Essential Health Research Articles

Sensitivity improvement of a deuterium-deuterium neutron generator based in vivo neutron activation analysis (IVNAA) system.

Our lab has been developing a deuterium-deuterium (DD) neutron generator-based neutron activation analysis (NAA) system to quantify metals and elements in the human body in vivo. The system has been used to quantify metals such as manganese, aluminum, sodium in bones of a living human. The technology provides a useful way to assess metal exposure and to estimate elemental deposition, storage and biokinetics. It has great potential to be applied in the occupational and environmental health fields to study the association of metal exposure and various health outcomes, as well as in the nutrition field to study the intake of essential elements and human health. However, the relatively low sensitivity of the system has greatly limited its applications. Neutron moderation plays an important role in designing an IVNAA facility, as it affects thermal neutron flux in irradiation cave and radiation exposure to the human subject. This study aims to develop a novel thermal neutron enhancement method to improve the sensitivity of the in vivo neutron activation analysis (IVNAA) system for elemental measurement but still maintain radiation dose. Utilizing a compact DD neutron source, we propose a new and practical moderator design that combines high density polyethylene with heavy water to enhance thermal neutrons by reducing thermal neutron absorption. All material dimensions are calculated by PHITS, a general-purpose Monte Carlo simulation program. The improvement of the new design predicted by the Monte Carlo simulation for the quantification of one of the elements, manganese was verified by experimental irradiation of manganese-doped bone equivalent phantoms. For the same radiation dose, a 67.9% thermal neutron flux enhancement is reached. With only 4.2% increase of radiation dose, the simulated thermal neutron flux and activation can be further increased by 84.2%. A 100% thermal neutron enhancement ratio is also achievable with a 20% dose increase. The experimental results clearly show higher manganese activation gamma ray counts for each specific phantom, with a significantly reduced minimum detection limit. Additionally, the photon dose was suppressed. The thermal neutron enhancement method can increase the number of useful neutrons significantly but maintain the radiation dose. This greatly decreased the detection limit of the system for elemental quantification at an acceptable dose, which will broadly expand the application of the technology in research and clinical use. The method can also be applied to other neutron medical applications, including neutron imaging and radiotherapy.

Real‐time reliability evaluation method for IGBT module in MMC based on junction temperature and bond wire failure online monitoring

AbstractThe lack of an MMC reliability evaluation approach that incorporates data on essential components' health monitoring in the already related research prevents reliability from being further improved. Therefore, this article proposes a real‐time reliability evaluation method of the multi‐state IGBT module in MMC through iterative calculation of the Markov chain model. The degradation process of the IGBT module is divided into multiple states based on the monitored bond wire failure, and the failure rate of the IGBT module is updated in real time using the accumulated monitoring data of junction temperature. The proposed method can more accurately reflect the real state of MMC compared with the binary state evaluation method. Besides, a multi‐channel high‐speed data acquisition board is designed to measuring the gate voltage and collector voltage of the IGBT for the health evaluation of IGBT modules in MMC; the typically measured results validate the effectiveness of the data acquisition board.

Utilization Postnatal Care Services in Hyolmo Community

Postnatal care (PNC) utilization among the Hyolmo community highlights significant gaps in existing literature and underscores the critical need for targeted healthcare interventions in remote and ethnically distinct populations. This study reveals that, while considerable attention is given to urban and accessible rural populations, remote communities face unique challenges that can impede access to essential maternal health services. The results demonstrate that age, education, and socio-economic factors significantly influence PNC uptake, suggesting disparities that are compounded in remote areas like the Helambu Rural Municipality of Sindhupalchowk District. This study shows that younger mothers, often less aware or hindered by accessibility barriers, are less likely to utilize PNC services compared to their older counterparts. This disparity highlights the necessity for community-specific educational programs that can enhance understanding and encourage the use of PNC services among younger women. Additionally, the influence of education and socio-economic status on PNC utilization points to the broader implications of systemic inequities in healthcare access. Moreover, the study brings to light the role of cultural practices and beliefs in shaping healthseeking behaviors, which varies significantly across different communities. In the traditional beliefs may conflict with modern healthcare practices, there is a clear need for culturally sensitive health interventions that respect and integrate local customs and practices. This research not only contributes to a deeper understanding of the factors affecting PNC service uptake in a specific Nepalese community but also calls for comprehensive policy responses. By addressing the multifaceted challenges faced by the Hyolmo community ranging from geographic isolation to cultural and educational barriers the study advocates for a holistic approach to healthcare. This should include the development of policies that ensure equitable access to health services, enhance community health education, and promote cultural competence among healthcare providers. Ultimately, such efforts are essential for improving maternal and infant health outcomes in remote communities, ensuring that every individual, regardless of their socio-economic or cultural background, has access to the necessary postnatal care.

