American Adults Research Articles

Abstract B119: Evaluation of a navigator training program to increase clinical trials and genomic research participation among adult African Americans and Hispanics residing in the Southern United States

Abstract Introduction: Patient Navigators (PNs) have have proven to be effective along the cancer care continuum. However, emerging data suggest that the scope of patient navigation should be expanded to include other contexts such as the recruitment of racial/ethnic minorities for cancer clinical trials. Because the processes of recruitment and retention are often linked, the same barriers hindering minority recruitment often hinder minority retention. The potential benefits of studying generalizability and statistical power for subgroup analyses may be lost with disproportionately high attrition among the enrolled minorities. The dual focus of the training curriculum on both recruitment and retention distinguishes it from the few previous efforts focused on the traditional PN model for minority recruitment in clinical trials and genomic research studies. Methods: A two-phased navigator training program was implemented. Components of the training program was adapted in collaboration, with the Joint Cancer Advisory Council and Bioethics Co-Leaders, from the existing UAB IMPACT Patient Navigation Training Curriculum. A systematic literature review will be conducted to identify the most salient genomic educational and resource needs and concerns of AAs and Hispanic populations regarding participation in genomic-focused research and clinical trials. These findings informed the adaptation of the training curriculum based on principles of adult education. Results: We conducted a joint training for the Clinical Trials and Genomic Navigators at each Partnership institution (MSM, TU, UAB) for the proposed project. The Co-Leaders from the Partnership Outreach Cores, the Bioethics Shared Resource, and the Joint Cancer Advisory Council planned and assigned responsibilities and dates for completion of the training activities. The initial training was the GW Navigator On-line Training Program. A supplemental training was held at one of the partnering sites, a safety-net hospital (Grady Cancer Center for Excellence). The in-person training featured an overview presentation on Genetic Risk Assessment in Oncology by a licensed genetic counselor, followed by a case study approach to enrollment and the implementation of a research study with training materials such as tablets provided by the training conductors. An evaluation was completed by the team for training conductors. The third training was held at Tuskegee University and ttopics included the importance of consent training. For this presentation, we will present the qualitative and quantitative findings. Conclusions: The training outcomes were standardized and included input from the Bioethics Co-Leaders and JCAR members. We measured changes over time (pre vs. posttest) in: 1) knowledge and skills of clinical trials and genomic research; 2) ability to identify barriers and solutions to participation in research, 3) ability to implement the two toolkits, and 4) level of ease in identifying open protocol research studies and clinical trials. Citation Format: Osato Eke, Makeeta Rayton, Teresa Hall, Lleana Barrios-Zermeno, Jennier Culbertson, Angela Morris, Vivian Carter, Yu-Mei Schoenberger, Victoria Churchill, Desiree Rivers, Stephen Sodeke, Mohamed Mubasher, Roland Matthews, Brian Rivers. Evaluation of a navigator training program to increase clinical trials and genomic research participation among adult African Americans and Hispanics residing in the Southern United States [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B119.

Association between C-reactive protein, Life's Essential 8, and mortality in American adults: Insights from NHANES 2005–2010 data analysis

ObjectiveTo evaluate the independent, mediating, interactive, and associated effects of C-reactive protein (CRP) and Life's Essential 8 (LE8) on all-cause and cardiovascular mortality. MethodsUtilizing data from 10,043 participants in the NHANES 2005–2010, we employed Cox proportional hazards regression models and causal mediation analysis to investigate the joint and interactive effects of Life's Essential 8 (LE8) and C-reactive protein (CRP) on mortality risk. ResultsDuring an average follow-up of 137.10 months, there were 1591 all-cause deaths and 485 cardiovascular deaths. Weighted linear regression showed that for patients with low cardiovascular health (CVH), the adjusted β was −0.22 (95 % CI: −0.27 to −0.17) for moderate cardiovascular health (CVH) and -0.36 (95 % CI: −0.43 to −0.30) for high cardiovascular health (CVH). Mediation analysis revealed that C-reactive protein (CRP) mediated 10.43 % of all-cause mortality and 9.20 % of cardiovascular mortality for moderate cardiovascular health (CVH) compared to low cardiovascular health (CVH), and 9.95 % and 8.32 % respectively for high cardiovascular health (CVH) compared to low cardiovascular health (CVH). No significant multiplicative or additive interactions between Life's Essential 8 (LE8) and C-reactive protein (CRP) were found in all-cause mortality or cardiovascular mortality. Individuals with high cardiovascular health (CVH) and the first quartile of C-reactive protein (CRP) had HRs of 0.30 (95 % CI 0.18–0.48) for all-cause mortality and 0.31 (95 % CI 0.13–0.74) for cardiovascular mortality compared to those with low cardiovascular health (CVH) and the fourth quartile of C-reactive protein (CRP). ConclusionThese findings suggest that CRP could significantly influence the relationship between cardiovascular health (CVH) and mortality. Interventions that target both lifestyle factors and CRP levels may improve cardiovascular health and potentially lower mortality risks.

