Central Ohio Research Articles

8118 Effect of Rurality on Diabetes Technology Use Among Medicaid-Insured Youth Enrolled in a Mid-Western Accountable Care Organization

Abstract Disclosure: E.E. Bell-Sambataro: None. J. Kilbarger: None. A. Lahoti: None. J.M. Ladd: None. Background: Diabetes technology (continuous glucose monitors (CGM) and insulin pumps), is associated with improved glycemic control and quality of life in children with type 1 diabetes (T1D), but technology use is not equitable. We explored whether rural/urban disparities exist in CGM and pump use among pediatric patients with T1D enrolled in an Accountable Care Organization (ACO) and thus on Medicaid. Methods: We conducted a retrospective cohort study using claims data from the central Ohio ACO database from January 1, 2018 to September 30, 2022. Individuals aged 1 to <21years were identified using T1D-specific billing codes. CGM or pump use was defined using established prescription codes. Rurality was based on zip codes of residence linked to RUCA codes. For descriptive analyses, we calculated proportions, means and standard deviations. T-tests were used to compare continuous variables; chi-square tests were used to compare categorical variables. Multivariable Poisson regression was used to model the association between rurality and CGM or pump use, adjusted for age, sex, race, and era (pre-/post-COVID pandemic). Results: We identified 1079 enrolled individuals with T1D during the study period; 878 (81.4%) were using CGM and 259 (24%) were using insulin pumps. In descriptive analysis, CGM users were younger than non-users (users 11.4±4.4years vs non-users 15.3±3.8years, p<0.01). The distribution of rurality between CGM users and non-users was similar (users 73.5% urban, 26.3% rural vs non-users 66.6% urban, 33.3% rural, p=0.05). There were no age or rurality differences between pump users and non-users (users 12.2±3.8years vs non-users 12.1±4.8years, p=0.86; users 72.6% urban vs non-users 72.1% urban, p=0.92). In regression modeling, rurality was not significantly associated with CGM use (adjusted risk ratio (aRR) 0.95, 95% confidence interval (CI) 0.89-1.02) whereas age, race, era, and pump use were significantly associated. Rurality was significantly associated with pump use (aRR 0.79, 95% CI 0.63-0.99) as were age, race and era. Conclusions: In this cohort limited to pediatric patients with T1D on Medicaid, rural residence did not have a significant effect on CGM use but did make pump use less likely. Those of older age or non-White race were significantly less likely to use CGM and pumps. Future efforts targeting these disparities should be undertaken to increase use of these standard of care technologies among all children. Presentation: 6/2/2024

Barriers to correct pronoun usage in healthcare settings

BackgroundUsing correct pronouns is an impactful way to establish affirming environments for transgender and nonbinary (TGNB) patients. However, physicians often report struggling with this.ObjectiveThis study set out to conduct an initial root cause analysis of factors contributing to medical students and physicians failing to use TGNB patients’ correct pronouns.MethodsA 10-item Qualtrics survey was sent to medical students, residents, and physicians practicing in Central Ohio. Participants were asked to describe perceived challenges or barriers colleagues have regarding correctly using TGNB patients’ correct pronouns. A directed content analysis of participant responses was performed utilizing a fishbone diagram root cause analysis tool as a basis for conceptualizing and categorizing barriers. All coding was completed by independent reviewers utilizing a consensus reconciliation methodology.ResultsOf 928 survey respondents, 763 met the study inclusion criteria, of which 453 provided analyzable responses. Of these 453, attendings with five or more years of practice (32.5%) and medical students (27.4%) made up the two largest demographic categories. 1.7% of respondents identified as transgender, nonbinary, and/or genderqueer, and 64% identified as heterosexual/straight. Five core barrier categories were identified: documentation, patient care, environment, knowledge, and individuals. Sub-categories were also identified, including lack of documentation, discomfort, medical culture, lack of standardization, prejudice, and assumptions.ConclusionThe study identifies important barriers to medical professionals correctly using TGNB patients’ pronouns. The root cause analysis conducted as part of this study demonstrates the necessity of multi-pronged, system-level interventions to support ensuring TGNB patients are addressed using the correct pronouns.

