Preventive Behaviors Research Articles

Abstract B090: Assessing the relationship between family history of cancer and self-perceived cancer risk among Black adults in the United States

Abstract Introduction: Cancer family history is a risk factor for multiple cancer types. Knowing and sharing cancer family history can help inform cancer screening and genetic testing which ultimately aids in cancer prevention and early detection. There is limited knowledge about how people with cancer family history appraise their own risk of developing cancer which may influence screening and preventive behaviors, particularly among marginalized populations like Black adults. The objective of this study was to conduct a community-engaged survey to assess the relationship between self-reported cancer family history and perceived risk of developing cancer among Black adults. Methods: Using community-based recruitment methods in partnership with national Black-led organizations we conducted an online survey on cancer family history in Black communities. Individuals could participate if they self-identified as Black or African-American, were 18 or older, resided in the US, and could complete a survey in English. In the survey, participants were asked if members of their immediate families had ever been diagnosed with cancer, and if so which family members. Participant responses were categorized into: No family history, 1 family member with cancer history, 2+ family members with cancer history. Participants without a personal history of cancer were asked “On a scale of 0 to 100, what do you think your chances are of getting cancer? (0 = no chance of getting cancer and 100 = you will definitely get cancer)”, and to rate their level of agreement with the following statement “I feel I will get cancer sometime during my life.” Chi-squared and Kruskal-Wallis tests were used to assess the relationship between the number of family members with cancer and self-perceived cancer risk. Results: Overall, 100 participants from 17 states responded to the survey. Among participants, 93% were women, 84% had a bachelor’s degree or higher, and 16% reported a personal history of cancer. In total, 20% (n=20) reported no cancer family history, 30% (n=30) reported 1 family member with cancer, and 50% (n=50) reported 2 or more relatives with cancer. The mean perceived chance of developing cancer was 41.3% (95% CI: 33.6, 49.0) among people with no family history of cancer, 29.0% (95% CI: 22.2%, 35.6%) among people with one relative with cancer, and 48.2% (95% CI: 42.1, 54.2) among people with multiple relatives with a cancer history (p=0.0002). In addition, 17.6% of people with no family history, 0% with 1 relative family history, and 16.7% with 2 or more relative cancer family history somewhat or strongly agreed to the statement , “I feel I will get cancer sometime during my life,” (p=0.001). Conclusion: In this community-partnered survey of a diverse Black US adults, there was an association between number of family members with a cancer history and self-perceived risk of developing cancer. Understanding the appraisal of perceived cancer risk by level of cancer family history in Black adults could help inform targeted cancer prevention and early detection interventions. Citation Format: Mya L. Roberson, Laura Crandon, Jordyn A. Brown, Jordan Speller, Monique Gary. Assessing the relationship between family history of cancer and self-perceived cancer risk among Black adults in the 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 B090.

Abstract B038: Developing and refining a digital skin cancer intervention among Hispanics

Abstract Background: Over the last 20 years, the incidence of melanoma in Hispanic populations has increased by 20%. The mortality rate of Hispanics is higher compared to non-Hispanic whites. In general, compared to NHW, Hispanics diagnosed with melanoma are younger, have thicker tumors, and have worse survival rates. Skin cancer can be prevented with regular sun protection, and early detection can improve skin cancer outcomes. This study aimed to refine and develop a culturally relevant mobile-based skin cancer prevention intervention for Hispanics through group and individual interviews. Methods: Three focus groups of Hispanics at risk for skin cancer and eight individual interviews with key stakeholders, including healthcare providers and community leaders, were conducted via Zoom. Participants were shown culturally relevant messages developed from previous community interviews and provided further feedback to improve and enhance both the messages and intervention design. The interviews lasted for 60-90 minutes and participants received up to $70 electronic gift cards as an incentive. Results: The focus group (two in English and one in Spanish) participants (n=18), aged 18 to 60 years (M=30). Of these participants, 61.1% were female (n=11), and half reported having an educational level lower than a bachelor's degree. Additionally, more than half of the group indicated a household income below $50,000. Among the eight individual interviews with healthcare providers and community leaders, the participants aged from 18 to 56 and reported being family workers, student group leaders, church leaders, and nurses. Emerging themes from the interviews included: 1) messages and images developed from previous community interviews were relatable and informative; 2) the majority favored visuals with text, and preferred a combination of human and cartoon images; 3) information related to general sun protection and skin examination, such as melanoma and SPF needed to be included, as well as information regarding health literacy such as how to effectively find health information and communicate with a health care provider; 4) some common misconceptions, such as the effectiveness of sunscreen on dark skin and reapplication times, were identified. Additionally, participants expressed hesitancy about undergoing skin examination by oneself and/or a doctor, highlighting the importance of providing more detailed guidance to address misperceptions and enhance adherence. Gender differences in adhering to skin protection measures were evident, with women demonstrating greater commitment despite men's higher melanoma rates and sun exposure, emphasizing the need for targeting of men. Conclusions: Participants expressed satisfaction with the intervention's relevance and informativeness for skin cancer education and promoting preventive behaviors. Insights and new ideas regarding intervention design gained from both the interviews will refine the final intervention, enhancing its cultural relevance and effectiveness in preventing skin cancer among the Hispanic community. Behavioral and Social Science: Community-based Interventions Citation Format: Niu Zhaomeng, Karen Dhami, Yonaira Rivera, Emily Peters, Jemima Baskar, Carolina Lozada, Carolyn Heckman. Developing and refining a digital skin cancer intervention among Hispanics [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 B038.