Abstract B091: Listen, Empower, Co-Create: Conducting listening sessions to create tailored messages about colorectal health for American Indian communities

Abstract Background We conducted Listening Sessions using a modified version of boot camp translation (BCT), a validated community engaged approach, to engage American Indian community members in the Great Plains and the Pacific Northwest to develop culturally and locally relevant colorectal cancer (CRC) screening messages and materials. Methods CRC is one of the leading causes of cancer death in the US and disproportionally affects American Indian adults. Routine CRC screening leads to earlier diagnosis and prolonged survival from the disease. In partnership with Great Plains Tribal Leaders Health Board (GPTLHB), South Puget Intertribal Planning Agency (SPIPA), and National Association of Chronic Disease Directors, we used a modified BCT approach to obtain feedback from tribal communities to create CRC screening messages and materials. To make the BCT process more meaningful for our partner communities, we reframed the BCT sessions by referring to them as Listening Sessions. The Listening Session engagement process was designed to help community leaders and champions learn about local barriers and gaps in care (listen), share health information in a collaborative way (empower), and develop messages and materials that resonate with and motivate community members to take control of their health (co-create). Eligible tribal community members from GPTLHB and SPIPA were between the ages of 45-75 and able to participate in three Listening Session meetings (one five-hour in-person meeting including expert presentations, brainstorming opportunities, and interactive small group sessions, and two follow-up virtual sessions (one-hour each) to refine messages and materials). Results Common Themes. Both groups emphasized the importance of using a multigenerational approach by including grandchildren and Elders in the messages and materials. Additionally, they highlighted the need for materials to be relatable and culturally relevant by incorporating local cultural imagery and traditions and multigenerational family support .Differing Themes. The GPTLHB findings focused specifically on including Lakota words to reinforce cultural identity, using visuals for colon health education, and incorporating details about healing traditions. The SPIPA findings recommended highlighting intertribal milestones like the canoe journey and incorporating water as a symbol of spiritual healing. Materials and Dissemination Methods. Preferred materials and channels for dissemination were: 1) fact sheets, posters, and visual stories to be distributed in-clinic or at community events, 2) animated videos for CRC screening education to be shown in clinic, 3) live action videos with community member CRC stories to be shown in clinic. Final materials will be available here: www.KPCHR-engage.org Conclusion We conducted Listening Sessions to incorporate participant feedback to develop CRC screening messages and materials and identified preferred dissemination channels for tribal communities in the Great Plains and Pacific Northwest. Citation Format: Jamie Thompson, Jennifer Rivelli, Priyanka Gautom, LaToya Brave Heart, Jamie Nikander, Lorrie Graaf, Gloria Coronado. Listen, Empower, Co-Create: Conducting listening sessions to create tailored messages about colorectal health for American Indian communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B091.

Abstract A069: Leading causes of death among Asian American individuals compared with Pacific Islander individuals in the United States, 2018-2020

