COVID-19 Prevention Behaviors and Mistrust Among Black and Latino Public Housing Residents in NYC.

Historically, blood pressure control in Hispanics has been considerably less than that of non-Hispanic whites and blacks. We compared determinants of blood pressure control among Hispanic white, Hispanic black, non-Hispanic white, and non-Hispanic black participants (N=32 642) during follow-up in a randomized, practice-based, active-controlled trial. Hispanic blacks and whites represented 3% and 16% of the cohort, respectively; 33% were non-Hispanic black and 48% were non-Hispanic white. Hispanics were less likely to be controlled (<140/90 mm Hg) at enrollment, but within 6 to 12 months of follow-up, Hispanics had a greater proportion <140/90 mm Hg compared with non-Hispanics. At 4 years of follow-up, blood pressure was controlled in 72% of Hispanic whites, 69% of Hispanic blacks, 67% of non-Hispanic whites, and 59% of non-Hispanic blacks. Compared with non-Hispanic whites, Hispanic whites had a 20% greater odds of achieving BP control by 2 years of follow-up (odds ratio: 1.20; 95% CI: 1.10 to 1.31) after controlling for demographic variables and comorbidities, Hispanic blacks had a similar odds of achieving BP control (odds ratio: 1.04; 95% CI: 0.86 to 1.25), and non-Hispanic blacks had a 27% lower odds (odds ratio: 0.73; 95% CI: 0.69 to 0.78). We conclude that in all patients high levels of blood pressure control can be achieved with commonly available medications and that Hispanic ethnicity is not associated with inferior control in the setting of a clinical trial in which hypertensive patients had equal access to medical care, and medication was provided at no cost.

As announced by the World Health Organization (WHO), since March 2020, the COVID-19 pandemic has become a global pandemic. In order to prevent the spread of COVID-19, Chinese government carried out very strict prevention and control policy. The study aimed to explore the effect of news reports on COVID-19 vaccine from traditional media and social media on COVID-19 preventive behaviors. Adults aged between 18 and 58 years old completed an online survey reporting how they gathered media information sources regarding the COVID-19 vaccine, as well as any details relating to risk perception, vaccine efficacy, and preventive behaviors in COVID-19 pandemic. Our results showed that traditional and social media information sources both significantly and positively influenced people's COVID-19 preventive behaviors, with the former showing a stronger effect. COVID-19 contact risk perception and vaccine efficacy awareness of media audiences partly mediate this relationship. Audiences who reported more exposing news reports on COVID-19 vaccine from the media show stronger risk perception and vaccine efficacy awareness. This increases their COVID-19 preventive behaviors. This study found that media information sources have an important impact on people's COVID-19 preventive behaviors. People believe more in the news information of the mainstream media about the COVID-19 pandemic. Moreover, much of the news information of social media is also from the important mainstream media. Media organizations should shoulder greater social responsibility, embed the health-related benefits of COVID-19 vaccination into the values and cultural order of the whole society, find and shape a common space of meaning, and produce forms of internal coupling and value identification.