Digital health tools and technologies dimensions for equitable access to health, including Universal Health Coverage in developing economies

This study sought to investigate digital health tools and technologies dimensions for equitable access to health, including Universal Health Coverage in developing economies. Universal Health Coverage (UHC) is a promise of accessible and high-quality healthcare, which addresses coverage of essential health services and catastrophic health spending, in line with goal 3 of the United Nations Sustainable Development Goals (SDGs). However, the problem of inequitable access to health, including UHC, continues to plague the entire endeavour, even with notable technological advancements among the population and within the health sector. This study uses a narrative literature review methodology to investigate the dimensions of digital health tools and technologies for equitable access to health, including UHC. The findings from this study identify internet access, availability of internet, availability of a smart device, and device access to digital content as key dimensions for equitable access to health, including UHC in developing economies, and in line with digital health tools and technologies. Considering these dimensions will ensure that developed and deployed interventions are available and accessible to the majority of the population. Ultimately promoting digital health and equitable access to health, as well as ensuring that key dimensions of digital health tools and technologies are not assumed.

Leveraging Digital Health Data to Transform the United Nations Systems for Palestine Refugees for the Post Pandemic Time

ABSTRACT The COVID-19 pandemic presented a grave threat to the continuity of health services that UNRWA provides to 5.9 million Palestine Refugees in the Near East. UNRWA runs 140 primary health care clinics, providing approximately nine million medical consultations a year. During the pandemic, UNRWA’s e-Health system (and other digital health tools) were crucial in maintaining health services. The e-Health system enabled the identification of at-risk patients and transformed UNRWA’s services for sustainability and efficiency. Innovations like telemedicine and two smartphone applications (e-NCD and e-MCH) enhanced service delivery and staff management. To evaluate the effectiveness of digital health integration in UNRWA’s services during and after the pandemic, the team analyzed reports, events, and e-Health data from 2019–2022. Results show that digital tools, like e-NCD and e-MCH applications, helped reduce COVID-19 among Palestine Refugees, enabling remote care and continuous access to essential health services. Digital health has now become essential in UNRWA’s post-pandemic operations. This paper offers a paradigm for future outbreak responses. By harnessing the power of digital health, UNRWA’s e-Health system served as a beacon of hope, demonstrating how innovative approaches can empower patients, enhance health care outcomes, and ensure equitable access to health care services during crisis situations and beyond.

Designing an Intervention to Improve Medication Safety for Nursing Home Residents Based on Experiential Knowledge Related to Patient Safety Culture at the Nursing Home Front Line: Cocreative Process Study.