Age-Friendly Communities, Housing Tenure, and Affordability: Implications for Older Adult Health

This study used data from the 2021 Central Ohio Regional Assessment on Aging to examine the capacity of housing tenure and housing affordability to modify the relationship between subjective community age-friendliness and health. Associations were modeled using ordinary least squares regression and assessed using hierarchical model comparison and moderation effect size. There was partial support for the modifying role of housing affordability in the association between subjective community age-friendliness and health, but none for the modifying role of tenure. Future implementations of the age-friendly model should consider how housing affordability may differentiate the individual-level impacts of community-level initiatives.

Profiles of community support and challenges associated with insomnia symptoms: Findings from the pilot Bhutanese Community of Central Ohio Health Study

Study objectivesWe investigated profiles of community support and challenges in relation to insomnia symptoms among the Bhutanese living in the United States. MethodsUsing data from the pilot Bhutanese Community of Central Ohio Health Study (N = 495; 51.5% men, 69.8% aged 18-44years), we used latent class analysis to identify distinct profiles of neighborhood social cohesion, social support, and community challenges (e.g., limited access to healthcare services and transportation, crime and safety issues, substance use, intimate partner violence) and their associations with insomnia symptoms. Insomnia symptoms were self-reported as difficulty falling and staying asleep and dichotomized as “not at all” vs. “some to always.” Identified classes/profiles were further differentiated by self-reported sociodemographic, socioeconomic, health, acculturative, and discrimination factors. ResultsLatent class analysis revealed four distinct classes/profiles. The High Cohesion (class 1) profile (30.1% of sample) had the lowest likelihood of insomnia symptoms at 6.5%, followed by class 2 or High Support (23.6%) with a 15.3% likelihood. Class 3 or High Challenges profile (11.5%) had a moderate likelihood of insomnia symptoms at 49%. Class 4 or the Low Cohesion/Support profile (34.7%) had a 100% likelihood of reporting insomnia symptoms. Class 4 when compared to class 1 was more likely to report cardiometabolic conditions, experiences of everyday discrimination, limited English linguistic proficiency, and not using telehealth. ConclusionCommunity social cohesion and support may play an important role in mitigating insomnia symptoms among Bhutanese refugees. Further investigations are warranted.

Census Tract-Level Social Vulnerability and Gonorrhea Rates in Central Ohio: Results From the STD Surveillance Network, 2020-2021.

Gonorrhea remains a significant burden in central Ohio, particularly in socially disadvantaged communities. This study evaluates gonorrhea case rates and changes from 2020 to 2021, focusing on geographic patterns associated with social vulnerability. We analyzed gonorrhea case data from the Columbus STD Surveillance Network for 2020 and 2021. Cases were linked to census tracts and categorized into low (0-0.66) or high (0.67-1.0) vulnerability groups based on the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index (SVI). We mapped gonorrhea case rates per 100,000 population, stratified by SVI group, and compared changes using Jenks natural breaks to determine cutpoints. High case rates were defined as ≥605 (2020) and ≥532 (2021). A change in case rates was defined as <154 (decrease/no change) or ≥154 (increase). Demographic factors were summarized for both years. In 2020 and 2021, nearly half of high-SVI tracts had high gonorrhea rates, compared with about 4% to 7% of low-SVI tracts. Median rates in high-SVI tracts were approximately 5 times higher than in low-SVI tracts, with rates of 546 and 598 per 100,000 in 2020 and 2021, compared with 98 and 104 per 100,000, respectively. Gonorrhea rates increased in 23 (9%) of low-SVI tracts and 37 (25%) of high-SVI tracts. Demographic characteristics remained consistent between the 2 years. Gonorrhea rates increased in central Ohio between 2020 and 2021, with higher burdens in high-SVI census tracts. Understanding the dynamics of social vulnerability at the community level is crucial for targeting limited STD resources effectively.

