African American Population Research Articles

Identification of Non-Coding RNA Biomarkers in Non-Small Cell Lung Cancer to Address Racial Disparities.

Lung cancer significantly impacts mortality, with African Americans (AAs) showing higher rates than White Americans (WAs). Noncoding RNAs (ncRNAs) play a crucial role in lung tumorigenesis. To identify ncRNA biomarkers associated with racial disparities in lung cancer, we used droplet digital PCR to examine 93 lung cancer-associated ncRNAs in plasma and sputum samples from participants with AA and WA, including 118 patients and 92 cancer-free smokers. In the AA population, plasma showed differential expression of ten ncRNAs, while sputum revealed four ncRNAs when comparing lung cancer patients to the control group. In the WA population, the plasma displayed 11 ncRNAs, and the sputum had five ncRNAs showing differential expression between lung cancer patients and the control group. For AAs, we identified a three-ncRNA panel (plasma miRs-147b, 324-3p, 422a) for diagnosing lung cancer in AAs with 86% sensitivity and 89% specificity. For WAs, a four-ncRNA panel comprising sputum miR-34a-5p and plasma miRs-103-3p, 126-3p, and 205-5p was developed, achieving 88% sensitivity and 87% specificity. These panels remained effective across various stages and types of lung tumors, and were validated in an independent cohort of 56 patients and 72 controls. Ethnicity-related ncRNA signatures hold promise as biomarkers for tackling racial disparities in patients with lung cancer.

Abstract 4125334: Disparities In Clinical And Demographic Outcomes Of Non-Acute Myocardial Infarction-Associated Cardiogenic Shock In African American Vs. Non-African American Patients: An Analysis From The National Inpatient Sample Database

Background: Limited knowledge exists regarding non-acute myocardial infarction-associated cardiogenic shock (nACS-CS) and its associated outcomes within the African American population. Aim: This investigation aimed to examine the clinical outcomes of nACS-CS in the African American population compared to the non-African-American population in the United States. Methods: The National Inpatient Sample (NIS) database was employed to identify hospitalizations with nACS-CS from 2018 to 2020. Patients were categorized as either African Americans or non-African Americans. Statistical analyses, including Chi-square and t-tests, were conducted using STATA version 18. Results: Out of 8,607 nACS-CS hospitalizations, 1,325 (15.4%) involved African Americans between 2018 and 2020 (Figure 1a). African American patients with nACS-CS tended to be younger (60.9±16.6 vs. 65.8±16.7 years; p < 0.05). Moreover, the length of stay for this cohort was notably longer (16.2±0.75 vs. 14.8±0.32 days; p < 0.05). The demographic age group affected by cardiogenic shock exhibited a decreasing trend as time progressed up to 2020 (p-trend<0.05; Figure 1b). The mean hospital charges were also higher for the African American cohort (p<0.05). In-hospital mortality also showed a progressive increase among African Americans over time (p<0.05). Conclusion: Among African American patients with nACS-CS, there is an escalating burden on healthcare, evidenced by a progressively younger demographic being affected over time, coupled with worsening rates of in-hospital mortality. Furthermore, there is a higher mean cost of hospitalization and a prolonged length of stay compared to their non-African American counterparts.

Abstract 4119327: Tyrosine Kinase Inhibitor and Their Cardiotoxic Profile in the African American Population at a Community Safety Net Hospital