253 Current US birth data mask significant racial disparities in pregnancy outcomes

Background: Recent studies suggest racial and ethnic differences in tumor genomics and receipt of systemic treatment may be drivers of racial and ethnic disparities in clinical outcomes (e.g., mortality, recurrence) in patients with breast cancer (BC). For patients of Hispanic ethnicity, the relationship between ethnoracial categories (i.e., Hispanic Black, Hispanic White), tumor genomics, and receipt of systemic has not been well elucidated. The objective of this study is to examine implications of ethnoracial categories on Oncotype DX recurrence score (RS), receipt of chemotherapy for high risk RS and endocrine therapy (ET) use in the National Cancer Database (NCDB). Materials/Methods: Patients diagnosed from 2004-2017 with stage I or stage II HR+/HER2- BC with RS available in the NCDB were identified. The data was divided into Black and White patients then stratified by ethnicity. Study ethnoracial categories included non-Hispanic White (NHW), Hispanic White (HW), non-Hispanic Black (NHB) and Hispanic Black (HB). High-risk RS was defined using the original definition of RS&amp;gt;30. On univariable analysis, intra-racial differences in RS score (t-test) and the proportion of patients with high-risk RS (chi-square test) were examined by ethnicity. Systemic therapy (chemotherapy and ET) were assessed with univariable analysis within racial groups by ethnicity (chi-square test). Results: The ethnoracial composition of the cohort was 220,490 (87.5%) NHW, 20,690 (8.2%) HB, 10,477(4.2%) HW and 296 (&amp;lt; 1%) HB. Overall, Hispanic patients had higher mean RS relative to non-Hispanic patients (18.4 [11.8] vs. 18.0 [10.8], p=0.0004) and a higher proportion of RS&amp;gt;30 (10.4% vs. 9.6%, p=0.0028). Amongst White patients, Hispanic ethnicity was associated with higher mean RS (18.3 [11.7] HW vs. 17.8 [10.6] NHW) and higher rate of RS&amp;gt;30 (10.4% HW vs. 9.1% NHW, p&amp;lt; 0.0001). There was no significant difference in mean RS between NHB and HB patients (19.0 [13.5] HB vs. 20.0 [12.7], p=0.1855) but there was a trend towards a lower proportion of RS&amp;gt;30 in HB patients (10.8% HB vs. 14.6% NHB, p=0.0688. In patients with RS&amp;gt;30, the proportion that received chemotherapy was similar based on ethnicity within White (80.7% HW vs. 82.3% NHW, p=0.1843) and Black (78.1% HB vs. 81.2% NHB, p=0.6601) patients. ET use was slightly lower in HW vs. NHW patients (90.6% vs. 91.7%, p&amp;lt; 0.0001). There was no significant difference in ET use in NHB vs HB patients (89.9% vs. 89.9%, p=0.9651). Conclusions: In our examination of the early-stage breast cancer patients in the NCDB, Hispanic ethnicity was associated with higher RS amongst White patients with an opposite trend in Black women. Systemic therapy use was largely similar across ethnoracial categories. Future, studies should disaggregate Hispanic ethnicity by race to better understand tumor characteristics and clinical outcomes in this population. Citation Format: Jose G. Bazan, Sachin R. Jhawar, Daniel Stover, Sasha Beyer, Julia White, Samilia Obeng-Gyasi. Understanding Ethnoracial Differences in Oncotype DX Recurrence Scores in Patients with Early-Stage Breast Cancer: An Analysis Based on Hispanic Ethnicity [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-05-60.

To understand the impact of Black race on breast cancer (BC) presentation, treatment, and survival among Hispanics. It is well-documented that non-Hispanic Blacks (NHB) present with late-stage disease, are less likely to complete treatment, and have worse survival compared to their non-Hispanic White (NHW) counterparts. However, no data evaluates whether this disparity extends to Hispanic Blacks (HB) and Hispanic Whites (HW). Given our location in Miami, gateway to Latin America and the Caribbean, we have the diversity to evaluate BC outcomes in HB and HW. Retrospective cohort study of stage I-IV BC patients treated at our institution from 2005-2017. Kaplan-Meier survival curves were generated and compared using the log-rank test. Multivariable survival models were computed using Cox proportional hazards regression. Race/ethnicity distribution of 5951 patients: 28% NHW, 51% HW, 3% HB, and 18% NHB. HB were more economically disadvantaged, had more aggressive disease, and less treatment compliant compared to HW. 5-year OS by race/ethnicity was: 85% NHW, 84.8% HW, 79.4% HB, and 72.7% NHB (P < 0.001). After adjusting for covariates, NHB was an independent predictor of worse OS [hazard ratio:1.25 (95% confidence interval: 1.01-1.52), P < 0.041)]. In this first comprehensive analysis of HB and HW, HB have worse OS compared to HW, suggesting that race/ethnicity is a complex variable acting as a proxy for tumor and host biology, as well as individual and neighborhood-level factors impacted by structural racism. This study identifies markers of vulnerability associated with Black race and markers of resiliency associated with Hispanic ethnicity to narrow a persistent BC survival gap.