Epidemiologic Analysis of a Postelimination Measles Outbreak in Central Ohio, 2022-2023

Postelimination outbreaks threaten nearly a quarter century of measles elimination in the US. Understanding these dynamics is essential for maintaining the nation's measles elimination status. To examine the demographic characteristics and transmission dynamics of the 2022 to 2023 central Ohio measles outbreak. This cross-sectional study used electronic medical records and publicly available measles reports within an extensive central Ohio primary care network involving inpatient and outpatient settings. Participants included 90 children in Ohio with confirmed measles cases in 2022. The exposure of interest was confirmed measles cases in Ohio in 2022. This included 5 internationally imported cases and 85 locally acquired cases. The primary outcome involved documenting and analyzing confirmed measles cases in Ohio in 2022, focusing on demographic characteristics, immunization status, and transmission links in outbreak-related cases. This study analyzed 90 measles cases (47 [52.2%] male participants) in Ohio during 2022. Most participants self-identified as African or American Black (72 [80.0%]), with additional race categories including Asian, Hispanic, multirace (6 [6.7%]), White, and unknown (6 [6.7%]). Most participants were of Somali descent (64 [71.1%]), with additional ethnicity categories including American (16 [17.8%]), Guatemalan, Nepali, and unknown (6 [6.7%]). Participants were predominantly younger than 6 years (86 [95.5%]), unimmunized (89 [98.9%]), and resided in Franklin County, Ohio (83 [92.2%]). Prior to November 20, 2022, all cases occurred among unimmunized children of Somali descent in the Columbus area. Nosocomial superspreading events expanded the outbreak beyond the initially affected community. This cross-sectional study of measles cases in Ohio during 2022 found that the outbreak primarily affected unimmunized children of Somali descent, highlighting the necessity for culturally tailored public health strategies to maintain measles elimination in the US. These findings underscore the importance of implementing targeted interventions and enhancing community engagement to increase vaccination rates.

A snowfall climatology of the Ohio River Valley, USA

Snowfall in the Ohio River Valley, USA, presents a relatively unique challenge due to the large gradient of event frequency and magnitude, and subsequent levels of preparation within local communities. Even relatively small magnitude events can cause widespread impacts due to available infrastructure. Here we present a climatology of snowfall conditions and events over a 74-year period using a network of daily observational stations across the region. Snowfall totals and event frequencies both exhibit a southwest to northeast gradient of increasing snowfall, where the majority of snowfall (> 80%) occurs during the core winter months of December through February. There is a clear influence of Lake Erie on snowfall conditions in the northeast corner of the domain, where snowfall frequency, totals, and trends are substantially higher within the lake belt relative to areas further inland. Over time, snowfall significantly increased downwind of Lake Erie by as much as 42%, while significant decreases of over 55% occurred in central Tennessee and eastern Ohio. Intra-seasonally, snowfall totals trended significantly less during November and March for much of the domain, suggesting a compression of the snowfall season to more core winter months. Trends in snowfall frequency were apparent for many sub-regions, however evidence here suggests the trends in snowfall totals were primarily driven by trends in snowfall magnitude per event.

Clinical and Genomic Characteristics of Candida auris in Central Ohio: An Insight into Epidemiological Surveillance

Background: Candida auris is an emerging threat to hospitalized patients and invasive disease is associated with high mortality. This study describes clinical and microbiological characteristics of nine patients identified with C. auris at Ohio State Wexner Medical Center discovered through active surveillance or clinical investigation and uses whole genome sequencing (WGS) to compare isolates. Methods: In November 2022, an active C. auris surveillance program was implemented to screen patients admitted to high-risk units (intensive care units and progressive care units). Bilateral axilla and groin swabs were obtained upon unit admission and, if positive, were submitted for C. auris polymerase chain reaction (PCR) with culture and sensitivity testing. Patients with a positive screening or clinical isolate from November 2022 to November 2023 underwent chart review for clinical characteristics, microbiologic data, and index admission information. For each isolate, DNA was extracted and WGS was performed. Core single nucleotide polymorphism (SNP) variation identified from the sequence data was used to infer genetic relationships among the isolates. Results: Nine patients were identified between November 2022 and November 2023. The clinical and microbiologic characteristics are summarized in Table 1. All patients were hospitalized at various acute care facilities across the state at least once in the preceding 12 months. C. auris was determined to be present on admission for 6 patients. For 5 of these patients, it was their first interaction with our healthcare system. Three patients were not in contact isolation for &gt;3 days before C. auris was identified. Unit wide point-prevalence screening was completed in these cases and no evidence of transmission was found. WGS showed eight of the nine isolates were related with 28 or less core SNP differences between isolates (Figure 1). One isolate (8) was genetically distinct with &gt;45000 core SNP differences. Five isolates were highly related with a range of 4-15 SNP differences. No temporal or spatial overlap at our institution was identified among these five patients. Conclusions: The active surveillance program identified several patients colonized with C. auris in addition to those found through clinical testing. Multiple risk factors for C. auris were identified with high patient mortality (67%). Majority of the isolates were closely related without association with a known outbreak or epidemiologic link, suggesting a possible diffuse common reservoir. Next steps with surveillance in acute care and long-term care facilities will be critical for early detection to halt transmission of this organism.