Abstract Background: Asian American and Pacific Islander races are two distinct groups that continue to be aggregated in many large, national mortality statistics in the United States (US), which leads to structural biases encoded into databases and inaccurate health implications that may deprive Pacific Islander individuals from opportunities for interventions aimed at reducing health disparities. Examining mortality rates for disaggregated Asian American and Pacific Islander populations across all 50 states was not possible until 2018. We compared the leading causes of death between Asian American and Pacific Islander individuals in the US during 2018-2020, stratified by sex and age. Methods: Cause of death among non-Hispanic Asian American and Pacific Islander individuals aged ≥20 years who died during 2018-2020 were obtained from the US National Center for Health Statistics. Age-standardized all-cause mortality rates (MRs) and the 5 leading causes of death were reported per 100,000 person-years separately for Asian American and Pacific Islander individuals, by sex (female/male) and age (20-54/55-64/65-74/75- 84 years). MR ratios (MRRs) were calculated by comparing MRs among Pacific Islander with Asian American individuals (reference group), by sex and age. Results: During 2018-2020, 63,338 female and 85,601 male deaths occurred among Asian American adults, and 4,116 female and 5,512 male deaths occurred among Pacific Islander adults. Compared to Asian American individuals, all-cause mortality was higher for Pacific Islander females (MRR=2.50,95%CI=2.43-2.59) and males (MRR=2.10,95%CI=2.04-2.16). Cancer was the leading cause of death for Asian American (MR=93.8) and Pacific Islander females (MR=181.6) and second for Asian American (MR=100.4) and Pacific Islander males (MR=185.2) after heart disease. Death rates for leading causes were substantially higher for Pacific Islander compared to Asian American females: cancer (MRR=1.93,95%CI=1.82-2.06), heart disease (MRR=3.18,95%CI=2.95-3.42), stroke (MRR=2.41,95%CI=2.13-2.73), diabetes (MRR=4.03,95%CI=3.55-4.56), and COVID-19 (MRR=2.60,95%CI=2.25-3.01) and for Pacific Islander compared to Asian American males: heart disease (MRR=2.56,95%CI=2.42-2.71), cancer (MRR=1.52,95%CI=1.42-1.62, diabetes (MRR=3.14,95%CI=2.81-3.50), accidental death (MRR=2.60,95%CI=2.33-2.88), and COVID-19 (MRR=2.04,95%CI=1.82-2.27). The largest relative cancer mortality rate disparity occurred in those aged 20-54 years and declined with older age among women (MRR range=1.37-2.67) and men (MRR range=1.16-2.26). Conclusion: Cancer was among the leading cause of death for both Asian American and Pacific Islander individuals, but cancer mortality rates were twice as high among Pacific Islander women and men compared to Asian American women and men. These disparities persisted among Pacific Islander individuals for nearly all leading causes of death, regardless of sex and age, underscoring the need to disaggregate Pacific Islander from Asian American race data to improve tailored health equity-focused interventions. Citation Format: Jacqueline B. Vo, Jazmyn L Bess, Kekoa Taparra, Paloma R. Mitra, Amy Berrington de Gonzalez, Neal D. Freedman, Meredith S. Shiels, Jaimie Z. Shing. Leading causes of death among Asian American individuals compared with Pacific Islander individuals in the United States, 2018-2020 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A069.

Type 2 diabetes mellitus modifies and mediates the association between the visceral adiposity index and depression: A cross-sectional study using NHANES 2005–2018 data

BackgroundThe objective of this investigation was to explore the correlation between the visceral adiposity index (VAI) and depression, and to analyze how type 2 diabetes mellitus (T2DM) may influence this relationship. MethodsThis study included data of 12,378 participants sourced from the National Health and Nutrition Examination Survey (NHANES) 2005–2018. Utilizing multivariate logistic regression and restricted cubic spline (RCS) regression, we examined the correlation between VAI and depression. Additionally, we investigated the interactive and mediating effects of T2DM on the association between VAI and depression. ResultsControlling for all potential confounders, the Ln logarithmic transformation of VAI showed a significant positive correlation with depression [odds ratio (OR) = 1.16, 95 % confidence interval (CI): 1.01–1.35, P = 0.041]. T2DM exhibited a notable interaction effect on the relationship connecting lnVAI and depression (P for interaction = 0.013). Specifically, the T2DM group exhibited a notable positive correlation between lnVAI and depression (OR = 1.46, 95 % CI: 1.17–1.82, P < 0.001), whereas such correlation didn't reach statistical significance within the non-T2DM group. The RCS model revealed a J-shaped nonlinear link between lnVAI and depression, with an inflection point value of 0.052. Mediation analysis indicated that diabetes accounted for 8.0 % of the correlation between lnVAI and depression. Furthermore, sensitivity analysis confirmed the consistency of these findings. ConclusionsA J-shaped nonlinear dose-response relationship was observed between lnVAI and depression among American adults, with a threshold of 0.052. T2DM not only served as a mediator between the two variables but also modified their association.