Rural residents have lower levels of engagement in health-promoting behaviors and treatment adherence than their urban counterparts. This cross-sectional study sought to understand the role of health self-efficacy as a precursor to engagement in health-promoting behaviors and treatment adherence in 273 rural patients. Structural equation model was used to examine whether health self-efficacy predicted engagement in health-promoting behaviors and treatment adherence. Results show that health self-efficacy predicts engagement in health-promoting behaviors and treatment adherence. Boosting patients' health self-efficacy could be a way of increasing their engagement in health-promoting behaviors and treatment adherence and thus of improving their health outcomes.

Introduction: Few studies have examined the distribution of breast cancer outcomes among Hispanics by race (i.e. Hispanic Black, Hispanic White). Understanding the diversity of breast cancer characteristics among Hispanic women is key to explaining the differences in breast cancer outcomes. Purpose: To assess the distribution of tumor stage, joint estrogen receptor (ER)/progesterone receptor (PR) status, and breast cancer-specific mortality with race and ethnicity, among Hispanic Black, Hispanic White, non-Hispanic Black (NHB), non-Hispanic White (NHW) women using Surveillance, Epidemiology, and End Results (SEER) Program data. Methods: We used data on 441,742 women aged 20–79 years who were diagnosed with primary invasive breast cancer between January 1992 and December 2008, with no prior history of cancer, and who were identified through the SEER 17 population-based registries. Women less than 20 and older than 79 years of age were excluded from the study. The primary outcomes of interest were: AJCC tumor stage, joint estrogen receptor (ER)/progesterone receptor (PR) status, and breast cancer-specific mortality. Our primary exposure of interest was race/ethnicity, which was categorized into four groups, based on SEER data: non-Hispanic White, non-Hispanic Black, Hispanic White, and Hispanic Black. Covariates included age at diagnosis, year of diagnosis, % population below poverty level, % population with less than a high school education, % foreign born, % non-English language, SEER registry, and treatment (surgery and/or radiation therapy). Results: Hispanic Blacks had the highest risk of being diagnosed with stage III and IV tumors compared to NHWs (RRR=2.4 [95% CI:1.9-3.1] and RRR=2.0 [95% CI:1.4-2.8], respectively; p&amp;lt;0.01). Both NHBs and Hispanic Blacks had 2.4-fold greater risk of being diagnosed with ER–/PR– breast cancer compared to NHW women (RRR=2.4 [95% CI:2.3-2.5] and RRR=2.4 [95% CI:2.0-2.9], respectively; p&amp;lt;0.01). Hispanic White women had a significantly increased risk of being diagnosed with both ER–/PR– (64% increase) and ER+/PR– (24% increase) breast cancers compared to NHW women (RRR=1.6 [95% CI:1.6-1.7] and RRR=1.2 [95% CI:1.2-1.3], respectively; p&amp;lt;0.01). Hispanic White and Hispanic Black women were at increased risk of breast cancer-specific mortality compared to NHW women (HR=1.2 [95% CI:1.2-1.3] and HR=1.5 [95%:1.2-1.80, respectively, p&amp;lt;0.01). Conclusion: Hispanic Black women have disproportionately higher rates of late stage invasive breast cancer diagnoses, ER–/PR– breast disease, and breast cancer-specific mortality compared to non-Hispanic White women. Furthermore, RRR estimates suggest that the increased risk associated with late stage and ER–/PR– may be greater than or equal to those estimates observed for non-Hispanic Black and Hispanic White women. The findings from this study will be among the first studies to present information on breast cancer characteristics and outcomes in both Hispanic Black and Hispanic White. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B66.