Mosquito abundance and diversity in central Ohio, USA vary among stormwater wetlands, retention ponds, and detention ponds and their associated environmental parameters.

Mosquitoes (Diptera: Culicidae) are one of the most impactful pests to human society, both as a nuisance and a potential vector of human and animal pathogens. Mosquito larvae develop in still aquatic environments. Eliminating these habitats near high human density or managing them to reduce the suitability for mosquitoes will reduce mosquito populations in these human environments and decrease the overall negative impact of mosquitoes on humans. One common source of standing water in urban and suburban environments is the water that pools in stormwater control measures. Previous studies have shown that some stormwater control measures generate large numbers of mosquitoes while others harbor none, and the reason for this difference remains unclear. Our study focuses on elucidating the factors that cause a stormwater control measure to be more or less suitable for mosquitoes. During the summers of 2021 and 2022, we collected and identified mosquito larvae from thirty stormwater control measures across central Ohio to assess variation in mosquito abundance and diversity among sites. Our goal was to determine if specific types of stormwater control measures (retention ponds, detention ponds, or constructed wetlands) harbored different abundances of mosquitoes or different community structures. We also assessed environmental parameters of these sites to elucidate their effects on mosquito abundance and diversity. Overall, we recorded the highest number of mosquito larvae and species in constructed wetlands. However, these sites were dominated by the innocuous species, Culex territans. Conversely, detention ponds held fewer mosquitoes but a higher proportion of known vector species, including Culex pipiens and Aedes vexans. The total number of mosquitoes across all sites was correlated with higher vegetation, more shade, lower water temperatures, and lower pH, suggesting stormwater control measures with these features may also be hotspots for mosquito proliferation.

The FITNESS study: longitudinal geriatric assessment, treatment toxicity, and biospecimen collection to assess functional disability among older adults with lung cancer.

Older adults with chronic disease prioritize functional independence. We aimed to describe the feasibility of capturing functional disability and treatment toxicity among older adults with lung cancer using a longitudinal comprehensive geriatric assessment (CGA) and molecular biomarkers of aging. This prospective study included adults ≥60years with any newly diagnosed non-small-cell lung cancer. Participants were recruited from central Ohio (2018-2020). Study assessments included the Cancer and Aging Research Group CGA (CARG-CGA), short physical performance battery (SPPB), and the blessed orientation-memory concentration (BOMC) test at baseline, 3, 6, and 12months. Activities of daily living (ADLs) and instrumental ADLs (IADLs), quality of life (QoL, PROMIS 10), and treatment toxicity were captured monthly. Stool and blood were collected to characterize the gut microbiome and age-related blood biomarkers. This study enrolled 50 participants with an average age of 71.7years. Ninety-two percent of participants were Caucasian, 58% were male, and all were non-Hispanic. Most had advanced stage (stage III/IV: 90%; stage I/II: 10%), with adenocarcinoma the predominant histologic subtype (68% vs. 24% squamous). First-line treatments included chemotherapy (44%), immune checkpoint inhibitors (ICIs, 22%), chemotherapy and ICIs (30%), or tyrosine kinase inhibitors (4%). The median baseline CARG toxicity score was 8 (range 2-12). Among patients with treatment-related toxicity (n = 49), 39 (79.6%) cases were mild (grade 1-2), and 10 (20.4%) were moderate to severe (≥ grade 3). Treatment toxicity was greater among those with a CARG score ≥8 (28.0% vs. 13.6%). Higher IADL independence, QoL, and SPPB scores at baseline were positively associated with Candidatus Gastranaerophilales bacterium, Lactobacillus rogosae, and Enterobacteria phage P4. Romboutsia ilealis, Streptococcus, and Lachnoclostridium sp An138 and T cell lag3 and cd8a were associated with worse IADLs, QoL, and SPPB scores at baseline. A longitudinal CGA and biomarker collection is feasible among older adults undergoing lung cancer treatment. Gut microbe and T cell gene expression changes correlated with subjective and objective functional status assessments. Future research will test causality in these associations to improve outcomes through novel supportive care interventions to prevent functional disability.

