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1. 'Cigarettes play the equalizer': discrimination experiences and readiness to quit cigarette smoking among African Americans experiencing homelessness: a qualitative analysis

Author

Alexandria Jones-Patten, Sanghyuk S. Shin, Adeline Nyamathi, and Dawn Bounds

Subjects
African Americans, Homelessness, Cigarette smoking, Discrimination, Medicine (General), R5-920, Social pathology. Social and public welfare. Criminology, HV1-9960
Abstract

Abstract Background Approximately 70–80% of people experiencing homelessness in the United States use tobacco. Smoking cessation programs specifically for this population have been found to be less effective for African American participants. The purpose of this study was to explore discrimination experiences and their impact on smoking habits and readiness to quit cigarette smoking while experiencing homelessness. Methods In the qualitative phase of this mixed methods study, five focus groups were conducted for African Americans residing in a homeless shelter in Skid Row, Los Angeles, CA. Using a semi-structured interview guide, we asked participants about discrimination experiences, how smoking habits were impacted by these experiences, and tools needed to successfully abstain from cigarette smoking. Qualitative descriptive content analysis was used to explore discrimination experiences and its association with readiness to quit cigarette smoking. Results Of the 17 participants, 14 (82.4%) were male, and the average age was 46.8 years. Using a qualitative In Vivo coding method, three themes were revealed: “Experiencing Discrimination while Black”, “The Psychosocial Fabric—Why Quitting Cigarette Smoking is a Challenge”, and “The Lesser of Two Evils—Choosing to Smoke over More Harmful Options.” Participants discussed working in the blue-collar workforce while Black, identifying as a double minority, smoking to cope with stress, early exposure to cigarettes, smoking being a central part of one’s belonging to a group, and the legality of cigarette smoking. Discussion Our findings show that African Americans experiencing homelessness (1) may experience discrimination in multiple settings, regardless of housing status, (2) could have grown up around cigarette smoking and remain surrounded by it while experiencing homelessness, and (3) may experience a calming effect with smoking, which slows some from reacting negatively to adverse situations. Conclusion Barriers to successfully abstaining from smoking are multifactorial among African Americans experiencing homelessness and should be addressed individually. Future research should explore the cultural tailoring of interventions that support cessation efforts unique to minoritized populations to improve smoking cessation programs offered to this population.

Published
2024
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2. The race-based stress reduction intervention (RiSE) study on African American women in NYC and Chicago: Design and methods for complex genomic analysis.

Author

Jacquelyn Y Taylor, Alexandria Jones-Patten, Laura Prescott, Stephanie Potts-Thompson, Cara Joyce, Bamidele Tayo, and Karen Saban

Subjects
Medicine, Science
Abstract

RiSE study aims to evaluate a race-based stress-reduction intervention as an effective strategy to improve coping and decrease stress-related symptoms, inflammatory burden, and modify DNA methylation of stress response-related genes in older AA women. This article will describe genomic analytic methods to be utilized in this longitudinal, randomized clinical trial of older adult AA women in Chicago and NYC that examines the effect of the RiSE intervention on DNAm pre- and post-intervention, and its overall influence on inflammatory burden. Salivary DNAm will be measured at baseline and 6 months following the intervention, using the Oragene-DNA kit. Measures of perceived stress, depressive symptoms, fatigue, sleep, inflammatory burden, and coping strategies will be assessed at 4 time points including at baseline, 4 weeks, 8 weeks, and 6 months. Genomic data analysis will include the use of pre-processed and quality-controlled methylation data expressed as beta (β) values. Association analyses will be performed to detect differentially methylated sites on the targeted candidate genes between the intervention and non-intervention groups using the Δβ (changes in methylation) with adjustment for age, health behaviors, early life adversity, hybridization batch, and top principal components of the probes as covariates. To account for multiple testing, we will use FDR adjustment with a corrected p-value of

Published
2024
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4. Correlates of SARS‐CoV‐2 anti‐RBD IgG antibody titers among persons experiencing homelessness in Los Angeles

Author

Adeline Nyamathi, Sanghyuk S. Shin, Brianna M. Doratt, Alexandria Jones‐Patten, Benissa Salem, Lillian Gelberg, Darlene Lee, Dana Garfin, Kartik Yadav, Alicia H. Chang, Kathryn White, Nicholas Arce, and Ilhem Messaoudi

Subjects
substance use, Nursing, Article, Antibodies, Vaccine Related, COVID-19 Testing, Clinical Research, Humans, Viral, Pandemics, General Nursing, SARS-CoV-2, Prevention, Public Health, Environmental and Occupational Health, Multimorbidity, COVID-19, Los Angeles, SARS-CoV-2 antibody seroprevalence, Brain Disorders, Cross-Sectional Studies, Infectious Diseases, Emerging Infectious Diseases, Mental Health, Good Health and Well Being, Immunoglobulin G, Case-Control Studies, Ill-Housed Persons, people experiencing homelessness, Public Health and Health Services, Immunization, Infection
Abstract