Abstract A030: Racial Disparities in Cancer Beliefs among Oregon Residents

Abstract Introduction: Beliefs and perceptions about cancer risks significantly influences a person’s cancer screening and overall health behaviors. To better understand the factors associated with perceptions surrounding cancer in Oregon, this study examined racial differences in cancer risk beliefs among Oregon adults as part of the Population Health Assessment in Cancer Center Catchment Areas effort. Methods: This study utilizes data from the Understanding Cancer in Oregon (UCanOR) project, which included a 47-item cross-sectional survey capturing demographic and behavioral information. The survey was administered to participants selected through an area-based sampling strategy (51.8%) and a convenience sample (48.2%). Cancer beliefs and perceptions were assessed through five questions: 1) “There are so many different recommendations about preventing cancer, it's hard to know which ones to follow;” 2) “Cancer is most often caused by a person's behavior or lifestyle;” 3) “It seems like everything causes cancer; 4) When I think about cancer, I automatically think about death;” 5) “There is not much you can do to lower your chances of getting cancer.” Multivariable generalized linear regression and logistic regression analyses were used to assess the association between race/ethnicity and cancer beliefs either as a summed continuous variable or five specific binary variables with Agree vs. Disagree as the outcome, adjusting for confounders (age, sex, employment status, marital status, BMI, cancer history, insurance status). Results: The study included 1,357 respondents aged over 18 years old with a mean age of 50.0 (SD = 17.8), with the majority being Non-Hispanic White (87.3%), followed by Asian/Pacific Islanders (8.4%), Hispanic White (3.5%), and Black (0.8%). Asian/Pacific Islanders were significantly more likely than individuals of other racial backgrounds to have negative beliefs about cancer. Specifically, compared to Non-Hispanic White, Asian/Pacific Islanders were 2.5 times as likely to agree that “cancer is most often caused by a person’s behavior or lifestyle” [OR (95% CI) = 2.48 (1.64-3.75)] and that “there is not much you can do to lower your chances of getting cancer” [OR (95% CI) = 2.80 (1.70-4.62))], and 1.5 times as likely to agree that “when I think about cancer, I automatically think about death” [OR (95% CI) = 1.61 (1.07-2.41)]. Conclusion: This study found that Asians/Pacific Islanders in Oregon had significantly more negative cancer beliefs. In terms of future directions, interventions aimed at promoting healthy cancer prevention behaviors should particularly target Asian/Pacific Islander communities. This study enhances our ability to effectively plan and implement outreach, tailor interventions, engage patients, and recruit for clinical trials. Citation Format: Sophie Feng, Jian Li, Paige E. Farris, Jessica Currier, Zhenzhen Zhang, Jackilen Shannon. Racial Disparities in Cancer Beliefs among Oregon Residents [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 A030.