Despite years of attention, avoiding medication-related harm remains a global challenge. Nursing homes provide essential health care for frail older individuals, who often experience multiple chronic diseases and polypharmacy, increasing their risk of medication errors. Evidence of effective interventions to improve medication safety in these settings is inconclusive. Focusing on patient safety culture is a potential key to intervention development as it forms the foundation for overall patient safety and is associated with medication errors. This study aims to develop an intervention to improve medication safety for nursing home residents through a cocreative process guided by integrated knowledge translation and experience-based codesign. This study used a cocreative process guided by integrated knowledge translation and experience-based co-design principles. Evidence on patient safety culture was used as an inspirational source for exploration of medication safety. Data collection involved semistructured focus groups to generate experiential knowledge (stage 1) to inform intervention design in a multidisciplinary workshop (stage 2). Research validation engaging different types of research expertise and municipal managerial representatives in finalizing the intervention design was essential. Acceptance of the final intervention for evaluation was aimed for through contextualization focused on partnership with a municipal advisory board. An abductive, rapid qualitative analytical approach to data analysis was chosen using elements from analyzing in the present, addressing the time-dependent, context-bound aspects of the cocreative process. Experiential knowledge was represented by three main themes: (1) closed systems and gaps between functions, (2) resource interpretation and untapped potential, and (3) community of medication safety and surveillance. The main themes informed the design of preliminary intervention components in a multidisciplinary workshop. An intervention design process focused on research validation in addition to contextualization resulted in the Safe Medication in Nursing Home Residents (SAME) intervention covering (1) campaign material visualizing key roles and responsibilities regarding medication for nursing home residents and (2) "Medication safety reflexive spaces" focused on social and health care assistants. The cocreative process successfully resulted in the multifaceted SAME intervention, grounded in lived experiences shared by some of the most important (but often underrepresented in research) stakeholders: frontline health care professionals and representatives of nursing home residents. This study brought attention toward closed systems related to functions in medication management and surveillance, not only informing the SAME intervention design but as opportunities for further exploration in future research. Evaluation of the intervention is an important next step. Overall, this study represents an important contribution to the complex field of medication safety. RR2-10.2196/43538.

Impact of COVID-19 lockdown measures on mother and child health - the case of Ghana.

The lockdown measures in response to the coronavirus disease (COVID-19) have led to a wide range of unintended consequences for women and children. Until the outbreak of COVID-19, attention was on reducing maternal and infant mortality due to pregnancy and delivery complications. The aim of this study was to interrogate the impact of lockdown measures on women and children in two contrasting districts in Ghana - Krobo Odumase and Ayawaso West Wuogon. This study adopted the mixed-method approach using both qualitative and quantitative data. The qualitative study relied on two data collection methods to explore the impacts of COVID-19 control measures on women and children in Ghana. These were: Focus Group Discussions (FGDs; n = 12) and Key Informant Interviews (KIIs; n = 18). The study complemented the qualitative data with survey data - household surveys (n = 78) which were used to support the nutrition and school closure data; and policy data gathered from government websites consisting of government responses to COVID-19. The qualitative data was analysed using the thematic approach with codes generated apriori with the NVIVO software. The quantitative data used percentages and frequencies. Engagements with participants in the study revealed that the lockdown measures implemented in Ghana had consequences on child and maternal health, and the health care system as a whole. Our study revealed, for example, that there was a decrease in antenatal and postnatal attendance in hospitals. Childhood vaccinations also came to a halt. Obesity and malnutrition were found to be common among children depending on the location of our study participants (urban and rural areas respectively). Our study also revealed that TB, Malaria and HIV treatment seeking reduced due to the fear of going to health facilities since those ailments manifest similar symptoms as COVID 19. Government responded to COVID-19 using different strategies however the policy response resulted in both intended and unintended consequences especially for women and children in Ghana. It is recommended that national policy directions should ensure the continuous provision of child and maternal healthcare services which are essential health services during lockdowns.

Holistic support framework for doctors training as rural and remote general practitioners: a realist evaluation of the RVTS model.

To develop theory about how and why the supervision and support model used by the Remote Vocational Training Scheme (RVTS) addresses the professional and non-professional needs of doctors (including many international medical graduates) who are training towards general practice or rural generalist fellowship while based in the same rural or remote practice. We conducted a realist evaluation based on the RAMESES II protocol. The initial theory was based on situated learning theory, networked ecological systems theory, cultural theory and geographical narcissism theory. The theory was developed by collecting empirical data through interviews with 27 RVTS stakeholders, including supervisors, participants and RVTS staff. The theory was refined using a project reference and a stakeholder advisory group and confirmed using individual meetings with experts. Theory about how the contexts of person, place and program interacted to address professional and non-professional needs. The RVTS program offers remote access to knowledgeable and caring supervisors, real-time tailored advice, quality resources and regular professional networking opportunities, including breaks from the community. It worked well because it triggered five mechanisms: comfort, confidence, competence, belonging and bonding. These mechanisms collectively fostered resilience, skills, professional identity and improved status; they effectively counteracted the potential effects of complex and relatively isolated work settings. This theory depicts how a remotely delivered supervision and support model addresses the place and practice challenges faced by different doctors, meeting their professional and non-professional needs. The participants felt valued as part of a special professional group delivering essential primary health care services in challenging locations. The theory could be adapted and applied to support other rural and remote doctors.