Where have all the arrows gone? A cross-cultural comparison of Lowland Maya and Central Ohio arrow use

Where have all the arrows gone? A cross-cultural comparison of Lowland Maya and Central Ohio arrow use

Monitoring the impacts of rainfall characteristics on sediment loss from road construction sites

Exposed soils associated with active construction sites provide opportunities for erosion and sediment transport during storm events, introducing risks associated with excess sediment to downstream infrastructure and aquatic biota. A better understanding of the drivers of sediment transport in construction site runoff is needed to improve the design and performance of erosion and sediment control measures (ESCMs). Eleven monitoring locations on 3 active road construction sites in central Ohio were established to characterize runoff quality from points of concentrated flow during storm events. Grab samples were analyzed for total suspended solids (TSS), turbidity, and particle size distribution (PSD). Median TSS concentrations and turbidity levels across all samples were 626 mg/L (range 25–28,600 mg/L) and 759 NTU (range 22–33,000 NTU), respectively. The median PSD corresponded to a silty clay loam, mirroring the soil texture of much of Ohio’s subsoils. TSS concentrations and turbidity were significantly positively correlated with the rainfall intensity 10 min prior to sample collection, suggesting that higher flow rates created greater shear stress on bare soil which resulted in more erosion. Conversely, rainfall duration was negatively correlated with particle size, indicating that prolonged moisture from rainfall promoted the dispersion of soil aggregates which mobilized smaller particles. Multivariable linear regression models revealed that higher rainfall intensities corresponded to higher turbidity values, while higher TSS concentrations were associated with higher rainfall intensities, depths, and durations. Results from this study highlight the importance of reducing raindrop impact and subsequent shear stress applied by concentrated flows through the use of ESCMs to limit sediment export from construction sites.

232 Establishing Quality and Universal Access for LGBTQIA2+ Patients (EQUAL)

OBJECTIVES/GOALS: LGBTQIA2+ patients experience many healthcare inequities and often do not seek healthcare due to stigma andprevioustraumatic experiences in the healthcare system. A paucity of healthcare centersprovidesreduced-fee or free healthcare to LGBTQIA2+ individuals. METHODS/STUDY POPULATION: This project was initiated by the primary author who volunteered at an established student-run free clinic in Columbus, OH. The primary author engaged other students and faculty members, including the co-authors. A needs assessment was conducted by the authors, highlighting the unique needs of LGBTQIA2+ patients in central Ohio. In April 2022, members of the community and volunteer faculty providers established the Rainbow Clinic. The Rainbow Clinic provides primary care services including sexual health/STI testing and gynecology care. The Rainbow Clinic exclusively serves members of the LGBTQIA2+ community in central Ohio and creates a safe and inclusive space to educate medical and nurse practitioner students on the care of LGBTQIA2+ patients in a culturally sensitive way. RESULTS/ANTICIPATED RESULTS: The Rainbow Clinic has provided care for 60 patients equating to 78 visits. Most patients sought care for general primary care (17.9%), gynecological care (11.5%) or STI testing and treatment (7.7%). In addition to medical services, social work services are also provided as part of available mental health services and to provide additional linkage to care. To our knowledge, The Rainbow Clinic is the first student-run free clinic in Ohio to offer pre-exposure HIV prophylaxis (PrEP) medication as well as the required laboratory monitoring. The Rainbow Clinic has ongoing research evaluating patient comfortability throughout their encounters and has launched research studies to evaluate how best to address social determinants of health that affect the health and healthcare of the LGBTQIA2+ community. DISCUSSION/SIGNIFICANCE: The Rainbow Clinic deliversfree healthcareand social work servicesto patients who experience healthcare inequities anddisparities.Additionally, the Rainbow Clinic is a source of education for medical and nurse practitionerstudents to ensure their cultural humility in treating future LGBTQ+ patients.