Associations between well-being and nature-based recreation: A cross-sectional study among adults in the United States, Brazil, and Spain

Growing evidence suggests that engagement in nature-based recreation can improve people's well-being. However, there is a lack of information regarding which specific nature-based recreation activities are related to specific well-being indicators. We conducted a cross-sectional study to explore how different types of nature-based recreation (i.e., any nature-based activities, forest-based activities, gardening, nature-based adventure activities) relate to five indicators of well-being on the WHO-5 index among American (n = 606), Brazilian (n = 448), and Spanish (n = 438) adults. Americans and Brazilians who reported engaging in nature-based recreation at least monthly in the last 12 months, or weekly during a typical week, were more likely to feel cheerful, relaxed, vigorous, rested after waking up, and interested in life than those who did not engage that frequently. Results in these two countries were similar across all five indicators of well-being and types of nature-based activity, except for gardening, where we observed slightly weaker correlations. In Spain, the correlation between nature-based recreation and well-being tended to be null or even negative, highlighting some variability in these relationships across countries. Further cross-country experimental work is needed to support these findings and identify the relative efficacy of specific nature-based interventions for enhancing human well-being around the world.

Validation of Short-Form Scales of Self-Control, Procedural Justice, and Moral Foundations

Self-control, perceived procedural justice, and moral foundations are prominent theoretical constructs in the criminological literature. However, existing measures of each are long. Long scales crowd questionnaires, increase cognitive burden, and lengthen completion times. Using a set of heuristic guidelines for scale construction, we develop short measures of self-control, procedural justice, and moral foundations and then test experimentally whether they can replace the existing longer versions. We conducted a series of split-ballot experiments with a national sample of American adults (N = 1191). Respondents were randomly assigned to receive the existing long scale or our shorter version. We then compared the scales on factor structure, reliability, and validity. The short scales performed as well, and sometimes better than, the longer versions. Our results suggest that researchers can use our short scales of self-control, procedural justice, and moral foundations in lieu of the existing long scales while maintaining data quality.

Association of diastolic and systolic blood pressure with depression: a cross-sectional study from NHANES 2005-2018.

Many studies worldwide have reported the association between mental health and blood pressure, but the results are mixed, and even contradictory. We aim to investigate the relationship between systolic and diastolic blood pressure and depression in the entire US population. This study analyzed cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. All adults completed 3-4 blood pressure measurements after sitting quietly for 5 minutes. Depression was diagnosed based on the Patient Health Questionnaire (PHQ-9), with a score ≥10 defined as depression. Weighted logistic regression and restricted cubic splines (RCS) were used to assess the relationship between blood pressure and depression. Two-piecewise linear regression was used to determine the inflection point. Additionally, subgroup analyses and interaction tests were conducted to identify potential subgroups. Finally, two sensitivity analyses were conducted. A total of 26,581 American adults were included, with a mean age of 47.2 years, of whom 13,354 (49.54%) were male; 2,261 individuals were defined as depressed, with a weighted prevalence of 7.41%. All participants' mean systolic blood pressure (SBP) was 121.7 mmHg, and the mean diastolic blood pressure (DBP) was 70.9 mmHg. RCS showed a nonlinear association between SBP and depression, while DBP showed a positive linear association with depression. Two-piecewise linear regression showed that the inflection point of the association between SBP and depression was 129.7 mmHg. Weighted logistic regression showed that after fully adjusting for depression-related risk factors, there was a significant positive correlation between per 10 mmHg increase in DBP and depression (OR: 1.06, 95% CI: 1.00-1.12, P=0.04); however, only on the left side of the inflection point, SBP tended to decrease the odds of depression (P =0.09). Furthermore, interaction analysis showed that the association between DBP and depression was significantly stronger in cancer patients (P for interaction=0.02); on the left side of the inflection point (<129.7 mmHg), current smokers also significantly interacted with SBP (P for interaction=0.018). Finally, two sensitivity analyses also supported our findings. In the adult population of the United States, there is a positive linear association between DBP and depression, while the association between SBP and depression exhibits a significant threshold effect, maintaining SBP at 129.7 mmHg is associated with the lowest prevalence of depression.

Asthma and Obstructive Sleep Apnea Overlap in a Sample of Older American Indian Adults: The Strong Heart Study.