Intro: Tyrosine Kinase inhibitors (TKI) have been an effective treatment option for multiple cancer types. Unfortunately, TKIs have shown to have off-target Kinase binding to cardiac tissue. The examination of these cardiotoxic side effects have not been sufficiently explored in minority populations and studies such as DASISION and ENESTnd with high NAA homogeneous demographics reflect this issue. AA tend to have higher rates of HTN and HF at baseline, so further evaluation of TKI cardiotoxicity in this population is warranted. Methods: A total of 181 patients (pts) charts were reviewed in this study, who were exposed to either Ibrutinib, Imatinib and Sorafenib. First, Patients’ demographic data, such as age, gender, race, malignancy type were obtained along with their corresponding exposure to TKIs discussed above. Next, each patient (pt) chart was examined for any cardiotoxic etiologies after starting a TKI, such as arrhythmias, new- onset heart failure (nOHF) , cardiac arrest (CA), and Myocardial infarction (MI). Echocardiography reports were examined for Ejection fraction ( EF). In summary, this is an observational study looking at Cardiotoxicity secondary to TKI use in the AA population. Results: This study's demographics consisted of 149 AA and 32 NAA (non- african american), with the average age of 64.2, and had 128 males and 53 females. A total of 89 pts were on imatinib, 57 on Ibrutinib, 35 on sorafenib. In our population, 64 pts received cardiac echography while on TKIs, with 9 of them demonstrating nOHF. In terms of cardiac arrhythmias, a total of 67 pts experienced this while on TKI, with about 34% (51/149) of AA compared to 50% (16/32) of NAA. A total of 18 pts in the study required hospital management as a sequelae of their cardiotoxicity. Conclusion: There were a few trends that diverged from most studies regarding cardiotoxicity associated with TKIs in our study. When looking at individual items, such as rate of Atrial Fibrillation (AF), seen commonly in patients on Ibrutinib, our rate seen is 4.6% which is lower compared to earlier pooled homogenous population studies (6-7%). Earlier clinical trials of Sorafenib had a 2 % rate of HF in mostly homogenous NAA populations, and our study had 0% rate in total. Overall, several cardiotoxicity trends seen with the TKIs in this observational study warrant need for future studies to enable improved cardiac surveillance strategies post treatment in heterogeneous populations.

Abstract 4137949: Trends in Hypertensive Related Heart Disease Mortality Among Older Adults in the United States, 1999 - 2020

Background: Hypertensive heart disease (HHD) is a major global health concern that impairs quality of life and causes significant morbidity and mortality, especially among older adults. We aimed to examine the temporal trends in HHD-related mortality in the United States (U.S.) between 1999 to 2020. Methods: The CDC WONDER multiple-cause of death database was utilized to identify HHD-related mortality among adults aged ≥ 55 years from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by year, gender, race, and geographic region. Results: A total of 1,186,183 HHD-related deaths were recorded among individuals ≥ 55 years old. Overall, AAMR increased from 36.7 in 1999 to 133.9 in 2020. AAMRs showed a steady increase between 1999 and 2017 (APC: 3.72 [95% CI: 2.72 to 4.49]), followed by a surge from 2017 to 2020 (APC: 14.28 [95% CI: 8.21 to 22.93]). Gender-based analysis showed a constantly higher AAMR among older men compared to older women. Variations in AAMR based on race revealed that Non-Hispanic (NH) Black or African American population had the highest AAMRs. Geographic disparities among states showed that the District of Columbia had the highest AAMR while Nebraska had the lowest. The southern U.S. also had a consistently higher AAMR followed by the West, Northeast, and Midwest. Moreover, metropolitan areas had a higher AAMR than nonmetropolitan areas. Conclusion: Our findings reveal an increase in HHD-related deaths and demonstrate that NH Blacks consistently bear a higher burden of disease mortality. These insights underscore the importance of integrating demographic and geographic variables into public health planning and interventions.