Background: Breast cancer is the most common cancer diagnosed among Hispanic women in the US and is the leading cause of cancer-related death in this population. However, controversy remains as to whether this population has improved, or worse, overall survival (OS) outcomes compared to their non-Hispanic White (NHW) and non-Hispanic Black (NHB) counterparts. Given our location in South Florida, where Hispanics account for approximately 70% of the population we are perfectly poised to analyze breast cancer overall survival (OS) outcomes in a Hispanic population compared to a non-Hispanic population. Furthermore, given the diverse nature of our Hispanic population, this is the first study to also evaluate outcomes in Hispanic Whites (HW) compared to Hispanic Blacks (HB). Methods: Patients presenting to our medical campus with stage I-IV breast cancer from 2005-2017 were identified from the local tumor registry. Kaplan-Meier survival analysis was performed to identify patient, tumor, and NCCN-guideline based treatment characteristics associated with OS. Factors with a p &amp;lt; 0.1 were included in the Cox proportional hazards model. Results: 5,951 breast cancer patients were evaluated from 2005-2017. Patient demographics, tumor characteristics, and treatments received are presented in Table 1. NHB tended to be more economically disadvantaged, presented with later stage disease, had rates higher triple negative disease, and were less likely to complete NCCN-guideline based treatment. The 5-year OS across all races/ethnicities was 82.5% with a median follow-up of 65 months. The 5-year OS stratified by race and ethnicity is as follows: NHW 85%, HW 84.8%, HB 79.4%, and NHB 72.7%. On Cox proportional hazards model, when adjusting for stage, race/ethnicity, insurance, marital status, income, smoking/alcohol, receptor status, tumor grade, and NCCN-guideline based treatment, NHB had a hazard ratio of 1.25 [(95% CI:1.01-1.52), p&amp;lt; 0.041)]. Conclusion: At our institution, located in South Florida, we treat a large number of patients with breast cancer from South Florida, Central and South America, and the Caribbean who self-report as Hispanic. Our study is the first to suggest survival differences amongst HW and HB. Moreover, HB had improved OS compared to NHB, suggesting unaccounted for protective factors associated with Hispanic ethnicity. Table 1: Patient demographics, tumor, and treatment characteristicsFactorNHWHispanic WhiteNHBHispanic BlackAllp-valueN=1647N=3127N=1070N=107N=5951PATIENT DEMOGRAPHICSAge at diagnosisp&amp;lt;0.001&amp;lt;50 years441 (26.8%)990 (31.7%)358 (33.5%)30 (28.0%)1819 (30.6%)50-69 years898 (54.5%)1769 (56.6%)607 (56.7%)62 (57.98%)3336 (56.1%)70-79 years205 (12.4%)279 (8.9%)76 (7.1%)14 (13.1%)574 (9.6%)80+ years103 (6.3%)89 (2.8%)29 (2.7%)1 (0.9%)222 (3.7%)Birthplacep&amp;lt;0.001US-born778 (47.2%)139 (4.4%)482 (45.0%)4 (3.7%)1403 (23.6%)Foreign-born214 (13.0%)2307 (73.8%)430 (40.2%)92 (86.0%)3043 (51.1%)Unknown655 (39.8%)681 (21.8%)158 (14.8%)11 (10.3%)1505 (25.3%)Relationshipp&amp;lt;0.001Married947 (57.5%)1462 (46.8%)355 (33.2%)34 (31.8%)2798 (47.0%)Single295 (17.9%)756 (24.2%)472 (44.1%)42 (39.3%)1565 (26.3%)Divorced/Separated/Widow346 (21.0%)832 (26.6%)218 (20.4%)28 (26.2%)1424 (23.9%)Other/Unknown59 (3.6%)77 (2.5%)25 (2.3%)3 (2.8%)164 (2.8%)Area Deprivation Index35.4 ± 27.252.8 ± 26.767.0 ± 23.166.1 ± 23.850.9 ±28.3p&amp;lt;0.001Median Income Quartilesp&amp;lt;0.001&amp;lt;$36,572130 (8.0%)909 (29.8%)405 (39.6%)40 (38.1%)1484 (25.6%)$36,573-48,450317 (19.6%)787 (25.8%)384 (37.5%)32 (30.5%)1520 (26.2%)$48,451-64,599521 (32.3%)700 (22.9%)143 (14.0%)26 (24.8%)1390 (24.0%)&amp;gt;$64,600649 (40.1%)658 (21.5%)91 (8.9%)7 (6.7%)1405 (24.2%)Insurancep&amp;lt;0.001Private1054 (64.0%)1111 (35.5%)397 (37.1%)24 (22.4%)2586 (43.5%)Medicare320 (19.4%)343 (11.0%)117 (10.9%)16 (15.0%)796 (13.4%)Medicaid94 (5.7%)716 (22.9%)276 (25.8%)34 (31.8%)1120 (18.8%)Uninsured72 (4.4%)667 (21.3%)187 (17.5%)28 (26.2%)954 (16.0%)TUMOR AND TREATMENT CHARACTERISTICSClinical Stagep&amp;lt;0.001I765 (46.4%)1137 (36.4%)281 (26.3%)28 (26.2%)2211 (37.2%)II512 (31.1%)1120 (35.8%)386 (36.1%)38 (35.5%)2056 (34.5%)III211 (12.8%)563 (18.0%)221 (20.7%)24 (22.4%)1019 (17.1%)IV122 (7.4%)226 (7.2%)141 (13.2%)14 (13.1%)503 (8.5%)Unknown37 (2.2%)81 (2.6%)41 (3.8%)3 (2.8%)162 (2.7%)Tumor Gradep&amp;lt;0.001Well diff.334 (20.3%)531 (17.0%)132 (12.3%)13 (12.1%)1010 (17.0%)Moderately diff.715 (43.4%)1341 (42.9%)370 (34.6%)46 (43.0%)2472 (41.5%)Poorly diff.415 (25.2%)959 (30.7%)450 (42.1%)37 (34.6%)1861 (31.3%)Anaplastic/Undifferentiated7 (0.4%)19 (0.6%)20 (1.9%)2 (1.9%)48 (0.8%)Unknown176 (10.7%)277 (8.9%)98 (9.2%)9 (8.4%)560 (9.4%)Receptor Statusp&amp;lt;0.001ER+/HER2+170 (10.3%)336 (10.7%)109 (10.2%)18 (16.8%)633 (10.6%)ER+/HER2-1078 (65.5%)1983 (63.4%)525 (49.1%)60 (56.1%)3646 (61.3%)ER-/HER2-315 (19.1%)571 (18.3%)335 (31.3%)22 (20.6%)1243 (20.9%)ER-/HER2+84 (5.1%)237 (7.6%)101 (9.4%)7 (6.5%)429 (7.2%)Pathologic Stagep&amp;lt;0.001012 (0.7%)20 (0.6%)7 (0.7%)1 (0.9%)40 (0.7%)I759 (46.2%)1086 (34.7%)281 (26.3%)31 (29.2%)2157 (36.3%)II406 (24.7%)859 (27.5%)268 (25.0%)26 (24.5%)1559 (26.2%)III146 (8.9%)340 (10.9%)106 (9.9%)12 (11.3%)604 (10.2%)IV44 (2.7%)81 (2.6%)37 (3.5%)9 (8.5%)171 (2.9%)Unknown277 (16.8%)740 (23.7%)371 (34.7%)27 (25.5%)1415 (23.8%)TreatmentsSurgery1494 (90.7%)2782 (89.0%)856 (80.0%)88 (82.2%)5220 (87.7%)p&amp;lt;0.001Chemotherapy854 (51.9%)1891 (60.5%)658 (61.5%)61 (57.0%)3464 (58.2%)p&amp;lt;0.001Radiation848 (51.5%)1761 (56.3%)528 (49.3%)56 (52.3%)3193 (53.7%)p&amp;lt;0.001Endocrine Therapy1121 (68.1%)1924 (61.5%)482 (45.0%)59 (55.1%)3586 (60.3%)p&amp;lt;0.001NCCN Guideline-Based Care (by stage and receptor)1311 (79.6%)2366 (75.7%)745 (69.6%)77 (72.0%)4499 (75.6%)p&amp;lt;0.001Treatment at Comprehensive Cancer Center1368 (83.1%)1445 (46.2%)432 (40.4%)37 (34.6%)3282 (55.2%)p&amp;lt;0.001 Citation Format: Sina Yadegarynia, Kristin Kelly, Seraphina Choi, Susan Kesmodel, Neha Goel. Breast cancer outcomes among a diverse racial/ethnic south Florida population [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-41.