Responding to fluctuations in public and community trust and health seeking behaviour during the COVID-19 pandemic: a qualitative study of national decision-makers’ perspectives in Guinea and Sierra Leone

BackgroundThe level of trust in health systems is often in flux during public health emergencies and presents challenges in providing adequate health services and preventing the spread of disease. Experiences during previous epidemics has shown that lack of trust can impact the continuity of essential health services and response efforts. Guinea and Sierra Leone were greatly challenged by a lack of trust in the system during the Ebola epidemic. We thus sought to investigate what was perceived to influence public and community trust in the health system during the COVID-19 pandemic, and what strategies were employed by national level stakeholders in order to maintain or restore trust in the health system in Guinea and Sierra Leone.MethodsThis qualitative study was conducted through a document review and key informant interviews with actors involved in COVID-19 and/or in malaria control efforts in Guinea and Sierra Leone. Key informants were selected based on their role and level of engagement in the national level response. Thirty Six semi-structured interviews (16 in Guinea, 20 in Sierra Leone) were recorded, transcribed, and analyzed using an inductive and deductive framework approach to thematic analysis.ResultsKey informants described three overarching themes related to changes in trust and health seeking behavior due to COVID-19: (1) reignited fear and uncertainty among the population, (2) adaptations to sensitization and community engagement efforts, and (3) building on the legacy of Ebola as a continuous process. Communication, community engagement, and on-going support to health workers were reiterated as crucial factors for maintaining trust in the health system.ConclusionLessons from the Ebola epidemic enabled response actors to consider maintaining and rebuilding trust as a core aim of the pandemic response which helped to ensure continuity of care and mitigate secondary impacts of the pandemic. Monitoring and maintaining trust in health systems is a key consideration for health systems resilience during public health emergencies.

Integrated Service Pos Program Outcomes for Elderly in Kebonsari Village

Background: The elderly population has unique health needs requiring specialized services. Specific Background: This study investigates the implementation of the Posyandu Lansia Wijaya Kusuma program, focusing on operational procedures and challenges in a rural context. Knowledge Gap: There is a lack of understanding regarding specific obstacles faced in implementing such health programs in similar communities. Aims: This research aims to evaluate program operations and identify hindering factors. Results: Data from interviews and participatory observations indicate a structured Standard Operating Procedure (SOP) for the Posyandu Lansia, facilitating essential health services. While the program follows a clear framework, operational barriers impact service delivery. Novelty: This study highlights the importance of adhering to SOPs to enhance healthcare outcomes for the elderly, offering insights distinct from previous research emphasizing SOP improvements. Implications: Findings emphasize the need to optimize health services for the elderly, informing policy decisions to improve healthcare systems in rural areas and advocating for ongoing evaluation of health programs to address evolving elderly needs. Highlights : Structured SOP: The program follows a clear Standard Operating Procedure for service delivery. Operational Barriers: Identified challenges impact the effectiveness of health services for the elderly. Policy Implications: Findings inform improvements in rural healthcare systems and program evaluation. Keywords: elderly care, health services, Posyandu Lansia, implementation, rural health

Impact of the COVID-19 pandemic on maternal, neonatal and child health service utilisation, delivery and health outcomes in Gauteng province, South Africa: an interrupted time series (ITS) analysis.