Hepatitis C Infection Confirmation and Fewer Visits Contribute to Improving Treatment Rates in a Predominantly African American Health Center

Background/Objectives: The approval of direct-acting antiviral (DAA) therapy for hepatitis C (HCV) resulted in a highly effective oral treatment for patients. The primary objective of this study was to identify reasons that patients were not treated versus why patients were treated. Identifying potential reasons for the failure to treat can provide a pathway to interventions using evidence-based data. Methods: The electronic medical records in an urban predominately African American (AA) population were searched for all patients with HCV seen at least once in a Gastroenterology or Infectious Disease clinic in 2019. Data collected included demographics, treatment visits, laboratory data, insurance and ZIP codes for median income. Results: Of the 441 patients who were not yet treated at the first 2019 visit, only 43% were treated by July 2020. Insurance and median income were not factors in failure to treat. Patients with an average of four visits were more likely to be treated than those with two or less, suggesting that failure to follow up was a significant factor for patient treatment (42% vs. 8% p < 0.0001). Confirmation of viral infection at first visit was an important factor with respect to treatment (treated 38% vs. not treated 25% p < 0.02). Conclusions: Significant numbers of our patients (57%) failed to be treated after at least one clinic visit. The two critical factors were PCR confirmation prior to the initial visit and the requirement for multiple visits before the initiation of treatment. Since the degree of fibrosis had no impact on treatment, initiating treatment immediately after confirming infection with HCV should improve patient treatment rates and outcomes.

An Urgent Need to Promote Equitable Buprenorphine Administration for Opioid Use Disorder in the Emergency Department.

In recent years, there has been a marked surge in opioid overdose deaths among Black, Latino, and Native American populations. The emergency department (ED) represents a crucial opportunity to address these racial and ethnic inequities by initiating buprenorphine and providing referral for ongoing addiction treatment. Yet Black, Latino, and Native American populations encounter substantial inequities in ED-based addiction treatment access. Within this context, Koeber et al conducted their cross-sectional study of ED patients who screened positive for opioid misuse to evaluate inequities in buprenorphine administration. The authors found that Black ED patients were less likely (odds ratio, 0.56; 95% confidence interval, 0.35-0.88) to receive buprenorphine. There is an urgent need for mixed methods research to understand the drivers of these inequities and interventions to address the multilevel factors across the opioid use disorder care continuum to promote equitable, accessible, person-centered opioid use disorder treatment.

The association between alpha-1 antitrypsin and B-type natriuretic peptide blood levels in healthy African Americans

ObjectiveB-type natriuretic peptide (BNP) is a neurohormone primarily secreted from cardiac ventricles in reaction to increased volume and pressure. The plasma level of BNP is used to measure the mechanical function of the heart and the risk of developing chronic obstructive pulmonary disease (COPD). Alpha-1 antitrypsin (AAT) is a glycoprotein that acts as an inhibitor of serine proteases and plays a crucial role in protecting the lungs against potential harm. AAT deficiency also causes COPD. The data on the prevalence of BNP and AAT in African Americans (AA) are limited and inconsistent. No previous studies have investigated whether any association exists between BNP and AAT. We collected fasting blood samples from 114 AA subjects who provided informed consent. The plasma levels of the biomarkers were measured using ELISA.ResultsOur findings revealed a significant negative correlation between AAT and BNP (r=-0.266, p = 0.01) as well as between AAT and TNF-α (r=-0.242, p = 0.01). Sex hormones (estrogen and testosterone) have a significant relationship with the levels of AAT and BNP. Increasing the AAT and reducing the levels of inflammation can lower the levels of BNP, which in turn could help lower the risk of heart disease in the AA population.

Serum EpCAM or PECAM Levels and Risk of Ischemic Stroke: A Two-Sample Mendelian Randomization Study.