Study Objectives: Our study aimed to investigate the association between asthma and obstructive sleep apnea (OSA) in American Indian communities, a historically underrepresented population in clinical research with a high prevalence of asthma and OSA risk factors like smoking and obesity. Methods: This cross-sectional study used data retrieved from the Strong Heart Study cohort. Participants who attended both the Asthma Sub-study and the Sleep Heart Health Study around the same time were compared for active asthma diagnosis, OSA diagnosis, and potential risk factors for asthma and OSA. The association between asthma and OSA was then evaluated. Results: Among the 2480 participants who attended the Strong Heart Study Phase III exam, 123 participated in both the Asthma Sub-study and the Sleep Heart Health Study. Of these, 13 were diagnosed with OSA, with 4 having moderate to severe OSA. There was no statistically significant difference in OSA prevalence between the active asthma group and the non-active asthma group (former asthma or no asthma) (9.6% vs. 12.5%, p = 0.63). Additionally, body mass index did not differ significantly between participants with both active asthma and OSA and those without active asthma, OSA, or both. OSA diagnosis was significantly associated with male sex (Odds Ratio [OR] 9.2 [1.85-45.87], p = 0.007) and body mass index (OR 1.1 [1.02-1.26], p = 0.016) but not with age or a diagnosis of active asthma. Conclusions: In this American Indian cohort, no significant difference in OSA prevalence was observed between participants with and without active asthma, contradicting previous studies. Further research is needed to explore the underlying reasons for this discrepancy.

You don’t understand me! But, I do! Awareness of cross-generational differences in collective remembering of national historic events

ABSTRACT Collective memories refer to a group’s shared representation of the past, which are slow to change over time. In this study, representative samples of American and German Younger Adults (YAs) and Older Adults (OAs) rated the emotional valence of 12 national historic events. Critically, both age groups were also asked to take on the perspective of the other: OAs imagined how YAs feel, whereas YAs imagined how OAs feel about the same events today. The results replicated previous findings that OAs and YAs hold differing opinions on numerous events. Both age groups successfully recognised these different collective perceptions between generations to some extent. Yet, OAs were more accurate in the perspective-taking task, with YAs consistently underestimating the intensity of OAs’ emotional valence. Self-reported perspective-taking strategies suggest that OAs relied more on stereotypes and considered education, while knowledge from specific people was universally used to rate the other age group’s perspective.

Gender-specific correlations between remnant cholesterol and severe abdominal aortic calcification in American adults.

Remnant cholesterol (RC) predicts cardiovascular risk and is associated with a range of diseases, including asthma, hypertension, depression, periodontitis, and alcoholic fatty liver disease. However, its correlation with abdominal aortic calcification (AAC) has not been reported. Using a cross-sectional approach, this study examined data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) cycle. Multiple logistic regression, generalized summation models, and subgroup analyses were used in examining the correlation between RC and the prevalence of severe AAC. The mean age of participants in this study was 57.70 ± 11.73 years, with 142 individuals (9.67%) suffering from severe AAC. The median RC was 0.52 mmol/L (Q1-Q3, 0.36-0.75 mmol/L). Among female participants, a significant positive correlation was observed between RC and severe AAC (per natural log [RC] increment: 2.14; 95% CI, 1.07-4.27). Smooth curve fitting and threshold effect analysis revealed a saturation effect at an RC level of 0.57 mmol/L. Conversely, in male participants, no significant correlation was found between RC and the prevalence of severe AAC (per natural log [RC] increment: 0.88; 95% CI, 0.43-1.78). Our findings suggest a significant interaction between gender and RC in relation to severe AAC (P for interaction = 0.0042). Higher RC levels were significantly associated with an increased prevalence of severe AAC in women.

Racial and Ethnic Differences in the Prevalence of Severe Aortic Stenosis by Echocardiography.