Gauteng was one of the provinces in South Africa most hit by COVID-19. However, there has been no assessment of the pandemic's impact on essential maternal, neonatal and child health (MNCH) services in Gauteng, for planning against future emergencies. This study sought to assess the impact of the COVID-19 pandemic on essential MNCH service utilisation, delivery and health outcomes in Gauteng province. We employed a quasi-experimental interrupted time series (ITS) study design, using the District Health Information System (DHIS) data set to evaluate the impact of COVID-19 on eight key MNCH indicators between March 2019 to February 2021. Using Stata V.17.0 and 5% alpha, a segmented linear regression (ITS) model quantified the trends of the indicators before COVID-19 (March 2019 to February 2020) (β1), the immediate change in level due to the March 2020 lockdown (β2), the post-lockdown (March 2020 to February 2021) trend (β4) and the change in gradient from before to after the lockdown (β3). COVID-19 lockdown exerted a significant decline in primary healthcare headcount<5 years (n) (β2= -60 106.9 (95% CI, -116 710.4; -3503.3), p=0.039); and postnatal care visits within 6 days (rate) (β2=-8.2 (95% CI, -12.4; -4.1), p=0.001). Antenatal care first visits before 20 weeks (rate) declined during COVID-19 (β3=-0.4 (95% CI, -0.7; -0.1), p=0.013) compared with the pre-COVID-19 period. COVID-19 adverse effects on service delivery (measles second dose coverage and fully immunised<1 year) and health outcomes (facility deaths 0-6 days, maternal mortality ratio and pneumonia case fatality<1 year) were insignificant. While some indicators post-lockdown attempted to recover, others deteriorated. In Gauteng province, the COVID-19 pandemic significantly disrupted essential MNCH service utilisation, particularly during the March 2020 lockdown. The mechanism of MNCH service disruption by COVID-19 was induced by both supply and demand services. It is imperative to strike a balance between maintaining routine healthcare services and managing an outbreak.

Experiences of Digital Transitions in Health and Social Care Services in Later Life: Findings and Reflections from a Collaborative, Interdisciplinary Exploratory Review

Health and social care services are increasingly shaped by the emergence of new digital developments. Research suggests that older adults are less likely to use digital devices and, therefore, risk missing out on essential health and social care services as these become more digital by design. We carried out an exploratory literature review using the terms ‘onboarding’ and ‘offboarding’ within the design, engineering, health, and social science literature to understand how researchers are currently thinking about older adults’ digital service needs, informed by discussions of stakeholder engagement with older adults in Edinburgh to explore their own experiences of digital transitions. The review process was implemented based on the methodology of Arksey and O’Malley for scoping reviews, and the findings were reported according to the PRISMA-ScR checklist. The databases used were Web of Science, PubMed, CINAHL Plus, IEEE Xplore, Engineering Village, PsycINFO, ASSIA and ACM. In total, 18 studies were finally included. Our findings show different interpretations of onboarding across disciplines and a lack of use of offboarding in the design of digital interventions. Additionally, our findings reveal inequalities in digital onboarding, as evidenced by the limited number of studies. Finally, we share a snapshot of our findings, together with reflections on interdisciplinary and collaborative processes.

Projected health workforce requirements and shortage for addressing the disease burden in the WHO Africa Region, 2022–2030: a needs-based modelling study

IntroductionAn adequate health workforce (HWF) is essential to achieving the targets of the Sustainable Development Goals (SDG), including universal health coverage. However, weak HWF planning and constrained fiscal space for...

Enhancing sustainable healthcare practices through energy-efficient wireless body area networks

This paper explores how the integration and performance of Wireless Body Area Networks (WBANs) contribute to sustainable healthcare practices. WBANs play a crucial role in reducing the environmental footprint of healthcare systems by providing continuous monitoring that can prevent unnecessary hospitalizations and reduce the consumption of disposable medical supplies. Additionally, the design of WBANs using environmentally friendly materials, low-power devices, and recyclable components is discussed to optimize the sustainability of healthcare practices. To enhance infrastructure, services, and quality of life, new technologies have been integrated to improve WBANs. Patients' essential health data may be continuously and instantly collected thanks to these networks, and healthcare providers can receive the data right away for quick analysis and action. WBANs have healthcare benefits, but there are also major drawbacks. Technologies that can combine low power consumption, minimal delay, and high enough data rates are needed for WBANs in order to support a variety of medical applications. The effectiveness of the LoRaWAN and IEEE 802.15.6 technologies in WBAN is assessed in this paper. With the use of seven crucial metrics which are throughput, arrival rate, delay, energy consumption, residual energy, network lifetime, and packet delivery ratio (PDR), this paper seeks to study which technology is appropriate with WBANs using NS3 as a simulation program. With network parameters, 1000 seconds, and 50 nodes, the paper evaluated the performance of each technology. The results show that IEEE 802.15.6 is superior in terms of throughput, PDR, and arrival rate whereas LoRaWAN is superior in terms of energy consumption, residual energy, network lifetime, and delay.