Elevated serum Epithelial cell adhesion molecule (EpCAM) or Platelet endothelial cell adhesion molecule (PECAM) are associated with ischemic stroke (IS), but the causality remains unclear. A two-sample Mendelian randomization (MR) study was performed to examine the causal effect of serum EpCAM or PECAM levels on the risk of IS subtypes.The study utilized GWAS datasets from European and African American populations to identify SNPs associated with serum EpCAM and PECAM levels as instrumental variables. These were then used in MR analyses for IS subtypes, employing multiple methods including IVW, weighted median, MR-Egger, and maximum likelihood. Sensitivity analyses were conducted to validate the results. No significant causal association was observed for EpCAM levels with any of three IS subtypes. Main IVW MR analysis indicated that serum PECAM levels were negatively related to the incidence of large artery stroke (LAS), small vessel stroke (SVS), and cardioembolic stroke (CES), especially CES. Sensitivity analyses confirmed the robustness of these results. Our study reveals a negative correlation between genetically predicted PECAM levels and ischemic stroke risk, particularly for cardioembolic stroke, suggesting PECAM's potential as a biomarker for risk stratification. While no clear causal relationship was found for EpCAM, these findings have significant implications for stroke prevention and treatment strategies. Further research is needed to validate these results and explore their clinical applications, potentially leading to more personalized approaches in stroke management.

Exploring Ethnic Variability in Aryl Hydrocarbon Receptor Signaling: Delineating Differences in Prostate Cancer Outcomes Between African American and Caucasian Populations

Exploring Ethnic Variability in Aryl Hydrocarbon Receptor Signaling: Delineating Differences in Prostate Cancer Outcomes Between African American and Caucasian Populations

Global invasion history with climate-related allele frequency shifts in the invasive Mediterranean fruit fly (Diptera, Tephritidae: Ceratitis capitata)

The Mediterranean fruit fly (Ceratitis capitata) is a globally invasive species and an economically significant pest of fruit crops. Understanding the evolutionary history and local climatic adaptation of this species is crucial for developing effective pest management strategies. We conducted a comprehensive investigation using whole genome sequencing to explore (i) the invasion history of C. capitata with an emphasis on historical admixture and (ii) local climatic adaptation across African, European, Central, and South American populations of C. capitata. Our results suggest a stepwise colonization of C. capitata in Europe and Latin America in which Mediterranean and Central American populations share an ancestral lineage. Conversely, South American invasion history is more complex, and our results partly suggest an old secondary invasion into South America from Europe or a colonization of South America directly from Africa, followed by admixture with an European lineage. Throughout its invasive range, C. capitata is challenged with diverse climatic regimes. A genome wide association study identified a relationship between allele frequency changes and specific bioclimatic variables. Notably, we observed a significant allele frequency shift related to adaptation to cold stress (BIO6), highlighting the species’ ability to rapidly adapt to seasonal variations in colder climates.

Equity-centered adaptive sampling in sub-sewershed wastewater surveillance using census data.

Sub-city, or sub-sewershed, wastewater monitoring for infectious diseases offers a data-driven strategy to inform local public health response and complements city-wide data from centralized wastewater treatment plants. Developing strategies for equitable representation of diverse populations in sub-city wastewater sampling frameworks is complicated by misalignment between demographic data and sampling zones. We address this challenge by: (1) developing a geospatial analysis tool that probabilistically assigns demographic data for subgroups aggregated by race and age from census blocks to sub-city sampling zones; (2) evaluating representativeness of subgroup populations for COVID-19 wastewater-based disease surveillance in Davis, California; and (3) demonstrating scenario planning that prioritizes vulnerable populations. We monitored SARS-CoV-2 in wastewater as a proxy for COVID-19 incidence in Davis (November 2021-September 2022). Daily city-wide sampling and thrice-weekly sub-city sampling from 16 maintenance holes covered nearly the entire city population. Sub-city wastewater data, aggregated as a population-weighted mean, correlated strongly with centralized treatment plant data (Spearman's correlation 0.909). Probabilistic assignment of demographic data can inform decisions when adapting sampling locations to prioritize vulnerable groups. We considered four scenarios that reduced the number of sampling zones from baseline by 25% and 50%, chosen randomly or to prioritize coverage of >65-year-old populations. Prioritizing representation increased coverage of >65-year-olds from 51.1% to 67.2% when removing half the zones, while increasing coverage of Black or African American populations from 67.5% to 76.7%. Downscaling had little effect on correlations between sub-city and centralized data (Spearman's correlations ranged from 0.875 to 0.917), with strongest correlations observed when prioritizing coverage of >65-year-old populations.