Extreme Weather Disruptions and Emergency Preparedness Among Older Adults in Ohio: An Eight-County Assessment

The disproportionate risks and impacts of climate change and extreme weather on older adults are increasingly evident. While especially true in disaster-prone areas, human-caused climate change introduces an element of uncertainty even in previously identified “safe” regions such as the Midwestern United States. Using a cumulative disadvantage and vulnerability-informed framework and descriptive statistics from multiple data sources, this article provides an overview of climate impacts, vulnerabilities, and county-level characteristics, focusing on older adults living in Central Ohio. A comparative multiple-case study methodology was used to triangulate regionally representative primary and secondary data sources to examine state and county-level measures of vulnerability, emergency preparedness, and disruptions caused by extreme weather among older adults across eight counties in Central Ohio. Seventy-eight percent of older adults in the sample reported being prepared for emergencies per Federal Emergency Management Agency guidelines. Older adults in Union County reported the highest rates of preparedness, while those in Fayette County reported the lowest. County-level rates of disruption of life activities by extreme weather ranged widely. Among the most rural in the region, Fayette County emerged as uniquely disadvantaged, with the lowest median income, the most vulnerable across multiple social vulnerability dimensions, and the most reported disruptions to life activities from extreme weather. County profiles offer a snapshot of existing vulnerabilities, socioeconomic conditions, special needs, preparedness, and current disruptions among older adults in the region and can inform resource mobilization across community and policy contexts.

The effect of planting grass filter strips on fishes in agricultural headwater streams

Abstract Grass filter strips (i.e., herbaceous riparian buffers) are a widely used conservation practice in the United States to mitigate the impacts of agriculture on streams and rivers. Yet, only a limited amount of information is available on the effects of grass filter strips on stream fishes and instream habitat conditions and long‐term assessments are rare. The objective of this research was to document the long‐term effects of planting grass filter strips adjacent to channelized agricultural headwater streams on fish community structure and instream habitat. Fishes, instream habitat and riparian characteristics were sampled from three channelized agricultural headwater streams without grass filter strips, three channelized agricultural headwater streams with grass filter strips and two unchannelized streams having forested riparian habitats in central Ohio from spring of 2006 to autumn of 2015. Fish species richness, abundance, darter species richness, per cent darters, sunfish species richness, minnow species richness and per cent headwater fishes did not differ among riparian habitat types. Darter species richness and per cent darters differed annually. Mean water depth, velocity, wetted width, instream habitat diversity, dominant grain size and per cent instream wood did not differ among riparian habitat types. Mean water depth, water velocity, wetted width and instream habitat diversity exhibited annual differences. Additionally, mean riparian width, woody vegetation density and per cent canopy cover were greater in forested streams than the unplanted and grass filter strip streams. Riparian characteristics did not differ annually. The lack of fish community responses 10–13 years after planting grass filter strips is probably due to the lack of corresponding changes in hydrological characteristics, substrate and instream wood amounts. These results suggest that grass filter strips should not be implemented alone but in conjunction with conservation practices that will improve physical habitat quality and water quality.

First you need the farmers: The microfarm system as a critical intervention in the alternative food movement

After more than three decades, the alternative food movement has developed multiple strategies, most of which are still struggling. This essay surveys the literature on six key alternative food movement (AFM) strategies, assessing their strengths and weaknesses before describing a novel strategy, the microfarm system, which is being implemented in north central Ohio. It argues that key omissions from most AFM scholarship and practices include sustained attention to training and supporting suc­cessful farmers, concerted efforts to help facilitate needed social networks or communities of prac­tices around alternative food developments, and forwarding a set of ambitions that do not appreci­ate the scale of existing food systems nor the limits of alternative food systems’ impact. It offers the microfarm system as an emerging approach to address these omissions.