Nurses make up the single largest healthcare professional group in the Nigerian healthcare system. As frontline healthcare providers, they promote healthy lifestyles to patients and families. However, the determinants of Nigerian nurses’ personal health promoting behaviors (HPBs) remain unknown. Utilizing the socio-ecological model (SEM) approach, this study aimed to explore the perceived facilitators and barriers to Nigerian nurses’ engagement in HPBs. HPBs were operationalized to comprise of healthy dietary behaviors, engagement in physical activity, low-risk alcohol consumption, and non-smoking behaviors. Our study was carried out in a large sub-urban tertiary health facility in Nigeria. Data collection was via face-to-face semi-structured interviews and participants were registered nurses (n = 18). Interview data were transcribed verbatim and analyzed thematically to produce nine themes that were mapped onto corresponding levels of influence on the SEM. Findings show that in Nigeria, nurses perceive there to be a lack of organizational and policy level initiatives and interventions to facilitate their engagement in HPBs. The determinants of Nigerian nurses’ HPBs span across all five levels of the SEM. Nurses perceived more barriers to healthy lifestyle behaviors than facilitators. Engagement in healthy behaviors was heavily influenced by: societal and organizational infrastructure and perceived value for public health; job-related factors such as occupational stress, high workload, lack of protected breaks, and shift-work; cultural and religious beliefs; financial issues; and health-related knowledge. Organizations should provide facilities and services to support healthy lifestyle choices in Nigeria nurses. Government policies should prioritize the promotion of health through the workplace setting, by advocating the development, implementation, regulation, and monitoring of healthy lifestyle policies.

BackgroundDisparities in health among blacks and Hispanics compared to whites individuals exist for a number of health measures; however, the health profile of individuals who are both black and Hispanic...

Information regarding vaccination and the association with individuals' characteristics, experiences, and information sources is important for crafting public health campaigns to maximize uptake. Our objective was to investigate factors associated with intentions for COVID-19 vaccination among a sample of U.S. adults using a population-based cross-sectional survey. Data were collected via an online questionnaire administered nationwide from January 4, to January 7, 2021 following the emergency use authorization for two SARS-CoV-2 mRNA-based vaccines. Of 936 U.S. adult respondents, 66% stated an intention to be vaccinated once a COVID-19 vaccine was available to them; 14.7% responded "maybe" and 19.6% "no." Unadjusted and multivariate associations revealed "no/maybe" vaccination intentions were associated with younger age, female, Black race, lower income, history of not receiving the influenza vaccine, lower fear of COVID-19, suffering moderate to severe reduction in access to food/nutrition, and lower trust in health care authorities, personal health care providers, and/or traditional news media as sources of COVID-19 information. Of respondents "maybe" intending to be vaccinated, 65% reported "a lot" of trust in personal health care providers as sources of COVID-19 information. Respondents stating "no" intention to be vaccinated were skeptical of all COVID-19 information sources considered. Our findings confirm observations predating COVID-19 vaccine availability regarding sociodemographic characteristics associated with vaccine hesitancy in the United States. We further identify personal health care providers as the most trusted information source among people who "maybe" intend to get vaccinated and demonstrate the challenge in reaching people not intending to be vaccinated. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background The COVID-19 vaccination aims to prevent the transmission of the novel coronavirus (SARS-CoV-2) as well as to reduce severe courses of the disease and deaths. But various studies indicate social differences in willingness to be vaccinated. This study aims to examine the influence of different social determinants on COVID-19 vaccination in Germany. Methods The analyses are based on data from the sixth follow-up survey of the German Health Update (GEDA 2021), a nationwide cross-sectional telephone survey of the adult population living in Germany. COVID-19 vaccination rates are analyzed considering age, education, income, urban-rural residence and migration background. Poisson regressions were used to examine associations of each social determinant with COVID-19 vaccination rates. Adjustments were made for age, sex, (education) and date of participation. Results Overall, the rate of COVID-19 vaccination for the survey period was 86.7%, with significant differences in vaccination rate by social determinants. The vaccination rate increases significantly with age (94.2% for over 60-year-olds), higher level of education (91.5%) or income (93.0%). In addition, people living in rural areas in Germany (83.5%) and people with an own migration experience (79.1%) had a significantly lower vaccination rate. An age-differentiated analysis also showed the social differences in COVID-19 vaccination rate are significantly lower among those over 60-years old. Conclusions The results suggest social differences in COVID-19 vaccination especially in younger age groups. This should be considered when designing targeted measures to overcome potential barriers to vaccination. However, a large number of other factors affecting vaccination behavior must be taken into account like structural barriers, confidence in decision-makers, the safety of vaccination, and a sense of responsibility towards the community. Key messages • Sociodemographic and socioeconomic determinants affect COVID-19 vaccination rates. • The social differences in COVID-19 vaccination are lower among those over 60-years old.