The Black and African American Connections to Parkinson’s Disease (BLAAC PD) study protocol

Determining the genetic contributions to Parkinson’s disease (PD) across diverse ancestries is a high priority as this work can guide therapeutic development in a global setting. The genetics of PD spans the etiological risk spectrum, from rare, highly deleterious variants linked to monogenic forms with Mendelian patterns of inheritance, to common variation involved in sporadic disease. A major limitation in PD genomics research is lack of racial and ethnic diversity. Enrollment disparities have detrimental consequences on the generalizability of results and exacerbate existing inequities in care. The Black and African American Connections to Parkinson’s Disease (BLAAC PD) study is part of the Global Parkinson’s Genetics Program, supported by the Aligning Science Across Parkinson’s initiative. The goal of the study is to investigate the genetic architecture underlying PD risk and progression in the Black and/or African American populations. This cross-sectional multicenter study in the United States has a recruitment target of up to 2,000 individuals with PD and up to 2,000 controls, all of Black and/or African American ancestry. The study design incorporates several strategies to reduce barriers to research participation. The multifaceted recruitment strategy aims to involve individuals with and without PD in various settings, emphasizing community outreach and engagement. The BLAAC PD study is an important first step toward informing understanding of the genetics of PD in a more diverse population.

A 6-month Review of pRBC Transfusion Practices in a Tertiary Institution in Brooklyn, NY

Abstract Introduction/Objective Many factors are considered when managing hospital blood inventory. Because demographics and types of services vary per institution, a conscious effort to survey the prevalence of different blood types is necessary to make better predictions of inventory adequacy and decrease inappropriate use of O pRBC units. Methods/Case Report We reviewed the transfused pRBC units between October 2023 and March 2024 to determine the number of patients receiving ABO-type specific units and the number of D+ patients receiving D- units. Results (if a Case Study enter NA) After review, the patient population was found to be approximately 80% African Americans. Most of our patients were D+ with a monthly average of 224 patients. In contrast, we served 15 D- patients per month (PPM). Between 21-33% of D+ patients received D- units. O blood type was the most common, with an average of 224 PPM, followed by A blood type at 57 PPM and B blood type at 51 PPM. Since we see an average of 10 AB blood type patients monthly, it wasn’t surprising that they all received non-type specific units. Noteworthy is the significant proportion of A and B blood type patients receiving ABO type-specific units, ranging from 74-85% for A blood type and 70-90% for B blood type. Conclusion Our institution’s commitment to hemovigilance and conservation of O units is evident in the relatively high percentage of patients receiving ABO-type specific units. It is worth noting that we are a tertiary institution mainly serving the African American population. This creates a unique need to maintain adequate O units for emergency transfusion and increase the possibility of using O units to meet our sickle cell disease patients’ needs. Given that our demographics are primarily D+, some of our D- units were utilized in D+ patients. By adhering to our transfusion protocol and surveying our patients’ ABO and D blood types, we can anticipate our inventory needs and help prevent future O pRBC shortages.

Phenotype harmonization and analysis for The Populations Underrepresented in Mental illness Association Studies (the PUMAS Project).