Abstract P152: Linguistic Acculturation is Associated With Better Cardiometabolic Health Among Bhutanese Refugees Living in the United States

Background: United States (US) South Asians are a fast-growing immigrant group that on average, while having a higher socioeconomic status, present with an increased prevalence and faster development of cardiometabolic health (CMH) conditions. Acculturation—the process of adapting norms of a host culture—can give rise to a unique set of stressful challenges and is associated with poor CMH outcomes among immigrant groups. However, the impact of acculturation on South Asian CMH is relatively unknown due to limited studies, especially when considering the Bhutanese community; the third largest US refugee group. Hypothesis: We hypothesize that increased English linguistic acculturation among US Bhutanese adults would be associated with poorer CMH. Methods: Using 2021-2022 Bhutanese Community of Central Ohio Health Study data, we examined associations of linguistic acculturation and sociodemographic characteristics in relation to CMH conditions among Bhutanese adults living in Central Ohio (N=495). A summed score for responses of very limited (1 point); limited (2 points); fair (3 points); good (4 points); and excellent (5 points) English language proficiency in speaking, listening and understanding, reading, and writing was used to capture limited (≤8), intermediate (9-19), and excellent (20) linguistic acculturation. CMH was assessed from participant self-report of clinical diagnosed or treated hypertension, type 2 diabetes, and dyslipidemia, as well as weight and height to calculate body mass index (BMI). Adjusting for sex, age, and BMI, we used Poisson regression to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of associations of linguistic acculturation and sociodemographic characteristics in relation to CMH conditions. Results: Most participants were aged 18 to 44 years (69.8%) and migrated to the US ≥11 years ago (60.2%). Linguistic acculturation prevalence was 34.1% for very limited/limited and 65.9% for fair to excellent. Most participants reported no CMH condition (70%), while 12.9% reported one, 10.8% reported two, and 6.3% reported three. Fair to excellent vs. very limited/limited linguistic acculturation were associated with a lower prevalence of having three CMH conditions (PR=0.17 [95% CI: 0.03-0.97]). Migrating to the US ≥11 years vs. &lt;11 years was associated with a higher prevalence of having two CMH conditions (PR=1.67 [95% CI: 0.95-2.95]). Conclusions: In conclusion, more linguistic acculturation was associated with better CMH among Bhutanese adults living in the US. Given the burden of CMH disparities among minoritized racial/ethnic groups in the US, future studies should consider acculturation to further explore the role of language in shaping immigrant and refugee health across the lifecourse.

Abstract MP42: Insomnia Symptoms Are Associated With Poor Cardiometabolic Health Among Bhutanese Refugees in the United States