Understanding the burden of aortic stenosis (AS) across diverse racial and ethnic populations is important to ensure equitable resource allocation. This study explored whether severe AS rate varies by race and ethnicity. The rates of severe AS, stratified by race and ethnicity, were calculated among 615,038 adults with a transthoracic echocardiogram. Logistic regression analysis was performed to identify factors associated with severe AS. Severe AS rates ranged from 0.08% in adults < 50 years old to 3.8% in those ≥ 90 years old. Compared to non-Hispanic White and Asian American [adjusted odds ratio (aOR) = 0.47, 95% confidence interval (CI): 0.42-0.53] and non-Hispanic Black (aOR = 0.44, 95% CI: 0.39-0.50) patients were less likely to have severe AS, whereas Hispanic patients (aOR = 0.91, 95% CI: 0.87-0.98) had near similar likelihood. Age was the strongest risk factor for severe AS (compared to age < 50 years, aOR = 21.8, 95% CI: 17.8-26.6 for age 80-89 years, and aOR = 43.8, 95% 35.5-54.0 for age ≥ 90 years). Additional factors associated with severe AS included male sex (aOR = 1.38, 95% CI: 1.30-1.46) and diabetes (aOR = 1.23, 95% CI: 1.15-1.31). Asian American and non-Hispanic Black adults had lower rates of severe AS compared to White and Hispanic patients. The rate of severe AS progressively increases with age in all racial and ethnic groups, with higher rates in men compared with women. With a demographic shift toward an aging and more diverse population, the burden of AS is anticipated to rise. Ensuring adequate allocation of resources to meet the evolving needs of a diverse population remains a shared health care imperative.

Accelerated Longitudinal Glycemic Changes in Relation to Urinary Toxic/Essential Metals and Metal Mixtures Among Mexican Americans Living in Starr County, Texas.

Metal and metalloid exposures (hereafter "metals") are associated with adverse health outcomes, including type 2 diabetes; however, previous studies were largely cross-sectional or underpowered. Furthermore, underserved racial and ethnic groups are underrepresented in environmental health research despite having higher rates of type 2 diabetes and a greater risk of metal exposures. Consequently, we evaluated continuous glycemic traits in relation to baseline urinary toxic metal, essential metal, and metal mixtures in a cohort of Mexican American adults. A total of 510 participants were selected based upon self-reported diabetes status and followed over 3 years. Urinary metals were assessed at baseline. Linear mixed-effects models were used to estimate per-month changes in hemoglobin A1c, fasting plasma glucose, and postload glucose in relation to urinary metal levels. Multiple statistical approaches were used to assess the associations between glycemic traits and metal mixtures. After adjustment, higher urinary levels of arsenic, selenium, copper, molybdenum, nickel, and tin were associated with faster increases in measures of glycemia. The toxic metal mixture composed of arsenic, lead, cadmium, nickel, and tin was associated with faster increases in postload glucose. Using postload glucose criteria, highest versus lowest arsenic was predicted to accelerate conversion of normoglycemia to prediabetes and diabetes by 23 and 65 months, respectively. In this underrepresented, high-risk Mexican American population, exposure to toxic metals and alterations in essential metal homeostasis were associated with faster increases in glycemia over time that may accelerate type 2 diabetes development.

Conspiratorial thinking in a 50-state survey of American adults.

While the NIMH Research Domain Criteria framework stresses understanding how neuropsychiatric phenotypes vary across populations, little is known outside of small clinical cohorts about conspiratorial thoughts as an aspect of cognition. We conducted a 50-state non-probability internet survey conducted in 6 waves between October 6, 2022 and January 29, 2024, with respondents age 18 and older. Respondents completed the American Conspiratorial Thinking Scale (ACTS) and the 9-item Patient Health Questionnaire (PHQ-9). Survey-weighted regression models were used to examine sociodemographic and clinical associations with ACTS score, and associations with vaccination status. Across the 6 survey waves, there were 123,781 unique individuals. After reweighting, a total of 78.6% of respondents somewhat or strongly agreed with at least one conspiratorial idea; 19.0% agreed with all four of them. More conspiratorial thoughts were reported among those age 25 - 54, males, individuals who finished high school but did not start or complete college, those with household income between $25,000 and $50,000 per year, and those who reside in rural areas, as well as those with greater levels of depressive symptoms. Endorsing more conspiratorial thoughts was associated with a significantly lower likelihood of being vaccinated against COVID-19. A substantial proportion of US adults endorsed at least some conspiratorial thinking, which varied widely across population subgroups. The extent of correlation with non-vaccination suggests the importance of considering such thinking in designing public health strategies.