BackgroundIn Alzheimer’s disease (AD) trials, differential screen failure due to cognitive and biomarker requirements may contribute to underrepresentation of racially and ethnically minoritized groups. The AHEAD 3‐45 Study (NCT04468659) is an ongoing program testing lecanemab at the stage of preclinical AD that utilizes plasma biomarker prescreening, acquired before cognitive, clinical, and medical history eligibility assessments, to enrich for participants likely to qualify based on amyloid PET eligibility criteria.MethodsWe examined the frequency of plasma amyloid biomarker eligibility among racial and ethnic groups in the AHEAD Study. We assigned participants ages 55‐80 to mutually exclusive groups: Hispanic Black (HB), Hispanic White (HW), Non‐Hispanic Asian (NHA), Non‐Hispanic Black (NHB), and Non‐Hispanic White (NHW). We used univariate logistic regression models to explore group differences in screen failure rates as determined by an algorithm that includes the plasma Aβ 42/40 ratio, age, and APOE status. The algorithm indicates an adequately high probability of elevated brain amyloid (&gt;20 centiloids). We further explored whether APOE ε4 status (carrier vs non‐carrier) contributed to group differences.ResultsAmong 4274 participants undergoing plasma screening, 59 (1.4%) were HB, 622 (14.6%) were HW, 74 (1.73%) were NHA, 329 (7.7%) were NHB, and 3190 (74.6%) were NHW. Screen failure rates were 86% for HB, 76% for HW; 80% for NHA; 77% for NHB, and 62% for NHW. Using NHW participants as a reference group, we observed increased odds of screen failure among all other groups (HB OR = 4.0 95% CI 2.0, 9.1; HW OR = 2.0 95% CI 1.6, 2.4; NHA OR = 2.5 95% CI 1.4, 4.5; NHB OR = 2.1, 95% CI 1.6, 2.7). Observed differences were consistent across APOE ε4 carriers and non‐carriers.ConclusionDifferential rates of amyloid eligibility were observed despite the lack of systematic sample bias due to clinical or cognitive requirements observed in previous studies. Potential explanations for these observations include differences in clinical trial access, incidences of elevated amyloid, needed cutoffs for biomarker assays, and confounding due to comorbidities or other unmeasured covariates.This work is supported by a public‐private partnership between Alzheimer’s Clinical Trial Consortium (U24 AG057437) and Eisai.

INTRODUCTIONAlzheimer's disease (AD) biomarkers of Amyloid(A), Tau(T), and Neurodegeneration(N) have been increasingly studied to fill the gap in our understanding of racial and ethnic differences. This study aimed to examine the relationship between plasma AT(N) biomarkers and (1) AT(N) neuroimaging biomarkers, (2) demographics, (3) medical comorbidities, and (4) cognitive diagnosis.METHODSData were analyzed from n = 764 non‐Hispanic Black (NHB), n = 1230 Hispanic, and n = 1232 non‐Hispanic White (NHW) participants. Plasma AT(N) biomarkers were derived using single molecule array (SIMOA) technology on an HD‐X imager and included amyloid beta (Aβ)42/40, total tau, ptau181, and neurofilament light chain (NfL). Clinical reads of positron emission tomography (PET) amyloid and tau positivity were used to examine the link between AT(N) plasma and neuroimaging biomarkers. Generalized linear models were conducted to examine the relationship between plasma AT(N) biomarkers and select demographic, diagnostic, and medical comorbidities (hypertension, diabetes, dyslipidemia, chronic kidney disease).RESULTSDifferences in the AT(N) biomarkers were found across racial/ethnic groups. Plasma Aβ42/40 was found to be associated with PET amyloid positivity only among NHW participants, while plasma NfL was found to correlate with Meta‐ROI among NHB and Hispanic participants. Ptau181 was associated with PET amyloid positivity among NHB and NHW participants and well as PET tau positivity among the latter group and Hispanic participants. Diabetes was related to increased plasma AT(N) biomarkers among NHB and Hispanic participants. CKD was associated with increased AT(N) biomarkers for all race/ethnic groups with the exception of Aβ42/40. While Aβ42/40, total tau, ptau181, and NfL were found to be related to a dementia diagnosis among NHW participants, only ptau181 and NfL were found to be related to this same diagnostic category among NHB and Hispanic participants.DISCUSSIONOur findings indicate differential relationships between comorbidities (demographic, medical, diagnostic) across NHB, Hispanic, and NHW participants. This work expands our knowledge regarding the associations of plasma biomarkers to AD pathology in diverse populations.HighlightsDifferences in AT(N) plasma biomarkers were found in a diverse community cohort.While plasma Aβ42/40 was associated with PET amyloid positivity among non‐Hispanic white participants, this did not apply to non‐Hispanic Black or Hispanic participants.Medical comorbidity of diabetes and chronic kidney disease was related to increased plasma AT(N) biomarkers among the ethnically diverse segment of the cohort.Plasma AT(N) biomarkers were more so related to a diagnosis of dementia for non‐Hispanic white as compared to Hispanic or non‐Hispanic Black participants.Across racial/ethnic groups, the plasma biomarkers of neurodegeneration (NfL) and ptau181 were related to a diagnosis of dementia.