Abstract B048: Qualitative analysis of fieldnote and interview data for planning a food bank- based breast cancer screening intervention

Abstract Among individuals and communities with low-income, the experience of food insecurity is associated with greater delays in recommended mammography screening and late-stage breast cancer at diagnosis. Community-based interventions that address barriers to breast cancer screening in diverse communities of women with food insecurity can increase screening uptake, ultimately improving cancer health equity. In partnership with Sacramento Food Bank and Family Services (SFBFS), the largest non-profit provider of social services in Sacramento County, this study identified barriers and facilitators to implementing a breast cancer screening intervention in a food distribution setting, assessing the preliminary acceptability and logistical feasibility of the proposed intervention. Qualitative data about food bank distribution events and the clients served was collected over 24 weeks using participant observation with semi-structured fieldnotes and interviews, then analyzed via directed content analysis guided by the well-defined domains and determinants in the Consolidated Framework for Implementation Research (CFIR) and coded using Dedoose software. Fieldnotes were completed for 12 community food distribution events, and 20 stakeholder interviews were conducted with purposefully sampled food bank staff (N=10) and female clients (N=10) who regularly attend events. The results of this qualitative analysis identified barriers and facilitators to implementation in all CFIR domains, describing current workflows for food distribution events and existing health education efforts, capacity, client engagement logistics and modes of delivery, and resources available or needed to support implementation. Prominent CFIR determinants included characteristics of individuals, specifically the innovation recipients’ capability and motivation to receive a breast cancer screening intervention in this context. Participants often pointed out their awareness of important preventative behaviors such as nutrition while also acknowledging barriers such as time constraints, accessibility of breast cancer screening services, and culturally-specific health beliefs and practices. Determinants in the outer setting, inner setting, innovation characteristics, and process that relate to the overall theme of sustainability were identified as potential barriers including financing, the availability of resources, internal and external pressure to change, and the process of engaging with clients while they are at the food distribution event. Facilitators included buy-in from SFBFS leadership and staff, and the benefit of collaborating with reputable local partners. Intervention format should include tailored messaging that is culturally appropriate and empowers individuals to obtain recommended screening. Content of the intervention should provide interactive assistance that facilitates local support for screening eligibility and services. Overall, there was consensus that promoting breast cancer screening in the food distribution setting was beneficial and welcomed by all stakeholders. Citation Format: Charlotte L. Kerber, Julie HT Dang, Daniel J. Pasillas-Pablo, Jocelyn T. Canty, Laura Fejerman. Qualitative analysis of fieldnote and interview data for planning a food bank- based breast cancer screening intervention [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 B048.

Parental Factors Related to COVID-19 Prevention Behavior in Children with Intellectual Disability: Partial Least Square Structural Equation Modeling

Efforts to prevent COVID-19 in children with intellectual disability require the role of parents. Even though the vaccine has been implemented, the most important effort is to implement health protocols. Implementing health protocols cannot be separated from knowledge, attitudes, intentions, subjective norms, and social support from parents. This research aims to determine the influence of knowledge, attitudes, intentions, subjective norms, and social support on the COVID-19 prevention behavior of parents of children with intellectual disability. This type of research is descriptive correlational research, and the developed model is validated using the partial least squares structural equality modeling (PLS-SEM) approach based on data collected from 100 parents of children with intellectual disabilities taken using purposive sampling at Semarang Municipal Special Schools.The study results show that parental characteristics, namely education, influence attitudes, which can ultimately affect parental intentions. Parental education also affects social norms, namely social support and subjective norms, which can determine COVID-19 prevention behavior. Parental education is a priority in public health strategies because it can directly shape attitudes, intentions, and social norms that can improve the health of children with intellectual disabilities. Health programs and education for parents must be focused and carried out consistently and continuously.