Understanding the rationales and information environments for early, late, and nonadopters of the COVID-19 vaccine

Anti-vaccine sentiment during the COVID-19 pandemic grew at an alarming rate, leaving much to understand about the relationship between people’s vaccination status and the information they were exposed to. This study investigated the relationship between vaccine behavior, decision rationales, and information exposure on social media over time. Using a cohort study that consisted of a nationally representative survey of American adults, three subpopulations (early adopters, late adopters, and nonadopters) were analyzed through a combination of statistical analysis, network analysis, and semi-supervised topic modeling. The main reasons Americans reported choosing to get vaccinated were safety and health. However, work requirements and travel were more important for late adopters than early adopters (95% CI on OR of [0.121, 0.453]). While late adopters’ and nonadopters’ primary reason for not getting vaccinated was it being too early, late adopters also mentioned safety issues more often and nonadopters mentioned government distrust (95% CI on OR of [0.125, 0.763]). Among those who shared Twitter/X accounts, early adopters and nonadopters followed a larger fraction of highly partisan political accounts compared to late adopters, and late adopters were exposed to more neutral and pro-vaccine messaging than nonadopters. Together, these findings suggest that the decision-making process and the information environments of these subpopulations have notable differences, and any online vaccination campaigns need to consider these differences when attempting to provide accurate vaccine information to all three subpopulations.

The Impact of Social Determinants of Health and Acculturation on Quality of Life in Older Chinese American Adults With Chronic Pain: A Quantitative Study.

As of 2019, the United States houses 5.3 million Chinese Americans (CA), with 689,000 being older adults. The purpose of this study was to examine the relationships between social determinants of health (SDOH) and acculturation on quality of life in CA older adults, an underresearched area. Using a quantitative correlational descriptive design, CA older adults (n = 110) in NYC with chronic pain were examined. Data were collected by utilizing the PRAPARE Screening Tool, Asian American Acculturation Scale, and SF-12 Questionnaire. Regression revealed a negative correlation between SDOH and quality of life (p = .001). The acculturation's impact was nonsignificant (p = .647). While SDOH significantly impacted the quality of life, acculturation did not significantly predict the quality of life for older Chinese American adults with chronic pain. Further research is warranted to explore the nuanced dynamics between acculturation, SDOH, and quality of life in this population.

Association of sleep patterns and disorders with metabolic dysfunction-associated steatotic liver disease and liver fibrosis in contemporary American adults

Introduction and ObjectivesThe impact of sleep on metabolic dysfunction-associated steatotic liver disease (MASLD) in American adults remains unclear. This study aimed to address the relationship of sleep patterns and disorders with MASLD and liver fibrosis comprehensively. Materials and MethodsThis cross-sectional study included adult participants from the National Health and Nutrition Examination Survey 2017-2020. Multivariate adjusted regression analysis were used to examine the association of sleep with MASLD and liver fibrosis. We further addressed these associations using restricted cubic splines, mediation analysis, stratified analysis and multiple sensitivity analysis. ResultsWe enrolled 5368 participants. Certain sleep disorders, sleep duration, high sleep debt and specific sleep-wake time were associated with MASLD. Late workday sleep was a shared risk factor for MASLD and liver fibrosis. Short sleep on workdays and free days favored MASLD, whereas average weekly long sleep protected against MASLD. Workday, free day and average weekly optimal sleep duration was 7.5 h, 8 h and 7.78 h, respectively. Mediation analysis suggested that fasting glucose and high-density lipoprotein cholesterol indirectly mediated the relationship between sleep duration and MASLD, whereas stratified analysis showed that sex influenced the relationship, and that the correlation was only observed in women and specific age groups. ConclusionsSleep duration independently affected MASLD but only in women and specific age groups. Moreover, late sleep on workdays was a shared risk factor for MASLD and liver fibrosis. These results suggest targeting sleep behaviors for MASLD prevention and developing age- and sex-specific strategies.

A - 71 Cross-Cultural Comparison of Cognitive Performance between Americans and Cameroonians while Controlling for Age and Education