Purpose: Many patients presenting for lung cancer screening are current smokers; screening may be a teachable moment for cessation. The objective of the current analysis is to compare cessation readiness among lung screening patients by rural/urban residence and race/ethnicity to identify populations who may benefit from tailored support. Methods: We enrolled 1,095 current smokers presenting for low dose CT lung cancer screening at 24 NCI Community Oncology Research Program (NCORP) imaging clinics as part of the OaSiS trial (WF 20817CD). Prior to screening, we collected data regarding perceived risk and worry about lung cancer, perceived impact of cessation on lung cancer risk, cessation readiness, and quitting self-efficacy (both 1-10 Likert type scales). We classified participants as rural vs urban using the zip-code-based definitions of the Federal Office of Rural Health Policy. We summarized group differences using chi-square analyses. Results: Participants were 50.2% female; average age 64 years (range 55-79); 81.9% non-Hispanic White (NHW), 13.3% non-Hispanic Black (NHB), 2.6% Hispanic, 2.2% American Indian; 20.2% rural residence). The median cigarettes smoked per day was 20 and the median pack years smoked was 44. NHW participants were less likely than other groups to report being “extremely” worried about lung cancer [15.5% vs NHB (31.4%), Hispanic (35.7%), and American Indian (25%), p&amp;lt;.0001]. When queried about their perceived risk of developing lung cancer, NHB (21.8%), Hispanic (14.3%), and American Indian (12.5%) participants were also more likely to report that they didn’t know, compared to NHW participants (9.7%, p &amp;lt;.0001). NHB participants were more likely to believe that quitting smoking would “very much” reduce their risk of lung cancer (52.1%), compared to NHW (36.3%), Hispanic (35.7%), and American Indian (37.5%) participants (p&amp;lt;.001). NHWs reported lower cessation readiness compared to NHB, Hispanic, and American Indian participants (p&amp;lt;.001). NHB and Hispanic participants also reported high quitting self-efficacy compared to NHW and American Indian participants (p&amp;lt;.0001). With regard to rural/urban differences, compared to urban residents, rural residents reported lower or unknown perceived impact of cessation on lung cancer risk (9.5 vs 6.8% no impact &amp; 13.2 vs 6.9% unknown, p&amp;lt;.01). There were no other differences in cessation readiness factors by rural-urban residence. Conclusions: To advance health equity, it is important to understand cessation readiness, among patients presenting to community-based imaging clinics for lung cancer screening. Evidence-based cessation treatment for racial/ethnic minorities within these settings may be enhanced by tailoring for higher cessation readiness. Rural and racial/ethnic minority patients may benefit from enhanced education regarding lung cancer risk and the impact of cessation. This work was supported by the National Cancer Institute (R01CA207158 &amp; UG1CA189824). Citation Format: Kathryn E. Weaver, Erin L. Sutfin, Emily Dressler, Christina Bellinger, David P. Miller, Caroline Chiles, W. J. Petty, Glenn Lesser, Kristie L. Foley. Rural/urban and race differences in factors related to cessation readiness among cigarette smokers presenting for lung cancer screening in community settings [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 PO-009.