Determining the predictors of preventive behaviors adopted by pregnant women against COVID-19 based on the Health Belief Model constructs: a cross sectional study

BackgroundPregnant women face great challenges during the coronavirus disease 2019(COVID-19) pandemic. The purpose of this study was to explain the main dimensions of adoption of self-care behaviors against COVID-19 based on the health belief model(HBM) in pregnant women.MethodsThis cross-sectional and analytical study was conducted in Iran, at the end of the third wave of the COVID-19 pandemic, between January and April 2021. Two hundred and thirty pregnant women who referred to Urmia health centers were selected using multi-stage random sampling. The data were collected using an online questionnaire including items that measured the participants’ demographic characteristics, the knowledge questionnaire, the HBM items, and questions assessing the adoption of self-care behaviors against COVID-19. The data were analyzed using SPSS software version 20. Descriptive statistics, bivariate Pearson’s correlation test, and multiple linear regression were used to analyze the data.ResultsThe results of this study showed that the rate of self-care behaviors against COVID-19 in the pregnant women participating in the present study was not very favorable. It was also shown that among the constructs of the HBM, knowledge, self-efficacy, and perceived barriers were the most important predictors of adopting self-care behaviors with a variance of 24% change among the pregnant women.ConclusionKnowledge, self-efficacy, and perceived barriers were found in this study as the strongest predictors of self-care behaviors among pregnant women. Thus, it is suggested to implement interventions commensurate with the results of this study.

Qualitative study on health self-management of patients with metabolic syndrome among bereaved population after earthquake

The study explore the influencing factors and healthy self-management of MS patients with bereaved relatives after Wenchuan and Yushu Earthquake of their real life; explore difficulties and challenges in the process of self-management; and supply information that could not be sought in quantitative studies. Purposive sampling was used to recruit 36 MS patients who are bereavement population in two earthquakes, and those patients met the inclusion criteria for semi-structured focus group interview. The Nvivo11 software was used to collate and analyze the transcribed data. The main influencing factors of health self-management behavior for MS patients are as follows: the degree of understanding of disease prevention knowledge, emotion management induced by earthquake trauma, the source of disease-related information, access and identification are very limited; ethnic traditional culture, religious beliefs, and production activities and routines before and after the earthquake is an important factor in their healthy self-management behavior. The lack of health beliefs and self-efficacy of MS patients among bereaved families after Wenchuan and Yushu earthquake are key obstacle in their self-management. The overall level of the knowledge of patients’ MS prevention, self-efficacy and self-management behaviors are still low. Some positive factors that can be changed including MS prevention knowledge, self-efficacy, social support, and family function. Some negative factors which can be improved afterwards, including negative coping style, traumatic life experiences from earthquake and smoking.

Parental Knowledge, Attitudes, and Practices Regarding Early Childhood Caries in Bihor, Romania: A Cross-Sectional Study.

Early childhood caries (ECC) is a significant global health issue, particularly affecting deciduous teeth in young children. ECC is prevalent in Romania, where nearly half of children experience dental caries. This study aimed to assess the influence of gender, age, and living environment on parents' knowledge, attitudes, and practices (KAP) regarding ECC in Bihor County, Romania, using a KAP-type questionnaire. A cross-sectional study was conducted between March and September 2024, utilizing an online KAP questionnaire distributed via social networks. The sample comprised 419 parents of children under six years old. Respondents provided socio-demographic data and answered questions regarding their knowledge, attitudes, and practices concerning ECC prevention, treatment, and oral health. Statistical analysis was conducted using Chi-square tests to assess associations between demographic factors and parental KAP. A p-value of less than 0.05 was considered statistically significant. Of the 419 respondents, 83.1% were female, and 62.5% were between the ages of 31 and 40. Significant gender-based differences were found in knowledge about pain from caries (93.7% of female participants vs. 81.7% of male participants, p = 0.004) and the importance of brushing twice daily (93.7% of female respondents vs. 80.3% of male respondents, p = 0.010). Younger parents (aged 18-30) were more likely to affirm the effectiveness of fluoride (65.4%) compared to those aged 31-40 (53.1%, p = 0.02). Urban parents were more likely to correctly identify the timing of tooth eruption (59.1% vs. 52.6% of rural parents, p = 0.021). The study highlights gender, age, and urban-rural disparities in parental knowledge and attitudes towards ECC. These findings underscore the need for targeted educational interventions to improve oral health outcomes and reduce ECC prevalence in the Bihor region. Tailored public health strategies addressing demographic factors could enhance preventive oral health behaviors and reduce the healthcare burden associated with untreated dental caries.