Introduction: The prevalence of insomnia symptoms is higher among refugees globally compared to the general population, and poor sleep is a risk factor for poor cardiometabolic health. The resettled Bhutanese refugee community is the third-largest refugee group in the United States (US) and appears to be-based on a few existing studies-particularly susceptible to sleep disturbances such as insomnia symptoms as well as cardiometabolic conditions such as hypertension, and type 2 diabetes. No prior studies have investigated associations between insomnia symptoms and cardiometabolic conditions in this community. Hypothesis: We hypothesized that participants reporting insomnia symptoms will have a higher prevalence of cardiometabolic conditions. Methods: We used data from the 2021-2022 Bhutanese Community of Central Ohio Health Study (N=495) to examine associations between insomnia symptoms and cardiometabolic health. Insomnia symptoms, measured by self-reports of difficulty falling/staying asleep, were categorized as “not at all,” “sometimes,” and “often/all the time.” A cardiometabolic condition was based on self-reported medical diagnosis/treatment of one or more of the following conditions: hypertension, dyslipidemia, and type 2 diabetes. Poisson regression with robust variance was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) of cardiometabolic conditions among participants with insomnia symptoms compared to participants without insomnia symptoms while adjusting for sociodemographic characteristics and body mass index (using criteria for Asians). Results: The sample was mainly aged between 18-44 years (69.8%), 51% were male, and most lived in the US for ≥11 years (60.2%). Insomnia symptoms prevalence was 56.4% for “not at all”, 30.7% for “sometimes,” and 12.9% for “often/all the time.” Overall, 12.9% of participants had at least 1 cardiometabolic condition, 10.8% had at least 2 conditions, and 6.3% had all 3 conditions. Compared to not having insomnia symptoms, having insomnia symptoms sometimes was associated with a higher prevalence of type 2 diabetes [PR=2.15, 95%CI: 1.19-3.87], hypertension [PR=1.86, 95%CI: 1.24-2.79], dyslipidemia [PR=1.73, 95%CI: 1.01-2.96], and 1 or more cardiometabolic conditions [PR=1.67, 95%CI: 1.20-2.32]. Similarly, compared to not having insomnia symptoms, having insomnia symptoms often/all the time was associated with a higher prevalence of type 2 diabetes [PR=2.18, 95%CI: 1.04-4.54], hypertension [PR=1.71, 95%CI: 1.06-2.74], dyslipidemia [PR=3.03, 95%CI: 1.67-5.47], and 1 or more cardiometabolic conditions [PR=1.68, 95%CI: 1.15-2.47]. Conclusions: In conclusion, the burden of both insomnia symptoms and cardiometabolic health conditions were prevalent among the US Bhutanese refugee population, and the insomnia-cardiometabolic health associations were strong.

Dialect effects in hesitations in older children’s spontaneous speech

Natural speech is interspersed with pauses, word repetitions, phrase repairs, and other disfluencies. These hesitations, reflecting speakers’ performance delays including word fillers, self-corrections, and filled or silent pauses are typical traits of spontaneous speech. Acoustic characteristics of hesitations have been studied primarily in adults, providing evidence that at least some hesitation types exhibit speaker-inherent strategies that are language specific. It is unknown whether older children, whose abilities to engage in conversation approach those of adults, utilize hesitations that reflect the adult model prevalent in a given speech community. Here, we examine spontaneous conversations of American English-speaking 8–12 years-old children growing up in the South (Western North Carolina) and in the Midwest (Central Ohio). We seek to determine whether hesitation types in their speech are shaped by features of their regional dialect. Acoustic analyzes include breathing pattern, phrase length, articulation rate, silent and filled pauses, filler vocalizations, and repair strategies. Preliminary findings indicate that dialect does have an effect on the nature and frequency of hesitations. The work is currently ongoing, and the results will be discussed.

Effect of ultra‐early, early, and normal soybean planting dates and rye cover crop on soybean grain yield

AbstractWith changes to climate and crop insurance, earlier soybean [Glycine max (L.) Merr.] planting dates need to be investigated. Additionally, the use of a cover crop prior to soybean is promoted as a sustainable practice though little is known about cover crop and ultra‐early soybean planting (prior to April 15). The objective was to evaluate soybean planting date and cereal rye (Secale cereale L.) cover crop termination timing on cover crop biomass, soybean plant population, and yield. The study was conducted in Northeast and West Central Ohio in 2021 and 2022. Treatments included three soybean planting dates (early April, late April, and late May) and three cover crop treatments (termination 1–2 weeks prior to planting or “early,” termination at or after planting or “late,” and no cover crop). Cover crop biomass increased as termination was delayed. Soybean planted in early April resulted in a yield reduction of 1.8 Mg ha−1 when planted into a cover crop compared to the no cover crop control. However, when soybean was planted in late April, grain yield was not different among cover crop treatments. Yield reduction associated with early April planting with a cover crop was likely due to low soybean plant population, especially in Northeast Ohio, where plant population was &lt;55,000 plants ha−1 with a cover crop and &gt;120,000 plants ha−1 without a cover crop. To maximize yield, soybean should be planted by the end of April in Northeast Ohio. In West Central Ohio, soybean can be planted in early April without a cover crop.