Abstract Objective The development of cognitive abilities varies based on social and cultural factors. Given the expansion of neuropsychological measures internationally, an accurate understanding of performance across different countries is necessary to understand the appropriateness of different cognitive tests. To expand the existing knowledge base, this study explores the differences in cognitive test performance between Cameroonian and American adults. Methods The Cameroonian sample, 250 adults ages 22–72 (mean age = 42.91 [SD = 13.76], 52% male, mean education = 13.54 [SD = 4.58]) resided in Yaoundé, Cameroon. Participants were tested at a district center. Deidentified data from a community mental health center’s archival database comprised the American sample. A one-factor between MANCOVA examined differences in performance on selected measures between Americans and Cameroonians after controlling for age and education. Results Age and education statistically significantly affected scores on all selected subtests except for WMS-IV Logical Memory I. Additional analyses revealed that performance still differed between conditions while controlling for age (F (6, 749) = 33.87, p &amp;lt; 0.001; Wilk’s ∧ = 0.787, partial ŋ2 = 0.21), and education (F (6, 749) = 18.95, p &amp;lt; 0.001; Wilk’s ∧ = 0.868, partial ŋ2 = 0.13) for WAIS-IV Digit span, WAIS-IV Symbol search, WAIS-IV Coding, Stroop color word, and WMS Logical Memory I &amp; II subtests. Conclusion Age and education are important predictors of performance on cognitive tests. The importance of appropriately norming new assessments and re-norming older assessments is underscored when those variables are controlled for and differences in performance are maintained between the two conditions. Current findings indicate that cultural differences and their effect on cognitive development explain performance beyond age and education level.

B - 68 Executive Functioning Skills of Verbal and Emotional Intelligence and Borderline Personality Predict Posttraumatic Growth

Abstract Objective Research found a positive connection between emotional intelligence and both borderline personality and posttraumatic growth. Prior research has not examined the combination of emotional intelligence, borderline personality, and cognitive intelligence as predictors of posttraumatic growth (PTG); our research helped fill this gap. Method American adults (N = 402; M age = 38.7 years, SD = 13.0) were recruited from Prolific to complete an online survey including Shipley Institute of Living Scale-2, Assessing Emotions Scale, Posttraumatic Growth Inventory-Expanded, and screening questionnaire for DSM-5 Personality Disorders. PTG was measured in relation to any previous trauma. Participants reported being white (67.2%), African American/Black (9.7%), Asian/Asian American (9.7%), Hispanic/Latinx (9.0%), and other ethnicities (4.5%), and men (48.0%), women (47.8%), non-binary (1.5%), transgender men (1.2%) or women (0.5%), or other genders (0.9%). Results Hierarchical regression revealed that emotional and verbal intelligence significantly predicted PTG, F(2, 391) = 78.54, p &amp;lt; 0.001, adj. R2 = 0.28, 95% CI [0.20, 0.35]. Adding borderline characteristics to the model resulted in significantly greater prediction of PTG, F(3, 390) = 61.22, p &amp;lt; 0.001, F change p &amp;lt; 0.001, and explained 32% of the variance in PTG, adj. R2 = 0.32, 95% CI [0.24, 0.39]. Greater emotional intelligence (beta = 0.535), more borderline personality characteristics (beta = 0.189), and lower verbal reasoning (beta = −0.159) predicted more PTG. Conclusion Our findings suggest that executive functions and borderline characteristics play a complex role in the development of posttraumatic growth after trauma.

Association between composite dietary antioxidant index and erectile dysfunction among American adults: a cross-sectional study

Erectile dysfunction (ED) is closely related to oxidative stress, and antioxidant is a treatment and prevention method for erectile dysfunction. The Compound Dietary Antioxidant Index (CDAI) represents the overall dietary antioxidant intake of the human body. However, the link between CDAI and ED is unclear. The objective of this research was to examine the linkage between CDAI and ED. The research utilized information collected from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2001 to 2004. To assess the association between CDAI and ED, the analysis employed weighted multivariate logistic regression along with weighted restricted cubic splines (RCS). Additionally, subgroup interaction analysis was conducted to confirm the findings. In this investigation, 3184 adults from the U.S., all above the age of 20, were part of the study cohort, with 863 of them identified as having ED. Adjustments for potential confounding variables revealed that the odds ratio (95% confidence interval) of CDAI associating with ED was 0.95 (0.92–0.99; P = 0.01). Besides, compared to the lowest tertile, the highest tertile of CDAI was associated with a lower risk of ED (0.63 [0.46–0.88]; P = 0.01). The application of weighted restricted cubic splines (RCS) analysis delineated a nonlinear inverse relationship between CDAI levels and the probability of ED. Subgroup analysis further demonstrated that the association between CDAI and ED remained consistent across subgroups. This cross-sectional analysis revealed a significant correlation, indicating that elevated levels of CDAI are closely linked with a lower likelihood of ED.