Analysis of Healthcare Workers' Behavior in Maternal and Child Health Services During the COVID-19 Pandemic in Aceh Province

Healthcare workers, including midwives, face a high risk of disease, including the coronavirus. It is expected that healthcare workers possess good knowledge and behavior regarding the management of care for pregnant women, childbirth, newborns, and the handling of emergency complications during the COVID-19 pandemic. This study aims to explore the behavior of healthcare workers in providing health services to mothers and children during the COVID-19 pandemic. This descriptive study employs a cross-sectional design, involving all midwives in Aceh Province, with data collection conducted through Google Forms from June to July 2021. The results indicate that there is no relationship between age, length of service, and sources of health information with the behavior of healthcare workers in providing health services to mothers and children during the COVID-19 pandemic. However, there is a significant relationship between knowledge and COVID-19 prevention behavior, with a p-value of 0.000. In conclusion, healthcare workers with higher knowledge are more likely to exhibit good behavior in preventing the spread of COVID-19. Therefore, it is important to continue enhancing their knowledge, particularly regarding virus transmission, to strengthen supportive behaviors and contribute to breaking the chain of COVID-19 transmission.

Testing the theory of normative social behavior in Italy and the USA during COVID-19

The COVID-19 pandemic has underscored the importance of understanding how social norms influence preventative health behaviors across cultures. Based on the theory of normative social behavior (TNSB), this study investigates the direct and moderated effects of social norms on intentions to wear masks and practice social distancing cross-culturally during the peak of COVID-19 in 2020. Representative samples were recruited from the United States (N = 333) and Italy (N = 331), two countries with different cultural tightness-looseness and orientations (individualistic-collectivistic; indulgence-restraint; uncertainty avoidance). Results revealed that perceived descriptive norms directly influenced behavioral intentions in the U.S., while perceived injunctive norms were more influential in Italy. Outcome expectations moderated the relationship between descriptive norms and mask-wearing intentions in both countries. Specifically, as perceived benefits increased, the effect of norms on mask-wearing intentions attenuated in both countries. Group identity strengthened the association between descriptive norms and mask-wearing intentions only in Italy. These findings highlight that cultural differences play an important role in normative influence mechanisms, with the U.S. being more influenced by what others do (descriptive norms) and Italy by what others approve of (injunctive norms). The study contributes to the refinement of the TNSB and emphasizes the importance of considering cultural factors in developing effective norm-based interventions to address global health challenges.

Research on the use of communication big data and AI artificial intelligence technology to construct telecom fraud prevention behavior portrait

A solid foundation for behavior portrait construction in the fight against telecom fraud is the goal of this research. The study explores the integration of communication AI and Big Data technologies, focusing on the perspective of artificial intelligence. By using insights obtained from a telecom fraud detection model that relies on users’ behavior variations expressed through time-varying signatures, the goal of this study is to enhance fraud prevention strategies in the telecom industry. Through the examination of call detail records and customer profile information, the TeleGuard AI Fraud Prevention Framework (TGAI-FPF) aims to recognize suspicious trends and variations that are potentially suggestive of fraudulent actions. The purpose of the model is to generate behavior portraits that are capable of capturing the distinctive aspects of fraudulent conduct in telecom networks. This will be accomplished through the utilization of advanced analytics and machine learning algorithms. The study highlights the significance of leveraging big data analytics and artificial intelligence technologies to efficiently detect and thwart fraudulent activity in the telecom industry. The results of this study should fortify the defenses of telecom networks against growing fraudulent schemes and help in the development of preventative measures to combat fraud. This is the anticipated manner in which the results will add.

Can a Trusted Messenger Change Behavior When Information Is Plentiful? Evidence from the First Months of the COVID-19 Pandemic in West Bengal

Abstract Can information from a credible messenger shift behavior in an information-saturated environment? In a randomized controlled trial involving twenty-eight million individuals in West Bengal, we find that SMS-delivered video messages containing information about COVID-19 symptoms and health-preserving behaviors recorded by a credible messenger increased adherence to targeted and non-targeted preventive behaviors, measured by two objective measures (symptoms reported to a health worker, and phone usage at home), as well as self-reported behaviors. We find large spillovers onto non-targeted recipients. Credible light-touch messaging can play an important role in crisis response, even when similar information is widely available.

The Role of Health Belief Model Constructs and Content Creator Characteristics in Social Media Engagement: Insights from COVID-19 Vaccine Tweets.