The Populations Underrepresented in Mental illness Association Studies (PUMAS) project is attempting to remediate the historical underrepresentation of African and Latin American populations in psychiatric genetics through large-scale genetic association studies of individuals diagnosed with a serious mental illness [SMI, including schizophrenia (SCZ), schizoaffective disorder (SZA) bipolar disorder (BP), and severe major depressive disorder (MDD)] and matched controls. Given growing evidence indicating substantial symptomatic and genetic overlap between these diagnoses, we sought to enable transdiagnostic genetic analyses of PUMAS data by conducting phenotype alignment and harmonization for 89,320 participants (48,165 cases and 41,155 controls) from four cohorts, each of which used different ascertainment and assessment methods: PAISA n=9,105; PUMAS-LATAM n=14,638; NGAP n=42,953 and GPC n=22,624. As we describe here, these efforts have yielded harmonized datasets enabling us to analyze PUMAS genetic variation data at three levels: SMI overall, diagnoses, and individual symptoms. In aligning item-level phenotypes obtained from 14 different clinical instruments, we incorporated content, branching nature, and time frame for each phenotype; standardized diagnoses; and selected 19 core SMI item-level phenotypes for analyses. The harmonization was evaluated in PUMAS cases using multiple correspondence analysis (MCA), co-occurrence analyses, and item-level endorsement. We mapped >6,895 item-level phenotypes in the aggregated PUMAS data, in which SCZ (44.97%) and severe BP (BP-I, 31.53%) were the most common diagnoses. Twelve of the 19 core item-level phenotypes occurred at frequencies of > 10% across all diagnoses, indicating their potential utility for transdiagnostic genetic analyses. MCA of the 14 phenotypes that were present for all cohorts revealed consistency across cohorts, and placed MDD and SCZ into separate clusters, while other diagnoses showed no significant phenotypic clustering. Our alignment strategy effectively aggregated extensive phenotypic data obtained using diverse assessment tools. The MCA yielded dimensional scores which we will use for genetic analyses along with the item level phenotypes. After successful harmonization, residual phenotypic heterogeneity between cohorts reflects differences in branching structure of diagnostic instruments, recruitment strategies, and symptom interpretation (due to cultural variation).

Semi-Supervised Triply Robust Inductive Transfer Learning

In this work, we propose a Semi-supervised Triply Robust Inductive transFer LEarning (STRIFLE) approach, which integrates heterogeneous data from a label-rich source population and a label-scarce target population and uses a large amount of unlabeled data simultaneously to improve the learning accuracy in the target population. Specifically, we consider a high dimensional covariate shift setting and employ two nuisance models, a density ratio model and an imputation model, to combine transfer learning and surrogate-assisted semi-supervised learning strategies effectively and achieve triple robustness. While the STRIFLE approach assumes the target and source populations to share the same conditional distribution of outcome Y given both the surrogate features S and predictors X , it allows the true underlying model of Y⏧ X to differ between the two populations due to the potential covariate shift in S and X . Different from double robustness, even if both nuisance models are misspecified or the distribution of Y⏧ S , X is not the same between the two populations when the shifted source population and the target population share enough similarities, the triply robust STRIFLE estimator can still partially use the source population when the shifted source population and the target population share enough similarities. Moreover, it is guaranteed to be no worse than the target-only surrogate-assisted semi-supervised estimator with an additional error term from transferability detection. These desirable properties of our estimator are established theoretically and verified in finite samples via extensive simulation studies. We use the STRIFLE estimator to train a Type II diabetes polygenic risk prediction model for the African American target population by transferring knowledge from electronic health records linked genomic data observed in a larger European source population. Supplementary materials for this article are available online, including a standardized description of the materials available for reproducing the work.