In Their Own Words: Narratives of Sudanese Pediatricians Displaced By Conflict

Background: This study examines the profound personal and professional impact of the armed conflict in Sudan since April 2023 on pediatricians, particularly focusing on their displacement from Khartoum and the resultant challenges in providing essential health services to children in conflict-affected areas. Methods: Utilizing a mixed-methods approach, this study targeted displaced pediatricians from Khartoum identified via purposive sampling. Data were collected through a semi-structured questionnaire, featuring both quantitative items and an open-ended question for qualitative insights, administered electronically. The analysis combined descriptive statistics and thematic analysis with ethical oversight provided by the IRB of Prince Sattam Bin Abdulaziz University. Results: In a study of 42 displaced pediatricians from Sudan, 66.67% were female and the majority were aged between 30 and 45 years. Despite facing adversities due to armed conflict, these pediatricians displayed remarkable resilience and continued to provide pediatric care under challenging conditions. Key themes emerged from their narratives, including professional commitment amid scarcity, emotional turmoil coupled with spiritual reflection, and relentless pursuit of providing care. Safety concerns primarily drove displacement, with 95.24% citing this as a reason. While 61.90% of the respondents relocated within Sudan, 38.10% moved abroad, reflecting the profound personal and professional impact of the conflict. Conclusion: The armed conflict in Sudan has severely disrupted the pediatric healthcare system, leading to widespread displacement of pediatricians and jeopardizing child healthcare. The study highlights the resilience of healthcare professionals amidst adversity, their struggle to maintain care delivery, and the critical need for support and strategic planning to restore healthcare services in conflictaffected areas.

Harnessing Hope in Digital Spaces for Health Equity: How Group Comparison Information and Supportive Comments Influence Bone Marrow Donor Intentions for African Americans.

Pursuing health equity necessitates recognizing health disparities that disproportionately impact disadvantaged groups and eliminating their barriers to essential health resources. Interactive digital technologies-specifically, popular social media platforms such as blogs and social networks-can be leveraged to engage underserved minority populations in collective social action aimed at addressing key determinants of health disparities and promoting equitable health outcomes. The present research focuses on the plight of African Americans-a minority group facing significant health disparities. Particularly in the domain of bone marrow donation, African Americans remain the group least likely to find a matching donor. Guided by the social comparison framing literature, we conducted an online experiment to investigate how group comparison information (GCI) emphasizing group-based disparities and supportive user comments on social media platforms influence African Americans' intentions to join a bone marrow registry. In doing so, we considered hope as a mediator and group identification as a moderator. Results based on a conditional process analysis showed that GCI led to greater bone marrow donor intentions in the presence of supportive comments through elicitation of hope, particularly among those low in group identification. The current findings demonstrate that it is important to consider the role of supportive message environments and group identification when addressing health disparities with GCI. Theoretical and practical implications are discussed.

Competencies needed for public health workforce in the programs of Iran's health transformation plan: A descriptive study based on programs, operations, and competencies chain.