The Health Belief Model (HBM) has been widely studied, but it is unclear how social media post creators use HBM constructs to influence the public's awareness of health topics, particularly for COVID-19 preventative health behaviors. Moreover, there is limited knowledge about how content creators enhance user engagement with COVID-19 vaccine tweets. A content analysis of COVID-19 vaccine tweets (n = 362) examined how HBM constructs were used in social media posts and their relationship to content creator characteristics (e.g., race, education level) and user engagement behaviors (e.g., number of favorites). Content creators' tweets about COVID-19-related topics generally centered on two HBM constructs-benefits and barriers-while fewer tweets emphasized perceived susceptibility or self-efficacy; tweets containing these constructs were retweeted less often. Findings revealed that tweets from politicians, health experts, and white and Asian sources emphasized the perceived benefits of the COVID-19 vaccine. Individual tweets, especially from Black individuals and celebrities, generated more user engagement. Understanding the factors that contribute to social media user engagement with health-related content is important for designing more focused and impactful health communication campaigns and promoting healthier habits and perspectives. Thus, by demonstrating the possible relevance of the HBM to digital communication strategies or health campaigns, our study provides useful guidance for health promoters and policymakers who use social media to raise public health awareness.

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.

Designing a Culturally Relevant Digital Skin Cancer Prevention Intervention for Hispanic Individuals: Qualitative Exploration.

In the past 2 decades, melanoma incidence among Hispanic individuals has risen by 20%. The mortality rate of Hispanic individuals is higher than that for non-Hispanic White individuals. Skin cancer can largely be prevented with regular sun protection, and skin cancer outcomes can be improved through early detection, for example, by skin self-examination. Alarmingly, Hispanic individuals are less aware of the symptoms and harms of skin cancers, tend to have misperceptions regarding the risks and benefits of skin cancer prevention behaviors, and engage in less sun protection behaviors than non-Hispanic White individuals. This study aimed to use a community-engaged approach and conduct both group and individual interviews among Hispanic individuals and relevant key stakeholders to explore the potential design of a mobile-based skin cancer prevention intervention for Hispanic individuals. This study used a qualitative design (focus groups and individual interviews). Participants were recruited from local community organizations' social media, local events, and contact lists (eg, email). Zoom interviews were conducted to examine whether Hispanic individuals would be interested in a mobile-based skin cancer intervention and to explore their preferences and suggestions to inform skin cancer prevention intervention design. Five focus groups (2 in Spanish and 3 in English) among self-identified Hispanic individuals (n=34) and 15 semistructured, in-depth individual interviews among key stakeholders (health care providers and community leaders; eg, dermatologist, nurse practitioner, licensed social worker, and church leader) were conducted. The main themes and subthemes emerging from the group discussions and individual interviews were organized into the following categories: intervention platform, delivery frequency and format, message design, engagement plan, and activities. WhatsApp and Facebook were identified as suitable platforms for the intervention. Messages including short videos, visuals (eg, images and photographs), and simple texts messages were preferred. Recommendations for message design included personalized messages, personal stories and narratives, culturally relevant design (eg, incorporating family values), and community-trusted sources. Potential engagement and retention recommendations were also discussed. Additional details and exemplar quotes of each theme and subtheme are described. This study provides important insights and directions for the design of a mobile, digital skin cancer intervention to modify Hispanic individuals' sun protection and skin self-examination behaviors to help improve skin cancer outcomes. Insights gathered from community leaders and health care providers provided valuable additions to the community-derived data. Leveraging popular digital platforms among Hispanic individuals such as WhatsApp or Facebook could be a promising approach to skin cancer prevention. Recommendations from the community included the use of concise videos, illustrative images, clear text messages, tailored communications, narratives featuring personal experiences, designs that reflect cultural significance, and information from sources that are trusted by the community, which provided useful strategies for future intervention design among Hispanic individuals.

Exploring Demographic and Cognitive Predictors of Self-Management in Quasi-Randomized Fall Prevention Intervention for Older Adults With and Without Traumatic Brain Injury.