MNGA-04 SOCIOECONOMIC DISPARITIES IN ACCESS TO SUBSPECIALTY CARE FOR MENINGIOMA PATIENTS: A LITERATURE REVIEW

Abstract Meningiomas, the most prevalent brain tumors, constitute nearly 40% of all head tumors, with the majority being benign. Presenting symptoms vary widely, including headaches, vision changes, seizures, and extremity weakness. Given the frequency of meningiomas and their diverse symptoms, access to subspecialty care is crucial for determining treatment necessity. However, existing global healthcare disparities often limit access to the necessary subspecialty care for addressing meningiomas. This literature review investigates the impact of socioeconomic disparities on neuro-oncologic care access, drawing from retrospective cohort studies and multi-cohort analyses. PubMed was utilized to search for articles published between 2000 and 2024, focusing on the relationship between socioeconomic status (SES) and care access, treatment, and outcomes among meningioma patients. Demographic analyses across studies revealed disparities in access to care across age groups, from young adults (20-39 years old) to the elderly (60 years and older). Additionally, disparities were noted among racial and ethnic groups, including African American, Hispanic, and Caucasian populations. Geographic disparities were also evident, with studies spanning regions within the United States and globally, underscoring variations in healthcare access and outcomes. Findings consistently emphasized the disproportionate burden borne by individuals from lower SES backgrounds, characterized by delayed diagnosis, limited treatment options, and poorer survival rates compared to their higher SES counterparts. Structural barriers, such as inadequate health literacy, limited insurance coverage, and geographical constraints, were significant contributors to these disparities, perpetuating health inequities among meningioma patients. Addressing disparities requires comprehensive interventions, including policy reforms to improve insurance coverage, enhance specialist access, and promote culturally sensitive care. Prioritizing initiatives targeting socioeconomic barriers ensures equitable care for all meningioma patients. In conclusion, concerted efforts at all levels are needed to dismantle structural barriers and foster equitable healthcare access and delivery.

Degree of Food Processing Is Associated With Glycemic Control in African American Adults With Type 2 Diabetes: Findings From Texas Strength Through Resilience in Diabetes Education Clinical Trial

BackgroundType 2 diabetes mellitus (T2DM) disproportionately affects African American (AA) populations. Despite the importance of diet in diabetes management, the association of diet quality and/or the degree of food processing with glycemic control in AA adults with T2DM remains unclear. ObjectiveThis study aimed to examine associations between diet quality scores and the degree of processing in the diet with glycosylated hemoglobin (HbA1c) level in AA adults with T2DM. DesignThis cross-sectional study used baseline data from participants in Texas Strength Through Resilience in Diabetes Education, an ongoing clinical trial. Participants/settingParticipants involved in this analysis (N = 273) were AA adults with T2DM recruited through local churches in Austin, TX, and the surrounding areas from August 2020 through April 2023. Main outcome measuresParticipants provided 2 24-hour dietary recalls (1 weekend and 1 weekday) and a blood sample to measure HbA1c level. Healthy Eating Index 2015, Alternative Healthy Eating Index 2010, and Alternate Mediterranean Diet scores were calculated. The NOVA method was used to calculate the percentage of grams and calories that came from ultraprocessed foods and unprocessed or minimally processed foods. Statistical analyses performedLinear regression and analysis of variance models tested associations between the diet quality scores and degree of food processing with HbA1c level, adjusting for demographic covariates. Models were stratified by insulin use after finding a significant interaction with ultraprocessed foods and unprocessed or minimally processed foods. ResultsRegression analyses revealed that the percentage of grams in the total diet from ultraprocessed foods was positively associated with HbA1c level (βadj = .015; Padj = .032), whereas unprocessed or minimally processed foods were inversely associated with HbA1c level (βadj = –.014; Padj = .043). There was no significant association between any diet quality score and HbA1c level. ConclusionsIn AA adults with T2DM, only the degree of food processing was associated with HbA1c level. Future research should explore whether a causal relationship exists between food processing and HbA1c level and investigate mechanisms by which ultraprocessed foods may affect glycemic control.

The Cancer Equity Compass: Interactive maps showing the association between social determinants of health and cancer disparities.