The public health workforce faces a wide range of challenges related to people's health. Thus, they need a combination of different professional skills and competencies to perform essential public health operations and provide services to people. The present study was conducted to determine the competencies needed for the public health workforce to implement health transformation plan programs at Ahvaz University of Medical Sciences in the capital of Khuzestan province in Iran. This research was a descriptive cross-sectional study that was conducted in 2020 among 51 managers and experts of the health deputy and faculty members of the public health school. STROBE guideline was used for the present study. The research tools were two researcher-made questionnaires based on the chain of Programs, Operations, and Competencies (POC). Additionally, the validity and reliability of the questionnaires were checked. Cronbach's alpha coefficient was equal to 0.87 for the first questionnaire (programs-operations) and 0.85 for the second questionnaire (operations-competencies). The operations of surveillance of population health and well-being, monitoring and responding to health hazards and emergencies, and disease prevention, including early detection of illness, obtained the highest mean total score (3.9 (95% CI: 3.6 to 4.2)). Respect for and adherence to ethical principles and confidentiality in any professional activity obtained the highest mean total score (4.0 (95% CI: 3.7 to 4.3)) among the needed competencies. To properly implement public health programs, managers must plan and take necessary measures to improve such operations as surveillance of population health and well-being, monitoring and responding to health hazards and emergencies, disease prevention (including early detection of illness), and promotion of the workforce competencies in the field of respect for and adherence to ethical principles and confidentiality in any professional activity.

Gender Representation of Health Care Professionals in Large Language Model–Generated Stories

With the growing use of large language models (LLMs) in education and health care settings, it is important to ensure that the information they generate is diverse and equitable, to avoid reinforcing or creating stereotypes that may influence the aspirations of upcoming generations. To evaluate the gender representation of LLM-generated stories involving medical doctors, surgeons, and nurses and to investigate the association of varying personality and professional seniority descriptors with the gender proportions for these professions. This is a cross-sectional simulation study of publicly accessible LLMs, accessed from December 2023 to January 2024. GPT-3.5-turbo and GPT-4 (OpenAI), Gemini-pro (Google), and Llama-2-70B-chat (Meta) were prompted to generate 500 stories featuring medical doctors, surgeons, and nurses for a total 6000 stories. A further 43 200 prompts were submitted to the LLMs containing varying descriptors of personality (agreeableness, neuroticism, extraversion, conscientiousness, and openness) and professional seniority. The primary outcome was the gender proportion (she/her vs he/him) within stories generated by LLMs about medical doctors, surgeons, and nurses, through analyzing the pronouns contained within the stories using χ2 analyses. The pronoun proportions for each health care profession were compared with US Census data by descriptive statistics and χ2 tests. In the initial 6000 prompts submitted to the LLMs, 98% of nurses were referred to by she/her pronouns. The representation of she/her for medical doctors ranged from 50% to 84%, and that for surgeons ranged from 36% to 80%. In the 43 200 additional prompts containing personality and seniority descriptors, stories of medical doctors and surgeons with higher agreeableness, openness, and conscientiousness, as well as lower neuroticism, resulted in higher she/her (reduced he/him) representation. For several LLMs, stories focusing on senior medical doctors and surgeons were less likely to be she/her than stories focusing on junior medical doctors and surgeons. This cross-sectional study highlights the need for LLM developers to update their tools for equitable and diverse gender representation in essential health care roles, including medical doctors, surgeons, and nurses. As LLMs become increasingly adopted throughout health care and education, continuous monitoring of these tools is needed to ensure that they reflect a diverse workforce, capable of serving society's needs effectively.

Abstract B066: Empowering Black and Latine breast/ovarian cancer survivors with lower quality of life through community-based patient navigation programs