Changes in health behavior are key to maintaining health, safety, and independence of older adults. The purpose of this study was to explore factors impacting training in self-management and behavior change in older adults with and without traumatic brain injury (TBI), informing efforts to improve safety and independent function. Forty-one older adults, 19 with TBI, completed a self-regulation intervention (mental contrasting with implementation intentions; MCII) to promote fall prevention behavior change. Participant outcomes were related to single and recurring behavior changes; implementation outcomes were measured as modifications to treatment. Although participants with TBI performed more poorly on tests of neurocognitive function, there were no differences in behavior change rates following MCII, suggesting the treatment worked similarly for participants with and without TBI. Across both groups, those with higher executive function scores were more likely to complete recurring behavior changes. Participants with higher stress, higher Fall Risk Scores, or history of TBI were more likely to need modifications to treatment. This quasi-experimental pilot study describes cognitive and psychosocial predictors that may be critical for participation and success in health behavior change and self-management of fall prevention for older adults with and without TBI.

The direct effects of media exposure on behaviors aimed at preventing COVID-19 and its indirect effects as mediated by interpersonal communication: a longitudinal study in Japan.

We aimed to examine the direct effects of exposure to media information about infection-preventing behavior and its indirect effects via interpersonal communication at two time points during the pandemic. In August 2020 and August 2021, a web-based survey of Japanese people under a declared state of emergency was conducted. We collected sociodemographic data and data on seven types of exposure to media information, three types of exposure to interpersonal communication, and six types of infection-preventing behavior. A total of 784 participants completed both surveys. Exposure to information in the mass media decreased over the year, while interpersonal communication about COVID-19-related topics increased. The direct effect of exposure to information in the media about preventive behaviors was statistically significant in the pandemic's early stages, but this was no longer true after 1 year. The indirect effect via interpersonal communication was statistically significant at both time points. Our results suggest that the influence of media information on infection-preventing behavior during the pandemic was maintained over time as an indirect effect via interpersonal communication. For risk communication media strategies during pandemics, adopting strategies to generate interpersonal communication will have a sustained effect on preventive behavior.

Identifying Population Segments by Differing Levels of COVID-19 Vaccine Confidence and Evaluating Subsequent Uptake of COVID-19 Prevention Behaviors: Web-Based, Longitudinal, Probability-Based Panel Survey.

The COVID-19 pandemic prompted the launch of the US Department of Health and Human Services' COVID-19 Public Education Campaign to boost vaccine confidence and uptake among adults, as vaccines are key to preventing severe illness and death. Past segmentation research relevant to COVID-19 behavior has found important differences in attitudes, sociodemographics, and subsequent COVID-19 prevention behaviors across population segments. This study extends prior work by incorporating a more comprehensive set of attitudes, behaviors, and sociodemographic variables to identify population segments by differing levels of COVID-19 vaccine confidence and evaluate differences in their subsequent uptake of COVID-19 prevention behaviors. Data were obtained from 5 waves (January 2021 to June 2022) of a web-based longitudinal, probability-based panel survey of US adults (N=4398) administered in English and in Spanish. Participants were recruited from NORC at the University of Chicago's national AmeriSpeak panel and were invited to participate across multiple waves. Latent class cluster analysis estimated segments of respondents based on over 40 COVID-19 attitudes, beliefs, behaviors, and sociodemographics as reported in wave 1. Survey-weighted cross-tabulations and bivariate regression analyses assessed differences in COVID-19 vaccine uptake, booster uptake, mask use, and social distancing in all segments across all 5 survey waves. A total of 6 segments (hardline nonintenders, prevention-compliant nonintenders, burned-out waiters, anxious waiters, skeptical confidents, and ready confidents) were identified, which differed by their COVID-19 vaccine confidence, prevention-related attitudes and behaviors, and sociodemographics. Cross-tabulations and regression results indicated significant segment membership differences in COVID-19 vaccine and booster timing, mask use, and social distancing. Results from survey-weighted cross-tabulations comparing COVID-19 vaccine and booster uptake across segments indicate statistically significant differences in these outcomes across the 6 segments (P<.001). Results were statistically significant for each segment (P<.01 for booster uptake among burned-out waiters; P<.001 for all other coefficients), indicating that, on average, respondents in segments with lower intentions to vaccinate reported later receipt of COVID-19 vaccines and boosters relative to the timing of vaccine and booster uptake among ready confidents. Results extend previous research by showing that initial beliefs and behaviors relevant to COVID-19 vaccination, mask use, and social distancing are important for understanding differences in subsequent compliance with recommended COVID-19 prevention measures. Specifically, we found that across respondent segments, the probability of vaccine and booster uptake corresponded with both COVID-19 vaccine confidence and mask use and social distancing compliance; more compliant segments were more likely to get vaccinated or boosted than less compliant segments given similar levels of vaccine confidence. These findings help identify appropriate audiences for campaigns. Results highlight the use of a comprehensive list of attitudes, behaviors, and other individual-level characteristics that can serve as a basis for future segmentation efforts relevant to COVID-19 and other infectious diseases.

