4] , Todd Lucas [sup.2] [sup.3] , Hayley Thompson [sup.1] [sup.2] , Louis Penner [sup.1] [sup.2] Author Affiliations: (1) grid.254444.7, 0000 0001 1456 7807, Department [...]

OBJECTIVE The extent of shared decision making (SDM) use in the care of Black patients is limited. We explored preferences, needs, and challenges of Black patients to enhance SDM offerings. METHODS We performed interviews with 32 Black patients receiving type 2 diabetes care in safety-net primary care practices caring predominantly for Black people. RESULTS The following 4 themes emerged: preference for humanistic communication, need to account for the role of family in decision making, need for medical information sharing, and mistrust of clinicians. CONCLUSION Given the dearth of research on SDM among ethnic and racial minorities, this study offers patient-perspective recommendations to improve SDM offerings for Black patients in primary care settings. To enhance SDM with Black patients, acknowledgment of the importance of storytelling as a strategy, to place medical information in a context that makes it meaningful and memorable, is recommended. Triadic SDM, in which family members are centrally involved in decision making, is preferred over classical dyadic SDM. There is a need to reconsider the universalism assumption underlying contemporary SDM models and the relevancy of current SDM practices that were developed mostly without the feedback of participants of ethnic, racial, and cultural minorities. Key words: shared decision making; health disparities; Black/African Americans; type 2 diabetes https://doi.org/10.1370/afm.2943 Annals 'Online First' article, INTRODUCTION Type 2 diabetes (T2D) is especially prevalent among racial and ethnic minorities. (1-3) Black and Hispanic Americans are at increased risk of T2D compared with non-Hispanic White Americans, (4) [...]

Purpose Acute respiratory distress syndrome (ARDS) is accompanied by a dysfunctional immune-inflammatory response following lung injury, including during coronavirus disease 2019 (COVID-19). Limited causal biomarkers exist for ARDS development. We sought to identify novel genetic susceptibility targets for ARDS to focus further investigation on their biological mechanism and therapeutic potential. Methods Meta-analyses of ARDS genome-wide association studies were performed with 1250 cases and 1583 controls in Europeans, and 387 cases and 387 controls in African Americans. The functionality of novel loci was determined in silico using multiple omics approaches. The causality of 114 factors potentially involved in ARDS development was assessed using Mendelian Randomization analysis. Results There was distinct genetic heterogeneity in ARDS between Europeans and African Americans. rs7967111 at 12p13.2 was functionally associated with ARDS susceptibility in Europeans (odds ratio = 1.38; P = 2.15 x 10.sup.-8). Expression of two genes annotated at this locus, BORCS5 and DUSP16, was dynamic but ultimately decreased during ARDS development, as well as downregulated in immune cells alongside COVID-19 severity. Causal inference implied that comorbidity of inflammatory bowel disease and elevated levels of C-reactive protein and interleukin-10 causally increased ARDS risk, while vitamin D supplementation and vasodilator use ameliorated risk. Conclusion Our findings suggest a novel susceptibility locus in ARDS pathophysiology that implicates BORCS5 and DUSP16 as potentially acting in immune-inflammatory processes. This locus warrants further investigation to inform the development of therapeutic targets and clinical care strategies for ARDS, including those induced by COVID-19., Author(s): Mulong Du [sup.1] [sup.2], Joe G. N. Garcia [sup.3], Jason D. Christie [sup.4], Junyi Xin [sup.5], Guoshuai Cai [sup.6], Nuala J. Meyer [sup.4], Zhaozhong Zhu [sup.1], Qianyu Yuan [sup.1], [...]

Examine the effectiveness of a holistic stress management program in a community-based setting. Post-session evaluations utilized to examine participant health knowledge and behaviors attained as a result of programming. Following items were examined: (1) participant perception of program delivery and (2) new health knowledge/skills gained. Post-session evaluations showed substantial knowledge/skill attainment in the following areas: (1) types of stress, (2) mindfulness, (3) stress and nutrition, (4) creative expression, and (5) holistic health and (6) relationship management. Program outcomes show relax and restore to be an effective community-based model in delivering holistic health stress management education., Author(s): Renee Mahaffey Harris [sup.1] , Akhil Kesaraju [sup.2] , Joshua Jay Jordan [sup.3] , Rhyanne McDade [sup.1] , Jenise Brassell [sup.4] Author Affiliations: (1) Center for Closing the Health [...]

The public Vocational Rehabilitation (VR) program provides key services and supports to individuals with disabilities seeking to improve their employment, careers, and economic mobility However, engagement in the VR program is not consistent across all populations, with a focus on those residing in historically underserved and marginalized low-income communities of color. The purpose of this study was to better understand the needs of current and former Black American VR consumers residing in a large urban area to inform current and future policy and practice needs within the state agency. While data was collected just prior to the COVID-19 pandemic, the views shared by participants regarding the stress and trauma of experiencing a chronic lack of resource and recommendations for improvements within the public VR program are perhaps even more relevant considering the disproportionate impact of the pandemic on this and similar communities. Recommendations for training and future research to enhance engagement, understanding, and better serve this population through the public VR program are offered. Keywords: poverty, race, disability, vocational rehabilitation, Research suggests that individuals with disabilities experiencing poverty can successfully achieve positive employment outcomes through the public VR system when provided with the necessary services and supports (Hartman et al., [...]