Abstract Community-based organizations (CBOs) offer essential health information and support through programming directed toward women at-risk for and surviving with breast/ovarian cancer. This includes services delivered to women of color–who are more likely to have unmet medical and psychosocial needs, and high social determinants of health burdens. Yet, little is known about the effectiveness of CBO’s programs and services on these women’s levels of empowerment (e.g., their perceived control, self-efficacy, knowledge/skills, and coping with cancer risk, treatment, and survivorship) that could impact the outcomes of their cancer care. To study this, we conducted a secondary data analysis among N=124 breast/ovarian cancer survivors identifying as Black and/or Latine participating in CBO-led cancer control activities, and assessed their care satisfaction, quality of life, patient navigation, and empowerment. Patient empowerment was high: most women of color (M age=50, 54% Black, 48% Latine) felt more informed (75%) and confident (75%) in managing their care following program engagement. Care quality was also very high (87%), and perceived as: recommendable to others (94%), helpful (91%), informative (92%), timely (90%), reliable (91%), supportive (91%), and effective (91%). Regarding care satisfaction, these underrepresented women felt supported by abundant resources (93%) and programs (95%), understood (93%), and helped (91%) by the CBOs programs. Regarding quality of life, 69% were in fair/poor health and 24% endorsed frequent mental distress–with an average of 9.1 physically unhealthy days, 9.4 mentally unhealthy days, and 7.8 activity-limited days in the past month. Disparities in empowerment were observed as a function of survivors’ navigation experiences and physical/mental well-being, as empowerment was highest among those who benefited more from patient navigation (r=.58, p&amp;lt;.001), and had poorer quality of life (r=-.44, p&amp;lt;.001). In a multivariable model controlling for satisfaction with CBO-led cancer control, both patient navigation (B=.81, SE=.13, p&amp;lt;.001) and quality of life (B=-.18, SE=.07, p&amp;lt;.005) were associated with survivors’ experience of empowerment: those who rated their patient navigation experience more highly, and those who were more impaired, felt most empowered. Community cancer control empowers Black and Latine breast/ovarian cancer survivors: addressing disparities, through programs such as patient navigation, could enhance their effectiveness, and particularly for those with lower quality of life. Behavioral and Social Science: Socioeconomic Influences Citation Format: Marcelo Sleiman Jr, Dheeraj Oruganty, Adina Fleischmann, Mingqian Liu, Sahana Arumani, Kenneth Tercyak. Empowering Black and Latine breast/ovarian cancer survivors with lower quality of life through community-based patient navigation programs [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 B066.

Abstract B066: Empowering Black and Latine breast/ovarian cancer survivors with lower quality of life through community-based patient navigation programs

Abstract Community-based organizations (CBOs) offer essential health information and support through programming directed toward women at-risk for and surviving with breast/ovarian cancer. This includes services delivered to women of color–who are more likely to have unmet medical and psychosocial needs, and high social determinants of health burdens. Yet, little is known about the effectiveness of CBO’s programs and services on these women’s levels of empowerment (e.g., their perceived control, self-efficacy, knowledge/skills, and coping with cancer risk, treatment, and survivorship) that could impact the outcomes of their cancer care. To study this, we conducted a secondary data analysis among N=124 breast/ovarian cancer survivors identifying as Black and/or Latine participating in CBO-led cancer control activities, and assessed their care satisfaction, quality of life, patient navigation, and empowerment. Patient empowerment was high: most women of color (M age=50, 54% Black, 48% Latine) felt more informed (75%) and confident (75%) in managing their care following program engagement. Care quality was also very high (87%), and perceived as: recommendable to others (94%), helpful (91%), informative (92%), timely (90%), reliable (91%), supportive (91%), and effective (91%). Regarding care satisfaction, these underrepresented women felt supported by abundant resources (93%) and programs (95%), understood (93%), and helped (91%) by the CBOs programs. Regarding quality of life, 69% were in fair/poor health and 24% endorsed frequent mental distress–with an average of 9.1 physically unhealthy days, 9.4 mentally unhealthy days, and 7.8 activity-limited days in the past month. Disparities in empowerment were observed as a function of survivors’ navigation experiences and physical/mental well-being, as empowerment was highest among those who benefited more from patient navigation (r=.58, p&amp;lt;.001), and had poorer quality of life (r=-.44, p&amp;lt;.001). In a multivariable model controlling for satisfaction with CBO-led cancer control, both patient navigation (B=.81, SE=.13, p&amp;lt;.001) and quality of life (B=-.18, SE=.07, p&amp;lt;.005) were associated with survivors’ experience of empowerment: those who rated their patient navigation experience more highly, and those who were more impaired, felt most empowered. Community cancer control empowers Black and Latine breast/ovarian cancer survivors: addressing disparities, through programs such as patient navigation, could enhance their effectiveness, and particularly for those with lower quality of life. Behavioral and Social Science: Socioeconomic Influences Citation Format: Marcelo Sleiman Jr, Dheeraj Oruganty, Adina Fleischmann, Mingqian Liu, Sahana Arumani, Kenneth Tercyak. Empowering Black and Latine breast/ovarian cancer survivors with lower quality of life through community-based patient navigation programs [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 B066.