Factors influencing preventive self-care behaviors to avert Diabetes Mellitus among Thai Buddhist Monks, Thailand: A Cross-sectional Study

A cross-sectional study was conducted to investigate factors related to self-care behavior for diabetes mellitus prevention among 393 Thai Buddhist monks in the upper northeastern region of Thailand. Data were collected using questionnaires and analyzed using descriptive statistics, including percentages, means, minimums, maximums, and standard deviations. Relationships between factors related to self-care behaviors among Buddhist monks were analyzed using bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression). The findings demonstrated that significant factors included age under 35 years (AOR=5.34, 95% CI=2.02-14.14), eating two meals per day (AOR=2.99, 95% CI=1.33-6.76), self-management (AOR=6.51, 95% CI=3.52-12.02), access to health information and health services (AOR=0.26, 95% CI=0.15-0.47), and making correct health decisions (AOR=1.98, 95% CI=1.04-3.78). These factors were significantly related to self-care behaviors among Buddhist monks (p &lt; 0.05). The study concludes that improving health literacy among Thai Buddhist monks, particularly those under 35 years of age, is crucial for effective T2DM prevention. Targeted health education programs can significantly enhance their self-management skills, enable them to make informed health decisions, and encourage the adoption of better self-care and consumption behaviors.

Loneliness and Social Isolation Factors Under the Prolonged COVID-19 Pandemic in Japan: 2-Year Longitudinal Study.

Worsening loneliness and social isolation during the COVID-19 pandemic have become serious public health concerns worldwide. Despite previous research reporting persistent loneliness and social isolation under repeated emergency declarations and prolonged pandemics, long-term studies are needed to identify the actual conditions of loneliness and social isolation, and the factors that explain them. In this study, 3 web-based surveys were conducted at 1-year intervals during the 2 years after the first state of emergency to examine changes in loneliness and social isolation and the psychosocial factors associated with them in the Japanese population. The first survey (phase 1, May 11-12, 2020) was conducted at the end of the first emergency declaration period, the second survey (phase 2, June 14-20, 2021) was conducted at the end of the third emergency declaration period, and the third survey (phase 3, May 13-30, 2022) was conducted when the state of emergency had not been declared but many COVID-19-positive cases occurred during this period. We collected data on 3892 inhabitants (n=1813, 46.58% women; age: mean 50.3, SD 13.4 y) living in the 4 prefectures where emergency declaration measures were applied in phases 1 and 2. A linear mixed model analysis was performed to examine the association between psychosocial variables as explanatory variables and loneliness scores as the dependent variable in each phase. While many psychosocial and physical variables showed improvement for the 2 years, loneliness, social isolation, and the relationship with familiar people deteriorated, and the opportunities for exercise, favorite activities, and web-based interaction with familiar people decreased. Approximately half of those experiencing social isolation in phase 1 remained isolated throughout the 2-year period, and a greater number of people developed social isolation than those who were able to resolve it. The results of the linear mixed model analysis showed that most psychosocial and physical variables were related to loneliness regardless of the phase. Regarding the variables that showed a significant interaction with the phase, increased altruistic preventive behavior and a negative outlook for the future were more strongly associated with severe loneliness in phase 3 (P=.01 to <.001), while the association between fewer social networks and stronger loneliness tended to be more pronounced in phase 2. Although the interaction was not significant, the association between reduced face-to-face interaction, poorer relationships with familiar people, and increased loneliness tended to be stronger in phase 3. This study found that loneliness and social isolation remained unresolved throughout the long-term COVID-19 pandemic. Additionally, in the final survey phase, these issues were influenced by a broader and more complex set of factors compared to earlier phases.