149 Background: Cancer incidence and mortality in Black, Hispanic and Native American populations is over twice that in the White population for some prevalent cancers. A new, publicly available mapping tool, the Cancer Equity Compass (CEC), was developed to inform data-driven initiatives to improve equity by identifying community factors associated with cancer disparities. The tool is comprised of interactive maps that visually reveal correlations between two variables. Development of the tool began with assembling a group of nine advisors with expertise in cancer prevention, treatment and health equity. These experts inform the strategy, data sources, variables of interest, and stakeholder value propositions for the CEC. Methods: The data source for the CEC is a national, multi-level database developed using individual, health system, and community data, aggregated by county. For the three most common cancers in the U.S., breast, prostate and lung, screening and prevalence rates were collected from 2021 Medicare 5% research identifiable files and mortality rates from 2020 SEER Medicare rates. These metrics were each mapped with a variety of social determinants of health (SDOH) variables. Population rates for minorities, education, poverty, income and unemployment, and an air quality measure were from the Area Health Resources File. Environmental risks were derived from the Environmental Justice Index and included environmental burden (ranked 0-17 for pollution, toxic sites, built environment, transportation infrastructure and water pollution), air pollution (ranked 0-4), and social vulnerability (ranked 0-14 across socioeconomic variables). Results: Each map includes one cancer metric and one SDOH variable. Each variable is stratified to show the top quartile, middle 50%, and bottom quartile. The choropleth heat maps, created on Tableau, display 9 colors representing each combination of the three levels (>75%, 25-75%, <25%) for both mapped variables. The CEC currently has 140 maps presenting visualizations of county SDOH associations with cancer disparities. Conclusions: The expert advisors on the project have outlined four avenues for the CEC to aid efforts to improve cancer equity: 1) Enhance diversity in clinical trial recruitment and data registries through targeted site recruitment; 2) Identify high opportunity targets for improving equity and informing solutions; 3) Identify common correlates of disparities within and across U.S. counties to direct priorities for national policy and programs for large-scale impact; and 4) Measure change to support improvement efforts and report impact of equity initiatives. The CEC will be expanded with additional measures including healthcare access. The goal is use by stakeholders and changemakers who can apply the reported data to fuel advocacy efforts and enact positive change.

S1710 Evolving Patterns of Cirrhosis Etiology in the Era of Direct-Acting Antivirals on in a Predominately African American Population

S1710 Evolving Patterns of Cirrhosis Etiology in the Era of Direct-Acting Antivirals on in a Predominately African American Population

Psychometric Assessment of Anxiety Measures in a Pilot Study of African American Patients with Obstructive Sleep Apnea.

African American patient populations are disproportionately diagnosed with severe obstructive sleep apnea (OSA) compared to non-Hispanic white adults. Research suggests a link between OSA and anxiety. However, OSA and anxiety symptoms may present differently across minority groups. Research examining the reliability and validity of measures used to assess anxiety symptom severity in African American patient populations living with OSA is needed. This pilot study evaluated the reliability and validity of the Patient Reported Outcomes Measurement Information System (PROMIS) Anxiety short form and the longer State-Trait Anxiety Inventory-State (STAI-S) in a sample of African American adults recently diagnosed with OSA. In this cross-sectional pilot study, 32 African American patients newly diagnosed with OSA were recruited from an academic sleep medicine clinic in the Southeastern United States to complete survey measures. Participants completed the 6-item PROMIS Anxiety short form and 20-item STAI-S. Cronbach's alphas assessed the internal reliability of measures, and concurrent validity between measures was assessed using correlation coefficients (rs). Both PROMIS Anxiety and STAI-S showed excellent internal consistency with Cronbach's α ≥.90. The PROMIS Anxiety T-scores and STAI-S scores were positively moderately correlated with each other (rs = .68; p < .0001), indicating concurrent validity. These results illustrate that both the PROMIS Anxiety and STAI-S scales have strong internal reliability in this sample of African American adults with co-occurring OSA and prediabetes. The brief PROMIS Anxiety short-form measure is validated to the longer STAI measure in this sample. An advantage of the PROMIS Anxiety scale is that it has a lower participant burden when completing questionnaires, contributing to a more refined approach to diagnosis and management when both OSA and anxiety coexist. These findings also underscore the importance of validating psychometric measures in marginalized populations, such as African Americans, who have historically been underrepresented in psychometric research.