OBJECTIVES: People experiencing homelessness (PEH) have been especially impacted by the COVID-19 pandemic, likely due to increased vulnerabilities stemming from chronic diseases, substance use, and mental health conditions. DESIGN: A case-control study to assess the presence of antibodies against SARS-CoV-2 among PEH and associations with key variables. SAMPLE: A convenience sample of 97 PEH in Skid Row, Los Angeles. MEASUREMENTS: A structured questionnaire assessing socio-demographic, mental health, drug and alcohol use, health care access, pandemic stress, and other COVID-19-specific questions. RESULTS: We found high anti-receptor binding domain (RBD) IgG titers among 5 of 15 PEH who reported no prior COVID-19 diagnosis or being vaccinated, suggesting undiagnosed and/or asymptomatic COVID-19. While anti-RBD IgG titers across vaccination categories were not statistically significant (P = 0.069), participants vaccinated with Janssen had the lowest mean anti-RBD IgG titers. In multivariable analysis, we found negative associations between level of SARS-CoV-2 antibody titers with the Janssen vaccine and depression; thus a need for integrated care for PEH with depression and COVID-19. CONCLUSIONS: Further research is warranted to confirm the immune response, initial and over time, to SARS-CoV-2 infection and to COVID-19 vaccinations, particularly among PEH whose immune systems may be impacted by multiple health conditions.

Published
2023

7. Depression, Anxiety, and Cigarette Smoking Among Patients with Tuberculosis

Author

Alexandria Jones-Patten, Qiao Wang, Keneilwe Molebatsi, Thomas E. Novotny, Kamran Siddiqi, Chawangwa Modongo, Nicola M. Zetola, Bontle Mbongwe, and Sanghyuk S. Shin

Subjects
Tobacco Smoke and Health, Depression, Prevention, cigarette smoking, Nursing, Anxiety, Anxiety Disorders, Cigarette Smoking, Brain Disorders, Cross-Sectional Studies, Mental Health, Good Health and Well Being, Rare Diseases, Clinical Research, 2.3 Psychological, Tobacco, Behavioral and Social Science, Prevalence, Humans, Tuberculosis, social and economic factors, Aetiology, Lung, General Nursing
Abstract

Smoking adversely affects tuberculosis (TB) outcomes and may be associated with depression and anxiety among people diagnosed with TB in Botswana. We conducted a cross-sectional study among patients newly diagnosed with TB in Gaborone, Botswana, evaluating factors associated with self-reported cigarette smoking. We performed Poisson regression analyses with robust variance to examine whether depressive and anxiety symptoms were associated with smoking. Among 180 participants with TB enrolled from primary health clinics, depressive symptoms were reported in 47 (26.1%) participants and anxiety symptoms were reported in 85 (47.2%) participants. Overall, 45 (25.0%) participants reported current smoking. Depressive symptoms were associated with a higher prevalence of smoking (adjusted prevalence ratio [aPR]: 2.04; 95% confidence interval [CI]: 1.29–3.25) in the adjusted analysis. The association between anxiety symptoms and smoking did not reach statistical significance (aPR: 1.26; 95% CI: 0.77–2.05). Future studies should further investigate these associations when addressing TB care.

Published
2023

9. Depressive symptoms are associated with cigarette smoking among tuberculosis patients in Botswana

Author

Chawangwa Modongo, Thomas E. Novotny, Alexandria Jones-Patten, Nicola M. Zetola, Sanghyuk S. Shin, Bontle Mbongwe, Q. Wang, Keneilwe Molebatsi, and Kamran Siddiqi

Subjects
medicine.medical_specialty, Tuberculosis, business.industry, medicine.disease, symbols.namesake, Cigarette smoking, Internal medicine, Statistical significance, symbols, Medicine, Anxiety, Poisson regression, medicine.symptom, business, Adverse effect, Depression (differential diagnoses), Depressive symptoms
Abstract

BackgroundResearchers have increasingly recognized the adverse effects of smoking on tuberculosis (TB) outcomes. Smoking may be a maladaptive coping mechanism for depression and anxiety among TB patients; however, this association has not yet been investigated.Design/MethodsWe conducted a cross-sectional study among newly diagnosed TB patients between January and December 2019 in Gaborone, Botswana, and evaluated factors associated with cigarette smoking. Using the Patient Health Questionnaire-9 and the Zung Self-Rating Anxiety scale, we collected depression and anxiety scores, respectively; scores of ≥10 indicate depression and scores of ≥36 indicate anxiety. We performed Poisson regression analyses with robust variance to examine whether depression and anxiety were associated with smoking.ResultsOne hundred and eighty participants with TB were enrolled from primary health clinics. Among all enrollees, depression was reported in 46 (27.1%) participants, while anxiety was reported in 60 (44.4%) participants. Overall, 45 (25.0%) participants reported current smoking, and the median number of cigarettes per day was 10. Depressive symptoms were associated with a higher prevalence of smoking (aPR: 1.82; 95% CI = 1.11, 3.01) after adjusting for sex, HIV status, food insecurity, anxiety, and income. The association between anxiety symptoms and cigarette smoking did not reach statistical significance (aPR 1.26; 95% CI: 0.78-2.05).ConclusionsWe found the association between depressive symptoms and smoking among TB patients in Botswana to be significant and the association between anxiety symptoms and cigarette smoking insignificant. Future studies should further investigate these associations when addressing TB care.

Published
2021

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